ACHENTX Executive Connections - Summer 2018

SUMMER 2018

HEALTHCARE LEADERSHIP

F E AT U R E S 4 President’s Message Kevin Stevenson, FACHE 6 Regent’s Message Ken Hutchenrider, FACHE ACHE Texas - Northern Regent 7 Member Spotlight 20 Event Encore 34 Calendar of Events 36 National News 38 Membership Annoucements

12 The Rewards of Mentorship in A Competitive Health Care Industry 15 2018 ACHE Congress on Healthcare Leadership

Editor-In-Chief

Joan Clark, DNP, FACHE Thomas Peck, FACHE

Contributing Writers

Creative Direction

DeAnna Bokinsky Lori Lemieux Kornely Tom Peck Craig Premo Phillip Prosser Jean-Paul Puryear Naveena Reddy Byron E. Westbrook Michael Wiggins, MBA, FACHE

Advertising/ Subscriptions

info@achentx.org

Caleb Wills, calebsemibold.com

Questions and Comments: ACHE of North Texas

Editorial Office, c/o Executive Connection

300 Decker Drive, Suite 300 | Irving, TX 75062

p: 972.413.8144 e: info@achentx.org w: achentx.org 2018 Chapter Officers President

Kevin Stevenson, FACHE Executive Vice President IntegraNet Health

President Elect

Jared Shelton, FACHE President Texas Health Presbyterian Hospital Allen

Immediate Past President

Janet Holland, FACHE Exec Advisor BroadJump LLC

Secretary

William “Scott” Hurst, FACHE Project Leader - Clinical Decision Support Methodist Health System

Treasurer

Dustin Anthamatten VP, Operations Methodist Charlton Medical Center

2018 ACHENTX Board of Directors Jennifer “J” Alexander Operations Mgr of Imaging Systems & Services, UT Southwestern Jennifer Conrad Dir of Healthcare Business Development, EYP Architecture & Engineering Jacquetta Clemons-Davis, FACHE

Jessica Daw Fuhrman, FACHE Principal, Catalyst Advisory Partners Fraser Hay, FACHE President, Texas Health HEB Hospital Edwin Kenneth “Ken” Hutchenrider, FACHE, President, Methodist Richardson Medical Ctr Benjamin Isgur, FACHE Leader, PwC Health Research Institute Kristin Jenkins, FACHE President, DallasFort Worth Hosp Council Educ & Research Foundation Valerie Johnston, FACHE Associate Professor, Texas Christian University Morten “Martin” Ostensen Univ of North Texas Health Science Center Amanda Thrash, FACHE Administrator, TX Health Neighborhood Care & Wellness-Prosper Nancy Vish President, Baylor Heart & Vascular Hospital

The ACHE of North Texas e-magazine, The Executive Connection, is published triannually 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.

President’s Message The world recently experienced a multi-faceted miracle in Thailand involving the Wild Boars soccer team and their coach. The coach and team were exploring a cave, becoming lost in the darkness on June 23rd with a limited food and water supply that was soon exhausted. Nine days later, the explorers were found on an elevated area in the cave by rescue divers more than a mile from the cave’s entrance.

The team’s joyous discovery soon gave way to the stark reality that extracting them was going to be a monumental task that had a very small chance of total success. Many of these kids could not swim. All were suffering from the impact of dehydration, malnourishment, isolation, and hopelessness. Monsoons were predicted for the region which would flood the passages. Expertise and equipment were limited. U.S. Navy Seals, trained for situations like this, were quoted that a rescue attempt would not have a positive outcome, considering the obstacles involved. This was a disaster for the team, their families, the Thai people and the world.

But good people, courageous people, said “We must try.” And, against all odds, they succeeded. Every boy was rescued.

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The coach was rescued. Sadly, one heroic rescuer died when he ran out of oxygen while placing additional oxygen tanks along the escape route, illustrating how dangerous water rescues can be. Despite this loss, a disaster was averted.

As healthcare professionals, we face the possibility of disaster every day. So, what can we take from the rescue of the Wild Boars as we craft our responses to disasters?

First, we must be prepared. Scenario planning is essential to disaster readiness. Most of us have been through countless drills, implemented command centers, rallied staff, etc., so that when and if a disaster strikes, we are prepared as best as we can. The Boars rescue team were practicing how they would extract the team even before they were found.

We then partner with others to optimize our efforts. The Thai government knew that they were not trained for the activities needed to rescue the Boars. They asked for help. Governments, corporations and individuals volunteered to help.

The rescuers made a promise to the families of the Boars that

A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2018

they would get them out of the cave. They had a mission and they were focused on its successful completion despite the odds. We as healthcare professionals feel that sense of mission for those whom we serve and are doggedly determined to fulfill that mission through the routine and through disaster.

As the rescue continued, situations changed so rescuers had to persevere. But no one quit. Their mission was clear.

Their resolve was true. That team was coming out alive.

Last but far from least, people prayed. The world drew on its collective faith and prayed for a miracle and the miracle occurred. We can be completely prepared, have exceptional partners, hold fast to our promises of care, commitment and service and persevere through great adversity and still fall short. Prayer was evident throughout the rescue of the Wild Boars. They were found alive after nine days, experienced divers arrived quickly, the predicted monsoons never materialized, the death of a colleague did not weaken the resolve of the rescuers, the timing of the extractions was perfect as the primary pump failed within an hour after the last group was brought out, the boys were healthier than expected. The faith of the world focused on Thailand and lives were saved.

Our profession allows us to make a difference every day for those whom we encounter. Their cancer, their MI, their fracture is a disaster to them. They look to us to help them through it. They expect us to be prepared, to collaborate and partner, to promise them our best, to persevere on their behalf and to pray. Remember the privilege that we have to do so.

