Latest / Becker’s Healthcare Podcast / John Voight, Vice President and Chief Nursing Officer at Memorial Hermann The Woodlands Medical Center

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John Voight, Vice President and Chief Nursing Officer at Memorial Hermann The Woodlands Medical Center · Becker’s Healthcare Podcast

0:02
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Hi, everyone, and welcome to the Becker's healthcare
0:35
podcast.
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I'm Mackenzie Dean, associate vice president and managing
0:39
editor of Becker's hospital review.
0:41
Today, I am so excited to be joined
0:44
by Jon Voigt, who's the vice president and
0:46
chief nursing officer at Memorial Hermann The Woodlands
0:49
Medical Center in Texas.
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Jon, thank you so much for being here.
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How are you doing? I'm doing great. Thank
0:55
you for having me.
0:57
Yeah. Excited to have you.
1:00
I was hoping you could kick us off
1:02
by just sharing a little bit more about
1:03
yourself and Woodlands Medical Center for anyone who
1:06
might not be familiar.
1:07
Yeah. So I appreciate the invite. And,
1:10
as you said, my name is John Voigt.
1:12
I'm the vice president, chief nursing officer at
1:14
Memorial Hermann, The Woodlands Medical Center.
1:17
Our campus is a 465
1:20
bed level two trauma center in the Northwest
1:22
Houston area,
1:23
And I have about 1,300
1:25
nurses that report to me.
1:27
The Woodlands medical center is one piece of
1:30
the Memorial Hermann health system,
1:33
which has been in the community for one
1:34
hundred and seventeen years. So quite a long
1:37
longevity.
1:39
To give give you a sense of scale,
1:40
it's 34,000
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employees, 14,000
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nurses,
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over 4,400
1:46
inpatient beds and 260
1:48
plus care sites in the community.
1:51
And I think that, you know, we we
1:54
recognize the value and the importance of giving
1:57
back to our community. So we've given back
1:59
$470,000,000
2:01
to the community last year. So that's a
2:04
integral part of what we do.
2:06
As a doctorally prepared,
2:08
nursing leader, my background is a bit different
2:10
than most CNOs.
2:12
I've had the fortune to serve in the
2:13
military,
2:14
and
2:15
the beginning of my my life,
2:18
worked in law enforcement, and then I spent
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all my clinical years as an emergency nurse
2:24
and trauma nurse.
2:26
I think it's important to note that each
2:29
chapter that I've been through,
2:31
has taught me about leadership, crisis response, and
2:34
taking care of people under pressure.
2:36
My focus now is on translating innovation into
2:39
practice, taking what's emerging in health care and
2:41
making it work in real clinical settings because
2:43
that's always a challenge.
2:45
But I'm glad to be here.
2:48
Glad to have you, and I appreciate appreciate
2:50
you sharing a bit more about your background,
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and thank you for your service, first of
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all.
2:55
Curious, can you talk more about those past
2:57
chapters in your lives? How has that shaped
2:59
your approach to leadership and your chief nursing
3:01
officer role today?
3:04
Well, I think, you know, there's a lot
3:06
of of,
3:07
challenges in health care now. And I would
3:09
say, specifically,
3:10
one of the the areas that I'm focused
3:13
on is workplace violence.
3:15
I think that
3:17
the not only post COVID, but just the
3:19
the
3:21
challenges
3:22
around,
3:23
mental health and access to services for mental
3:26
health and those kinds of challenges.
3:28
I think that it's,
3:31
caused a,
3:33
an increase in workplace violence events within our
3:36
organizations, both on the inpatient side and, the
3:39
outpatient sector.
3:41
And I think my background
3:43
in,
3:44
law enforcement and the military really helps to
3:48
understand that along with my ER experience because
3:51
the predominant
3:53
volume of incidents occurs in the emergency department,
3:57
especially the most egregious ones.
4:00
So I think those
4:02
those opportunities that I've had in the past
4:04
really have contributed,
4:07
holistically
4:08
to the to the ability to look at
4:10
these challenges,
4:12
around workplace violence
4:13
and and what we're doing to mitigate,
4:16
harm to our patients and to our staff.
