Strategy and new positions

We have an exciting week ahead!  Joe Tye will be here this week to help us go from good to great.  Also, we have a lot of good things that will be happening throughout the year.  The first part of my blog post will be discussing our strategy for the year, and the second part will be three new positions for the organization.

In the middle part of the year, administration gathers market data, thoughts from medical staff, you all, the board, trends for our town, region and nation.  We then compile this data, and then decide what the organization shall tackle in the next calendar year.  If you have been here for the last two years, you have seen this process, and know that we are a progressive organization that understands diversity in services is needed to survive in this ever changing healthcare landscape.

Two years ago when I started (Feb 2nd 2016)  we were a $14.7 million organization.  As of today we have formed a great team, and are now a $20.1 million organization.  We plan on reaching $24 million this year.  This is by focusing on services that are not usually done by critical access hospitals (retail pharmacy, optometry, joint programs, outreach lab services).

strategy 2

Below is the high level 2018 strategic plan dashboard.

Strategic Goal Who is Responsible
Strategic Plan Total Goal Achievement CEO
1.0 Growth  
1.1 Mental Health Integration-to bring in mental health workers in the clinics on a weekly basis. Heather, Trampas, Julianne
1.2 Dental/oral service line-business plan to start a full time dental practice. Heather, Trampas
1.3 Chemotherapy program-data shows that 3500 times a year someone leaves our community to receive this service Julianne, Amy
1.4 Outreach Lab service-innovative service where MMH will be employing phlebotomists to draw blood for primary care offices along the front range and courier samples to MMH to have our amazing lab staff run and result out the samples. Also, switching reference labs.  This results in a nice revenue stream for the org to reinvest into equipment and expense reduction (payoff) Trampas, Megan, Heather, Wes
1.5 Accountable Care Organization-Medicare Shared Savings Program where we will be focusing on population health and Medicare wellness exams. Heather, Julianne, Trampas
1.7 Increase primary care via OB strategy-bring in more OB practitioners from Banner to ensure that the patients return to us for the rest of their care.  Some hospitals try to keep the entire family for all care…Banner does not.  Trampas, Heather
1.8 Increase swing bed and in-patient utilization-study the transfers that we do to see where we can provide more services to keep at MMH.  Continue working with Banner and UChealth to receive all of the swing bed patients we can.  We typically have 1 to 2 patients come back for swing bed care from Banner every week.  Julianne, Trampas
1.9 Implement Paramedic in ED or community paramedicine-train paramedics for more use in the ER and do home primary care/social services type visits. Heather, Julianne, Trampas
2.0 Employee/patient investment  
2.1 Leadership development-developing training programs for leaders to have the tools to effectively lead their departments (accounting, HR, conflict management, culture) Jennifer, Trampas, Megan
2.2 Culture training-Joe Tye alues coaching where we want to have everyone take ownership in MMH to ensure the patients and each other are taken care of to the highest level-“proceed until apprehended” Trampas, Jennifer, Heather, Lane
2.3 Financial training for employees-Wes will be sharing his expertise with managers via a healthcare master’s level finance course he will teach twice a month all year.  Wes
2.4 Improve staff retention-determine what we can do to get our better than average turnover of 17% down to 10-12% to be one of the best in this category…and retain all of you…our rockstars. All
3.0 Community  
3.1 Daycare project facility design and selection-Move forward with the Holyoke Daycare Initiative 501 (c)(3) on the grounds of MMH. Trampas
3.2 Master Community Plan-start a plan for the land that MMH owns around the hospital for the potential of: assisted living, senior housing, staff housing, nursing home etc.  Trampas

You can see that a lot of these items are to better equip the entire workforce at MMH to become the best that they can be.  We truly want to be the best place for you all to work at, and the best place for our patients when they choose us.  I will go into detail in each of these items at our employee forum in Feb.


New Positions:

There are a couple of new positions that MMH has hired for that we have not had before.  These are Public Affairs Specialist, Wound Care Nurse, and EHR Support Specialist.


The Public Affairs Specialist will report to Megan and be responsible for the MMH story, internal and external relations, communications, public information officer during disasters, marketing, events, and awards and recognition…and so much more.  Elizabeth Hutches will be starting Monday the 22nd.  She has experience in each of the above areas.  Knowing the work that she has done for the chamber of commerce, her drive for success, healthcare experience and strong business relationship skills, she will be a great asset to MMH.

