Hawaii - Pacific Chapter of ACHE

Spring 2016 Edition

Message from your ACHE Regent, Spring 2016

Jen Chahanovich, FACHE

Help me welcome the incoming Chapter President - Art Gladstone, FACHE.  Art is the CEO of Straub Clinic & Hospital and Pali Momi Medical Center and has been dedicated to our local Chapter for a number of years.  You can expect another year of programs and networking opportunities for our members


Welcome to 2016!

I’d like to thank Gidget Ruscetta, FACHE for her leadership in 2015 as the Chapter President. Gidget and the board did an outstanding job moving the Chapter forward with educational programs, networking events and the opportunity for Face to Face credits. 

Help me welcome the incoming Chapter President - Art Gladstone, FACHE. Art is the CEO of Straub Clinic & Hospital and Pali Momi Medical Center and has been dedicated to our local Chapter for a number of years. You can expect another year of programs and networking opportunities for our members.

If your goal is to become board certified as a Fellow of the American College of Healthcare Executives, I have an important update for members: there is a change from the prior promotion period of March 1–June 30 to allow Fellow applicants more time to meet all requirements by year-end, thereby giving them the opportunity to participate in the Convocation Ceremony held at the annual Congress on Healthcare Leadership. The Board of Governors Exam Fee Waiver Campaign began February 1, 2016 and ends May 31, 2016.  Please visit the ACHE website for more information and check out how to prepare for the Board of Governors Exam on line.

My contact information is listed below – call or email anytime.

Jen H. Chahanovich, FACHE
Wilcox Memorial Hospital
President & CEO
Office:  (808) 245-1122
Cell:      (808) 524-6644

Message from the Chapter President, Spring 2016

Art Gladstone, FACHE

Our organization, the American College of Healthcare Executives, serves a purpose to connect us all as we maneuver, individually or collectively, through healthcare challenges, changes, opportunities, and innovation.  I am confident that many of us have a personal familiarity with the purpose of ACHE and what our organization does to connect members to issues, solutions, and to one another


In 2016, no surprise, health care continues to be both exciting and challenging. I personally like to stay focused on the exciting side of the equation and am glad to see our organization is doing the same. As ACHE’s Hawai‘i chapter, we have many opportunities to improve the healthcare system here in our state, and that in turn improves the care our communities and those who live here can receive. 

Our organization, the American College of Healthcare Executives, serves a purpose to connect us all as we maneuver, individually or collectively, through healthcare challenges, changes, opportunities, and innovation. I am confident that many of us have a personal familiarity with the purpose of ACHE and what our organization does to connect members to issues, solutions, and to one another.

As I looked at ACHE’s website and printed materials recently, something meaningful jumped out at me. Printed just below the American College of Healthcare Executives title is the tagline that reads: 'for leaders who care.' I point that out because I believe this is the essence of ACHE. We all belong to this organization for various reasons – perhaps for networking, or to give back, perhaps to learn more and support our individual need for life-long learning, or it could be any number of other reasons to belong. Whatever the reason, I believe this statement, for leaders who care, is a foundation principle of why we each belong to ACHE. We CARE! We all want to provide the best healthcare to our individual patients, our families, and our community. We want to be part of the solutions to improve our systems of care while at the same time addressing the issues of cost that our industry faces. We care, and we can make a difference. I want to personally thank each of you for being a member of ACHE and express my gratitude to you for being a leader who cares!

I am honored to serve as your 2016 Chapter President. We have had many excellent presidents who I thank for their leadership. In my new role, I give special recognition to Gidget Ruscetta, our immediate past president, for her work throughout 2015. I’d like to take this opportunity to congratulate our chapter for receiving the 2016 Chapter Distinction Award from the national organization.

Our chapter has a strong foundation in place that enables us to focus on ACHE’s goals of diversity, membership, and education. I am excited that members have stepped up their involvement and demonstrated personal commitment by joining the board of directors and committees to lead the work that we do. They recently completed an orientation that was focused on helping transition into their roles, understanding ACHE’s purpose, and knowing how their leadership helps us implement our plans. Finally, as you might expect, a newsletter message from a president would never be complete without a request for members to become involved. Please get involved. There’s lots of opportunity and we have the right spot for you that matches your passion!
Until next time,

Articles of Interest

Educating Clinicians About the Business of Healthcare

Stefan Fedusiv, MSN, RN
 ...the fact healthcare costs in the US are the highest in the world and continue to rise at an unsustainable rate is generally accepted by those knowledgeable in the field. There is a way we can help bend this cost curve and all it requires is for us to appreciate the differences in how our clinicians are trained to see “the big picture” and to educate them on the “business” of healthcare.

According to the American Association of Colleges of Nursing, nursing is the nation’s largest healthcare profession and Registered Nurses make up one of the largest segments of the US workforce as a whole. The Bureau of Labor and Statistics’ December, 2015 Employment Projections: 2014-2024 Summary states, “The healthcare and social assistance major sector is expected to become the largest employing major sector during the projections decade...” In other words, there are lots of clinicians and their numbers are expected to grow.  While some of these statistics might come as a surprise, the fact healthcare costs in the US are the highest in the world and continue to rise at an unsustainable rate is generally accepted by those knowledgeable in the field.  There is a way we can help bend this cost curve and all it requires is for us to appreciate the differences in how our clinicians are trained to see “the big picture” and to educate them on the “business” of healthcare.

