Latest / Becker’s Healthcare Podcast / C.J. Marbley, Chief Nursing Officer at University Medical Center New Orleans and Chief Nursing Officer and Chief Operating Officer at New Orleans East Hospital within LCMC Health

Transcript

C.J. Marbley, Chief Nursing Officer at University Medical Center New Orleans and Chief Nursing Officer and Chief Operating Officer at New Orleans East Hospital within LCMC Health · Becker’s Healthcare Podcast

0:02
This is where health care leadership comes together.
0:04
Becker's sixteenth annual meeting brings more than 3,500
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hospital and health system executives and nearly 800
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speakers to Chicago April.
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This year's event includes keynote conversations with Dallas
0:17
Cowboys legend Troy Aikman and former president George
0:20
w Bush. For the agenda and event details,
0:23
visit beckershospitalreview.com
0:25
and click on the events tab in the
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upper right. We're looking forward to hosting you
0:29
in Chicago.
0:32
This is Laura Dirdo with the Becker's Healthcare
0:34
podcast.
0:35
I'm thrilled today to be joined by CJ
0:37
Marberley, chief nursing officer of the University Medical
0:40
Center New Orleans and chief nursing officer as
0:43
well as chief operating officer at New Orleans
0:45
East Hospital LCMC Health.
0:48
CJ, it's a pleasure to have you on
0:49
the podcast today.
0:51
Thank you. I'm excited about being here.
0:53
Absolutely. Now I'm looking forward to our discussion
0:56
and learning a little bit more about some
0:57
of the great things you're doing at the
0:59
hospital and, you know, truly how you're thinking
1:01
about the future growth and development and more.
1:04
But before we dive in, can you tell
1:05
me a little bit more about yourself and
1:07
the hospital?
1:08
Sure thing. So I have been a nurse,
1:11
for thirty two years now.
1:14
Was trained at Howard University in Washington, DC,
1:17
and then started off as a trauma nurse,
1:20
adult, and then pediatric trauma,
1:22
moved on to the ICU.
1:25
I've been an ER director, an an ICU
1:27
director, a perioperative surgical services director,
1:31
and the senior director in all those areas
1:33
also.
1:34
And then I became the the chief nursing
1:37
officer
1:38
at New Orleans East Hospital in 2017,
1:42
took over the COO role also in 2020.
1:47
And then I became I took on a
1:49
dual role at the second hospital at University
1:51
Medical Center, in 2023,
1:54
at the 2023.
1:56
So it's been two years there.
1:58
And then I was additionally as VP and
2:01
then became CNO in August.
2:05
So I'm excited about the the work that
2:07
both hospitals do. New Orleans East Hospital
2:10
is a a a vital community hospital.
2:14
It is a, you know, really focused on
2:16
access and equity and making sure that we
2:18
have,
2:19
the right care right where people need it
2:21
right in the the East New Orleans area.
2:24
So we're excited about the being able to
2:26
provide provide vital care for a community that
2:29
went nine years after Katrina without a hospital.
2:32
So to bring bring that back to, the
2:34
community was was really big.
2:37
And then University Medical Center
2:41
is the large coronary
2:43
academic medical center. It's the safety net hospital
2:46
for not only the region and around New
2:48
Orleans, but also the state of Louisiana.
2:50
We are also the only
2:53
trauma,
2:55
trauma center,
2:56
comprehensive stroke center, and certified burn center,
3:00
all all three in one,
3:03
in the Gulf South.
3:04
So,
3:05
we're excited about bringing that that expertise,
3:09
to a safety net hospital and to the
3:11
to the region, to the state.
3:13
We have two large academic partners there. We
3:16
we we train,
3:17
physicians from Tulane University and LSU
3:20
at the same hospital.
3:22
And then we train every other discipline,
3:25
in health care,
3:26
at that hospital also. So it's the largest
3:28
training facility,
3:30
in the state,
3:31
and we're so excited about the access it
3:34
provides,
3:35
for our our community members
3:38
and the vital, you know, research
3:40
and advanced care that is provided there.
3:45
That's amazing to hear. And, you know, what
3:47
a a great experience that you've gotten over
3:49
your career, and cool to see how you've
3:51
been able to continue to work your way
3:52
up and add responsibilities
3:54
and grow.
3:55
Did you imagine when you first started off
3:56
in the health care space that you would,
3:59
rise into the leadership position that you have
4:01
and and continue to,
4:03
make strides in in in impact at the
4:05
executive level?
