Tim Johnsen, BSN, RN, brings decades of experience to his role as senior vice president and COO of Presbyterian Delivery System at Albuquerque, N.M.-based Presbyterian Healthcare Services.
In his current role, he oversees operations across a health system of nine hospitals and a medical group.
His other healthcare roles have included senior vice president of hospital operations at Presbyterian, as well as hospital division chair for Oklahoma City-based Integris Health and president of Integris Baptist Medical Center.
Mr. Johnsen told Becker's he's excited about helping workers feel supported and remain passionate about their work. He shared his top priorities for 2024, discussed a few of the ways his organization is addressing retention and offered some advice for his peers.
Editor's note: Responses were lightly edited for length and clarity.
Question: What has you most excited about your role as COO right now?
Tim Johnsen: It's nice to be in a place post-pandemic, for the most part, where we're seeing our workforce stabilize again. I think the joy of work is returning. We're seeing that in our teams and the way they come to work and show up and the commitment and dedication to providing excellent care to all New Mexicans. We serve in so many spots across the state with the largest provider of care. And it's nice to have so many access points for the citizens of our state and be able to provide that care. And, again, with the workforce, we're just seeing month-over-month improvements in our retention. People are thriving again. We actually use that word here a lot — thrive — to discuss our workforce and how they're doing. We check in on them with engagement surveys and obviously lots of visibility and rounding. It feels like we're in a much better place in terms of all the stress that we all felt during the pandemic. That seems to be dissipating.
Q: What are a few of your top priorities for 2024?
TJ: I've always seen it as my role in any leadership roles in healthcare to remove the obstacles and the barriers of the caregivers so that they can do what they're expertly trained to do. And so, certainly that's a key priority, that we continue to use automation, innovation, any tools that we can think of to make the work easier for the providers so that they can be more at the bedside with the direct patient care. We do focus on those retention efforts, that they have good career paths here.
I think also a priority for 2024 is to focus on smart growth. We are still very busy in our metropolitan areas and some of our regional areas as well. Smart growth may be counterintuitive in a fee-for-service environment but as an integrated health system, we look at that differently. We really want patients to receive care in the appropriate site of service. We have some really nice combined freestanding emergency departments and urgent care centers where the patient doesn't have to triage ahead of time themselves. They go into these locations we have across the Albuquerque metro area, and their assessment is completed, and about 70 percent of them leave an urgent care visit with a much lower cost of care bill as opposed to a hospital emergency room visit. We're well-equipped to do both. But it takes the decision away from a patient who isn't typically trained in being able to diagnose if they have an urgent care problem or an emergent problem. So that's fantastic to see.
We also focus a lot as an integrated system on value-based care, and we're leaning into those programs a lot more this year. Then continuing our focus on the care experience. We have adopted the Press Ganey model of compassionate connected care. And it is yielding fantastic results, and it's so nice to see that program really taking off.
Q: What is one new retention strategy the system has implemented in the last year?
TJ: An on-demand workforce gig app with ShiftMed. It is a new tool for us to bridge the gap in any of our scheduling that we may have. What it does is it tracks local New Mexico nurses, nurse techs, nurse aides, to a platform and really puts the power in their hands of how they select their scheduling and work with us. It's different from contract, typical agency labor that we use in that it's local people, and they may be working other places, and they've always wanted to try out Presbyterian. This gives them a really nice way to do that. If they retired early or are semi-retired, it puts the power back into their hands on how they schedule that. That scheduling flexibility is so critical. We hear it so much from our nurses, and a lot of disciplines across our organization.
Q: Health systems across the country are facing staffing shortages in certain roles. What are you doing to combat that challenge?
TJ: People want to know we are going to commit back to them to allow them to progress in their careers, to provide educational support. We're building a multimillion-dollar simulation center that will assist many different disciplines. That's a gift that was given to us from our foundation. It'll be a great tool to allow people to continue their skills-based education. And then of course we have other formal programs like tuition support. My impression as a nurse is that people look to an organization now to say, "How are you going to help me in my career?" And I think we're really well-designed to do that.
We've also got a lot of nice programs in terms of internships, externships, nurse residencies. And so, if you're a nurse in our health system and want to go to a completely different specialty within nursing — for example, if you're an ER nurse and you want to start working in the neonatal intensive care unit, obviously, that's a significant change in skill set. We spend anywhere from six to nine months with that nurse, developing his or her skills and training and education, to be ready to go for that new role. People really get energized by that. They feel very comfortable. They feel supported. And they feel ready by the time they get to the new area. Our data shows that it enhances retention. Once people feel that we've invested in them, they tend to reinvest back in us and stay with our organization. Those nurse residencies and those nurse fellowships that support experienced nurses as they transition into new areas of specialty have been some ways that we have found to pay off in terms of retention and commitment back to the organization.
Q: If you could pass along one piece of advice to other hospital executives, what would it be?
TJ: A couple of weeks ago, we had about 140 nurse leaders together and gave them three minutes to find a friend in the room and tell each other why they got into healthcare. And it's amazing to watch. The energy in the room increases tenfold. They get passionate. They get excited. They remember why they got into this, and then we turn it into the question about, "Why do you choose, X number of years later, to still stay in this?" And it's a very thoughtful way to reignite that passion sometimes that we all need. I think that reconnection of purpose is vital, and because people get into healthcare for the right reasons, and helping them remember that, and get centered on that as often as they can, is very helpful for me personally. It's incredible for me. Obviously, we spend a lot of time on calls and a lot of in-office time or in- meeting time, and I do the same. But also rounding and connecting with our patients. I can, obviously as a nurse, feel very comfortable entering a patient room and sitting down with the patient and family and talking with them. It's amazing what that does to me personally. So I know that transfers to all of our caregivers, because again, I think people get into these careers for a reason.