When I was in nursing school, one of the most important and dominant principles emphasized was “to do whatever is best for the patient.” Rightly so. Nursing, respiratory therapy, physical therapy, and other clinical disciplines are generally qualitative even though they all have quantitative aspects. We are compassionate. We listen.  We care.  We know this has value even if we are unable to count or measure these behaviors.  Most everyone knows medical equipment and supplies are expensive, but many if not most caregivers continue practicing with little regard for resource management. This is most likely due to a lack of understanding regarding costs associated with patient care. Managers, on the other hand, have more quantitative responsibilities including finding and implementing ways of improving efficiency and reducing waste. When these two trains of thought collide, everyone ends up with a headache.

There is a difference between quality of care and convenience. For example, in an eye surgery center, it was common practice to have eye drop medications at each patient’s bedside.  This made it convenient for the nurses to administer drops. However, once opened, each medication bottle must be discarded after 28 days. This convenience resulted in many bottles being discarded despite being more than 75% full. At almost $100/bottle, this was an unnecessary expense which had nothing to do with quality of care. Instead, it was a matter of convenience. Once the nursing staff was educated on this situation and understood the reasoning behind the manager’s request, a positive change in behavior was realized quickly and easily. Another example is when various supplies are unpackaged and set-up in preparation for a procedure. While this is a fine example of time management, it results in unnecessary waste and expense when opened but unused supplies must be discarded.  Quality of care is unaffected by these cost-saving changes in behavior. Identifying these cost-saving opportunities requires analysis, critical thinking, and an understanding of the work being performed by the clinicians under the manager’s purview. Once an opportunity is identified, an appropriate modification must be designed, communicated, and implemented. Probably the most important of these is proper communication. The first step is to understand the context of how clinicians approach their work. They generally do not think in terms of patient satisfaction scores, reimbursements, or budgets. And for the most part, they should not. Their focus should be on providing the best care possible. With that in mind, the manager can prepare a presentation in proper context so clinicians will understand the situation and reasoning behind the proposed change. Sometimes, this is enough. Other times, requests will be met with resistance oftentimes because it requires a change from the way “it’s always been done.” Sometimes clinicians think the proposed change cannot be done even though the new idea has never been tried before. Do not be deterred. Be willing to try new ideas and admit it when they are not working. This will teach your staff to become less fearful of change because they know only the successful ideas will be kept.

Despite myriad attempts at cost reduction, opportunities remain which do not require huge training programs, new software, or large up-front capital expenditures. Managers generally think quantitatively and need to be able to measure inputs and outputs. Clinicians generally think qualitatively and spend much of their time and effort on activities which are valuable yet immeasurable. By understanding and appreciating the differences in how managers and clinicians think, simple behavioral changes with large cost-saving impacts can be implemented when properly communicated. With proper education, clinicians can continue to do whatever is best for the patient while being effective stewards of healthcare resources – and that’s good business. If you have any comments or would like to share examples of simple cost-saving discoveries made within your own department or organization, please send them to stefanf@hawaii.edu.

Image courtesy of: http://www.kevinmd.com/blog/2013/03/physicians-role-cost-containment-absent-training.html 

An Update on Antimicrobial Stewardship Programs in Hawai‘i Hospitals

Jen Dacumos, PharmD, MBA
A growing body of evidence demonstrates that hospital based programs dedicated to improving antibiotic use, commonly referred to as Antibiotic Stewardship Programs (ASPs), can both optimize the treatment of infections and reduce adverse events associated with antibiotic use.

Improving the use of antibiotics is an important patient safety and public health issue as well as a national priority. Past research has shown that 20-50% of all antibiotics prescribed in U.S. acute care hospitals are either unnecessary or inappropriate. Like all medications, antibiotics have serious side effects, including adverse drug reactions and Clostridium difficile infections.  Patients who are exposed unnecessarily or inappropriately to antibiotics are placed at risk for these events with no clinical benefit. The Centers for Disease Control and Prevention (CDC) estimates that more than two million people are infected with antibiotic-resistant organisms, resulting in approximately 23,000 deaths annually. The misuse of antibiotics has also contributed to the growing problem of antibiotic resistance, which has become one of the most serious threats to public health.   

A growing body of evidence demonstrates that hospital based programs dedicated to improving antibiotic use, commonly referred to as Antibiotic Stewardship Programs (ASPs), can both optimize the treatment of infections and reduce adverse events associated with antibiotic use. In 2014, the CDC recommended that all acute care hospitals implement ASPs. There is also anticipation that both the Centers for Medicare & Medicaid and The Joint Commission will publish regulatory measures related to hospital-based ASPs sometime in 2017.

