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Episode 97: Embracing Innovation and Driving Change in Healthcare

May 10, 2023

Episode 97: Embracing Innovation and Driving Change in Healthcare

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May 10, 2023

Episode 97: Embracing Innovation and Driving Change in Healthcare

May 10, 2023

Dani:

Welcome to the Handoff, the podcast for nurse leaders from Trusted Health. I'm Dr. Dani Bowie. I'm thrilled to share my conversation with Dr. Bryan Sisk. Bryan is the Senior Vice President and Chief Nursing Executive at Memorial Hermann Health System, and he shares his insights on embracing innovation and driving change in the healthcare industry. We'll dive into the exciting work that's happening at Memorial Hermann Nursing Institute, exploring their community-centric approach, and discuss the crucial roles nurses play as problem solvers and innovators in healthcare today. Bryan, welcome to the Handoff.

Bryan:

Well, thank you so much. I'm incredibly happy about the opportunity to spend an hour or so with you today.

Dani:

Bryan, I wanna jump into it and just start helping our listeners understand a bit more about who you are and your professional journey. So if you could tell our listeners a little bit more about your professional background and journey and how you got to where you are today.

Bryan:

I look back and I'm so fortunate to have worked in, you know, all models of healthcare just about with some really amazing people. Started my nursing career in the military as a computer programmer, transitioned into nursing best decision ever for me, cuz I absolutely love being a nurse. Retired after a 20 year short stent in the military and a lot of amazing opportunities in that system. I wouldn't have traded that for anything. And you know, that in that period of my life, I really discovered something about myself that I don't know that I fully appreciated until kind of now. And that's, I'm incredibly mission driven. So I transitioned from the army into the VA health system as in their ambulatory footprint. A c and o. C and o was in that system a total about 10 years. Then moved to an incredible opportunity with H C A was with them in the for-profit world, both at their corporate office and at their system level for about four years. And then how could you not take an opportunity when Memorial Hermann established this role? I saw that as just, yeah, that really is the opportunity. Kind of been looking for my whole life to be honest with you. And was fortunate enough to to be here. And I've been here for about a year.

Dani:

Wow. The stars aligning and I am so intrigued by your background, computer science through military and then for-profit, not-for-profit. It's quite diverse and unique and probably gives you some really important perspective, I think for healthcare in general. And I just love hearing your mission-driven approach. Now, considering your diverse background, both non-nursing, military, private, you know, all these different sectors that you mentioned. As you think about your journey, are there any unique programs or nursing initiatives that you found to be particularly impactful or interesting as you went throughout your career?

Bryan:

Yeah, there, there's so many. You know, in thinking about that, I'll dive into one that really developed over a period of years started with my military background, cuz where I ended my military background is I had the opportunity to really work alongside and build capabilities and drive outcomes with nurses from all over the world. Not just with the US Army, but with our Allied Nations. Looking at how they develop strategies based on populations, how we intervened in health systems. And again, doing that all over the world really opened my eyes to the capabilities of what nurses can be as true professionals and being partners in some of these incredibly complex situation. And, you know, it didn't matter the environment. They're working in incredibly austere environments as you can imagine, all the way to these tertiary quaternary really complex urban type environments.

And so, looking at the world from really a different lens of the nursing perspective, had the capability to say, Hey, you know, as nurses, we had the opportunity to change lives, not only just at the individual at the bedside, but we can impact entire communities. So when I transitioned into the va had the opportunity to find a couple of people that really believed in the vision of, you know, dealing with populations and making an impact on a bigger scale. We started a small two person population health nurse-led clinic, if you will. The outcomes were amazing and over a period of years that really blossomed into a multidisciplinary integrated case management process. Don't want to try to take credit for what the, the VA's integrated care management program has become. But I do like to think that our efforts from that time where we started with a two person shop to, you know, over 50, that the outcomes were so amazing that we helped spark innovation, spread modernization throughout the whole VA system, and really proud of two of those leaders that were part of that original MO model, Dorothy and Rachel, they have continued to lead those efforts all over the country.

And so, you know, really buying into that something that we can start small produce the outcomes is a really good example of what nurses bring to the table. Dorothy being the nurse Rachel's actually a social worker who is actually a big part of, of building that multidisciplinary team on, on how we work together, deliver outcomes that not only just improve what we're doing at a health system level, but ultimately really can impact populations not just for your community, but all over the, all over the country.

Dani:

That's amazing. And I did not know that you had such a global view of nursing and I'd be so interested to just have a conversation for an hour about what you learned, you know, around the world and, and the nursing profession in, in different cultures and countries. The integrated model that you developed as I was listening to that, I loved hearing how you started small and then built and refined the process and are and allowed for that innovation with, you know, it sounded like true P D C A and obviously I also heard the alignment of mission driven and, and community health. You know, I want to focus a bit more also on, on the work that you're doing presently. I know that as you mentioned in your intro as the System c Memorial Hermann, you know, that was the role that you have been looking for throughout your career and it's a perfect fit for you. And can you share a bit more about the nursing vision and core principles that you're living by and, and leading through at Memorial Hermann?

Bryan:

Yeah, AB a absolutely, this is you know, Memorial Hermann, it had to brag on the system just a little bit. You know, we were a community owned healthcare entity. We're the largest provider of healthcare in our region. So we feel like we have, we have a true duty to our community and to, to operate in a way that actually builds healthier communities now and for generations to come. And so, a little bit about our health system. You know, we have around 12,000 nurses and the dedication to excellence is, is amazing. And we have multiple Beacon awards, lantern awards you know, our Salute to Nurses, which is a thing the Houston Chronicle does that really highlights nursing excellence in our communities. We have over 70 nurses that were recognized this year out of 200 five in the top 15. And then at the same time, incredibly proud to say we have eight magnet designated facilities.

If you just take a look at that, soon to be nine, we have number nine right in the cross areas that we're, we're chasing down as we speak. But, but if you just take a look at that you know, there is a reason where you see, you know, some of the, the Joint commission accreditations, the US news reports and things, there's a reason that our system consistently shows up in, in multiple, and I think that it has a lot to do with, we as a system are committed to excellence. But I'm more proud to say that as nursing, we're committed to that. And I think it's incredibly important that we leverage that. And so what we've done here is really work hard to elevate the voice of nursing. And as we have gone around through our surveys direct conversations with, with different nurse leaders and frontline nurses, rounding all the things we've done to really make sure that we're taking a, a shot at giving every voice an opportunity to be heard and then really acting on that.

