The best at getting better: Hartford HealthCare’s relentless pursuit of excellence

Episode 1 February 19, 2025 00:35:57
The best at getting better: Hartford HealthCare’s relentless pursuit of excellence
PG Pulse
The best at getting better: Hartford HealthCare’s relentless pursuit of excellence

Feb 19 2025 | 00:35:57

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Hosted By

Thomas H. Lee, MD

Show Notes

In healthcare, standing still means falling behind. Leading organizations don’t defend the status quo—they dismantle it, embedding continuous improvement into every action. It’s not about being the best, but the best at getting better.  

Tune in to the first episode of season 2 for a dynamic conversation between two CEOs and longtime friends. Jeff Flaks from Hartford HealthCare and Press Ganey’s Pat Ryan discuss bold leadership, breaking norms, and why people—not deep pockets or pedigree—shape the future of healthcare. ny’s mission to make communities healthier.  

Together, they explore:  

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Episode Transcript

[00:00:02] Speaker A: Welcome to PG Pulse, Press Gainey's podcast on all things healthcare, tech and human experience. In this podcast, we'll be joined by some of the best and brightest minds in the industry to discuss challenges, share insights, and innovate the future of healthcare. Thanks for tuning in. We hope you enjoy the conversation. [00:00:21] Speaker B: Fantastic. Well, I'm here with Jeff Flack, CEO of Hartford Health System. Jeff, you and I have known each other for 14 years. I first met you by you calling me, which is an unusual strategy. I'm usually tracking down CEOs of health systems when you picked up the phone. Tell me about your thought process and how that's evolved today because you partner with organizations across the country. [00:00:46] Speaker C: You know, it is remarkable when you think back to that 2010 timeframe. And for us, we were so early in our journey and we had an ambition to become, evolve, to be a national leader around quality and safety and the patient experience. And it was in the early formation of Hartford Healthcare, and I remember seeing a citation in some magazine of some sort that Pat Ryan was appointed to the board of trustees of the Avon Old Farm School, which is here in the Greater Hartford community. And then it said, he's the CEO of Press Ganey. And I remember saying to one of my team members, he must come to Hartford. We've got to get him to come to our campus. If we want to become this type of national leader, we need to bring the CEO of Press Ganey here, listen, learn, see if we can engage him. He'd have an interest. So I remember reaching out, thinking, you know, this might be a long shot based on where we were in that moment. And you said, I'd love to come. And, you know, you ended up coming. And then by the benefit of your son playing lacrosse at Avonal firms, you were here in Hartford a lot. As I ultimately learned, I ended up. [00:01:49] Speaker B: Harassing you more than you expected through that process. [00:01:52] Speaker C: It's been tremendous. And we've had this long standing relationship and obviously we've grown. As we've grown, we've grown with Press Ganey, and neither one of our organizations look anything like they did then, which is part of the progress that has occurred, which needs to occur. [00:02:07] Speaker B: You know, as you, as you think about that, it's been a great friendship, too. I appreciate that. And we did get to recruit your son to play basketball and had great success there. So they. The story went outside of the health system, but your partnership model has continued to evolve. That ability to look outside your system, to spend a lot of time listening and learning. Tell me about that philosophy, both in your management style and why it's important to you and how it's applied to the system. [00:02:36] Speaker C: Yeah, part of it, I think, is the premise we have, which is we're not trying to protect the status quo, we're trying to change it. And we recognize and healthcare, it's not accessible at the level it needs to be. It's not nearly as affordable as it must become. It's inequitable, it's not as equitable as it needs to be, and it's still, from an excellence, quality standpoint, inconsistent. So for us, we need to disrupt ourselves. We need to do many things very differently. So the notion of this partnership model is we need to innovate and we need to align with the best people, the best thinking, the best organizations who are figuring out new and better ways to do things. So the partnership model for us has been incredibly important. It's allowed us to accelerate our change and take advantage of the agility of this organization. But what we try to do is put our organization in the center of that partnership model. So we're integrating all these different partners who bring new technologies, new approaches, new capabilities, but they deliver it, we execute on it through kind of the central services of Hartford Healthcare. It's made tremendous differences as you think. [00:03:47] Speaker B: About that partnership and execution. You use the word execution, you see, I think you told me 23,000 patients a day. What is your people strategy to ensure that each person, as they meet one of your team