Latest / Becker’s Healthcare - Clinical Leadership Podcast / Rosemary Wurster, Chief Nurse Executive of Patient Care Services at Bayhealth

Transcript

Rosemary Wurster, Chief Nurse Executive of Patient Care Services at Bayhealth · Becker’s Healthcare - Clinical Leadership Podcast

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  - This is Laura Dedo with the Becker's Healthcare Podcast.
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  I'm thrilled today to be joined by Rosemary Worcester,
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  who is the Senior Vice President of Patient Care Services
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  and Chief Nursing Executive at Bay Health.
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  Rosie, it's a pleasure to have you on the podcast today.
• 0:14
  - Thanks for having me, Laura. Happy to be here.
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  - Now, I know we've got a lot to talk about.
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  Certainly there's so much happening in healthcare right now,
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  and I'm especially interested in digging deeper into
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  how you're looking at nursing at Bay Health.
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  But before we dive into that discussion,
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  can you tell us a little bit more
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  about yourself and your background?
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  - Yeah, I'd be happy to.
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  Um, I am presently, uh, the Chief Nurse Executive
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  and senior Vice President
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  for patient care services here at Bay Health.
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  And, uh, bay Health is a medium sized health system,
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  and we serve, um, our communities in central
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  and southern Delaware.
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  Um, and the landscape is, uh, quite unique.
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  We have a number of rural areas that we serve
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  and, um, some coastal regions as well.
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  Um, but Laura, I have been a nurse for 27 years,
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  and, um, I became a nurse because I love
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  and appreciate and continue to love
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  and appreciate the intersection of science and people.
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  And, um, that has carried me through these 27 years.
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  My clinical background is emergency nursing.
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  Um, I have loved my time in, uh, a variety of, uh,
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  emergency departments,
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  and I've had a number of, uh, different leadership roles.
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  Um, one of my favorites was being a house supervisor.
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  Uh, you know, when you're a nursing supervisor on the off
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  shift, you get a real, um, valuable slice
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  of not only people, but also of healthcare.
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  Um, I've done things from being a unit manager
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  and, um, I've led some program development from
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  orthopedic service line.
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  And, um, interestingly, I, um,
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  took an opportunity in the middle of my career to move out
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  of operations
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  and into more of the nursing infrastructure role.
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  And I became a director of, uh,
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  professional excellence in nursing.
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  Uh, and this is important because, uh,
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  I got this bird's eye view of
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  what are the professional elements to our practice
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  of nursing that, um, are critical in,
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  in the way we deliver care.
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  And then from there, um, I've been really blessed
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  to be in a vice president role for almost 10 years.
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  And, um, in my time as an executive leader, I've, um,
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  been able to work at, um, in large health systems.
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  I have been the campus leader, uh, chief nurse, uh,
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  chief nursing officer for, um, uh,
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  health campus within a health system, uh,
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  in community settings
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  and also in academic medical center, uh, environments.
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  Um, and now here I am at Bay Health
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  and, um, sort of pulling on all of those experiences to, um,
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  be the chief nurse executive here.
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  - So that's an amazing career journey,
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  and it sounds like you've had so many different experiences,
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  and I love the way that you positioned your passion as
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  that intersection between science and people
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  and being able to really lean into, to both areas, um, uh,
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  of, of having that people
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  and connection while also understanding it
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  and being on the forefront of science and, and treatment
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  and technology as well.
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  - Mm-Hmm, . Well, it is what we are doing
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  sort of every day, all day in healthcare.
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  You know, when I think about the biggest issues
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  that we face, um, not just daily,
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  but in how we, we create sort of sustainability to be able
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  to continue to take care of our patients.
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  We've got a lot of science going on, um, technology,
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  et cetera, and I'm sure we'll dig into that.
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  We also have groups of people that we are leading
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  to take care of people,
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  and I find that that's sort of a grounding theory for me,
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  um, because it's, it really people is the, um,
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  is is the center of it all.
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  - I love that. I think that's so important in really, um,
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  sets the, the site scene well for the healthcare space now.
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  What are those biggest issues
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  that you're following right now in healthcare?
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  What are some of the things that you spend most
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  of your time on and are really
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  thinking about a lot right now?
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  - So, um, great question, Laura.
