The Value of Leadership and Optimization: A CNO to CEO Story

Phil Sobol:

Welcome to the CereCore Podcast, where we focus on the intersection of healthcare and IT, from practical conversations to strategic thought leadership. Let's unpack the decisions, challenges and journey of those whose purpose it is to deliver technology that improves healthcare in their communities.

Today, we are pleased to welcome to the CereCore podcast Dr. Kathy Tussey. Dr. Tussey is the CEO of Harrison Memorial Hospital, located in Cynthiana, Kentucky. Kathy started her career as an emergency department nurse at Baptist Health in Lexington. Leaders took notice of Dr. Tussey's knack for leadership, and she quickly became a charge nurse. She went on to become the director of the emergency department and then executive director for nursing administration. She joined Harrison Memorial in 2022 as COO and Chief Nursing Officer, and along the way she earned her Doctor of Nursing Practice. Kathy, welcome to the CereCore podcast.

Dr. Kathy Tussey:

Thank you so much for having me.

Phil Sobol:

Well, we're excited to have you. As a hospital CEO with such an extensive nursing background like yours, it's kind of unique. If you wouldn't mind, just walk us through how things unfolded for you from a career perspective.

Dr. Kathy Tussey:

Well, I started in the emergency department, as you said, and I think that's always a good path to start in. The emergency department is a unique location, full of interesting things that happen, so you never knew what was going to come through the door. I think it was something I fell in love with. It was an area of passion and interest that I really enjoyed.

You know, as a nurse, you're kind of a problem solver, and just trying to solve different problems that would come up, as things arose through the emergency department and through my career there. I think I just started getting involved in things on ways that we could make things better, and always pushing for different positive ways that we could either impact patient care or maybe staff improvement, or anything that we could do to make the environment better. I think that started me down that path and I quickly became a charge nurse, about a year or so out of nursing school, which was scary in itself.

Phil Sobol:

Oh, yes.

Dr. Kathy Tussey:

It led me through education. I started teaching some classes and became an educator and then a manager, and eventually the emergency department director. I think that's what started my career in leadership and administration.

Phil Sobol:

Well, that's excellent. Certainly when you're working in the emergency department, definitely you learn a lot. You see a lot. In fact, I remember sitting around the Thanksgiving table listening to some relatives that worked in the emergency department. That certainly made for interesting conversation over Thanksgiving dinners.

Dr. Kathy Tussey:

Absolutely. My favorite shift was 3:00 PM to 3:00 AM. That's what I worked for several years. I always remember going home in the middle of the night and waking my husband up to tell him interesting things that I saw, and he'd not be able to fall asleep after some of those discussions.

Phil Sobol:

That's right. "You're not going to believe this."

Dr. Kathy Tussey:

Yeah, exactly. We never shared any HIPAA information, but that's an interesting story because you just see a variety of everything, so I think it makes it unique.

Phil Sobol:

well, tell us just a little bit about Harrison Memorial Hospital, what you're most proud of there, and maybe some of the important areas of focus for the organization.

Dr. Kathy Tussey:

Yeah. Well, I am lucky to be here. This hospital has been open since 1906. It's an independent hospital. It's been independent since day one. There was just some visionary leaders that really knew that they needed healthcare in this region and in this community. I've been fortunate enough to come here and figure out that really great things are happening here.

I came from a larger hospital in Lexington, Kentucky. I spent 30 years of my career there, and I'm thankful for every minute that I spent there. I learned so many things, but it is really nice to be in a small community where you're really impacting patients and the community, right here in front of you. I quickly learned when I came here that the staff here are just amazing, and they have a compassion that is just different in a community hospital because everybody they take care of, they're touched by in some way. Either it was their schoolteacher or it's a friend of the family, or it's their family.

I think it's just special. I'm really blessed to be here. I've had a lot of fun coming here the last few years, and I think the biggest enjoyment for me so far has been to highlight the staff and really help them understand what kind of work they're doing here. They just didn't have a lot of ways to report their quality and their data and their patient experience, and so we've brought that to the forefront. For the last two terms in a row, we've gotten the Leapfrog A Patient Safety grade.

