Dr. Bonnie Clipper is a top healthcare influencer, nursing innovation expert, care transformation consultant, podcast host, and global speaker. She is a former chief nurse executive, was the first Vice President of Innovation at the American Nurses Association, and is currently the chief clinical officer at Wambi, a health tech company.
As an internationally recognized nurse futurist and nursing innovation evangelist, she was a co-author on the seminal work, The Innovation Roadmap: A Nurse Leader’s Guide and was the lead author of the International Best-Selling book, The Nurse's Guide to Innovation. She publishes and blogs regularly on technologies impacting nursing. She is a Robert Wood Johnson Foundation Executive Nurse Fellow alumna and ASU/AONL Executive Fellow in Innovative Health Leadership alumna. Dr. Clipper is the sole nurse member of the HIMSS Innovation Board of Advisors and is a start-up coach for MATTER international health tech accelerator.
Education
DNP: Texas Tech University Health Sciences Center, College of Nursing
MBA: Lewis University
MA: Health & Human Services Administration, Saint Mary’s University
BSN: Winona State University
LinkedIn: https://www.linkedin.com/in/bonnieclipper/
Sponsor: Interact Solution: https://interactsolution.com/
Innovative SImsolutions.com: https://innovativesimsolutions.com/
Innovative SimSolutions.
Your turnkey solution provider for medical simulation programs, sim centers & faculty design.
Dr. Bonnie Clipper is a top healthcare influencer, nursing innovation expert, care transformation consultant, podcast host, and global speaker. She is a former chief nurse executive, was the first Vice President of Innovation at the American Nurses Association, and is currently the chief clinical officer at Wambi, a health tech company.
As an internationally recognized nurse futurist and nursing innovation evangelist, she was a co-author on the seminal work, The Innovation Roadmap: A Nurse Leader’s Guide and was the lead author of the International Best-Selling book, The Nurse's Guide to Innovation. She publishes and blogs regularly on technologies impacting nursing. She is a Robert Wood Johnson Foundation Executive Nurse Fellow alumna and ASU/AONL Executive Fellow in Innovative Health Leadership alumna. Dr. Clipper is the sole nurse member of the HIMSS Innovation Board of Advisors and is a start-up coach for MATTER international health tech accelerator.
Education
DNP: Texas Tech University Health Sciences Center, College of Nursing
MBA: Lewis University
MA: Health & Human Services Administration, Saint Mary’s University
BSN: Winona State University
LinkedIn: https://www.linkedin.com/in/bonnieclipper/
Sponsor: Interact Solution: https://interactsolution.com/
Innovative SImsolutions.com: https://innovativesimsolutions.com/
Innovative SimSolutions.
Your turnkey solution provider for medical simulation programs, sim centers & faculty design.
Welcome to The Sim Cafe, a podcast produced by the team at Innovative Simsolutions, edited by Shelly Houser. Join our host Deb Tauber as she sit down with subject matter experts from across the globe to re imagine clinical education and the use of simulation. So pour yourself a cup of relaxation. Sit back, tune in and learn something new from The Sim Cafe.
Sponsor Ad:We thank Interact Solution for sponsoring this week's episode of The Sim Cafe.
Deb:Hi, welcome to The Sim Cafe today. We are blessed to have Dr. B onnie Clipper, who is a major nurse influencer and, u m, Dr. Clipper, would you like to me to call you Dr. Clipper or B onnie?
Bonnie:Please call me Bonnie
Deb:Okay. Thank you very much, Bonnie will. Why don't you go ahead and tell our guests about your very interesting journey in healthcare.
