Projects by Timeline
Summary hours equate to over 18 years of full time clinical project or program management and healthcare supervisory experience as of 10/19/2015. Project designations I and O excluded from A through Z.
. . . . .
Projects F+G+H+J+K+L+M total hours: 7,034 (as of 10/19/2015)
Practice and Project D total hours: 16,920
Archived Projects A+B+C total hours: 13,520
. . . . .
Project K (9/2012 to 10/2013)
In collaboration with administrative peer group, analyzed Nursing Administrative Supervisor roles to align with PRMCE Strategic Plan. Roles established within eight primary categories: Operational Resource, Emergency Response, Executive Team Liaison, Risk Mitigation, Crisis Intervention, Human Capital Management, Bed Control, and Clerical Oversight. Additional metrics in progress.
Initiation: 2 hours
Met with Director of Nursing Administration to discuss proposed content, organization, and timelines. Meeting facilitated to determine categories and priorities of job description.
Planning: 8 hours
Refinement of categories with admin group. Development of details related to process and protocol serially reviewed by group and management.
Executing: 23 hours
Report created as to recommended next steps based on alignment with strategic plan.
Monitoring and Controlling: 35 hours
Shift-specific review for tasks to be included or excluded. Multiple meetings with various stakeholders to reassign or accept responsibility for duties accumulated secondary to scope creep over several years. Minor revisions to recommendations.
Closing: 4 hours
Draft and recommendations submitted to HR after a brief management caucus.
Project K total hours: 72
. . . . .
Projects J, L, M (1/2013 to 5/2015)
In collaboration with Administration, designed, implemented, and published the 2012, 2013, and 2014 Nursing Annual Reports for the Board of Trustees, Executive Teams, Nursing, and Marketing at Providence Regional Medical Center Everett. 2015 NAR set to occur in 2016.
Initiation: 4 hours
Met with Director of Nursing Administration to discuss proposed content, organization, and timelines. Information collection structures to be utilized as per Project H (Nursing Matters). Review of NARs 2009 through 2011.
Planning: 21 hours
Requests for content sent to shareholders. Annual Report mock-up created to determine available space for content and refine layout. Draft to serve as template for Marketing design stage. Discussed expectations and process with Copy, Format, and Photo contractors. Specific content needs discussed with executive team.
Executing: 150 hours
Articles received, edited, and organized per new nursing model. Five-element structure finalized and filled with related content. Evaluation of final length pending additional submissions. Target determined to be 20 to 24 pages. 100% submission rate estimated to constitute 40 pages. Review of missing content for essential articles initiated. Articles received and reduced by secondary editor for inclusion.
Monitoring and Controlling: 65 hours
Involvement of Marketing group to review initial template and articles available for formatting. Discussion expanded to include photography submissions. Charts and statistical information added. Ongoing review and editing of late submissions. Multiple editing rounds required.
Closing: 10 hours
Review of six proofs required before finalized. 20-page ideal attained. Authorization given to move completed work to print shop for scheduled distribution at next Nursing Congress.
Projects J, L, M total hours: 275
. . . . .
Project H (6/2009 to 4/2013)
Design, implement, and support internal newsletter within Providence Regional Medical Center Everett to facilitate shared governance, leadership communication, and staff recognition in alignment with Magnet Journey.
Initiation: 1 hours
Met with executive team to discuss development and implementation of new communication architecture designed to facilitate shared governance and support nursing. Proposed format and content based on previously produced Mentor newsletter with greater emphasis on house wide issues and shared governance.
Planning: 6 hours
Designed letterhead in collaboration with print shop. Format parameters adjusted and name selected. Additional content ideas incorporated. Structures for information collection investigated. Frequency and deadlines confirmed. Email-based submissions confirmed. Budget allocated.
Executing: 45 hours
Quarterly newsletter produced that corresponds with each Nursing Congress. Four to twelve pages of content and photos cover current matters within nursing. Approximately 3 hours of execution, by way of information collection and organization, are required each edition with 12 hours required per edition overall. Deadlines for submissions proven to be the greatest challenge.
Monitoring and Controlling: 105 hours
By the 5th edition, most processes in place for repetitive collection of information, editing, submission, and distribution. Editing and distribution are primary at this stage, requiring about 7 hours per edition. Categories of content include Nursing Governance Council Reports, new degrees and certifications, kudos to staff, award winners, upcoming events, new protocol and policy, and general article submissions from nursing staff and leadership. Frequency and volume adjusted. Processes continue to undergo minor refinement as needed.
