UAMS Medical Center CEO Richard H. Turnage Institutes Daily Safety Huddles to Improve Safety
Richard H. Turnage, MD, took over as vice chancellor of clinical programs for the University of Arkansas for Medical Sciences and as CEO of the UAMS Medical Center Dec. 1, 2016. In January, Turnage began instituting daily morning safety huddles where the leadership team meets with 60-80 managers from patient care units throughout the hospital.
"From 8:30 to 8:45 a.m., we talk about any problems on their units that could pose a risk to our patients or our employees," Turnage said. "We go over any injuries or risks seen the previous day. If a problem is identified in the morning, it has to be fixed within 24 hours. This kind of exercise is conducted at the best performing hospitals in the country."
The safety huddles are just the latest in a long list of safety initiatives at UAMS.
Prior to becoming vice chancellor, Turnage served as chief service line officer for the Integrated Clinical Enterprise. This organization has embraced the Institute for Healthcare Improvement's Quadruple Aim of better patient experience (which includes better care), improved community health, lowered cost of care, and improved employee engagement and satisfaction with their work.
There have been some impressive results from the safety focus.
"We have units of our hospital that have had no infections for more than a year," Turnage said. "Some units that have had no falls with injuries in more than a year and no pressure ulcers. All hospitals have risks associated with the care provided. But we do everything within our power to minimize those risks."
UAMS ranks among the best performing hospitals in the country for rates of blood stream infections and urinary tract infections. Turnage said he used to consider infections a cost of doing business.
"But the fact a unit can go a year without having this type of complication suggests you can eliminate it completely," Turnage said.
Turnage grew up in Bossier City, La. The first member of his family to attend college, he knew from an early age that he wanted to be a doctor.
"My track was pretty linear," Turnage said. "I was focused on getting into medical school and being a doctor. Early on, I knew I wanted to be a surgeon. As I moved my life toward that goal, I became interested in academics, and began to focus my residency search toward programs that would help me realize that goal."
He ultimately trained in surgery at the University of Michigan Medical Center in Ann Arbor.
Before being recruited to UAMS about nine years ago, Turnage was head of surgery at Louisiana State University Health Sciences Center in Shreveport.
"That was my home, I had a great job, and it was hard to leave," Turnage said. "I was attracted to working in a state as beautiful as Arkansas - a place my family would come for vacations. I also thought that being a part of the only academic medical center in a state was a tremendous advantage. This is beneficial from the standpoint of philanthropy, legislative support and being able to recruit high quality students, residents, and faculty."
The UAMS Medical Center provides high quality, complex medical and surgical care such as kidney, liver, and bone marrow transplantation, advanced trauma care, and complex cancer care. He considers these clinical services great responsibilities and great opportunities.
The third reason he decided to move to UAMS was a pervasive commitment to excellence.
"We strive to be excellent in everything we do," he said.
Turnage initially came to UAMS as head of surgery. Two years later he was selected to be the chief of the medical staff. This position provided his first opportunity to impact healthcare outside of the realm of surgery. For example, during that time UAMS began to inculcate patient and family centered care into the culture of the university. They also began to aggressively use data to improve patient experience and reduce infection rates for the hospital as a whole, not just in surgery.
These efforts expanded (and continue today) after he became the associate dean for clinical affairs, chief service line officer, and ultimately vice chancellor for clinical programs and CEO of the UAMS Medical Center.
Turnage thrives on big picture challenges. His management style is patterned after the Level 5 Leadership concept developed by Jim Collins, which encourages leaders to be humble, focused on what is best for the organization instead of himself or herself, and driven to produce excellence.
He believes organizations that focus on excellence are going to do well.
"A healthcare organization can be excellent only if physicians, nurses and other healthcare providers are absolutely engaged every day in solving problems," Turnage said.
Effective communication is a top objective.
"With thousands of employees and people all focused on their individual jobs, communicating effectively is probably the greatest challenge," Turnage said. "I receive more than 100 emails a day. Our clinicians are in the operating rooms, clinics or hospital wards all day long and then come out to face dozens of emails. I'm convinced that's not an effective way to communicate. My preferred method of communication is face-to-face. I try my best to keep emails pretty brief."
Turnage feels that his 26 years of being a surgeon brings some big advantages to his new role: a physician's patient centeredness, an academic surgeon's focus on education and research and the personal awareness of the difficulties and rewards of our caregivers' work.
In addition to safety, another important goal for UAMS is access to healthcare.
"We have to be efficient in how we use our resources so we can continue to provide the highest quality complex medical and surgical care to everyone who needs our services," he said. "Medicaid expansion helped. It improved our financial health which allowed us to continue to invest in clinical programs important to the people of Arkansas."
And the number of people receiving care has grown greatly since Turnage joined UAMS. When he first arrived, the Medical Center was performing about 10,000 operations per year. That number has doubled to nearly 20,000 operations performed in fiscal year 2017.
"We have seen phenomenal growth in our clinical services in the time that I've been here," Turnage said.
Many people say this is a very difficult time to be in medicine. It is certainly a time of change.
"Change for people and organizations is difficult," Turnage said. "That said, I feel incredibly blessed to be a physician and to be at UAMS. There are very few careers in which an individual can improve the lives of others every day. At UAMS our caregivers and staff have that kind of positive impact on hundreds of individuals and whole communities each day."
While routine care is best delivered at a local level, Turnage said UAMS is committed to improving the health and healthcare of all Arkansas communities by providing complex medical and surgical care, care not routinely available in community hospitals.
When he isn't working, Turnage enjoys reading - particularly about history - and spending time with his wife, Jill, and daughters, Maggie and Kelsey. He also enjoys fishing, especially on the White River.
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