- This is Laura Dedo with the Becker's Healthcare Podcast.
I'm thrilled today to be joined by Rosemary Worcester,
who is the Senior Vice President of Patient Care Services
and Chief Nursing Executive at Bay Health.
Rosie, it's a pleasure to have you on the podcast today.
- Thanks for having me, Laura. Happy to be here.
- Now, I know we've got a lot to talk about.
Certainly there's so much happening in healthcare right now,
and I'm especially interested in digging deeper into
how you're looking at nursing at Bay Health.
But before we dive into that discussion,
can you tell us a little bit more
about yourself and your background?
- Yeah, I'd be happy to.
Um, I am presently, uh, the Chief Nurse Executive
and senior Vice President
for patient care services here at Bay Health.
And, uh, bay Health is a medium sized health system,
and we serve, um, our communities in central
and southern Delaware.
Um, and the landscape is, uh, quite unique.
We have a number of rural areas that we serve
and, um, some coastal regions as well.
Um, but Laura, I have been a nurse for 27 years,
and, um, I became a nurse because I love
and appreciate and continue to love
and appreciate the intersection of science and people.
And, um, that has carried me through these 27 years.
My clinical background is emergency nursing.
Um, I have loved my time in, uh, a variety of, uh,
emergency departments,
and I've had a number of, uh, different leadership roles.
Um, one of my favorites was being a house supervisor.
Uh, you know, when you're a nursing supervisor on the off
shift, you get a real, um, valuable slice
of not only people, but also of healthcare.
Um, I've done things from being a unit manager
and, um, I've led some program development from
orthopedic service line.
And, um, interestingly, I, um,
took an opportunity in the middle of my career to move out
of operations
and into more of the nursing infrastructure role.
And I became a director of, uh,
professional excellence in nursing.
Uh, and this is important because, uh,
I got this bird's eye view of
what are the professional elements to our practice
of nursing that, um, are critical in,
in the way we deliver care.
And then from there, um, I've been really blessed
to be in a vice president role for almost 10 years.
And, um, in my time as an executive leader, I've, um,
been able to work at, um, in large health systems.
I have been the campus leader, uh, chief nurse, uh,
chief nursing officer for, um, uh,
health campus within a health system, uh,
in community settings
and also in academic medical center, uh, environments.
Um, and now here I am at Bay Health
and, um, sort of pulling on all of those experiences to, um,
be the chief nurse executive here.
- So that's an amazing career journey,
and it sounds like you've had so many different experiences,
and I love the way that you positioned your passion as
that intersection between science and people
and being able to really lean into, to both areas, um, uh,
of, of having that people
and connection while also understanding it
and being on the forefront of science and, and treatment
and technology as well.
- Mm-Hmm, . Well, it is what we are doing
sort of every day, all day in healthcare.
You know, when I think about the biggest issues
that we face, um, not just daily,
but in how we, we create sort of sustainability to be able
to continue to take care of our patients.
We've got a lot of science going on, um, technology,
et cetera, and I'm sure we'll dig into that.
We also have groups of people that we are leading
to take care of people,
and I find that that's sort of a grounding theory for me,
um, because it's, it really people is the, um,
is is the center of it all.
- I love that. I think that's so important in really, um,
sets the, the site scene well for the healthcare space now.
What are those biggest issues
that you're following right now in healthcare?
What are some of the things that you spend most
of your time on and are really
thinking about a lot right now?
- So, um, great question, Laura.
I think, um, I would be crazy not to begin with
what is the intersection of technology with care?
You know, you, it is really hard to open, um, a journal,
uh, a conversation about care, um, you know, conversations
with colleagues in other set, you know,
in other organizations without talking about what's going
on in the virtual space.
And, and that's two things for me.
One is what are the options
and opportunities we have in virtual care
and what I will call virtual care support?
So, you know, lots
and lots of discussion about the, um, the implementation
of virtual care, virtual nursing care,
and that is adjunctive to the individuals who are, uh,
at the bedside, so to speak, um,
or at, at the point of the patient.
Uh, and there's a number of different ways
that virtual nursing deploys here at Bay Health.
We are looking at, um, a virtual nursing model
that is supported in the teaching elements for patients,
patient teaching, patient education.
How, what does the patient need to know sort of
before they leave the hospital setting,
but also looking at what are those sort
of care coordinating, um, pieces that we can do
behind the scenes for the, so by that I mean, um,
you know, what is the likelihood
of a patient having a complication?
What is the likelihood of a patient, um, you know,
needing a readmission?
How do we mitigate those things, um, in advance?
And we're doing that in a virtual space and,
and building what that program looks like here.
Um, but I also look at this, you know, my job as a,
as a chief nurse is to, um, you know, remove barriers,
secure resources,
and, uh, sort of to, um, uh, drive the care,
but also be a good steward.