Closing: 30 hours
As of the printing of the 15th edition, time required to produce newsletter is limited to about 1 hour a week between editions, but occurs as an aggregate around deadlines. Closing is cyclic, by way of final review of proofs before print, and requires about 2 hours per edition. Project is well defined, mobile, reproducible, and able to transition when required. Closing by way of termination or transition is anticipated as requiring 1 to 3 additional hours.
Project H total hours: 187
. . . . .
Project G (7/2008 to 10/2015)
In collaboration with The Everett Clinic, design and implement a clinical continuity program for direct admissions to Providence Regional Medical Center Everett. Project to be carried out by several managers, directors, and executives.
Initiation: 260 hours
Variances in direct admit process identified. Standardization proposed. Discussions, meetings, and workouts around planned direct admit process undertaken in collaboration between PRMCE, The Everett Clinic (TEC), and other stakeholders. All admitting facilities impacted. Pathways reviewed and possibilities presented. Agreements made as to scope and charter. FTE positions allocated.
Planning: 520 hours
Initial process metrics identified as (1) time required to assignment, (2) number of calls required to assignment, (3) direct admit volumes, (4), complete information at assignment, (5) customer satisfaction, and (6) overall experience. Before metrics recorded for later comparison. Calls analyzed for peak call times. Developed Standard Operating Procedures (SOPs).
Executing: 720 hours
1.5 FTEs implemented as admission coordinator staff. 60 hours a week required for coverage of peak call volumes. Nursing supervisor role expanded to minimize training and execute new position. Nursing supervisor also primary for after hour coverage. Four dual role staff designed as project management team with overlapping responsibilities.
Monitoring and Controlling: 4,157 hours
Responsibilities included ongoing collection and analysis of metrics, ongoing revision of SOPs and implementation of revised protocols, ongoing collaboration with stakeholders and evaluation of needs, scheduling and staffing, off-hour coverage, complaint resolution, risk assessment, customer surveying, and technical issues. Lead established to oversee new program.
Closing: 160 hours
Project continues with new emphasis on decreasing time to bed placement. Protocols well established and effective. Technical issues proven as greatest challenge. Project is well defined, mobile, reproducible, and able to transition when required. Closing required 160 hours based on replacement training needs and level of expansion. See Metrics for additional details.
Project G total hours: 5,817
. . . . .
Project F (1/2008 to 6/2008)
Hire into a hospital job classification referred to as Diabetes Educators for the purposes of reviewing their necessity and providing coverage to clinical staff. Assessment to include ongoing clinical coverage viability with recommendations as to protocol and limitations.
Initiation: 3 hours
Met with executive team to discuss needs related to diabetes education and clinical coverage. Multiple previous failed attempts to train diabetes educators for patient assessment, education, and clinical coverage of unit. Project disclosed as final attempt. Risks assessed and initial coverage responsibilities determined.
Planning: 120 hours
Accepted placement as RN in diabetes ambulatory clinic to train as coverage diabetes educator. Orientation, training, and scholarly review anticipated to require approximately 6 weeks at 20 to 30 hours a week for limited coverage. Plan expanded to include review of literature for DM Educator certification. Revised plan anticipated to require an additional 6 to 12 months at 20 hours a week.
Executing: 240 hours
Clinic mapped, education conducted, and coverage applied. Classes taught on outpatient basis for patients with type 2 diabetes and diabetes in pregnancy. Type 1 diabetes training reserved for certified educators. A review of insulin and injection techniques included in coverage responsibilities. Completed rounds throughout Colby and Pacific campuses. Met with patients in outpatient setting to review needs and equipment.
Monitoring and Controlling: 240 hours
Clinical responsibilities balanced with review of literature and exam preparation for certification. Coverage deemed successful by administration. Unanticipated risks revealed. Evaluation of unit’s finances incorporated and patients surveyed for value of services offered.
Closing: 80 hours
Clinical services concluded. Unit opted to discontinue coverage to primary certified providers. Risks reviewed along with lessons learned, finances, and value metrics. Resources for training strained. Lack of certification at inception of coverage identified as central issue. Clinic determined to be highly valued by patient population while run at financial deficit. Options reviewed before diabetes clinical education unit consolidated. Project concluded 6/30/2008.
Project F total hours: 683
. . . . .
Project E (7/2007 to 12/2007)
Hire into a job classification as clinical nurse manager for busy gastroenterology (GI) clinic with difficulty retaining managers. Determine obstacles to success, review practice, and make recommendations for staff retention.
Initiation: 2 hours
Met with management group at Seattle Gastroenterology. Clinical coverage needs reviewed with one physician’s practice in greatest need. Difficulty retaining managers for clinic cited as central issue. Assessment with recommendations requested. Permanent placement offered.
