keeping your physical environment of care safe august 7, 2020 · consulting services and technology...
TRANSCRIPT
© HTS3 2020| 1
Brentwood, TN 37027
615.309.6053
www.healthtechs3.com
Keeping Your Physical Environment of Care Safe
August 7, 2020
Presented By: Dr. Frank Mineo, Ph.D., FACHE, CHSP, CHEP, CEM
5110 Maryland Way 2745 North Dallas Pkwy
Suite 200 Suite 100
Dallas, TX 75093
800.228.0647
www.gaffeythealthcare.com
© HTS3 2020| 2
Host
Carolyn began her career in healthcare as a staff nurse in Intensive Care. She has worked in a variety of staff, administrative and consulting roles, and has been in her current position as Chief Clinical Officer with HealthTechS3 for the last 15 years.
In her role as Chief Clinical Officer, Carolyn conducts mock surveys for Critical Access Hospitals, Acute Care Hospitals, Long Term Care, Rural Health Clinics, Home Health and Hospice. Carolyn also assists in developing strategies for continuous survey readiness and developing plans of correction.
Carolyn has extensive experience in working with rural hospitals to both develop, and strengthen, Swing Bed programs.
Carolyn St.Charles,Chief Clinical Officer
HealthTechS3
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Nationwide Client Base
Currently provides hospital management, consulting services and technology to:
• Serving community, district, non-profitand Critical Access hospitals
Example Managed Hospital Client: Barrett Hospital and Healthcare in Dillon, MT, Ranked as a Top 100 Critical Access Hospital for 8 years in a row
Example Technology and AR Services Clients: Two-hospital NFP systems in southeast GA with numerous associated physician practices
Preferred vendor to:
• California Critical Access Hospital Network
• Western Healthcare Alliance Partner with Illinois Critical Access HospitalNetwork
• Vizient Group Purchasing Organization
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• Executive management & leadership development
• Community health needs assessment
• Lean culture
• Executive and interim recruitment
• CEOs, CFOs, CNOs
• VP and Department Directors
• Performance optimization & margin improvement
• Revenue cycle & business office improvement
• AR outsourcing
• Continuous survey readiness
• Care coordination
• Swing bed consulting
Governance & Strategy
Recruitment Clinical Care & Operations
Finance
Areas of ExpertiseStrategy – Solutions - Support
© HTS3 2020
Interim Executive & Department Leadership 5
▪ The Right Person – Our experience and understanding
of your hospital is the key to placing the right Executive
or Department Leader
▪ Immediate Response – Interim needs are typically
immediate. Our bench strength allows us to find the
right executive quickly to provide a seamless transition
▪ Experience – Over 49 years of supporting executives &
teams in hospitals and healthcare companies of all
sizes
▪ Support Services – Our business is managing hospitals
more efficiently. We provide comprehensive support
services to all our Interim Executives and Department Leaders
▪ Our Depth:
We support all positions including CEO, CFO, CNO,
CIO, Clinic Administration and Department
Leaders
▪ Interim Executive Placement Services:
“Blue Mountain Hospital District has benefited from
the interim executive placement services
HealthTechS3 provides. Our current CFO started as
an interim placement for BMHD, prior to joining our
organization in a permanent capacity. The
success with this placement has motivated us to
consult Health Tech with two subsequent interim executive needs.” Derek Daly, CEO BMHD
Staffing Community Hospitals since 1971
HealthTechS3 Design.Build.Optimize High Performance Teams
Retained Contingency Interim Contract
© HTS3 2020
Mentoring/Support Team 6
Every Interim Executive and Department Leader is backed by a support team and mentor who help ensure that the team gets the right results
HealthTechS3 Design.Build.Optimize High Performance Teams
Retained Contingency Interim Contract
© HTS3 2020
