the executive connection of north texas: fall 2010

16
FALL 2010

Upload: achentx

Post on 31-Mar-2016

220 views

Category:

Documents


5 download

DESCRIPTION

 

TRANSCRIPT

Page 1: The Executive Connection of North Texas: Fall 2010

FALL 2010

Page 2: The Executive Connection of North Texas: Fall 2010

CONTENTMessage fromthe Regent 4John M. Haupert, FACHE

President’s Remarks 5J. Eric Evans

Our Business is KeepingPhysicians in the Loop 6

Meaningful Use 101 9Series Part 1

Patient Safety, The A3 Way 11

Member Spotlight 13

Event Encore 14

Calendar 16

ofACHE

North TexasACHE

North Texas

The ACHE of North Texas e-magazine, The Executive Connection, is published quarterly (Spring, Summer, Fall and Winter) and includes information on the latest regulatory and legislative developments, as well as the quality improvement and

and challenges facing hospital and health system leaders today. We make it our job to tell you about the great things the organization and Chapter are doing every day to ensure the health of our community. If you have any news and updates that you want to share with other members, please e-mail your items to [email protected]. Microsoft Word or compatible

are the types of information that our members shared in past ACHE of North Texas magazines: Advocacy Issues, Legislative Issues, Educational Opportunities, Awards / Achievements, Promotions (Members On the Move), Committee Updates, journal submissions, conference submissions, and workshop participations, sharing mentoring experiences, etc.

RTKL.COMUSA ASIA EUROPE MIDDLE EAST

RTKL proudly supports the ACHE North Texas Chapter.

TM

With the close of 2010 fast approaching, many of you meet the eligibility criteria to become a Fellow of the American College of Healthcare Executives. I strongly encourage you to take the next step in your career advancement and complete the Fellow application to earn your FACHE credential.

If you have submitted a Fellow application, I encourage you to move forward and take the Board of Governors exam. There are resources available at both the local Chapter website and ACHE National to assist you in preparing for the exam.

Now is the time to maximize your professional potential by earning the premier credential in healthcare management.

Michael Ojeda, FACHECo-Chair, Advancement Committee

Page 3: The Executive Connection of North Texas: Fall 2010

A Publication of the American College of Healthcare Executives of North Texas Chapter | FALL 2010 3

Editor-In-Chief Susan Edwards

Managing Directors Joan Clark, MSN, RN, FACHE

Angela CJVincent, MHS

Contributing Editors J. Eric Evans

Scott Schmidly, FACHE

Jania Villarroel, MHA

Pamela Doughty, Ph.D.

Lisa Cox

Felicia McLaren

Contributing Writers Pamela Doughty, Ph.D.

Joseph Barcie, MD, Ph.D., MBA

Kriss Barlow, RN, MBA

Jason James

Felicia McLarenMatt Van Leeuwe

Production Kay Daniel

Advertising/ Subscriptions [email protected]

Questions and Comments: ACHE of North Texas 3001 Skyway Circle, Suite 100, Irving, Texas 75038 p: 972.256.2291 | f: 972.570.8037 e: [email protected] | w: northtexas.ache.org

President J. Eric Evans Lake Pointe Health Network

President-Elect Brad Simmons, FACHE Parkland Health & Hospital Systems Co-Chair, Membership Committee

Past President Janet Henderson, MHA, FACHE Parkland Health & Hospital System Chair, Nominating Committee Co-Chair, Education Committee

Secretary Scott Schmidly, FACHE Medical City Dallas and Medical City Children’s Hospital Co-Chair, Communication Committee

Treasurer Gail Maxwell, FACHE Baylor University Medical Center

2010 Board of Directors

John Haupert, FACHE

Parkland Health and Hospital Systems

Ron Coulter, MHSM, FACHE

Texas Health Methodist Hospital—Cleburne

Co-Chair, Mentorship Committee

Leslie Casey

Coordinator, ACHE of North Texas Chapter

Beverly Dawson, RN, CCM

Elder Care LP

Co-Chair, Education Committee

Forney Fleming

University of Texas at Dallas

Jonni Johnson, CPSM

RTKL Associates Inc.

Chair, Sponsorship Committee

Michael J. Ojeda, MHA, FACHE

VA North Texas Health Care System

Co-Chair, Advancement Committee

Caleb F. O’Rear, FACHE

Denton Regional Medical Center

Co-Chair, Mentorship Committee

George L. Pearson, JD, FACHE

Texas Health Resources

Rick Stevens

JPS Heath Network

Co-Chair, Membership Committee

Matt Van Leeuwe

Parkland Health & Hospital System

Student Council

Jania Villarroel, MHA

Metropolitan Anesthesia Consultants, LLP

Co-Chair, Communications Committee

Demetria Wilhite

The University of Texas at Arlington

Co-Chair, Advancement Committee

Bethany Williams

PricewaterhouseCoopers, LLC

Chair, Networking Committee

Page 4: The Executive Connection of North Texas: Fall 2010

Message from the RegentJohn M. Haupert, FACHE

During this past month I have had the honor of speaking to students in various MBA and MHA programs about the benefits of membership in the American College of Healthcare Executives. During the Q&A portion of these presentations I sense an ever increasing level of anxiety among these students regarding the current job market and their ability to secure a position they find meaningful and aligned with their personal career goals. The level of anxiety is the highest I have seen in my career.

