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'Steal Shamelessly' Creating and Learning from your Patient Experience Network with CNO Jean Chirico
Jean Chirico from Eminent Medical Center talks with our host Julie Soukup. Jean comes with a wealth of inpatient, cardiovascular and clinical services before becoming Chief Nursing Officer at Eminent Medical Center. From her diverse experience in many specialties and clinics, she discusses how your community and colleagues can be the best resource for trying to implement new processes to strengthen culture and patient experience.
Julie Soukup Take 1: Patient Podcast 0:00
Hi, I'm Julie Sukup with another awesome episode of take one patient. Today I'm here with Jean Tara co she is the chief nursing officer of imminent Medical Center. And I'm so excited because she breathes such a depth of knowledge and experience in many different specialties and has really brought that into her role at eminent and I'm excited to learn a little bit about you know, what she has been doing there and what she's done in her past. So, Jean, thank you so much for joining us. Why don't you start by introducing a little bit more of your background? Give it a little more justice than I did.
Jean Chirico 0:41
Okay, thank you. I'm excited to be here with you. Let's see, I'm the Chief Nursing Officer currently at eminent Medical Center. I started my nursing career in the emergency department, which kind of led me into a house supervisor, stat nurse. Then as I grew in my own personal education, I also did some critical care, ICU, Cath Lab, Intermediate Care, med surg, kind of the whole inpatient gamut, as well as the nice thing about having the procedural areas is you get a lot of different exposure. So it's kind of made me a very well rounded nurse. And I kind of gradually moved up the chain and my career and kind of just taken everything with me.
Julie Soukup Take 1: Patient Podcast 1:29
Yeah. Well, I think one of the things that is interesting is, as you said, you were in emergency department, you were in critical care, you know, all these different places. Now you're in more of an outpatient setting where there's not as much of a quick pace and some of your patients, it's a little more scheduled.
Jean Chirico 1:45
Yes, it's very different than the emergency department, we know what our day typically is going to look like. We're a surgical hospital. So we do keep some inpatients. But most of our patients know when they're coming, they kind of have an expectation of when they're going to be leaving our facility, whether it's same day, or maybe a day or two or night or two that they're spending with us. So
Julie Soukup Take 1: Patient Podcast 2:07
Right. Well, and that's where I thought was really interesting is one of the things that you had mentioned in our in our call before today was, you know how, even though there's not that pace, and it's you know, your day, and it's structured, that there's still such a need for education and communication, when it comes to even patients that are being scheduled, and how you really started to kind of appreciate that from being in more of a rapid pace. So talk to me a little bit about kind of why that is something that you're really valuing now, and really focus on in your role now.
Jean Chirico 2:40
So patients always do better when they're very educated about their disease process, whether it's a chronic illness, or what's happening to them as far as if they're having a total knee replacement, kind of what to expect. So knowing what to expect, and what that journey is going to look like from you know, maybe very limited mobility to the rehab, and the work that it's going to take on their behalf is really important and vital in their part of their healing. So I think seeing kind of the big picture, if you will, the different phases of health care, understanding your own medical problems, illnesses, diseases, is how you're going to help yourself get better. And really, we're here as advocates for our patient. And we want them all to do well. So part of that is teaching them how to get to the end of the goal, right is to be able to walk or run or swim or, you know, get our patients back to being fully mobile.
Julie Soukup Take 1: Patient Podcast 3:38
Right. So talk to me a little bit as, as far as you know, kind of working up the chain and being involved in many different specialties. What are some of the things that either you've, you've tried or you've learned from as far as you know how to best educate your patients and give you a great and a great experience.
