Kelvin L.
Parks

The walk-in care centers serving seven states out of eight hospital systems needed to shorten wait times, improve patient safety, and help reduce emergency-room visits by the end of the year. The medical centers' managers disagreed as to the viability of a solution incorporating virtual care and toll-free phone access.

Proposed establishing a new autonomous center as an extension of the existing healthcare network and gained agreement with the concept from local leaders. Hired a director and placed regional leaders in charge of clinical triage, pharmacy, scheduling and administration, and virtual visits. Collaborated with staff to expand patient flexibility in deciding how, when, and where to receive care. Simplified the procedures for connecting with regional experts to enhance coordinated treatment.

With no monitoring systems, reinforcement incentives, or measures of accountability, the network's administrative processes failed to ensure compliance with corporate risk-management and organizational goals.

Designed a dashboard program focusing on critical performance indicators that revealed opportunities for quality improvements. To accelerate application of the data, organized and chaired a committee composed of clinical and business-function leaders and presented the challenge to use the tool in identifying and analyzing the system's exposure to risk. Held open-forum meetings with employees to ingrain a clear appreciation of the importance of readiness in advance of the Joint Commission's accreditation evaluation.

Wait-time increases created by growth in annual patient visits to 600,000 raised pressure to renovate substandard facilities. The current operating budget contained only a 12% increase for maintenance and improvement of structures in operation since 1934.

Prepared a presentation to senior management with the goal of enlarging the rehabilitation budget. Incorporated analyses of current metrics, a demonstration of the effect of inferior service on business fortunes, and an appeal to meeting community responsibilities. Won approval of an increase to $28 million. Assumed leadership of the resource allocation committee in budgeting long- and short-term expenditure and control of the funds. Oversaw dedicating $13.5 million to building upgrades and $14.5 million to equipment replacement.

Suspicion that false diagnoses offered by the organization's key pathologist harmed thousands of patients put the organization at a competitive disadvantage in the battle for new business. Restoring faith in the quality of care provided depended on building a positive perception of the institution. This would become the first pathology lookback of its kind in VA history.

Initiated a thorough investigation to determine the extent of patient vulnerability. Relieved the offender from duty and commissioned subject-matter experts to examine all work performed — 33,806 cases total. Organized a command center to manage all communications, instituted monthly town-hall meetings to provide continuing information to the public, and kept government bodies and Congressional oversight current on all actions taken. Conducted 52 consecutive weekly town halls throughout the crisis.

Merging two major hospital systems required transitioning 3,000 military and civilian personnel into the new organization without disrupting readiness or bargaining agreements. Accomplishing the mission meant resolving conflicting HR objectives and mediating differences in regulations and laws specific to the DoD, VA, and Navy.

Addressed the preeminent roadblock by preparing two official memoranda that allowed the Navy to avoid converting dental contract employees to civil-service positions. The uniqueness of the concept earned the solution inclusion in the National Defense Authorization Act and the language embodiment in an executive agreement signed by senior leadership of all participating branches.

Two years of drastic staffing reductions stemming from severe budget shortfalls caused tension between management and union leadership to escalate, a rise in EEO complaints, and probable congressional inquiries.

Recognized the solution lay in bringing widely disparate groups together in a common cause. Assembled sixty-five leaders from across the system representing the full spectrum of lifestyle preferences. Concentrated discussions on finding similar objectives, parallel needs, and available compromises to break through the silos and facilitate cooperation where only antagonism had reigned. Allowed every attendee the opportunity to express concerns and contribute ideas with the agreement that the group would reach consensus.