Latest / Becker’s Healthcare - Clinical Leadership Podcast / Shaping Nursing Excellence Across UF Health with Dr. Janice Walker

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Shaping Nursing Excellence Across UF Health with Dr. Janice Walker · Becker’s Healthcare - Clinical Leadership Podcast

0:02
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
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April.
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This year's 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. Today, I'm so
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so excited to be joined on the podcast
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by doctor Janice Walker who recently became the
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inaugural chief nursing officer of UF Health.
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Doctor Walker,
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thank you so much for joining us on
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the podcast.
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I'd love to turn it over to you
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to introduce yourself and tell us a little
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bit more about your background.
1:01
So thank you, Mackenzie. Thank you for the
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opportunity to speak,
1:05
to you this morning as well as all
1:07
my colleagues that I know will eventually listen
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because I listen to theirs, and I learn
1:12
things
1:13
every single time across Becker's
1:16
world when I listen to other system chief
1:18
nurses,
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other health care executive leads. So so blessed
1:22
to be in front of you today.
1:24
We are lucky to have you on the
1:26
podcast, and I'm glad that you've been enjoying
1:28
the episodes.
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So I know I believe you stepped into
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your new role January 19. Is that correct?
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That's correct. Wonderful. Congratulations.
1:37
So talk to you about a month and
1:38
a half in, you know, excited to hear
1:40
about everything and how it's going. But before
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then, can you share just a little bit
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more about your career and,
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you know, where you've come from and what
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you've done before joining UF California?
1:50
Absolutely. So,
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I have led I'm very been very blessed
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to lead
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large complex health care systems,
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period of time where I probably understood
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what systemness
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really was
2:05
as, we continue to grow when I was
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at Baylor Scott and White Health as the
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largest not for profit in Texas.
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I would say to you that's where,
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as we were flying the plane, we were
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building it to understand
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the beauty
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and the,
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scale
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you can create as well as on quality
2:25
outcomes,
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that bigger is better
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in terms of driving quality and outcomes. So,
2:34
as the as the system chief nurse at
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Baylor Scott and White,
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as well as during the pandemic,
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systemness just became very natural to me.
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So when the opportunity presented itself
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to come to UF Health,
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who also has given interviews and articles
2:53
related to transforming
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to a to an integrated health care system.
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I knew the the fit, and I was
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very hopeful that the fit was perfect.
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And then when I learned it was an
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inaugural role,
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what an additional blessing
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to build it from the ground up. So
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I have 12 hospitals currently with more coming
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on board.
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And for the last six weeks, I've devoted
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my time
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to getting to know those hospitals.
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By the end of this week, I'll have
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rounded in every single one.
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Mackenzie, I learned early in my career, I
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can't lead you if I don't know you.
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And so, therefore and I can't support you
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if I don't know you and know exactly
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where you are. So I've traveled all over
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the state of Florida getting to know my
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new hospitals, my new clinic settings, my new
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transfer center,
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and all the support that goes with them.
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I think those types of listening tours are
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are are so so crucial
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as you're jumping into the role, and it
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sounds like your expertise and systemness is really
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just so complimentary
4:00
to a lot of the work that's been
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going on at UF Health. I know there's
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been that focus on,
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unifying under
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academic operating model. As you said, You'll be
4:09
very focused on aligning the nursing infrastructure across
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the system in the inaugural role.
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Let's go a little bit deeper there.
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What does a truly integrated nursing strategy look
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like in practice? What are you focusing on?
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And how are you planning to balance standardization
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with maybe the needs of regional markets or
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specific hospitals across the state?
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That is a great question. As I'm meeting
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people out and about, I ask many of
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them, have you ever worked in a health
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care system that had a system chief nurse?
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And I probably get only 20% of hands
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raised. So it's new for them
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to understand where the balance is of my
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role
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as well as the the entity and the
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regional chief nurses.
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So I would say that I describe it
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to them very much like I'm gonna describe
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it to you. I'm here to represent
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nursing
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at the highest
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level of visibility
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at the UF Health System. That is at
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the the president of our entity organizations table,
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doctor Steven Motu.
