The Edge of Healthcare: Sick Systems Can’t Heal People

Notes:

[00:00:39] Saul Marquez: I’m so excited to be hosting the outstanding Jill Piazza on the podcast today. She is the Vice President and Chief Operating Officer of the Population Health Services Organization at AdventHealth. And she’s got over two decades of clinical and executive experience. She leads the value-based care strategy and execution, which is top of mind for so many providers today, with a lot of the payer agenda shifting this way. She also leads operations across multiple markets, helping drive population health transformation at scale.

[00:01:53] Jill Piazza: I’m an identical twin. So, we were three months old and she was diagnosed with a stage-four cancer, which back then had a very, very low survival rate. So, clearly, we didn’t understand the experience as we were going through it. But as we grew up hearing stories about what my parents went through and the access they had to premier pediatric cancer care, we were living just outside of Boston at the time. Now, knowing what I know today and reflecting on that. We were so lucky that we went where we did and that they had access to the care that they did, because I really don’t believe my sister would be with us today without that. But she survived, and she’s really a walking miracle that she survived that diagnosis. But hearing the stories and understanding that life experience that my family went through inspired both of us to go into healthcare. She’s now a pediatric nurse practitioner, and I’m just going to become a physical therapist. Really, my passions around helping to restore health and restore wholeness so nicely into my goal to become a PhD.

[00:02:56] Saul Marquez: if you could share a little bit about what you’re doing, leading value-based care at AdventHealth, just kind of share more about that with us.

[00:03:37] Jill Piazza: in Population Health Manager, one of the hallmarks is really around delaying progression of disease or preventing the onset of disease. So, we have a big focus on promoting health and wellness. And preventative screenings naturally are part of that. There’s a lot we can do through preventative screenings to diagnose conditions earlier and in a more treatable stage, prevent progression of disease or slow it at least, which helps to improve quality of life and, of course, outcomes and reduce unnecessary healthcare costs. So, that’s something I bring up every day, thinking about in my job, and we work with our primary care physicians, our provider networks, around the ways that they need to be focused on this work, as well as we continue to bring focus to prevention and really value-based care. So, it’s interesting, about four years ago, I was on the receiving end of the result of a preventative screening that really was life-changing for our family, and it was very unexpected. We went to a community event that was sponsored by AdventHealth for student athletes in our community for sports physicals, and I brought my then 16-year-old son, who has played soccer since he was four years old, to this routine screening, and you could opt in to an optional ECG screening. And I said, sure, we had a recent, actually, just a few months before that, a family friend of ours had experienced sudden cardiac arrest of their daughter at our local high school, and it was a really earth-shattering experience for all of us. Luckily, she is another walking miracle and survived that, but it was top of mind to me the importance of an ECG screening for my son because we had never had one before. So, we went to the screening, he got screened, and I left and honestly didn’t give it a second thought until a week later. I got the results, and it said he was positive for Wolf Parkinson White Syndrome, or WPW, which is a congenital arrhythmia of the heart that we had no idea that he had. And I then was shocked to find out that he’s been walking around with this condition since he was born, and it has a risk of sudden cardiac arrest. So, really, he’s been at risk his whole life, and without the screening, we wouldn’t have known. So, we were able to access pediatric specialty care. And he ultimately had a cardiac ablation, which did cure him from it. And he returned to soccer, and he’s now going into his junior year in college. And every day, I’m very grateful for what that screening allowed us to access for his own care needs that we were previously unaware of. So, I really just brought it home to me, on what population health is truly about, caring for our communities and identifying and preventing disease.

[00:06:19] Saul Marquez: What would you say is one population health initiative you’re most proud of, and what impact did it have on the community or outcomes?

