Susan Hernandez is the chief nursing officer at UT Southwestern University Hospitals. Hernandez started her nursing career in 1994 in Nashville, Tennessee, where she held leadership roles at the Vanderbilt Heart and Vascular Institute and the Vanderbilt Clinic. She later became the CNO and associate hospital director at the Monroe Carell, Jr. Children’s Hospital at Vanderbilt. Hernandez, who accepted her position at UT Southwestern in June 2014, helped transition the nursing team through its move to the new William P. Clements University Jr. Hospital.
Trib+Health: You spent some time in Vanderbilt before coming to UT Southwestern. What made you decide to come to Dallas?
Susan Hernandez: I was at Vanderbilt for 20 years, and I had never lived in another city but Nashville, so it was a big deal for me to look around. And initially, it was the job in this city that made me come here. My husband is also from Dallas, so, of course, I became wife of the year by bringing him back here because as you know, if you are a Texan, you are a diehard Texan. Obviously, you get emails with all kinds of job opportunities that are out there, and at the time I wasn’t really looking to leave, but when I saw UT Southwestern and I knew its reputation and I knew it was in Dallas, I thought I really should have a conversation. Once I arrived and I got to meet the people here, I told my husband as soon as I left, “I want that job,” and, luckily, it worked out.
Trib+Health: Could you outline some of the design changes in the new hospital layout that impact how nurses do their jobs? And what are the nurses saying about this?
Hernandez: The building was really designed with the patient in mind but also to put the care providers at the patients’ bedside more often. If you think about it, the nurse spends the most time with the patient. Physicians come and go, and they have other patients to see, but the nurse is really there around the clock. So we wanted to have an environment where we put needed supplies or equipment closer to the bedside so that the nurses have more of an opportunity to be there with the patients when the patients were in need or when the patients wanted to create more of a connection with the nurse or vice versa.
It was a change, and change is not easy. So when you’re from a nursing structure where everyone’s kind of in a circle and you can see everyone, it’s a change when you create the design that we have with longer hallways. The great thing about it is we were able to put computer spaces in between each room, as well as what’s called a nurse server, which holds the supplies and equipment right there between each room so that the nurses don’t have to step away so long to either go document something or to go find a supply or piece of equipment that they needed to provide patient care.
Trib+Health: So what are the nurses and patients saying about whether they like these changes?
Hernandez: The patients love it. Part of it is the beauty of the building. We all know that having light is healing, and that just doesn’t appeal to the patient. It helps your care providers feel better when they come to work every single day. So that’s been helpful. The nurses, now that they’ve gotten used to it, they love being able to be there where the patients are because it just builds a relationship, and when you have more of a relationship you provide better care, in my opinion.
It also has pushed us to think of other ways to stay close as a community — and what I mean by community is a community of nursing teams or nurses and physicians and therapist teams. For example, in the old building, you would have nurses’ stations. Everyone is together and so you build a community when you’re in that structure whereas here you’re more deployed to be near your patients first and then you create ways to build that community among each other at different times and in different ways than before. That was a change that people had to understand.
Trib+Health: Does technology play a role on this or are these more design concepts?
Hernandez: Oh no, technology absolutely plays a part in it, and there’s all kinds of things. It could be around educating the patient’s family members, it could be around how the families connect to other family members or friends who are not in the city or not in the environment and has to do with, “How do I know who’s taking care of me,” or “Wow, my trash can should probably be emptied right now. I don’t want to wait 15 more minutes.”
The technology plays a part in that to give the patient more control of their care actually, which is good. As nurses, we really want to make sure we’re doing things with the patient instead of to the patient as often as we can.
Trib+Health: When this was all being designed, where did you look for examples?
Hernandez: I actually was not involved in that, but those who were involved did go visit other places. I would actually say we are early on some of this. Other places are definitely looking at the same concept. We get lots of phone calls. I get calls from other chief nursing officers asking for visits here to look at it and to walk the space.
Trib+Health: How does this impact patient care at the end of the day?
Hernandez: I think it provides more time for the nurse to be at the bedside with the patients, which is always the benefit in terms of care, so it helps with outcomes.
Trib+Health: Any other design changes that are worth mentioning?
Hernandez: I think one of the things we are really looking at but we don’t have the end result yet is the steps it takes for nurses to get through their shifts and to properly care for their patients. What we think we’re going to find is that they actually take less steps away from the patients’ bedside cause we designed the unit so that the things that they need to provide care are closer to the patient rooms.
We started a study in St. Paul Hospital before we moved with a basic pedometer, and now that we’ve had time to get in the space and settled down in the new space, we’re about to do a new measurement to see if those steps decreased.