New Leadership and a New Vision for UPMC Children’s with Diane Hupp, DNP, RN

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Voiceover: This podcast is for informational and educational purposes only. It is not medical care or advice. Clinicians should rely on their own medical judgements when advising their patients. Patients in need of medical care should consult their personal care provider. Welcome to "That's Pediatrics", where we sit down with physicians, scientists, and experts to discuss the latest discoveries and innovations in pediatric healthcare.

Dr. Allison Williams: Hi, I'm Alli Williams, one of the pediatric hospitalists here at UPMC Children's Hospital of Pittsburgh.

Dr. Sameer Agnihotri: And I'm Sameer Agnihotri, a professor in the department of neurological surgery.

Dr. Williams: We are so excited today to be hosting a woman who I feel needs no introduction, Diane Hupp, who is the President of UPMC Children's Hospital of Pittsburgh. Thank you so much for joining us today on That's Pediatrics.

President Diane Hupp: Thank you. I am pleased to be here and so proud to be able to represent UPMC Children's Hospital and the legacy we have here.

Dr. Williams: Tell us just a little bit about your journey and your career role to taking this position.

Ms. Hupp: Sure. I started at Children's actually as a volunteer, and it's hard to believe that it's been 36 years ago that I started here.

Back in 1985 I was going to school at Duquesne University for my undergraduate degree in nursing, and decided that I wanted to do some volunteer work to just get my foot in the door. And I did just that. I would take the bus up from Duquesne up Forbes Avenue to Children's Hospital when we were back in Oakland, I spent some time volunteering and then was hired on as a childcare assistant.

And back then it was a more or less a nursing assistant type role so I was working under the direction of a registered nurse. And the following year I graduated and had my first job as a professional staff nurse here. And I feel as if I had a great clinical foundation, great clinical skills that I was able to utilize throughout my career.

I went back and got my master's degree and my doctorate degree, and was very privileged to have lots of opportunities throughout my entire couple of decades here. I spent some time in surgery. I spent some time with medical services, surgical services, and then about two decades ago was asked to step up to be the chief nursing officer.

And it really was my dream and my passion to serve in the chief nurse role. How I got to the president, I think over time assumed some more responsibilities, many of them in hospital operations, beyond the traditional chief nurse type of work. And with that, I felt it gave me a great foundation to do more and maybe have more of an impact.

UPMC Children's Hospital has such a strong team here, and I feel I'm surrounded by extraordinary physicians and extraordinary scientists and really dedicated, committed nurses and frontline staff who love what they do and have a passion for improving the lives of our children and their families.

Dr. Williams: You've had such a wonderful growth of your career, starting with clinical care and moving to more administrative roles. What led you to taking on the role of president and maybe seeking out that opportunity for your career?

Ms. Hupp: I will be honest, I hadn't always seen that in my career. Someone said, did you always have a passion to get up to be the president? And I would say I didn't. For years I was just so happy and I still loved my role as the chief nursing officer. I'm very proud of all that was accomplished.

But when Mark Sevco, our former president, was asked to step up to his new role, I gave it a lot of thought, a lot of soul searching to say, “Diane, you have a lot of the skills that I believe are needed to do this big job. And there's a wonderful team. And could I compliment this extraordinary team to continue to take Children's to the next level?”

I have a deep sense of pride, commitment, and passion for the work we do here, whether it's in academics, research, and particularly clinical care. So I felt I could really contribute and add more to the excellence that we already have here.

Dr. Williams: It's also wonderful that we're seeing, at least for me as a young female physician here at Children's, seeing a female leader step up to that role too. So I know that a lot of folks here were really pleased to see that change and have more women in our leadership team, so we're very thankful that you were able to take this role and help guide us.

Ms. Hupp: Thank you. Part of what I have been so overly amazed and impressed is the support and the confidence, and people reaching out and just saying, "Diane, I'm here to support you in whatever way. We want you to be successful. We want you to help take Children's to the next level." So it really is a great feeling and a great sense of pride.

Dr. Williams: And with such a leadership role there are many qualities you have to have for it. If you could pick one word to describe yourself, which might be a difficult question because there are many words that would be great to use. What word would you use to describe yourself?