So we've really come up with three things that have been pervasive. It is grow, excel, and reimagine. So we have bucketed our nursing strategy based on the input from the nurses. And those three, when we talk about grow, we're talking about optimizing clinical education efforts, advancing opportunities, different talent strategies, and then how we align with our academic partners to make sure that true career progressions available at all levels in our Excel space. We're talking about our professional practice, and that's where you see a lot of the outcomes of that, where the excelling in the magnet designations. We have a transition to practice program that is accredited with a accolades through the A N C C and a lot of the other industry recognitions. And then our advocacy platform. We took 80 nurses to the capitol just a few weeks ago to advocate for the workplace violence bills and for tuition reimbursement.

Those bills are moving nicely through the process at this moment. I'd like to think that, that the voice of our nurses had something to do with not only impacting our community, but Texas in general. And then, you know, in our re-imagined space really taking a look at, we've heard loud and clear we need to reimagine acute care and in particular med surg and what type of innovation and inquiry can we bring to that environment where we're looking at safety and wellbeing and building our nursing brand in that space where you can be a bed surge nurse and have all of the things that we can offer and deliver excellent care, be a part of the team, and do that maybe in a dual role, like with an academic partner or a professional practice partner or maybe with a robot. And it's really kinda looking at all of those types of things and delivering them to the bedside nurse, but delivering the things that they find valuable. And I think that's what's incredibly important is we talk about all of this strategy. It really is about elevating the voice of the nurse, what is valuable in that space, and then how can we wrap services around that to make sure that we, we had the best potential for those things to come to fruition.

Dani:

As I listened to this you know, you're talking a lot about elevating the voice of the nurse, and I was just really impressed by the example of taking 80 nurses to do advocacy work both in the, in the sense of safety and other initiatives at hand. And what a, a beautiful example of magni magnifying the nurse's voice at a national level to impact specifically what's important to their profession. I've, in my career, I've helped some help systems develop some strategic plans, and I really like how you've created those three categories. Do you have any insights into, as you develop this plan with, you know, these pillars and then you build programs into it? Are you setting this up at a, like two to five year mark? Is there specific KPIs or ways that you're trying to continue to show success and improvement with the, with your strategic plan associated with these, these three core principles?

Bryan:

Yeah, so I'll, I'll talk about one in particular. Because I really think that in healthcare in general, when you take a look at entry into healthcare as a profession we know that we have lots of vacancies all over, right? And we're not seeing just a flood of entrance into these application pools. And so some of that is, you know, some of the press that has been with Covid over the last few years. The other is, as we talk to some of the high schoolers who have no exposure to a healthcare environment, they look at that building and say, Hey, that's a big building. How do I go apply? I don't even know what jobs are in that building, right? And so, so as we look at our strategy, there are, there are things we've gotta look at in all levels. Number one, how do we take a look at the pipeline coming into healthcare?

How do we support that? And you, we hear a lot about working with high schoolers and giving them exposures and things like that. We think it's much bigger than that because I still think there is a barrier of an 18 year old coming outta high school and walking into an acute care environment and having the tools they need to be successful. So I think we gotta look at that differently, right? We gotta look at, you know, how do we build units that would support that type of growth where somebody can start in that environment? Or do we have the opportunity to really start them? Most of our prep high schools are really geared for somebody to go to college, but can we create an opportunity that is more about, well, I don't necessarily want to go to college now, but how do I get into healthcare, see what it is I want to do, but be on a pathway where I can go to college and then ultimately we would pay the tuition.

And so that really requires us to, to think differently with our academic partners. And we have some amazing things underway that happy to come back some other time and, and talk about what the outcomes of those are. But it really is, if I have an amazing patient care technician in one of my units, comes to work every day, smiled, patients love them, but to go to nursing school, it's four days a week. And if they've gotta work three days a week to put food on the table for their families, something doesn't, the math doesn't work in a favorable way for that. And so, so we've gotta look differently about how we partner with our academic partners to open up these opportunities. We are actively involved in that. And and then at the same time is as an l vn, how do I then do the same thing to get my RN and then as an individual, as an RN with an associate's degree, and I want to get my bachelor's degree, how do we open up those doors?

And so I think a lot of work we're doing right now is aligning those partnerships. We're doing no cost, tuition reimbursement a lot of those things to make sure we're, we're modifying our job descriptions, we're doing a lot of things in those areas based on direct feedback from our, from our frontline, again, at all levels. And then taking that, then really taking a look at how can we as a system align our jobs and our duties differently? And then how do we bring in our academic partners with some very clear expectations of this is what we really need to have in place for the individuals who work in the system to be successful.

Dani:

That is a, a, a differing approach that I, I haven't really heard in, in that I have heard of programs around, you know introduction of high school students to healthcare. But what I like hearing is how to make that a good experience and a successful experience, because I would agree, the tool sets you need and the skills you need to be able to enter into the complex space of healthcare, usually you're not adequately equipped as you are graduating high school. And even as a new nurse, I know when I started it was quite overwhelming. And so I, I think the approach that you're taking of looking at this holistically for success and sustainability of your workforce is something that I would to love, learn more about as you continue to grow those programs and show how you're helping the workforce move through, you know, building the pipeline is key. I am intrigued to know also kind of your retention metrics. I mean, you touched on this, but a bit about bringing the workforce in and helping them grow through their career. I heard career progression from LPN to rn. I also heard a little bit about flexibility, which we'll talk on in just a second. Scheduling, how do you align scheduling to match this, this personal personal growth and professional growth but any retention strategies at play to continue to also retain the workforce that you are working really hard to recruit and design?

Bryan:

Yeah, so here I'd had to really take an opportunity to brag on our transition to practice program. You know, in that program it's, there's several of these in the market, right? But we're really proud of ours. Number one, that it, we are accredited through the A N C C, which is a pretty rigorous process. But as we have brought individuals in, again, doing the initial upfront work, having discussions, really aligning their onboarding to what their needs are what we've seen as a system is, is we have upwards of 80% retention in that cohort, which is, is something for us to be really proud of. Honestly, I hadn't seen numbers like that before. So it's, it's, you know, that is working. And so how do we take that same type of approach into a patient care technician, into an lvn? Those are all things that we're actively exploring because I do think you know, in healthcare, we're hiring more people than we ever have just in general. But at the same time, our, our retention, if we don't get that under control, it's equally as important as bringing talent in. In fact, I would say it's more important. So putting a lot of energy in into how do we retain career growth and then wrapping services around individuals. So they wanna stay with your health system.

Dani:

Yeah. Which I'm guessing that's under kind of your Excel opportunity as well, and your, your grow, and then Excel. I wanna also speak to the reimagine. And, and we, we've talked a little bit about this. So you touched on it, you know, I'm doing this podcast to talk to leaders around flexibility, what it means to the workforce that you're leading, what it means to you as a leader. And it really then lends itself into like, what is the future of nursing. But Bryan, from your perspective as a nurse and a nurse leader, what do you think flexibility means to the nurses that you're leading and to you and the leaders that are in charge of those tho serving those nurses?

