Rafael Bloise

Chief Medical Officer | Driving national quality and safety direction in senior care for optimal aging in place Ascension Living Jan 2021 – Present As Chief Medical Officer for one of the nation's largest not-for-profit senior living providers with $39M annual EBITDARM, I provide cross-functional clinical and operational direction to Medical Directors and multidisciplinary care teams stationed across 38 senior care communities and PACE centers in 12 states. ▶️ HOW I TRANSFORMED ASCENSION LIVING 3-Year Quality & Clinical Safety Strategy | Lead multiple initiatives to optimize Medical Director staff, clinical care pathways, antimicrobial stewardship, and psychoactive reduction. ⚕️ Introduced a new onboarding system, scorecard performance and required Medical Directors to be certified within three years of onboarding ⚕️ Drove pilot programs for new osteoporosis, cardiovascular, and sepsis clinical care pathways ⚕️ Launched and scaled a national psychoactive clinical program that lowered medication use by 70%. ⚕️ Positioned Ascension Living as an infection control champion by building a national antimicrobial stewardship 30% reduction program. National Palliative Care Strategy | Champion specialty and primary palliative care access and referrals to inpatient, outpatient, community, and virtual settings and develop analytics-based clinical and administrative protocols. ⚕️ Increased initial and subsequent palliative care visits by 40,000 in 2021, translating to 8-figure savings ⚕️ Supported the integration of advanced care planning (ACP) tools into web-based EHRs to 138,000 ⚕️ Enhanced primary palliative care and ACP education among clinicians and their staff by 75% ⚕️ Deployed a $700K palliative care tool to identify and stabdardized earlier palliative care for seriously ill patients across 30> hospitals National Recognition | CAPC Awards winners through the John A. Hartford Foundation Tipping Point Challenge

My success in defining and executing the vision, resulting in expansive growth of the palliative and supportive care program at Saint Mary’s Hospital, led to my appointment as Regional Medical Director. Since then, I have collaborated, directed and guided a regional multi-stakeholder group in numerous strategy sessions and partnered with our primary ACO to define and execute a transformational palliative care vision for the West Michigan region. My efforts have been focused on defining and developing the 3-year, strategic healthcare plan to align system clinical and operational objectives and execute a coordinated approach to deliver access to high-quality care for patients in vulnerable populations and communities.

I joined the Trinity Health system to lead the growth, development, and optimization of specialized programs in palliative medicine ▶️ HOW I TRANSFORMED REGIONAL PALLIATIVE MEDICINE Community-Based Palliative Care | Created a regional multi-stakeholder team that strengthened Mercy's market position for the top 5% of high-cost ACO patients in a regional palliative care program leading 17 clinical FTEs, two acute care hospitals with multiple ambulatory palliative care clinics ⚕️ Recovered eight figures over four years by developing programs that captured 12,500 new consults from 300-bed acute care hospitals. ⚕️ Yielded joint venture with a local hospice to present the program to a state commercial insurance for a 7-figure grant ⚕️ Enrolled ~95 beneficiaries and reduced the total cost of care by 20%, netting 7-figures in savings Emergency Department Palliative Care | Established a committee that defined and introduced protocols to place palliative care clinicians in ED, hospital, and ICU settings within an hour of requested consult time. ⚕️ Saved 6 figures within 1st year of implementation ⚕️ Avoided 17 unnecessary hospital admission and hospice transmission events COVID-19 | Developed an integrated palliative care strategy into the pandemic planning, which included alternative forms of treatment, such as telemedicine, death and bereavement support, and symptom management training. ▶️ HOW I INFLUENCED HEALTHCARE OUTCOMES I identified and seized upon opportunities to integrate palliative care models in other critical healthcare areas. ⚕ Introduced care and business models to support the expansion of neuro-palliative care and oncology ambulatory clinics ⚕ Developed institutional rigorous palliative sedation policy for the terminally ill As a Physician Leader, I have driven palliative care-focused initiatives to reduce clinical variation and enhance utilization management, care coordination, clinical ethics standards, and physician education.

In addition to my Mercy Health duties, I also serve as a Clinical Assistant Professor at Michigan State University. While I provide clinical skills training and educational oversight to aspiring medical professionals, I am also focused on identifying high-performing students as potential residents to join the Palliative & Supportive Care Program.

After finishing my hospice & palliative medicine fellowship, I had the opportunity to build a brand new 24/7, inpatient palliative care program from the ground up. ▶️ HOW I INJECTED A CULTURE OF PALLIATIVE MEDICINE This experience challenged me in all the elements that come with healthcare program development and setting impeccable standards in clinical excellence, quality improvement, and physician engagement. My leadership was instrumental in identifying, developing, and implementing population-based health policies and forging key relationships with hospice organizations. ⚕ Achieved +70% transition rates to hospice and community-based palliative care services ⚕ Facilitated +85% MOLST penetration across the palliative care consulting process ⚕ Set the stage for YOY improvements in national quality metrics and growth penetration ⚕ Recruited and trained clinical staff in holistic approaches to end-of-life care ▶️ HOW I INFLUENCED HEALTHCARE OUTCOMES My leadership paved the way for additional transformation to continually support the palliative care function while enabling cross-over into other operational areas. ⚕ Advocated for futility and DNI/DNR policies to improve communication in end-of-life care discussions ⚕ Saved operational and utilization costs by incorporating palliative medicine into ICU, Oncology, Hospitalist, and ED ⚕ Mentored 5 NPs as a Preceptor in pain management, hospice, home care, and other critical palliative care elements I championed and develop a new hospital PCA policy for opioid naive and tolerant patients seeking improvement initiatives. Also as committee chair and council member on 5 committees, which strengthened the palliative care component, while refining service coordination and clinical quality and efficiency outcomes.

My experience as a Fellow in hospice and palliative medicine at the Cleveland Clinic served as an excellent and enriching world-class training ground in hospice & palliative care, from addressing the physical symptoms of pain, and spiritual impacts on patient's suffering and their loved ones. During this time, I studied with national and international palliative leaders, where I researched and developed academic work to increment the evidence of the field of palliative care.

After immigrating to the US, I was accepted into an internal medicine residency program at the Good Samaritan Hospital, the largest private teaching, and specialty healthcare center in Cincinnati, OH. Over 3 years, I gained valuable experience in all aspects of internal medicine by working directly with physicians, nurses, and patients and their families in the ward and ICU. My leadership, work ethic, and accountability caught attention, in combination with my consistently high evaluations and reviews from both patients and physicians. ▶️ MY TOP CONTRIBUTIONS ⚕ Selected as Chief Resident in 2010 and earned the Best Resident Teaching award in 2011