Bill Klaproth (Host): This episode is sponsored by Nuance, a Microsoft company. Explore a vision for nursing at nuance.com/nursing. This is a special episode of Today in Nursing Leadership, a podcast from the American Organization for Nursing Leadership, recorded live at the AONL 2024 conference. I'm Bill Klaproth as we talk about the Power of Human and Machine, Fuel for the Future Workforce. I love that title. With me is Adie Caldemone, Clinical Operations Manager at IU Health, Mandy Schultz, she is also a Clinical Operations Manager at IU Health, both with the System Resource Department.

And we also have Jonathan Helm. W.W. Granger, Inc. Faculty Fellow, Professor of Operations and Decision Technologies at Indiana University and Kelly School of Business. I want to welcome you all to our podcast booth here at AONL 2024. Adie, welcome.

Adie Caldemone, MSN, RN: Yeah thanks Bill, happy to be here.

Host: Absolutely. Mandy, same to you. Welcome.

Mandy Schultz, MSN, RN, CMNL: Thank you. Hey, good to see ya. Great to be here.

Host: Thank you so much. And Jonathan, great to see you.

Jonathan Helm: Thanks Bill. Great to see you as well.

Host: Yeah. This is going to be a great topic. I love this. The power of human and machine fuel for the future of workforce. I said earlier, I feel like Arnold Schwarzenegger is going to pop up. The Terminator, get in the chopper. So I love this title. I think it's cool. So Adie, tell us more about this title and this session and why you wanted to address more effective deployment of a resource float pool nurse.

Adie Caldemone, MSN, RN: Yeah, so I think to your point, the title we really created in hopes to attract people into our session. Which I think we had a great turnout. All together, just super excited for the opportunity to be here with other nursing leaders and kind of share the work that our team had, our team department has done this past year and really even back to COVID time and working out of pandemic time. So.

Host: Yeah, really interesting. So Mandy, tell us more about this. How did this whole thing get started? How did you put the building blocks in place?

Mandy Schultz, MSN, RN, CMNL: Yeah, absolutely. So, the exciting part is IU Health is really the largest organization of healthcare in the state of Indiana. And so fortunate for us, we have neighbors of Purdue University and Indiana University and the academia that are there, kind of the brains behind this project and the creativity around the technology piece of it.

And so, what we do know is we have 16 hospitals in our organization and there are times when one unit or one hospital has, has more than enough staff where another hospital is just like, give us some, we need help. And we, up until 2020, when we created this partnership with the universities, we didn't have a really good tool to predict where those needs were going to be and how we were going to do it.

So that really is the baseline of where this started back in 2020. What, like a week before the first COVID patient hit, right? And so that work was being done and then boom, COVID. So it created a little bit of a pivot. We like to say we did a lot of, we did more pivots in 2020 than the friends episode did.

Um, but I will say we had to get creative in looking at how do we put the right nurse at the right place at the right time. And that is the goal of this project and pilot.

Host: So COVID really forced you to ramp up on this thing.

Mandy Schultz, MSN, RN, CMNL: Sure, absolutely.

Host: You kind of got thrown into the fire with this whole Yeah, forced creativity at its best. Um, And what better way to get creative than to partner with academia as well as industry healthcare team, right? It doesn't happen all the time. So, we're very fortunate for that partnership to come into place and we're still leaning on it and it's getting even better. So, yeah.

And yeah, so Jonathan, let me ask you this, for somebody who wants to do the same thing you did or emulate what you have all done. What are some of the first steps to take? How do you get into this thing and start doing it?

Jonathan Helm: That's a great question, Bill I think what we have been able to do is unique in the fact that we have partnered between academia and a large health system. And that partnership gives us the opportunity to really explore beyond, for example, if you hire a consulting company, they come in, they have an idea what they want to do. They're not here to explore with you; they're here to deliver their solution.

