Bill Klaproth (Host): This podcast is brought to you by B Braun medical, Inc. B Braun is a leader in smart infusion therapy and safe and effective pharmacy products. Patient and provider safety and sustainable health solutions. Our purpose is to help providers constantly improve patient satisfaction and outcomes to learn more visit Braun usa.com.

This is a special AONL Podcast as we speak with session presenters from the AONL 2023 Conference. With me is Katie Boston-Leary from the American Nurses association, and we're going to talk about Nurse Leaders Building Partnerships to Transform Healthcare.

Host: This is Today in Nursing Leadership, a podcast from the American Organization for Nursing Leadership. I'm Bill Klaproth. Katie, welcome.

Katie Boston-Leary: Thank you. Thank you for having me.

Host: You bet. Great to see you. I hear they call you KBL, that's your name.

Katie Boston-Leary: Yeah, that kind of stuck. Someone actually left a note on my desk, said KBL means kicking butt and loving it.

Host: All right, KBL. Well, it's great to have you here. So, we're here at AONL 2023. And of course, our theme is Inspiring leaders. So as a nurse executive and leader who has inspired others, what keeps you motivated to keep raising the bar during these transformational times?

Katie Boston-Leary: Yeah, that's a great question. And first of all, thank you for saying that I'm inspiring others. I hope that's what I'm doing. So when you get that feedback, I don't lose sight of that. But part of it has to do with the fact that I'm inspired myself, right? I see so many things that are happening during a very difficult time, nurses doing amazing things, leaders really taking the charge and leading valiantly, not just in healthcare, just around the world. So, I get an inspiration from so many different sources, and that's what helps me inspire others, I guess.

And the other part is I really do believe that we have to raise the bar because the standard of excellence needs to improve and a number of things. There are a number of things that we took for granted that we'd done for years, that's not okay anymore. So, we have to continually raise the bar of the standard of excellence, and that's where I am and that's how I continue to push myself.

Host: I love that. So, you have to be inspired to be inspiring. So, that's great. And you're right, we do have to raise the bar. So, let me ask you about that raising of the bar, how can nurse leaders do that? How can they create valuable partnerships that will drive innovation and change, which hopefully will raise the bar? So when we talk about that raising of the bar and innovation, what does innovation in healthcare mean to you?

Katie Boston-Leary: Yeah, I think it does require stepping outside of your comfort zone. There's sayings that leadership is outside of your comfort zone. So, there are a number of things that we have to do in a way that we've never done before. Innovation comes also when you feel safe psychologically and emotionally. And we have to create environments that breed that, that makes it fertile for folks to feel safe to innovate. And innovate doesn't necessarily have to mean doing something new. It could also mean taking away things that don't make sense anymore. And we have a lot of waste in healthcare, we certainly have a lot of waste in nursing, and that's where the opportunity lies.

I've heard words of de-innovation and de-implementation. Not big fans of those words, but the meaning behind them is what I'm totally behind. And we have to look at making things make sense and making things simpler. There's a lot of things that we've done over the years that's gotten away from us, and we have to get back to the basics of what we are, why we do what we do, and how we want to contribute to the world in terms of how we deliver care to communities and people that we serve.

Host: Yeah, that's very well said. And I like what you said, also making things simpler as well and having things make sense. I like how you said that. So when we try to adopt more innovative or change things with innovative ways of doing things, how do we do that? It's great to have these ideas of, "Here, I think we should do this." how do you get things done? How do you implement these things?

Katie Boston-Leary: Yeah, that's the tough part, because almost anyone has an idea. But those ideas almost never come to fruition because it just remains an idea. So, that's why it's important for people to feel that ideas are welcome. It creates structure around harnessing those ideas. Put our money and our time and our resources where our mouths are, and support those ideas by providing the resources to make those ideas come alive as long as there's a justification for it. And a lot of work is done to vet those ideas because of a lot of other dynamics that play out where we work. It may be someone that's in a power position that has an idea, but it may not be the dead best idea.

