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Hello, everyone, and welcome to the Becker's Healthcare
podcast.
I'm Mackenzie Bean, associate vice president and managing
editor of Becker's Hospital Review. Today, I'm so
so excited to be joined on the podcast
by doctor Janice Walker who recently became the
inaugural chief nursing officer of UF Health.
Doctor Walker,
thank you so much for joining us on
the podcast.
I'd love to turn it over to you
to introduce yourself and tell us a little
bit more about your background.
So thank you, Mackenzie. Thank you for the
opportunity to speak,
to you this morning as well as all
my colleagues that I know will eventually listen
because I listen to theirs, and I learn
things
every single time across Becker's
world when I listen to other system chief
nurses,
other health care executive leads. So so blessed
to be in front of you today.
We are lucky to have you on the
podcast, and I'm glad that you've been enjoying
the episodes.
So I know I believe you stepped into
your new role January 19. Is that correct?
That's correct. Wonderful. Congratulations.
So talk to you about a month and
a half in, you know, excited to hear
about everything and how it's going. But before
then, can you share just a little bit
more about your career and,
you know, where you've come from and what
you've done before joining UF California?
Absolutely. So,
I have led I'm very been very blessed
to lead
large complex health care systems,
period of time where I probably understood
what systemness
really was
as, we continue to grow when I was
at Baylor Scott and White Health as the
largest not for profit in Texas.
I would say to you that's where,
as we were flying the plane, we were
building it to understand
the beauty
and the,
scale
you can create as well as on quality
outcomes,
that bigger is better
in terms of driving quality and outcomes. So,
as the as the system chief nurse at
Baylor Scott and White,
as well as during the pandemic,
systemness just became very natural to me.
So when the opportunity presented itself
to come to UF Health,
who also has given interviews and articles
related to transforming
to a to an integrated health care system.
I knew the the fit, and I was
very hopeful that the fit was perfect.
And then when I learned it was an
inaugural role,
what an additional blessing
to build it from the ground up. So
I have 12 hospitals currently with more coming
on board.
And for the last six weeks, I've devoted
my time
to getting to know those hospitals.
By the end of this week, I'll have
rounded in every single one.
Mackenzie, I learned early in my career, I
can't lead you if I don't know you.
And so, therefore and I can't support you
if I don't know you and know exactly
where you are. So I've traveled all over
the state of Florida getting to know my
new hospitals, my new clinic settings, my new
transfer center,
and all the support that goes with them.
I think those types of listening tours are
are are so so crucial
as you're jumping into the role, and it
sounds like your expertise and systemness is really
just so complimentary
to a lot of the work that's been
going on at UF Health. I know there's
been that focus on,
unifying under
academic operating model. As you said, You'll be
very focused on aligning the nursing infrastructure across
the system in the inaugural role.
Let's go a little bit deeper there.
What does a truly integrated nursing strategy look
like in practice? What are you focusing on?
And how are you planning to balance standardization
with maybe the needs of regional markets or
specific hospitals across the state?
That is a great question. As I'm meeting
people out and about, I ask many of
them, have you ever worked in a health
care system that had a system chief nurse?
And I probably get only 20% of hands
raised. So it's new for them
to understand where the balance is of my
role
as well as the the entity and the
regional chief nurses.
So I would say that I describe it
to them very much like I'm gonna describe
it to you. I'm here to represent
nursing
at the highest
level of visibility
at the UF Health System. That is at
the the president of our entity organizations table,
doctor Steven Motu.
So when they realize that I am their
voice
as well as their balance measure,
of driving quality outcomes,
then they start to embrace why we needed
one.
When you start to grow
and become
more complex with some
academic hospitals, some that are not, and adding
more hospitals,
you understand
that systemness
drives quality outcomes. So an example might be
we're we're working too hard to create
individual policies
when truly the best practice is found somewhere
in the industry, and that's the policy we
would like to adopt,
not having 12 different versions of it. Same
things with protocols
to prevent harm.
Same things with nursing professional development. What do
the plans look like? What do the succession
plans
and advancement of your degrees look like,
how do we celebrate them together, how do
we have standardization.
So the the list is endless
related to systemness,
and it's such exciting work. And I truly
think I was,
born to do that complexity work and support
them. I'm very cautious to describe to them
that it's not about losing your own entity
identity.
Even at Baylor and,
other health care systems I've worked at, you
still retain your own community identity,
but that doesn't mean that you don't have
to work as hard with creating standardization
of
of compliance
policies, standardization
with regulatory
policies.