Community Health Needs Assessments: More Than a Regulation – A Tool to Assist in Delivering CareDate : July 14, 2020 Time : 12pm CSTPresenter : Julie Haynes, Strategic Planning ConsultantPresenter : Faith M Jones, MSN, RN, NEA-BC Director of Care Coordination and Lean Consultinghttps://bit.ly/2ZqPgzr
Ask Carolyn – Your Swing Bed Questions AnsweredDate : July 24, 2020 Time : 12pm CSTSpeaker : Carolyn St.Charles, RN, BSN, MBA – Chief Clinical Officerhttps://bit.ly/2Zw55os
More Than a Plan: Keeping Your Physical Environment of Care Safe for Patients, Staff and VisitorsDate : August 7, 2020 Time : 12pm CSTHost : Carolyn St.Charles, RN, BSN, MBA – Chief Clinical OfficerSpeaker : Dr. Frank Mineo, FACHE, CEM, CHSP, CHEPhttps://bit.ly/3eRC5ho
Effective Communication in HealthcareDate : August 14, 2020 Time : 12pm CSTHost : Carolyn St.Charles, RN, BSN, MBA – Chief Clinical OfficerSpeaker : John A. Coldsmith, DNP, MSN, RN, NEA-BChttps://bit.ly/2AiNkAq
Bringing Care Coordination to Specialty Practices: Principle Care ManagementDate : August 27, 2020 Time : 12pm CSTSpeaker : Kevin Franke, BSN, Principal Consultant, Care Partner, LLCFacilitator : Faith M Jones, MSN, RN, NEA-BC - Director of Care Coordination and Lean Consulting, HealthTechS3https://bit.ly/3dQiaya
The Role of a Rural Hospital’s Board in a Time of Crisis: How the Hospital Board and CEO Ensure an Organization’s Success During COVID-19Date : September 4, 2020 Time : 12pm CSTSpeaker : Peter Goodspeed, Vice President of Executive Searchhttps://bit.ly/38fXyOI
Rural Healthcare Challenges in Times of ChangeDate : September 11, 2020 Time : 12pm CSTHost : Carolyn St.Charles, RN, BSN, MBA – Chief Clinical OfficerPresenters : Rhonda Mason, Cobre Valley Regional Medical Center; Margie Molitor, Hot Springs County Memorial Hospital; Deborah Morris, Blue Mountain Hospital; Terry Odom, Powell Valley Healthcarehttps://bit.ly/38gZWEI
Innovating Care Models for Opioid Use Disorder PatientsDate : September 24, 2020 Time : 12pm CSTPresenter : Rebecca Morgan, CEO, Spark Creative Presenter : Faith M Jones, MSN, RN, NEA-BC - Director of Care Coordination and Lean Consultinghttps://bit.ly/2ZyjQaC
The Hospital’s Role in Getting the Right Interim Leader – What Does it Need to Know?Date : September 25, 2020 Time : 12pm CSTSpeaker : Mike Lieb, FACHE – Vice Presidenthttps://bit.ly/2BvqXZ7
An Introduction to Our Cloud-Based Optimum Financial Statement Toolkit (OFST)Date : September 30, 2020 Time : 12pm CSTPresenter : John Freeman, Associate Vice PresidentPresenter : Kevin Stringer, Associate Vice Presidenthttps://bit.ly/2YPQG7G
ALL WEBINARS ARE RECORDED
8© HTS3 2020|
You may type a question in the text box if you have a
question during the presentation
We will try to cover all your questions – but if we don’t get to
them during the webinar, we will follow-up with you by
You may also send questions after the webinar to our team
(contact information is included at the end of the
presentation)
The webinar will be recorded and the recording will be
available on the HealthTechS3 web site:
www.healthtechs3.com
www.healthtechs3.com
HealthTechS3 hopes that the information contained herein will be informative and helpful on industry topics. However, please note that this information is not intended to be definitive. HealthTechS3 and its affiliates expressly disclaim any and all liability, whatsoever, for any such information and for any use made thereof. HealthTechS3 does not and shall not have any authority
to develop substantive billing or coding policies for any hospital, clinic or their respective personnel, and any such final responsibility remains exclusively with the hospital, clinic or their respective personnel. HealthTechS3 recommends that hospitals, clinics, their respective personnel, and all other third party recipients of this information consult original source materials and
qualified healthcare regulatory counsel for specific guidance in healthcare reimbursement and regulatory matters.
