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Welcome to All About Nursing with your host, Dr. Joyce Vacherlin. Executive nurse advisor, Dr. Vacherlin, will present a significant role in nurses' play in providing health care in a multitude of health care settings.
Listen to some of today's key nurses who work and practice in academia settings and talk about the challenges they face in today's modern medical world. So please welcome the host of All About Nursing, Dr. Joyce Vacherlin. Good evening.
I'm your host, Dr. Joyce Vacherlin, all about nursing and rely on the BBM Global Network and Tune in Radio. I'm excited to have a special guest with me this evening, who is Jennifer Thomasik. Jennifer is the vice president at the Center for Applied Research, which is a management consulting firm that was originally a research center inside the Wharton School.
Jennifer is a member of the firm's executive committee and board of directors and she leads to health care practice. She partners with clients on issues of strategy, change, leadership and governance in the transforming health care landscape. Jennifer is a fellow of American College of Health Care Executives for which she currently serves as the regent for Rhode Island. She holds a master's in health policy and management from the Harvard Chan School of Public Health.
I've had the pleasure of working with Jennifer and others from her consulting firm over the years, and I think it'll be great to have you on the show this evening, Jennifer. So welcome. Let's go ahead and start. Great to have you.
So Jennifer, let's start with what has led you to do the kind of work you currently find yourself involved in? Oh, wow. So first of all, Joyce, thank you so much. It's a great privilege to be here with you this evening.
And while I'm not a nurse, I do have the privilege of working with many, many nurses and nurses across the country. So I'm excited to be here talking to you about some really hopefully interesting issues in health care and nursing and such. So, I think I sort of stumbled into my profession a little bit accidentally, and it was a wonderful accident. I've always been drawn to interdisciplinary work and that started in my undergraduate education at Tufts University and American Studies, where I was virtually introduced to looking at issues from multiple perspectives.
And that carried on through my interest in public health, my graduate degree in public health, where I studied health policy management, and was really a focus on strategic management of health care organizations. And my goal at that time was to go and work in a large health system. That's really what I thought I wanted to do. But then I stumbled upon C-Far when I was actually in my second year of graduate school, and that was almost 20 years ago, I actually became an intern at C-Far and began to learn about the most interesting parts of organizational life, really understanding how organizations function, the tensions that exist, the role of structure, the role of strategy, the role of governance, how people, individual and collective motivations and ambitions come into play in organizational setting.
And so my love of health care coupled with my emerging love of those issues really came together inside C-Far. So it's been about 20 years, and while I started as an intern now, I run the business with a couple of my colleagues, and we really love the work that we do. We're so fortunate to be able to work on really fascinating projects, tricky, challenging projects that are really at the cutting edge of change in health care. And it's been such a privilege to do this work.
The time has gone by really fast, so it's been great. You know, one of the things that has been interesting is the work you're doing on interprofessional teamwork, and I constantly think about when we say teamwork, I think what we forget sometimes is how frequent our team changes. If you look at the traditional hospital, we change shifts all the time, and then there's always different people coming together, and I think it helps to really make it even more complex when you're trying to really make some of the progress that we're trying to work on. So what are some of the challenges that you're finding that a lot of organizations are really working on?
Well, you know, I think there's so many issues that are happening right now in health care, and there's so much uncertainty with the future of the ACA, the real cost crunch of health care and the rising costs of pharmaceuticals and care overall, and the increasing pressure that organizations and providers are under to bring those costs down, to improve cost, to improve experiences, and creatures are just thinking to do all these things in a world where, you know, we're simultaneously trying to reduce the amount of money overall that's spent on health care in this country. And mergers and acquisitions are taking place, you know, with the hope of bringing value to patients and the communities that these organizations serve, but often that's not the case often. Organizations have a really hard time coming together and really merchant cultures and the systems that are needed to provide care in a coordinated way. And you mentioned interprofessional collaboration, and I do think that interprofessional teams are a differentiator in some of the leading health care organizations, certainly that we've seen in many cases have had the opportunity and privilege of working with across the US.
I think about interprofessional collaboration is the kind of care that everybody assumes they're getting, but that is not necessarily the kind of care that they may be getting at least consistently all the time. Interprofessional care is really when all members of the care teams are able to work at the top of their license. Each person, each role understands their individual role, the role of the others on their team, and how together they create a hole that's greater than the sum of its parts. And that the leadership on those teams can change depending on the situation of the patient that that team is caring for.
