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Becker’s Healthcare Podcast
Expanding Access, Excellence, and Sustainability at Legacy Health
00:18:58
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- [00:02]
Podcast Announcer
This is where healthcare leadership comes together. Becker's 16th annual meeting brings more than 3,500 hospital and health system executives and nearly 800 speakers to Chicago, April 13th through the 16th. This year's event includes keynote conversations with Dallas Cowboys legend Troy Aikman and former President George W. Bush. For the agenda and event details, visit Beckershospitalreview.com and click on the Events tab in the upper right. We're looking forward to hosting you in Chicago.
- [00:32]
Mackenzie Bean
Hello everyone and welcome to the Becker's Healthcare Podcast. I'm Mackenzie Bean, Associate Vice President and Managing Editor of Becker's Hospital Review and today I'm so thrilled to be joined by Dr. Joy White, who is the Vice President and Chief Nursing and Operations Officer of Legacy Health. Dr. White, thank you so much for joining us on the podcast today. How are you doing?
- [00:54]
Dr. Joy White
Oh, fantastic. Thanks so much for having me. Really looking forward to just some time to talk with Beckers. I'm always super excited when I have the opportunity to be on this platform.
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Mackenzie Bean
Well, we're excited to have you too and I thought we could dive in by having you share just a little bit more about yourself, your career and Legacy Health. I know you've been on the podcast before, but I think it'll be a good refresher for our listeners. Yeah.
- [01:18]
Dr. Joy White
So Joy White, I always start by saying my pronouns are she, her. I'm the wife of an army veteran, the mom of three adult children and the grandma of one amazing little granddaughter, five months old. So I am also the caregiver for my father who was recently diagnosed with dementia and so learning healthcare in a whole new way. Right on the other side, I am a nurse practitioner by trade. I've been a nurse for over 22 years. So women's health and psychiatric mental health nurse practitioner and currently serving as a Vice President and Chief Nursing Officer at Legacy Good Samaritan Hospital. I will tell you I have and continue to enjoy being a nurse. In my nursing career. I've been afforded the opportunity to just do extraordinary things, work for 15 years in the Federal Service, working for the Department of Veterans affairs, have worked in private sector Catholic health care and so really well rounded in terms of the types of health care and environments. Also did some time and long term care. I've worked in everything from quality to education to and of course in the nursing realm. So really, really had the opportunity to zoom out and zoom in in terms of healthcare from the clinical side to the administration and operations side and feel very, very fortunate in my current role. Legacy Health is an eight hospital system spanning two states, Oregon and Washington, about 14,000 employees, and the largest deliverer of care to those with Medicaid and Medicare. And our mission really is to be good health and good health to, to not only our people, but our patients, our community and our world. And certainly we live that mission.
- [03:23]
Mackenzie Bean
Absolutely appreciate that introduction. And it's clear, you know, you've seen so many different sides of healthcare. So I'm excited to dive deeper into those perspectives today. Looking back on the past year at Legacy, what would you say has been the most important initiative that you have led? And can you tell us about some of the results you've seen so far?
- [03:46]
Dr. Joy White
Yeah, I would say healthcare in particular in the space of quality is what folks are looking for. I also think access to healthcare. So there's so many things that are flooding my mind now when you ask that question, but if I were to pull the thread on one, I guess I pulled the thread in this, this space of being more accessible to our community, how do we make sure that we are available, that we've got the products and services that our community really needs and we've got access. And so really excited that our emergency department left without being seen. The focus in that area. Rates have dropped significantly. Our closed or on divert for our emergency department, I mean, we're on divert maybe 2%. And so just being accessible to our community, working with our ED partners, our ED leaders, also close to admission for our family birth centers, you know, having so many operational opportunities to improve, as well as looking at our staffing and finding experienced nurses right. For our family birth centers to make sure that we can stay open in our family birth center. So a lot of work around being accessible to the community, making sure that we're efficient and we're open to serve them has been a lot of the work we've been focused on this year and particularly here at Good Samaritan. And I'm just excited that we've seen that type of, that type of impact that we've been able to have by simply recruiting the best and retaining the best and ensuring that we're operationally efficient so that we can continue to be here for good and be open to our community.
- [05:43]
Mackenzie Bean
Access really has dominated so many of the conversations with leaders last year and this year. We know it's so, so important, especially seeing some of the headwinds, even at the federal level, but I'm hoping you can talk to us a little bit more about some of those, some of the work you've done in the ED space I think. Right. We've seen increasingly constrained ED capacity and health systems nationwide. What's really moved the needle there?
