Ep 164 – Nurse-Led Innovation in the Future of Value-Based Care Transformation, with Rebecca Love, RN, MSN, FIEL

This week is National Nurses Week, and it is a time to honor the contributions and sacrifices of nurses who perform some of the most difficult and heartbreaking tasks in the medical world.  As workers who perform the most essential healthcare tasks, nurses serve as the first point of contact for most patients…and they save lives and restore health in the process.  Yet, nursing is often a thankless profession that is underappreciated and experiences high levels of burnout and moral injury.  There are a multitude of factors related to societal attitudes towards the nursing profession, and many of them result in a lack of recognition and support, inadequate compensation, limited opportunities for career advancement, and ultimately a lack of respect and appreciation for the work they do.  We must begin to think about how to better position the profession to take a leading role in healthcare innovation.  Nurses must become more empowered as we transition to a future of value-based care.

This week on the podcast, we are honored to be interviewing Rebecca Love.  She is an experienced nurse executive, the first nurse featured on Ted.com, and part of the first nurse panel at South by Southwest. Rebecca is a regular contributor on the Forbes Business Council, and has been featured in BBC, Fortune, Becker’s, Forbes, Chief Healthcare Executive Magazine and ABC news. Rebecca, was the first Director of Nurse Innovation & Entrepreneurship in the United States at Northeastern School of Nursing – the founding initiative in the Country designed to empower nurses as innovators and entrepreneurs, where she founded the Nurse Hackathon, the movement has led to transformational change in the Nursing Profession. In early 2019, Rebecca, along with a group of leading nurses in the world, founded and is President Emeritus of SONSIEL: The Society of Nurse Scientists, Innovators, Entrepreneurs & Leaders, a non-profit that quickly attained recognition by the United Nations as an Affiliate Member to the UN. Rebecca is a world renowned Nurse Entrepreneur and currently serves as the Chief Clinical Officer of IntelyCare.

Episode Bookmarks:

01:30 National Nurses Week – a time to honor the contributions and sacrifices of nurses who perform some of the most difficult and heartbreaking tasks in the medical world.

02:00 We must better position the nursing profession to take a leading role in healthcare innovation.  Nurses must become more empowered as we transition to a future of value-based care.

02:30 Introduction to Rebecca Love – a nationally-recognized nurse executive and entrepreneur, the first nurse featured on TED.com, and part of the first nurse panel at SXSW.

03:00 Rebecca founded and is President Emeritus of SONSIEL: The Society of Nurse Scientists, Innovators, Entrepreneurs & Leaders and currently serves as the Chief Clinical Officer of IntelyCare.

04:00 Support Race to  Value by subscribing to our weekly newsletter and leaving a review/rating on Apple Podcasts.

04:30 How do we better position the nursing profession in the value-based care movement?

06:30 “There is going to be no healthcare in the future without nurses leading value-based care.”

07:00 How tracking VBC outcomes by Provider NPI # is a challenge since nurses do not have assigned NPI #’s.

07:45 Nursing costs were rolled into room rates in the 1930’s with the establishment of modern-day insurance models. This occurred due to a male physician-dominated environment.

08:30 Nurses are the only clinical professional in the healthcare environment without a NPI for billing or tracking outcomes!

08:45 “Value-based care cannot fully be amplified or adopted until we address the lack of a NPI number with nurses.”

09:30 The infuriating pay inequity between executives and nurses. (Nonprofit hospital CEOs make on average 10X the rate of nurses!)

10:00 Should we align compensation to both executives and clinicians tied to patient outcomes?

10:45 North Carolina’s seven largest hospital systems reaped billions of dollars in profit from COVID Relief Funding but couldn’t afford to pay nurses!  (Read more hereand here)

12:00 CEO pay doubled over five years in North Carolina, but nursing pay there only increased 12-14% over the last decade!

13:00 The national increase in nurses pay over the last decade was 1.6% per year(less than the increase in cost of living).

13:45 The UK Nurses Strike – the largest labor protest in the history of the nursing profession.

14:00 How the cost allocation methodology for nursing will cause continued exacerbation of the nursing working shortage in the U.S.

14:45 “We have to find a way to unpack nursing overhead from the room rate to make sure our healthcare system stays operational and can support our communities.”

