Kathryn Lopez
March 2024
Kathryn
Lopez
,
DNP, RN, CCRN
Cardiovascular ICU and Cardiovascular Surgical Unit
UCI Health
Orange
,
CA
United States
Kay’s situational awareness is truly remarkable. She takes pride in the unit and the staff that care for the patients. She has high expectations for patient outcomes because she knows the teams’ capabilities and expects each team contributor to give their best.
I am honored to have the opportunity to nominate Kathryn Kay Anotado Lopez, nurse manager of the Cardiovascular ICU (CVICU) and Cardiovascular Surgical Unit (CVSU) at UCI Health, for the DAISY Nurse Leader Award. Kay has been a respected UCI Health employee for over 18 years and has demonstrated all the values that the DAISY Foundation represents since the day I met her almost 14 years ago. I will focus on stories from the most recent few years to explain why this individual is so deserving of this special recognition.
At the onset of the COVID-19 pandemic in early 2020, Kay took on the challenging role of nurse manager of the brand new, acuity-adaptable CVSU. She successfully hired over 40 staff within a matter of weeks, but perhaps more importantly, she made the unit feel like a cohesive team before the unit even opened its doors for the first patient. This was partly due to the group training that took place within the unit during the orientation process but more so due to the shared sense of purpose that Kay was able to establish from day one. Kay knew the background of every single staff member and took the time to genuinely get to know people. She learned strengths and interests and somehow did this without people even seeming to realize it at the time. Throughout the years, she presented countless opportunities to staff, but she also individualized opportunities based on interests. For example, there was a nurse interested in nursing informatics, and she spoke with him individually when the opportunity to be an Epic superuser arose. For nurses interested in getting into nursing management, she would notify them of house-wide opportunities if it meant the nurse would be a step closer to achieving their career goals. This strengths-based approach to leadership makes staff feel valued for what they bring to the table and supported in their future endeavors, whether within the unit or elsewhere. Kay creates psychological safety and a safe space for staff to learn and grow. Her selfless ability to mentor and promote growth from within is truly unparalleled.
The acuity-adaptable model of the CVSU was one of the first of its kind at the time of opening, with the primary focus being cardiac surgery patients. Kay was, of course, very interested in patient outcomes to determine the effectiveness of this new model. Kay took the initiative to obtain her Doctorate in Nursing Practice from the University of California, Irvine, and focused her defense on a retrospective review of the failure to rescue rates in postoperative cardiac surgery patients in the acuity-adaptable model versus the standard model (outcomes were better in the acuity-adaptable model that permitted patients to stay in the same room, regardless of telemetry or stepdown level of care). Kay fully supports her staff in advancing their education. She is accommodating of schedules and supportive of goals to ensure everyone is where they want to be. Additionally, Kay takes pride in seeing others succeed and is prompt to share individuals’ accomplishments with the entire team. Whether it be passing a certification exam or graduating with an advanced degree, every success is appreciated and celebrated at the unit level through emails, shift huddles, staff meetings, announcement boards, and/or unit practice council meetings, to name a few, along with photos to add a personal touch.
During the peak of the pandemic in 2021, Kay accepted the challenge of becoming manager of the CVICU in addition to the CVSU. At the time, the CVICU and the Medical ICU were considered one 24-bed unit despite the vastly different surgical versus medical patient populations. Kay collaborated with her fellow leaders and stakeholders to help facilitate the official separation of the two units, which allowed for the organization’s first 12-bed ICU specifically designated for cardiac surgery patients. Challenges inevitably go along with such a robust organizational structural change, and Kay overcame every challenge with poise, grace, professionalism, optimism, and patience. One of Kay’s leadership traits I find most admirable is that she asks questions; she asks questions to ancillary staff up to attending surgeons. Kay asked many questions to find out what the staff valued, defined current processes versus desired outcomes, and collaborated on best actions to take moving forward. Her approach is all-inclusive and multidisciplinary; she does not make isolated decisions, a testament to the value she places on each individual team member’s opinion. As a result, the CVICU has developed into a unit with a healthy, supportive work environment with staff who lift each other up and share a common love for cardiac surgery patients.
