In December 2021, amid a nationwide nursing scarcity, provide chain challenges and an ongoing pandemic, Dr. Sammie Mosier assumed her new position as Chief Nurse Govt at HCA Healthcare, one of many nation’s main suppliers of healthcare. In the present day, she shares key learnings from 12 months one main greater than 93,000 nurses to ship protected, high quality care, in addition to suggestions to assist different leaders form the way forward for nursing observe.
Once I started my profession 26 years in the past as a medical-surgical nurse at HCA Healthcare’s Frankfort Regional Medical Middle in Kentucky, I by no means imagined I used to be on the highway to main one of many nation’s largest nursing workforces. And like different healthcare leaders at present, I definitely couldn’t have predicted I’d play a component in serving to the healthcare trade navigate a world pandemic.
Whereas we can’t all the time anticipate what lies forward, we are able to do our greatest to answer identified challenges and put together for future alternatives. Somewhat multiple 12 months in the past, I took the helm as Chief Nurse Govt at HCA Healthcare to proceed doing simply that, main greater than 93,000 nurses via an ongoing pandemic, a nationwide nursing scarcity and quite a few trade headwinds. Whereas my tenure with HCA Healthcare and expertise in healthcare usually has knowledgeable my imaginative and prescient for the way forward for nursing, my seat at this explicit management desk and associated learnings over the previous 12 months have solidified it.
Realizing that nurses are the cornerstone to any healthcare group’s means to supply protected, high-quality, compassionate care, I supply 5 suggestions to assist different leaders guarantee they proceed doing so by elevating nursing observe within the years to come back.
1. Advocate for and develop nurses at each stage
All through my profession, I’ve persistently centered on advocating for nurses, to help their skilled improvement and drive scientific excellence. This has turn out to be extra necessary than ever over the previous few years, because the aforementioned challenges have contributed to a “Care Complexity Hole” as a result of:
- Workforce scarcity: rising demand and growing turnover
- Workforce expertise: growing reliance on new nurses to fill vacancies
- Care complexity: rising affected person acuity and complicated remedy plans
As we work to supply nice care to sicker sufferers within the face of present circumstances, we should develop extraordinary nursing leaders and supply alternatives for profession development, which can assist enhance nurse engagement and retention. I imagine we are able to accomplish this by guaranteeing nurses have a seat on the management desk, bringing nursing expertise into the sphere of affect.
We’d like packages and clear pathways to help aspiring nurse leaders. And whereas traditionally throughout the healthcare trade, we now have seen a scarcity of nurses in govt roles, at HCA Healthcare we’re proud to have many nurses in CEO, CNO and different management positions. I credit score this to the visibility into skilled improvement packages that assist nurses advance their careers at each stage, reminiscent of:
- Cost Nurse Management Certificates: a coaching curriculum that helps contributors develop abilities, language and expertise essential for achievement.
- Director Improvement Program: a 7- to 10-month cohort program to organize aspiring nurse leaders to imagine director positions.
- Chief Nursing Officer (CNO) Govt Improvement Program: a year-long program that gives aspiring CNOs with govt publicity, best-in-class curriculum, utilized expertise tasks and peer networking to assist put together for govt roles.
- Assistant Chief Nursing Officer (ACNO) Superior Management Program: a nominations-based program equipping ACNOs with management and operational abilities to maneuver into CNO roles.
- Management Institute Academy (for Administrators): equips leaders to execute technique, drive operational excellence and lead others to efficient motion.
- Management Necessities (for Supervisors and Managers): a 9-month cohort-based, interactive improvement program for managers and supervisors
2. Leverage full care groups in affected person care supply
With international nursing shortages anticipated to extend within the subsequent a number of years, as an trade we should embrace new fashions of care that leverage different workforce members to scale back the staffing disaster burden. This enables nurses to work on the high of their licenses, which might enhance nurse and affected person expertise in addition to outcomes.