Last Spring, the Hawai‘i Department of Health and the Daniel K. Inouye College of Pharmacy at the University of Hawai‘i at Hilo launched the Hawai‘i Antimicrobial Stewardship Collaborative (HASC). The primary goals of HASC are to:

  • Assist facilities in implementing and sustaining ASPs.
  • Reduce target antimicrobial use as measured by Days of Therapy (DOT) or Defined Daily Doses (DDD) per 1,000 patient days.  Target antimicrobials have been identified as the Carbapenems (meropenem, ertapenem, imipenem and doripenem) and linezolid.
  • Reduce healthcare-onset C. difficile infection rates per 10,000 patient days by 15%.

Participating facilities are: Castle Medical Center, Hilo Medical Center, Kahuku Medical Center, Kapi‘olani Medical Center for Women & Children, Kaua‘i Veterans Memorial Hospital, Kona Community Hospital, Kuakini Medical Center, Maui Memorial Medical Center, North Hawai‘i Community Hospital, Pali Momi Medical Center, Rehabilitation Hospital of the Pacific, Straub Clinic & Hospital, The Queens Medical Center, Tripler Army Medical Center, Wahiawa General Hospital, and Wilcox Memorial Hospital.  HASC leadership holds educational conference calls or webinars at least once per quarter. Ongoing communication and technical assistance visits by project staff to help facilities identify, develop, and refine existing ASP practices is also offered.

If you are looking for more information on hospital based ASPs, the CDC website is an excellent first stop. The CDC has published Core Elements of Hospital ASPs, which can be summarized as follows:

  • Leadership Commitment.  Dedicating necessary human, financial and information technology resources.
  • Accountability.  Appointing a single leader responsible for program outcomes.  Experience with successful programs shows that a physician leader is effective.
  • Drug Expertise.  Appointing a single pharmacist leader responsible for working to improve antibiotic use.
  • Action.  Implementing at least one recommended action, such as systemic evaluation of ongoing treatment need after a set period of initial treatment (i.e. “antibiotic timeout” after 48 hours of therapy).
  • Tracking.  Monitoring antibiotic prescribing and resistance patterns.
  • Reporting.  Regularly reporting information on antibiotic use and resistance to the appropriate healthcare team(s) and stakeholders.
  • Education.  Educating clinicians about resistance and optimal prescribing practices.

For more information, please visit: http://www.cdc.gov/getsmart/healthcare/implementation/core-elements.html


Centers for Disease Control and Prevention.  Core Elements of Hospital Antibiotic Stewardship Programs.  Available at:
http://www.cdc.gov/getsmart/healthcare/implementation/core-elements.html/  Accessed March 4, 2016.

 State of Hawai‘i, Department of Health, Disease Outbreak Control Division.  Hawai‘i Antimicrobial Stewardship Collaborative.  Available at: http://health.hawaii.gov/docd/dib/hawaii-antimicrobial-stewardship-collaborative-hasc/.  Accessed March 4, 2016.

Photo courtesy of:  http://thecompanion.in/the-misuse-of-antibiotics-can-be-deadly/

The Gift of Hope - Lessons Learned Through Medical Missions

Kelly A Wheeler, Process Improvement Specialist, Army Regional Health Command-Pacific
From December 30, 2015 through 8 January 2016, a team of over 40 personnel, brought together by the Dr. Saw Mra Aung Foundation, Suu Foundation, and Rotarians from Alaska, Nepal, and Hawaii including volunteer healthcare providers and Rotary members traveled together to the Rakhine state, Myanmar.  Their mission was to provide basic healthcare to the local population in and around the cities of Thandwe and Ngapali, Myanmar (formerly Burma). 

From December 30, 2015 through 8 January 2016, a team of over 40 personnel, brought together by the Dr. Saw Mra Aung Foundation, Suu Foundation, and Rotarians from Alaska, Nepal, and Hawaii including volunteer healthcare providers and Rotary members traveled together to the Rakhine state, Myanmar. Their mission was to provide basic healthcare to the local population in and around the cities of Thandwe and Ngapali, Myanmar (formerly Burma).  Services provided included vitals, laboratory, ophthalmology, optometry, basic dentistry, pediatrics, internal medicine, general practice, and pharmacy services. Patients received basic health education while they waited while local emergency workers and Red Cross volunteers that supported the mission were taught CPR.

Unknown to many, there is a strong connection to Myanmar in the heart of Honolulu. Nobel Peace Prize laureate, Daw Aung San Suu Kyi, founded the Suu Foundation and in 2014 established its home base in Honolulu. The Suu Foundation’s short-term goals include restoring the University of Yangon and the Yangon General Hospital.  The home of the foundation in Hawaii was a result of seeds planted by Burmese-born, Miemie Winn Byrd, an Associate Professor at the Asia-Pacific Center for Security Studies along with a strong Burmese community in Hawaii, many of whom work in the health care industry. For the past three years, doctors have been working in conjunction with the Suu Foundation, Dr. Saw Mra Aung Foundation, and Rotarians and Friends, to provide much needed healthcare services in rural areas in Myanmar.

