Permanente Impact Winter 2021

PERMANENTE

Winter 2021

Committed to caring

A Publication of Washington Permanente Medical Group

1

President’s letter

Taking care of each other During World War II, U.S. families often grew “victory gardens” to sustain them through economic and social uncertainty; 2020 brought similar struggles across America. In 2021, we relearned the value of caring for ourselves and one another as we fight COVID-19.

Fatigued and eager for an end to the pandemic, we administered more than 500,000 vaccinations and cared for more than 16,000 COVID-19-positive individuals while addressing both the delayed and day-to-day care of our patients. This is remarkable.

Working to get better

You told us through focus groups, surveys, and conversations how we can make meaningful changes, and we’re turning your experiences and feedback into action.

Clinical support staff: Local and national Kaiser Permanente leaders are working together to implement a robust recruitment and retention plan to secure our present and future.

Improving culture: The structural changes of our Reimagining WPMG effort go live in February.

We are also addressing longer-term cultural issues, including strategies and how we treat and recognize our people.

Operations director: We started a nationwide search for an Executive Medical Director of Operations (formerly chief operating officer, or COO) who will have a central role in stabilizing our Care Delivery operations and continuing our drive to get “brilliant at the basics.”

Focus on you: Many projects and resources are available to support you thanks to the work of our clinical wellness lead Mary Wierusz, MD and the Health and Wellness Advisory and Cultural Transformation Oversight groups.

Success call outs I also want to celebrate some of the “green shoots” that popped up in our own victory garden in 2021.

• WPMG achieved a 99% vaccination rate and clinicians volunteered hundreds of hours at our vaccination clinics.

• Our internalization work is showing benefits; our surgical services added substantial internal capacity by activating two additional ORs and expanding all three surgery centers to 12-hour days.

• We are increasing Integrated Pain Program capacity to allow in-person and virtual consults statewide and beginning longitudinal care for our highest-risk patients, including behavioral health, physical therapy, and medication management support.

• Silverdale and Olympia expanded their Urgent Cares to 24/7 and added a clinical decision unit to help reduce hospitalizations and expand best practices.

• Seattle and Snohomish districts piloted the Provider Proficiency training to teach sustainable use of the EMR; every clinician’s proficiency score improved. All Primary Care clinicians can participate in 2022.

• Our Primary Care People Plan is nurturing relationships between managers and direct reports through team building, recognition, supporting proficiency, and getting to know each other.

These are shining examples of the commitment to caring at the heart of Permanente Medicine. Your partnership has made this progress possible; I look forward to facing the challenges of 2022 with you.

With gratitude,

Paul Minardi, MD President

Table of contents

Permanente Impact Winter 2021 Letter from the President

2

COVID-19 progress

4-5

WPMG experts in the media

6-7

Local impact

8-13

Letter from Finance

15

Your board in action

16-19

Celebrating our retirees

20-21

Finding EID success

22-23

A community of learning

24-25

On the cover Seattle artist Jayashree Krishnan completed 165 watercolor portraits of health care providers throughout the COVID-19 pandemic. We’re honored to share her portraits of WPMG clinicians Dharini Gopalan, MD, Susan Masonis, MD, and Alexis Weil, MD on the front cover and Ru-Chien Chi on the back cover. The images are collected in The Art of Caring, a limited-edition book.

WPMG by the numbers Telehealth visits (YTD Dec 2021): 2,437,945 (46.96% of total) *includes Care chat, e-visit, staff e-visit, video visit, virtual consult

Operating revenue (YTD Nov 2021): $467.2 million Operating expense (YTD Nov 2021): $460.4 million Operating income (YTD Nov 2021): $6.8 million* *includes MOU incentives

progress

COVID-19

As winter nears, need for COVID preventive measures remains high

By Paul Thottingal, MD

With a potentially more advanced variant of COVID-19 now with us — and possible influenza re-emergence — masking, social distancing, and vaccinations all remain critical as we enter the winter season.

Unfortunately, SARS-CoV-2 will continue to evolve as long as we see high rates of transmission and low rates of vaccination anywhere in the world. While it is too early to assess the threat of this newest variant, we should continue to exercise a “care and caution” approach.

The newest variant The WHO-designated Omicron variant is now in the U.S. and in our state. Omicron is highly mutated and raises concern because of its potential to transmit faster than the Delta variant.

We still don’t know if Omicron is a threat that will outpace Delta, if it causes more severe disease, or if it will significantly evade our testing methods, therapeutics, or vaccines. New data arrives daily, and we will share what is known.

Current situation We are recovering from the Delta surge, but daily cases remain high. The upper Midwest and Northeast are suffering surges along with Europe and Russia, despite generally high vaccination rates. Preventative lockdowns and other increased restrictions have returned in many EU states.

Though vaccination progress has been good, rates everywhere still need to be higher. Here in Washington we sit at 79% for those 12+ who have had at least a single vaccine dose.

However, while vaccines have reduced hospitalizations and mortality, we know they alone may not provide 100% protection. Other safety practices are needed to keep case counts and hospitalizations down.

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COVID-19 progress

Yet, there is much to be optimistic about. COVID-19 therapeutics are on the way (including oral drugs from Merck and Pfizer) and a vaccine for children under 5 should be approved by the second quarter of 2022 that will help bring us closer together in the New Year.

Preventive measures still imperative The coming winter will likely bring increased cases to our communities because many Washingtonians remain unvaccinated. This makes masking and social distancing as important now as before.

Getting COVID-19 vaccine (as well as flu shots) in more arms is the highest priority (and boosters for those who are eligible) if we hope to keep our communities safer in 2022.

