1 00:00:02,000 --> 00:00:04,419 This is where health care leadership comes together. 2 00:00:04,559 --> 00:00:07,679 Becker's sixteenth annual meeting brings more than 3,500 3 00:00:07,679 --> 00:00:10,880 hospital and health system executives and nearly 800 4 00:00:10,880 --> 00:00:12,019 speakers to Chicago 5 00:00:12,320 --> 00:00:14,259 April. 6 00:00:14,535 --> 00:00:17,335 This year's event includes keynote conversations with Dallas 7 00:00:17,335 --> 00:00:20,214 Cowboys legend Troy Aikman and former president George 8 00:00:20,214 --> 00:00:22,934 W. Bush. For the agenda and event details, 9 00:00:22,934 --> 00:00:25,175 visit beckershospitalreview.com 10 00:00:25,175 --> 00:00:26,855 and click on the events tab in the 11 00:00:26,855 --> 00:00:29,574 upper right. We're looking forward to hosting you 12 00:00:29,574 --> 00:00:30,314 in Chicago. 13 00:00:31,710 --> 00:00:34,689 Hello, everyone, and welcome to the Becker's Healthcare 14 00:00:34,750 --> 00:00:35,250 podcast. 15 00:00:35,789 --> 00:00:38,909 I'm Mackenzie Bean, associate vice president and managing 16 00:00:38,909 --> 00:00:42,429 editor of Becker's Hospital Review. Today, I'm so 17 00:00:42,429 --> 00:00:44,750 so excited to be joined on the podcast 18 00:00:44,750 --> 00:00:47,765 by doctor Janice Walker who recently became the 19 00:00:47,765 --> 00:00:50,984 inaugural chief nursing officer of UF Health. 20 00:00:51,685 --> 00:00:52,585 Doctor Walker, 21 00:00:52,885 --> 00:00:54,405 thank you so much for joining us on 22 00:00:54,405 --> 00:00:55,145 the podcast. 23 00:00:55,604 --> 00:00:57,204 I'd love to turn it over to you 24 00:00:57,204 --> 00:00:59,284 to introduce yourself and tell us a little 25 00:00:59,284 --> 00:01:00,585 bit more about your background. 26 00:01:01,259 --> 00:01:03,500 So thank you, Mackenzie. Thank you for the 27 00:01:03,500 --> 00:01:05,040 opportunity to speak, 28 00:01:05,659 --> 00:01:07,579 to you this morning as well as all 29 00:01:07,579 --> 00:01:10,379 my colleagues that I know will eventually listen 30 00:01:10,379 --> 00:01:12,780 because I listen to theirs, and I learn 31 00:01:12,780 --> 00:01:13,280 things 32 00:01:13,659 --> 00:01:15,840 every single time across Becker's 33 00:01:16,325 --> 00:01:18,884 world when I listen to other system chief 34 00:01:18,884 --> 00:01:19,384 nurses, 35 00:01:19,844 --> 00:01:22,564 other health care executive leads. So so blessed 36 00:01:22,564 --> 00:01:24,024 to be in front of you today. 37 00:01:24,884 --> 00:01:26,484 We are lucky to have you on the 38 00:01:26,484 --> 00:01:28,325 podcast, and I'm glad that you've been enjoying 39 00:01:28,325 --> 00:01:29,064 the episodes. 40 00:01:30,019 --> 00:01:31,459 So I know I believe you stepped into 41 00:01:31,459 --> 00:01:34,760 your new role January 19. Is that correct? 42 00:01:34,979 --> 00:01:37,000 That's correct. Wonderful. Congratulations. 43 00:01:37,540 --> 00:01:38,900 So talk to you about a month and 44 00:01:38,900 --> 00:01:40,979 a half in, you know, excited to hear 45 00:01:40,979 --> 00:01:42,819 about everything and how it's going. But before 46 00:01:42,819 --> 00:01:44,340 then, can you share just a little bit 47 00:01:44,340 --> 00:01:46,025 more about your career and, 48 00:01:46,405 --> 00:01:47,765 you know, where you've come from and what 49 00:01:47,765 --> 00:01:50,025 you've done before joining UF California? 50 00:01:50,805 --> 00:01:51,944 Absolutely. So, 51 00:01:52,724 --> 00:01:55,604 I have led I'm very been very blessed 52 00:01:55,604 --> 00:01:56,265 to lead 53 00:01:56,724 --> 00:01:59,144 large complex health care systems, 54 00:01:59,909 --> 00:02:02,569 period of time where I probably understood 55 00:02:02,870 --> 00:02:03,769 what systemness 56 00:02:04,150 --> 00:02:05,049 really was 57 00:02:05,510 --> 00:02:08,150 as, we continue to grow when I was 58 00:02:08,150 --> 00:02:10,389 at Baylor Scott and White Health as the 59 00:02:10,389 --> 00:02:12,490 largest not for profit in Texas. 