Fuld transskription af Eric Perry - Executive Director & CEO, Avenir Behavioral Health Center

00:04:07.599 And then as I morphed into leadership, one of the things that was always difficult because it directly affects quality of care is staff turnover. 00:04:07.599 --> 00:04:11.520 And in behavioral health, turnover is it's expected. 00:04:11.520 --> 00:04:13.680 I'm blessed at the hospital that I'm at. 00:04:13.680 --> 00:04:18.720 Our turnover rate is like 5%, which in behavioral health is outstanding. 00:04:18.720 --> 00:04:21.600 At a level one hospital, it's unheard of. 00:04:21.600 --> 00:04:22.160 Yeah. 00:04:22.160 --> 00:04:26.639 That is something that I don't deal with as much where I'm at right now. 00:04:26.639 --> 00:04:27.519 Interesting. 00:04:27.759 --> 00:04:33.680 Um I'm curious because I can't remember off the top of my head, is Arizona a C C B H C state? 00:04:33.680 --> 00:04:34.639 Yes. 00:04:34.639 --> 00:04:35.360 It is. 00:04:35.360 --> 00:04:36.000 I thought so. 00:04:36.000 --> 00:04:37.279 I wasn't 100% sure. 00:04:37.279 --> 00:04:40.240 Rhode Island was a C C B H C state too. 00:04:40.240 --> 00:04:48.959 I'm kind of curious how did that go for Arizona, particularly from a hospital perspective, because I've been doing the sort of in the community CMHC work. 00:04:48.959 --> 00:04:55.279 For those listening in, that's Community Health Center, and CCPHC is a certified community behavioral health center. 00:04:55.279 --> 00:04:56.720 I'm very interested, Eric. 00:04:56.720 --> 00:05:02.480 How's your perspective from the hospital as CCBHC has event implemented in your state? 00:05:02.560 --> 00:05:07.439 Uh it's really difficult to say because I've worked at only two hospitals, both here. 00:05:07.439 --> 00:05:10.959 Everything prior to that was always in the outpatient scope. 00:05:10.959 --> 00:05:12.000 Ah, I see. 00:05:12.240 --> 00:05:14.560 How long has Arizona been a C C B H C state? 00:05:14.560 --> 00:05:14.959 Do you know? 00:05:14.959 --> 00:05:16.079 That I do not know. 00:05:16.800 --> 00:05:19.279 In Rhode Island here, we've been doing it about three years. 00:05:19.279 --> 00:05:23.040 Jason, now you've got me questioning if we actually are. 00:05:23.040 --> 00:05:24.000 Oh, okay. 00:05:24.000 --> 00:05:27.680 So yeah, I want to say yes, but now for whatever reason I'm questioning that. 00:05:27.680 --> 00:05:31.759 So you might want to hold off on adding this to the That's quite alright. 00:05:31.920 --> 00:05:32.639 That's quite alright. 00:05:32.639 --> 00:05:38.720 Well, still, I am very curious from your perspective, because I know there's been a lot of work with our CMHCs. 00:05:38.720 --> 00:05:41.360 We have one standing hospital here in Little Rhode Island. 00:05:41.360 --> 00:05:43.600 That is the place to work with. 00:05:43.600 --> 00:05:46.319 Perhaps there's two in Arizona gives you reference to. 00:05:46.319 --> 00:05:51.920 But I'm curious about your relationship potentially with the community mental health centers, even if they aren't CCBHCs. 00:05:51.920 --> 00:05:59.439 How's

that collaboration and sort of work within the community versus an inpatient setting working from your perspective? 00:06:00.480 --> 00:06:03.040 Arizona, well, Phoenix, rather, is a huge city. 00:06:03.040 --> 00:06:06.000 If you factor in the metro, it's absolutely massive. 00:06:06.000 --> 00:06:14.079 One of the things I learned really early on here is despite the size of the metro area, behavioral health is incredibly tight-knit. 00:06:14.079 --> 00:06:16.800 Everyone knows everyone. 00:06:16.800 --> 00:06:21.279 It's really fascinating to me how really intertwined everyone is. 00:06:21.279 --> 00:06:32.000 So with that being said, I try to the best of my ability to maintain some degree of open working relationships with all of the other hospital leaders, outpatient leadership. 00:06:32.000 --> 00:06:36.639 I want to be able to pick up the phone and call someone and say, hey, I got a patient that we can't take. 00:06:36.639 --> 00:06:37.839 Do you have availability? 00:06:37.839 --> 00:06:40.639 Or hey, I've got some questions regarding Coliseum Procedure. 00:06:40.639 --> 00:06:41.680 Can I bounce something off of you? 00:06:41.680 --> 00:06:46.959 So just having that open collaborative, I think at the end of the day makes all of the facilities run better. 00:06:47.279 --> 00:06:48.000 Yeah, I agree. 