Navigating the Waves of Change in Healthcare Leadership

With a rich background that includes roles such as Patient Care Director at NYP/Columbia University Irving Medical Center and Director of Nursing at New York Presbyterian-Brooklyn Methodist Hospital, Patricia Punzalan has demonstrated a sincere commitment to advancing healthcare practices. Her extensive experience spans clinical work, academia and quality improvement, showcasing her versatility and deep understanding of the healthcare sector. Punzalan currently serves as the Sr. Director for Patient Care Services at Dignity Health, bringing over a year of dedicated service to the organization. Her primary focus is on realigning clinical practices with evidence-based guidelines, along with redesigning workflows to eliminate redundancy and enhance efficiency. Her current projects aim at laying the groundwork for achieving excellence in patient care services.

Through this article, Punzalan discusses how she navigated her transition from the Philippines to the U.S. healthcare system, her ascent through various leadership roles and her insights on the current challenges and trends in the U.S. healthcare.

How has your journey been in the patient care services industry?

My journey in the healthcare industry began when I migrated to the U.S. from the Philippines in 2004. At the start of my career in Brooklyn, New York, I took on the role of a nurse manager, despite arriving from a foreign country with limited knowledge of the U.S. healthcare regulatory requirements like Joint Commission standards. I embarked on a steep learning journey, educating myself from scratch through online resources and with the support of a few trusted colleagues. Fast forward to today, that rigorous learning curve and the support I received have been instrumental in shaping my career and bringing me to where I stand now.

“Despite the advancements AI brings, the irreplaceable value of human touch and empathy in healthcare remains paramount, underscoring that technology cannot replace the humanity healthcare workers provide.”

I started with two community hospitals in Brooklyn before advancing to a major healthcare system on the East Coast as a patient care director. Returning to Brooklyn at New York Presbyterian's Methodist Hospital, I served as a director, overseeing acute care services, including emergency, critical care and other units. Throughout my career, I have held various leadership roles with expertise in process improvement, which I believe, is an essential skill in leadership.

Currently, as a Senior Director of Nursing, my primary focus is to ensure the nursing departments I manage align with the organization's strategic goals, providing direction and support to ensure a cohesive effort toward our objectives.

Where do you expect the healthcare industry moving forward in the next 12 to 18 months?

Globally, the healthcare industry has made significant strides but continues to face challenges from regulatory changes, evolving reimbursement models and the recent healthcare plans discussed in the State of the Union address, including medication costs and copay reductions. These developments in a complex geopolitical landscape will undoubtedly influence future healthcare directions. Besides, the sector struggles with hiring and retaining healthcare workers, with a notable shift of professionals to other industries. International recruitment is being revisited as a solution, although it raises concerns about its impact on the source countries, potentially leading to a brain drain.

In the contemporary climate, the rise of artificial intelligence (AI) represents a major technological evolution, offering improvements in efficiency, efficacy and patient safety. However, despite the advancements AI brings, the irreplaceable value of human touch and empathy in healthcare remains paramount, underscoring that technology cannot replace the humanity healthcare workers provide.

When it comes to Dignity Health, it is one of the largest health systems in the nation, with more than 400 care centers. We are embarking on an exciting new chapter as two of our hospitals, St. Mary’s Medical Center (SMMC) and Saint Francis Memorial Hospital (SFMH), transition into the UCSF Health system due to a recent acquisition. This integration is crucial as UCSF is one of the premier healthcare systems on the West Coast and among the top 20 hospitals nationwide, renowned for its Magnet recognition for nursing excellence. Unlike UCSF's traditionally academic focus, St. Mary's and St. Francis specialize in community-based healthcare, marking a complementary merger that enhances our collective strengths. As we shift from Dignity Health to UCSF Health, we are excited to blend Dignity Health's ethos of human kindness with UCSF's commitment to excellence, promising to deliver superior healthcare to the San Francisco community.

What are the key limitations in patient care services hinder providers from delivering the most effective solutions to challenges?

The need to consolidate clinical, managerial and financial platforms into a single, standardized system is essential for institutions. Such a unified platform, particularly for HR and people management, would streamline processes by housing information on licensure, certifications, continuing education, payroll, benefits, recruitment and more in one location. This integration is crucial for improving efficiency, as it saves time and, consequently, money.

How do emerging trends in patient care services impact the fulfillment of business requirements?

Among the emerging trends in patient care services, AI has become a prominent topic in healthcare, a field traditionally driven by human expertise. Notably, innovations in hiring and recruitment are being explored, aiming to optimize initial screening processes through AI-based decision support systems that evaluate candidates against behavioral and qualitative metrics. This development could significantly impact resume formats and relieve talent acquisition specialists of certain administrative tasks. Yet, the importance of human interaction remains irreplaceable in these processes.

Concepts like virtual nursing are transforming healthcare delivery, though their full implications on care quality, reimbursement and team dynamics are still under evaluation. While AI contributes to decision-making by analyzing data, it cannot substitute the critical thinking derived from personal experience.

Given your extensive experience in patient care services, what advice would you offer to your peers and aspiring professionals in this field?

In today’s VUCA world—characterized by volatility, uncertainty, complexity and ambiguity—it is crucial to steadfastly adhere to your core values and the foundational reasons you chose healthcare. Despite inevitable moments of doubt or deviation, the key to navigating challenges lies in consistently returning to your fundamental principles. Self-awareness and self-management emerge as critical behaviors in this journey, enabling you to remain aligned with your mission and purpose in healthcare.

As a nurse leader, my aim transcends promoting personal beliefs to influencing others toward shared values centered on patient safety and delivering the highest quality of care. My essential duty is to embody my core values, especially in the unpredictable and complex world we face today.

I believe it is important to lead authentically, standing firm in one’s beliefs even when you stand alone, and to return to one’s foundational principles should you stray. A commitment to making a difference in healthcare is both a personal and social responsibility, influencing every decision you make. Understanding yourself better enables one to lead effectively, and managing responses allows one to navigate the complexities of human interaction.