60 00:02:12,949 --> 00:02:14,650 I would say to you that's where, 61 00:02:15,114 --> 00:02:16,875 as we were flying the plane, we were 62 00:02:16,875 --> 00:02:18,495 building it to understand 63 00:02:19,194 --> 00:02:19,935 the beauty 64 00:02:20,235 --> 00:02:21,114 and the, 65 00:02:21,675 --> 00:02:22,175 scale 66 00:02:22,715 --> 00:02:25,775 you can create as well as on quality 67 00:02:25,914 --> 00:02:26,414 outcomes, 68 00:02:27,930 --> 00:02:29,870 that bigger is better 69 00:02:30,330 --> 00:02:33,389 in terms of driving quality and outcomes. So, 70 00:02:34,090 --> 00:02:36,409 as the as the system chief nurse at 71 00:02:36,409 --> 00:02:37,789 Baylor Scott and White, 72 00:02:38,169 --> 00:02:40,269 as well as during the pandemic, 73 00:02:41,294 --> 00:02:44,114 systemness just became very natural to me. 74 00:02:44,495 --> 00:02:47,155 So when the opportunity presented itself 75 00:02:47,775 --> 00:02:49,394 to come to UF Health, 76 00:02:49,935 --> 00:02:53,234 who also has given interviews and articles 77 00:02:53,694 --> 00:02:54,914 related to transforming 78 00:02:55,375 --> 00:02:58,299 to a to an integrated health care system. 79 00:02:58,680 --> 00:03:00,519 I knew the the fit, and I was 80 00:03:00,519 --> 00:03:02,699 very hopeful that the fit was perfect. 81 00:03:03,400 --> 00:03:05,000 And then when I learned it was an 82 00:03:05,000 --> 00:03:06,219 inaugural role, 83 00:03:06,680 --> 00:03:08,459 what an additional blessing 84 00:03:08,840 --> 00:03:11,394 to build it from the ground up. So 85 00:03:11,394 --> 00:03:14,995 I have 12 hospitals currently with more coming 86 00:03:14,995 --> 00:03:15,735 on board. 87 00:03:16,194 --> 00:03:19,254 And for the last six weeks, I've devoted 88 00:03:19,314 --> 00:03:20,055 my time 89 00:03:20,354 --> 00:03:22,294 to getting to know those hospitals. 90 00:03:22,914 --> 00:03:24,834 By the end of this week, I'll have 91 00:03:24,834 --> 00:03:26,989 rounded in every single one. 92 00:03:27,289 --> 00:03:30,090 Mackenzie, I learned early in my career, I 93 00:03:30,090 --> 00:03:32,189 can't lead you if I don't know you. 94 00:03:32,409 --> 00:03:34,569 And so, therefore and I can't support you 95 00:03:34,569 --> 00:03:36,329 if I don't know you and know exactly 96 00:03:36,329 --> 00:03:38,489 where you are. So I've traveled all over 97 00:03:38,489 --> 00:03:40,329 the state of Florida getting to know my 98 00:03:40,329 --> 00:03:43,905 new hospitals, my new clinic settings, my new 99 00:03:43,905 --> 00:03:44,965 transfer center, 100 00:03:45,264 --> 00:03:47,525 and all the support that goes with them. 101 00:03:48,224 --> 00:03:50,545 I think those types of listening tours are 102 00:03:50,545 --> 00:03:52,004 are are so so crucial 103 00:03:52,544 --> 00:03:55,010 as you're jumping into the role, and it 104 00:03:55,010 --> 00:03:58,290 sounds like your expertise and systemness is really 105 00:03:58,290 --> 00:03:59,750 just so complimentary 106 00:04:00,050 --> 00:04:01,330 to a lot of the work that's been 107 00:04:01,330 --> 00:04:03,169 going on at UF Health. I know there's 108 00:04:03,169 --> 00:04:04,469 been that focus on, 109 00:04:04,930 --> 00:04:05,990 unifying under 110 00:04:06,449 --> 00:04:09,435 academic operating model. As you said, You'll be 111 00:04:09,435 --> 00:04:12,235 very focused on aligning the nursing infrastructure across 112 00:04:12,235 --> 00:04:14,335 the system in the inaugural role. 113 00:04:14,715 --> 00:04:16,814 Let's go a little bit deeper there. 114 00:04:17,435 --> 00:04:19,834 What does a truly integrated nursing strategy look 115 00:04:19,834 --> 00:04:21,834 like in practice? What are you focusing on? 116 00:04:21,834 --> 00:04:24,770 And how are you planning to balance standardization 117 00:04:24,990 --> 00:04:27,550 with maybe the needs of regional markets or 118 00:04:27,550 --> 00:04:29,649 specific hospitals across the state? 119 00:04:30,350 --> 00:04:32,509 That is a great question. As I'm meeting 120 00:04:32,509 --> 00:04:34,350 people out and about, I ask many of 121 00:04:34,350 --> 00:04:35,790 them, have you ever worked in a health 122 00:04:35,790 --> 00:04:38,050 care system that had a system chief nurse? 123 00:04:38,324 --> 00:04:41,365 And I probably get only 20% of hands 124 00:04:41,365 --> 00:04:43,305 raised. So it's new for them 125 00:04:43,685 --> 00:04:46,165 to understand where the balance is of my 126 00:04:46,165 --> 00:04:46,665 role 127 00:04:46,965 --> 00:04:49,285 as well as the the entity and the 128 00:04:49,285 --> 00:04:50,665 regional chief nurses. 