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Featured FAN: Deborah Visconi

Emily Schweich
June 15, 2022

‘Walking the Walk’: A Conversation with Bergen New Bridge Medical Center’s Deborah Visconi

Each quarter, we feature a Federal Action Network (FAN) member leading the charge on Capitol Hill to protect essential hospitals. This quarter, we spoke with Deborah Visconi, MS, president and CEO of Bergen New Bridge Medical Center, in Paramus, N.J., about “walking the walk” of health care equity and the importance of community relationships. A county-owned hospital, Bergen New Bridge Medical Center is the largest hospital in New Jersey and one of the largest public hospitals in the country.

You’ve spoken frequently about workforce challenges at your hospital as a result of the COVID-19 pandemic and the strain that your hospital is facing; how are you balancing competing advocacy priorities, including those workforce challenges, infrastructure, and COVID-19 response along with the other challenges of being a safety net hospital?

For me, it is about prioritizing the front-line care providers while assuring that we provide a safe, comforting environment for our staff. It’s getting out into the front lines and understanding what the staff is dealing with — listening to their voices and responding accordingly.

The way I think about the title of CEO is not as chief executive, but as the chief engagement officer. It’s understanding and engaging with your front-line staff and the people who deliver care, but also engaging with your community and understanding what their needs are and how we can best prioritize taking care of them.

The pandemic brought to light those communities that didn’t or couldn’t access health care. We recognized the access issues, and these communities became our focus. We quickly went out with mobile vans and teams to test people right in their communities. We partnered with our religious faith leaders and different groups and organizations throughout the county of Bergen to identify the areas of need and provide care to them.

Every community was important, but one we were able to serve that stood out was the Ramapough Lenape Nation in Mahwah. They are an underserved and often ignored community — one that has not had a great deal of trust of institutions — so we reached out to them. It was not an easy “we’re here for you.” We worked very hard to start a relationship with them, engage them in what they needed, and earned their trust. We were able to travel to their communities and vaccinate them. We opened the door to providing other needed healthcare services for them and now we have doctors coming into the community to provide care. We help them with financial questions such as explaining what is needed to apply for Medicaid including what kind of documentation is needed and those who needed assistance in filling out the application.

I was recently interviewed for a leadership article, and one of the questions was, ‘during the pandemic, what was one of the most uplifting moments?’ As I was thinking about the last two years, working with the Lenape was probably one of those that was on the top of my list. When you hear the chief speak and say, “We’ve been here for hundreds of years and we’re invisible.” For us to be there with them hand-in-glove, providing lifesaving treatments, was just incredible.

The balance for us came from understanding and engaging with our front-line staff and our communities. It’s about retention of our workforce and identifying workplace nuances to help them have a more comfortable, safer environment. For example, for a nurse practitioner who would prefer to be working remotely, we can put that individual on the telemedicine team. Some of our front-end billing and registration staff can do a lot of their work remotely. So, we created hybrid environments and are looking at child care options on-site. Again, listening to the voices of our team members and asking, “what is it that you need so you can stay here and continue to work with us”?

As we enter the third year of the COVID-19 pandemic, how do you and your hospital plan to adjust your advocacy efforts? Do you see COVID-19 remaining in the spotlight?

COVID-19 will be part of our reality forever, just like other infectious diseases that have become endemic and part of what we learn to live with. Our focus as providers is going to be addressing the inequities of care and getting out to people in the communities that need it, understanding their needs, and addressing chronic conditions. Many people have not taken some of the preventive measures that they might have taken pre-pandemic, we’re seeing a lot more diseases that we may not have seen a couple of years ago.

Under your leadership, Bergen New Bridge Medical Center has appointed its first female board president. As equity takes a national spotlight in health care, how are you ensuring your hospital prioritizes it inside and out?

