1 00:00:00,278 --> 00:00:02,583 Hi, everyone, and welcome to the Becker healthcare 2 00:00:02,583 --> 00:00:03,401 care podcast. 3 00:00:04,014 --> 00:00:07,273 I'm Mackenzie Bean, Av and managing editor of 4 00:00:07,353 --> 00:00:08,863 Becker hospital review. 5 00:00:09,754 --> 00:00:11,991 Today, I'm thrilled to be chatting with Stephanie 6 00:00:12,071 --> 00:00:14,467 Wet, who is a chief Clinical Officer of 7 00:00:14,627 --> 00:00:15,985 Psychiatric Medical Care. 8 00:00:16,639 --> 00:00:18,149 Stephanie. Thank you so much for joining me. 9 00:00:18,308 --> 00:00:19,342 How are you doing today? 10 00:00:20,614 --> 00:00:22,602 I'm doing well, Mckenzie. Thanks for having me. 11 00:00:23,477 --> 00:00:24,272 Of course. 12 00:00:25,082 --> 00:00:27,809 I'm really excited to dig into our conversation 13 00:00:28,264 --> 00:00:28,502 today, 14 00:00:29,139 --> 00:00:30,355 and and tap your 15 00:00:30,809 --> 00:00:32,892 expertise on the top topic of behavioral health 16 00:00:32,892 --> 00:00:34,323 care and leadership. I know, 17 00:00:35,039 --> 00:00:36,867 improving access to behavioral. A health care is 18 00:00:36,867 --> 00:00:39,173 a tech priority for many of our readers 19 00:00:39,173 --> 00:00:41,184 and listeners today with those 20 00:00:41,653 --> 00:00:43,266 needs growing nationwide 21 00:00:44,356 --> 00:00:46,503 before we dive into the conversation though, I'd 22 00:00:46,503 --> 00:00:48,729 love to have you introduce yourself, and tell 23 00:00:48,729 --> 00:00:50,081 us a bit more about your background. 24 00:00:51,846 --> 00:00:52,803 Sure. I'd love to. 25 00:00:53,759 --> 00:00:56,490 Stephanie Weather. I am a nurse by background. 26 00:00:57,105 --> 00:00:59,256 I have my doctorate in nursing from Walden. 27 00:01:00,213 --> 00:01:00,713 So 28 00:01:01,343 --> 00:01:02,482 came up through 29 00:01:02,939 --> 00:01:04,316 the it kind of an interesting 30 00:01:04,853 --> 00:01:07,724 path. I actually became a nurse because I 31 00:01:07,724 --> 00:01:10,037 was a homeless mid midlife apprentice and moved 32 00:01:10,037 --> 00:01:10,969 to a state where 33 00:01:11,730 --> 00:01:13,010 late was not, 34 00:01:13,650 --> 00:01:15,890 licensed or legal. And so I just decided 35 00:01:15,890 --> 00:01:17,969 to become a nurse wise and, like, happens. 36 00:01:18,209 --> 00:01:19,489 So a lot of us. That's that's not 37 00:01:19,489 --> 00:01:20,624 the path I ended up walking. 38 00:01:21,343 --> 00:01:24,400 But but it intervene into the nursing profession 39 00:01:24,459 --> 00:01:26,935 and eventually into nursing leadership. 40 00:01:27,749 --> 00:01:29,347 Primarily in my career, I've done a lot 41 00:01:29,347 --> 00:01:29,847 of 42 00:01:30,706 --> 00:01:33,902 executive nurse leadership, quality, it as well as 43 00:01:33,902 --> 00:01:35,340 leadership in the quality arena. 44 00:01:35,994 --> 00:01:38,948 And then lots of extensive experience with the 45 00:01:38,948 --> 00:01:41,503 behavioral health leadership led me to my current 46 00:01:41,503 --> 00:01:44,318 role, this as Chief Clinical Officer for psychiatric 47 00:01:44,377 --> 00:01:44,935 medical care, 48 00:01:45,588 --> 00:01:48,530 we're a company that provides behavioral health expertise 49 00:01:48,530 --> 00:01:50,619 to around 03:50 50 00:01:50,835 --> 00:01:52,584 hospitals in 38 states. 51 00:01:53,394 --> 00:01:54,989 So I get a real bird's eye view 52 00:01:54,989 --> 00:01:57,063 of the behavioral health needs nationally, 53 00:01:57,940 --> 00:02:00,014 the needs of patients across the country and 54 00:02:00,014 --> 00:02:01,769 kind of trends around behavioral health. So it's 55 00:02:01,769 --> 00:02:02,588 an exciting 56 00:02:03,379 --> 00:02:06,436 company an exciting career for someone in clinical 57 00:02:06,735 --> 00:02:06,895 leadership? 58 00:02:08,572 --> 00:02:10,983 Absolutely. And I think your perspective is so 59 00:02:10,983 --> 00:02:13,056 valuable. Like you said, having that bird's eye 60 00:02:13,056 --> 00:02:13,955 view and seeing 61 00:02:14,970 --> 00:02:17,442 national trends and what hospitals and health systems 62 00:02:17,442 --> 00:02:19,536 across the country are doing to really 63 00:02:20,008 --> 00:02:21,601 improve care in this area? 64 00:02:22,477 --> 00:02:24,549 On that note, can you share some examples 65 00:02:24,549 --> 00:02:26,381 it tell a little bit more about some 66 00:02:26,381 --> 00:02:28,554 of the innovative programs or initiatives 67 00:02:28,931 --> 00:02:29,224 that's 68 00:02:29,901 --> 00:02:32,207 medical is implemented to improve, 69 00:02:33,003 --> 00:02:34,276 outcomes for behavioral patients? 