What are hospital leaders really focused on in 2026?

In this episode of The Surgical Journey, Lisa Miller speaks with Hayes Waldrop, founder and president of the Institute of Healthcare Executives and Suppliers, about the pressures shaping healthcare leadership today. Drawing on more than two decades of conversations with hospital executives, Hayes discusses capital constraints, slow implementation, AI adoption, and the growing responsibility for care beyond the hospital walls.

They also explore how technology, home-based care, and stronger organizational alignment could change the way health systems manage patients across the surgical journey.

0:00 Introduction to NovaNav

0:55 Guest Introduction: Hayes Waldrop

2:15 What Hospital CEOs Are Most Concerned About Right Now

3:57 Value-Based Care and the CFO's Growing Role in Post-Acute Outcomes

6:30 The Power of Peer Networks and Closed-Door Executive Conversations

8:00 How the Strongest C-Suite Leaders Make Big Decisions Differently

9:36 The $25 Million Problem: How Implementation Lag Kills ROI

11:00 Accountability Structures, Incentive Misalignment, and the Forcing Function Gap

13:25 Where the C-Suite Stands on AI Adoption Today

14:36 The IT Barrier, Epic's Roadmap, and Healthcare's Easy No on AI

15:44 Open-Source AI, Local Sandboxes, and Where Healthcare Is Headed

17:56 What Leadership Looks Like in 2026 vs. Five Years Ago

19:38 Hospital-at-Home, Side-of-Care Shifts, and the Role of Technology in Recovery

22:00 Managing the 30-Day Surgical Window and Post-Op Care Accountability

22:40 Robotics, Humanoids, and the Future of Home-Based Care

25:10 Closing Remarks and How to Connect with Hayes Waldrop

In this episode of The Surgical Journey, NovaNav's Lisa T. Miller speaks with board-certified vascular surgeon Dr. Chopra about the unusually complex recovery period vascular patients face after leaving the hospital. Many are managing multiple chronic conditions, strict antiplatelet or anticoagulation regimens, wound-care requirements, mobility limitations, and ongoing surveillance, often while also navigating transportation barriers, medication costs, limited health literacy, and fragmented access to specialty care.

Dr. Chopra explains why the first two weeks after surgery are such an important intervention window and how serious complications often begin with subtle, manageable changes rather than an obvious emergency. Mild incision redness, a gradual decline in walking tolerance, new calf discomfort, or an interruption in medication may be easy for a patient to dismiss, even when those changes indicate that a wound, bypass graft, or broader recovery plan is beginning to fail.

The conversation also examines the limits of a follow-up model built primarily around scheduled office visits. Routine surveillance remains essential, but long intervals between appointments can leave care teams without visibility into gradual deterioration, particularly when patients do not recognize that a symptom warrants earlier attention.

Lisa and Dr. Chopra discuss what more reliable post-discharge support should accomplish for this population: give patients clearer context for interpreting changes in recovery, reinforce medication and surveillance requirements, reduce the burden of knowing when to call, and help care teams identify emerging risk while there is still time for a limited course correction. The episode offers a practical look at why vascular recovery requires sustained clinical awareness beyond the procedure itself, and why preserving the opportunity to intervene depends on what happens between discharge and follow-up.

Episode Contents

0:00 Introduction to NovaNav

0:55 Guest Introduction: Dr. Chopra

2:04 What Concerns Vascular Surgeons Most in the First Two Weeks Post-Op

3:09 Wound Healing Complications in High-Risk Patients

4:44 Acute Limb Ischemia and the Cost of Waiting

5:12 Medication Adherence as a Silent Failure Point

6:17 Modifiable Risk Factors and the Intervention Window

7:12 Addressing Medication Cost Barriers Proactively

9:16 Why Vascular Follow-Up Is Uniquely Difficult

10:29 Transportation and Mobility Barriers to Surveillance

11:35 Comorbidity Overload and Health Literacy Gaps

12:58 Silent Graft Failure and the Surveillance Paradox

15:28 How Technology Must Be Designed for Rural and Elderly Patients

16:36 Low-Friction Design and the NovaNav Approach

19:10 Medication Understanding and Health Literacy

21:01 What One Change Would Most Improve Vascular Post-Op Support

22:16 The Case for a Single Clear Line of Communication Across the Care Team

Scott Becker, founder of Becker's Healthcare and partner at McGuire Woods, joins the Surgical Journey to discuss what separates genuinely great health systems from merely large ones, how the best CEOs navigate policy noise without losing clinical focus, and why patient navigation remains a chronically underinvested gap even in top-ranked systems. This conversation is for healthcare CEOs, CMOs, and CNOs navigating strategic growth decisions, workforce pressures, and the expanding accountability for post-acute outcomes under episode-based payment models.