4:06
I did not. I really didn't. I really
4:09
when I started off, I just really wanted
4:11
to be a good nurse. My mom was
4:13
a LPN,
4:14
and she got the opportunity
4:16
coming out of East Texas to become an
4:18
LPN. It really changed the course of our
4:20
family.
4:22
And when I came out, I just always,
4:24
you know, learn from her. You just wanna
4:26
be a really good nurse. And so that's
4:28
all I wanna do. I want I came
4:30
out
4:31
and I wanted to experience nurses who have
4:32
been there for a while to say, you
4:34
know, look at me one day and say,
4:36
hey. You know what? You're a really good
4:37
nurse.
4:38
That was my goal, really. And just to
4:40
take care of people
4:42
and really make an impact in people's lives
4:44
every day. You know, we grew up saying
4:46
that we wanna do stuff, do things, or
4:48
do a have a career that makes an
4:50
impact. And in nursing, you get to do
4:52
that every single day. And so I was
4:54
just enjoying that,
4:57
for, wow, maybe ten years or so.
5:00
And then,
5:03
I was asked by one of my, mentors
5:05
if I could help them out and just
5:08
take a temporary role as a manager.
5:12
I was like, sure. I'm I'll help out,
5:14
you know.
5:18
Two years later, they were like, why don't
5:20
you just take the take keep the job
5:21
permanently? I was like, no, I'm fine. I
5:23
don't I don't
5:25
and my wife convinced me to, like, listen
5:27
to him and, like, listen to the offer.
5:29
So
5:30
they made an offer, I couldn't refuse and
5:32
I got into management.
5:34
And then what I filed is
5:37
the same care
5:38
and concern and advocacy
5:41
that
5:42
I have for my patients, I was now
5:44
able to give that to my staff.
5:47
And that's how I really transitioned
5:50
and it's really able to keep the passion
5:52
up
5:53
and, you know, keep my motivation going. And
5:56
it's always been that's always my my motivation
5:59
is really around,
6:00
advocacy
6:02
and care for
6:03
the staff and the community
6:05
that we serve.
6:07
Make sure the staff have everything they need
6:09
to be experts and provide the highest level
6:11
of care for the community we serve. Because
6:13
most of, most of the places I've been
6:15
has been serving a disadvantaged community.
6:19
Well, that's amazing to hear. And, you know,
6:21
what a great story,
6:22
to inspire you to grow and develop and,
6:25
you know, take that leap and take those
6:27
leadership positions. Now
6:28
in thinking about the last year or so,
6:31
what is the most impactful initiative or project
6:33
that you led?
6:36
The last year has been, it's been quite
6:39
a year. You know? So in New Orleans,
6:41
we start off the year
6:43
with the
6:45
the terrorist attack,
6:47
the, the mass casualty event in the French
6:50
Quarter
6:51
in New Orleans on January 1.
6:55
And that really,
6:58
shook our community.
7:00
But I was so proud of our staff
7:02
because we had drilled this many times
7:05
and we were prepared,
7:07
but being prepared
7:09
and going through it,
7:11
you realize,
7:13
how important that we are to the community.
7:17
And we took our patients not only from
7:19
all over the city, but from all over
7:21
the world because it was it was New
7:23
Year's Eve.
7:25
It was New Orleans. We had the Sugar
7:27
Bowl in town,
7:30
and we had patients from all over the
7:32
people from all over the world in the
7:34
French court at the time.
7:37
And so it was,
7:38
that start of the year
7:40
really made us focus on,
7:43
what we the core of what we do,
7:45
and I was couldn't be more proud of
7:47
the staff and how they responded.
7:49
And then helping the families,
7:52
re reconnect with their with the patients,
7:56
and then being able to be there and
7:57
provide counseling for the for those who lost
8:00
their loved ones.
8:02
That was big. We did all that at
8:04
University Medical Center.
8:06
We were the place not only for the
8:08
traumas, but also for the family reunification.
8:12
So that start off the year, and then
8:15
we really turned our focus on increasing access
8:19
to care because we know that we have
8:22
these specialties
8:23
at the hospitals, and we have capacity
8:26
to take the sickest of the sick in
8:28
the state.
8:29
We try to increase our throughput,
8:32
for the hospital and increase our ability to
8:34
accept patients transfers in.
8:37
So, you know, two and a half years
8:40
ago when we first started,
8:42
at University Medical Center, we were,
8:46
we were probably at
8:48
a 70 high seventies, low eighties percent acceptance
8:51
rate for transfers,
8:54
and we realized that we need to get
8:56
better at that. So we've
8:57
increased our census,
9:00
by a 130 beds.
