Coordinating Care for all Heart Warriors, an Administrative Perspective

Coordinating Care for all Heart Warriors, an Administrative Perspective

Nicole Snyder: Hi, I'm Nicole Snyder. I am part of the Family Advisory Council for Children's Hospital of Philadelphia's Cardiac Center. Today, I am here with Julie Miller, another member of our council, and we'll be interviewing Mark Schwartz, Director of Service Line for the Cardiac Center at CHOP. Mark, many in our CHOP heart community see you at the Spin-In and they know that you are the man behind the strings making everything happen at the Cardiac Center, can you explain to us a little bit about what your role as director of service line is?

Mark Schwartz, MBA, Med, FACHE: Sure. Well the service line typically is focused on bringing services together for a population of patients, families that have similar diseases or challenges. And so in the Cardiac Center at CHOP we have created a service line about 15 or 20 years ago, which again focuses on how to bring the various clinicians and administrative support structure under one entity, so we can be a little more seamless as far as providing care, and how we operate. My role as a director is sort of a senior administrator for that service line. It has a lot of complexities to it involving relationships with our many referring physicians who send us patients, as well as some of the day to day operations that make the Cardiac Center run, and relationships with the, well over 100 doctors, that we deal with and 900 staff at the Cardiac Center in many different roles that I oversee or am involved with helping to facilitate things moving forward. It changes over time, things happen, we grow, we have new relationships, we focus on things in our culture to change things, we create a family advisory council.

And so I've sort of had a hand in these various kinds of things that have evolved over the several years that I've been at CHOP.

Julie Miller: So our family's been with the Cardiac Center for 21 years and you've been there for just about half of that time period. We've seen you as such an amazing resource, obviously your deep, deep knowledge of the operation.

There's a lot of families out there, while they're still having communication with their cardiologists and may perhaps their surgeon, they may not necessarily know to go, where to go for resources. And do you have any advice for families who are looking for additional resources to help them through their journey at the Cardiac Center?

Mark Schwartz, MBA, Med, FACHE: Sure. It is challenging. We had a lot of feedback about some of the challenges and communication with families from you and others. Really we've done a pretty good job of enhancing our website to have a lot of information on there. We very recently created, with your feedback, a comprehensive guide for families that's available on our web, and if you go to any one of our offices or call us at our main referral number, you can get that guide and it really lists pretty much everything that you would need to know to come to CHOP, even from parking, where to eat, where to sleep, how to talk to your doctor about this or that. Definitely our website has a direct link to that and that's a great place to start.

Also, our nurse navigators at our main number, which is also listed on the website, is a good place to just call and ask them questions. They're always on the phones during the week or email. They can always usually get information or answer questions about what experience is like to come into CHOP.

During COVID, we kind of shut down our direct tours of the hospital a little bit, but that's starting up again now and. Even if they want to come visit, if they're coming to CHOP, we can start that process again now.

Julie Miller: Excellent. So we've used a lot of those resources. I appreciate you giving our families some more insight into those.

Mark Schwartz, MBA, Med, FACHE: You were very instrumental in helping us create that and getting the feedback because it used to be, this started when I was trying to collect, well what do families get when they come in? And we saw they were giving folders with like 30 pages in them. And the feedback was, you know, we don't have time to read all this and it's overwhelming.

And then I looked at some other website like Boston's and they had it consolidated into one place. I thought, we can do this. It was an effort. We really got a lot of feedback from a lot of people. We talked to people throughout the Cardiac Center to make sure we got all the information. And I think we've done a pretty good job, it's still evolving a little bit and we're continue to enhance it, but it's a great tool.

Nicole Snyder: Yeah, I'm excited for families to be using it.

Mark Schwartz, MBA, Med, FACHE: We want to really make it less stressful. We know it's already stressful coming to the hospital, obviously.

Nicole Snyder: So Julie's been with the Cardiac Center a little bit longer than my family, just a little over eight years, but just in that time, we've seen so many new, wonderful programs begin and really take shape.

What is the general process for you in taking a specialized program from concept to reality?

