Hawaii - Pacific Chapter of ACHE

Summer 2014

Message from your ACHE Regent, Summer 2014

Coral T. Andrews, FACHE

Midyear is upon us and healthcare remains front and center in the national spotlight. There have been Cabinet level leadership changes emerging in our Nation’s Capital that undoubtedly will result in further policy reforms and resultant impact across all facets of the healthcare industry.

Midyear is upon us and healthcare remains front and center in the national spotlight. There have been Cabinet level leadership changes emerging in our Nation’s Capital that undoubtedly will result in further policy reforms and resultant impact across all facets of the healthcare industry. Keeping your finger on the pulse of these and other changes is an essential part of executive leadership.

In an effort to help you to stay informed, we are fortunate to have ACHE Immediate Past Chairman, Diana L. Smalley, FACHE, joining us in August for the Annual Chapter breakfast. In September, ACHE is holding a 2-day cluster event in Hawaii which will help to support the continuing education requirements of our members. Many members were affected by sequestration and unable to travel to the Congress on Healthcare Leadership in March. By holding a cluster in Hawaii, it eases that burden. Information about the cluster was mailed to members and can also be found on the ache.org website.

Midyear serves as a great checkpoint to assess progress in your annual professional and personal goals. As you reflect on the past 6 months and look ahead to the remaining half of the year, I encourage you to consider a few ACHE opportunities that will contribute positively to both professional and personal growth. They include
:


Advancing your knowledge and contributions to the discussion on diversity by applying for the Thomas C. Dolan Executive Diversity Program.
The deadline to apply is Tuesday, July 1. More details and information can be found at ache.org/ExecutiveDiversity. During this year-long program scholars will benefit from specialized curriculum opportunities addressing barriers in career attainment and developing executive presence, one-on-one interaction with a specially selected mentor and participation in formal leadership education and career assessments. Enhanced self-awareness, critical leadership skills and an expanded network of leaders will help prepare scholars to ascend to C-suite roles in hospitals, health systems and other healthcare organizations.


Serving as Regent.
The 2014-2015 Regent election process is under way and elections will be held in September and October across 20 Regent jurisdictions. The notice and position descriptions for geographic regions can be found in the Member Center on ache.org. You can also view declared candidates for all jurisdictions. All Fellows who wish to run for election must submit a letter of intent to elections@ache.org by Aug. 29, 2014. The beginning of the term coincides with the start of ACHE Congress 2015 (in March).
 

Paying it Forward. Give thought to

  • Serving as a mentor to a prospective Fellow.
  • Contributing to the viability of the Chapter by encouraging CEO colleagues, who may not be members, to join. The wisdom and input from senior leaders is essential to insuring meaningful dialogue around current healthcare industry issues and fosters shared learning across the membership.
  • Holding a breakfast or lunchtime session at your organization’s campus to engage in a small group discussion with early and mid-careerists.

In closing, thank you to the leaders and organizations that support the Hawaii-Pacific membership through sponsorship. The Chapter leadership works in earnest to bring value to its members and to be good stewards of your contributions. Continuing the partnership at this critical juncture of healthcare reform insures that healthcare executives in Hawaii and Guam have access to forums for increasing knowledge, the opportunity to expand their professional network, and the ability to stay dialed in to this ever changing environment of healthcare.

Have a wonderful, and productive, summer!

 

Message from the Chapter President

Darlena Chadwick, MSN, MBA, FACHE

Summer is officially upon us and half the year gone—time is flying by.

Aloha Everyone,

 

Summer is officially upon us and half the year gone—time is flying by. We have several outstanding initiatives going on in the chapter; a major membership recruitment initiative, our annual breakfast on August 14, the ACHE Hawaii Program and our EMBA partnership with UH Shidler School of Business.

 

Increasing ACHE membership and participation is a fundamental objective at both the local and national level for ACHE. To this end we have initiated a recruiting competition. The deadline is the end of November--we have a significant prize for the member who brings in the most new recruits.

 

The ACHE Hawaii Program, Session 1: September 15 – 16 and/or Session 2: September 17 - 18 at the Hyatt Regency Waikiki Beach Resort and Spa. This is an opportunity for face-to-face credits here in Hawaii (24 total for the whole course).  Session one by Thomas A. Atchinson EdD:  Comprehensive Leadership for Senior-Level Executives. Session two by Daniel K. Zismer, PhD: Integration vs. Competition: The Future of Hospital Physician Relations. This is a two or four day event so please plan to attend. For more information go to www.ache.org/Hawaii.

 

Additionally, as you know we continue dialog with the University Of Hawaii Shidler School Of Business for co-developing an EMBA in Healthcare Management degree/concentration to satisfy the unique market needs of our community. We have the first class starting in the fall. We have extended these discussions to a number of stakeholders in the community, including JABSOM, in an attempt to create a pipeline for future physician leadership as we travel down the road toward greater clinical integration. We envision leveraging the ACHE Physician Executives Forum to provide a framework for this pipeline. More to come, so please stay tuned.

 

Thank you for our new volunteers for committees and welcome to our recent new members. As always this is an excellent time to get involved in our chapter. We want your voice heard so please come share your innovative ideas!

 

We are very proud of our outstanding newsletter, we hope you are enjoying it, and we welcome ideas for articles and feedback from you. Thanks to all of you for your continuing support and participation. Please take advantage of our educational offerings and don’t hesitate to let us know how we can be of service to you.