Kevin W. Stevenson, FACHE President, ACHE of North Texas Executive Vice President, IntegraNet Health

A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2018

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Regent’s Message Dear Colleagues:

I also want to take a moment and encourage you to be a mentor or

Well we have certainly turned on

become a mentee. This summer I

the summer heat and most of us are

have the true fortune to have an MHA

looking for ways to stay indoors and

Student from Texas A&M University

remain cool!! I know that now is a

spend time at my facility experiencing

great time to stay indoors and attend

the daily life of healthcare. I am always

an upcoming ACHE education event

impressed with how much I receive

or study for the Board of Governors

from this process and always hope I

exam to become an ACHE Fellow.

pass on a few nuggets of wisdom to our

Two great ways to beat the heat and

future healthcare leaders. The ACHE of

gain knowledge for recertification or

North Texas 2018 mentorship program

advancement!!

is already underway, but the program will begin accepting applications again

Over the next several months, there are

early next year. Whether you hold

great opportunities for networking and

out to become a part of the formal

knowledge both locally and nationally.

mentorship program then or you

Over the years I have learned the

decide to explore informal mentorship

value in networking with fellow healthcare executives to gain

opportunities between now and then, I’m sure you will find the

a richer understanding of the many complexities we all face in

experiences to be extremely rewarding. As I tell each mentee, I

the care of our communities. While often we feel as if we are

will someday retire and be on the receiving end of healthcare. I

on a deserted island, we truly are not and often, a friendly and

want to receive great healthcare then, so I want each of you to

helpful voice is only a phone call or text away. Please strive to

be prepared as possible!!I hope everyone has a great summer

attend an upcoming session and expand your network. I am

and can beat the heat!!! If I can be of service to you please

always impressed with the quality, information and networking

contact me. Thanks!!!

opportunities provided and I look forward to seeing you at an event soon.

Ken Hutchenrider, FACHE ACHE Regent for Texas – Northern President, Methodist Richardson Medical Center

Member Spotlight Savanna Holmen

What are you doing now?

I recently graduated from Texas A&M with my master’s degree in Health Administration and have accepted a position as a Policy Administrator with Texas Health Resources.

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

When asked this question, I refer to the iron triangle, cost, quality, and access to care. Of the three, the cost is most important. This is because with quality comes cost, to an extent, and access to care costs money also.

How long have you been a member of ACHE? I have been a member of ACHE just shy of two years and hope to continue my membership for many years to come.

Why is being a member important to you? Has ACHE membership been a benefit to you in your career?

Being a member is important for many reasons including, but not limited to, the networking, continuing education, and

resource opportunities ACHE makes available. Without a doubt, ACHE has been a benefit in helping expand my network, being involved, and learning from various events, such as Congress.

What advice would you give early careerists or those considering membership?

As a recent graduate, I would absolutely recommend joining ACHE, especially to early careerists. There are a vast number of opportunities to make connections with those who you may work with in the future. In addition, learning from others in your region and all over the world about leading technologies, policies, and procedures, and standards will be well worth your membership.

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

I’m the first person in my family to work in healthcare and ultimately the first in my immediate family to pursue a master’s degree.

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Member Spotlight Adam Klement

What are you doing now?

I am a network development manager for Texas Health Physicians Group (under Southwestern Health Resources). My main responsibilities include partnering with primary care and internal medicine doctors to develop referral networks in order to minimize cost, track quality of care and to ensure patient care remains within the healthcare system. With ACOs, it is imperative to keep patients at the forefront and to reduce financial liability.

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

There are many directions this answer could go, however one issue that is near and dear to my heart is the lack of mental health programs across hospital systems.

The supply/access to behavioral health specialists seems to be inversely proportional to the growing demand. Aside from the obvious patient care aspect, mental illness costs US businesses nearly $450 billion each year.

How long have you been an ACHE member?

This is my first year as an ACHE member.

Why is being an ACHE member important to you?

Although I am a new member, I have already developed new friendships across various companies. ACHE is important

because it is a way for members to share what their roles are within the healthcare system and to network in an organic way. There are so many niches within the industry and it is interesting to me how people have found their footing within their career and how they are ultimately benefiting patients, physicians and healthcare systems. The passion ACHE members have for their careers is inspiring.

What advice would you give to early careerists?

I highly encourage early careerists to join ACHE. It is a great way for everyone to network, and I have appreciated how approachable everyone in the North Texas chapter have been. The events are engaging and lots of fun too.

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

In the Fall of 2015, my son was born, the Royals won the World Series, and the Broncos won the Super Bowl. My wife and I call it the year of Adam. That aside, I am the world’s worst golfer.

Member Spotlight Edward M. White, FACHE

What are you doing now?

Consulting with Mason White & Associates, Inc. We are a healthcare consulting firm that provides services to providers and payers including revenue enhancement/operational systems improvement, managed care, policy/ procedure development, program design, market analysis, mystery shopping, feasibility and demographic studies, along with sales/marketing and public relations.

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

Change is the most important issue facing healthcare today with consumerism and adaptation to new payment methodologies being at the forefront.

Healthcare is challenged with communicating and doing business with consumers, its customers, through venues and at times that consumers are using for almost everything else in their lives while complying with HIPAA and other regulations.

Also, new payment methodologies such as bundled payments, value-based payments, etc. offer challenges to healthcare organizations as they are working to deliver quality care and prevent revenue reductions.

How long have you been a member of ACHE? I have been a member of ACHE since 1997 and a Fellow since 2008.

Why is being a member important to you? Has ACHE membership been a benefit to you in your career?

Being a member of ACHE allows me to meet, work with, and learn from healthcare executives locally, regionally, and nationally that I might not otherwise. Additionally, the publications, seminars and meetings provide valuable information and insights into developments in healthcare. Lastly, the fellowship and volunteer opportunities are rewarding.

What advice would you give early careerists or those considering membership?

Join and get involved at your earliest opportunity, your career will be enriched as a result.

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

I am an outdoors person from growing a small garden to being out walking in the woods or boating on a lake.

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What are you doing now?

I recently graduated from Texas A&M with my master’s degree in Health Administration and have accepted a position as a Policy Administrator with Texas Health Resources.

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

When asked this question, I refer to the iron triangle, cost, quality, and access to care. Of the three, the cost is most important. This is because with quality comes cost, to an extent, and access to care costs money also.

How long have you been a member of ACHE? I have been a member of ACHE just shy of two years and hope to continue my membership for many years to come.

Why is being a member important to you? Has ACHE membership been a benefit to you in your career?

