Latest / Becker’s Healthcare - Clinical Leadership Podcast / Integrating Nursing Teams and Strengthening Care Transitions at Jefferson Health with Kate FitzPatrick

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Integrating Nursing Teams and Strengthening Care Transitions at Jefferson Health with Kate FitzPatrick · Becker’s Healthcare - Clinical Leadership Podcast

• 0:01
  Every year, Becker's annual meeting brings health care
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  leaders together to unpack the most pressing issues
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  facing the industry.
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  And every year, those conversations shift in profound
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  and unexpected ways. This April, more than 3,500
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  health care executives will return to Chicago for
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  Becker's sixteenth annual meeting.
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  elite speakers will offer new lessons, new case
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  studies, and predictions about what comes next. Join
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  us April 13 through the sixteenth.
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  For the agenda and event details, visit beckershospitalreview.com
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  and click on the events tab in the
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  upper right.
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  Hi, everyone. You are listening to the Becker's
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  Healthcare podcast. I'm Erica Carbajal with the Becker's
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  Hospital review team. And today, I'm very excited
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  to be joined by Kate Fitzpatrick,
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  chief nurse executive at Jefferson Health. Kate, so
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  happy to have you on today. Thanks for
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  being here. Oh, Erica, it's my pleasure. Great
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  to be with you. Yeah. Welcome.
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  Well, Kate, can you start off by telling
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  our listeners what your top priority as CNO
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  of Jefferson Health is this year? What's something
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  you're hoping to make some meaningful progress on
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  by year's end?
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  Yeah. I would say it's, it's always hard
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  to pick one top priority.
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  I would say it doesn't matter what year
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  it is. The top priority is always gonna
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  be safe quality personalized care.
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  But I would say given where Jefferson Health
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  is in their journey, we've recently expanded in
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  the last year and a half, and,
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  we grew from a 17 hospital health system
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  to now 33 hospitals.
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  And so one of the really important things
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  on the, horizon for the coming year is
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  to continue the horizontal integration work.
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  So really trying to bring together structures
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  across our 33 hospital systems so that we
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  can be as effective effective and as efficient
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  as we can.
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  And that's, there's a lot that goes into
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  that in terms of,
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  bringing people together, bringing teams together.
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  We have new geographies. So trying to make
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  all that,
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  come together in a meaningful way is, you
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  know, a a top priority for me.
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  Yeah. Sure. No small feat. A bit a
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  big merger there.
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  Okay. I know Jefferson has been doing a
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  lot of work to strengthen partnerships with federally
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  qualified health centers and other community organizations
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  to to help keep vulnerable patients connected to
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  care, especially with some
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  policy changes on the horizon that could increase
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  the number of uninsured patients.
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  I know I've talked to doctor Yahia quite
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  a bit about this, so I just wanted
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  to follow-up.
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  How are you thinking about that challenge,
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  particularly from a nurse leadership perspective?
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  And what role do nurses play in those
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  community partnerships and in helping patients stay connected
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  to the appropriate levels of care?
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  Yeah. It's,
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  it's such an important thing for us to
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  be thinking about. And, you know, one of
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  the things that we're really,
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  I think fortunate is the great,
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  partnerships and relationships we have in Philadelphia and
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  across Jefferson
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  with our federally
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  qualified health centers.
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  And one of the things I think about
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  is, you know, the patients treated at federally
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  qualified health centers,
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  you know, they flow in many directions, so
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  they cross multiple organizations within the Jefferson system.
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  And so we are cross referring all the
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  time.
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  And I see nurses as pivotal in the
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  journey of patients,
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  you know, outside the hospital, especially as they're
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  being treated,
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  you know, in in federally health, qualified health
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  centers,
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  and in our EDs. So thinking about things
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  like how nurses are critical in,
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  the communication and translation,
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  between settings to make sure that we have
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  the right level of reconciliation
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  and communication around care plans.
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  Nurses are exquisite around the relationships.
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  They,
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  they will understand probably at a deep level,
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  what patient's insurance status is and what that
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  means and what that might,
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  be restricting or enhancing about the things resources
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  they can access.
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  So I think they also educate patients, I
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  think, quite a bit about, you know, understanding
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  with, you know, some of the policy changes
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  you mentioned,
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  what might change at the patient level? What
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  might be new requirements around paperwork and things
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  that patients have to submit to access care?
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  So nurses will be a center point, I
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  think, in helping translate that to help patients
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  navigate that, help patients be attentive to the
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  things that are gonna be really important for
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  them to make sure they get the care
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  they need.
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  So I think it's,
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  you know, it's something that's top of mind
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  for me and and it's gonna continue to
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  evolve as as we, you know, as the
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  landscape evolves.
