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Speaker 1: 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.

Speaker 2: Thank you so much for having me. I'm excited to talk about our work.

Speaker 1: 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?

Speaker 2: 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.

Speaker 1: 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?

Speaker 2: 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.

Speaker 1: 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.

Speaker 2: 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.

Speaker 1: 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?

Speaker 2: 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.

Speaker 1: 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?

Speaker 2: 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.

Speaker 1: 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?

Speaker 2: 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.

Speaker 1: 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.

Speaker 2: Thank you, Lauren. I appreciate the opportunity to share my work.