Healthcare management is ever-changing. Join Lisa Miller where you will hear from innovators and leaders within healthcare and from other industries. Lisa will bring you topics on the business and clinical sides of healthcare on strategy, finance, managed care contracting, nurse engagement, physician engagement, new patient care models, patient satisfaction, innovation, leadership, communication, marketing, plus much more.
This radio show will challenge you to think differently through proven strategies and innovative approaches that will help you to elevate your healthcare management and healthcare leadership performance for the ultimate goal of providing exceptional patient care.
Enjoy diverse and thought-provoking conversations. Lisa will present best practices, new strategies, and ideas for you to think about and to implement in your career and your healthcare organization. To contact Lisa Miller, please email: email@example.com and on linkedin at https://www.linkedin.com/in/lisamiller/ .
The radio show is sponsored by VIE Healthcare Consulting; https://viehealthcare.com
Promoting Community Health Through School Nursing with Lisa Cagliostro| Episode 52
In Episode 52 of The Healthcare Leadership Experience Jim Cagliostro is joined by Lisa Cagliostro, to discuss the expanding role of a school nurse and its impact on community health.
School nurses are now playing a critical role in community health. In this episode, Jim Cagliostro, VIE’s Clinical Operations Performance Improvement Expert, interviewed Lisa Cagliostro to discuss the multiple demands on school nurses in the public school system, especially in communities where access to healthcare may be limited.
A varied nursing career helps to be a better school nurse The biggest challenge in school nursing Identifying emotional and mental health issues in children Contact tracing and implementing new policies Interconnectedness during a pandemic
Support is vital to school nursing School nurses are integral to their community
04:22 A varied nursing career helps to be a better school nurse
Lisa said the transferable skills learned in a previous case management role in health insurance helped her to adapt to school nursing.
‘’So of course lots of careers and jobs, you're always learning, and especially true in nursing, and so I think the more experience and the variety of experience that we can get just contributes to our growth and helps us to become more well-rounded. Having those experiences, when they come up again or something similar, it doesn't take you quite by surprise, you kind of have that muscle memory, you feel that all coming back and you can handle it with a little more wisdom, you have that experience behind you….case management was probably one of the jobs that probably stretched me the most. It was different than what I had ever done as a bedside nurse or in the hospital, and it was very challenging, but it did help to, I think, prepare me more for school nursing, because that is one of the areas that you see as needed in the school and in that nursing situation. A lot of the job or some of it was coordinating resources and finding resources. I remember just having to get familiar with what's available right here in our county and being able to point parents to, whether it was getting free immunizations, because they didn't have insurance or other resources, like even just an eye doctor, if the student needed to be referred and checked out further for any eye issues or same with hearing….. I think that case management job helped, because you have to have those assessment skills to do that, and then also having the knowledge and the resources to connect parents and guardians with that.’’
08:13 The biggest challenge in school nursing
Lisa said the biggest challenge of the role is the unpredictable nature of every day.
‘’Well, I would say for me, it's probably just the unpredictability of the day. You have your to-do list and there are things you got to get done, but of course you're there for the students and they're sometimes constantly coming in, and I just would never know how many students would be coming in or when. I mean, as you go through the school year and you get to know the student, you kind of start to see the rhythm, the routine. Yes, there are certain students that are coming at scheduled times and you kind of prioritize your day around them, and then you have anything and everything else coming in. So I know sometimes I just find myself getting a little frustrated, like, "Oh, I can't get this thing done, but okay, I'm here for the students. They're here, I need to be available to help them with whatever they need, whether big or small," because you kind of see it all. I don't have that emergency room experience, I kind of felt like that's more like what would prepare a school nurse for that. I know a lot of school nurses do have that experience, so yeah, just having that readiness, being prepared
Life As A Nurse Practitioner With Walter ‘’Buddy’’ Elliott | Episode 51
The Healthcare Leadership Experience is hosted by Lisa Miller for health leaders who want to think differently and learn how to improve their performance. On this episode, Jim Cagliostro is joined by Walter ‘’Buddy’’ Elliott, a nurse practitioner for the phase one cancer clinical research program for Hackensack Meridian Health, to explore the reality of life as a nurse practitioner.