Bonnie:Thanks, Deb. Yeah, it's pretty cool. I've been a nurse for over 30 years. I actually grew up in Chicago after I went to nursing school up in, uh, went Winona, Minnesota came back to Chicago and worked at Loyola and cut my teeth as a leader at rush. So great facility to do a lot of tremendous amount of learning, great supports there. And, uh, I was very fortunate. I was the first chief nursing officer of the newly joint ventured rush and Oak park hospital endeavor that was there in Oak Park, Illinois. So that was a whole lot from there. I certainly moved as a Chief Nursing Officer down to, uh, Austin, Texas did that for several years, moved to Colorado Medical Center of the Rockies. And then back to Austin, Texas, I then became incredibly fortunate throughout my career and ended up being a Robert Wood Johnson executive nurse fellow. So spent several years study innovation and part of our work when you're an RWJ fellow is really to make the commitment to continue to disseminate and study, to give back not only to our profession, but to improve the health and outcome of our communities. So I have been studying innovation, which is what got me into learning about technology and how we can use the, to help us improve the outcomes for patients, for our communities and improve workflows for nurses. Currently, I work part-time and wear several hats. I work part-time as the Chief Clinical Officer for Wombi, which is a patient experience and staff engagement platform. And then I also do a tremendous amount of coaching of startups and coaching of leaders that want to learn to think more innovatively. And in the last six months, I have been doing a fair amount of care transformation consulting, really help organizations changing the way they deliver care since, uh, we have this ongoing nursing shortage that isn't going to go away and really trying to help them understand how they can incorporate technology in a positive way into their workflows to improve the care and the outcome of patient.
Deb:Great. Do you have any, why don't you tell us a little bit about virtual reality and how you see that as an influencer in healthcare and how this pandemic has created this natural disruption to healthcare?
Bonnie:Yeah, absolutely. Well, I've been, I'm incredibly delighted to a have been named as a top voice in healthcare by LinkedIn. And that I feel like has given me not only the opportunity to share, but also it's a responsibility. So I try very hard to ensure that what I am writing blogging, putting out there is accurate information. I do not wanna be part of the misinformation or disinformation problems that we have. So I work very hard to make sure that I'm sharing information that is accurate from where it comes from, what it does and how it can be used. In my opinion, you know, we have never had a better opportunity to transform healthcare in particularly nursing because it has already been disrupted for us. So we don't have to go forth and break it. It's already broken, which means that there isn't much we're gonna do to actually make it worse. We can only make it better, whether it's large transformative innovations or whether it's incremental innovation. We have the ability to make things better. When I think about virtual reality, there is a complete opportunity around incorporating virtual reality into how we educate young upcoming nurses that are currently in the, the nursing school pipelines. And we have the opportunities to use virtual reality once you actually graduate, right? In terms of onboarding nurse, residency programs, orientation programs, annual training, competency programs, certification prep, anything that we do. And the way that we can leverage VR is, is actually pretty simple. If you think about it, it's really a delivery mechanism. So schools have the ability to put content in there and to develop what's important to them. Typically, the way that this happens is through scenario development or what we call assets. So we might develop scenarios that are a blend of didactic content, perhaps there's a, or someone talking about some content, and then you're in a scenario. And when you're immersed with the goggles and the earpieces and have the haptics in your hands, it actually gives you a failure safe environment. So what I mean by that is that we could push out VR training on how to assess patients or even how to handle emergency situations. And in fact, there already is ACLS training that's done via VR. That's been happening for a couple of years now. So in these scenario, your eyes and ears are completely immersed in this training. So your brain actually believes that you're in this scenario. And what it does is it allows you to actually go through the critical thinking steps to process the information that you've been taught and use what's in your head, along with the muscle memory skills. So the example of a patient that potentially is heading into a failure to rescue scenario or heading into maybe a code is something of that nature. You will see things happening in front of you, and you actually will have the ability to influence the scenario. You can make decisions. You can give medic, you can ask questions, you can put something on an IB pump. You can dial meds, change me, drip rates. You can actually do a whole variety of things. You could defibrillate patients. You can do any kinds of evaluation or assessments. So it's a pretty cool way to actually test how you can get critical thinking skills and problem scaling, solving skills, along with the muscle memory and put those scenarios together so that your patients have a good outcome. And because it's a failure, safe environment, no patients ever suffer harm, nothing bad happens. You can run those scenarios with a little bit different nuance time at after time. And in those scenarios, you actually can apply tremendous learning value to how we can change our thinking so that it becomes so hardwired. We know when we see it for real, what we need to think, what we need to do and how we need to act.
