1 00:00:02,240 --> 00:00:05,120 The most important health care decisions don't happen 2 00:00:05,120 --> 00:00:05,779 in isolation. 3 00:00:06,240 --> 00:00:08,179 They happen when leaders come together. 4 00:00:08,800 --> 00:00:11,519 Becker's sixteenth annual meeting brings together more than 5 00:00:11,519 --> 00:00:12,559 3,500 6 00:00:12,559 --> 00:00:15,525 hospital and health system executives this April in 7 00:00:15,525 --> 00:00:16,024 Chicago. 8 00:00:16,565 --> 00:00:18,664 With 800 speakers from Ascension, 9 00:00:18,964 --> 00:00:22,164 Cleveland Clinic, CommonSpirit and more, the conversations get 10 00:00:22,164 --> 00:00:24,964 real. Leaders will share how their scenario planning 11 00:00:24,964 --> 00:00:27,605 for policy shifts, breaking through value based care 12 00:00:27,605 --> 00:00:30,000 barriers, and building clinical teams that translate 13 00:00:36,479 --> 00:00:37,460 sixteenth. For the 14 00:00:37,840 --> 00:00:41,759 agenda and event details, visit beckershospitalreview.com 15 00:00:41,759 --> 00:00:43,520 and click on the events tab in the 16 00:00:43,520 --> 00:00:44,340 upper right. 17 00:00:46,375 --> 00:00:48,534 This is Lauren Dierda with the Becker's Healthcare 18 00:00:48,534 --> 00:00:50,695 podcast. I'm thrilled today to be joined by 19 00:00:50,695 --> 00:00:53,814 Perry Gee, enterprise director of nursing research and 20 00:00:53,814 --> 00:00:55,734 evidence based practice as well as a nurse 21 00:00:55,734 --> 00:00:58,314 scientist and associate professor of research at Intermountain 22 00:00:58,454 --> 00:01:00,054 Health. Perry, it's a pleasure to have you 23 00:01:00,054 --> 00:01:01,195 on the podcast today. 24 00:01:02,510 --> 00:01:04,189 Thank you so much for having me. I'm 25 00:01:04,189 --> 00:01:05,890 excited to talk about our work. 26 00:01:06,349 --> 00:01:08,270 Absolutely. And I'm excited to learn more, I 27 00:01:08,270 --> 00:01:10,189 think, especially when you're looking at the nursing 28 00:01:10,189 --> 00:01:12,189 profession. I mean, right now is such a 29 00:01:12,189 --> 00:01:14,605 transformational time in health care, and so, you 30 00:01:14,605 --> 00:01:17,084 know, there's no better topic as we're trying 31 00:01:17,084 --> 00:01:18,685 to dig deeper and and make big changes 32 00:01:18,685 --> 00:01:19,825 in the health care space. 33 00:01:20,204 --> 00:01:21,724 But before we dive into some of the 34 00:01:21,724 --> 00:01:23,805 cool things you're doing at Intermountain, can you 35 00:01:23,805 --> 00:01:25,564 tell us a little bit more about yourself 36 00:01:25,564 --> 00:01:26,465 and your background? 37 00:01:28,280 --> 00:01:30,920 Absolutely. So I've been a nurse for over 38 00:01:30,920 --> 00:01:32,140 forty years now. 39 00:01:33,159 --> 00:01:35,719 Most of my early days in nursing was, 40 00:01:36,040 --> 00:01:38,759 in critical care and in flight. But for 41 00:01:38,759 --> 00:01:40,680 really the last twenty five years, I've been 42 00:01:40,680 --> 00:01:42,539 a clinical informatics specialist. 43 00:01:43,115 --> 00:01:45,995 And then the last ten years or more 44 00:01:45,995 --> 00:01:48,475 than that now, I have been a nurse 45 00:01:48,475 --> 00:01:50,954 scientist. I was the first nurse scientist at 46 00:01:50,954 --> 00:01:52,734 Dignity Health out in California 47 00:01:53,515 --> 00:01:54,314 and then, 48 00:01:54,875 --> 00:01:57,995 the first nurse scientist for Intermountain Health. And 49 00:01:57,995 --> 00:01:59,609 that's some of what I'd like to talk 50 00:01:59,609 --> 00:02:02,010 about today is some of the challenges that 51 00:02:02,010 --> 00:02:04,329 we face as nurse scientists as we build 52 00:02:04,329 --> 00:02:05,230 these programs. 53 00:02:05,930 --> 00:02:06,750 Most important, 54 00:02:08,409 --> 00:02:10,169 is the work that we do around research, 55 00:02:10,169 --> 00:02:12,675 of course. But a lot of us are 56 00:02:12,675 --> 00:02:15,075 also doing work in the space of evidence 57 00:02:15,075 --> 00:02:18,115 based practice and building capacity with evidence based 58 00:02:18,115 --> 00:02:18,615 practice. 59 00:02:19,314 --> 00:02:21,814 And then as our nursing organizations 60 00:02:22,835 --> 00:02:24,629 evolve, and we'll talk quite a bit about 61 00:02:24,710 --> 00:02:27,430 the evolution of the nursing organization at Intermountain 62 00:02:27,430 --> 00:02:29,930 Health, as those organizations evolve, 63 00:02:30,629 --> 00:02:33,430 some of us aren't professional governance environment or 64 00:02:33,430 --> 00:02:35,909 really an environment that gives a voice to 65 00:02:35,909 --> 00:02:37,669 the nurses at the point of care. So 66 00:02:37,669 --> 00:02:39,530 I want to make sure that my work 67 00:02:40,014 --> 00:02:41,955 really integrates with that environment 68 00:02:42,254 --> 00:02:45,694 and actually bolsters and strengthens the environment of 69 00:02:45,694 --> 00:02:47,955 of professional governance. And then last, 70 00:02:48,254 --> 00:02:50,495 and and one of the most important parts 71 00:02:50,495 --> 00:02:52,675 of my job, I think, is is scholarly 72 00:02:52,974 --> 00:02:54,569 dissemination of our work. 73 00:02:55,210 --> 00:02:57,450 We at Intermountain Health have been known for 74 00:02:57,450 --> 00:02:58,430 years as 75 00:02:58,730 --> 00:02:59,469 a a top, 76 00:03:00,010 --> 00:03:00,510 organization 77 00:03:00,969 --> 00:03:04,830 for medical research and clinical trials and incredible 78 00:03:04,890 --> 00:03:07,210 work in that space, but we haven't really 79 00:03:07,210 --> 00:03:10,795 been known as a top organization for nursing 80 00:03:10,795 --> 00:03:11,295 research. 