KV Healthcare

healthcare

Behind the Scenes: Community Relations

· ·

Normally, Behind the Scenes pieces open with the line “We sat down with…,” but in this case, Community Relations intern Arianna Walker wrote the post herself from start to finish. As you’ll see, she has a wonderful writing voice. Our team has enjoyed working with Arianna over the past months, and we warmly congratulate her on earning a Bachelor’s in Public Relations. Watch out world, here she comes! 

Arianna Walker

There’s no place like marketing…I read that phrase every day that I’m in my office. This is mostly because it’s taped to the stapler that sits on my desk, but this phrase has also grown on me in the past couple of months.

I’ve been a public relations/advertising student at CWU for around two years now. Before that, I took courses in communication studies and graphic design. The experience I’ve gained through doing public relations/advertising in the classroom has helped me discover an enthusiasm and a passion for this line of work. The more I’ve learned, the more I have wanted to go out and experience this career in the real world.  KVH Community Relations gave me the opportunity to do this.

I heard about this KVH internship opportunity through my boyfriend’s uncle, who works at KVH. He was aware that I was looking for an internship for my last quarter of school and told me that Community Relations was interested in having a student intern. I jumped on the opportunity because it sounded like the perfect fit: something in town, something close by, and an opportunity to use my skills and knowledge in a real-world setting.

Before starting as an intern here, I hadn’t thought much about public relations/advertising in the healthcare industry. Even though I have learned in my studies that public relations is a need across almost all industries, I mainly associated it with companies that market products or food and companies that market specialty services. I was not sure what to expect in terms of projects, content creation, advertising, and other areas. The work I have done has been just the kind of experience I’ve been looking for.

During my two months interning in the Community Relations Department, I have worked on a variety of projects and utilized my skills and knowledge in multiple ways. I have created advertisements, assisted with event coordination/scheduling/promotion, created a newsletter, written web content, and so much more. I have also had the opportunity to work with two women who are experienced professionals. Michele Wurl and Jan Powell have both given me constructive feedback on the work I’ve done, which has helped me learn and grow as a professional. 

The most rewarding part of this internship has not only been seeing the successful finished products that I have created, but also the value of the experience I have gained. I have been able to see my hard work put in motion and produce results. The work I have done for KVH has been rewarding and valuable experience for my career.

Another rewarding part of this internship is the people I’ve met and the acquaintanceships I’ve made. Michele and Jan have both been a pleasure to work with and have supported me throughout my time here. I have also met most everyone on the administrative team and all of them have been friendly and have made me feel at home here.

The skills and professionalism I have gained during my internship are things I will carry with me as I begin my career after college. I am truly grateful for this experience and opportunity to “dip my toes” in the KVH Community Relations pool.

Behind the Scenes: KVH Commissioners

· ·

Libenow Altman

We sat down with KVH Commissioners Matt Altman, President, and Erica Libenow, Secretary, to learn more about the work and role of the five-person board in serving and representing the community.

What is the Board of Commissioners at KVH?

Matt: It’s easy to say what we’re not, right? We are not running the hospital. We don’t hire and fire anybody except the CEO. We task the CEO with running the organization. We form the strategic goals of the organization, and oversee the administration as they accomplish or implement those goals.

Do you have different areas of focus or interest?

Matt: We take on areas based on our interests. Erica’s is community engagement. As a local doc with a small business, Bob Davis has perspective on how the business is run. And with my background in medical ethics and health care policy, I bring that interest to the board. So we each bring a certain expertise, with different perspectives.

Being able to follow your passions must make it more rewarding to serve.

Erica: It does, and the amount of material that we have learned—it’s been an education in and of itself. Just looking back on how far I’ve come is gratifying. It’s been a long process.

Matt: You learn a bunch of stuff, then you figure out that there are five other things you don’t understand, so then you go and learn that stuff. And then each one of those has five other things…

Erica: Rabbit holes in every direction.

You’re both busy individuals, why add board service to your lives? And how do your feel your backgrounds have prepared you to do this work?

Erica: I saw a need for a new perspective on the board. I asked my friends who I thought would be really good at it, but they were all very busy or had other interests they were pursuing. I thought, somebody has to do this. And then I realized that I was somebody! So I put my name in the hat.

You have your own health care background, Erica?

Erica: Not clinical, but I worked in dental and oral surgery for several years in patient relations, billing, and insurance. Now I’m going to nursing school. When I graduate in December, I’ll be looking at emergency care. Making a difference for someone in their time of need is a soul moving experience. 

And you, Matt?

Matt: I teach medical ethics to premed students at Central, and occasionally to med students at Pacific Northwest University of Health Sciences. I have an interest in issues around doctor-patient relationships, healthcare, and various other medical ethics topics. I was on the ethics committee at KVH for six years. I’ve also published a bit on healthcare. But personally, I realize how important the hospital is to the community. Both my kids were born here. I want to support it as best I can. This is my community and I want to invest my time and energy in contributing to the community; this seemed like the best way I could do that, given my background.

What does it mean to you to serve in an elected position?

Erica: I’m constantly listening. I try my hardest to be a voice for all who approach me. It’s about representation and working with my fellow board members to encourage improvement across the organization. We always strive for improvement.

Matt: We have things like Coffee with a Commissioner, where people can come and talk to us about concerns that they have. We try to represent their views as their elected representatives. But we also do what we can to shape the organization, to serve the needs of the community. We do our best to maintain high quality and keep KVH as a strong, independent community hospital.

One of our strategic plan areas is access. And so we’re trying to expand the number of services and access to those different services. We opened the clinics to new patients for the first time in many years. We’ve expanded therapy services. We have dermatology now, and occupational health and wound care. These are all attempts to serve the needs of the community as best we can.

Having all clinics open to accepting new patients is a major, visible accomplishment.

Erica: I’ve heard community members say they’re happy we’re accepting new patients. My perception is that we are approachable as commissioners and people seem to feel at ease talking with us. That’s so important, to remain receptive to people’s thoughts and ideas. It’s important to keep our ears open.

Matt: When we’re talking about fiscal responsibility, there are a couple of different ways to do it. One is to cut back and reduce expenses. But another is to expand services to meet needs and to try to keep people in the community getting quality care here rather than going elsewhere. That’s our approach, and that’s Julie’s (Petersen, CEO) approach – to tap into an untapped market, and try to keep people in the community, getting the high quality healthcare that we can offer.

