Dani:

Welcome back to the Handoff from Trusted Health. I'm Dr. Dani Bowie. As a reminder, this season we're covering all things healthcare innovation and the importance of fearless leadership for change. In this episode, I speak with Nanne Finis, a seasoned nurse executive with experiences in clinical settings, regulatory and patient safety organizations and technology. In addition to her current role as Chief Nurse Executive of UKG, she serves as a board member for the Workforce Institute and a charter member for the AONL Foundation Corporate Advisory Council. Today, we discuss the importance of nursing leadership and digital transformation, the emergence of technology competencies for nurse executives, new innovative care models, and the need to get back to the basics and focus on the foundations. Here's my conversation with Nanne Finis.

Dani:

Well, welcome back to the handoff. I'm super excited to be speaking with Nanne Finis, the CNO for UKG. Nanne, welcome to the Handoff.

Nanne:

Thanks, Dani. I'm happy to be here.

Dani:

Really excited to have a conversation today. As you know, we've been talking about healthcare transformation and innovation, but to kick off the podcast, I would love to start off by keeping the patient and sacred work of nursing at the forefront of our discussion. Is there a particular patient experience or story that has had profound impact on you and your career?

Nanne:

You know, Dani, I have many. I my background is very clinical in nature, and so I cherish the times with patients probably as I look back on my career the most. But one experience really sticks in my mind. And just to give you the context, I was working in the emergency department at a large academic medical center here in Chicago. And so at that time, you know, just to also give context a hundred patients in a 24 hour period was a large volume. And we and this was in the mid eighties. So when you think about, you know, that kind of volume and your, you know, exposure to patients and all of that you're doing in the emergency department, you got to know your patients quite well. Many of them were repeat citizens, if you will.

That's my story, is I got married at a church, the sacred moment at Old St. Patrick's Church, downtown Chicago, the oldest church in the city. And I was coming down the aisle after getting married, and I heard sirens in the back of the church. So I'm walking out, I have two or three more pews to walk by, and there are patients of mine in the last row. Eddie, one of my favorite patients I had cured for, for several years homeless. And he was holding a huge lily plant to give to me as I walked out of the church <laugh>. So here I am, walking out of the church and he said, holy name cathedral, won't miss it. Don't worry about it. And he gave me the lily <laugh>. I walked out and there were several of our, you know, my paramedic colleagues and the ambulances ringing sirens.

And so I thought, oh my gosh. Life is, life is a blessing in so many ways. So just, you know, just, I think what what strikes me is life's different today in healthcare, nursing is different today. And we didn't worry about, you know, Eddie and his friends that were living outside on the streets near us at the hospital. We would, didn't worry about violent behavior if it happened. It was very unique and very infrequent. But we, we cared for them. We loved them. And, and it was all about community. And so, and, and our lives, you know, we all thought talked today about life work and how to keep balance, and, you know, we, we just didn't think about that they were part of my life. And and so anyway, I just thought I'd start off with that, with that story. It's probably a little longer than than I anticipated, but it was a, a memorable day. And I'm still married today, <laugh> <laugh> to Jerry, my, my same husband. And, and it was a wonderful day. So

Dani:

I love that. I, as actually, you were, as you were describing it, it was starting to like, make me tear up <laugh> you know, that something like, you know, you've impacted the patient's lives, and then the patients are equally, there's a reciprocal relationship of the impact that they have on our lives. Yeah. And the way that they were giving to you by their presence at your, at your wedding, and love the story of the plant. Right. And I think that's, that is centering us back to the essence of the work that we're doing is caring for people. Yeah. Building relationships. It's holistic. You know, Ann, you have a really unique career journey, and you've had experiences across clinical care. You've done regulation reform. Right now you're in the world of technology. And if you wouldn't mind just sharing with our listeners a little bit more about your journey and maybe some pivotal moments that helped you end up at UKG today.

