92: {Intervew} Passionate Healthcare Leaders: Making a Difference in Patient Care with Dr. Megan Carter

Frustrated with the healthcare system in the United States? This episode is for you! Today I sit down with Dr. Megan Carter, Founder of MC Heath Care Consulting and we talk through some of the obstacles and challeges heathcare organizations are facing today. 

Dr. Megan Carter, shares her journey from being a nurse to becoming a healthcare entrepreneur. She discusses the top three issues in healthcare: workforce shortage, burnout and PTSD, and complexity and workload. Megan introduces her patented clinician refocus framework, which helps healthcare professionals optimize their time and focus on patient care. She emphasizes the importance of data in driving change and highlights the passion of healthcare leaders to make a difference.

takeaways

• The healthcare sector is facing challenges such as workforce shortage, burnout, and complexity in workload.
• Megan Carter's clinician refocus framework helps healthcare professionals optimize their time and prioritize patient care.
• Data-driven insights are crucial in identifying areas for improvement and driving change in healthcare.
• Healthcare leaders are passionate about making a difference and improving patient care.

You can learn more about Megan HERE or connect with her on LinkedIn HERE

If you liked today's episode, don't forget to subscribe & leave a review! 

More on ChilledVino HERE https://chilledvino.com/

Start your podcast today!
Interested in starting a podcast, but don't know where to start? Check out Riverside.fm. It's easy!

Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.

Transcript

Caroline (00:01.452)
Welcome, Megan.

Megan Carter (00:03.216)
Thank you for having me, Caroline, I'm so excited.

Caroline (00:06.872)
So I love to hear your story. know you previously were a nurse and then you transitioned into healthcare, the healthcare executive space, and now you're a full -time entrepreneur. So tell me about where you are now and how did you get there?

Megan Carter (00:10.501)
Yes.

Megan Carter (00:14.684)
huh. Yes.

Yeah, thanks for asking. No, I'm currently the president and founder of MC Healthcare Consulting. And so what does that mean? I offer evidence -based solutions to address the top issues faced by hospital executives and nurse leaders. I just opened this business in April, so I actually have my first client. I'm very excited. It's a new path for me. And how I got here, my path has been pretty non -traditional in the healthcare world. So I've been a nurse for 17 years.

And I was on the traditional leadership path. So those who aren't familiar with healthcare and nursing, it's, you know, bedside supervisor manager, so on. And so I worked my way up to be an associate chief nursing officer at a really great hospital here in Fort Worth. And that was a member of the executive team. Went through the pandemic with my team. We all got through that. And then when the pandemic was over and things kind of calmed down enough to really pause and reflect.

I recognized that like many other healthcare workers who had gone through that experience, I needed to take some time for myself. So I chose to take a professional sabbatical, which is really unusual in America. And it's really even more unusual in healthcare, just based on our culture. So I made the difficult choice to take six months off, worked through that with the team. And that time was really powerful for me because I was able to really pause and reflect on how I wanted to spend the next 20 years of my career.

And realizing in that time that what I love to do is take care of nurses and doctors and the people who are giving patient care. And I wanted to do that full time. So had this crazy idea to start a consulting firm where I can offer the services that I know I feel like I do well and where I can be of best support to them. And having gone back to school so many times and being a sucker for that, it's...

Megan Carter (02:12.934)
The great thing about it is I met a lot of great people, but it's also given me skills to translate real research into practice and help these leaders really innovate at the bedside and make things better for the people who are working there.

Caroline (02:26.54)
love that story and I want to hear more about, okay, so you were on your sabbatical, did a light bulb go off? Did you have a conversation with your significant other? Were you with friends? What prompted you to start your own business?

Megan Carter (02:41.272)
Yes, yes to all those. It was not expected. It's funny in my mind, you know how you're you're just walking along and you have these great ideas. I thought, take these six months. I'll I'll heal. I'll feel great. I'll know exactly what I want to do. I'm going to get some cush remote job. I'm not going to be stressed out anymore. And then it actually comes time to to pull the, you know, the lever on that. And I thought, you know, I something inside me just kept saying, that's not the right path for you. reflecting with my husband, who's wonderful and my mom and sister and friends, it's

You know, Megan, clearly what you love is helping people. And the further along I got in the leadership role, the further I felt away from that. And so I thought, you know, they actually were the ones that suggested maybe you should be a consultant. And I laughed at first. thought, well, everybody's up to their ears and consultants. Who am I to come out and offer this service? And then just the positive feedback of, but you've also been in their shoes. You you've sat at the boardroom table listening to consultants pitch you things.

