Joni:

Hi, this is Dr. Joni Watson. Welcome to The Handoff, the podcast for nurse leaders, brought to you by Works, healthcare’s flexible staffing platform. I'm thrilled to introduce our episode guest today. We have Dr. Darius Love, a proud native of Muscle Shoals, Alabama, and a distinguished nursing leader with a remarkable journey in healthcare. Darius's career has been marked by an unwavering passion for nursing, a deep commitment to operational excellence, and a flair for leading teams to achieve excellence in some of the most critical areas of patient care, including comprehensive stroke and acute chest pain. 

In his current role as the assistant vice president of workforce optimization and redesign at Orlando Health, Darius is at the cutting edge of change. He's tasked with standardizing nursing workforce practices across the enterprise, utilizing the latest technology to enhance workflows and drive workforce efficiency. His visionary approach to redesigning healthcare delivery is setting a new standard for the future of healthcare. 

Today we're thrilled to have Darius on the podcast to discuss virtual care delivery, the role of technology in augmenting administrative tasks and the exciting world of nursing informatics. So without further ado, welcome to The Handoff, Dr. Darius Love.

Darius:

Oh my goodness. Thanks so much for having me. I'm super excited to be here with you and be here with you guys. Excited about our time together. Excited to share.

Joni:

Excellent, excellent. Well, you are doing some beautiful work at Orlando Health. Darius, for our listeners, can you explain to us what you're doing particularly around your virtual care delivery models serving as an extension of your in-person care delivery team?

Darius: 

I'm excited to share and happy to. So the way we lean into the work is foundational when it comes to how we approach the body of work. We live in the veins of simplification, optimization, and redesign, and we accomplish that by looking at people, process, and technology. And so when we endeavor to really look at how virtual could become our reality, hence virtual reality, no pun intended. We looked at people, process, technology, and asked “What's going on? How can we impact the work of our bedside clinical teams?” And so we really leaned into virtual, that's the vein that we leaned into. And the way we leaned in wasn't replacing team members because we were coming or living through a pandemic and there was nobody to replace and we needed everybody that we needed to. So how do we use the process or how do we endeavor to take our process and enhance it?

And so our virtual team members, our virtual platform became an extension of our care delivery team. We don't put our patients off on someone else. We have our virtual care team right there, right there with our bedside team members. And it is a warm handoff. This is your virtual nurse who's going to admit you and do some initial intake or educate you and your patient and your family members that might be in the room and might be in New York. And we're in Florida. So it is 100% an extension of our team members. It's not an augment. It is 100% how we've decided to really investigate how we lean into care delivery of the future.

Joni: 

Oh, Darius, I love how you phrase that. It's an extension of your team. That's beautiful. And so as you are shifting a lot of administrative tasks from your boots on the ground in-person team to the extended virtual team, can you tell us a little bit more about maybe how this shift has increased the high-touch aspects of care? Because I know sometimes that's a concern for organizations as they start to implement virtual teams that we might lose some of these high touch pieces. So tell me how you've worked on that and what it has looked like.

Darius: 

So foundationally, the voice of our team members is important when we decide on new work, impactful work to bedside team members. And so what we found when we started to do some pre-survey work and spend some time with our team members was that about 75 to 80% of the surveyed team members said that their current workflow did not allow them what they perceive to be the adequate time to spend with their patients.

We need to redesign the work, this is called work. And we all, as clinicians, want to leave work knowing that we were able to provide the care at the level in which we wanted to provide it because it's our calling. And so we took that feedback and initial data and very much so partnered across the continuum. So with our frontline team, our frontline leaders, the workforce redesign team, our nursing informatics team, and really looked at what tasks could be shifted from the bedside, the bedside clinical space to a virtual space. And we wanted an all encompassing model. We know that virtual, when people endeavor to start virtual, a lot of times they live in the admit discharge world and that became a part of the initial workflows that we leaned into. 

But there are some checklists and there are some screenings and there are some other things that are very much impactful to our patients and needed information, but sometimes they take a lot of time to accomplish. And what we found out when we spent time in the GBA was that nurses, on average, when they wanted to admit their patients were interrupted anywhere from three to four times in that timeframe. And so we endeavored to create a space, create an avenue where we could take those important tasks, shift them to a virtual space, and now we've created a space where a virtual nurse can admit a patient uninterrupted. That is their focus. They're able to create real synergy with the patient. Moments matter. And so uninterrupted moments are powerful moments. And so that virtual nurse is able to uninterruptedly, admit that patient discharge, that patient, educate patients, family members and things of that nature.

