Dani:

Welcome back to The Handoff, the podcast for nurse leadersfrom the team at Trusted Health. I'm Dr. Dani Bowie, our Chief Nursing Officer.Today we're sharing the inspiring story of Lavender. A nurse founded a nurseoperated mental health practice that emerged during the height of the pandemicin 2020. We'll explore how the founders, Dr. Pritma Dhillon-Chattha, and Dr.Brighid Gannon swiftly launched their innovative business model, which combinedpsychiatry and therapy. In one telehealth appointment, they've grown the remotepractice to serve tens of thousands of clients each month. Today, we'll heartheir take on the future of nursing and the need for flexibility, thechallenges and benefits of remote work, and the importance of embracing changein the healthcare industry. Welcome to the Handoff. We're excited to have aconversation today with Dr. Pritma Dhillon-Chattha, and Dr. Bridget Gannon. Welcome guys.

Pritma:

Thank you so much for having us. We're excited to be herewith our fellow alumni.

Dani:

I know I was really excited about this podcast. You guyshave been great friends and colleagues of mine through our Yale DNP program,and I've been watching your career over the last three to four years and theinnovation that both of you have taken head on in the industry and transformed.So I'd really love to share with our listeners today a bit more about whatyou've been doing with Lavender and the model of work that you've beendeploying for the nurses at Lavender and beyond.

Bridget:

We're ready.

Dani:

Perfect. Yeah, if you want to share a bit more Bridgetabout the model at Lavender and what that is for our listeners who may notknow.

Bridget:

Sure. I feel like Prima always does a story really well,but I'll, I'll try my best. So Prima and I started founded Lavender in theheight of the pandemic in May, 2020. And we basically kept hearing from peoplethat they really needed mental health resources and there was not a mentalhealth practice that was really accessible and took health insurance and wasresponsive and kind in every interaction with clients. So we launched in 45days and we, our team is nurse founded and nurse operated. We provide carethrough our psychiatric nurse practitioners that all work remotely. Um, it'sity psychiatry, and we provide psychotherapy and medication management in thesame appointment, which is quite unusual for mental health. Typically, youwould see a therapist and see a prescriber separately. So it's really helped toreduce siloed care. It's also much more cost effective for, for clients andmore efficient for them. Right, because they're not having to see twodifferent, uh, providers.

Dani:

First of all, one, how did you launch in 45 days? I mean,that, that is amazing. And just the acceleration of innovation to actuallyimple implementation. I would love to learn a little bit more about that. Andthen also, how did you come up with the model of care around, you know,ensuring that there was delivery of both elements that are needed versus havingto, you know, split up and silo the care for mental health?

Pritma:

It started very small. It started with just Bridget and I,and that was actually, it started in very dire straits. Bridget and I were veryscared in March of 2020. Bridget's business closed down, my business closeddown, and I was actually standing in my clinic in an empty shop that was shutdown, sweeping the floor and called Bridget and said, you know, we need to dosomething online. That's our next step. Um, we weren't business partners at thetime, but we are always in conversation about what are we doing next? How canwe support nurses? We have this idea about the next business we do. Maybe wewanna do a franchise model and do a business in a box, because nurses arealways asking us, how do we become entrepreneurs? How do we move forward withour ideas? And we thought, you know, if we could help them do that.

Um, so we were in those conversations, but in that momentwe're like, we need to do something online and it should be psychiatry andtherapy, because there's gonna be a huge need for that. And literally afterthat phone call was done, we said, okay, let's get to work. And we didn't knowwhen we would launch. We didn't know what we were doing. I started looking atEMRs and policies and things like that, and Bridget started looking at clinicalprocedures and we talked to her staff from her other business to see if theycould be redeployed if we launched this business. And we basically built theplane as we flew it. It was one step at a time, one foot after the other. Wedidn't even look at costs. You know, we, we each put in $6,000 and that was thesum, total sum of our investment in lavender. No vc, no money, no loans,nothing. Um, have never put a penny more in. And it's been amazing. It's been incredible.But guess what, had we not started and just closed our eyes and gone for it, wewouldn't be here today. So it's been very difficult. I can't say it's beeneasy, but I think it just takes us that push to start. So yeah, that's kind ofhow we did it in 45 days and we closed the first month with one appointment<laugh>. So,

You know, it starts very small and it continues to grow.But we've relied on a lot of peers and mentors along the way. We researcheverything online. Everything's available online. We have a great group offriends and a great network, including you, Dani, that we can rely on foradvice and consultation. So rely on your peers. They're so smart. They're oftensmarter than you.

