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- This is Laura Dedo with the
Becker's Healthcare Podcast.

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I'm thrilled today to be
joined by Rosemary Worcester,

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who is the Senior Vice President
of Patient Care Services

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and Chief Nursing Executive at Bay Health.

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Rosie, it's a pleasure to
have you on the podcast today.

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- Thanks for having me,
Laura. Happy to be here.

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- Now, I know we've got
a lot to talk about.

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Certainly there's so much
happening in healthcare right now,

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and I'm especially interested
in digging deeper into

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how you're looking at
nursing at Bay Health.

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But before we dive into that discussion,

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can you tell us a little bit more

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about yourself and your background?

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- Yeah, I'd be happy to.

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Um, I am presently, uh,
the Chief Nurse Executive

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and senior Vice President

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for patient care services
here at Bay Health.

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And, uh, bay Health is a
medium sized health system,

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and we serve, um, our
communities in central

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and southern Delaware.

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Um, and the landscape
is, uh, quite unique.

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We have a number of
rural areas that we serve

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and, um, some coastal regions as well.

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Um, but Laura, I have
been a nurse for 27 years,

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and, um, I became a nurse because I love

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and appreciate and continue to love

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and appreciate the intersection
of science and people.

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And, um, that has carried
me through these 27 years.

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My clinical background
is emergency nursing.

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Um, I have loved my time
in, uh, a variety of, uh,

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emergency departments,

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and I've had a number of, uh,
different leadership roles.

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Um, one of my favorites was
being a house supervisor.

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Uh, you know, when you're a
nursing supervisor on the off

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shift, you get a real, um, valuable slice

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of not only people,
but also of healthcare.

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Um, I've done things
from being a unit manager

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and, um, I've led some
program development from

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orthopedic service line.

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And, um, interestingly, I, um,

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took an opportunity in the
middle of my career to move out

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of operations

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and into more of the
nursing infrastructure role.

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And I became a director of, uh,

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professional excellence in nursing.

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Uh, and this is important because, uh,

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I got this bird's eye view of

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what are the professional
elements to our practice

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of nursing that, um, are critical in,

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in the way we deliver care.

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And then from there, um,
I've been really blessed

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to be in a vice president
role for almost 10 years.

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And, um, in my time as an
executive leader, I've, um,

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been able to work at, um,
in large health systems.

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I have been the campus
leader, uh, chief nurse, uh,

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chief nursing officer for, um, uh,

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health campus within a health system, uh,

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in community settings

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and also in academic medical
center, uh, environments.

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Um, and now here I am at Bay Health

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and, um, sort of pulling on all
of those experiences to, um,

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be the chief nurse executive here.

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- So that's an amazing career journey,

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and it sounds like you've had
so many different experiences,

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and I love the way that you
positioned your passion as

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that intersection between
science and people

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and being able to really lean
into, to both areas, um, uh,

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of, of having that people

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and connection while also understanding it

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and being on the forefront
of science and, and treatment

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and technology as well.

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- Mm-Hmm, <affirmative>.
Well, it is what we are doing

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sort of every day, all day in healthcare.

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You know, when I think
about the biggest issues

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that we face, um, not just daily,

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but in how we, we create sort
of sustainability to be able

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to continue to take care of our patients.

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We've got a lot of science
going on, um, technology,

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et cetera, and I'm sure
we'll dig into that.

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We also have groups of
people that we are leading

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to take care of people,

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and I find that that's sort
of a grounding theory for me,

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um, because it's, it
really people is the, um,

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is is the center of it all.

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- I love that. I think that's
so important in really, um,

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sets the, the site scene well
for the healthcare space now.

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What are those biggest issues

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that you're following
right now in healthcare?

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What are some of the
things that you spend most

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of your time on and are really

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thinking about a lot right now?

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- So, um, great question, Laura.

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I think, um, I would be
crazy not to begin with

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what is the intersection
of technology with care?