Ms. Hupp: That is a hard one. But if I had one word quickly in my mind, and I think if you asked others, they would concur. I would say it's committed. I've spent 36 years here. I do look at Children's Hospital as my second home. And it's not about the hours you work because everyone is working long hours and long days and trying to pull extra shifts, but it is more so about the commitment of what we do here and the commitment to the mission of taking care of every child, every time, at the right time. With a level of excellence, a level of compassion, and caring.

So that for every encounter, our patients and families leave and are able to say, "We had a great experience at Children's Hospital."

And that's truly the commitment that I applaud so many of our physicians and our frontline staff, because they make that happen every day. I couldn't be more proud to say right now, we're in the top percentile of the nation in patients and family experiences. And not every hospital can say that. It takes a lot of hard work. It takes having our frontline staff and our physicians really demonstrate true care and compassion.

And we know that to be a compassionate healthcare worker, we've learned, it takes seconds. It takes seconds to just give a little extra, sit down and meet the child or the family at eye level, and really leave the encounter saying, "Is there anything else I can do for you, because I have time and I want to."

And that takes a little bit extra but not much, but it goes a long way for these patients and families who, whenever they're here, it is if not one of the most difficult times in their life, particularly those that are sitting in our hospital beds.

Dr. Williams: I think commitment is such a wonderful word to use. It shows strength but it also shows compassion. And that's definitely what UPMC Children's Hospital of Pittsburgh tries to do not only for our patients, but for our community and for all who are a part of this UPMC Children's community as well.

Dr. Agnihotri: So what are some challenges that you have faced in your role at the hospital?

Ms. Hupp: Certainly over the past two years, two and a half years during this pandemic, everyone has been challenged. Our providers, our frontline staff, our patients, and our families. It's been a tough two years.

On a positive note, I think UPMC Children's has managed through the pandemic quite well. One of the most important things I think throughout this pandemic was communication, giving as transparent, clear communication as possible. There was a lot of unknowns.

At this point hopefully we are moving through the pandemic and we can see a little bit ahead of that. But with the pandemic has come, as we all know, a healthcare worker shortage. And UPMC Children's has seen that and is experiencing that as well.

On a positive note though, we have been able to hire a large amount of particularly frontline nurses over the past couple of months. From just January this year through the month of June, we'll have brought in nearly 200 new nurses.

Part of that has to do with growth and part of that has to do with some turnover. Many of this frontline staff have been moving to travelers, some have been burned out. And it's reasonable to think that everything they've gone through not only while at work, but in their home lives.

Some of the staff have said, "I feel as if I have three jobs, I'm a nurse or I'm a therapist, but I'm also a teacher at home, I'm a parent at home. So when you couple all that together, it has put insurmountable stress on our frontline staff. So one of the challenges and also priorities over this next year is stabilizing our workforce, investing in our workforce, making sure that our physicians, our providers, our frontline staff feels that we are taking care of them as very best we can. It's not easy.

I don't believe it's going to be one thing that can make that happen. It will take all of us to continue to build a great culture here. How we communicate, how we behave, how we respond and react. I do believe it's very important for everyone who works at Children's to believe when they come to work here that we're a community. We're one. We are inclusive. We believe in diversity. We want to be more diverse, and that we take care of each other. It does start with all of us.

So one of my focuses is definitely getting our workforce back to where it needs to be, and we're definitely investing in that. And making sure that when we come to work, all of us, that we believe it's a great place to work.

Dr. Williams: I think it's so wonderful to have so many new faces here at Children's as well. It adds a new breadth of experiences. It also revitalizes the units that have been so busy over the past few years. I think it's really important to also focus on mentorship. With the loss of some of our folks that have been with us for so long, we run the risk of losing that clinical excellence.

Is there a focus on mentorship as well for the new faces that we have coming to participate in patient care?

Ms. Hupp: Yeah, indeed. I think mentorship is ever so important and it even starts with the initial onboarding. When a new staff person, a new physician, a new resident, we're going to be having a lot of new residents come aboard here in July, as we do every year. And we need to take care of them.

Buddying them up with another individual that can just help them with the simple things, help them with understanding how the hospital works, where the key areas of the hospital are. And most importantly, when they're having a challenge in the day or they're having an issue in the day, they feel good about going to someone to say, "Hey, what would you do here? What do you think about this?"

