New CoxHealth nursing services VP evaluates operations

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by Clarissa French|ret||ret||tab|

SBJ Editor|ret||ret||tab|

cfrench@sbj.net|ret||ret||tab|

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Joan Roberts Cisna brings a unique perspective to the position of vice president of nursing services at CoxHealth.|ret||ret||tab|

She's worked on the front lines of care in emergency room, intensive care and medical surgical nursing. |ret||ret||tab|

She's served in hospital administration, overseeing people, making decisions and effecting change. |ret||ret||tab|

And she's taken the big picture view as a senior managing consultant in health care for BKD LLP in Kansas City, working with more than 50 hospitals and health systems and pioneering BKD's operations improvement product line.|ret||ret||tab|

The position with CoxHealth is something of a homecoming for Cisna.|ret||ret||tab|

"As much as I love consulting it's a wonderful experience and I wouldn't ever have not done it I was getting homesick," she said, longing for a hospital to call her own.|ret||ret||tab|

"As a consultant, just by nature you're a little bit transient: You go in for a defined period of time to do a certain thing. You do a lot of assessment and putting together plans and teaching and helping people get started, and then your job is to work yourself out of a job so they don't need you anymore. I was missing the continuity; to follow through and really see the results of my work," Cisna said.|ret||ret||tab|

Her new responsibilities are substantial: She oversees inpatient nursing for all three Cox hospital facilities Cox North, Cox South and Cox Walnut Lawn which include around 20 nursing units and related departments involving about 1,100 people, most of them direct providers of care.|ret||ret||tab|

Cisna, who started Jan. 5, replaces Ann Bryant who retired in December.|ret||ret||tab|

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Learning curve|ret||ret||tab|

In her work as a health care consultant, Cisna specialized in operations improvement streamlining procedures, maximizing resources and improving efficiency.|ret||ret||tab|

"In this day and age, when budgets are tight and everyone is stretched to do more with less, it just doesn't make sense to do things that don't add value," Cisna said.|ret||ret||tab|

However, for now, the first order of business is to understand existing operations at CoxHealth.|ret||ret||tab|

"We're still in the assessment phase here, I'm so new," said Cisna, who added that she's a firm believer in taking time to assess the situation. Often people cause unnecessary grief because "they go fixing things before they really understand how it's working," she said.|ret||ret||tab|

Through her consulting work, Cisna worked with small hospitals, large hospitals, general, specialty, urban and rural facilities, each with its own situation and dynamics. In addition to that broad perspective, she also brings a powerful tool in the form of her master's degree in business administration.|ret||ret||tab|

"Clinicians and businesspeople don't know how to speak the same language, and I learned very early in my nursing career that there were those challenges in communicating. So that was part of my motivation to pursue that graduate degree in business, and I think it's been extremely helpful," Cisna said. Her education enables her to serve as a kind of translator, she added, between caregivers and financial people, and vice versa.|ret||ret||tab|

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Challenges|ret||ret||tab|

Rapid advancements in medical knowledge, technology and medications make nursing a challenging profession these days.|ret||ret||tab|

The job requires "constant, lifelong learning," Cisna said.|ret||ret||tab|

"When I studied nursing, if you were having a disc removed from your back, you were in the hospital for 10 days; now you're in for 24 hours," Cisna said. |ret||ret||tab|

New technology, which allows doctors to do more procedures, contributes to the workload, but "technology can also be part of the solution," she said. |ret||ret||tab|

"A typical nurse in a hospital these days spends about a third of her time doing paperwork," Cisna said. "Computer technology in our clinical environments enables us to spend less time on paperwork and have more time to take care of patients."|ret||ret||tab|

Staffing is another challenge. A baby boomer-driven caregiver shortage is now looming on the horizon.|ret||ret||tab|

"Those of us who have been around a while in business know we've been through some nursing shortages, but this one is predicted to have a new dimension the others haven't had because of our baby boomers," Cisna said. "The average age of our nurses here is 44 years of age, so in the next 10 years or so, a high proportion of our staff will be coming into retirement age." |ret||ret||tab|

At the same time, demand for services from baby boomer patients is expected to skyrocket.|ret||ret||tab|

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