Among several suggestions I offer them, one of the most important is to identify a mentor in healthcare administration that can help guide them, serve as a confidant and also serve as a reference and advocate to future employers. I currently serve as a mentor to an early careerist from Children’s Medical Center in Dallas. I take very seriously the obligation I have to ensure that our field is armed with the best possible talent to serve the needs of patients and their families well into the future.

The American College of Healthcare Executives takes a very clear position on the obligation we all have to serve as mentors to students and early careerists. ACHE has a published policy statement entitled “Responsibility for Mentoring”. That policy states:

“The future of healthcare management rests in large measure with those entering the field as well as with mid-careerists who aspire to new and greater management opportunities. While on-the-job experience and continuing education are critical elements for preparing tomorrow’s leaders, the value of mentoring these individuals cannot be overstated. Growing through mentoring relationships is an important factor in a protégé’s lifelong learning process. In turn, by sharing their wisdom, insights and experiences, mentors can give back to the profession while deriving the personal satisfaction that comes from helping others realize their potential. For the organization, mentorships can lead to more satisfied employees and the generation of new ideas and programs.”

This policy statement goes on to outline how to establish successful mentor/mentee relationships. I hope you will go to ache.org and access this policy and review it. Most of all, I am asking each and every one of you who is a student or mid-careerist to establish a mentor relationship with an experienced healthcare executive and for the experienced executives among you to step-up, get involved and serve as mentors to the future leaders of our profession. It is one of the most rewarding experiences you will ever have. ACHE offers a national mentoring opportunity. To find out more information use this link: http://www.ache.org/newclub/career/mentoring_overview.cfm.

A Publication of the American College of Healthcare Executives of North Texas Chapter | FALL 2010 4

ofACHE

North TexasACHE

North Texas

Page 5: The Executive Connection of North Texas: Fall 2010

A Publication of the American College of Healthcare Executives of North Texas Chapter | FALL 2010 5

President’s RemarksJ. Eric EvansIn my final President’s Remarks I would like to say thank you for the opportunity to serve the North Texas chapter in 2010. Together we have accomplished a lot and have positioned the chapter for bigger and better things moving forward.

As you are aware, we set out at the beginning of the year to achieve the Chapter of Excellence designation. While we will not know whether we have reached our objective for several months, we can certainly measure our progress year over year.

Member Satisfaction - I am proud to report that our chapter earned a 7.7 mean satisfaction score in 2010, which exceeded the Chapter of Excellence objective of 7.6. While we are excited about this achievement, you identified a number of areas in the survey with which we have improvement opportunities. Please know that we take your feedback seriously. You will be receiving more details on the action plan to address our opportunity areas in future newsletters.

Education & Networking Performance – Through mid-October we have had more events and provided more programming hours than we did in all of 2009. Notably, the quality of our events and the caliber of our presenters continue to improve. For those of you who have joined us for education or networking events this year, you are aware that our chapter provides outstanding opportunities to learn from and meet the healthcare leaders in our region.

Net Membership Growth – Even in challenging economic times, we continue to grow our chapter membership. So far this year we have increased our membership by 2.1% and are still targeting the 9.8% Chapter of Excellence objective with several programs designed to incent people to join in the last quarter of 2010. As always, our current members are our best advocates, and I encourage you to reach out to your colleagues who have not yet joined us and encourage them to take advantage of all we provide.

Advancement of Eligible Members – Through mid-October, we have already exceeded our 2009 count of new Fellow designates and Fellows at 34. We are also well positioned to exceed our Chapter of Excellence target of 44. More importantly, we are excited to see so many of our members showing the dedication and commitment to the healthcare field required to earn the FACHE credential.

With the significant uncertainty we all face as healthcare leaders in the coming years, a strong local ACHE chapter is an important asset. Regardless of what happens with healthcare reform, the services our chapter provides - access to the insights of regional and national leaders, networking opportunities with your colleagues throughout the region, and career development and advancement assistance – are more important than ever.

As I complete my term as President, I believe ACHE of North Texas is poised for continued growth and success. We have a large group of committed sponsors, a dedicated Board, and a membership body that continually pushes us to raise the bar. I am especially excited that Brad Simmons, President Elect, will be serving as your President next year. Brad’s leadership skills and innovative ideas will no doubt improve upon our current foundation.

