In this episode of the Elevate Care podcast, Nishan Sivathasan sits down with Eric Wallis, Senior Vice President and System Chief Nursing Officer at Henry Ford Health, to discuss the changes happening in acute care. Henry Ford Health is leading the way by reimagining how care is delivered. Eric dives into the successful implementation of a virtual care model designed to support bedside nurses, reduce burnout, and improve patient outcomes. He shares insights on navigating the change management process, the vital role of listening to frontline staff, and the exciting future of AI in healthcare.
In this episode of the Elevate Care podcast, Nishan Sivathasan sits down with Eric Wallis, Senior Vice President and System Chief Nursing Officer at Henry Ford Health, to discuss the changes happening in acute care. Henry Ford Health is leading the way by reimagining how care is delivered.
Eric dives into the successful implementation of a virtual care model designed to support bedside nurses, reduce burnout, and improve patient outcomes. He shares insights on navigating the change management process, the vital role of listening to frontline staff, and the exciting future of AI in healthcare.
About Eric Wallis
Eric Wallis, DNP, MSA, RN, NE-BC, FACHE, was appointed Senior Vice President and System Chief Nursing Officer in December 2021, bringing over 20 years of nursing and healthcare leadership experience. His career began as a bedside nurse and progressed through roles of increasing responsibility in both large academic medical centers and community hospitals, including serving as the President of Henry Ford West Bloomfield Hospital. A transformational leader passionate about improving healthcare delivery, Eric holds degrees from Bowling Green State University, Central Michigan University, and Texas Christian University. He is a fellow of the American College of Healthcare Executives, is certified as a Nurse Executive, and serves on the Michigan Hospital Association Legislative Policy Panel and the Oakland University School of Nursing Board of Visitors.
Chapters
Henry Ford Health: Henry Ford Health | Henry Ford Health - Detroit, MI
AMN Healthcare: amnhealthcare.com
00:00:00:00 - 00:00:03:01
Speaker 1
Eric Wallis. Welcome to the show. Glad to have you here today.
00:00:03:03 - 00:00:05:05
Speaker 2
Glad to be here. Thanks for having me.
00:00:05:07 - 00:00:11:19
Speaker 1
Oh. You bet. Absolutely. So you're the senior vice president and system chief nursing officer for Henry Ford, is that correct?
00:00:11:21 - 00:00:13:01
Speaker 2
That is correct.
00:00:13:03 - 00:00:19:23
Speaker 1
Awesome. You want to take a few minutes to tell our listeners a little bit about your journey that you took throughout your career to, to get to your current role.
00:00:20:01 - 00:00:55:03
Speaker 2
Well, I always tell folks, I won't go back to my first days as a brand new baby nurse, but I've been very fortunate throughout my career to, journey from the time of being a bedside nurse and, med surge units and spent most of my life as, critical care nurse, and at the bedside. But pretty early on, figured out that, you know, if I wanted to actually make a difference in this profession and make things better, not just for the patients, but just but also for the people that I worked with trying to take care of patients, that stepping into leadership was probably the most effective way for me to do that.
00:00:55:05 - 00:01:16:12
Speaker 2
And so pretty early on, I had the opportunity to step into a leadership role. Had lots of really amazing mentors along the way that thought that I had some amount of talent or potential. And so they, had I guided me along my journey, and I've had the opportunity to work in both, you know, nursing leadership roles as well as hospital operations roles.
00:01:16:14 - 00:01:44:15
Speaker 2
So, you know, CEO thankfully, in 2021 was given the opportunity to step in and become the first full time chief executive for Henry Ford Health, as we were kind of in the midst of the pandemic. And so the last four years have been spending a lot of time trying to, you know, build some structure and process and really helping our health system grow and helping our nurses across Southeast Michigan, you know, have the resources and tools they need, to take great care of our patients.
