Erik Mikaitis, MD: Hello, I'm Dr. Erik Mikaitis, CEO of Cook County Health, and it's my pleasure to welcome you to Pulse Check, the new CCH podcast dedicated to keeping our team connected and informed. I'm here with Alex Normington, Interim Chief Communications and Marketing Officer. Alex?

Alexandra Normington: Thanks, Dr. Mikaitis. I'm excited to be here today on our first episode of Pulse Check. I thought we could kick it off by talking about why you wanted to start this podcast and what our colleagues can expect to hear on it.

Erik Mikaitis, MD: Absolutely. So, healthcare is so fast paced, and sometimes communications can be overwhelming. We wanted to create a space where we could slow things down a little bit, highlight the important work that's happening across our health system, including county care, our public health department, correctional health sites, and our hospitals and health centers.

Alexandra Normington: Right. We hope this podcast can help build engagement across our team and give people news that they can use. You know, I know we send announcements and system briefs to newsletters out via email and I know people are just inundated. It can be hard to get through those messages, and I know it is for me. We have the internet, which has a lot of information, but it isn't always the most user-friendly. So with this podcast, you know, you're encouraging us to find new ways to reach people where they are, and this is something you've been talking about for a long time, so I'm glad we can finally make it a reality.

Erik Mikaitis, MD: Me too. You know, I think a great way to talk about activities across the system that might not be visible to the entire team. We also want to keep our employees in the loop about changes and developments within our organization. And I really feel transparency is key, especially in a field as dynamic as healthcare.

Alexandra Normington: So on the podcast, we'll discuss topics like work-life balance, mental health resources, ways to support each other in tough times, and also highlight the impactful and innovative programs being done across the health system.

Erik Mikaitis, MD: Yeah. We just got our results back from the 2024 Employee Engagement Survey. The summary of those results will be shared very broadly soon. But I want to share some of the highlights. Overall, our engagements increased between 2022 and 2024. Our recent engagement survey was 3.84 out of 5 in the raw score, and that increased our rank compared to the national average.

In 2022, we were pretty low. It was 7th percentile compared to the national numbers. But in 2024, we've moved up now to the 21st percentile, which I know means we still have a lot of room to grow, but it's a really important improvement. We had a few departments that stood out and were above our average in terms of their engagement scores. County Care, the Juvenile Temporary Detention Center, and Providence were some of the standouts and a few areas where we maybe need to lean in and support a little more like ACHN and CCDPH and Stroger. We also have it broken down, the engagement scores, by age and role. Our nurses were actually above the national engagement benchmark, which is a huge testament to the ongoing cultural work that's been happening there.

A few other key points, 91% of our team said that they liked what they do. It's remarkable and it shows just how dedicated our team is to the mission. And 78% said that they're happy that they work at Cook County Health, that they're proud to work at Cook County Health.

What I also think is interesting is that most staff feel confident in the work that their team does, but perhaps less confident in the work that's happening outside of their unit. So, I'm hoping that, with things like this podcast, we'll be able to share a little more information, and it'll help us serve our patients, members, and communities even better.

Alexandra Normington: Excellent. And yeah, with this podcast, we'll highlight our Cook County health values and how they're lived in our day to day work, as well as the incredible diversity and talent within our system. So, this is our first episode of Pulse Check. You're also entering your first month as the permanent CEO. So for those who may not know you very well, tell us a little more about yourself and how you came to Cook County Health.

Erik Mikaitis, MD: Sure, sure. So just starting at the beginning, born and raised in Chicago, I grew up on the south side of the city. My family was focused in public service. My mom, she started out as a Chicago public school teacher, switched to the police department, retired from there after 20 plus years, and then went back to teach at CPS again and retired for a second time after about another 12 years. And then, my father worked at the University of Chicago in like plant operations essentially. And it afforded us the ability to go to the University of Chicago lab schools, which we were super fortunate. It was a great experience.

So from there, I went to UIC, got my bachelor's in Biology and then went on to DePaul for my MBA. And then, I left for med school, and that was the first time I ever really left the area, but then came right back for my clinical rotations. I did most of my clinical rotations right down the street from Stroger at St. Anthony, and then at West Suburban as well. And while I was at West Suburban, I really loved it there. It was a great experience and was able to stay there to do my Internal Medicine residency, which was just a fantastic opportunity.

So, after graduating, I knew I was very interested in hospital medicine, so I just really clicked with a group out in Crown Point, and ended up joining that group, and was a hospital medicine doc there for a couple of years. And, you know, in training and into kind of those first few years as an attending, really saw kind of that opportunity of areas where maybe our delivery system wasn't really performing well. And the first thing that really jumped out was, you know, end-of-life care. And there was an opportunity to really start kind of improving our palliative care services, there was a, you know, nursing and social work focus. And, you know, they offered an opportunity to kind of bring more of a clinical approach to it, which then grew into more of a regional position. It allowed me to, you know, open ambulatory clinics, which we hadn't had prior to that, hire a couple more physicians and APPs. So, really had that opportunity to grow in a place that I think we had a lot of opportunity.

And then, you know, did some stuff on the administrative side as well at that point. All of that then kind of came together to give me the opportunity to move into a med directorship with our accountable care organization. So, I got into that value-based care space. And then, after that, moved into become a hospital CMO for about four and a half years. And that's when I got a call from Israel about his need for some work around quality. And he told a very compelling story about the mission here. You know, it really, really clicked in terms of that mission of service. And, yeah, I took a leap. I came in September of 2022. I joined the team as the system's chief quality officer, and I was there for just over a year when Israel left. And then, I was given the opportunity to come into this role. So, here we are.

