In this episode, Leora, co-host of Elevate Care, interviews Laura Griffin, VP of Nursing Operations at ECU Health, on her journey in healthcare, her role in optimizing nursing operations, and the partnership with AMN Healthcare. The conversation covers the challenges faced in staffing post-pandemic, the importance of workforce analysis, and the implementation of a centralized staffing office. Laura emphasizes the significance of building a positive culture, addressing burnout, and leveraging data for informed staffing decisions. She expresses excitement for the future of nursing at ECU Health and the ongoing innovations in healthcare.
In this episode, Leora, co-host of Elevate Care, interviews Laura Griffin, VP of Nursing Operations at ECU Health, on her journey in healthcare, her role in optimizing nursing operations, and the partnership with AMN Healthcare. The conversation covers the challenges faced in staffing post-pandemic, the importance of workforce analysis, and the implementation of a centralized staffing office. Laura emphasizes the significance of building a positive culture, addressing burnout, and leveraging data for informed staffing decisions. She expresses excitement for the future of nursing at ECU Health and the ongoing innovations in healthcare.
Chapters
00:00 Introduction to ECU Health and Laura Griffin's Background
02:52 Laura's Role and Responsibilities at ECU Health
06:04 Partnership with AMN Healthcare: Challenges and Solutions
08:53 Workforce Analysis and Staffing Strategies
11:48 Centralized Staffing Office: A New Approach
14:57 Building a Positive Culture and Retention Strategies
18:10 The Importance of Data in Staffing Decisions
20:58 Future of Nursing Operations and Addressing Burnout
23:53 Final Thoughts on Healthcare Innovations and Partnerships
About Laura
Laura Griffin currently serves as Vice President of System Nursing Operations at ECU Health, a position held since November 2023. Prior to this role, Laura held multiple leadership positions at Allegheny Health Network from May 2012 to July 2023, including Vice President of the Nursing Institute and Vice President of Nursing Operations & Strategy. Laura's early career at Allegheny Health Network included roles such as Director of Network Nursing Operations and Clinical Project Manager at both Allegheny General Hospital and West Penn Hospital, focusing on clinical project design and implementation with a strong emphasis on data analysis. In addition to practical experience, Laura has contributed to academia as an Adjunct Assistant Professor in the Department of Health Policy and Management at the University of Pittsburgh Graduate School of Public Health from August 2018 to January 2024. Laura holds a Master of Health Administration from the University of Pittsburgh and a Bachelor's degree in Business Administration and Management from the University of Mount Union.
About Leora
As President of Workforce Strategy & Optimization (WSO) at AMN Healthcare, Leora leads the WSO team in strategy, technology, analytics solutions, and consulting. She has over 15 years of experience in healthcare services, business development, and program management. She holds an MBA from Nova Southeastern University and a Bachelor of Science in Biomedical Engineering from the University of Miami. Connect with Leora: https://www.linkedin.com/in/leorawestbrook/
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Hi, welcome to Elevate Care. It's wonderful to be here with our esteemed guest, Laura Griffin, VP of Nursing Operations with ECU Health. My name is Leora Westbrook, and we are going to be discussing the ECU Health Partnership. And for a few moments, Laura, I'd love for you to just share a little bit about your background. You have tremendous experience, 14 plus years in the industry. What's your why?
14 years in healthcare, it's been quite the journey thus far. I have, from a young age, really had been interested in healthcare and like many young children, wanted to be a doctor when I was growing up, but very quickly realized that I wasn't interested in doing that much schooling. And so when I was at the University of Mount Union, I had a wonderful professor who really shared with me, you're so involved in so many leadership activities and you have a great passion for healthcare, you know they need all kinds of people to run.
