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EmCare’s South Division Honors Physicians of the Year

Posted on Mon, Nov 28, 2016
EmCare’s South Division Honors Physicians of the Year

EmCare’s South Division has had a great year, and recently came together to recognize the clinicians and operational teams responsible for the division’s success in 2016.

Held at the Renaissance Tampa International Plaza Hotel Nov. 1 and Nov. 2, the division’s Annual Leadership Meeting was comprised of a series of lectures designed to increase the leadership skills of Medical Directors and Nurse Leaders, including one on the opioid crisis by Steven J. Stack, MD, FACEP, immediate past president of the American Medical Association.

Terry R. Meadows, MD, FACEP, chief executive officer of the division, served as emcee for the event, and named the 2016 Physicians of the Year.

Cesar Carralero, DO
Broward Health Imperial Point
Emergency Department Medical Director of the Year

Hospital administration calls Dr. Carralero “the best thing that could have happened” to Imperial Point. Not only has he impacted the emergency department, but he has profoundly impacted every department that has contact with the ED.

A former engineer, Dr. Carralero uses ingenuity and experience from his previous career to develop solutions that lead to dramatic metric improvement. He began at Broward Health 10 years ago and has been at the helm in the ED for two years. He and his team are committed to improving the patient experience and improve quality. He works hard to create an environment of accountability by developing metric reports to help drive continuing process improvement.

When he is not at work, Dr. Carralero enjoys spending time with wife and two daughters and tending to his Bonsai trees.  

Uday Tata, MD
Piedmont Newton Medical Center
Hospitalist Medical Director of the Year 2016

Dr. Tata was serving as interim medical director while the program at Piedmont Newton was being revamped. Hospital administration quickly realized his value and pressured him -- and EmCare -- to get him to stay on as medical director.

From the day he took on the hospitalist team, Dr. Tata has led from the front, often making personal sacrifices to help when there were holes in the schedule. Hospital leadership said, “He is not just a physician, but a physician leader. He leads his team by example. He has leveraged his wealth of knowledge and experience both as a hospitalist and medical director to establish a solid program.” Dr. Tata is an active participant in facility staff meetings and serves on the hospital’s infection control committee.

According to his peers, Dr. Tata understands the importance of teamwork and collaboration. He has worked hard to rebuild the program by improving relations between hospitalists and the specialists in the community.

Mark Lemons, MD
Christus Spohn Hospital Beeville
Anesthesia Medical Director of the Year

Dr. Lemons has been a medical director for the last 12 years and is the co-chair of the anesthesia department at several EmCare client sites. He is calm and steady during times of stress, even in the worst trauma situations, according to his peers. He demonstrates confidence that makes people want to work with him, and he always has a smile and kind word. He is as comfortable in the OR as he is with his patients, and he displays genuine compassion to his patients and their families. 

Dr. Lemons has worked closely with the providers and staff in the OR to develop a collaborative team environment focused on patient safety and outcomes. Our clients have commented on the improvements that he has made, from customizing an accountability reporting program to implementing a cost-reduction program for pharmacy expenses to implementing process-improvement initiatives. His leadership has helped generate patient satisfaction scores in the 96 to 98 percentile.

Whether it’s leading the anesthesia program for student nurse anesthetists, promoting a team environment or sharing clinical knowledge with the CRNAs to strengthen the team, his peers said that Dr. Lemons consistently demonstrates his commitment to the practice, the organization and the hospital system.

When he’s not working, Dr. Lemons enjoys spending time with his wife and their two sons. He also volunteers at the local dog shelter and is a foster for abandoned dogs.

Winners were selected based on feedback from internal and external surveys. Congratulations to all of this year’s honorees!

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Leadership Lessons: Turn to the 3 Cs

Posted on Mon, Sep 19, 2016
Leadership Lessons: Turn to the 3 Cs

By Ginger Wirth, RN

Leadership often can be linked to the great military minds of our country. Generals Patton, MacArthur and even as far back as George Washington are considered some of the greatest leaders.

Being a strong leader has so many implications, especially when leading teams. Think about it: Almost everything that you do involves some sort of team, unless you’re performing a solo task. Most often there is one person who emerges as the leader of these teams. That leadership carries a responsibility to get the identified task completed and help the team meet its ultimate goal.

