Your Resource

For Nurse-Led Smart Care Teams

We have dedicated this space to front-line clinicians driving the transformation of care using new technologies, including ambient sensors and virtual care solutions, so they can never stop caring.

Smart Care Team Spotlight Podcast

In a rapidly evolving healthcare landscape, the challenges faced by clinicians are mounting. Join host Molly McCarthy MBA RN-BC, former US Microsoft CNO, as she leads captivating conversations with today’s health leaders about the game-changing potential of AI and Ambient Intelligence for care teams. Visit virtualnursing.com, your go-to resource for accelerating the transition to smart care teams. Presented by care.ai ®.

Meet Your Host

Molly McCarthy, former US Microsoft CNO

Molly K. McCarthy MBA, BSN, RN-BC is the National Director, US Provider Market and the Chief Nursing Officer for Microsoft’s US Health and Life Sciences sector. Molly’s primary focus is business development and strategy for the US Health Industry team that includes supporting and developing solutions such as virtual health, patient engagement, care coordination and analytics. With almost twenty-five years of experience in the healthcare industry, Molly is passionate about uniting technology and clinicians to ensure improved patient safety and outcomes.

Episodes

"Now more than ever, nurses in particular have the opportunity to really lean in, be a part of entrepreneurialship, innovation, driving how technology is going to revolutionize and modernize the nursing care process." - Becky Fox

Becky Fox Chief Clinical Information Officer at Intermountain Health

Episode 26 Streamlining the Burden:

Leveraging Technology for Nursing Efficiency

SCTS_Becky Fox.mp3: Audio automatically transcribed by Sonix

SCTS_Becky Fox.mp3: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Intro/Outro:
Welcome to the Smart Care Team Spotlight presented by care.ai, the smart care facility, platform company, and leader in AI and ambient intelligence for healthcare. Join Molly McCarthy, former CMO of Microsoft, as she interviews the brightest minds in healthcare about the transformational promise of AI and ambient intelligence for care teams.

Molly McCarthy:
Too often, technology makes caregivers' lives harder, not easier. It's time for smart technology to empower care with a more human touch. I'm thrilled to share a little bit more about our guest today, Becky Fox. Becky is the chief clinical information officer for Intermountain Health, where she collaborates with clinical leaders to help set the strategy and vision of how we can bolster health information technology to help people live their healthiest lives possible. Becky has a diverse clinical and leadership background, serving as a champion for numerous large-scale IT implementations, an executive leader at Cerner, a founder of a startup using technology to make gatherings and events safer during Covid-19, and as an emergency department nurse. Becky is passionate about optimizing health care delivery, while at the same time innovating new processes, workflows, and technologies to enhance the health care experience for all. Welcome, Becky. It's so great to have you here today.

Becky Fox:
Thanks, Molly. Great to be here with you.

Molly McCarthy:
Well, first of all, thank you for taking time. I know that you're busy. And appreciate the insights for our audience here today over your career. And really thinking about your career, it's quite an inspiration to many, including myself. You have a diverse background with experiences in many clinical settings, and quite a unique path to your current role as CCIO at Intermountain Health. I would love for you to share a little bit more about how working in various settings, including a health IT company like Cerner, and I know founding a startup has prepared you for your various roles in a health system, both as CNIO and CCIO.

Becky Fox:
I've been very fortunate, you know, in my career to have lots of different opportunities. And I think, you know, when you go to nursing school, that's not necessarily what you plan is, you know, In two years, I'll do this, and in five years, I might take a different path and try something else. But that's the great thing about being a nurse is that you have really visions, like the aspects of your life that might be developing. So, for example, when I was newly married, it was a perfect time to join and partner with Cerner and travel around the world. I didn't have children and other responsibilities of soccer games or, you know, activities at school. So I was able to travel around and really dive into that aspect of learning different areas within the health care system. As my children got a little bit older and other dynamics changed our family, then it also became an opportunity for me to really hone my skills as a chief nursing informatics officer in my local community and really understand the challenges that every healthcare system faces, and then, most importantly, work collaboratively with other leaders to really make differences, which to me felt like in my backyard and still be at home. So that's always the biggest challenge, I think, for women, women leaders is how do you figure out the balance? And just always looking at it as every single opportunity that you have in your career is another skill set that you can put in your tool belt. So even when I look back at my graduate time, at that point in time, I really had to kind of piecemeal together some things to pay the bills. And so I got an opportunity to work part-time for a pharmaceutical company, I worked part-time for a staffing agency and got to work in an ambulatory clinic, got to work at a long-term care. And even though, you know, I'm sure my mom was probably questioning: What kind of career is this, that you're doing all these little things? What they really taught me later on, though, is really having that experience of being the boots on the ground and understanding what is medication delivery in a long-term care facility. What does it mean in an ambulatory clinic on Friday afternoon at 5:00, when patients are really trying to renew their prescriptions? How those different dynamics really make a difference, now, when we're trying to put in technology and make all of those processes less smoother? So I'm very thankful that I had those opportunities. And there's no other career than nursing that can give you all those opportunities to really learn about the entire continuum of health care.

Molly McCarthy:
Yeah, I love that. Really, obviously, balancing your personal journey with your professional journey is so important regardless of where you are, I think. And also I love your point around opportunity, just the ability to learn different skill sets and really taking those skill sets, they're transferable, from one role to another; I think that's really something that's unique about nursing. The other piece that I heard, actually, when you were mentioning your mom, is just flexibility, not just in terms of the roles that you have, but the opportunity to be flexible and creative in your life. And I'm sure that came in handy when you were at Atrium as the CNIO with Covid-19. So just being flexible during that time period, I know you did a lot of innovative work then, so really appreciate your insights there.

Becky Fox:
I want to, I do think that, you know, that is the thing in every opportunity. There's always great experiences that you can have in any job and any role. And sometimes there's challenging experiences. And what I always try to say is, even in the challenging moments where I'm like, man, I don't want to do this kind of work, or maybe this isn't the team for me, there's still a lot of nuggets of wisdom that you can take forward. So in Covid, we learned a lot. There were some things where like when, man, we shouldn't have done it that way, or we should have really gone in a different direction. And so just pausing and saying, Okay, what can I take that I learned from that to make me a better leader, to make me a better colleague, to make me a better nurse, and make me better for patients or our communities or our health system. If you can always have that perspective, that's what helps keep you going. You know, again, if I look back in my career, there's lessons I learned along the way that you just put in your tool belt and then you never know when you're going to need. You know, something I might have done ten years ago, and, you know, I used to support the special events team and help really provide nursing care at football games and basketball games and those kinds of things. And so when we were looking at vaccine distribution, well, that was a great example where I'm like, wait a minute, I know exactly how to take care of, you know, of patients as they're coming in through a football stadium, you know, because we had seen that. And so having those lessons learned, and even though there might be challenging at times, they might pay off later on somewhere in your career path. So always think of them as gifts and little nuggets of wisdom, and that someday you'll be able to use them to your advantage.

Molly McCarthy:
Yeah, I love that. Those little golden nuggets that sometimes you appreciate more in hindsight. So kind of switching gears now, talking a little bit about Intermountain, obviously it's, you know, I've worked with Intermountain in many different roles and it's a well known system, very highly respected for innovation. And you and your colleagues are really among an elite few major health systems that have embraced value based care at scale. Intermountain has ceded transformative companies like Civica RX and Graphite Health. You've embraced new models of care, expanded into new service areas with acquisitions, etc.. So I would love for you to tell our listeners about the advantages of the culture of innovation and what that brings to your role and how that manifests itself in your work every day.

Becky Fox:
So one of the important things is you can want to be innovative, but if you don't have the culture to build and sustain that, it's really difficult to get innovation done. And so we are very fortunate that Intermountain has a long history of really leaning into innovation and leaning into innovation that comes directly from the front-line caregivers and staff; nurses, providers, anyone in the organization today can submit an idea for change, which is really exciting to have that opportunity. When you walk through the campuses and the different, you know, health care settings within the Intermountain Health, you'll see posters or you'll see signs or big banners that will say, Submit your idea here. And, you know, any clinician or caregiver can take a picture of a QR code, submit an idea that will be evaluated by the organization to see if that's something that can bring efficiency, better quality, and outcomes for our patients. And we know that some of the best ideas that we had at our company and in healthcare really come from those that are delivering the work on a daily basis. So it is exciting to have that kind of culture and that climate. And right now we're doing some piloting and some work in expanding our telehealth services, looking at AI for nursing. And so if you have that culture where everyone says, Hey, we're going to lean in and try things out, there might be things that don't work, and we absolutely want to hear it, learn quickly, pivot as appropriate, and move things forward and share those experiences with both inside the organization as well as outside and externally. We do think there's a really important aspect of having a collaborative culture as well, so we can learn things, which is awesome, and we can make differences to patients and families and communities, but it's really much more a part of our bigger mission, which is to help everyone live their healthiest lives possible, which means that you have to be a good partner, you need to share these lessons learned with other healthcare entities in the entire ecosystem so that collectively, we can all make a difference together. And so that's what I'm very fortunate to work in that. It is something that is felt at all levels of the organization, I would say as well, which again, is really important to have not only a culture at the top line, but also at the front-line caregivers. And so when you have that culture where you have that openness, when you have that transparency and really seeking feedback, listening to learn, and really embracing that at all levels of the organization, that's why I think you're able to make differences and try new things out and hopefully make a difference to the patients and communities that you serve.

Molly McCarthy:
Yeah, I think that's really important, just the culture piece and then the ability for front line staff, and I'm assuming it's not just nurses, but it could be someone from pharmacy, it could be someone from PTOT, speech therapy, just all the different disciplines, as well as someone who might be in more of an administrative role can participate in that. So that's great. And I love your comment about collaboration internally and then really externally, because as we know, having been in healthcare for quite some time myself, I know that collaboration is key between health systems, between tech companies and health systems, really, because it's going to take a village to make transformation happen.

Becky Fox:
And that's the thing that we all really learned in the pandemic was, I would say five years ago, if someone discovered something great, a new process or a way to take care of patients, then a lot of health systems would then want to replicate that to validate the information. And so what we found is during the pandemic, instead of replicating things, we're just carrying it forward. So if someone has a great idea and they can get through steps one, two and three, then the next health care organization needs to do four, five, and six, and then collectively they all move together faster. That's what we really seen in the telehealth space, especially, how do we bring efficiencies to nursing? Every health care system is experiencing a shortage predominantly in nursing, but it's impacting all of the disciplines. And so if we don't collaborate together, really focus on retention, recruiting, making sure there isn't a burnout aspect and making life as best as we possibly can for our caregivers, then we're all going to be impacted by that. So it really is this collaborative attitude that I've found has really evolved in the last few years. I think the pandemic drove a lot of that, but I'm really excited to be at a point where we can all very quickly if we have a challenge in our telehealth space, I could pick up the phone, text some friends and say, Hey, what did you do to solve this? And then we can share ideas and most importantly, make a bigger difference quicker.

Molly McCarthy:
Yeah. Without like you mentioned, additional proof points, etc.. So obviously you've got a lot going on at your organization. I know you're about a year into your role, I think?

Becky Fox:
Yep. Just over a year.

Molly McCarthy:
Just over a year. Yeah. So how do you set your priorities? And would love for you to share some initiatives that are kind of top of your list today.

Becky Fox:
Probably the biggest one is how do we bring relief to our caregivers on the front line. So one of the things our CEO, Rob Allen, has really focused on is simplification. It really is just as simple as that. How do we make your work life experience easier? And so that can be anything from signing your time sheets to maybe having a name change to using our EMR, to placing orders to getting equipment supply chain; every aspect of the organization, we need to try to make it things as easy as possible. You know, even though we might have the best intentions, sometimes we put technology in place that might have a few speed bumps along the way. So really having open dialogue, transparency, and again, that culture of ideas sharing from our frontline caregivers has really been beneficial to helping us focus and reprioritize those things. There always is the challenge of, you know, there's 8 million things that we would like to go do, and we only have the time and or the resources to do a lesser number of those. So it really is important, again, to work with our operational leaders to help us with prioritizing those things. We are really focused on making sure that our tools are operating at the highest efficiency, bringing the biggest values to the caregivers, and smoothing and optimizing along the way. So for us as informaticians within the organization, we really focus on building tight relationships with our clinical and operational leaders so that we know directly from the top line. And then we also hear directly from our frontline caregivers. So really, again, listening, leaning into what are the biggest challenges and then trying to serve as the translators and help to reprioritize those things from an IT perspective is really important.

Molly McCarthy:
Yeah, I love that. You mentioned translators. I know that we often sit in that space between tech and clinical. It's so critical to really have you in that role, just because you're able to really understand from a technical perspective and clinical. So very unique. So that's great. I would love to kind of dig in a little bit more to technology. And as I mentioned at the beginning, sometimes technology can be somewhat of a hindrance. And our goal really, at least my goal in my career is to ensure that technology can really empower clinicians. And to your point around bringing relief to your frontline caregivers so that it's not so frustrating and they can do their job and they're not encumbered by administrative tasks. So I'd love for you to just share a little bit more around rapidly evolving technologies and workflows, like virtual inpatient care. I know you've done a lot with you mentioned telehealth, not just, you know, having cameras and rooms, but ambient monitoring. And then also, you mentioned artificial intelligence to really help address your priority of bringing relief to the front line.

Becky Fox:
So one of the things that we're really focused on is how do we bring tools and technology to help support the caregivers? So nursing staff, for example: How do we help them in the process? If there's administrative tasks that they're doing, then how can we relieve that burden? How do we streamline that burden? And then how do we optimize that activity? So for example, you know, in the last six months, we evaluated our admission process in one of our regions and really looked at some of the content. And we realized that here, content that we were gathering that was very important, maybe a few years ago, was now less important or perhaps it was gathered at other points during a patient's in-country visit. And so we realized that this was something we did not need to collect anymore. And so we went through all the right governance channels to make sure we were meeting regulatory compliance and those types of things. And we were able to remove just one section off of our admission process. And while some people might say, Well, that was just one section, it ended up being about 5.6 million clicks, you know, or assessment points that we were able to eliminate on an annual basis. Now, that does not mean that we can do with one less nurse on a unit, that doesn't mean that we're going to change FTEs, but what it does mean is that is not a bedside nurse standing with a patient and asking them for information that it really is not valuable or contributing to the care of the patient. So not only is it impacting, the nurse is not collecting the information that really doesn't go anywhere, it really is also the patient experience. I'm not asking the patient something that they really is not going to help and change their outcomes at all. And it did end up being, you know, quite a number of hours. If you add up all the time of all those 5.6 million clicks. But those are just examples where sometimes just reevaluating what you did and put in place five years ago, three years ago, can really find some little nuggets of benefit and simplification. Now, at the same time, we're also looking at how do you streamline alerts, how do you streamline notifications, how those notifications come to a nursing staff? I'm sure many of us in our own personal journey, as everyone has become acclimated and, you know, can't live without a smartphone, we all have that experience where, Oh my goodness, I'm getting this text message five times from the store or travel or whatever it might be, and they didn't, or the school or, you know, and they didn't mean to text me six times. Everyone's had that experience. So what I would also say is everyone lives their last best experience and their last worst experience. So if you have a terrible experience with a personal shopping or a personal travel that impacts you, when you come to work, you don't want to repeat that. If you have a great experience at any of those other personal things in life, you've come to work and you want to have the same similar great experience. And so that's what we're really trying to look at now of how do we make sure that alerts are functioning in the best way that they're really functioning in the most appropriate way, and then we're not driving people crazy by either alert, over-alerting, you know, fatiguing them with having to answer or re-answer things and really kind of trying to smooth the edges of the technology that we put in place.

