Latest / Becker’s Healthcare - Clinical Leadership Podcast / Dr. Janice Walker on Building a Stronger Nursing Workforce at UF Health

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Dr. Janice Walker on Building a Stronger Nursing Workforce at UF Health · Becker’s Healthcare - Clinical Leadership Podcast

• 0:02
  - There's a small circle of people who truly
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  - understand what it takes to lead a health
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  - system right now. The decisions are enormous.
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  - The variables are constantly shifting, and the stakes
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  - of getting a call wrong don't stay contained.
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  - That's not a complaint. It's a structural reality.
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  - And it's why the most effective c suite
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  - leaders are deliberate about where they go to
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  - pressure test their thinking.
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  - Becker's fourteenth annual CEO and CFO roundtable
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  - brings together more than 1,500
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  - executive level attendees
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  - and nearly 400 speakers for four days built
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  - around growth, financial sustainability,
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  - workforce strategy, and the leadership questions that don't
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  - have easy answers.
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  - Join us November second through the fifth in
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  - Chicago.
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  - 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
• 0:49
  - upper right.
• 0:51
  - Hello, everyone, and welcome to the Becker's Healthcare
• 0:53
  - Clinical Leadership podcast.
• 0:55
  - I'm Mackenzie Bean, associate vice president and managing
• 0:58
  - editor of Becker's Hospital Review.
• 1:01
  - Very excited for our conversation today with doctor
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  - Janice Walker, who is the system chief nursing
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  - officer and senior vice president of UF Health.
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  - Doctor Walker, so so nice to have you
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  - on the podcast again. Thanks for joining us.
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  - Thank you, Mackenzie, for the invite. Pleasure to
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  - be here.
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  - I thought we could,
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  - just briefly introduce yourself a bit more, doctor
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  - Walker,
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  - and talk a bit about your role at
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  - UF Health for any listeners who may not
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  - have caught your earlier podcast in the spring.
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  - Certainly. So I joined the UF Health family
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  - in January
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  - 2026.
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  - I'm pretty seasoned as a system chief nurse.
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  - I have a rich history of doing that
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  - in two large complex organizations.
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  - And so when this particular position
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  - came up and the fact that it's inaugural
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  - and that we have multiple hospitals but never
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  - had a system chief nursing officer
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  - to pull all of nursing
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  - practice and professional development and retention and recruitment
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  - and driving outcomes.
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  - What a great opportunity to do it in
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  - gorgeous Florida with the University of Florida and
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  - also the connection that we have with the
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  - University of Florida College of Nursing.
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  - So I tell people often,
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  - if you followed my career and followed my,
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  - different,
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  - places I've lived in The United States, that
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  - this is exactly where God intends me to
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  - be at this time.
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  - And the journey that got me here is
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  - incredible.
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  - And, hopefully, this is my last,
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  - hoorah building a large integrated health care system
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  - for nursing before I retire many years down
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  - the road.
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  - So I'm so blessed to be able to
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  - do it in conjunction
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  - with our c suite and our executives that
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  - are transforming
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  - into one system
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  - across the University of Florida Health.
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  - And we'll talk a bit more about that
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  - integration and standardization
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  - and the systemness,
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  - from the nursing perspective.
• 3:01
  - But first, I just wanna check-in. I know
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  - we spoke in March, I believe,
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  - and you were just going on your listening
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  - to or really planning to visit all 12
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  - hospitals under the system and speak with the
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  - chief nursing officers,
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  - there to really identify your road map and
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  - your priorities. Can you just talk more about
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  - where are you in the process right now?
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  - Has there been anything you've seen or heard
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  - on the ground that's kind of shifted what
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  - you thought you would tackle first?
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  - Somewhat. In that in order
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  - to lead an organization,
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  - you have to acclimate to their culture and
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  - their their beliefs and their their mission and
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  - values. And so I started
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  - with lots and lots of rounding and still
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  - do that today,
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  - but have clearly
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  - touched all of the acute care hospitals,
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  - all the high volume
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  - patient care settings,
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  - our freestanding
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  - EDs,
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  - our psych hospital,
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  - our mobile medicine
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  - community clinics,
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  - and our acute care,
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  - surgery centers.
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  - So, I've hit the most of the highlights,
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  - but still love to go in into small
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  - unique areas like this week.
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  - Rounding in one of our
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  - Alzheimer's,
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  - day care areas for the geriatric
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  - population.
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  - So,
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  - once I started all the rounding and the
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  - building of the relationships
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  - and the trust and the visioning,
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  - that took about ninety days. And then I
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  - moved into
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  - really,
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  - bringing all the chief nursing
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  - across our enterprise together
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  - to start to build in conjunction with our
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  - college of nursing
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  - executive leads, the nursing
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  - strategic plan for UF Health.