Nanne:

Sure. That's you know, Dani, as we kind of, I think as the older we get, the more we tend to reminisce and look back. And, and first off, I've been very fortunate to be in several organizations that and I loved every one of them. I had mentoring managers. I have been able to keep relationships going throughout all of my career, which I think is probably the most pivotal and influential piece of, of what I would share. You often hear of individuals that are planning their whole career. I wanna do this for four years. I wanna do this for, and, and mine is a little more dynamic and a little more fluid. I was at Northwestern for 25 years. That was probably the epitome of my career clinically, from a leadership perspective. I was engulfed with coaches, mentors that I still keep in, in very close contact with.

And I was at a point where I wanted something different. So I went into the Joint Commission for 15 years and, and traveled a bit. I started part-time and then emerged, you know, into a full-time position. And there, I, I was able to really begin to innovate. I knew I was creative didn't know how much I could create and innovate within the healthcare space, but that, that position, that organization, strangely enough, you would think in a regulatory accrediting body that, that you might not have that opportunity. But I certainly did. I was able to start a patient safety quality consulting division, and hired, it was like 60 consultants at the time, all working different hours and so forth. So not all full-time, certainly, but, you know, physicians and pharmacists and respiratory therapists and infection preventionists and, you know, so really a, a wonderful array of leaders.

And we helped organizations really use the standards to, to think about how to improve quality and safety using the joint commission standards as the framework but not focused on accreditation necessarily, but using them, you know, to, to build their performance. From there, I also had the opportunity to create industry relationships with the Joint Commission. That was, that was a new business line that we began. And so through that I met several leaders in tech. I've had, you know, relationships that brought me into both of my recent positions in technology through relationships. I've been at UKG for four years now. And this is the next epitome of my career, is I'm able to really use all the relationships, use the work that I've done throughout my career, and leverage that in different ways that I'd never thought I could. The opportunities we have as nurses and leaders is just incredible, you know, knowing the patients like we do, knowing healthcare from the inside out and being able to be that expert and subject matter expert for not only the clinical piece, but, but operationally is a skill that is very needed today in businesses, industries, and then obviously in healthcare. So it's been a wonderful career.

Dani:

That is an incredible journey as you mentioned. And a couple things struck me as you were talking. One, I was kind of tickled to hear that, you know, you found this creativity and innovation within the joint commission space, which is, you know, regulatory s that's really actually funny, but amazing as well, that you can use standards then also to think about creating opportunity within health systems. It's like entrepreneurialship within that space of the joint commission and building out division. So well done. And then additionally, the relational component. You know, I had a mentor and still have a mentor who really speaks to me a lot about networking, building relationships, and how pivotal that is in our career, is the network we have, the relationships we build, and the way that that can transform the path that we take and make it, as you mentioned in your, in your interests dynamic. And your career has opened up before you because of some of these marrying the innovation, the practice, the clinical space and, and relational component. You are working on a task force for A O N L and specifically looking at developing and recommending competencies for nurse leadership related to digital transformation which is really exciting. I'm super pumped to hear about that. Can you tell the listeners a little bit more about what you're doing and what you're hoping to achieve as you're working with AONL in this space?

Nanne:

So I think as, as we're experiencing together relationships, you know, I think, I think we have a special, even though we may be competitive in our space, nursing has, I think we professionally and as colleagues are able to rise above that and, and you know glean the best out of each other. And so this AONL project is actually an exciting one. I'm working with my colleague Carlene Fu. Carlene and I were asked to lead this task force. We haven't named it yet, but there has been so much innovation, obviously happening, tech in technology. I recently spurt on by ai and, and all that's happening there. At least recently, the discussion has been emerging more fervently. But as nurse leaders, as we look back on, on how we have convened our profession, our focus on technology, I think AONL and its leadership, were finding that it was very disparate.

There wasn't a unifying collective voice about nursing's role leading technology. And at the same time I think Carlene and I were both talking to AOL's leadership about the fact that we are in organizations often where nursing is not at the table to make decisions about staffing and scheduling, right? Or the use of mobile devices for their, for their staffs. The technology that should be deployed in these organizations to enable the work, particularly our frontline staff and managers is so critical to the future. Yet we were feeling that there was a disconnection or, you know, anyway, just that nurses and leadership was not, not engaged. So the work of the A one L group is really to do a few things. One is to clearly articulate nursing's leadership role in digital transformation. We are currently pulling together all the various competencies that are out there whether it's the a n a nurse executive competencies that we're just completed.