Kay’s interdisciplinary approach to leading is reflected in her daily work. She often rounds on the units, asking questions to staff and patients. Her rounding helps hold staff accountable for quality care and also gives her the opportunity to recognize nurses that patients mention as going above and beyond in real time. While undoubtedly busy with her day-to-day obligations, she maintains an open-door policy and is available to staff 24/7. Open communication is always reflected in her leadership. While staff are welcomed and encouraged to approach her, she also takes the initiative to be present within the units. I have never seen a manager know so much about every single patient in the unit, both CVICU and CVSU. Kay’s situational awareness is truly remarkable. She takes pride in the unit and the staff that care for the patients. She has high expectations for patient outcomes because she knows the teams’ capabilities and expects each team contributor to give their best.
In situations in which policies or processes are not adhered to as expected, Kay handles it gracefully using Just Culture. Depending on the plan of action needed, she will collaborate with the key stakeholders to ensure everyone is on the same page. This alone can be a difficult task given her units are home to patients in the cardiovascular, thoracic, cardiology, heart failure, and medicine service lines. Regardless, Kay is not one to take the path of least resistance but rather does what is necessary to ensure the highest quality of care for patients moving forward. She demonstrates the values of shared governance, appreciates the opinions of others, and implements a multidisciplinary approach to problem-solving. One such action that relatively recently came to fruition is the implementation of nurse-led rounds in the CVICU. At the start of each shift (night shift included), the ACCM (Anesthesiology Critical Care Medicine) team performs nurse-led rounds on all cardiac surgery patients in the ICU. This allows for streamlined communication and closer relationships among team members, both of which have been linked to improved patient outcomes. In another example, thanks largely in part to Kay’s strong collaborative skills, the CVICU can now offer qualifying patients verticalization therapy (VT therapy), allowing earlier progressive mobility for the unit’s critical patients. This required a strong partnership with the ACCM attendings and Director of Critical Care Nursing to get the initial approval, followed by a collaboration with the Nursing Quality, Research, & Education department to create and implement a standardized order set for the VT therapy, which is now available in Epic for the providers to order.
One of the challenging decisions Kay has encountered was whether to hire new graduate nurses directly into the CVICU, a feat that had never been attempted given the high-acuity unit houses not only post-operative cardiac surgery patients, but also specialty devices such as extracorporeal membrane oxygenation (ECMO), intra-aortic balloon pump (IABP), Impella, and left ventricular assist devices (LVAD). With close collaboration among the unit leadership, clinical nurse educator, preceptors, and orientees, the CVICU now has a well-established process for onboarding new graduate nurses, along with dedicated preceptors. Regularly scheduled progress meetings throughout the orientation process ensure both the preceptor and preceptee feel supported, again creating a safe space to highlight strengths and convert opportunities for improvement into actionable SMART goals throughout the orientation. In fact, Kay submitted an abstract, “Improving Nurse Retention Through a Collaborative Approach to Orientation,” that was accepted for a poster presentation at the American Organization for Nursing Leadership national conference in New Orleans in April 2024. Our clinical nurse educator and I are elated and proud to join her in sharing the impressive outcomes to leaders from across the country.
Kay’s dedication does not end at the unit level. She recently helped spearhead the brand-new Peer-to-Peer Mentorship Program at UCI Health in partnership with the Human Resources Wellness Team and Faculty & Staff Support Services on campus. Kay matched the more veteran mentors with the newer-to-leadership mentees, which laid the foundation for the establishment of valuable relationships among the organization’s leaders, both inpatient and ambulatory. Cohort 1 of the program recently ended in late 2023 and planning is in place for the initiation of cohort 2, which will incorporate the input and recommendations from the mentors and mentees from the inaugural cohort. Kay has served as an incomparable mentor to many nurses, myself included, particularly as I transitioned into new roles throughout my career.
Unsurprisingly, Kay has been the recipient of multiple awards and nominations over the years; however, she is a humble leader and enjoys highlighting the accomplishments of her staff and teams. She takes the time to nominate her team members for DAISY Awards, Nurse Exemplar Awards, ARIISE Awards, and Great Catch Awards, to name a few. Despite her very large team of over 100 staff members, she still writes individualized personal notes to her team members. At special events and celebrations, Kay is the one behind the camera, documenting the moments that she then disseminates to the entire team to enjoy. Kay embodies all elements of a human-centered leader, and not because it is a new organizational initiative, but rather because it is who she is naturally. She is an absolute gem for her units and the enterprise as a whole.
Kay’s humble, supportive, human-centered leadership style not only leads to a culture of excellence among the units, but also patient outcomes: 1000+ days and counting without a catheter-associated urinary tract infection (CAUTI) in the CVSU, two years and counting without a central-line associated bloodstream infection (CLABSI) in the CVSU, and seven consecutive quarters and counting without a surgical site infection (SSI) in post-operative cardiac surgery patients in the CVICU and CVSU as of March 2024.
