Rhonda Anderson - Connected Careers

Speaker 0 00:00:07 No shame, which moment next man. Good. Speaker 1 00:00:19 Welcome. I'm Dr. Robert groves, your host for the groves connection podcasts, the groves connection brings you intimate conversations with pundits providers, patients, leaders in late people all to help us understand a contradiction. How can our healthcare system be both magnificent and yet so deeply flow. We're going inside healthcare to talk candidly with those who know what they have to say, may delight, surprise frustrate, or at times even anger. But I invite you to get curious and listen to the truth about healthcare and those who want to fix it. Maybe the answers have been there all along. We just need to make the connection. Speaker 1 00:01:17 My next guest is another story. Healthcare leader. Her name is Rhonda Anderson, and she would have, you know, that the one career highlight of which she is most proud is that she is a nurse. Now there isn't time to cover all that she has done in this brief introduction because this nurse seems almost superhuman. She is a health care consultant for RMA consulting of Arizona, a surveyor for global health care accreditation president, no less of the American nurses credentialing center and that's in retirement. Her storied career includes seven years as the chief executive officer of Carden children's medical center. Now banner children's medical center until her retirement from banner in 2016, she has served as the joint commission commissioner as a trustee of the American hospital association board, as well as the joint commission international. And as the association of nurse executives, president, are you getting the idea that many in healthcare trust Ronda's leadership and her wisdom, she also has too many awards to count, including the distinguished achievement award from the Arizona state university college of nursing. Speaker 1 00:02:30 She was named the 2012 hospital executive of the year by Arizona business magazine and was also named one of the 50 most influential women in Arizona business. And the list goes on now, weaving through all of her accolades awards and leadership positions. You'll find three clear themes, a strong commitment to the nursing profession, a commitment to the care and education of our children and a passion for innovation and the transformation of our fragmented system to one of which we can all be proud. I am honored to sit down with Ronda for a candid conversation that ranges from delivering babies on the South side of Chicago to being the sole practitioner at night on a busy orthopedics unit. Truly Rhonda has blazed a trail, a trail for leaders in healthcare for nursing, and for caring enough to show up, I am so proud to present this episode of the groves connection, connected careers with Rhonda Anderson. Ready? Speaker 2 00:03:46 Yeah. Speaker 1 00:03:55 Welcome Rhonda Anderson. It's good to have you on the groves connection. Thanks for coming by. Thank you for inviting me. Yes, absolutely. And it's been a long time. We've, uh, we've worked together, uh, indirectly for years, but it's been a while since we've been face-to-face and it's, uh, it's nice that things are settling down enough that we can do that now. Speaker 3 00:04:15 That's for sure. Um, it's been fun to be able to do things virtually and learn new things, but boy it's much nicer in person. Speaker 1 00:04:23 Yes it is. Um, Rhonda, I, uh, I'm fascinated by your career journey and how it is that you came to be where you are. When did you decide, uh, growing up that nursing was the thing that you wanted to do? Speaker 3 00:04:40 When I was in actually grade school and high school, my grandmother was the superintendent of a TB Sanitarium. Wow. And so as a young girl, I went down there, worked in the kitchen, obviously, not out with patients, but it was fascinating for me. And that began my journey and then became a candy striper. And did all of those types of things that most people do, um, if they're interested in a health career. Yeah. Speaker 1 00:05:09 Yeah. Yeah. And, and so give us an idea, where did you grow up Speaker 3 00:05:15 In Illinois? Um, I actually was born in Idaho, but my dad was killed in world war II when I was just a couple months old. Some other went back to Illinois because she came from a large family with a mother who was one of 19 children. And so we had a lot of love surrounding us, uh, and helping as mom was trying to take care of me. And, um, so I grew up there and really learned about how to take care of each other because everybody in that family took care of each other, um, big farming family. And just, you knew, um, that it was your responsibility to each other. I'm almost Speaker 1 00:05:58 Getting nostalgic for that, uh, that style of life. I mean, it, it, it, it is not as much present as it used to be, but, uh, I guess the next thing that I'm to, uh, want to hear about is what about the formative years? I mean, let's say you're graduating from high school. And how did you think about higher education? Was that a big deal in your family? Speaker 3 00:06:21 No, it was not. Um, I was the oldest, um, my mother remarried and I was the oldest of the group. Speaker 1 00:06:28 I bet that means you had a lot of responsibilities for those younger ones, Speaker 3 00:06:32 Especially the two youngest ones, because I was 17 when the first of the two youngest was born and then they had another one right after. So yes. Um, you know, the responsibility was what really taught me what I wanted to do. I did all kinds of things in high school, um, from the science clubs to working as a candy striper. My dad owned a lot of bit. My stepdad owned a lot of businesses working in the businesses and working with my grandmother. But I think one of the most formative things was when my grandmother was 88. She called me and asked me to come over and I thought something was wrong. And she shared with me, she pulls out a piece of paper. She had received her GED at 88. It was a goal because in that large family, the women had to work the farm and cook and do all of those kinds of things. So they, they never were able to complete anything and she was determined. She was going to do that. And even without that education, she was the superintendent of that TV Sanitarium. And then, um, the S like a CEO, she was called the senior administrator of a long-term care facility talking about all those old people when she was 90. You know, so we, we, uh, we just no responsibility, Speaker 1 00:07:56 So impressive. Wow. In