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Becker’s Healthcare Podcast
Strengthening the Nursing Workforce at Hackensack Meridian Health
00:19:28
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- [00:02]
A
Every year, Becker's annual meeting brings healthcare leaders together to unpack the most pressing issues facing the industry. And every year, those conversations shift in profound and unexpected ways. This April, more than 3,500 healthcare executives will return to Chicago for Becker's 16th annual meeting. 795 elite speakers will offer new lessons, new case studies, and predictions about what comes next. Join us April 13th through the 16th. For the agenda and event details, visit BeckersHospitalReview.com and click on the Events tab in the upper right.
- [00:38]
B
This is Laura Dirdo with the Becker's Healthcare Podcast. I'm thrilled today to be joined by Regina Foley, president of Specialty Hospitals and Clinical Services, as well as chief Nurse Executive at Hackensack Meridian Health. Regina, it's a pleasure to have you on the podcast today.
- [00:51]
C
Good to talk to you too, Laura, and all your, all your listeners.
- [00:54]
B
Awesome. Well, thank you so much for being here. I'm excited to have you because I know Hackensack Meridian Health is on the forefront of a lot of amazing things in the clinical care space and especially thinking about nursing. You know, you're really, really interesting ways that you've been adapting to the current environment in building on the ecosystem. But before we dig into that, can you tell us a little bit more about yourself and the organization?
- [01:19]
C
Sure. So I Hackensack Meridian Health, located in New Jersey, 38,000 team members strong. We cover about eight counties in the state of New Jersey, 18 hospitals, about 500 locations. I'm a career HMH ER. I've been in our company for 39 years. As we roll into 26 years, 39 years, different places, different roles. It's been part of the gift of being a nurse, whether it be nurse at the bedside, a chief nurse at one of our hospitals, or a hospital president or leading transformation efforts, which is all the changes or even landing to the role I'm in today. I certainly have a lot of longevity within Hackensack Meridian Health. I would say I'm not alone though. We have many nurses that have been promoted from within or stay a career within our company. Certainly proud of the organization. We had a recent restructuring in 26 where we were divided in or segregated kind of in a regional role within our state. And our CEO and board thought let's, you know, we need to get a little bit more provocative thinking and forward thinking here. So we actually eliminated a regional structure which was north, Central and south and then we eliminated those roles in that kind of although care is very local and you know, we keep care as local to the patient as possible or community as possible. Administratively. Now we've organized that our acute care hospitals are kind of one side of the house. And then areas like specialty hospitals or clinical services, that's what I have the responsibility of. So it's really allowed for a lot of further integration, further continuity, you know, transparency of information, timeliness, which certainly at the end of it all helps us with caring for our patients. So this kind of recent reorganization we did in the latter half of 25 certainly I think turned out to be beneficial for the company.
- [03:31]
B
That's great to hear. Certainly always a lot goes into those kind of restructures and reorganizations. But I love that goal of making sure care is local and putting the right people in the right places to transform that care experience. Now, when you think about the last year, what was the most important initiative that you led? What did you do and what were the results?
- [03:54]
C
I think one of the top three priorities would be strengthening and supporting the workforce, the nursing workforce. I would say stabilization of the workforce. You know, the pandemic really took its toll on the work on the healthcare workforce globally. We also were part of, certainly a part of that. So recently I would say the most important initiative that we tackled in 25 was stabilization of the workforce, which has led to. We have a very low vacancy rate today, just about 4% actually. We have two of our hospitals that have below 4 vacancy rate. Retention is extremely strong. We also were able to reduce contracted labor agency utilization by about, gosh, $41 million last year, which is not insignificant. So I would say making significant strides in stabilization of the workforce and making sure that we have very strong retention efforts, which is really is led from culture in the organization. So it's not just about recruiting net new. We want those nurses to stay in the organization, just like me. Here it is a few years later. So that I would say there's many priorities. But I can tell you that's one standout important initiative for 25 was the stabilization of the work environment. I gave you some stats. Vacancy retention, agency utilization, and behind the scenes of all of that, there's different kind of unique programs to help on the recruitment side, because many our care is local, our team members are local, we're very community based. So our physicians, team members and patients are living within the communities that they're practicing in. So we have different programs in place to ensure that if somebody wants to go to school as a second career choice, how do we support them to do that? They always wanted to be a nurse. We kind of mentor and Figure out different ways, whether it be tuition reimbursements, scholarships, or things that we're bonusing. So a lot of detail there. There's a lot to unpack. But I can say that probably stabilization of the work environment was a key initiative that we had success with last year.
