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Hi, everyone. You are listening to the Becker's
Healthcare podcast. I'm Erica Carbajal with the Becker's
Hospital review team. And today, I'm very excited
to be joined by Kate Fitzpatrick,
chief nurse executive at Jefferson Health. Kate, so
happy to have you on today. Thanks for
being here. Oh, Erica, it's my pleasure. Great
to be with you. Yeah. Welcome.
Well, Kate, can you start off by telling
our listeners what your top priority as CNO
of Jefferson Health is this year? What's something
you're hoping to make some meaningful progress on
by year's end?
Yeah. I would say it's, it's always hard
to pick one top priority.
I would say it doesn't matter what year
it is. The top priority is always gonna
be safe quality personalized care.
But I would say given where Jefferson Health
is in their journey, we've recently expanded in
the last year and a half, and,
we grew from a 17 hospital health system
to now 33 hospitals.
And so one of the really important things
on the, horizon for the coming year is
to continue the horizontal integration work.
So really trying to bring together structures
across our 33 hospital systems so that we
can be as effective effective and as efficient
as we can.
And that's, there's a lot that goes into
that in terms of,
bringing people together, bringing teams together.
We have new geographies. So trying to make
all that,
come together in a meaningful way is, you
know, a a top priority for me.
Yeah. Sure. No small feat. A bit a
big merger there.
Okay. I know Jefferson has been doing a
lot of work to strengthen partnerships with federally
qualified health centers and other community organizations
to to help keep vulnerable patients connected to
care, especially with some
policy changes on the horizon that could increase
the number of uninsured patients.
I know I've talked to doctor Yahia quite
a bit about this, so I just wanted
to follow-up.
How are you thinking about that challenge,
particularly from a nurse leadership perspective?
And what role do nurses play in those
community partnerships and in helping patients stay connected
to the appropriate levels of care?
Yeah. It's,
it's such an important thing for us to
be thinking about. And, you know, one of
the things that we're really,
I think fortunate is the great,
partnerships and relationships we have in Philadelphia and
across Jefferson
with our federally
qualified health centers.
And one of the things I think about
is, you know, the patients treated at federally
qualified health centers,
you know, they flow in many directions, so
they cross multiple organizations within the Jefferson system.
And so we are cross referring all the
time.
And I see nurses as pivotal in the
journey of patients,
you know, outside the hospital, especially as they're
being treated,
you know, in in federally health, qualified health
centers,
and in our EDs. So thinking about things
like how nurses are critical in,
the communication and translation,
between settings to make sure that we have
the right level of reconciliation
and communication around care plans.
Nurses are exquisite around the relationships.
They,
they will understand probably at a deep level,
what patient's insurance status is and what that
means and what that might,
be restricting or enhancing about the things resources
they can access.
So I think they also educate patients, I
think, quite a bit about, you know, understanding
with, you know, some of the policy changes
you mentioned,
what might change at the patient level? What
might be new requirements around paperwork and things
that patients have to submit to access care?
So nurses will be a center point, I
think, in helping translate that to help patients
navigate that, help patients be attentive to the
things that are gonna be really important for
them to make sure they get the care
they need.
So I think it's,
you know, it's something that's top of mind
for me and and it's gonna continue to
evolve as as we, you know, as the
landscape evolves.
Yeah, Kate. I I think it's interesting too
to hear about
nurses' role in in the education piece, especially
with all of the the changes happening around
Medicaid and,
you know, so much of that could potentially
be logistical errors and and having nurses step
up and helping
patients navigate just the logistical side to to
ensure they can stay connected to their insurance
status, you know, if it is a logistical
issue.
Oh, you know, one thing, Sarah, I'll just
add there is we're fortunate as an enterprise
to have, you know, an integrated health system,
a health plan,
and a university
having access to the experts in our health
plan. One of the things we've talked about
recently is how we can bolster the education
we provide for nurses and nurse leaders about
understanding
insurance and understanding
the impacts to patients and how we can
better support patients given all the changes that
are in front of us.
Yeah. Certainly. It's important piece.
Kate, I wanted to chat with you too
about Jefferson's nursing seal team. I know it's
gotten a lot of attention just as a
way to reduce agency reliance while also supporting
units with less experienced staff. Been a really,
important effort over the past few years that's
shown a lot of great results that we've
covered. So as you scale that model now
with the integration with Lee Valley Health Network
across the 30 plus hospital system,
what are some of the biggest lessons
so far? And do you see this kind
of flexible workforce model
becoming a more permanent
feature of how health systems actually structure their
nursing teams?
Yeah. I think the seal team has
been just a remarkable
part of our work workforce optimization strategy, for
sure. And I think we've had many lessons
that we've learned over the years since we've
launched it. And and our relearning
and trying to,
leverage and remind ourselves as we grow into
the Lehigh Valley. But I think a couple
of things that I would say in terms
of lessons, one is just reminding
everyone about the clarity and purpose of the
seal team and this flexible workforce.
You know, they're really most effective,
when they are positioned as short term, more
stabilizing
resource and not a replacement for core unit
staffing. And I think that's been, you know,
an education point.
I think experience on that team matters as
much as the flexibility. So as we've looked
at our experience level across the system for
our registered nurses,
really, this,
ability to pair highly experienced nurses with
those units or those clinics or areas that
have a higher proportion of newer staff
is,
I think, a real benefit for us. It's
not just filling shifts. It's it's being able
to provide real time mentoring and helping to
model clinical judgment and reinforcing standards of care,
especially when units are under strain. So that
that's been a a real important lesson for
us that it's it's not just the flexibility.
It's the level of experience and prioritizing
how we deploy the team, I would say,
is really important.
