The Report Room - nursing, healthcare, and leadership conversations with Brian Weirich

Healthcare today is changing at an incredibly rapid pace and the stakes have never been higher. In order to weather this storm and come out on top, the industry needs to look at innovations, leaders, patient experiences and all around past successes and failures. This is what The Report Room is all about. Brian Weirich is himself a skilled and experienced nurse leader who wants to help those in the nursing field up their game in terms of patient care and experience. His passion is to see the medical profession and nurses, in particular, become more skilled in not only the technical aspects of their profession but also in the softer skills such as compassion, empathy, communication, and more. If you are a healthcare professional, Brian wants to help you keep your heart aligned with the reason you got into healthcare in the first place - to help people who are suffering the worst experiences of their lives.
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Healthcare today is changing at an incredibly rapid pace and the stakes have never been higher.  In order to weather this storm and come out on top, the industry needs to look at innovations, leaders, patient experiences and all around past successes and failures. This is what The Report Room is all about.  Brian Weirich is himself a skilled and experienced nurse leader who wants to help those in the nursing field up their game in terms of patient care and experience. His passion is to see the medical profession and nurses, in particular, become more skilled in not only the technical aspects of their profession but also in the softer skills such as compassion, empathy, communication, and more.

If you are a healthcare professional, Brian wants to help you keep your heart aligned with the reason you got into healthcare in the first place - to help people who are suffering the worst experiences of their lives.

Scroll down to see the episodes we've published so far and use the player at the bottom of each episode to listen... and let us know what topics you'd like to see covered by contacting us at the email link at the top of this page.

Dec 15, 2016

New Belgium Brewery has nothing to do with the healthcare industry. And that’s exactly why I chose to interview Brian Simpson of New Belgium. Brian is one of many employees of the company who has been there for a long time - almost 20 years in Brian’s case, and I wanted to find out what enables the company to retain its employees for so long. You’re going to be amazed at the things this company does to make its employees happy - but it’s more than that. They’ve convinced their employees that they are truly cared for because they are.

You learn the core values of New Belgium Brewery on day one. And it never stops.

The healthcare industry is slowly learning that the values at the core of what we do need to saturate the culture of the organization and be better communicated early on in the hiring process. New Belgium Brewery makes sure that every new hire understands both the history and the values of the company beginning on day one. They also help employees understand that it’s the employees that make the company what it is. If that sounds impossible to you I challenge you to listen to this episode. You'll hear how the company has done it and I want you to ask yourself what we could do in the healthcare industry to make similar changes… and why do they seem so far fetched to us?

The healthcare industry needs to stop thinking of itself as a Fortune 500 company.

When an industry thinks of itself as a big player and doesn’t get down to the level of its team members, it’s no wonder that people are treated as commodities and the morale of the organization suffers. Not only that, performance declines and its customers (patients in our case) are not cared for well. What can we learn from other industries about culture and employee retention? A lot in my opinion. I’m excited to start the conversation about innovative ways to care for our people better and build healthcare teams that thrive and carry out the vision of patient care in extraordinary ways. New Belgium Brewery is an example of a company I’d love to see us model.

How New Belgium makes its employees the boss after only one year of employment.

We often talk about giving our people ownership of the organization, but do we really mean it? New Belgium Brewery has taken that to a whole new level by giving each employee stock in the company after only one year of employment. It’s one of the ways that ownership is made a reality. Along with paid sabbaticals, employee rewards and connections, and a host of other innovative means the New Belgium leadership is setting a new standard in culture and employee morale that the healthcare industry needs to learn from. I hope you listen and open your mind to the possibilities of what might happen at YOUR organization.

When healthcare matters to a brewing company they hire a doctor. No kidding.

The leadership of New Belgium Brewing was concerned about the health of their employees, so instead of encouraging them to get regular checkups or fund a new healthcare incentive they did the unthinkable, they hired a Doctor of their own to be on site for the benefit of employees and their families. The response has been overwhelming, with employees and their families not only appreciating the gesture but also taking full advantage of the doctor-patient ratio that makes truly personal care a reality. You can learn more about how this brewer is making a difference in the healthcare of its employees, on this episode of The Report Room.

Outline of This Episode

  • [1:08] Who is Brian Simpson and why did he go to work at New Belgium?
  • [2:12] The history of New Belgium Brewery.
  • [4:00] The role of core values and beliefs at the company.
  • [8:38] The New Belgium milestone program for employee retention.
  • [10:00] How the company provides paid sabbaticals.
  • [15:00] Why New Belgium Brewery brought healthcare “in house.”
  • [17:37] What Brian likes most about working for New Belgium.
  • [18:10] The path ahead for New Belgium.

Resources & Links Mentioned In This Episode

Connect with Brian

Dec 1, 2016

Improving organizational culture in the healthcare environment can be an uphill battle. The stress and pressure of the jobs we do make it easy for discontent, frustration, and irritation to rule the vibe of the organization. But Kit Bredimus and his team at Midland Memorial Hospital were not happy with the continually low scores they received for patient satisfaction and sought ways to change the culture. What they discovered is that it’s impossible to change the organizational culture without positively changing the people who make up the culture. That meant creating ways to care for the individuals on the staff. The results have been nothing short of remarkable. You can hear this healthcare miracle story on this episode of the podcast.

How a terrible track record and awful organizational culture transformed.

