EP49 - Leadership by Design: Creating Cultures Where Caregivers Thrive - Elizabeth Jeanes

EP50 - Treat the Patient, Not the Alert: AI, Alert Fatigue, and Nursing Decision Support

AI can identify a patient at risk. But what happens when the nurse receiving the alert is already caring for another patient? As hospitals continue adopting AI-powered clinical decision support tools, nursing leaders face a practical challenge: identifying risk is only part of the equation. Acting on it requires people, workflows, communication, and clinical judgment. In this episode of Beyond the Blueprint, Gregg Malkary is joined by Daniel Gracie, Carolyn S. Harmon, and Troy Seagondollar to explore how AI-driven alerts intersect with the realities of nursing practice. The conversation examines alert fatigue, cognitive overload, accountability, workflow design, and the limits of technology when resources and staffing remain constrained. The discussion also explores why AI should support -- not replace -- clinical judgment, how poorly designed workflows can undermine even the most advanced tools, and what healthcare organizations should consider before introducing new AI-driven alerts into patient care environments. Whether you're a nursing leader, informatics professional, healthcare executive, or technology innovator, this conversation offers a grounded look at what it takes to translate AI insights into meaningful action at the bedside. Key Takeaways * AI can identify risk, but it can't create capacity * Clinical decision support is not clinical decision making * Alert fatigue remains a significant patient safety challenge * The right alert at the wrong time may not change care * Experience still matters when prioritizing patient needs * Technology can't fix broken workflows * Escalation pathways matter as much as the alert itself * Frontline nurses should help design AI-enabled workflows * Better data leads to better clinical decision support * AI should augment clinical judgment, not replace it Episode Highlights 00:00 | AI Alerts Are Decision Support Tools, Not Decision Makers 04:29 | When a Nurse Can't Respond to an Alert Right Away 06:09 | Why the Same Alert Means Different Things to Different Nurses 07:40 | Alert Fatigue, Cognitive Load, and Patient Safety 11:15 | What Happens When a Nurse Leaves One Patient to Respond to Another 14:12 | "Treat the Patient, Not the Alert" 16:04 | Do We Need Air Traffic Control for Clinical Alerts? 16:26 | Why AI Can't Fix Poor Workflow Design 18:25 | AI as Decision Support, Not Decision Making 20:30 | Lessons from Telemetry Monitoring and Alarm Fatigue 21:57 | Who Is Accountable When an Alert Is Missed? 23:07 | Why Technology Can't Fix Broken Processes 24:12 | The Cost of Automating Bad Workflows 28:16 | Can AI Be Personalized for Different Clinical Environments? 29:51 | Why Data Quality Determines AI Performance 30:32 | Translating AI Research into Clinical Practice 32:23 | What Nursing Leaders Should Do Before Implementing New AI Tools Guests: Daniel Gracie, [https://linkedin.com/in/daniel-gracie-dnp-rn-bc-8284a9186] Carolyn S. Harmon [https://linkedin.com/in/c-harmon], Troy Seagondollar [https://linkedin.com/in/troy-seagondollar-msn-i-rn-ni-bc-72950b13] Host: Gregg Malkary - Lighthouse Healthtech [https://www.lighthouse-healthtech.com/] Sponsored by: Simplifi Medical [https://simplifimedical.com/] Audio/Video: Tim Jones - Health Nuts Media [https://healthnutsmedia.com/] Marketing: Josh Troop - Troop-Creative [https://www.troop-creative.com/] Learn More at: www.beyond-blueprint.com [http://www.beyond-blueprint.com/]

EP49 - Leadership by Design: Creating Cultures Where Caregivers Thrive - Elizabeth Jeanes

