Ahead of the game

October 2, 2018

Maxim No. 8: “Skate to where the puck is going to be, not where the puck is.”

Maxim No. 8 came to me by way of Wayne Gretzky, one of the greatest hockey players of all time. When asked by a reporter how he managed to stay at the top of his game, he answered, “I think it’s because I skate to where the puck is going to be, and everyone else skates to where the puck is.”

When you apply Wayne’s perspective to the world of health care, it essentially translates to market differentiation – distinguishing a product or service from others to attract or create a new target market.

Historically, we at Texas Children’s have been very good at market differentiation or skating to where the puck is going to be. We are an organization that is constantly looking at what’s around the corner, forecasting what families will need, and proactively creating solutions before a challenge even fully materializes. It is this type of thinking that led to the Pavilion for Women, Texas Children’s Pediatrics, Texas Children’s Health Plan, the Jan and Dan Duncan Neurological Research Institute, and our hospital campuses in Katy and The Woodlands.

Sure, there were naysayers and critics who said these things wouldn’t work and that we should just focus on being a children’s hospital, but we were impervious and pushed forward with our plans, confident they were what our patients and families needed. Time and again, our instincts have been proven to be right.

So many of you are making bold, proactive moves throughout the organization, and I want to highlight Kabby Thompson, Director of Managed Care, is a great example. She and her team negotiate contracts on behalf of Texas Children’s Hospital, Texas Children’s Pediatrics, Texas Children’s Urgent Care and Texas Children’s Physician Service Organization with insurance companies, providing in-network access for our patients.

Kabby’s job is critical to making care accessible and affordable for patients and their families. Her team and the work they do is also extremely important to the vitality and sustainability of our entire organization, especially in this dynamic climate of transformation in the insurance industry.

Kabby joined Texas Children’s three years ago after working for several large insurance companies. She’s perfect for this role because she is a strategic, forward-thinker who is constantly looking five to 10 years ahead to the future of health care reimbursement, rather than simply focusing on how we are paid today.

She assesses and plans ahead based on long-range health care reimbursement risks and does not allow day-to-day fluctuations to distract her focus on high-impact areas. Kabby also works to build business partnerships with health plans that can collaborate with us in ways that benefit Texas Children’s and our patients.

It’s inspiring to watch Kabby navigate this ever-changing world of managed care with such focus, agility, and compassion. She never loses sight of the fact that our patients and families are what is most important and that they count on the stability that Texas Children’s provides. With people like Kabby on our team, we will continue to always be ahead of the game.

I’d like to hear from you … how do you skate to where the puck is going to be to stay ahead in your role at Texas Children’s?

Take the leadership challenge, and score a spot at a Houston Texans event!

Over the past few weeks, Mark Wallace’s blog has been highlighting employees who demonstrate his Maxims of Leadership. Each blog post poses a leadership question that Texas Children’s employees may respond to in the comments section until October 19. 

Afterward, the Corporate Communications team will randomly select 75 people from the comments to attend a private event with the Houston Texans, including a behind-the-scenes tour of NRG Stadium, an autograph session with two Houston Texans football players and photos with the Texans cheerleaders.

44 Responses to “Ahead of the game”

  1. Jeanette McMullen

    I look forward to seeing where the puck is going to be with us in Austin. Managed care is getting tougher to profit from, yet we as an organization keep expanding to serve the children. They don’t care about insurance. They just want to be healed. Thanks for being forward thinking in ALL that we do as an organization.

  2. Pam Tuley

    My version of “going where the puck will be” is to anticipate problems before they happen so we can avoid delays in patient care and services. Going out of my way and asking a few extra questions can often give me the foresight to accomplish a task that might have been taken more steps than necessary. I always try to remember that our families come from great distances and maneuver through people and traffic to get here. Multi-tasking at an appointment can save them extra trips.

  3. Elizabeth Davis

    When our unit is faced with a change or challenge, I try to see how it can best help the team and where some will struggle with it. I try my best to diminish the struggle through rationalization of why we are facing this challenge and work out ways to combat it. I also try to enhance what will work and include the team in this process so that all the shareholders will see it through.