members, has a Hartford Healthcare experience? How have you evolved around that? [00:04:08] Speaker C: Yeah, it's a wonderful question we describe at Hartford Healthcare. We never talk about statistics, we talk about human beings. So 23,000 human beings we care for every day. There's 43,000 colleagues who do that every single day within our health system. For us, we have an Amazon One medical partnership that we deliver subscription based primary care. We have a wonderful partnership with Go Health Urgent Care. 600,000 people we care for in that setting every year. [00:04:40] Speaker B: Why didn't you do those things on your own? What was the decision to work with a partner? [00:04:44] Speaker C: These were innovators. They had built new approaches, new models, new technology. But to your question, really, the key is it's still the Hartford Healthcare electronic health record. The provider who's delivering service still wears the Hartford Healthcare white coat. The patient still has kind of in the palm of their hand the coordinated care within Hartford Healthcare. So even though the service delivery may be going through Go Health, going through Amazon, going through an odd kiosk station, being in a Walgreens where they get care from us. All of those services are still delivered through, from a patient experience standpoint through Hartford Healthcare. They, the Hartford Healthcare core values, the Hartford Healthcare commitments we make around experience and so forth, all go through those partnerships and they're embedded within those partnerships. And that's a really critical distinction because even though the alignment with these different providers may be through national leaders, if you get that care within our health system in our geography, the patient really wouldn't even know it in most instances. [00:05:51] Speaker B: That's it. That's interesting. So you're using their tech and what they've experienced across the country, but applying it through your own brand. So the focus is on building that brand. And as you think about your people, what efforts have you made so that your team, those 43,000 caregivers, feel the culture of Hartford Healthcare and embrace it in their day to day work? [00:06:16] Speaker C: You know, Pat's interesting. We've been really fortunate to receive many distinctions. You know, one we're most proud of recently is leapfrog. You know, for the second time to have an A within every facility, which has been our commitment to have one standard. [00:06:30] Speaker B: Just pause on that for a minute. An A in every facility. [00:06:33] Speaker C: And we've done it twice now. And what it really means is anywhere someone encounters Hartford Healthcare, they should have one experience, one expectation around quality, safety and experience. And people will say, well, how did you do that? And I always say, look, we don't have certainly the biggest pedigree in the country. We don't have the largest endowment. We don't have the most modern campuses. What we have is the best people. We have the best culture. It is culture. The culture of Hartford Healthcare has allowed us to perform from a quality and safety standpoint at the highest level in the country, repeatedly in a number of ways. And it has allowed us to grow and to diversify and to differentiate the way people, the consumer experiences health care in Connecticut. And you know, Connecticut has many distinctions. I think we were recently rated second in the country for access by U.S. news and World Report. I think we were a fourth overall for quality of care by Forbes. We've had a whole series of distinctions around quality, around access, around safety. I think we're third now overall for leapfrog scores as a state. And I'm very proud. Hartford Healthcare plays a very meaningful role in achieving the distinctions in this state. It's done through our culture. And that culture is really driven by our behaviors which are embedded at every segment of how we orient people, how we retain people, how we Evaluate our people, how we incentivize and align our people. It's really predicated on a very specific and purposeful approach to our culture that we have to live and role model and experience every day. [00:08:13] Speaker B: As you started out by talking about safety and your ACE scores and culture, our data will tell us that if a team member does not feel that the organization is either safe for their patients or safe for them, both physically or psychologically, that they will not be engaged. So you mentioned that first. Is that the tip of the spear for you, safety? [00:08:33] Speaker C: It is. It is. You know, it's become an area that we invested heavily in. You know, we brought some of the best people in leadership roles from around the country to join us on this journey. And it's been, you know, since 2008, but where it really began. And my predecessor, Elliot Joseph, restructured our governance process, and our regional governance process now makes the board members of our regions who oversee our hospitals fiduciaries for quality and safety. So they focus on quality, they focus on safety, they both focus on experience, and they focus on community health. And as we built that model, they've become fixated in holding us accountable, becoming deeply embedded in that process. And