Planning: 120 hours
Accepted placement as RN in GI ambulatory clinic to train and cover as clinical manager. Responsibilities included maintaining surgical schedules, supervision of office staff, ordering of equipment and pharmaceuticals, facilitating chart review and completion, refilling prescriptions, and general ambulatory nursing interventions. Orientation, training, and process review anticipated to require approximately 3 weeks at 40 hours a week.
Executing: 240 hours
Clinic mapped. Physician interviewed. Scheduling, management, and clinical services conducted. Personnel evaluated. Risks identified and threats assessed. Revisions made to data management and scheduling processes.
Monitoring and Controlling: 305 hours
Assessment and recommendations discussed with executive team. Selection of replacement made and new manager trained in alternate protocols. Processes streamlined. Ongoing assessment of personnel with additional recommendations offered to human resources. Multiple threats to success identified.
Closing: 200 hours
Five weeks required to train replacement at 40 hours a week with disclosure of threat assessment and ongoing process improvement recommendations. Personality of new manager deemed ideal for continuity. Project concluded 12/31/2007.
Project E total hours: 867
. . . . .
Project D (1/2007 to 12/2012)
Evaluation and execution of multiple roles as physician, nurse, administrator, counselor, consultant, vendor, and project manager conducted via IO Nurse private practice with a concentration at Providence Regional Medical Center Everett. Clinical practice continued via NWND.llc. Ongoing portfolio of various roles conducted as project D with all roles overlapping. 30 weeks were required at 20 hours/week followed by 272 weeks at 60 hours a week in combined activities excluding travel. First 30 weeks overlapped with Project C.
Initiation: 1,040 hours (includes 266 hours for Projects E+F+G+H overlapping)
Project D initiated as transition of clinical to consulting practice. Initial focus on advanced clinical counseling as well as consulting as physician and project manager for corporate clients. Networking and consulting services extended to Microsoft, Nordstrom, and Peet's Coffee & Tea.
Planning: 3,120 hours (includes 766 hours for Projects E+F+G+H overlapping)
Clinical practice distilled as patient evaluation, diagnosis, treatment, billing, and training students. Consulting practice incorporating high performance team development, select interviewing techniques, direct project and program management, motivation, ergonomics, conflict resolution, personality assessment, quality process improvement, human resource management, employee health strategies, efficiency, and social systems.
Executing: 5,200 hours (includes 1,248 hours for Projects E+F+G+H overlapping)
Seattle Gastroenterology management role accepted at Swedish Medical Center. Placement required 22 weeks at 40 hours a week. Placement included evaluation and revision of surgical schedule, scheduling procedures, direct patient care, evaluation of personnel, and training of replacement. Project conducted as interim manager for ambulatory GI practice. Clinical practice maintained at 20 hours a week.
Part-time placement accepted as dual role at Providence Regional Medical Center Everett (PRMCE). Initial services included coverage for administrative supervisor position. Role expanded six months later to include coverage to diabetes educators for an additional 6 months. PRMCE placement expanded to full-time coverage of administrative supervisor and admission coordinator positions. Admission coordinator developed as new role within Nursing Administration. Newsletter developed as independent project. See Metrics for additional details. Clinical practice maintained for a total of 60 hours a week and incorporating consulting roles as portions of projects in progress.
Monitoring and Controlling: 7,240 hours (includes 2,483 hours for Projects E+F+G+H overlapping)
Coordination and execution of multiple roles conducted, excluding orientation and evaluation activities. Individual discrete projects managed as vendor and consultant. Protocols flexible and adjusted as needed.
Closing: 280 hours (limited to Projects E+F overlapping)
Project D total hours: 16,920
. . . . .
Project C (7/2006 to 7/2007)
Hire in to hospital job classification as registered nurse in order to provide direct patient care, design complementary and alternative treatment protocols for pain and anxiety management, implement protocols, and assess for response to treatment. 52 weeks were required at 40 hours a week. Final 22 weeks overlapping with Project D.
Initiation: 173 hours
Project proposed as clinical trial combining conventional and complementary treatments in catastrophically ill patient population. Protocols reviewed from previous clinical practice, amended for population, and submitted to Medical Director and Pharmacist. Approved with minor revisions.
Planning: 347 hours
Risks reviewed. Patient population directly assessed for candidacy. Parameters of project defined. Alternative therapies distinguished from complementary therapies. Protocol developed for patient involvement and consent. Specific botanical therapeutics chosen.
Executing: 347 hours
Ethical review conducted. Non-blinded approach adopted. Patients enrolled in trial as receiving either alternative or complementary treatments with conventional treatment as the control group.
Monitoring and Controlling: 1040 hours
Initial metrics suggested mild success for complementary group, but final analysis showed significant decrease in effective pain management for alternative group as reported by patients. Anxiety control remained relatively neutral in non-control groups. Interdisciplinary team agreed to suspend project based on patient response to specific interventions.
