When Holly joined us in 2022, she brought a deep experience of success putting her purpose into practice in the hospice and intensive care spaces, plus a positive, growth-minded attitude. She knew Duke HomeCare & Hospice came with challenges and was ready to face them head-on.

“I just started going around with the staff and trying to learn more about the workflows, what the expectations were, and observed where we could make improvements based on what the staff were reporting and what their requests were for a more acceptable work life balance,” Holly shares about her early days here.

She quickly introduced new protocols to relieve areas of team member strain—shifting the team from a therapy-driven model to a case management staffing model.

“We had to do it appropriately and strategically as we didn’t want to burden the clinics, and wanted to ensure that the patients got the services they needed,” emphasizes Holly. “With the new case management staffing model, the nurse is assigned to the patient through the duration of therapy. This provides continuity of care and allows nurses the opportunity to build relationships with the patients.”

She also introduced geographic territories. This helped cut down on the amount of driving the nurses were doing in the field.

“The goal is to cut down on the time behind the wheel of the car and provide more time with the patients,” she emphasizes.

To address concerns about long hours, with assistance from hospice leadership, we streamlined the on-call process to include—clarifying expectations, setting firm timelines, and adding supplemental pay to full-time infusion staff should they cover any on-call duties. We added two after-hour positions to take the burden off the full-time staff. The restructuring of the unit was enhanced by other impactful changes. Duke HomeCare & Hospice also modernized the unit’s technology by updating the Electronic Health Record system to match the broader health system and streamlining documentation.

“We organized a documentation improvement work group and our time study showed it took 180 minutes to create a care plan,” she said. “When we did the Beta testing, in the trial it cut the time almost in half. Once we implemented the new templates along with the smart phrases, it now takes them 18 minutes to do a care plan.”

These changes addressed daily pain points—but Holly also focused on long-term growth. Many nurses wanted to advance their careers, so they were introduced to Duke Health’s nursing career ladder to advance with promotion.

Alongside operational changes, Holly reshaped the culture—uplifting morale, building community, and creating space for regular check-ins and shared affirmations.

The results speak volumes.

“Turnover dropped from 120% to 30%,” says Holly. “The goal is a team that wants to stay. When people feel supported, everything changes. The team feels happy, valued and supported—the patients are happy, and I'm happy. This is an incredible group of nurses and support staff. I am honored to be a part of the team!”

If you’ve been searching for a place where you can put your purpose into practice—somewhere that will welcome your big ideas and give you a platform for your innovative leadership—explore opportunities here.

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