The explanation of why Kathryn Kay Anotado Lopez deserves the DAISY Nurse Leader Award could easily continue. Thank you to UCI Health and the DAISY Foundation for the opportunity to shed light on this extraordinary individual and her contributions to the nursing profession.
At the onset of the COVID-19 pandemic in early 2020, Kay took on the challenging role of nurse manager of the brand new, acuity-adaptable CVSU. She successfully hired over 40 staff within a matter of weeks, but perhaps more importantly, she made the unit feel like a cohesive team before the unit even opened its doors for the first patient. This was partly due to the group training that took place within the unit during the orientation process but more so due to the shared sense of purpose that Kay was able to establish from day one. Kay knew the background of every single staff member and took the time to genuinely get to know people. She learned strengths and interests and somehow did this without people even seeming to realize it at the time. Throughout the years, she presented countless opportunities to staff, but she also individualized opportunities based on interests. For example, there was a nurse interested in nursing informatics, and she spoke with him individually when the opportunity to be an Epic superuser arose. For nurses interested in getting into nursing management, she would notify them of house-wide opportunities if it meant the nurse would be a step closer to achieving their career goals. This strengths-based approach to leadership makes staff feel valued for what they bring to the table and supported in their future endeavors, whether within the unit or elsewhere. Kay creates psychological safety and a safe space for staff to learn and grow. Her selfless ability to mentor and promote growth from within is truly unparalleled.
The acuity-adaptable model of the CVSU was one of the first of its kind at the time of opening, with the primary focus being cardiac surgery patients. Kay was, of course, very interested in patient outcomes to determine the effectiveness of this new model. Kay took the initiative to obtain her Doctorate in Nursing Practice from the University of California, Irvine, and focused her defense on a retrospective review of the failure to rescue rates in postoperative cardiac surgery patients in the acuity-adaptable model versus the standard model (outcomes were better in the acuity-adaptable model that permitted patients to stay in the same room, regardless of telemetry or stepdown level of care). Kay fully supports her staff in advancing their education. She is accommodating of schedules and supportive of goals to ensure everyone is where they want to be. Additionally, Kay takes pride in seeing others succeed and is prompt to share individuals’ accomplishments with the entire team. Whether it be passing a certification exam or graduating with an advanced degree, every success is appreciated and celebrated at the unit level through emails, shift huddles, staff meetings, announcement boards, and/or unit practice council meetings, to name a few, along with photos to add a personal touch.
During the peak of the pandemic in 2021, Kay accepted the challenge of becoming manager of the CVICU in addition to the CVSU. At the time, the CVICU and the Medical ICU were considered one 24-bed unit despite the vastly different surgical versus medical patient populations. Kay collaborated with her fellow leaders and stakeholders to help facilitate the official separation of the two units, which allowed for the organization’s first 12-bed ICU specifically designated for cardiac surgery patients. Challenges inevitably go along with such a robust organizational structural change, and Kay overcame every challenge with poise, grace, professionalism, optimism, and patience. One of Kay’s leadership traits I find most admirable is that she asks questions; she asks questions to ancillary staff up to attending surgeons. Kay asked many questions to find out what the staff valued, defined current processes versus desired outcomes, and collaborated on best actions to take moving forward. Her approach is all-inclusive and multidisciplinary; she does not make isolated decisions, a testament to the value she places on each individual team member’s opinion. As a result, the CVICU has developed into a unit with a healthy, supportive work environment with staff who lift each other up and share a common love for cardiac surgery patients.
Kay’s interdisciplinary approach to leading is reflected in her daily work. She often rounds on the units, asking questions to staff and patients. Her rounding helps hold staff accountable for quality care and also gives her the opportunity to recognize nurses that patients mention as going above and beyond in real time. While undoubtedly busy with her day-to-day obligations, she maintains an open-door policy and is available to staff 24/7. Open communication is always reflected in her leadership. While staff are welcomed and encouraged to approach her, she also takes the initiative to be present within the units. I have never seen a manager know so much about every single patient in the unit, both CVICU and CVSU. Kay’s situational awareness is truly remarkable. She takes pride in the unit and the staff that care for the patients. She has high expectations for patient outcomes because she knows the teams’ capabilities and expects each team contributor to give their best.