Wound care

Wound care nurse is a new position.  Since we have moved the wound care to the specialty clinic and focused on it to being a service line, it has grown to 75 to 100 visits a month!  This is pretty cool, however, this is way too much for our gracious staff who have assisted in the service (Krista, Barb, Deaun, Mary Kay, Julianne, Heather and all others who have helped).  This position will be responsible for the care and coordination of this service line.  We are blessed to have Cindy Locke rejoin us (start date TBD).  Cindy comes from us as the leader of the cancer center in Sterling.  We are happy to have her back, and hope to utilize her expertise in restarting the chemo program as listed before.


EHR Support Specialist is a new position that will have a lot of implications on everyone’s workflows. Athena brings the best technology and software assisted healthcare delivery in the industry.  There are so many tools that Athena has, and we want to use this to the best of its ability.  Furthermore, this position will train all staff on the use, and do refresher training on this system.  We have invested a serious amount of time and money into Athena, and the expectation is to use it to the highest level.  I would like to welcome Fabian Basurto.

Fabian retired from the Army after 20 years of military service and spent the last 9 years contracting with the DOD.  He has been an army medic, dental tech, lab tech, has coding experience, has a radiology certification as well as a HIPAA certification and has been a EHR trainer/Healthcare Informatics for the last 12 years.  Fabian’s most recent stint was at the Naval Hospital in Sigonella, Italy conducting instructor led and on-the-job training for 520 EHR clinical end users.

Congrats on job




Making my rounds…

Hi All…as part as the investment back into the culture with the Florence Prescription book, leadership development, financial training for managers, transitioning to accountability to ownership; you will see that the senior leadership team will be doing things to address communication, and listening to your ideas that you have given us via multiple venues. You may have already seen the email from Heather about joining the employee benefits committee.  We are also looking for a part-time public affairs specialist to take care of external and internal communications (and a whole host of other marketing/PR items) to bridge gaps.  One thing that I will be doing is intentional rounding to listen to you all, and give you all a voice beginning Jan 1, 2018.


What the heck is intentional rounding? It is where I will be coming around to each department once a month, and visit with one or two random staff members of that department.  I will be asking a couple of standard questions to get feedback on how we can better serve you.  These questions are:


  1. How can we improve daily work conditions for you?
  2. What can we do to improve work/life balance at MMH for you?
  3. Tell us what support you need to take the patient experience to the next level?


I will then compile the answers for a set monthly leadership meeting to see where we can improve the organization as a whole. I will communicate via this blog, and in person what any items may be. This may be a little awkward at first, but I hope to have amazing open and honest communication…my overall goal is to ensure that everyone is heard, and we work on the things that matter most to you to make MMH the very best place to work. However, we can’t do everything; but we will do our very best to ensure that this is the very best place to work.


Culture of Ownership.

Merry Christmas to you all!  I will be coming around the hospital Monday the 11th handing out the Christmas cards for those of you that have not got them yet.  In addition to the Christmas cards I am handing out a book that we have purchased for the entire organization.  This is called The Florence Prescription: From Accountability To Ownership by Joe Tye.  This should be read by 1/23/2018 (whoa 2018?) as this will kick off what I am calling “reinvesting back into our most valuable asset…you all”.  I will get into the specifics in a moment…

I don’t know if most of you know my background prior to becoming a CEO here at MMH.  I started my healthcare career 25 years ago when I was 16 (if you are doing the math I am 41).  Back when child labor laws were different, and you could be a Nurses Aid in long term care units.  I was an aide in high school, and realized my true calling was in healthcare.  I got my degree at UNC in Kinesiology with a minor in Community Health thinking I was going to be a physical therapist.  I did my internship and got a job in cardiac rehab after graduating.  I worked at Parkview in Pueblo where I did  cardiac rehab, and then was crossed trained into cardiac treadmill testing then subsequently the cardiac cath lab.  I spent several years in this realm moving to Denver to work at St. Anthony’s cath lab and cardiothoracic surgery program were we were trained to do all of the procedures from an electrophysiology study to a bypass surgery.  This was one of the most demanding jobs I have ever had due to being a level 1 trauma center, and  was in one of the poorest neighborhoods at the time.