129 00:04:51,720 --> 00:04:53,720 So I would say that I describe it 130 00:04:53,720 --> 00:04:55,720 to them very much like I'm gonna describe 131 00:04:55,720 --> 00:04:57,899 it to you. I'm here to represent 132 00:04:58,279 --> 00:04:58,779 nursing 133 00:04:59,879 --> 00:05:00,779 at the highest 134 00:05:01,240 --> 00:05:03,019 level of visibility 135 00:05:03,664 --> 00:05:06,245 at the UF Health System. That is at 136 00:05:06,305 --> 00:05:09,925 the the president of our entity organizations table, 137 00:05:10,704 --> 00:05:12,004 doctor Steven Motu. 138 00:05:12,704 --> 00:05:15,185 So when they realize that I am their 139 00:05:15,185 --> 00:05:15,685 voice 140 00:05:16,259 --> 00:05:18,759 as well as their balance measure, 141 00:05:19,539 --> 00:05:21,479 of driving quality outcomes, 142 00:05:21,779 --> 00:05:24,419 then they start to embrace why we needed 143 00:05:24,419 --> 00:05:24,919 one. 144 00:05:25,300 --> 00:05:27,319 When you start to grow 145 00:05:27,699 --> 00:05:28,519 and become 146 00:05:28,899 --> 00:05:30,839 more complex with some 147 00:05:31,404 --> 00:05:34,845 academic hospitals, some that are not, and adding 148 00:05:34,845 --> 00:05:35,824 more hospitals, 149 00:05:36,365 --> 00:05:37,185 you understand 150 00:05:37,485 --> 00:05:38,545 that systemness 151 00:05:39,324 --> 00:05:43,185 drives quality outcomes. So an example might be 152 00:05:43,740 --> 00:05:46,240 we're we're working too hard to create 153 00:05:46,699 --> 00:05:47,759 individual policies 154 00:05:48,460 --> 00:05:51,759 when truly the best practice is found somewhere 155 00:05:52,139 --> 00:05:54,379 in the industry, and that's the policy we 156 00:05:54,379 --> 00:05:55,520 would like to adopt, 157 00:05:55,875 --> 00:05:58,995 not having 12 different versions of it. Same 158 00:05:58,995 --> 00:06:00,295 things with protocols 159 00:06:00,675 --> 00:06:01,895 to prevent harm. 160 00:06:02,355 --> 00:06:06,115 Same things with nursing professional development. What do 161 00:06:06,115 --> 00:06:08,775 the plans look like? What do the succession 162 00:06:08,915 --> 00:06:09,415 plans 163 00:06:09,839 --> 00:06:12,740 and advancement of your degrees look like, 164 00:06:13,120 --> 00:06:15,360 how do we celebrate them together, how do 165 00:06:15,360 --> 00:06:16,180 we have standardization. 166 00:06:17,199 --> 00:06:19,300 So the the list is endless 167 00:06:20,000 --> 00:06:21,459 related to systemness, 168 00:06:22,665 --> 00:06:25,144 and it's such exciting work. And I truly 169 00:06:25,144 --> 00:06:26,444 think I was, 170 00:06:27,625 --> 00:06:30,504 born to do that complexity work and support 171 00:06:30,504 --> 00:06:34,524 them. I'm very cautious to describe to them 172 00:06:35,100 --> 00:06:38,639 that it's not about losing your own entity 173 00:06:38,779 --> 00:06:39,279 identity. 174 00:06:40,699 --> 00:06:42,300 Even at Baylor and, 175 00:06:42,699 --> 00:06:45,660 other health care systems I've worked at, you 176 00:06:45,660 --> 00:06:48,959 still retain your own community identity, 177 00:06:49,925 --> 00:06:52,084 but that doesn't mean that you don't have 178 00:06:52,084 --> 00:06:54,264 to work as hard with creating standardization 179 00:06:54,564 --> 00:06:55,064 of 180 00:06:55,444 --> 00:06:56,345 of compliance 181 00:06:56,805 --> 00:06:58,024 policies, standardization 182 00:06:58,404 --> 00:06:59,144 with regulatory 183 00:06:59,524 --> 00:07:00,024 policies. 184 00:07:00,404 --> 00:07:02,824 So let's let's work smarter together 185 00:07:03,289 --> 00:07:05,209 so we can continue to care for our 186 00:07:05,209 --> 00:07:07,850 communities. And and once you describe to them 187 00:07:07,850 --> 00:07:10,029 what a system chief nurse really does, 188 00:07:10,410 --> 00:07:12,430 then they understand why now. 189 00:07:12,970 --> 00:07:15,069 They understand the purposeful work. 190 00:07:15,370 --> 00:07:17,529 And I tell them all along the way, 191 00:07:17,529 --> 00:07:18,509 you'll be part 192 00:07:18,875 --> 00:07:20,654 of identifying the variation 193 00:07:21,354 --> 00:07:22,654 as well as prioritizing 194 00:07:23,754 --> 00:07:26,235 which piece of the variation we're gonna go 195 00:07:26,235 --> 00:07:26,735 after 196 00:07:27,115 --> 00:07:27,615 first 197 00:07:28,074 --> 00:07:30,735 as well as how we're doing on removing 198 00:07:30,875 --> 00:07:31,615 that variation. 