Excellent Nursing Care Close to Home with Camille Filoromo, BSN, M.E.d., Ph.D., RN, NEA-BC

MUSC Health patients who call the Lancaster and Chester county areas of South Carolina home don’t have to go far from where they live and work to receive higher levels of care. There are excellent MUSC Health primary care physicians and specialists across these two counties and about 400 nurses between the Lancaster and Chester hospitals.

Camille Filoromo is the chief nursing officer at MUSC Health’s Lancaster and Chester hospitals. In this episode of Advance with MUSC Health, she talks about this special community of talented nurses and how patients benefit from receiving nursing close to home.

“While nurses want optimal outcomes for anybody that they care for, it's especially close in our hearts and minds when it's folks that we know, we understand, we know their families, and we share a common geography, but also a culture.”
- Camille Filoromo

Topics covered in this show

• Filoromo was drawn to a career in medicine after witnessing her mother have a heart attack at home at a young age.
• She says nurses are motivated to serve and she says this is especially true of her staff at MUSC Health who have a huge sense of pride and fulfillment for the care they give their patients.
• Being part of MUSC Health is important to the Lancaster and Chester communities because Filoromo says having an academic facility in the middle of a rural area allows access to cutting edge care such as 3D mammography and robotic surgeries.
• People living in rural areas often have difficulty with access to care including primary care and screenings. Now that MUSC Health is in Lancaster and Chester and is hiring record numbers of dozens of new physicians and nurses, she expects to see more people in this area served than ever before.
• She talks about taking on the chief nursing officer role at MUSC Health's Lancaster and Chester Hospitals during the COVID-19 pandemic and why she saw the timing as a perfect way to share her strong leadership and innovative initiatives with a dedicated team.
• Nurses are a critical part of telehealth success, launching new initiatives and providing a continuum of care for patients. Filoromo is particularly proud of nurse-led initiatives such as an infusion center that was started during the Delta surge of the COVID-19 pandemic.
• Filoromo is also looking for new ways to address nurse fatigue and nurse shortages such as partnering with local high schools to help students transition to nursing programs soon after graduation.

Transcript

Erin Spain [00:00:04] Welcome to advance with U.S. Health. I'm your host, Erin Spain. This show's mission is to help you find ways to preserve and optimize your health and get the care you need to live well. MUSC Health patients who call the Lancaster and Chester County areas of South Carolina home don't have to go far from where they live and work to receive higher levels of care. There are excellent MUSC Health primary care physicians and specialists across these two counties and about 400 nurses between the Lancaster and Chester hospitals. Camille Filoromo is the chief nursing officer at MUSC Health's Lancaster and Chester Hospitals. She's here to talk about this special community of talented nurses and how patients benefit from receiving nursing care close to home. Welcome.

Camille Filoromo [00:00:54] Thanks. It's great to be here, Erin.

Erin Spain [00:00:56] Take me back to the beginning of your career. What made you want to become a nurse?

Camille Filoromo [00:01:00] My mother had a significant heart condition throughout my childhood. She passed away when I was pretty young from a heart attack at home. And my father and I were there alone when it occurred. And neither of us knew CPR. And this was a pretty defining moment for me in that I never wanted to feel helpless like that again or in that situation. And it wasn't just about knowing CPR. It was this complete lack of knowledge around health, emergent situations, just the entire picture.

Erin Spain [00:01:26] It might not be uncommon for a patient to see a relative or neighbor working as a nurse here in the Lancaster and Chester hospitals. Tell me about the benefits of having a close knit community of patients and nurses, and how does it impact the care that patients receive?

Camille Filoromo [00:01:40] It's my thoughts that nurses are motivated to serve, and that service philosophy really begins in the community setting. So, those we serve here are our neighbors, our friends, our family, and many come just because they know in turn, their friends and neighbors are the nurses here that are dedicated to their well-being. And while nurses want optimal outcomes for anybody that they care for, it's especially close in our hearts and minds when it's folks that we know, we understand, we know their families, and we share a common geography, but also a culture. So, I think the great thing for our amazing nurses in this division is that they get to see the folks that they've cared for in the community in the entire continuum of care and with outcomes that give us a huge sense of pride and fulfillment when we see them after we render care to them.

Erin Spain [00:02:25] MUSC Health is part of an academic medical center. Explain that. And the benefit for patients who come to emergency health in Lancaster or Chester. What's the benefit of being part of the MUSC Health system?

