Summary In this episode of the Elevate Care podcast, host Nishan Sivathasan sits down with Paola Buitrago, Vice President of Workforce Optimization at Emory Healthcare, to explore the future of clinical workforce management. Emory Healthcare is taking a bold approach to retention and operations by placing culture and staff well-being at the center of their strategy. Paola discusses the shift from recruitment to retention, highlighting Emory’s “North Star” of culture and leadership development. She shares insights on co-creating solutions with frontline staff, implementing technology that brings the “human closer to the human,” and the importance of diversifying staffing models to offer clinicians a menu of career options.
Summary
In this episode of the Elevate Care podcast, host Nishan Sivathasan sits down with Paola Buitrago, Vice President of Workforce Optimization at Emory Healthcare, to explore the future of clinical workforce management. Emory Healthcare is taking a bold approach to retention and operations by placing culture and staff well-being at the center of their strategy.
Paola discusses the shift from recruitment to retention, highlighting Emory’s “North Star” of culture and leadership development. She shares insights on co-creating solutions with frontline staff, implementing technology that brings the “human closer to the human,” and the importance of diversifying staffing models to offer clinicians a menu of career options.
About Paola Buitrago
Paola Buitrago serves as the Vice President of Workforce Optimization at Emory Healthcare, where she oversees workforce contingency strategy, float teams, staffing, and nursing analytics. Her career journey began with unique roles in sickle cell research and global health at the Carter Center while in nursing school, providing her with a broad perspective on healthcare operations. With over 20 years of leadership experience and a PhD in Industrial and Organizational Psychology, Paola is passionate about designing systems that support frontline personnel and improve patient outcomes through operational excellence.
Chapters
00:00 – Introduction
01:07 – Paola’s Journey: Research to Leadership
05:07 – Prioritizing Retention and Culture
07:54 – Redesigning Work with Technology
10:34 – Co-Creating with the Frontline
11:50 – Navigating Change through Leadership
17:50 – Workforce Diversification & Upskilling
25:20 – A Human-Centric Approach to AI
00:00:00.440 — 00:00:19.960 · Speaker 1
Welcome to the Elevate Care podcast. The show where health care professionals, visionaries and thought leaders come together to explore the limitless possibilities of healthcare innovation. I'm the chance of your host for today's episode with Paola Buitrago, vice president, Workforce Optimization at Emory Healthcare.
Well, welcome to the show.
00:00:20.120 — 00:00:26.320 · Speaker 2
Thank you so much. Thank you and your team for having me here. I'm excited about our conversation.
00:00:26.360 — 00:00:32.720 · Speaker 1
Me too. I'm glad to have you here. I know you run workforce optimization at Emory. You want to tell us a little bit about that?
00:00:32.759 — 00:00:57.240 · Speaker 2
Sure. So I've been at Emory for a little bit over two years, and I am responsible for our workforce contingency strategy and optimization. So we have contract labor, all of our float teams. We have our staffing and scheduling office, as well as data analytics and budgeting for our nursing enterprise.
00:00:57.280 — 00:01:07.600 · Speaker 1
Okay. Wow. It's a much, much larger scope than I anticipated, but very exciting to. I'm sure you want to share with our listeners a little bit about your journey, how you started off your career to sort of lead to where you are today.
00:01:07.640 — 00:04:33.490 · Speaker 2
Sure. I'll be happy to. So my professional journey actually started at Emory University Hospital. Okay. I was in nursing school at that time at Emory University, and I had two jobs, which are really when I think about this now, I think they were some of the most forming jobs I ever had. So one of them, I was a biologist and I worked at the research floor.
We called it the research floor. We were doing sickle cell anemia research, and it was incredible because not only was I able to do research, I was able to interact with the patients. So it taught me a lot about what the pets do today. Right. Vital signs, that type of interaction. I was in nursing school, but I wasn't allowed to do a lot of the things.
So, um. It was about three times a week. I was back in the research lab, and the other two days I was with patients. So actually seeing what our research was doing for these patients. And I don't know if you know anything about sickle cell anemia, but this is a very chronic illness that, eh, that affects a lot of our population down in the South.
So it was, um, truly an incredible experience. And then the second job I had was at the Carter Center and completely different experience, but it was really incredible. Um, I learned a lot about all of the geopolitical, um, complexity that exists in global health, in preventive medicine, in diplomacy.
