1 00:00:00,190 --> 00:00:02,760 This is Laura Ddo with the Becker's Healthcare Podcast. 2 00:00:03,220 --> 00:00:05,320 I'm thrilled today to be joined by Kathy English, 3 00:00:05,320 --> 00:00:08,800 executive Vice President and Chief Operating Officer at Children's Hospital and 4 00:00:08,800 --> 00:00:11,680 Medical Center. Kathy, it's a pleasure to have you on the podcast today. 5 00:00:12,710 --> 00:00:14,800 Thanks so much. I'm glad to be here. 6 00:00:15,740 --> 00:00:19,080 Now I know we have a lot to talk about in terms of what's happening in 7 00:00:19,080 --> 00:00:22,880 pediatrics and clinician burnout, but before we dive into our discussion, 8 00:00:22,880 --> 00:00:25,120 can you tell us a little bit more about yourself and your background? 9 00:00:25,910 --> 00:00:28,760 Sure, I'd be happy to. In terms of my background, 10 00:00:29,030 --> 00:00:31,480 I've spent my career in pediatric healthcare. 11 00:00:31,710 --> 00:00:36,040 I have master's degrees in nursing administration and business administration. 12 00:00:36,590 --> 00:00:41,480 I actually came to Omaha's, the chief nursing officer over 30 years ago, 13 00:00:41,740 --> 00:00:45,320 and I've served as the chief nursing officer and also the chief operating 14 00:00:45,320 --> 00:00:49,360 officer and sometimes as both during my tenure here. 15 00:00:49,870 --> 00:00:53,560 When I think about the opportunities I've had in both of those roles, 16 00:00:53,610 --> 00:00:58,560 it just reinforces for me the versatility of a nursing career and how closely 17 00:00:58,560 --> 00:01:01,960 patient care and hospital operations are linked. 18 00:01:02,650 --> 00:01:07,280 My goal every day is to balance the clinical side of care and the operational 19 00:01:07,280 --> 00:01:11,440 side of care to create the best environment for the patient and the 20 00:01:11,440 --> 00:01:12,273 organization. 21 00:01:12,820 --> 00:01:17,200 I'm lucky to also have the opportunity to carry that outside of the walls of 22 00:01:17,320 --> 00:01:21,360 Children's Hospital by doing some international consulting work for joint 23 00:01:21,360 --> 00:01:22,193 commission. 24 00:01:22,900 --> 00:01:25,990 That sounds like, um, lots of great opportunities you have there. 25 00:01:26,040 --> 00:01:29,390 So based on your background, your time at Children's and, 26 00:01:29,390 --> 00:01:33,830 and then obviously your other experiences, um, I know that people have a lot of, 27 00:01:34,400 --> 00:01:37,750 uh, options, especially in healthcare. Why did you choose pediatrics? 28 00:01:37,750 --> 00:01:38,710 What led you down that line? 29 00:01:39,320 --> 00:01:43,100 You know, as I thought back about why pediatrics, 30 00:01:43,570 --> 00:01:46,780 I knew when I was really quite young that I wanted to be a nurse. 31 00:01:46,850 --> 00:01:51,580 I read books about nurses. I was a hospital volunteer in high school, 32 00:01:51,580 --> 00:01:54,700 and so I was destined for nursing as a career. 33 00:01:54,720 --> 00:01:57,580 The mission of wanting to help to heal, 34 00:01:57,910 --> 00:02:00,460 to connect was all really personal for me. 35 00:02:00,720 --> 00:02:03,980 But during my junior and senior year in nursing school, 36 00:02:03,980 --> 00:02:08,220 I worked in the operating room of a large adult hospital that was connected to a 37 00:02:08,340 --> 00:02:12,100 children's hospital and the surgery for kids was done in the adult facility. 38 00:02:12,190 --> 00:02:15,380 So they would trust me to go pick up a child, um, 39 00:02:15,380 --> 00:02:17,380 and bring them over for surgical care. 40 00:02:17,520 --> 00:02:20,780 And while I was at the children's hospital, I could feel the difference. 