The Inside View: Spring 2009

ACHE of North Texas

THE INSIDE VIEW

Spring 2009 A Publication of the ACHE of North Texas Chapter

ACHE of North Texas Expands The Brand Unveiling a new look in 2009 Leading Healthcare Design Ellerbe Becket Again Recognized As One Of World’s Leading Healthcare Designers

MAGAZINE

In Hospice Care Longer Livers Mean Money Lost

Economic Crisis Implications For Healthcare Finance

Joel Allison, CEO Honored With Texas Hospital Association’s Higher Award

Knowledge . Leadership . Marketability . Relationships.

A Publication of the American College of Healthcare Executives of North Texas Chapter The Inside View Spring ‘09 Issue

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Jesse S. Brown Veterans Affairs Medical Center Bed Tower Addition and Renovation Chicago, Illinois Joint Venture: Ellerbe Becket and SOM

contents & special features

Samsung Cancer Center Seoul, Korea Architect: Ellerbe Becket

northtexas.ache.org Spring 2009

The Inside View Photo Cover Janet D. Henderson, MHA, FACHE President, ACHE of North Texas Chapter Director, COPC for Parkland Health & Hospital System

Special President Message 4

Excerpt From Chapter Bylaws 14

Janet D. Henderson, MHA, FACHE President, ACHE of North Texas Chapter

ACHE of North Texas Chapter

Special Regent Message 6

Texas Hospital Association’s Highest Award ‐ Collier Award

Britt R. Berrett, FACHE President & CEO, Medical City Dallas Hospital

Hospice Care

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Providers face financial consequences with the cost of longer lives

Economic Crisis

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Implications for healthcare finance

Leading Healthcare Design 11 Ellerbe Becket again recognized as one of the world’s leading designers

News Briefs

Register for Congress and Advance Your Career

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Joel Allison Honored

Parkland VP Readies

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Brad Simmons, FACHE Named Senior Vice President of Surgical Services

Chapter Award Recipients 17 ACHE of North Texas to be honored Tuesday, March 24 at Congress

Career Positioning

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Proactively managing your professional development

2009 Event Calendar

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Upcoming events © 2009 All Rights Reserved

A Publication of the American College of Healthcare Executives of North Texas Chapter The Inside View Spring ‘09 Issue

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Need An Organization Join Us At ACHE of North Texas Knowledge . Leadership . Marketability . Relationships

The American College of Healthcare Executives is an international professional society of more than 30,000 healthcare executives who lead hospitals, healthcare systems and other healthcare organiza‐ tions.

ACHE is known for its prestigious credentialing and educational programs and its annual Congress on Healthcare Leadership, which draws more than 4,000 participants each year.

ACHE is also known for its journals, the Journal of Healthcare Management and Frontiers of Health Services Management and its maga‐ zine, Healthcare Executive, as well as ground‐breaking research and career development and public policy pro‐ grams.

ACHE's publishing division, Health Administration Press, is one of the largest publishers of books and jour‐ nals on all aspects of health services management in addition to textbooks for use in college and university courses.

Through such efforts, ACHE works toward its goal of being the premier professional society for healthcare leaders by providing exceptional value to its members.

Contact our Membership Committee Co‐Chairs for more information:

Ron Coulter, FACHE Texas Health Harris Methodist Hospital‐Cleburne roncoulter@texashealth.org

Bethany Williams Perot Systems bethany.williams@ps.net

ACHE of North Texas 3001 Skyway Circle, Suite 100 . Irving, Texas 75038 p: 972.256.2291 . f: 972.570.8037 . info@northtexas.ache.org northtexas.ache.org

A Publication of the American College of Healthcare Executives of North Texas Chapter The Inside View Spring ‘09 Issue

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The Importance of Conferencing Knowledge A Message From The President of the ACHE of North Texas Chapter

Janet D. Henderson, MHA, FACHE

“We will open the book. Its pages are blank. We are going to put words on them ourselves. The book is called Opportunity and its first chapter is New Year’s Day.” Edith Lovejoy Pierce

Happy New Year! I hope you had a wonderful holiday season and are looking forward to great things in 2009! I am looking forward to serving as your President this year and want to thank both John Self (Immediate Past‐ President) and Paula Zalucki, FACHE (Past‐President) for preparing me for this important role. They are great leaders and I truly appreciate their guid‐ ance and support! A very special thank you to all of our 2008 Sponsors! It’s because of their generosity that we are able to carry out our mission!

Last year was a good year for ACHE of North Texas! Our membership re‐ mains strong and we continue to grow as a Chapter. We were successful in bringing you great programs such as the visit to Careflight, the “Ritz Carlton Experience”, and an evening with best‐selling author John Nance. A new year provides endless opportunities and we are excited about moving for‐ ward in 2009, with innovative programs and events that add value to your membership experience!

The Board of Directors has been working diligently to plan educational and networking events for 2009. We begin the year with our “Breakfast with the CEO” series. What could be more fitting this time of year than breakfast at the internationally recognized Cooper Clinic! The event is scheduled for February 2 and will feature Kenneth Cooper, M.D., Founder & Chairman and Tedd Mitchell, M.D., President & CEO. I am very excited about this event and hope that you will be able to join us. Please visit our website for additional information about the breakfast.

We have more exciting programs coming down the pike! Here are a few things to look for: The Education Committee is working fast and furious to make it easier for you to obtain Category I credits. Stay tuned for the committee’s introduction of Local Program Coun‐ cils in both Dallas and Fort Worth. The Networking Committee is exploring different venues around the metroplex for our networking events. The Communications Committee will be giving our newsletter a “facelift” and we will be adding a “suggestions” tab to solicit your feedback about the Chapter.

This is going to be an exciting year for ACHE of North Texas! As your President, I am committed to doing the best possible job to meet your needs and expectations. I encourage you to contact me with any questions, concerns or feedback about the Chapter. Our suc‐ cess is based on your satisfaction and we want to be sure that you are receiving the best value for your membership in ACHE of North Texas.

Best wishes for a great 2009!!

Janet D. Henderson, MHA, FACHE 2009 President ACHE of North Texas

If you have comments for President Janet Henderson, send them to info@northtexas.ache.org.

A Publication of the American College of Healthcare Executives of North Texas Chapter The Inside View Spring ‘09 Issue

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The Inside View Editor‐In‐Chief

Managing Director

Contributing Editors

ACHE NOTES PUBLISHING

Publishers

Production/Creative Director

Director of Editorial Research

Advertising

Subscriptions

Address All Questions and Comments To: Editorial Office c/o The Inside View ACHE of North Texas 3001 Skyway Circle, Suite 100 Irving, Texas 75038 p: 972.256.2291 f: 972.570.8037 e: info@northtexas.ache.org w: northtexas.ache.org

Janet D. Henderson, MHA, FACHE Michael Ojeda, FACHE J. Eric Evans John G. Self Brad Simmons, FACHE Gail Maxwell, FACHE Britt R. Berrett, FACHE Ron Coulter, MHSM, FACHE Beverly Dawson, RN Forney Fleming Jonni Johnson, CPSM Sandy Lutz Elizabeth McGrady, FACHE Caleb F. O’Rear, FACHE George L. Pearson, JD, FACHE Scott Schmidly, FACHE Rick L. Stevens Demetria Wilhite, Ex‐Officio Bethany Williams Jania Villarroel

ACHE of North Texas info@northtexas.ache.org ACHE of North Texas Janet D. Henderson, MHA, FACHE info@northtexas.ache.org info@northtexas.ache.org

2009 Chapter Officers President Janet D. Henderson, MHA, FACHE Parkland Health & Hospital System jhende@parknet.pmh.org

President‐Elect J. Eric Evans Chair, Education Committee Lake Point Medical Center Eric.evans@tenethealth.com

Immediate Past‐President John G. Self JohnMarch Partners, Inc. jgself@johnmarch.com

Secretary Brad Simmons, FACHE Methodist Health System bradleysimmons@mhd.com

Treasurer Gail Maxwell, FACHE Baylor Health Care System gailm@baylorhealth.edu

2009 Board Members‐at‐Large Britt R. Berrett, FACHE Ex‐Officio Medical City Dallas Hospital Medical City Dallas Children’s Hospital britt.berrett@lonestarhealth.com

Ron Coulter, MHSM, FACHE Chair, Membership Committee Texas Health Harris Methodist Hospital‐Cleburne roncoulter@texashealth.org

Beverly Dawson, RN Chair, Networking Committee Elder Care LP bdawson@eldercarelp.com

Forney Fleming, Ex‐Officio Co‐Chair, Advancement Committee The University of Texas at Dallas fwfleming@gmail.com

Jonni Johnson, CPSM Chair, Sponsorship Committee RTKL Associates Inc. jwjohnson@rtkl.com

Sandy Lutz PricewaterhouseCoopers Health Research Institute sandy.lutz@us.pwc.com

Elizabeth McGrady, FACHE Chair, Advancement Committee University of Dallas elizabethmcgrady@sbcglobal.net

Michael Ojeda, MHA, FACHE Chair, Communications Committee VA North Texas Health Care System Michael.ojeda@va.gov

Caleb F. O’Rear, FACHE Co‐Chair, Sponsorship Committee Denton Regional Medical Center caleb.orear@hcahealthcare.com

George L. Pearson, JD, FACHE Co‐Chair, Education Committee Co‐Chair, Networking Committee Texas Health Resources georgepearson@texashealth.org

Scott Schmidly, FACHE Co‐Chair, Mentorship Committee Medical City Dallas Hospital Medical City Dallas Children’s Hospital scott.schmidly@hcahealthcare.com

Rick L. Stevens Chair, Mentorship Committee JPS Health Network rsteve01@jpshealth.org

Demetria Wilhite, Ex‐Officio Co‐Chair, Advancement Committee The University of Texas at Arlington demetria@uta.edu.