199 00:07:32,399 --> 00:07:32,899 So, 200 00:07:33,279 --> 00:07:34,980 you know, as long as they understand 201 00:07:36,160 --> 00:07:38,180 you are part of the integration, 202 00:07:38,480 --> 00:07:40,500 this is something we're gonna do together. 203 00:07:41,600 --> 00:07:43,920 We don't we're not gonna make decisions about 204 00:07:43,920 --> 00:07:44,980 nursing practice 205 00:07:45,464 --> 00:07:47,404 without nurses at the table, 206 00:07:47,865 --> 00:07:49,564 then they understand the why. 207 00:07:50,745 --> 00:07:52,125 Mhmm. It sounds like 208 00:07:52,425 --> 00:07:54,904 that work upfront on the education and the 209 00:07:54,904 --> 00:07:55,404 communication, 210 00:07:56,345 --> 00:07:58,425 and that very collaborative approach is is so 211 00:07:58,425 --> 00:08:01,870 crucial to ensuring the system approach really works. 212 00:08:02,810 --> 00:08:05,229 And one of the things that that, 213 00:08:05,610 --> 00:08:06,669 I'm very purposeful 214 00:08:07,129 --> 00:08:07,629 with 215 00:08:08,009 --> 00:08:11,050 is, the chief nurses, the regional chief nurses, 216 00:08:11,050 --> 00:08:12,970 and and what was the entities. I've met 217 00:08:12,970 --> 00:08:15,845 them all, but I'm not bringing them together 218 00:08:15,845 --> 00:08:19,125 to really start to strategize what we go 219 00:08:19,125 --> 00:08:21,764 after first until I visit all of these 220 00:08:21,764 --> 00:08:22,264 hospitals. 221 00:08:22,644 --> 00:08:24,485 Because, again, I have to know you to 222 00:08:24,485 --> 00:08:26,024 lead you, and I can only 223 00:08:26,324 --> 00:08:28,264 know you if I come to your space 224 00:08:28,790 --> 00:08:30,709 and meet you where you are. So they're 225 00:08:30,709 --> 00:08:32,649 giving me grace to get that done. 226 00:08:33,190 --> 00:08:36,409 And once that really starts to come to 227 00:08:36,710 --> 00:08:37,450 a final, 228 00:08:38,470 --> 00:08:39,610 traveling journey, 229 00:08:40,070 --> 00:08:40,970 listening tours, 230 00:08:41,475 --> 00:08:43,634 then I will do it at a cadence 231 00:08:43,634 --> 00:08:44,695 of about quarterly, 232 00:08:45,075 --> 00:08:47,254 and we will really get to work on 233 00:08:47,394 --> 00:08:48,615 identifying our variation 234 00:08:49,154 --> 00:08:50,534 and how we're gonna transform 235 00:08:51,154 --> 00:08:53,335 to one center of nursing excellence 236 00:08:53,970 --> 00:08:56,690 with the academic arm as well as the 237 00:08:56,690 --> 00:08:57,909 operational arm. 238 00:08:58,610 --> 00:09:00,610 That timeline makes sense, and you'll truly be 239 00:09:00,610 --> 00:09:02,769 able to hone in and get a little 240 00:09:02,769 --> 00:09:06,049 bit more strategic of which areas you're gonna 241 00:09:06,049 --> 00:09:08,309 tackle first and and go from there. 242 00:09:09,205 --> 00:09:11,764 I'm looking forward to following along and, hearing 243 00:09:11,764 --> 00:09:13,924 about some of the progress. I also wanted 244 00:09:13,924 --> 00:09:16,565 to talk with you about nursing recruitment and 245 00:09:16,565 --> 00:09:19,044 retention. I know you're nationally recognized for your 246 00:09:19,044 --> 00:09:21,730 work here, have great expertise on it. I'm 247 00:09:21,730 --> 00:09:24,529 curious what's been successful for you in the 248 00:09:24,529 --> 00:09:26,529 past when it comes specifically to recruiting and 249 00:09:26,529 --> 00:09:27,429 retaining nurses? 250 00:09:27,809 --> 00:09:31,669 What distinguishes organizations that really achieve workforce stability 251 00:09:31,730 --> 00:09:33,970 from those who are being a little bit 252 00:09:33,970 --> 00:09:36,549 more reactive in trying to solve nurse turnover? 253 00:09:37,625 --> 00:09:40,264 So let's let's answer recruitment, and then I'll 254 00:09:40,264 --> 00:09:41,865 then I'll talk a little bit more about 255 00:09:41,865 --> 00:09:43,164 retention. But recruitment, 256 00:09:44,184 --> 00:09:45,725 what I found that, 257 00:09:46,585 --> 00:09:49,725 health care systems and complex health care systems 258 00:09:49,865 --> 00:09:52,279 really have to zone in on is 259 00:09:52,740 --> 00:09:56,179 I would describe it as candidate centric work 260 00:09:56,179 --> 00:09:59,159 versus employee centric. So there's a difference. 