Instructions for Today’s Webinar
© HTS3 2020| 9
Presenter
Dr. Frank Mineo has been involved in emergency services for more than 40 years as a provider, educator, and leader in emergency response and management, environment of care, and life safety. Frank retired as a Deputy Chief, FDNY EMS in 1999; since that time he has worked at multiple hospitals in the New York area as a Director of Emergency Management and Environment of Care/Life Safety Compliance Officer providing consultation and leading programs related to emergency management planning/operations and Environment of Care and Life Safety. Frank earned his Ph.D. in Business, Emergency Services Organization and Leadership from Capella University in 2009 and an MPA from Baruch College in 1992. He is a Fellow of the American College of Healthcare Executives (FACHE), Certified Emergency Manager (CEM), Certified Healthcare Safety Professional (CHSP), and Certified Healthcare Emergency Professional (CHEP).
Dr. Frank Mineo,FACHE, CEM, CHSP, CHEP
© HTS3 2020
Program Description 10
Maintaining a safe physical environment of care for patients, staff
and visitors is more than being ready for a survey, and/or a plan or
policy.
Rather, it is the day-to-day focus by staff, at all levels, doing their
part to ensure that safety is a way of life, one which demonstrates
the reasons (and not the rule) for maintaining a safe environment
of care.
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So, What is Our Goal? 11
To maintain an Always Ready safety culture that promotes and
encourages active participation from all stakeholders in maintaining
the physical environment.
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Objectives 12
✓ Understand the reasons for maintaining a safe physical
environment of care.
✓ Understand the importance of department-focused daily
activities as part of an organizational culture of safety.
✓ See how written policies and management plans support
department ownership of safety.
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Establishing an Organizational Culture of Safety 13
A culture of safety is one that embraces a practice of
responsibility and accountability by staff at all levels
throughout the organization.
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Focus of the Environment of Care Chapter (TJC) 14
Safety and security: addresses risks in the physical environment, access to security-sensitive
areas, product recalls, and smoking.
Hazardous materials and waste: addresses risks associated with hazardous chemicals,
radioactive materials, hazardous energy sources, hazardous medications, and hazardous
gases and vapors.
Fire safety: addresses risks from fire, smoke, and other products of combustion; fire response
plans; fire drills; management of fire detection, alarm, and suppression equipment and
systems; and measures to implement during construction or when the Life Safety Code® *
cannot be met.
Medical equipment: addresses selection, testing, and maintenance of medical equipment
and contingencies when equipment fails.
Utilities: addresses inspection and testing of operating components, control of airborne
contaminants, and management of disruptions.Source: Joint Commission
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EOC Chapter Standards 15
I. Plans (EC.01.01.01)
II. Implement
A. Safety and Security (EC.02.01.01, EC.02.01.03)
B. Hazardous Materials and Waste (EC.02.02.01)
C. Fire Safety (EC.02.03.01, EC.02.03.03, EC.02.03.05)
D. Medical Equipment (EC.02.04.01, EC.02.04.03)
E. Utilities (EC.02.05.01, EC.02.05.03, EC.02.05.05, EC.02.05.07,
EC.02.05.09)
F. Other Physical Environment Requirements (EC.02.06.01, EC.02.06.05)
III. Staff Demonstrate Competence (EC.03.01.01)
IV. Monitor and Improve (EC.04.01.01, EC.04.01.03, EC.04.01.05)
Source: Joint Commission
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Special Note 16
Where this presentation will focus primarily on the Environment of Care,
participants should also ensure that associated chapters such as Life
Safety, Infection Control. Emergency Management, and Leadership are
assessed as part of an organizational compliance program.
Specific examples include the various NFPA standards (i.e., LSC 101 and
99 related to life and fire safety); including the requirement to ensure all
testing and inspection documentation is in order and available at the
time of a survey.
Organizations must also ensure through direct observation that all
required fire/life safety equipment, barrier designations as per the Life
Safety Plans, doors, etc. are functioning as designed.
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Top 10 Findings (2019 TJC) 17
1) EC.02.06.01 (maintenance of a safe environment), 56%
2) EC.02.05.01 (management of utility system risks), 53%
3) IC.02.02.01 (reduction of infection risk from equipment, devices and
supplies), 52%
4) LS.02.01.20 (maintenance of egress integrity), 50%
5) RC.01.01.01 (maintenance of accurate, complete medical records for all
patients), 49%
6) EC.02.03.05 (maintenance of fire safety equipment and building
features), 48%
Source: Joint Commission
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Top 10 Findings (2019 TJC) cont’d 18
7) LS.02.01.10 (minimization of fire, smoke and heat damage via building
and fire protection features), 46%
8) LS.02.01.30 (building features provided and maintained to protect from
fire and smoke hazards), 43%
9) LS.02.01.35 (fire extinguishment features provided and maintained) 43%
10) EC.02.02.01 (management of hazardous materials and waste risks), 36%
Source: Joint Commission
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What is a Management Plan?(EC.01.01.01)
19
Source: Joint Commission Perspectives 2013
Written management plans help the hospital manage risks.
