Latest / Becker’s Healthcare Podcast / Expanding Access, Excellence, and Sustainability at Legacy Health

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Expanding Access, Excellence, and Sustainability at Legacy Health · Becker’s Healthcare Podcast

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This is where health care leadership comes together.
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Becker's sixteenth annual meeting brings more than 3,500
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hospital and health system executives and nearly 800
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speakers to Chicago April.
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This series event includes keynote conversations with Dallas
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Cowboys legend Troy Aikman and former president George
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W. Bush. 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. We're looking forward to hosting you
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in Chicago.
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Hello, everyone, and welcome to the Becker's Healthcare
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podcast.
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I'm Mackenzie Bean, associate vice president and managing
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editor of Becker's Hospital Review.
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And today, I'm so thrilled to be joined
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by doctor Joy White, who is the vice
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president and chief nursing and operations officer of
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Legacy Health. Doctor White, thank you so much
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for joining us on the podcast today. How
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are you doing? Oh, fantastic. Thanks so much
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for having me. Really looking forward to just
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some time to talk with Becker's. I'm always
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super excited,
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when I have the
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Well, we're excited to have you too, and
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I thought we could, dive in by having
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you share just a little bit more about,
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yourself, your career, and Legacy Health. You know,
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you've been on the podcast before, but I
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think it'll be a good,
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refresher for our listeners.
1:17
Yeah. So Joy White, I always start by
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saying my pronouns are sheher.
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I'm the wife of,
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an army veteran, the mom of three adult,
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children,
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and,
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the grandma of one amazing,
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little granddaughter,
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five months old.
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So I am also the caregiver for my
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father who was recently diagnosed with dementia.
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And so learning healthcare in a whole new
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way, right, on the other side.
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I am a nurse practitioner by trade, I've
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been
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a nurse for over twenty two years,
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so women's health and
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psychiatric mental health nurse practitioner,
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and currently serving as a vice president and
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chief nursing officer at Legacy Good Samaritan Hospital.
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I will tell you I have,
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and continue to enjoy
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being a nurse in my nursing career. I've
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been afforded the opportunity to just do extraordinary
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things. I worked for fifteen years in the
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federal service working for the Department of Veterans
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Affairs,
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have worked in private sector, Catholic healthcare,
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and so really well rounded in terms of
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the types of healthcare and environments, also did
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some time in long term care.
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I've worked in everything from quality,
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to education,
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to
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and of course in the nursing realm. So,
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I really, really
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had the opportunity to zoom out and zoom
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in in terms of healthcare from the clinical
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side to the administration and operations side and
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feel very, very fortunate.
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In my current role, Legacy Health is an
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eight hospital system spanning two states, Oregon and
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Washington,
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about 14,000
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employees,
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and
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the largest
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deliverer of care to those with,
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Medicaid and Medicare. And and our mission,
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really is,
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to be good health,
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and good health to not only our people,
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but our patients, our community, and our world.
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And and certainly, we live that mission.
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Absolutely. Appreciate,
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that introduction. And it's clear, you know, you've
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seen so many different sides of health care.
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So I'm excited to dive deeper into those
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perspectives today.
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Looking back on the past year at Legacy,
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what would you say has been the most
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important initiative
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that you have led?
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And can you tell us about some of
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the results you've seen so far?
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Yeah. I would say, you know, health care
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and particularly in the space of
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of quality
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is what folks are looking for. I also
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think
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access to health care. So
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there's so many things that are that are
4:00
flooding my mind now when you ask that
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question, but if I were to pull the
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thread,
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on one, I guess I pull the thread
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in this,
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this space of
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being more,
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accessible to our community.
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How do we make sure,
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that we are available,
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that we've got the
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products and services that our community really needs
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and we've got access. And so, really excited
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that our emergency department left without being seen,
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the focus in that area, rates have dropped
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significantly.
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Our closed or on divert
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for our emergency department, I mean, we're on
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divert maybe 2%.
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And so just being accessible to our community,
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working with our ED partners, our ED leaders,
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also close to admission for our family birth
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centers.