You've seen it work well, you've seen what doesn't work well, why wouldn't you put that together? And if your passion is helping them, why not focus on that? So that just lit a fire in my chest. I just knew that that's what I was meant to do. And it's been very difficult in the transition, but it's also been the most exciting, fulfilling thing that I've ever done. So I'm very grateful to be here.

Caroline (03:59.502)
So let's talk more about the work that you do. We all know that the healthcare, the healthcare sector, at least in America, is all over the map. And especially with a lot of private equity going into buying out hospitals now, it just is like, okay, are we here to make a profit? Are we serving our patients? So what are the top three issues that you're seeing in healthcare right now?

Megan Carter (04:09.723)
Mm

Megan Carter (04:14.786)
Mm

Megan Carter (04:19.717)
Mm -hmm.

Megan Carter (04:24.708)
Yeah. So, so to follow along with what you just said, for folks who aren't aware, they're not, maybe don't work in healthcare that are listening to this. The United States healthcare system is number one on the planet for cost. We are the single most expensive healthcare system on planet earth. And you would think that being the most expensive, that must mean we give really great care. Well, when you look at quality and you look at safety, breaks my heart to say this, we're actually at the bottom.

And that's even if you exclude third world countries from that. If you look at other first world countries around the world, we rank at the bottom for things like maternal mortality. So you have to ask yourself, we're spending all this money, this money's flying around. It's so expensive here. You guys all feel it when you go to the doctor's office. Where the heck is that money going and why can't we get better care? And I'll tell you, so the top three issues facing these healthcare leaders right now, number one's the workforce.

And you probably hear sometimes in the news, it might touch your lives a little bit, but we have a massive shortage in the healthcare workforce in the US, especially with nurses and specialty physicians. And the American College of Healthcare Executives does a survey every year of CEOs in healthcare. And year over year, 2023, really jumped up. Workforce was number one on their mind. And just an example of that, there's only on average nine nurses per 1 ,000 people in this country.

And that's an average, by state that varies. Some states are better off, some are worse, but that's, there's a shortage, it's very real. The second issue that's on their mind is burnout and PTSD, both in their employees and themselves. It was bad before the pandemic. We were very fragile to begin with. And then when the pandemic hit, it took that fragile system and just tore it to pieces. And unless you've been through that, through a healthcare worker lens,

It's really hard to understand what we felt and what we saw. I compare it to, it's like we were in a two and a half, three year war with an invisible enemy. And just like a citizen can't possibly begin to fathom what a military person sees and feels in a battle, no one else understands. So it's really hard to talk about. It's really hard to relate to people who weren't in it with us. But that's still very much a problem. I know people are saying it's over, the pandemic, that's great.

Megan Carter (06:42.18)
And I'm grateful that it's over. I'm glad people are safer, but the burnout and the PTSD is still prevalent. And the third issue right now is the complexity and the workload that these folks are facing, whether it's a hospital, nursing home, wherever. We've thrown so much technology that's meant to do a real good and it is doing real good, but we've thrown it at people at such a pace and we've changed processes so fast. We've never really stopped to reevaluate previous workflow. So what you end up with

are these metaphorical plates that are too full and the impact is that patient care suffers. So again, bottom of the planet, when you rank quality and safety, it's because it's just too chaotic and too complex.

Caroline (07:25.176)
So I want to dig a little deeper here. So why is there such a shortage?

Megan Carter (07:29.446)
Yeah, yeah, we study this like this is a full -time job for so many people. There are brilliant, brilliant groups of people that are studying this. we know currently, so these are statistics. So we know nurses are leaving the workforce en masse here in the US. One of the reasons is retirement. The median age of the RN in the US is 46. Folks are looking to retire. I don't blame them one bit. If I could afford to do it, I'd join them.

And then that was the plan to begin with. And then of course, the pandemic, you can afford to get out, why wouldn't you? It's a lot of hard work. There's another surprising portion though, that's under the age of 35. And this group is really concerning to us because they're leaving the profession due to the burnout and the PTSD. They're leaving because of the patient workloads that they're facing. These are all contributing factors. We also know that over half of RNs leave their job in a current organization.

within the first two years. So they're not staying because of the conditions they're facing. And these conditions are not the result of negligence or poor management. It's the result of a big complex system here in the US. We can't graduate enough new nurses to keep up with demand. And that's because faculty are not paid well enough. That's one issue.

We know in 2021, over 90 ,000 qualified nursing school applicants were turned away from these degree programs because of a faculty shortage. So I'm giving you these examples in this data to paint this picture for you that it's not just one issue or two. There are so many factors feeding into this. And the current efforts that we're trying to put in place are like putting a bandaid on an arterial bleed. We have to just innovate with what we have today to survive, because we're not going to be able to fix this quickly and overnight.