And in that, I find that I want to make the connection
between virtual care
and unburdening our care teams
from unnecessary work, right?
So, uh, we're going to be, um, beginning an exercise
where we really take a good deep dive into
what is the necessary work to take care of patients
and, you know, what are the opportunities
that we have here locally to move any of that
or leverage technology to assess.
Um, so I, I think that we use the terminology virtual care
and virtual nursing in a very wide range,
but that's sort of what, what that means here at Bay Health.
And, um, other things that are really on my mind here.
Um, again, maybe an overused terminology here,
but if that is the academic practice partnership, right?
So I'm changing gears a little bit,
but, um, that is how are we partnering to sort
of give and receive in the academic practice partnership?
So I, I'm gonna give you an example here.
Um, we have a number of, um, very vibrant, um,
nursing programs,
undergraduate nursing programs
here in the state of Delaware.
And, um, I, we've just developed a partnership with, um, one
of those who, uh, you know, we are working
to create more faculty for them,
and they're working to create more nurses for us.
And what that actually looks like is developing a tactical
plan where we both have a part
in helping one another now.
Um, I enjoy tremendous partnerships with, um, the leaders
of our, um, academic programs, um, up,
up and down the state really.
It's, it's a, it's a wonderful thing and,
and we work at that relationship.
Um, but why that's important is that
what we create might be something
that another organization wants to adopt or use.
Maybe it's scalable, maybe it's applicable
in different parts of the country.
Um, but that, that partnership to, you know, sort of,
um, be in that cycle of
how can we help create faculty at the clinical level
and how can, um, our academic partners, um,
help to create nurses.
Um, honestly, I'm very pleased with how
that's going in Delaware at the moment.
Um, again, one of the benefits
of being in a smaller state is that, you know,
we could pick up the phone, Hey, it's Rosie,
I have this crazy idea.
Can we talk about it? Can we, you know,
can something come of that?
And I see wonderful things on the horizon
for, um, these partnerships that, uh,
that I'm a part of right now.
So those are, those are really two things
that come to mind immediately.
There's so many other things.
Um, but, you know, um, all of that to say
there is an operational imperative
that we're living in right now, Laura,
and that is, um, you know,
I mentioned the word stewarding resources.
As a chief nurse, I definitely need
to remain attentive in these big issues to, um,
being, um, a, a sustainable health system.
We need to be very, very dialed into the cost of care
and what are the steps
that we can take in the patient care services zone that can,
um, you know, offset costs really, um, for our patients.
- That's such a great point,
and I appreciate you talking through all of those elements
because so many hospitals
and health systems are working on very similar things,
looking at some of the technology in the virtual space, um,
how to really coordinate nurses
and make sure that they're still able to connect
with patients and, and build that relationship.
And then two, um, working together across lines
with academic practices
and partnerships, especially thinking about the next
generation of nurses and training them
and building up the next generation of the workforce.
So that's fascinating to hear.
And, and thinking about all of those things,
plus any other operational challenges
and issues you have coming up,
what are you most excited about right
now and what makes you nervous?
- Um, wow. So I'm a very excited person as a baseline.
Laura, you have to know that about me.
I have a lot of energy and, um, I have
just sustained passion for being a nurse.
It's an honor to me.
So there's a lot of things that excite me, um, uh,
about our industry.
You know, one thing though that really rises
to the surface is I get excited about work in
health equity, right?
We've got, um, an imperative as an industry
to look at health equity as
an action item.
This is an, it is an action.
It is a, it's a verb, it's a, it's a what we do,
and sometimes we get, um, sort of stymied
or a little bit stuck maybe in doubling down on awareness.
Awareness is a huge piece of this, right?
We, uh, many organizations have had, um, uh,
the initiatives importantly, so in diversity, equity,
inclusion, belonging, you know,
pulling the organization apart, seeing
where we've got, um, opportunities.
But I get excited when we are turning health
equity into that action.
And, and I think furthermore, it's really about
embedding health equity
as an imperative in every single thing that we do, right?
Um, how, what are my recruitment practices?
What are my, um, you know, readmission
avoidance practices?
How does health equity sort of layer in
and become a part of just the work that we do?
Um, so I get excited about that here at Bay Health.
Um, we have, um, uh, a, a very, a,
a detailed roadmap on how to be, um,
pulling health equity into everything that we do so
that it is just what we do.
Um, and, um, you know, sometimes we get, um,
we might get a little discouraged when we see
that we've got, you know,
we've discovered a big opportunity,
but let's not be discouraged.
Let's see that identifying that opportunity as a gift,
and then let's make action.
And those are the things that really excite me.
You know, when I look at, um, you know, we have a,
a diverse population of patients that we care
for in our community,
and, um, you know, they're looking to us,
they trust us, right?
We're nurses. Were most trusted, uh, again
for the 2020 fifth year, they trust us to, um,
be leveraging
and, um, making health equity our action.
