Hawai'i-Pacific Chapter
A quarterly e-newsletter for the Hawai'i Pacific Chapter of ACHE Fall 2019 Vol. 3
In This Issue
Messages from Chapter Leadership
Message from the Regent
Message from the Chapter President
Member Spotlight
Meet our New Physician Representative
Articles of Interest
Sales Representatives in Healthcare: Partnering to fill a need for Healthcare Organizations
Improved Communication Leads to Higher Patient Outcomes, Lower Readmission Rates
US Medical Students Choosing Primary Care Specialties in an Eight-Year Decline
Diversity
The Hawaii-Pacific Chapter of ACHE Advocates for Diversity and Inclusion
Calendars and Recent Events
Annual Breakfast Highlidghts: A Pictorial
Calendar of Events
Calendar of Educational Events
News & Committee Updates
News from the Education Committee
News from the Guam Local Program Chapter
Student Corner
Membership Report: New Fellows, Members, and Recertified Fellows
ACHE Resources
ACHE National News
Career Corner
Disclaimers/Sponsors
Ensure delivery of Chapter E-newsletter (Disclaimer)
Thank you to all our Sponsors
Newsletter Tools
Search Past Issues
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Poll
As a healthcare executive, of these priorities which do you consider the most pressing?
Addressing Social Determinants of Health
Healthcare Provider Well-Being
Protection of Patient Privacy and Data
Reducing the Medical Cost Curve
CHAPTER OFFICERS

   

 

REGENT
Gidget Ruscetta, BSN, MBA, FACHE
gidget.ruscetta@palimomi.org

PRESIDENT
Darlena Chadwick, MSN, MBA, FACHE
dchadwick@queens.org

PRESIDENT-ELECT
Andrew Giles, MBA, FACHE
andrew.t.giles@kp.org


IMMEDIATE PAST PRESIDENT
Micah Ewing, MBA, FACHE 
micah.ewing@hawaiipacifichealth.org


CHAIR, GUAM LOCAL COUNCIL
Geojun Wu
wugeojun@gmail.com


TREASURER
Suzie So-Miyahira, MPH, MBA
suzie.so-miyahira@kapiolani.org

SECRETARY
Emiline LaWall, MA
emiline.lawall@hawaiipacifichealth.org


STUDENT REPRESENTATIVE
Rachelle Gallegos
rachelleg.0128@gmail.com

PHYSICIAN EXECUTIVE
James C. Lin, MD
jclin@hawaiipacifichealth.org

MILITARY REPRESENTATIVE
Col Kara Gormont, BSN, HSMP-MHA, FACHE
gormont1@yahoo.com

DIRECTORS

Travis Clegg, FACHE, MBA
travis.clegg@ah.org 

Josh Carpenter
josh.carpenter@trane.com

Nick Hughey, RN, MBA, FACHE
nhughey@wcchc.com

Laura Bonilla, BSN, MA, FACHE
laurab@kapiolani.org

Robyn Polinar
robyn.polinar@gmail.com

Carolyn Voulgaridis, JD
carolynvoulgaridis@gmail.com

Robert Diaz, FACHE
robert.d.diaz@kp.org


COMMITTEE CHAIRS

Miguel Guevara, CMRP | Audit
miguel.guevara@af.af.mil

Sally Belles, MBA-HCM, RDN, CDE | Communications
sally.belles@hawaiihealthpartners.org

Maj Jackie Lou E. Kim, USAF | Diversity
jackielou.kim.1@us.af.mil

Jerome Flores | Education
JeromeF@maunalani.org

Andrew Giles, MBA, FACHE | Membership
Andrew.T.Giles@kp.org

Miguel Guevara, CMRP | Nominating
miguel.guevara@af.af.mil 

Micah Ewing, MBA, FACHE | Sponsorship
micah.ewing@hawaiipacifichealth.org

Articles of Interest
Sales Representatives in Healthcare: Partnering to fill a need for Healthcare Organizations
Kenny Morris, MBA-HCM

In this multi-part series, we will be exploring the role and value of sales representatives in the healthcare space as well as ways that healthcare organizations can better partner with their local sales force to help drive positive outcomes at the bedside.

Part III: Bridging the Gap between Inputs and Outcomes

Connecting the clinical and operational inputs at the bedside with enterprise level quality and financial data is essential to driving positive change in healthcare organizations throughout the continuum of care.

Sales representatives can provide value in this space by providing high-quality evidence-based practice guidelines, sharing product knowledge and connecting healthcare professionals across organizational boundaries to solve problems and improve care.  Beyond these conventional duties, sales representatives should also be held accountable in ensuring their products are delivering value through a periodic and ongoing analysis of utilization inputs and quality-based outcomes.  At the most basic level, we seek to answer a simple question about any product being utilized in the healthcare supply chain: “Is it working?”.