Episode Chapters 0:00 Introduction to NovaNav 0:55 Guest Introduction: Scott Becker 1:30 Scott's background and new book overview 2:03 How hospital CEOs should think about niche and strategic expansion 3:53 Being great versus being big: the strategic clarity imperative 5:18 Profit from the Core and adjacent growth strategy 6:12 Jack Welch's number one or two rule applied to healthcare 8:09 Transitioning to overcoming setbacks and building momentum 8:43 Filtering noise: how the best leaders stay focused under pressure 9:31 Jenny Spiesel and UCLA Health as a model for leadership clarity 11:59 Jim Collins, great teams before strategy, and loving your 90 percenters 12:27 The evolution of a founder and building teams that outrun leadership 14:08 Why beating up 90 percenters is the core of organizational stupidity 16:57 The three strategic priorities for hospital leaders in the next six to twelve months 18:46 Technology adoption: the case for being a second mover 21:14 Last question: post-acute care, CMS episodes, and patient navigation 22:36 Why even top-10 systems are often awful at patient navigation 23:27 The reimbursement gap that explains chronic underinvestment in navigation 24:33 Closing remarks

In this episode of The Surgical Journey, Lisa Miller is joined by Dr. Mallika L. Mendu and Dr. Kathryn M. Corelli of Mass General Brigham for a practical discussion on what it takes to manage the full surgical episode under value-based care and the CMS TEAM model.

Dr. Mendu is Chief Population Health Officer at Mass General Brigham, Vice President of Clinical Operations and Care Continuum at Brigham and Women's Hospital, and Associate Professor at Harvard Medical School. Dr. Corelli is Associate Medical Director of Strategy and New Program Development within MGB Population Health and an Instructor in Medicine at Harvard Medical School.

The conversation moves beyond policy and into the operational work required to support patients across preoperative optimization, the hospital stay, post-acute care, and recovery at home. Dr. Mendu explains why patient-centeredness is central to value-based care, and why episode accountability requires a more connected infrastructure across surgeons, primary care, specialists, home health, post-acute partners, pharmacists, social workers, and care navigators.

Dr. Corelli shares how Mass General Brigham is building these programs in practice, including stakeholder interviews, data-driven opportunity analysis, caregiver coaching, physical therapy navigation, post-acute collaboratives, and risk stratification. The discussion also covers what moves the needle in the post-discharge window, why readmission prevention depends on both human touchpoints and scalable technology, and how Healthcare at Home and Home Hospital models may shape the future of surgical recovery.

For health system leaders preparing for mandatory episode-based payment, this episode offers a grounded look at the infrastructure needed to support safer recoveries, better patient experiences, and more coordinated care after surgery.

Timestamps / Contents

00:00 Welcome to The Surgical Journey 00:54 Introducing Dr. Mallika Mendu and Dr. Kathryn Corelli 01:49 How the CMS TEAM model changes surgical accountability 02:17 Why MGB sees TEAM as an opportunity to improve care delivery 03:45 The challenge of building new workflows for episode-based care 04:16 Dr. Corelli's framework: preoperative optimization, hospitalization, and recovery 05:24 Using stakeholder interviews and data to design better workflows 06:15 Why caregiver coaching matters after surgery 07:42 Patient-centered value-based care across surgery, primary care, and post-acute care 10:04 Surgeon engagement and shared ownership of outcomes 11:02 Physical therapy, case management, and preparing patients for home recovery 13:17 The practical details that make recovery at home safer 13:53 Designing programs that align primary care, surgeons, and post-acute partners 14:22 SNF and home health collaboratives, shared learning, and quality standards 15:10 Using benchmark data to identify post-acute utilization opportunities 15:56 Readmissions and the critical 30-day post-discharge window 17:04 Navigation, medication reconciliation, home services, and care team coordination 18:52 MGB's post-discharge follow-up work and readmission reduction 19:51 Where technology fits into scaling navigation 20:15 Risk scores, frailty measures, FLEX score, and predictive modeling 21:22 Healthcare at Home and Home Hospital in surgical recovery 22:10 Why home-based care aligns with patient-centeredness 23:03 Building workflows for appropriate surgical patients at home 23:40 Neuro spine pilots, SNF at Home, and future care models 24:23 Advice for health systems building TEAM infrastructure 25:01 The need for real-time data and actionable risk identification 25:35 Benchmarking, culture change, patient feedback, and frontline insights 26:20 Why TEAM is a signal for where care delivery is headed 27:21 Closing remarks

What really happens after a patient leaves the hospital—and why does so much still break down in the first 10 days?