Historical sanctions have been in place on the Burmese military regime since 1998, and the Foreign Assistance Act barred the country from receiving major international assistance initiatives-except for humanitarian assistance, due to the challenges their previous military government had placed on the population. Corruption within the system further exacerbated the lack of available resources. Foreign sanctions limited international support and development, and there was an extreme lack of government investment in the healthcare of the people of Myanmar with less than 3% of the GDP spent on the provision of healthcare. The Myanmar healthcare system remains inadequate to address the medical needs of its population, ranking 190 out 191 in the 2015 World Health Organization health system rankings. Low life expectancy and high death rate caused by malaria, Dengue, and other largely treatable diseases is further evidence of the lack of basic healthcare availability throughout the country.

The medical mission team experienced the outcomes of limited access to quality care first hand. After three days in Rakhine, more than 3,000 people had received basic healthcare from the international team, some waiting for over a day as they had traveled from distant villages that have no accessible healthcare. Most conditions treated were preventable-including eye diseases and blindness caused by untreated infections, deformities, mentally challenged children resulting from untreated jaundice, and dental issues from a lack of basic dental hygiene. In addition to the mission in Ngapali, the team fitted and distributed over 150 prosthetic hands in Yangon. 

There is a change in the political environment with political, economic, and administrative reforms after the democratic elections in November 2015. There has been a top-down revolution of political, economic, and social transformation in Myanmar, and the leadership of the country is striving to promote the end of brutality by the military, and encourage peace and democracy within the populace.  Knowing there is hope for the government, many Burmese-born doctors are returning and encouraging their families and associates to return and rebuild the medical capabilities within the country.

The 2015-2016 medical mission was the third time that the Suu and Aung Foundations have brought a medical mission to Myanmar.  Each year the mission improves, most notably with an increase in the number of foreign-trained Burmese doctors, most residing and working in the United States. Provider-patient communication is enhanced by having healthcare personnel who can speak the native language and also affords the opportunity for medical students with Burmese heritage to work along-side medical students studying at the University of Yangon, thereby achieving short term goals of the Suu Foundation. 

There is much to learn by volunteering on a medical mission.  First, the importance of inter and intra-country relationships cannot be over-stated. The key success factor of the missions conducted by the staff and family of the Dr. Saw Mra Aung Foundation included having support personnel that work closely with the government and healthcare institutions within Myanmar while other personnel are connecting and recruiting support for personnel, financing, and medical supplies throughout the US and other countries. The inter/intra-country support made it possible to obtain medical supplies, needed transportation, and lodging requirements among other things. Second, one gains a better understanding of various cultures. In a time of increasing focus on cultural competency, nothing can replace “putting the shoe on the other foot” and experiencing being in a culture that is very unlike your own. Third, one has the opportunity to be creative. You do not find the latest and greatest devices; therefore, you are forced to be creative and use what limited resources you have to meet your objective. Finally, and most importantly, personnel are reminded that the mission not only providing healthcare, but the mission and all those that volunteered provide the gift of hope and reassurance to the people and patients in Myanmar that they have not been forgotten by the rest of the world.

For more information on upcoming medical missions to Myanmar organized by the Suu and Aung Foundations, please visit the Dr. Saw Mra Aung Foundation website at http://www.dsmafoundation.org/2015/03/about.html or contact Ms. Kelly Wheeler, kelly.a.wheeler23.civ@mail.mil.


Calendar of Events for Spring 2016

Tamara Pappas

The Spring 2016 Calendar of Events for ACHE, Hawaii Chapter.

March 2016 March      
Su  Tu  Th  Sa  03/10/16 Hawaii Pacific ACHE Chapter  Chapter Event
      1 2 3 4 5   Board Meeting  
6 7 8 9 10 11 12 03/15/16 2016 Annual HI Pacific Chapter  Chapter Event
13 14 15 16 17 18 19   Dinner (TBD), Congress on   
20 21 22 23 24 25 26   Healthcare Leadership  
27 28 29 30 31       03/25/16 Good Friday Holiday
April 2016 April              
Su  Tu  Th  Sa  04/17/16 Hawaii Pacific ACHE Chapter  Chapter Event
          1 2   Board Meeting  
3 4 5 6 7 8 9 04/18 - 04/19 Leaders Conference Special Program
10 11 12 13 14 15 16 04/18 - 04/20 Examination Review Course Special Program
17 18 19 20 21 22 23 04/21 - 04/22 HFMA Hawaii Chapter Annual Chapter Education
24 25 26 27 28 29 30   Conference  
May 2016 May      
Su  Tu  Th  Sa  05/10/16 New Member and Social Mixer Chapter Event
1 2 3 4 5 6 7   Hawaii-Pacific Chapter of ACHE
8 9 10 11 12 13 14 05/05/16 Hawaii Pacific ACHE Chapter Chapter Event
15 16 17 18 19 20 21   Board Meeting  
22 23 24 25 26 27 28 05/30/16 Memorial Day Holiday
29 30 31        
June 2016 June              
Su  Tu  Th  Sa  06/06 - 06/08 ACHE Executive Program Special Program
      1 2 3 4 06/09/16 Hawaii Pacific ACHE Chapter Chapter Event
5 6 7 8 9 10 11   Board Meeting  
12 13 14 15 16 17 18
19 20 21 22 23 24 25
26 27 28 29 30    

Education Calendar for Spring 2016

Tamara Pappas

Spring 2016 Education Calendar. Take advantage of numerous educational opportunities!