These plans are not the same as operational policies or
procedures but provide a framework for managing the
environment of care.
© HTS3 2020
Example of a Management Plan 20
PURPOSE: This Safety Management Plan (Plan) provides a framework to
promote a safe environment for patients, staff, and others coming to our
facilities. This plan identifies the policies, programs, and processes used
to establish, support and maintain an effective safety management
program.
SCOPE: This plan shall cover all areas of the main campus and applies to
all staff including LIPs and Volunteers.
RESPONSIBILITIES: Department managers are responsible for area-
specific safety. Department leaders as the local “owner” have a
working knowledge of their areas and are best able to maintain a safe
workplace and to motivate employee safety.
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Paper to Practice Sequence 21
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Plan Effectiveness(EC.04.01.01; 03; 05)
22
Plan-Do-Check-Act
The hospital uses the results of data analysis to identify
opportunities to resolve environmental safety issues.
The hospital acts on the identified opportunities to resolve
environmental safety issues.
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PDCA Cycle 23
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Examples of Plan Metrics(EC.03.01.01)
24
The hospital establishes a process for continually monitoring, internally reporting,
and investigating the following:
✓ Injuries to patients or others within the hospital’s facilities
✓ Occupational illnesses and staff injuries
✓ Incidents of damage to its property or the property of others
✓ Security incidents involving patients, staff, or others within its facilities
✓ Hazardous materials and waste spills and exposures
✓ Fire safety management problems, deficiencies, and failures
✓ Medical or laboratory equipment management problems, failures and use
errors
✓ Utility systems management problems, failures, or use errors
Source: Joint Commission
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Let’s Discuss! 25
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Safety Plan(EC.02.01.01)
26
SAFETY IS EVERYONE’S RESPONSIBILITY!
Each staff member must…
• Report any/all safety hazards to a supervisor
• Report all accidents and/or injuries to a supervisor
• Know department alarms, emergency numbers, evacuation
plans, and emergency eyewash station locations.
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Security Plan(EC.02.01.01)
27
• Child Abduction (may be part of the emergency plan)
• Active Shooter (may be part of the emergency plan)
• Agitated or Violent Person
• Safeguard personal property
• Report all missing, lost and found property immediately
• Display ID cards on outermost garment.
• New for Covid-19-Visitor Policies
• No Smoking Policy
• Secure Area Access Policy
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Hazardous Materials Plan(EC.02.02.01)
28
• Spill Response and Management
• Chemical Inventory/Safety Data Sheets
• Special Areas (i.e. labs, infusion centers)
• Storage, Labels, and Handling
• Staff Education
• Personal Protective Equipment
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Fire Safety Plan(EC.02.05.01)
29
Fire Dos Fire Don'ts
Every employee must know
location of emergency exits, fire
alarm pull stations & fire
extinguishers in their work area.
Never block fire pulls stations!
Never block fire extinguishers!
Never block fire or smoke doors!
Never block fire exits!
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RACE and PASS 30
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Egress Essentials 31
All egress corridors, hallways, aisles must be kept clear so that nothing
blocks the movement of stretchers or people in the event of an
evacuation.
YES NO NO
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Keep Fire Safety Equipment Clear! 32
Blocked fire extinguisher
and medical gas valve
Blocked fire alarm pull
station
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Containment No…No! 33
This….
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Patient Room and Corridor Outside the Room(door open)
34
Can Lead to this:
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Special Considerations: MRI 35
MAGNETIC FIELD WARNING
If you work around extremely high field magnets such as magnetic
resonance imaging (MRI) machines, you should only have non-
magnetic fire extinguishers on hand.
The magnetic field of an MRI machine is strong enough to make a
steel cylinder fly across the room with lethal force.
This type of extinguisher is located around the MRI Unit.