70 00:02:35,787 --> 00:02:36,105 Sure. 71 00:02:36,756 --> 00:02:39,697 We're super passionate about outcomes. We're we're passionate 72 00:02:39,697 --> 00:02:41,764 about evidence based care, and that's really what 73 00:02:41,764 --> 00:02:43,989 outcomes are. You know, did you follow evidence 74 00:02:43,989 --> 00:02:45,204 based care practices 75 00:02:45,753 --> 00:02:47,662 to see improvement in patient outcomes. 76 00:02:48,776 --> 00:02:51,082 It's a challenge often in the behavioral health 77 00:02:51,082 --> 00:02:53,802 arena. We're not as hard wired around evidence 78 00:02:53,802 --> 00:02:55,552 based practice. You know, it's not like a 79 00:02:55,552 --> 00:02:57,382 knee placement where we all know. You go 80 00:02:57,382 --> 00:02:58,972 in. You enter on this day. You do 81 00:02:58,972 --> 00:03:01,223 this exact treatment on this day, We provide 82 00:03:01,223 --> 00:03:03,161 this exact medication and these, 83 00:03:03,780 --> 00:03:06,337 intervention. And we know without a doubt that 84 00:03:06,337 --> 00:03:08,507 the patient going to have this outcome the 85 00:03:08,507 --> 00:03:09,699 vast majority of the time. 86 00:03:10,810 --> 00:03:13,351 In behavioral health, there's a lot more triggers 87 00:03:13,351 --> 00:03:16,210 to pull to impact how a patient is 88 00:03:16,210 --> 00:03:17,004 going to improve. 89 00:03:17,734 --> 00:03:19,090 So 1 of the things that we did 90 00:03:19,090 --> 00:03:20,365 to try to look at all of those 91 00:03:20,365 --> 00:03:20,865 different 92 00:03:21,482 --> 00:03:24,533 areas is we created our own platform 93 00:03:24,910 --> 00:03:26,266 for outcomes measurement. 94 00:03:27,236 --> 00:03:29,225 And in doing so, we invested a lot 95 00:03:29,225 --> 00:03:31,691 of capital into doing that to ensure that 96 00:03:31,691 --> 00:03:34,411 we are looking at evidence based testing for 97 00:03:34,411 --> 00:03:35,766 our patients. That's 1 of the ways you 98 00:03:35,766 --> 00:03:38,076 measure in the behavioral health arena. We look 99 00:03:38,076 --> 00:03:41,104 at tools that are evidence based to see 100 00:03:41,104 --> 00:03:44,009 how the patient is on arrival at during 101 00:03:44,229 --> 00:03:45,370 specific times 102 00:03:45,669 --> 00:03:48,150 during their treatment and then at discharge so 103 00:03:48,150 --> 00:03:50,150 that we can see patients improvement. 104 00:03:51,599 --> 00:03:53,820 Some interesting things that we discovered in doing 105 00:03:53,820 --> 00:03:55,406 this, it it allowed us to look at 106 00:03:55,406 --> 00:03:57,255 both micro and macro 107 00:03:58,120 --> 00:04:00,360 parts of the system and treatment that patients 108 00:04:00,360 --> 00:04:00,840 were getting. 109 00:04:01,639 --> 00:04:03,159 So 1 of the examples that comes to 110 00:04:03,159 --> 00:04:03,659 mind 111 00:04:04,120 --> 00:04:05,659 is we noticed 112 00:04:06,213 --> 00:04:07,560 that there was a team that was really 113 00:04:07,560 --> 00:04:09,858 struggling and their patient outcomes weren't where we 114 00:04:09,858 --> 00:04:11,997 would expect them to be looking at the 115 00:04:11,997 --> 00:04:12,710 national data. 116 00:04:13,519 --> 00:04:14,019 And, 117 00:04:14,476 --> 00:04:16,310 you know, immediately, your gut instinct as well, 118 00:04:16,550 --> 00:04:18,246 there must be an issue with the people 119 00:04:18,305 --> 00:04:19,022 providing treatment. 120 00:04:19,820 --> 00:04:22,293 So, you know, we actually had some observations 121 00:04:22,293 --> 00:04:24,963 done. We observed the group therapy. We observed 122 00:04:25,182 --> 00:04:28,218 individual therapy. We observed the patient's treatment process, 123 00:04:28,777 --> 00:04:30,375 and all of that was really rock solid. 124 00:04:31,026 --> 00:04:33,803 So like okay, Well, what's going on. So 125 00:04:33,803 --> 00:04:36,660 we dove into the actual testing process itself 126 00:04:36,660 --> 00:04:37,374 with the patient. 