The reputation of Midland Memorial Hospital in its own community was anything but stellar. The community didn’t trust the hospital to provide good care and the patient survey forms showed it to be true. Kit Bredimus grew up in the Midland area so he knew the challenge the team was up against when the hospital leadership began their consideration of The Values and Culture initiative. They were skeptical but were quickly proven wrong as the medical team at Midland Memorial began to take on a new life. You can hear the story on this episode, so be sure you listen.

What to do when the staff resists new hospital policies with a “flavor of the month” attitude.

Throughout the history of Midland Memorial Hospital, many things had been tried to turn around the sagging patient satisfaction scores. The efforts either didn’t work, didn’t stick, or were not taken seriously by the hospital staff so the results were nonexistent. When the Values and Culture Initiative was introduced many of the old timers at the hospital saw it as “the flavor of the month” - a new initiative that would be around for a while but would fade out fairly quickly. But something was different this time. One thing the leadership focused on got everyone on board and brought about lasting change. Find out what it was in this episode.

To improve organizational culture you’ve got to improve the lives of its members.

The primary approach that brings about true organizational change is not one that focuses on the desired outcomes or results that are needed. It’s an attitude from the leadership on down that fosters a sense of concern for the well-being of the team members who make up the culture of the organization. As individuals on the team begin to believe that the leadership wants them to be the best version of themselves that they can be - and makes opportunities for them to take steps in that direction - everything changes. On this episode of The Report Room, Kit Bredimus tells the story of how the emergency department at Midland Memorial Hospital went from the lowest percentile in patient satisfaction scores to the 95th percentile.

If organizational improvement doesn’t start with the leadership, it’s already dead.

The turnaround that happened at Midland Memorial Hospital in Midland, TX was only possible because the leadership team - from the top down - was entirely committed to making the changes needed and agreed on what it would take to bring about the improvements they wanted to see. That kind of unity is what it takes to change something as pervasive and powerful as organizational culture. Kit Bredimus tells how it happened at Midland Memorial and gives his suggestions for how medical services organizations with similar needs could begin moving in the right direction, on this episode.

Outline of This Episode

  • [0:43] My introduction of this episode’s guest, my friend Kit Bredimus
  • [1:27] The history and specifics of Midland Memorial Hospital.
  • [4:53] The values and culture initiative Midland started.
  • [6:57] The staff’s initial reactions to the ideas of improving values and culture.
  • [7:44] How the program started and progressed through its stages.
  • [11:58] When the team began to see improvements.
  • [13:22] The current state of Midland Memorial.
  • [15:35] The response Kit is getting from participants from the presentations he’s doing.
  • [18:31] The first steps an organization should take to make improvements.
  • [21:35] The next thing on the agenda for Midland Memorial.
  • [22:40] The team members who have been instrumental to the success.

Resources & Links Mentioned In This Episode

Connect with Brian

Nov 17, 2016

The role of a nurse has changed dramatically over the years. From the first days of professional nursing care when nurses were nothing more than glorified assistants who did whatever physicians dictated - to the integral and important role nurses play today as partners in providing the best care to patients - nurses have come a long way. In this conversation, I’m talking with Dr. Melanie Roberts, a long-time nurse who has experienced many of those changes over the years and is excited about the trajectory of nursing and healthcare in general. I you will be encouraged by Dr. Roberts’ optimism and enthusiasm.

A lot has changed from the days when nurses didn’t even wear gloves.

Dr. Melanie Roberts remembers the days when she was just starting out as a nurse. No matter the situation, nurses in those days seldom wore gloves of any kind. There wasn’t the concern and attention to transmission of germs and disease through unsanitary conditions that there is today. On this episode, she and I walk through the annals of her memories, comparing the role of nurses today to the role they played in years past. It’s an interesting comparison that should give every nurse encouragement about how far we’ve come.

Navigating the changes in a community hospital as it grows and becomes successful.

As Dr. Melanie Roberts worked as part of the Poudre Valley Hospital in Colorado during her early days as a nurse she found the work stimulating and challenging. As the hospital grew and changes were needed in both processes and procedures she found that the desire to provide better care for patients and their families always served her well - giving her a good compass for determining how to navigate the changes as the hospital grew, established a second location, and eventually was merged with a larger healthcare system. Her insights and experience - which she shares in this conversation - will serve you well if you are involved in the administration or organization of a nursing or hospital staff that’s experiencing growing pains. I hope you take the time to learn from Dr. Roberts’ story.

The way to better nursing care is to improve the systems used to provide it.

When Dr. Melanie Roberts first began her career as a nurse the typical way of dealing with issues that arose was to cast blame on individuals for mistakes or oversights. That’s understandable since people are at the core of medical care but what she discovered over the course of her career is that since human beings are prone to mistakes it’s important to establish systems that negate human error as much as possible. The effort becomes a way to build teamwork and team spirit surrounding patient and family care rather than an opportunity to cast blame.

What an experienced nurse would tell her 25-year-old self.

If you had the opportunity to go back in time and tell your 25-year-old self a few things about the career you are in, what would you say? When I asked Dr. Melanie Roberts that question she said that she’d mainly tell herself the things that seem obvious but that she isn’t sure she recognized as she was starting out. Nursing is hard work, both physically and emotionally and it’s vital that she learn how to fill her life with things that refresh and nurture herself or else she won’t have the strength or capacity to truly benefit patients over the long haul. What would you tell your 25-year-old self given what you know today?