How does the board help to fulfill the mission of KVH?

Matt: Well, one way is to establish the mission, right? A couple of years ago, we put together a new mission, vision, and values. The four pillars of that mission really encapsulate what the board is interested in. (1) Providing access to the community with new services and access to existing services. (2) Overseeing the financial sustainability of the organization so we can remain independent and focused on the community, as opposed to just an outpost of some larger organization. (3) Collaborating and partnering with all local providers rather than competing with them. Working together to provide the community with what it needs. (4) Engaging with the community, finding out their needs and then serving them as best we can.

Erica: When we did strategic planning and formed the mission, we sought input from the organization and community. People are invested in their ideas, so it just naturally flows that they would uphold a mission they helped create with their input. That’s a lot easier than determining a mission with no outside input and then hoping people will embrace it.

Matt: And each member of the board is tasked with overseeing one piece of that mission. We get together regularly with our partners in the administration who are carrying out the specific tasks that will accomplish those things.

What are the challenges of being a commissioner?

Erica: On a national level, health care is a bit of a swinging pendulum – it can be hard to keep up with the changes. On a local level, we must consider how change affects our organization and what we do as board members, while remaining nimble. It is a real challenge.

Matt: You have to have some decent grasp of finances, but you also have to have a decent grasp of politics and where healthcare policies are going, as well as a decent grasp of good science and what care we should be providing. You need to have some sense of HR and hiring practices, too.

Erica: It’s really highlighted to me how important it is to be a part of a team that you can trust. I’m very grateful that we have expertise in all our departments, people who know what they’re doing and can convey their understandings to the board in a way that makes sense to us.

What are the rewards of being a commissioner?

Matt: You’re actually doing something that has an impact on the community and on people’s lives. Personally, it’s rewarding because I’m learning so much and can bring my academic interest to bear on my work at KVH. What I learn here also informs the work I do on campus with students and other faculty and in my research. But the main reward is in serving people.

Erica: Serving patients, staff, and our community, knowing that the board is a way that they can have their voice heard. That’s why I set out to do this; to put it into action is rewarding.

Matt: It feels really good to work with competent people. If the board has questions, we’ll get those questions answered, clearly, in a timely manner. We know that when things come down from the CEO or the board that the people involved are going to do a good job of carrying those things out. And that amount of trust is really valued by the board.

What does it take to be a commissioner? What advice would you give on that?

Matt: Listen to what people have to say. Be inquisitive, and if you don’t understand something or you don’t agree with something, be ready to ask questions. You don’t want to be overbearing, but you also don’t want to be passive, because we do have a role to play as an elected board. Negotiating that balance can be difficult.

Erica: I agree with Matt.  Also, don’t be afraid to ask about “alphabet soup.” Maybe more than anybody else on the board, I’m like, “What does this acronym mean?” There are acronyms for acronyms! 

That’s something you have in common with many of us.

Erica: You just need to keep an open mind, ready to fill it with information. There’s so much to learn, and I don’t anticipate that that’s ever going to change. Every encounter I have as a commissioner, there’s tons of learning going on. And that’s the way it should be.

How would you like people to remember this board’s accomplishments and your service here?

Erica: As the board that was devoted to serving the community. I hope we are remembered for improving and increasing opportunities and services so people can stay local for care. We have a lot of talent here that people outside of KVH might not be aware of. When I was running for commissioner, there was this concern that KVH was going to be swallowed up by a larger entity. The community was very clear that we should stay independent, and I intend to hold that banner up as long as I serve.

Matt: One of the things that’s been a guiding principle from the beginning is an appreciation of what people do on a day-to-day basis. Those who do the work to give patients the excellent care that they deserve. Nurses and housekeeping and doctors and lab technicians and everybody else – the organization can’t function without them. So, one of the things that I want to accomplish as a board member is to turn the focus back on staff and away from administration, who are also important but already pretty visible in the community.

Erica: Can I cosign that? It’s true. And I feel that deeply – an appreciation for frontline staff and less visible heroes of the organization.

Matt: If we want to talk about strategy, I think the board is going to be remembered for being able to operate in a financially responsible way, and, as Erica said, maintain that community focus and the independence of the hospital in a time of great challenges in health care.

I was just at an American Hospital Association meeting in DC, and there are independent community hospitals all over the country that are closing. It’s incredible. There’s this great pressure to consolidate, to be swallowed up by large organizations, but we’ve hired a CEO with a very good strategy for growth and financial sustainability. We’ve increased the footprint of KVH in the community with some strategic building purchases, and we’ve increased and expanded services. So I think that our big legacy is maintaining independence while growing services in a challenging time.

Not just surviving, but thriving. Right?

Matt: Yes. And if you want to attribute that line to one of us when you write up this interview…

Anything else that you would like to add?

Erica: Just an expression of gratitude for this organization. I feel fortunate that of all the places to serve, this is the board I serve on.

It is a great place to work. Thank you both for your service.

Behind the Scenes: Provider Recruitment

· ·

Mitch

We sat down with KVH Provider Recruiter Mitch Engel to learn more about the process of bringing new providers to the community. 

Okay. So what in the world is provider recruitment?

It’s helping us, as a critical access hospital and rural health clinics, keep up with the demand that the community needs and wants for providers.

There’s a national shortage, specifically of family practice and primary care general providers. So being able to recruit those doctors to the area to supply the demand that this community needs and deserves is what I do. Not just physicians, but also PAs and nurse practitioners. In the last few years we’ve hired over 30 providers across all specialties that we have. The big majority of those are family medicine providers.

Provider recruitment is fun. It’s challenging, especially for specialty positions that just don’t have a lot of docs out there currently looking for jobs. This October will be three years that we started our new applicant tracking tool. Whenever anybody applies to a position, they apply through our applicant tracking system. Whenever I post a position, it posts to a number of job aggregators of which there’s 30 or 40 depending on the specialty.

Our applicants come from a number of different online resources. Word of mouth is incredible. We’ve had a number of people self-refer. We’ve had a number of people email or call and say, “Hey, my friend or my wife or my husband is a provider, I think you should talk to them.” Doors open that way as well. We occasionally will use big national recruitment firms, but not very often.

