VOLUME 14 ISSUE 4, JULY/AUGUST 2018
Patients need care that fits their schedules. Through teamwork and creativity, we are making that care a reality.
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How quickly can you get in to see a doctor? In the health care world, it’s common for everyone to accept that it may take a few months. The problem is, our patients are in a world with instant access to all kinds of services. They live busy lives and they need care on their schedules. At the spring Leadership Development Institute, Regional Services Vice President Max Buetow spelled out the situation at CoxHealth: On average it took three to seven months for new patients to get in with a provider. “That lit a fire for our clinics and providers,” says Brock Shamel, administrative director. “We all own the fact that we allowed access to get to that point where it was. Patients want in – today. “We know that when you shut the door, patients will go elsewhere. We See ‘CULTURE OF YES,’ Page 5
Photo: Janell Patton
Monett celebrates Best Place to Work “I am always shopping for the best bargain,” says Elise Hege. 1906 The Employee Store offers deep discounts on household staples, including diapers as low as 10 cents each.
Photo: Randy Berger
Ready to save money? Check out new 1906 E
lise Hege knows the price of each diaper she buys assistant at the CoxHealth Foundation. “We want to for her young son down to the penny. utilize the discounted rates on items that the hospital is When she heard at a recent Employee Communica- able to get and pass those savings on to employees.” tion Council meeting that one of the changes coming to The changes to 1906 won’t only benefit employees. 1906 The Employee Store would be new lower prices for Because of the new connection to the foundation, profits diapers, her shout of excitement could be heard above from 1906 will benefit our patients and employees the others. through the foundation’s many patient funds, as well as “I am ecstatic,” says Hege, assistant registrar the employee crisis fund. at Cox College. “It’s just amazing. It’s fantastic. I am “The fact that the store is helping employees and always shopping for the then helping our patients best bargain. If we do buy at CoxHealth, that’s generic, we get them at win-win,” says Hege. 20 cents apiece. Under Besides lower 19 cents each would be prices on diapers and amazing. It will save our other popular items like The employee store is in the tunnel at Cox South family a lot of money.” batteries, shoppers will and is open Monday-Friday, 7:30 a.m.-5:30 p.m. When 1906 was find more grocery, housere-launched in July in parthold and personal care nership with the CoxHealth Foundation, the price for a items, as well as additional services such as tax filing package of diapers dropped from $6.50 to $4.50 and a support. The online store will now offer everything that’s case of diapers dropped from $26 to $14. on sale in the store. That’s as low as 12 cents a diaper for a package of The foundation is also adding an employee spotlight size one diapers, and an incredible 10 cents each for size program. Once a month through an application process, one diapers if you buy them by the case. employees who make their own products, like soaps, “We want the employee store to be an even better jewelry and other accessories, can put their handmade benefit to our employees so we are really focusing on wares in the store for sale during their designated month. cost and convenience,” says Sydnie Myers, executive No direct sales items are included in this program.
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Cox Monett Hospital was selected as one of the top 150 Best Places to Work in health care for 2018 by Modern Healthcare Magazine. Specific rankings will be announced at an awards gala in Dallas on Sept. 27. The Cox Monett team celebrated with an employee cookout (above) and a community celebration. Modern Healthcare’s Best Places to Work program recognizes the top workplaces in the industry. The awards honor employers who go above and beyond to support their employees, empowering them to provide patients and other customers with the best possible care, while also promoting work-life balance. Cox Monett employees completed a 78-question online survey in April. The survey earned a 71 percent response rate. All winners will appear in a special supplement of the magazine and will be listed by ranking in the Oct. 1 issue.
New Fire Starter and other key leaders recognized at LDI Three CoxHealth leaders were recognized at the summer Leadership Development Institute in July. Celeste Cramer, system director of Recruitment and Retention, received the Fire Starter Cramer Award in recognition of her innovative recruitment efforts. Emergency Physician Dr. Matthew Brandt was honored with an Emergency Medical Commendation Medal from the Sons of the American Revolution. Brandt The award recognizes his work on community EMS improvements. Howard Fisk and Springfield Fire Chief David Pennington presented the award. Karen Kramer, vice president and Kramer system chief nursing officer, received the Missouri Center for Nursing Excellence in Nursing Leadership Award for Leading with Purpose. This award recognizes Kramer is a positive change agent who leads with purpose on a daily basis.