Deb:Wow, that's, that's, uh, very for the future. How long do you think that is gonna take until we can really get to it?
Bonnie:It's here now. So it's only a matter of us changing our paradigms. It is about really learning to adapt from an innovation perspective. We have to develop more of a tolerance of risk and failure. We also have to be willing to spend some of our money, some of our capital, some of our operating expenses on these things that exist. And I I'll tell you that oftentimes whether I'm talking to a Dean or talking to a CNO, I will get pushback in terms of, well, we don't have the money or we can't do it. I got news for you. Most organizations are spending the money. They're spending it in turnover. They're spending it in nurses that are leaving sometimes because they don't feel prepared and safe sometimes for other reasons. So just carving out some of what you're already spending and dedicating it to things of this nature. It isn't, it isn't impossible. I believe it's doable would also say that that comes with a complete paradigm shift around how you orient and onboard new people or even nursing students, right? There's nothing that says we actually can't send them an Oculus. That's wrapped with your university's logo and build that into some of the expenses, right. That have to do with being a student. We charge them for other fees. And when you buy these kinds of products and create VR assets in scale, it lowers the price points. The same thing would be true of hospitals that are orienting and onboarding people, right? We can actually buy those more them. So they look great. They remind these new people where they are and every person doesn't have to own their own headset. Right. They can utilize it for a duration. And then when they send it back or bring it back to the organization, those can be, be reprocessed in a very simple way using what's called a safe box that basically them with UV light, and they're completely clean, not sterile, but clean. And there's no bio burden, no virus or bacteria on them. And they can be repurposed for someone else.
Deb:I can see that. I can see that. And that sounds great. I'm curious about what you think about cultural fits for people going in into this environment. Cuz you also talked about retention. How are we gonna keep these nurses and these clinicians in their spots?
Bonnie:Well, I think the answer to that is very, very complex, right? Because there isn't one reason that people are leaving right now. There's actually a multitude of reasons. So I think we have to get real clear about what problem we're trying to solve when we talk about how can virtual reality play into some of that and begin to chip away at some of that retention. I think that that's true. If it's turnover that is related to training nurses, that don't feel safe, don't feel adequately onboarded or prepared, then we can use virtual reality to help us with that. The same is gonna be true of managers. Particularly the nurse managers are beginning to leave. And that's the big fear this year is that we are going to see a pretty sizable Exodus of assistant nurse managers, nurse managers, even directors who are closer to those patients and often stuck in the middle, pretty particularly of resource conversations like staffing and workload. I think that there are ways to help deliver training content and scenarios that can help better prepare our nurse manager and director ranks. However, there are other things that are really very important that we also have to do. We have to make staffing doable. We have to take a look at how we staff our organizations. We also have to make the span of control and the scope as well as the job of being a nurse leader manageable. We have to set those people up for success and we haven't always done that. And I would say that means that we're gonna have to spend money to stop the hemorrhaging of money.
Deb:No, that's a really good point. That's an excellent point. What are your, what are your thoughts on 12 hour shifts compared to the eight hour shifts?
Bonnie:Yeah, so you, you know, you're probably not gonna like my answer. We know what the data says. The data says man, 12 hour shifts really that their safety issues associated with that. However, as a chief nursing officer myself for 20 plus years, I would tell you that the answer lies somewhere in the middle. You also have to find ways to accommodate your workforce. And young people in particular tend to like 12 hour shifts because is it means that they can work fewer of them. However, the corollary to that is that during the pandemic, we know that travelers have been paid crazy amounts of money and they were working up to six, 12 hour shifts a week. That's not safe. Right? And, and I would even say, that's almost borders on abuse. That's a low lot of time to ask someone to be committed, to keeping their head in the game and being on their toes for potential safety issues. It's not like we make mufflers in nursing, right? It's not like you're just standing at an assembly line, kind of using a robot to drill in parts. What we do is incredibly thoughtful. We have to be on our toes to be problem solvers and critical thinkers all the time. So I think working too many, 12 hour shifts is probably a detractors. However, somewhere in the middle is the answer. And I would say we are gonna have to be very, very creative and probably go back to things that were done in the nineties and resurrect, many of those things that do it work that's everything from four hour shifts, six hour shifts, eight hour shifts, 10 hour shifts. We paid people to, to have what we used to call a teacher schedule, meaning they worked nine months and they could spread that over 12 and take three months off over the summer. We also had people that worked at three months over the summer and were paid for that. So I think it's incumbent upon us as leaders to be very mindful about our workforce and figure out how we can be creative to bring people back into nursing.