Chapter education events, webinars, and cluster events! Use this calendar to plan out your educational and credentialing opportunities. Cluster events are highlighted in blue and chapter education events in red.  

Click on events for more details.


March 2016 March      
Su  Tu  Th  Sa  01/20 - 03/02 Physician Alignment and  Online Seminar
      1 2 3 4 5 Engagement: Dos and Taboos
6 7 8 9 10 11 12 02/17 - 03/30 A Review of Health Law Online Seminar
13 14 15 16 17 18 19 03/02/16 The Art of Building Trust and Webinar
20 21 22 23 24 25 26 Creating an Inspired Workforce
27 28 29 30 31       03/14 - 03/17 Congress on Healthcare 
ACHE Education 
03/25/16 Good Friday Holiday
03/30 - 05/11 Management Mistakes, Moral Online Seminar
Dilemmas and Lessons Learned
April 2016 April              
Su  Tu  Th  Sa  03/30 - 05/11 Management Mistakes, Moral Online Seminar
          1 2 Dilemmas and Lessons Learned
3 4 5 6 7 8 9 04/06 - 05/18 Population Health: The Road Online Seminar
10 11 12 13 14 15 16 to Transformation
17 18 19 20 21 22 23 04/11 - 04/14 Kiawah Island Cluster ACHE Education
24 25 26 27 28 29 30 04/13 - 05/25 Strategic Planning That Works: Online Seminar
                    Integrating Strategy with
04/20 - 06/01 Developing Physician Leaders  Online Seminar
for Clinical Integration
May 2016 May      
Su  Tu  Th  Sa  03/30 - 05/11 Management Mistakes, Moral Online Seminar
1 2 3 4 5 6 7 Dilemmas and Lessons Learned
8 9 10 11 12 13 14 04/06 - 05/18 Population Health: The Road Online Seminar
15 16 17 18 19 20 21 to Transformation
22 23 24 25 26 27 28 04/20 - 06/01 Developing Physician Leaders  Online Seminar
29 30 31         for Clinical Integration
                     05/16 - 05/19 San Antonio Cluster ACHE Education
05/30/16 Memorial Day Holiday
June 2016 June              
Su  Tu  Th  Sa  04/20 - 06/01 Developing Physician Leaders  Online Seminar
      1 2 3 4 for Clinical Integration
5 6 7 8 9 10 11 06/06 - 06/09 Puerto Rico Cluster ACHE Educaton
12 13 14 15 16 17 18 06/13 - 06/16 Seattle Cluster ACHE Educaton
19 20 21 22 23 24 25
26 27 28 29 30    

Committees and Events

Message from the Guam Local Program Council

Chuck Tanner, FACHE
A major function of our group is to create bridges between our military and civilian members and what better way to do that than enjoying what our island has to offer.

March 9, 2016

Hafa Adai from Guam! The Guam Local Program Council of the Hawaii-Pacific Chapter of American College of Healthcare Executives is transitioning leadership. As we change we want to give our sincere thanks to LCDR Joe Fromknecht, John Ray, and LTJG Matt Gallagher for their work last year!

The incoming leaders are:

  • Chuck Tanner, FACHE, President
  • Lt. Irene Mitchell, President Elect
  • John Ilao, Treasurer
  • Fabrienne Reyes, Secretary (welcome back Fabrienne!)

The new leadership team had an initial meeting and made plans for the upcoming year. The first item is to have monthly all member meetings either during lunch or after hours. This “all member” meeting is tentatively scheduled for March 29. This meeting will host Senator Dennis Rodriguez, Jr., Chairman of the Guam 33rd Legislature Healthcare Committee speaking on the System of Care and initiatives to improve healthcare delivery. In addition to our monthly guest speaker meetings we are considering adding some “social mingles” to our palette! A major function of our group is to create bridges between our military and civilian members and what better way to do that than enjoying what our island has to offer!

Since our membership is a healthy mix of civilian and military members we are looking to have future speakers speaking on how the military and civilian sectors collaborate to provide services. Other topics concerning the not for profit sector and the establishment of coalitions are on the docket too! Guam is busy with Healthcare events and the upcoming FESTPAC celebration. I would like to highlight some of those “busy” moments here on Guam!

In February our military partners conducted showcased disaster response support during Cope North 16. In addition to Air Force and Navy personnel, this exercise included counterparts from Australia, Japan, Korea, New Zealand and the Philippines spreading throughout the Mariana Islands. To read more about this major event check out this article!  http://www.andersen.af.mil/News/tabid/1981/Article/673588/andersen-medical-teams-showcase-disaster-response-support-during-cope-north-16.aspx

The 12th Festival of Pacific Arts is fast approaching and is scheduled for May 22 to June 4, 2016. The Festival of the Pacific Arts is held every four years since 1972, and brings together artists and cultural practitioners from around the Pacific region for two weeks of festivity. It is recognized as a major regional cultural event, and is the largest gathering in which Pacific peoples unite to enhance their respect and appreciation of one another. To learn more visit https://festpac.visitguam.com/

On the legislative side there are several healthcare related bills in the works. Of note is Bill 277-33 that was recently introduced by Senator Dennis Rodriguez, Jr. This Bill would call on the Guam Economic Development Authority to launch a Request for Information so prospective contractors could provide information on how to transition the operation of the hospital to a public-private partnership. For more information on this and other bills check out the legislative website at http://www.guamlegislature.com/index.htm .