Bethany Williams Co‐Chair, Membership Committee Perot Systems bethany.williams@ps.net

Jania Villarroel Co‐Chair, Communications Committee Metropolitan Anesthesia Consultants, LLP jvillarroel@metroanesthesia.com

The ACHE of North Texas e‐magazine, The Inside View, is published quarterly (Spring, Summer, Fall and Winter) and includes information on the latest regulatory and legislative developments, as well as the quality‐improvement and leadership trends that are shaping and influencing the hospital and health system field. Readers get in‐depth reporting on the issues and challenges facing hospital and health system leaders today. We make it our job to tell about the great things the organization and Chapter are doing every day to ensure the health of our community.

If you have any news and updates that you want to share with other members, please e‐mail your items to info@northtexas.ache.org. Microsoft Word or compatible format is preferable. If you have a graphic or picture that you’d like to include, please send it as a separate file.

The following are the types of information that our members shared in our past ACHE of North Texas magazine: Advocacy Issues, Legislative Issues, Educational Opportunities, Awards / Achievements, Promotions (Members On the Move), Committee Updates, Journal submissions, conference submissions, and workshop participations, Sharing mentoring experiences, etc.

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A Message From The Greater DFW Regent “Attaining the tools, guidance and support you need to gain an edge in the field of health care.”

Regents Advisory Council

Ronald E. Coulter, FACHE Texas Health Harris Methodist Hospital‐Cleburne

Harvey L. Fishero, FACHE Medical Center of Plano

Brett S. McClung, FACHE Texas Health Harris Methodist Hospital Southwest FW

Troy D. Thibodeaux, FACHE East Texas Medical Center

Elmer G. Ellis, FACHE East Texas Medical Center Regional Healthcare System

Michael A. Lieb, FACHE Wadley Health System

John G. Self JohnMarch Partners, Inc.

Paula M. Zalucki, FACHE Salus Strategy Group, LLC

James C. Edmonson, RN, FACHE Medical City Dallas Hospital

Don’t Miss ACHE’s Congress on Healthcare Leadership

Join us in Chicago March 23‐26 for ACHE’s 2009 Congress on Healthcare Leadership, the premier educational event for health‐ care executives and one of the year’s best opportunities to learn, connect with leaders and advance your career.

Whether you are new to Congress or you have attended many times before, it is one of the best values for your educational dollar and a great way to make the most of your membership in ACHE.

Congress will be held at the Hilton Chicago & Palmer House Hilton. Register early so you can have first pick of more than Britt R. Berrett, FACHE President and CEO 100 high‐quality seminars, networking events and career de‐ Medical City Dallas Hospital Medical City Dallas Children’s Hospital velopment sessions, along with opportunities to meet and interact with leaders in the field.

Get a jump start on Congress by attending a pre‐Congress seminar or one of our Boot Camps.

Watch for the complete Congress brochure, which was mailed in mid‐November, or view it online at ache.org.

About Britt R. Berrett, FACHE Britt Berrett has served as president and chief executive officer of Medical City since April 2000. He oversees strategic planning and operations for both Medical City and Medical City Children’s Hospitals, guiding the hospital in its mission to be a dynamic learning healthcare organization that sets the standard of excellence for its employees, patients, physicians and community.

While on a two‐year mission in Peru, Berrett developed a great appreciation for the role that healthcare providers can play in improving the quality of life for an entire community. It is his concern for the quality of life in the community that makes him a passionate advocate for excellence in healthcare and a perfect fit for Medical City.

Prior to joining Medical City, Berrett served as chief executive officer of Sharp Chula Vista Medical Center, a 306‐bed facility located in San Diego and Daniel Freeman Memorial Hospital in Los Angeles, California. He received his bachelor's degree in finance from Brigham Young University and his master's degree in hospital administration from Washington University School of Medicine in St. Louis.

ACHE of North Texas Learn how today’s leaders are ensuring tomorrow’s solutions >> northtexas.ache.org

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www.ellerbebecket.com HOW TO LINK EDUCATION AND HEALTHCARE IN A GLOBAL MARKET? Regarded as one of the world’s leading healthcare designers, Ellerbe Becket is sought after to program, plan and design state‐of‐the‐art facilities for many highly respected healthcare providers worldwide.

We believe that the design of healthcare environments can impact clinical outcomes and patient, family and caregiver satisfaction. This means that every healthcare facility we design works to improve op‐ erational efficiency; allow for future flexibility; and provide a safe and efficient work environment for nurses and physicians, and safety, comfort and privacy for patients and their families.

We learn from legitimate research in evidence‐based design and inte‐ grate that knowledge into the design process. Our 100 year old firm is constantly learning more, testing new ideas and designing healthcare facilities that inspire and improve the human condition.

Stacy E. Marshall A global Business Development Director ELLERBE BECKET architectural and 3131 McKinney Avenue, Suite 200 Dallas, Texas 75204 engineering firm 1+ 214.758.3138 direct 1+ 214.336.8082 mobile creating [SUCCESS] 1+ 214.481.0999 fax Stacy_Marshall@ellerbebecket.com without limits.

ACHE OF NORTH TEXAS COMMITTEES Communications Committee: Oversees and maintains communications among chapter members through web services, publications, electronic mail, and other delivery mechanisms to ensure effective and timely communication among the chapter members.

Educational Programming Committee: Develops, plans, and coordinates educational programs related to current and pertinent issues facing the healthcare industry. At least two ACHE cate‐ gory II educational programs shall be provided to members each calendar year. This committee will plan category I programming, using the panel dis‐ cussion format and onsite programming options. This committee will also explore establishing regional Program Councils to deliver educational pro‐ grams within the chapter’s geographic territory.

Member Services Committee: Coordinates recruitment and retention activities through the chapter’s Ambassador program.

Develops member recognition programs, promotes ACHE amongst area graduate programs, and provides career services for current and potential chapter members.

Advancement Committee: Encourages chapter affiliates to prepare for advancement to Fellow. Conducts exam preparation courses, organizes study groups as needed. Encourages existing Fellows to re‐credential.

Mentoring Committee: Oversees and coordinates the healthcare executive mentorship program, and produce an Early Careerist seminar.

Networking Committee: The Networking offers members opportunities to network with their peers. Networking opportu‐ nities include but are not limited to: 1) Bi‐monthly executive leadership breakfast meetings; and 2) Bi‐monthly social/networking events. The breakfast meetings and social events are hosted by senior executives of local healthcare facilities or health related organizations.

Sponsorship Committee: The Sponsorship Committee solicits sponsorships to support chapter events and ACHE Congress scholarships.

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IN HOSPICE CARE, LONGER LIVES MEAN MONEY LOST

By Kevin Sack, Contributing Editor for The New York Times

Photo By Ozier Muhammad/The New York Times

For Charles Brown Jr., 81, with his wife, Cora, growing old in Wilcox County, Ala., means care from Hometown Hospice.

CAMDEN, Ala. — Hundreds of hospice providers across the country are facing the catastrophic financial consequence of what would otherwise seem a positive development: their patients are living longer than ex‐ pected. Over the last eight years, the refusal of patients to die according to actuarial schedules has led the federal government to demand that hospices exceeding reimbursement limits repay hundreds of millions of dollars to Medicare.

The charges are assessed retrospectively, so in most cases the money has long since been spent on salaries, medicine and supplies. After absorbing huge assessments for several years, often by borrowing at high rates, a number of hospice providers are bracing for a new round that they fear may shut their doors. One is Hometown Hospice, which has been provid‐ ing care here since 2003 to some of the most destitute residents of Wil‐ cox County, the poorest place in Alabama.

The locally owned, for‐profit agency, which serves about 60 patients, mostly in their homes, had to repay the government $900,000, or 27 percent of its revenues, from its first two years of operation, said Tanya O. Walker‐Butts, a co‐owner. Its profits were wiped out in the time it took to open the demand letters, Ms. Walker‐Butts said.

Hometown paid its first assessment with a bank loan. When the bank declined credit for the second year, the hospice structured a five‐year payment plan with the Centers for Medicare and Medicaid Services, the federal agency that administers the program, at 12.5 percent interest.

The next bill is expected any day.

“If they hit us with a number in the several hundred‐thousand range, I just don’t see how we can survive,” said Gaines C. McCorquodale, Home‐ town’s other owner.

In the early days of the Medicare hospice benefit, which was designed for those with less than six months to live, nearly all patients were cancer victims, who tended to die relatively quickly and predictably once cura‐ tive efforts were abandoned. But in the last five years, hospice use has skyrocketed among patients with less predictable trajectories, like those with Alzheimer’s disease and dementia. Those patients now form a ma‐ jority of hospice consumers, and their average stays are far longer — 86 days for Alzheimer’s patients, for instance, compared with 44 for those with lung cancer, according to the Medicare Payment Advisory Commis‐ sion.