4:20
I know that's such a crucial focus area
4:22
for so many clinical executives in so many
4:24
hospitals across the country.
4:26
How, specifically are you looking at Memorial Hermann,
4:29
The Woodlands Medical Center of, you know, tackling
4:32
some of that workplace violence or improving prevention?
4:36
Yeah. We've kinda taken a different approach. I
4:39
think,
4:40
you know, our system we've been very fortunate
4:42
that the system recognized the need to start
4:45
this about three to four years ago.
4:47
And,
4:48
what I call our workplace violence,
4:50
prevention strategy one point o really focused on
4:54
infrastructure support
4:56
with security enhancements, you know, increased security officers,
5:00
weapons detection systems, things like, tasers and body
5:04
worn cameras
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and virtual training for our security officers,
5:09
really focusing on making sure that we had
5:12
the resources in place to respond when we
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had one of these events.
5:17
Now we're working on,
5:19
what we call workplace violence two point o,
5:21
which is our clinical response to these situations.
5:25
You know, how we provide care can often,
5:29
change the trajectory
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of the patient's response. And,
5:34
so I spoke specifically of our mentally ill
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population.
5:39
And we're taking a pretty good approach at
5:42
at looking at this,
5:45
from a multi angled lens
5:47
with all of the the care providers, whether
5:50
that's psychology, psychiatry,
5:52
ER physicians, ER nurses, techs, security guards,
5:57
and figuring out how do we provide better
5:59
care to mitigate workplace violence. How do we
6:02
get patients
6:03
in a stable situation,
6:06
that they don't deescalate
6:08
as often as they currently do. And it's
6:11
a challenge because many of the mentally ill
6:13
patients,
6:14
can't get services out in the community, so
6:17
it's that connection to care,
6:19
and or they take medications and they stop
6:22
taking them because the side effects are challenging
6:24
and
6:25
they decompensate. So
6:27
that's our that's our approach right now is
6:29
looking at how can we how can we
6:30
improve the standard of care for certain populations
6:33
to
6:34
to reduce the number of incidents of workplace
6:37
violence proactively instead of reactively.
6:40
Mhmm. Really looking a lot farther upstream and
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recognizing that that higher standard of care can
6:45
hopefully prevent some of the need to even
6:47
deescalate situations if they're not escalated to begin
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with. Absolutely.
6:51
That makes sense.
6:52
Well, I'm I'm chatting with you, at the
6:55
2025,
6:56
which is, in a way hard to believe,
6:58
and I think that's always a nice time
6:59
to look back
7:01
on the past year and do some reflection.
7:03
So it's clear you've made some important progress
7:06
on workplace violence. I'm curious, are there any
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other initiatives
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or efforts over the past year,
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that you're particularly
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proud about? And if so, can you tell
7:15
us a little bit more?
7:17
Yeah. I think that, you know, as we
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talked about workplace violence is always a hot
7:20
topic and that's top of our list. But
7:23
I I one of the other things that
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we've done recently,
7:26
at The Woodlands Medical Center specifically
7:29
is we had,
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initiated what we call our community paramedicine program,
7:35
that's targeting our CHF readmissions
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specifically.
7:39
The concept's pretty straightforward,
7:41
but execution required a lot of thoughtful planning.
7:45
And and instead of waiting for patients to
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deteriorate at home and end up back in
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our EDs,
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we're focused on sending our trained paramedics into
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their homes post discharge
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to ensure that they stay on track,
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for that post or post discharge period of
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time.
8:03
I I would add these paramedics aren't just
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checking vital signs and and those kinds of
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things or just doing nice visits.
8:09
They're really assessing their fluid status, reviewing their
8:12
medical medication adherence, making sure they've received their
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medications from the pharmacy,
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talking to the patients, building relationships with them
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where they they establish trust and respect,
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where these chronically ill, somewhat non compliant patients,
8:28
in many cases,
8:31
will follow the direction of the paramedic. And
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this has been really critical for us, to
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get them to comply.
