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Ugochukwu “Ugo” Uwaoma, MD
President, Medical Group and Provider Services
Trinity Health of New England
Hartford, Conn.
Q: Briefly describe your current role and professional responsibilities.
A: I serve as the leader for all Medical Group and Provider Services-related entities and practices, including all ambulatory and hospital-based providers. All total, our group includes about 1,000 physicians and advanced practice providers across Connecticut and Massachusetts.
Q: You transitioned jobs during an unprecedented global health crisis. What did you do to prepare to hit the ground running in your new position?
A: I was able to prepare for my new position by focusing on the following three things:
- Self-reflection. Before beginning my new role, I asked myself, “What went well in the last role? What did you learn about yourself and leadership? How do I unlearn from one organization and prepare to be curious and learn in the new environment?”
- Spending time with family. During the most challenging period of the pandemic, I spent time with loved ones in Washington state. Spending that extended period together with family allowed me to recharge and prepare to jump back into long work hours.
- Building relationships before day one. I identified some key stakeholders at my new organization and began reaching out to connect and get to know my future coworkers before I even began the new role.
I have been very blessed to have a supportive leadership team at Trinity Health of New England. President/CEO Reginald J. Eadie, MD; Senior Vice President/Chief Clinical Executive Syed A. Hussain, MD; and other colleagues have made the transition much easier than anticipated.
Q: What are some of the specific challenges your medical group has faced during the COVID-19 pandemic? And what solutions have you/has your team devised to overcome those hurdles?
A: Since the onset of COVID, our patient visits have declined roughly 50%. We had to quickly address issues related to the safety of our members and colleagues, PPE supply and margin erosion. Because elective surgeries were on hold, several physicians provided surge staffing to our ICUs.
Trinity Health also established a national incident command structure and included our Regional Health Ministry. The framework has allowed us to manage the peak of the pandemic. We have since begun focusing on a emergence recovery plan built around five pillars (safe operating procedures and elective surgery ramp-up; national virtual and in-home care; optimizing non-acute configuration; operating model size and scope; and delivery system design and configuration), each with a dedicated multidisciplinary team.
With these countermeasures we were able to leverage virtual care across the continuum to a peak of 70% of our visits. We have recovered close to 85% of our surgical services, and ambulatory visits are within 5% of our pre-COVID levels.
Q: How is your organization preparing for a possible second wave of COVID-19 cases or future emergencies?
A: We are building on the learnings we’ve gained and the successes we have achieved with continued hardwiring of virtual health. We are also maintaining our COVID-free zones and processes to include our specialized fever and upper respiratory infection (FURI) clinics. Lastly, our regional incident command center structure remains in place with continued planning and monitoring of our national, state and local COVID-19 activity.
Q: Burnout and fatigue are major concerns for many clinicians right now. How is your organization supporting the wellness of your physicians and other front-line workers?
A: Trinity Health has expanded the employee assistance program and made work-life services available for free. These services have provided access to confidential, professional guidance and counseling to help employees develop preparedness plans, create care plans for dependents, talk to children about the outbreak, manage nuances during difficult times, and cope with personal anxiety and uncertainty.
This year has brought us all unprecedented stress and for some, especially physicians, it can be very difficult to seek help when feeling overwhelmed. Following our commitment to the health and well-being of our medical staff, physician trainees, providers and colleagues, Trinity Health is sponsoring its third annual campaign to raise awareness of physician suicide in September. The goal is to open the topic for conversation, and present information on prevalence, signs of suicidal ideation and how we can respond.
We have also increased leadership rounding to help check in and care for each other.
Q: What role has ACHE played in your professional development?
A: I have significantly benefited from my ACHE membership. The networking has allowed me to connect with local and national peers to gain advice and share best practices. The focused materials I have received at the annual Congress on Healthcare Leadership and Physician Executive Forum meetings have all been helpful, and I have taken advantage of ACHE’s career resources (including career counseling and resume review), publications and books.
Editor’s Note: Are you interested in being featured as our Member Profile subject in an upcoming issue of the Physician Executive Newsletter? If so, email Shannon Barnet, content marketing strategist, ACHE, at sbarnet@ache.org.
Physicians and Nurses: Uniting on the Front Lines
By Timothy M. Carrigan, PhD, RN, FACHE
Despite the turbulence we’ve seen in 2020, healthcare professionals have met the challenges presented by the pandemic with perseverance, innovation and empathy. Direct care clinicians, including physicians and nurses, have come together to handle unprecedented surges of sick patients and devise resourceful care delivery solutions.
Like many hospitals and health systems across the globe, Loyola University Medical Center began to see an influx of patients requiring inpatient care for COVID-19 in mid-March. The organization had to act fast to dedicate numerous units to the exclusive care of patients with COVID-19, including ICUs, general floor areas, and areas for pediatric and obstetric care.
Although the changes we made were quick and disruptive to our typical day-to-day operations, effective collaboration between physicians and nurses on the front lines and all the way up through executive-level leadership made those transitions less disruptive to normal patient care. Our direct care clinicians made recommendations to the physician and nurse leaders working with the incident command center team to make decisions quickly.
Let’s take a look at how to foster an environment that breeds collaboration and positive working relationships between clinicians, even during the most difficult times.