So let's let's work smarter together
so we can continue to care for our
communities. And and once you describe to them
what a system chief nurse really does,
then they understand why now.
They understand the purposeful work.
And I tell them all along the way,
you'll be part
of identifying the variation
as well as prioritizing
which piece of the variation we're gonna go
after
first
as well as how we're doing on removing
that variation.
So,
you know, as long as they understand
you are part of the integration,
this is something we're gonna do together.
We don't we're not gonna make decisions about
nursing practice
without nurses at the table,
then they understand the why.
Mhmm. It sounds like
that work upfront on the education and the
communication,
and that very collaborative approach is is so
crucial to ensuring the system approach really works.
And one of the things that that,
I'm very purposeful
with
is, the chief nurses, the regional chief nurses,
and and what was the entities. I've met
them all, but I'm not bringing them together
to really start to strategize what we go
after first until I visit all of these
hospitals.
Because, again, I have to know you to
lead you, and I can only
know you if I come to your space
and meet you where you are. So they're
giving me grace to get that done.
And once that really starts to come to
a final,
traveling journey,
listening tours,
then I will do it at a cadence
of about quarterly,
and we will really get to work on
identifying our variation
and how we're gonna transform
to one center of nursing excellence
with the academic arm as well as the
operational arm.
That timeline makes sense, and you'll truly be
able to hone in and get a little
bit more strategic of which areas you're gonna
tackle first and and go from there.
I'm looking forward to following along and, hearing
about some of the progress. I also wanted
to talk with you about nursing recruitment and
retention. I know you're nationally recognized for your
work here, have great expertise on it. I'm
curious what's been successful for you in the
past when it comes specifically to recruiting and
retaining nurses?
What distinguishes organizations that really achieve workforce stability
from those who are being a little bit
more reactive in trying to solve nurse turnover?
So let's let's answer recruitment, and then I'll
then I'll talk a little bit more about
retention. But recruitment,
what I found that,
health care systems and complex health care systems
really have to zone in on is
I would describe it as candidate centric work
versus employee centric. So there's a difference.
You have to go after talent
faster and more agile than you ever could
imagine pre pandemic.
For every vacancy you have,
you have to source those talents, and you
have to move at a cadence
of what I like to build as seven
days.
From from the moment that we find the
candidate or the candidate finds us till job
offer is in the hand,
we can do it in seven days if
we have structure,
important
metrics, escalation
of metrics,
whether it's on the recruiter's end or the
hiring manager's end. So completely rebuild the way
you go after talent. That's the recruitment arm.
And you measure yourself, am I hitting that
seven day cycle?
So,
I've nationally published about that. I've taken that
to other states to talk about, and the
model works. It's a joint effort with talent
acquisition, recruitment, and operators
to know we must have to we must
go after the applicant faster than ever. So
turn it from
employee centric employer centric, excuse me, to candidate
centric.
So once we have the talent in the
door
and have made the commitment,
to them, then let's talk about the retention
strategies.
So retention
has to do with the listening of the
voice of your clinician
in any discipline, not just nursing.
So do you have a professional
shared governance structure
where we don't make decisions about nurses without
nurses? We don't make decisions about pharmacy workflows
without pharmacists.
We shouldn't be making decisions about therapy
workflows without therapists.
So professional shared governance
is
is a pillar of magnet organizations.
But I would say to you, it should
be a pillar of all organizations where you're
magnet or not.
Because if you are not listening to the
voice of your clinicians who are the experts
in the care they provide, you're gonna have
gaps,
and you're going to lose staff quicker, and
you're gonna have challenges with retention.
So put in that professional shared governance structure.
Start with small projects.
Learn to get
stronger
in removing barriers of their practice
through your shared governance structure, and continue to
celebrate your successes.
So one of the things that I've done
in my career around huddle boards where you're
taking on your most complex
problem
inside of an entity,
you track the progress
of that shared governance solution
and the ownership of that shared governance solution
until you really get meaningful solutions.
But you also
keep a track record of everything that professional
shared governance has accomplished, and you maybe surround
that Huddl board with the annual
successes.
So you never lose sight of what you've
actually accomplished
in a professional shared governance setting. Because if
we don't elevate it and celebrate it, our
staff tend to tend to forget it because
we always have issues and problems
that we need them to lean in and
help us solve.