hospitals too. And so that week I switched my major to a business degree with a concentration in healthcare and went directly in to get my MHA at the University of Pittsburgh. I spent 14 years in the healthcare market in Pittsburgh, which is highly competitive. And then over the last year of transition into rural health at ECU Health, I think my passion for healthcare has changed over time. Like many others, your why changes as you grow in your career. And I think
you know, as your family and friends are going through different healthcare challenges, you start to develop passion for the things that they're going through and wanna fix all the problems that they've encountered along the way in trying to seek healthcare. And so my why has changed over time, but I think in my career portion of my why, a lot of the challenges we see with our staff in terms of burnout and the staffing shortages,
We're really there for our patients in our communities. And so I want to make sure that everything that we're doing is serving our patients in our communities and building teams to support that. That's amazing. Tell me a little bit more about your role specifically at ECU Health. Sure. I'm the vice president of nursing operations for the system. And so I am primarily focused on optimizing the workforce right now in my role. While nursing operations is a
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expansive topic, the primarily I've been focused over the first year here at ECU Health on the workforce. And so I'm in charge of our site based and enterprise flow pools, our system staffing operations, our staffing offices, our patient observer program, and rolling out our new scheduling system that will be coming soon. In addition to that, I'm also the liaison for all of our business partners in nursing. And so I often work with HR.
finance, recruitment, to really help develop those plans in partnership with nursing with our non-clinical colleagues. That's incredible. You certainly have a multifaceted role. Yes. Wear a lot of hats. I do. And I'd love to hear from your perspective, how do you infuse those business strategies into the nursing space, the nursing industry? Yeah, think it's
It's delicate balance. So our nursing partners are very focused on the clinical care, which is absolutely important. Having someone like myself in the role that I'm in, I'm not a nurse. So I bring a totally different perspective. And so being able to combine the two clinical and non-clinical perspectives really helps us drive purposeful execution when it comes to initiatives, because we have the opportunity to really understand the problem from a clinical perspective and what's really driving the challenges.
And from a business perspective, I'm helping them build the case for why the challenge that they're facing needs to be addressed. And is there a return on investment in addressing that? And how do we really make sure that we get to the right solution, not just the easy solution? So we've been partners now, AMN Healthcare and ECU Health, since 2018. Can you share a little bit about the challenges your organization faced that we've really been able to partner and solve together? Sure.
Like you said, AMN and ECU Health have been partners since 2018. I've only been there a little over a year, but I've been really involved in the partnership since I've arrived at ECU Health. And one of the things that we have been primarily focused on is that contract labor space. Although we have expanded our partnership in additional areas, which we'll also discuss. But really the biggest challenge that we had was
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post-pandemic staffing and really trying to stabilize our workforce. And our partnership with AMN has helped us really infuse the right staff and the right number of staff into our facilities to be sure that we were able to maintain operations. In addition to that, we have been very successful in our partnership around the International Nurse Program with OGP. And so we have about a 90 % retention rate with all of our international nurses that have come in. And I'm really excited to share that
Over the course of the next year, we have about 150 new international nurses in the pipeline to come to ECU Health. And so we're excited to welcome them into our system and to really have them be a part of our team and continue that partnership around the International Nurse Program with AMN as it's been something that has helped stabilize our workforce as well. That's so incredible. The International Program and ECU Health's innovation in that space.
is remarkable. Now, I love visiting you all. It's beautiful. And it's an amazing culture. So it's not hard to see why folks would want to stay and flourish within that community. Any other efficiencies and operations that you saw as we started to embark on addressing some of those challenges?
Yeah, I think in terms of the efficiencies, we also went through the workforce analysis with your team. And so that was a really important part of helping us come to the conclusion that we really needed to change the way that we did staffing across the system, not just at our largest academic medical center, but in our rural hospitals as well. And so that has really helped us understand the assessment that we did with your team, really has helped us understand where we had gaps in our staffing.
and where we really needed to be sure that we were serving all of our facilities, not just our largest partner. And so I think that that is where we gained our biggest efficiencies. The data and the processes that the team helped us design were really beneficial in that. Now we're early on in the process, so we have just finished that portion with the team, with the AMN team, but we are excited and know that there will be several great things that come out of that.
