WPMG Impact 2020 by wpmg

Impact 2020 Courage. Compassion. COVID-19.

A Publication of Washington Permanente Medical Group

CEO letter

Table of contents

As one Permanente Medicine, this is our time

What, if anything, do all these events have in common? They underscore how – for WPMG and Permanente Medicine – this is truly our time. Back in 1945, our founders Sidney Garfield, MD and Henry J. Kaiser launched a physician-led medical care program partnered with a health plan. That concept was groundbreaking then, and it is the answer to health, health care, health equity, and wellness in our country now. United in our belief that medicine is a calling, we are connected as a community of practice that brings Permanente Medicine to life. Here at WPMG, our own community of practice contributes to – and benefits from – the greater PMG community of practice by sharing ideas and supporting one another. We may be 22,000 physicians working with 90,000 employees across eight medical groups, but we must always endeavor to be unified as one Permanente Medicine. Our community of practice, committed to health equity, inclusion by belonging and the diversity of our people will transform the health of our communities. Moreover, when fully aligned with our integrated, coordinated model of care, will see us through these extraordinary and challenging times. Even now, when we are physically more disconnected than ever before, our community is ever present and growing in strength. Please take every opportunity to continually build that connection by joining the nearly 1,000 clinician colleagues who spoke up in 2020. Whether you raise your concerns in an “Open Mic” session, speak out via Permanente Pulse, provide feedback (anonymous or otherwise) on Permanente “Voice” Box, or e-mail or comment on Talk to Paul, I want to hear what’s on your mind. As we work to achieve our growth, affordability, and experience goals in 2021, deployment of our digital assets, including virtual capabilities, will be the focus of our care delivery future. Our work in the months ahead is to pivot our focus from “virtual readiness” to digital deployment – making sure we’re confident we can consistently deliver a seamless, high-quality virtual care experience that exceeds our patients’ expectations.

Permanente Impact 2020 In an unparalleled year, we bring you this publication as a look back at the tremendous accomplishments we’ve made as an organization in service to our patients, our communities, and each other. Together, we’ve created a resounding impact as One Permanente. Be proud.

Letter from the CEO About us COVID-19 impact EID Impact Governance WPMG University Our people Our calling

TA B L E O F C O N T E N T S

s if we need reminding, 2020 was a year filled with a global pandemic, social unrest, divisive election-year politics, natural disasters, and economic downturn that flipped our health care industry on its head. But it was also when we celebrated Kaiser Permanente’s 75th anniversary and, just days later, our Bernard J. Tyson School of Medicine welcomed its inaugural class.

4-5 6-7 8-9 10 11 12 13

Letter from the CFO

Acceleration office

Local impact PMGs map

16-21 22-23

Getting to this point has taken nothing less than reinventing how we do business, and the work isn’t done. I am forever proud and grateful for what we have accomplished. We have the best team and there’s nothing we can’t accomplish together. All my best,

Paul Minardi, MD President and Executive Medical Director

About us

255

*Hired in 2020: 118 *Hired in 2020: 118

01 01

WPMG company composition (as of 11/16/2020) WPMG company composition (as of 11/16/2020)

About us Our unique community of practice is made of a wide array of professionals from many areas of expertise and

in optometry and radiology across the state, to new hires and clinicians who have been with us for more than 30 years, we are a community of caring, committed individuals.

Medical staff expertise Medical staff expertise

Generation (as defined by Pew Research Center):

7 25

0.1%

Administrative Staff

Administrative WPMG company composition (as of 11/16/2020) Staff

324

109

21.9%

Administrative Staff

828 Shareholder 828 medical staff

Shareholder medical staff

828

542

697

Associate medical staff

21.9%

457

Silent Generation

457 30.9%

Baby Boomers Gen X

Associate medical staff

Shareholder medical staff

324 30.9%

542 Associate 542 medical staff

02 02 02

05 05

Generation (as defined by Pew Research Center):

109 Administrative 109 Staff

697

Millennials

Silent Generation

259

Baby Boomers

7 25

Acute & post acute care* Specialty

259 561

Millennials

47.1%

469

*includes hospice, palliative care, NHS

Discipline Discipline

Specialt Mental health & wellness Primary Care

561

Primary

Research

469 49 *includes hospice, palliative care, NHS

Researc

Medical staff administration Medical

Discipline

CNM: 29 CNM:29 29 CNM:

East King: 234

PA-C: 238 238

PA-C:PA-C: 238

(Bellevue, Factoria, Redmond)

DO: 82

DO: 82 DO: 82

MD: 954

Staff locations

DPM: 2

MD: 954 MD: 954

Olympia: 119 (Olympia, West Olympia)

Peninsula: 88

DPM: 2 DPM: 2

(Poulsbo, Silverdale, Port Orchard, Gig harbor)

ARNP: 1

ARNP: 1 ARNP: 1PhD: 10 PSYD: 5

PhD: 10 PhD: 10

Tenure*

Renton: 114

OD: 49

OD: 49 OD: 49

PSYD: 5 PSYD: 5 30+

20-30

114

10-20 5-10 >1-5

619

331 255

(Admin Campus)

Region

Seattle: 422

(Northgate, Capitol Hill, South Lake Union, Ballard, Downtown, Rainier)

Snohomish: 96

(Everett, Smokey Point, Lynnwood, Northshore)

South King: 79

(Renton, Burien, Kent, Federal Way)

Spokane: 102

(Kendall Yards, Northpoint, Lidgerwood, Veradale, Riverfront, South Hill)

Tahoma: 225

(Tacoma, Steele Street, Puyallup)

*Hired in 2020: 118

Acute &

Mental h Gen X

47.1%

every working generation. From clinicians specializing

04 04

COVID-19 impact

Before the general public knew a pandemic would soon impact everything about the way they live and work, Kaiser Permanente Washington was setting up an incident command center to prepare for the oncoming battle. On Leap Day, February 29, 2020, when the second and third cases of COVID-19 were diagnosed, 4 command center leaders— Carolyn Barton VP, Compliance and Regional Compliance Officer; Paul Thottingal, MD; Barbara Detering, MD; Alicia Eng, Vice President, Clinical Operations, Western WA–along with a crossdisciplinary team from across KPWA, began a 6-week, 12-hour-a-day sprint to make the rapid decisions required to meet each new development in the evolution of the COVID-19 pandemic.