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You know, you, it is really
hard to open, um, a journal,

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uh, a conversation about care,
um, you know, conversations

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with colleagues in other set, you know,

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in other organizations without
talking about what's going

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on in the virtual space.

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And, and that's two things for me.

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One is what are the options

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and opportunities we have in virtual care

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and what I will call virtual care support?

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So, you know, lots

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and lots of discussion about
the, um, the implementation

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of virtual care, virtual nursing care,

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and that is adjunctive to
the individuals who are, uh,

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at the bedside, so to speak, um,

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or at, at the point of the patient.

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Uh, and there's a number of different ways

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that virtual nursing
deploys here at Bay Health.

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We are looking at, um,
a virtual nursing model

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that is supported in the
teaching elements for patients,

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patient teaching, patient education.

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How, what does the patient
need to know sort of

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before they leave the hospital setting,

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but also looking at what are those sort

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of care coordinating,
um, pieces that we can do

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behind the scenes for the,
so by that I mean, um,

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you know, what is the likelihood

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of a patient having a complication?

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What is the likelihood of
a patient, um, you know,

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needing a readmission?

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How do we mitigate those
things, um, in advance?

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And we're doing that
in a virtual space and,

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and building what that
program looks like here.

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Um, but I also look at
this, you know, my job as a,

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as a chief nurse is to, um,
you know, remove barriers,

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secure resources,

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and, uh, sort of to,
um, uh, drive the care,

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but also be a good steward.

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And in that, I find that I
want to make the connection

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between virtual care

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and unburdening our care teams

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from unnecessary work, right?

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So, uh, we're going to be,
um, beginning an exercise

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where we really take a good deep dive into

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what is the necessary work
to take care of patients

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and, you know, what are the opportunities

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that we have here locally
to move any of that

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or leverage technology to assess.

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Um, so I, I think that we use
the terminology virtual care

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and virtual nursing in a very wide range,

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but that's sort of what, what
that means here at Bay Health.

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And, um, other things that
are really on my mind here.

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Um, again, maybe an
overused terminology here,

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but if that is the academic
practice partnership, right?

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So I'm changing gears a little bit,

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but, um, that is how are
we partnering to sort

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of give and receive in the
academic practice partnership?

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So I, I'm gonna give you an example here.

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Um, we have a number of,
um, very vibrant, um,

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nursing programs,

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undergraduate nursing programs

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here in the state of Delaware.

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And, um, I, we've just developed
a partnership with, um, one

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of those who, uh, you know, we are working

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to create more faculty for them,

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and they're working to
create more nurses for us.

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And what that actually looks
like is developing a tactical

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plan where we both have a part

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in helping one another now.

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Um, I enjoy tremendous
partnerships with, um, the leaders

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of our, um, academic programs, um, up,

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up and down the state really.

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It's, it's a, it's a wonderful thing and,

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and we work at that relationship.

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Um, but why that's important is that

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what we create might be something

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that another organization
wants to adopt or use.

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Maybe it's scalable, maybe it's applicable

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in different parts of the country.

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Um, but that, that partnership
to, you know, sort of,

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um, be in that cycle of

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how can we help create
faculty at the clinical level

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and how can, um, our
academic partners, um,

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help to create nurses.

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Um, honestly, I'm very pleased with how

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that's going in Delaware at the moment.

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Um, again, one of the benefits

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of being in a smaller
state is that, you know,

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we could pick up the
phone, Hey, it's Rosie,

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I have this crazy idea.

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Can we talk about it? Can we, you know,

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can something come of that?

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And I see wonderful things on the horizon

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for, um, these partnerships that, uh,

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that I'm a part of right now.

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So those are, those are really two things

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that come to mind immediately.

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There's so many other things.

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Um, but, you know, um, all of that to say

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there is an operational imperative

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that we're living in right now, Laura,

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and that is, um, you know,

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I mentioned the word stewarding resources.