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Wonderful. I am so excited to dig into some of these strategies, including the workforce assessment that we did in partnership with you. Going back a bit, as we think about the challenges that you so beautifully laid out and the path that you went to finding the right solution, the right partner, tell me about the experience you had when finding that solution, that partner. What were you all considering?
I think we were looking for a partner who was not just going to be someone to provide staff, but also to help provide insights. One of the things that our team frequently asks is what's going on in the market. And that's something that I have weekly in my conversations with our senior director, Stacey, who's responsible for our partnership. She has been amazing at giving us weekly insights where not only North Carolina stands, where ECU health stands in the rankings of
the amount of contract labor that we're utilizing. What I find to be interesting is that staffing shortage, the staffing shortage feels like a lonely space. I think everybody thinks when they're in the thralls of having a staffing shortage, it's just us. It's my department only, it's my hospital only, it's my system only. But when you look at those insights that you get every week from the team at AMN, you really start to understand.
everybody's going through the same challenges. We're all competing for the same staff and we're all really just trying to do what's best for our patients and our communities. And so while North Carolina is still in the top five states utilizing contract labor, we've been able to titrate down a little bit on that contract labor and some, you know, that is in due to our partnership with AMN and really keeping our pulse on what's happening in the market and in our needs. Right, right. And I think you hit on it.
perfectly as it being a multi-tiered approach. It is not just one lever that you're pulling. It's really having those insights to make those informed decisions, dare I say, predict in advance some of the moves so you can peek around the corner and be prepared to support your clinicians so they can support the community. Yes. And I'm really excited because we also now have access to the workforce dashboard. So the dashboard that has been provided to
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to us through the WFA really gives us analytics across the system that we maybe never had before. Or we had to go in multiple places to find. And so we have the one stop shop to be able to view where everyone's at and where our needs are. And I think that'll help us expedite our ability to staff the facilities and really pay attention to where our holes are in real time rather than a few days and a few days behind, I think.
Absolutely. That enterprise view with the ability to drill down to the unit level is really powerful. And you mentioned the WFA, that's our workforce assessment and being able to look at your enterprise holistically and assess your workforce operations, those practices to policies, as well as how your resources are spread across the organization.
and then be able to come back and make some recommendations that really pull into the key performance indicators that inform that workforce analytics or workforce planning dashboard that you referenced a moment ago. One thing I think that is really incredible as you think about ECU Health's journey is how you've leaned into some of the flexible staffing strategies.
as it relates to the flow pools. And so when we think about that in a multifaceted way, it's again, not just one lever, it's how do we leverage our enterprise resources differently, right? Our core, and then thinking about what are the other flow pool layers? Maybe that's your enterprise flow pool, maybe that's site-based, and maybe even PRNs, right? But understanding
where you need to move those resources and when through those analytics, it sounds like has been very powerful. Yes, absolutely. And I think one of the beautiful things that we've learned over the course of our time with AMN is just exactly how much staff that we need in each one of those pools. And so the analysis that we received was very thorough. And it wasn't just a number based on how many vacancies we had. It was calculated a number of different ways, including
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by specialty of nurse we would need to hire in. And so we've taken all of that data and we're starting to work on recruiting both for our site-based float pools that would support daily operations and also our enterprise float pool that would support both daily and long-term needs across the system. We know we have a long way to go to recruit into those pools, but we're starting slow. And I think as we begin to recruit those core,
team members will again be able to come down on the amount of contract labor we're utilizing, knowing that we'll never ultimately get rid of contract labor. That's just the era that we're in right now. But I do think that this float pool strategy that we've developed will be very successful in helping us get to our staffing needs. I think you said it right on in the fact that it's
a balance and it's going to evolve and being able to have those insights to understand proactively those needs and then be able to allocate those resources across those pools appropriately. And it's going to ebb and flow over time. One of the things that you mentioned also that I'd love to have you share a little more on is the central staffing office, because that is certainly an initiative in itself. That ability to manage
deploy resources at an enterprise level. Can you share a little bit more about the work there? Sure. So previously, we had been all decentralized staffing offices. So we did have a staffing office at corporate who helped staff some of the rural hospitals. And then the medical center had their own staffing office. And so we've just taken on combining those to make one centralized staffing office.