261 00:09:59,779 --> 00:10:02,039 You have to go after talent 262 00:10:03,220 --> 00:10:06,565 faster and more agile than you ever could 263 00:10:06,565 --> 00:10:08,024 imagine pre pandemic. 264 00:10:09,524 --> 00:10:11,784 For every vacancy you have, 265 00:10:13,044 --> 00:10:16,084 you have to source those talents, and you 266 00:10:16,084 --> 00:10:17,625 have to move at a cadence 267 00:10:18,004 --> 00:10:20,485 of what I like to build as seven 268 00:10:20,485 --> 00:10:20,985 days. 269 00:10:21,460 --> 00:10:23,460 From from the moment that we find the 270 00:10:23,460 --> 00:10:26,580 candidate or the candidate finds us till job 271 00:10:26,580 --> 00:10:27,879 offer is in the hand, 272 00:10:28,259 --> 00:10:30,659 we can do it in seven days if 273 00:10:30,659 --> 00:10:31,960 we have structure, 274 00:10:32,740 --> 00:10:33,240 important 275 00:10:33,620 --> 00:10:34,919 metrics, escalation 276 00:10:35,539 --> 00:10:36,279 of metrics, 277 00:10:36,924 --> 00:10:39,004 whether it's on the recruiter's end or the 278 00:10:39,004 --> 00:10:42,764 hiring manager's end. So completely rebuild the way 279 00:10:42,764 --> 00:10:45,264 you go after talent. That's the recruitment arm. 280 00:10:45,325 --> 00:10:48,285 And you measure yourself, am I hitting that 281 00:10:48,285 --> 00:10:49,409 seven day cycle? 282 00:10:50,449 --> 00:10:50,949 So, 283 00:10:51,649 --> 00:10:54,610 I've nationally published about that. I've taken that 284 00:10:54,610 --> 00:10:57,329 to other states to talk about, and the 285 00:10:57,329 --> 00:11:01,190 model works. It's a joint effort with talent 286 00:11:01,250 --> 00:11:03,589 acquisition, recruitment, and operators 287 00:11:04,125 --> 00:11:05,804 to know we must have to we must 288 00:11:05,804 --> 00:11:08,524 go after the applicant faster than ever. So 289 00:11:08,524 --> 00:11:09,504 turn it from 290 00:11:09,884 --> 00:11:13,904 employee centric employer centric, excuse me, to candidate 291 00:11:13,965 --> 00:11:14,465 centric. 292 00:11:15,085 --> 00:11:16,924 So once we have the talent in the 293 00:11:16,924 --> 00:11:17,424 door 294 00:11:17,870 --> 00:11:19,250 and have made the commitment, 295 00:11:20,350 --> 00:11:23,089 to them, then let's talk about the retention 296 00:11:23,309 --> 00:11:23,809 strategies. 297 00:11:24,429 --> 00:11:25,330 So retention 298 00:11:26,190 --> 00:11:29,389 has to do with the listening of the 299 00:11:29,389 --> 00:11:30,929 voice of your clinician 300 00:11:32,134 --> 00:11:34,475 in any discipline, not just nursing. 301 00:11:35,014 --> 00:11:37,035 So do you have a professional 302 00:11:37,735 --> 00:11:39,514 shared governance structure 303 00:11:40,215 --> 00:11:43,254 where we don't make decisions about nurses without 304 00:11:43,254 --> 00:11:46,769 nurses? We don't make decisions about pharmacy workflows 305 00:11:46,910 --> 00:11:47,809 without pharmacists. 306 00:11:48,190 --> 00:11:50,690 We shouldn't be making decisions about therapy 307 00:11:51,070 --> 00:11:52,529 workflows without therapists. 308 00:11:52,910 --> 00:11:55,090 So professional shared governance 309 00:11:55,710 --> 00:11:56,210 is 310 00:11:56,574 --> 00:11:59,074 is a pillar of magnet organizations. 311 00:11:59,774 --> 00:12:01,294 But I would say to you, it should 312 00:12:01,294 --> 00:12:03,534 be a pillar of all organizations where you're 313 00:12:03,534 --> 00:12:04,514 magnet or not. 314 00:12:04,815 --> 00:12:06,815 Because if you are not listening to the 315 00:12:06,815 --> 00:12:09,394 voice of your clinicians who are the experts 316 00:12:09,855 --> 00:12:12,529 in the care they provide, you're gonna have 317 00:12:12,529 --> 00:12:13,029 gaps, 318 00:12:13,409 --> 00:12:16,450 and you're going to lose staff quicker, and 319 00:12:16,450 --> 00:12:18,549 you're gonna have challenges with retention. 320 00:12:18,929 --> 00:12:21,830 So put in that professional shared governance structure. 321 00:12:22,850 --> 00:12:24,629 Start with small projects. 322 00:12:25,445 --> 00:12:26,825 Learn to get 323 00:12:27,284 --> 00:12:27,784 stronger 324 00:12:28,085 --> 00:12:30,504 in removing barriers of their practice 325 00:12:31,044 --> 00:12:34,164 through your shared governance structure, and continue to 326 00:12:34,164 --> 00:12:35,544 celebrate your successes. 