You’re part of Medical Staff Services.

Dr. Martin, Kyle West, Lisa Potter and myself. When I bring in new providers, Kyle is the one who gets them privileged or credentialed. He and I talk daily. Lisa does pro forma for new service lines and takes new providers out to meet community members, so she needs to be aware of what’s going on with us. Dr. Martin is CMO and my boss; I work with him closely.

I typically make first contact with providers, and then work with them throughout the process. So I stay inside that loop. And I don’t ever exit it entirely. In the other part of my job as provider liaison, I remain a good point of contact for questions, or as a resource, or whatever it may be.

In what ways does your role support KVH’s stated mission?

We had an access problem, but things have gotten much better over the last three years simply because we’ve been successful in provider recruitment. There was a time when none of our clinics were accepting new patients, so community members were going to the ED, or traveling to Yakima, Wenatchee, wherever.

By bringing in more providers, we’ve been able to provide more access to the community and open up a lot of our practices, including starting up new specialties like Dermatology and Workplace Health.

What are the challenges of being a provider recruiter?

Certain positions are increasingly rare in terms of candidates searching for new jobs. Like internal medicine docs, who do a three-year residency and then have the choice to be a general internist and begin practice, or get a subspecialty and double their income.

A lot of internists are subspecializing in cardiology, or endocrinology, or nephrology, or a number of things, and it allows them to make much, much more money. People who exit med school with $300-400,000 in student loans, they want to make more money so they go into something else, right? They go into surgical specialties. So the general internist doc is increasingly rare. Same thing for orthopedics and general surgery. And while the primary care realm is challenging, there seem to be more family medicine docs seeking employment.

We struggle to get people who are interested in living in Ellensburg, because they’d like to live in the greater Seattle area or even Wenatchee or Yakima. But we’re close enough that people can hop on the road and get there pretty quickly. It seems the vast majority of people want to be in downtown Seattle.

When you get interested candidates, Medical Staff Services has a thorough process for vetting providers above and beyond what Human Resources does.

Yeah. Because we need to be certain that the people we’re bringing here are who they say they are, and are going to improve and increase access to patient care.

What are the rewards of your position?

It’s very rewarding work. It’s difficult work. It’s challenging work. When things come together, and you successfully hire somebody who is well liked by their colleagues and coworkers and patients, and we see access open up, it’s super rewarding. Years ago, when I worked at Boys Smith Vision Center, we’d get patients in for surgery pre-ops, and if they couldn’t get in to see their primary care providers quickly enough, we’d have to delay their surgeries. So I’ve seen the other side of things as well.

It’s rewarding to bring new providers in to provide that care that the community needs. (Laughs) I’m a horrible patient. I don’t get seen nearly as often as I should. But I’m very prompt to take my kids to the doctor when they need it. Being able to get them in quickly is nice. And just being able to hear my grandparents and their friends, my parents and their friends, say to me, “Hey, I saw so-and-so, and they were great…,” that’s incredibly rewarding.

What does it take to do this job?

It takes patience. Persistence. Promptness.

Doctors are very well educated, and they know that what they do is in high demand. And so it’s just an interesting group to talk with because they’re very intelligent. They’re very particular.

When someone applies, I need to get back to them within 24-48 hours. Because if people don’t hear back quickly enough, they’ll move on. They’re not normally applying to just one position. And so the people who respond to them first typically go to the top of their list.

The uniqueness of my position is as challenging as it can be overwhelming at times, because I never step away from the process, as that consistent point of contact for our providers. It’s actually nice. I’m not handing them off to somebody else.

While my job isn’t rocket science, and it’s certainly not particularly challenging from a technical standpoint, it is about being willing and available to do the work.

Thank you for what you and your team do to bring quality care to our community.

Behind the Scenes: Volunteer Services

· ·

Gift Shop Volunteers

We sat down with Debby Crull and Carolyn Jennings to learn about gift shop volunteers at KVH Hospital. Both women have an employment history that includes working at west-side grocery chains. One of them was a jail cook. One was encouraged to work here by her son and daughter-in-law, who are both KVH employees. One worked in the hospital kitchen, and now also volunteers with Hospice Friends. You can find out who did what by engaging them in conversation at – where else? – the KVH gift shop. (Photo, L to R: Carolyn and Debby, and their trademark smiles.)

Ladies, you have something besides Safeway in common: clearly, you like to stay busy.

BOTH: Oh yes, definitely.

Tell me about the work that you’re doing in the gift shop.

DEBBY: We wait on customers. We receive order shipments, pre-price them and put them out for sale. We work with the manager [Jonna Hiner]. And wait on the public, and the employees that shop at the gift shop.
 
Do you work different hours when there’s a special sale happening?

DEBBY: We had a Pajama Party night. That was exciting.

CAROLYN: And then we’ve got a Garden Party coming up on May 4th. We’ll be serving tea and shortbread.

Have either of you volunteered in other areas besides the gift shop?

DEBBY: I stock the patient care kitchens and department kitchens on Wednesday afternoons. And I’ve been doing that for almost 12 years. I saw it in the paper, you know, about volunteering here. And then I knew somebody that volunteered here out on the desk. 

Is there anything that you feel people misunderstand about what it’s like to be a volunteer?

CAROLYN: Well, I know I didn’t understand what a volunteer was until I started. While I’ve been here, I’ve watched the courtesy desk folks across the hall from us. They take care of patients really well, and make sure they get whatever help they need. They’re always polite and nice. But I just wanted to learn how to make coffee! (Laughs)

DEBBY: When I retired from the kitchen, I really wanted to go into the gift shop and then do the coffee, also.

What are the challenges of being a volunteer?

DEBBY: If you’re brand new, it can be confusing to learn everything, especially the register.

CAROLYN: Yeah. I’d say about the same thing. I don’t have a computer at home. So learning the automated sales system was challenging. That’s why I went to two days a week, to get more experience. The more I do it, the easier it becomes. Jonna is really helpful to us, and so is Debby, if I have any problems or anything like that. That was one of my concerns and one of my fears, but everyone has been great. You never once made me feel inadequate or incompetent or anything.

