Latest / Becker’s Healthcare - Clinical Leadership Podcast / Perry M. Gee, Enterprise Director of Nursing Research and Evidence-Based Practice, Nurse Scientist, and Associate Professor of Research at Intermountain Health

Transcript

Perry M. Gee, Enterprise Director of Nursing Research and Evidence-Based Practice, Nurse Scientist, and Associate Professor of Research at Intermountain Health · Becker’s Healthcare - Clinical Leadership Podcast

• 0:02
  The most important health care decisions don't happen
• 0:05
  in isolation.
• 0:06
  They happen when leaders come together.
• 0:08
  Becker's sixteenth annual meeting brings together more than
• 0:11
  3,500
• 0:12
  hospital and health system executives this April in
• 0:15
  Chicago.
• 0:16
  With 800 speakers from Ascension,
• 0:18
  Cleveland Clinic, CommonSpirit and more, the conversations get
• 0:22
  real. Leaders will share how their scenario planning
• 0:24
  for policy shifts, breaking through value based care
• 0:27
  barriers, and building clinical teams that translate
• 0:36
  sixteenth. For the
• 0:37
  agenda and event details, visit beckershospitalreview.com
• 0:41
  and click on the events tab in the
• 0:43
  upper right.
• 0:46
  This is Lauren Dierda with the Becker's Healthcare
• 0:48
  podcast. I'm thrilled today to be joined by
• 0:50
  Perry Gee, enterprise director of nursing research and
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  evidence based practice as well as a nurse
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  scientist and associate professor of research at Intermountain
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  Health. Perry, it's a pleasure to have you
• 1:00
  on the podcast today.
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  Thank you so much for having me. I'm
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  excited to talk about our work.
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  Absolutely. And I'm excited to learn more, I
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  think, especially when you're looking at the nursing
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  profession. I mean, right now is such a
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  transformational time in health care, and so, you
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  know, there's no better topic as we're trying
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  to dig deeper and and make big changes
• 1:18
  in the health care space.
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  But before we dive into some of the
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  cool things you're doing at Intermountain, can you
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  tell us a little bit more about yourself
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  and your background?
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  Absolutely. So I've been a nurse for over
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  forty years now.
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  Most of my early days in nursing was,
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  in critical care and in flight. But for
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  really the last twenty five years, I've been
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  a clinical informatics specialist.
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  And then the last ten years or more
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  than that now, I have been a nurse
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  scientist. I was the first nurse scientist at
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  Dignity Health out in California
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  and then,
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  the first nurse scientist for Intermountain Health. And
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  that's some of what I'd like to talk
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  about today is some of the challenges that
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  we face as nurse scientists as we build
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  these programs.
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  Most important,
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  is the work that we do around research,
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  of course. But a lot of us are
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  also doing work in the space of evidence
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  based practice and building capacity with evidence based
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  practice.
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  And then as our nursing organizations
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  evolve, and we'll talk quite a bit about
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  the evolution of the nursing organization at Intermountain
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  Health, as those organizations evolve,
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  some of us aren't professional governance environment or
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  really an environment that gives a voice to
• 2:35
  the nurses at the point of care. So
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  I want to make sure that my work
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  really integrates with that environment
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  and actually bolsters and strengthens the environment of
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  of professional governance. And then last,
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  and and one of the most important parts
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  of my job, I think, is is scholarly
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  dissemination of our work.
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  We at Intermountain Health have been known for
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  years as
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  a a top,
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  organization
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  for medical research and clinical trials and incredible
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  work in that space, but we haven't really
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  been known as a top organization for nursing
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  research.
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  Even though we've been doing that work, we
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  just haven't disseminated
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  or talked about what we're doing. And so
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  that's what I'm excited about is getting the
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  word out that we are,
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  certainly going to be a top nursing research
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  organization,
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  and we're on the pathway to getting to
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  that. And that's kind of what I wanna
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  talk about today.
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  Absolutely. I think that's amazing to hear it
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  and definitely,
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  a space where there's a lot of interest
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  and a lot of, you know, growing needs.
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  So,
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  let's jump right in. Can you tell us
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  a little bit about, your nursing research organization
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  and and some of the initiatives that you've
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  led over the last year especially? What did
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  you do, and what were the results?
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  Well, you know, so this this is a
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  fascinating question and and really complicated.