00:06:48.000 --> 00:07:00.879 The biggest challenge I've seen, at least in our community here in Rhode Island often, is the transition of care as people are exiting the level one hospitals and coming back into the community and sort of that strong handoff. 00:07:00.879 --> 00:07:04.399 So the emergency getting somebody in fairly well identified. 00:07:04.399 --> 00:07:11.519 It's when they've got well, and you guys have done your great job in the hospital and getting people back into the community in a strong, sustained way. 00:07:11.519 --> 00:07:16.399 There's great successes, but there's also been some misses, to be honest with you. 00:07:17.040 --> 00:07:24.480 Well, the step down piece is one of the hardest things to deal with because if you're in outpatient care, you're typically there for an extended period of time. 00:07:24.480 --> 00:07:26.079 So there's an establishment. 00:07:26.079 --> 00:07:34.000 My hospital, and we're one of about 15 across the valley that is just a level one facility, we're discharging five, six patients a day. 00:07:34.000 --> 00:07:42.879 And now if you factor in some of the more pre-screening agencies or the acute observation centers, they're sometimes discharging 20 or 30 patients. 00:07:42.879 --> 00:07:53.759 So if you factor in all of those hospitals, that they all need step-down services, not just their PCP and their site, but often specialized services based on their social determinants of health. 00:07:53.759 --> 00:08:12.399 So the availability of a lot of step-down services, be it a residential, outpatient, intensive outpatient, partial, sometimes it's really hard to get someone in as quickly as you

want to or need to, with the proximity that works for them, with the level of care and to get everything to work together. 00:08:12.399 --> 00:08:17.120 The biggest piece in that, because it's one of those, you really need to strike where the iron's hot. 00:08:17.120 --> 00:08:39.200 Because when a patient leaves, if you don't literally give them your here's your appointments, and you got something like set up for tomorrow, hypothetically, if it's two weeks out, the likelihood of them showing up drops significantly, which just reinforces the probability that they're going to be back at a level one at some point in the future because that safety net from a step-down perspective just isn't there. 00:08:39.519 --> 00:08:40.159 I agree. 00:08:40.159 --> 00:08:41.679 It's a challenging work. 00:08:41.919 --> 00:08:42.799 Yeah, yeah, it is. 00:08:43.279 --> 00:08:45.679 You know, you've clearly been in this career for a long time. 00:08:45.679 --> 00:08:50.240 So looking back, what was a mentor for you that challenged you to become a different kind of leader? 00:08:50.240 --> 00:08:54.159 And sort of what was the conversation that you had with them that sticks with you today? 00:08:54.480 --> 00:08:57.120 Every leader I've had has brought something to the table. 00:08:57.120 --> 00:09:04.000 Honestly, probably the one that impacted me the most was the one that I thought was the worst leader. 00:09:04.000 --> 00:09:05.200 Ha ha, really? 00:09:05.200 --> 00:09:08.720 Yeah, because it really just taught me what not to do. 00:09:08.720 --> 00:09:16.399 And she was incredibly knowledgeable, and she was a clinical background, and her and I personally got along very well. 00:09:16.399 --> 00:09:25.759 But she always took this approach from I'm older than you at the time, I was not licensed, I was just bachelor level. 00:09:25.759 --> 00:09:32.159 And she always took this almost condescending, and I know the answers and you don't kind of thing. 00:09:32.159 --> 00:09:41.360 And at the time, I was an inpatient family therapist, and I'm with my partner going out, meeting these families, and meeting for having conversations with them firsthand. 00:09:41.360 --> 00:09:47.679 We would staff them on a clinical level with her, and she would often override one or both of us and say, Yeah, that's not right. 