We recently had the pleasure of meeting with the Founder and CEO of Washington Health Institute (WHI), Jose Bordon, MD, PhD, and the new Chief Operations Officer, Michael Shankle, MPH, to discuss how Renaye James Healthcare Advisors (RJHA) has impacted their organization in providing patient-centered medical home/practice transformation support, harnessing change management initiatives, and implementing a culture change transformation. The answers they provided during our meeting truly align with our mission which is to create healthy communities by transforming healthcare organizations and healthcare partners into high-quality, efficient, safe, patient-centered, value-based venues for healthcare.
Can you tell me about the organization and how it got started?
Dr. Jose Bordon:
Providence Hospital, which was chartered by Abraham Lincoln more than 150 years ago, announced that it will be closing in late 2018. At that time, I was the Chief of Infectious Diseases and we provided inpatient and outpatient services available at the hospital. Once we knew the hospital would be closing, I spoke with my medical team as well as Michael Shankle, who was at a different organization at the time, and we decided that we will continue to work in the same place under a new name. We then drafted a nonprofit organization, which is today called the Washington Health Institute (WHI), and we received technical assistance from the Government of the District of Columbia, under Michael Shankle’s leadership. It took about 3-4 months of extremely hard work to get the healthcare practice up and running as WHI.
On May 1, 2019, we went live and since then we haven’t stopped working. I can tell you our services today, under the WHI direction, are much better and more developed than it was in the past with Providence Hospital. We truly have this passion and dedication of providing quality healthcare services to our community.
When did you start working with Renaye James Healthcare Advisors (RJHA)?
Dr. Jose Bordon:
In the summer of 2021, it was a very unique time, it was a time of crisis for us at WHI. I would say more than a unique time, it was in the knick of time when we were dealing with some challenges and we were referred to Dr. Washington at Renaye James Healthcare Advisors.
In any organization you have challenges, ups and downs, peaks and valleys in part related to the rapid growth of our organization and items were not fully aligned in relation to operations and various staff positions. Our culture was not the best, our communication was not optimal. Therefore, we had to put the brake pedal down as much as we could to essentially reassess our practice. We got a call that Dr. Washington was there to help and offer business consulting to improve our operations. We acquired an angel, Dr. Washington, and her team.
What are the challenges that RJHA is helping to address at your organization?
Dr. Jose Bordon:
RJHA arrived with many consultants and WHI underwent a thorough assessment, and then a time and milestone-oriented plan was ultimately developed. We agreed to two projects, one was change management which is fantastic, and the next was the culture change. These two projects ran in parallel with one another and supported us in providing missing resources and tools, such as SOPs, policies and procedures, job descriptions, trainings and competencies. The culture change was more in relation to challenges related to not having the optimal communication and management of our employees, including supervisors and staff.
Michael Shankle:
Dr. Bordon and his team, when they decided to move the clinic from the hospital (Providence Hospital) to a nonprofit organization (WHI), it occurred under an extremely tight timeline and it seemed impossible to do. They went from a corporate model to having to move very rapidly to this new nonprofit organization without the foundational materials, including policies and procedures and training that was needed to transition from a hospital clinic to an outpatient/ambulatory project.
The clinic staff realized, during that transition process to WHI, there was a tremendous amount of other community needs. Other local practices were closing so there was also a need to expand the practice. WHI had to rapidly transition and hire staff originally employed by Providence Hospital to start serving the community. During this rapid change, there were a lot of missing pieces they had to tighten up and provide clarity. This is one of the steps RJHA is doing is building clarity amongst our team, and defining different roles that each team member plays in helping a patient drive towards their health outcomes.
Today, we are looking to go further than that. We want to move from this model that has been conceptualized as an integrated patient home and become accredited as a Patient-Centered Medical Home (PCMH) model so that we can really drive quality measures more effectively and efficiently for our patients. RJHA is helping us implement this truly comprehensive PCMH quality model that will serve to drive performance improvement and ultimately improved health outcomes.
Who were the RJHA consultants working on your projects?