I look forward to seeing many of you at our upcoming general membership meeting and awards dinner on November 4th. Please continue to take advantage of the many great programming offerings we have scheduled for the remainder of the year, and thanks again for your support of our chapter.

Page 6: The Executive Connection of North Texas: Fall 2010

A Publication of the American College of Healthcare Executives of North Texas Chapter | FALL 2010 6

The concept for many healthcare executives these days is managing change. Organizations are working to become more nimble adaptors and paying careful attention to competitors of every type.

Change means that people and departments are in a state of flux. New plans are emerging and leaders are striving to predict what their future stance will be. In fact, executives are shifting their focus almost daily, from developing new payer strategies, to managing the labor shortage to weighing the feasibility of adding an additional ambulatory center – to name but a few needs.

“What is all of this change doing to the customer side of the business?” Because all the energy is focused inward – inside the organization – communication to patients, employees, employers and physicians is being compromised and fragmented. Messages and relationships become secondary because the desire to innovate, offer ROI strategies or reduce costs takes center stage.

Implications for Medical Staff

For the medical staff, more change is coming at a time when hospital trust is already shaky. Many physicians believe that hospitals lack understanding of and support for their issues; many are making less money while working harder than ever.

While employment is rising, in most markets, physicians guide much of the referral business regardless of their business structure. As they work on Accountable Care Organizations and other business strategies, hospitals need to develop a plan to ensure trust and strong working relationships. The hospital and physician together can then focus on what is good for medicine, and what is good for the patient. Without a doubt, keeping physicians involved and supportive of the organization is the right thing to do. So, what needs be in place to ensure a working relationship with the key source for referrals, i.e., physicians?

Develop a Physician Relationship StrategyHealth system leaders assume their employees understand that because physicians bring in referrals and are necessary for the organization’s financial survival, the team – doctors and staff – should work together. It cannot be assumed that everyone believes that nurturing, maintaining or developing physician relationships is part of their job. A physician relationship strategy must be developed. Following are the steps involved in creating such a strategy.

• Examine the current physician relationship strategy. Evaluate physician relationships, methods of communicating, methods of involvement, measures of effectiveness and the skill sets of the responsible staff.

Our Business isKeeping Physicians

In the Loop

continued on page 7

Kriss Barlow, RN, MBA

Page 7: The Executive Connection of North Texas: Fall 2010

A Publication of the American College of Healthcare Executives of North Texas Chapter | FALL 2010 7

• The next step, an analysis of referral data, will delineate the level of dependence on a specific physician or group. Research the percentage of hospital revenue by specialty and by individual. For many organizations, these numbers are often sobering; a few physicians are responsible for a very large percentage of the hospital’s revenue.

If your analysis indicates a need to re-tool, then the time is right to move forward.

• Assess the data, the current process, competitive vulnerabilities and market opportunities. The action portion of the plan is then developed with activities, accountabilities and outcome measures.

• The traditional business planning process provides an excellent framework. Use the process and people in the planning and business development functions to evaluate where market opportunity exists. Assess internal and external market forces and how they affect the medical staff. Use trends and satisfaction indicators to develop the target market, expectations and desired outcomes.

Communication with the Medical Staff

Different groups need different approaches. The assumption is that because specialists are “in the building”, they understand and have their finger on the pulse of the inner works of the organization. Primary care physicians are a vital link and today’s leaders appreciate the need to connect with them. As you assess your program consider your approach and the effectiveness to date.

Many organizations now recognize that just because updates and information are printed in physician communications materials, that does not mean the medical staff will remember the details and respond appropriately.

Communication seems to be a chronic problem with so many distractions that individuals fail to hear important messages. Communication is an issue for everyone, not just marketing or the CEO, but all system members across the continuum. Set physician communication as a priority and measure the impact.

There is no single perfect approach for getting your message to physicians; a mix of communication strategies must be employed to ensure a consistent flow of information.

Some Tips to Get Communication Rolling

1. Get people talking. Beyond the usual approach of telling the physicians what the hospital has to offer, communication should include opportunities for dialogue. The messages must be relevant or you’ll lose interest.

• Get physicians involved by soliciting their input and then showing them how their input is used.

• Ask physician representatives to share targeted messages and solicit feedback as a part of their regular visits.

2. Determine regular checkpoints for soliciting feedback – not just from the chief or department directors, but also from a variety of members of the medical staff.

• Again, the physician representative can be an ally. Every physician who receives a face-to-face visit can be asked the same question. Over time, trends will become apparent. The advantage is that every targeted physician responds rather than just those who can be reached by traditional survey methods.

continued on page 8

Texas Health Resources is proud to support the ACHE North Texas Chapter.