127 00:04:38,024 --> 00:04:40,594 And what was interesting is that the culture 128 00:04:40,651 --> 00:04:41,629 of this team 129 00:04:42,085 --> 00:04:44,792 had conveyed to the patient that these tests 130 00:04:44,792 --> 00:04:46,168 were kind of burdensome them 131 00:04:46,956 --> 00:04:49,022 And so we were able to work with 132 00:04:49,022 --> 00:04:51,009 that team and really explain to the. It's 133 00:04:51,009 --> 00:04:53,155 kinda like you know, Mackenzie, if you went 134 00:04:53,155 --> 00:04:55,076 today to an north a pe doctor, and 135 00:04:55,076 --> 00:04:56,743 they wanted to take X rays, and they 136 00:04:56,743 --> 00:04:58,409 wanted to start you physical therapy, 137 00:04:59,521 --> 00:05:00,870 You wouldn't look at the X rays as 138 00:05:00,870 --> 00:05:02,791 a burden. Right? It's it's a it's a 139 00:05:02,791 --> 00:05:04,222 test that's going to tell you whether you 140 00:05:04,222 --> 00:05:07,401 need this certain intervention and process. And the 141 00:05:07,401 --> 00:05:09,309 behavioral health arena, a lot of times our 142 00:05:09,309 --> 00:05:12,424 patients can feel that does tests our burden 143 00:05:12,424 --> 00:05:13,856 to figure out you have already answer these 144 00:05:13,856 --> 00:05:15,605 questions. 5 people asking these questions. 145 00:05:16,241 --> 00:05:18,388 So we really worked as a out a 146 00:05:18,388 --> 00:05:20,868 scripting and how do we impact those so 147 00:05:20,868 --> 00:05:22,541 they understand the importance of this test. 148 00:05:23,179 --> 00:05:25,489 And it was amazing within a 3 month 149 00:05:25,489 --> 00:05:29,095 period doing recheck, we found the patients actually 150 00:05:29,095 --> 00:05:31,254 looked worse the very next time we tested 151 00:05:31,254 --> 00:05:33,415 them because they understood the importance of answering 152 00:05:33,415 --> 00:05:34,395 the test honestly 153 00:05:34,855 --> 00:05:36,935 and with truth about how they were doing. 154 00:05:37,349 --> 00:05:38,941 And then as over the period of the 155 00:05:38,941 --> 00:05:40,216 next 3 to 6 months, we saw a 156 00:05:40,216 --> 00:05:43,003 huge increase in improvement in these patients. And 157 00:05:43,003 --> 00:05:44,835 was a really great lesson that we learned 158 00:05:44,835 --> 00:05:47,241 on a micro level that we took macro 159 00:05:47,241 --> 00:05:48,299 to our whole company 160 00:05:48,916 --> 00:05:51,228 and hardwired some processes so that all of 161 00:05:51,228 --> 00:05:54,418 our patients understand the importance of these tests 162 00:05:54,418 --> 00:05:55,216 in their progress. 163 00:05:55,869 --> 00:05:57,544 Because we set their goals and we set 164 00:05:57,544 --> 00:06:00,415 their discharged all around their progress. So that's 165 00:06:00,415 --> 00:06:03,685 just 1 example of how we implemented improvement 166 00:06:03,685 --> 00:06:06,652 around patient outcomes to really drive patient improvement. 167 00:06:07,929 --> 00:06:10,025 Yeah. I I think that's such a powerful 168 00:06:10,243 --> 00:06:11,142 example of 169 00:06:11,840 --> 00:06:13,537 the important role that 170 00:06:14,248 --> 00:06:17,426 culture and, you know, patient education can really 171 00:06:17,426 --> 00:06:19,413 play in this work and how important it 172 00:06:19,413 --> 00:06:20,923 is for to really take the time and 173 00:06:20,923 --> 00:06:22,774 do the due diligence to understand 174 00:06:23,564 --> 00:06:26,441 what are obstacles, both staff members and patients. 175 00:06:26,681 --> 00:06:28,779 So it's great to hear those improvements. 176 00:06:29,718 --> 00:06:32,455 I'm curious, you mentioned that was 177 00:06:32,927 --> 00:06:33,427 shared 178 00:06:34,039 --> 00:06:34,539 across 179 00:06:34,992 --> 00:06:37,295 the company. So when that really a an 180 00:06:37,295 --> 00:06:39,756 example from a specific hospital that you were 181 00:06:39,756 --> 00:06:40,233 working with? 182 00:06:42,003 --> 00:06:44,401 So that was 1 of our specific locations. 183 00:06:44,720 --> 00:06:47,118 At Len mentioned earlier were in 03:50 184 00:06:47,118 --> 00:06:48,817 locations. That was occurring in 1 185 00:06:49,196 --> 00:06:49,696 particular 186 00:06:50,075 --> 00:06:52,724 location. But we... I'm just such a believer 187 00:06:52,724 --> 00:06:53,362 in systems. 188 00:06:54,081 --> 00:06:56,475 And when you learn something, you kind of 189 00:06:56,475 --> 00:06:58,230 make the assumption that if it's happening here, 190 00:06:58,390 --> 00:07:00,802 it probably happening in other places, and so 191 00:07:00,802 --> 00:07:02,720 we can all learn from each other. And 192 00:07:02,720 --> 00:07:03,998 so that's that's what I meant by that. 193 00:07:04,158 --> 00:07:06,316 We've been rolled that out in that process 194 00:07:06,316 --> 00:07:07,375 for how we train 195 00:07:07,849 --> 00:07:10,486 our staff and how we communicate the testing 196 00:07:10,486 --> 00:07:11,545 to our patients 197 00:07:12,244 --> 00:07:12,744 into, 198 00:07:13,762 --> 00:07:14,961 a nationwide practice. 199 00:07:16,889 --> 00:07:17,128 Yes. 200 00:07:18,160 --> 00:07:19,589 Very magnified results. 