Life Detours, Innovation, and Healthcare
Episode

Jessica Smith-Amara, Clinical Program Manager at Cohere Health

Life Detours, Innovation, and Healthcare

Many people take detours with their careers but ultimately keep working in healthcare. 

 

This episode’s guest is Jessica Smith-Amara, a board-certified nurse executive with a particular journey in healthcare. She has taken a couple of detours in her career with teaching, practicing nursing in pediatrics and bedside patients, and clinical project management. Her love for innovation brews from troubleshooting and presenting solutions to any obstacle she encounters. She also shares her three principles for innovation: awareness of the starting point, recognition of the low-hanging fruit, and starting with what you know. Jessica also reflects on her overall design thinking process, networking, and the nursing workforce. 

 

Tune in and enjoy this episode with a true innovator because the more hats you can wear, the more you can offer in your roles! 

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Life Detours, Innovation, and Healthcare

About Jessica Smith-Amara: 

Jessica Smith-Amara has more than 15 years of healthcare experience spanning nursing, quality improvement, and managed care operations. She is a Clinical Program Manager with Cohere Health. Cohere drives collaborative utilization management (UM) by aligning physicians and health plans on evidence-based care paths for the patient’s entire care journey. 

Jessica is a board-certified nurse executive and certified professional in healthcare quality. She is passionate about healthcare delivery innovation and the optimization of the nursing profession within the healthcare delivery landscape.

 

Outcomes Rocket Podcast_SONSIEL_Jessica Smith-Amara: Audio automatically transcribed by Sonix

Outcomes Rocket Podcast_SONSIEL_Jessica Smith-Amara: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

OR SONSIEL Intro:
Welcome to the SONSIEL podcast, where we host interviews with the most transformational nurse scientists, innovators, entrepreneurs, and leaders. Through sharing their personal journeys, we create inspiration, provide guidance, and give you actionable ideas you can use to be a catalyst for change.

Mary Lou Ackermann:
So, Jessica, thank you for joining us. I’m Mary Lou Ackermann, I’m one of the founders of SONSIEL, that was founded a couple of years ago now. And it has just been so exciting to be a part of this, this nursing innovation entrepreneurship team. And I’m also one of the co-hosts of the SONSIEL podcast, so I appreciate you taking the time and spending it with us over the next half hour. My real job, I’m vice president of Innovation and Digital Health at SE Health, which is one of Canada’s just social enterprises. We are, provide services in home care, long-term care, first nations communities, and all disciplines, all health disciplines, I’ve been at SE Health for over 30 years, started as a nurse going from home to home and then back and augmented my nursing degree with the MBA and really took an interest in innovation in health and digital health. So that’s a little bit of my background and maybe you could tell us a little bit about who you are and your role, that would be great.

Jessica Smith-Amara:
Wonderful. Yes. And nice to meet you. Jess Smith-Amara, I am in Pittsburgh, Pennsylvania, I’ve been a nurse for 12 years. I have worked in healthcare for more than 15 years, spanning nursing, quality improvement, and managed care operations. I’m a clinical program manager with Cohere Health. Cohere is a health IT company that drives collaboration, collaborative utilization management. We work to align physicians and health plans on evidence-based care paths for really the patient’s entire care journey. I am a board-certified nurse executive and certified professional in healthcare quality. I started my nursing career in pediatrics, in patients, so I worked pediatric cardiac ICU, cardiac stepped down, and then worked for a couple of years as a float nurse, all in pediatric acute care. And then I took a detour over to managed care. So for six years I worked in the Medicaid and dual-eligible Medicare base in insurance, working in quality improvements and care management as well, and have just recently started with Cohere Health and also still practice nursing at the bedside at my community hospital, so I do med search telemetry.

Mary Lou Ackermann:
Wow.

Jessica Smith-Amara:
Little detour, I had a little detour in teaching as well. I love teaching because I have a master’s in nursing education and leadership and have taught in an adjunct capacity in pediatrics.

Mary Lou Ackermann:
Yeah, I love the way you used the word detour, because I think that all of those different experiences that we gather along our nursing career and the journeys we take are really what helps drive forward some of the innovation and new ideas that we see surfacing in our profession, so good for you for testing different waters and taking all of that knowledge with you and then back into your new journey. So one of the questions I wanted to talk to you a little bit about was what really inspires you to work in sort of the healthcare environment?