We are really excited because I think the staffing analysts who are working in those offices are coming together as one team. It was important for us that it wasn't one team joining another team, that we really rebranded it as an entirely new operation. So they felt that they weren't just coming together against each other, that they were really one new function. And so we also offered them the opportunity to look at the new space that we would be in, help develop
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what that space should look like. What is the best functionality for the work that you do every day? Understanding that at different parts of the day, different types of activities are going to be happening. What are the reports? What are the dashboards that you want up on the walls, on the TVs? What do the workstations look like? So they've had a lot of fun designing that. And we're really excited to see it all come together because I really think that that is going to be an opportunity for us to ensure that
we are seeing the full picture rather than just piece-mealing it together facility by facility that lets us also be a little bit more nimble with our float pool staff that we have to deploy because we can see the needs from all angles, not just segmented. Yeah, absolutely. And I think it also brings a breath of fresh air to the clinician leaders because they are no longer having to manage that.
by the minute daily, it's being managed at that enterprise view where they may not have that visibility and opportunity to navigate that staff appropriately. I think it's also challenging sometime because there's a control factor when it's in your facility, you have the opportunity to be in the moment of every decision. And so we took that out of the facilities and have it housed centrally for a number of reasons, but also to
allow our nurse leaders to really be able to focus on the things that they need to focus on and we'll alleviate that burden. It's all about trust. You have to trust that we're going to make the decisions that are needed for the system and what's best for our patients and our families and our communities and the staff. And so we will be, we have algorithms built and system staffing processes that we're following that will make this really a seamless transition.
That's wonderful. And you said it perfectly in the trust factor, because this is your most cherished resources, right? And you always want to build that confidence. the beautiful thing about the solutions and the strategies is they're only going to get better over time. The more that the staff lean into these key strategies and the analytics and leverage those, it will start to really not manage itself, but
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provide those efficiencies that allow those key resources, your clinician, nurse leaders, and others to focus on other key areas, their team members, continuing to give the best care that they can. I know it's early in the journey. Yes. But what are you most excited about thus far as you think about some wins, either that you've experienced or you're looking forward to through this partnership?
I think one of the most exciting things for me is just to see the excitement of the teams coming together. This is something that they've wanted to do for a long time. This wasn't something that AMN and our team just pulled out of thin air that we decided this would be a good idea to do. It's something that in focus groups came out from our teams that, you know, we're making decisions on staffing that
it's very fragmented and we could do this differently. And so when we started having the focus groups with the AMN team, it was really powerful to see all of those leaders and frontline team members empowered to speak up about here's how I'd like to see it done or here's how we think it could be done better. And so really getting the voice of the customer that we were serving in the staffing office, also the voice of the team members who were doing the work.
helped us really design that. And so this is their product. This isn't our product. This isn't ECU Health is really committed to making sure that we have the voices of our team members heard. And this is living proof of that. Wonderful. And I think too about how you drive that sustainable change management in a journey like this. And it's through the buy-in and collective voices of the team.
And one of the things that we hear a lot as we start to initiate on these flexible staffing strategies, the flow pools and others is the flexibility that's given back to the clinicians. And it's an opportunity for them to grow their skillset and really adjust to what they're looking for at that point in their life. Yes. I think it's an alternative to
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traveling for many nurses and so they really like the opportunity to travel not be in one unit all of the time and but they want to stay home. They want to still be with their families. They don't want to travel all over the country. So this gives them the opportunity to travel within a facility if they want to be in the site base float pool within a number of units or within the region picking one two three up to eight of our hospitals they could travel to if they were really bold and so that gives them.
the opportunity to really have that same experience just closer to home. Absolutely. Absolutely. I want to go back to the assessment that you mentioned, the workforce analysis. Were there any interesting insights that you found as we reported out? Anything that surprised you maybe?
