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Healthcare Heroes

At the Soldiers’ Home, She’s a Nurse, Leader, Mentor, and Role Model

Celeste Surreira

Celeste Surreira

Celeste Surreira was talking about her work, and, more specifically, the unique constituency she serves, when she abruptly stopped in mid-sentence.

Strains of “Anchors Away,” the fight song of the U.S. Naval Academy, had permeated the walls of her office, and she knew exactly what that meant: the Soldiers’ Home in Holyoke was giving a Navy veteran a ‘farewell.’

Rising from her seat quickly, she invited BusinessWest to follow her to what she promised would be a solemn and immensely powerful ceremony. That was an understatement.

In the front lobby of the Soldiers Home sat a casket covered by a quilt, patterned specifically for a Navy veteran, that was made by one of the facility’s nurses. Behind it stood many family members. To the sides were Soldiers’ Home staffers, who, in many respects, are also ‘family’ for this individual — and all other veterans who come there.

Collectively, they assembled, with hands over their hearts, and heard about his life — not just about his service in the Seabees (the U.S. Naval Construction Battalions) during World War II, but about his family (three sons, 13 grand-children, and “eight, soon to be nine” great-grandchildren); the decades he spent as a commercial painter (he and his father helped paint the Soldiers’ Home when it first opened in 1952); his love for Holyoke, his long-time home; his affection for golf; and more.

Then came “Taps.” And many tears.

Walking back to her office, Surreira put the ceremony in its proper context, and in so doing helped explain why she came to the Soldiers’ Home in 2014 and why she is so passionate about the many facets of her work that she was named the Healthcare Hero in arguably the most competitive category — Health/Wellness Adminstrator/Administration.

“They go out the same door they came in — it’s our honor to them,” she said of the servicemen and women being given a farewell. “And that’s very important. When I worked in the hospital, death was something we hid, like it was like a failure; they [deceased patients] went out the back door. Here, death is a celebration of life; there’s no shame. They go out the front door.”

“When I worked in the hospital, death was something we hid, like it was like a failure; they [deceased patients] went out the back door. Here, death is a celebration of life; there’s no shame. They go out the front door.”

Surreira would speak often about the veterans she now serves as she talked about her career and her current work, because the clientele, if you will (they simply call them ‘veterans’ here), is truly unique, and this is reflected in everything from how services are delivered to how these individuals are addressed.

“I thought this was a really interesting population to have the honor to work with,” she said, adding that the Soldiers’ Home, a 265-room, long-term-care facility (which also has outpatient services and a domiciliary), represents a significant career shift for her, with most of her 33 years in nursing having been spent in the emergency room. But in many ways, the issues and challenges facing veterans at the facility and the providers caring for them mirror those of society in general as the population ages and people live longer.

“This is where healthcare is going,” she told BusinessWest. “The population is living longer with chronic diseases. This is the population with which we’re really going to have to make an impact if we’re going to manage the needs of the overall population over the next 30 years.”

In her role as assistant director of Nursing, Surreira has a lengthy job description, and considers herself — and, more to the point, she’s considered by others — to be a care provider, leader, teacher, mentor, and role model.

And she takes each of those responsibilities very seriously, especially the leader and role-model parts.

“Leadership and management are two different things,” she told BusinessWest. “You can manage, which means doing payroll or doing a schedule or telling someone what to do. Or you can lead, which to me means inspiring people to become leaders.

“You can’t lead if you don’t have emotional intelligence,” she went on. “People are just going to see you as the boss. And no one really follows the boss; they’re not inspired by bosses. I’ve always said, if you have to tell someone what your title is in order for them to know you’re the leader, then you’re not really the leader — someone else in the room is the leader.”

One of Surreira’s working definitions of a leader is that of an individual who can work with others to achieve positive change and improve quality of life for those being served, and as we’ll see, there are many examples of how she’s been able to do just that, and thus become a true Healthcare Hero.

Walking the Walk

They call it the ‘Walk Across America.’

This is a walking track of sorts at the Soldiers’ Home, located just outside the facility’s rehab area; 22 laps equals a full mile. There’s a mural covering a few hallways depicting different places across the country, hence the name, said Surreira, and different administrators are actually assigned to certain veterans to walk with them across America on days the veterans choose themselves.

Celeste Surreira says the Walk Across America

Celeste Surreira says the Walk Across America (that’s the St. Louis panel within the mural behind her) is one of many initiatives aimed at improving the mobility of veterans at the Soldiers’ Home in Holyoke.

The track is one of several ‘places to move,’ as Surreira calls them, that have been created in recent years as part of a broad effort to enhance the mobility of the veterans at the Soldiers’ Home and thus improve quality of life and actually reduce the rate of falls.

As with most all initiatives at this facility, this was (and is, as such work is ongoing) a team effort — actually a team with several smaller teams within it, such as the one assigned the task of creating places to move, she told BusinessWest.

The Walk Across America is just one example of that positive change and improvement in quality of life mentioned earlier that Surreira has helped orchestrate since arriving at the Soldiers’ Home in 2014.

She had been working just outside Atlanta as an interim director of Emergency Services at Rockdale Medical Center, and was looking to return to Western Mass., where she spent much of her career.

Indeed, she started in the emergency department at Ludlow Hospital in 1985, then spent more than two decades at Mercy Medical Center, starting as an staff RN and eventually advancing to manager of the Emergency Department. Earlier this decade, there was a short stint as administrative director of Emergency Services at Cooley Dickinson Hospital.

“I was looking at different positions up here, and I received a call regarding an opportunity at the Soldiers’ Home,” she recalled. “They were looking for a leader, someone who could come in and do some mentoring on leadership, and it sounded very interesting; it was a real change of pace for me to go into long-term care as well as geriatrics, but given my interest in leadership and veteran healthcare, a chance to work clinically, and all those things coming together, I thought that it would be a good opportunity for a change.”

And to work with an older population (most of the veterans are in their 80s and 90s) that, as noted earlier, reflects some of the larger, more complex issues facing all those in healthcare — specifically, not only caring for older individuals, but also helping them maintain independence and a high quality of life.

“Our focus is truly on how to promote a good quality of life for these older veterans,” Surreira explained. “We have 94- and 95-year-olds living very well.”

With this broad goal in mind, Surreira has created, and serves on, a number of process-improvement teams working on such matters as reducing the use of anti-psychotic medications, lowering the rate of falls, improving mobility, medication safety, and many others.

And as these teams address each of these areas, they do so with quality of life in mind, she said, using reduction of falls as an example. This could easily be accomplished by reducing one’s mobility, so he or she doesn’t get into positions where they can fall, Surreira went on. But this doesn’t equate to a high quality of life.

“This is where healthcare is going. The population is living longer with chronic diseases. This is the population with which we’re really going to have to make an impact if we’re going to manage the needs of the overall population over the next 30 years.”

“What we don’t want to do is promote the use of things like restraints and alarms, because they don’t allow people to move and self-propel,” she explained. “So what we try to do is advise them of safety and encourage their mobility; we want people to move, we want to take them for walks, we want to do everything we can to promote mobility while also reducing the risk of getting hurt from that fall if you do fall.”

To accomplish all this, Surreira leads the so-called ‘enhancing mobility team,’ which consists of several departments, including nursing, rehab, social work, facilities, and pharmacy working collaboratively to implement evidence-based interventions that will enhance mobility and reduce falls. This team has implemented a series of policies and procedures, including the introduction of a daily ‘fall huddle,’ interdisciplinary rounding, quarterly mobility screens, individualized care plans that include mobility goals, and regular review of polypharmacy.

As a result, the Soldiers’ Home has seen a confirmed reduction in fall-related injuries and a noticeable increase in the mobility of its population.

Taking the Lead

As noted earlier, Surreira’s position comes with a lengthy job description and list of responsibilities. And only a portion of them actually apply to the veterans being served.

The rest have to do with those other functions (for lack of a better term) that she carries out, including that of being a leader, a mentor, and a role model. Her ability to be all those things is a big reason why she was hired — and her desire to continually build upon those skills and add new layers to already considerable amounts of experience explains why she took it.

As she talked about being a leader, for example, she equated it to parenting.

“You mess up a lot, and then you learn how to be a better parent; it’s the same with being a leader,” she explained. “I think I’m a different leader now than when I started this journey, because it’s very humbling.”

Elaborating, she noted that one of the things she’s learned over the years is the importance of active listening.

“In order to hear the person, you can’t be thinking about your response already,” she said, citing a mindset held by all successful leaders. “You have to be totally focused on what they’re trying to tell you.

“You also need emotional intelligence, which means taking the time to know where that person is coming from and be queued into what they’re trying to communicate to you,” she went on. “Often, I tell people, ‘it’s not what they’re saying, but what they’re not saying; it’s not the words they’re saying, necessarily, but how they’re saying them. They may be saying something, but that’s not what they’re meaning or even intending.”

Surreira said mentoring takes place in many ways and on several different levels in her work at the Soldiers’ Home, including the formal teaching she does on subjects ranging from leadership to role-modeling.

“Mentorship from a leadership perspective takes place in a number of ways,” she explained. “Sometimes it takes place in just day-to-day interactions where you have opportunities to have a conversation with someone, provide someone with feedback … it’s all part of relationship building with those folks. Other times, it is more formal, such as the teaching I do.

As for the role-modeling, well, that part of it can really only happen as one adds layers of hands-on experience to their résumé, learns from previous mistakes, and develops a high degree of that necessary ingredient known as emotional intelligence.

“Even though someone may be handling a situation in a certain way, you can role-model a different way — that’s probably the most powerful thing to do,” she explained.

As an example, she cited a situation where there’s conflict going on and the discussion among individuals is getting quite heated.

“Managing yourself is probably the most important thing in those situations,” she said. “You manage your own reactions — the louder other folks may get, the quieter you get; the faster they talk, the slower you speak.

“Overall, mentoring involves building relationships and inspiring trust,” she went on, adding that ‘leading by example’ isn’t a formal line on her job description, but it’s a duty she carries out every day.

Waves of Emotion

Walking back to her office from the Navy veteran’s farewell, Surreira said the Soldiers’ Home obviously conducts many of these ceremonies. “Sometimes there will be two or three a day, and sometimes we’ll go a week without one,” she said, adding that, like most staff members, she tries not to miss a single one.

That’s because, as she said, at this facility, death isn’t something to be ashamed of; it’s not a failure. It’s part of a life being celebrated.

And improving the overall quality of that life has become the focal point of each individual and each team at the Soldiers’ Home.

Surreira’s leadership, mentoring ability, and passion for being a positive role have not only played a pivotal role in all this, they’ve made her a Healthcare Hero in administration.

George O’Brien can be reached at [email protected]

Healthcare Heroes

In the Emerging Field of Bioethics, He’s a Leader and a Pioneer

Peter A. DePergola II

Peter A. DePergola II

Oddly, he doesn’t actually remember where or when he got it.

But Peter DePergola’s copy of Rembrandt’s renowned The Return of the Prodigal Son looms large in his small office (it takes up most of the back wall) and, far more importantly, in his life and his work.

The painting, as most know, depicts the moment in the Biblical parable when the prodigal son returns to his father after wasting his inheritance and falling into poverty and despair. He kneels before his father in repentance, wishing for forgiveness and a renewed place in the family.

DePergola, director of Clinical Ethics at Baystate Health, the first person to wear a name badge with that title on it and the only clinical bioethicist in the region, says the painting — and the story of the prodigal son — provides a constant reminder of the importance of not judging others and providing them with what they need, not what they deserve. And that serves him very well in his work.