81 00:03:11,995 --> 00:03:13,915 Even though we've been doing that work, we 82 00:03:13,915 --> 00:03:14,974 just haven't disseminated 83 00:03:15,275 --> 00:03:17,275 or talked about what we're doing. And so 84 00:03:17,275 --> 00:03:19,514 that's what I'm excited about is getting the 85 00:03:19,514 --> 00:03:21,295 word out that we are, 86 00:03:22,909 --> 00:03:25,889 certainly going to be a top nursing research 87 00:03:26,030 --> 00:03:26,530 organization, 88 00:03:26,909 --> 00:03:28,590 and we're on the pathway to getting to 89 00:03:28,590 --> 00:03:30,110 that. And that's kind of what I wanna 90 00:03:30,110 --> 00:03:31,090 talk about today. 91 00:03:32,830 --> 00:03:35,069 Absolutely. I think that's amazing to hear it 92 00:03:35,069 --> 00:03:35,729 and definitely, 93 00:03:36,275 --> 00:03:38,354 a space where there's a lot of interest 94 00:03:38,354 --> 00:03:40,514 and a lot of, you know, growing needs. 95 00:03:40,514 --> 00:03:41,014 So, 96 00:03:41,474 --> 00:03:42,995 let's jump right in. Can you tell us 97 00:03:42,995 --> 00:03:45,895 a little bit about, your nursing research organization 98 00:03:45,955 --> 00:03:47,555 and and some of the initiatives that you've 99 00:03:47,555 --> 00:03:49,715 led over the last year especially? What did 100 00:03:49,715 --> 00:03:51,175 you do, and what were the results? 101 00:03:52,650 --> 00:03:54,650 Well, you know, so this this is a 102 00:03:54,650 --> 00:03:57,069 fascinating question and and really complicated. 103 00:03:57,370 --> 00:03:59,449 Probably some of the most complicated work that 104 00:03:59,449 --> 00:04:01,530 I've done in my career was what we 105 00:04:01,530 --> 00:04:03,370 did last year. And what we did last 106 00:04:03,370 --> 00:04:05,449 year, and I should say it really started 107 00:04:05,449 --> 00:04:07,634 a couple of years ago, but it really 108 00:04:07,634 --> 00:04:08,454 came together 109 00:04:08,834 --> 00:04:09,954 in 2025 110 00:04:09,954 --> 00:04:10,454 is, 111 00:04:11,314 --> 00:04:12,454 we are integrating 112 00:04:12,914 --> 00:04:15,555 our nursing organizations. And when I when I 113 00:04:15,555 --> 00:04:17,634 say that, what I mean is we had 114 00:04:17,634 --> 00:04:18,294 a merger, 115 00:04:18,675 --> 00:04:19,814 a few years ago, 116 00:04:20,435 --> 00:04:22,375 with Sisters of Charity of Leavenworth, 117 00:04:23,290 --> 00:04:26,490 a health system primarily in in, Colorado and 118 00:04:26,490 --> 00:04:26,990 Montana. 119 00:04:27,449 --> 00:04:29,230 And when we merged with those organizations, 120 00:04:29,770 --> 00:04:31,850 what we also did, and I I didn't 121 00:04:31,850 --> 00:04:34,810 fully understand, was we merged the cultures of 122 00:04:34,810 --> 00:04:37,514 those two organizations as well. So our nursing 123 00:04:37,514 --> 00:04:39,615 cultures operated a little bit differently. 124 00:04:40,235 --> 00:04:43,514 We had even, some difference in philosophy around 125 00:04:43,514 --> 00:04:45,214 research and evidence based practice. 126 00:04:45,675 --> 00:04:47,675 So the thing that's so exciting right now 127 00:04:47,675 --> 00:04:49,294 is that we're becoming one 128 00:04:49,779 --> 00:04:53,879 large nursing organization at Intermountain Health. We span 129 00:04:54,020 --> 00:04:55,240 all six states. 130 00:04:55,540 --> 00:04:56,360 We span 131 00:04:56,819 --> 00:05:00,120 from children's health to adult health, 132 00:05:01,540 --> 00:05:02,439 to geriatrics, 133 00:05:02,899 --> 00:05:04,279 to ambulatory environments, 134 00:05:05,045 --> 00:05:08,345 to very rural and frontier environments, 135 00:05:08,725 --> 00:05:11,464 to very urban environments. So what 136 00:05:11,764 --> 00:05:13,145 a great opportunity 137 00:05:13,925 --> 00:05:14,425 to 138 00:05:14,805 --> 00:05:16,345 grow nursing in 139 00:05:16,805 --> 00:05:19,620 that same space. And so that's the biggest 140 00:05:19,620 --> 00:05:21,779 work that we have been doing is developing 141 00:05:21,779 --> 00:05:23,560 an enterprise wide nursing 142 00:05:24,259 --> 00:05:26,840 research and evidence based practice infrastructure 143 00:05:27,699 --> 00:05:29,000 that will help support 144 00:05:29,620 --> 00:05:31,220 that overall nursing, 145 00:05:31,620 --> 00:05:34,120 strategy. And so to do that, 146 00:05:34,665 --> 00:05:36,904 again, we're gonna leverage the voice of the 147 00:05:36,904 --> 00:05:38,845 nurses who work at the point of care. 148 00:05:39,144 --> 00:05:39,964 They have 149 00:05:40,345 --> 00:05:42,204 the wisdom and the knowledge 150 00:05:42,665 --> 00:05:43,564 and the skills 151 00:05:44,105 --> 00:05:45,865 that we need to be listening to when 152 00:05:45,865 --> 00:05:47,964 we make these decisions. And so we're gonna 153 00:05:48,024 --> 00:05:50,044 include them in our professional governance 154 00:05:50,500 --> 00:05:52,899 organization. We're gonna include them in this transition 155 00:05:52,899 --> 00:05:55,000 plan, and they have been included. 