Latest / Becker’s Healthcare - Clinical Leadership Podcast / Tim Plante, SVP & CNO at Midwest Division - CommonSpirit Health

Transcript

Tim Plante, SVP & CNO at Midwest Division - CommonSpirit Health · Becker’s Healthcare - Clinical Leadership Podcast

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  Thanks for listening. Now here's the episode.
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  Welcome everyone, to the Becker's Healthcare podcast series. I'm Ryan Mohammed,
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  writer and moderator Becker's Healthcare. Now,
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  I'm absolutely thrilled to have with me today, Tim pl,
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  senior Vice President and division Chief Nursing Officer at Midwest Division
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  Common Spirit Health. Tim, very nice to have you on the podcast today.
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  How are you?
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  I'm doing well. Thank you for having me.
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  Yeah, of course. Well, too good. It started.
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  Would you mind please introducing yourself and telling us a bit about your
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  background?
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  Absolutely. So I am the division, uh, CNO for the Midwest Division. Um,
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  and that's of Common Spirit Health, which, um,
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  is a national organization providing not-for-profit Healthcare, um,
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  across the country. Um, like you can tell by my title,
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  I am a registered nurse. I've been, so, um, for about 20 years now,
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  I got my start as an LPN for a short time before, you know, going on and, um,
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  getting, uh, my, my RN degree. Um, since then I've gotten, uh,
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  my BSN and then two masters. One, I have an MSN. Um,
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  and then I have an MHA as well.
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  I am originally from the West coast, so I, uh, was, uh,
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  raised in the Seattle area where I worked for, um, a,
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  the Common Spirit, uh, subsidiary, uh, the Franciscan Health System at the time,
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  um, where I sort of, uh, grew up as a nurse. I was an ICU nurse there.
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  And, um, where I then went into management where I was a clinical manager.
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  I worked in an ED as the director, um,
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  before I was the CNO of that hospital there. Back in 2016,
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  I decided to make a small move, well, maybe not so small to some folks,
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  but I moved to Nebraska from Washington State,
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  and I did that to take a role as a, a critical access hospital, um,
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  CEO. Um, so had a lot of learning there. And then, um,
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  was the chief nurse at St.
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  Elizabeth in Lincoln before moving into this division role, um,
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  with, uh, common Spirit Health in the Midwest division.
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  Wonderful, wonderful. Thank you so much for giving us all that insight.
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  Definitely sounds like you're busy.
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  So the first question I wanted to ask you is,
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  can you tell us about your most successful project or initiative from the last
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  year? What issues were you trying to solve and also what drove the success?
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  Absolutely.
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  So I believe from the bottom of my heart that if you are able to
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  engage your frontline staff,
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  and so these are the folks that are the clinical experts, um,
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  physicians and nurses and all the other, uh,
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  disciplines that contribute to the team,
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  if you're able to engage them and put decision making where I believe it needs
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  to be, which is with, um, your staff, um,
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  only good things come from that and you end up, uh, with more success, um,
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  than, say if you, um,
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  decide to do perhaps a top down initiative or something, um,
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  you know, where, where you don't rightfully engage, uh, those,
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  those frontline teams. And so to do that within our health system, um,
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  we have built a, uh, system, shared governance. And so just to give you an idea,
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  we are a 28 hospital system, um, where we operate in four states.
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  Um, and, and I saw the need to, you know, really, uh,
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  bring everybody together from a nursing perspective. We are only as good as,
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  um, as the team. And, um, we are often, in most cases,
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  the largest part of any hospital or hospital system, healthcare system,
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  workforce. And so at having a collective voice is a very powerful thing, um,
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  for, for nursing. So, um,
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  we created a system process where our hospitals have, um, councils,
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  the units on the hospitals have councils, and then we have a system council.
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  And, um, this is all consisting of frontline staff and they're able to, um,
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  participate in change management processes, but they're also able to, um,
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  bring the voice, um, of our bedside staff through this process, um,
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  all the way up to the system level where decisions are getting made. Um,
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  like I said, this, this really promotes frontline ownership and leadership,
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  right? And so you're able to, um, through the,
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  the different delegates that participate in this, you are able to build a, um,
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  you know, a, a network or a team, um, that also helps, you know,
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  identify your leaders of tomorrow. So as they start to,
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  to to work with other hospitals and bring their ideas to the forefront and then
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  actually see them get put into action, that's, that's very powerful.
