The COURAGE to CARE
Winter 2020
2020
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From a distance
ARKANSAS HOSPITALS | WINTER 2020 1
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to free resources and tools for your hospital! AFMC can guide and assist hospitals – whether a prospective payment system or critical access, urban or rural – with implementing best practices for safety, quality and data reporting. Go to afmc.org and get instant access to information that Arkansas hospitals can use.
2 WINTER 2020 | ARKANSAS HOSPITALS
The COURAGE to Care COURAGE DURING COVID-19
10 Raising the Bar for COVID-19 Response 12 COVID-19 Testing in Arkansas 41 Contact Tracing Behind the Scenes 44 Five Actions to Promote Health Equity 46 Looking Toward the Legislative Session
SPECIAL SECTION
19 2020 Trade Show – from a Distance
IN EVERY ISSUE
5 President’s Message 7 Editor’s Letter 8 Virtual Learning Opportunities 8 Hospital Newsmakers 16 Coach’s Playbook 36 Leader Profile: Shane Frazier 48 Where We Stand: Flu Prevention During the Pandemic
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 Elisa M. White, Editor in Chief Nancy Robertson, Senior Editor & Contributing Writer Ashley Warren, Associate Editor Katie Hassell, Graphic Designer Roland R. Gladden, Advertising Traffic Manager
BOARD OF DIRECTORS
Chris B. Barber, Jonesboro / Chairman Ron Peterson, Mountain Home / Chairman-Elect Peggy Abbott, Camden / Treasurer Darren Caldwell, Jonesboro / Past-Chairman Ryan Gehrig, Fort Smith / Director, At-Large Greg Crain, Little Rock Barry Davis, Paragould David Deaton, Clinton Marcy Doderer, Little Rock Kathy Gammill, Searcy Phil Gilmore, Crossett Vince Leist, Harrison James Magee, Piggott Mike McCoy, Danville Johnny McJunkins, Nashville Gary Paxson, Batesville Larry Shackelford, Fayetteville Brian Thomas, Pine Bluff Debra Wright, Nashville
EXECUTIVE TEAM
Robert “Bo” Ryall / President and CEO Jodiane Tritt / Executive Vice President Tina Creel / President of AHA Services, Inc. Elisa M. White / Vice President and General Counsel Pam Brown / Vice President of Quality and Patient Safety Lyndsey Dumas / Vice President of Education
Winter 2020
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 | WINTER 2020 3
Arkansas Heart Hospital Bryant, Arkansas (currently under construction)
CHI St. Vincent Arkansas Neuroscience Institute Sherwood, Arkansas
CARTI Cancer Center Pine Bluff, Arkansas (coming in 2021) 4 WINTER 2020 | ARKANSAS HOSPITALS
UAMS South Central Campus (at JRMC) Pine Bluff, Arkansas
Little Rock | Bentonville | Dallas
PRESIDENT’S MESSAGE
Wholehearted
Endurance
W
hen a building collapses, when a tornado or hurricane strikes – and even in times of war – there's a beginning and an end to the stream of patients entering our hospital doors. With COVID-19, thus far, we have only seen the beginning. It’s so different than anything we’ve ever lived through. With numbers of new cases still climbing, hospital care teams return day after day, ready to care – but they’re wearing out. Not since the 1918 Spanish Flu pandemic have health care teams seen such unrelenting illness. As during that pandemic, today’s public health precautions of masking, social distancing, handwashing, and limiting gatherings are currently our only defensive tools against the virus. Vaccines are on the nearest horizon, and planning for their distribution is a high priority today. But the top priority remains: Care for the sick, give them comfort, help them heal. After nearly a year of helping patients fight this virus, our health care workers are physically, emotionally, and mentally drained. Their work during the COVID-19 pandemic saves the lives of Arkansans every single day, but it’s wreaking havoc on their own health and well-being. They tell us, here at the Arkansas Hospital Association, that they don’t want to be glorified as heroes; they just
want everyone to work together to end this pandemic, so they don’t have to move mountains every single day. We can do this. We know that applying those four public health standards can bring cases down, so we continue to mask and socially distance. We wash our hands, stay home as much as possible, and we limit all gatherings – even on holidays and birthdays. But we can also voice our thanks, so that they know they aren’t taken for granted. Governor Asa Hutchinson offers appreciative words to Arkansas caregivers at his press conferences. Our communities thank them with gifts of food and free services, citizens offer prayers and drive-by “thank
you” parades, and still the cases keep coming. The toll on our health care workers continues. What can each of us do to help lift their share of the COVID-19 burden? We can offer kindness in myriad ways. We can greet fellow caregivers with a sincere word of thanks. We can offer health care colleagues, both clinical and non-clinical, a “thank you for your service,” as we do for those in our military. We can send or deliver meals to the health care workers who live in our neighborhoods, so there’s one less thing for them to do when they come home tired to the bone. We can “pay it forward” by buying their coffee or a meal at the hospital cafeteria. We can continue to support one another by listening when tears come or emotions escape. COVID-19 hits us all on a very personal level. For those of us involved in health care, its toll is almost overpowering. But we’re still all in this together, and every supportive word and deed counts. Today, we thank our coworkers for their endurance, and we pledge to watch for ways to offer support. Offering a simple “thanks,” recognizing their strength and enduring compassion, is a good place to start.
Bo Ryall
President and CEO Arkansas Hospital Association
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6 WINTER 2020 | ARKANSAS HOSPITALS
EDITOR’S LETTER
Innovating
in a Crisis O
ver the past months, we have all seen the toll that COVID-19 is having on patients, health care workers, and the entire health care system. The word “unprecedented” seems to have lost its weighty meaning, with new case and hospitalization records being shattered across the nation. Collectively, we mourn those we have lost to the pandemic, even as we celebrate doctors, nurses, and others in the health care field who work so hard to help us fight the virus and heal. I doubt that many of our health care workers feel like heroes as they show up each day to work. After all, real heroes never think about their heroism. They just keep doing what needs to be done despite personal risks and consequences. The doctors, nurses, respiratory therapists, x-ray technicians, laboratory staff, environmental services workers, engineers, supply chain managers, and all of the others who make our hospitals function deserve our praise. But in the midst of this crisis, we see opportunities to do even more. Together, we are seizing this moment to change health care for the better. We find ourselves meeting challenges and supporting Arkansas communities by being agile and innovative. What did Ouachita County Medical Center staff do when they needed to open COVID-19 testing up to all who requested a test? In our cover story, that medical center’s President and CEO Peggy Abbott will tell you about the innovations that changed an entire county’s access. We are showing empathy for those on the front lines of patient care by thinking up real and concrete ways to honor them – ensuring they have the protective equipment they need, improving systems and operations to help streamline their workload, and finding heartfelt ways to thank them. In her column, “Coach’s Playbook,” Kay Kendall shares a number of ways communities and individuals are saying “thanks” to their health care workers, including the provision of much-needed PPE. Recognizing the immense mental and emotional pressure COVID-19 places on our patients and health care staff, this pandemic gives us a real opportunity to dispel the stigma around mental health and normalize asking for help and admitting the need for support. In
this issue’s Leadership Profile, Shane Frazier, Group CEO of Pinnacle Pointe Behavioral Healthcare System, shows us the importance of addressing mental health during the pandemic. The intricacies of continuing care during school closures and the loss of in-person therapy were a challenge quickly met by Frazier and his staff, offering lessons for teams everywhere. The re-imagining of health care is happening all around us. When the pandemic finally comes under control, I believe we’ll look back and see that our innovation during its darkest days will brighten health care’s future for years to come.
Elisa M. White Editor in Chief
ARKANSAS HOSPITALS | WINTER 2020 7
HOSPITAL NEWSMAKERS Methodist Family Health Hospital will begin celebrating its 20th anniversary year, starting January 1. The hospital cherishes the thousands of Arkansas children and their families who have received help over the past 20 years, as well as those who will be helped over the next 20. Methodist Behavioral Hospital first opened its doors in 2001 with 16 acute care and 44 subacute care beds, and in its first 20 years it has served more than 20,000 patients. The facility currently serves more than 1,800 patients and their families each year.
Governor Asa Hutchinson announced in mid-November his formation of a task force to address hospital capacity challenges caused by the pandemic, facilitate coordination between hospitals statewide, and encourage all Arkansans to adhere to the mask mandate. Members of the task force include: • Elizabeth Smith, Secretary of the Department of the Inspector General. • Dr. Greg Bledsoe, Surgeon General. • Larry Shackelford, President & CEO, Washington Regional Medical Center. • Chris Barber, CEO, St. Bernards Healthcare. • Scott Street, CEO, Medical Center of South Arkansas. • Dr. Cam Patterson, Chancellor, UAMS. • Rachel Bunch, Executive Director, Arkansas Assisted Living Association and Arkansas Health Care Association. • Bo Ryall, President & CEO, Arkansas Hospital Association. • Troy Wells, President & CEO, Baptist Health. • Ryan Gehrig, President, Mercy Hospital Fort Smith. • Major General Kendall Penn, The Adjutant General, Arkansas National Guard. • A.J. Gary, Director & State Homeland Security Advisor, Arkansas Department of Emergency Management. • Dr. Jose Romero, Secretary of the Department of Health. • Dr. Jerrilyn Jones, Preparedness Medical Director, Arkansas Department of Health. • Dr. Jennifer Dillaha, Medical Director-Immunizations, Arkansas Department of Health. • Dr. Naveen Patil, Medical Director-Infectious Disease, Arkansas Department of Health. • Dr. Keyur Vyas, Associate Professor of Medicine in the Internal Medicine Division of Infectious Disease, UAMS. • Phillip Gilmore, CEO, Ashley County Medical Center. • Dr. Steven Collier, CEO, ARcare. • R on Peterson, President & CEO, Baxter Regional Medical Center. 8 WINTER 2020 | ARKANSAS HOSPITALS
In addition to the formation of the task force, the governor announced that $1.6 million dollars will be invested in public health marketing this winter, and 30 National Guard members will assist with contact tracing and investigation. CHI St. Vincent Hot Springs received national Magnet designation by the American Nurses Credentialing Center for its continued commitment to nursing excellence and compassionate patient care. Magnet designation is the highest honor bestowed upon an organization for professional nursing practice and recognizes excellence in nursing leadership, clinical practice, innovations and positive outcomes. CHI St. Vincent Hot Springs becomes the fourth hospital in Arkansas to receive Magnet designation and one of only 530 hospitals nationwide to receive that recognition. CHI St. Vincent Infirmary in Little Rock became the first hospital in Arkansas to earn Magnet designation in 2013 and was re-designated in 2018. Other Arkansas hospitals with the designation are Arkansas Children’s Hospital and Conway Regional Medical Center.
CHI St. Vincent Hot Springs
EVENTS AND VIRTUAL LEARNING
During the pandemic, AHA is offering virtual educational offerings and affiliate meetings in order to protect our health care teams. More webinars and affiliate group meetings will be added to the online event calendar as they are finalized. Please check the “Upcoming Events” page at arkhospitals.org for more information.
JANUARY
January 22
Arkansas Association of Healthcare Engineering (AAHE) 2021 Virtual Conference
FEBRUARY
February 16
Tech Tools for Serious Self Care Beth Ziesenis Webinar sponsored by Qualified Plan Advisors
More Than A Medical School 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. Located in Jonesboro, NYITCOM at Arkansas State is uniquely situated to improve access to health care and health education in the state and the greater Mississippi Delta region. NYITCOM students are eager and ready to address the region’s significant health care needs through research, outreach, wellness initiatives, and superior patient care.
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ARKANSAS HOSPITALS | WINTER 2020 9
A Rural Hospital
Raises the Bar for COVID-19 Response By Nancy Robertson
P
eggy Abbott, President and CEO of Ouachita County Medical Center (OCMC), a 98-bed general, acute care hospital in Camden, Arkansas, saw the fear on people’s faces – in their eyes – during the earliest days of the pandemic. Those were the days when tests were only available for the most vulnerable, or those with multiple co-morbidities that could complicate recovery. They were the days when it was nearly impossible to gather enough test kits or the reagents to use with them; it was the time when testing labs were overrun and results being returned much past their date of usefulness.
