Latest / Becker’s Healthcare - Clinical Leadership Podcast / Mandy Richards, DNP, RN, APRN, ACNS-BC, NEA-BC, Chief Nursing Executive and President of Children’s Health at Intermountain Health

Transcript

Mandy Richards, DNP, RN, APRN, ACNS-BC, NEA-BC, Chief Nursing Executive and President of Children’s Health at Intermountain Health · 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 do they go
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  - to 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 the Becker's Healthcare Clinical Leadership podcast.
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  - I'm Mariah Taylor, assistant editor, and I'm thrilled
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  - to be speaking with Mandy Richards,
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  - chief nursing executive and president of children's health
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  - at Intermountain Health. Thank you so much for
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  - joining me today, Mandy. I'm so excited to
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  - learn more about your career ladder for your
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  - nurses. But before we dive into all of
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  - that, I'd love for you to introduce yourself
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  - and tell us a little bit about your
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  - background.
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  - Maria, thank you so much for having us
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  - on today.
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  - I'm just thrilled to be here. I have
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  - been a nurse for over twenty five years,
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  - obviously started in Australia,
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  - and have been in nursing leadership positions for
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  - over twenty years.
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  - And I'm really excited to be here at
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  - Intermountain Health and excited to share some of
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  - our great work today. So thank you again.
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  - Yes. I'm so excited to hear it. Now
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  - some of our readers who have been reading
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  - recent articles here at Becker's might be familiar
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  - with a few of the programs we're about
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  - to talk about because I wrote about it
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  - not that long ago. So if this sounds
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  - familiar to you, that might be why. But
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  - we're gonna do a deep dive into two
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  - of the cool career ladder initiatives you have.
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  - One being I Aspire.
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  - So two years ago, Intermountain launched this initiative
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  - that really helps nurses
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  - figure out how to advance their careers, both
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  - at the bedside and beyond. So can you
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  - tell us a little bit more about I
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  - Aspire and how it works?
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  - Sure can. So I love it when we're
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  - rounding with our nurses
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  - and we hear some of the things that
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  - they're interested in. And so we were rounding
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  - in the ICU,
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  - and some of our nurses said we would
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  - love to stay at the bedside and grow
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  - and develop in our careers,
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  - but there's really not a program to do
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  - that. It feels like we have to move
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  - into
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  - nurse educator roles or nurse manager roles in
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  - order to advance.
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  - And I'm like, that shouldn't be the way.
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  - And so with that, we pulled together some
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  - work groups to say, well, how would we
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  - create a program where nurses can thrive in
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  - our organisation and at the bedside?
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  - So we have nurses that
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  - are in really acute care facilities where there's
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  - a breadth to there's a depth to their
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  - clinical knowledge that they need. But we've also
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  - got nurses in rural facilities where
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  - there is breadth to what they need to
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  - know, and that might be where one moment
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  - they're delivering a baby in labour and delivery,
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  - and then they're running down to the ER
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  - because there's a trauma, and they're kind of
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  - needing that breadth of expertise.
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  - So as we're developing
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  - the program, we're like, how do we accommodate
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  - a program that really is accessible to all
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  - of our nurses, not just those that have
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  - the acute, you know, high ICU
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  - competencies that they need, but for all of
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  - our nurses that spend more than 50% of
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  - the time at the bedside. So and we
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  - actually included our LPNs as well. And so
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  - we actually started by including our nurses and
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  - our nurse educators
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  - to come up with what this looks like.
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  - They looked to the literature, and what we
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  - found is there's a lot of programs out
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  - there that just look at the clinical ladder,
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  - but there's not a lot that look at
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  - the professional development side as well, which is,
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  - what we've talked about before, which is advanced
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  - degrees
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  - that are used at the bedside,
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  - certifications,
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  - evidence based practice projects, and things like that.
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  - And so we came up with IASPIRE,
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  - which has five levels to it, and it
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  - really is accessible to all of our nurses
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  - to continue to grow. And that was what
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  - was really important to us no matter where
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  - they work in our system.