As we approach 2022, thank you Sara shows off the lion she received from Two years into this pandemic, we all are suffering from getting vaccinated at Redmond Medical Center. immense fatigue and pandemic burnout. Through trying times, you continue to answer the call to vaccinate our community and care for our patients. Such remarkable commitment to each other and our community represents the best of WPMG. I am also proud of our medical group’s success in vaccinating nearly 100% of our own. Please continue to advocate vaccination to our patients and safe practices in the community.

Our patients view us as trusted partners in their care.

When vaccinations increase for COVID-19 and for influenza — and we continue preventative practices at work and in our communities — 2022 will be a better year than the last two that we all have endured.

COVID by the numbers

Confirmed COVID-19 cases: 16,417 COVID-19 tests conducted: 223,330 COVID-19 vaccines injected/ delivered: 540,556 COVID-19 completed vaccination series: 317,764 Data current as of 12/21/21

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WPMG experts in the

media

Leading on EID Colin Fields, MD, HIV/PrEP Program and Gender Health Program, demonstrated EID leadership in his 40 under 40 profile in the Puget Sound Business Journal.

“I want all care providers to recognize people’s identified differences and preferences and remember that we’re all here to provide exceptional care,” Dr. Colin Fields said. “And we need to ground in a shared sense that we all make mistakes, it’s OK to apologize and move forward.”

Facing another COVID-19 holiday season Michael Alston, MD, advocated for Santa in The News Tribune with this playful admonition: “Santa is known for his old age, and also his generous belly, both of which have a higher risk profile with COVID.”

“It’s really important to have conversations ahead of time about people’s vaccination status, which might be something that you haven’t had to do before at a holiday gathering in the past. It’s going to be important to understand who you’ll be having your dinner with,” explains Avantika Waring, MD, in a piece on holiday safety on the KOMO news website.

“Not everybody is vaccinated and so we really need to think about whether we might be putting others in the community at risk. Again if you have folks who maybe haven’t been fully vaccinated, but are still high risk, the virus is still spreading in our communities. It’s not gone,” she cautions.

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Regular contributors to medical excellence Though many WPMG clinicians work with the media throughout the year, Susanna Block, MD, Peter Barkett, MD, and Jeff Markin, MD each deliver a frequent dose of medical expertise to inform and educate their readers.

With topics from sun safety to COVID-19 vaccinations, Ask the Pediatrician with Susanna Block, MD, provides parents with actionable insights.

Peter Barkett, MD, is a trusted voice for readers of the Kitsap Sun with tips on drinking habits, blood pressures, and suspicious skin spots.

Every month in “House Call,” Jeff Markin, MD shares health and medical information on a wide variety of topics include seniors aging in place, navigating the pandemic holiday season, and prepping for flu season.

‘Their Crisis’ Is ‘Our Problem’ David Ward, MD, served as COVID-19 subject matter expert in the pages of the Spokesman-Review.

His powerful description of his COVID-19 patients with symptoms months after their diagnosis really hit home: Some are still on oxygen; others need inhalers to breathe; some haven’t returned to work because of the brain fog associated with long COVID. “Collectively, they say, ‘Please tell your patients (considering) getting the vaccines, don’t wait to get the illness like I did,’ ” Ward explained.

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Local impact

Local

impact Though our statewide and national leadership is vital for our ongoing success, the care and commitment

East King

of WPMG clinicians and staff at the local level is where we demonstrate our vision to be the best place to get care and give care. It’s the time you take every day to treat one another with kindness, work together to overcome incredibly challenging situations, and build the teams that serve our patients that make WPMG unique. The following pages celebrate the successes you’ve had throughout 2021. Thank you for your contributions.

East King continued to navigate multiple waves of the pandemic this year while showing remarkable dedication to our patients and colleagues. The COVID-19 vaccine clinics were a huge demand for everyone—and we’re proud of our teams’ resilience and stepping up time after time to serve our members. Thank you for your time and energy in supporting our community in this way.

We’re also proud of our how our teams rallied to keep up access, service, quality, and MCR (>95%) despite tremendous pressure from changes to our operations and clinical provider teams. This year we implemented flex templates—a huge change from our blocky templates and increased access to members.

We commend our strong leadership in East King including operations chiefs Emily DonaldsonFletcher, MD, and Lan Nguyen, MD, who have stayed

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Local impact on and stabilized our clinics at Bellevue and Factoria, respectively. Dr. Yan Baum, MD, also stepped up to help ensure the Redmond is working smoothly.

Thank you, East King, for addressing the total health of our patients.

East King new hires Sik Kim Ang, MD, Inpatient Palliative Care, Bellevue & Overlake Elisa Chong, MD, Anesthesiology/Interventional Pain Medicine, Bellevue, Capitol Hill, & Tacoma Tessa Commers, MD, Pediatrics, Factoria Gary Henkel, MD, Emergency Medicine, Bellevue Daniel Hwang, MD, Gastroenterology/Interventional, Bellevue & Capitol Hill Suha Kadura, MD, Pulmonary, Bellevue Yin Ping Liew, MD, General Internal Medicine, Factoria Jillian Liner, MD, Pediatrics, Bellevue Kantha Medepalli, MD, Pulmonary/Sleep Medicine, Bellevue, Capitol Hill, & Tacoma Aida Mekouar, OD, Optometry, Bellevue, Burien, Capitol Hill, Everett, & Northgate Ali Mendelson, MD, Hospice & Palliative Care, Bellevue & Redmond Christopher Mock, DO, Emergency Medicine, Bellevue Andrew Nguyen, DO, Gastroenterology/Transplant Hepatology, Bellevue & Capitol Hill Sara Pauk, MD, Women’s Health, Bellevue Kaleigh Prendergast, PA-C, Gastroenterology, Bellevue & Capitol Hill Richard Pulido, MD, CIM/Nocturnist/Swing, Bellevue & Overlake Sharat Raju, MD, Otolaryngology, Bellevue, Capitol Hill & Tacoma

all of KPWA in patient visit yield (average patient visits per day per clinician).

