Search Quest Example

SearchQuestSM

NAME: Administrative Director, Cancer Center
DATE:
POSITION:

ORGANIZATIONAL OVERVIEW
1. Describe your current organization (please provide an organization

chart).
 Community healthcare system with 3 acute care hospitals- 489 beds, 1 LTAC-

114 beds, 14 clinics and over 7,000 employees. (See org charts, Cancer Care
reports under the Ambulatory Care and Medical Specialties)

2. Please provide a brief overview of the area of responsibility that you
currently lead and direct. Indicate scope of operations and departmental
structure, budgetary oversight and number of FTE’s.

 I have financial oversight for a $66M service line and 130 frontline staff.
Operational oversight across 2 acute care hospitals in Medical Oncology,
Infusion, Radiation Oncology, Oncology Navigation, Genetics, Cancer
Psychotherapy, Cancer Registry & Quality Program, and Breast Care Centers.
Direct reports include 10 leaders across the service line. I have a dyad
partnership with the Oncology Medical Director.

3. Describe your organization’s corporate culture, your impact on the
culture and the morale within your organization and your department?

 The system culture is very patient centered and rooted in the Christian
tradition. The corporate culture has undergone significant change the past 2
years with numerous changes in the leadership structure and new personnel.
They are continuing to develop the new corporate culture; during times of
change there is significant stress, uncertainty and high turnover. The current
turnover for new employees hired within a year is 30% which is significantly
higher than the national average.

 The culture in cancer care is much different. The oncology staff are very
engaged and feel completely supported by the cancer care leaders. There
have been significant investments over the past 3 years to raise cancer care
staff engagement and satisfaction within cancer care.

 The message that I and my leadership team deliver to the staff is positive and
unified. We stress that the organization is working through strategies, their
positions are secure and they will continue to be supported.

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4. Discuss service excellence within your organization. List any customer
service assessment tools used and pertinent results.

 The Press Ganey tool is used to assess our patients’ experience. We measure
against the top box score for the overall rating of care question. The outpatient
service survey is utilized for our 4 infusion centers. The latest results place all
infusion areas at the ≥ 90% as compared to all facilities nationally. In our
Medical Oncology and Radiation Oncology Clinics, the medical practice survey
is utilized. The percentile rank for our provider group has improved from below
the 50th percentile to the 75th – 80th percentile over the last year and a half.

 Improvements in both areas were due to the following strategies:
o Standard communication with all staff in regards to overall results, trend
scores, and results of question analysis.
o Targeted improvement strategies focusing on 1 specific question within
the survey.

VIEWS and OPINIONS
5. In your view, what are the issues that most affect Radiation Oncology

facilities and what trends will shape and influence Radiation Oncology
services over the next five years?
 Advanced therapies, such as SRS/SBRT will require fewer treatments than
conventional therapies and lead to fewer radiation therapy visits per patient.
However at this time even though there are fewer visits, the reimbursement is
considerably higher than conventional therapies. As SRS becomes more
common place, I would expect reimbursement to fall.

 Hypofractionation which delivers fewer but more intense fractions has shown
to provide equal or improved outcomes as compared to standard IMRT for
many cancers. The use of hypofractionation results in fewer visits per patients,
decreased volumes and fee for service revenue.

 Continued confusion around screening guidelines especially with
mammography and PSA testing may negatively impact screening volumes in
some areas which in turn effects cancer treatment volumes.

6. What do you consider to be the role of an Administrative Director,
Cancer Center with respect to the executive team, the medical staff, the
clinicians and patients?

 The administrative director role in respect to the executive team and medical
staff is to act as a liaison between upper administration and the cancer care
physicians and staff. The director needs to communicate organizational vision
and strategy down and to communicate cancer care needs upward.

 I am most familiar with the Cancer Center Director being in a Dyad partnership
with the Cancer Center Medical Director. In my current Director role I work
closely with the Medical Director and provider group to ensure operational
efficiency and to support their clinical practice. I work closely with the

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management team to support the front line staff in taking care of patient
needs. I focus all efforts on providing patient centered care while maintain a
balance with supporting providers and frontline staff.