The commission, which analyzes Medicare issues for Congress, recently projected that 220 hospices — about one of every 13 providers — re‐ ceived 2005 repayment demands totaling $166 million. The National Alliance for Hospice Access, a providers’ group that is lobbying for a three ‐year moratorium on the collections, places the numbers at 250 hospices and $200 million. Because fewer than a tenth of all hospice providers have faced repayment, Medicare officials suggest that management might have been an issue. But Lois C. Armstrong, president of the hospice access alliance, said that if the cap on Medicare reimbursements was not lifted, the availability of care would tighten at a time when demand for hospice care was exploding and when new research suggests it saves money for the runaway Medicare program.

Many elderly people here in the remotest reaches of the state’s Black Belt would most likely live out their last days alone if not for Hometown Hospice nurses like Meg Appel Youngblood.

One recent autumn morning, Ms. Youngblood forded the Alabama River by ferry and set off on her rounds of the storied quilting enclave of Gees Bend, looking in on old women who had grown too feeble to quilt or to care for themselves. continued on page 9

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IN HOSPICE CARE, LONGER LIVES MEAN MONEY LOST

(continued from page 8)

By Kevin Sack, Contributing Editor for The New York Times

Photo By Ozier Muhammad/The New York Times

Inside a clapboard house, she checked the vital signs of Loretta L. Pettway, a former farmhand whose stitchwork has been celebrated in postage stamps and picture books, and found that her blood pressure was a bit high.

“Miss Loretta, have you had your medicine?” she asked, and Ms. Pettway, 65, weary from chronic heart disease, shook her head no. “I didn’t think so,” Ms. Youngblood said, as she started to inventory the 14 pill bottles Ms. Pettway had stowed in a plastic bag.

Medicare’s coverage of hospice, which began in 1983, has become one of the fastest growing components of the government’s fastest growing entitlement. Spending nearly tripled from 2000 to 2005, to $8.2 billion, and nearly 40 percent of Medicare recipients now use the service.

To be eligible, patients must be certified by two doctors as having six months or less to live, assuming their illness runs a normal course. They must agree not to bill Medicare for curative procedures related to their diagnosis.

Medicare, which pays the vast majority of hospice bills, reimburses pro‐ viders $135 a day for a patient’s routine home care. The hospice is then responsible for providing nurses, social workers, chaplains, doctors, drugs, supplies and equipment, as well as bereavement support to the family.

Studies have reached various conclusions about whether hospice care actually saves money, especially for long‐term patients. But a new study

by Duke University researchers concluded that it saved Medicare an average of $2,300 per beneficiary, calling hospice “a rare situation whereby something that improves quality of life also appears to reduce costs.”

In 1998, Congress removed limits on the number of days that an individ‐ ual could receive Medicare hospice coverage, a move that encouraged physicians to refer terminal patients.

But lawmakers did not remove a cap on the aggregate amount that hos‐ pice providers could be reimbursed each year, a measure designed to contain the program’s cost. A hospice’s total annual reimbursement cannot exceed the product of the number of patients it serves and a per‐ patient allowance set by the government each year ($21,410 in 2007).

For reasons that are not fully understood, problems with the cap have been most prevalent at small, for‐profit hospices in Southern and West‐ ern states like Mississippi, Alabama and Oklahoma.

Those programs typically have had higher proportions of noncancer patients and, thus, longer lengths of stay. But the Medicare advisory commission’s analysis also determined that the average length of stay in the cap‐busting programs was significantly higher for all types of pa‐ tients, including those with cancer.

Herb B. Kuhn, the deputy director of the Center for Medicare and Medi‐ caid Services, said that finding was attracting attention at the center, which is eager to keep the hospice care benefit from morphing into a long‐term care entitlement. “Well over nine out of 10 hospices seem to be managing well, including the ones in higher‐wage areas, so it does raise an issue of management,” Mr. Kuhn said. Mr. Kuhn said it remained a question whether hospice care saved money, but called it “a wonderful benefit” that “probably needs refinement” after nearly 25 years.

Among the matters meriting review, he said, is whether doctors have been premature in certifying patients as terminal. Medicare has issued disease‐specific guidelines for the certifications, which must be made by both a personal physician and the hospice medical director.

The medical director at Hometown Hospice, Dr. Sumpter D. Blackmon, said he relied heavily on the judgment of the hospice’s nurses to deter‐ mine whether prospective patients were rather likely to live longer than six months. But of the 56 patients on the books on Oct. 31, 17 had been there for at least that period, including two for more than 500 days.

“Doing this for 40‐something years,” said Dr. Blackmon, a longtime physi‐ cian here, “every time I think somebody is going to die tomorrow, damned if they don’t live for a year and a half.”

A number of hospice providers said ethical and legal constraints would prevent them from discharging patients who outlived their profit poten‐ tial. But some said they sometimes delayed admission for those patients with illnesses that might result in longer stays.

Like other providers, Richard R. Slager, the chairman and chief executive of VistaCare, which is based in Arizona and has programs in 14 states, said his company now aimed its marketing at cancer patients.

“In communities where we have had cap issues, we have to really look hard for shorter‐length‐of‐stay patients to offset it,” Mr. Slager said. “It’s a never‐ending nightmare.”

After being hit with $200 million in cap charges over four years — the equivalent of a year’s revenues — Mr. Slager said he chose to close or sell 16 of 58 hospices.

Some providers have survived only by aggressively recruiting new pa‐ tients, using this year’s Medicare reimbursements to pay off last year’s cap charges, while stalling for Congressional relief. Ms. Youngblood, the Hometown Hospice nurse, said that after she visited her charges — dol‐ ing out their pills, and turning the sweet potatoes in their ovens — she trolled for new patients at nursing homes and senior centers.

At the small hospital here, she said, the nurses joke about her “marketing” forays: “They’ll say, ‘Here comes Nurse Kevorkian. She has no shame.’ And I’ll say, ‘Look, I have to have a paycheck, too.’”

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ECONOMIC CRISIS: IMPLICATIONS FOR HEALTHCARE FINANCE

By Richard L. Clarke, President and CEO, Healthcare Financial Management Association (HFMA)

Turmoil in the markets and the looming threat of recession pose significant risks for healthcare organizations.

HFMA is committed to keeping our members up to date on the implications of this crisis for healthcare fi‐ nance. We will continue to update this page with information and resources as the situation unfolds.

A Message from Richard L. Clarke, President and CEO of HFMA “May you live in interesting times.” Although it sounds good at first hearing, this old proverb was meant as a curse. Interesting times are unsettled, challenging, and often harsh and unpleasant. We’ve all felt unsettled and challenged in recent days as financial markets have swooned and credit mar‐ kets have frozen. Indicators point to an imminent, deep recession that may already be upon us. These really are interesting times.

For many healthcare organizations, the times got interesting before the current market turmoil. In 2003, when HFMA began its series of Financing the Future reports, a widening gap between “have” and “have not” healthcare organizations was already apparent. The “have” organizations have the size, revenue diversity, and balance sheet strengths to support capital and other investments. They generate adequate cash flows and have had access to capital markets to support strategies of renewal and expansion. The “have not” organizations‐‐as much as one‐third of all hospitals, according to our research‐‐struggle to meet critical capital needs, and have had limited access to capital markets. They have relied on cash flow from operations, grants from private and public organizations, bank lines of credit, and philanthropy to keep their doors open.

In recent years, the financial markets flooded the economy with a glut of capital. This provided “have” organizations with ready access to very low‐cost capital, enabling them to stretch their dollars further. And it kept the economy going, which helped the “have not” organizations keep their operations going. In both cases, important services to their communities were maintained and often enhanced.

Today, both the “haves” and “have nots” face interesting times. The capital markets have become constrained for all organizations. All but the highest rated organizations will find limited appetite for their debt (or equity, if your organization is investor‐owned), and liquidity instruments or credit enhancement approaches will probably be unavailable. The credit crunch, if it continues, will starve organizations in need of capital. Deterio‐ rating economic conditions will squeeze cash flows. Philanthropic contributions will likely decrease. What can be done?

First, it is critical that healthcare organizations act responsibly. A lack of responsibility on the part of many (capital markets, government, businesses, and consumers) has contributed to this crisis. As hospitals face difficult decisions in the coming months, they must strive to ensure that their decisions reflect the best interests of their communities. In doing so, hospitals will be able to retain the special position of trust they occupy in their communities at a time when trust in so many other institutions has been eroded.

Second, recognize that we may be at a “tipping point” that will prompt a restructur‐ ing of the healthcare industry. Healthcare leaders must consider the future of their organizations. Should they attempt to acquire or be acquired by another entity?

Should they change their service orientation away from capital intensive service delivery? May they have to consider closure? In the end, these decisions must be tempered with the realities of capital access and effective service delivery, but they also must be focused on what best serves community needs. Trust is enhanced when actions support the caring mission.

