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This is Lauren Dierda with the Becker's Healthcare
podcast. I'm thrilled today to be joined by
Perry Gee, enterprise director of nursing research and
evidence based practice as well as a nurse
scientist and associate professor of research at Intermountain
Health. Perry, it's a pleasure to have you
on the podcast today.
Thank you so much for having me. I'm
excited to talk about our work.
Absolutely. And I'm excited to learn more, I
think, especially when you're looking at the nursing
profession. I mean, right now is such a
transformational time in health care, and so, you
know, there's no better topic as we're trying
to dig deeper and and make big changes
in the health care space.
But before we dive into some of the
cool things you're doing at Intermountain, can you
tell us a little bit more about yourself
and your background?
Absolutely. So I've been a nurse for over
forty years now.
Most of my early days in nursing was,
in critical care and in flight. But for
really the last twenty five years, I've been
a clinical informatics specialist.
And then the last ten years or more
than that now, I have been a nurse
scientist. I was the first nurse scientist at
Dignity Health out in California
and then,
the first nurse scientist for Intermountain Health. And
that's some of what I'd like to talk
about today is some of the challenges that
we face as nurse scientists as we build
these programs.
Most important,
is the work that we do around research,
of course. But a lot of us are
also doing work in the space of evidence
based practice and building capacity with evidence based
practice.
And then as our nursing organizations
evolve, and we'll talk quite a bit about
the evolution of the nursing organization at Intermountain
Health, as those organizations evolve,
some of us aren't professional governance environment or
really an environment that gives a voice to
the nurses at the point of care. So
I want to make sure that my work
really integrates with that environment
and actually bolsters and strengthens the environment of
of professional governance. And then last,
and and one of the most important parts
of my job, I think, is is scholarly
dissemination of our work.
We at Intermountain Health have been known for
years as
a a top,
organization
for medical research and clinical trials and incredible
work in that space, but we haven't really
been known as a top organization for nursing
research.
Even though we've been doing that work, we
just haven't disseminated
or talked about what we're doing. And so
that's what I'm excited about is getting the
word out that we are,
certainly going to be a top nursing research
organization,
and we're on the pathway to getting to
that. And that's kind of what I wanna
talk about today.
Absolutely. I think that's amazing to hear it
and definitely,
a space where there's a lot of interest
and a lot of, you know, growing needs.
So,
let's jump right in. Can you tell us
a little bit about, your nursing research organization
and and some of the initiatives that you've
led over the last year especially? What did
you do, and what were the results?
Well, you know, so this this is a
fascinating question and and really complicated.
Probably some of the most complicated work that
I've done in my career was what we
did last year. And what we did last
year, and I should say it really started
a couple of years ago, but it really
came together
in 2025
is,
we are integrating
our nursing organizations. And when I when I
say that, what I mean is we had
a merger,
a few years ago,
with Sisters of Charity of Leavenworth,
a health system primarily in in, Colorado and
Montana.
And when we merged with those organizations,
what we also did, and I I didn't
fully understand, was we merged the cultures of
those two organizations as well. So our nursing
cultures operated a little bit differently.
We had even, some difference in philosophy around
research and evidence based practice.
So the thing that's so exciting right now
is that we're becoming one
large nursing organization at Intermountain Health. We span
all six states.
We span
from children's health to adult health,
to geriatrics,
to ambulatory environments,
to very rural and frontier environments,
to very urban environments. So what
a great opportunity
to
grow nursing in
that same space. And so that's the biggest
work that we have been doing is developing
an enterprise wide nursing
research and evidence based practice infrastructure
that will help support
that overall nursing,
strategy. And so to do that,
again, we're gonna leverage the voice of the
nurses who work at the point of care.
They have
the wisdom and the knowledge
and the skills
that we need to be listening to when
we make these decisions. And so we're gonna
include them in our professional governance
organization. We're gonna include them in this transition
plan, and they have been included.
So that's been some of the tough work.
We've had a significant
increase in our evidence based practice nursing projects
over the last few years.
We've had,
great scholarly output,
and have been presenting at conferences regionally and
nationally.
We've had publications
and some externally funded nursing research,
and we are really building this alignment.
Laura, it it's really complicated when you think
about we're building an alignment now that we've
never had before between nursing research and evidence
based practice
and nursing
clinical practice at the point of care. And
let me explain
explain that. The way that we operate is
we have new,
several programs of care. So we have an
executive director of
nursing critical care, for example,
or an executive director of nursing care for
perioperative services.
And those people
have had their own operational
goals and ideals
and standards that they've been setting. We're partnering
with them as research and evidence based practice
folks who've traditionally been working out on our
own. We're now partnering with with them to
make sure that we are standardizing,
that we are streamlining
our work, and that we're supporting the goals
of not only the individual practice settings,
but also the overall organization.
So how does nursing research and evidence based
practice
support the KPIs at our organization? We wanna
make sure that we're able to to state
that and that we're doing those things.
The other projects are important,
and they're interesting,
but we really need to be focusing our
work right now, especially in this environment that
is so complicated.