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  So our system, uh, shared governance team has three different councils.
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  We have evidence-based practice and research. Um, that's one.
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  We have a professional practice group, and then we have a, uh,
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  team that works on, uh,
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  what we call triple our recruitment recognition and retention. Um,
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  and, and then these three teams have done so much,
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  we've seen changes to order sets, um, or processes in our EMR.
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  Um, we have implemented many different practice changes, um,
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  all the way from, you know, I, you know, how we, we do a,
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  a dressing change for a central line to, um, alcohol,
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  um, order sets, um, for alcohol withdrawal. Um, and,
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  and probably most our biggest achievement is the implementation of
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  a clinical ladder, um, which we affectionately called, uh, the PNAP,
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  and that stands for Professional Nurse Advancement Pathway.
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  This was literally created by a team of bedside nurses that saw a need for
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  professional growth, um, but they also saw a need for some sort of incentive.
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  And so, uh, through a yearly process, um,
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  our bedside staff can put in a, a package where they have to, uh,
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  participate in different professional activities from poster presentations to
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  research, to just, you know, attending your staff meetings and, and committees,
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  and you build a point profile and they can actually earn up to $4,000 a year,
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  uh, doing this. And so, um, we just had our second, um,
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  our second payout is happening this month, and so we're really proud of that.
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  And, uh, just so many different initiatives we've been able to bring, um,
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  you know, to, to the level of decision making and change that we're really, um,
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  organic in growth and, and, and the ideas belong all to our bedside staff.
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  Yeah, that sounds absolutely amazing. Congratulations on that success. Thanks.
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  As you know, the clinical workforce has changed a lot in the last few years.
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  What challenges are you still facing?
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  How do you see the clinical workforce evolving?
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  Yeah, it has been a very tumultuous few years, and, you know,
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  over the course of my 20 years in the profession,
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  I would say the last three have been the most challenging. And, you know,
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  for a long time we've been saying, you know,
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  if there's any constant in healthcare, it's changed. And I don't,
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  I don't know of any other time where that's been, um, more prevalent in our,
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  um, in our profession. Y you know, we are in a post pandemic, um,
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  period, um, c Ovid 19,
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  and how we took care of patients and how we addressed issues and how we
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  communicated really everything, um, that, that leaders need to be working on.
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  Um, the, the pandemic changed everything.
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  We lost a significant amount of our experienced nurses. Um,
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  evidence is still unclear as to why that happened, but, uh,
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  I know our researchers in the profession are working on it,
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  but opted out, opted out of nursing, opted to go do other things or, you know,
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  change careers or maybe just, you know, um, not be a nurse anymore.
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  And we saw a lot of our experienced nurses leave.
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  And so what, what that did is, um, you know, it, it two things.
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  Um, it, the wisdom and, uh, that, that,
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  that you get by being, doing this for many years, um,
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  is very important as you look at safety and quality of care.
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  And when you had so many of our experienced nurses, um,
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  decide to go do other things, you know,
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  we've been able to catch up with staffing, but our staffing workforce,
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  our nursing workforce is much, uh, much newer, much younger.
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  We've seen a significant decrease, um, in years of experience. And,
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  um, and, and that correlates to average age. Um, and,
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  and I'm really excited that we have a new, you know, uh, uh,
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  invigorated nursing workforce.
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  But I'm also very concerned that our experience level and our
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  knowledge, um, has, has taken a hit through, through this process.
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  And so, um, I think that the main challenge that we're facing,
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  um, as, as,
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  as nursing leaders and healthcare leaders is how do we equip this very
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  new, um,
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  in some cases inexperienced workforce with the tools and the processes
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  to still achieve safe outcomes for our patients? How do we,
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  um, achieve that high reliability, um,
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  organization that most of us are, are, are seeking? Um,
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  and, and so I, so, so this is evolving day by day. Um, right now,
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  I, I think the answer is we need to develop job aids, um, for these, um,
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  nurses and healthcare workers that can, um,
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  help make sure that you're thinking of everything. So this could be, you know,
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  best practice advisories and the EMR, um, checklists.