00:01:44:17 - 00:01:59:03
Speaker 1
Yeah. I mean, stepping into a leadership role at the peak or onset of the pandemic, I'm sure had to be a wild and crazy ride. Any anything in particular stand out to you as you sort of led led your teams in the workforce? Henry Ford during that time?
00:01:59:05 - 00:02:27:13
Speaker 2
One, I'm just extremely grateful for the, you know, amazing people that we have that lead at the bedside, you know, not nowhere or nurses or taking care of patients, but our frontline nurse managers just doing an amazing job. And, you know, through that time, and as stressful as it could possibly be, you know, they did a great job of one taking care of each other, taking care, of their team members, and really, being willing to escalate and elevate the things that they needed.
00:02:27:15 - 00:02:55:15
Speaker 2
And so I think our nurse leadership team did an amazing job, and, we dealt with a lot of, kind of things you never expect come along in your nursing career, but but being agile and, listening to the folks who are doing the work and helping to kind of move the organization forward, I think was it was things I'll never forget from that time frame, because, yes, we had a lot of hard things that we did, but we also had a lot of, I think one big progress that we made during that time, too, because we knew we had to do things differently.
00:02:55:17 - 00:03:13:00
Speaker 1
Yeah. It seems to be a hallmark of a lot of, health care leaders in general. The two things that you, two things that you focused on, one was gratefulness and two was listening. Right. So, and maybe that leads us to a little bit about, the virtual care model that you all, have released.
00:03:13:00 - 00:03:18:07
Speaker 1
So, maybe talk me through the journey, how you arrived at that and what your what you're currently doing.
00:03:18:09 - 00:03:36:12
Speaker 2
Well, I think the important thing about that is, and to your point is, is trying to listen and kind of think through some of the big challenges that we have, in health care today. You know, the reality is, nobody is coming to hospitals and health care systems and said, gosh, we really think that you guys are overworked and underfunded, so let's pay you more, you know?
00:03:36:12 - 00:03:52:22
Speaker 2
And at the same time, we got a workforce that has just come through. You know, hopefully a once in a lifetime event. People are burned out. They're tired. We saw, you know, large numbers of folks who were kind of at the end of their career decide, you know, what good. I'm good. I don't need to go through this again.
00:03:52:22 - 00:04:10:23
Speaker 2
So I'm going to step out of the workforce. And so I think, you know, our system, like a lot of them around the country, came out the other side of the pandemic going, gosh, one, we got a really young workforce member and and two, we got a workforce, that hasn't done a lot of this stuff the way that we're trying to do it now.
00:04:10:23 - 00:04:30:20
Speaker 2
And so we got to figure out how we reinvent health care, to still make it attractive to them. How do we support them from many cases as they enter into practice without having had the benefit of, you know, what we probably call the traditional journey through nursing education? And so we started to look at, you know, what's out there and how do we take advantage of this boom that we have right now.
00:04:30:20 - 00:04:49:18
Speaker 2
And folks that are investing in artificial intelligence and, you know, tools that can actually help to do some of the work. I'm very excited. I love technology, I love where we are in health care. But, you know, the reality is for the last four years, every time we talked about a new technology and health care, what it did was it made documentation more complete.
00:04:49:18 - 00:05:08:14
Speaker 2
It was places where folks had more to more boxes to check or and helped us to get paid more accurately, etc. so it really just added to the burden of the team member and the caregiver at the bedside. We're really at a moment right now when we get technology that can actually take work away from our bedside team members and make their jobs easier.
00:05:08:16 - 00:05:29:22
Speaker 2
Our job as health care leaders is to figure out how do we deploy it, so that that it's actually useful to them. As we go forward. So as we started to think about that, and our health system has a, a line on our storage system strategic plan, that is, how do we reimagine work, how do we think about work differently as we go forward?