Third, remember that others are working on your behalf. The American Hospital Association, for example, is speaking out on the national importance of a stable, functional healthcare system at a time when families and communities are under strain. HFMA is spearheading an effort for healthcare payment reform to ensure that payments reflect the actual costs of providing high‐quality, efficient care to your communities, access to care by the uninsured, and the costs of other societal bene‐ fits that hospitals provide. HFMA will also support you by carrying the message that dollars invested in healthcare organizations generate a significant return for the communities they serve, and are critical to ensure that the organizations can con‐ tinue to fulfill their vital public mission.

Finally, keep doing what you have been doing‐‐striving to ensure that your organiza‐ tions are providing high‐quality, safe services in a cost‐effective manner. These interesting times did not originate in the healthcare sector, nor in the municipal bond markets. But these challenges are before us and you have an important job to do. On our part, we pledge to continue to serve you with the networks, resources, and information you need to perform at your best in these difficult, interesting times.

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ELLERBE BECKET AGAIN RECOGNIZED AS ONE OF WORLD’S LEADING HEALTHCARE DESIGNERS

Ellerbe Becket received unique recognition in the October issue of Healthcare Design, the publication’s annual “International” issue.

Featured on the cover is the recently completed Samsung Cancer Center in Seoul, Korea. Inside is the under‐construction University Hospital in Dubai, UAE, which Healthcare Design recognized with the only “Citation of Merit” award bestowed on an international project.

Samsung Cancer Center is first of its kind and the largest cancer center in Asia. Opened in January 2008, the 1,200,000‐square‐foot facility aims to become one of the top ranked cancer centers in Asia with 650 hospital beds dedicated to cancer patients. Of particular note is the project’s integration with the surrounding landscape, which creates a sense of being in a garden and enhances the rela‐ tionship between nature, patients, families and staff. A large‐scale atrium focuses on the gardens and forest preserve areas while serv‐ ing as the primary public space for the new building.

The outpatient podium, containing the primary diagnostic, treatment and exam functions, provides immediate access and natural light to the patient environment. Roof gardens further extend the connec‐ tion with nature and its healing effects. Likewise, the bed‐tower plan offers efficiency and flexibility while enhancing patient healing.

As the centerpiece of Dubai Healthcare City’s Mohammed Bin Rashid Al Maktoum Academic Medical Center, the award winning University Hospital will define a new standard of healthcare excellence in the Gulf region. When complete in 2011, the hospital will accommodate 400 beds and cover approximately 1.45 million square feet of pro‐ gram space. The University Hospital design creates an image, both internally and externally, of modern healthcare technology fused with the cultural traditions and forms of the region’s traditional architecture.

Adjacent and connected to Harvard Medical School Dubai Center, integration between education, patient care, research and culture truly differentiates University Hospital. The hospital aims to improve patients’ health and education while serving as a catalyst for ad‐ vancements in innovation and technology. It will contribute to the well‐being of the overall community and help develop a sustainable Samsung Cancer Center healthcare delivery model for the region.

Seoul, Korea

Published in association with The Center for Health Design, Healthcare Design is a premier publication devoted to professionals who design, build and renovate healthcare facilities. October is Healthcare Design’s annual international showcase issue, and 2008 marks the third consecutive year that the publication featured an Ellerbe Becket‐designed project on the special issue’s cover.

Ellerbe Becket, which marks its 100th anniversary in 2009, is a leading designer of healthcare facilities with significant projects at academic medical centers in North America and throughout the world. The firm recently designed the OU Cancer Institute at the University of Oklahoma Health Science Center and the University of Kentucky Albert B. Chandler Hospital. International projects include Yonsei University Medical Center’s new Severance Hospital in Seoul, Korea and the Sidra Medical and Research Center in Doha, Qatar, among many others.

To learn more about these and other Ellerbe Becket design solutions for healthcare, please visit www.ellerbebecket.com.

Ellerbe Becket provided specialized architectural design, planning, engineering, interior design and medical equip‐ ment planning to develop a new paradigm in cancer treatment facilities for the 652‐bed Samsung Cancer Center, the largest cancer center in Asia. A naturally beautiful landscape surrounding three edges of the building creates a sense of being in a garden. The architecture and interior design has enhanced the relationship between nature and the cancer patient, both inside and outside. A large‐scale public atrium focuses on the gardens and forest preserve areas, while serving as the primary organizing space for the new building. The atrium reinforces patient wayfinding and the perception of a healing environment throughout the project. Roof gardens accessed from the outpatient podium further extend the connection with nature and its healing effects.

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NEWS BRIEFS

ACHE Call for 2010 Nominations Slate The Nominating Committee is calling for applications to serve for 2010. All affiliates are encouraged to participate in the nominating process. Fellows are eligible for any of the Governor and Chairman‐Elect vacancies and are eligible for the Nominating Committee and Regent‐at‐Large vacancies within their district. Application deadline is July 15, 2009. Visit www.ache.org to learn more and view a list of open positions.

Register for Congress and Advance Your Career In an uncertain economy, it’s more important than ever to ensure your professional skills are finely tuned. By attending Congress you can access an abundance of complimentary career development opportunities throughout the week. Arrange to have your resume reviewed and critiqued by an experienced ACHE Fellow. Schedule time to meet with a senior healthcare executive to help plot your long‐term career goals. Attend a networking breakfast and connect with your colleagues. These and other valuable programs are provided by the Healthcare Executive Career Resource Center during Congress. Register online to reserve your space.

Learn How to Accelerate and Achieve Change The new book What Top‐Performing Healthcare Organizations Know: 7 Proven Steps for Accelerating and Achieving Change details the crucial role leaders should play in the performance‐improvement process. Authors Greg Butler and Chip Caldwell, FACHE, researched more than 220 healthcare organizations to determine what differentiates high performers from organizations that fail to achieve lasting operational success. For more informa‐ tion on this or other Health Administration Press publications, please visit www.ache.org/HAP.

'Wired' Hospitals Post Lower Death, Complication Rates One of the first comprehensive studies on the effects of health IT on patient care finds a positive correlation between strong healthcare IT and lower patient mortality rates. According to the study published in the Archives of Internal Medicine's Jan. 26 edition, there are four types of health informa‐ tion technology: notes and records for case and admission histories, test results, order entry and decision support. However, only 25 percent of hospi‐ tals have a form of emergency medical records and 5 percent have a physician order entry system. Researchers analyzed the inpatient mortality rates, length of stay and treatment costs for more than 167,000 patients 50 years and older in Texas hospitals between Dec. 1, 2005, and May 30, 2006. A 10‐ point hike in computerization of notes and records correlated to a 15 percent decline in mortality rates, analysts reported after taking into account how well physicians were trained on the new system, the usability of the system and other factors. Additionally, high decision‐support scores corre‐ lated to a 16 percent decline in complications, while high scores in test results, order entry and decision support helped hospitals reduce expenses.

Devon M. Herrick of the Dallas‐based National Center for Policy Analysis says, "I assume that over the course of the next few years, with or without the government's prodding, that we will begin to integrate this more and more, because it is a good idea." ‐ From "'Wired' Hospitals Post Lower Death, Complication Rates" ‐ U.S. News & World Report (01/27/09) Gardner, Amanda

Claims Denied More than 60 hospitals in the United States will miss out on $5 million in reimbursements this year if Medicare decides they did not correctly submit their quality data. Medicare denied these hospitals' 2 percent yearly payment update for fiscal 2009 because inpatient care reports submitted to the program contained errors, information was missing, reports were submitted after deadline or the hospital failed to have a designated staff member working with the program's Quality Net reporting platform. Those hospitals submitting claims for reconsideration may receive final decisions at the end of January. Statistics show that out of the requests for reconsideration received previously, the Centers for Medicare and Medicaid Services (CMS) has overturned about 50 percent of those decisions based upon hospitals' extenuating circumstances and their communications with the agency and data vendors. CMS hopes to mine the data from these reports to populate its quality measure Web site, Hospital Compare. ‐ From "Claims Denied" ‐ Modern Healthcare (01/26/09) Vol. 39, No. 4, P. 6; DerGurahian, Jean

CLABSI in the Crosshairs Central‐line‐associated blood stream infections (CLABSI) are a major problem in ICUs and other hospital departments, resulting in the deaths of ap‐ proximately 62,000 patients annually. The Health Research & Educational Trust (HRET) recently received almost $3 million from the Agency for Health‐ care Research and Quality to help 100 hospitals across the country implement best practices outlined in the Comprehensive Unit‐Based Safety Program (CUSP). CUSP was successfully implemented in some Michigan hospitals, which went for six months without reporting a single central‐line infection.

