Archive for October, 2009

Learning Together by Listening

Wednesday, October 28th, 2009

Over the last few weeks, I have been including information in the blog about opportunities in which our leadership team has taken to  work with others, acknowledging the activities, projects and efforts outside their own specialties or functions.  In order to learn more about the ongoing, daily expectations of our departments and people, members of Leadership Council are getting back to place of work.  I received this report from Jenean Blackmon, our Chief Information Officer.  Working directly with the team in Medical Records, Jenean was able to listen, learn and gain a better understanding of the daily work in Medical Records.  I asked Jenean for an update about her day in Medical Records, especially after the August implementation of the Imaged Electronic Record.  After speaking with Jenean, I wanted you to see what she learned.

Jenean in Medical Records

Stephanie Thompson inputs data while Jenean Blackmon, VP of Information Systems, observes.

 

Rob,

I wanted to share with you about my time in Medical Records with Susie Daniels, one of our Coders. I had the privilege of working with Susie and it was truly a pleasure. Susie is a very knowledgeable, skilled coder and it was amazing to watch how quickly she can scan a chart, identify what needs to be coded,
and associate the correct codes. 

Many people may not realize that the medical records department does much more than filing away a paper chart or pulling a chart when needed. The coders are responsible for reviewing the chart and based on the information documented in the chart, assigning codes for each condition or procedure. The codes assigned reflect the level of illness of the patient, which insurance payors use to determine the reimbursement McLeod receives for the care provided.

Now that we have an electronic medical record after the patient is discharged, the roles and responsibilities of the medical records staff has changed considerably.  Part of that change was the implementation of the Coding Management system which provides the coders with an electronic copy of the chart to review online for coding. While Susie still has to read the handwriting and assign the appropriate codes, the chart is pushed to her electronically and she does not have to find the paper copy in order to code.

The time I spent with Susie was very valuable and I thank her for allowing me the opportunity to come and shadow with her.  All of the staff in Medical Records are to be commended for their hard work. Over the last few months, they have continued to provide excellent service to physicians, staff, and the patients that request records while taking on new roles and responsibilities and learning a new system. I appreciate each of you and all you do for McLeod.   I also want to thank Mavis Turner for her excellent leadership in Medical Records and in the transition to the electronic medical record. 

Sincerely,

Jenean Blackmon

Supporting the Culture of Health

Friday, October 23rd, 2009

I am proud of all that we do in striving to make McLeod “The Choice for Medical Excellence".  Each and every day, I see the tangible ways all of us live our mission to improve the overall health and well-being of the people within our region.

I am equally proud of the importance we place on developing innovative, cost-effective programs that support the health and well-being of our employees through Living Well. Living Well is a “home-grown” health and wellness initiative developed as part of our Strategic Plan.  Living Well provides a platform for extending our philosophy of care internally to our employees and their families. As an Employer of Choice in our community, we want to lead by example, which includes helping our patients—as well as members of our team — to lead healthy lives.

This year, we are taking Living Well to a new level by growing a “culture of health” at McLeod. This journey is a shared partnership between McLeod and You, and is intended to help keep you healthy.

This exciting and broad-based initiative will be overseen by Jeanette Glenn, Vice President of Human Resources. Ms. Glenn will work with many internal experts, including Dr. Peter Johnson, Medical Director of Occupational & Employee Health and Dr. Charles Jordan, Medical Director of McLeod Physician Associates, Dieticians and others in order to develop our “culture of health” initiative.

One of the next action steps we are taking is the “Health Resource Expo” that will feature free health screenings, a health assessment and informative resources on a variety of topics designed to help you better manage your health. The Expo will coincide with our annual benefits enrollment period and will run from November 2 through November 18.

You will be hearing more about the Expo over the next week. While participation is voluntary, I urge you to attend the Expo to learn about the wide range of health and wellness programs available to you as we work together to develop a “culture of health.”

Thanks,
Rob

Learning Together by Listening

Thursday, October 15th, 2009

I want to make note of something our leadership team is engaged with in order to listen and learn about the ongoing work of our departments and organization.  I received this update from Brad Willbanks, McLeod Health Legal Counsel.  Working directly with the team in Reservations and Scheduling, Brad was able to listen, learn and gain a better understanding of the daily work in that department.  I asked Brad for an update about his day.  After speaking with him about the experience, I wanted you to hear about his impressions.

Res-Sch-group

Brad Willbanks (center) recently observed the Reservations and Scheduling staff to learn how they perform service excellence. From left to right on the front row, Melanie Mastle, Cathy Godbolt, and Wanda Shepherd; (back) Daisey Gray, Brad Willbanks and Myra Allen.