201 00:07:20,304 --> 00:07:21,733 Let's shift if gears a bit and talk 202 00:07:21,733 --> 00:07:22,233 about 203 00:07:22,766 --> 00:07:23,821 your specific 204 00:07:24,849 --> 00:07:25,988 leadership experience. 205 00:07:26,927 --> 00:07:29,025 I know you are in your chief clinical 206 00:07:29,084 --> 00:07:30,123 officer role now. 207 00:07:30,762 --> 00:07:32,521 What would you say are the biggest challenges 208 00:07:32,521 --> 00:07:35,167 you're encountering when comes to leading a team? 209 00:07:36,759 --> 00:07:38,989 We definitely face a lot of challenges around 210 00:07:38,989 --> 00:07:41,719 multi site leadership. And I think that's trans 211 00:07:42,269 --> 00:07:44,107 to whomever is listening to this today. 212 00:07:44,906 --> 00:07:47,304 It's very difficult for any clinical leader to 213 00:07:47,304 --> 00:07:49,461 have their finger on the pulse of everything 214 00:07:49,461 --> 00:07:51,634 happening that's under their purview view at 1 215 00:07:51,634 --> 00:07:53,714 time. Whether we're in in my case or 216 00:07:53,714 --> 00:07:56,514 you're in 38 states or whether you're in 217 00:07:56,514 --> 00:07:57,175 a single 218 00:07:57,475 --> 00:07:57,975 building 219 00:07:58,369 --> 00:07:59,646 you're, you know, you're not aware of what 220 00:07:59,646 --> 00:08:01,641 every clinician is doing at every minute. 221 00:08:02,280 --> 00:08:03,977 Some of the things that specifically 222 00:08:05,153 --> 00:08:08,037 I've encounters lack of frequent contact with staff. 223 00:08:08,593 --> 00:08:10,502 So, you know, it's kind of inability to 224 00:08:10,502 --> 00:08:12,491 oversee on a day to day basis, what 225 00:08:12,491 --> 00:08:15,455 teams are doing, frequent clinical drift is a 226 00:08:15,455 --> 00:08:17,531 a term I kind of coined and it's 227 00:08:17,531 --> 00:08:20,165 just where people start out, everybody starts out 228 00:08:20,165 --> 00:08:22,535 following your processes and rules and then over 229 00:08:22,653 --> 00:08:24,238 time if you don't have enough touch points 230 00:08:24,238 --> 00:08:27,407 or oversight, people drift kind of from the 231 00:08:27,407 --> 00:08:28,675 mid line of what they're supposed to be 232 00:08:28,675 --> 00:08:28,992 doing. 233 00:08:30,279 --> 00:08:32,200 And then I'm sure something thing that everybody 234 00:08:32,200 --> 00:08:34,919 can relate to hiring newly licensed staff members. 235 00:08:35,080 --> 00:08:36,059 And we're all 236 00:08:36,519 --> 00:08:37,980 in a place today where 237 00:08:38,293 --> 00:08:40,361 you're not often looking at 20 resumes to 238 00:08:40,361 --> 00:08:42,428 find the best fit for a position. You 239 00:08:42,428 --> 00:08:43,962 might only have newly, 240 00:08:44,814 --> 00:08:45,791 licensed graduates 241 00:08:46,659 --> 00:08:48,653 whether it's registered nurses, 242 00:08:49,610 --> 00:08:50,110 therapist, 243 00:08:51,365 --> 00:08:52,583 even physicians 244 00:08:53,438 --> 00:08:55,672 to choose from. And so how do you 245 00:08:55,672 --> 00:08:57,065 engage and train 246 00:08:57,924 --> 00:09:00,184 newly licensed staff members. So, 247 00:09:00,965 --> 00:09:03,304 you know, some of the things we've created 248 00:09:03,365 --> 00:09:04,424 to try to make 249 00:09:05,376 --> 00:09:07,148 that better, we created our own 250 00:09:07,603 --> 00:09:10,727 Emr platform. So across those 350 251 00:09:10,784 --> 00:09:12,476 locations, we can have people documenting 252 00:09:13,345 --> 00:09:15,045 in a way that it's transparent 253 00:09:15,504 --> 00:09:16,004 to 254 00:09:16,465 --> 00:09:18,625 clinical leadership, what's going on. We have the 255 00:09:18,625 --> 00:09:20,225 ability to see into that, which I think 256 00:09:20,225 --> 00:09:21,125 so important 257 00:09:22,237 --> 00:09:24,623 creating training systems. So how do you onboard 258 00:09:24,623 --> 00:09:26,613 your staff and how do you keep staff 259 00:09:26,613 --> 00:09:28,522 current in their field In the behavioral health 260 00:09:28,522 --> 00:09:30,375 field, I think it's just so important 261 00:09:31,402 --> 00:09:33,312 if if you were working in critical care, 262 00:09:33,471 --> 00:09:35,643 you wouldn't go into critical care and think 263 00:09:36,178 --> 00:09:37,930 in 2 weeks, somebody can become an expert 264 00:09:37,930 --> 00:09:38,248 in that. 265 00:09:39,456 --> 00:09:41,465 I think there can be a mis perception 266 00:09:42,077 --> 00:09:44,856 in the acute care environment that behavioral helps. 