The Becker's team is excited to announce the launch of our new CFO and Revenue Cycle podcast. Tune in for conversations with finance experts from the top hospitals and health systems. We'll discuss key trends and ideas to drive meaningful change in the industry. Look for Becker's CFO and revenue cycle podcast wherever you listen to episodes. This is Laura Dirdo with the Becker's Healthcare podcast. I'm thrilled today to be joined by Cathy Sanford, senior executive vice president and chief nursing officer at CommonSpirit Health. Cathy, it's a pleasure to have you on the podcast today. Thank you. I'm really happy to be here, Laura. Now I'm excited to have you on the podcast because I know Common Spirit has just some very innovative things happening today. You know, really, truly one of the great health systems across the country. And, two, I'll be excited to learn more about how you're thinking about the future. But before we dive in, I'm wondering, can you tell us a little bit more about CommonSpirit and what makes it unique? You know, I, have always felt privileged to work in health care, and I feel privileged now to be working in health care as the chief nursing office for CommonSpirit Health. We, serve communities across the country, both large and small, facilities. We have 22 2,200 care sites. We're in 24 states. We have 35,000 plus providers, forty five thousand plus RNs taking care of patients. We have more RNs than that because there are a lot of nurses who do other things in the system, but over 45,000 that are actually taking care of patients. And we employ over a 50,000 people. So it's a it's a very large, complex, and fun place to work. We have hospitals. We have home health. We have long term care, and we have a variety of clinics. And because we have that combination, it gives us significant impact on the health care delivery across the entire continuum of care. And that's what is exciting to me because I think that that's so important that we have an impact and that all of us who work in health care have an impact in making health care better for this country. Well, that's amazing to hear, you know, and certainly a sprawling enterprise that you have. That's a lot of nurses working to, create better care for their patient communities and and really making a difference across the board. I'm wondering if you go back to the last year or so, what is the accomplishment that you're most proud of? There's so many. Really. Right? There's so many things that are happening. But I think that I would say that, because we have a goal, and I've talked about this before in different, venues. We started five years ago with a five year plan for nursing, five year strategic plan because I believe very strongly that not only do organizations have to have strategic plans, but functions have to have functional strategic plans that feed into the strategic plan. So we started five years ago with our strategic plan for nursing, and we're in our fifth year. So I think I would say what I'm proud about is that we were able to do so many things in that plan that's made a difference. And it's made a difference in our KPI, our key performance indicators in, for our patients and for our staff. And those are both really very important. So I'd like to tell you a little bit about what we've done, and here's some favorite examples. And one is, of course, we have, virtually integrated care. And I say, of course, because I believe that I've been asked to talk about that, in several venues. It addresses the nursing shortage, and it lightens the load for our bedside nurses. Our virtual nurses are assisting in all aspects of patient care, and we're having very, very good results both in the patient care area and, the quality and patient experience as well as the experience of nurses. And that's going to be so important because the shortages that have alleviated slightly now are going to be back. So I'm really proud that we've done that and we've started on that. I'm proud of our nursing, residency program. We've been able to put in a one year program that helps all of our young new nurses with their professional development. We do coaching with them. We have mentorship for them. We give them consistent feedback. And we make sure that even with the number of experienced nurses that are leaving, we are able to help these new young nurses as they get on their feet in a profession that is wonderful, but very challenging. And so, I'm proud of that. And I'm also proud of our what we call our care based team. Some places call them command centers, but it was part of our we changed the word the name to care based because it isn't someplace where we command people. And I know about command. I'm a retired army nurse. It's it's more about, basing our care somewhere centrally that can help the rest of the country to take care of patients. So we we augment and enhance our patient flow. We work on our progression of care. We provide direct care to patients across the care continuum. We monitor, centrally. We let's see what else. We have physicians and advanced practice providers there. And we're focused on unburdening nursing and creating provider capacity while we're decreasing readmissions, falls, and contract labor. So I'm really proud of the five year plan that it did what we said it would do, and now we're ready for the next five year plan. Well, that's amazing to hear, you know, and certainly a time of a lot of transformation in the last five years, especially, to get to where you're at today, and really see the results of some of those efforts. I think it's