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  - And, it was the first UF Health transformation
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  - strategic plan for nursing.
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  - So it became pretty clear that after we
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  - got
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  - some
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  - ideas onto paper
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  - that we truly needed to bring more people
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  - to the table to start to vision our
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  - variations,
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  - our pockets of excellence,
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  - and where are... Where our most challenging
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  - opportunities for improvement.
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  - So we repeated the retreat,
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  - went a level lower, took the,
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  - associate vice presidents of nursing
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  - out for retreat along with our educators,
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  - our magnet
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  - leads,
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  - some of our communication
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  - leads, and HR talent acquisition.
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  - So what started
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  - to become a document
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  - click... Clearly classified by our pillars of excellence
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  - then needed a timetable
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  - laid on top of it, Mackenzie, because it's
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  - a lot, you know, and you can't boil
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  - the ocean overnight
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  - and transform nursing into one center of excellence.
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  - So it started to transform
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  - into categories,
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  - that I really loved in the category of
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  - must,
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  - should, and could
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  - as you start to categorize
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  - the
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  - the strategic plan for nursing and ask for
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  - help
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  - by key leaders in driving change.
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  - So that document has been finalized.
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  - We continue to socialize it to our directors,
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  - our nurse managers,
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  - and asking for help on how we're gonna
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  - align and what category of variation
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  - have we found across all of our UF
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  - Health practice environments.
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  - I'm curious. How did how did you weigh
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  - those conversations between should and could? Or can
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  - you talk more about those buckets? I mean,
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  - it's a a lot of the cold conversations.
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  - Related
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  - to the return on investment.
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  - So
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  - it's not just focused on growth and financial
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  - and cost elimination as much as it's focused
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  - on the development
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  - of the professional
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  - nurse.
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  - So examples might be because we
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  - have a couple of magnet hospitals
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  - inside of UF
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  - Health, both of those magnet hospitals have their
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  - own professional model of practice,
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  - and that becomes
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  - intimately important for their magnet document.
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  - And it also guides their councils,
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  - what types of councils, who is represented in
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  - the nursing councils
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  - for the overall model of care,
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  - for the magnet document.
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  - And to be an integrated health care system,
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  - I need similarities
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  - in those models,
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  - and they have always been standing alone.
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  - And so there's a journey there
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  - to take on
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  - our
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  - models of nursing professional development
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  - and what councils we're gonna have, who are
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  - the representation
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  - across all the UF health hospitals,
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  - and how do we talk to each other
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  - and learn from each other. So that took
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  - a a priority.
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  - And then things that,
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  - are not the same, policies and procedures
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  - related to nursing practice,
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  - how we onboard our new grads might be
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  - different per campus,
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  - how we onboard,
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  - seasoned nurses is different,
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  - How we
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  - recruit,
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  - very agile and very concise
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  - and very quick is different per campus.
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  - Peer review of nursing practice is different per
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  - per per campus.
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  - So all the things that
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  - a seasoned system chief nurse exec would expect
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  - to be aligned is where the priorities started
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  - to show themselves.
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  - And our our frontline and our AVPs of
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  - nursing and our CNOs are so excited
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  - to have that infrastructure
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  - built,
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  - that really make their jobs a little easier
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  - at the entity level.
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  - I'd imagine all of those structures set such
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  - a strong foundation for the the work. I
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  - know you're highly focused now continuing, as you
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  - said, on aligning nursing practice across the enterprise.
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  - Can you talk a little bit more about
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  - where your focus is there, what that will
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  - look like in the coming year or two?
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  - So I would start at the front door,
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  - which is the nurse residency and onboarding,
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  - new grads. So we have some centers of
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  - excellence that are accredited
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  - as through the ANCC
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  - to be a nurse residency.
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  - And then we have some that are homegrown,
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  - and not quite to the point to be
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  - accredited. And then we have some that have
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  - just started the journey.
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  - So we have put the,
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  - the flag in the sand per se that
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  - we are going to one nurse residency
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  - accredited
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  - by the ANCC
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  - with, Busyant as our partner of our database,
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  - how we track all of our new graduate
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  - nurses across the University of Florida.
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  - And so the curriculum
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  - alignment
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  - of that residency
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  - will be one and the same,
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  - evidence based.
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  - So that process in itself
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  - starts to integrate
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  - the work that our preceptors
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  - and our mentors and our educators do for
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  - onboarding new grads. That's just one example of
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  - a lot of variation
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  - in the practice environment
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  - that we have opportunity for improvement to continue
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  - to advance nursing.
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  - I know we've also spoken before on,
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  - pipeline development
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  - and how crucial that is as a a
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  - priority for for any chief nurse executive,
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  - whether that's high school outreach, internal succession planning.
