Diane Hupp was recently appointed president of UPMC Children's of Pittsburgh, a 313-bed hospital that sees pediatric patients from around the country, admitting roughly 11,000 and performing more than 20,000 surgeries annually. The facility is anticipating its third Magnet designation by the American Nurses Credentialing Center, which recognizes excellence in nursing — which is appropriate, as Hupp began her career at the hospital as a nurse.

HealthCare Business News spoke with Hupp about her long history with the hospital, the response to pandemic-related staffing shortages and the changes to the overall healthcare landscape.

HCB News: Can you tell us a bit about what attracted you to UPMC Children's of Pittsburgh initially and why you've been so at home there?
Diane Hupp: I have been here for my entire career [spanning] 36 years. I went to school locally at Duquesne University, starting out in business school. [After] having been in business school for two years, I do believe I had a call from above to become a nurse. There was something special and unique about being able to give back and give back big, so I transitioned during my mid-college years to nursing. But at the time when I said, “I think I want to be a nurse,” I wasn't certain so I actually decided to volunteer at Children's Hospital, and that was in 1985. I would take the bus up from Duquesne University, up the street to Children's Hospital.

I've really never looked back, since. The following year, in 1986, as I was finishing college, I was able to be hired as a child care assistant. A year later, I had my first job as a registered nurse. I spent several years at the bedside, but then moved into different leadership positions, and really have worked throughout the organization in inpatient and ancillary areas, surgical services, so pretty much throughout the hospital.

Children's is a gift to the community and Children's Hospital has a legacy of delivering world-class care; and I knew that 35 years ago.

HCB News: How have your most recent positions at the hospital prepared you for your new role?
DH: In 2005, I was asked to serve as the chief nurse. I had a passion for nursing from my career, but I had been doing that for about 17 years. Most recently, just this year, I thought when the president position became open, that I could continue to have an influence and an impact. There's such an extraordinary team here at Children's that I feel honored and privileged to serve in this president role, and I do believe my administrative roles and operational roles, and nurse clinical skills, have helped to get me to where I am today.

HCB News: Who or what inspired you to follow a career in healthcare?
DH: Going back to my time at Duquesne, I recall seeing a lot of nurses on campus. And I know it may sound odd and peculiar, but I honestly believe it was a call from above that said “You should be a nurse.”

My father was a businessman himself, and self-employed with a great business, and I thought well, “maybe I could follow those step sets.” My mother would be described as a caring, compassionate woman, so I feel I have a complement of both of them. I also would attribute it to the values that my parents instilled upon me at a very young — the values of respect and values of dignity, and just values of life and the gift of life.

HCB News: Can you tell us about the demographics and patient populations you're serving?
DH: A little bit over 90% of our patients are from Pennsylvania, but we actually serve well beyond Pennsylvania. For the other, maybe, 7% we serve nearly 40 patients from 40 different states in the United States. We do see less than a percent of international patients.

We’re the only Level I trauma center in Western Pennsylvania. We have a very long legacy of transplants and we perform the most pediatric liver transplants in the country with extraordinary clinical outcomes. We're also recognized by U.S. News as the No. 2 cardiac program in the country, so given those, what I call “centers of excellence” here at Children's, it does attract patients from well beyond the state of Pennsylvania.

Almost half of our patients are less than 5 years of age. We have a 55-bed neonatal unit and nearly 1,000 patients a year come to us that are newborns requiring intensive care.

HCB News: What is the leadership environment like at the hospital?
DH: It has always had a very good culture, but the focus has really been getting to a great culture of consistency, as it relates to both the employee experience and the patient family experience. it's a focus on how we communicate, how we deliver care. Our goal is to provide an extraordinary experience for every patient and family, every time with every encounter.

When I look at the employee experience, certainly we’ve been challenged with the health care worker shortage. But on a little brighter note, we have been able to attract nurses, we've been able to attract providers. It is a place that I believe people want to work.

And we've been working on the culture of also spreading and growing our brand. UPMC Children's Hospital has an extraordinary brand, and we're working to expand that in areas such as Central Pennsylvania and Erie, Pennsylvania, where we believe we can help elevate the care.

HCB News: Are there any initiatives or special projects you're undertaking, or planning to undertake?
DH: First and foremost is our access and growth as major goals, and growing not necessarily in terms of patient bed capacity, but more how we open our doors to have a very consistent, easy access that's patient-family centric. We are working hard on elevating our digital front door, so online scheduling of virtual appointments when appropriate, opening up all of our ORs, making sure throughput in our emergency department is good.

We're also expanding what we call ED affiliations. These are partnerships with some adult hospitals to help them with emergency department care, and ensure when they have a very sick child come in that they would be able to call us 24/7 to be able to telemed with one of our pediatric experts in our ED to help ensure that the right care is being delivered. In addition, when patients leave emergency departments, if they need a subspecialty visit, we want to be able to have them call a number and have a subspecialty appointment be connected immediately.

HCB News: Have you been dealing with the same type of staffing shortages that have been hurting hospitals across the country?
DH: We certainly have not been exempt from experiencing some shortages similar to the rest of the country, but on a positive note, we have been able to recruit. We have a pipeline of new nurses in particular, that have started January through July, which will really help to get us back to optimal staffing.

With the new hires that we've been able to pull in, our physicians have been relatively stable. We have been working throughout with all of our essential health care workers on flexible schedules, looking at some incentives, some premium pays. We've implemented with our UPMC health system in particular robust career ladders, so that year after year staff believe they're advancing, and trying to incentivize them to stay.

We're doing work with schools and training programs and partnering with them to do our best to create pipelines to our top job families that we continue to recruit for.

HCB News: Do you foresee the pandemic creating any long term or permanent changes to the way healthcare is delivered?
DH: I would say, first and foremost, telemedicine is here to stay. For many of our families, it makes it convenient. It's consumer friendly. It creates a sense of efficiency, and I’m very pleased to see that it's being fully funded right now.

COVID-19 has really taken a toll on everyone, and we have seen a definite increase in demand for behavioral health services, and especially in pediatrics. So pediatric behavioral health is also a priority of mine. Western Psychiatric Hospital is our adult hospital, which provides service to both children, adolescents and adults, and we’re partnering with them to look at the continuum of care from when a child comes into our ED or any ED, and making sure that we have people able to evaluate and triage these children to the services they need. Not every child needs an inpatient bed, but we certainly need to ensure that we can meet demands for outpatient and partial programs, as well as looking at embedding behavioral health into our primary care offices to help meet the needs.

HCB News: Healthcare continues to push away from fee-for-service toward value-based care. Are you seeing those efforts manifest at UPMC Children's?
DH: The pediatric world, I believe, is lagging a bit with that. There's certainly a focus on what we can do for value-based care, but primarily it's Medicare driven right now.

We have started a clinically-integrated network, so we are working on some of these issues, and the focus is really on prevention. It's ensuring that we can prevent illnesses with certain populations, and how we can help manage the populations better. We aren't as far along in some of the areas as maybe the adult world.

HCB News: Over your career, what is one of the most important lessons you've learned?
DH: I think the most important lesson I've learned over time is the importance of surrounding yourself with great people and great teams in a great healthcare system. Here at UPMC, we have the privilege of working with the amount of resources and the amount of investments that are made within a great system.

During these past two years, more than ever I've realized the importance of the teams who were committed and dedicated and caring. It helps carry you through very challenging and difficult times. These great teams and great people, they put the hospital and the care of the children above themselves, because they're doing what's right.