 

Respectfully,

Darlena Chadwick, MSN, MBA, FACHE

Guam Local Program Council

LT Joseph M. Fromknecht, Medical Service Corps, United States Navy, President, Guam Local Program Council

Guam ACHE would like to congratulate Fabrienne Reyes for her selection to the International Liaisons Committee.

Guam ACHE would like to congratulate Fabrienne Reyes for her selection to the International Liaisons Committee.  Fabrienne Reyes is currently  the Treasurer for Guam's ACHE council.  The purpose of this committee is to assist ACHE in developing relationships with associates and potential members.  She will serve as a resource for international strategic planning and identify potential opportunities to further ACHE's mission through collaboration.  Her term will serve until March 2015.

 

Very Respectfully,

 

LT Joseph M. Fromknecht

 

 

Recent Chapter Events

Lieutenant Colonel Tanya Peacock, FACHE, Medical Service Corps, United States Army and Kelly Hardee Wheeler

A Hawaii-Pacific chapter social event took place on Thursday, March 13th from 5:30-7:00 p.m. at the Queens Conference Center. Members who recently passed the exam shared their experiences and assisted members interested in preparing for the BOG exam.

 

A Hawaii-Pacific chapter social event took place on Thursday, March 13th from 5:30-7:00 p.m. at the Queens Conference Center. Members who recently passed the exam shared their experiences and assisted members interested in preparing for the BOG exam.


Attendees for the March 13 FACHE Board of Governors Exam Session 

The Hawaii-Pacific Chapter of ACHE held a panel discussion in conjunction with the Hawaii chapter of the Healthcare Financial Management Association on Monday April 21, 2014 about Physician-Hospital integration in the 21st Century. The moderator for the discussion was Mr. Steve Robertson, Executive Vice President and Chief Information Officer for Hawaii Pacific Health.  Panelists included Dr. Whitney Limm, The Queen’s Medical Center; Mr. Money Atwal, Chief Financial Officer and Chief Information Officer for Hawaii Health Systems Corporation East Hawaii Region; and Dr. Gerard Livaudais,  Executive Director, Hawaii Health Partners (Hawaii Pacific Health).  Panelists discussed the various models which are evolving in the Hawai’i civilian healthcare sector to meet requirements resulting from the Affordable Care Act and accompanying payment reforms. The various models, from hospitals aligning with independent physicians and physician groups to physician-led accountable care organizations, seek to help physicians and hospitals surmount the tremendous challenges and demands that face the healthcare sector. Attendees received 1.5 face-to-face education credits.

 
Panel Members from Left to Right:   Steve Robertson (moderator), Money Atwal
(HHSC), Dr. Whitney Limm (Queen's), and Dr. Gerard Livaudais (HPH)


The ACHE Hawaii Cluster will take place September 15-18, 2014 at the Hyatt Regency Waikiki Beach Resort & Spa.


Session 1: September 15– 16, 2014
Comprehensive Leadership for Senior-Level Executives


Session 2: September 17– 18, 2014
Integration vs. Competition: The Future of Hospital-Physician Relations


Two-Day Seminar Details
Time: 7:00 a.m.–1:30 p.m.
Credits: 12 ACHE Face-to-Face Education credits
Tuition: ACHE member $1,375/Nonmember $1,575


The tuition fee covers one seminar selected from either Session 1 or Session 2. If you would like to attend two seminars, you will be charged two tuition fees. Due to the timing, you may only register for one seminar from each session.

http://www.ache.org/SEMINARS/cluster.cfm?MEET=HAWAII2014
 


 

    

 

Regent Awards

CDR Robert Rawleigh, FACHE, Chief Financial Officer, Navy Health Clinic Hawaii received the American College of Healthcare Executives Senior-Level Healthcare Executive Navy Regent’s Award on April 4, 2014.

Senior-Level Healthcare Executive Navy Regent’s Award 

CDR Robert Rawleigh, FACHE, Chief Financial Officer, Navy Health Clinic Hawaii received the American College of Healthcare Executives Senior-Level Healthcare Executive Navy Regent’s Award on April 4, 2014.

CDR Robert Rawleigh, FACHE joined ACHE in 2009. He serves on the Regent Advisory Council for the Navy Regent. He has served on the Board of Directors for the Hawaii-Pacific Chapter of ACHE since 2012.   He also served as the Chair of the Education Committee for the Hawaii-Pacific Chapter since 2013.

The Senior-Level Healthcare Executive Regent’s Award recognizes ACHE members who are experienced in the field and have made significant contributions to the advancement of healthcare management excellence and the achievement of ACHE’s goals. Members are evaluated on leadership ability; innovative and creative management; executive capability in developing their own organization and promoting its growth and stature in the community; contributions to the development of others in the healthcare profession; leadership in local, state, or provincial hospital and health association activities; participation in civic/community activities and projects; participation in ACHE activities; and interest in assisting ACHE in achieving its objectives.

The award was presented to CDR Rawleigh by  CDR David Morrison, Medical Service Corps, U.S. Navy, FACHE, the Navy Regent.

Commander Robert Rawleigh, (Naval Health Clinic Hawaii Comptroller),
Commander Traci Brooks, (Naval Health Clinic Hawaii Director for Health Services)
and Lieutenant John Piccone, (Naval Health Clinic Hawaii Material Management Officer).

