Cheryl Martin (Host): Dignity Health St. Joseph's Medical Center is known for its commitment to delivering high quality, compassionate, and affordable health services, with special attention to the poor and underserved. It has a national reputation as one of the best hospitals in America. We'll learn more about this center of excellence and what makes it stand out with its President and CEO, Don Wiley.

This is Hello Healthy, a Dignity Health podcast. I'm Cheryl Martin. Don, delighted to have you on.

Donald Wiley: Well, thank you very much, Cheryl.

Host: I've heard that quality in patient safety is of the utmost importance at St. Joseph's. Tell us about the steps that St. Joseph's take to ensure quality care to patients.

Donald Wiley: I'd be happy to. It's a complicated question though. It spans from really our CommonSpirit Health leadership and all the way down to every single employee here at St. Joseph's. One of the things that I would say we do is the High Reliability Organizing, which is safety by choice, not by chance. This is a set of tools that we use to prevent harm to patients that every employee and every medical staff member is trained to. And then, we use those tools to be able to reduce potential serious safety events. So, that's one way.

The other way is that both as part of national company CommonSpirit Health and our local operations here, we measure a lot of quality indicators, things like hospital-acquired infections or hospital-acquired pressure injuries.

In addition, from there all the way up to outcomes, risk-adjusted outcomes for things like open heart surgery, where we compare ourselves to national databases. And I may comment on that again later. So, we believe that we've got reproducible, high quality results that are based upon the utilization of safety tools and then the measurement that compares our outcomes for various safety measures against all the hospitals in the country.

Host: Give us an example of one of those tools that you mentioned.

Donald Wiley: Within high reliability is a number of tools. One is, for example, being an accountable team member, being an accountable team member means that you make yourself available for questions, that you call out another team member if you see they're doing something that might be unsafe. It also are things like making rounds with a team as opposed to individually. It means for medications that are look-alike, sound-alike, making sure that you have an accountable team member who checks those medications with you. So, there's a whole bunch of tools and subtools of high reliability organizing that we use. Those are just a few examples.

Host: That's great. Now, the St. Joseph's Cancer Institute is a staple of the Stockton community. So, what makes the patient experience at St. Joseph's different from other facilities?

Donald Wiley: As a community hospital, you know, I think that being available to our community in the sort of the comfort of their own community is something that's really important. The secondary thing I would say is that our staff all live and work here and the patients that we take care of are from here, so it has, you know, a feeling of home. We also offer a tremendous amount of support services that are really not available in either small standalone cancer centers and are probably not reproducible in an academic medical center. Things like nurse navigation, local tumor boards for various subspecialty conditions, library for cancer patients, support groups, a number of things like that that I think really are very high touch. They go along with the really high quality healthcare that we can offer our patients.

Host: Now, speaking of the Cancer Institute, St. Joseph's introduced a new TrueBeam linear accelerator. What is this and what does it mean for cancer patients in the Stockton community?

Donald Wiley: The TrueBeam is you hear of state-of-the-art, but essentially there might be a handful of equivalent radiation-oncology units in all of Northern California. So, we have a technology here for our local community that's equal to just about what anyone can provide in terms of delivering accurate and high intensity radiation to either provide cure or palliative treatment.

So, cancer patients here locally are really able to get the highest quality radiation oncology service, along with those high touch services that I just mentioned that are really not available anywhere else in our community and are only available typically in San Francisco or perhaps Sacramento, and as I said, literally just a handful of other places that can offer this kind of care.

Host: Now, another standout area at St. Joseph's is the Morrissey Family Heart and Vascular Institute. It continues to receive national recognition. Please share more about what makes this institute so notable.

Donald Wiley: I've been here for 34 years. Prior to my coming here, we started contributing data for cardiovascular surgery as an example, to National Society of Thoracic Surgery Database. It's really a database, now international database, that's made up of the best hospitals in the country that voluntarily contribute data that allow them to risk adjust their outcomes for all types of cardiac surgery. We later duplicated that when the American College of Cardiology came out with their national database for interventional cardiology, carotid stenting, other things that what I would consider to be high risk and high cost types of procedures.

