The Executive Connection of North Texas: Summer 2013

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SUMMER 2013

CONTENT President’s Remarks Caleb O’Rear, FACHE

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4th Annual ACHE of North Texas Case Study Competition

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Medicare Audits Protecting Against Adverse Financial Impact

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Congratulations New Fellows

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Patient Experience of Care 8 Inventory of Improvement Resources

northtexas.ache.org

Social Media The communications committee would like to announce our new ACHE of North Texas social media offerings and encourage your membership on these sites! Specifically, we are revamping our LinkedIn account, which many of you are connected to, and have created a brand new Facebook account. We hope to encourage member networking as well provide additional outlets for dissemination of chapter announcements through these platforms. You can find us at:

Low-Income Patients Say ER is Better than Primary Care

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News from National

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Event Encore

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https://www.facebook.com/ACHENTX

Event Extras

Calendar

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Furthermore, as we continue to broaden our social media interaction with membership, we would also like to solicit your participation on the social media sub-committee. If you have experience or interest in social media strategy development, please reach out to Dana Lujan (dana@dylconsultinggrp.com) or Chip Zahn (chip.zahn@scasurgery.com) for further information.

http://www.linkedin.com/groups?home=&gid=1945730&trk=anet_ug_hm

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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 leadership trends that are shaping and influencing the healthcare industry. Readers get indepth reporting on the issues 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 info@northtexas.ache.org. Microsoft Word or compatible format is preferable. If you have a graphic or picture that you’d like to include, please send it as a separate file. The following 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.

ACHE of

North Texas

A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2013

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2013 Board of Directors Teresa Baker, FACHE John Peter Smith Health Network Beverly Dawson, RN, CCM, FACHE Elder Care Editor-In-Chief

Susan Edwards, FACHE

Managing Directors

Matthew van Leeuwe Joan Shinkus Clark, DNP, RN, FACHE

Contributing Editors

Lisa Cox

Contributing Writers

Dana Lujan | Edward Perry Jenifer Greenway | Stan Kovarik

Production

Kay Daniel

Advertising/ Subscriptions info@northtexas.ache.org Questions and Comments:

ACHE of North Texas Editorial Office, c/o Executive Connection 250 Decker Drive | Irving, TX 75062 p: 972.413.8144 e: info@northtexas.ache.org | w: northtexas.ache.org

2013 Chapter Officers President

Caleb F. O’Rear, FACHE

Denton Regional Medical Center President-Elect

Winjie Tang Miao

Texas Health Harris Methodist Hospital Alliance Secretary

Josh Floren, FACHE

Texas Health Presbyterian Hospital Plano Treasurer

Pam Stoyanoff

Methodist Health System

Forney Fleming University of Texas at Dallas Dresdene Flynn – White John Peter Smith Health Network Jay Fox Baylor Medical Center - Waxahachie Michael Hicks, MD, FACHE Pinnacle Anesthesia Consultants Janet Holland Rendina Companies Jonni Johnson, CPSM RTKL Ashley McClellan, FACHE Medial Center of Lewisville Kevin Stevenson, FACHE Matthew van Leeuwe Lake Granbury Medical Center Demetria Wilhite University of Texas at Arlington Bethany Williams Zirmed Chip Zahn, FACHE Surgical Care Affiliates Lisa Cox Chapter Coordinator

Regent

Michael D. Murphy, FACHE

Abilene Regional Medical Center

ACHE of

North Texas

A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2013

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President’s Remarks

Caleb O’Rear, FACHE Dear Chapter Members, Well the dog days of Summer have arrived, and if you are like me, keeping cool and out of the Texas heat is a daily chore. What better way is there to stay cool than. . . . . staying inside and catching up on some of your needed education credit hours! Don’t miss Chip Caldwell’s “Preparing to Live on Medicare Rates,” Executive Education Session on Thursday, August 15th from 9:00 am – 3:00 pm at the HCA North Texas Resource Center in Irving. Did you know that on this day in 2011 the actual high for the day was 105? Or how about Breakfast with Kirk King, President of Arlington Memorial Hospital on September 11th from 7:30 am – 9:00 am at Texas Health Arlington Memorial Memorial. Speaking of breakfast, did you know that on a hot August day in Texas, the heat from the sun can warm the hood of a car to temperatures greater than 145 degrees, the temperature at which you can actually begin to fry an egg?

Okay so maybe the heat has gotten to me. Last plug – don’t forget our Membership Drive in September and be sure to join us at the Rangers Ballpark in Arlington on Thursday, September 26 at 6:00 p.m. Bring an interested colleague and we will do the rest. The best part……it’s an air conditioned Suite!