Outline of This Episode

  • [0:27] My introduction of Poudre Valley Hospital and Dr. Melanie Roberts.
  • [1:46] When Dr. Roberts first decided to become a nurse.
  • [2:59] Melanie’s first nursing role and what it was like in those days.
  • [7:48] The impact of a national news story on the small community hospital.
  • [10:34] The differences in family support from then until now.
  • [13:07] The first experiences with “magnet” designations.
  • [16:07] The opening of a sister hospital in the same city.
  • [20:40] Changes required in order to win the Malcolm Baldridge award in 2008.
  • [23:50] Navigating the merger with a much larger healthcare system.
  • [26:30] Noteable accomplishments Dr. Roberts is known for.
  • [28:55] What Dr. Roberts would tell her 25 year old self if she could.
  • [29:26] How would Dr. Roberts spend a million dollar donation in her healthcare system?
  • [30:04] Advice for today’s new nurses.

Connect with Brian

Nov 3, 2016

There’s a new approach to leadership that has gained a lot of popularity in the last 10 years. It’s called strengths-based leadership and the primary tool used in this approach is the StrengthsFinder assessment. I was curious about how this assessment might be applied in healthcare roles so I asked Rose Sherman to be my guest on the podcast to walk me through what strengths-based leadership is, why it’s proving to be a helpful way of approaching any leadership role, and how the StrengthsFinder assessment can be used to improve leadership, create healthier teams, and increase overall productivity and quality of care. You’ll enjoy hearing Rose’s expertise shared so clearly, on this episode.

What’s behind the idea of strengths-based leadership?

The originator of the StrengthsFinder assessment, Dr. Donald O. Clifton believed that people grow and develop more healthily and quickly if they focus on enhancing their areas of strength rather than improving their areas of weakness. Toward that end, he created the StrengthsFinder assessment to enable people to clearly identify their personal areas of strength so that they could intentionally focus on improvements in those key areas. My guest today, Rose Sherman is a StrengthsFinder trainer who has a wide range of experience in using and applying StrengthsFinder assessments to help leaders and their teams expand their productivity and success. You’ll gain a lot of insight into your own leadership style by listening to what she has to share.

Once you discover your own personal strengths what should you do?

According to the philosophy behind the StrengthsFinder assessment, the purpose of discovering your key areas of strength is to look at your leadership style and approach to life through those strengths so that you can understand the ways in which you are best suited to make a difference. Intentional focus on your key strengths will make you better at whatever you do, whether it be nursing or nursing leadership. Rose Sherman helps us understand how we can do that using the results of my personal StrengthsFinder assessment on this episode.

Will your StrengthsFinder assessment results change over time?

Due to the fact that people grow and develop over time, it’s natural to think that the results of a StrengthsFinder assessment that you take today could be different were you to take the assessment again in 10 years. But Rose Sherman says that the only way she notices significant changes in the results people receive from multiple assessments is in the ordering of their strengths. The strengths themselves remain pretty much the same. The change of order is likely due to either concentrated focus on improving some of the strengths discovered in the first assessment or through the demands placed on particular strengths due to the experiences the person has had. Rose unpacks the meaning and power of using the StrengthsFinder assessment tool, on this episode.

What would an experienced nurse and professor do differently knowing what she knows now?

One of the things I asked Rose Sherman in this episode is what she’d do differently if she could redo her career knowing what she knows now. While she’s pretty satisfied with the overall results of her career choices she says that the one thing she’d probably change is her willingness to risk. She didn’t take enough appropriate risks in the early stages of her career which may have limited some of her options and held her back from accomplishing more, sooner. What would you change if you could go back? Listen to Rose’s personal story and experience leading and teaching nurses to help you learn without the mistakes, on this episode.

Outline of This Episode

  • [1:07] Who is Rose Sherman?
  • [1:46] Rose’s first nursing job and how her career progressed.
  • [5:00] What made Rose take the turn into nursing leadership?
  • [7:00] What IS strengths based leadership?
  • [10:30] How did Rose get interested in using the Strengthsfinder 2.0 assessment?
  • [13:40] What should a person do once they know their top strengths?
  • [20:30] Should a strengths assessment results change over time?
  • [25:07] Rose’s picture of what nursing will be in 10 to 15 years.
  • [28:24] Advice for today’s new nurses.
  • [29:15] Things Rose would do differently if she could go back.
  • [29:49] Must read books for healthcare leaders.
  • [30:40] How you can connect with Rose.

Resources & Links Mentioned In This Episode

Connect with Brian

Oct 20, 2016

Measuring performance in any organization is a very clear way to insert much-needed accountability into the system of managing and rewarding employees. But the argument is being made more and more these days that the traditional ways of doing performance management are not the most helpful approaches. Today’s guest is Dr. Anna Tavis and I decided to invite her on the show after reading an article she co-wrote on the Harvard Business Review called, “The Performance Management Revolution.” In her article, Dr. Tavis highlights why some companies are taking another look at their performance measurement systems and how a handful of them have made dramatic changes to the process with great results. I’m curious how these innovations can be applied to the healthcare sector, so I wanted to hear more from Dr. Tavis - and I hope you take the time to listen.

Why performance management systems of the past are being abandoned.