7. Discuss how you adapt and how you assist your staff in adapting to the
fast changing technology in the Medical Oncology and Radiation
oncology field.

 Change is the new norm, and that is communicated to staff on a regular basis.
When implementing any change, it is important to follow a process. I assess
the stakeholders to better understand any concerns or feedback. I
communicate the background and the rationale for the change and guide
leaders and staff through the change. I engage frontline staff whenever
possible to identify improvement strategies and follow the PDCA cycle.

8. Are you a visionary? Why?
 Vision requires that one clearly sees where you choose to be in the future,

identify and take the necessary steps to get your program/organization there. I
work with others to create a multi-year plan to move the program to the next
level. I am not content to stay with the norm; I strive to advance the program.
I have the passion, and doggedness to stick with something until the goal has
been achieved. I have used my passion to inspire others to follow. Several
examples:

o Implementation of SuperD- technology used to biopsy peripheral lung
lesions; the second system in the state of WI. This technology helped
increase our thoracic program volume by 30%.

o Transitioned all of our breast centers to full field digital technology,
becoming the first system in the state of WI to be completely digital.

o Worked to develop and implement a survivorship program before the
CoC identified this as an accreditation standard.

o I believe there are opportunities ahead to use telemedicine for clinic
visits for a subset of oncology patients.

9. Are you a good decision-maker? Why?
 One of my best skills is the ability to make good decisions, to feel comfortable

and confident and accept accountability for the decision. Before making a
decision I gather pertinent data and seek feedback from stakeholders before
presenting the rationale and along with the decision. Whenever possible I
collaborate with a team of staff/providers before making a final decision. I allow
staff to be involved in the decision making whenever possible. There are
times however when staff do not have a say in the decision; I clearly identify
those as decisions as being “non-negotiable”.

 I also believe if you are unwilling to make a decision you cannot move forward.
Decisions should be made good intent, be patient centered and fiscally
responsible. If the decision made does not result in the outcome expected,
then use the PDCA cycle, check and reassess.

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ACCOMPLISHMENTS and EXPERTISE
10. Discuss your involvement in managing the potential of your area of

responsibility. List significant accomplishments achieved at your
direction that improved the patient’s experience in your facility.
 I am a very engaged leader and actively involved in all the areas that I
oversee. Significant accomplishments within my current role at HealthEast,
which have positively impacted the patient’s experience are as follows:

o Created a system strategy for cancer and breast care. Standard
processes across all sites have increased the patient’s experience by
creating the same ambience, same atmosphere, same processes, so
patients know what to expect no matter which site they receive their
services at.

o Redesigned the care navigation model so every patient is assigned a
RN Navigator. The new model allows the RN’s to follow the patient
through the entire continuum of care from diagnosis, through treatment,
and end of life. Prior to the redesign, the navigator program was
focused at diagnosis and start of treatment. The RN’s did not have the
time to focus on the continuum of care beyond initial start of treatment.

o Redesigned the patient schedule in our main comprehensive breast
center, which has improved patient access and allows for same day
needle biopsies based on patient preference. Patients have provided
very positive feedback in regards to having a same day biopsy option.
to

o Implemented a 12-week Survivorship Series, which goes above and
beyond the survivorship care plan. This 12-week series is offered to
our patients at no charge and allows them a variety of experiences to
help reduce anxiety and improve their quality of life. Sessions focus on
meditation, yoga, healthy cooking, sexuality, etc. This has been very
well received by our patients.

o Implemented new technology: Varian TrueBeam which allows us to treat
patients with SRS and 3D mammography which reduces call backs for
our patients.