On top of this, our staff came together to serve our dedicated flu and COVID-19 vaccine clinics. We have also built up strong and cohesive relationship with our health plan partners.

As our Olympia staff faced numerous challenges this year—including pandemic fatigue, staffing shortages, and Primary Care programmatic changes—we are incredibly proud of the resilience, fortitude, dedication, and compassion you’ve shown. Thank you.

Olympia new hires Ahmad Abadullah, MD, Hospitalist, Olympia Alexa Barcena, PhD, Psychology, Olympia Doris Hahn, CNM, Midwifery, Olympia Alexander Jeffrey, PA-C, Virtual Care Chat, Olympia & Renton Bryan Morris-Ward, MD, Family Medicine, Olympia Heather Muehler, OD, Optometry, Olympia Gregory Pendle, PA-C, Urgent Care, Olympia Anthony Roland, PA-C, Urgent Care, Olympia Ronald Spiegel, MD, Pediatrics, Olympia Natalie Tajipour-Glass, PA-C, Urgent Care, Olympia Scott Voelpel, PA-C, Urgent Care, Olympia

Peninsula

Olympia

We can’t imagine a better team to serve our community than our Olympia colleagues. We are truly grateful to get to work alongside what we consider our very own superheroes. Thank you for your strength Olympia—our community is blessed to have you.

After much hard work and preparation, Olympia Urgent Care expanded to 24/7 this year. We are also proud of our West Olympia teams who led

Peninsula began the year on a high note as we expanded our Silverdale Urgent Care to 24/7, the result of much hard work and planning by our teams. Our Silverdale Ambulatory Surgery Center now offers minor outpatient surgery as well. We continue to improve our specialty access by fully staffing up our cardiology and oncology services.

Gig Harbor is getting top marks for MCR coding and achieving our target provider visit yield. Their hard work earned Gig Harbor NCQA Medical Home status, one of the first KP microclinics to do so. Insufficient space continues to be a concern in Poulsbo, Silverdale, Gig Harbor—and we appreciate our staff for continuing to navigate these constraints.

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Local impact

This year we welcomed new operations chiefs David Bolthouse, MD, Poulsbo, and PA Rachel Mcelvain, Port Orchard. We also formed new partnerships with our health plan colleagues with incoming DDO Randy Hartman and Silverdale COM Shi Peckham.

Looking ahead, we hope that more stabilized workloads will lead to improved staff retention in 2022. We celebrate our Peninsula heroes for time and again rising to the challenges and finding new ways of caring for our patients and each other. Thank you.

Peninsula new hires Franklin Brown, MD, Psychiatry, Bremerton Behavioral Health Talia Firestein, MD, Family Medicine, Gig Harbor Claire Kennedy, PA-C, Urgent Care, Silverdale Christopher Kinney, PA-C, Occupational Medicine, Port Orchard Borislav Kirov, MD, General Internal Medicine, Port Orchard Shawn McLane, PA-C, Emergency Medicine, Silverdale Arla Mistica, MD, Psychiatry, Bremerton Behavioral Health Carly Oslin, OD, Optometry, Port Orchard & Silverdale Raquel Rudy-Lemanski, OD, Optometry, Port Orchard & Silverdale Michael Schnyder, PA-C, Hematology/Oncology, Silverdale & Tacoma Yudi Wibisono, DO, Occupational Medicine, Port Orchard

Seattle

Despite the challenges of 2021, the Seattle district has taken a proactive approach to balancing staff well-being while also providing superior patient care. We commend Rainier for achieving the region’s highest engagement scores and Northgate for leading the district in quality metrics like BP control and access.

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Seattle proudly piloted the HealthConnect Provider Proficiency training this year. Aimed at arming clinicians with the skills needed to practice medicine sustainably using the EMR—the curriculum improved every Seattle clinician’s proficiency score in Signal and helped increase their “Close As You Go” rates.

100% of our clinicians found the training a valuable use of their CME. The training will spread to all primary care clinicians in Q1/Q2 of 2022.

We welcomed new leadership with Scott Itano, MD, stepping into the District Medical Director role and Bradford Volk, MD, as the new Medical Chief for Northgate. Christine Nguyen, MD, Medical Chief of the Downtown clinic, helped navigate the closure of that clinic and joined our leadership team at Capitol Hill Medical Center.

In the coming year, Seattle hopes to adapt workflows around the flex templates, become fully staffed at the MA level, and maintain an environment where all providers and support staff can achieve work-life balance. Thank you for your hard work, Seattle!