[00:06:55] Jill Piazza: there’s a lot of our work that I’m proud of because this is tough. We’re essentially waking up every day and trying to transform how healthcare is delivered and reimbursed, and it’s not for the faint of heart. So, the great thing about it is we get to do a lot of really innovative things, and we get to think differently about how healthcare is delivered. And that unlocks really a creative aspect of the work, which is really exciting because we get to do new things. So, there’s really two things that I’m really most proud of. One of them has to do with addressing social determinants of health. And that was really kind of a turning point for me in my career, where I shifted from physical therapy and rehabilitation into the pop health space. And it was an opportunity that I had to build a brand new program that helped address high utilizers of hospital care who had either no insurance or were underfunded, and there was no roadmap, or script, or program structure that I was given. We had to just invent it and build it from the ground up. So, we assembled a team of nursing and social work, and nutrition services, and followed patients out of the hospital who have tremendous utilization, let’s say, 20, 30, or 40 visits to the hospital a year and follow them home and sat with them and did a comprehensive assessment to understand what is getting in your way. Why are you coming back to the hospital so many times and time and time again, the underlying drivers were social determinants of health. So, these are people who had health concerns. They were chronically ill and not managed well. But the reasons why were so much deeper than what you can understand in an acute hospital setting. It took getting outside the four walls of the hospital, going into these patients’ homes, visiting with them, understanding their life and the barriers they face. But it allowed us to really take this no-holds-barred approach to doing whatever it took to keep these people out of the hospital. And we learned so much about community resources and charity programs and health literacy, and how that plays into things, and just the psychosocial aspects that many people are dealing with in their lives. When you start to really unpack that and understand what people are waking up with and facing every day, it makes a lot more sense why checking your blood sugar before or after your meals really isn’t high on the priority list to manage your diabetes. So, that became a passion of mine, is how do we begin to really address the fundamental drivers of health outcomes in a very different way? And that learning now has kind of infused every program I’ve overseen since then? That was about 12 years ago that we started that. And as we’ve built new programs for outreach and managing of the patients that we serve. There’s always this more whole person, holistic approach that we take, and the program designed to really understand all the factors that might be getting in someone’s with managing their health, and our ability to design that in that holistic way is something I’m very happy about. And, you know, it’s core. AdventHealth, to our tagline, really is providing whole-person care. And we get to do that every single day with the way we deliver our services. And then more recently, we’ve developed a program about four years ago that where we can coordinate care in our ED in real time. And one of the problems we face, particularly in Central Florida, is patients tend to over-utilize the emergency room for things that are not necessarily emergent conditions, meaning that they’re showing up with things that could be treated in a primary care office. And oftentimes people delay care and end up in the emergency room, and the doctor’s kind of on the fence about whether to admit them or not. And oftentimes, we end up admitting patients to the hospital that could have been treated in another setting of care, had additional care coordination or resources been available in that moment. So, that’s what this program does. We identify patients who are in emergency room who are likely going to be admitted. And I had a team of nurses and social workers who are able to intervene in real time and get that patient connected to care in the most appropriate settings. So, we may be able to do a same-day primary care appointment. We can deploy home-based urgent care services to their house. We can get them in to see a specialist or arrange for home care or things like that. We really kind of have this big toolbox of options available to us, and every time we avoid an admission that wasn’t necessary, the patient wins because they’re getting care delivered to them in a more appropriate setting and avoiding an inpatient hospital stay. The provider in the ED is happy because they didn’t really want to admit the patient to begin with, but really didn’t have a lot of other resources in that emergent acute care setting to hell. And then we can follow the patient through the continuum of care and make sure they’re getting connected back to primary care or educating them along the way. So, it’s really kind of a win-win. And we’ve seen such great outcomes from that program as well. So, those are probably the two biggest things I’m proud of.

[00:12:00] Saul Marquez: what’s a good way to scale these types of insights and stay deeply connected with the people that need it?

[00:12:20] Jill Piazza: that was probably one of the biggest challenges I think we face within my work, because we’re trying to transform from a fee-for-service driven model into a more value-focused or value-based model of reimbursement to allow us to provide better care to the populations that we serve. So, in fee-for-service medicine, addressing social determinants of health was never really a standard part of the care model, because it wasn’t a billable service; it wasn’t something you could get reimbursed for. So, it just wasn’t in the realm of the standard of care. So, trying to get it integrated into the standard primary care model, in my opinion, is the most scalable way to do that. So, you have a relationship with your primary care physician and having a standard step in the assessment process of understanding what social determinants might be factors in that patient’s life, and then incorporating that into their primary care plan, to me, is the best first step. And then we need to rethink the team-based model within primary care and what resources are then available to support those patients and address those needs. And I think if we invest in that, we’ll see the downstream benefits of reduced unnecessary ED visits, reduced admissions, which ultimately will help to reduce healthcare costs and improve the outcomes of the patients that were responsible for them.

[00:14:01] Saul Marquez: what have been your biggest lessons or challenges as a leader in healthcare?