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  Yeah, Kate. I I think it's interesting too
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  to hear about
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  nurses' role in in the education piece, especially
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  with all of the the changes happening around
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  Medicaid and,
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  you know, so much of that could potentially
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  be logistical errors and and having nurses step
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  up and helping
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  patients navigate just the logistical side to to
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  ensure they can stay connected to their insurance
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  status, you know, if it is a logistical
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  issue.
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  Oh, you know, one thing, Sarah, I'll just
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  add there is we're fortunate as an enterprise
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  to have, you know, an integrated health system,
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  a health plan,
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  and a university
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  having access to the experts in our health
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  plan. One of the things we've talked about
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  recently is how we can bolster the education
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  we provide for nurses and nurse leaders about
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  understanding
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  insurance and understanding
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  the impacts to patients and how we can
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  better support patients given all the changes that
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  are in front of us.
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  Yeah. Certainly. It's important piece.
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  Kate, I wanted to chat with you too
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  about Jefferson's nursing seal team. I know it's
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  gotten a lot of attention just as a
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  way to reduce agency reliance while also supporting
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  units with less experienced staff. Been a really,
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  important effort over the past few years that's
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  shown a lot of great results that we've
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  covered. So as you scale that model now
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  with the integration with Lee Valley Health Network
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  across the 30 plus hospital system,
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  what are some of the biggest lessons
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  so far? And do you see this kind
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  of flexible workforce model
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  becoming a more permanent
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  feature of how health systems actually structure their
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  nursing teams?
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  Yeah. I think the seal team has
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  been just a remarkable
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  part of our work workforce optimization strategy, for
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  sure. And I think we've had many lessons
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  that we've learned over the years since we've
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  launched it. And and our relearning
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  and trying to,
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  leverage and remind ourselves as we grow into
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  the Lehigh Valley. But I think a couple
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  of things that I would say in terms
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  of lessons, one is just reminding
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  everyone about the clarity and purpose of the
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  seal team and this flexible workforce.
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  You know, they're really most effective,
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  when they are positioned as short term, more
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  stabilizing
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  resource and not a replacement for core unit
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  staffing. And I think that's been, you know,
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  an education point.
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  I think experience on that team matters as
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  much as the flexibility. So as we've looked
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  at our experience level across the system for
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  our registered nurses,
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  really, this,
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  ability to pair highly experienced nurses with
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  those units or those clinics or areas that
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  have a higher proportion of newer staff
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  is,
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  I think, a real benefit for us. It's
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  not just filling shifts. It's it's being able
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  to provide real time mentoring and helping to
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  model clinical judgment and reinforcing standards of care,
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  especially when units are under strain. So that
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  that's been a a real important lesson for
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  us that it's it's not just the flexibility.
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  It's the level of experience and prioritizing
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  how we deploy the team, I would say,
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  is really important.
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  And then we we've really tried to be
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  very responsive
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  to our regional chief nurses and our local
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  teams around
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  what they wanna see as we grow the
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  seal team or modify the the seal team.
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  And one of the things we've heard is
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  just
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  re
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  adjusting
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  the compliment of nurses that work off shifts
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  and weekends
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  and, bolstering some of the team in terms
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  of specialty backgrounds like critical care. So we've
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  certainly spent a lot of time to make
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  sure that as we think of the compliment
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  of that team, that we're
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  being responsive and addressing the things that are,
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  you know, the people that we're serving really
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  need or or see as their their top
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  priorities.
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  Yeah, Caitlin. I imagine that just, you know,
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  being so intentional with the experience level of
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  nurses who are on that seal team goes
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  such a long way and and also helping
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  improve engagement among
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  newer nurses and and confidence and being able
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  to have that at the bedside, especially in
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  units where a good portion of staff are
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  novice nurses.
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  Absolutely. I I right now across our system,
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  roughly fifty five percent of our nurses are
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  less than five years experience, so that's really
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  significant. And so we're really intentional as we
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  think about
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  system wide strategies like the seal team to
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  consider that and how do we support retention,
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  how do we help those nurses to thrive.
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  You know, and and ultimately, it's about supporting,
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  you know, safe patient care. So it it's
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  been a tremendous resource for us.
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  Yeah.
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  Kate, one of the things too that recently
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  in the last few months, I feel like
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  has increasingly come up in conversations, especially with
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  clinical leaders, chief nursing officers, and medical officers,
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  are just breakdowns in the transition from hospital
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  to the next point of care as a
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  growing challenge. So whether it's related to timely
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  follow-up or medication access,
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  those communication
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  breakdowns
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  seem to be a growing challenge.
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  Where do you see the biggest gap today
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  between discharge and the next touch point in
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  in in care in a in a patient's
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  care, and how can nursing maybe help close
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  it?
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  Yeah. It's such a great question. And I
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  also have
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  care management as part of my portfolio for
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  this system. So I I spend a lot
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  of time thinking about this exact question.