- [06:20]
B
That's amazing to hear. And, you know, definitely something that a lot of hospitals and systems are trying to achieve. And so when you think about, you know, reaching those goals, being such a low vacancy rate and truly, truly having that kind of retention that you need and then the savings as well by reducing the contract labor, I know, you know, there's a lot of components that go into being a great place to work and, you know, setting that right type of question culture that people want to be at. So, you know, when you look at that differentiating factor, what did it take to achieve these, these results and really transform the way you were thinking about the workforce?
- [06:57]
C
Yeah, I first think nurses, and it's more just that it's not just nursing, but, you know, we're on that topic right now. But the workforce wants to feel respected, appreciated, and that their opinion counts. So our, you know, myself, our CEO, our COO are very grassroots oriented that we're at. You know, as I talked to you today, I'm at one of our hospitals where we're very, we have a lot of visibility. I mean, you're never as visible as the team members want, but we definitely are at the site routinely to keeping things very real. And that, that's, that's, I feel, very symbolic on where culture begins. Our CEO was a hospital executive or CEO at one of our hospitals. Our leadership team, our executive leadership team for our company network, all have come from a hostile environment. And that really pays dividends because the team members, they, I'll say they, I feel like that they always know a faker, right? Like they can feel like, what are you talking about? You're saying this, but did you really live it? And in, you know, truth be told, myself, the coo, the CEO have done that. You know, clinicians by background have, have literally rendered patient care and came from very humble beginnings. So I think culture begins there because we, it is very family oriented. I don't just say it to resonate like, oh, Virginia, you got to be kidding me. You know, again, I'm in our company for 39 years. It is an extension of my house. I, you know, three kids, they're adult children now, but they know where, where I practice and what, what I do for a living is extremely important. Even to our family. And so therefore that translates because of, I would say, the style and type of communication being authentic. Team members know that they're cared for. They know that they're respected. We want nurses to work at full scope of practice and full license. We partner with our medical community to ensure that that happens for potentially advanced practice providers. So again, culture, it's not, it could probably be a whole other podcast is culture really sets the tone of how you're able to really move the needle in your, in your organization, whether it be workforce, whether it be financial results, God forbid, a situational issue. You're able to see very, very clearly in a quick period of time when everybody's on the same sheet of music and moving in the same direction, how you can really make things happen in a very short, short, very timely. And I would say the definition of that is having a healthy culture. So I appreciate you bringing up because very often when health care executives are asked, you know, it's about margin and volume and we don't necessarily think that way. I mean, yes, it's in. Those are important, but at the, at the beginning of it, you know, quality is at the bedside. How do we make sure that the quality that we're rendering, how do we make sure the individuals rendering that care know, are we listening to them? And that's again, where it begins with culture. So probably a long way of answering it, but that, I mean, that's just from, you know, my heart sharing that with you.
- [10:10]
B
I really appreciate it and such an important thing to share and I can tell your passion for what you're doing and everything that goes into the organization there in HMH is really shining through. So that's amazing. I think when you look ahead to 2026, are there any other prior looking at or headwinds that you're focused on right now?
- [10:31]
C
Easy answer is yes. One is how and where we can leverage technology. We, we did launch virtual nursing in the last two years and we have 147 beds activated with virtual nursing. So it's a nursing partner, it's somebody else taking care of the administrative burden of caring for the patient. And we are, you know, we'll monitor it for a solid year to make sure to just to see it's for those 147 beds from four different hospitals. A UN in four different hospitals. And we're in the process now of evaluating to see is that something should be expanded or not. So I think leveraging technology to lighten the load for individuals that are patient facing it could be A doctor could be a nurse, it could be a pct, a partner, a partner in care. So I would say one of the biggest priority or headwinds would be leveraging technology and advancing technology we have in place as we're monitoring it and we're measuring it. What are the benefits and is it something that could be expanded? We can't underestimate the power of AI. We are at HACSAC Meridian. We do utilize and leverage the EPIC platform and we have some generative AI that are helping nurses with notes, you know, end of shift notes to help that change of shift time to, you know, could we reduce that in any way and can we be more comprehensive? So, you know, if you would have said five years ago we were going to be leveraging AI at the bedside, I'd say, I don't know, I'm not quite there now. Early adopter. And the answer is yes, because AI can really be another partner in helping that nurse or clinician care for the patient. So those are two, I would say, big priorities for us this year.
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B
Got it. I love that. Fantastic. Thank you so much for sharing. Now, what do you think the hardest thing you're going to have to do will be in the next year?