Phil Sobol:

Yes. Congratulations on that.

Dr. Kathy Tussey:

That's an amazing feat all in itself for just a normal hospital, but for a rural community hospital, that's amazing. Just to be able to show them that they're doing great things here, I think that's been the biggest reward that I've had.

Phil Sobol:

Oh, that's outstanding. You mentioned the fact that you've worked in various size hospitals and organizations, from large to a little smaller. Let's talk a little bit about that, maybe some of the lessons learned or commonality between larger and smaller when it comes to the people aspect of it, when it comes to the processes in place, and even adding in technology.

Dr. Kathy Tussey:

Right. Well, I think the interesting thing is a hospital is a hospital. You're all governed by the same rules, regulations, no matter where you are or what you're doing. I think that the biggest thing that I miss from the bigger hospital is I always had somebody to call, to help me answer a question or figure out a question or an answer. Here, you have to know a little bit about everything. You're a master of all here. I think that's the biggest thing that I've learned moving from a larger facility to a smaller facility, that having those resources at your fingertips are really nice to have. I totally understand how a community hospital has more needs, and maybe we have to look for other external ways for us to gain that information and partner with different people.

I think one of the things that we've really learned over the last year with our CereCore team being here is that we've really relied on them to help us optimize and really identify better ways that we can gain information, and use that information for some of our challenges and our processes that we have here in the hospital. I think it's even more meaningful here to have those technologies right at your fingertips, or at least having a way that we can coordinate those here at a smaller facility. I think it's a huge gift for us to be able to partner with them and see different ways that other people are using the technology, and figure out how we can best use that here at Harrison Memorial.

Phil Sobol:

I think you touched on one of those critical components, which is sometimes it helps to learn what others have done before in other areas and to get that external perspective. As you mentioned, our partnership started, I think, with just a simple assessment in and around the EHR platform. When sitting in that CEO seat, you've obviously got a vision for Harrison and where that's going. Sometimes in order to execute on the vision ... and I'd love to hear your take and perspective on this ... sometimes you have to start with that baseline. In this case it was a portion, right, of the EHR. Maybe give our listeners just a little bit of guidance as far as the process in thinking about that, and getting that baseline and then aligning the results with the vision for the organization, and then getting your team members on board.

Dr. Kathy Tussey:

Yeah, yeah. I think one of the opportunities that you always have with an EHR is it's always unique for your hospital. You have to have good processes in place to be able to utilize the EHR tool to your benefit. I think I felt like that was the one vision that I had here, is that they had their EHR in place for several years, but I'm not sure that they fully optimized how they were using the EHR. When I came ... of course, nursing background, working with physicians ... everybody had a little piece of the puzzle, where they just had a few things that we started to hear maybe it wasn't working the best that it could for them.

I think that's what got us moving in this direction, and we just felt like we just needed a really good assessment of the system, where are we today, and then try to figure out from a quality perspective, a regulatory perspective and a revenue cycle perspective, honestly. That's what got us started in this direction. We needed to make sure that the system was working for us and that we weren't working for the system.

I think that's the biggest thing and the biggest opportunity that I see, is that your EHR is a tool. It's really a tool for you to make it be the best that it can for your facility. You need to be able to get the outcomes from the EHR that you need, to be as successful as you can from a patient and safety and quality perspective. Of course, we are a business, so we do have to get paid because we have to keep the lights on, just like everybody else does. You just have to make sure that all the pieces of the EHR are working in the background, as well as the staff that are using the tool, and that everything is coming together.

That was my vision, is that we could just make it as seamless as possible, where it wasn't too much work for the staff to be doing extra things they didn't need to do, and having each person work to the role that they should be working at, and not trying to do clinical stuff and clerical stuff and the physicians doing clerical stuff. I think it's just a blend of being able to do that. I think from the assessment that we had, it really gave us a toolkit and a roadmap so we could see, okay, where's critical that we need to start, and then how else can we work to make things better and easier for the staff.