Bryan:

Yeah, one of the things that I have to say is, is when we talk about flexibility, you know, we tend in the industry to get locked right in the schedule, right? And, and I think it's much bigger than that. And, you know, we've got some wonderful HR partners in our system leaders as we're looking at this, we think it's much bigger than that. It's, it's about, you know, the skills of, of lifestyle management, your physical health, your nutrition financing skills, you know, your community, your social wellbeing, your career mobility, emotional health. It's all of those things. It's about where you are in life. And then how do we bring things to you? Again, scheduling incredibly important. Certainly don't want to underestimate how important that is because that does allow you to kinda align your life. But there's all these other stressors that, you know, as we have an incredibly mobile workforce, now, how do we wrap these things around you in a way that you can get to them, right?

So it's not that you have to come to a clinic, but how do you have access through things like apps and, you know, 24 hour hotlines and things like that so you have access to them when you need them, versus the traditional model that, you know, I think we've all worked with over the years where the clinic is open from eight to four, and if you need something give us a call during that window. So what we have noticed is when we, when we talk about flexibility, it's much bigger than that. And so, again, getting this information came directly from our workforce, you know, so we didn't, we didn't make this up. This is something that we have spent a lot of energy collecting the voice and then reacting to that and really kind of delivering on things that matter.

Dani:

Yeah. How did you get, get the voice of the nurse? Was it through surveys? Was it listening tours? I'm sure our leaders would, and and listeners would love to know kind of what your strategy was, because you are, this is a theme I'm hearing through this conversation. It's community focused, but also the voice of the nurse that's informing your strategic plan priorities and the way that you're serving as a leader. So what did you do to help get the voice of the nurse to, you know, the executive table as you think about these strategic plans and building out programs?

Bryan:

So it it, it gets back to, you mentioned a few of them. We do a lot of surveys right in, in different, different facets. But what I really want to talk more about from the nursing side is our, our professional practice nurse shared governance, because I think that is ultimately is just a wealth of information. So you have individuals at the frontline who are really leading the charge on how we deliver on nursing practice. And in under the magnet principles, it's not just about nursing, it's about workplace and everybody being bought into, we're gonna deliver excellence and this is our bar. And so you get that bar from talking to your front line. And by creating this really robust shared governance committee, we're able to really glean a lot of information from them. So when we take a look at, you know, we've initiated like a military style challenge coins for those who impact our system through some of the practice innovation work they've done.

So as we developed that recognition program, you know, old school method, we would've just kind of put that into practice and moved on. But the way we prefer to do that is to give them those things and say, Hey, how, how do you think this would be the most meaningful way to do this type of experience? What would, what would be the best way to do that? And, and we let them develop it. And then when they bring that forward, then we work as a system to make sure that we can execute on that and, and take that forward. So that, that's really what I think is, is one of our strengths, you know, with having so many magnet designated facilities. I think that is just an outcome of the amazing work that, that our governance committees are doing.

Dani:

Yeah, I was gonna say, I'm not surprised that you are moving towards, you know, a ninth hospital getting magnet designated, as I heard your strong shared practice council and and governance, which is a key foundation for magnet. So that's really exciting. And I think something that is a model that, you know, creates sustainable change. And it's me both the full spectrum of who needs to be involved in these types of changes, which is definitely the frontline, the frontline leader. They are the boots on the ground and carrying it out. And so hearing that a lot of the solutions come from those that are doing the work, and then your leadership team and executives, you know, giving the resources and clearing the path to make this reality is just a phenomenal model. What are your thoughts about the future of nursing? And as you talked about reimagine as one of your core principles for Memorial Hermann, a strategic vision for nursing, you mentioned just briefly a little bit about the med-surg space a little bit of emergence of dual roles, and can you elaborate a bit more on your thoughts on that and what, and what you were implying when you talked a bit about the med-surg space and these dual roles?

Bryan:

Yeah, so I think I need to back up just a little bit, because to be a leader in this space, we have to have individuals who are committed to a vision like this, right? And I, and I have to say, none of this happens without our amazing leadership at our facility level. And I would be remiss if I did not call out our chief nursing officers, cause I do think we have the best in the industry, bar none. And, and they have really bought into, if we're gonna do things differently, you know, being an innovator isn't always the easy space to live in. So we realize if we're going to be an innovator, we're gonna have to, you know, think about things differently and stretch differently. And then how do we rely on each other across the market to, to make sure that as we align in this space, that things we're doing replicate, right?

And so, so one of the things that we have done in that space is that we think about what the future of nursing is. And especially in the med-surg space is one of the things they put on the table early on is, is we need a nursing institute. And so what we have done is, I'm very proud to say that, that we have launched our nursing institute officially as of January now, we'll have the messaging like the Big bang, we'll go out around nurses week. Cause I think it's just an amazing story. But under our nursing institute, what we're looking at is how do we elevate the nursing profession everything from excellence to wellbeing and be the national leader. How do we accelerate that innovation to the bedside? So we have amazing nurse leaders in our facility. How do we wrap the services around them so they can move fast, right?

But purposeful at the same time, because what we learned in Covid, I'm a big fan of I believe innovation fatigue is real. We had a lot of things thrown at the bedside during Covid. And I think that, you know, we, we want to make sure that we're avoiding that, oh, here's the one more thing and it's gonna create work for me, right? But that's because the model was backwards. If we take a look at what the bedside nurse and our nurses, le nurse leaders at the facility are looking for, and then we answer that question, it is not one more thing. This is something I can get behind and if it works, awesome. If it doesn't, dude, we try. And so I think that's, that's the difference in messaging. Cause we really leverage that workforce differently and then that helps us to excel in our outcomes and our operations and everything that we're doing.

And so as we take a look at how do we reimagine med-surg, a lot of the ideas that we've heard that have been put on the table are, I really like med-surg, but, but it's a hard environment to work. And so how do we answer the question of maybe I can work one day as a faculty member for one of our academic partners and then two days on that same unit as a staff member. And you think about the incredible continuity we would have because what we tend to see with, you know, multiple schools rotating through, through our different environments is none of the hospitals in our market do things the same. And so individuals are constantly bombarded with how we do business versus somebody else in the market. And so you just take a look at how can we create continuity and open up opportunities and extend somebody's career in med-surg. These are some of the things that we're really taking a look at is how do we create these dual type roles where we can do some of these things because we think it would be great for students and it would also be great for our facility as we create that pipeline that truly gets, gets to know us as a system at the same time, you know, really buys into our culture about how we deliver that type of care at the highest level to, to everybody who walks in the door.