Hospital officials estimate that the program saved approximately $175 million and almost 1,500 lives per year. CUSP focuses on changing the culture of ICUs so medical workers recognize how dangerous some procedures can be to patients. HRET will spend most of the $3 million grant training personnel in the collection and analysis of data as part of an effort to determine if hospital ICUs can fully embrace CUSP and packaging the program to be used by other hospitals. The CUSP approach likely would be effective in reducing other medical problems, such as ventilator‐assisted pneumonia and wound infections. Once the program is successfully implemented in a hospital's ICU, the techniques could be taught to healthcare workers in other depart‐ ments, say experts. ‐ From "CLABSI in the Crosshairs" ‐ Materials Management in Healthcare (01/09) Vol. 18, No. 1, P. 9; Combes, John R

America's Safest Hospitals HeathGrades recently released its seventh annual study of quality and clinical excellence that identified 270 top hospitals out of the 5,000 hospitals studied. These top hospitals have a 28 percent lower mortality rate and an 8 percent lower complication rate than the national average. Researchers suggest that if all the nation's hospitals performed at the same level, more than 152,000 lives could have been saved between 2005 and 2007. Im‐ proved safety rates also could result in lower insurance premiums and billions less in medical malpractice claims. Missouri Baptist Hospital, which en‐ gages rapid response teams to help troubled patients within 90 seconds, is on the list. At the hospital, family members and staff can call for a physi‐ cian's assistant, respiratory therapist and nurse to respond to a patient emergency. Meanwhile, officials at Lancaster General in Pennsylvania say its transparency policy accounts for its high rating. Internal reports on fall rates for patients and complication rates among heart patients are distributed internally to staff. Consumers, according to experts, should ask hospitals about their performance. ‐ From "America's Safest Hospitals" ‐ Forbes (01/27/09) Ruiz, Rebecca; Whelan, David

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NEWS BRIEFS

Rapid Response, Better Outcomes The Institute for Healthcare Improvement has made the creation of rapid response teams (RRTs) a crucial component of its 5 Million Lives Campaign, and while 1,800 hospitals across the country have implemented RRTs, results of the MERIT trial indicate that they may not be effective at reducing mortality rates and cardiopulmonary arrests outside the ICU. William Yarbrough, MD, chief of ICU informatics, and Steve Rypkema, RN, clinical informa‐ tion administrator, at VA North Texas Health Care believe RRTs are not successful in many instances because providers miss the warning signs of clinical deterioration. To successfully employ RRTs, Yarbrough and Rypkema say hospitals should depend on technology, not caregiver vigilance, to identify early warning signs. In response, VA North Texas Health Care interfaced its electronic medical records system and automated data surveillance system in all of its ICUs. The resulting system looks at vital signs, laboratory and medications to flag declining patients. Ensuring vital signs are input into elec‐ tronic patient records and transmitted to the interfaced system helps providers determine whether or not to administer medication. ‐ From "Rapid Response, Better Outcomes" ‐ Health Management Technology (01/09) Yarbrough, William C. ; Rypkema, Steve

Take a Deep Breath and Brace Yourself Fitch Ratings' recent decision to downgrade its projection for the U.S. nonprofit sector to negative after maintaining a stable outlook since 2003 is a death knell for already deteriorating hospitals, but some healthcare CEOs see market conditions as an opportunity to restructure and improve in 2009 or 2010. Hospitals with strong balance sheets and those in rural locales already are in a better position than some of their larger counterparts, states Mark Doak, CEO of Elkins, W. Va.‐based Davis Health System. Regardless of financial solvency, nearly all major healthcare networks anticipate a reining in of new spending, construction and overhead costs in 2009. A possible bright spot for some hospitals with projects in the works may be a recession‐ induced plunge in commodities prices. J.P. Morgan Healthcare Group head Michael Maloney says hospitals "that are No. 1 and No. 2 in their markets" and are in a position to withstand the crisis could acquire smaller hospitals and expand. However, executives should carefully vet growth opportunities to ensure they will not hamper their hospitals' financial position. ‐ From "Take a Deep Breath and Brace Yourself" ‐ Hospitals & Health Networks (01/09) Vol. 83, No. 1, P. 22; Bush, Haydn

EHR Security and Privacy Implementing an electronic health record (EHR) system without adequate consideration for security can cause hospitals and physician practices to lose community support and patients' trust. Insufficient controls can lead to a data breach, which would lead to violations of the Health Insurance Portabil‐ ity and Accountability Act. The act spells out administrative controls, such as security training and contingency planning; technical safeguards, such as access controls and personnel authentication; and physical controls, such as perimeter and device access. The security program must be directed with strong support from senior executives. If an outside vendor provides the security service, it is imperative to audit that firm's security credentials ahead of time to reasonably mitigate immediate risks. The healthcare facility should create a computer incident response team to investigate and respond to security incidents and form new policies following those breaches. Finally, an in‐depth security awareness training program with executive‐level sup‐ port can prepare workers to head off and avoid security threats from the outset. ‐ From "EHR Security and Privacy" ‐ SC Magazine (01/09) Hamilton, Keith

Complete Cost Control As the continuing economic crisis drives up the price of healthcare construction projects, executives are looking for ways to economize projects. One step executives should consider is effectively arranging project financing and taking into account the effect of lending practices and supplier agree‐ ments. Additionally, hospitals should consider using virtual technology to construct the building ahead of time to account for costs and scheduling, which can help coordinate efficiencies. Budgeting for potential cost fluctuations 12 months to 18 months ahead of time can improve efficiency, and executives would be wise to order materials earlier and stockpile them rather than order them too late and face project delays. Lastly, technology solutions, like building information modeling, can help executives and others realize greater cost and construction efficiencies and foster good commu‐ nication and teamwork. ‐ From "Complete Cost Control" ‐ Health Facilities Management (01/09) Vol. 22, No. 1, P. 29; Slomsky, Dave Advanced Medical Simulation and Team Training Center Tulane University recently opened the Tulane Center for Advanced Medical Simulation and Team Training. The $3 million, 14,000‐square‐foot facility was designed to improve patient safety and prevent medical errors by training healthcare professionals. The environment inside the building with its fully equipped emergency room, ICU, operating room, patient rooms and a nurses station is realistic. Healthcare professionals can use the facilities for training exercises, treating life‐sized robotic patients that can mimic symptoms and react to treatment. The simulations also feature standardized pa‐ tients that are trained to act as though they have a real disorder. The Tulane Center focuses on inter‐professional team training, also known as Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS). TeamSTEPPS was developed by the U.S. Department of Defense in collaboration with the Agency for Healthcare Research and Quality and is expected to teach healthcare professionals how to work together in response to different emergencies. Students will take part in every aspect of a patient's simulated case from initial diagnosis to a life‐saving operation. The facil‐ ity also is equipped with a surveillance system of 42 cameras and a number of microphones to record the simulations so participants can analyze their performance and learn from their mistakes. ‐ From "Tulane University Opens Advanced Medical Simulation and Team Training Center" ‐ Science Centric (01/26/2009)

Using Stakeholder Feedback to Set Strategy and Manage Risk Hospital boards must touch base with shareholders and stakeholders more frequently through surveys, interviews and assessments to determine whether the organization is meeting its goals and operating in line with its mission statement and values. These tools can help hospitals reposition themselves for risk and reward, according to advisory board consultant Tracy E. Houston. Boards must identify the risks that will have the highest im‐ pact on the organization and those exposures that require sophisticated solutions. Houston recommends boards use risk reduction models and strate‐ gic intelligence to determine what the risks and solutions are and then compare those results with stakeholder expectations and the organization's mission. Models should seek feedback from internal and external stakeholders regarding organizational culture, values and plans. Through careful analysis, board members can then determine where stakeholders and the organization are in sync and use additional data to proactively fill in gaps.

From "Using Stakeholder Feedback to Set Strategy and Manage Risk" ‐ Trustee (01/09) Vol. 62, No. 1, P. 15; Houston, Tracy E.; Orlikoff, James E.; Totten, Mary K.

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EXCERPT FROM THE NORTH TEXAS CHAPTER BYLAWS The ACHE of North Texas Board of Directors is chaired by the President and will consist of officers of the organization, eight to twelve members and designated ex‐officio members. The ex‐officio positions may be voting or non‐voting. In addition, any Regent of ACHE who is a member of the chapter and the Program Directors shall be ex‐officio, voting member of the Chapter Board.

The voting members of the Board of Directors must be Active members of the Chapter and have a current and active status in ACHE. Preference shall be given to those having Active Chapter membership for a mini‐ mum of two years. A regular term of a Board member is one year with a maximum of five consecutive years. Board Members must serve on at least one additional committee of ACHE of North Texas.

Nominees for membership on the Board of Directors shall be submitted to the Nominating Committee to the Board of Directors. Upon the rec‐ ommendation of the Nominating Committee, vacancies on the Board of Directors may be filled. Board members who are filling vacant positions shall be eligible to be nominated and elected to the immediately suc‐ ceeding full term. The Board of Directors and Officers are elected annu‐ ally at the last business meeting of the year. Elections consist of simple majority.

Anyone interested in submitting a nominee for consideration should do so by sending their resume and cover letter to the following weblink on the ACHE of North Texas Website under "Contact Us".

>> northtexas.ache.org

2008 Spring Issue: March / April / May Artwork / Materials Received Deadline: January 15, 2008 Issue Released: March 2008

2008 Summer Issue: June / July / August Artwork / Materials Received Deadline: April 15, 2008 Issue Released: June 2008

2008 Fall Issue: September / October / November Artwork / Materials Received Deadline: July 15, 2008 Issue Released: September 2008

2008 Winter Issue: December / January / February Artwork / Materials Received Deadline: October 15, 2008 Issue Released: December 2008

2009 Spring Issue: March / April / May Artwork / Materials Received Deadline: February 15, 2009 Issue Released: March 2009

2009 Summer Issue: June / July / August Artwork / Materials Received Deadline: April 15, 2009 Issue Released: June 2009

2009 Fall Issue: September / October / November Artwork / Materials Received Deadline: July 15, 2009 Issue Released: September 2009

2009 Winter Issue: December / January / February Artwork / Materials Received Deadline: October 15, 2009 Issue Released: December 2009

2008‐2009 Editorial Calendar

For advertising information or to reserve ad space, contact info@northtexas.ache.org

More information online at: northtexas.ache.org

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Joel Allison Honored With Hospital Association’s Highest Award Source: Baylor Health Care System Copyright 2008, InterestAlert

Profitability a Concern But Hospitals Expect Increased Utilization in 2009 A new report from the Noblis Center for Health Innovation has found that hospitals and health systems across the United States are cutting back on both capital spending and unprofitable healthcare services as a result of the economic crisis.

