Arkansas Hospitals, Spring 2022

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No matter how many beds you oversee, we make sure you sleep well in your own.

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STEPPING UP FEATURES

12 Reducing Workplace Violence 19 Arkansas Hospice at 30 46 Advancing Health

SPECIAL SECTION: LOOK FOR THE HELPERS

29 Hospital Engineers 31 Health Care Communicators 33 Auxiliary Volunteers 36 Nurse Leaders 38 Hospital Trustees

IN EVERY ISSUE

5 President’s Message 7 Editor’s Letter 8 Hospital Newsmakers 10 Event Calendar 25 Coach’s Playbook 40 Leadership Profile: Steven Webb 50 Where We Stand

ARKANSAS

HOSPITALS Arkansas Hospitals is published by The Arkansas Hospital Association

419 Natural Resources Drive | Little Rock, AR 72205 To advertise, please contact Brooke Wallace magazine@arkhospitals.org Ashley Warren, Editor in Chief Nancy Robertson, Senior Editor & Contributing Writer Katie Hassell, Graphic Designer Roland R. Gladden, Advertising Traffic Manager

BOARD OF DIRECTORS

Ron Peterson, Mountain Home / Chairman Larry Shackelford, Fayetteville / Chairman-Elect Peggy Abbott, Camden / Treasurer Chris Barber, Jonesboro / Past-Chairman Ryan Gehrig, Fort Smith / Director, At-Large Greg Crain, Little Rock Barry Davis, Paragould Carol Evans, Harrison Phil Gilmore, Crossett Vince Leist, Harrison James Magee, Piggott Johnny McJunkins, Nashville Gary Paxson, Batesville Jay Quebedeaux, Mena Brian Thomas, Pine Bluff Steven Webb, Searcy Debra Wright, Nashville

EXECUTIVE TEAM

Robert “Bo” Ryall / President and CEO Jodiane Tritt / Executive Vice President Tina Creel / President of AHA Services, Inc. Pam Brown / Vice President of Quality and Patient Safety Lyndsey Dumas / Vice President of Education Debbie Love / CFO Melanie Thomasson / Vice President of Financial Policy and Data Analytics

Spring 2022

DISTRIBUTION: Arkansas Hospitals is distributed quarterly to hospital executives, managers and trustees throughout the United States; to physicians, state legislators, the congressional delegation, and other friends of the hospitals of Arkansas. Arkansas Hospitals is produced quarterly by Central Arkansas Media. Periodicals postage paid at Little Rock, AR and additional mailing offices. The contents of Arkansas Hospitals are copyrighted, and material contained herein may not be copied or reproduced in any manner without the written permission of the Arkansas Hospital Association.

Articles in Arkansas Hospitals should not be considered specific advice, as individual circumstances vary. Products and services advertised in the magazine are not necessarily endorsed by the Arkansas Hospital Association. To advertise, email magazine@arkhospitals.org.

ARKANSAS HOSPITALS | SPRING 2022 3

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PRESIDENT’S MESSAGE

Standing Together H

istory will note many things about the COVID-19 pandemic, and most of them will not be positives. But I’ve been thinking lately about the interconnectedness the pandemic is creating and the positive changes that means for health care in Arkansas.

Before COVID, there was collaboration among hospitals. We all had the same mission of caring for our fellow Arkansans. We all focused on staying solvent. We all worked hard at being strong backbones for our communities.

COVID added to this collaboration, and it helped us build true camaraderie.

Something happens when we go through emotional challenges together.

We have shared with one another – equipment, ideas, resources, best practices, a shoulder during the worst times, big smiles during the best.

Part of this sharing occurs within the formal and informal groups affiliated with the AHA. Dedicated to the many, varied professions doing their work within our hospitals’ walls, these groups serve hospital engineers,

nurses, auxiliaries, trustees, and public relations professionals, among others.

In this issue of Arkansas Hospitals, we bring you their COVID stories. Their examples of interconnectedness are both interesting and remarkable… remarkable, because when all around them COVID was causing the world to fall apart, these groups dug in and created solutions to keep our hospitals functional.

Something else hospitals share during COVID is, unfortunately, a rise in workplace violence. We can identify the “whys” of this – and we know we must find answers to stop it. The AHA has a new collaborative forming on workplace violence, and in this magazine Michigan Medicine expert Brian Uridge shares

resources for addressing and curbing this problem.

I’d like to congratulate Arkansas Hospice on its 30th year of caring. We’re glad to highlight their achievements, and we’d like to shine the spotlight on some new ideas they have for helping hospitals reduce readmissions and length of stay. Once again, I’m reminded of the interconnectedness of our health care partners. We are so fortunate to have this organization serving families in Arkansas.

I can’t miss another opportunity to thank every single worker in our health care systems for your dedication during this horrendous pandemic. I know you’re bruised and battered. COVID is a trial like nothing else we’ve faced.

But, finally, hospitalization numbers are coming down. Maybe we can breathe. Maybe we can rest.

Whatever comes next, we’ve grown closer and stronger. We’re connected in ways we never dreamed possible. As we head into a new Spring, we know that we’ll face whatever comes – together.

Bo Ryall

President and CEO Arkansas Hospital Association

ARKANSAS HOSPITALS | SPRING 2022 5

6 SPRING 2022 | ARKANSAS HOSPITALS

EDITOR’S LETTER

Safe Spaces W

hat do you think of when you hear the words “hospital safety?” Does safe patient care spring to mind? A safe environment? Keeping patients and hospital workers safe is a top priority for all Arkansas hospitals. This includes safety of care for our patients, certainly, and providing a safe work environment for care professionals.

But it also means providing a trusted and secure environment, something that is becoming a more crucial issue in health care every year. When I asked a friend of mine what he thought of the rise in health care workplace violence, he looked confused and was aghast when I told him that nurses, physicians, and others caring for patients are increasingly pushed, slugged, yelled at, spat upon, threatened, even stalked.

Agressive behavior toward hospital staff, though not new, has risen significantly as the pandemic has progressed. Has the stress of the pandemic had such a profound impact on some people's judgment and selfcontrol? Surely threats and physical aggression against health care workers are behaviors that we, as a society, are unwilling to accept.

This is a growing problem – one AHA is committed to helping hospitals alleviate. This year, AHA’s education team has heightened its focus on workplace violence by offering dynamic education and training sessions from security experts. A new collaborative workgroup that gives hospital leaders

a venue for idea sharing and problem solving on workplace violence is also forming. Security expert Brian Uridge’s article in this issue offers an overview of the current crisis of violence in hospitals, and he provides a realistic framework for equipping all facilities with the strategies and tools they need to be prepared, confident, and responsive in the face of danger.

Right now, the number of COVID cases is falling, and for that we are grateful. Arkansas is finally seeing a reduction in hospitalizations; perhaps as tensions ease the dangers to health care workers’ safety will decrease. In the meantime, it’s good to remember just how many people are involved in keeping our hospitals running every day, both at the frontlines and the many people behind the scenes involved in caring for people at their most vulnerable.

At AHA, we have the pleasure of working with hospital employees in a wide variety of roles, so we never forget how rich and complex the “ecosystem” of a hospital is. The smooth operation of all the moving parts makes every individual’s service essential to the whole. In a special section in this issue, we meet some of those individuals and we see the hospital from each of their perspectives. We also hear from them how they have been part of the hospital’s response to the COVID-19 pandemic.

AHA and its dedicated COVID-19 workgroup, which we’ve called the ArkPrepare team, continues to help our hospitals respond to the multiple policy and governmental regulation questions that arise as the pandemic progresses. The ArkPrepare team just reached the two year mark of our work. Like the many moving parts of a hospital in miniature, each member of the team streamlines and condenses information relevant to one particular piece of the COVID response puzzle.

Together, we have committed to providing our members with top-level, need-to-know information on regular calls and in email communications.

For more than two years, many of us have reminded one another to "Stay Safe" when we end our conversations or Zoom calls. Staying safe – keeping our hospitals safe – is what AHA is all about. We hope the information in this issue of Arkansas Hospitals is helpful as we, together, keep fighting COVID and whatever new challenges lie ahead.

Ashley Warren Editor in Chief

ARKANSAS HOSPITALS | SPRING 2022 7

HOSPITAL NEWSMAKERS Three AHA member hospitals are ranked among the Top 100 Rural Hospitals in America, according to The Chartis Center for Rural Health. Receiving the honor are Ouachita County Medical Center (Camden), Baxter Regional Medical Center (Mountain Home), and Baptist Health-Stuttgart. Rural hospital performance is assessed on 36 indicators in eight major areas: Inpatient Market Share, Outpatient Market Share, Quality, Outcomes, Patient Perspective, Cost, Charge, and Finance.

Juli McWhorter, MSN, BSN, RN, is the new CEO at Willow Creek Women’s Hospital and the Northwest Health Physicians’ Specialty Hospital, both part of the Northwest Health system. She has been with Northwest Health for more than 30 years, most recently serving as Willow Creek’s Chief Operating Offer and Chief Nursing Officer. She earned both her bachelor’s and master’s degrees in Nursing from Western Governors University.

Arkansas Children’s is the recipient of a $2.25 million, four-year commitment from the Windgate Foundation to help support the health care system’s nursing recruitment and retention efforts. This gift will help fund recruitment of talented nursing staff and provide valuable career and educational opportunities to retain the system’s current nursing staff.

The Arkansas Hospice Foundation presents Party at the Plaza, a community-oriented celebration of food, art, music, and family fun Saturday, April 23, at the Argenta Arts District and Argenta Plaza on Main Street in North Little Rock. The event will run from 2:00 p.m. to 10:30 p.m., and admission is free.

Concerts, awards ceremonies, and contests, including the Pawty at the Plaza Dogtown Dog Costume Contest, will be part of the fun. All proceeds benefit the mission of Arkansas Hospice.

CHI St. Vincent Hot Springs has earned The Joint Commission’s Gold Seal of Approval® and certification as both an Advanced Primary Stroke Center and a Primary Heart Attack Center. Certification required an unannounced onsite review during which reviewers evaluated compliance with related certification standards, conducted interviews, and documented onsite observations.

Conway Regional Health System is one of only 10 U.S. health care organizations to earn a 2021 Press Ganey Pinnacle of Excellence Award for Physician Engagement.

The award recognizes organizations that achieve and maintain consistently high levels of excellence in physician engagement for at least three years.

Jose Echavarria, MHA, has been named CEO of Northwest Medical Center Springdale after holding the position on an interim basis since October. Echavarria was previously the hospital's Assistant CEO for the Northwest Health market, where he focused on strategic initiatives to advance the health system. He also served as Administrator of St. Joseph Medical Center in the Houston, Texas area. Echavarria holds a Master of Health Administration degree from Trinity University and a Bachelor of Science degree in Psychology earned at Texas A&M University.

The Arkansas Rural Health Partnership (ARHP) will have new leadership as of May 1, 2022. Rex Jones, currently the CEO of Magnolia Regional Medical Center, will leave that position April 24 to accept the position of ARHP CEO. He will succeed Mellie Bridewell, who will continue to serve the nonprofit as President. ARHP will continue its partnership with the University of Arkansas for Medical Sciences, and as ARHP’s CEO, Jones will work with the UAMS strategy team on initiatives and collaborations focused on improving health care access and delivery in rural Arkansas.

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David Mantz, MBA, was named CEO of Dallas County Medical Center in January. Mantz previously served as COO at Mainline Health Systems; he was also the former CEO at Chicot Memorial Medical Center. Mantz earned his Master of Business Administration/Healthcare Administration at Columbia Southern.

Jefferson Regional and Kindred Rehabilitation Services recently announced their new joint venture, a 76-bed hospital that will be located in White Hall. The facility will combine a 40-bed inpatient rehabilitation site with an additional 36-bed behavioral health unit. The hospital is set for completion in 2024.

A preliminary drawing of the new inpatient rehabilitation and behavioral health hospital that Jefferson Regional and Kindred Healthcare are planning to build in White Hall.