In situations in which policies or processes are not adhered to as expected, Kay handles it gracefully using Just Culture. Depending on the plan of action needed, she will collaborate with the key stakeholders to ensure everyone is on the same page. This alone can be a difficult task given her units are home to patients in the cardiovascular, thoracic, cardiology, heart failure, and medicine service lines. Regardless, Kay is not one to take the path of least resistance but rather does what is necessary to ensure the highest quality of care for patients moving forward. She demonstrates the values of shared governance, appreciates the opinions of others, and implements a multidisciplinary approach to problem-solving. One such action that relatively recently came to fruition is the implementation of nurse-led rounds in the CVICU. At the start of each shift (night shift included), the ACCM (Anesthesiology Critical Care Medicine) team performs nurse-led rounds on all cardiac surgery patients in the ICU. This allows for streamlined communication and closer relationships among team members, both of which have been linked to improved patient outcomes. In another example, thanks largely in part to Kay’s strong collaborative skills, the CVICU can now offer qualifying patients verticalization therapy (VT therapy), allowing earlier progressive mobility for the unit’s critical patients. This required a strong partnership with the ACCM attendings and Director of Critical Care Nursing to get the initial approval, followed by a collaboration with the Nursing Quality, Research, & Education department to create and implement a standardized order set for the VT therapy, which is now available in Epic for the providers to order.
One of the challenging decisions Kay has encountered was whether to hire new graduate nurses directly into the CVICU, a feat that had never been attempted given the high-acuity unit houses not only post-operative cardiac surgery patients, but also specialty devices such as extracorporeal membrane oxygenation (ECMO), intra-aortic balloon pump (IABP), Impella, and left ventricular assist devices (LVAD). With close collaboration among the unit leadership, clinical nurse educator, preceptors, and orientees, the CVICU now has a well-established process for onboarding new graduate nurses, along with dedicated preceptors. Regularly scheduled progress meetings throughout the orientation process ensure both the preceptor and preceptee feel supported, again creating a safe space to highlight strengths and convert opportunities for improvement into actionable SMART goals throughout the orientation. In fact, Kay submitted an abstract, “Improving Nurse Retention Through a Collaborative Approach to Orientation,” that was accepted for a poster presentation at the American Organization for Nursing Leadership national conference in New Orleans in April 2024. Our clinical nurse educator and I are elated and proud to join her in sharing the impressive outcomes to leaders from across the country.
Kay’s dedication does not end at the unit level. She recently helped spearhead the brand-new Peer-to-Peer Mentorship Program at UCI Health in partnership with the Human Resources Wellness Team and Faculty & Staff Support Services on campus. Kay matched the more veteran mentors with the newer-to-leadership mentees, which laid the foundation for the establishment of valuable relationships among the organization’s leaders, both inpatient and ambulatory. Cohort 1 of the program recently ended in late 2023 and planning is in place for the initiation of cohort 2, which will incorporate the input and recommendations from the mentors and mentees from the inaugural cohort. Kay has served as an incomparable mentor to many nurses, myself included, particularly as I transitioned into new roles throughout my career.
Unsurprisingly, Kay has been the recipient of multiple awards and nominations over the years; however, she is a humble leader and enjoys highlighting the accomplishments of her staff and teams. She takes the time to nominate her team members for DAISY Awards, Nurse Exemplar Awards, ARIISE Awards, and Great Catch Awards, to name a few. Despite her very large team of over 100 staff members, she still writes individualized personal notes to her team members. At special events and celebrations, Kay is the one behind the camera, documenting the moments that she then disseminates to the entire team to enjoy. Kay embodies all elements of a human-centered leader, and not because it is a new organizational initiative, but rather because it is who she is naturally. She is an absolute gem for her units and the enterprise as a whole.
Kay’s humble, supportive, human-centered leadership style not only leads to a culture of excellence among the units, but also patient outcomes: 1000+ days and counting without a catheter-associated urinary tract infection (CAUTI) in the CVSU, two years and counting without a central-line associated bloodstream infection (CLABSI) in the CVSU, and seven consecutive quarters and counting without a surgical site infection (SSI) in post-operative cardiac surgery patients in the CVICU and CVSU as of March 2024.
The explanation of why Kathryn Kay Anotado Lopez deserves the DAISY Nurse Leader Award could easily continue. Thank you to UCI Health and the DAISY Foundation for the opportunity to shed light on this extraordinary individual and her contributions to the nursing profession.