Brian, Becker's Healthcare (00:00):

Hello everyone and welcome to today's webinar, Nurse Retention 2.0: How Top Systems Are Strengthening the Workforce. My name is Brian Zimmerman and I'm pleased to serve as your moderator today on behalf of Becker's Healthcare. Thank you so much for joining us. Before we get going here, I'm going to just cover a few quick housekeeping instructions, so we'll begin today's webinar with a panel discussion and we certainly welcome any comments or questions as we move through this conversation. You can submit those throughout the webinar by typing them into the q and a box you see on your screen. Today's session is being recorded and will be available after the event. You can use the same link you use to log into today's webinar to access the recording. If at any time you have trouble with your audio or video, please try refreshing your browser. You can also submit any technical questions into the q and a box. We've got folks on the backend who are available to help out with those.

(00:47):

So with that, let's meet our panelists. It's a really, truly impressive group and I'm really excited to engage with each of them today. Let's begin by just hearing each of you introduce yourself and share a bit about your professional background, current role, that sort of thing. Meagan, I'm going to tap on you to get us going here.

Meagen, Mayo Clinic (01:06):

Absolutely. Thank you. Meagen Driskill, Vice Chair of Nursing for Mayo Clinic, the organization. I have a career history of about 30 plus years of nursing, primarily in critical care with the last 10 to 15 years of those being more in nursing leadership positions. Most recently was associate Chief nursing officer for a health system before joining Mayo Clinic about three years ago. Delighted to be a part of this conversation today.

Brian, Becker's Healthcare (01:35):

Delighted to have you and pull out your expertise today. Thank you for being here. Meagen, Betty Jo, let's hear from you.

Betty Jo, Mercy (01:41):

Yeah, delighted to be with all of you today. I have been in nursing for 32 plus years. The majority of it's been in leadership, but I'm a nurse anesthetist by background, so I still do practice a little bit to keep my hand in that nursing side. I've been in the OR space in leadership, I've been in the nursing space. I've also done procedural areas, so a little bit of a varied background. My true love is working on the workforce, which this is a great time to be doing it, but taking a look at how technology and analytics can help us be better in that workforce

Brian, Becker's Healthcare (02:22):

And we'll certainly touch on that today for sure. Betty Jo, so appreciate you being here. Dre, why don't you go ahead.

Dre, Allina Health (02:29):

Thanks, Brian. Excited to be here to talk about such an important topic. Dre Carpenter, I'm the Senior Vice President, Chief Nurse Executive for Allina Health, which is based out of Minneapolis, Minnesota. Primarily operate in the Twin Cities. I've been in my role just under three months joining as the system CNE. Prior to that, I've been a system CNE at another large system based in the Midwest, and before that, an associate chief nurse executive for a system based on the East coast widely. Systems integration work is primarily my background, including previous stents as nursing informatics and analytics role with data science. So excited to be here to talk about this topic.

Brian, Becker's Healthcare (03:11):

Yeah, very excited to hear more from you, Dre. Thank you so much for being here. And Melissa, why don't you round out these introductions?

Melissa, Ochsner Health (03:18):

Good morning. Hello, I'm Melissa Kappel, the Chief Nursing Officer at Ochsner Hancock Medical Center in Bay, St. Louis, Mississippi. I've been in this role for over a year. I currently have eight years of leadership experience with 20 plus years in nursing in the cardiac arena telemetry and in the floors. My medical career started by serving eight years as emergency medical technician in United States Air Force National Guard. From there, I worked part-time as a nursing assistant. I pursuing a degree in nursing, a bachelor's in science and nursing at University of Louisiana Lafayette, and I graduated from Tulane S'S Administrative Leadership Certificate Program. Thank you for allowing me to be here today and I'm excited to be a part of this discussion.

Brian, Becker's Healthcare (03:59):

Excited to have this group together to dive in here and talk about this very important topic in healthcare today. Of course, nurses have been at the center of Healthcare Workforce conversations for some time now. Been talking about everything from shortages, alarming projections of future shortfalls, early retirements, and that's just a sample some of the common things that come up during conversations like this. One, I want to hear from each of you in terms of how you've seen these trends unfold at your organization in your regions. What concerns are really top of mind for you right now? Melissa, go ahead and get us going here.

