- Welcome everyone to the Becker's
Healthcare podcast series.
I'm Ryan Mohammed, writer
and moderator with Becker's Healthcare,
and I'm absolutely thrilled to have
with me today Dr. Elizabeth Adams, chief Nurse executive
of HCA Health Trust and President of Match Healthcare.
Doctor, it's very nice
to have you on the podcast today. How are you?
- I am doing great.
I am so honored to be here with you today,
and I really appreciate you
and our good friends with Becker's
Healthcare for this invitation.
And thank you for all the great work
that you do to support healthcare.
- Oh, thank you so much.
We absolutely love doing it
and love talking to people just like you.
Um, so to get us started,
would you mind please introducing yourself
and telling us a bit about your background?
- Sure. Thank you. So I'm Dr. Elizabeth Adams,
and, um, as Mariah mentioned, I'm the president
of Match Healthcare, which is a healthcare consulting firm,
and I'm also a Chief nurse executive with health, uh,
HCA Health Trust.
And, um, it's a, it's been a blessing to serve in healthcare
for almost three decades.
Um, you know, I started when I was 10 years old.
the seriously, um, on a serious note, um,
I've been in healthcare for three decades.
Uh, half of my career was spent in a very large
academic healthcare organization in Texas where I served
as a trauma and ER nurse,
and then, um, progressed into management.
Um, I think at the University of Texas,
I developed a strong foundation for evidence-based
clinical practice, research and professional development.
And, um, practicing
and leading in a magnet recognized organization, uh,
taught me early on the power of having a great culture
with highly engaged caregivers.
Um, over the course of my, uh, career journey,
there's been key opportunities
where I was given the opportunity to grow professionally
and impact care delivery.
I served at a large health system, um, the,
actually the University of Texas where I was promoted
to lead their internal staffing agency.
And in that role, I was able to utilize my business,
financial and clinical skills to grow that business,
expand services across Texas, um, increase the scope
of the services we provided,
and we, um, pretty much eliminated all contingent labor.
Um, and then I was given the opportunity to serve
as a healthcare executive in something really unique.
It was a public healthcare district, um, where I served
as a chief nurse and implemented programs
around reducing readmissions,
addressing social determinants of care.
I worked with utilization management
and really learned, um, about value-based care.
And Mariah, as you know, rural healthcare is an a, a
challenging environment, but yet very, very rewarding.
Um, I felt like I was, uh, really connected to my purpose.
I ended up advocating for rural health at the local, state
and national levels, and then really learned the value
of creating community
and partnerships with academic organizations
and, um, uh, professionals in our industry
as well as businesses.
And, um, and so really to improve access, uh,
work on workforce development and, um, recruitment.
And then I also have served as a chief nurse
and COO where I learned about operations, capital,
equipment expansions.
And then, uh, most recently I served
as a chief nurse executive for one
of the largest hospitals in Southern California
and the busiest er in, uh, Los Angeles County.
And this was the third time that I led teams to Magnet.
And, uh, we just had a really great culture.
Um, we, uh, when I started,
we were last in our total performance ranking,
and then when I left that organization, we were, uh,
at the top ranking for our large hospitals.
And, um, and then we just, um, we had an amazing culture.
Like I said, we achieved magnet,
and so I've had a really unique opportunity
to serve in diverse organizations
and, um, have served at the national level
for the American organization nurse leaders,
and then have served on the board
of the Healthcare Business Women's Association.
So just really blessed to have those experiences.
- Yeah, absolutely.
Uh, thank you so much for sharing your background with us.
And if you started at 10 years old,
I'll definitely interview you every day
because I'm sure you would have the best stories.
Um, would you be able
to tell us about your most successful project
or initiative from the last year at HCA?
What issues were you trying to solve
and also what drove the success?
- Sure. You know, I'd like to, I'd like to share with you,
um, maybe one of the major initiatives in the last year,
and it wasn't necessarily with HCA,
but um, with another organization
and, um, it was in reducing, um, harm to our patients
and improving our quality outcomes.
Uh, my brother died
of a hospital acquired infection at the age of 34,
and so I'm very passionate about keeping
our patients safe from harm.
Um, our teams were able
to reduce healthcare associated infections by 44%,
and we reduced falls by 35%.
We did this by implementing a model called the Healthcare
Restoration Design Model, and it's a high reliability model.
Our, um, the, the other thing too is that they were able
to do that because we had such a strong professional
governance culture in place, more than 10 to 20%
of our workforce were committed
and dedicated to improving quality outcomes
and finding root causes.
So, um, we also utilized relationship-based care concepts.
Um, for example, we, uh, started every meeting
with a patient story,
and when we reviewed our cases, uh,
the team members would present the case first
by showing a picture of the patient, calling the patient
by name and sharing something personal about the person.
And so, um, we really had some great outcomes when it came
to reducing hospital, uh, associated harm.
And then, um, we know when patients stay in the ER
or in the hospital too long, uh,
that can negatively impact their quality outcomes.
So we, we, those teams put together an air traffic control
center to optimize flow.
They also were very adamant that they wanted to try a, a
hospitality center, which was a discharge lounge,
and nine times outta 10, those don't work.
But, um, but they really wanted to do it,
and I think it's important that we let,
let our teams try sometimes,
and they, they proved that it could work.
They shaved about 30 to 40 minutes off discharge time.