PRAYING, PLANNING, HOPING
“We knew we needed a plan to guide us, and a way to test those who feared they had COVID-19. As with all hospital staffs, we felt an intense sense of responsibility to 10 WINTER 2020 | ARKANSAS HOSPITALS
our community and the people living in the area we serve,” Abbott says. “Our COVID-19 Task Force got to work in those earliest days and put us on a testing path we didn’t expect. We were fortunate to have in our hospital lab a chemical analyzer that could be used for rapid testing of the virus. We begged for test kits, with which it could be validated for use, and the University of Arkansas for Medical Sciences (UAMS) answered our call for help. Authorization to use that analyzer opened the door for our hospital: We would chart our own COVID-19 testing, tracing, and treatment path.” “Offering open testing seemed to be the key. We had the nagging suspicion that for every case we tested [using the early criteria], there were 10 more we should have been testing,” she says. ”Believing that many people have an almost intuitive sense when they need to be tested, we wanted to offer tests on demand. Those early days taught
us that many people requesting tests – those who did not qualify based on age or health qualifications – were going home sick. Their faces showed both fear and disappointment when testing protocols didn’t allow us to test upon request. So, we came up with our own testing strategy for fighting COVID-19.” That strategy includes testing on demand and a targeted and monitored tracing system designed to keep fear and case numbers as low as possible in the Ouachita County area. The COVID-19 Task Force led by Diane Isaacs, RN, Risk Manager for OCMC, unites medical professionals with community leaders, including Ouachita County Judge Robbie McAdoo, Camden Mayor Julian Lott, Ouachita County Public Health Officer Dr. Larry Braden, and others, to guide Ouachita County’s pandemic response. “Central to the effort is community education,” Abbott says. “Of course, we teach about masking, social distancing, and handwashing, but our efforts move beyond that. We instruct those with COVID-19 on how to safely care for themselves at home, how to successfully quarantine, how to work with contact tracers, and how to know when it's time to head for the hospital.”
THE NITTY GRITTY
To open the testing-on-demand service, OCMC purchased test kits on its own, apart from those supplied through federal or state sources. This freed the task force to make its own rules for test availability. “Our regional response began with partnering with UAMS to provide a one-day screening/test clinic at the SAU Tech campus in East Camden; however, we realized that individuals left that day disappointed when they did not meet the criteria for a COVID-19 test. So, OCMC soon followed that event with self-funded, one-day testing clinics in Stephens and Chidester, two of Ouachita County’s smaller communities,” Abbott explains. “Immediately, positive tests began showing up in patients who, otherwise, would not have been
...We see our fight against COVID-19 as a war and ourselves as a reconnaissance force.
Testing-on-demand is part of Ouachita County Medical Center's fight against COVID-19. "Our Express COVID-19 Testing Clinic offers testing to everyone, regardless of ability to pay," explains Peggy Abbott, President and CEO of the medical center, which is located in Camden.
identified as COVID-positive because they were asymptomatic.” “These positive tests pushed us forward,” Abbott says. “We set out to identify pockets within our communities where COVID-19 was active, so that we could catch and minimize the spread. We opened our seven-day COVID-19 testing clinic, and by August, we had other quarantine and virus surveillance strategies in place. Flexibility and the ability to act fast are helping us rapidly respond to our county’s needs.” OCMC’s Urgent Care Clinic was the natural location for the seven-day testing clinic. “Our Express COVID-19 Testing Clinic offers on-demand testing to everyone, regardless of ability to
pay,” Abbott explains. “We’re open every day of the week (Monday-Friday 8 a.m.-6 p.m., Saturday 8 a.m.-1 p.m., Sunday 1 p.m.-6 p.m.). Every clinic staffer is trained to decide in-house whether a patient will be tested using the rapid test or if the specimen will be sent away to be tested. No appointment is needed, nor is a referral from a physician. If people have insurance, we will bill their insurance companies; however, if they have no insurance, their test is provided free of charge.” She says that UAMS criteria as to which test will be conducted are applied in the OCMC clinic. Geographic data are followed so that pockets of infection can be (Continued on page 13) ARKANSAS HOSPITALS | WINTER 2020 11
COVID-19 Testing in Arkansas
“O
uachita County Medical Center (OCMC) shows us that proper use of testing data can really help reduce case numbers and hospitalizations,” says Melanie Thomasson, MPH, Director of Data for the Arkansas Hospital Association (AHA). “That hospital’s study and application of locally collected data helps its staff identify and isolate COVID-19 pockets within their county, and their dedication to make the quarantine process workable for each family is a great model.” With no national COVID-19 testing strategy developed for the U.S. (as a whole), every state continues developing its own policies through trial and error. Arkansas Governor Asa Hutchinson is a strong advocate of testing, and he supports its use as one key to beating the virus. The utilization of test data, combined with contact tracing, quarantine, isolation, and other public health measures, is proven to reduce the spread of SARS-CoV-2, the virus that causes COVID-19. “Arkansas is considered a ‘low-resource’ state, but we make the best use of the resources we do have,” Thomasson says. She points to regional hospital collaborations and partnerships as pluses in the fight to test and isolate those who contract the virus. “We’re fortunate in Arkansas to have a good, instate PCR reference lab,” she says. “This helps Arkansas stay current with testing and results, helping avoid the backups other states sometimes report. In addition, many local hospitals, like OCMC, are acquiring their own testing platforms to provide testing in their communities.” The Arkansas Public Health Lab has been important to the fight against COVID-19 from the beginning, she says, and lab staff are growing their testing capacity as time goes on. “As testing improves, we’re able to catch more positive cases and better manage patient and contact care,” she says. “We can use OCMC’s example to replicate on-demand testing at the local level. In the future, we’ll see tests available for the home market. Some of these are becoming available now.” The important thing is to keep testing, she says, and to make good use of the data. “Timing our testing is also important,” she says. “Carefully timed testing and proper use of isolation and quarantine can help us reduce the spread of COVID-19.”
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(Continued from page 11) identified and immediately dealt with. “When we find an area where infections are breaking out, we have a two-pronged strategy,” Abbott says. “We start with the patient who tests positive. We teach why quarantining is so important in stopping the spread of the virus. And we assess their needs during quarantine to make that time workable for them. If the patient needs groceries and doesn’t have the means to buy them, we work with our local agency, HUB, to provide them with food. If they have means, but they cannot go out, someone in the community will be their feet and shop for them.” “We send every ‘positive’ patient home with a pulse oximeter and a thermometer,” Abbott says. “We show them how to watch their oxygen levels, and what lowered levels may mean. Knowing what to do if/when certain levels are reached gives them peace of mind and a known strategy for fighting the virus, including when to stay put and when to come to the hospital for help. Giving patients the tools to track their progress at home alleviates fears and saves lives.” Step two of the strategy involves contact tracing. Tracers notify identified contacts of patients testing positive for the virus. “If contacts do not test positive themselves, of course they still need to quarantine. The same community strategies apply to everyone in quarantine. We work to help them be successful,” Abbott says.
Quality Care Rooted in Arkansas
hope Is The Foundation. recovery Is The Journey. In response to the growing needs of our community, The BridgeWay has expanded its continuum of care for substance use disorders. The acute rehabilitation program will provide hope and recovery for adults struggling with substance use disorders. Led by Dr. Schay, and a Board Certified Psychiatrist and Addictionologist, the Substance Use Disorder Rehabilitation Program is for adults at risk of relapse. Rehabilitation requires the supportive structure of a 24-hour therapeutic environment. To learn more about our continuum of care for substance use disorders, call us at 1-800-245-0011. Physicians are on the medical staff of The BridgeWay Hospital but, with limited exceptions, are independent practitioners who are not employees or agents of The BridgeWayHospital. The facility shall not be liable for actions or treatments provided by physicians.
Dr. Schay
Medical Director Of Substance Use Disorders & Patriot Support Program
LETTER TO THE GOVERNOR
Knowing that Arkansas’s governor, Asa Hutchinson, is a strong advocate for testing, Abbott wrote to him, explaining OCMC’s expansive strategic plans for testing and tracing in the Ouachita County area. “It must be hard to lead an entire state in this tough fight against the virus. I wanted to thank him for his leadership during this pandemic, for his belief in testing, and to share our approach,” she says. “I told him that we see our fight against COVID-19 as a war and ourselves as a reconnaissance force,” she explains.
ARKANSAS HOSPITALS | WINTER 2020 13
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“Our COVID-19 Task Force and our health care workers are on reconnaissance and surveillance missions to seek out and isolate the ‘enemy,’ which is the COVID-19 cases in our area. Governor Hutchinson said he appreciated knowing how we are tackling the COVID-19 enemy in our area, and he asked me to share our methods with others as part his weekly press conference and in a meeting with community leaders in a specific area of Southwest Arkansas. We know other health care centers are fighting this common enemy in their own ways, and we hope our ideas can help them in their fight.”
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14 WINTER 2020 | ARKANSAS HOSPITALS
TASK FORCE: THOUGHT LEADERS AND PLANNERS
While testing and tracing take precedence outside the hospital walls, there’s an equal fight happening inside. “Fighting COVID-19 is unbelievably hard,” Abbott says. “We not only compassionately care for those who are hospitalized, all of us in health care are finding ways to help family members communicate with their loved ones who are hospitalized. As the months wear on, we are offering PPE and quiet rooms to unite family members with dying loved ones. I must say, it’s a blessing to work with people in these ways. Each death of a community member is so grievous to us; we are each doing all we can to help one another.” And then, there’s the planning for “Phase 2” – vaccinating Ouachita Countians against the virus. “Plans for vaccinating our population began even before vaccines were on the near horizon,” Abbott says. “We have finalized our Phase 2 planning and have done the paperwork. We’re ready to begin as soon as vaccines are distributed.” “What we do here, in this little institution, is care for our patients in every way we can,” Abbott reflects. “Our fight against the COVID-19 enemy continues. We know we have many months ahead of us. With our reconnaissance and surveillance, every day we hope to lessen the ‘worst’ for our community. And every day, we continue praying, planning, and hoping.”
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COACH'S PLAYBOOK
Community Support Cuts Both Ways in the
Time of COVID-19 by Kay Kendall
O
ne of the Baldrige Excellence Framework’s Core Values and Concepts is “Societal Contributions and Community Health.” I always thought that was meant to encourage applicants to contribute to societal well-being and provide community support. But during COVID-19, we’re seeing the tables turn. At BaldrigeCoach, several of our health care clients tell us that, though their investment in hometown communities constantly pays back dividends, one totally unexpected bonus is the warm support for hospitals and their staff members shown by the community during the coronavirus pandemic. Here are some examples showing that community care is a two-way street: Colquitt Regional Medical Center is located in a rural area of Southern Georgia. Not content to serve only area residents, this hospital offers innovative education and health care services to seasonal migrant workers. One service is ensuring that those working under the hot sun remain hydrated and protected with sunscreen to prevent skin cancer. The community also benefits from prenatal education and health care that have resulted in zero early elective deliveries since 2017 – far surpassing the Leapfrog benchmark and the Achievable Benchmark of Care. When COVID-19 hit, Colquitt Regional’s home county received federal support related to the disease. County leaders used this funding to develop a stockpile of PPE for future surges. In consultation with hospital staff, county leaders learned that prison and jail populations can become hotspots for the virus, so the county used some of its COVID-19 funding to develop isolation cells to stop the spread. As ready availability of PPE became a challenge, the county shared its stockpile. To help further, members of the community began making masks and re-usable gowns for the hospital’s nonclinical staff. Churches serve as drop-off locations. When the schools closed in early spring, teachers donated their sanitizing wipes to the medical center. Local restaurants continue to donate prepared meals for the staff, and local farms donated a semi-truck packed full of vegetables to be distributed to hospital employees. When many staff members began experiencing facial irritation from their masks, Mary Kay ladies provided lotion kits. As local hotels shut down due to the lack of travelers, the Hampton Inn donated hundreds of rolls of toilet paper to the hospital.