Melissa, Ochsner Health (04:33):

Our hospital has seen a significant shift in age variants among nurses. There are a multitude of millennials and a handful of baby boomers. Of course, this imbalance has created concerns about training and educating new graduate and less experienced nurses. As we see this shift, there are real concerns about burnout. Of course, nurses leaving for higher wages or remote work to understand the dynamics of the wellbeing of our team. We have partnered with the American Medical Association to measure the causes of levels of burnout among our nurses, the mini Z surveys. Our hopes is to mitigate the risk and offer more support to our teams, but right now, those are some of the things that we're seeing is concerns with preceptorships and educating our staff appropriately.

Brian, Becker's Healthcare (05:20):

And in terms of, it sounds like you're really trying to get your arms around, causes the burnout and figure out what kind of supports you can offer. What kind of supports come to mind? What are you thinking about now? I know you may not have made some of these decisions yet, but just thinking through where your head might be at right now.

Melissa, Ochsner Health (05:38):

Yeah. We're offering leadership cafes for leaders, really honing in on our leaders to get a good understanding of where they stand and with the dynamics that they're facing, as well as creating programs like nurse residency programs, which has been a huge success in our system. That way we can give different various offerings to our employees. We also looked at some key strategies within our hospital to consolidate some things and to make sure our staff and nurses get the correct preceptorships and onboarding.

Brian, Becker's Healthcare (06:15):

Appreciate you sharing those details. Dre, let's hear from you now in terms of how you've seen some of these challenges unfold and really where you're most concerned right now.

Dre, Allina Health (06:25):

Yeah, so similar to Melissa, significant focus around employee wellbeing. We've set up a few different committees to help address that across the system. The other thing we're looking at, while we're starting to see some stabilization, at least in our overall turnover rates, our first year turnover rate for new to practice RNs continues to be a challenge primarily because of some of the expedited efforts in which we've had to take on in the past and how we're getting team members productive earlier on in their practice. So we're revisiting a lot of that to look at our residency and pathway programs to ensure that we're providing the proper education and spending the right amount of time, preceptor time with our team members as they're coming into the organization. So a huge focus there. Stabilization and our turnover rates is allowing us an opportunity to focus on some really key significant pipeline programs that we're considering.

(07:16):

We got to figure out a way to get clinicians into our organization different than we have before. The rising retirement age is one of the things that we're acutely focused on. I think I heard someone refer to it recently as the silver tsunami, which is to suggest that there's a significant amount of folks that will be exiting the workforce by 2035 in our baby boomer generation, and we haven't produced enough programs and opportunities to get clinicians into our health system sooner. So thinking about that differently, certainly focusing on it from an equitable standpoint to ensure that we're promoting a diverse workforce while we're doing that is something that we're focused on here in our organization.

Brian, Becker's Healthcare (07:54):

Yeah, I think the thing that I want to tease out there a little bit is sort of there's this urgent need to fast track here a little bit, right? There's an urgent need to fill some of these roles, but Dre, as you sort of pointed out with some of the first year turnover, you also have to make sure you're giving the folks the proper training, the right support, so you got to move fast, but you also got to give them, set them up for success. Can you talk about that tension a little bit, how you try to navigate that or if I'm thinking about it the right way?

Dre, Allina Health (08:22):

No, I think you absolutely are, and it's really a delicate balance. I think this is where we've really relied on our opportunity to standardize onboarding across our system to ensure that we are providing a consistent experience for team members as we're thinking about that. We only have a short amount of time with them and we want to make sure that we're maximizing what that look like looks like. So we've taken on a few different things. We've standardized an accredited residency program, which we've had a few different cohorts go through that's already started to show some significant improvements in the way that we're onboarding new to practice RNs.

Brian, Becker's Healthcare (08:57):

Excellent. Well, thanks for sharing those details as well. Betty Jo, let's hear from you now and then Meagen, I'll check in with you.

