- This is Laura Dedo with the Becker's Healthcare Podcast.
I'm thrilled today to be joined by Erin Keefe,
chief Nurse Executive Officer at St.
Bernadine Medical Center.
Erin, it's a pleasure to have you on the podcast today.
- Yes, thank you for inviting me. I'm excited to be here.
- Absolutely. And I'm excited for our conversation, too.
I think it'll be really amazing
to hear more about what you're doing at St.
Bernard Medical Center, um, with your nursing team
and really some of the big trends
and issues that you're following.
But before we dive into my questions,
can you tell me a little bit more
about yourself and your background?
- Um, sure. I have been a registered nurse for
over 30 years, and I actually, um,
I did my initial undergrad education in Canada, which is
where I grew up, and I moved to the US in, uh, 1995
and, um, have been here for most of that time.
I, I went back for, for a period of a couple of years,
but I, I worked in six different states
and, uh, a variety of different clinical areas primarily,
uh, critical care, so ICUs and emergency departments.
Um, but I also, um, spent some time working in ambulatory
as well as perioperative leadership.
And, uh, I've been in a leadership role, um,
for over 15 years
and, uh, um, very lucky to, um, to be
where I am right now.
I think, um, St.
Berna Medical Center is a 342 bed, uh, acute care
facility in San Bernardino, California.
A very vulnerable, uh, community underserved population, uh,
where, uh, you know, we have been, um, doing a lot of work
to try and improve the health of this community and, um,
and, and provide a great place for medical care.
Uh, we're doing a lot of great things here, I think.
Uh, but I'm biased of course, so that's me.
- Fantastic. And, and I, I think that's amazing
what great experiences that you've had in
so many different aspects of healthcare, um, you know, in,
in especially serving underserved
populations is so important.
Um, so I wanna dig in here a little bit deeper.
What are some of your top priorities right now?
What do you really have top of mind?
- You know, it's, um, not, not very much different from
what I think everyone else is, is going through.
You know, we're still, um, in recovery phase,
even though we like to think the pandemic is
behind us completely.
Um, we've, we've had a huge focus on stabilization
and rebuilding our staffing pools, so, uh, a lot of work
with our local universities
and colleges to improve, uh, the pipeline for new nurses.
Um, we've adopted the system, uh, nurse, uh,
residency program for new graduates,
and we also, um, are continuing our, um, new
to service line residencies for nurses that are already here
with us, uh, that maybe want to try a new, uh,
a new area of practice.
And, uh, that helps us, obviously
with decreasing our turnover, keeping our staff here.
Um, we've also, uh, had a huge focus on staff wellbeing,
uh, staff and positions.
Um, there, there is that lingering impact from the pandemic
that just, it took a huge emotional toll
and, um, we are very lucky to be able
to have on site, um, a, a therapist who works
with our staff both individually
and in groups, um, as part
of our employee assistance program.
And, uh, so that, that remains a high focus for us.
And then sustainable growth for, for the organization.
Uh, healthcare, the landscape continues to shift
and, um, it becomes more challenging with, with payers.
And, uh, so we are, again,
we serve an underserved population
and how can we sustain for the long term into the future?
- That's such a great point.
And, and definitely, um, having that ability to, um,
understand the workforce, understand
what the clinical teams are going through,
and then provide, uh, some of that support
and some of the recovery that they need in order
to really get into a space where, um, you know, you're able
to provide care for the communities that they need.
And, you know, when you talk about being able
to decrease staff turnover, um,
and really be, you know, have a, a great pipeline
of talent coming in and
unless something a lot of hospitals aspire to, I,
is there anything that you've, um, done recently to try
to tackle some of those challenges?
I know you mentioned, um,
having a therapist on site and some other things.
Um, um, you know, is there anything else that you're doing
to try to reduce that turnover rate?
- Uh, um, one thing that
geographically our facility's located for those
who are familiar with, um,
Southern California in the Inland Empire,
it's a bit isolated
and, uh, it, it, it's not a place where a lot of people want
to necessarily relocate to.
So for, from a turnover perspective, when we're hiring,
we're looking at people that,
that are somewhat familiar with the area.
Uh, you know, San Bernardino's,
I think the largest county in the United States.
