1 00:00:00,275 --> 00:00:02,645 - This is Laura Dedo with the Becker's Healthcare Podcast. 2 00:00:03,345 --> 00:00:06,005 I'm thrilled today to be joined by Mark Perkins Carillo, 3 00:00:06,415 --> 00:00:09,485 chief Nursing Informatics Officer at Moffitt Cancer Center. 4 00:00:09,595 --> 00:00:11,605 Mark, it's a pleasure to have you on the podcast today. 5 00:00:12,385 --> 00:00:13,725 - Oh, thank you for having me, Laura. 6 00:00:15,025 --> 00:00:16,485 - Now I know we've got a lot to talk about, 7 00:00:16,665 --> 00:00:18,725 and certainly excited to hear more about 8 00:00:18,725 --> 00:00:20,485 what you're doing at Moffitt Cancer Center. 9 00:00:20,845 --> 00:00:23,205 I know there's some really exciting things happening 10 00:00:23,205 --> 00:00:25,485 with innovation within the cancer care space, 11 00:00:25,505 --> 00:00:27,205 and so looking forward to that. 12 00:00:27,265 --> 00:00:29,285 But before we dive into the broader discussion, 13 00:00:29,305 --> 00:00:30,405 can you tell us a little bit more 14 00:00:30,405 --> 00:00:31,725 about yourself and your background? 15 00:00:32,595 --> 00:00:35,725 - Sure. So I've been with Moffitt for about five years now. 16 00:00:36,885 --> 00:00:39,565 I started my career at a very young age, 17 00:00:39,905 --> 00:00:43,005 and I started out at the lowest level of a, 18 00:00:43,485 --> 00:00:45,165 a certified nursing assistant. 19 00:00:45,505 --> 00:00:47,365 And I've worked my way all the way up. 20 00:00:47,825 --> 00:00:50,725 And so I have now been a nurse almost 30 years. 21 00:00:51,545 --> 00:00:55,445 Uh, my career has spanned anything from nursing home 22 00:00:55,505 --> 00:01:00,005 or SNF critical care, emergency room, outpatient 23 00:01:00,705 --> 00:01:03,125 med surg, just about everything. 24 00:01:03,285 --> 00:01:04,885 I didn't deliver too many babies, 25 00:01:05,545 --> 00:01:08,165 but, um, I did in the emergency room deliver one or two. 26 00:01:08,745 --> 00:01:11,045 But my work history has been across the United States, 27 00:01:11,045 --> 00:01:14,965 which I think really gives me a greater insight than someone 28 00:01:15,145 --> 00:01:17,325 who stayed in one location all the time. 29 00:01:17,605 --> 00:01:19,845 'cause I've been experiencing a lot of different things. 30 00:01:22,065 --> 00:01:23,485 - Oh, wow. That's fascinating. 31 00:01:23,515 --> 00:01:25,965 What a great, um, breadth of experience and career. 32 00:01:26,725 --> 00:01:29,245 I, I think, you know, like you mentioned, being able 33 00:01:29,245 --> 00:01:30,605 to have those different experiences 34 00:01:30,785 --> 00:01:32,325 and certainly bring them into new roles 35 00:01:32,385 --> 00:01:34,965 and facilities, um, can make a big difference. 36 00:01:35,385 --> 00:01:37,485 I'm wondering, you know, after having worked in 37 00:01:37,485 --> 00:01:40,325 so many places across the us, do you have a kind 38 00:01:40,325 --> 00:01:41,405 of sweet spot for any of them? 39 00:01:41,585 --> 00:01:42,965 Or was there a location 40 00:01:43,105 --> 00:01:46,125 or a particular role within the nursing spectrum that, 41 00:01:46,185 --> 00:01:48,005 you know, you really is close to your heart? 42 00:01:48,675 --> 00:01:49,925 - Well, I mean, of course I have 43 00:01:49,925 --> 00:01:51,285 to say I love being at Moffitt, 44 00:01:51,305 --> 00:01:54,925 but no, there, I would say that, you know, I, 45 00:01:54,995 --> 00:01:57,245 I've worked in Hawaii, I've worked in California, 46 00:01:57,355 --> 00:01:59,605 I've worked in some really wonderful places. 