Supporting Safer Healthcare

An Interview with Vicki Searcy, CPMSM

It's been quite a while since I've posted an interview with an interesting person in healthcare, but I recently had an opportunity to chat with my long-time friend Vicki Searcy, and wanted to share some of her fascinating professional experience with you. 

Vicki is a Certified Professional in Medical Services Management and a past-president of the National Association Medical Staff Services (NAMSS).  She currently serves on the NAMSS Past-President's Council, and works as a consultant in the field of medical staff services.

Now I don't want to say that Vicki is my "old" friend, but both she and I started working in the field of medical staff administration at a time when desktop computers were not yet common in hospitals.  She however, holds an accolade that I do not; Vicki had the FIRST personal computer in her hospital, and was sent to IBM programing school to learn how to write basic programs for its use. An original "propeller head!"

Vicki recently joined forces with the Morrisey Company; heading up their new medical staff consulting service, as well as providing content guidance for enhancements to the popular Morrisey credentialing and privileging software package used by hospitals around the country.  Vicki explained that she is developing criteria for both clustered and stand-alone privileges, as well as working with the programmers to incorporate tracking methodologies for both OPPE and FPPE.  (Ongoing professional performance evaluation and focused professional performance evaluation for those who do not "speak credential.")

Vicki and I talked about the profession of medical staff services/administration; its history, where it stands today, and where we believe it's heading.  Forty years ago hospitals hired medical staff secretaries, who often functioned far beyond the normal scope of a secretarial role, and who in general learned to be "the woman behind the doctor."  It's been a learning process over the years to change that perception, both internally and externally. 

Individuals attracted to this field are often highly organized, utilize excellent project management skills, are politically savvy, and exhibit a high degree of emotional intelligence. Those traits provide a solid foundation for the work of today's Medical/Professional Staff Department, which often functions as a central communication hub for the organization. Credentialing professionals work with senior leadership to ensure that only competent, safe practitioners are permitted to provide patient care.  And that determination is ongoing; there is no such thing as "once privileged always privileged" in healthcare.

Because the rules and standards that apply to the work of medical staff service professionals are in a continual state of flux, ongoing education is a necessity. To that end Vicki shared with me yet another of her many concurrent projects.  (I began to wonder when she finds time to sleep!)  She is partnering with Hugh Greeley and HG Health Consultants to provide an upcoming education program called The Credentials Experience, which will be held in Chicago on April 2-3, 2009.  I asked why MSSP's should choose this particular conference, and was told that attendees can expect content that is on point and realistic.  Presentations are being planned with the goal of offering limited theory and considerable practical application.  Vicki and HG Health Consultants hope that teams of physicians and medical staff service professionals will attend together, as they have found that team attendance facilitates both learning and change.  An additional benefit is a six-month period of follow-up via eResources, eConsultation and eNewsletter. 

If you don't get the opportunity to attend The Credentials Experience, Vicki will also be speaking at this year's annual NAMSS Conference being held in Reno, NV in October.  Her topics include Criteria Based Privileging and Using Best Practices to Set up a CVO.

If you'd like to contact Vicki, she can be reached at vsearcy@morriseyonline.com.

Medscape Interview and Call for Grand Rounds Submissions

My Pre Rounds interview with Nicholas Genes, M.D., Ph.D. has been posted and can be found on the Medscape (WebMD)  PreRounds Index. (Free registration required.)

The November 7th edition of Grand Rounds will be hosted here at the MSSPNexus Blog in honor of National Medical Staff Services Awareness Week. 

Send your best offerings to info@msspnexus.com no later than 5:00 p.m. Eastern Time on Monday, November 6th.  Please put Grand Rounds in the subject line.

Interview - Carole La Pine, CPMSM, CPCS

Welcome to my fifth interview with interesting people in healthcare. This one is with Carole La Pine, CPMSM, CPCS, Director of the Credentialing Department at Saint Joseph Mercy Health System in Ann Arbor, MI, and President-Elect of the National Association Medical Staff Services.

