Message from the Regent

Coral T. Andrews, FACHE

With the Presidential Election behind us, implementation of the Patient Protection and Affordable  Care Act (ACA) continues and its impact will be reflected across all aspects of the healthcare industry.  The simultaneous consideration of the “federal fiscal cliff” lends additional uncertainty as organizations work to strategically position themselves in a “grey” environment.  All of this turmoil necessitates that organizations be well-positioned with the talent that can carry them through the implementation.  ACHE’s flagship issue is Diversity (ethnicity, gender, equal access to leadership positions, respecting diverse points of view, etc.).  More information about his initiative can be found at I am actively working with Regent colleagues to provide feedback to the ACHE Board of Governors on this issue.  As the healthcare industry evolves into new business models, new professional structures and new models of care, so too will the strategy by which we attract and retain our human capital.  Our workforce will be blended and pull from multi-industry markets,  not just health.  As a result, we have to be competitive with these other industries as well.  The shapes and sizes of talent won’t be the traditional ones that we’ve long since expected.  Professionals within and outside of  healthcare, will emerge in leadership positions to support the requirements needed to fully implement ACA.  Our leaders will need to diversify their thinking and align their strategies different to insure that they attract and retain talent. CEO’s and Senior Executives will need to assist  their Governance Bodies with access to information that helps to clarify / contrast pre-ACA ideology with post-ACA realities.  Diversity in the talent, diversity  in the approach to human resources and diversity in the workforce  are all things that will need to evolve alongside the more visible challenges that we are seeing in the models and systems of care.  I look forward to supporting ACHE’s efforts to advancing Diversity at all levels of the healthcare industry.

Registration for the Congress on Healthcare Leadership (March 11-14, 2013) is now open.  This annual educational event provides an opportunity to gain insights on the “latest and greatest” issues impacting the healthcare industry and to foster learning.  ACHE Face-to-Face Education credits are offered and work to support recertification and advancement to Fellow.   ACHE CEO, Thomas C. Dolan, PhD., FACE, CAE, is retiring and a grand sendoff is planned.  Hope to see you there!

A fond Farewell from Chapter President

Jen Chahanovich, FACHE




First, It has been an honor to serve as the President of the Hawai‘i Pacific Chapter of the ACHE. 

As we close 2012 – I would like to thank the Board members for serving the Chapter over the past year.  The Board members volunteer their time to ensure as a Chapter we offered educational, networking and advancement seminar opportunities. There was a total of 9 events in Hawai‘i and Guam for the year.


The Chapter set a goal to recruit 35 new members and to advance 5 members to Fellow.  As of December 10th – 40 new members joined and 4 members advanced to Fellow. I welcome the new members and congratulate the members that passed the Board of Governors Exam.


I also want to thank our 2012 sponsors – without their support – the Chapter could not sponsor the events.


·         Castle Medical Center

·         The Queens Heath System

·         Wilson Homecare

·         HMSA

·         Hawai’i Pacific Health

·         CareResource Hawaii


Happy Holidays



Aloha and Welcome from Chapter President 2013

Martha Smith, FACHE


Aloha  fellow Hawaii Pacific Chapter members!


I am excited to be your incoming president for 2013.  Our chapter had a phenomenal year with Jen in the lead as our president.  She and her team set the stage for a bright future for our chapter.  During the next year, we will be working on a more definitive 3 year plan, with the focus on the key areas of recruitment, communication, education.  Sponsorship strategies will be an area that Jen and I will focus on in order for our chapter to work out a sustainable plan for our chapter future. 


Thanks to all of you who volunteered to run for election on our 2013 board.  I look forward to working with our new board, as well as with the rest of our members to continue building on the success to make 2013 the best year ever. 





Mahalo to the 2012 Chapter Board and Welcome to the 2013 Chapter Board

Barbara Ornellas, FACHE


At this time, we extend a sincere “Mahalo” to all who served on the  2012 Chapter  Board….