[00:14:36] Jill Piazza: I’ve started to identify with other women leaders who have similar themes as me. And I did go to an all-women’s college, so I think the education I experienced when I was in college helped to empower the way I think about what’s possible, and it probably unlocked certain aspirations that I maybe wouldn’t have had had I not gone to an all-women’s college. So, in those formative years, that was helpful for me because it kind of laid the foundation. But I do know I do this myself, is we tend to doubt our capabilities until we’ve proven to ourselves that we can do the thing. So, I think being more open to what we have the potential to do as we continue to grow in our careers will help eliminate some of the many fear or doubt that we have in our ability to become leaders or grow in leadership. I just know that’s a tendency of myself, and I have heard that resonated and other women leaders that we just had to doubt saying we doubt what we’re capable of until we have shown that we can do it. So, really, I think flipping that script for ourselves is probably the biggest lesson that I’ve had, and just being more open-minded to what opportunities are presenting themselves to us. Because if you’re presented with an opportunity, clearly somebody knows that you’re capable of doing what they’re asking you to do.

[00:15:56] Saul Marquez: What’s one piece of advice you want to give them that you wish somebody had given you earlier in your career?

[00:16:25] Jill Piazza: as a clinician who became a leader, one of the things I tried to maintain is like staying grounded in the work we do at the front line. So, as a leader, I try to make sure that I’m still doing that. And it’s harder as you move up in leadership, as you get further and further away from the front line. But I don’t think that’s something we should lose sight of because everything we’re doing every day, instead of acting patients that we serve. So, I actually just recently listened to a recorded soul call where one of our care managers was helping one of our patients navigate the healthcare system to find and schedule an appointment with the primary care physician to avoid an incident, and it was a 20-minute-long, so, and I listened to the entire call because they were probably six different instances during a call where this healthcare coordinator that saw our team encountered a barrier to trying to get this patient scheduled for a primary care appointment. And time and time again, she overcame those barriers. So, just reminded me how difficult our job is sometimes, we can lose sight of that in leadership, where we have these people on the front lines every single day trying to help our patients access to care they need. And if we don’t deeply understand seemingly small barriers and work to resolve those, we’ll never get ahead of the things that we’re trying to fix in healthcare. So, it was just a great reminder to me and reminding me that I need to really stay connected to the work that our teams are doing in the front lines. So, as far as advice or what I wish somebody had told me early is I tend to be a planner. I mean, I love being spontaneous in my personal life, but with work I like to have a plan and I like stick to the plan, and I like to measure the output or the outcomes of that plan. But now that I’ve assigned college, who’s getting ready to launch this career in a couple of years, I’m now reminded that I did have a plan back then to be a physical therapist. That’s why I went into graduate school and started working in PT. Never in a million years did I imagine that I would be working in a field that I technically did not go to school for, so I think I wish someone back then had told me to be open to the journey and just focus on that first door opening and looking to see where it takes you. And finding your passion can lead you down a road that you never dreamed for yourself. And these are conversations I’m having today, now with my son, who is worried because he doesn’t know what he wants to do. He knows area he’s majoring in, but he can’t see. Like, what is he going to do in his career? And I told him, you don’t need to know that right now. You just need to focus on getting that first door to open, finding your passion, and then following where it leads you. If you’re continuing to learn and grow and be challenged with new opportunities, and you’re allowed to do things that fulfill you, you’re on the right path. So, I just wish somebody had told me that, because I wouldn’t have been so strict on what my plan was for myself early on in my career.

[00:19:48] Saul Marquez: What closing thought would you leave our listeners and viewers with as we close today?

[00:20:13] Jill Piazza: be open to the journey. And, you know, if you have a deep understanding of your why and you’re following that, you can’t go wrong.

Transcript:

[00:00:06] Martin Cody: Welcome to The Edge of Healthcare, where the pulse of innovation meets the heartbeat of leadership. Tune in to gain exclusive access to strategies, experiences, and groundbreaking solutions from influential payer and health system leaders. This isn’t just a podcast, it’s your VIP ticket to the minds shaping the future of healthcare right now. Buckle up, subscribe, and get ready to ride to The Edge of Healthcare, [00:00:30] where lessons from leaders are ready for you to use today.