Dani:

That approach I think is gonna be really important in the days ahead, specifically, you know, as we look at the workforce that may potentially retire. And is there a way we know the advisory board, there's the, the potential knowledge gap that comes with retiring workforce. And so extension of the career and that knowledge, institutional knowledge, but also practice knowledge that's so important for our health systems and coming up with unique ways of engaging, such as dual roles like faculty or med-surg. I've worked with some other health systems that have been like mentor and preceptor and then one day med-surg. So I think being able to create that diversity of experience for those that are looking to continue to practice, but maybe just not in the extensive way that it was of the past is gonna be really powerful. The nursing institute, you, you briefly mentioned that what exactly is the nursing institute? What, what does that encompass? You know, you mentioned that's gonna be launched during the nurses week, which is coming up soon, the impactful work of your CNOs at every hospital and leaders at the frontline. But I'm just curious if you can share a little bit more about what the nursing institute at Memorial Harmon is.

Bryan:

Yeah, so the way we look at the nursing institute is, you know, it really is an accelerator, right? So we have so many things that are coming down the pipe. You know, healthcare is evolving at a pace that it's stressful and energizing all at the same time, right? <Laugh>, yeah, it suck <laugh>, but we take a look at the nursing innovation. Really the current model is based on, you know, a leader kind of wrapping their, their arms around a PI project or if you're going to the evidence-based practice route, really like struggling with the question, kind of gathering the resources around it, executing it, and then getting those outcomes really kind of all lands in their laugh on how we get those outcomes and then scale them across the system. The way we're taking a look at the nursing institute is how do we bring these wraparound services to that individual who's interested in innovation and, and really, you know, give them the playbook on, hey, let's measure things this way and can we actually do that measurement for you versus you spending your time there cuz you're delivering direct patient care.

That's what we want you to do. We want you to do that at a high level, but at the same time, we want to help you get through some of this innovation because when we know that's important to you, it's important to us certainly too, right? And so how do we wrap these services around? It may be a less intense P D C A type exercise or it may be all the way to some of the things we're looking at that'll be true nursing research. And so we actually have some nurse scientists aligned up under our nursing institute to help with things like designing research and then how do we execute on that and making sure that we stay aligned with the research question. So it really provides the whole gamut of services and as we look at technology, even the, the list on looking at technology, by the time you get through vendors and the security and all the things that it takes to make that happen, really want to take that as much off the facilities as we can because we think that actually puts us in a much better spot to be innovative than if we kind of follow the traditional way of, of handling some of those things that we've done in the industry for a hundred years.

Right?

Dani:

Yeah. Where you can accelerate, please do. We know that it takes 17 years on average to get, you know, new evidence and to practice by that point, it's not new anymore, but practice transformation is a bit of a lift. And so the nursing institute sounds like something that can help bring innovation and accelerate that. One last question. You talk a lot about wraparound services and so would that be the support of those that you have in the nursing institute, like nursing scientists or others to help kind of guide those that are a part of it around, you know, the process, whether it is a PD C cycle or a true nursing research or leading a project. Is that how you would define kind of those wraparound services? Cuz I've heard you mention that a lot and it's kind of a new hearing.

Bryan:

Yeah, yeah, absolutely. And this is what we're growing into. You know, it's new, but this is exactly what we're growing into is, is what we're asking right now as we have brought in a couple of nurse scientists to actually help with some of these early, early initiatives that we've already identified. But it really is what type of service do you need? Is it a data need? And so we have an individual in the nursing institute who is aligned with delivering some of that data. We have a nurse scientist to the nursing institute who's helping with, you know, the questions and you know, not everybody knows how to write scientifically if you're, if you're, you know, and so bringing some of those expertise to the table so that we can help with that.

Dani:

I wish I had some wraparound services, sometimes I, that would've been really helpful in my career. A lot of proud by fire in some of the learnings. And so your ability to help support the nurses at Memorial Hermann with these types of support structures is phenomenal. You know, I know Memorial Hermann is a very community-centric organization. You're committed to serving your local communities. Can you share a a bit more about unique programs or initiatives that you have in place to help accomplish this mission-driven purpose that Memorial Hermann has?

Bryan:

Yeah, you know, I'm so proud to be in a system. You know, we, you know, in our community contribution or are running around 470 billion and that does, that does so much in our communities. We have, you know, about a dozen or so free clinics in the market. We all that include some of our school-based health clinics. A lot of initiatives around exercise and recreation. We're doing a lot of with the restoration of parks. And at the same time is, you know, taking a look at, you know, how do we align differently? And I talked about our, our, our real, our real drive to look at making education more accessible. But it just is an amazing, just amazing to sit back and take a look at, you know, all the opportunities we have as a system our size to really to take a look at a system that's our size and the impact that we have.

You take a look at our Southwest Hospital, we have committed to being an anchor institution. And what that means is we are gonna hire from the community that surrounds our hospital. We're gonna be dedicated to making that possible. So that's where we've done a lot of the energy we talked about earlier as far as looking at our job descriptions, removing barriers to entry as a healthcare. And what that really does for us is, is we'll have to have the services to make those things, you know, successful. So it really is full circle because then the individual who is coming from the communities part of the healthcare team and is making our community healthier and at the same time delivering excellence at the bedside,

Dani:

That is really an impactful model of, and, you know, the community approach, you're really holistic in how you're, you're looking at health, which we know it's not just the entry point to a hospital or even a doctor's visit. It's, it's friends, family, lifestyle, you know, professional opportunities, academic spiritual, you know, all these components that make us, make us human. And being able to impact in, in different ways before someone enters into a, a acute facility or a doctor's offices. Really a forward thinking mindset. And I'm, I can see now why you said the stars aligned with joining Memorial Hermann and your background in some of the work that you had done with population health prior and leading in in that space. Bryan, this has been really insightful and I think inspiring as I listen to the mission driven approach that you and your leaders at Memorial Herman are taking. As a final question, I would just love to know, you know, what would you like to hand off to our listeners today?

Bryan:

Yeah, so, you know, we talked a lot about healthcare evolving and I think that, you know, we really need to embrace that and, and lean into the opportunity that is being presented every day as far as innovation goes. This space is wide open for nurses and to be leaders in this space. You know, there's a reason that we are consistently rated as the top trusted profession. I think it's time to add innovation to that. So it really should be nurses, trusted innovators all rolled into one. And I think the opportunity is sitting right here in our lap. We just gotta own it.

Dani:

I love it. Yes, I would agree. Innovators, problem solvers, and I mean, it's what they, what we do every day when we care for patients or communities, and the time is now. And it, it sounds like you're, you and your team is leading the charge in this space. I would love to check back in, in a year or so and hear how everything's going. I really appreciate your time today, Bryan, and thank you and your leaders at Memorial Hermann for how you're serving your communities with health, but also with new ways of operating to sustain and change healthcare.

Bryan:

Oh, thank you for letting me spend some time with you today. It's been a pleasure.