Molly McCarthy:
I think optimizing your investment in what you've already financially committed to is so important in this day and age. I love the example around the admission process, and that's quite a tangible number, 5.6 million clicks on an annual basis. I know sometimes as a nurse or a patient, some of the questions are like, well, it's charted or it's been asked of me 20 times. It's got to be somewhere. So that's wonderful. And it's not just because, you know, you're making changes because it just doesn't make sense for the clinician or the patient. And then the, obviously, the streamlining alerts and notifications, as you mentioned, I do that on my smartphone. I don't like to be disturbed by certain apps, etc.. The thing that I heard you say, which was really neat, that I just want to repeat for everybody, is, you know, your last, best experience and your last worst experience. And that's really true. And it's not just for that patient coming in, but it's for our clinicians at the bedside. So I commend you guys for looking at it from kind of both of those lenses because I think that's really important to improve the overall experience.

Becky Fox:
Yeah. So that simplification, how do we make things simple, it's everything from how do we help patients with scheduling appointments, how do we ensure they get notifications. And the other thing I would just encourage, like I said, there's always a full agendas and schedules and calendars and meetings that every one of us have to attend to, that if you don't have the opportunity to go and see it, to feel it, to experience of what our patients and their families experience, it's really hard sometimes to see some of those nuances that need to go away. I know recently I had, you know, had to schedule an appointment annual well checks for some of my family members, and the process, again can be very easy or it can be very challenging depending on the technology that set up the health systems. And so it's really important for folks to understand that, that there's a lot of different nuances that go into that, whether if you have one child you're trying to schedule an appointment for, if you have three children and you're trying to schedule an appointment for, and really trying to understand, how do we make that as simple as possible? That's what's really important is because the best experiences are what's going to keep patients coming back and families coming back; the worst experiences are what it makes it easier for them to go somewhere else.

Molly McCarthy:
And that's really important. And not only thinking about how you make that appointment. I know for me, for example, I had to make an x-ray for my son's foot for this evening, and I was like, if I can't do it online, I'm not going to make it at a certain place. But I think that's important. As we think about the demographics of today, who's in the workforce, who's in the patients in terms of five generations of people and what they might prefer. Some people might want to call and speak with someone. Other people are like, you know, for me, I was like, I want to do it online. If I can't do it online, then, you know, I'll find another place. So I think that's really a great point around ease of use and simplification.

Becky Fox:
I think the other key aspect is it's more than 80% of all health care decisions for families are made by women in the family. So the reality is, if you're not focusing on that of how do I make it easier for the woman of the household to make appointments, to schedule things, the convenience, the information, make it easy for them to access that information, get to it in a multitude of different ways, meaning, if I go to the website, it's the same type of experience as if I was on my phone versus if I was calling in. It's all the same types of information, same experience, a good experience at every point of the way. And that's how you're going to help women make the decision to keep coming back. The women are the primary decision makers of health care for not only themselves and their immediate family, but also for extended family. And so we have to again, continue to remember the last best experience they had is what they're going to compare you against. And so if you can make it convenient, easy, forward-thinking for them, then that's how you're going to have a loyal family that'll keep coming back to your health care organization. And so as Informaticist, we have to keep that perspective in mind. And when we find pain points, when we find stumbling blocks, when we find those little bumps in the road that make it a little bit harder, that's what our role, is to really help surface that, help everyone else understand that, and then make better choices and make it easier.

Molly McCarthy:
Really great points. Thanks for, you know, mentioning that. And just what keeps, you know, to some extent our loyal consumers, it's important in this day and age, and just to drive that continuum of care as well. So my second to last question is I would love for you to share your vision for the future of nursing within the hospital. Really, when you think about change management as care models are being reimagined right now, and obviously the role of technology will play to empower bedside caregivers as well as patients in new ways. We've talked a little bit about scheduling. Just would love for you to share some of your thoughts around care models within nursing, and how that will help nurses simplify as well as patients.

Becky Fox:
I'm really excited to be in health care right now because there is so much technology that's evolving, and even though there are some scarier aspects, uncertain aspects from a regulatory perspective of what's going to happen in the future, I'm also really excited because now more than ever, nurses in particular have the opportunity to really lean in, be a part of entrepreneurialship, innovation, driving how technology is going to revolutionize and modernize the nursing care process. I'm sure many of my colleagues out there remember writing on paper, which now sounds so like dinosaurian. And the dinosaurs brought us a piece of paper and we wrote down a care plan. But really, this is our opportunity to say, like, I don't want to just take the care plan and put it in an electronic format. I really want to say, Why am I writing this care plan at all? For how can we completely have AI help generated and make me focus as a nurse on the more higher priority things for a patient? That's where I think is the greatest opportunity. And nurses, in particular, have the opportunity now to really be a part of those conversations, to drive those conversations about what this technology needs to be. So to me, it's an exciting time to be a part of that, to be a voice at the table that says, Hey, this is what we need to do and change and really revolutionize what we've been doing. What I envision is there is going to be a lot of technology coming at us fast and furious, and I'm really excited because no longer will the nursing staff have to spend a lot of time trying to figure out staff scheduling as a nurse manager. We have tools, and there will be tools that will help them figure out where the challenge is going to be in the staffing model, where are the gaps going to be, and how do you help fill those? Where are you going to have overage? And how do you help shift things around? We want the technology to help drive those things. So the nurse manager, instead of filling in holes, is really focusing on managing the units and supporting the team that he or she is responsible for. When I'm really excited for too is that the nursing assessments can change and the care planning can change. And again, now with AI capabilities, you can look at this large data sets of patient information and serve up to the nursing staff priorities, things that might need further evaluation, and really refine and hone in their assessments where in the past might have been something that was overlooked. So I am excited about how it will change not only the operations of things, but the assessments and how we plan care and how we are notified that the patients at risk for different things into the future. And then I am really excited about the capabilities that are coming with regards to data analytics. So right now we make decisions with the best sources of information that we have. And you can imagine now, not only having information within our health system, but across other health systems, I really think there's going to be a greater ability to drive care planning, meaning treatment planning, interventions, surgeries, etc., for our patients. So I do think that's just going to be a really a big change and shift in how, you know, it's not going to be the same cookie cutter treatment perhaps for patients; it really can be much more personalized, much more driven, and that will hopefully lead to better outcomes, lower costs, and a better experience for everyone.

Molly McCarthy:
Yeah, so many good points that you mentioned. Just, you know, one thing that I heard right off the bat was just, you know, we don't want to take what exists today and just digitize it for the sake of making it digital. And I think that's so critical. Even when we think about documentation, you know, moving from paper to computer, really as nurses working with our critical thinking skills, so important. And that's what technology can enable us and allow us to do is to work to the top of the license. So that's where we're focused. And really, I'm going to reiterate your point about nurses more than ever, having the ability to drive the transformation within nursing. We own it. So we should be driving it, quite frankly, in partnership with our technology, vendors, and our IT departments, chief clinical information officers. But there's no reason why we shouldn't be at the table.

Becky Fox:
Absolutely. And so what I would say to encourage those out there, because some folks might say, Well, how do I get involved in that? So the first thing is really just learning all you can. You can simply Google, Safari, any of the platforms you can go and just research what other folks and other healthcare systems, what other companies are doing around the AI development, and understanding how people are using it. That's the first thing is really to help educate yourself. ANA is a great source of information, AONL; there's a number of different professional organizations that also are bringing forth educational sessions so that nurses can really understand, and all caregivers can really understand how AI might impact the care that they deliver, and most importantly, change things for the better. The second thing I would say is raise your hand anytime you get asked an opportunity of, Hey, do you want to get involved in a project, a pilot, you can reach out to the technology arm of your healthcare system and ask about how you can get involved, and you'll be surprised about if you let others know that you're interested in helping it to be a voice of that, and learn and test things out, then you'll be surprised how you can find some great ways to really expand your involvement in your ability to make a difference.

Molly McCarthy:
That's great. My last question, which I think you just answered, but I'm going to ask it just to make sure we didn't forget anything, is obviously our listeners from different cross-sections, but CNO, CNIOs their respective teams. And so given that your experience is, you know, very unique within healthcare and really across different portions of the health care system, if you had to give one piece of advice to our listeners, what would that be as they are thinking about the responsibility of being tireless advocates for their patient? I know I do want to reiterate what you just said in terms of learn all you can and raise your hand to get involved. Anything else that you want to leave our listeners with today?

Becky Fox:
I would say the other thing is don't be afraid. Well, it's two pieces of advice. Don't be afraid to jump in. You'll be surprised. Like if you can figure out how to connect up a chest tube in a crisis moment and do CPR and save lives and all those kinds of things, you can do really big, amazing, incredible things. So don't be afraid to jump in with an idea, with an innovation, and really helping to lead the way. The other thing I would say is don't sweat the small stuff, and build relationships along the way. So I guess it's three pieces of advice and that is, I've been surprised in my lifetime that there's been things that might have felt like stumbling blocks, and maybe I gave it more emotional energy and time and effort than it really needed to. And so instead of focusing on that stumbling block, instead focusing on how to get around the stumbling block and how to proceed forward. And so I think if you spend your time and energy on the path forward, even though it might be a different path forward, you'll come out further in the end and your idea will come out further in the end. And then, like I said, just don't sweat the small stuff and don't be afraid to jump in.

Molly McCarthy:
Well, Becky, thank you so much. Always great to have you enlighten me with all of your amazing experience and wisdom as well as our audience. So thank you so much for your time today and I look forward to seeing you soon.

Becky Fox:
Always good to see you, Molly.

Intro/Outro:
Thanks for listening to the Smart Care Team Spotlight for best practices in AI and Ambient Intelligence, and ways your organization can help lead the era of smart care teams. Visit us at VirtualNursing.com, and for information on the leading smart care facility platform, visit care.ai.

Sonix is the world’s most advanced automated transcription, translation, and subtitling platform. Fast, accurate, and affordable.

Automatically convert your mp3 files to text (txt file), Microsoft Word (docx file), and SubRip Subtitle (srt file) in minutes.

Sonix has many features that you'd love including powerful integrations and APIs, collaboration tools, automated translation, automated subtitles, and easily transcribe your Zoom meetings. Try Sonix for free today.

(function(s,o,n,i,x) { if(s[n])return;s[n]=true; var j=o.createElement('script');j.type='text/javascript',j.async=true,j.src=i,o.head.appendChild(j); var css=o.createElement("link");css.type="text/css",css.rel="stylesheet",css.href=x,o.head.appendChild(css) })(window,document, "__sonix","https://sonix.ai/widget.js","https://sonix.ai/widget.css");
Spotify Apple Podcasts  Amazon Music iheart Radio

"I would say that we have optimized the monitoring of children across states. We can go into the room and see the patient, but then this next phase of virtual nursing has taken that to a whole new level. So with the new technology and with support from our technology partners, this camera now, not just can see in the room, but it can be interactive and that the virtual nurse can come up on the screen. We've actually been able to pull up an interpreter as well." - Dr. Jane Mericle

Dr. Jane Mericle Executive Vice President at Nemours Children's Health

Episode 25 Innovating for Our Little Ones:

A Spotlight on Pediatric Healthcare

SCTS_Jane Mericle.mp3: Audio automatically transcribed by Sonix

SCTS_Jane Mericle.mp3: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Intro/Outro:
Welcome to the Smart Care Team Spotlight presented by care.ai, the smart care facility, platform company, and leader in AI and ambient intelligence for healthcare. Join Molly McCarthy, former CMO of Microsoft, as she interviews the brightest minds in healthcare about the transformational promise of AI and ambient intelligence for care teams.

Molly McCarthy:
Too often, technology makes caregivers lives harder, not easier. It's time for smart technology to empower care with a more human touch. I'm thrilled to share a little bit more about our guest today, Doctor Jane Mericle. Doctor Mericle is executive vice president, enterprise chief nursing executive, and patient operations officer with Nemours Children's Health. She is a member of the executive cabinet and serves as the senior nurse executive for Nemours Children's Health. Doctor merkel brings more than 40 years of health care experience to her role, and is a certified and executive nursing practice with expertise in clinical quality and patient safety, strategic planning, fiscal accountability, operational management, magnet designation, performance improvement, patient experience, and interprofessional collaboration. She is a Team Step Master Trainer, a certified Six Sigma Black Belt, an executive leader for LEAN, and she completed the Disparities Leadership Program sponsored by Mass General Hospital. Prior to joining Nemours, Doctor Mericle served as associate chief nurse for Duke Children's Hospital and Health Center. She has received numerous professional awards during her career, including the very prestigious Founder's Medal from Vanderbilt University, the North Carolina Great 100 Award, and the Duke University Health System Emeritus Presidential Award. Doctor Mericle completed her Doctor of Nursing Practice program at Vanderbilt School of Nursing, earned her Master of Health Science in Clinical Leadership from Duke University School of Medicine, and her BSN from Columbia University. Welcome, Doctor Mericle, it's so great to have you here today. Do you mind if I call you Jane?

Jane Mericle:
That would be perfect. Thank you.

Molly McCarthy:
Thank you so much for taking time today to speak with me and our listeners and share your story and insights. So, Jane, I almost don't know where to start. Your career obviously is so rich in terms of experiences around nursing quality and safety and children's health care. And I'd like to dive into all of these areas. But first, really want to start with Nemours and Pediatric Care, as you are a first guest on the podcast leading a dedicated children's hospital. And I'm biased because I started my career as a NICU and pediatric nurse. Many of our listeners and including the podcast host, myself, have a special place in our hearts for those who care for children. So I'd love for you to share a little bit more about what leaders and innovators should know about what is different about delivering care in a pediatric setting, rather than in an adult-focused hospital? And what are the issues that you may differ but also have in common?

Jane Mericle:
Sure. Thank you, Molly. I'm glad to hear about your experience, because clearly you understand what a privilege it has been for me to serve and enrolls in children's health. All of my whole career has been as a nurse in children's health, and I can't think of a more important mission. When you think about children's health, we clearly say, It's not about having, taking care of little people. We will care for children and infants from prematurity to all the way through adolescence, 18, 21 and so, as you can imagine, just as you think of that span and the body and the size that changes, so we're having to think about that, we're thinking about developmentally; what an infant, what a child, what an adolescent needs. So highly specialized care around there. Move on to the kind of ways we communicate where you're not just communicating with the families and the adults, but we're communicating with the children. And there are definite ways of doing that in the different developmental stages. And I would say another thing is that children's health is always around the family-focused approach. Families have to be a part of that care, part of the care plan, a part of that understanding. And our teams are really specialized in delivering that sort of care. Then when we move from caring for children in periods of wellness, great deal of focus on prevention. So we want to have that health care delivered with that priority so that we can prevent disease from even developing. And then we have subspecialists who are specially trained in pediatrics and then in the specialties because there are children, small proportion, but there are children that have congenital defects, that have special childhood diseases, childhood cancer. I could go on and on. But there, it is, all wrapped around these children. And so you can imagine then also the psychological support for both children and the families that are a part of their care. So very specialized and very specialized around the different ages and phases of these children.

Molly McCarthy:
Yeah. Thank you. I've worked both in hospitals that take care of pediatric patients and specialized children's hospitals like Nemours. And the family-centered care is definitely an aspect I remember just because you are, and the parents, obviously, so important in the communication loop, especially having worked in the NICU, you have extended stays so the parents might not be at the bedside all the time. So even today, thinking about how far we've come, I'm just going to throw out technology just to.

Jane Mericle:
And I was going to add to that, Molly, even one of the comments that I saw last week from one of our parents was, Thank you so much. This was a child that was pre-teen. Said to the providers, Thank you so much for speaking directly to my child as well and knowing how that was important. So it's both ...

Molly McCarthy:
Yeah, that's a really good point because obviously that child, depending upon where they are developmentally, wants to be and should be included in that process. Thank you. I hope our listeners really can differentiate that specialized care that you provide. From a quality and safety perspective, specifically, what unique challenges must you address in pediatric settings as you consider opportunities for innovation?