Much of the change that’s happened around performance measurement has to do with the desire of managers to not only rightly assess and reward performance but also to address issues of culture and trust within the organization that can bring the organization's performance as a whole to a much higher level. Dr. Anna Tavis shares some of the ways companies of all stripes are changing their performance management processes on this episode. If you’re the person in charge of performance management for your organization or part of a PM team, you'll discover some great ideas from what she has to share.

Are your managers serving as coaches more than critics?

One of the key components of how companies are approaching the issue of measuring performance in new ways has to do with the role of the managers in the organization. Rather than training management to be the watchdogs of the organization who are ready to dole out punishment for those who are not performing, the emphasis is on supervisory positions as more of a coaching role. The manager’s job is to help the employees grow and learn in their role, encouraging and cheering them on to higher levels of accomplishment. This approach is showing great promise in the way it encourages a team mentality over the adversarial relationships that have existed in the past. Find out more about this performance management revolution from Dr. Anna Tavis on this episode of The Report Room.

How bonuses connected to performance reviews skew the review process.

The old systems of performance review often entail the use of quarterly or annual reviews to assess employee performance with the promise of financial bonuses or other rewards tied to that review. But Dr. Anna Tavis says that tying the reward to the review skews the process in ways that are not helpful. If that assertion makes sense to you, or if you’re curious how it could be true, you need to hear Dr. Tavis’ explanation of it on this episode of the podcast.

Expert advice for those who are figuring out their performance review system.

If you are part of a team that is working to establish a healthy and effective performance assessment program for your organization, Dr. Anna Tavis, a performance management specialist has this advice for you: Take ownership of the process as it relates to your overall goals as an organization. Ask yourself whether the things you’re measuring in your evaluations are aligned with the goals and vision of the entire team. And figure out if the method by which you're evaluating is truly assessing your effectiveness toward those goals. You can hear more great suggestions like this from Dr. Tavis on this episode of the podcast.

Outline of This Episode

  • [0:29] My introduction of Dr. Anna Tavis, and the issue of performance management.
  • [1:16] The background that has equipped Dr. Tavis for her current work in performance management.
  • [2:36] The process of researching and writing her article with Peter Cappelli.
  • [4:30] How we’ve come to the place we are in managing and appraising performance.
  • [11:32] The trend toward no more performance evaluations for employees.
  • [14:13] What are companies doing today instead of annual evaluations?
  • [18:13] Why some companies are resisting these new approaches.
  • [20:39] How should compensation be decided if it’s not connected to performance?
  • [25:02] What are the risks and losses possible by making these changes?
  • [27:08] Books and articles Dr. Tavis recommends about this topic.
  • [28:46] Dr. Tavis’ recommendation: Every organization needs to take ownership and align their performance measurement systems

Resources & Links Mentioned In This Episode

Connect with Brian

Oct 6, 2016

Using the methodologies of LEAN in healthcare is a new trend that is gaining quite a bit of momentum. It’s a management methodology borrowed from the production industry (Toyota originated it) that streamlines processes, increases efficiency, and decreases waste. On this episode of The Report Room, I’m chatting with an expert at implementing LEAN into healthcare, Steve Newlon. If you listen you’ll learn what LEAN is, how it works, how many hospitals are implementing it successfully, and how Steve recommends healthcare organization go about introducing LEAN to their staff and organization.

What exactly IS LEAN? defines LEAN methodology in this way: The core idea is to maximize customer value while minimizing waste. Simply, LEAN means creating more value for customers with fewer resources. A LEAN organization understands customer value and focuses its key processes to continuously increase it. The ultimate goal is to provide perfect value to the customer through a perfect value creation process that has zero waste. To accomplish this, LEAN thinking changes the focus of management from optimizing separate technologies, assets, and vertical departments to optimizing the flow of products and services through entire value streams that flow horizontally across technologies, assets, and departments to customers. Find out more about LEAN and the benefits it is proving to have in healthcare organizations from my guest, Steve Newlon, on this episode.

How does LEAN work in a healthcare environment?

Since LEAN was first developed in an industrial setting it seems a bit awkward to think of it applying directly to healthcare systems. But Steve Newlon says that many hospitals today are applying the LEAN methodology very successfully, seeing their patient satisfaction rise while waste and inefficiencies are going down. Steve shares some great case studies that highlight how LEAN is being applied to the healthcare field on this episode so be sure you take the time to listen so that you can assess whether LEAN might be beneficial to your organization.

Should a hospital hire a LEAN consultant or develop their own teams?

As with any new methodology, there are plenty of consultants that are willing to come alongside organizations to help them implement the methodology effectively. But even though he is a LEAN consultant, Steve Newlon isn’t convinced it’s always the right move to hire a consultant. On this episode, Steve describes why he believes that hospitals and other healthcare organizations will be better served by training and equipping their own personnel to be at the forefront of LEAN implementation in their organization and how consultants could be used on a limited basis to supplement the efforts of the LEAN team. You can hear his perspective on this episode.

Will LEAN still be relevant to the healthcare industry in 5 to 10 years?

Steve Newlon refuses to try to predict the future of LEAN in the healthcare sector but he does have concerns about its future. He wonders if the high cost of many LEAN consultants will cause hospital administrators to get a sour taste in their mouths about the LEAN methodologies without even giving them a chance. But that’s just one of his concerns. You can hear is perspective on why LEAN is so beneficial to the healthcare industry and how you can implement LEAN in your organization from the ground up, on this episode.