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  - Curious, how are you thinking about all of
• 10:36
  - that at at UF Health, and how does
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  - that go
• 10:38
  - side by side with some of the new
• 10:40
  - nurse graduate efforts?
• 10:42
  - So it's it's,
• 10:44
  - it goes hand in hand with new nurse
• 10:47
  - graduate recruitment as well as experienced nurse graduates.
• 10:51
  - So in conjunction with our partnership with our
• 10:54
  - talent acquisition,
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  - we have committed to a more candidate centric
• 10:59
  - model,
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  - and we have
• 11:02
  - milestones that must be met by our sourcers
• 11:05
  - and recruiters
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  - on a
• 11:08
  - twenty four, forty eight, seventy two hour cadence
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  - when an applicant has applied,
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  - all the way up to
• 11:17
  - at what point and what cadence are we
• 11:19
  - trying to achieve that the nurse manager or
• 11:22
  - the hiring manager
• 11:23
  - has booked the interview
• 11:25
  - and made the offer.
• 11:27
  - So standard best practice and what I've seen
• 11:30
  - across the nation, what I've published on previously.
• 11:34
  - We're trying to replicate and do it even
• 11:36
  - a little better at the University of Florida
• 11:38
  - Health. And then our candidate centric model for
• 11:41
  - nursing needs to be seven days.
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  - Seven days from applying
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  - to,
• 11:47
  - managers made a decision and an offer is
• 11:49
  - being extended.
• 11:50
  - And you can only do that with, a
• 11:53
  - little bit of rigor
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  - around the timetables
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  - of
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  - of the timing and the framing
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  - of that seven day cycle.
• 12:03
  - And if for some reason there's a gap
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  - on the twenty four, forty eight, seventy two
• 12:08
  - hour milestones,
• 12:09
  - an alert must fire
• 12:12
  - built into our dashboards and our processes so
• 12:14
  - someone can come behind them and pick up
• 12:17
  - the slack so it can still hit the
• 12:18
  - seven day cadence. And an example for the
• 12:21
  - nurse manager might be
• 12:23
  - if they're out of the hospital or out
• 12:25
  - of the office
• 12:26
  - on PTO or a vacation day, someone has
• 12:29
  - to be taking up the slack related to
• 12:31
  - interviewing a,
• 12:33
  - seasoned candidate
• 12:35
  - because we know the talent is precious.
• 12:37
  - We know that the literature tells us the
• 12:40
  - the timing of an offer to actually accepting
• 12:44
  - that offer is very time sensitive,
• 12:46
  - and we cannot continue to move at an
• 12:49
  - employer centric pace. We must change our,
• 12:53
  - way of thinking and processing talent in more
• 12:55
  - of a candidate centric
• 12:58
  - place. So that has kicked off. That's new
• 13:00
  - for all of our sources, recruiters, and nurse
• 13:03
  - leaders, but how exciting to be able to
• 13:05
  - extend an offer in seven days
• 13:08
  - versus something that maybe was twenty one days.
• 13:13
  - Very exciting, and I imagine has hue... Humongous
• 13:16
  - benefits to your workforce and your pipeline.
• 13:18
  - Yeah. One other thing I wanted to ask
• 13:20
  - you about, especially as we're thinking about new
• 13:23
  - nurses
• 13:24
  - entering the workforce, is the clinical skills gap.
• 13:27
  - I've spoken with a a lot of chief
• 13:29
  - nursing executives who've talked about that gap feeling
• 13:32
  - like it's grown in recent years or that
• 13:35
  - once a new nurse enters their system, they
• 13:37
  - really are doing a lot more heavy lifting
• 13:39
  - to get them prepared for practice, whether that's
• 13:42
  - just straight clinical skills or critical thinking. So
• 13:45
  - I'm curious, one, what's your perspective on that?
• 13:47
  - And do AMC's have a a a sort
• 13:50
  - of a unique advantage when they're coming to
• 13:52
  - closing that gap?
• 13:54
  - I think we do. And and maybe a
• 13:56
  - follow-up,
• 13:57
  - incredible Webex might be in conjunction with my
• 14:01
  - my partner who's the dean of the College
• 14:03
  - of Nursing at the University of Florida Health,
• 14:06
  - doctor Shakira Henderson.
• 14:08
  - And so we have kicked off,
• 14:11
  - just this semester,
• 14:13
  - our process that we refer to clinical
• 14:17
  - reimaging
• 14:18
  - reimagining
• 14:19
  - model, and we call it the CRIM model,
• 14:21
  - c r I m, stands for clinical reimagining
• 14:25
  - model,
• 14:26
  - where our students and our future talent at
• 14:29
  - the College of Nursing,
• 14:31
  - the didactic in theory
• 14:34
  - comes at the front of the semester.