Jane Mericle:
I think that if you think about, and what we just talked about, the individuality, we're thinking about the kind of care that really optimizes within that communication, optimizes within whatever developmental stage helps whether a parent is present or not present. And I think that the safety and the quality, also children are more vulnerable to complex systems if they don't go well. When we think about something like medication safety, the kind of dose from an infant to an adolescent is very different. And some of the equipment that we use is very different. And so we have to be able to create systems that are really address each in those sizes and the individual needs. And I think neonates are particularly vulnerable around infections because they have an immature system that protects them. And so we have to take all of those into consideration.

Molly McCarthy:
Yeah. Just drawing upon what you said earlier, they're not little adults, regardless of where they are in the developmental. And so both physically and I think spiritually and mentally they're at different levels. So very important. I know you mentioned medication dosing, which obviously done per the weight when they're very tiny, but also even the technologies aren't necessarily approved to use at at certain weights or levels of care. Really important as we look at the pediatric market to make it, it is very different and specialized.

Jane Mericle:
So when we think of technological innovation in pediatrics, I have to say that it's always been a part of our DNA at Nemours. So let's think about that vulnerability and children. We've had cameras in rooms and in patient rooms since 2011, where we knew that we wanted additional ability to monitor and to see those children in case there was an adult in the room, or in case there was vital signs that were telling us that they needed attention, or we could alert a nurse to go check on a child. We've had Kidshealth.org, which is an information sharing platform, since 1995, and that has been to really be able to share information to providers, to parents, and to those kids that can take in that information like school age and adolescence. And so we've been developing that over time. Telehealth has been part of what we've adopted to make care easier. And as during a period of Covid, the adoption absolutely skyrocketed because in some cases, it was the only way that we could deliver that care. And what a profound way, if you think about, for example, a child needing to have some counseling or a therapeutic intervention and being able just to be comfortably at home and dial in with their provider or parent, being able to ask the questions and have that interaction. It's really, it is part of what has enhanced our care. But there's so much more to do.

Molly McCarthy:
Yeah. Thank you. I love you mentioned having cameras in the room since 2011. I'm going to come back to that in a little bit. But you mentioned telehealth and my next question is a couple different parts. So I'll piece it out. But obviously Nemours is you are multi-state operator with, you have two hospitals, one in Delaware and one in Florida. And I know that you've got multiple outpatient clinics in Jersey and Philadelphia area, etc.. So I'd love to better understand how you think of care geographically. Obviously you oversee all of those sites.

Jane Mericle:
Yes. We are one of the largest multi-state pediatric healthcare systems in the country, and we're very fortunate to have such diversity across regions geographically, socioeconomically, regulatory, politically, which challenges us, but also this helps us to really push on new approaches that withstand diversity and the needs of our patients. Ultimately, we believe we can develop innovative approaches at Nemours, and it can be emulated by many other diverse organizations across the country. It's important to underscore the importance of Nemours Children's, and that we see ourselves as not only providing health care, but delivering health. And so we're really looking at how do we intervene with children in those healthy phases, because a healthy child creates a healthy adult, and we understand that and we take that burden seriously. And so we see ourselves also as both a leader and a convener. I would say that part of children's health care is also about coming together, whether it's different children's hospitals as an organization such as the Children's Hospital Association or whether it's in different collaboratives because there is nothing that should be protected around learning and quality and safety and technology and interventions and research. I could go on and on. But the more that we do that together, so as a health system, we're learning how to do that regionally, internally. But we're also doing that externally with many partners and with many other caregivers.

Molly McCarthy:
Yeah, I just want to point out that historically, and this was the next part of my question, which you already really touched upon it, that children's hospitals have always been, from my standpoint, really collaborative and open to sharing with one another. Obviously, how can, as you mentioned, how can we share our findings so that other hospitals don't necessarily have to recreate the wheel? I love that, I love the collaboration among children's hospitals. I worked with the Children's Hospital Association of America before. I've done some work with the International Society of Pediatric Innovation. That's fabulous, and I love that sharing of knowledge. Do you have any specific examples where you've led in that space or particular projects that you've worked on?

Jane Mericle:
I think probably the one that we want to talk about is the newest of our projects, where we're doing it across the state, but we're also doing it as hospitals is the virtual nursing care, and we can get into that. But I think that's a good example. I think the other thing is we collaborate on care bundles for ... bloodstream infections in children; how to prevent them. We collaborate on strategies for preventing harm in children. And I think that one of the areas that we led in several years ago was identifying septic shock. We were in a collaborative with SPS, or solutions for patient safety, and how to create the bundles and their response for early recognition of that septic shock. So I think there are examples of where were the innovators examples were that happy to be the partners and early adopters as well.

Molly McCarthy:
That's wonderful. I know, I do want to tell you mentioned virtual nursing, so I will take advantage of that and really dig into that a little bit more, obviously, with my tech background and our listeners wanting to learn more about the different uses of technology and sharing, really, that's the purpose of this podcast. So you mentioned earlier that you installed cameras in every patient room way back in 2001. So congratulations to you. I know that's so important, not just as a nurse, but as a parent myself and having kids in the hospital before. I think that's really important. And so building off of that foundation, what's your vision for the future of nursing within your hospitals when you think about the next generation of, for example, advanced sensors, which have broader capabilities beyond just the camera in the room, but thinking about ambient monitoring or smart alerts? So just, can you tell our listeners a little bit more about how technology will enable you and your nurses to reimagine care models and really to broaden the scope, and ultimately, from my standpoint, what I've seen is improve patient satisfaction, improve the caregiver experience? I want to hear where you are in that journey.

Jane Mericle:
There's so much there. And let me just, by contrast, let me share a one short story with you as a new nurse on a medical unit taking care of children. When I started, I would count drops in an IV to regulate the rate of a fluid that a child got. So I would literally stand there and adjust a roller clamp to be able to deliver the right amount of fluid to gravity. And fast forward, now it's, you talk to our nurses now and they can hardly even imagine. But fast forward to then using smart pumps and having IV delivery systems, a technology that not only delivers it accurately but also has guardrails and libraries so it alerts the caregiver as to are you sure you want to deprogram that? Or, this is infusion is done; your next, ready for the next. So we've already seen some of that progress in the same way in a more started with cameras in the room. And I would say that we have optimized the monitoring of children across states. We can go into the room and see the patient, but then this next phase of virtual nursing has taken that to a whole new level. So with the new technology and with support from our technology partners, this camera now, not just can see in the room, but it can be interactive and that the virtual nurse can come up on the screen. We've actually been able to pull up an interpreter as well. So if English is not your first language, right there, we're starting to do the interpretation where that virtual nurse is also doing something. Not all the listeners may understand that sometimes the team's work is administrative and entering a lot of information into the computer, into our electronic record. And so while the electronic health record has been an advance, it's also one of those things that has a double edged sword because there's a lot of interacting with computers. And now what we're finding is these nurses are able to do a lot of that administrative work virtually. Our families understand the virtual model because of what we've just gone through with Covid and Zoom. And what we're able to do then is create much more space for the caregivers that are right at the bedside to do the hand on, the interaction, the human connection. And so what we have found that is done is really twofold. One, you talked about our workforce. Nurses, about 80% of our nurses are still express a great degree of satisfaction. However, when nurses are not feeling satisfied, we do know that one of the largest impacts is that burden, that work burden, that burnout. So many things to do, so many things to handle. But we are finding that this kind of model, the virtual nurse, has lifted up some of that burden. And so the satisfaction at the bedside is great. The satisfaction for the virtual nurse can be great, because it may be that they're at a point in their career where they couldn't imagine running the halls anymore and doing that, and that being able to use all their expertise in that kind of fashion is a beautiful thing. So that's been really positive. We're about eight months into our pilot, and we early on, 75% of the nurses that experienced virtual nursing model were very positive about it. But then there's the thing around the parents and the families. We have some early data that's coming in that also says it's improving their ability to interact with the nurses, to communicate, to understand, and to get that information. And we're seeing some of that, those early outcomes from both English-speaking and Spanish-speaking families, which is just really very positive, because in health care, sometimes those language barriers can be daunting. And then when we think about, let's go back to quality and safety, which you know is near and dear to my heart. We are finding that by having this overlay of this virtual nurse, that we are having opportunities to prevent harm, whether it's clarifying education and making sure that the caregiver really understands, whether it's a clarification of an order that may have not been fully understood, it may even be that they're being able to understand whether there's a therapy available fo the child at home. So we're seeing this and not just helpful to our teams, but incredibly impactful to the care that we're delivering. So that is an exciting new model of care. However, to your point, I think it's just the tip of the iceberg. I think that what it's telling us is we have to get out of our traditional models and thought process. And so what about this on-demand voice? What would it be like to have a nurse dialoguing in the room with a family and that program, being able to discern that and put that into the record as part of our record, what would it be like? And we could, I'm sure we can do this now, is to say, just like Alexa or Google, say, Hey, I'm worried about my child and have a rapid response team come ..., right? So there's so many possibilities of this. And I think that we won't get to that by working in traditional silos, the way that we are going to get to it is like what we're doing now is where we work with clinicians, analytics, engineers, technology, and that we really break down those silos, and that is what we're doing now. That's what's helping us to advance, to think of, so what are the possibilities? And then what is the application in this particular environment?

Molly McCarthy:
You have so many great points. I just want to summarize a few that I heard from you and congrats on. I know you mentioned you're eight months into your pilot, and I love always to hear the anecdotal feedback and outcomes. Maybe it's not published yet, but I think it's really important and very important learnings just in terms of burnout. You mentioned alleviating burnout and increasing the satisfaction of the nurse as well as the virtual nurse, which is fantastic. I have heard that so many times. And one thing I do want to mention too about that partnership between that maybe you have a seasoned nurse who's remotely and working with, for example, a newer nurse. I know when I was a new pediatric moving from NICU into pediatrics, I remember the nurse manager saying, It's going to take you one year to see every diagnosis across the pediatric spectrum, from newborn to, all the way up to the adolescent. And I just remember thinking, actually, today I think about what if I had a resource, a seasoned nurse at that time just to help me through those newer situations. So I think that's amazing. And it does increase that seasoned nurse. Her knowledge is being put to use, and that newer nurse has more confidence.

Jane Mericle:
I have to tell you that you are right on point there, and we are using that resource. The other thing is, it sometimes is very hard for nurses to ask for help, or you look down the hall and there's nobody there, and you think, I'll just, you know, and this is just so easy because it's set up as this is a person you call, this is the backup. These cameras, this technology is getting so good they can even do a double check on a dressing change. We haven't tested that yet, but those are the kind of applications it doesn't take two bodies in the room, right? We can do it with a virtual ... And so you're right: mentor support. And the other thing I would say is we are moving away from calling it virtual nurse and calling it virtual care because our other disciplines like our pharmacists, our respiratory therapists, our social workers are seeing applications for this as well as we deliver care to these kids.

Molly McCarthy:
And then we'll move to, we'll take out the virtual because that will just be expected, that care is both in person and it will hop some of it remote. And we're obviously not there yet. But I think eventually the whole concept of virtual health it's health includes virtual on-site, etc.. One other point that I just want to call out to the listeners is that you mentioned the quality and safety. Obviously, you're very well known for all of your work in that and the opportunities to prevent harm. And just going back to even thinking about physically how, for example, ... units are built today more as single room rather than you had when I worked, I've actually worked in both single rooms, and then you have more of a cohort with nurses and the babies more together. And I think from a patient safety, you mentioned just having the ability to call out for help. I think about a baby that I remember was coding multiple times. He had a congenital heart defect, and just the fear of actually even leaving him in that room alone. So having that virtual nurse and really for that patient safety and peace of mind for the nurse. So really great callouts. And then also just your comment about it's really a partnership. It's, people, we need to come out of our traditional silos and work together across IT, clinical, biomedical engineering to make this transformation happen. So thank you for that. I know, I could probably sit here and talk to you forever, but we do need to wrap up. And one thing that I always love to hear from my guests; our listeners are CNOs, CNIOs, nurses, hopefully some other clinicians just learning about what's going on in the nursing world. But obviously you've got a ton of experience in healthcare, and I would love for you as you think about all of your experience and where you are today, just leaving one little parting gift of wisdom with our listeners. So what would be your single most important practical piece of advice as it relates to their responsibility of being tireless advocates for their patients?

Jane Mericle:
I would just say that probably one of the most important things that I test myself on as well is being open. I think that so much has changed, yet there is so much possibility. How do we create for ourselves the ability to see what's next, what's down the road, and not to stop because these children deserve it? And so I am a big believer in building relationships, building these partnerships, collaboration, asking the questions. And I think that's going to be what we need to do. And I need to do that individually. You look at, my experience has been very hospital-centric, it's been very operationally-centric. But by adding in these relationships and these partners, I can just start in my head thinking about, could we do this? Can we do that? So I think as leaders. And secondly, is really to say the kids come first in children's health care. So our children, our family are central to everything that we do, and our teams. Taking care of our people, making sure that we are delivering systems and adjunct technologies that support them, that help simplify, that help make their work easier because a happy caregiver is going to help deliver the best outcomes that our children deserve.

Molly McCarthy:
Yeah, I love that. I just interviewed someone from Leapfrog the other day, and she said that the best organizations, in terms of quality and safety, are the ones that have the most respect for their nurses and the nursing protocols. So spot on. Thank you so much, Doctor Mericle. Really appreciate all your insights today and wish you the best as you continue on your journey.

Jane Mericle:
Thank you, Molly. Really appreciate the time.

Intro/Outro:
Thanks for listening to the Smart Care Team Spotlight for best practices in AI and Ambient Intelligence, and ways your organization can help lead the era of smart care teams. Visit us at VirtualNursing.com, and for information on the leading smart care facility platform, visit care.ai.

Sonix is the world’s most advanced automated transcription, translation, and subtitling platform. Fast, accurate, and affordable.

Automatically convert your mp3 files to text (txt file), Microsoft Word (docx file), and SubRip Subtitle (srt file) in minutes.

Sonix has many features that you'd love including advanced search, automatic transcription software, world-class support, automated subtitles, and easily transcribe your Zoom meetings. Try Sonix for free today.

(function(s,o,n,i,x) { if(s[n])return;s[n]=true; var j=o.createElement('script');j.type='text/javascript',j.async=true,j.src=i,o.head.appendChild(j); var css=o.createElement("link");css.type="text/css",css.rel="stylesheet",css.href=x,o.head.appendChild(css) })(window,document, "__sonix","https://sonix.ai/widget.js","https://sonix.ai/widget.css");
Spotify Apple Podcasts  Amazon Music iheart Radio

"When nursing and nursing perspectives and nursing leadership are respected within a hospital, that's when you feel like the patients are better protected because it is the nurses who are really closest to the patient in an ongoing way, and they're the ones also with that expertise." - Leah Binder

Leah Binder President and CEO of The Leapfrog Group

Episode 24 Nurturing Excellence:

Celebrating the Role of Nursing in High-Performing Hospitals

SCTS_Leah Binder.mp3: Audio automatically transcribed by Sonix

SCTS_Leah Binder.mp3: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Intro/Outro:
Welcome to the Smart Care Team Spotlight presented by care.ai, the smart care facility, platform company, and leader in AI and ambient intelligence for healthcare. Join Molly McCarthy, former CNO of Microsoft, as she interviews the brightest minds in healthcare about the transformational promise of AI and ambient intelligence for care teams.