41 00:02:21,200 --> 00:02:24,860 The staff was a team, the atmosphere was lighter, 42 00:02:25,360 --> 00:02:30,140 the kids were so strong and resilient and that's when I knew pediatrics was 43 00:02:30,140 --> 00:02:30,973 for me. 44 00:02:31,330 --> 00:02:36,260 I spent the early years of my career in a children's hospital in Texas and when 45 00:02:36,260 --> 00:02:40,100 it was time for me to gain experiences at a new organization, 46 00:02:40,570 --> 00:02:44,020 I honestly looked at some adult hospitals in the area, 47 00:02:44,680 --> 00:02:47,940 but I couldn't do it not even to stay close to home. 48 00:02:48,490 --> 00:02:53,020 I moved from Texas to Nebraska for the next opportunity at a children's 49 00:02:53,260 --> 00:02:56,420 hospital. Something that most people would think wouldn't happen. 50 00:02:56,690 --> 00:03:00,640 People in Texas said to me, you are going where to do what. 51 00:03:01,460 --> 00:03:06,280 But the pull of pediatrics was that strong and um, as I said, 52 00:03:06,280 --> 00:03:08,600 I've spent my career in children's hospitals. 53 00:03:09,230 --> 00:03:10,080 That's amazing. 54 00:03:10,080 --> 00:03:13,800 And I can imagine it's still as rewarding today as it was all those years ago. 55 00:03:14,350 --> 00:03:17,920 Absolutely. Every day there's something new to learn, 56 00:03:17,920 --> 00:03:21,480 there's something to celebrate, there's a child to help. 57 00:03:21,630 --> 00:03:24,200 It's new and and exciting every day. 58 00:03:25,170 --> 00:03:26,450 Fantastic. Well, 59 00:03:26,450 --> 00:03:30,450 what are some of the hurdles or challenges of pursuing a career in pediatrics? 60 00:03:30,450 --> 00:03:32,010 How do you address and overcome those? 61 00:03:32,480 --> 00:03:33,250 You know, 62 00:03:33,250 --> 00:03:37,980 I think that it's the uniqueness of pediatrics that makes it 63 00:03:38,300 --> 00:03:40,900 special, but it's also one of the biggest hurdles. 64 00:03:41,250 --> 00:03:45,820 Nurses don't always feel prepared to care for, uh, children. 65 00:03:46,710 --> 00:03:48,500 So one of the biggest challenges, 66 00:03:48,500 --> 00:03:52,980 especially for new graduates is the lack of pediatric exposure that they get in 67 00:03:52,980 --> 00:03:55,340 nursing school. It's not just in the classroom, 68 00:03:55,340 --> 00:03:57,180 but it's also in the clinical areas. 69 00:03:57,510 --> 00:04:02,420 Schools these days are under lots of pressure to fit everything in to their 70 00:04:02,420 --> 00:04:03,540 educational plan, 71 00:04:03,800 --> 00:04:07,980 and since pediatrics is a relatively small part of the patient population, 72 00:04:08,070 --> 00:04:10,980 schools often have to cut that curriculum short. 73 00:04:11,750 --> 00:04:16,300 So what we do here at Children's is to support excellent pediatric 74 00:04:16,740 --> 00:04:21,020 training experiences by using some of our best and brightest staff as 75 00:04:21,020 --> 00:04:25,660 instructors so that we're sure the students have a great experience here when 76 00:04:25,660 --> 00:04:28,500 the instructor knows the hospital and the patients. 77 00:04:28,730 --> 00:04:31,100 That makes a world of difference for the student. 78 00:04:31,620 --> 00:04:36,060 We've also started a scholarship program for 20 junior nursing 79 00:04:36,060 --> 00:04:37,180 students every year, 80 00:04:37,400 --> 00:04:41,940 and we support them as they're going through school and into a career in 81 00:04:41,940 --> 00:04:42,580 pediatrics. 82 00:04:42,580 --> 00:04:46,820 So that gives us a pipeline of 20 new nurses who are ready to join our team 83 00:04:46,820 --> 00:04:49,900 every year, which is amazing. And finally, 84 00:04:49,900 --> 00:04:53,700 we have a year long nurse residency program for new grads to make sure that 85 00:04:53,700 --> 00:04:57,860 they've got the support they need to start their career in pediatric healthcare 86 00:04:57,860 --> 00:04:58,693 with us. 87 00:04:58,740 --> 00:05:03,660 We've also just recently implemented an adult to pediatrics program 88 00:05:03,720 --> 00:05:08,500 for those nurses who've spent their time in adult healthcare and wanna try and 89 00:05:08,500 --> 00:05:10,500 make a smooth transition to peds. 90 00:05:11,240 --> 00:05:15,010 That's amazing. And, and really just such an important aspect, as you said, 91 00:05:15,060 --> 00:05:19,650 of training the next generation of nurses and clinical workers in pediatric 92 00:05:19,650 --> 00:05:23,530 space. And great to hear that there's still a strong pipeline. Now, 93 00:05:23,560 --> 00:05:27,730 I know that over the last few years it's been a challenge in healthcare and the 94 00:05:27,730 --> 00:05:30,130 burnout stats are high for healthcare professionals. 