And one of the things I learned as a leader is that sometimes my mouth and what I say makes work for other people. So, I'm very mindful of the fact that an idea that I may have may be creating work and burden for others. So, we have to think along those lines as well. And once you create structure and a system for people to bring their ideas to the table and create a system where you can support ideas, then that's the environment that we want, right? That is what creates a healthy work environment where people feel valued and they feel as if they matter. I always talk about mattering as a concept. And it really means adding value and knowing that you are adding value. And that's what's missing in a lot of organizations where people perform and work, particularly in nurses.

Host: So, I think that as well said. You mentioned making things make more sense, making things simpler, and not creating work just for the reason of creating work. That's just a waste of time. So, this podcast is being sponsored by B. Braun Medical. They are transitioning their entire clinical organization to bring more value to healthcare staff and workers. So, let me ask you this, what should B. Braun and other organizations be thinking about in how to bring more value to nurse leaders during the clinical moments that matter most to them?

Katie Boston-Leary: I think it's pretty open right now and I do believe that nurse leaders and organizations where care is delivered, they're more open than in the past to organizations like B. Braun Medical. In the past, particularly over the past few years, the adage has been vendors are the enemy and treat them as such because they only want to sell you something. But there are organizations like B. Braun that I've worked with that really are all about mission, and they want to make a difference.

So, there are so many great stories about these types of partnerships. I just read about something amazing is happening in Wisconsin where nurse apprenticeship has been started and it really engages an EHR organization, an institution of learning and an institution where care is delivered. Those are the types of partnerships that we want and that's what's needed right now because we know that the task is heavy and the urgency to get things done is yesterday.

So, we have to leverage every opportunity that we have to help move things in a direction that it needs to, because the numbers don't look so good in healthcare or in a nursing profession, so where we can get help, where it's appropriate, where you have organizations that are willing to support, really because they believe in it. Because as much as we all are deliverers of care, we're consumers too. We all participate in this industry a number of different ways. And you can be a consumer at any minute. You could be healthy one day and all of a sudden suffer a fall, or your loved one can certainly need services in an instant, all of a sudden you're on the other side. So, I do believe that there is a willingness more than ever for organizations particularly like B. Braun to engage. And as leaders, we need to open our arms and listen and see how we can partner better.

Host: So, you mentioned B. Braun Medical, you said they want to make a difference. So, let me ask you this, how has B. Braun or other organizations partnered with you?

Katie Boston-Leary: Oh, I can tell you about two things. I was able to work with B. Braun Medical on curriculum development for peripheral IV care to improve that type of care in healthcare. And that is one of those mundane tasks that people say. You know, compared to all the things that happen when you're hospitalized, this is one of those little things that happen during your stay, but not so much. And there's so much data that indicates that there's so much improvement that's required there, particularly given the amount of devices that are sold for peripheral IVs and the number of IVs that are inserted in patients during their stay, some because of failures with that type of care. So, that's one.

And the other that I'll talk about, which I'm really excited about, is I'm partnering with AVA and B. Braun on doing research on how there's a possibility, even though there's history that dictates this, but we're doing research on this, that it's likely that people with darker skin tones are receiving less and optimal care when it comes to peripheral IV care, particularly with insertions, because of course the elimination and all those other pieces that happen. And I've had experiences too as a patient where because of my skin color and the lack of visibility with my veins when I have an IV that needs to be started, it's a fishing expedition. I have to suffer until they hit a vein. And there seems to be a lack of tolerance for me to complain when I'm suffering from pain, especially since I'm a nurse myself. So, that is something I'm really excited about because I think it could set the course for how we should deliver care differently and be culturally humble with how we deliver care to people of all shades, particularly all races and also all ethnic backgrounds.

Host: So, B. Braun seems to be sensitive to this, and they're providing innovative value added programs and services to address alarm fatigue and excess needlesticks caused by poor IV technique. So if you were to design a perfect model collaborating with the industry, what would that look like for you?