I decided then that radiology was my calling, and went back to Pueblo to earn my Radiologic Technology degree.  While I did this I worked as an anesthesia technologist at St. Mary-Corwin in Pueblo to help make ends meet.  I was responsible for 20+ anesthesiologists, their inventory, machines etc.  I then graduated and moved to Sidney, NE where I spent 10 years doing XR, CT, MRI, US, Dexa..I moonlighted at several small hospitals in NE, and helped install and train on multi-slice CT scanners in small hospitals (I did Wray’s current unit).  I then wanted to make a transition into administration.  I got my Master’s in Healthcare Administration from Univ. Nebraska Lincoln, Univ. Nebraska Medical Center Clarkson College (I am not a Husker fan, sorry).

I was then fed to the wolves at Middle Park Medical Center as the Chief Operations Officer.  MPMC was the nation’s first critical access hospital system in the United States, three hospitals and five clinics under one CAH license.  Here I was Interim CEO twice, Interim CFO and had CIO (chief information officer) added to my permanent job duties.  At one point I was doing MRI’s, COO/CIO and Interim CEO during one month…I did this because I felt a sense of ownership over my work, and my hospital…and the jobs were vacant, patients needed MRI’s and the hospital was without a CEO.

I am sure you all are wondering is this bragging or what?  I can’t lie…I am proud of my accomplishments…however, my point is that up to 2011, I was a negative, toxic employee, at every single job…it all felt the same.  Everything that went wrong was someone’s else’s fault, I did not take ownership on anything.  I despised administration.  Nurses didn’t know how to put a simple chest xray order in, so they must be stupid.  Doctor’s put a generic abd pain on an order for a CT, so they must not have a clue and are on a fishing expedition or paid a percentage of revenue from the hospital.  Why are they calling me in at 3 am for a pinky xray…stupid inconsiderate patients.  We just did 92 radiology exams between the three of us today, but administration won’t give us more help…they don’t care.  I take all of the call, and nobody else helps out.  The EHR is crap…it’s not anything I am doing it is all their fault.

I was mad at things out of my control, with no knowledge on why they were happening.  I was withdrawing from work and home-life.  I wouldn’t attend any hospital function because I didn’t like anyone, they were all to blame.  I was flying under the radar collecting a paycheck…had my best façade on when dealing with patients.  I hated my job, because nothing ever changes.  I would leave a job because it was everyone else’s fault…because the grass must be greener on the other side, right?

This all sound familiar to you, have you had these thoughts?

Enter Joe Tye in 2011.  Joe was brought in to Sidney Regional Medical Center to help create a culture of ownership.  I read his book (mentioned above), and thought was decent, but just another administration flavor of the month.  When Joe did his onsite work, and his presentation…I was literally floored.  I was one of the toxic employees that he was talking about.  His pledge is excellent, and I credit it with me loving my job every single day.  I used it to make the leap that I did.  I still use his pledge to this day:

Monday-I will take complete responsibility for my health, my happiness, my success and my life, and will not blame others for my problems or predicaments.

Tuesday-I will not allow low self-esteem, self-limiting beliefs, or the negativity of others to prevent me from achieving my authentic goals and from becoming the person I am meant to be.

Weds-I will do the things that I’m afraid to do but which I know should be done. Sometimes this will mean asking for help to do that which I cannot do by myself.

Thurs-I will earn the help I need in advance by helping other people now, and repay the help I receive by serving others later.

Friday-I will face rejection and failure with courage, awareness and perseverance, making these experiences the platform for future acceptance and success.

Saturday-Though I might not understand why adversity happens, by my conscious choice I will find strength, compassion and grace through my trials.

Sunday-My faith and my gratitude for all that I have been blessed with will shine through in my attitudes and in my actions.

In the next month, we will be reading the Florence Prescription, be doing a culture assessment, working on the MMH mission, vision and values, Joe will be on-site Jan 22-24, and we will embark in a great transition to accountability to ownership at MMH.  I can’t wait to get this going.

New Docs signed!

Hello All!