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As a chief nurse, I definitely need

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to remain attentive in
these big issues to, um,

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being, um, a, a sustainable health system.

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We need to be very, very
dialed into the cost of care

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and what are the steps

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that we can take in the patient
care services zone that can,

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um, you know, offset costs
really, um, for our patients.

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- That's such a great point,

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and I appreciate you talking
through all of those elements

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because so many hospitals

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and health systems are working
on very similar things,

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looking at some of the technology
in the virtual space, um,

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how to really coordinate nurses

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and make sure that they're
still able to connect

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with patients and, and
build that relationship.

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And then two, um, working
together across lines

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with academic practices

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and partnerships, especially
thinking about the next

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generation of nurses and training them

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and building up the next
generation of the workforce.

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So that's fascinating to hear.

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And, and thinking about
all of those things,

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plus any other operational challenges

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and issues you have coming up,

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what are you most excited about right

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now and what makes you nervous?

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- Um, wow. So I'm a very
excited person as a baseline.

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Laura, you have to know that about me.

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I have a lot of energy and, um, I have

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just sustained passion for being a nurse.

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It's an honor to me.

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So there's a lot of things
that excite me, um, uh,

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about our industry.

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You know, one thing
though that really rises

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to the surface is I get
excited about work in

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health equity, right?

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We've got, um, an
imperative as an industry

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to look at health equity as

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an action item.

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This is an, it is an action.

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It is a, it's a verb,
it's a, it's a what we do,

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and sometimes we get, um, sort of stymied

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or a little bit stuck maybe
in doubling down on awareness.

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Awareness is a huge piece of this, right?

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We, uh, many organizations
have had, um, uh,

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the initiatives importantly,
so in diversity, equity,

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inclusion, belonging, you know,

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pulling the organization apart, seeing

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where we've got, um, opportunities.

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But I get excited when
we are turning health

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equity into that action.

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And, and I think furthermore,
it's really about

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embedding health equity

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00:12:20,585 --> 00:12:24,045
as an imperative in every
single thing that we do, right?

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Um, how, what are my
recruitment practices?

252
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What are my, um, you know, readmission

253
00:12:31,915 --> 00:12:33,125
avoidance practices?

254
00:12:33,265 --> 00:12:35,885
How does health equity sort of layer in

255
00:12:36,425 --> 00:12:39,365
and become a part of
just the work that we do?

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Um, so I get excited about
that here at Bay Health.

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Um, we have, um, uh, a, a very, a,

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a detailed roadmap on how to be, um,

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pulling health equity into
everything that we do so

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that it is just what we do.

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Um, and, um, you know,
sometimes we get, um,

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we might get a little
discouraged when we see

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that we've got, you know,

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we've discovered a big opportunity,

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00:13:07,465 --> 00:13:08,965
but let's not be discouraged.

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Let's see that identifying
that opportunity as a gift,

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00:13:13,665 --> 00:13:15,005
and then let's make action.

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And those are the things
that really excite me.

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You know, when I look at,
um, you know, we have a,

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a diverse population of
patients that we care

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for in our community,

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and, um, you know, they're looking to us,

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they trust us, right?

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We're nurses. Were most trusted, uh, again

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for the 2020 fifth year,
they trust us to, um,

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be leveraging

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and, um, making health equity our action.

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So that excites me. Um,
what makes me nervous?

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I, I, I fall back to the
workforce situation, sort

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00:13:53,545 --> 00:13:56,185
of the state of the state
in terms of our workforce

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as making me somewhat nervous.

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00:13:58,685 --> 00:14:03,455
Um, I feel that we've got, uh, opportunity

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00:14:03,475 --> 00:14:04,815
to lean in and to,

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00:14:04,915 --> 00:14:07,975
to be really intentional about
developing our workforce.

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00:14:08,235 --> 00:14:11,495
But, uh, you know, I'm a
nurse. I, I love being a nurse.

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00:14:11,635 --> 00:14:12,895
I'm honored to be a nurse.

