Latest / Becker’s Healthcare - Clinical Leadership Podcast / Erin Keefe, Chief Nurse Executive Officer at St. Bernardine Medical Center

Transcript

Erin Keefe, Chief Nurse Executive Officer at St. Bernardine Medical Center · 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 Erin Keefe,
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  chief Nurse Executive Officer at St.
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  Bernadine Medical Center.
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  Erin, it's a pleasure to have you on the podcast today.
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  - Yes, thank you for inviting me. I'm excited to be here.
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  - Absolutely. And I'm excited for our conversation, too.
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  I think it'll be really amazing
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  to hear more about what you're doing at St.
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  Bernard Medical Center, um, with your nursing team
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  and really some of the big trends
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  and issues that you're following.
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  But before we dive into my questions,
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  can you tell me a little bit more
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  about yourself and your background?
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  - Um, sure. I have been a registered nurse for
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  over 30 years, and I actually, um,
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  I did my initial undergrad education in Canada, which is
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  where I grew up, and I moved to the US in, uh, 1995
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  and, um, have been here for most of that time.
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  I, I went back for, for a period of a couple of years,
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  but I, I worked in six different states
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  and, uh, a variety of different clinical areas primarily,
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  uh, critical care, so ICUs and emergency departments.
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  Um, but I also, um, spent some time working in ambulatory
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  as well as perioperative leadership.
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  And, uh, I've been in a leadership role, um,
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  for over 15 years
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  and, uh, um, very lucky to, um, to be
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  where I am right now.
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  I think, um, St.
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  Berna Medical Center is a 342 bed, uh, acute care
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  facility in San Bernardino, California.
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  A very vulnerable, uh, community underserved population, uh,
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  where, uh, you know, we have been, um, doing a lot of work
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  to try and improve the health of this community and, um,
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  and, and provide a great place for medical care.
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  Uh, we're doing a lot of great things here, I think.
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  Uh, but I'm biased of course, so that's me.
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  - Fantastic. And, and I, I think that's amazing
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  what great experiences that you've had in
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  so many different aspects of healthcare, um, you know, in,
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  in especially serving underserved
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  populations is so important.
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  Um, so I wanna dig in here a little bit deeper.
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  What are some of your top priorities right now?
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  What do you really have top of mind?
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  - You know, it's, um, not, not very much different from
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  what I think everyone else is, is going through.
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  You know, we're still, um, in recovery phase,
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  even though we like to think the pandemic is
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  behind us completely.
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  Um, we've, we've had a huge focus on stabilization
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  and rebuilding our staffing pools, so, uh, a lot of work
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  with our local universities
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  and colleges to improve, uh, the pipeline for new nurses.
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  Um, we've adopted the system, uh, nurse, uh,
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  residency program for new graduates,
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  and we also, um, are continuing our, um, new
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  to service line residencies for nurses that are already here
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  with us, uh, that maybe want to try a new, uh,
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  a new area of practice.
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  And, uh, that helps us, obviously
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  with decreasing our turnover, keeping our staff here.
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  Um, we've also, uh, had a huge focus on staff wellbeing,
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  uh, staff and positions.
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  Um, there, there is that lingering impact from the pandemic
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  that just, it took a huge emotional toll
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  and, um, we are very lucky to be able
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  to have on site, um, a, a therapist who works
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  with our staff both individually
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  and in groups, um, as part
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  of our employee assistance program.
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  And, uh, so that, that remains a high focus for us.
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  And then sustainable growth for, for the organization.
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  Uh, healthcare, the landscape continues to shift
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  and, um, it becomes more challenging with, with payers.
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  And, uh, so we are, again,
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  we serve an underserved population
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  and how can we sustain for the long term into the future?
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  - That's such a great point.
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  And, and definitely, um, having that ability to, um,
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  understand the workforce, understand
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  what the clinical teams are going through,
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  and then provide, uh, some of that support
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  and some of the recovery that they need in order
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  to really get into a space where, um, you know, you're able
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  to provide care for the communities that they need.
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  And, you know, when you talk about being able
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  to decrease staff turnover, um,
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  and really be, you know, have a, a great pipeline
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  of talent coming in and
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  unless something a lot of hospitals aspire to, I,
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  is there anything that you've, um, done recently to try
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  to tackle some of those challenges?
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  I know you mentioned, um,
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  having a therapist on site and some other things.
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  Um, um, you know, is there anything else that you're doing
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  to try to reduce that turnover rate?
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  - Uh, um, one thing that
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  geographically our facility's located for those
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  who are familiar with, um,
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  Southern California in the Inland Empire,
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  it's a bit isolated
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  and, uh, it, it, it's not a place where a lot of people want
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  to necessarily relocate to.
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  So for, from a turnover perspective, when we're hiring,
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  we're looking at people that,
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  that are somewhat familiar with the area.