really cool, especially as you were talking through the nursing residency program. I think so many organizations are trying to figure out how to strengthen their pipeline of nurses, nurse leaders as well, and figure out how they can bring in additional caregivers into their health system in a strategic way. So, for those folks, do you have any advice when you're trying to set up a program like this, whether it's a large regional system or a smaller community hospital? How do you do it justice? Well, you have to start with finding out what the nurses think. You have to start and you have to start it with a vision. What is it you wanna do? What is it you're trying to solve? I think sometimes we're in such a hurry to solve things that we come up with solutions before we have carefully defined what the issue is and what the issue is for the staff. So, the advice that I always give people is be sure that you are involving the people who you are going to ask to do the work. Be sure you ask them what they think, and be sure that when you come up with what you wanna do going forward, you know where it is, where you wanna go. You know, where where did you wanna go? We we you have to have a vision first, then figure out where you are and then figure out the steps of how to get there. And as long as you do that, I think you'll be on the right track with one caveat. When we get started on new and different plans to go to the future, we need to be willing to change if those plans don't work out and dust stand up, dust ourselves off dust ourselves off and say, hey, that didn't work. But what would work? Let's see how we could change this and make it work and not get so set in what we have come up with that it's the perfect solution that we're not willing to change along the way because the world is gonna continue to change. Health care is going to continue to change. We know that. Policies, procedures, everything is going to change, and we need to be ready to change as we go along to get to that future. That's really great insight, and I appreciate, the extra context around there. What a great inspiration and and, motivation to really connect, as you mentioned, with the nurses and those and and listen to, what's important to them as they are working towards that goal of providing better patient care. Now when you look at the future, the next year or even five years as you were talking about, what are some of the big opportunities for growth that you're focused on? Well, I wanna start with something in the past a little bit and then go forward. I left nursing. Can I tell you a little story if we have time? I left nursing for a short while. I didn't really leave it, but I took a different job for a short while working for strategy. And a while I before I came to CommonSpirit, I worked in a small smaller system in the strategy area. And one of my jobs was to go out and go to the Lions Club and the Rotary Club and all the local community clubs and ask people what they wanted in health care. And it was fascinating to me. I wouldn't call it a true research study, but it was fascinating to me how many people said what we are missing is coordination. We're looking for someone to coordinate our care. And I would say, well, do you your physician's office, your primary physician. They said, no. No. No. That's not what we're looking for. We're looking for someone who would coordinate all of the different places we could go and help us get there. So when we talk about growth for the future, I think that the work that we're working on is, all about that, about how we are going to coordinate. I talked about who CommonSpirit Health is. But we are also have we also have opportunities to figure out how we're going to coordinate that care and give people what they want. So one of the things we did a couple years ago also was my physician partner and I wrote a book on dyad leadership. And I'm excited about for growth going forward that I have a new dyad partner and common spirit has formally adopted that the clinical services across the country is Colette by an RN and an MD, equal partner, equal senior executive vice presidents at the organization to figure out how we are going to do this together and not just doctors and nurses, but the entire team. How are we going to bring all clinicians together and then our other partners as well? But we'll start with all clinicians together to be around the care of the patient and to coordinate our care. That's going to help us a lot with growth. We also know that we're going to be having more and more technology to work with, and, we think that some of that technology will help us grow and that we need to be very careful because we don't want to get excited about new technology. Right now, you know, AI is the big thing. Right? Everybody wants AI, AI, AI, and I get vendors sending me notes all the time saying, we got this great new AI thing. And so I, I think that for growth, we need to understand that you shouldn't lose track of what your goals are. The goals are what are important, not the toys. And, my IT people might be concerned that I call them toys, but sometimes I think that we think new technology is the greatest, the best, or this new AI thing. What we need to do is know what our goals are and then figure out what technology and AI will help us get there. So that's a big area of growth, I think, as long as we remember to do that, to keep our eye on what our goals are. And then we, are going to be doing, more with our virtual nursing. We have some areas of growth where all kinds of virtual clinical activities