ID with a ‘secret handshake’ New technology uses a palm vein scan to prevent errors and enhance patient safety.
PatientSecure technology identifies patients with a palm vein scan tied to the patient’s medical record. The scans smooth the check-in process and reduce the risk of pulling up the wrong chart, either from similarly named patients or through human error.
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In his 44 years at CoxHealth, Si3 Administrative Director Jack Cole has seen a lot of technology changes. He’s seen computers evolve from devices that filled an entire room down to the small phone in your pocket. But he says the leap CoxHealth is about to make is the most exciting change of all. Later this year, we are set to roll out a new patient identification system called PatientSecure. The system will identify patients with a unique palm vein scan, tied to the patient’s medical record. It’s a step that uses technology to address the nation’s number one patient safety goal: Correct patient identification. “This is the most exciting thing I have seen in a very long time, because of the potential of truly making a difference for our patients,” Cole says. Implementing the PatientSecure system will provide a variety of benefits, including reducing the risk of errors, eliminating duplicate records and preventing fraud and ID theft. Correct patient identification is at the top of the patient safety priority list because health systems across the United States have the same challenges with patient identification. Common names and multiple patient records make it possible to select the wrong chart, leading to numerous problems with patient care. “This will smooth the
Photo courtesy of Imprivata
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This is the most exciting thing I have seen in a very long time, because of the potential of truly making a difference for our patients. Jack Cole
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administrative director, Si3
PatientSecure FAQ PatientSecure is used in 75 U.S. health systems, 500 hospitals and 2,500 clinics. The technology identifies 125,000 patients per day. Check out coxhealth.com for a list of frequently asked questions. check-in process. Instead of looking through common names, it will go directly to the correct person,” Cole says. “We have a lot of double-checks we do to prevent those issues, but this technology will stop the problem entirely.” When you enroll in Patient-
Secure, the system creates a biometric identifier using the unique vein pattern in your palm. “It’s like a secret handshake between you and CoxHealth,” Cole says. Patients can then check in at clinics or our hospitals using a palm scan and their date of birth. If an enrolled patient is in an accident and arrives in the ED unconscious and without ID, a simple scan will immediately pull up the correct record. Making 100 percent sure we have the correct record ensures caregivers are treating patients with the correct medications, allergies and medical history.
The scan also prevents medical fraud, meaning no one can use a stolen or borrowed medical insurance card. “We want to protect our patients, that’s the primary motivator,” Cole says. “We will protect them medically and secure their record against ID theft. No one can walk in and say they’re you and you get a bill later.” On the back end, PatientSecure will help CoxHealth ensure that each patient has a single, up-to-date medical record. “This is a patient safety issue and no other hospital in Missouri is addressing it this way,” Cole says. “Health care organizations using this technology have achieved a 99 percent success rate and are thrilled with it. It brings a significant benefit to our patients. Consider a person arriving in the ED with no ID, it could make all the difference in the outcome. This technology will save lives.” 3
Being the best = Building great With LEADs, we are giving leaders the tools they need to make an outstanding environment.
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s anyone who has ever stepped into a leadership role knows, there is more to leadership than day-to-day management. Great leadership is a hallmark of a great organization. Effective leaders are key to the culture that makes CoxHealth a Best Place to Work. Great leadership doesn’t happen by accident – we must build great leaders. CoxHealth is making a major investment in leaders and our work environment with the Leadership Education and Development series, LEADs, which launched earlier this year. The program includes a Management 101 Boot Camp, followed by Leadership Foundations courses for all new supervisors, managers and directors. The training covers everything from the tactical skills new leaders need, to in-depth training on six core competencies. “The key to our success is getting the most out of our leaders,” says Andy Hedgpeth, vice president of Human Resources. “Having a great leader sets the tone for working here. Everyone we recruit and retain depends on a great leader making their experience positive.” LEADs is the result of months of effort to create a leadership development program that supports all CoxHealth leaders in a standardized way. Human Resources and the Center for 4
Learning Consultant Tina Moore coaches leaders through an exercise in a LEADs class. The in-person training focuses on real-life scenarios to prepare leaders for situations they will face in their roles.