8:38
And and we've had great success so far.
8:41
Mhmm. That's such an interesting program to hear
8:44
about. Sounds like
8:46
really helping improve care coordination and and patient
8:48
engagement
8:49
outside of the hospitals.
8:52
Are there any specific results you can share
8:54
whether qualitatively
8:55
or or quantitatively that, you've seen the benefits
8:58
of the program so far?
9:00
Absolutely. I I think, early indications
9:03
show that we're reducing our readmissions pretty substantially.
9:07
We're reducing our length of stay for these
9:09
patients in the hospital as well.
9:12
I think what what matters for this population
9:15
is that we're meeting patients where they are.
9:17
We're not
9:19
forcing them to come to the bricks and
9:20
mortar, you know,
9:22
offices or inpatient areas as much as they
9:26
might have had to in the past.
9:28
We're trying to reach out and extend that
9:31
care where they're at. Because
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specifically the the chronically ill non compliant patients,
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they tend not to seek
9:39
post discharge care with their primary care providers
9:42
or with their cardiologists as much, and then
9:44
they wait and wait and wait and then
9:45
they de compensate requiring an admission back to
9:48
the hospital to get tuned up again.
9:51
And so our paramedics are able to intervene
9:53
and keep them on track
9:55
through positive reinforcement
9:57
and, education
9:59
and helping them with, you know, getting weighed
10:02
every day and and just a lot of
10:04
motivation. So that's through discharge calls. You know,
10:07
they call them every two or three days.
10:09
They go out to the house to check
10:10
on them. And I think that's the that's
10:12
the key is making sure that you establish
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a positive,
10:15
trusting
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relationship
10:17
that,
10:18
that the patients feel like I have a
10:20
friend, I have an ally that's not gonna
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judge me, that's not going to beat me
10:25
up and tell me I gotta go to
10:27
the doctor, I gotta go to the doctor.
10:28
That, you know, you're gonna listen. And,
10:31
and recognize that how can you take care
10:34
of me at home when I'm not gonna
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go to the doctor? How can you keep
10:38
me optimally,
10:40
healthy as much as you can where I
10:43
wanna be?
10:45
Mhmm. It all sits on that trust with
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the the care provider. Right? Absolutely.
10:51
I'm curious how how did the hospital land
10:53
on paramedics as being the right role,
10:56
to do this work as opposed to say
10:57
a community health worker or a nursing role?
11:01
Yeah. It's a great it's a great question
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because,
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you know, nurses practice under the nursing model,
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and we take orders from physicians.
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And
11:11
and that's great in an acute care hospital
11:13
where you have access to physicians regularly who
11:15
come in and write orders and, and then
11:18
you execute those orders. That's great.
11:20
Community health workers on the other hand are
11:22
unlicensed
11:23
personnel,
11:24
who can't do assessments and they can't,
11:27
take orders or implement those orders, they can
11:29
go and do basic things for patients like
11:31
clean their house or help them, you know,
11:34
move around the house, get dressed and, you
11:36
know, activities of daily living, things like that.
11:39
But when it comes to the clinical window
11:41
or the clinical picture of the patient, it's
11:42
much more challenging.
11:44
Paramedics operate in a in a different model.
11:47
They practice under the medical model.
11:50
And, and they're
11:53
really directed by clinical protocols approved by a
11:56
medical director. And so
11:59
you can create protocols that the medical director
12:01
signs off on that says you can do
12:03
these things for this, for patients that present
12:06
with this criteria.
12:08
And so if you go to somebody's house
12:09
and they've gained four or five pounds of,
12:12
you know, overnight,
12:13
you can administer,
12:15
forty milligrams of Lasix,
12:17
orally to the patient without having to call
12:19
the doctor or do anything. You just document
12:22
it as a protocol order if it's in
12:24
your protocols. So it really is helpful because
12:27
paramedics have,
12:29
assessment skills. They have clinical knowledge. They often
12:32
will go get these patients when they've decompensated
12:35
and now they are acutely or critically ill.