Katie Boston-Leary: Ooh, I do think with addressing our pipeline issues with nursing, I think that is a great opportunity that organizations, particularly in industry, can really lean in. They have not been in this space before. We have not seen them in this space before, so there might be a reluctance. But because of the pinch point that we have in our pipelines, I really do think that industry private and public partnership is the way to go for us to move forward. And it can come in a number of different ways. We can start small or start in a larger scale, but I really do think with pipelines addressing how we can get more nurses in the profession or aspiring nurses in the profession is where there's great opportunity for industry.

Host: And then also, how should nursing leaders create valuable partnerships that drive innovation and change in healthcare?

Katie Boston-Leary: So, I'll tell you my story. I was a chief nursing officer at a hospital in the rural part of Maryland, I think it was in 2018. And I had a small pediatric unit. It was only six beds and I could not retain a lot of my nurses because there was a large children's hospital about 20 minutes away while I lose a lot of my nurses too. So, I became the training ground for that hospital. Whenever they got their experience, they would leave.

So, after a number of rounds of the cycle of, "Oh, we are down two or three nurses. Where are we gonna get some more nurses? Can't get them. What are we going to do? We have to cover the unit. Now, we're going to close beds," I realized that I could call on my own the CNO of that large children's hospital and figure out how I could partner with her on how we could be stronger together, whereas she could help me because I was a training ground for her nurses, obviously.

Host: You were the minor league team.

Katie Boston-Leary: Exactly. And she was a major, to use your analogy. So, I felt that this was an opportunity for me to partner with her. We had never worked together, never knew who I was. And I boldly called her one day and it was out of frustration, but it was also out of hope. And she answered the call and I didn't have the idea of what this was going to look like. I just said, "I just think that we can figure this out together," and that started a number of conversations. I'm still friends with her today. And we created a master services agreement where she actually employed all of my nurses in my small hospital. We named that pediatric unit after the brand for her children's hospital, which had brand recognition and that became a marriage made in heaven and it became a huge community event where the community came and we had a ribbon-cutting and everything. So, those are the types of innovations we have to do and partner with people who were supposedly deemed to be competition. I learned that there's a word called coopetition that we need to embrace more.

Host: Coopetition. I like

it.

Katie Boston-Leary: Where, you know, you keep an eye on your competition, but at the same time, you partner with them, right? And it's to that old adage like, you know, if you can't beat them, join them. So, I do think that that's where the opportunity lies for us to think about where we are struggling, who could we engage. And it doesn't have to be in healthcare. It could be even outside. I remember we had a program with AT&T to monitor congestive health failure patients with telemonitoring years ago. Who would've thought partnering with AT&T would've been such a positive? But those are the things that we need to do.

Host: That's innovative.

Katie Boston-Leary: Completely, because they can fill in our gaps, so where we fall short. We can engage organizations like that to help close those gaps for us to deliver the care that we want, particularly in the post-acute realm.

Host: That's how you drive innovation and change. That's a great story.

Katie Boston-Leary: Completely. Thank you.

Host: Thank you for sharing that. That's really a great story. So Katie, I want to thank you so much for your time. This has really been interesting and you've been a wealth of knowledge. What other things would you like to share with us when we're talking about building partnerships to transform healthcare?

Katie Boston-Leary: Yeah, I think it's just time for us to think differently. I think there also should be an acknowledgement that there's not a lot of patience to wait another four or five years for us to figure this out. A lot of us have been doing this for a long time and people that depend on us say, "You haven't figured this out yet and you're still trying to figure it out?" So, there is some grace that needs to be afforded as well to us that are still figuring it out. But for us that are figuring it out, we have to get to a real sense of urgency. Not to know that this is something we need to fix now, but actually do the work because, We can do hard things and it could be that elevation to doing some of those things that we've never done before and going in places we've never been before. We may lose some friends, but I do believe we'll gain some new ones that will help propel us move even further.

Host: We can figure it out. As you said, think differently. Don't wait.

Katie Boston-Leary: Don't wait.

Host: Wow. This has really been great. Katie, thank you so much for your time. I appreciate it.

Katie Boston-Leary: Thank you.

Host: Once again, that's Katie Boston-Leary or KBL as she's known.

Katie Boston-Leary: Kicking butt and loving it.

Host: Kicking butt and loving it. 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.