Mark Schwartz, MBA, Med, FACHE: Sure. Usually, starts with an idea. And many of these ideas are generated by some of our various team faculty who come up with these concepts. Sometimes they're brand new programs, sometimes they're a program that just needs to grow and evolve.

And from the hospital perspective, every year hospitals have to make decisions. What should I spend money on? Because there is a finite amount of money to spend, you know. So we usually start with an idea and bring people together, physicians, nurses, other people, and I try to guide them through the process.

What is the idea? What do we need to make this happen? What are we going to show hospital administration as far as the potential for supporting itself once we develop it? What's the return on investment, which meaning how will it grow and sustain itself? Because again, the hospital has, not unlimited resources.

And so once they invest the money, we want to make sure that we can sustain it and do our job to make the program grow. So that's the basics of it. And then we've put the program together. We work on a business plan. We meet with senior administration, we get feedback from families, from other physicians, put the whole comprehensive plan together.

We've had success in multiple programs. CHOP has a great concept of supporting what they call Frontier Programs, programs that are on a cutting edge or have potential to be excellent. But there's other processes too that we've used that are maybe not as expansive as the Frontier process. And it all starts with this great energy that comes from our faculty or nursing staff or other staff to just, this is a great idea that makes sense for this for families, it's going to enhance care, it's going to support itself and more. And we just takes off. And we've got a lot of support from CHOP administration because we do a good job of our homework with these kinds of programs. They've been very supportive over the years.

We have the Lymphatics Program that we started and recently our Valve Center and others that have really grown and taken off over the last couple of years. Our most recent one is our Heart Failure Program, is expanding, to broaden its approach and we're working with Penn actually on that from the research perspective, which is kind of exciting.

Some of the developments that could happen over the next couple of years.

Julie Miller: That's awesome. Excellent. So CHOP is certainly on the cutting edge of a lot of different technologies, innovations, kind of bringing it back to the family again. Really as a family, I was so grateful for the care we received at CHOP.

It was amazing from start to finish, and since our first time in 2001 till currently. If a family wants to give back to CHOP, whether it's maybe their time, their talents, their treasure, whatever that might be. How would you suggest someone can get involved in a productive way to help CHOP continue growing?

Mark Schwartz, MBA, Med, FACHE: I think there are several opportunities. Obviously, we do depend a lot on philanthropy. People want to give back often the CHOP if they've had an experience like you've had and, frankly, philanthropy has been fantastic for us because we use it directly for things like enhancing the patient family experience, like enhancing the wellness culture for the nursing staff and others.

Things that the hospital would struggle to maybe support more because they have to spend so much money on technology and everything else. We use a lot of philanthropy for those kinds of things. I think participating in a Family Advisory Council, like both of you do, is invaluable because it gives us feedback that in a day to day world, things happen so fast. We don't have time to sit down and maybe get that and then say, this is a great idea, let's look at this. Supporting other families on the units through your networks is really important. Reaching out to families, especially come in for the first time, for the experience and being sort of a liaison is very important.

And for those who want to volunteer, there's also those opportunities through our volunteer office at times to do that as well. So there's multiple opportunities and it is very a critical piece of how we can improve, really is.

Julie Miller: It makes sense. I think giving back is one of the greatest gifts you can give.

So we appreciate all that you're doing there.

Nicole Snyder: Yeah. Sure. And on the topic of philanthropy, I think one amazing aspect that we've seen come out of the Cardiac Center and in terms of bringing in funding has been the Philly Spin In. Can you speak a little bit about why an event like that is so important to the Cardiac Center?

Mark Schwartz, MBA, Med, FACHE: The way our philanthropy works is we have various funds that are set up and some donors like to give for a specific purpose. Lymphatics might be one or surgery sometimes. We want to be able to fund innovation, but innovation is expensive, a lot of times. When I first started the Spin In, I talked to the Foundation, I said, let's set up a fund and anything that comes from the Spin In will go into a specific fund called our Innovation Fund.

And the great thing about it is multiple. One is now we have money to support these ideas that we don't depend on the hospital always to just supporting us. B, the Spin In has been very successful, so it's not an insubstantial amount of money. Then every year we can show the donors what we've really used the funds for.

