The Exec: New CMO Says Connecting With Frontline Staff Is Crucial

For a CMO, listening to staff is imperative to promote patient safety and care quality.

Listening is an essential skill for a CMO, the new CMO of VA Rocky Mountain Network says.

Susan Bray-Hall, MD, was named CMO of VA Rocky Mountain Network on July 1. She had been serving as Interim CMO of the Denver-based U.S. Department of Veterans Affairs (VA) health system since November 2023. Prior to joining the VA Rocky Mountain Network, Bray-Hall served as chief of staff for the Oklahoma City VA Health Care System.

VA Rocky Mountain Network features 18,000 employees, eight hospitals, and a $5 billion operating budget. It has the largest geographic footprint of VA health systems in the lower 48 states, serving five primary states (Colorado, Montana, Oklahoma, Utah, and Wyoming) and portions of five other states (Idaho, Kansas, Nebraska, Nevada, and Texas).

One of the primary challenges of leading clinical care in such a large organization is listening and making sure that staff members are heard, according to Bray-Hall.

"I need to build relationships, spend time at all of the facilities, encourage the building of teams, and get staff to speak up," Bray-Hall says. "If I am listening to the staff, we won't miss important concerns."

For a CMO, listening is essential to promote patient safety, according to Bray-Hall.

"My primary approach to patient safety is empowering staff to speak up," Bray-Hall says. "I want staff to be able to comment on their concerns and have them taken seriously. They are the ones who are most likely to see patient safety issues."

Bray-Hall says her patient safety concerns include medication safety, surgical safety, and healthcare-associated infections, but she must be aware of the full spectrum of patient safety.

"I am concerned about taking care of patients' mental health, physical health, primary care and prevention, and all of the services in between," Bray-Hall says. "So, when it comes to patient safety for me, it is not a particular focus, it is always a global focus."

For a CMO, listening is also pivotal to promoting quality care, according to Bray-Hall.

"It is important to listen to your staff," Bray-Hall says. "The best ideas come from the frontline staff when they are taking care of the veterans."

Susan Bray-Hall, MD, is the new CMO of VA Rocky Mountain Network. Photo courtesy of VA Rocky Mountain Network.

The VA model of care

VA health systems are veteran-focused and provide comprehensive care, according to Bray-Hall.

"We embrace population health," Bray-Hall says. "We have special education for staff to care for veterans. We focus on the multi-morbid patients, so we are concerned about the global needs of our veterans. We do a ton of prevention. We provide comprehensive and coordinated care."

Given the needs of their patient population, VA health systems have several focal points, according to Bray-Hall.

"The data supports that the VA provides some of the best care in the country for cardiovascular care and preventative health," Bray-Hall says. "We are focusing on making sure that patients are getting the comprehensive care they need for their cardiovascular care in the primary care setting. Mental health and suicide prevention are core services."

Care coordination is a top priority at VA health systems, according to Bray-Hall.

"We have social workers that do care coordination and intensive case management for high-risk veterans. These are patients who have significant conditions and hospitalizations," Bray-Hall says. "We have nurses who do care coordination in primary care and that is their main job."

The VA provides care coordination in medication management.

"We have a single pharmacy record, which is extremely helpful because medications can get mixed up when a patient is going to multiple pharmacies and multiple sites of care," Bray-Hall says.

Prepared to lead

Bray-Hall is board certified in internal medicine, geriatrics, hospice, and palliative care, which provides a solid foundation to serve in the CMO role.

"I rely on my medical background all the time," Bray-Hall says. "Internal medicine gives you the breadth and knowledge base across the adult lifespan. My geriatric training taught me a lot about systems-based care and how to improve systems to provide quality care and take safer care of patients. My hospice and palliative care training taught me about listening and empathy."

Bray-Hall says her approach to leadership as CMO is to be accessible to peers and staff.

"I also share my successes and my failures," Bray-Hall says. "I want to always be authentic, which helps people feel they can come to me. I also have a connection with clinicians. I will be doing geriatric consultations via telemedicine for veterans who are frail."