then we had to restructure our management teams and the way we ran and operated the organization around that governance model that we built. So it is structural, it's been deliberate, and over many years now, it's evolved to where we're able to execute and perform with that level of consistency. So the quality and safety journey here has been longstanding. And, you know, I had the privilege. I spoke at the leapfrog board meeting in June, and, you know, it's, you know, they are safeguards over quality and safety, you know, for the country in many ways. And I said, you're going to hear from the academic health systems. They can't achieve leapfrog scores. They're biased because of their teaching and research agenda and the severity of care they deliver to people they care for. You're going to hear from the large urban teaching hospitals that they are adversely impacted based on the socioeconomic status of the people they care for. You're going to hear from the rural hospitals. They can't achieve it because of the limited resources they have and limited scope and capabilities of their clinicians. At Hartford Healthcare, we're academic, we're teaching, we're urban, we're suburban, and we're rural. And in every one of those settings, we achieve A's repeatedly. So it can be done in its culture, which is the point that you've really made. [00:10:36] Speaker B: Yeah. Having been a patient, family members a patient, if you're not safe, then you're not going to have an experience. And it truly, I think what we also see in our data is that people want to be proud of their organization. They want to appreciate the mission and the passion for what they do. And you've allowed folks to do that. You mentioned community and I want to go to community because these systems, these large systems are truly a community asset. And you talk about both diversity, equity and inclusion in your workforce and equity in care. Can you expand upon your focus there? And you mentioned your hospital in Bridgeport. I want to get that data on this discussion. [00:11:23] Speaker C: You know, it's interesting. What you're really highlighting in many ways is the purpose and the role of not for profit healthcare. You know, an organization like ours, we exist for our communities. We are community assets. Our purpose, you know, is to reinvest in our communities, to deliver the best quality care and service we can. That we have to maintain sustainability. We have to be able to reinvest in our, you know, our work. We have these tremendous campuses that require huge capital investment. We have to ensure that people have state of the art technology, state of the art pharmaceuticals, medications available to them. So there is a need to remain sustainable. But at the same time, our purpose is community. So in our health system, we keep that front and center. You know, there isn't an event, there isn't an activity, there isn't something that occurs within the state that we're not behind and supportive of. Just think about the economic health and vitality of the community. We're the second largest private employer in Connecticut. So we're crucial to the health, well being vitality of this community at every level. I mean, our primary purpose is healthcare, clearly, but we also recognize as a very large employer that we have to uplift the community. We have to create opportunity for all. And what we've done post Covid, we learned so much and we said we can't go back to normal, we have to be better than normal. We're investing in ways in communities that we've never done before. We have street medicine, we have neighborhood health, we run pop up shops, we're in barbershops, we are in churches, we're in homeless shelters. We can't expect people to come to us. We have to go where they are. We can't let. Hold on pause there. [00:13:05] Speaker B: That's earth shattering now for health systems to think that way. The system has been designed from the inside out historically. How do you unwind that thinking in an organization to be reaching out to all of these locations. [00:13:22] Speaker C: You couldn't be more right. I mean, go back to the Flexner report, the early 1900s. I mean, health systems, academic health systems like us. I mean, we evolved, organized around providers, around doctors, and we need to be organized around consumers, around patients, and around communities and people. So we've got to disrupt ourselves in many ways. But what we learned during COVID pat, you know, when we did mobile testing, you know, when we did community based vaccination, we realized that we were connecting with people differently who were lost, people who'd never been in the health system, people who refused for good reason to register within the health system, who wouldn't seek care, or when they did, it was too late and they were too sick. And it was through emergency medicine. They didn't have primary care, health or wellness or prevention. So we said to ourselves, we can't go back to normal. Normal was in fact bad. It was producing bad results. The inequities in health care in this country are staggering. So we built a neighborhood health division, we built a street medicine service. And now what we do is our ambition is to ensure no person and no community is left behind. But places like us can't do it by showing up