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00:14:13,805 --> 00:14:17,675
Nurses are pivotal to
the healthcare system.

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00:14:18,655 --> 00:14:22,935
So when I think about,
um, you know, the project,

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00:14:23,195 --> 00:14:26,775
the projected numbers
of nurses either leaving

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00:14:26,875 --> 00:14:28,415
or remaining in the profession,

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00:14:30,055 --> 00:14:32,385
that does make me a little bit on edge.

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00:14:32,445 --> 00:14:37,165
So I, I find myself turning
system level activities

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00:14:37,355 --> 00:14:40,085
into reinforcing the
nursing infrastructure.

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00:14:41,155 --> 00:14:43,575
You know, a lot of my
experiences as a clinical nurse

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00:14:44,105 --> 00:14:46,135
where the nurse was at
the point of the patient,

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00:14:46,835 --> 00:14:50,735
and, you know, I want to be
directing activities to really

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00:14:51,365 --> 00:14:55,085
reinforce that there will
be nurses well trained

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00:14:55,265 --> 00:14:58,445
and up for the challenge of
taking care of our patients.

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00:14:59,345 --> 00:15:03,445
You know, it's, it's, and it's
a multifaceted issue, right?

300
00:15:03,545 --> 00:15:05,085
We, we study it, you know,

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00:15:05,085 --> 00:15:06,765
there are workforce compendiums out there

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00:15:06,765 --> 00:15:10,725
that can be really helpful
in guiding our organizations.

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00:15:10,865 --> 00:15:15,325
But here at Bay Health, we have
made investment in workforce

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00:15:16,225 --> 00:15:20,605
not only keeping people at the
bedside, um, but attracting

305
00:15:20,605 --> 00:15:22,125
and retaining top talent.

306
00:15:23,195 --> 00:15:25,375
Um, so I think this is a long game for us.

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00:15:25,535 --> 00:15:26,895
I think it's a long game for all of us.

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00:15:27,095 --> 00:15:31,655
I talk with, um, other colleagues
in the region, um, and,

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00:15:31,675 --> 00:15:35,855
and we are definitely
unified on, um, activities

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00:15:35,855 --> 00:15:37,775
to reinforce that nursing workforce.

311
00:15:40,575 --> 00:15:42,835
- That's great to hear, and
definitely, as you mentioned,

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00:15:42,895 --> 00:15:45,155
so important to be engaged
with the nursing workforce.

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00:15:45,335 --> 00:15:48,675
And really, um, as the future in mind,

314
00:15:49,035 --> 00:15:51,715
I know healthcare will look
quite a bit different, um,

315
00:15:52,135 --> 00:15:54,035
in even five years than it does today,

316
00:15:54,135 --> 00:15:55,635
let alone 10, 15 years.

317
00:15:55,815 --> 00:15:58,435
So from your perspective,
especially given some

318
00:15:58,435 --> 00:16:00,035
of the topics we've been
talking about today,

319
00:16:00,035 --> 00:16:02,795
thinking about health equity in nursing

320
00:16:03,015 --> 00:16:05,115
and some of the different things that, um,

321
00:16:05,855 --> 00:16:08,595
health systems are doing right
now to really meet the needs

322
00:16:08,595 --> 00:16:11,315
of their patients, what do
you think most successful

323
00:16:11,315 --> 00:16:13,315
healthcare leaders will
need to continue to grow

324
00:16:13,315 --> 00:16:15,035
and develop over the
next two to three years?

325
00:16:17,785 --> 00:16:20,045
- Um, really great question
and great timeframe.

326
00:16:20,185 --> 00:16:23,925
Two to three years I think
is, um, we've gotta be really,

327
00:16:23,945 --> 00:16:26,725
really intensely dialed in on
that next two to three years.

