Portfolio


Portfolio is limited by confidentiality agreements and may include both vendor (traditional consultant) and full-time equivalency (FTE) roles. The FTE roles below are healthcare specific. Many have involved hiring into the practice, position, or project in need in order to clinically map a new or challenging position, identify resources, enhance processes, design or modify the job description, recruit and train staff, and support or conclude the role. 

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IO Nurse LLC • Private Practice • Seattle, WA
Enterprise Consultant, Strategic Business Partner and Special Projects 
2020 to present

Healthcare Operations
• Incorporating clinical assessment, accountability audits, direct project and program management, patient safety, quality assurance, customer and employee satisfaction and developing high reliability systems
Behavioral Consulting
• Including motivational coaching, performance assessment, select interviewing, candidate review, mentoring, loss prevention, process improvement, marketing, supply chain and service line optimization in technology, retail and healthcare venues
Organizational Development
• Focusing on strategic change implementation, innovation, high performance team development, conflict resolution, human capital management, financial audits, management and technology
Regulatory Compliance and Accreditation
• Awareness of CMS, DNV, ACR, ACHC and TJC, Medical Staff Development, Credentialing, HAC/Harms, and multiple survey venues, as well as DOH, CLIA, and OIG surveys and audits 

http://www.ionurse.com/

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Kindred Hospital LTAC (Downtown and Northgate) • Seattle, WA
Director of Quality Management & Special Projects 
2019 to 2020 

Responsibilities defined as a continuation of Lake Cumberland Regional Hospital (below): Quality, Patient Safety, Healthcare Operations, Performance Improvement, Infection Prevention (oversight), Accreditation and Compliance, Data Abstraction/Tracking/Trending, Database Administration (oversight), Resource Management and Risk Mitigation

Special Projects included CMS, TJC and DOH accreditation, readiness, visits, education and tracers • Survey and Specialty Certification coordination and completion in Respiratory Failure and Sepsis (clinical response) • Data Abstraction, Tracking and Trending • Ongoing Data Abstraction and Database Administration oversight • Medical Staff Development through Focused and Ongoing Professional Practice Evaluations (FPPE and OPPE) and Peer Review

http://www.kindredhospitalseattle.com/

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Lake Cumberland Regional Hospital • Somerset, KY
Director of Quality Resources
2018 to 2019 

Quality and Patient Safety
• Fostering Patient Safety, Just Culture, High Reliability and policy updates • Oversight and support provided to executives, Ethics Committee, Environment of Care, Quality Committee, Credentialing, Patient Safety Clinical Quality Committee, Medical Executive Committee, Board of Trustees and all Clinical Service Lines • Tracking and reduction Hospital Acquired Conditions (HACs), Hospital Acquire Infections (HAIs), harms, complications, mortality and morbidity • Development of presentations and support to local executives for biannual reports to corporate executives • Direct support of Internal Medicine (IM) and Family Medicine (FM) residents’ research, proposals and publications

Healthcare Operations
• Quality and Risk Management department operational efficiency • Succession planning, cultural change facilitation, Quality of Care Investigations, RCA, FMEA and interviews • Daily leadership rounding - direct patient and family advocacy and complaint resolution • Performance Improvement • Issue identification, coordination, facilitation and data to drive improvements • Communication architecture between frontline staff and executive team • Foster ownership and buy-in via collaborative resolution • Infection Prevention (oversight) • Infection Prevention, education, surveillance, reporting and patient care • Coverage to IP, as needed, with an emphasis on program expansion

Accreditation and Compliance
• CMS, TJC and OIG accreditation, readiness, visits, education and tracers • Culture of Safety and Engagement (CoSE), AHA, Anthem, Leapfrog, KHIIN, WSHA and other survey coordination and completion • Data Abstraction, Tracking and Trending • Risk event tracking, Core Measures, KHIIN data submissions, Ongoing Data Abstraction, Database Administration oversight • Medical Staff Development through Focused and Ongoing Professional Practice Evaluations (FPPE and OPPE) and Peer Review • Resource Management • Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) improvement and content knowledge updates • Provided coverage to Risk Director, as needed, for legal matters and lead all patient safety investigations 

https://www.lakecumberlandhospital.com/

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Washington State Hospital Association • Seattle, WA
​Director of Quality and Performance Improvement, Patient Safety 
2015 to 2017

Provided leadership and joint program oversight for Patient Safety and Care Transformation in AK, OR and WA (directly supported 120 facilities) • Facilitated an annual reduction in harms related to:
Sepsis (31.2% decrease in mortality)
Rapid Response Teams (46% increase in staff-initiated processes)
Honoring Choices PNW (contributed to over 1,500 conversations)
Children’s Radiation Safety (mapped 110 CT imaging protocols)
Readmissions (13% decrease in all-cause hospital readmissions)

Directly supported clinical providers in developing strategies to improve clinical outcomes, design interventions and small tests of change • Provided research and guidance on development and implementation of policy, protocol, documents and toolkits for diverse stakeholders • Provided remote and in-person support to facilities and provider practices struggling with performance improvement measures by way of Six Sigma, Lean and other Total Quality Improvement methodologies

http://wsha.org.s152772.gridserver.com/staff/ryan-hosken/

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Providence Regional Medical Center Everett • Everett, WA                      
Nursing Administrative Supervisor and Admissions Coordinator
2007 to 2015

Operational role as Administrative Supervisor providing oversight and leadership for two clinical facilities within Providence Ministries. Responsibilities involve complex issues requiring triage, professional judgment, and executive representation. Analyzed Nursing Administrative Supervisor role to align with Strategic Plan. Eight primary categories defined to include: Operational Resource, Emergency Response, Executive Team Liaison, Risk Mitigation, Crisis Intervention, Human Capital Management, Bed Control, and Clerical Oversight. Tiered triage of multiple critical events mapped.