I've known Carole for a number of years, and admire her steadfast excitement about the value and future of the MSP role. She works diligently to promote our profession. She is a leader who is "comfortable in her own skin," which gives her the ability to celebrate the wins of her professional colleagues. Carole is a great mentoring role model, and a wonderful asset to NAMSS. 

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MSSPNexus - How long have you worked in the medical staff services field and how would you explain our profession’s role in the delivery of safe, effective healthcare? 

I’m sure like many who have entered this field, we just got there. And once we got immersed, we saw opportunities and challenges to make a difference and that’s what got us hooked. So truth be told, I entered the medical staff services field when JCAHO required organization of the medical staff even when physicians were employed by a medical school. At that time I was working at the University of Michigan Hospital and all of our “medical staff” were employees of the Medical School. So to meet JCAHO standards, we developed Medical Staff Bylaws and we began “credentialing” the physicians who worked in the hospital. My favorite activity was to “credential” the new residents and fellows who became part of the University of Michigan health care delivery system. I’ve seen changes through the years that all lead to the important role we, the medical services professionals, play in the delivery of quality health care services.

To explain our professional role as it relates to the delivery of safe and effective healthcare is a challenge. We can call ourselves “practitioner investigators’ or “medical service managers” but all descriptions are not totally succinct. The problem is that we, the MSPs, have numerous responsibilities as we fulfill roles our organizations require us to fulfill. I like to say that I “investigate the individuals who provide health care services to ensure that they are indeed qualified and competent to deliver those services”. Although I’d like to add that I ensure adherence to JCAHO, NCQA, CMS and state regulations, I know I would see facial expressions of “what are you talking about”. This is one of the problems .. or challenges…. NAMSS struggles with: Who are WE and how do we tell the public who WE are.

MSSPNexus - How long have you been a member of the National Association Medical Staff Services, and what benefits do you feel you’ve received from your association with the organization?

My state association provided the connection to a larger community of Medical Service Professionals. If those in my Michigan Association had not provided educational opportunities and awareness, I would not have known about NAMSS. In large institutions mail addressed to “generic” individuals usually does not reach the targeted recipient. I’m sure mail was sent to the University but never found its way to my little desk.

So after experience with the State Association, I became aware of the “NATIONAL” organization through the conference material. I was so excited to know that there were educational opportunities beyond the State level and I could hardly contain my enthusiasm. I challenged my peer and long-time co-worker, Arlene Schneider, to join me in our mission to “save” the U/M Medical Staff. We were allowed to attend our first NAMSS conference and from that point on, I was hooked. Following attendance at that first NAMSS Conference, I was so energized that I thought I could change the world of credentialing.

I had the drive to keep moving forward, to get more. Along the way I heard about “Certification”. First thing I said was “ME?” Okay! I got together with a small study group that was led by Lillian Skidmore, a former Michigan State Association President and a person I consider my mentor. We met for several months, made up questions, shared reference material, and supported each other through the exam process. I was certain that I didn’t pass the CMSC exam. Every day I would watch the mail, hoping that I would finally get my results so I could stop feeling sick to my stomach. I’m happy to report that both Arlene and I passed! Then I didn’t stop. As soon as the CPCS exam was available, I had to take that too. Still I didn’t stop…. I entered an accelerated bachelor program, completed that. Then enrolled in an accelerated Master’s program and finished that as well. So for me, the certification programs fed my motivation to higher learning.

It would be a very long answer to address the benefits I’ve received from my association with MAMSS and NAMSS. Primarily my answer would be to (1) move into a leadership role, (2) to mentor others, (3) to influence changes in both organizations, and (4) to see opportunities beyond our current goals.

Going back to my fifth grade goal of being a medical staff secretary, I NEVER envisioned that I would one day be President of my state association, Chair of the NAMSS Certification Commission, member of the NAMSS Board of Directors, or President-Elect of NAMSS.