Deb:Uh, yes, those are some great ideas and that's gonna be great for the listeners to hear because we just can't go back to same old, same old.
Bonnie:Not gonna we're past it. We're past it.
Deb:Anybody who says, well, this is the way we've always done it. Well, that's the way we always did it, but not any longer.
Bonnie:Well that's actually what got us here.
Deb:Yeah, Yeah.
Bonnie:Right? So that's over. We're never going back to how it was. We can't, we cannot allow ourselves to not only from our professions perspective, but also for our patients. Right. We know it didn't work and it was falling apart before these two years, this literally just exacerbated things for us. So we literally have a disrupted clean slate and we can build what this needs to look like going forward.
Deb:So what do you think that it needs to look like going forward? What are some of your, how do you see the, the future of healthcare?
Bonnie:You know, for people like me, um, I have this really kind of nerdy creative mind. The future's never looked more bright because literally it's so broken. We can't make it worse. Right? We can only make it better. And that's everything from what you and I just talked about to how we educate new nurses, to what shifts look like to how we staff units. We are going to have no choice, but to incorporate into what we do, we will not have enough nurses. I keep hearing we're between a million and a 1.2 million nurses short, literally starting at the end of this year, going forward, we will never make that up. So then the next question is what then? How do we handle nursing? Well, we also know that 30% of what nurses do on a day to day basis when they're an inpatient, caregiver is not value added from a nursing perspective, how do we carve those pieces off and give them away? Well, we can give them to non-licensed personnel. Well, the question that I I get is where do we find enough of those people? Because we're short there too. Okay. We can use service bots, service bots have never been more prevalent than they are today. Their use continues to grow. Their affordability continues to improve because price points come down. The more they're being used, the more they actually become affordable for our organizations. So I was on a call last week with an organization that is now incorporating their fourth service bot. They do all kinds of things from lab deliveries, either way from your unit to the lab, from the lab to the unit, whether you need tubes or slips or whatever this might be. We also use pharmacy delivery bots, so they can actually help bring your meds up. And when you think about it for every human that was making those deliveries, that's the potential to upskill someone to do a different function.So can that person be trained as a CNA, a PCT an NA, a sitter, how do we use that human to do things where humans really need to spend their time so that we offload those non-value added tasks and use technology. I'm also seeing a higher adoption rate of computer vision. Essentially. Ambient computer vision is a way to Mount what looks like a smoke alarm on a patient's wall. And through Bluetooth, low energy and wifi, it actually can detect what the patient is doing. Is the movement purposeful or not purposeful? Do I need to alert a nurse that your patient's trying to get out of bed can also tell how many minutes caregivers are in the room and who the caregivers are. Is it a licensed individual or non-licensed individual? Our shift reports, you know, handoffs happening in the patient's room with the patient and the family involved. It can tell those kind of things. Those have been proven to improve safety outcomes. So we're starting to see more of a use of that. Also artificial intelligence. We, at the more we can embed that into our EHRs. That's actually extra set of eyes and ears for the nurses. So there is, there are systems out there today that can actually predict with very high accuracy patients that are going to become pre-septic, not septic, but pre septic. So it allows us to intervene and those things happen through three data points. Typically the triangulation of the nurses, translational database of their notes. Also looking at lab values, also looking at vital signs and it can perceive things that our human eyes and ears can't. So AI is also used to assess patients and predict who's gonna throw a lethal arrhythmia up to an hour before that happens. Imagine how we can change patient outcomes. If we know an hour before it happens that somebody gonna is gonna have a lethal event, we can actually get in there and intervene. So that patient doesn't have to have code, right? So there are a lot of things that we can do today to use technology, to help be a force multiplier. And typically what a companies that is us reevaluate, how, how we assemble the care delivery team.