15:30 Inspiration from President John F. Kennedy about recognizing the opportunity in a crisis.

16:00 There is a shortage of 450,000 nurses in the US today, and it is projected that over 1 million registered nurses in the U.S. will leave the workforce by 2030.

16:45 70% of new nursing graduates have left the bedside since last year!

18:00 Rebecca speaks about the compassion and empathy of nurses and how they are suffering due to burnout and moral injury.

19:30 How the healthcare industry treats nurses like an “endless commodity” and does little to address their burnout.

20:00 What if we invested only a quarter of what we spend in healthcare technology on nurses?

20:30 “Nurses have been degraded and relegated to the lowest rung of healthcare delivery today. If we want VBC to be successful, we must stabilize the nursing workforce.”

21:00 “Value-based care will certainly not survive without the nursing workforce at the heart and the center.”

22:00 93% of nurses are experiencing staffing shortages in their hospitals, which is a significant increase from 59% in a 2020 survey.

23:00 Last year over 90,000 qualified nursing applicants to nursing school were turned away due to lack of space!

24:00 We have more nurses today than any other time in American history, but we have a critical shortage because they are unwilling to work in the current healthcare environment.

24:30 The highly controversial RaDonda Vaught Homicide Case where a nurse was found criminally negligent for a self-reported medical error.

26:00 1 in 3 bedside nurses have left the profession since the RaDonda Vaught case!

26:30 Nurses and CNAs being criminally prosecuted for errors in long-term care delivery when not a single owner is held responsible for the unsafe care environment!

27:00 Rebecca speaks about the role of Higher Education in building bridge pathways and ensuring diversity to support the nursing workforce shortage.

30:30 Workforce challenges are now the #1 issue on the mind of hospital CEOs (ACHE Survey)

31:00 Hospitals have turned to travel nurses to ease staffing shortages during the pandemic, contract labor expenses have risen more than 250% over the past three years!

31:30 Annual burnout-related turnover costs are $9 billion for nurses!

32:30 Rebecca speaks about the need to enable more nurses to serve in senior leadership roles and as governing fiduciaries on hospitals boards to redesign care delivery.

33:30 “Innovation is opposite of the definition of insanity.”

34:00 How hackathons can be utilized in the empowerment of a nurse-led innovation movement.

35:30 Investing in technology to improve nurse staffing (e.g. improving float pool and per diem services).

35:45 80% of women nurses do not return full-time after they have a baby! (Could tech solutions provide staffing flexibility to empower nurses to continue working?)

37:00 “Reverse pitch events” – honing frontline innovation to address adverse events in the healthcare setting.

37:45 Applying the UI/UX methodology to the healthcare end user in order to improve care delivery at scale.

40:30 The lack of nursing input when health systems role out new technologies (and how these tech decisions often end up creating more work and administrative complexity).

42:30 The importance of the Chief Nurse Health Informatics Officer.

43:45 The role technology can play in Patient Safety.

46:00 The work of Healing Politics in getting nurses more involved in the political arena to reshape healthcare.

47:00 The lack of business education in nursing programs.

48:00 The need for more nurses holding political positions and why more nursing input is needed in health policy. (Betty Rambur is currently the only nurse on MedPAC.)

49:00 Nurse-led innovation happens when nurses are trying to save lives!

50:00 How the COVID-19 pandemic depended on nurse-led innovation.

51:30 “Why are we not trusting in nurses now – to hear them and trust them – so we can build the system needed to sustain workforce, sustain healthcare, and sustain our communities?”

52:00 How Florence Nightingale forever fundamentally changed the future of science, history, and medicine with the establishment of the nursing profession.

54:30 Rebecca discusses how attending a healthcare hackathon changed her life and led to a career path in nursing innovation!

60:00 What the hackathon taught Rebecca about the importance of the nurses voice and how they can save healthcare.

62:30 Parting thoughts from Rebecca and the life lesson learned from surviving a shipwreck at sea.  (Bet on yourself and believe you can overcome adversity!)

64:00 “Were there none who were discontented with what they have, the world would never reach anything better.” – Florence Nightingale

65:00 2030:  Florence Nightingale’s prediction of a future nursing renaissance.