MSSPNexus - As President-Elect of NAMSS, what is your vision for the future of the organization?

First I wanted to learn the dynamics of our organization as well as current strategic goals. I believe one needs to understand our past, acknowledge our current situation, and see clearly where our organization can go. So this year, my goal has been to become familiar with all NAMSS initiatives, our strategic plan, member and certificant expectations, governance structure, and the dynamics of our management company to help up achieve the goals we have established. This year has been a terrific learning opportunity; to look at our past accomplishments and see what resources we need to accomplish today’s goals. I can truly say that I see NAMSS as a very assertive organization…we no longer will wait for change, but will be the catalyst for that change. I see my involvement as keeping the progress going.

MSSPNexus - What advice do you have for individuals new to the field?

My best advice is to find a mentor! Or if you don’t like that term, partner with a peer. No one is alone in this field. If there is competition and an unfriendly environment, know that there are many in the profession who are willing to be a mentor. I strongly encourage involvement in local and state educational opportunities. Certainly check out NAMSS, use the web site, consider educational opportunities, and set certification as a goal. For those who may be unsure as to what to do or where to go, think local, state, and know that NAMSS is there for you regardless of your geographic locale.

MSSPNexus - What advice do you have for medical staff and administrative healthcare leaders who work with MSPs?

I’m not sure I would consider this “advice” but I strongly encourage the medical staff and administrative healthcare leaders to take some time to consider what MSPs truly do. Anyone thinking that these are clerical positions does not understand the responsibilities placed on MSPs today. It is sad that so many highly qualified and experienced MSPs do not receive the financial rewards or the recognition they so deserve. I hope that NAMSS will be able to influence a change in salary levels and bring awareness of our roles to Human Resource Departments, Medical Staff leaders, and hospital and healthcare leaders.

MSSPNexus - Any other thoughts?

It is an honor to be the President-Elect of NAMSS. I am so excited about the strategic plans and goals NAMSS has coming up in 2007. NAMSS is on the move and I want to invite others to come along. The journey will be awesome!

Interview - Kay Brown, CPMSM, CPCS

Welcome to the fourth in my interview series with interesting people in healthcare. This interview is with Kay Brown, CPMSM, CPCS, Manager, Medical Staff Services for Palm Beach Gardens Medical Center in West Palm Beach, FL. Kay, a self-proclaimed former government bureaucrat, moved to Florida just a month before Hurricane Frances came to call in 2004. Her background in Medical Staff Services, Emergency Management, and Emergency Medical Services turned into a real asset for her organization.

MSSPNexus: How long have you worked in the medical staff services field, and what attracted you to this type of work?

I began my Medical Staff Services journey about 11 years ago, after spending 20 years as a paramedic and state government bureaucrat. I wanted to return to the hospital setting because of the family-centric philosophy of hospitals. I spent a year analyzing medical records for deficiencies and couldn't understand why a physician was still granted temporary privileges after 6 months. I found out that the Medical Staff person had left several months prior and no one had yet been hired to take her place. So...I applied and took over a department that had 1200 physicians listed on its active roster.

I was a lone MSSP. I learned the process of MS management from the NAMSS self study programs and attending local meetings. What attracted me to the position was the ability to influence not only the physicians but also patient safety. The public often has no idea that their best interest is being looked out for by hospitals that are maintaining high credentialing and privileging standards.

MSSPNexus: Have you had a "best moment" when you felt like you were really able to make a difference?

I previously was involved with an academic medical center that provided high quality patient care and exceptional credentialing standards. The problem that I encountered was that everyone lived in "silos" and didn't understand how their department/position integrated into the big picture of patient care. I worked very hard to become involved with many aspects of the institution from the development of websites to the integration of communication with physicians and other departments. Many of the departments that I had contact never knew what Medical Staff Services did. They also didn't understand what our department could do for them on a daily basis to make their jobs easier and to help them be more informed. Communication became the key to integration and cooperation.