Until next edition, Caleb O’Rear, FACHE

4th Annual ACHE of North Texas Case Study Competition Registration is now open for the 4th annual ACHE of North Texas Case Study Competition. The competition is open to all students currently enrolled in a graduate level health care administration program.

The winning team will be awarded a cash prize, be invited to attend an event with the Board of Directors, have their annual ACHE Membership dues reimbursed for 2014, and be recognized in Chapter publications.

To enroll in the competition, read the competition rules and complete the registration form found at http://northtexas.ache.org/. All registration forms must be submitted via email to info@northtexas. ache.org no later than September 27th.

A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2013

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The Institute of Medicine, a branch of the National Academy of Sciences, released a report dated Sept.13, 2012 asserting the U.S. health-care system wastes about $750 billion each year due to overpayment, poor billing practices and inaccurate diagnosis.

Fraudulent, wasteful and abusive billing practices in the Medicare reimbursement system have become a routine talking point in households, a staple headline in national news and a heated subject for pundits and politicians. Election cycles present another opportunity to discuss methods of improving the efficiency of every dollar spent by the Medicare Trust Fund.

There are two main fraud audit contractor programs used by Centers for Medicare and Medicaid Services (CMS) to ensure compliance with current billing policies. Recovery Audit Contractors (RACs) target improper payments while Zone Program Integrity Contractors (ZPICs) focus on identifying fraud. Hospitals, physicians, hospices, skilled-nursing facilities and home-health agencies are subject to both programs.

Providers with Medicare revenues should be aware of the regulatory landscape and prepare for the possibility of compliance audits. Protecting against an adverse financial impact (i.e., delayed reimbursement or recoupment of alleged overpayments) begins with developing a compliance plan that includes identifying key personnel to facilitate ongoing training, conduct internal audits, draft appropriate policies and procedures and ensure medical records are organized for easy access.

ZPICs The primary purpose of Zone Program Integrity Contractors is to identify cases of suspected Medicare fraud, investigate in a thorough and timely manner then take immediate action to ensure monies are not inappropriately paid and any mistaken payments are recovered. This is accomplished through independent firms with the authority to:

Medicare Audits: Protecting Against Adverse Financial Impact This article has been reprinted with permission of Lancaster Pollard

• Analyze data to identify actual or potential payment errors and fraud.

• Investigate allegations of fraud made by beneficiaries, providers, CMS, Office of Inspector General−U.S. Department of Health and Human Services and other sources.

• Recommend administrative actions to deny or suspend payments.

• Identify overpayments.

• Recommend exclusion from the Medicare program.

• Report cases for consideration of civil and criminal prosecution and/or application of administrative sanctions Auditors may show up with little or no notice to perform a review of billing procedures and compliance to CMS policy. Confirmation cont. on page 6

A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2013

of fraudulent or wasteful activity is the objective, not discovering it. The process may include requests for medical records and documentation, interviews with staff and beneficiaries, inspections of facilities and analyses of claims. If a ZPIC auditor finds a sustained or high level of payment error, it can elect to extrapolate overpayment amounts through statistical sample. For example, the auditors test 50 claims and from that sample predict the billing amount for the population of claims; if the total dollar value of claims submitted is much greater than the inferred value, the ZPIC has authority to force recoupment payments to CMS. Adverse findings can be challenged through an appeals process.

Altogether, there are five levels of appeal ─beginning with redetermination then reconsideration and ending in a U.S. District Court. The entire process for reversing or modifying a decision can be costly, lengthy and daunting.

Prepayment review, which usually begins once an audit is initiated, is a process wherein a percentage of claims, ranging from 25−100%, undergo review before payment is authorized. There is no administrative appeals process to contest being placed on prepayment review or specific method to eliminate it. Providers are subject to very strict Medicare reimbursement limitations during the review. They can experience significant challenges to financial viability because claim determinations are made after services have been provided, thereby impacting cash flow.

Reviews have taken as long as 18 to 24 months. Denied claims can be appealed. Even after review and subsequent approval, it can take as long as 90 to 120 days for reimbursement.

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In response to the efforts of several Florida providers and representative associations complaining about the consequences of prepayment reviews, CMS halted the process in August. While this announcement only affects nursing homes in Florida, the long-term-care industry views it as a step in the right direction toward fairness and the restoration of due process.

RACs CMS introduced Recovery Audit Contractors as a demonstration project in 2005 for the purpose of identifying underpayments and overpayments then recouping overpayments. The demonstration project found more $1 billion of improper payments of which 96% were overpayments. The program was subsequently implemented on a permanent basis.

Unlike ZPICs, which sign a contract at a specific payment, RACs are paid on a contingent basis for detecting and correcting overpayments and underpayments. This includes both collecting overpayments from providers as well as refunding underpayments to providers.

