Joanne's Journal - Thursday, November 16, 2017
Over the last two months as a leadership team, we have spent a significant amount of time discussing what an effective system leadership structure would look like. At the highest level of leadership, many team member transitions have occurred over the last two years. This has resulted in very broad areas of responsibility for current team members and has left very little bandwidth for our leaders to be proactive and strategic.
In our effort to think and act more like a system and achieve critical operational efficiencies, we are making some changes. We have been purposefully not filling some vacated leadership roles in order to design the most efficient and effective infrastructure for the system. And if you recall from my message last week, when we refer to the system, we are talking about Dartmouth-Hitchcock (D-H) and our affiliate members.
From my conversations with many of you, you have been honest with me. People have asked, “Why do we hire executives when we can't hire enough frontline staff to do the work?” I get it. It is really important to make sure we have adequate frontline staff in order to take care of the growing number of very complex patients who want to receive care here. Our frontline staff—both clinical and non-clinical—are the most important part of our daily operations to ensure we are providing high-quality care and an exceptional patient experience. And behind the front line are additional staff and leaders—both clinical and non-clinical—who make sure operations run smoothly so frontline staff have what they need to do their work. Our goal is to balance these roles so there isn’t a disparity—this is what I believe had prompted the question of hiring too many leaders and not having enough staff to run our organization. As a leader, I need to make sure that we are building the infrastructure that allows you to function in your roles more efficiently, creates a positive environment in which to work and ensures that you can address problems at the frontline level.
To achieve these goals, we are doing several things:
In our effort to think and act more like a system and achieve critical operational efficiencies, we are adding the role of Chief Operating Officer of Dartmouth-Hitchcock Health (D-HH), who will have direct responsibility for operations at Dartmouth-Hitchcock, as well as line of sight on operations throughout the health system. This role will also be responsible for the support services components of D-HH—like information systems, facilities and pharmacy. I am pleased to let you know that Patrick Jordan, III, MBA, see press release for more details, will join our team on November 20th. The executive team, affiliate CEOs, and several D-H operational leaders have met with Patrick and the feedback has been overwhelmingly positive.
Steve LeBlanc, currently our Chief Administrative Officer and long-time D-H leader, will become the Chief Strategy Officer (CSO) for D-HH and will have responsibility for developing partnerships and driving system integration. The CSO will also have responsibility for our payer relationships and our risk performance in our ACO work. Our future depends on us finding integration efficiencies and driving costs out of the system. We believe this new structure will help us achieve that.
To achieve the balance in roles I mentioned, we are going to eliminate a leadership role and consolidate some leadership responsibilities. We have sunset the role of D-H Chief Academic Officer. Instead, the Clinical Chairs will report to Dean Duane Compton at Geisel for their academic/research scholarship and their departments’ contribution to undergraduate medical education. This is a much more traditional model of reporting and further strengthens our relationship with the College and Medical School. Dr. Rich Rothstein who held this role will continue to support the transition of our research enterprise from Geisel to D-H as Medical Director of Research Operations.
Sue Reeves, EdD, RN, D-HH’s Chief Nursing Executive, will be the senior leader who is responsible for our research and education efforts. In collaboration with Dean Compton and the Clinical Chairs, she will support our research infrastructure and the Center for Learning and Professional Development which includes Graduate Medical Education (GME), Continuing Medical Education (CME), Continuing Nursing Education (CNE), the Simulation Center and Learning Technology. With Sue’s experience as both an educator and a leader, I think we will be able to do some very exciting things with inter-professional education and practice.
Below is an organization chart that describes these changes. Please note that this org chart doesn't reflect all departments and is a work in progress so to speak, meaning it may not reflect what is currently in place, but shows the direction we are going in.
Our team is committed to being transparent about both decision-making and direction for D-H and D-HH. We can’t accomplish what we need to do without all of you. Thank you in advance for your support and feedback!
Dartmouth-Hitchcock Health System Organizational Structure
Joint Commission Accreditation Survey Completed
Dartmouth-Hitchcock (D-H) has completed another successful survey by The Joint Commission, the major national accrediting body for hospitals and health systems.
A team of seven Joint Commission surveyors were on hand at Dartmouth-Hitchcock Medical Center (DHMC) in Lebanon from November 7 to 10, visiting DHMC’s inpatient units, ambulatory clinics, diagnostic and procedural areas, the operating rooms and other areas of the hospital. Surveyors also visited the Outpatient Surgery Center and Norris Cotton Cancer Center locations in Nashua and St. Johnsbury, VT.