Dani:

I'm impressed with the story of, I've often heard likeneed is the mother of invention. Hmm. And so it, it, it allows you to look andsee like, what's the need and where do we need to go? And so hearing yourjourney of faith, even of just going in, you had a need and a need that wasbroader than just even your immediate professional need. But for a communityand for service within healthcare, that was a true need as well is is quiteinspiring. Now the second question was around the model and how you decided tocome up with the model of care that you deliver, which Bridget had mentionedwas, was a combining of two elements that typically are two differentappointments. And so, you know, what caused you to design that way? And, and isthere any limitation in that type of design? Because I like to understand, youknow, models of care. And also was there any type of flexibility or thoughtbehind how you were designing some of those models?

Bridget:

When we were kind of doing an environmental scan of howpeople access mental health services, it's difficult enough to find anyprovider. So to define two is even more impossible. It's within a psych and pscope to provide psychotherapy, but they just aren't utilized like that.They're utilized as med management machines because those are what, those arethe highest billing codes. So, you know, companies make more money when theyutilize nurse practitioners in a strictly men management model. So we thought,why don't we think of this differently? Why don't we use an psych and p totheir full scope and allow them to provide therapy in the same appointment?There's no reason that they shouldn't. Um, and it's been really interesting.Nurse practitioners that we interview with don't have other opportunities likethis. I know very few practices except for private practice where you can, theycan flex their psychotherapy muscles as we like to say, you know, for somepsych and PEs it's very uncomfortable and it's not really something that theywanna do. But we, at lavender, you know, our nurse practitioners really wannaspend a lot of face-to-face time with clients. They don't wanna just meet withthem 15 minutes once a month.

Pritma:

I think what's also interesting and, and what contributedto our model was that Bridget is a psychiatric nurse practitioner, whereas I amnot, I am, my background is in, uh, health informatics and entrepreneurship.And so bringing us together and, and as we were founding the company anddeveloping all these processes, it was really interesting cuz I'd ask hardquestions about the clinical process and she'd ask hard questions about theoperational process and things that were typically just standard and customaryand we don't know why. But it requires someone else outside of that expertiseto ask, well, why is it the way it is? So another thing that's different orunique about our model is that our appointments are 20, 40 and 60 minutes inlength and the client can choose what length they want and month over monthbecause we ask the question as to why are therapy or psychiatry appointments,why are they always a standard 45 minutes or 60 minutes every month or everytwo weeks? Why can't they be different? And we couldn't really find the answer,so we said, let's just try it. And it's been really successful.

Dani:

I I was gonna mention that when, when we started talkingthat you guys were like match made in heaven with your backgrounds, right? Techand entrepreneurship and then it with your clinical expertise and the, the waythat you also manage your own businesses. Um, so I loved seeing you guys come together.I love also hearing that you're providing flexibility to the patients and whatthey choose, right? They get to drive the way that they interact with you,which is a really powerful concept. And then also giving your clinicians top oflicensure experience, which is amazing. And that is another form of thatflexibility and autonomy that often I hear, you know, people talking aboutprimarily on the inpatient side. As we think about leaders, often we know thatour nurses and our nurse leaders are not operating to the top of leisinger justdue to the models of care. And sometimes the documentation burden to

Bridget:

Add to that, you know, one of, I think the reasons ourpsych NPS really like the work is that there's flexibility in their day. Youknow, they'll see a patient for an hour and that's a very different feelingthan seeing a patient for 20 minutes at the next appointment. So their brain ischallenged differently throughout the day, which I think is one of the reasonsnurses become nurse leaders, right? They don't, they wanna be able to havefocused quiet project work and they wanna be able to manage and be in meetings.And you have differences throughout the day. And I think for clinicians, one ofthe reasons they burn out is that they're doing the same thing over and overagain and it can be very taxing. So they have a lot of flexibility in terms ofthe types of patients they treat and the the types of care that they provide.And I think it's really helped, I think it's really helped them not burn out asquickly with care, with patient care.