And the bedside clinician is able to again, create impactful quality physical touch points and things of that nature. And we also found that the workforce is new nurses. And so we want to create a space where nurses can practice and hone in on those skills that our impact assessment covers by feeling, touching, doing those things. And so how can we create avenues where our frontline clinicians can touch and feel and see and how our virtual nurses can surround them, them being our clinical team and our patients, and augment or take away some of that administrative burden that comes along with our calling.

Joni:

Ah, Darius, I love “moments matter.” That is a beautiful mantra and I appreciate the way that you and the Orlando Health team are finding the win for everyone, especially the patient. I mean, being on the other side of that assessment that's routinely interrupted can be frustrating in a lot of different ways. And so to have uninterrupted time and a smooth admission and then a nurse to do all of the expert assessment skills that they need to do, wow, that, that's pretty powerful. And with virtual nursing, there's a lot of operations that go into making virtual nursing a success. And that usually includes dovetailing and starting and working closely with nursing informatics who are tremendous partners in all areas of care, but especially in virtual nursing. And so you've mentioned how important the voice of the nurse doing the work is in redesigning care. So how did partnering with nursing informatics help examine and inform and impact these interrupted workflows that could potentially be completed virtually?

Darius: 

So what it did for us was that our partnership with nursing informatics really gave us foundational data, it allowed us, our nursing informatics partners really dove into Epic and found out where nurses were spending time, what workflows we believe would be impactful to our bedside clinicians. And so we were able to come together and say, “Hey, this is what the data showing” and marrying it with the voice of our clinicians and really leaning into the question, “are we being true to the work?”

And so if we're not being true to the work, then we need to go back to the drawing board so that we're capturing the voice of our team members, creating impactful workflows that create wins across the board. And so really partnering strongly with our nursing and informatics partners gave what's really served as a launching pad for us with marrying the data because we have to make data-driven decisions, marrying the data to the voice of our frontline team members and really collectively coming up with the best way to lean into the work.

Joni: 

I love that. Marrying the data with the voice of the nurses. That's gold right there, Darius. And so with virtual nursing, as with most care work design, people always laugh when we say, “Hey, we need to redesign work” Because we do. And then we start redesigning it. And it can be painful. I mean, change is hard. It really is. There's always, whether it's a little bit of resistance or a lot of resistance, resistance will be there with any change and redesign. So whether we're talking about strategies, processes, technology, people, how did you manage the resistance? Well, lemme back up. Did you have resistance as you worked on care redesign? I don't want to assume that. And how did you manage that resistance if you had it during implementing virtual care models?

Darius: 

Change is hard. And when leaning into, again, our virtual reality, this was new work for us. And so we're asking people to do things differently, to think about things differently, to approach it differently, to give up a task and trust that someone is doing it and completing it. And we know for nurses, that is hard. That is hard. No matter how much you tell me, it's going to make your life better. Giving up some of that is difficult sometimes. And so for me, we leaned into it with number one foundational best. But we also have to realize that. And my leader says it all the time and it stuck with me. “What you do for me, you do to me.” And so what we do for our team members, we inadvertently do to them. And so it impacts the work that they do. So we should include 'em and the work that we're doing to them. And then I think it goes back to that foundation. I know what's used for behavior coaching. “Nothing about me without me.”

Joni: 

Yes.

Darius: 

And so I think it's applicable in this space too. We're doing this even if the best intent is for you, we need to bring you along on the journey. And so how do we create avenues and spaces where we provide, and again, I didn't come up with this on my own, but it has stuck with me and it's the way that I lean into the work, how we provide hope and a plan and how do we allow, or how do we encourage and inspire and motivate our frontline teams, our frontline leaders, to be a part of that plan and that strategy and really be a beacon of hope for what their future looks like.

And that to me, that has served as really the sweet spot for change management, if you will. People always want to know why, and people always want to know what's in it, what's in it for me and how does this impact me? And so being able to explain those things, walk them through what the methodology is, walk teams through the why and then create synergy so it’s not a flyby. It's not just a one-time forum where we say, “give us everything and then we'll go off somewhere and do something about it.” No, we want you to give it to us and we want you to journey with us as we do something about whatever the problem, the solution, the implementation is.

Joni:

Wow. So what did that feedback look like while you were actually implementing? How often did you get feedback from team members?

Darius: 

It's funny you asked that. When we went live with our first pilot with virtual nursing, it was in our clinical decision unit (CDU) at one of our community hospitals. It was a high-turnover unit, lots of admissions, lots of discharges, lots of opportunity to jump in and really augment some of those administrative tasks away from the bedside clinicians. We know that it is hard to get any two people to agree on any one thing. And so we did our pre-survey at the very beginning and then 90 days later we did a post-survey. 100% of those team members said that virtual nursing, the addition of virtual nursing, allowed them adequate time to spend with their patients. 100% of those team members said that the addition of virtual nursing enhanced their joy at work.

