Latest / Becker’s Healthcare Podcast / Expanding Care Access & Strengthening Nursing Teams in Louisiana Healthcare with C.J. Marbley

Transcript

Expanding Care Access & Strengthening Nursing Teams in Louisiana Healthcare with C.J. Marbley · Becker’s Healthcare Podcast

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  delivering them. Visit us at insightglobal.com.
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  Welcome to the Becker's Healthcare podcast. I'm Kelly
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  Gooch, managing editor with Becker's, and I'm thrilled
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  to be joined today by CJ Marbly, chief
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  nursing officer at University Medical Center New Orleans
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  and chief nursing and operating officer at New
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  Orleans East Hospital. CJ, thank you so much
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  for joining us today. Thanks for having me.
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  Of course. To start off with, I was
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  wondering if you could just briefly introduce yourself,
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  your role, the scope of your organization, and
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  what's currently commanding most of your attention as
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  a leader right now. Sure thing. So I'm
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  CJ Marbly. I've I've been a nurse for
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  thirty two years,
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  graduate of Howard University.
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  I've been the chief nursing officer at New
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  Orleans East Hospital for nine years.
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  In 2020,
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  in April 2020, I took on the COO
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  role also
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  because wasn't much going on in 2020. Right?
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  And so, so I took on an added
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  role in a in in kind of a
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  crisis situation,
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  and have maintained those two roles since 2020
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  at, New Orleans East Hospital.
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  And then in 2020 in 2023,
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  I took on,
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  the VP role additional VP role at University
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  Medical Center.
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  And just this past summer, I took on
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  the CNO role at University Hospital also,
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  not giving up my other two roles at
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  New Orleans East Hospital. So we serve one
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  commune one small community hospital that's 50 beds
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  and then one large academic medical center. The
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  community hospital serves as a kind of a
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  safety net for that community because it's in
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  Eastern New Orleans. It's really kinda isolated from
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  the rest of the city,
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  and you have to cross a bridge to
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  get in and out of it either way.
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  Then the other the big university hospital is
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  the safety net hospital for the entire state,
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  not only just the city, but the entire
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  state. It's the hospital University Medical Center's hospital
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  took the place of Charity Hospital after Katrina.
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  So, three hundred,
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  well, two hundred eighty year history. I think
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  we're the oldest,
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  MPI number,
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  oldest continuing NPI number in this in the
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  country.
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  Us and Bellevue go back and forth on
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  that, who's the oldest.
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  But really excited about the work we do
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  because
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  provide provide access
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  and,
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  the highest level of quick care for the
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  communities we serve.
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  University Medical Center,
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  is the only hospital in the Gulf South
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  that'd be, level one trauma center, a comprehensive
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  stroke center, and a verified burn center.
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  So we get patients in from all over
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  Gulf South to for those specialties.
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  So,
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  it's exciting to to have that mission every
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  single day to be the place where people
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  come no matter where no matter no matter
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  their ability to pay
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  or what's wrong with them.
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  You know, your your roles obviously span so
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  many different scopes and even just different
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  structures Mhmm. Across the board. So excited to
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  dive in a little more now. I know,
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  of course,
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  a year mark marked with rapid change. So
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  I'm curious just what recent decision or pivot
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  required the most leadership conviction from you, particularly
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  when it came to aligning people, resources, or
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  capabilities.
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  Well, I I say at both hospitals, it's
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  really about,
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  expanding our access and not so much about,
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  the communities we serve, but how can we
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  be more efficient and see more patients
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  with the,
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  with the supplies and the people we have
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  right now?
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  So
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  at New Orleans East,
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  we really expanded our we're we're expanding our
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  footprint
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  to add inpatient behavior health unit to our,
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  hospital.
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  Because we're seeing every month, we're transferring out
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  30 to 40 behavior health patients,
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  who need inpatient care,
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  to sites all around the state because we
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  have a limited,
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  capacity for beds.
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  And then at University Medical Center, it's about
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  add we opened up, multiple over the last
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  two years, we opened up multiple, med surg
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  units.
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  This year, we're adding an an additional
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  cardio
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  cardiovascular
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  surgical ICU
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  in a bone marrow transplant unit.
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  So it's it's expanding that those those areas
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  of ex expertise that we have so we
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  can get more patients into those centers and,
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  also,
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  improving our throughput
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  in the hospitals, so we can see more
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  patients. If we if we decrease our length
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  of stay by one day, we see a
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  extra 400 we can set up the extra
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  400 transfers in from around the state that
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  month.
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  So we know that just a small improvement
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  in our throughput
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  makes a huge impact on a number of
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  patients we can get into high quality care,
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  at this at our at our University Medical
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  Center.
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  Mhmm.
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  Yeah. Absolutely. And so many
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  so many initiatives and just different expansions going
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  on. So I'm curious how
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  through all of this, what really challenged your
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  assumptions maybe, and and what did it change
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  about just how you approach decision making talent
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  or organizational readiness today?
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  For me, it's challenged by decision making on
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  looking at how we work together as a
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  team
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  and
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  how do we redesign our care team to
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  be more efficient.
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  So
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  working with our case management team,
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  social workers and case and our end case
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  managers, but we added in case management assistants
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  who can do some, some of those the
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  busy work that the social workers and case
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  managers or in case managers are doing, gather
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  them get getting DME for patients,
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  looking at transportation for patient. So those
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  those things is needed to get them, discharged
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  home or discharged to another facility,
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  but that didn't require RN or social worker
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  license to do it. We also looked at,
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  how do we rebuild our nursing care team
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  so we can be more,
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  have more hands with the patients, have more
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  time with the patients.
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  So we add in LPNs into our acute
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  acute care settings.
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  So we have PCTs with our nursing assistants.
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  We have LPNs, and we have RNs
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  completing the com the the full nursing team.
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  And so that provides us,
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  more ability to have more people interact with
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  the patients, round on the patients, make sure