her eighties, she had her 88 will be darn I, so, so there's a lot of motivation. And by the way, I have to say that you have one speed and that's full speed ahead. I've never seen anything else. It sounds like it started at a very young age. Yeah. You're in, you're involved in so many things now that it's, that it's hard to keep track of and, and some very, uh, key and important roles and obviously played key and important roles at banner health over the years. But, uh, but take it, where did you go to college? Speaker 3 00:08:32 I was, uh, uh, a student in a diploma program at Evanston hospital. And then, uh, we received some additional education at Northwestern. Uh, Roosevelt university was where I was, which is in Chicago, received my master's in public administration. Speaker 1 00:08:49 And, and did you always know that you wanted to be an administrator when you, this journey, is that, uh, uh, to be an executive at a large healthcare company? Is that something that you aspire to? Speaker 3 00:09:02 Um, not really. I had a mentor when I was at working at Evanston hospital who made me the associate chairman of the department of nursing. And she kept saying, you need to do this, you need to do this. I loved what I was doing. So I did keep a practice also of oncology patients of my own. And in that had a lot of fun because we created primary nursing, which was, uh, not in any other hospital. It was a very new concept. And we with Beth Israel, um, develop the model with Marie Manti. And that was my primary responsibility as the associate chairman and then clinical ladders, um, which again were new at that time from nursing professionals. So just a lot of opportunity for those and, and taught. I taught at the same time. Speaker 1 00:09:54 Very nice. Now, what was your first job? What was your first, uh, independent nursing job? Speaker 3 00:09:59 Livering babies in the projects of South Chicago with the Chicago maternity center, baptism by fire. I loved it. It was great. And the gangs would come and surround us. Cause anytime of the day or night you were going out, they'd protect us because we were helping what we did was after delivery, boiled water, let it cool off dripped it in the mouths of the babies to be sure they could swallow, stayed for three hours and then left or sent the babies someplace. Like we delivered triplets on a kitchen table one time. So, Oh my goodness. Speaker 1 00:10:33 You, you work with what you have figured out. Yeah. When was this? What year were you? Speaker 3 00:10:39 Uh, back in 65. Wow. Okay. Speaker 1 00:10:43 Yeah. That's a very different medical world than the one we live in today. Speaker 3 00:10:47 Very much so. Yeah. And Speaker 1 00:10:49 We'll talk a little bit about those differences in, in your, uh, insights on that, but, but take us through now your journey from delivering babies on the South side of Chicago, to a CEO of a carton children's hospital. Yeah. That's a quite a journey, but I'm interested in how you think about that career, you know, how did it unfold and, and do you have any advice for aspiring? Speaker 3 00:11:19 Well, it was interesting because, um, June Warner was my mentor that mentor I talked about and, um, I knew I could do that work, but I also was under her shadow. And so, um, a position came available at Samaritan out here and I thought, Hm, are my wings going to go by themselves? Or do I still need June take care of me? And, uh, so I applied for it and received a position, which was a senior administrator. So it was a combination of the responsibilities for the nursing department, as well as some other departments and programs. And then, um, after I left that role, I went to Connecticut. Oh. And I was in Connecticut with Hartford healthcare corporation as the executive vice-president for Hartford healthcare and did a lot of different things, purchased properties, purchased the Institute of living, which was the first psychiatric facility out there, East coast. Speaker 3 00:12:24 And we, it was adjacent to our properties. So did that also helped, uh, design and build the children's hospital on the campus and consolidated children's, um, programs from the university, et cetera, taught at the university at the same time and just really enjoyed the East coast, my husband, however, didn't move. He was not an East coast guy. Well he's, he was a teacher. And, um, so he would come in the summers or, um, you know, vacation time and things like that. So we'd commute. It was, it was somewhat hard. Our daughter, we thought she was going to UCLA and she went to UMass instead. And so she was close by. So, Speaker 1 00:13:07 Um, I'm struck by something else. Uh, you know, when I, when I asked you, you know, what's your first job and what was the next one you very rapidly were promoted to positions of responsibility. I mean, that's, that's a rocket ship. Speaker 3 00:13:20 Well, there, there was a little bit of a difference in between. Okay. I didn't, I told didn't tell you about one. And that was down in Decatur, Illinois. My husband was teaching down there. And so after we got married, I went down there, um, obviously, and, uh, worked for Decatur Memorial and I, this was a fascinating job. I was the only RN at night on a 72 bed orthopedic unit with a couple of LPMs and AIDS, and nobody was in the emergency department at night. So they would ring the doorbell and I'd run down the stairs and deal with an emergency patient and then come back up and take care of them. Speaker 1 00:14:01 Yeah, it's a trial by fire. Once again, you're on your own, figure it out. Speaker 3 00:14:06 Yeah. But had great, great staff that I was working with and, and a wonderful leader on that unit. So it was really nice. And in that role, I also, um, worked during the day for them teaching LPN at the hospital. Speaker 1 00:14:21 Wow. I, you know, something else strikes me as is you're, uh, helping us, uh, unfold this story. And, and that is that we talk a lot today about innovation and, and, you know, uh, doing new things that are more effective, more efficient, uh, more, cost-effective better quality. It sounds like you've been doing that your whole career too, although you may not have called it innovation at the time. I've heard, you mentioned several programs that you either conceived of and initiated or initiated. And, and is that been part of your DNA or are you always, Speaker 3 00:14:53 Yeah, absolutely. Well, I was there in Decatur. Um, they didn't have a cardiac care unit. And so they asked if I would be willing to