9:02
We've,
9:05
increased our transfers now so we accept
9:09
96%
9:10
of all transfer requests come into the hospital.
9:14
And we also
9:16
are able to,
9:17
we were able to decrease our length of
9:19
stay,
9:21
by a day.
9:22
So all that helps in increasing access,
9:25
not only for our community right around us,
9:28
but also from, the the whole state,
9:31
being able to transfer,
9:33
patients into the hospital.
9:35
So that I think that's really made a
9:36
difference in the health and well-being of the
9:38
state
9:39
and may really stands up to our mission.
9:42
We are University Medical Center is the hospital
9:45
that took the place of Charity Hospital,
9:48
that was destroyed during Katrina.
9:51
And so we're just we're still the same,
9:53
you know, MPI number. We're still the spirit
9:56
of charity still is alive and well in
9:58
at University Medical Center.
10:00
And we still
10:02
you know, it's we debate with Bellevue who's
10:04
the oldest,
10:05
hospital in the country.
10:07
But we're still with oldest continuous
10:10
serving hospital,
10:12
in the country. And so we know the
10:14
importance that we are to this this region,
10:18
and to the Gulf South.
10:19
So, we try to we try to increase
10:22
our capacity to serve more people.
10:28
I love that. And, you know, especially impressive
10:30
to hear that you've been increasing your census.
10:33
A 130 beds is a lot and then
10:35
being able to take additional transfer requests, especially
10:38
at a time right now when so many
10:40
hospitals and leaders I talk to are are,
10:43
really at capacity
10:44
and, you know, stressing about some of those
10:46
access issues, trying to, you know, go to
10:49
great lengths, in order to bring in additional
10:51
access to their patient base. It's really cool
10:54
to hear how you've been able to do
10:55
that,
10:56
and and continue to provide a great quality
10:58
care and service to the community.
11:01
Yeah. It's been it's been exciting. It's been
11:03
a busy time, but it's been really good.
11:04
We you know, good thing about it is
11:06
that we start off the year with over
11:09
a 100
11:10
external contract,
11:12
nurses working.
11:14
And now we're down to
11:16
about 30.
11:18
And we expect that that's gonna decrease significantly
11:20
over the next,
11:22
ninety days also.
11:23
So we've been able to recruit,
11:25
grow our own,
11:27
staff throughout our nurse tech programs that we
11:29
have in partnership with the schools, with the
11:31
local nursing schools here,
11:33
and really,
11:37
provide a place where we can learn nurses
11:40
can learn and grow.
11:43
That's amazing.
11:44
I guess looking ahead into next year, are
11:46
there any other big priorities or headwinds that
11:48
you have your eye on?
11:51
The the biggest things for next year is,
11:53
you know, we're gonna focus on throughput,
11:55
making sure that we can, you know,
11:59
lower our length of stay by another day.
12:02
We
12:03
can keep accepting more and more patients. We
12:05
can see another, you know,
12:07
almost 500 patients a month if we just
12:09
by lowering
12:10
the lift of stay by one day,
12:13
so that that provides us more access
12:16
to care. The other things we see that
12:18
with there's a need in our community for,
12:21
more inpatient behavior health. We have a large,
12:24
behavioral health inpatient unit. We have 60 beds
12:27
at the University Medical Center,
12:30
and then we have a behavioral health ER
12:31
at the hospital also.
12:33
But we see that we are still having
12:35
to move patients outside of the region to
12:39
apply inpatient care. So we're gonna open up,
12:42
you know, partner between the two hospitals and
12:45
open up another 28 beds at New Orleans
12:47
East Hospital this year,
12:49
for inpatient behavior health, adult inpatient behavior health.
12:53
So I think that's gonna make a difference
12:54
in keeping people
12:56
who are in crisis
12:57
in their community,
12:59
so their families can, you know, stay connected
13:02
with them.
13:03
We think that's really, really important.
13:05
We're also expanding our
13:08
cancer
13:09
service, in the on the road to NCI
13:12
destination.
13:14
But we think that by expanding we're doubling
13:17
our
13:18
clinic beds and cancer our cancer service. We're
13:21
doubling our infusion beds,
13:24
and then we're also starting,
13:26
bone marrow bone marrow transport plant service there.
13:29
So,
13:30
you know, in the we're
13:32
just
13:33
a few miles away from what's called Cancer
13:37
Alley in Louisiana.
13:39
So we wanna be the place where those
13:41
patient can get seen early,
13:45
early diagnosis
13:46
and get the most cutting edge treatment,
13:49
for cancer to increase
13:52
their, survivability
13:53
of of diseases.