1-877-THR-Well | TexasHealth.org

Texas Health Resources is Harris Methodist, Arlington Memorial and Presbyterian hospitals.

MAKING HEALTH CAREHUMAN AGAIN.

Page 8: The Executive Connection of North Texas: Fall 2010

A Publication of the American College of Healthcare Executives of North Texas Chapter | FALL 2010 8

• Make an effort to call other physicians who might be impacted by your initiative. Offer information, tell them how you will use their opinions and make sure to give them a first look.

3. Conduct small task force meetings – six physicians attending two to three meetings can be a very effective format for soliciting feedback and input. The task force meetings should have a much focused structure – their job is not to develop copy or determine how customer service issues should be addressed, but to identify the areas where their understanding, buy-in and communication with colleagues is beneficial.

4. See things from physicians’ perspective. Consider how physicians would respond if they are not made aware of changes. Listen carefully in the dialogue-based meetings. There will be good indicators of physician red flags, issues that are priorities for them and their main concerns when communicating with others. 5. Provide a conduit for information and messages regarding hospital happenings, educational opportunities, referral source follow-up, and appointment challenges, all prime areas for hospital-physician dialogue.

Growing the Relationship and Growing the Business

There is renewed interest in using face-to-face relationship sales calls to communicate with the medical staff. The old physician liaison role has changed to reflect the current marketplace. The framework, including targeted physicians, strategy, message and methodology, is derived from the physician strategy plan.

Rather than focusing on problems that never really gained new business, today’s model focuses on using the physician relations representative as a resource for targeted medical staff. The representative becomes a single point of contact for needs, updates, and education as well as for facilitating the physician-to-physician referral process. While problems will still surface and need to be managed by the team, gone are the assumptive days when we believed that just because we fixed their oncology problem, for example, they would naturally send us all of their cardiac referrals.

Physician relations representatives should have a specific scope of responsibilities and be evaluated for their ability to increase revenue and volume, enhance satisfaction, provide market intelligence or whatever else the organization defines as the need.

The Time is Right

While internal challenges and efficiencies do demand attention, it should not be at the expense of strategic growth and attention to customers. Successful businesses, like successful healthcare organizations, look for ways to enhance and improve their offerings and to grow. Physicians are generally the entry points for accessing healthcare. Hospitals need to make sure that physicians know what services are offered if additional care is required. The referral relationships, communication and a sound strategy will ensure a collaborative relationship with the medical staff. Change is affirming and the rewards are many when the outcomes validate the process.

Kriss Barlow RN, MBA is a principal with Barlow/McCarthy, a training and consulting firm focused on hospital- physician solutions. Contact Kriss at (715) 381-1171 or [email protected]

214.283.8700

www.perkinswill.com

Solutions for the Changing Healthcare Environment

Architecture

Branded Environments

Interior Design

Planning + Strategies

Preservation + Reuse

Urban Design

A Proud Sponsor of ACHE of North Texas

Page 9: The Executive Connection of North Texas: Fall 2010

A Publication of the American College of Healthcare Executives of North Texas Chapter | FALL 2010 9

Implementation of electronic health records (EHRs) in hospitals is the first step in meeting the requirements for “meaningful use” in order for hospitals to receive the CMS incentive payments. The EHR system must meet the certification standards set by the U.S. Health and Human Services Department (HHS) three different times. The vendors must be able to report meaningful use criteria for 2011 and then to meet the upcoming meaningful use criteria for 2013 and 2015. The first ONC Certified HIT Product List (CHPL) was published on October 9, 2010 with a list of vendors who meet the criteria. According to Office of the National Coordinator for Health Information Technology HITECH, EHR technology is classified as Complete EHRs are certified to meet all applicable certification criteria adopted by the Secretary in the Standards and Certification Criteria Final Rule. EHR Modules are those EHR technologies that have been tested and certified to at least one of the certification criteria adopted by the Secretary in the Standards and Certification Criteria Final Rule. Due to the regulatory requirement that EHR Modules be tested and certified to the security criteria, as elaborated in the Temporary Certification Program Final Rule, EHR Modules will typically be tested and certified to more than one of the adopted certification criteria (ONC, 2010).

Each Complete EHR and EHR Module included in the CHPL has been tested and certified by an ONC-Authorized Testing and Certification Body (ATCB), and reported to ONC by an ONC-ATCB, with reports validated by ONC. Only those EHR technologies appearing on the ONC-CHPL may be granted the reporting number that will be accepted by CMS for purposes of attestation under the EHR Incentive Programs.