and saying we're here to help. We go with the pastor who leads our biggest church. You know, in certain communities we go with elected officials, we go with community organizers, we go with the people who run our homeless shelters and they build trust and bring us in as a partner in care. And now I'm so proud of the impact we're making. And we're making progress every day, you know, on being better. And this is an important point. I mean, it's part of the role of a health system like ours. I mean, I always point out we have to do well enough, but we have to define well by doing good. And this is how we do good. [00:15:10] Speaker B: It's interesting. I had the opportunity to visit hospital in New York City, very well known, very big endowment. And I got in an Uber and went over to Elmhurst in Queens. And the ability to provide service al nursing Queens operates like a fine watch. I walked in the door, they, they greeted me with enthusiasm, had no idea who I was. I toured the facility. The emergency room was running, very organized, packed to the gills. The quiet system, like people were really delivering amazing care. And so when, when you think of the, the inequity and care, you're 15 minutes away from the Upper east side of New York where Money is not an object. And you go to Elmhurst where they're operating just a fine tooth comb. How do you see that differentiated? What is it that makes Elmhurst so passionate about it and be able to deliver care? And, and what do you think about the system with regard to what needs to change? Because it seems unfair that Elmhurst doesn't have any money just because of the location they're built in. [00:16:31] Speaker C: Yeah. You know, first of all, I mean, Pat's probably no one in the country has been in more hospitals than you. Certainly has. No one has been. I mean, your 40 year plus career, you've seen it all. [00:16:41] Speaker B: One state left. One state left. I haven't been to North Dakota. [00:16:45] Speaker C: I'm sure you will though. [00:16:46] Speaker B: It's on my list. [00:16:47] Speaker C: And you know, when you think about what you've seen, there are these differences. I think there's a few things. One, leadership matters. Leadership matters. There are examples around the country where when you look at performance and today we have better measurable data. Press Ganey has led the charge in providing data and measurable data around outcomes and around ratings and so forth. The data was in dispute for so many years. I used to always marvel. People would talk about various organizations and it said, well, you know what? The data's flawed, the data's flawed. Today most people accept the data is. If it's not correct, it's directionally correct. And so we're beyond that, thank God. But what I point out is there are places you could see performance and then leadership changes and performance changes. So leadership does matter, both at the board and governance level and certainly the leadership of the organizations. But when you think about it, it's really knowing what matters most. And you've been such an advocate for that. And I've always been so amazed at your consistency of message. People talk about innovation, they're talking about all these different changes, certainly AI and machine based learning. And you always talk about how's your bed shift handoff, Are you rounding, are you doing daily rounding, hourly rounding? And you get back to the fundamentals and the basics. You have to focus on both. You have to focus on both. But the fundamentals are still the most essential thing because what matters most to the human being who's being cared for, the hourly rounding, the handoff, the oversight of their care, the checks and balances that need to be in place. [00:18:27] Speaker B: Fundamentals drive safety. [00:18:29] Speaker C: Isn't that true with AI we're going. [00:18:30] Speaker B: To be able to tell you where the event will likely occur. But fundamentals matter. And I think if we had LeBron James here, he would tell you fundamentals matter. Steph Curry would tell you fundamentals matter. How do you keep your organization thinking about innovation but focused on fundamentals? [00:18:48] Speaker C: What we've tried to do is to be intentional about it and really be deliberate. We have a center for artificial Intelligence here at Hartford Healthcare. We have a center for education, simulation, innovation. We've got amazing leaders in those spaces. You know, we want them to be a bit unhinged, right? We're challenging them to think differently, to think more broadly and to disrupt us. And at the same point in time, we have a system wide chief quality officer, a system wide chief nursing patient care executive, a chief clinical officer whose focus and obsession needs to be on the fundamentals and on the day to day oversight, you know, of that response, awesome responsibility. We have to care for people, you know, whether it's in their greatest moment of need and vulnerability or from health, wellness and prevention. So we've tried to bifurcate the organization and have great clarity and specificity or role definition and to ensure that, you know, we're both, you know, I use the term transforming and performing and we want to, we have to perform today and we perform defined performance by our press ganey