Being a member is important for many reasons including, but not limited to, the networking, continuing education, and resource opportunities ACHE makes available. Without a doubt, ACHE has been a benefit in helping expand my network, being involved, and learning from various events, such as Congress.

Visit us online achentx.org

What advice would you give early careerists or those considering membership?

As a recent graduate, I would absolutely recommend joining ACHE, especially to early careerists. There are a vast number of opportunities to make connections with those who you may work with in the future. In addition, learning from others in your region and all over the world about leading technologies, policies, and procedures, and standards will be well worth your membership.

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

I’m the first person in my family to work in healthcare and ultimately the first in my immediate family to pursue a master’s degree.

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A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2018

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A RCHI TEC TURE I NTERI OR DE SIGN CORG A N.COM

The Rewards of Mentorship in A Competitive Health Care Industry Byron E. Westbrook

Healthcare has become an evolving multi-dimensional industry requiring the utilization of many disciplines. The changes in healthcare have made it challenging for early careerist to thrive in a competitive industry without having leadership experience.

Taking advantage of the American College of Health Care Executive’s Mentor and Mentee program, is an way for graduate students and early careerists to gain insight and prepare for the DFW healthcare market.

The North Texas American College of Health Care Executives (ACHENTX) mentor and mentee program was established in 2012 to benefit the seasoned health care professional as well as the early careerist. Mentees are expected to approach the program with a long-term commitment, enhancing their professional growth through their pairing with a mentor. The program encourages mentees to consistently initiate communication and arrange meetings with their mentors, despite challenging schedule conflicts. Mentors are expected to provide candor and commitment to the process, providing their mentees an effective and rewarding mentorship experience.

The five-month program provides structured direction. Many mentor/mentee pairs continue their professional relationship after the formal program has been completed.

It is a requirement for each mentor and mentee pair to complete sixteen meeting hours in which twelve of the sixteen hours are met in person. The program concludes with a reception ceremony, honoring the dedication and commitment of mentors and mentees. The ceremony also features time for the mentors and mentees to share their experiences with others.

The ACHENTX mentor and mentee program is nationally recognized for the model it has created and effectively executed. In fact, the Chicago and Northeast ACHE chapters have consulted with ACHENTX on ways to expand their programs.

Mentees with ACHENTX have benefited from the program by refining their professional abilities and applying them to the job market as well as connecting with other professionals for mutual counseling to enhance career advancement. Mentees recognize the direction provided by mentors to focus on specific areas in healthcare and to pursue and gain opportunities in their recommended fields. ACHENTX mentors benefit by enhancing their leadership and communication skills from regular collaboration and direction given to their mentees.

The ACHENTX mentor and mentee pairings have doubled in just one year. ACHENTX’s commitment to helping early professionals shape their career path is evident through the effectiveness and growth of the program.

A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2018

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2018 ACHE CONGRESS ON HEALTHCARE LEADERSHIP

A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2018

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2018 ACHE CONGRESS ON HEALTHCARE LEADERSHIP

“ ACHE has yet again put on a successful Congress.

This year’s focus to “be a part of something bigger” was inspiring as well as inviting for all health care leaders to come together and raise the boat for everyone. As a member of the national Board of Examiners for the Malcolm Baldrige Quality Award, I am always grateful to learn about organizations that strive to be the best they can be. At Congress, the educational event “Leadership Secrets of Malcolm Baldrige Award Recipient Presidents” provided true insights of the critical attributes demonstrated by effective leaders who leverage the talents of their organizations to drive performance excellence. It is no surprise that ACHE, with its focus on educating, engaging and inspiring leaders to improve health care, would provide a session where leaders can take what they learn, apply it within their organizations and improve their value to the communities they serve.

“

DeAnna Bokinsky

Richard J. Stull Student Essay Competition in Healthcare Management The American College of Healthcare Executives announced the winners of its 2018 Richard J. Stull Student Essay Competition in Healthcare Management.

Capt. Jean-Paul Puryear of The University of Texas at Tyler won third place in the graduate division for his essay “Treatise on Effective Performance Management: A Healthcare Executive’s Guide.” The scholarship and award were presented March 28, 2018, at the Leon I. Gintzig Commemorative Lecture and Luncheon during ACHE’s 61st Congress on Healthcare Leadership in Chicago. In addition, Puryear was selected by the American College of Healthcare Executives to work the fourday event as a program associate, helping serve the more than 4,000 Congress attendees.

Puryear is an active member of both the ACHE of North Texas chapter and the East Texas ACHE Forum. Currently, he serves as the programing committee chair for the East Texas ACHE Forum where he directed the 2018 East Texas ACHE Forum & ACHE North Texas Spring Summit which brought together more than 80 executives for a unique four-panel, all-day education and networking event.

Puryear is a former Air Force officer and pilot with 20+ years of experience as a healthcare professional, with extensive leadership experience in operations, practice management, and marketing.

Jean-Paul Puryear

A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2018

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2018 ACHE CONGRESS ON HEALTHCARE LEADERSHIP

“ One of the aspects of Congress that I enjoy the most is the diversity of topics.

I attended engaging sessions on various subjects such as high-reliability organizations, physician engagement, and servant leadership. Perhaps my most memorable session was Bonnie St. John’s Gintzig Lecture. Bonnie recounted her Olympic silver-medal performance in the 1984 Winter Paralympics skiing competition. She was in first place after the first run, but the course for the final run was very difficult due to icy conditions. According to Ms. St. John, every skier fell during the second run. When she reflected on how the woman who won the gold medal had beaten her, Ms. St. John acknowledged, “She got up faster than I did.” What an excellent lesson on grit and determination. We will all have falls professionally and personally. Those who are most successful will be the ones who get up the fastest and continue pursuing their goals.

“

Michael Wiggins, MBA, FACHE Sr. Vice President, System Operations Children’s Health

“ As

a first-time attendee of ACHE Congress, I thought the event was excellent!

