Revamped portal helps patients take charge

Technology has changed the way we do nearly everything, from how we watch TV to how we keep in touch with our friends, and even how we manage our health and wellness. CoxHealth has long been a leader on this front – in 2007 our Information Technology department earned the prestigious GE Innovator Award for Patient Express, one of the first online portals allowing patients to actively manage their health. To date, thousands of people have signed up to use this tool.

In December, the IT Internet Services team launched the newest version of this service, now called CoxHealth Express, with enhanced features and an even more user-friendly format. CoxHealth Express still includes many of the features people liked about Patient Express, including eVisits. It also adds new functionality, including the ability to schedule a physician’s appointment online with some of our clinics, the ability to view your lab results and more. 

Dr. Louis Krenn, chief medical information officer and physician at CoxHealth Center Willard, says he’s seen utilization of the portal increase dramatically since it re-launched as CoxHealth Express. He says the tool offers a number of benefits, but the most important is how it allows patients to take charge of their health care. 

“CoxHealth Express gives our patients the information they need to be better prepared for their appointments, take ownership of their health and really become an active partner in their care,” he says. 

The portal offers even more if you are a member of the CoxHealth Wellness program. Members use CoxHealth Express to access Wellsuite, the new online tool for managing your wellness. Wellsuite features an activity tracker, online tutorials for areas of health concern, a calendar of events and more.
Future upgrades to CoxHealth Express will include the ability to register online for classes, manage your Fitness Center membership and pay your hospital or physician bill.

If you had an existing Patient Express account, your information rolled over to CoxHealth Express. If you don’t have an account, you can sign up for CoxHealth Express at coxhealth.com, or through your Regional Services or Ferrell-Duncan physician.

Focus boosts satisfaction at Cox North ER

Cox North ER staff members, including patient care manager Lisa Busker (above), are taking time to highlight medication information and other vital details for patients during their discharge. The department recently implemented a program focused on reviewing the details with patients. That program has increased patient satisfaction scores on questions regarding discharge instructions by 14.9 percentage points.

When Rachel Wells enters a patient care room in the Cox North Emergency Department, she’s armed with more than just the usual syringe and gloves. She also carries a highlighter marker in the pocket of her scrubs.
 
She uses the marker to “Hit the Highlights” on patients’ written discharge instructions to make them aware of information concerning new medications that they’ve been prescribed.

Giving highlighters to the nursing staff is one of the creative ideas North ER leadership and staff brainstormed to improve patient perceptions of care on two patient satisfaction survey questions.

One question asks patients how often the patient care staff explained what a new medicine was for. The other asks how often patients felt the care and services received during the visit were well coordinated.

After implementing the strategies during the July-September 2011 reporting period, the unit had increased the score for explaining new medicines by 12.5 percentage points compared with the previous quarter. The question received a Top Box score of 87.5 percent, which moved them into the 95th percentile nationally for that question.

The score for coordinating care and service increased 8.3 percentage points to 66.3 percent, which placed the North ER in the 76th percentile nationally for that question.

Besides highlighting information about new medications, nurses also use key words during the discharge process to explain what new medications are for and any possible side effects to watch for when patients return home. After implementing “Hit the Highlights,” the unit also saw a 14.9 percentage point increase over the previous quarter for patient perceptions of clear and complete discharge instructions.

To improve medication communication for pediatric patients, nurses give parents an oral syringe with the dosage clearly marked so parents know exactly what dose to give their child when they return home.

To improve patient perceptions about care coordination, dry-erase boards were placed in patient care rooms. During assessments with patients, nurses write down each test and procedure the physician orders, such as X-rays or EKGs. As each one is completed, the nurse marks a line through the test. Patients see the progression of their care and what exam or procedure they’re waiting on.

“Patients have told us the new process made them feel like the staff was keeping them in the loop about what’s going on with their care,” says Misty Denevan, North ER director. “The use of these visual aids and the use of key words to explain the coordination of care and the new medications helped shape the patients’ perceptions about our consistency with these two important aspects of their care.”
 
“Just saying little things and making small process improvements that didn’t cost anything and didn’t take any extra time really improved our patients’ satisfaction,” says Wells.