Closing: 173 hours
Project findings reviewed for possible retrial with different therapeutic agents and shifting focus from alternative to complementary treatments. Financial considerations weighed and project closed.
Project C total hours: 2,080
. . . . .
Project B (4/2001 to 4/2005)
Hire into a hospital job classification referred to as Patient Care Coordinators (PCCs) for the purposes of reviewing their necessity, standardizing care delivered, and implementing a continuity program across 19 ambulatory clinics. 208 weeks were required at 40 hours a week. The first 78 weeks overlapped with Project A. Map Explore Define Implement Control cycle continued.
Initiation: 960 hours
Stage one initiated. Stakeholder buy-in was initially tenuous as this had been attempted twice previously and the success of this project had many challenges. Six clinical positions and associated procedures were mapped over the first six months by way of coverage. Psychological and skill set evaluations of PCCs also initiated.
Planning: 2,080 hours
Clinical mapping expanded to include coverage to and assessment of 30 PCC positions over the next year. Initial care protocols distilled as pertaining to surgical, medical, or allied clinics. Proposed standardization limited to each subset.
Executing: 3,120 hours
Stage two initiated. Clinical mapping expanded to include coverage to and assessment of 49 PCC positions. Survey of job satisfaction implemented. Standardized care protocols refined for three types of clinics. Position cost/revenue analysis incorporated. Skill sets analyzed. Profiles of successful PCCs produced. Discussed expanding project services to insurance carrier negotiations. Determined to be beyond scope and charter of project in progress.
Monitoring and Controlling: 1,480 hours
Services and evaluation expanded to 55 positions including four financial counselors. Clinical coverage process maintained as parallel to clinical mapping. Standardization to roll out with the hiring of new PCCs trained using standardized protocols. Float Pool (or Resource Team) designated as trainers for new positions (previously not possible). HR included in profile analysis and survey results.
Closing: 680 hours
Stage three initiated. Three new coverage PCCs hired and employed for clinical coverage, ongoing clinical mapping, and new PCC training as needed. Project management continued in training and advisory roles to include lessons learned. Deliverables included standardized protocols for (1) surgical, (2) medical, and (3) allied (non-surgical/non-medical) care coordination, (4) successful coordinator profiles, (5) skill set analyses, (6) job satisfaction survey, (7) profitability analysis, and (8) documentation in preparation for insurance carrier negotiations (proposed as stage four).
Project B total hours: 8,320
. . . . .
Project A (10/2000 to 10/2002)
Establish a virtual clinic called Health On Call with physician telephone consultations and supplement shipments for clients. Break even with or exceed initial investor contributions. Assess sustainability of venture. The first 26 weeks required 60 hours/week (in-person) followed by 78 weeks at 20 hours/week (virtual management) overlapping with Project B. Map Explore Define Implement Control cycle utilized.
Initiation: 180 hours
Travel to Global Conference in Cancun, Mexico to propose services and retain investors. Virtual clinic was initially presented as a perk to investing capital into clinical hyperbaric research and was soon after established as a free standing service for those who opted not to invest. 40 initial investors contributed $260,000 to company research and development. Investments ranged from $1,000 to $20,000 with an average of $6,500.
Planning: 180 hours
Virtual clinic opened to non-investors by word of mouth advertising. Costs for consultations and supplements detailed. Products designed and purchased and talent secured. Initially, five newly licensed naturopathic physicians and one accountant were hired. Residency stipend of $1000 to $2,000/month accepted as private contractors. Triage and referral protocols developed and submitted to director.
Executing: 1,200 hours
Consultations implemented in coordination with shipments of supplements to virtual clients. Refined vitamin/mineral sets to custom label. Refined medical consult protocol. Researched and developed treatment protocols in conjunction with consultation and referral services. Virtual clinic integrated with primary clinic through referrals. Refined delivery and billing processes. Ethical and legal issues addressed.
Monitoring and Controlling: 1,040 hours
Services revised for growth of client base. Limits set on consultations and emergency protocol refined for immediate referrals. Net income by the end of year two exceeded initial investment of $260,000. Attrition was noted as 7% or less annually, offset by consistent 300% growth. Deliverables included refined protocols for virtual management, product delivery, consults, treatments, billing, tracking, and accounting as well as private label vitamin sets. Project concluded by resale. Venture sustainable.
Closing: 520 hours
All protocols and designer supplement sets purchased by private company. Negotiations coordinated by legal team. Project management continued in training and advisory roles to include lessons learned. Deliverables included refined protocols for (1) virtual management, (2) consults, (3) treatments, (4) billing, (5) tracking, and (6) accounting as well as (7) product delivery and (8) private label vitamin sets.