There are two types of reviews: automated and complex. An automated review is a computerized analysis of claims and coding practices. Typically, only billing errors are found. In a complex medical review, auditors study the actual medical record or other documentation.

cont. on page 7

A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2013

RACs have the authority to review three years of provider data and claim submission for hospital inpatient and outpatient services, skilled-nursing facilities, physician, ambulance, laboratory and durable medical equipment. Auditors use internally created and managed computer programs to detect likely payment errors, such as duplicate payments, intermediary mistakes, necessity of service and coding errors. Much like ZPICs, RAC audits can be triggered using statistical analysis of historical submission data and identifying outliers. Claim and medical record discrepancies, rejection rates of claims, and beneficiary complaints can also prompt an examination.

CMS began prepayment review under Recovery Audit Prepayment Demonstration (RAPD) in August. This demonstration project was initially scheduled to begin in January this year, but was postponed to allow for comment, and will run until Aug. 26, 2105.

It will involve 11 states - Florida, California, Michigan, Texas, New York, Louisiana, Illinois, Pennsylvania, Ohio, North Carolina and Missouri - and focus on claims with a high risk of fraud, beginning with those involving short stay inpatient hospital services. The program will expand to include specific types of claims with a high incidence of fraud.

The program will attempt to prevent improper payments as well as help providers understand how to accurately bill future claims. As such, there will be a review of claims before they are paid to ensure the hospital or provider complies with all Medicare payment rules. RAPD will not replace prepayment reviews by Medicare administrative contractors (MACs). RACs and MACs are supposed to coordinate activities so as to avoid duplicate efforts.

Audits, Credit Consequences and Planning A provider’s credit profile, which is both qualitative and quantitative, changes once a ZPIC or RAC audit occurs. For instance, the audit, in and of itself, may be an indication of poor billing practices and noncompliance with CMS policies. Additionally, cash flow could be negatively impacted as a result of the audit or pre-payment review. Furthermore, the possibility of a considerable recoupment payment from a finding of overpayment will impact various leverage and liquidity ratios. Many loan agreements and bond documents contain financial covenants directly tied to these same ratios and changes to them may trigger a default.

The best protection against the adverse impact of an audit is the adoption and implementation of appropriate policies and procedures. A sound strategy includes developing a compliance plan. Some recommended actions:

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• Identify a single person or group to communicate with an auditor as well as respond to requests for information.

• Develop a denials management process to monitor and track denials.

• Develop an appeals process that includes support for claims and involvement of legal counsel.

• Create a mechanism for employees to file complaints anonymously.

• Ensure easy access to past medical records that are wellorganized.

The Opportunity CMS is attempting to ensure the long-term viability of the Medicare Trust Fund. ZPICs and RACs have proven to be an effective method of detecting, preventing and deterring fraud. Success begets success. As such, providers can anticipate expanded efforts by the government to eliminate waste.

ZPICs and RACs present an opportunity for providers to more thoroughly understand the rules and regulations regarding Medicare reimbursement. A detailed plan for navigating the regulatory environment will mitigate the risks of adverse findings while minimizing any negative impact to the credit profile. Any processes that strengthen financial performance should be welcomed by providers and are always encouraged by the capital markets. As they say, success begets success.

MAY Jay T. DeVenny, FACHE, Plano William S. Hurst, FACHE, Lantana JUNE Ashley K. Reid, FACHE, Dallas Samuel Wesson III, FACHE, Euless JULY Bradley T. Ervin, FACHE, Fort Worth Virginia H. Rose, FACHE, Dallas

• Perform a self-audit focusing on known vulnerabilities or areas targeted by auditors.

• Conduct regular billing and coding training while seeking third party assistance on processes to avoid audits (e.g., admissions screening and case management).

• Adopt any necessary technology that will assist in the implementation of processes.

Congratulations to Our New Fellows

A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2013

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Patient Experience of Care Inventory of Improvement Resources This article has been reprinted with permission of the Robert Wood Johnson Foundation

This inventory lists a variety of free resources—including toolkits, guides, reports, and webcasts—that are available to support health care organizations in determining what they need to do to improve patient experience and how to implement those improvements. These resources are available for both ambulatory care settings and hospitals. This inventory was developed by the Shaller Consulting Group, which updates it on a regular basis.

Please note that several resources developed by the Agency for Healthcare Research and Quality as part of its CAHPS (Consumer Assessment of Healthcare Providers and Systems) program are temporarily unavailable. This inventory will be updated once those resources are accessible.

Improving Experience with Ambulatory Care: Toolkits and Guides CAHPS Improvement Guide The website for this resource is temporarily unavailable. However, a PDF version is available on request. Contact Dale Shaller (d.shaller@ comcast.net).