CAROLYN: Used to be, I was in the coffee shop and I’d wait on customers when they came. But in the gift shop, I can answer questions. I can help. There’s been some days we talk with customers and they wind up buying out the store. That’s fun.

DEBBY: It’s fun to communicate with them and they come in with stories for us.

CAROLYN: Usually everybody’s real happy to be shopping. That helps.

DEBBY: It’s good to be around people.

CAROLYN: You get all kinds of people shopping here. Some are happy, some aren’t. Some are having troubles, and, you know, we got that thing (HIPAA) where we can’t ask them any questions. Some of them come in, you know, their hearts are broken, they’re hurting. And so you have to judge carefully, so that you don’t ask inappropriate questions, but at the same time you give them the encouragement and the help that they need.

That’s one of the things that makes what you’re doing different than if you were doing it somewhere else. Having it in a healthcare environment, where all these things are going on.

CAROLYN: I think it’s more personal with healthcare. When I worked behind the Safeway counter and dealt with people, you just said “Hi, how are you doing?,” and asked them what they needed, and then they left and went their way. But here, you get more interaction.

CAROLYN: I think the gift shop is very important to the hospital. It gives an opportunity for people to relax, and have that emotional safety. Many times for the folks who come in, there are really serious problems with their families and whatnot. So this way they get a chance to be in this space and focus their minds on something else for a while, if they want to.

Thank you for sharing that because I’ve never heard that before. And that’s a big deal.

What are the rewards of working where you do?

CAROLYN: Oh, we have too much fun. Too much fun. I mean we enjoy the people, we enjoy each other. And working with Karen Schock is great, too. I’ve been with her for 10 years.

DEBBY: It’s a fun little job –

CAROLYN:  – and you go home, relax –

DEBBY: – you’re not stressed out…

I think I’m gonna come volunteer in the gift shop. (Laughter)

So, what does it take to survive a day in the gift shop?

CAROLYN: Well, just enjoy what you’re doing.

DEBBY: You have to be outgoing and friendly and you have to enjoy people.

CAROLYN: And you have to not be afraid to ask them questions.

DEBBY: “Are you looking for anything special?”

CAROLYN: Some days I do really good at that and other days I forget.

As a team, what qualities do you all possess?

CAROLYN: Well, for one thing, we’re patient with one another. I mean, there’s times I get real nervous with the cash register and they’re always kind, and suggest, “Well, let’s do this, and let’s try this.”

So you show each other some grace when you’re struggling.

CAROLYN: Yeah. I guess that’s the word. Grace, and we giggle together a lot. We just have fun. It’s definitely teamwork. We don’t get nervous with each other, we don’t get upset –

DEBBY: We thank each other for everything.

You’re like your own little family.

DEBBY: Yeah. We have our own little family. And by the way, we need more family members. We still have some days that need four-hour volunteers.

Okay. I’ll make sure to include that.

Behind the Scenes: Health Information Management

· ·

We recently sat down with HIM employee Cindy Ness to discuss the history and value of medical records management.

Cindy Ness

Photo: Her coworkers affectionately refer to Cindy as “mother hen,” texting her when they they’re late or not coming in to work. She’s also the only HIM staffer who can keep plants alive, as evidenced by the row of (everyone else’s) plants on her desk.

Okay, let’s talk shop. What is health information management?

First we were Medical Records (MR, or “mister”). Now we’re Health Information Management (HIM).

We’re responsible for coding charts, which are turned over to the insurance companies, then returned to us as revenue. Our coders play a huge role in financial wellness of the organization. And I don’t know if enough people really understand that part of it.

Three techs on our team analyze charts to make sure they’re complete before they get to the coders. If there’s something lacking, like the provider forgets a progress note or didn’t sign something, we apply a deficiency to ensure the provider completes what they need to.

Then we’re able to pass things onto the coders. They can do their job and just code. Back in the day when we had paper charts, the coders would flag all the deficient places and hand wrote the codes. We didn’t have computers. Everything was done on ledgers, on paper. When the hospital got its first fax machine, it was in our department. They wanted a secure location for it, to protect privacy.

And that’s another part of what we do. Privacy. Cynthia Kelly, our department director, is the KVH privacy officer. She investigates potential health information breaches. Plus, she keeps us ducks going down the stream in the right direction.

Release of information. That’s another big thing we do. A patient asks for copies of their record, they fill out a release of information and we provide the copies.

I also do birth certificates. That’s really changed over the years. Before you had this big long form, you put it on a typewriter and typed it out. If you made a mistake, you start over. Now there’s a website where you securely submit the information.

Health information management is multi-layered. There’s a lot to us. We’re small, but we’re mighty.

So things come to you from various areas, departments, clinics, including external clinics?
 
Yes. If they have privileges here, we often process their paperwork, because they don’t have an electronic connection with us, so to speak. External providers can chart here in the hospital electronically, but if they have office notes that come over, we scan those in. Also, any external provider who wants lab or imaging work done and their patient chooses to have it done here, those are paper orders also, so they need to be scanned in. Anything that comes from the nursing home or even from providers from Seattle or Yakima or Spokane, if the patient lives here and their specialist wants specific tests done, we can do them here. Saves the patient from having to go out of town.

Where is HIM in the flow of patient information? You’re the last stop?

Pretty much. We really are.

And you’re housing the information, so it needs to be complete because you are retaining the record?

Right. And, if something happened incorrectly upstream from us, we catch it and then we have to figure out what happened and how to fix it, and hopefully get everybody on board in the same direction.

Now, am I misremembering that you used to do transcription?

You are correct. I used to do transcription. That was what I was hired for originally.

And was that within medical records?

I’ve been in the same department my entire career here. Which is 31 years and two months.

But who’s counting?

Exactly.

Transcription was done with a typewriter and a transcriber and a micro cassette. The providers could use the telephone. There was a series of tapes. One would kick over for recording, it would get four dictations on it and then it booted over to the ready to transcribe side. And so they were able to call from pretty much anywhere, into the dictation system.

Then it progressed to a display typewriter, and then to our first computer. Then we ended up with speech recognition. We’d read along to make sure we caught everything, cleaned it up, made sure it was accurate and everything was spelled correctly, and then that was the final product. So basically we were the gatekeeper, making sure everything was pretty and nice and correct. Then we went to physician documentation, and my role was to create the templates that the doctors used and set them up to gather all the information that was needed to make the record complete for coding and other purposes.