And I think that that's impactful. But we did it together before we put a camera on a unit, we all sat around a table and walked through workflows, walked through the data, walked through a day in the life as a CDU RN and a unit secretary. We introduced the virtual nurse to the CDU team members. We did all of that work upfront and initially and once we were ready to go, it felt like a plug and play really. And we adapted that approach through our various go lives. And it's been a joy. It's been a joy to watch the deployment of virtual nursing across several of our community hospital units.

Joni: 

Yeah. Darius, your leadership style really resonates with me. I'm a fan, I know my bias. I'm a fan of being with the team and listening to the team. And you mentioned gemba (a Japanese term that means "the actual place" or "the real place". It's a key concept in lean management and is used to refer to the physical location where value is created in a business) It is one of my favorite things to do, to actually be with the team and see what the work looks like. And so I'm curious, you emphasize spending time in the gemba and reworking processes that don't resonate with the team, I appreciate that language. How do you ensure continuous improvement and how do you effectively gather frontline feedback?

Darius: 

So we're a part of a magnet organization, so of course shared governance is how we lean into the work that we do. So engaging our corporate nurse practice council, having regular cadence at our hospital, nurse practice councils, having regular cadence to just round and just see and just see what's going on, I think are areas in which we've leaned into. How do we make sure that we capture the voice of the voice of our frontline team members? We've also started, it's hot off the press when there's a new implementation, we put out a flier that just speaks to why we're doing it, what are we looking to gain, any FAQs, and then at the end we, we've created an email receptacle for workforce optimization and redesign. So as the flier is disseminated, if you do have a suggestion, you're able to email us. Most people know the team anyway. But if you don't or if you see it somewhere and you have an idea, you're able to take this email, shoot it to us, and we actively watch it and we go around and see what category does this fall in? Is this something that's already on our roadmap that we need to circle back and make sure that people have communication about? How do we ensure that? And what becomes important there is how do we make sure that the message is cascaded? And so we capture the voice of our team members, this is what we're doing and about it. How have we created communication, communication strategy for site leaders, different cross-functional teams that might be impacted and things of that nature. So it's the joy of communication, but really it happens by being visible and really, really being unafraid and bold enough to ask the question, what's ailing you? What don't you like? What's not working well, what do we need to stop today? And if we can stop it today, let's stop it today. And if we can't, how again, can you journey along with us to create a strategy or a process that redesigns this nuance that you're experiencing?

Joni: 

You're right, that does take courage as a leader to ask those questions because hopefully if you're in a safe environment, you're going to get all those answers right, which aren't always easy, but they are important. I really appreciate that.

So you've mentioned a couple of times the cross-functional team as being key to your strategy. How do you create avenues of representation and collaboration across different departments and levels of the organization?

Darius: 

So I always tell people growing up I always heard, “it takes a village, it takes a village, it takes a village.” And that's something that just becomes a part of your vernacular. You say it living through COVID, going through COVID really gave that proverb a different perspective. For me, it takes a village to do the work that we are called to do. This work can not be done in a vacuum, this work can't be done in a silo. And then brought over and said, Hey, now join us.

How do we create, when we think about sustainability, when we think about setting our team members, our leaders, our organization up for success, it is the work of the village. And so if it's going to impact you, even if it's downstream, hey, we are creating, we're discovering what's next for us and we want you to be a part of the discovery call, or hey, we know that this might not impact you initially, but we see where it has downstream impact. Give us a representative to, again, journey with us. I think that those things are important and impactful because again, we're doing work that hopefully resonates across the gamut. And whether we know it or not, the work that we do, I mean it does impact, it's simple to finance, it's impactful to human resources. Workforce is the work of human resources. It's impactful to our operators. There's clinical leaders in that space, and even if they're not clinical leaders, there are people there that impact the clinical operation. So we should include them in the work that we do. And then perspective is also important too. It's easy for us to visualize or perceive a thing in a way because that's the way our mind is wired.

But when we have new eyes, fresh eyes, eyes that view things from a different perspective and even a different part of the brain to, I think it just causes us to be even more successful than we would have had we delayed, including the work of the cross-functional team or including it at all. And then putting it on somebody's plate and saying, Hey, now we need you to be engaged. No, let's be engaged from the beginning.