Health Literacy and Patient Safety: Help Patients Understand http://www.ama-assn.org/ama/pub/about-ama/ama-foundation/ our-programs/public-health/health-literacy-program/healthliteracy-kit.page Improving the Patient Experience Change Package http://www.calquality.org/programs/patientexp/resources/ documents/Improving_Pt_Experience_Spread_Change_Pkg_ UpdatedMay2011.pdf

Improving Patient Experience Program Resources http://www.calquality.org/programs/patientexp/resources/ Resources for Patient Experience of Care Improvement http://www.massgeneral.org/stoecklecenter/programs/patient_ exper/about.resources.aspx Practice Transformation http://www.safetynetmedicalhome.org/practice-transformation Improving Experience with Ambulatory Care: Case Studies, Papers, and Webcasts Good For Health, Good For Business: The Case for Measuring Patient Experience of Care http://www.r wjf.org/en/research-publications/find-r wjfresearch/2010/04/good-for-health--good-for-business.html Improving Patient Experience: A Hands-On Guide for Safety-Net Clinics http://www.chcf.org/publications/2011/10/patient-experiencesafety-net-clinics A Tale of Three Practices: How Medical Groups Are Improving the Patient Experience http://forces4quality.org/tale-three-practices-how-medicalgroups-are-improving-patient-experience

cont. on page 10

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Low-Income Patients Say ER is Better Than Primary Care New RWJF Clinical Scholar research helps debunk commonly-held myths about frequent emergency room use.

This article has been reprinted with permission of rwjf.org

One of the drivers of high health care costs in the United States is the use of emergency rooms (ER) for preventable conditions by patients who generally come from the most vulnerable populations. Estimated to cost as much as $30.8 billion a year in a recent Health Affairs study, avoidable ER use is a primary target for experts seeking to reduce health care costs.

To achieve this goal and “generate system-wide savings, experts need to listen to patients and address their concerns about the cost, quality and accessibility of outpatient care,” said Shreya Kangovi, MD, a Robert Wood Johnson (RWJF) Clinical Scholar (2010-2012) supported in part by the U.S. Department of Veterans Affairs.

Kangovi’s new study reports that current approaches to getting patients from low-socioeconomic groups to seek preventive and primary care in physicians’ offices or accountable care organizations instead of hospitals are often ineffective.

Kangovi and her team conducted one-on-one interviews with 64 patients, ages 18-to-64, from two urban Pennsylvania hospitals.

Forty of them met the criteria to be included in the study.

They were uninsured or insured by Medicaid. The respondents, who were 90 percent African American, also lived in one of five Philadelphia zip codes where more than 30 percent of the residents had incomes below the poverty level.

The results were published in the July Health Affairs cover story “Understanding Why Patients of Low Socioeconomic Status Prefer Hospitals Over Ambulatory Care.”

“We asked them: ‘What are some of the reasons you might prefer to come to the emergency room rather than your primary care doctor’s office or clinic?’” Kangovi said. “The interviews were conducted by a community health worker who was a member of their community, so there was more of a trusting relationship.”

“Our findings suggest that these efforts could backfire by making hospitals even more attractive to these patients. We also debunk the notion that people from these groups abuse the emergency room for no reason and need to be taught how to use it properly.”

Study respondents (both the insured and uninsured) explained that they consciously chose the ER because the care was cheaper, the quality of care was seemingly better, transportation options were more readily accessible, and, in some cases, the hospital offered more respite than a physician’s office.

Insurance Status is Not the Key

Excessive Barriers to Primary Care

Working from literature that shows ER usage patterns are not necessarily linked solely to insurance status, Kangovi explained that she “wanted to find a way to address the ongoing disparities” she saw in her patient population. “To do so, I designed the study so that we could talk with patients whose voices are seldom heard in policy discussions.”

“As a physician, I found the results very disturbing. We discovered that our system is just riddled with barriers to primary care,” Kangovi said. Patient voices taken from study interviews tell the story best: cont. on page 10

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cont. from page 9

cont. from page 8

Convenience. “You must call on the same day to set up a [primary] care appointment … whenever they can fit you in.” This openaccess scheduling resulted in people taking days off from work and still being unable to see a doctor. It also made it impossible for many to access transportation covered by Medicaid because the transport arrangements had to made 72 hours in advance.

Late hospital hours also made care more available.

Improving Experience with Hospital Care: Toolkits and Guides

Cost. “I don’t have a co-pay in the ER, but my primary [physician] may send me to two or three specialists and sometimes there is a co-pay for them. Plus there’s time off from work to go to several appointments.”

