Latest / Becker’s Healthcare - Clinical Leadership Podcast / Andrea Hauser, Chief Nursing Officer and Vice President – Acute Care La Crosse Nursing at Gundersen Health System

Transcript

Andrea Hauser, Chief Nursing Officer and Vice President – Acute Care La Crosse Nursing at Gundersen Health System · Becker’s Healthcare - Clinical Leadership Podcast

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  - This is the Becker's Healthcare Podcast created
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  by the team of Becker's Healthcare,
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  Thanks for listening. Now here's the episode.
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  - Welcome everyone,
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  to the Becker's Healthcare podcast series.
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  I am Ryan Mohammed re and moderator with Becker's Healthcare
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  and I'm absolutely so thrilled to have with me today.
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  Andrea Hauser, chief Nursing Officer
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  and vice president of Acute Care lacrosse nursing at
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  Gundersen Health System.
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  Andrea, it's very nice to have you on the
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  podcast today. How are you?
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  - I'm great, thank you. I'm very excited to be here.
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  - Yeah, I'm very excited to talk with you today.
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  Um, but 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?
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  - Yes, of course. I am a registered nurse
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  and as you said, I'm the Chief nursing officer
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  and vice president of acute care nursing
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  for the Gunderson region of Bellin
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  and Gunderson Health System.
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  I have been with the Gunderson Health System for 21 years
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  and have loved mostly every minute of it
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  and I'm really excited to be partnering with Bellin
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  and I'm excited to share
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  that we are actually coming up on our one year
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  anniversary as a health system.
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  So Bellin Gunderson is a not-for-profit
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  community-focused healthcare network.
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  We have headquarters in Green Bay
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  and La Crosse, Wisconsin, serving patients
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  with our 11 hospitals
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  and more than 100 clinic locations in Wisconsin, Minnesota,
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  upper Michigan and Iowa.
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  - Wonderful. Thank you so much
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  for giving us that background.
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  So with all you're doing right now,
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  can you tell me your most successful project
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  or initiative from the last year?
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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. So one of our most successful initiatives
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  that will continue is our internal
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  and external work to redesign the care surrounding one
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  of our, of our most vulnerable populations.
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  And this is our aging population who have more
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  and more chronic disease and less
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  and less available support.
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  So what was the problem?
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  We were faced with consistent barriers
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  to accessing post-acute care placement,
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  specifically long-term care and skilled nursing beds.
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  LA Cross County where Gunderson is located lost 40%
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  of our skilled nursing beds in the last 10 years.
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  Nursing home staffing continues to be a challenge
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  to our partners in being able
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  to maximize the nursing home beds available in our region,
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  ultimately turning hallways
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  of previous care spaces into storage rooms.
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  It's no secret our population is aging quickly.
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  While resources are dwindling,
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  the situation not only impacts the health of the patient
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  and family awaiting transition to post-acute care,
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  but it impacts others who are seeking care
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  as bed availability is limited
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  and creates a need to divert patients
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  to other healthcare facilities that are far from home.
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  In the fall of 2022, on many days, 40
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  of our 185, so 22%
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  of our medical surgical hospital beds were holding patients
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  who are medically stable
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  but awaiting a post-acute bed to open.
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  So what did we do?
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  We pulled on multiple threads to approach this complex issue
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  and I'm only providing just a couple
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  of the examples in our own walls.
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  We found that we were lacking a standard of care
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  for patients with dementia
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  and that this often led to increased behavioral escalation
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  as well as increased length of stay
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  and created even more difficulty in securing post-acute
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  placement for this specific population.
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  We really looked internally
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  and we researched best practices, completed site visits
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  with successful dementia units, created focused education
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  for internal staff and transformed our physical dementia
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  care space to provide dementia friendly features.
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  We created a hospital geriatric clinician consult service
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  to help standardize the very special care for this subset
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  of patients with dementia where behaviors were significant.
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  This type of care looks much different from other attending
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  hospital services by which detailed behavior tracking in
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  patients is key to assisting these patients.
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  In the four months since implementing the changes,
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  we have reduced the need to use medications to deescalate,
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  deescalate behaviors