The comprehensive list with the criteria for each vendor is located on http://onc-chpl.force.com/ehrcert/productperformanceoverview. Included in the Complete EHR list are eClinical Works LLC version 8.0.48; Epic System’s

Meaningful Use 101(Series Part 1)

EpicCare Ambulatory – Core EMR version Spring 2008 and EpicCare Inpatient – Core EMR Version 2007.19.12, P2 Sentinel Version 4.2.1; NextGen Ambulatory EHR version 5.6 SP1; GE’s Centricity Advance version 4.0; and Allscripts Professional EHR version 9.2. Included in the Module list are Allscripts ED 6.3 Service Release 4 and Allscripts Peak Practice version 5.5; QRS, Inc.’s PARADIGM version 8.3 and Wellsoft EDIS version 11 (ONC, 2010). The list is a snapshot of the vendors at the time of certification; the CHPL will be updated periodically. The CHPL is version 1 and version 2 has promised to have more information available for those choosing a vendor. Below are the criteria for every vendor. Each vendor is scored according to this list of criteria and can be found on the website next to each certified vendor so that a purchaser can determine how each vendor scored. Not all the criteria must be met for a vendor to become certified.

170.302(a) Drug-drug, drug-allergy interaction checks. 170.302(b) Drug formulary checks.

170.302(c) Maintain up-to-date problem list. 170.302(d) Maintain active medication list.

170.302(e) Maintain active medication allergy list. 170.302(f ) (1) Record and Chart Vital signs.

170.302(f ) (2) Calculate Body mass index. 170.302(f ) (3) Plot and display growth charts.

170.302(g) Smoking status. 170.302(h) Incorporate laboratory test results.

170.302(i) Generate patient lists. 170.302(j) Medication reconciliation.

Pam Doughty, Ph.D.

continued on page 10

Page 10: The Executive Connection of North Texas: Fall 2010

A Publication of the American College of Healthcare Executives of North Texas Chapter | FALL 2010 10

170.304(j) Calculate and submit clinical quality measures. 170.306(a) Computerized provider order entry.

170.306(b) Record demographics. 170.306(c) Clinical decision support.

170.306(d) (1) Electronic copy of health information. 170.306(d) (2) Electronic copy of health information Note: For discharge summary.

170.306(e) Electronic copy of discharge instructions. 170.306(f ) Exchange clinical information and patient summary record.

170.306(g) Reportable lab results. 170.306(h) Advance directives.

170.306(i) Calculate and submit clinical quality measures.

Each hospital and provider must meet some of the meaningful use criteria listed in the vendor criteria above. The next article in this series will discuss hospitals criteria for 2011 to insure they receive the incentive payments.

Reference:Office of the National Coordinator (ONC). (2010). Certified Health IT Product List. Retrieved October 13, 2010 from http://onc-chpl.force.com/ehrcert

170.302(k) Submission to immunization registries. 170.302(l) Public health surveillance.

170.302(m) Patient specific education resources. 170.302(n) Automated measure calculation.

170.302(o) Access control. 170.302(p) Emergency access.

170.302(q) Automatic log-off. 170.302(r) Audit log.

170.302(s) Integrity. 170.302(t) Authentication.

170.302(u) General encryption. 170.302(v) Encryption when exchanging electronic health information.

170.302(w) Accounting of disclosures (optional). 170.304(a) Computerized provider order entry.

170.304(b) Electronic prescribing. 170.304(c) Record demographics.

170.304(d) Patient reminders. 170.304(e) Clinical decision support.

170.304(f ) Electronic copy of health information. 170.304(g) Timely access.

170.304(h) Clinical summaries. 170.304(i) Exchange clinical information and patient summary record.

Page 11: The Executive Connection of North Texas: Fall 2010

A Publication of the American College of Healthcare Executives of North Texas Chapter | FALL 2010 11

In World War I, it was common knowledge among Officers that during trench warfare fatal head wounds were caused by bullets or hard blows directly to the head. It wasn’t until the day after a severe artillery battle, when the French Intendant General August-Louis Adrian visited the wounded that he was told by a recovering soldier that many in his troop were killed by small, slower velocity fragments. When asked how he survived, the soldier replied that he put a metal mess bowl on his head. Inspired by the story, General Adrian created a metal bowl to be worn under a soldier’s cap. This metal bowl later evolved to become the soldier’s metal helmet that we all recognize today.

So what does this have to do with A3 and patient safety you ask? Plenty!

Every Hospital Administrator today is very concerned about lowering costs; improving efficiency and safety. Even with new government priorities these trends continue. A solution is needed, one that uses an easy, inexpensive, and most of all effective tool.

This solution must be a proven method that can be applied to any problem in any area of the hospital and consistently yield success. And, like the soldier who described his comrades dying from fragments and not bullets, so too can healthcare workers be trained to use this method to solve problems in their work area and not by the Officers far removed from the trenches.