The role of a nurse practitioner has changed in recent years. In this episode, Jim Cagliostro, VIE’s Clinical Operations Performance Improvement Expert, interviewed Walter ‘’Buddy’’ Elliott to discuss the benefits of previous ‘’hands-on’’ nursing experience for nurse practitioners, the critical role they play in enhancing the patient experience, and the support they offer physicians.
‘’Bedside nursing’’ experience is essential for nurse practitioners Identifying prospective patients for clinical trials The indepth knowledge required of cancer studies From cost savings to better patient care Drawing on the expertise of more experienced nurses Nurse practitioners enhance the patient experience Achieving formal qualifications through multiple routes
04:35 ‘’Bedside nursing’’ experience is essential for nurse practitioners
Based on his personal experience, Walter said hands-on nursing care provides vital experience for nurse practitioners.
‘’I definitely feel it is essential as a nurse practitioner to have had experience in nursing because as a floor nurse, you have increased access to being able to see how care is carried out. From the orders that are placed and the management of the patients' care, being able to watch a patient's vitals and how a patient is reacting to a certain treatment and being that first line of being able to counter anything that would be negatively impacting the patient. Being able to have the access of seeing multiple different types of disease processes and modalities of care, I think definitely increases the experience for a nurse practitioner to be able to draw off of. So I definitely feel it is important to have had a couple of years or more of nursing, hands-on nursing care, before pursuing nurse practitioner roles just because it allows you to have that experience.’’
06:21 Identifying prospective patients for clinical trials
Walter outlined his involvement as a nurse practitioner in identifying patients for clinical trials.
‘’Well speaking for myself personally, in research, my role as the nurse practitioner whenever a prospective patient is identified or referred to our program, my job is to help identify the appropriate enrolling study for their disease process and then to help evaluate their eligibility based off the criteria of the prospective trial. We work primarily in solid tumors so anything such as non-small cell lung cancer, colorectal cancer, those being examples of disease processes that we see, I help look at what's available for them because trials open and close based off of how many they've been able to enroll in a cohort and then I can say, "We have these three open trials that would be available for you. We would like you to review the consent, the process, of what you would be undertaking in this clinical trial." And then meet back up with the patient in the screening process to determine whether they would like to sign and then go on from there.’’
08:18 The indepth knowledge required of cancer studies
Walter outlined the complex nature of working as a nurse practitioner on cancer treatment trials.
‘’I definitely feel now that there are a number of different roles that a nurse practitioner is able to help fill. The research role is in and of itself a different avenue that beforehand I wasn't aware of but intrigued me as I became more aware of what the position entailed, mainly because of the in-depth
The Growing Importance of Healthcare Informatics With Joe Cagliostro | Episode 50
In Episode 50 of The Healthcare Leadership Experience Jim Cagliostro is joined by Joe Cagliostro, Informatics Site Manager at Robert Wood Johnson, Barnabas Health, to discuss the impact of informatics on healthcare.
Healthcare as a sector has been slow to adopt technology. Healthcare informatics can help to bridge that gap. In this episode, Jim Cagliostro, VIE’s Clinical Operations Performance Improvement Expert, interviewed Joe Cagliostro to discuss the benefits technology offers healthcare. These benefits include patient safety, Joe’s role in bridging the gap between IT and nursing, virtual resources for novice nurses, and how to encourage staff buy-in.
The shift to healthcare informatics How the ‘’RN tag’’ builds trust between IT and clinical teams Lab specimen barcode scanning How healthcare informatics enhances EMR processes An on-call virtual resource for smaller community hospitals
The challenge of keeping patient information secure Encouraging staff buy-in to technology
02:33 The shift to healthcare informatics
Joe outlined his career history and the need to learn a whole new language in nursing informatics.