95 00:05:30,600 --> 00:05:33,170 When you talk to tenured nurses and team members, 96 00:05:33,170 --> 00:05:35,130 what's keeping them at your organization? 97 00:05:36,090 --> 00:05:37,730 Annes down right away, 98 00:05:37,730 --> 00:05:42,010 they would say they stay because of our mission and because of the team. 99 00:05:42,560 --> 00:05:43,370 You're right, 100 00:05:43,370 --> 00:05:47,810 the last few years in healthcare have been hard and the huge 101 00:05:47,810 --> 00:05:52,530 resignations from healthcare across the country have created incredible 102 00:05:52,560 --> 00:05:53,890 stress for the team. 103 00:05:54,590 --> 00:05:59,240 But it's also opened up the opportunity for us to be innovative and focused on 104 00:05:59,240 --> 00:06:00,720 our team more now than ever. 105 00:06:01,250 --> 00:06:05,440 We have discussions regularly about the importance of supporting and 106 00:06:05,440 --> 00:06:10,440 prioritizing mental wellbeing and we've developed a variety of programs for 107 00:06:10,440 --> 00:06:13,320 that. During rounds, we ask questions like, 108 00:06:13,320 --> 00:06:17,960 what have you incorporated into your routine to cope? How do you de-stress? 109 00:06:17,960 --> 00:06:21,240 How can we support you? And when we have those insights, 110 00:06:21,240 --> 00:06:26,200 we develop systems that support the team and we've got many 111 00:06:26,230 --> 00:06:30,720 programs from formal employee assistance programs to time to just 112 00:06:30,720 --> 00:06:35,240 celebrate each other and have fun engaging team members 113 00:06:35,320 --> 00:06:38,960 we've found starts with reconnecting them to their why. 114 00:06:39,420 --> 00:06:42,760 Why did they go into healthcare when they tell us their story? 115 00:06:43,070 --> 00:06:47,240 That rere recruits our staff every day and it helps them 116 00:06:47,810 --> 00:06:52,360 to rekindle their passion about healthcare. And you know, 117 00:06:52,360 --> 00:06:55,400 healthcare providers are naturally nurturers. 118 00:06:55,400 --> 00:07:00,320 So when we can help one another and recognize our team for the good work 119 00:07:00,320 --> 00:07:03,280 that they're doing, we're reconnecting with the why. 120 00:07:04,120 --> 00:07:06,870 An example I could give you is, uh, 121 00:07:06,870 --> 00:07:11,590 this last year we put into place a program where we have paid 122 00:07:11,590 --> 00:07:16,470 days for our staff to volunteer and community agencies that are supporting 123 00:07:16,470 --> 00:07:19,070 the needs of the children that we serve. 124 00:07:19,410 --> 00:07:23,110 And not only is that helping that agency and helping those kids, 125 00:07:23,110 --> 00:07:27,950 but it's helping our team to connect with each other and reconnect with 126 00:07:27,950 --> 00:07:30,870 the mission. And you know what, it's working. 127 00:07:31,330 --> 00:07:33,670 Our nursing retention rate, um, 128 00:07:33,670 --> 00:07:38,150 today is almost 87% against a national average of 129 00:07:38,150 --> 00:07:42,620 81. So getting people into healthcare is important, 130 00:07:42,680 --> 00:07:46,700 but keeping them there is really the key. 131 00:07:47,650 --> 00:07:51,060 That's a great point and definitely makes a big difference when you've got a 132 00:07:51,060 --> 00:07:54,740 sense of community within the organization when people feel like they belong 133 00:07:54,740 --> 00:07:57,500 there and really enjoy what they do. Now, 134 00:07:57,500 --> 00:08:01,180 could you talk a little bit about what Children's Leadership is doing to support 135 00:08:01,180 --> 00:08:02,980 its team members specifically? 