00:05:29:22 - 00:05:46:06
Speaker 2
And so, one of the things that we started to look into was, how do we use these virtual care models? But started to pop up during the pandemic when, frankly, we couldn't always go into a patient's room. But how do we bring that to scale? And how do we actually use that to think about work differently?
00:05:46:12 - 00:06:16:14
Speaker 2
Or I think the reality is, you know, nursing in this country has probably not really invented a new model of care in about 70 years. You know, we've we've reinvented team nursing, we reinvented primary care and, you know, all these other models. But we really tried anything new for a very long time. And so ultimately, what we did was to to come back, look for some partners in the technology space that we thought, were and were kind of like minded to us.
00:06:16:15 - 00:06:36:18
Speaker 2
And thinking about how can we use, technology to reinvent boy care delivered. And, and that allowed us to sit down with our, some of our bedside nurses and say, hey, let's have a conversation about, you know, what, one, what are the things that waste your time, that, you know, someone else could do them? That would make your life easier.
00:06:36:19 - 00:07:00:15
Speaker 2
And then to let's think about if we had a camera and in these rooms and someone was partnered with you virtually, what what type of license work look like for you and maybe what what type of license work look like for the nurse or the team member who's working virtually. And through having that conversation with our bedside nurses, how we kind of came up with what is our, virtual care model, but we're starting to deploy hundreds out.
00:07:00:17 - 00:07:20:17
Speaker 1
Oh, terrific. And I remember how did the pandemic just usage of telehealth, telehealth platforms sort of skyrocketed. We'd actually look at adoption rates or trends for e-commerce versus physical brick and mortar store. And then all of a sudden, I think when we saw reimbursement rates change for in-person versus virtual, you sort of saw it recede a little bit.
00:07:20:19 - 00:07:32:01
Speaker 1
Did you all work through any of those adoption challenges or patterns, or was it did you maybe start your journey a little bit more deliberately post pandemic, maybe walk me through a little bit how you all sort of navigated that?
00:07:32:05 - 00:07:56:04
Speaker 2
Yeah. And I think is, you know, as a large integrated delivery system, clearly we had gone down that path on the ambulatory side, right where we saw big adoption and patients, being willing to do some specialty use, more virtual care, you know, a little bit in the primary care space, certainly in the behavioral health space. So we had an entire workstream around, virtual care in ambulatory setting.
00:07:56:06 - 00:08:19:04
Speaker 2
So this idea of bringing it into the acute care setting was a little bit different. And, you know, required, I think, some different, thought processes. But at the same time, we didn't want to run these as two completely separate things. And so we've had to make sure that we, we built, strategies and structures so that we're staying connected because ultimately these things start to overlap.
00:08:19:06 - 00:08:41:08
Speaker 2
We very intentionally moved away from calling this virtual nursing because virtual nursing is a use case. It is not the the the sum total of what we're trying to do. What we're really trying to do is reinvent the way that acute care is delivered. And so when you start thinking about use cases beyond nursing, there's position use cases, there's pharmacy, there's case management.
00:08:41:12 - 00:09:01:23
Speaker 2
And really whatever you can imagine it's there. And ultimately making sure that we're tying these together so that if we say if we build a, a structure to where, you know, we're sort of our highly trained specialists that may be at our academic medical center to be able to do consults at one of our rural hospitals. We're going to make sure that that fits in with the schedule they've also got.
00:09:01:23 - 00:09:21:11
Speaker 2
Maybe we'll be doing specialty consults on the industry side virtually. So how do we weave these things together? So it's not disjointed and not making things more frustrating for our providers in that space. So it's definitely something that we're trying to be very, intentional and thoughtful about this in patient model has to also sync up with what we're doing in the inventory space.
00:09:21:16 - 00:09:41:19
Speaker 1
Very thoughtfully done. I think the one thing that's been consistent is you talked about this need to reimagine how work is being done, been done the same way for over 70 years. And it's not it's not an isolated use case. And so you're you're fully unlocking the true value of this capability. And, you know, again, listening comes up from you quite a bit when talking to you and engaging your team.