Alexandra Normington: It's been a whirlwind and a good one.

Erik Mikaitis, MD: A little bit, yeah.

Alexandra Normington: So, you talked a little bit about this, but what drew you to Cook County Health?

Erik Mikaitis, MD: Yeah. So again, it's that mission of service. It's serving the underserved. That's really kind of what got me interested in the first place, and then talking to Israel really kind of the areas where he perceived there being a need for some focus and some additional effort. And it was an area that I had worked on in my previous role as a hospital CMO, was a lot of the things that he was looking for some help on were things that I had worked on already. So, beyond the mission really kind of touching me, it was something that I thought maybe I can come here and do some good.

Alexandra Normington: Excellent. So, you know, you had the opportunity to be chief quality officer for a year, almost a year as interim CEO. So, that gives you the chance to really hit the ground running now as permanent CEO. What are your biggest priorities?

Erik Mikaitis, MD: Yeah. So, you know, I think really three things that are kind of right now are continuing that have been worked on over the last year or so. First and foremost, hiring. We really need to bring everybody together and really figure out how we're going to improve our hiring processes from how we're outreaching in the community to how our internal processes are working. And, you know, I might broaden that umbrella and say shared services in terms of areas of focus. But for me, the first one, right now is hiring, and I'll come to kind of forward-looking things. But in addition to that, I think the fantastic work that was happening in quality and finance before I got here that continued after I joined and, you know, I think we need to continue kind of building on all that momentum. There's a lot of really wonderful things happening right now in both those areas.

And then lastly, I think finishing to build out those structures that have come to be in the last 12 to 18 months, the Office of Behavioral Health, Office of Life Science, and probably our newest one, the Office of Population Health, to finish building those teams in and then getting to work in those areas. But then, I think looking forward, really focusing in on our processes around strategy planning and deployments. We're at a really great spot right now. We're starting. So, it's a three-year periods for our strategic plan and we're moving into our last year of the current one, and it takes about a year if you're going to do it very kind of in depth and robustly. So, we're gearing up for the next three-year cycle, right? It's really good timing in that sense. And I know, you know, Andrea and team did a lot of work to kind of hone down from where we were really focusing in the select. Well, I know that that's going to be a theme going forward that, you know, we really want to go an inch wide mile deep on things that we really know need to be a priority. So, it's really kind of bringing that focus and that discipline in terms of strategy planning and deployment for that.

And then, you know, the VBC, Value-Based Care of Population Health work, that's another big one that kind of dovetails from the Office of Population Health that I just mentioned. I'm happy to say we've signed a couple of contracts now that have moved us in that direction. We're doing a lot more work in discussions around, you know, how do we build an ACO essentially, an Accountable Care Organization. So, there are issues around equity that CMS has realized around that where urban centers, urban healthcare centers have kind of not jumped into the fray in that regard. And they've even pivoted and realized that the early designs of these types of products really did not lend themselves from an equity lens to, you know, have systems like ours engage. So, they've changed that now. And I think it's an opportunity for us to be one of the early adopters in this space.

And then, lastly, the Change Institute, which I know everyone's heard of, but I think I'd like to maybe broaden the scope and make it more about innovation. Both payer innovation, technical innovation, really how are we leveraging those things to up our game, to improve efficiencies for our team members, improve engagement for our patients? How do we connect better in between visits with our patients, all of those types of things.

Alexandra Normington: That's excellent. For those of us who are not as familiar with value-based care, what do those contracts mean for our health system?

Erik Mikaitis, MD: Absolutely. So, those contracts will incentivize us to really get upstream focus on prevention, better care coordination in between visits. So instead of waiting for someone to get sick and end up in the emergency department, we're now incentivized financially to provide better care, more upstream. So, right care, right place, right time.

Alexandra Normington: And that's an important incentive for a health system like ours, and with all the needs of our patients. That's wonderful. What is your vision, Dr. Mikaitis, for Cook County Health as a whole?

Erik Mikaitis, MD: So, I think we've kind of covered it in the sense of, you know, where we're heading, right? The things that I want to work on, I want us to be a standout of quality. You know, the team's doing really great work already. I think we're on a wonderful trajectory. But I want to be known for top tier quality, not just being a, you know, public safety net hospital, but one that stands out for those types of things, patient safety, quality, and then being at the forefront of, you know, all these payer innovations, improving how we're wired at the hospital, how we connect with our patients, right? That we're extremely accessible for our patients as well through leveraging a lot of that technology.

Alexandra Normington: Well, thank you so much for sharing. I think those goals and that mission of service is exactly what attracts people to Cook County Health, whether they're on the provider side, on CountyCare's payer side, or as a steward of public health with CCDPH.

Erik Mikaitis, MD: Absolutely. I'm looking forward to having more of these conversations with our colleagues across the system. And I really hope that this medium, the Pulse Check Podcast, becomes a go-to resource for everyone. You know, hopefully, be a place where we can stay informed and feel inspired. So, stay tuned for more information about our employee engagement results, and what we're going to do to support our staff and continue to build on the good momentum.

Alexandra Normington: And we're excited to hear your feedback. As we launch this podcast and we start rolling, we'd want to hear your story ideas or comments or things that you'd like to hear covered. So if you've got any suggestions, please email me at alexandra.normington@cookcountyhhs.org. I'm in the phone directory and on TigerConnect as well.

Erik Mikaitis, MD: Thank you for tuning in to our inaugural episode. We're thrilled to have you with us as we start this conversation and build a stronger, more connected Cook County Health. Thanks everyone.

Alexandra Normington: Thank you.