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You know, having so
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many operational,
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opportunities to improve as well as,
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looking at our staffing and finding experienced nurses,
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right, for our family birth centers to make
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sure that we can stay open,
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in our family birth centers. So, a lot
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of work around being accessible to the community,
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making sure that we're efficient and we're open
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to serve them,
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has been a lot of the work we've
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been focused on this year,
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and particularly here at Good Samaritan and I'm
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just excited that we've seen,
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you know, that type of,
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that type of impact that we've been able
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to have by simply
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recruiting the best,
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and retaining the best and ensuring that we're
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operationally efficient, so that we can continue to
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be here for good,
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and be open to our community.
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Access really has,
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dominated so many of the conversations
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with leaders last year and and this year.
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We know it's so so important, especially seeing,
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some of the headwinds even at the federal
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level. But I'm hoping you can talk to
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us a little bit more about,
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some of those, some of the work you've
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done in the ED space. I think, right,
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we've seen,
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increasingly
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constrained ED capacity at health systems nationwide.
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What's really moved the needle there?
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Yeah. So I think one of the things
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is, and I think it's foundational,
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is making sure we've got the right people.
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And we've got we've got people, right? Recognizing
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that there are shortages,
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in our physician team members, our nursing team
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members,
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even emergency department technicians,
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and recognizing that a lot of folks who
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are coming, that we're servicing,
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in our emergency departments are not just there
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for medical needs, but also mental health needs,
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right, Behavioral health needs and so we're seeing
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a lot of crowding and emergency departments across
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the country,
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with patients who don't have a medical need
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but more of a behavioral need. And I
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think,
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Good Sam, and Legacy Health is really, really
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fortunate in that way. We do have Unity,
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which is one of our behavioral health hospitals,
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also within our emergency department here at Good
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Samaritan. We have four behavioral health beds. And
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so being able to serve that population
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and also continue to see, those patients who
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are coming through our doors who require,
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mental health support, and I think that has
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been super helpful. So I would say, one,
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foundationally,
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making sure that we have the team members
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that we need. Our physicians,
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our nurses,
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our emergency department technicians, that we are well,
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we're running efficiently with our imaging department, right,
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and some of those other collaborative or clinical
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support services and that we really have good
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throughput, right,
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and I think that throughput has also been
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something we've worked on, to help relieve that
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emergency department congestion, if you will. And that's
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making sure that we have
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beds available in our inpatient unit, that we're
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discharging
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as appropriate, that we're turning over
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rooms as appropriate, and that folks are, you
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know, having that ability to move very quickly
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from the emergency department once an admission
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order has been written to the inpatient area.
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It's that type of efficiency.
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So it's the people and then it's the
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process, right? And then last, of course, is
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the technology. So how do we use
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our epic tools, our medical record? How do
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we use the tools that we have available
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to us to also ensure that we're getting
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patients moving timely? So, we've had a full
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on, full court press on inpatient throughput,
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and that has served us exceptionally well focusing
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on people process and then how technology can
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support us with that throughput.
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Mhmm.
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All of those pieces of the puzzle come
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together and have such Yeah. Such huge benefits,
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of course. Yeah.
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So I'm talking to you in, late January
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now. It's hard to believe we're already, almost
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through January, but I'm curious for,
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your priorities and headwinds looking into the next
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twelve months. What's top of mind for you?
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This is an easy one. This is super
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easy. Access continues to be number one.
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Heard that story before. So continue to be
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accessible.
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Also excellent. Really focused on our quality.
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Our quality indicators, our
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fall rates with injury, CAUTIs, you know, CLABSIs,
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HAPIs, all of the things that,
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when we think about,
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clinical
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excellence, this is what we think about. Also
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within that excellence bucket is, what is the
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experience of
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our employees working for legacy Good Samaritan Medical
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Center? So, how is that employee experience? Are
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we able to attract, recruit the best and
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the brightest and not just recruit them, but
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retain them? So we're really focused in that
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excellence bucket, not just on clinical quality, but
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also experience for our employees and experience for
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our patients. So, all that
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falls within excellence. And then last would be
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sustainability.
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Are we
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efficient in our processes?
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Are we also thinking about and thinking through
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making sure we have a frictionless system, a
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sustainable system,
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with our the products that we use, efficiency
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in our operating rooms,
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that type of thing. So, how do we
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ensure that we're here for good? How do
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we ensure
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that we're sustainable?