go to Chicago and work at Weiss Memorial with a Dr. Bessinger, um, and then come back and establish a cardiac care unit in Decatur, which I did. And, and so, yes. Um, and I love nursing because you can do all those different ortho, you know, cardiac kids, whatever. Uh, it's just, it's great. And orthopedics especially was wonderful because most of those ortho patients had some other disease process and chronic illness. And so you didn't just have that surgical procedure. You had a variety of options to, to really learn from and work with and teach. Um, so I, I loved ortho. Speaker 1 00:15:46 I have to ask you now, do you ever say no to an opportunity? Speaker 3 00:15:50 No. It's funny you say that because when I left banner quote for retirement, I called it preferment and I said, you can say yes or no, but my husband says, I don't say no. Speaker 1 00:16:02 Yeah, I get that sense. That, that if, uh, if you see something that has potential, you can't help yourself. You're right. You're going to be in talk to us about your career at banner. How did you wind up at banner and what did that look like? Speaker 3 00:16:19 So I was with Samaritan and then I left and, but I knew a lot of the people, um, and Bruce Pearson was one of those. He was more of an intern at that time. And John Harrington and Bruce called and asked if I would be interested in coming back and working with now, Matt desert, he needed a CNO, but he also wanted to do something with pediatrics. He had one floor that was paeds. Speaker 1 00:16:44 Give us an idea of what year this is when it was Speaker 3 00:16:46 2000. Okay. So started working with Bruce out at desert. We then, you know, really worked through what did we need to do for pediatrics? And then there were a lot of changes in banner at the top level, not Peter, but others. And each time, um, somebody would tap me on the shoulder and say, well, maybe we should have a pediatric service line, or maybe we should do this. And you said, yes. I said, yes. And then it would change because the leadership up there would change. And so, you know, we navigated all of that, but we never lost sight of the need. And I still say, if you're going to manage patients through a managed care division, why would you give your pediatrics away when you birth so many babies in the system? Yeah. Um, that makes no sense to me. And, and that was really the reason I wanted to take that position. It never really came to fruition the way I thought it might not the position, but the, the idea, well, that idea that in our managed care division, it isn't just about adults, um, or newborns. You've got the whole life cycle. Why not own it, you know? Um, and Speaker 1 00:18:03 You still don't see that happening the way you'd like Speaker 3 00:18:05 To no, no way. And it's sad because it really could and should, and as I vision what's happening in healthcare and in managed care and in pay for performance, why, why wouldn't you and really be purposeful about it? It just, it, why would you pay some other place to take those kids? You know, it just doesn't make any sense to me, Speaker 1 00:18:31 There's so much opportunity to influence behavior at a young age. Speaker 3 00:18:36 Absolutely. Yeah. With the chronic illnesses, with everything you have such an opportunity and even the brain development piece, you know, we started the music therapy for brain development and so important, but then just think about that because then in memory care units at the age of whatever, 90 music, again, you know, for that brain to soothe and peace, peaceful, et cetera. So it just, there's so many opportunities I think. But yeah, I think what I see most organizations are looking at things in pieces, not in the continuum of life. And that's so sad. Speaker 1 00:19:17 Well that, that, that's sort of the characteristic of our entire healthcare system. It's fragmented bolt-on this or that. And, uh, no interoperability. And I mean, that, that is the nature of our healthcare system. That's the way it's going to, I think of it as kind of like a Kluge, you know, it is, uh, a mess that, uh, we've built piece by piece and never really connected all the dots. Speaker 3 00:19:41 Right. I always use the example of a jigsaw puzzle. You know, what it looks like on the front of the box, but the pieces are all scattered all over. Can you at least put the corners in place? You know? Speaker 1 00:19:52 Yeah. You know, that's kind of a scary concept, but, but, but it, it rings true. It really does. So, so I've discovered, or at least I think I hear two passions and probably a third, uh, and one is nursing clearly a second is kids and taking care of kids. And then the third is a more of an orientation responsibility. Speaker 3 00:20:15 I would say, making a difference, trying to make a difference in public policy and those types of things. I was on the joint commission board for nine years and, um, the aha board also, and, um, all of those and Aon L all of the boards on which I was sitting, but also some of them, I still do. The research that we're trying to do is in that space that you and I were just talking about. I hope that we will be able to just make it a little bit of a difference. Do you think Speaker 1 00:20:48 We're making progress Speaker 3 00:20:50 Sometimes? And then I think, and then I think we have setbacks. And what I see is with COVID, even though it's been horrific, there's a lot of opportunity things we learn during COVID that we shouldn't get rid of. And actually I'm working with a group of nurses called nurses everywhere. I'm one of the founding members, and we are identifying the things that happened in COVID that should not be let go, and that we should really keep and move forward and try to get into public policy, walk us through some of those things. Well, one of those is, um, tele-health, but I call it tele professional management because it is, it could be nursing. It could be physicians, it could be physical therapists, it speech therapists, everybody. So with the tele professional management of patients, we should all be able to do that. If we have a license, why not in our space. Speaker 3 00:21:49 And yet there are so many restrictions in, in so many places and obviously payment, you know, we're all working through that as well. But when you think of, and I'll use speech therapy as an example, um, I have a niece who is a speech therapist, and for years she has been, she kept her clients all over the world, but she can't get paid for it. Now she's not doing it for the money she's doing