KPWA rapidly responds to COVID-19 outbreak

Their mission: to coordinate the organization’s response to the daily developments of COVID-19. Every day, the team assessed the developments and with a balance of agility and decisiveness charted the course forward for the next 24 hours. An early win was standing up drive-through testing sites. The team pulled together all the elements in a single weekend to be the first region and first medical system to deliver drive-through testing. KP was also the first major medical system in the country to convert, nearly overnight, to a virtual medicine strategy. In addition to serving the needs of members and the community, the incident command center prioritized safety at work, achieving a workplace infection rate far below that of the general population. Though the expectation was to retire the command center at the end of November, the team will pivot as needed to continue coordinating a consistent response to the pandemic. The original team of five has grown to about 30 members and each district has set up a local incident command center to build continuity across the organization.

COVID-19 impact

Barbara Detering, MD directs new COVID-19 Division

Paul Thottingal, KPWA launches MD, guides national world’s first COVID COVID-19 response -19 vaccine study

In September, after more than seven months of running COVID-19 response efforts through the command center, Drs. Detering and Thottingal were named medical leaders of KPWA’s new COVID-19 Division.

After living in the eye of the COVID-19 storm in Washington, WPMG’s service line chief for Infectious Diseases, Paul Thottingal, MD, stepped up to guide Kaiser Permanente’s national COVID-19 response in August.

Dr. Detering, recipient of the lifetime achievement award, is lauded as a steady leader with vital experience and expertise in rapid care transformation.

“Embarking on this role has given me a broader perspective on the larger work going on to confront this once-in-a-lifetime pandemic,” Dr. Thottingal said. “I am proud and inspired to be partnering with so many dedicated colleagues to further Kaiser Permanente’s efforts in support of our patients across the country.”

The Division will continue to respond to the day-to-day COVID-19 issues but also have the ability to look ahead and be more planful as they integrate COVID-19 care into the practice of medicine throughout KPWA. “The challenge is going to be trying to be proactive and think ahead while effectively responding to the daily changes this pandemic brings,” Dr. Detering explains. COVID-19, like all viruses, will continue to change rapidly. Experts expect it to be a clear and present danger for at least another year. Looking forward, Dr. Detering says, “I believe my goal is that we all will be enjoying the holidays next year WITH our families and friends without risk of infection, and that our management of the pandemic helps our staff and patients further add to their trust of Kaiser Permanente.”

In his new role, he leads the COVID-19 Expert Group/Infectious Disease Inter-Regional Clinical Practice Group and serves as chief medical officer of KP’s COVID-19 National Incident Command Center. He continues to offer his expertise in infectious diseases to WPMG clinicians and patients here in Washington. Dr. Thottingal’s selection was a testimony to KPWA’s steadyhanded COVID-19 leadership. It was the most recent example of our leaders – such as David Grossman, MD, who in January assumed the role of national senior medical director for Community Health – being recognized at the national level for their capabilities.

Less than a month after the first verified cases of COVID-19 hit Washington, KPWA’s Health Research Institute (KPWHRI) in Seattle embarked on a collaboration to support the creation of the first of its kind COVID-19 vaccine. “We can feel confident that our continued work on the front lines through the pandemic will ultimately help save lives around the world,” said Senior Investigator Lisa Jackson, MD, of KPWHRI. The research, started on March 16, is working to ascertain the effectiveness and safety of a vaccine co-developed by biotechnology company Moderna, Inc., of Cambridge, Mass., and the National Institutes of Health (NIH). It is 1 of 8 vaccines currently in development. “Our research team is thrilled with the results from this positive interim analysis and tremendously grateful to the thousands of study volunteers,” said Dr. Jackson. As we monitor the ongoing COVID-19 vaccine trials, WPMG is working toward our ultimate goal: a safe and effective COVID-19 vaccine that is available and deployed to staff, members, and community via an equitable, riskstratified plan.

EID impact

Equity, inclusion, and diversity While inequities existed long before COVID-19, disparities in health and health care revealed during the pandemic have contributed to a sense of urgency to ensure accessible, culturally respectful care across diverse populations. WPMG’s Equity, Inclusion, and Diversity Council, led by Kristin Conn, MD, Sr. Medical Director, EID, made solid progress toward goals this year so that KP members and communities can experience optimal health. With representation from the medical group and health plan, the Council is crafting work streams that promise to move us more quickly toward culturally respectful care. Priorities include: •

•

Benchmarking and influencing outcomes among Latinx patients with diabetes, starting with better understanding an equitable care experience from the patient’s perspective. A new language qualification program that will

•

Kaiser Permanente Bernard J. Tyson School of Medicine: Committed to making a difference

help identify clinicians who speak a second language so that we can provide care to patients in their preferred language. Better understanding the stratified data to reveal disparities by race, ethnicity, language, and other factors beyond the current metrics we measure. These data filters are being embedded in dashboards across care delivery. Several leaders are surfacing this work at team meetings, talking about roles and functions to improve equitable outcomes, working to develop new care model metrics, and better understanding community health data.

Each of the Council’s 40 members – operational leaders, research institute staff, members of regionwide equity teams, and representation from Business Resource Groups – have personally made equity commitments to further and improve the work over the coming months. Kristin Conn, MD, Sr. Medical Director, EID

Health Equity and Action Team

Community health: reaching those most vulnerable

HEAT, the Health Equity and Action Team, dedicated to fostering education and deepening understanding of the social factors of health, hosted a number of vital discussions throughout 2020. KPWA staff and clinicians as well as external community members gathered to learn more about important topics such as: structural racism; equity in virtual medicine; the impact of COVID-19 on the economy, race and equity; voting, health, and democracy; and the intersectionality of climate change and racial injustice.

Since the beginning of the COVID-19 pandemic, KPWA supported some of our most vulnerable patients by delivering meals, providing exercise equipment, and sending hand-written notes (read more about our contributions here). In early 2021, screening for those social health needs – food, housing, and financial security – will be the center of a new program dedicated to whole patient health.