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  I think, um, I would be crazy not to begin with
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  what is the intersection of technology with care?
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  You know, you, it is really hard to open, um, a journal,
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  uh, a conversation about care, um, you know, conversations
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  with colleagues in other set, you know,
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  in other organizations without talking about what's going
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  on in the virtual space.
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  And, and that's two things for me.
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  One is what are the options
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  and opportunities we have in virtual care
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  and what I will call virtual care support?
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  So, you know, lots
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  and lots of discussion about the, um, the implementation
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  of virtual care, virtual nursing care,
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  and that is adjunctive to the individuals who are, uh,
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  at the bedside, so to speak, um,
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  or at, at the point of the patient.
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  Uh, and there's a number of different ways
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  that virtual nursing deploys here at Bay Health.
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  We are looking at, um, a virtual nursing model
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  that is supported in the teaching elements for patients,
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  patient teaching, patient education.
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  How, what does the patient need to know sort of
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  before they leave the hospital setting,
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  but also looking at what are those sort
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  of care coordinating, um, pieces that we can do
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  behind the scenes for the, so by that I mean, um,
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  you know, what is the likelihood
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  of a patient having a complication?
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  What is the likelihood of a patient, um, you know,
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  needing a readmission?
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  How do we mitigate those things, um, in advance?
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  And we're doing that in a virtual space and,
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  and building what that program looks like here.
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  Um, but I also look at this, you know, my job as a,
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  as a chief nurse is to, um, you know, remove barriers,
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  secure resources,
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  and, uh, sort of to, um, uh, drive the care,
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  but also be a good steward.
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  And in that, I find that I want to make the connection
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  between virtual care
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  and unburdening our care teams
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  from unnecessary work, right?
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  So, uh, we're going to be, um, beginning an exercise
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  where we really take a good deep dive into
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  what is the necessary work to take care of patients
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  and, you know, what are the opportunities
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  that we have here locally to move any of that
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  or leverage technology to assess.
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  Um, so I, I think that we use the terminology virtual care
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  and virtual nursing in a very wide range,
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  but that's sort of what, what that means here at Bay Health.
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  And, um, other things that are really on my mind here.
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  Um, again, maybe an overused terminology here,
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  but if that is the academic practice partnership, right?
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  So I'm changing gears a little bit,
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  but, um, that is how are we partnering to sort
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  of give and receive in the academic practice partnership?
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  So I, I'm gonna give you an example here.
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  Um, we have a number of, um, very vibrant, um,
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  nursing programs,
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  undergraduate nursing programs
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  here in the state of Delaware.
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  And, um, I, we've just developed a partnership with, um, one
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  of those who, uh, you know, we are working
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  to create more faculty for them,
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  and they're working to create more nurses for us.
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  And what that actually looks like is developing a tactical
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  plan where we both have a part
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  in helping one another now.
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  Um, I enjoy tremendous partnerships with, um, the leaders
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  of our, um, academic programs, um, up,
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  up and down the state really.
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  It's, it's a, it's a wonderful thing and,
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  and we work at that relationship.
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  Um, but why that's important is that
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  what we create might be something
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  that another organization wants to adopt or use.
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  Maybe it's scalable, maybe it's applicable
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  in different parts of the country.
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  Um, but that, that partnership to, you know, sort of,
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  um, be in that cycle of
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  how can we help create faculty at the clinical level
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  and how can, um, our academic partners, um,
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  help to create nurses.
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  Um, honestly, I'm very pleased with how
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  that's going in Delaware at the moment.
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  Um, again, one of the benefits
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  of being in a smaller state is that, you know,
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  we could pick up the phone, Hey, it's Rosie,
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  I have this crazy idea.
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  Can we talk about it? Can we, you know,
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  can something come of that?
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  And I see wonderful things on the horizon
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  for, um, these partnerships that, uh,
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  that I'm a part of right now.
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  So those are, those are really two things
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  that come to mind immediately.
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  There's so many other things.
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  Um, but, you know, um, all of that to say
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  there is an operational imperative
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  that we're living in right now, Laura,
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  and that is, um, you know,
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  I mentioned the word stewarding resources.
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  As a chief nurse, I definitely need
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  to remain attentive in these big issues to, um,
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  being, um, a, a sustainable health system.
