Chapter 19: The Patient Education Office in MD Anderson’s Organizational Structure, Past and Present
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Description
Ms. Villejo describes organizational restructuring that has led to Patient Education reporting to the administrative director of Radiotherapy. She critiques the administration’s decision to hire her replacement in a Directorship position rather than as an Executive Director. She notes that as the institution expands, the Patient Education Office does not have the staff to take on projects that would make a difference.
Identifier
VillejoL_03_20150605_C19
Publication Date
6-5-2015
City
Houston, Texas
Interview Session
Louise Villejo, MPH, MCHES, Oral History Interview, June 05, 2015
Topics Covered
The University of Texas MD Anderson Cancer Center - An Institutional Unit; Building/Transforming the Institution; Growth and/or Change; Institutional Processes; MD Anderson in the Future; Critical Perspectives on MD Anderson; Beyond the Institution
Transcript
Tacey Ann Rosolowski, PhD:
Well, can we move on and talk a little bit about the institution? I wanted to talk about change at the institution. Because obviously in the time you’ve been here it’s gone through a lot of changes. And in most recent memory of course there’s been a lot of transformation since 2011 when Dr. DePinho came and also at that time, I think it was shortly thereafter, maybe it was in 2012, Steve Stuyck retired, which had a direct impact on patient education, because there was a lot of restructuring. So maybe that would be a good place to start. The restructuring what was the home for—you said you had four bosses.
Louise Villejo, MPH, MCHES:
Mm-hmm. Mm-hmm. In the last two years. So when Steve left, they were starting to restructure Public Affairs, which was our division at the time, to combine with Marketing. At the beginning Physician Relations, but they moved on to another department. And Development.
Tacey Ann Rosolowski, PhD:
What were some of the reasons for those shifts?
Louise Villejo, MPH, MCHES:
Well, I think they were looking at it. They renamed our area Institutional Advancement. So I think they were looking at us as really groups that worked very closely together anyway.
Tacey Ann Rosolowski, PhD:
So was this creating a new division?
Louise Villejo, MPH, MCHES:
Mm-hmm.
Tacey Ann Rosolowski, PhD:
OK, a Division of Institutional Advancement.
Louise Villejo, MPH, MCHES:
So I know that they were just trying to pull the resources together that worked very closely together anyway that would advance the mission of the institution internally and really a lot of facing externally. And then they also developed a department. Oh gosh. I’m not going to remember the name of it right now. I’ll think of it in a minute. And then so that was—so in Public Affairs and Volunteer Services also was involved with that. Volunteer Services, Children’s Art Project, Public Education, and Patient Education. We were all part of Public Affairs. So then we all went over to Institutional Advancement. And of course the volunteers are both in the community and mainly in the hospitals and clinics. And then our role is very internally focused obviously. So that made us a little bit different than this other big group that was internally but mainly externally focused. And then the senior VP for Clinical Operations at the time was very interested in restructuring his area. And he saw a role for Patient Education in that restructuring. And so he very shortly—so I reported to Jo Ann Ward, who was the associate director for Public Affairs right after Steve left. And then moved over to Gerard Colman, who was the senior VP for Clinical Operations. So he was envisioning—and he also brought askMDAnderson, which was another department under Public Affairs. And I think that was pre Epic but they were considering that because they had already promoted somebody to oversee electronic health record type issues. And so he was seeing us in one group. And so we moved over to him in September and I think he announced that he was leaving in December. So—
Tacey Ann Rosolowski, PhD:
This was September of what year, 2013?
Louise Villejo, MPH, MCHES:
Must have been. Yes.
Tacey Ann Rosolowski, PhD:
OK, so then he left.
Louise Villejo, MPH, MCHES:
Then he left. And then he had actually about thirty direct reports. So when Dr. Buchholz was given—so then that left a big gap and Dr. Buchholz I believe was over that big—the physician-in-chief and so forth at the time. So obviously he didn’t need thirty people plus his thirty people reporting to him. So what they did was they reorganized. All the center administrative directors reported to Gerard Colman. And so they reorganized everybody that reported to him to four division administrators. So each division administrator got like Surgery, Medical, and DI, and those kind of things. And we were put in the area for the administrative director of Radiotherapy. And so was askMDAnderson and the International Center. So we’re little odd ducks in there. But we were supportive. And basically I can run my shop. I definitely needed leadership support. And Robin Famiglietti stepped into that role and we felt that she was very supportive. She had a huge division to run and over time was also put in charge of Patient Access. So she had like two huge jobs and us.
Tacey Ann Rosolowski, PhD:
So again the division she was head of?
Louise Villejo, MPH, MCHES:
Radiation Therapy.