Quality. “The [primary care doctor] never treated me or my husband aggressively to get blood pressure under control. I went to the hospital and they had it under control in four days. The [physician] had three years.” This patient was one of many who expressed far more trust in the quality of hospital care.

Shelter from the Storm In order to better understand study participants’ needs, Kangovi sorted them into two groups—those with five or more acute care episodes a month (group A) and those with less than five acute episodes a month (group B).

“The patients in group A had often gone through extraordinary trauma and were more likely to say that a traumatic event set off a cycle of social dysfunction, mental illness, and disability that drove their repeated hospital visits,” Kangovi explained.

“The group B patients were most often highly functional caregivers for social networks strained by poverty and illness. These people often put off caring for themselves. Both groups had extremely eloquent and valid reasons for avoiding preventive care, waiting to get sick and choosing emergency care,” she added.

Creating a National Model for Change Acknowledging that this research has some limitations, such as the small size of the study sample, Kangovi intends to encourage other researchers to focus on vulnerable patients.

“I used the health services research training I gained as a Clinical Scholar, as well as the incredible support I received from my Clinical Scholar program mentors including my co-authors David Grande, MD, MPA, and Judith Long, MD, to address problems I saw from a public health and eventual policy perspective,” Kangovi said. “We plan to disseminate the study strategy.”

“We learned that the patients are the experts in the flaws in our health care system and the people we need to listen to,” Kangovi advised. “You hear the term ‘patient-centered care,’ well you have to talk to patients to create that care. Right now, they are telling us that we are creating a maze of hoops and hurdles that are driving them out of primary care and into the hospital.”

Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care: A Roadmap for Hospitals h t t p : / / w w w. j o i n t c o m m i s s i o n . o rg / a s s e t s / 1 / 6 / ARoadmapforHospitalsfinalversion727.pdf Advancing the Practice of Patient- and Family-Centered Care in Hospitals: How to Get Started http://www.ipfcc.org/pdf/getting_started.pdf Always Events® Tool Box Picker Institute http://alwaysevents.pickerinstitute.org/?page_id=882 Go Guide—Transform Care in Six Steps: The Patient- and Family-Centered Care (PFCC) Methodology http://www.pfcc.org/ Health Care Leader Action Guide to Effectively Using HCAHPS http://www.hpoe.org/resources/hpoehretaha-guides/807 Patient-Centered Care Improvement Guide h t t p : / / w w w. p a t i e n t - c e n t e re d c a re. o rg / i n s i d e / abouttheguide.html Strategies for Leadership: Patient- and Family-Centered Care http://www.aha.org/aha/issues/Quality-and-Patient-Safety/ strategies-patientcentered Improving Experience with Hospital Care: Case Studies, Papers, and Webcasts Achieving an Exceptional Patient and Family Experience of Inpatient Hospital Care Institute for Healthcare Improvement http://www.ihi.org/knowledge/Pages/IHIWhitePapers/ Improving Patient Experience in the Inpatient Setting: A Case Study of Three Hospitals http://forces4quality.org/improving-patient-experienceinpatient-setting-case-study-three-hospitals Patient Experience Case Studies http://www.whynotthebest.org/contents/index/1/5 Profiles of High-Performing Patient- and Family-Centered Academic Medical Centers http://pickerinstitute.org/profiles-of-medical-centers/

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NEWS FROM NATIONAL

ACHE’s New President and CEO Takes the Helm ACHE welcomed its new president and CEO, Deborah J. Bowen, FACHE, CAE, on May 13. Bowen was executive vice president and COO at ACHE and replaces Thomas C. Dolan, PhD, FACHE, FASAE, who retired as ACHE’s president and CEO on May 10 after 27 years of service to ACHE and the healthcare management profession.

Bowen looks forward to working with ACHE’s Board of Governors, Regents, chapters and staff to help ACHE members be successful leaders in transforming healthcare. To learn more about Bowen, read her interview in the July/August 2013 issue of Healthcare Executive.

2013 Congress Recap Nearly 4,000 healthcare executives recently gathered in Chicago to participate in ACHE’s 56th Congress on Healthcare Leadership.

This year’s Congress offered attendees opportunities to learn, connect with colleagues, share knowledge and insight, and gain fresh perspectives so that together we can design and implement strategic initiatives to meet the challenges of healthcare delivery. Relive or experience for the first time some of the best leadership presentations from Congress at ache. org/CongressMultimedia. Finally, save the date for next year’s Congress! The 57th Congress on Healthcare Leadership will be held March 24–27, 2014, at the Hyatt Regency Chicago.

