The Incubator

🟠 CHNC 2023 COVERAGE - Transforming Healthcare Collaboration: A Deep Dive with Rebecca Rose and Joan Smith

October 13, 2023 Ben Courchia & Daphna Yasova Barbeau
The Incubator
🟠 CHNC 2023 COVERAGE - Transforming Healthcare Collaboration: A Deep Dive with Rebecca Rose and Joan Smith
Show Notes Transcript Chapter Markers

What if we told you there's a revolutionary approach in healthcare that's improving patient outcomes in Children's Hospitals? This  episode of our podcast features an enlightening conversation with healthcare champions,  Dr. Rebecca Rose and Joan Smith. They're spearheading a groundbreaking project that enhances collaboration between nursing and physicians. Listen in as they unveil the importance of trust and respect within this dynamic tandem, the value of shared vision and the critical role this partnership plays in tackling rare diseases and implementing best practice.


As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

Enjoy!

Speaker 1:

Hello everybody, welcome back to the podcast. We are joined by Rebecca Rose Becky. Good morning and. Joan Smith. Joan, good morning. Thank you for making the time to come on the show today and maybe for the listeners, can you introduce yourselves and tell us where you're from, where you're coming from today and what work do you do with the CHNC?

Speaker 3:

My name is Becky Rose. I am a neonatologist. I work at Riley Children's Health in Indianapolis, indiana. With Indiana University. I have a couple roles in CHNC I'm the site sponsor for our site and then I'm also part of several focus groups. But I'm going to let Joan talk about what we're doing together through the CHNC.

Speaker 1:

Of course.

Speaker 2:

Great. My name is Joan Smith and thank you for having us. I am a. By training. I'm a neonatal nurse practitioner and has spent the majority of my career at St Louis Children's Hospital. I've been part of CHNC since pretty close to its inception, so about 2007.

Speaker 1:

Very close then, yeah.

Speaker 2:

And so it's been a great and wonderful experience for me and my own learning, and I have been involved specifically on the quality improvement steering committee. I am also a member of the children's executive sponsor I mean executive steering committee and I am now also part of what Becky and I are working on for the dyad and also I'm helping with the education component.

Speaker 1:

Very cool.

Speaker 2:

That's first agency so.

Speaker 4:

So tell us about this joint project for the dyad, like you said.

Speaker 2:

Yeah. So I think it's critical, I mean, as healthcare continues to get more and more complex and you've heard probably this whole week of how complex our patients are and it takes a village, it takes a team and so strategically really bringing together the physician and nurse dyad so this is again a wonderful and welcoming group and majority of primary physicians, which is fantastic, and we're just making sure that we're having the partnerships from the dyad and the other, the nursing partnerships with that. But I would say specifically, we're going to start first with focusing on our NICU nursing leaders, so the directors, so that they can really understand the vision and purpose and the value of being part of this critical group and then they can help support that for having their own nurses come to the table as well.

Speaker 3:

And I think the importance of the nurse physician dyad is that we know there's several examples in healthcare where conditions are improved or patient safety is improved by the biggest degree when you have both the nursing leadership and the physician leadership working together, because you're kind of hitting things from all the angles. That are necessary because we all bring our own perspectives and our own little piece of the pie that we're good at, and then trying to leverage the ability of us to show our differences and work with our strengths in these projects together really helps us to move the bar more quickly and farther.

Speaker 4:

What are some of the drivers that you're tackling? What do we need to work on?

Speaker 3:

Well, I think the whole vision of CHNC is for us to really get Better leverage for these rare diseases and how we can understand what the best care truly is and developing best practices. But once we know what those best practices are, we need to figure out how to implement them in our own NICUs, and having the physician dyad work together to help with implementation is really critical to having the ability to truly implement these best practices and improve care for these patients.

Speaker 2:

And I would say that the biggest driver I mean really our ultimate goal is to make sure that we have the best outcomes for our patients and we have the best engagement of all of our teams Because, as we know, in the last three and a half years it's been very difficult and really we have to rely on each other. I mean, I'm not going to go into a whole burnout story, but burnout is real among healthcare workers and us. Being able to have a component we feel psychologically safe, we have mutual trust and respect for one another.

Speaker 1:

it's critical for when we come to the table to deliver the best care for our patients, and that we endorse one another's skills as well, to recognize the value that each one of us brings to the table. I think it's critical to feel valued and to feel like you're an active member of the team.

Speaker 2:

And you want to show up together right, exactly. And you have, I would say, a higher purpose and your work is meaningful, and so that's what we want to bring people back together, and again, this is one of our most vulnerable populations, so there's no better place to do that.