And I think sort of reaching out to your big universities, figuring out who's doing the kind of work that you want to explore, is critical to being able to develop real innovation in terms of healthcare staffing and data driven healthcare delivery.

Host: So it's working together to come up with a better way to forecast staffing needs internally, if you will?

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Jonathan Helm: That's correct. Essentially what it's got two components to it. So we first, we forecast staffing needs out two weeks in advance. That allows us to create a system where we can move our nurses around with advanced notice. So you, one thing you don't want to do, you don't want to have to call up a nurse 12 hours, five hours in advance and say, Hey, by the way, you're not going to work at your home hospital. You're going to be traveling a hundred miles today. So it really, the analytics behind it is what allowed us to develop a program that is not only great for the system, but also works for our nurses.

Host: So did you partner with someone to come up with a solution for this forecasting?

Jonathan Helm: No, the two faculty, one from Purdue and myself, we're actually healthcare engineers. So we developed it ourselves. So the forecasting model is based on generative AI, which no one knew what it was until this little thing called ChatGPT. We did predate Chat GPT with our forecasting. And then we built an optimization model on top of it that creates smart recommendations about where to send our nurses to maximize the probability that we're going to be combating understaffing most effectively.

Host: Yeah, that's really interesting.

They're basically the Arnold Schwarzeneggers of technology, AI, yeah.

Get in the float pool. Yeah. I love it. So Jonathan then, so what are the key things to remember or to understand or key takeaways for a nurse leader to remember from what you all have done?

Jonathan Helm: I think some of the key takeaways are that this was definitely an interative process.

Jonathan Helm: There was a lot of get to know you, get to understand what are the kind of solutions that we as academics can deliver, what are the kind of solutions that the nursing leadership and the nursing organization needs. And we really, I mean, when we first kicked this off, we had a two day summit at IU Health where we brought in undergrads, masters, doctoral students, faculty, and they brought in their nursing leadership and floor nurses and whatnot.

And we all basically talked through the process together. So we could be all be on the same page and we could start brainstorming how do we develop a solution that's going to deliver what is both a sort of quality staffing solution for them and also deliver research products for us because we get, we, we get judged on how many papers we publish, how many awards we win. So we've also got to get our side of the, our side of the picture taken care of.

Host: So you got the stakeholders involved and then you really understood uh, everybody's on the same page as you said, but it, that took getting a two day kind of intensive workshop to really start this off. Is that right?

Jonathan Helm: Indeed, and another thing we did that I thought was kind of great for the collaboration and creating connections is IU Health hired a couple interns over the summer that were from our universities that we knew and we were able to use like sort of that created a nice bridge between the academic side and the hospital health system side that really made it much more efficient for us to work together, that kind of bridge.

Host: Yeah, that makes sense. And, Adie, what have the results been so far?

Adie Caldemone, MSN, RN: Yeah, definitely. So, the pilot did come with positive results in that were able to use the analytics that Jonathan and his team created, and then operationalize it with the nurses who were being redeployed outside of their region. So really saw results of decreasing shifts that were over or under staffed. There were cost savings initiatives with it. And then also, because of kind of the partnership and the marrying of the analytics to the actual role and job that the nurses were having to implement; that created satisfaction with them because the data was sending them and moving them outside of their comfort zone, their home hospital, to other hospitals statewide in a manner that made sense and they felt good about doing and supported and comfortable, so really having the analytics meet the needs of the role.

Host: Yeah, like Jonathan was saying, letting people know way ahead of time. Hey, you're going to be here instead of, Hey, guess what, tomorrow you're driving a hundred miles away. I can see where that's very beneficial right?

Adie Caldemone, MSN, RN: Yeah.

Jonathan Helm: And you know, Bill, I'd like to add to that. Um, I think one of the differences in partnering with academics like us is that I actually have spent my entire career working in healthcare organizations, working with healthcare organizations. If you get an analytics group coming in, they're not tied to the healthcare scene, they're often sports analytics or you know, marketing analytics, these kinds of things.