We are “walking the walk.” It’s not only about appointing people, which is very, very important, but leadership starts at the top. At every staff meeting, every senior team meeting, we talk about our communities of color. We talk about how we can integrate with those communities. We have a large Korean community here in Bergen County. So, how do we identify those pockets of need with the communities and how do we, as a team, make sure that we are sensitive to those issues?

We were talking to leadership of faith communities of color. We are entering into a huge partnership with one of the very large churches in the area, and it’s starting with COVID testing and vaccines, of course. That’s everybody’s priority. When you start to listen to the voices of your community, it really is telling.

For instance, at one point, a church pastor said to me, “Would you consider giving away at-home testing kits?” I said, “That’s a great idea. Absolutely. Let me go see if I can buy some.” And then one of my staff says, “Well, the government’s giving them away” — it was a learning moment for this individual because [the pastor] responded, “Well, first of all, the government’s only giving away four per household, and many households in this community have way more than four people living under one roof. Secondly, some of these people live in buildings that [have small] mailboxes, and when the postal service delivers the boxes, they can’t put them into the mailboxes, so they put them on a counter and then other people come and take them.”

It’s about reaching deep and thinking about what other people experience. For me, it’s educating our front-line staff, our managers, our directors. Understanding cultural and ethnic nuances, recognizing unconscious bias, showing compassion, empathy, and emotional intelligence, these are tools that create more equitable interactions because they help create a lens where we all see the person and the need and not just an age, gender, skin color, or orientation.

To me, it’s about respecting and listening to our communities. The LGBTQ community is another big group — highly stigmatized — that doesn’t like to come to hospitals. We have an education program for our staff on how to provide culturally appropriate care and communicate respectfully, creating a safe and welcoming environment.

You may remember, before COVID, there was an early release program for incarcerated individuals. These individuals get released and from a medical standpoint — never mind the work and the housing that they must find for themselves — they’re released with only two weeks of medication for substance use disorder, mental health, or cardiac conditions, for example.

We partnered with the New Jersey Re-entry Corporation, providing linkages back to Bergen New Bridge Medical Center primary care providers, and specialists. When people left incarceration, they were assigned to community social workers through the New Jersey Re-entry Corporation, and when they got to the social worker’s office, there was a room with a Bergen New Bridge Medical Center iPad and connection to our doctors. They were able to do a little history and a quick physical exam, get their medication, and be connected back up to us for future care. I think those are the equity issues that we’re focused on.

Community equity begins with equity from within the organization. We actively recruit not only the best people for our staff opportunities, but people representing the rich diversity of those who seek our care. We invest in developing people. We have our own certified nursing assistant (CNA) school at Bergen New Bridge. There’s a huge shortage of CNAs across the country. It’s a challenging job, and I herald my staff every time I see them. We identified a need, so we partnered with Bergen Community College and created our own CNA school right here on site. We had to put it on hiatus for COVID, but, when people graduate from the school, we give them jobs at our medical center. We’re going to create apprentice and intern training program for the trades — heating, ventilation, and air conditioning technicians, auto technicians, and plumbing professionals.

There’s so much more to equity than the color of the skin of your management team. That’s part of it, of course, but it’s about everything. I’m a Latina woman, growing up in an underserved family, which adds to my ability to lead the organization into different places and a recognition and respect of what our communities need.

Is there anything else that you would like to share or anything that you wish we had asked you?

We are a unique organization. I have an acute care background, and I’ve been at hospitals throughout New Jersey and New York for many years, but Bergen New Bridge Medical Center is a unicorn of hospitals, and it’s a very special place. It’s been in the community for 105 years. It was opened by the freeholders (now county commissioners) and was called Bergen County Isolation Hospital. It was opened to serve the public health needs of the communities of the time; back then it was tuberculosis and polio. If you fast forward 105 years, we’re still in the community serving the public health needs of our communities. It’s just that now it’s mental health, addiction services, geriatric care, and chronic conditions. It’s incredibly fascinating to watch the history of this organization and its evolution to modern-day time.

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