I was lucky enough to meet President Carter and his wife. Oh, wow. Yeah. This was. And, of course, all of this was over 20 years ago. Okay. So the work environment, the health care space was in a very, very different environment. And so that was really, really neat. Um, I served as a translator for many of their conferences.
I helped them with organizing a lot of their operations in terms of global health initiatives, preventive health. So in the meantime, I was, you know, I held this two jobs while I was in nursing school, and I was having all kinds of experiences before I even graduated. So extremely forming, like I said at the beginning.
So from there, I graduated nursing school and went to a completely different health care system in Georgia and another amazing health care system. And that's where I held, um, a lots of different leadership and operations roles throughout the last 20 years. And. During that time, I really found my passion in overseeing systems so that our frontline.
Personnel can really work with with a lot of our support. So I went through a master's program and eventually a PhD in industrial and organizational psychology, and I left that healthcare system where I was about 20 years and went to Emory. Um, like I said, two and a half years ago.
00:04:33.530 — 00:05:07.570 · Speaker 1
Wow. That's terrific. So just a good wide breadth of experiences that, you know, engaging with the patients directly, the clinical research piece and just operations in, I guess that translates very nicely and cleanly to what you're doing today. So talk to me. I think workforce is certainly be at the forefront, top of mind for a lot of health care systems out there.
And I think Emory in particular has been, I would say, at the front of the curve in terms of how you thought about things. Can you share, care to share with our listeners some of your strategies or thought processes that go into how you run the operations today?
00:05:07.610 — 00:07:05.130 · Speaker 2
Sure. Sure. So we've been very lucky to have been in a journey due to some leadership changes. At Emory Healthcare, we have a wonderful CEO, doctor Lee and a wonderful Chro, ROK Anderson, that has really, um, helped us navigate through this very, very difficult workforce environment. And two of the things that we have been really concentrated on are one is our compensation structure.
So we really want it to be a place where people came but felt very comfortable with their compensation structure. So we have invested millions of dollars into our front line to kind of have that as a basis. Right. Uh, if you think of Maslow's, uh, pyramid. We meet that first. And so we exactly we've invested in that significantly.
And then number two we're really focusing on retention. And of course that brings a multifaceted approach. Right. We want to make sure we have the right people at the right place doing the right type of job, especially the job that they want to be doing. So we are concentrated on engagement surveys and really looking at trust, at leadership, at physical safety.
Right. 20 years ago, I didn't have to deal with the safety issues that our frontline has to deal with today. So we've invested in physical safety. Um, we have a wonderful wellness program that focuses on psychological safety and all of that to really and truly focus on retention. So that's basically our North Star.
We we want to move away from just thinking about recruitment and really focus on retention.
00:07:05.170 — 00:07:53.890 · Speaker 1
Okay. No. Terrific. So a lot of a lot of focus on just security and safety is kind of what I'm hearing. Yeah. And so number one is how you take care of me in terms of my financial needs. Um, and then two, from a retention engagement standpoint, what's important to me, what do I need? And then how do you build and construct an environment that's conducive for that for your staff?
Exactly correct. Terrific. Um, so talk to me about how you think about workforce more broadly. So I was talking to somebody earlier today, and they were telling me that when you think about the clinical workforce in general, not much has changed over the last 70 years. And so now, especially coming out of the Covid, you hear about telehealth, virtual care solutions and things of that sort.
There's also different ways to run and optimize your workforces, too. Right. With the mix of core, if there's contingent, there's internal labor, there's external. Just how do you think about and navigate all that?
00:07:54.570 — 00:08:12.690 · Speaker 2
That's a great question, and one that we're thinking about on a daily basis. Right. Because that's that's a great point, is that we are today redesigning for the future. Right. We have stopped thinking about the past. So we've come from a very tech,
00:08:14.170 — 00:10:19.220 · Speaker 2
um, kind of tech has helped the front lines, but it has kept us away from the bad side. Right. Um, our frontline spends more time documenting than really interacting with patients. So it's almost like technology has been sort of a burden. And now we're moving into a space where technology might actually help us get closer to the patient.
So we're trying to think about that work environment and how to redesign it in a way where it takes the frontline staff back into actual patient care, and that's going to help us, you know. Virtual nursing. We have implemented a virtual nursing model that helps us with admissions and discharges. We're looking into ambient listening.
We've done a couple of pilots, but not only with physicians. We have now included nursing. So that think about a nurse getting into a patient's room. And instead of being in front of a computer documenting everything she has done or will do, she's actually having a conversation with the patient. And ambient listening is taking care of the documentation.