And I was on that workforce that, that team AONL's competencies and, you know, others to pull together what are we saying about technology competencies for nurse executives, and is there a, a coalescing of, of all of that. So that's number one. The second thing we're doing is really doing an inventory of what's happening across the industry in healthcare. And what, where should a O one L specifically play so that we don't duplicate efforts with HIMS or you know, the A n A or the A M a, but that we, we collectively come together and ideally have a, have a voice about nursing's role in this future. We have a list of about 40 that Carlene and I have met with, I think everybody, about 40 individuals that are helping us to, will be helping us to kind of craft this more will come out as far as, you know, written work, we hope by one L'S conference next year. So we're working towards that. And so we're, it's very, very early. We just finished the charter last week. We do want to get some public you know, sentiment and feedback and, and realization about this work. So more to come, but it's an exciting time to really think about how, how we really engage in this work.

Dani:

Absolutely. I am really excited to hear that this is happening. And I also love that you and Carlene are partnering together. This is a pretty dynamic deal for those of you listening, Nanne and Carlene. I mean, if you can get two of 'em, both of 'em in the room working on the same thing, I can't imagine what's gonna be produced exponentially because mm-hmm. <Affirmative>, you know, you guys are working for your companies and bringing transformation through the space of nurse staffing with technology, and now together, as you mentioned, rising above. And we're doing this professionally as nurses, because there is a need. I know as a nurse leader and manager, I didn't go through a lot of training. It was kind of trial by fire, and the fire was pretty hot. Sometimes you came out pretty crispy trying to learn what was happening and, you know, unveiling too.

 So if there is some more structure and guidance for leaders as they emerge in a space that's pivotal for our future and how we deliver care, this is gonna be something that will be, you know, really groundbreaking and, and helpful to the next generation of leaders. We continue to talk about this digital transformation that's happening in the industry and healthcare. And I would love to know from your perspective, Nian, what, what trends are you seeing and you know, what's emerging as some innovative models that you are excited about and could share with our listeners?

Nanne:

Yeah, so I think that's one of my challenges today. And perhaps you have the same challenge, Dani, as trying to, you know, sve through all the innovation and sort of find the, the best strategic route to take and, and thought provoking work. Because I think there's so much, you know, focus on that shiny new object and what it's gonna do for us. So I would just say that some of the most innovative organizations and leaders that I am interacting with are those that are putting significant effort in building their foundations, building the basics. And, you know, yes, the robotics, the, you know, all of the, all of the technology excitement is out there, but they're focused on how do we deliver safe quality care to patients? How are we monitoring that? How are we measuring that? How are we staffing for that?

And, and that's not the, if I will say the sexy part of the work. It's just, you know, it's hard to focus on that. But those leaders and organizations that are emerging are those that I see having had real effort in that area. The labor modeling that's happening today. And for those of us who've, you know, we, who I hear some of my colleagues, I've been there done that before, team nursing, you know the use of assistive personnel and all of that. And I'm, I'm by nature a very optimistic individual. But when I think of sort of the future and, and the optimism might have, it's, it's, you know, technology is here to enable and to, you know, sort of reinforce some of that infrastructure in different ways so we can propel innovation much, much more readily.

What I see happening is there's becoming more clarity in the roles each of us play when we think about the care model. You know, my background was, you know, heavily in ed and trauma for a a while, and we were very clear on everyone around the patient, you are doing this and you're doing that. It was kind of like, you know, everyone's role was just clear and, and, and there was no confusion. Wow. so I see that happening with, you know, some of the labor modeling today is really putting together a collection of talent, if you will, that best supports the patient and their families. And, and doing that in a way that takes into consideration the employee's preference. Having nurses particularly focus on what shift do you want to work? When do you want to work, who do you work best with?

