Mark Reed Hospital and Grays Harbor Public Hospital District No. 1’s new chief executive officer, Renee Dunham, who began Aug. 1 after her longtime predecessor Jean Roberts retired, has no problem with small towns. She grew up in one – Monroe (though the town northeast of Seattle’s been growing.)
Before coming to McCleary, Dunham, 30, worked for seven years at a hospital in the Eastern Washington town of Dayton, northeast of Walla Walla. Dayton is smaller than Monroe and just a bit larger than McCleary.
In fact, the previous hospital Dunham worked for is much like McCleary’s, she says. Both are critical access hospitals, which means, among other things, that they’re rural, not close to other hospitals and offer emergency care.
Dayton General Hospital, part of the Columbia County Health System, has 25 beds, as does Mark Reed, though the health system in Dayton also has a nursing home and two rural health clinics. Mark Reed has a primary care clinic on site.
Mark Reed’s staff numbers 73, the equivalent of 46 full-time employees, and the hospital district extends from the boundary between Grays Harbor and Thurston counties to the Satsop River and from the boundary between Grays Harbor and Mason counties to Gibson Creek, near Porter.
Both Dayton and McCleary hospitals have also had similar challenges, Mark Reed’s new CEO says. “I’m very familiar with the challenges, because they had all the same ones.”
Cash flow is “probably the biggest” of those challenges, Dunham says. But “cash flow is tough for all small hospitals. It’s nothing unique to Mark Reed. Funding to purchase large capital improvements is difficult, as well,” Dunham says.
As a public hospital district, Mark Reed receives revenue from taxpayers living within the district. But that doesn’t raise enough to completely support the hospital, and Medicaid and Medicare reimbursements can take several months to receive. There are fewer patients with insurance, nowadays, as well, she says.
However, the hospital is leasing a new CT (“CAT”) scanner, which should be operational early next month or maybe even late this month. “We’d love it to be late September,” says Dunham, obviously excited about having the new piece of diagnostic equipment, which means more patients will be able to use Mark Reed Hospital, instead of having to travel to Olympia or elsewhere.
The increased number of patients visiting Mark Reed because of the available CT scanner is expected to pay for the cost of leasing the special imaging device. A pad is being poured for the modular unit that will house the CT scanner outside the hospital’s emergency room, and the construction is going well and so far is on target, Dunham says.
Education, experience, enthusiasm
Dunham’s experience includes being the director of quality improvement and patient safety at the Dayton hospital. She was also laboratory manager and, after earning a master’s degree in health care administration, worked full time in administration, including helping change the “culture of the district as a whole.”
“We were working with Virginia Mason and trying to implement some of the Toyota production theory of manufacturing into health care.” The Seattle hospital has “a wonderful model of how manufacturing can be applied to health care to make it more lean and more efficient,” she enthuses.
“It revolves around also changing the culture of the organization to be a blame-free culture and a shared-accountability culture.”
Dunham’s duties included “helping the employees to realize how they could improve their physical work space and work environment, as well as the overall atmosphere, making it more positive and more productive to patient care and patient safety, implementing a patient-and-community-comes-first type of culture within their organization,” she says.
As the Patient Safety and Quality Director, Dunham headed a staff of 130. Her work also involved implementing “best business practices” and performance improvement at the facility, developing a “Medication Reconciliation program” in the system that reached a 93 percent improvement in medication errors, achieving revenue growth of 7 percent in 2004 and 10 percent in 2005 and increasing efficiency.
She also established a laboratory internship program for high school and college students and led a survey team that ensured compliance with Medicare and state licensing requirements.
Last year, the Dayton facility was recognized by the Institute for Healthcare Improvement; Qualis Health, a private, nonprofit healthcare quality improvement group; the Washington State Hospital Association and the Washington Health Foundation for improving its quality of care.
In addition to her experience and her master’s in health care administration, Dunham is also a board certified medical technologist, graduating with honors and among the top students at the Sacred Heart Medical Center in Spokane in 1999. During her clinical training, she was employed as a hospital phlebotomist and lab assistant. She is also a board certified clinical laboratory scientist.
‘A country girl’
In other areas of her life, Dunham says, “I’m kind of a country girl,” who loves horses – including her two quarter horses, Zip and Taylor – other animals and anything else outdoors, such as hunting, fishing, camping and hiking. She’s recently taken up golfing, as well.
Though she wanted to live in the hospital district, after looking for a place for about three months, Dunham has purchased a home between Montesano and Brady. She needed some land with pasture and something that was “pretty much already set up for that,” she says, so “for now this will work.”
She’s also anxious to get to know her the community and says in a statement she wrote for the hospital board and the community, “I am committed to being a sincere, straightforward, hard-working leader, both within the hospital district and the community.”
She wants to be a “transparent leader who shares information in an open and honest forum, to be energetic and provide the necessary vigor to stimulate change, and to make value-driven decisions that are fair, honest and equal to all parties,” her statement continues. And “I am committed to including the community and employees in every step of the process. I will enlist feedback and input and try my best to incorporate those responses into the work I do. I want the community, employees and board to have a great sense of pride and ownership in the hospital district as a whole.”
In her office last week, Dunham enlarged on her statement: “I’m committed to doing a good job here and serving the community in what they need and making this hospital what the community would like it to be, not what we think it should be.
“That’s really important to me.”
Toward that end, Dunham says, she wants “the community to be able to ask questions and get answers.”
Having a new CEO at the hospital is an “excellent opportunity for this community to be heard and to come to me and tell me what their concerns are, what their issues are” she says. “It allows them to come to somebody who’s not going to be defensive because I don’t have a history here. I’m looking at this with fresh eyes and an open thought process.”
That thought process includes the possibility that there could still be a new hospital. Three times, the district tried to get voter approval to sell bonds to build a new hospital, but the proposal failed each time to get the voter support it needed.
However, Dunham says, “if the hospital wants to continue to provide excellent high level of care and meet the needs of the community, they do need a different space.” But “how we achieve that, I’m not sure yet,” she admits, though “I would love to have the community’s support to be able to do that in the next couple of years.”
But, she stresses, “the hospital needs to be sure that we are supporting our community just as much as we’re asking them to support us.”
‘Jobs, people and economy’
Mark Reed is a “huge asset,” Dunham says. It “brings jobs to the community; we see customers outside of our district using our services. If there was ever a natural disaster, the community would have the hospital here to support them if they were unable to get the services somewhere else.
“The hospital also is able to support the community business leaders and the businesses that are within McCleary and Elma and Malone,” the newCEO says. “We bring jobs and people and economy.”
Dunham isn’t concerned only about patients; she’s interested in helping people stay well and has already contacted schools in the area toward that end. She says she’d “love to see the hospital develop a good, strong relationship with the schools” and is especially interested in seeing schools help her “coordinate with Elma and McCleary and get us together as a hospital district” to join the push to become “the Healthiest State in the Nation.”
She’s also looking into the possibility of students helping with Mark Reed’s Web site, “to come up with some creative design elements and help do some of the Web site itself. I think that would be a lot of fun.”
Dunham is also becoming involved with the Chamber of Commerce and Rotary Club, and about a dozen of the hospital’s staff members, including its CEO, helped stage the recent Outlaw Days Parade in Elma and rode in the procession on eight four-wheelers.
In short, Dunham says, any opportunity that the hospital has “to partner and have a collaborative type of relationship with the community I’m very interested in.
“This hospital needs to belong to the community – the entire hospital district.”
Source: The Vidette, September 6, 2007, story by Tommi Halvorsen Gatlin