What a crazy last couple of weeks.  I am proud of how we all handled the Athena conversion.  Things are getting resolved at a rapid pace.  One way to think about Athena, is that it is pushing us to do everything in real-time, it has patient safety at the forefront of its platform.  You may be asking what that means… take a look at your clinical inbox…it requires you to verify many tasks, look at labs/x-rays and medication refills and requires action so nothing gets missed.  It requires us to enter an action item for each of the items.  If we do not stay on top of this, we will get behind.  I am excited to see the workflows coming together.

I want to end the week on a great note.  We have signed not one or two, but four new Docs.  Two are family practice, two are specialty.  Dr. Daniella Boyer has signed on to practice like Dr. Wilson and her start date is after she finishes her residency on July 31, 2018.  One not so new Doc…Dr. Kevin Cuccinelli has agreed to provide 120 hours per month ER/IP/Obs/Clinic coverage.  Dr. Yakel, our Podiatrist, will become an employed Doctor like Dr. Schiefan.  His hours will not change, but we will assume all billing for him.  Dr. Mike Solomon, our cataract surgeon (ophthalmologist) will begin in Nov.

Also, Dr. David Mendez, our first resident, begins Tuesday 10/3/17 for a month of seeing patients in the clinic and the ER etc.

Thank you all for your hard work!

Go Live!

Woohoo!  A long journey is getting ready to hit a major milestone!  Hopefully you all know what this is.  Tuesday, 9/19/17, at 0700 hrs…we move forward with using Athena Health for our EMR!  This will be one of the biggest things that MMH will go through.  These past few weeks has been challenging, everyone has experienced many emotions: excitement, anxiety, fear, happiness, pettiness, apprehension etc.

There will be many more emotions, there will be bumps in this process…things will crash, things will work really well, things won’t be as promised from sales people…things will be worse off, at the end WE WILL PREVAIL and will be better.  I challenge everyone to attack this with relentless curiosity, positivity, courage and hit this project with the utmost ferocity that we will serve our patients, be patient to ourselves and be kind to one another, and come together to make MMH the very best organization we can.

Surely we will end up where we are headed if we do not change direction. —Confucius

Change is hard, I admire everyone’s courage to take this journey together.  Let’s take this opportunity to take our vulnerability, this time where we can mold MMH to be the healthcare provider of choice, and employer of choice.

Here are a lot of fun things and ways to help de-stress:

Friday, September 15th

  • Distribution of shirts- 10:30 am

Tuesday, September 19th

  • Free massages- 1:00 p.m. – 4:00 p.m.

Wednesday, September 20th

  • Free massages- 9:00 am- noon

Tuesday, September 19th – Friday, September 22nd

  • Coffee bar- Mornings
  • Cookies and canned pop- 2:00 pmMonday, September 25th – Friday, September 29th
  •  Coffee bar- mornings
  • Cookies and canned pop- 2:00 pm

Setting the Direction

Happy beginning of the week!  The past month while everyone is prepping for the Athena conversion the board and senior team has been focused on multiple different things.  The board retreat was held on August 10th, where a strategic update was given based on financial data, year to date volumes, market analysis, the employee satisfaction survey, external trends and other data.  This was a very good retreat catered by the MMH Dinning Extrodinaires…it was a tasty meal (did you know Sue, Spencer and Fil served 1,600 meals in August?  Wow!)  After this retreat the teams emerged with high level strategy to put into place for the next 18 months.  These items were touched upon in the past managers meetings.

This past week on Thursday and Friday the senior team had it’s retreat:party scene.png


What actually happened:

retreat 3

We took the information from the board and managers, and turned it into tactics and plans.  We also took information from a 700 question leadership survey called the Hogan Leadership Assessment that each of the senior team member took, along with the employee satisfaction survey, and identified strengths and weakness in our fairly new senior leadership team.  This was all facilitated by Tony Blake from Strategic Impact.  Tony is a highly regarded expert in leadership, strategy, culture etc.  He took DaVita and beat Microsoft out for best culture in the United States a few years ago.

retreat 1

By now I am sure you all are wondering what we are looking at for strategy for the next 18 months.  Here is the high level list: Mental health integration, dental clinic, chemotherapy, day care, staff education, organizational culture improvement, financial education for non-financial staff, leadership development, staff retention, swing bed and IP utilization, retention of family medicine through prenatal and post-partum strategy, increase primary care utilization via accountable care organization, process improvement methodology, and outreach lab services.

