Pittsburgh-based UPMC Western Psychiatric Hospital ranked No. 7 on U.S. News & World Report’s 2026-27 Best Hospitals for Psychiatry list, released Aug. 4. It was one of 17 hospitals nationwide recognized in the specialty.
The rankings are based on three years of surveys asking physician specialists which hospitals they would trust with their sickest patients.
Kenneth Nash, MD, chief of clinical services at UPMC Western Psychiatric Hospital, shared with Becker’s the leadership principles, operational changes and metrics behind the hospital’s performance, and the challenges he expects to define psychiatric leadership over the next three to five years.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: In your view, what separates a truly high-performing hospital psychiatry department from the rest?
Dr. Kenneth Nash: The biggest differentiator is workforce and physician leadership development. High-performing departments get the right people in the right roles and create a culture in which psychiatrists, nurses, social workers, psychologists, therapists, milieu staff, peer support specialists and other team members are working toward the same goals.
That requires a shared understanding of the environment we want to create and how we want patients and families to experience their care. It also requires timely feedback, particularly hearing directly from patients and front-line staff about their experience and getting that information back to front-line teams.
Finally, a high-performing psychiatric hospital cannot operate in a vacuum. There needs to be excellent communication with referral sources and with the clinicians and programs receiving patients after discharge. One of our strengths has been developing ambulatory services that are closely integrated with inpatient care while also maintaining strong relationships with providers outside our formal system. Transitions into and out of the hospital are critical points in psychiatric care.
Q: What operational priorities have had the greatest impact on your department’s success over the past few years?
KN: One of the most important has been getting better information into the hands of the people providing care. That includes patient feedback as well as clinical and operational data — prescribing patterns, diagnostic patterns, outcomes, safety measures and other information that helps front-line teams understand how they are performing.
The second is having a mechanism for rapidly translating evolving evidence and best practices into everyday clinical care. Data are only useful if they lead to learning and changes in practice.
Q: What are two or three leadership principles that guide how you lead your psychiatry team?
KN: I would go with three principles:
Develop your people. Find what individuals are good at and passionate about and, whenever possible, align their work with those interests. Someone passionate about psychosis, addiction, child psychiatry or another population is much more likely to build expertise and provide exceptional care when given the opportunity to develop in that area.
Put patients first and build teams around them. Psychiatric care is inherently multidisciplinary. Good communication and mutual respect across disciplines are essential.
Create a culture of continuous learning. One of our strengths is that our academic and clinical missions are closely connected. Teaching, learning, research and clinical care reinforce each other. That creates an environment where people are continually improving, and ultimately that benefits patients.
Q: Which behavioral health metrics tell you the most about whether your department is performing well, and why?
KN: There is no one measure to capture the quality of mental healthcare — and there is a need for improved development nationally on defining and applying the “right” tools for measurement-based care. We deeply appreciate that many organizations default to the legacy metrics used for physical health hospitals (e.g., length of stay, mortality, readmission rates), but those measures may not be the best ways to assess behavioral outcomes.
As an example, “restraints and seclusions” are a key measure of relevant avoidable events in inpatient settings — rivaling outcome for certain [healthcare-associated infections] that may be rare in psychiatric hospitals. There is opportunity in assessing the continuity of care during transitions and between episodes of care. There are opportunities related to improving staff safety.
What has been more valuable is creating transparency around our metrics and engaging the entire team and, when possible, patients in understanding what those measures are telling us. We look across patient experience, quality, safety, clinical and operational measures and, importantly, look at trends over time rather than isolated numbers.
Benchmarking is also increasingly important. We are fortunate to have multiple psychiatric units within our own health system, which gives us opportunities to compare performance and learn from one another. But I think we need to continue expanding that externally, comparing ourselves with national benchmarks when they are available and talking directly with leaders of other high-performing psychiatric programs about what they measure and what they are learning.
Q: What’s one operational change your team has made that produced a meaningful improvement in patient care, safety or efficiency?
KN: One of our most meaningful operational changes has been developing Patient Safety and Quality Reviews, or PSQRs, across our different levels of care. These bring multidisciplinary teams together monthly to review safety and quality data, individual events and longer-term trends.
Importantly, the PSQR process doesn’t end when we identify a problem. When we introduce a new initiative or intervention, we continue to follow the patient, and follow the data across settings, to determine whether it actually improved care and safety for patients and staff. That creates an ongoing cycle of identifying problems, making changes, measuring the impact and adjusting when necessary.
I would add another important component: Our leaders stay connected to the actual clinical environment. Our physician leaders continue to provide inpatient coverage, including weekday and weekend responsibilities. Members of our executive team also spend substantial time on the units through executive rounding, talking directly with patients and front-line staff.
That direct exposure matters. Data can tell you that something is happening; being on the unit helps you understand why it is happening. Combining the PSQR process with leaders who remain clinically connected has allowed us to make more meaningful and practical changes in patient safety and patient care.
One important change within the hospital has been creating a more consistently structured and safe inpatient environment. That includes reliable observation practices, predictable treatment-team processes, regular rounding, therapeutic groups and clearly defined daily structure.
In psychiatric inpatient care, these things can appear basic, but reliability matters enormously. When they happen consistently — not just most of the time — they improve safety, communication, engagement and the overall patient experience.
Q: What challenge do you think will define psychiatric/behavioral health leadership over the next three to five years?
KN: First, we need to respond rapidly to changes in the clinical population. The increase in substance-related psychiatric illness, including cannabis-associated psychosis, is one example of how the patients coming into hospitals are changing.
Second, we need to think beyond formal psychiatric treatment to the social supports and community networks patients need to succeed after hospitalization. Excellent inpatient treatment has limited impact if patients leave without the relationships and supports necessary to sustain their recovery. This includes a need to better understand and connect patients to nonclinical social services that may be available in community-based organizations.
Third, workforce development will remain a major challenge. We need to expose people to inpatient psychiatry early in their training and create environments where talented clinicians see psychiatric hospital work as an exciting and rewarding place to build a career.
Q: What’s one piece of advice you’d give another psychiatry leader working to build an exceptional behavioral health department?
KN: Take the long view. It is easy in hospital operations to become focused on the immediate problem and the quick fix. Sometimes that is necessary, but repeatedly solving problems only for the short term can actually weaken an organization over time.
Building an exceptional psychiatric department requires sustained investment in people, leadership, culture, teamwork and systems of care. Developing the workforce takes longer, but ultimately it is the workforce that creates and sustains excellence.
You cannot operationally engineer your way to excellence without investing in the people who provide the care.
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