Jessica Smith-Amara:
Oh, sure. You know, when I was really little, I wanted to be a librarian. I, and I’m still interested in that. I love, love books, love reading, love learning. I have a twin sister and she would want to go outside and play, and I would say, well, you have to play library first. So I think that was my first love is learning. And then somewhere along the line I became interested in, probably as a teenager, became interested in really marginalized populations, vulnerable populations. I have a family that works in healthcare, my dad was a chiropractor, lots of nurses in my family, so I had some exposure there and for quite some time I really debated do I want to pursue nursing or do I want to be a therapist? And at the time, I don’t think I realized that the psych-nursing specialty even existed. But I obviously chose nursing. And as you said, I’ve had had a good journey, worked in a lot of different areas, actually worked in psych as well. And I think what’s great about the nursing side of healthcare is that you can explore so many different areas of interest. But for me, I think what really led me into nursing was this interest in helping vulnerable populations. And that’s where I’ve spent the majority of my career, whether it was in pediatrics or even in managed care, working in that kind of public health, population health space with the underserved and Medicaid population.

Mary Lou Ackermann:
Right, interesting. Yeah, those are, those populations present some really unique challenges that, you know, when we look at things like diversity and health equity and especially as we produce and create solutions, often those, what I call the, the fringe populations aren’t addressed. And for some reasons that’s because the, we tend to always go to the 80%, use the 80% rule, we can make an impact on 80%, but there is this 20% of individuals who still require care and perhaps our solutions don’t always meet their needs. And I’ve been really pleased to see, though, an increase in attention to health equity as we create new solutions and drive forward new programs in healthcare. So at what point in your career did you then recognize that you were an innovator?

Jessica Smith-Amara:
Oh, I love this question. So I would say my first nursing role, like I mentioned earlier, was in pediatric cardiac ICU. And I had a wonderful preceptor, and when I was first starting, I think my orientation was six months. But right out of the gate, my preceptor said to me, most new nurses or novice nurses really struggle sometimes to see the big picture and throughout their shift and their care delivery, sometimes as a new nurse, they’re more focused on the small details, the task, making sure that all the tasks are complete. And she said, you know, you almost have the opposite problem. You’re very focused on this big picture. And in that same role in the ICU, what I found was I got the most enjoyment out of my work, not just by taking care of patients and helping them, but I really loved the troubleshooting, the problem solving and the constant on-your-feet, critical thinking. I don’t think that the word innovation or the concept of innovation was really in my vocabulary or maybe better set on my radar until I left the bedside for a period of time actually, and worked in managed care. And almost as soon as I started working in managed care, in care management and clinical program design as a clinical design specialist, I realized, oh, this love of troubleshooting, of solutioning, this is, this is innovation. And I was very excited by that. I think that is empowering, just, just knowing that.

Mary Lou Ackermann:
Yeah, that’s a great description. And I think you’re so right. When we talk about nurses as innovators, it’s almost something that’s built into their daily practice. We know that they’re constantly solving problems and what we call MacGyver-ing solutions because they don’t always have the right tools at their fingertips, so I love that component. And I also love that you mentioned your preceptor. I think it is these leaders that we meet along the way that we learn from and take some of their wisdom and guidance as we take on those next steps. So it’s about our formal learning, but it’s also really about our informal learning and experiences that we have along the way, so great comments, thank you. What has been some of the biggest challenges that you’ve had to face as, in your roles as an innovator?

Jessica Smith-Amara:
I think back to, I participated in the Fall, last year, 2021 in the Nurse Hack for Health Hackathon, sponsored and hosted by SONSIEL, and Johnson & Johnson, and Microsoft. That was an amazing, just an incredible, tons of energy experience. And I was able to, I knew I was joining the hackathon with a specific problem that I wanted to solve, which is really experienced nurses leaving the bedside or actually patient care delivery space to go into other settings, managed care, consulting, you name it, for a variety of reasons. So that’s the reason I joined the hackathon. I knew that was the problem that I wanted to I’d get on and solve for. I found my hackathon teammate who had come with a very similar problem. She wanted to work on this concept of retired nurses and all of that expertise that kind of leaves the bedside. Through that hackathon experience, it was a little more formal, I learned even more about the design thinking process, it opened a lot of doors, met a lot of people, and I continue to work on that project. And the barrier that I found, at least initially, was that it can be a little, innovation can feel a little bit daunting. It’s overwhelming, especially if you’re trying to solve for a big problem, my team was. And I, at some point kind of landed on allowing three guiding principles to creep in to the design process for me. So the first was just knowing that you have to start somewhere. Second, I decided I wanted to grab the low-hanging fruit. And third, I realized I’m just going to start with what I know. I’m going to start with using the process improvement tools that I know, and that took me very far. So I would say for me, innovation barriers I’ve experienced are more around trying to solve for a big problem and just finding a way to not make that daunting, stay focused. And again, those were my guiding principles. You know, start with what I know, grab the low-hanging fruit and you just have to start somewhere.