it because that client needed the help, but why not? Why not? Um, the difference and the outcomes are great and yet not able to be reimbursed. So just things like that are the things that we're working on through this group. Speaker 1 00:22:31 Very good. Uh, do, do you see any opportunities that we're likely to miss? Yeah. Speaker 3 00:22:37 Yes. I think hospital at home during the pandemic, some places are keeping it many are discarding. It, the question is why, you know, years ago I S I said, a hospital for our future will be one intensive care unit and that's it. Yeah. And I think this hospital at home could help us get there. Speaker 1 00:23:02 You know, I, I, I had been thinking about this too. And one of the things that gives me a little bit of hope is I think we discovered during the pandemic that we don't have surge capacity or stable supply chain. Absolutely. And, and we have to address that it's a matter of national security we learned in a global pandemic. And one of the things that gives me a little bit of hope, I mean, we, we have so much Malays in, in the, particularly in the middle part of the spectrum and in terms of income and a lot of those manufacturing jobs went away. Um, um, uh, I'm hopeful that we'll do some onshoring for, I don't know, production of ventilators and PPE and medication. I mean, things that are critical to our survival in the setting of a pandemic. Do you see that as a, something that's likely to occur? Speaker 3 00:23:54 It's interesting that a company that I work with them on their board, all venture capitalists work, but it's an orthopedic company. And, uh, many of the parts of our product were, um, from China and we changed it all and moved it to North Dakota. So yes, I absolutely see that. Speaker 1 00:24:14 And that could really be a boon for folks that haven't had opportunity. Yeah. Yeah, exactly. So I'm, I'm optimistic about that part of it, at least, uh, I can't help, but say that since we've been talking here, I think you've mentioned, I don't know, eight or nine boards. I don't, I don't know how many you're on. There's that inability to say no, right. Yeah. Yeah. And do you have a, do they have a theme? Is there, you know, are, are they aligned with your passions and how so? Speaker 3 00:24:49 I would say so one is like the venture capitalist one. I have, uh, three, besides the one that I talked about that are in that bucket. And they're exciting because they're innovative companies, Gary, and I like to, you know, work on those types of things anyway. And, uh, we think that they will help within the future. So that's one, the second one is, uh, my professional boards. So AOL L foundation, um, Arizona nurses association foundation, and then president of the American nurses credentialing center and all of those in the professional space. Um, and then the third is volunteer boards on which I both reside and, and pres preside in a couple of them. And all of those are around children, um, at the national level healing, the children at the local level, uh, Ryan House and Make-A-Wish and feeding matters. And all of those Speaker 1 00:25:47 That frames your passions pretty nicely, doesn't it? It's children and nursing and innovation. I mean, that's so cool. And a few minutes ago you said the word retirement doesn't sound like retirement to me, I call it preferment. Yeah. So you get to do what you want. Exactly. Yeah. Good, good. What I'm really interested in is your perspective on healthcare. What what's been the barrier to progress? Why do we see costs go up exceeding inflation every single year in spite of all these efforts and value-based care and CMI and, and, uh, you know, uh, driving out variation, uh, the adoption of all of these strategies has been relatively weak overall. And what's the barrier to that. What's standing in our way of really transforming the healthcare system to something that we can be extremely proud of. Speaker 3 00:26:39 There are quite a few things I would say the first thing is the lack of commitment to innovating new models. Can't get to value based care, doing things the way we used to do it. And yes, we've had some slight evolution, I guess, but the focus is not on the whole patient. It's on getting that outcome. So I get paid. So the second thing I would say is our primary care system is not in good shape. If in fact we really were managing chronicity, we would be in a whole different place, I believe. And we're not, I mean, I went into my primary care and this isn't a slam it's they, what they get paid for 15 minutes. Didn't even look at my chart. I was in a car accident two years ago in my leg is still not good and no conversation unless I brought it up. Yeah. So who's managing the whole person the person has to, but who's making the partnership with them. Right. So I think those two things are foundational to a real change. So what I, my observations are we change things according to either the regulatory standard or to the most recent payment mechanism, but we don't change the entire system to manage it. Speaker 1 00:28:20 Do you see that happening anytime in the near future? Speaker 3 00:28:22 I think there are a couple of places out there that that possibly would do this. You know, I've talked to a friend of mine at Cedars and they're really working on more of a holistic approach like we were just talking about. So I think that there are people thinking about it. I don't know if they have the stamina to transition because you take a loss during the transition time, but the long-term you're way ahead. Speaker 1 00:28:55 Yeah, yeah. You know, it, it strikes me that, uh, at 18% of GDP, we spend enough money on health care, but we're not getting the value that I was, uh, in a conversation, uh, with a physician executive not too long ago, uh, that's engaged internationally. And the point that he made is that problems with quality waste are not unique to the USA. True. Um, and that every healthcare system in the world is thinking about, you know, how are we going to take care of the next generation? But they're starting from a very different place. Singapore is all the way up to 3% of GDP I'm told. And, and so we have plenty of money. It's it's so misallocated, how do you think about incentives? How, how might incentives play a role in transforming the system? What do we need to do? Is it time for universal coverage, single payer, a capitation? W how do you think about all of those? Speaker 3 00:30:00 I don't know that that makes a difference. It makes it, uh, a small difference at the