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Top, right: Restaurants contribute meals so health care workers don't need to leave the floor to eat. Bottom: Mayor Steve Mason of Cedar Hill, Texas, addresses a group of citizens who gathered to thank health care workers for their work during the pandemic.
And in a truly innovative solution for nurses concerned about taking COVID-19 home to their families, local families set up their personal campers in their back yards and offer them as safe places for these nurses to sleep. Yuma Regional Medical Center (YRMC) in Yuma, Arizona, is like Colquitt Regional Medical Center in that it is the only hospital serving its community. Staffers there worked hard to develop rapid testing, making it available through a lab annex. This allowed community residents to be tested without entering the hospital itself. Knowing that hand sanitizer and disinfecting wipes were in short supply, the Yuma schools responded with large donations of wipes and hand sanitizers upon their in-person classroom closures. Local restaurants provide free meals to health care workers and deliver some of these meals directly to the med center campus. Members of the community sew masks for the workers, and a local dry cleaner professionally launders them. The local Yuma police, fire department, first responders, and community members organized a car parade to tour the whole campus. Vehicles festooned with banners expressing appreciation to the essential workers of YRMC made their way around the medical complex. Food trucks and a snow cone truck make regular rounds of the campus to provide free food and icy treats. And even with financial hardships caused by the pandemic, community residents are increasing donations to the YRMC Foundation, the charitable
arm that funds hospital programs and services as well as contributing to community philanthropic projects. Methodist Health System (MHS), serving North Texas and the Dallas metropolitan area, is not a single community hospital, but a health system comprised of four area hospitals. It demonstrates that huge metro areas surrounded by bedroom communities embrace their regional hospitals as do their smaller community colleagues. MHS is known for a long history of offering a variety of community outreach and support initiatives with a culture reflected by the motto, “We treat patients like family.” As COVID-19 cases were on the rise this spring and summer, particularly in Dallas County, community residents began an outpouring of hospital support. At each of the system’s four hospitals, Directors of Volunteers and Public Relations Directors adjusted their responsibilities to become full-time coordinators of donations coming in. When donations of food were received, these directors and their teams disinfected each individually wrapped package. When local community members made masks for
patients, families, non-clinical staff, and visitors, these teams distributed them. On the Richardson campus, hospital staffers started a movement called #RichardsonStrong, which resonated so well that it has spread across the community with the slogan showing up in store and apartment windows and on lawn signs throughout area neighborhoods. On the Charlton campus, the mayor spoke and offered thanks to the hospital staff. He posted it to the city’s Facebook page, drawing attention to a huge sign of appreciation placed in front of the hospital by community members. Each of the hospital campuses have been greeted with “drive-by” parades
in the early evenings as shifts change, expressing encouragement to staff members as they prepare to go home. Our conclusion? The Baldrige Excellence Framework continues to unlock solutions across the entire spectrum of societal contributions and community health. One lesson being learned in hospitals everywhere is that, much like programs focused on customer and employee engagement, health care exemplifies a two-way commitment built on trust, respect, and caring. It is a mechanism that develops numerous routes to community engagement, and it magnifies the caring and supportive nature of hospitals with their communities.
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.
Supporting you, supporting patients. The COVID-19 outbreak is an evolving crisis, and we want to support hospitals and other frontline health providers with the latest tax and accounting updates to help them navigate the inevitable economic effects. Visit our COVID-19 Health Care Resource Center at bkd.com/ covid-19healthcare for relevant news, changing guidelines, and new regulations.
Everyone needs a trusted advisor. Who’s yours?
800.472.2745 • bkd.com • @BKDLLP 501.372.1040 • @BKDHC ARKANSAS HOSPITALS | WINTER 2020 17
18 WINTER 2020 | ARKANSAS HOSPITALS
2020
Trade Show From a distance
The exhibitors who provide essential products, solutions, and services to our hospitals could not meet you in person this year, because our hospital leaders and health care workers have been tirelessly working to face the many challenges posed by the COVID-19 pandemic. Here, we offer our Sponsors and Supporters a chance to connect with you from a distance. They have not wavered in their support of AHA, and we are grateful for their partnership.
DIAMOND LEVEL, p. 20 PLATINUM LEVEL, p. 25 SPECIALTY LEVEL, p. 27 GOLD LEVEL, p. 28 SILVER LEVEL, p. 28 BRONZE LEVEL, p. 31 SUPPORTERS, p. 31
ARKANSAS HOSPITALS | WINTER 2020 19
THANKS, DIAMOND LEVEL SPONSORS!
TAP INTO SUCCESS!
AHA
SERVICES
YOUR TRUSTED, IN-HOUSE BUSINESS CONSULTANT Join your fellow Arkansas Hospital Association members and tap into the carefully vetted business services offered through AHA Services, Inc.
INFORMATION Strategic Planning | Market Planning |
AHA membership means you don’t need to call in outside consultants when searching for business solutions. AHA Services, as a subsidiary of the AHA, is YOUR in-house consulting firm, trusted for years by hospitals of all sizes across the state, and ready to serve you.
Benchmarking | Patient Satisfaction |
Quality Measurement | Staffing Solutions | Translation Services
FINANCIAL
Offering business services at specially brokered rates to AHA member hospitals – that’s what we do. We bring you projectand/or department-specific consultations that help you connect with companies ALREADY VETTED, ALREADY PROVEN, HOSPITAL-SPECIFIC, and providing special rates for member hospitals.
WE COME TO YOU!
340B Program Management | 340B Contract
Pharmacy Program | 340B Split Billing | Accounts
Payable Solutions | Class Action Settlement Claim
Management | Supply Chain Services: Medical and Surgical
INSURANCE
Tina Creel and Liz Carder are dedicated to our member hospitals, connecting them with the specific help they need to meet today’s health care business challenges. Whether it’s in the area of Translation Services, Data Analytics, Insurance, Supply Chain Solutions, Staff Education and Certification, or Financial Services, Tina and Liz will help your hospital tap into vetted and proven resources and services as your hospital seeks to improve upon its success.
Employee Benefits Packages | Volunteer and Student Nursing
Coverage | Workers’ Comp | Liability Consulting | Property
SET UP AN APPOINTMENT TODAY
Reach us on the web, by email or phone. AHAServicesInc.com
EDUCATION Learning Management | Compliance Training | Common Orientation for Clinical
Rotation Programs | Competency and Performance Management
WORKFORCE Staffing Solutions | Supplemental Staffing Solutions | Online Healthcare Careers Portal | Executive Search and Interim Leadership Recruitment | Short Term Physician Specialties
Staffing, CRNA | Temporary Allied, Mid-Level Health Staffing | Permanent Physician, Allied
Health Staffing | Risk Assessments | Active Shooter Training | Patient Violence Management | Provider Enrollment Services 20 WINTER 2020 | ARKANSAS HOSPITALS 1 FALL 2020 | ARKANSAS HOSPITALS
TINA CREEL, PRESIDENT
AHA Services, Inc. TCreel@arkhospitals.org 501.224.7878
LIZ CARDER, ASSISTANT
AHA Services, Inc. LCarder@ arkhospitals.org 501.224.7878
DIAMOND LEVEL
Healthcare Division
IT’S TIME HOSPITALS AND PHYSICIANS GET A LITTLE T.L.C. OF THEIR OWN The healthcare division of BXS Insurance is the largest and most experienced group of medical professional liability and property specialists in Arkansas and one of the largest in the Southeast. We currently serve over 34 hospitals, over 2,300 physicians and hundreds of other healthcare providers. Most importantly, our expertise and broad access to markets offers maximum protection at the very best value.
COVERAGE WITH A PULSE
• Medical professional liability for hospitals, long-term care facilities, surgery centers, imaging centers, diagnostic and clinical laboratories and other freestanding healthcare facilities. • Specialized programs for group practices within networks. • Medical professional liability for physicians and surgeons of all specialties from individual, PHOs, IPAs and group practices within networks. • Managed Care Errors & Omissions Liability. • Directors’ and officers’ liability, employment practices liability, fiduciary and crime specific to healthcare exposures. • Specialized property protection tailored to meet the needs of high-valued facilities and complex exposures. • Automobile coverage for a wide range of healthcare vehicles, including emergency transport and mobile imaging units.
OUR HEALTHCARE INDUSTRY EXPERTISE INCLUDES:
• Exclusive companies: Our specialized focus, size and commitment gives us unique access to a broad range of companies for healthcare facilities in Arkansas — several of which are on an exclusive or preferred basis. We maintain constant communication with companies regarding trends and available coverages beneficial to health care providers and facilities. • In-house claims staff available 24/7: Having expert claim representatives with local knowledge of plaintiff and defense attorneys, jurisdiction and claim values with 24/7 availability is one of the most valuable benefits of teaming with BXS Insurance. In fact, several companies use our staff to service claims because of our expertise, local presence, and in-depth understanding of the changing legal environment in Arkansas and the Southeast. • In-house account management team with extensive healthcare underwriting expertise. • Third-party administrative services for medical professional, general liability, and workers’ compensation self-insured programs. • Comprehensive management of your self-insured program: BXS Insurance has structured, and currently manages, self-insured trusts related to medical professional, general liability, and workers’ compensation.
BXS Insurance – Arkansas Healthcare Division is a sponsored service provider of AHA Services, Inc. BXS Insurance – Risk Management Resources Division is the third-party administrator for the Arkansas Hospital Association's Workers’ Compensation Self-Insured Trust. BXSI Contact: Bill Birch, Sr. Vice President – Risk Consultant Email: bill.birch@bxsi.com; Phone: (501) 614-1170
ARKANSAS HOSPITALS | WINTER 2020 21
DIAMOND LEVEL
Thoughtful approaches, real outcomes. Your patients have choices among healthcare providers. When considering quality of care, they look at your staff as well as your facilities. The national Healthcare Practice group at Gallagher is dedicated to helping you build a better workplace—one which will inspire your employees and clinicians to give their personal and professional best to the community they serve. Our comprehensive set of boutique consulting practices are designed to address the different needs of your executive, clinical and support staff and our focus on organizational as well as individual wellbeing helps you foster a culture of loyalty and pride. Loyal and proud employees will accelerate quality and customer service improvements which drive revenue. Loyal and proud employees will also increase their own use of domestic facilities and providers which reduce costs. The end result is a holistic approach that mitigates cost and risk while supporting your organizational growth goals and aligning the interests of employees, clinicians and the community you serve.
Firsthand knowledge from bedside to boardroom.
Gallagher solutions are backed by real-world experience. Senior leaders in our Healthcare Practice are former health system executives, physicians, and nurses. Our consultants engage with the decision makers at thousands of healthcare clients each year and our compliance experts pore through thousands of pages of regulations each year. Our data analytics draw on a claims data warehouse fed by over three dozen payers covering millions of lives, and our strategy and plan design benchmarking data draws on information provided by over 400 healthcare clients.
Integrity, compassion and real results.
Talk to a Gallagher advisor today. Learn how our national Healthcare Practice can help you create a sustainable total rewards program that helps you compete for top talent, maintain a sustainable cost structure, and leverages incentives in support of evolving organizational goals.
Strengthen your organization with the Gallagher Better WorksSM approach: • Leverage health data and targeted communications so employees can improve their physical and emotional wellbeing, leading to better quality care and customer service • Enhance career wellbeing using clearly articulated and supported career development paths • Promote better financial wellbeing with a secure environment for employees to save and plan for the future • Protect organizational wellbeing by reducing benefits spending through custom networks and richer claims reimbursement • Establish HR as a strategic partner through documenting clinical quality improvement under the employer’s medical plan
Consulting and insurance brokerage services to be provided by Gallagher Benefit Services, Inc. and/or its affiliate Gallagher Benefit Services (Canada) Group Inc. Gallagher Benefit Services, Inc. is a licensed insurance agency that does business in California as “Gallagher Benefit Services of California Insurance Services” and in Massachusetts as “Gallagher Benefit Insurance Services.” Neither Arthur J. Gallagher & Co., nor its affiliates provide accounting, legal or tax advice.