I don't know that anything necessarily surprised you, or surprised me. I think I've spent a lot of my time in my career studying staffing. And so I think I had the opportunity to really sit with the data a lot longer than many folks. And so when we looked at our holes in some of our facilities, what was surprising was the amount of resources we were deploying to the medical center, but also the amount of daily resources that
the community hospitals needed as well. And so that really drove us to the strategy of we need to develop something to make sure that we're stabilizing the community hospitals on a daily basis and not just giving them long-term contract labor placements, which in some cases their individual float pools had been reliant on. And so we're trying to flip the script there, make those core staff members rather than...
any of our contract labor. What I will say is it's also been important for us to really build a great culture. And that culture is so important, not just for our core team members, but also our contract labor resources. We've been fairly successful over the last six months also in converting a number of our contract labor to core team members, some of those who are interested in joining our float pools. So I think we are really...
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trying to deploy all of the best strategies based on the data and analytics we were provided and the amount of resources that we need. It's quite a large number to staff a big system like ours, but we're confident that we'll be able to get there and let the data kind of drive the way. I love that. Let the data pave the path. And just to underline the comment on culture and what you all have cultivated at ECU Health.
is incredible and it is why you have the retention and conversions that you do. And in building almost this brand around your float pool, that it's an incredible opportunity and it's just one piece in the broader employee value proposition of what makes ECU Health so wonderful. Now, you did mention staffing's your background. You know it, you breathe it, you love it. It's interesting because
You're not an RN. And you just excel in this space, working in the clinical setting. Can you talk a little bit about how you merge that nursing perspective in with a business and an integrated approach? Sure. About 10 years ago, I got a phone call from the chief nurse executive at my formal organization, Claire Zangerle, and she said, you don't know me, but I have a
an interesting offer for you, would you like to go to dinner? And we went to dinner one night and she presented me with the role of nursing operations. And I thought it was a very visionary idea. And I said, well, I'm not a nurse. And she said, I know you're not a nurse. I'm looking for someone to help infuse business principles with nursing practice and help really have the organization drive purposeful execution around nursing and build that value of nursing, demonstrate that. And so
At the time it was a pretty unique position and I think it's grown a little bit over the years and so when I accepted the role and talked to our chief nurse executive at ECU Health, Trish Bayes about the role, she was very excited because it was a lot of things that I had done previously but also interesting new challenges that I would be able to take on here. And so I really think that the bottom line is nursing is the largest workforce.
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And oftentimes people see them as an expense because they don't generate revenue. But really there's such value to the work that nurses do. We needed to find a way to make sure that we are demonstrating that value every day. And so the work that I do has been, I think my passion project because I love to be able to sit with our team members and hear about the challenges that they're experiencing, help them develop new processes to change those.
to address those challenges, but then also build that return on investment so that the executive team and anybody externally can see there was absolutely value in changing the way that we did this based on what our team members were telling us. I I think an example, I talk a lot about staffing, but I do have experience in some other areas. Just last week, I sat down with our folks in infection prevention, our nurses there.
and they were telling me about some of the quality challenges that they were having and some new processes they were thinking about developing. we really combined our expertise and were able to develop a return on investment to implement some new quality procedures. And at that moment, they were very excited and I was very excited because we both learned a little bit from each other and we were able to demonstrate really that there was
going to be success in the work that we were planning to do, but also it was beneficial for the infection prevention team and the nursing team, but also the organization for giving us really the latitude to work together to be able to create that. Great example. And as I'm sitting across from you, I can see and hear, feel the passion. It radiates as far as what you do. And I'd love to get your perspective on how you see this.
role evolving? I think it'll evolve over time. Right now, given where the healthcare industry is, obviously workforce is a huge portion of that and will always be. But as we're building the processes at ECU Health and the teams to support workforce and also implementing a new scheduling system and the things that we're taking on, when those operations have stabilized,
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Staffing shouldn't be such a big challenge, and so I look forward to having the ability to work a little bit more in some other operational areas, thinking about innovation and nursing and how we at ECU Health are going to implement some of the exciting innovative ideas that they have out there right now. And so I look for nursing operations to grow, but I also think it will stay somewhat the same in terms of partnership.
our nurse leaders will always need a strong partner to help advocate for them on the business side. And whether it's building a business case or helping in the recruitment space or just really looking at policies and procedures and standardizing some of that across the system, they'll always need that support. And I'm always going to be the person that's excited to help build the team to provide that for them.