So that excites me. Um, what makes me nervous?
I, I, I fall back to the workforce situation, sort
of the state of the state in terms of our workforce
as making me somewhat nervous.
Um, I feel that we've got, uh, opportunity
to lean in and to,
to be really intentional about developing our workforce.
But, uh, you know, I'm a nurse. I, I love being a nurse.
I'm honored to be a nurse.
Nurses are pivotal to the healthcare system.
So when I think about, um, you know, the project,
the projected numbers of nurses either leaving
or remaining in the profession,
that does make me a little bit on edge.
So I, I find myself turning system level activities
into reinforcing the nursing infrastructure.
You know, a lot of my experiences as a clinical nurse
where the nurse was at the point of the patient,
and, you know, I want to be directing activities to really
reinforce that there will be nurses well trained
and up for the challenge of taking care of our patients.
You know, it's, it's, and it's a multifaceted issue, right?
We, we study it, you know,
there are workforce compendiums out there
that can be really helpful in guiding our organizations.
But here at Bay Health, we have made investment in workforce
not only keeping people at the bedside, um, but attracting
and retaining top talent.
Um, so I think this is a long game for us.
I think it's a long game for all of us.
I talk with, um, other colleagues in the region, um, and,
and we are definitely unified on, um, activities
to reinforce that nursing workforce.
- That's great to hear, and definitely, as you mentioned,
so important to be engaged with the nursing workforce.
And really, um, as the future in mind,
I know healthcare will look quite a bit different, um,
in even five years than it does today,
let alone 10, 15 years.
So from your perspective, especially given some
of the topics we've been talking about today,
thinking about health equity in nursing
and some of the different things that, um,
health systems are doing right now to really meet the needs
of their patients, what do you think most successful
healthcare leaders will need to continue to grow
and develop over the next two to three years?
- Um, really great question and great timeframe.
Two to three years I think is, um, we've gotta be really,
really intensely dialed in on that next two to three years.
And, you know, also, of course, looking at the long game,
but here's a couple of things that come to mind,
and I'm gonna speed date these things
because I think they, um, I think it's a lot of things,
frankly, but the first that comes to mind for me, Laura,
is getting connected with legislators
and those in governments.
And, um, that falls under a, a big umbrella
that I call advocacy, right?
That is we who are in healthcare
and in nursing think it's incumbent upon us
to share the experiences that we're having with our,
um, our legislators
and, um, those who represent us in Senate and house.
Um, and, and
otherwise understanding what are those bills
that are coming up and
where do we stand on those in particular, you know,
this was not necessarily a core competency of,
of nurses 25, 27 years ago.
It is today. And, um, you know, as a nurse leader,
I feel really strongly about being at the table
for those conversations.
So advocacy. Um, secondly, I think, um, you know,
understanding that, uh, leadership in healthcare
is a package deal.
You've, uh, I find that, um, conversations I had
with colleagues in similar roles, you know,
we're all talking about that nimbleness that is required
to move through, you know, um, the business acumen, the,
um, operational ability
and also stewardship of resources, driving,
um, the clinical care and then understanding
and being very connected with care where it's happening.
Um, you know, these are not issues that are exclusive
to acute care hospitals
or, um, you know, freestanding, uh, rehabilitation hospitals
or, um, or offices.
We have to understand how, how to move in all
of those spaces, pushing outside of
what the traditional walls are, where are our patients,
where do they need us to be,
and then how do we make sure we can connect
in those variety of settings?
You know, it brings us back
to the conversation about virtual care.
Um, can I, um, connect with somebody on my phone, um,
you know, via FaceTime
or, um, you know,
am I gonna be seeing them in the emergency
department, what have you?
My point is, we have to move in a lot of, um,
sectors and we've gotta meet patients where they are
and figure out how to access them wherever that is.
You know, we talk about people, one
of the most important things we can do in leadership is go
talk to the people who are at the front line.
My, not only does my bucket get filled by rounding
with our teams, you know, talking to people,
but we have to be creating this environment of trust
where we're gonna hear from the people who are responding
to a rapid response at one o'clock in the morning, uh,
you know, on a Saturday and night,
what are their experiences
and challenges so that we can really keep the system,
uh, whole and moving.
- Absolutely. I love that point.
You certainly put an exclamation point on, um,
our discussion today with thinking about
how you can make those connections with the frontline team,
um, and, and really grow
and foster exactly the culture that you want
and the experience that you want for them, as well
as the patients coming through.
I, I think it's so important today, especially to keep
that front and center.
Rosie, thank you so much
for joining us on the podcast today.
This has been a fun conversation.
I've learned a lot, and I look forward
to connecting with you again soon.
- Laura, thank you for inviting me. Um, it's been wonderful.
I appreciate your time too.
- 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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