Seattle new hires Kirsten Andrews, MD, Family Medicine PRS and Care Chat, Capitol Hill & Renton Michela Blain, MD, Infectious Disease, Capitol Hill Elisa Chong, MD, Anesthesiology/Interventional Pain Medicine, Bellevue, Capitol Hill, & Tacoma Stephen Dong, MD, Hematology/Oncology, Capitol Hill Gryska Gonzalez, PA-C, Orthopedic Surgery, Capitol Hill Daniel Hwang, MD, Gastroenterology/Interventional, Bellevue & Capitol Hill Duangporn Jitjai, MD, Nephrology, Capitol Hill David Kim, MD, PM&R, Physical Medicine and Rehabilitation, Capitol Hill Ian Mallett, MD, Urgent Care, Capitol Hill Monica McMillan, MD, Urgent Care, Capitol Hill Kantha Medepalli, MD, Pulmonary/Sleep Medicine, Bellevue, Capitol Hill, & Tacoma Aida Mekouar, OD, Optometry, Bellevue, Burien, Capitol Hill, Everett, & Northgate Nancy Mora Becerra, MD, Endocrinology, Capitol Hill & Lynnwood Rachel Nakanishi, MD, Family Medicine, Capitol Hill Andrew Nguyen, DO, Gastroenterology/Transplant Hepatology, Bellevue & Capitol Hill Kaleigh Prendergast, PA-C, Gastroenterology, Bellevue & Capitol Hill Arielle Radelet, PA-C, Neurosurgery, Capitol Hill Sharat Raju, MD, Otolaryngology, Bellevue, Capitol Hill & Tacoma Danielle Robertson, OD, Optometry, Northgate Janet Singh, MD, Hospitalist/Clinical Review Unit, Swedish First Hill Julie Smith, PA-C, Plastic Surgery, Capitol Hill Nhi Tan, MD, Nephrology, Capitol Hill Giselle Teston, CNM, Midwifery, Capitol Hill

Local impact

Joanna Toner, OD, Optometry (WPMG Resident), Northgate Emelia Udd, CNM, Midwifery, Capitol Hill Ke Wang, MD, Nephrology, Capitol Hill Deborah Washington, MD, Hospitalist, Swedish First Hill Vivian Yu, MD, OB/GYN, Capitol Hill Amy Yuen, MD, Genetics, Capitol Hill

Snohomish

Snohomish new hires Chad Cleven, DO, Internal Medicine, Lynnwood Elizabeth Fetzer, MD, OB/GYN, Everett Aida Mekouar, OD, Optometry, Bellevue, Burien, Capitol Hill, Everett, & Northgate Nancy Mora Becerra, MD, Endocrinology, Capitol Hill & Lynnwood Rachel Nakanishi, MD, Family Medicine, Everett Ryan Ngo, MD, Optometry, Everett & Smokey Point Saraga Reddy, MD, Family Medicine, Everett Sophia Tong, MD, Primary Care Internal Medicine, Smokey Point Tessa Lee Voges, PA-C, Gastroenterology, Lynnwood

South King

As COVID-19 continued to sweep through our communities, our Snohomish teams responded to the needs of our patients and colleagues at every turn. Many stepped up to serve in our COVID-19 vaccine clinics again and again. We are so grateful for your dedication and sacrifice in support of our mission.

In 2021 we implemented flex templates—a huge change for our teams who are mostly appreciating this change. Our WIC teams are well-staffed for the second straight year and adding pediatric RNs has been a welcome addition to our clinics.

Despite the challenges of 2021 we’re proud that we didn’t lose staff to our local competitors and that our clinician staffing overall was very stable. We’re also grateful to our operations chiefs who continued to lead in their position, offering stability year-over-year: Tolani Mwatha, MD, Smokey Point; Tim Whitley, MD, Everett; Elisa Frost, MD, Lynwood; Katina Galliano, PA, Northshore.

We’re proud of our Snohomish staff and it’s been exciting to see your leadership appreciated, including: Lenny Smith, PA, getting elected to the Board; Mark Flynn, MD, serving as Medication Safety Liaison; Maggie Chin, MD, serving as quality champion; and Dr. Mwatha earning the inaugural Christine Fordyce Women in Medicine award.

Despite the impact of COVID-19 on our patients and care teams, South King has learned to not just endure but also support each other and find ways to thrive where we can.

We’ve led successful vaccine clinics at Federal Way and the Renton Admin Campus as well as testing at Burien. In addition, Federal Way is now home to Addiction Recovery Services, filling a huge gap in care for many patients. All South King clinics completed dyad partnership training, solidifying the foundation of excellent Primary Care. In addition, Burien has completed Belong@KP to prioritize equity as part of our patient care.

Expansion planning is underway to move Kent Medical Center to a downtown location in 2024 and offer more specialties and providing better care to our members. We’re also looking to better utilize our Renton space and bring in more MH&W services.

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Local impact

South King new hires Kirsten Andrews, MD, Family Medicine PRS and Care Chat, Capitol Hill & Renton Matthew Beecroft, MD, Emergency Medicine, Renton Amelie Fillebeen, MD, Family Medicine, Burien Kisung Hong, MD, General Internal Medicine, Burien Alexander Jeffrey, PA-C, Virtual Care Chat, Olympia & Renton Joshua Keanu, PA-C, Virtual Care Chat, Renton Aida Mekouar, OD, Optometry, Bellevue, Burien, Capitol Hill, Everett, & Northgate Meghan Mosbo, PA-C, Primary Care, Federal Way Judith Oh, OD, Optometry, Federal Way & Tacoma Frida Pena Benitez, MD, Care Chat and Family Medicine PRS, Renton Carlos Ramos, MD, Virtual Care Chat, Renton

Thank you, Spokane teams, for all you have done and continue to do!

Spokane new hires Coralyn Alexander, MD, Psychiatry, Riverfront Michael Allen, DO, Family Medicine, Lidgerwood Lindsay Hamlin, OD, Optometry, Riverfront Jeremiah Johnson, PhD, Psychology, Riverfront Renee Mueller, PA-C, Family Medicine, Riverfront and Veradale Raksha Pradhan, DO, Rheumatology, Riverfront Yuliya Shayunussova, MD, Family Medicine, Lidgerwood

Tahoma

Spokane

Spokane has weathered the multitude of changes and COVID-19 impacts with resilience, innovation, and bold moves. We are incredibly proud of our care teams and the leadership you display on a daily basis.