Joni:

Darius, you are hitting the nail on the head with exactly why and how adaptive leadership moves complex systems forward. It is absolutely that boundary spanning with cross-functional colleagues who have different mental models than we do. So no doubt that's a part of why your strategy is so successful. Darius, we have talked about so many different things today. I have loved spending time with you and unpacking how you and the Orlando Health team have moved virtual nursing care forward as an extension of your team. I already told you I'm biased towards your leadership style. I'm always curious what other leaders are reading or doing or thinking about to spur themselves forward. How do leaders sharpen themselves personally, professionally, as holistic beings? And so I'm curious, Darius, what are you reading or learning about or doing these days to spur your thinking or nourish your soul?

Darius: 

So over the past few months I have refreshed myself. One of my favorite books is The Power of Moments. I absolutely love that book as a leader. It causes us to rise to the occasion. Moments do matter. It's our responsibility to create moments. It's a part of our strategy and responsibility to create them and to make sure that they linger for our team members, our patients. If we're leaders of leaders, we need to make sure that those moments are impactful to those leaders. And I just think that it's the work of heart. It's what we should be doing. So that's one of my favorite books. Every so often, I'll pull it back out and reread it and just make sure I'm aligned. I am originally from Alabama, so I absolutely love Alabama football. So Nick Saban is the greatest.

Joni:

I'm from Texas, we won't go there.

Darius: 

He's the greatest of all time. But I also love basketball and I lived in North Carolina for about three and a half years and Coach K, Coach K and Leading with Heart is a really good read. Timeless, timeless read.  If I could say that. 

Joni: 

Agreed. 

Darius: 

And he has a quote or I dunno if it's a quote, but it's just some points that we should give our team time and attention. We should be able to be nimble and adaptive, learn when to stick to the script and learn when to improvise. I think that that is super important. We can have it all laid out, but monkey wrenches are okay sometimes. And it is hard sometimes to lean into the monkey wrench. It is okay to lean into the monkey wrench and create new strategies and to improvise. It's a part of what it is. And so those, I've spent time over the past few months really bringing those books back to the forefront of my library and really leaning into what we should be. Making sure I am being self-aware that I continue to rise to the occasion.

Joni: 

Yeah, yeah. Those are all great suggestions, Darius. Thank you for that. So again, we've talked about a lot of different things today and I have been taking a couple of notes as we've been talking, and you have some great soundbites, Darius, you really do. I mean, a couple of mantras, like “moments matter,” and “we can have a hope and a plan.” I'm totally going to replicate that phrase in my practice. “What you do for me, you do to me” and I just wrote down, “monkey wrenches are okay at times.”

Darius: 

They are, they are.

Joni: 

I'm going to start incorporating some of these into my vernacular. So we've talked about various things, virtual nursing, the voice of the nurse, the power of gemba, the influence of cross-functional teams. Ultimately, what would you like to hand off to nurse leaders at all levels and in every setting today?

Darius: 

Gosh, a couple of things. I would never, ever underestimate the power of positive thinking and speaking. It is super important. This is called work. And yes, it does become strenuous sometimes, but never let it, never let the stress of the work, never let the stress of the called work really sway you away from what you're called to do. It is a privilege and an honor to take care of people. It's a privilege and an honor to take care of the people that are taking care of the people. It foundationally, it's called work. And the second thing, I would leave just by way of workforce thinking and re-imagining care or someone I told the moderator or the team that I was with, that I imagine that the future of healthcare looks like something off of the Jetsons. There's robotics, there's automations, there's people coming from screens, this, that, and the third.

That can be even as fun as it is. I think it's fun. It could be overwhelming. And so how do we create avenues to where we're able to, that we promote agility and we promote being nimble and rethinking and re-imagining things of that nature. I just think that that is a gift of goal to the future of healthcare, is the ability to lean in when we need to shift, pivot, and be okay with it. I think that those are, I think that things are super important as we really journey in our journey to reimagine what care delivery looks like.

Joni: 

Yes. So Darius, I know that people are going to want to connect with you after this podcast airs to learn from you and just continue conversations. Where can people follow or connect with you to find more of your work?

Darius: 

I am all over. I'm very much a millennial leader. I'm all over social media. So I'm on LinkedIn and you can use Darius Love to search for me. I'm viewable via searching. So LinkedIn, Facebook, Instagram. I'm there and would love to connect. I am a connector. I love to connect. I love to shamelessly take ideas. Yes, replicate. Yes. Yes. And I love to give. So I love mutualistic relationships and exchange and mutualistic avenues of exchange. So super excited about the opportunity to connect with everyone.

Joni: 

Excellent. So everyone, it sounds like no matter what social media channel you're on, you can certainly find Dr. Darius Love on LinkedIn or other social media channels. Be sure to find him and connect with him to learn more. Darius, thank you so much for today for sharing your time, energy, expertise, and passion. It has been a real delight having you on The Handoff.

Darius:

No, I appreciate you having me, and I hope that I said something to inspire somebody to dig deeper and reach further.

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