Warm Springs Rehabilitation System

Administrative Residency Monthly Update Report

 

February 1-4

I began the first week of February in the auditing and compliance department, observing and assisting Alma Sander, Director of Internal Audit and Chief Compliance Officer.  Alma provided me with numerous opportunities to experience and gain a better understanding of auditing and compliance, and I thoroughly enjoyed my time spent working with her.  I first became better acquainted with the department by reading the charter for the Internal Audit Department as well as the policies and procedures for internal auditing.  Throughout the week, I was able to assist in editing new department forms and policies and procedures as well as assist in the development of the department’s audit plan, reviewing and planning according to the OIG requirements and helping to estimate the audits and hours that staff members will work over the next three years.  I also had the unique opportunity to sort and summarize information received from risk assessment questionnaires that had been recently sent to system directors and managers.  After compiling and organizing the various responses from the questionnaires, I provided Alma with a data summary that contained results from the risk assessment questions as well as summaries of comments, suggestions, and audit recommendations from the questionnaire participants.  It was fascinating to see the variety of responses on the questionnaires and the numerous requests and recommendations that were made by various individuals.

 

During the week I also had the opportunity to attend the community advisory board meeting at Warm Springs Specialty Hospital in Luling.  A particularly memorable moment during the meeting came before the meeting actually began, when a former patient came and gave her testimony regarding the care she received at Warm Springs.  The patient had been the victim of a motorcycle accident that actually put her in a comatose state for three weeks.  As a patient at the hospital in Luling, the woman was able to fully recover, and she was enthusiastic and heartfelt as she told of the extraordinary service she received and how she even had developed separation anxiety from the staff at Warm Springs.  I do not doubt that her remarkable experience and inspiring attitude made a significant impact on all who heard her story, and her commitment to praising the service and care she received at Warm Springs created a profound impression upon me of the importance and significance of the work done by Warm Springs and its dedicated staff.

 

February 7-11

After spending a week in the auditing and compliance department, I began the second week of February by observing and shadowing Sharon Kuhn, an external case manager from the San Antonio hospital.  During the day, we made referral visits to patients at the Healthsouth RIOSA hospital, the Methodist Ambulatory Surgery Hospital, and Methodist Children’s Hospital.  Sharon also provided me with a tour of the Methodist Hospital in the medical center, which provides the most referrals to SAWSRH, and I quickly discovered how large the hospital is and how extensive its operations are.

 

I also had the opportunity to attend numerous meetings during the week.  I enjoyed observing my first town hall meeting when I traveled with Rick Marek to the Floresville Clinic on Wednesday afternoon.  During the meeting, Mr. Marek discussed with the staff at the Floresville clinic various topics and important matters regarding the organization, including financial statistics, facility updates, outpatient clinic updates, and recent developments including major purchases and plans to build the endowment fund.  Following the meeting, Sue Schaitel gave us a tour of the new facility space for the Warm Springs clinic at the Connally Memorial Medical Center, to be opened in the beginning of March.  The next day I attended the town hall meeting at the Northeast Clinic, where comments of frustration regarding the computer systems and CLEOs were voiced, and Mr. Marek assured the staff that these concerns would be promptly addressed and forwarded to David Chionsini.  During both town hall meetings, I observed how valuable the meetings were to get all of the employees on the same page as the organization’s administration, and how they provided a system-wide perspective that prompted employees to generate care and concern for the entire Warm Springs team and system, not just their individual facility.

 

Additional meetings I attended during the week included a referral management and marketing meeting at the San Antonio hospital on Wednesday morning as well as the inpatient and outpatient therapy management meeting at the corporate office on Thursday.  On Tuesday evening I had the opportunity to have dinner with some fellow graduate student classmates from Trinity University who were also completing their administrative residencies in San Antonio.  The group consisted of six classmates who are completing our residencies at Warm Springs Rehabilitation System, Baptist Health System, Methodist Healthcare System, Audie L. Murphy Memorial Veterans Hospital, and the Cancer Therapy and Research Center.  We enjoyed meeting together and catching up on each other’s experiences and stories from our residencies, and we agreed to meet on a monthly basis to continue sharing our experiences with one another.  During the meeting we also expressed interest in the possibility of spending a day at other students’ residency facilities to gain a better understanding of the health care environment and industry.

 

On Friday the 11th, I spent the day at the wound care center and hyperbaric oxygen clinic at the San Antonio hospital.  During the day I observed and shadowed several staff members, including Patricia Rios, Marco Nicasio, and Sylvia Cortez, as they went about their routine activities.  I also met Dr. Reyes, toured the clinic, and learned about the WoundStar Information Database.

 

February 14-18

The third week of February offered some exciting experiences as I made rotations in the therapy department at Luling as well as the recreational therapy department at the San Antonio hospital.  On Wednesday I spent the day with Tonya Huston, director of rehabilitation at the Warm Springs Specialty Hospital in Luling.  In addition to observing her daily activities as a director of rehabilitation and touring the department, we also discussed her responsibilities, the plans for a comprehensive outpatient care program, the hospital’s relationship with Cartwheel Lodge, and the success of the fitness and wellness program and how it all began.  In the afternoon I sat in on the hospital’s leadership meeting, led by Brenda Miles, and I also reviewed financial reports for the hospital from January 2005 as Tonya attended a private meeting between therapists and Dr. Haverlah.  In the evening I observed and participated in both of the water aerobics classes, meeting numerous friendly individuals and getting a pretty good workout at the same time.  The evening was special for me because I enjoyed getting to know the community members that participated in the fitness and wellness program and had the chance to hear directly from them how the services at Warm Springs had benefited them and contributed to improving their health and quality of life.