Deb:Is there anything else that you'd like to share with our listeners as a nurse influencer?
Bonnie:I think we, as nurses have to recreate and build what nursing looks like going forward. We can't just say, no, this isn't how we do it, or no, I'm not open to technology or no, we don't have the money. We are the ones that have to design the future of nursing. And if we don't do it, I got news for people. It will happen to us and it won't necessarily be nurses. And I shared with you before we started that I've been in an organization. And as I was rounding, I talked to a medical assistant who is being used, uh, in an organization and asked them what they did. And they described their role as I'm kind of like a nurse. I think that's important for us to hear that because if, if we really do wanna preserve what is unique and special and the differentiator of what we bring to the health and wellness ecosystem, we gotta figure out how to solve this. And in my opinion, technology has to be a part of that along with us redesigning roles and figuring out how things should look, where should care be delivered, should it be delivered in the hospital or can we do things in the home by utilizing the family much more than we do? Europe is well ahead of us on this. They've done it for 25, 30 years home care and including families in the delivery of that care model. So we do have a lot of exemplars that are out there that we can draw from and it's our future. So we're the ones that have the opportunity to get excited about this and redesign it.
Deb:Yes, this you've been very, very optimistic and I think you're, um, you're right. Other countries have done things. And now that we developed a lot more relationships with different people due to the, the inability to do the things that we always did. So I think those are some really, really great points.
Bonnie:Well, and I think the biggest challenge in where we often get stuck is that we need to include our not only our CNOs, but our executive teams in the redesign of these models. Cause quite often things are designed and then we take'em to a CEO that says no money or a CMO, no physicians, aren't gonna like this. We have to include all stakeholders in the redesign of these delivery models because there aren't other options. So looking at at everything, it means that we have to have all disciplines at the table as redesign the future,
Deb:The systems integration.
Bonnie:Absolutely. Yeah, absolutely. This is a systems challenge we got here because of broken systems. We have to make sure that our key stakeholders represent diverse disciplines and all systems other, otherwise we're gonna continue to trip ourselves up.
Deb:Yeah. When everyone thinks alike, no one thinks a lot. And that's, We need to remember that now, Bonnie, if our listeners wanna get a hold of you, if they have questions for you, if they are curious about how they can help and support you in this, uh, this movement, how, how can they get ahold of you?
Bonnie:Yeah. I am very prominent on LinkedIn. Uh, so I hope that you follow me out there, but please feel free to send me a message through LinkedIn. I return every single message I get, which is probably close to about a hundred a week. Please feel free to reach out. I'm always happy to help. And I love to see organizations particularly where nurses are very involved in reimagining what the future's gonna look like for them and how they're gonna do things differently.
Deb:You know, I think that that would give our listeners a great opportunity that they wake up in the middle of the night with a great idea on how they can improve healthcare. They could bring it to you or
Bonnie:If, yeah, I'm,
Deb:It's really
Bonnie:Totally, totally happy to do that. And I can point people in different directions. I do engage with some organizations that are looking for care, transformation consulting. So I do work with those organizations, but I am always happy to point people in directions and let them know kind of from my vantage point, what is going on. And if there's someone that may be interested or may have a way to help them with their particular idea, sometimes it's literally around a product in a device, sometimes it's around a model of care. So I do respond to those.
Deb:Thank you so much. It has just been a delight to visit with you and until the next Sim Cafe. Thank you.
Bonnie:Thank you.
Outro:Thanks for joining us here at The Sim Cafe, we hope you enjoyed connect with us at www.innovativesimsolutions.com and be sure to hit that like and subscribe button. So you never miss an episode of The Sim Cafe.