00:09:41:19 - 00:09:59:06
Speaker 1
So maybe walk me through the process that you went through in selecting the technology vendors that you chose to partner with, because I'm assuming listening was a key part of that for you and your teams. And and just how did you figure out which ones were actually listening to you all, as opposed to kind of showcasing their views of the world?
00:09:59:08 - 00:10:22:21
Speaker 2
Yeah, I think it really started with, from the very beginning, one of the the stakes that we put on the ground through talking with our teams was that whatever technology we chose to adopt couldn't add to their work. So meaning we talked to several partners that when you talk about their models or how they will work or practices, we'll talk to some other healthcare systems about how they were standing up pilots around virtual models.
00:10:22:22 - 00:10:38:16
Speaker 2
A lot of times it involved, well, the nurse has to go get something, you know, an iPad or the nurse has to get a camera, but that's on a that's on a rolling cart, and bring it into the well, ultimately, that just means they've got one more thing that they have to do to try to try to use this technology.
00:10:38:18 - 00:11:08:03
Speaker 2
And so pretty quickly we kind of narrowed that on. We were looking for a partner that had, the ability to, to deploy fixed cameras into the patient rooms so that, you know, it was always there. It was part of the, you know, I call it the health room of the future, number one. Number two was that partner has to be able to make it make the technology functionally, that it doesn't disrupt the patient and it doesn't require, you know, somebody in the room to do something to to bring Bill to bring that virtual team member into the room.
00:11:08:05 - 00:11:41:10
Speaker 2
And so, believe it or not, finding a partner that was able to actually control the television virtually or remotely, and then when the interaction was done, put it back to whatever the patient was doing, you know, before the virtual team member stepped in, was was eliminated. A lot of technology. And so, you know, ultimately, we were fortunate that we landed on a partnership with, a company called Carried Out AI, that it is now part of Stryker that was able to meet kind of all those needs where we got to work from there was just working with them and working with our nurses and starting to say, okay, how do how do we want
00:11:41:10 - 00:11:52:22
Speaker 2
this to function and how do we make sure the technology is working for our team and for the patient, and not having our team members kind of work around the technology was terrific.
00:11:52:22 - 00:12:11:10
Speaker 1
So let's talk about change. So that sounds like the one thing that's been constant, I guess in the in your time since you took on the role, really. But obviously when you think about changing the workforce, how work gets done, especially since the models have been in place for over 70 years, maybe walk me through the change management process you went through with your teams.
00:12:11:10 - 00:12:17:19
Speaker 1
Where did you see resistance? Where did people embrace it? And more importantly, what did you do to help lead your teams through it?
00:12:17:21 - 00:12:33:06
Speaker 2
So, as you would imagine, right, any time that you walk into a unit or we identify a couple of units that we thought would be great pilot sites at one of our hospitals. And, you know, the first day you walk in and say, hey guys, we got this great opportunity. We want to completely change how you do everything.
00:12:33:08 - 00:12:52:21
Speaker 2
And by the way, we want to do it with a virtual, team member. There's a lot of skepticism at the beginning of that conversation. Right. Because this is not how we have done things. It's not how people are educated. And frankly, in health care, we are trained that, whatever we learned in school was the best, best way to do it, because that's held space and that's the way we should never do things.
00:12:52:23 - 00:13:24:05
Speaker 2
Immediately we start changing that. How in graduation. But, you know, it's it's the principle was built into us. And now we're going to talk about and do something that maybe there's not a huge evidence base behind yet, but we're going to actually be creating that. And so, you know, for us, it was it was very much about how do we create a committee of some of those team members, people who, are both skeptics and people who are very interested in this, to come together and work with us, work with our technology partner, and again, actually design the workflows.