Professional Development spent basis. The programs are giving more than a year working with leaders the tools to do that.” CoxHealth leaders and educators The LEADs program begins perfecting the LEADs approach. with a Management 101 boot Early in the process, survey camp, which features everything results made the need clear: 92 leaders need to know to get started. percent of leaders said access “The boot camp is a survival to professional development is class,” Kirkup says. “It is filled important. Only 25 percent felt with things everyone will need in like they were Making sure leaders are effectively trained to lead. confident in what they are “We set out doing will lead to staff feeling to make sure supported as well. leaders have the Matt Turner knowledge, skills, system director, Radiology attitudes and competencies to be effective,” their first 30, 60 or 90 days.” says Marcie Kirkup, manager Leaders will complete the of the Center for Professional boot camp during their first three Development. “We want everyone months. It includes an on-demand to understand our workforce’s video series and seated classes. strengths and motivations. We The in-person classes focus want to align them with what we on simulations of activities leaders are asking them to do on a daily will encounter: the new-hire
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process, requesting a position in Position Manager, completing an eCar and more. In addition to tactical training for managers, the boot camp also includes exercises designed to help leaders take a system view of CoxHealth. Matt Turner, system director of Radiology, says the budgeting exercise led by John Chastain, system director of budgeting, was particularly eye opening. “We formed a mock C-suite, choosing a CEO and CFO,” Turner says. Chastain gave the group a list of capital items to choose from for investments. The goal? Create a positive financial performance over three years. “The list had everything
Culture of yes
leaders
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Leadership foundations LEADs starts with a Management 101 boot camp, featuring everything leaders need to get started, including: Time keeping Payroll process Lawson Budget concepts Policy manager Performance manager Customer service The boot camp is followed by Leadership Foundations, focusing on the six key competencies in the above graphic. Photo: Randy Berger
from software and patient monitors to market adjustments for staff,” Turner says. “This forced us to reflect and understand organizationally what the priorities and needs are overall.” The boot camp is followed by a Leadership Foundations series, designed to build well-rounded leaders. The series focuses on six key leadership competencies, ranging from vision and innovation to accountability and staff development. The foundations are presented in a mix of video and in-person classes, which focus almost entirely on scenarios, discussion and real-world examples. “There’s no talking ‘at you,’” Kirkup says. “It’s interactive, which is what adult learners need. Studies show if I tell you something, after three days you
will retain about 20 percent of it. If I tell you, show you and then have you teach it back to me, the retention is closer to 80-90 percent.” By the end of summer, LEADs will have graduated 90 leaders from the full program, with 60 more underway. Turner says the program’s scope makes it clear CoxHealth is aggressively investing in our people. “This shows a lot of sincerity and intention behind how we want the culture to function,” he says. “Making sure leaders are trained and confident in what they are doing will lead to staff feeling supported as well.” Hedgpeth says when it comes to our future, there are no better investments to make. “What will define 2018 for us is a leap forward in leadership development. Leadership is important – organizations that invest in it perform much better.”
have to improve if we are going to be sustainable.” To keep growing and thriving, CoxHealth has to have a culture of yes. Over the past few months, we have made great strides in making sure patients hear: “Yes, we can care for you, and we can do it now.” If a new patient needs a primary care appointment, we can now see them in one or two days. “The doctors put themselves in our customers’ shoes and they took Shamel ownership,” Shamel says. “We can’t hold back – to thrive for our patients, we have to do what’s right.”
A team effort
To make the improvements happen, physicians and clinics have gone above and beyond to find creative ways to build in access. A few of the key tactics: Centralized scheduling To smooth the process for our customers, providers allowed patients to be scheduled directly through 417-269INFO. Patients can now make appointments and get expert guidance from the info line team with a single call. In the past, 16 providers offered info line scheduling, now 120 providers have appointments available. Online scheduling In addition to the info line, a number of providers now offer online scheduling for new and established patients. Online scheduling is available for 75 providers. Shamel says that’s up from just a handful of providers using the system in the past.
