OR_Elizabeth Steger: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Saul Marquez:
Hey everybody! Welcome back to the Outcomes Rocket, Saul Marquez here and I’m so privileged to have you join us again on this series on Nurse Leadership. Today, I have such a pleasure to introduce Elizabeth Steger to the podcast. She’s a Senior Vice President of Clinical Practice Integration and Chief Nursing Executive with an impressive track record as a collaborator, an inspirational leader, and an outcomes-focused nurse and nurse strategist anchored in relationship-based care and highly skilled in change management. She joined St. Luke’s in June of 2021 and immediately began developing and leading efforts to innovate, integrate and improve care delivery across the St Luke’s Health System, helping to guide strategic direction and leadership across all sites of care during and after COVID-19. Her work has resulted in new care delivery design in models that optimize quality, safety, and access for healthcare consumers while creating stronger structures and teams within the nursing workforce. Her leadership in creating and implementing recovery and regeneration for the workforce has made a difference for clinical stakeholders and patients alike. Alongside her team of nurse leaders, colleagues, and community of stakeholders, she continues to innovate and lead initiatives to improve patient care in the nursing workforce. It’s such a pleasure to have Elizabeth here with us today. And so I just want to, just welcome you to the podcast, Elizabeth, so thankful you’re here with us.
Elizabeth Steger:
Thanks, Saul. I’m glad to be here today.
Saul Marquez:
Yeah. So it’s worth noting, too, so Elizabeth has her bachelor’s in science in nursing from University of Mary Hardin-Baylor, and also her master’s of science degree in nurse administration from University of Texas, Arlington, putting it all to work here. So we’re going to talk a lot about the importance of taking care of, not only our clinicians to take care of our patients, but taking care of ourselves. And so before we dive into that, Elizabeth, I’d love to know more about what inspires your work in healthcare.
Elizabeth Steger:
Saul, I think my love for people has been the thread throughout my career. Just being able to contribute to someone’s quality of life is pretty inspirational. I think as I was choosing a career, I definitely thought about serving the sick, that was my big goal in becoming a nurse. And what first hooked me, I remember I started out in the operating room, and so the pediatric scoliosis surgery was my favorite, I love scrubbing those cases. You’d see at the beginning of the case a child with this really crooked spine, and then they leave the OR with just a much straighter spine. So the hands-on, same kind of healing an accident honestly, firsthand, was the initial draw and inspiration. Then I started understanding more about influence and saying, you know, by precepting, I became an educator. I was really inspired by the fact that we could impact more people’s lives in some of these kinds of roles, which later led me to administration, for the same reason, learning to lead through influence, being able to work with such capable and dedicated teams, and that became the inspiration. And then I would say within the last year, just progressing to this role here at St. Luke’s, I was truly inspired by the system because of the way that they had embraced population health and started to understand that there is a place for every piece of my career, obviously in the healthcare continuum, but thinking about really preventing illness in more promoting wellness, meeting people where they are on their health journey, that really got me excited. And I thought, what a great way to spend this part of my career in a senior leadership role in a system that’s got that kind of commitment. So a lot of inspiration. One thing with nursing, I’ve never been disappointed in any aspect of my career, I just love it.
Saul Marquez:
That’s wonderful. Thanks for taking us to the beginning there with scoliosis and how things have pulled you to go from the bedside, which is so critical to now the system level driving efforts like population health, and care at scale. You’re driven by this relationship-based care approach, and I’m really intrigued just by some of the models and things that you’ve designed. Can you share more about what you guys are doing there at St Luke’s that is adding value to the healthcare ecosystem?