time, but they're have to want to. And what we're, what concerns me most is I don't see a lot of individuals who not just want to, but have the vision of the, how it can happen. People seem to spring to whatever the new payment mechanism is. Like I was saying before, versus let's take two steps backwards and, and really create what's new and what should be our future. Speaker 1 00:30:39 Talk to me a little bit about what that ideal system looks like in your mind. Speaker 3 00:30:45 Well, I would say it starts, it starts with a primary care working with their patient population to partner toward health, whatever that means for each person. Right. And have a real plan for it. Then we have our community issues, but our federally qualified health centers could fill that space. And some of our profitable organizations, even though they're not nonprofit could help fill that space. I really was hopeful when originally we had to do the community health needs assessments, I thought, Oh, wow, here's the beginning. This is the foundation we found out about this community, whatever, wherever you were. Now, we can build on that with partnerships between the healthcare organizations and community agencies and whatever doctors, groups, et cetera, hasn't happened. Speaker 1 00:31:49 Yeah. How do you talk a little bit about healthcare disparities in particular and, uh, also the, the widening gap between haves and have nots. Uh, how do you think about those things? What can we do to begin to address that? Is, is there any hope in your mind for, uh, coming to grips with that issue? Speaker 3 00:32:12 I, I belong to a couple book clubs and one of the book clubs is all on, um, diversity and inclusion, equity, and inclusion. And one of the books we read was white fragility. I don't know if you've read it or not. I have not, no, it's a fascinating book. And it really speaks to what you're talking about. We will have a terrible time closing gap. If those who think they are superior, can't step up to the plate and understand the issue. And it's interesting because after reading that and having the discussion, I was part of a, a community somewhere in the U S that they asked me to come and consult and look at, they were trying to deal with diversity inclusion and equity and look at their, uh, city council documents of how they were going to do it. And so they talked about in the documents, inclusion, except in country clubs. So yeah, exactly. That's the point that, and that's the point the book was making. Speaker 1 00:33:28 Yeah. And, and I laugh. It's not funny, but it is, it is ironic, Speaker 3 00:33:33 Crazy. I looked at that and I couldn't believe that they would even put a document like that out if that's, if they really meant what they said. And so I thought, Hmm, we have a long way. Speaker 1 00:33:45 So how did that conversation go, Rhonda? What was that like to, Speaker 3 00:33:49 I said, you should not have that as an exclusion. Well, you know, they might not like those people. And I said, you know what, clearly not ready. You're not ready. And you shouldn't put out any document. You need a lot of work in education before you, you think you're going to just make something public that you think will say, Oh, now we include people. Um, yeah. So it was, it was pretty discouraging, I guess. Speaker 1 00:34:22 And what's been discouraging to me in particular, is that groundswell of ignorance that is apparent in our political system. Um, and I, I say that as gently as I can, because, uh, the willingness to adopt, uh, false news, the willingness to get behind, uh, ideas that simply are non-scientific the willingness to, uh, all of that is in, in part, I think, related to that sense of superiority and, uh, the need to make sure that I stay in this position on top. And, uh, in that drives a lot of the behaviors out there. And it's not really about belief. It is, it's almost an instinctual survival, uh, strategy. It seems like Speaker 3 00:35:25 In white fragility, they call it, uh, the S the structural, um, foundation that we've all grown up with and go through a lot of the history that brought us through that. But they said, unless we essentially demolished the structural foundation and rebuild something new, we're going to continue to have what you just discussed. Speaker 1 00:35:51 Yeah. And, and, and hence the, uh, the longing in some circles to go back to the way it was before, which was more structured and, uh, and less open. And, uh, that is, uh, is a comfort zone for, um, certain groups. And it's, uh, uh, it's really, uh, it's taken a toll on us politically. And, and, you know, my biggest fear frankly, is that the political paralysis that we see has no end in sight and policy now drives so much of the behaviors in health care, uh, the federal government foot, so much of the bill that it matters what CMS says and, uh, send what CMI says. And, uh, uh, and, and everything else kind of follows, uh, on, on the heels of that. And in the current environment, it's, it's hard to understand how we can get transformational bills through Congress. I mean, it's just going to be a real challenge. Speaker 1 00:36:53 I, I tell you why, uh, I retain a little bit of hope and may not see it this way, but I, I believe, and I believe very strongly that most people, if you go back to, uh, their commitment to get into healthcare, it's because they wanted to help people. It's because they have good hearts and they're good people and bad systems can Trump good people at times. And then there's the need to have the courage to break out of that system and try something new and, and commit to doing that with both feet. And that's a really difficult thing to do, particularly if you've got family, you've got to worry about it, et cetera. Um, you've been able to do that. I you're one of those people that I have always admired because you speak your mind. It doesn't matter. Who's on board, or who's not on board. You're going to call them as you see them. Is that something you got from being the eldest child in a large family? Where did that come from? Speaker 3 00:37:55 Um, I think, I think that's part of it, definitely. Um, but I watched my mom who, you know, was widowed at a very young age and before she remarried, had to really figure out how to navigate this world with, uh, with a little one. And I've watched her mother who, my grandmother, who, and my great-grandparents, because there were five generations all living through all of these times, including our grandkids. And, um, we just, they were, they