Latest / Becker’s Healthcare - Clinical Leadership Podcast / Dr. Elizabeth Adams, Chief Nurse Executive of HCA HealthTrust and President of Match Healthcare

Transcript

Dr. Elizabeth Adams, Chief Nurse Executive of HCA HealthTrust and President of Match Healthcare · Becker’s Healthcare - Clinical Leadership Podcast

• 0:00
  - Welcome everyone to the Becker's
• 0:01
  Healthcare podcast series.
• 0:03
  I'm Ryan Mohammed, writer
• 0:04
  and moderator with Becker's Healthcare,
• 0:06
  and I'm absolutely thrilled to have
• 0:07
  with me today Dr. Elizabeth Adams, chief Nurse executive
• 0:11
  of HCA Health Trust and President of Match Healthcare.
• 0:15
  Doctor, it's very nice
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  to have you on the podcast today. How are you?
• 0:18
  - I am doing great.
• 0:20
  I am so honored to be here with you today,
• 0:23
  and I really appreciate you
• 0:25
  and our good friends with Becker's
• 0:26
  Healthcare for this invitation.
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  And thank you for all the great work
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  that you do to support healthcare.
• 0:33
  - Oh, thank you so much.
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  We absolutely love doing it
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  and love talking to people just like you.
• 0:38
  Um, so to get us started,
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  would you mind please introducing yourself
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  and telling us a bit about your background?
• 0:44
  - Sure. Thank you. So I'm Dr. Elizabeth Adams,
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  and, um, as Mariah mentioned, I'm the president
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  of Match Healthcare, which is a healthcare consulting firm,
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  and I'm also a Chief nurse executive with health, uh,
• 0:56
  HCA Health Trust.
• 0:58
  And, um, it's a, it's been a blessing to serve in healthcare
• 1:02
  for almost three decades.
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  Um, you know, I started when I was 10 years old.
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  the seriously, um, on a serious note, um,
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  I've been in healthcare for three decades.
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  Uh, half of my career was spent in a very large
• 1:19
  academic healthcare organization in Texas where I served
• 1:23
  as a trauma and ER nurse,
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  and then, um, progressed into management.
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  Um, I think at the University of Texas,
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  I developed a strong foundation for evidence-based
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  clinical practice, research and professional development.
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  And, um, practicing
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  and leading in a magnet recognized organization, uh,
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  taught me early on the power of having a great culture
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  with highly engaged caregivers.
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  Um, over the course of my, uh, career journey,
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  there's been key opportunities
• 1:59
  where I was given the opportunity to grow professionally
• 2:02
  and impact care delivery.
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  I served at a large health system, um, the,
• 2:09
  actually the University of Texas where I was promoted
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  to lead their internal staffing agency.
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  And in that role, I was able to utilize my business,
• 2:18
  financial and clinical skills to grow that business,
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  expand services across Texas, um, increase the scope
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  of the services we provided,
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  and we, um, pretty much eliminated all contingent labor.
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  Um, and then I was given the opportunity to serve
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  as a healthcare executive in something really unique.
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  It was a public healthcare district, um, where I served
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  as a chief nurse and implemented programs
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  around reducing readmissions,
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  addressing social determinants of care.
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  I worked with utilization management
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  and really learned, um, about value-based care.
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  And Mariah, as you know, rural healthcare is an a, a
• 3:01
  challenging environment, but yet very, very rewarding.
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  Um, I felt like I was, uh, really connected to my purpose.
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  I ended up advocating for rural health at the local, state
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  and national levels, and then really learned the value
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  of creating community
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  and partnerships with academic organizations
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  and, um, uh, professionals in our industry
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  as well as businesses.
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  And, um, and so really to improve access, uh,
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  work on workforce development and, um, recruitment.
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  And then I also have served as a chief nurse
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  and COO where I learned about operations, capital,
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  equipment expansions.
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  And then, uh, most recently I served
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  as a chief nurse executive for one
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  of the largest hospitals in Southern California
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  and the busiest er in, uh, Los Angeles County.
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  And this was the third time that I led teams to Magnet.
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  And, uh, we just had a really great culture.
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  Um, we, uh, when I started,
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  we were last in our total performance ranking,
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  and then when I left that organization, we were, uh,
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  at the top ranking for our large hospitals.
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  And, um, and then we just, um, we had an amazing culture.
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  Like I said, we achieved magnet,
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  and so I've had a really unique opportunity
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  to serve in diverse organizations
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  and, um, have served at the national level
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  for the American organization nurse leaders,
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  and then have served on the board
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  of the Healthcare Business Women's Association.
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  So just really blessed to have those experiences.
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  - Yeah, absolutely.
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  Uh, thank you so much for sharing your background with us.
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  And if you started at 10 years old,
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  I'll definitely interview you every day
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  because I'm sure you would have the best stories.
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  Um, would you be able
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  to tell us about your most successful project
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  or initiative from the last year at HCA?
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  What issues were you trying to solve
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  and also what drove the success?
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  - Sure. You know, I'd like to, I'd like to share with you,
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  um, maybe one of the major initiatives in the last year,
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  and it wasn't necessarily with HCA,
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  but um, with another organization
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  and, um, it was in reducing, um, harm to our patients
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  and improving our quality outcomes.
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  Uh, my brother died
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  of a hospital acquired infection at the age of 34,
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  and so I'm very passionate about keeping
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  our patients safe from harm.
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  Um, our teams were able
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  to reduce healthcare associated infections by 44%,
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  and we reduced falls by 35%.
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  We did this by implementing a model called the Healthcare
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  Restoration Design Model, and it's a high reliability model.
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  Our, um, the, the other thing too is that they were able
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  to do that because we had such a strong professional
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  governance culture in place, more than 10 to 20%
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  of our workforce were committed
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  and dedicated to improving quality outcomes
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  and finding root causes.
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  So, um, we also utilized relationship-based care concepts.
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  Um, for example, we, uh, started every meeting
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  with a patient story,
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  and when we reviewed our cases, uh,
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  the team members would present the case first
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  by showing a picture of the patient, calling the patient
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  by name and sharing something personal about the person.
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  And so, um, we really had some great outcomes when it came
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  to reducing hospital, uh, associated harm.
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  And then, um, we know when patients stay in the ER
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  or in the hospital too long, uh,
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  that can negatively impact their quality outcomes.
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  So we, we, those teams put together an air traffic control
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  center to optimize flow.
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  They also were very adamant that they wanted to try a, a
• 6:57
  hospitality center, which was a discharge lounge,
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  and nine times outta 10, those don't work.
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  But, um, but they really wanted to do it,
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  and I think it's important that we let,
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  let our teams try sometimes,
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  and they, they proved that it could work.
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  They shaved about 30 to 40 minutes off discharge time.
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  So I think all of those things, um, helped us to deliver
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  high quality, efficient,
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  and, uh, compassionate care to our patients.
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  - Wonderful. Absolutely wonderful.
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  Thank you so much for sharing that insight.
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  As you know, the clinical workforce has changed a lot
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  in the last few years.
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  What challenges are you still facing
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  and how do you see the clinical workforce evolving?
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  - Sure. You know, that's a great question.
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  Recruitment and retention is still an opportunity.
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  You know, I was fortunate that our turnover, um,
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  has been 6.9% compared to a national benchmark of 22%.
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  But, um, there are areas where it's still a big challenge.
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  You, you, you might be able to even recruit nurses in,
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  but how do you keep 'em, especially with an aging workforce,
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  um, early retirement,
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  and then people just wanting to leave the bedside
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  because they're still burned out
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  or they're advancing their education.
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  And so it is a really big challenge.
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  Um, I think through covid we've learned a lot,
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  and if we look at team nursing models,
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  and not all models may fit the same
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  or you know, the same for each organization,
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  but if we look at team nursing models, we learned
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  that there are other skill sets
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  that can help us take great care of our patients.
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  And the more that we work together as a team,
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  the more effective we can be.
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  Um, it also, you know, when you have a team nursing model,
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  it also allows the RN to practice
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  at the highest extent of their license.
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  And, um, and then, you know, when we look at technology,
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  can we utilize virtual nursing to do, do some
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  of those things that the RN at the bedside does not
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  necessarily have to do?
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  Can we do patient education on admission, um,
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  health assessments where we're gathering health history
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  and discharges discharge information?
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  So I think we, we need to look at, um, recruitment
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  and retention and other models.
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  Um, the other thing that I think that we, you know,
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  is a challenge is we've got a lot of, uh,
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  rapid fire changes in technology.