Exam Online Community Offers a Complimentary Interactive Learning Platform Members preparing for the Board of Governors Examination can access the Exam Online Community as a complimentary and supplementary resource that can boost their confidence and help them succeed. The Online Community is an interactive platform to learn and glean study tips from other Members taking the Exam. Plus, there is the opportunity to discuss Exam topics with experts for better understanding and the option to participate in study groups. Interested Members can join the Exam Online Community at bogcommunity.ache.org.

Executive Diversity Program Accepting Applications The scholarship application process for the Thomas C. Dolan Executive Diversity Program opened on Monday, June 3, 2013.

The deadline for submissions is Friday, Aug. 2.

The year-long program will provide full scholarship support to a cohort of mid- and senior-level careerists who aspire to higher leadership roles and will provide specialized curriculum opportunities addressing barriers in career attainment and developing executive presence. A maximum of six scholars will be selected.

The Executive Diversity program scholars will participate in all of the following events in 2014: January 2014 March 24–27, 2014

June 2–4, 2014

August 4–6, 2014

October 13–15, 2014

December 2014

Orientation Meeting - Chicago 57th Congress on Healthcare Leadership - Chicago Senior Executive or Executive Program Session I - Chicago Senior Executive or Executive Program Session II - San Diego Senior Executive or Executive Program Session III - Orlando Customized Educational Event/ Wrap Up - Chicago

In addition, the program features one-on-one interaction with a specially selected mentor and participation in formal leadership and career assessments.

The Foundation of ACHE’s Thomas C. Dolan Executive Diversity program was established by the Board of Governors to honor Thomas C. Dolan, PhD, FACHE, FASAE, president and CEO of ACHE from 1991–2013, and his long-standing service to the profession of healthcare leadership and to further his strong commitment to achieving greater diversity among senior healthcare leaders.

Visit ache.org/ExecutiveDiversity for more information or to apply. Please direct any program questions about the Thomas C. Dolan Executive Diversity Program to Jennifer L. Connelly, regional director, at jconnelly@ache.org or (312) 424-9328.

The Foundation of the American College of Healthcare Executives is still encouraging donations to the Thomas C. Dolan Executive Diversity Program. Gifts—no matter the amount— will shape the future of healthcare leadership. Visit ache.org/ ExecutiveDiversity to make a donation.

A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2013

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NEWS FROM NATIONAL

Attend the Inaugural Physician Executives Forum Education Program

Postgraduate Fellowship Area Provides Resource to Healthcare Organizations

As part of the new Physician Executives Forum, launched in January 2013, its inaugural education program will be held on Friday, Aug. 9, at the Grand Hyatt New York, following the New York Cluster. This one-day program will strengthen your skills and build your knowledge base in three key areas: leadership, communication and strategic planning. Gain valuable advice from a panel of C-suite executives who are successfully working with physician leaders to improve patient care. Expert faculty include Thomas A. Atchison, EdD and Alan M. Zuckerman, FACHE, FAAHC. Physician executives can register now at ache.org/PEprogram.

Physician Executives Forum members will receive a $100 discount off the registration fee. To learn more about membership in the Physician Executives Forum, visit ache.org/PEForum.

Postgraduate Fellowships are essential to attract and develop highly qualified healthcare management professionals. ACHE offers robust online resources on postgraduate fellowships at ache.org/PostGrad whether an organization seeking to develop a postgraduate fellowship, an organization that wants to find the best candidate or new healthcare management entrants looking for a fellowship opportunity. The site includes the Directory of Fellowships in Health Services Administration for organizations to post their fellowship opportunities and for students to find opportunities they want to pursue. Additionally, resources for organizations looking to start a Fellowship include sample manuals, templates and checklists.

Fund for Innovation Offerings The ACHE Executive Program is designed to help healthcare ACHE is offering a new special session funded in part by the Foundation of ACHE’s Fund for Innovation in Healthcare Leadership. On Tuesday, Sept. 24, in conjunction with the San Diego Cluster, ACHE and the Fund will present “The Innovation Center: Taking Action to Improve Care and Reduce Costs,” led by Valinda R. Rutledge, former director of the Patient Care Models Group at the U.S. Center of Medicare and Medicaid Innovation (Innovation Center). During this valuable, half-day session, you will gain an understanding of the Innovation Center and the impact that various funded initiatives will have on the delivery of healthcare to Medicare and Medicaid beneficiaries and on healthcare organizations that deliver that care. See how the Innovation Center supports healthcare leaders in creating new care delivery models. Discover opportunities to deliver better health, improved care and lower costs to people with the highest healthcare needs in your communities.

In addition, leaders from three organizations that are participating in different pilots with the Innovation Center will share their experiences, outcomes and challenges in implementing these pilots. Participation in this workshop qualifies for 4 hours of ACHE Face-to-Face Education credit.