156 00:05:55,300 --> 00:05:57,160 So that's been some of the tough work. 157 00:05:58,020 --> 00:05:59,240 We've had a significant 158 00:05:59,540 --> 00:06:02,580 increase in our evidence based practice nursing projects 159 00:06:02,580 --> 00:06:03,944 over the last few years. 160 00:06:04,504 --> 00:06:05,305 We've had, 161 00:06:06,665 --> 00:06:08,685 great scholarly output, 162 00:06:09,545 --> 00:06:12,745 and have been presenting at conferences regionally and 163 00:06:12,745 --> 00:06:13,245 nationally. 164 00:06:13,865 --> 00:06:14,845 We've had publications 165 00:06:15,464 --> 00:06:17,964 and some externally funded nursing research, 166 00:06:18,610 --> 00:06:21,430 and we are really building this alignment. 167 00:06:23,410 --> 00:06:25,569 Laura, it it's really complicated when you think 168 00:06:25,569 --> 00:06:27,650 about we're building an alignment now that we've 169 00:06:27,650 --> 00:06:30,370 never had before between nursing research and evidence 170 00:06:30,370 --> 00:06:31,189 based practice 171 00:06:31,875 --> 00:06:32,615 and nursing 172 00:06:33,314 --> 00:06:35,795 clinical practice at the point of care. And 173 00:06:35,795 --> 00:06:36,615 let me explain 174 00:06:36,995 --> 00:06:39,154 explain that. The way that we operate is 175 00:06:39,154 --> 00:06:40,355 we have new, 176 00:06:40,835 --> 00:06:43,875 several programs of care. So we have an 177 00:06:43,875 --> 00:06:45,720 executive director of 178 00:06:46,120 --> 00:06:48,060 nursing critical care, for example, 179 00:06:48,519 --> 00:06:51,319 or an executive director of nursing care for 180 00:06:51,319 --> 00:06:52,540 perioperative services. 181 00:06:53,319 --> 00:06:54,379 And those people 182 00:06:54,759 --> 00:06:56,540 have had their own operational 183 00:06:56,920 --> 00:06:58,220 goals and ideals 184 00:06:58,955 --> 00:07:02,014 and standards that they've been setting. We're partnering 185 00:07:02,074 --> 00:07:04,795 with them as research and evidence based practice 186 00:07:04,795 --> 00:07:07,754 folks who've traditionally been working out on our 187 00:07:07,754 --> 00:07:09,995 own. We're now partnering with with them to 188 00:07:09,995 --> 00:07:12,479 make sure that we are standardizing, 189 00:07:13,180 --> 00:07:14,399 that we are streamlining 190 00:07:14,779 --> 00:07:17,339 our work, and that we're supporting the goals 191 00:07:17,339 --> 00:07:20,000 of not only the individual practice settings, 192 00:07:20,379 --> 00:07:22,240 but also the overall organization. 193 00:07:22,699 --> 00:07:25,099 So how does nursing research and evidence based 194 00:07:25,099 --> 00:07:25,599 practice 195 00:07:26,595 --> 00:07:29,555 support the KPIs at our organization? We wanna 196 00:07:29,555 --> 00:07:31,955 make sure that we're able to to state 197 00:07:31,955 --> 00:07:34,375 that and that we're doing those things. 198 00:07:34,754 --> 00:07:36,375 The other projects are important, 199 00:07:36,675 --> 00:07:37,735 and they're interesting, 200 00:07:38,194 --> 00:07:40,275 but we really need to be focusing our 201 00:07:40,275 --> 00:07:42,720 work right now, especially in this environment that 202 00:07:42,720 --> 00:07:43,699 is so complicated. 203 00:07:45,360 --> 00:07:47,779 And then last, we we really wanna improve 204 00:07:47,839 --> 00:07:48,899 the the visibility 205 00:07:49,600 --> 00:07:52,079 of our research and evidence based practice teams 206 00:07:52,079 --> 00:07:54,160 in nursing. And I'll talk a little bit 207 00:07:54,160 --> 00:07:57,144 about about how we did that, but but 208 00:07:57,144 --> 00:07:59,485 part but part of it was being recognized 209 00:08:00,985 --> 00:08:01,884 in the organization 210 00:08:02,985 --> 00:08:04,925 as a program of research. 211 00:08:06,024 --> 00:08:08,584 Nursing, you know, typically was not recognized as 212 00:08:08,584 --> 00:08:10,584 one of our strong programs of research at 213 00:08:10,584 --> 00:08:13,389 Intermountain Health, and we are now. And it's 214 00:08:13,389 --> 00:08:16,129 been a tough journey, Laura. It's taken several 215 00:08:16,269 --> 00:08:19,250 several years. But this last year, we really, 216 00:08:20,349 --> 00:08:21,329 turned the corner. 