Day One: Inside Steve Edwards' first day as CEO

Editor's note: On Jan. 3, I had the chance to shadow Steve Edwards as he took over as CEO, a role he calls his dream job. Here’s an inside look at his first day -- Randy Berger

CEO Steve Edwards is in a hallway meeting in Executive Administration when I arrive to shadow him for his first day on Jan. 3. He’s standing in an office doorway, talking with chief hospital officer Dr. John Duff. Almost as soon as I spot him, he’s on the move, headed down the hall and discussing an issue with vice president Brian Williams.

Even if you don’t work directly with Edwards, you probably know from seeing him walking through the halls at CoxHealth that his natural state is one of purposeful motion. This morning is no exception as I catch up with him on his way to the conference room, where the weekly Core Group meeting is about to begin.

“Are you ready? The day’s already half over,” Edwards says with a grin.

As the members of the Core Group take their places, he prepares to lead the first meeting of his tenure as president and CEO of CoxHealth. It’s the first step in a decades-long dream come true for Edwards. His desire to lead the system grew from a seed planted when he was a child, walking the halls of Cox North with his father, longtime administrator and CEO Charlie Edwards. Over the years, the younger Edwards nurtured that desire with a mix of determination and careful planning. Today he begins putting the full force of his dream into action.

Soon after he was named to the position last fall, Edwards likened the feeling to what a bull rider must feel atop a bucking beast in the chute in the final seconds before its release. As the clock ticked the last few months, Edwards used the time to meet with leaders and employees. He asked questions and got feedback. He laid out a 10-point pledge to employees here in Connection. He’s prepared everyone for a ride that will involve change, adaptation and evolution.

By the end of the day, it would become apparent that the dawn of his leadership illustrates the way Edwards approaches his work and his life. His pace is fast and his energy level is high. But underneath all of this action lies a detailed plan that is rooted in core values: being true to family and yourself, giving your all and serving your community.

8:30 a.m.

Members of the Core Group, a team of high-level CoxHealth leaders that focuses on overall strategy for the organization, follow a new set of “rules of engagement” handed out before the meeting – rules that call for a fast pace and active participation. Edwards says one of his immediate goals is less talk and more accountability in meetings. He prefers to keep things focused, find specific issues to be solved and then designate people to solve them.

The topics this day include access to Cox services and finding a way to standardize how CoxHealth measures “access” throughout the enterprise. The group also discusses progress toward Magnet status and the new Discharge Hospitality Center.

As the meeting nears its end, Edwards reminds everyone of what he expects from them. He needs their feedback, their support and a willingness to put in extra effort. There will be no shortage of challenges in CoxHealth’s immediate future, but he makes it clear he intends for CoxHealth to be second to none.

10:20 a.m.

Edwards is back at his desk in the corner office on the fifth floor of Hulston Cancer Center. The décor is still a work in progress, with one wall dominated by a Robert E. Smith painting and a framed certificate signed by president Woodrow Wilson when Edwards’ grandfather became a U.S. Postmaster. Edwards’ computer monitor is flanked by two notable birds: a bald eagle cast in bronze on the left, and Scrooge McDuck, animated advocate of “working smarter, not harder,” on the right.

After checking a few emails, Edwards calls a local florist to order flowers for his wife, Jennifer.

“I can’t do this job without her. I rely on her to do a lot of the things a typical dad would do. I try to make up for it on the weekends, but she makes it possible.”

Balancing work and family is one of Edwards’ top priorities. He’s passionate about both – it’s tough to leave his wife and kids in the morning and it’s tough to leave work at night when there’s always more to do.

That’s why his typical morning starts early.

When he said the day was half over at 8, he was only kidding a little. Today, he has gone through his usual morning routine, which has him up at 5, perusing the New York Times and Wall Street Journal websites. This morning, he also added a fresh coat of paint to his son’s Pinewood Derby race car, an ongoing father-son project.

By 6:30 a.m., he was getting in a workout at The Meyer Center, where he ran about five miles and lifted weights. By 7:45, he was headed to the office – “There’s not a lot of primping for me; the hair doesn’t take long.”

He had taken a few moments to draft a note to donor Ken Meyer, thanking him for his support of the facility. Edwards was struck by how busy the fitness center is and he wanted to let Mr. Meyer know how his generosity is benefiting the community. Edwards appreciates the power local leaders have to improve health and he’s glad to be among them.

“It’s rare to be a CEO of a large organization in the town where you grew up. You have to pinch yourself to believe that you’re in a position to influence not just the organization but the community.”

