Michelle Arnold, MD, MBA, recently held the position of Vice President and Chief Medical Officer at St. Mary’s. Previously, she was the medical director of the Swedish Medical Center in Issaquah, Washington.
During her tenure, her focus on growth, transformation and stewardship has improved performance outcomes that have weathered the impacts of COVID-19. Board-certified in physical medicine, rehabilitation and accredited subspecialties in neuromuscular medicine, Arnold has held a variety of clinical and leadership roles across Swedish health services, including the regional executive medical director of the musculoskeletal service lines.
As a key member of the St. Mary’s Leadership, Dr. Arnold will work to improve the experience for both patient and caregivers and to grow high-quality, value-added care to Grand Junction and the surrounding communities.
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repair status: As Chief Medical Officer of St. Mary’s Medical Center, what is your vision for the hospital as the Grand Junction community looks to recover from the pandemic?
Michael Arnold: “It is clear that ongoing care for our patients who contract COVID will undoubtedly continue. It will be in conjunction with many other infectious diseases. [and] Infectious diseases that we treat on a regular basis. We have learned a lot during COVID and we will draw all the lessons and put them into the post-pandemic future. What comes to mind most is telehealth and telemedicine, which will continue to be a welcome extension of in-person care. This is something we defended for a long time before COVID. [The pandemic] He was really the quickest factor in this positive change for all of us.
Another thing that comes to mind is infection prevention programs. They have become highly capable and will continue to be the source of the next wave no matter what is coming.
The other thing I was involved in during COVID was the incident order, and our hospital leaders are now much more skilled in the incident command structure. We have moved into this mode of constant readiness. Medical teams actually really took shape during COVID. Doctors who worked together through [the] The dark days of COVID seem to be showing with this new passion and they are better equipped to coordinate care.
Then the ugly side is that fatigue is still a problem and has escalated during the pandemic. Here in a post-pandemic future, we struggle with over 50% of clinicians acknowledging one or more components of burnout. It is the most significant workforce disruption of my life and employment will become a focus for years to come. From a social point of view, there is a growing distrust of authority, including [for] health care workers. Often people don’t know what or who to believe. Thus, transparency and integrity will be essential to rebuilding that trust. I think where that really happens is one-on-one, patient-to-doctor logically in bed or in the clinic, and that’s actually my biggest hope for the future of our healthcare is to restore trust, starting with that relationship.”
SOR: What are the immediate needs of St. Mary’s Medical Center and its patients? How can state and federal reforms support these needs?
Master’s: “So when talking about burnout, caregiver wellness is really the big response and remains the focus of healthcare systems. We need to suppress attrition and turnover. Just today, I was in a nursing meeting not an hour ago and heard stories of silent quitting. Burnout really does a lot. of resentment.
Caregiver wellness is going to be an important focus and we have programs here, but I think this is so global that it would be really good to get some statewide federal support for caregiver wellness initiatives. We fully support the efforts that continue to ensure the continued protection of our caregivers and we have a lot of resources, but I think they are still not enough.
Another piece about reimbursement. There is a growing mismatch between healthcare reimbursement and the plain old cost of doing business. Things like equipment, durable medical supplies and labor, they are rising along with inflation but even at a faster rate. Meanwhile, reimbursement for health care providers has been in steady decline for more than a decade. There is intense pressure on hospitals to develop efficiencies and reduce costs. So we’re managing the supply chain and trying to improve the productivity of our workforce, but in the end it’s going to be the turn of a care redesign. This will ensure our sustainability and can be a noisy place to go.
It’s like trying to build an airplane in flight, and we’re constrained by various regulatory demands that sometimes make it hard for us to be agile. Efforts to redesign care will be really important. then [there are] Our workforce limitations. here in St. Recruitment in our society and geography can be really challenging, especially for advanced physicians and practitioners.
Training programs need to use predictive modeling to help assess current and future workforce needs, so that we can serve our community, particularly around nurses, physicians, therapists, behavioral health professionals, technologists, assistants, pharmacy staff, and laboratory staff. Those were really difficult. The intensification of training programs and then vocational training programs can be an opportunity that we can explore to help close the gaps so that these trainees actually enter the workforce.
Then finally, today’s social and economic challenges come to mind. Basically, patients in our society are facing increasing social and financial stress, hence the elderly are most at risk. They lack adequate support. We have people who don’t have a home to live in, those who live in transitional housing, [and] People with behavioral health conditions or substance abuse or dependence. These are the most vulnerable in our society.
Of all the things I could use as a magic wand, regulatory efforts and/or financial incentives that expand the safety net for the most vulnerable, this would be the thing to fix.”
SOR: Can you talk to programs or initiatives that address access and equity for rural and underserved people?
Master’s: “One big effort is partnering with other local hospitals and critical access hospitals and clinics [and] Acute aftercare facilities to provide primary care, specialist care, surgical care and intensive care, [and] Trauma services for our community and beyond. Efforts are underway to expand the interoperability of our medical records. This obviously facilitates the safe and secure sharing of health information to coordinate care across sites and specifically in our rural communities.
For example, we are currently hosting our electronic medical record [called] “Epic” of Craig Memorial Hospital. We are looking at other ways in which we can ensure the interoperability of the medical record as a good starting point for good communication. Second – this is an Intermountain initiative as much as it is Saint Mary’s – and this is a patient dignity …
There is ongoing education for caregivers about patient dignity, and we explore our own implicit bias and hope to ensure health care inclusion for all individuals in our service area, with an emphasis on inclusion and ensuring patient dignity.
And then finally, our community health needs assessment process is the means by which we look for specific programs and services and how they might meet the needs in our immediate community, not just in our community, but in our secondary and tertiary service areas to reach these village communities.
This is what we use to help with our recruitment efforts. It helps us to get services of the right size to ensure that all the required services can be accessed. It was difficult during the pandemic because resources were scarce. But we are constantly measuring and monitoring our wait times and re-examining ways we can streamline our operations and improve patient access and health outcomes.”
SOR: How is Saint Mary working with stakeholders to prepare for the end of the public health emergency?
Master’s: “The biggest issue here is that if you consistently focus on patient outcomes, quality of care and safety, you will never go wrong. Value-based care is the newest entity looking not only to provide good, safe and high-quality care, but to do it in an affordable way. We are trying to follow this A community approach to reducing the social determinants of health.This requires a lot of meaningful coordination between all the different hospitals in the system, but also with some of the community organizations and the people around us here so that we can create a healthier community.
We try to simplify some of the internal processes, we try to reduce unnecessary waste and duplication in the system. As you might imagine, when you try to integrate two different healthcare systems, even though we are deeply committed to mission and values, we have some duplication and so we eliminate that helps simplify and deliver care in the most cost-effective way. That’s the work that we’re going to continue to do sort of in the post-pandemic integration phase that we’re going through.”
This interview has been edited for clarity and length.