“The story is about sins and forgiveness, but what it teaches me about healthcare is that we should never treat our patients based on what we think they deserve morally, but on what they need, and only what they need,” he explained. “We don’t get to say, ‘you’re a murderer,’ or ‘you’re an adulterer,’ or ‘you’re an alcoholic — if you really wanted to stop, you can.’

“We have to meet them in the middle of their chaos, to sort of run out to them,” he went on, “and to treat them based on what they need and who they are, not on what we think they deserve.”

“It’s not that they don’t understand that medicine has its limits — I think they do. But they’re living in this larger narrative of ‘who am I if I don’t do everything I can for the person I love most?’”

‘Meeting them in the middle of their chaos’ very often translates into a time when decisions have to be made — difficult decisions — about what can be done for a patient and what should be done; about what is proper and what is needed (there’s that word again).

“There are plenty of things we can do, but shouldn’t,” he went on, adding that such dilemmas are becoming ever more common as the population ages and modern science finds new and different ways to extend life.

The issue he confronts most often involves what kind of life is being extended — and whether that kind of life should be extended. And within that broad universe there are countless other matters to consider, discuss, and debate — and they involve everything from raw science to individuals’ base emotions and perceptions about what is right, wrong, and proper.

“Family members will say, ‘I know this isn’t going well, but am I a loving daughter if I say this is the end? How do I think through this?’” he told BusinessWest as he recounted the type of conversation he has most often. “It’s not that they don’t understand that medicine has its limits — I think they do. But they’re living in this larger narrative of ‘who am I if I don’t do everything I can for the person I love most?’”

Overall, his work in the broad realm of bioethics involves everything from these end-of-life issues to the use of animals in research to potential conflicts of interest and conflicts of commitment. DePergola summed it all up in intriguing fashion by saying “no one ever calls me when something good is happening.”

Despite this, and despite the difficulty of his work — not to mention the long hours and often unusual hours; he was recently called to Baystate at 1 a.m. — DePergola finds it rewarding on many levels.

He likes to say he helps people make sense of nonsense and not necessarily answer questions that can’t be answered, but enable people to cope with them.

“People will say, ‘I’ve lived a good life, and I’ve always done the right thing, and here I am, with six months to live. Why must I suffer? Why do I have to be in pain? Why do I have to be in the hospital?’” he noted. “And at the end of the day, I’d say, ‘I don’t know, it’s not fair, I don’t understand. But let’s not understand together.’

“You don’t have to go through not knowing alone,” he went on, hitting upon the best answer to the question of why his role now exists. “And that may be the only antidote to that question; I can’t tell them why bad things happen to good people, but I can be there with them when they’re asking that question and looking for answers and looking for compassion.”

For his multi-faceted efforts — many if not all of which fall into the category of pioneering — DePergola has, well, emerged, into not just a leader in his field, but a Healthcare Hero.

Work That Suits Him

There’s a white lab coat hanging on a hook just inside the door to DePergola’s office, and it’s there for a reason.

While not a medical doctor, DePergola is a member of a clinical team that interacts with patients and their families. The white coat isn’t required attire, and he didn’t wear it earlier on his career. But he does now, and the explanation as to why speaks volumes about the passion he brings to this unique job every day.

“When I used to come dressed in a suit to have these very important conversations with patients and families, I think it was intimidating in a way,” he explained. “I did it out of respect … you’re going to have the most intimate conversation a family’s ever had — what would you wear to that? You’d want to wear something that says, ‘I really care about this. and I care about you.’

“But it looked like I was a lawyer, and people couldn’t get past the outward appearance,” he went on. “Sometimes just a shirt and tie is too casual, but the combination of the lab coat and the tie seems to send the right message.”

There are other examples of this depth of his passion for this work, including his desire to understand the role religion plays in making those hard decisions described earlier.

“I knew that what I was getting into had a lot of value implications,” he explained, “and that the primary pathway into those values was religious commitments. So I got a master’s degree in theological bioethics so I could make sure that I understood what Hindus and Buddhists believed about end-of-life care the same as Orthodox Jews and Catholics, and what Muslims thought about autopsy, so I could meet them not just where they are clinically, but where they are biographically and in their values.”

As he talked about his career and what he was getting into, DePergola stated what must be considered the obvious — that he didn’t set out to be a bioethicist. That’s because this field hasn’t been around for very long — only since the early ’80s, by his estimates — and it’s especially new in the Western Mass. region. In essence, and to paraphrase many working in healthcare, the field chose him.

“Larger American cities — New York, Boston, Los Angeles — have had full-time clinical bioethicists since probably the end of the 1980s,” he explained, adding, again, that he’s the first in the 413. And in many respects, he helped create the position he’s in and write the lengthy job description.

To fully explain, we need to back up a bit.

After earning his bachelor’s degree in philosophy and religious studies at Elms College (early on, he thought he might join he priesthood, but settled on a different path), and then a master’s degree in ethics at Boston University and his Ph.D. in healthcare ethics at Duquesne University, DePergola completed a residency in neuroethics at University of Pittsburgh Medical School and then a fellowship in neuropsychiatric ethics at Baystate, then the western campus of Tufts Medical School, in 2016.

“The patient is always the priority. In risk management, it’s the hospital first, then the patient. With me, it’s the exact opposite; I make sure everyone’s voice is heard.”

While completing that fellowship, he took on some duties in the broad realm of research ethics, a large subset of this emerging field, but this work was eventually expanded into a new leadership position at Baystate — director of Clinical Ethics, a role he said he helped create in partnership with the health system.

“I did a lot of convincing, and I sort of sold the problem,” he said.

“Medicine tells us what we’re able to, and the law tells us what we’re allowed to do. But neither one tells us what’s good to do. And how we navigate the mean between extremes? If we did everything possible for our patients, we’d be deficient, and there are plenty of things we could do without breaking any laws, but that wouldn’t be in itself good for patients. So we needed someone to step into a leadership role.”

In creating the position and its job description, he and members of Baystate’s leadership team borrowed from models already in existence at similarly sized healthcare systems, especially those at Maine Health, the Carolinas Health System, and the Henry Ford Health System.

DePergola said there are four main categories, or pillars, to his work: clinical ethics, research ethics, organizational ethics, and academic ethics, or ethics education.

The primary domain, as one might expect, is clinical ethics, and in that role, he meets with patients, family members, and healthcare professionals “as they navigate the moral terrain of life-and-death decision making at the beginning, middle, and end of life,” he explained.

“I see everyone — from patients and their families in the Neonatal Intensive Care Unit to our geriatric patients, to everyone in between, whether it’s a patient in infectious diseases or genetics or ob/gyn.

And, as he said, no ever calls him when anything good is going on.

Questions and Answers

As he talked about his work in bioethics and many of the difficult conversations he becomes part of, DePergola summoned a quote from Aristotle that he’s undoubtedly already used countless times in his short career.

“He said, in essence, that something is good if its fulfills the purpose for which it was made, and bad if it doesn’t,” said DePergola, adding that such a benchmark, if one chooses to call it that, should be applied to all aspects of healthcare, including everything from a feeding tube to any other step that might be taken in an effort to prolong life.

“If it’s not going to fulfill the purpose, is it good? We need to think about the logic of what it would mean to provide a clinical treatment without a clinical reason,” he went on, adding that such questions loom large in his field of work and often bring him to another difficult discussion — the one juxtaposing quantity of life against quality of life.

Such thought patterns help DePergola as he goes about his various duties, during which — and he makes this point abundantly clear — he advocates for the patient first, not the health system that employs him.

And this distinguishes his work from that of those in the broad realm of risk management.

“The patient is always the priority,” he explained. “In risk management, it’s the hospital first, then the patient. With me, it’s the exact opposite; I make sure everyone’s voice is heard.”

And not only heard, but understood, he went on, adding that the cornerstone of success in this field (if one can even use that word within it) is establishing trust.

Wearing a white coat instead of a suit coat is part of it, but a bigger part is understanding exactly where someone is coming from. And this comes from taking the time to understand their situation, their religious beliefs, and much more.

Even then, the decisions don’t come easy, he went on, adding that his work often comes down to helping parties decide between the better of two bad options and coping with questions that, as he noted, can’t really be answered.

Such sentiments are reflected in DePergola’s thoughts on other aspects of his work, especially his teaching — he’s an assistant professor of Medical Humanics at Elms College, where, in the small-world department, had Erin Daley, director of the Emergency Department at Mercy Medical Center and the first Healthcare Hero in the Emerging Leader category, as one of his students.

“I always try to emphasize to my students that the big questions of medicine that patients are asking have little to do with medicine, that the big problems in medicine have little to do with medicine,” he told BusinessWest. “They’re questions of meaning, purpose, identity, and value.

“They don’t show up on X-rays, you can’t write prescriptions for them, and we can’t bill for that,” he went on. “Medicine is very good at addressing ‘how’ questions — as in ‘how does ammonia work?’ — but it’s very poor at addressing the ‘why’ questions. And I think that, when we fail to connect with our patients in medicine, it’s because we’re giving ‘how’ answers to ‘why’ questions.”

Framing the Question

Returning to Rembrandt’s Return of the Prodigal Son, DePergola said there’s another reason why that painting resonates with him.

It has to do with how many times he has the same conversations with different people, such as the one about miracles, and walking them through the argument that there’s no logical connection between believing in a miracle and concluding that life-sustaining medical treatment should continue.

“You don’t offer life-sustaining medical treatment for miracles to occur, and I often dread having another one of these conversations,” he said. “But then, I remember that every time I have any of these conversations, it might be the 12th one of the day, but it’s the first for these families. They deserve for me to treat it as the most important and the only conversation, not the 12th.

“Again, I give them what they need,” DePergola went on, expressing sentiments that clearly explain why he’s an emerging leader, a pioneer, and a Healthcare Hero.

George O’Brien can be reached at [email protected]

Healthcare Heroes

This Pediatrician and Coalition Builder Has Helped Create a Healthier Community

Dr. Matthew Sadof

Dr. Matthew Sadof

Most people who have been working professionally for nearly 40 years have had a number of desk chairs, especially as technology has advanced and the office has become more ergonomically correct.

Dr. Matthew Sadof has had exactly … one.

It was given to him upon completion of his residency at New York Hospital, and it’s been with him ever since. It’s a low, wooden chair with arms, and Sadof obviously likes how it looks and feels — for the most part, anyway. But the reason he keeps it is what’s written on the back: “Go and do thou likewise.”

That’s the school’s motto, but far more importantly, it’s Sadof’s approach to life and also his life’s work, as will be made clear as we explain why he is the Healthcare Hero in the Community Health category.

“One of the things that I’ve tried to practice my whole life is something called tikkun olam, which means to heal the world,” he told BusinessWest. “And that’s what I try to do. I’ve been sitting in this chair since I graduated. It’s my chair; I’ve had opportunities for other chairs, but I like this one.”

The Heroes award is only the latest of many to be bestowed upon Sadof, a pediatrician at Baystate Children’s Hospital, whose chair resides in a small office at the Baystate High Street Health Clinic, in the middle of one of Springfield’s poorest neighborhoods, as it has for the past 20 years.

“Dr. Sadof has demonstrated that a physician who is dedicated to improving the health and well-being of his patients must go beyond the office walls and work diligently to improve the health of the community.”

This office is, by his own admission, not at all asthma-healthy, with its carpeting, drop ceiling, and somewhat poor ventilation. Which is ironic, because he is perhaps best known for helping to lead an all-out battle against asthma in a city consistently ranked among the worst in the nation for asthma health.

His leadership role in the Community Asthma Coalition and related initiatives has dramatically improved the environment across Springfield and reduced hospitalizations dramatically, but he would be the first to note that, with the city’s poor housing stock, there is considerable work still to do.