Charles Mayer, MD, HEAT lead over the past 5 years, grew the membership from about 200 to over 700 during his tenure. “One thing we’ve learned is our members are passionate about health equity and justice,” he said. In January 2021, Dr. Mayer will pass the leadership baton to Raj Sundar, MD. Currently on the HEAT Steering Committee and a team lead at the Burien clinic, Dr. Sundar is committed to creating a more equitable and compassionate organization to heal our communities.

Cindy Burdick, MD, Medical Director for Medicare and Medicaid, is partnering with colleagues in Community Health, Quality, and Medicaid, to stand up a new program to screen every patient for social health needs in addition to the current mental and physical health screenings. The research-informed program was created in collaboration with Kaiser Foundation Health Plan of Washington, the Kaiser Foundation Health Research Institute’s Learning Health System, and KP’s Care Management Institute. David Grossman, MD, MPH, Sr. Medical Director, Community Health and External Relations, and National Sr. Medical Director, Community Health, says that while adding the screening seems easy,

In a year where social justice took center stage, the Kaiser Permanente Bernard J. Tyson School of Medicine is ahead of the curve with a foundational commitment to health equity and eliminating disparities. The school’s design and curriculum are informed by its mission: to create and develop wellrounded clinicians whose approach to health care includes a community and service mindset. The first cohort of 50 students began their medical school journeys in July and are performing better than expected given working within the parameters of a pandemic. Several of our own WPMG clinicians—including Sumam Abraham, MD, and Cicely White, MD—are contributing their expertise and passion to helping educate future Sumam Abraham, MD doctors at the school. In 2016, Dr. Abraham began helping to develop the new KP SOM from the ground up. She currently serves as clinical science faculty at the new school and continues to support academic mentorship and curriculum. (Read a profile of her work here.)

there’s a lot of behind-the-scenes work to ensure our clinicians know how to screen and what to do with the results – from connecting members to helpful Community Resource Specialists to referring them to Thrive Local program support. KPWA will be the first to launch the program among KP regions, and it’s expected this new screening will become standard across the KP enterprise, with other regions learning from our experience. By screening every patient for social health needs, KPWA clinicians will have a broader scope of resources to support some of the most vulnerable communities we serve.

Dr. White is an admissions interviewer, serves on the school’s clinical science faculty, and was involved early in the school’s design and curriculum—including developing real case studies. (Learn more about why she teaches here). Together with their colleagues, Dr. Abraham and Dr. White are shaking Cicely White, MD up the traditional medical school paradigm, recruiting students from all walks of life, and advancing the diversity of the medical profession.

WPMG University

Governance

WPMG University

Message from the WPMG board Your WPMG board has incredible gratitude for all you accomplished in 2020. It’s a year for the history books, to be sure. While managing significant changes in our personal and professional lives, distancing ourselves from each other, our patients, and our loved ones, we have nonetheless demonstrated unparalleled courage and determination. Our board’s work this year has centered on the following major areas: Supporting a successful first year for our new executives CEO Dr. Paul Minardi, CFO Cindi Johnson, and VP of HR Dalph Watson all hit the ground running, adding their leadership and deep expertise to our group. They worked tirelessly to understand your work and respond to what you need, while maintaining a strategic long-term focus. Overseeing risk The rapid changes of this year put our people, quality, strategy, and finance all at higher risk. The board took time to understand these risks and to ensure robust mitigation plans are in place. No furloughs and no layoffs have occurred, our membership is stable, our workplaces have remained safe, and communication has been substantial.

We are well-positioned for the demands and opportunities of the future.

“

I’m honored and humbled to serve as your board chair, and to lead this extraordinary team. The operational expertise within this group is considerable, and together, we’ll work to ensure the continued success of our medical group.

“

Hello colleagues,

Mike Maxin, MD Board Chair, eff. Oct. 2020

Becoming an antiracist organization Though equity has been a board and organizational focus for some time, the shocking murder of George Floyd and the revolutionary activism that followed prompted us to intensify our work. The result is our antiracism commitments and plans—formulated with your input, insights, and experiences. We view this as a running start to a critically important journey: striving to eliminate injustice due to racism. As a board, we embrace the opportunity inherent in change. And with that, it’s a great honor for me to introduce Michael Maxin, MD, Interventional Radiology, as your new WPMG Board of Directors chair effective Oct. 2020. Dr. Maxin has over 8 years of board experience and is a kind, capable, and highly qualified leader, fully endorsed by the entire board for this role.

This fall, your Practice & Leadership Development team launched WPMG University—a new way of looking at lifelong learning at WPMG. With straightforward learning pathways, direct links to register for courses, and access to additional resources across Kaiser Permanente, we hope this new approach makes personal and professional development something you plan for and look forward to, bringing you more joy in work. Starting with their first day as an Associate, clinicians follow the Clinician Pathway throughout their WPMG careers. Emerging and current clinical leaders take the Leader Pathway, and Board and Committee members take the Governance Pathway. Sign up today! Find all classes offered for all three pathways in the combined Full Class Schedule.

Personally, I appreciate beyond measure the privilege of serving you, my outstanding colleagues, in this role these last three years. Sincerely,

Sarah Philp, MD, Chair (Outgoing) On behalf of your Board of Directors

Watch: The Board’s Antiracist Commitments

Our calling

Our people

The Permanente Pulse Every week the Permanente Pulse, an electronic digest, is delivered straight to your inbox with a selection of stories about WPMG that feature our business, our goals, and our diversity. No matter where you come from or how you appear—we’re glad to include you in our community of practice. Enjoy this selection of The Pulse stories commemorating a handful of our colleagues and their unique lives, professions, and passions.

Remembering the many contributions of allergist Al Krause, MD.

Midwifery veteran Jana Swett, CNM, delivers more than 28 years of care.

Angela Sparks, MD, heads up opioid and safety policy.

Mary Wierusz, MD, takes the clinical lead for WPMG’s health and wellness program.

