Dr. Roxane Townsend

Q&A with Dr. Roxane Townsend

January 15, 2015
by John W. Mitchell, Senior Correspondent
HealthCare Business News had the opportunity to speak with Dr. Roxane Townsend recently. Townsend, who was named CEO for UAMS in 2012, offered some insight into her career as well as advancements happening in her facility.

HCBN: You have a medical degree and started your career as a registered nurse. How does that help you serve as CEO at UAMS?

You often hear that doctors are not socialized to be team leaders; they are socialized to be gladiators (independent medical judgment). In an academic medical center, doctors have to work hard to be at the top of their field. So I can relate peer-to-peer to get real engagement from physicians and to put them in charge of our clinical improvement. And of course, having been a nurse for nine years, I have perfect experience for establishing credibility with the staff on the floors.

HCBN: How did you transition from nurse to physician to hospital CEO?

My career plan was certainly unplanned. I became a physician because my sister was in medical school while I was a director of nursing. She thought I would be a good doctor. After finishing my residency, I worked as faculty in the internal medicine residency program where I had trained. Our hospital medical director was one of my faculty who decided to move into the CEO role. I jokingly said I'd need to reactivate my nursing license so I could serve as his director of nursing. Next thing I knew, I was interviewing to be his chief operating officer.

HCBN: Tell me about clinical improvement at UAMS.

We are working to reduce readmissions after 30 days of discharge (UAMS is one of only a handful of hospitals in Arkansas with three straight years of declining readmission penalties) and reduce length of stay. It's safer patient care when we improve these metrics and it helps to get cost out of the system.

HCBN: What initiatives are currently in progress at UAMS?

The hospital has been on a journey the past three years to create a family-centered care environment. For example, we no longer have visiting hours. We have a family presence policy based on whom the patient tells us they want to see while they are in the hospital. Our nurses round at the bedside in front of the patient and family now, instead of in a back room. So the patient can hear the hand-off from one shift to the other and get an update on their care and progress.

HCBN: What should people know about UAMS?

We have the only Level I Adult Trauma center in the state of Arkansas. UAMS has bolstered our staff of attending trauma surgeons on duty 24 hours a day. We also have recruited fellowship-trained orthopedic surgeons for our trauma program. The hospital and medical staff responds to over 200 adult trauma cases a year.

HCBN: What are your biggest challenges at UAMS?

Arkansas has 210,000 newly insured patients. So we have to budget for the next year as if the legislature is going to make funding available at that level. We spend a lot of time educating the legislature about health care to help them make an informed decision.

We have capacity issues right now. We opened a new patient tower in 2009 and it's 94 percent occupied - some days we've had to hold as many as 14 patients in the ER until a bed opened up.

We also have many transfers from other hospitals who decide a patient would be better off with us, so we work hard to accommodate those patients. Patients don't want to wait, but as a Level I Trauma Center, sometimes an elective surgery patient, for example, may have their case delayed until later in the day if we have an emergency.

HCBN: What else is going well at UAMS?

We knew the newly insured would be looking for doctors. So we have added 10 new primary care doctors and opened new offsite family clinics. We did see a gain in revenue of $10 million from the beginning of our fiscal year in July through September, but we also saw a corresponding increase in expenses related to these higher volumes. We had some increased expense related to electronic medical records, but that also helped us do a better job with charge capture. We are seeing a positive bottom line so far this year.

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