So what is this method? It’s the “A3 Method” and the tool is the “A3 Report”, named after the A3 size of 11” X 17” paper still used by many to workup these reports today. This

problem solving method and tool have been so successful that they have been the driving force behind many organization wide transformations, including our acute care hospitals. There is no need for expensive software, complicated technology or even complex training. The A3 Report uses an established outline design on a sheet of paper that guides the person making the report through a few key steps toward resolving the problem they experience in their daily work, all the while effortlessly employing the scientific method.

The A3 Report outline contains: a title for the report; relevant background information; description of the current situation or process using drawings and icons; description of the cause, which by utilizing the 5 whys, will uncover the root cause of the problem; another drawing containing the ideal condition; the user has space to suggest an alternate process, just like the soldier suggesting the use of a metal mess bowl; a brief plan

Patient Safety, The A3 Way

TITLE Surgical note placed in medical record 100% compliance IDEAL/TARGET CONDITION

TO Betty Rose in Medical Record Dept

BY Jane Rodriguez, RN in Surgery Dept

DATE 12, July 2008

DESCRIPTION OF PROBLEM

The patient chart is sent to the medical record department missing the surgical note

after the patient has been discharged.

BACKGROUND

The surgeon dictates his surgical note usually in the doctor's lounge and leaves the

recording in voice mail for days. Nursing sends the chart post discharge before receipt

of surgical note was trascribed.

ACTUAL CONDITION

COUNTERMEASURES

Transfer the surgical department transcription service to the hospital current dictatiton and

transcription services. Then inservice the surgeons on the new process and how use it.

IMPLEMENTATION PLAN

WHAT WHO WHEN OUTCOME

Create new SOP Ana Gonzales within 30 days new SOP

Inservice schedule Christina Raye same 30 days education

Inservice classes Christina Raye 60 days post intro new procedure

COSTS $ BENEFIT $

creation SOP 275

training 2,890

Reduction of incomplete medical record charts

TEST WASTE

none found

none found

PROBLEM ANALYSIS

1. Surgeon leaves without dictating the surgical report:

Why? Because surgeon has surgery at other hospital FOLLOW UP

Why? Because the surgeon didn't program all surgeries at this hospital

Why? The patient has a preference elsewhere

2. Some dictations may be of poor quality and/or inaudible

Why? Because the system in the doctors lounge is an old dictation

Why? Because it was not replaced as a part of the budget

Why? Because the new technology was more expensive

Why? Because Purchasing only evaluated one system only

Why? Purchasing ran short on time, but now has less expensive solution

3. Report is missing words or signature

Why? Dictation quality is poor or words are difficult to hear and the surgeon needs to

be called and correct word is edited.

Why? Because the surgeon is not at the hospital and Transcriptionists have to find them

Why? The system forces the surgeon to only dictate from the surgeon lounge

kickoff is set for Sept 1, 2008

Measure medical record compliance

Report to COO and CNO monthly updates

A3 REPORT

NEXT DAY

alpha test was done inhouse for one week

beta test was done with doctors for one week

dictationsnot in queue

w/poor quality

report missingwords orsignature

Surgery Doctor'slounge

Surgeon leaveswithout dictating

Sugeon dictatessurgical note

Transcription

Note placed invoice mail

correctedreport printed

and signed

Report sent toFloor

Report sent toMedical Records

Patient d/c

physicianscall onenumber

fromanywhere

TranscriptionDept

Report forsignature sent

to floor

FinalTrascriptionfiled in chart

CentralizedTranscription

Database

Joseph S. Barcie, MD, Ph.D., MBA

continued on page 12

Page 12: The Executive Connection of North Texas: Fall 2010

A Publication of the American College of Healthcare Executives of North Texas Chapter | FALL 2010 12

Patient Safety, The A3 Way, continued

on how to implement this ideal condition, a brief plan to ensure the ideal condition was achieved and space to measure the results.

It sounds simple enough, but we have found that if shortcuts are used, the process yields poor results. Although this method and this tool can quickly solve problems, it would be a mistake to think of the A3 method as a short term strategy, it is not.

In order to successfully implement the A3 method in all our hospitals, it required dedicated leadership at the highest levels of the hospital and our corporate office. It required a change in organizational behavior at all levels. It changed many from feeling powerless to empowered, from being overlooked to being valued – everyone, a part of the team.

There are those who say that in today’s healthcare environment everyone is already too busy and that this tool requires too much time. However the truth is that as problems are corrected and processes made more efficient, re-work, work-arounds and errors will be eliminated, leaving more time available for A3’s.

The beauty of the A3 method is that since services interact with other services in long value chains, when implemented and supported, the results expand ever broader until the entire organization improves and everyone benefits, most importantly our patients.

Dr. Barcie is the President, Centralized Operations for International Hospital Corporation (IHC) in Dallas, Texas.