Dani:

Yeah, I I think that's a really good call out. And burnouthas been, uh, a topic of mine for many health systems and something that we'vebeen trending here at Trusted. We, we looked at the mental health of our nursesto understand, you know, how are they faring in conditions post pandemic anddiscovering they're not recovering the way that they were even pre pandemicwas, was not at a good state. And some of the, the concepts or the things thatthey're looking for is flexibility and autonomy. Um, which I think is a goodpoint is the diversity of experience creates that as well. Now we know your,your nurses all work from home. What have you heard from them about some of theadvantages or maybe disadvantages of this? Uh, and what are some of themisconceptions? This is a really hot trending topic about working from home andwould love your guys' perspective on leading teams in that space.

Pritma:

I've been working from home actually since 2014, so almosta decade now. And it has a lot of misconceptions. And I remember even back inthe day before Covid, people used to say, oh, you work from home, that must beso nice. You must be getting your laundry done and getting your meals cookedand you know, everything else in between. And I thought, gosh, they have noidea. <laugh>. Um, working from home is you often end up being moreproductive and busier and I find that you're in back to back meetings that youdon't have a moment to step away from your desk. So there's a lot ofmisconceptions around what the workday looks like, particularly if you're in anenvironment that's driven by appointments or meetings, a lot of that time isnot your own time. It's meeting time, appointment time for her and peace.

There's a big misconception around that. Sometimes it'staken a little bit too casually. So to be successful to work from home, youreally do need to make it a workspace. And that's not something that's justextra or fluffy. It's, it's a necessity. So just like in the, in the office youhave a sit-stand station, you have a desk that's ergonomic and it's proper. Youhave multiple screens, you have a wireless keyboard, you have your laptop up ona stand, you have a headphone. You need all of that in order to stay healthy atwork and stay focused, um, and be more productive. And so that's, you know, we,we teach a lot of these concepts in our onboarding program, uh, to ensure thatpeople are set up for success in their workstation and they're not workingfrom, you know, a temporary spot. It needs to be a fixated spot in their homeand it needs to be separated from their personal life because it could getdraining. You don't want to be working in your bedroom where you're alsosleeping cuz then you won't be able to sleep. You're gonna be thinking aboutwork. There needs to be that separation between work and home. And if someoneis to work from home on a full-time basis, surely they need to do that and theyneed to do that very quickly within the first four weeks. Otherwise it can bevery difficult to navigate, um, a balance in in your life. So I think that'sthe biggest misconception that I find.

Dani:

Uh, I appreciate that, especially you being a veteran, uh,pandemic is really what accelerated me into the work from home. And you have toadapt your mindset. And I agree, setting up that separate space to really focusis key. Um, and ability to like stand or sit or move is also important.

Bridget:

Yeah, I mean I think, I think, um, it can be like a littleisolating. I think people don't anticipate how isolating working from home canbe specifically for our nurse practitioners. They can't go like knock on theircolleague's door, right? And just say, Hey, like, what do you think about thiscase? Or Have you ever had this side effect with the medication? All that kindof like informal mentorship. You know, we probably, all three of us probablyhad people that we worked with as nurses that were not, our bosses are reallyformally our mentors, but really mentored us, right? Mm-hmm.<affirmative> because we were with them in person. So at Lavender wereally, especially for the new graduates, we have to be really intentionalabout setting up mentorship time because they don't get, there's nobody forthem to ask while they're working. So I think people don't anticipate theisolation. I think also the relationship building is harder with your team whenyou don't, um, see each other in person. So, um, I know even for Primo we'rereally intentional about making sure that we see each other in personthroughout the year because there's just something that magical happens whenyou, when you spend time together. In person terms of the positives, I feellike we're getting really negative about the work proposal.