Brian Cherry, MHA, is the new CEO at CHI St. Vincent Sherwood Rehabilitation Hospital. He most recently served as vice president of operations at Calvert Health in Prince Frederick, Maryland, and prior to that served as Assistant Vice President of Patient Services and other positions at Baptist Health headquartered in Little Rock. He earned his Master of Health Administration degree at UAMS, and his Bachelor of Science in Business Administration from the University of Arkansas.

AHA DIAMOND AWARDS: CALL FOR ENTRIES Entries are now being accepted for the 2022 A r k a n s a s Hospital Association (AHA) Diamond Awards, honoring excellence in health care marketing. The annual Diamond Awards are co-sponsored by the AHA and the Arkansas Society for Healthcare Marketing and Public Relations. This year’s recipients will receive their awards during the November 10, 2022, Awards Luncheon at the Hot Springs Convention Center.

The 2022 Diamond Awards recognize excellence and encourage improvement in the quality, effectiveness, and impact of health care marketing and public relations in the state of Arkansas.

Awards will be presented in several categories, including advertising, annual report, foundation, publications, and writing. Diamond Awards’ divisions include hospitals with 0-25 beds (CAHs), 26-99 beds, 100-249 beds, and 250 or more beds. Emphasis will be placed on the budget for each entry within each division.

Nominations and entries, accompanied by appropriate documentation, must arrive at AHA headquarters no later than July 8, 2022, by 4:00 p.m. A discounted entry fee is available for those who submit their entries by the early bird deadline of May 20, 2022.

A brochure providing details of the awards competition was distributed to hospital CEOs and marketing and public relations directors. The brochure can also be found on the AHA website (arkhospitals.org).

Join us June15-17

In Person for the Arkansas Hospital Education and Research Trust Hospital Executive Leadership Conference Plan now to join us June 15-17 for the AHERT in-person Hospital Executive Leadership Conference, to be held at the Embassy Suites NWA in Rogers, Arkansas. Registration information for the event will be mailed soon. Check AHA’s website, arkhospitals.org, for details.

Family Friendly Activities Include: • Indoor Driving from Hitting Bays at Top Golf • Networking Receptions • A Night at the Ball Park with the Arkansas Naturals

Learn from Experts, Including:

Speakers include:

Thom Mayer, MD, Medical Director for the NFL Players Association, will discuss Health Care Leadership from his view at the front lines and the NFL. Tania Glenn, PsyD, will lead a workshop on Resilience through Chaos, and she will help us define and learn how to build personal resilience toward living the best life possible.

Thom Mayer, MD

Phil Gwoke, Strategist, will discuss the intricacies of recruiting and retaining Millennial employees.

ACHE Workshop, 3 Face-to-Face Credit Hours

Mitchell Kusy, PhD, Organizational Development Scholar, will present Top Strategies to Erode Toxic Behavior and Build Teams of Everyday Civility in Healthcare. Toxic behaviors in the health care workplace can affect not only team effectiveness, but also patient safety and critical decision-making.

Learn how to stop toxic behaviors in the workplace and earn ACHE credits.

Tania Glenn, PsyD

Phil Gwoke

Mitchell Kusy, PhD ARKANSAS HOSPITALS | SPRING 2022 9

2022 Spring Calendar

SAVE THE DATE

AHA Annual Meeting November 9-10 | Hot Springs Convention Center

APRIL

April 13-14

2022 Emergency Preparedness Forum Holiday Inn Airport Conference Center, Little Rock In-Person Event

April 19

340B Quarterly Meeting Virtual Event

April 20-22

Arkansas Association for Healthcare Engineering (AAHE) 55th Annual Meeting and Trade Show Embassy Suites by Hilton Hot Springs Hotel & Spa, and Hot Springs Convention Center In-Person Event

April 22

Arkansas Association for Medical Staff Services (ArkAMSS) 2022 Virtual Spring Conference 8:00 a.m. – 12:00 noon Virtual Event

April 28

Workplace Violence Collaborative Virtual Event 10 SPRING 2022 | ARKANSAS HOSPITALS

MAY

May 5-6

Society for Arkansas Healthcare Purchasing and Materials Management (SAHPMM) 2022 Annual Meeting and Trade Show Embassy Suites by Hilton Hot Springs Hotel & Spa In-Person Event

May 11, 17, 25

EMTALA 2022: Problematic Areas All Sessions 10:00 a.m. – 12:00 noon May 11 | Session 1: EMTALA Basics May 17 | Session 2: EMTALA Issues May 25 | Session 3: Physician Involvement with EMTALA Webinar Series

May 17

Governance Ethics in Health Care Organizations 12:00 noon – 1:00 p.m.

Webinar

May 26

Workplace Violence Collaborative Virtual Event

JUNE

June 2

Arkansas Hospital Association Workers’ Compensation Self-Insured Trust (AHAWCSIT) Board Meeting Virtual Event

June 9

The Human Factor in Emergency Management 9:30 a.m. – 10:45 a.m.

Virtual Event

June 15-17

AHERT Executive Leadership Conference Embassy Suites Northwest Arkansas – Hotel, Spa, & Convention Center, Rogers In-Person Event

June 23

Workplace Violence Collaborative Virtual Event

Register for AHA Events Online!

Employees of AHA member hospitals can now log in to www.arkhospitals.org and register for events online.

Leaders in Medical Education New York Institute of Technology College of Osteopathic Medicine (NYITCOM) at Arkansas State University is committed to training talented physicians who aspire to become servant leaders that positively impact their communities.

Contact us to learn more about the two degree programs offered on our Jonesboro campus: Doctor of Osteopathic Medicine (D.O.) Master of Science, Biomedical Sciences

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ARKANSAS HOSPITALS | SPRING 2022 11

Learning to de-escalate potential violence to health care workers in health care settings is part of this training session at Michigan Medicine. Also part of the team is K-9.

Reduce Workplace Violence with These Three T's

By Brian Uridge

H

ere’s an eye-popping factoid: According to the Bureau of Labor Statistics, health care workers are five times more likely to suffer an intentionally inflicted injury at work than are workers in any other field.

Pre-pandemic statistics, shown for 2011-2018 in Chart 1, below, indicate that workplace violence is growing at an alarming rate. But over the past two years we know that intentionally inflicted injuries – many delivered by those infected with the COVID virus or their family members – are on an even steeper rise.

WHAT IS WORKPLACE VIOLENCE?

Health care professionals, particularly nurses and nurse aides, report an increase in cases of being pushed, punched, spat upon, yelled at, threatened with bodily harm (including shooting), and being stalked (when leaving the hospital) since the pandemic began.

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Some COVID-related incidents occur because, in the quest to keep case transmissions down, family members not allowed to accompany loved ones into the hospital become angry and abusive. Some occur because patients refuse to believe they have a diagnosis of COVID. And some occur when a patient’s “preferred” treatment – hydrochloroquine, ivermectin, herbal concoctions, and other non-authorized treatments touted on the internet – are not acknowledged and administered.

In Missouri, nurses and other staff at Cox Medical Center in Branson are experiencing such a surge in assaults from patients that they now have panic buttons installed on their badges. If a staff member is in danger and the panic button is pushed, security is alerted, and a tracking system pinpoints the staff member’s location. Help is immediately sent.

Between 2019 and 2020, assaults by patients tripled at the Branson hospital. In 2020, 123 attacks against hospital staff were reported – up from 40 in 2019. Injuries related to the assaults jumped from 17 to 78 during the same period.

Similar reports of rising assaults are reported from many regions of the country. Actual data, however, are difficult to discern as studies show that only 30% of nurses and 26% of physicians who are assaulted will officially report the assault. This underreporting indicates that violence in the health care field is even more prevalent than statistics show.

To effectively address workplace violence and foster a culture of security in health care, we need to change existing culture and our understanding of what it means to keep an organization “safe.”

Outside our hospital walls, communities rely upon relationships of trust to build effective cultures of security.

Neighborhood leaders, families, police officers, and firefighters, all work together and build trust as security for the community – and each neighborhood – is defined.

As we consider the culture of security in the health care setting, it’s helpful to look at each health care organization as a community, with each floor, department, or clinic within a health care organization as a neighborhood. As in our outside communities, effective security in our hospital workplaces depends on relationships built between members of each “neighborhood.”

Nurses, aides, physicians, therapists, environmental care staff, patients, families … each are members of the neighborhood and every person wants to feel safe.

Using non-traditional measures focused on reducing risk and anxiety will help our hospitals in their quest to ramp up their security cultures while ramping down incidents of workplace violence.

The increase in workplace violence incidents affecting health care workers was already on the rise 2011-2018. Incidents attributed to patients with COVID or their family members increased even more 2020-2021.

THE THREE T's

Actively building and improving your hospital’s security culture involves addressing the three T's of security: trust, training, and technology.

TRUST

Building trust in your health care security teams means focusing first on relationships.

I work as Director of Michigan Medicine Security at the University of Michigan, where we ask our security officers to do two unusual things every day: Make a non-traditional contact with both 1) a patient and 2) an employee they have never met, and engage each of these people in a three-minute conversation. There is no assigned topic of conversation; these conversations can be about anything.

The goal is to reduce people’s anxiety around security staff, to build trust, and to help create a feeling of assurance.

Studies tell us that “assurance” is our

patients’ number one need; we know that feeling safe and assured around hospital security staff is also important for every hospital worker.

We also ask that each week our officers create an unexpected, exceptional experience for a patient or staff member. For example, instead of simply offering verbal directions, an officer may walk the person to their destination and engage them in conversation along the way. It’s amazing how meaningful and reassuring these small gestures can be. Below, I share a letter from a patient who was deeply grateful that an officer walked them to their destination and spoke with them the entire time. These interactions make a marked difference in levels of trust. Remember, 75% of all patients make their health care decisions based on a recommendation from a friend or family member. While improving your security culture, you might also be improving future HCAHP scores.

ARKANSAS HOSPITALS | SPRING 2022 13

TRAINING

When assessing how best to prevent workplace violence, the word “de-escalation” is always a top consideration.

De-escalation is one of your most important security tools.

Training your staff – at all levels – by creating scenario-based training programs for high-risk areas is critical. At Michigan Medicine, we use a variety of training programs to help us reduce workplace violence. Each of these programs is based upon open-source training modules that combine tactics used in health care, law enforcement, and the military. Each of our programs (outlined below) has been developed, designed, and delivered by clinical nurse educators, security staff, and law enforcement professionals. Each augments traditional security training and supports de-escalation. You can research similar programs and choose those that seem most appropriate for your staff culture and desired outcomes. I’m sharing some of our most useful programs here, for your consideration.

When security officers go out of their way to help patients, families, and hospital workers, their kindness begets goodwill and raises the trust level for everyone.

People training for the REACT program, designed to help health care workers who see and care for patients in their homes, receive both classroom training and on-location training.

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REACT

Rapid Environmental Assessment Control Training (REACT) is a first-of-its-kind, in-home health care situational awareness training for professionals delivering care in people’s homes. It’s a four-hour training that combines classroom learning with virtual and real-life, scenario-based training that includes role-playing in actual home environments.

During the classroom portion of the training, participants learn about different safety mindsets, scanning the environment for potential threats, and the importance of things like eye contact and body language. Employees learn to assess their surroundings and identify immediate and potential concerns.

When designing this program, each of our Michigan Medicine security officers was required to do a ride-along with a home health care worker to understand what they face every day. After this step was completed, nurse educators and security officers developed scenario-based training that includes situations an in-home caregiver might face, such as incidents of domestic violence, the threatening use of weapons in homes, and how to respond to critical incidents like encountering illegal drugs lying out in the open. We teach what to look for when exiting a car or entering a room – how to scan your environment and look for anomalies. In addition, a separate module focuses on vehicle awareness and preparedness. We want to be sure all employees, especially those who are going into unfamiliar environments, are armed with knowledge and experience that will help them stay safe.

We are glad to share the REACT program with other hospitals at no charge.