 

Individual Accomplishments in Diversity Regent's Award

LTC Tanya A. Peacock, FACHE was selected for the Individual Accomplishments in Diversity Regent's Award by Lt. Col. Gigi Simko, FACHE, Regent-at-Large, District 6  due to her contributions to the American College of Healthcare Executives (ACHE), Army Medicine, and the local community. She was nominated for the award by COL Noel Cardenas, Medical Service Corps, FACHE, Army Regent.

LTC Tanya A. Peacock, FACHE joined ACHE in 2005.  She is a member of the Regent Advisory Council for the Army Regent, District 6 and has served on the Board of Directors for the Hawaii-Pacific Chapter of ACHE since 2012. At the national level, LTC Peacock serves on the Book of the Year Award Committee. 

The Individual Accomplishments in Diversity Regent's Award Regent’s Award recognizes ACHE members who are experienced in the field and have made significant contributions to the advancement of healthcare management excellence in the area of diversity.

BG Dennis Doyle, Medical Service Corps, U.S. Army, FACHE presented LTC Tanya Peacock with the award on May 16, 2014.

BG Dennis D. Doyle, FACHE presents LTC Tanya A. Peacock, FACHE with the
2013 Individual Accomplishments in Diversity Award

Hawai'i Pacific Chapter Volunteer Award

Maj Charlotte Hildebrand

Nominate the Volunteer Award recipient today!

The Hawai'i Chapter's Board of Directors is currently requesting nominations for the Hawai'i Pacific Chapter Volunteer Award.

 

The Hawai’i Pacific Chapter Volunteer Award was established in 2013 to recognize an individual for exemplary contributions to the Hawai'i-Pacific Chapter of ACHE.  Eligible candidates must demonstrate superior service to the Chapter in the areas of time, achievement, and innovation for over a 3-year period.  All Hawai'i-Pacific Chapter members (including those located in the neighboring islands and the Guam Local Program Council) in good standing are eligible for consideration.

 

Criteria includes two parts::

  • Dedication to Chapter for more than 3 years (can be waived by the board of directors)
  • Exemplary commitment to the Chapter in one or more of the following areas (time, achievement, innovation)

Last year's Hawai’i-Pacific Chapter of ACHE Volunteer Award recipient was Barbara (Bobbi) Ornellas, Care Coordinator, Veteran’s Affairs.

 

Recommendations should be e-mailed to Charlotte Hildebrand at clhildebrand@hotmail.com by July 17th and include the awardee's name and health care position, years of service to the Chapter, and a brief narrative (200-300 words) of his or her superior service.  The Hawai'i Pacific Chapter Volunteer Award will be voted on by the Board of Directors and presented by the Chapter President at the August 14th Chapter Breakfast. 

News from the Education Committee

Commander Robert Rawleigh, FACHE, Medical Service Corps, United States Navy

The Hawaii Chapter Healthcare Financial Management Association (HFMA) Annual Conference was held at the Ala Moana Hotel on April 21 & 22.

The Hawaii Chapter Healthcare Financial Management Association (HFMA) Annual Conference was held at the Ala Moana Hotel on April 21 & 22.  ACHE members earned 1.5 ACHE Face-to-Face Education credits during the chapter’s panel discussion on “Physician-Hospital Integration in the 21st Century.”  Mahalo!” to the following leaders from the healthcare industry for providing an excellent presentation and discussion on this topic:

Moderator - Mr. Steve Robertson, Exec VP and CIO, HPH

Panelists:

  • Mr. Money Atwal, CFO/CIO HHSC East Hawaii Region
  • Dr. Whitney Limm, The Queen’s Medical Center
  • Dr. Gerard Livaudais, HPH Executive Director Hawaii Health Partners.

Other ACHE events on the horizon include:

August 14: The Hawaii-Pacific Chapter of ACHE Annual Breakfast at the Hawaii Prince Hotel starting at 7:00 a.m.  Ms. Diana Smalley (ACHE Immediate Past Chairman) will be the guest speaker during the event.  ACHE members will receive 1.0 ACHE Qualified Education credit for attending the presentation.

September 15-16 and 17-18: ACHE Hawaii Program.  Earn ACHE Face-to-Face Education credits during the two, separate clusters.  Contact ACHE for details and registration requirements.

I would like to say a very warm “mahalo” for allowing me to serve you as the Chair of the Education Committee.  I am also very appreciative of the opportunity to work under the direction of Ms. Jen Chahanovich (CEO Pali Momi Medical Center), Ms. Martha Smith (Immediate Past President Hawaii-Pacific Chapter of ACHE and CEO Kapiolani Medical Center for Women and Children) and Ms. Darlena Chadwick (President Hawaii-Pacific Chapter of ACHE and Vice President, Patient Care The Queen’s Medical Center) and alongside the Officers and Directors of the local ACHE Board.  Finally, thank you and welcome to the new members of the Education Committee who are dedicated to developing and implementing future networking and education events:

  • Ms. Bobbie Ornellas, RN Care Coordinator, VA Pacific Islands Healthcare System (Chair)
  • Mr. Lance Segawa, President-Elect Hawaii-Pacific Chapter of ACHE and Chief Executive Director of Operations and Planning, HHSC
  • Dr. Natalie Pagoria, Business Analyst, HHIE.