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  We need to be very, very dialed into the cost of care
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  and what are the steps
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  that we can take in the patient care services zone that can,
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  um, you know, offset costs really, um, for our patients.
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  - That's such a great point,
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  and I appreciate you talking through all of those elements
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  because so many hospitals
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  and health systems are working on very similar things,
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  looking at some of the technology in the virtual space, um,
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  how to really coordinate nurses
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  and make sure that they're still able to connect
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  with patients and, and build that relationship.
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  And then two, um, working together across lines
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  with academic practices
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  and partnerships, especially thinking about the next
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  generation of nurses and training them
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  and building up the next generation of the workforce.
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  So that's fascinating to hear.
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  And, and thinking about all of those things,
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  plus any other operational challenges
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  and issues you have coming up,
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  what are you most excited about right
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  now and what makes you nervous?
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  - Um, wow. So I'm a very excited person as a baseline.
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  Laura, you have to know that about me.
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  I have a lot of energy and, um, I have
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  just sustained passion for being a nurse.
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  It's an honor to me.
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  So there's a lot of things that excite me, um, uh,
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  about our industry.
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  You know, one thing though that really rises
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  to the surface is I get excited about work in
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  health equity, right?
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  We've got, um, an imperative as an industry
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  to look at health equity as
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  an action item.
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  This is an, it is an action.
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  It is a, it's a verb, it's a, it's a what we do,
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  and sometimes we get, um, sort of stymied
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  or a little bit stuck maybe in doubling down on awareness.
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  Awareness is a huge piece of this, right?
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  We, uh, many organizations have had, um, uh,
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  the initiatives importantly, so in diversity, equity,
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  inclusion, belonging, you know,
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  pulling the organization apart, seeing
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  where we've got, um, opportunities.
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  But I get excited when we are turning health
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  equity into that action.
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  And, and I think furthermore, it's really about
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  embedding health equity
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  as an imperative in every single thing that we do, right?
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  Um, how, what are my recruitment practices?
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  What are my, um, you know, readmission
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  avoidance practices?
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  How does health equity sort of layer in
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  and become a part of just the work that we do?
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  Um, so I get excited about that here at Bay Health.
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  Um, we have, um, uh, a, a very, a,
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  a detailed roadmap on how to be, um,
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  pulling health equity into everything that we do so
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  that it is just what we do.
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  Um, and, um, you know, sometimes we get, um,
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  we might get a little discouraged when we see
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  that we've got, you know,
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  we've discovered a big opportunity,
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  but let's not be discouraged.
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  Let's see that identifying that opportunity as a gift,
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  and then let's make action.
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  And those are the things that really excite me.
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  You know, when I look at, um, you know, we have a,
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  a diverse population of patients that we care
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  for in our community,
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  and, um, you know, they're looking to us,
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  they trust us, right?
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  We're nurses. Were most trusted, uh, again
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  for the 2020 fifth year, they trust us to, um,
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  be leveraging
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  and, um, making health equity our action.
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  So that excites me. Um, what makes me nervous?
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  I, I, I fall back to the workforce situation, sort
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  of the state of the state in terms of our workforce
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  as making me somewhat nervous.
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  Um, I feel that we've got, uh, opportunity
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  to lean in and to,
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  to be really intentional about developing our workforce.
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  But, uh, you know, I'm a nurse. I, I love being a nurse.
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  I'm honored to be a nurse.
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  Nurses are pivotal to the healthcare system.
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  So when I think about, um, you know, the project,
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  the projected numbers of nurses either leaving
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  or remaining in the profession,
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  that does make me a little bit on edge.
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  So I, I find myself turning system level activities
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  into reinforcing the nursing infrastructure.
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  You know, a lot of my experiences as a clinical nurse
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  where the nurse was at the point of the patient,
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  and, you know, I want to be directing activities to really
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  reinforce that there will be nurses well trained
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  and up for the challenge of taking care of our patients.
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  You know, it's, it's, and it's a multifaceted issue, right?
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  We, we study it, you know,
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  there are workforce compendiums out there
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  that can be really helpful in guiding our organizations.
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  But here at Bay Health, we have made investment in workforce
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  not only keeping people at the bedside, um, but attracting
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  and retaining top talent.
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  Um, so I think this is a long game for us.
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  I think it's a long game for all of us.