00:09:47.679 --> 00:10:00.720 And while she may have been right, and I don't question her clinical acumen, while she may have been right, not accepting what the frontline person has to say was just, it was always demoralizing to me. 00:10:00.720 --> 00:10:09.679 And it was one of those things like, if or when I become someone on a top-tier leadership position, I'm never gonna do that. 00:10:09.679 --> 00:10:19.600 And I've always, probably because of her, I've always taken the stance that the individuals that are working with the people are the experts, regardless of what the initials after their name are. 00:10:19.840 --> 00:10:21.519 Yeah, I can't agree with you more. 00:10:21.519 --> 00:10:30.879 It's funny, one of the questions I was hoping to ask you, because behavioral health hospitals are often, at least from an accountant's perspective, I am an accountant by training, I'm not a clinician like you are. 00:10:30.879 --> 00:10:37.679 But having worked in behavioral health, it's always sometimes comes down to more beds and bums and seats, for lack of a better phrase. 00:10:37.679 --> 00:10:44.080 But that's not really true, and it really comes down to the employees and the patient or client. 00:10:44.080 --> 00:10:48.399 I don't know if you refer to them as clients in your behavioral health system, that trust you're building. 00:10:48.399 --> 00:10:56.720 So what has in your journey taught you about earning trust of employees, investors, and even the community to do this kind of work? 00:10:57.120 --> 00:11:06.639 I think it was Richard Branson that that made a comment that was really famous and it still is to this day, stating that everyone says you need to take care of your client, and that's the most important thing. 00:11:06.639 --> 00:11:08.799 And he had said, you know, I very much disagree with that. 00:11:08.799 --> 00:11:10.799 I think you need to take care of your team. 00:11:10.799 --> 00:11:16.960 And if you do that, the rest of it kind of falls into place naturally, and then they take care of the client. 00:11:16.960 --> 00:11:22.480 So I think the first thing for me is just acknowledging the work that my team does. 00:11:22.480 --> 00:11:25.519 I try to visit the floor as often as I can. 00:11:25.519 --> 00:11:32.000 I try to make my rounds between all of the disciplines in the facility, but I also recognize that there's a separation there. 00:11:32.000 --> 00:11:36.000 I'm not doing the degree of work that they are doing. 00:11:36.000 --> 00:11:43.039 And on any given day with a level one facility, our patient turnover rate, length of stay is approximately seven days or so. 00:11:43.039 --> 00:11:50.320 So if I leave work on a Friday afternoon where I come in Monday morning, I got 10, 15 patients sometimes that are brand new. 00:11:50.320 --> 00:11:54.159 So every day you really don't know what the population brings. 00:11:54.159 --> 00:12:02.159 So recognizing how difficult that is from a staff standpoint and showing them that you do recognize that and you're there to help. 00:12:02.159 --> 00:12:06.879 For example, on any given Saturday or Sunday, I'll pop in the hospital to make my rounds. 00:12:06.879 --> 00:12:10.799 We run, obviously, as a hospital, we're 24-7 facility. 00:12:10.799 --> 00:12:13.360 So we run two shifts seven to seven. 00:12:13.360 --> 00:12:16.399 So I try to be at work between 6 and 6:30 in the morning. 00:12:16.399 --> 00:12:20.399 So I have at least some time to interact with my night shift. 00:12:20.399 --> 00:12:23.200 If I didn't do that, half of the hospital, I would never meet them. 00:12:23.200 --> 00:12:25.519 And I just think that's an incredible

disservice. 00:12:25.840 --> 00:12:38.960 Have you ever come across a team that was really struggling in the or a part of the organization that was really struggling and you kind of need to change your tactic and leadership to get them where you know you want them to be or get them to realize where they needed to be? 00:12:39.120 --> 00:12:40.960 Perhaps tell us a Tory about that? 00:12:40.960 --> 00:12:41.840 Yeah. 00:12:41.840 --> 00:12:47.440 One of the departments at my facility has been a work in progress since I've started. 00:12:47.440 --> 00:12:52.080 It's gone through some leadership change, and I think the pieces are in place right now. 00:12:52.080 --> 00:12:59.360 But getting it to kind of function with a degree of autonomy without some level of micromanagement, which I'm very much against. 00:12:59.360 --> 00:13:06.000 I think the team is starting to come around, but there is that one team that has struggled, and it's one of the more important teams. 00:13:06.000 --> 00:13:07.600 It's our intake department. 00:13:07.600 --> 00:13:20.879 And getting everything to work as it should, it's not strictly staff related, it's part of its operations, part of it is state mandates and what we can, can't do, and getting everything to just function well has been a little bit of a challenge. 