“This is about making it as easy as possible – we don’t want to be a burden to our customers,” he says. Expansion of NPs and PAs Clinics are now using nurse practitioners and physician assistants to help with new patient onboarding. In the past, midlevel providers worked primarily with established patients. Now patients receive what Shamel calls “team-based care.” They may see a physician or they may see an NP, but they will be seen quickly. “A single-provider model won’t meet patient expectations,” Shamel says. “The environment has created expectations and we have to grow.” Redesigned Welcome Clinic CoxHealth’s Welcome Clinic is now seeing follow-up visits for patients from the Urgent Care and Emergency Department. In the past, we worked to connect patients from the ED or Urgent Care with a primary care provider if they didn’t have one. Frequently, patients didn’t keep their first appointments with those providers. Now, the Welcome Clinic provides a better transition. “The Welcome Clinic is our landing zone,” Shamel says. “They help patients find a great provider, based on their conditions or their location. It has been more successful than letting patients do it on their own.” Performance improvement The team is also pursuing performance improvement for the clinics. Six clinics are currently working to make processes more efficient. Shamel See ‘ACCESS,’ Page 6 5
Getting creative with medication education Being prescribed a new medication with a long list of descriptions and side effects can be confusing for patients. That’s why Cox Medical Center Branson launched a new “Ask Three, Teach Three” initiative to better educate their guests. “We realized a lot of our patients weren’t reading the single-spaced documents about their medications,” says Cheryl Gabriel, assistant nurse manager at Cox Branson. Photos: Brandei Clifto n “It is my hope and prayer that these shorter, colorful, visual aids will really help them understand what medications they are receiving.” Here’s how the initiative works: Patients will have a small poster portraying a medication bottle by their bedside. Nurses have sets of magnets with the names of common prescriptions. They will adhere the name of the medication to the patient’s poster to correspond with what they are receiving. Nurses will then personally hand the patient a card with three key pieces of information: The name of the medication, what the medication does and common side effects. Nurses will also wear buttons that say “Ask me” to remind patients and themselves to be diligent in communicating this information effectively. “Through surveys, our patients asked us for this,” says Andrea Romeiser, nurse manager at Cox Branson. “They wanted clearer communication about their medications, so our administration challenged each unit to come up with a visual aid to tackle that problem. This new, color-coded system was our winner. But, the real winners will be our patients because they’ll now be armed with important information that’s much easier to understand.”
Access
Nurse Practitioner Dina Bieker and Dr. Mark Schultz collaborate on patient care at CoxHealth’s Chesterfield Clinic. The Chesterfield team has expanded hours and is currently working on process improvement to care for more patients.
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says the need is clear: if we are asking providers to see more patients, we need to make their workdays as smooth as possible. “We want to put the providers in a winnable position so they leave work at the end of the day knowing they accomplished their goals,” he says.
Growing the right way
CoxHealth Center Chesterfield, which had housed two providers, needed to grow. They knew they would be adding providers and leaders saw the growth as a chance to expand their patient-centered approach. In January, the clinic moved to a larger location and it now has seven providers – five physicians and two mid-level providers. The clinic uses creative scheduling, allowing for extended 6
Photo: Randy Berger
hours: 7 a.m.-7 p.m. and 8 a.m.noon on Saturdays. “We surveyed a few clinics to see what hours patients would like,” says clinic manager Leesa Wallace. “The prime time they needed is 4-6 p.m.” Extended hours allow patients to come in before work or school or in the early evening. Wallace says new providers were hired with extended hours in mind, while staff have worked together to adjust their hours. “It gives both patients and employees options,” she says. “Some people like to start early
or leave early, others like to come in later.” Six providers at the clinic are currently open to new patients. Wallace and clinic staff members work closely with the info line team to keep them informed of the availability. “Most new patients can be seen within one or two days, depending on what works for the patient,” she says. “If we have a scheduling conflict and can’t get them in, we work with the call center to find a clinic that can serve them best.” In addition to new providers,
the clinic also added additional staff members, including a triage nurse who handles incoming phone calls. This allows clinic staff to focus on patients in the clinic while freeing up front-desk personnel to work with patients as they arrive. For patients calling in, it means no waiting for a call back. “We want to think of ourselves as the patient,” Wallace says. “We no longer make patients wait for responses or results. Their question may be something small or it may be life changing, but no one wants to be kept waiting.” Wallace says the changes have made daily work better for clinic staff as well. “We hated when we couldn’t get patients in – especially people who had moved to the area and need a doctor. Now, the clinic has exploded and we love it. We are doing what Steve Edwards asked. And we are helping patients. That’s a great feeling.”
This year’s event included panel discussions and sketches (below) to inspire discussion. Sessions focused on issues around all types of diversity, from race and culture to age and disability. “In health care, we have to be inclusive and understanding of everyone we come in contact with,” says Christina Hofmeister, international talent coordinator in Nursing Administration.