Project A total hours: 3,120
. . . . .
Projects F+G+H+J+K+L+M total hours: 7,034 (as of 10/19/2015)
Practice and Project D total hours: 16,920
Archived Projects A+B+C total hours: 13,520
. . . . .
Project K (9/2012 to 10/2013)
In collaboration with administrative peer group, analyzed Nursing Administrative Supervisor roles to align with PRMCE Strategic Plan. Roles established within eight primary categories: Operational Resource, Emergency Response, Executive Team Liaison, Risk Mitigation, Crisis Intervention, Human Capital Management, Bed Control, and Clerical Oversight. Additional metrics in progress.
Initiation: 2 hours
Met with Director of Nursing Administration to discuss proposed content, organization, and timelines. Meeting facilitated to determine categories and priorities of job description.
Planning: 8 hours
Refinement of categories with admin group. Development of details related to process and protocol serially reviewed by group and management.
Executing: 23 hours
Report created as to recommended next steps based on alignment with strategic plan.
Monitoring and Controlling: 35 hours
Shift-specific review for tasks to be included or excluded. Multiple meetings with various stakeholders to reassign or accept responsibility for duties accumulated secondary to scope creep over several years. Minor revisions to recommendations.
Closing: 4 hours
Draft and recommendations submitted to HR after a brief management caucus.
Project K total hours: 72
. . . . .
Projects J, L, M (1/2013 to 5/2015)
In collaboration with Administration, designed, implemented, and published the 2012, 2013, and 2014 Nursing Annual Reports for the Board of Trustees, Executive Teams, Nursing, and Marketing at Providence Regional Medical Center Everett. 2015 NAR set to occur in 2016.
Initiation: 4 hours
Met with Director of Nursing Administration to discuss proposed content, organization, and timelines. Information collection structures to be utilized as per Project H (Nursing Matters). Review of NARs 2009 through 2011.
Planning: 21 hours
Requests for content sent to shareholders. Annual Report mock-up created to determine available space for content and refine layout. Draft to serve as template for Marketing design stage. Discussed expectations and process with Copy, Format, and Photo contractors. Specific content needs discussed with executive team.
Executing: 150 hours
Articles received, edited, and organized per new nursing model. Five-element structure finalized and filled with related content. Evaluation of final length pending additional submissions. Target determined to be 20 to 24 pages. 100% submission rate estimated to constitute 40 pages. Review of missing content for essential articles initiated. Articles received and reduced by secondary editor for inclusion.
Monitoring and Controlling: 65 hours
Involvement of Marketing group to review initial template and articles available for formatting. Discussion expanded to include photography submissions. Charts and statistical information added. Ongoing review and editing of late submissions. Multiple editing rounds required.
Closing: 10 hours
Review of six proofs required before finalized. 20-page ideal attained. Authorization given to move completed work to print shop for scheduled distribution at next Nursing Congress.
Projects J, L, M total hours: 275
. . . . .
Project H (6/2009 to 4/2013)
Design, implement, and support internal newsletter within Providence Regional Medical Center Everett to facilitate shared governance, leadership communication, and staff recognition in alignment with Magnet Journey.
Initiation: 1 hours
Met with executive team to discuss development and implementation of new communication architecture designed to facilitate shared governance and support nursing. Proposed format and content based on previously produced Mentor newsletter with greater emphasis on house wide issues and shared governance.
Planning: 6 hours
Designed letterhead in collaboration with print shop. Format parameters adjusted and name selected. Additional content ideas incorporated. Structures for information collection investigated. Frequency and deadlines confirmed. Email-based submissions confirmed. Budget allocated.
Executing: 45 hours
Quarterly newsletter produced that corresponds with each Nursing Congress. Four to twelve pages of content and photos cover current matters within nursing. Approximately 3 hours of execution, by way of information collection and organization, are required each edition with 12 hours required per edition overall. Deadlines for submissions proven to be the greatest challenge.
Monitoring and Controlling: 105 hours
By the 5th edition, most processes in place for repetitive collection of information, editing, submission, and distribution. Editing and distribution are primary at this stage, requiring about 7 hours per edition. Categories of content include Nursing Governance Council Reports, new degrees and certifications, kudos to staff, award winners, upcoming events, new protocol and policy, and general article submissions from nursing staff and leadership. Frequency and volume adjusted. Processes continue to undergo minor refinement as needed.
Closing: 30 hours
As of the printing of the 15th edition, time required to produce newsletter is limited to about 1 hour a week between editions, but occurs as an aggregate around deadlines. Closing is cyclic, by way of final review of proofs before print, and requires about 2 hours per edition. Project is well defined, mobile, reproducible, and able to transition when required. Closing by way of termination or transition is anticipated as requiring 1 to 3 additional hours.