267 00:09:45,809 --> 00:09:48,032 Everybody will say they handled behavioral health patients 268 00:09:48,032 --> 00:09:48,404 because 269 00:09:48,844 --> 00:09:51,481 if our patients our behavioral health. It's throughout 270 00:09:51,481 --> 00:09:53,319 our care environment and the care continuum, 271 00:09:54,118 --> 00:09:56,195 but we are a specialty, and so we 272 00:09:56,195 --> 00:09:57,802 need to invest in that. You know, are 273 00:09:57,802 --> 00:10:01,237 we encouraging our staff to become certified nurses 274 00:10:01,292 --> 00:10:02,823 around behavioral health. And 275 00:10:03,275 --> 00:10:05,075 in whatever their specialty pre is 276 00:10:05,513 --> 00:10:07,368 encouraging them to become board certified. 277 00:10:09,339 --> 00:10:12,230 The other thing is just making sure that 278 00:10:13,576 --> 00:10:15,085 we have consultation calls, 279 00:10:15,720 --> 00:10:18,658 so we do a monthly clinical training specific 280 00:10:18,658 --> 00:10:21,174 to behavioral health for any clinician within our 281 00:10:21,294 --> 00:10:23,284 company, and then we do a consultation call 282 00:10:23,284 --> 00:10:24,796 to talk about difficult cases, 283 00:10:26,467 --> 00:10:29,188 persistent problems that are seeing across the board, 284 00:10:29,427 --> 00:10:31,817 know whether it's dealing with difficult patients, discharge 285 00:10:31,817 --> 00:10:32,693 planning process, 286 00:10:34,207 --> 00:10:36,119 you know, whatever that could be for that 287 00:10:36,119 --> 00:10:37,154 specific location, 288 00:10:38,684 --> 00:10:40,524 we wanna make sure we're supporting our team. 289 00:10:41,165 --> 00:10:42,205 And then a big thing, 290 00:10:42,845 --> 00:10:44,764 I think to kind of overcome these leadership 291 00:10:44,764 --> 00:10:47,259 challenges is always asking why you know, as 292 00:10:47,259 --> 00:10:49,039 a clinical leader, you get asked 293 00:10:50,059 --> 00:10:53,419 annoying question today, and it can become easy 294 00:10:53,419 --> 00:10:54,459 just to give an answer. 295 00:10:55,273 --> 00:10:57,025 But 2 things happen when we do that 296 00:10:57,025 --> 00:10:58,220 when we give the answer of course, we're 297 00:10:58,220 --> 00:10:58,720 not 298 00:10:59,096 --> 00:11:01,167 encouraging people to learn to answer questions themselves. 299 00:11:01,804 --> 00:11:03,397 But more specifically than that, 300 00:11:04,210 --> 00:11:06,769 we're sometimes missing why they were asking the 301 00:11:06,769 --> 00:11:08,450 question. And when you ask that why, 302 00:11:09,009 --> 00:11:10,769 you might uncover a lot of things you 303 00:11:10,769 --> 00:11:12,629 weren't aware of. And so 304 00:11:13,183 --> 00:11:15,642 I almost never answer questions. I always ask 305 00:11:15,642 --> 00:11:17,411 for more information first 306 00:11:18,021 --> 00:11:20,584 to make sure that I'm getting the full 307 00:11:20,718 --> 00:11:22,957 picture and you'll be surprised what you learned. 308 00:11:24,785 --> 00:11:27,725 I'm sure. I love that approach. Do you 309 00:11:27,725 --> 00:11:28,575 find that 310 00:11:29,332 --> 00:11:31,885 employees often can land on the answers themselves 311 00:11:31,885 --> 00:11:34,139 after you ask some additional questions? 312 00:11:35,713 --> 00:11:37,228 I do think so that. I think most 313 00:11:37,228 --> 00:11:37,728 people 314 00:11:39,238 --> 00:11:40,376 they lack the confidence 315 00:11:41,231 --> 00:11:42,906 to tell you that you they've already formed 316 00:11:42,906 --> 00:11:44,342 the answer a lot of times, but it 317 00:11:44,342 --> 00:11:46,097 can be easy for a frontline staff member. 318 00:11:46,336 --> 00:11:47,772 They just wanna to get the answer and 319 00:11:47,772 --> 00:11:49,774 move on. Because they have so much on 320 00:11:49,774 --> 00:11:52,154 their plate. So it can become very easy 321 00:11:52,154 --> 00:11:53,740 to become the question answer. 322 00:11:54,851 --> 00:11:55,351 But 323 00:11:55,819 --> 00:11:57,975 if we wanna really grow our staff. It's 324 00:11:57,975 --> 00:11:59,731 it's kinda like, you know, when I have 325 00:11:59,731 --> 00:12:01,487 4 adult children now, but when they were 326 00:12:01,487 --> 00:12:03,403 young, you know, so much easier just to 327 00:12:03,403 --> 00:12:04,681 load the dishwasher myself. 328 00:12:05,413 --> 00:12:07,402 Then to teach them to load it took 329 00:12:07,402 --> 00:12:09,311 twice as much time. But in the long 330 00:12:09,311 --> 00:12:11,857 run, you know, they wouldn't be very productive 331 00:12:11,936 --> 00:12:13,709 I had done that for them. So 332 00:12:14,498 --> 00:12:16,809 Absolutely. It goes back to the deep the 333 00:12:16,809 --> 00:12:18,164 man fish outage. Right? 334 00:12:19,041 --> 00:12:19,541 Exactly. 335 00:12:20,874 --> 00:12:21,374 Wonderful. 