Position on Board

ACHE Member


       Jen Chahanovich, FACHE

Immediate Past President

Stan Berry, FACHE


Martha Smith, FACHE


Coral Andrews, FACHE


Lance Segawa, FACHE


Darlena Chadwick

Guam Local Program Council

Albert Gurusamy


LCDR Daren Verhulst, FACHE

Student Representative

Jen Dacumos


Steve Robertson, FACHE


Hilton Raethel


LCDR Robert Rawleigh


Charlotte Hildebrand, FACHE


Barbara (Bobbie) Ornellas, FACHE


Joanne Reid, FACHE

    and welcome with “Aloha”  the 2013 Chapter Board:

Position on Board

ACHE Member


             Martha Smith, FACHE

Immediate Past President

       Jen Chahanovich, FACHE


Jay Kreuzer, FACHE


Coral Andrews, FACHE


Steve Robertson, FACHE


Darlena Chadwick

Guam Local Program Council

LCDR Daren Verhulst, FACHE

Student Representative

Jen Dacumos


Lance Segawa, FACHE


Tanya Peacock, FACHE


Art Gladstone, FACHE


"Accountability for the Care We Provide" Panel Discussion November 8th, 2012

LCDR Robert Rawleight MSC, USN

The Queen’s Medical Center in Honolulu, HI hosted a networking/educational event on behalf of the Hawaii-Pacific Chapter of ACHE.  The event was held on November 8, 2012.  A panel of three executives and leaders in the local healthcare community provided insight into their respective organizations’ strategies and efforts to address the topic of “Accountability for the Care We Provide.”  The panel members included Mr. Art Ushijima, FACHE (The Queen’s Medical Center President & CEO), Ms. Kathy Raethel, FACHE (Castle Medical Center President & CEO) and     Virginia Pressler, MD (Hawaii Pacific Health Executive Vice President).  The panel moderator was Mr. Steve Robertson, FACHE (Hawaii Pacific Health Executive Vice President).

Mr. Robertson opened the discussion by introducing the panelists and offered a conceptualization of Accountable Care (AC) as the need for government entities, patients and providers to partner together to gain efficiencies in the healthcare system in addition to stating that healthcare organizations and providers must work towards delivering quality outcomes.  He also shared thoughts from a blog indicating that there is a commonly held contempt between providers, patients and insurance companies [as each seeks to reach their respective goals which could include some level of utility, financial performance or otherwise].  Mr. Robertson also mentioned that Information Technology (IT) and organizations such as the Hawaii Health Information Exchange (HIE) can assist with better care coordination and collaboration to improve the delivery of healthcare.

The panelists were asked the questions listed below.

 We are seeing big changes in the way healthcare providers are being reimbursed as we move toward accountable care and away from pure fee for service.  What steps can healthcare providers take now to prepare themselves for accountable care?”  The following responses were provided:

Mr. Ushijima: First and foremost, healthcare organizations must ensure patients receive safe and quality care.  This is a fundamental tenant for any organization to follow.  In addition, organizations must provide safe and quality care, efficiently and effectively, by focusing on business practices such as investing in Information Technology (IT) and focusing on the organization’s core competencies such as tertiary care in the case of Queen’s.

Dr. Pressler: Organizations must accept the changes brought about by the Patient Protection and Affordable Care Act (PPACA).  The healthcare industry must also be truly accountable in practice for the care it provides and not simply in just belief.  Some in the industry often blindly operate due to the lack of data to objectively guide decision making.  Operating absent from data guiding the way often leads to frustration amongst physicians.  However, organizations can prepare themselves to use data to guide operations by agreeing on specific measures to assess AC, determining how to collect accurate data, providing timely feedback to providers and patients, organizing the entire enterprise for AC, and cultivating a culture of working together to achieve the aims of AC.

Ms. Raethel: Healthcare organizations and providers must overcome any state of denial that change has not arrived due to implementation of AC related policies as well as remaining positive in the face of the changing environment.  Organizations should also seek to partner with and align themselves to the community and be held accountable to it.  Moreover, society must prepare itself for significant issues such as end of life care.

[In summary, healthcare organizations and providers can prepare for AC by leveraging IT, focusing on core competencies, utilizing data to guide business and medical practices, and accepting the implications of AC policies.  All this, and others, must be undertaken while ensuring safe and quality care to patients as organizations and providers seek efficient and effective practices.]