The study found that more than 56 percent of respondents saw a decrease in operating margin over the last quarter, and 39 percent expect a decrease in the next 12 months. Of even greater concern were investment losses, which were significant last year and remain uncertain for 2009. Virtually all respondents who recently attempted to access capital or refinance encountered difficulties in doing so, and two‐thirds had halted, resized, or changed major capital projects. As major construction projects wind down, philanthropic prospects for the coming year are also diminished.

While overall profitability is a concern, most respondents believe that utilization at their facilities will continue to grow. Seventy‐one percent of respondents expect inpatient utili‐ zation to increase slightly during the next 12 months, and 82 percent expect outpatient utilization to increase in the same time period.

Established in 1965, the Collier Award is the highest honor bestowed by Texas Hospital Association (THA). Allison received the award on January 22 at THA's annual Leadership Conference in Austin.

'Joel Allison exemplifies the leadership qualities that this award recognizes,' said Dan Stultz, M.D., FACP, FACHE, president/CEO of THA. 'He is an approach‐ able, hands‐on leader whose commitment to patient care is an example for all,' Stultz said. Allison has been on the front lines of change throughout his career, which included leadership in a turnaround situation, a faith‐based facility, a public sector facility and a children's hospital before joining Baylor in 1993. He spent seven years as senior executive vice president/CEO at Baylor before becoming president/CEO in 2000.

Each of his previous positions prepared Allison for the unique demands of leading a large and growing health system like Baylor. As CEO, he launched a system‐wide quality initiative, which includes a Qual‐ ity Institute, Office of Patient Centeredness and the new role of chief safety officer. The initiative is designed to influence every aspect of care at every Baylor facility.

'I am so honored to receive this award, especially since I was fortunate to know Mr. Collier,' said Allison.

Early in his career, Allison served as an administrative resident at Hendrick Medical Center in Abilene, where Earl Collier built his reputation as the dean of hospital administration in Texas. 'Although he had retired as CEO, he was still very much involved with the hospital, visiting patients and staff every day,' said Allison. 'Mr. Collier believed in making patients the center of all that you do, and that has influenced me throughout my career.' To those who work with him, Allison's commitment to quality is apparent. 'When you are around Joel, you know that quality and patients come first,' said Irving Prengler, M.D., vice president of medical staff affairs at Baylor University Medical Center. 'Whether you are with him one‐on‐one or in a crowd of thousands, you're always aware of what the Baylor vision is. When he tells you about our vision, it's not rote recitation, it's got energy and enthusiasm ‐ and it makes you believe you can attain that vision.'

Allison gives much of the credit for his success to his wife, Diane, who he married 40 years ago when they were both students at Baylor University.

They have a daughter, two sons and five grandchildren.

In addition to his active involvement with the Texas Hospital Association, Allison is a fellow of the American College of Healthcare Executives. Nationally, he serves on the Healthcare Leadership Council and the National Quality Forum, and he also is a member of the United Surgical Partners International board. In addition, he serves on numerous state and local boards, including VHA Texas, Texas Associa‐ tion of Voluntary Hospitals, Dallas Citizens Council, Dallas Education Foundation and the Dallas Re‐ gional Chamber. He is the recipient of numerous awards and consistently is ranked by Modern Health‐ care as one of the '100 Most Powerful People in Healthcare.

About the Texas Hospital Association Founded in 1930, the Texas Hospital Association is the leadership organization and principal advocate for the state's hospitals and health care systems. Based in Austin, THA enhances its members' abilities to improve accessibility, quality and cost‐effectiveness of health care for all Texans. One of the largest hospital associations in the country, THA represents more than 85 percent of the state's hospitals and health care systems, which employ some 340,000 health care professionals statewide. To learn more, visit www.texashospitalsonline.org.

About Baylor Health Care System Baylor Health Care System, a not‐for‐profit health care provider based in North Texas, is a growing network of hospitals, primary care and specialty care centers, rehabilitation clinics, senior health cen‐ ters and affiliated ambulatory surgery centers. An employer of more than 16,000 people, Baylor ranks as one of the largest private‐sector employers in the Dallas/Fort Worth Metroplex. Founded as a Christian ministry of healing, Baylor exists to serve all people through exemplary health care, educa‐ tion, research and community service. For fiscal year 2008, Baylor Health Care System will report $429.5 million in community benefits to the Department of State Health Services.

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Parkland VP Readies For New Challenges

By Parkland Health and Hospital System Media Department Brad Simmons has been named Senior Vice President of Surgical Services at Parkland Health & Hospital System.

The appointment became effective January 19.

He replaces Jason Farhlander who resigned in November to accept a position as chief operating officer at Memo‐ rial Health System in Colorado Springs.

Simmons comes to Parkland from the Methodist Health System in Dallas. He has held numerous administrative positions over the past six years and most recently served as Vice President of Operations at Methodist Charlton Medical Center. His operational responsibilities included surgical services, physical medicine, radiology, cardiology, pathology, respiratory therapy, community relations and the hospitalist program. In addition, Simmons designed surgical services performance improvement plans, authored organizational service line plans focused on competi‐ tive growth strategies and implemented hospital‐wide throughput initiatives.

"Brad is well known as a servant leader who is highly patient and staff focused," said John Haupert, executive vice president and chief operating officer of Parkland.

"His commitment to health care and the Dallas community will further Parkland's mission of achieving excel‐ lence in all that we do."

Simmons will oversee Parkland's surgical services division, which includes inpatient and outpatient surgical care, anesthesiology, the emergency de‐ partment, the North Texas Poison Control Center, BioTel Medical Control Agency, operative suite, day surgery, and physical medicine and rehabilita‐ tion.

Simmons received his Bachelor of Business Administration in Human Resources Management from Baylor University and his Master of Science in Healthcare Administration from Washington University School of Medicine in St. Louis. He is a Fellow in the American College of Healthcare Executives.

"Parkland's long‐standing mission of caring for the underserved is something I want to be a part of," said Simmons. "The organization excels beyond its mandate and sets the standards for other health care facilities. I'm excited to help shape Parkland's future.

Apply for Membership As an affiliate, you’ll join more than 30,000 healthcare leaders from across the country and around the world who are dedicated to improving healthcare delivery.

Choose the Membership Status that Best Suits You

APPLY FOR MEMBERSHIP TODAY!

Click on the links below to determine your eligibility or apply for membership. Note: Dues are prorated based on the month you join.

Member ‐ If you have a minimum of a bachelor's degree and a commitment to the profession of healthcare management, then you are in‐ vited to join ACHE as a member. There is no better resource to have at your fingertips than the premier organization for healthcare execu‐ tives. Annual dues are $150. If you prefer, you may be eligible for the following membership levels. Keep in mind that Faculty Associates, International Associates, and Student Associates are ineligible for Fellow status.

Faculty Associate ‐ If you maintain a full‐time position with an appointment in a graduate or undergraduate program in health services ad‐ ministration, you may be eligible for a discount on your dues. You will have access to cutting‐edge knowledge—knowledge that you can share with your students and colleagues—via ACHE's highly respected publications, ground‐breaking research, and online resources. Annual dues are $115.

International Associate ‐ If you live outside the U.S. and are not a member of the U.S. military, you may be eligible for a discount on your dues. Keep abreast of the latest trends in the healthcare field and acquire the tools you need to succeed. Annual dues are $150.

Student Associate ‐ If you are enrolled in a health services administration or related administrative program, you may be eligible for a dis‐ count on your dues. Find answers to your most pressing career questions—and gain a competitive edge—through ACHE's countless re‐ sources. Annual dues are $75.

Are you still unsure? Contact ACHE’s Customer Service Center at (312) 424‐9400 or contact@ache.org.

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Chapter Award winners will be recognized at ACHE's Congress on Healthcare Leadership on Tuesday, March 24, 2009 during both the MacEachern Luncheon and the Chapter Leaders Reception.

2009 Chapter Award Recipients Congratulations to the 2009 Chapter Award Recipients Forty‐three chapters earned an ACHE Chapter award for chapter performance by meeting or exceeding the chapter performance indicators associated with the Chapter Management and Awards Program (MAP) for performance in 2008.

2009 Award of Chapter Merit: Awarded to all fully chartered chapters that meet or exceed at least one of the three performance standards needed to qualify for the Award for Chapter Excellence.