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So when they realize that I am their
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voice
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as well as their balance measure,
5:19
of driving quality outcomes,
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then they start to embrace why we needed
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one.
5:25
When you start to grow
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and become
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more complex with some
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academic hospitals, some that are not, and adding
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more hospitals,
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you understand
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that systemness
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drives quality outcomes. So an example might be
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we're we're working too hard to create
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individual policies
5:48
when truly the best practice is found somewhere
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in the industry, and that's the policy we
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would like to adopt,
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not having 12 different versions of it. Same
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things with protocols
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to prevent harm.
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Same things with nursing professional development. What do
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the plans look like? What do the succession
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plans
6:09
and advancement of your degrees look like,
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how do we celebrate them together, how do
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we have standardization.
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So the the list is endless
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related to systemness,
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and it's such exciting work. And I truly
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think I was,
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born to do that complexity work and support
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them. I'm very cautious to describe to them
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that it's not about losing your own entity
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identity.
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Even at Baylor and,
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other health care systems I've worked at, you
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still retain your own community identity,
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but that doesn't mean that you don't have
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to work as hard with creating standardization
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of
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of compliance
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policies, standardization
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with regulatory
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policies.
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So let's let's work smarter together
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so we can continue to care for our
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communities. And and once you describe to them
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what a system chief nurse really does,
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then they understand why now.
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They understand the purposeful work.
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And I tell them all along the way,
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you'll be part
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of identifying the variation
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as well as prioritizing
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which piece of the variation we're gonna go
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after
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first
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as well as how we're doing on removing
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that variation.
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So,
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you know, as long as they understand
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you are part of the integration,
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this is something we're gonna do together.
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We don't we're not gonna make decisions about
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nursing practice
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without nurses at the table,
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then they understand the why.
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Mhmm. It sounds like
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that work upfront on the education and the
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communication,
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and that very collaborative approach is is so
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crucial to ensuring the system approach really works.
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And one of the things that that,
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I'm very purposeful
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with
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is, the chief nurses, the regional chief nurses,
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and and what was the entities. I've met
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them all, but I'm not bringing them together
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to really start to strategize what we go
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after first until I visit all of these
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hospitals.
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Because, again, I have to know you to
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lead you, and I can only
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know you if I come to your space
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and meet you where you are. So they're
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giving me grace to get that done.
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And once that really starts to come to
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a final,
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traveling journey,
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listening tours,
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then I will do it at a cadence
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of about quarterly,
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and we will really get to work on
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identifying our variation
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and how we're gonna transform
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to one center of nursing excellence
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with the academic arm as well as the
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operational arm.
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That timeline makes sense, and you'll truly be
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able to hone in and get a little
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bit more strategic of which areas you're gonna
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tackle first and and go from there.
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I'm looking forward to following along and, hearing
9:11
about some of the progress. I also wanted
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to talk with you about nursing recruitment and
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retention. I know you're nationally recognized for your
9:19
work here, have great expertise on it. I'm
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curious what's been successful for you in the
9:24
past when it comes specifically to recruiting and
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retaining nurses?
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What distinguishes organizations that really achieve workforce stability
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from those who are being a little bit
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more reactive in trying to solve nurse turnover?
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So let's let's answer recruitment, and then I'll
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then I'll talk a little bit more about
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retention. But recruitment,
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what I found that,
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health care systems and complex health care systems
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really have to zone in on is
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I would describe it as candidate centric work
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versus employee centric. So there's a difference.
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You have to go after talent
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faster and more agile than you ever could
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imagine pre pandemic.
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For every vacancy you have,
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you have to source those talents, and you
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have to move at a cadence
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of what I like to build as seven
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days.
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From from the moment that we find the
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candidate or the candidate finds us till job
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offer is in the hand,
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we can do it in seven days if
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we have structure,
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important
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metrics, escalation
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of metrics,
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whether it's on the recruiter's end or the
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hiring manager's end. So completely rebuild the way
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you go after talent. That's the recruitment arm.
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And you measure yourself, am I hitting that
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seven day cycle?