00:13:20.879 --> 00:13:27.440 But I think the leadership of the team is in place, and it's just getting everyone to really look at it from a team mentality. 00:13:27.759 --> 00:13:33.679 And what tactics can you use them to try to get that realization perhaps already occurred because it sounds like you're on your way. 00:13:34.159 --> 00:13:35.679 Yeah, I've definitely seen improvements. 00:13:35.679 --> 00:13:43.919 And again, we've made some leadership changes with the department earlier this year, and it's just acknowledging the work that the team is doing. 00:13:43.919 --> 00:13:50.320 And when you've got a patient coming in, you've got a packet in a referral source that may or may not be accurate. 00:13:50.320 --> 00:13:51.039 You don't know. 00:13:51.039 --> 00:13:59.120 And it's not too uncommon to, you know, I've got my sheet of paper and this is who I'm expecting to have walk through the door, but this is not who's walking through the door. 00:13:59.120 --> 00:14:02.720 So there's always that you don't know who's coming in the door. 00:14:02.720 --> 00:14:14.799 So there's a safety component, and it's just getting everyone focused because with intake, it's kind of feast or famine in that they're absolutely slamming with packets coming in or intakes, or it's really quiet and crickets. 00:14:14.799 --> 00:14:20.559 So keeping them motivated, keeping them driven has been a little bit of a work in progress. 00:14:20.559 --> 00:14:29.440 So we have seen some turnover with that department, and as we're replacing some of those pieces that have left, I think we're seeing a little more cohesion with each step. 00:14:29.440 --> 00:14:41.360 I've got new employee orientation that starts today, and a good handful of my people, once or twice a month, depending on hires, but a number of the people that are starting today, tomorrow are intake. 00:14:41.360 --> 00:14:47.440 So I'm very optimistic that we're continuing to get the pieces in place to get that team to be really self-sufficient and autonomous. 00:14:47.759 --> 00:14:51.360 Would it be correct for me to assume you you've done some recent hiring around this? 00:14:51.360 --> 00:14:52.320 It sounds like you have. 00:14:52.720 --> 00:14:53.519 In that department. 00:14:53.519 --> 00:14:55.600 With leadership, that changed. 00:14:55.600 --> 00:14:58.000 We needed to bring in an assistant director. 00:14:58.000 --> 00:15:01.120 Some of the staff had left because of those changes. 00:15:01.120 --> 00:15:04.320 I just had three individuals that left within a very short period. 00:15:04.320 --> 00:15:09.120 Actually, if you count everyone within like a two months time frame, I lost about five or six individuals. 00:15:09.120 --> 00:15:09.679 Wow. 00:15:09.679 --> 00:15:11.360 That's big for Intake team. 00:15:11.360 --> 00:15:16.480 Other than one or two core players, the department over the last six months is brand new. 00:15:16.799 --> 00:15:17.200 Wow. 00:15:17.200 --> 00:15:21.519 So then if you have these many individuals joining you, there's one question I was curious to ask. 00:15:21.519 --> 00:15:31.039 When someone joins your team, you're always looking for that one quality that doesn't necessarily show up on their resume, but for you predicts some long-term success for your team. 00:15:31.039 --> 00:15:39.279 I'm curious, as you've got this new team, was there something you can point to that was one of those kind of things that was like, yep, this is a member that's right for this team? 00:15:39.600 --> 00:15:42.559 Well, I think a resume is what gets you in the door for an interview. 00:15:42.559 --> 00:15:43.039 Yep. 00:15:43.039 --> 00:15:44.399 And it ends there. 00:15:44.399 --> 00:15:49.840 And I'm also very cognizant of the fact that not everyone is completely transparent and honest on the resume. 00:15:49.840 --> 00:15:51.840 That's the truth. 00:15:51.840 --> 00:15:52.960 I've experienced it. 00:15:52.960 --> 00:15:59.600 So I think I feel really strongly like I read the resume and I want to know who's coming in, and I make the determination, yeah, let's bring them in. 00:15:59.600 --> 00:16:00.799 The resume is great. 00:16:00.799 --> 00:16:04.879 From that point forward, I really don't give a damn about the resume. 00:16:04.879 --> 00:16:14.080 I also am very much against, I've worked some larger facilities that you need to follow the scripted questions, and you cannot deviate. 00:16:14.080 --> 00:16:18.559 So if you're interviewing five, 10 people, you need to measure them on the same metric. 00:16:18.559 --> 00:16:19.919 Very objective. 00:16:19.919 --> 00:16:23.679 And I'm not a fan of that because it's always the same