In regular daily briefings with D-H leadership, the Joint Commission surveyors noted the responsiveness of D-H’s providers and staff: of note was the immediate action taken by staff to address 15 issues that were identified by the surveyors during their visit. The surveyors also noted how open and engaged staff were, and their great pride when talking about their work. The team classified many of DHMC’s programs as “best in class” when compared to other hospitals they have visited around the country. Among those programs are the Safety Champion program, the Inpatient Operations Center, the Intensive Care Nursery’s interdisciplinary rounds, the Patient Safety Training Center, and an “open chest cart” developed for use in the Cardiovascular Critical Care unit.
The issues noted by the surveyors in their preliminary report will be addressed in the next 25 days, in time for a return visit by The Joint Commission to confirm full compliance. As a result, of the new survey process, including the return of Joint Commission surveyors in December, we will be making rapid process improvements in some areas. A special task force is overseeing this process improvement work and are meeting twice a day to track our progress. Status of these improvements are on display on the fifth floor hallway near the President’s Conference Room of DHMC (see photo at left). Ongoing communication will be sent to all staff and specific role groups with details of immediate changes that need to be made.
An independent, not-for-profit organization, The Joint Commission accredits and certifies nearly 21,000 health care organizations and programs in the United States. Joint Commission accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards. D-H is accredited by The Joint Commission every three years.
D-H in the Community: Flu Clinics a Success
With many children wearing Halloween costumes, there was a festive feel to Dartmouth-Hitchcock Medical Center’s (DHMC) final fall public flu vaccination clinic on Sunday, October 29. Even those who weren’t in costume were in high spirits on the drizzly day, laughing and joking with nurses at the front entrance who provided “drive-thru” flu shots for those with limited mobility.
“This is the highlight of our year. It’s the only time we get out!” Norwich resident Kathy Petersen joked with nurses Brenda Moore, RN, and Maureen Troumbley, RN, as they administered flu shots to Petersen, Sheila Taraska, and Faith Boone outside their mini-van in front of DHMC.
“These gals were out here waiting for us,” said Taraska, a retired nurse like Petersen. “We love it! It’s so quick and they’re all so friendly. And they know what they’re doing!” Petersen added, “But seriously, it’s always a pleasure having people like you all take care of us in the community.”
Inside at the flu clinics for adults in Auditoria A through D and the flu shot clinic area for families, in the Spine Clinic, you heard that same gratitude from local residents. “I think it’s fabulous that Dartmouth-Hitchcock offers this service to the community,” said Elizabeth Duval of Quechee, who was getting a flu shot with her husband David. “I like going right to the source here at the hospital, and feel more confident getting my flu shot here.”
NH Arts Award Given to D-H Programs
The Creative Arts Team at Dartmouth-Hitchcock (D-H) received the NH Governor's Award for Arts in Healthcare on November 1. The award was given in recognition of the Creative Arts Team’s work at the Norris Cotton Cancer Center for many years, and their new expansion into all departments at D-H, including Psychiatry, Neurology, Cardiology, Medical Specialties, the Intensive Care Nursery and Intensive Care Unit. The program is comprised of writer/poet/story teller Marv Klassen-Landis, therapeutic harpist Margaret Stephens and visual artist Christine Orcutt Henderson. The team visits patients at the bedside, offering art, music and writing as part of the holistic approach to care—meeting patients "where they are" and assessing what would help the patient the most at that given time. They also offer group classes.
At Dartmouth-Hitchcock Medical Center, as well as other medical centers around the world, studies have shown the positive impact of art activities with patients, including increased patient satisfaction and self-esteem, pain reduction, shorter hospital stays and decreased feelings of anxiety and depression.
Currently, philanthropy entirely supports the program, with money raised through the Prouty, grants and generous donors.
Honoring Those Who Serve Our Country
“Thank you for your service,” was said with respect and gratitude to recognize Veterans Day last week to the many veterans who work for Dartmouth-Hitchcock (D-H), as well as those who were patients and visitors. To celebrate our veterans and their family members, D-H leaders at all of our locations offered sweet treats and free hot beverages on Friday, November 10, and Saturday, November 11.
Pictured below (left) is Joanne Conroy, MD, CEO and president of D-H who gave out cake in the main dining room at DHMC. Dr. Conroy spoke with D-H security officer Mary Berry, who proudly shared that each of her three sons have served six years in the military. She later sent the photos of her sons below (right) to Dr. Conroy.
At D-H, we also celebrate our employees who have served by recognizing them on the D-H Wall of Honor. If you know of other D-H staff who have served or currently serve in the military and would like to be a part of the Wall of Honor, please send an email to: D-H.Today@hitchcock.org.
Visit from New Hampshire’s Governor Sununu
Recently, Governor Chris Sununu paid a visit to Dartmouth-Hitchcock to meet in person for the first time Joanne M. Conroy, MD, CEO and president. Governor Sununu and Conroy had a productive visit and took some extra time to visit the Intensive Care Unit (ICU) where the Code Silver event took place on September 12. Governor Sununu met with some of the ICU staff (see photo at left) express his support for what they went through during the traumatic event.