In this episode, Dr. Robert Cunningham, a fellowship-trained bariatric and metabolic surgeon, shares what it takes to build a surgical program from the ground up in one of the most underserved regions in the Midwest. From launching a de novo bariatric program at Methodist Jennie Edmundson to navigating real-world access challenges, he offers a candid look at the operational and human realities behind growth.

The conversation goes beyond program building. Dr. Cunningham breaks down how GLP-1 medications are reshaping—and in some cases complicating—the surgical pipeline, and why the biggest gaps in care still happen after discharge. Despite advances in technology, the first week at home remains one of the most vulnerable periods for patients.

This is a practical, on-the-ground discussion for health system leaders, surgeons, and operators focused on access, outcomes, and the parts of recovery that clinical pathways and digital tools still struggle to solve.

0:00 Introduction to NovaNav

0:55 Guest Introduction: Dr. Robert Cunningham

1:00 Dr. Cunningham's background: Ireland, MGH, and UNMC

3:40 Fellowship training at Geisinger and entering practice during COVID

4:15 Launching the bariatric program at Methodist Jenny Edmondson

5:52 Technology's impact on surgical safety: AI image overlays and intraoperative guidance

7:21 Bile duct injury and the holy grail of cholecystectomy safety

9:07 Molecules and nerve identification for inguinal hernia repair

10:25 Patient-facing technology: what patients actually experience

12:13 Immediate result release in patient portals and the cancer diagnosis problem

15:48 The host's personal experience: discharge instructions and post-op confusion

17:55 Where perioperative navigation platforms fit into the care continuum

20:46 Building the bariatric program: institutional support and proforma negotiation

23:55 Program components: dietitians, physical therapy, psychiatric evaluation

26:07 First surgical outcomes and the role of the program coordinator

27:32 Post-discharge follow-up, phone calls, and the literature on outcomes

29:13 GLP-1 medications and their effect on bariatric volume

35:20 Cost analysis: surgery versus lifelong GLP-1 therapy

36:41 Rural healthcare, critical access hospitals, and workforce challenges

39:06 The limits of AI and the risks of removing human interaction from care

43:00 Loneliness, social isolation, and surgical logistics for older patients

44:17 Advice for surgical residents: communication as the defining non-technical skill

48:40 The full spectrum of communication: bad news, colleagues, and conflict

50:30 Malpractice data and surgeons who communicate well

51:44 Closing remarks

Dr. Robert Cerfolio, Chief of Clinical Thoracic Surgery at NYU Langone and former COO of an $11 billion academic health system, joins The Surgical Journey to discuss what nearly 20,000 operations have taught him about the difference between technical excellence and true episode management. Drawing on decades of surgical and executive leadership experience, he explains why better outcomes depend not only on what happens in the operating room, but on what happens before surgery, after discharge, and across the recovery journey at home.

Exploring direct physician access, wearable-based remote monitoring, pre-op home assessment, and the structural barriers that keep health systems from adopting approaches already shown to reduce readmissions and improve recovery, Dr. Cerfolio makes the case that extending surgical accountability beyond the hospital is not simply a patient experience initiative. It is a quality, operational, and financial imperative.

He also reflects on the cultural changes required to make this model work: physician transparency, personalized recovery goals, stronger continuity after discharge, and a willingness to redesign care around the patient's actual environment rather than the assumptions of the inpatient setting. For surgical service line leaders, CMOs, CNOs, and operators building infrastructure beyond the hospital walls, it's all about what it takes to manage the full episode well.