328
00:16:27,465 --> 00:16:29,965
And, you know, also, of course,
looking at the long game,

329
00:16:29,985 --> 00:16:31,845
but here's a couple of
things that come to mind,

330
00:16:32,185 --> 00:16:33,845
and I'm gonna speed date these things

331
00:16:33,845 --> 00:16:37,285
because I think they, um, I
think it's a lot of things,

332
00:16:37,395 --> 00:16:40,205
frankly, but the first that
comes to mind for me, Laura,

333
00:16:40,385 --> 00:16:43,885
is getting connected with legislators

334
00:16:44,425 --> 00:16:45,645
and those in governments.

335
00:16:46,545 --> 00:16:49,525
And, um, that falls
under a, a big umbrella

336
00:16:49,755 --> 00:16:51,525
that I call advocacy, right?

337
00:16:51,675 --> 00:16:54,485
That is we who are in healthcare

338
00:16:54,625 --> 00:16:58,185
and in nursing think
it's incumbent upon us

339
00:16:59,235 --> 00:17:03,735
to share the experiences
that we're having with our,

340
00:17:04,675 --> 00:17:06,855
um, our legislators

341
00:17:07,515 --> 00:17:11,095
and, um, those who represent
us in Senate and house.

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00:17:11,715 --> 00:17:13,135
Um, and, and

343
00:17:13,135 --> 00:17:16,655
otherwise understanding
what are those bills

344
00:17:16,685 --> 00:17:18,745
that are coming up and

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00:17:18,955 --> 00:17:22,065
where do we stand on those
in particular, you know,

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00:17:22,295 --> 00:17:25,785
this was not necessarily
a core competency of,

347
00:17:25,925 --> 00:17:28,305
of nurses 25, 27 years ago.

348
00:17:28,765 --> 00:17:31,905
It is today. And, um, you
know, as a nurse leader,

349
00:17:32,025 --> 00:17:34,225
I feel really strongly
about being at the table

350
00:17:34,405 --> 00:17:35,505
for those conversations.

351
00:17:35,645 --> 00:17:40,155
So advocacy. Um, secondly,
I think, um, you know,

352
00:17:40,185 --> 00:17:44,755
understanding that, uh,
leadership in healthcare

353
00:17:46,235 --> 00:17:47,415
is a package deal.

354
00:17:47,795 --> 00:17:50,845
You've, uh, I find that,
um, conversations I had

355
00:17:50,845 --> 00:17:52,845
with colleagues in
similar roles, you know,

356
00:17:52,855 --> 00:17:56,205
we're all talking about that
nimbleness that is required

357
00:17:56,305 --> 00:18:01,125
to move through, you know,
um, the business acumen, the,

358
00:18:01,185 --> 00:18:03,495
um, operational ability

359
00:18:04,315 --> 00:18:09,195
and also stewardship
of resources, driving,

360
00:18:09,815 --> 00:18:14,805
um, the clinical care
and then understanding

361
00:18:15,265 --> 00:18:19,125
and being very connected with
care where it's happening.

362
00:18:20,065 --> 00:18:22,725
Um, you know, these are not
issues that are exclusive

363
00:18:22,725 --> 00:18:24,445
to acute care hospitals

364
00:18:24,665 --> 00:18:29,485
or, um, you know, freestanding,
uh, rehabilitation hospitals

365
00:18:29,585 --> 00:18:31,685
or, um, or offices.

366
00:18:33,115 --> 00:18:35,895
We have to understand
how, how to move in all

367
00:18:35,895 --> 00:18:39,455
of those spaces, pushing outside of

368
00:18:39,565 --> 00:18:43,295
what the traditional walls
are, where are our patients,

369
00:18:43,345 --> 00:18:45,175
where do they need us to be,

370
00:18:45,955 --> 00:18:49,615
and then how do we make
sure we can connect

371
00:18:50,545 --> 00:18:52,205
in those variety of settings?

372
00:18:52,265 --> 00:18:53,525
You know, it brings us back

373
00:18:53,525 --> 00:18:55,885
to the conversation about virtual care.