217 00:08:21,870 --> 00:08:24,110 Now we are recognized as a program of 218 00:08:24,110 --> 00:08:24,610 research. 219 00:08:24,990 --> 00:08:26,610 Now we have a, 220 00:08:28,084 --> 00:08:31,044 scientific review board to help stand up our 221 00:08:31,044 --> 00:08:33,684 project and make sure that they're ready to 222 00:08:33,684 --> 00:08:36,325 go to the IRB. So that's kind of 223 00:08:36,325 --> 00:08:38,164 the work that we've been doing over the 224 00:08:38,164 --> 00:08:40,245 last year is just getting our infrastructure in 225 00:08:40,245 --> 00:08:42,620 place so that we're really, really ready to 226 00:08:42,620 --> 00:08:43,360 move forward. 227 00:08:46,139 --> 00:08:47,980 Absolutely. I I love that, and I think, 228 00:08:47,980 --> 00:08:49,039 you know, it definitely, 229 00:08:49,659 --> 00:08:51,659 is cool to have that type of rigor 230 00:08:51,659 --> 00:08:53,980 around how you're looking at the nursing practice, 231 00:08:53,980 --> 00:08:56,694 how you're thinking about standardizing the things that 232 00:08:56,694 --> 00:08:59,254 will help improve patient care and really getting 233 00:08:59,254 --> 00:09:02,214 the research behind it, and then expanding that 234 00:09:02,214 --> 00:09:04,934 in in creating that visibility across the board. 235 00:09:04,934 --> 00:09:07,174 And, you know, I'm curious as you're looking 236 00:09:07,174 --> 00:09:09,399 at, some of the different KPIs either that 237 00:09:09,399 --> 00:09:11,100 you've always used or, 238 00:09:11,559 --> 00:09:13,879 new ones that you've developed in more recent 239 00:09:13,879 --> 00:09:14,379 years. 240 00:09:15,399 --> 00:09:18,360 How what does it take to really, you 241 00:09:18,360 --> 00:09:18,860 know, 242 00:09:19,875 --> 00:09:21,495 create that culture of, 243 00:09:22,115 --> 00:09:24,434 looking at the data and following those metrics 244 00:09:24,434 --> 00:09:26,355 that you know will be beneficial for patient 245 00:09:26,355 --> 00:09:28,835 care in developing those or or following those 246 00:09:28,835 --> 00:09:29,575 best practices, 247 00:09:30,035 --> 00:09:31,715 that you put out there? Because I know, 248 00:09:31,715 --> 00:09:33,475 you know, that can certainly be a challenge 249 00:09:33,475 --> 00:09:36,050 when you're looking at making a change management 250 00:09:36,050 --> 00:09:36,710 or transformation 251 00:09:37,090 --> 00:09:40,050 process and becoming more of a evidence based 252 00:09:40,050 --> 00:09:40,550 organization. 253 00:09:42,290 --> 00:09:45,570 What a great question, and it's really pertinent 254 00:09:45,570 --> 00:09:48,050 for our company. When you think back, at 255 00:09:48,050 --> 00:09:50,554 the history of Intermountain Health, we are one 256 00:09:50,554 --> 00:09:52,335 of the early adopters 257 00:09:52,714 --> 00:09:55,115 of the electronic health record. Even as far 258 00:09:55,115 --> 00:09:57,434 back as the seventies and eighties, we were 259 00:09:57,434 --> 00:09:59,214 working in that in that space. 260 00:10:00,714 --> 00:10:01,214 So 261 00:10:01,595 --> 00:10:04,290 over the years, we have amassed a tremendous 262 00:10:04,509 --> 00:10:07,389 amount of clinical data. And and when when 263 00:10:07,389 --> 00:10:08,750 you think about the role of the nurse, 264 00:10:08,750 --> 00:10:11,309 you know, we've got 18,000 nurses at Intermountain 265 00:10:11,309 --> 00:10:14,290 Health. All of those nurses have been documenting 266 00:10:15,070 --> 00:10:16,129 around the clock 267 00:10:16,750 --> 00:10:19,009 for decades. We have, 268 00:10:20,164 --> 00:10:21,225 we have just 269 00:10:21,845 --> 00:10:25,284 huge amounts of large data sitting there ready 270 00:10:25,284 --> 00:10:26,745 to answer our questions. 271 00:10:27,125 --> 00:10:28,884 One of the things that we're doing in 272 00:10:28,884 --> 00:10:31,065 nursing research and evidence based practice 273 00:10:31,684 --> 00:10:33,924 is letting our nurses know at the point 274 00:10:33,924 --> 00:10:34,664 of care, 275 00:10:34,990 --> 00:10:37,149 we have access to that data. By the 276 00:10:37,149 --> 00:10:39,629 way, we we have ready access to that 277 00:10:39,629 --> 00:10:42,450 data. We have expert analysts in our organization 278 00:10:42,910 --> 00:10:44,670 that can help us pull that together. And 279 00:10:44,670 --> 00:10:46,509 by the way, it's not just data within 280 00:10:46,509 --> 00:10:49,735 Intermountain Health. They can also pull external data, 281 00:10:49,735 --> 00:10:50,394 and they're 282 00:10:50,695 --> 00:10:53,834 part of some other large research collaboratives. 283 00:10:54,294 --> 00:10:56,235 So we really have access to 284 00:10:56,934 --> 00:10:57,995 as as probably 285 00:10:58,774 --> 00:11:01,034 as good of data as any organization. 286 00:11:01,654 --> 00:11:04,649 But our nurses haven't haven't, been exposed to 287 00:11:04,649 --> 00:11:06,649 that, so we're exposing them to that to 288 00:11:06,649 --> 00:11:08,889 that right now. We'll sit down with them, 289 00:11:08,889 --> 00:11:10,730 with a data analyst and say, here's your 290 00:11:10,730 --> 00:11:13,289 question. Let me give you an example, Laura. 