Photos: Christina Hofmeister
Seeing another perspective Multicultural and Inclusion Day focuses on frank discussion and cultivating empathy.
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At the end of the 2018 Multicultural and Inclusion Day, Regina Bradford says one thing is clear: This is something everyone needs to see. Bradford, who works at the Branson West Clinic, says she was surprised at the way the event tackled sensitive issues – around race, sexuality and religion – head-on. Attendees began the day watching a skit featuring a black man and a white woman in a break room. The topic of conversation was Civil War memorials. It’s an issue people have strong opinions about, which made it the perfect opportunity to consider an opposing viewpoint. After the skit, the discussion opened up to the room. “This was very honest,” Bradford says. “Usually, no one wants to offend anyone, so you skim over the surface. I loved that they got down to the nitty-gritty immediately.” The discussion forced everyone to consider an alternative viewpoint, and put themselves in someone else’s shoes. “People make it seem like things are black and white: you’re biased or you’re not biased. It’s not that simple,” Bradford says. “I thought I was open-minded, but there are a lot of times when I didn’t see things from
someone else’s point of view.” Now in its second year, the Multicultural and Inclusion Day is designed to build empathy and increase understanding, which makes all of us better caregivers. “CoxHealth is a team and we must treat each other with respect, regardless of what our differences and backgrounds may Hofmeister be,” says Christina Hofmeister, international talent coordinator in Nursing Administration. “In health care, we have to be inclusive and understanding of everyone we come in contact with, whether it is our patients, our colleagues, or someone we meet at the grocery store.” Kelsey Bagwill, patient experience consultant, says a yearlong experience with AmeriCorps in Boston-area schools had inspired her interest in diversity and inclusion. “I was so excited to see CoxHealth do this. We have less diversity than in Boston, which is neither good nor bad, it just is,” she says. “People take things for granted and
don’t always think about other viewpoints, not because they don’t want to but because they haven’t had to.” Group exercises illustrated the advantages and disadvantages people face. One called for participants to stand side-by-side on a line. Each had an assigned identity and organizers called out circumstances – like family resources or accidents – that could cause them to move forward or backward. “It showed how different circumstances can put you far ahead or behind,” Bradford says. “Now, I back up and try not to second guess what’s going on in someone’s life. Don’t assume you know what’s going on.” The event also included panel discussions on topics ranging from religion to culture and clinical care. “I appreciated everyone who sat in front and told us what they faced, based on their religion, race or lifestyle,” Bradford says. “That took guts and it made it personal. They want to make it better for the next person.” Bagwill says the day made it clear we all need to take time to understand one another. “It never hurts to ask people how they prefer to be respected – what they want to be called, how they want to be touched and treated,” she says. Considering a new perspective goes far beyond the sometimes loaded words of multiculturalism or diversity. “Ultimately, this is about considering other people and relating to them better.” 7
3850 S. National Ave. Springfield, MO 65807
Photo: Randy Berger
Primrose Perk now serving coffee and more Primrose Perk, a coffee and smoothie bar, is going strong in the lobby of Cox South. In addition to coffee and smoothies, Primrose Perk offers freshly baked, preservative-free pastries and more. Primrose Perk is open 6 a.m.-8 p.m., Monday-Friday, and 7 a.m.-7 p.m. on weekends.
Magic Word
Find the magic word and you could win your choice of a shirt or coffee mug from 1906, The Employee Store. Call 269-4154 and leave a message with the magic word and the page on which it can be found. Include your name,
department and phone number. The 23rd correct answer will win. Clue 1: An area with a particular characteristic or use. Clue 2: Springfield native Tom Whitlock co-wrote a Kenny Loggins hit that promised to deliver us to a hazardous one of these.
Connection is a regular publication for the employees of CoxHealth 3801 S. National Ave. Springfield, MO 65807
Email us any time at CorporateCommunications@coxhealth.com Editor: Randy Berger 269-3171
Contributors: Brandei Clifton Janell Patton
Yvette Williams Mike Wingo
When patients need a doctor, our answer is “yes, we can care for you, and we can do it now.� See how creative approaches are offering new appointments in days, not weeks. Page 1
The LEADs program is training leaders to make a great work environment. Page 4
See a new perspective at our second Inclusion Day. Page 7
July / August 2018
New palm vein scanning technology will improve patient safety and smooth the registration process. Page 3