An email from one of the nurses who attended the REACT training says: “OMG, this will help me so much. This was priceless … I am so grateful!"

MILO

Multiple Interactive Learning Objectives (MILO) was originally developed for training military and law enforcement personnel. MILO creates a feeling of reality by surrounding the learner with 300 degrees of multimedia screens, essentially mimicking a real-life situation where the learner is at the center of the action. Skills taught through reallife scenarios include verbal de-escalation, good judgment, recognizing implicit bias, dealing with an active shooter, and other skills. Through established partnerships with local law enforcement agencies, this training tool is free and has now become standard training for ED nurses, security officers, and guest services staff at Michigan Medicine. When you present this training at your hospital, your MILO training coordinator can change the intensity and outcome of each scenario based on the learner’s response and verbal skills.

One of our security staff had just gone through the MILO training for the first time, and within two days she was faced with a person screaming at her in the ED. When our security video of the incident was reviewed, we saw that the officer had done an exceptional job in maintaining a reactionary gap and de-escalating the situation.

SAPS

Situational Awareness and Personal Safety (SAPS) is a program that teaches staff how to stay safe before, during, and after work. Using methods derived from law enforcement programs and the military’s Combat Hunters Course, staff members are taught to remain aware of their surroundings at all times. They learn to identify a baseline, look for anomalies, detect potential threats, and avoid any threats that present themselves. These training materials are available in a wide variety of scenarios and can be

We want to be sure all employees ... are armed with knowledge and experience that will help them stay safe. found free-of-charge from open-source materials. You can find training videos that teach how to react when a patient becomes agitated, how to de-escalate a potentially violent encounter, and how to stay safe when entering or exiting the hospital and moving through the parking lot. For example, if you do a YouTube search using the full title of the program – Situational Awareness and Personal Safety – you will find multiple training tools to review and utilize. Remember, an engaged workforce that is trained to spot and react to threatening behavior provides the best defense while preventing incidents and minimizing risk.

Curb Workplace Violence in Your Facility The TEAM® program offered by HSS is designed for health care workers who may encounter angry, disruptive, or potentially dangerous individuals. Unlike generic programs, TEAM® is focused exclusively on situations health care workers, including medical, clinical, and professional support staff, are likely to encounter. TEAM® is fully compliant with The Joint Commission, CMS, OSHA, DNV (NIAHO), and NIOSH guidelines.

HSS can train staff to recognize the signs of potential violence. Properly training your staff to recognize, understand, react to, and manage aggressive

behavior provides a safer, more productive environment for both health care staff and patients.

Hospital employees are routinely exposed to volatile patients and visitors. This dynamic environment and its potential for violent disruptions have health care leaders searching for answers.

AHA’s endorsed vendor, HSS, can help with its TEAM® program.

As an AHA member hospital, you will receive preferred rates and exceptional customer service.

ARKANSAS HOSPITALS | SPRING 2022 15

SAVE

Situational Awareness for Violent Events is an active shooter program that focuses on pre-incident indicators and behaviors that most often precede an active shooter incident.

SAVE also provides training on what actions to take during these traumatic, though rare, events.

Statistically, active shooters account for less than 1% of all homicides in the United States, however this is one of the most sought-after trainings requested in the health care field.

Active shooter incidents anywhere cause anxiety among citizens and workers everywhere. In a study of active shooters in school-related settings, the FBI completed a 20year study finding that in every case, the attackers exhibited concerning behaviors prior to the incident itself.

In fact, they showed an average of three planning behaviors, pre-

incident. Learning to identify these behaviors before an incident occurs can save lives. When looking for SAVE programs, you might also consider searching for TED talks devoted to surviving active shooter incidents.

TECHNOLOGY

Successful security planning can focus on those technologies that reduce risk and anxiety. Security cameras and closedcircuit video monitoring are popular forms of technology employed in the safety field. Necessary to their successful use is the concurrent employment of trained staff who monitor them, people taught to recognize, identify, and alert security officers when someone exhibits rapid changes in behavior and/ or movements which are above the baseline for that area.

Magnetometers, although only used by 12% of hospitals, are an oftenrequested technological addition.

STOP WORKPLACE VIOLENCE AHA Collaborative Invites Participation

Eliminating or reducing workplace violence in the health care setting is the mission of a new collaborative being formed by the Arkansas Hospital Association. You’re invited to join us as we learn from one another in our quest to stop workplace violence in our hospitals.

The collaborative meetings are free and open to all employees of AHA member hospitals. More information will soon be available at the AHA website, www.arkhospitals.org, and employees of member hospitals may register through the AHA website calendar (https://bit.ly/35pQFwF).

Future dates of the collaborative: • March 24 • April 28 • May 26 • June 23 • July 28 • August 25 • September 29 • October 27 • December 8

Scan QR code for AHA website calendar

For questions regarding the collaborative, please contact Tina Creel, AHA’s Vice President of Member Services, by email (tcreel@arkhospitals.org) or phone (501) 224-7878 x131.

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Overall patient experience, security staffing requirements, and the possible need for an armed officer at the checkpoint are all areas that need to be evaluated prior to implementation of this equipment.

Increased lighting, self-locking doors, and panic buttons like those used by our friends in Missouri are additional forms of technology employed by many hospitals today.

In any health system small changes, like ensuring lines of sight, creating safer reception desks (those with a 30-degree slope toward the public side, fabricated from a slick material like stainless steel that make it difficult to climb over), and the use of nonbreakable glass, can enhance safety.

Most importantly, creating lockdown capabilities in our EDs, where 41% of all health care violence occurs, must be a priority. Controls need to be installed in both clinical stations and security stations so that multiple people, upon seeing a problem outside, can immediately lock the perimeter.

ENVIRONMENTAL DESIGN AND K-9 CREWS

Crime Prevention through Environmental Design (CPTED) is a timetested method to reduce both risk and anxiety. Used by law enforcement for years, the process focuses on physical improvements that change an environment and are proven to reduce violent incidents. For example, in parking garages, better lighting and bright paint colors on walls will deter perpetrators.

Ensuring that landscaping doesn't hinder safety is an element of CPTED as well. Trees with branches hanging below six feet and bushes growing higher than two feet are examples of landscaping that detract from safety. Low-hanging

branches and tall bushes provide possible concealment and cover for would-be attackers. Keeping vegetation trimmed is an important safety tactic.

Several studies show the benefit of using Security K-9s in the health care setting. At Michigan Medicine, our K-9s are trained in both explosives detection and pet therapy. They do not respond to situations where patient, staff, or visitor behaviors are escalating. Instead they make rounds on units proactively engaging patients, staff, and visitors, allowing them to pet the K-9 and interact with the handler. K-9s are one of the best examples of non-traditional technologies that reduce both risk and anxiety.

An email from a patient who interacted with one of our K-9s tells the whole story: "I seriously can’t thank you enough for bringing Leo to see me. It totally made my entire year. Thank you both for keeping us all safe."

Michigan Medicine seeks to reduce workplace violence and uses these programs to increase security. We encourage their use for teams on your hospital campus as well. Now more than ever, we need to engage our security staff members in non-traditional outreach. The focus must be on building trust, creating scenario-based training for clinical staff, and implementing technologies that proactively keep people safe. Excellent security measures reduce risk and anxiety while ensuring people both feel safe and experience a reduction in workplace violence.

Brian Uridge, MPA, CPP, CHPA, CTM, is the Deputy Director of the University of Michigan Division of Public Safety and Security and Director of Michigan Medicine Security. You may reach him at buridge@med.umich.edu.

Now more than ever, we need to engage our security staff members in non-traditional outreach.

Consider training your K-9 force as both pet therapy ambassadors and explosives detection experts.

ARKANSAS HOSPITALS | SPRING 2022 17

Treatment Adherence

Safety Patient Experience

Patient Experience Value-Based Reimbursement

Population Health

Patient Engagement

Clear Communication Health Care Utilization

Patient-Centered Care

Clear communication is critical to the outcomes you care about most.

At the UAMS Center for Health Literacy, we work to make health information easy to understand and use. We support organizations across the globe who communicate health information with patients and the public.

Our services include: ¾ Plain language assessment and editing ¾ Spanish translation ¾ Workforce training on health communications ¾ Health literacy consulting

To get started or for more information, contact us at 501-686-2595 or healthliteracy@uams.edu.

healthliteracy.uams.edu 18 SPRING 2022 | ARKANSAS HOSPITALS

Goals of care are developed with input from the patient and caregivers.

Arkansas Hospice

Providing Solutions for Hospitals, Patients, and Families From the Arkansas Hospice Communications Team

T

he origins of hospice and palliative care in Arkansas coincide with the origins of Arkansas Hospice, which this year celebrates its 30th year of service to Arkansans.

Nearly 40 years ago, Michael Aureli took his cancerstricken mother to the emergency room only to learn there was nothing more that could be done to control her pain or manage her symptoms.

That event left an indelible mark on the young priest.

He dedicated his life to providing the highest quality care available for patients with life-limiting illnesses and pledged to support the related needs of families and caregivers.

Through a series of events nearly 10 years later, Michael partnered with Dee Brazil-Dale, who was led to a mission of comforting others after the loss of her son. Together, they formed the origins of what is known today as Arkansas Hospice.

The nonprofit first provided care in patients’ homes, but the vision was always to create the state’s first inpatient hospice unit. In late 1999, Dr. Eugene Towbin arranged for

a wing of his namesake center at Fort Roots in North Little Rock to be leased to the hospice, and in February 2000, Arkansas Hospice opened the first inpatient hospice center in Arkansas.

Today, Arkansas Hospice is the state’s largest nonprofit provider of hospice care, covering a 43-county service area from 10 area offices and three inpatient centers. Service lines have expanded to include inpatient and community-based palliative care, as well as non-medical in-home care.

While most patients and their families are served in their own homes, nursing homes, and assisted living facilities, general inpatient (GIP) services are also provided in hospitals and inpatient hospice centers for patients who have uncontrolled symptoms. Arkansas Hospice provides this level of care for patients in 30 hospitals across the state, while also transitioning patients into home hospice or palliative care (through its subsidiary, Arkansas Palliative Care) upon discharge from the hospital.

ARKANSAS HOSPITALS | SPRING 2022 19

BENEFITTING BOTH HOSPITALS AND PATIENTS

Arkansas Hospice provides benefits across the continuum of care for both hospitals and patients. Arkansas Hospice and hospital social workers, case managers, and discharge planners work together, guiding patients and families through the hospital discharge process.

Upon receiving a physician’s order, patients can be promptly admitted to hospice care at any time, day or night, seven days a week, including holidays. This streamlined admissions process can benefit not only patients but also eases the workload for hospital staff who are already fatigued after two years of fighting the COVID-19 pandemic.

Patients can also be admitted to home or GIP hospice care directly from the hospital emergency department, thereby avoiding an unnecessary acute care hospitalization.

When a patient is admitted to GIP in the hospital, the patient, family, and hospital all benefit from a common understanding that the goals of care have transitioned from curative to comfort and quality of life. Arkansas Hospice works closely with the hospital staff, providing emotional and spiritual support as well as guidance through the specialized clinical care hospice provides.

Hospice admissions can have a positive effect on hospital length of stay, mortality, and 30-day readmission statistics.

However, the primary shared goal is for patients to be able to discharge safely to their desired location with the care and resources they need.

REDUCING HOSPITAL READMISSIONS

“A key benefit we provide to hospitals is a significant reduction in patient readmissions,” says Arkansas Hospice Vice President and Chief Clinical Officer Anita Deal, RN. “Studies show that patient readmissions to the hospital from a hospice are significantly lower than those discharged to other post-acute settings, and we see this trend continuing.”

PATIENT AND FAMILY SATISFACTION

Patients and their families benefit from hospice care for both at-home and GIP hospital admission scenarios. Nationally, 96% of families who have had loved ones die in hospice care would “probably or definitely” recommend hospice to others. Ratings for Arkansas Hospice and other individual hospices in the state can be found at the Hospice Compare website: www.medicare.gov/hospicecompare.