And then last, we we really wanna improve
the the visibility
of our research and evidence based practice teams
in nursing. And I'll talk a little bit
about about how we did that, but but
part but part of it was being recognized
in the organization
as a program of research.
Nursing, you know, typically was not recognized as
one of our strong programs of research at
Intermountain Health, and we are now. And it's
been a tough journey, Laura. It's taken several
several years. But this last year, we really,
turned the corner.
Now we are recognized as a program of
research.
Now we have a,
scientific review board to help stand up our
project and make sure that they're ready to
go to the IRB. So that's kind of
the work that we've been doing over the
last year is just getting our infrastructure in
place so that we're really, really ready to
move forward.
Absolutely. I I love that, and I think,
you know, it definitely,
is cool to have that type of rigor
around how you're looking at the nursing practice,
how you're thinking about standardizing the things that
will help improve patient care and really getting
the research behind it, and then expanding that
in in creating that visibility across the board.
And, you know, I'm curious as you're looking
at, some of the different KPIs either that
you've always used or,
new ones that you've developed in more recent
years.
How what does it take to really, you
know,
create that culture of,
looking at the data and following those metrics
that you know will be beneficial for patient
care in developing those or or following those
best practices,
that you put out there? Because I know,
you know, that can certainly be a challenge
when you're looking at making a change management
or transformation
process and becoming more of a evidence based
organization.
What a great question, and it's really pertinent
for our company. When you think back, at
the history of Intermountain Health, we are one
of the early adopters
of the electronic health record. Even as far
back as the seventies and eighties, we were
working in that in that space.
So
over the years, we have amassed a tremendous
amount of clinical data. And and when when
you think about the role of the nurse,
you know, we've got 18,000 nurses at Intermountain
Health. All of those nurses have been documenting
around the clock
for decades. We have,
we have just
huge amounts of large data sitting there ready
to answer our questions.
One of the things that we're doing in
nursing research and evidence based practice
is letting our nurses know at the point
of care,
we have access to that data. By the
way, we we have ready access to that
data. We have expert analysts in our organization
that can help us pull that together. And
by the way, it's not just data within
Intermountain Health. They can also pull external data,
and they're
part of some other large research collaboratives.
So we really have access to
as as probably
as good of data as any organization.
But our nurses haven't haven't, been exposed to
that, so we're exposing them to that to
that right now. We'll sit down with them,
with a data analyst and say, here's your
question. Let me give you an example, Laura.
We are
we had a nurse who who who wondered.
She's been
trying to walk patients on a ventilator.
You know, that's a difficult process,
but it's a very worthy process. It really
helps patients who are on a respirator
to get off the respirator earlier,
to, have better outcomes at home, potentially,
you know,
not have to be readmitted to the hospital
in the future. All those things, we think
that we'll have better outcomes
if we have our long term patients on
a on a ventilator
up and walking in the hallways.
So what does that mean? Well, we've got
the data
around that sitting out there right now. So
one of my nursing research fellows right now
is gathering the data about
ambulation of patients who are on a respirator,
how far they went, what were their physical
therapy orders like, those kinds of things. We're
gonna be able just to look at that
data
and then say, hey. You know what? Maybe
this is a best practice that we should
be doing not only across our organization,
but across the country. So that's the kind
of work that I'm hoping
that our nurses will be able to lead
using this vast amount of data that we
have. And and keep in mind, Laura, what
we're talking about right now doesn't even really
include our use of AI, which has not
necessarily started
in that kind of a clinical setting yet
or in the analysis of clinical data. But
down the road, I'm sure we'll be able
to use that as well to help us
predict.
And and I want our nurses to have
that level of understanding, not coming from me
as the nurse scientist. I want the nurses
at the point of care to know, you
know what? I bet we've got data that
will help me answer this question.
That's amazing to hear. And, you know, really,
really, helpful to understand how you think about
that kind of cultural change and then really
make sure that it's,
integrated within the whole organization and they understand
why it's happening and using technology and and
data,
you know, I I think that's really critical.
And now looking ahead, what are some of
the big priorities and headwinds that you're focused
on for 2026?
2026,
I think, is even gonna be,
more challenging and more difficult than 2025. And
and by the way, I mean that in
a good way, Laura. I think we're gonna
have,
an incredible time
working through 2026
in the background.
Stirring in the background, of course, is AI,
and we don't know how that is going
to be
impacting our practice. But we know that it's
out there. So in 2026,
my team would really like to focus on
scalability,
consistency,
and measurable outcomes
across the enterprise
using,
the data that we were just talking about.
You know? But but more important to us,
Laura, for 2026
is as we scale evidence based practice
to our nurses that are working at the
point of care,
I want them to do more than just
think about evidence based practice. I want to
see
us use implementation
science
to help them
do the best job they can to implement
the evidence. So using implementation science tools
or theories to help us with that. That's
one. And then, two, the reason that's so
important is because
the evidence is only as good
as how we use it. Right? So if
we identify evidence and we think this is
gonna be the best practice, but we can't
implement
that practice, then we're not gonna make any
headway. But if we can implement the practice,
the best practice,
and then
get ourselves to high adherence of that best
practice. Right? So we implement,
let's say we implement a bundle
to,
help patients with oral care, for example, maybe
ventilator patients with oral care. We implement that
bundle. We get
ninety five percent of the nurses doing it
ninety five percent of the time, and then
we sustain that
over a period of years,
that is
best practice in, using evidence based practice. Right?