6325 Ranch Dr., Little Rock, AR 72223 | 501.485.3075 Merlin Hagan Area Vice President merlin_hagan@ajg.com
22 WINTER 2020 | ARKANSAS HOSPITALS
Chris Newkirk Area Vice President chris_newkirk@ajg.com
providing the most qualified
healthcare staff when and where they’re needed. Throughout the COVID-19 pandemic,
hourly rates are necessary. Hospitals across the country are competing with other states that are also surging and need staff. The hourly rate must increase for your jobs to get competitive consideration.
facilities across the country
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process. Hospitals can’t wait for based on each hospital’s unique needs, the next scheduled orientation to bring which means healthcare staff is quickly staff on board. Consider an expedited mobilized. You are always in control and process that allows you to bring on staff we are accountable. quicker. Provide a guarantee of 48 hours Accept that clinical higher Allow the Qualivis teamthan per week. This will ultimately normal hourly rates are to conduct candidate interviews. allow you to useHospitals fewer temporary staff necessary. across Our team of more than 30 clinical leadersthe and provide relief for your core staff. country competing runs pointare on clinical interviewswith and other Offer an expedited orientation states thator are also surging and makes offers recommendations process. Hospitals can’t wait for Whether or not your member hospitals based on each hospital’s uniquerate needs,must need staff. The hourly the next scheduled to bring are currently facing orientation a surge in healthcare which meansfor healthcare is quickly increase your staff jobs to get staff on board. expedited staffing needs, Consider having anan accountable mobilized. You consideration. are always in control and competitive process within that allows bring on staff partner reachyou is ato good idea. we are accountable. quicker.
DIAMOND LEVEL
Practices for Filling Crisis Jobs Best BEST Practices PRACTICES for Filling FOR Crisis Jobs Best FILLING Practices JOB forCRISIS Filling Crisis Jobs
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To learn more about our crisis response HOSPITALS | WINTER staffing, ARKANSAS or to discuss your needs, contact2020 23 your Qualivis account specialist. If you
DIAMOND LEVEL
“WHO WE ARE”: TGA Solutions has been serving healthcare
providers for more than a decade. TGA has successfully increased revenue deriving from both Third-Party Liability and Workers' Compensation claim recovery.
“WHAT WE OFFER”: Third-Party Liability and Workers'
Compensation claim recovery services. TGA Solutions increases revenue while lowering accounts receivable days. TGA claim recovery services are tailored for each hospital because TGA recognizes that the community served by each hospital is unique.
“WHY US”: TGA Solutions has proven expertise acting as an extension
of a hospital's revenue cycle management thereby augmenting outcomes. TGA has established a consistent record of recovering payment of hospital claims as quickly as possible. The difference between what TGA does and what others in this field do is derived from diligent and consistent investigation of the facts underlying each claim.
“QUICK FACTS”: TGA requires no up-front payment. All costs
are paid by TGA with no payment required until claims are paid and posted to accounts. TGA has developed software and efficient procedures that both shorten recovery time and consistently track all claims.
421 E. Comanche, Suite A, Norman, OK 73071 | 405-329-7644 | tgasolutionsok.com
24 WINTER 2020 | ARKANSAS HOSPITALS
The Mitchell Williams team of health care lawyers understands the issues, challenges and rapidly-changing regulations facing the health care industry today. To effectively operate in this evershifting environment, hospitals and health systems need experienced legal and business counsel to address complex regulatory, risk management, corporate and operational matters. Megan Hargraves mhargraves@mwlaw.com
We leverage our comprehensive health care industry knowledge with the extensive resources of our firm to provide effective regulatory, compliance, transactional, and litigation counsel to hospitals and health systems. Working closely with our clients as business advisors, we develop effective strategies and provide sophisticated services to help navigate the changing operational and regulatory health care environment. We help hospitals and health systems manage health care industry challenges while keeping their focus on serving and caring for patients. We assist clients with: • Health care risk management and compliance • Compliance program development, monitoring, and documentation • Contract drafting including physician contracts and non-compete agreements • HIPAA and privacy issues including medical records, electronic health records, and telemedicine • Regulatory and operational issues including the Stark Act, Anti-Kickback Statute, and FDA guidelines • Fraud and abuse claims and investigations • Legislative and health care public policy • Information security and privacy • Obtaining licensure • Corporate formation and structure • Mergers, acquisitions, and restructuring businesses • Health care real estate transactions and leasing • Employment and labor matters • Tax structuring • Physician group transactions and health ventures
THANKS, PLATINUM LEVEL SPONSORS!
MITIGATE YOUR RISK
Ben Jackson bjackson@mwlaw.com
Zach Steadman zsteadman@mwlaw.com
425 W. Capitol Ave., Ste. 1800
|
Little Rock, AR 72201
|
(501) 688-8800
|
MitchellWilliamsLaw.com ARKANSAS HOSPITALS | WINTER 2020 25
PLATINUM LEVEL ST. BERNARDS MEDICAL CENTER Jonesboro
Relationships aren't built on flashy projects. They aren’t built on doing a spectacular job on an $80 million new hospital. Instead, relationships are built on consistently performing on every project, and on helping our clients solve problems at any budget. Our goal is to meet you where you are and perform work that makes day-to-day operations smoother for your employees. We strive to be a partner that helps our clients stay in step with the changing technology and demands of patients. We’ve dedicated time, money, and people to become experts in healthcare construction. Nabholz has the capabilities to be a single-source provider of all construction and facility maintenance services for healthcare clients. These capabilities include: • PRECONSTRUCTION & CONSTRUCTION • MACHINERY INSTALLATION, MOVING, & SERVICE • MAINTENANCE & REPAIRS • CRANE & EQUIPMENT RENTAL • ENVIRONMENTAL HAZARD SERVICES • INFRASTRUCTURE & EXCAVATION • ENERGY PERFORMANCE & SOLAR SERVICES • CUSTOM FABRICATION & CABINETRY
26 WINTER 2020 | ARKANSAS HOSPITALS
NORTHWEST HEALTH PHYSICIANS’ SPECIALTY HOSPITAL, Fayetteville UAMS DONALD W. REYNOLDS INSTITUTE ON AGING, Little Rock ARKANSAS CHILDREN’S NORTHWEST, Springdale
Lynda M. Johnson ljohnson@fridayfirm.com
Our healthcare lawyers have the insight, capability and experience to effectively address the complex issues inherent in the healthcare industry, including regulatory and compliance matters, contract negotiations and preparations, reimbursement issues, and audit reviews and appeals. The practice group includes Attorneys Lynda M. Johnson, Timothy C. Ezell and Amie K. Alexander. For more information, visit www.fridayfirm.com/healthlaw.
Timonthy C. Ezell tezell@fridayfirm.com
THANKS, SPECIALTY SPONSORS!
Whether you are a hospital, physician group, healthcare provider, or a company that serves provider organizations, you know that the demands on the health sector are complex. At Friday, Eldredge & Clark, our health law practice encompasses a wide range of legal services to address not only issues that arise in the highly-regulated healthcare industry, but also the counsel to handle business operation needs as well.
Our Vision
Amieambitions. K. Alexander Inspiring people to achieve their life’s
aalexander@fridayfirm.com
Our locations
At Prime Capital Investment Advisors, your personal financial advisor is complemented by a customized team, each with a specific area of expertise, addressing the individualized requirements needed to guide you on your road to successful wealth management.
Inspiring people to achieve their life’s ambitions.
By working as a team, we closely monitor changes in your needs, concerns, and objectives as they change throughout the years. Our planning process requires interaction and communication between team members, each having the same objective: to keep you and your individual financial At Prime Capital Investment Advisors, your personal Individual goals our top priority. financial advisor is complemented by a customized team,
each with a specific area of expertise, addressing the individualized requirements needed to guide you on your Individual Wealth road to successful wealthPrime management. Capital Wealth Management offers a fee-based approach to individual wealth
Wealth
Prime Capital Wealth Management offers a feebased approach wealth management Growing to by individual the Numbers *As of 3/31/2020 services. We help individuals achieve their financial goals through customized wealth $10.8 planning BILLION*solutions throughout all stages of their financial life cycle. Assets Under Management
services. We help individuals By working as a team, wemanagement closely monitor changes in achieve their financial goals change through customized Retirement your needs, concerns, and objectives as they 160+ Plans 27established LOCATIONSfiduciary wealth planning solutions throughout all stages Qualified Team Plan Advisors is an throughout the years. Our planning process requires Members across the United States of their financial life cycle. focusing on improving qualified plan health and interaction and communication between team members, participant education. Our goal is to help qualified each having the same objective: to keep you and your Plans plan participants retire with dignity. individual financial goals Retirement our top priority. Contact us Qualified Plan Advisors is an established
fiduciary focusing on improving through qualified plan Advisory products and services offered by Investment Adviser Representatives Prime Capital Investment 6325 Ranch Drive Advisors, LLC (“PCIAâ€?), a federally registered investment adviser. PCIA: 6201 College Blvd., 7th Floor, Overland b‚Ѵ; !o1hġ ! Ć•Ć‘Ć‘Ć‘Ć’ health and participant education. Our goal is Park, KS 66211. PCIA doing business as Prime Capital Wealth Management (“PCWMâ€?) and Qualified Plan Advisors help qualified plan participants retire with (“QPAâ€?). Securities offered by Registeredto Representatives through Private Client Services, Member FINRA/SIPC.Ĺ?Ć”Ć?Ć?Ĺ‘ ќƑƒŊƓѾƒƕ PCIA and Private Client Services are separate entities and are not affiliated. dignity.
PCIAWealth.com
Contact us: 6325 Ranch Drive, Little Rock, AR 72223 | (501) 823-4637 | PCIAWealth.com Advisory products and services offered by Investment Adviser Representatives through Prime Capital Investment Advisors, LLC (“PCIAâ€?), a federally registered investment adviser. ARKANSAS HOSPITALS | Ŀőĺ ";1†ub|b;v WINTER 2020 Äš ѾƑĆ?Ć? oŃ´Ń´;]; Ń´Âˆ7ĺġ Ć•|_ Ń´oouġ ˆ;uŃ´-m7 -uhġ " ѾѾƑĆ?Ć?Äş 7obm] 0†vbm;vv -v ubl; -rb|-Ń´ );-Ń´|_ -m-];l;m| Ĺ?Äž ) Ŀő -m7 †-Ń´b=b;7 Ń´-m 7ˆbvouv Ĺ?Äž o==;u;7 0‹ !;]bv|;u;7 !;ru;v;m|-|bˆ;v |_uo†]_ ubˆ-|; Ń´b;m| ";uˆb1;vġ ;l0;u ! ņ" Äş -m7 ubˆ-|; Ń´b;m| ";uˆb1;v -u; v;r-u-|; ;m|b|b;v -m7 -u; mo| -==bŃ´b-|;7Äş
27
THANKS, GOLD LEVEL SPONSOR!
www.afmc.org
THANKS, SILVER LEVEL SPONSORS!
Our mission is to promote and inspire innovation in health, wellness and technology through partnerships in our communities.