291 00:11:13,289 --> 00:11:14,029 We are 292 00:11:14,889 --> 00:11:16,990 we had a nurse who who who wondered. 293 00:11:18,009 --> 00:11:18,750 She's been 294 00:11:19,205 --> 00:11:22,105 trying to walk patients on a ventilator. 295 00:11:22,644 --> 00:11:24,424 You know, that's a difficult process, 296 00:11:25,605 --> 00:11:27,764 but it's a very worthy process. It really 297 00:11:27,764 --> 00:11:30,024 helps patients who are on a respirator 298 00:11:30,485 --> 00:11:32,264 to get off the respirator earlier, 299 00:11:33,899 --> 00:11:37,039 to, have better outcomes at home, potentially, 300 00:11:39,419 --> 00:11:40,079 you know, 301 00:11:40,459 --> 00:11:42,379 not have to be readmitted to the hospital 302 00:11:42,379 --> 00:11:44,379 in the future. All those things, we think 303 00:11:44,379 --> 00:11:45,839 that we'll have better outcomes 304 00:11:46,284 --> 00:11:48,764 if we have our long term patients on 305 00:11:48,764 --> 00:11:49,745 a on a ventilator 306 00:11:50,445 --> 00:11:52,225 up and walking in the hallways. 307 00:11:52,524 --> 00:11:54,284 So what does that mean? Well, we've got 308 00:11:54,284 --> 00:11:54,945 the data 309 00:11:55,325 --> 00:11:57,565 around that sitting out there right now. So 310 00:11:57,565 --> 00:12:00,144 one of my nursing research fellows right now 311 00:12:00,500 --> 00:12:02,440 is gathering the data about 312 00:12:02,899 --> 00:12:05,159 ambulation of patients who are on a respirator, 313 00:12:05,539 --> 00:12:08,019 how far they went, what were their physical 314 00:12:08,019 --> 00:12:11,139 therapy orders like, those kinds of things. We're 315 00:12:11,139 --> 00:12:12,820 gonna be able just to look at that 316 00:12:12,820 --> 00:12:13,320 data 317 00:12:13,779 --> 00:12:16,214 and then say, hey. You know what? Maybe 318 00:12:16,214 --> 00:12:17,894 this is a best practice that we should 319 00:12:17,894 --> 00:12:20,154 be doing not only across our organization, 320 00:12:20,534 --> 00:12:22,934 but across the country. So that's the kind 321 00:12:22,934 --> 00:12:24,235 of work that I'm hoping 322 00:12:24,615 --> 00:12:26,714 that our nurses will be able to lead 323 00:12:27,095 --> 00:12:29,334 using this vast amount of data that we 324 00:12:29,334 --> 00:12:32,049 have. And and keep in mind, Laura, what 325 00:12:32,049 --> 00:12:34,289 we're talking about right now doesn't even really 326 00:12:34,289 --> 00:12:37,329 include our use of AI, which has not 327 00:12:37,329 --> 00:12:38,549 necessarily started 328 00:12:38,929 --> 00:12:41,169 in that kind of a clinical setting yet 329 00:12:41,169 --> 00:12:43,904 or in the analysis of clinical data. But 330 00:12:43,904 --> 00:12:45,745 down the road, I'm sure we'll be able 331 00:12:45,745 --> 00:12:47,184 to use that as well to help us 332 00:12:47,184 --> 00:12:47,684 predict. 333 00:12:49,105 --> 00:12:51,424 And and I want our nurses to have 334 00:12:51,424 --> 00:12:53,924 that level of understanding, not coming from me 335 00:12:53,985 --> 00:12:56,065 as the nurse scientist. I want the nurses 336 00:12:56,065 --> 00:12:57,424 at the point of care to know, you 337 00:12:57,424 --> 00:12:59,429 know what? I bet we've got data that 338 00:12:59,429 --> 00:13:01,129 will help me answer this question. 339 00:13:03,350 --> 00:13:05,350 That's amazing to hear. And, you know, really, 340 00:13:05,350 --> 00:13:07,909 really, helpful to understand how you think about 341 00:13:07,909 --> 00:13:10,230 that kind of cultural change and then really 342 00:13:10,230 --> 00:13:11,504 make sure that it's, 343 00:13:12,304 --> 00:13:15,125 integrated within the whole organization and they understand 344 00:13:15,264 --> 00:13:17,664 why it's happening and using technology and and 345 00:13:17,664 --> 00:13:18,164 data, 346 00:13:18,705 --> 00:13:20,804 you know, I I think that's really critical. 347 00:13:20,865 --> 00:13:22,945 And now looking ahead, what are some of 348 00:13:22,945 --> 00:13:24,865 the big priorities and headwinds that you're focused 349 00:13:24,865 --> 00:13:26,245 on for 2026? 350 00:13:27,690 --> 00:13:28,809 2026, 351 00:13:28,809 --> 00:13:30,269 I think, is even gonna be, 352 00:13:31,049 --> 00:13:34,169 more challenging and more difficult than 2025. And 353 00:13:34,169 --> 00:13:35,450 and by the way, I mean that in 354 00:13:35,450 --> 00:13:37,210 a good way, Laura. I think we're gonna 355 00:13:37,210 --> 00:13:37,710 have, 356 00:13:38,410 --> 00:13:39,790 an incredible time 357 00:13:40,169 --> 00:13:41,804 working through 2026 358 00:13:42,044 --> 00:13:43,024 in the background. 