MSSPNexus: Shortly after you moved to Florida you experienced your first hurricane. Can you tell us a bit about what that was like, and do you have any "surviving disaster" tips to share with others who work in healthcare?

I came to South Florida 30 days before Hurricane Frances decided to also visit. Being a Midwesterner and having worked in Emergency Management and Emergency Medical Services I started to ask questions. I guess when the hospital hired me it was strictly based on my experience as a medical staff service professional. That all changed as Frances neared our coast. I was asked to participate not only in the preparation of the Medical Staff Office, but also on a more global level with incident command. We were hit hard and had significant problems both structurally and operationally. We learned from our mistakes and within 30 days following Frances implemented many changes. Communication was the key to success.

Having physicians in house was optimal but they are people too. Concerns about families either facilitated the physicians bringing their entire family to our facility or in their staying home. Staying home created serious problems when conventional communications failed. We had to rely on emergency services to find physicians and provide transportation. We established internal communications with physicians in house with spectralink phones dedicated to physician use. We employed a call tree to keep physicians and their offices notified of the impending storm. We obtained physician rosters from local facilities in the event of evacuations and credentialing needs. We received ICU patients from a hospital that evacuated and had to credential ten physicians to manage the transferred patients. We established the need to credential early on so that temporary privileges could be granted without jeopardizing the credentialing standards.

Lessons learned regarding the credentialing process include making sure that essential sites are loaded onto the command center computers. The MSS office was not wired for emergency power so we had to conduct credentialing in the emergency operations center. Keep good paper rosters that include every potential contact number available for your physicians. Keep open dialog with your physicians so that they feel comfortable telling you where they will be during the storm, including address and alternative phone numbers.

Learn the incident command system and participate in drills. Become part of the big picture and step out of your comfort zone. Personal and family safety is so important. Make sure you have your personal life secure so that you can focus on your work tasks. Never underestimate the power of a storm or the effects post disaster.

We lost power and water at our facility for 5 days with Frances. We defended in place and found ways to keep essential services going. You do whatever you need to do to work as a team for a common good. During an emergency, stay visible and keep tabs on your physicians. Know where they are and know their concerns. You many not have all the specialists in house so the physicians have to be versatile and manage patients they may not normally care for under optimal circumstances.

MSSPNexus: What do you think will be different about our roles as MSSPs five years from now?
We are the masters of our own destiny. If we want to be integrated into the hospital structure, we need to spread our wings and be open to opportunities to serve and participate on committees, provide input and think creatively. We are the ultimate organizers and planners. We have a lot to offer any organization and it's up to us to get involved and prove that Medical Staff Management is serious work that involves every aspect of the hospital community. Embrace change and challenges. We need to stand up and be noticed and to demand recognition. If you believe you have more to offer your facility, be bold and say so.

MSSPNexus: Any other thoughts?
We all have the opportunity to grab the brass ring and use the talents we have developed in the Medical Staff Management arena. I challenge every medical staff professional to step forward and increase your leadership role in your organization. It starts with one day, one task, one new adventure. Leadership and respect come to those who are willing to accept responsibility and strive for excellence.

MSSPNexus: Thanks Kay for sharing your experience and insight with us.  Here's hoping for clear skies and smooth sailing in 2006 for all of you in coastal communities.

Interview - Kim Pakney, CPCS, CPMSM

Welcome to the third in my interview series with interesting people in healthcare.  This interview is with Kim Pakney, CPCS, CPMSM, a co-founder of the Alaska Association Medical Staff Professionals and a current member of the NAMSS Certification Board.

MSSPNexus: How long have you been working in the field of medical staff services, and what drew you to the profession?

I've been working in medical staff services for nine years, and like many people got into the field by working as a temp. I helped an overworked, understaffed hospital Medical Staff Coordinator catch up on reappointments that had expired over a year's time. I got hooked. The job can be fairly repetitive, but I find it interesting because our customers keep it different and keep me coming back for more. I love a challenge!