12:38
So for them, it's been tremendously rewarding because
12:41
they get to go see these patients before
12:43
they get to that, to that point. And
12:45
they're able to keep them healthy,
12:47
as much as possible
12:49
without having to be brought back into the
12:51
hospital. But the paramedic is a unique role
12:54
because it does allow us to do a
12:56
little bit more
12:57
out in the field than we could could
12:59
with a nurse or with a community health
13:01
worker.
13:02
Yeah. It seems like there's some natural efficiencies
13:05
there. That's really interesting.
13:07
Well, let's look ahead now to 2026.
13:10
What are some of the big priorities
13:12
on your radar for the year and some
13:13
of the headwinds that you're thinking about?
13:16
Yeah. Well, it's pretty exciting because,
13:18
not unlike a lot of our,
13:21
colleagues across the country,
13:24
probably our biggest priority is implementing a comprehensive
13:27
virtual care delivery model.
13:29
And, you know, really trying to take the
13:31
time to nail the integration of technology into
13:33
nursing and clinician workflows.
13:36
This is gonna be a challenge,
13:38
as we've talked, with our colleagues across different
13:42
hospital organizations
13:43
or health care organizations
13:45
that, there's no road map for this. There's
13:48
no there's no manual or or,
13:51
toolkit.
13:52
You've gotta kinda figure it out and figure
13:55
it out for what works best for you
13:57
and your organization. And so that's what we're
13:59
gonna be challenged with.
14:02
But it's not about technology just for technology's
14:04
sake. It's about using virtual nursing,
14:08
ambient technology, and other tools to extend our
14:11
reach while keeping care personal and high quality.
14:14
The challenge is doing this in a way
14:16
that clinicians actually embrace it rather than resist
14:19
it because,
14:20
you know, they they don't see things,
14:23
the same way we do necessarily because they
14:25
don't have access to all that latest and
14:26
greatest information.
14:29
Mhmm. Absolutely. And I think it's
14:31
thinking about that, t team member buy in
14:33
is such a crucial piece of it.
14:35
Where are you in the in the timeline
14:37
of rolling that out? Do you have a
14:39
tentative date, or or what's the process like
14:40
right now? Yeah. We're we're in the process
14:43
right now, and we've already got vendor selection.
14:45
And we are we have,
14:47
you know, project team working on it. We'll
14:49
be rolling hours out at the Woodlands Medical
14:52
Center somewhere in the first quarter,
14:55
first or second quarter of this upcoming year.
14:58
That's so exciting. And then I know you
15:00
mentioned the first virtual nursing component.
15:03
Are are there specific
15:05
units or specialties
15:07
that you're planning to launch first for virtual
15:09
care?
15:10
Well, we're looking at our medical surgical units
15:13
first,
15:15
because we think that has the biggest opportunity.
15:17
And,
15:19
before we roll it out into the more,
15:22
critically ill units or ICUs, we want to
15:24
be able to get it hardwired and to
15:27
figure it out,
15:29
in the med surge area where we have
15:31
a little bit more time to,
15:34
to work with the patient and the families,
15:36
in making this work.
15:40
That makes sense. And
15:41
I know oftentimes with rollouts like this, it's
15:44
so crucial to to hear from the frontline
15:47
stakeholders what sort of processes you have in
15:49
place to sort of get their feedback or,
15:51
guidance on on how to roll it out?
15:55
Yeah. Well, I
15:56
it's it's a challenge. We're starting that now,
15:59
and we've actually started it maybe six months
16:02
ago. And and I call it planting seeds.
16:04
Right? We
16:05
We talk about the evolution of healthcare and,
16:09
you know, it's probably one of the hardest
16:11
challenges we have coming up,
16:14
is change management. And I think when you
16:17
look at change management with highly educated credentialed
16:20
clinicians,
16:22
you know, they they
16:24
are somewhat resistant. And, and I say that
16:27
with complete respect because they're really brilliant people
16:30
who spent years honing their expertise, and they've
16:32
done it a certain way, and they've gotten
16:34
good results.