I encourage all who attend to take the EQ-I Session! It included a personal assessment taken weeks before the class. EQ or often called EI is the art and science of managing your emotions in a healthy way. The measure of Emotional Intelligence and the importance of its components relate to the overall success of a leader. In the session there was some comparison of IQ & EQ as it relates to leadership. EQ-I is becoming a popular tool. I also learned that 83 percent of leadership success is attributed to a leader’s EI. EQ Measures five distinct aspects of emotional and social functioning. The five aspects include self perception, selfexpression, interpersonal, decision making, and stress management. The personal assessment results are so fascinating and the Book “The EQEdge” is included. The session is a must do for all!

“

Lori Lemieux Kornely Business Development Envision Healthcare

A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2018

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EVENT ENCORE

Cocktails with the Chief April 18, 2017 The first Cocktails with the Chiefs event for 2018 took place on April 3 at The Mercury Grill in Dallas. Moderated by Nancy Vish, president of Baylor Heart & Vascular Hospital, the panelists were John A. Gillean, executive vice president and chief clinical officer, CHRISTUS Health; Ken Hutchenrider, president, Methodist Richardson Medical Center; Winjie Miao, executive vice president and chief experience officer, Texas Health Resources; Dr. Zach Mueller, division chief nursing executive, Medical City Healthcare; and Troy Thibodeaux, regional president, Sound Physicians.

The panel discussion at the well-attended event revolved around insights from the book The Captain Class: The Hidden Force That Creates the World’s Greatest Teams by Sam Walker.

Topics included: When building a winning organization, which comes first, the culture or the talent?

Dr. Mueller stated that it was important to hire the right leader, and then the culture can flourish. Thibodeaux added that a great culture will grow great talent. When it comes to succeeding in a given culture, Miao noted that not only was it important to know the values of that culture, it was vitally important to know how decisions get made. “How we make decisions is what drives culture,” she stated. Gillean added that culture takes root in part through the relationships you build with the team.

The importance of the coach/captain relationship Hutchenrider related a story from an earlier experience as head of a hospital, where counsel from a mentor was key to his success. The other factor to success, he said, is having “the right people to execute the plays.”

Emotional intelligence and its impact on personal success Thibodeaux reflected that as humans, we’re all fallible, and that it was important to “recognize your tragic flaw and how to control it.” Miao stated that she found understanding her physiological responses to stressful situations was helpful to controlling her actions and words. Dr. Mueller emphasized reading the room and noting non-verbal behavior, as well as picking up the phone to have delicate conversations, rather than using email.

The paradox of management It has been said that management sometimes attracts those for which it is not well suited. Hutchenrider stated that he looks for passion when hiring, and noted that quality is something that can’t be taught. The panel agreed that transparency was key to being a good leader, and is something to look for in building a team. Thibodeaux added that showing vulnerability as a leader and admitting mistakes has made for a stronger bond with his staff.

Thanks to Sound Physicians for sponsoring the event, to The Mercury Grill and to everyone who attended.

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A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2018

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EVENT ENCORE

ACHENTX 2nd Quarter Education Event April 26, 2018 More than 100 registrants gained the latest insight from two expert panels at ACHENTX’s second quarter educational event hosted by CHRISTUS Health on April 26, 2018.

Panel 1: Financial implications: the push from inpatient to outpatient care Moderator: Brent McClung, FACHE, executive vice president & north zone operations leader, Texas Health Resources Leslie Pierce, vice president revenue cycle, Methodist Health System Tina Barker, vice president, strategy management and development, CHRISTUS Health Steve Newton, MPH, FACHE, president, Baylor Scott & White west region, north division McClung began by asking each panelist to address a specific question.

To Barker: What trends are you seeing with respect to inpatient, outpatient and traditional observation patients?

CHRISTUS has focused on building its ambulatory platform over the past two years. We are still shifting the organization’s mindset to pull in ambulatory leaders. Working on physician alignment. CHRISTUS has micro hospitals in several areas and is experimenting with combining urgent care with imaging, primary care and making it more ambulatory care.

Diversification is the number one strategy.

To Newton: How will Baylor Scott & White Health accommodate growing outpatient volumes and what resources will be necessary? We are making investments in physical assets and digital assets. Because consumers want different ways to access us, we have more than 1,000 access points, only 47 of which are hospitals. We have a variety of solutions – micro hospitals, digitally based clinics (telehealth, email, virtual visits), easier access to primary care, pharmacies, groceries stores, outpatient imaging, and more. We are becoming more of a retail business. Baylor Scott & White Health has joint ventures with outpatient imaging, freestanding rehab organizations. We are also interested in the retail pharmacy

EVENT ENCORE

business. We are making big investments in easy-to-use apps and easy-to-navigate websites. We are thinking hard about everything we do because our revenues are someone else’s costs. We need dollars to invest in our future.

To Pierce: Are you seeing an increase in payer denials due to reclassifying patients? Yes, across the board. Nationally, 15-17 percent of all new claims that go out the door clean are denied at the payer level and require some type of rework.

That’s expensive so we need to learn how to work better with payers. The two-midnight rule prepared us for the future when our managed care platform began to change. Blue Cross has implemented a new policy for HMO business, targeting patients in the ED to determine whether they will pay for the event. To reduce claims denials, we spent lots of time with physicians, listening to their concerns about the burden of the two-midnight rule. We’ve learned that correct documentation of services is key. We are also spending a lot of time educating physicians about who needs to be admitted and who doesn’t.

We are seeing most of the claims denials in the managed care space. We are probably going to have to have the hard conversations with patients about the outpatient setting being a more appropriate place for the care. We are also seeing an increase in prepayment reviews even if we have received an authorization for their stay. We are also seeing changes in surgery. Knee replacements are moving to same-day surgery status. Hip replacements will probably move to the outpatient setting next year. Between one and three percent of net patient revenue will go to write offs.

Panel 2: Managing Your Clinical Supply Chain Moderator: Ben Isgur, FACHE, leader, PwC Health Research Institute Julianne Helsel, MSHM, BSN,RN, utilization director, ROi Tony W. Johnson, SVP and chief supply chain officer, Baylor Scott & White Health Bill Lammers, MHA, RT(R)(CT), service line dire tor, capital equipment, CHRISTUS Health Nathaniel Mickish, MBA, VP strategic sourcing, Texas Health Resources

Isgur framed the panel discussion with a question – why focus on the supply chain? He outlined three reasons: 1. Focus on healthcare costs and are they sustainable?