Project H total hours: 187
. . . . .
Project G (7/2008 to 10/2015)
In collaboration with The Everett Clinic, design and implement a clinical continuity program for direct admissions to Providence Regional Medical Center Everett. Project to be carried out by several managers, directors, and executives.
Initiation: 260 hours
Variances in direct admit process identified. Standardization proposed. Discussions, meetings, and workouts around planned direct admit process undertaken in collaboration between PRMCE, The Everett Clinic (TEC), and other stakeholders. All admitting facilities impacted. Pathways reviewed and possibilities presented. Agreements made as to scope and charter. FTE positions allocated.
Planning: 520 hours
Initial process metrics identified as (1) time required to assignment, (2) number of calls required to assignment, (3) direct admit volumes, (4), complete information at assignment, (5) customer satisfaction, and (6) overall experience. Before metrics recorded for later comparison. Calls analyzed for peak call times. Developed Standard Operating Procedures (SOPs).
Executing: 720 hours
1.5 FTEs implemented as admission coordinator staff. 60 hours a week required for coverage of peak call volumes. Nursing supervisor role expanded to minimize training and execute new position. Nursing supervisor also primary for after hour coverage. Four dual role staff designed as project management team with overlapping responsibilities.
Monitoring and Controlling: 4,157 hours
Responsibilities included ongoing collection and analysis of metrics, ongoing revision of SOPs and implementation of revised protocols, ongoing collaboration with stakeholders and evaluation of needs, scheduling and staffing, off-hour coverage, complaint resolution, risk assessment, customer surveying, and technical issues. Lead established to oversee new program.
Closing: 160 hours
Project continues with new emphasis on decreasing time to bed placement. Protocols well established and effective. Technical issues proven as greatest challenge. Project is well defined, mobile, reproducible, and able to transition when required. Closing required 160 hours based on replacement training needs and level of expansion. See Metrics for additional details.
Project G total hours: 5,817
. . . . .
Project F (1/2008 to 6/2008)
Hire into a hospital job classification referred to as Diabetes Educators for the purposes of reviewing their necessity and providing coverage to clinical staff. Assessment to include ongoing clinical coverage viability with recommendations as to protocol and limitations.
Initiation: 3 hours
Met with executive team to discuss needs related to diabetes education and clinical coverage. Multiple previous failed attempts to train diabetes educators for patient assessment, education, and clinical coverage of unit. Project disclosed as final attempt. Risks assessed and initial coverage responsibilities determined.
Planning: 120 hours
Accepted placement as RN in diabetes ambulatory clinic to train as coverage diabetes educator. Orientation, training, and scholarly review anticipated to require approximately 6 weeks at 20 to 30 hours a week for limited coverage. Plan expanded to include review of literature for DM Educator certification. Revised plan anticipated to require an additional 6 to 12 months at 20 hours a week.
Executing: 240 hours
Clinic mapped, education conducted, and coverage applied. Classes taught on outpatient basis for patients with type 2 diabetes and diabetes in pregnancy. Type 1 diabetes training reserved for certified educators. A review of insulin and injection techniques included in coverage responsibilities. Completed rounds throughout Colby and Pacific campuses. Met with patients in outpatient setting to review needs and equipment.
Monitoring and Controlling: 240 hours
Clinical responsibilities balanced with review of literature and exam preparation for certification. Coverage deemed successful by administration. Unanticipated risks revealed. Evaluation of unit’s finances incorporated and patients surveyed for value of services offered.
Closing: 80 hours
Clinical services concluded. Unit opted to discontinue coverage to primary certified providers. Risks reviewed along with lessons learned, finances, and value metrics. Resources for training strained. Lack of certification at inception of coverage identified as central issue. Clinic determined to be highly valued by patient population while run at financial deficit. Options reviewed before diabetes clinical education unit consolidated. Project concluded 6/30/2008.
Project F total hours: 683
. . . . .
Project E (7/2007 to 12/2007)
Hire into a job classification as clinical nurse manager for busy gastroenterology (GI) clinic with difficulty retaining managers. Determine obstacles to success, review practice, and make recommendations for staff retention.
Initiation: 2 hours
Met with management group at Seattle Gastroenterology. Clinical coverage needs reviewed with one physician’s practice in greatest need. Difficulty retaining managers for clinic cited as central issue. Assessment with recommendations requested. Permanent placement offered.
Planning: 120 hours
Accepted placement as RN in GI ambulatory clinic to train and cover as clinical manager. Responsibilities included maintaining surgical schedules, supervision of office staff, ordering of equipment and pharmaceuticals, facilitating chart review and completion, refilling prescriptions, and general ambulatory nursing interventions. Orientation, training, and process review anticipated to require approximately 3 weeks at 40 hours a week.