Business Impact Analysis
Ensuring Healthcare Provider Resiliency As one of our nation’s 16 critical infrastructure sectors, healthcare is looked to for its resiliency in providing services in the event of a terror or cyber attack, a public health disease outbreak, and during natural disasters. To gauge their organization’s resiliency, hospital and health system leaders must ask hard questions such as: • Do we have a continuity plan in place that covers our most critical business processes? • Do we know what those critical processes are? • Do we know what our vital systems and applications are? • If disaster or disruption happens, could our organization continue to deliver services? • How can we minimize the risk of disruption to our operations? Leading organizations recognize the value of a Business Impact Analysis (BIA) in helping answer those important questions. A BIA is a systematic process to determine and evaluate the potential effects of an interruption to critical business operations because of a disaster, accident, or emergency. The goal of a BIA is to identify information assets and tier them in order of criticality which can be used to determine the Recovery Time Objective (RTO) and the Recovery Point Objective (RPO). 28 WINTER 2020 | ARKANSAS HOSPITALS
SEE WHAT CLEARWATER CAN DO FOR YOU. 800-704-3394 | clearwatercompliance.com
Violence in our Hospitals is on the rise. Staff are routinely exposed to volatile patients and visitors under the influence of drugs and alcohol or suffering from psychological disorders. This dynamic environment and its potential for violent disruptions have staff, physicians, hospital administrators and security professionals searching for answers. HSS workplace violence training solution, TEAM ®, has been designed exclusively for healthcare workers including medical staff, professional support staff, and volunteers who may encounter angry, disruptive, or potentially dangerous individuals. Unlike generic programs, TEAM ® is focused exclusively on situations healthcare workers are most likely to encounter. TEAM ® is deliverable via inperson training or virtually through the award-winning eLearning program that can be provided to all hospital employees. TEAM ® is fully compliant with The Joint Commission, CMS, OSHA, and NIOSH guidelines. For more information or pricing options, please contact: Seth K. Karnes Director, Business Development T: 844-477-7781 C: 720-641-5209 skarnes@hss-us.com
In addition to Workplace Violence Training, HSS also offers a wide variety of healthcare-focused Emergency Management opportunities through their EM Solutions® division such as: • Active Shooter Training • Business Continuity Planning • HICS Training • Security Assessments • Behavioral Health Risk Assessments • Emergency Management • Disaster Planning.
SILVER LEVEL
Workplace Violence and Emergency Management Solutions for Arkansas Hospital Association Members
TEAM® and EM Solutions® were developed by HSS, the nation’s #1 source of healthcare security according to the Modern Healthcare Outsourcing Survey.
www.impact-healthcare.net pthomas@impact-healthcare.net What We Do
While we specialize in medical billing, we also provide a variety of revenue cycle and consulting services.
Company Overview
Impact Healthcare Solutions is a dynamic healthcare business services firm specializing in Revenue Cycle Management, Healthcare Administration, and Consulting. Led by a diverse team of hospital, practice management, and revenue cycle executives, our revenue cycle professionals provide business solutions to hospitals, medical practices, and other healthcare organizations across the United States. We combine high performance and data analysis with process integrity and data security to deliver greater efficiency, lower risk, and increased payments. We understand the complexity of medical billing for private practices, acute care hospitals, Critical Access Hospitals, and Rural Health Clinics. This is not only our job; it is our passion. We provide high-performance services and deliver quality results because we care about our customers, their patients, and our communities. Providing quality services is our business.
How We Do It
Our team becomes an extension of your team bringing high performance and productivity to help you and your organization achieve your goals. Impact is strategically positioned to employ highly capable individuals able to process claims, perform denial management, and provide follow-up while providing the critical thinking required to navigate the challenges of high-performance Revenue Cycle Management. We operate within your software infrastructure without the need of changing your operating system or moving your data outside of your IT environment. Our extensive experience with multiple platforms and clearinghouses provides us the flexibility to adapt to your organization's environment. We are not a technology company selling software. We are a Revenue Cycle Management company with the ability to master your technology. We understand that every hospital and medical practice faces its own unique challenges. We offer services tailored to meet your needs as standalone options or a customized, multi-service Revenue Cycle solution. ARKANSAS HOSPITALS | WINTER 2020 29
SILVER LEVEL
Using SHARE is the fastest, most secure way to exchange patient health records from one provider to another. Improve Transitions of Care and connect with other facilities sharing clinical records for over 2.5 million patients. SHARE gathers your patients’ clinical data from all participating health care providers to instantly give you a holistic view of your patients’ health history, treatment and progress. That’s powerful information that can transform the way that a facility plans, delivers, and coordinates health care.
We’ll assess the following ke
• Bed management and patie placement
• Interdisciplinary care coord
SHARE allows care teams to coordinate patient care with other providers and provides critical information about your patients to the entire care coordination team across all stages of care.
• Clinical practice variation • Observation management
• Emergency department flow process, dwell times and bo • Clinical decision units
Leverage data to identify im
501.410.1999 | Email: SHAREhealth@arkansas.gov |
Vizient Advisory Solutions: Length of Stay and Throughput Optimize care coordination and patient flow to improve quality, financial performance, and patient satisfaction
Vizient Advisory Solutions results
• Reduced length of stay (LOS) by 0.5 days from baseline, yielding an annual supply savings of approximately $1.5 million for a medium-sized hospital in the Northeast • Improved medical necessity review by 60 percent in a large academic medical center in Texas • Reduced LOS from 3.82 days to 3.37 days for major hip procedures and from 3.68 days to 3.38 days for knee procedures in one year at a large Pennsylvania orthopedic hospital • Reduced pre-operative waiting time from 81 minutes to 50 minutes per patient, improved on-time, first case starts from 38 percent to more than 80 percent, and freed up time to increase extra cases per day — for a potential revenue increase of more than $1 million per month for an acute care hospital in Tennessee • Improved door-to-physician time by 88 percent and increased emergency department capacity by 25 percent without the need for expansion at an acute care hospital in Illinois
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We partner with your care tea analytics to assess and identi care process. Working in tand operations and protocols and SHAREarkansas.comyour team coordinates care, h approach, the impact of care t work streams exist today.
The new era of health care reform is dramatically Assess and prioritize organiz changing the health care landscape. The influx of newly our presents assessment results insured patients entering the health careUsing system ensure your futu enormous challenges — making it morework vitalplan thantoever people coordinating care, the for health care organizations to have a multidisciplinary flow necessary for improveme approach and sound operational procedures to improve care coordination, flow, and capacity. To keep Implement sustainable clinic pace, hospitals and health systems are stretching their analytics and a pro resources to streamline throughput andLeveraging provide safe, care team to implement best high-quality care while reducing costs.
improved patient and employ services and analytics to addr Vizient™ Advisory Solutions offers proven methods to
help hospitals optimize care coordination and patient Our team collaborates with yo flow to improve operational efficiency and outcomes. unnecessary process steps, al
monthly operational reviews t
processes necessary to optim We focus on four primary areas:
• Data and analytics to drive strategic improvement Measure and sustain and investment decisions Sustain your results with visu • Clear goals and targets for future state, best organization to continue achie practices, and performance improvement targets plan toto continuously • Care coordination and clinical alignment improve build on patient flow and outcomes • Management systems and metric-driven reporting to achieve and sustain improvements As the nation’s largest me
improvement company, V
Our experts apply analytics and proven methodologies the critical areas of clinica to help your organization reduce waste, improve your members t and empowers overall care environment, and decrease bottlenecks to improve your timeliness and quality of patient care.
For more information contact us For more informati For more information contact us at consulting@vizientinc.com. at consulting@vizi at consulting@vizientinc.com. © 2017 Vizient, Inc. All rights reserved
© 2017 Vizient, Inc. All rig
eLearning. Real-World Advantages.
For information on AHA Services businesses, contact: Tina Creel: tcreel@arkhospitals.org Liz Carder: lcarder@arkhospitals.org
Training and education for healthcare professionals Learning Management System Competency & Performance Management System Regulatory Training Continuing Education Customized Training Live Event Management For more information: careLearning.com | 866-617-3904
Virtual Trade Show contacts:
THANKS, BRONZE LEVEL SPONSOR!
We appreciate all of our Sponsors and Supporters!
Lyndsey Dumas: ldumas@arkhospitals.org Anna Sroczynski: asroczynski@arkhospitals.org
Each year, ACHE Regents have the opportunity to provide awards for outstanding health care executive leadership in their jurisdiction. The Regent’s Awards recognize exemplary leadership of both Early Career and Senior Level health care executives.
2020 Early Career Healthcare Executive
Michael Wood, DPT Director of Inpatient and Outpatient Rehabilitation Services Mena Regional Health System Mena
2020 Senior Level Healthcare Executive Judith S. Wooten, FACHE President and CEO Arkansas Hospice, Inc. North Little Rock
AHA Workers’ Compensation Self-Insured Trust AHA Workers’ Compensation Self-Insured Trust Program was established in March 2003. The program provides workers’ compensation coverage to AHA members. Risk Management Resources, a division of BXS Insurance Services, the third-party administrator for the program, assists members in the areas of underwriting, claims management, safety, and loss control.
THANKS, SUPPORTERS!
2020 ACHE Regent’s Awards Announced
Contact: Tina Creel, President AHA Services, Inc. 419 Natural Resources Drive Little Rock, AR 72205 (501) 224-7878 tcreel@arkhospitals.org ARKANSAS HOSPITALS | WINTER 2020 31
SUPPORTERS Alliant Purchasing helps to maximize value in your supply chain. They have been leading the way in supply chain expertise, service, and partnership for over 40 years. Plus, there is no cost to become a member! Contact: Thomas E. Camp, MBA, SVP Sales and Marketing 1600 Airport Fwy #409, Bedford, TX 76022 (817) 532-3030 | tcamp@alliantpurchasing.com
The Chartis Center for Rural Health The Chartis Center for Rural Health (CCRH) brings an unmatched capability to assess the performance of rural healthcare assets with its deep consulting and rural-relevant analytic experience. The CCRH builds upon the well-established iVantage history of experience providing thought leadership to rural health leaders. This rural-relevant expertise and a proprietary database of operational indicators is critical in the assessment of the efficiency and effectiveness of rural assets when comparing like facilities across the nation.
Contact:
Billy Balfour, Marketing 509 Forest Ave, Suite 251, Portland, ME 04101 (207) 245-6761 ¡ wbalfour@chartis.com 32 WINTER 2020 | ARKANSAS HOSPITALS
To help do more for those who already do so much, we created Constellation. Working together with Arkansas Mutual, a member of Constellation's growing portfolio of medical professional liability insurance carriers, we offer innovative products and services that help reduce risk and streamline care. Because at the end of a long day, good care is good business. See how we can benefit you at ConstellationMutual.com.
Contact: Ryan P. Schott, Business Development Consultant 11300 N Rodney Parham, Suite 220 Little Rock, AR 72212 (952) 847-4397 | ryan.schott@constellationmutual.com
Crews & Associates is a regional broker-dealer headquartered in Little Rock, Arkansas. Our team includes knowledgeable and experienced professionals that specialize in the origination and distribution of revenue bonds, capital leases, and other types of credit facilities. For over 40 years, we have served the financial needs of our clients through the structuring and distribution of tax-exempt and taxable bonds for new projects, refinancings, restructurings, and more. This knowledge and experience, coupled with hard work, integrity, and exceptional service, allows us to be a reliable and unique funding source for our healthcare clients in the State of Arkansas and around the nation. Crews’ parent company, First Security Bancorp, is a bank holding company based in Searcy, Arkansas, with $1.3+ billion in total capital and $6+ billion in assets.