That's amazing. And one area that I know is near and dear to your heart is burnout prevention. We hear about it. We see it. How do you anticipate addressing that? I think that the role of the nurse leader is one of the most challenging in the organization. Oftentimes, they are the go-to for everything. If somebody doesn't know where to find something in the organization or how to get something done,
They typically start with a nurse leader and they're able to help guide them in some sense, but sometimes senses they also take that on as additional work. And so for us that's been really important for us to hear sort of from our nurse leaders. What is it that they're doing that maybe they don't necessarily love? And what is it that they're doing that they love? And how do we balance that? I think it's about balancing the amount of
work that needs to be done and also building the structures around the teams to support them, making sure that they have the right resources, making sure that they have the leadership structures within their individual divisions to support that they don't necessarily have to be on 24 seven. They are accountable for those departments, but we can also train them to be able to delegate and
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have other resources available to them so that they don't feel necessarily like they have to take it all on themselves. And so we've spent a lot of time digging into that in our focus groups with our leaders because it's important to hear what it is that they need from us, not that we're just imposing on them what we think they need. That's awesome. And that balance to your point, the work-life balance, the ability for your clinicians to feel like they have the
opportunity to grow and develop their skill sets. And I hear a lot from clinicians this desire not only to care for their patients, but help develop and grow other clinicians. And I think that's a key area that we need to provide bandwidth for for our clinicians as well. Yes, absolutely. think nurse later professional development is really important, but they also get such passion from spending time with their teams and growing their teams.
as you mentioned. And so everything that we do, we hope to give them the time back to go back and spend with their team members and also the patients and the families that are on their units, because that is something that fuels, fuels them as well. Being able to care for the people who are seeking care within their individual departments. Absolutely. Well, let me ask you this. We've covered a lot of grounds. You've been incredible in providing a amazing overview as far as all of the
levers you're pulling in the multi-tiered strategies. Any final thoughts? I think the healthcare market is very ever-changing at this moment and so I think our partnership with AMN will continue to evolve as we work through the industry together and so I think as we're working towards phasing out some of our contract labor there are other things like the International Nursing Partnership.
and in the workforce assessment that we have been partnered on that will continue to be a part of our journey together. So I'm really excited to look forward to that. In general, I am really excited for the future of nursing at ECU Health because I think it's a bright future there and we're doing a lot of exciting work that hopefully will translate to us being a national leader in that rural healthcare nursing space.
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Laura, it's wonderful to have you here during our 2024 Client Summit, Talent and Innovation, where we're talking about trends and opportunities across healthcare. Would love any final thoughts that you have as you think about healthcare, our partnership, and what's ahead. Sure. I think the healthcare market is going to continue to evolve, and that means that our partnership has to also evolve and be nimble. And so as we may be
phasing out some of our contract labor. There are other things that we're doing in our partnership around the International Nursing Partnership and strategies as well as our workforce analysis and continuing to help us through that implementation process of our work in centralized staffing. So I'm really excited for us to be able to continue that work together. I think as we look at healthcare in general, it
There are exciting times ahead. There's a lot of innovation ahead. And I think there are spaces that we will probably enter in together in those partnerships. And I am very happy to be here and happy to be a part of the Client Summit as well. Thank you so much for joining us and sharing not just your perspective, but the journey. We are so grateful for the partnership and excited to continue to innovate with ECU Health. Thanks for tuning in.
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