Description

Dani speaks with Bryan Sisk, Senior Vice President and Chief Nursing Executive at Memorial Hermann Health System, to discuss their transformative work in the healthcare industry. Bryan shares insights about the Memorial Hermann Nursing Institute, which is designed to accelerate innovation and support nurses in their professional development. He also highlights their community-centric approach, with a focus on impacting health holistically through unique programs, initiatives, and partnerships. Bryan calls for nurses to embrace their roles as innovators and problem solvers in the ever-evolving healthcare landscape.

Transcript

Dani:

Welcome to the Handoff, the podcast for nurse leaders from Trusted Health. I'm Dr. Dani Bowie. I'm thrilled to share my conversation with Dr. Bryan Sisk. Bryan is the Senior Vice President and Chief Nursing Executive at Memorial Hermann Health System, and he shares his insights on embracing innovation and driving change in the healthcare industry. We'll dive into the exciting work that's happening at Memorial Hermann Nursing Institute, exploring their community-centric approach, and discuss the crucial roles nurses play as problem solvers and innovators in healthcare today. Bryan, welcome to the Handoff.

Bryan:

Well, thank you so much. I'm incredibly happy about the opportunity to spend an hour or so with you today.

Dani:

Bryan, I wanna jump into it and just start helping our listeners understand a bit more about who you are and your professional journey. So if you could tell our listeners a little bit more about your professional background and journey and how you got to where you are today.

Bryan:

I look back and I'm so fortunate to have worked in, you know, all models of healthcare just about with some really amazing people. Started my nursing career in the military as a computer programmer, transitioned into nursing best decision ever for me, cuz I absolutely love being a nurse. Retired after a 20 year short stent in the military and a lot of amazing opportunities in that system. I wouldn't have traded that for anything. And you know, that in that period of my life, I really discovered something about myself that I don't know that I fully appreciated until kind of now. And that's, I'm incredibly mission driven. So I transitioned from the army into the VA health system as in their ambulatory footprint. A c and o. C and o was in that system a total about 10 years. Then moved to an incredible opportunity with H C A was with them in the for-profit world, both at their corporate office and at their system level for about four years. And then how could you not take an opportunity when Memorial Hermann established this role? I saw that as just, yeah, that really is the opportunity. Kind of been looking for my whole life to be honest with you. And was fortunate enough to to be here. And I've been here for about a year.

Dani:

Wow. The stars aligning and I am so intrigued by your background, computer science through military and then for-profit, not-for-profit. It's quite diverse and unique and probably gives you some really important perspective, I think for healthcare in general. And I just love hearing your mission-driven approach. Now, considering your diverse background, both non-nursing, military, private, you know, all these different sectors that you mentioned. As you think about your journey, are there any unique programs or nursing initiatives that you found to be particularly impactful or interesting as you went throughout your career?

Bryan:

Yeah, there, there's so many. You know, in thinking about that, I'll dive into one that really developed over a period of years started with my military background, cuz where I ended my military background is I had the opportunity to really work alongside and build capabilities and drive outcomes with nurses from all over the world. Not just with the US Army, but with our Allied Nations. Looking at how they develop strategies based on populations, how we intervened in health systems. And again, doing that all over the world really opened my eyes to the capabilities of what nurses can be as true professionals and being partners in some of these incredibly complex situation. And, you know, it didn't matter the environment. They're working in incredibly austere environments as you can imagine, all the way to these tertiary quaternary really complex urban type environments.

And so, looking at the world from really a different lens of the nursing perspective, had the capability to say, Hey, you know, as nurses, we had the opportunity to change lives, not only just at the individual at the bedside, but we can impact entire communities. So when I transitioned into the va had the opportunity to find a couple of people that really believed in the vision of, you know, dealing with populations and making an impact on a bigger scale. We started a small two person population health nurse-led clinic, if you will. The outcomes were amazing and over a period of years that really blossomed into a multidisciplinary integrated case management process. Don't want to try to take credit for what the, the VA's integrated care management program has become. But I do like to think that our efforts from that time where we started with a two person shop to, you know, over 50, that the outcomes were so amazing that we helped spark innovation, spread modernization throughout the whole VA system, and really proud of two of those leaders that were part of that original MO model, Dorothy and Rachel, they have continued to lead those efforts all over the country.

And so, you know, really buying into that something that we can start small produce the outcomes is a really good example of what nurses bring to the table. Dorothy being the nurse Rachel's actually a social worker who is actually a big part of, of building that multidisciplinary team on, on how we work together, deliver outcomes that not only just improve what we're doing at a health system level, but ultimately really can impact populations not just for your community, but all over the, all over the country.

Dani:

That's amazing. And I did not know that you had such a global view of nursing and I'd be so interested to just have a conversation for an hour about what you learned, you know, around the world and, and the nursing profession in, in different cultures and countries. The integrated model that you developed as I was listening to that, I loved hearing how you started small and then built and refined the process and are and allowed for that innovation with, you know, it sounded like true P D C A and obviously I also heard the alignment of mission driven and, and community health. You know, I want to focus a bit more also on, on the work that you're doing presently. I know that as you mentioned in your intro as the System c Memorial Hermann, you know, that was the role that you have been looking for throughout your career and it's a perfect fit for you. And can you share a bit more about the nursing vision and core principles that you're living by and, and leading through at Memorial Hermann?

Bryan:

Yeah, AB a absolutely, this is you know, Memorial Hermann, it had to brag on the system just a little bit. You know, we were a community owned healthcare entity. We're the largest provider of healthcare in our region. So we feel like we have, we have a true duty to our community and to, to operate in a way that actually builds healthier communities now and for generations to come. And so, a little bit about our health system. You know, we have around 12,000 nurses and the dedication to excellence is, is amazing. And we have multiple Beacon awards, lantern awards you know, our Salute to Nurses, which is a thing the Houston Chronicle does that really highlights nursing excellence in our communities. We have over 70 nurses that were recognized this year out of 200 five in the top 15. And then at the same time, incredibly proud to say we have eight magnet designated facilities.

If you just take a look at that, soon to be nine, we have number nine right in the cross areas that we're, we're chasing down as we speak. But, but if you just take a look at that you know, there is a reason where you see, you know, some of the, the Joint commission accreditations, the US news reports and things, there's a reason that our system consistently shows up in, in multiple, and I think that it has a lot to do with, we as a system are committed to excellence. But I'm more proud to say that as nursing, we're committed to that. And I think it's incredibly important that we leverage that. And so what we've done here is really work hard to elevate the voice of nursing. And as we have gone around through our surveys direct conversations with, with different nurse leaders and frontline nurses, rounding all the things we've done to really make sure that we're taking a, a shot at giving every voice an opportunity to be heard and then really acting on that.

