Emory University’s new chief of hospitals, health care and health research has been on the job for the past six months, and he’s making changes. Dr. Ravi Thadhani sat down with The Atlanta Journal-Constitution to review his priorities and challenges as new executive vice president for health affairs and executive director of the Woodruff Health Sciences Center at Emory University, and as vice chair of the board of directors of Emory Healthcare.
Thadhani, former chief academic officer at the Harvard-affiliated Mass General Brigham health system, took the helm at a precarious time in health care, with hospital finances under scrutiny and health care often a political football.
Here are some highlights from his vision for Emory Healthcare and health research, and his initial observations, and actions he’s already taken.
Some of Thadhani’s responses were edited for length and clarity.
Miguel Martinez
Miguel Martinez
Thadhani spoke about Emory’s mission and what makes it different from other health care systems.
“What differentiates us is we’re an integrated academic health care center. There are very few academic medical centers and one of the reasons I came here is because the university has everything. The university has schools and hospitals. Around the country, there are systems where they have separated. The hospital sits over here and the school system sits over here. We can talk about the pros and cons of that. But there are few systems where the university has all of that under its umbrella with somewhat of a seamless integration of the two. But the plan is, at least for the foreseeable future, that we remain an integrated academic health care center. As such, we have a three-part mission of care, of research, and education.”
Miguel Martinez
Miguel Martinez
The demand for temporary, short-term nurses and other health care workers to fill staffing gaps rose dramatically during the pandemic. Many hospitals relied on these expensive contractors. Thadhani talked about reducing the number of these positions.
“Contract labor has, not surprisingly, been the bane of the existence of many health care systems, but it’s been a necessity on many different levels just given the number of health care workers who have decided to leave health care in the last several years, at least certainly during the pandemic. In the last four months, we’ve gone from just over 1,300 to just over 700 contract health care workers.”
Miguel Martinez
Miguel Martinez
“So the question then would be ... ‘Have you compromised care?’ And my answer is no. The reason we can say that is because we have focused on nursing work for nurses and not extra nursing work. When I walked the floors, and you ask nurses, ‘What do you do every day? Give me a sense of what you do.’ And they say that when transportation is late, they transport the patients, and when the plate for dinner is late, they run down to the dining room in the cafeteria and pick up dinner for their patients. They care deeply about their patients. We obviously want them to serve our patients, don’t get me wrong, but I can hire other people to do the transport and I can hire other people to do those trades.”
“The second thing we’ve done is we’ve said to those contract laborers, ‘We will give you benefits, and obviously the appropriate kind of working hours and so forth, and move from contract to our permanent employee status.’ A number of the contract laborers have migrated to be on permanent employee status. We had people during the pandemic that left Emory Healthcare, went to contract companies and we hired them back. And so we have stopped that sort of roundabout, if you will.”
Miguel Martinez
Miguel Martinez
The impact of the closure of Wellstar Atlanta Medical Center on Nov. 1, 2022.
“We weren’t expecting the increase in volume to our emergency rooms. And the downstream of course is more admissions, more procedures, at a time when our staffing challenges were at its highest. It could not have come at a worse time for us. Now, that said, we’ve rallied around that and we’re accommodating as best as we can. We’re not turning any patients away. And Grady Memorial Hospital has stepped up as well. So it’s not ourselves alone.”
HYOSUB SHIN / AJC
HYOSUB SHIN / AJC
Thadhani worked on groundbreaking research that has led to a test that can predict preeclampsia, one of the top six causes of maternal death in Georgia. After years in the pipeline, the Food and Drug Administration recently approved the test for use in the U.S., the first of its kind.
“I always felt that one day the FDA would approve the markers as a way to predict who would go on to get this condition as well as prognosticate who would go on to get bad outcomes. We’ve worked on this for 15 years so when it was approved, we couldn’t believe it ourselves, for that matter.”
“The challenge is that companies did not make the significant investment in doing the studies in this country. We had gotten the test approved in Europe, interestingly enough, more than seven years ago. But in the United States, there was limited interest. I’ll say there was limited interest probably for two reasons: The diagnostic companies came to us and said that the return on the investment would not be high enough, that people would not use such a test. The FDA said we’re not going to approve a test based on data from Europe. So my colleague and I got the money to do the tests. And to make a long story short, the FDA accepted the academic/industry collaboration. It’s available in some sites now, not hospitals yet, but central labs like Quest Diagnostics and the tests will start being rolled out in the fall.”
“It gives information as to who’s at risk, who’s going to get the condition who’s not going to get the condition. And again, in high-risk women, this will be incredibly important.”
