Azmat Husain, MD: The Hospital Administration's Ability to Provide Structure

In Part 2 of a 4-part interview with MD Magazine, Azmat Husain, MD, the senior vice president of clinical operations and chief medical officer of American Academic Health System, at Hahnemann University Hospital, spoke about the importance of the hospital administration in providing structure to an otherwise chaotic environment such as the emergency department.

Husain spoke about how critical it is for there to be open lines of communication with senior management, and for them to be on the ground floor with the staff. He also discussed how Hahnemann has shifted its focus in administration back to clinical issues in a time where the financial sector has overtaken hospital management. Husain then detailed how the administration is, in tandem with a dedicated approach to structure, using provider satisfaction as a true measurement for its success, as it is so often a key to improving patient satisfaction.

Watch the previous installment, Part 1 of the interview, here.Watch the next installment, Part 3 of the interview, here.

MD Magazine: As an administrator, what is your role in all of this? Are you on the ground floor of the emergency department, or are you making decisions from above?

Azmat Husain, MD, senior vice president of clinical operations and chief medical officer, American Academic Health System:

You know, normally, hospital administrators—and it's interesting, myself a hospital a health system administrator now—rarely get down to the granular frontline level. I think that is so key to our entire health system’s success. Our owner and CEO of the entire health system is down in the emergency department meeting with staff and engaging the staff. It's very rare, if you go across the nation, for an emergency department frontline nurse or staff to have a kind of direct communication to senior leadership in the hospital, or even much less, the health system.

Opening those communication channels was incredibly key. It's a new health system that came in, and we needed the frontline staff to be able to engage with us, so we could truly assess what's going on—what is the reality for them and what is that frontline reality for the patient. That's been incredible. As an emergency department physician, if I was working a department I thought about if I had that, or have I ever had that, level of communication I have here. I'm happy to be in my position now so that I can now provide that and recognize how important that is to our frontline staff.

It's an interesting thing, what is happening in healthcare right now, where increasingly, hospitals and health care systems are being run by Wall Street, investment bankers, CPAs operations people, business administrators, right? Where are the clinical folks? Where are the physicians and the nurses?

That's why my position is unique, and I really enjoy being that that clinician who can translate to the administration world. That's what we need more of—we need more physicians and nurses and clinical staff to take charge of our destiny because we're largely being taken over by the financial world. The financial world is driving healthcare, and if we don't, as physicians and as nurses, step up and aren’t able to translate our clinical priorities to the financial world, then I'm concerned about the direction of healthcare.

We talk about patient satisfaction all the time, and it’s one of the metrics that we built in to measure ourselves against, and so I challenged the team, then, that another one of the metrics were going to measure ourselves by is nursing and provider satisfaction. The only way you get satisfied patients is if your nursing staff, your frontline staff, is satisfied. Are they overworked? Are they overburdened? How do they feel about the culture of the place? Are they being treated with respect? That is so key to the culture of a department because patients feel it. When they come in, they can tell the energy that you exude as a provider, as a nurse. It’s palpable to the patient, and that's why, really, for patient experience to be top-notch, the clinical provider experience and comfort need to be.

Now they'll be working hard, but oftentimes what happens is, when you put systems and processes in place, you will be seeing more patients, but you'll feel less burden in the end. Everybody loves structure, and unfortunately emergency departments because of the nature of it—it's chaotic. But how do you put structure in that place, in that chaotic world? That is the challenge and it requires a very, very dedicated approach, which I'm happy to say that we've initiated here.

Transcript edited for clarity.