Northport's new Chief of Staff always on the move - Northport VA Medical Center
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Northport VA Medical Center

 

Northport's new Chief of Staff always on the move

Northport VAMC Chief of Staff Dr. Mark Kaufman

Northport VAMC Chief of Staff Dr. Mark Kaufman

By Todd Goodman
Wednesday, April 13, 2016

Northport’s new chief of staff doesn’t have an office-based administrative policy. Instead, he walks nearly 10 miles a day through the medical center clinics to ensure veterans receive the care they have earned.

For Dr. Mark Kaufman—a Nassau County native and Northport’s chief of Neurology for the past 22 years—seeing his clinical time reduced in his new role has taken some getting used to.

  
“It’s a big adjustment, absolutely,” said Dr. Kaufman. “How does someone who has been taking care of patients—if you include training—since 1979 step back a little bit? The hardest thing is being involved in policies and oversight and being a little bit removed from the frontline. But one of the things that, hopefully, people will see is that I don’t spend a lot of time in my office. I spend a lot of time moving through the clinics and the Emergency Room.”


And moving through the clinics and ER has led to change. His method of achieving this is through two things—communication and process analysis. He demands better communication from the top to the bottom—especially between providers and patients.

 
“Do the patients have closure on their questions? Do they understand the plan? Do they understand how they will follow up if they are being sent for tests or a consultation with somebody else? It’s very important that those things are laid out clearly, and if necessary gone over a couple of times so they understand why they were here,” he said. “It’s a sense of closure, that the visit accomplished the purpose.”

 
Process analysis, which is huge for him, is the breaking down of something into various components to see what is needed, what isn’t, and how things can be streamlined for more efficiency. For instance, Northport’s use of hospital beds has undergone a dramatic change, and the ER processes have begun to change.

 
“We have to maximize the efficiency for our patients,” he said. “It’s one thing to have great time measures for how long you wait to get an appointment with us, but that’s not going to be remembered if the patient comes and sits for 90 minutes and feels like they barely saw the people they came to see. We do so well at getting them into a scheduled appointment; we need to do well in the flow of the appointment itself. That’s how we use space.”


The use of beds also focuses on efficiency by shortening the patient’s length of stay. Now VA is coming into the same range for length of hospital stay as the private sector. VA length of stay, which is 20 percent shorter than it was seven months ago, is important for two reasons—patient well-being and fiscal responsibility. Also, the more time a patient spends in a hospital beyond what is necessary, the greater the risk of exposure to very sick patients.

    
VA faces many challenges, the most important being to maintain a relationship with its patients where they know that this is the place and this is the staff that can do the best for them.

 
“There are more challenges to that concept now than probably any recent period in VA’s history,” he said. “There is questioning about the efficiency and quality of VA care, more so than we’ve seen in the past, and it’s spilled over to campaign issues, public inquiry, and congressional hearings. I believe patients are wondering more now than probably 10 years ago, ‘How good is the VA?’ And I think we have the responsibility—as the expression goes—to show them what we’ve got.”


What “we’ve got” {in Dr. Kaufman} is a leader who studied math and science at an engineering school before medicine and neurology. Engineering influences the way he views clinical operations, breaking things down to their essence and discarding what doesn’t fit. It seems so simplistic, but this type of process analysis in some clinical areas probably hadn’t been done in a long time, he said.  

“I want to be there, to be involved, and go to the meetings that are deciding things,” he said. “To monitor the processes, to follow up, to keep in touch with the people involved, and to let people know that I appreciate what they are doing ... that’s very important to me.”

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