So whether you're in an acute setting or really in a care team that's managing patients with chronic disease, or even just in a primary care setting, interprofessional collaboration is something that is, you know, is surprisingly unique, but when it's done, it's just an amazing, amazing thing to see, and the benefits are really terrific. In fact, it had an opportunity to do some work on behalf of the Robert Wood Johnson Foundation a couple of years ago, where the foundation, which for those folks who don't know about the Robert Johnson Foundation, they're really the largest health care foundation in the world, and they do transformative work in communities around the country. When I started working on this particular project, they had just changed their mission to creating a culture of health in America, and the big piece of that strategy and mission was to think about the role that interprofessional collaboration could play in creating a culture of health. And so what the charge was for that work was to say, look, you know, here's what we mean when we say interprofessional collaboration.
Let's go out and try to find where this is happening in places around the country, not just in the best of the best, in the biggest, maybe most complicated academic medical centers in the country, but in a variety of different settings, in a variety of different geographies, some of the teachings that went out, community health centers, you know, standalone specialty hospitals, and smaller community hospital systems to really get a range of perspectives and experiences and identify what is it that these folks are doing that's different than other places, and what are the practices that they're doing so we could capture those practices and be able to share them more broadly across the country so that folks who are interested in doing that work could catalyze those practices in our organization. Well, that's great, Jennifer. We'll talk a bit more about that in just a little bit. This is all about nursing, Dr.
Joyce Bachelor, we're live on the BBM Global Network in Tune & Radio, and it's time to take a short break. Dr. Rob Moyer is the director of the Ocean River Institute, and he is passionate about saving the ocean by helping dolphins suffer from nitrogen pollution. Nitrogen is a dangerous pollutant affecting our oceans, altering ocean ecosystems, and contributing to global warming.
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Thank you. America is out of control. Today's capitalism and the approach to money is in fact the symptom of a more widespread pattern of excessive behavior. In his book, The Culture of Excess, how America lost self-control and why we need to redefine success.
Clinical psychologist Dr. Jay Slosar portrays in America where excess fuels live drive to succeed. Dr. Slosar examines the cultural factors that lead to excess ranging from obesity to fraud to pervasive budget deficits.
His book examines the powerful economic and social factors and their impact on our psychological well-being. Dr. Slosar explores the psychological impact of increasing narcissism, perfectionism, self-destruction and our identity confusion. He offers recommendations for helping generation me, become generation we.
Those who resist Slosar's message will want to avoid his discussion of regulation and his recent message that at this point, democracy must be more important than today's capitalism. Get his book now, online or by visiting thecultureofexcess.com. Welcome back everyone. You're listening to All About Nursing Live from the VPM Global Network and tuning radio.
I'm Dr. Joyce Batchelor, the host of the show. And before the break, Jennifer was telling us about the very exciting, interesting work that she's involved with at the Center for Applied Research called CFAR, and really trying to work on how to help organizations enhance the inner professional team work in collaboration. So you want to say a little bit more about that and the work that you've been doing with the Robert Richardson Foundation and how those kind of go together?
Yeah, no, absolutely. Well, I was thinking back to when we started talking about this a few minutes ago, you really started talking about the function of teams. And I think one of the pieces that was so central to this work was thinking about a shifting concept of team. So one of our colleagues at the Harvard Business School, Liam Benson, writes about teaming, the concept of teaming.
So in any way, it transitions the concept of a team as a real stagnant, kind of fixed entity in a healthcare setting. As you describe Joyce, teams are changing all the time. People are coming in and out. The partnerships are changing.
The people in the team are often changing. And so instead of thinking about the team as a noun, it really becomes more of a verb concept of teaming, right? So it's an active interactive, engaging piece. And a lot of that thinking was central to the way we thought about interprofessional collaboration in the study, which led to the six practices that we ultimately identified, where no matter what type of organization we were looking at, no matter where they were located across the country, they really focused in on six main areas.
In these areas, we have, in a report actually that you can find on the Robert Johnson website called Lessons from the Field Promising and a Professional Collaboration Practices. This document has got amazing case studies that help organizations with many different sizes and shapes to take these ideas and give them other ideas to think about how they could employ them in their organizations. For example, one of the first things to do is to think about the importance of putting patients first. So the reason that that's important, you know, part of the teaching, obviously that's important.