Jean Chirico 3:59
So some of that is just learning yourself and knowing how best to meet your patient where they're at. So the one thing I really would like staff to focus on. And I think, as a leader, it's important that we get our staff the tools and resources that they need to do their jobs, so that they can focus on the important things like education. So an initiative early in my leadership career. I were living in Wisconsin at the time and part of the Wisconsin Hospital Association. They had an initiative of transforming care at the bedside. And really how we do that is small things to increase staff time at the bedside and giving your staff time to be with the patients because that's how they're going to learn and that's how they're going to be able to have time to do that. So I think the one thing that they taught me was about stealing shamelessly don't reinvent the wheel. There are a lot of people in healthcare healthcare is huge nationwide. And the nice thing about moving from one state to another There is, I still have a plethora of step of friends and colleagues and peers and nothing's ever new. We all face similar problems in our environment. So if someone has a great idea, share it. No, you don't have to start from scratch, no reinventing the wheel. But the most important thing is really understanding how staff can see the importance of it and why we're doing what we're doing. And also feel that same passion, because honestly, they're the ones doing the work. And sometimes your staff have the best ideas. So it's really giving them the freedom of how we can say, this is our goal, how do you think we can get there, and honestly, sometimes it's little things like, you know, I have to take 57 steps to go get a bedside commode or a walker before I can actually go and walk my patient. So you can reorganize your space, you can do some small changes. We just you just have to be able to listen and to try things out. And now sometimes we have great ideas, acuity based staffing tools, for example, we had a great idea that we were going to trial this, and it was taking the charge nurse two and a half, three hours to do assignments, well, because we want you to score every patient and see how many resources they were taking, well, the tool became a burden. So it's okay to learn early on, we're going to abandon this this is too, it's sucking too much time away from you actually taking care of the patient, and it's defeating the purpose. So you can't be afraid to fail or afraid to abandon a project like I'm not going to work. So I think that's the biggest thing. One,
Julie Soukup Take 1: Patient Podcast 6:36
I think that you hit on something that's really awesome, which is really is it's being aware of the community around you and how to address these certain challenges. And if any, a lot of the challenges are the same, but cultures in different departments or hospitals might be different. And so saying, okay, what can I What can I steal, but that's only part of it is what you're really saying is okay, now, now that I'm trying to try something that I learned from a colleague, or I learned from someone in my network, now, what is my staff really saying? And how do they optimize it? And how do they either, you know, make it make it really work and align within the system, because it's not usually just like playdough and sticks, you know, it kind of has to weave in slowly. But then also saying, Okay, I'm listening to my staff, this is great, or I'm listening to my staff, maybe we need to relook at that, you know, so it's really you're listening on all sides of, you know, what, you're a conduit of what can I learn? And what can I give you? No,
Jean Chirico 7:31
absolutely. And I think that's the biggest thing. It's the give and take of staff and listening to them and what they need. They're the ones doing the work. They're the ones who are at the bedside with the patient. So it's how we can we make their job easier? How can we improve a process to be less time consuming for them? To give them a little bit more time to be with their patients? Right.
Julie Soukup Take 1: Patient Podcast 7:53
And I it's so interesting, you know, medical memory is a HIPAA compliant app, that video records patients, and we grew really aggressively with COVID, where we started doing family updates in the hospital, we were doing more on a consultative space. Thanks for doing this. And it's interesting that you're saying that so what they're the our biggest hospitals, St. Joe's in Arizona, that's really what their leadership did. They said, Hey, this is a great tool. And as we use in other spaces, and it was the nurses that helped us make the app faster said hey, can you put the button here, hey, this makes more sense that this screen is on the back. And they really were given that voice to help us even as a as a client, you know, they're our client or us as a company, make it more useful for them. And just as you said, it may just be 57 steps to go get you know, an iPad or go get a bedpan, or whatever it might be to do it. So how is it even taking that process back and making it okay, we want to implement this tool, but we have to look at the processes and making sure And that's I think, really what their leadership to to now how do you go about really taking that hindsight look and saying, Alright, well, what are the pieces that I need to do as a leader? How do you go about seeing these things and shifting those things for your nurses,