Camille Filoromo [00:02:37] I think it's our dedication to academic mission and research. And not only that, I think it's a commitment to innovation as well. So, I think that's what an academic enterprise brings to a smaller rural community hospital. We've certainly answered the call to community needs as an academic system here. And if I just think about one of the things that we do here that is exclusive in this particular area is in our nursing shared governance, we really push a spirit of inquiry, which means we're asking nurses to think outside the box. Somebody said to me, "You took a chief nursing officer job in the middle of a pandemic. What were you thinking?" The first thing out of my mouth is what a better time for really strong leadership. When you're coming into an academic medical center, your expectations are different. You know that you're coming for cutting edge care. And I think that's one of the things that we offer here. This is not the Lancaster Memorial Hospital that you might remember from five, ten years ago. This is an academic facility in the middle of a rural area that serves a very dedicated population to this hospital. So we have 3D mammography, we have the Da Vinci robot. We're doing robotic surgeries. We're about to embark on a transplant program. We've recruited 36 physicians in one year. That's something in my 30 year career that's unheard of. So, this is cutting edge medicine right next to home.

Erin Spain [00:03:59] You mentioned that this encompasses a more rural area of the state. So, tell me, are there common issues or health concerns that patients face in these rural areas? And how do your nurses help navigate these issues.

Camille Filoromo [00:04:11] Like many other areas of the country that are rural you have certain lack of access challenges that are mutually exclusive to those areas. So, we're talking about mostly wellness screening. We're talking about access to primary care. We talk a lot about in public health,how we want folks to do preventive medicine, but we've got to give them access. And I think that's what we're about here. And that's really part of our mission at MUSC. And the reason for this broad footprint that we have across the state is to make sure that we are improving access for those that we serve across the state. And this is truer in our rural areas than anywhere else. It's important. So like our lung cancer screening program, for example, we did well over 200 screenings by a nurse practitioner led program since last April that already identified numerous people in this community that otherwise would have never gotten diagnosed and never been able to gain access to manage this cancer. Those types of things to me that are very mission driven and then also making sure that we are bringing the technology to the people. That's the leverage that we have as an academic system.

Erin Spain [00:05:26] What do you want people to know about the care that they can receive at the Lancaster and Chester hospitals?

Camille Filoromo [00:05:33] The expectations of seeking care in an academic facility far surpass anything you're going to get in the immediate area. Number one, you're getting access to a host across the entire state of specialists and and exclusive type procedures and surgeries that elsewhere wouldn't be provided necessarily. And I think the wellness initiatives are huge as well, too. So we've been able to incorporate a lot of that work. Care close to home is tantamount for anybody. And I think when you can offer primary care to give these people a place to start where they can grow in a relationship with a provider who gets to know them and understand their individual care needs. And most importantly is there. Is part of their community, part of the geography, part of that culture. They're going to stay with you and then you're going to have greater opportunities to influence their wellness and then have them in your continuum of care. So, you know, most of the care that we render in our facility here, we're servicing the entire family. So it might not just be, you know, mom and dad, it's you know, we've got kids that are going to the pediatricians and we've got parents and grandparents and great grandparents that are seeing folks within our facility as well. And that's really what this community is about. So, because of there's something here that we need to refer to another specialist, it's still close to home. You're right here. We're going to take great care of you.

Erin Spain [00:07:00] Tell me about the cases when patients do need to go to Charlson for some reason, maybe for a surgery. How is your team able to support them before and after the procedure close to home?

Camille Filoromo [00:07:11] We work very closely as a system. Follow up is so important. The focus is not just on treatment. The focus is really again on community wellness and diagnostics and prevention. I mean, this is really where we are going. So it's not only consistent with what Healthy People 2030 is telling us to do and what we hear on the news every night. But it's also consistent with how we're going to drive health care to that next level with our communities.

Erin Spain [00:07:36] How are you using telehealth right now with patients who are local and then as far as hooking them up with specialists in Charleston?

Camille Filoromo [00:07:44] Most of the specialists we can hook them up with right here at Lancaster while they're with us. And and we do that not only using folks in our own division here, but but also folks in the Charleston division as well. Or it might be Florence. Could be Columbia. It depends on what the specialty is. So we do tap into all of those that are needed. And I think that's a huge advantage. I think, you know, in the future that will become even more broad. So, so that's one of our again, another one of our initiatives across the system is to really focus on how we get that care to where it's needed.

Erin Spain [00:08:18] How do your nurses embrace innovation and technology in nursing?