336 00:12:22,404 --> 00:12:24,884 I think you you you almost hinted at 337 00:12:24,884 --> 00:12:26,884 this a bit in some of your examples 338 00:12:26,884 --> 00:12:27,544 from the 339 00:12:27,924 --> 00:12:28,085 organization. 340 00:12:28,804 --> 00:12:30,085 But I'm curious if you can speak a 341 00:12:30,085 --> 00:12:33,046 little bit more to How specifically you're working 342 00:12:33,046 --> 00:12:34,658 to create a culture 343 00:12:35,032 --> 00:12:37,677 of continuous improvement and innovation 344 00:12:38,368 --> 00:12:39,242 among your teams. 345 00:12:41,244 --> 00:12:42,520 Really good question. 346 00:12:44,195 --> 00:12:45,471 1 of the things that we do is 347 00:12:45,471 --> 00:12:47,545 every year in October, I send out an 348 00:12:47,545 --> 00:12:49,162 email to all of our staff members 349 00:12:49,619 --> 00:12:50,757 and request 350 00:12:51,228 --> 00:12:55,366 their thoughts on forms, process change, policy change. 351 00:12:56,082 --> 00:12:58,946 We typically get somewhere between 02:50 352 00:12:58,946 --> 00:12:59,923 to 300 353 00:13:02,070 --> 00:13:04,146 potential for improvement suggestions every year. 354 00:13:05,183 --> 00:13:07,578 And we like to call through those. Sometimes, 355 00:13:07,738 --> 00:13:09,036 you know, we can always 356 00:13:09,429 --> 00:13:11,669 act on them if there's a regulatory reason 357 00:13:11,669 --> 00:13:13,669 or a compliance reason that we're doing something. 358 00:13:14,070 --> 00:13:15,669 But the people who are closest to the 359 00:13:15,669 --> 00:13:18,244 patient, they often know how to fix the 360 00:13:18,244 --> 00:13:19,917 problems that we might not even have the 361 00:13:19,917 --> 00:13:21,670 answers to. So I love actually just as 362 00:13:21,670 --> 00:13:24,300 simple as that sounds asking people. Ask for 363 00:13:24,300 --> 00:13:25,097 their suggestions. 364 00:13:26,146 --> 00:13:27,837 And then follow ups on them. We 365 00:13:28,211 --> 00:13:30,673 take from October to December to go through 366 00:13:30,673 --> 00:13:33,214 those and in January, we do roll of 367 00:13:33,214 --> 00:13:35,064 changes based off of the staff 368 00:13:35,692 --> 00:13:36,192 process 369 00:13:36,807 --> 00:13:37,206 suggestions. 370 00:13:37,922 --> 00:13:39,435 The other thing we do is that we 371 00:13:39,435 --> 00:13:41,426 have a process every month where our teams 372 00:13:41,426 --> 00:13:44,468 perform self audits on their documentation. And then 373 00:13:44,468 --> 00:13:46,086 we perform quarterly una 374 00:13:46,623 --> 00:13:47,362 oversight audit 375 00:13:47,820 --> 00:13:50,294 so that we can ensure that the teams 376 00:13:50,294 --> 00:13:52,105 themselves know what's going on in their chart 377 00:13:52,304 --> 00:13:54,377 and that we as of the corporate team 378 00:13:54,377 --> 00:13:55,813 know what's going on in those records. 379 00:13:57,009 --> 00:13:59,162 Based off of those audits, we do performance 380 00:13:59,162 --> 00:14:01,576 improvement plans with the team. So the teams 381 00:14:01,889 --> 00:14:03,408 are aware of. It's an open book test. 382 00:14:03,647 --> 00:14:04,606 I'm really big on that. 383 00:14:05,645 --> 00:14:08,123 You, we all know the standards that we 384 00:14:08,123 --> 00:14:10,840 are being accredited by through our accreditation bodies. 385 00:14:11,254 --> 00:14:12,695 But should be an open book test for 386 00:14:12,695 --> 00:14:15,095 the teams. They should know what we're gonna 387 00:14:15,095 --> 00:14:16,455 look at, They should know what they should 388 00:14:16,455 --> 00:14:17,975 be looking at so that we can all 389 00:14:17,975 --> 00:14:18,774 be successful. 390 00:14:19,589 --> 00:14:21,026 And then we, of course, have a safety 391 00:14:21,026 --> 00:14:24,220 culture for... Through incident reporting to make sure 392 00:14:24,220 --> 00:14:27,493 that we encourage people to notify not even 393 00:14:27,493 --> 00:14:29,010 just incidents that near misses. 394 00:14:29,977 --> 00:14:31,959 And if you're in the behavioral health arena, 395 00:14:32,276 --> 00:14:33,544 I would give you this 1 thing to 396 00:14:33,544 --> 00:14:35,153 take away with you from today's 397 00:14:35,842 --> 00:14:36,080 call, 398 00:14:36,889 --> 00:14:38,509 which is the debrief process. 399 00:14:38,970 --> 00:14:40,669 If you want to change your culture 400 00:14:41,129 --> 00:14:41,370 debrief, 401 00:14:42,169 --> 00:14:45,463 debrief, debrief. So we normally behavioral health pretty 402 00:14:45,463 --> 00:14:47,857 common to do an immediate debrief after something 403 00:14:47,857 --> 00:14:48,256 happens. 