Healthcare leaders often talk about culture, engagement, and retention. But what if many workforce challenges aren't simply staffing problems at all? In this episode of Beyond the Blueprint, host Kris Baird and co-host Keith Washington welcome nurse leader and workforce strategist Elizabeth Jeanes for a conversation about the connection between leadership, culture, and workforce design. Drawing on years of experience in nursing leadership and organizational development, Elizabeth explores why culture isn't built through mission statements or posters on a wall—it's built through consistent leadership behaviors, accountability, and the daily decisions leaders make about what they tolerate and what they reinforce. Together, they discuss leadership burnout, generational differences in the workforce, the importance of purpose-driven leadership, and the difficult reality of managing toxic high performers. The conversation also examines how healthcare organizations can create environments where caregivers feel valued, connected, and supported—and why those efforts ultimately impact both retention and patient care. Whether you're a nurse leader, executive, frontline manager, or healthcare innovator, this episode offers practical insights into building cultures where both caregivers and patients can thrive. Key Takeaways * Culture is shaped by leadership behaviors, not mission statements. * Organizations often achieve the results their systems are designed to produce. * Leadership development is essential for workforce stability and retention. * Toxic high performers can cause significant damage to team culture. * Gen Z caregivers place a high value on culture, belonging, and trust. * Strong leaders help teams stay connected to purpose and meaning. * Leadership burnout is an often-overlooked challenge in healthcare. * Psychological safety requires active leadership and accountability. * Technology should help caregivers spend more time with patients, not less. * Positive culture change often begins with influential frontline team members. Episode Highlights 00:00 | Toxic Superstars and What Leaders Tolerate 03:30 | Culture by Design vs. Culture by Default 04:35 | Why Leadership Behaviors Shape Organizational Culture 06:09 | Promoting Great Clinicians Doesn't Automatically Create Great Leaders 09:52 | Helping Leaders and Teams Reconnect to Purpose 11:25 | The Hidden Cost of Leadership Burnout 13:16 | Why Gen Z Views Leadership and Workplace Culture Differently 17:13 | Building Psychological Safety in Healthcare Teams 18:05 | The Difficult Decision: Keeping or Losing a Toxic High Performer 22:17 | Bringing Purpose Into Everyday Leadership 25:05 | Seeing Patients as People, Not Room Numbers 26:16 | How Technology Can Help Nurses Return to the Bedside 28:53 | What Every Generation Wants from Leaders 30:06 | Finding the Culture Champions Already Inside Your Organization Guest: Elizabeth Jeanes - Jeanes Strategic Consulting [https://www.jeanesstrategicconsulting.com/] Host: Kristin Baird - Baird Group [https://baird-group.com/] Co-host: Keith Washington - Companions in Courage Foundation [https://cic16.org/] Sponsored by: Simplifi Medical [https://simplifimedical.com/] Audio/Video: Tim Jones - Health Nuts Media [https://healthnutsmedia.com/] Marketing: Josh Troop - Troop-Creative [https://www.troop-creative.com/] Learn More at: www.beyond-blueprint.com [http://www.beyond-blueprint.com/]

EP48 - Healthcare Doesn't Have a Staffing Problem: Rethinking Workforce Design - Elizabeth Jeanes

What if healthcare's staffing crisis isn't really about staffing at all? In this episode, Elizabeth Jeanes, founder of Jeanes Strategic Consulting and a healthcare leader with more than 20 years of experience in nursing, leadership development, and organizational strategy, challenges one of healthcare's biggest assumptions: that workforce shortages are purely a numbers problem. Instead, Elizabeth makes the case for rethinking workforce design from the ground up, starting with preceptors, frontline influencers, and the leadership systems that shape culture from day one. Her take? The people are already in your building. We're just not developing them. Beyond the Blueprint Host Keith Washington and Elizabeth unpack generational intelligence, why quad pay won't fix a broken culture, how preceptor programs should be leadership development, not skills training, and what it actually takes to earn the loyalty of a workforce that's done handing it over for free. Whether you're building teams, leading culture change, or rethinking workforce strategy, this episode offers a fresh blueprint for the future of healthcare leadership. Key Takeaways • Healthcare's staffing crisis may be less about shortages and more about workforce design. • Preceptors and frontline influencers have outsized impact on culture, retention, and new hire success. • Leadership is an action, not a title, and organizations should develop informal leaders early. • Generational intelligence helps leaders better understand what motivates today's workforce and why loyalty looks different now. • Younger workers value mental health, work-life balance, and professional growth as much as compensation. • Strong onboarding and evidence-based training programs can improve retention and reduce costly turnover. • The future of workforce strategy is not just hiring talent, but building pathways to grow the talent you already have. Episode Highlights 00:00 Intro 02:26 Why Preceptors Are the Most Overlooked Leaders in Healthcare 04:10 Culture First: Building Leadership from the Ground Up 09:09 Workforce Pipelines Beyond Nursing 12:05 "We Don't Have a Staffing Shortage. We Have a Design Problem." 14:24 The ROI of Retention and Evidence-Based Training 17:13 Generational Intelligence and the New Rules of Loyalty 21:29 Why Younger Workers Prioritize Mental Health Over Money 23:20 Mapping Your Workforce by Generation 28:28 Transferable Skills vs. Technical Skills 30:25 Inside Elizabeth's Leadership Framework and New Book 35:16 Gen Z, Technology, and the Future of Learning 37:15 Can VR Improve Leadership Development? 38:31 Preparing Gen Alpha for the Workforce 40:27 Final Thoughts & Where to Connect with Elizabeth Guest: Elizabeth Jeanes [https://linkedin.com/in/elizabeth-jeanes] Host: Keith Washington - Companions in Courage Foundation [https://cic16.org/] Sponsored by: Simplifi Medical [https://simplifimedical.com/] Audio/Video: Tim Jones - Health Nuts Media [https://healthnutsmedia.com/] Marketing: Josh Troop - Troop-Creative [https://www.troop-creative.com/] Learn More at: www.beyond-blueprint.com [http://www.beyond-blueprint.com/]