Highlights for the year include our design and piloting of a flexible primary care template initiative at our South Hill location that was later adopted by the rest of the region. This concept allows for both the market and the care team to shape and respond to the ever-changing needs of our members—and has shown great initial success.

We’re also proud to have welcomed a host of new clinicians this year, including the expansion of rheumatology and sports medicine in Spokane.

These moves have positioned us well for the impacts of the upcoming major network and payer changes and to support a closer alignment to the quality, safety, and affordability standards of the KP model of care. In leadership news, Eastern Washington was pleased to announce Heather Brennan, MD, as our new District Medical Director.

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Our Tahoma staff displayed great resilience in a year of challenges including understaffing, the ongoing pandemic, and system changes.

We launched a pilot of the Practice Partnership 3.0— an evolution of this practice model that we hope will lead to more sustainable practice and improved member access. We also expanded our Oncology services, onboarding six new physicians. To better allocate our scarce IM resources, we’re piloting new risk assessment tools to determine which patients will most benefit from IM preoperative consults.

This year we completed facility improvements at Tacoma Medical Center that will bridge us to our new multispecialty hub—updating and expanding the Urgent Care and Oncology spaces and renovating the 4th floor to better accommodate Pulmonary.

Lastly—and perhaps another indicator of the need for a new hub—staff and managers really came together in response to the flooding at Tacoma, incredibly resulting in only 23 patients needing to be rescheduled. Our staff are our strength at KP Tahoma.

Local impact Tahoma new hires Erin Boylston, MD, Family Medicine, Tacoma Ananda Brinkmann, Urgent Care, Tacoma Elisa Chong, MD, Anesthesiology/Interventional Pain Medicine, Bellevue, Capitol Hill, & Tacoma Imelda De Villa, General Internal Medicine, Tacoma Jennifer Jenkins, PhD, Neuropsychology, Tacoma Mall Behavioral Health & Speech Yena Kim-Hall, OD, Optometry, Puyallup Kevin LaFave, PA-C, Urgent Care, Tacoma Natasha Ludwig, PA-C, Urgent Care, Tacoma Sarah Maichel, PA-C, Plastic Surgery, Tacoma Benjamin Mclean, MD, Psychiatry, Tacoma Mall Behavioral Health & Speech Kantha Medepalli, MD, Pulmonary/Sleep Medicine, Bellevue, Capitol Hill, & Tacoma Huma Memon, MD, Hospitalist, St. Joseph’s Heather Nattkemper, PA-C, Urgent Care, Tacoma Amy Noland, MD, Emergency Medicine, Tacoma Judith Oh, OD, Optometry, Federal Way & Tacoma Sharat Raju, MD, Otolaryngology, Bellevue, Capitol Hill & Tacoma Michael Schnyder, PA-C, Hematology/Oncology, Silverdale & Tacoma Jordan Starr, MD, Anesthesiology, Tacoma Ulyana Tishchenko, PA-C, Family Medicine, Tacoma Christopher Walsh, PA-C, Urgent Care, Tacoma Jeffrey Whittall, MD, Hospitalist/UC Pediatrics, St. Joseph’s & Tacoma Louise Zhou, MD, Hematology/Oncology, Tacoma

WPMG Administration

eye care utilization, the launch of KP First, and employing the Surgical Strategy to save the organization more than $15 million. Primary Care and District Business Operations supported design and rollout of new programs, including Demand Management and flex templates in Primary Care.

The commitment and creativity of these teams has delivered incredible improvements for the whole organization.

Administration new hires Kanthi Akkineni, PA-C, Team Clinical Reviewer, Renton Kayla-Marie Biros, Recruiting Coordinator, Renton Yennifer Celis, Healthcare Careers Intern, Renton Carolyn Davidson, HR Coordinator, Renton Brandon Hale, Executive Consultant, Care Delivery Specialist, Renton Serena Hughes, HR Generalist, Renton Ruth Krauss, Communications, Renton Elrond Lawrence, Temporary Project Manager, Renton Jeremiah Lee, PLD, Renton Kay Lui, Director, Talent Acquisition, Renton Amber Nelson, Sr. Director, Strategic Communications and Branding Jose (Abraham) Oliva, Staff Accountant, Renton Marichelle Oliva, Strategy Consultant, Renton Nikhita Pakki, Sr. Healthcare Data Analyst, Renton Aseem Pandey, Business Operations Director III, Renton Cheryl (Michelle) Pfarr, Clinical Referral Management Department, Riverfront Sarah Ramsey, WPMG Administrative Staff, Renton Jessica Sandhu, Business Operations Director II, Renton Kelly Shaw, Executive Assistant, Renton Chardai Thomas, Administrative Intern, Healthcare Careers Pathway Program, Renton

Across the board and across the state, eighteen different administrative teams pivoted to meet the changing needs of the organization.

Compensation and Benefits navigated the new state requirements for long term care, Referral and Review Services maintained prior-year reductions in the number of Site of Service appeals and implemented several cost savings strategies like High End Imaging/Site of Care reviews. The Finance Division automated and standardized many functions while Specialty Business Operations saw significant gains in

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Finance letter

Strong principles and smart adaptation are in our DNA As I start my second year with WPMG, I’m continuing to learn about the inspiring origins of our medical group, and I hear echoes of Kaiser Permanente’s beginnings in stories of Group Health’s history.

Dissatisfied with the fee-for-service medical norms in Seattle in the 1940s, early Group Health leaders created a physician-led, pre-paid practice considered so radical at the time that the King County Medical Association refused to admit Group Health doctors to the association. Similarly, Kaiser Permanente took shape during WWII, serving shipyard workers with dues-based care. This lowcost, comprehensive model was also controversial, but aligning with the needs of California’s labor unions and post-war industrialists fueled KP’s early growth.