Executing: 240 hours
Clinic mapped. Physician interviewed. Scheduling, management, and clinical services conducted. Personnel evaluated. Risks identified and threats assessed. Revisions made to data management and scheduling processes.
Monitoring and Controlling: 305 hours
Assessment and recommendations discussed with executive team. Selection of replacement made and new manager trained in alternate protocols. Processes streamlined. Ongoing assessment of personnel with additional recommendations offered to human resources. Multiple threats to success identified.
Closing: 200 hours
Five weeks required to train replacement at 40 hours a week with disclosure of threat assessment and ongoing process improvement recommendations. Personality of new manager deemed ideal for continuity. Project concluded 12/31/2007.
Project E total hours: 867
. . . . .
Project D (1/2007 to 12/2012)
Evaluation and execution of multiple roles as physician, nurse, administrator, counselor, consultant, vendor, and project manager conducted via IO Nurse private practice with a concentration at Providence Regional Medical Center Everett. Clinical practice continued via NWND.llc. Ongoing portfolio of various roles conducted as project D with all roles overlapping. 30 weeks were required at 20 hours/week followed by 272 weeks at 60 hours a week in combined activities excluding travel. First 30 weeks overlapped with Project C.
Initiation: 1,040 hours (includes 266 hours for Projects E+F+G+H overlapping)
Project D initiated as transition of clinical to consulting practice. Initial focus on advanced clinical counseling as well as consulting as physician and project manager for corporate clients. Networking and consulting services extended to Microsoft, Nordstrom, and Peet's Coffee & Tea.
Planning: 3,120 hours (includes 766 hours for Projects E+F+G+H overlapping)
Clinical practice distilled as patient evaluation, diagnosis, treatment, billing, and training students. Consulting practice incorporating high performance team development, select interviewing techniques, direct project and program management, motivation, ergonomics, conflict resolution, personality assessment, quality process improvement, human resource management, employee health strategies, efficiency, and social systems.
Executing: 5,200 hours (includes 1,248 hours for Projects E+F+G+H overlapping)
Seattle Gastroenterology management role accepted at Swedish Medical Center. Placement required 22 weeks at 40 hours a week. Placement included evaluation and revision of surgical schedule, scheduling procedures, direct patient care, evaluation of personnel, and training of replacement. Project conducted as interim manager for ambulatory GI practice. Clinical practice maintained at 20 hours a week.
Part-time placement accepted as dual role at Providence Regional Medical Center Everett (PRMCE). Initial services included coverage for administrative supervisor position. Role expanded six months later to include coverage to diabetes educators for an additional 6 months. PRMCE placement expanded to full-time coverage of administrative supervisor and admission coordinator positions. Admission coordinator developed as new role within Nursing Administration. Newsletter developed as independent project. See Metrics for additional details. Clinical practice maintained for a total of 60 hours a week and incorporating consulting roles as portions of projects in progress.
Monitoring and Controlling: 7,240 hours (includes 2,483 hours for Projects E+F+G+H overlapping)
Coordination and execution of multiple roles conducted, excluding orientation and evaluation activities. Individual discrete projects managed as vendor and consultant. Protocols flexible and adjusted as needed.
Closing: 280 hours (limited to Projects E+F overlapping)
Project D total hours: 16,920
. . . . .
Project C (7/2006 to 7/2007)
Hire in to hospital job classification as registered nurse in order to provide direct patient care, design complementary and alternative treatment protocols for pain and anxiety management, implement protocols, and assess for response to treatment. 52 weeks were required at 40 hours a week. Final 22 weeks overlapping with Project D.
Initiation: 173 hours
Project proposed as clinical trial combining conventional and complementary treatments in catastrophically ill patient population. Protocols reviewed from previous clinical practice, amended for population, and submitted to Medical Director and Pharmacist. Approved with minor revisions.
Planning: 347 hours
Risks reviewed. Patient population directly assessed for candidacy. Parameters of project defined. Alternative therapies distinguished from complementary therapies. Protocol developed for patient involvement and consent. Specific botanical therapeutics chosen.
Executing: 347 hours
Ethical review conducted. Non-blinded approach adopted. Patients enrolled in trial as receiving either alternative or complementary treatments with conventional treatment as the control group.
Monitoring and Controlling: 1040 hours
Initial metrics suggested mild success for complementary group, but final analysis showed significant decrease in effective pain management for alternative group as reported by patients. Anxiety control remained relatively neutral in non-control groups. Interdisciplinary team agreed to suspend project based on patient response to specific interventions.
Closing: 173 hours
Project findings reviewed for possible retrial with different therapeutic agents and shifting focus from alternative to complementary treatments. Financial considerations weighed and project closed.
Project C total hours: 2,080
. . . . .
Project B (4/2001 to 4/2005)
Hire into a hospital job classification referred to as Patient Care Coordinators (PCCs) for the purposes of reviewing their necessity, standardizing care delivered, and implementing a continuity program across 19 ambulatory clinics. 208 weeks were required at 40 hours a week. The first 78 weeks overlapped with Project A. Map Explore Define Implement Control cycle continued.
Initiation: 960 hours
Stage one initiated. Stakeholder buy-in was initially tenuous as this had been attempted twice previously and the success of this project had many challenges. Six clinical positions and associated procedures were mapped over the first six months by way of coverage. Psychological and skill set evaluations of PCCs also initiated.
Planning: 2,080 hours
Clinical mapping expanded to include coverage to and assessment of 30 PCC positions over the next year. Initial care protocols distilled as pertaining to surgical, medical, or allied clinics. Proposed standardization limited to each subset.
Executing: 3,120 hours
Stage two initiated. Clinical mapping expanded to include coverage to and assessment of 49 PCC positions. Survey of job satisfaction implemented. Standardized care protocols refined for three types of clinics. Position cost/revenue analysis incorporated. Skill sets analyzed. Profiles of successful PCCs produced. Discussed expanding project services to insurance carrier negotiations. Determined to be beyond scope and charter of project in progress.
Monitoring and Controlling: 1,480 hours
Services and evaluation expanded to 55 positions including four financial counselors. Clinical coverage process maintained as parallel to clinical mapping. Standardization to roll out with the hiring of new PCCs trained using standardized protocols. Float Pool (or Resource Team) designated as trainers for new positions (previously not possible). HR included in profile analysis and survey results.
Closing: 680 hours
Stage three initiated. Three new coverage PCCs hired and employed for clinical coverage, ongoing clinical mapping, and new PCC training as needed. Project management continued in training and advisory roles to include lessons learned. Deliverables included standardized protocols for (1) surgical, (2) medical, and (3) allied (non-surgical/non-medical) care coordination, (4) successful coordinator profiles, (5) skill set analyses, (6) job satisfaction survey, (7) profitability analysis, and (8) documentation in preparation for insurance carrier negotiations (proposed as stage four).
Project B total hours: 8,320
. . . . .
Project A (10/2000 to 10/2002)
Establish a virtual clinic called Health On Call with physician telephone consultations and supplement shipments for clients. Break even with or exceed initial investor contributions. Assess sustainability of venture. The first 26 weeks required 60 hours/week (in-person) followed by 78 weeks at 20 hours/week (virtual management) overlapping with Project B. Map Explore Define Implement Control cycle utilized.
Initiation: 180 hours
Travel to Global Conference in Cancun, Mexico to propose services and retain investors. Virtual clinic was initially presented as a perk to investing capital into clinical hyperbaric research and was soon after established as a free standing service for those who opted not to invest. 40 initial investors contributed $260,000 to company research and development. Investments ranged from $1,000 to $20,000 with an average of $6,500.
Planning: 180 hours
Virtual clinic opened to non-investors by word of mouth advertising. Costs for consultations and supplements detailed. Products designed and purchased and talent secured. Initially, five newly licensed naturopathic physicians and one accountant were hired. Residency stipend of $1000 to $2,000/month accepted as private contractors. Triage and referral protocols developed and submitted to director.
Executing: 1,200 hours
Consultations implemented in coordination with shipments of supplements to virtual clients. Refined vitamin/mineral sets to custom label. Refined medical consult protocol. Researched and developed treatment protocols in conjunction with consultation and referral services. Virtual clinic integrated with primary clinic through referrals. Refined delivery and billing processes. Ethical and legal issues addressed.
Monitoring and Controlling: 1,040 hours
Services revised for growth of client base. Limits set on consultations and emergency protocol refined for immediate referrals. Net income by the end of year two exceeded initial investment of $260,000. Attrition was noted as 7% or less annually, offset by consistent 300% growth. Deliverables included refined protocols for virtual management, product delivery, consults, treatments, billing, tracking, and accounting as well as private label vitamin sets. Project concluded by resale. Venture sustainable.
Closing: 520 hours
All protocols and designer supplement sets purchased by private company. Negotiations coordinated by legal team. Project management continued in training and advisory roles to include lessons learned. Deliverables included refined protocols for (1) virtual management, (2) consults, (3) treatments, (4) billing, (5) tracking, and (6) accounting as well as (7) product delivery and (8) private label vitamin sets.
Project A total hours: 3,120