Phil Sobol:

Oh, that's excellent. Well, you talked a little bit about your career, and starting from bedside nurse, chief nursing officer, chief operating officer and now CEO. A lot of change there from a career standpoint. Has your view of technology or even IT strategy changed over the years as you've matured in your roles?

Dr. Kathy Tussey:

Yes, for sure, because when I started we were doing narrative charting, so we didn't even have EHR back in the day.

Phil Sobol:

Right, right.

Dr. Kathy Tussey:

Now we have folks in healthcare that have never done narrative charting, and so they only know EHRs. Yeah, it's a blend of folks that have a strong background of that narrative and never wanted to go away. I think the one thing I've seen over the years is once you go to any EHR, your life does get a lot better. It gets a lot easier. There's just better ways to document things, and know that you're putting things in the record that's appropriate and you're not missing anything. I think that was one of the big opportunities when we all started to go towards an electronic health record, that we weren't missing those critical pieces of documentation that we used to do from a narrative perspective.

I think, again, like I said earlier, it's really a tool, and it's all about how you utilize it to your advantage and making sure that that is what you're using it for. It should be a partner with you. It should be a tool that you're using as a partnership. It's not going away. Complaining about it doesn't help. We're not going to magically make it go away, the more we complain, but just making it as good as it can be.

I think the world is changing right in front of us. Of course, with AI technology that's coming out, we're seeing that technology, and a lot of people are scared of it. I'm not necessarily scared about it. I think it's going to innovate some of the ways that we can really care for patients. Because one of the things I've seen over the years is the EHR has gotten to a point where it does take you away from the patient a little bit more than what I would like for it to.

I really want to use AI as a technology to where it really does give you the opportunity to spend that extra minute or two with the patient, because as stats show and statistics show, that extra two minutes makes a huge impact to your patient. Their experience goes up so much more if you can just sit down for that one extra minute, to have that one little conversation with them that makes them feel better. If AI can help us do some of those things and get back to that piece, I'm really excited for what the future can bring for EHR and the way we're looking at things for the future as well.

Phil Sobol:

Well, you bring up a really, really good point. EHR, it is a tool, and it is always adopting and growing and there's always area of optimization in and around that platform, but there's also a lot of stakeholders. There's leadership, there's board members, physician champions, nursing, departments, et cetera. How do you manage all of that? What works when it comes to getting everybody on the same page as it relates to what optimization needs to occur and when?

Dr. Kathy Tussey:

Yeah. Well, I think having input is really important. I'm a leader that feels like you need to get input from everybody. I like to listen. I like to get input. Ultimately, as the leader and the administrator, we have to make the best decision that's going to be best for the system or the hospital, but you do need to understand the pains that people are going through and understand where things can get better for them. I think listening as much as you can, to try to benefit them as much as possible, with also being able to meet your value of revenue cycle and regulatory and all the reporting that we're doing in the industry now.

I mean, you can't survive without our reports and our EHR and being able to get data out of the electronic health record. I do think that there are opportunities to make it better for the people that are using it every day, and we can't ignore those either. We really have to be able to manage their expectations, I think is one very important thing. I don't think we do that well enough sometimes. Then also, listening to them to have them understand that we are going to be open to make those nimble changes that we need to make, if that's what helps them to make their life a little bit easier.

Phil Sobol:

Agreed. Just in thinking about your career journey, certainly you had to employ some personal and professional disciplines when it came to your own education, when it came to learning. I'd be curious to know, and I'm sure our listeners would as well, what were some of your approaches and strategies for that? Were there mentors that poured into you that really helped you down that path? Then what's your take and philosophy in returning the favor and investing in others in their career journeys?

Dr. Kathy Tussey:

That's a great question, and I've been asked that quite a bit since I've been here, actually, because like I said, I was at my previous position for 30 years or job for 30 years, and I never thought I would leave that organization. When I reflect on all the people that have impacted my career, I would not be doing my job in healthcare and nursing if I did not share that moving forward. To keep all that knowledge in one place and to have all the people that invested in me for me to not move forward and share that with others I think would be a travesty.