So we've really come up with three things that have been pervasive. It is grow, excel, and reimagine. So we have bucketed our nursing strategy based on the input from the nurses. And those three, when we talk about grow, we're talking about optimizing clinical education efforts, advancing opportunities, different talent strategies, and then how we align with our academic partners to make sure that true career progressions available at all levels in our Excel space. We're talking about our professional practice, and that's where you see a lot of the outcomes of that, where the excelling in the magnet designations. We have a transition to practice program that is accredited with a accolades through the A N C C and a lot of the other industry recognitions. And then our advocacy platform. We took 80 nurses to the capitol just a few weeks ago to advocate for the workplace violence bills and for tuition reimbursement.

Those bills are moving nicely through the process at this moment. I'd like to think that, that the voice of our nurses had something to do with not only impacting our community, but Texas in general. And then, you know, in our re-imagined space really taking a look at, we've heard loud and clear we need to reimagine acute care and in particular med surg and what type of innovation and inquiry can we bring to that environment where we're looking at safety and wellbeing and building our nursing brand in that space where you can be a bed surge nurse and have all of the things that we can offer and deliver excellent care, be a part of the team, and do that maybe in a dual role, like with an academic partner or a professional practice partner or maybe with a robot. And it's really kinda looking at all of those types of things and delivering them to the bedside nurse, but delivering the things that they find valuable. And I think that's what's incredibly important is we talk about all of this strategy. It really is about elevating the voice of the nurse, what is valuable in that space, and then how can we wrap services around that to make sure that we, we had the best potential for those things to come to fruition.

Dani:

As I listened to this you know, you're talking a lot about elevating the voice of the nurse, and I was just really impressed by the example of taking 80 nurses to do advocacy work both in the, in the sense of safety and other initiatives at hand. And what a, a beautiful example of magni magnifying the nurse's voice at a national level to impact specifically what's important to their profession. I've, in my career, I've helped some help systems develop some strategic plans, and I really like how you've created those three categories. Do you have any insights into, as you develop this plan with, you know, these pillars and then you build programs into it? Are you setting this up at a, like two to five year mark? Is there specific KPIs or ways that you're trying to continue to show success and improvement with the, with your strategic plan associated with these, these three core principles?

Bryan:

Yeah, so I'll, I'll talk about one in particular. Because I really think that in healthcare in general, when you take a look at entry into healthcare as a profession we know that we have lots of vacancies all over, right? And we're not seeing just a flood of entrance into these application pools. And so some of that is, you know, some of the press that has been with Covid over the last few years. The other is, as we talk to some of the high schoolers who have no exposure to a healthcare environment, they look at that building and say, Hey, that's a big building. How do I go apply? I don't even know what jobs are in that building, right? And so, so as we look at our strategy, there are, there are things we've gotta look at in all levels. Number one, how do we take a look at the pipeline coming into healthcare?

How do we support that? And you, we hear a lot about working with high schoolers and giving them exposures and things like that. We think it's much bigger than that because I still think there is a barrier of an 18 year old coming outta high school and walking into an acute care environment and having the tools they need to be successful. So I think we gotta look at that differently, right? We gotta look at, you know, how do we build units that would support that type of growth where somebody can start in that environment? Or do we have the opportunity to really start them? Most of our prep high schools are really geared for somebody to go to college, but can we create an opportunity that is more about, well, I don't necessarily want to go to college now, but how do I get into healthcare, see what it is I want to do, but be on a pathway where I can go to college and then ultimately we would pay the tuition.

And so that really requires us to, to think differently with our academic partners. And we have some amazing things underway that happy to come back some other time and, and talk about what the outcomes of those are. But it really is, if I have an amazing patient care technician in one of my units, comes to work every day, smiled, patients love them, but to go to nursing school, it's four days a week. And if they've gotta work three days a week to put food on the table for their families, something doesn't, the math doesn't work in a favorable way for that. And so, so we've gotta look differently about how we partner with our academic partners to open up these opportunities. We are actively involved in that. And and then at the same time is as an l vn, how do I then do the same thing to get my RN and then as an individual, as an RN with an associate's degree, and I want to get my bachelor's degree, how do we open up those doors?

And so I think a lot of work we're doing right now is aligning those partnerships. We're doing no cost, tuition reimbursement a lot of those things to make sure we're, we're modifying our job descriptions, we're doing a lot of things in those areas based on direct feedback from our, from our frontline, again, at all levels. And then taking that, then really taking a look at how can we as a system align our jobs and our duties differently? And then how do we bring in our academic partners with some very clear expectations of this is what we really need to have in place for the individuals who work in the system to be successful.

Dani:

That is a, a, a differing approach that I, I haven't really heard in, in that I have heard of programs around, you know introduction of high school students to healthcare. But what I like hearing is how to make that a good experience and a successful experience, because I would agree, the tool sets you need and the skills you need to be able to enter into the complex space of healthcare, usually you're not adequately equipped as you are graduating high school. And even as a new nurse, I know when I started it was quite overwhelming. And so I, I think the approach that you're taking of looking at this holistically for success and sustainability of your workforce is something that I would to love, learn more about as you continue to grow those programs and show how you're helping the workforce move through, you know, building the pipeline is key. I am intrigued to know also kind of your retention metrics. I mean, you touched on this, but a bit about bringing the workforce in and helping them grow through their career. I heard career progression from LPN to rn. I also heard a little bit about flexibility, which we'll talk on in just a second. Scheduling, how do you align scheduling to match this, this personal personal growth and professional growth but any retention strategies at play to continue to also retain the workforce that you are working really hard to recruit and design?

Bryan:

Yeah, so here I'd had to really take an opportunity to brag on our transition to practice program. You know, in that program it's, there's several of these in the market, right? But we're really proud of ours. Number one, that it, we are accredited through the A N C C, which is a pretty rigorous process. But as we have brought individuals in, again, doing the initial upfront work, having discussions, really aligning their onboarding to what their needs are what we've seen as a system is, is we have upwards of 80% retention in that cohort, which is, is something for us to be really proud of. Honestly, I hadn't seen numbers like that before. So it's, it's, you know, that is working. And so how do we take that same type of approach into a patient care technician, into an lvn? Those are all things that we're actively exploring because I do think you know, in healthcare, we're hiring more people than we ever have just in general. But at the same time, our, our retention, if we don't get that under control, it's equally as important as bringing talent in. In fact, I would say it's more important. So putting a lot of energy in into how do we retain career growth and then wrapping services around individuals. So they wanna stay with your health system.

Dani:

Yeah. Which I'm guessing that's under kind of your Excel opportunity as well, and your, your grow, and then Excel. I wanna also speak to the reimagine. And, and we, we've talked a little bit about this. So you touched on it, you know, I'm doing this podcast to talk to leaders around flexibility, what it means to the workforce that you're leading, what it means to you as a leader. And it really then lends itself into like, what is the future of nursing. But Bryan, from your perspective as a nurse and a nurse leader, what do you think flexibility means to the nurses that you're leading and to you and the leaders that are in charge of those tho serving those nurses?