• • • • • • • • • • • • • • • • •

ACHE ‐ NJ ACHE ‐ Nevada Chapter ACHE ‐ Southeast Louisiana Chapter ACHE of North Texas American College of Healthcare Executives ‐ Rhode Island Chapter American College of Healthcare Executives ‐ Wisconsin Chapter Arkansas Health Executives Forum Arizona Healthcare Executives California Association of Healthcare Leaders Central Texas Chapter ‐ ACHE Central Virginia Healthcare Executive Group Chicago Health Executives Forum Colorado Association of Healthcare Executives Eastern Pennsylvania Healthcare Executive Network Greater Charlotte Healthcare Executives Hawaii‐Pacific Chapter of ACHE Health Care Management Association of Central New York

• • • • • • • • • • • • • • • •

Healthcare Executive Forum, Inc. Healthcare Management Association of Massachusetts Mid‐South Health Care Executives Northern New England Association of Healthcare Executives Oregon Society of Healthcare Executives Puerto Rico Chapter of the American College of Healthcare Executives, Inc. Sandhills Healthcare Executives Forum South Carolina ACHE Chapter South Dakota Healthcare Executive Group Texas Midwest HealthCare Executives Triad Healthcare Executive Forum Triangle Healthcare Executives’ Forum Twin Tier Healthcare Executive Association Utah Healthcare Executives Washington State Healthcare Executives Forum West Virginia Chapter of the American College of Healthcare Executives

2009 Award of Chapter Distinction: Awarded to all fully chartered chapters that meet or exceed at least two of the three performance standards needed to qualify for the Award for Chapter Excellence.

• • • • • • • • •

ACHE ‐ SouthEast Texas Chapter Alaska Healthcare Executives Network Great Lakes Chapter of the American College of Healthcare Executives Healthcare Executives Forum of Middle Tennessee Midwest Healthcare Executives Group and Associates Network of Overseas Healthcare Executives San Diego Organization of Healthcare Leaders South Texas Chapter of the American College of Healthcare Executives South Florida Healthcare Executive Forum, Inc.

2009 Award for Chapter Excellence: Awarded to all fully chartered chapters that meet or exceed all three performance standards.

•

CT Association of Healthcare Executives

A Publication of the American College of Healthcare Executives of North Texas Chapter The Inside View Spring ‘09 Issue

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Career Positioning Proactively Managing Your Professional Development The panel will focus on the nuts and bolts of career planning. It will explore steps an individual should take within his or her organization and in the surrounding community to reach the next level in his or her career. The program will begin with brief opening remarks of approximately 10 minutes by the moderator, followed by 15‐minute presenta‐ tions by each of the three panelists. The program will conclude with a 30‐minute question‐and‐answer period.

February 19, 2009 | 7:00 AM | Parkland Health & Hospital System ‐ MacGregor Day Auditorium, 1st Floor | 5201 Harry Hines Blvd. | Dallas, TX 75235

Winjie Tang Miao ‐ President, Texas Health Harris Methodist Northwest Winjie currently serves as the President of Texas Health Harris Methodist Azle, TX, a community hospital serving the growing communi‐ ties in northwest Tarrant County.

Winjie began this role in September of 2007 and is excited to join the hospital in its efforts to provide a quality patient experience and expand services in order to address the needs of the changing communities in the area.

Prior to joining Harris Methodist Northwest, Winjie served as Administrative Director ‐ Oncology Services, Clinics, Planning & Construc‐ tion at Texas Health Presbyterian Hospital Dallas. During that time, Winjie lead the planning and construction process for projects totaling over $517 million, including the Acute Care Expansion. This $207 million expansion of the hospital campus included a new, seven‐floor, 180 bed tower, new diagnostic and treatment space, renovation of existing clinical areas and related infrastructure support projects.

In addition to facilities development activities on campus, Winjie also had operational oversight for the oncology program, as well as eight ambulatory clinics. Some of her most fulfilling work during her tenure at Presbyterian Hospital Dallas was the creation of efficient spaces that optimized hospital workflow which enhanced the patient experience and the development of an integrated breast health program.

Winjie received a Bachelors of Science degree in Biomedical Engineering from Johns Hopkins University in 1998 and went on to complete her Masters in Healthcare Administration in 2000 at the University of North Carolina at Chapel Hill.

Winjie is a member of ACHE and volunteers her time as a mentor through outreach programs and remaining active with her alumni associations. She has served on various community boards including the Dallas Chapter of the American Cancer Society, the Greater Dallas Asian American Chamber of Commerce, and the Museum of Nature and Science. She is a graduate of the Leadership Dallas Class of 2007.

Winjie and her husband, Darryl, reside in Fort Worth.

Kent Helwig, FACHE ‐ Assistant Vice President for Ambulatory Operations, The University of Texas Southwestern Medical Center at Dallas As assistant vice president for ambulatory operations at The University of Texas Southwestern Medical Center at Dallas, Kent Helwig is responsible for providing oversight, policy development and centralized planning for all ambulatory clinics in support of the faculty practice plan, as well as all support services impacting ambulatory operations.

Prior to joining UT Southwestern in 2008, Kent served in the Air Force for over 21 years, including roles as CEO, COO, and vice president at both the hospital and health system levels. He received his Bachelor’s degree in finance from the University of Illinois and a Master’s degree in health policy from the University of North Carolina at Chapel Hill.

Kent is board certified in healthcare management and a Fellow in the American College of Healthcare Executives. He has served as both a Governor and Regent with the American College of Healthcare Executives and presently serves on the editorial board of the ACHE’s Health Administration Press Management Series.

This program has been developed and is presented locally by the North Texas Chapter of ACHE. The American College of Healthcare Executives will award Category I (ACHE Education) credit hours to this program. To receive credit, your name MUST appear on the Sign‐In Sheet.

THE VALUE OF SPONSORSHIP ACHE of North Texas thanks the following Corporate Sponsors for assisting the organization’s mission. By sponsoring various events throughout the year, these sponsors are provided local and national exposure with an opportunity to showcase their organization, brand, career opportunities, products and services to the ACHE membership and its affiliates.

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Career Positioning Proactively Managing Your Professional Development (cont.)

Brenda Routt, Executive Vice President of Consulting Services ‐ Right Management Brenda Routt is an Executive Vice President of Consulting Services with Right Management.

[Coaching and Consulting Experience] Brenda has worked with organizations specializing in healthcare, retail, manufacturing, and restaurant/food production. She has made presentations to events such as the national convention of the Association of School Nurses and the state and national conventions of the American Society of Healthcare Human Resources Association. Skills in communication have led to Brenda’s accomplishments as a facilitator, coach, and planner. She partners with organizations to identify problems and desirable outcomes for various levels of em‐ ployees, from associates to presidents. Companies have tapped Brenda’s abilities when mapping out strategy, working through the im‐ pact of change, or assisting an individual to address gaps in communication.

Representative coaching engagements include: Coached executives to address communication skill gaps with critical stakeholders to improve multi‐ departmental relationships. Success was acknowledged by executive team, boss, and other departments in areas described as being more approach‐ able when having to report issues and more collaborative with other members of the leadership team; Collaborated with general manager/head of sales for manufacturing to adjust his style so that he could more effectively interface with strategic sales efforts. CEO, COO, and national VP of Sales cited his new ability to modulate his message, remove undesirable phrases, and eliminate annoying habits; Coached Medical Directors and Physician Specialists to achieve greater understanding of leadership competencies valued by the organization, honed and practiced skills to enhance success in communications with all stakeholders, and formulated effective relationship strategy. Outcomes included physician leaders were able to take a broader view of the organization, were seen as being more respectful of others’ roles and departments, and had become more articulate when pro‐ moting programs to varied constituents; Coached Department Head and Vice President to increase awareness of the negative impact of current com‐ munication methods on interactions and relations with departments and superiors. Changed behavior was described as less angry when dealing with contentious situations, people stopped avoiding interactions with the leaders, and a calmer, more professional presence was evident; Facilitated stra‐ tegic planning with CEO and management team to create a process for capturing vision, accountabilities, and metrics; Worked with Vice President of facilities, who managed millions of dollars for maintaining and constructing new facilities, to find a more acceptable way to balance relations with di‐ rect reports and upper executives with his personal values. Descriptors following coaching included written and verbal communication became more professional, less accusatory, and more focused on solutions; Created an assimilation strategy and coached individuals to prepare for situations includ‐ ing a promotion to an executive level role, assimilation from the outside into a new organization, and promotion into a leadership role. Outcomes included guiding coaching to create the first orientation curriculum with finance, identifying blockers in the management team, and helping define how to create a strategic department; and Coached Executive Vice President in developing alternative skills in dealing with highly charged situations and interfacing with board members in an extremely political environment. Change noted included a calmer demeanor, a consultative versus dictatorial style, and less stress.

[Business/Organizational Leadership Experience] Prior to joining the team at Right, Brenda served in various management roles in hospital administration, including Associate Executive Director and Director of Nursing. Her accomplishments relating to her previous role encompass managing operations for large teaching facilities, overseeing con‐ struction projects for building a new hospital, a bed tower and a new wing, creating an monitoring capital and operating budgets, serving as preceptor to undergraduate and graduate students, facilitating multi‐disciplinary teams for value management, and leading management teams.

[Education and Training] Brenda received her Bachelor of Science in Nursing from Texas Woman’s University and her Master of Science in Human Relations and Business from Amber University. She has served as adjunct faculty at The University of Texas at Arlington and on the board of the Dallas Fort Worth Healthcare Hu‐ man Resources Association.