However, there is more to Sadof’s story than helping children and families breathe easier, literally and figuratively. He has also been a passionate advocate for the underserved and the marginalized, working with medically fragile and technology-dependent children and their parents, who are often overwhelmed by their medical needs. Meanwhile, he has worked to address the social and medical difficulties faced by adolescents in Springfield, patients who often fall through the cracks as they age out of pediatrics and fail to connect with an adult-medicine provider.

As he sat down to talk with BusinessWest to talk about the many facets of his work — yes, in that chair from NYU — Sadof made it clear that, while he is honored to be named a Healthcare Hero, he stressed that whatever progress has been made in terms of making Springfield a healthier community has been a team effort, not the work of one man.

“I can’t over-emphasize that it’s not just me,” he said, referring not only to the asthma initiatives but a deep portfolio of projects he’s been involved with. “I work with lots of wonderful people; you need a whole community of people to really change a community.”

Still, Sadof has established himself as a clear leader in these efforts and a role model for the medical students and residents he teaches.

Dr. Laura Koenings, vice chair of the Education Department of Pediatrics at Baystate Children’s Hospital, who nominated Sadof for the Healthcare Heroes award, may have summed up his devotion to community — and his approach to achieving progress — best.

“Dr. Sadof has demonstrated that a physician who is dedicated to improving the health and well-being of his patients must go beyond the office walls and work diligently to improve the health of the community,” she wrote. “A role-model physician looks for gaps in the healthcare-delivery system and strives to bring better healthcare to the underserved, whether that is the infant with complex medical needs on a home ventilator and a gastronomy tube for feeding, or the teenager out on the streets without a medical home.”

Sadof continues to do all these things, and that explains why he’s a true Healthcare Hero.

Clearing the Air

Sadof said it wasn’t long after he arrived at the High Street Clinic that he began to realize the full extent of the asthma problem in Springfield.

“My very first week, there was a kid who came in who had really, really, really bad asthma,” he recalled. “So bad that I had to go on the ambulance and transport him to ICU. He needed a breathing machine — he needed to be intubated — and while I was there, I looked at his mother, and I couldn’t help but notice that she had a Band-Aid on her arm and a hospital bracelet on her wrist.

“I said, ‘what happened to you?’ he went on. “And her asthma was really bad. I asked her where she lived, and she went on to describe an apartment building that had cockroaches, rodents, leaky windows, and mold — all of which are very potent triggers for asthma.”

Dr. Matthew Sadof says he’s had one desk chair throughout his lengthy career

Dr. Matthew Sadof says he’s had one desk chair throughout his lengthy career and lives by what’s written on the back: ‘Go and do thou likewise.’

Thus began what might be called a crusade against asthma, as well as a pattern of not only treating patients but asking them where they live. And not only asking them where they live, but taking steps to do something about where they live and removing some of those triggers for asthma.

“We teach people how to clean with vinegar, baking soda, baking powder, and castile soap, and that’s made a huge difference,” he explained. “We also showed people how to store food properly and store garbage properly in a way that doesn’t promote the growth of rodents and insects.”

Before getting into more detail about his efforts to combat asthma and the many other aspects of his work, it’s necessary to explain how Sadof arrived at the High Street Clinic.

Our story starts back at medical school, where, by this third year, Sadof realized he wanted to spend his career working with young people.

“I knew that I liked to talk to people, and I knew I liked to work with young families,” he recalled. “And I knew I liked working with children because they’re growing, and there’s the possibility to make a real impact on the trajectory of someone’s life when you start early.”

He practiced in Pittsfield for 10 years, doing general pediatrics, before he and his family relocated to Philadelphia to “try something new,” as he put it. Things didn’t exactly work out there as he hoped, so the family decided to return to what they considered home.

A former colleague was working at the High Street Clinic at the time. Sadof asked her what the lay of the land was, and she mentioned that the clinic was looking for someone. And, long story short, Sadof became that someone.

“Something about this place just felt really good,” he told BusinessWest, noting that, 20 years later, he still feels the same way.

“There was a huge need for services,” he explained. “And there were bright students and residents that I could work with. And practicing and teaching medicine at the same time keeps you really sharp. They’re always asking you questions that you may not know the answers to, so we all look it up and learn it together.”

Finding answers to some of Springfield’s most vexing health problems has been Sadof’s M.O. since arriving on High Street, and, as noted, asthma soon become one of his top priorities.

But to address it, he knew the city needed to bring together a number of players to form a solid, united front against the disease. And it really started with that visit his first week on the job.

“That’s when I started thinking about how important it was for me to start to address some of the root causes of asthma, and about what I could do to build a bridge from the clinic to the community,” he recalled. “They weren’t calling it the ‘social determinants of health’ back then, but that’s really what we were doing.”

Within a year after arriving at High Street, Sadof became the medical director of the clinic, and around that same time, he was approached by a grant writer from what was then Partners for a Healthier Community (now the Public Health Institute of Western Mass.) to apply to be part of the National Collaborative Inner-city Asthma Study.

Fast-forwarding a little, the local group was awarded a grant, and a social worker was hired to be an asthma counselor, he went on, adding that parent groups were formed, individualized counseling was provided, and other steps were taken not only to treat people who were sick but to make homes more “asthma clean.”

In 2001, the Pioneer Valley Asthma Coalition was formed, and Sadof, who started in what he called an observer role, became its chair in 2004. In 2009, he help forged a partnership with Boston University whereby a stimulus grant from the national Institute of Environmental Health was secured to create something called the READY (Reducing and Eliminating Asthma Disparity in Youth) program.

“We trained community health workers to teach people how to keep their home asthma clean,” he explained, adding that there would be a series of five home visits in the course of six months. “And anecdotally, I could tell which families were in the program and which ones weren’t; we cut hospitalizations down dramatically and cut hospital days down dramatically.”

Care Package

But while Sadof is perhaps best known for his work to combat asthma, there are many other aspects to his practice, all of which relate directly to what’s written on the back of his chair.

Indeed, while recognizing a real problem with asthma, Sadof said he also quickly realized there was a large number of children with severe disabilities and families struggling to care for them. And he’s continuously looking for new and innovative ways to meet the many needs of both these children and their families.

“I have lots of children who are technologically dependent,” he explained. “These are children who are on ventilators at home, they have feeding tubes, they often require 24-hour care … they and their families require services, and they need help.

“From listening to these kids, I was always trying to figure out a better way to do things,” he went on, adding that he was approached in 2012 by officials at Boston University Medical School with the goal of developing a grant to help improve complex care.

Baystate and BU were eventually awarded a $6 million grant ($1 million each over three years) to develop something called the 4C program. That’s an acronym for Collaborative Consultative Care Coordination program, which was created to help parents and pediatricians coordinate care for the most medically complex children in Western Mass. Each word in that acronym is important, and collectively they explain what it is and how it works.

“We developed a couple of teams, with myself as the complex-care doctor, where we brought people in, took in all their data, and put it into a cloud-based care plan,” he explained. “These care plans lived on their phones, and they were accessible by any kind of electronic device and were accessible by their primary-care doctor and by the hospital and the families.

The consultative-care program created for each family consisted of a nurse care coordinator, a social worker, a so-called ‘family navigator,’ a nutritionist, and a psychologist, he went on.

“There’s been a huge influx of patients from Puerto Rico, people whose lives were blown away who are medically complicated and very fragile. People with heart defects, lung defects, neurological issues, and we’ve been working hard to keep them healthy. It’s great work and its very rewarding.”

“And we really improved the lives of lots of kids,” he said with a large dose of satisfaction evident in his voice. “We were able to decrease the cost of healthcare by a lot and improve the satisfaction of families. This was a consultative program where we worked with primary-care doctors to keep the care inside the patient’s medical home, close to where they lived; we worked with schools, we worked closely with housing to make sure we could make accommodations, we did home assessments and home visits. The idea was to try to support families through this work, and it was incredibly rewarding.”

He used the past tense because the grant funding ended at the close of 2017. The plan is to find a way to restore and continue the initiative through the new accountable-care program being created. Meanwhile, Sadof continues to care for children with complex needs, mostly without the same comprehensive teams made possible by the 4C program, and the number of patients in that category has swelled in the wake of Hurricane Maria, which devastated Puerto Rico almost exactly a year ago.

“There’s been a huge influx of patients from Puerto Rico, people whose lives were blown away who are medically complicated and very fragile,” he explained. “People with heart defects, lung defects, neurological issues, and we’ve been working hard to keep them healthy. It’s great work, and its very rewarding.”

There’s that phrase again. Sadof uses if often, and it speaks to the passion he brings to his work, which, by and large, involves a poor, very challenged constituency, and many of the sickest children in this region — and beyond it.

To explain that passion, Sadof related the story of his father, who had tuberculosis.

“I just have this vision of my grandmother bringing my father to a clinic, where his test came back positive,” he explained, noting that his father had two aunts who died from the disease. “I carry that picture of my father and my grandmother with me always … and I look at the mothers here, and I say, ‘100 years ago, this was my family.’

“And the test about what decisions I make is that ‘if this was my family, what would I want to do? What would I want done for my family?’” he went on. “It has to pass that test. And it’s not always the easiest answer, and it’s certainly not the fastest answer.”

It Sits Well with Him

For the last word on the honoree in the Community Health category, we return to Laura Koenings’ nomination:

“Dr. Sadof recognized early on that it takes a village, and not just the actions of a single physician, to improve the long-term health of the community,” she wrote. “This is why he has always been a coalition builder — helping to unify patients, families, community agencies, and government entities to work together for a healthier community. He also recognized that, in order to advocate for his patients and their families, he must understand their needs and bring their voices to the agencies and government entities that are part of his coalition.”

He has done all that, and that’s why, from the day he earned that chair, he’s been a Healthcare Hero. u

George O’Brien can be reached at [email protected]

Healthcare Heroes

This Unique Venture Exists at the Intersection of Innovation and Technology

Christian Lagier

Christian Lagier, managing director and co-founder of TechSpring.

Christian Lagier has a deep background in entrepreneurship, business operations, and strategic business development.

He’s been involved with startups and high-growth companies in Paris and Copenhagen, and he spent 10 formative years in Silicon Valley’s high-octane startup environment at arguably its zenith (the ’90s).

Thus, he’s an expert in … collisions.

That’s a word you hear quite often within the realms of innovation and entrepreneurship. Generally, it refers to the art and science (because it’s both) of bringing people together and making things — meaning products, services, and the companies to provide them — happen.

Soon after leaving the San Francisco area behind to come to Western Mass., Lagier became a key driver in an effort to bring collisions to a different, higher level, and to a sector where you don’t hear that word as much as you do in others — healthcare.

The result was TechSpring, a unique venture that is based in Springfeld. But its exact location, as Lagier likes to say, is at “the intersection of healthcare and technology.”

“We’re trying to bring these sides together in a place where we can democratize technology development, or bring people into the process.”

That phrase speaks volumes about not only what TechSpring is, but why, more than three years after it was launched, it has met or exceeded both expectations and goals. And why a panel of judges determined that it (meaning the sum of all its parts and the all the people behind it) is the Healthcare Hero in the highly competitive category called simply ‘Innovation in Health/Wellness.’

Summing it all up, Lagier, the venture’s managing director and co-founder, said TechSpring has realized a vision established four years ago to take external innovators into a partnership of sorts with Baystate Health, its 1 million patients, and thousands of providers to accelerate innovation in healthcare technology.

“We’re trying to bring these sides together in a place where we can democratize technology development, or bring people into the process,” he explained, “and do it in a way that’s aligned with the goals of an organization that is working hard to deliver high-quality, high-value care every day.”