And it's been tremendous. We've had so many great innovative ideas. Not all research. Some of them in scientific research, obviously the high level laboratory work in it, pharmaceutical research and et cetera. But a lot of it's been patient and family and programmatic experiences. It is a great process. We have a application process, which we'll just start in a few weeks for people who wanted the grants and some of them are funded pretty highly at like $100,00 a year for the real high end ones because, you know, they involve a fair amount of expenses made, whether it's research or programs or staff or whatever. There's really little limitations on supporting that.

And it's incredible. We get a lot of applications every year. The tremendous amount of work that's been done over the last six years from the Spin In funds is remarkable and every year they seem to do more and more. So we're very grateful for that event. It's energized a lot of people in the Cardiac Center that we're able to do this.

Julie Miller: Yeah. And trying to hone that energy and good energy surrounding innovation, looking kind of broadly, the privilege of being at this conference is really getting the excitement of that innovation that's on the horizon. Are there any particular things that are innovative that you're looking forward to over the next few years that you think would benefit the Cardiac Center?

Mark Schwartz, MBA, Med, FACHE: It's a very challenging field, especially congenital heart disease sort of come to a point where, surgical options are sort of like, there's more that can be done, but there's only so much that can be done. But there's a lot of innovation in the cath lab and investment in certain kinds of procedures that are going to be helping children have less surgery and have a shorter recovery time.

That's one innovation that's definitely going to continue to expand. And our cath lab, probably one of the best in the country, that we do things that in many other places would require surgery. It's a big effort on data analytics and understanding that we're investing now in a program that's going to further enhance our early warning signals across all of our clinical staff, our nurses, even much earlier than we do now, we can pick up potential challenges of a child who's in the ICU for signs that they might need assistance earlier. There's so much out there technologically that we don't even know yet. There's a lot of work being done in some of the pharmaceutical labs or do drugs, heart failure, or there's this hope that there's going to be some progress there.

You never heard about lymphatics. Some of this unfortunately takes many years. But it's very exciting to see all this happening at our institution and some of the really great scientists and nursing staff that are involved in this.

Julie Miller: It sounds very promising, very exciting for our patients.

Mark Schwartz, MBA, Med, FACHE: I mean, as an administrator, I don't always understand it all.

But they all come to me and say, can we do this? This is how much money it costs. You know, is it what we need? And we talk it through and I said, okay, well, let's look at it this way. We can find support here.

Nicole Snyder:

I always think it's amazing too, how you can involve the heart community in those, in that process.

Like, like with the Spin In and sharing out exactly what's happening.

Mark Schwartz, MBA, Med, FACHE: There's other grants too, from some of the other organizations, Big Hearts, Little Hearts, that provide us with some grants periodically that, that helpful, you know, research is expensive. CHOP spends, I don't even know how many millions on research.

It's money they have to take from their operations and do that. So. Things like, so the philanthropy a lot helps with that and it's this cycle, you know, the more innovation, people get more excited, discover something new. I think we have maybe among the most publications of a congenital heart program in the country for ...

Julie Miller: We're really fortunate to be part of that.

That's amazing.

Mark Schwartz, MBA, Med, FACHE: Exciting place to work. Always something going on. And as an administrator, you're sort of like, almost like an orchestra director. You know, it's all these different pieces moving at the same time.

Julie Miller: And you're a maestro.

Nicole Snyder: Yes. Exactly. And it well sometimes I think of you as like the puppeteer behind the

Mark Schwartz, MBA, Med, FACHE: But it's like I'm behind the scenes.

Like they're the ideas, but the ideas don't always happen. You have to make them happen. It takes a lot of conceptual thinking, but also who to talk to, how to do it, really looking at the resources, you know, how do you get them, all these kinds of things.

Julie Miller: Well, thank you. Thank you very much for your time today.

We really enjoyed the conversation and thank you for all you do for our families and for the broader CHD community.

Mark Schwartz, MBA, Med, FACHE: Well, thank you for your tremendous participation in our Family Advisory Council. I look forward to continuing our efforts and for interviewing me, I appreciate the opportunity. Thank you.

Julie Miller: Thank you very much.