EP47 - Teaching Doctors in the Age of AI: Trust, Risk, and the Future of Clinical Thinking

In this episode, we explore how AI is reshaping physician training — and what medical educators must do now to keep pace. Dr. May Lin (Touro University), Dr. Saroj Misra (A.T. Still University), Dr. Renu Agnihotri (A.T. Still University), and Dr. Shivam Vedak (Stanford University) share what's working and what isn't when it comes to preparing residents and medical students to use AI responsibly. From faculty development and inconsistent guidance across clinical sites, to automation bias and the pressure to see more patients faster, the panel examines the hard tradeoffs facing medical education today — and why building critical thinking alongside AI fluency is the only path forward. Key Takeaways * Faculty development is critical — attendings must understand AI tools before they can effectively guide trainees. * Consistent AI policies across clinical training sites help reduce mixed messages for residents and students. * AI should be thought of as augmented intelligence, not a shortcut or replacement for clinical reasoning. * Trainees who understand how AI models work are better equipped to recognize when they fail. * Automation bias is a real risk — trainees may accept incorrect AI outputs without sufficient scrutiny. * Core clinical reasoning skills must be developed independently of AI, especially in early training. * Hospital productivity pressures can undermine the thorough, deliberate habits that good training requires. * Patients using AI without clinical background face similar — and potentially greater — risks than trainees. * The EHR era offers a cautionary tale: physicians must engage early to shape how AI tools are built and deployed. * Building a healthy relationship with AI from the start of medical education sets the foundation for safer clinical practice. Episode Highlights * 00:00 Intro * 02:29 Are We Training Doctors for the World They're Entering? * 04:05 Meet the Guests * 05:08 Aligning Faculty and Trainees on AI Use * 08:36 Moving Beyond the "AI as Cheating" Mindset * 10:20 Which AI Tools Show the Most Clinical Promise? * 13:05 Building the Right Relationship with AI from Day One * 15:27 Why Upskilling the Whole Generation Matters * 18:58 Teaching How AI Models Work — and Fail * 20:01 The Faculty Development Challenge * 20:39 How Do You Know a Trainee Truly Understands? * 25:32 Balancing Thoroughness with Hospital Productivity Pressure * 27:15 AI Should Improve Care Quality, Not Just Speed * 29:32 When Patients Use AI Without Clinical Reasoning * 31:15 Dr. Misra's Challenge: Should Any Task Be Off-Limits for AI? * 33:18 Renu: The Cognitive Exoskeleton and Productive Struggle * 34:33 May: A Ban on Banning AI * 36:52 Shivam: Protect the Process of Clinical Reasoning * 37:50 Final Thoughts & Closing Guests: Dr. May Lin [https://linkedin.com/in/drmaylin], Dr. Saroj Misra [https://linkedin.com/in/saroj-misra72], Dr. Renu Agnihotri [https://linkedin.com/in/dr-renu-agnihotri-md-iemr], Dr. Shivam Vedak [https://linkedin.com/in/svedak] Host: Gregg Malkary - Lighthouse Healthtech [https://www.lighthouse-healthtech.com/] Cohost: Keith Washington - Companions in Courage Foundation [https://cic16.org/] Sponsored by: Simplifi Medical [https://simplifimedical.com/] Audio/Video: Tim Jones - Health Nuts Media [https://healthnutsmedia.com/] Marketing: Josh Troop - Troop-Creative [https://www.troop-creative.com/] Learn More at: www.beyond-blueprint.com [http://www.beyond-blueprint.com/]