Outline of this great episode

  • [0:27] My introduction to this episode with Steve Newlon.
  • [2:12] What IS the LEAN methodology?
  • [3:46] How Steve ended up in healthcare after the Air Force.
  • [4:42] Why are hospitals suddenly interested in implementing LEAN?
  • [7:05] The approaches to LEAN that Steve sees as working the best.
  • [9:27] At what point should front line employees be introduced to LEAN concepts?
  • [12:20] An example of LEAN implementation.
  • [15:59] What are daily huddles and who is involved in them?
  • [20:10] What is managing for daily improvement in LEAN?
  • [21:42] Should hospitals hire LEAN consultants or develop their own teams?
  • [27:40] An example of getting consulting from another company that uses LEAN.
  • [35:13] What are the areas where hospitals can get small LEAN wins?
  • [38:25] Steve’s perception of where healthcare will go with LEAN in 5 to 10 years.
  • [40:20] How you can connect with Steve.  

Resources & Links mentioned in this episode

ImplementLEAN(at) - connect with Steve

Connect with Brian

Sep 22, 2016

If you’re wondering what palliative care is, you’re not alone. The phrase, “What is palliative care” is searched on Google almost 100,000 times every month. The reason for the widespread interest is that it’s a fairly new area of focus in the history of health care and it specializes in pain management and end of life issues and scenarios. But don’t confuse it with hospice. The two are very different things. On this episode of The Report Room, I chat with palliative care nurse, Carey Ramirez about those differences, his journey into palliative care, and why the discipline is an area of important focus for health care both now and in the future.

Palliative care is not the same as hospice.

Most people are familiar with the idea of hospice care so it’s important that you understand that palliative care is not a synonym for hospice. Palliative care is for anyone with a serious illness and can be administered at any age and at any stage of an illness, not just during the dying process. Hospice provides care for terminally ill patients who may have only months to live. People who receive hospice are also no longer receiving curative treatment for their underlying disease while those receiving palliative care may be. You can hear why those distinctions are important from my guest today, Carey Ramirez.

Dealing with suffering every day: the life of a palliative care nurse.

One of the questions I asked Carey Ramirez on this episode was what his typical day was like. He described a day filled with a series of emotionally-laden conversations with patients and their families that could even include the subject of death and dying. It’s not a job that just anyone can do, but Carey seems especially equipped for it, not only through his training but also by virtue of his temperament, personality, and gifts. You can hear how Carey moved into the area of palliative care and why he’s eager to see the subject taught in nursing and medical school, on this episode.

When someone asks, “Am I dying?” - what do you say?

As a palliative care nurse, Carey Ramirez is often asked by a patient if they are dying. It’s at that moment that a combination of knowledge, education, experience, and compassion go to work to help him assess exactly what that particular patient needs to hear - and how best to say it. He doesn’t shy away from speaking the difficult truths the question demands but also doesn’t want to cause unnecessary harm to the patient on an emotional level by an abrupt or uncaring response. You can hear what his years as a palliative care nurse have taught him about dealing with such difficult questions, on this episode.

Two books every nurse and medical practitioner should read.

When I asked Carey what resources he recommended for those who are interested in pursuing more knowledge about palliative care, he was quick to reference two books. First, he mentioned a more recent book, “Being Mortal” by Atul Gawande. His other recommendation was “On Death and Dying,” a classic by Elisabeth Kubler-Ross. Both books equip healthcare professionals to face the difficult questions they’ll face as they deal with the life and death situations they face daily. You can hear more of the suggestions Carey made concerning nursing and palliative care in particular, on this episode.

Outline of this great episode

  • [0:28] My introduction of my guest and today’s topic.
  • [1:35] What is palliative medicine?
  • [3:00] How palliative care is different from hospice.
  • [4:32] Carey’s first nursing job and the path that led to palliative care.
  • [7:43] Why are healthcare professionals focusing on end of life issues now?
  • [11:58] How to get around the difficulties of talking about death and dying.
  • [16:19] How Carey’s typical day runs at the hospital.
  • [18:02] A typical conversation Carey has with patients and family.
  • [22:59] How often do patients ask, “Am I dying?” and what does Carey say?
  • [25:45] What are the basics about palliative care that  nurses need to understand?
  • [30:46] How does Carey separate himself from the emotional load of his work?
  • [32:58] What Carey feels is the best part of his job.
  • [34:06] What nurse leaders can do to support palliative medicine.
  • [39:06] Resources Carey recommends for those seeking to know more about palliative care.
  • [40:35] Advice for those facing death or helping someone who’s dealing with death.

Resources & Links mentioned in this episode

Connect with Carey: Carey.Ramirez (@)

BOOK: Being Mortal

BOOK: On Death and Dying

Connect with Brian

Sep 8, 2016

Nurse leaders are always under the gun to bring higher quality care to their work. But the danger can be that they get stuck in a rut, doing the same type of things repeatedly because it’s easier than thinking through new, more innovative solutions. Dr. Bonnie Clipper and her team at the Executive Nurse Fellows completed a project that examined the role of innovation in nursing care and on this episode I’m chatting with her about their findings. I think you’ll find it challenging and inspiring. I know my gears are turning with ideas. Be sure to listen.

What kind of innovation should nurse leaders be considering?