Contact: Paul Phillips, Senior Managing Director, Capital Markets 521 President Clinton Ave, Suite 800 Little Rock, AR 72201 (501) 978-6309 pphillips@crewsfs.com
SUPPORTERS
Integrated software solutions from Evident help community hospitals improve their financial and clinical operations. Technology solutions from Evident advance the delivery of quality healthcare to the communities we serve across the care continuum. The company you choose as your partner will play a critical role in setting you up for future success and transitioning to a world of value-based care and reimbursement. We are that company. Thrive, our future-focused EHR solution, is built with today’s real world in mind. Spanning the continuum of care, you get optimized workflows – physicians, clinicians and office staff each have workflows designed specifically for them. Learn more by visiting evident.com. Contact: Evident 6600 Wall Street Mobile, AL 36695 (800) 711-2774 | info@evident.com
Home Health, Hospice, Home & Community Based Services, Facility Based Care, and ACO Management
Harding University is a private, Christian university located in Searcy, Arkansas. Accredited by the Higher Learning Commission, the University offers degrees at the undergraduate, master’s, specialist, and doctoral levels. The Graduate School of Business offers a Master of Business Administration, Master of Science in information systems, and graduate certificates, all designed to be highly flexible and completely online. Contact: Harding University, the Graduate School of Business 915 E. Market Ave., Searcy, AR 72149-5615 501-279-4523 | gsb@harding.edu
Lone Star Communications provides full-service systems integration in the design, installation, and servicing of critical building systems for the healthcare, education, and commercial markets. Contact Us: lonestarcom.com 5200 Northshore Lane North Little Rock, AR 72118 (501) 225-4910
Contact: John Robbins, LFACHE Business Development Consultant 9220 Forest Hill Lane Germantown, TN 38139 (901) 491-9193 johnnrobbins@yahoo.com ARKANSAS HOSPITALS | WINTER 2020 33
SUPPORTERS
Hospitals play a vital role in improving patient care and reducing healthcare costs. In a rapidly-evolving industry, hospitals must also continually work to improve performance and achieve strategic objectives. To support you in these challenging times, MedPro has strengthened our hospital offerings. Our customized healthcare liability solutions complement the risk strategies of a variety of hospital types throughout the nation – protecting not only you, but your patients as well. As the nation's first provider of healthcare liability insurance, MedPro Group has protected the healthcare community since 1899. MedPro offers customized insurance, claims, and risk solutions. With an A++ rating from A.M. Best, the company protects over 300,000 professionals and facilities across the country. Visit www.medpro.com to learn more. Contact: Steve Simmons 5814 Reed Road, Fort Wayne, IN 46835 (214) 220-7520 | steve.simmons@medpro.com
Rich & Cartmill Insurance is one of the largest, privately-held Trusted Choice® independent agencies in the country. Since 1992, we have been committed to assisting individuals and organizations find insurance options that protect their most precious assets. Contact: Scott Selman, VP 2738 E 51st Street, Suite 400, Tulsa, OK 74105 (918) 809-1461 | sselman@rcins.com
PCM provides accounts receivable management services to healthcare providers. Founded in 1980, PCM specializes in bad debt recovery, early-out services, presumptive charity scoring, account segmentation, and specialty projects. Contact: April Miller 500 W Washington Ave Jonesboro, AR 72401 (800) 999-3780 business@pro-credit.com
TruBridge is in the business of helping hospitals of all sizes get paid faster and get paid more through a combination of people, products, and process optimization. Our arsenal of RCM offerings ranges from revenue cycle consulting to an HFMA Peer Reviewed® product to complete business office outsourcing. TruBridge has been helping hospitals, physician clinics, and skilled nursing organizations become more efficient at serving their communities for years. Today, our trained experts stand ready to do the same for your organization, enabling you to overcome the unique revenue cycle challenges you face every day. Visit www.trubridge.com. Contact: TruBridge 6600 Wall Street, Mobile, AL 36695 (877) 543-3635 | info@trubridge.com
34 WINTER 2020 | ARKANSAS HOSPITALS
ARKANSAS HOSPITALS | WINTER 2020 35
LEADER PROFILE
Light in COVID-19’s Darkness By Nancy Robertson
T
here’s always a glimmer of hope somewhere, even during the COVID-19 crisis. One that’s shining brightly is at Pinnacle Pointe Behavioral Healthcare. In the midst of a pandemic, Pinnacle Pointe’s staff is reinventing mental and behavioral health care for its patients. Adapting and innovating have become the order of each day, and patients and families are reaping the benefits. “We work with kids aged 4-17, and with about 1,500 adults, as well,” says Shane Frazier, Group Chief Executive Officer of Pinnacle Pointe Behavioral Healthcare System. “Through our network of 12 clinics and 250 school-based programs, we serve about 7,500 families. In addition, we have kids receiving care in our 127-bed hospital. When the pandemic hit last spring, schools started closing and, as people will remember, none of us had much time to figure out how to navigate in a new, virtual world. It was the opposite of ‘normal,’ where so much revolves around the school and classroom settings.” Pinnacle Pointe’s leadership and staff had to figure out how to effectively meet with clients when face-to-face visits at clinics and schools abruptly stopped. “We’re lucky that we’ve had a robust telemedicine platform since 2016,” Frazier says. “When Governor Asa Hutchinson lifted some of the restrictions on telemed services during the early months of the pandemic, it opened access to care for our patients. This was extremely helpful, as we already had the platform in place. It allowed us to get folks back on a counseling schedule, which is instrumental to success for our families. It’s actually a real lifeline to health.”
36 WINTER 2020 | ARKANSAS HOSPITALS
Shane Frazier and his leadership team gathered in the Pinnacle Pointe gym to serve breakfast and celebrate employees at the annual Employee Appreciation Breakfast. Shane Frazier gave patients and staff the opportunity to “Dunk the CEO” to raise money for the Children’s Protection Center of Pulaski County (where he serves on the board). Staff paid $1 per ball, patients played for free, and Frazier says he was waterlogged by the end of the event!
Telemedicine offers our patients increased access to care on their own schedules, and we’re seeing more family involvement than ever before.
We Asked...
What’s on your music playlist? I have a pretty
eclectic mix of music shuffling currently: Maroon 5, Imagine Dragons, Marvin Gaye, ELO, Stevie Wonder, Carole King, and One Republic.
What would you be doing if you weren’t in health care? I’ve often said I’d like to have Michael Buble’s job. I enjoy his style of music and he makes a lot of money, but he’s not so famous he can’t enjoy time out with his family without being mobbed!
What are you reading? (non-work-related material) I just finished “Gentle on My Mind” by Kim Campbell.
LITERALLY SAVING LIVES
He says the Pinnacle Pointe care team asked itself if quality of care would suffer without the benefit of same room, faceto-face sessions. Carefully tracking clinical outcomes both before and after the onset of the virus, he says the team is amazed at how telemedicine can actually improve delivery of services. “Telemedicine offers our patients increased access to care on their own schedules, and we’re seeing more family involvement than ever before,” Frazier says. “We have fewer cancellations and see our patients and family members experiencing a more relaxed back-and-forth when they’re in their home environments. Those who suffer from anxiety or
Shane and his partner, Curt, enjoy watching their boys Corey (10) and Jack Campbell (5) playing in their front yard.
Glen Campbell was my uncle, my mother’s brother. I found it fascinating to read and revisit some of my memories through the eyes of his widow.
Where would you travel, if you could go anywhere? I would travel to Italy. We had a two-week
vacation planned for Italy in August; we had to cancel due to the pandemic.
What’s a life-changing lesson COVID-19 has taught you? I think we’ve all learned a valuable lesson
to cherish those you love and never take your time with them for granted. When you can’t spend time in close proximity hugging your parents, siblings, or close friends, you realize just how special those hugs were.
anxiety disorder are more comfortable working with us from their own homes. We’re seeing more breakthroughs and more participation from family members.” Why is this? Parents of patients, or adult patients themselves, often work multiple jobs, making it difficult to meet traditional person-to-person appointment schedules. When telemed visits can be arranged in the evenings or on parental days off, it’s more likely that appointments will be kept. “It’s also a socio-economic solution,” Frazier says. “Meeting with parents on their schedule allows them to both meet workday requirements and keep appointments with their own or their child’s counselor.” ARKANSAS HOSPITALS | WINTER 2020 37
Success from crafting appointments to the family’s schedule is measurably linked to recent positive outcomes. “Telemedicine has been an incredible service for our patients and their families. When patients keep their appointments and counseling proceeds unabated, suicidal ideations are reduced,” he says. “I want to commend Governor Hutchinson for loosening restrictions on this service and make clear the advantages it
unlocks. We hope it continues after the pandemic abates.”
RECOGNIZING SITUATIONAL ABUSE
The pandemic brings with it a lot of stress-inducing fallout. Situational abuse can arise from this stress – in families that do not normally show abusive tendencies. Increased time together, the stress of job loss, and/
or financial hardships imposed by the pandemic can add to family stress and put children at risk. When situational abuse arises, the rapid availability of “meeting” counselors online can defuse hurtful situations and bring calm to the family. School closures can, however, be harmful for those children who are “watched” at school by teachers and counselors because they come from known abusive environments. Teachers and counselors who monitor for signs of abuse cannot always do so with remote access. In this case, counselors are hyper-aware during their online conversations, and they can conduct online drop-in wellness checks. Whether a child is monitored at school or online, the safety and security of patients is the number one priority of Pinnacle Pointe caregivers.
WHEN SCHOOLS CLOSE
School closures present their own challenges to students, both inside and outside the behavioral care network. Stress, fear, grief, and uncertainty brought about by COVID-19 wears on everyone, but children and teens can have especially tough times coping. “So much of a child’s identity is wrapped in their peer group,” Frazier says. “This is especially true for adolescents. New data tells us that those who tend toward depression are suffering at a higher rate during the pandemic, because social isolation increases depression.” Maintaining connections with peers is important, and there are ways to avert the feeling of isolation through the use of social media. “Facetiming is a great solution,” Frazier says. Because a child or teen can see his/ her friend while conversing by phone or laptop, this simulates in-person conversation. “We suggest that kids make videos of what they do at home, then share these with each other,” Frazier says. “The videos can be viewed over and over again when loneliness sets in, and they provide an excellent social link to friends.”
38 WINTER 2020 | ARKANSAS HOSPITALS
INPATIENT SETTINGS CHANGE
“The pandemic also forces us to come up with new ideas for treating kids at Pinnacle Pointe’s inpatient hospital,” Frazier says. “Our patients are busy all day, every day, moving from classwork to recreational therapy, life skills settings to oneon-one therapy. The norms all change with logistics required by COVID-19.” Social distancing, masking, and small group requirements bring their own challenges to the inpatient setting. “Everything we do involves people interacting with one another,” Frazier smiles. “Our degree of safety planning increased significantly with the onset of COVID-19 restrictions. You can imagine how social distancing requirements exacerbate the normal social interactions at a psychiatric facility.” Frazier offers high praise for the staff members with whom he works. “They have re-created the safety environment for every interaction that takes place in the inpatient setting,” he says. “People who for years have worn street clothes for their work are re-learning the intricacies of proper PPE use. They’re figuring out how to make social distancing work during group therapy sessions, and they’re breaking their normal group sizes down to smaller and smaller clusters as the virus dictates. We’re utilizing staff in different ways, even staffing up to socially distance.” What of those whose illness causes them to defy COVID-19 restrictions? “We have some patients who defy mask-wearing, or who won’t maintain the proper distance from one another,” he says. “In their cases, COVID-19 restrictions cause us to come up with new solutions linked to behavior. Again, I offer praise for our staff! It’s amazing to watch them handle difficult situations with calm and decisive actions. When our patients show signs of stress, our nurses step in and defuse the situation.”
CARING FOR THE CAREGIVERS
Frazier keeps a constant eye on his team, watching for signs of caregiver burnout. “COVID-19 brings a level of stress to every person,” he says. “Health care professionals continue to do their work, regardless of what’s happening at home, regardless of isolation from their families, regardless of the challenges the virus serves up every day, and they deserve our attention. We offer group sessions for our
staff, meditation tips, self-care options… to help keep these valuable caregivers healthy and well.” Those who care for the physical and mental health of others are precious in the most normal of times. They juggle shifts and home life, keep people safe, and show up every day to care for us. During the COVID-19 pandemic, we particularly recognize them as bright spots in the darkness. They take care of one another; they take care of each of us.