Dani:

<laugh>. Yeah, yeah,

Bridget:

Yeah. Like the positives are that you can wear your pajamapants and you can, you know, you, you just have to get dressed from like thewaist up. Um, I feel very efficient. Like I can, like treatments said, get somuch done, you know, I can like squeeze a workout online in between meetings,which you would normally never be able to do if you were working in an office.You save time in your life not having to commute, which is really fantastic.Um, I think for like our moms and dads on the team, you know, they get tosqueeze in little hugs and kisses. Yes. Um, which is really special, you know,to do that throughout the day. So

Pritma:

Especially even for new moms, we have a lot of new moms onthe team. Um, and that transition back to work is really hard. And so it'sactually a lot easier in a remote environment where, and, and even on anongoing basis, like the comfort I feel knowing I'm just downstairs and my kidsare upstairs with the nanny that, you know, it's, it's comfort. I know that ifthere was anything going on, I'm here. So, and, and particularly for newborns,I think that's really great.

Dani:

You guys have done a really thoughtful job in how toonboard and the support needed to address both the pros and cons of work fromhome. I would say I am an advocate for, uh, you know, the sweatpants that youget to wear <laugh> <laugh>, it's like this Seinfeld episode, likeI gave up on life. I'm in sweatpants, but I'm not because the top isprofessional, um, <laugh>. So, you know, but like I, I really, uh, admirethe mindfulness and the approach that you have taken to create an environmentthat helps breed success in a new environment for our clinicians and, um, the,the profession of nursing in general. Um, now what are some of the challengesthat nurses face as they're moving from maybe a salary model to being a 10 99employee? Uh, and what advice do you usually give them as they're getting thatset up? Which I, and you may wanna add a bit more about the lavender model, ifthat's the model that you're, um, working under at Lavender, if you can.

Pritma:

Yeah, for sure. So all of our, uh, clinicians, all of ournurse practitioners are 10 99 contractors. And that's the typical model, um,within the medical community within physicians. And it's relatively new,however, to nurse practitioners. So there is definitely a learning curve andwe've tried a, a variety of strategies. We've had one pagers, we've, you know,now we're actually talking about other things that we can do on onboarding,whether it's supporting them set up a corporation or, you know, getting someguidance from an accountant or, you know, a partner. It's an ongoing thing thatwe're continuing to address to help our nurse practitioners be successfulbecause in the 10 99 model, you can be very successful and there's very,there's a significant amount of advantages of being a 10 99 contractor versusan employee. And what finding is that our staff aren't taking advantage of alot of those opportunities. And so we are constantly trying to figure out howwe can help them take better advantage from day one and not, you know, threemonths in or six months in or a year in. Do you have anything? Yeah, I mean,

Bridget:

And I would say like the major opportunities arefinancial. Like you can save legally save a lot of money on taxes. And as Primasaid, one of what we realized a few weeks ago is our nurse practitioners arenot benefiting as much as they, they should. They're actually tonight at five30, we hook them up with an accountant who specializes in 10 99. So they're,they're, they're doing an in-service on that. I've been a 10 99 since 2013. Iwas the only person at the shelter who was employed as a 10 99. And Inegotiated that because I didn't need health benefits. I was healthy and I, youknow, I, I understood the tax code and I wanted to get as many, um, deductionsas possible. I mean, tho those were like the main benefits I think as taxes.I'm trying to think of other benefits as a 10 99.

Dani:

Yep, absolutely. I what I'm hearing is you're, you're settingup your employees to truly be as well entrepreneurs business owners. Yeah. Likethey're managing their destiny in a way that historically and traditionally thenursing profession has not been taught mm-hmm. <affirmative>. And so Ithink that that's wonderful and there is a lot of tax advantages to the 10 99model and being able to kind of set the course of your destiny and, and youknow, being able to, instead of be at cost, like we talked about inpatientnursing, when the workforce is a cost associated with the room, you're actuallya service. And that's a amazing transformation. So it sounds like you'rereplicating this mindset that you both had as, uh, strong entrepreneurs andbusiness leaders into your workforce at Lavender, which is tremendous.