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  Probably some of the most complicated work that
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  I've done in my career was what we
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  did last year. And what we did last
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  year, and I should say it really started
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  a couple of years ago, but it really
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  came together
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  in 2025
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  is,
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  we are integrating
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  our nursing organizations. And when I when I
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  say that, what I mean is we had
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  a merger,
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  a few years ago,
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  with Sisters of Charity of Leavenworth,
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  a health system primarily in in, Colorado and
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  Montana.
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  And when we merged with those organizations,
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  what we also did, and I I didn't
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  fully understand, was we merged the cultures of
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  those two organizations as well. So our nursing
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  cultures operated a little bit differently.
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  We had even, some difference in philosophy around
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  research and evidence based practice.
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  So the thing that's so exciting right now
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  is that we're becoming one
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  large nursing organization at Intermountain Health. We span
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  all six states.
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  We span
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  from children's health to adult health,
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  to geriatrics,
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  to ambulatory environments,
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  to very rural and frontier environments,
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  to very urban environments. So what
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  a great opportunity
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  to
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  grow nursing in
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  that same space. And so that's the biggest
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  work that we have been doing is developing
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  an enterprise wide nursing
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  research and evidence based practice infrastructure
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  that will help support
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  that overall nursing,
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  strategy. And so to do that,
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  again, we're gonna leverage the voice of the
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  nurses who work at the point of care.
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  They have
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  the wisdom and the knowledge
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  and the skills
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  that we need to be listening to when
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  we make these decisions. And so we're gonna
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  include them in our professional governance
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  organization. We're gonna include them in this transition
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  plan, and they have been included.
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  So that's been some of the tough work.
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  We've had a significant
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  increase in our evidence based practice nursing projects
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  over the last few years.
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  We've had,
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  great scholarly output,
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  and have been presenting at conferences regionally and
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  nationally.
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  We've had publications
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  and some externally funded nursing research,
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  and we are really building this alignment.
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  Laura, it it's really complicated when you think
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  about we're building an alignment now that we've
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  never had before between nursing research and evidence
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  based practice
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  and nursing
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  clinical practice at the point of care. And
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  let me explain
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  explain that. The way that we operate is
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  we have new,
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  several programs of care. So we have an
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  executive director of
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  nursing critical care, for example,
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  or an executive director of nursing care for
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  perioperative services.
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  And those people
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  have had their own operational
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  goals and ideals
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  and standards that they've been setting. We're partnering
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  with them as research and evidence based practice
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  folks who've traditionally been working out on our
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  own. We're now partnering with with them to
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  make sure that we are standardizing,
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  that we are streamlining
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  our work, and that we're supporting the goals
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  of not only the individual practice settings,
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  but also the overall organization.
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  So how does nursing research and evidence based
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  practice
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  support the KPIs at our organization? We wanna
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  make sure that we're able to to state
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  that and that we're doing those things.
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  The other projects are important,
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  and they're interesting,
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  but we really need to be focusing our
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  work right now, especially in this environment that
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  is so complicated.
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  And then last, we we really wanna improve
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  the the visibility
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  of our research and evidence based practice teams
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  in nursing. And I'll talk a little bit
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  about about how we did that, but but
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  part but part of it was being recognized
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  in the organization
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  as a program of research.
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  Nursing, you know, typically was not recognized as
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  one of our strong programs of research at
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  Intermountain Health, and we are now. And it's
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  been a tough journey, Laura. It's taken several
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  several years. But this last year, we really,
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  turned the corner.
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  Now we are recognized as a program of
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  research.
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  Now we have a,
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  scientific review board to help stand up our
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  project and make sure that they're ready to
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  go to the IRB. So that's kind of
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  the work that we've been doing over the
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  last year is just getting our infrastructure in
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  place so that we're really, really ready to
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  move forward.
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  Absolutely. I I love that, and I think,
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  you know, it definitely,
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  is cool to have that type of rigor
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  around how you're looking at the nursing practice,
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  how you're thinking about standardizing the things that
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  will help improve patient care and really getting
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  the research behind it, and then expanding that
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  in in creating that visibility across the board.
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  And, you know, I'm curious as you're looking
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  at, some of the different KPIs either that
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  you've always used or,
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  new ones that you've developed in more recent
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  years.
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  How what does it take to really, you
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  know,
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  create that culture of,
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  looking at the data and following those metrics
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  that you know will be beneficial for patient
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  care in developing those or or following those
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  best practices,
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  that you put out there? Because I know,
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  you know, that can certainly be a challenge
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  when you're looking at making a change management
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  or transformation
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  process and becoming more of a evidence based
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  organization.
