UCM's new chief nursing officer holds a dual role as corporate VP and CNO.
Allison Guste has been in healthcare for 18 years. She began her career as an emergency nurse, and then later found her passion for quality and healthcare management in an outpatient clinic setting. She studied at the Louisiana State University (LSU) School of Nursing and holds a master’s degree in healthcare administration from LSU Shreveport.
Currently, Allison serves as Chief Nursing Officer at University Medical Center, as well as the Corporate Vice President of Nursing and Clinical Services for LCMC Health. providing leadership across eight LCMC hospitals.
For our latest installment of the Exec, we sat down with Allison to discuss how she began her journey into nursing, her thoughts on recruiting and retention, and how CNOs can fill their own cups at work.
The success of AI varies, and depends largely on proper implementation.
AI is currently being implemented in many aspects of nursing, including documentation, admission and discharge processes, measuring and monitoring vitals, and data collection and analysis.
According to Betty Jo Rocchio, Senior Vice President and Chief Nurse Executive at Mercy, a lot of thoughtful planning goes into ensuring that AI won’t become a disruptor to nurses.
Here's what CNOs need to know about AI in nursing.
Virtual care, wearables, and AI are going to revolutionize nursing, says this CNO.
On this week’s episode of HL Shorts, we hear from Lisa Dolan, Senior Vice President and Chief Nursing Officer at Ardent Health Services, about technological trends in nursing. Tune in to hear her insights.
AI can be a huge disruptor, but it has a lot of potential.
AI is currently being implemented in many aspects of nursing, including documentation, admission and discharge processes, measuring and monitoring vitals, and data collection and analysis.
However, the success of AI varies, and depends largely on proper implementation.
According to Betty Jo Rocchio, Senior Vice President and Chief Nurse Executive at Mercy, a lot of thoughtful planning goes into ensuring that AI won’t become a disruptor to nurses.
“It’s not just automated intelligence, but how we augment that intelligence that the nurse brings to the bedside,” Rocchio said.
Solving problems
Ultimately, the goal of any CNO wanting to implement AI in their workforce is to solve problems and make the delivery of care more efficient and effective.
“We can never replace the care that we deliver and the critical thinking of a nurse,” Rocchio continued, “but we can help nurses be much more equipped to be able to deliver… care in a much more streamlined fashion.”
Rocchio said Mercy is partnering with Epic and Microsoft, along with other resources, to implement new processes and smaller innovations that will lead to larger future projects.
One problem that the team at Mercy is trying to solve is handoffs between departments. Typically, according to Rocchio, when a patient arrives in the emergency department and is admitted, there is typically a handoff from the emergency department nurse to the inpatient nurse.
To make this process more efficient, Mercy is exploring the use of AI to first develop a note from the emergency department record, then develop the key points in an AI automated fashion. The last step would be to deliver that note to the inpatient nurse via the nurses’ mobile phones.
“We’re trying to use AI to scour that record and deliver the most important points up to the inpatient nurse without nursing having to intervene,” Rocchio said.
AI is also assisting CNOs, not just bedside nurses.
Mercy has launched a workforce platform that allows the team to get the right clinician to the right spot without manual intervention. Rocchio said they are using AI in the background to calculate the number of necessary shifts and set the rate on incentive shifts for nurses who want extra work.
“Just like [how] Uber and Lyft use a supply-and-demand model and use data in the background,” Rocchio said, “we’re starting to use that in healthcare to be able to develop our workforce and get them in the right spots at the right time.”
AI technology can also help with hiring and recruiting processes.
“We use platforms now for hiring and recruiting that [help] candidates get to the right spot for interviews quicker,” Rocchio continued, “as well as deliver information to the candidates and collect [candidate] information… [that helps us] prioritize the areas we want to focus on.”
Challenges and concerns
As with any new technology or trend, there are challenges that come along with implementation, that CNOs should carefully consider before moving forward.
“An office is a very dangerous place to start making decisions about clinical areas from,” Rocchio stated.
The nurses themselves do have concerns about AI, but not about the use of it. The concern lies with understanding how AI will fit into their nursing practice. Nurses want to make sure that AI is going to actually be incorporated into their workflows.
“There’s no concern as long as [implementing AI] isn’t done to [nurses], but it’s done with them,” Rocchio said.