Warm Regards,

Commander Robert Rawleigh, Medical Service Corps, U.S. Navy (FACHE)

 

 

 

 

 

 

 

 

4th Annual Health IT Summit

Holly Iwasaki, Communication & Outreach Specialist, Hawai'i Health Information Exchange
The Hawai‘i Health Information Exchange hosts the 4th annual Health IT Summit on Saturday, July 26, at the Sheraton Waikiki Hotel.

The Hawai‘i Health Information Exchange is pleased to announce that it will be hosting its 4th annual Health IT Summit on Saturday, July 26, at the Sheraton Waikiki Hotel. This year’s event will focus on topics related to improving care coordination using health information exchange, achieving stage two meaningful use, improving patient engagement and implementing the patient portal.  There is no cost to attend this event, please see below for more details.

When:            Saturday, July 26, 2014

Registration: 7:30 a.m. – 8:00 a.m.

Event:            8:00 a.m. – 4:30 p.m.

Where:           Sheraton Waikiki Hotel

CME: Up to 8 hours of CME credits has been approved by the Hawaii Consortium for Continuing Medical Education*.

Register at: https://www.hawaiihie.org/Events-and-Meetings/

Questions: Please contact Holly Iwasaki at 808-441-1317 or hiwasaki@hawaiihie.org

Deadline to Register: Friday, July 18, 2014

*The Hawaii Consortium for Continuing Medical Education (HCCME) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Tuition Assistance Waiver Program

Adapted from the ACHE website (edit - use National news version?)

Receive Tuition Assistance to attend the Hawaii Cluster, 15-18 September.

To reduce the economic barriers to ACHE educational programming for ACHE members experiencing economic hardship, ACHE has established the Tuition Waiver Assistance Program.

ACHE makes available a limited number of tuition waivers to ACHE Members and Fellows whose organizations lack the resources to fund their tuition for education programs. Members and Fellows in career transition are also encouraged to apply. Military members are also eligible for the tuition assistance waiver. Tuition waivers are based on financial need. All requests are due no less than eight weeks before the program date. ACHE is currently accepting applications for tuition assistance for the September 15-18 Hawaii Program. If you are interested, please submit your application to ACHE no later than 18 July.

To submit your application, please visit this website: http://www.ache.org/tuitionwaiver/Default.aspx?meet=HAWAII2014

A detailed personal statement, resume and letter of support are needed for consideration to receive a tuition waiver. Incomplete applications and applications received after the deadline will not be considered.

Summer 2014 Calendar of Events

Micah Ewing

The Summer 2014 Calendar of Events for ACHE, Hawai‘i Chapter.

 

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Chapter Breakfast (HAH)
Hawai‘i Prince
Haleakala Room

 

Aug. 14, 2014
7AM - 9AM

 

Hawai‘i Program / Cluster
Hyatt Regency

 

Sept. 15-18, 2014
7AM - 1:30PM

 

Chapter Leaders Conference
Rosemont, IL

Sept 29-30, 2014
ACHE.org

 

 

 

 

FUTURE EVENTS:

None for this quarter.   

 

Summer 2014 Education Calendar of Events

Micah Ewing
Educational and credentialling opportunities.

 

 

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EVENTS THIS QUARTER:

(Click on Hyperlink for Event Info)

Seattle Cluster

6/23 – 6/26

Washington D.C. Cluster

8/11-12

Hawai‘i Chapter Breakfast

 

8/14

Online Seminar:  Exceptional Leadership

 

9/3 – 10/15

San Francisco Cluster

9/8 – 9/11

Online Seminar:  Superior Productivity

 

9/10 – 10/22

Hawai'i Program

9/15 – 9/18

Online Seminar:  A Review of Health Law

 

9/17 – 10/29

 

 

FUTURE EVENTS:

 

Austin Cluster

 

 

 

 

10/13 – 10/16





 

Summer 2014 Financial Report

Gidget DG Ruscetta

I am pleased to report the chapter's financial health continues strong at $35,354.70.

I am pleased to report the chapter's financial health continues strong at $35,354.70. We are well positioned to continue to fund a full array of educational services and events for our members through the remainder of 2014. Please take a few minutes to review our website to take advantage of our many educational opportunities ranging from tuition reimbursement, conference sponsorships, etc.  We encourange you to explore them all.

 

Gidget  

 

 

Membership: New Fellows, Members, and Recertified Fellows

Art Gladstone, FACHE

The Hawai'i-Pacific Chapter would like to recognize and congratulate all new Fellows, recertified Fellows, and new members. 

 The Hawai'i-Pacific Chapter would like to recognize and congratulate our new Fellows:

May 

Brett Hadley, FACHE, Honolulu

The Hawai'i-Pacific Chapter would like to recognize and congratulate our recertified Fellows:

March

MAJ Dan Wood, RN, , FACHE, Honolulu

May

Coral T. Andrews, FACHE, Honolulu

Robert Diaz, FACHE, Honolulu

Jay E. Kreuzer, FACHE, Kealakekua

A warm welcome to our new chapter members:

March

CDR Patrick Fitzpatrick, Santa Rita 

Col N.T. Greenlee, Honolulu

Kathleen K. Morimoto, Honolulu

CPT Wendy Price, Ewa Beach 

April

Paige Besze, Honolulu

Julie Doyle , Honolulu

PO1 Maria Vasquez, Dededo

May 

Andrew Moats, Honolulu

Liana Peiler, Kane'ohe

June 

Dan Brinkman, Hilo

Noah England, Lihue 


 

 

Health Care Management Executive MBA Program Recruiting and Program Update

Alice Li Hagan, Director, Custom Executive programs, Shidler College of Business

Since we announced our new program in March, the College has received overwhelmingly positive support from the community.  Here are some recruiting highlights:

 

Since we announced our new program in March, the College has received overwhelmingly positive support from the community.  Here are some recruiting highlights:

Advisory Board

We have formed a 12-member advisory board to help provide guidance to the curriculum and the recruiting effort.  The board members consist of executives and leaders from the healthcare community across the State.