136 00:08:04,150 --> 00:08:08,930 I'd be happy to. I think that, um, key to our success, 137 00:08:09,060 --> 00:08:11,490 success is the culture that we're creating. 138 00:08:11,880 --> 00:08:16,010 I know that I stay at Children's because every day I have the opportunity to do 139 00:08:16,010 --> 00:08:18,170 my personal and professional best, 140 00:08:18,170 --> 00:08:22,370 and that's because we have a culture of transparency and support. 141 00:08:23,260 --> 00:08:27,490 So the first thing I would say to anyone who's going into healthcare is to find 142 00:08:27,490 --> 00:08:31,770 an organization that has the kind of culture where they're comfortable because 143 00:08:31,770 --> 00:08:34,250 that's where they'll be able to grow and thrive. 144 00:08:35,340 --> 00:08:39,890 So to support our team members, we're working hard to create that culture. 145 00:08:40,510 --> 00:08:45,490 And that's all about listening and two-way conversations. 146 00:08:46,300 --> 00:08:50,970 We use, um, mechanisms like nursing, shared governance, executive rounding, 147 00:08:51,330 --> 00:08:54,370 frequent town hall meetings to connect with the team. 148 00:08:54,710 --> 00:08:59,640 And when the healthcare teams talk about recognition and 149 00:08:59,640 --> 00:09:01,680 we ask them what that means, 150 00:09:02,150 --> 00:09:06,680 what they tell us is that thank yous and gifts are important, 151 00:09:07,540 --> 00:09:11,880 but what they really want in terms of recognition is for their ideas and their 152 00:09:11,880 --> 00:09:15,320 input to be heard and valued and acted on. 153 00:09:16,290 --> 00:09:19,960 So we're supporting our team by, um, 154 00:09:19,960 --> 00:09:23,440 implementing a philosophy that we call people first. 155 00:09:23,830 --> 00:09:27,280 What we know is that if we care for our team members first, 156 00:09:27,870 --> 00:09:31,840 that will impact all the other outcomes we're seeking in healthcare. 157 00:09:32,730 --> 00:09:36,840 So we're sending a strong message from leadership that people are valued at 158 00:09:37,000 --> 00:09:37,640 Children's. 159 00:09:37,640 --> 00:09:42,080 We're looking at how we can make decisions that give our team options for the 160 00:09:42,080 --> 00:09:46,480 long term, whether it's flexible staffing or contemporary benefits. 161 00:09:47,260 --> 00:09:50,520 And what we've come to realize is that one size doesn't fit all. 162 00:09:50,850 --> 00:09:52,640 So wherever we can offer a choice, 163 00:09:52,640 --> 00:09:56,840 we do so because we know our team members are at different stages of life. 164 00:09:57,710 --> 00:10:00,360 That, um, makes me think of a great example. 165 00:10:01,550 --> 00:10:06,360 Lots of hospitals are, are working hard around social determinants of health. 166 00:10:06,360 --> 00:10:11,280 What we know is that 80% of what impacts a patient's health 167 00:10:11,280 --> 00:10:14,240 happens outside of the walls of a hospital. 168 00:10:14,810 --> 00:10:19,600 So we're all working hard to address those social determinants of health. 169 00:10:19,620 --> 00:10:24,600 And we stopped and realized that we also needed to 170 00:10:24,600 --> 00:10:28,280 address social determinants of health for our own staff. 171 00:10:28,860 --> 00:10:33,520 How could we ask them to talk to a patient about food insecurity or 172 00:10:33,520 --> 00:10:37,960 financial stability if they were experiencing those things themselves? 173 00:10:38,380 --> 00:10:40,160 And when we surveyed our staff, 174 00:10:40,160 --> 00:10:44,360 we found pockets of staff that really needed support 175 00:10:44,790 --> 00:10:47,200 with their own social determinants of health. 