- [06:10]
Dr. Joy White
Yeah. So I think one of the things is, I think it's foundational is making sure we've got the right people, and we've got people. Right. Recognizing that there are shortages in our physician team members, our nursing team members, even emergency department technicians, and recognizing that a lot of folks who are coming, that we're servicing in our emergency departments are not just there for medical needs, but also mental health needs. Right. Behavioral health needs. And so we're seeing a lot of crowding in emergency departments across the country with patients who don't have a medical need, but more of a behavioral need. And I think Good Sam. And Legacy Health is really, really fortunate in that way. We do have Unity, which is one of our behavioral health hospitals. Also, within our emergency department here at Good Samaritan, we have four behavioral health beds. And so being able to serve that population and also continue to see those patients who are coming through our doors who require mental health support. And I think that has been super helpful. So I would say one foundationally making sure that we have the team members that we need, our physicians, our nurses, our emergency department technicians, that we are. Well, we're running efficiently with our imaging department. Right. And some of those other collaborative or clinical support services, and that we really have good throughput. Right. And I think that throughput has also been something we've worked on to help relieve that emergency department congestion, if you will. And that's making sure that we have beds available in our inpatient unit that we're discharging as appropriate, that we're turning over rooms as appropriate, and folks are, you know, having that ability to move very quickly from the emergency department once an admission order has been written to the inpatient area. It's that type of efficiency. So it's the people and then it's the process. Right. And then last, of course, is the technology. So how do we use our EPIC tools, our medical record? How do we use the tools that we have available to us to also ensure that we're getting patients moving timely? So we've had a full on full court press on inpatient throughput, and that has served us exceptionally well, focusing on people, process, and then how technology can support us with that throughput?
- [08:34]
Mackenzie Bean
All of those pieces of the puzzle come together and have such, such huge benefits, of course. So I'm talking to you in late January. Now, it's hard to believe we're already almost through January, but I'M curious for your priorities and headwinds, looking into the next 12 months, what's top of mind for you?
- [08:53]
Dr. Joy White
Oh, this is an easy one. This is super easy. Access continues to be number one. Heard that story before. So continuing to be accessible. Also excellence, really focused on our quality, our quality indicators, our fall rates with injury, cautis clabsis, happies, all of the things that when we think about clinical excellence, this is what we think about. Also within that excellence bucket is what is the experience of our employees working for legacy Good Samaritan Medical Center. So how is that employee experience? Are we able to attract, recruit the best and the brightest and not just recruit them, but retain them? So we're really focused in that excellence bucket, not just on clinical quality but, but also experience for our employees and experience for our patients. So all that falls within excellence. And then last would be sustainability. Are we efficient in our processes? Are we also thinking about and thinking through making sure we have a frictionless system, a sustainable system with the products that we use, efficiency in our operating rooms, that type of thing? So how do we ensure that we're here for good? How do we ensure that we're sustainable? So those are the things we're focused on, access, excellence and sustainability. Those are key drivers, if you will.
- [10:23]
Mackenzie Bean
And so much of that directly supports high quality care given to patients as well.
- [10:28]
Dr. Joy White
You got it, you got it, you got it.
- [10:30]
Mackenzie Bean
I'm curious to hear what's the hardest thing you think you'll have to do in the coming year.
- [10:36]
Dr. Joy White
Yeah, that's not a hard one either. And it's all really focused around the headwinds with increasing, you know, increasing cost, increasing demand for services and decreasing reimbursement. So that story of having to do even more with less, recognizing we are getting reimbursed lower than we ever have. Also thinking about some of the legislation, particularly HR1 and its impact on healthcare as a whole. And organizations across the country, Oregon and Washington are expected to be impacted 6th and 8th respectively by HR1, which is something that we've got a brace for. We're gonna have to be really, really efficient. I think we're gonna have to be really creative and we're gonna have to really lean into supports that we can gain from our local partners, partnerships and legislative entities. So I think that's gonna be the biggest thing. How do we continue to deliver the type of service and meet the demand in this area? Recognizing those, those headwinds, a significant challenge.
- [12:07]
Mackenzie Bean
I know you mentioned legacy health, caring for a large population of Medicaid and Medicare patients. What does this preparation or creativity look like from the nursing perspective specifically? Have you started to kind of frame that out or still sort of in brainstorming mode?
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Dr. Joy White
Yeah, that's such a great question. And I think the answer is yes. And it's in development.
- [12:31]
Mackenzie Bean
Right.