  4. Isabel De La Torre

    Consistently staying ahead of the game is the perfect description of the collaboration my Nursing Director and I have created. Since working together, my part of being on her team requires me to always anticipate where the “puck” is going to be at all times. Building that working relationship prepares me to anticipate the worst and always plan ahead or have a back up to things. This preparation has be looking ahead to the upcoming days (weeks and months) to plan and predict what is required. It may a presentation, agenda copies, extra pens for a meeting, etc. Without the “staying ahead” mentality, I would suffer with my job and lack the skills required to anticipate the next movement of the “puck”.

  5. Staying ahead of the ‘game’ provides an opportunity to practice proactively rather than reactively. As a nurse practitioner in the Maternal-Fetal Medicine department, I persistently evaluate care processes and identify areas of practice that would benefit from a slight modification or a complete renovation. Evaluating processes and determining the most efficient path to improvement is a challenge I enjoy and has been proven to improve patient outcomes. A recent patient care improvement process I led revealed a statistically significant improvement in care and offered an opportunity to meet DSRIP funding measures for our department. By continually evaluating patient care processes, our department was able to have a solution in place prior to the ‘need’ of having a solution in place. This has also allowed our department to be in the forefront of future quality improvement and research in this field which is key to leading in the health care field. But most importantly, leading health care in front of the puck allows us to care for our patients on the cutting edge of health care while anticipating and addressing deficiencies before they affect our patients, resulting in improved patient outcomes.

  6. Nathan Money

    Skating to where the puck will be has both clinical and research-related implications. In research, you need to be thinking about the next step or you may find yourself behind, as projects may take years to complete. Clinically, an important part of inpatient management is making contingency plans in case children don’t go the direction we hope they will, so we can be prepared at a moment’s notice.

  7. Cindy Alvarado

    I work at the Sugarland Health Center. The way I “skate to where the puck is going to be” is by making sure insurance verification is done before the patient wants into the doors and making sure their authorizations are on file and accurately notated. If an authorization on file is set to expire within a couple of weeks, its better to start the process in advance of getting a new authorization in order to make sure no interruption in (PT, ST, OT) services happen. Because I truly believe that without our ‘patients’ WE would not be where we are!! 🙂

  8. Lorianne Classen

    In patient experience, one way we “skate to where the puck is going to be” is to better understand the expectations of our patients and families, so we can proactively manage, or meet, those expectations.

  9. Jerry Garcez

    When I’m speaking with a parent prior to their appointment I try to listen and proactively prepare their rooms for what they might need or even ask for before they arrive. The patients have a better night, the parents have a better night and the staff can have a great night!

  10. Lucia Del Valle

    In my role as an Ambulatory Service Representative, I do my very best to always be efficient and “skate to where the puck is going to be to stay ahead of my game” not only to make it easy for me but to also have things in order to be welcoming and organized for our patients. I strive to be ready to take on each work day to not only meet my patients and peers expectations but to exceed them. I make sure when I call my new patients to confirm their upcoming appointment, to have a friendly voice and to make sure their questions or concerns are answered, with a friendly tone. I also make sure to complete my work for any days I am going to be off and complete my work for the days I am going to be out, to reduce any workload and not cause any stress to my peers. I enjoy staying ahead of where the puck is going to be and staying ahead of the game.

  11. Lauren Westerfield

    I skate to where the puck is going to be by devoting significant effort to the new Baylor College of Medicine genetic counseling training program, and by performing clinical research on cutting-edge fetal testing options. Sure it’s extra effort to juggle in addition to the daily needs of my patients, but this will help ensure that 2-3 years from now we’ll have a built-in pipeline of new counselors to support expansion of genetic services in Texas and that by the time insurance companies catch up with reimbursing new testing and making it available to a larger population of patients, TCH patients will be able to access providers who are already highly experienced with it.

  12. Crystal

    Technology is a field that is ever evolving. Most times when you think you got it, there’s something new that has evolved. I skate to where the puck is in my role by staying informed to the new and exciting trends, so that I can fashion my instructional design to meet the future needs of my customers.

  13. Charmaine Patterson-Victor

    My definition of skating where the puke is going to be is being unique, different and unlike the “norm”. Not following the crowd….being an individual and making choices others don’t see. It’s taking a risk that everyone may not see now, but all will benefit later. I jokingly tell my team, “there’s a method to my madness”. Leading a newly developed department with TCP-Central Business Office has challenged me to skate where the puke is going and I have been leading my team with honesty, integrity, hard work and empathy. I’m taking risk and not listening to the nahsayers and pressing forward with my team by my side.