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  I think there's a lot of room for us to use more checklists in, in healthcare,
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  much like aviation has done, it really does result in safer outcomes.
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  We've struggled with that in healthcare.
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  We've struggled getting checklists to be a part of our day-to-day work. Um,
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  but most of what we do is evidence-based.
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  There is good signs behind it. If we would only follow a process,
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  it's when we deviate from that, when we forget things or we don't notice things,
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  you know, these small changes in our patient's conditions, um,
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  might go unnoticed because we might be skipping steps or we might be, um,
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  you know, focused on something else and not looking at the whole picture. So,
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  so our plan is to keep evolving our workforce, um, and,
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  and making sure that we're giving them the right tools, um,
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  that really doesn't substitute experience and wisdom. We have to rebuild that,
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  but we still need to keep patients safe. Um, so that's,
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  that's what we're working on.
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  Yes, definitely an important thing to work on always, um,
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  even throughout the year. So thank you so much for sharing that insight.
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  And Tim, before I let you go, the last thing I wanted to ask you is,
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  what is your best advice for aspiring physician and nurse leaders?
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  You know, there,
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  there's so much opportunity out there for physician and nurse leaders.
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  I think that, you know, over the years I've, I've, I've learned a lot,
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  but I continue to be humbled and, uh, every day as I, um,
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  you know, uh, engage in the team. So I, I, I, I have a,
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  I do have a couple of pieces of advice here.
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  So the first one is something I'm still working on every day, and that's to, um,
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  have a vision. We need to have visions, we need to share it with our teams.
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  Now our, our visions need to be aligned with that of the organization,
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  the mission and the values and our leaders, you know, uh, their visions.
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  But we need to be able to articulate where we're going, um, to our staff and,
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  and, and to all the folks that report to us, we need to be able to say why. Um,
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  because people will rally around that. Um,
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  it's important to have a very well thought out, um, strategic, um,
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  plan and vision so that, um, you know, provides the roadmap. And then of course,
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  uh, we may not be working on all the tactics, um,
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  depending on what level of leadership you're at. Um,
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  but constantly reinforcing that. So that's number one.
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  Number two is to place decision making as much as possible with the
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  frontline caregivers. Um, I will say this is, takes extra work.
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  It's much easier to make a top down, quick decision. Um,
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  and engaging more people can lengthen a process.
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  But every time that I make the decision, um,
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  to not engage our frontline staff and physicians, it always takes longer,
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  um, to, to get the buy-in. And it often, um,
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  fails because, because of just that,
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  that we didn't rally the right support and get the right advice.
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  Anyone can be a captain when the cess are calm, right? So I was in the Navy, uh,
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  many years ago, and when things are going well, um, it's just that, it's, it's,
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  it's not hard to be a leader.
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  It's when times get tough or you're faced with adversity where you really gotta
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  lean in, um,
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  rely on the vision of your leader and your own vision, um,
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  and get those frontline leaders, um, engaged and the frontline staff engaged.
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  And the last piece of advice I'd have is to be obsessed with safety. Um,
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  sometimes when you see something happen, for instance, patient falls,
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  when you start to see that happen over and over again, um,
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  or you know, that we miss counts in the or, or you know,
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  we're copying pasting in the EMR, all these,
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  these things that it becomes normalized, right? And so,
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  so you often kind of accept the fact that patients fall and get injured. And,
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  and, and I'm not okay with that. I think we need to be obsessed with improving,
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  um, the safety for our patients.
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  But that means you gotta pay attention and you gotta talk to people and you
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  gotta learn, um, where these safety issues are.
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  So somebody within the organization,
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  hopefully everybody needs to be obsessed with patient safety, um,
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  to make sure that it stays in the forefront.
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  Thank you so much for those final thoughts. Tim.
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  This has been an amazing discussion. So again,
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  I wanna thank you so much for coming on Beckers Healthcare,
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  and I look forward to connecting again with you soon.
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  Very good. I appreciate the opportunity.
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