Prior to working in medical staff services I worked in the travel industry. My last job was for a firm that hired airline pilots and contracted them out to air carriers. (That's where I met my awesome husband). My job was to help determine a pilot's eligibility for the contract, and bring them into the company (contracts, HR paperwork, etc.). Sound familiar? The only difference between pilots and doctors is what they do, one group saves lives, the other carries lives.  The issues and attitudes we deal with in credentialing both are very similar.

MSSPNexus: What made you decide to co-found the Alaska Association of Medical Staff Professionals?

In Alaska most of our hospitals and/or healthcare entities only have one Medical Staff Professional. In addition, many of those MSP's work in very remote areas. Most of our cities in Alaska cannot be accessed by road, only by air. So most of us here had no connection to each other; we often didn't even know about each other. When I went to my first NAMSS conference in Orlando Florida in 1997 I quickly realized the benefit of networking with others who do what you do.

Barb Kuper, who became our first president and who was a Medical Staff Coordinator at Providence Alaska Medical Center at the time, and I co-founded the Alaska Association Medical Staff Services in February 1998.

Many of our small facilities were going through MSP's like water because there was very little training or education available to them without traveling to the lower 48, which was cost prohibitive for many of them. So I figured if we got a state organization together and had an annual education conference, it would allow networking and education for those who might not otherwise get the help they need. I hoped it could help us maintain MSP's in the state for a longer period of time. I'd say it's working for the most part. Are we responsible for that? I'd like to think so, but we don't really know.

MSSPNexus: How has AKAMSP benefited you?

The camaraderie in our state is amazing. We are working on a mentoring program, and people new to the medical staff profession are contacted about our group and learn quickly that they have access to help. I love coming together annually with all my colleagues around the state, enjoying their company and learning about things that effect our profession. Also we have some unique challenges here, so it's nice to be able to get input from the group as a whole.

MSSPNexus: Keeping a state associaton active and growing is a challenge. Do you have recommendations based on your state's experience?

What has worked best for us is that we communicate regularly by e-mail with all our members. Our meetings are held via conference call, only annually do we all meet in person. That detail keeps us active in light of growth, because new members are simply added to our e-mails and quickly become involved. We also have MSP's in the state who are not members of the state association and we still keep in touch with them as well. Some messages are sent only to members, but some are sent to all MSP's in the state, especially the annual education session, we invite EVERYONE!

MSSPNexus: You're a member of the NAMSS Certification Board. Why do you feel that certification is important?

I think certification helps an MSP prove that they have a high level of knowledge about our profession. They stand out because they worked for a higher level of education in the field. It offers employers a certain confidence, knowing that an employee has passed a national exam that verifies a high level of knowledge. I personally love certification, and strived to attain dual certification for my personal satisfaction, to prove to myself that I have obtained that level of knowledge. An awesome side benefit of that is getting to serve on the Certification Board of NAMSS.

MSSPNexus: Any closing comments?

I wish more people could see the medical staff field as a profession and not just a job. I make it my personal mission to help with this. I love my chosen career and will stick with it for as long as I am still working. It's fun, challenging and worthwhile.

Interview - Ruth Jackson, CPMSM, CPHQ, CPCS

Welcome to the second installment in the MSSPNexus Interview Series.  This interview features Ruth Jackson, CPMSM, CPHQ, CPCS, Director of Professional Staff Services at Children's Hospital of The King's Daughters Health System in Norfolk, VA.

Ruth came to my attention when I found out that she joined the National Association Medical Staff Services (NAMSS) in 1983, just five years after the association was founded.  Truly, she is the voice of experience in the medical staff services profession.  She is also well known for her willingness to share her knowledge and experience with other MSSPs.    

MSSPNexus: How long have you been working in the field of medical staff services?
Since March 1, 1982.