Elizabeth Steger:
I’d love to do that. I don’t know how familiar everyone is with St. Luke’s. So just briefly, eight medical centers, three rehab communities, a little under 350 clinics and centers. The only not-for-profit health system based in Idaho, the ninth entrusted for 125 years, and so it’s an impressive system. In so many ways we’re imagining healthcare, reimagining healthcare in a lot of different areas, and understanding how important culture is. Quality safety’s always been a big part of what we do, but how we engage our consumers, how we engage our communities, and how we are good students of really the resources that we have, it’s just becoming increasingly important. We touch roughly 520,000 patients annually. And so when you think about the continuum of care and all of the services we provide, it’s pretty immense. And thinking about patient outcomes, we’ve done, been a strong performer in inpatient care and ambulatory care for a while, the awards and all those things to prove it, that designation is a magnet recently in the Treasure Valley.
Saul Marquez:
Congratulations on that. That’s a big deal.
Elizabeth Steger:
Yes, a lot of great work there. But what we realized is we really want to contribute to the people in our community before they become our patients. And so that’s been the most recent development, I would say, over the last several years. We’re fully accountable for 260,000 Idahoans in southern Idaho, and that’s a footprint of roughly a million people, so a pretty large span there. And we really are doing, I think, a great job of balancing that individual health need with the needs of the population. And so a lot of touchpoints, and we’re really holding ourselves accountable to delivering value-based, high-quality care focused on accessibility and affordability. And I think moving upstream, we’re also contributing to the ecosystem in a number of ways. One, we provide significant funding and partnership with a lot of our community agencies supporting housing, behavioral health services, food security, and for vulnerable members of our community. And we, of course, provide a lot of care to those who need it as well. We’re really also committed to supporting workforce needs for our community into the future, we are large employer, so that makes a big difference. But I think right now with challenges in workforce throughout the healthcare community, we are also inviting 2000 clinical students per year from 50 disciplines into our care sites and supporting their learning. So I feel like that’s another way we’re paying it forward into that ecosystem.
Saul Marquez:
That’s just incredible. And, you know, it’s those health systems that are able to integrate across the, not only the continuum of care but the continuum of life, right? And you talk about some of the things around like the social determinants of health and things that make care delivery, excellent care delivery possible, you guys have touched on a lot of those. It’s admirable to be part of an organization that thinks about engagement with patients even before they’re patients, you know, and I think that’s a fantastic organization to be a part of. If you had to think about anything, Elizabeth, around what you believe makes St. Luke’s different or stand out, what would you say that that is?
Elizabeth Steger:
I think one thing that stands out for me, and again, being here only a year, I feel like I come in with some pretty fresh eyes. There is a super clear vision in strategy and what I see is us really holding ourselves to that and keeping it at the forefront each and every day. We know who we are, we know what we’re trying to accomplish on behalf of our communities. And I think that clarity, it really supports our focus. And one of the things that we’re doing right now, after our intense focus on the pandemic, like every other healthcare system, we’re really trying to have clarity in what we need to take on so that we can ensure that we don’t overwhelm our teams and that we are staying focused on the most important needs of our communities. We are a regional delivery system and so it allows us to still be really sensitive to the unique needs of our communities because they are a little bit different. I think something else I’ve already mentioned is just that strong reputation and more importantly, trust that we do have after being in the Idaho environment for all of these years. We’re also fortunate that we have the financial stability, that we can try some new things. And so one of the new things that I would say we’re not trying but we are doing is adding a health plan and that, yeah.
Saul Marquez:
That’s a big move.
Elizabeth Steger:
It’s not only going to allow us to be accountable to value-based care but to really align all the incentives. You know, we need that, you were talking about integration, we need that vertical integration between payer and providers, and that’s how we’re designing our new health plan. We see the full continuum, so we know we’re going to be able to foster that collaboration. We know our patients and communities are going to benefit doing some really innovative things, like in thinking about decreasing the cost of care and making our care more accessible as well as affordable. We’re going to eliminate most of the prior authorizations because our providers are going to really be placing additional focus on evidence-based care. And we’re looking out for a lot of things, zero co-pays because we want our community to access our services when they need it, not put it off because it’s a financial burden. And so I’m pretty excited about where this is going. And I know it’s still new, it’s still in development. We’ll start beginning of 2023 with initial enrollment, we’re going to start small, but we expect that this is going to be something to really make a big difference over time.