And then we we've really tried to be
very responsive
to our regional chief nurses and our local
teams around
what they wanna see as we grow the
seal team or modify the the seal team.
And one of the things we've heard is
just
re
adjusting
the compliment of nurses that work off shifts
and weekends
and, bolstering some of the team in terms
of specialty backgrounds like critical care. So we've
certainly spent a lot of time to make
sure that as we think of the compliment
of that team, that we're
being responsive and addressing the things that are,
you know, the people that we're serving really
need or or see as their their top
priorities.
Yeah, Caitlin. I imagine that just, you know,
being so intentional with the experience level of
nurses who are on that seal team goes
such a long way and and also helping
improve engagement among
newer nurses and and confidence and being able
to have that at the bedside, especially in
units where a good portion of staff are
novice nurses.
Absolutely. I I right now across our system,
roughly fifty five percent of our nurses are
less than five years experience, so that's really
significant. And so we're really intentional as we
think about
system wide strategies like the seal team to
consider that and how do we support retention,
how do we help those nurses to thrive.
You know, and and ultimately, it's about supporting,
you know, safe patient care. So it it's
been a tremendous resource for us.
Yeah.
Kate, one of the things too that recently
in the last few months, I feel like
has increasingly come up in conversations, especially with
clinical leaders, chief nursing officers, and medical officers,
are just breakdowns in the transition from hospital
to the next point of care as a
growing challenge. So whether it's related to timely
follow-up or medication access,
those communication
breakdowns
seem to be a growing challenge.
Where do you see the biggest gap today
between discharge and the next touch point in
in in care in a in a patient's
care, and how can nursing maybe help close
it?
Yeah. It's such a great question. And I
also have
care management as part of my portfolio for
this system. So I I spend a lot
of time thinking about this exact question.
I think there's a number of things where
I see see big gaps. One is education.
One is communication.
I would say follow through. And the last
is really,
our ability to meet patients where they are.
And as I think about those things,
I think nurses play a tremendous role in
helping us close those gaps.
So thinking about unique roles for nurses, for
example,
transitional care nurses, nurse navigators who can help
with appointments,
follow-up,
tracking,
plans after discharge and making sure patients are
adhering to those, keeping the connection between primary
care specialists and helping coordinate that for patients,
tracking, you know, patients that are at higher
risk after discharge.
And then, you know, just more operationally and
concrete building into the the whole discharge process,
making sure that
we have
people, particularly nurses, play an important role here
leading post discharge charge follow-up call,
calls to make sure that we're clarifying discharge
instructions. People understand the medications they're on. They
know the the signs to look for for
any complications
that might come up. And how they can,
avoid,
unnecessary
or avoidable emergency department visits.
So those are all things that I think
nurses play a critical role in. And then
I think, you know, one of the things
in particular that we've seen that's a challenge
is really in the whole realm of medication
reconciliation.
You know, we have patients that are on
lots of medications, some complex medications.
So really making sure that we support patients
to to understand their medication regimen.
They have the right access to the medications
they need and helping them connect the resources
if they don't.
So there's a lot of things. And I
would say the last thing is in the
comment I made about meeting patients where they
are,
I do think,
we will continue to leverage technology,
things like remote patient monitoring,
helping patients use patient the patient portal,
coordination of telehealth,
connections,
And nurses can play and do play a
critical role in helping patients navigate that, but
it also helps us meet patients where they
are. So so those are the some of
the things I've thought about around
care management, some of the gaps we're continuing
to close.
Yeah. Definitely a multi pronged approach there. Yeah.
Kate, to close us out, what's one policy
shift or workforce trends you believe could have
the biggest effect on the nation's nursing workforce
in the next three to five years? Maybe
something leaders should be paying closer attention to
right now.
You know, I again, this is it's hard
to think of just one, but I would
say that one of the things that we've
kept a close eye on is is, you
know, the workforce. Obviously, we've made tremendous strides
at Jefferson around
our workforce,
but we have to stay vigilant about the
workforce moving forward. And it really, it's sustaining
the workforce gains that we've made, but we've
gotta continue to redesign the model. So what's
the care delivery team around the patient,
given the projections we know in terms of
of longer term pipeline
for nurses, for patient care techs, for certified
nursing assistants? So looking at at the teams
around the patients and saying we're gonna have
to continue to redesign what that looks like.
And I think, you know, the the strategic
question is no longer how many nurses are
needed, but, really, it's more about how nursing
work is gonna be optimally designed and deployed.
And
so I think that's something we're all gonna
have to continue to pay attention to. And
there's so much,
I think, exciting,
things that are on the horizon around workforce
in terms of, how we're already using hybrid
virtual roles,
how we've done some really creative work on
redesigning,
and upskilling
patient, people who are patient facing on our
teams right now. So I think that that's
all gonna continue.
I think we're gonna see more around,
exciting enhancements, tech enabled care,
things like ambient listening that's gonna help our
clinicians,
be more efficient and effective and take away
some of their task burden. So I think
for me, it's really gonna be about the
workforce gain, sustaining those, and continuing to redesign
the model as we move forward.
Yeah, Kate. I I think so spot on.
I know we just, one of my colleagues
just covered a story sort of similar just
looking at workforce strategy and touched on a
lot of this just in terms of redesigning
the care delivery model. Like, the workforce strategy
has really shifted away from
hiring
and kind of competitive
competitive hiring and more so how do we
ensure that the folks we have are practicing
at the top of their license. We're utilizing
technology to the best of our ability and
and reducing that reliance on contract
work as well. So really interesting points there.
Well, Kate, thank you so much for joining
me on the podcast today. Really appreciated your
time, and I know our audience will appreciate
your insights.
Oh, it was great. Thank you so much,
Erica.