Episode Contents

0:00 Introduction to NovaNav

0:55 Guest Introduction: Dr. Robert Cerfolio

2:27 Why Cerfolio Gives Every Patient His Cell Phone Number

3:44 Accessibility as a Clinical Standard, Not a Personal Quirk

4:52 How Residents Respond and Whether This Model Scales

5:34 Leveraging Digital Technology: Telemedicine and Pulse Ox Papers Rejected Before COVID

6:37 Innovation Resistance and Hiding Behind the Safety Card

7:52 The Three-Month Standardization and Continuous Improvement Cycle

9:10 Consumer Wearables in Post-Op Monitoring: Whoop, Apple Watch, and Actionable Data

10:09 The Pneumonia Catch: How Remote Metrics Prevented a Potential Death

11:43 Care as a Spectrum: Before Admission Through Long After Discharge

13:18 Scaling Post-Op Visibility and Where AI Fits

14:25 Video Navigation for Surgical Patients: A Practice Started in 1996

16:00 Barriers to Scaling Across Education, Technology Access, and Demographics

19:44 Accountability, Culture, and Ownership Across Surgical and Medical Teams

20:08 The Efficiency Quality Index: Physician-Defined Metrics That Stick

22:47 Building the Ideal System-Wide Perioperative Infrastructure

23:05 Pre-Op Virtual Home Walkthroughs and Environmental Safety

24:19 Personalized Post-Op Goals and Real-Time Metrics at Home

25:00 Why Getting Home Faster Produces Better Outcomes

26:25 Pre-Op Home Visits, Fall Prevention, and Leading Before the Adverse Event

Dr. Nizar Wehbi, physician, health policy expert, and former North Dakota State Health Officer, joins the NovaNav Surgical Journey to examine why perioperative outcomes are decided far more by what happens outside the hospital than inside it. He breaks down fragmented episode-of-care ownership, misaligned post-acute incentives, and how tiered alert systems can function as a genuine workforce capacity lever. The conversation closes on the Rural Health Transformation Program and why the real opportunity is not self-sufficiency for rural hospitals but connectivity to regional and urban hubs. His expertise and insights are perfectly framed for CMOs, CNOs, CFOs, and health system strategists who are accountable for what happens after discharge.

Episode Contents

0:00 Introduction to NovaNav

0:55 Guest Introduction: Dr. Nizar Wehbi

6:11 Biggest Gaps Between Discharge and Full Recovery

10:25 Social Determinants and the Case for Navigation Support

14:46 CMS Bundled Payments and Outpatient Shift: How Leaders Should Prepare

19:15 Process Mapping the Episode of Care and Cross-Team Accountability

22:42 Standardizing Patient Management Across Sites and Teams

25:30 Policy Opportunities to Improve Patient Experience at the System Level

29:38 Fragmentation as a Design Problem and the Role of Incentive Alignment

32:48 30-Day Readmission and the Misaligned Incentives Across Post-Acute Facilities

35:24 Risk Stratification, Yellow and Red Flag Alerts, and Clinical Escalation

36:50 Workforce Shortage, AI, and the 80-20 Principle in Post-Discharge Monitoring

41:45 The $50 Billion Rural Health Transformation Program and Infrastructure Investment

48:51 Hub-and-Spoke Models, Rural-Urban Connectivity, and Community-Based Recovery

51:37 Closing Thoughts and Full Circle on the Process Map

In Episode 11 of The Surgical Journey, Fred Neis — best-selling author of The Disciplined Leader, registered nurse, and healthcare executive — joins the show to discuss what makes the surgical experience feel coordinated, reliable, and well designed. Patients may not use those exact words, but they know when care feels predictable and when it does not.

Neis explains why stronger follow-up, better coordination, and more consistent standard work are essential to perioperative operations. He also makes the case that high reliability requires leadership that is willing to reduce unnecessary variation across teams and build a more dependable experience for both patients and staff.

Episode Contents

00:00 NovaNav Introduction 00:51 Guest Introduction: Fred Meese 02:16 What patients really want: service, predictability, and tailored interactions 07:35 The biggest disconnect after surgery: what happens once patients go home 11:41 High reliability, standardization, and reducing variation in care 16:20 Value-based care, risk-based contracts, and where AI can improve outcomes 20:49 Nurse coordinators, workforce strain, and using AI to extend clinical capacity 24:41 Why healthcare technology adoption fails and how to build trust 30:18 Fred's book: The Discipline Leader 33:49 Referrals, reputation, and preventing network leakage 37:21 Where to find Fred and his book 38:25 Closing Remarks

Most cancer patients experience their worst anxiety not during surgery, but in the days between diagnosis and treatment. Dr. Lisa Atterbury, a board-certified breast surgical oncologist with 18 years of experience, and Dr. Dupree, a breast radiologist, walk through the specific operational breakdowns that turn clinical delays into worse outcomes. They explain why the standard discharge instruction model fails, how 48-hour biopsy windows correlate with patient outcomes, and why post-operative ER visits often signal gaps in structured follow-up rather than true emergencies. This episode offers a clinical operations perspective on patient navigation, caregiver coordination, and the friction points that health systems can address without adding headcount. If you manage cancer programs or surgical services, this is a rare look at how two clinicians think about the space between appointments.