327 00:12:36,245 --> 00:12:37,845 So one of the things that I've done 328 00:12:37,845 --> 00:12:41,159 in my career around huddle boards where you're 329 00:12:41,159 --> 00:12:42,779 taking on your most complex 330 00:12:43,080 --> 00:12:43,580 problem 331 00:12:44,039 --> 00:12:45,339 inside of an entity, 332 00:12:45,639 --> 00:12:47,019 you track the progress 333 00:12:47,799 --> 00:12:50,220 of that shared governance solution 334 00:12:51,000 --> 00:12:53,899 and the ownership of that shared governance solution 335 00:12:54,404 --> 00:12:56,745 until you really get meaningful solutions. 336 00:12:57,204 --> 00:12:58,184 But you also 337 00:12:59,204 --> 00:13:02,424 keep a track record of everything that professional 338 00:13:02,485 --> 00:13:05,784 shared governance has accomplished, and you maybe surround 339 00:13:06,004 --> 00:13:08,664 that Huddl board with the annual 340 00:13:09,480 --> 00:13:09,980 successes. 341 00:13:10,360 --> 00:13:13,320 So you never lose sight of what you've 342 00:13:13,320 --> 00:13:14,460 actually accomplished 343 00:13:15,080 --> 00:13:18,279 in a professional shared governance setting. Because if 344 00:13:18,279 --> 00:13:21,639 we don't elevate it and celebrate it, our 345 00:13:21,639 --> 00:13:24,384 staff tend to tend to forget it because 346 00:13:24,384 --> 00:13:26,725 we always have issues and problems 347 00:13:27,105 --> 00:13:28,704 that we need them to lean in and 348 00:13:28,704 --> 00:13:29,605 help us solve. 349 00:13:29,985 --> 00:13:32,225 And they do such great work that I'm 350 00:13:32,225 --> 00:13:34,565 very purposeful in always monitoring 351 00:13:35,024 --> 00:13:38,245 what you've accomplished and celebrate it. So 352 00:13:38,830 --> 00:13:40,929 professional shared governance is a nonnegotiable 353 00:13:41,389 --> 00:13:42,450 related to retention 354 00:13:43,549 --> 00:13:45,009 as well as understanding 355 00:13:45,870 --> 00:13:48,990 the different generations that we lead in the 356 00:13:48,990 --> 00:13:49,889 same infrastructure. 357 00:13:50,750 --> 00:13:51,250 So 358 00:13:52,115 --> 00:13:53,954 one of the things I would suggest for 359 00:13:53,954 --> 00:13:56,615 all listeners and I've shared across the nation 360 00:13:56,674 --> 00:13:59,174 as well as looking for nuggets of success 361 00:13:59,235 --> 00:14:01,794 is what is best practice to teach our 362 00:14:01,794 --> 00:14:04,534 leaders to leave five generations at once? 363 00:14:04,940 --> 00:14:06,399 Because they really have to, 364 00:14:06,940 --> 00:14:08,720 start to develop a generational 365 00:14:09,259 --> 00:14:12,299 emotional intelligence on how to do that and 366 00:14:12,299 --> 00:14:14,799 meet each generation where they are 367 00:14:15,179 --> 00:14:18,080 related to their needs of balanced work harmony, 368 00:14:18,975 --> 00:14:21,534 their needs on how they learn, whether it's 369 00:14:21,534 --> 00:14:23,315 technical versus classroom, 370 00:14:24,095 --> 00:14:27,214 how they process information is different from the 371 00:14:27,214 --> 00:14:27,714 generations. 372 00:14:28,254 --> 00:14:30,254 So one of the things that I think 373 00:14:30,254 --> 00:14:30,754 we 374 00:14:31,110 --> 00:14:33,929 must always do as nurse leaders and clinical 375 00:14:33,990 --> 00:14:35,850 leaders is never forget 376 00:14:36,389 --> 00:14:39,289 that our that our direct management staff 377 00:14:39,669 --> 00:14:40,730 must understand, 378 00:14:42,070 --> 00:14:43,289 generation complexity 379 00:14:44,605 --> 00:14:46,684 because they deal with it front and center 380 00:14:46,684 --> 00:14:47,504 every day. 381 00:14:47,884 --> 00:14:50,684 And, the evidence is still being gathered on 382 00:14:50,684 --> 00:14:53,504 how to to lead our generation x, 383 00:14:54,284 --> 00:14:54,784 teammates 384 00:14:55,245 --> 00:14:56,625 and what their expectations 385 00:14:57,164 --> 00:14:57,664 are. 386 00:14:58,044 --> 00:15:00,500 So there's nothing we can do that's more 387 00:15:00,500 --> 00:15:01,000 important 388 00:15:01,620 --> 00:15:04,279 to our frontline leaders than to teach, 389 00:15:05,220 --> 00:15:05,720 generation, 390 00:15:07,059 --> 00:15:07,559 intelligence. 