Nicklaus Children's Hospital has been at the frontier of pediatric medicine for more than 70 years. A member of the Nicklaus Children's Health System, Nicklaus Children's Hospital is the only Level 1 pediatric trauma center in South Florida, providing comprehensive pediatric treatments across various specialties for all pediatric age groups in the region.
Medical Tourism Magazine sat down recently with the CEO of Nicklaus Children's Hospital, Matthew. A. Love, discussing the Hospital's achievements, successes, and challenges faced under his leadership, becoming accredited by the Global Healthcare Accreditation, and what the future holds for the health institution.
Could you share with us the journey of Nicklaus Children’s Hospital under your leadership and some of the milestones you are most proud of?
Despite a global pandemic, challenged economy, rapidly evolving healthcare system, and changing workforce, over the last four years, Nicklaus Children’s has been through an amazing transformation.
When I started, we were in a solid market position, performing nicely every quarter but there was little to no growth and our financial performance was not great – losing about $40 million every year – employee engagement was low and we were not focused on physician recruitment.
When I took over as CEO in late 2019, my first priority was to build a strong foundation by bringing the organization back to our fundamentals, to our reason for existing – the children and families we are privileged to serve.
Because of that strong foundation, we’ve been able to grow by leaps and bounds over the last few years. We created a system of consistent and sustained progress leading to some of the strongest financial years in our organization’s history. We’ve been able to create a cost-saving, waste-reducing program that we’ve termed “Game Changers” that engages our leaders and staff to “own the business” and drive performance, resulting in over $30 million of savings and counting. That’s unheard of in the healthcare industry right now as many of our counterparts are struggling with changes in the industry that have impacted our economy and workforce.
Strong finances are only a small piece of a successful health system. Our teams have also been critically focused on the patient and family experience, innovation and research, and delivering the highest quality, expert pediatric care to every child so that no family has to leave Florida.
What have been some of the biggest challenges you've faced as a CEO, and how have you overcome them?
Over the last several years, the healthcare industry has been through one of its most significant transformations because of the Covid-19 pandemic. The pandemic brought with it economic challenges, workforce evolution, shifts in healthcare delivery, and so much more. And we’re still seeing some of its effects take hold on our industry.
Pediatric healthcare was even more impacted by the pandemic and its rippling effects. It is going through a dramatic shift. Like everyone else, we still struggle with staff shortages, overworked colleagues, and much larger changes in the healthcare industry. As larger, adult health systems move away from pediatric healthcare – and that is a clear shift we have been seeing – there is now more pressure on healthcare systems like Nicklaus Children’s to take care of the children in our communities and beyond.
In addition, reimbursement challenges remain. In fact, the patient population we serve in South Florida is approximately 70 percent Medicaid. And, in pediatric healthcare, we don’t commonly conduct procedures that are the biggest revenue generators. This all translates to real and significant cost pressures for an organization like ours. So, we do rely to a certain extent on state funding and the amazing contributions from our donors and community supporters.
With careful planning, optimism and incredible teamwork, Nicklaus Children’s was able to successfully get through the pandemic and we even saw some of the strongest financial years in our hospital’s history. Thanks to focused effort on employee engagement and retainment, we’ve kept employee turnover rates well below industry average at around 12%. We’ve implemented organizational programs like Game Changers – 100-day tournaments focused on reducing waste, increasing revenue and patient satisfaction, and high-quality outcomes – to sustain operational excellence leading to cost savings of over $30 million in just a year and half.
We’ve also continued to answer the call from our patients and families by increasing access to expert pediatric care in South Florida and beyond through innovation, research, growth through collaborations and growth through construction. We’ve brought in programs like Project ADAM focused on heart health in schools and community organizations by arming their staff with the knowledge they need to immediately respond to a heart incident. This year, we certified 100% of schools in Miami-Dade County. We’re expanding beyond that by certifying organizations in Broward and we’ll keep going. In the summer of 2024, you will here of the grand opening of our Kenneth C. Griffin Surgical Tower, a 131,000 square foot state-of-the-art facility that will house the latest surgical technology aimed at providing children with the expert surgical care that they need within Florida.
Nicklaus Children’s Hospital is renowned as a leader in technology and innovation. What role does technology and innovation play in shaping the future of Nicklaus Children’s Hospital and its commitment to serving the needs of children and families in Florida and globally?