13:59
Absolutely. That's amazing to hear. And, you know,
14:01
especially the cancer treatment programs are so critical
14:05
right now. I I know that it it's
14:07
a huge need within the broader population, so
14:10
that's great to know that you're expanding and
14:12
able to achieve those great clinical outcomes. And
14:16
I wanted to go back just a minute
14:17
to something you've said,
14:19
you know, at the beginning of this conversation.
14:21
I was looking at, you know, the throughput
14:23
and,
14:24
being able to accept about 500 more patients
14:27
per month by lowering that length of stay
14:29
by just one day.
14:31
I'm curious. When you look at that lowering
14:33
the length of stay, how are you thinking
14:35
about doing that? How have you been successful
14:36
in the past? Is there anything new you're
14:38
trying in the new year?
14:40
Yeah. So we one of the things that
14:42
we started this year is we started a
14:45
a discharge lounge. So it's a place where
14:48
patients can go and wait for discharge,
14:51
out of the hospital.
14:53
So it makes it convenient for us to
14:55
start to turn beds quicker on on day
14:58
of discharge.
14:59
We've also started to,
15:01
we have what's called lightning rounds where every
15:03
every day we meet with one of the
15:06
academic teams,
15:08
either,
15:08
LSU or Tulane
15:10
and look at the the to forecast discharges
15:14
ahead.
15:15
So we do that with our case management
15:17
team, and the academic teams meet every every
15:19
day to make sure that we're planning ahead
15:22
so we can prepare those things early. And
15:25
so we're not delaying discharge by just,
15:27
sometimes those minor minor things we need to
15:29
get in place. The other thing we're we're
15:31
looking at is making sure that, you know,
15:34
patients are have the
15:36
the right follow-up care that they need.
15:39
So we're planning their their after visits,
15:42
their clinic visits upon upon discharge
15:46
So they're getting connected to care,
15:48
and then they bounce them back to the
15:50
hospital when they leave.
15:52
Those have been the the major initiatives,
15:56
that has really
15:58
helped us to,
15:59
improve our throughput.
16:01
We have a throughput coordinator who that's his
16:04
only focus is our our throughput measures. So
16:07
he partners with case management, partner with our,
16:10
assistant,
16:11
CMO,
16:13
and
16:13
really look at how we can you need
16:16
a bottle of mix in the system and
16:17
how we can resolve them. So every day,
16:20
we're looking at that, not only doing the
16:22
lightning rounds, but also in the afternoons.
16:25
If we see that the bottle of mix
16:27
happening, we'll get together again at three, 03:30
16:31
and look at how we can eliminate those
16:33
bottlenecks.
16:37
Got it. That's really helpful to understand. Thank
16:40
you for digging a little bit deeper there.
16:42
Now I know heading into the next year
16:44
too, there'll be a lot of different things
16:46
happening. So what do you think the hardest
16:48
thing you'll have to do will be in
16:49
the coming year?
16:52
You know, the thing that I I'm trying
16:55
to
16:56
really,
16:59
focus on,
17:00
I don't think it'll be hard. I think
17:02
the, the thing we're focused on next year
17:04
is really,
17:06
just improving
17:07
the our,
17:09
quality
17:10
and how we how we take care of
17:12
patients and really getting back to,
17:15
being excellent at the basics
17:18
of nursing care.
17:21
And then the other part is
17:23
trying to because we have a a young
17:26
staff
17:27
and really reconnecting
17:29
our nurses with their why,
17:32
and why they got into the profession,
17:35
and reminding them
17:37
that that is the, you know, reason they
17:39
come to work every day.
17:41
I think in, you know, post COVID,
17:45
we've we've tend to drift it away from
17:48
that some as I talk to every year,
17:51
every semester, I go to talk to the
17:52
nursing students in our community,
17:55
the the graduates.
17:57
And really, you know, trying to remind them
18:00
that this nursing is a is a calling
18:04
And is a calling that will, you know,
18:07
really provide satisfaction,
18:08
a career that
18:10
that enhances your life, and it can be
18:13
your life's work,
18:15
if you focus on the calling
18:18
and the care we provide and the advocacy
18:21
we provide for patients.
18:23
If you focus on other things like, you
18:26
know,
18:28
pay
18:29
and,
18:30
aesthetics and,
18:32
you know, all the things that are not
18:34
perfect in nursing,
18:36
it can be a rough ride.
18:39
And I think we've, you know, through some
18:41
social media things, through some,
18:45
you know, labor disputes across the country and
18:47
things of that nature.
18:49
People have gotten into,
18:50
you know, talking about what's bad about nursing
18:54
and nursing has been the most trusted profession
18:56
for years and years and years.