Marketing and Recruiting Outreach

In our effort to reach out to prospective candidates for the program and with the sponsorship of some of our advisory board members, we had a series of information sessions at the following organizations:

  • Tripler Army Medical Center

  • Hawai'i Medical Association

  • Kapi'olani Medical Center

  • Queen’s Medical Center

  • Straub Medical Center

We presented the new program to all the military education centers across Oahu and attended the Healthcare Financial Management Association (HFMA) annual conference.

Webcast

Three of our program advisory board members were featured on the webcasts of ThinkTech Hawai'i, a non profit organization that raises public awareness about issues that impact the State’s economy and future.

  • Coral Andrews, the Regent of the Aloha-Pacific chapter of the ACHE

  • Tanya Peacock, ACHE member and faculty at the Army-Baylor MHA/MBA Program

  • Reg Baker, Executive Vice President, Hawai'i Medical Assurance Association


First Cohort in Fall 2014

We anticipate a small cohort for our inaugural program in the Fall with a kickoff residential session from August 21st to 25th at the Turtle Bay Resort in Kahuku.  This will be an opportunity for the participants to meet the program faculty and interact with their fellow classmates to begin their journey on this 22-month program.

 

 

 

 

 

 

 

POLST A Step Forward in Advanced Directives and Achieving the Triple Aim

Kelly Hardee-Wheeler, MHA, Health Systems Specialist, Enhanced Multi-Service Market Office, Tripler Army Medical Center
Healthcare professionals at the University of Oregon recognized the limitations of traditional healthcare advanced directives, including living wills and the appointments of medical proxies in the early 1990s, which gave birth to the Physician Orders for Life-Sustaining Treatment (POLST) Paradigm Program (POLST).

Healthcare professionals at the University of Oregon recognized the limitations of traditional healthcare advanced directives, including living wills and the appointments of medical proxies in the early 1990s, which gave birth to the Physician Orders for Life-Sustaining Treatment (POLST) Paradigm Program (POLST).  These professionals recognized physicians needed to be more involved in discussing end-of-life care with their patients and translating patient preferences into medical orders that would be adhered to in an emergent event.   POLST is a medical order that tells others your wishes for life sustaining treatments and used by people who have a serious health condition (Bomba et al., 2012).  In Hawaii, the orders on the POLST form are legal and are followed by parametics and other healthcare providers across the entire state.  POLST requires a signature of the doctor, the patient, and the patients’ or patients’ identified representative, such as someone with healthcare power of attorney or a surrogate decision maker.  It should be used if you have a serious health condition and you want to make decisions about life-sustaining treatment.   The doctor can use the POLST form to write clear and specific medical orders regarding the patients’ medical condition and their preferences for medical treatments including: 1) attempt cardiopulmonary resuscitation (CPR), 2) administer antibiotics and IV fluids, 3) hospitalization, 4) use of a ventilator, 5) use of a feeding tube, and 6) preference for comfort care (Kokua Mau, 2009).

The implementation of POLST creates the opportunity to improve the experience of care including the quality of care and quality of life for those with serious health conditions in addition to reducing per capita cost, in particular, end-of-life healthcare costs.  With the promulgation of patient-centered care throughout healthcare organizations as a basis for improving quality, the adoption of POLST is a means by which to make care and medical decision making at the end-of-life more patient-centered and preserve patient autonomy.   Living wills are general statements of a patients’ preference and still require medical orders requiring further interpretation by the medical proxy or healthcare professionals. Likewise, the healthcare proxy, has been found to incorrectly predict a patients’ end of life wishes (Shalowitz et al., 2006) or it is difficult for the family member to act on those wishes (Krieger, 2012). As quoted by a bioethicist of the Hastings Center, “What medicine provides is more and more ways to keep people going…an extra few days or a month—it is very, very hard for doctors and families to give that up” (Krieger, Lisa, 2012).  Studies are finding that in states with POLST programs, patients’ preferences were by in large adhered to.  A National Institute for Health study (Hickman et al., 2010) found that nursing home residents who used a POLST form to indicate their preference for comfort care only were 59 percent less likely to receive life-sustaining medical interventions that were not requested, when compared to residents with DNR orders, suggesting that POLST promotes closer adherence to documented treatment preferences than DNR orders.   Additionally, findings from other studies of POLST programs indicate that “patients’ values are accurately reflected in the orders, that the orders are followed by first responders, that life-sustaining treatment orders beyond CPR are useful to guide care consistent with the patient’s wishes, and that implementation can evolve to become a standard of care in a community, region, or state”(Citko et al, 2010). 