• 14:37
  - Mhmm. Then they have their skills
• 14:41
  - acclimation. And then toward the end of the
• 14:43
  - semester,
• 14:44
  - they immerse into the workforce
• 14:48
  - with a
• 14:50
  - clinical mentor
• 14:51
  - who is a University
• 14:53
  - of Florida
• 14:54
  - registered nurse,
• 14:56
  - adjunct faculty to the College of Nursing.
• 15:00
  - And that mentor is there to focus, focus,
• 15:03
  - focus
• 15:04
  - on the assessment
• 15:06
  - skills, the time management,
• 15:08
  - the,
• 15:10
  - clinical skills, proficiency.
• 15:12
  - So think about it. I'm learning at the
• 15:15
  - very beginning of my semester,
• 15:17
  - my theory
• 15:19
  - and my didactic.
• 15:21
  - Then I am completing some skills fairs with
• 15:24
  - my
• 15:25
  - with my,
• 15:26
  - professors.
• 15:27
  - And then toward the end of the semester,
• 15:30
  - I am
• 15:31
  - intensely
• 15:32
  - emerging
• 15:33
  - into the clinical workforce
• 15:37
  - with a University of Florida Health registered nurse.
• 15:40
  - And so
• 15:42
  - we,
• 15:43
  - have a CRM governance
• 15:45
  - council that's watching our outcomes from this. It's
• 15:49
  - something
• 15:50
  - brand new across the nation that may not
• 15:52
  - always exist.
• 15:54
  - Usually, in times past and when when I
• 15:57
  - went to nursing school and others that are
• 15:59
  - listening,
• 16:00
  - theory is mixed with clinical
• 16:03
  - throughout the same week.
• 16:05
  - So, hopefully, it allows our professors,
• 16:08
  - our adjunct faculty,
• 16:10
  - our University of Florida registered nurses, as well
• 16:13
  - as our students to truly focus
• 16:15
  - during the week that they are in during
• 16:17
  - the semester.
• 16:19
  - Our bedside nurses that have become
• 16:22
  - adjunct faculty as well as mentors to these
• 16:25
  - students
• 16:27
  - are so
• 16:28
  - excited to see dedicated time to those students
• 16:32
  - because teaching is hard during a during a
• 16:35
  - busy twelve hour shift.
• 16:37
  - But they are receiving
• 16:39
  - the skills
• 16:40
  - to teach a little differently,
• 16:42
  - and they clearly know what semester
• 16:45
  - the student has completed
• 16:47
  - and what they, have mastered
• 16:50
  - in their theory content. And so they're applying
• 16:53
  - it in the skills content.
• 16:55
  - CRIM. Mhmm.
• 16:56
  - Yeah. CRIM. That's
• 16:58
  - such a great example of trying to solve
• 17:01
  - the challenge much farther upstream and something that
• 17:04
  - as an ethnographical
• 17:05
  - center makes it possible for. Yes.
• 17:08
  - And it's also But more to come. More
• 17:09
  - to come and maybe a future hosting on
• 17:12
  - really looking at our outcomes.
• 17:14
  - Exactly. I'm I'm so curious to hear what
• 17:16
  - the benefits are. I'm sure they'll be numerous.
• 17:19
  - And it's also clear just
• 17:21
  - you've really hit the ground running in your
• 17:23
  - role. It's amazing to see all of the
• 17:24
  - work and initiatives that are already in store
• 17:26
  - at UF Health. So, doctor Walker, I just
• 17:29
  - wanna thank you again for joining us on
• 17:30
  - the podcast and giving us an update about
• 17:32
  - all of your initiatives.
• 17:34
  - Thank you so much for reaching out.
• 17:37
  - And also thank you to to Becker's for,
• 17:41
  - understanding the power of of the voice of
• 17:45
  - nursing executives and creating a nursing advisory council
• 17:49
  - at Becker's that I was very blessed to
• 17:51
  - see the email come across that I've been
• 17:53
  - invited to join that because we all can
• 17:56
  - learn together and become stronger together through Becker
• 17:59
  - support.
• 18:00
  - Absolutely. And it's such a honor to have
• 18:02
  - you on our advisory board, and we wanna
• 18:04
  - create that space for pure learning and best
• 18:07
  - practice
• 18:08
  - best practices. You know, that's how you really
• 18:09
  - shape the industry, isn't it?
• 18:12
  - Everyone getting better together. Exactly.
• 18:14
  - Wonderful. Well, doctor Walker, thank you so much.
• 18:16
  - Yeah. It's always a pleasure to speak with
• 18:18
  - you. Thank you for the invite.