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  that we're doing the things we need to
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  do. And that interaction and those,
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  those multiple touch points
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  helps us make sure make sure we're we're
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  getting the patient healed properly
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  and getting them out the door in a
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  in a timely manner.
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  No. Absolutely. I know you've been talking about
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  that throughput aspect. You mentioned nursing teams. And
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  so I'm curious when you think about
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  all of the forces,
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  essentially, reshaping the industry right now, where do
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  you believe leaders need to be more decisive,
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  especially when balancing speed, risk, and having those
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  right teams in place?
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  I think it's around
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  making sure that we are
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  listening to our patients,
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  listening to our, stakeholders,
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  listening to our frontline staff,
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  and and then making the making the best
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  decision based on that feedback.
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  Because we can from a top down sense,
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  we can think that we know the exact
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  things to do.
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  But if our frontline staff can't articulate
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  the strategy
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  or they they don't feel engaged in the
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  strategy,
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  and then it it won't work. So what
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  I've what I've done is started multiple listening
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  sessions.
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  I had to do, coffee with the CNO,
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  so multiple times a month, where people can
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  pop in, and I can go over initiatives
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  we're doing, and they can ask ask me
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  question any question they want. I go to
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  multiple staff meetings
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  to make sure that they can they know
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  what what's happening and know what's, going on,
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  with the hospital and with nursing.
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  And then I round at night with our
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  house supervisor.
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  So, so I can get to know and
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  get to get to,
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  meet and engage with our night nurses.
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  I had a friend of mine,
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  a former,
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  CNO of mine,
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  Jamie Wiggins. He's actually here, this week this
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  week also.
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  He makes a point,
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  does does the nurse who works Saturday night
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  know what the strategy is?
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  And can can she speak to the strategy?
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  If that's possible, do you know the the
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  information is flowing properly?
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  So being more decisive about getting up getting
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  the information to
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  the stakeholders,
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  getting to the frontline staff, and making sure
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  that they know how important they are to
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  the plan.
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  That's that's such a great point. And and
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  those night shifts,
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  the perspective they bring as well with those
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  frontline workers. So
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  it seems like, of course, right now,
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  one of the the certainties is that there's
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  uncertainty
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  right now. So
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  I'm curious what leadership habit or mindset has
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  mindset has been most critical in keeping your
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  organization and people moving forward during this time?
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  I've really tried to talk to our leaders
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  and put in place things that help us
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  grow our own people.
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  So
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  if we have a strong,
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  environment for growth, then no matter what the
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  challenge that comes, we can pivot and address
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  that challenge.
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  So we put in things
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  at each level to grow out grow grow
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  out staff and grow out nurses so we
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  have a
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  a free patient care tech nursing assistant training
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  program.
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  So we can have enough of enough nurse
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  assistants. We're training them the way we need
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  them to to the with the things we
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  need them know to function on our units.
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  We have,
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  LPNs programs that we support and and help,
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  with scholarships
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  and,
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  clinical rotations and things that need and we
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  encourage our leaders, our educators, and our nurse
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  leaders to be clinicians,
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  clinical faculty for those programs, for the LPN
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  programs and RN programs, so as a give
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  back to the community.
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  We also have, scholarship programs for RN and
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  BSN
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  to make sure that we're helping people transition
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  to those levels. And then we have a
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  a program
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  to help nurses go from RN to CRNA.
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  So and then that's so that's on the
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  clinical side. And then on the leadership side,
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  we have multiple leadership programs to help people
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  grow in their development as leaders.
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  So we have an emerging leader program for
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  frontline staff who've never had leadership experience before.
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  We have a leadership academy,
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  frontline leadership academy, we just started for supervisors
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  and charge nurses to go into. We have
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  then we have a director leadership academy to
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  help them grow into senior leaders. If we're
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  continuing to invest in our staff, we continue
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  to help them grow in their in their
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  careers.
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  And then so no no matter what
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  obstacle comes or challenge comes,
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  we can pivot
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  and attack those things because we've invested in
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  our staff.
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  Yeah. And that actually
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  segues into what I wanted to to ask
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  you about today too, regarding the workforce
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  because,
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  of course, as labor departments remain tight and
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  care demands continue to grow,
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  I'm I'm just curious how you are rethinking
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  traditional workforce models and including greater use of
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  international or contingent talent to build resilience rather
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  than just essentially fill staffing gaps. Yeah. So
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  we're we're looking at it from multiple
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  approaches.
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  So we talked about how we invest in
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  scholarships,
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  partnering with nursing programs in the area.
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  We also have implemented
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  a more team nursing approach, and I talked
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  about the the PCT, the LP, and RN
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  all working together as a team,
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  to to to make sure we did take
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  care of a group of patients together.
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  And then the the other thing is we
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  have recently started in the last six months
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  start to accept international nurses in.
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  So we've had our first three cohorts are
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  international nurses to come into the,
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  building.
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  And they're our employees. We've, you know, we've
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  helped them with the
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  the visa issues and things of that nature.
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  But they're coming in, and they're bringing a
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  lot of years of experience,
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  a different perspective,
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  new ideas.
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  So
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  there's no one approach that fits it all
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  that we have to look at all the
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  different pull all the levers
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  to make sure that we can have the
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  workforce that we need as we grow and
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  move into the future.
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  Absolutely.
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  Well, thank you so much, CJ, for for
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  joining me today for this interesting and fun
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  conversation, and looking forward to connecting with you
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  again soon. Thank you very much. Appreciate it.