Successes and struggles made us who we are today, shaped by the forces of rapid growth and innovation that rocketed through the late 20th Century. Seven decades have taught us much about navigating complexity. Regulators continually change the rules, science advances our tools, and government is now a major driver of U.S. spending on healthcare. As in nature, adaptability determines survival.

In my role, I work with our medical leaders and Board of Directors to understand external forces, support well-informed decision making, and assess the risks worth taking. Adaptability is in our DNA and important to draw on as we combine our region’s talents, services, and investments for the best chance of success.

Even with radical thinking in our DNA, our predecessors stayed grounded in these principles: population health, comprehensiveness, evidence-based medicine, and engaging patients in their care. They’re constant, even if the ways we act on them adapts to what’s happening around us.

So, what’s in the next episode of our story? Building on our principles, we will: • Reinvigorate population health with enhanced registries and safety net programs, • Build up our specialty practices with new and expanded facilities, starting with Everett in 2022, and • Bring Permanente Medicine to more people, through internalization, strategic partnerships, and expanding virtual options.

Clinicians who joined our medical group when it was called Group Health will remember the symbolism of the logo: a caduceus flanked by towering evergreen trees. This was a deliberate choice because evergreens are so deeply rooted, they can bend without breaking in the strongest winds.

As we move through the stormy winter months, both literally and metaphorically, let’s remember the strong roots of our predecessors and carry on the tradition of strong principles and smart adaptation.

With appreciation,

Cindi Johnson CFO, VP of Strategy, interim COO

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Your

board in action

The WPMG Board of Directors maintains several cross-functional committees that include Board members, administrative professionals, and frequently—at-large frontline clinicians.

Our board committees are highly diverse in their membership, scope, and skill set yet remain unified in a singular goal: To convene regularly and give voice to the sharp minds and broad perspectives of our group to ensure our governance is as strong, fair, and representative as possible.

Open committee positions are posted on a rolling basis in the Permanente Pulse newsletter.

Please reach out to the committee chairs to learn more about their work and how to get involved.

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Governance

Compensation and

benefits

Prepared by Committee Chair Deb Gore, MD, Family Medicine, Riverfront

“Comp & Ben” continued our ongoing oversight to ensure that WPMG offers a fair and competitive total compensation package that aligns to our values and enables us to recruit and retain world-class clinicians.

Revisiting the clinical base salary methodology, the committee endorsed a change to eliminate current provisions allowing for programmatic salary decreases, and the Board approved that change for 2022. The committee also oversaw the implementation of a “W-System” as part of the redesign of our PA compensation methodology, checking and adjusting that program throughout the year. As it does every year, the committee worked with external consultants and advisors to benchmark all of our programs to ensure market competitiveness.

Two new at-large members joined the committee: Antonio Brandt, MD, Urgent Care, Olympia; and Viral Shah, MD, Hospitalist, Bellevue. WPMG Board Member Lenny Smith, PAC, Family Medicine, Everett, also joined the Committee, and the Chair position passed from Ilan Zawadzki, MD, Nephrology, Capitol Hill, to Deb Gore, MD, Family Medicine, Riverfront.

Board

development

Prepared by Committee Chair Grace Kim, MD, ENT, Capitol Hill

The “BDC” oversaw the planning of a meaningful Annual Meeting with guest speakers Greg Adams, CEO of KFHP, who spoke on his commitment to One KP and KPWA; Ron Copeland, MD, FACS, shared his personal story of confronting racism and gave guidance on being more inclusive.

BDC and the board reviewed the governance needs assessment administered by Practice and Leadership Development (PLD). The assessment provided valuable information regarding the gaps on the board and its committees and will inform the development of the Governance Pathway within WPMG U. We also initiated an equity project that includes the formation of the Governance Pipeline subcommittee, an inclusive pipeline for board and committee members and serve as a platform for information on governance work at WPMG. We welcomed our newest at-large member, Natasha Vanchinathan, MD, Nephrology, Tacoma.

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Strategy and

finance

Prepared by Finance Subcommittee Chair Jean Walsh, MD, Orthopedics, Tacoma; Performance Subcommittee Chair Jeffrey Sullivan, MD, Pulmonary, Capitol Hill; Growth Subcommittee Member Sarah Philp, MD, Addiction and Recovery Services, Federal Way The Strategy and Finance committee is composed of three subcommittees—Finance, Performance, and Growth.

From the Finance perspective, we monitored the annual MOU process, and reviewed both the cash balance plan and our expanded family leave benefit to ensure their sustainability.

We also worked with the Comp & Ben committee to recommend to the Board the distribution bonus that was paid in the spring of 2021.

The board created the Performance subcommittee in 2021 to improve our governance role on quality, staffing, and risk for our organization. One of our first tasks has been to develop oversight of a broader array of quality metrics that reflect inpatient, outpatient, and surgical outcomes for our members. We’ve requested that these measures also include race, gender, and LGBTQ status. Another major focus has been working with HR leaders to ensure appropriate clinician staffing and that our group grows more diverse to better match and serve our patient communities. Lastly, we’ve been working with leaders to address clinician wellness—central to our ability to perform as an organization.

The Growth subcommittee continued to focus on our competitive landscape and customer insights as well as the planning and monitoring of our strategic business goals. We are expanding our view in 2022 to understand better the current mechanisms that exist to solicit customer insights to promote the use of equitable methods.

Equity Governance

Collaborative

Prepared by Collaborative Convener Sarah Philp, MD, Addiction and Recovery Services, Federal Way The WPMG Board proudly established the Equity Governance Collaborative (ECG) this year.