As a result of this program you will identify breakthrough strategies leading healthcare organizations are developing to: • Improve patient safety • Promote care that is coordinated across healthcare settings • Invest in primary care transformation • Create new bundled payments for care episodes For those already participating in the San Diego Cluster continue your professional growth with this special offering. Or, participate solely in this program and discover tremendous opportunities for improving patient care and the overall health of the communities you serve.

Visit ache.org/CMSinnovation for details.

This program is just one way the Fund brings innovation to the forefront of healthcare leadership. For more information about the Fund for Innovation in Healthcare Leadership, visit ache.org/Innovation or call ACHE’s Customer Service Center at (312) 424-9400.

A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2013

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EVENT ENCORE

A Collaborative Practitioner Model for Efficiency & Safety in Patient Care Submitted by Stan Kovarik On April 18, 2013, Texas Scottish Rite Hospital for Children hosted an educational program on a Collaborative Practitioner Model for Efficiency & Safety in Patient Care. The program was moderated by Michael Hicks, MD, MBA, MHCM, FACHE, CEO, EmCare Anesthesia Services President & Chairman, Pinnacle Anesthesia Consultants Regional Medical Director, HCA Ambulatory Surgery Division and panelists were Adam Corley, MD, Executive Vice President at West Division of EmCare, Dr. Cole Edmonson, DNP, RN, FACHE, NEA-BC Chief Nursing Officer & Vice President of Texas Health Presbyterian Hospital Dallas and Charles Williams, FACHE, Chief Operating Officer of Doctors Hospital at White Rock Lake.

Dr. Hicks opened the session by providing an excellent introduction into the most common issues involving the interaction between physicians and nursing staff. He pointed out how bullying can negatively impact staff morale and patient outcomes. Dr. Edmondson expanded on Dr. Hicks statement by providing eye opening statistics on conflicts between practitioners and provided some examples of these negative behaviors and their impact on the delivery of care. Mr. Williams described the situation he encountered upon his arrival as a COO at his facility and shared his experiences with addressing the conflicts between their doctors and nursing staff. Utilizing effective conflict resolution techniques and active leadership, they were able to improve the patient satisfaction scores by 10% and physician satisfaction scores by 11% in the first 12 months.

Several questions followed from the audience. To a question “Is there a concept of low hanging fruit in addressing disruptive behavior”, Mr. Williams responded by sharing his example from a previous employer. In order to address the issue of new nursing staff being afraid to speak up when bullied, their leadership team implemented a buddy system, pairing a young nurse with an experienced one, so when needed, the senior nurse would help facilitate the tough situations on their behalf with great results. Another example of a similar model was provided by Dr. Edmondson where they grouped nursing staff into three major groups, based on experience levels to address generational gap issues in mentorship.

An important takeaway was delivered when a question of empowering the nursing staff to take a leadership role in resolving conflicts was raised. Mr. Williams emphasized the importance of a “timeout” education and hospital executives being actively involved in supporting their staff when they bravely stand up to bullying and provide crucial feedback to the parties involved.

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

A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2013

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EVENT ENCORE

After Hours Networking Event Hosted by Matt Chance, FACHE, CEO, Baylor Uptown and Eric Jacobson, FACHE, Assistent Director Submitted by Dana Lujan A spectacular evening for networking hosted by Matt Chance, FACHE, CEO of Baylor Uptown Medical Center and Eric Jacobsen, FACHE, Assistant Director of the VA North Texas Healthcare Systems at the AT&T Performing Arts Center.

Kellye Stephens, Ed White, Sam Ndinjiakat

With 88 members in attendance, they were all stunned by the view and enjoyed speaking with the hosts on topics such as: ACO’s, healthcare reform and what is on the horizon for the industry while networking and mingling with each other.

Everyone who attended made the most of this event and made valuable connections. Once again, ACHE-North Texas appreciates Matt Chance, FACHE and Eric Jacobsen, FACHE for hosting this event and the members who attended. For more information on future events, please visit us at www.northtexas.ache.org or send us an email at info@northtexas.ache.org.

Host Matt Chance, FACHE with committee members John Duckert, FACHE and Scott Hurst, FACHE

Making Sense of Performance Transformation Methodologies Submitted by Jenifer Greenway On Thursday, June 20, 2013, Steve Newton, President, Baylor Regional Medical Center at Grapevine & Executive Director, West Region, Baylor Healthcare System hosted the North Texas chapter face to face education program, “Making Sense of Performance Transformation Methodologies”. A panel of performance excellence experts including Liz Youngblood, President, Baylor Specialty Health Centers & VP, Patient Support Services, Baylor Health Care System, Clint Abernathy, Professional Support Service Officer, Texas Health Harris Methodist Hospital Alliance and Jon Souder, Director, PwC Health Industries Advisory Practice delivered presentations, followed by a panel discussion moderated by Mr. Newton.