taught us that, you know, they taught us that now grandpa would sit at a table like this with all, all of us for dinner, and you couldn't speak until he spoke to you, but he would ask everybody the answer to the question that he was asking. So you were encouraged to speak up just not over somebody else. Yeah. Speaker 1 00:38:54 Yes. Okay. Interesting. I want to move now to, what are you working on today? Where are you having an impact today? What are you trying to drive right now? Speaker 3 00:39:06 So I talked about nurses everywhere. We're trying very hard to, to drive the things that were good from the pandemic and to keep those in practice settings, et cetera. The other thing is with, um, a couple of the nursing organizations that I'm with, we're working on research projects for new models of care that we will fund those. And, uh, we we've developed the criteria and we're going to be, um, asking for individuals or groups who would like to, um, do that research. Um, the other thing is, I don't know if you knew Dr. Malnik, she was a Dean of nursing here at ASU. She's now at Ohio state. Uh, one of the things we're all concerned about the suicides and depression and things that have occurred, and we don't know what's going to occur with, you know, all the online school and not in person and all those things. Speaker 3 00:40:05 So she developed a tool cope, which is, um, an online tool for different age groups. And if, and the kids love going online and taking these little fun tests, you know, but it gives us an idea of their level of depression or not happiness, et cetera, and, um, suicidal tendencies. And so, um, she's worked with 40 pediatricians across the country, and now we're going to be doing the research and sharing it in children's hospitals. So through one of the organizations that I chair, we're going to give grants to children's hospitals, so we can use it in emergency departments and pick use, and then see how we help those children as they progress. So that's a really exciting one. And then of course I told you about global health care accreditation. Oh my gosh. So we had to pivot, obviously I had four days of 12 hours for two, sir. So two different surveys, four days, each 12 hours each day, virtually internationally. It was a great experience. They carry me around on a cart to patients, patients. So I could interview patients and do all the things I would have normally done in person. So yes, it's kind of fun and a new way. Um, we're not, hopefully not going to stay that way, but you never know. Speaker 1 00:41:36 So previously you were traveling a lot to do those. Yeah, yeah. Yeah. Tell us, this is another interesting perspective that you've gained is, is a comparison of, uh, our healthcare system. I mean, we hear all the time that in some ways we have the best healthcare system in the world. If you talk about rescue medicine, you know, uh, time to balloon major trauma, we do that pretty darn well, compare us to other health systems that you've seen. What's your favorite that you've seen so far? Speaker 3 00:42:06 Maybe Thailand? Well, I think there, the, um, there's Speaker 1 00:42:12 A collectivism there that we don't, Speaker 3 00:42:15 And that that's a part of it. Um, there is a pride that we don't see, um, as surveyors, they want to show you everything. They don't want to hide anything, and there's a pride in what they do. And when you talk with the patients and they're grateful, I guess, is the word I would use for everything that they get, we complain all the time. Yeah. So it's just that, that sense of pride and I'm doing something good for somebody else and the other person recognizes it. Speaker 1 00:42:54 You know, it's interesting you remind me of, uh, the reason that I, uh, started my practice in Greeley, Colorado, because it's a, it's a fairly busy referral center, full compliment of services, but the patients come from Eastern, Colorado and Nebraska and Wyoming, and they are so grateful for the care that they received. These are the kinds of guys that, you know, the farmer that comes in with his arm on ice and says, well, yeah, put a tourniquet on. I brought the arm, man had to finish getting the crops. I don't know if you can say, you know, I mean, just that this is what happened and this is how I deal with it. And I'm grateful that somebody is paying attention to me and caring about it. Uh, so there is that, uh, there are pockets of that. Speaker 3 00:43:42 There are, uh, we have friends up in Wyoming and we go up there periodically and, and they are really grateful for the care that they are able to receive. And same, I, that's what I grew up with and, you know, great grandma and grandpa had literally thousands of acres of farmland. And that's how you were, you were grateful that somebody was able to help you. Speaker 1 00:44:06 I learn every time I do one of these interviews and I'm, I'm learning so much from you, but I'm going to, I'm going to share something that I, uh, learned, uh, from, uh, Brent James. And he reminded us that for most of the history of medicine showing up at a doctor meant you were not going to live as long. And that in spite of that, it was an integral part of, and that correlates with surveys of patients who rank caring above anything else. And I think that's a message that needs to be reiterated as much as possible. Patients don't expect miracles. What they expect is somebody to care about their situation and to do the very best they can. They understand that we're human, uh, and, uh, in not everything works out the way that we plan those things. Uh, if we can get back to that, if we can give docs and nurses time to create the relationships, uh, to engage with individuals, uh, uh, that's, what's missing is the opportunity for those connections, those relationships, uh, in somehow we've got to get that back because that's the foundation I think, of, of health. Speaker 3 00:45:27 Exactly. You know, I would add a word to that and that's listening. Um, I'm working with four friends, uh, three who have cancer and one who is wheelchair bound with a neurological disease and what they all have said. And I say, you have the right. You just go right back there and ask, um, is they don't listen to them and they know what changes their body has had. I don't, you don't. But if they would just ask that question first and then listen, and then be able to talk about how we together can, you know, go to the next steps, whether that's radiation or there's nothing we can do, or all those were answers that people