Podcast Summary

Episode Overview

Podcast: Becker’s Healthcare Podcast
Episode Title: Strengthening Nursing Fundamentals to Improve Patient Experience
Guest: Dr. Sadie Durham, DNP, RN, Chief Nursing Officer, Ascension St. Vincent's Clay County, Middleburg, FL
Host: Mackenzie Bean, Associate Vice President & Managing Editor, Becker's Hospital Review
Date: February 17, 2026
Episode Theme:
This episode discusses how refocusing on foundational nursing practices—specifically, bedside shift reporting and hourly rounding—led to dramatic improvements in patient experience metrics at Ascension St. Vincent's Clay County. Dr. Sadie Durham shares how her team identified the need to return to nursing fundamentals, the steps they took to standardize these practices, and the sustained impact on patient satisfaction and staff engagement.

Key Discussion Points & Insights

1. Recognizing the Problem and the Decision to Refocus (00:36 - 02:34)

• Context: In 2024, the hospital experienced a notable decline in patient experience scores, spurring leadership to investigate root causes.
• Initial Approach: The team analyzed patient comments about long wait times, communication gaps, and inconsistent care.
• Diagnosis: They recognized lapses in basic nursing practices—bedside shift reporting and hourly rounding—rather than the absence of new technological tools.
• Quote (Sadie Durham, 01:09):

  "We saw a significant decline in our patient experience scores ... What we determined was, in just our general assessment, is there were some key fundamental nursing things that we just weren’t doing or we weren’t doing consistently. And those things were bedside shift reporting and hourly rounding."

2. Leadership Philosophy and Patient-Centered Care (02:34 - 03:25)

• Philosophy: Dr. Durham sees her core responsibility as ensuring safe, high-quality care with the patient at the center of every decision.
• Intentionality over Innovation: Rather than chasing new initiatives, she championed getting “back to the basics.”
• Quote (Sadie Durham, 02:34):

  "Ultimately, it’s always to ensure that we’re giving our patients the best care possible ... It’s really important for us to engage our patients, to listen to their voice, and really to ensure that they have a great experience."

3. Implementing Change: Overcoming Barriers and Educating Staff (03:42 - 05:39)

• Understanding Barriers: Leadership engaged bedside nurses directly to understand why fundamentals weren't being followed, using their feedback to shape the approach.
• Building a Team: Charge nurses were recruited as “champions” to advocate for and model these practices among their peers.
• Education and Validation: A comprehensive training program was rolled out to all staff, focusing on both the “how” and the “why.” Leaders then validated adoption with real-time observation and feedback.
• Onboarding All Staff: Emphasis on universal participation—veterans and newcomers alike.
• Quote (Sadie Durham, 03:42):

  "We needed people. We needed cheerleaders for the cause, essentially. So we pulled in our charge nurses ... and we did training with them, talked to them about what their perceived barriers were."

4. Early Results and Cultural Change (05:39 - 06:49)

• Unexpected Wins:
  • Noteworthy changes in staff behavior: nurses were present in patient rooms during shift changes, even on weekends.
  • Sustained adherence to the new procedures, indicating true culture change rather than temporary compliance.
• Quote (Sadie Durham, 05:57):

  "...One of the measures of true success is going on a floor on a weekend when there are no nursing managers, when there are no directors walking around, and seeing that at 7 am the floor is clear because the staff are in the rooms doing bedside shift reporting."

5. Sustaining Progress through Empowered Frontline Leaders (06:49 - 07:56)

• Sustained Progress: The key to ongoing compliance was ensuring that charge nurses not only promoted, but also consistently modeled the desired behaviors.
• Accountability: Frontline leaders set the tone and expectations for their teams, preventing regression to previous habits.
• Quote (Sadie Durham, 07:04):

  "...If you don’t have charge nurses that hold the teams accountable and model the behavior, then the staff will say, ‘okay, we don’t have to do it because our charge nurse isn’t doing so.’"

6. Impact: Improved Net Promoter Score (NPS) and Staff-Patient Connection (07:56 - 09:18)

• Measurable Results:
  • Net Promoter Score rose by about 40 points within six to eight weeks after program implementation.
  • Increased staff awareness of how consistent, simple practices drive patient feedback.
• Patient-Focused Benefits: Enhanced team responsiveness and communication recognized directly by patients.
• Quote (Sadie Durham, 08:09):

  "...We saw almost, I would say within about six to eight weeks of rolling it out and everyone being trained ... we saw immediate increases in our scores in those points."

7. Advice for Nurse Leaders Facing Similar Challenges (09:18 - 11:01)

• Return to Basics: Leaders should first ensure the fundamentals are being done well before seeking entirely new solutions.
• Importance of Standardization: Success relies on consistent expectations across departments and validation by leaders at every level.
• Fundamental Principles: Reinforces that basic nursing care is the driving force behind quality improvement and patient experience.
• Quote (Sadie Durham, 09:39):

  "We don't always have to look to new technology, always need significant financial investment. Sometimes it’s just as simple as going back to our basic practices and ensuring that we’re executing them."

Notable Quotes & Memorable Moments

• On simplicity and leadership:

  "Sometimes it’s just as simple as going back to our basic practices and ensuring that we’re executing them."
  — Sadie Durham, 09:39

• On visible behavior change:

  "Seeing that at 7am the floor is clear because the staff are in the rooms doing bedside shift reporting ... that was an immediate shift."
  — Sadie Durham, 05:57

• On the patient as the center:

  "It’s really important for us to engage our patients, to listen to their voice and really to ensure that they have a great experience."
  — Sadie Durham, 02:34

Timestamps for Key Segments

• 00:36: Discovering decline in patient experience and identifying fundamental issues.
• 02:34: Dr. Durham’s nursing leadership philosophy and decision-making.
• 03:42: Engaging frontline nurses, addressing barriers, and building buy-in.
• 05:39: Observing early positive cultural shifts post-implementation.
• 06:49: The importance of frontline leaders in sustaining change.
• 07:56: NPS improvement and linking results to practice changes.
• 09:18: Advice to peers and the case for focusing on fundamentals.

Conclusion

This episode underscores that returning to and rigorously applying nursing fundamentals—specifically bedside shift reporting and hourly rounding—can drive significant improvements in both patient experience and internal culture. Dr. Sadie Durham’s story highlights the power of clarity, staff engagement, and strong frontline leadership, offering listeners a practical, replicable path to quality improvement in healthcare environments.