10:30 a.m.

Edwards checks in with executive assistant Vickie Nelson, who has a few memos for him to review. Stopping by Nelson’s desk is a regular feature of the day since she manages the calendar and organizes tasks. The phrase “I’ll ask Vickie” is one of the day’s most uttered.

 

Nelson is reviewing a request from a pair of doctors who want to join our network. Edwards heads down the hall to brief assistant vice president Amanda Hedgpeth (above) on the physician request – she’ll be in charge of finding out more and setting up initial meetings.

Back in the hall, there’s a question about the food for a noon board meeting. Edwards makes a single, simple request: Make sure it’s healthy.

En route to ask a question of Dr. Ken Powell, we walk with executive assistant Damaris Crow. There is a brief discussion about staff evaluations. As you can tell by now, the hallway walk-and-talk meeting is a key part of how things get done in Edwards’ day.

Edwards says the need to move quickly and use time wisely is simply a matter of adjusting to our rapidly changing business. The piece of advice he’s heard most in preparing to become CEO is “pace yourself.” He knows everyone who tells him that means well, but every life we touch is important and he’s not interested in moving slowly when the stakes are so high.

“For every patient we see, if there’s something we could be doing better, we need to do it – now,” he says. “We see 100,000 people a year in the ER. If we wait a month to improve something, we’ve affected 10,000 people.”

He says giving his all in his daily work is the least he can do.

“Think about how many kids’ games or holidays a nurse may have missed to do the work of patient care.

“To give anything less than everything you have is disrespectful to the people who have given so much to our organization.”

11 a.m.

Edwards begins preparing for his first speech to Systemwide Orientation that afternoon. After getting some input from orientation educator Joe Woodring, Edwards admits that he may wing it a bit, at least in the first week. He then turns his attention to email. In the inbox is:

• an email from Marketing & Planning VP Pat Walsh on the upcoming community perception study

• a joint commission fee invoice

• an email from a banker wanting to discuss ways to reduce an interest rate

• a note from his mom that reads: “Does it feel good sitting and working in your new office? I’m sure it must, have a great day.”

Noon

This Tuesday is one of only two or three days a month when Edwards has no lunch meeting scheduled, so we head to the cafeteria. As we’re eating, Edwards tells me about the shadowing he’s done in various departments during the last few months. It’s a chance to meet with the people who make CoxHealth function and see how their work is done. He says it’s eye-opening to see the organization from different viewpoints.

We finish lunch in a few moments and Edwards wonders aloud if he should help make a few omelets at today’s action station. In minutes, he’s behind the counter, having traded his suit jacket for an apron and a baseball cap, and he’s taking omelet orders during the lunch rush. Edwards chats with staff members, volunteers and the public as they select omelet fillings.

There’s a meeting scheduled for 1 p.m., and Edwards builds omelets right up until the last minute. He makes conversation with diners, but keeps an eye on the clock.

1 p.m.

We arrive back in Executive Administration for a quickly assembled meeting with Dr. Duff, Charity Elmer, Brian Williams and Jake McWay. The team has gathered to address an issue raised by a partner health care organization. During the next 40 minutes the team engages in a high-level debate. This decision-making process is at the heart of executive leadership, but those of us who don’t appear on an organizational chart rarely see it in action. While the content of the meeting is confidential, the team discusses possible options and weighs what each would mean for CoxHealth.

By 1:45, decisions are made, tasks are delegated and Edwards heads downstairs to meet with this week’s new employees. Edwards takes his spot in front of the group of 35 new hires and begins to talk about what it means to be a part of the CoxHealth family. He may be winging it by his standards, but it’s clear Edwards can deliver this sort of speech at a moment’s notice.

“We’re serving humanity, not doing factory work or merely treating broken bones,” he tells the group. “If you’re working on a hospital floor and you’re saying ‘there’s a gallbladder here’ or a ‘broken leg over there,’ you’ve already lost your perspective. These are not cases, they are people.”

He talks about the focus on safety and the responsibility we all have to make sure our processes are safe. He talks about what change means for the health system. In a time of rapid change, he says, it’s important to remember that the call to serve others is at the core of what we do.

“I want you to write down today why you came here and tuck it away,” Edwards tells the group. “You can pull it out next year, or in five years, and look at it to remind you of what brought you to CoxHealth.”

3 p.m.