scores, by our leapfrog scores, by our clinical outcomes, by the STS database for cardiac surgery. All these different places that we look at routinely, daily, if weekly and monthly. And then we have the transformation side of the house. Who has to be looking at, are we moving fast enough? Do we have solutions to solve today's problems that have been intractable? Do we have enough trials in place? Are we leveraging our sandbox so that we're trying to find enough new solutions? And to me it's the dynamic tension that we need to have around. First and foremost you have to perform in the here and now. But if you're strictly trying. That's why I always describe, you can't protect the status quo. If you're strictly trying to perform in the here and now, you're not going to be performing in the near term, midterm and long term and vice versa. If you put too much emphasis on what you need to become and you're not honoring the commitments today, we're not doing our job. So there's a real tension on this. [00:20:53] Speaker B: There's a balance there. I talk at press Gandhi that we have a two year strategic plan, the way things are moving and as I look at my team over 14 years, we just had a meeting where I met a number of new managers, people who are New to Hartford. And you've turned over teams and I've turned over teams through the process. As a leader, how do you think of continuing to refresh your team, bringing in the right talent for the right time? How do you think about that? [00:21:20] Speaker C: And has the world changed? Hasn't it? Like when I did my fellowship in Detroit in the mid-1990s, my first assignment was staffing, you know, the strategic planning exercise, which was a 10 year strategic plan, a book, you know, an entire bookcase full of big binders, you know, by every domain, right. And you think you know to how the world worked then, to how it does today. And you know, I'm an advocate, Pat. I always say this is the best health care has ever been. It's the most accessible, the most safe, it's in many ways the most affordable. The way we've been able to create all these new sites of care that are far less expensive and certainly from an outcome perspective, quality wise, there's never been less serious safety events and so forth, it's gotten so much better. And the rapidity of improvement and change now is better than ever before. But this is also, when you look three and five years from now, this will seem prehistoric because it is still inherently flawed in so many ways and will only get better and needs to get better. So the way I view it is we have a mantra here. We actually own the trademark for being the best at getting better. And the way I try to lead this organization and talk to our team every day, we just have to try to be better tomorrow than we are today. And some days it's going to be just small increments of better. And every so often we're going to make huge leaps forward. But we want to be the best at getting better. We don't want to be the best. What does that really mean? It's a moment in time. To what end? But if we can have a culture that's focused on constant improvement, continuous improvement, we will be honoring our commitments to the people we serve. And to me, again, this is all about culture and bringing people together who want to be the best at getting better, who aspire for that, who are, who are uncomfortable enough where they're not, you know, trying to have the rigidity of just, you know, staying where we are, but accept kind of this ambition, right, of becoming something very different and appreciating that it needs to be better. [00:23:27] Speaker B: What is the role of humility in leadership? [00:23:30] Speaker C: You know, it's interesting. That's a, that's a wonderful question. I look at my leadership team, and I have a fascinating leadership team. So we have 10 people who are in the CEO cabinet. Five of my 10 people are actually people who immigrated to this country, and we talk a lot about that. Five people weren't born in this country. All came from very challenging and different circumstances. Of our 10 most senior leaders, the vast majority of us came from a whole series of different types of backgrounds. I think staying humble is crucial because arrogance is a very dangerous thing. And if you're performing at a high level, you can't allow that to allow you to start to believe that you are entitled to anything. You have to remember we're here to serve. Health care is the greatest field in the world to work in because of what it means and stands for, the privilege that we have, and it's an incredibly honorable field. So I try to keep ensuring that every person who works here appreciates the awesome responsibility it is in my organization. We're 202 years old. We're stewards of this organization. God willing, we're going to be here for 200 more years and beyond. But while we're here as leaders to understand that responsibility, to do the right thing, to serve, and to be here for all people. I mean, it's an incredible opportunity. [00:24:55] Speaker B: Yeah. I make the statement that if you're not humble, humility will find you. And you're in a profession where the person who walks in the door every day, these 23,000 people are new. This is a very important experience to them. And they don't really