 “How are the intended outcomes of accountability playing out in your hospital?  Tell us a little about how you are achieving them.” 

 Dr.  Pressler:  Hawaii Pacific Health (HPH) publishes quality related metrics.  The organization is realizing phenomenal results in these measures; catheter related and central line infections have decreased significantly, for example.  HPH also utilizes evidence-based care, provides AC related training to leaders and holds employees accountable by using biometrics to determine insurance rates.  The healthcare system has also achieved success via the Patient-Centered Medical Home (PCMH) concept by encouraging a patient to be an engaged member of the team rendering care.  The individual is also considered a customer as well as a patient.

Ms. Raethel: Castle Medical Center uses quality reports and strives to be the best in the country.  Physician incentives must be aligned with organizational objectives.  Also, organizations may use non-monetary incentives as well to align physicians to its strategies.  An efficient workforce is also greatly desired when working towards achieving AC objectives.


Mr. Ushijima: It’s important to define the organization’s mission and purpose and to create a strategic framework to meet them.  Mr. Ushijima shared stories how Queen’s neonatal intensive care unit and organ transplant program exist to meet its particular mission and purpose.  In the case of the organ transplant program, Queen’s positioned itself to be ready to continue offering this service to the community after Hawaii Medical Center and its transplant program closed.  This decision was approved by the Queen’s Medical Center leadership despite forecasted operating losses over the first five years. 

Good patient care is about seeing to the spiritual, emotional, mental, and physical well being of the individual.  At times, taking care of the patient may also involve meeting the needs of those accompanying him/her to ultimately meet all of the patient’s personal needs.  Meeting these aspects of patient care contribute to fulfilling King Kamehameha’s IV and Queen Emma’s mission to provide care to Hawaii residents.

Additionally, the organization is achieving the intended outcomes of AC through strategic planning, providing quality and safe care, becoming the employer of choice, being a responsible citizen, and also remaining financially sound.

[To summarize, the local healthcare leaders are ensuring their respective organizations achieve the intended outcomes of AC by measuring quality indicators, exercising standards such as evidenced-based medicine and PCMH, aligning physician incentives, creating a strategic framework to meet its mission and purpose, and taking into consideration overall patient health which includes physical, emotional and other facets of well being.]

 Physician and clinical alignment is a crucial component to ACOs.  How has your organization looked to successfully engage providers to move toward an ACO structure?”

Ms. Raethel: Castle Medical Center is a 160 bed community hospital and follows the community hospital model.  Therefore, the hospital must be partnered with the community and has developed eight key strategic areas to ensure it meets organizational goals.  The future is unknown.

Mr. Ushijima: The organization wrestles with physician/clinical alignment due to its physician staff composition; i.e. 1,100 doctors provide care at Queen’s, but only 100 of them are employed.  The majority of physicians are in private practice and the organization is built on them.  The answer to this question is unknown.  Can the hospital and physicians share the same values?

Dr. Pressler: HPH is forming a new AC subsidiary with physician employees and private practices.  There is an opportunity and advantage for private practice providers to share in savings realized by AC.  Also, some physician groups use hospitals as contracted vendors; examples of this exist in Maine.

[Aligning physicians with organization goals to move towards AC is challenging to say the least.  Answers to this dilemma are not abundant.  One organization is seeking to create an AC subsidiary to address the issue of physician alignment.  Physicians may find this beneficial if savings are shared between the entities.]

At the conclusion of the three questions directed to the panelists by Mr. Robertson, two questions from audience members were entertained:

 How does an organization ensure adequate financial performance to operate under the AC concept?  The panelists responded by saying that organizations must innovate, increase quality while decreasing costs, focus on resource stewardship, appropriately address chronic medical conditions, and commit to long-term investments.

What examples of high performing industries may be a model to follow?  Responses: the airline industry and its safety standards, retail approach to customer satisfaction and the hospitality industry.  Other thoughts offered by the panelists include encouraging creative thinking, developing a culture of innovation and exploring options outside of the organization’s healthcare delivery mission to generate capital (e.g., Queen’s has access to revenue from its real estate holdings).