Keeping with our collaborative and educational mission we are happy to share items of interest in healthcare with our members. To affect this, we have an email group of Guam members and if members have an event they would like to share, you may send me the information and I will pass it on! This service is also available for our Hawaii friends too! Just send me an email and I will add you to the list! (For privacy, I send information BCC)

Until next time.
Si Yuus Maase

Chuck Tanner, FACHE
President, GLPC ACHE

Leaders Who Care: Meet Your New Chapter Board Members!

Micah Ewing

The Hawai'i-Pacific Chapter of ACHE board recently completed elections and a new board member orientation in February.

Greetings and welcome to 2016!

This past December, the Hawai'i - Pacific Chapter of ACHE held elections for Officers and Directors.  Additionally, a new board member orientation was hosted by Art Gladstone and Nicholas Hughey on Tuesday, February 2 and was a great opportunity for board members to become acuainted with chapter policies, position responsibilities, and goals for the upcoming year.   

Meet our new incoming board members (L to R):  Directors Suzie So-Miyahira and Stefan Fedusiv;
Secretary, Nancy Wilson 

Accepting the exciting challenges in healthcare leadership, we look forward to the remainder of the year and have already began the process of incorporating new ideas towards the goal of providing our chapter membership with rich educational, networking, and career resources on the path of developing healthcare leadership. 

Below are the election results released in January.  Please congratulate and welcome new and returning members of the board!  

Chapter President -  Art Gladstone


President Elect – Nick Hughey


Secretary- Nancy Wilson


Student Representative- Emiline Buhler


Directors -     Micah Ewing


                        Major Charlotte Hildebrand


                        Suzie So-Miyahira


                         Stefan Fedusiv


                        Tamara Pappas

Bobbie Ornellas 

Please know that your involvement and engagement in the chapter is important; as a result, your feedback on how we can better serve you through any of our resources is important--be it the newsletter, website, or our events.  We look forward to meeting you in person at our Spring Social on May 10!   

Diversity Programs: Effectiveness through Transparency and Accountability

Charlotte Hildebrand, FACHE
In its January 4, 2016 edition, the Harvard Business Review (HBR) published an article that shows how diversity programs and policies fail to improve the overall diversity of organizations.

In its January 4, 2016 edition, the Harvard Business Review (HBR) published an article that shows how diversity programs and policies fail to improve the overall diversity of organizations. The article entitled, “Diversity Policies Rarely Make Companies Fairer, and They Feel Threatening to White Men,” references a recent study that reviewed the diversity programs of 700 U.S. companies. The findings of the study showed that diversity programs do not necessarily increase minorities and women in organizations, and that they may strain relationships with the dominant group who feel that systems are generally fair. The article offers two recommendations for managers:

  1. “appreciate the potential effect of diversity messages on groups that have traditionally been favored in organizations” and
  2.  “know the limits of diversity initiatives for minorities and women.”  In order to help women and minorities thrive in environments that support diversity, accountability is key to maximize effectiveness.

If you are interested in reading more, here is a link to the article: https://hbr.org/2016/01/diversity-policies-dont-help-women-or-minorities-and-they-make-white-men-feel-threatened
ACHE also shares some interesting resources that center on the 2014 ACHE “Racial/Ethnic Comparison of Career Attainments in Healthcare Management.” It is one of five studies ACHE conducted that started in 1992.  It holds nothing back and is surprisingly transparent along four main sections: demographic comparisons, career outcomes, accounting for different career outcomes, and recommended best practices. For example, in the career outcomes section, the study shows that, in calendar year 2013, white males earned a median of $190,000. Hispanic males earned a median of $157,700 (17 percent less than white men) and black and Asian men earned a median of $142,500 (25 percent less than white men). The salaries of Hispanic, Asian and black men are closer to those of white men in the 2014 study than in the 2008 study--when they differed by 21 percent, 34 percent and 30 percent, respectively. White women also earned 25 percent less than white men (also a median of $142,500).  Asian women earned 11 percent less than white women (a median of $127, 500) and black and Hispanic women both earned 21 percent less than white women (a median of $112,500). This represents a smaller salary gap between white and Asian women than was found in the 2008 study.

Best practices offered in the report include equal pay for equal work, mentorship programs, and residencies and fellowships offered to people of diverse backgrounds. These offer alternatives to diversity programs and policies that have been shown to be less effective in the HBR article.  The full ACHE report is accessible online from: http://www.ache.org/pubs/research/raceandgender.cfm#Gender.
A webinar summarizing the highlights of ACHE’s 2016-2018 Strategic Plan and ACHE’s proposed Executive Leadership Diversity initiative is another resource. The Executive Leadership Diversity Initiative calls for ACHE to take a leadership role in helping to advance diverse healthcare executives by forming sustainable partnerships, engaging stakeholders, activating a call to action, and building an executive diversity road map.  The report is available at


News from the Education Committee

Maj Angel Vargas

 Springtime is here and there is a lot going on with ACHE-Hawai'i.