Molly McCarthy:
Too often, technology makes caregivers' lives harder, not easier. It's time for smart technology to empower care with a more human touch. I'm thrilled to share a little bit more about our guests today, Leah Binder. Leah Binder is president and CEO of The Leapfrog Group, representing employers and other purchasers of healthcare, calling for improved safety and quality in hospitals. She is a regular contributor to Forbes.com and consistently named among Modern Healthcare's annual list of the 100 most influential people in Healthcare. Under her leadership, the Leapfrog Group has grown fourfold in size and launched major new initiatives, including the Leapfrog Hospital Safety Grade, which assigns letter grades assessing the safety of general hospitals across the country, as well as ratings of ambulatory surgery centers and outpatient surgery, and the Judy Burrows Education Institute. She spearheaded successful initiatives nationally, including partnerships to reduce early elective deliveries, promote better hand hygiene in health settings, reduce infections, improve healthcare transparency, and promote safe use of health technology. Leah has served numerous national boards and councils, including the National Quality Forum, Women of Impact, CMMIs Accountable Action Collaborative, the National Alliance of Healthcare Purchaser Coalitions, the Jewish Healthcare Foundation, and AARP's Champion for nursing. Prior to her position at the Leapfrog Group, Leah spent eight years as Vice President at Franklin Community Health Network and award-winning Rural Hospital Network in Farmington, Maine. Prior to that, she served as senior policy advisor at the New York City Mayor's Office. She started her career at the National League for Nursing, where she handled policy and communication for more than six years. Welcome, Leah. It's so great to have you here today.

Leah Binder:
Well, thank you for having me, Molly. It's great to be here.

Molly McCarthy:
And first of all, really appreciate time out of your day to speak with us and our listeners. And I suspect that many of our listeners know Leapfrog as a name and associate that name with quality and healthcare. But I also suspect that very few really know the who, when, how, and why of Leapfrog. So can you take us back to the beginnings of the Leapfrog Group and tell us the story of the inspiration of its founding mission and how the organization has evolved over time?

Leah Binder:
Absolutely, and I will say, I can brag about the founding of Leapfrog, in part because I'm not telling my own exact story. I didn't start at Leapfrog until Leapfrog had been around for about eight years, so I can look back fondly at its origins and brag about them all I want without sounding a little too pompous. But they started with a group of employers. These were large companies, and they were HR executives or like GM, GE, Boeing, Marriott Corporation, some very large companies, all of which you would know the names of. And these executives got together because they were very concerned about safety and quality in healthcare. A report had just come out in the year 2000, or actually the report came out in 1999 called 'To Err Is Human'. It was from the Institute of Medicine, and it suggested that upwards of 100,000 people were dying of preventable medical errors in hospitals, and they were concerned about that. They had very concerned about that because they had spent decades really trying to improve the healthcare their employees were getting, and both from a quality point of view, but also cost effectiveness point of view. And both of those they felt had not been successful.

Leah Binder:
And here they were hearing about yet another issue that was perhaps the most outrageous of all, that people were dying of preventable errors. That was just terrible. So they formed Leapfrog, and that was the nonprofit with a very focused, very simple mission, which was to make public how hospitals are doing on preventing these errors and accidents and encourage their employees to use the information. And they use the information themselves when they contracted for healthcare benefits. So when they would try to pay for the best care and not pay for the worst care and really be more businesslike, in other words, in their approach to their purchase of healthcare. And so a simple idea, really, of public transparency and really driving the ability to be discerning about picking among hospitals. And they started with hospitals. It was very little data at the time, but they went out to hospitals and said and via a survey called the Leapfrog Hospital Survey, they said, could you please provide us with information? And here are the questions, and the questions were about things, as Bob Galvin at the time was a GE, and he said he wanted the Leapfrog survey to ask questions that his mother would want to know about a hospital.

Leah Binder:
So that's what they did. There was some evidence behind it, so they still had some really top experts in patient safety to advise them. But even so, at the time, there just wasn't much that they could use. That was really great measures of safety that they could really call on. Anyway, so fast forward, and today we do the same thing. We really have that same fundamental value, which is we should be transparent about how hospitals are doing on safety. We should publicly report that information, and people should use it to make decisions and to communicate with the hospitals that they work with or the communities that they live in. They should be communicating with hospitals and saying, we expect you to do better on safety, and we will reward you when you do. And that's the same with employers to do the same thing that when you do better on quality and safety, employers should reward that with their purchasing. So that's still fundamental to what we do. We have a lot more tools in our toolkit and a lot more people involved, but it is really fundamentally the same principle, and it's working.

Molly McCarthy:
That's wonderful. I know early in my career, around the start of Leapfrog, I was actually back in DC working for A1 and I, you know, worked on a consulting group with really looking at root cause analysis, and patient safety was really becoming such a highlighted item, really, as you mentioned, really to provide that transparency to consumers to, as you mentioned, GE GE's, uh, executives mom, what they would want to know about healthcare. So, so important to provide that transparency. So kudos to to, you know, being part of that evolution. I want to switch gears a little bit and talk a little bit about looking at healthcare providers and obviously starting my career as a nurse. And you've worked in healthcare for quite some time, National League for Nursing. So, our healthcare providers take an oath to do no harm. And every one of our caregivers really choose this profession to heal those in need, obviously with compassion, empathy, and even with the best intentions, quality and safety have room for improvement. What's the current state of quality and safety across our hospitals, and where have we made progress, and where do you think we have more to do?

Leah Binder:
So I think the current state is certainly not what we would all want. It certainly is not the healthcare system that I think anyone who chose a career in healthcare wants. I mean, we all, everybody who's involved in healthcare in any way wants the United States to have the very best healthcare in human history. That's basically what we want. And we don't have that. But we do have progress, and I believe progress is something to celebrate. So I do think there are really bright spots and those are worth celebrating and also learning from, because I think we can build very quickly, we can scale some of those successes. So the success that I would see that, that I see every day actually is in patient safety. Now, patient safety is an example of where there's a lot to complain about. So, the statistics on patient safety are quite disturbing. There was a recent report from the office of the Inspector General. It's sort of independent body that looks at how the Department of Health and Human Services is doing, and they looked at a random set of records of Medicare beneficiaries who had been admitted to the hospital, and they found that 1 in 4 of them were harmed at some point during their stay.

Leah Binder:
That's a very high rate of harm. 25% is a very high rate. Anybody in any other industry that would never be even in the realm of tolerable. So it is very high. And we know also now with good estimates in peer-reviewed journals, that it's about 250,000 people die every year from these preventable errors. So that's also a very high number that would make it the third leading cause of death. So we have a long way to go, I always have to preface with that, this is a major problem. It should be considered a top national priority to address it. For every single person in healthcare, this should be a top priority. That's it. We have seen real progress in especially in the past decade with hospital-acquired infections. There was a spike in them, they went up during the pandemic. That was a major problem, which we reported on and discussed at length at the time. However, that's coming down really rapidly. We also have seen a reduction in the patient safety indicators, so-called, that are measured by CMS, the federal government, and the ones that are most publicly reported. We are seeing real reductions of falls, pressure ulcers, injuries such as that. We're seeing very significant reductions in those as well.

Leah Binder:
So I think in hospitals we are definitely seeing progress. And I mean by like 20 or 30% in some cases even higher than that 50%, I think, for central line infections. So, really, really significant reductions in. Some very high profile and deadly, in many cases, deadly events. So that's good news. And I think what makes that the kind of news that I want to focus on in my own work, and I think everybody should look at, is because it's a success, it's progress. And we need to ask ourselves, how did that progress come about? What did we do as a country because we did something as a country to see that kind of change nationally. And I think there's a variety of things we did. But I will say one thing that's different in the past decade when we saw this progress that's different from other decades where we have continually not seen progress, is transparency. We have been publicly reporting those measures since the Affordable Care Act since 2009. I certainly want to take some credit for Leapfrog, which I think has put patient safety and transparency on the map, especially in the last decade when we launched the hospital safety grade. So I think we've seen but so we take part of the credit for that.

Leah Binder:
But really, having that data available publicly reported has made a difference. It's not just the difference, by the way, for the public, I'm not sure if everyone in the country says, oh, I have to figure out what CMS says about this hospital before I go there. I actually don't think that's necessarily happening all the time. Some people do, but not it's not happening all the time. The biggest thing that's happening is that hospital leaders themselves and clinicians are aware of this data. They see it, they recognize it. They challenge themselves to do better on it when it's there, when it's in front of you when it's public, it just has a galvanizing effect. You really want to see it change. You want to be better than your competitors in those met. You want to. It's galvanizing. So I think that's been a big difference, along with all of the tools and efforts that have been really put out there from not only from a little bit from Leapfrog, but a lot from CMS and many other really great organizations that are out there really helping hospitals especially get better. So I think combined with that push from transparency, we've seen real progress, and now we need to grow it.

Molly McCarthy:
So many great examples. I love that you really focus on the progress that we've made, because I think that's really key. And especially over the past ten years with hospital-acquired infections, falls, pressure ulcers, central line infections, I know those are all, you know, never they should be never happen events. And really attributing that to transparency and awareness. I always like to say you can't really change what you don't measure. And so measuring that and providing that back to the hospital leadership is key. And to your point, I am a consumer. We're all consumers. I don't necessarily go every time and look up the safety scores, although I am probably a little bit more in tune than others. But to your point, it's information back to the leaders of where they are and where they need to go, which is fantastic. And they need that in order to have the CQI in that improvement. So, thank you for sharing that.

Leah Binder:
It's also information back to everyone who works there.

Molly McCarthy:
Right.

Leah Binder:
It's the leaders. Yeah, And the board. But it's also the person who's serving the meals to the patients. The inpatient unit, from dietary, everybody gets involved. And that's especially true when they get a good grade. So what we find is when we give an A to a hospital, they will often celebrate it throughout the entire hospital. But where pins that say we got an A for patient safety, it's just very visible. And it's a recognition of their achievement when they get this and when they don't get it, they know about that too. That can be really, I'm sure, upsetting. But it's also goading. It says, no, we got to do better. We got to do better. Everybody gets involved. And I think that's, um, you just can't substitute that level of all team engagement.

Molly McCarthy:
Yeah. Thank you for pointing that out. I think that's really crucial. You know, it's not just those at the top, but it's very much everyone across that value line, value chain who provides care, whether they're delivering a medication or taking a patient from the floor to a procedure. It's really critical and it is a team approach.

Leah Binder:
Yeah.

Molly McCarthy:
So we've talked a little bit about the trends that you've seen and the current state and the improvement. What characteristics do you see as common to the top-performing health systems as it relates to quality, safety and patient experience?

Leah Binder:
I would say the first thing I notice about the highest performing hospitals when we look at the data when I go to visit the highest performing hospitals, the number one characteristic I will see that is at least striking to me, is that the CEO or top leadership will be unsatisfied with their own performance. I can't tell you how many CEOs of truly, outstandingly safe hospitals. I mean, now nobody's perfectly safe. There's no hospital in this country that's perfectly safe, but ones that have shown continuous excellence. The CEO will say, well, you know, I don't know. I worry about this, I feel like we don't do enough with that or we don't have people trained the way they should be and something else, or our hand hygiene. And I still wonder if people are truly washing their hands, and I want it monitored. They always have something else that they think needs to be done. They're never satisfied. They're always worried about safety, they're always worried about the patients. And it strikes me every time because I don't always see that with hospitals I visit that aren't doing so well sometimes. That will be a long story from CEO of how all the great things they're doing, which is important here, by the way. I do respect and like to hear that, but it also it is very different from other kinds of hospitals where they're that just are never satisfied that they've got to do better and better and better and better.

Leah Binder:
And that's I think that's needed for safety, because safety is a 24\7 ongoing enterprise, and you got to be worried about the patient 24/7. That's got to be your keeping you up at night in order to maintain safety. You can't just say, oh we got our central line infection down. We got that rate down to zero, pop-open the champagne and we're done. Because if you stop what you were doing to prevent those infections, then the very next day they'll be back, and your patients are at risk. So you can't see it that way. It's not a series of like one-offs. Patient safety is an ongoing way of life in a hospital, and it means that you have to worry, worry, worry about your patients all the time. Are we doing everything we can to make them safe? And when you see that from the top, from the CEO, that's when you recognize an excellent hospital that's really standing out for its performance. And I would say the other thing that I've observed in hospitals that are particularly high performing is a real respect for nursing. Most of what a hospital does is provide nursing care. Those are usually the most numerous of all the professionals working there. And everything that happens when you're a patient, nurses are just 90% of your day is nurses.

Leah Binder:
You depend on nurses, you depend on their expertise enormously. You look to them for their also their concern. And when you're scared in the middle of the night, it's the nurse that you want to talk to, and it's the nurse who has that expertise and education to really help you in the way you need to be helped as a patient. It's just they're very important. And when nursing and nursing perspectives and nursing leadership are respected within a hospital, that's when you feel like the patients are better protected because it is the nurses who are really closest to the patient in an ongoing way, and they're the ones also with that expertise. I saw a really interesting presentation by a collaborative in Michigan that came out of the Michigan Hospital Association, and they actually worked with us to go through Leapfrog data to find highest-performing hospitals. And they found, among many interesting insights, one of the top insights was that where in hospitals that where nursing protocols are respected by everyone, whether it's the chief of surgery or the dietary staff, everybody respects the nursing protocols and adheres to them, that those were the hospitals that were just much at the top of the quality spectrum. So I think that nursing is something to look at.

Molly McCarthy:
Well, I know our listeners are going to love that. The one other thing that I was just thinking about why we were talking and you were mentioning some of the common top-performing health systems with leadership who are unsatisfied and really always worried about their patients. And then to the respect for nurses, one of the things that I saw in the shift, probably around the time Leapfrog started, was just the involvement of patients and their families in terms of asking questions. And I think historically, like I think about, if I take my father to an appointment, he might not grill them as much as I do. But how have you seen, like, the patient engagement change over time to I'm just curious.

Leah Binder:
Significantly, that's a very good point. That has really changed, especially over the past decade. And one of the things you see now are, most hospitals, at least, that I've encountered, have patient and family advisory councils, and some of them have a variety of them throughout. We have many more standards now related to engagement with patients or patient perspectives. We have, for example, on our survey, we have a standard around patient consent and how that should work and engagement of patients when there's a root cause analysis done. Are the patients and families of engaged in that, things like that. And that's really consistent with I think, where a lot of hospitals are going, is really bringing patients into the really the center of how everything is done, which is where they belong, and everything should be about the patient because that's why the patient is there, because the delivery system is delivering care to them. But we haven't thought of them as part of the team. And you're right, that has been a really major trend. And CMS also drove that trend, that was part of their efforts in the Affordable Care Act, that a lot of supports for hospitals in moving and shifting toward having more engagement of patients in their overall operations, and also measuring whether that was working with the H-Caps surveys, which are the patient experience surveys that are CMS requires hospitals publicly to report on their results. That also had an impact, and so I think I think we've definitely seen that shift.

Molly McCarthy:
Yeah. And I think just that curiosity and questioning, I think from patients really as a partner rather than, you know, a threat to what's the institution or the team that's providing the care, I think is really important. Just that mindset shift.

Leah Binder:
Absolutely.

Molly McCarthy:
So you may have noticed that I opened our podcast today with the statement that too often technology has made caregivers' lives harder, not easier. And I've been in tech for a long time, so I feel okay saying that. But from your view, has healthcare technology made patients safer or in any way at greater risk? And this is kind of a two-part question. So I'll let you answer that and then I'll go on to the next part.

Leah Binder:
Yes, and yes. I guess I'd have to say one of the founding principles that Leapfrog, incorporated into that overall overarching transparency mission is that we need hospitals and health systems to adopt technology in a way that improves safety, and we actually want them to adopt the technology. We are very pro technology because that improves our world. We kind of see that in other industries, and we want it to happen in healthcare. And, you know, we know healthcare tends to be behind on technology. I always joke that it's the last place you can sell a fax machine to anyone. And my son, who's 20, he said, mom, they asked me to fax over something to the doctor's office and I said, okay, just do that then. And he said, well, I don't even know what a fax is. He didn't know what it was in his 20. You know, the rest of the world is not using fax machines, but healthcare is. So anyway, we want to use it to the greatest benefit of patients. And we started Leapfrog with one of our founding, we call them Leaps was around computerized prescriber order entry CPOE. So that's the systems that even back in 2000 were available. It was used by about 1% of hospitals, but it was available.