 

The following day I spent with Erin Stinson in the recreational therapy department at the San Antonio hospital.  During the day I toured the therapy department, discussed the scope and value of recreational therapy, observed an animal assisted therapy session, observed a portion of a stroke victim support group meeting, and shadowed Erin as she visited numerous patients to spend time with them and inform them about upcoming recreational events and activities.  In the afternoon I played chess with a pediatric patient that I had met during the first week of February when I followed Sharon Kuhn on a referral visit to Methodist Children’s Hospital, which was a lot of fun.  I also observed and participated in a group outing, in which Erin and Sarah Yawn took three patients to the Ingram Park Mall to help them adjust to functioning in a public environment.  Afterwards I observed as Erin and Sarah completed forms and assessments on patient charts, and I stayed into the evening to assist and observe the Thursday night activity in which patients watched the movie, “Mr. 3000.”

 

The remainder of my week was spent in the corporate office attending several meetings, including the compliance committee meeting on Monday, and working on two projects that I had been given earlier in the month.  The first project was a task that Sue Schaitel had asked for me to help her with, which involved developing a PowerPoint presentation on careers in therapy for a career day presentation at Pearsall High School in March.  The second project was compiling information and writing the community benefits reports for fiscal year 2004 for the four Warm Springs hospitals.

 

February 21-25

During the final week of February, I continued to work on putting together community benefits reports, having completed the careers in therapy presentation for Sue Schaitel the previous week.  Throughout my work of compiling information from numerous individuals from each facility, searching for information regarding the competitive environment and communities that each facility operates within, and organizing information received regarding community benefits that were provided in fiscal year 2004, I gained a firm perspective and better understanding of the contributions and impact that Warm Springs provides to its communities, in addition to the quality rehabilitative care that it offers to patients.  Besides working on community benefits reports, I also spent time attending several meetings, including the operations meeting on Thursday and the morning session of the San Antonio hospital town hall meeting on Friday.

 

Looking Ahead

As I look ahead towards the month of March, I am eager to complete my work on the community benefits reports and submit the reports to the finance department.  Some of my scheduled rotations that I anticipate completing include shadowing Dr. Ellen Leonard during her visits to a state hospital, Jana Richardson in nursing at Luling, Lisa Maltony in health information management services, and Candi Ward in system accreditation and process improvement.  I also plan on attending numerous meetings, including several process improvement meetings, the finance committee meeting, the operations meeting, and weekly executive management meetings.  Finally, I am looking forward to attending ACHE’s 2005 Congress on Healthcare Management in Chicago, Illinois from March 13th to the 17th.  During the conference, I am scheduled to attend numerous seminars and hot-topic discussions, including seminars relating to legislative updates, employee and customer satisfaction, patient care, the healthcare environment, IOM recommendations, the nursing shortage, healthcare technology, and entrepreneurial thinking.  I was also invited to participate in a focus group for ACHE during the conference, which I anticipate will be an exciting and educational experience.

 

Lessons Learned

A recurring theme that I took away from this month was the impact that Warm Springs makes upon our patients and their families as well as the communities we serve.  From interacting with a pediatric patient during my time shadowing external case management and recreational therapy, to my evening with the fitness and wellness program in Luling, to the countless efforts I learned that Warm Springs is involved in to benefit the community while working on the community benefits report, I have gained a much better understanding and grasp of how Warm Springs is involved not only in the lives of our patients, but also in the lives of the cities we serve.  I also came away with a profound appreciation for how our patients and customers are the foundation for our business, giving me a much broader perspective of the overall scope and purpose of Warm Springs in contrast to the work that I do as an administrative resident for the organization.  This was reiterated by a recent response from Lorna Lambert to an article that Rick Marek had sent to organizational members, in which she stated that “we need to make customers the center of our culture.”  Related to this, Lorna also stated that the organization must seek to “build lifelong relationships with patients, extending care and communication beyond the hospital stay,” as well as to “enhance prevention and education efforts and increase community involvement and visibility.”  Organizational programs such as the fitness and wellness program, support groups, Wall-of-Fame recognition, and community meetings and presentations fulfill such goals, and we must continue to implement new methods of involvement and build upon these efforts to continue building patient and community relationships.  By participating with the recreational therapy department and the fitness and wellness program, as well as learning about Warm Springs’ community activities through the development of the community benefits report, I learned a great deal about how the communities that Warm Springs serves, specifically its customers and their families, are ultimately the center of the organization’s culture and focus.

 

That being said, maintaining customers as the center of an organization’s culture often does not come naturally but requires consistent dedication and effort.  Organization members must continually be reminded and remind themselves of the purpose of their work and be guarded against adopting a narrow perspective of their individual work which fosters complacency and apathy.  This relates once again to recent comments from Lorna Lambert, stating that “it is no longer enough to meet the industry benchmark but that we have to set audacious goals and develop and implement appropriate strategies to reach them.”  Mr. Marek reiterated this response when he added the comment that we need to “separate ourselves from the crowd” and “be better than most, not as good as average.”  Working with the auditing and compliance department as well as attending several town hall meetings this month brought these comments to life for me personally.  By continually monitoring the organization’s activities, as well as continually communicating goals and objectives with organizational members, Warm Springs can work to ensure that we always progress towards excellence rather than settle for “acceptable.”  Employees that strive for excellence while focusing on customer relationships will enable Warm Springs to stand out from the crowd and be a cherished member of the south Texas community.