Alejandro Gonzales, MD, on his new role as Chief of Bellevue Urgent Care.

Physician Assistant Chau Pham on the pride of PA Week.

Acute/Post-Acute Heroes We want to recognize our acute and postacute care clinicians and their outstanding work to manage our patients through all phases of the pandemic—including Urgent Care, Hospitalists, Nursing Homes Services, and Hospice/ Palliative Care. As much of our care has transitioned to virtual options, these colleagues have continued face-to-face care amidst concerns for their personal safety and rapidly evolving protocols from both within KP and at our partner facilities. Your vigilance for our patients’ safety, infection prevention, and continuity of care is commendable. You’re not just a welcome presence, you’re a critical link back to our integrated system when our patients are at their most vulnerable. And when you walk the halls in a partner facility, you’re a critical link to our integrated system. Moreover, thank you to our primary care and specialty colleagues who volunteered for hospital surge planning. That we are approaching this crisis as a unified organization gives all of us great pride and serves as another example that all of us are all in.

Answering the call

Vocal point: Amid COVID-19 outbreak, a family doctor learns full meaning of a calling

More than 20 of our

Thu., April 2, 2020

WPMG community

Special to The Spokesman-Review

members volunteered in 2020 as media spokespeople. Your contributions delivered education, insight, and inspiration. We’re highlighting one such piece here as a clarion call for our army of advocates.

By Dr. David Ward Calling. I typed various words for my medical school acceptance letter. I altruistically meant them. After reflecting on the last few days, I now know I didn’t fully understand the meaning at that time. I still have so much to learn. I’ve been contemplating my mortality and the direct relationship with this “calling.” I know that the coronavirus is considerably more dangerous for those with chronic disease and as one ages. I also know emergency department, hospital and first responder teams are on the absolute front lines. I hear that health care workers are 3 to 5 times more likely to contract the disease and 20% of U.S. intensive care unit admissions are people ages 20 to 50. Should I stay home? Absolutely not. I ride at dawn. Calling. I contacted a wise physician friend and heard the following: “How could a health care clinician look a grocery store clerk, gas station employee or a pharmacist in the eye if the professional wasn’t willing to help themselves?” This is the moment. A crisis that hasn’t happened for generations. Our Super Bowl. Our calling. We put on our personal protective equipment. We wash our hands. We go virtual as much as possible. However, we will always be here in person to help our patients when they need us. It’s our calling. We work to heal. Rich, poor, sick, guilty, innocent, worried, send them to us. What would I do if I was 65 years of

age? I can’t be sure. I haven’t leveled up there. But at this moment, in my mind, I’m resolute that this is my calling. Put me in and let me help as long as I can. There are so many professions that take incredible risks far beyond what I experience. Thank you to each of them. Iron workers, soldiers, first responders, janitors, so much more. We don’t thank you enough. There are many who are sacrificing way more than me. I’m so fortunate I have a job. An amazing job. My calling. The risks to me are “low.” Many people in our country have considerably higher obstacles. I’ll stay at work to do what I can to help. I’ll stay at work so, please, if you can, stay at home. Stay at home but get connected with each other. Look for the good. Build one another up. Help each other. How can you contribute to the cause against this global pandemic? How do we come out of this a better people? As a world we fight one common enemy. As a physician I’m all in. CALLING! Dr. David Ward is a family doctor at Kaiser Permanente Kendall Yards Medical Office and is the acting director of operations in Spokane for the Washington Permanente Medical Group. He and his family live in Spokane.

Acceleration office

Letter from the CFO

Establishing stability in tough times My first year with WPMG makes me incredibly proud to be a part of your medical group. Together, we managed the fastest, most dramatic operational changes we’ve ever seen and your hard work leapfrogged us ahead in our capabilities. Bold clinical and operational leadership, built on a solid business foundation, delivered stability in 2020. We reacted quickly to the pandemic from both a clinical and business perspective which delivered strong financial results. Unlike some health systems that are scaling back to manage costs, we met our budgets without job losses or reductions in schedules. Throughout the year, our new Acceleration Office helped us rigorously track regional operating initiatives. By closely managing to our strategic plan, we gained high visibility on our risks and clarity about opportunities for departments to coordinate more tightly. In March, we stood up a Business Command Center (parallel to the COVID-19 Incident Command Center) and brought together the best thinking from across the organization to develop a revised business plan. This helped us maintain performance throughout 2020 and allowed WPMG to emerge as a stronger organization positioned for growth in 2021. Also in March, we increased our telehealth and virtual care from 25 percent to 75 percent of all care. Our rapid redesign of operations kept our patients and people safe with video visits, phone encounters, online care chats, or e-visits. We are continuing to refine our virtual presence and balance of visit types as we align our service delivery strategy to best support our patients’ clinical needs. We wrestled with our operational complexity and tapped the wisdom of our front line to redesign work in smarter ways. This included refining roles and processes in our teams so that clinicians can better manage incoming

demand with optimal support. Though we still have much to accomplish in practice optimization, we’ve made significant strides in foundational areas including visit preparation; launch of a full-blown information management initiative to address in-box management; and a phased roll-out of eCheck-in across primary and specialty care. The challenges will continue in 2021, with increasing pressure on financial performance, COVID-19 management and vaccine distribution, and intensely competitive hiring for critical front-line roles. We will focus on maintaining and improving experience for every member, every time, and developing our capacity to internalize care. We need everyone all in to deliver on our goals and grow our membership in 2021. Most importantly, we will avidly support team and personal resilience, helping one another manage the stress of home and work lives that are radically different than they used to be. Let’s keep improving in how we recognize each other, and encourage one another to utilize the valuable help resources that are available. The events of 2020 accelerated our competitiveness and positioned us to lead into the future. I know it has been a challenging year for all of us, both personally and professionally. Thank you for your steadfast leadership and your dedication to our patients. Be well,

Cindi Johnson CFO, VP of Strategy, interim COO

Acceleration office speeds up efficiency Every Tuesday morning the newly formed Acceleration Office convenes a cross-functional group of leaders to assess the current status of the many initiatives in KPWA’s strategic plan. Whether meeting in the recently completed Acceleration Office or virtually, their job is always the same: review all initiatives that are faltering and work with great focus as a team to get the projects back on track. Because they have the right decision-makers present, they can quickly identify both issues and solutions. “As soon as we see something, we take care of it,” says Acceleration Office Medical Director David Rankey, MD. The team utilizes an approach based on “Lean” management principles: continuous improvement created by small, incremental process changes that systematically support long-term change to increase efficiency and quality. Their attention to detail is paying off: they’ve decreased costs by approximately $111 million this year. Those savings came from a very specific process that starts with a value-based single-intake system for all regional strategy. This requires an executive sponsor to sign off on the proposed idea, finance sizes the work, while other departments such as compliance, legal, marketing, and analytics conduct an early review. Next, Christy Lindsey and Dr. Rankey review to make sure all necessary documents are complete.