404 00:14:48,734 --> 00:14:50,808 You know, is everybody okay? Is everyone safe? 405 00:14:52,339 --> 00:14:53,857 What do we think happen in this moment. 406 00:14:54,177 --> 00:14:55,934 But I would encourage you to do a 407 00:14:55,934 --> 00:14:58,331 debrief process 3 or 4 days after an 408 00:14:58,331 --> 00:14:59,050 incident occurs. 409 00:14:59,703 --> 00:15:01,312 To really dive into 410 00:15:01,684 --> 00:15:03,428 what worked well, what didn't work well. It's 411 00:15:03,428 --> 00:15:05,171 not punitive in any way it's a chance 412 00:15:05,171 --> 00:15:07,648 for the team who is who were there 413 00:15:07,648 --> 00:15:09,164 at that incident to look at it with 414 00:15:09,164 --> 00:15:10,441 fresh eyes, kind of a little bit of 415 00:15:10,441 --> 00:15:11,499 a detached guy 416 00:15:12,116 --> 00:15:14,771 because that's really going to help you 417 00:15:15,484 --> 00:15:15,803 change, 418 00:15:16,443 --> 00:15:17,961 things that we may or may not have 419 00:15:17,961 --> 00:15:20,199 been able to change through just talking to 420 00:15:20,199 --> 00:15:22,037 people, letting the people who have that lived 421 00:15:22,037 --> 00:15:24,526 experience come in and talk through it. And 422 00:15:24,526 --> 00:15:27,622 having experts at the table, whether that experts 423 00:15:27,622 --> 00:15:29,925 in behavioral health, experts in a physical incident, 424 00:15:30,083 --> 00:15:31,592 if it was something that happened physically, 425 00:15:32,163 --> 00:15:33,993 gets everybody at the same table and we 426 00:15:33,993 --> 00:15:35,426 can talk about how we wanna do things 427 00:15:35,426 --> 00:15:36,460 different than next time. 428 00:15:37,972 --> 00:15:39,188 Right know that can be 429 00:15:39,579 --> 00:15:41,034 so powerful to 430 00:15:41,411 --> 00:15:43,402 how folks have their voices be heard and 431 00:15:43,402 --> 00:15:45,871 then no. The organization is really acting on 432 00:15:45,871 --> 00:15:48,442 some of the suggestions. That come out of 433 00:15:49,313 --> 00:15:51,710 Well, Stephanie, the last question that I have 434 00:15:51,710 --> 00:15:52,988 for you is, 435 00:15:53,867 --> 00:15:56,276 what is your advice for aspiring chief clinical 436 00:15:56,276 --> 00:15:58,105 officers. What do you wish maybe you knew 437 00:15:58,105 --> 00:15:58,980 earlier in your role, 438 00:16:00,014 --> 00:16:01,366 what wisdom would you pass on? 439 00:16:02,814 --> 00:16:04,671 Well, I'm gonna start out by being cheesy 440 00:16:04,889 --> 00:16:05,927 and tell you a quote, 441 00:16:07,124 --> 00:16:08,561 I'm 1 of those people that loves quotes, 442 00:16:08,801 --> 00:16:11,847 and this quote is from Florence Nightingale. And 443 00:16:11,847 --> 00:16:13,994 it says let whoever is in charge, keep 444 00:16:13,994 --> 00:16:15,584 the simple question in her head. 445 00:16:16,379 --> 00:16:18,049 Not how can I always do the right 446 00:16:18,049 --> 00:16:19,026 thing myself 447 00:16:19,814 --> 00:16:21,650 but how can I provide for this right 448 00:16:21,650 --> 00:16:22,927 thing to always be done? 449 00:16:24,523 --> 00:16:27,817 And that truly is how I try to 450 00:16:28,768 --> 00:16:29,268 aspire 451 00:16:29,880 --> 00:16:30,277 to lead. 452 00:16:30,913 --> 00:16:32,978 And what I would recommend for for anyone 453 00:16:32,978 --> 00:16:34,988 that is leading, it's its systems. 454 00:16:35,854 --> 00:16:37,845 The very first when I my first role 455 00:16:37,845 --> 00:16:39,995 in leadership, I was an assistant director of 456 00:16:40,154 --> 00:16:40,632 Nursing. 457 00:16:41,429 --> 00:16:42,645 And my 458 00:16:43,420 --> 00:16:43,920 administrator 459 00:16:44,789 --> 00:16:47,442 was a systems focused thinker and he really 460 00:16:47,501 --> 00:16:49,176 impacted my leadership journey. 461 00:16:50,292 --> 00:16:51,967 Where human beings taking care of humans. 462 00:16:52,605 --> 00:16:54,302 And so there's inherent risk 463 00:16:55,012 --> 00:16:57,239 we're going to screw up. Right? We're going 464 00:16:57,239 --> 00:16:58,511 to mess up because we're human. 465 00:16:59,227 --> 00:17:00,738 So as a leader, you have to create 466 00:17:00,738 --> 00:17:02,408 systems for your team to succeed. 