Project role as Embedded Consultant engaged in communication architecture and behavioral analysis. Productions involved coordination and production of quarterly newsletters and the development and implementation of high-profile marketing materials for Nursing Administration. Annual projects consistently on-time and under budget ($20,000) by 3%, 21%, and 49%. Change initiatives supported through behavioral analysis with emphasis on policy updates, patient throughput, and information security. Key initiatives involved Diabetes Education and Admissions Coordination. 

Technology role as Super User supporting new users through four successive EMR applications: BedBoard, TeleTracker, McKesson HEV, and EPIC. Ancillary support provided for Pyxis, ANSOS, Kronos, SharePoint, and Reg/ADT applications. Additionally proficient with MS Suite (Excel, PowerPoint, Word, and Outlook) for presentations, communication, and scheduling. Expandable utility with Microsoft Access, SPSS, and other database, graphic arts, and statistical analysis software applications.

http://www2.providence.org/northwest-washington/Pages/default.aspx

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IO Nurse • Private Practice • Seattle, WA
Strategic Business Partner
2007 to 2020 

Private practice with a heavy emphasis on advanced clinical counseling, behavioral analysis, and Applied Jungian Archetypes. Specialties include complementary primary care, employee health, cognitive medicine, functional nutrition, corporate services, project management, social systems reengineering, and meditative modalities. Consulting practice transitioned to IO Nurse LLC in 2020. 

http://www.ionurse.com/
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Puget Sound Gastroenterology (First Hill) • Seattle, WA
Interim Clinical Manager 
2007 

Management of annual budgets, oversight to GI procedures, and supervision of non-clinical staff. Central role involved practice review and staff evaluation. Primary obstacles to provider success identified and disclosed. Six direct reports. Interim role 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. 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. 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. 

http://www.pugetsoundgastro.com/

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Kindred Hospital LTAC (Vencor Group) • Seattle, WA
Registered Nurse
2006 to 2007

Initial post-BSN placement. Hired on as RN to provide direct patient care to acute and long-term ventilated or catastrophically ill patients. Clinical project developed for the Vencor Group at Kindred Hospital in Seattle included assessment of patients for alternative therapies related to anxiety and pain management. Evaluations conducted with clinical pharmacist and chief medical officer as interdisciplinary team. 

http://www.kindredhospitalseattle.com/

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IO Physician • Private Practice • Seattle, WA
Licensed Provider and Behavioral Analyst
2003 to 2007

Private natural medical practice focused on house calls, coordinated supplement deliveries, and virtual medicine with heavy emphasis on clinical counseling, cognitive medicine, and mediative modalities. Provided health education and assisted with proper utilization of community, social, and healthcare resources. Clinical practice transferred to NWND.llc after conclusion of Harborview Medical Center project. Academic sabbatical engaged in 2005. Consulting practice consolidated under IO Nurse in 2007. 

http://www.ionurse.com/

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Harborview Medical Center • Seattle, WA
    
Project Manager and Patient Care Coordinator                                   
2001 to 2005

Designed and implemented a three-stage clinical continuity program for Harborview Medical Center. Metrics included cost of position set against revenue generated by clinic and individual, personality profiles matched with patient satisfaction and job satisfaction surveys, and task-specific measurements for time/cost analysis. Trained to 49 ambulatory PCC, 2 in-patient PCC, and 4 financial counselor positions for the purposes of standardizing to Medical, Surgical, and Ancillary job descriptions. PCCs noted to account for $2,940,000 in annual returns set against $2,107,000 in salaries ($833,000 annual revenue). Refinements correlated with a revenue increase to $954,600 by the end of year two across all ambulatory clinics. Surgical income excluded. First year metrics defined an 11% increase in revenue versus costs adjusted for inflation across all clinics. Returned to school to complete BSN.

http://www.uwmedicine.org/patient-care/locations/hmc/Pages/default.aspx 

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Administrative Internship • Seattle, WA
Program Manager and Experimental Systems Analyst                          
2000 to 2002                                                

Program initiated using DFSS methodology. Designed program for the Hyperbaric Oxygenation Corporation designated Health On Call, aimed at supporting individuals' health by phone consult, triage, referrals, and supplements by mail. Program implemented by 5 Elements Naturopathic Health Center, LLC. Organized intermittent fundraisers in conjunction with Global Health Fairs. Opening administrative budget of $14,200 (offset by $10,600 in initial operating costs) grew to a monthly income of $9,870 six months later as the virtual clinic grew from 40 to 94 subscribers, nearing a break-even point. At one year the subscriptions had tripled to 126 ($13,230 monthly income against $12,200 in operating costs). Triple growth sustained over the second year of the project. Managed team of consulting physicians and accountant. Six sigma methodologies applied to supplement line, delivery protocols, medical consults, therapeutic protocol development, and research with oversight from Philips Corporation.

http://www.5elementsnhc.com/