18:59
So
18:59
is it perfect? No.
19:01
But it
19:02
is an incredible opportunity to
19:05
have, you know, a lifetime of work that's
19:08
meaningful.
19:10
And, you know, even
19:12
if you focus on that, all those other
19:13
things will come. I tell them all those
19:15
other things come. Nursing has made me probably
19:17
the most successful person in my family,
19:20
but
19:21
I never focused on the success
19:23
of that. I've always focused
19:26
on the the calling and the mission.
19:28
And if you if you always have that,
19:30
the why at your center,
19:33
you'll learn you'll learn to love nursing
19:36
throughout
19:37
this the third like, I have for the
19:39
thirty two years I've been in it.
19:41
So I've been so that's what that's one
19:42
of the big messages, you know. You know,
19:45
folks don't be excellent at the basics
19:47
this year.
19:48
Make sure that we're providing the highest quality
19:51
of care.
19:52
We know that we can
19:53
do the complex things well, but let's let's
19:56
make sure that we do the basics well
19:58
and then,
19:59
return into the why.
20:04
I love that. Wow. It is so inspiring
20:06
to think about. And especially as you mentioned,
20:08
you know, being able to stay focused, that
20:10
meaning the mission of what nurses can do
20:12
and the impact that they have on their
20:14
communities and and patients,
20:16
is just incredible
20:17
to think about that opportunity and and continue
20:19
to have a career and build a career
20:22
and be successful in a variety of fronts.
20:25
I I know, like you said, there's so
20:26
much happening in the space today and so
20:28
much opportunity to get distracted, but, you know,
20:31
staying focused and really understanding,
20:34
how special health care is,
20:37
is just a great opportunity.
20:39
I think, you know, when you look at
20:40
growth and development for the next year, where
20:42
do you see some of those additional opportunities
20:44
coming from? How is LCMC Health thinking about
20:47
growth over the next twenty four to
20:50
months or so?
20:51
Well, I think, you know, for LCMC Health,
20:53
it's been it's been a mission of, of
20:56
making sure that we're providing
20:57
care for all communities.
20:59
So, you know, it's few one of the
21:01
few health systems birthed out of children's hospitals.
21:04
So we we have the safety net hospital
21:06
for children in the state and for adults
21:08
in the state. So access
21:11
and care,
21:12
and commute connection to community is always gonna
21:15
be our focus. So as we move forward,
21:17
you know, really growing out ambulatory and community
21:20
based access points,
21:22
will be key,
21:24
to make sure we
21:26
providing the right care at the right place
21:29
for community members so they don't have to
21:31
search. They
21:33
have the right connection to care right in
21:35
their community.
21:36
And then, you know, really
21:38
looking at our
21:40
nurse and physician partnerships,
21:43
making sure that we are, you know, working
21:45
as a dyad as we move forward
21:48
and
21:49
building that into the culture and the fabric
21:51
of what we do as we train so
21:54
many new learners
21:55
at our facilities.
21:57
We wanna make sure that we're training that
22:00
that that diet is is important as we
22:02
move forward, even in even in training.
22:05
And then lastly,
22:08
you know, I've mentioned earlier,
22:10
behavior health. We have the largest behavior health
22:12
platform
22:13
in the region,
22:14
and we want we're looking to expand that.
22:16
We know that behavior health and mental health,
22:19
emotional health is important
22:22
these days for everyone.
22:24
We see
22:25
the negative impacts of it,
22:27
on the news often,
22:29
but we know that how much it can
22:31
destroy our families if we if it's not
22:33
taken care of. So we wanna make sure
22:35
that we continue to expand that platform in
22:37
the in the in the region,
22:39
and then also look at,
22:42
our post acute partnerships in the area,
22:45
to make sure that that as patients leave
22:47
the hospital, that they're going to the right
22:50
facilities to
22:51
recover some more if they're not ready to
22:54
go home.
22:57
That's fascinating to hear. CJ, thank you so
22:59
much for joining us on the podcast today.
23:01
This has been a really amazing discussion, and
23:04
I look forward to seeing you again soon.
23:06
And I know you'll be speaking at our
23:07
annual meeting in April, which will be a
23:09
great chance to catch up and continue this
23:11
conversation as well as dig even a little
23:13
bit deeper into some of the processes and
23:15
systems you've put into place, for
23:18
the successful expanding capacity and growth and development
23:21
of your nursing team. So I'm looking forward
23:23
to that and and seeing you soon. Thank
23:25
you very much. I appreciate the opportunity.