Pritma:

And one of the reasons we wanted to go with the 10 99model was because when we were thinking about lavender and what we wanted to dofor not just clients, but for nurses, is we wanted to give nurses flexibilityand autonomy on their schedules. So we don't dictate our staff schedule at all.They build it according to how many hours they want to work per week and whatthat shift actually looks like. So they start, some of them work Monday, someof them work Thursday, some of them work, you know, they start at seven, somestart at two, some like, there's no set start or end time. There's no, we'reopen seven days a week. So nurses can, or NPS can, can make their schedule asit's suitable for them. At first it was completely kind of limitless. Um, but aswe grew, the one restriction we did pose, because it became very difficult tomanage headcount was a minimum number of hours per week. So we have implemented20 hours minimum per week, um, that they need to commit to lavender if theywanna join. But beyond that, it's quite flexible. And that's worked really,really well.

Dani:

That's a common theme that I've seen as well with theflexibility is, uh, starting limitless and then recognizing what is the, theability to run ops and ensure that you have the right coverage for the needs.Um, and so then putting in some, you know, expectation around work requirementssuch as, for instance, in the inpatient, which that's really where my mindsetgoes is like, you, we will have you work one shift every 30 days is ourexpectation. And that's just the, and you can work more beyond that, but expectjust maintain competency and, and, uh, things like that.

Bridget:

We also found with engagement, you know, and culturemm-hmm. <affirmative>, it's very difficult to feel like you're a part ofa company or an organization when you're only working like one day every threemonths. Right. So from an engagement and cultural perspective, we felt that 20hours a week was sort of the soft, the sweet spot. Um, because we, you know,we're a community of nurses. We have a really active slack community. We wantpeople engaged, we want people supporting each other. That was another reasonwe had a minimum hours.

Dani:

That makes sense. And, uh, would continue to love to talkto you guys a year from now and hear the transformation of lavender and thegrowth and, and the new things that you're doing. Um, so do you guys have anypredictions about what nursing will look like in the future? And this can be,you know, at the bedside remote work. Obviously you guys have created a newfuture, I think in the space of, of nursing and the model that you're providingfor mental health. But would love to hear your guys' thoughts on that.

Pritma:

I'm excited for the future of nursing. I think nurses arefinally getting their voice and they're speaking up and they're becominginnovators and they know that they're innovators. We always were. It's just wethought that we were, we had to be told that we're innovators. But, so now nurnurses are naturally taking that position and I think roles are gonnadramatically change and it's due time that it changes, right? Nursing and theway we work in our models have not changed for a century. And it's ripe timethat they do. And, and we need to change it at a lightning pace at this point.Staffing models are gonna be very different hopefully in the next five years,if not 10 years. And hybrid is gonna be very common. I think many nursingpositions will be remote and many will be hybrid. And you know, even in terms ofscheduling, I think we're gonna turn it on its end and we're gonna do a lotmore self-scheduling and a lot more flexibility, or at least that's what weshould do and we need to adopt it. We need to just take the risk, take theplunge and do it. Um, and I don't know how many more signs we need from nursesthat it needs to be done, but yeah, that's what I think the future will hold. Ithink it, it will be more flexible and more open and empathetic to the nurse.

Bridget:

I think it has to be, I mean I, you know, like I, nursesare in so in such high demand and they're demanding flexibility and more peoplewanna work from home and the industry has to respond to that or they won't getpeople to work for them. So like, it has to be a more flexible hybrid model, um,of nurses working from home. Yeah, I agree. Prima.