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So,
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I've nationally published about that. I've taken that
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to other states to talk about, and the
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model works. It's a joint effort with talent
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acquisition, recruitment, and operators
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to know we must have to we must
11:05
go after the applicant faster than ever. So
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turn it from
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employee centric employer centric, excuse me, to candidate
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centric.
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So once we have the talent in the
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door
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and have made the commitment,
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to them, then let's talk about the retention
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strategies.
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So retention
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has to do with the listening of the
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voice of your clinician
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in any discipline, not just nursing.
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So do you have a professional
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shared governance structure
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where we don't make decisions about nurses without
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nurses? We don't make decisions about pharmacy workflows
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without pharmacists.
11:48
We shouldn't be making decisions about therapy
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workflows without therapists.
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So professional shared governance
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is
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is a pillar of magnet organizations.
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But I would say to you, it should
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be a pillar of all organizations where you're
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magnet or not.
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Because if you are not listening to the
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voice of your clinicians who are the experts
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in the care they provide, you're gonna have
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gaps,
12:13
and you're going to lose staff quicker, and
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you're gonna have challenges with retention.
12:18
So put in that professional shared governance structure.
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Start with small projects.
12:25
Learn to get
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stronger
12:28
in removing barriers of their practice
12:31
through your shared governance structure, and continue to
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celebrate your successes.
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So one of the things that I've done
12:37
in my career around huddle boards where you're
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taking on your most complex
12:43
problem
12:44
inside of an entity,
12:45
you track the progress
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of that shared governance solution
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and the ownership of that shared governance solution
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until you really get meaningful solutions.
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But you also
12:59
keep a track record of everything that professional
13:02
shared governance has accomplished, and you maybe surround
13:06
that Huddl board with the annual
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successes.
13:10
So you never lose sight of what you've
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actually accomplished
13:15
in a professional shared governance setting. Because if
13:18
we don't elevate it and celebrate it, our
13:21
staff tend to tend to forget it because
13:24
we always have issues and problems
13:27
that we need them to lean in and
13:28
help us solve.
13:29
And they do such great work that I'm
13:32
very purposeful in always monitoring
13:35
what you've accomplished and celebrate it. So
13:38
professional shared governance is a nonnegotiable
13:41
related to retention
13:43
as well as understanding
13:45
the different generations that we lead in the
13:48
same infrastructure.
13:50
So
13:52
one of the things I would suggest for
13:53
all listeners and I've shared across the nation
13:56
as well as looking for nuggets of success
13:59
is what is best practice to teach our
14:01
leaders to leave five generations at once?
14:04
Because they really have to,
14:06
start to develop a generational
14:09
emotional intelligence on how to do that and
14:12
meet each generation where they are
14:15
related to their needs of balanced work harmony,
14:18
their needs on how they learn, whether it's
14:21
technical versus classroom,
14:24
how they process information is different from the
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generations.
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So one of the things that I think
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we
14:31
must always do as nurse leaders and clinical
14:33
leaders is never forget
14:36
that our that our direct management staff
14:39
must understand,
14:42
generation complexity
14:44
because they deal with it front and center
14:46
every day.
14:47
And, the evidence is still being gathered on
14:50
how to to lead our generation x,
14:54
teammates
14:55
and what their expectations
14:57
are.
14:58
So there's nothing we can do that's more
15:00
important
15:01
to our frontline leaders than to teach,
15:05
generation,
15:07
intelligence.
15:08
I appreciate that comprehensive overview for listeners of
15:12
those crucial components of retention, as you said,
15:15
shared governance, and then, of course, understanding different
15:17
generations. And then when it comes to recruitment,
15:20
it seems like really the speed and efficiency,
15:23
is key there. And I wanna ask a
15:25
quick follow-up on that seven day timeline you
15:27
mentioned.
15:29
What have you seen as the biggest perhaps
15:31
operational challenges or pitfalls that
15:34
are commonly blocking hospitals or health systems from
15:38
realistically hitting that timeline?
15:41
You've not taken the time to build infrastructure
15:45
that,
15:47
prompts you that you're falling out of the
15:50
seven day metric.
