Bill Klaproth (Host): This is a special AONL podcast, as we speak with session presenters from the AONL 2023 conference. With me is Traci Gibson, Director of Nursing Professional Development. We also have Bertha Nunez, Senior Director of Cardiovascular and Neurosciences Services. And we have Amy Trueblood, Chief Nursing Officer of OU Health Adult Services. All three of you are from OU Health. And uh, I want to thank you all for being here. As we talk about a Revolutionary Interprofessional Collaborative Care Delivery Model. This is Today in Nursing Leadership, a podcast from the American Organization for Nursing Leadership. I'm Bill Klaproth. Traci, Bertha, and Amy, thank you all for being here today. We appreciate it.

Amy Trueblood, MS, RN, NE-BC: Thank you for having us Bill. We're excited to be here.

Host: You bet. It's great to have you here and talk about your session, A Revolutionary Interprofessional Collaborative Care Delivery Model. Amy, let me start with you. So what is the compelling leadership issue or problem that your session addressed?

Amy Trueblood, MS, RN, NE-BC: Oh, thank you for that question, Bill. I think the, the compelling issue is the need to redesign inpatient care delivery for the elevation, satisfaction, wellbeing of the registered nurses, as well as for quality care to our patients and utilization of other healthcare professionals as a part of that as well. So, that is really the issue that we were addressing through this collaborative care delivery model.

Host: Well, thank you for that. And Bertha, then let me ask you, for a nurse leader that wants to learn from what you've done, what are important first steps to keep in mind? What should someone do?

Bertha Nunez, BSN, RN: Keep the patients at the center of everything. And truly collaborate with everyone, every discipline, every professional. Focus on what the patient's needs are, the goals trying to accomplish and then lean on your colleagues, the experts to work towards achieving those goals.

Host: Okay. So keep the patient and center.

Bertha Nunez, BSN, RN: Yes.

Host: When thinking about everything.

Bertha Nunez, BSN, RN: Correct. Yes. What do our patients need and how can we work together and meet the needs of the patients?

Host: Okay. So understanding that, knowing that, keeping the patient front and center, Amy, what tactics or initiatives you develop address this?

Amy Trueblood, MS, RN, NE-BC: The first, as Bertha was saying, is collaboration with colleagues. We know that we need to do something different than we've done in the past. And even just identifying, building a delivery model, a care delivery model for an inpatient specific patient population versus generalizing and taking one model and and trying to put it everywhere. Really it changes the key players that you are involved with. So our session focuses on a model we did in our neurosciences department. We had our neurosurgeons, we had our neuro physicians, our EVS, our phlebotomists, others, our quality department around looking at the patient needs of that department. The patients seen in that department, primarily stroke and craniotomy patients. And how is it that we build a model that matches their needs and utilizes care providers in a way that we haven't done that before. So, that initial collaboration in and of itself was an important tactic. And then we had how did we prepare the practitioners to function there, which I'll let Traci speak to how we did that from an education perspective.

Host: Yeah.

Traci Gibson, MSN, RN: Thank you, Amy. We really developed a robust education program to prepare all team members going into this. So, not only the nursing programs, RNs, LPNs CNAs. But also we were going to have direct care pharmacists, phlebotomists. And so we really developed an education program that would not only highlight what the role was and people practicing at the top of their scope, but also how they would practice together, how they would delegate and how they would come together and, and work across these scopes of practice that have a lot of overlap.

Host: And Bertha then what are, what have the results been from this? What have you learned? What, what has happened with this?

Bertha Nunez, BSN, RN: The results have been outstanding. We have been able to make a human connection with our patients and their families. We have been able to bring pharmacists to direct patient care, which I don't believe had been done before. We've been able to reduce readmissions. We haven't had any RN or CNA turnover. We have allowed for the LPNs to come and practice in an acute care setting, to the top of their licensure and truly grow in that manner.

Host: So metrics, so a wide range of metrics then.

Bertha Nunez, BSN, RN: Yes.

Host: Improvements and results. Well, that's, really impressive, from what you've done and Amy overall then as a nurse leader, what is the key takeaway to remember from what you've discovered and done?

Amy Trueblood, MS, RN, NE-BC: I think the key takeaway is change is possible with collaboration. We need to not be afraid. We need to be courageous to take on some issues that we know have been existent for a long time. To recognize that the solutions of the past are not going to get us to where we need to be in the future. And really help people understand and see that and then another piece of not waiting for perfection before. This model is still not perfect. The execution of it isn't to where we want it to be. But the idea and how it came to be, and the outcomes that we have seen are tremendous, and we know that we can only go further from there. So having the courage in yourself as a leader and your staff and the people around you, that when presented with an issue, people really can come up with creative solutions and it's time. We need to be doing something different across the country, as it relates to inpatient care and the role of the registered nurse.

Host: As a CNO, how important is it for other CNOs, like yourself to really look at this issue and, and take it head on, like you've done.

Amy Trueblood, MS, RN, NE-BC: Yeah, I think it's critically important. I mean, the, the inpatient work environment, we know it's not. not, the same as it used to be. It is not any longer pleasing to registered nurses for their own physical safety, for their own emotional wellbeing, for turnover, for different types of things. And just continuing to try to replace registered nurses into an environment and a care delivery model that needs to be changed, will continue to get us the outcomes that we're getting, and that is they're leaving the inpatient setting. And so I think it's critical that we work together within our organizations and at places like AONL to learn from each other and find new partnerships and collaborate to as to how we can do this cause this certainly isn't only an issue at the University of Oklahoma Medical Center. This is something that is widespread in the profession of nursing and our patients need us to do something different.

Host: Well, they have this saying proof is in the pudding and the, the results certainly proved that. So what you've learned and taken on certainly has made a difference. Congratulations to all of you. So as we wrap up, I'd like get final thoughts from each of you. As we talk about this revolutionary interprofessional collaborative care delivery model. Bertha, let me start with you. Final thoughts from you on this.

Bertha Nunez, BSN, RN: The final thought. It is important to have the right person in the right place. And not just with care providers, but also with leaders. And with your teams. To spark that desire to change and that willingness to come on the challenge and, and things, things have got to change for us to have different outcomes. So having the right, right people in the right place, is a key takeaway for me.

Host: That makes sense. So thank for sharing that. And Traci, how about you? Final thoughts?

Traci Gibson, MSN, RN: I think we need to have a broad understanding of how entrenched the current registered nurse role is. And, and how much lift it is to get them to think in a different way and to elevate their practice because it, it's not anything most people have seen before. Especially in this generation of nurses.

Host: Yeah, thank you for that. And Amy, let's wrap up with you. Final thoughts.

Amy Trueblood, MS, RN, NE-BC: I think we've covered pretty much all that, all that I would say. I think that again, the, the need for change is here. We have the right people, the right experiences and, and the right collaborators to get something done that's different. We already know what the issues are. And I think I just challenged my CNO colleagues and other leaders to look deeper. One of the principles of high reliability is a reluctance to simplify. And sometimes we look at our, our care models, or we look at the inpatient setting and we say, oh, this is just about staffing or the issues that we're seeing are because the RNs are burnt out. And it's, it's all of those things and more, and we need to find the and more, and be courageous enough to put solutions in place that maybe haven't been seen before. And at least see because our patients and our teams will be better off for it.

Host: Yeah. Find the and more. I like that. That's great. Well, Traci, Bertha and Amy, thank you so much for your time today. This has been great.

Amy Trueblood, MS, RN, NE-BC: Thank you for having us.

Traci Gibson, MSN, RN: Thank you.

Host: Great story. I'm, I'm glad you shared it with us. So thank you again. 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.