Latest / Becker’s Healthcare - Clinical Leadership Podcast / Building Better Healthcare AI Through Nursing Co-Design with Terry McDonnell

Transcript

Building Better Healthcare AI Through Nursing Co-Design with Terry McDonnell · Becker’s Healthcare - Clinical Leadership Podcast

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  - There's a small circle of people who truly
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  - understand what it takes to lead a health
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  - system right now. The decisions are enormous.
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  - The variables are constantly shifting, and the stakes
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  - of getting a call wrong don't stay contained.
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  - That's not a complaint. It's a structural reality.
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  - And it's why the most effective c suite
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  - leaders are deliberate about where they go to
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  - pressure test their thinking.
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  - Becker's fourteenth annual CEO and CFO roundtable
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  - brings together more than 1,500
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  - executive level attendees
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  - and nearly 400 speakers for four days built
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  - around growth, financial sustainability,
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  - workforce strategy, and the leadership questions that don't
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  - have easy answers.
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  - Join us November second through the fifth in
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  - Chicago.
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  - For the agenda and event details,
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  - visit beckershospitalreview.com
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  - and click on the events tab in the
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  - upper right.
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  - Welcome to Becker's Healthcare Clinical Leadership podcast. I'm
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  - Mariah Taylor, assistant editor, and I'm thrilled to
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  - be speaking with Terry McDonnell,
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  - senior vice president and chief nurse executive at
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  - Duke University Health System and vice dean for
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  - clinical affairs at Duke University School of Nursing.
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  - Thank you so much for joining me today,
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  - doctor McDonnell. It's so exciting to have you
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  - on the podcast again, and I am excited
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  - to get diving into how nurses need a
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  - seat at the table to help develop AI.
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  - But before we dive into all of my
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  - questions, I'd love to turn it over to
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  - you to introduce yourself and tell us a
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  - little bit about your background.
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  - Sure. Mariah, it's lovely to be here with
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  - you today.
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  - You you you very nicely,
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  - put my titles out there. I get the
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  - pleasure of
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  - serving about 10,000,
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  - nurses and patient care services staff here at
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  - the health system.
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  - And, by way of background and trade, I
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  - am a GI oncology nurse practitioner and I
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  - still see patients.
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  - It is the why and it regrounds me
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  - in in, you know, all of the the
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  - craziness of the day. Everything we do is
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  - still in service to taking care of a
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  - patient.
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  - So it is truly a pleasure to be
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  - here with you.
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  - Yes. And we're excited to have you as
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  - always.
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  - Now today, we're gonna be chatting about the
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  - importance of having nurses at the AI development
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  - table and having them involved in this. So
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  - I would love to understand
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  - your process of what you're doing at Duke.
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  - What does nursing representation
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  - actually look like in your AI development process?
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  - Well, you know, we have been very deliberate
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  - as we've been adopting these tools both with
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  - nursing
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  - and clinicians.
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  - And we have
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  - nurses we actually for we have a governance
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  - framework
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  - whereby we've got frontline nurses, nursing leaders,
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  - side by side with our technology leaders,
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  - with our industry partners,
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  - all examining
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  - together how we evaluate
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  - these tools,
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  - how we develop them, and how we implement
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  - them in the care setting.
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  - You know, we've got some very exciting projects
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  - right now going on in our inpatient
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  - units and three of our inpatient units at
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  - University Hospital here in Durham.
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  - We call them our innovation units and we're
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  - actually testing out different technologies,
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  - different whiteboard systems, we've got
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  - integrated
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  - computer vision technology. We're working with an industry
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  - partner on that, building AI algorithms
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  - around falls,
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  - and and,
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  - pressure injury prevention.
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  - And we've got staff nurses at the bedside
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  - who are giving us feedback. We are getting
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  - their,
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  - satisfaction with all of these tools. We're getting
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  - feedback
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  - from patients. We're actually publishing on a lot
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  - of this. We've got informaticists
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  - embedded in this, and we've got process engineers
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  - as well as leaders all together
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  - working around how we're going to lead
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  - in the implementation
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  - and development of these tools as we transform
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  - care.
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  - Amazing.
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  - How do you select which nurses are gonna
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  - be involved in a co design, and do
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  - they tend to be the same people?
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  - We intentionally try not to make it the
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  - same people. We want diversity of opinions and
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  - thought in this process.
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  - You know, if you only build the coalition
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  - of the willing,
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  - and don't include people that are skeptics or
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  - have questions or might even have fear around
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  - implementation of these technologies,
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  - then you're losing opportunities
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  - to integrate all of that rich feedback into
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  - how you design and roll out these things.
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  - Change management is a huge issue for us.
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  - You know, we need the people who are
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  - closest to the work informing what these tools
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  - look like and how we leverage them. And
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  - we all know, and in fact, in Becker's
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  - today and the CEO report, I saw,
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  - that there's an article around clinicians opting out
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  - when they're not involved
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  - in evaluating these tools. Well, you know, the
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  - same thing happens at the front line with