For more information: “Understanding A3 Thinking: A Critical Component of Toyota’s PDCA Management System” by Durward K and Art Smalley.

Page 13: The Executive Connection of North Texas: Fall 2010

A Publication of the American College of Healthcare Executives of North Texas Chapter | FALL 2010 13

Mia JohnsonAdministrator,UT Southwestern

What are you doing now?

I am the Senior Administrative Associate for the Mobility Foundation Center at UT Southwestern making me responsible for all center affairs.

In your opinion, what is the most important issue facing Healthcare today?

Aside from healthcare reform legislation, I believe the most important issue is keeping populations healthy. Developing community health initiatives that advocate disease prevention, health promotion and reduce health disparities is necessary to meet our growing demand for healthcare services.

How long have you been a member of ACHE?

I became an ACHE member this year.

Why is being a member important to you?

I learned about ACHE over the course of my MBA studies. From that experience I realized ACHE is a chief resource to further my education, add value to my career and collaborate with industry leaders.

What advice can you give to Early Careerists or those considering membership?

ACHE offers a wealth of information along with educational and networking opportunities. Membership allows participants several ways to exercise these options like involvement with various ACHE committees and educational training. Healthcare is a vast industry and ACHE provides a forum for validation.

Tell us one thing that most people don’t know about you.

Most people are not aware of my love for the arts.

MEMBER SPOTLIGHT

Is there a member you would like to seein the next Member Spotlight section?

If so, please send their name andcontact information to us at

[email protected]

Madhura ChandakBusiness Service Manager,Children’s Medical Center, Dallas

What are you doing now?

Currently, I serve as the Business Services Manager for the Heart Center at Children’s Medical Center.

In your opinion, what is the most important issue facing Healthcare today?

According to me, the key issue revolves around design and implementation of a shared responsibility network between health care organizations, private insurance companies, government programs and agencies and community groups to provide accessible, affordable and quality health care to all. It is an overarching goal that demands and deserves dedicated effort from each one of us.

How long have you been a member of ACHE?

Half a decade…Since 2005

Why is being a member important to you?

Being a member is my opportunity to stay current with the healthcare industry dynamics in DFW metro & nationwide. It forms the robust foundation for networking. It also provides resources for professional development and community involvement.

How did you gain your first position in healthcare? Also, describe any scenario (career planning, professional development, mentorship, project) that you feel was crucial in your success.

I began my healthcare journey as a Physical Therapist and now continue as a health care administrator where my clinical and business interests are complementary to each other. ACHE North Texas chapter event – ‘Career Positioning - Proactively managing your Professional Development’ – led me to align my actions to my professional goals. The result is my continued professional success as an early careerist.

If you could be any figure in history, who would it be and why?

Helen Keller – She was the first deaf & blind person to earn a Bachelor of Arts degree. Her quote - “It is a terrible thing to see and have no vision” – is my inspiration to do bigger and better things everyday while keeping life in perspective.

Page 14: The Executive Connection of North Texas: Fall 2010

A Publication of the American College of Healthcare Executives of North Texas Chapter | FALL 2010 14

EVENT ENCORE

Candy Knowles and Cathy Fraser

Scott Manis and John Self

Early Career Networking at Truluck’sSubmitted by Felicia McLaren

Bench Strength Development Event SummarySubmitted by Jason James

On Thursday, September 16, 2010, Doctors Hospital at White Rock Lake hosted the Talent Management for Bench Strength Development educational event for the North Texas ACHE chapter. The event was organized by Ms. Chakilla Robinson White, Ms. Jessica Daw, and Mr. Mikhail Gorbatenko, and was attended by 30 members of the organization.

The panel for the event was comprised of Candy Knowles, Chief Human Resource Officer, Parkland Health & Hospital System; Cathy Fraser, Chief Human Resource Officer, Tenet Healthcare Corporation; and John Self, President, John G. Self Associates. Moderated by Scott Manis, FACHE, the panelists discussed the importance of a comprehensive human capital strategy, with each panelist sharing specific initiatives used in their respective organizations.

There is a concern that in many healthcare organizations, talent management is still a ‘bottom-up’ approach with senior executives only giving lip service to the fact that people are the most important asset. Senior leadership must buy in and lead the effort toward preparing the workforce for new opportunities. Ms. Fraser spoke specifically of her organization’s partnership with MBA programs and of a nursing leadership pipeline. It is crucial that all employees (not just senior executives) feel they have ample opportunities to continually build their skill-set and improve at their work. Sustained ‘bench strength’ will come in those organizations, whose employees view their opportunity as ‘transformational’, as opposed to merely ‘transactional’.

For more information on future events, please visit us at northtexas.ache.org or send us an email at [email protected].