  14. Haley S

    I skate to where the puck is going by trying to anticipate my patients’ needs and questions. I work hard to empower them with information and always be prepared with additional resources to ensure they are comfortable. We are the experts and therefore can use our expertise for prognostic guidance and making patients feel comfortable.

  15. Olga Chen

    As a case manger in complex care, I “skate to where the puck is going to be” by planting seeds with TCHP members. Sometimes the members are overwhelmed by their current situation so we discuss how we can plant seeds today so that when they are ready to take the next they have set themselves up for success.

  16. Amber Hill

    As a certified child life specialist we always try to anticipate the outcome so that we can put the best support measures in place for children and families in order to have the most optimal hospital experience. It takes good team work communication to help make this happen.

  17. We need to focus on the goal by staying connected and understanding what the voice of our patients is telling you. Moving back and forth between what we think might happen. The patient is the puck, when we align our work to their needs we spend our time increasing value.

  18. Kathy Beekman

    I skate where the puck is going to be by prepping the rooms and machines for the next shift, because they are ready to go at a moments notice and well prepared they can cut down the time it takes to get to the patient or do the exam.

  19. Taylor Ruthstrom

    In the PICU, we skate to where the puck is going to be by anticipating problems before they happen. We have to do more than treat patients for their current issues – we have to prepare and anticipate future problems and try to prevent or avoid them, recognize signs and symptoms that could indicate changes, and always stay two steps ahead to keep our patients safe, strong and to get them back to being healthy. We skate to where the puck is going to be by acting proactively instead of reactively.

  20. Always anticipate for the worst but hope for the best. Time management is always a must when it comes to working in a hospital because we never know when an emergency occurs. Never procrastinate because it will always put you further behind, better early than late.

  21. Stephanie

    In the EC, I “skate to where the puck is going to be” by anticipating what and where I am needed before I am asked. I observing how each of my co-workers operate and when I know they are anticipating a procedure, IV, urinary catheter, laceration repairs, etc. I make sure I am close by to assist where needed and have the supplies ready. If there is a patient in MTR, I have IV supplies ready as well as being prepared for cultures to be drawn. I get vitals on patients before they are due and have them done before the nurse can ask for them, on a patient being discharged.

  22. Melanie

    I ” Skate where the puck is GOING to be” by always approaching my unit with a critical eye and consistently looking to see where we can improve! There is always room for improvement and I embrace CHANGES by Stepping OUT OF THE BOX to Create a better method for Patient care as well as Procedures.

  23. Melissa Bayne

    Skating where the puck is going to be (for me) means pursuing continuing education classes with new innovative treatment techniques that will lead us as therapists into the next level of care. For my patients, it means guiding patients and their families toward the goals that are further out in their treatment – looking at the big picture and how their functional outcomes will affect their future abilities.

  24. Christina Joseph

    Skating to where the puck is going to be is critical to market oneself as well as to market a specific department can contribute for TCH overall. When one department seeks to go where the puck is going to be, then this can help out TCH overall. In my current role as an intern and a full-time graduate student, I find ways to be where the puck is going to be by taking steps to accomplish my goals. Looking at the current market and keeping up-to-date on where the industry is going is vital in order to be knowledgeable about what improvements and changes are coming our way. For the ambulatory department, this department always seeks ways to add more innovation in order to go where the puck is going to be.

  25. Victoria Gomez

    Skating where the puck is going to be for me is consistently exceeding our patients/families/customers’ expectations by showing passion/love on what we do on a daily basis.

  26. Heather Eppelheimer

    I try to “go where the puck is” by being actively involved and aware of research within the field of Child Life and perinatal loss since I have a unique role at the PFW. I obtained a CPLC (Certification in Perianal Loss Care) last year as a self driven initiative to demonstrate expertise in the field and unique area. I’m continuing to skate where the puck is being involved with PLIDA- both by being a member, on committees and as a presenter at their International Conference where I will learn about new research within the field and be able to bring this back to PFW.

  27. Vic Griffis

    Anticipating what my customer’s needs and expectations are and exceeding those expectations
    by acting with a sense of urgency, regardless of what else is going on. If my customer believes they are my top priority, and I produce results and positive outcomes, exceeding their expectations, a trust and very positive relationship is formed. Consistency of the above continues to build those relationships.