The team also developed team norms in which to function under, did a hit or miss inventory from Jan 2016 (my arrival) to today, and focused on mission, vision and values of the organization.  After the dust settles from the Athena conversion, there will be a team put together to focus on the mission statement, and subsequently the vision and values that we all will abide by.

We will be having a quarterly town hall coming up soon, and we will go over this more in detail.  If you have any questions feel free to reach out to me.  I hope everyone has a wonderful week!


100,000 providers strong!

Hi All! Had a great strategic client forum for Athena Health the past few days. There are a lot of very cool things happening with Athena that by virtue of the cloud and network…no other partner can do.  A few of the new things:

  1. Secure mobile app for Athena Net to be on your phone/mobile device
  2. 100% pre-auth service…this takes their rules engine, live operators and power of the network to auth all procedures from surgeries to medications to DME…the statistics on their success is amazing. In fact insurers are very happy with how they do this. A top 5 reason for denial is lack of pre-auth. They can obtain a pre-auth within an hour for urgent exams.
  3. Increasing the speed of their network
  4. They have over 100,000 providers on the network

Due to having this many providers on the network they can drill into data quickly to show that:

  1. Text message reminders are the best at preventing no shows. 4.2% of patients that received a text message no-showed compared to 10% for phone call reminders. This includes Medicare patients!
  2. A spike in Lyme disease has enabled Athena to assist the CDC to get warnings out to the public about tick bites.
  3. They can see that while the average wait time for the US for a wellness exam is 30 days, 27% of schedules are never filled in the past 30 days…meaning that with the daily cancellations and no shows every day schedules go unfilled, so they developed a new text feature that when a no-show or cancel happen it will send text messages out to people that are on the schedule with similar appointments to ask if they want to be seen now and give the practice a call to schedule ASAP. Pretty cool
  4. They are collecting data on the hospital side that re-works the medication bar code scanning workflows for improvements…these are just a few of the new items.

This is a great segway to the first question: Senior Management is always out for education, what about other employees who work directly with patients, could they go off site for education or training? ABSOLUTLEY! I don’t believe I have turned down a request for this, unless it was a timing issue, extravagant cost (I was asked about a $6,000 off-site 1 week course once) or did not pertain to the job. I always encourage to look for the free trainings first. For example, Athena Health has paid for this trip to Boston. At a strategic lab trip I took to Austin last month that organization paid for. The trips for Athena implementation team, selection teams etc. Were all paid for. For the Colorado Rural Health Center Rural forum and annual conference there is typically a scholarship to help offset the costs.   

I understand that not everyone can find these and afford them, however, I encourage offsite training as needed as it pertains to your job. However, be prepared to present what you learned to me or others to ensure that you all are learning. Also, training costs over a certain amount are subject to employment contracts. Unfortunately, some folks will get a lot of training and then leave the organization. As an organization we should invest in our employees, however, we also have to protect that investment as well.

Specialty Clinic along with the Specialty Clinic Providers and our patients we provide so many different services and our patient care is our main priority. The specialty clinic is a pretty special area (pun intended). It is our strategy to create access to our community, this includes specialty clinic. It was our goal this year to surpass a 50% specialty clinic market share…we are projecting to beat that even with-out the Coumadin clinic and eye clinic numbers. Add those numbers in and the specialty clinic is projected to see nearly 5,000 patients this year compared to the 7,300 in the primary care clinic. This creates access access access all around. What is cool also is that the primary care clinic is on schedule to have its 3rd best year in history. Keep it up!

I like my co-workers and having adequate ancillary help, ward clerks, CNA’s etc.  I love all of my co-workers (you all!) Glad to hear on the rest.



Too many Chiefs, not enough Indians

I hope that you all have a great, and safe Fourth of July! Here are a few comments from the comment section I will address:

The time clock system. bigger equipment.

