Gary Passama

Gary Passama retired as president and CEO of NorthBay Healthcare on March 31, 2017. An active blogger since 2010, here’s a collection of his work.

Making the Pond Bigger

June 25, 2015
 

Earlier this week, in "More Fish, Bigger Pond," I addressed the continued rising demand for NorthBay Healthcare's two emergency services even though we started two new urgent care programs ("Care 'til 8") at two locations of our Center for Primary Care.

The shortage of primary care physicians, not addressed by the Affordable Care Act ("Obamacare"), means more patients for the same number of providers.

We are working hard at NorthBay to find ways to make care more accessible and to use our existing resources as productively as possible. We changed processes and sought new ways to increase patient throughput and improve patient satisfaction. That is part of our "Lean" journey.

We have had success in NorthBay VacaValley Hospital's emergency service with our "In Quicker" appointment service. Patients with problems that are not true emergencies, but which may need immediate attention, can go online at www.northbay.org and make an appointment to be seen at a specific time. They do their waiting at home instead of the lobby of the ER.

Last week we reviewed the first 10 months of "In Quicker." 

Well more than 100 patients per month have scheduled appointments at NorthBay VacaValley Hospital's emergency service. In fact, 96 percent of our surveyed patients have indicated they would welcome using "In Quicker" for their family and friends. About 79 percent of NorthBay VacaValley Hospital "In Quicker" users registered for their visit using a mobile device. Of them, 61 percent were female. The average age of users was 31.

Of the users of "In Quicker" at NorthBay VacaValley Hospital, 33 percent did not have a primary care physician, yet another indication of the inadequacies of the Affordable Care Act. This is quite telling given the increased use of NorthBay's two emergency services.

Many of the "In Quicker" patient comments were interesting:

* "It was quick and easy, much better than waiting in the hospital waiting room. It was very nice, thank you."

* "I was pleased that I could wait from home, and that when I came the wait was fairly short."

* "Brilliant minds. The only word I can think of to describe all the people who came up with the appointment online ER. This is the best thing anyone could have thought of… I was very pleased, took a few flyers to hand out."

* "Great! Quick and easy."

With demand mounting and resources constrained, it is going to take new thinking and flexibility to care for patients. We must find ways for the pond to become bigger.

Comments

 
  1. Gary Passama
    July 31, 2015 at 01:04
     

    And here’s some more input on the subject from our Human Resources Department: NorthBay strongly supports employees’ career development and upward mobility. Upward movement of staff depends on having both the requisite education and licensure, but also the necessary clinical experience required to provide the level of patient care needed. Admittedly, gaining the work experience post a degree program can be a challenge and we are sympathetic with new graduates’ frustrations. However, NorthBay cannot compromise its standards when it comes to well-established minimum qualifications for employment or promotion.

     
  2. Gary Passama
    July 29, 2015 at 02:54
     

    Lorraine Martinez: Again, some feedback and clarification from Rhonda Martin could be helpful: “Graduate nurses applying for a Clinical Nurse I position only have licensure requirements. New positions open as skill mix allows on our units. Experienced registered nurses applying for a Clinical Nurse II position are required to have six months to one year of acute care experience, depending on the department. One year of skilled nursing care, long-term acute care or acute rehabilitation is equivalent to six months of acute care experience for our noncritical care units.”

     
  3. Gary Passama
    July 29, 2015 at 02:53
     

    Lindsay Hunter: Thank you for sharing your concerns. I’ve asked Rhonda Martin, interim vice president and chief nursing officer, to clarify some details and share NorthBay’s perspective on this matter. “Our foray into the use of Nurse Practitioners has grown steadily. Although we cannot create a specific job for each nurse who graduates with an advanced degree, we do create positions as they are needed to support advanced medicine, close to home. In a manner most consistent with enhancing patient outcomes, we have added nurse practitioner (NP) positions. As to experience required: job descriptions in fact require two years clinical experience, although it does not specify experience as an NP. The work of an NP is overseen by the medical staff, so there is input from the medical staff on experience level needed for specific jobs.”

     
  4. Lorraine Martinez
    July 25, 2015 at 11:48
     

    I agree with Lindsay Hunter above. I am a CNA at northbay and I am currently finished with all nursing prerequsets to enter nursing school and I am on the waitlist at solano communty college and applying to other school. My plan was to get as much experience in the hospital as I could before nursing school and have a foot in the door so after school I could work for Northbay but I recently found out that I would have to have 2 years experience in a SNF before being able to apply to Northbay. I feel that even though I wont have 2 years as a RN in the hospital I still work on the floor side by side with RN's and already in the NorthBay system and know and practise the NorthBay way already.

     
  5. Lindsay Hunter
    July 04, 2015 at 07:49
     

    One solution to the shortage of primary care physicians is to continue to utilize nurse practitioners within NorthBay. I am currently in a Family Nurse Practitioner program and am scheduled to graduate May 2016. I was told by human resources that in order to work as a nurse practitioner at northbay you need 3 years experience. I LOVE Northbay and have worked here for the past three years. I have zero desire to leave Northbay and seek employment anywhere else. However, if there are no nurse practitioner opportunities for me within the organization then I may need to. It would be amazing if we could consider hiring current Northbay employees who are new grads into a FNP position even if we don't have the work experience yet. Why not transition staff who already exemplify the Northbay Way and are dedicated to our organization over into a position where there is such a need? Just a thought! : )

     
 

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