467 00:17:03,218 --> 00:17:05,848 And to prevent failure. And I'm sure everybody 468 00:17:05,848 --> 00:17:07,841 that's listening. This has probably been on a 469 00:17:07,841 --> 00:17:09,674 culture of safety journey and knows this swiss 470 00:17:09,674 --> 00:17:10,492 cheese model 471 00:17:10,884 --> 00:17:12,716 So so we have to create backup up 472 00:17:12,716 --> 00:17:13,433 to the backup, 473 00:17:13,991 --> 00:17:15,743 so you have to look at... When you're 474 00:17:15,743 --> 00:17:18,372 thinking of implementing something. From the very first 475 00:17:18,372 --> 00:17:20,460 step of it being... Of it touching a 476 00:17:20,460 --> 00:17:23,200 staff member to when it touches to patient 477 00:17:23,340 --> 00:17:25,100 to when the patient discharge, are you looking 478 00:17:25,100 --> 00:17:26,940 at the whole thing and where can it 479 00:17:26,940 --> 00:17:27,440 fail 480 00:17:27,914 --> 00:17:29,342 And so before we even roll it out, 481 00:17:29,500 --> 00:17:31,564 how can we ensure that when those failures 482 00:17:31,564 --> 00:17:33,627 happen, the failure not going to touch the 483 00:17:33,627 --> 00:17:36,190 patient. So that's probably my number 1 thing. 484 00:17:36,349 --> 00:17:38,349 The second would be that you have to 485 00:17:38,349 --> 00:17:40,990 create systems for yourself as a clinical lease 486 00:17:40,990 --> 00:17:42,670 leader to be successful. 487 00:17:43,723 --> 00:17:46,351 Crisis management is the number 1 job of 488 00:17:46,351 --> 00:17:49,058 a clinical leader. You're a constantly managing crisis, 489 00:17:49,297 --> 00:17:51,048 but you have to balance that as the 490 00:17:51,048 --> 00:17:51,548 leader 491 00:17:52,099 --> 00:17:53,935 with daily pass that have to be completed 492 00:17:53,935 --> 00:17:55,612 for you to be successful and for you 493 00:17:55,612 --> 00:17:57,767 to perform your role. It can be really 494 00:17:57,767 --> 00:18:00,880 easy. Most of us come into clinical work. 495 00:18:01,613 --> 00:18:03,366 Because we have heart for care getting. 496 00:18:04,004 --> 00:18:05,757 And so it can be really easy to 497 00:18:05,757 --> 00:18:07,670 be pulled in a million directions by a 498 00:18:07,670 --> 00:18:08,547 million problems. 499 00:18:09,598 --> 00:18:12,390 And you have to protect yourself and your 500 00:18:12,390 --> 00:18:14,463 ability to do your job. And that means, 501 00:18:14,543 --> 00:18:16,457 you know, setting boundaries, it means having time 502 00:18:16,457 --> 00:18:18,053 where your office stores closed and you have 503 00:18:18,053 --> 00:18:18,930 a sign on it, you know, 504 00:18:19,902 --> 00:18:21,497 email text me and I'll come... When I 505 00:18:21,497 --> 00:18:23,491 have a minute, I'll outcome find you because 506 00:18:23,491 --> 00:18:25,405 you have to do the job role that 507 00:18:25,405 --> 00:18:26,921 you have to do and not do everybody 508 00:18:26,921 --> 00:18:28,516 else's job, and that can be really hard 509 00:18:28,516 --> 00:18:29,964 for new clinical leaders. 510 00:18:30,839 --> 00:18:32,510 And then lastly, I would say do what's 511 00:18:32,510 --> 00:18:34,498 right for your patients and the rest will 512 00:18:34,498 --> 00:18:35,294 work itself out. 513 00:18:36,264 --> 00:18:37,783 And if you keep that at the core 514 00:18:37,783 --> 00:18:39,861 of what you're doing that you're here to 515 00:18:39,861 --> 00:18:42,578 serve the patients, you'll find that you can 516 00:18:42,578 --> 00:18:44,416 figure out a solution for most anything. 517 00:18:46,827 --> 00:18:47,327 Absolutely. 518 00:18:47,864 --> 00:18:50,119 I don't think that was a a cheesy 519 00:18:50,257 --> 00:18:52,412 at all. I I love that quote, Stephanie, 520 00:18:52,651 --> 00:18:54,899 I think you you should very point that 521 00:18:54,899 --> 00:18:57,930 remarks. And I just appreciate your time today 522 00:18:57,930 --> 00:18:59,526 to join us on the podcast. This has 523 00:18:59,526 --> 00:19:01,041 been such an a informative of discussion. And 524 00:19:01,121 --> 00:19:03,035 I feel like our listeners have, 525 00:19:03,528 --> 00:19:05,516 glean so many bits of wisdom done from 526 00:19:05,516 --> 00:19:06,709 you. So thank you so much. 527 00:19:07,743 --> 00:19:09,255 Thank you for having me It's been my 528 00:19:09,255 --> 00:19:09,573 pleasure. 529 00:19:10,384 --> 00:19:10,884 Wonderful. 530 00:19:11,499 --> 00:19:13,890 And listeners, you can catch more of Stephanie 531 00:19:13,890 --> 00:19:16,838 at our upcoming clinical leadership forum at the 532 00:19:16,917 --> 00:19:20,079 Becker Ceo Cfo Round table, November eleventh to 533 00:19:20,199 --> 00:19:23,233 14 in Chicago. We do have some limited 534 00:19:23,233 --> 00:19:25,489 space available for attendees and sponsors. 535 00:19:25,947 --> 00:19:28,422 If you're interested in joining, please contact us 536 00:19:28,422 --> 00:19:28,922 at 537 00:19:29,380 --> 00:19:31,862 at health dot com to learn more.