374
00:18:56,585 --> 00:19:00,685
Um, can I, um, connect with
somebody on my phone, um,

375
00:19:01,065 --> 00:19:02,285
you know, via FaceTime

376
00:19:02,505 --> 00:19:03,685
or, um, you know,

377
00:19:03,685 --> 00:19:05,445
am I gonna be seeing them in the emergency

378
00:19:05,445 --> 00:19:06,605
department, what have you?

379
00:19:07,145 --> 00:19:11,205
My point is, we have to
move in a lot of, um,

380
00:19:12,075 --> 00:19:16,435
sectors and we've gotta
meet patients where they are

381
00:19:16,455 --> 00:19:20,075
and figure out how to access
them wherever that is.

382
00:19:20,935 --> 00:19:23,755
You know, we talk about people, one

383
00:19:23,755 --> 00:19:27,035
of the most important things
we can do in leadership is go

384
00:19:27,305 --> 00:19:29,795
talk to the people who
are at the front line.

385
00:19:30,855 --> 00:19:34,275
My, not only does my bucket
get filled by rounding

386
00:19:34,275 --> 00:19:36,915
with our teams, you
know, talking to people,

387
00:19:38,055 --> 00:19:42,515
but we have to be creating
this environment of trust

388
00:19:42,605 --> 00:19:45,925
where we're gonna hear from
the people who are responding

389
00:19:45,925 --> 00:19:48,685
to a rapid response at one
o'clock in the morning, uh,

390
00:19:48,745 --> 00:19:50,005
you know, on a Saturday and night,

391
00:19:50,315 --> 00:19:51,605
what are their experiences

392
00:19:51,665 --> 00:19:54,525
and challenges so that we
can really keep the system,

393
00:19:55,025 --> 00:19:56,165
uh, whole and moving.

394
00:19:58,565 --> 00:19:59,685
- Absolutely. I love that point.

395
00:19:59,865 --> 00:20:02,845
You certainly put an
exclamation point on, um,

396
00:20:02,865 --> 00:20:04,685
our discussion today with thinking about

397
00:20:04,865 --> 00:20:07,325
how you can make those connections
with the frontline team,

398
00:20:07,785 --> 00:20:09,165
um, and, and really grow

399
00:20:09,185 --> 00:20:11,565
and foster exactly the
culture that you want

400
00:20:11,625 --> 00:20:13,645
and the experience that
you want for them, as well

401
00:20:13,645 --> 00:20:14,805
as the patients coming through.

402
00:20:15,365 --> 00:20:17,885
I, I think it's so important
today, especially to keep

403
00:20:17,885 --> 00:20:18,925
that front and center.

404
00:20:19,495 --> 00:20:20,565
Rosie, thank you so much

405
00:20:20,645 --> 00:20:22,045
for joining us on the podcast today.

406
00:20:22,045 --> 00:20:23,805
This has been a fun conversation.

407
00:20:23,995 --> 00:20:25,285
I've learned a lot, and I look forward

408
00:20:25,285 --> 00:20:26,565
to connecting with you again soon.

409
00:20:28,065 --> 00:20:30,855
- Laura, thank you for inviting
me. Um, it's been wonderful.

410
00:20:31,215 --> 00:20:32,215
I appreciate your time too.

411
00:20:34,925 --> 00:20:37,375
- It's so important for leaders
at the top of organizations

412
00:20:37,375 --> 00:20:40,215
to keep learning, stay
sharp, grow their networks

413
00:20:40,515 --> 00:20:43,055
to help our audience better
do this in a more simplified,

414
00:20:43,055 --> 00:20:44,735
personalized, and meaningful way.

415
00:20:45,295 --> 00:20:47,765
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416
00:20:48,275 --> 00:20:50,245
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417
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418
00:20:52,505 --> 00:20:53,525
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419
00:20:54,235 --> 00:20:55,325
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420
00:20:55,325 --> 00:21:00,085
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421
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