Bryan:

Yeah, one of the things that I have to say is, is when we talk about flexibility, you know, we tend in the industry to get locked right in the schedule, right? And, and I think it's much bigger than that. And, you know, we've got some wonderful HR partners in our system leaders as we're looking at this, we think it's much bigger than that. It's, it's about, you know, the skills of, of lifestyle management, your physical health, your nutrition financing skills, you know, your community, your social wellbeing, your career mobility, emotional health. It's all of those things. It's about where you are in life. And then how do we bring things to you? Again, scheduling incredibly important. Certainly don't want to underestimate how important that is because that does allow you to kinda align your life. But there's all these other stressors that, you know, as we have an incredibly mobile workforce, now, how do we wrap these things around you in a way that you can get to them, right?

So it's not that you have to come to a clinic, but how do you have access through things like apps and, you know, 24 hour hotlines and things like that so you have access to them when you need them, versus the traditional model that, you know, I think we've all worked with over the years where the clinic is open from eight to four, and if you need something give us a call during that window. So what we have noticed is when we, when we talk about flexibility, it's much bigger than that. And so, again, getting this information came directly from our workforce, you know, so we didn't, we didn't make this up. This is something that we have spent a lot of energy collecting the voice and then reacting to that and really kind of delivering on things that matter.

Dani:

Yeah. How did you get, get the voice of the nurse? Was it through surveys? Was it listening tours? I'm sure our leaders would, and and listeners would love to know kind of what your strategy was, because you are, this is a theme I'm hearing through this conversation. It's community focused, but also the voice of the nurse that's informing your strategic plan priorities and the way that you're serving as a leader. So what did you do to help get the voice of the nurse to, you know, the executive table as you think about these strategic plans and building out programs?

Bryan:

So it it, it gets back to, you mentioned a few of them. We do a lot of surveys right in, in different, different facets. But what I really want to talk more about from the nursing side is our, our professional practice nurse shared governance, because I think that is ultimately is just a wealth of information. So you have individuals at the frontline who are really leading the charge on how we deliver on nursing practice. And in under the magnet principles, it's not just about nursing, it's about workplace and everybody being bought into, we're gonna deliver excellence and this is our bar. And so you get that bar from talking to your front line. And by creating this really robust shared governance committee, we're able to really glean a lot of information from them. So when we take a look at, you know, we've initiated like a military style challenge coins for those who impact our system through some of the practice innovation work they've done.

So as we developed that recognition program, you know, old school method, we would've just kind of put that into practice and moved on. But the way we prefer to do that is to give them those things and say, Hey, how, how do you think this would be the most meaningful way to do this type of experience? What would, what would be the best way to do that? And, and we let them develop it. And then when they bring that forward, then we work as a system to make sure that we can execute on that and, and take that forward. So that, that's really what I think is, is one of our strengths, you know, with having so many magnet designated facilities. I think that is just an outcome of the amazing work that, that our governance committees are doing.

Dani:

Yeah, I was gonna say, I'm not surprised that you are moving towards, you know, a ninth hospital getting magnet designated, as I heard your strong shared practice council and and governance, which is a key foundation for magnet. So that's really exciting. And I think something that is a model that, you know, creates sustainable change. And it's me both the full spectrum of who needs to be involved in these types of changes, which is definitely the frontline, the frontline leader. They are the boots on the ground and carrying it out. And so hearing that a lot of the solutions come from those that are doing the work, and then your leadership team and executives, you know, giving the resources and clearing the path to make this reality is just a phenomenal model. What are your thoughts about the future of nursing? And as you talked about reimagine as one of your core principles for Memorial Hermann, a strategic vision for nursing, you mentioned just briefly a little bit about the med-surg space a little bit of emergence of dual roles, and can you elaborate a bit more on your thoughts on that and what, and what you were implying when you talked a bit about the med-surg space and these dual roles?

Bryan:

Yeah, so I think I need to back up just a little bit, because to be a leader in this space, we have to have individuals who are committed to a vision like this, right? And I, and I have to say, none of this happens without our amazing leadership at our facility level. And I would be remiss if I did not call out our chief nursing officers, cause I do think we have the best in the industry, bar none. And, and they have really bought into, if we're gonna do things differently, you know, being an innovator isn't always the easy space to live in. So we realize if we're going to be an innovator, we're gonna have to, you know, think about things differently and stretch differently. And then how do we rely on each other across the market to, to make sure that as we align in this space, that things we're doing replicate, right?

And so, so one of the things that we have done in that space is that we think about what the future of nursing is. And especially in the med-surg space is one of the things they put on the table early on is, is we need a nursing institute. And so what we have done is, I'm very proud to say that, that we have launched our nursing institute officially as of January now, we'll have the messaging like the Big bang, we'll go out around nurses week. Cause I think it's just an amazing story. But under our nursing institute, what we're looking at is how do we elevate the nursing profession everything from excellence to wellbeing and be the national leader. How do we accelerate that innovation to the bedside? So we have amazing nurse leaders in our facility. How do we wrap the services around them so they can move fast, right?

But purposeful at the same time, because what we learned in Covid, I'm a big fan of I believe innovation fatigue is real. We had a lot of things thrown at the bedside during Covid. And I think that, you know, we, we want to make sure that we're avoiding that, oh, here's the one more thing and it's gonna create work for me, right? But that's because the model was backwards. If we take a look at what the bedside nurse and our nurses, le nurse leaders at the facility are looking for, and then we answer that question, it is not one more thing. This is something I can get behind and if it works, awesome. If it doesn't, dude, we try. And so I think that's, that's the difference in messaging. Cause we really leverage that workforce differently and then that helps us to excel in our outcomes and our operations and everything that we're doing.

And so as we take a look at how do we reimagine med-surg, a lot of the ideas that we've heard that have been put on the table are, I really like med-surg, but, but it's a hard environment to work. And so how do we answer the question of maybe I can work one day as a faculty member for one of our academic partners and then two days on that same unit as a staff member. And you think about the incredible continuity we would have because what we tend to see with, you know, multiple schools rotating through, through our different environments is none of the hospitals in our market do things the same. And so individuals are constantly bombarded with how we do business versus somebody else in the market. And so you just take a look at how can we create continuity and open up opportunities and extend somebody's career in med-surg. These are some of the things that we're really taking a look at is how do we create these dual type roles where we can do some of these things because we think it would be great for students and it would also be great for our facility as we create that pipeline that truly gets, gets to know us as a system at the same time, you know, really buys into our culture about how we deliver that type of care at the highest level to, to everybody who walks in the door.