Yeah. In what environment? How far do you wanna go from home? What, you know, all those preferences. If individuals are happy and content and, and feel that purpose in work they're gonna be delivering that quality and safe care, as we all know. So I think those are some of the models that I see is, is really becoming much more focused on the employee meeting their needs at the same time understanding what's required in the workplace, and then matching the supply and demand, if you will you know, use with using technology. Yeah. Because you just can't do it manually anymore. It's too complex. Yeah. But that's where I think the innovation's happening at that, you know, at that point of care delivery,

Dani:

Getting back to foundations and doing those well and Right. And then building upon that, you mentioned talent teams bringing in top talent to work together and define clear roles, which again, when you gave the example of trauma and everyone knew their place and their role around the patient. Yeah. just how critical that is and how critical that is to even translate into business ops of the hospital roles and helping to create more of the synergy amongst the talent and then employee centric and being able to support employees, as you mentioned, as they, how they wanna work, how are they growing in their career, even this digital that the task force you're doing for AONL can be used by organizations hopefully in the future of pathways. You know, how do you develop this digital acumen, whether in leadership or you wanna move into that space as a clinical leader.

So that's great. I think, I think you're mentioning some really key callouts for our listeners here. And I want to talk a bit more about nurse staffing. I mean, this is, UKG has some great technology around staffing and scheduling and workforce management, and you know, we're seeing in the headlines just post pandemic. It's been a lot around the nursing shortage, safe staffing, how do we continue to move the conversation forward and think broader than just staffing numbers? And, and truly how do we deliver best patient care and safe staffing together? And what's your kind of perspective on all the conversation that's happening out there?

Nanne:

So just a couple of things that have, you know, happened over the last couple of days. So ANOL released a press release yesterday reaffirming the importance of safe staffing, safe staffing that uses critical judgment, flexible to meet the patient needs and, and really is driven by what's happening in the environment at the time. So, you know, mandated staffing ratios are, are not the, the way to truly use clinical critical judgment. You don't staff to numbers, you staff to what's happening in the unit. Staffing should be incorporating clinical judgment, workload, and then really looking at the skills and competencies and all of that of, of staff that are caring for patients. But the and I think non-clinician and non nurses are often surprised that we really don't have a way to measure consistently the workload that a patient requires.

So yes, we can look at patient acuity or the diagnosis of a patient, but if you think about each patient and the unique features or aspects of that, of that care that not only the patient and family require, that should be determining workload for, for the nurse for the shift, there are technologies that are emerging that are automating workload based on motion, based on care providers going in and out of the room, and really getting into that, the analytics of, of that experience, if you will, there are manual ways to capture what workload is depending on you know, sort of what you're seeing with each patient, and then tracking that over time. So we have to make this more simple, but it's not just a number and it's not a staffing ratio. Yes, you can start, you know, there as a, as a budgeted number to, to use as a benchmark, but, but there has to be critical judgment and clinical judgment to really think through you know, what's gonna be happening in these next couple of hours as we think about the patients that we're caring for.

And some of that might not be related to the individual patient, but just that dynamic of, of the environment and what's happening. Each organization is unique, perhaps each unit and clinical setting are unique. So it's really understanding the activity level that's happening in that place of work. And, then understanding the skills and talents that you have. You know, CEOs have no idea in their healthcare organizations what capabilities they have from a staffing skill mix. Of course they don't, we haven't been clear on what skills really are needed to care for patients. What are those competencies? What are those skills? What about the tenure of your staff on any given unit, perhaps in a given shift? And do you have that senior person there that can really mentor model care? So, it's multi-pronged, it's complex, but I think we're beginning to see technologies emerge or, you know, pieces of technology that can support that critical thinking in a way that we've never thought about before, and then predict the future.

I can't imagine leading in these healthcare organizations today, how challenging that is day to day. But if we don't start looking at what the workload is, how, how we staff we're gonna continue to lose our, our own staff. And we will not be able to recruit in staff. So I think as you think about staff dis satisfiers or, you know, some of the root causes of turnover, it is workload, it is not working with, with peers that they can count on and, you know, that have each other's back to really support that clinical effort. So I think it's a very challenging period, but know that there's technology out there that can support you as you sort of think about your own organizations and what your needs are.