At HCA Healthcare, we’re creating revolutionary and efficient care supply fashions to help care groups and meet affected person wants via our efforts to:
- Diversify and broaden care groups to incorporate Licensed Sensible/Vocational Nurses (LPN/LVNs), permitting RNs and LPN/LVNs to work at high of their licenses
- Create different new or expanded roles to assist help the nursing workload, together with Affected person Care Technicians (PCTs), Nurse Externs and Paramedics
Diversifying care fashions will proceed to be an necessary a part of labor and resiliency plans which might be aware of market dynamics at present and for the foreseeable future, as we work to ship care via the pandemic and past.
3. Foster scientific schooling and tutorial partnerships
A major method we’re addressing the nationwide nursing scarcity is by making a pipeline of recent nurses via work with our Galen School of Nursing, in addition to different tutorial organizations.
In 2020, HCA Healthcare grew to become a majority proprietor of Galen School of Nursing, one of many largest tutorial observe partnerships in U.S. healthcare, which permits us to supply nurses elevated schooling and improvement alternatives. Since then, we now have opened 12 new campuses throughout the nation.
Importantly, our HCA Healthcare-Galen School of Nursing Grant supplies a tuition-free, on-line RN to BSN diploma for nurses with direct billing, so nurses pay no tuition upfront. This system permits nurses to study on their schedules, with mobile-friendly coursework constructed with nationally acknowledged subject material consultants and aligned with our high quality measures.
Galen additionally affords an internet MSN choice in Healthcare Management developed in collaboration with our nurse leaders, to develop new leaders who will form the way forward for nursing observe in advanced techniques via innovation, superior crucial considering and care transformation.
Different initiatives to assist construct the nurse expertise pipeline and develop nurse colleagues embrace:
- Certification Reimbursement: encourages colleagues to develop by buying and or recertifying nationally acknowledged certifications
- Nurse Residency and StaRN Program:
- Nurse Residency helps graduates as they transition to observe
- 12 months-long program begins with StaRN (Specialty Coaching Apprenticeship for Registered Nurses), a 10-12 week onboarding program
- Consists of 500+ hours of scientific schooling within the classroom and on the bedside, with abilities and simulation coaching, scientific preceptorship and specialty improvement
- Facilities for Medical Development
- Bridge a niche between classroom and bedside with practice-based instruction
- Caregivers study affected person security and high quality of care in a protected, reasonable atmosphere
- Simulation situations / academic curriculum standardized throughout all services
Whereas not all healthcare suppliers can supply diploma packages via their very own nursing colleges, they’ll encourage ongoing schooling and profession improvement via accomplice organizations. As an trade, we must always prioritize this work collectively. Our means to collectively present care to our nation depends upon it.
4. Embrace expertise to raise nursing observe
Possession of evidence-based observe is a baseline for constructing a tradition of excellence in nursing and healthcare usually. At HCA Healthcare, we’re laser-focused on help and accountability for guaranteeing that finest practices are developed, applied and scaled throughout our group. That mentioned, in such a big group — and even in small techniques — you can find variations in how care is delivered. Expertise can assist us bridge that hole.
By means of initiatives like our division of Care Transformation and Innovation, a devoted workforce working with leaders and frontline clinicians to enhance workflow and care, we’re utilizing expertise to assist cut back nurse administrative burden and staffing challenges…and create the hospital of the longer term.
We study from colleagues what’s working, what just isn’t…and the place we now have alternatives. Whereas the healthcare trade has an extended strategy to go by way of innovation, we’re striving to know and deal with constructing blocks that may result in massive image healthcare transformation to enhance effectivity, high quality and expertise for healthcare suppliers and sufferers.