[00:00:39] Saul Marquez: Hello everyone, and welcome back to The Edge of Healthcare. I’m so excited to be hosting the outstanding Jill Piazza on the podcast today. She is the Vice President and Chief Operating Officer of the Population Health Services Organization at AdventHealth. And she’s got over two decades of clinical and [00:01:00] executive experience. She leads the value-based care strategy and execution, which is top of mind for so many providers today, with a lot of the payer agenda shifting this way. She also leads operations across multiple markets, helping drive population health transformation at scale. Her background is a physical therapist. Her story is just so powerful. And so, I’m really excited to have her share that with us and her experience on The Edge of Healthcare. So, Jill, without further ado, I want to welcome you [00:01:30] to the podcast.

[00:01:31] Jill Piazza: Thank you so much. It’s a pleasure being here. I appreciate it.

[00:01:34] Saul Marquez: Of course, of course. And look, your journey into healthcare started with a very personal experience: your twin sister’s diagnosis as an infant. How did that moment influence your path toward physical therapy, which is where you started, and then later leadership and population health?

[00:01:53] Jill Piazza: Yeah, so, it’s really an interesting story. I’m an identical twin. So, we were three months old and she was diagnosed [00:02:00] with a stage-four cancer, which back then had a very, very low survival rate. So, clearly, we didn’t understand the experience as we were going through it. But as we grew up hearing stories about what my parents went through and the access they had to premier pediatric cancer care, we were living just outside of Boston at the time. Now, knowing what I know today and reflecting on that. We were so lucky that we went where we did and that they had access to the care that they did, because I really don’t believe my sister would be with [00:02:30] us today without that. But she survived, and she’s really a walking miracle that she survived that diagnosis. But hearing the stories and understanding that life experience that my family went through inspired both of us to go into healthcare. She’s now a pediatric nurse practitioner, and I’m just going to become a physical therapist. Really, my passions around helping to restore health and restore wholeness so nicely into my goal to become a PhD.

[00:02:56] Saul Marquez: Jill. I mean, that is powerful. I’m glad your sister is with us. [00:03:00] And God bless your parents, who, God knows what we go through as parents with our kids, such a difficult time. But you guys made the most out of it. And now both of you are doing just incredible things to pay it forward. Jill, you are active on LinkedIn, and I’ve been following a lot of your thought leadership. And one of the things that I wanted to kind of bring up is that post you did about your son and the power of routine screenings. I love just to kind of touch on that. And if you [00:03:30] could share a little bit about what you’re doing, leading value-based care at AdventHealth, just kind of share more about that with us.

[00:03:37] Jill Piazza: Yeah, I’m happy to. So, in Population Health Manager, one of the hallmarks is really around delaying progression of disease or preventing the onset of disease. So, we have a big focus on promoting health and wellness. And preventative screenings naturally are part of that. There’s a lot we can do through preventative screenings to diagnose conditions earlier and in a more treatable stage, [00:04:00] prevent progression of disease or slow it at least, which helps to improve quality of life and, of course, outcomes and reduce unnecessary healthcare costs. So, that’s something I bring up every day, thinking about in my job, and we work with our primary care physicians, our provider networks, around the ways that they need to be focused on this work, as well as we continue to bring focus to prevention and really value-based care. So, it’s interesting, about four years ago, I was on the receiving end of the result [00:04:30] of a preventative screening that really was life-changing for our family, and it was very unexpected. We went to a community event that was sponsored by AdventHealth for student athletes in our community for sports physicals, and I brought my then 16-year-old son, who has played soccer since he was four years old, to this routine screening, and you could opt in to an optional ECG screening. And I said, sure, we had a recent, actually, just a few months before that, a family friend of ours had experienced [00:05:00] sudden cardiac arrest of their daughter at our local high school, and it was a really earth-shattering experience for all of us. Luckily, she is another walking miracle and survived that, but it was top of mind to me the importance of an ECG screening for my son because we had never had one before. So, we went to the screening, he got screened, and I left and honestly didn’t give it a second thought until a week later. I got the results, and it said he was positive for Wolf Parkinson White Syndrome, or [00:05:30] WPW, which is a congenital arrhythmia of the heart that we had no idea that he had. And I then was shocked to find out that he’s been walking around with this condition since he was born, and it has a risk of sudden cardiac arrest. So, really, he’s been at risk his whole life, and without the screening, we wouldn’t have known. So, we were able to access pediatric specialty care. And he ultimately had a cardiac ablation, which did cure him from it. And he returned to soccer, and he’s now going [00:06:00] into his junior year in college. And every day, I’m very grateful for what that screening allowed us to access for his own care needs that we were previously unaware of. So, I really just brought it home to me, on what population health is truly about, caring for our communities and identifying and preventing disease.