Springtime is here and there is a lot going on with ACHE-Hawai'i.

First, the Hawai'i Pacific Chapter's Education Committee has partnered with the Healthcare Financial Management Association's (HFMA) Hawaii Chapter to co-sponsor a one-hour ACHE panel. This panel is just a portion of a two-day HFMA annual conference beginning Thursday April 21, 2016 to Friday April 22, 2016 at the Ala Moana Hotel in Honolulu. Local ACHE members will receive the discounted HFMA member rate to attend this conference. 

The ACHE Panel will be held on April 21, 2016 from 2:00pm to 3:00pm.  The topic is "Engaging Physicaian Leaders: The "What's In It For Me (WIIFM)?" Problem.  Our moderator is Dr. Gearda Livaudais, FACP, Vice President of Hawaii Health Partners. Our speakers also include Dr. Kenric Murayama, FACS, the Chair and Program Director for the Department of Surgery at the University of Hawaii in Manoa,  Ms. Martha Smith, FACHE, Chief Executive Officer of Kapiolani Medical Center for Women and Children, and Ms. Kathy Raethel, President and Chief Executive Officer of Castle Medical Center.  This panel of physicians and hospital leaders will address how to engage physicians who often approach leadership requests with the question, "What's in it for me?" These questions include; money, power, title, or other resources. The discussion will also look at suggestions on how to move from transactional thinking to transformational thinking. 

We are hopeful this type of event becomes an annual opportunity for our members on island. ACHE Qualified Education Credits are currently being finalized. For more information regarding this event, please contact Maj Angel Vargas (angelvargasjr1@gmail.com).

Next, the Hawai'i Pacific Chapter's Education Committee is working to solidify an "Advancement to Fellow" support program for local members seeking to earn ACHE's prized certification--Fellow! Steps are being taken to establish study groups across the island, as well as organize study materials in support of a collaborative, peer-focused resource for qualified members. Bottom line: your success is our success!

Finally, the Education Committee continues to seek out energetic, detailed individuals to help coordinate events for 2016 and beyond. If you are interested in becoming an active member in the Chapter and want to know more about how you can help, please feel free to contact us at any time.

Membership: New Fellows, Members, and Recertified Fellows

Nick Hughey, RN, MBA

The Hawaii-Pacific Chapter had a strong beginning of the year with  continued membership  growth in the first quarter. 

The Hawaii-Pacific Chapter had a strong beginning of the year with continued membership growth in the first quarter.

Our efforts in recruiting and providing educational programs toward credentialing are definitely making a difference. In the first quarter the chapter had 6 new members, and 4 recertified Fellows! I am always available to present if you or your organization ever wants information on ACHE and benefits of membership.  If individuals are interested, I can certainly make time to follow up and discuss and provide information as well.  Please see below information on big upcoming chapter event!!

The Hawaii Pacific Chapter will be hosting an information session  for  professionals and students that want to learn more about potential membership. This presentation will be immediately followed by a social mixer open for all members and those who attend the information session. This is a great way to learn about ACHE and see the networking potential in action!! I encourage all members to attend the social mixer and set a goal to bring prospective members to the information session. We will be sending out additional information and collateral on the big event!! Come and bring somebody!!!

Spring Social Mixer
May 10, 2016

Hasr Bistro
31 N. Pauahi Street , Honolulu

6:00 PM-6:30 PM – Information presentation on ACHE and Membership Benefits (for prospective members)

6:30 PM – 8:30 PM social mixer (Heavy Pupus)  (Open to all members)


New Members


      Reynold Cabarloc, Hilo
      1SG Christopher P. Gruber, Honolulu
      CPT Alyse Trejo, Honolulu


      LTC George O. Gilbert Jr., Ewa Beach
      Linda Puu, Honolulu


      Isabella K. Gary, Honolulu

Recertified Fellows

      Darlena D. Chadwick, RN, FACHE, Honolulu
      Maj Scott D. Cook, FACHE, Kapolei
      Christi L. Keliipio, FACHE, Honolulu

Mahalo Nui,

Nick Hughey RN, MBA, FACHE
President Elect and Membership Chair
Hawaii Pacific- Chapter of ACHE




Spring 2016 Financial Report

Selma Yamamoto


We are starting 2016 in strong financial standing. The Hawaii Pacific Chapter has a current balance of $39,496.60 and the Guam account has a balance of $374 as of 2/23/16.

Career and Leadership

Career Corner

Richard Giardina, RN, MPH, CIC, FACHE
We are happy to provide a link to the new Career Edge link to the ACHE career development resources. We hope that you will find this helpful in the development of your career at any level. 

This quarter's Career Corner offering is an excerpt on understanding your employment needs:

Remember that ACHE provides 3 primary resources to assist with Career Development:

  1. Introducing CareerEDGE™  (available as a complimentary benefit to ACHE members). 'CareerEdge' is a resource available to assist in this planning process. Check it out!
  2. The ACHE Job Center is a database of employment opportunities and positions in healthcare.
  3. The Career Resource Center.