00:13:24:05 - 00:13:45:02
Speaker 2
One, as I said, we started with, you know, what are the things that we're trying to solve? So that kind of concept, you know, have to chew back thinking, what do we want this to look like when we're all said and done? And let's work backwards from there. And so ultimately, it was our bedside nurses who told us what use cases they wanted us to work on first.
00:13:45:04 - 00:14:12:07
Speaker 2
They're the ones who work through with our partners, on how that workflow should go, how to how do you have that interaction? Who talks to or who calls who? How do we, you know, work back and forth and then, you know, the concept of running a pilot for about nine months to make sure that we not only worked through some of the things that, you know, maybe we didn't anticipate, but also start to think about what are some new use cases that we think have some value in starting to test those out.
00:14:12:09 - 00:14:35:16
Speaker 2
Ultimately, I think what we learned in this and my chief nursing informatics officer said this, and I will never forget it. Pilots of technology simply tell you it is the technology work or not. Eventually, if you want to find out if you actually can, can, you know, generate value out of something new, they actually have to take it to scale and see, does it actually perform the way that you want?
00:14:35:18 - 00:14:52:01
Speaker 2
Can it actually change outcomes? And so we we went through and we said about line months or pilot, we saw positive variance in our, in the outcomes that we were tracking. But ultimately we knew that we got we had to take this to, to full scale to say, is it really going to help us achieve what we want to.
00:14:52:03 - 00:15:01:05
Speaker 1
You know, it's terrific. So you talked about looking at the metrics to understand the outcomes that you're driving. Could you care to share maybe some of the key metrics that you're trying to monitor at the at the system level?
00:15:01:07 - 00:15:24:01
Speaker 2
Yeah. So we're like a lot of other probably health care systems. Right. Balanced scorecard. So we get everything from finance, quality engagement, you know, kind of metrics that we're looking at. Ultimately in our, in our pilot stage, what we saw was, reduction in nursing turnover. We saw, you know, metrics, tracked metrics that were processed measures as well as outcomes measures.
00:15:24:03 - 00:15:43:21
Speaker 2
So we were looking at how many interactions the virtual nurse was having with the patient on a daily basis. You're looking at how much time were they saving the nurses at the bedside. And so you know what we saw pre succinctly is in two units we were saving about about 150 hours of work for the bedside nurse every single month.
00:15:43:23 - 00:16:11:08
Speaker 2
Taking that work away, having a virtual nurse do it. Through that work, we saw our completion percentages of, you know, admission paperwork, discharge paperwork, patient education, all, dramatically increase, small changes in, length of stay, patients getting out the door a little bit sooner. And after the discharge order was written, we saw patient experience scores jump up, and and really soar again.
00:16:11:08 - 00:16:30:07
Speaker 2
You know, when you look at these databases, they're pretty, pretty tight bell curves. And so, you know, small, small improvements had a very large percentile rank. And ultimately we tried to do this in a way that we were designing the system so that we're we're adding additional cost, meaning, we were using the same nursing hours in the service to achieve.
00:16:30:07 - 00:16:33:17
Speaker 2
But to that work, just just arranging it differently.
00:16:33:19 - 00:16:46:21
Speaker 1
Wow. Sounds like some really nice improvements across the board. Did you all or it may even be too early. Any impact in terms of extending the, clinician's time in the health care system to. Are you seeing any impacts there?
00:16:46:23 - 00:17:05:11
Speaker 2
So I would say that's more anecdotal, at this point. But, you know, what I would say is I've been doing this a long time and, you know, have a lot of different change projects. I have never had one where universally you walk in the nurses how this is going and the feedback has been, this is the best thing we've ever done.
00:17:05:13 - 00:17:24:16
Speaker 2
You know, when we were in a pilot phase, the conversation from the other units was, how soon can we get this? Because they saw about it too. But, our, we kind of set our model up on a hybrid model, meaning, we do have some team members that are full time doing, working in the virtual role.