Strong leadership skills can be attained by focusing in three areas – the three Cs of leadership:
 

  1. Commitment: This is where leading by example comes into play. A great leader demonstrates his or her commitment to the cause often by being right there in the middle of it all, showing the team that they are willing to get right down and dirty with those in the trenches. When a leader works alongside the team, a very strong sense of teamwork develops. It also shows the team that you can evaluate how things are going when you are able to do the work.

  2. Confidence: Believing in yourself and your ability to lead a team will take you a long way! Make sure that you are self-aware, know your limitations, triggers and strengths. Use this knowledge to your advantage, and believe that you can get to the end point successfully. Oftentimes we need to take time to look in the mirror and know what traits within us may be a barrier to the team’s success.

  3. Communication: Be the kind of leader who makes sure that the team clearly understands the who, what, when, where and why of any project. It’s imperative that objectives are shared openly and honestly. A great leader demonstrates his or her trustworthiness, honesty and integrity in how they communicate to the team. A successful leader needs to “talk the talk” and be able to “walk the walk.”

There are many other traits and qualities that define a great leader and they’re certainly not limited to those listed above. But, whether you are leading the U.S. Military, a Fortune 500 company or your neighborhood watch group, these three areas are a fantastic starting point on your road to success.

Ginger Wirth

Ginger Wirth, RN, joined EmCare in 2013 as a Divisional Director of Clinical Services for the Alliance Group. Her goal is to make positive changes in healthcare by helping others focus on quality, excellence, and the overall patient experience. Wirth regards her role as Director of Clinical Services as the ideal opportunity to partner with nursing, physician and facility leaders to make positive changes to the entire patient care experience. Her 20-plus year nursing career has been dedicated to quality and excellence, promoting overall positive outcomes and safety for patients.
 

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Keeping Your Cool Amid the Chaos in the ED

Posted on Wed, Jun 29, 2016
Keeping Your Cool Amid the Chaos in the ED

By Ginger Wirth, RN

I’ve written about leading by example, and recently I had the opportunity to watch a fairly new leader do not only that but also lead from the front. I thought that I understood what that meant, but when I watched this medical director in action, it became even clearer to me.

I was observing processes in an emergency department and when I walked in at 10 a.m., things were clearly beyond the “norm.” I looked at the tracker and noted that names, numbers, different colors and flags filled the whole screen. There was nary a blank space to be seen. In the 24-bed department, the tracker told me that there were 18 patients waiting to be admitted and 11 of them were waiting for critical care beds. There also was a critical patient awaiting transfer. All of the other beds were filled with regular ED patients, and EMS was bringing more in the back door. I failed to mention that four of the critical care patients had been in the ED for more than 24 hours.

I saw the staff hurrying around the department, some looking more stressed than normal, while others maintained a smile despite the chaos. The medical director and I met in the ED at the same time. Without saying a word, she looked at me and I knew that she needed to fully assess the situation to determine the best way to help.

I watched her and was impressed. As many of us who have worked in emergency medicine know it’s frequently easiest to just grab the next chart and start seeing patients, go give the medication or provide the treatment. This medical director resisted that urge and she began making calls, activated the provider surge protocol, and assisted the facility and nursing leadership in implementing their capacity plan. The doctor remained in the middle of the nurses’ station directing the team, assisting advanced practice providers with reviewing discharges and turning over the low-acuity patients safely and rapidly. She also facilitated getting additional help for the hospitalists upstairs. They were able to get another hospitalist to come in and assist from the direction and notification from the ED SMD. She also made sure that the entire team was aware of the resources that were mobilized and what the plan was.

That entire scenario is exactly what I mean by “leading from the front.” Because of her leadership, providers and nursing staff were able to continue providing hands-on care to patients – and that’s exactly where we want them. The team felt comfortable knowing that the “administrative” stuff was being handled by the site medical director. By having the medical director there in the middle of the ED making calls, providing direction and supporting the staff, the team knew exactly what was happening and they were confident that relief was coming and beds would be found. While those calls could have been made in an office outside the ED, when action happens “outside” the chaos, many assume that nothing is happening. This frequently leads to dissatisfaction and low morale, and can have a negative impact on the care being provided.