Pritma:

I think we also have to think about the way we work andthe benefits for nurses and clinicians in general and, and iterate as quicklyas we do for clients. Clients demand access, they demand transparency, theydemand empathy and flexibility, and that's what clinicians demand. And so justlike we're constantly thinking about how do we improve care for our, for ourclients, we call our patients clients because they're high functioning membersof the community and we don't want to label them with the term patient atlavender. And so I'm used to saying client, but um, you know, we wanna innovatefor clients every single day and improve their care. And as hospitals andhealthcare systems and clinics and offices, we should be doing the same for ourclinicians, our our colleagues. And so, you know, this year we're particularlylooking at how do we, you know, for those that aren't on the front lines, likemyself and Bridget, and a lot of people are our ops team, um, our clients areour colleagues and that's our nurse practitioners, it's other departments andwe need to treat them like our patients. And if they're happy and healthy, ourpatients will be happy and healthy. We've all heard that before, right? But weactually need to deliver on that.

Dani:

Yeah, I think that's a really great perspective ofessentially like who's your customer in a, in a way mm-hmm. <affirmative>and shifting the mindset of nurses and your clinicians who are the customer.Um, I've led a lot of staffing offices and hospitals and that was always how Iwould train my team is that the nurse managers and the nurses are yourcustomers and we're here to give 'em a great experience around staffing. Nowwas it as a flexible as we wanted? No, when we were really pushing the limit onwhat technology can do. And, and I am hopeful too that we will move into thespace of true flexibility and tech enabled staffing and scheduling in a new waythat's driven autonomously by the user versus dictated by, you know, a verytraditional models of like seven to seven shifts. Or this is when you have toadminister and do all of your tasks that then dictate how we schedule you.

And so I'm hopeful that we will innovate and change. Irecently heard a, a quote, um, from a leader that said, you know, there was awar on talent and talent has won. So the talent, meaning your clinicians, yournurses, they've won. And we need to respond to that as leaders in healthcare,uh, and listen and then invest the right way with people, process andtechnology to uh, accelerate the innovation. We've talked a lot aboutflexibility. I just wanna touch a little bit more on like what does flexibilitymean to you as a nurse leader? We've talked about your team at Lavender, howyou've been leading from this, this space. It's very holistic. Uh, and ifthere's any other pieces of wisdom that you wanna share with your readersaround, uh, the listeners around what flexibility means to you as a nurseleader that we haven't touched on? Uh, please, please do.

Bridget:

Can I sort of by coastal life? <laugh>. So I meanfor me it's being able to live in Los Angeles and New York, it's reallyimportant and how could I have done that? Right. Not working remotely, youknow, I also think, not that I do this a lot, but it's nice to sometimes take ameeting while I'm walking my dog outside. That's really special and remarkable.I think being able to, you know, even though I don't actually do this and I'venever this, just knowing that the option to like if I wanted to move to Italyfor a month and work from Italy is there just psychologically I think knowingthat you have that freedom is very, uh, comforting to me even though I've neveractually done it.

Pritma:

You may not have done it, but we do have a nurse, we havean NP who lives in Spain. We have another NP who lives in Bangalore. Yes. Um,so we do have NPS around the world and, and that's very special and very cool.Um, yeah, I personally, flexibility for me is, um, you know, I'm a mom and Ilike the flexibility of being able to pick up my kids and drop off my kids andtake them to lessons and things like that in the middle of my day as I need to,and, and book that in. And, and our, our operation staff have the sameflexibility as do our mps where they can block their schedule and, and do whatthey need to do cuz it's not, you know, punch in, punch out. It's, you know,the productivity and the quality of your work, not the hours that you commit toit.

So, uh, that's really important for me, uh, as a leader.And what's the other thing that's even more important for me is that we takeour work seriously, but we don't take ourselves seriously. So we have a verycasual culture where sometimes we swear, sometimes <laugh>, you know, um,we're not so polished and proper all the time, but you know, when you actuallylook at, when you, when you open the doors, look at our policies and ourprocesses. We are years ahead of the game, um, for what a startup would be twoyears along, along because we do have that rigor and we started with thatrigor. Bridget and I always wanted proper policies and procedures andcompliance programs and everything in place because when we do something, wewanna do it right. But that doesn't mean that we have to be stuffy on the phoneor on on our video calls and, you know, we, we wanna be able to make mistakesand learn from them and we wanna be able to admit to them because we're allhuman. And that's what I really love about working with Bridget and<laugh> and working with our team

Bridget:

And that it makes me think Prima like that's such a greatpoint in the sense I don't think that kind of intimacy happens when you work inthe office always. Cuz like we're seeing each other in each other's homes.Right. You know, and sometimes like somebody's kid will be on their lap orlike, we have one mp, Melissa has all the, all these cat beds behind her andher cats are constantly like behind her. And I feel like there is this, eventhough you're not in person and you don't get that kind of connection, I thinkbecause you're seeing your colleagues in their home, you kind of have like amore intimate relationship with them, which is really nice. And I think peoplefeel very comfortable to be themselves more than they would in an office.