questions. 00:16:23.679 --> 00:16:35.039 They're always so expected that anyone that's either planned for an interview or has gone through interviews knows these questions and has a canned answer in their back pocket ready to go. 00:16:35.039 --> 00:16:36.320 So I don't do that. 00:16:36.320 --> 00:16:38.480 I'm far more concerned when someone comes in. 00:16:38.480 --> 00:16:40.480 I want to know who you are as a person. 00:16:40.480 --> 00:16:44.480 I have your resume, I read your resume, I know what your experience looks like. 00:16:44.480 --> 00:16:45.600 Who are you? 00:16:45.600 --> 00:16:46.960 What drives you? 00:16:46.960 --> 00:16:50.639 I want to know what makes them want to do the work that they do. 00:16:50.639 --> 00:17:00.320 And probably more important, especially at a facility like mine, where you need to function as part of a team and a team that's part of a much larger team of multiple teams. 00:17:00.320 --> 00:17:00.799 Yes. 00:17:00.799 --> 00:17:04.480 I want to know that you could function across lines. 00:17:04.480 --> 00:17:08.400 Nursing and intake, it's not uncommon to have some some butting of heads. 00:17:08.400 --> 00:17:12.640 My nursing department does a really good job of wanting to make sure that everyone is safe in the hospital. 00:17:12.640 --> 00:17:17.759 My intake department, at least previous leadership, their only concern was we need to fill the beds. 00:17:17.759 --> 00:17:21.680 So there was a constant power struggle between the two. 00:17:21.680 --> 00:17:28.960 So when I have someone that comes in for an interview, it's all about are you going to fit the culture here or wherever? 00:17:28.960 --> 00:17:31.839 And what do you bring to the table from a personal standpoint? 00:17:31.839 --> 00:17:40.799 I will tell you that just after I started, and I've been at the hospital now rather for about three years, when I started, I didn't have a social work director. 00:17:40.799 --> 00:17:44.400 So one of the first things that I did is like, we need to get this posted. 00:17:44.400 --> 00:17:54.880 And I am not in a rural area by any means, but surprise Arizona, which is where the hospital is, is enough outside of Phoenix that I'm not getting a lot of Phoenix applicants. 00:17:54.880 --> 00:18:00.720 So when I posted that job, I literally got a pool of one to choose from. 00:18:00.720 --> 00:18:05.440 And her resume was great clinically, but she completely lacked leadership experience. 00:18:05.440 --> 00:18:06.160 She had none. 00:18:06.160 --> 00:18:07.920 And I've been very vocal with her about this. 00:18:07.920 --> 00:18:12.400 And I said, if you were fighting against two or three other people, I never would have even called you in for an interview. 00:18:12.400 --> 00:18:13.680 So she knows this. 00:18:13.680 --> 00:18:19.440 But I thought, let me bring her in just because I've got nobody else to choose from and I need to fill this position. 00:18:19.440 --> 00:18:21.359 So let's just see what she has to say. 00:18:21.359 --> 00:18:22.880 She might surprise me. 00:18:22.880 --> 00:18:26.720 And she's younger, and again, at the time she had no leadership experience. 00:18:26.720 --> 00:18:37.039 And she walked in with this attitude of, I mean it's appropriately or sincerely, this attitude of, I know how to do this job and I'm very confident in my ability. 00:18:37.039 --> 00:18:43.119 And she sat and she not only had great answers, but she clearly owned those answers. 00:18:43.119 --> 00:18:52.000 And I was really impressed with the lack of congruence between who presented in my office and her resume and how thin it was. 00:18:52.000 --> 00:18:57.039 So it was pretty easy, even though I don't like to hire from a pool of one ever. 00:18:57.039 --> 00:18:58.880 I felt much more comfortable. 00:18:58.880 --> 00:19:00.799 Like, let's give this a shot. 00:19:00.799 --> 00:19:04.960 And she's been with us over two years now, and she's been an absolute rock star. 00:19:05.279 --> 00:19:12.480 So if I'm hearing you this succinct thing you're looking for that's not on the resume, it's that sort of connection to quality and why they're doing this work. 00:19:12.480 --> 00:19:16.880 What, as our title of our podcast is what makes the work worth it to them. 00:19:16.880 --> 00:19:17.920 Yeah, fair. 00:19:18.079 --> 00:19:18.799 Yeah, exactly. 