Richard (Rick) J. Gannotta is a Senior Lecturer of Health Administration at NYU’s Robert F. Wagner Graduate School of Public Service.
He is the Chief Healthcare Administrative Officer at Masimo, a global technology company that develops and manufactures a variety of innovative noninvasive patient monitoring technology and clinical solution sets designed to improve patient outcomes and reduce the cost of care. In his role Rick is charged with advancing the organizations clinical strategy, hospital and health system partnerships and key product initiatives.
Prior to joining Masimo, Gannotta was the chief executive officer of the UCI Health System where he oversaw Orange County’s only academic medical center and the associated clinical and patient-serving operations, including the UCI Medical Center in Orange and ambulatory sites across the county. Before that, he was senior vice president of hospitals at New York’s NYC Health + Hospitals, the nation’s largest public healthcare system. He also held roles as president of Chicago’s Northwestern Memorial Hospital, where he led hospital operations and worked closely with the leadership of Northwestern University’s Feinberg School of Medicine, and as president at Duke Raleigh Hospital, part of the Duke University Health System, and North Carolina-based WakeMed Health & Hospitals.
Gannotta’s areas of research interest include the economic impact of alternative models of care, patient safety, high reliability systems and healthcare disrupters. His academic affiliations include teaching at the undergraduate and graduate levels.
Gannotta received his bachelor of nursing science and nurse practitioner degrees from Florida International University. He earned a master of business administration from Campbell University in North Carolina, a doctorate in healthcare administration from the Medical University of South Carolina and was a Johnson & Johnson Fellow for Nurse Executives at the Wharton School of the University of Pennsylvania.
Objectives: Simulation-based mastery learning (SBML) programs have been shown to be beneficial to improve procedural skill acquisition. However, simulated procedure performance can be affected by a host of factors, including stress. This investigation examined the preliminary efficacy of bolstering an established SBML program for medical residents with a brief mindfulness intervention (called a PITSTOP) to reduce procedural stress and improve simulator performance.
Design: The study employed a partially blinded, parallel-group, randomized, repeated-measures intention-to-treat design. Participants were blinded to the primary outcome (simulator performance) and instead were informed of the study's secondary outcome (stress prevention). The SBML faculty instructors and study investigators were blinded to participants' group assignment.
Settings/location: Northwestern Memorial Hospitals of Chicago.
Subjects: Twenty-six postgraduate year (PGY) 1 internal medicine residents enrolled in a required SBML central venous catheter (CVC) insertion training from June 2015 to January 2018 participated in the study.
Interventions: SBML consists of a simulated skills pretest, deliberate practice, and a simulated skills post-test (within 1 week of pretest). PGY 1 participants were randomly assigned to the PITSTOP intervention (12-min PITSTOP mindfulness training video) or control group (12-min control video on ways to increase physical activity) before the SBML pretest.
Outcome measures: The primary outcome was a comparison of each group's simulator performance during pre- and post-tests. Secondary outcomes were changes in groups' procedural stress during these tests (assessed using self-reported, instructor-rated, and physiologic indicators), and self-reported self-regulation outcomes.
Results: Residents who watched the PITSTOP video before their SBML training made fewer procedural errors relative to controls during their pretest for intrajugular CVC insertion (p = 0.03). PITSTOP participants also had lower heart rate (p = 0.03) and less visible trembling (p = 0.003) relative to controls at the post-test.
Conclusions: This study provides preliminary evidence that a brief, mindfulness intervention may reduce stress during SBML training.