Mary Lou Ackermann:
Right, right. And those are great guiding principles. And I think it takes a lot of courage to take on especially the big problems. But I think even, within a big problem is also the result of many little problems as well. So I think your concept of let’s grab the low-hanging fruit and just start chipping away at this, knowing that at some point we will get some, we’ll, we’ll see some impact. And it does take patience and perseverance for sure. So I love that approach and I love those tips for people as they take this, start to dip their toe in the, into the water.

Jessica Smith-Amara:
Yeah, absolutely. And I’ll add one more thing, you know, when I landed, I, for my definition phase of the design thinking process, it’s an iterative process. I went back to the definition over and over because I do have a tendency to get excited and jump into ideation and I have literally probably half a notebook full of just ideas around this problem of not retaining nurses, or not having lucrative enough opportunities for them. So again, iterative process went back to the define phase and what worked the best for me and really allowed me to get past that barrier of not knowing what solution to pick was, I used the Five Whys tool, which I love. It’s a very simple process improvement tool, just asking, okay, what’s the problem? Why does that happen? Why does that happen? Asking five times, and I ended up with really a rather large matrix, like you said, of all the little problems that add up to this one big problem. So a little plug there that, that worked very well for me and design process.

Mary Lou Ackermann:
Yeah, I think finding your methodology that works is really important and also building out a toolkit on how to do innovation and what tools do you use, at what point in that cycle that will work best for you. But yeah, I’m a big fan of the Five Whys as well, it really helps us to understand the problem and then the opportunities. So yeah, that’s great. I also love that you talked about the hackathon that you attended. I, I attended the first one that they had in-person a couple of years ago that SONSIEL hosted in person, and I have never felt as energized and optimistic and excited about the impact that nurses will have on transforming our health system after I left that two day event, and although we’ve had to have virtual ones the last couple of years, I have even found those great opportunities for, for nurses, so thank you for for attending that and joining us. Yeah, wonderful. So how aside from the hackathon, how else has SONSIEL helped you with your journey?

Jessica Smith-Amara:
Right! I just recently joined officially as a member, so really excited to start that journey. I know that, what I’m looking forward to is I know that it’s a large network that all have common, common goals of advancing the nursing profession. And number two, they have a lot of available resources. You know, on their website, we’ve got all of our podcasts, they have information on the design thinking process, all of the same trainings are available on their website that folks attend in order to participate in the hackathon. So really looking forward to meeting even more folks and met a ton of folks during the hackathon, that opened a lot of doors, but I think SONSIEL is a good place to network, to open those doors, and get additional resources.

Mary Lou Ackermann:
Yeah, we’re really, we’re really excited about all of the members, all the members we have and the expertise that they bring and the experience they bring, you know, some more than others. But also what’s nice about that is all the different perspectives from nurses who are just tipping their toes into innovation and entrepreneurship versus those who’ve been in it for a long time. We learn from each other all the time and we’re really excited now that hopefully we’re through this, we’re at the endemic stage now and we can start to get back together in person because I think building those relationships is, is really key, it does happen virtually and we have had incredible growth in our membership over the last couple of years. But I hope you can attend some of the in-person events as they start to unfold over the next year or two because you’ll, you’ll really enjoy those. So what do you have most excited about with innovation and in nursing and science, those sorts of things?

Jessica Smith-Amara:
I think what I’m most excited about at the moment is that nursing is one of the largest workforces, so we’re the largest sub-workforce within healthcare, the fifth largest in the country. And I think we’re all seeing this kind of pivotal moment where nursing has a platform. And I think we are realizing that we are an enormous workforce, we do have the upper hand in the fact that we have the skill set and the tools that we need to be able to get some of the things that we’re asking for in terms of care delivery, safe patient ratios, and I think that excitement is very exciting. It feels like everybody knows now is the moment for nurses to innovate.

Mary Lou Ackermann:
Yes, for sure. I think the last couple of years in particular have been really a great learning experience for the healthcare system around the importance of the role of the nurse and all of the innovation, just bedside innovation that’s had to happen over the couple of years to service clients in unknown situations. Remember when COVID first hit some of the stories we heard about people jerry rigging isolation, isolation tents or isolation opportunities because we still weren’t sure about how it was transmitted and stuff like that. And all through just maintaining a workforce that was, worked incredibly hard to keep patients safe and, as well as they could be and ensure that they had a good healthcare experience. So, yeah, it’s, it is an exciting time, I like the way you used the word platform. I think it’s, nurses are joining together and supporting each other and encouraging each other. So part of SONSIEL’s role is to amplify the voice of the nurse and make sure that they are heard as new solutions are surfacing, if they’re not driving them forward themselves, they should be at the tables of the organizations or companies that are driving and creating these solutions to help transform health. So I think it’s a really exciting time for for healthcare and and for nurses for sure. What would be one thing that you would like to leave the audience with today?