Leah Binder:
They would check orders, medication orders and check against the patient record to make sure that the patient you know wasn't allergic or the variety of other reasons that a medication order could be dangerous to the patient. Those would alert to the physician so that the order would not go through or that the prescriber could order something else. So that was available and very important. And the studies at the time back in 2000 suggested that it will really did reduce medication errors by like 40%. It was very significant improvement, but it really wasn't again, until the Affordable Care Act actually, after that, when the stimulus money after the economic crisis of 2008, we had stimulus money thrown into the economy, and a huge amount of that was used to help hospitals invest in electronic medical records, and with that, CPOE. So then all of a sudden, we saw almost every hospital had CPOE, and we did something else with that. So we realized that it wasn't going to be enough. Just to ask, do you have CPOE? We also want to know, does it actually work to the benefit of your patients? Because you can't assume that it's automatically works when you turn it on. And it turns out we were right about that. We had, um, developers who include David Bates, David Klassen; these are world-renowned experts in patient safety and technology who developed a test that hospitals take as part of their completion of the Leapfrog Hospital Survey every year. They take this test, and we give them a set of dummy orders for a set of dummy patients, and they administer the orders, and then they report back on what happens in their cpoe system when they make these orders. And the all of the orders are almost all of them will would result in harm to the patient, very significant harm in some cases death to the patient like very these are not kind of nuanced orders. These are orders that would definitely harm the patient if they were administered. So they should alert. And there are a few that we throw in there that shouldn't alert, that actually are frivolous problems, that should not alert because you don't want to have too many alerts or you have alert fatigue. And that's also dangerous, right? So we actually test for that. But this for the most part is just really bad or really dangerous orders. And can they are they alerting to them. So the thing that we found is that in about half the time not really. These systems are not alerting properly today.

Leah Binder:
We've seen lots of improvement, but we still don't see most hospitals getting to even like 80% of the orders, they're not getting there. So we're still a problem, and our advice to hospitals has always been and continues to be: You have to double-check and triple-check. It's not enough. Just because you have a CPOE system doesn't mean that's the end of it. It's got to be checked again and checked again and checked again before it actually gets to the patient because we can see that it's not always there and it needs to improve, but it's not always there. So technology yes, it definitely improved. We did see improvement with CPOE and we're seeing it more over time. So it is got to be better then a scribbled prescription on her pad. God knows how that ever worked in a hospital. It's just scary to think about it, you know? But nonetheless, they are not always doing the whole job. And there's lots of things that aren't safe. And if they're not administered correctly, if not watched, if they're not, these systems are not really fine-tuned over time and checked over time. Then they can actually backfire and not be safe at all. So yes, to both of your questions. Yeah.

Molly McCarthy:
And I think that's so important. Just and I actually even use CPOE in 1995 locally I worked at Inova and I remember it coming into play versus the handwritten orders. But it goes to the point where, you know, it's not just the technology. It's really it's important for the nurse, for that care provider, whoever it is could be, you know, perhaps even that person who might be inputting orders. But it's really important to have that critical thinking piece that nurses can utilize in that human aspect of it. You know, that won't ever go away into question, I think is really important. So the second part of my question is moving ahead and thinking about the technologies that are available today. So for example, next-generation solutions like artificial intelligence, and ambient monitoring, I've done a lot of work in the virtual nursing area, but how can they work to ensure that quality and safety can paradoxically improve in an era where there's a lot of ongoing shortages of caregivers, people leaving the profession due to many different reasons and challenges, but using technology to do more with less providers, I guess.

Leah Binder:
Yeah, I I'll step back a little bit from the question because I'm not as I don't live my day-to-day life in a delivery system. I live in front of tons of data looking at how we're doing, but I don't necessarily see it close up. I like to visit hospitals and see it, but I don't always see it right. But what I would say that we're concerned about with AI and just all the advanced technology that we're seeing really rapidly grow in hospitals is that there are many ways to deploy this technology badly and not do it well, or do it in a way that is not helpful to the patient or harmful even to the patient. Now, the example I just used, or how decisions work within CPOE doesn't always work the way people think it will, and can lead to some complacency because you think the system is going to check for that. And if nobody else does, you can, you know, that's a danger. So I think that's the case in, you know, maybe exponentially with AI, we know that AI has makes mistakes, but it looks like it's not making mistakes and it has hallucinations, but you can't tell they're hallucinations unless you dig in. You know, the most famous example are footnotes that they'll give to some research and they make up studies. Just make them up out of thin air. They don't exist. So you got to get someone to double-check their references.

Leah Binder:
So that is directly dangerous to patients. If the AI is giving advice or decision support or whatever support and it's incorrect but looks correct, which it will look correct because it always comes out of AI, it looks really pretty impressive. So that's a danger. And if there's too much reliance and there's not a system set up to double-check it, that's a problem. So that's one worry. And then the other thing that we're excited about, on the other hand, is that it can be used for some really positive things. I mean, it can be used, for example, to automatically check through ongoing patient records as they're happening, as the patient's in the bed, they can check through EHRs and trigger when there appears to be some issue that could lead to a problem. I mean, that's exciting. We think that's that could potentially be a game changer for patient safety. The other thing that we think is exciting is an ability to synthesize a patient record itself quickly. I would imagine that it must be frustrating for all providers when you have a very long EHR, let's say, and you've got to figure out right now what's happening with that patient because you're talking to them and you want to know right now what was their last blood pressure reading or something you want to know now. And definitely AI is going to be able to help with that.

Leah Binder:
So I think that's exciting. I think that it'll help. I think anyway, make the day-to-day experience of a provider better, but it also will help the patient. So I think that's an exciting use of it. So I guess I don't know what that's going to mean in terms of being able to manage around a shortage in the workforce. I'm not sure how that's going to play out. I don't know, I've seen actually, I should say I have seen one example that I didn't like, which was using AI to handle call. And the example they showed me was a pediatrician's office where a mom calls in the middle of the night. A three-year-old swallowed a dime and what do I do? And the call is answered by basically a bot that's AI. And the AI says this two-page explanation of the clinical issues and risks, and something like that misses a key thing, which is make sure that it wasn't actually a battery instead of a dime, because it's a battery. They get under the ER and all that. So I missed a clinical indicator that was important, but I think even more so, it just was as somebody who's been a mom calling in the middle of the night to the pediatrician's office, I don't want to talk to a bot, and I don't want two pages of clinical gibberish. So that was not a good example.

Molly McCarthy:
Now, I think I appreciate that and I appreciate your perspective. I think, you know, different from maybe someone who's in the hospital every day, but really important from that patient safety perspective and just even your, I think, comment around the ongoing analysis retrospective, instead of looking at patient trends, root cause analysis, a week after an event happens, you know, we're sifting through the data as that patient's decline. Maybe their temperature is going up, their heart rate's going up. They're becoming septic and making that alert then and there rather than a significant decline coding etc. and a poor outcome. So appreciate that perspective. I could sit here and talk to you for so much longer, but I want to be mindful of everyone's time and want to wrap up with just one question, one piece of advice. I always like to ask our guests, but so our listeners are primarily Chief Nursing Officers, CNIOs, and respective teams within healthcare systems. And obviously, you bring a really unique perspective, understanding priorities and opportunities across large employers, payers, government, and providers. I guess if you could just share a parting gift of wisdom with our listeners. So what would be your single most important practical piece of advice for them as it relates to their responsibility of being the front line for patient safety?

Leah Binder:
I would say lean into transparency. That works on a political level, but it also works on a personal level. But it isn't human nature, so you have to be deliberate about it. So on a political level, is the one thing that both parties are maybe the one, maybe there's other things. But really, one thing that both parties agree on here in Washington is that we should have more transparency in healthcare. And there's all kinds of ways they define that, but basically they want more transparency. And that's been the movement on both sides of the aisle. And that's where it's going, the transparency is the name of the game. Their employers are also under enormous pressure to make everything they know public about how hospitals and health systems are doing. There are lots of risks if they don't nowadays, so it's really a big deal to them as well. It is also a big deal, though, if you are a clinician or working in a hospital because it is, you want to build trust. And one of the things I think we've we're losing in all segments of our society, unfortunately, but healthcare included, is that personal trust among people.

Leah Binder:
And you want patients to trust you, and patients really do want to trust you. And the best way to build trust is by being as honest and open as possible. And that starts with transparency and lean into it on every way. You're a hospital administrator. The one thing we report to Leapfrog, I mean, I'm going to say that because that's how you're transparent. It's not a doesn't cost you anything. Just do it because it's do anything you can to show that you're not hiding anything, that you're public, even if everything's not perfect, even when you have to tell a patient something that is uncomfortable, telling them, being honest about it will build trust, and trust is what is going to carry the day for all of us. It carries the day for every single one of us. It will get us away from this burnout problem and all the problems we're seeing for people who are frustrated and feeling like they're not fulfilling their life purpose. Transparency is a way past that. It's just uncomfortable and hard. But please do it. It will help.

Molly McCarthy:
Well, thank you. Leah Binder, CEO of Leapfrog. Transparency and trust are key for safety for our patients. Appreciate your time today and look forward to hopefully meeting you in person soon. Thank you.

Leah Binder:
Thank you Molly. It's great to be here.

Intro/Outro:
Thanks for listening to the Smart Care Team Spotlight for best practices in AI and Ambient Intelligence, and ways your organization can help lead the era of smart care teams. Visit us at virtualnursing.com. And for information on the leading smart care facility platform, visit care.ai

Sonix is the world’s most advanced automated transcription, translation, and subtitling platform. Fast, accurate, and affordable.

Automatically convert your mp3 files to text (txt file), Microsoft Word (docx file), and SubRip Subtitle (srt file) in minutes.

Sonix has many features that you'd love including generate automated summaries powered by AI, upload many different filetypes, automated subtitles, automatic transcription software, and easily transcribe your Zoom meetings. Try Sonix for free today.

(function(s,o,n,i,x) { if(s[n])return;s[n]=true; var j=o.createElement('script');j.type='text/javascript',j.async=true,j.src=i,o.head.appendChild(j); var css=o.createElement("link");css.type="text/css",css.rel="stylesheet",css.href=x,o.head.appendChild(css) })(window,document, "__sonix","https://sonix.ai/widget.js","https://sonix.ai/widget.css");
Spotify Apple Podcasts  Amazon Music iheart Radio

"Our nurses are incredibly intelligent. They're doing wonderful things. They know the criticality of their patients; they know their right and wrong answers. But there's a lot going on throughout the day. And I think having that added buffer to just say, listen, hey, did you see this? Or maybe I can pop in and just check on that patient for you while you're in another room? I think that's a neat way to look at the cure model that we now have the technology to do." - Amy McCarthy

Amy K. McCarthy, MSN, RNC-MNN, NE-BC Director Of Nursing, Women, Infants and Oncology at Texas Health HEB President-Elect, Texas Nurses Association

Episode 23 Beyond the Bedside:

Exploring the Evolution of Nursing in the Digital Age

SCTS-Amy McCarthy: Audio automatically transcribed by Sonix

SCTS-Amy McCarthy: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Intro/Outro:
Welcome to the Smart Care Team Spotlight presented by care.ai, the smart care facility, platform company, and leader in AI and ambient intelligence for healthcare. Join Molly McCarthy, former CNO of Microsoft, as she interviews the brightest minds in healthcare about the transformational promise of AI and ambient intelligence for care teams.

Molly McCarthy:
Too often, technology makes caregivers' lives harder, not easier. It's time for smart technology to empower our care with a more human touch. I'm thrilled today to share a little bit more about my guest, Amy McCarthy. And just for our listeners, Amy and I are not related, but she would be a really fun sister, just as a side note.

Amy McCarthy:
Thanks, Molly.

Molly McCarthy:
Amy currently serves as the Director of Nursing for women, infants, and Oncology at Texas Health Resources at HEB. An alumna of George Washington University, she earned her DNP with a focus on executive leadership. Amy is a champion of transformational and heart-led leadership, aiming to foster innovative and health-centered environments for nurses. Her decade-long experience involves collaborating with state and national leaders in nursing improve outcomes for the public and employees she serves at the bedside and in leadership. Amy serves as the president-elect of the Texas Nurses Association and is a member of the Nursing Advisory Council for Hippocratic I. She has notably served as Director at Large on the American Nurses Association Board of Directors, addressing crucial issues like safe staffing, workplace violence, and racial equality in nursing. Her involvement with the National League of Nursing includes contributing to the Advisory Board of Accelerating to Practice program, focusing on new graduate integration into the workforce. Amy's role extends to the Nurses on Boards Coalition, where she was a Texas Action Coalition representative and co-chair of the Communications Workgroup, overseeing coalition marketing and communication strategies. As the secretary of the Texas Nurses Association from 2019 to 2021, she was instrumental in integrating younger voices into the organization, fostering ties with the Texas Nursing Student Association, and launching a podcast that highlights nursing innovation and mental health. Amy's educational background includes a Bachelor of Arts in Biology from Southern Methodist University and both a Bachelor of Science and Master of Science in Nursing Administration from the University of Texas at Arlington. She holds professional certification in executive nursing and maternal newborn nursing. Welcome, Amy. You have a fabulous background, and I can't wait for our listeners to learn a little bit more about you.

Amy McCarthy:
Thanks, Molly. I'm really excited to be here today.

Molly McCarthy:
Great. Well, first of all, thank you for taking time out of your schedule to speak with me and our listeners and share your story and insights. Obviously, you've got an extensive background and varied background, which I didn't mention. You started your career in communications and then transitioned into nursing and health systems and also have extensive experience in the association world, which is fabulous. I think that gives you a really diverse perspective. So just to start out, I would love for you to share with our listeners more about your career journey, maybe starting with how you transition from communications into nursing and then how communications actually assists with your role today.

Amy McCarthy:
Yeah, absolutely. So it's funny, looking back, I never realized how important that communications background would be in my current role in my career as a nurse, but I had always been really creative. I had taken a lot of art classes in high school into college. I had served as the editor-in-chief of my college yearbook, and a friend of mine had offered me an internship to a nonprofit management consulting company early on in my college days. And so I started to dabble in the world of communications and PR, do graphic design, photography, and media. And that led to another internship at the local hospital here in the DFW area, where I was able to do communications and PR specific to healthcare, which was so neat. I spent about almost a year and a half being able to cover things throughout the hospital, being able to go on media sources, and oh, can we stop that? Can we start that again?

Molly McCarthy:
Yeah, yeah. Um, yeah.

Amy McCarthy:
Okay. I spent about a year and a half at the hospital, just kind of rotating with our media team, with our communications team, and just learning the ropes of how to handle PR and communications in healthcare. And there's a lot that goes on in the background that you're having to manage when it comes to patient stories, when it comes to news, when it comes to patients who are entering the facility.

Amy McCarthy:
And so it was just a really neat experience to be able to see that side. And as I was doing nursing school at the same time, I really continued to delve into this, had a lot of interest at actually ended up working throughout nursing school for a nonprofit that was focused on crisis communication, and so was still able to take a look at that healthcare lens, but offer communication support, offer that PR. And as I transitioned into nursing, that communication piece became vital, especially as I started serving on boards, even just talking to my patients. One of the key things that you learn in communications and PR is that you have to alter your message and be very specific with the population that you're marketing to or that you're serving well. The same occurs in nursing. I have to really tailor my message whether my background is in women's health. If I'm talking to a first-time mom, how am I communicating to that family versus a mother who has 3 or 4 kids? It's a very different experience for them. And so it came in instrumental in that early phase of nursing.