MSSPNexus:  You're a long-time member of NAMSS, what do you consider the best benefit(s) you've received over the years?
One of the greatest benefits is the ability to network with my peers - people who are doing the same thing and who understand all the ins/outs/problems and offers of help so we all don't have to "re-invent the wheel"

MSSPNexus: What advice do you have for people who may be new to the profession?
Remember that your life and family are important - take time for them.

MSSPNexus:  Why do you feel that the work you do as a medical staff service professional is important? 
I am in a PEDIATRIC HOSPITAL - and those babies and little children need someone to make sure that the people "touching them" are trained, qualified and competent - and understand that children are not just "little adults".  I am proud to play a part in that.

MSSPNexus: Any closing comments? 
This is a great profession - very demanding, often under appreciated, but the pride we can take in what we do is wonderful!!!

MSSPNexus: Thanks Ruth - we appreciate you!

   

Interview - Jennifer Jarvis, CPCS

There are so many interesting people working in healthcare, many of them in our own field of medical staff services, that I want to get to know a few of them better. Therefore, I've added an informal "interview" category to my posts so others can get acquainted with them as well. If you have a suggestion about someone with a story to tell, drop me a line at info@msspnexus.com. - Rita

Meet my first "interviewee" Jennifer Jarvis, CPCS, Credentialing Coordinator at Children's Hospital of Orange County in Orange, CA. I decided to start with Jennifer because she developed the Medical Staff Internet Reference Guide online to assist her colleagues around the country in locating useful links and resources.

MSSPNexus: What made you decide to develop and post the Medical Staff Internet Reference Guide online?

Jennifer: I used to keep (and still do actually) a three-ring binder stuffed full of helpful little tidbits. People kept calling me to ask questions, and it got to the point where it was falling to pieces. Then the medical industry discovered the internet and I started tracking internet websites. My favorites folder just got bigger and bigger and more unwieldy so I thought to myself "why don't I just make myself a webpage - It can hold more information and I can share it with my friends!"  At first just my coworkers and I used it.... and then the page ended up being tossed around a local CAMSS (California Association Medical Staff Services) meeting.... then somehow I started getting calls and emails from across the US.

I try to keep the page as simple and non-graphics heavy as possible, so it's not always the prettiest of sites, but the information is there and easy to navigate.

MSSPNexus: What other resources would you like to see online that would help us in our work?

Jennifer: It would be wonderful if all hospitals would do their verifications online, and there was something similar to the American Hospital Directory that listed all of the applicable links. Other things that would be nice? Having access to DEA verification that doesn't cost an arm and a leg.

MSSPNexus: How long have you been working in the field of medical staff services?

Jennifer: I've been working in hospitals since 1984, and started credentialing in 1991 for a consulting company. I moved on to a CVO, then went to acute care in 1995.

MSSPNexus: Why do you feel that the work you do as a medical staff service professional is important?

Jennifer: I'd say 97% of the doctors out there are fine, with clean files or no major problems... It's the 3% that we have to be careful and on the lookout for. It's hard thinking that doctors can be unethical and try to hide things... so it's our job to find things to protect the bottom line - the patient. Working in a Children's Hospital makes you even more cautious because it's the future you're helping to protect.

MSSPNexus: Any closing comments?

Jennifer: I am constantly updating the information on the web page, so input from people really helps. I'm thinking about adding a section on malpractice carriers and providers with their addresses. If users have suggestions they can send them to me at jennfurr@yahoo.com

MSSPNexus: Thanks Jennifer - and keep up the good work!

Note: A link to the Medical Staff Internet Reference Guide can also be found on the Education Resources page of the MSSPNexus.com web site.

SoundPractice Podcast Interview

I had the pleasure of being interviewed by Kent Bottles, Editor-in-Chief of The Journal of Medical Practice Management, and SoundPractice blogger, about blogging, credentialing, and other assorted topics. 
http://www.soundpractice.net/article.cfm?id=256

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