Jessica Smith-Amara:
I think just to touch on how we kind of opened this segment, that nurses have the opportunity to work in almost any space. And my experience has been working in several different areas, leaving bedside nursing and then actually coming back. I would say my message would be keep an open mind, if there is an area that you want to work in, go for it, but don’t feel like doors are closing as you leave one area and go to the next. So that’s been really a huge eye opener for me. Like I said, away from the bedside for six years, wanted to go back for quite a long time, there were a couple of things holding me back. I was afraid that I would have to work night shift, that I wouldn’t be able to balance things, and none of that has proven to be true. I’ve lucked out, I have two great employers and I’m able to balance things between Monday through Friday role and also working at the bedside. But I think my big lesson learned and what I want to share with people when I left clinical care delivery, it really felt like a door closed. And I remember being very disappointed that that door had to close, that I needed additional opportunities. I was looking for growth and new areas, and what I’ve realized years later is that the door doesn’t close and returning to bedside nursing, whether it’s full time, part time, per diem, casual, really is like riding a bike. And I think the more hats you can wear, the better off you will be in terms of what you can offer in your current roles. And, and also the better off you’ll be, you’ll have more perspective to participate in innovation. Well, so I think for me, it’s all about perspective, wearing as many hats as you can and knowing that those doors don’t necessarily close.

Mary Lou Ackermann:
Yeah, I love that. I think, because, I think that’s probably a common feeling that when you are making that choice to leave the bedside, you know, how comfortable will you be to come back? So those are really wise words to share with people because we, we do know that part of the reason why it’s so important for nurses to be involved in innovation is because they are at the bedside, they have that closest relationship with the with the patient and their family. And they’re, they are the ones who can really help us shape those new experiences as they come out. So either combining roles or within your own role as a bedside nurse, participating in innovation, innovative activities or health transformation activities, those sorts of things are really important. So there’s many, many ways that nurses can provide some leadership in this space.

Jessica Smith-Amara:
Absolutely. And, one more thing, concept that I guess I would leave in parting, I do believe, you know, we talked about this being really a pivotal moment in healthcare and in nursing, I believe now is is the time that we have an opportunity to really articulate or re-articulate maybe what it is that that nurses do. And I think that is also related to having all those different perspectives working in different areas, returning to the bedside if you’ve left. But yeah, what I see is that sometimes nurses themselves actually struggle to articulate what nursing is, what it is that we do, even our colleagues or counterparts sometimes struggle to articulate what that is. And what I’m working on post hackathon, just continuing that work is really building a, I want to build a toolkit and a business case for nurses to help them better articulate what it is that they’re doing in their role and how to, with a value proposition, maybe even a return on investment proposition to show a business case for what it is that they they need in their in their role, whether it’s different staffing arrangements, different workflows, potentially job description changes, but that’s a major focus right now. And I think I, happily it is something that people are really thinking about is how do we better articulate nursing and the value proposition for nursing.

Mary Lou Ackermann:
Wow. Great. Well, that’s a big undertaking because it is such a vast profession with all kinds of different opportunities within it, which is one of the reasons why it’s such a wonderful profession too. So I think lots of opportunity there and I wish you all the best with that for sure. And wanted to thank you for joining us today, Jessica, and sharing your insights and your wisdom, it was just great talking with you and hopefully we’ll see you at the next SONSIEL meetup.

Jessica Smith-Amara:
Absolutely. Thank you. Wonderful chatting!

OR SONSIEL Outro:
Thanks for tuning in to the SONSIEL podcast. If today’s podcast inspired you, we invite you to join our tribe or support our mission by visiting us at SONSIEL.org. That’s S O N S I E L.org.

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Things You’ll Learn:

  • Underserved populations are often not considered when solutions are developed. 
  • Innovation is overwhelming for any type of solution. 
  • When working in innovation, use the 5 Why’s to solve problems. 
  • Building connections in person is key to networking, even though it can happen virtually. 

 

Resources:

  • Connect and follow Jessica Smith-Amara on LinkedIn
  • Learn more about Cohere Health on their Website