Two new CT&I options which might be serving to nurses enhance effectivity and spend extra time centered on scientific care embrace:
- Workers Scheduler
- Automated scheduling resolution to handle affected person demand
- Handle workers preferences and day by day quantity variation
- Optimize care workforce to replicate precise quantity, matching nurse talent set and competencies with affected person wants and threat profiles
- Use quantity forecast algorithm, mixed with enterprise guidelines and nurse chief data, to enhance the forecast of productive hours based mostly on nationwide requirements
- Considerably cut back the time for workers scheduling whereas enhancing satisfaction and outcomes and leading to a extra balanced, equitable nursing schedule
- Medical Documentation
- Automation-driven options to optimize the documentation course of
- Guarantee documentation is well timed, correct, constant, extra environment friendly
- Leverage expertise to allow caregivers to spend extra time with sufferers whereas enhancing nurse satisfaction
Along with CT&I’s quickly rising ebook of labor, we spend money on many different applied sciences to ship the most effective outcomes for our sufferers and enhance efficiencies for our nurses, together with:
- Deploying practically 100,000 safe smartphones to present nurses a cell expertise
- Utilizing voice and textual content amongst care groups to enhance effectivity and communication
- Receives necessary notifications and simply takes images for documentation
- Digital Nurse
- Makes use of an RN remoting into the affected person room via a video digital camera to work together with the affected person
- Encompasses actions that don’t want hands-on from the nurse, reminiscent of admission historical past, affected person instructing, reassessing for ache or discharge planning
- Seasoned nurses as digital RNs to assist mentor new grads
- Coding for Caregivers
- A quick-track expertise improvement occasion leveraging cross-functional groups (importantly, nursing and Info Expertise groups)
- Aim of the occasion is to design expertise to present nurses extra time on the bedside, much less redundant work and extra alternatives to use experience
We all the time wish to the longer term to design options for alternatives at present, embodying HCA Healthcare’s mission dedication to the care and enchancment of human life.
5. Prioritize collaboration and “Voice of the Nurse”
In the present day greater than ever, management in healthcare requires educating hospital operators on the realities and desires of nurses. Advocacy abilities and establishing key partnerships are necessary talents for all leaders — and particularly within the nursing atmosphere. We should prioritize collaboration and take heed to the “Voice of the Nurse” so as to rework nursing observe.
At HCA Healthcare, we take heed to nurses via councils and lots of different initiatives, leveraging partnerships to drive efficiencies and nurse engagement (e.g. via Useful resource Councils that affect focus areas to help nursing workload). We all know that nurses are extra engaged once they really feel heard and supported, which might translate to raised experiences for suppliers and sufferers.
We take heed to our nurses and collaborate with companions on their behalf via:
- Skilled Follow Councils, the place nurses make selections about how we offer care
- Advisory Councils that govern how finest practices are shared throughout the enterprise
- Useful resource Councils at divisions/services convey collectively key stakeholders to resolve operational challenges, drive engagement and elevate sources wanted
- Stroll in Your World initiative, the place company and division executives shadow nurses
- Important Voices, a steady listening strategy via which colleagues actively search to resolve issues and generate concepts
- Unit of Distinction Awards, which acknowledge models of excellence and finest practices
Each tier of HCA Healthcare’s organizational construction contains nursing leaders, and worker rounding supplies nurses with a stronger voice in nursing observe and the way we function. By coming collectively, our shared voices accomplish extra.
Associated, fairness have to be foundational in all that we do in healthcare. I proudly work carefully with our Variety, Fairness and Inclusion groups and councils to make sure people representing a various vary of backgrounds and views are included in well being fairness conversations, throughout our nursing group and past. Collectively, we work to determine continuity between group public well being and healthcare supply, working with public well being and community-based organizations to handle well being inequities.
A various, inclusive workforce offers us the most effective probability to supply the most effective care at HCA Healthcare – and in healthcare usually – so we work towards creating a various pipeline of nurses. We advocate for all nurses and promote fairness in any respect ranges of our group. As a result of we all know success in healthcare requires a resilient, caring workforce of genuine and numerous leaders who connect with the mission of affected person care…and encourage others to be a part of the journey.
HCA Healthcare Senior Vice President and Chief Nurse Govt