Becoming a Center of Excellence: A Member’s Story
Since 2013, the National Council has worked with our members, direct care clinicians, and other healthcare leaders to develop and solidify the concept of a behavioral health center of excellence. At the 2014 Conference, we released a concept paper for organizations interested in implementing the tenets of a center of excellence. Today, dozens of organizations throughout the country have worked to make elements of a center of excellence a reality within their own organizations. And while taking the necessary steps to become a center of excellence doesn’t come with a certificate or accreditation, it helps to improve the lives of those we are all committed to serve and prepare your organization to be ready to take most advantage of business opportunities ahead.
The National Council recently sat down with Jeff Rothenberg, Chief Executive Officer for Vermont Psychiatric Care Hospital (previously Green Mountain Psychiatric Care Center Hospital), a newly opened hospital and the only state-run psychiatric facility in Vermont. In recent years, the state has undertaken an ambitious policy direction; aimed at strengthening community resources, while reducing overall statewide psychiatric inpatient capacity. The state of Vermont has no forensic psychiatric hospital, meaning that with an operating budget of $20 million, the hospital cares almost exclusively for involuntary patients, who are the most acute clients in the state.
Mr. Rothenberg, a member of the National Council’s 2014 Executive Leadership Program, spoke with us about his experience in becoming a behavioral health center of excellence, and detailed how his hospital continues to strive for center of excellence status.
National Council: What inspired you to begin implementing center of excellence within your organization?
Jeff Rothenberg: I was a new CEO of a state hospital that was rising from the ashes like a phoenix. The previous hospital entity that the state of Vermont had run had been decertified by the Centers for Medicare and Medicaid Services (CMS); lost its federal funding; had multiple investigations; there had been a flood, which closed the hospital; and here I was, the new CEO of an interim-state hospital that had just opened. I was ready for ideas.
When I agreed to the new position, I asked the Commissioner of Mental Health, “What is your goal for the hospital?” And he said, “I’d like you to run the best small psychiatric hospital in the country.” So – a clear standard of excellence was set that I was being asked to reach. That resonated with me – after kind of gulping. I thought, “Why didn’t he say top five or top ten? But, okay. Why not number one? Why shouldn’t we set that as the goal?”
National Council: How did you go about building buy-in with your staff and leadership team around becoming a center of excellence?
Jeff: We have spent a lot of time listening to staff about what they wanted to be different. And by listening, we realized there had been a huge chasm in communication between the previous administrative leadership and frontline staff.
The goal of being number one in the country, although it may sound daunting, people immediately bought into, “Why not set this as the goal?” The leadership team was a new team, and people had strong work ethics and were ready to create something new. We were ready to shoot for the stars. It’s hard not to agree with the goal of being a center of excellence and people felt positive about that.
National Council: How was the implementation process and how long did it take you to go about executing the elements of a center of excellence?
Jeff: While we had policy and procedures from the old hospital, we had a chance to relook at everything because we were basically starting from scratch. We had the opportunity to dig a little deeper into the way we wanted our facility to work. It coalesced with strategic planning. I was told, “You need to have a strategic plan.” But I’m an impatient person, and I was getting frustrated that it took about six months to get this completed. We hired a new medical director shortly thereafter, she looked at it and said, “This looks great, but you know, no one really reads these things. You should put this into a format that staff will see widely.” This led to the creation of our “Mission Board.”
National Council: How did you decide what you wanted to put on your Mission Board?
Jeff: By narrowing it down to what we controlled – recovery focus, safety training, quality assurance, communication with staff, quality improvement, and staying connected with the rest of the mental health system. In meeting with dozens of individuals, I got lots of responses about what to do, but so much of it had to do with things that were beyond our control. For example, a lot of people thought the courts should handle things differently, or that the funding should be different for certain things.
National Council: Which goal has been the most difficult or challenging?
Jeff: That’s difficult. I can give brief blurbs about each of our goals, there’s always room for growth, but there’s not one area we’re lagging behind in. We’ve made progress across the board and we continue to work daily to become and sustain center of excellence status.
National Council: Looking forward, what are your next steps and how do you plan to continue building excellence?
Jeff: It’s following through with all of these different things. Our Advisory Committee approved our Mission Board in July. By putting our goals up on posters throughout the hospital, it holds everyone accountable to do the things we say we’re going to do. Hospitals are more tightly regulated than community mental health centers, so we already have all kinds of quality improvement and quality outcomes, but there are things in our goals that are specific to our organization – which takes us beyond the state’s requirements. We are continually checking in and making sure the work we are doing aligns with the goals we’ve set for ourselves.
National Council: What is one piece of advice you would give to another organization looking to become a center of excellence?
Jeff: Make your goals something that staff will buy into. And make it visual. Make it something people can see and take. Put it in different places. It forces people to see it. It becomes a living document. Our goals are displayed in our waiting room where visitors see it, as opposed to it being a strategic plan that a board approves and gets filed away and people don’t actually see it.
Is your organization in the process of setting new standards of excellence? Share your story in the comment section of this blog. Or perhaps your organization is interested in implementing new standards of excellence? Is the Behavioral Health Center of Excellence a concept you think you can achieve? Contact the National Council to inquire about how we can help.