Time clock system…YES! We agree!  We are moving away from ADP and using Kronos which is a very big player in the healthcare market place.  We will go live Jan 1st.  We opted to do this Jan 1st.  for a couple of reasons one reason is Athena…’nuff said.  Also, this will be easier for our and your taxes…two payroll system equals 2 W-2’s.  Also, on Jan 1st, we will move from a twice a month payroll to every other Friday…26 pay periods a year.  This helps with accounting, planning, taxes and benefit methodologies, and gives everyone a solid date on which you will get paid…every other Friday!

Bigger equipment? Hmmm.  I am not sure we want bigger equipment?  Nope.  Colon scopes…NOPE!  I am not sure what this means.

I sometimes feel there are too many chiefs and too few Indians.

There are actually less Chiefs than a year ago. There was a CEO, CFO and CNO last year, now there are two.  This is always brought up in every survey I have been part of.  I am going to lump my answer in with the next comment…

I do not feel that we have a safe relationship with administration. They do not seem to invest time in learning about our department and our needs, nor do I feel like it is ok to go to administration with concerns. There are way to many people in charge of areas that they are not well educated about. I am never sure who is in charge at any moment because there are so many heads that turn over frequently. Also those in charge do not come into our department or get to know us on a personal level to keep communication open or even an option.

First let me start off on some information about my leadership style. My style of management is a very hands off type.  I give my vision, my expectations and my timelines.  How things get done from A to B is not my job, nor do I want it to be.  My strengths lie in my strategic planning, authenticity, public relations, collaboration, relationship building, consensus building and my loyalty.  The Senior Leadership Team took a 6-700 question leadership personality exam called the Hogan Leadership Forecast.  Those listed above, particularly my imagination and strategic thinking is off the charts.

However, on the other side, my weaknesses are granular detail, going around the block to get across the street, intricate workings, day to day monotone activities and large crowds. This is why I have the team in place that I have.  If they were not here, more work would fall onto the managers.

I was hired to be the face of this organization, grow the organization, improve the employee satisfaction, improve public relations, improve medical staff relations and install a team that carries out my vision/strategy of a high performing, high quality and patient focused organization. (we’ve accomplished a lot here!)

My predecessor was a complete opposite, his leadership style was managing the minute details, doing the work to get from A to B. The team that was assembled was under that type of leadership style. There is no right or wrong style.  There are, however, right and wrong styles for certain organizations, goals, and cultures.  It wasn’t until about 45 days ago that I truly had my first day where I focused strictly on CEO duties as defined by the board and the governance policies.  So yes, the comment about heads turning over on the administrative team can be accurate, this is the reason.

The comment of being way too many people in charge of areas they are not well educated about…healthcare is one of the most difficult industries with a wide variety of skills and personnel. I have been in health care since 16 (25 years ago) when I was a CNA…I have been a biller, Anesthesia Tech, Cardiac Cath Tech, Cardiac Rehab Exercise Physiologist, Rad Tech, MRI Tech, CT Tech, US Tech, Director for 4 primary care clinics/3 rehab clinics/2 specialty clinics, Chief Operations Officer, Chief Information Officer over 3 critical access hospitals all at once…I still am uneducated in many many areas.  We all have to start somewhere, we have some very good leaders.

“Those in charge do not come into our departments”…this is untrue. I have seen multiple leaders in all departments, some have gone with radiology for surgeries, spent hours mentoring at their desks, I myself have gone to areas and sat with my lap top…I did this once in the clinic last fall and it was more distracting to staff than helpful.  We can do more of this and you will see more of this.  Communication is always key.  We want to improve this.

The word safe in this comment is a buzz word that creates visions of violence in my head. My first questions that come to mind is, have you been beaten?  Screamed at?  Called names?  After all the definition is “1. Protected from or not exposed to danger; not likely to be harmed; 2. Uninjured; with no harm done”.  If any of the above has happened, this needs reported right away.  Perhaps go back to last week’s blog for a better explanation and clarity around this

Getting to know people at a personal level can be a touchy thing between leaders and front line staff. I have been in instances where personal information is shared, and then used against me when an employee had to be re-directed into a performance improvement plan stating I was retaliating.  I then became more hesitant to get too involved with employees.  I have seen this happen on more than one occasion here.  However, we want to be approachable, try to know about your lives…but just remember if there is hesitation, at least from the team that is in place now…the above is why.