In the process of democratizing the innovation process, TechSpring has become a real force within the region’s economy and, especially, its innovation sector. It serves as an innovation hub in every sense of that word, said Lagier, noting that brings people together in all sorts of ways.

Christian Lagier, seen here with team members at TechSpring

Christian Lagier, seen here with team members at TechSpring, says the facility, and especially its kitchen, were designed to promote collisions.

First, as co-working space — there are about 80 people working there now — but also as a conference center and site for programs such as its monthly innovation open house, known as Tap into TechSpring.

“It was important to us as we were doing this project to have healthcare come out of the ivory tower, if you will,” Lagier explained. “We wanted to open the doors and create a public forum, a physical hub for all the people in Western Mass. and beyond who are working at that intersection of healthcare and technology.”

There is mounting evidence that this model works and should be emulated. For example:

• It has grown from one employee to eight;

• There have been more than 30 completed innovation projects, all with learning or operational outcomes;

• Tap into TechSpring, has attracted more than 4,000 participants since it was initiatied more than three years ago;

• The venture has received trade delegations and leadership visits from Israel, Denmark, Ireland, Singapore, Australia, and other countries;

• At any given time, there are between five and 10 projects in development or active execution; and, perhaps most importantly,

• TechSpring has generated more than $7 million in revenue or savings for Baystate Health.

Which means that the sizable investment made by the system in TechSpring has more than paid for itself.

Maybe the best example of how TechSpring works, and why it was named the hero in the Innovation category, is Praxify, an intuitive, easy-to-use mobile application designed to enhance the provider experience by bringing patient information directly into the palm of one’s hand.

“We heard clearly from our organization, and specifically from our physicians working at Baystate, that the electronic medical record system had grown unwieldy and that it was consuming too much time to get information in and out,” Lagier explained, adding that NTT, one of TechSpring’s innovative partners, introduced people there to a startup in India that had developed a mobile app that was user-friendly and fast to use.

When representatives of that company came to Springfield with their demos, they were introduced to roughly 30 Baystate doctors who, long story short, helped them refine the concept into something that works.

Thus, Praxify is an example of just how well the original vision for TechSpring has, in fact, become reality.

“When we started this project, it was big ideas and PowerPoint slides,” he told BusinessWest. “And you have this vision. Looking back on it four or five years later, after making many of these come to life and become real … that’s a great point of pride.”

Food for Thought

As he talked about collisions and the ongoing work to bring them about, Lagier said everything about TechSpring’s facility on the fifth floor at 1350 Main St. was designed with that goal in mind.

Even the kitchen. Or especially the kitchen, as the case may be.

With the old-fashioned water cooler pretty much a thing of the past, the kitchen is the place where people gather now, he told BusinessWest, adding that, in addition to politics, sports, and what TV shows they’re binging, people at TechSpring also talk about what they’re doing.

And they listen to other people talk about what they’re doing, and when there’s two or three or four people having such conversations, this is how collisions take place. So the kitchen was designed to promote this kind of activity.

“It’s large, open, and has seating,” Lagier explained. “This is the place where people connect informally and begin chatting, and where a wonderful thing happens every day at TechSpring — someone finds an opportunity to help someone else, and that’s what we need to accelerate change in healthcare.”

Kitchen design is one of the few things not on Lagier’s résumé. As for what is, well, it’s an interesting mix.

Out of high school, he actually worked as a foreign-language tour guide in bustling Copenhagen (he’s fluent in six languages, including Danish, French, and English). He also worked as a deck hand on an offshore oil rig in the North Sea and hitchhiked his way around the world for a year.

He eventually settled down and earned master’s degrees in economics and business administration from Copenhagen Business School and Université Catholique de Louvain in Brussels and then went to where the action was.

“I moved to Silicon Valley to seek adventure and the application of technology to real-world problems,” he said, hitting upon what could be considered a theme to his career. “I was there in ’95, which was an exciting tine to be in Silicon Valley.”

After starting out in management consulting, Lagier held management positions in companies such as Memolane, Vivino, and Proxicom. He spent a decade in Silicon Valley, but decided, in collaboration with his wife Allison, who had ties to this region, that Western Mass. (Williamsburg in Hampshire County, to be exact) was the place to raise a family.

“It was a lifestyle choice for us,” he said, adding that, while he’s lived in some fast-lane places — Paris, Copenhagen, and San Francisco are all on that list — this is home, and the mailing address he’s most fond of.

Fast-forwarding a little, Lagier worked in administration at Smith College for a few years. Just over five years ago, had lunch at Max’s Tavern with Joel Vengco, chief information officer for Baystate Health. It was a lunch that would eventually pave the way for TechSpring and begin to change both the innovation and healthcare landscapes in this region.

“Joel, like me, has broad experience from different geographies and parts of life, and when he came here, he had a vision for an opportunity that presented itself to a region like this one and an organization like Baystate to be a better participant in the transformation of healthcare that we all know is necessary,” he explained. “He presented this vision to me of creating a small and nimble organization that could facilitate the collaboration between external technology innovators and a full-size, real-life health system.”

That vision represented something very different from anything that existed at that time, he went on, adding that there was no real model for TechSpring and that those who launched it created a new model. But it was also something very necessary given the way technology was advancing and healthcare was evolving.

“We all know that healthcare needs to change,” he explained. “We know that part of the solution is process and people, and we know that technology needs to support these changes that are necessary. TechSpring is an effort to help those two sides — the people and the technology — come closer together in solving these problems.”

While doing that, there are broader goals as well, he said, adding that, from the beginning, those involved with TechSpring clearly understood that innovation had to “pay off,” as he put it, meaning there had to be a direct line of sight to the value that comes from innovation.

“We talked a lot about how this can’t be science experiments, and it can’t be long-term R&D — there have to be some concrete outcomes from this, and also financially,” he explained. “We had also set the goal of TechSpring being self-funded, and we’ve achieved that goal.”

Getting the Idea

At the core of this unique model, made possible by a $5.5 million grant from the Massachusetts Life Sciences Center, TechSpring becomes a consulting company of sorts, said Lagier, one that supports external technology innovators that have ideas for effective solutions in healthcare and helps them collaborate more closely with healthcare professionals and even patients, and then brings all these parties together in the technology-development process.

Over the years, the list of innovative partners has grown and now includes such companies as:

• Cerner, the leading provider of electronic-medical-record (EMR) and population-health systems worldwide;

• Imprivata, a Boston-based company focusing on solutions that make access to IT systems easier for employees and patients;

• NTT Data, a worldwide leader in systems integration and delivery of technical solutions;

• Kordova, a Boston- and Springfield -based startup focused on creating cost visibility in surgery supplies;

• athenahealth; a Boston-based provider of EMR systems; and

• Firefly Labs, a local startup originated at Baystate Health that has created a solution that makes case reporting and the accreditation process easier for surgery residents.

Connecting such innovators with a large health system like Baystate sounds simple and rather obvious, but such collaboration between these two worlds has mostly been missing, and is still missing in many markets.

“There’s been too much technology that has been developed and sort of pushed into healthcare,” he went on. “It’s our ambition to turn this around and have it be more of a pull from users, the healthcare professionals and patients, who say, ‘these are the solutions that we need,’ and then enabling the technology innovators to solve for that.”

“He presented this vision to me of creating a small and nimble organization that could facilitate the collaboration between external technology innovators and a full-size, real-life health system.”

While doing that, the broad goal is to create those aforementioned collisions.

“They’re a key piece of innovation theory,” Lagier explained. “Innovation is not linear — it’s not something you can plan out or mastermind. Innovation depends on a lot of coincidence, but, as Pasteur said, ‘chance favors the prepared mind.’ At TechSpring, we’ve created an environment that is conducive for coincidences to happen.”

And there were a number of coincidences and collisions behind Praxify, which was born, as most innovative concepts are, out of a need to solve an identified problem.

“To this day, this industry has a challenge — that doctors are spending too much time at the computer, and that takes away time that they can spend with a patient,” said Lagier. “There are many facets to that challenge, and we put that challenge out into the world, saying, in essence, ‘what solutions are out there that we can bring to our physicians that might improve this problem?’”

As noted earlier, a startup in India had a solution — or the makings of a solution. And to refine its concept, the company worked in tandem with doctors at Baystate.

“Rather than sitting in a conference room or drawing something up on whiteboards, we said, ‘first, you have to experience real healthcare,’” Lagier noted. “And they got to just follow a physician and watch over his or her shoulder and get direct feedback — ‘this works for me,’ or ‘this doesn’t work for me.’”

With that feedback, rapid prototyping ensued, he went on, adding that the innovators went back and said, in essence, ‘is this what you’re looking for?’ Some said yes, some no, and more collaboration followed.

A prototype was developed, validated at Baystate, and put into production for a pilot user group comprised of 80 physicians. The development was so successful and promising that the startup was acquired by athenahealth, another of TechSpring’s innovation partners, for $63 million.

For Lagier, the key takeaway from the example of Praxify is how the collaborative model — bringing innovators together with healthcare providers to accelerate new-product development — works not just in theory, but in reality.

“I had dozens of physicians who were energized by the process — just having a voice, just having an opportunity to be part of the technology-development process,” he told BusinessWest. “That they got an app out of it that they could use and that made their life better was a bonus.”

Healthy Collaboration

As Lagier noted, there have been a number of delegations from different states and different countries that have come to the TechSpring suite to see how the unique concept works — and how it might work for them.

The kitchen is usually part of the tour because that’s where a good number of collisions happen — collisions that can lead to practical solutions to the issues and problems facing those providing healthcare in today’s challenging and always-changing environment.

Those tours — a world apart from those Lagier led before busloads of tourists in Copenhagen — represent one of the best indicators of the success of the TechSpring model and its ability to bring innovators and healthcare providers and patients together in collaboration — something that’s needed to solve these complex problems.

As much as anything else, they show why all those at TechSpring are Healthcare Heroes.

George O’Brien can be reached at [email protected]

Healthcare Heroes

This Unique Initiative Has a Simple Mission: to Save Lives

The Consortium and the Opioid Task Force

The Consortium and the Opioid Task Force

Larry Thomas remembers not knowing exactly what to say or how to respond.

He had just been encouraged to apply for a job as a peer coordinator and recovery coach for something called the Recover Project, a recovery support center operating in downtown Greenfield under the umbrella of the Western Mass. Training Consortium and funded by the Bureau of Substance Abuse Services in Massachusetts. Thomas paused, because the last job he held was as part of a work-release program operated by the Department of Corrections.

“I had never had a job as a free man, applying on my own,” he explained. “When they posted the job, people said I should apply. I said, ‘maybe I should, but I don’t even have a résumé.’ I did apply, but I was scared to put down the last place I worked, because I was still in jail.’”

Thomas, in applying and then earning the job, essentially put his past behind him and focused on solidifying his future, which is, by and large, what he encourages others to do as a recovery coach. He takes his ‘lived experience’ — that’s a phrase you’ll read often in this article — and puts it to work helping others combating addiction and trying to put their lives back together.

Thus, he’s become part of a huge, multi-faceted, truly groundbreaking collaboration forged by the Western Mass. Training Consortium and the Opioid Task Force of Franklin County and the North Quabbin Region.

Actually, he was part of it before he became an employee, as we’ll see.

But first, by ‘huge collaboration,’ we mean more than 300 public and private partners, representing law enforcement, the healthcare community, the court system, a host of nonprofit agencies such as the Recover Project, addiction specialists, and addicts themselves. Collectively, these partners have one overriding mission — to save lives.

Sahern Ahern

Sahern Ahern says she learned that, when it comes to addiction, a community has to make change from the inside out.