- [12:32]
Dr. Joy White
So, yes, we need to make sure that again, we're taking care of our people, the people who work for Legacy Health, that we're addressing well being among our team members. You know, there's a book, and I think it's somewhere on the shelf behind me and it says it's called Patients Come Second. And what a profound thought. When you think about healthcare being a service industry and we're here to support patients, that answer or that notion is absolutely true. But it can't happen unless we take care of the people that are doing this work. And so I think part of preparing for the headwinds is making sure we have people that we have again. And I've said it, if I have said it probably seven times already in this interview, is how do we recruit the best and brightest and then how do we retain them? So part of that preparation is making sure we've got the people and that we are addressing their well being. We've done something here called stress first aid, and we have made that training available to every single member of Legacy Health is stress first aid. So addressing the well being of our people to make sure that they're able to take care of the patients that are walking through our doors. I think I've talked about some of the other preparation is making sure that we've got exceptional throughput, that we are able to see those patients that arrive and that we've got good processes and systems to be able to care for them and then to transition into their next, next location to receive care, whether that's home, whether that is rehab, wherever that is. So I think throughput being very, very efficient in our inpatient capacity and inpatient throughput. I think it's also something that is ongoing, that's partnering with our outpatient. We think very insular a lot of times about health care and this focus on the inpatient arena. We've got to also think about that partnership with our outpatient and our primary care and our specialty clinics. Because when we do that work, well, when we have access in our outpatient, when we have access in our specialty care, we may see less of those folks having an emergency and having to come to the inpatient side. And so also focusing on our outpatient access, our specialty Care access, our primary care access is also super important. And then what do partnerships look like? I think we've got to think about our community partners and where care is being provided in other places and how we might partner with, especially given the headwinds that will impact all of us financially. We can't all be centers of excellence. We need to think about what makes sense to do where. And so I think that collaboration is going to be super important. Thinking about a system like Legacy Health, how do we take advantage of the economies of scale?
- [15:27]
Mackenzie Bean
Right.
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Dr. Joy White
We're eight hospitals, and so how do we take advantage of the economies of scale of being a large, large health system? So I think it's all those things. Looking at our quality, I think everything that I've mentioned is part of that preparation. We want to be the organization where people choose to receive care. Patients have choices. And so we want to be known for the place that not only has exceptional quality, but our experience is just phenomenal. So people will choose Legacy Health because of those things, because of quality, because of experience. I think that's how you get there. And again, of course, goes without saying to be efficient and how we do that work so on time starts and turnaround times and making sure that we can serve the most in the most efficient.
- [16:21]
Mackenzie Bean
Absolutely. Dr. White, I so appreciate you taking the time to share with our listeners a bit more about your work at Legacy Health, how you're thinking about the future. I think it's like you said, that collaboration and idea sharing, problem solving is more important than ever right now. Is there anything you'd like to leave our listeners with?
- [16:40]
Dr. Joy White
Oh, thanks for that. I wasn't prepared for that. I think one of the things I am really big on and I think it just kind of speaks to who I am. Being a nurse practitioner and mental health is kind of my jam. And one of the things I say in healthcare is we think about, we think about everyone else often. It's always solving the next problem. It's the next challenge that we face. And very often as healthcare administrators, providers, caregivers, we don't turn that same lens on ourselves. We don't apply the same medicine, we don't take the same medicine as we offer to others. And I would say we need you in health care as administrators, as executives, as CEOs, CNO's, COO, CFOs, layperson. We need you in health care. This is an industry of caring. And taking care of ourselves in these roles is equally important. So if it is once a week or once a day, Take a mindful moment. Remember that as. As taxing as healthcare can be, it is also extremely rewarding. And so if you can take the opportunity once a day, once a week, if you have a gratitude jar, if you have a moment just to reflect on one win, something that went really well today, whether that was an exchange with a patient or family, whether that was working together with a colleague to address something hard, whether it was, you know, a new employee who's got a twinkle in their eye about walking into your organization as a new employee and making a difference, take an opportunity to reflect on. On one win, because we're always solving problems and putting out fires, but take the opportunity to have a grateful moment and recognize something that you've done that probably just once a day.
- [18:43]
Mackenzie Bean
I love that. I think that's such a great message to end on. Dr. White, thank you so much again for your time and all of your thoughtful remarks. And we're so excited to see you and you speak at our annual meeting.
- [18:53]
Dr. Joy White
Awesome. Looking forward to being there. Mackenzie, thanks so much.