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  What a great question, and it's really pertinent
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  for our company. When you think back, at
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  the history of Intermountain Health, we are one
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  of the early adopters
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  of the electronic health record. Even as far
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  back as the seventies and eighties, we were
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  working in that in that space.
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  So
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  over the years, we have amassed a tremendous
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  amount of clinical data. And and when when
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  you think about the role of the nurse,
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  you know, we've got 18,000 nurses at Intermountain
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  Health. All of those nurses have been documenting
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  around the clock
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  for decades. We have,
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  we have just
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  huge amounts of large data sitting there ready
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  to answer our questions.
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  One of the things that we're doing in
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  nursing research and evidence based practice
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  is letting our nurses know at the point
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  of care,
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  we have access to that data. By the
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  way, we we have ready access to that
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  data. We have expert analysts in our organization
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  that can help us pull that together. And
• 10:44
  by the way, it's not just data within
• 10:46
  Intermountain Health. They can also pull external data,
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  and they're
• 10:50
  part of some other large research collaboratives.
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  So we really have access to
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  as as probably
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  as good of data as any organization.
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  But our nurses haven't haven't, been exposed to
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  that, so we're exposing them to that to
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  that right now. We'll sit down with them,
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  with a data analyst and say, here's your
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  question. Let me give you an example, Laura.
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  We are
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  we had a nurse who who who wondered.
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  She's been
• 11:19
  trying to walk patients on a ventilator.
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  You know, that's a difficult process,
• 11:25
  but it's a very worthy process. It really
• 11:27
  helps patients who are on a respirator
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  to get off the respirator earlier,
• 11:33
  to, have better outcomes at home, potentially,
• 11:39
  you know,
• 11:40
  not have to be readmitted to the hospital
• 11:42
  in the future. All those things, we think
• 11:44
  that we'll have better outcomes
• 11:46
  if we have our long term patients on
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  a on a ventilator
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  up and walking in the hallways.
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  So what does that mean? Well, we've got
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  the data
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  around that sitting out there right now. So
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  one of my nursing research fellows right now
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  is gathering the data about
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  ambulation of patients who are on a respirator,
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  how far they went, what were their physical
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  therapy orders like, those kinds of things. We're
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  gonna be able just to look at that
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  data
• 12:13
  and then say, hey. You know what? Maybe
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  this is a best practice that we should
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  be doing not only across our organization,
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  but across the country. So that's the kind
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  of work that I'm hoping
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  that our nurses will be able to lead
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  using this vast amount of data that we
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  have. And and keep in mind, Laura, what
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  we're talking about right now doesn't even really
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  include our use of AI, which has not
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  necessarily started
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  in that kind of a clinical setting yet
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  or in the analysis of clinical data. But
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  down the road, I'm sure we'll be able
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  to use that as well to help us
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  predict.
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  And and I want our nurses to have
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  that level of understanding, not coming from me
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  as the nurse scientist. I want the nurses
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  at the point of care to know, you
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  know what? I bet we've got data that
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  will help me answer this question.
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  That's amazing to hear. And, you know, really,
• 13:05
  really, helpful to understand how you think about
• 13:07
  that kind of cultural change and then really
• 13:10
  make sure that it's,
• 13:12
  integrated within the whole organization and they understand
• 13:15
  why it's happening and using technology and and
• 13:17
  data,
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  you know, I I think that's really critical.
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  And now looking ahead, what are some of
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  the big priorities and headwinds that you're focused
• 13:24
  on for 2026?
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  2026,
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  I think, is even gonna be,
• 13:31
  more challenging and more difficult than 2025. And
• 13:34
  and by the way, I mean that in
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  a good way, Laura. I think we're gonna
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  have,
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  an incredible time
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  working through 2026
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  in the background.
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  Stirring in the background, of course, is AI,
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  and we don't know how that is going
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  to be
• 13:51
  impacting our practice. But we know that it's
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  out there. So in 2026,
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  my team would really like to focus on
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  scalability,
• 13:59
  consistency,
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  and measurable outcomes
• 14:02
  across the enterprise
• 14:04
  using,
• 14:06
  the data that we were just talking about.