I miss doing transcription. It was always a challenge. I learned something new every day and I enjoyed it very much. And I know the doctors really appreciated the quality of work that we put out. That’s really rewarding, providing a product that’s correct and accurate and readable, and even though we weren’t providing direct patient care, we were that checkpoint to make sure it was accurate.

From your perspective, what are the challenges of health information management?
 
Accurate and adequate documentation. For the coders to do their job, they need to have specific items within a document in order to assess the appropriate level of care that the provider provides. And so if they miss one of those pieces, it lowers the level of care value.

What would you consider the rewards of working in health information management?

I work with an absolutely fabulous team. Everybody is so positive and upbeat. We have a real cohesiveness and it’s fun to go to work. It’s neat to watch my younger teammates grow in their careers. To see people grow and learn new things. Health information management is not static. That’s for sure. It’s ever changing. And it keeps changing.

What qualities does it take to do well in HIM? Is humor important?

Oh, yeah. When we’re reviewing charts, some of these things are pretty sad. And if you don’t have a sense of humor to balance that sadness, you’re going to be in trouble.

I would think attention to detail is important.

Yes! You have to really be on it, and don’t be afraid to ask questions to find out what’s going on.

Working in HIM, seeing all this patient information you have, you have to be a trustworthy group. You have to keep things confidential.

Let’s put it this way. My husband quit asking me, “How was your day at work?” Because I couldn’t tell him.

You were here when HIPAA laws went into effect. Was that a big change in how you did things?

No, because we already worked hard to protect our patients’ privacy. Prior to HIPAA, if you had a friend who was admitted to the hospital, they’d say “Come by and see me.” So, I’ve explained to people, “I’m trying to respect your privacy.” You have to be very careful. I’m not on Facebook anymore, but when I was, I never said anything about anybody that I saw in the hospital. You just can’t. It’s a fine line of working in a healthcare facility and being a member of a community; it can be difficult at times.

Behind the Scenes: Human Resources

· ·

Human Resources

We recently sat down with Jenn Strater and Marlo Willis, the two most veteran members of KVH’s Human Resources team, to learn about the function and flow of HR in a healthcare environment.

What is human resources?

Jenn: In some form or fashion, we are responsible for employees before they walk in the door until they walk out the door. Everything that happens in their life cycle here at KVH, HR touches.

Marlo: HR is employee oversight. Personnel files. Benefits, wages, compensation, policies you’re held accountable for. Retirement documentation. It’s the ultimate record of your time here at KVH.

HR has a lot of moving parts. Do you cross train to cover each other, or how does that work? 

J: It’s unacceptable for somebody to come in and say, “I want X,” and for our answer to be “Sorry, Marlo’s gone.” Nobody responds well to that. So all of us know how to do the basics. We can at least give the person a place to start.

M: People who have been here a long time think, “I have to talk to Marlo.” Well, no, you don’t have to talk to Marlo. Cheyanne can help you.

Kind of like triage?

M: Sure. In a sense that’s what it is. She might be able to help the person right away.

What do you wish people knew about working in HR?

M: We’re not a party planning committee. I think people think HR just plans parties, but there’s a whole professional side of HR.

You have to know a lot in your day-to-day work.

J: And be prepared for anything. You never get the same day twice. You have no idea what’s going to be walking through that door.

M: People come and go. And so you deal with all of it. Employees concerned about leaves and sickness and whether their pay runs out.

J: These are important aspects of a person’s life and career, and HR is woven into that. So we are a place to go, whether things are going well or they’re unraveling.

You’re the safe place for a lot of people, right? Or, when you don’t know where to go, go to HR.

J: Right. Anybody can come into our office, share their joys and frustrations, and know we’re going to treat you the exact same way the next day.

And how do you support each other?

J: Things can feel incredibly overwhelming if you don’t have people that you trust there with you. We allow ourselves those “offstage” moments with each other.

M: I don’t think it’s any secret, Carrie, Jenn and I have worked together for a long time. We have to find people like Cheyanne and Dan and Karen and Babbi, who have been good additions to our team.

J: We’re a balance of strong personalities, people pleasers, doers, and conceptualizers. It’s a good blend.

How did you get into HR, and what’s been your career path at KVH?

M: I was graduating from Central, and my husband loved the police department here. I didn’t have any experience, but I had a management degree. Andy Shock was the OR director. He hired me for an internship in the OR. (Thank you, Andy!)

J: What did you do?

M: I did clerical, nurse scheduling, time cards. Then I worked for the Foundation, Accounting, and Registration. Once they added an FTE to HR, I just fell into it. I was the HR assistant, then I took on payroll and benefits. We were small, with 167 employees. I’ve done everything in HR, benefits, coordinator, backup director… And now I’m at the end of my career. (Laughs)

HR has been a good fit for you.

M: I always felt it was good, because of the variety of roles I had at KVH. I could speak to an FTE situation, or about working the evening shift. I knew what all that meant because I’d lived it.

How did you get into HR, Jenn?

J:  I always knew I’d wind up in business. I don’t like math and I don’t like science.

There’s math in business.

J: Yeah. But the computer does it. I went to school for got my AA, then decided I didn’t like school and went into customer service. It was interesting, but there was no opportunity to grow. I thought, there’s got to be more to this thing called life. So I went back to school. I took a basic HR class, and my professor, James Avey, told us, “You have the ability to change lives.” That got me really excited. I got my degree, then I saw a posting at KVH for an intern to fill in whilst the HR assistant was out on maternity leave. I applied –

And they didn’t get rid of you.

Yeah, it was awesome. I had a lot of fun. Then when that individual decided not to come back after maternity leave, I applied for the full time position and haven’t looked back. I was HR assistant for eight years, and now recruiter for two.

How is HR different in a healthcare environment?

M: HR healthcare is the Cadillac of HR. A lot of companies have one HR person and they do everything but nothing in-depth. In healthcare, we have unions and so much going on, and specialties, we really go deep in our roles. Healthcare is a cool industry to be in and it changes so much. We’re constantly having to keep updated and really connect with other hospitals.