On this day the team felt fully supported by the medical leadership in the ED. There was strong collaboration with nursing as well as the inpatient and administrative leaders. Frontline staff was able to focus on communicating with patients and their families about the delays and the plan going forward rather than making calls, assumptions and getting frustrated with the situation.

I know that this incident is nothing unique and there are EDs all over the country facing the same or similar days. I hope that they have nursing and physician leaders who can not only lead by example but also lead their departments and practices from the front.

Leadership requires collaboration, organization, planning and structure. It’s also important to be able to demonstrate the ability to stay calm in the face of stress, manage emotions – not only yours but at times the emotions of those around you – and to support and motivate the team. Be out there with your team, not only making sure that they believe you can do the things they are expected to do, but that you also are out there “in the trenches” with them.
 

“A true leader has the confidence to stand alone, the courage to make tough decisions, and the compassion to listen to the needs of others. He does not set out to be a leader, but becomes one by the equality of his actions and the integrity of his intent.”
-General Douglas MacArthur

Ginger Wirth

Ginger Wirth, RN, joined EmCare in 2013 as a Divisional Director of Clinical Services for the Alliance Group. Her goal is to make positive changes in healthcare by helping others focus on quality, excellence, and the overall patient experience. Wirth regards her role as Director of Clinical Services as the ideal opportunity to partner with nursing, physician and facility leaders to make positive changes to the entire patient care experience. Her 20-plus year nursing career has been dedicated to quality and excellence, promoting overall positive outcomes and safety for patients.
 

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5 Leadership Tips for Weathering Tough Times with Your Team

Posted on Wed, May 25, 2016
5 Leadership Tips for Weathering Tough Times with Your Team

By Ginger Wirth, RN
 
On a recent flight from Houston to Dallas I was stalled on the tarmac for almost 3 hours due to a horrible series of storms. When we finally were able to take off, I looked out of the window of the plane as we made our way into the sky and noticed the changes in the atmosphere. I saw the dark grey sky, storms and rain, change into just dark clouds, then white cotton-like puffs and eventually transforming into a majestic blue sky. It took the ascent to almost 30,000 feet to escape what was happening on the ground – a weather disaster to tranquility. How often do we get caught up in what is happening "on the surface" that we forget to see what is above us? Can we find calm, blue skies if we simply push past what surrounds us?
 
It’s easy to be stuck in the “thunderstorm” of what is going on around us. We feel the cold rain on our face, feel the shaking boom of the thunder and the flash of lightning. We conclude that it’s a "force of nature" and we have no control or recourse. We simply concede and eventually accept it as so. Inevitably it “the storm” will pass, but what happens when we simply choose to only live in that moment? Many times we get sucked into the darkness of the storm, and sometimes fail to see the positives or the opportunities that may hidden within.
 
In times like this, we as leaders have the unique opportunity to bring the team up to that 30,000-foot level.

 

  1. Recognize the situation. Don't ignore the potential flood that may be heading your way. Use this as a chance to rise above it. Encourage your informal leaders to step up and support their efforts. You would be surprised to see them shine when they know that you believe in them in times like this! Encourage those who are "on the fence" to participate in solutions to get through the challenge. It’s highly likely that you will find some new or undiscovered talent right in front of you!

  2. Communicate, communicate, communicate. Make sure that your team is aware of what’s happening. Don't assume that they know what’s going on even if they are in the middle of it. Make sure that all are aware of the solutions and the steps that are being implemented. Remember, teams are more stressed when they don't know what’s going on or don't know what’s being done to address it.

  3. Learn from each and every situation. Go back and dissect what happened. Recognize opportunities for improvement, solicit feedback from all members of the team, and duplicate and celebrate what went right. Behaviors will be repeated when there is positive reinforcement faster than when the focus is on what went wrong.

  4. Focus on the future. Make sure that the team knows that there are blue skies ahead. They need to believe that they will reach the goals, that this dark time will not be the norm. If for some reason it’s happening more frequently, they need to know that there will be a solution, and, when appropriate, that they can participate in that solution.

  5. Be an advocate and champion for change. Challenges will happen. It’s how we approach them and deal with them that will make the difference. Leading by example is always a good strategy. 