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  You know? But but more important to us,
• 14:10
  Laura, for 2026
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  is as we scale evidence based practice
• 14:15
  to our nurses that are working at the
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  point of care,
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  I want them to do more than just
• 14:22
  think about evidence based practice. I want to
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  see
• 14:25
  us use implementation
• 14:26
  science
• 14:27
  to help them
• 14:29
  do the best job they can to implement
• 14:32
  the evidence. So using implementation science tools
• 14:36
  or theories to help us with that. That's
• 14:39
  one. And then, two, the reason that's so
• 14:41
  important is because
• 14:42
  the evidence is only as good
• 14:45
  as how we use it. Right? So if
• 14:48
  we identify evidence and we think this is
• 14:50
  gonna be the best practice, but we can't
• 14:51
  implement
• 14:52
  that practice, then we're not gonna make any
• 14:55
  headway. But if we can implement the practice,
• 14:57
  the best practice,
• 14:59
  and then
• 15:00
  get ourselves to high adherence of that best
• 15:03
  practice. Right? So we implement,
• 15:05
  let's say we implement a bundle
• 15:08
  to,
• 15:09
  help patients with oral care, for example, maybe
• 15:12
  ventilator patients with oral care. We implement that
• 15:14
  bundle. We get
• 15:16
  ninety five percent of the nurses doing it
• 15:18
  ninety five percent of the time, and then
• 15:21
  we sustain that
• 15:23
  over a period of years,
• 15:25
  that is
• 15:27
  best practice in, using evidence based practice. Right?
• 15:30
  That is using implementation science
• 15:33
  to assure high adherence
• 15:35
  and to assure sustainability.
• 15:38
  That's something that's gonna be new to the
• 15:40
  nursing culture to most people. Implementation science principles
• 15:44
  are relatively new to,
• 15:47
  to to many nurses.
• 15:49
  The other thing that we wanna do is
• 15:50
  is we are gonna expand our professional governance
• 15:53
  environment for nursing,
• 15:55
  which gives the voice to the nurses at
• 15:57
  the point of care.
• 15:59
  We can share these tools like implementation science
• 16:02
  with those nurses at the point of care.
• 16:04
  So now they now they have access to
• 16:06
  data. They have access to implementation
• 16:09
  science skills,
• 16:10
  and we want them to feel confident with
• 16:12
  evidence based practice. And we believe that they
• 16:15
  are going
• 16:17
  to change practice, that their
• 16:19
  collective wisdom as this mass of 18,000
• 16:23
  nurses
• 16:23
  will really help us answer some of the
• 16:25
  most difficult questions that we have at Intermountain
• 16:28
  Health.
• 16:31
  Absolutely.
• 16:32
  I love that. And, you know, it sounds
• 16:33
  like a very exciting time to be at
• 16:36
  Intermountain and in the nursing workforce and and
• 16:38
  to have all of that information,
• 16:41
  and being able to continue to grow and
• 16:43
  develop in that space, you know, it is
• 16:45
  really exciting.
• 16:46
  I'm curious. What do you think is the
• 16:48
  hardest thing that you'll have to do in
• 16:50
  the next year will be? I I know
• 16:52
  nothing, you know, ever, becomes
• 16:55
  perfect, but what do you think the hardest
• 16:57
  thing that will be?
• 16:59
  Well, that's the that is the best question,
• 17:02
  you could possibly ask, and it's what we
• 17:04
  are really focusing right now. I think the
• 17:07
  hardest thing, you know,
• 17:09
  the longer I work in health care, the
• 17:11
  more I realize it's about culture. It's about
• 17:13
  culture and it's about communication.
• 17:15
  Some of the the basic fundamentals
• 17:18
  of of communication.
• 17:19
  And by culture, what I mean is I
• 17:21
  would really like every nurse at Intermountain Health
• 17:24
  to feel comfortable
• 17:26
  in accessing
• 17:28
  or utilizing
• 17:29
  their evidence based practice skills.
• 17:32
  So I'd like to operationalize
• 17:34
  that across the system. I don't want it
• 17:36
  to be a central command,
• 17:39
  resource. I want it to be a resource
• 17:41
  that happens in the field
• 17:43
  and that we here working centrally
• 17:45
  can support the nurses in what they need.
• 17:48
  You know what? I have a question,
• 17:50
  doctor Gee, about
• 17:51
  about patient falls, but I don't know where
• 17:53
  to start. Well, I can help them get
• 17:56
  started with their question and get them connected
• 17:59
  with the resources that we have because I
• 18:01
  bet you that we have nurses at one
• 18:03
  of our hospitals in Montana or Colorado
• 18:07
  or Idaho or Utah that's working on some
• 18:09
  of those similar things. So those are sort
• 18:12
  of the the areas that I wanna focus
• 18:14
  on this year, focus on the culture,
• 18:16
  creating this culture of inquiry that nurses are
• 18:19
  not afraid to ask the question,
• 18:21
  but they're really ready to get their their
• 18:23
  hands dirty in digging in and working on
• 18:26
  the questions themselves
• 18:28
  and the solutions right there at the point
• 18:30
  of care.