11. What tools do you use to provide management and operational
leadership?

 Daily huddle call and standard huddle form: My leadership team and I
participate in a huddle call every day at 9am. There is a standard form that we
use to keep us all informed of the daily operations, and identify any concerns
or issues that need to be escalated to a higher level. (See attachment)

 Frontline staff rounding: I round in all areas at whatever site I am working at
on a particular day.

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 VBI Boards (Value Based Improvement Boards): All areas within the
organization have an improvement board in their individual work areas.
Specific department metrics are tracked by the frontline; these metrics support
the foundational pillars of the organization: Clinical Quality, Patient
Experience, Employee & Physician Engagement, and Smart Growth &
Financial Health.

 Regular reporting of operational metrics: new patient volumes, third next
available appt., unused appts, no show rate, etc.

12. Describe your approach to coordination, evaluation and supervision of
clinical function and activities in multiple treatment centers.

 When I first moved into the director role within my current organization, the
staff did not feel valued, there were different clinical practices and operational
practices amongst the sites, as well as clinical staff that were non-union and
union. One of the first things I did was to create a leader structure that I
believed would be value added and hire competent leaders to fill those roles. I
am very involved from an operations standpoint. It is important for me to
understand the work flow within all the areas of cancer care. The cancer care
managers and I have a daily huddle call as described above. I have a very
open door policy and my leaders frequently connect with me during the day if
they have any concerns or simply want to run something by me. My schedule
allows me to spend 3 days at one site and 2 days at another site; this allows
me to round with most staff on a weekly basis. The 2 RN Clinical Managers
over Medical Oncology work extremely closely to ensure that processes are
the same, and that staffing is covered. The Radiation Oncology Manager and
Breast Care Manager have oversight for all centers within their area of
expertise, which helps to build a cohesive program. We also use the same
approach and standard work for our frontline staff meetings in all areas.

13. Please relate your experience with fiscal operations as it pertains to
budgeting of medical supplies, personnel and expenses relating to
direct and indirect patient care. Describe a successful project that you
developed or led that significantly increased bottom-line revenue.

 I am extremely comfortable with operational budgeting and capital budgeting.
Since labor is one of the most significant expenses that we can influence, we
track HPUs on a daily and weekly basis to ensure we are staying within the
budget target.

 There have been two recent successful projects that have led to increased
revenue:
o Our system was losing significant revenue with GYN ONC patients; due
to lack of a GYN ONC surgeon. Our PCP’s were referring all GYN
ONC cases to a local competitor for surgical reasons; however those
referrals never came back within the system for medical oncology or
radiation oncology services. We worked on a collaborative partnership
with the private GYN ONC surgeons to provide surgical care within our

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system when possible and to refer patients back to our oncology
providers for treatment. Within the first 4 months we had 20 surgical
cases which would have gone outside the system prior to this
agreement this has resulted in over $200K. In addition we have had
some patients referred back for oncology treatment.
o The other recent project was implementation of 3D mammo. Over the
past year we had lost $900K in screening mammogram revenue due to
patients leaving our system to go elsewhere for 3D imaging. Due to
severe financial constraints within the organization, it required
significant effort to bring this to the attention of executive leadership and
make the case for this technology. This improvement will make a
significant impact with increasing screening volumes, which brings in
significant revenue from screenings, diagnostics, biopsies, and cancer
treatment.

