- It's been too long, but she's back.

Linda Schwimmer, President and CEO of New Jersey Health Care Quality Institute.

Good to see you, Linda.

- Good to see you, Steve.

- Go back and see some previous interviews we did with Linda.

Linda, as we put the website up, tell everyone what the institute is and why you matter.

- We are a non-profit organization based here in New Jersey.

We're unique in that we have all of the stakeholders in healthcare working together in our membership at our table to work on safety, quality and affordability in healthcare.

So we ask them to kind of take off their day hat and work together for the greater good.

- In New Jersey, really?

- In New Jersey.

- So the members include, what?

You've got hospitals.

You've got what, who else do you have?

- We've got hospitals, health plans, pharmaceutical companies, doctors, nurses, consumer groups.

Really, you name it, they're at our table if they're even thinking about healthcare and working on healthcare.

- One of the areas we've talked to, the First Lady, Tammy Murphy about a lot is maternal mortality.

Tell us where we are in New Jersey and what we need to do to improve the horrific situation disproportionately for African American mothers who die at a, I believe, seven to one rate compared to white women giving birth to a child, please.

- Right.

No, I'm glad you raised that topic.

It's an issue that is really important to me on a personal level as a person who's given birth and raised two kids in New Jersey.

And it's something that the Quality Institute's been working on for a very long time.

Unfortunately, we've been going in the wrong direction for the last couple of decades, rather than the right direction.

And so I appreciate First Lady Murphy's focus on this issue and highlight it.

- Nurture NJ.

I'm sorry for interrupting, Linda.

It's Nurture NJ.

We'll put up the website so you can find out more.

Why does Nurture NJ matter, Linda?

- Well, Nurture NJ matters a lot, because Tammy Murphy has the bully pulpit as the First Lady.

And that's really important, because a lot of this comes down to focus and leadership.

And then with focus and leadership follows the resources and the attention.

So she put out, along with the help of a lot of others, a strategic plan called Nurture NJ It's huge.

It's comprehensive.

It really is a fundamental change of our systems in New Jersey and really across the country.

It takes on racism head-on, and it really addresses, tries to tackle all of the systemic issues that are leading to that disparity that you mentioned at the top of your question.

What the Quality Institute did was kind of boil down a lot of what's in Nurture NJ to what are, I would say, top four issues that people can work on and focus on no matter where they're sitting.

- Sorry for interrupting Linda, what are they?

- Okay, so top four issues are, first of all, the healthcare workforce itself.

We need to have the right healthcare workforce to really address maternal infant health and to get at these disparities.

So that means supporting, having midwives in every hospital in New Jersey, having policies that allow for doulas and are welcoming to doulas, and to really getting at changing the culture around the education within the people serving in those hospitals so that they're more aware of providing respectful care.

We know that they're providing great care for the most part, but really focusing on cultural needs and delivering care in a respectful way.

Listening to patients.

The heartbreaking part of a lot of these deaths is that such a huge percentage of them were preventable just by listening to patients.

- I'm sorry for, you're talking about deaths of women giving birth to a child.

Heartbreaking in and of itself, but I believe you're gonna be talking about how some of it's avoidable or preventable.

Please, go ahead.

- Right.

So a lot of this, the vast majority of this is preventable had the providers listened to the patient when they said, "I have a headache, I've had it for days.

Something's not right.

I don't feel right.

I need you to check me out.

I don't want to be discharged yet."

I mean, the list goes on and on.

But really there's a whole campaign that the CDC has called "Hear Her," and it really, you know, it has the warning signs listed and instructions of what to do.

And it's really as basic, but also as critical of that, that we really need to center the patient and listen to what she's saying when she's saying something's not going right.

So that's a big part of it is the healthcare workforce.

- And because I want to get to mental health.

So, what are some of the other issues, real quick?

- So the three other issues, the workforce, it's data.

It's looking at data and then using it, particularly the patient experience.

It's the payment system.

It's really paying for higher quality care.

The way our system is set up now we actually reward and incentivize a lot of the care that we don't want to be seeing more of.

And the fourth, is social supports.

Really supporting the types of social supports that really make a difference in terms of healthy pregnancy outcomes, but then just healthy care in general for women and infants.

- So important.

Again, go on to the Nurture NJ website.

It'll be up right now for people to find out more.

Linda, the time we have left.

Mental health, always a concern, but the situation exacerbated in the last several years, largely because of the pandemic, but not exclusively.

What is the role of the institute in trying to understand the mental health crisis that we are facing?

- So what we're trying to do is to look at, what are the barriers to providing integrated care?

We know there's never gonna be enough mental health providers in New Jersey to take care of everybody who needs mental health.

So there's a lot of different things that we could just do by breaking down some of the barriers to providing mental health.

Within settings, people are already going for getting care, such as integrating primary care and mental health together.

That's really the gold standard of care.

Why we've broken apart mental health and physical health?

There's a long history there.

It has to go to stigma, being uncomfortable with providing that type of care.

But we're looking at, what are the barriers?

And again, you know, some of those are payment system, some of those are regulatory licensing.

We have laws on the books that just haven't been implemented yet.

So we are convening our members to, many of whom are primary care providers, as well as mental health providers, to really get together, come up with a list of actionable things that they're gonna work on to tackle this.

- Linda Schwimmer is the president and chief executive officer of a really important organization in this state, particularly if you want to understand what's going on in the world of healthcare, the New Jersey Healthcare Quality Institute.

And I thank you for joining us.

Every time you're with us, we learn more about this complex, but incredibly important system of healthcare.

Thank you, Linda.

- Thank you.

Thanks for having me.

- You got it.

I'm Steve Adubato.

That's Linda Schwimmer.

See you next time.

- [Narrator] Think Tank with Steve Adubato has been a production of the Caucus Educational Corporation.

Funding has been provided by The Turrell Fund, supporting Reimagine Childcare.

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