3 Tips for Effective Clinician Collaboration
The relationship between physicians and nurses has evolved considerably over the last 50 years. While nurses might once have been viewed as “assisting” the work of physicians, much of that has changed as the scope of nursing practice has become more deliberate, distinct and evidence-based. Still, disagreements and areas of tension may still occur between clinicians from time to time. When that happens, it helps to focus on these three best practices:
- Promote patient-centered care versus discipline-focused care. Throughout the pandemic, the most important goal has been to protect the health and safety of our patients, visitors/families and staff. Our true north has been to prevent unnecessary exposure and preserve PPE. Focusing on safety and wellness has removed much of the focus on specific positions and what each discipline or role traditionally provides for patient care. For instance, to prevent multiple staff members from entering the room of patients with COVID-19-like symptoms, physicians would obtain cultures to send to the lab during exams, something nurses or other clinicians typically do.
- Ensure all professions are practicing at the height of their licensure. The practices of medicine and nursing are distinct and separate professions. Having both doctors and nurses practice at the top of the scope is always important, and became even more critical during the height of the pandemic. The circumstances created by COVID-19 led Loyola and other health systems to truly capitalize on advanced practice nurses and physician assistants for both telehealth and in-person visits. Top of license practice allows both APNs and PAs to independently assess, diagnose and treat patients. This is particularly important during a health crisis when resources and manpower are limited, and the principle is relevant at all levels of clinical care. The COVID-19 pandemic has shown just how important this is, as APNs and PAs have taken on new responsibilities in areas where physicians may have previously practiced.
- Play to clinicians’ strengths at a systems level. By nature of nursing education, nurses are taught to be critical thinkers, problem solvers and coordinators. When physicians and nurses collaborate at a systems level to create care pathways, it’s important to consider the unique strengths of each clinical profession. One ongoing problem related to COVID-19 is hospital visitor restrictions, which limit in-person family and caregiver involvement with patients’ discharge plans. This problem provided an opportunity for nurses to coordinate care differently, by using various technologies as well as discharge phone calls to involve family members in the patient's post-acute plan of care.
Caring for Caregivers Amid COVID-19
Making sure clinicians are working collaboratively with one another is crucial to ensuring the best possible care delivery for patients. That said, it’s also important to make sure our healthcare organizations are taking care of our caregivers as well, especially during these trying times.
One powerful tool Loyola Medicine has embraced during the pandemic is debriefing after critical events. Whether the critical event is related to COVID-19 or not, our clinical team are coming together after each traumatic experience to regroup, discuss the emotions around the event, review the work that went into the care provided and identify areas of improvement. Not only have the debriefs allowed physicians, nurses and other staff members to lean on one another, they have also helped leaders identify people who may need additional check-ins or to be referred to more formal assistance programs.
Debriefing has been a valuable tool for Loyola Medicine’s clinicians, but we know from research that ensuring the wellness of care providers must be multimodal. As healthcare professionals review the operational, clinical and financial lessons they have learned from leading through a global pandemic, considerable attention must also be paid to the ongoing support physicians, nurses and other front-line workers will need to recover from delivering patient care during these trying times.
Timothy M. Carrigan, PhD, RN, FACHE, is the CNO of Loyola Medicine in Maywood, Ill. (timothy.carrigan@lumc.edu).
ACHE understands the COVID-19 pandemic has impacted healthcare professionals across the globe. To help healthcare leaders continue to grow and learn, we are offering a 25 percent discount on the registration fees for all paid live webinars, webinar recordings and online seminars now through Dec. 31, 2020. Learn more here.
New National Action Plan for Patient Safety Released
The Institute for Healthcare Improvement-convened National Steering Committee for Patient Safety has just released a National Action Plan intended to provide health systems with renewed momentum and clearer direction for eliminating preventable medical harm. Safer Together: A National Action Plan to Advance Patient Safety draws from evidence-based practices, widely known and effective interventions, exemplar case examples and newer innovations. The plan is the work of 27 influential federal agencies, safety organizations and experts, and patient and family advocates. Learn more about the plan—and access the self-assessment tool and implementation resource guide—here.
Virtual Customized Education for Your Organization
With so much change affecting the way we live, work and learn, ACHE is now offering virtual Choice, enabling leaders to continue to invest in their organization at their own pace.
Choice, ACHE’s customized professional education series, allows leaders to choose from a variety of program formats and topic areas, including quality and safety, executive leadership and physician-executive partnerships. Now, ACHE will bring our experts to you virtually to provide convenient, cost-effective education designed to meet your organization's learning needs and close competency gaps.
Our program specialists will help you assess your needs, build a program and provide resources to promote your virtual event. Visit ache.org/Choice and get started today.
Advance Your Career With ACHE Resources
ACHE is committed to supporting our clinicians and physicians transitioning to healthcare executive roles. We invite you to explore our resources for physician executives, available to support the unique career development needs of members with clinician and physician backgrounds. Resources include articles, books, assessments and more.
Joint Accreditation for ACHE Education Programming
ACHE has your education needs covered. In addition to offering continuing medical education (CME) for physicians, ACHE also offers contact hours for continuing nursing education, continuing pharmacy education credit and physician assistant continuing education. All in-person events, online seminars and live webinars are approved for Joint Accreditation.
Please visit the continuing education information page on ache.org to learn more.
Connect With Forum Members
Looking to connect with your Forum colleagues? You can locate them at the ACHE Member Directory. Scroll down to the "CEO Circle/Forums" drop-down menu in the directory, select "Physician Executives Forum" and look for the "PE" icon beside their names.
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Please note that any views or opinions presented in this online newsletter are solely those of the author and do not necessarily represent those of ACHE.