So we're doing a lot of experimenting. We really want to be at the front of this. We don't want to be told, what's the new greatest thing? Um, Emory is really good at, um, doing research, being innovative and listening to the frontline. Right? Um, they're not just sitting there waiting for us to tell us what to do.
They are, um, really wanting to be part of the change. So we're we're really looking at several different things that can ultimately aid the frontline clinicians in spending more time with the patient. So to then hopefully increase, improve patient outcomes.
00:10:19.260 — 00:10:34.660 · Speaker 1
Yeah. What I'm hearing from you a lot is a lot of focus on listening and empathy and patient outcomes. So how, if at all, do you co-create some of these workforce strategies with your clinical workforce? Just how much say do they have in it? And just what's that feedback loop or process look like for you?
00:10:34.700 — 00:11:23.060 · Speaker 2
So for us it's really part of the culture. Okay. Emory is a magnet facility. Most of our hospitals have been magnet designated, so it is part of our culture to listen to involve professional, government, governance and anything we're doing. We are including the front line. It actually most of the ideas have come from them.
Oh, terrific. And so that's that's really it's kind of like our North Star in terms of what type of organization we want to be. And like the engagement surveys I was talking about, we do them frequently. We don't just do them once a year. And that is the premises. Our intention is that we are here co-creating the work environment with them.
00:11:23.140 — 00:11:50.340 · Speaker 1
No, I love that you focus so much on the engagement survey because at the end of the day, it's about engagement plus outcomes. If you haven't got outcomes in new engagement, it's not sustainable, right? If you have engagement, new outcomes, you're just having a party that's going to run out. So. Right.
Um, it's really important that you focus on on doing both. But as you're leading your system through so much change, how do you strike the right balance of leading and guiding your teams through change, through the constant evolution of how you think about workforce and how work gets done?
00:11:50.540 — 00:12:46.860 · Speaker 2
Mhm. I think you know what really matters is that North Star, which is our culture, right? Because we have accepted, we have all accepted that we're going to go through more and more periods of change. And so to do that, we all know that no one follows a process during crisis, right? We all follow a leader so that leadership development is crucial to us.
So I would say three things. Leadership development, our culture which is our North star. And then making sure that you're closing the loop right through those listening sessions. It's not a one time done deal. It's a truly a listening session on a day to day basis. You know, I'll be curious to know how some of your other partners are dealing through this change.
00:12:47.100 — 00:13:35.420 · Speaker 1
Yeah, I think it's different for everybody. Right? They're all at different sizes and scales and points of their journey. You have your larger systems that have significant capital. They're willing to make heavier investments, be it in technology, in their workforce. And then you have others that need to be a little bit more nimble.
And so they're trying to use solutions such as virtual care as a way to extend their clinician's time in the workforce. So they're finding it's a way to actually alleviate burnout. And so it might be, hey, Monday, Tuesday you're by the bedside. Maybe Wednesday or Thursday you're virtual. And then Friday is an option sort of day.
So I think it's different for each one. I think one of the things I really love and appreciate about healthcare is when one system solves it. You all are so great about sharing it with everybody else, right? And it's something that's very unique and special about the healthcare space, but that I've found to be very, very interesting.
00:13:35.900 — 00:13:53.750 · Speaker 2
That's so true. We we really manage expectations with best practices and share and trial them out because you you're right. We can all be very different and be at very different points at certain times. But best practices work out everywhere?
00:13:53.790 — 00:14:26.390 · Speaker 1
Absolutely. So when you think about technology that you use for your teams and you said it earlier, best I think like there's a there's a piece where when you use technology, sometimes it creates more work than it actually solves. And so as you go through selection criteria for different technology vendors you choose to work with across the system.
Is there a set of criteria or are there things that certain technology vendors do that really stand out to you in your teams? Maybe it's about listening to your staff and solving for your needs, versus sort of what they're able to do out of a box, right.
00:14:26.430 — 00:16:22.270 · Speaker 2
And that's another great question that we were just talking about with one of your team members. And I would say that the number one thing we think about and look at when we are having a conversation about any sort of technology or tool that we're bringing into the health care system, is one. Did you have Frontline People co-creator develop this tool or technology.
Right. Were we part of that process? And number two is are you bringing in efficiency? Are you removing friction. Right. Or do we have a tool that we now have to work with another tool and increase that amount of really inefficiency for the team member. So we're always thinking back at the end user and was that end user involved?