Caroline (09:13.614)
So what can employers or healthcare organizations do to increase, let's say they have a new nurse come on and they want her to stay longer than two years. Obviously life circumstances happen with family or moving or whatnot, but what can they be doing to help lengthen that number?

Megan Carter (09:30.918)
Yeah. Yeah. It's a great question. So I'll tell you that that's the number one question. 90 % of the professional conferences around healthcare are completely focused on that exact thing. And there are lot of really great health systems that are doing very innovative things to try and address it. We're trying anything and everything. So the short answer is anything and everything, but things like new patient care models. So, you know, assigning one nurse to X number of patients, maybe that's not the way to go. Maybe we take some of the tasks and assign it to someone else.

Bringing LVN, so Licensed Vocational Nurses, back into the workforce, was something that, for whatever reason in the 80s, we kind did away with, well, now we're bringing these folks back. They're brilliant and they're capable. We're looking for travel nurses. mean, we're offering incentive programs, throwing as much money as we can at it to pull people in. And we even have formal partnerships with universities. But the reality is there's just not enough people. There aren't enough qualified nurses for everyone. So what you end up with is...

We're all competing with each other for the few qualified clinicians that are out there. So my hospital's gonna pay my new nurse this much, my competitor across the street's gonna up that by 10 cents and you end up in these bidding wars. And these rural hospitals and these nursing homes are hit the worst. We're seeing closures at a rate we've never seen before in this country because they just can't afford and they can't find the right people. They can't find enough good nurses to do the work.

Caroline (10:55.662)
I'm glad you brought that point because for those of you listening in my audience, at one point, it was actually during the pandemic, I did do travel nurse staffing and the portals that we would go into that would have the job opportunities as a recruiter, the ones that were paying the most money were the rural hospitals.

Megan Carter (11:14.737)
Yeah. And that tells you just how desperate they are. We know there isn't a lot of money at the hospital or the organizational level. So because nurses are so crucial, mean, we're 60 to 70 % of the healthcare workforce. If you don't have nurses, you have to close your doors. And I'm not trying to paint a picture of gloom and doom, but just for folks who aren't in the healthcare world.

This should concern all of us, you guys, because if you are gonna seek any kind of medical care in the next five years, you're all gonna feel the impact of this. If you have a doctor's appointment or you end up a patient in hospital, I know that today your experience probably, despite best efforts, feels like people are popping in and out of your room spending 30 seconds or less. It's not because they don't care. It's not because they don't know how to do the job. It's just that chaotic and they're spread that thin.

Caroline (12:05.07)
Thank you for sharing more insight into that because I definitely have had similar experiences when I've been at the doctor or at the hospital. So it's good to know that everyone is experiencing it and that the healthcare professional is on your side. It does care about you. It just, they're under the gun with time.

Megan Carter (12:20.004)
Yeah. Yep, absolutely.

Caroline (12:23.916)
So I'd love to hear more about your patented clinician refocus framework.

Megan Carter (12:28.142)
Yeah, yeah. So when I opened this consulting firm, I clearly thought about how best can we support people and address this. So this framework is for me, it's designed to address this workload or workflow issue. So just to say out there again, not all doom and gloom, not all hope is lost. We're all trying to innovate. And so what I do with this framework is I try to really focus on how these folks are spending their time.

and trying to increase the amount of time they actually spend with the patient. Because we know when these folks have more time to really engage with you, to understand you, to do a full assessment, really direct your care, you're going to get safer care. So a great example, it's best explained if you're not familiar, just the way a shift works for like your average hospital nurse, very short example. They come in for their shift, they are given a patient assignment, they get handoff report from the person leaving who had those patients.

And then they hit the ground running, trying to do an assessment, understand the full clinical picture. They become the air traffic controller for all the other disciplines that are coming in to give great care. they have to anticipate what the physician's going to need. Has the patient gotten better or worse? When is lab coming? When is respiratory coming? When is speech? Everybody. So they're trying to do all this, but at the same time, while they're trying to get to know you and build trust with you and look in your chart and understand this huge, big picture,

their phone's ringing, their pager's going off, there's call lights going off, someone down the hallway is having a cardiac arrest and now I have to leave and go address that. It's just pure chaos. Not all shifts are that bad, not all shifts are like that, not all hospitals are like this, but that's sort of your average day -to -day what it's like to be a nurse. It's oversimplifying it. So this framework is I do time motion observations with the nurse. What the heck is a time motion observation? So I'm shadowing them.

and I have a tablet in my hand and I'm using software where I track their movement, I track the task that they're completing, so I name the task, but I'm also calculating how much time they're spending in that task. So I'm spending three to four hours, I'm not talking to anybody, I'm not interacting with any, I'm literally just, I am documenting how this person is spending their time. Well, when you do this 10 to 20 times and you get this really great baseline, you can take all that information and put it in something as simple as a pie chart.