can happen, both to make care better for the patients and make the work that the clinicians do better as well. So that's where we think we're gonna be growing in the clinical area. That's amazing to hear. You know, big goals, but I I think very important reminders too, as you said, to make sure that you've got the right goal in mind, that you're looking, to make improvements in the right areas. And then the technology to support that, is so critical. And it's been fascinating to see how quickly technology has evolved in the space both clinically as well as, operations for the health system, and in health care in general. I can imagine, you know, it's both exciting, but also a little bit nerve wracking to to make sure that, you know, you're you're doing everything right, and moving quickly than more quickly than you ever have in the past. That's true. I I I think it's exciting, but anything that's worth doing also is going to have its challenges, and it's also going to have, things that you need to be thinking about all the time. But we believe, I believe, that as long as you keep your eye on what's right and what's good for the people we serve, the communities we serve, and the people who do the serving, you're going to come up with the plans that are gonna help you get there. Well, that makes a lot of sense and is very reassuring, of course. And you mentioned challenges. I'm wondering, you know, what are some of those challenges that you're seeing ahead? I know a lot of opportunities, which is great, but, leaders also have to be thinking about those headwinds and things that could be roadblocks potentially. So what do you have your eye on? Well, first of all, thank you for recognizing that. And I know that you do it, Becker, that health care is constantly changing, and we are experiencing headwinds. And we will always experience headwinds across health care and not unique to us. There's always gonna be challenges. The one that I, fear that we might forget because we're so busy with so many of the technology or financial challenges is that we've got to continue to pay attention to staffing. We've got to pay attention to what's gonna happen and what's gonna happen as, as, our our society ages. It's not just the society that's aging is gonna need more care. The caregivers are aging. And we cannot cannot lose sight of that challenge and make sure that we're taking care of our teams so that we have people to take care of everybody else. We found and I'm I'm back to virtual nursing again. We found that that virtual nursing models help us with staffing shortages. Nurses tell us that they don't want to go anywhere else that doesn't have virtual nursing. So once people get used to those types of new ways of taking care of patients, it's hard for them to go back, and it's going to be hard for people to get, we believe, it'll be hard, a challenge to get people to work for us if we don't have those tools and those new models in the future. And we also, believe that it's important that we help, provide a career path for our own employees. I I read somewhere that the and I can't tell you where, so I'm not gonna quote it correctly. But I read somewhere that the new generation is going to change professions, totally change professions multiple times in their life. And if we don't have career paths and help people figure out how to change professions and still stay engaged with care, we're gonna lose them from health care. I think it's okay if they move around in health care or to help us with health care, as supportive in support, agencies. But if we don't come up with career paths, I think we're gonna be constantly challenged and not be able to take care of people. And that would be a very sad thing if we didn't keep our eye on that and take care of that issue. Well, it's fascinating to hear and think about, especially given, how many, you know, nurses are coming into the space and people are coming into health care wanting to have that, that laid out for them or have options too within the system, to really, you know, vary their responsibilities and grow in a meaningful way. Before we wrap up here, I'm wondering, could you talk a little bit about the number one thing that you're doing right now to, prep for long term success in the future? Well, I'm gonna sound repetitive because we did a five year strategic plan, and we are at the end of that plan. And so what we're doing right now is starting our next five year plan, and we're going to do it very similarly to the way we did it before, which means we're going to invite frontline nurses to take part in helping us figure out what we need to do to get, things done in the next five years. We need to figure out what our assumptions are. We need to figure out how we're going to continue to meet our mission, and we need to figure out which things we should continue, which things we should change. We, are pretty excited about that because we did well with the first five years. So we fully expect that we're gonna do well with the next five years. And we're spending a little extra time helping our nurse managers and others learn about how you think strategically. Because if we don't learn that, all of us, then we miss the opportunity to do the things that we could do to change health care in this country and to help our own organizations succeed and do well, of course. That's such a great point. Kathy, thank you so much for joining us on the podcast today. This has been a very inspiring conversation, and I look forward to connecting with you again soon. Thank you. Thank you for inviting me.