Episode Contents

00:00 NovaNav Introduction 01:02 Guest Introduction: Dr. Lisa Attebery 02:43 What clinicians often miss between appointments 06:40 Common post-op issues patients face at home 08:52 How technology can support patients before and after surgery 11:54 Why delays in care can worsen outcomes 15:43 Reducing unnecessary ER visits with better guidance 18:18 Redesigning the space between appointments 20:33 The first days after diagnosis: delivering news with hope 22:05 Biggest friction points in the cancer journey 24:58 Access challenges, workforce strain, and rural care realities 28:08 Mobile mammography and meeting patients where they are 29:13 The role of families and caregivers in cancer care 32:27 What it means to care for breast patients for life 35:11 Closing Remarks

Dr. Vamsi Ithapu has spent his career studying how people process information and building technology that reduces cognitive overload. His work is grounded in a deceptively simple question: how much information can people actually process in critical moments? During his PhD at the University of Wisconsin-Madison, he built predictive models for Alzheimer's disease. Later, at Meta Reality Labs, he led teams building systems designed to reduce cognitive overload for millions of users.

In this episode, he brings that perspective into healthcare and makes a compelling case for why patient communication should be designed with cognitive load in mind.

This conversation explores why discharge instructions so often fail, what healthcare gets wrong about information delivery, and how systems can be built around what patients are actually able to absorb in vulnerable moments. Vamsi also breaks down the difference between prediction, reasoning, and planning in AI, where large language models are useful in clinical settings, and where leaders should be far more skeptical.

We also discuss what it takes to move from research to real-world product, what healthcare can learn from consumer-scale technology, and why defining an ideal recovery state may be the most important starting point in designing better surgical journeys.

The Surgical Journey is sponsored by NovaNav, the surgical patient journey platform designed to reduce readmissions, coordinate post-surgical care, and support patients from the OR through full recovery. Learn more at NovaNav.ai.

In this conversation, we discuss:

• Dr. Ithapu shares four lessons from Meta's product experience that translate directly to health system AI strategy

• The three core things AI systems actually do: prediction, reasoning, and planning, plus where healthcare expectations often go wrong

• The reality of large language models in clinical environments: where they are useful, where they hallucinate with dangerous confidence, and what hospital leaders should be asking vendors right now

• A different way to think about discharge instructions. Cognitive overload is a design problem as much as it is a technology problem. We talk about what "minimum viable information" might look like for a surgical patient going home

• The idea of a "North Star" recovery state: defining what ideal recovery actually looks like for a patient, then designing the entire surgical journey backward from that point

Throughout the episode, Dr. Ithapu disvusses where these systems help, where they fail, and what healthcare leaders need to understand before adopting them in clinical workflows. The discussion is especially relevant for anyone thinking seriously about discharge, recovery, and the gap between technical capability and patient reality.

The Surgical Journey is sponsored by NovaNav, the surgical patient journey platform designed to reduce readmissions, coordinate post-surgical care, and support patients from the OR through full recovery. Learn more at NovaNav.ai.

Episode Timestamps

• 0:00 Introduction to NovaNav

• 0:58 Introduction to Dr. Ithapu

• 4:38 From Alzheimer's research to Meta Reality Labs

• 5:52 Why "AI" is an overloaded term

• 6:03 The three functions of AI: prediction, reasoning, and planning

• 7:40 What AI is actually good at today, and where it still struggles

• 10:16 What hospital executives should ask AI vendors

• 11:42 Why personalization in healthcare is different from consumer tech

• 18:49 Where LLMs are genuinely useful in clinical settings

• 19:45 Hallucinations, opacity, and why failure is hard to detect

• 25:57 Discharge instructions and cognitive overload

• 29:40 "Minimum viable information" for patients going home

• 32:17 What it takes to move from research to real-world product

• 33:10 Four product lessons healthcare can borrow from Meta

• 41:23 Why not every healthcare problem needs an AI solution

• 47:26 The "North Star" framework for recovery and care design

• 48:11 Closing