[00:06:19] Saul Marquez: Jill, I really appreciate you sharing that. And, you know, I’m very moved by your leadership and how personal this is for you, from your sister, your twin sister, [00:06:30] to your son. You use the word walking miracles. And like the reality is, the work that you do at Advent is probably the business of scaling walking miracles, like finding the people that need the care, that don’t know that they need it. What would you say is one population health initiative you’re most proud of, and what impact did it have on the community or outcomes?

[00:06:55] Jill Piazza: Oh, that’s a great question. So, there’s a lot of our work that I’m proud of because this is [00:07:00] tough. We’re essentially waking up every day and trying to transform how healthcare is delivered and reimbursed, and it’s not for the faint of heart. So, the great thing about it is we get to do a lot of really innovative things, and we get to think differently about how healthcare is delivered. And that unlocks really a creative aspect of the work, which is really exciting because we get to do new things. So, there’s really two things that I’m really most proud of. One of them has to do with addressing social determinants of [00:07:30] health. And that was really kind of a turning point for me in my career, where I shifted from physical therapy and rehabilitation into the pop health space. And it was an opportunity that I had to build a brand new program that helped address high utilizers of hospital care who had either no insurance or were underfunded, and there was no roadmap, or script, or program structure that I was given. We had to just invent it and build it from [00:08:00] the ground up. So, we assembled a team of nursing and social work, and nutrition services, and followed patients out of the hospital who have tremendous utilization, let’s say, 20, 30, or 40 visits to the hospital a year and follow them home and sat with them and did a comprehensive assessment to understand what is getting in your way. Why are you coming back to the hospital so many times and time and time again, the underlying drivers were social determinants of health. So, these [00:08:30] are people who had health concerns. They were chronically ill and not managed well. But the reasons why were so much deeper than what you can understand in an acute hospital setting. It took getting outside the four walls of the hospital, going into these patients’ homes, visiting with them, understanding their life and the barriers they face. But it allowed us to really take this no-holds-barred approach to doing whatever it took to keep these people out of the hospital. And we learned so much about community resources and charity [00:09:00] programs and health literacy, and how that plays into things, and just the psychosocial aspects that many people are dealing with in their lives. When you start to really unpack that and understand what people are waking up with and facing every day, it makes a lot more sense why checking your blood sugar before or after your meals really isn’t high on the priority list to manage your diabetes. So, that became a passion of mine, is how do we begin to really address the fundamental drivers of health [00:09:30] outcomes in a very different way? And that learning now has kind of infused every program I’ve overseen since then? That was about 12 years ago that we started that. And as we’ve built new programs for outreach and managing of the patients that we serve. There’s always this more whole person, holistic approach that we take, and the program designed to really understand all the factors that might be getting in someone’s with managing their health, and our ability to design that in that holistic way is [00:10:00] something I’m very happy about. And, you know, it’s core. AdventHealth, to our tagline, really is providing whole-person care. And we get to do that every single day with the way we deliver our services. And then more recently, we’ve developed a program about four years ago that where we can coordinate care in our ED in real time. And one of the problems we face, particularly in Central Florida, is patients tend to over-utilize the emergency room for things that are not necessarily emergent [00:10:30] conditions, meaning that they’re showing up with things that could be treated in a primary care office. And oftentimes people delay care and end up in the emergency room, and the doctor’s kind of on the fence about whether to admit them or not. And oftentimes, we end up admitting patients to the hospital that could have been treated in another setting of care, had additional care coordination or resources been available in that moment. So, that’s what this program does. We identify patients who are in emergency room who are likely going [00:11:00] to be admitted. And I had a team of nurses and social workers who are able to intervene in real time and get that patient connected to care in the most appropriate settings. So, we may be able to do a same-day primary care appointment. We can deploy home-based urgent care services to their house. We can get them in to see a specialist or arrange for home care or things like that. We really kind of have this big toolbox of options available to us, and every time we avoid an admission that wasn’t necessary, the [00:11:30] patient wins because they’re getting care delivered to them in a more appropriate setting and avoiding an inpatient hospital stay. The provider in the ED is happy because they didn’t really want to admit the patient to begin with, but really didn’t have a lot of other resources in that emergent acute care setting to hell. And then we can follow the patient through the continuum of care and make sure they’re getting connected back to primary care or educating them along the way. So, it’s really kind of a win-win. And we’ve seen such great outcomes from that program as well. So, those are probably the two biggest things I’m proud of. [00:12:00]