Tacey Ann Rosolowski, PhD:
Radiation Therapy, OK.
Louise Villejo, MPH, MCHES:
She is the division administrator, and also over Patient Access, which was a huge institutional initiative that’s being developed. I mean it’s huge. And so she was very supportive. And we were waiting for the new senior VP for Clinical Operations to come in and get a lay of the land and see where he thought—how he was going to reorganize the different areas. And so of course I got on his calendar right away to give him an overview. So he would have that information.
Tacey Ann Rosolowski, PhD:
And this is?
Louise Villejo, MPH, MCHES:
That’s Bob Brigham. So he started in January. So I know that he has his idea that he’s moving through as far as restructuring of his area. But I think that because I’m retiring and have put off my retirement three times already, and somebody new is coming on, they wanted to not have that person report five minutes to one person and then switch over. It would be better to do it under my watch so that we could start moving forward with that. So he announced Wednesday the new structure. So we will be in Performance Improvement and they have also moved Kay Swint from Division of Nursing to Performance Improvement. It’s basically I guess a lateral, because she’s still the director, and she’s director of Patient Experience. And then we will report to her. So it’s a little odd because I’m an executive director. The person coming in they’ve changed that title to director. And then she’ll be reporting to Kay who’s a director. I think because—well, this is what I’ve been told. From the beginning they’ve told us that we were going to have reduction in revenues with Epic coming on. So they’re forecasting about a $250 million dip in our budget. And then with the budget request coming in there’s probably another $100 million. So I think they’re trying to keep positions flat and not hire a lot more people. I mean we’ve hired a tremendous amount of people through Epic. And so that’s—of course I don’t agree with that. I think if she’s taking on this huge initiative I think she definitely should have staff and title. Because I think it’s going to be—the way that the organization is structured right now, I think it’s going to be very positive for our group, because we do a lot of performance improvement projects. All the managers have been trained with a clinical performance—what is it? Clinical. Oh my god. CS&E. It’s the CS&E Program, which is what I call performance improvement on steroids. You go for like six months and are trained and then you do a project. Blanking on the name. And we have a tremendous amount of processes in place. And we do a lot of data collection. And we’re always trying to find the best ways to show that what we do is making an impact on outcomes for patients. And I know Sarah Christensen, who’s coming in as the director for Patient Education, has a lot of background in performance improvement and a lot of training. And so some of those projects that we’ve done and evaluated we can have them continuously, instead of like we did a great project with our—we had a little Patient- and Family-Centered Care Advisory Committee and we talked to them about some of our Press Ganey scores and talked to them about what can we do to improve this and what are your ideas, and we developed a performance improvement project. And looking at the scores we were actually able to move the needle on that. It was teaching about discharge medications. But what would be great is then have that on our dashboard to continue to monitor throughout, so that here we have a best practice we can move to the different inpatient areas or wherever we’re targeting that intervention. I mean that would be great that we could do that. And I think we’ll get the support to do that in our new area. We just don’t have the staff to do a lot of that. We have five health educators that do all the clinical areas, all the outlying areas, all the Bay Area and Woodlands and Katy. Responsible for all that. And then we also work closely with Banner in Phoenix and trying to get Cooper on board. And now we’re going to have Baptist in Florida. And all the other projects. I mean that’s five health educators. We have a small communications group that is tremendous support for that. And then our Learning Center staff that their focus is the patient-facing focus. So I think people don’t realize what a small group that we have. And of course the associate director and I do a lot of program development. We don’t just look down and manage. We have to actually—and I love to do it, so maybe I should have let go of some of that. But that’s of course my passion too. So if we’re going to step up then we really have to look at staffing. And that’s one thing that I’ve been telling every single new boss that I have. How desperately we need to have more staff. Because you can imagine. Each health educator has fifteen areas. And that’s maintenance. So you’re maintaining 3,000 documents, making sure they’re up to date. Videotapes, all the processes and procedures to get them linked into the right place to make sure that myMDAnderson has the videos incorporated that the patients need to view, and the documents available. And I mean with Epic it’s going to be even more, because hopefully we’ll be able to provide them the information they need at the time instead of giving them a database of materials that they have to go in and see which one is appropriate. Or the clinical staff might assign them a group of documents, but then as they go through the continuum of care they might need other materials, and there’s nobody feeding that to them. So I’m really hoping that Epic can do that.
Recommended Citation
Villejo, Louise and Rosolowski, Tacey A. PhD, "Chapter 19: The Patient Education Office in MD Anderson’s Organizational Structure, Past and Present" (2015). Interview Chapters. 1534.
https://openworks.mdanderson.org/mchv_interviewchapters/1534
Conditions Governing Access
Open