Dani:

I really like that you're bringing up workload because oftentimes, you know, you mentioned like staffing standards and numbers is usually a budgetary perspective more than anything, and it does look at historical census and can help you start to create that schedule. But the day-to-day staffing is that, is so critical, is a component of skill as well as the mix of your workforce and the patient condition. And so it's beyond a number. And my mind was kind of thinking as you were talking about skills, and that's the beauty of going back to the basic basics and the foundations of tech. Where do you keep your skills so that you can see your workforce, ensuring that you build it into your scheduling solutions and your staffing solutions so you can see the skill mix of your workforce. And then being able to move into the workload conversation or space, I think is critical for helping us solve these issues at the root versus a number isn't gonna still create the right condition of work. It can help, but it's not gonna be holistically able to really meet the dynamic condition of our patients and the work environments that we're in. So I think workload and conversation is a critical piece in this. And you're right, we shouldn't shortcut around this. We should really dive head into how do we solve our nurse staffing issues?

Nanne:

The labor data that we have, that our technologies are creating are, are often in a silo and a disparate piece of technology, if you will, from quality and safety. So, and Linda Aiken published a new paper looking again at safety issues. We know that staffing and safety are, are, and patient, patient quality are critically aligned. So how do we support our organizations, our healthcare organizations to look at both quality, safety and labor data and financial all together so that there's that composite view and that informs safe staffing for the future. So I think that's where we need to go short term. Yep. I think we're beginning to see those data models easily accessible for leaders with dashboards and things that leaders can, you know, look at quickly and say, you know what? We we're going down the wrong path here today. This is what's happening in the unit. Let's, you know, let's change our model, our staffing this afternoon, or what have you. But I think realtime data is needed to, as you said, pivot quickly on some of these, but also give more of a prediction of the long term and how to staff accordingly. So just a thought.

Dani:

It's a great thought. And it is, you know, I, I think it's a, again, the foundations of a clean DA data, so determining your sources of truth, how are you coding it? And once you can do that, I mean, you can build amazing reporting capabilities with leading indicators, not lagging. That can create opportunity to allow your organization to lead from a place of proactive versus reactive and even build your strategic plans into the future. So this is music to my ears, you know, embracing the foundations, but also embracing in the form I think of, of technology to bring transformation to workforce management and staffing is key. Just quickly, Nanne, you know, again, you've worked with so many healthcare organizations, both at Joint Commission, UKG, and your path throughout your career, and, you know, let's talk about organizational transformation. And this is a lot easier said than done. We can talk about it all day, but really it's when you start to put action to your words and from your years of experience and expertise, what would be some key things that health systems should think about as they wanna approach workforce transformation that could help, one, bring this to life and two, hopefully accelerate it so that they are, they got the foundations and they can move into the innovation in the days ahead?

Nanne:

Yeah. I was at a conference recently on digital transformation and you know, I saw many presentations of organizations from their top leadership you know, with, with impressive plans two to four years out, maybe five years with digital transformation strategy, elaborate plans, you know, just a pretty impressive foresight into where technology is moving. But there wasn't a lot of conversation around the operational transformation that needed to happen. And we see this all the time in our, in our organizations that we work with, is you can turn a technology on but if your people organization is not prepared or adept or at that point of being able to absorb a, a new change you know, the technology's gonna fail and the the process will, you know, obviously ultimately fail as well. The other thing that, that we're challenged with is, is, you know, UKG talks about people-centric organizations.

So our purpose is people. And so we talk about what does that mean to be people-centric, and that is truly doing whatever you need to do to care for your people. Hmm. We see that, I, I see that every day at UKG and in, hence that's why I'm here. And, and you know, I'm very excited about the future of UKG, but in healthcare organizations as well, you know, it's, it's how do you become very focused on people, your people, yes, your people are, your culture, your people are, are why patients come to your organization. One thing that we do see in organizations is, as we talk about workforce management or human capital management executives, that, and maybe maybe some that are listening won't agree with me, which is, which is fine. I think it is unclear what that future vision is.