Was their world reviewed? Right. Because you would be shocked and surprised that we hear about all sorts of technology companies. Now, AI created companies that have never worked in a healthcare environment. Right. That just want to translate technology into healthcare. And I know that a lot of industries think that we say we're so different.
But the fact is, is we are we are dealing with humans and we are caring for patients. So we are different and our involvement is crucial in that step. So we're always thinking about how involved was the front line. And then are we actually going to make this efficient for the front line. Otherwise we'll go back into the EMR mess that we have all encountered, which is we placed physicians and nurses, you know, back into a technology space where they are really away from the patient because they're documenting.
00:16:22.310 — 00:17:30.310 · Speaker 1
It creates a disconnection. It's actually interesting. Um, so before I joined am, uh, every other interesting I've been a part of has not been health care, but my wife's a physician, and she would spend hours in her EMR system. And I would tell her, over here I was like, you're doing something wrong. There's no reason somebody should spend that much time in there, right?
And then after a couple of years here, I was like, okay, I get it right to your point. There are nuances to the space. There are differences in, you know, having a clinical mindset or at least appreciating the clinical process and infusing that into the technology solution that's built actually yields a very different outcome that can be very powerful.
So one system in particular, they were cross training clinicians with technologist. So specifically we talked about virtual care solutions. They actually taught nurses about concepts such as packet loss. Mhm. And so now that the nurse understood that they were actually able to contribute to the new solution in a very unique and interesting special way.
Right. So it's almost like how do you understand a broader piece of the entire system and process. And that allows you to bring your perspective in a way that unique and different to solve for, you know, a key outcome.
00:17:30.350 — 00:17:31.190 · Speaker 2
Right.
00:17:31.390 — 00:17:50.510 · Speaker 1
So let's talk about workforce back up there a little bit. Just given kind of that your key area of focus today. Um, so it sounds like you've been through a lot of change in transformation with your core staff as you think about where you are today at Emory in your journey. What do you anticipate as being next for your system to unlock further gains or efficiencies.
00:17:50.790 — 00:19:59.080 · Speaker 2
So we've been on a journey to really diversify. Right. If you if you think about our workforce staffing sources as a pyramid. Right. And our core being that that really larger part of the pyramid, um, we wanted to ensure that the contingency part is not only the lesser of the percentage, but it's also diversified.
So we we did a really nice job increasing the amount of float staff, people that Emery hires into full time positions. So they are truly Emery employees but work in a contingency type of space. Um, we have over 690 at this point. Wow. And they're not only nurses, they're surgical techs, respiratory therapists, um, all kinds of frontline team members that are now Part of that diversification of the pyramid.
So we continue to look at it from that perspective. How diverse are we? Do we have all sorts of skill sets right. Do we have all sorts of FTE counts full time, PRN part time? We look at everything in terms of workforce as how diverse can I be in this space? Because it's really almost a menu of options for the clinician.
You know, I can truly be wherever I want to be. I can work wherever I want to work, I can work the hours I want to work. And then we are really focusing on upskilling. So I'm an Ed nurse that has, you know, always wanted to be an EDI nurse. How will you get me to the EDI? And so we've made it really easy and seamless for the clinicians to be upskill to another role or skill set, which has made it really, really valuable for our organization because it really reduces the dependency on anything coming from the outside.
00:19:59.120 — 00:20:22.360 · Speaker 1
Sure. Now it's almost like you have a concept, a total career. So it's almost like you want to take the nerf from the minute they graduate all the way up until retirement. Right? And is their journey or life changes, you know, what are the different solutions or options you have for them to still make it, you know, work, meaningful and relevant while they can also participate in whatever it is that's important to them personally.
Is that sound.
00:20:22.360 — 00:21:37.480 · Speaker 2
Fair? It's exactly right, because if you think about it, we all have those experiences and those moments in life where where whatever we're doing is not working. Why do you have to leave that organization? Emory healthcare is the type of organization that makes it easy for you to stay, and that means that we will invest in you, right?
Becoming a needy nurse is not easy. It's highly specialized. And then for us to train you and develop you into an ICU nurse, that's a that's a very heavy lift. But we do it because we want you to be where you want to be. We want you to have the type of work and role that's joyful and meaningful in your life. And we are invested in each of our team members.
That's the only thing that matters to us, really. Um, not what you want to do in two years or three years, so long gone is that notion that we are afraid of losing people from our specific department. We want to see them grow. And if it's not here, if it is at another OU, at another facility, we want to see that process happen.