359 00:13:44,845 --> 00:13:47,345 Stirring in the background, of course, is AI, 360 00:13:47,644 --> 00:13:49,644 and we don't know how that is going 361 00:13:49,644 --> 00:13:50,304 to be 362 00:13:51,004 --> 00:13:53,485 impacting our practice. But we know that it's 363 00:13:53,485 --> 00:13:55,419 out there. So in 2026, 364 00:13:55,419 --> 00:13:57,519 my team would really like to focus on 365 00:13:58,059 --> 00:13:58,559 scalability, 366 00:13:59,580 --> 00:14:00,080 consistency, 367 00:14:01,019 --> 00:14:02,480 and measurable outcomes 368 00:14:02,779 --> 00:14:03,759 across the enterprise 369 00:14:04,700 --> 00:14:05,200 using, 370 00:14:06,220 --> 00:14:07,980 the data that we were just talking about. 371 00:14:07,980 --> 00:14:10,804 You know? But but more important to us, 372 00:14:10,865 --> 00:14:12,804 Laura, for 2026 373 00:14:13,024 --> 00:14:15,605 is as we scale evidence based practice 374 00:14:15,904 --> 00:14:18,065 to our nurses that are working at the 375 00:14:18,065 --> 00:14:19,044 point of care, 376 00:14:20,304 --> 00:14:22,350 I want them to do more than just 377 00:14:22,350 --> 00:14:24,590 think about evidence based practice. I want to 378 00:14:24,590 --> 00:14:25,090 see 379 00:14:25,470 --> 00:14:26,290 us use implementation 380 00:14:26,670 --> 00:14:27,170 science 381 00:14:27,790 --> 00:14:28,850 to help them 382 00:14:29,550 --> 00:14:31,889 do the best job they can to implement 383 00:14:32,190 --> 00:14:36,370 the evidence. So using implementation science tools 384 00:14:36,855 --> 00:14:39,414 or theories to help us with that. That's 385 00:14:39,414 --> 00:14:41,095 one. And then, two, the reason that's so 386 00:14:41,095 --> 00:14:42,235 important is because 387 00:14:42,774 --> 00:14:44,875 the evidence is only as good 388 00:14:45,414 --> 00:14:48,054 as how we use it. Right? So if 389 00:14:48,054 --> 00:14:50,134 we identify evidence and we think this is 390 00:14:50,134 --> 00:14:51,860 gonna be the best practice, but we can't 391 00:14:51,860 --> 00:14:52,360 implement 392 00:14:52,820 --> 00:14:55,059 that practice, then we're not gonna make any 393 00:14:55,059 --> 00:14:57,720 headway. But if we can implement the practice, 394 00:14:57,779 --> 00:14:58,679 the best practice, 395 00:14:59,220 --> 00:14:59,879 and then 396 00:15:00,259 --> 00:15:03,139 get ourselves to high adherence of that best 397 00:15:03,139 --> 00:15:05,495 practice. Right? So we implement, 398 00:15:05,875 --> 00:15:07,495 let's say we implement a bundle 399 00:15:08,195 --> 00:15:08,674 to, 400 00:15:09,315 --> 00:15:12,115 help patients with oral care, for example, maybe 401 00:15:12,115 --> 00:15:14,595 ventilator patients with oral care. We implement that 402 00:15:14,595 --> 00:15:16,134 bundle. We get 403 00:15:16,595 --> 00:15:18,995 ninety five percent of the nurses doing it 404 00:15:18,995 --> 00:15:21,519 ninety five percent of the time, and then 405 00:15:21,519 --> 00:15:22,980 we sustain that 406 00:15:23,519 --> 00:15:24,899 over a period of years, 407 00:15:25,279 --> 00:15:26,019 that is 408 00:15:27,039 --> 00:15:30,319 best practice in, using evidence based practice. Right? 409 00:15:30,319 --> 00:15:33,059 That is using implementation science 410 00:15:33,644 --> 00:15:35,185 to assure high adherence 411 00:15:35,884 --> 00:15:37,585 and to assure sustainability. 412 00:15:38,605 --> 00:15:40,925 That's something that's gonna be new to the 413 00:15:40,925 --> 00:15:44,465 nursing culture to most people. Implementation science principles 414 00:15:44,845 --> 00:15:46,919 are relatively new to, 415 00:15:47,399 --> 00:15:48,860 to to many nurses. 416 00:15:49,240 --> 00:15:50,840 The other thing that we wanna do is 417 00:15:50,840 --> 00:15:53,740 is we are gonna expand our professional governance 418 00:15:53,960 --> 00:15:55,179 environment for nursing, 419 00:15:55,720 --> 00:15:57,879 which gives the voice to the nurses at 420 00:15:57,879 --> 00:15:58,940 the point of care. 421 00:15:59,445 --> 00:16:02,565 We can share these tools like implementation science 422 00:16:02,565 --> 00:16:04,504 with those nurses at the point of care. 423 00:16:04,725 --> 00:16:06,805 So now they now they have access to 424 00:16:06,805 --> 00:16:09,225 data. They have access to implementation 425 00:16:09,605 --> 00:16:10,504 science skills, 426 00:16:10,884 --> 00:16:12,965 and we want them to feel confident with 427 00:16:12,965 --> 00:16:15,819 evidence based practice. And we believe that they 428 00:16:15,819 --> 00:16:16,559 are going 429 00:16:17,019 --> 00:16:19,039 to change practice, that their 430 00:16:19,500 --> 00:16:23,019 collective wisdom as this mass of 18,000 431 00:16:23,019 --> 00:16:23,519 nurses 432 00:16:23,899 --> 00:16:25,419 will really help us answer some of the 433 00:16:25,419 --> 00:16:28,480 most difficult questions that we have at Intermountain 434 00:16:28,539 --> 00:16:29,039 Health. 435 00:16:31,235 --> 00:16:31,735 Absolutely. 