47 00:02:00,465 --> 00:02:04,365 Um, I don't know that any one of 'em stand out of, oh, 48 00:02:04,445 --> 00:02:08,005 I have to go back, but always open to, you know, 49 00:02:08,575 --> 00:02:10,125 where life leads us, right? 50 00:02:10,185 --> 00:02:12,205 We should be, at least. Anyway. 51 00:02:13,645 --> 00:02:15,445 - I love that. That's such a great way to put it. 52 00:02:15,445 --> 00:02:18,765 And, and certainly, um, the opportunity to, you know, grow 53 00:02:18,765 --> 00:02:20,605 and develop within your career, um, 54 00:02:20,665 --> 00:02:23,645 can come in many different ways in, in shapes and sizes. 55 00:02:23,665 --> 00:02:25,165 And so being open I think is 56 00:02:25,165 --> 00:02:26,485 such a great way to approach it. 57 00:02:26,945 --> 00:02:30,045 Now, can you tell me about your most successful project 58 00:02:30,275 --> 00:02:31,445 from the last year or two? 59 00:02:31,595 --> 00:02:33,845 What did you do and how did you measure the results? 60 00:02:35,375 --> 00:02:39,515 - Wow, the last year has been a whirlwind of change for us. 61 00:02:40,215 --> 00:02:43,395 So, uh, we were very lucky to open a brand new hospital. 62 00:02:44,215 --> 00:02:46,835 Uh, not very many organizations get to say they open a, 63 00:02:47,275 --> 00:02:50,075 a complete brand new from the ground up hospital. 64 00:02:50,735 --> 00:02:53,595 Uh, but we just did, and it's a, it's a smart hospital. 65 00:02:54,025 --> 00:02:55,275 It's surgery based only. 66 00:02:56,015 --> 00:02:58,555 Uh, we spent about two years mapping out our current 67 00:02:58,925 --> 00:03:01,605 workflows from the clinical informatics side, especially. 68 00:03:02,025 --> 00:03:04,485 We really worked on those workflows. What do we do now? 69 00:03:05,115 --> 00:03:06,165 What are we gonna change 70 00:03:06,905 --> 00:03:09,085 and what, why do we need to even change? 71 00:03:09,185 --> 00:03:10,325 Is there something that we could do 72 00:03:10,325 --> 00:03:11,445 better in our new location? 73 00:03:12,485 --> 00:03:15,365 I think that this implementation of all these digital 74 00:03:16,795 --> 00:03:20,185 attributes are really gonna be time saving for nursing 75 00:03:20,885 --> 00:03:22,865 and for the other clinical staff, of course, 76 00:03:23,765 --> 00:03:26,105 but we implemented our digital door signs 77 00:03:26,175 --> 00:03:29,305 that now alert you immediately to whether 78 00:03:29,325 --> 00:03:31,345 or not a patient is on isolation. 79 00:03:31,365 --> 00:03:33,225 You know, with cancer care, that's really important 80 00:03:33,225 --> 00:03:36,025 because a lot of times it's not about protecting the staff, 81 00:03:36,295 --> 00:03:38,305 it's actually protecting the, the patient. 82 00:03:39,525 --> 00:03:41,425 So we can do that instantly with orders. 83 00:03:41,845 --> 00:03:45,145 And back in the day, I, I'm sure most of of our 84 00:03:45,895 --> 00:03:48,865 listeners will remember this, is we used to take a piece 85 00:03:48,865 --> 00:03:50,185 of paper and stick it on the door, 86 00:03:50,185 --> 00:03:52,505 and so you had to wait on someone to get that sticker 87 00:03:52,885 --> 00:03:55,905 and get all of those things together and put it on the door. 88 00:03:55,925 --> 00:03:57,905 So there was opportunities for people 89 00:03:57,905 --> 00:04:00,585 to go in without actually knowing that they shouldn't. 90 00:04:01,345 --> 00:04:02,885 Uh, now we're protecting our staff 91 00:04:02,885 --> 00:04:04,485 and our visitors a lot faster. 