Betty Jo, Mercy (09:04):

Yeah. In Mercy, we're across a couple of states. Our health system has 45 hospitals, so we're trying to standardize around that Midwestern type of look. We are having great luck with LPNs. RNs are a little bit challenged still in that workforce pipeline, but our LPNs are really coming back, so we're looking at how do we use our skill mix, and one of the ways that we're looking at handling all of the problems that Dre and Melissa talked about is we've made a professional practice development center by region and our systems, so any of our new nurses that are coming in get specialized attention. We do a talent assessment on all of them to help them see what area their talents might be most successful in for that cultural fit into the area, as well as looking at some of their skills, their competencies that they're going to need to brush up on straight out of nursing school.

(09:59):

We are, again, hiring a lot of nurses straight out of nursing school. It seems like the experienced nurses aren't moving around as much, and we're really having to rely on the classes that are coming out of nursing school, so that professional practice development center interviews does the 30, 60, 90 day follow up. They are assigned a specific preceptor and educator to work with once they get to the units and our residencies are housed out of there. So for example, if a nurse comes out of residency and is struggling in a particular unit, they have that professional practice person that's assigned to them, kind of like a navigator that helps them navigate our system and get back into the right area rather than losing them. It has had a significant impact on our retention. Our first year turnover has come down by over 25%, and we are leading the nation in our rolling 12 turnover at about 13%. So I think that has been the key, that professional practice development center of walking them in Benner's model from novice to expert.

Brian, Becker's Healthcare (11:07):

Yeah, really just several different things coming together to really drive those results. So really knowing the nurses upfront, really getting a good sense of where they're strong, where they may need help, and then having those navigators in those supports when you first start them out. Right. It's sort of all this collectively working together. Yes. Yeah, appreciate you sharing that Betty Jo's impressive results. Meagen, let's hear from you now.

Meagen, Mayo Clinic (11:35):

Yeah, as my colleagues mentioned, very similar experience. We certainly have noticed that attrition, although fortunately it's stabilized as 2023 came to a close and we've noted an interest in returning to the workforce in meeting that desire by offering some different types of roles and variety of work, and we continue to really focus on the workforce, but really encouraging our teams to think a little differently about the work more broadly and inclusive of that workforce strategy. Certainly continue pipeline development, recruitment, retention, those priorities certainly remain, but really looking at that care environment, which I think I heard from several of you as well, we have to look at where those opportunities for efficiency, those innovative care models re-imagining clinical skill mix, even space utilization and then complimentary services and how we are utilizing our nursing workforce to really maximize those efficiencies as well as incorporating technology related solutions.

(12:37):

We've done so by some of the various roles such as hybrid roles where nurses have the ability to work in an inpatient as well as an ambulatory setting. Certainly lots of scheduling flexibility, virtual care nursing, which is something that our more tenured nurses are interested in supporting and participating and has provided a wonderful opportunity to help guide our graduate nurses, new nurses entering into the workforce to help them continue to that transition to practice and foster their orientation and development and refining of their skills. We've also done some, I think, innovative strategy with utilization of our internal float teams as well as our enterprise float team and providing more flexibility in that sense, but also I think as we look at retaining those newer nurses, really helping our nurse leaders and giving them the tools to be able to engage with these new nurses and providing that ongoing support.

(13:42):

And some of our nurse leaders are more adept and comfortable at doing that, but others, as far as that leadership development, it's critical to help support them to understand how they can best support new nurses entering the workforce, or even retaining nurses that are maybe considering leaving the workforce and helping them be comfortable with that type of engagement, being sensitive to what the needs of their workforce are and realizing that for the first time we've got five generations of workforce and each one size fits all approach is no longer the right fit. It's really being cognizant of those different generations and the different needs and wants of our workforce and how to really meet that with the work environment as well as the work that they do and what we can do to help support that work environment.

Brian, Becker's Healthcare (14:38):

And Meagen and your comments there sort of around no one size fits all and your earlier comments around flexibility to really set this up nicely where I wanted the conversation to focus on next, which is really that flexibility component. You talked a little bit about how you've embraced flexibility with hybrid roles, different scheduling, flexibility, any other additional examples there or anything to tease out in terms of how you've got to change management or how you manage a workforce that's got flexibility, hybrid roles, different things, different things for different people? Can you keep that out a little bit more for us?