got recently, that that would make a huge difference. Speaker 1 00:46:16 Yes, yes, absolutely. Do you think that we can change that? And if so, how do we go about doing that? Speaker 3 00:46:25 I think we can change it by in our education systems and I'm on the, uh, uh, a trustee for Chamberlain university. Speaker 1 00:46:34 I'm not surprised another, another, uh, obligation. Okay, go ahead. Speaker 3 00:46:40 But we have, uh, um, developed a program to support our students called Chamberlain care because we take students that maybe wouldn't, weren't able to get into other places, but we have a 97% pass rate in our name and clicks because of Chamberlain care. But my point is, in your question, we're teaching them, we care about you, you care about your patients, and that makes a huge difference, huge difference. Speaker 1 00:47:11 So it starts with education, you know, another, another interesting, uh, tidbit that I've, I've learned along the way, um, is that dollar for dollar investments in general education do more to prolong life than investments in healthcare. Yeah. And of course, you know, the, what we call healthcare and spend three point whatever trillion dollars on now accounts for maybe 15% of mortality outcomes. Some of it's genetics hard to, although we're getting there, I guess, mess with that. Some of it's environment, you know, whether you're exposed to bad air, et cetera, uh, but a huge part 40% is his behaviors. And on the one hand, uh, there's a faction that has taken the stance that, well, it's your personal responsibility. And if you can't quit smoking, lose weight, whatever it is, then, uh, we'll charge you more for insurance. And I, in my mind, that's exactly the wrong approach that the, the approach should be education, health, literacy, and it has to start, uh, in children. You know, what's fascinating to me too, is, is how much influence kids can have over their parents. Speaker 3 00:48:23 Amazing. It is absolutely amazing. Or their grandparents or a little six year old has a lot of influence. Speaker 1 00:48:32 No, but they learn stuff and yeah, it's so fresh and new to them that it's, you can't ignore it. And, and, uh, uh, they can really influence behaviors of, of, uh, as you've mentioned, parents and grandparents, when they learn those things, Speaker 3 00:48:47 You know, that's why I really, when I was at carton, we were just talking about, and I really wanted to start. And then obviously I left, but, um, some the CEO. Right, right. But we, I wanted to us to do games for the kids that would teach them, you know, the health, health, healthy nutrition, et cetera, but it would be a game. It would be a fun thing. And we had Getwell network, um, and they were just ready to, um, partner with us to develop some of those. I don't know. I don't think they pursued it. The, the carton people do, they're not called Carden anymore, but the banner children's people didn't anymore. But I, I just think, I mean, they're all learning remotely. They're all on the computer. I mean, my grandson, the other day, I, he, well, this was around Christmas time. He was telling me what he had learned about Hanukkah and all the different religions, you know? And I said, you know, we went to, we went to, um, Jamaica when your mom was little and they, they celebrated boxing day. Well, what's boxing day. I said, you know what? I honestly don't know. They just had a big celebration, runs in the house, gets on the computer. It looks it up and comes out and tells me. And so why wouldn't we do health education that way, you know, they would have fun with it, have a game. Speaker 1 00:50:06 Yeah. There's a natural curiosity at that age that, uh, yeah. We, we should be taking advantage of it. Yes, Speaker 3 00:50:12 Absolutely. And I think we will, the flip side of that is there's a book, a different book that I read. I, Jen, I don't know if you've read that book interesting about, I gen like a internet generation, a small, I G there's two things in there that one that's relevant to this. This is the way they want to learn. Um, but the other thing is relevant to a previous conversation. You, you and I just had, and that is, they don't want any conflict. So many of them don't want to learn to drive. Yeah. They don't want to, um, have any professor or person say, some of them don't want to go to college because they're afraid that be put in like a debate discussion and they don't want that. Nothing that causes them to feel uncomfortable. So after reading that, I thought, wow, we have been focusing on millennials, but we shouldn't. We need to focus on these new couple younger generations because this psychologist, if she's right, we've got an issue before us, that we're going to really struggle with in everything in healthcare and everything. And I was just talking to a friend the other day, who's struggling with a teenager who does not want to learn to drive. She fits the exact, uh, description of what this psychologist wrote. So if that's the case, I mean, I think about who's coming into healthcare. Speaker 1 00:51:44 Yeah, yeah. You know, I th th the way I think about that is that, uh, when I was younger, whatever the latest book was about behavioral health or say it was everything right. Everything fits in that little bucket and I'm gung ho and they're really just variable perspectives. And you put it in the mix and you say, okay, that's interesting. There is a component of that here. And, and how do we address that? Yeah. Speaker 3 00:52:10 Well, and that's the question that there is a component of it. So how do we address it if we really are looking at workforce of the future and whether it's physician nurses, respiratory therapists, how do we early on talk with them, work with them. We had a program here that, uh, when I was teaching at grand Canyon, one of my students was he was in a graduate program. I just did it. Speaker 1 00:52:36 Those are you keeping score. I think that's number 17 or 18. Okay. Speaker 3 00:52:42 Um, and he was a school nurse. And so Randy and I conceived of something let's start. And he did it as a, uh, project, um, started a healthcare program in their freshman year. They could become nurse AIDS. Yeah. They could become LPN if they were the right age, before they graduated. And then they also had matriculation into a baccalaureate program. They stopped that after Randy left. And that's so sad because that's what we need to be doing to get at what you and I were just talking about and really helping our, our young, enthusiastic kids. One, the