I'm so grateful for mentors in my life throughout my career. I've had some awesome mentors. Frankly I don't know what I've done without them.

When I first became chief nurse a couple of decades ago, the hospital actually said, "We want you to have a mentor. A formal mentor, a coach. Somebody that you can rely on, somebody that you can talk to. Somebody that's going to give you good advice and counsel, and somebody who has wisdom.

I find that very valuable and I think that we need to give back. So in part of my role, I do mentor. I have frontline staff that'll say, "Can you just spend 15, 30 minutes with me because I'm not sure what I want to do on my next step."

And I'll find the time because I believe it's that important. So my hope is that we will all share in the mentorship. There are a lot of people that have been here many years, and even people that are newer but have different experiences can help to mentor and grow our frontline staff.

Dr. Agnihotri: A little bit of a fun question, you know budgets and things like that. In a perfect world, if you had let's say infinite resources, can you speak on with your leadership and how you envision the program growing over the next few years, and what areas you would like to see?

Ms. Hupp: Sure, that's a great question. I love to think about if I had infinite resources, so thank you for that question. That's a powerful question. It's almost as if put your wishlist down there.

And definitely it would be first and foremost, further investment in our people. Because if we take care of our people, I do believe we will take care of our patients and families very well.

Research. We are a top 10 children's hospital, we have to invest in scientists and be able to partner and support our scientists who do extraordinary research here in pediatrics. So if we had infinite resources, we would definitely be putting additional and more support to our research.

Certainly philanthropy is a branch of the hospital that helps us so well. They are great partners. They're great contributors. And we look to our foundation partners to help us grow our research, as well as certainly the national organizations, the NIH, and those that do help us.

But that's a tough one right now. And where does the money go for priorities? That's probably one of my biggest challenges is prioritizing funding, but certainly I would put research up there at the top. I would also put pediatric behavioral health. I didn't speak to that, but pediatric behavioral health I really have moved up on the agenda.

We know that this pandemic has taken a toll, particularly on our teens and on our adolescents. The numbers are growing every day, the demand and the volume of children coming in. For children that come in the emergency department, right now we're seeing 50%, one out of every two children that come in, have some type of need for help in the behavioral health space.

We also, in a given month, 30 to 40 children that come in we're transferring out to inpatient behavioral health services.

So one of our areas that we will be doing some further strategic planning on where should we invest? Where should the services be? How do we maybe co-brand with UPMC Western. These are all very important pieces that I think will help us to be able to deliver more higher level of care to these patients.

Dr. Williams: It's so important to provide this care. I know as a hospitalist here that's been one of the most frustrating and difficult patient populations that we've had admitted to this hospital. There's been an extraordinary number of teens that have been suffering over the past couple of years.

You mentioned co-partnering and developing all of these resources here at Children's, but UPMC Children's Hospital of Pittsburgh is also expanding, which I think is really important to touch on the expanse of UPMC Children's and your vision for that.

Ms. Hupp: Thank you for that question. Part of UPMC's Children's, one of the biggest priorities is certainly our growth. We have a legacy here. Serving as a top 10 children's hospital we want to expand our footprint. One of the areas that we are expanding, and we have over the past couple of years and continue to do more in, is in central Pennsylvania.

Some may be aware, but if you aren't it's important to note, we actually helped partner to put up a UPMC Children's Hospital within the Harrisburg Hospital. And within Harrisburg Hospital right now we started out with about 15 beds, and we're looking to expand that to get that eventually to 30 beds. So it's a small hospital within a hospital. We have put sub-specialists that have gone to central Pennsylvania, they see patients there every month in multiple specialties.

We're also looking north and up towards the Erie and the Hamot Market. There's a need. And if we can solve the need of access, access is one of the big priorities that we're working hard on. Certainly Mike Comunale, Dr. Terry Dermody, and so many of our division chiefs have been so supportive in helping to get patients in.

We will grow by solving our access problem. We will grow and be able to see more patients if we can get the patients in the door in a timely manner. We've made great progress over the past couple of years, but we still have opportunity so that we can consistently get every patient in at the right time at the right level of care.