care about the 23,000 people who came in yesterday. And repeating that performance is a challenge. What's the secret sauce that at Hartford Healthcare? [00:25:23] Speaker C: You know, I think it's the golden rule. You want to treat people the way you would ever want to be treated, period. And that applies to how we treat our colleagues who work here, how we treat our community that we interact and engage, certainly how we treat, you know, the tens of thousands of people we care for. And look, we see it every day. I saw it yesterday. A person in my life, you know, made a phone call to me. My barber, interestingly, said he's having terrible chest pain, you know, and, you know, people end up in, you know, we got to the hospital, and when you see people who are in perfect health until the moment they're not, and then the world changes, and then an organization like ours has to be able to wrap her arms around people and has to be able to be there for them and help them in their moment of greatest need. It happens every day when you least expect it, or for people who suffer from chronic disease, we become their partner every day of their life. Right. And one of the things, Pat, I think we need to do, and you've been a leader at this, at Press Ganey and you've been an advocate, we need to move away from the transactional notion of health care that, you know, we're here to care for you in the moment you identify a need. And we need to become something really different, which is this notion of relational healthcare. And as we move away from fee for service and more risk based care, where we're incentivized actually for health, wellness, prevention, the health system becomes something very different. We become your partner and that's what we have to become. But when people have the moment of truth where they need care, whether it's unexpected or for a significant moment, you have to put yourself in the shoes of the person you're caring for. And it doesn't matter if this only happens 0.2 of 1% of a time, if it's you, it's 100%. [00:27:17] Speaker B: It's 100%. Yeah. There's a much different perspective standing over the bed or lying in the bed. So that's fantastic. As you think about the future, we've got a new administration. If you had a moment to give the new president your best advice as to here's what you need to do to help the healthcare systems, what would it be and if you could snap your fingers and make it so, Tell us what you would snap your fingers and fix in the system locally. [00:27:49] Speaker C: I'll start there. Because it's both a state and effectively a federal program. Right. Is Medicaid. I think there's lots of opportunities to reimagine Medicaid and it's administered through the states and every state has unique aspects of how its program is delivered in different ways. But I think there's lots of opportunity within Medicaid for change and to ensure that we do reach more people and that we can do it in a way that's more sustainable and that brings more providers, you know, into the focus. And we can't have two standards of care. Yeah. [00:28:23] Speaker B: I think the social safety net system is badly broken. When you think about food, housing, health care, we should be talking about all three of those components and safety in the community. How do you feel about that? [00:28:40] Speaker C: Totally interrelated. I couldn't agree with you more. I think there's got to be real reform in that space and different incentives and different ways to deliver all those components. Of the social services in a coordinated way. Secondly, I think on Medicare itself, I think there's going to be new opportunity to continue to reassess aspects of Medicare and the range and scope of services and how they're delivered as we go forward, in many ways, how they're protected also. So I think that's going to be another piece like the government plays an important role in health care when you think about it, for an organization like ours. And we're not atypical. 60% of how we're paid effectively reimbursed is through Medicare and Medicaid. So government funded programs. So how these programs are designed, how they're incentivized, how they're invested for innovation, whether it's new pharmaceuticals or new technologies and so forth, the government has the ability to really influence healthcare in a very positive way. So, you know, I'm hopeful, you know, as we look at in the future. [00:29:46] Speaker B: So we sit down. We've known each other 14 years. So 14 years from now I've said I'm, you know, 20 years is all I'm going to work after this. We sit down 14 years from now. What's going to be the things that we're just shocked at the changes. [00:30:00] Speaker C: I think AI is going to be ubiquitous. It's going to be in every aspect of health care. And I think it's an absolute difference maker. We're using it now in a number of ways. It's going to address things around workforce burnout. You know, we're able to take tasks that have become so burdensome. I mean we got to return clinicians and caregivers to the bedside and to care for people. So much of their work today is done administratively, bureaucratically for medical, legal purposes and otherwise. Artificial intelligence, machine based learning could revolutionize that. I'm seeing it happen at the ground