It may seem like the words “innovation” and “nursing” don’t - and even shouldn’t - go together. Nursing is a high-pressure career field where mistakes can cost lives. How can there be room or safety to try things a bit outside of the box? Dr. Bonnie Clipper and I chat about the need for innovation in nursing care and how nurse leaders can, well, lead the way in bringing about changes that could improve the quality of care and make the nursing role more fulfilling and effective. The topics we cover are from a report Dr. Clipper and some associates complied called, “The Innovation Roadmap: A Guide For Nurse Leaders.” You’ll get some great ideas from our chat, so be sure to listen.

Fail fast and fail often. That’s the mantra of innovation.

The idea of innovation can seem scary to those in the healthcare industry. That’s because the safety of our patients is our primary concern. Failure is often not an option. But it’s when that mindset carries over into the non-essentials that we get stuck doing the same old things because we’ve always done them. Dr. Bonnie Clipper shares how the mantra of innovation encourages failure. In fact, “fail fast and fail often” is a guiding principle that sparks discoveries and creativity. You can hear how she recommends nurse leaders pursue innovation in the nursing care they provide, on this episode.

Varied perspectives make for a truly innovative team.

Many hospitals and healthcare organizations are establishing innovation teams to get outside the box of the normal and expand the ways they provide care to patients and their families. When I asked Dr. Bonnie Clipper what that looks like on a team level she said that the broader the team’s experience, expertise, and backgrounds, the more creative and innovative the team can be. She gives a handful of great examples of the kinds of things these teams come up with, on this episode.

Think ahead about your contributions to nursing.

When I asked Dr. Bonnie Clipper her advice to someone coming into the nursing field today she encouraged all new nurses to look at their role realistically. By that, she means that you shouldn’t underestimate your role and your contributions. You are an important part of the healthcare industry and you can contribute significant things. Every nurse leader was once in your shoes, so set your sights higher and think toward the future. What might you be able to bring to the industry that will change things for the better?

Outline of this great episode

  • [0:27] My introduction to Dr. Bonnie Clipper.
  • [2:41] What is “The Innovation Roadmap: A Guide for Nurse Leaders?”
  • [7:13] The characteristics of innovation in nursing.
  • [12:28] The components of innovation.
  • [16:19] How should employee feedback be solicited?
  • [17:37] Suggestions for finding the right team members.
  • [22:10] The importance of varied perspectives on an innovative team.
  • [24:16] What will nursing look like in 10 to 15 years?
  • [25:16] The person Dr. Clipper thinks of when she hears the word “leadership.”
  • [25:54] Advice for new nurses.
  • [26:422] A failure Dr. Clipper now sees as a benefit to her career.
  • [28:07] A must-read book for healthcare leaders.

Resources & Links mentioned in this episode

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Aug 24, 2016

Family and patient centered care may not be terminology you’re familiar with…

but after hearing this conversation you’ll be eager to see it implemented in your local hospital systems. It’s an innovative new way to get insights into the real experiences that both patients and families are having while receiving care at your facility so that you can both improve the level of care you provide overall and anticipate needs before they actually become issues. I was very impressed with some of the things Fran Culler and her team have been able to accomplish for patients and families in their facility. I am certain you will be too.

Most of us are familiar with the concept of patient centered care...

But what I’m chatting with Fran Culler about on this episode goes a step further. Naturally, we want our patients to receive the very best care possible while they are in our care, but the reality is that their families are often just as impacted by what we do as the patient. On this episode, I asked Fran to give us an overview of exactly what a family and patient council is and how it goes a step beyond patient centered care to give a comprehensive level of quality to the experience that everyone we serve receives.

Thinking outside the box of patient centered care.

The typical Family Patient council is a group of people including hospital staff, former patients, administrators, chaplains, and others who care about the quality of care the organization is providing. They come together regularly to assess the quality of care being given, receive concerns that are expressed, and formulate plans to take action on things that otherwise might go unnoticed or could make the quality of care better for patients and families alike. You’ll enjoy hearing some of the stories Fran Culler shares about the improvements her team has been able to make in their hospital. I was quite impressed with their accomplishments and I hope you are inspired to take some action in this direction at your medical facility.

Coming together to make medical care better for everyone.

When a patient is in the care of any medical team it’s important to realize that it’s not just the patient who is affected. Many times family members won’t leave their bedside and the fear and stress of the event extend far beyond the hospital room. A family and patient centered approach focuses on all of those issues and more to ensure that those who are most impacted by a patient’s stay in the hospital are cared for where they are and in ways that make a difference to them. You’ll hear Fran Culler’s experience as part of a Family Patient council in northern Colorado on this episode.

Family and patient centered care goes beyond exit surveys.

Asking departing patients and their families to complete an exit survey is a great idea but it’s often the last thing on the minds of people who are heading home from the hospital. But getting a true sense of what those people experienced while in the care of the hospital staff is still vitally important for the sake of quality control and quality of care. On this episode of The Report Room Fran Culler shares many stories of what her family patient council has been able to do to improve the quality of care for their patients and their families - from the addition of more handicapped parking spaces in the parking lot to pet visiting hours and washing machines. You’ll be surprised and encouraged to hear what’s possible when people come together to make the patient and family experience better for everyone.

Outline of this great episode

  • [0:27] My introduction to Fran Culler? and the issue of patient and family centered care.
  • [2:44] What IS a patient-family care?
  • [4:46] How the patient family advisory council at Fran’s facility came to be and how the team works.
  • [7:56] Could this work for large and small medical organizations?
  • [9:32] How the hospital staff members are selected.
  • [11:10] How and when meetings happen.
  • [13:12] A typical council meeting and the kinds of impact they’ve been able to have.
  • [20:48] The first one or two steps a hospital should take to start its own council.