Jean Chirico 9:10
I like to spend time on the units and really getting to know the staff and kind of what they need from me. I never want anyone to feel like I'm unapproachable or not available. I make myself available all the time, to my 24 hour units. I say call me I don't care if it's middle of night, call me through them. And honestly, like I've been the leader to have to come and staff and ICU. I'm not afraid to go in a patient's room and I'm gonna go take a patient to the bathroom. I don't care what role I am. I'm still a nurse, I still have a patient in need. So it's really, I'm not afraid to do the work with you and I want to work with you. So and I really want an open door policy. But I'm not afraid to hear like hey, Gene, you're really doing this and it's not helping. Okay, great. I won't know that. I'm not helping you as a leader if you don't tell him me. So I mean, even like just meeting with staff members kind of kidding appalls kind of always feeling the undercurrent, so to speak. Because sometimes in leadership, I think it's really hard. Because we're like, so focused on trying to meet a goal. Sometimes you are not seeing what's happening, like what falling to the wayside. And I think that that's the vital piece is, you can't lose space of that time. Because I mean, we're all busy. And it's crazy, our schedules, what we do in a day sometimes. And it's important to have that relationship with every role in the hospital and facility, not even if they report up through nursing. But like, from the front desk, from your facilities people from we're all a team, like we are all needed, like our Oh, our team here, we're always, we're always laughing, how great and everyone in the hospital says how great our housekeeping staff is. Because really, we're pretty busy. So trying to get our rooms turned over to get the next patient in. And they're in there. They're quick, and facilities clean, like our patients, when I'm rounding on patients, they say, you know, oh, my gosh, it's clean, and the staff is great. So it's important to make sure that housekeeping knows like, we appreciate you. So your vital team member,
Julie Soukup Take 1: Patient Podcast 11:11
right? Well, I mean, that's, that goes back to ensuring your team has a voice and making sure that they know they can come to you for the good and the bad. And I think I you know, having that respect, if I'm right here with you, like, I'll take this bet I'll take this, you know, more difficult patient, or I'll do this. But how do you make sure even just as a leader that outside of being boots on the ground and showing appreciation that they really feel that comfort? Is it kind of meetings that you have or conversations that are more intimate? Or, you know, how do you really set that as a value for your, for your teams,
Jean Chirico 11:50
I'm in meetings, I like to send out communications, especially as things are updated or changing for processes, via we I do something called an eminent update, where I'll send out an update of him saying, Hey, this is what really went well this week. Or we have, we usually try to utilize our platforms differently, we have an app called Cool leaf about staff recognition. We also have like, if you have an idea, I tell the staff like I want you to come forward, you know, revamping it from orientation, like so you know, and then also kind of getting to know like, we're here we spend a lot of time at work. So it's important to know, like, I know that my staff members who have dogs and who has kids and like, you know, I share my family with them because you're more of a person and you know, then we're all in this together. And you kind of feel like your work family, right? So we spend a lot of time together. So it's more like I have my work family. And then I have my home family. And it's one of those things where just being supportive. And I think understanding everybody has life's challenges and lives healthcare is crazy, especially last couple of years has been crazy. So trying to fully adapt and be flexible. And then also understanding the challenges that people have faced. Yeah.
Julie Soukup Take 1: Patient Podcast 13:05
And you were talking about really feeling like the undercurrent and the culture of your nursing staff. So that you're knowing if if, if something's working or something's not working, talk to me a little bit more about like, how do you because sounds oftentimes, I mean, people won't always come if they're doing sometimes you might have to pester a little or ask a little bit. But what are kind of the nuances when you're feeling an undercurrent, that's that's overstretched, or maybe not ready? Even if it's an amazing tool? It's not you, they're not ready right now. Like, how do you? How do you feel that or sense that or what are you looking for?