391 00:15:08,980 --> 00:15:12,679 I appreciate that comprehensive overview for listeners of 392 00:15:12,865 --> 00:15:15,665 those crucial components of retention, as you said, 393 00:15:15,665 --> 00:15:17,985 shared governance, and then, of course, understanding different 394 00:15:17,985 --> 00:15:20,085 generations. And then when it comes to recruitment, 395 00:15:20,144 --> 00:15:22,565 it seems like really the speed and efficiency, 396 00:15:23,585 --> 00:15:25,345 is key there. And I wanna ask a 397 00:15:25,345 --> 00:15:27,825 quick follow-up on that seven day timeline you 398 00:15:27,825 --> 00:15:28,325 mentioned. 399 00:15:29,639 --> 00:15:31,820 What have you seen as the biggest perhaps 400 00:15:31,879 --> 00:15:34,299 operational challenges or pitfalls that 401 00:15:34,759 --> 00:15:38,120 are commonly blocking hospitals or health systems from 402 00:15:38,120 --> 00:15:39,899 realistically hitting that timeline? 403 00:15:41,705 --> 00:15:44,524 You've not taken the time to build infrastructure 404 00:15:45,705 --> 00:15:46,205 that, 405 00:15:47,384 --> 00:15:50,425 prompts you that you're falling out of the 406 00:15:50,425 --> 00:15:51,644 seven day metric. 407 00:15:52,264 --> 00:15:52,764 So 408 00:15:53,144 --> 00:15:55,165 you really have to build the infrastructure 409 00:15:55,545 --> 00:15:56,764 to fire alerts 410 00:15:57,279 --> 00:15:59,700 that we have a candidate in the queue, 411 00:16:00,080 --> 00:16:02,100 and we're approaching that deadline. 412 00:16:02,720 --> 00:16:04,339 And what is the escalation 413 00:16:04,720 --> 00:16:05,220 methodology 414 00:16:06,080 --> 00:16:08,799 that the backup plan or plan b is 415 00:16:08,799 --> 00:16:09,940 gonna kick in? 416 00:16:10,720 --> 00:16:12,339 An example might be 417 00:16:12,684 --> 00:16:15,725 if the manager nurse manager is out for 418 00:16:15,725 --> 00:16:17,345 that day and a candidate 419 00:16:17,725 --> 00:16:19,745 say they're on PTO for the week, 420 00:16:20,045 --> 00:16:21,345 but we have a seasoned 421 00:16:21,725 --> 00:16:24,845 nurse that's shopping for a certain specialty, but 422 00:16:24,845 --> 00:16:27,825 the manager's out, then who is in charge 423 00:16:28,379 --> 00:16:31,600 of their seven day cadence of decision making? 424 00:16:32,059 --> 00:16:33,519 Don't leave that 425 00:16:34,299 --> 00:16:36,399 such an important role unattended. 426 00:16:36,860 --> 00:16:38,080 You gotta have backups, 427 00:16:38,460 --> 00:16:40,000 and so does the recruiter. 428 00:16:40,634 --> 00:16:44,175 Some hospital systems divide up recruitment by specialty. 429 00:16:44,475 --> 00:16:46,654 So if someone's out for 430 00:16:47,274 --> 00:16:48,815 emergency room recruitment, 431 00:16:49,195 --> 00:16:50,335 who is the backup? 432 00:16:51,035 --> 00:16:53,855 Because the talent is so precious 433 00:16:54,370 --> 00:16:55,750 to health care organizations. 434 00:16:56,690 --> 00:16:58,149 We cannot afford 435 00:16:59,490 --> 00:17:02,769 to lose candidates just because someone is off 436 00:17:02,769 --> 00:17:05,410 for the day or out on PTO, so 437 00:17:05,410 --> 00:17:06,470 a backup plan. 438 00:17:06,769 --> 00:17:08,150 And then you monitor 439 00:17:09,335 --> 00:17:11,434 any fallouts. Treat them like 440 00:17:11,894 --> 00:17:14,134 a never event that we should never have 441 00:17:14,134 --> 00:17:17,434 lost a particular candidate because of our slowness. 442 00:17:18,134 --> 00:17:20,555 So all fallouts must be 443 00:17:21,015 --> 00:17:21,914 looked at, 444 00:17:22,580 --> 00:17:25,160 measured, and solution for the next candidate. 445 00:17:26,099 --> 00:17:28,839 Mhmm. That's incredibly incredibly valuable 446 00:17:29,380 --> 00:17:31,940 advice for our listeners. And just speaking with 447 00:17:31,940 --> 00:17:34,339 you, doctor walk Walker, you're such a, you 448 00:17:34,339 --> 00:17:36,815 have such a wealth of knowledge and wisdom. 449 00:17:36,815 --> 00:17:38,335 And looking at your career, I know, as 450 00:17:38,335 --> 00:17:39,474 you said, you've led 451 00:17:39,775 --> 00:17:41,875 large, complex, multi state systems 452 00:17:42,174 --> 00:17:43,474 now really shaping, 453 00:17:44,255 --> 00:17:46,654 your new flagship academic health system role at 454 00:17:46,654 --> 00:17:47,474 UF Health. 