© HTS3 2020
Special Considerations: Peri-Operative Areas 36
Estimated Frequency: 200-240 per year in the U.S
➢ 44% on head, neck, or upper chest
➢ 26% elsewhere on the patient
➢ 21% in the airway
➢ 8% elsewhere on the patient
Of the 200-240 OR fires per year in the U.S:
➢ 20 to 30 are serious and result in disfiguring or disabling injuries
➢ 1 to 2 are fatal
Source: AORN 2015
© HTS3 2020
Staff Focus: Evacuation 37
• Emergent - life-threatening-move now! (the Rescue in RACE)
• Urgent/Planned - have some time (hours to days)
• Horizontal - move to same floor to an area of safety (know
where to go for safe refuge)
• Vertical - move to different floor depending on location of
emergency (know how to move patient)
© HTS3 2020
Medical Gas Valves 38
Know who can shut them off, and which areas the valve controls
Never Block a Valve!
© HTS3 2020
Staff Focus: Gas Cylinders 39
• All tanks regardless of size must be in an approved holder or
chained to the wall to prevent falling
• Stored cylinders shall be secured against unauthorized access
• Ensure tanks are stored in proper rack (full/empty)
• Separation signage
© HTS3 2020
Medical Equipment Plan(EC.02.04.01)
40
• Equipment Inventory
• Inspection
• Missing and/or Damaged Equipment
• Temperature/Humidity Considerations:
follow manufacturers recommendations
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Utility Management Plan(EC.02.05.01)
41
• Loss of power
• Water
• Telecommunications
• Computer/IT Cybersecurity
Staff should know how a failure would affect them
and/or their patient!
© HTS3 2020
Ligature Risk: Organizational Focus 42
Source: GNYHA 2019
• Room Design
• Evaluation (risk assessment)
• Mitigation
© HTS3 2020
Emergency Preparedness 43
COVID-19 Pandemic has made this a focus area of surveyors!
© HTS3 2020
CMS Requirements(November 2019)
44
• Must have an emergency plan (policies and procedures)
• Conduct Risk Assessment (referred to as an HVA)
• Staff education and training (drills)
• Communication Plan
© HTS3 2020
Emergency Plan and Procedures 45
• CMS requires an All-Hazards Emergency Plan, one which
describes how the hospital functions in any type of emergency,
regardless of cause, impact, or areas affected
• Accrediting Organizations (AO) will examine the effectiveness of
your response to the Covid-19 pandemic
• Staff and patient safety, and Infection Control are areas of
surveyor focus!
© HTS3 2020
Emergency Plan and Procedures 46
• Portable radios
• Emergency backup telephone system
• EMERGENCY NOTIFICATION SYSTEM
• Overhead announcements (Plain Language)
• Runners and written messages
• Up-to-Date Contact List (staff, external agencies)
• Method to contact patient care providers and family
© HTS3 2020
When is a Plan NOT a Plan? 47
When it’s part of a daily routine!
© HTS3 2020
Brainstorm Ideas 48
Consider…How can your team work together to accomplish this goal?
Understand…There is no wrong way (other than doing nothing)!
All ideas are welcome!
© HTS3 2020
Examples of Easy Fixes (and citations) 49
• Storage under sprinkler heads (18-inch rule)
• Penetrations
• Combination Codes on doors
• Smoking
• Medical Gas Storage
• Chemical Storage
• Alcohol-Based Hand Sanitizers (ABHS)
• Eyewash Stations
• Hazardous Waste Storage
© HTS3 2020
More Examples (Infection Control) 50
• Adequate cleaning
• Linen on top of cart
• Solid bottoms to storage racks
• Storage of Supplies
• Emergency pull cords are appropriate and properly
maintained hang freely. Not tied or wrapped.
• Construction/renovation projects (infection control and
life safety permits)
© HTS3 2020
First Steps 51
• Daily rounds using a checklist
• Dedicated “safety champions” on each shift
• Easy incident reporting process (concerns, repairs)
• Multi-disciplinary rounding team (all staff levels)
• Accountability through department (local) ownership
© HTS3 2020
Summary 52
Management Plans drive the policies and processes needed to
maintain a safe environment of care…but its our staff that make a
safe environment a reality!!
To be successful, organizations must adopt a safety culture that
requires staff at all levels to adopt “When I see something, I can
and will do something!”
