As fall gets underway and nurses head back to school, it’s important to look at how academic and professional education can shape a nurse in different ways.

September’s Nurse On the Move,Paula Roe BSN, MBA/HCM, FACHE, has a unique experience with nursing. She currently serves Simpler Consulting as a senior advisor - where she helps clients achieve sustainable breakthrough improvements in care quality, productivity, and cost reduction by applying process improvement techniques to daily operations – and operational excellence practice leader, responsible for Simpler’s internal process improvement.

She previously spent six years as the vice president of operations for St. Elizabeth Healthcare, a regional hospital system located in northern Kentucky. Before that, Roe spent 13 years with the Toyota Motor Engineering and Manufacturing American, where she learned the tools of the Lean management trade.Roe’s experiences have shaped her perspective as a nurse and operations leader. Through our interview, I discovered how these different settings impacted her thoughts on nursing and patient care. 

Q: Why did you choose to receive your BSN and start your nursing career?
A: A career in nursing was not my original plan. When I enrolled at Ohio State University, I was on course for a degree in engineering. By my sophomore year…I was forced to take the pre-medical school-level anatomy class to fulfill an undergraduate requirement. As soon as the class was underway, I knew I was hooked. I soon met with my advisor and found that nursing was the best match for me.

Q: You went on to manage a CTU/SICU department of a hospital. How did this shape your decision to earn your MBA in health care management?
A: Early in my nursing career, I was involved in staff nurse counsel and had the opportunity to present to hospital administration on a regular basis. I really enjoyed this interaction and pursued hospital administration as department manager of the CTU/SICU. When I went to work for Toyota as a safety, health and environmental administrator, I never lost that dream of working in healthcare administration. Lucky for me, Toyota offered MBA programs on campus, and I was able to earn my master’s degree specifically for healthcare management. 

Q: Please describe what Lean management means to you and why you believe it’s an important tool for nurses to use?
A: Lean is all about delivering value to the customer. From a nursing perspective, the customer is the patient and the patient’s family. When you think about nursing and the tenants of Lean – striving for zero defects, the relentless pursuit of value, and the delivery of service in the least wasteful way – the two are necessarily harmonious…The delivery of care is spending time with the patient and delivering care value. We need to relentlessly pursue the elimination of wasteful steps, challenging our day-to-day activities to spend more time with patients and deliver the best care in the least wasteful way. 

Q: In your role at Toyota, how did Lean management practices and role process improvement techniques shape your perspective as a nurse and operations leader?
A: When you start a career with Toyota, you start a lifelong journey of hands-on learning. The training advances as you practice and apply these Lean skills. Lean is also a team-based model; it allows teams to bring their ideas and thoughts together so the whole group is focused on what matters most. But with Lean, the team makes decisions together on execution and output as well. And action is immediate, meaning you are able to achieve breakthrough results within a very short time. I very quickly saw how Lean’s team-based approach could be applied to the nursing world.

Q: How do you define a nurse leader?
A: I came across not long ago a quote from renowned leadership expert Dr. Stephen Covey: “Leaders do what’s right and managers do the right thing.” To me, a nursing leader is one who does what’s right for his or her staff, the patient, the organization, and the population served.. 

Q: What do you see for the future of nursing?
A: I believe that nursing will continue to be developed from within the profession and innovative ways to deliver care and patient treatment models will emerge. But, nurses will have to also look outside of nursing for solution approaches. I foresee Lean and other management techniques more widely accessed. I believe the pace of change in the industry is going to require new and breakthrough ways of looking at things, and traditional improvement approaches are going to be challenged. As Einstein said, “Insanity is doing the same thing over and over again and expecting different results.” In nursing, we’ll need to think outside of the traditional nursing box to eliminate waste and to ultimately spend more by the patient bedside.

Do you know a great candidate to be featured for Nurses On the Move? We want to know about the nurses who are advancing the profession and inspiring others to do the same. We will feature a new nurse every month. Email your submissions to [email protected].