00:19:18.799 --> 00:19:19.279 Yeah. 00:19:19.279 --> 00:19:24.559 And she just she had this attitude and she's shown it consistently through her time there. 00:19:24.559 --> 00:19:33.839 And I try to emulate, not emulate, but I try to I've always been kind of the same way is that first and foremost, I want to support you, and I will always do everything I can to do that. 00:19:33.839 --> 00:19:37.279 That being said, there are still expectations for any position here. 00:19:37.279 --> 00:19:37.839 Yeah. 00:19:37.839 --> 00:19:43.599 So I will support you up to a point, but then it becomes we need to have a different conversation. 00:19:43.599 --> 00:19:51.279 And she does a really good job of being her expectations, they are very clear-cut, but she also is very much supportive of everyone in the team. 00:19:51.279 --> 00:19:53.200 And I've always been the same. 00:19:53.200 --> 00:19:58.640 So that's probably one of the reasons when I interviewed her that I saw a lot of myself in her from a leadership standpoint. 00:19:58.640 --> 00:19:59.279 Oh, wow. 00:19:59.440 --> 00:20:00.720 Sounds like she's a great actor. 00:20:01.440 --> 00:20:02.160 Yeah, she is. 00:20:02.160 --> 00:20:03.519 She's great to work with. 00:20:03.519 --> 00:20:09.359 And I'm really blessed that all of the leadership at my hospital, every one of them are great to work with. 00:20:09.359 --> 00:20:18.960 This is one of only, despite the difficult nature of the job, this is only one of a couple jobs I've had my entire career that on a Monday morning, I'm looking forward to going to work. 00:20:18.960 --> 00:20:19.920 Oh, wow. 00:20:19.920 -->

00:20:21.119 That's fantastic, Eric. 00:20:21.119 --> 00:20:22.160 That's actually true. 00:20:22.160 --> 00:20:28.000 I've had maybe one, two, one, maybe two other jobs that I'm really looking forward to it. 00:20:28.000 --> 00:20:37.359 And again, the thing with a level one hospital is what I'm walking into Monday morning, it can be very different from where I left Friday afternoon because of patient turnover. 00:20:37.359 --> 00:20:37.759 Yeah. 00:20:37.759 --> 00:20:43.039 So you're always walking into a little bit of a eh, I don't know what I don't know what I'm going to get into. 00:20:43.039 --> 00:20:45.519 But despite that, I look forward to getting there. 00:20:45.519 --> 00:20:46.480 How is your weekend? 00:20:46.480 --> 00:20:47.599 How is everyone doing? 00:20:47.599 --> 00:20:49.119 What do we got going on today? 00:20:49.119 --> 00:20:52.960 And it's just the cohesion there is refreshing. 00:20:52.960 --> 00:20:54.559 That's fantastic. 00:20:54.559 --> 00:20:55.039 Yeah. 00:20:55.200 --> 00:20:56.240 Well, very exciting for you. 00:20:56.240 --> 00:20:56.720 And for a job. 00:20:56.720 --> 00:20:57.440 Yeah, it really is. 00:20:57.440 --> 00:20:59.359 He's been a little bit three years already in. 00:20:59.359 --> 00:21:02.720 So for it to still feel that fresh is must be very exciting. 00:21:03.039 --> 00:21:03.440 Yeah. 00:21:03.440 --> 00:21:05.599 And we just started expanding. 00:21:05.599 --> 00:21:09.119 When I started, there was some chatter about do we want to expand the hospital? 00:21:09.119 --> 00:21:12.559 But it was just kind of lunchtime chat. 00:21:12.559 --> 00:21:17.519 But about a month, a little over a month ago, we broke ground on the lot right next door to us. 00:21:17.519 --> 00:21:19.680 We're adding an additional 24 beds. 00:21:19.680 --> 00:21:28.559 So the excitement about literally seeing, I could see it from the window of my office, literally seeing construction of we're almost going to double in size. 00:21:28.559 --> 00:21:31.119 And the ex and the excitement that brings with it. 00:21:31.119 --> 00:21:40.079 And just to know that between myself and some of our other leaders, we were part of the planning of this, having those pre-discussions, meeting with architects and contractors. 00:21:40.079 --> 00:21:46.799 And the way it's unraveled has been an incredible learning experience and just the degree of excitement. 00:21:46.799 --> 00:21:53.200 And I just can't wait until we have that certificate of occupancy and I could walk the halls of what's going to be our new facility. 00:21:53.519 --> 00:21:54.720 Oh, that's fantastic. 00:21:54.720 --> 00:21:55.519 Very exciting. 00:21:55.519 --> 00:21:58.880 I'm gonna have to watch you guys online to see about your expansion there. 