Amy McCarthy:
And then, as I mentioned, when I started to serve on boards, one of the skills that I was tapped for was this communications and PR experience. I was able to help lead campaigns, lead entire communications and rebranding efforts for boards, most notably for the Nurses on Boards Coalition, and helping them to get to the metric that they were looking for to get more nurses involved get more nurses serving on boards. Several of the campaigns that were utilized throughout that were things that I had designed that I had worked with that entire board and organizations. So it's been really neat to be able to combine both of these worlds into what I do today. It is certainly been, like I mentioned earlier, just instrumental in what I've been able to do, and I'm very grateful for the experience that I had early on. I had no idea that I would use it almost on a daily basis, especially in leadership and in talking with my nurses, whether it's in the hospital or within professional associations. But it has truly enabled me to be able to reach more people and to be very specific in my messaging, to be able to convey what we need to do.

Molly McCarthy:
I love that I think you have some great experience. You mentioned the crisis communication, and obviously, when you're dealing with patients and families, it can be difficult, difficult conversations. And I'm sure that your patient's experience was so improved through your ability to communicate with them in the family. And I know that, too. You know, you mentioned you're in maternal child care, and it's not just taking care of the patient, but in specifically, it's really family-centered care. So, so critical. And just a shout out to Nurses on Boards Coalition and Laurie Benson. I worked with her when I was at Microsoft and love what they're doing there. I know they just celebrated an anniversary, so that's great. I'm glad to see that you're involved with that organization.

Amy McCarthy:
Absolutely.

Molly McCarthy:
Digging deeper in a little bit more into your nursing experience with where you are now at Texas Health Resources. And then, obviously, you've done a lot of advocacy work, and through Texas Nurses as well as your position with the ANA, just curious how you're involved in tackling some of the ongoing workforce issues that are plaguing our US health system, maybe locally and then nationally, if you have any examples?

Amy McCarthy:
Yeah, absolutely. So, with the Texas Nurses Association, we've done a lot of work over the last legislative session that's really pinpointed on workplace violence and ensuring that nurses have a safe space to be able to work in. We all know, as nurses and nurse leaders, there has been such a just evacuation, for lack of a better term from the healthcare space because nurses don't feel safe anymore. And so this became a really prime topic for the Texas Nurses Association. We previously had a law in the state where emergency nurses were protected. If they were attacked, it was a felony that they could charge the individual who had attacked them, but not for the rest of the hospital, which was kind of heartbreaking, especially for someone like me who's not in that realm. While people think that maternal newborn can be a very happy place, and it is, but there are things that happen on that unit that are also very difficult for nurses to work through. And so the protection was really needed for healthcare workers across the board. And so we actively worked with partners across the state and building coalitions and building relationships to ensure that we could bring forth a bill that would be passed to offer all healthcare workers this protection. And this previous legislative session, we were successful in being able to pass into law a bill that protects all healthcare workers, regardless of what unit they're working in, any time that they are attacked in the workplace. That is considered a felony charge. And that was such a big win for us. When you think about the shootings that have happened in the Dallas-Fort area across the United States, people are angry when they're coming in the hospital, and you have to think there's a lot going on when they enter the healthcare space; there's a lot of unknown.

Amy McCarthy:
They're losing control of their situation. And so it does lead to a lot of anger, whether it's intentional or not. We need to make sure that our healthcare workers feel safe. They feel empowered in that environment and that they feel protected. And so this was a huge win for the association and for our nurses across the state to be able to now say, yes, I do have that protection. While it's only a piece of solving the problem for sure, it at least gives us somewhere to start from and offers that additional protection as well. And when I think about my work at the national level, we've certainly had the conversation about workplace violence overall. In fact, I worked with the Ana board of directors to draft a proposal at our membership assembly that focused on gun violence and how we help to protect nurses and healthcare workers from that. Specifically, how do we partner with not only nurses and nursing associations but associations outside of that? Sometimes, the nursing, we like to say, within our own bubble, we're very guilty of that. But being able to talk with people across the board, people who are experts in this space. So, it was a huge proposal for us to be able to bring to our membership to all the states who are involved in this discussion. And it went you could tell in the room how grateful people were that we were having this discussion, that we were saying out loud, listen, this can't be tolerated anymore.

Amy McCarthy:
Nurses need to feel that they have that protection, that we're actively doing things while we don't have the solution and there's no immediate solution, at least we're working on it. And, of course, you know, the next big topic is staffing, right? It's something that nurses are talking about all the time. And same thing there. There's, unfortunately, not a one-size-fits-all solution. And so we're having to have very active conversations with our hospital associations, with our, our legislators to say, how do we fix this problem? Because the fact is, that current state isn't working. It's leading to nurses leaving the bedside. It's leading to an unstable healthcare system. And so the ANA board, we released a statement that showed that, you know, we do support tools to be able to focus on safe staffing, whether that be staffing ratios, whether it be talking with hospital associations. We want to ensure that we are doing our part to support states across the nation and ensure that we're having a good conversation about this because, for so long, we've avoided this topic. We've kind of stayed away from it just because it's something that's hard to talk about because there isn't a black-and-white solution and no matter how you look at it. And so I'm proud of the work that we've been able to do around that. But certainly, the work is not done. And so we're continuing to have those conversations across the board.

Molly McCarthy:
Well, congratulations, first of all, on your hard work within Texas and having that bill passed. That's amazing. You know, it makes me sad to think that that's where we are in our world. But that's the truth. And good for you for really pushing for that and also the collaboration with other disciplines. I think it is important, as you mentioned, you know, within healthcare, it can be siloed sometimes based upon your professional, where you are professionally or what licensure you have. But I do think moving forward, that team approach and collaboration, not only within healthcare but quite frankly, like you mentioned, with our policymakers, etc. So kudos.

Amy McCarthy:
Thank you.

Molly McCarthy:
The other question I have for you. And then staffing, we could spend a lot of time on that. I think, you know, that's very challenging. And it's not black and white and it depends upon so many factors. I'm just wondering too, if you think about staffing, what also just in terms of care models, you know, that's another component that I know we're revamping. Obviously, this podcast is looking at virtual nursing, which we'll get to in a minute, but I think those are all considerations when you take a look at the current environment. So absolutely, with that in mind, I think that obviously there are lots of challenges, but kind of as a follow up to that question, what reasons do you and your colleagues have to be optimistic about the future of inpatient nursing? And maybe we talked about some of the obstacles, but maybe specifically for you, what are you seeing at your local level with obstacles to realizing that future?

Amy McCarthy:
Yeah, absolutely. You know, I will tell you that the nurses and nurse leaders who are entering the profession right now are just so creative. They have so many ideas, and they're committed to really revamping health care, which is very exciting to see. And I think part of that is they have resources today that nurses previous to them didn't have. You think about the internet, you think about social media. There's this constant exchange of ideas. I was talking to my lab manager yesterday about something that I had seen on a social media group of what we should implement in our hospital, and that's just it. You know, we're able to do that on a daily basis to get these ideas and be able to implement a lot of them fairly quickly. And so I'm optimistic because I'm seeing this constant interchanging of ideas that we're implementing at a faster rate, and people are trying to make this better. I will tell you when I look at the obstacles, when I look at technology, I think that there's so much out there. My husband works in tech, and we have these conversations all the time of things that he's seeing in his world that haven't even touched healthcare yet. And so there's such a gap between those two worlds.

Amy McCarthy:
And the gap needs to get smaller because there is so much that has been produced that can really be so beneficial in our hospitals today. When you think about ambient monitoring, you're starting to see that, especially between providers and patients. I would love to see that for nursing. When you're walking into a room for that technology to exist, where a lot of this charting burden that you see today because nurses will tell you about 70% of their job is charting everything that they're doing. If we could have technology in place, that helps to eliminate some of that burden, and we're starting to see that. But I think that's a major area that we need to focus on so that nurses can practice to the full scope of their license and they can actually do what they set out to do, which is care for patients. Right? I think part of the obstacle with that, of course, is just financing some of that technology. As hospitals continue to experience limited reimbursements, decreasing profit margins, it becomes harder and harder to sometimes implement these technologies at such a huge scale. It involves really understanding that technology, being able to do that education and keeping an open mind. Sometimes I joke with my nursing colleagues that we are also the worst barrier to the implementation of new tech because we're fearful of it or we don't understand it. And then there's that automatic shutdown that happens, and we can't continue to think like that anymore because we need to have things in place, whether it's AI, whether it's that ambient monitoring that helped to make nursing what we want it to be, which is really being able to sit down, have those conversations with patients, provide that education, and taking away so much of the burden that has been placed on nurses.

Amy McCarthy:
I mean, when I sit in meetings, whether it's in associations or within the hospital, it's always, well, you know, the nurse can do that, the charge nurse can do that, the nurse manager can do this. And we've got to stop saying, let's put this on human people. How can we utilize the technology that we have, even if we're not spending millions of dollars in implementing all of these things within our organizations? But how do we leverage what we have to be able to really look at things creatively? And I think that requires nursing leaders who are willing to step outside of the box of how we've always done it. And that's a common phrase in nursing, whether we like to admit it or not. This is just the way we've always done it. We've got to step outside of that space and be able to say, listen, we've got to try something new because there's just not working anymore.

Molly McCarthy:
Well that's great. I'm excited to hear you talk about the up and coming generations in terms of the creativity. And quite frankly, they're new and they have fresh ideas and they're not necessarily molded to doing it a specific way, obviously. Absolutely, with patient safety in mind and optimal patient outcomes. But I agree there are different ways to think about care delivery. And really, to your point, ensuring that the nurses and the care team really are doing high value. I don't want to say tasks, but working on high value processes, etc. and taking away that administrative burden. Yeah, obviously documentation burden is a whole other topic, but I think you touched a little bit about on the rapidly evolving technologies, and that was kind of part of my next question. So just to as we think about specifically workflows like including virtual inpatient care mentioned ambient monitoring and AI, what use cases specifically within your areas do you see that would potentially make an immediate impact within your hospital system? I know that, and I'll just give you an example that I've heard having a virtual nurse doing admissions or discharge, teaching, etc.. I'm just curious, specific to you work in oncology and labor and delivery and NICU, where do you see technology kind of easing the burden?

Amy McCarthy:
I think the virtual nurse concept is one that we really need to take a long, hard look at because we have a lot of nurses. In fact, I had a conversation with the leader yesterday about this. We have a lot of nurses who are wanting to transition to something that doesn't look like the bedside anymore. They still enjoy the clinical realm. They want to be involved, they want to be engaged, but they're not necessarily wanting to do three 12-hour shifts anymore. And I think, you know, being able to transition individuals like that into a virtual nursing model where they can, to your point, instead of having a person handle admission and discharge teaching, being able to have a nurse pop on a screen. And a lot of our hospitals have adopted electronic keyboards, being able to utilize that technology and have that nurse pop in and say, hey, you know, how are you doing? Are there any questions that I can answer for you? Let's go over your admission teaching. Let's go over any questions you might have. How is your experience going today and being able to notate all of that so that it's traveling back to the nurse, it's going back to the nurse leader again; it helps with the overall flow of that nurse's work day because they're able to be engaged. I think about a labor and delivery nurse. They're in and out of that room every 15 minutes, charting to be able to ensure that a patient is having a safe delivery. And so even in that regard, to have a virtual nurse who is watching feel, monitoring strips and being able to give that feedback in real-time, because the reality is, is that the nursing workforce right now is relatively new at what they're doing.

Amy McCarthy:
There's a lot of questions, there's a lot of feeling as uncomfortableness, because all of a sudden, these nurses who have been around for 3 to 5 years are looking around and saying, well, I guess I'm the expert on the unit. And that's an uncomfortable feeling when I think about when I entered the workforce; I was surrounded by tenured veterans who had been on that floor for 15, 20 years. They knew the answers to my questions, and I think to have that virtual nurse there to one be a coach, but also to be able to pick up on those things. Our nurses are incredibly intelligent. They're doing wonderful things. They know the criticality of their patients; they know their right and wrong answers. But there's a lot going on throughout the day. And I think having that added buffer to just say, listen, hey, did you see this? Or maybe I can pop in and just check on that patient for you while you're in another room? I think that's a neat way to look at the cure model that we now have the technology to do. Ten years ago, we couldn't have had this conversation, but today, there are things now in place in rooms that allow us to have this conversation, to be able to really create a very patient-centric experience in a way that we've never been able to do so before. So I would say between that and then, of course, going back to the charting aspect of it, to be able to implement technology that makes that a little bit easier for them, that decreases some of that documentation burden. I think if you could do those two things, Molly, in a hospital, that would take such a burden off of the so many nurses today.

Molly McCarthy:
I agree with you wholeheartedly. I loved your example around the fetal monitoring piece. Obviously, we talked about I worked in NICU, etc., and worked for A1 with their fetal monitoring program. Yeah, but such a huge help for the nurses who are physically on the the unit. The other piece, just holistically, obviously patient safety comfort level of the newer nurses. And like you mentioned, it is not an exit strategy but a different role that the seasoned nurses can take on without having maybe the physical burden of being on a unit for 12 hours. I've seen that anecdotally as well. And then obviously, at the end of the day, thinking about the quintuple aim and looking back to not only the clinician experience, but that patient experience and really driving towards better outcomes, lower cost of care too.

Amy McCarthy:
Yeah, absolutely.

Molly McCarthy:
Well yes. Go ahead.

Amy McCarthy:
Oh, I was going to say, you know, and I think one thing that I'm definitely seeing in my world is that the patient population is growing sicker. You know, we joke in women's and infants that used to be somewhat of a plain vanilla type of patient population. They'd come in; they were relatively healthy. They were coming in to have their baby. Everything was great. But I will tell you, Molly, just from my patch, from my experience just being on the floor to where I am today, the acuity of that patient population has changed immensely. We are talking more and more about maternal morbidity and mortality. We're talking about patients coming in with multiple comorbidities in their late 20s to early 30s. And so you can only anticipate what that looks like later down the road. And so having these tools in place, even for, you know, your regular nursing care model, would be so instrumental because there's so much to be watching in these patients today. They're unlike even the patients of 5 to 10 years ago. And having this ability to be able to constantly monitor and to have that, you know, second person there, just kind of looking at everything, I think would just, you know, it would help to really decrease a lot of fears and a lot of burden on the nurses today. Yeah, I.

Molly McCarthy:
Agree; I mean, I worked in NICU and peds, and I took care of a lot of cystic fibrosis patients, for example, that lived to a certain age. But I know now some of them are having children, etc.. So, to your point, the chronic illnesses, the comorbidities really make the care so much more complex. So many more things to consider. So a couple more questions I want to ask. The next one is, as you think about all your experience with the association's communications and your current role, what's your vision for the future of nursing and smart care teams, and how do you see nursing spearheading this collective effort?

Amy McCarthy:
That's a loaded question. Uh, you know, when I look at the future of nursing, and I'm an optimist, I'm going to put that right out there. And my team sometimes makes fun of me for this because I am the eternal optimist. But I truly do believe that nurses have the power to change health care. We know so much about our patient population. We're there 24 over seven and. Any instances were able to spot trends before anyone else can. Not just trends with in one patient but within an entire population. I'll share my experience of just in maternal health, of being able to track when postpartum hemorrhages started to become a major issue. That hasn't been something that's been, you know, necessarily a thing that we've talked about for the last 20 years. But I remember specifically in my career when that started to become a huge trend, and we started to see more and more of that. And that's an example of what nurses are able to bring to the table. And so when I look at the future of nursing, I see a future where nurses are fully practicing to the full scope of their license that we are able to no longer have to be combined with room and board, that we are a line item in and of itself, where we're able to capture what nursing is doing and bringing to the table when it comes to caring for patients.