Then a team of four executives review the business case and provide feedback before a final iteration goes to Paul Minardi, MD and Susan Mullaney for their approval. Finally, the work can begin. Currently, the team is preparing for the 2021 work plan. All of the approved initiatives are dated and monitored with a weekly check in to make sure everything is on track. If more visibility is needed or priorities need to be recalibrated, projects are surfaced in the Tuesday morning meetings to achieve alignment on next steps. The weekly gatherings provide a forum for executing on long-term strategy across the region. From immediate accountability to real-time tracking, to the high-level dialogue about what’s working and what needs to be modified, the Acceleration Office is where it all happens. Our newly designed Acceleration Office virtual room includes big screen designated “process wall,” an executive dashboard on a second wall, and inspirational quotes as décor. The Acceleration Office was custom-designed to be the central hub for executing on high-level strategy. All the tech supports true accountability, speaking up, and working through challenges in real time. The result is a more transparent, courageous culture. Another result? An impressive goal of $380 million in cost savings for 2021.

Local impact

Local impact Nadezhda Kholodnaya, MD, Oncology, Steele Street Jaideep Kochhar, PA-C, Emergency Medicine, Tacoma Amanda Lee, MD, Hospitalist, St. Joseph’s Elizabeth Neuhalfen, MD, Family Medicine, Puyallup Kathy Thu Quynh Nguyen, OD, Optometry, Tacoma Brenda Niu, MD, OB/GYN, Tacoma Leilani Rosa, PA-C, Family Medicine, Steele Street Stephen Schoeff, MD, Otolaryngology, Tacoma Namrata Sethi, MD, Oncology, Tacoma/Silverdale Kenneth Sheil, PA-C, Emergency Medicine, Puyallup Greg Sidell, MD, Mental Health & Wellness, Tacoma Faisal Siddiqui, MD, Family Medicine, Puyallup Eric Smith, DO, Occupational Medicine, Tacoma/Port Orchard Shanthi Srinivas, MD, Oncology, Tacoma/Olympia Ruby Stocking, CNM, Midwifery, Tacoma Winston Tavee, MD, Emergency Medicine, Tacoma Weigang Tong, MD, Oncology, Tacoma Swapna Vaidya, MD, Mental Health & Wellness, Tacoma Derek Yu, MD, Neurology, Tacoma Louise Zhou, MD, Oncology, Tacoma/Olympia

Tahoma retirees

Local impact Across the state of Washington, our people have demonstrated courage and compassion throughout an incredibly challenging year. Here we celebrate their accomplishments and recognize their standout stars.

Tahoma One of our first priorities during the COVID-19 outbreak was protecting our most vulnerable members. We moved our Oncology & Infusion clinic overnight from alongside Urgent Care to a safer location on the second floor. Kudos to Chris Nephew in PT and Iffa Hughes in Oncology, our CBRE colleagues, and everyone who acted so quickly. Also part of our COVID response, Allergy, Pulmonary and OSAS, and Rheumatology all moved within TAC. Wound care relocated from TAS to TAC and is now seeing great payoffs with better coordinated care as they collaborate closely with General Surgery, Ortho, and our new Plastic Surgery service. Occupational Medicine moved from TAS to TAC to be co-located with Urgent Care. Neurology moved their TAC services to join their TAS colleagues. Primary care did amazing work in access, service, quality and MCR while responding to the pandemic and despite being significantly understaffed this year. We are so grateful for our wonderful Tahoma teams who answered the call of duty in remarkable ways this year.

Tahoma new hires Melissa Chin, MD, Hospitalist, St. Joseph’s Lorraine Coli, MD, Pulmonary Medicine, Tacoma Alexander Divin, MD, Hospitalist, St. Joseph’s Bryan Eberle, MD, Hospitalist, St. Joseph’s Brian Hagan, MD, Hospitalist, St. Joseph’s Emily Henderson, MD, Endocrinology, Steele Street Samah Hussain, MD, Family Medicine, Puyallup Jennifer Jenkins, PhD, Mental Health & Wellness, Tacoma Mall Courtney Kassow, PA-C, General Surgery, Tacoma

Terrence Clark, OD, Optometry, Steele Street Alex Moreano, MD, Otolaryngology, Tacoma Raymond Parker, MD, Mental Health & Wellness, Tacoma Jill Rosenthal, MD, Dermatology, Tacoma

Tahoma award winners 2020 Katie Thilo, MD, GIM, Tacoma David Dempster, MD, Nephrology, Tacoma

The spirit of teamwork in our community of practice is exemplified by the way providers from across the Olympia district volunteered to see patients in person at a time when little was known about COVID-19. They took on safety risks themselves so their colleagues with children or health concerns did not have to. We see similar examples of teamwork here every day. The Olympia community is lucky to be served by such an amazing medical group.