The medical inflation rate outpaces the general inflation rate by two to three times.

2. The increase in healthcare costs is related to price, not utilization.

3. The unsustainable growth rate is creating disruption in the system (example: new partnerships such as CVS and Amazon).

Isgur: You are on the front lines of quality, cost containment and system efficiency. What is your fundamental role?

Johnson: I see myself as a chief culture agent helping to change the organizational culture, bringing clinicians together to ask the tough questions. We have to be willing to make tough decisions.

We have to be the voice or conscious of the organization when it comes to creating a culture to contain costs. We need to ask—what are we really doing compared to what we think we are doing.

Mickish: We are investing in tools and processes to make evaluating products and services more scientific. We have lots of estimating tools that gather information from as many stakeholders as possible. I am also leading the effort to work closer with the suppliers and to involve us early in the process.

Helsel: As a consultant, I partner with organizations and help them reach the next step. I dig through data to bridge the gap between administrators and physicians. I have frank discussions with physicians about the appropriate utilization of products for the appropriate patients without sacrificing quality of care.

Lammers: I spend a majority of my time dealing with capital expenditures. Because we have limited resources, how can we spend our money wisely? One of the biggest issues is to determine when it is appropriate to purchase new technology.

We have to consider the total cost of ownership. We are not just looking at the cost of acquisition, but the total cost to own and operate it over the life of the technology. Ultimately, we have to put in the right technology in the right place at the right time for that hospital and community’s specific needs.

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EVENT ENCORE

Isgur: Q: How has your world changed in terms of with whom you are interacting?

Mikish: Our triad leadership, physicians, clinicians and administrators are a key audience for us. Having good information is a necessity as it gets us to the table with them.

Helsel: My conversations with physicians have changed from how much revenue they bring in to how much each case is costing the organization.

Lammers: The hardest thing is learning to say no to physicians because we can’t afford to do what they request. We have to work with administrators and clinicians. At CHRISTUS, all supply chain teams are led by clinicians.

Isgur: Q: Can each of you address best practices you are following related to engaging clinician and executive leadership?

Johnson: At Baylor Scott & White Health we have had a holistic change over the past two years. We have elevated the professionalism and expertise of our supply chain staff.

We analyze everything we do from spend to benchmarking

and we look for every opportunity for improvement. We have representatives on all governance councils and clinical governance councils. We source as a whole system. We also produce a variety of data based reports covering utilization, clinical outcomes, cost variation, and practice variation.

Mikish: One of our biggest challenges is aligning employed physicians. What problem can we solve for them? We start where there is obvious alignment. You have to think about everything from their perspective. You have to understand their business before your ask something of them in a meeting.

Helsel: Because there is so much data, the challenge is to find what data is meaningful that is going to create the change we want to achieve. Data helps build credibility with physicians, but the wrong data can also destroy credibility.

Johnson: We are striving to include all of the physicians that need to be involved in decision-making. That’s difficult even when we’re working with governance councils at the hospitals.

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World-class care, close to home.

goes by one name.

MethodistHealthSystem.org/Mayo

Texas law prohibits hospitals from practicing medicine. The physicians on the Methodist Health System medical staff are independent practitioners who are not employees or agents of Methodist Health System. Methodist Health System complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

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DME Exchange Event May 5, 2018 On a beautiful Saturday morning 21 healthcare leaders and ACHE North Texas (ACHENTX) chapter members volunteered their services at DME Exchange, a nonprofit agency that collects and then re-distributes medical equipment to those individuals in need in Dallas County. This is an annual ACHENTX effort to give back to the community by helping DME Exchange to clean, repair and refurbish the donated medical equipment, including canes, crutches, walkers, rollators, bedside commodes, tub transfer benches, manual and power wheelchairs, Hoyer lifts, hospital beds and mattresses.

The ACHENTX volunteers cleaned and sanitized 213 pieces of medical equipment and prepared them for donation to the patients in need. This is almost twice the number of pieces of equipment cleaned last year! Betty Hersey, executive director at DME Exchange addressed the group and expressed her appreciation. Several of the participants mentioned that they do this every year and actually look forward to the annual event.

ACHE North Texas sincerely appreciates DME Exchange for hosting the event and the members for participating in this event. For more information on future events, please visit our website or email us.

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Life Fellows/Retirees Breakfast Meeting May 8, 2018 What a treat to be the guest of Baylor Scott & White Medical Center of Irving with a hearty breakfast provided by Baylor Heart and Vascular Hospital! We shared our journeys through health care administration as well as post retirement pursuits.

Our attendees continue to stay active by volunteering at selected hospitals, serving on community boards, assisting in political campaigns, and even playing in a band or two! We shared our perspectives on Medicare Advantage plans and were educated on various retirement plan options by a respected financial advisor.

We are planning a Fall meeting and hope to increase participation with another stimulating program. Perhaps the most significant decision made was to meet at lunch time. We may still get up at the crack of dawn however we don’t have to be firing on all cylinders at 7:00 am!

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North Texas – East Texas Joint Educational Event May 25, 2018 An overflow crowd of more than 100 people attended the annual ACHE of North Texas and East Texas ACHE annual educational event. Held at the First Baptist Church in Terrell, attendees represented a wide variety of health related organizations from the surrounding community Panel 1: Physician Integration Approaches Scott Hurst, FACHE, moderator, project leader, Clinical Decision Support, Methodist Health System Jennifer Beal, vice president, Physician Integration and Shared Services, CHRISTUS Clinic Management Services Roger Fowler, MD, FAAFP, chief medical director of Population Health and Health Plans, CMO for the CHQCA and CLACO, Trinity Mother Frances Hospitals and Clinics Michael Hicks, MD, MBA, MHCM, FACHE, executive vice president, Health Partnerships & Clinical Affairs, University of North Texas Health Science Center Josh Liggon, director of physician network, Southwestern Health Resources Hurst: Q: What’s driving the need to align?

Beal: Changes in healthcare are driving physicians to align with health systems. The impact of healthcare legislation is also driving alignment.