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  and have reduced length of stay from 5.4 days to 4.7 days.
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  And we are extremely proud of the care we are providing.
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  We feel better prepared as we know
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  that there are 7 million people living in the US
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  with dementia and that this number continues
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  to rise externally.
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  We work to build relationships
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  with local skilled nursing facilities
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  and collaborated with them to rent
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  and reopen beds which had been previously
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  turned into storage rooms.
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  We currently rent 27 beds from three facilities,
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  and this partnership is beyond renting beds.
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  We are creating a relationship where we take care
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  of these patients together.
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  Our new average number
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  of stable patients awaiting post-acute placement is now
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  closer to 20, so cut nearly in half from a year ago.
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  Lastly, we are building relationships with our county
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  and state leadership to break down barriers related
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  to the guardianship process In Wisconsin.
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  When a patient is incapacitated
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  and unable to make decisions, it is our courts
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  who must appoint a guardian to do so.
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  If one had not been named in a power of attorney,
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  this process can take anywhere from four
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  to six weeks in which the patient stays in the acute
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  hospital space awaiting the decisions to be made.
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  We are working both at the county level,
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  but also with Wisconsin state legislators
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  to move forward led legislation that would allow next of kin
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  to assist with the decision making.
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  And these are just a few of the examples of
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  how we are working together
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  to make sure we are taking really great care
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  of our super special aging population.
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  - Wonderful. Thank you so much
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  for giving the us those examples.
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  Really, really helpful. Um, as you know,
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  the clinical workforce has changed a lot
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  in the last few years.
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  Um, pretty much everyone in in healthcare is still talking
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  about the issues coming from that.
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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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  - I think as it relates to this topic of post-acute care
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  and really looking at our population who is aging, coming in
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  with more complex issues, having less
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  and less support, this problem will really take an effort
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  from everyone in the healthcare workforce,
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  from the frontline to the c-suite all banding together.
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  It's really looking at understanding the landscape
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  and really looking at, um, socioeconomic demographic
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  data to see what is in your, um,
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  what is coming down the pike in terms of what will change,
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  how you need to respond to take better care of our patients.
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  So it's really understanding that landscape.
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  Um, in our region,
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  we have really remodeled our workforce again by adding on
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  that geriatric clinician, really changing the way
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  that we take care of this patient.
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  Uh, one of the patient populations impacted by this,
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  but we've also prioritized this work
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  and we have segmented this work out into a separate area
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  of responsibility that is led by specific
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  clinical administrative and strategic leaders.
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  And what this has done,
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  this has helped kept the relationships tight,
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  it has helped us keep an eye on improvements needed
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  and really helps us celebrate the small wins along the way.
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  And I am so, so thankful for these teams
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  as we keep improving.
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  - Yeah, absolutely, definitely essential to,
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  uh, to improve growth.
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  And before I let you go, 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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  - Leaders?
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  My advice is to learn how to improve not only in your walls,
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  but how to partner outside of your walls
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  to improve the entire landscape of
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  how healthcare is delivered, be it schools, county,
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  other healthcare organizations, your state
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  and federal government, really learning how to advocate.
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  I would give advice to aspiring physician
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  and nurse leaders to surround yourself with a genius
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  of various disciplines.
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  We have amazing people from social services, strategy,
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  therapies, finance,
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  that can help us solve these really complex problems.
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  So really my advice is branch out
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  to truly evolve the care that we deliver.
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  - Great advice. Thank you so much for those final thoughts.
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  This has been an amazing
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  and informative, uh, informative discussion truly.
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  So again, I wanna thank you so much
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  for coming on Becker's Healthcare
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  and I look forward to connecting with you again soon.
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  Thank you. Have a great day. You too.
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