92 00:04:05,475 --> 00:04:07,895 The other thing that we did in is these rooms is we put 93 00:04:07,895 --> 00:04:08,975 in a digital whiteboard. 94 00:04:09,315 --> 00:04:12,255 Um, I'm sure most everyone remembers walking in 95 00:04:12,255 --> 00:04:14,415 and writing your name on the board as the nurse 96 00:04:14,415 --> 00:04:15,655 and putting your telephone number, 97 00:04:15,715 --> 00:04:18,975 and then updating all that information over and over 98 00:04:18,975 --> 00:04:20,855 and over every single day. 99 00:04:21,395 --> 00:04:23,095 And we now have digital whiteboards 100 00:04:23,095 --> 00:04:26,695 that actually update from our charting from our orders, 101 00:04:27,595 --> 00:04:29,695 and it's all integrated with our, uh, 102 00:04:29,745 --> 00:04:31,215 electronic health record. 103 00:04:32,415 --> 00:04:34,315 And so it's just so much easier 104 00:04:34,455 --> 00:04:35,795 to get some of these things to do. 105 00:04:36,615 --> 00:04:38,995 And when you ask about how do we measure our results, 106 00:04:39,455 --> 00:04:42,835 you know, it's hard to measure, you know, what kind 107 00:04:42,835 --> 00:04:44,195 of success did you have? 108 00:04:44,375 --> 00:04:47,595 But the best success I think that we could have measured was 109 00:04:48,255 --> 00:04:51,635 on day three, our clinical leadership came to us 110 00:04:51,655 --> 00:04:54,235 and said, wow, things are going really good. 111 00:04:54,565 --> 00:04:57,075 Maybe we should consider closing the command center. 112 00:04:57,575 --> 00:05:00,595 Now, I'll tell you, I was adamantly opposed to CLO closing 113 00:05:00,595 --> 00:05:03,355 that command center, at least for one week, 114 00:05:03,455 --> 00:05:05,795 but we did close it after only a single week. 115 00:05:06,135 --> 00:05:08,755 And I've been through many implementations, 116 00:05:09,735 --> 00:05:11,915 and those command centers don't close in a week. 117 00:05:12,055 --> 00:05:14,115 So I think we did something right there. 118 00:05:16,345 --> 00:05:17,605 - That's an amazing story 119 00:05:17,625 --> 00:05:19,645 and certainly, you know, so impressive 120 00:05:19,705 --> 00:05:22,645 to have from the clinical leadership team such faith 121 00:05:22,645 --> 00:05:25,125 after a week that, you know, they can really, um, 122 00:05:25,195 --> 00:05:26,845 make a difference in, in, like you said, 123 00:05:26,895 --> 00:05:28,045 close the command center 124 00:05:28,065 --> 00:05:31,405 and get into a space where people really feel comfortable 125 00:05:31,425 --> 00:05:34,605 and confident, um, you know, going into the rooms and, 126 00:05:34,665 --> 00:05:36,565 and, you know, that makes it seems like 127 00:05:36,565 --> 00:05:37,685 it made such a big difference. 128 00:05:38,805 --> 00:05:41,285 - I, I think so. I think it was, I think it was huge. 129 00:05:42,465 --> 00:05:45,125 - That's amazing to hear. Well, um, you know, it, 130 00:05:45,185 --> 00:05:48,005 it really cool, especially to think about, um, 131 00:05:48,185 --> 00:05:50,285 how you're making a difference for the clinical team, 132 00:05:50,285 --> 00:05:52,725 because I know so many organizations are dealing with, 133 00:05:53,145 --> 00:05:55,725 you know, uh, nurses and, and doctors 134 00:05:55,865 --> 00:05:59,205 and, um, clinical staff who are, um, understaffed 135 00:05:59,225 --> 00:06:01,285 or, you know, um, challenges 136 00:06:01,285 --> 00:06:02,725 with burnout and those kinds of things. 