Meagen, Mayo Clinic (15:15):

Certainly as all nurse leaders are doing, being creative and innovative, but I think it really starts with really listening to the needs of our teams and understanding perhaps where those opportunities are. As we all know, they're brilliant at giving us the guidance of what really is going to work versus maybe making a unilateral decision of what we think that workforce needs or what flexibility means. It's defined differently, and as I spoke about the five different generations, flexibility with staffing scheduling or what their needs are looks vastly different when we look at graduate or new nurses entering into practice versus more tenured. So I think really being cognizant of that and taking the time to develop a workforce strategic plan instead of a, let's try this, let's try that. Certainly that there's merit to that as well, but really honing in on what are those key things that are going to provide value and meet the needs of our workforce as well as supporting our frontline leaders to help champion those efforts and what those roles could be and where can we enhance that flexibility.

Brian, Becker's Healthcare (16:26):

Yeah, definitely. And thank you Meagen, Betty Jo, you talked a lot obviously too about bringing in a lot of nurses out of nursing schools, so different generations flexibility means different things to different generations. As Meagen just pointed out here, so I want to hear some thoughts from you as well in terms of how you're thinking about flexibility at nursing.

Betty Jo, Mercy (16:46):

For us, flexibility in nursing means not requiring people to work, but opening up and incentivizing people in the right way to your areas of greatest need. For example, we no longer monitor productivity. We're looking at fill rate across our system, so that's patient demand by unit over the nursing staff that you have, and one of the things that we've done is work with an outside company Trusted Health and developed a flexible staffing technology solution that we have, but that isn't the full solution. It's about straightening out your workforce layers, understanding why people would want to work in every single workforce layer. For example, we have core, we have some agency, we'll probably never totally get rid of agency, but in that middle is that flexible workforce that you're talking about, Brian, and it's made up of regional float pool, local float pool, and a gig nursing workforce.

(17:43):

So we have nurses, I have over 3,000 nurses that give us all their time in all of our local markets. So instead of working overtime at their hospital where they work full time, they are a Mercy nurse, they're fully credentialed, they have all their competencies, but they give us their extra time and they do it through an app, which is really easy to pick up. And so our core staff that pick up incentivized shift pick up in this app as well as outside nurses, it's taken us from about a 72% fill rate up to a 99% fill rate over the last year. Having that technology and that ease, I think that's important because Meagen talked about it, what she said was, there's several generations, five generations, everybody seems to love this app because we run our whole life off our phones and an app, so they're able just to incorporate picking up extra shifts in their daily life. They can see the rate they're going to be picking it up at. It's an automatic payment. It's so easy for them to pick up an extra shift. So that has been a game changer and has helped our core and balance our workload. So we're also helping the people that aren't in that flexible layer decrease the workload at the front lines and it's been a total game changer.

Brian, Becker's Healthcare (19:01):

Yeah, and you mentioned sort of where my head went when you brought up the app. Has that been well received across sort of the generations of workforce and was that a concern I guess before you rolled that out? Can you talk about that a little bit?

Betty Jo, Mercy (19:14):

It was, we wondered how well it would be embraced. So we did do a peer reviewed journal article on the five generations of workforce, and we took a look at how they would embrace technology in the workplace and it came back very positive and I would say that proved out. So yeah, we've had no problems with the technology. The other thing I have to mention is it's been good for our nurse managers because they no longer call people to pick up extra shifts. If somebody calls off at 4:00 AM it's put into our staffing and scheduling system and launches the shifts out there and the people that want them know to pick them up. And so it's just been a really big pickup across our system for our leaders as well as our coworkers. Yeah, I was a little bit worried about that. You know what the hardest piece of launching this was the change management around getting people used to not having to set incentivize rates because it's done with AI in the background. So as the fill rate, as you have more of a fill rate meet, it launches a higher incentive. So it works on that Uber Lyft technology in the background, and so nobody has to set a rate, an incentivized rate, and nobody has to make phone calls anymore. That was, you would think that would be easy. That was the hardest thing to get nurse managers used to not having their total schedule filled, but letting that do the work for them. That was probably our most difficult thing in launching this.