[00:12:00] Saul Marquez: I love that. And you know this topic of social determinants of health is very, it’s very real. It’s not just soft. It’s really concrete things that we can pay attention to. And in your view, what’s a good way to scale these types of insights and stay deeply connected with the people that need it?

[00:12:20] Jill Piazza: Yeah, and that was probably one of the biggest challenges I think we face within my work, because we’re trying to transform from a fee-for-service driven model into [00:12:30] a more value-focused or value-based model of reimbursement to allow us to provide better care to the populations that we serve. So, in fee-for-service medicine, addressing social determinants of health was never really a standard part of the care model, because it wasn’t a billable service; it wasn’t something you could get reimbursed for. So, it just wasn’t in the realm of the standard of care. So, trying to get it integrated into the standard primary care model, in my opinion, is the most scalable way to do [00:13:00] that. So, you have a relationship with your primary care physician and having a standard step in the assessment process of understanding what social determinants might be factors in that patient’s life, and then incorporating that into their primary care plan, to me, is the best first step. And then we need to rethink the team-based model within primary care and what resources are then available to support those patients and address those needs. And I think if we invest in that, we’ll see the downstream benefits of reduced unnecessary [00:13:30] ED visits, reduced admissions, which ultimately will help to reduce healthcare costs and improve the outcomes of the patients that were responsible for them.

[00:13:38] Saul Marquez: Yeah, no, thanks, Jill. That’s fantastic. I love that start at that primary care layer. It’s where a lot of things could get captured, and we could be proactive about. Remind me, Jill, does AdventHealth also have a health plan or not?

[00:13:53] Jill Piazza: We are a self-funded employer, so we administer our own employee health plan, but we do not have a branded healthcare product [00:14:00] we own.

[00:14:01] Saul Marquez: Got it. That’s what I thought. I wasn’t sure, but yes, from a self-funded employer plan perspective, like critical, right? In a big way. I love that. I want to shift a bit here for all the women listening, and actually also men in hiring roles. I’ve always said that we need more women leaders in healthcare, and so healthcare will be better if we hire more women in leadership roles. As a woman who trained at an all-women’s college and now leads a large-scale [00:14:30] health operation, what have been your biggest lessons or challenges as a leader in healthcare?

[00:14:36] Jill Piazza: I think for me it’s been really personal, and now I’ve started to identify with other women leaders who have similar themes as me. And I did go to an all-women’s college, so I think the education I experienced when I was in college helped to empower the way I think about what’s possible, and it probably unlocked certain aspirations that I maybe wouldn’t have [00:15:00] had had I not gone to an all-women’s college. So, in those formative years, that was helpful for me because it kind of laid the foundation. But I do know I do this myself, is we tend to doubt our capabilities until we’ve proven to ourselves that we can do the thing. So, I think being more open to what we have the potential to do as we continue to grow in our careers will help eliminate some of the many fear or doubt that we have in our ability to become leaders or grow in leadership. [00:15:30] I just know that’s a tendency of myself, and I have heard that resonated and other women leaders that we just had to doubt saying we doubt what we’re capable of until we have shown that we can do it. So, really, I think flipping that script for ourselves is probably the biggest lesson that I’ve had, and just being more open-minded to what opportunities are presenting themselves to us. Because if you’re presented with an opportunity, clearly somebody knows that you’re capable of doing what they’re asking you to do.

[00:15:56] Saul Marquez: Yeah, I think that’s such a great, great tip there, Jill. And one that [00:16:00] I think is worth really believing from somebody that’s in a leadership seat that’s been through it. And what about the other side of it? I want to know. There’s also a lot of clinicians starting to look at leadership roles, which is another critical piece, right? Keeping that clinical perspective in the leadership in the boardroom. What’s one piece of advice you want to give them that you wish somebody had given you earlier in your career?