Patients, on the other hand, are very excited about AI technology. According to Rocchio, patients want information to come to them quickly and completely, and if AI can accomplish that, then they view it as a positive.
“It’s just frightening to [patients] if [information] comes in pieces,” Rocchio said, “but if it’s a part of their standard care and they can see it, they’re embracing their piece in helping us reach their healthcare goals.”
Solutions
To help test new AI and mitigate some of these concerns, Mercy has launched innovation units where frontline staff can also give their input. The innovation units are there to help not only nurses, but also staff in other departments, to see where the technology could help them in their workflows.
“It’s not just AI off to the side, it’s AI embedded into the workflows and how that comes together with the frontline giving us their feedback on how it works,” Rocchio said. “We’re doing some rapid cycle improvement processes with this and making sure that we’re taking the frontline into account.”
Alongside innovation units, Mercy has put up electronic boards in every patient room that provide a connection point for information between the patient, the family, the nurse, and the physician. The boards also help speed up communication and set goals with the patient, said Rocchio.
“We’re finding [that] the power of those boards and connecting [them] into the electronic health record is helping nurses think about how they plan their day better,” Rocchio said, “and I think that’s going to be a real game changer.”
Additionally, Mercy has been using AI in the background to monitor the blood sugar of patients living with diabetes, Rocchio said. The AI tool pushes information to the patient and allows physicians and nurses to see that information as well. Clinical staff can then clearly communicate with patients in a timely manner and help them manage their blood sugar. The data can also be g used to monitor health trends for the patient.
“If it’s buried in a medical record, somebody has to dig it out to have communications,” Rocchio said, “but when AI serves it up to the physician, the nurse, and the patient, we’re able to stay on top of it in real time.”
Measuring outcomes and success
According to Rocchio, Mercy has already seen great outcomes from the testing they’ve done in their innovation units, and in other areas of the health system. In general, the team has been able to take information and compare it with other metrics.
“We export that data into dashboards and allow our frontline nurse leaders to make good decisions around filling shifts [and] how often they need help,” Rocchio said, “in a very automated fashion, so they don’t have to manually do it.”
The same thing is true for patients, the data is aggregated, and both patients and providers are able to track, trend, and monitor patient health conditions.
Mercy has been measuring how many EHR clicks are being saved i through a mobile platform that nurses can use to chart at the bedside.
“To date, we’ve saved over 200,000 clicks in the electronic medical record,” Rocchio said, “which is important because that keeps nurses by the bedside, not spending time in documentation.”
Advice for CNOs
The implementation of AI technology can be overwhelming, so it’s important that CNOs approach it carefully and strategically.
“Get a partner that’s been working in the AI lane, like Microsoft or Google, or somebody that’s used it outside of healthcare first,” Rocchio said. “[Somebody] that understands the limitations as well as the power of it, because we’re just dipping our toe in and we want to make sure we use it in the right way.”
Rocchio recommends looking at the problems in workflows and addressing them in ways that do not involve manual intervention, but use technology or analytics to present the problem in a different way.
“It takes us leaders thinking about things differently and how to solve them,” Rocchio said, “because today the world’s moving in a while different direction.”
CNOs must be role models in a healthy work environment, says this nursing leader.
There is an overwhelming sense of nurse dissatisfaction in the industry, due to exhaustion from heavy workloads, staffing shortages, workplace violence incidents, and other external disruptors.
A healthy work environment is necessary for nurses to thrive, and for patients to get the highest quality care and experience when visiting a health system.
As part of our coverage on healthy work environments, we sat down with Vicki Good, Chief Clinical Officer at the American Association of Critical-Care Nurses (AACN), to learn more about the AACN's six standards for a healthy work environment, and the new Health Work Environment National Collaborative program.
Safe patient handling programs help reduce nurse injuries.
Working in healthcare poses many safety concerns, including exposure to illness, physical injury, and workplace violence.
According to the Occupational Safety and Health Administration (OSHA), in 2020, hospitals recorded nearly three times more work-related injuries and illnesses for every 100 full-time employees than in all industries combined.
CNOs must ensure that there are proper safe patient handling procedures in place so that nurses avoid sustaining injuries. Here's what you need to know about safe patient handling.