Jean Chirico 13:41
So I'm a big believer and keep asking, if you're not hearing feedback, there's a reason. So I kind of, you know, your staff members well enough to know, like, the people that will say, hey, this isn't working, and then also know the ones that will kind of like, just take it in, and they will suffer in silence, so to speak. So it's making this you know, meeting them kind of, I'm going to help pull them aside just a one on one like, hey, I really want your honest opinion, it would really help me out. I've noticed you've been kind of quiet lately. Is there something going on, and not trying to make it awkward, but if there's something you need, or if I've changed the process, and I've done this before, where we're like, Yeah, we're gonna work on our patient experience scores, and we're gonna do this. And then you kind of sit there and people are looking at you, but they're not really sharing ideas. And it's like, okay, they're not ready for it yet. So it's kind of reading the room and then reading, if you're not getting feedback, sometimes not receiving any feedback, good or bad. It can be a bad thing. And you don't want to have a negative environment. That's the biggest thing like everyone who wants to be happy when they go to work. You don't want to suffer and you don't want to make it miserable for someone else. So we have to implement some things for patient safety reasons. There's things but it's also an understanding when we're going to implement something new. Explain the why and the rationale. And then again, you ask for ideas. No, no process is cookie cutter. and it's going to work. Just because it works on my med surg unit doesn't mean it's going to work in pre op and pack you short, the O R. So I think you just have to really know your audience. And then know your key players, like you're gonna have cheerleaders, and you're gonna have, you know, my director of nursing and my supervisors. You know, sometimes they get different feedback than I get, and it's making it okay, that they went to their supervisor and letting them break the news, like, hey, just so you know, not sure that this is gonna work, and that's okay. I'm like, okay, great. Let's see how else we can get there. You know what I mean? And it's like, I'm glad they came to somebody.
Julie Soukup Take 1: Patient Podcast 15:36
Yeah, absolutely. Now, so one of the things too, and I'll even speak very much, you know, medical memory, I have a complete opposite. So one of the things that we have found is that we have quite a few nursing leaders that are like, we love this tool. We think it's amazing. We see the value in each apps, we see the value and saving time, but my team is just not ready. They're not they're overstretched. They're overburdened. So even though we know in the end, we'll have save time. We know it'll be easier. We can't do it right now. We're What are where do you kind of when when that kind of processes I know it's better in the long run? We can't do it. Now. How did you a evaluate, okay, they really can't do this right now. And see, what is that current of, of your team being stressed? Sounds like it's a lot of they'll tell you, which is nice, or what won't tell you. And that's how you're like, okay, they don't even have to type it down mean, they can't implement something new, but also is how do you for some, you know, how do you kind of push them to say, you know, try this, or you could do this or, or don't stay stagnant? I mean, you're such a person, that's more of your personality of trying new things steal shamelessly. But but some other people are not more that way. They like what they're they're doing now. And it's harder to stress. So how do you kind of have those conversations are evolved with with that kind of either culture or even individual people?
Jean Chirico 17:03
So I mean, you always have those people that the first answer is always going to be that's not gonna work. Yeah. So it's, you have to know that. And that's, I think, when you're when I started out know, as a leader, and that, you know, you have these bright ideas, and then the first time you encounter someone who's like, well, that's not gonna work. I'm like, why? You know, and it really kind of asking the why I'm a huge believer of like, even as I'm a patient myself, I'm like, Why? Why would I do that? Why would I take this? Why is this the best approach? So it's, I'm a white person, and some people just need to know, like, I think the hardest people like that are when they're really like, well, this is the way we've always done it. Yeah. And it's like, I think you have to take the time and hear their rationale. But sometimes you also have to give those people a little push in the right direction, saying, I understand, but can you please try. Because in the long run, this is the ultimate goal. You know, and I understand we can't do that right now what could be change, or alleviate, to make room for this product or this process, that sometimes hearing them where they're at, and then really evaluating the process, because I'm also a big person who likes process mapping and how every role plays a part, right? So it's from something as simple as putting charts together, like our front desk, staff put charts together, but they don't understand how vital that is. Because if one thing is incorrect in the chart are missing, it creates a different workflow. And it's not ready for when we're ready to get have that patient in the back. So I think it's understanding you might have to change something else. And then you have to make everybody at least not afraid to try. So it's kind of pushing them. But it's also trying to make room. So if there's a different way that they're currently like for your medical memory app, it's a great tool and resource for patient education. But especially right now, we don't all have extra bodies, to have somebody just do something as simple as send maybe an email or a video to that patient. You know what I mean? So sometimes it's Oh, my gosh, I have to do it. Another thing. I think you have to introduce it at the right time. I wouldn't do it on a crazy day when everyone that pull it ready to pull their hair out. That's not the day I'm going to come to the unit be like guess what we're going to try to do? I think you have to understand, again, the atmosphere the moment and maybe it's not going to happen today or even in the next week. But I really want to focus maybe on our next staff meeting on how we can implement it and giving them a space when they're not stressed.