Speaker 1:

And it's interesting to me that your project seems like something that should be happening naturally. Right, and it seems like the most natural thing. Of course, the nursing workforce and the physician workforce should be working closely together, and yet that's not the case. Can you tell us a little bit what?

Speaker 4:

are? You're like parallel circuits sometimes.

Speaker 1:

Yeah, yeah, but it's nature would want this to be the norm, and yet we have to actively work on this, and I think that's one of the challenges that you guys have identified, that is, preventing this diet from naturally happening.

Speaker 2:

I'll let you go, and then I'll go.

Speaker 3:

I think again, it's communication and the understanding of the value that each group brings. I think healthcare in a lot of ways works in silos and that's sort of been developed over time and I think that this type of dyad relationship is helping to break down those silos and make that happen.

Speaker 2:

And I would say that I mean, I've been here a really long time, so I've been in part of my career for 37 years, and there are some pockets that do this really well, and so I don't want to act like nobody is doing this, because some people do do it well. I will say the last three and a half years I'll go back to that have been a very challenging, and so people you know we've had not only burnout that I've talked about, but just all the patients, but we have people leaving the workforce, and so not only we have physicians and nurses and our support teams are leaving the workforce, and so really now is more critical than ever for us to come together as a team. And technology healthcare there's so much data and research coming out daily that not one discipline can keep up with that, and so we need to be interdependent and we need to have reliance on one another.

Speaker 1:

You're stealing our talk.

Speaker 2:

Our talk.

Speaker 1:

Our upcoming talk is basically exactly what you guys are talking about.

Speaker 4:

Well, you know I am, especially when we think about all the data that was presented this week, a lot of which focused on implementation science. So how do we take a great idea and we roll it out on our units? Because if we don't roll it out on our units then it doesn't matter if the great idea exists. And you know in my experience, you know it's not uncommon that the physician says this is what I think we need to do for our patients, but without the buy-in for the rest of the team, it is literally impossible to get anything done. Any tips and tricks, if we haven't seen the educational modules on how to optimize that in our units.

Speaker 2:

So I'll just say for me, for what I grew up in, it's about relationships, and so it's about developing these relationships. You have the mutual trust, you have the respect, and then you have each other's back at the end of the day. If you have that, then you're all gonna be collectively, have a shared accountability and shared vision of where you're going, and so, and gone are the days where it's oh, we're gonna do this because this is interesting. We need to align it with the organization priorities and the strategies, as well as within the unit itself, and not just be doing our own thing, because then, once you do that, then it'll have the resources and support that it needs. But that's how you bring people together to do that.

Speaker 3:

Yeah, I think also. I think the things that I think about when I have something newly that I want hey, we really need to do this is one to set up your burning platform. You know why? Why is this important and how do we make it important to everybody? And then number two is getting all the stakeholders involved early, which would be these diads where we've got people from the physician group and the nursing group working together, because what's the worst thing to happen is for me to come and say, as a physician, here's what we need to do, and I'm gonna plan it all out and I'm gonna actually start implementing it, and what I haven't gotten is the nursing input, and I've actually either added two barriers for them or chosen to do something that makes their work harder, and then it's just, it's gonna fail. So we just need to have all the stakeholders involved in that initial planning so we can plan what's gonna work best for everybody.

Speaker 2:

And I would say also with the Institute for Healthcare improvement, has a great white paper out specifically looking on the psychology of change, and it brings all of that together and so having the key stakeholders, anyone that's impacted by the change, and having them come together and help co-design, and so it's not just a this is what we're doing. Chnc is gonna work on this and this is what we're gonna do. Now. It's really those impacted and it couldn't be also EVS or any other supportive role that is impacted, and we need anybody impacted by that change, including our parents and families, to have a voice.

Speaker 1:

How are the institutions responding to this project? I feel like, again, it follows common sense, but we, like you said, you need alignment, you need buy-in. So, beyond the nursing, beyond the workforce, how has the administration responded to these initiatives and maybe helped you achieve your goals?

Speaker 2:

Yeah, so I will just say as far as it again, I think each organization does it differently within the organization and some of them doing extremely well and some of them really is just getting off the ground. For CHNC specifically, we are being very intentional and so I think that what we've heard support. We spent the last year of just kind of building this up, so really putting the infrastructure together, and now we want the people that are the leaders and that they need to work together to co-design what this is gonna look like. And so I would say that we've had some nursing directors specifically this week who have never been here before, and they've been energized and they're very excited to be brought to the table and really kind of just think about what this plan looks like for the future. That's great.

Speaker 1:

Yeah, becky Joan, thank you so much for coming on and sharing your project with us.

Speaker 2:

Great. Thank you for having us. Thank you.

Improving Collaboration in Healthcare
Building CHNC and Future Planning