176 00:10:47,200 --> 00:10:51,440 So we've put lots of programs in place to get people ready to buy a house, 177 00:10:52,090 --> 00:10:56,560 um, to address their food needs, to address their financial stability. 178 00:10:56,900 --> 00:10:59,120 And that's been an amazing success. 179 00:10:59,530 --> 00:11:03,840 We don't often stop and think about our own team at home. 180 00:11:04,080 --> 00:11:06,480 We're so busy focusing on the patients. 181 00:11:07,350 --> 00:11:09,480 That's a really great point and I love that. 182 00:11:09,480 --> 00:11:13,520 It's amazing to hear how you've been able to really care for everybody at 183 00:11:13,680 --> 00:11:17,880 Children's and be supportive of them, whatever stages or needs that they have. 184 00:11:18,300 --> 00:11:18,720 Now, 185 00:11:18,720 --> 00:11:23,200 I know leadership is always evolving and looks different in 2023 than it has in 186 00:11:23,440 --> 00:11:24,273 previous years. 187 00:11:24,380 --> 00:11:27,600 How have the last few years shaped or or changed your leadership? 188 00:11:28,380 --> 00:11:32,560 You know, I think that I'm listening more. 189 00:11:33,940 --> 00:11:38,390 What I've learned over the past few years is, 190 00:11:38,720 --> 00:11:39,070 um, 191 00:11:39,070 --> 00:11:43,910 how collaborative and people oriented leadership really should 192 00:11:43,910 --> 00:11:47,670 be. I spend a lot of time seeking to understand, 193 00:11:47,670 --> 00:11:52,590 and I've learned over and over that if I identify the outcome and I 194 00:11:52,590 --> 00:11:56,680 get out of the way that we have a smart team who will figure out what's best for 195 00:11:56,680 --> 00:12:00,120 the patient, the organization, and for themselves as team members. 196 00:12:01,210 --> 00:12:06,040 We learned during COVID that we needed to move more quickly and like many other 197 00:12:06,040 --> 00:12:06,680 organizations, 198 00:12:06,680 --> 00:12:09,600 we were really surprised at how quickly we could move when we needed to. 199 00:12:09,940 --> 00:12:14,320 And now I'm working hard to hang on to that ability to be 200 00:12:14,640 --> 00:12:15,880 agile and nimble. 201 00:12:16,300 --> 00:12:20,640 And that means hanging on to empowering our team 202 00:12:21,340 --> 00:12:26,080 and allowing them to have a voice in the direction of the organization. 203 00:12:27,230 --> 00:12:30,000 That's amazing and I can imagine really makes a difference. 204 00:12:30,060 --> 00:12:33,600 How can other leaders engage their team members? What advice do you have? 205 00:12:34,550 --> 00:12:39,480 I think I would advise other leaders to be 206 00:12:39,480 --> 00:12:44,360 authentic leadership for so long carried with it that aura 207 00:12:44,370 --> 00:12:47,640 of being all knowing and all being. 208 00:12:48,500 --> 00:12:53,200 And we need to acknowledge that healthcare is challenging for all of us right 209 00:12:53,200 --> 00:12:58,160 now, whether we're leaders or team members. And that healthcare's a team sport. 210 00:12:58,690 --> 00:13:02,840 We all have to share our vulnerabilities, our experiences, 211 00:13:02,840 --> 00:13:05,200 and our coping mechanisms with each other. 212 00:13:06,190 --> 00:13:09,880 I really learn so much when I ask how are you taking care of yourself? 213 00:13:10,820 --> 00:13:13,680 And when I share my strategies with others, 214 00:13:13,890 --> 00:13:18,520 so approaching leadership as people first engages the team and I would 215 00:13:18,700 --> 00:13:20,720 reemphasize, um, 216 00:13:20,720 --> 00:13:25,280 making sure that people feel heard because that also makes them feel valued. 217 00:13:25,980 --> 00:13:28,750 That's a really great point and amazing to hear. Now, 218 00:13:28,750 --> 00:13:32,030 what's the most rewarding part of pediatrics for you? Both, 219 00:13:32,030 --> 00:13:34,790 I guess for you as well as the team members you talk to? 220 00:13:35,800 --> 00:13:36,340 You know, 221 00:13:36,340 --> 00:13:40,820 there's so many rewards to pediatric healthcare at 222 00:13:40,820 --> 00:13:41,660 foundationally. 