Also, I challenge those of you that want to know more about us to come to us, get to know us, come sit with us…take a look to see what we do all day. Moving from frontline to administration my eyes were opened to how much goes on, and the caring, emotions, wins, losses, tears, time and sweat that goes into what we do…just like the rest of the organization.

Here are some comments of two things you like most about the organization in bold with my response:


I enjoy the interaction with my patients. 2. I enjoy the freedom I have to do my job –awesome!

Friendly co-workers Benefit package- Insurance is pretty good considering the things going on at the national level!

Professional environment to work in The quality of the people and their abilities

I like it!


Have you seen my stapler?

Hi All!  Great news!  We are going to have a party!  80.2% of you took time to take the employee satisfaction survey!  Thank you so much for doing this.  These surveys are an important tool to help take our amazing organization to a world-class organization…I am not even joking.  Take a gander:


For our overall scores, it is much like the HCAHPS methodology, it is based on favorable (top box scores) and unfavorable (bottom box scores).  According to the Press Ganey database, which is the biggest in the world, the best in class healthcare score is 82.5, the average healthcare norm score is 74.3.  MMH scores:

  • 2013:  70
  • 2014:  65.8
  • 2015:  67.8
  • 2016:  82.8
  • 2017:  87.7

Wow!  In 2016 we were a best in class!  In 2017 we are WORLD CLASS!  This is indicative in many of the comments in the comments section…we are truly an employer of choice!  Meaning that the majority of people love working for us!  However, there are always areas for improvement.  I will take time to address the negative comments in here and several more blogs in the future.  Without further ado:


“Communication/transparency between senior leadership and staff. There is a sense of fear and insecurity whenever seemingly exemplary employees are fired for no apparent reason. I think it would be helpful to know that policies for progressive discipline are being implemented or be given examples of what behavior would constitute an immediate dismissal”.

First let me deconstruct the first comment regarding communication/transparency.  Communication…yep, we have some work to do here.  Part of our strategic plan will be implementing methodology to improve this.  We have started by moving the manager meeting to the day after the monthly board meeting, and dedicate 30 mins. to an hour disseminating the information from the night before for managers to present to departments.  However, this is a two-way street…we have implemented newsletters, email blasts etc. in the past, and asked what you all wanted to hear…all we heard were crickets in most instances.

The next in line is transparency…this is a tough one.  If it is transparency with financials, quality, strategy etc.  I can buy this…we can always be more transparent in this area.  With Wes White on-board there will be much more financial transparency with budget and responsibility reports.  However, if it is personnel transparency as this comment suggests…I will give an absolutely not!  After all, should we be saying hey all, Trampas Hutches is no longer with the organization because he was on dating sites on the hospital network while at work?  Then you all will ask Trampas were you on that dating site?  What do you think he will tell you?  Can anyone say lawsuit in this instance?

“There is a sense of fear and insecurity whenever seemingly exemplary employees are fired for no apparent reason”.  This seems to cross into that transparency area above.  I can appreciate the sense of fear and insecurity when not every detail is shared.  In fact this is one of the reasons I became a CEO, I felt that the old school style of “at will” termination was unreasonable.

“I think it would be helpful to know that policies for progressive discipline are being implemented or be given examples of what behavior would constitute an immediate dismissal”.  This is a more constructive statement.  First it is always the goal to redirect the behavior for success of all parties.  MMH has not had a consistent progressive discipline policy in place until this year.  Senior leadership went through great discussion, and debate trying to do the right thing in implementing this policy.  We tried to balance all sides of the employee, the organization and the patients, we tried to be as fair as possible, and put it through multiple scenarios…we knew it would be hard.  I encourage you all to go back, and take a look at policy 900.17A and B in MCN Policy Manager.