Dani:

Mm-hmm. <affirmative>. Yeah. I I think that's a,that's a really good point that I didn't think about, which is the intimacy ofseeing someone in their space that they called their home. Even if it is atransformed work from home office, it still has elements of animals that comein that you didn't want them to come in or, you know, spouses, kids e etcetera. And really what I'm hearing too is authenticity prma as you describe,you know, open to conversation and we, you know, you have polish and properprocedures and your, you're doing it the right way, uh, clinically and how youlead your teams, but the human element of being able to share yourself and yourlearnings along the way with the authentic, uh, communication is, is reallyinspiring. Exactly.

Pritma:

Yeah. You, you know, taking that home environment, andwe've actually heard that from our NPSs as well cuz we get that question askeda lot is how do NPS find it meeting with their, with their clients online? Andhow is it more or less difficult to develop raport, um, and a therapeuticrelationship? And every time we hear that, it's actually quicker in developinga therapeutic relationship in Raport because I get to see them in their homeenvironment. Um, I get to see their surroundings and they're in a comfortablespace that they can open up and more easily speak is what we hear across theboard. So that's been really interesting.

Dani:

We're getting close to the end. I just wanna ask a couplemore questions. What would you recommend for health systems to stay up ontrends regarding flexibility or innovation? Any advice for our leaders whomaybe aren't in the space that you're in but are leading our health systems andlooking to continue to innovate and just making sure that they can stay aheadof the curve or reach up to the curve?

Pritma:

I think healthcare systems need to have a startup mindset.I think every year, every quarter is different for healthcare systems, just asit is for startups. They're growing equally as fast and um, living in the sameworld. That's grow, that's changing faster than we've ever experienced itbefore. So if they don't keep up, they're gonna be left behind and that's noless likely for a large healthcare system than it is for a startup. Uh, soreally having that nimble startup mindset, and again, I've, I've said thisbefore, not just for the client, but for your most valued asset, your ownpeople, they are just as equal as the patient and the client. So I think that'ssometimes often the piece that's missing is, you know, having that nimblemindset and, and trimming away some of the fatty processes that develop overtime.

Bridget:

I think also, I prima alluded to this in the beginning, Ithink bringing people onto your team that don't work in healthcare so they can challengeyou to think differently about why we do things the way we do them. I think inhealthcare tend to just do them like Prima said in the very beginning of thisconversation because we've always done them that way. And I think it's reallyhelpful to bring in other people from other industries to make you thinkdifferently. And I think looking to other industries because um, you know,healthcare is tends to be a little bit behind, you know, like other industrieshave been doing remote work for 15 years and we're sort of catching up now.

Pritma:

It's funny, Dr. Dan Weiberg just posted about this theother day about how healthcare often looks to the airline industry and we didfor many, many years. Yeah. From a safety perspective. But do we still continuelooking to them? You know, many would say not right <laugh>,<laugh>, um, not about bash the the airline industry, but you know, um,Bridget and I often look to the hotel industry. We want to provide the level ofcare that you would get at a five store hotel but at an affordable price. Sothat concierge level of service and care that is unheard of in mental health.And wouldn't that be amazing When you're at your lowest, someone helps andsupports you and gets you the care that you need and talks to you like, like anempathetic human who understands what you're going through and gets you towhere you need, gets you booked and, and is accessible.

