Issue link: https://beckershealthcare.uberflip.com/i/1517468
22 CMO / CARE DELIVERY Health systems rethink nursing By Laura Dyrda H ospitals are redesigning nursing and care team models to meet patient needs and leverage technology to better support nurses. While still in the early stages, a few health systems are seeing promising results for patient care and nurse satisfaction. Trinity Health in Livonia, Mich., is moving the needle with its TogetherTeam Virtual Connect Care™, which uses three-person teams of nurses with one virtual and two on-site to support direct patient care. "Patients receive comprehensive care from a collaborative team, made up of a direct care registered nurse, a nursing assistant or LPN, and an on-site registered nurse connecting virtually," Michael Slubowski, president and CEO of Trinity Health, told Becker's. "We continue to see encouraging results in nurse and care team engagement, reduced turnover, improved quality and safety, and patient and family satisfaction with their care." e program is live at 21 of the system's hospitals across 10 states. ere are around 1,900 beds covered within the program. BJC HealthCare in St. Louis is also leveraging virtual nursing to boost patient care. omas Maddox, MD, vice president of digital products and innovation at BJC HealthCare and Washington University School of Medicine, told Becker's the program has "demonstrated a significant impact" by virtual nurses assisting beside nurses with their inpatient responsibilities. e program supported 4,951 inpatient admissions and yielded positive results: • 100% HCAHPS score for virtual nursing in the "Nurse Courtesy/ Respect" domain • Gave bedside nurses 1,650 hours back for direct patient care • Improved admission documentation rates to greater than 85% • Helped reduce nurse adjusted voluntary turnover to 6.4% "We are continuing to scale across our entire system in 2024 and are excited to see its continued impact," Dr. Maddox said. Joseph Webb, DSc, CEO of Nashville (Tenn.) General Hospital, created and implemented a new model of care management in recent years informed by the science of healthcare delivery, called Community Care Team. e team includes non-nurse navigators, nurses, nurse practitioners, social workers and dietitians. "e goal is to change the local culture of healthcare by engaging in a no-discharge structure and process whereby delivery of healthcare/ wellness services is provided in the hospital, home, physician's office, or other post-acute care setting," Dr. Webb told Becker's. "e provision of services is aligned with the mission of NGH and population health needs of Nashville and the Davidson County community." Dr. Webb's team is diversifying its methods for identifying and recruiting patients into the program, with the goal of reducing unnecessary ER visits and hospital readmissions. e program provides support for patients to self-manage care and connect with community resources. "We identify high-risk patients through a high utilizer registry report that indicates patients with potential avoidable utilization," Dr. Webb said. n Tenet invested in nursing to cut costs in 2023. Did it work? By Laura Dyrda D allas-based Tenet Healthcare has been intentional over the last year about reducing contracted labor to lower costs, and the 58-hospital system is seeing results. Tenet reported fourth-quarter contract labor accounted for 2.8% of consolidated salaries, wages and benefits, down 62% over the same period in 2022. Salary, wages and benefits were also 160 basis points lower in the fourth quarter year over year. "Our investments in nurse recruitment and retention have paid dividends as we have strengthened our workforce and effectively reduced contract labor spend throughout the year," said Saum Sutaria, MD, CEO of Tenet, during the quarterly earnings call, as transcribed by Seeking Alpha. He added, "This best-in-class contract labor cost management performance helped drive strong results in 2023 and we expect to continue to benefit from our operational discipline in the future." Tenet reported $1.3 billion in net income for the full year and revenue jumped 7.2% year over year to $20.5 billion. The system's leaders expect similar trends over the next 12 months. "We took a lot of benefit from contract labor reduction in 2023," Dr. Sutaria said. "Now don't get me wrong, there's an annualization effect that will improve in the coming year. The volume strength was also very good during the year, and so I think that we believe that we'll continue to see acute care recovery in 2024, like we saw in 2023." In 2024, Tenet projected adjusted EBITDA growth of around 5% by the midpoint of 2024, on a normalized basis, due to small admissions bump and "continued operating discipline," according to Dr. Sutaria. "Having captured much of the value from contact labor rationalization last year, in 2024 we plan to continue to strategically open up capacity to meet growing demand in a number of our markets, leveraging our previous capital investments," he said. Sun Park, executive vice president and CFO of Tenet, said during the earnings call that salary, wages and benefits were still elevated compared to historical rates, and his team projects more normalized rates in 2024 fiscal year guidance. "We're continuing to make investments into our workforce in the right areas on our base wages, and then on contract labor," he said. "… We do still expect some savings from contract labor going into fiscal 2024 guidance." n