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.

Comments

[LeAnne]

Nice interview - I hope you and your colleagues don't have to get more experience dealing with hurricanes this year.

LeAnne