The Institute of Medicine (IOM) report, Approaching Death: Improving Care at the End of Life (Field & Cassel, 1997) stated, too many people suffer needlessly at the end of life, both from errors of omission and from errors of commission.  There are problems of under-treatment but the counterpoint is aggressive treatment that prolongs and even dishonors the period of dying.  Care for dying patients is in considerable proportion covered by Medicare or Medicaid programs; 30% of Medicare expenditures are attributable to the 5% of beneficiaries who die each year and approximately one third of the expenditures in the last year of life are spent in the last month (Zhang B, Wright AA, Huskamp HA, & et al, 2009).  Several studies have found that there are lower medical costs in the final week of life as well as in the last six months of life when the patient had end-of-life discussions with physicians, in particular for cancer and chronic heart failure diagnoses.  Lower costs resulted due to a more limited use of intensive interventions (Zhang et al., 2009).

The Military Health System has a fourth aim, Readiness, at the center of its mission.  My husband and I often get into the discussion of what would we do if his mother was hospitalized or required a higher level of care than what she currently receives.  You see, she is a diabetic who three years ago began dialysis and who has no known advanced directives in place.  Like our civilian counterparts, it is close family members, sons and daughters, who become the medical proxies for our aging parents and family members.  Part of being ready and resilient is mental preparedness.  Having a tool such as POLST is a good starting platform for discussion and mental preparedness for dealing with our aging loved ones.  I know from personal experience with the death of my father several years ago, that having discussed everything from medical intervention to preparing all things necessary financially and spiritually reduced our stress and gave our family peace knowing we did things the way that he wanted. 

The IOM report defines a good death as “one that is free from avoidable distress and suffering for patients, families, and caregivers; in general accord with patients’ and families’ wishes; and reasonably consistent with clinical, cultural, and ethical standards” (Field & Cassel, 1997).  The POLST programs placed into law or being developed in currently 47 states is another step forward for advanced directives that is in alignment with the IHI Triple Aim by improving the experience of care and reducing healthcare costs, and has the potential to improve the readiness and resiliency of families in the Military Health System which have loved ones facing terminal illnesses.  As healthcare executives, we are charged with addressing ethical issues and care issues surrounding death and dying as well as promoting public dialogue that will lead to awareness and understanding of end-of-life concerns (American College of Healthcare Executives, 2009).  The POLST program and the form, is a tool that can facilitate conversations on end-of-life decisions, making something that can be very difficult, just a little bit easier for executives, healthcare providers, patients, and families. 

More information about POLST in Hawaii can be found at http://www.kokuamau.org/professionals/polst and more information and research about the National POLST Paradigm Program can be found at http://www.polst.org/

References

Agency for Healthcare Research and Quality. (2001). Improving the health care of older americans. Rockville, MD. Retrieved from http://www.ahrq.gov/research/findings/final-reports/olderam/index.html

American College of Healthcare Executives. (2009). Decisions near the end of life policy statement. Retrieved from https://www.ache.org/policy/endoflif.cfm

Bomba, P., Kemp, M., & Black, J. (2012). POLST: An improvement over traditional advance directives. Cleveland Clinic Journal of Medicine, 79(7), 457–464. doi:10.3949/ccjm.79a.11098

Citko, J., Moss, A., Carley, M., & Tolle, S. (2010). The National POLST paradigm initiative, 2nd Edition. Retrieved from http://www.eperc.mcw.edu/EPERC/FastFactsIndex/ff_178.htm

Field, M. J., & Cassel, C. K. (Eds.). (1997). Approaching death: Improving care at the end of life. Washington, DC: The National Academies Press. Retrieved from http://www.nap.edu/openbook.php?record_id=5801

Hickman, S., Nelson, C., Perrin, N., Moss, A., Hammes, B., & Tolle, S. (2010). A Comparison of methods to communicate treatment preferences in nursing facilities: Traditional practices versus the physician orders for life-sustaining treatment program. Journal of the American Geriatrics Society, 58(7), 1241–1248. doi:10.1111/j.1532-5415.2010.02955.x

Institute of Healthcare Improvement. (2014). The IHI triple aim. Retrieved from http://www.ihi.org/offerings/Initiatives/TripleAim/Pages/default.aspx

Kokua Mau. (2009). POLST. Retrieved from http://www.kokuamau.org/professionals/polst

Krieger, Lisa. (2012, February 5). The cost of dying: It’s hard to reject care even as costs soar. Mercury News. Retrieved from http://www.mercurynews.com/cost-of-dying/ci_19898736?source=pkg

Shalowitz, D., Garrett-Mayer, E., & Wendler, D. (2006). The accuracy of surrogate decision makers: A systematic review. Archives of Internal Medicine, 166(5), 493–497. doi:10.1001/archinte.166.5.493

Zhang B, Wright AA, Huskamp HA, & et al. (2009). Health care costs in the last week of life: Associations with end-of-life conversations. Archives of Internal Medicine, 169(5), 480–488. doi:10.1001/archinternmed.2008.587

National News - Summer 2014

Micah Ewing

National News

 

Apply for the Thomas C. Dolan Executive Diversity Program by July 1

The deadline to apply for the 2015 Thomas C. Dolan Executive Diversity Program is Tuesday, July 1.

During this year-long program scholars will benefit from specialized curriculum opportunities addressing barriers in career attainment and developing executive presence, one-on-one interaction with a specially selected mentor and participation in formal leadership education and career assessments. Enhanced self-awareness, critical leadership skills and an expanded network of leaders will help prepare scholars to ascend to C-Suite roles in hospitals, health systems and other healthcare organizations.