And so, I think that collaboration, it gave me a chance to learn and I was willing and excited to learn about how nursing really works at IU Health and how to use that knowledge of the operations itself to deliver the analytics that is going to be most useful in practice.

Mandy Schultz, MSN, RN, CMNL: I think at the end of the day, I would echo what Adie and Jonathan have both spoken to. Everybody wants to provide that best patient care, no matter where you are, right? So I think what this tool does is allows us to see where those needs are going to be, where our nurses are and how can we line them up to take best care of the patients in our health care system, which is the end goal, right? You want to provide that best patient care.

Jonathan Helm: And I'm going to put a little plug because my colleagues from IU Health are very humble here, but I'm going to say that our pilot, we had some incredible results. We were able to reduce understaffing by 17%. We were able to reduce overstaffing by 43%, and we created a system that we were able to measure and demonstrate that it was fair to the nurses participating in the program and to the hospitals participating in the program.

One other thing that I think really speaks to the efficiency of the program is that, after our pilot, we analyzed the data and we found that every one of our Delta nurses that is, flexible and moving between hospitals is worth approximately 1.6 non Delta nurses. So we're talking about 60 percent increase in efficiency in terms of reducing understaffing and overstaffing.

Host: So, it sounds like there's an ROI benefit to this as well.

Jonathan Helm: There's a huge ROI and we initially estimated the ROI based on premium pay and overstaffing you know paying for nurses that we didn't need and that comes out to about a 712,000 thousand dollars a year with just ten nurses and we think that that nursing program can grow much larger.

On the other hand, there was another benefit that we were hoping to see and we recently did see is a reduction in travel nursing hours. Travel nurses are so expensive and we're, we reduced over the last six months by about 7,300 hours of travel nursing due to this program, which is approximately 6.1 FTEs annually.

Host: That's amazing. Wow. It is exciting is exciting That is great. Well, thank you for bringing what y'all learned and what you put in place to AONL 2024. As we wrap up, I'd love to get final thoughts from each of you. Adie, anything you want to add?

Adie Caldemone, MSN, RN: I think it just makes me excited looking into the future of how analytics can be leveraged more to make our workforce more satisfied make their workloads more manageable really just provide an overall well being for our caretakers at bedside. So, super excited about that.

Host: Yeah, for sure. And Mandy, how about you? Final thoughts?

Mandy Schultz, MSN, RN, CMNL: Yeah, 100%. I think the importance of partnering with academia. Oftentimes we are in academics and then we move on when we, you know, are in our careers and that partnership between academia and industry is vital. It has to continue and I think this project is a perfect example of what can come when you come together.

Host: Yeah, sure. And when you're using, as we're now going to call it, HelmGPT.

Adie Caldemone, MSN, RN: Yeah.

Host: I'm kidding. Jonathan, final thoughts from you.

Jonathan Helm: Yeah, actually, I'd Yeah, I'd like to just give a shout out to Mary Drewes, who is the Chief Nursing Executive of Operations at IU Health. She's been our champion through this whole process. Like I said, it started in COVID. We've been together for a long time, and she has consistently supported the program and helped grow it and develop it.

And without her and the innovation that we see at IU Health. And for me, I've worked with hospitals, lots of hospitals, for a very long time, and I've never seen anyone be as innovative and as bold in taking these steps towards a better future than IU Health System, and a lot of that is thanks to Mary.

 Definitely.

Host: That's great that's a great shout out, Jonathan. Thank you for that. I want to thank you each for your time today. Thank you for stopping by our podcast booth.

Mandy Schultz, MSN, RN, CMNL: Thanks, Bill, it's been fun.

Host: You bet. Once again, we have Adie Caldemon, we have Mandy Schultz and Jonathan Helm. Thank you again.

And thanks to Nuance, a Microsoft company for sponsoring this podcast. 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, just like this one, at aonl.org. This is Today in Nursing Leadership. Thanks for listening.