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  - nurses.
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  - People will vote with their feet, and we
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  - actually need to transform health care delivery, and
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  - we need these tools.
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  - But we need these tools
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  - designed in a way that helps us make
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  - the work easier and that most importantly improves
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  - our outcomes.
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  - Absolutely.
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  - What do you do when a frontline nurse
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  - pushes back on a tool that leadership in
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  - IT is committed to?
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  - We take their feedback.
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  - You know, this is a dialogue. It's and
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  - we try very intentionally
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  - not to
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  - exclude the opportunity
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  - for feedback to help us improve.
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  - And in fact recently with the innovation units,
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  - we had an opportunity where we realized that
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  - some of the staff were reluctant
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  - to talk to patients
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  - about
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  - opting in
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  - for some of these
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  - technologies like the computer vision.
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  - And when we did some listening sessions, when
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  - we got feedback, when we really dug in
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  - to engage with the staff to find out
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  - what the concerns were,
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  - it was
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  - one simple switch that we could turn off
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  - that they could then see
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  - that
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  - they were controlling how,
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  - we were calling the system live.
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  - Simple
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  - simple
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  - thing that we could do
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  - in response to their feedback.
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  - And if we had not engaged with them
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  - and understood
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  - why they were hesitant to to use the
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  - technology,
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  - then we would have run the risk of
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  - the entire project
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  - going offline.
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  - And I think it's really important for us
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  - to ensure that as we're trying to move
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  - care in in a different way by leveraging
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  - technology,
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  - that we ensure that we're continually going back
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  - to those humans that need to be in
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  - the loop and getting their feedback and helping
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  - improve things.
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  - We don't live binary lives. I don't think
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  - it's a yes or a no situation.
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  - It's a we would like to and how
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  - can you help us inform the best way
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  - of moving forward.
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  - In that same kind of vein, how do
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  - you handle it when nurses'
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  - input during the co design process conflicts with
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  - what the data or the vendor's evidence base
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  - says?
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  - Well, I mean, we've
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  - we've had the opportunity for nurses to,
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  - really inform industry partners
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  - that some of their assumptions might be incorrect
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  - because, you know, every day, I get pinged
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  - by vendors
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  - who tell me they've got a solution to
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  - to my problems.
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  - But very often, they don't truly understand
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  - what problems we're trying to solve.
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  - And the people who are closest to the
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  - work
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  - are the best people to help inform those
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  - solutions.
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  - So very often we'll have
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  - a a tool or a technology
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  - where assumptions have been made,
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  - but then nurses
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  - and clinicians
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  - will give real and meaningful feedback
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  - and will help the industry partner understand where
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  - they may have solved for the wrong problem
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  - or where they have they may have neglected
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  - a process
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  - or a concern that we can then provide
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  - them the feedback to to make their tool
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  - ultimately better.
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  - Amazing.
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  - Now looking at this all a lot more
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  - broadly, what do you think it will take
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  - for nursing co design to become a standard
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  - practice practice across the industry rather than something
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  - that leading institutions like Duke do well?
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  - Well,
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  - I think there's a cost associated
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  - with not
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  - having nurses
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  - codeveloping
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  - these things.
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  - Because again, as we've talked about already and
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  - as we've seen play out,
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  - if you don't have the people that are
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  - going to be using these tools and technologies
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  - helping inform what they look like and what
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  - the implementation looks like,
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  - then you run the risk of people
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  - voting voting with their feet and opting out.
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  - And there's an expense tied to that.
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  - These things are
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  - are expensive.
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  - The time that it takes to integrate, roll
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  - out, do the change management
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  - is all
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  - cost associated
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  - with time,
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  - with finance.
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  - And,
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  - you know, if if we
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  - don't
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  - ensure
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  - that the people who are going to be
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  - using these tools are hoping are helping co
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  - develop,
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  - then it it's going to cost us more
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  - in the long term.
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  - And the headwinds right now around around the
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  - nation are such that we need to be
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  - cost efficient.
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  - And the most cost efficient way to transform
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  - care
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  - is to really have our physicians, our nurses,
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  - our techs,
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  - all involved in co developing these technologies.
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  - Excellent.
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  - Well, thank you so much for being here
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  - today and sharing your thought leadership. It's been
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  - a pleasure. It's always a pleasure talking to
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  - you.