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  - That's amazing.
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  - And since you've been running this program, what
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  - have some been some of the most impactful
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  - results?
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  - Yeah. It's been great to work with our
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  - with our nurses to say, okay. Was it
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  - easy to apply? How how what would you
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  - do to change the program? And so we
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  - have an intake process each year. But some
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  - of the benefits that they found was their
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  - professional growth.
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  - They felt that they were in had more
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  - motivation because they could see the impact of
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  - what they were doing. The quality improvement, obviously,
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  - those projects enhance the the care that we're
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  - delivering. But the thing that I loved is
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  - we did a we did a survey,
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  - of our teams before entering into the program,
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  - and some of the results from the survey
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  - pre and post were really awesome. So let
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  - me share with with you some of those.
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  - So seventy two and a half percent of
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  - our nurses felt rewarded for their professional efforts.
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  - Seventy three percent felt that they reported, they
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  - improved in their evidence based practice knowledge.
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  - 80%
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  - said that they would participate in the program
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  - again, which was huge.
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  - And ninety two percent
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  - intended to remain employed at Intermountain for at
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  - least two years. So to me, that was
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  - outstanding enough. But then there was one more
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  - thing that was so compelling and really
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  - gets to the whole point of why we
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  - did this, and that's to keep our nurses
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  - at the bedside.
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  - So we had an interesting situation where we
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  - had nurses that were eligible. Some of them
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  - participated, early adopters,
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  - and some of them said, you know what?
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  - I'm gonna wait for the first round of
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  - this and see how it goes. So those
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  - that were just sitting back but were eligible.
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  - When we looked at those two cohorts, it
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  - was very nice because we almost had a
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  - study a study group and a control group.
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  - And what we found is that the nurses
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  - that did participate in the program
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  - had an had an almost 8%
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  - decrease in their turnover rate compared to those
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  - that were eligible and did chose not to
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  - participate.
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  - So it just shows us that by being
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  - in this program,
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  - it really does impact the engagement of our
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  - nurses and them wanting to
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  - stay at the bedside.
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  - They feel that their, efforts are being rewarded
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  - and recognized.
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  - And what I'm really excited about, Mariah, for
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  - our next year is to now we'll be
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  - a few years into the program
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  - to see what impact it's having on the
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  - quality outcomes that our nurses are delivering. Because
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  - with all these evidence based practice projects that
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  - we're doing, we anticipate to see an elevation
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  - in all the quality of the clinical care
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  - we're giving.
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  - That's amazing. I love that. Now what makes
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  - this, I think, even more impressive is right
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  - around the same time that you launched I
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  - aspire, you also launched a nurse leadership program.
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  - So can you tell us a little bit
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  - more about the nurse leader academy and what
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  - that entails?
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  - We did. And so part of why we
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  - launched them at the same time is we
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  - really had a desire
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  - to grow all of our nurses, whether they're
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  - nursing leaders or moving into nursing leadership roles,
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  - like nurse manager roles, as well as our
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  - frontline nurses. So this one was for our
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  - nurse managers. So
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  - I remember my first nurse manager role, and
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  - I had been an advanced practice nurse in
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  - an ICU. And I loved being at the
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  - bedside caring for patients and families. And I
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  - got asked the question,
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  - Mandy, would you like to be the nurse
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  - manager, or have you thought about being the
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  - nurse manager? And I remember I'm thinking, no.
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  - I haven't. And and and as I moved
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  - into the role,
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  - I you didn't really know what you didn't
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  - know. And I remember I would always walk
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  - into the unit every morning thinking,
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  - I'm in I am overseeing a $20,000,000
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  - budget, and I have no idea what I'm
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  - doing. Like, I truly was like, do they
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  - know that I had no idea what I'm
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  - doing? But you worked it out as you
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  - went, and I asked lots of questions. And
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  - but it has always stuck with me that
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  - we don't always prepare our nurse lead as
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  - well. Like we have a lot of really
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  - good professional development programs at Intermountain that that
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  - are leadership development, but we didn't have one
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  - that was specific for nursing leaders.