 

By understanding and measuring these inputs and outcomes, the value (and eventual return on investment) of products and services can be better understood by healthcare facilities.  To simplify and explain this relationship between measuring inputs and valuing outcomes, let’s use a non-hospital example: seatbelts in cars.

Peer reviewed, published evidence supports that wearing a seatbelt while in a car will reduce the likelihood of major injury or death in the event of an accident.  So, for this example, our sales representative is selling and installing aftermarket seatbelts to customers in our target area where no factory standard seatbelts come installed (again, just a simple example here!).

Establishing the Inputs:
  • Because we cannot easily measure the number of people wearing seat belts at any given time, the simple input metric we will use is the number of aftermarket seatbelts sold by the sales representative to customers in the target area by year.  While we cannot make every customer that has a seatbelt wear it, we can measure who has a seatbelt available in their car.
    • This example correlates to many of the products utilized in healthcare– while they may not always be used, we can at least establish that they are being stocked and delivered to the patient / clinical staff etc.

Establishing the Outcome Measures:

  • Because the expectation on the part of the customer (and most likely the selling point and value proposition utilized by the sales representative) is that having a seatbelt will help to reduce major injury or death in the event of the accident, we will use major injuries and deaths due to car accidents as our outcome metric.
    • This can be related to the claims and evidence used by healthcare manufacturers to sell their products.  Read any healthcare industry magazine and claims of “50% reduction in infections!” or “75% improvement in rates!” are not uncommon.  Tracking those rates or outcomes against utilization is the important part of this process as it relates to healthcare quality
Once we have our inputs and outcome measures established, we can move forward with collecting data.  Our sales representative can provide us with the total sales and installations of seatbelts in the target area which we can use to run our analysis.  For the purposes of this example let’s use the below numbers as our sales representative’s sales for the past 10 years:

 

YEAR

1

2

3

4

5

6

7

8

9

 SEATBELTS SOLD

20

30

60

90

100

30

40

140

130



From there, we can look at collecting our outcome data related to major injuries and deaths associated with car accidents for our target area (let’s say we were able to pull this from local Emergency Medical Services records for our example):

 

YEAR

1

2

3

4

5

6

7

8

9

 Car Accidents Involving Major Injury Or Death

 

 5

 

6

 

6

 

5

 

4

 

9

 

9

 

2

 

2

 

Since this is very much a big picture analysis, we can do a graphical representation with a bar chart representing the input (# of seatbelts sold and installed) and a line chart overlaid to represent the outcome metric (# of Car accidents involving major injury or death).  Here’s what that would look like based on the above data:

 

 

 

Ideally what we want to see is a situation like our example above where the number of seatbelts sold and installed increases, the overall number of major injury or deaths appear to decrease (again, this is just an example).  Additional statistical analysis (such as regression analysis etc.) can be used based on the type and quality of data inputs available and to get more specific but generally, improvement over time and correlation is what would be expected in this high-level analysis.

To provide a simple statistical analysis, a trendline can be inserted for the two metrics to show as the input increases (seatbelts) the outcome would decrease as is shown below:

 

 

These trendlines express graphically our assumption and expectation – as installations of seatbelts increase, major injuries and deaths should decrease.

Beyond this, additional analysis can be performed to determine return on investment (both human and financial), as well as where additional focus and management are necessary in relation to this specific product or outcome.

Due to the scope and scale of healthcare products and outcomes, it is important to prioritize which products and outcomes you are scrutinizing based on cost of the product and cost of the outcome.  Additionally, delegating the collection of data associated with the inputs and products (and outcomes where appropriate) to the sales representative to be presented quarterly or at some predetermined interval will help to spread the load of collecting data and managing the analysis.

This basic analysis is a starting point – a 30,000ft view where insights on where additional resources can be applied to drive continued value and return on investment are generated.

This model can be applied in many ways to many different products and services.  Some examples from my background in hospital products include:

  • Lateral and in Bed Positioning Systems and Staff Injuries
  • Oral Care Kits and Hospital Acquired Pneumonia
  • Barrier Cream Cloths and Hospital Acquired Pressure Injury or Incontinence Associated Dermatitis
  • Bathing Cloths and Catheter Associated Urinary Tract Infections
  • Presurgical Prep Kits and Surgical Site Infections

 A sales representative selling a product that is designed to deliver an outcome that understands that both the inputs and outcomes associated with their product are being tracked and analyzed periodically should be highly engaged in managing those inputs to ensure a positive outcome is delivered. 

Since in this model their sales depend on it (a product that does not deliver on its proposed value should not be retained), a good sales representative will be incentivized to understand whether or not their product is working and if it is not, using their skills and expertise to make it work.

Ultimately this model creates a collaborative and long-term relationship between healthcare systems and sales representatives where incentives are properly aligned behind quality, outcomes and delivering on promises made during the sales process.


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