Fowler: All you have to do is follow the money. Thanks to availability of data, the care delivery model has changed dramatically, away from reactive care to a focus on caring for populations of people. Payers are pushing this change.

Liggon: The issue is how do you fund the transition to health care from sick care? Many tools to monetize and incentivize the transition, including PCM, care management, and risk contracting.

Hicks: I left the private sector for the academic sector. I became convinced we were failing the clinical workforce and not preparing them for the changing world they were being put into.

We have to change the educational system. The aggregation of clinicians is different from the integration of clinicians. The workforce is looking for someone who can bring stability and predictability.

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Hurst: When should you partner and when should you compete?

Hicks: I can’t think of another industry where it is so crazy in terms of relationships. In truth, our ultimate goal is to put hospitals out of business. Beds should be empty so the concept of competition is crazy. The conversation we should be having starts with the patient and works out from there.

Liggon: We compete at the bedside. We cooperate in the continuum of care.

Fowler: We compete when we have different visions and goals. We have lost the trust of patients because we don’t have systemness. Our focus should be on sharing as much information as we have on patients with everyone on the care team to eliminate duplication. We need actionable information.

Hurst: What is the biggest mistake that you see now that you didn’t see when you started? How do you avoid mistakes.

Liggon: Trying to be too data agnostic with physicians. We started out thinking how do we integrate data? We learned that physicians need to be educated about how to use their EMR. They are starving for help with their data.

Hicks: Competition has failed us. Original thinking was the free market would drive standardization and interoperability. But we wound up with what we have today. Some degree of regulation and standardization up front would have been smarter.

Beal: Do the cultures align? Can we make sure our cultures and values align?

Panel 2: Customer Service in Healthcare Louise Thornell, PhD Candidate, MSN, MsBA, RN, NE-BC, moderator, vice president & chief nursing officer, CHRISTUS St Michael Health System Sherri Gould, RN, BSN, executive practice manager- Pediatrics, Tyler Family Circle of Care FQHC Jennifer Blake, Glenwood Site executive practice manager & Women Health/Title X project manager, Tyler Family Circle of Care

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George Roberts, Jr., FACHE, chief executive officer, Northeast Texas Public Health District Thornell: Q: What is the experience that patients really want in healthcare?

Blake: The highest quality care, to be treated in a timely fashion, to be kept informed, charged correctly, greeted and spoken to in a caring way. It’s really pretty simple, but we overthink what they want.

Roberts: People want to be heard and listened to.

Gould: Focus on the patients’ expectations. Need to understand their definition of quality care. We need to put ourselves in their shoes. We need to make people feel comfortable and trust the care we are going to be providing to them. We should always strive to exceed patients’ expectations. We need to take care of folks as if they are our own family. Employee engagement is a good place to start.

Satisfied employees will result in satisfied patients.

Thornell: Q: What can healthcare organizations really do for our patients?

Roberts: It goes back to leadership and leading by example.

Knowing employees by name is critically important.

Blake: As a manager I pride myself on being hands-on.

You must lead by example and teach staff about cultural differences.

Gould: Cultural diversity training.

Thornell: Q: How can we meet patient and provider needs in a better, faster, cheaper way?

Blake: Communication is key. ` Roberts: Read leadership books. Hire for compassion and train for skills.

Gould: Transparency is key. Engage clients as well as staff.

One approach we use in our facility is the bedside shift report takes place with the patient and his or her family, if they are there.

Thornell: Q: How can we excel in safety, satisfaction and outcomes?

Gould: Use evidence based approaches. Learn from best practices. Test it with PDSA.

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Roberts: Hire the right people. We have a set of questions we take throughout the organization when we interview to hire.

Hire for values of the job. Train staff to be good interventionists to solve problems. Practice the power of influence. Be attentive.

Treat everyone with respect.

Blake: Listen to understand.

Panel 3: Executive Role in IT Decisions Nick Kagal, FACHE, FHIMSS, moderator, senior regional director, Premier, Inc. Tim Pugsley, FACHE, chief information officer, Titus Regional Medical Center Tom Cutler, RN, MBA, FACHE, senior manager Information Resources, UT Southwestern Medical Center Don Taylor, MHA, director of Southwestern Health Resources Integration, UT Southwestern Medical Center Kagal set the sage for the panel discussion by citing a 2016 CIO survey that showed healthcare IT spending will continue to increase by 8.8 percent. Current spend is $40 billion annually.

New value based care models will drive IT spend. Kagal defined technology as anything that wasn’t around when you were born.

He also cited a quote that, “Technology is a word that describes something that doesn’t work.”

What keeps CIOs and healthcare technology professionals up at night? The list included cybersecurity, optimization of IT systems, 21st century cures, managing the data deluge, mergers and acquisitions, the talent gap, apps (mHealth, BYOD), and embracing the care continuum.

Governance and engagement Cutler: Even if an organization’s technical side is perfectly fortified by a strong infrastructure, technology can still fail if

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people don’t use the system or if it’s vastly underutilized. It is important to have the correct governance committee that includes executive leadership, select clinicians, doctors, nurses, and allied health practitioners. Don’t load the committee with physicians who love and use technology. IT imposes change on people and they don’t like it. You have to make sure people are engaged to achieve successful implementation. You must do the right training at the right time, especially with clinicians for the EMR. Pugsley: Focus on key success measures for implementation.

Three layers, decision tree, nine project managers and three program directors – decisions primarily made through PMO – moved up to advisory committee – then moved up to enterprise steering committee. Proper governance in best interest of all involved.

Drivers of Success Pugsley: The first question we always ask is why are we doing this? Financial, operational, patient experience and quality drivers are considered. No IT drivers. Every measure of success needs to be a lag measure. Through the entire process we are infusing the ultimate measures of success. Document the lag measures to document moving the needle. Create a charter for every initiative and monitor and include measures of success.

Cutler: Look for a package solution. Write a well thought-out RFP. Get the right system for your organization.

Taylor: Setting appropriate expectations is important because it won’t go as they hoped. There will be a disruption to daily work so reasonable expectations need to be set from the beginning.

Invest in adequate training, especially on extracting information from the system.