And they are doing just that by effectively bringing an entire community together to combat a problem that that is prevalent across the country, but especially in rural areas like Franklin County.

As John Merrigan, register of Franklin Probate and Family Court, recalls, in the summer of 2013, all those players were essentially confronting the opioid epidemic separately and in their own ways — and not making much headway, really. By the end of the year, they were confronting it together, collaborating, communicating, building bridges, combining resources, and fighting the problem not by locking people up but by using lived experiences, peer-to-peer counseling, and even massage and acupuncture to help them find a pathway (another word you’ll read often) to treatment and recovery.

As they talked with BusinessWest about the collaboration at the Recover Project’s facility on Federal Street in Greenfield, the many assembled players spoke with one voice about the power of such peer-to-peer counseling and the even greater power of a community coming together to address a problem that has touched everyone in that community directly.

Sarah Ahern, another peer leader and recovery coach, lost two family members to overdose, and remembers feeling a wide range of emotions, but especially anger at a system she felt had failed miserably to prevent such a tragedy.

“I’m that person who decided to bang on the doors from the outside, because I was really angry, and I saw the system was broken,” she recalled. “But someone told me — and I’m pretty sure it was someone here at the Recover Center — you can’t make change that way; you have to make change from the inside out.

“So I started attending task-force meetings,” she went on. “And I met all kinds of wonderful people who are just trying to figure out a solution.”

“I’m that person who decided to bang on the doors from the outside, because I was really angry, and I saw the system was broken. But someone told me — and I’m pretty sure it was someone here at the Recover Center — you can’t make change that way.”

‘Creating change from the inside out.’ That’s one way of describing what this collaboration is doing. But there are many others.

David Sullivan, Northwestern district attorney, had his own way.

“Going back five years, there was recognition on my part, and also by [Franklin County] Sheriff Christopher Donelan, that there needed to be a fundamental shift in the approach to addiction,” he said. “We needed to look at this as a chronic disease and not be looking toward incarceration and criminal sanctions. So the emphasis has been on treatment and recovery, and we’ve put a lot of resources into moving in that direction.”

Deborah McLaughlin, coordinator of the Opioid Task Force, may have summed it up best when she said, “people creating these terrible drugs have no shortage of creativity on their end, so we have to respond in kind to keep ahead of this as much as we can.”

In most all ways, this collaborative effort is creative and truly cutting-edge in its approach to combating opioid and heroin addiction. And it is becoming a model that other community task forces are trying to emulate. Indeed, individuals and groups from across the Commonwealth as well as other New England states, New York, and Ohio have reached out to learn more about this collaboration and its unique approach.

The crisis is far from over, said all those we spoke with. But they were also in agreement that the energy and, more importantly, the hope created to date is fueling general optimism in a region where that commodity has been in short supply in recent years.

And for generating that optimism, all those involved in this collaborative are true Healthcare Heroes.

Coming Together

Anthony Bourdain, the colorful host of the Parts Unknown series who tragically took his own life earlier this year, came to Franklin County in the fall of 2014 to learn about the task force and the many players involved in this collaboration.

He immediately sensed that it was something different and something special, and described the collaborative as a grass-roots response — people coming together to find a “community-based solution to what is finally being recognized as a public-health crisis rather than just a criminal-justice problem.”

He would go on to say, “‘war on drugs’ implies us vs. them, and all over this part of America, people are learning that there is no ‘them’ and only ‘us.’ And we have to figure this out together.”

Nearly four years later, those words seem prophetic. The nation now considers opioid addiction a public-health crisis, and the many players involved in this collaborative effort in Franklin County clearly understand that there is only ‘us.’

Indeed, in a small community like this, almost everyone has a family member, friend, or co-worker who is addicted to opioids or has overdosed. And this closeness to the problem, this familiarity with tragedy, certainly helped bring people together behind that mission to save lives, said Merrigan.

“The district attorney, the sheriff, and myself, who had worked closely together on a number of initiatives in the past, really saw our community being uprooted by the opioid epidemic,” he explained, flashing back roughly five years. “We saw it within our families, within our neighborhoods, and we knew we had to respond and convene members of the law-enforcement community, the medical community, the court community, and the recovery community.”

That response started with a phone call he placed to Linda Sarage, then the director of the Recover Project, and a request — more like a plea — to start a dialogue, something that didn’t exist between the two entities before that call.

Larry Thomas says he was hesitant to apply for a position as recovery coach, because the last time he held any kind of job, he was still in prison.

Larry Thomas says he was hesitant to apply for a position as recovery coach, because the last time he held any kind of job, he was still in prison.

“He introduced himself to me,” said Sarage, noting that there was some irony in the fact that an introduction was needed. “he knew of the work that the Recovery Project had been doing — we been doing some re-entry work at the jail and some re-entry work in the community that really put the importance of recovery out there.”

Those initial talks led to many more and eventually what D.A. Sullivan called an epiphany about the importance and power of recovery communities to finding a long-term solution to the addiction problem.

“You can’t incarcerate your way out of this crisis,” said Sullivan. “I think that people have come around to this, although others still need to be convinced. It’s absolutely clear to all of us that, with really good treatment and recovery, people can lead productive lives and not be wrapped up into the criminal-justice system; the last thing I want to see is people going to court and going to jail — I’d rather see them go to treatment and find that pathway to recovery.”

Which brings him to the subject of lived experience and recovery coaches like Larry Thomas, who are, Sullivan said, some of the real keys to changing the equation in this ongoing battle.

“Five years ago, we were flat-footed — we did not know how to approach this problem. Our system was built for alcohol situations and domestic-violence situations, and the one thing we’re seen across the spectrum — medical, the court community, the recovery community — is the peer-mentor piece,” he explained. “That lived experience, as opposed to a probation officer in the court system, has many advantages. A recovery coach can approach someone who’s struggling; it’s people helping people, and that’s the bottom line, because there’s no magic bullet otherwise to help us cope with this.”

This is what the architects of the collaborative had in mind, said Mary Lou Sullivan, executive director of the Western Mass. Training Consortium, a Holyoke-based agency which has a stated mission of “creating conditions in which people with lived experience pursue their dreams and strengthen our communities through full participation.”

And each word in that phrase is important, she said, starting with that word ‘conditions.’

“A lot of what’s happened in our society is that people are looked at as if they’re broken and they need to be fixed,” she explained. “And we feel like a lot of that is response to life and what’s going on in the world. The opposite of addiction is connection; you can’t separate out people and say, ‘what can we do to tinker with you and fix you?’ That’s a fundamental flaw in the way we go about things.

“So we try to turn the tables on that,” she went on, adding that the next key part of that phrase is ‘lived experience.’ Everyone has it, she said, and there are proven benefits to bringing people together who can share common experiences, whether its addiction, domestic violence, or significant health issues.

Then, there’s the ‘strengthen our communities through full participation’ part of that phrase, she told BusinessWest, echoing Sullivan and others when she said that the community is much stronger when people like Larry Thomas are involved with helping others and not incarcerated.

“It doesn’t serve us to have all these people in jail that we do in this country,” she said. “It would serve us much better if these people were part of the community.”

Parts of the Whole

As she talked, as others did, about the many ways the collaborative is changing the fight against addiction and generating momentum and progress, McLaughlin said groups working together can achieve much more than individuals and groups working independently of one another.

“We’ve been able to do things we wouldn’t be able to do ourselves,” she said, offering as examples everything from a ‘Building a Resilient Community’ event that focused on the role of trauma in one’s life, to a toiletry drive for individuals in recovery — an initiative that involved five locations, with donated items distributed to nine different organizations — to a recovery-friendly resource fair called ‘Where to Turn?’ involving more than 30 nonprofit agencies from the Greenfield, Franklin County, and North Quabbin areas.

And those represent just the tip of the iceberg, she said, adding that there have been a host of other initiatives ranging from a ‘bowling for recovery’ event to a program focused on recovery during the holidays.

Collectively, these events and others show how the community is coming together in this fight and grasping Bourdain’s wisdom when he said, “there is not them and only us.”

“There’s a groundswell of support for individuals impacted by opioid-use or substance-abuse disorder,” she said. “There’s support for families, there’s support for individuals, and I think we want to find out more about what it means to be a recovery-friendly community so that people feel that they are welcome here.”

This support takes many forms, from peer-to-peer counseling to a theater program, to the People’s Medicine Project, an emerging program of the consortium. This is a small but committed group of alternative-health practitioners, gardeners, social-justice advocates, and community members who believe that all people have a right to wellness and an empowered connection to their health.

Leslie Chaison, director of the project, said one of its main goals is to focus attention on the problem of pain and, more specifically, the over-prescription of opioid medications and the need to help people discover alternatives.

“We offer alternative therapies to people in recovery,” she said, adding, however, that the project has been hampered by a lack of funding and has been kept alive by the task force. “We have multiple therapies in our clinic, including acupuncture, massage, homeopathy, craniosacral therapy, herbal consults, and more.”

Through a grant from the task force, the project forged a partnership with Greenfield Community Acupuncture that has enabled a number of early-stage recovery individuals to receive acupuncture treatment for their pain.

“The feedback has been really great,” she said, adding that the project’s regular clinic, housed at the Recover Project and staffed by volunteers, has brought a variety of treatments to people in need.

Count Thomas in that group, and as one of the believers.

“We needed to look at this as a chronic disease and not be looking toward incarceration and criminal sanctions. So the emphasis has been on treatment and recovery.”

“Every Tuesday, they set this up back here,” he said referring to a space within the Recover Project. “There were lights and low music and all this stuff. I remember saying, ‘what is all this?’ and walking out; it took me a while to trust and just make an appointment.

“But I came to trust,” he went on. “And I have full-body massages, herbal medicine … they gave me tea, and it worked better than the medicine I was getting from CVS.”

Summing up the collaboration and the progress made to date, Sullivan said the most notable change has come in breaking down barriers and putting people in the same room — either literally or figuratively.

“In Franklin County, I think there were more silos than there were barns,” he explained. “This is really about good people communicating with other and working on solutions. It’s a big problem, and it still exists, but we’re seeing progress.

“It’s about having that day-to-day conversation with providers — ‘how do you link people up? How does a family find a place for a person to go for treatment? Where do they go for recovery?’ It’s all about these great conversations that are happening now that weren’t happening in the past.”

Bottom Line

Linda Ahern, that angry individual who started banging on doors from the outside out of frustration with a broken system, became emotional as she started talking about battling the problem from the inside — and about the progress made collectively.

“I’m just really proud of what we’ve done together with all our strengths and all the connections that we have,” she said, “and to really welcome people with lived experiences, and not in a token kind of way, but in a ‘your-voice-really-matters’ way.

“We’re setting precedents that are being looked at across the country,” Ahern went on. “I talk to people from all over who say ‘wow, you did that? — share it.’ And that’s what we do; we share the information so that someone in a state that’s not as progressive can do the same things that we are.”

With that, she spoke for everyone in the crowded room. Anthony Bourdain wasn’t there, of course, but in a way, he was — still reminding people that there’s ‘only us.’

Those involved in this massive collaboration don’t need such a reminder; they live and breathe it every day.

George O’Brien can be reached at [email protected]

Healthcare Heroes

He’s Spent a Half-century in the ‘Helping Profession’

Dr. Robert Fazzi

Dr. Robert Fazzi

There’s more than a little irony attached to the fact that Bob Fazzi’s office has a window that looks out on what was the main gate to the old Northampton State Hospital.

Indeed, Fazzi, the Healthcare Hero in the Lifetime Achievement category, has spent his life working diligently to keep individuals out of institutions like the massive mental-health facility that once dominated the Northampton landscape in myriad ways, and make them part of the community — the one word that probably best defines every aspect of Fazzi’s life and work.