137 00:06:02,745 --> 00:06:05,925 And so being able to take away some of that, um, you know, 138 00:06:05,985 --> 00:06:08,685 the, I guess, um, repetitive tasks 139 00:06:09,565 --> 00:06:10,685 I can imagine was really helpful. 140 00:06:12,005 --> 00:06:15,445 - Absolutely. - Now, looking ahead, what are some 141 00:06:15,565 --> 00:06:17,765 of your top priorities for the next 12 months or so? 142 00:06:18,765 --> 00:06:19,865 - So Laura, you really kind 143 00:06:19,865 --> 00:06:21,145 of touched on something you said. 144 00:06:21,165 --> 00:06:22,905 You, you talked about the burnout and, 145 00:06:23,005 --> 00:06:25,665 and the fact that people are leaving healthcare, 146 00:06:25,805 --> 00:06:28,665 and I think that that is one of our big concerns is 147 00:06:28,765 --> 00:06:31,345 of course, burnout, but with burnout 148 00:06:31,485 --> 00:06:33,905 and people leaving, you've gotta replace 'em. 149 00:06:33,905 --> 00:06:37,425 And so you have so many new graduate RNs that are coming in. 150 00:06:37,845 --> 00:06:40,985 And so my big two priorities is patient throughput 151 00:06:41,405 --> 00:06:44,065 and ensuring that the largest, these large numbers 152 00:06:44,085 --> 00:06:45,985 of new graduate nurses feel 153 00:06:45,985 --> 00:06:47,425 supported in their nursing units. 154 00:06:48,505 --> 00:06:51,965 So I'm really partnering with our chief nursing officer, 155 00:06:51,975 --> 00:06:54,885 Kelly Gonzalo, and we're designing 156 00:06:54,885 --> 00:06:57,885 and implementing, um, some of our smart, uh, 157 00:06:57,895 --> 00:07:00,405 we're implementing a smart operations center, 158 00:07:01,065 --> 00:07:02,365 and what does that really look like? 159 00:07:02,515 --> 00:07:03,725 It's really hard to explain, 160 00:07:03,825 --> 00:07:07,135 but sometimes the way I like to say is it's kind 161 00:07:07,135 --> 00:07:08,975 of this central hub to understand 162 00:07:09,115 --> 00:07:11,215 how the patient flow is going to work. 163 00:07:12,155 --> 00:07:14,695 And so they'll focus on appropriate 164 00:07:14,715 --> 00:07:17,975 and timely discharges, freeing up those bed spaces 165 00:07:18,155 --> 00:07:19,255 for new admissions. 166 00:07:19,765 --> 00:07:22,375 They're also gonna house our virtual nursing program, 167 00:07:23,185 --> 00:07:25,615 which will act as eyes in the sky 168 00:07:25,675 --> 00:07:27,775 for monitoring declining patient status 169 00:07:28,315 --> 00:07:31,175 and serve as a mentor for those new, uh, graduate 170 00:07:31,175 --> 00:07:33,095 or less experienced nurses on the units. 171 00:07:33,995 --> 00:07:38,775 So those are our really big two focuses for right now, 172 00:07:39,405 --> 00:07:42,055 from a nursing standpoint, we have many, many, 173 00:07:42,085 --> 00:07:45,855 many projects here at Moffitt, but these two are really near 174 00:07:45,855 --> 00:07:47,055 and dear to my heart because 175 00:07:47,595 --> 00:07:51,295 so many patients need cancer care and they can't get in 176 00:07:51,295 --> 00:07:53,415 because we can only serve so many people, 177 00:07:53,915 --> 00:07:55,335 and we're really trying to figure out 178 00:07:55,335 --> 00:07:58,095 how do we serve more patients who really need 179 00:07:58,095 --> 00:07:59,735 that lifesaving care. 180 00:08:01,585 --> 00:08:03,505 - Absolutely. I think that's such an important point, 181 00:08:03,525 --> 00:08:07,385 and definitely being able to provide that kind of care 182 00:08:07,445 --> 00:08:10,945 and the close support to, um, patients is vital. 