Since I have been here there have been a wide range of instances of progressive discipline.  One person had 31 incidents of improper conduct before termination, 28 were prior to my arrival.  Now the incidents range from 1-3, a lot of people own the mistake and are successful in their positions.  This is job specific, item specific, and can vary.  For example, at one of my prior jobs the IT Tech would utilize their ability to look into, email of others and was tracked looking at multiple different people’s email accounts without permission over 40 times.  Looking once without permission in this instance would constitute immediate termination as this is a gregarious violation of trust in a position where it is paramount.  The employee was terminated, denied any wrong doing even in the face of the screenshots showing proof.  They filed unemployment and were denied.

computer stare

Here are examples of behavior that will warrant action and or immediate termination.  These are actual behaviors I have experienced here and other organizations:

  • Viewing significant others medical records 71 times in one day
  • On dating sites during work hours on hospital equipment
  • Destruction of hospital property
  • Intoxication at work
  • Multiple instances of tardiness
  • Gossip and spreading rumors
  • Surfing the internet for an average of 2 hours per day (all things can be tracked via IT audits)
  • Missing work deadlines multiple times
  • Selling diapers purchased in employee purchase program at higher rate than bought for profit to those outside of an organization
  • Not clocking out and notifying supervisor in order to get overtime when called in during night.  Then bragging about it in the community jump starting the investigation.
  • Patient abandonment
  • Under the influence of opioids
  • Absenteeism
  • Opioid diversion
  • Leaving drug cabinets unlocked, multiple incidents
  • Workers comp fraud
  • Insubordination
  • Negative Facebook/social media comments about workplace or people in the workplace
  • Sexual intercourse during work hours
  • Poor performance
  • Falsifying patient records
  • Poor productivity
  • Sleeping on the job
  • Violating employee standards of conduct/behavior policies

The list can go on and on.  Some of the best employees, can also have struggles in the area above.  Also, as management, our philosophy around employee resignation is that we will accept all communications of resignation or threats of resignation during a corrective action process.  We do not take any of the above lightly, we have thorough investigations prior to making determinations of phases of corrective action.  I, personally, am always communicated with during these incidences, and I can assure you that we always strive to do the right thing.


All in all, this task is always difficult for any organization.  Balancing the line of corrective action and termination, and workplace fear is challenging.  I beg you all to do two things:  1.  Consider that you will only hear one side or no sides of the incident; and 2.  Strive to be the best team member that you can be…give it your 110%, and there will never be a problem.

I will always be available if any of you have questions or are concerned with any of these things that I have blogged about today.

Have an amazing weekend!




Dress code

Dress Code. There has been a lot of concerns, questions, and confusion lately about this very personal topic. This is my attempt to make light of the situation, and hopefully clarify some of the expectations for clothing that are already in existence merely because we work in the healthcare industry.

We all can relate to our patients in the fact that we already have expectations for what others should be wearing in the hospital/clinic setting. It’s important to try to see yourself, and your wardrobe through the patient’s eyes. What do you think they’re thinking when they see you in your chosen outfit? Or who would you rather help you with your healthcare needs?

Hi, I am Dr. Smith, what are you in for today?

Hello, I am here to draw your blood.

I’ll take your credit card for payment.


I would like to go over your medications with you.


Hello, I am the CEO.


The philosophy that I personally use in the morning is: Would I wear this again to Home Depot on Saturday?  If the answer is yes, then it might be too casual for the workplace, and I save it for the weekend. I’d rather not have the hassle of being sent home like what happened several years ago when my manager informed me that I needed to have on sheer panty hose to cover the portion of leg showing between my capri dress pants and shoes. SIGH! Ladies, panty hose were invented by a man named Allen Gant Senior in 1959 for… reasons unknown. I can honestly say, that I haven’t worn capri dress pants OR panty hose to Home Depot.


As an organization, we want you to be comfortable and be able to express your personality! How you dress is extremely personal; you spend your hard earned money on clothes you like, on clothes you feel good in. But I’ll be honest, I feel most comfortable in stretchy pants, a tank top and flip flops, but I don’t think that would gain any respect in the workplace with my peers or patients that see me in the hall. It’s never fun to feel stifled, whether that be by dress code rules or panty hose. So, here are some examples for business casual for us folks that don’t get to wear scrubs every day.

Patients still have opinions on Fridays, so please continue to reserve your jeans and slightly more casual wear for Fridays only. Continue to be conservative with your wardrobe choices so that we don’t ruin “Casual Fridays” like our poor friend, Kevin.

Thank you for taking the time to read this and please consult your manager or a leadership team member if you have questions!