223 00:13:42,050 --> 00:13:45,740 I think we have the satisfaction of knowing that we're helping children and 224 00:13:45,740 --> 00:13:49,060 their families have a better future. And, um, 225 00:13:49,410 --> 00:13:53,780 caring for kids not only helps us to 226 00:13:53,930 --> 00:13:58,180 ensure the the future that those children will bring, 227 00:13:58,600 --> 00:14:02,700 but it also allows us to be ourselves to our fullest potential. 228 00:14:02,700 --> 00:14:05,300 You can be silly, you can be fun. Um, 229 00:14:05,300 --> 00:14:09,500 you can be joyful because you can be fully yourself with kids. 230 00:14:10,930 --> 00:14:14,940 I also believe that people who have a passion for caring for kids are 231 00:14:15,260 --> 00:14:19,620 like-minded individuals who are all united around a common purpose. 232 00:14:19,640 --> 00:14:24,540 And when you're working with a team that has the same focus, the same goals, 233 00:14:24,540 --> 00:14:29,540 and the same values that you do, it's um, incredibly rewarding. 234 00:14:29,540 --> 00:14:34,340 I think we all come to our jobs in a children's hospital with the 235 00:14:34,340 --> 00:14:39,220 same framework and mindset that it's an incredible 236 00:14:39,220 --> 00:14:43,780 privilege to be able to care for a sick child and to be entrusted to care for 237 00:14:43,780 --> 00:14:46,860 the life of another. It's incredibly rewarding. 238 00:14:47,510 --> 00:14:50,880 That's outstanding to hear. Now, before we wrap up our conversation, 239 00:14:50,880 --> 00:14:54,680 I just have one more question. What are you most excited about right now? 240 00:14:56,150 --> 00:14:58,560 Well, I'm excited on a couple of fronts. 241 00:14:59,720 --> 00:15:04,400 Tangibly I'm excited that we're developing a mental health and wellness center 242 00:15:04,400 --> 00:15:08,360 for children. It's a much needed resource, um, 243 00:15:08,360 --> 00:15:13,160 here in Nebraska that will help us support the whole child. 244 00:15:14,540 --> 00:15:15,560 And so that, 245 00:15:15,630 --> 00:15:20,160 that I can really see coming out of the ground and making a tangible difference 246 00:15:20,970 --> 00:15:22,240 at a cultural level. 247 00:15:22,240 --> 00:15:27,240 Though what's exciting is that we're moving from surviving 248 00:15:27,240 --> 00:15:32,240 through covid to thriving and anticipating the 249 00:15:32,240 --> 00:15:36,600 future and instead of trying to get back to the way things were, 250 00:15:37,490 --> 00:15:41,240 we are creating the next normal, um, 251 00:15:41,240 --> 00:15:43,800 looking at new and innovative ways of moving forward. 252 00:15:43,800 --> 00:15:45,920 Whether it's digital wayfinding, 253 00:15:45,920 --> 00:15:50,440 we've created some apps that are gonna actually help us 254 00:15:50,990 --> 00:15:52,880 care for chronically ill children. 255 00:15:53,680 --> 00:15:57,320 We're diving deeper into telehealth and home monitoring. 256 00:15:58,210 --> 00:16:03,160 So all those new and innovative ways of connecting with staff 257 00:16:03,160 --> 00:16:07,440 and working with a team are are bringing a new energy 258 00:16:08,100 --> 00:16:12,680 and a sense of discovery and emerging from, 259 00:16:13,610 --> 00:16:16,160 um, the struggles of the last few years. 260 00:16:16,420 --> 00:16:19,320 And I think that's the most exciting part. 261 00:16:20,470 --> 00:16:22,360 That's awesome to hear. Kathy, 262 00:16:22,360 --> 00:16:24,440 thank you so much for joining us on the podcast today. 263 00:16:24,440 --> 00:16:27,400 This has been a really fun discussion and I look forward to connecting with you 264 00:16:27,400 --> 00:16:28,233 again soon. 265 00:16:28,640 --> 00:16:32,280 Thank you. I appreciate the conversation.