[This concluded the evening.]                    

Insight from our future Healthcare Administrators on the Panel Discussion of November 8, 2012

Barbara Ornellas, FACHE

Students from multidisciplinary programs were invited to attend the panel discussion sponsored by the Hawaii Pacific Chapter of ACHE on November 8, 2012.  This event was held in the Queen’s Conference Center Auditorium on Oahu.  The panel discussion entitled “Accountability for the Care We Provide” was moderated by Steve Robertson, FACHE.  Distinguished panel members included Mr. Art Ushijima, FACHE / President & CEO of The Queen’s Medical Center, Kathy Raethel, FACHE / President & CEO of Castle Medical Center and Virginia Pressler, M.D. / Hawai’i Pacific Health Executive Vice President.

The following are excerpts from our future healthcare administrators:

“ …As a student, learning of the most current activities and goals with our major healthcare systems in Hawai’i gave me a more concrete understanding of the concepts, ideas and terms I have been learning in this system… To satisfy the trend of accountable care, these systems are moving towards establishing more partnerships with other organizations and vendors that contribute to the continuum of patient care … Accountable care goes both ways: provider and patient are responsible for the patient’s health…We as a community have to work towards finding methods that link the current processes of our organizations to that of the new regulations to move our businesses forward.  It is how our businesses survive and earn the respect and trust of healthcare consumers…” 

                                                                       Doris Jane Viloria / Student at University of Hawaii at West Oahu


“…The three focuses of accountable care are quality, efficiency, and cost effectiveness  in order to provide patient-centered care and the highest possible error-free environment for patients…. In Hawaii, we have high ER use …we have to utilize the emergency department wisely for people with severe injuries and medical conditions.  About 40% of the ER use is for patients with chronic conditions, mental illnesses and substance uses.  We need to create an entire new care model…We need to increase our sensitivities to care for patients, people, and things that patients care for…”

Yuni Otsuka / Student at University of Hawaii at West Oahu


“…All organizations and doctors should have data and reports that need to be transparent and accurate in order to make ‘the highest level of zero error’.  In addition, seeking care for patients when they are sick is not enough to define the best quality of healthcare services that caregivers can provide.  Suppliers of healthcare services need to concentrate more on out-patient care, at the same time needing to diffuse their knowledge about healthcare prevention and guide patients to reach better states of wellbeing…”

Giang Taylor / Student at University of Hawaii at West Oahu


“…Having everyone involved and being  transparent helps everyone be able to be a part of the care that they seek as well as hold each other accountable so that they can receive the best care possible…Alignment is so important within the relationship between doctors/physicians, nurses, patients and any staff that is involved with providing care to the people…”

Jaisa Ganir / Student at University of Hawaii at West Oahu


“…Each panelist describes how their common goals were to improve quality, reduce costs and maintain the safety of their patients.  They are all striving with an alignment with their physicians, patients and the community…”

Tina Bansuelo / Student at University of Hawaii at West Oahu









Guam Program Council Luncheon on November 14th, 2012

Daren Verhulst, LCDR MSC USN


The Guam Local Program Council (GLPC) of the Hawaii-Pacific Chapter of American College of Healthcare Executives (ACHE) held another successful networking lunch at the Fiesta Resort World Café on Tumon Bay in Guam.  The event was well attended by 32 health care professionals from diverse organizations within the private and public healthcare sectors.  The GLPC meets monthly and has hosted three networking lunches this year to carry on the learning precepts of the ACHE, and collaborate professionally on the unique challenges facing the healthcare landscape on Guam and the Pacific Islands in Micronesia.