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So that those are the things we're focused
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on, access, excellence,
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and sustainability.
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Those are key drivers, if you will. Mhmm.
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And so much of that directly supports high
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quality care given to patients as well. You
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got it. You got it. You got it.
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I'm curious to hear,
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what's the hardest thing you think you'll have
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to do in the coming year?
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Yeah. That's not a hard one either,
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and it's all,
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really focused around,
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the headwinds,
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with increasing,
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you know, increasing
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cost, increasing demand for services,
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and decreasing reimbursement.
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So that story
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of having to do even more,
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with less.
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Recognizing we are getting, you know, reimbursed
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lower than we ever have,
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also thinking about some of the legislation,
11:11
particularly HR one and its impact on healthcare
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as a whole and organizations across the country.
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Oregon and Washington are expected to be impacted
11:21
sixth and eighth respectively by HR one,
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which is something that we've got a brace
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for. We're gonna have to be really, really
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efficient.
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I think we're gonna have to be really
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creative,
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and we're gonna have to really lean into,
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supports that we can gain from our local,
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our local
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partners, partnerships,
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and,
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legislative,
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entities.
11:50
So I think that's gonna be the biggest
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thing. How do we,
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continue,
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to deliver,
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the type of service,
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at the
11:59
and meet the demand,
12:01
in this area,
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recognizing
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those those headwinds. Mhmm.
12:06
A significant challenge. I know you mentioned legacy
12:08
health,
12:09
caring for a large population of Medicaid and
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Medicare patients.
12:13
Yeah.
12:14
What does this preparation or creativity
12:16
look like from the nursing perspective specifically? Have
12:20
you started to kind of
12:21
frame that out or still sort of in
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in brainstorming mode?
12:25
Yeah. That's such a great question, and I
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think the answer is,
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yes, and it's in development. Right?
12:32
So yes, we need to make sure that,
12:34
again,
12:35
we're taking care of our people, the people
12:38
who
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work for Legacy Health, that we're addressing well-being
12:43
among our team members. You know, there's a
12:45
book and I think it's somewhere on the
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shelf behind me and it says, it's called
12:50
Patients Come Second.
12:52
And, you know, what
12:54
a profound thought when you think about healthcare
12:57
being, you know, a service industry and we're
12:59
here to support patients that answer or that
13:03
that notion is absolutely true, but it can't
13:06
happen unless we take care of the people
13:08
that are doing this work. And so, I
13:10
think part of preparing,
13:13
for the headwinds is making sure we have
13:16
people. That we have again, and I've said
13:18
it, if I have said it, you know,
13:19
probably seven times already in this interview, is,
13:22
you know, how do we recruit the best
13:24
and brightest and then how do we retain
13:26
them? So part of that preparation is making
13:29
sure we've got the people,
13:31
and that we're addressing their well-being.
13:33
We've done something here called stress first aid
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and we have made that training available to
13:39
every
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single member,
13:41
of Legacy Health is stress first aid. So,
13:43
addressing, the well-being of our people to make
13:46
sure that they're,
13:47
able to take care of
13:50
the patients that are walking through our doors.
13:51
I think I've talked about some of the
13:53
other preparations, making sure that we've got exceptional
13:55
throughput,
13:57
that we are able to see those patients
13:59
that arrive,
14:00
and that we've got good,
14:03
processes and systems,
14:05
to be able to care for them and
14:06
then,
14:07
to transition into their next,
14:10
next location
14:11
to receive care, whether that's home, whether that
14:13
is
14:14
rehab, wherever that is.
14:15
So I think throughput being very, very efficient,
14:19
in our inpatient capacity and inpatient throughput. I
14:22
think it's also,
14:23
something that is ongoing that's partnering with our
14:26
outpatient. We think very insular very,
14:29
a lot of times about healthcare and
14:31
this focus on the inpatient arena. We've gotta
14:34
also think about that partnership,
14:35
with our outpatient and our primary care and
14:37
our specialty clinics.
14:39
Because when we do that work well, when
14:41
we have access in our outpatient, when we
14:43
have access in our specialty care,
14:45
we may see less of those folks having
14:48
an emergency and having to come to the
14:49
inpatient side.