Visit ache.org/ExecutiveDiversity for more information or to apply. Please direct any questions about the Thomas C. Dolan Executive Diversity Program to Jennifer L. Connelly, CAE, regional director, at jconnelly@ache.org or (312) 424-9328.

The Foundation of ACHE’s Fund for Innovation in Healthcare Leadership is accepting donations to the Thomas C. Dolan Executive Diversity Program. Gifts—no matter the amount—will help shape the future of healthcare leadership. Visit ache.org/ExecutiveDiversity to make a donation.

2014 Fund for Innovation in Healthcare Leadership Education Programs

The 2014 innovations program, “The Journey to Value-Based Care for Population Health: Sharing, Scaling and Replicating to Accelerated Results,”  will be led by Stephanie McCutcheon, FACHE, innovation and transformation advisor and principal at McCutcheon & Co. McCutcheon will share the successful value-based journey and innovation/transformation models of four organizations that have accelerated sustainable change. A panel of healthcare leaders will share their best practices, challenges and critical success factors for population health management. This half-day program will be offered in conjunction with the Washington, D.C., Cluster on Aug. 11. Full details will be available soon at ache.org/Innovation.

The 2014 ethics program, “Ethical Leadership in Uncertain Times,” will be led by Jack Gilbert, EdD, FACHE, clinical associate professor and director of executive and professional development in the College of Health Solutions and the College of Nursing and Health Innovation at Arizona State University. Offered in conjunction with ACHE’s Salt Lake City Cluster on Oct. 28, this half-day session will explore effective, intentional and practical ways for healthcare leaders to strengthen their organization’s focus on doing the right thing by leveraging challenging uncertainty and their leadership to create practical solutions to ethical dilemmas. A select panel of healthcare leaders will react to Gilbert’s remarks and share their experiences with the ethical challenges and discuss the link between ethical decision making and organizational performance. Full details will be available soon at ache.org/Ethics.

Both programs qualify for ACHE Face-to-Face Education credits.

For more information on the Fund for Innovation in Healthcare Leadership and to donate, visit ache.org/Innovation.


Apply for Fellow Now Through June 30 and Save $200 on Exam Fee

ACHE is pleased to offer once again the Board of Governors Exam fee waiver promotion to ACHE Members who apply for the FACHE® credential between March 1 and June 30. Members must submit their completed Fellow application and $250 application fee during the promotion period. Pending application approval, ACHE will waive the $200 Board of Governors Exam fee. All follow-up materials (i.e., references) must be submitted by Aug. 31 to receive the waiver. For more information on the promotion, go to ache.org/FACHE

Exam Online Community Offers a Complimentary Interactive Learning Platform

Members preparing for the Board of Governors Examination can access the Exam Online Community as a complimentary and supplementary resource that can boost their confidence and help them succeed. The Online Community is an interactive platform to learn and glean study tips from other Members taking the Exam. Plus, there is the opportunity to discuss Exam topics with experts for better understanding and the option to participate in study groups. Interested Members can join the Exam Online Community at bogcommunity.ache.org.

Forum on Advances in Healthcare Management Research

ACHE would like to invite authors to submit proposals for presentation to the seventh annual Forum on Advances in Healthcare Management Research. This three-hour session will take place during ACHE’s 2015 Congress on Healthcare Leadership, March 16–19 at the Hilton Chicago.

The senior author of the selected proposal (or designate) will receive a complimentary Congress registration. Travel and related expenses will not be reimbursed.

Presentations for the Forum are intended to be reports of theoretical and/or empirical research by faculty, researchers, and practitioners in the field with the potential for high impact on healthcare management. Each of the six Forum presenters will have about 30 minutes to present their work and its implications for healthcare practitioners.

Please visit ache.org/Congress/ForumRFP.cfm for the selection criteria and to submit your proposal by July 8.

Save the Date: Healthcare Consultants and Physician Executives Forum Programs

The Physician Executives Forum and Healthcare Consultants Forum launched last year to provide added value to physician executive and healthcare consultant members via tailored resources to meet these groups’ unique professional development needs. A one-day education program is a cornerstone benefit of both Forums that offers an affordable learning and networking opportunity. Dates and location for these programs are as follows:

Healthcare Consultants Forum Education Program

Sept. 12, 2014

Chicago Marriott O’Hare

More details available at ache.org/HCForum

Physician Executives Forum Education Program

Oct. 11, 2014

Hyatt Regency O’Hare

More details available at ache.org/PEForum

Tuition Waiver Assistance Program

To reduce the barriers to ACHE educational programming for ACHE members experiencing economic hardship, ACHE has established the Tuition Waiver Assistance Program.

ACHE makes available a limited number of tuition waivers to ACHE Members and Fellows whose organizations lack the resources to fund their tuition for education programs. Members and Fellows in career transition are also encouraged to apply. Tuition waivers are based on financial need and are available for the following ACHE education programs:

  • Congress on Healthcare Leadership

  • Cluster Seminars

  • Self-Study Programs

  • Online Education Programs

  • Online Tutorial (Board of Governors Exam preparation)

  • ACHE Board of Governors Exam Review Course

All requests are due no less than eight weeks before the program date, except for ACHE self-study courses; see quarterly application deadlines on the FAQ page of the tuition waiver application. Incomplete applications and applications received after the deadline will not be considered. Recipients will be notified of the waiver review panel's decision not less than six weeks before the program date. For ACHE self-study courses, applicants will be notified three weeks after the quarterly application deadline.