Uh, so there's a lot of, of, uh, square footage
and square mileage for people to move around in.
Um, we have made, um, relationships with a couple
of our local universities to do dedicated cohorts
for students, so they do their entire program
with the exception of the service lines
that we do not offer here, like pediatrics.
Uh, they spend their entire, um,
four year program doing their clinicals with us, and,
and that allows them
to get a true feel if the culture here works for them, uh,
and, and vice versa.
And, and it just, it's a better onboarding.
They know what they're getting into.
They're not starting at a facility
where they don't know the people,
they don't know the physicians or the practices.
And, um, that has had a huge impact, uh, for us to,
to work on decreasing our turnover.
Um, you know, we obviously are still, uh,
figuring out the new landscape with, um, the,
the newer generations wanting
to move around a little bit more.
So our turnover's a little higher than we would like it
to be, but our vacancy rate is currently at 4%.
So, um, you know, it, it's starting that, starting
that process has made an impact.
- That's great to hear. Thank you so much for, um,
digging one bit deeper into that.
Now, I'm wondering too, when you look into the future,
how will, um, the hospital grow
and evolve over the next two to three years?
What do you really see as being, uh, on the horizon?
- You know, I think, um, looking
to the future things will continue
to shift into the outpatient ambulatory world.
And you know, for us, we're exploring, um, the potentials
of an FQHC just to better serve our community.
We currently have, uh, this great,
we call it our transition clinic,
but it's, um, it's a follow-up clinic for patients who
have been discharged
and can't get into see either their primary care
or their specialty physician, um, within
that first week following discharge.
And so we've started that process
and it's had a huge impact on decreasing our readmissions.
Uh, but again, as we start
to move things further into the outpatient world,
we think having better access, um, to either primary care
or follow-up care, um, surgeries are moving out.
Uh, and so I think you're going to see a lot
of organizations, um, having more partnerships
with ASCs and things like that.
And, um, and so for us it's really looking at the services
that we're offering, what is the need of the community?
Do we need to add or change things?
And of course, we're part of Common Spirit Health, which is,
you know, the largest not-for-profit, um, in the country.
And, and so there's also making sure that we align with,
with the system strategy
and, uh, that we're all moving in that, that one same
or similar direction.
- Got it. That makes a lot of sense and,
and definitely, you know, is, um, so important
as you mentioned, to be able to, um,
have those partnerships go to the outpatient setting and,
and really being in the most
efficient and effective site of care.
Uh, before we wrap up here, I'm wondering what is one change
that you or your team has made, um, recently
that yielded great results?
- You know, it was, um, the one thing I think that has, has
touched every point of this facility, of this hospital, um,
it was a few years ago actually, the region, uh,
facilities adopted the principles of high reliability.
And so it has changed how we speak to each other, uh,
how we look at things from every level of the facility.
And it, it has had a direct positive impact in, um,
the day-to-day workflows as well as patient outcomes.
Uh, we've been able to improve, you know, our,
our quality scores, uh, leapfrog,
we've achieved an a, uh, we were up
to a CMS four star rating, and,
and I really do put it all back to
those principles being transparent
and seeking solution, um, for,
for just every challenge that comes our way.
And, uh, so if there's ever any, anyone listening
who is thinking about it, uh, for us it has been a true,
um, life altering journey
for our staff and for our patients.
- I love that. Um, you know, having that high reliability,
um, you know, and,
and really looking at where that can make a big difference,
as you said, clinically, as well as, um, within the teams.
I can imagine. Um, just really it instills a sense of pride
and also a culture that can be really positive, um,
for the organization overall.
- Yeah, it's a, it's a game changer
and, uh, you know, we live it, it's, uh, a lot
of times you get sort of wrapped up into some,
sometimes they call it like the flavor of the month or,
or something new and shiny,
but this was, was very thoughtfully rolled out, um,
not just to staff, but also to the physicians and, um, and,
and it has changed the way we all
practice and for the better.
- Excellent. Well, Aaron, thank you so much
for joining us on the podcast today.
This has been such a fan, fascinating discussion
and I look forward to connecting with you again soon.
- Thank you so much for your time. I appreciate it.