Right. And so we always, you know, in all all of ourmeetings internally or or otherwise, you know, we talk, talk about what is thestandard and, and sometimes we are just talking about this today, you know, thestandard wait time if someone's late for an appointment typically is 10minutes. And we're like, but we're not the standard. We need to go above and beyondthat. We need to wait for 15 or 20 minutes or whatever it might be. Um, sowe're always looking to do better than what the standard is cuz the standard isthe minimum standard. Yes.

Dani:

Hospitality is a great industry to look at the hotelindustry and, and, and actually I believe the hcaps I, from what I recall hcapssurvey was based more off of a hospitality survey like the hotel industry. Um,and that is the premise is patient experience and how to ensure that yourpatients are getting the right experience when they're on the inpatientsetting.

Bridget:

And we, we actually we're the patients, the client surveythat we're doing is based is a modified HCAP survey. Um, and the reason wechose that is because we wanted it to be really based on the client journey andexperience. Um, because you don't have to, you don't have to compete forpatients and mental health or such a human need, but that doesn't mean that youshouldn't compete. Like what would care look like in mental health andpsychiatry if you had to compete for patients

Dani:

Yeah.

Bridget:

Would look very different. I think.

Dani:

I agree

Bridget:

It would look like lavender. No self-promotion. I know<laugh>

Dani:

<laugh>

Bridget:

But maybe you can keep that in there. I don't, I don'tknow. You should.

Dani:

Uh, that should be in there. It would look like lavender.It, it's the truth. You're coming in. That's the beauty of, of the country thatwe're living in and the way that we can start to provide care, um, to patientsand innovate and compete, you know, for the best. But I wanna end with whatwould you like to hand off to our listeners? We really like to in leave to ourlisteners like that one piece of wisdom or final nugget of truth that you wantthem to walk away with, uh, in any aspect, you know, healthcare, personal. Andso I would just love to hear from both of you what you'd like to hand off toour listeners today.

Bridget:

I think the one, the thing I would repeat and I'm sort ofconflicting myself is I do think that nurse leaders should make sure tointentionally make time to bring their teams, uh, together in person at leastonce a year. I think it makes a huge, huge difference in terms of workingeffectively as a team and, and building community and building a cohesive team.I think it's, you know, in some ways the remote work is intimate because likeyou were talking about you, you see someone in their home and it's veryinformal but there is something really magical that happens when you spend timewith somebody in person. And this is literally from treatment I knowing thisand we make a lot of in intentional opportunities to bring our team in person.Like the relationships with the nurse practitioners that we've met in personare very different than the relationships I have with the nurse practitionersthat I haven't had an opportunity yet to meet in person.

Pritma:

Yeah, and I think what's really important about that inperson meeting, and particularly for us cuz we're all remote, but even in thefuture hybrid world, the future is hybrid, but even in a hybrid future there'sgonna be missed opportunities of interaction between teams, across teams, amongpeers, um, and there needs to be opportunities for teams to collaborate andinteract across departments. So what I find is beautiful is when our nursepractitioners get to connect with our concierge team, our front desk kind ofreception staff, um, it's so important for them to build those relationshipsand not be siloed. Cuz oftentimes in healthcare settings you kind of end upworking against each other, like you're on two separate teams working acrosspurposes when really your purpose is the same. Um, but what's missing is theunderstanding of rationale behind standard operating procedures and the waythings are done.

And so I think that's really important is building thoseoperations together and really letting nurses, allowing nurses the time and thespace and the opportunity to understand why things are the way they are. So youmight not be making the the decision that is going to land best with nurses,but nurses are really great at understanding if they're given an opportunity tolearn the information as to what went into that decision making. So, um, I findthat that's often missing. Uh, and so the more opportunities that are given tonot only nurses, but all staff to really understand what went on behind thedecision is really important and, uh, will, will create greater engagement.

Dani:

Thank you so much, Primo and Bridget for your time here onthe handoff. It was so valuable and insightful, um, and I really look forwardto watching Lavender grow and continue to win in the industry in this newspace. More to come, I'm sure in the future and, uh, I look forward tohopefully another interview, maybe a year from now to hear some moretransformation of what you're doing.

Bridget:

Thank you Dani.

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