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  Uh, you know, San Bernardino's,
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  I think the largest county in the United States.
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  Uh, so there's a lot of, of, uh, square footage
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  and square mileage for people to move around in.
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  Um, we have made, um, relationships with a couple
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  of our local universities to do dedicated cohorts
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  for students, so they do their entire program
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  with the exception of the service lines
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  that we do not offer here, like pediatrics.
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  Uh, they spend their entire, um,
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  four year program doing their clinicals with us, and,
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  and that allows them
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  to get a true feel if the culture here works for them, uh,
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  and, and vice versa.
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  And, and it just, it's a better onboarding.
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  They know what they're getting into.
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  They're not starting at a facility
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  where they don't know the people,
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  they don't know the physicians or the practices.
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  And, um, that has had a huge impact, uh, for us to,
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  to work on decreasing our turnover.
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  Um, you know, we obviously are still, uh,
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  figuring out the new landscape with, um, the,
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  the newer generations wanting
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  to move around a little bit more.
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  So our turnover's a little higher than we would like it
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  to be, but our vacancy rate is currently at 4%.
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  So, um, you know, it, it's starting that, starting
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  that process has made an impact.
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  - That's great to hear. Thank you so much for, um,
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  digging one bit deeper into that.
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  Now, I'm wondering too, when you look into the future,
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  how will, um, the hospital grow
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  and evolve over the next two to three years?
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  What do you really see as being, uh, on the horizon?
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  - You know, I think, um, looking
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  to the future things will continue
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  to shift into the outpatient ambulatory world.
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  And you know, for us, we're exploring, um, the potentials
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  of an FQHC just to better serve our community.
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  We currently have, uh, this great,
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  we call it our transition clinic,
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  but it's, um, it's a follow-up clinic for patients who
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  have been discharged
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  and can't get into see either their primary care
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  or their specialty physician, um, within
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  that first week following discharge.
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  And so we've started that process
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  and it's had a huge impact on decreasing our readmissions.
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  Uh, but again, as we start
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  to move things further into the outpatient world,
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  we think having better access, um, to either primary care
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  or follow-up care, um, surgeries are moving out.
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  Uh, and so I think you're going to see a lot
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  of organizations, um, having more partnerships
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  with ASCs and things like that.
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  And, um, and so for us it's really looking at the services
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  that we're offering, what is the need of the community?
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  Do we need to add or change things?
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  And of course, we're part of Common Spirit Health, which is,
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  you know, the largest not-for-profit, um, in the country.
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  And, and so there's also making sure that we align with,
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  with the system strategy
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  and, uh, that we're all moving in that, that one same
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  or similar direction.
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  - Got it. That makes a lot of sense and,
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  and definitely, you know, is, um, so important
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  as you mentioned, to be able to, um,
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  have those partnerships go to the outpatient setting and,
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  and really being in the most
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  efficient and effective site of care.
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  Uh, before we wrap up here, I'm wondering what is one change
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  that you or your team has made, um, recently
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  that yielded great results?
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  - You know, it was, um, the one thing I think that has, has
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  touched every point of this facility, of this hospital, um,
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  it was a few years ago actually, the region, uh,
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  facilities adopted the principles of high reliability.
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  And so it has changed how we speak to each other, uh,
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  how we look at things from every level of the facility.
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  And it, it has had a direct positive impact in, um,
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  the day-to-day workflows as well as patient outcomes.
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  Uh, we've been able to improve, you know, our,
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  our quality scores, uh, leapfrog,
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  we've achieved an a, uh, we were up
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  to a CMS four star rating, and,
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  and I really do put it all back to
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  those principles being transparent
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  and seeking solution, um, for,
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  for just every challenge that comes our way.
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  And, uh, so if there's ever any, anyone listening
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  who is thinking about it, uh, for us it has been a true,
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  um, life altering journey
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  for our staff and for our patients.
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  - I love that. Um, you know, having that high reliability,
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  um, you know, and,
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  and really looking at where that can make a big difference,
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  as you said, clinically, as well as, um, within the teams.
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  I can imagine. Um, just really it instills a sense of pride
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  and also a culture that can be really positive, um,
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  for the organization overall.
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  - Yeah, it's a, it's a game changer
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  and, uh, you know, we live it, it's, uh, a lot
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  of times you get sort of wrapped up into some,
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  sometimes they call it like the flavor of the month or,
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  or something new and shiny,
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  but this was, was very thoughtfully rolled out, um,
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  not just to staff, but also to the physicians and, um, and,
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  and it has changed the way we all
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  practice and for the better.
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  - Excellent. Well, Aaron, thank you so much
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  for joining us on the podcast today.
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  This has been such a fan, fascinating discussion
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  and I look forward to connecting with you again soon.
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  - Thank you so much for your time. I appreciate it.