Sadly, I think a lot of healthcare is necessarily designed at the center. But in interprofessional collaboration environment, the patients really are at the center. And one of the ways that the team can overcome a lot of the professional hierarchy and some of the differences in training and education and language and approach to patient care can get neutralized and create more of a level playing field when you're thinking about what are the best interests of patients. Let me not think about what I'm worried about as a cardiologist or what I'm worried about as a physical therapist, but together, what's really listening to what the patient has to say and how can we really create a collective plan of action that's going to be best suited for this person at this moment in time.
Also thinking a lot about the importance of leadership in organizations where interprofessional collaboration is able to thrive. If you don't have leaders that are working together and really demonstrating and modeling collaborative behavior, it's really hard to say, hey, everybody worked together when they are doing it themselves. And this report has a lot of terrific examples, not only of say chief nursing executives and chief medical officers partnering, but also many of the other leaders of different clinical services and administrative leadership will collaborate across these, you know, for different initiatives, strategies and other professional efforts. And then I think that, you know, there are a whole bunch of things in here, but one of the last things that I like to talk about is the importance of actually training these teams together.
We had the privilege of doing some work recently with some departments of South and Medicine across the country, and a lot of the working family medicine is really built on terrific principles of effective interprofessional collaboration, and a lot of this is about helping educate teams as early as they say, you know, how do you train nurses and physicians and PA's and pharmacists, you know, to all nutritionists, to all work together and to learn how to function as a unit in the earliest stages of their training before they get trained in, you know, maybe they'll say, well, fashion ways where the silos are much more predominant and, you know, that collective team is teeming, isn't really as effective as it could or perhaps should be. So those are some of the areas that I think were pretty fascinating in this. And I think one of the quotes I was thinking of from one of the folks who participated in the study was inter-prosessional collaboration. It's not a fad, it's not a, you know, just something that's going to come and go.
It's really, truly, deeply a different way of working together. And it's something that you do on a day-to-day basis. It's not like the fad of the week, right? It's just a different way of thinking about and approaching your work and collaborating and the best service of the patient.
You know, I think the comment that you made about the patient being at the center, it sort of signals to me that that is the one constant is the patient himself or herself really knowing what their care should be like and the family certainly helping to assist in all of that. Because even with the hospitalists now and residents, I mean, there's just changes, even with having more consistent positions practicing in those organizations, they still change a lot too. And then you have lots of different years of experience and new to the organization. So it seems like the patient being the focus is going to be extremely important going forward because I think they're going to know more what they need.
And I'm excited about that. I was just curious, how are you seeing health care leaders navigating this uncertainty and the changing environment with all the pressures and things that are going on? Yeah. Well, it's certainly not a picnic being a health care leader these days.
On the one hand, there are a lot of challenges. On the other hand, there's a lot of opportunities to do some really amazing things. I think one of the things that we've seen organizations taking a sharper look at is strategy. In the past, a lot of our clients, for example, every five years, here's our strategy.
We're going to go through this process and, you know, write a strategy and the strategy is pretty good. You know, it guides behavior for at least some period of time, but not necessarily the full five years. They're not necessarily, you know, kind of necessarily driving the kind of behavior that or researching the best in that you might hope would have a strategy. What we're starting to see now is a lot more attention to flexible strategy where leaders are fully engaging their organization and identifying what we might call a strategic framework that provides clarity and guidance about what their organization is trying to accomplish overall without all the needed to detail because things are moving so quickly.
They need to really adapt and they need to be able to move and adapt quickly, which is not always easy for some of these more healthcare organizations. So, it's exactly one area. Well, we are coming to you live from the BBM Global Network and TuneIn Radio for all about nursing. I'm Dr.
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Before the break, Jennifer was telling us about the International Team Work and Collaboration and the kind of worker organization is involved in. And I was really taken as you were talking, Jennifer, about the need to have people really working well together and reminded of the work that you all helped us do when I was in my prior role at Austin as a systems CNO and creating a triad, which was the top CEO who at that time was Charles Barnett and then the Chief Medical Officer, Jim Lindsay, and myself. The three of us really talking about what we needed to do to really change the culture and drive to zero-prenewal deaths and injuries. And that kind of synergy was probably some of the best time I had as a senior executive in my career.