14. Describe your efforts and results relative to retention, recruitment and
training of qualified staff.

 When I became the Director of Cancer Care at my current organization, the
staff morale was low, especially in Medical Oncology. The staff felt passionate
about their patients, but did not feel valued by the prior director or the
physicians. One of the first things I focused my energies on was to support
the staff and let them know they were valued. There are approximately 130
frontline staff in Cancer and Breast Care, less than 10 have left over the last 4
years. The staff that left have either retired or moved out of the area, with the
exception of 2 who simply were not happy with the current environment.
Efforts that have helped:
o Cancer Care Appreciation Day: every other month we celebrate
cancer care staff appreciation. I send out an inspirational message
to all the staff via email. The cancer care leaders go around to each
facility and department; they distribute a token gift and hard copies
of the inspirational message. We thank the staff for everything they
do for our patients. The staff really look forward to this, the
inspirational messages are found hung up at many of the nursing
areas, bulletin boards and individual work spaces.
o We have developed orientation plans and a buddy system so new
staff that we have hired have felt comfortable and valued from the
start. New staff also have an opportunity to shadow in other areas
of cancer care so they are well rounded in the services we offer and
get to know staff in other cancer care departments.
o We hold 2 events each year that the providers host: a bowling event
in the winter and a picnic in the summer.
o As a cancer care group we volunteer for several events each year:
Feed My Starving Children, and we support several needy families
at Christmas.

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15. Indicate your experience with remodeling or construction of treatment
centers.

 I have had the opportunity to be actively involved in the design and build of
several cancer centers and breast centers. Most recently I have been involved
with a new Cancer Center at our Woodwinds Acute Care hospital. I have
participated from the visioning stage to the design, build and opening of the
center. This has been a 2 phase, multiple year project. The Radiation
Oncology Center opened in March of 2015; state of the art technology was
installed: Varian TrueBeam along with Vision RT Motion Management system.
We are currently in the final FF&E selection process for the Medical Oncology
and Infusion center. The Medical Oncology addition is expected to open Jan 2,
2017. I would be happy to discuss the plans and rationale for the design.

16. Relate your involvement in radiation safety. Discuss your experience
with JCAHO, NRC, state agencies and other surveys. Discuss pertinent
results.

 I am knowledgeable of the regulatory requirements in regards to radiation
oncology, however the medical physicist handled all radiation safety and
regulatory requirements at my current and prior organization.

 I am extremely knowledgeable and have oversight for all mammography
regulatory requirements.

 At our recent JCAHO survey, I acted as the scribe for the ambulatory surveyor.

LEADERSHIP
17. What is your definition of leadership? Relate the most difficult decision

you have made in a leadership role.
 I strongly believe in servant leadership. As a servant leader I am there to

establish a clear vision, share that vision with others and support the team
along the journey. I believe in supporting and growing each individual member
on the team to develop and utilize their highest skill sets.

 The most difficult decision/s I have made while in a leadership role deal with
staff. In my current role and at my prior organization I have had to reduce
FTE’s. I look at the business needs of the organization, gather data to support
my decision and be as objective as possible. Anyone who states this is easy,
doesn’t truly care about people. Layoffs, or workforce reductions impact
people’s lives; nothing to take lightly. Emotionally I struggle, but I do not shy
away from making difficult decisions. I try and be as sensitive and respectful
to the individuals involved as well as the team. The two times I have had to lay
off staff, we parted on good terms and with mutual respect.

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18. What makes you an “enhancement leader” with respect to team
building, quality outcomes, cost containment and revenue generation?

 I relate to and connect with people very easily. I am very adept at reading
body language and picking up on nonverbal cues. When building a team, I
identify people’s strengths and use those strengths to benefit the team as well
as whatever project is being worked on. Currently I have one leader who does
an outstanding job with metrics and has a wonderful ability to display the
metric in a visually appealing and easily understood manner. As a team we
work together to identify opportunities for expense reduction and ideas to
generate revenue. I rely on my team members using their individual strengths
to help make the best decision.

19. How do you win the support of others and get them involved? Give an
example of a situation when you convinced others to follow your point
of view.

 I am a very down to earth, sincere, honest and collaborative person. I win the
support of others by supporting them, listening to their ideas, being open to
change, and encouraging others to challenge my thoughts.