He was doing such work back when his career was getting started as he joined the organization known as Downey Side, which focused on helping to keep delinquent youths out of juvenile institutions and get them into group homes where many layers of support were available.

It was the same when he became the first director of the agency now known as the Center for Human Development. Back then, it was called the Center for the Study of Institutional Alternatives, a name that spoke volumes about its purpose.

And it’s the same, although on a different level and scope with Fazzi Associates, the company he started 40 years ago and incorporated in 1995. Its stated mission is to make a real difference in healthcare by strengthening the quality, value, and impact of home care, hospice, and community-based services.

Fazzi Associates has been a leader and a pioneer in this sector, developing products and services — including the industry’s first home-health patient-satisfaction services — as well as research to make agencies stronger and better able to serve their patients.

The company has grown steadily over the years, so much so that it has had to relocate to larger quarters several times. With the last such move, Fazzi scouted a number of sites, including Tower Square in Springfield, but opted to stay in the community that by then had become home — but in a much different setting.

And in a poetic sort of way, that new mailing address, 11 Village Hill Road, just a few hundred yards from where the state hospital’s administration building, ‘Old Main,’ once stood, represents a lifetime of work well done.

And done in what Fazzi referred to as the “helping profession.”

That’s the term he applied to not only the home-care field, but hospice and the broad human-services spectrum, all touched in one way or another by the company he launched — and the man himself.

Jim Goodwin, the current president and CEO of CHD, who was hired by Fazzi in the late ’70s, describes him as a tireless advocate for those in need, a true leader, visionary, motivator, consensus builder, and manager who was ahead of his time in many ways.

“Today, you hear about CEOs being trained to hire people smarter than they are, to hire people that know things they don’t know,” said Goodwin. “He was one of the first people to actually do that; he hired people like that and made himself successful before that kind of thinking was popular; he put together all the component parts and put the right people around him.”

Fazzi, who noted that he was influenced by a number of mentors in his life, including Father Paul Engel, founder of Downey Side, Paul Doherty, one of that agency’s early board members, and many others, said he’s tried to take the values they’ve impressed upon him and pay it forward, if you will, while also becoming a mentor and inspiration to others.

“I had some great mentors in my life — some people who influenced in my life in a very positive way,” he said. “I’ve tried to do the same for others.”

This manifests itself in a number of policies, formal and informal, at Fazzi Associates. For example, the firm gives away 10% of its profits every year to nonprofit organizations, and has a policy of giving every employee 16 paid hours to volunteer at any nonprofit health, human-service, or anti-poverty organization.

As he talked with BusinessWest, Fazzi was embarking on another new chapter in his life and career. Indeed, after a lengthy search for the right partner, he recently sold the company he founded to Mediware Information Systems Inc., a portfolio company of TPG Capital and a leading supplier of software solutions for healthcare and human-service providers and payers.

He will serve in a strategic advisory role with Mediware, and also be one of the founding board members of ElevatingHome, a new organization created to elevate the role, impact, and influence of the home- and community-based healthcare field.

So, while he’s not exactly retiring, he’s moving in that direction, a step that’s providing some anxiety about what comes next, but also a chance to reflect on his work and his career, which he did for BusinessWest.

At Home with the Idea

While Fazzi is proud of his mailing address, the team assembled to work there, and its many accomplishments, he’s equally proud of something else: how much mail gets delivered there every day.

Indeed, in a community that boasts institutions such as Smith College and Cooley Dickinson Hospital, more pieces are probably delivered to Fazzi Associates than any other location in Northampton.

That’s because those home-health patient-satisfaction surveys, among others developed by the company, must be sent there for processing rather than to the specific agency being evaluated.

“We get almost 1 million pieces of mail a year from patients,” he noted, adding that surveys cannot be completed online at this time. “We compare agencies by how well they do with patients.”

The volume of mail is one qualitative measure of not only how much Fazzi Associates has grown over the years, but also how Fazzi’s career has evolved and touched ever more lives over the decades.

And, as noted earlier, Fazzi may not have known early on what direction his life and his career would take, but he did know he would be getting involved with his community in many ways.

Bob Fazzi

Bob Fazzi has been described by others as a visionary, motivator, mentor, and manager who was in many ways ahead of his time.

“I came from a strong, community-oriented family,” he recalled, noting that he grew up in the Forest Park section of Springfield. “My parents were involved with the church, they were involved with different things within the community; we were always involved.”

During college, he said he was “lost,” as many people who attended in the late ’60s were, but still managed to get involved with a number of groups and organizations, many with community-minded missions and reasons for being.

After college, he had planned on going into AmeriCorps VISTA (Volunteers in Service to America), and thought he had been accepted into that program, but it was so disorganized, as he recalled, that six months later he still wasn’t sure.

While waiting to hear from VISTA, Father Engel invited him to get involved with Downey Side, and he did, living in a number of group homes and working as a community organizer.

He spent only a few years with the program, but its mission, and Engel’s approach to carrying it out, had an indelible impact on Fazzi’s career track and approach to life itself.

“I mention Downey Side all the time, even though I was only there two or three years, and that was a long time ago,” he recalled. “Father Engel was really evangelistic about it, saying, ‘we’ve got to get these kids out of these institutions.’ He was always saying, ‘these kids don’t belong here — we have a moral responsibility to help them.’ That really resonated with me.”

Fazzi eventually left Downey Side to be the first director of the Center for the Study of Institutional Alternatives, which was somewhat of a radical concept back then, he noted, although there was plenty of data to back up that basic premise — and data would be the foundation for the work that would dominate the rest of his career.

The new center started with one program, something similar to Downey Side’s in that the goal was to help keep young people out of institutions, but its mission quickly expanded, he noted, citing as one example that the families of these young people were often challenged by a host of issues, so programs were developed to assist them.

“We found that, in some cases, some of the parents were dealing with severe mental illness; they were up at the state hospital,” he said, referring to the facility in Northampton. “So we began to get involved with the Department of Mental Health.

“The value piece was the key,” he went on. “The value was the least-restrictive alternative; where’s the best place to service people in the least-restrictive manner?”

The answer to that question was “in the community,” he went on, adding that what became CHD was a clear leader in the movement to place individuals with behavioral-health issues in residences within the community.

And while the concept made sense on many levels, there were many individuals who didn’t want such residences in the neighborhoods.

Goodwin remembers some fierce battles with residents in Springfield and West Springfield in particular, and that Fazzi stood his ground and fought hard for those he was working to serve.

“I mention Downey Side all the time, even though I was only there two or three years, and that was a long time ago. Father Engel was really evangelistic about it, saying, ‘we’ve got to get these kids out of these institutions.’ He was always saying, ‘these kids don’t belong here — we have a moral responsibility to help them.’ That really resonated with me.”

“He took a lot of risks,” Goodwin recalled. “In the beginning, when we first opened group homes, there were terrible battles with neighborhoods; people would come out and threaten him and throw things at him. But he always stuck to his guns and worked hard with people in the community to get them to understand the value of community-based programming.”

By the late ’70s, Fazzi knew he wanted to start a new chapter in his career — one that would build on those that came before — and focused on consulting work in realms such as home health and hospice care.

“I felt I wanted to be involved in healthcare, but not the human-service side,” he explained, adding that his doctorate is in organizational behavior and he considered himself proficient at planning and organizational change. His plan was to take those skills and put them to work in consulting to other agencies involved in healthcare.

In Good Company

To say that starting and then growing Fazzi Associates into a business that now employs more than 40 people was a learning experience would be an understatement.

And it started with the first bill he sent.

“I did some consulting work for an agency in Worcester, and they paid me $500,” he recalled. “I sent them a bill, and I called myself ‘Management Consulting’ — very clever; I really stood out with that. He sent it back saying I either had to incorporate or have my name in the title.”

He was set to incorporate but found out that this cost $1,000, twice what he made for the first job. So he opted for plan B and just put his name on the invoices moving forward.

In time, though, and not much of it, ‘Fazzi’ would become more than the name on the bill. It would become synonymous with excellence and innovation in the home-care and hospice realms as the company developed new products and services to help clients better serve their customers and measure their performance.

So much so that, when Fazzi finally decided to incorporate in 1995, and was mulling a name change while doing so, advisors told him the name ‘Fazzi’ had too much name recognition and too much clout for him to consider a change. So he didn’t.

Fazzi recalled that, while he started out working for other people, he always considered himself entrepreneurial.

At CHD, for example, he said the agency was funded by the state, which was often if not always behind in its payments. “I remember having to put my house up in order to carry the organization, and there were other people who did the same thing; if you believed in it, that’s what you did.”

With Fazzi Associates, he started out doing planning and training, with most of the early clients involved with home care and hospice. But the scope of services quickly grew, as did the client list.

While doing organizational-improvement work, home-care agencies would often ask if they were doing a good job, he recalled, adding that he replied, in general terms, that he wasn’t the one to be answering that question; clients should be. And when he asked those agencies if they had patient-satisfaction surveys, most all of them didn’t. And the ones who did lacked that one that would be considered valid.

So Fazzi created one, and before long it was providing them to hundreds of agencies. Then, when the Department of Health and Human Services created the Outcome and Assessment Information Set (OASIS), Fazzi made sure his company became an expert on the subject and began offering OASIS education.

In 2009, responding to the industry’s need to optimize operations to focus on patient care, Fazzi introduced outsourced medical coding, and is now the largest coding company serving the home-health and hospice industries. Through its operational consulting division, the company has helped hundreds of agencies by putting in place best practices in structure, clinical and operational practices, and supervisory models.

Still another contribution Fazzi has made involves conducting scientific best-practice research and then giving that information away for free to the entire industry. The first such study, titled “Collaborating to Compete: A National Study of Horizontal Networks,” was released in 1996. Others to follow included the National Home Care Re-engineering Study, the National Best Practices Improvement Study, and the National Quality Improvement Hospitalization Reduction Study.

“We’re absolutely indebted to our industry — we’ve been in this field since 1978 and believe we have a responsibility to give back to our industry,” he explained. “We feel the best way is to provide every agency in the country with insights on best practices that will make them stronger and more viable.”

Transition Stage

While doing that for his industry, Fazzi wanted to do the same for his company, so he put in place a succession that has Tom Ashe, one of five major partners in the company, succeeding him as CEO.

That leaves him with a problem of sorts.

“I love coming to work every day — I can’t wait to get up and go to work,” he said, adding that, like others facing the transition to retirement, he’s somewhat — OK, maybe a little more than somewhat — apprehensive about what the next phase of his life will be like.

He doesn’t know exactly what he’ll be doing, but it’s a pretty safe bet that that he will stay involved within the helping profession and find new ways to put his vast experience, energy, and compassion to work helping others.

That’s what he’s been doing for a lifetime, and with very positive results for the community known as Western Mass. And for evidence of that, all he needs to do is look out the window toward the gates of the state hospital that no longer exists.

George O’Brien can be reached at [email protected]

MGM Springfield

For Starters…

Alex Dixon, seen here at MGM Springfield’s South End Market

Alex Dixon, seen here at MGM Springfield’s South End Market, says ‘normal’ isn’t something to expect at the facility for some time.

The long-awaited opening of MGM is now being talked about in the past tense. It was, as most everyone predicted it would be, a momentous event in the city’s history. But thanks to some careful planning, it was not the disruptive force that some were anticipating.

Alex Dixon came away with a few observations — and a few questions — after MGM Springfield’s first weekend of operation late last month.

In that latter category … well, he was wondering out loud if that fruity libation ‘Sex on the Beach’ is the official drink of Greater Springfield. It must be, he concluded, because the bars on the premises ran out of some or all of the ingredients needed to make it — vodka, peach schnapps, orange juice, and cranberry juice — so some people had to drink something else. And usually did.