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  - And so that's why we started with that.
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  - And so I'm like, okay, It would be
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  - far better for our nursing leaders to have
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  - a year long
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  - academy which supported their learning and all the
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  - fundamentals of what they needed to know to
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  - be a nurse manager.
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  - And so it's a year long program,
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  - and it is, structured around two six month
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  - sessions, and it focuses on four key domains.
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  - So it's really about their professional development as
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  - a leader,
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  - leading their teams,
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  - leading their teams through change management,
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  - and
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  - achieving operational outcomes. Like, how do they how
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  - do they drive for those results? But what
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  - I really enjoyed about what we set up
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  - was that,
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  - it was really individualised to each individual nurse
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  - manager, and so there was some simulation that
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  - was involved where, you you know, they might
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  - have a simulated environment where they're having a
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  - crucial conversation with one of their caregivers,
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  - and it would help them
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  - by giving them some tips and some feedback.
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  - And then they would have some learning modules
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  - based upon what their needs were in how
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  - to improve. And so that would happen throughout
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  - the year multiple times.
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  - I loved that the as we developed it,
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  - the team,
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  - of our
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  - professional development team
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  - worked around the core competencies that ground us
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  - in the American Organization of Nursing Leaders,
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  - which is fantastic.
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  - And then it also provided a great network
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  - of support for each other. So as new
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  - nurse managers are coming in and more seasoned
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  - nurse managers are in this cohort as well,
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  - There was some really good networking and support
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  - and mentorship.
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  - Amazing.
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  - And that's run through about two cohorts at
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  - this point. So what have some of those
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  - results been?
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  - So the results have been really exciting, and
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  - they the the nurse leaders that have been
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  - through it said that they really did feel
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  - it enhanced their leadership skills and confidence.
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  - They liked that it was personalized to their
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  - own opportunities,
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  - and they felt that they were more empowered
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  - to drive results, and foster a culture of
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  - collaboration on their units. But, of course, I
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  - love the data. And so we did another
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  - survey, and it was an authentic nurse leadership
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  - questionnaire.
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  - One of the questions we asked is pre
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  - and then post the first cohort.
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  - It was the question was, as a leader,
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  - I am confident in my ability to empower
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  - my caregivers in the workplace.
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  - And before going through the Nurse Leader Academy,
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  - the score out of four was 2.75,
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  - and then after, it was three point o
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  - nine. So it had increased
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  - point 34%.
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  - And so what was good about that was
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  - that was only just after the the course
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  - had finished. They're gonna continue to grow and
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  - evolve. So we're we're excited to do this
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  - survey another year out and see how much
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  - more that's improved up to the four point.
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  - But we certainly have seen lower turnover rates
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  - with our nursing leaders,
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  - increased engagement by their by both their teams
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  - and their participants,
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  - and increasing
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  - engagement scores from our caregivers. So we know
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  - that we're still learning. We'll continue to adapt
• 11:07
  - the program to meet the needs of our
• 11:08
  - nursing leaders, but now we're starting to move
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  - this across all of the system so all
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  - of our nursing managers have a chance to
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  - participate. And then the goal in mind for
• 11:18
  - the future would be
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  - we should be putting through some of our
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  - high performing
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  - talent that we anticipate will want to move
• 11:25
  - into a nurse leadership role in the future.
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  - So they're getting some of these skills even
• 11:29
  - before they move into these roles. So that
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  - is that is that will be the next
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  - evolution of the program, but we're really excited
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  - to see, the responses of our nursing leaders
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  - who have gone through it.
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  - Incredible.
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  - Well, thank you so much for being here
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  - and sharing so much about your two programs.
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  - This has been such a great discussion.
• 11:47
  - Thank you so much for having me.