Athena Minor, RN, CNCO, serves as Chief Nursing Officer for Ohio County Hospital.
On April 1st, Dr. Anand will speak at Becker's Hospital Review 10th Annual Meeting. As part of an ongoing series, Becker's is talking to healthcare leaders who plan to speak at the conference, which will take place April 1-4, 2019 in Chicago.
To learn more about the conference and Athena's session, click here.
Question: Healthcare takes a lot of heat for not innovating quickly. What's your take on this?
Athena Minor: Healthcare is one of the most regulated industries in the world. Innovation in healthcare is slowed by the overwhelming magnitude of forces and agencies that determine the speed at which processes are allowed to move within the system itself. While research and evidence-based processes may be studied and evaluated in a relatively short amount of time in controlled environments with pre-established infrastructures and priorities, implementation of these innovations in the real world of healthcare is another matter altogether. Should innovations in healthcare navigate the phases of research and development required to satisfy regulatory standards (and this is not necessarily a bad thing to ensure safety and quality), there are other barriers to rapid implementation. What changes must be made to the current infrastructure to accommodate the innovation? Must there be changes or additions to the facility? Does it require the services of engineers? Special permits? Does it require special licensure or certification? Does it require more staff? Will the technology successfully interface with current technology/EHR? What is the cost of the implementation? Is this a service or product that is reimbursable? What payor sources will or will not reimburse? What are the risks vs. the benefits? What are the regulatory requirements/restrictions? What is the liability? Many of the answers to these questions are determined outside of the control of Healthcare Organizations who seek to implement innovative ideas or technology and the process of obtaining answers, alone, may be extremely time consuming. It is easy to innovate quickly when you answer only to yourself. Healthcare does not fall into that category.
Q: Tell us about the last meaningful interaction you had with a patient.
AM: As the Chief Nursing and Clinical Officer of a small, rural Critical Access Hospital, I like to be involved in New Employee Orientation (NEO). One of the things we do on the last afternoon of the two-day Organizational NEO, before the new employees go to their departmental orientation the following week, is to take a tour of the facility, then send them out on a scavenger hunt. I usually conduct the tour. As I was conducting a tour down our Medical/Surgical unit a few weeks ago, we found ourselves on the far end of the hall. The rooms there used to be double occupant rooms in the years prior to our CAH status and are larger single occupancy rooms now. This is where we place patients who are at end of life whenever possible because they usually have a great deal of visitors, many from out of town. As we approached, a well-dressed man who looked to be in his mid-sixties was standing outside one of these rooms. He stopped me, with my group of new employees trailing behind me, and said, "Excuse me, ma'am, but did you used to work in the ICU here about 15 year ago?" I confirmed that I did and he said he thought he remembered me. He went on to say that he was sorry to interrupt whatever I was doing, but that he saw my name badge identified that I was now a part of the administration. He stated that his mother was in the process of passing away, and that he was currently living in another state. He wanted to let me know how much he appreciated "this little hospital" and how nice everyone had been to them. He then reminded me that his father had passed away in our ICU 15 years ago and that I was his father's nurse. He said he had remembered me because their family had been treated so well. At that time, his parents had moved from California to this small, rural area in Kentucky and he had come to the hospital with some very misguided, pre-conceived notions and with the intent of removing his father from "Hicksville" and taking him someplace that could provide him with competent care. He wanted me to know that he was wrong then and that, when his mother was brought here, he was very pleased to know that this is where she would come to be cared for in her last hours. He said he wasn't disappointed, it was just as nice as he remembered and he just wanted me to know that. It was the best new employee tour I have ever conducted!
Q: Can You Share Some Praise with Us About People You Work With? What Does Greatness Look Like to You When It Comes to Your Team?
AM: Healthcare is my second career; it was through my first career path, in the U.S. Air Force, that I was introduced to the successes that can be achieved when leadership truly value and promote a teamwork mentality throughout the operational structure. I am extremely fortunate to have found this in the healthcare organization team of which I am a team member. Located in a small, rural part of Kentucky, Ohio County Healthcare faces many challenges, as do most rural healthcare facilities. Physician recruitment and retention, qualified staffing shortages, increasing costs vs. decreasing reimbursement, payor mix, insurance negotiations and out-of-network issues, aging facilities and inadequate infrastructure, the list goes on and on. Where many larger organizations have the luxury of specialization, small, rural organizations must be equipped with generalists. This includes leadership that wear multiple hats. It goes without saying that teamwork is essential to survival. Fortunately, Ohio County Healthcare thrives on teamwork, from the top down. From our Board and CEO, to our housekeeping staff, there is not one individual who has not been willing to pitch in and help out in whatever capacity they have been able to do if called upon. As an example, in the past few months I have had case managers who have volunteered to pre-cert for sleep lab because our pre-cert staff have been short staffed with family illness. I have had Endo and Outpatient CNA's volunteer to go over to the Provider Practices and Quick Care to assist with staffing on days off or after hours. We have had a registration staff member fill in for a transporter without being asked, because we had a transporter go home ill on a busy surgery day. We had an organizational director come to the ED to triage patients while the supervisor performed bedside nursing one day until replacement staff arrived after two of the ED nurse's children were injured in the same automobile accident (both were not seriously injured and recovered).
When we had a large amount of snow hit our area and our housekeeping staff were unable to get to the hospital for several hours, our administration staff (including myself), picked up trash and cleaned the patient rooms. If your staff know that the CEO and CNO are willing to pick up the trash so they can concentrate on taking care of the patients when it is really needed, they know that when the big decisions need to be made it is done with the same consideration. When the staff know they are being cared for by a team who are willing to work with them and for them - side by side as needed, then they are willing to do the same for one another. That teamwork and trust translates to the patient experience. The message everyone shares is that we are in this together: Board, Administration, provider, staff, patient, family, and community...that's what greatness looks like.