14:51
And so also focusing on our outpatient access,
14:54
our specialty care access, our primary care access
14:57
is also super important. And then what do
14:59
partnerships look like?
15:00
I think we've gotta think about our community
15:03
partners
15:05
and where care is being provided in other
15:07
places and how we might partner,
15:09
especially given the headwinds that will impact all
15:11
of us financially.
15:12
We can't all be centers of excellence. We
15:15
need to think about what makes sense to
15:17
do where, you know, and so I think
15:19
that collaboration is gonna be super important. Thinking
15:22
about a system like Legacy Health,
15:24
how do we take advantage of the economies
15:26
of scale, right? We're eight hospitals, and so
15:28
how do we take advantage
15:30
of the economies of scale of being a
15:32
large,
15:33
large health system.
15:35
So I think it's all those things looking
15:37
at our,
15:38
looking at our quality. I think everything that
15:41
I've mentioned is part of that preparation.
15:44
We want to be the organization
15:46
where people choose to receive care. You know,
15:49
patients have choices.
15:50
And so we wanna be known for the
15:53
place that not only has exceptional quality,
15:56
but our experience is just phenomenal. So, people
15:59
will choose Legacy Health because of those things,
16:01
because of quality, because of experience. I think
16:04
that's how you get there.
16:06
And and again, of course,
16:08
goes without saying to be efficient,
16:10
in how in how we do that work.
16:13
So on time starts and turnaround times and
16:15
making sure that we can serve the most,
16:19
in the most efficient.
16:21
Absolutely.
16:22
Doctor White, I so appreciate you taking the
16:24
time to,
16:26
share with our listeners a bit more about
16:27
your work at Legacy Health, how you're thinking
16:29
about the future. I think it's like you
16:31
said, that collaboration and idea sharing on something
16:34
is more important than ever right now.
16:37
Is there anything you'd like to leave our
16:38
listeners with?
16:40
Oh, thanks for that. I wasn't wasn't prepared
16:42
for that. I think,
16:44
one of the things
16:45
I am really big on and I think
16:47
it just kinda speaks to
16:49
who I am being a nurse practitioner and,
16:52
you know, mental health is kinda my jam.
16:55
And one of the things I say in
16:56
healthcare is we think about,
16:59
we think about everyone
17:02
else often.
17:03
It's always solving the next problem,
17:06
it's the next challenge,
17:08
that we face.
17:11
And very often as healthcare,
17:13
administrators,
17:14
providers,
17:16
caregivers,
17:17
we don't turn that same lens on ourselves.
17:21
We don't apply the same medicine. We don't
17:23
take the same medicine as we offer to
17:24
others. And I would say, we need you
17:26
in healthcare.
17:28
As administrators, as executives, as CEOs, CNOs, COOs,
17:32
CFOs,
17:34
layperson,
17:35
we need you in healthcare.
17:37
This is an industry of caring,
17:41
and taking care
17:42
of ourselves,
17:44
in these roles is equally important. So,
17:47
if it is once a week or once
17:49
a day, take a mindful moment, remember that
17:52
as
17:53
as, taxing as healthcare can be, it is
17:56
also extremely rewarding. And so, if you can
17:59
take the opportunity once a day, once a
18:01
week,
18:02
if you have a gratitude jar, if you
18:04
have a moment just to reflect on one
18:07
win, something that went really well today,
18:10
whether that was an exchange with a patient
18:12
or family, whether that was,
18:14
working together with a colleague,
18:16
to address something hard,
18:18
whether it was, you know, a new employee
18:20
who's got a twinkle in their eye about
18:22
walking into your organization as a new employee
18:25
and making a difference, take an opportunity,
18:28
to reflect
18:29
on one win, because we're always solving problems
18:32
and putting out fires, but take the opportunity
18:35
to have a grateful moment and recognize something
18:38
that you've done,
18:39
that probably
18:40
just once a day.
18:42
I love that. I think that's such a
18:43
great message to end on. Doctor White, thank
18:46
you so much again for your time and
18:48
all of your thoughtful remarks, and we're so
18:49
excited to see you and have you speak
18:51
at our annual meeting.
18:53
Awesome. Looking forward to being there, Mackenzie. Thanks
18:55
so much.