• 18:34
  I love that. I I love that idea
• 18:36
  of culture of inquiry as well, being able
• 18:38
  to feel comfortable asking those questions and raising
• 18:41
  issues and and working through together some of
• 18:43
  the big challenges that they're thinking about and
• 18:45
  that they see upcoming.
• 18:48
  I I I love that kind of phrase
• 18:49
  and that thought process.
• 18:51
  Now before we wrap up here, I wanted
• 18:53
  to ask you about growth as well. Where
• 18:55
  do you see some of the biggest opportunities
• 18:57
  for organizational growth?
• 19:00
  Well, as you mentioned earlier,
• 19:02
  data analytics and predictive analytics, I think, are
• 19:05
  gonna be important for us.
• 19:07
  Leveraging
• 19:08
  AI,
• 19:09
  it may not even happen this year, right,
• 19:11
  at the clinical setting, but I think it's
• 19:12
  gonna happen over the next few years.
• 19:15
  I want to empower the frontline nurses
• 19:18
  through the professional governance process to feel comfortable
• 19:22
  with evidence based practice.
• 19:24
  I really like to find you know, by
• 19:26
  the way, evidence based practice can't happen if
• 19:29
  we don't have
• 19:30
  nursing research and knowledge to support the evidence.
• 19:33
  And then sometimes we have to generate new
• 19:35
  evidence. So I wanna make sure that we're
• 19:37
  supporting and generating
• 19:39
  new research, new nursing research,
• 19:42
  and and by the way, validating some of
• 19:44
  the old research that we've done in the
• 19:46
  past as well.
• 19:48
  And then I think it's important for us
• 19:50
  to remember that this research and evidence based
• 19:52
  practice
• 19:53
  transcends
• 19:54
  the
• 19:56
  the clinical areas
• 19:57
  because we wanna use best practices and the
• 20:00
  best evidence for leadership decisions
• 20:02
  and for decisions around how we educate our
• 20:06
  our people.
• 20:07
  And and one last thing, Laura, and it's
• 20:09
  sort of an opportunity for growth.
• 20:11
  In addition to this work that I'm doing
• 20:12
  at Intermountain Health,
• 20:14
  we have,
• 20:15
  the Sigma Theta Tau International, which is a
• 20:18
  a scholarly nursing organization.
• 20:20
  We have a nurse scientist collaborative, and I've
• 20:23
  been co leading that collaborative
• 20:25
  with doctor Esther Chips from the Ohio State
• 20:27
  University for the last couple of years.
• 20:30
  And with that group,
• 20:32
  we are pulling together nurse scientists from all
• 20:36
  over the country
• 20:37
  because we don't really have a common platform.
• 20:40
  We,
• 20:41
  all operate a little bit differently,
• 20:44
  and we all need the same resources. In
• 20:46
  fact, many of us I I did this
• 20:47
  at my my job here. Many of us
• 20:50
  had to create our own job descriptions, for
• 20:52
  example, or create our own policies in our
• 20:55
  department.
• 20:56
  So we're we're developing this national collaborative right
• 20:59
  now.
• 20:59
  We've got about 200 members in that
• 21:02
  with nurse scientists from across the country so
• 21:05
  that we can share our wisdom and what
• 21:07
  we've learned along the way.
• 21:12
  That sounds like an amazing organization and group
• 21:14
  to be part of in space that you
• 21:16
  can really collaborate, learn, and grow together. Perry,
• 21:19
  thank you so much for joining us on
• 21:20
  the podcast today. This has been such a
• 21:22
  fun conversation. I learned a ton, and inspired
• 21:25
  by your energy and passion for what you
• 21:27
  do. And I'm looking forward to meeting you
• 21:29
  in person as well at our annual meeting
• 21:30
  coming up here in April. I know you'll
• 21:32
  be speaking on a panel and,
• 21:34
  continue to share some of the insights and
• 21:36
  expertise you've had through your years of research
• 21:38
  and,
• 21:39
  the great things that you've been able to
• 21:41
  accomplish at Intermountain. So, thank you for your
• 21:43
  time today, and I look forward to seeing
• 21:45
  you in a few months.
• 21:46
  Thank you, Lauren. I appreciate the opportunity to
• 21:48
  share my work.