I just took every opportunity possible to learn something new. Everything that was brought in front of me, if it gave me the opportunity to grow, I tried every way to take advantage of those opportunities. I think the great thing about nursing is that you can reinvent yourself a hundred different ways, because there's different ways that you can serve in the nursing world. I've done everything from education to research to admission department to emergency department to a little bit of everything, and even the inpatient world, which I knew nothing about as an ED nurse, of course. It's made me a well-rounded person and a well-rounded nurse.

I think that's why I'm able to do the job that I'm doing today, because I've lived all of those and I've experienced them, and I understand what relationships are. I think that's the one thing that I took away, is you have to have great relationships with people, and they have to trust that you're going to do what's best for them as well as your department as well. I used to work with lab and radiology and we'd have common goals, but I worked well with them because I also had to feel their pain, because they have pains in their department just as much as I had pains in mine. I think that collaborative approach is something that I've always just taken as something that's been a part of my career.

I think the biggest reward that I have now is seeing people around me grow. I feel like I've done everything I can from my perspective, and obviously giving back as much as I can in the nursing world and the healthcare world, but seeing people around me that I'm investing in grow and their knowledge getting better. Surrounding yourself with great people, I think, is the best thing that you can do for your career.

Phil Sobol:

Oh, that's excellent. That's excellent. I appreciate you sharing that. I've even had conversations recently with young folks that are trying to pick a career or pick a major and they hear the title, whether it be nursing, and they think, "Well, it's one thing." Someone who's had your experience can come in and say, "No, it's so much more than that one thing, and here's all of the paths that you can go down when you start here." All of a sudden, then it becomes real to them, and it's really beneficial and healthy. Thank you for sharing that.

A lot of our listeners are in the IT space, so I obviously have to ask an IT-related question, and you're in a unique position to answer. Perhaps what's the most misunderstood thing about nurses and technology, using your old hat, and then with your new hat, what is maybe one of the misunderstood things between a CEO and technology in the healthcare space?

Dr. Kathy Tussey:

Wow. Oh, that's a hard one. Well, I think probably from a nursing perspective, they don't truly understand the impact of how what they're putting into the record is impacting the outcomes. I do think that's an opportunity where we need to share with them more why it's so important to put the information that we're asking them to put in and why we ask them to do so much, is because it's the outcome that we need and we need to be able to show that we're doing great things, taking great care of patients, and not just from a legal perspective, but also from a regulatory perspective and a community perspective. I mean, especially in a rural community, our competition is big facilities. We need to show the community that we're doing just as great here as they would if they went to a big facility or a university setting. I think it's really important for staff to understand the impact that their documentation and work makes.

From an IT perspective, I don't think anybody has any idea what goes into being in clinical informatics or information technology. The one thing I've learned, being in management, is that everything I do touches them in some way, and you can't forget to tell them what you're doing. That collaboration isn't easy, because you can't do anything without technology. Either there's an interface or there's a build that has to happen or it's just clicking a button to turn something on, or it's a huge workflow that you thought sounded really easy as a nurse because I just got to go do this, this, and this. Well, to document that is a five-month progress. I think the bedside folks don't understand that piece, and so bringing them together is really important to have them understand each other's role.

Then of course, as the CEO, just understanding everybody's role in healthcare, and making sure that we're supporting them and giving them the opportunities to do their job well and the financial backing to be able to have the help that they need. That was one thing that we did here, is I think we quickly realized that we had an undersized clinical informatics team, and so we have invested in them and giving them the resources that they need, because you can't do it all. Even though it looks like you can, you can't. I think that's been the biggest takeaway for me.

Phil Sobol:

Oh, that's excellent. Well, you made mention several times of just the responsibility ... and I'll use that word ... of delivering healthcare in a community setting. We all know being a healthcare leader can be very, very stressful, particularly in those sorts of situations. Healthcare doesn't sleep, at all. I'm just curious, how do you balance all of that when it comes to all of that responsibility, all of that just taking ownership, really, of the community from a healthcare perspective? How do you manage that? How do you help your employees manage that?