‘’And as I took on more of those responsibilities, it really developed my interest in the IT side of healthcare in the informatic side of nursing. And an opportunity came up, a job opening within the RWJBarnabas system. And I applied for it after finding out a little bit more. And I started working in that role about a year and a half ago. Now it was eye opening to me because when I was in nursing education, I knew everything about IT because I knew how to double click a mouse, or I knew what an icon was, but then coming into the true IT department, it was like I had to learn a whole new language. Now keep in mind. My MSN was in nursing education. Now it is incredible to see the number of programs out there for an MSN in nursing informatics. It was a whole new language. It was a whole new world that I had to learn working in this clinical informatics role.’’
07:00 How the ‘’RN tag’’ builds trust between IT and clinical teams
Joe explained how his experience of the challenges nurses face helps to establish relationships more quickly.
‘’I know when I first came into the role, a lot of my coworkers that I was training with, they said, you know what, Joe, in addition to your ID badge, make sure you hold on to your RN tag that hangs underneath your badge. You want people to know as you're rounding that you are indeed a nurse because the nurses, although they'll respect anyone they interact with, they have just a higher degree of appreciation for someone who knows the struggle. Someone who knows the challenges, the time constraints, the barriers, especially since my role is working specifically with the electronic medical record. When they know that I know the struggles that they have with the EMR, they're more likely to give an open ear. They're more likely to say, Hey, you know what? He knows what it's like. I'm going to listen to what he has to say, because I know a little bit of their struggles. The challenges that come up during any given shift for the nurse, for the physician, the provider, and part of that experience helps me in translating things from the clinician to the analyst and vice versa, right? The clinician has a problem. I have to relay that to the analyst in a way that they'll understand, or the analyst wants to present a solution, or they have a problem. I need to explain that to the clinician in a way that they can understand.’’
11:22 Lab specimen barcode scanning
Joe gave an example of how his role helped analysts to understand workflow on the frontline of healthcare.
‘’A little while ago, one of our last hospitals in our system to go liv
Clinical Research With Todd Nicklas | Episode 49
In Episode 49 of The Healthcare Leadership Experience Jim Cagliostro is joined by Todd Nicklas, Senior Clinical Trial Manager and Head of Clinical Operations at Trevena to discuss the benefits and challenges of clinical research trials.
Clinical trials can transform healthcare and the patient experience, yet they are not without their challenges. In this episode, Jim Cagliostro, VIE’s Clinical Operations Performance Improvement Expert, interviewed Todd Nicklas to discuss his experience with clinical research, including the positive impact for hospitals that participate in clinical trials, overcoming patient hesitancy, and the high cost of achieving FDA approval.
Why clinical trials matter to healthcare From bench research to real life scenarios Clinical research can reduce patient readmissions Trialing heart donors with Hepatitis C Overcoming patient hesitancy The $2.6 billion cost of successful clinical trials The impact of COVID-19
01:55 Why clinical trials matter to healthcare
Todd said clinical research can attract patients to hospitals by giving them access to brand new treatments.
‘’Physicians and patients have access to cutting edge new technologies and that's brand new technologies and medicines that maybe are a few years down the road in development, or maybe that just got approved and that hospital has it ready to go in their formulary and ready to be used. They're maybe ahead of the game versus other hospitals around their area. And that might get people excited to come to their institution. I worked in clinical research on the hospital side for about 10 years, and some patients would come to our hospital for the very reason of trying out a research medication or trying to work with a physician that's doing a trial with us with a medication. Got them excited to come to that institution versus maybe their own hospital that they're at.’’
03:56 From bench research to real-life scenarios
Todd shared an early example of artificial hearts, trialed in a cow.