J: And we have a national organization for healthcare human resources. That’s not true for a lot of industries. I would hazard to guess there are more people in a healthcare environment because we don’t have just full time or part time, we’ve got per diem and –

M: We’re a unique environment –

And it’s 24-7-365.

M: It’s kind of fun to be in HR.

J: Yeah, it is. And we’re hiring people that have a direct impact on our community. We’re hiring the people that are going to take care of my grandma.

What are the challenges of human resources?

M: Actually, our main challenge is the same as the other areas of healthcare: the rapid pace of change.

And the rewards?

J: Every day that I get to extend a job offer, that’s a great feeling. You can’t beat it.

M: It says a lot that we have so many employees with longevity. The reward is that we’re a good employer and try to educate managers to support their staff. We have good policies, benefits, pensions. We have all of that. So employees want to stay.

J: KVH has a lot of people like Marlo who started in one area and worked their way to the next stepping stone in their career. That’s the case for all but one of our nursing directors, and many other KVH directors and managers, too.

What I would love about HR is that you meet everyone.

M: Yeah, we get access to everybody.

And it just feels good to know, hey, that person’s here and they’re taken off and they’re doing well.

M: I love that. And if you have a question, come in and ask the question. We’re not scary. It’s okay. Email us. What do you need? What might I be able to answer? At least I can point you in the right direction. You know, it’s nice to be able to answer questions. But it’s also fun to occasionally plan parties. (Laughter)

What do you put in your HR go-bag to survive day at work?

M: A cup of coffee.

J: And patience.

M: I have to remember not to react to anything, and just listen –

J: – and always remember that there’s two sides to every story.

Anything else you want to add?

J: Goodness Gracious. I think we’re awesome, but we couldn’t do it without the entire team.

M: We do a lot, and I think we forget to toot our own horn.

Maybe somebody needs to plan a party for you.

It takes a village. KVH Human Resources Division includes:

Dan, HR Benefits & Wellness Coordinator
Jenn, HR Recruiter
Marlo, HR Business Partner
Cheyanne, HR Division Assistant
Carrie, Director – Human Resources
Karen, Director – Volunteer Services & Cancer Outreach Coordinator
Arla, Staff Development RN
Babbi, Staff Development RN
Lacey, Staff Development RN

Behind the Scenes: Medical Staff Services

· ·

We recently sat down with KVH Medical Staff Coordinator Kyle West to learn more about the work of his department. Also present was Kyle’s predecessor, Mandy Weed, now Executive Assistant for KVH Administration.

What is your role at KVH?

I’m the Medical Staff Coordinator, which reports to Dr. Martin, the Chief Medical Officer. I serve the providers who provide care at KVH.

A lot of what I do involves helping providers apply for privileges to work here. Honestly, the more interesting angle is not what I do – which is a lot of gathering paperwork and data – but why I do it. You want to have providers who are well qualified, who’ve been checked out and are going to provide good care for the patients and the community.

We go through a thorough screening before providers come here, and a rescreening every other year when they come up for reappointment, making sure they’re still a solid provider, well-trained and doing a good job.

Are you part of the provider hiring process?

For KVH positions, candidates talk first with provider recruiter Mitch Engel. They interview, he makes an offer, and they sign a contract before he refers them to Medical Staff. Then I help with the privileging process. HR does the standard HR drug and background check, and I do an additional check of references, past employment, claims history and other hospital affiliations.

You previously worked at Community Health of Central Washington.

I was the Residency Program Coordinator for the rural training site of the Central Washington Family Medicine Residency Program. I would work with Mandy to coordinate orientation for the residents, when they would come in, and make sure that they weren’t doing rotations with the same KVH provider at the same time. I did a lot of other things, too. It was a multifaceted job, just like this one.

What are some of the other things that you do as the MSC?

I help coordinate medical staff department meetings.

Mandy: Which also involves 14 different committees.

(Gasp!) Do you sit through all of those meetings?

I do. And take minutes, and help the meeting leader put together the agenda.

Anything else?

Mandy: Kyle coordinates the medical students that come into the facility, working with the school, with Pam Lutz for current contracts, and with another person who does our insurance credentialing. He funnels all that stuff and sends it off for processing. And he’s the point of contact, as well.

Kyle: Say you’re a patient who goes to a KVH clinic, and you have Premera insurance. KVH wants the provider who sees you to be able to bill Premera. Each insurance company has their own process, so I facilitate getting the information to the companies’ credentialers.

Mandy: Kyle also coordinates provider liability insurance.  He also gets the pleasure of the on-call schedule.

Sounds busy. Do you ever get time off?

(Laughs) I’ve only been here 90 days, so, no. Not yet.

What are the major challenges of medical staff coordination?

There are a lot of demands. It requires being good at prioritizing, and a lot of attention to detail. So far, prioritizing has been the most challenging, when several people are all saying, “this is urgent, I need this now,” and there’s only one of me. I can’t do it all.

How do you keep track of your work?

I’ve got a program to manage provider privileging, and a tracking whiteboard in my office. Mandy has been super helpful in training and helping me prioritize, and gives me feedback when I miss something.

Mandy: So in Washington, providers use a WPA, Washington Practitioner Application, to apply for privileges. It’s 16 pages, sometimes more. All of that information, Kyle then takes and enters into this program, so that he can then send out peer references, hospital affiliations, insurance verifications…

Any other challenges that come to mind?

There’s a lot to learn.

What are the rewards?

It’s a nice team of folks to work with. Everybody’s easy to get along with. It’s a rewarding job, because I feel like I’m making a difference for the community and KVH.

What would you put in a go-to bag to succeed in a typical day on the job?

Mandy: Lots of patience. You’re always going in different directions. You have to be able to shift gears quickly and then get back to what you were doing. It’s very fast-paced. There’s a lot going on.

Kyle: Have a sense of adventure, and don’t be afraid to ask questions!

Behind the Scenes: Information Systems

· ·

Jeffrey Yamada

We recently sat down with KVH Chief Information Officer Jeffrey Yamada to learn more about the function of IT in a healthcare system.

While technology is a part of everyday life, it’s not usually the first thing one thinks of when talking about healthcare. What role does IT play in an organization like ours?

It’s always about the patient, and IT provides the technology and the tools to help patient care.