Dr. Kathy Tussey:

Right. Well, it's definitely a different world over the last five years, of course. None of us like to talk about post-Covid, but this is where we are. Work-life balance is definitely something we talk a lot about. It's really important. I'm a firm believer in you have to have time away from here. You have to reinvest in yourself, whether it be education or relaxation, a weekend trip or vacation or whatever that is that rejuvenates you. I highly encourage everybody to do those things. It's really important, for you to be an effective leader, to be able to take that time away and come back fresh, because you get a little grouchy if you're here too long and don't take a break, but you're right. I mean, it never stops.

In the new world that we all live in, virtual and everything else, our phones ring all day long and our meetings never end. It's just learning that balance. Learning to be present when you need to be present, not just for your family but also for your employees. Giving them the opportunities to grow within the organization I think is another way that you can show them that they matter, and that you're giving them chances to learn and invest in themselves in different ways. I surround myself with great people, because I'm not the smartest person in the room, the other people are. I'm just here to listen and try to give them the tools and the opportunity to do their jobs.

I think it's just a well-rounded team is really important to have, and to allow them the opportunities to take time off, to encourage them to do those things. I tell them all the time, "I might answer an email at eight o'clock, and don't you dare answer me back. I don't want you to. Please don't. That's just the time that I had a chance to look at it." I finally learned on my phone that I can time my messages to somebody at eight o'clock the next morning, so I use that tool a lot. We're back to technology again. I'm learning technology every day too. I try to use those tools as much as possible, so my staff know that they can take a break as well and enjoy their family.

Phil Sobol:

Yeah. One of my kids told me that trick just this past week.

Dr. Kathy Tussey:

Yeah, I'm not going to admit that I just learned it a few months ago myself.

Phil Sobol:

Oh, I just did. That's okay.

Dr. Kathy Tussey:

I learn something new every day. Every day.

Phil Sobol:

Absolutely. You have to.

Dr. Kathy Tussey:

That's right.

Phil Sobol:

You have to. No, that's excellent. Well, this has been just a great conversation, and really appreciate just all of your insights and guidance. We always like to wrap these up with just a call for any last words of wisdom that we may have not asked you.

Dr. Kathy Tussey:

Oh, gosh. Yeah. I mean, I think we've pretty much covered everything. I always just like to leave people with a little advice. Just take every opportunity that you can. Most of the time you get offered one opportunity, and if you don't take advantage of it, that opportunity may not come around again. Whether it's learning something new or doing something different, it's okay. You can do those things. Yeah, I think that's how you grow. I encourage anybody that's looking to advance their careers or do anything like that is just take those opportunities as they come, and make the best of it that you can.

It's a rewarding career, for sure. For me, it has been. I have learned a lot and I've been able to give back a lot. I'm excited to be in healthcare, especially at this time. I tell my new nurses all the time when they come out that this is the best time in the world to be back in healthcare, after Covid, because we've got to recreate everything again. What an exciting time to have innovation in our career. I try to encourage them to bring those brains that are full of innovation and great ideas to us, because we need that to survive. It's really true.

Phil Sobol:

Absolutely. How else are we going to know that we can schedule emails in the future?

Dr. Kathy Tussey:

That's right. That's exactly right, and learning how to do ChatGPT. I didn't know that was a thing until a year ago. Yeah, it changes your life.

Phil Sobol:

Yes, it does. Yes, it does. You're absolutely right. It is an amazing time to be a part of our industry, and I don't think there's another career path that's as rewarding.

Dr. Kathy Tussey:

Yeah, I agree.

Phil Sobol:

Well, Kathy, thank you so much for your time and for your insights today. We've really appreciated it.

Dr. Kathy Tussey:

Great. Thank you. I really appreciate you asking me, and it's nice to meet you.

Phil Sobol:

Wonderful.

Thanks for listening to the CereCore podcast. We hope you enjoyed this conversation. Follow us on your favorite podcast platform for more episodes. Connect with us on LinkedIn. Visit our U.S. website at cerecore.net, and for those abroad, visit cerecoreinternational.net. Learn more about our services and find resources.

At CereCore, we are healthcare operators at heart, and know the difference that the right IT partner can make in delivering quality patient care 24/7. Let's help make IT better. Here's to the journey.