Some of our first acts were to recruit and welcome our collaborative members, and draft and approve our charter. The collaborative prides itself on creating a supportive and challenging environment where stories and expertise are shared and perspective is gained, while also using our collective skills to further the goals of the WPMG Governance antiracism strategic plan.

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Governance Our Dashboard subgroup has been working to identify oversight metrics to monitor organizational progress as well as WPMG Governance progress toward our own antiracism commitments.

Our Community Voice subgroup has been working with an outside consultant to provide expertise on the inclusion of community members on our equity governance collaborative.

Additionally, the EGC provides a support structure and resource for all board committees.

Each committee assigns a designee to the EGC. For further reading, please read our governance year-end equity report, and background on our at-large members.

Executive

The Executive committee met monthly to fulfill its chartered responsibilities, which include: WPMG bylaws updates; coordinating and arranging board meetings and agendas; establishing, reviewing, and updating policies related to overarching corporate function for approval by the board of directors; overseeing WPMG CEO performance review and strategic talent development planning; and serving as the corporate compliance committee.

The Executive committee also welcomed Brad MacKinnon, MD, Family Medicine, Port Orchard, as new vice-chair earlier in 2021 and more recently, Jeffrey Sullivan, MD, Pulmonary, Capitol Hill, joined the committee as a voting member. Deb Gore, MD, Family Medicine, Riverfront, remains on committee in her role as Secretary and CFO Cindi Johnson assumed the role of Treasurer.

Audit

The Audit committee continued to provide oversight of the financial reporting process, the audit process, the system of internal controls and compliance with laws and regulations. Every spring our auditors at Moss Adams make a full presentation to the Board. This year, as in all prior years, we received a “clean bill of health.”

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Celebrating our

retirees

Adventure on the Horizon After 16 years of service, Gakyung Chung, MD, Director of Operations, Specialty Services, is retiring to embark on a fun-filled retirement. Her first adventure “will find me preparing to join the Oyster World Rally, a twoyear circumnavigation of the globe,” says Dr. Chung. “This once in a lifetime experience will require me to learn new skills: ocean sailing, celestial navigation, scuba diving, creating drone videos, blogging, cutting my husband’s hair…”

“Over the years, Dr. Chung established herself as a clear voice and strong advocate for the ideals of Permanente Medicine and surgical excellence,” says Cindi Johnson, CFO. “She leaves behind a legacy of an immensely talented and caring department that has grown in size and scope—operating at the forefront of our delivery system and mission.”

As she prepares for her next chapter, Dr. Chung says, “As a physician and a classical musician, my advice is to live each day as if it were your last performance. It will bring your personal and professional endeavors into sharp focus. You will find tremendous energy and discover that you have nothing to fear. You will then be able to bring your absolute authentic self to the table every time.”

Her last day with WPMG is December 24, 2021. Join us in wishing her bon voyage.

Gratitude and Optimism David K. McCulloch, MD, shares highlights of a 37-year-long career that included the implementation of electronic medical records, the infancy of evidence-based guidelines and the implementation of treatment protocols, building the foundations of the Patient-Centered Medical Home, and the introduction of Kaiser Permanente in Washington. He also extends thanks and recognition to colleagues past and present.

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Celebrating our retirees Connecting after retirement The Association of Retired Medical Staff (ARMS) was established in 1990 to facilitate the transition from active practice to retirement, foster continued collegial relationships amongst retirees, and maintain a connection between retirees and Washington Permanente Medical Group.

ARMS sponsors a series of events centered around learning or volunteer opportunities. Still, the main emphasis is on sharing the retirement experience and continue the friendships formed throughout medical careers.

Currently led by Ruth Krauss, MD, and Annie Iriye, MD, the group is composed of more than 360 members, including those who’ve retired as early as the 1980s. Retired medical staff, associate and affiliate staff, and selected medical staff all form ARMS. Additionally, spouses or partners of deceased members are invited to continue as members of Extended ARMS. In its early days, ARMS hosted gatherings at members’ homes and organized field trips, picnics, and musical events. In recent years, it’s transitioned into luncheon meetings held three times a year featuring guest speakers and opportunities to socialize.

“ARMS has helped generations of retirees keep in touch with each other and with the medical group,” says Dr. Krauss. “After a painful hiatus due to COVID, Annie and I look forward to resuming our activities — and to enhancing them. If you are about to retire, we look forward to welcoming and congratulating you!”

Offer congratulations to recent retirees and learn more about ARMS here.

2021 Retirees East King

George Beito, MD, General Surgery, Bellevue Abid Haq, MD, Occ Medicine, Bellevue Michelle Heng, MD, Pediatrics, Redmond Simeon Rubenstein, MD, Cardiology, Bellevue Robert Sandblom, MD, Pulmonary Medicine, Bellevue Steven Short, MD, ENT, Bellevue

Olympia

Stephen Albrecht, MD, Urgent Care, Olympia George Brennan, MD, General Surgery, Olympia John Lewicki, PA-C, ENT, Olympia John Merslich, OD, Optometry, Olympia John Chris O’Neill, PA-C, Urgent Care, Olympia Julia Sokoloff, MD, Family Medicine, Olympia Ann-Kristin Sundell, MD, Pediatrics, Olympia

Peninsula

Gregory Cain, MD, Pediatrics, Port Orchard Patricia Daly, OD, Optometry, Port Orchard Don LaPlant, MD, Family Medicine, Silverdale Linda Radka, APPP, Family Practice, Silverdale Jean Riquelme, MD, Family Medicine, Port Orchard Lindsey Sewell, OD, Optometry, Silverdale Thomas Siler, MD, GIM, Port Orchard Mark Sugimoto, MD, Family Medicine, Poulsbo