Resources & Links mentioned in this episode

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Aug 24, 2016

Overcoming adversity is a vital skill in the healthcare field.

We face adversity every day. Learning to handle the difficulties that are inherent in life and death situations is one of the most important things we can do. Toward that end, I wanted to chat with someone who’s been in the trenches for a long time and knows what it takes to build teams that can overcome adversity together. I’m honored that Jim Tressel, President of Youngstown University and former College Football Coach agreed to join me for a conversation about the subject. Jim’s the author of two amazing books, “The Winner’s Manual” and “Life Promises for Success.” While it may seem strange that I’m chatting with an educator about healthcare leadership it won’t take you long to discover exactly why I felt Jim was the perfect person for this conversation. Enjoy.

Great leaders help their teams know how to overcome adversity.

It’s been said that the success of any organization rises or falls on leadership. Jim Tressel is a clear advocate of that philosophy. In this conversation I spoke with Jim about some chapters in his book that focus on the issues of adversity and success and how leaders can help their teams face both situations in a way that brings even greater success to the entire organization and benefits the people who are being served. This is a very insightful interview so I hope you’ll set aside the time to listen.

Challenge: Submitting individual ambition to the needs of the group.

Every person in an organization has their own personal ambitions and desires in life. That’s a good thing. But sometimes those desires can come in conflict with the good of the organization. A good leader is one who has developed the skill to encourage and support the personal ambitions of each team member but at the same time is able to encourage them toward giving their highest for the overall goals of the team. Jim Tressel has learned that lesson on the playing field as a successful college football coach and continues to apply it as President of Youngstown University. I trust you’ll be helped by what Jim shares with us about team dynamics and overcoming adversity together.

You are only as good as your thinking.

One of the most difficult parts of building a strong team that can withstand the pressures of adversity and success is getting the right people on the team in the first place. I asked Jim Tressel what he does to ensure that he’s selecting the right people for his teams and he spoke at length about the importance of how a person thinks. It found his comments to be not only insightful but also practically helpful as I think about adding people to teams in the healthcare field. If you are in charge of hiring for your area of specialty you’ll want to hear what Jim has to say. If you’re not, you may be some day so I’d recommend you give this conversation your attention.

Fighting the tendency toward complacency and status quo.

One of the natural bents of human nature is to become complacent. Satisfaction with the way things are is fine if it’s in the form of inner contentment but when it leads us to complacency it’s an obstacle to higher achievement and greater success. You and your teams will have no chance of overcoming the adversity you face day to day if members of the team are drifting into a complacent attitude. On this episode, Jim Tressel guides us to understand the tendency toward complacency and to understand what healthcare leaders can do to equip their teams to fight the pull of the status quo and perform at the level of excellence. It’s a great conversation with one of my heroes. I hope you’ll take the time to listen.

Outline of this great episode

  • [0:27] My introduction of Jim Tressel.
  • [3:51] Discovering how to bring individuals into a group mission with effectiveness.
  • [8:10] How to handle adversity and success.
  • [16:32] The characteristics President Tressel looks for when hiring team members.
  • [19:03] Staying motivated during adversity and success.
  • [25:41] Handling transitions from lesser positions to senior positions.
  • [28:55] Jim’s mentors and what he looks for in a good mentor.
  • [29:50] Books all aspiring leaders should read.

Resources & Links mentioned in this episode

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Aug 22, 2016

Nursing Management is a position many nurses attain in time, but to move from nursing to the position of CEO is not very common at all. Today’s guest is Lamont Yoder, CEO at Banner Health at Banner Gateway & Banner MD Anderson Cancer Center. Though Lamont’s path from nurse to CEO is uncommon it’s one he feels more and more nurses should strive to follow. He believes that having nurses at the highest levels of healthcare administration is one of the best ways to improve the quality of healthcare overall. On this episode Brian asks all the questions you’d want to hear about an intriguing journey like Lamont’s, so be sure you set aside time to listen.

How Lamont Yoder set his sights higher and moved up the ranks.

It as in the natural course of events in his career as a nurse that Lamont Yoder discovered that he had gifts and abilities that suited him for leadership roles. He naturally gravitated toward the positions of responsibility and through his contributions in those roles he was recognized and tapped for other, more weighty roles over time. On this episode, Brian asks Lamont to share how he moved from nurse, to nursing management, to CEO and what made him feel it was a good fit for him. And Lamont not only shares his personal story but also how new or experienced nurses could set the stage so that they could follow in his footsteps if they so chose.

I want mentors who are two levels above me.

One of the practices Lamont intuitively adopted when he first got into nursing management roles was to find mentors he could learn from. But beyond that he realized that those mentors should not only be people who were at the next level he wanted to attain but people who were one level above that. By learning from people two levels above him he was able not only to see the role he would move into next with greater clarity, he’d also be able to learn what was ahead so he could position himself to move even higher over time. If you’re eager to build a career of upward mobility into nursing management and executive leadership. Lamont has a lot of great advice for you in this episode.

Being part of building a state of the art healthcare facility from scratch.