30-Day Hospital Readmission Rates for Patients Discharged to Hospice Arkansas Hospice 0.8% All hospices in Arkansas 1.4% National hospice average 1.8% Data based on the 12-month period from July 1, 2020 – June 30, 2021, for FFS Medicare patients. Arkansas Hospice percentage from North Little Rock provider number service area.

An interdisciplinary team of doctors, nurses, pharmacists, CNAs, social workers, chaplains, bereavement specialists and volunteers provides care for patients and their families.

20 SPRING 2022 | ARKANSAS HOSPITALS

Arkansas Hospice Celebrates “Caring for 30 Years” Over the past 30 years, Arkansas Hospice has built a strong, trusted reputation and has grown to become the state’s largest non-profit provider of hospice care.

As the organization continues to find new ways to help Arkansans live better, Arkansas Hospice is celebrating its first three decades with the theme, “Caring for 30 Years.”

While the organization officially began on January 17th, 1992, the need for end-of-life care was evident to Arkansas Hospice Founder Michael Aureli years earlier when he carried his pain-ridden mother to the doctor, only to hear, “There’s nothing more we can do.” It

Arkansas Hospice serves 43 counties in the state from 10 area offices. Care is provided in patient’s homes, nursing homes, hospitals, and three inpatient hospice centers. The organization is headquartered in North Little Rock.

was at that moment that he realized there had to be another way.

With the help of community leaders, Aureli and co-founder Dee Brazil-Dale formed a grass-roots movement focused on building a not-for-profit organization to help Arkansans with life-limiting illness live their final days in dignity and comfort.

As a result, Arkansas Hospice opened the state’s first hospice inpatient center in February 2000. Since then, Arkansas Hospice has grown to 10 area offices and three inpatient centers that serve 43 counties.

“Continuing and expanding the mission of Arkansas Hospice can be attributed to our visionary founders, Dee Brazil-Dale and the late Michael V. Aureli,” says Arkansas Hospice President & CEO Judy Wooten.

“We continue to thrive because of our dedicated employees, whose compassion sets the standard for care throughout the state. 2022 marks not only a celebration of caring since 1992, but also a time to look to the future as we continue to develop new and better ways to serve our fellow Arkansans.”

The recipient of numerous local, state and national awards for quality of care, Arkansas Hospice has expanded its continuum of care through the years, launching a palliative care division in 2015 and acquiring non-medical, in-home care provider First Choice Senior Care in January of this year. Arkansas Hospice was also the first hospice in the state to have a dedicated pediatric team.

A timeline of key milestones in the history of Arkansas Hospice and more anniversary content is available at https://www.arkansashospice.org/30years.

ARKANSAS HOSPITALS | SPRING 2022 21

Recent data indicate that less than 1% of patients discharged from hospitals to Arkansas Hospice are re-admitted, which is significantly lower than the average of other hospice providers in the state and less than half the national average.

Families say that one of the greatest benefits that hospice provides is expert bereavement care for up to 13 months after the death of a patient. Arkansas Hospice provides these services free of charge not only for the families whose loved ones were served by Arkansas Hospice, but also to the community at large.

“Comprehensive grief support following loss has been a long

tradition of Bereavement Services at Arkansas Hospice,” explains Arkansas Hospice Director of Bereavement Barbara Ross. “Both anticipatory grief and support following a death are integral components to overall care during one of the most difficult times for families. Bereavement Services includes care from a specialized group of professionals who provide a variety of unique, evidenced-based programs

A dedicated pediatrics care team and other innovative programs such as hospital- and community-based palliative care, minority outreach, and “Committed to Veterans,” serve the special needs of Arkansans with life-limiting illnesses.

22 SPRING 2022 | ARKANSAS HOSPITALS

following loss to support positive coping and offer a choice to those navigating a complex grief journey.

Supportive calls, multiple virtual grief support groups, resources, and education are all part of the comprehensive grief support provided

by Arkansas Hospice.”

With a holistic view of data and consistent comments from families who say they wish they had accessed hospice care sooner, it is apparent that patients, families, and hospitals benefit when hospice admissions happen earlier, rather than later, in the terminal disease process.

“When the effectiveness of curative treatment wanes or the patient no longer wishes to pursue aggressive measures, hospice can make a huge difference in the quality of life for both the patient and the family,” says Arkansas Hospice Chief Medical Officer Dr. Brian Bell. But too often that decision isn’t made until it’s too late to receive the full benefit of hospice care.

“While we provide beneficial care to patients at any point in their disease process, it typically takes at least two weeks for the patient and

their family to start realizing the full benefit of care,” Dr. Bell says. “Since hospice is available to patients with a prognosis of six-months or less, patients can experience a significantly improved quality of life for a longer period of time with earlier, rather than later, admissions.”

Bell further elaborates on a series of outcomes demonstrating the benefits Arkansas Hospice provides to hospitals: • Improve and streamline post-acute care transitions.

• Decrease LOS by transitioning hospice patients to appropriate venues of care.

• Improve Value-Based Purchasing scores with decrease in 30-day readmissions, improved CAHPS scores, and reduced Medicare Spending per Beneficiary.

• For hospitals with an ACO/CIN, decrease utilization and increase cost savings.

• Educate hospital staff on end-oflife care.

• Access to hospice bereavement services for mutual patients at no cost to the hospital.

Families can gather in the Grace W. Dyer Sturgeon Family Room in the Arkansas Hospice Ottenheimer Inpatient Center located at CHI St. Vincent Little Rock. If more privacy is needed, The A. Reed Thompson, M.D. Meditation Room is available. Arkansas Hospice also operates an inpatient center at CHI St. Vincent Hot Springs, plus the free-standing River Valley Home in Russellville.

THE FUTURE FOR ARKANSAS HOSPICE

Arkansas Hospice President and CEO Judy Wooten sees Arkansas Hospice and other providers expanding their continua of care to meet patients where they are. “Patients and families are becoming more informed health care consumers and looking for options to traditional health care,” she says. “Hospice has always promoted care at home, and now other models, including community-

based palliative care, in-home primary care, and hospital-at-home programs are following that lead. ACOs and other value-based systems will also continue to grow and create new and innovative care models to reduce costs and improve outcomes.”

Dr. Bell sums it up: “Our goal is to help Arkansans live better. We see Arkansas Hospice expanding service lines and partnering with other providers as part of the solutions patients and families present to us all.”

ARKANSAS HOSPITALS | SPRING 2022 23

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COACH'S PLAYBOOK

Building an Organization of

Problem Solvers

by Kay Kendall

H

ow would you describe your staff members? Are they troublemakers? Clock watchers? Problem solvers? The first group may be difficult to lead. The second may be difficult to motivate. But the third group can elevate a good organization to one of excellence. What leadership skills make the difference?

Last week I had the privilege of talking with the CEOs of two highly regarded health care organizations, Brian Dieter of Mary Greeley Medical Center in Ames, Iowa (a 2019 Baldrige Award recipient in Health Care) and Dr. Fred Cerise of Parkland Memorial Hospital in Dallas, Texas (highly ranked

by U.S. News and World Report in five adult specialties).

I’d like to share their organizations’ similar approaches for engaging staff in problem solving.

WHO’S RESPONSIBLE FOR PROBLEM SOLVING?

In both organizations quality and reliability serve a centralized function. Both CEOs, however, view these departments as “centers of expertise” and “facilitators of improvement” … but not the solitary “owners” of problem-solving. In Parkland’s case, it’s the Performance Improvement group within the Quality function that promotes centrally driven projects. Mary Greeley Medical Center devises both strategic projects that

align with overall (“Big Dot”) goals and “local” projects that are driven by functional owners within a department or unit.

Both organizations employ various improvement processes to work through challenges: Parkland uses Lean, as its High Value Care Team seeks to eliminate waste.

Mary Greeley’s Performance Improvement group uses Rapid Improvement Events and Small Tests of Change before new or re-engineered processes are adopted as standard work.

Neither organization does extensive training for the sake of training. In many instances, improvement project teams are given just-in-time training, teaching whatever tools are best suited to address their specific circumstances.

THE GRASS IS GREENER “OVER THERE”

I’ve worked in some organizations where people are quick to point out problems in other departments while turning a blind eye to their own. I asked Brian and Fred how they prevent this.

Mary Greeley requires that a team’s first 90-day opportunity for improvement be in its own department. Leaders encourage a fresh set of eyes from another department be brought in to question the “why” of current processes.

ARKANSAS HOSPITALS | SPRING 2022 25

Parkland simply puts the problem on the table; whichever cross-functional team is affected by the issue becomes the single owner of its improvement process. Fred stresses that having a culture of humility helps!

THE SECRET SAUCE

Brian Dieter, FACHE President and CEO Mary Greeley Medical Center Ames, Iowa Brian Dieter has served as President and CEO of Mary Greeley Medical Center since July 2008 and prior to that, he served the medical center as Vice President and Chief Financial Officer for nine years. Before joining Mary Greeley, he spent 10 years in financial leadership at three affiliates of Ancilla Systems Inc. Dieter received his B.S. degree in Business from Indiana University and his M.S. degree in Administration from the University of Notre Dame. He is a Fellow in the American College of Healthcare Executives and active in several national, state, and local organizations.

Both leaders emphasize the need to help people see how their role fits in with their organization’s bigger picture and ensure that everyone connects personally with the organization’s purpose.

At Parkland, this means setting the tone during the hiring process.

From the beginning it is stressed that Parkland’s culture is one of innovation and improvement, that they seek people who will go beyond a set of job expectations.

At Mary Greeley, Brian reminds people at every opportunity that they have two responsibilities – do their job and improve their job. This helps every employee continually recognize their value and ensures that their work remains relevant. In turn they, themselves, become increasingly valuable to the organization.

BIG DOT GOALS

Frederick P. Cerise, MD, MPH President and Chief Executive Officer Parkland Health & Hospital System Dallas, Texas Frederick P. Cerise, MD, MPH, was named President and Chief Executive Officer of Parkland Health & Hospital System in March 2014.

Prior to joining Parkland, Dr. Cerise served as Vice President for Health Affairs and Medical Education of the Louisiana State University System. From 2004 to 2007, he served as Secretary of the Louisiana Department of Health and Hospitals. Dr. Cerise began his career at the Earl K. Long Medical Center, Baton Rouge, Louisiana between 1991 and 2004 as an LSU Clinical Faculty member in Internal Medicine.

He holds a Bachelor of Science degree from the University of Notre Dame and earned his Medical Degree at Louisiana State University in New Orleans.

He completed a residency in Internal Medicine at the University of Alabama in Birmingham. In 2011, he earned a Master of Public Health degree from Harvard University School of Public Health. From 2010 to 2016 he served on the Kaiser Commission on Medicaid and the Uninsured and currently serves on the Medicaid and CHIP Payment and Access Commission.

26 SPRING 2022 | ARKANSAS HOSPITALS

Mary Greeley’s Brian Dieter describes a time when the hospital tried to connect staff members with its overall goals using an old-fashioned red/ yellow/green scorecard with 43 metrics. He says, “Almost no one outside of the executive team understood what the metrics meant or how their job contributed to the results.”

So Mary Greeley adapted best practices from IHI philosophies and fellow Baldrige Award recipients to develop “Big Dot Goals” which create for every staff member a sense of organizational focus, alignment, and connection.

With four overarching objectives that encompass all supporting tactics, everyone in the organization can identify at least one Big Dot Goal that their work directly supports.

• Reduce preventable harm.

• Increase employee engagement.

• Increase inpatient engagement.

• Achieve operating margin.

Every department has its own Big Dot Goal huddle board showing how its workers support the organization’s Big Dot Goals. The huddle boards help teams tracking their progress on related project processes and improvements.

Each employee carries a Big Dot Goal card (Figure 1) behind their identification badge. On it is handwritten their personal commitment to at least one of these goals.