After orientation, Edwards heads into a meeting with vice president Rod Schaffer for Schaffer’s annual evaluation. That 3 o’clock meeting is the final one on Edwards’ schedule. By 4:15, he’s back at his desk checking email. Since it’s the first official workday of the new year, today’s schedule is lighter than most. The end of the day offers a few rare moments of stillness, which we use to talk about the path that brought him to his new role.

He admits that when he was younger he briefly considered pursuing another field, one that would set him apart from the health care family in which he grew up. He pursued a liberal arts education, studying political science, philosophy and communication at Drury College. But by the time he graduated, his goal was clear: “I wanted to get the best experience and take it back to my hometown hospital to make it the best in the country.”

He went straight from undergraduate work to graduate school at Washington University in St. Louis. There, he was a young student among accomplished professionals, including attorneys and a neurosurgeon, who were pursuing a second degree. His classmates were extraordinarily bright, but many had a better handle on business, science and math than they did on the mission of health care that came so naturally to Edwards.

He was struck by the way topics like business ethics were taught in isolation, as though business consisted of constant work with numbers and spreadsheets punctuated by ethical decisions once or twice a year.

“Everything is an ethical decision,” Edwards says. “From putting together your own way of life that you can enjoy living to every resource you allocate in a business, it’s all ethical decisions.”

The ethical obligations that are a part of health care are obvious daily in a community like Springfield. At any given time, there are a dozen people Edwards knows personally who are our patients, which lends extra weight to the pursuit of excellence.

“I want to celebrate the successes, but you can’t ignore the fact that any time we fall short, there is a life affected,” he says. “People in the hospital are vulnerable. We are born here and we die here. What happens here is sacred and we need to be respectful of that. In a small town, you have very dear connections with people. Those connections are rewarding and they inspire your determination to do something right.”

5:12 p.m.

Brian Williams drops by the office to see if Edwards can discuss strategic planning with him and Scott Rogers. By 5:45, Edwards is headed back to his office to wrap up a few emails with the goal of being home by 7. That’s later than normal, but the kids are at tutoring this evening, which means he’s not missing time with them.

Edwards says keeping family at the center of his life is key to doing good work. Growing up, he read biographies from his father’s collection about business titans like Conrad Hilton and Colonel Harland Sanders. Those books focused on business, but they also contained lessons about work-life balance.

“Those people did great things. But if you read between the lines, you see they didn’t have the best family life.”

Edwards took that lesson to heart when making his career plans. Balance is now a guiding principle: He’s committed to his work, but he makes time for family, for rest and for exercise. And he says he likes to begin any project with the end in mind.
 
“I like to plan big things and let the spontaneous things exist between those events. Let me show you something,” he says, beginning to look through the neatly stacked items on his bookshelf. He pulls out a thick diploma cover that holds a certificate from his residency at Baylor Health Care. Tucked behind the certificate is a sheet of typing paper that’s beginning to yellow around the edges.

On it is a spreadsheet Edwards made in 1990. Mapped horizontally across the page are career and personal goals, each tied to a rough time frame. Finishing school, serving on local and state boards, owning a home, starting a family – all these goals are here, making his comment about liking to plan things appear to be an understatement. Right there, at age 45, is: “become CEO of CoxHealth.”

Edwards says that’s not the kind of thing you say out loud at age 22, but that goal and the others on the page have kept him focused on the ongoing task of becoming not just a leader, but the kind of person he wants to be.
 
“People may want to be the best accountant or architect that there is, but it’s not the profession that’s important,” he says. “It’s most important to be the best person you can be.

“Everybody is different with their own strengths and weaknesses, but there is brilliance in every one of us. There are tons of unique opportunities; you just have to put the right person in the right place so they can prosper. If you asked me about my ideal job, this beats shortstop for the St. Louis Cardinals. It’s the best job you could ever dream of. It’s an incredible sense of responsibility; you don’t want to let anyone down.”

The challenges ahead are great and Edwards frequently reminds us to be open to change and growth that will make us stronger. He holds himself to that same standard, knowing that while meeting those challenges will keep him moving constantly, he remains in the right place.

“You have to ask, ‘Does your job make you a better person?’ You should take a job that makes you become the best person you can be. The right job makes you better.”