One of the most memorable accomplishments during Lamont’s career was the ground floor to grand opening creation of a brand new, state of the art healthcare center. Lamont remembers the time with fondness not only because of what was achieved but also because of the challenges and innovation that were part of the process. Lamont shares the story on this episode and gives a bit of vision to upcoming nurses relating to what they can shoot for in the ever expanding nursing field.

How to maintain work life balance in a medical career.


With a job as demanding as nursing can be one of the most difficult things to attain as an individual or as a team is work-life balance. Brian asked Lamont how he maintains his own work life balance on this episode and Lamont shared how everyone on their team, from nursing management to executive management are expected to maintain their own work-life balance in a way that sets the example for the rest of the staff. You’ll enjoy hearing some of the practical ways Lamont’s teams accomplish that, on this episode.

Outline of this great episode

  • [1:41] Lamont’s first nursing job and why he chose nursing as a career.
  • [2:30] Why Lamont moved into hospital leadership.
  • [4:43] Mentors and coaching Lamont received over the years.
  • [7:00] The roles Lamont has enjoyed the most and where he’s grown the most professionally.
  • [9:19] What Lamont looks for in a CNO position.
  • [11:24] How Lamont made the decision to move from CNO to CEO.
  • [12:57] Why Lamont stays very involved in nursing as a CEO.
  • [15:43] What successful leaders in nursing need to understand to be successful.
  • [17:40] How to move from a nursing position to an executive leadership position.
  • [19:06] The task of work/life balance and how it has to be exampled from the top.
  • [21:37] What will nursing look like in 10 to 15 years.
  • [22:15] Those who are heroes to Lamont.
  • [23:10] What Lamont would tell his 25 year old self.
  • [23:35] The best read for healthcare leaders.
  • [26:04] How to connect with Lamont.

Resources & Links mentioned in this episode

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Aug 20, 2016

Compassionate care is what nursing is all about.

It’s why most of us got into nursing in the first place - to compassionately help human beings who are experiencing some of the most horrific sufferings they’ll ever experience. I’m Brian Weirich and this is the first episode of The Report Room podcast. TRR is an opportunity for you to hear the stories of patients, nurses, and other healthcare professionals who are dedicated to providing compassionate care to the people who come through the emergency rooms, hospitals, and care facilities where we work. I wanted to start out the show with a conversation with a guy who knows it from the other side of the stethoscope - as a patient. Today you’re going to hear the incredible story of Marcus Engel who suffered a terrible accident as a college student and has transformed that potentially paralyzing event into a source of hope for many. I hope you enjoy his inaugural episode.

Human presence is one of the biggest parts of compassionate care.

Today’s episode of The Report Room tells the story of how one 20-year-old patient care technician, or nurses aid, saw one man through the most terrifying day of his life simply by being present and letting him know that she was there. Jenny’s compassionate care for Marcus when he was suffering the loss of his sight and the pain of every bone in his face being broken was what got him through the most difficult moments. Marcus’ story is powerful and you can hear it from the beginning on this episode.

Nurses need to put themselves in the patient’s shoes more often.

Nursing care that is effective is care that is focused on helping the patient where they are at in the moment of their need. Patients often experience the greatest amounts of fear, panic, and confusion they will ever experience when they are in our care. My hope is that conversations like this one with Marcus Engel equip you to be a better caregiver and medical professional from the perspective of those you are caring for. If you want to hear what it’s like from the other side of the stethoscope, Marcus shares his story and the insights it’s provided about compassionate care on this episode.

As a nurse, you can clear up your patient’s confusion in simple ways.

We live every day in the midst of medical acronyms and jargon so they are simple for us to understand. But our patients are easily overwhelmed and confused by the medical world. Part of our jobs as nurses is to alleviate their fears and give them confidence in the care they receive. You can do that by making sure your patients know the titles of the people who are coming into their rooms, that they are able to comprehend the medical jargon on a basic level, and that the staff members who are caring for them are top notch. If you feel a bit intimidated about how you are to do all that, this episode will prove very helpful to you, so be sure you listen.

If you make a promise to a patient, it’s your job to ensure it’s kept.

The patients you treat every day as a nurse often have nothing to do but lie in bed and worry about their health and the care they receive. That puts them in a place where they can be especially sensitive to the things you say to them. So be aware of the promises you make regarding their care. Don’t give deadlines or set expectations that may not be met. Help your patients be confident in you and your medical team by setting realistic expectations and seeing that what you do promise is actually done. It’s another way your compassionate care as a nurse can benefit the people who are under your care.

Outline of this great episode

  • [0:27] My introduction of today’s guest: Marcus Engel.
  • [1:41] The night Marcus’ life changed forever.
  • [2:55] Marcus’ previous experiences in the medical fields.
  • [4:30] The impact a patient care tech had on Marcus’ life.
  • [8:15] Reuniting with the person who had such powerful impact on him that night.
  • [9:56] The A.I.D.E.T. - and the concept of managing up.
  • [13:37] The importance of stating your title, not your task.
  • [15:55] Respecting the patient’s time and manage their expectations.
  • [17:40] Why patients need better explanations of what’s going on with their health.
  • [21:39] Key takeaways from Marcus’ book “The Other End of the Stethoscope.”
  • [29:02] How Marcus would spend a check from a big donor to a hospital.
  • [30:59] The advice Marcus would give to student or new nurses.
  • [33:37] How you can connect with Marcus.

Resources & Links mentioned in this episode and  

BOOK: I’m Here

BOOK: The Other End of the Stethoscope

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