Michael Shankle:
Brandon L. Jones for board activities, Nancy McLean for nursing services, Sharon Lipford for case management and behavioral health services, and Dr. Wyndy Webb for operations and pharmacy.
What solutions to your challenges are being addressed or have been addressed?
Dr. Jose Bordon:
The solutions that RJHA have implemented, are the resources and tools WHI so desperately needed, including the standard operating practices (SOPs), policies and procedures, job descriptions, trainings, assessment of competencies, as well as the culture change project to help and enhance our new organization and create our identity and core beliefs. Today, we have 6 core beliefs - promote teamwork, be grateful, provide clarity, promote diversity, create wellness, and strive for excellence. Our employees are really identifying with these beliefs.
Based on these new beliefs, we truly go above and beyond when serving our community. We ask the questions “how can I help you” or "what else can we do for you?” So, I think the framework and the vision of our employees are much different today, the landscape is quite different. People believe that they own this organization, they are happy to do this service. The culture is quite different these days. We are very grateful to RJHA and Dr. Washington and her team for their contribution. I think the RJHA services are fantastic, a big injection of energy, a tremendous reassurance that what we are doing here makes perfect sense. The train keeps running, and we made a stop in July/August 2021 to assess our plan, and now we are back on track and we are moving at a good pace.
Can you discuss how working with Renaye James will impact/has impacted your clinical care and organizational operations?
Michael Shankle:
I’ve only been with WHI for 8 weeks, and part of the culture change process was driving to a point of people taking ownership of their tasks. We are enlightened as we have identified challenges. Often times, I’ve seen this over the years, organizations develop standard operating procedures and policies, and they put them into a nice binder and then the binder goes on the shelf and then people don’t follow them. Part of this process is to allow us to codify these policies and procedures in our daily operations and within the culture of the organization. You can see that happening all over the place and within every piece of the organization from the client experience at the front door, to the medical assistants working with the patients, to our clinical providers. This was really an opportunity for us to break down the silos that naturally occur within organizations and within departments.
We started reconceptualizing as this integrated team model. I think things have gone very well. We have put together a series of quality metrics and developed baselines for those quality standards so that we can demonstrate our success and make sure that continuous quality improvement is built into our organization. We are constantly taking what we’ve done, the data that we’ve gathered, and putting it to use to make informed decisions to improve our outcome and efficiencies as an organization.
Have you seen growth since 2018?
We have grown the past 3 years. When we started we were focused on medical services and had a very small case management service and research department. Our practice was a small 200 square feet suite and today we have 6 suites so this clearly tells you how much we’ve grown in 3 years. Today, we have 25 employees and a case management service with medical, non-medical and behavioral health services. We have several grants from the Department of Health for $1.2 million dollars which is a sign that the Department of Health trusts us. This was at least double the amount from the previous cycle. Also in research, we grew from HIV research to vaccine, and vaccines now include COVID, meningitis, RSV, and influenza.
Most importantly, we are doing research with the University of Maryland in Georgetown, and sponsored by American Gene Technologies, for genetically modified p cell transplant. We successfully administered the p cell transplant to 5 patients. We are, in fact, the research site with the most participants that received the transplants. WHI has also grown to include a COO and Director of Operations. The growth is very substantial. We are humble. The secret here is to have the passion, to be careful, to work hard, and nothing else. We arrive to the workplace everyday, with a smile, and ask “how can I help you.”
Would you work with RJHA again?
Dr. Jose Bordon:
We wouldn’t hesitate to call RJHA again if we have any new challenges. I certainly wouldn’t hesitate to recommend RJHA to any organization in need of support and coaching in relation to outpatient services like ours.
Michael Shankle:
One of the most powerful aspects of RJHA is that the consultants will lend a hand to guide us in the right direction or find someone who will. They will also share policies and procedures with us and go out of their way to be constructive and supportive as the organization grows. We were focused on working towards a Patient-Centered Medical Home (PCMH) model and discovered that we had to make cultural adjustments and we were able to make those adjustments and navigate very fluid-like versus being very rigid and staying in your own lane. If Dr. Washington does not know the answer directly, she will find out or will bring you someone to talk to and that is so helpful and so insightful.