Amy McCarthy:
But I also see nurses active throughout our systems, not just being contained to the bedside. And sometimes, especially with my communications background, I think about how we market ourselves as nurses. Still, the public today sees us as those individuals in scrubs as the bedside. And so I think that we have to do a whole rebranding campaign, just of the profession to say, listen, nurses are found everywhere. They're found in technology, they're found in government, they're found. I mean, truly, the skills that we develop as nurses, as we go through our careers are just invaluable in a variety of different ways. And so I see nurses inserting themselves into those conversations and finally making room for themselves at these tables or pulling up a chair if there's not one already. And when I think of, you know, what might be obstacles to that, you know, I'll be really frank, Molly. I think sometimes it's ourselves. When I was completing my doctorate work, one of the things that I focused on was the self-efficacy of nurses and how that motivates them to pursue board leadership positions. And what I found with so many times is that when you examine nursing, you also are examining the history of females in the workplace. 88% of nursing is female today. And so you have to think of that and how that has worked itself in history. Nurses are you know, typically we like to be people pleasers.

Amy McCarthy:
We're the ones that will work ourselves; we'll put ourselves last, and we really need to change that. We need to ensure that we're taking care of ourselves, that we are developing that confidence, whether it's through mentorship, whether it's through training. And I'm speaking to my nurse leaders, we've got to do more of this coaching and developing of our nurses who are coming into the field. We've got to start talking about advocacy at a much earlier point in an individual's just career in their education so that they come into the workforce understanding that my job is not just to take care of patients, it's also to advocate on behalf of the profession, but also for the patient population and where we want healthcare to be. And so I tell nurses all the time, listen, we've got to start somewhere. There is a place for your voice. But the most important thing is that you put your voice out there, that you don't stay silent, that you don't stay just within the four walls of your work environment, that you're out there, and that you're sharing what you're seeing. Because people need to understand those stories; it's how we're going to reshape healthcare, and we've got to have a place for ourselves in that narrative because otherwise, the story of healthcare will continue. But it may not be as friendly as we want it to be.

Molly McCarthy:
Yeah. No, I mean, I couldn't agree with you more. And as soon as you said the biggest obstacle is, you know, nurses, I was like, yep, I see that. And that's why it's so important to have that cross collaboration within healthcare. But then quite frankly, outside and looking at other industries, how other industries tackle certain problems.

Amy McCarthy:
Absolutely.

Molly McCarthy:
So critical. So, thank you for that comment. I think, you know, it couldn't have been said better.

Amy McCarthy:
Thank you.

Molly McCarthy:
So, last question. And so, you know, our listeners, our CNOs, CNIOs directors, the respective teams, other nurse leaders, nurses at the bedside. So, obviously, you've had some varied experiences in healthcare. And I guess I always ask my guests to share a parting gift with our listeners. Your single most important, practical piece of advice for them as it relates to responsibility being tireless advocates for their patients. And then I'm going to also say, and your nurses, as I hear you doing.

Amy McCarthy:
Absolutely. You know, I think to sum it all up, I would tell my colleagues out there to stay curious and to stay connected. Like I mentioned, I think sometimes it's the fear of the unknown that causes us to shut down. And when you think about AI and technology and all of the change that's happening almost on a daily basis, if we're going to be real about this, sometimes I think nurse leaders shut down because they don't know where this is headed, and they don't know the answer right off the top of their head because they've never experienced anything like this before. And what I tell nurse leaders and those leaders that I'm working with right now is that it's okay to not have all the answers to everything. In fact, it's okay to say, like, let's ask some more questions. That's what I love about my CNO is that, you know, I come to her with a lot of crazy ideas. I'm going to be the first to admit it, but one of the things that I love about her and what I've instilled in just in my leadership, too, is that I never completely say no. I say, well, let's explore this. Let's talk about how we can put forth this idea. And maybe now is not the time, but I'd love to understand a little bit more about what you're bringing to the table, how we could implement this. You know, we haven't done this before, but that doesn't mean that we can't do it.

Amy McCarthy:
And I think that for nurse leaders, having that type of inquisitive mindset to try and get past that fear, that not knowing all the things because we don't know, I mean, there's so much that's happening with these technologies that we don't have all the answers and we don't know how it might fit into the healthcare space, but that doesn't mean that we shut it out again. When I'm talking with leaders when I'm talking with nurses, you can tell that fear that just bubbles up a little bit, and they're like, oh, well, there's a regulatory reason that we can't do this and all of these things. And instead of just going straight for that, saying, well, you know, maybe we need to change things. So, where do we start with that? How do we have these conversations to start to change the hospital space or work environment that it is able to coexist with some of these new things that are coming out, and the stay connected portion is just, you know, when I think about what I do, whether it's within the hospital, whether it's within my professional associations, I always think back to where I started and I think back to nurses today and where they're starting, and that's who I'm advocating for in so many different ways. I know that the bedside today looks way different from when it did when I started ten years ago, and I'm knowledgeable of that.

Amy McCarthy:
And I ask a lot of questions to my staff. I try to follow them, see how their day-to-day is going, and just ask the question of what's happening. What is the biggest barrier to you being able to be a nurse successfully? And I think sometimes what happens is as a leader, as you go up and up and up, you sometimes lose that connection. But I challenge leaders today that if you don't connect with that bedside nurse, if you don't connect to the heart of your organization and the heart of the profession, if you will, you're losing out on a lot of knowledge and a lot of the reality of what it looks like today because we can't read always from our personal experiences of what nursing looked like when we started, we have to understand that the reality is quickly changing. And so while I may not have the same lived experience as a nurse who's starting today, I'm at least going to try and understand it, and then I'm going to advocate tirelessly for it because that is what I'm doing in these positions. That's why I love what I get to do every day. And I know that so many nurse leaders share the same sentiment as I do. And so those are certainly two things that have worked for me and I continue to recommend to leaders as they come out today.

Molly McCarthy:
Well, Amy McCarthy, thank you so much. I love your focus on curiosity and staying connected. Yeah. And to your point around being curious, not knowing everything. When I was at Microsoft, we had what we called learn it all rather than know it all. So really going after what you don't know and not taking a little risk. So that's so fantastic. I love your passion and optimism. And let me know if you want to run for some official position, because I love to work on your campaign.

Amy McCarthy:
Absolutely, Molly. I'll let you know. Well, thank you so much.

Molly McCarthy:
And I look forward to seeing you again in person soon.

Amy McCarthy:
Absolutely. Thanks, Molly.

Intro/Outro:
Thanks for listening to the Smart Care Team Spotlight for best practices in AI and Ambient Intelligence, and ways your organization can help lead the era of smart care teams. Visit us at VirtualNursing.com and for information on the leading smart care facility platform, visit care.ai.

Sonix is the world’s most advanced automated transcription, translation, and subtitling platform. Fast, accurate, and affordable.

Automatically convert your mp3 files to text (txt file), Microsoft Word (docx file), and SubRip Subtitle (srt file) in minutes.

Sonix has many features that you'd love including collaboration tools, advanced search, automated translation, upload many different filetypes, and easily transcribe your Zoom meetings. Try Sonix for free today.

(function(s,o,n,i,x) { if(s[n])return;s[n]=true; var j=o.createElement('script');j.type='text/javascript',j.async=true,j.src=i,o.head.appendChild(j); var css=o.createElement("link");css.type="text/css",css.rel="stylesheet",css.href=x,o.head.appendChild(css) })(window,document, "__sonix","https://sonix.ai/widget.js","https://sonix.ai/widget.css");
Spotify Apple Podcasts  Amazon Music iheart Radio

"I think there needs to be this while disruption of just how the care team is created and nurses need to be a core of that. But I think the same workflows and the same tools and all the stuff we've been using for a long time just aren't cutting it. And so I think we have to rethink, like, who needs to be on the team and how we do that?" - Dr. Dan Weberg

Dan Weberg, PhD, MHI, RN, FAAN National Executive Director of Nursing Workforce Development and Innovation at Kaiser Permanente

Episode 22 Redefining Nursing:

Building a Future of Empowerment and Growth,

SCTS_Dan Weberg: Audio automatically transcribed by Sonix

SCTS_Dan Weberg: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Intro/Outro:
Welcome to the Smart Care Team Spotlight presented by care.ai, the smart care facility, platform company, and leader in AI and ambient intelligence for healthcare. Join Molly McCarthy, former CNO of Microsoft, as she interviews the brightest minds in healthcare about the transformational promise of AI and ambient intelligence for care teams.

Molly McCarthy:
Too often, technology makes caregivers' lives harder, not easier. It's time for smart technology to empower care with a more human touch. I'm thrilled to share a little bit more about our guest today, who I met at the Digital Health conference at South by Southwest in 2017. Doctor Dan Weberg is a fellow of the American Academy of Nursing and an expert in nursing, healthcare innovation, and complex systems leadership. He has extensive clinical experience in emergency departments, acute inpatient hospital settings, and academia. Dan currently supports Kaiser Permanente as the Executive Director of Nursing Workforce Development and Innovation. He has also held leadership roles within Kaiser in Nursing innovation, research, and technology strategy across eight regions, 38 hospitals, and 70,000 nurses. Dan was part of the founding faculty for the new Kaiser Permanente School of Medicine. Dan also previously served as the Vice President for Transformation Services at Ascension, supporting over 60,000 nurses and 140 facilities in modernizing nursing technology, developing new care models, and measuring innovation outcomes. Prior to Ascension, Dan was Head of Clinical Innovation for Trusted Health, the staffing platform for the healthcare industry, where he helped drive product strategy and work to change the conversation around innovation in the healthcare workforce. Welcome, Dan. It's great to see you.

Dan Weberg:
Yeah, great to see you too, Molly. Thanks for having me.

Molly McCarthy:
Yeah. So thank you so much. First of all, for taking time to speak with me and share your story with our listeners today. You obviously have an extensive and varied background between academia, startups, large health systems. I love your diverse and interesting perspective, and I actually think I first met you or had a first phone call with you. I was on a train actually going to New York. I remember it when you were at Kaiser and then, right after that, Trusted Health. So this is your second go-round with Kaiser. So I wanted you just to share with our listeners a little bit more about your role at Trusted Health and how it impacts your current approach at Kaiser, specifically with regards to how you're tackling ongoing workforce issues that are plaguing our US health system, and obviously, any insights from Ascension and other experience, too?

Dan Weberg:
Yeah, it was interesting. It was really hard to leave. I had spent about seven and a half years at Kaiser at very varying roles, from innovation, working in the Innovation Center all the way through, starting the new medical school and working at the national level across multiple markets, and thinking about nursing innovation. And in 2019, made the choice to jump over to the startup world. At the time, I had been advising a lot of startups through my role at Kaiser and Innovation. And so I was working with UCSF and their accelerator program and just various, including groups that I met at South by Southwest, continue to work with some of those connections, and it was time to double down and say, If I'm going to advise startups, I probably should have experience in one. And Trusted Health was there. They were actually talking to Kaiser at the time, at the venture group, at Kaiser for some funding, and I had met Matt Pearce there and Sarah Gray, who's the founding clinician. Matt's a co-founder of the company, and we just hit it off and ended up creating a role. So I was employee number 50 at Trusted Health, which in a startup that was really interesting to go from 50.

Dan Weberg:
I think by the time I left two years later, there was about 300 or 250 employees. So that scale and just understanding how organizations work it was really fun. What really opened my eyes at Trusted was I got to see across eight regions of Kaiser, and while Kaiser's massive, I got to see across 5000 healthcare facilities and how they treated nurses and specifically travel nurses. It was a travel nurse company and technology company. So I got to see all of the broken things in healthcare, from how you onboard nurses to the competency assessments, to the hiring methods, to the amount of pre-work that a nurse has to go through, even if they have 20 years experience. And it worked at the top health systems. Now they're coming to your organization. You make them go through the same stuff, just the waste in the system and the sort of the flip side. And I was asked this in a meeting at Kaiser the other day was, why, Dan? Why do nurses gravitate towards travel companies, as like the big difference between a health system and a travel company? Is health systems see nurses as a cost, and travel companies see nurses as a revenue stream.

Dan Weberg:
And just that simple flip changes the way they treat the entire workforce. I get to see all these broken things and see how you could potentially engage a workforce differently and how you could treat them as very special, important, knowledgeable individuals and clinicians. And that just opened my eyes, that experience. And then, as well as working at another large health system, comparable size of Kaiser is Ascension. And again, just how a different health system manages that sort of huge complexity. And those two learnings really help me come back to KP and just have a different perspective on things. I just got that outside view, and many times, they keep people stay there for a very long time. That's one of the benefits of KP is people have a long tenure, and my whole goal from day one at KP was not to be what they call Kaiser-ized and become part of that sort of one worldview. And so just leaving allowed me to have that perspective from across the nation and have just interesting conversations to bring back and hopefully catalyze some things at Kaiser.

Molly McCarthy:
Yeah, I love that. That's great. I think that having that experience in different settings, and we didn't even touch on the academia, but just to have your perspective on why and how nurses are treated differently, and just to highlight what you said within our system is health IDNs large facilities see nurses as a cost. And quite frankly, travel agencies see them as a source of revenue. And that is a huge difference. Always trying to cut costs, always trying to grow your revenue. So that's a great perspective. How have you with your second tour at Kaiser, how has that impacted your approach just in terms of what within your own system and maybe some of the biggest issues that you're tackling right now within the workforce?

Dan Weberg:
Yeah, it's been really interesting. What's nice is I came back to many of the same colleagues I had before because I was only gone for three years, and it was like it wasn't really starting over. It was coming back to a group of friends who were very welcoming and warm and ready to do some great work. That part that is part has been great, and KP is just a very mission driven organization. And right now, with all of the the sort of drama and healthcare and finances and all that kind of stuff that KP is really trying to grow out of it instead of reduce out of it, which I appreciate. And I think that's the right approach. So I think for us, it's really about growing programs. And I got to step into this role, this workforce development and innovation role, which is really the hardest problem in healthcare. How do you recruit, retain, optimize, grow your clinical talent in one of the largest health systems in the country? So, I see it as the ultimate innovation challenge. And I've been approaching it like that. And I stepped in with a senior director who had been there, Lori Hill, who's amazing, and we created a residency program, a new grad residency program.

Dan Weberg:
Lori had done the business case, and it was time to execute it. What we ended up doing is hiring or reorganizing about 20 folks to run a multi-million dollar program across eight markets. So, this is one of Kaiser Nursing's first standardized approaches to clinical education. So, each market was doing their own residency program. Many were getting accredited. But what we saw is there's still a lot of variation that did need to be there. And what we did is pulled that program to a national perspective and run it as a single platform across all eight markets. And so that's that rolled out late 2023 and 2024. All of those next cohorts will be in the national program. We're really excited to have that. So that's one that's bringing in roughly 800 new grads last year into the KP, which was never really a focus or a hard focus. And we're continuing to grow that program. I think for us, it's really about how do you engage the workforce and understand it. So we're starting to look at platforms. How do we have single clinical education platforms, competency platforms, just to understand our workforce. And then the next step is let's look at what do we what can we standardize and not from the traditional approach of standardization, where everyone has to fall in line and follow this one tool that's not sensitive to local conditions, but really just looking at big programs like residency, like transition between specialties that don't need that variation between markets, because moving from an OR to an ICU is basically the same everywhere in the country.

Dan Weberg:
And so we can standardize some of those core education components, which frees up educators to do more of that local work and gap assessments and that kind of stuff. So we're working on those initiatives as well. And I think for us, we're also looking at our retention is actually really good. Our turnover is really low. And we're looking at now what are those career growth because we've nailed keeping people in the company and keeping nurses around, which is great. But we want to help them grow as well. We're focusing on what are those leadership development, what are those career paths, and things that we can get nurses engaged in so they can grow and become the best nurses on the planet, whether that's at the bedside or in a leadership role or educator, etc.. So those are some of the problems we're tackling now.