183 00:08:11,445 --> 00:08:14,105 Um, you know, and, and I just really appreciate you talking 184 00:08:14,115 --> 00:08:16,345 about how, um, the nurses 185 00:08:17,165 --> 00:08:20,785 and especially supporting some of the, um, newer nurses or, 186 00:08:20,785 --> 00:08:22,585 or those who are early on in their career, um, 187 00:08:22,645 --> 00:08:23,785 can make a huge difference. 188 00:08:24,025 --> 00:08:26,865 I know entering the workforce in the last couple years, um, 189 00:08:27,085 --> 00:08:29,185 is, has been a unique experience, um, 190 00:08:29,335 --> 00:08:30,665 amid covid and then after. 191 00:08:30,885 --> 00:08:33,985 So, um, from your perspective, is there anything, um, 192 00:08:34,715 --> 00:08:38,065 additional or, or unique that you've done to attract nurses 193 00:08:38,245 --> 00:08:42,585 or really strengthen the workforce as, um, these nurses, um, 194 00:08:42,585 --> 00:08:44,265 really enter into the space 195 00:08:44,325 --> 00:08:47,345 and want to become a bigger part of Moffitt going forward? 196 00:08:48,965 --> 00:08:51,705 - So that, uh, would be a better question 197 00:08:51,765 --> 00:08:54,745 for our CNOI do know that they are partnering 198 00:08:54,745 --> 00:08:59,045 with universities to help attract the, the smartest 199 00:08:59,185 --> 00:09:02,005 and the best, uh, candidates to us first. 200 00:09:02,945 --> 00:09:07,285 And, but I am not really privy to all of the efforts 201 00:09:07,285 --> 00:09:08,565 that they're doing on recruiting. 202 00:09:09,285 --> 00:09:11,205 I will just say from an informatic standpoint, 203 00:09:11,205 --> 00:09:12,405 recruiting is always hard. 204 00:09:12,545 --> 00:09:14,085 We have really high standards. 205 00:09:14,105 --> 00:09:15,885 To be an informaticist at Moffit 206 00:09:16,425 --> 00:09:19,365 and getting those really talented people in 207 00:09:20,105 --> 00:09:21,125 is really important. 208 00:09:21,905 --> 00:09:23,045 One of the things that we have, 209 00:09:23,065 --> 00:09:25,965 and I believe we're probably one, if not only 210 00:09:26,545 --> 00:09:29,325 the only one in the nation is we have a 211 00:09:30,395 --> 00:09:32,765 trainee program for informaticists. 212 00:09:32,785 --> 00:09:36,165 So we bring in nurses who have a desire 213 00:09:36,185 --> 00:09:37,365 to be an informaticist, 214 00:09:37,365 --> 00:09:41,045 and over the two years we train them to be informaticists. 215 00:09:41,665 --> 00:09:44,485 Um, we have some strict guidelines on how to get in 216 00:09:44,485 --> 00:09:46,645 and everything, but it's, um, it's an amazing program. 217 00:09:47,065 --> 00:09:49,285 We were just published on that, 218 00:09:49,625 --> 00:09:51,725 and so I think that's a huge way 219 00:09:51,725 --> 00:09:54,525 of attracting new people is is having these 220 00:09:55,035 --> 00:09:56,245 kind of internships. 221 00:09:58,645 --> 00:09:59,685 - Absolutely. That's great to hear. 222 00:09:59,705 --> 00:10:03,645 And I, I know technology, um, in, in that informatics role, 223 00:10:03,665 --> 00:10:05,365 it seems like has really gained a lot 224 00:10:05,365 --> 00:10:07,005 of traction in the last couple of years. 225 00:10:07,065 --> 00:10:08,685 And now with AI 226 00:10:08,685 --> 00:10:12,285 and artificial intelligence, um, really becoming more 227 00:10:12,285 --> 00:10:13,805 and more part of the healthcare system, 228 00:10:14,275 --> 00:10:17,005 it's just really cool to have that opportunity, um, 229 00:10:17,005 --> 00:10:18,805 especially at a place like Moffitt. 