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  I talk with, um, other colleagues in the region, um, and,
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  and we are definitely unified on, um, activities
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  to reinforce that nursing workforce.
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  - That's great to hear, and definitely, as you mentioned,
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  so important to be engaged with the nursing workforce.
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  And really, um, as the future in mind,
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  I know healthcare will look quite a bit different, um,
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  in even five years than it does today,
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  let alone 10, 15 years.
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  So from your perspective, especially given some
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  of the topics we've been talking about today,
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  thinking about health equity in nursing
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  and some of the different things that, um,
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  health systems are doing right now to really meet the needs
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  of their patients, what do you think most successful
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  healthcare leaders will need to continue to grow
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  and develop over the next two to three years?
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  - Um, really great question and great timeframe.
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  Two to three years I think is, um, we've gotta be really,
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  really intensely dialed in on that next two to three years.
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  And, you know, also, of course, looking at the long game,
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  but here's a couple of things that come to mind,
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  and I'm gonna speed date these things
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  because I think they, um, I think it's a lot of things,
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  frankly, but the first that comes to mind for me, Laura,
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  is getting connected with legislators
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  and those in governments.
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  And, um, that falls under a, a big umbrella
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  that I call advocacy, right?
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  That is we who are in healthcare
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  and in nursing think it's incumbent upon us
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  to share the experiences that we're having with our,
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  um, our legislators
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  and, um, those who represent us in Senate and house.
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  Um, and, and
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  otherwise understanding what are those bills
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  that are coming up and
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  where do we stand on those in particular, you know,
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  this was not necessarily a core competency of,
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  of nurses 25, 27 years ago.
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  It is today. And, um, you know, as a nurse leader,
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  I feel really strongly about being at the table
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  for those conversations.
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  So advocacy. Um, secondly, I think, um, you know,
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  understanding that, uh, leadership in healthcare
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  is a package deal.
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  You've, uh, I find that, um, conversations I had
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  with colleagues in similar roles, you know,
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  we're all talking about that nimbleness that is required
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  to move through, you know, um, the business acumen, the,
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  um, operational ability
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  and also stewardship of resources, driving,
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  um, the clinical care and then understanding
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  and being very connected with care where it's happening.
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  Um, you know, these are not issues that are exclusive
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  to acute care hospitals
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  or, um, you know, freestanding, uh, rehabilitation hospitals
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  or, um, or offices.
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  We have to understand how, how to move in all
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  of those spaces, pushing outside of
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  what the traditional walls are, where are our patients,
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  where do they need us to be,
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  and then how do we make sure we can connect
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  in those variety of settings?
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  You know, it brings us back
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  to the conversation about virtual care.
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  Um, can I, um, connect with somebody on my phone, um,
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  you know, via FaceTime
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  or, um, you know,
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  am I gonna be seeing them in the emergency
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  department, what have you?
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  My point is, we have to move in a lot of, um,
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  sectors and we've gotta meet patients where they are
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  and figure out how to access them wherever that is.
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  You know, we talk about people, one
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  of the most important things we can do in leadership is go
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  talk to the people who are at the front line.
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  My, not only does my bucket get filled by rounding
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  with our teams, you know, talking to people,
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  but we have to be creating this environment of trust
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  where we're gonna hear from the people who are responding
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  to a rapid response at one o'clock in the morning, uh,
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  you know, on a Saturday and night,
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  what are their experiences
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  and challenges so that we can really keep the system,
• 19:55
  uh, whole and moving.
• 19:58
  - Absolutely. I love that point.
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  You certainly put an exclamation point on, um,
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  our discussion today with thinking about
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  how you can make those connections with the frontline team,
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  um, and, and really grow
• 20:09
  and foster exactly the culture that you want
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  and the experience that you want for them, as well
• 20:13
  as the patients coming through.
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  I, I think it's so important today, especially to keep
• 20:17
  that front and center.
• 20:19
  Rosie, thank you so much
• 20:20
  for joining us on the podcast today.
• 20:22
  This has been a fun conversation.
• 20:23
  I've learned a lot, and I look forward
• 20:25
  to connecting with you again soon.
• 20:28
  - Laura, thank you for inviting me. Um, it's been wonderful.
• 20:31
  I appreciate your time too.
• 20:34
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• 20:37
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• 20:40
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