[00:16:25] Jill Piazza: I think as a clinician who became a leader, one of the things I [00:16:30] tried to maintain is like staying grounded in the work we do at the front line. So, as a leader, I try to make sure that I’m still doing that. And it’s harder as you move up in leadership, as you get further and further away from the front line. But I don’t think that’s something we should lose sight of because everything we’re doing every day, instead of acting patients that we serve. So, I actually just recently listened to a recorded soul call where one of our care managers was helping one of our patients navigate the healthcare system [00:17:00] to find and schedule an appointment with the primary care physician to avoid an incident, and it was a 20-minute-long, so, and I listened to the entire call because they were probably six different instances during a call where this healthcare coordinator that saw our team encountered a barrier to trying to get this patient scheduled for a primary care appointment. And time and time again, she overcame those barriers. So, just reminded me how difficult our job is sometimes, we can lose sight of that in [00:17:30] leadership, where we have these people on the front lines every single day trying to help our patients access to care they need. And if we don’t deeply understand seemingly small barriers and work to resolve those, we’ll never get ahead of the things that we’re trying to fix in healthcare. So, it was just a great reminder to me and reminding me that I need to really stay connected to the work that our teams are doing in the front lines. So, as far as advice or what I wish somebody had told me early is I tend to be a planner. [00:18:00]I mean, I love being spontaneous in my personal life, but with work I like to have a plan and I like stick to the plan, and I like to measure the output or the outcomes of that plan. But now that I’ve assigned college, who’s getting ready to launch this career in a couple of years, I’m now reminded that I did have a plan back then to be a physical therapist. That’s why I went into graduate school and started working in PT. Never in a million years did I imagine that I would be working in a field that I technically did not go to school for, [00:18:30] so I think I wish someone back then had told me to be open to the journey and just focus on that first door opening and looking to see where it takes you. And finding your passion can lead you down a road that you never dreamed for yourself. And these are conversations I’m having today, now with my son, who is worried because he doesn’t know what he wants to do. He knows area he’s majoring in, but he can’t see. Like, what is he going to do in his career? And I told him, you don’t need to know that right now. You just need to focus [00:19:00] on getting that first door to open, finding your passion, and then following where it leads you. If you’re continuing to learn and grow and be challenged with new opportunities, and you’re allowed to do things that fulfill you, you’re on the right path. So, I just wish somebody had told me that, because I wouldn’t have been so strict on what my plan was for myself early on in my career.

[00:19:20] Saul Marquez: I love that. What a great piece of advice for all of us to heed. And it’s never too late in your career to make a shift if something’s calling you. So, [00:19:30]I think a great call there from Jill. She’s done it. Maybe you haven’t thought about that for yourself. And now that there’s an opportunity, it’s not too late for you to think about that thing that’s been calling you. Maybe you should answer it.

[00:19:46] Jill Piazza: … my …

[00:19:48] Saul Marquez: Hey, it’s yours. I’m reiterating it, Jill. So, certainly, wow, what an incredible opportunity, Jill, to connect with you. I really want to, first of all, just say thank you for spending the time to share your story, the personal motivations [00:20:00] behind why you do what you do, the movement that you’ve started there at Advent with the value-based care to what you’ve got going on in your career. What closing thought would you leave our listeners and viewers with as we close today?

[00:20:13] Jill Piazza: That’s a great question. I guess, be open to the journey. And, you know, if you have a deep understanding of your why and you’re following that, you can’t go wrong.

[00:20:21] Saul Marquez: I love that, Jill. There you have it, folks. Know your why. It’s just been such an incredible opportunity to connect with [00:20:30] Jill Piazza, she’s the Vice President and Chief Operating Officer of the Population Health Services Organization at AdventHealth. Thank you all for tuning in. Check out the show notes for ways to get in touch and learn more about Jill. She’s just an incredible leader that I really, really think everybody should follow. Jill, thanks for being with us.

[00:20:49] Jill Piazza: Thank you, Saul. It’s been a pleasure.

[00:20:54] Martin Cody: Thanks for diving into The Edge of Healthcare with us today. I hope these insights will fuel your journey in [00:21:00] healthcare leadership. For more details, show notes, and ways to stay plugged in to the conversation, head over to MadaketHealth.com. Until next time, stay ahead of the curve with The Edge of Healthcare, where lessons from leaders are always within reach. Take care of yourselves, and keep pushing the boundaries of healthcare innovation.