00:21:59.359 --> 00:22:05.599 So I Every leader has decisions that are hard to make, but that you can't avoid. 00:22:05.599 --> 00:22:08.480 And I love uh work the work here to ask those kind of questions. 00:22:08.480 --> 00:22:15.759 A story about uh one difficult decision that ultimately you made the organization stronger because you had the courage to do so. 00:22:15.759 --> 00:22:18.240 I was curious if you had a story about that that you've done. 00:22:18.240 --> 00:22:21.039 Maybe not this organization currently, because you have lots of great things happening. 00:22:21.200 --> 00:22:23.119 But Avia Breyer, one you were at? 00:22:23.119 --> 00:22:25.119 No, I would say this one. 00:22:25.119 --> 00:22:30.000 Because of our smaller size, we don't employ our own psychiatric group or psychiatrists. 00:22:30.000 --> 00:22:32.799 We have a third party coming, so we contract with them. 00:22:32.799 --> 00:22:37.039 And when I started, the group that we had for the most part was really good. 00:22:37.039 --> 00:22:46.880 The nurse practitioners and psychiatrists I had on site were good, but there were limitations and there were some gaps that I felt really needed to be replaced or upgraded, I should say. 00:22:46.880 --> 00:22:52.400 So we started to have those discussions about do I want to move in a different direction? 00:22:52.400 --> 00:22:58.079 Which is as a psychiatric facility, I mean, we're very much tied to our psychiatric group. 00:22:58.079 --> 00:22:59.119 We need them. 00:22:59.119 --> 00:23:05.680 I mean, all of the departments really, but you know, they're the ones obviously prescribing all the medications. 00:23:05.680 --> 00:23:08.960 And as a level one facility, we're basically a stabilization unit. 00:23:08.960 --> 00:23:11.359 And a lot of that comes down to medication. 00:23:11.359 --> 00:23:18.160 So the recognition was there that a change needed to be made, but is that a boat you really want to rock? 00:23:18.160 --> 00:23:22.480 And sometimes people are reluctant to make the change because change is difficult. 00:23:22.480 --> 00:23:25.920 And most of us, at least to some degree, are creature of habit. 00:23:25.920 --> 00:23:28.960 But I finally made the decision let's bring on a new group. 00:23:28.960 --> 00:23:32.160 There's a psychiatrist that I had known from a larger hospital out here. 00:23:32.160 --> 00:23:38.240 He and I began having some early discussions, and we kind of came up with a framework of how that would work. 00:23:38.240 --> 00:23:42.000 And over the course of a few months, we got them credentialed. 00:23:42.000 --> 00:23:47.119 I had parted ways with our previous psychiatric group, and we brought the new group in. 00:23:47.119 --> 00:23:59.039 And obviously, with changes like that, there are some growing pangs, and getting everyone up to speed and on board took a couple months, but in no way, shape, or form do I regret making that change. 00:23:59.039 --> 00:24:01.519 The group that I have now is outstanding. 00:24:01.519 --> 00:24:03.200 They really care about the patients. 00:24:03.200 --> 00:24:06.799 They're directly involved with us on an administrative level. 00:24:06.799 --> 00:24:09.839 Everything is a

cohesive approach. 00:24:09.839 --> 00:24:15.279 So it was a really scary change to make because you don't know what could potentially happen. 00:24:15.279 --> 00:24:19.599 But it's one of those things like if it works out well, it's going to be well worth the work. 00:24:19.599 --> 00:24:25.519 And this is a great example of where once that once the death settled, there's nothing about that transition that I regret. 00:24:26.160 --> 00:24:26.480 Wow. 00:24:26.480 --> 00:24:30.960 So was that going from an outsource psych team to another outsource type team? 00:24:30.960 --> 00:24:32.559 Or two, all right. 00:24:32.720 --> 00:24:35.519 And what's the most difficult group to convince? 00:24:35.519 --> 00:24:37.279 Potentially the nurses, I would guess. 00:24:37.279 --> 00:24:41.039 Yeah, because they're the ones that are essentially working the most closely with them. 00:24:41.039 --> 00:24:50.000 And there obviously there was the apprehension because the end it was primarily the nurse practitioners that were on site every day, but they were great and the interactions were great. 00:24:50.000 --> 00:24:53.920 So it was the a lot of the feedback I got was do you really want to go there? 