Seattle

Randi Beck, MD, PM&R, Capitol Hill David Bender, PA-C, Urgent Care, Capitol Hill David Bender, PA-C, Urgent Care, Capitol Hill Gakyung Chung, MD, Dir of Ops, Specialty, Capitol Hill Eric Froines, MD, General Surgery, Capitol Hill Peggy Goldman, MD, Urgent Care, Capitol Hill David McCulloch, MD, Clinical Plan/Impr, Capitol Hill Larry Otwell, OD, Optometry, Capitol Hill Susan Warwick, MD, OB/GYN, Capitol Hill Wende Wood, MD, Family Medicine, Downtown Seattle

Spokane

Mary Badger, DO, GIM, Northpointe Andrew Batchelder, MD, Family Medicine, Veradale Julie Celeberti, MD, Pediatrics, Lidgerwood Dale Ann Petersen, PA-C, Urgent Care, Riverfront Nicholas Tanner, MD, Podiatry, Riverfront

Tahoma

Karen Ackerman, MD, Radiology, Tacoma South Dawn MacLennan, CNM, OB/GYN-Midwifery, Tacoma Lorette Meske, MD, CIM, Tacoma Paula Smith, MD, OB/GYN, Tacoma

WPMG Administration

Mary Bethune, PA-C, Care Clinic, Renton Administration Margaret Stephanie Lee, PA-C, Care Chat, Renton Administration

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Finding EID success:

a year in re

By Kristin Conn, MD, Sr. Associate Medical Director, Equity, Inclusion & Diversity

We’ve made great strides toward our EID goals over the last twelve months. Specifically, our work has made care disparities more visible to leaders in quality, pharmacy and care delivery through the creation of the EID QFR composite. We launched the first cohort of KPWA Equity Guardians through the Transformational Leadership for Racial Equity and started our Belong@KP engagement with medical leaders and admin staff.

We also rolled out QBS in primary care, kicked off the Healthcare Career Pathway program and we hired a Thriving Families Assistant Medical Director. As we continue our anti-racism journey into the new year, I want to share with you more details around one of our eight key objectives: include all patients in our EID journey.

Our anti-racism journey requires that we be inclusive and one way to do that is by welcoming patients with clinicians who speak their language. Our Qualified Bilingual Staff (QBS) program identifies and qualifies clinicians in the most frequently spoken languages in the communities we serve including Spanish, Vietnamese, Mandarin, Cantonese, Russian, and Korean. The testing protocol includes not just proficiency in casual language usage, but also competencies in the provision of care by evaluating knowledge of medical terms.

Our health plan partners will be piloting the QBS program next year for support staff including medical assistants, nurses and PARs. Nearly two dozen primary care providers have already qualified as bilingual including Bellevue clinician Lan Nguyen, MD. As a qualified bilingual staff member in Vietnamese, she finds that patients “are more likely to communicate their concerns and fears.” Dr. Nguyen says having a clinician that speaks a patient’s language, “helps with rapport and follow up especially with chronic conditions and mental health.” She’s seen patients feel less anxious and more reassured about their medical care and finds they are “more likely to follow up on their chronic conditions like diabetes,” and “more likely to be honest and upfront about their needs.”

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EID progress

eview This program will be expanded to include more WPMG clinicians in 2022 for our most frequently requested languages. Our work is just the beginning of building a foundation of dyads and teams that are culturally and linguistically concordant with our members, which improves both our quality of care and patient experience. If you’d like to participate, please contact Jane Dulski, WPMG EID Program Manager. Across the organization, we’re progressing step by step toward a more equitable, inclusive, and diverse experience for everyone.

WPMG leaders and admin staff, please support our EID journey by completing your Belong@KP modules by December 31 if you haven’t yet done so.

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A community of

learning

As a member of WMPG’s community of practice, you’re invited to the learning journeys available through WMPG University. With a trio of learning pathways (clinician, governance, and leader), WPMG U supports the growth of every member of our organization.

Clinicians All clinicians work through the WPMG U Associate Program over three years on their way to becoming shareholders. The various offerings include quick, snacksized virtual classes as well as more intense learning opportunities. Courses include Pathway to Proficiency — a program to help personalize and optimize your KP HealthConnect experience, Clinic Patient Communication: Using the Four Habits, and Mitigating Bias in Care Delivery.

Leaders The career path possibilities at WPMG are many. The leadership courses offered in this pathway provide essential skills through classes including Coaching for Success, Change Management Practices, and Leading Inclusively.

The wide array of offerings provide learning opportunities for those considering a leadership role as well as those seeking or engaging in senior leadership roles.

Governance WPMG’s board of directors is fundamental in the organization’s success and relies on the commitment of committee members and chairs to realize its potential. When you’re ready to consider a board role, this slate of classes will prepare you through the Foundational Leadership Series, Cultivating a Speak Up Culture, and Mentoring and Developing Leaders.

Whether you’re a clinician or an administrative staff member, WPMG U can help you learn new skills to support your career journey. Learn more about the possibilities by visiting WPMG U.

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WPMG University

Register Now For 2022 Classes! WPMG University’s three pathways are: Clinician Pathway: WPMG’s Associate Program includes classes for new clinicians, communications courses for everyone, and more Leader Pathway: A mix of short virtual programs and longer immersive experiences for leaders Governance Pathway: Courses selected for board and committee members’ development needs WPMG University combines revitalized versions of PLD’s most popular courses with brand new classes tailored to your current needs. Join your colleagues for sessions like Coaching for Success or Leveraging Feedback for Success.

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A Publication of Washington Permanente Medical Group