These are literally the best data comparisons for how we perform as a risk adjusted program against all of the good programs in the rest of the country. And St. Joseph's Medical Center, for the last, well now, five years, but off and on prior to that, but for the last five years, has had the best outcomes, top 10%, three-star, for coronary artery bypass surgery, which is the most common type of open heart. And we also were that same three stars for the combination of coronary artery bypass graft and aortic valve surgery. We also offer our patients TAVR procedure, which is a minimally invasive valve replacement of the aortic valve. We do approximately a hundred of those procedures a year. And we've been able to offer that procedure to patients who otherwise would not have been candidates for open heart surgery or would have been very high risk candidates to a procedure that allows them to have a procedure today and go home tomorrow or the latest the next day, and actually have their valve replaced and have their cardiac output restored.

So, very exciting from the standpoint of, again, offering our community really a full-fledged cardiovascular program. St. Joseph's Cardiac Surgery Program is the ninth largest cardiac surgery program in the state of California, and there's 123 cardiac surgery programs in the state, and as I said, with outcomes that are in the top 10% of all of those programs and in the top 10 percent of all programs in the United States.

Host: Well, something else that's exciting is St. Joseph's has been named one of Healthgrades' 250 best hospitals in America. That's quite a distinction, Don. So, what does this mean to you and why should people, when selecting where to go, choose St. Joseph's?

Donald Wiley: The Healthgrades report really takes publicly available data that's reported primarily to Medicare for risk-adjusted mortality across a number of diagnoses, but it's a direct and indirect indicator of very high quality care to patients with high risk, high mortality kinds of conditions, congestive heart failure, acute heart attack, severe sepsis, coronary bypass, intensive care. These are just some of the examples of what's measured in Healthgrades and how they come up with how we compare and become a top 250 best hospital. it really means that, you know, across a large continuum of clinical indicators, we perform better than most hospitals in the country. There's probably over 4,000 hospitals in the country that are participating in Medicare program and, as such, that data is available. So, Healthgrades putting us in the top 250 really is great recognition for all of the things that we just got done talking about and a great recognition for our medical staff, our nurses, and all of our clinical teams.

Host: Anything else you'd like to add about services at St. Joseph's or anything coming up?

Donald Wiley: You know, the only other thing that I would just mention, and it really is sort of about our strategy and our commitment to the local community, is that we approximately five years ago, developed our first residency training program. So, that's a training program that involves physicians who have completed medical school, but have yet to do a residency in any specialty.

And since 2018, we've developed nine new training programs for resident physicians in the areas of Emergency Medicine, Family Medicine, Internal Medicine, Transitional Year, Psychiatry, Anesthesia, Neurology, Orthopedics. And we really plan to change the landscape of the kind of physician complement and availability in the Central Valley. The Central Valley is known for its shortages of physicians in many of the areas I just mentioned. And for us, it's allowed us to recruit physicians who want to be involved in training, who are already taking care of patients and are attending physicians. And we believe over time will allow us to retain resident physicians who train here. Currently, we have 166 resident physicians here at St. Joe's in those nine specialties, and we're really excited about the future expansion of both the hospital and the services, that these physicians will allow us and help us to build over time. So, a very exciting, very unique effort by a community hospital.

Host: Don Wiley, President and CEO of St. Joseph's Medical Center. Thanks so much for giving us your perspective on St. Joseph's outstanding commitment to excellence. And also, it's obvious that you're passionate about what you do and the community you serve. Thanks so much.

Donald Wiley: Thank you very much, Cheryl. My pleasure.

Host: You can learn more when you visit dignityhealth.org/stockton. And if you found this podcast helpful, please share it on your social media. Check out the entire podcast library for other topics of interest to you. This is Hello Healthy, a Dignity Health podcast. Thanks for listening.