Olympia new hires Mary Adcock, MD, OB/GYN, Olympia Jessica Bursey, PA-C, Family Medicine, West Olympia Brian Fox, DO, Emergency Medicine, Olympia Steen Goddik, MD, Mental Health & Wellness, Olympia Molly Kern, MD, OB/GYN, Olympia Kara Kime, PA-C, Family Medicine, West Olympia Kevin LaFave, PA-C, Emergency Medicine, Olympia Michael Larson, MD, Emergency Medicine, Olympia Yung Lee, MD, Emergency Medicine, Olympia Ryan Louie, MD, Mental Health & Wellness, Olympia Naomi Nardi, DO, Emergency Medicine, Olympia Craig Nattkempter, DO, Emergency Medicine, Olympia Maria O’Rourke, MD, Emergency Medicine, Olympia Thomas Varghese, MD, Hospitalist, St. Peter’s

Olympia retirees

Elizabeth Alberti, PA-C, Family Medicine, Olympia George Brennan, MD, General Surgery, Olympia Kim Hoover, OD, Optometry, Olympia Kathleen Jones, CNM, OB/GYN, Olympia Richard Meltzer, MD, General Surgery, Olympia

Olympia award winners 2020 Frederick Chancellor, MD, Family Medicine, Olympia Julia Anuras, MD, Nephrology, Olympia

Katie Thilo, MD

David Dempster, MD

Olympia We began the year by ramping up the West Olympia Medical Center, which opened the last week of December 2019. From day one, West Olympia excelled at patient experience and MCR completion rates. The team frequently finds innovative ways to handle challenges efficiently. In early spring, the Olympia Medical Center staff rallied around the rapidly changing COVID-19 challenges. They developed and initiated new processes overnight. The teams quickly and continually adjusted to on-going and evolving external pressures from the pandemic.

Frederick Chancellor, MD

Julia Anuras, MD

Seattle As we confronted a highly changeable COVID-19 situation, our teams continually pulled together to keep our people and patients safe. We adopted rapidly changing policies and

Local impact

procedures, deployed drive-up COVID-19 testing, launched an upper respiratory infection (URI) clinic, and found creative ways to maintain safe social distance in a variety of clinical settings. The Family Medicine Residency led our community service through the YouthCare’s Orion Center, Mary’s Place Seattle, and Mary’s Place permanent shelter in Burien.

Barbara Schinzinger, MD, Family Medicine, Capitol Hill Uma Shenoy, MD, Pathology, Capitol Hill Paula Togawa, PA-C, Family Medicine, Capitol Hill Isaac Varon, OD, Optometry, Downtown

Elizabeth Ho, MD, Internal Medicine, Kendall Yards Bilal Ittiq, MD, ASEM, Riverfront

Seattle award winners 2020

Mary Badger, MD, Internal Medicine, Northpointe Harold Bailey, MD, Family Medicine, South Hill Walter Balek, MD, Family Medicine, Liberty Lake Janice Graham, MD, Family Medicine, Lidgerwood Alan Maddox, MD, Family Medicine, Lidgerwood Robert Riggs, MD, Family Medicine, Riverfront Timothy Ritchey, MD, Family Medicine, Veradale

Kristin Conn, MD, Family Medicine, Capitol Hill Susan Masonis, MD, Hospitalist, Swedish First Hill

The Residency also revamped our application process to seek greater inclusion and diversity. As a result, under-represented minorities on our rank-list has risen from 29% to 55% in the past 3 years. We’ve accomplished this by seeking out applicants that match our values such as service commitment, initiative, leadership, and resiliency.

Spokane retirees

Spokane award winners 2020 Cicely White, MD, Pediatrics, Veradale

Melyssa Galloway, MD, Hospitalist, Overlake Jennifer Gibert, MD, Endocrinology, Bellevue/Everett Mohamad Haque, MD, Bariatric Surgery, Bellevue Bryan Heidrich, MD, Emergency Medicine, Bellevue Chris Henderson, MD, Dermatology, Bellevue/Renton Micah Mohler, PA-C, Orthopedics, Bellevue David Wegner, MD, Pulmonology, Bellevue Sierra Widmer-Rodriguez, PA-C, Bariatric Surgery, Bellevue Ling Zhou, MD, Otolaryngology, Bellevue

East King retirees Karen Mcconnell, CNM, Midwifery, Bellevue

East King award winners 2020 Ru-Chien Chi, MD, Hospitalist, Overlake Medical Center Scott Emery, MD, General Surgery, Bellevue

Seattle new hires Taneev Escamilla, MD, Family Medicine, Northgate Alexander Grigalunas, MD, Ophthalmology, Capitol Hill/Everett Ling Guo, MD, Gastroenterology, Capitol Hill Shannon Guo, OD, Optometry, Capitol Hill Olga Hewett, MD, Mental Health & Wellness, Capitol Hill Heather Hosmer, PA-C, Gastroenterology, Capitol Hill Judy Hsu, DO, Family Medicine, Northgate Eunice Ko, MD, Family Medicine, Capitol Hill Reena Koshy, MD, Family Medicine, Capitol Hill Erik Lind, PA-C, Family Medicine, Rainier Spencer Lunbeck, MD, Mental Health & Wellness, Northgate Kathleen Matthews, PA-C, Gastroenterology, Capitol Hill Anupama Nair, MD, Nephrology, Capitol Hill Erica Pascarelli, MD, Hospitalist, Capitol Hill/Swedish Lahari Rampur, MD, Allergy, Capitol Hill/Everett Sierra Read, MD, Emergency Medicine, Capitol Hill Jesse Reinking, DO, Mental Health & Wellness, Capitol Hill Michael Sandlin, MD, Orthopedics, Capitol Hill Lisa Schrafft, PA-C, General Surgery, Capitol Hill Benjamin Seo, MD, Emergency Medicine, Capitol Hill Aimee Shariat, MD, Hospitalist, Capitol Hill/Swedish Shelini Sooklal, MD, Gastroenterology, Capitol Hill Brian Tran, MD, Informatics/Hospitalist, Renton/Swedish Orion Wells, MD, Family Medicine, South Lake Union Sarah Whiteside, OD, Optometry, Capitol Hill Jonathan Yin, MD, Orthopedics, Capitol Hill Neda Zarghami Esfahani, MD, Neurology, Capitol Hill Irving Zavala, MD, Hospitalist, Capitol Hill/Swedish