View from the C-Suite Taylor: CEOs need to understand the intrinsic value of information transformation. What can be done with this capability/asset? In my role, I need the CIO to not be isolated

A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2018

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identified it already as a problem, don’t call me. Don’t look for issues that aren’t issues yet. Keep it focused, simple and pure.

Kagal: Q: What are some of the new disruptive technologies and mindsets that will prove to be threats and opportunities in the near future?

Cutler: The cloud. When you are in the cloud, what are your security concerns? Who is your partner and what about their security?

Pugsley: Disruption is creating something that people want to use over and over again. What do our consumers want and need? If a large percentage of patients can’t make it to their appointments, what disruptive interventions can be introduced?

Uber Health?

Taylor: Other, non-traditional industries are moving into healthcare. Uber partnered with AMR (the ambulance company).

Fitbit partnered with Google to offer incentives and gaming patterns to keep you well. Amazon partnerships will go direct to consumers. A1.1492 is the Amazon think tank about the future of health care and how to change it. What about Apple’s impact on the future of the EMR industry? Millenials are disrupters so we need to be recruiting for empathy, rather than academic excellence. AI will partner with physicians and be their copilot.

Panel 4: Executive On-Boarding

Kagal: Q: How do you differentiate technology fact from fiction?

Pugsley: Professional affiliations are important. Also, we can rely on our partners such as Advisory Board.

Taylor: My advice to vendors or consultants…if I haven’t

Ekta Pathare, FACHE, moderator, president, CGAIT Global LLC Erich Koch, FACHE, chief financial officer, Tyler Family Circle of Care Patty Boeckmann, RN, MHA, FACHE, chief operating officer, Titus County Medical Center David Helfer, FACHE, CMPE, MS, BA, R-CVT, EMT,CEO, Texas Health Institute for Surgery at Texas Health Presbyterian Hospital Dallas Pathare: Onboarding is not new to anyone. How is executive onboarding different than employee onboarding? What are the factors for success?

Hoefler: All of us need to be successful and we can’t know everything. Here are the qualifications I’ve seen listed in a CEO job description: Disruptive and pragmatic. Risk-taking and cautious. How do you get someone to be an expert in all of these things? The McKinsey Quarterly May 2016 outlined differences in terms of expectations between internal and external CEO candidates. External candidates are generally hired to be turnaround experts. Internal candidates are generally hired to maintain the status quo. Regardless, a CEO needs the support from the organizational culture and from the board. Frequently, internal politics result in a promoted

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internal candidate being resented by other members of the legacy executive team. HR is often forgotten as a resource for onboarding. Transitioning must include a team of people to help the CEO. From an organizational cultural standpoint, the CEO needs to select a team that will help him/her be successful.

Boeckmann: I am speaking from my experience from Hawaii from working at Allina. Pay attention to outcomes you want to achieve. Everything is relative to the location where you will be. Start aligning interests during the interview. Borrow good ideas from others. As you engage with the CEO candidate, be extremely clear and honest about your organization, the reality as well as the vision. Be prepared when the new CEO arrives on the scene. Provide the new hire with a little pre-work. Make sure you are ready for him/her to be there. Establish a schedule for his/her first few weeks. Identify key people for the CEO to talk to. Give him/her bios on all of these people. CEOs usually come with ideas and have a plan in place. Provide bios of board members. Hawaii Pacific paid attention to the new hire’s family and their needs. Always go back and check on how things are going. Allow for mistakes and opportunities to ask questions.

Koch: Let people in your organization ask questions so they

can learn more about the candidate. When you get to know someone as a person you have more to talk about than if you just know him or her as a title. I’ve found this makes it much easier for the new CEO to be integrated into the organization.

From day one, getting to know the person is the key to executive onboarding. In my current situation, I have stepped into an interim CEO role. I’ve tried to make sure that the barriers of pre-conceived notions are dropped.

Pathare: Q: What steps should an organization take to make sure new hires understand the core business, the vision and the strategy?

Helfer: It depends on where the candidate is coming in, but everyone needs help.

Boeckmann: Trust but validate. Once goals are put out for the new hire, starting a discussion in the organization about what is expected of the person is critical.

Koch: Give an overview and let the new executive come to his/ her own conclusions. Assign the new executive to an influencer who can shows him/her around, then let the executive come to his/her own conclusions.

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Local Program Council Event June 21, 2017 The North Texas Chapter of the American College of Healthcare Executives (ACHE) in collaboration with Baylor Scott & White Medical Center - Waxahachie held a panel discussion on the topic, “It’s All About Vision - The Role Vision Plays in Your Strategic Planning Process.” More than 50 ACHE members gained insight from the discussion that focused on population health, the integration of innovative technology, and gateways on how healthcare leaders must be ready to consider new avenues to reach patients and engage healthcare workers through Vision. The panelists included: Moderator: Christopher York, FACHE president Baylor Scott & White Medical Center - Waxahachie Panelists: Michael Freeman Associate Vice President for Health System Planning and Analytics UT Southwestern Health System Laura Irvine Executive Vice president and Chief Administrative Officer Medical City Healthcare Nkem Okafor, MPH, FACHE Vice President of Strategy & Planning Methodist Health System Each area covered was involved with the Vision statement of an organization. We looked at the role it plays, aligning it with prioritization, how it’s driven by a CEO or President of a company, meeting goals, revisiting the Vision statement, addressing the magnitude or barriers, using your best strategy and tactics to apply these scenarios and resources from competitors, and accelerate or outsource others by looking at ways to grow and being marketable.

We appreciate all the support from our sponsors and members that were able to attend.