So I think all of those things, um, helped us to deliver
high quality, efficient,
and, uh, compassionate care to our patients.
- Wonderful. Absolutely wonderful.
Thank you so much for sharing that insight.
As you know, the clinical workforce has changed a lot
in the last few years.
What challenges are you still facing
and how do you see the clinical workforce evolving?
- Sure. You know, that's a great question.
Recruitment and retention is still an opportunity.
You know, I was fortunate that our turnover, um,
has been 6.9% compared to a national benchmark of 22%.
But, um, there are areas where it's still a big challenge.
You, you, you might be able to even recruit nurses in,
but how do you keep 'em, especially with an aging workforce,
um, early retirement,
and then people just wanting to leave the bedside
because they're still burned out
or they're advancing their education.
And so it is a really big challenge.
Um, I think through covid we've learned a lot,
and if we look at team nursing models,
and not all models may fit the same
or you know, the same for each organization,
but if we look at team nursing models, we learned
that there are other skill sets
that can help us take great care of our patients.
And the more that we work together as a team,
the more effective we can be.
Um, it also, you know, when you have a team nursing model,
it also allows the RN to practice
at the highest extent of their license.
And, um, and then, you know, when we look at technology,
can we utilize virtual nursing to do, do some
of those things that the RN at the bedside does not
necessarily have to do?
Can we do patient education on admission, um,
health assessments where we're gathering health history
and discharges discharge information?
So I think we, we need to look at, um, recruitment
and retention and other models.
Um, the other thing that I think that we, you know,
is a challenge is we've got a lot of, uh,
rapid fire changes in technology.
And so as we look at care delivery, how can we embrace
and leverage technology, uh, to allow us
to be more efficient, um, to lean up our work?
And, um, and also how do we leverage technology
to allow the patient to be the driver of healthcare?
So I, I think that's gonna be a big challenge.
You know, especially when we look at, um, chat GPT,
we look at robotics
and workplace safety to keep our caregivers safe,
and then we look at robots in healthcare and organizations
and, um, how can we leverage those things?
So, so I think those are definitely challenges.
The other thing I wanna mention is physician recruitment.
Our, I I, I'm concerned about our physicians
and burnout as well, and recruitment for physicians
because it's been challenging,
especially in rural healthcare, to recruit nurses
and doctors and then to retain them.
So I think we need to create environments and,
and be better at, um, those, uh,
providing those environments
where people feel valued and appreciated.
Um, they're treated like owners in the operations of the,
um, the hospitals and, um,
and that we're really, um, supporting equity diversion
and inclusion because we know that when we do that,
we become better leaders, um,
and we provide better care to our diverse populations.
So I think those areas are still challenges, um,
but we're making progress,
but we need to keep those areas as a priority, you know,
over the next five to 10 years.
- Yes, I completely, completely agree.
Thank you so much for sharing.
And before I let you go, doctor, the last thing I wanted
to ask you is what is your best advice
for aspiring physician and nurse leaders?
- Yeah, thank you. You know, I, I, I think, um,
the most important thing is to prioritize, um,
our own health and wellness
and to take time for work-life balance.
You know, I look back over, you know,
three decades in my career
and I wonder if I should have taken more time
to do those things to, um, you know,
to focus on my health and my family.
And if you ask my family, my family will assert that,
yes, , I should have done that.
I think we get caught up in what we love to do.
And, you know, my husband's been in ministry
and he said, you can lose yourself in the service of others.
And it, it is an amazing, amazing vocation that we have.
It's the best job in the world to care for people,
and then as a leader, to care for people who lead people.
But as leaders, we have got to prioritize our health
and have that work-life balance,
and we've gotta role model that
because if we don't, our leaders will continue to burn out.
And we've seen a huge turnover in nursing leaders,
um, physician leaders.
We've also seen a, a huge turnover in, um, the c-suite too.
And so it's really important that we role model that.
And so I would ask you to consider that,
and then also to be lifelong learners, um, engage
with your professional organization
because no matter where you go throughout the country
or which system you work with,
you're all working towards the same things.
And find a mentor, someone who can, um,
who can support you in the journey,
who can be transparent and help you grow.
And then it's also good
to have a sponsor within the organization
who can advocate on your behalf.
Um, lastly, I think, don't be afraid
to admit when you're wrong.
None of us are perfect. And when you fail, I like
to tell my teams, when you fail, you pick yourself up,
you dust your knees off, and you learn from it.
And then share that with others so that we can all continue
to grow and help each other.
And, you know, as a transformational leader, a lot
of people talk about transformational leadership,
but as a transformational leader, you will never
transform the culture or move the performance scorecard
until you learn how to be a servant leader.
So I think more important than anything
is take a look at servant leadership
and what it really means,
and then ask yourself, you know,
what else can I do to serve others?
So I think those are the key things that I would, you know,
that I would recommend
or ask that, you know, for consideration.
- Absolutely. Absolutely. Thank you so much
for those final thoughts.
Dr. Adams. This has been an amazing
and informative discussion.
So again, I wanna thank you so much
for coming on Becker's Healthcare,
and I look forward to connecting again with you soon.
- All right, thanks, Mariah. Take care.
- It's so important for leaders at the top of organizations
to keep learning, stay sharp, grow their networks
to help our audience better do this in a more simplified,
personalized, and meaningful way.
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