00:17:24:18 - 00:17:45:21
Speaker 2
But we actually have a number of team members who are working maybe two days at the bedside. One day in the virtual or one day in the virtual world, or, you know, vice versa. And ultimately the the feedback from them has been it's so nice one that gives them a break right from some of the physical demands and allows them to work a little differently, have different kinds of interactions with our patients.
00:17:45:23 - 00:18:03:07
Speaker 2
And the benefit to it is these are the same nurses that work with our patients in our positions all the time, so they still know each other. And they still have that, that level of trust because they work in, you know, at the, at the elbow with them as well. So, you know, it's been a, I think a really good model to start.
00:18:03:09 - 00:18:24:19
Speaker 2
We're now, fully deployed across our first hospital and working on the next one. And I think what we're trying to be very intentional about is that each one of these go lives is going to be one and one when it comes to a change management process. We don't want to just assume that because we did this on one site with one team that we can just say, look, it works great over there, you do it too.
00:18:24:21 - 00:18:31:17
Speaker 2
So we're trying to be very intentional about making sure that we, work through that change process with each side as we know what.
00:18:31:19 - 00:18:49:19
Speaker 1
Well, it's a very thoughtful, deliberate point of view, and that probably makes all the difference in the world. The one on one comment, as opposed to thinking each and every single system looks exactly the same. So maybe the last question I'll have for you today is sort of just sounds like great progress in terms of rethinking the workforce through leveraging virtual solutions.
00:18:49:21 - 00:18:56:18
Speaker 1
What about AI? Any other thoughts from you as far as, AI and maybe the impact it has on the clinician workforce?
00:18:56:20 - 00:19:16:08
Speaker 2
Well, that's the great thing is, as we talked about in this current new model in the acute care, we know I got to be a piece of it too. The the first use cases that we're bringing live are actually being able to use the sensor that's in these cameras in our room, to do things like bed action alarms, so that we don't have to have a sitter sitting there.
00:19:16:10 - 00:19:36:03
Speaker 2
We've obviously, obviously spent a lot of time thinking about, you know, the safety of our team members in the world in which we live. And, you know, having the ability of the AI in the room that's they're listening to understand when, you know, things may be escalating and being able to call for help without somebody having to find a button or pick up a phone.
00:19:36:05 - 00:19:55:00
Speaker 2
You know, we've talked about, you know, it's Henry Ford Health. We've talked about having key words like, hey, Henry, to activate a series of events through the through that a, so, I think we're in the early phases of, starting to implement some of those things. But but certainly I think this is where the future is.
00:19:55:02 - 00:20:23:07
Speaker 2
Really excited that, you know, within the next 12 months, we're working toward, I'll call it the golden, the golden goose of, of nursing, which is can we actually do a voice activated documentation by using the tools in the room? Right. Having, having that ability that some of our physicians now have, but actually doing that in the nursing space, you know, still true nurses spend 80% of their time doing documentation, and so can we can we use the AI to take that burden away?
00:20:23:12 - 00:20:42:06
Speaker 2
And so I'm really excited that, again, I think that, I think, the future is, is limitless in this space. You're only bound by what we can imagine or what we can try. So, having, having, a teams and team, a team and teams that are willing to, try out some of those things can be really key as we go into the future.
00:20:42:08 - 00:20:51:16
Speaker 1
Sure. Well, Eric, thanks for stopping by today. I really enjoyed the opportunity to catch up and learn a little bit more from you about, how you're transforming the workforce at Henry Ford.
00:20:51:18 - 00:20:53:20
Speaker 2
Absolutely. Thank you so much for having me.
00:20:53:21 - 00:21:14:16
Speaker 3
Thank you for joining us today on Elevate Care. If you found this episode valuable, please consider sharing it with a colleague and subscribing to our show on your favorite podcast platform. You can learn more about this episode in our show on our website at AMN healthcare.com and follow us on social media to stay updated on new episodes and the ever changing world of health care.