With more than 60 attendees scheduled for the event, this topic proved relevant and timely. Audience members were treated to an overview of the Quality Texas Foundation, Baldrige National Quality Award and the ‘hamburger’ systems perspective inherent to generating aligned improvements. In addition, lean six sigma project examples and tips were highlighted from the healthcare operations perspective, while a fresh take on issues based problem solving was presented from the consulting vantage point.

Recognizing that poor quality has a detrimental ripple effect, performance transformation holds the key to improving quality while simultaneously enhancing productivity, lowering cost and increasing profitability. The North Texas ACHE chapter thanks these presenters for sharing their insights and best practices regarding these critical practices. For more information on future events, please visit us at ww.northtexas.ache.org or send us an email at info@northtexas.ache.org.

Attendees Paul Musgrave and Jean Ann Larson

Panelists Clint Abernathy - Texas Health Alliance; Liz Youndblood Baylor; Jon Souder - PwC

Moderator Steve Newton with program attendee William Cooksey and Program Organizer Charmaine Christiansen

Program Moderator, Steve Newton Baylor Grapevine

Panelists Clint Abernathy and Joe Souder

Program Organizer Charmaine Christiansen Baylor HEART

A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2013

15

EVENT ENCORE

Career Mentoring: Extracting Value from Mentoring Relationships at Every Career Level Submitted by Edward Perry This July 10th event provided valuable insight to the early careerist. With answers to tough questions: How do I create a Mentor/Mentee relationship? This question generated multiple responses from the panel. 1) Seek out your mentor. Most C suite members are willing to provide guidance to young employees and appreciate differing viewpoints. 2) Join professional organizations such as ACHE who enable Mentor/Mentee relationships.

How long do you maintain a mentor/mentee relationship? Most professional programs have a defined term for mentor/mentee relationships. This term should not be looked on as the end date to the relationship. Any good mentor/mentee relationship will last a life time. Think of the relationship similar to one with a very close friend from early in your lifetime. When you do reach out it should feel natural like your reaching out to that old friend.

This excellent event provided collaboration between all levels of Healthcare Administrators.

It allowed early careerists a window into how mentor/mentee relationships are formed and retained.

Mark Boles, FACHE and ACHE colleague

Annemarie Campbell, Carlie Gotlieb, La-Toya Rivers-Azanga

We would like to thank our Moderator Jared Shelton and Panel Members Richard Fiske, Angel Benschneider, Chris Surley and Jared Shelton for sharing the stories of a successful mentor/ mentee relationship.

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

Diane Wolfe and ACHE colleague

EVENT EXTRAS

Breakfast with the CEO - April 2nd Hosted by Lillie Biggins, President, Texas Health Harris Methodist Hospital Fort Worth Host Lillie Biggins, FACHE and member Jenifer Greenway

Event Organizer, Maria Murray

May 16th Spring General Membership Dinner

Theresa Vu, board member Deresdene Flynn White and Cindy Dao

Cody Campbell, Nancy Myers, Keith Southerland, Marc Gelinas, FACHE and Steve Whitson

Panelists Dr. Lou Brewer, Tarrant County Public Health; Carrie Camin, Methodist Health System; and Larry Tubb, Cook Children’s Hospital

2013 CALENDAR

Thursday, August 22nd After Hours Event Time: 5:30 - 9:00 pm Location: Perot Musuem https://afterhoursatperot.eventbrite.com/ Wednesday, September 11th Breakfast with the CEO: Kirk King Time: 7:30 - 9:00 am Location: Arlington Memorial https://kirkkingbreakfast.eventbrite.com/ Thursday, September 19th Care for the Uninsured and Underinsured Credit: 1.5 face to face credits apply Time: 5:30 - 7:30 pm Location: Parkland Health & Hospital System

Wednesday, October 23rd Women’s Event Time: 7:30 - 9:00 am Location: Hotel ZaZa Thursday, November 14th General Membership Dinner Time: 5:30 - 8:00 pm Location: W Victory Hotel Thursday, December 5th Holiday After Hours Event Time: 5:30 - 7:30 pm Location: TBD

Thursday, September 26th Membership Drive Location: Rangers Ballpark Time: 6:00 pm

Wednesday, October 2nd Breakfast with the CEO: Ken Malcolmson Time: 7:30 - 9:00 am Location: Humana

Thursday, October 17th Physician-Hospital Integration in the 21st Century and Medical Staff Relations Credit: 3 face to face credits apply

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

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.