EP46 - AMDIS Roundtable - Restoring Clinical Cognition in the AI-Ready EHR

In this AMDIS Roundtable, Dr. Eve Cunningham (Cadence), Dr. Howard Landa (Adventist Health), and Dr. Deepti Pandita (UCI Health) explore what it really means to build an AI-ready EHR. Moving beyond features and vendor roadmaps, they examine how data governance, workflow design, and clinical validation shape the physician's day — from inbox overload to exam-room disconnect. Together, they discuss shadow AI, cognitive burden, and the hard tradeoffs between optimizing legacy workflows and redesigning care. Their message is clear: the next generation EHR isn't about adding more technology — it's about restoring clinical cognition and rebuilding trust in how care gets delivered. Key Takeaways * Bad data leads to bad AI — governance must come first. * AI is math, not magic — noisy and inconsistent data amplify risk. * Clinical validation is as important as data hygiene for meaningful AI use. * The EHR disrupts connection when clinicians must focus on screens instead of patients. * Ambient documentation restores presence but does not yet create a true intelligent clinical partner. * Most AI tools solve isolated tasks, not the full end-to-end care workflow. * Health systems need internal prompt and AI literacy — clinicians are not trained engineers. * Third-party innovation fills gaps, but long contracts slow adaptation. * Shadow AI often signals unmet needs, not noncompliance. * Governance should enable safe experimentation rather than block innovation. * Clinicians remain accountable for AI-driven decisions under current regulations. * Patients are rapidly adopting AI tools, often without reliable guardrails. * AI's highest near-term value is reducing cognitive and administrative burden. * True progress requires redesigning workflows, not endlessly optimizing legacy processes. * Leadership prioritization, not technology limits, often slows transformation. * The next generation EHR must restore clinical cognition and trust. Episode Highlights 00:00 | The Key to a Successful EHR: Restoring Clinical Cognition 02:36 | When the EHR Slows Care Instead of Supporting It 01:08 | Why This Isn't About Features or Vendor Roadmaps 02:36 | When the EHR Slows Care Instead of Supporting It 03:46 | AI Is Math, Not Magic 04:05 | Data Governance as the Prerequisite for AI 05:23 | Governance + Clinical Validation = Actionable Intelligence 06:44 | The Keyboard Breaks the Sacred Patient Encounter 08:25 | Ambient Tools and the Return of Joy in Medicine 09:19 | The "Intelligence-Ready" EHR Vision 11:10 | Why Clinicians Aren't Prompt Engineers 12:39 | Is Epic Cosmos Ready for Prime Time? 14:01 | Contextual, Specialty-Specific Views at the Point of Care 15:08 | Third-Party Innovation vs EHR Vendor Lag 16:49 | When to Replace vs Layer New AI Tools 18:09 | Shadow AI as a Signal of Unmet Need 19:08 | Enabling Safe Experimentation Through Governance 20:55 | If AI Makes a Mistake, Who Is Liable? 23:35 | Where AI Should Help First: The Patient Journey 25:19 | Patients Are Already Using AI for Medical Advice 27:33 | Cognitive Scaffolding: Removing Clinical Noise 28:31 | Intelligent Synthesis vs Data Mining 29:13 | The Peer Challenge: How Do We Move 2–3x Faster? 30:02 | Leadership Indecision Slows Transformation 30:47 | Stop Optimizing Legacy Workflows 31:46 | Final Message: Technology Isn't the Barrier Anymore Guests: Dr. Eve Cunningham [https://linkedin.com/in/evecunninghammd], Dr. Howard Landa [https://linkedin.com/in/howard-landa], Dr. Deepti Pandita [https://linkedin.com/in/deepti-pandita-b361ab117] Host: Gregg Malkary - Lighthouse Healthtech [https://www.lighthouse-healthtech.com/] Cohost: Keith Washington - Companions in Courage Foundation [https://cic16.org/] Sponsored by: Simplifi Medical [https://simplifimedical.com/] & Storage Systems Unlimited [https://www.storagesystemsul.com/] Audio/Video: Tim Jones - Health Nuts Media [https://healthnutsmedia.com/] Marketing: Josh Troop - Troop-Creative [https://www.troop-creative.com/] Learn More at: www.beyond-blueprint.com [http://www.beyond-blueprint.com/]