Just imagine yourself or a family member as a patient in an exam room, where the physician can’t access your records because the computer’s down, or your complete electronic record isn’t available. Our team works to minimize the impact on patients, and guides providers in their use of the systems.

It seems like there’s a wide range of responsibilities covered by KVH Information Systems. 

We have major systems, such as our Cerner Community Works system, that have multiple people working on them. These systems have ongoing changes and maintenance, and with new functionalities comes the question of access, training, and education, which we call change control or change management.

When users let us know their systems aren’t working properly, we manage those incidents through SR (service request) tickets, which feed into the Cerner helpdesk.

There are some 30 additional systems unrelated to Cerner, like HR, payroll, dietary – a mishmash of miscellaneous systems; two of our team members take care of them.

We have maintenance and infrastructure, which covers network and connections across the board, wireless, all the servers in our data centers – which includes the issue of backing up everything in one place in case something happens.

Then there’s IT security, breaches of systems, prevention and protection, and some user education, as well.

How do you stay on top of changes in technology?

Yeah, it goes by pretty fast! Actually, as an industry, healthcare is slow to take on new technology; you can imagine why, when regulatory agencies need to get involved, or there’s a concern that it could impact patients.

What about changes in relation to security?

It’s kind of a catch 22, the way things are currently, because everybody wants their information, and everybody wants it accessible, so how do you do that and still protect everything? Or do you get to the point where you’re so secure that you’re hindering your own people from trying to access information? There has to be a balance.

What are some of the challenges faced by IT?

Number one is user education. Everyone has their own way of using the systems, so guiding people through a standardized workflow is key for avoiding problems that could occur by not following a common process. Not all systems were built from a user standpoint, a lot of them are older systems that have just built upon themselves, so one of the challenges is obviously training and how to train providers and others to use it in the context of their patient care workflow.

There are a number of detailed IT systems – known in the industry as “best of breed” – which take into account the workflow of an individual area, like the emergency department. But what everybody’s going to these days are integrated systems, which connect to the entire enterprise.

The ‘detailed’ systems are more tailored and user-friendly, but the integrated systems allow information sharing, so that patients’ information can be accessed by all of their care providers across the KVH system. It’s definitely a challenge.

What are the rewards of being involved in IT?

We have a great team here, and if you’re focused on the patients, trying to help provide the best patient care you can, knowing that IT plays a big hand, whether the patient is here or even at some other hospital in Seattle, all of their information is available, and it helps the patient through their experience. That’s why we’re all in healthcare at some point.

What’s your background and how did you get here?

I’ve worked in hospitals for 36 years. As a student, I worked at both hospitals in Yakima. After getting my undergrad in Idaho, I went through the medical technology program at Central. It included a year internship in a hospital setting. I worked in the hospital during the day, in addition to classes. Just like other clinical areas, training and education led up to passing the board exams.

I’m originally from Hawaii, so I always said, “Nope, when I’m done, I’m going back, not even a question.” I said that for almost the entire year of my internship, until the lab director at one of the hospitals offered me a job after graduation. I thought, “OK, I’ll grab some experience, I’ll work a year – and then I’ll go back to Hawaii.”

One thing led to another, and I stayed for 36 years in that same hospital.

The lab was highly technical, a lot of electronics, a lot of robotic instruments. I got into that side of it as a systems manager, and implemented two LIS systems (Lab Information Systems). Then there was an opening for an IT director. I thought, “Well, I’m doing it for the lab, I can probably do it for the hospital,” and that was a big leap out of my comfort zone.

Several years later I became the VP CIO at Virginia Mason Memorial. We started with 18 employees, and by the time I left we had around 50 in IT, and some 29 locations. We were considered high tech for a smaller hospital system, and applied to be part of the Top 100 most wired hospitals. So it was a pretty big deal.

Coming here to KVH is kind of fun, because it reminds me of the older days. It’s the family feeling you get with a smaller environment. It’s a different vibe. I like it. So now we’re getting things rolling —

And at some point, it’s back to Hawaii?

(Laughs) Yeah, maybe when I retire.

What would you put in an IT “go bag” for a successful day at work?

Calmness. We have so much equipment, things just happen randomly, and just to be able to be calm and think through things is a great tool. You can go from ‘one thing affecting one patient’ all the way to ‘the entire hospital is down,’ and it’s just like a flick of a switch. You can come in thinking you’re gonna have a great day, and – you just never know. So the goal is to reduce those situations. They’ll still happen, just not as often.

Pack a good sense of humor, keep things light, be able to work as a team, and just be a great communicator.

It’s nothing like you think of a technology person, “I have to have a laptop and my smartphone.” I’m more the opposite. When people who sit next near each other start emailing back and forth, something’s lost by not having face-to-face conversation. In those cases, I say, “Forget the email and talk. Just talk to each other.”

Behind the Scenes: House Supervisors

· ·

Vicky Machorro

We recently sat down with CNO Vicky Machorro to learn more about House Supervisors at KVH Hospital. 

What exactly is a house supervisor?
The main role of a house supervisor is to ensure patients have adequate care coverage by coordinating staffing, while monitoring the flow of patients in and out of the hospital. That also includes managing employee injuries and sick calls, and even managing visitors at times.

During the day shift, the house supervisor works in collaboration with department directors. At night and off-shift/holidays, house supervisors also take on an administrator role.

When we hear a “Code Blue” or “Rapid Response” call overhead, what does that mean for the house supervisor?
The house supervisor is expected to responds to every code called at the hospital. They ensure we’ve got adequate people that can handle the situation. Sometimes they delegate tasks, depending on the code. They also set up staffing for code response, which means at the end of each shift, house supervisors assign staff to respond to codes for the next shift.

What kind of qualifications are needed to be a house supervisor?
You have to be a registered nurse, and stay up to date on certifications including Advanced Cardiovascular Life Support, Pediatric Advanced Life Support, and Basic Life Support. You also have trauma education, and neonatal resuscitation certification. Bottom line, house supervisors are expected to be able to perform to some extent in any clinical area.

What’s challenging about being a house supervisor?
It’s a multifaceted role. Boss, customer, supervisor, mediator – so you have to be able to adjust to all the different hats you may wear. And in that position they take on a large amount of responsibility, which means having broad shoulders when something doesn’t go as expected or people are discontented.