Technology and innovation are huge at Nicklaus Children’s. In fact, one of our core values is transformation because we understand that healthcare, especially pediatric healthcare, continues to evolve. As diseases and conditions evolve, as children’s healthcare needs change, we too must continue to innovate so that we are at the forefront of what families need from us. To support our caregivers and the children and families we serve, we are constantly looking at ways to innovate and advance pediatric healthcare in ways that make sense.
Making healthcare accessible to all is essential to providing the best care to every patient that walks through any hospitals’ doors. The last few years have highlighted some of the ways this is important, with the significant rise in telehealth services especially during the pandemic when we saw a 7500% increase in telehealth usage. Today telehealth has become a key component of a patient’s care continuum. In fact, Baby Steps our neonatal intensive care program, which provides transition of care from hospital to home, uses telehealth as a key element to ensuring moms and babies feel supported during their most vulnerable time. In the first three years of the program, close to 700 infants and caregivers have been enrolled in Baby Steps, spanning the state of Florida. Significant reductions in readmission and unplanned emergency care use in the first month after discharge were noted for patients who received services.
We are also leading access to healthcare through the My Nicklaus Children’s App - an industry-leading, location-aware digital health platform that helps us create a welcoming environment minimizing the potential for undue stress during a child’s care journey is critical to our mission. Through the My Nicklaus Children’s App, powered by Gozio, patients, families and visitors are able to navigate the hospital campus with GPS-like turn-by-turn directions to their appointments, onsite retail, restaurants, restrooms and so much more. They are also able to schedule appointments and access our physician directory and their patient records, all in the palm of their hands.
As technology advances, we look for ways to apply it to the care setting to support with clinical care and even support with distraction for children who may be nervous in an unknown medical setting. To do this, we’ve implemented a virtual reality program to help us address patient and family stress in a non-invasive way.
Patients wear VR goggles, play immersive games, listen to soothing music, all aimed at reducing anxiety to avoid the use of sedation. To date, we’ve had tremendous results using these immersive rooms including a 60% reduction in the use of sedation for patients in our Echo Unit.
We are extremely excited to continue to implement innovations that will give patients and families more access to their healthcare journey and improve the overall patient experience. Our Kenneth C. Griffin Surgical Tower will house some of the latest technological advances that will provide clinicians with ease of use during surgeries and families comfort in knowing their child is in the best hands at the best facility receiving expert pediatric care.
Patient Experience: What specific initiatives or programs has Nicklaus Children’s Hospital undertaken to address the evolving expectations of tech-savvy parents in terms of quality and overall patient experience?
Some of the initiatives mentioned above were exclusively implemented to support families during their child’s care journey and beyond. The My Nicklaus Children’s App puts families in direct contact with us 24/7/365 and gives them access to their child’s records.
Our programs in virtual reality will continue to expand as findings show that patients and families are more at ease with these distractions giving clinicians the opportunity to provide patients with expert care in a calm environment.
The Nicklaus Children’s website and all of our social media platforms are created with patients and families in mind so that they have all of the information they need at their fingertips. In fact, our YouTube channel has a series of playlists on varying topics giving families access to our experts in short videos that answer some of the most frequently asked questions, like what to expect at the different stages of newborns. In late 2023, we launched “For Peds Sake,” a podcast dedicated to exploring the latest pediatric healthcare breakthroughs, sharing patient stories, and discussing essential tips for parents and caregivers.
Pursuit of Excellence in Global Patient Services: Nicklaus Children’s Hospital recently achieved GHA Accreditation for Medical Travel Services for a second term. Why did you choose GHA and what benefits does it offer traveling patients?
Global Healthcare Accreditation with Excellence for Medical Service Travel is a global, prestigious recognition that showcases organizations that prioritize high-quality, safe care to families who travel to receive the expert medical treatments that their family members need. Receiving this accreditation speaks volumes about
the importance we place on providing the best care to every child. We are committed to delivering amazing patient care through a focus on high quality, safe care to every child from anywhere. This GHA accreditation shares our commitment to excellence for international families who already have to leave the comfort of home to care for their child. Leaving your home is stressful enough, and we are dedicated to providing families with comfort while their child receives care.
Personalized Care: Given the diverse cultural backgrounds of your international patients, how does Nicklaus Children’s Hospital ensure a personalized and culturally sensitive healthcare experience for each individual?