Molly McCarthy:
Yeah. In summary, obviously, you mentioned the residency program, which I love. I remember being a part of that way back when, and that's so critical. Just as we onboard new nurses in terms of ensuring they have those competencies, but then also are comfortable and can really fly once they're released into the wild, so to speak. So, really investing in your nurses, which has oddly paid off because your retention. I don't know your rates, but you just mentioned that they're good. And yeah, that's amazing. And I've talked to with so many different people tackling similar problems; I'm just wondering, from your perspective, what reasons do you and your colleagues have to be optimistic around the future of inpatient nursing. We've talked about some of the obstacles, but what have you seen since you've been back to Kaiser, or just even in the market that gives you hope and your colleagues a positive outlook?

Dan Weberg:
I think I frame it as this is our blockbuster moment, and the theme that I've been doing in different talks around the country and things is and people think of blockbuster as like the latest, greatest movie. But I see it as the video store. And so this is Nursing's chance to do the blockbuster moment. We can double down on brick-and-mortar in the past, or we can move boldly and build the future that we want. And right now, there's so much chaos that really the only way is up. And so building these programs, like the residency program, into these career paths and different platforms to help our clinicians, it's exciting. COVID hit the bottom of the barrel. And if we can set a new standard for how nurses work, the way that we support them, that there's only up from here. And so I think that gets people excited. I think the growth of KP and just the sort of the energy that I see in nursing right now to do things differently and coming out of the pandemic and wanting a better support system to do the great work that they're doing; I think everyone's really excited about that. There's a lot of energy in the air around that, and I think that keeps people moving, and I think the opportunity to really work with a sort of stabilized workforce allows us to not just have to fill holes and get more travelers and figure out that piece, but really work on these long term programs that will benefit the profession moving forward. So I think we're excited about that piece and just building things that haven't been done before. And there's a new appetite for that, and that that keeps us moving.

Molly McCarthy:
Yeah, I love that. Especially your reference to the blockbuster moment. I actually know you're located in Northern California, and I lived in the Bay area for some time around the birth of Netflix. And I remember my husband saying, hey, we can get these videos sent to our house on DVDs in the mail and then return them. And I was like, why would we want to do that? I like going to the video store, but I think that's a really great comparison because we do need to think about new models, and quite frankly, we need to define them as nurses. And I think the combination of people like you and some of my other guests on the show can really help move that with the energy that we're seeing in the younger generations. And one other thing I wanted to mention is this what I think is a misnomer in the market: when I see a headline every day about nursing shortage, I think it's just a shortage of nurses who want to continue to practice in the brick-and-mortar, old style way, quite frankly. And so, I don't know, just as a sidebar, your thoughts on that terminology and how you address it, if you're seeing that or what are your thoughts around that time?

Dan Weberg:
Yeah, I get mixed. I don't know; I have mixed thoughts on that. I do think we have a lot of nurses that are sitting on the sidelines right now, and I think that we need to rethink our care models. And I think at the end of the day, what the frame of reference that most health systems have is this sort of industrial model. Do we have enough nurses to run our med surg unit in a physical capacity or on location? And I think there needs to be this whole disruption of just how the care team is created and nurses need to be a core of that. But I think the same staffing and the same workflows and the same tools and all the stuff we've been using for a long time just aren't cutting it. And so I think we have to rethink, like, what? Who needs to be on the team, and how do we do that? And yeah, I'm still figuring out the virtual nursing and the benefits and those type of things. But I think those are sort of models that we need to start considering because I don't think we're going to have enough. And I don't see a day where overnight, where it automatically becomes attractive to go work at the bedside if that's not what you want to do. So, I think we do have to rethink our care teams and the way we do it. I think we can learn from the risk takers and the disruptors, like the Amazons and the Googles, and things that are willing to take that massive, the massive leap into the future and really disrupt fundamentally those assumptions that legacy healthcare systems have. So I think we can learn from that. But I really do think it's creating superpowers for our clinicians that do remain at the direct care in hospitals and brick and mortar.

Dan Weberg:
I see the robots, we have the AI, we have virtual nursing, all of those tools we have to really optimize to make nursing less burdensome. And I think Marilyn Chow was at KP for a long time, a great mentor of mine, and she kept saying 30%. She does study in 2007, I think is 36% of nurse's time is wasted on hunting and gathering information, people, and supplies. And that's four hours out of a 12-hour shift that's wasted on stuff that dental. And so I think we have a lot of room to just remove the waste out of the nurse's day and make it easier for them to spend time with patients. I think if we do that, the less that burden, and I think then we need a whole culture change in how we treat each other. Within health systems, there's been a lot of stress and drama and violence and all those type of things that just it just feels unsafe. So I think we have to address those pieces, and we'll have people come back. And then I think the other piece is we also need to really invest in our new nurses entering the profession, programs like new grad programs. We have a 90% retention rate. If they go through a new grad program versus a not 90% retention rate if they don't. And so I think just building those sort of pathways allow people to have more connection points and a little bit more legitimacy in their profession as they enter it, if they have a formalized, supportive environment. So to just being thrown in there and say, in three months you'll figure it out like I did, I think we got to break that in half.

Molly McCarthy:
I actually have a couple more questions, which you've touched on two things. One is technology and then smart care teams. And I wasn't sure which how to order these, but I'm going to go for more technology question first. And we've touched on this. So when you think about different technologies like you mentioned, virtual nursing, virtual inpatient care, ambient monitoring, artificial intelligence, where do you see the best use cases for immediate impact? That would really drive change within your health system if you are seeing any of those. I know that talking with so many people across the country and it's really the virtual nursing is really been the tip of the iceberg in terms of what it can open up. So just, what are your thoughts specifically around avoiding that 30% based?

Dan Weberg:
Well, what one we have to change some of the policies. There's still health systems that don't allow nurses to use smartphones in their facilities or at the nurses' station, which I think at the end of the day, the driving factor here is that care is too complex to memorize, and nursing school has been in medicine for much of it, is built on the memorization of care pathways and treatments and drugs and all that kind of stuff. And I think it's impossible to know all that anymore. And I think we need to have that foundation. You have to have a foundation. But then it's about accessing information in real time. And so I think we have to enable our clinicians with things like machine-generated insights, whether that's pure AI or machine learning, or even just really great algorithms that can take massive data sets and put out relevant information to clinical decision-making. I think that's the holy grail so that you can walk in a room and ask a natural language question to a device to help you make a clinical decision for your patient. I think that's where we need to get to, and I know there's pieces and parts in flight for that, and it's really been a focus on physician workflow. And then they try to adopt it into the nursing workflow.

Dan Weberg:
And you're like, nursing workflow is very it's not linear. And so it's very hard to adapt to those type of things into a nursing workflow. But I think we can do it. And I think if we have those tools we're going to we're going to be great. I think the other part of that problem is that very few nursing schools teach how to take machine-generated insights and put it into clinical decision-making. We teach evidence based practice, which is a longer process, but we don't say, how do you trust that algorithm that's built into your sepsis monitoring system? How do you even know that's right, and how can you question it or trust it? And I think we have to do as a profession really enable that education, or we're going to have people just either, and I've seen this happen, choose to completely reject that technology and still use the sort of old tools like music scores and those type of things that they can hand calculate, or they blindly trust the machine and they miss that issues that we have with data, insights that maybe aren't trained on all the right data sets. And so we're missing pieces are falling through the cracks. And I think we have to find a medium where it becomes another source of data for that clinical decision-making.

Dan Weberg:
So I think if we can enable those types of tools in the nursing workflow will go really far. And then I think we have to think about just who goes into a hospital and who doesn't. And this whole idea of remote monitoring and admission, direct admission to home, and those types of things are a great place for nurses. Because I'm in these conversations, they keep saying, we're going to direct, admit we're going to do remote monitoring, all these different things. And I'm like, well, who's going to look at the data? Oh, the primary care physician is going to look at that data. I'm like, they're not going to look at that data. They can't even manage their inboxes. They're overwhelmed but who's entire profession is based on longitudinal data assessment, its nurses. And so, why don't we have nurses doing all this remote monitoring and those type of things? I think that's a future I see in the next two, three, five years that's really going to impact our profession is just these in-context insights that are relevant. And then also the idea that nurses are trained to take those in and make decisions off them.

Molly McCarthy:
Yeah. And that's exciting to me. Just the different it just opens up a whole other pathway for students and nurses to enter into, quite frankly. One, a couple of things that I heard you say that I want to just shed some light on or bring to the forefront again is that I felt really important is just policies need to be changed. For example, smartphones, obviously there's a plethora of information that's coming at our clinicians, regardless if they're physicians or nurse 24 over seven. And so, how do they sift through that? Do they even have the time to hunt and gather, so to speak? No, they don't. And that's why we've improved some of the technologies around AI and machine learning, as well as just sifting through the tons of information. The other point you made was nursing-physician workflows aren't the same, which may sound obvious, but the other digging a little bit deeper in that, and even within nursing, it depends if you're in an ICU or if you're on what type of floor or specialty unit you might be working on, what type of setting. Obviously, I'm preaching to the choir here, so just some important pieces to consider. I think even when tech companies are looking at the health space because it's not apples to apples and just the investment, I think in general, in nursing the education piece, we could have a whole other podcast on that. That's very complex, especially when I've done guest lectures and gone in and talked about technology, and technology to them was be an EMR. So, just that whole piece is a Pandora's box. So I'm not going to go there. I'm going to switch gears and go to something that you mentioned earlier around, how do we work smarter? How do we work to the top of our license? How do we do what we need to do to take care of the patient and improve those outcomes? So, what's your vision of what we call smart care teams, and how can nursing really spearhead this effort within changing working models and transformation within the inpatient setting?

Dan Weberg:
Yeah, I think because one, and this is like one of those provocative statements, but I think in the foreseeable future, we're not going to have enough clinicians. And you can name your profession within healthcare. We're not going to have enough. We don't have enough nurses, physicians, etc. So the only way in the short term to mitigate that, I think, is with other tools, whether those are technological tools that allow for better workflow or better decision making, or better coordination of the limited resources, etc., and the idea that you can place a single clinical resource to help monitor or support multiple other resources, that would be something like virtual care. And virtual care has been around for a long time. Banner was one of the first, I think, to set up the ICU way back in 2007 and had been running those programs for a really long time, and there's value to it, especially in rural hospitals where they really don't have enough. You can put really experienced clinicians behind a screen and cameras and with tools and insights to help support boots on the ground. I think that's the way we need to go. Do you think the challenge is become and especially in states like California now, Oregon, and other ratio-related states, the business case becomes hard because if you're staffed on the floor now, you're adding another resource on top of it? If you're mandated staffing is met, now you have another resource on top of it.

Dan Weberg:
So, trying to create that business case is something that multiple organizations are struggling with. And while I think there's data to show quality outcomes and those types of things, I think they're still trying to figure out, do we invest in the virtual person or do we invest in the boots on the ground? And making those cases, I think, is still up in the air. But I think for the smaller hospitals, for big networks, it just makes sense. And to consolidate some of those virtual resources to work across state lines and all those types of things. I think that scale is the way to go and then enables the people boots on the ground to have the tools to be able to do their work more seamlessly and communicate. And I think the last piece is it's not just popping someone in the back of into some command center and zooming in and saying, hey, you missed your rounds today, but you have to figure out how to embed that virtual person as part of the on-site clinical care team. And they're doing rounds and all those types of things. They build that relationship because that's so much of how the care team manages itself. So I think if we get that technology, that virtual approach at scale, then we can mitigate some of those staffing issues and care gaps that we have right now.

Molly McCarthy:
Yeah, I think you make some great points. And one is trust and those relationships. And I've seen some great programs working out there with virtual nurses. And it's not just someone sitting watching a camera, but it's really participation in the care process. And I've seen more successful sites do it when they have nurses who've already had those relationships in person, and then going out virtual and ensuring that there's crossover and meaning. Sometimes, they're remote monitoring, and then sometimes, they're on in the unit. So really good points I do need to wrap up. So I've got one question here for you that I usually ask everyone, but would love your thoughts for our listeners, our CNOs, CNIOs, their respective teams, and just giving your experiences within healthcare, academia, and health IT. I would love for you just to share one parting gift of wisdom with our listeners. So what would be your single most important practical piece of advice for them as it relates to their responsibility of being tireless advocates for their patients?

Dan Weberg:
Yeah, I think for me, it's if it touches a nurse, you need to include a nurse. And that's very biased. But I know, Molly, you've been advocating for that for a long time. I just see too many of these solutions. It's we have a physician leader on our team and he'll figure it out if it's touching nurses, that's not that. They're not going to know the workflow. They don't get taught that in medical school. And despite their years of service, they probably don't understand how the profession works or even the scope of practice that well. So I think just with that, if and that goes for really any profession, it's if it touches the physical therapist, the physical therapist leading the charge on how you design that technology, that workflow, or it ends up in the drawer at the nurse's station and it never to come out again. And I know both of us have seen that happen many times. So I think that's the biggest piece of advice. And I think the other one is just we got to challenge some of these old assumptions, things like service lines and just this structure and bureaucracy we've set up within healthcare. I think challenging those things now is the time and to enable it with really quality technology, not this vaporware sort of shiny object. Hey, ChatGPT, everything, but really fundamentally workflow-driven technology. I think that now is the time to make that happen. And nurses want it. They want to be involved. I talked to three nurses last week who want to be involved in technology. So go out and find them because they're there, and they're probably on LinkedIn. And so, I think just including the right clinician at the right time it will make a world of difference. I know it's probably been said many times, but I just still don't see it happening. I still don't see these large disruptors like the Amazons and stuff really hiring, the right clinicians necessarily to make the change they want in healthcare. And so I think just being intentional about that is the biggest piece of advice I could give.

Molly McCarthy:
I love that, obviously, because I'm going to just pile on to your drum here and go on my soapbox. I recently chatted with Shawna Butler, too, and it's I've been saying this for years and it's smart business all around. It's including nurses in the discovery of the problem, the design and development of the solution, and the deployment. To your point, you just can't bring them in when you're like, here, we're ready to implement, I don't know, a new Vital Signs machine or a new EMR. And they have to be part of the process or, to your point, it will sit in the drawer. Thank you so much, Dan. It was great to chat with you and hear your insights and your amazing career journey. And I look forward to hopefully seeing you in person again.

Dan Weberg:
Yeah, no, I appreciate it, Molly. It's great to be on here, and let's hope, hopefully, someone gets a nugget and make some change.

Intro/Outro:
Thanks for listening to the Smart Care Team Spotlight. For best practices in AI and Ambient Intelligence and ways your organization can help lead the era of smart care teams, visit us at VirtualNursing.com and for information on the leading smart care facility platform, visit care.ai.

Sonix is the world’s most advanced automated transcription, translation, and subtitling platform. Fast, accurate, and affordable.

Automatically convert your mp3 files to text (txt file), Microsoft Word (docx file), and SubRip Subtitle (srt file) in minutes.

Sonix has many features that you'd love including transcribe multiple languages, upload many different filetypes, automated subtitles, generate automated summaries powered by AI, and easily transcribe your Zoom meetings. Try Sonix for free today.

(function(s,o,n,i,x) { if(s[n])return;s[n]=true; var j=o.createElement('script');j.type='text/javascript',j.async=true,j.src=i,o.head.appendChild(j); var css=o.createElement("link");css.type="text/css",css.rel="stylesheet",css.href=x,o.head.appendChild(css) })(window,document, "__sonix","https://sonix.ai/widget.js","https://sonix.ai/widget.css");
Spotify Apple Podcasts  Amazon Music iheart Radio

Presented by care.ai

care.ai is the artificial intelligence company redefining how care is delivered with its Smart Care Facility Platform and Always-aware Ambient Intelligent Sensors. care.ai’s solutions transform physical spaces into self-aware smart care environments to autonomously enhance and optimize clinical and operational workflows, delivering a transformative approach to virtual care models, including Virtual Nursing.