PERSONAL BEST PRACTICES

Brian and Fred each emphasize the importance of removing organizational barriers to problem solving as people test new ideas and evaluate potential improvements. Both leaders are active listeners and help their problem solving “idea generators” attain the needed data for making informed decisions about a potentially intelligent risk.

Fred Cerise stresses the importance of not expecting every change to have an immediate ROI; one of his investments includes building a data analytics group with the anticipation that it will have a future positive impact on hospital readmissions.

Brian Dieter blocks out four hours each week on his calendar to personally facilitate work systems mapping and problem solving with front line staff. He says, “It’s rewarding and fulfilling to me. I feel like I give more value to the organization and learn more about what’s really happening than [when simply using those hours for] meetings.”

Big Dot GOALS

REDUCE PREVENTABLE HARM Goal: 95 (or less)

IMPROVE INPATIENT ENGAGEMENT Goal: 85th Percentile

INCREASE EMPLOYEE ENGAGEMENT Goal: 77th Percentile

ACHIEVE OPERATING MARGIN Goal: 3.0%

IS YOUR HOSPITAL FILLED WITH PROBLEM SOLVERS?

I hope that your answer is a resounding, “yes,” but if it isn’t, here’s a quick checklist to help you turn that situation around.

1. Do you recruit, hire, and onboard people with a bigger job in mind for them?

2. Do you encourage improvement and innovation beginning in new employee orientation?

3. Do you ensure that your employees have the right tools to identify problems, analyze, and solve them?

4. Do you recognize problem solving as a desirable trait for your employees to have?

5. Do you connect every employee with the purpose of your organization? Do they know, in a very tangible way, how they contribute?

6. Do you look for and personally see to it that barriers to improvement are removed?

The team at BaldrigeCoach would be glad to help guide your hospital’s quest for process improvement. As CEO and Principal of BaldrigeCoach, Kay Kendall coaches organizations on their paths to performance excellence using the Malcolm Baldrige National Quality Award Criteria as a framework. Her team, working with health care and other organizations, has mentored 24 National Quality Award recipients.

In each edition of Arkansas Hospitals, Kay offers readers quality improvement tips from her coaching playbook. Contact Kay at 972.489.3611 or Kay@Baldrige-Coach.com.

Doing what's right.

Name:

My commitment to: Reduce Preventable Harm

Increase Employee Engagement

Increase Inpatient Engagement

Achieve Operating Margin

Figure 1. Mary Greeley Medical Center produces this graphic as a fold-over card each employee can fill out and keep in their badge sleeve.

ARKANSAS HOSPITALS | SPRING 2022 27

FAMILY FUNERAL HOMES

28 SPRING 2022 | ARKANSAS HOSPITALS

Look for the Helpers

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COVID-19 continues to challenge health care employees in every department of every hospital. This special section introduces several AHA Affiliated Group leaders who tell their hospitals' behind-the-scenes stories of triumphing over COVID challenges.

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(Below) Conway Regional Environmental Services Supervisor Raymond Butler cleans a room.

(Above) Conway Regional Health System Maintenance installs a temporary wall. Pictured are Senior Maintenance Electrician Sean Brown (on the ladder) and Senior Maintenance Technician Tony Starnes.

(Photos by Montie Hennard, Creative Specialist, Conway Regional Health System)

Behind the Scenes:

Hospital Engineers Meet COVID Challenges

By Eric Kindsfater, President, Arkansas Association of Healthcare Engineering

H

ospital engineers are experts at problem solving. Every day in our work, we find solutions to difficult or complex issues – the very definition of meeting challenges.

Members of the Arkansas Association for Healthcare Engineering (AAHE), an affiliate group of the Arkansas Hospital Association, provide clinicians, patients, and visitors with safe and functional environments of care.

It's been my distinct privilege to serve as AAHE President since 2019. As my term draws to a close this April, I’m reflecting on the significant contributions health care engineering professionals provide to their facilities.

Though not involved directly in patient care, hospital engineers – often-unsung men and women – provide an undeniably critical X factor to every health care organization.

During normal operations, health care engineering tasks range from the challenging and demanding to the routine and mundane. Managing positive and/or negative air flows, balancing the requirements of heating and cooling, providing availability of clean water, maintaining air exhaust and return systems, performing necessary preventive maintenance on all systems (both critical and non-critical), identifying efficiencies for energy consumption ... the list may at times seem never-ending.

OH, THE MESSES!

Health care engineering includes Environmental Services, whose teams dutifully execute their assignments 24/7. Visitors, patients, staff of all types … we make a lot of messes and generate a tremendous amount of work for the EVS staff.

Whether it’s biohazardous waste from the lab and main operating room, cardboard boxes from Materials Management/ Supply Chain, or simple coffee spills from visitors, the Environmental Services team is there day-in and day-out to address needs.

These processes are endless. The work is never finished.

Work orders, emails, and phone calls continuously roll in.

Which is more important: testing functionality of the critical branch of electrical service or adhering to strict cleaning guidelines for patient rooms? The truth is, each item, no matter how it may appear on the surface, is equally important.

And the performance of these duties occurs Every. Single.

Day. The scope of these efforts can be daunting: serving thousands of people, maintaining buildings with hundreds of thousands of square feet. We manage every operational system that keeps the air and water clean, the temperature comfortable, and the lights on.

ARKANSAS HOSPITALS | SPRING 2022 29

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THEN, COVID

COVID has changed the roles of health care engineers in a significant and impactful way. Gone are the days of traditional project timelines. Conway Regional Health System Maintenance and Facilities Director and AAHE member Paul Mauldin explains: “When COVID first hit in early 2020, our team felt that renovating an existing 11-room behavioral health unit to accommodate COVID patients was in the best interest of all the patients we serve. We added negative air, medical

Like our clinical counterparts, health care engineering teams are stretched

by COVID to limits we have never experienced.

Our charge to provide a safe and sustainable environment of care is very challenging, and sometimes sobering, for health care engineers and their teams. Add a novel global pandemic to the mix and an already-complex web of systems and processes is compounded.

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gases, anterooms for each patient room, and anterooms for the unit. Our team began the work on a Friday and worked all weekend. We were up and rolling in a code-compliant COVID unit, ready for patients by 6 p.m. Sunday night. Under normal circumstances, a renovation of this scope would’ve taken closer to three weeks, not 58 hours. As the COVID patient surge increased, we performed the same process for an additional 15 rooms the next weekend. The way the team works together makes me proud; the crew is cohesive. The way they performed then, and the way they perform now, speaks to what they are able to achieve.”

We have all felt the effects of COVID. The landscape in which clinical care is delivered and the environment in which that care is practiced is changing in dramatic fashion. As each new COVIDrelated guideline is issued at the federal and/or state level, health care professionals, including its engineers and their teams, are answering the call.

Health care engineers take pride in rising to the demands of this historic period. Our mentality: adapt and overcome. Navigating any challenge allows for the emergence of problem solvers, and the privilege of serving our communities is certainly taking on a renewed and more purpose-driven approach during this pandemic. I have seen health care engineers rise to the occasion and exceed expectations for what otherwise might have been an impossible challenge. I know I join many of my colleagues in saying that we could not be prouder of the teams of problem solvers with whom we work each day.

– AAHE’s motto is “Education Through Association.” Since its founding nearly 60 years ago, the associative nature of AAHE has been invaluable to members.

Formation of professional relationships very often organically turns into longlasting, personal friendships. AAHE members can (and do) routinely reach out to one another for concepts, ideas, and solutions essential to the provision of facilities-related services. Whether attending our quarterly educational conferences or the opportunity to fellowship during one of our AAHE Scholarship Trust fundraising events, association with one another is irreplaceable.

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(Above) Left to right) Wendy Talbot, Chief Experience Officer and Jamie McCombs, Director of Marketing, Communications and Public Relations, both at Jefferson Regional, discuss colors for an ad campaign.

(Right) Brooke Pryor speaking with a volunteer at CommUnity of Caring, an annual medical mission Unity Health hosts. The event pivoted to a drive-thru format due to COVID.

Attention Grabbers!

Creative Communication Strategies Emerge during COVID-19 Pandemic From the Arkansas Society for Hospital Marketing and Public Relations Professionals

H

ow do we get Arkansas hospitals’ COVID messages out to the community? Health care communicators, marketing professionals, and public relations specialists are always chasing a new, creative approach that will grab the attention of people of all ages in the communities they serve.

Marketing a health care facility’s service lines and providing timely patient education requires expert planning and precision under the calmest of circumstances, but during the COVID-19 pandemic the challenges morph day by day – sometimes hour by hour.

Glenn Crain, President of the Board of Directors of the Arkansas Society for Healthcare Marketing and Public Relations (ASHMPR), is a 15-year veteran of the Jefferson Regional Marketing Department and says he and his colleagues around the state experience these challenges firsthand.

“The pandemic has definitely made the past two years hectic,” he says. “Our hospital was the first in the state to identify a case of COVID-19, and that brought an onslaught of media attention at the very moment we were scrambling to adjust our visitation policy, launch a web page with COVID-19 information, and devise a plan for keeping our social media accounts timely. It was important to keep the public aware of what was going on.”

Praising the Jefferson Regional communications team, Crain explains that having a group that works well together and is dedicated to transparency is vital. “When you are in a crisis situation, transparency and keeping the community’s best interests at heart matter. No matter how chaotic things get, these two principals drive us.”

Crain says he’s always been interested in writing, design, and photography, and he gets to use those skills every day at his job as Marketing and Communications Manager. “We have excellent leadership in the department, and that frees me to do the things I enjoy. I’m lucky to be able to spend most of my time creating.”

Crain notes that the job is often challenging, but there is always something different to explore. “We have new projects walk in the door every day, especially during COVID-19,” he says. “For example, there might be an immediate need for new signage for a COVID testing location, so we lay other projects aside to design and print the needed signage on the spot, that very day.”

Recognizing frontline workers and encouraging the hospital workforce was a vitally important role for the Jefferson Regional Marketing Department as the pandemic unfolded. “We did our best to encourage those who were ARKANSAS HOSPITALS | SPRING 2022 31

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dealing directly with COVID patients and their families; I think the outpouring of support from our community made a real difference too,” he says. “The job of facilitating the support projects fell mostly to our department.”

Brooke Pryor, Marketing Director at Unity Health in Searcy, agrees that the pandemic is shifting the focus of health care marketing. “It has drastically changed many things in my role, from what we are communicating to how best to communicate it,” she explains. “Early in the pandemic, we shifted our messages to community education. We explained what COVID is and how each person could protect themselves and those around them.

We kept our audience (the community and people in our service area) informed on how and where to seek medical care as well as ever-changing visitor policies and guidelines. We learned to react quickly to new information and transform it into digestible pieces of information.”

Pryor currently serves on the ASHMPR board and is the group’s past president. “I’ve always been drawn to creativity and problem-solving,” she says. “I also love truth and transparency, two things I find incredibly refreshing.” This combination of passions led Pryor to a career in the field and ultimately led her to Unity Health. “This is an organization I believe in at every level,” she says.

In one pandemic project, Pryor and her team recognize staff members for frontline work. “We have a social media series called ‘Behind the Mask’ which features our associates and how they contribute to Unity Health’s mission to improve the quality of health and well-being of the communities we serve,” she smiles. They also implemented a “Hero 2 A Hero” initiative where community groups wishing to do something for the hospital staff volunteer to provide a medical unit with some sort of treat or meal.

“Another skill we have developed during the pandemic is pivoting,” Pryor explains. “All the plans we make for marketing and communication now must be fluid.

COVID takes a front seat. As events and other normal marketing work ceased, what was left is transparency and communication about what is most relevant at this moment.

We also are shining a light on the mental health of the community and our associates. We introduced a free hotline for anyone needing to discuss, with a licensed therapist or counselor, any fear or anxiety they are experiencing due to the pandemic.”

Keith Whitworth, Director of Marketing at the University of Arkansas for Medical Sciences, experienced similar situations as COVID-19 spread across the state. Though his team was in a separate department from communication and public relations before the pandemic, he found himself called upon to achieve many of the same goals as other colleagues around the state early on.