Megan Carter (14:52.134)
and you show these frontline folks how they're spending their time. What surprises so many people is that of all the tasks, we really want them to spend most of their time in patient care. They're maybe getting 10 to 20 % of those four hours in actual patient care. The other 80 to 90 % is everything else. It's charting, it's running back and forth for supplies, it's being interrupted constantly.

And so I show people that it's really powerful for non -clinical leaders to see that. They know nurses are overwhelmed, but showing them data that validates that's really powerful. So what do you do with that? So we take the nurses and who are the experts and I say, what would you like to do about this? What are your biggest barriers? And we just brainstorm. We just, there's no bad ideas. We talk about everything in the world we could possibly do. Then we narrow that down to one or two interventions. We pick one or two things and nine times out of 10 at zero cost.

It's something as simple as a refresher course on how to chart smarter, not harder, or it's reorganizing the medications and the cabinet where they're stored so I can get to the little things. So we put these interventions in place and then I replicate, I repeat the time motion observations to see how much time is saved. One powerful example is in my very first apartment where I did this, this is back in 2014, we looked at the first four hours of their shift, the busiest time.

And we shaved off two hours, Caroline. So 50 % of their shift of waste, we got rid of it. How did we do that? We listened to them. They told us what they needed. We gave them what they needed. We reorganized the way they did things. We, the medications, we reduced interruptions. So they got more time. That two hours is time back at the bedside with the patient. So guess what happened to all those metrics that we measure? Safety, quality, patient satisfaction, employee engagement, all of those one up.

It was so successful that actually our CEO at that hospital at that time, who I've still to this day have great respect for, had me present this to the board. And he said, maybe, maybe this is the way we evaluate and how, you know, how we innovate to address, take the few precious people we have and just simply reorganize their workload and their workflow. If I can't make enough nurses come out, you know, if I can't, if I can't get enough human beings to do all this work, why don't we look at the work itself and just reevaluate. And the power of it is you're letting the people

Megan Carter (17:11.718)
doing the work, the experts giving care, decide how they want to address their workflow and their workload. And it's powerful. And nine times out of 10, costs absolutely nothing. Those interventions are usually very simple things. They just need the space to really see their data and space to really think about how they could do it differently.

Caroline (17:29.166)
Okay, that is seriously so brilliant. And what employer would not want to get 50 % of their employees time back to them serving their clients, customers, patients, whatever fill in the blank that is. That's amazing.

Megan Carter (17:40.132)
Yeah.

Well, thanks. I hope so. I hope it's helpful.

Caroline (17:46.616)
So what's lighting up with some of the clients you're working with right now?

Megan Carter (17:50.336)
I love this. I love this question on your episodes. I really had to think about this. I love my clients. What's lighting me up is seeing their passion for their patients and their teams. These leaders genuinely want to make it better, believe it or not. I know it's hard for some people to believe because it's, you know, we all get disconnected, but I genuinely believe every single health care worker and every leader wakes up and they go to work with the intention to ease human suffering and give great care.

It's just not always possible with the way the system is set up here in the US. So when I share my framework with them, it lights me up to see them get so excited and for them to be so open to trying it, because it is different, especially when they've already worked with these larger consulting firms and they've spent time and money and maybe they didn't get the results they were hoping for. I think they just need someone who knows their work on both sides, understands the frontline and the leadership perspective.

respects that perspective and expertise to show them a better way. Not the only way, but a better way than maybe they've known before.

Caroline (18:55.074)
The data piece is huge because you can say all these things that have to do with emotions, like how people feel the burnout, especially let's just use that word. And, but then when you have data to back it up and ways you can prove it, it's the game changer.

Megan Carter (19:04.421)
Yeah.

Megan Carter (19:09.018)
Yep, absolutely, yeah.

Caroline (19:13.016)
So as we wrap up, how can our listeners find you?

Megan Carter (19:15.844)
Yeah, love that. So I obviously have my website. I know you'll share the link here with folks. I'm also on LinkedIn. You can find me, Dr. Meghan Carter. I also have, I'll attach my email to that. I'm very open to meeting new people and especially fellow entrepreneurs in other industries as well.

Caroline (19:32.322)
Thanks, Megan.

Megan Carter (19:33.53)
Thank you, Caroline.