Bill Klaproth (Host): This podcast is brought to you by Omnicell. As a leading provider of medication management solutions and adherence tools, Omnicell delivers optimized outcomes through a set of advanced services, powered by a connected, intelligent infrastructure. To learn more, visit omnicell.com.

Host: This is a special AONL podcast as we record live from the show floor at AONL 2023. With me is Kristine Shepherd, clinical nurse consultant for Omnicell, and Jackie Smith, Principal Product Designer at Omnicell as we talk about Empowering Nurses Through Innovation, Optimized Workflows for Medication Administration.

This is Today in Nursing Leadership, a podcast from the American Organization for Nursing Leadership. I'm Bill Klaproth. Kristine and Jackie, welcome.

Jackie Smith: Hey, Bill. Great to be here.

Kristine Shepherd: Thank you, Bill.

Host: It's great to have you here. I'm excited to talk to you for sure. So, the title of this podcast is Empowering Nurses Through Innovation, Optimized Workflows for Medication Administration. Kristine, let me start with you. Can you talk to me about your approach to nursing workflows?

Kristine Shepherd: Sure. Well, as a contributor to product design and a nurse consultant, we are really at the forefront of collaboration between innovation and implementation. When we're in the field working with our clients, we really have an opportunity to talk with nurses and find out what's working for them, what's not working for them. And we discuss that with our product design to improve our products that we already have our solutions, and also in the development of new solutions.

Host: And Jackie, how about you? Thoughts on that?

Jackie Smith: Sure. So as a product designer, before I can even start solutioning, it always starts with research. In fact, the product design team at Omnicell recently completed a year-long multi-site observation on how medication moves through a hospital. We went into hospitals, we did standard research methodology that included time-motion studies, and we really looked to see how long does it take to complete a task.

So, we followed nurses into med rooms. We observed them removing medications from our cabinets. We then observed as they returned and wasted, so we could really start to understand their workflows and what they do in their day-to-day.

Host: Yeah. That's really cool. So, Kristine, let me ask you then, what impact does the nurse perspective have on a solution design?

Kristine Shepherd: Yeah. One thing that was evident to me in my nursing practice and that I continue to see is that nurses will do more with less. They'll cope with scarce resources to offer the best care they can to their patients. In other words, they do the best job that they can with what they have. They don't know what they don't know. There may be something out there that exists that would help them save time and do their job more efficiently, but they don't know about it, and they really shouldn't have to just cope or to get by.

The Dean of the School of Nursing at UCSF, Dr. Catherine Gillis, recently spoke at a Scottsdale Institute Fireside Chat about the next generation of nursing. And just wanted to share a quote of hers that stood out to me. She said, "There could be a stronger partnership between the CIOs who deliver information and the nurses who benefit from that data in making their decisions. Nurses are experts at workarounds. They can always solve problems. But when these problems are solved as one-offs, then leadership doesn't have the benefit of applying that knowledge to generate more lasting solutions. Nurses need to be in the conversation of what's not working. If they're just fixing, it's not helping."

Host: Jackie, you want to give us your thoughts on that?

Jackie Smith: Yeah. Like Kristine mentioned, we are actively investigating in research and development. So as a product design team, we want to know where those pain points exist. And we want to be able to remove that friction. But we're also looking for where can we introduce new technology to address opportunities. Essentially, we want to be able to enable nurses to do what they are trained to do, which is care for patients. I'm not out here building a product for myself. I'm working with nurses to build a product that really meets their needs. And ever since Omnicell has been in the medication management space, we've really partnered with nurses to streamline their process, enhance patient safety and provide nurses the appropriate technology really to minimize workarounds.

Host: So, Kristine, why then is technology so important right now?

Kristine Shepherd: Well, right now, we're experiencing both the Graying Of America and the Great Resignation. By the year 2030, all baby boomers will be over the age of 65. And by 2034, older adults will outnumber children for the first time in the US history.

Host: Wow.

Kristine Shepherd: Yeah, that's amazing. And while this influx of patients is growing, the nursing pool is really draining. But the nurses out there listening to this podcast, I don't need to tell them what the statistics are from the US Census Bureau or the Department of Labor. They're already experiencing this in their hospitals. Technology adoption is important now because with more patients and fewer resources, every minute counts when you're talking about direct patient care.

Host: Yeah. that's so true. Jackie, your thoughts on that?

Jackie Smith: Yeah. So at Omnicell, we know that technology depends heavily on ease of use. And we want to make sure that it meets your needs. So to provide some examples of how we are leveraging technology in our solutions today, for example, if you can remove a controlled substance one dose at a time, not only are you keeping nursing and patient safety from drug diversion, but you're limiting that time-consuming end-of-shift countbacks. And if you can remotely queue medications from your EHR, instead of waiting in line at the cabinet, you have more time to review medication orders. If you can consolidate your multi-use items within patient-specific bins in the cabinet, you're not spending time tracking down those medications. And if your medication management is interoperable with your EHR, you eliminate redundant documentation. In the end, all this is really resulting in more time with your patients.

Kristine Shepherd: Jackie, that's so true. It all adds up. And with the increase in patient volume, nurses are going to need the time and the technological support that these advances offer them. The problem is whether it's an underfunded IT department, lack of training or competing projects or understaffing or any other reason, technology just isn't being implemented, adopted or utilized to its full potential and we really want to change that.