You have to be very diplomatic, you have to listen, you have to allow people to vent – and sometimes that’s all you do is listen, because you don’t have a solution. There are times when you just roll up your sleeves and get to work in uncomfortable situations. It’s part of the job.

What’s rewarding about the position?
Every day is a new day. Nothing is the same two days in a row. There are always new challenges.

What would you pack in a House Supervisor “go bag” to get through the day?
Food. A lot of times house supervisors don’t get lunch if things get busy at mealtime. Keep snacks handy to eat when you’re hungry. And I’m sorry, but sometimes it’s challenging to get to the bathroom during busy times. Or you have your phone on you but you miss calls.

You learn to be prepared and aware to take care of your daily needs as best you can. Because you’re also in a counseling type role, you need good coping skills to manage your own emotions while being there for patients and colleagues throughout the day.

We support each other, like when someone needs time to recover after a tough situation. It’s a little more challenging after hours or on weekends, but there are resources and we do back each other up.

Is it true that one of your crew also enjoys decking out the office for holidays?
Yes – and that’s great for our morale! Valentine’s Day is coming, so I’m sure we’ll see those decorations in the next week or so.

What’s it like, being the house supervisors’ supervisor?
Oh, wow. They’re a great bunch. This group has been consistent for quite some time. We haven’t had a lot of new people, so that’s good. They love what they do, they enjoy it, they’re professional, they’re very competent. And they know when to call to me about something – that’s so reassuring to me.

Did you ever do work as a house supervisor?
Yes, I did it for four years! It was my most favorite job, because you had your finger in everything. You got to know the staff. And every day is a new day.

Behind the Scenes: CEO

· ·

Julie Petersen

We recently sat down with CEO Julie Petersen to learn more about her leadership role at KVH.

You’re the CEO. What does that mean?
My title is Chief Executive Officer, but I think of myself as an administrator. Because we’re a public hospital district, I’m also the superintendent, which implies responsibility for public resources. I administer operations and strategy for the district.

What was your career trajectory?
I consider myself an “accidental” CEO. I’m a certified public accountant. I came up through Finance. I was a controller for 15 years, and then a CFO. My skill set is in reimbursement and understanding the financials of the healthcare delivery system, so the transition to CEO came with a lot of surprises. 
What I learned in that transition is how to listen, how to be present.

And now that you’re in the CEO role?
I consider it my job to have a 360-degree perspective. I’m a community member. I’m also directly responsible to the Board. I have relationships with the Board, the senior leadership team, the physicians. I learn about their concerns, their pressure points. I learn why people come to work, and what keeps them awake nights. Whether it’s department directors talking about how to motivate their teams or share patient satisfaction information, or it’s physicians trying to balance their responsibilities to the patients and their responsibilities to their own families – I am privileged to be a part of those conversations.

When the organization comes to a decision point, I can put the people together that have like interests or are going to impact one another. People want to do what’s best for their patients and their department. And so I ask, “How does that decision fit into what the rest of the organization is doing?”, or “Who else needs to hear about this?”

What was your best real-world preparation for this role?
My mother was one of the most positive people in the world. It had an impact on me. One of the disciplines that I strive to bring every day, is to go into every conversation, every situation, assuming that people are coming from a good place, that they’re trying to do the right thing. It’s about listening to learn. People have a true and valid perspective they’re sharing. And I learned that from my mother.

What’s the hardest part of being CEO?
Being candid can be tough. We put a lot of stock in transparency, and that means that even when people would prefer the platitude, you still have to say, “No, this really is a hard job. It really is hard to make a margin in rural healthcare. I am talking about finance a lot. We do talk about patient safety all the time. We do have to follow policies and procedures.”

Sometimes it’s easier to be agreeable, but in reality, we’ll never be able to choose between high-quality care and cost efficiency. You don’t get to choose. You get to do both. People want to be told, “It will be okay.” And it will be – because we’re going to work really hard to make it okay.

What’s the funnest part of being CEO?
That’s easy. I get to buzz around the organization and talk to anybody I want to. I get to go into the lab and talk to the lab about what’s going on. I get to go down to the emergency department. I always feel welcome where I go.

Most people don’t get that experience of being able to say “What’s going on back here? What are your priorities? What happens when you’re busy? What happens when you’re not busy? What do you need most?” Being able to do that, and having people share what’s going on, or when I’m the person that gets to say to a patient, “Can I help you find what you’re looking for?” – that to me is a great day.

What’s most meaningful to you about being CEO?
I truly believe in community healthcare. When you look at a strong, local community, you can feel energy around the schools, the arts, the neighborhoods, and downtown. The community with a community hospital has an extra element that makes them whole.

The great thing about community healthcare is that you become whatever your community needs. For some community delivery systems, it’s more long term care and primary care. For us, it’s a pretty broad spectrum. That’s the glorious thing about community healthcare: it’s not just about healthcare, it’s also very much about the community.

What do you hope to accomplish as KVH CEO?
Every person who’s had this job has built on the work of the person that came before them. And all of them have built towards the future, so you have to thank everyone who’s ever held this job. When I came to KVH, I looked around and realized that I was seeing problems that the industry is delivering to all hospitals right now. This was familiar territory. I was ready to start fixing the problems.

I’d like to see KVH advance down the path of our strategic plan. That means providing more access, and more engagement with the community. I want this community to be aware of the relationships we have with larger systems. We remain independent, but we get bench strength and get clinical strength from our deliberate relationships with other organizations.

What would you pack into a CEO “go bag” to get through the day? 
I would take a name tag so people knew who I was. I’d also pack a coat so I’d be sure to hit the clinics and go outside the building to touch base with other people, rather than waiting in my office for them to come to me to talk, which can take a lot of courage for some people.

I’m not someone who carries my phone with me everywhere. I don’t even carry a pad and pencil. Being single-mindedly present with whoever you’re talking with is something we’re not very good at, and it’s really rewarding.

Anything else you’d like to add?
Every community hospital is unique, but when I look at the elements in Ellensburg, it’s all there: the hospital, a strong school system, a state university, the flow of I-90, and the presence of county and city government. We are an incredibly dynamic healthcare delivery system. It’s a dynamic community. And it’s a pretty darn special place to work as a CEO.