Dani:

That approach I think is gonna be really important in the days ahead, specifically, you know, as we look at the workforce that may potentially retire. And is there a way we know the advisory board, there's the, the potential knowledge gap that comes with retiring workforce. And so extension of the career and that knowledge, institutional knowledge, but also practice knowledge that's so important for our health systems and coming up with unique ways of engaging, such as dual roles like faculty or med-surg. I've worked with some other health systems that have been like mentor and preceptor and then one day med-surg. So I think being able to create that diversity of experience for those that are looking to continue to practice, but maybe just not in the extensive way that it was of the past is gonna be really powerful. The nursing institute, you, you briefly mentioned that what exactly is the nursing institute? What, what does that encompass? You know, you mentioned that's gonna be launched during the nurses week, which is coming up soon, the impactful work of your CNOs at every hospital and leaders at the frontline. But I'm just curious if you can share a little bit more about what the nursing institute at Memorial Harmon is.

Bryan:

Yeah, so the way we look at the nursing institute is, you know, it really is an accelerator, right? So we have so many things that are coming down the pipe. You know, healthcare is evolving at a pace that it's stressful and energizing all at the same time, right? <Laugh>, yeah, it suck <laugh>, but we take a look at the nursing innovation. Really the current model is based on, you know, a leader kind of wrapping their, their arms around a PI project or if you're going to the evidence-based practice route, really like struggling with the question, kind of gathering the resources around it, executing it, and then getting those outcomes really kind of all lands in their laugh on how we get those outcomes and then scale them across the system. The way we're taking a look at the nursing institute is how do we bring these wraparound services to that individual who's interested in innovation and, and really, you know, give them the playbook on, hey, let's measure things this way and can we actually do that measurement for you versus you spending your time there cuz you're delivering direct patient care.

That's what we want you to do. We want you to do that at a high level, but at the same time, we want to help you get through some of this innovation because when we know that's important to you, it's important to us certainly too, right? And so how do we wrap these services around? It may be a less intense P D C A type exercise or it may be all the way to some of the things we're looking at that'll be true nursing research. And so we actually have some nurse scientists aligned up under our nursing institute to help with things like designing research and then how do we execute on that and making sure that we stay aligned with the research question. So it really provides the whole gamut of services and as we look at technology, even the, the list on looking at technology, by the time you get through vendors and the security and all the things that it takes to make that happen, really want to take that as much off the facilities as we can because we think that actually puts us in a much better spot to be innovative than if we kind of follow the traditional way of, of handling some of those things that we've done in the industry for a hundred years.

Right?

Dani:

Yeah. Where you can accelerate, please do. We know that it takes 17 years on average to get, you know, new evidence and to practice by that point, it's not new anymore, but practice transformation is a bit of a lift. And so the nursing institute sounds like something that can help bring innovation and accelerate that. One last question. You talk a lot about wraparound services and so would that be the support of those that you have in the nursing institute, like nursing scientists or others to help kind of guide those that are a part of it around, you know, the process, whether it is a PD C cycle or a true nursing research or leading a project. Is that how you would define kind of those wraparound services? Cuz I've heard you mention that a lot and it's kind of a new hearing.

Bryan:

Yeah, yeah, absolutely. And this is what we're growing into. You know, it's new, but this is exactly what we're growing into is, is what we're asking right now as we have brought in a couple of nurse scientists to actually help with some of these early, early initiatives that we've already identified. But it really is what type of service do you need? Is it a data need? And so we have an individual in the nursing institute who is aligned with delivering some of that data. We have a nurse scientist to the nursing institute who's helping with, you know, the questions and you know, not everybody knows how to write scientifically if you're, if you're, you know, and so bringing some of those expertise to the table so that we can help with that.

Dani:

I wish I had some wraparound services, sometimes I, that would've been really helpful in my career. A lot of proud by fire in some of the learnings. And so your ability to help support the nurses at Memorial Hermann with these types of support structures is phenomenal. You know, I know Memorial Hermann is a very community-centric organization. You're committed to serving your local communities. Can you share a a bit more about unique programs or initiatives that you have in place to help accomplish this mission-driven purpose that Memorial Hermann has?

Bryan:

Yeah, you know, I'm so proud to be in a system. You know, we, you know, in our community contribution or are running around 470 billion and that does, that does so much in our communities. We have, you know, about a dozen or so free clinics in the market. We all that include some of our school-based health clinics. A lot of initiatives around exercise and recreation. We're doing a lot of with the restoration of parks. And at the same time is, you know, taking a look at, you know, how do we align differently? And I talked about our, our, our real, our real drive to look at making education more accessible. But it just is an amazing, just amazing to sit back and take a look at, you know, all the opportunities we have as a system our size to really to take a look at a system that's our size and the impact that we have.

You take a look at our Southwest Hospital, we have committed to being an anchor institution. And what that means is we are gonna hire from the community that surrounds our hospital. We're gonna be dedicated to making that possible. So that's where we've done a lot of the energy we talked about earlier as far as looking at our job descriptions, removing barriers to entry as a healthcare. And what that really does for us is, is we'll have to have the services to make those things, you know, successful. So it really is full circle because then the individual who is coming from the communities part of the healthcare team and is making our community healthier and at the same time delivering excellence at the bedside,

Dani:

That is really an impactful model of, and, you know, the community approach, you're really holistic in how you're, you're looking at health, which we know it's not just the entry point to a hospital or even a doctor's visit. It's, it's friends, family, lifestyle, you know, professional opportunities, academic spiritual, you know, all these components that make us, make us human. And being able to impact in, in different ways before someone enters into a, a acute facility or a doctor's offices. Really a forward thinking mindset. And I'm, I can see now why you said the stars aligned with joining Memorial Hermann and your background in some of the work that you had done with population health prior and leading in in that space. Bryan, this has been really insightful and I think inspiring as I listen to the mission driven approach that you and your leaders at Memorial Herman are taking. As a final question, I would just love to know, you know, what would you like to hand off to our listeners today?

Bryan:

Yeah, so, you know, we talked a lot about healthcare evolving and I think that, you know, we really need to embrace that and, and lean into the opportunity that is being presented every day as far as innovation goes. This space is wide open for nurses and to be leaders in this space. You know, there's a reason that we are consistently rated as the top trusted profession. I think it's time to add innovation to that. So it really should be nurses, trusted innovators all rolled into one. And I think the opportunity is sitting right here in our lap. We just gotta own it.

Dani:

I love it. Yes, I would agree. Innovators, problem solvers, and I mean, it's what they, what we do every day when we care for patients or communities, and the time is now. And it, it sounds like you're, you and your team is leading the charge in this space. I would love to check back in, in a year or so and hear how everything's going. I really appreciate your time today, Bryan, and thank you and your leaders at Memorial Hermann for how you're serving your communities with health, but also with new ways of operating to sustain and change healthcare.

Bryan:

Oh, thank you for letting me spend some time with you today. It's been a pleasure.

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