15:52
So
15:53
you really have to build the infrastructure
15:55
to fire alerts
15:57
that we have a candidate in the queue,
16:00
and we're approaching that deadline.
16:02
And what is the escalation
16:04
methodology
16:06
that the backup plan or plan b is
16:08
gonna kick in?
16:10
An example might be
16:12
if the manager nurse manager is out for
16:15
that day and a candidate
16:17
say they're on PTO for the week,
16:20
but we have a seasoned
16:21
nurse that's shopping for a certain specialty, but
16:24
the manager's out, then who is in charge
16:28
of their seven day cadence of decision making?
16:32
Don't leave that
16:34
such an important role unattended.
16:36
You gotta have backups,
16:38
and so does the recruiter.
16:40
Some hospital systems divide up recruitment by specialty.
16:44
So if someone's out for
16:47
emergency room recruitment,
16:49
who is the backup?
16:51
Because the talent is so precious
16:54
to health care organizations.
16:56
We cannot afford
16:59
to lose candidates just because someone is off
17:02
for the day or out on PTO, so
17:05
a backup plan.
17:06
And then you monitor
17:09
any fallouts. Treat them like
17:11
a never event that we should never have
17:14
lost a particular candidate because of our slowness.
17:18
So all fallouts must be
17:21
looked at,
17:22
measured, and solution for the next candidate.
17:26
Mhmm. That's incredibly incredibly valuable
17:29
advice for our listeners. And just speaking with
17:31
you, doctor walk Walker, you're such a, you
17:34
have such a wealth of knowledge and wisdom.
17:36
And looking at your career, I know, as
17:38
you said, you've led
17:39
large, complex, multi state systems
17:42
now really shaping,
17:44
your new flagship academic health system role at
17:46
UF Health.
17:48
As you're thinking about your current stage in
17:50
your own career, I'm curious how has your
17:52
leadership philosophy evolved?
17:54
What does it really take today for a
17:55
chief nursing officer to not just function as
17:58
a very important nursing leader, but really as
18:00
that strategic voice operating at the system level?
18:04
So I would say,
18:06
the strategic voice
18:08
right now
18:10
is constantly leaning in on outcomes, but even
18:13
stronger than outcomes
18:15
is talent pipelines.
18:18
So what I bring to the table strategically
18:21
is years of experience of successful
18:24
succession planning.
18:26
So not only where is our pipeline
18:29
of
18:30
talent entering our organizations? Where where are we
18:33
in our high schools
18:35
counselors?
18:36
Where are we with taking,
18:38
students that may
18:40
be considering entering health care? So that's the
18:43
front end pipeline.
18:44
What have we designed strategically
18:47
to grow future
18:50
health care workers? But then on the back
18:52
end,
18:53
what are we doing and what are we
18:55
building inside of our infrastructure
18:58
to do our own talent
19:01
navigation,
19:02
coaching, and counseling
19:04
for our current teammates
19:06
that are continuing to grow in the cycle
19:08
of entry inside of health care. So, strategically,
19:13
the voice of the chief nursing officer
19:17
is a,
19:18
balance of operational
19:21
expertise,
19:22
quality outcome
19:24
expertise,
19:26
and pipeline development that is
19:29
a, must have for strong retention metrics.
19:33
Well, doctor Walker, this has been this is
19:36
such a,
19:37
enlightening discussion. And speaking with you, it's just
19:40
clear you have helped us so lucky to
19:42
have such a
19:43
strategic passionate leader like you on their team.
19:46
So we're, so excited for you and your
19:48
new role and to follow along of all
19:50
the great work you're doing, and just thank
19:52
you for your time to join us on
19:53
the podcast today.
19:54
Thank you. There's no doubt in my mind.
19:57
I I'm the one blessed,
19:59
to be at UF Health, and I'm exactly
20:02
where I'm supposed to be during my final
20:04
season season as a chief nurse, leader. So
20:07
thank you.
20:08
Of course. Thank you again. And to our
20:10
listeners, thank you as always for tuning in.
20:13
You can find more podcast episodes by visiting
20:16
the Becker's Healthcare podcast page at beckershospitalreview.com/podcast.