  28. Heather Lauterbach

    I stay on top of evidence based research and have joined clinical nursing societies in order to ensure my patients are receiving the best care I can possibly provide, while providing a main focus on family centered care.

  29. Helen Grosskreuz

    Education and Networking! Reading journals, attending seminars and belonging to professional organizations provides important insight into business and health care trends. Education and networking fuel creativity.

  30. Deborah J. Davis

    I have enjoyed the progressive attitude at TCH! “Skating to where the puck will be” is a great illustration of the forward thinking and planning that this organization offers it’s employees and the consumers.

  31. Jane Head

    I am not sure whose quote this is, but it has guided me for many years, “The end is where you start at.” As I approached turning 50, like many, soul searched asking myself what my life was missing, what are my regrets, and what are my triumphs. I had been talking about getting my master’s degree to the same coworker for a few years. One day she said, “Either do it or quit talking about it.” That caused me to realize that I was not looking forward at all, I was simply looking at where the puck was. This made me think about what I wanted and where I wanted to go, starting right then in the summer of 2012. I wanted to do research so decided on a degree plan to get a MSN in Clinical Research Administration, and took a research position that opened in my department while I got busy with school. With this end in mind, I started on a path that required many route and time adjustments, but I got there in January of 2017. My MSN from George Washington University is in Health Care Quality. I am now a Care Manager at the main campus. This experience and accomplishment has served me well in my role. I look at each patient who has found themselves in the hospital setting, and project where they need and want to be, wherever home is, and determine what pieces need to be put into place to get them there. Discharge planning would be like several pucks and players being set into motion toward the goal line, and the Care Manager is the coach who makes sure the players and pieces arrive to the goal at the planned time. Dr. Stephen R. Covey said, “Your most important work is always ahead of you, never behind you.” Gretzky is indeed a world class athlete who’s success in skating toward where the puck will be was monumental, as he worked side by side with his hockey “team”. For Care Managers, the importance of having a forward thinking daily vision, making frequent adjustments to the plan, and working together as a team cannot be overstated. Embracing Mr. Wallace’s Maxim No. 8 is essential in care management to ensure that appropriate and timely discharges have exceptional outcomes for our patients and families.

  32. Emily Berman

    I “skate where the puck is going to be” in my role as the physical therapist at The Rise School of Houston, an affiliate of Texas Children’s, by building relationships with both the families I work with and the staff. This leads to trust and teamwork which is essential in making progress towards therapeutic goals. Thankful to work for Texas Children’s Hospital now for 15 years!

  33. Holly Underwood

    In my role within the organization, I try to anticipate the questions that leadership will need answered when presenting an issue or recommendation to a current process. When a complete picture is presented to the leadership team, they are enabled to make critical decisions or propose next steps to move forward. It has been beneficial to work with others closely across multiple departments to collaborate and identify opportunities that can be addressed proactively for our team.

  34. Ashley Hamilton

    Being where the puck is going to be denotes getting ahead and forward thinking. I raise my awareness to the growing trends; current market; and hold a key seat in activities or committees that affect the principalities of this organization’s progress. Also, understanding that my influence and servitude directly impacts the patients and families we serve. Texas Children’s knows that the patients we nurture back to optimal health today will be the leaders of our tomorrow and that too is skating where the puck will be.

  35. My husband is currently getting his masters in data analytics and he’s always looking at the growth and future of companies. I’ve told him several times to look in to joining me at TCH

  36. Vince Kiel

    I love the hockey analogy!

    “Skating to where the puck is going” can be used every day in my position as a Biomed. The goal (more hockey 🙂 is 100% reliable and accurate equipment. If I always skate towards that, the daily tasks seem to take on more significance and job satisfaction!

  37. April Drebert

    As a nurse I am always “skating to where the puck is going” when I first start taking report at the beginning of my shift. I am reviewing all of the patient’s information and learning what the patients goals are short and long term. So even if we are not there yet, what are the steps we need to do in order to get there. As a nurse I am also anticipating needs for my patient. Beginning discharge planning so the patient and family is not waiting at discharge for everything to arrive or be done.

  38. Nelson Castellon

    Keeping a “skating to where the puck is going” attitude has helped me personally in many ways. It allows me to keep moving forwards and not become stagnant in a situation for too long, moreover, staying prepared and pro-active is always a quality that is appreciated by families and patients. Oftentimes when things don’t go as planned, having a vision of what the end goal can be fundamental!

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