If you have any questions, please contact one of the board members or send an email to our chapter email account: hawaii@achemail.net


ACHE National News - Spring 2016

Richard Giardina RN, MPH, CIC, FACHE

The Spring 2016 National News from ACHE.org. 

Latest Edition of Competencies Assessment Tool Now Available
The 2016 ACHE Healthcare Executive Competencies Assessment Tool (PDF) is now available. This self-assessment instrument is designed to help healthcare executives identify their strengths as well as areas to include in a professional development plan. The tool also may be used by supervisors to facilitate dialogue with staff or by organizations to better define the requirements of specific roles and to develop targeted training.

A limited number of hard copies of the assessment tool are available. If you wish to receive a hard copy, please contact Oriana Wise, administrative assistant, Division of Member Services, at owise@ache.org.

Intermountain Healthcare Offers Novel Plan That Cuts Costs
Intermountain Healthcare is guaranteeing to hold yearly rate increases to one-third to one-half less than what many employers across the country usually face with its new health plan, SelectHealth Share. To help keep the rate increases similar to a rise in consumer prices, Intermountain says it will produce savings of $2 billion over the next five years. The health system, which has established itself as a leading health system by tracking and analyzing both the cost and quality of patient care, has already saved money by renegotiating the cost of surgical staplers and ensuring that heart attack patients get into catheterization labs within 90 minutes of emergency department contact, which will help them recover faster. Other health systems and insurers will be watching the rollout of Intermountain's new plan. A few will be offering similar types of plans; others, however, would be more likely to reduce services or shrink their devaluing operations if they were to guarantee a long-term hold on price increases.

Abelson, R. "A Novel Plan for Health Care: Cutting Costs, Not Raising Them’"The New York Times, Feb. 17, 2016

ACHE Awards Chapter Innovation Grants
ACHE has awarded two 2016 grants under ACHE's Chapter Innovation Grant Program. This program fosters chapter innovation by funding the development of new programs and processes that other chapters can emulate. Learn more about ACHE's Chapter Innovation Grants.

Have You Downloaded the 2016 Congress App?
Get the latest information about ACHE's 2016 Congress on Healthcare Leadership and enhance your on-site experience with the official Congress app for mobile devices. Download your preferred format or access a mobile web version for use with any Web browser.

Wolterman Discusses Tips for Creating a Clinically Integrated Health System
In an interview for ACHE's new digital publication, Elevating Leadership, Daniel J. Wolterman, FACHE, CEO, Memorial Hermann Healthcare System, Houston, discusses the organization's early success in creating a clinically integrated health system. Read the full issue now.

Save 30 Percent on HAP's March Book of the Month
The healthcare environment is changing rapidly, and so are the skill sets needed for successful organizational leadership in the field. Strategic Analysis for Healthcare: Concepts and Practical Applications arms readers with strategic analysis methods, tools and frameworks. Order your copy today.

Scholarships Are Still Available for ACHE's Executive Programs
ACHE is still accepting scholarship applications for ACHE's 2016 Executive Programs, but the deadline to apply is approaching quickly. Learn more and apply—all scholarship requests are due by Wednesday, March 30.

Postgraduate Fellowships: Creating Future Leaders
The Postgraduate Fellowship Area of ache.org gives you the tools you need to develop a fellowship, including detailed resources on logistics, compensation and benefits, recruiting, onboarding and assessing fellow candidates. Give back to the field by offering a postgraduate fellowship in your organization.

Apply to Advance to Fellow and Save $200
Earning the distinction of board certification as a Fellow of the American College of Healthcare Executives demonstrates your competence, dedication and commitment to lifelong learning. Learn more about Fellow requirements and apply online.

Healthcare Newsbriefs

Obama Administration Will Test Payment Alternatives for Medicare Part B Drugs
The Obama administration recently announced it will test a half-dozen proposed ways of paying for prescription drugs under Medicare Part B. The current payment formula does not incentivize physicians to choose the lowest-cost therapy to treat patients effectively, according to the administration.
Pear, R. "U.S. to Test Ways to Cut Drug Prices in Medicare'The New York Times,March 8, 2016

Study Finds Fee-for-Service Payments Increase Despite Efforts to Link Pay to Quality
New research has found that fee-for-service payments account for 95 percent of payments for physician visits, despite efforts to move toward payment based on quality, not quantity. The research indicates healthcare has far to go in linking payment to quality.
Daly, R. "Share of Fee-for-Service Physician Payments Increases"Healthcare Business News, HFMA, March 8, 2016

Four Areas That Hospital Boards Must Fulfill 
There are four areas that can be blind spots for hospitals boards, and for which boards need independent insight to fulfill their fiduciary roles: publicly accessible data and cybersecurity, clinical innovation and culture. Why are these four areas "blind spots" for hospital boards?
Keckley, P. "The Four Blind Spots in Hospital Governance"H&HN , March 7, 2016

Ways to Become a More Focused and Mindful Leader
Harvard University researchers have found that people spend nearly 47 percent of their waking hours thinking about something else other than what they are doing. Simple strategies can help leaders become more focused and mindful.
Hougaard, R. and Carter, J. "How to Practice Mindfulness Throughout Your Work Day"Harvard Business Review, Mar. 4, 2016






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