Camille Filoromo [00:08:21] Not just about having a spirit of inquiry and wanting to know more. This is a really about a whole other level to that, about making sure that you really understand disease progression and that you're able to educate the patients that you serve in a meaningful way, in a way that they can understand, and to make sure that you remediate with them so that they're clear about what their plans are after they finished their care with us. And then, you know, you just mentioned telehealth, yet nurses are a critical part of the success of telehealth because they're the ones that are actually with that automated piece of equipment that are in the room with the patient for that consultation. So, so they are the essentially the eyes, the hands, the ears, the real person in place of that particular domain. For us, nursing is a healing touch. You know, I had a CNO tell me very early in my career that nurses heal with a compassion. And I can tell you after doing what I do for 30 years, I want very much to reach back out to her and say that is very true, that we heal with compassion, but we do so very much more. We heal with compassion and skill and the desire to carry our profession to the next level and to carry health care and policy into such a way that we remove the burden of illness for those that we serve.

Erin Spain [00:09:44] As I mentioned at the beginning of the show, there are more than 400 nurses across these two hospitals and nursing right now with the pandemic, it's just been a field where these folks have been under a lot of pressure. Tell me about how things are going right now with your nurses and how you're able to support them so that they can in turn, you know, give back to the community and do their job that they do so well.

Camille Filoromo [00:10:07] So nursing fatigue is significant. To be completely transparent, it's very real. The things that you hear and see in social media and on the news, those are very real scenarios for nursing right now. And it's also why we encourage our communities to seek health care for wellness as much as you would for emergencies. Because our message is about prevention. What keeps me awake at night is ensuring that our nurses have resilience. And right now they've demonstrated amazing resilience, not just in this community, but across the state for us at MUSC. And it's probably the most predominant area of concentration for us in the division right now, in addition to recruiting and retention of top talent nurses, because as you know, that is a national issue that we're addressing right now. So, what we've seen as truly congruent with what you're seeing in the news across the country, we're working on several different fronts to address the ability to provide nursing education. That's a challenge. And then many of our staff are partnered as clinical instructors with universities and tech schools. We're trying to do our contribution to make sure that we are getting additional folks into the workplace to help to relieve some of this fatigue and make sure that we are providing resources to our staff to be able to to debrief and just take a moment while on the job, especially when you're dealing with such a heavy burden of illness. We also encourage a lot of continuing education and certification of our current nurses. And this is critical, I think, in keeping this is investing in your nurses and investing not only in the profession and driving the industry of nursing forward, but really investing in your people. And that inspires loyalty. And we certainly want to ingratiate ourselves to those people that are bringing that talent to the bedside and providing great care. And we've also reached out to our local school districts. And I think this is kind of where nursing is probably going now and throughout in the future is partnering with schools very early on, especially in dual enrollment programs. Catching these young people in very early years of high school is start getting those interests in health care careers and offering them early training. I mean, some of these young people can graduate high school with two years of of an associate's degree already completed. How crazy would we be not to latch on to that and make sure that we're providing an avenue that they can further their career in nursing and get them to the bedside, get them contributing to their communities to provide care.

Erin Spain [00:12:32] Tell me about some nurse led initiatives that you were the most proud of.

Camille Filoromo [00:12:36] Specifically our infusion clinic in our response to the Delta variant, where you knew that there was a need to be offering infusions to the public. And I can tell you that we opened up an infusion clinic in one of our offices here on campus and immediately began seeing patients in a very safe environment so that we could quickly get them in and get them scheduled because, you know, that's a very time sensitive thing in terms of the treatment once the symptomatology starts. And so I'm very proud of that. I can tell you the data is overwhelming. Not only did we have really great outcomes with these patients, but we also had great experiential data with these folks as well too. In terms of their contact with our hospitals. We do have a very robust nursing shared governance and one of the things that I believe in, my leadership model is really about putting structural empowerment into the hands of the nurses at the point of care. These are your direct care folks that will always tell you what's up at the point of care and where you've got opportunities to improve. And I think, you know, we have to provide venues as leaders for them to be able to voice that, and they do. So they've made many advances in the short period of time that they've been assembled as a shared government group and driving innovation every day. One of the things that they're working right now on is looking at new and innovative staffing models. We know that we are faced with a national shortage and we've got to do business a little differently going forward. And so what do you do when you have limited resources and how do you respond to that in a meaningful way, in a very safe way that's still ensures not only great outcomes for your patients, but good staff satisfaction as well? So, I think that those are really critical components that the nursing shared governance is working on. Couldn't be prouder to be part of this team to see the work that they put together every day.

Erin Spain [00:14:28] What do you do to optimize your health and live?

Camille Filoromo [00:14:31] Well, I do try to run regularly. I have a lot of hobbies and I enjoy time with my family and I think I try to do as best as I possibly can in making sure that I've got some work life balance in there.

Erin Spain [00:14:45] Thank you so much for coming on the show and telling us all about the incredible nursing staff and MUSC Health lancaster and Chester.

Camille Filoromo [00:14:52] You bet. Thank you so much for your time and have a great day.

Erin Spain [00:14:59] For more information on this podcast, check out advance.muschealth.org.