“It was all-hands-on-deck to get signs and other materials designed and printed to notify visitors and employees about new policies,” he says. “We were also in the process of making this information available online. Despite the anxiety and unknown circumstances, it was a proud moment to be part of a team that excelled at managing the many requests that arise at a larger organization.”

Whitworth currently serves on the ASHMPR board of directors. “Being a part of ASHMPR definitely gives me a perspective on the unique opportunities and challenges at hospitals across the state,” he says. “The best part is that group members help one another by asking and answering questions about issues we might face. As the state’s only health sciences university, UAMS has partnerships with many hospitals across the state, and being a member of ASHMPR allows me the opportunity to meet the marketing staff at those hospitals. Those relationships are invaluable because at the end of the day, we are all part of the same health care team.”

Those interested in becoming a part of ASHMPR will find applications online at www.arkhospitals.org.

WHAT MAKES A HOSPITAL COMMUNICATOR? Before entering hospital marketing, Crain worked at a regional newspaper for more than a decade as a reporter and then served as news editor for a time. He also owned a photography studio for several years. He helped market another nonprofit in the region for several years before coming to the hospital.

Pryor began her professional career at Unity Health back when it was known as White County Medical Center. She says that having a healthy desire to solve problems in creative ways is important for hospital communicators. Commitment to truth and transparency are also key.

Early on, Whitworth was drawn to photography and videography. His passion for using videography as a communication tool led to his desire to explore other marketing vehicles. He worked at an advertising agency before moving into the health care field. “The process of strategizing to help businesses increase their brand awareness drew me to having a larger role with planning and implementing marketing campaigns, particularly in health care,” he says.

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(Above) Unity Health associates and volunteers were elated when the volunteers came “home.” Here, Dr. Justin Franz, Orthopaedic Surgeon, hugs volunteer Lynda Goldman, Surgery Waiting Desk. Their eyes express the happiness all felt.

(Right) Charles Kitts, Unity Health volunteer, helped establish the Lobby Greeter/Screening station. Having volunteers fulfill the task of screening all who enter the facility helps our staff tremendously. Before this service began, associates were rotating shifts.

Ready,Willing and Able: Volunteers Fill Gaps During COVID

By Carol Evans, President, Arkansas Hospital Auxiliary Association

C

OVID-19 can’t keep the spirit of Arkansas Hospital Auxiliary Association (AHAA) volunteers down! When the pandemic struck, most hospitals asked volunteers in our 52 auxiliaries to stay home and stay safe. Before many days passed, AHAA volunteers found ways to safely keep up our service. In the early days when masks were hard to find, volunteers sewed hundreds of masks for hospital workers and community members. Many of us learned how to conduct Zoom meetings and did all we possibly could to keep our groups connected. Some auxiliaries were allowed, under strict rules, to open their thrift stores to serve the public. Some devised creative ways to hold fundraisers.

Some were allowed to serve hospital employees by keeping their gift shops open. Many auxiliary volunteers worked call centers and vaccination clinics when they began operating throughout the state.

Auxiliary members are devoted to their hospitals. Each of us comes to this work in our own way. My volunteer life began after my second bout with cancer; I knew I wanted to be of help to others. I never dreamed I would hold a leadership role, let alone during a worldwide pandemic. From this vantage point, I can tell you that the commitment of AHAA’s board of directors and district chairs, its local leaders and hospital auxiliary teams, is amazing. Like many organizations

during COVID, our in-person meetings are still replaced by Zoom meetings, but we are finding remarkable ways to help our hospitals despite the challenges COVID puts in our path.

We can all be proud of AHAA’s auxiliaries and how they've handled themselves during the pandemic! We’re an aging group, yet we do all we can within each hospital’s COVID restrictions to continue helping Arkansas’s hospitals and the public. No day is guaranteed, but every day is a blessing.

Every hospital has its own processes during COVID; though some hospital auxiliaries are not yet able to volunteer in person, many are returning, in whole or in part, to their inperson work.

Please read on to see how three of our auxiliaries are blessing others during COVID-19.

UNITY HEALTH: NON-TRADITIONAL VOLUNTEER SERVICES

When the pandemic hit, many everyday activities, including hospital volunteer programs, came to a halt. While scientists researched the pandemic, our hospitals were faced with supply shortages, coordinating testing centers, and protecting staff while caring for our communities. As the initial months of the pandemic subsided, many volunteers became vaccinated and were ready once again to serve.

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Shortages of masks and isolation gowns brought the Unity Health Auxiliary into action. Its Gentle Hugs Committee is comprised of volunteers who agreed to sew masks and gowns.

Hospital associates and a local church donated material, and the volunteers began supplying masks by the hundreds.

They also made many washable gowns to be used if the need arose.

At the beginning of the pandemic, Unity Health utilized a Memphis lab which could provide COVID test results in 24 to 48 hours. Couriers – multiple Unity associates – took shifts delivering tests to the Tennessee lab each day. Then I was approached for assistance; could the auxiliary provide courier service to the lab? Knowing our auxilians’ heart for service (not to

(Above) Mercy Hospital Berryville Surgery Waiting Area Chairman Anita Spearman (left) orienting new auxiliary volunteer Robin Butler (right). In the background is one of the surgical status monitors which the auxiliary purchased for the hospital during the COVID shutdown.

(Bottom) Volunteers Peg Meyer and Sheila Middleton at the check out counter of Baxter Regional Medical Center's Flippin Bargain Box, one of two auxiliary thrift shops. Proceeds support special services and equipment needs for the medical center.

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mention that many were experiencing “cabin fever” and were ready to get back to work), I was able to build a team of drivers within a day. They enjoyed the drive time, but the true reward was knowing they filled an urgent need.

The next COVID testing hurdle: calling patients with lab results.

We quickly assembled a team, and volunteers were making negative result call-backs in no time, helping deliver prompt answers to patients.

Processing the amount of equipment being received into Materials Management was the next challenge.

Volunteers, who prior to the pandemic helped twice per week placing labels on each incoming product, were now needed daily. This volunteer team is still providing much-needed relief to the staff.

When regulations called for every person entering the hospital to be screened and documented, volunteer stations were built at the entrances.

Several auxiliary members answered this call and are still serving the need today.

After a year of COVID isolation, Unity Health was ready for its surgery desk, messengers, and gift shop volunteers to return. Although processes had changed, the volunteers were a welcome sight to patients and visitors, but mostly to our associates who deeply missed the “grandparents” of our Unity Health family. Having volunteers provide the additional layer of communication in surgery waiting is priceless. Receiving confirmation that they are in the right place provides comfort to an already-nervous patient and family member. We knew this before COVID, but we appreciate these volunteers even more after being without them for so long.

Each year, the Special Olympics of Arkansas is held in Searcy on the Harding University campus. The event was canceled in 2020 but when it was scheduled for 2021, excitement filled the air. Unity Health auxiliary volunteers were able to play games, educate people on proper sunscreen application, and provide healthy snacks.

Another annual mission for the Unity Health Auxiliary is Unity Health's medical mission, CommUnity of Caring. The auxiliary not only donates

Sp monetarily, but several volunteers help in the preparation and execution of this event. During COVID, volunteers filled bags with personal care items and groceries, and they also acted as escorts for community members seeking free health care.

Over time, more volunteers are returning. We aren’t at our pre-COVID numbers, but we are on a steady path of growth.

Returning to volunteer stations and longtime projects such as sewing oversized stockings for the Christmas babies, making newborn caps, and stamping linens means a lot. We are especially grateful to have served as COVID-specific hurdles arose. Our volunteer program remains strong.

-Kathy Gammill, President, Unity Health Auxiliary

MERCY HOSPITAL BERRYVILLE: STILL SERVING!

Mercy Hospital Berryville Auxiliary continues to provide service during the COVID shutdown by volunteering at the Surgery Waiting Area. Although the auxiliary hospital gift shop, information desk and thrift store have been closed, we are still able to provide service to our hospital.

The auxiliary has recently participated online in the 2022 Black and White Roundup, sponsoring a COW (Computer on Wheels).

The Roundup is the annual Mercy Health Foundation fundraiser to provide equipment for the hospital.

-Neta Sue Stamps, President, Mercy Hospital Berryville Auxiliary

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Another challenge was the opening of our hospital gift shop and two community thrift stores. We are responsible for enforcing mask and social distancing disciplines with customers. We post signage detailing requirements to shop, encourage customers to use floor decals as guides for maintaining social distancing, and urge the use of disinfection stations. Masks are available for those shoppers who enter without one, and a volunteer is stationed at each entrance to ensure compliance with these precautions.

To safely continue offering our popular passenger shuttle service, volunteers can no longer allow seating next to the driver. All passengers are required to mask before boarding, and sanitizers are readily available to all.

Another area where our volunteers serve during COVID is at vaccination sites within the hospital as well as those in public locations. Baxter Regional held several COVID-19 Vaccination Clinics for the community, and our volunteers assisted staff at each of these.

Even during COVID, this past year our BRMC Auxiliary is proud to have volunteered in excess of 64,000 hours and raised a record total of $647,000 to meet the capital needs of our hospital. We are proud to serve Baxter Regional Medical Center.

-Jim Whalen, President, Baxter Regional Medical Center Auxiliary

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BAXTER REGIONAL MEDICAL CENTER: CHALLENGES CONFRONTED AND MET

2020 and 2021 are now pandemic benchmarks in Baxter Regional Medical Center Auxiliary’s 60-year record of memories.

Many adjustments have been necessary to accommodate changing requirements during the years of the pandemic.

For the auxiliary, one stabilizing component is the regard that our hospital demonstrates for its volunteers. At Baxter Regional, each auxiliary member feels empowered because our hospital leaders consider the volunteers integral and valued components of the organization. From COVID’s outset, the senior leadership team’s total transparency and inclusivity kept all employees and volunteers aware of and current on developments surrounding COVID. We appreciate being included in hospital communications.

When volunteers were eventually given clearance to once again become engaged throughout the organization, there were caveats. Due to COVID-19, we could not hold group gatherings, a mainstay of volunteer organizations. In the interim, we are developing substitute activities.

Traditionally, our monthly (and popular) group luncheons were held with a brief program to celebrate and recognize volunteers having a birthday within the calendar month. As an alternative, Baxter Regional Volunteer Services contracts with a local bakery to exchange large, decorated cupcakes for birthday coupons sent to celebrating volunteers. Participation has been very strong.

Baxter Regional Medical Center holds periodic Drive Thru Thank You events for the volunteers, where they drive through the hospital parking garage and pick up various gifts of thanks for their service. Here, Jim Whalen, Auxiliary President, and Carolyn Hannon, Auxiliary Scheduling Chair, prepare to hand out Tervis stainless steel tumblers.

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(Above) The Baxter Regional Medical Center team celebrates earning Magnet status.

(Left) Helping new RNs gain a sense of belonging is the thought behind a new onboarding program at National Park Hospital.

Innovation and Recruitment Lead Nursing Changes

By Katie Lea, President, Arkansas Organization of Nurse Leaders

I

t goes without saying that the past two years have been incredibly difficult. In the health care field specifically, the COVID-19 pandemic is causing a shift within our care strategies and our recruitment and retention efforts. While it is certain that COVID brought tumultuous times, the pandemic also brings great resiliency to the forefront in the nursing profession. Some of the most resilient Nurse Leaders display compassion, innovation, and are inspiring members of the nursing community.

First, innovation is playing a significant role in the success of care delivery during the pandemic. With limited resources including personnel, supplies, and the loss of families at the bedside, Nurse Leaders are adapting and innovating in ever-changing circumstances. Along with limited resources, Nurse Leaders also struggle with the lack of nursing students in our facilities due to COVID-19 restrictions. This not only impacts our recruitment efforts, but it also lessens hands-on experience for the novice nurse.