Saul Marquez:
Wow, that’s amazing, Elizabeth. And kudos to you and the leadership team there for making bold moves. You know, in the environment that we’re in, it’s going to take bold moves to move the needle. And you know what? You guys are so integrated and embedded there that these types of moves, I would say, are not risky. They’re calculated and they’re meant to serve the greater good. So I’m excited to hear you talk about some of these things and to hear about the potential of that that you guys will have with value-based care on some of the initiatives. You know, and so there was COVID, there’s been challenges with workforce engagement. What would you say is one of the biggest setbacks that you’ve experienced and a key learning that’s come out from that?
Elizabeth Steger:
Well, being that my time here has been just this last year, I think it’s pretty easy to say the pandemic was definitely the biggest setback. I know I don’t have to say this to this audience, but the disruption in access for our communities, just that was devastating for some people. And that is hard on us because we want to make sure that our doors, whether it’s a clinic door or a hospital door, is always open. And I know we have surgeries that had to be postponed like other places and just really changed things for our patients. It also, as you know, took a huge toll on our teams, seeing, like other places across the country, huge staffing gaps at times resulting from that, which has then created a dependency on travelers, which has certainly had both continuity and implications at times, as well as financial implications. And so that was definitely the biggest disruption. With that though, the silver lining is the learning that you mentioned, and I think one of the things that we learned is our model of care does work because people did still have access to primary care physicians. We really ramped up our virtual care and we had all of what we needed to be in place to get that going and going quickly, our telehealth services, we have remote patient monitoring, all of that was highly successful during this time when people couldn’t easily get into the doors because we were overflowing with patients, especially during crisis standards. We saw, and this is no surprise, that exceeded all expectations how innovative and creative our teams were. They would just repurpose spaces. They just shift how they were delivering care based on what was needed in the moment and the resources that were available. And so we knew our team was smart and dedicated, but they’re super gritty and they proved it during this time. I think the unity of purpose in caring for those who were in need was unprecedented, and that was true of our community, how they stepped up and really felt that support in that way. We also saw within our walls all of the different disciplines how we work together in ways maybe we had and before. A great example is we had clinical dietitians who were in the ICU anyway taking care of these very sick COVID patients. And they said, hey, we can learn to help the nurses with patients, and they did. We had therapists who said, we’re in the middle of doing treatment, won’t you let us help with the feeding of that patient? And then countless nurses left their routine jobs and sometimes even desk jobs just to go where they were most needed and dust off some of those skills and competencies that maybe they hadn’t used in a little bit. But there was a lot of learning, we had a lot of iterations of some of the processes that we were trying to put in place quickly. But I do think today we are much better prepared for any kind of disruptive event that comes our way based on how we wanted to work together. And I would say lastly, you alluded to this at the beginning, and I say this is probably one of the most important learnings, is just how valuable it is to invest deeply, deeply in the well-being of our workforce. We had some really good wellness programs in place, and with the pandemic it was not enough. So we just continually added programs to support the whole continuum of care, wellness all the way through truly crisis intervention in the moment. And we’re going to continue to do that because we’ve realized the benefit in just regeneration of our teams through those kinds of efforts.
Saul Marquez:
That’s amazing. Yeah, you know, Elizabeth, well, kudos to you and the team and everybody listening if you’re a caregiver, thank you, right? I mean, we got through this, you did so much. Thank you. Thank you. Without you, our communities, our families wouldn’t be as safe as they are. And we’re so far ahead now, but there’s so much left to go. And Elizabeth, you called out, we’re, we’ve made so much progress and just in virtual care and how we take care of patients, the front door to healthcare continues to shift and change. What would you say is one healthcare trend or technology that’s going to change healthcare as we know it today?