436 00:16:32,274 --> 00:16:33,794 I love that. And, you know, it sounds 437 00:16:33,794 --> 00:16:36,355 like a very exciting time to be at 438 00:16:36,355 --> 00:16:38,834 Intermountain and in the nursing workforce and and 439 00:16:38,834 --> 00:16:40,774 to have all of that information, 440 00:16:41,475 --> 00:16:43,339 and being able to continue to grow and 441 00:16:43,339 --> 00:16:45,580 develop in that space, you know, it is 442 00:16:45,580 --> 00:16:46,399 really exciting. 443 00:16:46,779 --> 00:16:48,539 I'm curious. What do you think is the 444 00:16:48,539 --> 00:16:50,139 hardest thing that you'll have to do in 445 00:16:50,139 --> 00:16:52,559 the next year will be? I I know 446 00:16:52,700 --> 00:16:54,879 nothing, you know, ever, becomes 447 00:16:55,634 --> 00:16:57,315 perfect, but what do you think the hardest 448 00:16:57,315 --> 00:16:58,535 thing that will be? 449 00:16:59,795 --> 00:17:02,375 Well, that's the that is the best question, 450 00:17:02,995 --> 00:17:04,914 you could possibly ask, and it's what we 451 00:17:04,914 --> 00:17:07,154 are really focusing right now. I think the 452 00:17:07,154 --> 00:17:08,880 hardest thing, you know, 453 00:17:09,339 --> 00:17:11,339 the longer I work in health care, the 454 00:17:11,339 --> 00:17:13,660 more I realize it's about culture. It's about 455 00:17:13,660 --> 00:17:15,200 culture and it's about communication. 456 00:17:15,660 --> 00:17:17,440 Some of the the basic fundamentals 457 00:17:18,059 --> 00:17:18,960 of of communication. 458 00:17:19,579 --> 00:17:21,805 And by culture, what I mean is I 459 00:17:21,805 --> 00:17:24,605 would really like every nurse at Intermountain Health 460 00:17:24,605 --> 00:17:25,585 to feel comfortable 461 00:17:26,365 --> 00:17:27,505 in accessing 462 00:17:28,205 --> 00:17:29,025 or utilizing 463 00:17:29,644 --> 00:17:31,585 their evidence based practice skills. 464 00:17:32,285 --> 00:17:33,744 So I'd like to operationalize 465 00:17:34,045 --> 00:17:36,365 that across the system. I don't want it 466 00:17:36,365 --> 00:17:38,039 to be a central command, 467 00:17:39,220 --> 00:17:41,220 resource. I want it to be a resource 468 00:17:41,220 --> 00:17:42,839 that happens in the field 469 00:17:43,220 --> 00:17:45,240 and that we here working centrally 470 00:17:45,619 --> 00:17:48,019 can support the nurses in what they need. 471 00:17:48,019 --> 00:17:49,480 You know what? I have a question, 472 00:17:50,085 --> 00:17:51,384 doctor Gee, about 473 00:17:51,765 --> 00:17:53,845 about patient falls, but I don't know where 474 00:17:53,845 --> 00:17:56,164 to start. Well, I can help them get 475 00:17:56,164 --> 00:17:59,444 started with their question and get them connected 476 00:17:59,444 --> 00:18:01,125 with the resources that we have because I 477 00:18:01,125 --> 00:18:03,890 bet you that we have nurses at one 478 00:18:03,890 --> 00:18:06,390 of our hospitals in Montana or Colorado 479 00:18:07,170 --> 00:18:09,970 or Idaho or Utah that's working on some 480 00:18:09,970 --> 00:18:12,289 of those similar things. So those are sort 481 00:18:12,289 --> 00:18:14,210 of the the areas that I wanna focus 482 00:18:14,210 --> 00:18:16,070 on this year, focus on the culture, 483 00:18:16,375 --> 00:18:19,494 creating this culture of inquiry that nurses are 484 00:18:19,494 --> 00:18:21,355 not afraid to ask the question, 485 00:18:21,734 --> 00:18:23,974 but they're really ready to get their their 486 00:18:23,974 --> 00:18:26,694 hands dirty in digging in and working on 487 00:18:26,694 --> 00:18:27,914 the questions themselves 488 00:18:28,375 --> 00:18:30,615 and the solutions right there at the point 489 00:18:30,615 --> 00:18:31,275 of care. 490 00:18:34,429 --> 00:18:36,109 I love that. I I love that idea 491 00:18:36,109 --> 00:18:38,509 of culture of inquiry as well, being able 492 00:18:38,509 --> 00:18:41,549 to feel comfortable asking those questions and raising 493 00:18:41,549 --> 00:18:43,710 issues and and working through together some of 494 00:18:43,710 --> 00:18:45,629 the big challenges that they're thinking about and 495 00:18:45,629 --> 00:18:46,690 that they see upcoming. 496 00:18:48,424 --> 00:18:49,865 I I I love that kind of phrase 497 00:18:49,865 --> 00:18:51,005 and that thought process. 498 00:18:51,464 --> 00:18:53,545 Now before we wrap up here, I wanted 499 00:18:53,545 --> 00:18:55,785 to ask you about growth as well. Where 500 00:18:55,785 --> 00:18:57,484 do you see some of the biggest opportunities 501 00:18:57,545 --> 00:18:59,085 for organizational growth? 502 00:19:00,099 --> 00:19:01,720 Well, as you mentioned earlier, 503 00:19:02,179 --> 00:19:05,299 data analytics and predictive analytics, I think, are 504 00:19:05,299 --> 00:19:06,759 gonna be important for us. 505 00:19:07,299 --> 00:19:07,799 Leveraging 506 00:19:08,259 --> 00:19:08,759 AI, 507 00:19:09,059 --> 00:19:11,059 it may not even happen this year, right, 508 00:19:11,059 --> 00:19:12,819 at the clinical setting, but I think it's 509 00:19:12,819 --> 00:19:14,919 gonna happen over the next few years. 