today. I'm incredibly encouraged. The issues around safety, things like hand washing around, you know, how we address things around disease prevention, infectious disease, so forth. The way we're building, smart rooms, smart pumps, medication errors, the types of things we can do to ensure better safety in how we care for people. Incredible opportunities. Predictive analytics press gain is doing it. You're going to tell us where we need to be before we're there and what we can anticipate before it happens. You're doing the power of big data. Unbelievable. We're working, we have a partnership with Google, some of the things we've moved all of our data to the cloud. The way we're able to get and use our Big data now like never before. And it's going to help us with population health, movement to risk, how we care for populations differently, how we manage chronic disease, the home care, I think we're going to see. We're a huge believer. We keep investing in expanding home care. Why today we actually lose money on home care. This is where not for profit. Health care can play a long game. We're able to tolerate, you know, a loss and a huge subsidy for it because we're going to see hospital beds in the home, physicians doing house calls, advanced practitioners doing house calls in the home, nurse, you know, more advanced levels of nursing care in the home, home monitoring wearables, you know, virtual care capabilities embedded in the home, differently, less expensively, more impactfully, more effective. So I think the next number of years, the rapid nature of change and improvement will be more so than we've ever experienced in our entire lives, probably ever in our history in healthcare. The targeted therapies around medications, personalized medicine. I'm seeing incredible things. You know, it's not generic any longer. They kind of know what works for Pat Ryan. Specific to your family history, your background, you know, what you've tolerated. So I've never been more optimistic. I've never felt more encouraged. It's going to. There'll be turbulence. Nothing's, you know, think about the iPhone. We're on version 18.02 or something. It had to get better, every version. And by the way, 1802 is not going to be as good as 2402. So it's about constantly being the best at getting better and embracing it, being willing to fail forward, fail fast, maybe in some instances in the spirit of improvement and change, but effectively embracing the opportunities to make health care better, safer, more affordable, more accessible. Inexperience. It has to get better. [00:33:12] Speaker B: All right, I'm going to give you the last word, last question, which is you're talking to a young manager and director within the health system, or a young manager in any organization, and they're thinking about their career and where they go. And what do you think? What advice would you give to a young executive as far as their leadership direction, their leadership skills, how, how to. How to lead? [00:33:36] Speaker C: I'd be curious to hear your answer as well, because you've got incredible wisdom and experience. I think I'm thankful every day for the privilege of working in healthcare. I mean, it's a life of service. It's, it's not a job. It's a calling for people who have the benefit of knowing that they can improve their, the health in their community. Knowing they can change individuals lives and systemically change tens of thousands of lives is an incredible thing. So the notion of having that motivation out of being able to wake up every day and know that you can contribute to the betterment, you know, of society, of community is an incredible thing. So I am a tremendous advocate for people who choose to make their profession in healthcare. I think it's the most fulfilling things someone could do, most gratifying things someone could do. What I'd encourage people who are in it today is to not be constrained by what has occurred in the past and by the status quo. So often we hear, we've tried that, done that, it's always been this way and that's been true a lot. But today there's new tools, new approaches, there's things that are beyond what used to be imaginable. So I'd encourage people, and that's why I think younger people today, earlier careerists, they're going to be the change agents because they're less constrained, they're more facile, more willing to, I think, allow themselves to think differently. So that's my encouragement to people is both be imaginative, be ambitious, but stay humble and principled on why we do what we do and what it means and never lose sight of what, what matters most, the magic moment of when someone's in need, however we connect with them. That's why we're here, that's what we do, that's our purpose. [00:35:22] Speaker B: Jeff Flacks, Servant leader thank you very much for taking time and it's been a pleasure. [00:35:30] Speaker C: Thank you. Thank you my friend. [00:35:31] Speaker B: Thank you. [00:35:31] Speaker A: That's a wrap. Thank you for joining us today and special thanks to our guests for sharing their time and insights. Stay tuned for our next episode which will be released soon. In the meantime, visit our website where you'll find more information on the human experience and a lot more.

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