‘’Another great thing, I would say, is a fair amount of hospitals have translational bench research and they want to translate that into real life scenarios and putting it in patients and giving it to patients. So you see something that maybe was developed 30, 40 years ago. You and I worked at Penn State Hershey Medical Center for a few years, and I love the story in the, I believe it was the 1970s. They were working on the first total artificial hearts. And this device was pretty primitive at the time. It's developed a good bit as of today, but they put it in a cow and they have a neat story that it was a pneumatic system. It was an air compressed system and they plugged it in, it was back in the 70s, they had the plugs in and I guess some electrical problem happened, and the cow dropped like it was dead because the power went out and somebody thought to blow on the pneumatic tubing that was in the back of the machine to have the blood pump for that cow and, to bring it back to life until they get the electrical power back on. And the cow lived for weeks and months after that. But it gets people excited, "Oh, Hershey Med's doing this? And look at this neat story." And then the years to come, the cow survived, they put it in patients a few years after that, but it's doing great and people can get that now at home. They can actually go home with a total official heart and a driver. ‘’
05:24 Clinical research can reduce patient readmissions
Todd said new medications can improve patient outcomes, leading to fewer readmissions, rehospitalizations and ER visits.
‘’….Physicians that are so used to certain procedures, certain medications, certain devices, they might have good outcomes and they might do fine. But what if there's a new medication that gives them 50% better outcomes or 50% less hospital burden where people are coming into the h
The Reality & Challenges of Nursing With Jim Cagliostro (Part 2) Nursing Burnout| Episode 48
In Episode 48 of The Healthcare Leadership Experience, Lisa is joined by Jim Cagliostro, a Registered Nurse and VIE’s Clinical Operations Performance Improvement Expert. Together they continue to discuss the role of nursing in healthcare, with a focus on the challenges of burnout.
The role of nursing has undergone a transformation in recent years. In this second episode of a two-part discussion, VIE Healthcare Consulting’s founder and CEO Lisa Miller interviewed Jim Cagliostro to explore effective solutions for burnout, the benefits of frontline driven innovation, and encourages all hospital leaders to listen to their nursing teams.
Patient care assistance enables nursing staff to focus on their strengths Volunteers can enhance the patient experience Cost effective staffing solutions to overcome burnout Healthcare needs leadership that listens – and shows up Lessons for the healthcare sector from Undercover Boss The concept of shared governance When leadership doesn’t listen: an example from a patient’s bedside
02:13 Patient care assistance enables nursing staff to focus on their strengths
Jim shared his experience on the benefits of patient care assistance.
‘’And so I mentioned that patient care assistance. And by that, for anybody, most people know, these are people that are trained in terms of what's the safe way to help a patient who's had a certain procedure to help them to the bathroom, or to sit them up or get them over to the chair and set them up for a meal. For recognizing, "Okay, there's certain restrictions that this patient has. So I can go get a drink of water for this patient, but that one needs thickener in their liquid." Or when do we need vital signs and daily weights. These are all activities that patient care assistants or nurse assistants, depending on where you're at, they have different names, that they can help with. And then it allows nurses to focus on the things that only the nurses can do.’’
04:28 Volunteers can enhance the patient experience
Lisa shared a personal experience of her daughter’s stay in hospital.
‘‘My daughter was in the hospital, and we were in a children's wing of a hospital. And it's interesting, because I think that anything to do with children, people tend to be more innovative….But this young man that came in, and I would say he was about 17 or 18, and he would just come into the room and talk to me, talk to my daughter, and really just chatt with her. And he is like, "Oh, I'll go get coloring books and I'll color with her." And I'm just like, "Okay, who are you?" I'm like, "This is great." I mean, he was great. I mean, I knew he had a badge and I knew he was there legit, but I'm like, "What's your role? You got to tell me your story. What's going on here?" And he's like, "Oh, I'm going to start medical school and I have a program here at the hospital where I can volunteer." And he wanted to be a pediatric orthopedic surgeon, which is amazing, because he was not even in medical school and he knew what he wanted to be, but of course that made a change.’’