00:24:53.920 --> 00:24:56.319 Do we really want to rock this boat? 00:24:56.319 --> 00:25:11.839 And there were just some gaps that I felt needed to be filled, and I just wasn't, I wasn't sure that the group we had in place at the time, and this is nothing against them, it was just with as as thinly spread as they were, I didn't know if they were able to do that. 00:25:11.839 --> 00:25:16.160 So we ripped the band-aid off, we made the decision to change. 00:25:16.160 --> 00:25:22.559 And the group that I have now, it's kind of co-medical directors, and I've got typically one of them in the building every day. 00:25:22.559 --> 00:25:24.160 They're always popping in my office. 00:25:24.160 --> 00:25:25.119 How's things? 00:25:25.119 --> 00:25:26.480 What's going on today? 00:25:26.480 --> 00:25:28.000 What do we need to do? 00:25:28.000 --> 00:25:30.000 So they work as part of the team. 00:25:30.000 --> 00:25:32.880 They're open to feedback, both administratively and clinically. 00:25:32.880 --> 00:25:47.759 They want to hear from the techs and the nurses their feedback on patients because if they feel like a patient needs to stay longer or leave earlier, and the rest of the team disagrees, they're all ears and they want to have that open conversation about what's best for the patient. 00:25:48.240 --> 00:25:48.559 Wow. 00:25:48.559 --> 00:25:50.640 So you've done some pretty major changes there. 00:25:50.640 --> 00:26:03.920 You're in the process of rebuilding your entire take team, which is the evaluation of people coming in initially, and then you've really kind of pivoted your care team, because I agree with you 100%, your site team and medication in stabilization. 00:26:03.920 --> 00:26:07.759 It's one of the key tools that you do to deploy good health. 00:26:07.759 --> 00:26:10.000 And you've been there about three years. 00:26:10.000 --> 00:26:15.920 So although you've been there for a while, there's still pretty broad sense of the terms new. 00:26:15.920 --> 00:26:22.240 So did you see these changes when you first came in, or is there because of this podcast here, is worth the work? 00:26:22.240 --> 00:26:29.839 And I truly like to find organizations that leadership sees that are worth rebuilding, and then ask the question why? 00:26:29.839 --> 00:26:44.160 And I was kind of curious if these are two things you saw when you first got there, or was there somebody else something else while you were doing that interview process to join this organization or when you first got there that went, yep, this is a great place, and I know I can make a significant impact. 00:26:44.480 --> 00:26:52.960 On the surface, the team was functioning really well, but from a medical leadership standpoint, they weren't as involved as I felt they needed to be. 00:26:52.960 --> 00:27:09.920 We had an interview with our state licensing department came in, which they do with all facilities periodically, and they wanted to be with our medical director at the time because he was so spread thin across other facilities around the valley, he didn't have as much working knowledge of our hospital. 00:27:09.920 --> 00:27:12.160 And I thought that was a real disservice. 00:27:12.160 --> 00:27:15.200 And again, I can't stress enough, there's nothing against him. 00:27:15.200 --> 00:27:23.920 It was just a matter of with all of his hands in so many cookie jars that he just could not give us what I felt we really needed. 00:27:23.920 --> 00:27:26.480 He typically wasn't there very often. 00:27:26.480 --> 00:27:28.960 He wasn't seeing patients directly himself. 00:27:28.960 --> 00:27:36.799 And now by contrast, I've got my two medical directors that are full board certified psychiatrists that are seeing their own patients every single day. 00:27:37.200 --> 00:27:38.240 Wow, that's fantastic. 00:27:38.240 --> 00:27:45.680 Having a medical director staying connected to patients and not an administrative job is super important in behavioral health, in my opinion. 00:27:45.680 --> 00:27:48.240 Uh it really stays connected to the community. 00:27:48.240 --> 00:27:52.720 Well, Eric, I've really enjoyed having you here as a guest here on Worth the Work. 00:27:52.720 --> 00:27:59.680 To remind everybody, this is about Eric Perry, who is the director and CEO of Avenir Behavioral Health in Arizona. 00:27:59.680 --> 00:28:01.680 And thank you so much for joining us. 00:28:02.079 --> 00:28:02.880 Thank you, Jason. 00:28:02.880 --> 00:28:03.920 Really appreciate it.