As we all know, the development of preceptors and the onboarding of novice RNs is an essential transitory period in the nursing field. But with turnover in staff and utilization of agency personnel, the past two years have been difficult for those transitioning into practice. COVID restrictions are

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causing us to re-think ways of bringing up new staff so they have a greater sense of belonging.

Lisa Wallace, Chief Nursing Officer at National Park Hospital in Hot Springs, partnered with Trumont to bring a different approach to onboarding through an apprenticeship program. As the hospital’s new Chief Nursing Officer, Lisa first identified strong, developing preceptors and then offered a seamless transition to practice that supported clinical excellence, leadership, and organizational culture.

"On many levels, our staff, as well as the patients they may be caring for, are hurting and broken,” Lisa says. “Now, more than ever, I am mindful of supporting the teams I lead on a multitude of levels. This program provides a foundation for professional development of existing staff as preceptors and provides a strong support network for novice nurses.

Successful recruitment and, especially, retention, are key to stabilization of nursing as a profession. It is vital that organizations create innovative ways to both recruit and retain our teams for the health care field to continue its growth.”

While recruitment numbers are important, it's also about who we're recruiting. When Nurse Leaders were faced with exhaustion during the pandemic, they continued to demonstrate compassion. For our team, and for many

others, this was most often displayed through resiliency.

Trenda Ray, Chief Nursing Officer at University of Arkansas for Medical Sciences (UAMS), led new programs that emphasized the well-being of nurses with courses in relaxation and mindfulness. As Trenda created and offered dedicated spaces for team members to decompress, she championed the mental health and physical renewal of her staff. Trenda's leadership emphasized that while so many nurses take care of others, their own mental and physical health must remain a priority.

When looking at the profession, we have identified ways to share our inspirational stories of healing and hope. One goal of ArONL is to support Nurse Leaders through professional development and promote leadership and collaboration.

When I think of those who exhibit exemplary displays of leadership and collaboration, many inspirational Nurse Leaders come to mind. One facility that I find particularly inspiring is Baxter Regional Medical Center (BRMC) in Mountain Home. The facility received Magnet designation in 2021, during a pandemic! What an accomplishment! As a community hospital, this was achieved without a consultant and as a first-time designee. "Any time we had issues or deficiencies, the team of leaders and clinical nurses met to resolve the situation,” says Susan Musgrave, Director of Ambulatory Clinical Nursing at BRMC. “As leaders, we trusted their abilities and teamwork to promote excellent patient care for every patient, every time."

In reflecting on the past two years and how the health care field is shifting, it's evident that innovation and recruitment efforts are at the forefront. With the work of Lisa Wallace, Trenda Ray, and the success of Baxter Regional Medical Center, these people and facilities, among many others, are leading the way into the future of nursing where compassion and care are of the utmost importance.

ARKANSAS HOSPITALS | SPRING 2022 37

Pictured from left to right are David Pearson, hospital advocate and American Hospital Association Regional Executive; Rob Robinson, Medical Center of South Arkansas (MCSA) Board Chair, and Dwayne Blaylock, MCSA Interim Chief Executive Officer. Robinson is holding the hospital's award for its 100 year membership in the American Hospital Association.

Hospital Trustees Serving During COVID

By Johnny McJunkins, President, Arkansas Association of Hospital Trustees

H

ospital trustees are a unique group. Most of us are unpaid volunteers who display a strong desire to serve the communities in which we live. People think our duties involve lots of time spent in meetings or studying background material that will be addressed when the board gathers, but it goes well beyond that. Hospital trustees are dedicated to assuring that our community hospitals remain strong and vital, even in the toughest of times.

The Arkansas Association of Hospital Trustees (AAHT) is an affiliate group of the Arkansas Hospital Association (AHA) with members from hospital boards all over the state. AAHT bylaws outline our purpose: “The purpose of the Association shall be to dedicate itself to helping individual hospital trustees become more informed and effective board members through education and communication, and to promote the hospitals of Arkansas.”

Hospital trustees must be willing to keep abreast of current issues not only in the community but also in health care. They offer both time and expertise to meet, discuss, and resolve hospital business and governance issues,

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assuring that the hospital’s best interests are always front of mind. AAHT helps member trustees better understand their role within the hospital and its governance.

THEN CAME COVID

COVID-19 threw a wrench into the operations of medical organizations in Arkansas and all over the world. The AHA, AAHT, and hospitals throughout the state put on hold much of their usual work in order to decide, prepare, and maintain the best solutions for handling the pandemic. Like most groups accustomed to meeting in person, the AHA and AAHT moved to meeting and communicating virtually to protect members and reduce transmission of the virus.

The pandemic brought an onslaught of questions to hospital boards. How contagious is this disease? How do we treat it? Are our hospital employees safe? How are we going to financially handle this and survive? When will we be able to return to normal?

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Johnny McJunkins, AAHT President (left), and Mark Kitchens, Chairman of the Howard Memorial Hospital (HMH) Board (center) discuss board business with HMH CEO Debra Wright (right).

More than two years into the pandemic, these questions are still not answered definitively. Our medical professionals have fought this pandemic, learning as they fight. Those of us who serve on hospital boards have been right in there with them, seeking answers and trying to help guide as we learn more and more about the virus.

I serve on the board of trustees at Howard Memorial Hospital, located in Nashville, Arkansas. We are a rural critical access hospital, and we take pride in the quality of community care offered at our facility.

I am also the current president of the board of trustees for AAHT. I’d like to share two of my fellow trustees’ ideas on board service. These are two trustees for whom I have the deepest respect.

RURAL BOARD SERVICE

Mark Kitchens is chairman of the board at Howard Memorial Hospital in Nashville, a community in southwest Arkansas. He is dedicated to public service and is involved in a variety of community projects and groups. Mark’s family was honored as the 2014 Farm Bureau Farm Family of the year.

I asked Mark what drew him to a position on the hospital board and to the job as chairman. “I feel it is my duty to do what I can to help provide quality health care in our rural areas,” he says. Curious how the pandemic affected his leadership role on the board, we talked about COVID challenges. “Of course, we moved to having virtual meetings,” he says. “But I was most concerned about what would happen in the community. Would our hospital employees be safe from the virus, and could the hospital still provide acceptable service to the area? The stress that we all feel has greatly increased.”

He says he is proud of the board members for their achievements in working as a team, and for maintaining the financial stability of the hospital during the pandemic. “We are a diverse board whose members get along well. We can disagree but still work as an effective board. We all know and appreciate one another.”

Mark says that working with Debra Wright, Howard Memorial Hospital CEO, is a positive endeavor. “She is willing

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to work together with board members and the community for the betterment of the hospital,” he says. He also expressed appreciation for AAHT because of the organization’s dedication to keeping trustees updated through webinars and legislative updates.

SERVICE IN AN URBAN SETTING

Rob Robinson is president of the board at the Medical Center of South Arkansas, a 166-bed facility located in El Dorado, Arkansas.

The hospital offers a wide selection of services to the community of El Dorado and the rural areas surrounding it.

Rob’s background is finance, and he is the Community President/Senior Credit Officer at Simmons Bank in El Dorado.

He is past president of the AAHT, and in that role he shared his strong leadership abilities with trustee boards across the state.

“Our hospital is a significant contributor to our community’s economic development success,” he says. “When asked to serve on its board, I was glad to make my time and energies available for helping my community.”

Rob says he couldn’t be prouder of the way the team at the Medical Center is handling the stress and heartache caused by the pandemic. “The hard work, dedication, and selflessness in the face of such difficult circumstances is a testament to their professionalism as health care workers and their compassion as human beings,” he says.

He’s quick to credit AAHT as an important resource for hospital boards. “AAHT is a trusted source of information, training opportunities, and advocacy issues for hospital trustees,” he says.

AAHT is a nonprofit organization dedicated to benefiting hospitals of any size through offering resources to board members, hospital administrators, and executive teams. These tools include e-communications, quarterly newsletters, The Arkansas Trustee, AHA communications, and discounts on trustee events. Education offered to AAHT member hospitals include conferences, workshops, virtual events, legislative updates, and regional networking dinners.

Hospital board members interested in learning more about AAHT membership can visit the Affiliated Groups tab on the AHA website: www.arkhospitals.org.

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LEADER PROFILE

The inscription above his door says it all ...

Love God, Love People

By Nancy Robertson

T

he premature birth of his son started Steven Webb, President and CEO of Unity Health, on his path to health care administration. “As the parent of a preemie, you come into close contact with compassion in every hospital department involved in the care of your baby,” he says. “My wife, Elizabeth, and I were amazed and so grateful for the many people with whom we had contact over the two-month period our son spent in the NICU. Though it’s now 18 years later, I still remember the case coordinators, respiratory therapists, residents … and the cafeteria cashier, the dietary workers. They all became very familiar to us in those months. Teams coordinated with one another, and they made us feel confident. There are times in our lives when God simply opens a door. I had a desire for my work to be a ministry, and the people in health care opened my eyes to work that makes a difference.”

Webb says he didn’t know how to go about entering the health care field. At the time of his son’s birth, he was in the insurance industry, having graduated with a bachelor’s degree in Business Administration and Management. “I talked to a number of young men and women in health care, and I learned about the master’s program in Health Care Administration being offered at the University of Arkansas Little Rock. I enrolled in the program and completed it in 2006.”

His first foray into hospital administration began soon after, when he was named CEO of Good Shepherd Medical Center in Linden, Texas. “I wish every administrator could start work in a small hospital,” he says. “It affords you the opportunity to see, firsthand, how every role in the hospital functions. It’s a learning experience like none other.” He says that being able to experience leadership with teams in the small hospital environment is extremely valuable.

After several years at Good Shepherd, Webb returned to Arkansas and began filling leadership roles in a large Arkansas-based health system. He served as Administrator, Vice President of Patient Services, and Vice President/ Administrator. Nearly four years ago, he was named President and CEO of Unity Health, which brought him home to Searcy.

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Steven Webb, President/CEO of Unity Health Photo: George Dillin Photography

We Asked...

What’s on your music playlist?

I haven’t caught up with technology and I don’t have a playlist. My radio presets are Contemporary Christian, Classic Rock, and 80s-90s Country Music.

What is the best advice you were ever given?

My dad started telling me as a preteen through my teenage years two pieces of advice: Number 1, “Use your brain,” Number 2, “Keep your mouth shut and your options open.”

Do you have a favorite movie? Why do you like it?

I have several favorite movies. The one I quote a lot is Remember the Titans. I like it because of the leadership lessons it addresses, as well as lessons about overcoming differences and working together to be champions. The lessons I learned playing sports myself continue to help me in my professional career.

What would you be doing if you weren’t in health care?

Without a doubt, I would be the lead actor in the Jurassic Park movies. In all seriousness, health care is my ministry. If I were not in health care, I would be working in some way to serve others.

What do you like to do in your downtime?

With four teenagers at home, I don’t get much downtime. I enjoy spending time with my family at the lake, working with my son restoring my grandfather’s truck, and watching my girls’ volleyball games, theater performances, and dance competitions.

(Top) Dr. Roddy Lochala, CMO, and Dr. Amy Daniel working COVID testing drive-thru at Unity Health.

(Left) Steven Webb, President/CEO working the drive-thru portion at CommUnity of Caring, Unity Health’s annual medical mission.

ARKANSAS HOSPITALS | SPRING 2022 41

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In January of 2020, Webb says Unity Health-White County Medical Center’s Chief Medical Officer, Dr. Roddy Lochala, first approached him with serious concerns about a new virus making its way to the U.S. “He told me we needed to spend 50% of our time, starting right then, to prepare for the coming of SARS CoV-2,” Webb says. “That was a real eye-opener. We immediately began making preparations and, because of Dr. Lochala’s foresight, we have been able to not only stay one step ahead of the virus and its repercussions, we’ve been able to help other hospitals as they planned for the disease.”