455 00:17:48,450 --> 00:17:50,210 As you're thinking about your current stage in 456 00:17:50,210 --> 00:17:52,210 your own career, I'm curious how has your 457 00:17:52,210 --> 00:17:53,909 leadership philosophy evolved? 458 00:17:54,450 --> 00:17:55,970 What does it really take today for a 459 00:17:55,970 --> 00:17:58,549 chief nursing officer to not just function as 460 00:17:58,769 --> 00:18:00,929 a very important nursing leader, but really as 461 00:18:00,929 --> 00:18:03,944 that strategic voice operating at the system level? 462 00:18:04,984 --> 00:18:06,204 So I would say, 463 00:18:06,984 --> 00:18:08,444 the strategic voice 464 00:18:08,904 --> 00:18:09,644 right now 465 00:18:10,105 --> 00:18:13,784 is constantly leaning in on outcomes, but even 466 00:18:13,784 --> 00:18:15,164 stronger than outcomes 467 00:18:15,784 --> 00:18:17,484 is talent pipelines. 468 00:18:18,059 --> 00:18:20,399 So what I bring to the table strategically 469 00:18:21,339 --> 00:18:24,240 is years of experience of successful 470 00:18:24,619 --> 00:18:25,679 succession planning. 471 00:18:26,380 --> 00:18:28,799 So not only where is our pipeline 472 00:18:29,659 --> 00:18:30,159 of 473 00:18:30,494 --> 00:18:33,775 talent entering our organizations? Where where are we 474 00:18:33,775 --> 00:18:34,994 in our high schools 475 00:18:35,615 --> 00:18:36,115 counselors? 476 00:18:36,734 --> 00:18:38,115 Where are we with taking, 477 00:18:38,974 --> 00:18:40,355 students that may 478 00:18:40,654 --> 00:18:43,214 be considering entering health care? So that's the 479 00:18:43,214 --> 00:18:44,275 front end pipeline. 480 00:18:44,789 --> 00:18:46,890 What have we designed strategically 481 00:18:47,910 --> 00:18:49,369 to grow future 482 00:18:50,070 --> 00:18:52,309 health care workers? But then on the back 483 00:18:52,309 --> 00:18:52,809 end, 484 00:18:53,269 --> 00:18:55,269 what are we doing and what are we 485 00:18:55,269 --> 00:18:57,289 building inside of our infrastructure 486 00:18:58,150 --> 00:19:00,170 to do our own talent 487 00:19:01,045 --> 00:19:01,545 navigation, 488 00:19:02,085 --> 00:19:03,384 coaching, and counseling 489 00:19:04,005 --> 00:19:05,545 for our current teammates 490 00:19:06,005 --> 00:19:08,664 that are continuing to grow in the cycle 491 00:19:08,724 --> 00:19:12,025 of entry inside of health care. So, strategically, 492 00:19:13,710 --> 00:19:16,049 the voice of the chief nursing officer 493 00:19:17,069 --> 00:19:18,029 is a, 494 00:19:18,990 --> 00:19:20,450 balance of operational 495 00:19:21,309 --> 00:19:21,809 expertise, 496 00:19:22,910 --> 00:19:24,210 quality outcome 497 00:19:24,669 --> 00:19:25,169 expertise, 498 00:19:26,029 --> 00:19:28,369 and pipeline development that is 499 00:19:29,005 --> 00:19:32,144 a, must have for strong retention metrics. 500 00:19:33,804 --> 00:19:36,285 Well, doctor Walker, this has been this is 501 00:19:36,285 --> 00:19:37,025 such a, 502 00:19:37,724 --> 00:19:40,684 enlightening discussion. And speaking with you, it's just 503 00:19:40,684 --> 00:19:42,444 clear you have helped us so lucky to 504 00:19:42,444 --> 00:19:43,345 have such a 505 00:19:43,700 --> 00:19:46,420 strategic passionate leader like you on their team. 506 00:19:46,420 --> 00:19:48,500 So we're, so excited for you and your 507 00:19:48,500 --> 00:19:50,099 new role and to follow along of all 508 00:19:50,099 --> 00:19:52,099 the great work you're doing, and just thank 509 00:19:52,099 --> 00:19:53,380 you for your time to join us on 510 00:19:53,380 --> 00:19:54,440 the podcast today. 511 00:19:54,900 --> 00:19:57,160 Thank you. There's no doubt in my mind. 512 00:19:57,220 --> 00:19:58,579 I I'm the one blessed, 513 00:19:59,484 --> 00:20:02,284 to be at UF Health, and I'm exactly 514 00:20:02,284 --> 00:20:04,204 where I'm supposed to be during my final 515 00:20:04,204 --> 00:20:07,325 season season as a chief nurse, leader. So 516 00:20:07,325 --> 00:20:07,984 thank you. 517 00:20:08,524 --> 00:20:10,524 Of course. Thank you again. And to our 518 00:20:10,524 --> 00:20:13,264 listeners, thank you as always for tuning in. 519 00:20:13,509 --> 00:20:16,150 You can find more podcast episodes by visiting 520 00:20:16,150 --> 00:20:21,690 the Becker's Healthcare podcast page at beckershospitalreview.com/podcast.