ARKANSAS HOSPITALS | WINTER 2020 39
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RESULTS RESULTS RESULTS RESULTS RESULTS
WHAT WE -- SERVICES WHAT WE --DO WHAT WHAT WE WEDO DO DO -SERVICES SERVICES SERVICES WHAT WE DO - SERVICES WHAT WE DO SERVICES Preventive, predictive && corrective maintenance Preventive, predictive &&corrective corrective maintenance Preventive, Preventive, predictive predictive & corrective maintenance maintenance Preventive, predictive corrective maintenance Preventive, predictive & corrective maintenance Asset management – accounting and lease administration Asset management – accounting and lease administration Asset Asset management management – – accounting accounting and and lease lease administration administration Asset – accounting and lease administration Assetmanagement management – accounting and lease administration
HAT WE DO - SERVICES Energy conservation && sustainability programs eventive, predictive & corrective maintenance Energy conservation &&sustainability sustainability programs Energy Energy conservation conservation & sustainability programs programs Energy conservation sustainability programs Energy conservation & sustainability programs
277K 277K 277K 277K 277K
Project management && construction oversight set management – accounting and lease administration Project management construction oversight Project Project management management &&construction construction oversight oversight Project management construction oversight Project management & construction oversight Leasing & brokerage services ergy conservation & sustainability programs Leasing & services Leasing Leasing &&brokerage brokerage services services Leasing && brokerage services Leasing brokerage services savings &&avoidance cost avoidance savings &&cost savings savings &cost cost avoidance avoidance savings avoidance savings &cost cost avoidance oject management & construction oversight NWA 479 845 3000 | Central AR716 501 716 5511 HOW WE DO IT -- STRATEGIES year 1, including reduction NWA 479 845 3000 AR 501 716 5511 NWA NWA 479 479 845 845 3000 3000 | |Central | Central Central AR501 501 5511 NWA 479 845 3000 | Central AR AR 501 716 716 55115511 WE IT STRATEGIES year 1,year including reduction to HOW HOW WE WEDO DO IT-DO -STRATEGIES STRATEGIES year year 1, 1, including including reduction reduction toto to HOW WE DO IT STRATEGIES 1, including reduction to NWA 479 845 3000 |AR Central 501 HOW WE IT - STRATEGIES year 1, including reduction to HOW asinghospital & brokerage services Establish baseline building performance guidelines and benchmark facilities payroll due Establish baseline building performance guidelines and benchmark Establish Establish baseline building building performance performance guidelines guidelines and and benchmark benchmark Establish baseline building performance guidelines and benchmark hospital facilities payroll due hospital hospital facilities facilities payroll payroll due due hospital Establish baseline building performance guidelines and benchmark hospitalfacilities facilitiespayroll payrolldue due to CW Sage assuming Strategic detailed budgeting CW CW Sage Sage assuming assuming fullfull-fullStrategic Strategic detailed budgeting budgeting tototo CW Sage assuming fullStrategic detailed budgeting NWA 479 845 3000 | Central AR 501 716 5511 to CW Sage assuming fullStrategic detailed budgeting OW WE DO IT STRATEGIES to CW Sage assuming fullStrategic detailed budgeting time employees Hire top talent / highly educated // experienced team members time time employees employees tablish baseline building performance guidelines benchmark time employees time employees Hire Hire top top talent talent / / highly highly educated educated //and /experienced experienced team team members members Hire top / highly educated experienced team members Hire top talent experienced team members time employees Hire toptalent talent / educated highly educated / experienced team members Partnership approach with clients ategic detailed budgeting Partnership Partnership Partnership approach with with clients clients Partnership approach with clients approach with clients Partnership approach with clients Leverage relationships through network of && Cushman’s buying power e top talent / highly educated / experienced team members Leverage Leverage relationships through through network network of ofcontractors contractors &&&Cushman’s Cushman’s buying power power Leverage relationships through network of contractors contractors Cushman’s buying power Leverage relationships through network of contractors Cushman’s buying Leverage relationships through network of contractors & Cushman’s buying powe Integrate high quality operations & maintenance support services through our rtnership approach with clients Integrate Integrate highquality quality operations operations & &maintenance maintenance support support services services through through our Integrate high quality operations & maintenance support services through our reduction in janitorial costs Integrate high operations & maintenance support services through our Integrate highplatform quality operations & maintenance support services through our reduction reduction janitorial janitorial costs costs reduction in costs reduction ininin janitorial costs state-of-the-art reduction injanitorial janitorial costs state-of-the-art state-of-the-art state-of-the-art platform platform state-of-the-art platform verage relationships through network of contractors & Cushman’s buying power platform while increasing the service state-of-the-art platform
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frequency egrate high quality operations & maintenance support services through our frequency frequency frequency frequency frequency platform WHY WE DO IT -- RESULTS te-of-the-art WHY WHY WE WEDO DO DOIT IT IT- -RESULTS RESULTS WHY WE DO IT RESULTS WHY WE RESULTS WHY WE -DO IT - RESULTS Cost control Cost Cost control control Cost control Cost control Cost control Insure operation within lease guidelines Insure Insure operation operation within within lease lease guidelines guidelines Insure operation within lease guidelines HY WE DO IT - RESULTS Insure operation within lease Insure operation withinguidelines lease guidelines Maximize employee comfort & safety st control Maximize Maximize employee employee comfort comfort & & safety safety Maximize employee comfort & safety Maximize employee comfort & safety annual projected savings Maximize employee comfort & safety annual annual projected projected savings savings annual projected savings Provide a consistent, convenient, streamlined maintenance process ure operation within lease guidelines annualannual projected savings Provide Provide a aconsistent, consistent, consistent, convenient, convenient, streamlined streamlined maintenance maintenance process process Provide a consistent, convenient, streamlined maintenance process projected savings in year 2 Provide a convenient, streamlined maintenance process in in year year 2 2 Provide a consistent, convenient, streamlined maintenance process in year 2 in yearin2year Enhance value & improve patient “first impressions” ximize employee comfort & safety 2 Enhance Enhance value value &&improve improve patient patient “first “first impressions” impressions” Enhance value & improve patient “first impressions” Enhance value & improve patient “first impressions” Enhance value & risk improve patient “firstrisk impressions” Reduce regulatory as well as ovide a consistent, convenient, streamlined maintenance process Reduce Reduce regulatory regulatory risk riskas as well well asliability liability risk risk risk Reduce regulatory risk asas well as liability liability Reduce regulatory risk as well as liability risk Reduce regulatory risk as well as liability risk first class patient care Allow clients to on business; providing hance value & improve patient “first Allow Allow clients clients toimpressions” tofocus focus on ontheir their business; business; providing providing first firstclass class patient patient care carecare Allow clients to focus focus on their their business; providing first class patient Allow clients to focus theironbusiness; providing first class care care Allow clients toon focus their business; providing firstpatient class patient duce regulatory risk as well as liability risk savings on clinic savings savings on onone oneone clinic clinic
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40 WINTER 2020 | ARKANSAS HOSPITALS Independently Owned and Operated/Member of the Cushman & Wakefield Alliance
Contact Tracing: Behind the Scenes By Michelle Rupp
PHOTO COURTESY KARK-TV
Implement these steps to create awareness and help with contact tracing efforts:
I
n early 2020, most Arkansans were conditioned by telemarketers not to answer their cell or home phones if they did not recognize the caller ID. But by midsummer, new advice had emerged. As contact tracing became an integral part of the COVID-19 pandemic response, citizens were asked to pick up, even if the number was from an unknown caller. It became vital for the nation’s network of contact tracers to reach people, and to do that, their phone calls had to be answered. The Arkansas Department of Health contracted with the Arkansas Foundation for Medical Care (AFMC) and others to make these tracing calls. Contact tracers have the important job of notifying Arkansans who are known to have been exposed to someone who tested positive for COVID-19. Today, hundreds of Arkansans place contact tracing calls each day. “We regularly reach more than 80% of the direct contacts assigned to us,” says Kristy Bondurant, Ph.D., MPH, Interim Program Director for Contact Tracing at AFMC.
HOW CONTACT TRACING WORKS
Index cases (those individuals who test positive for the virus) are asked to supply a list of people with whom they have been in contact. Those “contacts” are then notified by the army of contact tracers. These “contacts” are often already aware of their personal exposure. However, if the tracing call is their first notice, real hesitation and many questions can arise. Contacts are advised to get tested for COVID-19 within 3-5 days of their last exposure to the index case. Even if the test is negative, they are advised to quarantine for two weeks, as they could still develop symptoms of the virus during this time. “Their first thought is ‘Oh my gosh, 14 days, I can’t go to work or take my kids to school,’” Bondurant says. “These things start going through their minds when we call.” She explains that many contact tracers have backgrounds in social work or counseling, which helps in these fraught situations. All tracers are trained
• Inform each patient who tests positive for COVID-19 that they should expect an initial call from a case investigator and contact tracer on behalf of the Arkansas Department of Health (ADH). • Stress the importance of selfisolation to prevent the spread and transmission of the virus to family and friends. • Encourage patients to talk directly to the people with whom they have been in contact while contagious, and urge them to ask those contacts to quarantine, if possible. • Ask patients to make a list of contacts beginning two days before symptom onset. If the patient is asymptomatic, the list will contain contacts beginning two days before the collection date of a positive COVID-19 specimen. This will prepare the patient to share that information when taking a call from the contact tracer. • Make patients aware of phone numbers from which to expect calls: • Arkansas Foundation for Medical Care (833) 283-2019. • General Dynamics Information Technology (877) 272-6819. • Other phone numbers may be used. • Educate patients regarding known scams. Make them aware that anyone calling on behalf of ADH will not ask for credit card information, money, or social security numbers.
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in active listening. In addition, contact tracers follow a script that includes advice on quarantining and how to be successful at stopping the virus’s spread. They also provide resources for such things as food, shelter, and support that might be necessary during the period of quarantine. Contact tracers agree that every day brings a new experience, and
no two calls are the same. All tracers are mindful that each Arkansan has individual needs and experiences, many of which might be shared during a call. “Our callers feel accomplished when they can support individuals,” Bondurant says. “We get a lot of ‘hoorays’ and excitement when we connect someone with a particular resource they need.”
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POSITIVE RESPONSE GROWING
Caller efficiency has increased since AFMC’s summer onset of contact tracing, and contact tracers regularly participate in trainings to keep their skills sharp. A close look at the data reveals certain times of day and days of the week that people are most likely to answer tracers’ calls. For example, calls made in the afternoons seem to be more successful in reaching contacts. “It’s impressive how our state has responded,” Bondurant says. “From the state agency level to the contractors working on this, we constantly remind ourselves that we are all in this together, and as contact tracers, we feel it is critical to support each one of our fellow Arkansans. This is an impressive and rewarding project.”
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HOSPITALS’ ROLE
Hospitals play a vital role in the success of contact tracing efforts. As the health care backbone of its community, a hospital connects patients, families, and often entire regions with important education about the virus and its containment. “Hospitals can educate the patient at the time of testing, explaining what the next steps will be, and they can encourage staff and patients to answer a contact tracer’s call.” Hospitals help advise tested individuals to create their own lists of known contacts. That list will include close contacts who spent time with the index case two days prior to their presentation of symptoms or a positive test. They can also prepare internal infection control staff members to help case investigators who may, themselves, have questions. “Contact tracing efforts are strongest when we have partners,” Bondurant explains. “Our health care providers and hospitals are strong partners who support our efforts.”
Michelle Rupp is AFMC’s Chief Communications and Strategy Officer. You may reach her at Michelle.Rupp@ afmc.org.