It was the most satisfying time. So maybe you could share a little bit more about what you're seeing people doing in that regard in terms of trying to take the silos down. Oh, yeah, no, absolutely. Well, and I think that's a great example of work in a professional work.
And maybe even in some ways that that work that you all do together, even predates the actual term in a professional collaboration, but really is one of the very early examples of a really powerful triad that got a lot of great things done at beaten. So I think that taking the same concept of getting people, you've got people who need to work together just as colleagues who need to bridge different ways of thinking, different ways of being, different leadership styles, different professional identities, and the language and education and training and everything that comes back to each of those things. And that all comes together in a complicated way when you're trying to create these interprofessional teams and I as a triad. And when it comes together really well, it's just amazing what it can accomplish.
We have seen with the fact that interprofessional collaboration and examples like you're talking about on the floors in academic health centers, one of our clients has for years created a similar kind of structure that they call uni-based clinical leadership. And that became really the arm for a much broader interprofessional collaboration strategy around quality and safety for the entire organization. It started off where they realized that they had all these issues would come up in quality or safety issues. And they identified something, you know, hospital acquired infections.
They were having a problem with hospital acquired infections. You know, they would go, they would put processes into place. They would do all the work that they needed to do and they bring those rates down. And then by the time they were working on that, they turned and something else was happening.
And it became as one of the chief nurse at that time, she talked about it as feeling like it was like a whack-a-mole game. You know, just one thing will talk about the knock it down and you get to shift and think about something different. You know, and so what they did was they created these teams where you brought together a physician on the floor, a nurse manager on the floor, and a data quality manager who worked with the teams on each unit, but also worked across a number of different units. So that person not only was able to bring data to the issues that these different units were facing, but was also able to bring best practices and innovations from other parts of the system, where otherwise the nurse and physician payer wouldn't necessarily have insight into what was happening in other places.
That might also be interesting to help them solve issues that they could be facing. So they started off with highlighting a couple of these different teams. And over the past 10 years, and I actually believe it or not, you know, it helps. I've been blashed for about, you know, have a shelf life for about a year or two years.
But this model has really stood the test of time. And now they use it to implement a shared quality blueprint that they have each year, where again, it's not the physician organization coming up with quality and the nursing organization comes as a quality strategy. But together, they create a shared strategy for the entire health system. And then each unit on the health system at each of the different hospitals and different affiliated organizations identifies the priorities that they're going to take to ultimately crack the bigger issues and goals that they're trying to talk.
So it went from being a way to kind of deal with this sort of walk-a-mole challenge to a real consistent and professional approach to not only identifying, but really successfully implementing and managing their quality blueprint for the entire institution. That's wonderful. As you were describing that, I was thinking of a phrase that, and one that I still use, which is everybody teaches, everybody learns because we do both. And how to get used to that, you know, and then my other favorite is stealing shamelessly from each other.
There's no reason to not be able to learn from someone who's doing something better. You know, how do you find out what they're doing and get their ideas and then it speeds up your ability to really get the kind of improvements that you need. And so those were just a couple of my favorite little phrases that came to my mind as you were describing that. There's just so much wisdom out there.
It's a matter of how do you get it consistently in all organizations at the same time, which is just still very challenging. Right. And, you know, often I find that even within an institution, you know, different hospitals within a health system, instead of feeling open to learning from their colleagues and other parts of the system, they often feel like, well, we're doing it just fine the way we do it here. And there's some, I don't know if it's a competition or, you know, different kinds of challenges, but depending on the overarching culture of that particular institution, there's a lot of learning a lot because the different units or, you know, the different units or hospitals or different pieces of the system part of the continuum aren't open for that kind of learning as they could be.
And it's a real loss of knowledge because, you know, there's so many pockets of innovation are happening inside healthcare institutions across the country that could really catalyze change. And, you know, I always just ask clients to be open to that and to really think about ways to learn from the spotlight and highlight what's working well and how to help others get inspired by and motivated by that change to help make improvements in their own areas. And I think you said it earlier that if the leaders at the top are role modeling that kind of synergy and teamwork, it filters down. If it's not, then people tend to want to be one up, one down versus this is really about the people we serve and they should all be getting the best from all of us.