Julie Soukup Take 1: Patient Podcast 19:43
For sure. Well, I think what you have alluded to a few times is even just looking at the process that they're currently going through, and even the physical space that they're that they're going through, you know, and some of that it was interesting, one of our clients was like, can we just have more iPads and then I can reach it outside of my nursing station, which is going down the hall and you're like, well, that's a really okay. That's, that's not even a function that's more of the environment or saying, as a leader, you know, this is something we value. You know, patient education is something we value when we see the end goal, we see the why. So what what do we need to do process wise to make it easier for you to look there, and so almost reevaluating fields, look at our day or look at our environment? Or look at our space? And where do we need to work? If these are the end things that we value? That's awesome. That's very, I think, helpful and continuing to bring it back to that to that end game. Yeah. And unfortunately, with a lot of your questioning is where you are questioning are like, they they they got into medicine, nurses and doctors get into medicine for the same why, too, you know, so by asking questions, kind of helps probably then get there in their own way to what would you say? Or what are your thoughts a little bit about that?
Jean Chirico 21:01
No, I agree. And I think we all got into healthcare, I have into healthcare into nursing. Never did I really think I was going to be a leader or until the Leadership track, but to help people and that's kind of what I still take with me from my very first nursing job is understanding the importance of our role and how we we see people in healthcare at their worst times. Sometimes, you know, it's so critical illness, life or death situations. And sometimes it's just scary. Like, if you've never had surgery, and you're coming in, and you're having surgery, this is every day for us. Sometimes you have to be empathetic to an understanding where that patients at so maybe, yeah, they need a visitor with them, someone to hold their hand until we are ready to take them to the O R. So it's just understanding what are each patient needs and what their differences and why we came into healthcare with women to help her to make it better, right to help people. And that is always changing. Unfortunately, like in order to do things better, we have to change so
Julie Soukup Take 1: Patient Podcast 22:06
well, and I love just as your matches, you're saying is the one thing I think that's been consistent is you're you you're asked questions, you're asking questions to other nursing leaders to figure out different things to implement asking questions to your team asking, you know, and that's probably what's really creating this space of like a, like a big pool of knowledge, you know, because if you don't ask, you're not going to know, but it provides somebody she wants to know if you're asking, you know, that space to feel to feel really safe. And that's, that's an awesome, awesome attribute as far as kind of I think we're talking in implementing things successfully. Yeah. Well, awesome. Was there anything else? I think that's, that's awesome information to be able to kind of pass on to new leaders or someone who's wanting to try things a little bit differently. Is there anything else that you'd like to add or anything about kind of your your experience but but outside of kind of like steal shamelessly ask questions. Anything else you you're thinking of?
Jean Chirico 23:04
Um, don't be afraid to network and don't be afraid to fail? And definitely don't be afraid to learn new things. Because the one thing that I've done my entire career is never said no to an opportunity to try something new. That may not be something you've ever thought of.
Julie Soukup Take 1: Patient Podcast 23:18
No, awesome. Absolutely. Because you never know. It could be the you know, simplify and work really well. And as you said, no one to abandon and if it doesn't, then you might as well try. Well, thank you so much for your wisdom and your intellect and your leadership. I think it's providing a lot of value there. So thanks again for joining today. Thanks, Julie. Have a good one. You too.
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