Dr. Williams: It's almost like a catch 22 being this large children's hospital with a huge catch area. It's great for training purposes. It's great for our staff to be able to take care of patients from so many different places, but I know it's stressful for families too.

And I think that growth is going to be really beneficial for families in our Western Pennsylvania and Central Pennsylvania community.

Ms. Hupp: Absolutely, and I'll mention one other area of growth. And I really thank Dr. Steve Janoski and Molly Gibson, who are two of our staff in the ED that are working on ED affiliation partnerships. And it's just that. It is a partnership where our ED physicians and our ED nurses are going to do assessments in adult hospitals to say, "What can we help you with? Let us take a look at your ED."

In many of these adult emergency departments, they see approximately 10 to 15% of their population is actually children. So when they see these children, we want to share, have them share in our best practices and be able to deliver high qualities of care. And how can we help them with that?

We're working with telemedicine and hope to expand the telemedicine in these hospitals. We're also setting up a concierge service where eventually we will be able to on a consistent basis, if a child is seen in an emergency department outside Children's and they need to have a follow-up specialty appointment, they will be able to, before they leave the ED, call down, there's one number to call, and we will get them scheduled for a timely appointment.

And that's something that I definitely believe it's not only the right thing to do, but will certainly help with our growth and help to excel the level of pediatric quality care out in the communities.

Dr. Agnihotri: Right. And there's something that you've touched on, maybe you could expand a bit more. But Children's Hospital of Pittsburgh is, it's world famous now. It's top 10 as you mentioned. There's so much brand recognition and just growing in the local communities. I think that would bring a little bit of... No kid wants to be at a hospital or no family wants to be at a hospital, but knowing that Children's Pittsburgh is expanding to areas that people can't travel as much.

Ms. Hupp: That's right. You are absolutely right, you're spot on. These organizations, they do want our help. They're reaching out. It's hard to be able to deliver high quality and high reliable, safe care to pediatrics when that's not your business every day.

So they're dabbling in it, but at the same time they need further support and they need further expertise. And we're committed to doing just that. Because again, it's the right thing to do for our patients and our families outside the immediate community and outside the Lawrenceville area.

So I anticipate that we will be collectively together working very hard on expanding our footprint.

Dr. Williams: There's so much to be proud of working here and being a part of this community. I know that when I moved from Florida, you can even feel the Pittsburgh pride the second you arrive at the city. With that there's a lot to be proud of being at UPMC Children's Hospital of Pittsburgh, but what's one or two things that you're the most proud of for the future and things that will happen here?

Ms. Hupp: Sure. Thanks for that question. I couldn't be more humbled and honored to serve in this role of president of UPMC Children's Hospital of Pittsburgh. Children's Hospital here in Pittsburgh, it's a legacy. It's a legacy for 130 plus years. And the legacy and the pride is in the care we deliver, that's the core of our mission. It's what we do day in and day out.

Despite the challenges that we've had, we rise above. We rise above, and I have no doubt we will continue to get through the challenges that we see now and come out a lot stronger. I do anticipate the pediatric behavioral health, we will do better. We will do more. We will make pediatric behavioral health more accessible. That is a primary goal.

We will continue to focus on access, whether it's through the emergency department, opening up our operating rooms more, and having patients be able to be seen when they need to be seen in a timely manner.

So access to care, delivery of care. And finally, but just as important, I bring up the people again, because we can't do any of that unless we have the people who are here committed, dedicated, and helping us to deliver world class care.

The acceleration of excellence, we want to go beyond our footprint, and very committed to working with the extraordinary physicians and leaders here to do that.

Dr. Williams: Thank you so much again for coming in and chatting with us, we really appreciated hearing your vision and hearing thought processes for the exciting future that awaits.

Dr. Agnihotri: Yeah, an absolute honor. Thank you so much.

Ms. Hupp: Yeah, thank you so much. It's really an honor to be here. And I thank all of those of you who are listening out here, whether you are from the community, one of UPMC Children's, or other.

Thank you for your care, your commitment. And I commit back to you that I will be doing my very best with this extraordinary team to deliver on these priorities.

Thanks for having me today.

Dr. Williams: And thanks for listening to That's Pediatrics!

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