Alua Mamade and Tre Douglas Maria Islam-Meredith, Michael Lombard,Andrew Ulrich, and Kimberly Anderson

Bethany Williams, Networking Chairand Becky Tucker, event host

On Thursday, October 7th Becky Tucker, the Administrator of Texas Health Harris Methodist Outpatient Center in Burleson, hosted an Early Career networking event at Truluck’s in Addison. The event, organized by Angela Vincent and Felicia McLaren, is the second of its kind.

It was aimed at providing early careerists an opportunity to network with others that are on similar career paths. Seasoned

professionals were also welcome to attend, as they provided ample beneficial career advice.

ACHE of North Texas would like to extend our appreciation to the host, Becky Tucker, as well as the members who participated.

For more information on future events, please visit us at www.northtexas.ache.org or send us an email at [email protected].

Page 15: The Executive Connection of North Texas: Fall 2010

A Publication of the American College of Healthcare Executives of North Texas Chapter | FALL 2010 15

EVENT ENCORE

Breakfast with the CEO: Trevor FetterTenet HealthcareSubmitted by Matt Van Leeuwe

Trevor Fetter, President and CEO of Tenet Healthcare, has helped transform the Tenet system over the last several years. Mr. Fetter was kind enough to speak on Tuesday, October 5th at the Fairmont Hotel in downtown Dallas and detail some of his organizations difficulties, initiatives, and subsequent successes.

As expected, a large crowd of 74 people attended the event to hear Mr. Fetter speak. ACHE of North Texas Board Officers Eric Evans (President), Brad Simmons (President-Elect), Gail Maxwell (Treasurer), and John Haupert (Regeant) were among the many ACHE members in attendance.

The Fairmont Hotel offered a beautiful setting for the event providing a wonderful breakfast buffet and a comfortable atmosphere for the audience. Mr. Fetter spoke at length about his experiences and then answered several probing questions from the audience. I would like to extend a very sincere thank you to Mr. Fetter for taking the time to share his insights with us and an additional thank you to all of those who participated in the event.

For more information on future events, please visit us at www.northexas.ache.org or send us an email at [email protected]

Before Choosing an Anesthesia Group, Consider the Facts. Metropolitan anesthesia Consultants…

214.252.3500 3300OakLawnAvenue,Suite200•Dallas,Texas75219www.MetroAnesthesia.com

•isoneofthelargestphysician-onlyanesthesiagroupsinNorthTexas.

•providesanesthesiaatmajorareahospitalsystems,includingHCA,Tenet,THRandBaylorfacilities.

•isinnetworkwithallmajorinsurancecarriers.

•iscommittedtoexcellenceinprovidinganesthesiaconsultantservicestoourhealthcarepartners.

www.hdrarchitecture.com

The Ambulatory Care Center at Lackland Air Force Base San Antonio TX

Page 16: The Executive Connection of North Texas: Fall 2010

CALENDARNovember 4, ThursdayBreakfast with the CEOMeet Britt Berrett, Ph.D., FACHE, President, Texas Health Presbyterian Hospital Dallasand Executive VP, Texas Health ResourcesTime: 7:30 a.m. – 9:00 a.m.Location: Texas Health Presbyterian

Dallas Hospital8200 Walnut Hill Ln. | Dallas

RegistrationFee: Free to members

$20 non - members

November 4, ThursdayGeneral Membership Meeting• 2010 ACHE Member Recognition and Awards• Student Council Case Study Competition Awards• Vote on 2011 Chapter Officers and New Board Member Recommendations• Chapter Performance Update • CEO Roundtable Discussion Featuring Dr. Ron J. Anderson, President and CEO, Parkland Health & Hospital System and Doug Hawthorne, FACHE, CEO, Texas Health ResourcesTime: 5:00 p.m. – 8:00 p.m.Location: The Palomar, Opus Room

5300 E Mockingbird Ln.Dallas, 75206

RegistrationFees: $40 members

$50 non-members$25 students

ACHE of North Texas thanks the following Corporate Sponsors for assisting the organization’s mission. By sponsoring various events throughout the year, these sponsors are provided local and national exposure with an opportunity to showcase their organization, brand, career opportunities, products and services to the ACHE membership and its affiliates.

November 18, Thursday Sustaining a Financially Vibrant Healthcare OrganizationCat I Educational eventTime: 5:30 p.m. – 7:30 p.m.Location: Methodist Mansfield Medical Center 2700 E. Broad Street, Mansfield

December 2, ThursdayAfter Hours Networking EventTime: 5:30 p.m. - 7:00 p.m.More details to come...

December 16, ThursdayStrategic Marketing: Winning the Battle for Markets and ShareEducation Event | 1.5 Category I Credits awardedMore details to come...

We are currently working on new educational and networking opportunities for 2011.For the latest updates please check our website or watch your inbox for the event guide.