© HTS3 2020
From This to This(not just on survey day)
53
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Success Cycle 54
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Reason, Not the Rule! 55
Remember:
While it’s important and necessary to ensure compliance with rules
and regulations (i.e., Accrediting Organizations, CMS, OSHA)…
Its more about keeping our patients, staff, and visitors as safe as
possible every day!
© HTS3 2020
Questions 56
© HTS3 2020
Community Health Needs Assessments: More Than a Regulation – A Tool to Assist in Delivering CareDate : July 14, 2020 Time : 12pm CSTPresenter : Julie Haynes, Strategic Planning ConsultantPresenter : Faith M Jones, MSN, RN, NEA-BC Director of Care Coordination and Lean Consultinghttps://bit.ly/2ZqPgzr
Ask Carolyn – Your Swing Bed Questions AnsweredDate : July 24, 2020 Time : 12pm CSTSpeaker : Carolyn St.Charles, RN, BSN, MBA – Chief Clinical Officerhttps://bit.ly/2Zw55os
More Than a Plan: Keeping Your Physical Environment of Care Safe for Patients, Staff and VisitorsDate : August 7, 2020 Time : 12pm CSTHost : Carolyn St.Charles, RN, BSN, MBA – Chief Clinical OfficerSpeaker : Dr. Frank Mineo, FACHE, CEM, CHSP, CHEPhttps://bit.ly/3eRC5ho
Effective Communication in HealthcareDate : August 14, 2020 Time : 12pm CSTHost : Carolyn St.Charles, RN, BSN, MBA – Chief Clinical OfficerSpeaker : John A. Coldsmith, DNP, MSN, RN, NEA-BChttps://bit.ly/2AiNkAq
Bringing Care Coordination to Specialty Practices: Principle Care ManagementDate : August 27, 2020 Time : 12pm CSTSpeaker : Kevin Franke, BSN, Principal Consultant, Care Partner, LLCFacilitator : Faith M Jones, MSN, RN, NEA-BC - Director of Care Coordination and Lean Consulting, HealthTechS3https://bit.ly/3dQiaya
The Role of a Rural Hospital’s Board in a Time of Crisis: How the Hospital Board and CEO Ensure an Organization’s Success During COVID-19Date : September 4, 2020 Time : 12pm CSTSpeaker : Peter Goodspeed, Vice President of Executive Searchhttps://bit.ly/38fXyOI
Rural Healthcare Challenges in Times of ChangeDate : September 11, 2020 Time : 12pm CSTHost : Carolyn St.Charles, RN, BSN, MBA – Chief Clinical OfficerPresenters : Rhonda Mason, Cobre Valley Regional Medical Center; Margie Molitor, Hot Springs County Memorial Hospital; Deborah Morris, Blue Mountain Hospital; Terry Odom, Powell Valley Healthcarehttps://bit.ly/38gZWEI
Innovating Care Models for Opioid Use Disorder PatientsDate : September 24, 2020 Time : 12pm CSTPresenter : Rebecca Morgan, CEO, Spark Creative Presenter : Faith M Jones, MSN, RN, NEA-BC - Director of Care Coordination and Lean Consultinghttps://bit.ly/2ZyjQaC
The Hospital’s Role in Getting the Right Interim Leader – What Does it Need to Know?Date : September 25, 2020 Time : 12pm CSTSpeaker : Mike Lieb, FACHE – Vice Presidenthttps://bit.ly/2BvqXZ7
An Introduction to Our Cloud-Based Optimum Financial Statement Toolkit (OFST)Date : September 30, 2020 Time : 12pm CSTPresenter : John Freeman, Associate Vice PresidentPresenter : Kevin Stringer, Associate Vice Presidenthttps://bit.ly/2YPQG7G
ALL WEBINARS ARE RECORDED
© HTS3 2020| 58
We hope the information in this webinar has been helpful!
Please contact us if you would like to schedule a review of your facility,
or have questions about the presentation
Frank [email protected]
THANK YOU
Carolyn St.CharlesChief Clinical Officer,
HealthTechS3
Dr. Frank Mineo,FACHE, CEM, CHSP, CHEP
Carolyn St.Charles5110 Maryland Way
Suite 200Brentwood, TN 37027Phone: 206-605-3748