CNOs must know how to define healthy work environments in order to build them.
On this week’s episode of HL Shorts, we hear from Deana Sievert, Chief Nursing Officer at Ohio State Wexner University and Ross Heart Hospitals, about the qualities of a healthy work environment. Tune in to hear her insights.
Creating a safe patient handling program can help reduce injuries and time lost due to injury.
Working in healthcare poses many safety concerns, including exposure to illness, physical injury, and workplace violence.
According to the Occupational Safety and Health Administration (OSHA), in 2020, hospitals recorded nearly three times more work-related injuries and illnesses for every 100 full-time employees than in all industries combined.
One concern for nurses is the use of equipment to handle patients who are less mobile and need assistance, says Deana Sievert, Chief Nursing Officer at Ohio State Wexner University and Ross Heart Hospitals.
“Nurses are utilizing many different pieces of equipment to complete patient care,” Sievert said. “Those pieces of equipment can be very heavy or difficult to move.”
“It is more common than it should be for nurses to sustain musculoskeletal injuries such as pulled or strained muscles, and damage to bones or joints,” Sievert added, “and these can range from small sprains to career ending injuries.”
CNOs must ensure that there are proper safe patient handling procedures in place so that nurses avoid sustaining injuries.
Policies and procedures
Sievert believes CNOs need to build a culture focused on safety, where nurses have the tools they need to be successful. The policies created for safe patient handling should promote the concepts of a no-lift environment, and treat the use of safe patient handling equipment as a non-negotiable.
“Creating a ‘no lift whenever possible’ culture is something each CNO should strive for,” Sievert said. “It is imperative to ensure that nurses have [the] appropriate pieces of equipment that assist with lifting, repositioning, increasing mobility, walking aides, and emergency equipment when lifting may be necessary.”
Sievert recalls one of the most successful no-lift cultures she worked in, where there was a safe patient handling coordinator who visited each department and made the no-lift expectations clear. The safe patient handling coordinator also evaluated each department and identified needs, providing the appropriate equipment for each kind of care.
“Safe patient handling equipment was in all areas of the hospital including ambulatory areas,” Sievert said, “and the hospital had overhead patient lifts in each patient room.”
Additionally, there were safe patient handling coaches on each unit, according to Sievert.
“These coaches were key to departmental culture,” Sievert said. “All of this body of work helped significantly drive down injury costs and days lost to injury.”
According to OSHA, having a written safe patient handling policy ensures implementation and continued success. Programs will work when there is consistent leadership making safe patient handling a visible priority, and when nurse managers and frontline staff members are involved during the development stage.
OSHA provides a safe patient handling checklist that health systems can use to evaluate their programs. The checklist is broken up into several sections:
Policy development
Management and staff involvement
Needs assessment
Equipment
Education and training
Program evaluation
CNOs can use this resource to see which areas in their safe patient handling programs are well developed and which components of the programs might need more attention.
Training
To make safe patient handling programs a success, CNOs need to make sure that nurses receive the proper training, and that they understand the equipment and procedures to the fullest extent.
Sievert recommends that training follow the resources the organization has in place to address physical hazards.
“Training should be crystal clear in regard to the culture the organization wants to create, the expectations, and resources available,” Sievert said. “Creating that culture is key to success, and training and retraining is critical.”
According to OSHA, all staff, including physicians, must be trained in safe patient handling, through onsite demonstrations of equipment use and maintenance and broader education programs. OSHA provides the following recommendations to create a safe patient handling training program.
Train all relevant workers on using mechanical lift equipment
Refresh, remind, and require ongoing training
Use mentors and peer education
Train caregivers to check each patient’s mobility every time
Engage patients and their families
For more information on OSHA’s recommendations for safe patient handling, click here.
It's important that your health system stands out, says this CNO.
On this week’s episode of HL Shorts, we hear from Cassie Lewis, Chief Nursing Officer, Bon Secours Richmond Market, about how CNOs can distinguish their health systems to new nurses during the recruiting process. Tune in to hear her insights.
Here are some best practices for recruiting, according to CNOs.
There are many strategies to help with recruiting, with varying degrees of success. CNOs need to focus on those solutions with proven positive outcomes to build their workforces.
Here are five tips for recruitment, by CNOs, for CNOs.