Personalized care is all we do at Nicklaus Children’s because every child is unique, and their care journey will be different than any other. Understanding these differences is key to delivering high quality, safe care to every child which is why we have special programs that focus on these factors and help us coordinate care.
As parents, hearing a sentence like, “I am so sorry, we have done everything we could, but we simply do not know what it is your child has,” from a doctor is among the worst scenarios imaginable. And yet, to this day it happens all too often. A delay in proper disease diagnosis can have devastating consequences for rare-disease patients, either worsening their conditions, prolonging testing and treatment to identify their diagnosis, or leading to death. Today, for a person living with a rare disease, it takes an average of six years to receive an accurate diagnosis with many patients initially being misdiagnosed. Through Project Baby Manatee, experts at Nicklaus Children’s can have an in-depth look at the entirety of genes that make up the genome of a child. By doing that, they may be able to identify genetic mutations that could be the root cause of a given condition or disease. In fact, Nicklaus Children’s completed a pilot program, supported by the State of Florida – called Project Baby Manatee – that showed rWGS being an effective way to help in the identification of rare genetic diseases. Parents desperate for a diagnosis now often receive one within days, reducing uncertainty by nearly six months. That is six months less of unnecessary testing, diagnostics, and failed treatments.
In the State of Florida, rWGS will now be more easily accessible for parents whose children have undiagnosed diseases. During its latest state legislative session, the Florida State Legislature supported funding the Andrew John Anderson Rapid Whole Genome Sequencing Program, which will benefit children and families who are desperately waiting for answers about an undiagnosed or rare illness and treatment path. The Program provides funding for the Agency for Health Care Administration to add rWGS as a covered fee-for-service benefit for enrollees who are 20 years of age or younger, have an undiagnosed condition and are receiving in-patient treatment in a hospital ICU.
Another example is a recent clinical research study that we collaborated with Florida International University (FIU). When eight-year-old Logan learned his cancer had returned it was not the news he or his family had hoped to hear. Just two years earlier during the COVID-19 Pandemic, Logan was told he was cancer-free, but that celebration turned to heartache when he learned he had to face that battle for a second time.
Dr. Maggie Fader, pediatric hematologist/oncologist, KIDZ Medical at the Helen & Jacob Shaham Cancer & Blood Disorders Institute at Nicklaus Children’s Hospital, in collaboration with a team of researchers led by Diana Azzam, assistant professor of environmental health sciences at the FIU Robert Stempel College of Public Health and Social Work at FIU, has developed a functional precision medicine approach that targets cancer by combining genetic testing with a new way to test individual drugs on tumor samples.
This is life changing for children, their families and healthcare providers from all over the world and Nicklaus Children’s is proud to be at the forefront.
Future Trends: What future trends do you foresee in healthcare, and how is Nicklaus Children’s preparing to adapt to these changes?
Pediatric healthcare will continue to evolve as will the needs and wants of patients and families. Nicklaus Children’s will remain nimble and adapt to these changes with agility and expertise. The healthcare industry in general will continue to shift so we will all have to focus on our processes for reimbursements and legal matters. Despite the difficult reimbursement environment – we need to invest in additional capacity to cope with increasing demand. We assume this will continue for some time.
In addition, adult-focused healthcare systems and hospitals are reducing their pediatric services. This is a trend we’re seeing across the country, and it is related to the same reimbursement challenges we are seeing as well. Because of this, we are seeing more and more patients at children’s hospitals simply because they have fewer places to go to leaving pediatric organizations with the need to increase access in traditional and innovative ways.
That doesn’t mean investing in traditional ways like brick-and-mortar locations, but rather collaborating with adult healthcare providers and seeing how we can align with them to deliver pediatric expertise to more families and more locations.
In the short term, we also ramped up mental health services, and in 2023 we increased our inpatient psychiatry unit from 20 beds to 40. We hope that this need will decrease again soon.
Ultimately, our goal is to make it easier for children and their families to receive the high-quality care they need, as close as possible to where they live so they don’t have to travel far to receive care from one of our expert clinicians.
Lastly, I think the healthcare landscape and workforce will continue to evolve leaving organizations with the challenge of finding creative ways to recruit and retain talented professionals who are passionate about their mission.
All in all, Nicklaus Children’s is well positioned to address these future trends. Our leadership team is forward thinking while our operations team is focused on the here and now so that, together, we are all committed to providing hope and high quality care to every child and family who needs us. Simply put – this is the reason why Nicklaus Children’s is where every child matters most.