Rob,

Last week I was able to work in the Reservations and Scheduling Department to observe, several of the team truly define the standards set forth in our Service Excellence expectations.  I chose Reservations and Scheduling because apart from beginning at the physician’s office with a patient, most often a patient’s first exposure and experience with McLeod will come through this department.  I wanted to be able to “track” a patient’s journey through the system in this manner.  Scott Faulkenberry, the Director, was very accommodating and introduced me to Cathy Godbolt, a Scheduler who has been with McLeod ten years.  I was able to observe and listen as Cathy interacted with patients, family members, departments here at McLeod, and physician’s offices as she coordinated the patient’s needs with the availability of services here at McLeod. 

Although I sat with Cathy as she explained the process, all ten of the schedulers should be commended for their attention to our customers’ needs.  Each scheduler fields approximately two hundred calls a day ranging from new appointments, re-scheduling appointments due to a patient’s change in circumstances, coordination with physician practice personnel, to collaboration with the various McLeod outpatient departments to determine if add-on appointments are feasible.  The computer program that we utilize rotates the calls between the schedulers, and also alerts the staff of the availability of fellow staff members (ex. on a call, in a meeting, etc).  The calls are generally fielded within three rings and the scheduler is able to track the total call time to ensure that the patient’s, department, and or physician’s office time is utilized efficiently.  The caller is also given the choice to leave a message and a scheduler can call them back.  The scheduled information is automatically electronically passed along to registration which prevents duplication of efforts from a registration stand-point.

I was next able to chat with Myra Allen, a McLeod employee since 2005.  Mrs. Allen, like all of the schedulers I spoke with, was very attentive to detail.  Myra’s focus for that day revolved around returning the voicemail messages I spoke of earlier and ensuring that all of the Medicare scheduled services meet medical necessity.  In order to determine whether or not a service indeed meets the medical necessity requirements, Myra has to determine that a valid diagnosis is given with each test.  Communication for clarification is often made to the physician’s office or hospital floor when orders contain vague terms such as “rule out, abnormal, or possible.”  When a scheduled service does not meet government mandated requirements, this information is logged into the computer and communicated to registration that an Advance Beneficiary Notice (ABN) is needed.  When a patient later presents to registration, it is explained to them that the service that they are receiving may not be covered by Medicare.

Wanda Shepherd, a McLeod employee since 2001, and with the Reservations and Scheduling Department since 2005, acts as Call Center Support and is checking the orders as they come by way of fax to ensure that they are valid.  In addition to checking for the all too familiar “signature, date and time” requirements, Ms. Shepherd checks for other discrepancies as well and follows up with the physician’s offices as necessary for clarification.  These orders are scanned  for the departments to access when the patient’s present for their procedures. 

Finally, I was able to spend time  with Melanie Mastle, who has also been with McLeod since 2005.  Mrs. Mastle is an insurance representative who coordinates and verifies insurance benefits for outpatient procedures.  She also has a counter-part, Daisey Gray, who performs a similar service for inpatient procedures.  Mrs. Mastle is constantly communicating with financial counselors, physician’s offices, patients, and McLeod departments to determine what benefits are available to the patient for the services to be performed.  Although most Medicare beneficiaries’ benefits may be accessed internally through our computer system, the commercial payors often require very patient specific information such as insurance benefit numbers, National Provider Numbers (NPI’s) from the physicians’ offices, etc. 

All of the team that I spoke with were very professional and courteous in their communications, whether it be the patient, an insurance representative, physician office staff, or other McLeod personnel.  Our ‘customers,’ we realize, are not only the patients and their families, but also those physician offices and payor benefit organizations who we must rely upon, and they us, to give timely, accurate information to ensure a seamless, no-delay service experience for our patients.

Thank you for allowing me the opportunity to listen and learn in this department, and a special thanks to each and every person in the Reservations and Scheduling Department for the work that they do here at McLeod.

Brad Willbanks
McLeod Health Legal Counsel

Community Leaders Learn About Diabetes

Wednesday, October 14th, 2009

I attended a 7 am session on Tuesday morning, presented to the McLeod Fellows.  This is a program offered by the McLeod Foundation for community leaders to learn more about the hospital, and the mission and values of McLeod Health.  The program is composed of professionals and volunteers who have actively demonstrated leadership abilities in our community.  In eight monthly sessions, members get an intimate glimpse of the many facets of healthcare.  While in the program, participants have one-of-a-kind experiences they are able to share with other community leaders, physicians and healthcare professionals.  They also obtain a working knowledge of the healthcare needs of our community and how McLeod Health is meeting those needs.  Participants gain insight into medical and technological advances through access to areas of McLeod Regional Medical Center not commonly available to the public.  They have the opportunity to network with members of the medical community from a wide variety of specialties and hear presentations from a number of experts on healthcare. These areas include McLeod Cancer Center for Treatment and Research, McLeod Diabetes Center, McLeod Children’s Hospital, McLeod Heart and Vascular Institute, McLeod Hospice.