Brian, Becker's Healthcare (20:40):

Encouraging nurse managers to let go of it. It sounds like

Betty Jo, Mercy (20:45):

They were miserable and they were burned out by getting them to actually embrace it was harder than I imagined.

Brian, Becker's Healthcare (20:51):

Yeah. Thank you so much, Betty Jo, Melissa, let's go back to you hear from you and then Dre, we'll check in with you as well.

Melissa, Ochsner Health (20:58):

Yeah. A key static strategy that we did at our hospital here was we were having trouble with the preceptorship like I spoke to in the beginning. I think some of my colleagues also said the same thing was we blended our med-surge and ICU unit. This became one unit as a comprehensive care unit, which is an acuity adaptable model where the patients receive complete care in the same room for their whole stay. This initiative has blown up. It has helped with our patient satisfaction, increased our employee satisfaction. It also has allowed us to place less experienced nurses with experienced nurses in one area, thus having better onboarding and preceptorship processes and experience. We also noticed that cross-training was an issue and trying to have enough people to cross train as far as the generations as we have a big gap. So this has helped with cross-training between Med-surg telemetry and ICU, which has been a game changer for our retention to our staff because it gives them opportunity to decide of what path they want to go into or what they want to see.

(22:04):

We've also received feedback from our student nurses and clinical instructors that this model has given them a chance to experience progression of the patient at different levels of care under one roof, and then they can decide of what they want to go into as far as a nurse and instead of at the last minute decision, trying to figure out what they want to do, but they get to see all the different dynamics of care in that one model. So this has been a real game changer for us and our turnover in employee satisfaction has reduced in this area and has helped us.

Brian, Becker's Healthcare (22:38):

Yeah, and talking about that cross-training a little bit more, do you think it ultimately, when they decide where they end up landing, do you think them having that context of this whole spectrum of care just helps them be better even in their specialized area? Melissa?

Melissa, Ochsner Health (22:54):

Definitely. Sometimes you have nurses who just want to be a med-surg nurses, and that's great because we need med-surg nurses and we also need ICU nurses, but it does that decision making of experiencing of what they want to see and what they want to do as far as the patient care and how they take care of patients is something that I think that they get to see and decide right there because they're working alongside the other, the nurses that are ICU or telemetry and that decision is made based on what they're seeing and visually being transparent within that one area.

Brian, Becker's Healthcare (23:35):

Yeah, it helps collaboration it sounds like from showing.

Dre, Allina Health (23:46):

Yeah, I think with complete flexibility is what our team members are asking for. This latest generation has certainly shown us that they want to have more flexibility around their work schedule and much to many things that Betty Jo, Melissa and Meagen mentioned, the idea of OpenShift scheduling is something that's highly important, especially when we're thinking about expanding and increasing the size of our pools across the system, both at the regional level and our enterprise pool as well as we are looking to augment and optimize this a lot with technology. I'm stressing the team to think a little bit beyond that to consider more around the casual model. Betty Jo mentioned Uber and Lyft, and one of the things as we studied their staffing model that's been so successful is that casual model, the ability for people to show up when they want to show up and sign off when they want to sign off, and we've been so traditional in nursing and care delivery and how we staff based on a specific model that we've used for years.

(24:43):

It's hard for us to imagine doing anything outside of that. So the idea of having a more casual workforce is something that we are exploring in our organization as we look to expand our flexible pool. So I think we got to start looking to other industries perhaps for some of this because what we've done in healthcare more often is not solving some of the challenges that we're seeing and the ability to scale that with technology and mobile technology that really speaks to and gives and motivates our younger generations that are working today as something that we're trying to embrace as well.

Brian, Becker's Healthcare (25:19):

Thank you, Dre. And I want to dig in here and talk more about this technology component as well, Joe. Of course, we talked a bit about that, Dre, you're referencing it now, but it comes to mind especially because Trusted Health about a survey 2023 frontline nurse career report. I think it was a survey of 500 nurses across more than 11 different specialties, and they rank that self-scheduling as their top preference for flexibility in that survey. So I just want to dig in here and really talk more about how Dre, maybe you can start us off here and then we'll Betty Jo will hear from you again how you're using technology here. Just any more details you can share for folks watching this.