The Chair of the GLPC, LCDR Daren Verhulst, opened the luncheon event with a short business meeting and then introduced guest speaker CAPT Jeff Plummer, Commanding Officer, U.S. Naval Hospital Guam (NHG).  CAPT Plummer began his remarks with an overview of Navy Medicine’s mission to provide high quality healthcare to patients worldwide in wartime and peacetime aboard ships, in the air, at sea and on the battlefield.  He then spoke to Navy Medicine’s 113 years of service on Guam and praised the military and civilian partnerships that provide care in the Western Pacific far from other resources.  He then shared lessons on leadership, and spoke about the professional responsibility we have as active members of the ACHE to live up to our motto "For Leaders Who Care."  CAPT Plummer’s remarks to the audience emphasized the fact that in healthcare, there is no single style of leadership and focused on the importance of healthcare executives staying current with professional readings, driving leadership engagement in their respective institutions, and seeking personal development of leadership traits and skills.  He discussed several books from his personal reading list to illustrate the lessons learned and the value of continued professional reading.  CAPT Plummer is board certified in healthcare management and a Fellow in the American College of Healthcare Executives, where he actively serves on the ACHE Regent's Advisory Council.


LCDR Verhulst concluded the meeting with an invitation to all members to participate in the upcoming ACHE Board of Governors (BOG) Study group program, which will be hosted by the Medical Service Corps officers of NHG.  The next networking event for the Guam Council of the GPLC will be held in February 2013.  




Chapter News: New Fellows, Recertified Fellows, New Members

Barbara Ornellas, FACHE



November:      Arthur A. Ushijima


                        September:      Philip Kahue


                        October:         Charles K. Tanner




                        CDR David J. Damstra

                                                Grace Devera-Montano

David F. Fray

Brett Wallace

Mark H. Yamakawa



                        Hui-I Chen

                        Kristen Chun


5 Ways to Keep Your Organization Upbeat

Imported from the ACHE Newsletter Library

Optimistic people are happier and more successful than their pessimistic counterparts. So says Martin Seligman, PhD, known as the “father of positive psychology.” For example, in one of his studies, salespeople with the highest optimism scores outsold their pessimistic counterparts by 20 to 40 percent.

But it’s not always easy to stay upbeat when your industry and workforce are facing significant change. Here are five mental toughness strategies that will boost optimism at your organization:

1. Encourage self-evaluation. Ask team members to answer three questions every day: What am I doing well? What do I need to improve? How will I make this improvement?  Check in with a different worker each day. Talking to your people about their successes and their challenges—as well as your own—gives everyone a sense of forward movement, possibility and camaraderie.

2. Develop a team vision. What do you all want for the organization? Where do you expect it to be in a year? The more detailed the vision, the better. Post those goals where everyone can see them daily. Expectancy theory says: That which we focus on expands.

3. Develop a relentless solution focus. RSF is a technique that takes practice, but once you and your employees get the hang of it, it will have a dramatic effect on people’s mood and your organization’s success. RSF is one’s ability to quickly transform every problem-focused thought into a solution-focused thought.

4. Strive for any improvement, no matter how small. See even a tiny improvement in any situation as a win and part of the solution. That’s a positive mental technique that you can share and teach to others as well.

5. Teach them to “get it done.” Staying upbeat is more than just a set of thought processes. It’s also linked to discipline. Permeate your culture with the practice of finding a way to “get it done.” Employees gain optimism by knowing that they can control outcomes. They do that by tirelessly translating hope and confidence into success through disciplined action.

—Adapted from “5 ways to keep your business upbeat” by Jason Selk, EdD, Communication Briefings, December 2012; (800) 791-8699;

Chapter end of year financial report

Lance Segawa, FACHE

I am pleased to report the Chapter’s financial health continues to be strong!  2012 was another active year filled with value added educational and networking events for our members.  We began the year with an operating fund of $16,846.  Your chapter board prepared an annual budget and began planning the events for the year.  Income for the Chapter came from corporate sponsors and our ACHE Chapter Dues Rebate which together totaled $9,228.  For the year, we spent $10,563 for all events.  Included in this figure is our $2000 sponsorship to our Guam partners.  The Guam Council is very appreciative of our financial support and will be submitting financial reports to the Board on a regular basis.  With all expenses accounted for, we are ending the year with an operating fund of $15,511.  As we anticipate a full slate of activities in 2013, much thanks to all of you for your generous contributions in service, time, and money!