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5 Actions to Promote Health Equity
During the COVID-19 Pandemic From the American Hospital Association’s Institute for Diversity and Health Equity, with specific examples from Arkansas hospitals and health care organizations
R
ecent reports indicate how diverse and vulnerable populations are disproportionately suffering from COVID-19. Hospitals and health systems are working to address the health equity challenges highlighted by this crisis in different ways. Here are five areas where hospitals are making a difference in their communities – and ideas your hospital might employ to increase communication about COVID-19:
1. Educating in Ways that Resonate with Every Patient in Your Community
We applaud hospitals and health systems continuing to educate their patient base and surrounding communities on prevention, social distancing, and deterring the spread of COVID-19. Some, including the seven members of the Northwest Arkansas COVID Coalition (Arkansas Children’s Northwest, Community Clinic, Mercy Northwest Arkansas, Northwest Health, UAMS Health, Veterans Health Care System of the Ozarks, and Washington Regional), have worked with the Northwest Arkansas Council to create public education tools on COVID-19 symptoms, specifically reaching the Marshallese and Hispanic populations in Northwest Arkansas. The Coalition also reaches out to these communities by partnering with community chaplains, who serve as trusted sources of information and translation assistance (via iPad) during the pandemic. Above all, hospitals are reassuring the public that they care and continue to provide medical expertise for all persons in need of care.
2. Leveraging Community Partnerships
Hospitals and health systems are leveraging communications channels to not only keep communities safe but also expand their reach into underserved areas. For example, faith leaders are reinforcing the importance of staying home, despite the desire of members to congregate, food pantries can help amplify critical health and prevention information while still serving vulnerable populations, and community health workers can distribute educational materials as well as medicine, food, and other essentials to those who need them.
3. Continuing to Collect Patient Data
Pandemics are all-hands-on-deck situations. Some things fall through the cracks in favor of more pressing needs; data collection cannot be among these things that are left behind. The Arkansas Department of Health (ADH) works with hospitals and 44 WINTER 2020 | ARKANSAS HOSPITALS
other health care providers, local school districts, communities, and counties to provide data serving a number of purposes. The University of Arkansas for Medical Sciences, Arkansas Center for Health Improvement (ACHI), and hospitals and other health care organizations across the state use ADH data in a number of ways to help inform local decision makers including policymakers, school personnel, and parents, about the impact of COVID-19 in their communities and individual school districts. Hospitals that stay the course on collecting Race, Ethnicity and Language (REaL); Sexual Orientation and Gender Identity (SOGI); and Social Determinants of Health (SDOH) data for all seeking care position their clinical care teams to make betterinformed decisions. It’s these hospitals that are best able to connect patients with resources to address social needs and improve equity.
4. Advocating on Efforts to Address COVID-19 Disparities The American Hospital Association, the American Medical Association and the American Nurses Association last spring urged the United States Department of Health and Human Services to mobilize its agencies to identify and address disparities in the federal response to COVID-19, including increasing the availability of testing, ensuring access to equitable treatment and disseminating timely, relevant, culturally appropriate and culturally sensitive public health information. As noted, local groups, for example the Northwest Arkansas COVID Coalition and the Northwest Arkansas Council, continue to develop and distribute language-specific educational materials including handouts and flyers, video PSAs, radio PSAs, and infographics to help stop the spread of the virus.
5. Sharing What You Learn
Equity comes from lessons being shared with every community, regardless of size, demographics or geographic location. Share your pearls of wisdom, the pitfalls you experience and everything in between with your peers. AHA is helping compile these bright spots, best practices, and stories of resilience. Together, we can amplify great ideas for the greater good. To share your hospital’s or coalition’s stories of addressing health equity during the pandemic, please contact Arkansas Hospitals Senior Editor Nancy Robertson at nrobertson@arkhospitals.org.
The Northwest Arkansas COVID Coalition, along with the Northwest Arkansas Council, addresses the multicultural needs of citizens it serves through the use of language-specific educational materials. Here, a poster addressing the simple things we can do to keep ourselves and others healthy is presented in English, Spanish, and Marshallese.
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Looking Toward
the Legislative Session By Jodiane Tritt, Executive Vice President, Arkansas Hospital Association
T
he Arkansas legislative session begins, officially, on January 11, 2021, in compliance with the Arkansas Constitution, Article 5, § 5 and Arkansas Code § 10-2101(a). As a result of Arkansas’s response to the COVID-19 pandemic, legislative hearings are sure to look and feel different than usual. In fact, they already do. Budget hearings began on October 13, 2020, and they are ongoing. Governor Asa Hutchinson presented his balanced budget proposal on November 10, 2020, using the Zoom platform. Many committee rooms and the House floor are now outfitted with plexiglass dividers, and members are encouraged to wear face coverings in an attempt to prevent seatmates from spreading the virus to one another. No doubt, expert testimony by the AHA team and our members will look different, too. Legislators have been encouraged to pre-file their bills, beginning on November 16, 2020, to solicit feedback from supporters and opposition alike. The look and feel at the Capitol aren’t the only big differences for the new year. November 3, 2020 was Election
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Day in the United States. While Arkansas’s federal delegation remains unchanged, changes in Arkansas’s House of Representatives and Senate bring about potential challenges to what will, no doubt, be the Arkansas Hospital Association’s highest priority for the 2021 session – continuing Medicaid coverage for Arkansans that, by state statute and federal regulation, ends on December 31, 2021. Every year since 2013 – the year the Health Care Independence Act (also known as the Private Option) was created to allow Arkansans between the ages of 19 and 65 who are between 0% and 138% of the Federal Poverty Level to be covered by Medicaid – the AHA has diligently defended Arkansas’s Medicaid Expansion program. The statutorily created program, itself, requires a simple majority of both the House of Representatives and the Senate, but the appropriation that allows funding for the program, which is part of the overall Department of Human Services Division of Medical Services budget, requires a 75% supermajority of each chamber (27 of 35 Senate votes and 75 of 100 House of Representatives votes).
The program [...] reduces the burden of uncompensated care on hospitals and keeps Arkansans healthier. The Arkansas Private Option has undergone many substantive changes since 2013. It has evolved into the present-day Arkansas Works program, with modifications to the program occurring each session in order to ensure that enough legislators would approve the appropriation. Over the last seven years, the federal-to-state match rate funding the program has incrementally shifted from 100% federal funding to 90%, meaning that the state is projected to pay its 10% portion – $194.5 million – of the overall $1.945 billion next year. Of course, this Medicaid coverage program is just a piece of the overall Medicaid budget, which is anticipated to reach between eight and nine billion dollars in fiscal year 2022. Each year, DHS’s Medical Services appropriation has achieved supermajority approval. Each election season, the AHA and its members have worked to educate candidates on the benefits of Medicaid coverage to ensure that, when the time came to take a politically significant vote, Arkansas’s Senators and Representatives voted for hospitals and for our patients by approving the appropriation that continues the program. After the 2020 elections, the Arkansas Senate now has a Republican supermajority, with 28 Republicans and 7 Democrats. Three of the newly elected Senators are freshmen, two of whom are entering state legislative service for the first time. When the dust finally settled on November 18, and the last of the contested races was certified, the makeup of the Arkansas House stood at 78 Republicans and 22 Democrats. Thirteen of the House members will be freshmen; 23 will be serving their second term; 17 will be serving their third term; 20 will be serving their fourth term; 17 will be serving their fifth term; and 10 will be serving their sixth term.
On Friday, November 6, 2020, the Arkansas Senate and Arkansas House met in their caucuses to welcome the newly elected members and to begin organizing. Historically, this is the day that committee memberships, floor seats, parking spaces, and seniority are determined. Because of the unsettled races in Pulaski County, the Arkansas House of Representatives held its organizational meeting only to announce that those selections will be made at a later date, which is now scheduled for December 3, 2020. The Senate did organize and spent most of the day choosing committees. Most noteworthy are the makeup of the Senate Public Health, Welfare, and Labor Committee, which has historically been the committee that approves the substantive legislation authorizing Arkansas Works and its predecessors; the Insurance and Commerce Committee; and State Agencies and Governmental Affairs. As always, special attention is paid to the Arkansas Legislative Council, which provides approval for rule changes and Joint Budget, which is where appropriations are approved. Joint Budget will be chaired by Senator Jonathan Dismang, and Senator Dave Wallace will serve as Vice Chair. Legislative Council will be chaired by Senator Terry Rice, and Senator Missy Irvin will serve as Vice Chair. Also of special note this year, the State Agencies and Governmental Affairs Committee will be more influential than normal, as it is a year to determine legislative districts through the reapportionment process. On November 10, 2020, Governor Asa Hutchinson proposed a $5.84 billion general revenue budget for the fiscal year starting July 1, 2021, which is a $161 million increase over the current budget. Governor Hutchinson said that his priorities are tax cuts, education,
public safety, and information technology infrastructure. As with all budgets proposed by the executive branch, the legislative branch has the ability to change those priorities and fund its own priorities. The AHA and our members must remain steadfast in our education and advocacy efforts this year. Nearly 270,000 Arkansans depend on expanded Medicaid coverage to continue greater access to health care. Promoting the passage of a new law (and appropriation) to continue coverage under Medicaid is vital for these citizens and for the hospitals that serve them. The program has proven year-overyear to reduce the burden of uncompensated care on hospitals and to keep Arkansans healthier.
SENATE PUBLIC HEALTH, WELFARE, AND LABOR Cecile Bledsoe – Chair Scott Flippo – Vice Chair Dave Wallace Kim Hammer Dan Sullivan Ben Gilmore Bart Hester Breanne Davis
SENATE INSURANCE AND COMMERCE Jim Hendren – Chair Larry Teague – Vice Chair Keith Ingram Joyce Elliott Missy Irvin Jonathan Dismang Jimmy Hickey Mat Pitsch ARKANSAS HOSPITALS | WINTER 2020 47
Flu Prevention During Coronavirus Pandemic Fall and winter months bring the flu season. Here is what you need to know to help protect you and your family from the flu and COVID-19. FLU
COVID-19 PREVENTION
Flu shot. A flu shot protects you and your family from most strains of the flu.
Physical distancing, mask wearing, frequent hand washing. These important safety measures help prevent COVID-19 and also protect against the flu.
SYMPTOMS Flu and COVID-19 can have similar symptoms. Call a doctor or health care center if you have any of these symptoms: • Stuffy or runny nose • Muscle or body aches • Shortness of breath or • Cough • Nausea or vomiting difficulty breathing • Diarrhea • New fatigue/feeling tired • Sore throat • Fever or chills or without energy • Headache • New loss of taste or smell WHAT TO EXPECT Fever and aches should end within five Some people may never have symptoms. Recovery days. Coughing and fatigue/feeling tired can take up to two weeks for mild cases, or not having energy can last about two or six weeks or more for severe cases. weeks. See your doctor if symptoms COVID-19 may also lead to lasting organ get worse. Severe cases may lead to damage, hospitalization or death. hospitalization or death. TREATMENT Mild cases: rest, fever reducers and Rest, a fever reducer, such as cough medicine. acetaminophen, and an antiviral medicine to reduce the amount Serious cases: hospitalization, of time you have the flu and breathing support with a ventilator or prevent complications other therapies. COMPLICATIONS This disease can result in pneumonia and lasting damage to your lungs, kidneys, Flu can turn into heart and brain. COVID-19 can be fatal.* pneumonia, and very severe cases * More research is needed, but doctors and scientists can be fatal. currently believe that the death rate of COVID-19 could be 10 times higher (or more) than most strains of the flu.
CAUSE
This disease is caused by a coronavirus called SARS-CoV-2, which emerged late in 2019.
WHEN TO CALL YOUR DOCTOR. Call your doctor or health center if you have any signs or symptoms of illness. Explain what is happening, and follow their advice.
48 WINTER 2020 | ARKANSAS HOSPITALS
INF2009013
It is caused by several different influenza viruses that change each year, which is why there is a new vaccine each flu season.
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CONSTRUCTION
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INNOVATIVE SOLUTIONS FOR OUR CLIENTS Constructing St. Bernards five-story surgical tower involved innovation at every turn. When it came to the headwall units for patient beds, Nabholz’ construction team called on our inhouse custom cabinetry and millshop to create one-of-a-kind pieces that met our client’s exact needs. Our millshop prefabricated the headwalls down to the last detail, including 9,680 pre-drilled holes for electrical, medical, and structural connections. This reduced installation time, meaning our clients were able to occupy their new space sooner.
1 . 8 7 7. N A B H O L Z | n a b h o l z . c o m