Dre, Allina Health (25:59):

Yeah, just make sure that it's scalable. We took some time to really talk to our team members to ask them what they wanted, what are the things that are most important for you when you think about work life and home life and simple things like the ability to get my kid off the bus at the end of a school day was important. So things like that started to emerge as we started to think about how we can incorporate some of this flexibility within technology. We're on a journey, so we're in the process of overhauling and looking at our platform overall. We've got some good systems that are in place, but we know in order to get to where we want to get to, particularly with digital automation and mobility, we've got to look at a little bit different of a technology in order to do that. So it's an exploration right now that we're underway in our organization to see what technology could land us in that space.

Brian, Becker's Healthcare (26:47):

Gotcha. Gotcha. Appreciate you sharing a little bit about that journey with us today, Betty Jo, let's hear from you again on this piece. And then Meagen, I want to check in with you.

Betty Jo, Mercy (26:56):

So this flexible model, Dre, you are so spot on. They literally want to work whenever they want to work the amount of hours they want to work, we're adjusting our practice model around that. So we do have flexible hours, but what we're noticing is it's not about working shifts anymore, but it's collectible hours to meet the patient demand. And so we're starting to look at why does everybody have to start at 7:00 AM or 7:00 PM because they may not be your high productivity periods. We're starting now to process map workflows to be able to put into the technology to be able to launch the hours of the shifts we need. So the example you gave Dre was perfect because we may have a mom or dad that might have stayed home to get their kids off the bus that now they can come in and work from nine to three, and guess what?

(27:49):

That might be where we group if everybody wants to work, then we're going to start grouping our nursing workflows around that productivity. So we're starting to adjust workflows to the way people want to work and that we have never, ever, in my 30 some years of being in nursing, it's always been the same thing, very task driven, very shift oriented. Now it's hours adjusting workflows to when people want to work to get the work done. And so it's a very different way of thinking and that's my next fiscal year work is really honing down into that workflow piece so the workload is evenly distributed over the hours where people want to work and the technology will help us get there on both sides.

Brian, Becker's Healthcare (28:30):

To your point there too that the trusted health survey that I mentioned beforehand and also found that nurses aren't so much concerned with the length of their shifts. It's that control of their shifts. They don't want to have to plan their lives four to six weeks at a time. They like that flexibility and being able to use PTO that showed up in that survey as well.

Betty Jo, Mercy (28:54):

Yeah, I think that helps nursing Brian because nurses have always had to plan their profession around their life. They're now asking us that they can have a life and their profession fits into their life. It's really remarkable and I think that helps us with burnout and pipeline because people can start to see a better life in healthcare.

Brian, Becker's Healthcare (29:15):

Yeah. Thank you Betty Jo, Meagen, let's check in with you again and hear about how you're thinking about technology and as it relates to flexibility with the workforce.

Meagen, Mayo Clinic (29:24):

Yeah, thank you. We've certainly taken a deep dive into what are our scheduling and staffing technology resources to help with this to really help. Let's help nurses with self-scheduling by understanding where and when they're needed. So to expand on what Betty Jo had made a comment about in regards to the nursing workload, really looking at that workload and the work of what the nurse is doing and how does that intersect with when nurses want to work and what is important to them by listening to them and understanding that. And again, there's been varying interpretation of what that definition has been and really being responsive to that. But by understanding the nursing workload and utilizing some predictive analytics, we're really better able to forecast where we need those hours. And I think what I heard as an example, we have been in a traditional care model with traditional shifts starting at 7:00 AM 7:00 PM or thereabouts, and really looking at, is that really what we need?

(30:22):

Do we really need to have this many nurses all starting at 7:00 AM or does that look differently and what are those variables that impact, for example, for inpatient care when those patients are admitted, when they're coming from surgical or procedural areas and being admitted to inpatient units and really adjusting the shifts to meet our patient demands and needs. And I think we certainly all got a lesson in this with capacity management as we endured the pandemic and really adjusting and understanding where we could best utilize our workforce, but yet at the same time, learning how to meet the request for when to work.

