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EDUCATION
An Interview with Cathy Easter from Houston Methodist Global Health Care Services

By Deepa Lalu, MSN, RN-BC, Professional Development Leader, Houston Methodist Hospital

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Can you provide an overview of Houston Methodist Global Health Care Services and its mission?
Houston Methodist Global (HMG) facilitates treatment at Houston Methodist for thousands of international patients from more than 80 countries annually. In addition to international patient care, HMG leverages the subject matter expertise of Houston Methodist’s diverse professionals to provide advisory services, education and training to health care professionals and organizations around the world.
How does Houston Methodist Global collaborate with nurses across different countries?
We partner with international nurses and other health care leaders to enhance clinical excellence and advance the nursing field by sharing Houston Methodist’s best practices, approaches and expertise. We utilize the transformative work done by nurses across our system to provide customized educational programs and tailored consulting services to meet the unique challenges and opportunities facing our global partners. By sending our nurses abroad and bringing nurses from across the globe to Houston for consulting and training programs, we help create relationships and mentoring opportunities worldwide. Throughout this knowledge exchange, our nurses also bring global experiences, knowledge and expertise back to Houston Methodist to integrate into our own practice.
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Can you highlight some initiatives Houston Methodist Global has started to support nurses worldwide?
In Latin America, we provide advisory and educational services to several institutions with Magnet® and Pathway to Excellence® designation aspirations. We also create broader collaborations with nursing leaders throughout these organizations to improve safety, quality, service and innovation through our consulting work. We have a nearly 20-year relationship with the American British Cowdray (ABC) Medical Center in Mexico City. Not only have we helped ABC broadly with nursing collaboration, clinical care and efficiency, but we have also helped them with quality of care. We also have a longstanding relationship with TecSalud in Monterrey, Mexico which is affiliated with Tecnológico de Monterrey, one of North America's largest medical schools. They have two academic hospitals and are pursuing Pathway to Excellence®.
In the Middle East, our emphasis reflects a change in the nursing workforce. In Saudi Arabia, around 30% of nurses are Saudi nationals, while the remaining 70% are expatriates, primarily from countries such as India, the Philippines and Malaysia. Furthermore, expatriate nurses hold a significant proportion of leadership positions within the country. Historically, Saudi nationals comprised an even smaller percentage of the nursing workforce; however, as health care has become a growing priority as part of the Kingdom’s Vision 2030 aspirations, and more women have entered the workforce, they have prioritized advanced nursing education programs for Saudi nationals. Our role is to come alongside Saudi health care and educational institutions to create nursing training programs that expose the next generation of leaders to Houston Methodist’s nursing education, research and practice.
Within both regions, we have done this through a few different avenues. The Global Transformational Leadership program, which includes professionals from all health care backgrounds, including nursing, provides leadership education within the hospital setting. The Nursing Executive Education Program is focused entirely on nursing leadership, educating mid-level and senior-level nurses as they advance their careers. The program provides shadowing experience with Houston Methodist executives, observership in the medical center and community settings and leadership skills courses. This allows us to partner with nurses on the changes they are making in health care delivery today, but also as they’re laying the groundwork for their professional development in health care. Nursing observerships are another way we focus on development for staff-level nurses who have been identified as potential leaders.
How do these initiatives improve nursing practices and patient care globally?
Houston Methodist Global advisory and education programs improve nursing practices and patient care globally by transferring expertise, raising quality standards and building local human capacity. Moreover, these educational and advisory experiences often catalyze change within our partner organizations. Firsthand experience within the Magnet® culture at each of our hospitals can elevate the level of nursing and spark aspirations for continuous improvement and professional development.
Can you share success stories or case studies from these initiatives?
As I mentioned, Houston Methodist has a longstanding relationship with ABC Hospital in Mexico City that began in 2006. ABC is a preeminent institution, and for years, we exchanged best practices in clinical and administrative areas, including key service lines such as cardiology, oncology and orthopedics. However, one of the areas we are most proud of is our collaboration to help ABC achieve its Magnet® designation. It was a seven-year journey that leveraged the incredible nursing leadership expertise across Houston Methodist to help ABC become the first Magnet®-designated institution in Mexico and the second in Latin America. It is truly an honor to come alongside exceptional organizations like ABC that share a commitment to aligning nursing excellence with improved patient outcomes.
About half of my career here at Houston Methodist was on the operations side, and the other half has been in HMG. ABC's Magnet® designation is one of my proudest moments as a leader because of the hard work that so many nurses put into achieving the designation. Especially since there's no competitive advantage to pursuing the designation like there is here in the United States -- it was just truly out of ABC’s desire to elevate the profession. From a skills perspective at the bedside level, especially with our partners in Mexico, nursing has become more respected as an independent profession, not as dependent on their physician colleagues as it was historically. Additionally, one of the things we've seen in our work in Mexico is how the nursing profession creates economic empowerment for nurses and their families. It can change the financial trajectory of these families going forward.
There are only 21 internationally accredited Magnet® hospitals, so ABC's being one of them is really special. Nine of the 21 are in Saudi Arabia, which shows the commitment we've seen to nursing in the Kingdom and our opportunity to have a strong partnership around this global transformational leadership opportunity.
Can you share your experiences or insights from working with nurses globally?
Regardless of location, several core nursing challenges are remarkably consistent across countries and health care systems. These include nursing shortages, burnout and mental health strain, adaptation to new technologies and innovation, and the changing influence of nursing in patient care and hospital decision-making. We see many nurses across the globe working at multiple health care institutions. Some of them travel very long distances to be able to work in the larger cities, which have housing shortages. Nurses are impacted disproportionately because nursing is still underpaid in many countries. These global challenges reflect both systemic issues and evolving demands on the profession.
Houston Methodist has addressed many of these issues within our own workforce. We share our own strategic models to inform and inspire our international partners’ efforts, particularly as health systems adapt to the growing demands on nursing.
What motivates you and your team to continue striving for excellence in nursing globally?
At Houston Methodist, nursing drives high-quality care, innovation and continuous improvement. It is the core of compassionate, patient-centered care. Working with international nurses allows us to expand this influence, making a lasting impact on health systems and the well-being of patients across the globe. In partnership with nursing experts across the system, our team can help amplify the voice and impact of nurses globally, elevating the profession and improving patient outcomes worldwide.
We're motivated for more patients to be able to access higher-quality care where they live, as opposed to having to travel for that level of care. It has been exciting to watch it take shape, continue to grow and develop, and truly see the impact as the quality of care is increasing through the elevation of nursing.
Time and time again, the generosity of the profession and the natural inclination to partner with others, especially around improving clinical care and clinical excellence, creates a multiplier effect. Our team within Global is honored and fulfilled to be a small part of these efforts, and oftentimes, we're just the connector.