Seattle retirees Katherine Brown, MD, Internal Medicine, Capitol Hill Deborah Brunner, MD, Family Medicine, Northgate Christopher Diehl, MD, Ophthalmology, Capitol Hill Michael Gorman, MD, Ophthalmology, Capitol Hill Steven Hokoda, OD, Optometry, Capitol Hill Jamshid Honari, MD, Nephrology, Capitol Hill Daniel Johnson, MD, Podiatry, Capitol Hill Charles Jung, MD, Orthopedics, Capitol Hill Patricia Kato, MD, Family Medicine, Northgate Philip Paros, OD, Optometry, Capitol Hill

Kristin Conn, MD

Susan Masonis, MD

Spokane The distance between eastern and western Washington narrowed this year as Spokane and our west-side partners created opportunities to share innovations and resources. We also launched several internalization initiatives to maximize the talent and resources within WPMG and in collaboration with our west-side service lines including cardiology, rheumatology, allergy, dermatology, and ortho. A number of new leaders stepped up to bring fresh perspectives this year including several new location chiefs. IN addition, David Ward is now DO and we’re happy to welcome Adam Sanborn as DMD. The Spokane District proudly led the region in composite quality measures and welcomed a record number of new hires from the across the country who were impressed by our leadership, teamwork, and response to the COVID-19 pandemic.

Spokane new hires Saima Ahmad, MD, Internal Medicine, Lidgerwood Margaret Kristin Clark, MD, Hospitalist, Sacred Heart Todd Corn, MD, Hospitalist, Sacred Heart Jennifer Eickstadt, PA-C, Family Medicine, Lidgerwood Kristian Enghusen, DO, Family Medicine, Riverfront Antonio Gonzales, MD, Family Medicine, Veradale

Cicely White, MD

East King In the earliest days of COVID-19, our teams took initiative and reached out to vulnerable Medicare members to ensure they were OK—a practice that is now commonplace at KPWA. To keep our patients and colleagues safe, we rapidly evolved our practices, deployed COVID-19 drive-up testing, and volunteered broadly for surge planning. In terms of new services, we added 3D mammography in Bellevue this year, and our Overlake patients now have a WPMG inpatient palliative care provider to meet their needs. To expand access to care we held a senior clinic in Redmond, with additional clinics planned for Factoria and Bellevue.

Ru-Chien Chi, MD

Scott Emery, MD

Peninsula With compassion and dedication, the Peninsula staff continues to go above-and-beyond to ensure the well-being of our members and each other. As we’ve adjusted to life in a pandemic, we’ve found creative ways to alleviate stress for colleagues and members such as incorporating music into virtual huddles, intermittent comedic music memes by Dr. Martin, well-earned gratitude and appreciation, and launching virtual lunch CME sessions so that we can connect. The teams have shown unity and provided a safe haven for patients during a tumultuous time.

East King new hires

Our teams also innovated to move critical pieces of work forward. They are currently working to renovate Silverdale Urgent Care so that it can provide 24/7 medical services beginning in January 2021. We are also in the process of expanding the Silverdale Ambulatory Surgery Center to offer our general surgery, orthopedics and ophthalmology services to Peninsula members.

Jackson Brammer, MD, Mental Health & Wellness, Factoria Cezanne Ezekiel, CNM, Midwifery, Bellevue Elise Fogel, CNM, Midwifery, Bellevue

Thank you, Peninsula teams, for all you have done and continue to do!

A shout out to Bellevue primary care for leading for “Right Now Care” by exceeding our quality target of 50%. Thank you for addressing the total health of our patients.

Local impact/administration

Local impact

Peninsula new hires Anne Blankenheim, PA-C, Emergency Medicine, Silverdale Wendy Cronk, PA-C, Family Medicine, Poulsbo David Dabell, MD, Emergency Medicine, Silverdale Ana Maria Lee Digao, MD, Hospitalist, Silverdale Keith Fairbanks, DO, Family Medicine, Silverdale Yolanda Garoutte, PA-C, Orthopedics, Silverdale Richard Min-Tuan Hoang, MD, Dermatology, Port Orchard Alexander Kallas, MD, Emergency Medicine, Silverdale Claire Kennedy, PA-C, Emergency Medicine, Silverdale Shannon Phibbs, MD, Family Medicine, Silverdale Meghann Sprague, MD, Mental Health & Wellness, Bremerton Emmett Weissman, PA-C, Emergency Medicine, Silverdale

Peninsula retirees Robert Butler, MD, Dermatology, Silverdale Steven Schneider, MD, Family Medicine, Silverdale

Peninsula award winners 2020 Jarred Zacker, PA-C, Family Medicine, Port Orchard

deployed a drive-up testing site in Burien and evolved our care model to support virtual options. We also welcomed a new chief at Burien and developed the leadership pipeline with interim chief assignments to cover staff leaves. We are proud members of our highly diverse South King community.

South King new hires Yumi Ando, MD, Gastroenterology, Federal Way Josiah Belzer, MD, Family Medicine, Kent Tyler Chisholm, MD, Family Medicine, Federal Way Paula Colon, MD, Pathology, Renton Lateef Harper, MD, Family Medicine, Federal Way Samra Khan, PA-C, Family Medicine, Kent Jamie Klippert Fajardo, DO, Family Medicine, Federal Way Marlin Lobaton, DO, Family Medicine, Renton Douglas Mailman, MD, Addiction Medicine, Federal Way Pitiporn Suwattee, MD, Dermatology, Federal Way Monika Wells, MD, Internal Medicine, Renton

South King retirees Philip Doughten, MD, Family Medicine, Burien

South King award winners 2020 Raj Sundar, MD, Family Medicine, Burien

We also stood up a district command center, launched COVID-19 drive-up testing, and managed changes in virtual care within a matter of weeks. A major strategic focus has been the internalization of care and we’ve seen great progress this year. After adding several specialists in cardiology, dermatology, and neurology—we are now able to offer internal capacity with our WPMG colleagues, which has led to a downward trend in external referrals and the further strengthening of our group.