This concept can be applied to so many instances: personal, professional and leadership. Remember that once you break through that storm ceiling, there will be blue skies and calm winds ahead. How we prepare, react and deal with the blustering weather makes all the difference! It’s essential that you, as the leader, be the pilot, engage the team and help the team fly high and reach their potential! 
 
“Rise to the challenge of bringing your dreams to life! Do not be discouraged by resistance, be nourished by it. Success is the experience of rising to the level of your true greatness.” Dr. Steve Maraboli
 
Ginger Wirth

Ginger Wirth, RN, joined EmCare in 2013 as a Divisional Director of Clinical Services for the Alliance Group. Her goal is to make positive changes in healthcare by helping others focus on quality, excellence, and the overall patient experience. Wirth regards her role as Director of Clinical Services as the ideal opportunity to partner with nursing, physician and facility leaders to make positive changes to the entire patient care experience. Her 20-plus year nursing career has been dedicated to quality and excellence, promoting overall positive outcomes and safety for patients.

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Develop Your ‘A Team’ to Improve Employee Engagement and Enhance the Patient Experience

Posted on Mon, Nov 16, 2015
Develop Your ‘A Team’ to Improve Employee Engagement and Enhance the Patient Experience

By Thom Mayer, MD, FACEP, FAAP

Providing clinical care at the bedside is a difficult job that seems to get more so every day. Nowhere is that truer than the physician’s interaction with the patient in the emergency department and on to inpatient services.  The fiscal demands for improved patient satisfaction scores only add to the pressure. But how can we motivate physicians for service excellence?

Developing an “A Team” culture is essential—so your staff understands the traits of excellence exemplified by the A Team, as well as the demoralizing effects of B Team behavior.

The intention of customer service is almost universal, but the execution of customer service is often lacking. Unfortunately, patient satisfaction initiatives typically mean more work for clinicians that may even interfere with the care of their patient. In my opinion, if it doesn’t make the job easier, it isn’t really customer service.

Excellent customer service only takes place in an excellent work environment. If people don’t love their work, any customer service push will be in vain. A great work environment is created by great people. Therefore, the only way to achieve excellent customer service is to recognize and reward “A Team” clinicians and get rid of clinicians who are unwilling to change behaviors that have an adverse effect on the team and on the patient.

“A Team” clinicians are intrinsically motivated to care for their patients and do a good job. They are usually described as:
 

  • Communicator
  • Compassionate
  • Competent
  • Confident
  • Does whatever it takes
  • Has a sense of humor
  • Positive
  • Proactive
  • Teacher
  • Team Player
  • Trustworthy

“B Team” clinicians have a poisonous effect on their work environments. Their behaviors are predictable and subject to statistical analysis. Characteristics that typify them include:
 
  • “Can’t do” attitude
  • Confused
  • Constant complainer
  • Late
  • Lazy
  • Negative
  • Poor communicator
  • Reactive

Service excellence is good for the patient, the family, safety, risk reduction, market share and, yes, customer service scores.  But the No. 1 reason to get service excellence right in emergency and hospital medicine is that it makes your job easier!

EmCare works with physicians and nurses to create an “A Team” mentality so hospital clients can achieve their goals of improving communication, reducing left-against-medical-advice rates and improving patient satisfaction.

For more information about how EmCare can improve satisfaction and performance, visit the Resources section of our website.



Thom Mayer, MD, FACEP, FAAP, is an Executive Vice President with EmCare. He also is the Founder and CEO of Best Practices and serves as a Medical Director for both Studer Group and the NFL Players’ Association. Mayer has published dozens of articles and book chapters and edited 15 textbooks including the definitive text “Strauss and Mayer’s Emergency Department Management.” He has been recognized as Speaker of the Year by the American College of Emergency Physicians. On September 11, 2001, he served as one of the command physicians of the Pentagon Rescue Operation. Emergency departments under his guidance have won awards from Press Ganey, PRC, Gallup, the Robert Wood Johnson Foundation and others. Mayer’s academic appointments include Clinical Professor of Emergency Medicine at the George Washington and Senior Lecturing Fellow at the Duke University School of Medicine.

 

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