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Thursday, August 23

Thursday, August 16

Breakfast with the CEO - Charles Gressle Medical City Plano

Quarterly Education Event: 1) Care Coordination: Acute Hospital Becoming a Preferred Provider in a Narrow Network; 2) Improving the Bottom Line by Optimizing Patient Throughput Parkland Hospital, Dallas

Tuesday, September 11

Fall New Member Networking Blitz

Saturday, September 22

Community Event

Baylor Scott & White Medical Center, Grapevine

St. Jude Walk/Fun Run

Tuesday, September 25

Thursday, September 27

Reata, Fort Worth

Location TBD

Cocktails with the Chiefs

Multi-chapter Event

Tuesday, October 16

Tuesday, October 2

Women’s Event

La Cima Club, Irving

Quarterly Education Event: (84) It’s All About Vision: The Role Vision Plays in Your Strategic Planning Process; (85) Disruptive Innovation in Healthcare Delivery Location TBD

Wednesday, November 7

General Membership Dinner - Special Guest Speaker: Tony Hill, former Dallas Cowboys wide receiver, Super Bowl XII champion, football broadcaster and former local hospital trustee

Thursday, November 29

After Hours Event - Statler Hotel

Waterproof Lounge, Statler Hotel

Las Colinas Country Club

Tuesday, September 11

Fall New Member Networking Blitz Baylor Scott & White Medical Center, Grapevine

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National News Share the value of the FACHE® Credential With This New Video Share ACHE’s new FACHE video and help inform and raise awareness about the value of the credential to their healthcare management career advancement. Members can apply for Fellow status conveniently online and learn more about the steps and requirements needed to advance by visiting ache.org/FACHE.

Forum Member Directory Connects Executives With Healthcare Consultants ACHE’s Healthcare Consultants Forum Member Directory serves as a resource for healthcare executives and organizations seeking the services of a healthcare consultant with a specific area of expertise.

Are you a healthcare executive searching for a consultant?

The Directory’s robust search functionality can help identify ACHE Consultant Forum Members who may meet your needs.

Are you a Consultant looking to gain visibility with decision makers?

Join the Healthcare Consultants Forum, and select your primary area of expertise.

Questions? Please contact Liz Catalano, marketing specialist, Division of Member Services, at ecatalano@ache.org or (312) 424-9374 or Erika Joyce, assistant director, Division of Member Services, at ejoyce@ache.org or 312-424-9373.

ACHE’s Leader-to-Leader Program When you share the value of ACHE membership with your colleagues through encouraging them to join or advance to Fellow status, you can earn points to obtain rewards such as gift certificates toward ACHE education programs, a polo shirt, backpack tote, water bottle, umbrella and even a chance to be entered into a raffle for a free Congress registration when three or more are sponsored.

Each time a person joins ACHE or advances to Fellow status and lists your name as a sponsor on the application, you earn a point. The more points you earn, the more rewards you can receive. Points expire on Dec. 31 of the year after they were earned (e.g., a point earned on Jan. 1, 2018, will expire on Dec. 31, 2019). You can check your available points and discount program coupon codes in the My ACHE area of ache.org. To ensure colleagues reference you, referral cards are available that you can pass out so you receive the credit you deserve.

When you help grow ACHE, you make a strong statement about your professionalism and leadership in the healthcare field and also strengthen the organization. For more information on the program, go to ache.org/L2L.

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ACHENTX’S

NEWEST

FELLOWS

MARCH Teresa King, FACHE Trinette K. Pierre, DHA, FACHE Jana R. Voege, MS, FACHE

MAY Jennifer L. Faith, FACHE Monaliza Gaw, FACHE

WELCOME ACHENTX’S NEWEST MEMBERS MARCH

APRIL

MAY

Lakisha Bah-Stewart Jermaine T. Casey Jason K. Chiselbrook Panos Efsta Ivie L. Eguavoen Gabriel E. Fruge, RN Christine Gorham Andrew Hardin Phoebe Hawkins Tonya Jones Eboni Joseph Wilson Hector Juarez Jaya Kumar, MD Kevin D. Lee Jason Mageto Carol B. Maxwell Erin A. Memmer Kathryn Munsterman Rhonda Quintana Jeff Siegel Kristen Spoonts

Stefanie Beavers Kyle Dyke Ike R. Eke, MHA Brian Fox Leigh Griffis John Henry Ryan Jones Scott Kendle Teagan Lampkin Jon Lawton Laura B. Martinez Andrew Nikolopoulos Ruxandra G. Petty Blake Robinson Rukayat R. Sanusi Paul Schwendel Kelly A. Speckman Pia H. Walker, MAOL Tonya Waters Victor Watta Toya White, JD, RN LT Jackie Williams Senait Woldai Ossama Zafar

James M. Allen Ashley R. Anson Ajit Bisen, MD Vicki Brockman, DNP, RN Brett A. Chambers, MBA Keith Cockrum Octavio J. Diaz, MD Chris B. Geiger Kevin Greene David Irvan Patrice M. Johnson Corey Krentsa Deirdre LeBlanc Jorge A. Marrero, MD Zain Nauman Mallory L. Nwaokai Mark Olney Abis T. Olutimayin, MBA Jay Pennisson Rodneisha L. Powell, MBA Paige A. Salinas Jennifer N. Smith Tammy Stilling Rathan M. Subramaniam

Keerthi Kumar Tumkur Subash Chandra Suman Wali Mike Aljoe

JUNE Matthew Caldwell Robert J. Davis Ryan G. Gehrke Lori A. Jadick Tezra Jordan Evelyn M. Joseph Janell P. Mason-Briscoe Michael J. Moorhead, MHA Nico Nguyen Mrunalini Patel Sapna Patel Sean Poellnitz Jeffrey L. Settle Joshua J. Virnoche David White Gentry Zacheis

RECERTIFIED FELLOWS MARCH

JUNE

Aaron M. Bujnowski, FACHE

Erol R. Akdamar, FACHE

Matthew S. Chance, FACHE

Elaine W. Auerbach, FACHE

Jerri J. Garison, RN, FACHE

Scott J. Grandjean, FACHE

APRIL

Amanda O’Neal-Brummitt, FACHE

Derrick E. Cuenca, FACHE Noah D. Longino, Sr., FACHE

Robin A. Kraase, FACHE David Overton, RN, FACHE Christopher A. Phillips, FACHE Sandra H. Sneed, FACHE Mary R. Wylie, DHA, FACHE

MAY Sherry S. Griffin, FACHE Kimberly M. Montes, FACHE John E. Phillips, FACHE Wilson J. Weber, III, FACHE Michael S. Wiggins, FACHE Keith V. Zimmerman, FACHE

MEMBERS WHO RECENTLY PASSED THE BOARD OF GOVERNORS’ EXAM MAY Nishu Wadhawan

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