And I know that a simple question we used to ask is, was this the best we could do for this patient? And that was a pretty powerful question, especially when you were seeing in a meeting where you were discussing an error that had just been made. So those are simple things to ask, but yet powerful if you can really get them and culture it into your organization. So I'm amazed too that you were talking about an organization that was able to keep that unit leadership in place over time because I think one of the things I'm concerned about is how do you really sustain this when you see in the Becker's report on almost a weekly basis, 30 more CEOs have turned over, 20 have turned over this week.
And so we'll talk a bit more about that. But right now we're coming to you live in the Beaten Global Network in Tune in Radio. This is the Old Bounders in Show, Dr. Joyce Bachelard, the host of the show and we will be right back.
Renison Swamin, Trailblazer, Maverick. Those are just some of the words to describe to Chandra Poulard, owner and CEO of House of Virgo Entertainment, LLC, a woman minority veteran-owned entertainment company based in Washington, D.C. Ms. Poulard served 10 years honorably in the United States Navy and departed from active duty to pursue her dreams of becoming an entertainment mogul.
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I'm Dr. Joyce Bachelard, the host of the show. And prior to the break, we were talking a lot about the synergy that can come together in an organization to really create a culture that is really able to improve patient care tremendously. So I'd like to transition, Jennifer, to really asking you a little bit more about a hot topic, which is access to care.
And more importantly, how do we make it more convenient and affordable, which is definitely an issue that people are very concerned about. Can you describe the kind of work you and your colleagues have been involved in with the Family Medicine Physician Group? Oh, yeah, absolutely. So, um, so, HR has had really, again, a great honor and a privilege to work with eight different family medicine organizations that represent the field of family medicine.
And what's unique about that, and there's many, many, many things about this work, but we do a lot of work in professional societies and associations in all different areas of medicine, as well as in nursing, as well as in some of the other clinical areas, other clinical professions. And typically, if we're approached by an organization, it's to help them with a governance issue or a change issue or a strategy issue, but it's usually focused just on their particular organization. And in this case, in that organization, it could be one of, say, several organizations that represent the field of cardiology or obstetrician gynecology or other other areas. And the family medicine work, one of the things I thought was really powerful was early on, these organizations realized that if we really want to make a difference and changing, you know, how primary care is delivered and financed in this country, we need to come together, not only as a field, a collective field, but also to really treat many of the other related primary care organizations, whether that's in term medicine or whether it's working with a variety of different PA and nursing organizations, how do we really think about primary care broadly, and what's the strategy that we can agree to collectively and actually invest in and implement over time.
As you know, I think many professional societies will have a strategy, and that strategy can change quite frequently as the leadership in those societies turns over. And there are benefits to that, but also some drawbacks in terms of consistency and really being able to sustain long-term implementation of these strategies and clients. And I think when family medicine work, not only did they create this shared strategy, but then they came together and invested each of those entities invested into a joint venture called Family Medicine for American Health, where they launched thousands of people in active teams focused on the central strategy for the family medicine. So, for example, there is a team that's actively working to this day on issues of health equity, trying to reduce health disparities and increase social accountability of primary care organizations across the country.
There are tactics teams that are working on practice and really the future of primary care under a different thinking about payment, a more comprehensive practice and a comprehensive payment for primary care organizations. And that primary care and family medicine physicians can take comprehensive payment and use that to best provide the resources and care and support structures for the patients and their practices, whether they be urban communities or rural communities or many different boards. There's a lot of work going on thinking about health information technology and how to use it in innovative ways to tackle challenging primary care issues and also research and payment in different ways of engaging folks. So, it's been quite a robust strategy.
And again, I think really coupled with a large campaign to get the word out about family medicine and the role of family medicine in the healthcare system and certainly in providing primary care across the country. And these practices are just trying to find as many innovative ways as they can to create access and to enable people to get into these practices and to get access to the kind of service they need, whether on a cornucolated basis as a basis, or whether you're talking about people who really require intensive care management for one or more kind of a need. As you were talking about that, I was thinking about how important the access to care issue is, especially since there are so many people that are underserved or not having any kind of care, particularly in the rural areas. And living in Texas, I am keenly aware that there's a lot of rural hospitals.
And a lot of times there is no physician out there that advanced practice nurses many times are the individuals that are in those communities really trying to work with them and obviously needing to then coordinate with physicians when they are secure that's needed that's beyond the top of their license that they can do. And I was just curious too, because what do you think about or what potential do you think Wal-Mart and Amazon and the new mergers between some big companies could have in terms of impacting access to care because CBS has certainly been putting up the nurse physician assistants and their practitioners and having I think a big impact in those communities. Have you seen that or talked with clients or working with them on some of those challenges? Absolutely.