Elizabeth Steger:
Oh, there’s so many, t’s hard to choose! Something that’s been on my mind a lot lately is really consumerism. And when I think about that particular trend, humans are the center of what we do, the foundational center of everything we do, every decision we make, every action taken, it’s just all around people. And so we naturally want to balance what our consumers want in the way of convenience or service with the efficiencies needed by the healthcare providers. I think it’s a little bit daunting actually to think about how challenging that might be, especially in light of the challenges we’re having with filling all of our workforce needs. And so how do we make sure that we’re super accessible when our patients and consumers want us and at the same time balance the well-being of those providing? So that’s, I think, going to change how we do work. I also see so many competitors entering into the market in these various areas of episodic care and they are able to focus solely on one piece of that care. And so I think some of that convenience to the consumer, they can definitely offer that in a pretty amazing way, but how will that then impact the continuum of the patient’s care or the individual’s care and wellness, if some of those things are done in isolation? So I think that’s going to be another opportunity for us to really work through what that looks like. You know, listening to our communities, anticipating what needs they’re going to have as well is going to be another really important area of focus for us. It’s going to be more important than ever in just staying relevant.
Saul Marquez:
That’s wonderful, Elizabeth. And yeah, you know, you guys are certainly focused, listening and that consumer aspect, gosh, I mean, you mentioned it, right? I mean, with the entrant of consumer companies, the large ones, into our space and then smaller startups that are wanting to get these little niche areas, it’s become even more important for all of us to listen. So, folks, make sure you’re listening to your community and responding to what you hear because it’s certainly going to make the difference. Elizabeth, this has been so stimulating. I just want to, I could talk to you for another hour here, but unfortunately, we’ve got a limited time today. So first I just want to say thank you. This has been super interesting and I’ve enjoyed our time together. What closing thought would you leave all of us with and where’s the best place that listeners could follow you and connect with you in the work that you do?
Elizabeth Steger:
Well, thanks, Saul. I’ve enjoyed the time too, and I promise I won’t talk for another hour. Closing thought, I think, has to be about those who might be listening, working in healthcare. You know, we’ve talked a lot about people and relationships and you had a bit of a warning that that was always where my head goes and my heart goes. But when I think about the broader scope, even outside of healthcare, you know, we as a world are in the midst of a lot of just division and chaos. I see healthcare, I envision healthcare as a place that people can come, where they can be comfortable. It could truly be a place of solace. And I want it to be a place of solace for those that are entering into care. I think our healthcare workers, they’re are the hearts and hands of service, of care, of compassion. I what that environment just to feel safe for all of those that we serve. I’m still inspired by the idea that we really have the opportunity every single day to lift other people up by being present in the moment. And of course, that’s not just our patients, it’s our colleagues in the settings that we work in as well. You know, for those providing care, there is an individual responsibility in managing our own health and well-being. When there’s so much to do, it’s easy to feel like there’s not time. And frankly, we have difficulty admitting sometimes when we need a break. But I think the pandemic has shown us that to bring our best selves to others, we’ve got to address our own resilience and our regeneration needs. And I think lastly, we’ve seen that employers really have a role to play in service to our teams in this area. And so creating a organizational culture that promotes wellness and supports our employees, it’s not only the right thing to do, but as we talked about toward the end of this podcast, it’s going to be imperative in retaining the talent that we do have and sustaining them through the difficult days ahead. So I think flexibility, efficiency, creating that engaging culture, that’s just going to be key.
Saul Marquez:
Love that Elizabeth. Yeah, you know, I love that. It’s a good takeaway here. Doing all these things for our employees. It’s not the right thing only, it’s an obligation and a great way to close us off, Elizabeth. If people want to reach you and follow your work, where can they do that?
Elizabeth Steger:
So one way is LinkedIn, Elizabeth Steger, and certainly on her at St. Luke’s, so there’s an opportunity to reach out to me that way as well.
Saul Marquez:
Love it. Elizabeth, just want to thank you again for the insights you’ve shared, and looking forward to staying in touch.
Elizabeth Steger:
Thanks, you, too. Saul.
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