John G. Self, Immediate Past‐President, ACHE of North Texas Chapter ‐ Chairman & Senior Client Advisor with JohnMarch Partners, Inc. John G. Self founded JohnMarch Partners in 1994. JohnMarch is a healthcare search consultancy with clients throughout the U.S. and United Arab Emirates. Clients recognize Mr. Self for his ability to consistently find top leaders who deliver lasting value.

JohnMarch Partners is recognized for its innovative search process which includes providing clients with video summaries of the candi‐ date interviews.

He is the Immediate Past‐President of ACHE of North Texas Chapter, one of the largest of the American College of Healthcare Executives.

He is a member of the Regent’s Advisory Council. He is a frequent lecturer on career brand management, leadership values and development. A former investigative reporter and crime writer, he is one of the only executive recruiters with this unique background and experience.

In 1976 Mr. Self joined Houston's Hermann Hospital. He led the implementation of Life Flight helicopter system. As a former national marketing man‐ ager with Rocky Mountain Helicopters, Mr. Self implemented another 14 helicopter ambulance programs. He also worked in acquisitions for LifeMark Hospitals.

As Senior Vice President of Business Development for Hermann Affiliated Hospitals, he helped build a network of more than 45 managed affiliated hospitals.

From 1990 to 1994, Mr. Self served as Special Projects Manager for ETMC Regional Healthcare System, a nine hospital system based in Tyler, TX. During his tenure, Mr. Self ran a successful home infusion pharmacy business, correctional health clinics, East Texas EMS, one of the state's largest private ambulance providers, and an international recruitment company that specialized in recruiting nurses, physical and occupational therapists from Can‐ ada, the Philippines, Australia and South Africa. His diverse experience across the spectrum of healthcare operations and marketing enables

Mr. Self to deliver to his clients a unique blend of value‐added insight.

A Publication of the American College of Healthcare Executives of North Texas Chapter The Inside View Spring ‘09 Issue

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2009 EVENT CALENDAR

>> February 2, 2009

>> March 23‐26, 2009

>> July 16, 2009

Breakfast with the CEO Series Featuring: Kenneth H. Cooper, M.D. (Founder & Chairman) Tedd Mitchell, M.D. (President & CEO) Cooper Aerobics Centers Time: 7:30 AM ‐ 9 AM Location: Cooper Clinic, Berkley Room 12200 Preston Road, Dallas, TX 75230 Special Note: Enter at the main gate (#1), then drive around on the north side of #7 which is the Cooper Guest Lodge and go east to #9 where we will have valet parking.

RSVP: info@northtexas.ache.org or 972.256.2291

ACHE Congress Online registration for ACHE's 2009 Congress on Healthcare Leadership is now available.

Register today to attend the premier educational event for healthcare executives that attracts more than 4,800 healthcare executives each year!

This year's Congress will be held at the Hilton Chicago & Palmer House Hilton, March 23‐26, 2009, and offers more than 100 high‐quality semi‐ nars, networking opportunities and career develop‐ ment programs to enhance your professional growth. The interactive registration form makes it easy to build your Congress schedule while avoid‐ ing time conflicts. You can also make changes and additions to your registration online at any time.

Category 1 Education Session Presenters: ACHE of N. TX and Dallas Local Program Council Co‐Champions: Jeff Patterson and Eric Boon Course Title: Managing Your Clinical Supply Chain Category 1 credits: 1.5 hours

>> February 5, 2009

Category 1 Education Session Presenters: ACHE of N. TX and Dallas Local Program Council Co‐Champions: Gail Maxwell and Lynn Pappas Course Title: Reinventing Customer Service in Healthcare: Lessons Learned from the Best Category 1 credits: 1.5 hours

ACHE Members are invited to attend The Health Industry Council Annual Luncheon at the Sheraton Arlington Hotel. ACHE members are being offered this opportunity to purchase tickets at The Health Industry Council Member rate of $110 per ticket. To register or for more information, log onto www.healthindustrycouncil.org.

>> February 19, 2009 Category 1 Education Session Presenters: ACHE of N. TX and Dallas Local Program Council Co‐Champions: Bryan Winkler and Trey Abshier Course Title: Career Positioning ‐ Proactively Managing Your Professional Development Description: The panel will focus on the nuts and bolts of career planning. It will explore steps an individual should take within his/her organization and in the sur‐ rounding community to reach the next level in his/ her career.

Time: 7:00 AM to 7:30 AM Registration (Coffee and Light Breakfast included) 7:30 AM ‐ 9:00 AM Session 1 Location: Parkland Health & Hospital System 5201 Harry Hines Blvd., Dallas, TX 75235 Cost: $10/Members and Students $25/Nonmembers Category 1 Credits: 1.5 hours For more information contact Bryan Winkler at 214.450.6312 or Gerri Wessling at info@northtexas.ache.org or 972.256.2291

>> March 13, 2009 ACHE Board Meeting Time: 7:30 AM Location: The Health Industry Council Conference Room 3001 Skyway Circle North, Ste. 100 Irving, TX 75038 For more information contact Gerri Wessling at info@northtexas.ache.org or 972.256.2291

>> March 19, 2009 Category 1 Education Session Presenters: ACHE of N. TX and Ft. Worth Local Program Council Co‐Champions: Greg Terrell and Greg Butler Course Title: Developing High Performance Teams Category 1 credits: 1.5 hours

>> April 16, 2009

>> May 8, 2009 ACHE Board Meeting Time: 7:30 AM Location: The Health Industry Council Conference Room 3001 Skyway Circle North, Ste. 100 Irving, TX 75038 For more information contact Gerri Wessling at info@northtexas.ache.org or 972.256.2291

>> May 22, 2009 Category 1 Education Session Presenters: ACHE of N. TX and the Onsite ACHE Speaker Co‐Champions: George Pearson, Scott Schmidly and Eric Evans Course Title: Integration vs. Competition: The Future of Hospi‐ tal/Physician Relations Category 1 credits: 6 hours

>> June 18, 2009 Category 1 Education Session Presenters: ACHE of N. TX and Ft. Worth Local Program Council Co‐Champions: Mark Vaughan and Rebecca Tucker Course Title: Green Hospitals and Healthcare Category 1 credits: 1.5 hours

>> July 10, 2009 ACHE Board Meeting Time: 7:30 AM Location: The Health Industry Council Conference Room 3001 Skyway Circle North, Ste. 100 Irving, TX 75038 For more information contact Gerri Wessling at info@northtexas.ache.org or 972.256.2291

>> August 21, 2009 Category 1 Education Session Presenters: ACHE of N. TX and Arlington/Irving Area Program Council Co‐Champions: Eric Evans and Kyllan Cody Course Title: Comprehensive Leadership for Senior Level Executives Category 1 credits: 6 hours

>> September 11, 2009 ACHE Board Meeting Time: 7:30 AM Location: The Health Industry Council Conference Room 3001 Skyway Circle North, Ste. 100 Irving, TX 75038 For more information contact Gerri Wessling at info@northtexas.ache.org or 972.256.2291

>> September 17, 2009 Category 1 Education Session Presenters: ACHE of N. TX and Ft. Worth Local Program Council Co‐Champions: Tina Barker, Jonni Johnson, and Cynthia Nguyen Course Title: Physician Integration Approaches Category 1 credits: 1.5 hours

>> October 15, 2009 Category 1 Education Session Presenters: ACHE of N. TX and Dallas Local Program Council Co‐Champions: Chakilla Robinson White and Mark Graban Course Title: Sustaining a Financially Vibrant Healthcare Organization Category 1 credits: 1.5 hours

>> November 13, 2009 ACHE Board Meeting Time: 7:30 AM Location: The Health Industry Council Conference Room 3001 Skyway Circle North, Ste. 100 Irving, TX 75038 For more information contact Gerri Wessling at info@northtexas.ache.org or 972.256.2291

>> November 19, 2009 Category 1 Education Session Presenters: ACHE of N. TX and Ft. Worth Local Program Council Co‐Champions: Aaron Miri and Tina Barker Course Title: Service Line Development Category 1 credits: 1.5 hours

A Publication of the American College of Healthcare Executives of North Texas Chapter The Inside View Spring ‘09 Issue

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Public Policy Governance Ethics Diversity Education Research Legislative >> developing healthcare leaders one person at a time.

Inside The American College of Healthcare Executives The American College of Healthcare Executives is an international professional society of more than 30,000 healthcare executives who lead hospitals, healthcare systems and other healthcare organizations.

ACHE is known for its prestigious credentialing and educational programs and its annual Congress on Healthcare Leadership, which draws more than 4,500 participants each year. ACHE's established network of more than 80 chapters provides access to networking, education and career development at the local level. In addition, ACHE is known for its magazine, Healthcare Executive, and its journals, the Journal of Healthcare Management and Frontiers of Health Services Management, as well as groundbreaking re‐ search and career development and public policy programs. ACHE's publishing division, Health Administra‐ tion Press, is one of the largest publishers of books and journals on all aspects of health services manage‐ ment in addition to textbooks for use in college and university courses. Through such efforts, ACHE works toward its goal of being the premier professional society for healthcare leaders by providing exceptional value to its members. Ache.org

ACHE of North Texas . 3001 Skyway Circle, Suite 100 . Irving, Texas 75038 . p: 972.256.2291 . f: 972.570.8037 . info@northtexas.ache.org . northtexas.ache.org

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