That is using implementation science
to assure high adherence
and to assure sustainability.
That's something that's gonna be new to the
nursing culture to most people. Implementation science principles
are relatively new to,
to to many nurses.
The other thing that we wanna do is
is we are gonna expand our professional governance
environment for nursing,
which gives the voice to the nurses at
the point of care.
We can share these tools like implementation science
with those nurses at the point of care.
So now they now they have access to
data. They have access to implementation
science skills,
and we want them to feel confident with
evidence based practice. And we believe that they
are going
to change practice, that their
collective wisdom as this mass of 18,000
nurses
will really help us answer some of the
most difficult questions that we have at Intermountain
Health.
Absolutely.
I love that. And, you know, it sounds
like a very exciting time to be at
Intermountain and in the nursing workforce and and
to have all of that information,
and being able to continue to grow and
develop in that space, you know, it is
really exciting.
I'm curious. What do you think is the
hardest thing that you'll have to do in
the next year will be? I I know
nothing, you know, ever, becomes
perfect, but what do you think the hardest
thing that will be?
Well, that's the that is the best question,
you could possibly ask, and it's what we
are really focusing right now. I think the
hardest thing, you know,
the longer I work in health care, the
more I realize it's about culture. It's about
culture and it's about communication.
Some of the the basic fundamentals
of of communication.
And by culture, what I mean is I
would really like every nurse at Intermountain Health
to feel comfortable
in accessing
or utilizing
their evidence based practice skills.
So I'd like to operationalize
that across the system. I don't want it
to be a central command,
resource. I want it to be a resource
that happens in the field
and that we here working centrally
can support the nurses in what they need.
You know what? I have a question,
doctor Gee, about
about patient falls, but I don't know where
to start. Well, I can help them get
started with their question and get them connected
with the resources that we have because I
bet you that we have nurses at one
of our hospitals in Montana or Colorado
or Idaho or Utah that's working on some
of those similar things. So those are sort
of the the areas that I wanna focus
on this year, focus on the culture,
creating this culture of inquiry that nurses are
not afraid to ask the question,
but they're really ready to get their their
hands dirty in digging in and working on
the questions themselves
and the solutions right there at the point
of care.
I love that. I I love that idea
of culture of inquiry as well, being able
to feel comfortable asking those questions and raising
issues and and working through together some of
the big challenges that they're thinking about and
that they see upcoming.
I I I love that kind of phrase
and that thought process.
Now before we wrap up here, I wanted
to ask you about growth as well. Where
do you see some of the biggest opportunities
for organizational growth?
Well, as you mentioned earlier,
data analytics and predictive analytics, I think, are
gonna be important for us.
Leveraging
AI,
it may not even happen this year, right,
at the clinical setting, but I think it's
gonna happen over the next few years.
I want to empower the frontline nurses
through the professional governance process to feel comfortable
with evidence based practice.
I really like to find you know, by
the way, evidence based practice can't happen if
we don't have
nursing research and knowledge to support the evidence.
And then sometimes we have to generate new
evidence. So I wanna make sure that we're
supporting and generating
new research, new nursing research,
and and by the way, validating some of
the old research that we've done in the
past as well.
And then I think it's important for us
to remember that this research and evidence based
practice
transcends
the
the clinical areas
because we wanna use best practices and the
best evidence for leadership decisions
and for decisions around how we educate our
our people.
And and one last thing, Laura, and it's
sort of an opportunity for growth.
In addition to this work that I'm doing
at Intermountain Health,
we have,
the Sigma Theta Tau International, which is a
a scholarly nursing organization.
We have a nurse scientist collaborative, and I've
been co leading that collaborative
with doctor Esther Chips from the Ohio State
University for the last couple of years.
And with that group,
we are pulling together nurse scientists from all
over the country
because we don't really have a common platform.
We,
all operate a little bit differently,
and we all need the same resources. In
fact, many of us I I did this
at my my job here. Many of us
had to create our own job descriptions, for
example, or create our own policies in our
department.
So we're we're developing this national collaborative right
now.
We've got about 200 members in that
with nurse scientists from across the country so
that we can share our wisdom and what
we've learned along the way.
That sounds like an amazing organization and group
to be part of in space that you
can really collaborate, learn, and grow together. Perry,
thank you so much for joining us on
the podcast today. This has been such a
fun conversation. I learned a ton, and inspired
by your energy and passion for what you
do. And I'm looking forward to meeting you
in person as well at our annual meeting
coming up here in April. I know you'll
be speaking on a panel and,
continue to share some of the insights and
expertise you've had through your years of research
and,
the great things that you've been able to
accomplish at Intermountain. So, thank you for your
time today, and I look forward to seeing
you in a few months.
Thank you, Lauren. I appreciate the opportunity to
share my work.