 I have a workforce management strategy or strategic vision or when we sort of peel that onion, we're looking at it and saying, what does that look like? And it's very sort of action oriented. It's, it's not building a culture of people focus, people centric. How do all of our technologies bundle together to support organizations? And we have 200 partners as, as you well know with Trusted Health. How do we all work together to make sure that organizations can move towards an ideal state of people-centric organization? What does that look like, feel like? How is that measured? So we're kind of putting together some attributes of that type of organization, and if this works, we'll be, you know, publicly providing this in, in short order. But we're, we're looking at governance and, you know, structure process people, processes and operational processes.

And then how do you transform and change, you know, how are you change capable as an organization? What are some of the data metrics and visibility that's needed to really move to that ideal state of a people-centric organization so that we can say, this is the, if you really think about people centricity, if you will, this is the future. And we need to paint that picture for organizations that are just living day to day. They're getting shift to shift, you know, thank God I'm through this next shift. Yeah. you know, so, and, and strategically then back to the digital transformation, that those operational transformative actions have to situate itself right alongside the technology. You know, I think that's how change will be propelled. That's change will be sustainable and improvement will happen. But if you're doing digital transformation and not really paying attention to the people part of the business, it's not gonna, it's not gonna be effective and sustainable. Right? So that's what I'm seeing in the industry that I think is really a challenge. And hence our A one L initiative too, is how do we step up as nurses to really influence that future? What does that look like?

Dani:

Yeah. And people-centric you know, I think it is a good call out of being able to invest in technology is key to transformation, but equally important is the investment in the people, the infrastructure and the process to bring it to life. And your greatest talent and assets, I believe are your people working for you. And there's untapped talent there. And the ability to bring that to life is really, I think, that delight and joy of being a leader in the work that we get to do. So I'm really inspired and excited to know that UKG is thinking about the people-centric approach around technology and how that could bring transformation and aiding and guiding through partnership to bring that transformation to health systems. This has been so, so fantastic. So fun. Nanne, where can our listeners find you if they wanna reach out and, you know, just have a conversation knowing your expertise in this space? Do you have any? Yeah,

Nanne:

Yeah, sure. So obviously on LinkedIn, I'm, I'm okay there several times a day. And then I'm also on our board of the Workforce Institute at UKG. Okay. Which is really a great place to go with for thought leadership. It's, we, you know, provide global cross industry thought leadership for public consumption. So if you look at that and you'll, you'll see our bios of all the board members. And so it's a place where I think there's some really wonderful research going on and, and all, you know, obviously for, for everyone's consumption. So the Workforce Institute or LinkedIn would be probably the best places to reach me.

Dani:

Fantastic. You heard it all. Linkedin and the Workforce Institute specifically, if you want thought leadership and the best of the best this has been really insightful, Nanne, you know, we to end our podcast with. What would you like to hand off to our listeners today?

Nanne:

Yeah. Nursing has a bright, bright future as we look back. Perhaps we haven't been as collectively unified on many initiatives, but I see that happening across all the work I'm doing is through these challenging times. I think organizations as well as individuals have come together to say, how do we, how can we do this collaboratively to, to impact the industry the best we can? And so I, I'd like to give my years as a, as I kind of near my, you know, end of my employment over the next several years, I really would like to see that happening more and more. And that's what I'm working towards. It's an exciting time. Our communities, patients need us, need us to be well, need us to, to have life, life work, balance, be innovative, creative. And, and, and for us as, as, and I wanna say vendors, we used to say, oh, we're vendors, you know, the vs. But for us to really work together so that organizations don't have to, you know think about, you know, how do I cobble all these pieces of technology together? Yes, we should be serving up what healthcare organizations need to make their worlds and life and their clinician's life much more efficient and effective. And so that's our goal as well.

Dani:

I love it. The future is bright and we're rising above in collaboration. You are paving a path for future generations to help build a better world and a better healthcare. So thank you and to the work that you're doing and giving us your time today to share some of the exciting things that are happening. I can't wait to check back in, maybe in a year or so and hear some of the updates and progress that you can share.

Nanne:

Sounds great. All right. Thank you, Dani. Take care.

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