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  And so as we look at care delivery, how can we embrace
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  and leverage technology, uh, to allow us
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  to be more efficient, um, to lean up our work?
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  And, um, and also how do we leverage technology
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  to allow the patient to be the driver of healthcare?
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  So I, I think that's gonna be a big challenge.
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  You know, especially when we look at, um, chat GPT,
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  we look at robotics
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  and workplace safety to keep our caregivers safe,
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  and then we look at robots in healthcare and organizations
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  and, um, how can we leverage those things?
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  So, so I think those are definitely challenges.
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  The other thing I wanna mention is physician recruitment.
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  Our, I I, I'm concerned about our physicians
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  and burnout as well, and recruitment for physicians
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  because it's been challenging,
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  especially in rural healthcare, to recruit nurses
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  and doctors and then to retain them.
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  So I think we need to create environments and,
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  and be better at, um, those, uh,
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  providing those environments
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  where people feel valued and appreciated.
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  Um, they're treated like owners in the operations of the,
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  um, the hospitals and, um,
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  and that we're really, um, supporting equity diversion
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  and inclusion because we know that when we do that,
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  we become better leaders, um,
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  and we provide better care to our diverse populations.
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  So I think those areas are still challenges, um,
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  but we're making progress,
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  but we need to keep those areas as a priority, you know,
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  over the next five to 10 years.
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  - Yes, I completely, completely agree.
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  Thank you so much for sharing.
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  And before I let you go, doctor, the last thing I wanted
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  to ask you is what is your best advice
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  for aspiring physician and nurse leaders?
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  - Yeah, thank you. You know, I, I, I think, um,
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  the most important thing is to prioritize, um,
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  our own health and wellness
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  and to take time for work-life balance.
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  You know, I look back over, you know,
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  three decades in my career
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  and I wonder if I should have taken more time
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  to do those things to, um, you know,
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  to focus on my health and my family.
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  And if you ask my family, my family will assert that,
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  yes, , I should have done that.
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  I think we get caught up in what we love to do.
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  And, you know, my husband's been in ministry
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  and he said, you can lose yourself in the service of others.
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  And it, it is an amazing, amazing vocation that we have.
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  It's the best job in the world to care for people,
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  and then as a leader, to care for people who lead people.
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  But as leaders, we have got to prioritize our health
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  and have that work-life balance,
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  and we've gotta role model that
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  because if we don't, our leaders will continue to burn out.
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  And we've seen a huge turnover in nursing leaders,
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  um, physician leaders.
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  We've also seen a, a huge turnover in, um, the c-suite too.
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  And so it's really important that we role model that.
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  And so I would ask you to consider that,
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  and then also to be lifelong learners, um, engage
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  with your professional organization
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  because no matter where you go throughout the country
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  or which system you work with,
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  you're all working towards the same things.
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  And find a mentor, someone who can, um,
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  who can support you in the journey,
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  who can be transparent and help you grow.
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  And then it's also good
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  to have a sponsor within the organization
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  who can advocate on your behalf.
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  Um, lastly, I think, don't be afraid
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  to admit when you're wrong.
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  None of us are perfect. And when you fail, I like
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  to tell my teams, when you fail, you pick yourself up,
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  you dust your knees off, and you learn from it.
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  And then share that with others so that we can all continue
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  to grow and help each other.
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  And, you know, as a transformational leader, a lot
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  of people talk about transformational leadership,
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  but as a transformational leader, you will never
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  transform the culture or move the performance scorecard
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  until you learn how to be a servant leader.
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  So I think more important than anything
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  is take a look at servant leadership
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  and what it really means,
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  and then ask yourself, you know,
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  what else can I do to serve others?
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  So I think those are the key things that I would, you know,
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  that I would recommend
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  or ask that, you know, for consideration.
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  - Absolutely. Absolutely. Thank you so much
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  for those final thoughts.
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  Dr. Adams. This has been an amazing
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  and informative discussion.
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  So again, I wanna thank you so much
• 14:16
  for coming on Becker's Healthcare,
• 14:17
  and I look forward to connecting again with you soon.
• 14:19
  - All right, thanks, Mariah. Take care.
• 14:24
  - It's so important for leaders at the top of organizations
• 14:27
  to keep learning, stay sharp, grow their networks
• 14:29
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• 14:32
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• 14:34
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• 14:37
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• 14:39
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• 14:41
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• 14:44
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• 14:49
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