 Example working with a provider: One of our medical oncology providers had
an extremely busy practice, he took pride in the “number” of patients he could
see each day. With a daily average of 16 -18 oncology patients on his
schedule, he was often behind more than 1 hour. While patients loved this
physician, they did not find waiting to be value added time, especially when
they were not feeling well or anxious about recent scan results, etc. I
facilitated an A3 project where we developed a future work flow to reduce
patient wait times and thereby increased patient satisfaction. In order to
collect the data we needed, I convinced 6 providers to fill out a manual
tracking form for just over 300 patients. While this might seem simple it was a
huge accomplishment to get them all to take time during their clinical exams to
track data. I made the process as simple and easy as I could to engage
them. This data then allowed us to measure several processes. Based on the
results, we created separate RN time in the Epic schedule. This allowed the
RN’s 15 minutes of dedicated time to complete their assessment prior to the
MD coming in the exam room. The data also convinced the provider with the
extremely busy practice that not all FU appts. could be accomplished in 15
minutes. Guidelines were developed for patients appropriate for a 15 minute
FU visit and which patients would need a 30 minute FU appt. This project was
a huge win for the providers, the nursing staff, and ultimately the patients.

20. Discuss your view of the team concept and the role you play. What
drives your team? What do you do to initiate, stimulate and reward
positive performance?

 Teams are a group of people working together to achieve a common goal. My
role depends on the team. I have acted as a facilitator, team leader, and
general participant. In regards to my management team, we are a very close
knit team. I have worked hard to support each individual member and coach

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them in growth opportunities. Even though they report to me, I am simply a
member of the team; we are there to support one another. I am very direct but
also extremely fair and compassionate. I celebrate their successes, routinely
send personal notes to their homes; treat them to quarterly thank you lunches,
provide consistent positive feedback, support them when they take time off,
and encourage them to always strive to improve.

 I am very blessed to work with a team that will not hesitate to help me in any
way and will do anything in their power to support me.

21. What elements do you find most important in maximizing productivity?
How do you maximize your own efforts and your own successes?

 Productivity can be maximized by understanding the work flow, streamlining
processes, focusing on reducing waste, engaging frontline staff in problem
solving and providing recognition and celebrating successes.

 On a personal level, I am my worst critic and hold myself to extremely high
standards. I always try to improve and set personal goals for myself. I am
very organized and review priorities on a routine basis.

CAREER
22. What are the “drivers” in your career and your long-term goals?
 What drives me is always striving to provide high quality, outstanding customer

service along with an optimal patient experience for each patient, every time.
It is a blessing and a privilege to be able to impact a patient’s life when they
are vulnerable, to impact their life in a positive way. I am passionate about
programmatic development in order to improve the lives of our oncology
patients.

23. Please discuss your present compensation and benefits package? What
are your obstacles to relocation?

 Current compensation salary with an opportunity for an annual bonus based
on achievement of organizational goals. I currently have 5 weeks of vacation
plus holidays, short and long term disability, life insurance, and medical.

 To relocate I would need to sell my current home, be provided with temporary
housing until permanent housing can be found and a full move package.

24. Is there any additional information about you or your career that would
help to support your candidacy for this position?

 I recently took several leadership assessment tests with the following results:
o Watson-Glaser test which measures critical thinking; I scored in the
94%.
o Wesman Personnel Classification Test which measures strategic ability;
I scored in the 93%.

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USING A NUMERICAL RANKING FROM 1 TO 10, WITH 10 BEING THE
HIGHEST, PLEASE RATE EACH WORD LISTED BELOW FROM YOUR
PERSPECTIVE AS BEING MOST LIKE YOU.

LEADER 10 KNOWLEDGABLE 8
VISIONARY 8 MENTOR 9
PRACTICAL 8 GOAL-ORIENTED 10
ENTHUSIASTIC 10 TEAM PLAYER 9
ANALYTICAL 9 COMPETITIVE 9
CARING 9 DECISIVE 9
EGO 7 ETHICAL 10
SOCIALIZER 7 STRATEGIST 8
TIMELY 8 VISIBLE 9
INTELLECTUAL 8 RELATER 8

25. Please list up to 5 professional references that we have your
permission to contact. Please provide the name, title, and current
telephone number.

Thank you for completing

Mission Search’s SearchQuestSM

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