Fellows and Diabetes

Marilyn Henderson, RN and Director of McLeod Diabetes Services, gives a presentation to the McLeod Fellows.

 

The presentations on October 13 were made by Marie Segars, Administrator of McLeod Regional Medical Center, Dr. Andrei Talantov, McLeod Hospitalist and Marilyn Henderson, Director of McLeod Diabetes Services.  The group also toured the 4 East Nursing unit where Catherine Godwin, Nursing Director 4 East, and Bradley White, Pharm.D., updated the McLeod Fellows on renal disease in the region and medication safety.  It was interesting to hear our team talk about the improvements for patients at McLeod regarding medication safety and delivery. 

Below is a slide from Dr. Talantov’s presentation.  He did a great job of explaining the disease and the implications to one’s health when affected by diabetes.  The slide shows the a ‘heat map’ of the increase over time in the percentage of adults who are obese as well as the percentage of adults who have diabetes.  It speaks again to the personal responsibility we have to manage our health and future opportunities to create awareness and offer support programs to reduce this national issue.

While there has been significant advances in treatment, medications and knowledge … while there has been a trend to wellness, exercise and healthy eating … these graphs show that a significant part of our population is moving in the wrong direction. We must act on this information and help our community move forward to better health and habits.

DiabetesMap

Thanks for your part in improving the health and wellbeing of the people of this region.

Rob

Learning Together

Monday, October 5th, 2009

I want to make note of something our leadership team is engaged with in order to listen and learn about the ongoing work of our departments and organization.  I received this update from Donna Isgett about her work last week with the ‘bed board’ team.  Donna is our Vice President of Clinical and Operational Effectiveness, supporting the organization’s continuous improvement effort in quality and safety.  Working directly with the team in ‘bed board, Donna was able to listen, learn and gain a better understanding of the daily work in that department.  I asked Donna for an update about her day.  After speaking with her about the experience, I wanted you to hear about her impressions.

Donna & Brain Board

Donna Isgett and the "bed board" team.

 

Rob,

I had a fantastic day with the bed board team on Wednesday, September 30th.  I can best relate their work to that of an air traffic controller.  They were controlling the coming and going of patients in and out of intensive care units, the emergency department and the operating room during a time when we started the morning with limited beds and a census of 371 patients.  Both ladies, Sherill Hanna and Mercedes Little, managed with grace and ease the influx of multiple phones ringing and people standing over their shoulders.  It is certainly not the job for the ‘faint at heart .’   You must be able to multitask under conditions of stress and emotions.

What impressed me during my day, second only to the calm efficiency of Sherill and Mercedes, was the incredible teamwork that existed in this work.  For example, at approximately 9 am, the cardiac team (PCS’s from CCU, CVICU, 7 East plus nursing supervisor) came to the bed board for a daily ‘huddle.’  They talked together about how the day was looking, who was waiting for beds, what was happening in surgery and the cath lab, and how they would work to make sure all patients were cared for in a expeditious and expert way.  It made me smile because I remembered that this very huddle was designed by some of these specific staff members during a Rapid Improvement Event of Operational Effectiveness to make sure we could provide access to the regions cardiac patients that desired and deserved our excellent patient care.

I can not thank this team of Sherill and Mercedes enough for sharing of their time and expertise, allowing me to be an ‘official ‘ bed board team member for the day. They even let me answer the phone a couple of times. Thanks also to the staff in the Physician Access Center that have learned to work seamlessly with their ’sister ‘ department in making the transition for patients from other hospitals easy for both the patient and the medical staff.   Finally, thanks to Judith, the nursing supervisor for being the glue for all that we do.

Sincerely,
Donna Isgett

Grand Rounds: Outcomes Matter

Friday, October 2nd, 2009

On Thursday evening, our Heart & Vascular Grand Rounds was held in the McLeod Conference Center.  Dr. Christopher Cunningham presented the results in vascular surgery. Dr. Rajesh Malik shared details and advancements in electrophysiology. Dr. Ian Smith provided expertise on the use of Plavix and Anti Platelet Therapies with patients. Each of the physicians recognized their partners, physician colleagues and the team who support these programs in the care of these patients.

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Dr. Greg Jones and Dr. Rajesh Malik take questions from guests at Grand Rounds.

Results and Outcomes do matter. Outcomes should be a part of the collaboration as decisions are made about what is best for patients. We released the latest annual data from the McLeod Heart & Vascular program as we did earlier this year in Cardiothoracic Surgery. We are releasing our outcomes as the catalyst for further improvement and to inform the medical community in our region about the success of efforts on behalf of patients.

The most recent Outcomes booklet is now in print reflecting this McLeod Cardiology and Vascular Surgery performance data as well as information on advancements and technology.

Please contact Tammy White in the McLeod Public Information Office at 777-5389 for a copy of the outcomes booklet and review these results. This information will also be available soon as a link from our McLeod Health Website.