Host: So kristine, let me ask you this then, how can you improve adoption when time and resources are already stretched thin?

Kristine Shepherd: Yeah, that's a great question. There really has to be a vendor partnership. Omnicell's point-of-care layers our industry-leading XT Automated Dispensing System with the latest innovations in software and expert services. And it really guides you to more data, more analysis and more time. Nurses are not experts in analyzing data. So our integrated service model, we combine technology expertise and connected intelligence to accelerate and sustain value. And two of the biggest values being nurses' time and job satisfaction.

If we go back to that Scottsdale Institute Fireside Chat that I talked about earlier, another thing Dr. Gillis said is that people come into nursing to be involved in meaningful work. Many return to school after being in other industries for the same, and there's a threat against meaningful work. This must be central as we discuss the shortage of nursing. So, nurses go through years of training of meaningful work, and the definition of meaningful can really vary from one person to another. But I'm willing to bet that it's not on administrative tasks. It's direct patient care.

And if you follow hospitals on social media, you'll see them post Good Catch Awards, recognizing staff for lifesaving Good Catch measures. In fact, I saw one this week where a nurse was having a conversation with a patient. She noticed a change in that patient's speech, which was indicative of a stroke. And just because she was there, she saved that patient's life and that's amazing. But interestingly enough, according to the Journal of Nursing Care Quality, only 22% of a nurse's time is spent on direct patient care. So, those patient conversations, they're really becoming a scarce resource.

Host: And they're so important, right?

Kristine Shepherd: Yeah. And so much of what I hear from nurses and what I experienced in my own practice are the stories of patients and families. That's really what is meaningful. To make a good catch, to find meaning in practice, nurses need time for patient care.

Host: Kristine, thank you for sharing that. That was really interesting. So when we talk about improving adoption, when time and resources are already stretched thin, Jackie, I'd like to get your thoughts on that.

Jackie Smith: Of course. So, part of what technology enables is we can look at the behaviors, usage and adoption patterns of users through our data. I've talked about how data informs the future improvements in the software, but it's also really informing the solutions in our services. I have colleagues at Omnicell and they're providing ongoing advisory services focused on optimal workflow recommendations to really ensure the maximum adoption. And they're using this data and best practices, they're able to provide insights aligned with these site-specific goals. And at the same point, they're able to come back to my team in product and give us feedback as well as to how we can improve the product.

Host: Yeah, that makes sense. And meaningful work, of course, is valuable to all of us, no matter what profession. So, let me ask you this before we go. What is meaningful to each of you? Kristine, let's start with you.

Kristine Shepherd: Sure. I take a lot of pride in hearing stories from nurses and client hospitals, not about how they're enjoying using our technology, although I'm always really happy to hear that, but that they get to have the interactions with patients that are meaningful to them. Nursing really is a service. And I'll just share an experience I had as a bedside nurse back in the day.

I took care of a little girl who was part of Healing the Children Program who came to our hospital for a congenital heart repair. And she didn't have the privilege of coming with her parents. She had a sponsor with her who couldn't spend the time with her. So, I was at her bedside every day she was in our hospital. And I spoke with her parents over the phone with the translator. And I not only provided her nursing care, but I was also her parent for her while she was in the hospital. And she got better and went home. And a year later, she came back to the hospital and visited me and she brought with her this key chain that had a leather flip flop on it and said El Salvador. And to this day, I still use that key chain and it just is a reminder to me that nurses do make a difference. And to me, I feel that helping nurses to have more time with their patients, that's my contribution to nursing and serving my fellow nurses. And that's really what's meaningful to me today.

Host: Yeah. Well, thank you for sharing that. That's a great story, and what a keepsake you have to remember that little girl by, for sure. Jackie, how about you? What do you find meaningful?

Jackie Smith: So as a technologist, you know myself, others on my team, we're really driving towards outcomes that are meaningful to us, but also really these outcomes that are meaningful to both patient care and nurse productivity. And working at Omnicell is a way for us to be a part of this meaningful work. So for me, I want to be able to bring my expertise in research and design and really do that alongside the nurses so that we can, in the end, create a meaningful experience for them.

Host: Yeah. Thank you for that as well. Well, I want to thank you both for your time today. One last question. I would just like to get your final thoughts on this when we talk about Empowering Nurses Through Innovation, Optimized Workflows for Medication Administration. Jackie, let me start with you. Anything else you want to add to our conversation today?

Jackie Smith: Sure. As I mentioned like a lot of the work that we're doing at Omnicell is really to be on the ground with nurses and we're always looking for those partners. We want to be walking around the hospital observing you. And reach out to your local account managers and we can really start to connect all these dots and be there to solve solutions with you.

Host: Absolutely. And Kristine, how about you? Final thoughts on our discussion today? Anything else you want to add?

Kristine Shepherd: I just appreciate being able to work with nurses in the field. Even though I'm not a patient-facing nurse today, I really appreciate the work that nurses do and helping nurses help their patients is really a rewarding thing.

Host: Absolutely. Helping nurses help their patients, I can see how that is rewarding and what a great goal that is. So, I want to thank you both for your time today, Jackie and Kristine. Thank you so much.

Jackie Smith: Thank you, Bill.

Kristine Shepherd: Thank you.

Host: You bet. And for more information, please visit aonl.org. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is Today in Nursing Leadership. Thanks for listening.