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  I think there's a number of things where
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  I see see big gaps. One is education.
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  One is communication.
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  I would say follow through. And the last
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  is really,
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  our ability to meet patients where they are.
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  And as I think about those things,
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  I think nurses play a tremendous role in
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  helping us close those gaps.
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  So thinking about unique roles for nurses, for
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  example,
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  transitional care nurses, nurse navigators who can help
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  with appointments,
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  follow-up,
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  tracking,
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  plans after discharge and making sure patients are
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  adhering to those, keeping the connection between primary
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  care specialists and helping coordinate that for patients,
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  tracking, you know, patients that are at higher
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  risk after discharge.
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  And then, you know, just more operationally and
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  concrete building into the the whole discharge process,
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  making sure that
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  we have
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  people, particularly nurses, play an important role here
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  leading post discharge charge follow-up call,
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  calls to make sure that we're clarifying discharge
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  instructions. People understand the medications they're on. They
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  know the the signs to look for for
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  any complications
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  that might come up. And how they can,
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  avoid,
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  unnecessary
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  or avoidable emergency department visits.
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  So those are all things that I think
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  nurses play a critical role in. And then
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  I think, you know, one of the things
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  in particular that we've seen that's a challenge
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  is really in the whole realm of medication
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  reconciliation.
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  You know, we have patients that are on
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  lots of medications, some complex medications.
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  So really making sure that we support patients
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  to to understand their medication regimen.
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  They have the right access to the medications
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  they need and helping them connect the resources
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  if they don't.
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  So there's a lot of things. And I
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  would say the last thing is in the
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  comment I made about meeting patients where they
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  are,
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  I do think,
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  we will continue to leverage technology,
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  things like remote patient monitoring,
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  helping patients use patient the patient portal,
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  coordination of telehealth,
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  connections,
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  And nurses can play and do play a
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  critical role in helping patients navigate that, but
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  it also helps us meet patients where they
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  are. So so those are the some of
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  the things I've thought about around
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  care management, some of the gaps we're continuing
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  to close.
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  Yeah. Definitely a multi pronged approach there. Yeah.
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  Kate, to close us out, what's one policy
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  shift or workforce trends you believe could have
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  the biggest effect on the nation's nursing workforce
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  in the next three to five years? Maybe
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  something leaders should be paying closer attention to
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  right now.
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  You know, I again, this is it's hard
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  to think of just one, but I would
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  say that one of the things that we've
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  kept a close eye on is is, you
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  know, the workforce. Obviously, we've made tremendous strides
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  at Jefferson around
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  our workforce,
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  but we have to stay vigilant about the
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  workforce moving forward. And it really, it's sustaining
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  the workforce gains that we've made, but we've
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  gotta continue to redesign the model. So what's
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  the care delivery team around the patient,
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  given the projections we know in terms of
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  of longer term pipeline
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  for nurses, for patient care techs, for certified
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  nursing assistants? So looking at at the teams
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  around the patients and saying we're gonna have
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  to continue to redesign what that looks like.
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  And I think, you know, the the strategic
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  question is no longer how many nurses are
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  needed, but, really, it's more about how nursing
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  work is gonna be optimally designed and deployed.
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  And
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  so I think that's something we're all gonna
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  have to continue to pay attention to. And
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  there's so much,
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  I think, exciting,
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  things that are on the horizon around workforce
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  in terms of, how we're already using hybrid
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  virtual roles,
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  how we've done some really creative work on
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  redesigning,
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  and upskilling
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  patient, people who are patient facing on our
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  teams right now. So I think that that's
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  all gonna continue.
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  I think we're gonna see more around,
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  exciting enhancements, tech enabled care,
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  things like ambient listening that's gonna help our
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  clinicians,
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  be more efficient and effective and take away
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  some of their task burden. So I think
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  for me, it's really gonna be about the
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  workforce gain, sustaining those, and continuing to redesign
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  the model as we move forward.
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  Yeah, Kate. I I think so spot on.
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  I know we just, one of my colleagues
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  just covered a story sort of similar just
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  looking at workforce strategy and touched on a
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  lot of this just in terms of redesigning
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  the care delivery model. Like, the workforce strategy
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  has really shifted away from
• 15:02
  hiring
• 15:03
  and kind of competitive
• 15:06
  competitive hiring and more so how do we
• 15:08
  ensure that the folks we have are practicing
• 15:10
  at the top of their license. We're utilizing
• 15:12
  technology to the best of our ability and
• 15:14
  and reducing that reliance on contract
• 15:17
  work as well. So really interesting points there.
• 15:20
  Well, Kate, thank you so much for joining
• 15:22
  me on the podcast today. Really appreciated your
• 15:24
  time, and I know our audience will appreciate
• 15:26
  your insights.
• 15:28
  Oh, it was great. Thank you so much,
• 15:29
  Erica.