things that I think Speaker 1 00:53:27 Gets lost, particularly in maybe all of us when we're younger, is how much of the benefit accrues to us when we care about others. You know, it is such a rewarding thing to do. Um, some of my most proud moments have been when I was present, truly present for a patient with a, maybe an insurmountable problem. And I've benefited from that. I don't want to call it self-esteem because that's not what it is, but my feeling that I'm fulfilling a purpose that I'm here to fulfill. And in that sense, that sense of, uh, being not externally, but internally rewarded for putting oneself out there and really caring about another person, enough to listen carefully and enough to, to, to even take risks, to make sure that they get what they need. There is no greater reward that I'm aware of. Anyway, I haven't found one and I wish that everyone could experience that because I think it'd be a different world. So I, we probably should be wrapping up here. We've been going for over an hour. And I know you have a busy schedule. We have certainly Speaker 4 00:54:47 It was enjoyable. Yeah. Speaker 1 00:54:49 Right. Hour. But I guess to wrap up, I want to ask you maybe a couple of questions. One, you are a nurse. What advice would you give to young people? And, and this is kind of selfish because my son is, I told you he was going into nursing. What advice would you give to young people who are just embarking on a, on a career in nursing, Speaker 3 00:55:11 I'd say, find a mentor. That's also something that I love to do. And I was just over the last week on the phone with two different new nursing students, it's hard. They can talk with their faculty, they can talk with their peers, but I think sometimes the grounding comes from a mentor who's been through all of those different stages. So I would say find them. Speaker 1 00:55:35 Yeah. There is such a thing as wisdom and it's hard one, uh, w w there was a Gary McMann quote, an old cowboy poet who said a good judgment comes from experience and experience comes from poor judge. Speaker 4 00:55:49 Yes, it's true. I always say, um, Speaker 3 00:55:52 Failure is positive, not negative, Speaker 1 00:55:56 But by golly, if I can learn that from somebody else without having to go through it, that I'm open to that. So, uh, that, that's a great, uh, a great way to spend time, too. Again, we go back to no, not children, but young adults. I mean, you know, that there's a window of opportunity that you can really have an impact on somebody's life. And when you do that, the, the, the benefit accrues, you know, to the person mentoring just as much, it's kind of like the old adage that if you want to learn something, teach it, uh, taking advantage of that wisdom and helping young people, you know, discover what they need. I think that's great advice. So find a mentor. Now, here's the harder question. What do you think? Uh, the one thing we could do that would bring us closer to that ideal healthcare system that we all dream about, or w what's the one thing that individuals first and second organizations can do to, to forward that effort? Speaker 3 00:56:57 I think, um, and I'm going to put them in the same bucket because the individuals have to want it to do a think tank. But I do think that some of the larger systems could be the catalyst for a think tank and not just with their own staff, but outside people as well from maybe even different systems, um, and from the community. So it isn't just healthcare providers. Right? When we were with the children's hospital, we always had our advisory committee of different age groups of children and parents, because if you didn't, that's how we designed it, because if you didn't, you do something that they didn't want or feel Speaker 1 00:57:44 What a simple, obvious and brilliant idea. Speaker 3 00:57:47 So there was a futurist dress coil years ago, and Russ brought 25 of us together from across the country and envisioned what would healthcare look like in 2025? And it was 50 systems anchored by a university, either owned or contracted. And wasn't the design of the health system of the care system. It was the design of this house system to provide their workforce, et cetera. That's why they were anchored by their own university or, or contracted university. We're almost 20, 25. We see what Panner has done. We seen what, um, Dignity's done with Creighton. We see a think tank like that with a futurist leading it that could loosen up the thought processes of individuals and bring disparate individuals together, not just the healthcare providers. I think we create this. Speaker 1 00:58:46 That is awesome. And that's, that's probably a great place for us to stop today. I got to tell you though that, uh, this is one of the joys of my life now is getting to talk to people like you who have done so much and whose perspectives vary from mine, but I learn every time I do this, and the whole point of the groves connection is just that to make connections, to understand a variety of perspectives. I think we get too entrenched in our thought patterns and we have tunnel vision, and, uh, we have confirmation bias and being shaken out of that by somebody who is clearly, you know, had an incredibly successful career and may have a different perspective than we do. I think that's so valuable. And, and, and so I hope you'll agree to come back at some point and talk to us again, and it has just been such a great pleasure, Rhonda, thank you for, uh, for agreeing to, uh, to be honest. Speaker 3 00:59:42 Oh, you're welcome. It was fun and great to get to talk with you again. Thank you for having me. Thanks. Bye. Bye. Bye. Speaker 1 00:59:55 You've been listening to the groves connection, your connection to the inside story on healthcare. Featuring in-depth interviews with those who know you can find us on Apple podcast, Spotify, and anywhere else, you get your podcasts. If you like what you hear, give us a five star review to keep the connection going and hit the subscribe button to be sure you never miss a beat. The groves connection is produced by Dr. Robert groves, original music editing and creative direction provided by Alden groves, production, support, content guidance, courtesy of Janae sharp and Elizabeth Barrett. Thank you for listening. Professional ideas and opinions expressed in this podcast are mined and do not reflect those of any current or past employers. Thank you so much for listening and we hope you'll join us next time Speaker 3 01:00:55 On the groves connection.