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C
I would say continuing to innovate because our teams, they're not complacent and just same old, same old. They're always looking to challenge. There's. With all the smart scientists and things that are happening on the technology side, how can we, how can we afford to be early adopters when we see it benefits a patient? Robotic surgery comes to mind if, I mean, you can't argue with the technology. And robotic surgery patients are, they're back to work quicker, they're back to their regular activities of daily living, they're able to travel quicker, they have less complications, they have less time in the operating room, they have less time in a hospital meeting more time with the families. Again, that's where technology has really advanced. So I would just say that one of the hardest things is continuing to innovate and be early adopters of the technology as it, you know, as it evolves. Certainly I shared on the AI front or virtual, we have those 147 beds that we have activated. Well, how do we quantify the benefits of that hard savings? It can't just be soft. I can't just say to coo, so we're retaining nurses longer or we have less incidental overtime because the change of shift time is quicker. I need to quantify with hard savings. So that's what we're in the process of doing now. And that's hard because there's a lot of soft savings associated with virtual nursing. But our CEO and board are going to look for some hard savings. So those are tough because it's a delicate balance of to be innovative, to bring technology to the bedside. But now that we have it, how do we expand it? And I'm going to have to quantify that with hard savings. So that's certainly a big nut to crack for this year.
- [14:26]
B
Absolutely. That sounds like a huge, huge challenge. And I appreciate all the dynamics that go into trying to be that innovative and tech forward organization while at the same time making sure that you've got quality, safety, everything else there. And it can really prove the results coming from those different initiatives. So I love that, you know, kind of talking about those soft savings, especially in virtual nursing and then trying to continue to transfer that into the hard savings as well. Before we wrap up here, I'm curious, how do you see growth and development over the next year? Where do you see the best opportunities to continue growing?
- [15:05]
C
Well, I guess two, two things. We've had a pretty significant appetite the last couple of years to expand our ambulatory footprint. You know, patients that are in hospitals are so acute, right? They're really acute. The acuity is high. They're very sick. Patients are very sick. We want to keep people certainly if they need to come to us, we're the guy to take care of them. I have no problem with that. We want to keep people healthy and happy in their local community environment. So we've placed ambulatory locations peppered throughout the state. As I mentioned in the asset, we have about 500 locations. But even today I think there's about 14 or 15 shovels on the ground different areas in New Jersey building an ambulatory environment so that patients can go to, to see either a primary care doc, go to a pharmacy, get a CAT scan or an image done for something. So that's one. The other is, you know, as we roll into 26, we really can't talk about healthcare in New Jersey with Hackensack Marine Health without talking about the FIFA World Cup. We this global, this global, you know these games are going to be played here in New Jersey at MetLife Stadium beginning this summer, July, June into July. And our quaternary facility, Hackensack University Medical center will be on the world stage. I know that is this, that, that our hospital will be the hometown hospital for New Jersey, New York hosting this global, this global game, so to speak. So that on top of the 250th anniversary of our country, obviously we're booked in between New York and Philadelphia. A lot of activity happening in the Philadelphia market, certainly in the New York market, but right across the river here in New Jersey, we'll be hosting the, the FIFA World Cup. So that certainly is something. It certainly, it's a tremendous opportunity for us. But then it's on. You're on the global world stage of rendering care. God forbid somebody gets hurt. But in the world we live in on, you know, mitigating risk and protecting those, making sure that when they go to an event, it's as safe. Right. As safe as possible and that they're going to have a good time. So we'll, we're going to be part, we're, you know, very much early adoption in the, you know, this plans have been going on for more over more than a year, but certainly as we get into this year and opportunities on the growth side, you know, we're going to be hosting or we're sponsoring the FIFA World Cup. I believe that, you know, New Jersey, it's very highly diverse, diverse state. The post of it as, as this, the attention is on New Jersey for this to be, you know, to be shown for a month, you know, June into July. We're also going to build these, I think, like legacy fields. So in communities that need additional fields where kids need get away from technology, get outside team sport, be with your friends, get out in the environment. We're going to build three fields in our state so that kids could get excited about it as much as we are, but keeping them more in their community, certainly a global platform that we'll be able to share things that are important to us. Tackle kids, cancer. We do have two children's hospitals and they're doing a lot of cancer care with children. And we have, you know, we, we want to fundraise as much as we can for that because, I mean, nobody should be, nobody should feel sick or feel badly. But let me tell you, when a kid has cancer, it is really, it's a very pivotal thing for the those that are caring for the child as well as the family. So we have a lot of initiatives behind the scenes on that. So those are another areas of growth for us on the philanthropy side.
- [18:54]
B
That's amazing to hear. Wow. A lot of great opportunities coming up this year. Regina, thank you so much for joining us on the podcast today. I really appreciate your time. This has been a great conversation. I look forward to seeing you at our annual meeting as well. Coming up here, I know you'll be speaking on a panel, and we'll continue to deepen some of the themes we talked about here. And this will be a great opportunity to connect with all those from across the country leading very similar healthcare challenges as well as initiatives moving forward.
- [19:20]
C
Sounds good, Laura. You know, flattered to be asked and happy to partner with any of my friends and colleagues throughout our country.