510 00:19:15,285 --> 00:19:18,025 I want to empower the frontline nurses 511 00:19:18,805 --> 00:19:21,945 through the professional governance process to feel comfortable 512 00:19:22,005 --> 00:19:23,465 with evidence based practice. 513 00:19:24,725 --> 00:19:26,644 I really like to find you know, by 514 00:19:26,644 --> 00:19:29,445 the way, evidence based practice can't happen if 515 00:19:29,445 --> 00:19:30,424 we don't have 516 00:19:30,980 --> 00:19:33,559 nursing research and knowledge to support the evidence. 517 00:19:33,700 --> 00:19:35,700 And then sometimes we have to generate new 518 00:19:35,700 --> 00:19:37,720 evidence. So I wanna make sure that we're 519 00:19:37,859 --> 00:19:39,320 supporting and generating 520 00:19:39,859 --> 00:19:41,880 new research, new nursing research, 521 00:19:42,180 --> 00:19:44,625 and and by the way, validating some of 522 00:19:44,625 --> 00:19:46,384 the old research that we've done in the 523 00:19:46,384 --> 00:19:47,365 past as well. 524 00:19:48,465 --> 00:19:50,144 And then I think it's important for us 525 00:19:50,144 --> 00:19:52,305 to remember that this research and evidence based 526 00:19:52,305 --> 00:19:52,805 practice 527 00:19:53,505 --> 00:19:54,005 transcends 528 00:19:54,384 --> 00:19:54,884 the 529 00:19:56,099 --> 00:19:57,240 the clinical areas 530 00:19:57,700 --> 00:20:00,179 because we wanna use best practices and the 531 00:20:00,179 --> 00:20:02,440 best evidence for leadership decisions 532 00:20:02,980 --> 00:20:06,019 and for decisions around how we educate our 533 00:20:06,019 --> 00:20:06,759 our people. 534 00:20:07,140 --> 00:20:09,059 And and one last thing, Laura, and it's 535 00:20:09,059 --> 00:20:10,920 sort of an opportunity for growth. 536 00:20:11,255 --> 00:20:12,934 In addition to this work that I'm doing 537 00:20:12,934 --> 00:20:14,075 at Intermountain Health, 538 00:20:14,535 --> 00:20:15,275 we have, 539 00:20:15,735 --> 00:20:18,375 the Sigma Theta Tau International, which is a 540 00:20:18,375 --> 00:20:20,075 a scholarly nursing organization. 541 00:20:20,855 --> 00:20:23,255 We have a nurse scientist collaborative, and I've 542 00:20:23,255 --> 00:20:24,795 been co leading that collaborative 543 00:20:25,399 --> 00:20:27,639 with doctor Esther Chips from the Ohio State 544 00:20:27,639 --> 00:20:29,980 University for the last couple of years. 545 00:20:30,519 --> 00:20:32,220 And with that group, 546 00:20:32,679 --> 00:20:36,119 we are pulling together nurse scientists from all 547 00:20:36,119 --> 00:20:36,940 over the country 548 00:20:37,480 --> 00:20:40,139 because we don't really have a common platform. 549 00:20:40,865 --> 00:20:41,265 We, 550 00:20:41,664 --> 00:20:43,605 all operate a little bit differently, 551 00:20:44,225 --> 00:20:46,305 and we all need the same resources. In 552 00:20:46,305 --> 00:20:47,904 fact, many of us I I did this 553 00:20:47,904 --> 00:20:50,384 at my my job here. Many of us 554 00:20:50,384 --> 00:20:52,384 had to create our own job descriptions, for 555 00:20:52,384 --> 00:20:55,265 example, or create our own policies in our 556 00:20:55,265 --> 00:20:55,765 department. 557 00:20:56,130 --> 00:20:59,089 So we're we're developing this national collaborative right 558 00:20:59,089 --> 00:20:59,589 now. 559 00:20:59,890 --> 00:21:02,630 We've got about 200 members in that 560 00:21:02,930 --> 00:21:05,730 with nurse scientists from across the country so 561 00:21:05,730 --> 00:21:07,650 that we can share our wisdom and what 562 00:21:07,650 --> 00:21:09,269 we've learned along the way. 563 00:21:12,505 --> 00:21:14,904 That sounds like an amazing organization and group 564 00:21:14,904 --> 00:21:16,825 to be part of in space that you 565 00:21:16,825 --> 00:21:19,465 can really collaborate, learn, and grow together. Perry, 566 00:21:19,465 --> 00:21:20,744 thank you so much for joining us on 567 00:21:20,744 --> 00:21:22,424 the podcast today. This has been such a 568 00:21:22,424 --> 00:21:25,559 fun conversation. I learned a ton, and inspired 569 00:21:25,619 --> 00:21:27,299 by your energy and passion for what you 570 00:21:27,299 --> 00:21:29,380 do. And I'm looking forward to meeting you 571 00:21:29,380 --> 00:21:30,980 in person as well at our annual meeting 572 00:21:30,980 --> 00:21:32,340 coming up here in April. I know you'll 573 00:21:32,340 --> 00:21:34,039 be speaking on a panel and, 574 00:21:34,740 --> 00:21:36,580 continue to share some of the insights and 575 00:21:36,580 --> 00:21:38,660 expertise you've had through your years of research 576 00:21:38,660 --> 00:21:39,160 and, 577 00:21:39,674 --> 00:21:41,434 the great things that you've been able to 578 00:21:41,434 --> 00:21:43,835 accomplish at Intermountain. So, thank you for your 579 00:21:43,835 --> 00:21:45,194 time today, and I look forward to seeing 580 00:21:45,194 --> 00:21:46,174 you in a few months. 581 00:21:46,875 --> 00:21:48,954 Thank you, Lauren. I appreciate the opportunity to 582 00:21:48,954 --> 00:21:49,934 share my work.