Brian, Becker's Healthcare (31:03):

And follow up for you there, Meagen is of course there's a lot of work involved here in being able to offer this flexibility. You've got to rethink a few of the ways you used to do things, got to revisit those and change those. And of course you still have operational goals, clinical goals, growth goals, all this other stuff that you've got to continue to meet as you're doing that work. Meagen, can you talk about any of the challenges there that you've gotten around and navigated? It does sound like flexibility is actually aligned with these goals ultimately, but you've got to do the work to put the right model together to get those results. So can you talk about that work? What's challenging within that work?

Meagen, Mayo Clinic (31:43):

I think what's challenging is the work doesn't stop. We're continually needing to evaluate and adjust accordingly. So it's not a here's we've accomplished providing flexibility with scheduling. Now we're done and moving on to the next task at hand. It's really evolving and continuing as mentioned, the variance and generations in the workforce, so what our tenured staff want and how they interpret the need to be able to self-schedule means something very different around some other areas within our workforce as well as just those generational differences of what's needed. So really having to look at even our historical scheduling policies and how we have operated from a centralized model to meet the needs of our patient to being able to be adaptable and continue to be adaptable to what our workforce is asking of us to do and provide.

Brian, Becker's Healthcare (32:43):

Thank you so much, Meagen. Actually, we've got a couple more questions I want to get to before we close out, before we run out of time, but did anybody else want to chime in here in terms of the challenges piece? What's hard about doing this work in terms of rejiggering your models and everything like that? Anything to note that we haven't touched on yet for folks to be thinking about? And in my own peril, I'm just letting you take off yourselves off mute and dive at it. So Melissa, go ahead.

Melissa, Ochsner Health (33:10):

Yeah, I think everybody is right on track or we're on the same thinking as far as the challenge that we see with our leaders being knee deep in scheduling and trying to manage callouts. I think the biggest thing is you need to combat some of this is just utilizing different thought process and like Betty Jo and Dr. Dre said, and it is looking at things differently and being able to allow or empower our nurses to have control of their schedules and taking ownership of that is going to help with morale and retention and overall better patient experience. They want to commit their lives to their children, their education and their obligations. I think looking at platforms is essential. We're doing something similar where incorporating our epic system, looking at technology platforms to balancing out the workloads because I think that is essentially going to stop the call-ins that we have or call outs because people are getting burned out. So make sure that we're balancing workloads when they do come to work, so they do want to come back to work is what we want to do.

Brian, Becker's Healthcare (34:27):

Thank you Melissa. Betty Jo, see you took yourself off mute too to chime.

Betty Jo, Mercy (34:32):

Well, I just wanted to just throw this out for our audience. One of the things, everybody's a hundred percent right, keeping the daily work going and then trying to innovate and change care as it's happening is it's almost impossible. And so we've set up in each one of our regions an innovation unit that is trying out all these workflows and we've protected that unit. The people stay on the unit, the frontline coworkers are developing it with us. I've even changed the leadership model over these couple of units and we're going to get the workflows down. We started with med-surg, that's where probably the whole country is hurting the worst, but so these are innovation units on med-surg that completely redefine the workflow from the frontline coworker's perspective. And then once we get that, at least relatively right, we can talk about rolling it out to the rest of our system, but that's just one idea that the nurse leaders have. Believe me, it's not me it it's the nurse leader said, how can we protect ourselves while we're trying to think about,

Brian, Becker's Healthcare (35:33):

Thank you Betty Jo, Dre, let's hear from you and then we'll move to some closing thoughts from everyone.

Dre, Allina Health (35:38):

I think Melissa and Betty Jo's comments were spot on and it just triggered by thinking around how much are we actually willing to give up as well. So when I think we think about expansion of technology and there are technologies that are out there that advanced analytics automation that have truly helped other industries in this space. I think about robotic process automation and the fact that you can create systems around doing things that people do on a daily basis manually driven. And then I think about the amount of spreadsheets and all the other things that our staffing offices are holding on to with their life. How much of that are we actually willing to give up and replace of technology to help advance some of this? It just struck me that that's something that we continue to do more over and when we look at utilizing those technologies, we have to start applying more use cases to the clinical operations setting than instead of our rev cycle and and other areas in our organizations where we tend to invest significantly in that space.