I think you're just reminding me as you were talking about CBS, I live in Rhode Island and that's where CBS is located. They're corporate offices are located and I had streptoroid or something. I came down with over a weekend. It was the first time I went to a minute clinic and I was sick as a dog, had a fever, could barely stand up and I walked in and saw the kiosk and started entering in my data.
And all I could think of was, wow, this is unbelievable. Not only can I just walk into the CBS and basically see a nurse within about 10 minutes, get my test, get taken care of and walk out the door, but they are gathering and meeting the amount of critical data that's going to help manage care and give them insight into the patient population in this community and ways that will never get to see. That's great. We're going to need to move on here just for a second.
This is all about nursing. I'm your host, Dr. Joyce Bachelor. We're live on the VPN Global Network and Tune in Radio.
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Joyce Vachera, the host of the show. Before the break, Jennifer was telling us about her experience of going to a mini clinic at a CBS as we were talking about the importance of having access to care and making it convenient and affordable. So Jennifer, maybe you can finish telling us a little bit more about what that experience was like. Yeah, Joyce, I think it was really an eye-opening experience to me to see this.
It's such a simple model, convenient access to affordable healthcare, and it made me think a lot about how CBS is investing so much into primary care and in innovative ways that make it easy for people to get to know. And it made me think a lot about the trends that are happening more broadly in the population as we think about the millennium population. And these folks really want access to technology. They want to pay a lot of attention.
And it's really pushing incredible innovations in telehealth, in online prescriptions, in access to other kinds of medications, video, the country or medicine, just via Skype with a doctor or nurse practitioner and other advanced practice provider. And I think that these kinds of innovations are, I think at first, I think it's fair to say that first a lot of our clients were thinking that these might be kind of a flash in the pan type of competitive threats. But now I think it's very clear to many hospitals and health systems around the country. This is no joke.
This is a serious change in disruption in the healthcare landscape. And I think organizations that can find ways to partner in some ways with these entities are going to be out ahead because I think that they can really, if you think about a population health kind of environment, what are the opportunities for organizations to really think about ways to leverage these innovative low-cost healthcare settings to provide care for the populations in the communities that they serve, and how can they use those in ways to really drive down the cost of care in other parts of their system by trying to balance things out and really having care, whether that's the right place in the right time at the right cost. So I'm fascinated to see how the JP Morgan, your Berkshire Hathaway, you know, saying under a tool, one day is going to be working and to see things like the Comcast experience where they've really been able to drive down the total cost of their care by very significant percentage points by helping their employees navigate the health system in ways that they would otherwise all be trying to do on their own as their collective approach to making it happen. And it's nearly tremendously successful.
I've been working with a company here in Austin that's working on some artificial intelligence capabilities, and I think we haven't seen the disruption yet that technology can really bring to healthcare. And I think it's exciting as I listen and learn more about what the possibilities are, because I think people in other fields are looking at how we operate and can't believe how far behind we are when it comes to adopting technology and some of the things that you're describing. So I was just curious, what are leaders fighting hard to address on their own and the kind of work that your group is now helping them with? Yeah, well, I think I think one of the more interesting things that I find people talk a lot about but aren't necessarily doing as much about, and I think because it's such a challenge, is thinking about the role of culture inside organizations.
So you hear people say, oh, culture is strategy for lunch and you probably hear that once a day. And it's true. It's very true. And so when you think about, again, going back to this point, we talked a lot about throughout the conversation about the rising cost of care and the increasing pressure to reduce costs and to try to find ways to create efficiency and streamline the delivery of the cost of care.
So many mergers are happening and the rate of mergers continues to increase across the country and so many of those mergers fail. And one of the reasons that those mergers often fail is because tremendous amounts of due diligence go into thinking about the financial aspects and the operational aspects of these emerging organizations. But very little is done beyond risk service to thinking about the culture and the different cultures that are going to come together and how the lasting impact of what you might hear about your book called legacy cultures inside these new and emerging systems is really really really important. And really can increase the likelihood of success or failure in the organization and among really delay the amount of time it takes for these organizations to get up and running and really begin to meet the benefits of that potential collaboration and alignment in a new health system.