If you have questions about the program, please contact Teri Somrak, associate director, Division of Professional Development, at (312) 424-9354 or tsomrak@ache.org. For more information, visit ache.org/Tuitionwaiver.

ACHE’s 2014 Premier Corporate Partners

ACHE would like to recognize our 2014 Premier Corporate Partners, whose year-round support helps ACHE further its mission and adds value to our membership. Our Premier Corporate Partners demonstrate commitment to ACHE and its members in various ways, including providing financial resources, hosting networking events and offering educational opportunities. We are proud to recognize the following 2014 ACHE Premier Corporate Partners:

  • Aramark

  • Cardinal Health

  • CareFusion

  • Conifer Health Solutions

  • Philips Healthcare

  • Trane Healthcare Practice


Rejection-Proof Your Proposal

If you want your idea to be accepted by your boss, team or organization, you must choose your approach carefully. You can’t control everything that will affect—or prevent—approval. 

If you want your idea to be accepted by your boss, team or organization, you must choose your approach carefully.  You can’t control everything that will affect—or prevent—approval.  You can, however, increase your chances for success by asking yourself questions—and coming up with solid answers—about everything that could hurt your chances of gaining support for the proposal.  Questions to ask include:


Result
  • What has to happen so that I will consider my effort a success?

  • What roles will others have to play in that success?

  • What alternative outcomes will satisfy the underlying needs and achieve equivalent results?


Relationships
  • What’s the history of my (or my team’s) influence relationship with this person or decision-making group?

  • What are the current issues in this relationship?

  • What’s the current level of trust?


Context
  • What are the current priorities of the person (or group) that I want to influence?

  • Are there any significant common or conflicting vested interests in this situation? If so, what does each of us have to gain or lose if my proposal is accepted?

  • Are there relevant values on each side? If so, do we share the same ones?


Organizational
  • Will my idea fit well within the overall business strategy, structures and processes of the organization? If not, how far outside the norms is it?

  • Who are the other stakeholders in the outcome? How can I involve them?


Cultural
  • What are the formal and informal cultural norms of our organization that could be relevant to this issue?

  • Do any cultural practices already exist that could be useful in this situation? Any taboos that could derail my approach?


External Trends and Issues
  • What’s going on right now in the organization that could have a positive or negative impact on my influence opportunity?


—Adapted from “Exercising Influence,” by B. Kim Barnes, www.exercisinginfluence.com.

Avoid Wasted Time to Boost Productivity

How much time does your organization squander?  My colleagues and I gathered data about time use at one large company and found that people there spent 300,000 hours a year just supporting the weekly executive committee meeting.  

How much time does your organization squander?  My colleagues and I gathered data about time use at one large company and found that people there spent 300,000 hours a year just supporting the weekly executive committee meeting.

Some of that time was productive, no doubt.  But organizations in general can be remarkably cavalier about how they invest their scarcest resource, the time of their people.

How companies can use time effectively is just one piece of a larger and ultimately more important puzzle:  how to increase the productivity of their people. Boosting human capital productivity (HCP), we have found, is a powerful and often-neglected pathway to better performance.

Our research quantifies what’s at stake.  Using a decade’s worth of data for the S&P 500, we looked at revenue per employee, a crude but useful measure of HCP.  Then we compared those figures with each company’s financial performance. Since revenue per employee varies widely among industries, we confined our comparisons to companies in the same business.

The results jumped out at us. The best companies—those in the top quartile of revenue per employee—did 30 percent better than their peers in return on invested capital, 40 percent better in operating margin and 80 percent better in revenue growth. Those differences contributed to a whopping 180 percent differential in total shareholder return over the 10-year period.

Predictably, the differences were larger in people-intensive businesses, like software development and smaller in capital-intensive industries such as semiconductor manufacturing.  But the leaders in HCP outperformed the laggards in every industry, including healthcare.  The difference in profitability, of course, makes a lot of sense—if you get more revenue per employee, chances are your costs are going to be lower than rivals and your profits higher.  But higher HCP also goes hand in hand with significantly higher growth rates, a correlation easy to overlook.

Many business leaders intuitively understand the connection between HCP and performance, so companies around the globe have been trying for years to improve productivity.  The most common approach is to cut head count and hope you can generate the same or more revenue with fewer people.  But how often does that work?  Many executives we talk to have led repeated restructurings, streamlinings and right-sizings in the years since the financial crisis, without much to show for it. At some point, most realize that they can no longer increase HCP by reducing the denominator of the revenue-per-employee calculation. Instead they have to focus on increasing the numerator:  the output they get from each employee.

So how can companies increase the numerator?  In our experience, the key is to look closely at five potential obstacles and assess where they stand on each one:

  • A company’s people may not be up to the job—the basic stock of human capital may lack the necessary skills to deliver great performance.

  • The company may have good talent, but it deploys those people in ways that limit their effectiveness and output.

  • The company may have great people and potentially effective teams, but its organizational structure interferes with high performance.

  • The way people interact and communicate may require too much time for the level of output generated. (That’s where managing your scarcest resource comes in.)

  • Finally, none of those may be the real issue—rather, it’s that your people aren’t sufficiently engaged or inspired to deliver their best work.

Take a look around you. Is anybody wasting your or your organization’s time?

—Adapted from “This Weekly Meeting Took Up 300,000 Hours a Year,” by Michael C. Mankins, Harvard Business Review Blog Network, http://blogs.hbr.org.


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