In those earliest days of the pandemic, Dr. Lochala served as an advisor to Luminare, Inc. in collaboration with Microsoft for Startups, to deploy QuickScreen, an online self-assessment tool for consumers. “There was so much fear and confusion in the populace,” Webb says. “The web-based screening tool Dr. Lochala helped develop gave people at-home guidance as to whether or not they should seek testing for COVID-19.” By answering a series of questions online, people at home could determine their need – or not – to pursue testing for the virus. The tool was adopted not only in Arkansas, but also in a Houston, Texas hospital network, and from there was used more than five million times all over the world.

To determine the number of COVIDspecific beds and units they might need, Webb and his planning team studied the COVID-19 spread in Italy. “In those early days, we were all watching Italy as an example of what might be coming,” he says. “We started determining how many negative pressure spaces we might need, and we devised some creative solutions for where, on our Specialty Care campus, we could repurpose areas as COVID units.”

He credits Unity’s engineering team with creating 43 negative pressure rooms in an old ICU – “just in case.” In the coming months, these rooms were literally lifesavers.

Another challenge from the first months of 2020: the shortage of ventilators. Early on, Unity Health

developed contracts for leasing ventilators above the number they had readily available. But Webb didn’t stop there. “We work closely with Harding University here in Searcy,” Webb says. “When a national shortage of ventilators seemed likely, we worked with teams at Harding to build some working prototypes of ventilators from scratch. Knowing that we had those prototypes as our backup was a comfort. Though we never had to use their technology, we’re grateful to the people at Harding for their expertise.”

Staying ahead of the curve on personal protective equipment (PPE) supply was a challenge for hospitals everywhere during the first year of COVID, and it remains so in some areas today. “Again, we’ve all experienced many times when God made his presence known during this pandemic,” Webb says. “We were down to six N-95s of a certain size – not six boxes, six masks – at one point. That afternoon, a construction worker came in with boxes of N-95s of the exact size we needed, saying they were from his boss.”

At another point the hospital was down to 12 antigen tests. They lasted until a shipment of 1,200 arrived, just in time to replenish stock.

With community coordination, Unity Health held ‘Park and Pray’ events to support its staff and patients. People gathered on the health system’s campus simply to pray together from the safety of their cars.

“We’ve been pretty open about thanking God for divine intervention during these years of COVID,” Webb says. “For all who are in health care, I imagine it’s pretty normal.”

Another “right equipment, right time” coincidence: “We desperately needed the ability to process COVID-19 tests locally,” Webb explains. “Imagine our relief when a new Roche processor, which we purchased for testing in other capacities, was approved by the FDA as one of the first to allow COVID PCR testing!” That providential occurrence allowed Unity to process 96 tests every three hours around the clock.

It reduced turnaround time on test

results to 24 hours, and it allowed Unity to quickly process tests for other health care entities in all four corners of the state.

And freezers. Remember the extra-low temperature freezing capacity needed for the justdeveloped Pfizer vaccine? Unity Health had not one, but two of those freezers, and was able to become the regional hub for vaccine storage as the Pfizer vaccine rolled out of production.

RIGHT EQUIPMENT, RIGHT TIME

Whoever would have thought that the purchase of a Xenex LightStrikeTM robot for the cleaning of rooms could save on PPE during COVID? “We used the robot to zap N-95 masks when our supplies again ran low,” Webb says.

“This expanded the life of our PPE and gave everyone peace of mind that their masks were safe.”

ARKANSAS HOSPITALS | SPRING 2022 43

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SPECIAL SERVICES

Unity Health was an early provider of monoclonal antibodies (mAbs) when they were first made available as therapies for those who contracted COVID. “We were the third busiest mAb site in the state,” Webb says.

“We adopted the mAb therapies early, educating our providers with video programming to get them on board.

As a health system, we did everything we possibly could to lower people’s chances of developing serious disease and worked hard to help them stay out of the hospital.”

Patients, families, employees of Unity Health, and community members were offered tailored services to help them keep up with COVID rules and concerns.

“We became a trusted voice at the onset and height of the pandemic with our social media presence on Facebook,” Webb says. “Like many other hospitals, we used this marketing tool to reach people where they are. We also reached out to our local Spanish-speaking community through El Puente, Searcy’s Spanish Services Center. We have been diligent about staying in the public eye, keeping the public informed about vaccine availability, masking and social distancing protocols, testing availability, and other COVID updates.” As masking protocols change, citizens can always check the health system’s Facebook page for the most current information.

And what about those who find themselves more anxious and more stressed after more than two years of COVID isolation/regulations? Unity Health has offered a toll-free COVID hotline where members of the community could call and be connected with a licensed behavioral health expert. All calls were confidential. “This is a service we wanted to provide to the community because COVID is taking a mental toll as well as a physical toll on people everywhere,” Webb says. “It’s another way we’ve tried to stay one step ahead of what COVID throws at us, keeping our community in touch with the help they need.”

(Above) Xenex LightStrike Robot ( Bottom) Citizens were invited to "Park and Pray," praying with medical center staff for patients and for all of those working to fight COVID.

TAKING IT NATIONAL

Webb says Dr. Lochala and the entire Unity team continue to work closely to keep ahead of what COVID might bring next. “When COVID was at its height, [Arkansas] Senator John Boozman visited Unity and saw what we had been able to accomplish. In fact, he brought Senator Tom Cotton, Representative French Hill, and Representative Liz Cheney to to visit our Searcy campuses to learn how we were staying ahead of the disease. We told them it was a matter of recognizing the challenges ahead and devoting the time, early on, to planning and to remaining faithful to the people we serve, both associates and community residents. We know our team has done all it can to care for this community. We’re all just thankful for the opportunity to serve.”

The inscription above Webb's door tells the story of his service: "Love God, Love People."

ARKANSAS HOSPITALS | SPRING 2022 45

Advancing Health in This Pandemic

By Chad T. Rodgers, MD

S

cientists and health professionals around the world have long anticipated a viral spread that could resemble the devastating Spanish Flu pandemic of 100 years ago.

Though health care in the United States and around the globe has improved since that long-ago pandemic, the appearance in 2019 of SARS CoV-2, or COVID-19, was still a shock.

Even advances in technology – including ventilator improvements, ECMO, vaccine development, and new medications – did not prepare the world for COVID-19.

The changes at hospitals and clinics to prevent the spread of infection within their walls and to reduce complications of the disease, and even improved access to health care insurance, could not adequately prepare people for the current pandemic.

Prior to its arrival in the U.S. in early 2020, there existed an awareness of weaknesses within the health care setting.

Yet due to the already-busy health care world, many of these weaknesses were acknowledged and discussed, but they were put aside.

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And there were weaknesses that were not yet known.

The pandemic brought those weaknesses – coupled with a lack of information on how to respond – to the forefront.

LEARNING AS WE GO

When this novel virus emerged, disease surveillance and other methods of data collection quickly helped pinpoint those places where it appeared. Health care practitioners could see where it was popping up in the world and identify when it came to their regions. It was known to be deadly, especially for patients with certain disease states. What was not known was how the virus spread.

We soon learned that the virus was not spread from one person to another as readily on surfaces, but that transmission primarily occurred through respiratory spread.

Identification of the vulnerabilities of certain demographics became clearer, and so did knowledge about the original virus’s contagiousness.

The effectiveness of masking in prevention of spread was identified.

AFMC continues to work with hospitals, clinics, and other health care facilities to ensure good quality of care, despite the stresses the pandemic brings.

Vaccine technology that had been in development for years meant that new vaccines, designed to slow the spread of the virus, began to appear in nations including the U.S. The vaccines would enable those vulnerable populations a measure of protection. Hospitalizations could be prevented; the number of patients requiring ventilation could be reduced, and ultimately, lives could be saved.

Although it didn’t feel it was possible to move quickly enough, U.S. distribution of the vaccine to a large portion of the population, including Arkansans, moved swiftly.

Health care systems quickly stood up vaccine clinics within their hospitals and communities.

COLLABORATIONS ARE KEY

AFMC is a trusted source and is called upon frequently to lead initiatives.

Almost immediately at the pandemic’s outbreak in Arkansas, AFMC was asked to champion COVID testing events. Testing was administered throughout central Arkansas. Our work led to a unique partnership with a major university in the state to provide testing for students. These relationships carry on today.

AFMC collaborated with Blue Cross and Blue Shield and the State Chamber in a statewide campaign, “Vaccinate the Natural State,” to make vaccines available to everyone. This combined effort highlighted the importance of the vaccine and helped reduce initial vaccine hesitancy.

During the spring, summer, and fall of 2021, various governmental agencies and private businesses called upon AFMC to handle vaccine events. Nurses spent

days at businesses, schools, festivals, graduations, and football games making vaccines available to the public. Our work continues as we provide vaccine to Historically Black Colleges and Universities and other institutions of higher education in Arkansas.

MAKING LEMONADE

Health care research allowed quick development of new treatments for COVID-19. Monoclonal antibodies and new antivirals that allow high-risk patients to lower their risk of disease progression are now available. AFMC hosted several webinars on how to treat with monoclonal antibodies for health care providers around the state.

When telemedicine was emerging, providers did not prefer it as a way of managing their patients. But when COVID hit, many health care systems adapted and found ways to best utilize this technology for safe care of their patients. Payors responded, paying for telemedicine visits.

Though patients might have limited access to this service due to, perhaps, a lack of devices or internet connectivity, remote patient monitoring and telemedicine are growing as we learn more from research and best practice.

STILL LEARNING

COVID revealed a shortage of health care professionals, a situation that was exacerbated by some leaving health care; sadly, many in health care also became sick and died as a result of contracting this virus.

Not only did many hospitals run out of hospital beds, in some locations they also ran out of nurses and doctors to care for patients. In response, many nurses and other health-related

professionals traveled to those hospitals needing help the most. While this filled a need, it also created a loss of staff at those hospitals they left.

Staffing remains a challenge.

There is still room for improvement in health care coverage. Such improvement could result in a healthier population and a healthy workforce.

Access to providers, especially in rural areas, is often limited. We need more health care professionals.

During the pandemic, AFMC reached out, and continues to reach out, to providers to see where we could assist in responding to needs. We collaborated with other organizations to help meet needs as they arose. We assisted providers as they sought to improve use of telemedicine within their practices to better reach patients and receive reimbursement.

We continue to reach out to the community to respond to the increased stresses the pandemic brings. We seek to increase knowledge of Adverse Childhood Experiences and how to build and sustain resilience.

We continue to work with hospitals, clinics, and other health care facilities to ensure good quality of care despite the stresses the pandemic brings.

Although the pandemic may yet continue for a while, it is time to consider what life will be like on the other side. We can plan how to better respond to a pandemic and other health care needs. Health care must continue to move forward.

Chad T. Rodgers, MD, FAAP, serves as Chief Medical Officer at AFMC. He is a partner and pediatrician at Little Rock Pediatric Clinic.

ARKANSAS HOSPITALS | SPRING 2022 47

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re information.

See Sentinel Event Alert Issue 59, “Physical and verbal violence against health care workers,” for more information.

FEARLESS HEALTH. Arkansas Blue Cross and Blue Shield is committed to the health of Arkansans.

A whole person approach to health, including physical and behavioral well-being.

And we recognize that total health is influenced by many factors, including medical history, genetics, lifestyle, environment, nutrition, safety and physical activity.

We also realize it will take all healthcare providers working together to ensure future generations of Arkansans are their healthiest so they can fear less and live their best life. Fearless health.

00436.01.01-0322 ARKANSAS HOSPITALS | SPRING 2022 49

CONSTRUCTION

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INDUSTRIAL

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E XC AVAT I O N

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E N V I R O N M E N TA L

WE BUILD PLACES OF LEARNING

When the University of Central Arkansas set out to construct their Integrated Health Sciences Building, they brought in Nabholz and Doyne Construction to construct this cutting-edge, 80,000-square-foot facility. The first of its kind in the region, this four-story facility brings multiple healthcare-related degree tracks under one roof. The new building features simulation labs, mock hospital rooms, a working medical clinic for the public, audiological exam suite, and a therapy gym.

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SERVICE