And not even just in health systems, even thinking about in post-acute care and thinking about how, you know, addition practices in communities, they're working with hospitals and thinking about the various aspects of culture. And we've been fortunate to work with a number of different organizations to help them think about how to assess what are the different cultures that are happening and that are moving inside these organizations. Where are there opportunities, almost like a negotiation frame, right? Like their shared interests and the negotiation have to be using those shared interests to build a kind of trust and platform for an ongoing conversation and negotiation and decision making.
And cultures are the same way. If you can find places where their aspects of the culture that are similar, how can you use those to start to bring cultures together and then start to help people inside organizations understand, you know, what are some of the rules of engagement? What are some of the values and norms that we share? And what does that look like in terms of the behaviors that we exhibit?
If we think about respect as a value that both of our institutions never really merged, you know, hold, what does that look like on the ground? What does that mean about how we interact with each other when we walk down the hall or how we talk to each other or how we don't yell at each other or throw sharp objects at each other as we've seen? And some places, you know, that have since evolved with their culture, but there's so much work that can be done to really appeal, you know, kind of dissect and dig deep into understanding, you know, not what is the culture at a high level, but what are the component parts of the practices that shape that culture? And then how can you alter those practices in ways that help people better understand and do the kind of behavior and create the kind of culture that's going to be not only more collaborative, but perhaps increasing professional collaboration, increase, you know, culture safety, improve quality, and ultimately get things done faster in ways that are going to make the whole organization more successful than the other life have been.
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I'm your host, Dr. Joyce Bachelor, and all about nursing. We're live on the Beaten Globe and Network and Tune in Radio. Before the break, Jennifer was telling us a lot about the kinds of challenges and things that leaders are working on and the importance of trying to make sure that cultures align when mergers occur.
And I think that's all pretty insightful, that great information that you were sharing with us. Continuing along those lines, what are some of the biggest challenges or tensions that you're seeing inside health organizations? Great question, Joyce. I think in addition to some of the issues that we talked about, again, some of the organizations are just trying to figure out how to survive as payments are changing and will be shifting from falling to value and from fee-for-serve to more global payments and comprehensive payments.
And the timing of that in the market, so people aren't leaving important precious resources on the table as they are moving into more population health and more global environments. But I think so much of this is about coming to terms with the uncertainty and keeping it all the way. It wasn't that long ago, but I think prior decades, what we saw was something big would happen, and then there would be some change, and then things would sort of be stable for a while. And then maybe something else would happen, and it would be a regulatory form or impact, something would change, and then it would stabilize for a while.
What we've really been seeing is this sort of change and uncertainty, and it requires a different way of thinking of leadership, thinking more about influence, thinking more about adaptive capacity, thinking more about flexibility, creating more and more flexible structures within which to drive change and to enact strategy and organizations that can change as the assumptions on which those strategies will build our shifting beneath our feet. And a lot of the work that we've been seeing in health organizations is basically investing a lot in leadership and team development to help on all levels of the organization get some of the skills from the clinician standpoint, from the country skills that they maybe wouldn't have gotten in medical school or wouldn't have gotten in nursing school, but maybe more about how to influence about authority, maybe more about collaboration and negotiation, maybe more about finance. So providing development for individuals and for teams in ways that help these organizations have the kind of skills and support and even coaching that they need to be able to live in this world of uncertainty and constantly beyond your toes and constantly be adapting to the next change that shifting beneath your feet. I think that you brought up a lot of really great points this evening, particularly around the power of the whole, and if you can really unleash the ideas and passion of every worker and your organization as a leader, I think that you can have a whole lot of innovative ways that organizations can be ready to take on challenges.
I remember nurses asking me if we could just have one change a month, and what I had to say to them is that the one thing I could assure them is that we would have more changes because that's just the nature of health care right now. I think this has been an important opportunity to share with our listeners, the kinds of challenges organizations are facing, but I think that there's also a lot of innovative work going on because the passion people have about really making sure we take good care of the people we serve is really high. So thank you so much for agreeing to be on this show this evening. You're listening to All About Nursing Live and the Media and Global Network and TuneIn Radio.
I'm Dr. Joyce Bachelore, the host of the show and TuneIn next week. You've been listening to All About Nursing with your host, Dr. Joyce Bachelore.
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