But for a while, it was also a challenge to get something involving Coca Cola. “We ran out at one point,” said Dixon, general manager of the facility. “We managed to get some more, but we were out for a while.”

“We ran through so many different scenarios, and none of them came to be; we’re as excited for what happened as we are for what didn’t happen.”

As for observations … he said the company may have to take some steps to help some employees with their feet.

“We’re looking right now into getting some foot care for a lot of our employees,” he said several days after the opening. “People were on their feet more in the past 72 hours than they’ve been in a long time. So we’re looking to store some Epsom salts or some foot care, because people need to take care of their feet.”

OK, those were observations more of the tongue-in-cheek variety. Getting more serious — although he was quite serious about those foot problems — he said the long-awaited opening for MGM, meaning not just not opening day but those first several days, were noteworthy not just for what happened — huge crowds and general excitement for the region’s new, $960 million toy — but also for what didn’t happen.

And with that, Dixon summoned the contrived phrase ‘carmageddon.’ That’s not in the dictionary, but if it were, ‘gridlock’ would be listed as a synonym. Some people were predicting something approaching that, meaning Big E-like traffic jams and parking issues, during the first few days. Anxiety was such that some downtown Springfield-based businesses actually closed their doors or altered their schedules in the wake of some predictions. There were electronic signs on I-91 alerting motorists that MGM was opening on Aug. 24, and therefore they should expect delays.

But, for the most part, none of that happened, and what looked to the untrained eye to be a somewhat slow start for the casino was actually the fruits of some careful planning, said Dixon.

Elaborating, he said MGM officials made arrangements with the Big E for casino patrons to park there for free and be shuttled over. And then, in the countless media interviews that took place leading up to and just after the opening, those same officials kept urging people to park across the river to take advantage of that option.

Long story short, they did, and with positive results for area commuters and businesses downtown and elsewhere.

As for hard numbers on MGM’s opening day and first weekend, Dixon didn’t have any at press time. So he qualified things as best he could.

“It was phenomenal,” he said of the opening and the weekend that followed. “And the big jubilation is that we did it — and by ‘we,’ I mean literally the entire community, meaning the city, the Commonwealth, and all the different agencies we’ve been working with to coordinate things. We ran through so many different scenarios, and none of them came to be; we’re as excited for what happened as we are for what didn’t happen.

“We need to get people rested up because this is a marathon, although we had a sprint initially. People need their rest.”

“We did very well in terms of volume — we’re still tabulating the numbers,” he went on. “But we didn’t have the side effects that can potentially come with too many cars, too many pedestrians, and too many issues.”

Looking ahead, and, more specifically, addressing the question of when something approaching normalcy might descend on MGM Springfield, Dixon said it will be a while before that happens.

Indeed, while the week days after the opening were far less hectic, the Labor Day weekend (with Stevie Wonder appearing at the MassMutual Center on Sept. 1) was fast approaching, with Enshrinement weekend for the Basketball Hall of Fame coming the following week, and the Big E to open on Sept. 14.

“I don’t think we’ll see ‘normal’ for some time yet,” said Dixon with a huge smile on his face, implying that not normal is good, as in really good.

For this issue, BusinessWest talked with Dixon about MGM’s long-awaited opening and got a behind-the-scenes look (sort of, but not really) at what was happening, and, as he noted, not happening.

General Manager Alex Dixon didn’t have specific numbers

General Manager Alex Dixon didn’t have specific numbers, but he said volume at MGM Springfield those first few days met or exceeded expectations. Getty Images

Crowd Control

In the days leading up to the opening, there were many MGM employees working long days and often long nights as well, said Dixon, who put himself in that category.

So one of the many items on his to-do list as general manager in the days immediately following the opening was to make sure that those who needed to caught up on their rest.

“That Sunday was focused on really looking at people’s days off, to make sure that, if they couldn’t take a full day, they could at least take some hours off,” he explained. “We need to get people rested up because this is a marathon, although we had a sprint initially. People need their rest.”

After that first weekend, most certainly needed some rest, he went on, adding that the facility was at or near full capacity for many stretches, especially Friday and Saturday nights.

For the most part, the hundreds of employees, many wearing their uniforms for the first time, came through it well, despite what were for some 16-, 18-, even 20-hour days for those at the top levels.

As the bartenders, waiters, and waitresses serving up Sex on the Beach drinks — or not, as the case may be — they had some very long nights, but few seemed to be complaining, said Dixon.

“I heard anecdotally that someone said they made more in three hours than she did in three weeks at her last job,” he said. “That’s not only heartwarming, but it gives an indication of the sheer volume we encountered, and our restaurants were far busier than any of us could have imagined.”

Flashing back to opening day, he said that he and his team handled the different waves of visitors smoothly, but made some adjustments on the fly. The first wave comprised of the thousands who assembled on Main Street in advance of the 11 a.m. opening — some were on the street before 6, said Dixon, adding that the first order of business that day (literally and figuratively) was to get those people into the building safely and in an orderly fashion in order to reopen Main Street to traffic.

The first order of business for those at MGM Springfield

The first order of business for those at MGM Springfield was to get the throngs on Main Street who gathered on the morning of opening day into the facility safely and in an orderly fashion.

That all happened according to plan, he went on, adding that the next wave was a mixed group that included large numbers of workers spilling out of the downtown office buildings and walking the few blocks to the casino. Another wave came through that night, again filling the casino to something approaching full capacity.

As for the adjustments, or tweaks, as Dixon called them, they included everything from reconfiguring the ling lines for people looking to sign up for the M Life Rewards program to devising ways to handle all the traffic at the brick-oven pizzeria at the Cal-Mare restaurant.

“The pizza counter was wildly successful, and we needed more space, we needed another point of sale to handle everyone,” he noted. “That brick-oven pizza was just a hit, so we made some adjustments.”

Getting back to that phrase ‘carmageddon,’ Dixon said it didn’t happen on opening weekend, and that shows, by and large, that it’s not likely to happen on a large scale.

When asked if that was a good thing, he said it was — for MGM, the region, and its business community.

“Through this big peak, we’ve shown that there’s not an over-arching impact to the business community in a negative way, such as slowing down commerce to the rest of the city,” he told BusinessWest. “We’re just really proud of the planning we did in advance, with the city, West Springfield, and the Big E; that investment in the shuttles really paid off.”

And the investment grew in size, because the shuttle service, originally to be offered only on opening day (Friday), was extended through the weekend in yet another attempt to control the impact of the casino’s opening on the region and its businesses.

Drinking it In

When pressed, Dixon said he doesn’t know what goes into a Sex on the Beach drink and wouldn’t know how to make one.

“But apparently half of Springfield does, because that’s must have been the most popular drink,” he said with a laugh, adding that besides stocking on up on peach schnapps and whatever else might be needed, he and his team will continue to make tweaks and adjust as necessary, because ‘normal,’ as he noted, isn’t something likely to be seen at MGM for a while.

And as he also noted, this is a marathon, even though it started with a sprint.

George O’Brien can be reached at [email protected]

Features

Jim Barrett was talking about the future of work, market disrupters, and, more specifically, the skills that employees will need in the future. And to get his points across, he repeatedly referenced the F-35 stealth fighter jet recently introduced into service by the Air Force, Navy, and Marines.

“The pilot has a helmet that is custom-sculpted to their head,” Barrett, managing partner of the Holyoke-based accounting firm Meyers Brothers Kalicka, explained. “They put the visor down, and they see, through cameras, 360 degrees around the plane. They’re not really using their vision anymore; they’re looking straight ahead and seeing the screen in front of them.

“Years ago, when these planes touched down, people would run out to the tarmac and say, ‘how much fuel do you need? How much ammunition do you need? Is there anything wrong?’ And they’d do all the tests,” he went on. “This new jet actually has the ability to send back information to the base about how much fuel it’s used, how much ammunition it’s used; it does a self-diagnosis of what it needs such that, when the pilot touches down on the deck, there are people already lined up with the exact parts it needs and the exact amount of ammunition. They eliminated all the time and people it took to gather all that information.”

The moral to that story? Essentially, the same thing is happening in the workplace, said Barrett, adding that, in the future — and even now, for that matter — people will need a different set of skills to succeed in the workplace.

Using his sector, financial services, as an example, he said that, years ago, people would spend large chunks of time gathering and analyzing data. “Now, machines are going to do that for you,” he went on. “So you’ll need people who can make determinations about what data is relevant, because the data is already going to gathered and analyzed.”

Barrett will get into much greater detail about all this at the third installment of BusinessWest’s Future Tense series, created to help business owners understand the future and be better prepared for it, on Sept. 20.

Fast Facts:

What: Future Tense lecture series, the third installment
When: Sept. 20, starting at 8 a.m.
Where: Tech Foundry, 1391 Main St., Springfield, 9th floor
For More Information: Call (413) 781-8600
To Register: Visit businesswest.com/lecture-series

He will be joined by Mark Borsari, president of wire-brush manufacturing firm Sanderson MacLeod, who will discuss change and innovation through lean concepts and focus on resulting cultural considerations and the broad impact on competitiveness.

Barrett and Borsari will wrap up the series, which has drawn a wide range of business owners and managers to Tech Foundry’s facilities to hear about arguably the most vexing topic in business — the future.

In the first installment, Delcie Bean, founder of Paragus Strategic IT, talked about how technology — in such forms as artificial intelligence, driverless cars, and 3-D printing, will change not only the workplace, but society as a whole. In the second installment, wealth-management advisor Amy Jamrog presented a program titled “What Got You Here Might Not Get You There: Mistakes Business Owners Make Before and After Retirement.”

The third installment will have many focus points, said Barrett, but especially the market forces and market disrupters that will shape his sector, but also all industries.

And, as noted earlier, to succeed, people will need a different skill set.

“It’s not analyzing the data as much as determining what to do with it,” he explained. “It’s about making better decisions with the date you have, as opposed to gathering and analyzing it.”

The program will begin at 8 a.m. with registration and a continental breakfast. There will be then be remarks from sponsors — Paragus and the Jamrog Group — followed by the presentation and a discussion. Tickets are $25 each, with the proceeds going to Tech Foundry.

For more information, call (413) 781-8600. To register, visit businesswest.com/lecture-series.

MGM Springfield

The Moment Is Here

groundbreaking ceremonies

Few in attendance at the groundbreaking ceremonies three and half years ago could have imagined how Springfield’s South End would be transformed by MGM Springfield.

Back about 1,300 days or so ago, several hundred business and civic leaders and other dignitaries gathered in bright sunshine in Springfield’s South End to witness the official ground-breaking ceremonies for MGM Springfield.

Analysis

Those in attendance that day would probably struggle now to remember what that area looked like back then. Maybe not. The former Zanetti School and the old correctional facility (known as the ‘alcohol jail’ to many) on Howard Street were considerable landmarks, and it’s not difficult to conjure up remembrances of them and other structures now gone.

More to the point, it was virtually impossible for anyone there that day to stretch their imagination and conceive of the complex that occupies that site now. We had all seen the renderings, but back on that warm spring day, those architect’s drawings were a long, long way from reality.

Indeed, even though the journey began well before that day, those groundbreaking ceremonies marked the official moment, for most of us, anyway, when the $960 million MGM Springfield project became real. And even then, it didn’t actually seem real.

This was (and is) Springfield after all, and in the minds of many, something this big, something this grand, something this potentially life-altering, just wasn’t going to happen here. MGM was going to change its mind. The Legislature was going to screw things up. Something bad was going to happen.