CoxHealth named a U.S. News and World Report Best Regional Hospital

CoxHealth is among the nation’s Best Regional Hospitals 2011-12, according to U. S. News & World Report. The magazine publishes its well-known Best Hospitals rankings every July; at the midpoint of the 2011-12 year, the publication’s editors have now recognized 247 hospitals outside major metropolitan areas, including CoxHealth, as Best Regional Hospitals.

“All Best Regional Hospitals are what we call ‘high performers’ in at least one medical specialty,” says Avery Comarow, U.S. News Health Rankings Editor. “They are fully capable of providing first-rate care, even to most patients who have serious conditions or need demanding procedures.”

This summer CoxHealth was recognized by U.S. News as a high-performing hospital in gynecology; ear, nose and throat care; and neurology and neurosurgery.

About CoxHealth: CoxHealth is Springfield’s only locally owned, not-for-profit health system. It is accredited by The Joint Commission and distinguished as one of the nation’s Top 100 Integrated Healthcare Systems (2006-2012).

About U.S. News: U.S. News annually evaluates nearly 5,000 hospitals in 16 different medical specialties. Hard numbers stand behind its analysis in most specialties – death rates, patient safety, procedure volume and other objective data. Physicians’ responses to a national survey, in which specialists are asked to name hospitals they consider best in their specialty for the toughest cases, also are factored in.

CMN Hospitals receives grant from Kohl’s Cares

Children from Ed V. Williams Elementary in Springfield attended an assembly on Friday to learn about staying heart healthy – in kid-friendly way. It’s the kick-off of a new partnership between CoxHealth Children’s Miracle Network Hospitals and Kohl’s Cares that aims to identify children at risk for obesity and heart disease, and teach them and their families how to live a healthier lifestyle.

Childhood obesity has become an epidemic in the United States, and southwest Missouri is not immune. Poor eating habits, improper nutrition and a lack of exercise can lead to serious health problems as children grow. With the $45,020 donation from Kohl’s Cares, CMN Hospitals is launching the Kohl’s C.A.R.D.I.A.C. Fun program, which will work to fight the childhood obesity epidemic through a variety of fun events aimed at children ages 5-18 and their families. Through the program at-risk children and adolescents will be identified and will be able to participate in a number of fun events with their families, where they can learn more about living a healthy life. 

 “Studies have shown us how widespread and dangerous the epidemic of childhood obesity is. We’re thankful to Kohl’s Cares for this grant, and we’re thankful that with it we’ll be able to make a real impact on the health of local children,” says Lauren Holland (above), CoxHealth Health and Wellness coordinator and Kohl’s C.A.R.D.I.A.C. Fun coordinator.

Kohl's commitment to CoxHealth and Children’s Miracle Network Hospitals is made possible through the Kohl's Cares cause merchandise program. Through this initiative, Kohl’s sells $5 books and plush toys where 100 percent of net profit benefits children’s health and education programs nationwide, including hospital partnerships like this one. Kohl's has raised more than $180 million dollars through this merchandise program. In addition to the merchandise program, Kohl's Cares features the Kohl's Cares Scholarship Program, which last year recognized more than 2,100 young volunteers with a total of $410,000 in scholarships and prizes. 

Through Kohl’s Associates in Action volunteer program, more than 385,000 associates have donated more than 1.2 million hours of their time since 2001 and Kohl’s has donated more than $35 million to youth-focused nonprofit organizations. Kohl’s also offers fundraising gift cards for schools and youth-serving organizations. For more information, visit Kohls.com/Cares.

CoxHealth named Top 100 Integrated Health Network

CoxHealth has been named to the IMS Health Top 100 Integrated Healthcare Networks listing for the seventh year in a row – one of only three health systems in Missouri to make the list.

The IMS Health Top 100 list is the nation’s premiere integrated healthcare network rating system. Each year IMS evaluates nearly 600 health systems from across the country based on their ability to operate as a unified organization in each of eight categories: integration, integrated technology, contractual capabilities, outpatient utilization, financial stability, services and access, hospital utilization, and physicians.

“Integrated care means better care, and we are proud to be recognized as one of the most integrated health systems in the nation,” says Steve Edwards, CoxHealth president and CEO. “Our staff and our physicians work hard to provide a seamless, coordinated experience for our patients, and we’ve invested heavily in the tools and technology they need to achieve this goal.”

The listing was previously performed by research company SDI, which was purchased by IMS in 2011; CoxHealth is ranked 79th.