And they do such great work that I'm
very purposeful in always monitoring
what you've accomplished and celebrate it. So
professional shared governance is a nonnegotiable
related to retention
as well as understanding
the different generations that we lead in the
same infrastructure.
So
one of the things I would suggest for
all listeners and I've shared across the nation
as well as looking for nuggets of success
is what is best practice to teach our
leaders to leave five generations at once?
Because they really have to,
start to develop a generational
emotional intelligence on how to do that and
meet each generation where they are
related to their needs of balanced work harmony,
their needs on how they learn, whether it's
technical versus classroom,
how they process information is different from the
generations.
So one of the things that I think
we
must always do as nurse leaders and clinical
leaders is never forget
that our that our direct management staff
must understand,
generation complexity
because they deal with it front and center
every day.
And, the evidence is still being gathered on
how to to lead our generation x,
teammates
and what their expectations
are.
So there's nothing we can do that's more
important
to our frontline leaders than to teach,
generation,
intelligence.
I appreciate that comprehensive overview for listeners of
those crucial components of retention, as you said,
shared governance, and then, of course, understanding different
generations. And then when it comes to recruitment,
it seems like really the speed and efficiency,
is key there. And I wanna ask a
quick follow-up on that seven day timeline you
mentioned.
What have you seen as the biggest perhaps
operational challenges or pitfalls that
are commonly blocking hospitals or health systems from
realistically hitting that timeline?
You've not taken the time to build infrastructure
that,
prompts you that you're falling out of the
seven day metric.
So
you really have to build the infrastructure
to fire alerts
that we have a candidate in the queue,
and we're approaching that deadline.
And what is the escalation
methodology
that the backup plan or plan b is
gonna kick in?
An example might be
if the manager nurse manager is out for
that day and a candidate
say they're on PTO for the week,
but we have a seasoned
nurse that's shopping for a certain specialty, but
the manager's out, then who is in charge
of their seven day cadence of decision making?
Don't leave that
such an important role unattended.
You gotta have backups,
and so does the recruiter.
Some hospital systems divide up recruitment by specialty.
So if someone's out for
emergency room recruitment,
who is the backup?
Because the talent is so precious
to health care organizations.
We cannot afford
to lose candidates just because someone is off
for the day or out on PTO, so
a backup plan.
And then you monitor
any fallouts. Treat them like
a never event that we should never have
lost a particular candidate because of our slowness.
So all fallouts must be
looked at,
measured, and solution for the next candidate.
Mhmm. That's incredibly incredibly valuable
advice for our listeners. And just speaking with
you, doctor walk Walker, you're such a, you
have such a wealth of knowledge and wisdom.
And looking at your career, I know, as
you said, you've led
large, complex, multi state systems
now really shaping,
your new flagship academic health system role at
UF Health.
As you're thinking about your current stage in
your own career, I'm curious how has your
leadership philosophy evolved?
What does it really take today for a
chief nursing officer to not just function as
a very important nursing leader, but really as
that strategic voice operating at the system level?
So I would say,
the strategic voice
right now
is constantly leaning in on outcomes, but even
stronger than outcomes
is talent pipelines.
So what I bring to the table strategically
is years of experience of successful
succession planning.
So not only where is our pipeline
of
talent entering our organizations? Where where are we
in our high schools
counselors?
Where are we with taking,
students that may
be considering entering health care? So that's the
front end pipeline.
What have we designed strategically
to grow future
health care workers? But then on the back
end,
what are we doing and what are we
building inside of our infrastructure
to do our own talent
navigation,
coaching, and counseling
for our current teammates
that are continuing to grow in the cycle
of entry inside of health care. So, strategically,
the voice of the chief nursing officer
is a,
balance of operational
expertise,
quality outcome
expertise,
and pipeline development that is
a, must have for strong retention metrics.
Well, doctor Walker, this has been this is
such a,
enlightening discussion. And speaking with you, it's just
clear you have helped us so lucky to
have such a
strategic passionate leader like you on their team.
So we're, so excited for you and your
new role and to follow along of all
the great work you're doing, and just thank
you for your time to join us on
the podcast today.
Thank you. There's no doubt in my mind.
I I'm the one blessed,
to be at UF Health, and I'm exactly
where I'm supposed to be during my final
season season as a chief nurse, leader. So
thank you.
Of course. Thank you again. And to our
listeners, thank you as always for tuning in.
You can find more podcast episodes by visiting
the Becker's Healthcare podcast page at beckershospitalreview.com/podcast.