16:36
But I think that, you know, we're asking
16:38
them to adapt to an entirely new health
16:40
care delivery model,
16:42
driven by technology and,
16:44
things like AI assisted decision making. You know,
16:47
we're talking about wearable monitoring devices in the
16:49
future.
16:51
As I mentioned before, ambient technology
16:53
that documents while,
16:55
documents our,
16:57
clinical notes while we're providing care.
17:00
And then of course, the virtual care platforms.
17:02
The tools have a lot of potential,
17:05
but they also require the clinicians to trust
17:08
systems,
17:09
that work differently than what they've known for,
17:11
for decades. In many cases,
17:14
I think the hard part isn't the technology
17:16
itself. I mean, we talk about the implementation,
17:18
whether that be installation of,
17:21
hardware,
17:23
and workflows and developing all of those things.
17:27
It's helping experienced professionals
17:29
see these tools as enhancements to their practice
17:32
rather than threats or just more things to
17:34
learn. They don't want more work.
17:37
And,
17:38
I think it's gonna require a lot of
17:39
patience,
17:40
demonstrating value through real outcomes and genuinely listening
17:44
to their concerns. You can't mandate buy in.
17:46
You have to earn it. And I think
17:48
that's what we're trying to do now is
17:50
really just,
17:51
as I said, plant these seeds of of
17:53
information
17:54
to the team to say, hey, what about
17:56
this? What if what if we change the
17:59
the
18:00
team model? You know, we have primary nursing
18:03
models right now,
18:05
and nursing mostly across the country. Some have
18:08
adapted to a team model,
18:09
which is what we did back in the
18:11
seventies and eighties. And, that's where we use
18:14
RNs and LVNs or LPNs.
18:17
And,
18:18
and now we're, we're looking at a virtual
18:21
care delivery model.
18:22
So that's going to take time for people
18:25
to adapt to and to understand what does
18:27
that look like and to also understand that
18:30
the goal isn't to,
18:32
to reduce staffing, but to improve
18:36
the utilization or the integration of technology
18:39
and virtual care into the care we provide
18:41
now.
18:43
And often cases, you know, I look at
18:45
this as
18:46
keeping nurses to practice at the top of
18:48
their license,
18:50
which means let's offload some of the things
18:52
that they don't really like to do, like
18:54
the admissions and discharge documentation and the electronic
18:57
health record.
18:59
It makes sense to have,
19:00
a virtual nurse do that work for you
19:03
where you can be at the bedside providing
19:06
hands on care to the patient,
19:08
which most nurses thrive on. So so I
19:11
think there's it it's just how we talk
19:13
about it and how we how we communicate
19:16
the purpose, the intent behind it. We're not
19:19
trying to eliminate positions. We don't wanna eliminate
19:21
positions. We don't want to,
19:24
to impede nurses in delivering care. We wanna
19:27
enhance it. We wanna make it better
19:29
where nurses are actually at the bedside holding
19:32
hands of patients and giving them education about
19:34
their diagnosis and about their medications
19:37
and comforting them at the end of their
19:39
life or their loved one's life
19:42
and really doing what they do best,
19:44
which is not necessarily in the patient's chart.
19:48
Mhmm. It's clear you're being extremely thoughtful about
19:51
this rollout and how it will
19:53
have immense benefits for both your own nursing
19:56
workforce and patients alike. So, John, I so
19:59
appreciate you sharing
20:01
a bit of a glimpse into what's to
20:02
come in 2026
20:03
and taking some time to
20:05
celebrate some of your wins from the past
20:07
year at the Woodlands Medical Center with us
20:09
on the podcast. It's been so nice talking
20:11
with you. You too. Thank you so much.
20:13
I appreciate it. Thank you. I appreciate it.
20:15
And we're looking forward to seeing you at
20:16
the annual meeting in April. Sounds good. Excited
20:19
to be there. Thanks. Alright.
20:21
Bye bye, John. I hope you have a
20:22
great rest of your day. Thank you. You
20:24
too.