230 00:10:19,145 --> 00:10:20,845 Now, how do you anticipate your role 231 00:10:20,865 --> 00:10:22,845 and teams will change in the next year or two? 232 00:10:23,985 --> 00:10:26,905 - Wow. I mean, just like the rest of healthcare, 233 00:10:27,045 --> 00:10:28,505 my role is constantly changing. 234 00:10:29,625 --> 00:10:30,825 I continue to step further 235 00:10:30,885 --> 00:10:33,465 and further away from the daily operations 236 00:10:34,285 --> 00:10:37,345 and to focus on really long-term strategy of 237 00:10:37,345 --> 00:10:39,145 where the organization and 238 00:10:39,145 --> 00:10:41,665 where technologies are driving us, um, 239 00:10:41,975 --> 00:10:45,505 that will help really make patients care much better. 240 00:10:45,785 --> 00:10:48,545 I think that as a top-notch cancer center, 241 00:10:48,885 --> 00:10:50,945 we have an obligation to maintain that. 242 00:10:51,925 --> 00:10:54,425 And as the world changes 243 00:10:54,685 --> 00:10:57,425 and the technologies change, we have to evolve with that. 244 00:10:58,285 --> 00:11:01,985 Our care will always be high quality, 245 00:11:02,485 --> 00:11:03,945 but how do we deliver it differently? 246 00:11:04,085 --> 00:11:07,425 And I think that's where we're really, um, struggling 247 00:11:07,445 --> 00:11:09,345 to figure out how to keep up. 248 00:11:09,345 --> 00:11:12,385 Because every day, I mean, I can, I can't tell you every, 249 00:11:12,435 --> 00:11:14,105 every day when I read a Becker's article, 250 00:11:14,445 --> 00:11:16,185 how many times the word the, you know, 251 00:11:16,185 --> 00:11:17,865 the letter's AI is, is in it. 252 00:11:18,485 --> 00:11:21,865 So we're continuing to grow, we're expanding our size. 253 00:11:22,245 --> 00:11:24,465 Um, and that seems odd for a lot 254 00:11:24,465 --> 00:11:26,905 of organizations is why are you increasing? 255 00:11:27,965 --> 00:11:29,145 But you, you hit it. 256 00:11:29,475 --> 00:11:32,305 Technology is not just outta the box 257 00:11:32,365 --> 00:11:35,305 and it just doesn't fit into your workflow. 258 00:11:35,365 --> 00:11:37,905 And so you need someone that can help convey 259 00:11:37,905 --> 00:11:39,465 what the organization needs 260 00:11:39,765 --> 00:11:42,545 and then manipulate either the software 261 00:11:42,565 --> 00:11:45,745 or manipulate the workflow to make things work together. 262 00:11:46,845 --> 00:11:49,825 Um, also we're growing in size. Moffitt is expanded. 263 00:11:49,895 --> 00:11:51,945 Like I just said. We just opened a new hospital. 264 00:11:52,085 --> 00:11:54,205 We have two, what we call Max 265 00:11:54,265 --> 00:11:57,445 or Moffitt ambulatory centers that are, um, 266 00:11:57,445 --> 00:11:59,605 that will be opening over the next two years. 267 00:12:00,635 --> 00:12:02,855 And so we're just growing, our footprint's growing. 268 00:12:03,235 --> 00:12:05,255 So those people need support out there. 269 00:12:05,315 --> 00:12:07,335 And clinical informatics is that support that they need. 270 00:12:08,715 --> 00:12:09,975 - That's amazing to hear. 271 00:12:10,525 --> 00:12:12,975 Mark, thank you so much for joining us on the podcast today. 272 00:12:13,005 --> 00:12:15,135 This has been such a fun and interesting discussion 273 00:12:15,135 --> 00:12:17,055 and I look forward to connecting with you again soon. 274 00:12:18,095 --> 00:12:20,935 - I can't wait. Thank you so much for having me again. Bye.