Sheppard Pratt Health System

Harsh K. Trivedi, M.D., MBA is the president and CEO of Sheppard Pratt Health System (SPHS). A nationwide resource, SPHS provides 2.3 million services annually across a comprehensive continuum of care spanning hospital-based and community services. Since its founding in 1853, SPHS has been innovating the field with research, best practice implementation, and a focus on improving the quality of mental health care on a global level. SPHS has been consistently ranked as a top national psychiatric hospital by U.S. News & World Report for the past 26 years.

EDWIN WARFIELD: How did you get started with Sheppard Pratt?

HARSH TRIVEDI: I joined Vanderbilt in 2010. I was recruited to come to Vanderbilt at a time where the psychiatric hospital there was failing. What I mean by failing is I inherited a shop where we had patient satisfaction scores in the second percentile. We had difficulty providing what was the Vanderbilt level of care. We also had about half of the hospital that was staying empty, and we had challenges in terms of how we worked with the community.

Over the course of the next three years, due to the leadership of senior leaders of Vanderbilt, we engaged in renovating every single square inch of the hospital; re-engaging the community; building our a very strong network of associations with patients, families, and providers; and then, doing things to really improve the quality of care. Within the first three years, we went from being in the second percentile for patient satisfaction to being above 90th percentile and then actually achieving top performance status for three of our units.

In that time, after helping to get the hospital to a new place, there was a very big focus on “What are we going to do solve the issues that relate to population health?” I worked with our health affiliate network in terms of thinking about our population health strategy for meeting behavioral health needs across the state. We were thinking: How do we provide access to the right folks at the right space, closer to home, at the right level of care, and at the time that they needed it? Which is one of the most difficult things in healthcare across the country.

Q. As a practitioner, what excites you about this opportunity?

A. What excited me about the opportunity at Sheppard Pratt was the long history of providing compassionate, respectful care, but also doing things that have never been done before. Sheppard Pratt is very much the gold standard of what psychiatric care should be—both in the country as well as internationally—and it is the place where the most services are provided, so any age group, any diagnosis, any type of treatment, we are the largest not-for-profit health care system in terms of psychiatric and substance abuse services. But also at the same time, for me professionally, it is a place where there is a board who understands the importance of what we do, combined with professionals who are really at the top of their field in all areas and specialties, who then are providing the care that you would want your own family member to be getting. So, if it was your loved one that needed care, in my mind, there is no other place I would send them but Sheppard Pratt.

And so as I come here, I am inheriting an organization with a long history. Many, many years ago, Dorothea Dix was involved in what we do and framed what compassionate care should be for patients with mental illness. We are an organization where occupational therapy as a field first got started. A number of the major things that happened in terms of the provision of excellent care for patients, long before there was ever the term “patient-centered care,” we have been doing this since the 1800s, and we’ve been doing it while providing respectful care for patients with mental illness. But we also do that while including the family in that care, and also doing things in a way we would want to do them for any other medical illness.

Q. Can you tell us about Sheppard Pratt’s school programs?

A. When we think about our programs at the local schools, one of the things that’s most important for us is that we realize that our youth are our future. Particularly when we have kids that are coming from challenging backgrounds, it is very difficult to make the right things happen. Fundamental to that is, as we think about how we can best intervene, our mentality is honestly one where we want to find the kids where they are and improve that entire setting.

There have been previous attempts where mental health services are basically offered in the form of a clinic in a local public school, but the difficulty with that is only the child that is identified as having a problem or issue ever sees that clinician. By using PBIS [Positive Behavioral Interventions and Supports], what is very different is that we actually empower the entire school team to learn how to create an environment that is helpful for the education, training—as well as wellbeing—of everyone in that school.

It’s not simply the fact that you are going to help the one child who’s having difficulty; you’re creating a situation which every student in that environment will actually perform better. What we have found is that that actually leads to fewer kids who will get detention, fewer kids that drop out of school, and better scores in terms of exams. What we find is that it actually creates better satisfaction for the school teachers, but also for all the other adults who are in that school setting as well.

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