The city hasn’t really seen anything like this probably since George Washington picked that acreage on the hill above downtown as the site of the young nation’s first arsenal — what became the Springfield Armory.

But here we are, 1,300 or so days later. It is real, and is happening, even if for some it seems surreal.

That phrase ‘history-making’ is overused these days, to the point where it doesn’t mean much anymore. The talking heads at ESPN use it almost every night to refer to some relief pitcher, hockey goalie, or field goal kicker achieving some obscure statistical milestone.

But with MGM Springfield, it fits. The city hasn’t really seen anything like this probably since George Washington picked that acreage on the hill above downtown as the site of the young nation’s first arsenal — what became the Springfield Armory. The armory, as most know, changed the course of this city and this region in all kinds of ways.

The innovation and craftsmanship that marked the Armory’s early days — and all its days, for that matter — sparked waves of related businesses and an entire business sector — precision manufacturing. Meanwhile, the solid jobs available at the Armory spurred wealth and the construction of the large, beautiful homes that gave the city its nickname.

What kind of chapter in the city’s history will MGM author?

We really don’t know. No one does.

Back 30 years or so ago, the good people of Atlantic City hailed the gambling palaces being built there then as a renaissance, a rebirth for a city that had fallen on some very hard times. We all know how that turned out.

MGM Springfield is opening at a time when competition for the gambling dollar has never been stiffer, and the pace of competition will only accelerate as states and regions look to cash in on what appears to be a sure thing.

Only … there is no such thing, as anyone who gambles can surely tell you.

And while MGM Springfield is many things to many people, it is, overall, a gamble, and people shouldn’t ever forget that. And when you gamble, you can win, you can lose, and you can break even.

A lot can happen over the next few years or the next few decades, but we choose to believe that the city and this region will see this gamble pay off.

And while MGM Springfield is many things to many people, it is, overall, a gamble, and people shouldn’t ever forget that. And when you gamble, you can win, you can lose, and you can break even.

It will pay off in jobs, in vibrancy, in a trickle-down effect to other businesses in many sectors, and above all, in making this city relevant again, something it really hasn’t been for a long time. Remember, before that ground-breaking ceremony, there hadn’t been a significant private-sector development in downtown Springfield in almost 30 years.

Not every development will be positive; some businesses will definitely be hurt by the arrival of MGM, and there will be more traffic and hassles getting in and out of the city. And there is the very real possibility that many of those coming to visit MGM will get back in their cars, buses, and limos at the end of the stay and get right back on I-91 north or south and leave Springfield behind.

But for city leaders, the state, the Gaming Commission, this region as a whole, and especially MGM, this was a gamble well worth taking. In the end, we don’t believe anyone will regret putting their chips on Springfield and letting it ride.

Those are the kinds of words that can certainly come back to haunt someone, but we don’t believe they will. This is, as they say in this business, a solid bet — for MGM and this region.

BusinessWest invited area business and civic leaders to offer their thoughts on what the arrival of MGM Springfield means for this region. Maybe Peter Rosskothen, owner of the Log Cabin and a host of other businesses, all of them to compete with MGM in one way or another, said it best: “I am excited about the excitement.”

So are we.

George O’Brien is the editor of BusinessWest.

MGM Springfield

From Their Perspective

Editor’s Note: As the countdown to MGM’s grand opening ticks down to the final hours, we asked a number of area business and civic leaders for their thoughts on what this momentous development means for Springfield and the surrounding region.

Nancy F. Creed

Nancy F. Creed

Nancy F. Creed, president, Springfield Regional Chamber

“MGM is already making a difference in the local economy — from job creation to utilizing local vendors and suppliers to attracting all types of folks to downtown. You see those results every day. Just this past week, I met a couple from Sardinia who were here on leisure travel. The streets are bustling with people; restaurants are filling up; people are lined up to get coffee at cafes. It is an exciting time in Springfield and in the region and I can only imagine what more is to come once they officially open!”

Richard Sullivan, president and CEO, Economic Development Council of Western Mass.

“MGM presents an exciting economic opportunity for Springfield and Western Mass. Certainly the almost $1 billion investment in downtown Springfield, the construction jobs, and now permanent 3,000 new jobs are significant. However, the real opportunity is the yearly $50 million purchase of goods and services from the existing local economy. MGM has worked diligently to fulfill this commitment. All of this investment will stay local and provide our local businesses an opportunity to grow.

MGM also presents an opportunity to grow our travel and tourism economy and our convention business. Western Mass already has a lot to offer with the Hall of Fame, Museums, Yankee Candle, Northampton restaurant scene, the Armory, and Six Flags. Adding the new casino and entertainment options brings the region’s culinary and hospitality offerings to a new level.”

Peter Rosskothen

Peter Rosskothen

Peter Rosskothen, owner, Log Cabin, Delaney House, Delaney’s Market & D. Hotel & Suites:

“I am excited about the excitement. I hope to see some new businesses in downtown soon. I know that MGM will cannibalize some of our businesses, but we should be able to compensate for that with increased tourism and the support of its employees. Increased tax revenue, plus the commitment of funds from MGM to promote tourism should increase visitation to our market. I am hopeful that this rising tide lifts all boats. Welcome MGM!”

Mary Kay Wydra

Mary Kay Wydra

Mary Kay Wydra, president of the Greater Springfield Convention and Visitors Bureau:

“The primary role of the Greater Springfield Convention and Visitors Bureau is to attract visitors to Western Mass., and MGM Springfield will certainly help us accomplish that. Tourism is the state’s third-largest industry and continuing to grow in our region. We are confident that MGM Springfield’s incredible new development with a variety of entertainment in the heart of downtown will bring more visitors. It’s our job to encourage these folks to see more, do more, and stay longer, because that translates into additional spending. All of this extra revenue enhances businesses, governments, and residents across our region alike.”

Kevin Kennedy

Kevin Kennedy

Kevin Kennedy, chief development officer for the city of Springfield

“MGM and its $1.1 billion investment in Springfield is a game changer for the region. The job-creation, repeat vendor spending, and world-class entertainment will impact us well beyond anything we could have hoped for in the aftermath of the tornado. Trains through Union Station will provide first-class transportation south to Hartford and New York. In 2019 the service will expand as far north as Greenfield. More than 400 new units of market-rate housing have been created in the downtown. The excitement is real and it will hit home when we welcome Stevie Wonder on Sept. 1.”

Robert A. Nakosteen

Robert A. Nakosteen

Robert A. Nakosteen, professor, Isenberg School of Management, UMass Amherst

“Manufacturing activity in Springfield peaked in the 19th century, and though interrupted by two World Wars, has been in decline ever since. Though anchored by Mass Mutual and Baystate Health, employment growth in the city has been tepid or non-existent for a long time. Now, the MGM casino promises to bring renewed vitality and growth to Springfield. After a construction phase that created 2,000 jobs, once the Casino is fully operational it will employ 3000 people, with some of the hiring from long-neglected pools of available labor. To put these numbers in perspective, from 2010 through 2017, as the state economy was in a strong rebound from the “Great Recession,” Springfield added less than 4,000 jobs overall.”

Nicole Griffin

Nicole Griffin

Nicole Griffin, chief talent officer and owner, Manehire

“ManeHire is thrilled that this day has come when we can celebrate the opening of MGM Springfield. This investment will continue to induce development in the city and support both our tourist and surrounding businesses. The economic development and workforce impact MGM Springfield is providing is just what the city needed. Congratulations MGM Springfield and the residents of Springfield. We did it! #TheCityofWinners.”

Paul Robbins

Paul Robbins

Paul Robbins, president, Paul Robbins Associates Strategic Communications

“The term ‘game-changer’ is probably overused, but this may be one instance where it applies. Springfield, under many administrations, has been seeking to reinvent the core city. There have been many great ideas through the years, but each lacked the economic engine required, which MGM supplies, to create real transformational change downtown. It will be fascinating to see if and how that extends through the city center and regionally on things like job growth and housing values.”

Jack Dill

Jack Dill

Jack Dill, president, Colebrook Realty Corp.

“While I wasn’t a proponent of gaming in Springfield, I have been impressed with how MGM made the case and met its obligations through the approval and development process. Much of the impact on existing businesses in the area will depend on MGM’s ability to expand the market by drawing customers from outside the region and from other venues. If they succeed in long-term market expansion, other businesses in the food, lodging, and entertainment sectors should benefit. If they don’t succeed in growing the market, cannibalization would be an obvious outcome. I imagine MGM will make a concerted effort in the first several months to build market share and demonstrate the new casino’s value proposition; that would impact competitors of all types in the short term following the facility’s opening. We are already seeing the employment impacts in regional and local unemployment data; the Casino, CRRC, and an overall expanding regional economy have been good for job growth in segments that weren’t previously experiencing strong employment demand. We have observed wage rates and time to fill open positions reflecting this demand.”

Nate Costa

Nate Costa

Nate Costa, president, Springfield Thunderbirds

“I believe that MGM is going to be a game-changer for downtown Springfield. Everything they have planned is going to be top-notch, and first class — from their events to their facilities. To have a world-renowned brand steps away from the MassMutual Center and other downtown landmarks, I believe it will spur even more economic development and life in our city. They are also our presenting partner, and an organization that has stepped up and supported our vision from day one. We couldn’t be more excited for MGM to open their doors, and to join us in the true renaissance of a great American downtown. It truly will be a first in this city.”

Eugene Cassidy, president and CEO of the Eastern States Exposition

“The arrival of MGM presents a number of opportunities for this region, especially with regard to tourism, conventions, meetings — bringing a wide array of groups to the Greater Springfield area. The Big E already hosts a wide array of trade shows and events, but the arrival of MGM presents a great opportunity to drive more trade-show business to this region. To say that there is now a world-class resort casino in Springfield will be a great sales tool.”

David Cruise, president and chief executive officer, the Regional Employment Board of Hampden County

“The MGM casino is not about table games and entertainment, it’s about economic development and sustainable job-creation. It’s about the continued economic resurgence of the host community and the continued economic expansion of a critical region of the Commonwealth. We’ve always looked upon this as a job-creation initiative. We’ve always felt that our responsibility is to look at the broader region and make sure that the opening of MGM is a catalyst that helps everyone grow.”

John Doleva

John Doleva

John Doleva, president and CEO, Naismith Memorial Basketball Hall of Fame

“The Naismith Memorial Basketball Hall of Fame formally welcomes our ‘new’ neighbor, MGM, to Springfield with their beautiful new expansive complex just across the highway from the Hall of Fame. MGM has already proven to be an active, energetic and committed community partner and we know that our work together will provide visitors very unique options as they visit the Springfield region. The advent of the MGM property will be a magnet to our community and all attractions and businesses need to be prepared to put our best foot forward to complement the influx of these new and affluent customers.”

Kate Phelon

Kate Phelon

Kate Phelon, executive director of the Greater Westfield Chamber of Commerce

“Back in 2013, I remember being contacted by MGM with regards to building a casino in Springfield. While they didn’t even have the contract at that time, I must admit I was quite intrigued with the call. Fast forward to the present, and in a few days’ time, our area will have a world-renowned casino right in our back yard. We all know and understand the economic impact it will have primarily for Springfield, the vendors who were able to meander the procurement process, and those who are now employed with a prestigious enterprise. It is, no doubt, a very exciting moment for Western Massachusetts, when we are so often overlooked by major corporations. Having met and worked with several of the MGM teams over the past several years, I was impressed with their accessibility, enthusiasm, and genuine concern for fulfilling their contractual obligations. And, might I add, about wanting their guests to have an exceptionally good time. Whether you are for or against gambling, the opening of MGM will be electrifying, and only time will tell if it is sustainable.”