06:56 Cost effective staffing strategies to overcome burnout
Jim said improving nurse-to-patient ratios was just one way of better managing resources.
‘Every state should, I don't know if every state does, but states will have a minimum nurse-to-patient ratio. And so if you have this number of patients, then you need this number of nurses. So that's one thing... They have to meet that as a minimum, but they can have better standards in terms of, "Okay, the state says five-to-one or four-to-one on this step down unit. But we, as a hospital, are going to say, 'No, we're going to say three patients to one nurse, because we want to provide better care. And yeah, it's going to cost us more maybe upfront, but in terms of the quality of care, in terms of safety, in terms of preventing fall
The Reality & Challenges of Nursing With Jim Cagliostro (Part 1)| Episode 47
In Episode 47 of The Healthcare Leadership Experience, Lisa is joined by Jim Cagliostro, a Registered Nurse and VIE’s Clinical Operations Performance Improvement Expert. Together they discuss the evolving role of nursing in today’s healthcare organizations, and its inherent challenges.
The role of nursing has undergone a transformation in recent years, accelerated by COVID. Physician shortages have had a key impact on this evolution, but burnout is still the reality for many nurses. In this first episode of a two-part discussion, VIE Healthcare Consulting’s founder and CEO Lisa Miller interviewed Jim Cagliostro to discuss the day-to-day demands on the nursing profession, offer strategies to prevent burnout, and discuss the role of nurses in leadership.
The evolving role of nursing in the US CRNAs operate without an on-site anesthesiologist Specialized nursing roles lead to better and safer patient care Learning the business side of healthcare The current state of the nursing profession Understanding the causes of burnout Nursing in leadership: having a seat at the table
01:55 The evolving role of nursing in the US
Jim explained that nursing has expanded beyond the traditional helping role.
‘’… nurses as the frontline healthcare providers, they have grown also to become the backbone of the healthcare system because it's no longer viewed as just a helping role. Nursing has become a more prominent profession that has had a louder voice. Maybe the voice hasn't gotten louder, but maybe it's that more people are listening. I mean, there's so many descriptions we can give for nurses: patient advocates, policy makers, researchers, educators, community partners, caregivers. There are so many different descriptions in terms of what nurses do. So I love being a nurse. And I think when I got into it, I didn't realize just the breadth of what that might include, what it means to be a nurse. But I'm excited to be a part of a profession that really does have an impact in so many different aspects of healthcare in this country.’’
04:02: CRNAs operate without an on-site anesthesiologist
Jim said that due to staffing shortages, the need for nursing practitioners and CRNAs is increasing.
‘’I remember there was a client we were working with, and we were looking just at the topic of CRNAs, certified registered nurse anesthetists. And I know not in New Jersey, but in some other states, CRNAs are legally allowed to operate without an anesthesiologist on site. And simply that's just out of need. You have very rural locations, and you simply don't have enough anesthesiologists to cover every surgery center or whatever the operation might be in a very rural location. And so you have those who are still nurses. Now they've had more training, they've had more experience and they're perfectly capable of handling whatever the situation might be, but nurse practitioners is another example. They might work under the authority of a physician, but the need for nurse practitioners has really increased. And that's even before COVID.’’
06:47 Specialized nursing roles lead to better and safer patient care
Jim said that the passion at the heart of nursing can help hospitals to establish effective policies, in addition to better and safer patient care.
‘’I mentioned specialized roles like the nurse anesthetists and nurse practitioners. Those again are increasing in terms of not just the numbers, but what they're able to do and how they're able to provide better patient care. And that's in partnership with the whole system and partnership with physicians and administrators. I think the value comes in when there's like the hands-on direct patient care that nurses have as their foundation. That's where our training is. That's where our heart is. I believe that lays a wonderful foundation to bring with us into other are
The Healthcare Leadership Experience with Lisa Miller
I found the show to be quite interesting and it shared some helpful points to implement in the future.