Brian, Becker's Healthcare (36:37):

Thank you, Dre, appreciate you sharing those thoughts as well and we're coming up against our time together today. So I'll move to a final question here, which is just what's one closing piece of advice you want to share with our audience today or what's a thought you want to, a takeaway you want to share for the first time we didn't get to today or something you want to reemphasize or sort of leave it to you in terms of what you would like to leave folks with? Meagen, I think I've made you go last on questions too many times today, so I'm going to give you first crack at this one.

Meagen, Mayo Clinic (37:08):

Certainly happy to. I'll take a stab at it. I think nursing as a profession is very autonomous in practice and so affording them the ability to have that schedule, flexibility, whatever that may look like, and there's variations, right? We talked a lot about that today about those different considerations so that it continues to evolve. How do we use meaningful technology to support our workforce, to be able to give them that flexibility to meet them where they are at and to help them with that work environment to decrease burnout, to bring joy back into the workplace and to provide what's needed for them to continue to have that autonomous practice environment is essential and continues to evolve, and it's wonderful to have nurse leaders come together to share those ideas and to think about how do we learn from each other to best achieve that. Yeah,

Brian, Becker's Healthcare (38:05):

I appreciate that, Meagen, and it really has been a pleasure walking through this conversation with you all today. Melissa, let's hear from you.

Melissa, Ochsner Health (38:13):

Yeah, I think Betty Jo, thinking about the five generations that we have, we have to figure out how to connect everybody and how do we accommodate everybody to their needs. I think keeping a consistent pulse in the team is imperative. Rounding on your frontline staff leaders gives me an opportunity to listen to staff concerns and see processes and build relationships and just understanding why behind everything that we do and giving them the why behind everything we do. By making those connections, I think it makes it easier, easier for staff to be transparent with me and to give me ideas and give our leaders ideas because we do have five generations and we have to figure out how to create healthy work environments for our nurses, and that should be top of our mind when we sustain how to sustain our nursing workforce.

Brian, Becker's Healthcare (39:08):

Another theme from today's conversation, sort of that continu this process is continuous. Knowing your team doesn't stop. That work doesn't end. You have to continue continuously get to know them. Thank you so much, Melissa. Dre, go ahead.

Dre, Allina Health (39:23):

Yeah, Brian, I think as our team members are reflecting and recommitting their purpose to the profession, I think they're also asking us to be a little bit disruptive. We've relied far too many years on doing the same thing and expecting different outcomes and different results, and I think this is a time that we need to look at our profession for the future and be a little bit disruptive in this space. Let's break some tradition and really take an opportunity, opportunity to create a better guide path for the profession of nursing.

Brian, Becker's Healthcare (39:55):

Another thing from the conversation as well, it's time to reimagine some things. It's time to change some things, so Dre, appreciate that. Betty Jo, final words from you.

Betty Jo, Mercy (40:05):

I would say that it's going to take our nursing leaders being bold, being bright and understanding what we're trying to accomplish, which I think has shifted over the last couple of years. I think that as we start to reimagine nursing, we're reimagining patient care in general, and there are three things that I think for the next three to five years that we're going to be focusing on in Mercy as a team. It's going to be workforce, it's ever changing, it's going to be work environment. How do we clean up the noise that goes on around patient care and it's going to be workflows? How do we automate, how do we get more data around actual workflow to adjust it, and how do we go mobile with charting rather than having to go back to a bedside computer? I think staying mobile is going to be the key to keep everybody connected in great patient care.

Brian, Becker's Healthcare (41:01):

It's going to be interesting to see how all this evolves over time, and I look forward to having more conversations like this with leaders like yourselves as nursing continues to evolve and change. And Betty Jo, to your point, patient care as well. So Betty Jo, Meagen, Dre, Melissa, it's been a real pleasure. Thank you so much for taking the time to have this conversation with me. It really was wonderful, and I also of course want to thank Trusted Health for helping us put this together for sponsoring today's webinar. And to learn more about our conversation today, the content, please check out the resources section on your webinar console. And as always, do please fill out the post webinar survey. We love feedback here, so thank you for joining us. We hope you have a wonderful rest of your day.

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