Snohomish new hires Robin Atkins, PA-C, Family Medicine, Smokey Point Jeremy Chan, MD, Orthopedics, Everett Patricia Christiansen, PA-C, Family Medicine, Everett Kristin Colonna, OD, Optometry, Smokey Point Peter Edpao, MD, General Surgery, Everett Jack Eisaman, PA-C, Walk-In Clinic, Everett Elizabeth Fetzer, MD, OB/GYN, Everett Jeffrey Gallagher, PA-C, Family Medicine, Smokey Point Deirdre Gately, PA-C, Lynnwood Naseem Ghazanfari, MD, Cardiology, Everett Amy Nelson, MD, PC, Internal Medicine, Everett Elaine Peterson, DO, Pediatrics, Smoke Point Emily Prazak, MD, Family Medicine, Everett Rico Romano, MD, Internal Medicine, Smoke Point Miriam Smith, MD, Family Medicine, Lynnwood William Stanley, MD, Cardiology, Everett

Snohomish retirees Evangeline Erskine, MD, Family Medicine, Everett

Snohomish award winners 2020

Jarred Zacker, PA-C

Lenny Smith, PA-C, Family Medicine, Everett

South King With a 10% membership growth projected by 2024 for South King, we continue to invest in our future -- focusing on internalization and our care experience. This long-term strategy now includes plans to purchase land for a new multispecialty clinic.

Raj Sundar, MD

Snohomish

To better reach and serve our members this year, we launched a mobile mammography unit and established multiple site-of-practice specialty care locations to include GI, Derm, Neuro, and Nutrition.

Health care is challenging at any time, but when the country’s first COVID case lands in Snohomish County and you continually adjust your plans to meet your goals—it’s downright inspiring.

As COVID-19 has swept through our communities and clinics, we quickly navigated care delivery changes for patients and disseminated key information for staff. We

In a remarkable display of dedication and innovation, our teams successfully opened our new Smokey Point clinic in March while facing a rising global pandemic.

WPMG Administration Crisis planning is something all great organizations do, and because of our advance planning, WPMG Administration was able to quickly pivot when the pandemic landed at our doorstep. The critical business functions— Finance and Recruiting, among them—adopted a Temporary Remote Work policy and evolved how we worked to support our medical colleagues in caring for our patients. HR Business Partners, Business Operations Directors (BODs), and the Communications team helped clinical teams navigate daily changes to our delivery system and protocols. In addition our analyst group, contracting/provider relations, RMU, and strategy teams have been pivotal mapping our path to the future and creating new business processes to support that execution. Learning and development programs also required agility, with wellness workshops and professional development moving online— including the virtual launch of PLD’s WPMG University. The Benefits team introduced new benefits and an updated PA compensation model, our Recruiting team innovated to attract top talent through virtual outreach, and the EID team helped focus our passion for social justice. These are just a few examples of your dedication and excellence.

New hires Stacy Biermann, Sr. HR Business Partner Maritza Chott, Accountant Tracy Fennern,Director, Provider Relations Vanja Knezevic, Manager, Provider Relations, Shandi Lolagi, Admin Assistant Christopher Onwuka, Sr Data Sys Analyst Cynthia Perez, Analytics Developer Taryn Sato, Executive Assistant Cheryl Thach, Payroll CME Specialist Jennifer Van Ness, Consultant, HR Dalph Watson, Vice President of HR

Retirees Cathy Elwess, Human Resources Vikki Valdez, Analytics Lenny Smith, PA-C

Service areas of Kaiser Permanente

Washington

WPMG

Service areas of Kaiser Permanente and the Permanente Medical Groups, based on zip codes Oregon/S. Washington NWP Washington Washington Washington

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Oregon/S. Washington NWP Oregon/S. Washington NWP

Hawaii Hawaii

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Northern California TPMG Northern California TPMG

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Colorado Atrius Health allied member Northern California WPMG Atrius Health allied member Colorado CPMG

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Mid-Atlantic Atrius Health allied states member MAPMG CPMG Georgia

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Mid-Atlantic states MAPMG Mid-Atlantic states MAPMG Hawaii

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Hawaii Southern California

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Mid-Atlantic states MAPMG HPMG SCPMG Southern California SCPMG Northern California TPMG Washington WPMG Oregon/S. Washington NWP Oregon/S. Washington NWP Southern California SCPMG Southern California SCPMG Colorado CPMG Northern California Georgia TPMG TSPMG Washington WPMG Southern California SCPMG NWP Hawaii Mid-Atlantic states MAPMG HPMG Oregon/S. Washington Atrius Healthstates Hawaii Mid-Atlantic alliedMAPMG member HPMG Southern California SCPMG Mid-Atlantic states Oregon/S. Washington NWP MAPMG Mid-Atlantic states MAPMG Colorado CPMG Georgia TSPMG Colorado CPMG Hawaii Mid-Atlantic states Georgia HPMG MAPMG TSPMG

Colorado CPMG Georgia Colorado CPMG Georgia NorthernNorthern CaliforniaCalifornia TPMG TPMG Washington

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Atrius Health Atriusallied Health member allied member Atrius Health allied member

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COLORADO PERMANENTE MEDICAL GROUP, P.C. Margaret Ferguson, MD, MBA President and Executive Medical Director HAWAII PERMANENTE MEDICAL GROUP, INC. Geoffrey S. Sewell, MD, FACP1 President and Executive Medical Director MID-ATLANTIC PERMANENTE MEDICAL GROUP, P.C. Richard S. Isaacs, MD, FACS1 President and Chief Executive Officer NORTHWEST PERMANENTE, P.C. PHYSICIANS AND SURGEONS Imelda Dacones, MD1 President and Chief Executive Officer SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP Edward M. Ellison, MD1 Executive Medical Director and Chairman of the Board THE PERMANENTE MEDICAL GROUP, INC. Richard S. Isaacs, MD, FACS1 CEO and Executive Director THE SOUTHEAST PERMANENTE MEDICAL GROUP, INC. Mary L. Wilson, MD, MPH President and Executive Medical Director WASHINGTON PERMANENTE MEDICAL GROUP, P.C. Paul Minardi, MD President and Executive Medical Director THE PERMANENTE FEDERATION LLC Chris Grant Executive Vice President and Chief Operating Officer

1. Member of the National Permanente Executive Committee, The Permanente Federation LLC

A Publication of Washington Permanente Medical Group