00:21:37.640 — 00:22:09.760 · Speaker 1
Wow. Your your commitment to your workforce just goes beyond some of those core based security features. But it's more of a partnership, right? We're in this together. It's kind of what I'm hearing from you, and you're almost bringing down the walls. A traditional thinking of work which was contingent perm to.
There's this concept of workforce liquidity, right. Here's your skill set. Here's what you're able to do. Here's the work that needs to get done. How do we structure things to give you that flexibility. And it's almost like you take on that complexity to figure out how to make it work. Is that.
00:22:09.760 — 00:22:53.720 · Speaker 2
That's it. That's 100% you you can have set it any better. Our role is to be that system orchestrator. Right. So I have to orchestrate with HR finance. Where are the FTEs coming from. Right. But the ultimate scenario is to make sure that we have a clinician that is looking forward to going to work, wherever that is, at whatever time in their life and Ultimately is going to give better care, and the patient is going to receive better care and have better outcomes overall.
00:22:54.040 — 00:23:30.800 · Speaker 1
Yeah, that's the secret. There's an old model, the service profit chain, which is, you know, happy team members, creates happy clients in your case patients, you know, which leads to long term sustainable, you know, system. So take care of your people. That's where it all starts. All right. You talked about culture being your Northstar.
Yeah it's all the comp piece. And then it's really engagement and commitment. It's pretty special. And then you're taking on all that complexity. It's almost like the equivalent of an Apple product right. So it's very simple and easy to use, which is likely what your workforce feels. But it's actually really complex.
If you dig in there and, you know, untangle that there's a lot going on. So it's pretty special. Congratulations to you.
00:23:30.840 — 00:24:50.640 · Speaker 2
Thank you. Thank you. And you make a great point in terms of systems in general. Right? I saw it as a researcher, you know, when I was dealing with data slides and, and all of the things I was doing in the lab when those didn't translate to the patient I took care of the next day. It was almost a it was almost like everything I had done in the lab was for nothing.
And it's because our systems didn't work right. It happened at the Carter Center. Sure, you can have the best of intentions at a global scale, but if the geopolitical complexity is higher than what you're trying to do within the system, then it ends up not working. And I saw it as a clinician, right. We would have really chaotic shifts where you just you literally you would I would stop in the middle of the hallway and you're thinking, how am I going to get out of this?
And so I think all we're trying to do is to support that clinician in terms of what's happening around them so that they don't feel that burden and and all of that responsibility going to just one person.
00:24:50.680 — 00:25:20.000 · Speaker 1
Yeah. That's pretty pretty special. So you mentioned AI earlier. Technology is always innovating. It never stops. And sometimes it's helpful and sometimes it's I'll say messy. Mhm. Um but what would you see is next. Right. So there's a lot of talk and discussion about AI optimizing workforces. Um, and I know health systems are under tremendous financial pressure in today's environment.
So how do you all navigate sort of the current day. And then you know, think about what's next and sort of the new technologies that are emerging.
00:25:20.040 — 00:27:08.690 · Speaker 2
Um, so Emory is an academic health care system, extremely innovative, research based, and we are looking at the future in a very optimistic way. Um, number one, one of our culture Northstar priorities is that we want to lead change. We want to be part of that change. So we're not just receivers, you know.
We're not just going to be the consumers. We want to be those creators. And so a lot of this is happening at the university level, within our digital space, within healthcare. This is why we're piloting ambient listening with our nurses, so very optimistic about the future. And really we talk about this all the time.
Our CNA doctor Pappas, always reminds us that, um, truthfully, anything we look at on a daily basis regarding AI, any sort of technology has to have the answer to the question around how will the human right be closer to the human? Oh, wow. Right. How will we move from how will this technology or AI put us back closer to the human?
And what is that value proposition if we cannot answer that? very comfortable. If we cannot answer that quickly, then. Then we are asked to step back. But number one is how do we decrease the burden of the front line? How do we create efficiency, but not just for efficiency sake, but to answer the question, how will the human get closer to the human?
00:27:08.770 — 00:27:11.610 · Speaker 1
Know all that. Lead with the touch, not touched.
00:27:11.650 — 00:27:12.330 · Speaker 2
Yes.
00:27:12.570 — 00:27:19.290 · Speaker 1
Well, terrific. Well, I appreciate you stopping by today. Paula, this is a great conversation and I'm sure our listeners benefited greatly.
00:27:19.410 — 00:27:22.770 · Speaker 2
Thank you. Thank you again. This has been lovely.
00:27:22.930 — 00:27:44.050 · Speaker 3
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