Children’s Minnesota CEO talks about acting, reacting, and focusing on health equity

Dr. Marc Gorelick spent over 25 years in emergency medicine, and he says that experience proved to be invaluable in leading Children’s Minnesota.

Dr. Marc Gorelick, president and CEO of Children’s Minnesota, is retiring this summer after leading the pediatric system for more than seven years.

Emergency medicine physicians have to think quickly, and he says that has helped him lead the system through the COVID-19 pandemic, its fallout, and a rapidly changing healthcare landscape. He says he’s developed a degree of comfort in making choices without having all the answers.

“Emergency environment is not conducive to having comprehensive information over a period of time,” Gorelick says. “You do the best you can with the information you have. And I think that's really important for leaders, because we are never going to have all the information we'd like to have, and yet we need to act anyway. So I think that's been important.”

After more than seven years as president and CEO of Children’s Minnesota, Gorelick will soon be stepping away. He plans to retire in July.

He’s overseen significant growth in Children’s Minnesota and the services it provides. He says he takes pride in the system’s accomplishments. He also sees urgent needs to adapt and deal with a changing pediatric population.

In an interview with Chief Healthcare Executive®, Gorelick looks at the challenges he’s faced, including the COVID-19 pandemic, the rising number of kids with mental health needs, and the killing of George Floyd in Minneapolis. He also shares why he’s so passionate about focusing on health equity and improving diversity, and that also stems from his work in the emergency department.

“Over my 25 years in emergency medicine, I had sort of a frontline seat to some of the disparities in society, and that's really informed my commitment to equitable health care,” he says. “Again, not because it's woke. It's because of the people that I saw, the thousands and thousands of people that I had the privilege of serving up front and close, seeing what it was like for them, and that has informed the way I lead the organization.”

Facing the pandemic

Children’s Minnesota recently celebrated its centennial, and Gorelick says he’s proud of the growth of the system. The system has expanded its outpatient and ambulatory services in recent years.

“We've had a great first 100 years, and I think we're really well positioned for the next 100,” he says.

Gorelick says he’s optimistic about Children’s Minnesota because the organization has embraced the need for continuous improvement.

“One of our organizational values is adaptability, and I think that is increasingly important for any health system to succeed in a changing healthcare environment, and that pace of change is accelerating,” he says. “So I think our embrace of that over the last few years is really setting us up nicely to be able to deliver high quality care across all domains of quality, regardless of the changes that come at us from the larger healthcare system.”

The system demonstrated its ability to adapt and be nimble during the COVID-19 pandemic. Again, he points to his time in emergency medicine in navigating the crisis.

“We just didn't have all the information we needed, but we still needed to get comfortable with making decisions knowing that some of them were going to be right and some of them were going to be wrong, but knowing that we had to proceed nonetheless. So I think that was helpful, having that mindset,” he says.

During the early stages of the pandemic, Children’s Minnesota, like many pediatric hospitals, saw fewer patients. If kids contracted the virus, they typically weren’t sick enough to require hospital care, and children were less exposed to other illnesses, Gorelick says. For the kids that did need hospital care, the staff was forced to try new approaches.

“We faced sharply reduced volumes,” he says. “We faced disruptions in our labor force, but we were constantly keeping the ‘why’ in mind. The ‘why’ is about the kids that we serve and their families and being comfortable trying things, seeing what happened, and then continuing what worked and changing what didn't.”

Behavioral health crisis

Children’s Minnesota has seen more kids requiring treatment for behavioral health needs, and that’s been a problem for many pediatric hospitals around the country.

The system has seen “a real acceleration in the need for mental health services for kids,” Gorelick says.

“We've seen about a 30% increase in emergency visits for acute mental health crises and about a 50% increase in the need for hospitalization over the last few years,” he says.

Children’s Minnesota has been embedding more behavioral health within primary care clinics “so that kids can receive both physical and mental health services at the same time,” he says.

The organization has expanded acute care services, opening an inpatient mental health unit in its St. Paul hospital. Children’s Minnesota has also expanded outpatient programs around the Minneapolis region to serve kids.

“We've continued to build out the continuum of mental health services that we have,” Gorelick says.

After taking those steps, Children’s Minnesota has reduced the amount of time kids have had to spend in the emergency department for mental health crises. But he says there continue to be challenges, including kids who don’t need acute care but aren’t able to obtain the help they need from community providers.

“We continue to see those kids in our hospitals waiting for appropriate services, and we continue to advocate at local and state levels to try to get more resources in the community,” he says.

Pursuing equity

The killing of George Floyd spurred protests and calls for change nationwide. Floyd was killed just a few blocks from the system’s hospital in Minneapolis, Gorelick says.

After Floyd’s death, Children’s Hospital vowed to continue to work to improve diversity and health equity, but Gorelick notes that was not a new position.

“We were reaffirming an existing one, because it really is about how we do the best job of fulfilling our vision of being every family’s essential partner in raising healthier children,” Gorelick says.

When Gorelick first took over as CEO of Children’s Minnesota in late 2017, he signed a pledge with other CEOs to support a diverse workplace.

“That was really the start of our equity journey, and it came about because we recognize that we have a very diverse population here in the Twin Cities, again, particularly in the pediatric population,” he says. “We have a large immigrant community in the Twin Cities.”

Minnesota also has wide gaps among underserved groups, he adds. Those disparities also include maternal health, immunization rates and preventive care.

“We have fairly stark disparities in a variety of health outcomes for children and adults in the state of Minnesota …. So the problem is in front of us,” Gorelick says.

He says developing a more diverse staff is a key element in closing those gaps.

“There's a growing body of evidence that shows that a more diverse healthcare workforce delivers better outcomes for a diverse population,” he says.

Gorelick says he takes pride in Children’s Minnesota’s efforts to close disparities.

“We've really made a commitment to health equity and to fostering the kind of diverse and inclusive environment that allows for us to provide equitable care for all kids,” Gorelick says.

“I know that it's not necessarily particularly fashionable right now to talk about, but the population, especially the pediatric population, is getting more diverse, culturally, ethnically, racially, and we need to be able to serve an increasingly diverse population in an equitable way. And I think we're well positioned to do that.”