Knoxville: I do declare!: The first few weeks

Physicians Regional Medical Center from the air

Hey everyone! I’ve enjoyed reading your blog posts and imagining where you all are in your residencies. This is an exciting time. Rachel and I have loved it here in Knoxville. The people are funny, the weather is great, and the internship has been phenomenal. It’s been nice to be near her family in Atlanta and my dad in SC. Claire is now walking/running everywhere, so our lives have become a bit busier trying to keep track of her. She likes to put my hospital badge around her neck and waddle around the house. I knew she was destined for healthcare!

My preceptor is the COO of the hospital and has been a huge supporter. He’s a VCU grad so he hasn’t quite received the caliber of training that we have (haha), but he’s really invested in ensuring that the residency is a great experience. HMA entered the Knoxville market in October 2011 after they bought the 7-hospital Mercy Health Partners system. Mercy was formed in 2008 from the merger of two faith-based health systems. HMA has encouraged the hospitals to keep the faith-based culture, so many of our meetings begin with a spiritual thought and a prayer. Very interesting to see that. It’s been fascinating to speak with associates about the changes they’ve faced from transitioning from a deep-rooted faith-based organization to being part of an investor-owned company. That will be a post for another day. All in all, HMA acquired 7 hospitals and 29 clinics in Knoxville and the surrounding areas. I am located at the 400-bed Physicians Regional Medical Center, about 10 minutes from downtown Knoxville.

The hospital (and HMA) has had few, if any, administrative interns in the past, so I’ve been given a lot of freedom to do whatever will give me the best experience. I love that. I’ve spent time with employees in each department to better understand their role, their challenges, and what keeps them coming to work every day. Some of the more notable experiences are: I watched a laparoscopic robotic surgery, I put on a hair net and apron and helped on the tray line of the cafeteria (I was definitely the bottleneck there – who knew there were so many types of jello?), and I spent a shift with the security officers. As I go to each department, I’m humbled by how little I really know about healthcare delivery. There is so much that goes on behind the scenes, even though I only really think about the patient, nurse, and doctor. It’s been an eye-opening experience.

I have two main projects right now. When Mercy Health Partners was formed in 2008, they closed the doors of one of their large hospitals. This created a void in providers for the South Knoxville area, so an outpatient facility was built to recoup some of those losses. The facility currently has about 8,000 square feet of vacant space, and my project is to determine how to best utilize that space. I’ve been doing market research to better understand the demographics and healthcare needs of the areas the facility serves. Next week I will speak to physicians practicing there to gauge their interest in expanding their services. Ultimately I will provide recommendations and create a business plan for the service to be implemented there.

The second project deals with improving throughput in the ED. I’ve been observing patient flow and recording timestamp data to understand where the inefficiencies are. Sandy would be so proud! (I almost called her last week to ask a question, but couldn’t quite do it). The goal is to cycle admitted patients through the ED in less than 180 minutes, but the majority aren’t being admitted until 250-300 minutes. I don’t think they’ve really ever collected this data, so there’s a huge opportunity. HMA looks at the ED as the entry point to the hospital, so hopefully this project will have a lasting impact on the whole organization.

Sorry to write a novel, but this is the last (and most interesting) part. Since I was a little kid, I’ve dreamed of flying in a helicopter. Well that dream came true on Tuesday! I spent a 3-11pm shift with the LifeStar helicopter crew, and it was AWESOME! I drove to their base in Sevierville, about an hour from the hospital. Once I arrived, we suited up and were called out to transport a man who’d had a massive heart attack. We dropped him off in downtown Knoxville and then flew around the city for a while. We circled Physicians Regional (hence the picture at the top) and then they asked where I lived. We flew to my apartment complex and Rachel came out to see us. It was pretty funny how excited I was. We got another call later for a 17-year old who had a self-inflicted stab wound to the heart. We went to a landing zone in the mountains and picked him up to transport him to UT. This one was a bit more serious, and I was amazed at how quickly and efficiently the flight nurses handled everything. All in all, it was an incredible experience. They said they have ride-alongs all the time, so you all should ask around and go out if you get the chance! Here are some pictures: