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Healthcare Heroes

Healthcare Heroes


Healthcare Heroes 2020 to Honor the Heroes of COVID-19

Since the phrase COVID-19 came into our lexicon, those working in the broad healthcare field have emerged as the true heroes during a pandemic that has changed every facet of life as we know it. And over the past several months, the world has paid tribute to these heroes, and in all kinds of ways — from applauding in unison from apartment-complex windows to bringing hot meals to hospital and nursing-home workers; from staging parades in front of these institutions to donating much-needed personal protective equipment (PPE).

BusinessWest and its sister publication, the Healthcare News, will pay tribute in their own way, by dedicating our annual Healthcare Heroes program in 2020 to those who are have emerged as true heroes during this crisis. We invite you to nominate one, or several, for what has become a very prestigious honor in Western Mass. — the Healthcare Heroes award.

Here are some examples of those heroes:

  • Doctors and nurses;
  • ER nurses, orderlies, techs, triage, reception;
  • EMTs;
  • Police and firefighters;
  • Nursing-home staff
  • Administrators leading the efforts to battle the pandemic;
  • End-of-life care providers;
  • Individuals and groups from our community who have stepped up to help healthcare workers with everything from hot meals to PPE;
  • Companies that have pivoted and commenced production of materials such as PPE to help those in healthcare confront the pandemic; and
  • Scientists working behind the scenes to develop a vaccine or new types of PPE.

These are just a few examples, and there are a myriad of others.

To assist those thinking of nominating someone for this honor, we are simplifying the process. All we desire is a 400-500-word essay, and/or video entry explaining why the group or individual stands out as an inspiration, and a truly bright star in a galaxy of healthcare heroes. These nominations will be carefully considered by a panel of independent judges, who will select the class of 2020.


The judging process will commence July 2020 and be completed by end of July 2020. Nominees cannot serve as awards judges. All eligible nominations received will be judged by a panel of health care industry experts whose evaluations will determine winners of the “Healthcare Heroes” Awards from among the nominees under consideration. 


Nominations must be submitted via the designated online form. Mail-in nominations will not be accepted. Nominations may be submitted beginning December 2019 and must be received no later than 5 p.m. Eastern Standard Time on July 1, 2020. 

Notification and Recognition

BusinessWest plans to notify the winners of the “Healthcare Heroes” Awards by August, 2020 and will be profiled in the September 14 edition of BusinessWest and September issue of Healthcare News. Winners will be invited to attend the “Healthcare Heroes” Awards gala scheduled for Autumn 2020 at the Sheraton Springfield One Monarch Place Hotel. 


  • Nominees must work in either Hampden, Hampshire, Franklin, or Berkshire county and organization nominees must have offices in Hampden, Hampshire, Franklin or Berkshire county (may be for-profit or not-for-profit).
  • Nominations may be self-nominated or nominated by another person.
  • Nominees cannot be a member of the judges’ panel or member of the judges’ immediate family.

If using mobile device to submit nomination, please make sure your phone is in Portrait view mode.

Submitting multiple duplicate nominations does not enhance your chances of winning.

Healthcare Heroes 2020 Nomination Form





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Event Galleries Features Healthcare Heroes

Scenes from the October 2019 Gala

The 2019 Healthcare Heroes

There were eight winners in this third class, with two in the category of Lifetime Achievement, because two candidates were tied with the top score. The Heroes for 2019 are:

• Lifetime Achievement (tie): Katherine Wilson, president and CEO, Behavioral Health Network Inc.; and Frank Robinson, vice president, Public Health, Baystate Health;

• Health/Wellness Administrator/Administration: Emily Uguccioni, executive director, Linda Manor Assisted Living;

• Collaboration in Health/Wellness: Carol Constant, convener, Dementia Friendly Western Massachusetts; and director of Community Engagement, Loomis Communities;

• Community Health: Amy Walker, certified nurse midwife, Cooley Dickinson Health Care;

• Emerging Leader: Tara Ferrante, program director of the Holyoke Outpatient Clinic, ServiceNet;

• Innovation in Health/Wellness: Cristina Huebner Torres, vice president, Research & Population Health, Caring Health Center Inc.; and

• Patient/Resident/Client Care Provider: Shriners Hospitals for Children – Springfield.

Photography by Dani Fine Photography

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Cover Story Features Healthcare Heroes

Healthcare Heroes Class of 2019 to Be Honored on Oct. 17

When BusinessWest and Healthcare News launched Healthcare Heroes in 2017, there was no doubt this was a long-overdue award program in Western Mass. — in fact, we knew the challenge wouldn’t be finding quality nominations, but choosing just a handful to honor each year. Indeed, this year’s judges (see below) carefully studied about 100 different nominees in seven categories to choose the impressive group to be honored at this year’s gala in October.

Collectively, they are innovators and game changers in the region’s rich and vibrant healthcare community, and their stories — told on the following pages — reveal large quantities of energy, imagination, compassion, entrepreneurship, forward thinking, and dedication to the community.

There are eight winners in this third class, with two in the category of Lifetime Achievement, because two candidates were tied with the top score. The Heroes for 2019 are:

• Lifetime Achievement (tie): Katherine Wilson, president and CEO, Behavioral Health Network Inc.; and Frank Robinson, vice president, Public Health, Baystate Health;

• Health/Wellness Administrator/Administration: Emily Uguccioni, executive director, Linda Manor Assisted Living;

• Collaboration in Health/Wellness: Carol Constant, convener, Dementia Friendly Western Massachusetts; and director of Community Engagement, Loomis Communities;

• Community Health: Amy Walker, certified nurse midwife, Cooley Dickinson Health Care;

• Emerging Leader: Tara Ferrante, program director of the Holyoke Outpatient Clinic, ServiceNet;

• Innovation in Health/Wellness: Cristina Huebner Torres, vice president, Research & Population Health, Caring Health Center Inc.; and

• Patient/Resident/Client Care Provider: Shriners Hospitals for Children – Springfield.

3rd Annual Healthcare Heroes Gala
Thursday, October 17, 2019
5:30 p.m.-8:30 p.m.
Sheraton Springfield One Monarch Place Hotel
$90/person; $900/table of 10


Submit nominations for 2020 consideration HERE

Deadline to submit nominations is July 10, 2020, 5 p.m. NO EXCEPTIONS.

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Meet the Judges

Bob Fazzi

Bob Fazzi has spent a lifetime making a difference in healthcare, most notably 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. For this work, Fazzi was honored as a Healthcare Hero in 2018 in the category of Lifetime Achievement.

Mary Paquette

Mary Paquette, director of Health Services at American International College, is another 2018 Healthcare Hero, in the category of Patient/Resident/Client Care Provider. AIC is only the latest stop in a 35-year career that has seen her take on a variety of roles, from director of Nursing at Ludlow Hospital to per-diem hospitalist at in the GI Department of the Eastern Connecticut Health Network, to assistant director of Health Services at Western New England University — the job that became the springboard to her post at AIC. Since arriving at AIC 2012, she has turned a moribund health-services facility that few students knew about or ventured to into a thriving, innovative, important campus service.

Alan Popp

Alan Popp joined the Mason Wright Foundation as its Chief Executive Officer in 2008. His previous experience includes head of school and CEO at White Mountain School, a college preparatory school; and chief operating officer at Pine River Institute, a residential treatment center. He has also served as a consultant to more than 200 New England nonprofits, many of them providers of services to seniors. He serves on the boards of LeadingAge Massachusetts, Salvation Army Citadel Corps, and OnBoard Inc., and on the Leadership Council of the Alzheimer’s Assoc. of Massachusetts/New Hampshire. He is also a trustee of Antioch University New England and previously served on the campaign cabinet for the United Way of Pioneer Valley.

Healthcare Heroes

This Public Health Leader Is a Visionary and Innovator

Frank Robinson, Ph.D.

“Dr. Frank Robinson is a true visionary. He sees partnerships and systems that most other people don’t see. He doesn’t stop there … and he doesn’t allow other people’s short-sightedness or lack of imagination to get in his way. He persists because he loves to see other people, particularly young people, grow and thrive and achieve their dreams.”

Over the next few pages, you’ll read quite a bit of material that will help explain why Robinson, currently vice president of Public Health for Baystate Health, is one of two Healthcare Heroes in the Lifetime Achievement category for 2019. But none of the words to come can do that more effectively that those at the top.

They’re from the nomination form submitted by Jessica Collins, executive director of the Public Health Institute of Western Mass., a job Robinson once held himself, when the agency was known as Partners for a Healthier Community.

And Greater Springfield has, indeed, become a healthier community because of Robinson, who, over the past 35 years or so, has conceived or been closely involved with initiatives in realms ranging from children’s oral health to asthma; from food insecurity to sexual health; from health education to overall population health.

And who really knows if he would have been involved in any of that had it not been for … Hurricane Agnes.

The storm barreled into Elmira, N.Y. in late June, 1972, flooding the recently opened Elmira Psychiatric Center, where Robinson was working as a psychiatric social worker. That’s was, because the storm put him out of work.

He found new work essentially counseling youths displaced by the hurricane and relocated to nearby Elmira College.

“Dr. Frank Robinson is a true visionary. He sees partnerships and systems that most other people don’t see. He doesn’t stop there … and he doesn’t allow other people’s short-sightedness or lack of imagination to get in his way.”

“A call came out for help because these youngsters were running wild in the dorms unsupervised,” Robinson recalled, adding that he and a friend were dispatched to the scene because they were staff at a facility called the Elmira Neighborhood House — Robinson taught boxing there and knew most of the teens.

In some ways, Hurricane Agnes blew Robinson onto a different, more community-focused career path that, early on, featured extensive work with young people. And, by and large, he has stayed on that path.

Fast-forwarding through his résumé, he worked locally for the Mass. Department of Mental Health (at the same time as the other Lifetime Achievement hero for 2019, Katherine Wilson; see story on page 22); the W.W. Johnson Life Mental Health Center in Springfield; the Springfield Community Substance Abuse Partnership and Prevention Alliance, part of the Springfield Department of Health and Human Services; Partners for Community Health; and Baystate Health, first as director of Community Health Planning and now as vice president of Public Health.

At each stop, he has been a visionary and an innovator, leading initiatives ranging from the BEST Oral Health program to Baystate Academy Charter School to the Baystate Springfield Educational Partnership.

“Over the years, I have worked in positions that have advanced my specific interest in creating a healthier community and preventing health problems from occurring by giving people what they need,” he said while summing up his life’s work in a simple yet effective way, adding quickly that, while progress has been made, there is still a great deal of work to be done.

And he’s still doing it.

Indeed, Robinson, who turns 70 this month, acknowledged that he is working past what would be considered retirement age. He attributes this to both a passion for his work and the simple fact that he has some projects he’s still working on that he wants to see to conclusion.

These include something called 413 Cares, an online community-resource database that provides resource and referral information to residents as well as healthcare and social-service agencies across the region, and also works to make Baystate an “anchor network” within the region.

Explaining the latter, he said that, by adjusting and refocusing some of its spending — in such areas as goods and services, hiring, and real-estate facilities — an institution like Baystate can have an even more profound impact on the communities it serves.

“Simply by changing our business practices in terms of how we spend money — spending it deliberately, intentionally, to benefit communities where there’s been substantial disinvestment or there are substantial disparities — we can change those community conditions,” he noted. “That’s the healthcare anchor institution mission and vision.”

A lifelong desire to change community conditions for the better explains not only why Robinson is still working — and still innovating — but also why he’s a Healthcare Hero. Again.

Background — Check

Indeed, this will be Robinson’s second trip to the podium at the Healthcare Heroes gala.

He was one of a large contingent on hand to accept the award in 2017 in the category called Collaboration in Healthcare. The name on the envelope, if you will, was the Healthy Hill Initiative, or HHI, a broad effort to change the health landscape in the Old Hill neighborhood of Springfield.

Robinson, one of nearly a dozen players involved in the initiative who were gathered around a conference-room table at Way Finders to talk about it, described it as a program that existed at “the dynamic intersection of two social determinants of health — public safety and access to physical activity.”

And he should certainly know. In many respects, he has spent his whole career working to address the many social determinants of health, including poverty, food insecurity, inadequate housing, lack of transportation, domestic abuse, and the stress that results from all of the above.

Retracing his career steps, Robinson said there have been some pivots — such as the one forced by Hurricane Agnes — along the way, and also some pivotal moments.

One of the latter was the consent decrees that eventually closed Northampton State Hospital and Belchertown State School and the creation of community-based programs to serve the residents of those facilities.

Frank Robinson has been called a true visionary by those who have worked with him over the years, and a long list of accomplishments bears this out.

Robinson was involved in this work during his time with the Department of Mental Health, and he remembers it leaving him inspired in many ways.

“Both of those institutions were closed by forward-thinking insiders who worked with progressive outsiders, or advocates, and formed this sort of perfect union around change,” he told BusinessWest. “That was a pivotal event; I knew I could create large-scale community change if you got the formula right and if you got in front of problems, prevented problems, and worked to change the lives of individuals.”

And over the past 40 years or so, he has repeatedly demonstrated his ability to create community change by getting in front of problems and using teamwork to address them.

This has been the formula at each career stop, including a brief stint as deputy commissioner and superintendent of the Northeast Ohio Development Center in Cleveland in the early ’80s before returning to this area and working at the W.W. Johnson Life Mental Health Center, the community substance-abuse partnership, and especially at Partners for a Healthier Community, where Robinson spent nearly 20 years at the helm.

During his tenure there, his ability to convene, create partnerships, and stare down difficult problems resulted in several new initiatives to improve the overall health of the Greater Springfield community.

One such effort is the BEST Oral Health program, blueprinted to address the alarming problem that children with MassHealth had very limited access to oral-health preventive and comprehensive treatment services. Robinson secured state funding to launch a demonstration project in Springfield that became the BEST program; it created a local system of education, screening, and treatment for preschoolers to decrease oral-health disease.

Another example of coalition building during his tenure at PFC is the Pioneer Valley Asthma Coalition, which strives to improve asthma management and indoor air quality in Springfield and other area communities where substandard housing contributes to this ongoing health problem.

The Big Picture

Looking back over his career, Robinson said one of the goals — and one of the big challenges — has been to create change and generate solutions that would have an impact much longer than the typical three-year grant cycle.

“What you really need are initiatives with lasting impact where you can see change occur at a level where you improve the conditions of a whole population — where you can say, ‘we’ve changed community conditions,’” he explained.

With that thought in mind, he said there are two programs that “rise to the top,” as he put it, when he talks about career accomplishments.

One is the Baystate/Springfield Educational Partnership, an initiative that brings hundreds of students into the Baystate system to learn about careers in healthcare and places many of them in internships.

“Over the past 20 years, there have been substantial gains from our ability to work together across sectors and across organizations. And that’s new; there’s that essential element of trust across organizations that didn’t exist 15 years ago or 20 years ago, to be sure. And in spite of the competitive nature of social-service organizations in healthcare, there tends to be more agreement today that there is a public space where we can all come together and make a difference.”

These internships often lead to careers in healthcare, he went on, adding that, over the first 10 years of the program, there are many examples of this.

“Some of them are physicians, some of them are nurses — it’s across the whole spectrum,” he explained. “I know there are youngsters who are now physicians because of this program.”

The other program is the Baystate Academy Charter School, a 6-12 grade school based in Springfield and focused on healthcare careers.

The school graduated its first class of students, 45 of them, in June, said Robinson, adding that there was a 100% graduation rate and each graduating student was accepted at a two- or four-year college.

“The social determinant of health solution there is education,” Robinson explained. “The idea is that, if you graduate from Baystate Academy Charter School, you are college-ready.

“These two programs will be around long after I’m gone, producing change on a large scale and at a population level for our community,” he went on. “I’m very proud of both of them.”

Looking at the proverbial big picture from his unique vantage point, Robinson told BusinessWest there have been significant gains in many areas and many respects, especially when it comes to agencies and providers of healthcare working collaboratively, but significant challenges remain.

“Over the past 20 years, there have been substantial gains from our ability to work together across sectors and across organizations,” he explained. “And that’s new; there’s that essential element of trust across organizations that didn’t exist 15 years ago or 20 years ago, to be sure. And in spite of the competitive nature of social-service organizations in healthcare, there tends to be more agreement today that there is a public space where we can all come together and make a difference.

“This is especially true with matters of equity,” he went on. “We understand that there are significant challenges for large segments of our community, and the only way you’re to change those conditions is if people work together collaboratively and pool resources. There’s a clear recognition that this is the way to go.”

Elaborating, Robinson said there have always been coalitions, but today there is greater strength and “sophistication” to such partnerships, which has generated progress in a number of areas.

But when asked if Springfield is a much healthier community than it was 20 or 30 years ago, Robinson paused for several seconds and said ‘no.’

He based that answer on standard health measures and still-apparent gaps, or disparities, in overall care as viewed through what he called a “racial-equity lens.”

“If I compare poor people to the average, and black or brown people to the average, there are huge health-disparity gaps,” he noted. “The infant-mortality rate is still three times higher for black women than it is for white women; although the rate for black women has improved over time, the gap still exists.

“We find that same gap in issues such as low birth rate,” he went on. “These are measures not necessarily of the quality of healthcare, but measures of the conditions under which people live. Those gaps still exist, and so this city is still not healthy.

“We’re great as a community, and as a health system, when it comes to dealing with stuff that occurs inside the skin,” he continued, referring to the care provided at Baystate and other area facilities. “But if you think of health as things outside the skin that actually determine one’s health, we haven’t really improved there; poor people are sicker.”

These problems are not unique to Springfield, obviously, said Robinson, adding that most large urban centers continue to have these inequities in overall health based on income and opportunity. Progress has come, slowly, and the hope is that, by continuing to build coalitions and get in front of problems, more progress can be achieved.

This is what Robinson has spent a career doing, and he shows no signs of slowing down.

View to the Future

“Dr. Frank Robinson has worked tirelessly over the past 30 years to address public health and health inequities in our city and beyond. He is a recognized leader and a visionary in creating systems that make it easier for people to access needed healthcare services and creating systems in our neighborhoods that make it easier for people to make the healthier choice.”

There’s that word ‘visionary’ again. This time, it was put to use by Springfield Mayor Domenic Sarno, in that same nomination submission, as he went on about trying to put Robinson’s career, and his contributions, in perspective.

And visionary certainly fits. He’s been able to look at the community he serves, identify needs, and most importantly, create solutions for meeting those needs.

He’s spent a lifetime doing that, and that’s why he’s a Healthcare Hero.

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

Healthcare Heroes

While She Manages People and Programs, Her Job Is About Changing Lives

Katherine Wilson

It’s probably fair to say that the discussions had at the dining room table when Katherine Wilson was in high school were not like those going on in most households in the mid’-60s.

Indeed, Wilson’s father was a physician, specializing in family medicine. Beyond the work at his practice, he was one of the pioneers of a sort when it came to the broad subject of healthcare management.

“From having a solo private practice, he got into the development of systems of delivery of healthcare,” she recalled. “He started an HMO, he was the first medical director of Community Health Center … my father was a big part of the systems that are now in place.

“We had discussions around the kitchen table about healthcare,” she went on. “His interest was in healthcare management, and he was progressive in his thinking at a time when they didn’t have community health centers and they didn’t have HMOs; he did a lot of work with the community physicians and community hospitals.”

One might say that Wilson, certainly inspired by not only those dinnertime talks, but later work at her father’s practice and in one of the first community health centers, has a made a career — a long and very successful career — of working innovatively and in partnership with others to find new and better ways to manage healthcare, and especially mental and behavioral healthcare, in this region and across the Commonwealth.

She’s done this in a variety of settings, most notably, for the past 30 years, as president and CEO of Behavioral Health Network Inc.

Created in 1992 through the merger of four entities — the Child Guidance Clinic of Springfield, Agawam Counseling Center, Community Care Mental Health Center, and the Hampden District Mental Health Clinic — BHN now serves more than 40,000 individuals annually in a service area that stretches across the four western counties.

There are 40 locations in all and more than 2,000 employees. Together, they provide and manage services that come in a variety of forms, from detox centers and ‘step-down’ facilities to a wide variety of counseling services for adults, youth, children, couples, and families; from a 24-hour crisis-intervention service to a host of developmental and intellectual disability services.

“In a society where, even today, stigma may still surround mental illness and those it affects, Kathy not only keenly understands, but goes to every length to help others understand as well. Kathy Wilson has changed innumerable lives for the better, and she’d be the first to say her work is far from finished.”

Wilson has spent the past three decades building and shaping BHN into a $115 million network that continues to expand and find new ways to provide care and a support network to those in need. In recent years, she has been at the forefront of efforts to better integrate general healthcare with behavioral healthcare, particularly in the Medicaid population, with the goal of driving down the ballooning cost of care nationally (more on that later).

And certainly this work to build and manage BHN goes a long way toward explaining why Wilson was chosen as a Healthcare Hero for 2019 in the Lifetime Achievement category. Actually, she is one of two who tied for the high score. The other winner is Frank Robinson, vice president of Public Health at Baystate Health (see story, page 19). Suffice it to say, these two won’t have to introduce themselves when they meet at the Healthcare Heroes gala on Oct. 17. They both worked for the Department of Mental Health in the late ’70s, and both worked to create community programs for residents of Northampton State Hospital and Belchertown State School after those institutions were ordered closed. And they’ve been working in concert on many initiatives ever since.

But there is more to this honor than the vast portfolio of programs and initiatives that is today’s BHN. Indeed, it’s also about a lifetime spent advocating for those with mental illness, substance-abuse issues, or developmental disabilities, anticipating and then meeting their needs, and then asking the difficult but necessary question, ‘what else can be done?’

It’s a philosophy, or mindset, perhaps best summed up with these words from her nomination form, submitted by her daughter, Amy Greeley, formerly a nurse manager at BHN:

“Kathy exemplifies a unique combination of innate compassion and fervent determination that’s led to the helm of a regionally renowned institution. It’s from a position from which she never stops working for greater, more advanced, and even more accessible services for all who need them.”

“In a society where, even today, stigma may still surround mental illness and those it affects, Kathy not only keenly understands, but goes to every length to help others understand as well. Kathy Wilson has changed innumerable lives for the better, and she’d be the first to say her work is far from finished.”

Care Package

It’s called the ‘Living Room.’

As that name suggests, this is a warm, home-like place where anyone age 18 or older can come to “regroup and get help,” said Wilson.

Elaborating, she said the facility, one of many that BHN has carved out of old, mostly unused or underutilized manufacturing buildings in the Liberty Street area, is one of the latest additions to the agency’s portfolio. It was designed for people in a developing crisis, a current crisis, or a post-crisis situation, and is a place where people “can find help from others who have had similar experiences and who can provide support, encouragement, and guidance,” according to a brochure on the facility.

The Living Room, as noted, is just one of dozens of facilities under the BHN umbrella, and its creation speaks to Wilson’s ongoing work — and mission — to continually find new and different ways to meet unmet needs and build support networks for those who desperately need them.

And, as mentioned, this has been her career’s work — going all the way back, in some ways, to those discussions at the dining-room table.

Retracing her route to the corner office at BHN, Wilson said that, after working at her father’s practice and other health settings while in high school and college, she eventually decided that psychology, not healthcare, would be her chosen field; she earned a bachelor’s degree in that field at Denison University and a master’s in clinical psychology at SUNY Plattsburgh.

After a very short stint as a psychotherapist, she applied for a job with the Department of Mental Health, and was hired as a planner during that critical time when Northampton State Hospital and Belchertown State School were ordered to close.

“It was my responsibility to identify individuals from both institutions, look at what their needs were, and see what we could create in the community,” she recalled, adding that she worked to develop some of the group homes that are in use today. “I also worked with agencies that began to adopt the agenda of creating community programs to support people, such as the Community Care Mental Health Center in Springfield, which created day programs so individuals could get some of their rehabilitation in a clinical setting.”

The consent decrees that shuttered the institutions in Northampton and Belchertown coincided with national initiatives imbedded within the Community Mental Health Act, established by President John F. Kennedy. It made federal funds available to create more community systems of care, said Wilson, adding that, locally, a consortium of agencies was created to administer this flow of federal money.

“We got together and said, ‘survival means you have to get bigger, you need to have a stronger base at the bottom to support what we do, and this will give us a platform for growth.”

Called the Springfield Community Mental Health Consortium, it administered a number of initiatives, including hospital supports, group-living environments, outpatient systems of care, emergency services, and more, said Wilson, who transitioned from working for the state to being employed with the consortium as a planner.

“It was my responsibility to help establish the Community Mental Health Center range of services,” she explained. “Now that we had more people in the community living with mental illness, we needed to create the system of healthcare support.”

When the Reagan administration closed the tap on federal money for these services, with funding to be secured through state-administered block grants instead, the agencies that were part of the consortium broke apart and continued to do their own work, said Wilson, who then went to work with Child Guidance Clinic of Springfield, first as Business and Finance director and then executive director of the Child Guidance Clinic of Springfield.

As funding for mental-health programs became more scarce, Wilson said, she and the directors of three other agencies — Agawam Counseling Center, Community Care Mental Health Center, and the Hampden District Mental Health Clinic — decided that the best strategy was to merge those entities into one corporation.

“We got together and said, ‘survival means you have to get bigger, you need to have a stronger base at the bottom to support what we do, and this will give us a platform for growth,’” she recalled, adding that this new entity would become BHN.

And over the years, it would continue to get bigger and widen that base of support, as those administrators knew it had to, through additional mergers and the addition of many new programs.

Room to Grow

As president and CEO of BHN, Wilson wears a number of hats and logs tens of thousands of miles each year traveling back and forth to Boston for meetings on a range of topics and with a host of groups and individuals.

As for those hats, Wilson said she is the face of BHN and, for many, a first point of contact. She also considers herself a problem solver and a “convener,” a strategist, a mentor for many, and even an interior designer.

“I’m often the one that picks the colors for the walls,” she said, referring to the seemingly constant work to open and renovate new facilities, not only at what has become a ‘BHN campus’ off Liberty Street in Springfield, but across the region, while also noting that much goes into to picking those colors.

All those skills have been put to use over the past 30 years, an intriguing time of growth and evolution for BHN as it responds to emerging needs within the community, said Wilson, who cited, as one example, profound expansion into addiction services.

“One of the areas we identified maybe 10 years ago is that we were seeing many more of the parents of the children we were seeing at the Child Guidance Clinic, and many more adults coming in to adult outpatient clinics having mental-health issues co-occurring with substance use,” she explained. “And we said, ‘we can’t just treat mental-health problems without acknowledging the fact that there is a substance-use disorder concurrently, and that we really need to think about building a system of care that serves that population.’”

As a result, BHN collaborated with Baystate Health, which had a community-based system of care that included a detox and some community group-living environments for post-detox care, said Wilson, adding that Baystate asked BHN to manage those facilities and eventually transfer them into its system of care.

“We inherited Baystate’s system of community services for those with addiction,” she said. “And once we did that, we got established with the Department of Public Health and its Bureau of Substance Abuse Services, and we became known as an agency that could handle co-occurring treatments as well as individuals whose primary diagnosis was addiction, and from there, they helped us grow a system of treatment for people with substance-abuse disorder, and that really took off because the state was making significant investments in that world.”

That system now includes two detox operations, two step-down facilities, and a number of beds in what are called ‘residential recovery,’ or group-living facilities, she told BusinessWest, adding that this is just one example of how BHN continues to grow and evolve.

And it’s also just one example of how Wilson has led efforts to improve access to a wide array of care at a time when more people need access. The creation of the Northern Hope Center and Recovery Services in Greenfield, blueprinted in response to needs created by the opioid crisis in Franklin County, is still another case in point.

And these initiatives provide ample evidence of the additional emphasis placed on integrated healthcare and behavioral healthcare with the twin goals of improving population health and bringing down the cost of care, said Wilson, adding that BHN has been at the forefront of these efforts.

“This is what the federal government wants its funding to support, particularly for the Medicaid population,” she explained. “This is the population whose behavioral health — addictions or mental health — really interfere with their managing health.

“You have this small group of people that is driving high costs to Medicaid and both commercial and private insurance,” she went on. “So the move these days is for physicians and healthcare systems to work with behavioral-health systems of care and provide wrap-around services for individuals to see if you can manage the behavioral health, because that will help bring the cost of healthcare down.”

BHN adopted this rather profound operational shift several years ago, said Wilson, adding that, overall, it is part of her job description to keep the agency on the cutting edge of trends and developments in healthcare, while also making sure it remains viable and able to function properly in the years to decades to come.

That means continuing to find more ways to grow the network (the ‘N’ in BHN), building upon its base of support, and developing new methods for providing all-important access to care.

When asked about her most significant accomplishment, she quickly changed the subject of that question to ‘we,’ meaning BHN, but in doing so still managed to sum up her career’s work.

“I think we’ve created excellent, value-based, top-of-the-line service delivery for people who need access, sometimes very quickly, to good treatment,” she noted. “I have excellent medical leadership on both the addiction and behavioral healthcare side, and we hire really good, skilled, competent people. So I think people who are not used to getting good access to care now get it.

“Also, we’ve hired so many people that we have helped come from an addiction to sobriety, reunification, and now they’re BHN employees,” she went on. “To me, that warms my heart to know that people have been able to turn their lives around with the help of BHN.”

Change Agent

Which brings us back to that passage from Wilson’s nomination form. There are a number of key phrases within it that explain why she will be at the podium on Oct. 17 to receive her Lifetime Achievement award.

There’s the part about battling the stigma attached to mental illness, something she’s been doing for more than four decades. There’s also that point about how she would be the first to acknowledge that her work isn’t finished — because it never is.

But perhaps the words to remember most are those concerning ‘changing thousands of lives for the better.’

Indeed, while Wilson manages people, programs, and facilities for BHN, changing lives is what she does for a living.

And that’s why she’s a Healthcare Hero.

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

Healthcare Heroes

‘There’s a Magic Here,’ Built on Dedication, Innovation, and Culture

H. Lee Kirk Jr. was speaking at a public event recently, when a woman stood up to tell him about her 3-year-old grandson’s experience at Shriners Hospitals for Children – Springfield.

“She said, ‘when we take him to the doctor’s office or another healthcare provider, he cries going in, and he’s sprinting out the door to get back home. When he comes to Shriners, he’s sprinting on the way in and happy to be coming, and he’s kicking and screaming when he has to leave,’” he related. “There’s a magic here that’s really hard to get your arms around.”

But Kirk, administrator of the 94-year-old facility on Carew Street in Springfield, tried to explain it the best he could over the course of a conversation with BusinessWest after the hospital was chosen as a Healthcare Hero for 2019 in the Patient/Resident/Client Care Provider category.

“This is a special healthcare organization because of the mission,” he said. “The culture is unlike any other I’ve been involved in. We want to be the best at transforming the lives of kids. And we get the privilege of seeing that every day here.”

It’s a culture that employees find attractive, said George Gorton, the hospital’s director of Research, Planning, and Business Development, adding that consulting physicians from other hospitals say, after visiting, that it’s the happiest place they’ve ever worked.

“It’s a palpable difference,” he went on. “As employees, we love that caring, family feeling of being employed by an organization that aligns with our own personal mission. That’s just not seen anywhere else.”

Last year, the hospital produced some short videos with employees to celebrate the opening of its inpatient pediatric rehab unit. In one of them, a nurse hired specifically for that unit talked about how she’s wanted to be a nurse at Shriners since being treated there for a rheumatology issue when she was a child.

“She was in tears, expressing the joy and positivity she had, to be able to take that experience of receiving care and become the person who provides that care to other people,” Gorton said. “It was a really touching moment to hear her express that.”

Then there’s the boy Gorton — who’s been with Shriners for more than a quarter-century — examined decades ago in the motion-analysis center; he’s now a physician assistant at the hospital.

Gorton said it’s impossible to single out any individual person responsible for creating the generational success stories and culture that makes Shriners what it is. The judges for this year’s Healthcare Heroes program agreed, making a perhaps outside-the-box choice in a category that has previously honored individuals, not entire organizations.

Yet, the choice makes sense, said Jennifer Tross, who came on board two years ago as Marketing and Communications manager, because of that unique culture that draws people back to provide care decades after receiving it, and that has kids shedding tears when they have to leave, not when they show up.

“The day I arrived,” Tross said, “I went home and said, ‘I knew this place would change my life, and it has.’”

Countless families agree, which is why Shriners is deserving of the title Healthcare Hero.

Step by Step

When a boy named Bertram, from Augusta, Maine, made the trek with his family to Springfield in February 1925, he probably wasn’t thinking about making history. But he did just that, as the hospital’s very first patient. The Shriners organization opened its first hospitals primarily to take care of kids with polio, but Bertram had club feet — a condition that became one of the facility’s core services.

After the first Shriners Hospitals for Children site opened in 1922 in Shreveport, La., 10 other facilities followed in 1925 (there are now 22 facilities, all in the U.S. except for Mexico City and Montreal). Four of those hospitals, including one in Boston, focus on acute burn care, while the rest focus primarily on a mix of orthopedics and other types of pediatric care.

As an orthopedic specialty hospital, the Springfield facility has long focused on conditions ranging from scoliosis, cerebral palsy, and spina bifida to club foot, chest-wall deformities, cleft lip and palate, and a host of other conditions afflicting the limbs, joints, bones, and extremities — and much more.

While many of the hospitals overlap in services, each has tended to adapt to the needs of its own community. In Springfield’s case that includes pediatric specialties like rheumatology, urology, and fracture care, as well as a sports health and medicine program that includes three athletic trainers and a pediatric orthopedic surgeon with training in sports medicine.

H. Lee Kirk (left, with Jennifer Tross and George Gorton) says Shriners is a special healthcare organization because of its mission.

The latter, Kirk said, includes services to kids without medical problems, as the hospital works with schools, clubs, and leagues help provide more preventive and conditioning services and follow up when injuries occur.

Meanwhile, the BFit exercise program targets kids with neuromuscular problems who normally don’t participate in physical activity, sports, or even gym class. The program aims to improve the physical activity of this group, and does it by involving students from area colleges who are studying fields like physical and occupational therapy, exercise science, sports medicine, and kinesiology.

“They volunteer as personal coaches,” Gorton said. “The child learns to adapt their environment and become physically active, and those students learn what it’s like to care for children. Many have gone into pediatric healthcare to do that kind of training because of their experience here. They see it here, and it spreads like a good virus through the population.”

Then there was the 2013 community assessment determining that an inpatient pediatric rehabilitation clinic would fill a persistent need. That 20-bed clinic opened last year following a $1.25 million capital campaign that wound up raising slightly more — reflective of the community support the hospital has always received, allowing it to provide free care to families without the ability to pay (more on that later).

Still, more than 90% of the care provided in Springfield is outpatient — in fact, the facility saw 12,173 visits last year, a more than 40% expansion over the past several years.

The care itself, the clinical component, is only one of three prongs in the Shriners mission, Kirk said. The second part is education; over the past 30 years, thousands of physicians have undertaken residency education or postgraduate fellowships at the various children’s hospitals. In Springfield, residents in a variety of healthcare disciplines — from orthopedics to nursing, PT, and OT — have arrived for 10- to 12-week rotations.

The third component of the mission is research, specifically clinical research in terms of how to improve the processes of delivering care to children. That often takes the shape of new technology, from computerized 3D modeling for cleft-palate surgery to the hospital’s motion-analysis laboratory, where an array of infrared cameras examine how a child walks and converts that data to a 3D model that gives doctors all they need to know about a child’s progress.

More recently, a capital campaign raised just under $1 million to install the EOS Imaging System, Nobel Prize-winning X-ray technology that exists nowhere else in Western Mass. or the Hartford area, which enhances imaging while reducing the patient’s exposure to radiation. That’s important, Kirk said, particularly for children who have had scoliosis or other orthopedic conditions, and start having X-rays early on their lives and continue them throughout adolescence.

Averting Disaster

It’s an impressive array of services and technology, and collectively, it meets a clear need — and not just locally. While about 60% of patients hail from a 20-mile radius, the hospital sees young people from across New England, New York, more than 20 other states, and more than 20 countries as well.

Yet, only a decade ago, the hospital was in danger of closing. At the height of the Great Recession, the national Shriners organization announced it was considering shuttering six of its 22 children’s hospitals across the country — including the one on Carew Street.

In the end, after a deluge of very vocal outrage and support by families of patients and community leaders, the Shriners board decided against closing any of its specialty children’s hospitals, even though the organization had been struggling, during those tough economic times, to provide its traditionally free care given rising costs and a shrinking endowment.

To make it possible to keep the facilities open, in 2011, Shriners — for the first time in its nearly century-long history — started accepting third-party payments from private insurance and government payers such as Medicaid when possible, although free care is still provided to all patients without the means to pay, and the hospital continues to accommodate families who can’t afford the co-pays and deductibles that are now required by many insurance plans.

“It was a wise decision to accept insurance — but it was a controversial decision,” Kirk said. Yet, it makes sense, too. A very small percentage of patients in Massachusetts don’t have some kind of coverage, yet 63% of care at Shriners is paid for by donors — a disconnect explained by the fact that Medicaid doesn’t pay for care there, and gaps exist in other insurance as well.

So, if a family can’t pay, the hospital does not chase the money, relying on an assistance resource funded by Shriners and their families nationwide.

“Donor support allows us to provide free care,” Kirk said. “We don’t send families to collections and contribute to the number-one cause of personal bankruptcy in America, which is medical care. It’s a very unique model, and a unique healthcare-delivery system.”

And one that, as Kirk noted, treats a patient population that can be underserved otherwise. For instance, the cleft lip and palate program — a multi-disciplinary program integrated with providers from other hospitals in the region and serving about 30 partients at any given time — begins assessing some patients prenatally, and most need care throughout adolescence and even into young adulthood.

Those consulting relationships are critical to the success of Shriners, which doesn’t seek to compete with other providers in the region, but supplement them while striving to be, in many cases, the best place for young people to receive specialized treatment, whether for orthopedic conditions or a host of other issues.

When Kirk arrived in 2015, the hospital underwent a comprehensive self-assessment process that made two things clear, he said: that there’s a real need for what it does, and that it needs to reinvest in its core.

“And that’s what we did. And that’s about people, not bricks and mortar,” he went on, noting that the facility has added about 70 positions since that time.

“We’re a completely different place today than we were in 2009,” Gorton added, noting that the hospital is stronger in leadership, internal communication, and external connections. Among the 22 Shriners specialty hospitals, Springfield ranks second in the proportion of the budget offset by donations. “Why? Because we have a great relationship with the community. We’ve become more outward-facing, and we’re integrated everywhere in the community.”

The Next Century

Getting back to that 3-year-old who doesn’t want to leave when he visits Shriners, surely the hospital’s child-friendly playscapes and colorful, kid-oriented sculptures and artwork help create a welcoming environment, but those wouldn’t make much difference if the people providing care didn’t put him at ease.

That environment begins with employees who love what they do, Kirk said, and this Healthcare Hero award in the Provider category is definitely shared by all of them. Other families feel the same way, as the facility regularly ranks in the 99th percentile on surveys that gauge the patient and family experience.

“We have happy employees who love being here, who love working with kids, who love delivering the mission — and the patients and families sense that and respond to that,” Gorton said.

That’s why the hospital’s leaders continue to examine the evolving needs of the pediatric community and how they can continue to deepen its clinical relationships and expanding services most in demand — always with the philosophy of “mission over model,” Kirk said.

“We are always thinking about the future,” he added, “so we can sustain this healthcare system for the next 100 years.”

Joseph Bednar can be reached at [email protected]

Healthcare Heroes

This Leader Is Focused on Dismantling the Barriers That Limit One’s Ability to Thrive

Cristina Huebner Torres, Ph.D.

Dr. Cristina Huebner Torres was moving into a new home a little while back, and during the unpacking process happened to come across the essay she wrote while applying for entry to New York University for her master’s degree.

Re-reading it gave her the feeling that, career-wise, she really was doing exactly what she knew she always wanted to do. Well, sort of.

“I have always had a goal of creating a multi-cultural wellness center where people explore their health, bodies, creativity, minds and their holistic self through integrating movement, art, nutrition and other forms of … biomedical and traditional medicine,” she said, quoting from the essay, adding that at the time her work was largely focused on women and women’s reproductive health.

As things worked out, as vice president of Research & Population Health for the Caring Health Center (CHC) in Springfield, she’s working with a much larger constituency — and a much broader range of health matters. And rather than just ‘having a career’ at this facility, she has assumed a pivotal leadership role in efforts to not only study the many and persistent social determinants of health — such things as poverty, food insecurity, inadequate housing, crime, lack of transportation, and more — but doing something about them.

Her ongoing work has earned her the 2019 Healthcare Heroes award in the highly competitive category called ‘Innovation in Healthcare and Wellness.’

Huebner Torres has helped develop and administer a number of initiatives designed to improve the overall health and well-being of the generally underserved population that comes to the Caring Health Center, including creation of its Wellness Center.

Opened a decade ago — a significant milestone, to be sure — this facility lives up to its name and is a unique, innovative addition to a federally qualified community health center. It includes both a fitness center and a full kitchen, where individuals (generally referred to as patients, but also clients) can learn about general nutrition and how to prepare healthy meals for their families.

“After conducting a year and half of focus groups with community and patients, we found that the community was asking for a place where they could engage in group-based exercise, that was cost-free, culturally tailored, taught by someone who was licensed or trained in the area, and located within primary care,” she said, adding that the Wellness Center was developed to meet these community-identified needs.

“She is steadfast in her belief that services that are respectful of gender and sexual identity, widely accessible, culturally tailored, and based on the individual strengths and interests of the patient stand the best chance of bringing about long-lasting health.”

Huebner Torres said there are many ways to qualify and quantify the impact of the many facets of her work, and especially the wellness center, on the overall health and well-being of those served by the CHC. And she’s currently working to attain grants to help with this measuring process. But she believes there is already ample evidence that the center and other initiatives are helping to support patients actively engaged in their wellness.

And all of this is embodied — figuratively, but also quite literally — in an individual who asked to be identified only as ‘Lamont.’

He started coming to the wellness center the first day it opened, not long after his cancer surgery and when Huebner Torres was leading the fitness classes. Today, he leads several classes himself, helping a wide range of individuals with stretching, cardio exercises, and more.

He said these classes are doing what they did for him back when he first started.

“I had lost quite a bit of weight and wasn’t in very good shape,” he said, referring to the impact of the cancer medication. “I told my doctor, ‘I don’t want to stay home, I don’t want to deteriorate, I want to do everything possible that I can to get healthy.”

Many of those he’s now instructing arrive with a similar attitude, and this is exactly what Huebner Torres had in mind when she conceptualized the facility.

Her work, and her approach to it, is best summed up in this summation in the nomination submitted by CHC’s president and CEO, Tania Barber:

“Cristina’s core values and goals are informed by her belief that people are healthier when they feel safe and respected, eat nutritious foods, have opportunities for regular exercise, are knowledgeable about health and well-being, openly celebrate their cultural traditions, and receive services in their own language,” she wrote. “Her work is focused on dismantling the barriers that limit each person’s ability to thrive, both in the community at large as well as the healthcare setting, increasing access to community and social support, addressing structural bias, and promoting peer-led models are important aspects of her approach. She is steadfast in her belief that services that are respectful of gender and sexual identity, widely accessible, culturally tailored, and based on the individual strengths and interests of the patient stand the best chance of bringing about long-lasting health.”

Stress Test

As she talked about her work at the Caring Health Center, especially in the broad realm of the social determinants of health, Huebner Torres honed in on the subject of stress.

More specifically, she talked about how those who come to the CHC combat what would have to be considered a different, more virulent strain of stress.

“We’re not talking about a morning being stressful because you had some extra traffic on your daily commute,” she explained. “We’re talking about not having sufficient food every day for you and your family, and not having sufficient housing for you and your family, or many of those things co-occurring, and the effects of that over time.”

One might say researching this higher level of stress — resulting from those aforementioned social determinants of health — and doing something about it have become Huebner Torres’s life’s work.

As she noted, it was essentially her life’s ambition and she went on to earn a bachelor’s degree in Medical Anthropology from Mount Holyoke College, while also focusing on modern dance. She earned a master’s degree in somatic studies from New York University, and her doctorate in Epidemiology at the UMass School of Public Health and Health Sciences.

Cristina Huebner Torres stands in the kitchen in the Wellness Center at the CHC, which hosts many popular classes in cooking and nutrition.

Building on her undergraduate and master’s studies, she focused her doctorate in social epidemiology on the social determinants of chronic disease management. Her work considers the role of food insecurity and social stressors on the ability to prevent or manage diseases like diabetes and hypertension within community health center settings. She started her career at the Hispanic Health Council in Hartford, where she also interned while in college.

“This was an applied-research environment in a community-based setting, and it really set the stage for my career,” she told BusinessWest, “because I’ve been a community-based investigator, meaning that I find ways to create and partner in opportunities for conducting research within a public health practice and applied framework.

“It’s research driven by emerging trends within the community,” she went on, “and we use that research to inform opportunities for intervention that are culturally and community informed and making sure those interventions are actionable and integrated and sustainable.”

This explanation sums up her job description at the CHC, which she came to in 2007 as director of Research and Wellness. Since opening in 1995, the CHC has become the preferred health provider in Springfield serving a population that is diverse and challenged in many ways. Indeed, 70% of the more than 21,000 are Medicaid beneficiaries and the majority have one or more chronic illnesses. Nearly half of the patients speak languages other than English, and most live with medically complex conditions, often comprised of two or more chronic diseases, such as diabetes, hypertension, emphysema, heart disease, viral hepatitis, and chronic pain. And many patients also navigate behavioral-health conditions such as bipolar disorder, schizophrenia, depression, anxiety, post-traumatic stress disorder, or engage in opioid, alcohol, or other substance abuse.

The culturally diverse population served by CHC has many strengths as well as complex needs, and in her time at the CHC, Huebner Torres has collaboratively led the development of a number of services and programs to address them. These include an award-winning community health worker program that addresses the social determinants of health, as well as writing the grant to integrate the behavioral-health department with staffing and innovative programming to meet the culturally and linguistically diverse needs of refugee and immigrant individuals and families, and to support patients navigating multiple chronic co-morbidities.

Each of these innovations has been supported by leadership at CHC, she went on, and are sustained by a “tremendous collaborative team of dedicated and talented staff at CHC.”

The Shape of Things to Come

As she led BusinessWest on a tour of the Wellness Center, Huebner Torres started in the Wellness Center teaching kitchen.

There, she said, the center provides both nutrition education and cooking demonstrations, such as the very popular “Ask and Cook with the Dietitian!” sessions staged every Thursday by CHC’s registered dietician Vela Nicasio.

The kitchen-focused programs are designed to support patients as they look to follow primary-care treatment plans and recommendations for dietary improvements. The same is true of the workout facilities, which feature a number of cardio machines, weights, and large spaces for group classes in ‘stretching and restoring,’ cardio fitness, and open wellness (including one for women only).

‘Lamont,’ who first came to the Wellness Center the day it opened as a participant recovering from cancer surgery, is now an instructor.

The foundation of all that takes place in the center is the acronym CLAS, which stands for culturally and linguistically appropriate services, said Huebner Torres.

“It’s in the mission of what we do; it’s the heart of what the Caring Health Center does,” she explained, adding that the underlying goal behind creation of the center was to create a place where everyone could exercise and feel comfortable, including populations that just didn’t have such a space.

As an example, Huebner Torres listed Muslim women.

“They didn’t have a place to go because that place couldn’t include men, and it needed to not include music,” she explained. “And if you walk into any gym environment, there’s men and music. So early on, we created a Muslim-women-only exercise class, and it’s the first and only one in this area that we’re aware of.”

That class eventually became simply a women-only class because the Muslim women decided to open it to all women, she went on, adding that, overall, these classes and other programs are designed to help patients deal with health issues, but also the enormous amounts of stress they face in their lives — and do so in a group setting where they can interface with others facing similar challenges.

“A huge part of what people said they wanted in a center like this was for it to be group-based, and I think the concept of social support and social engagement, for many patients, becomes the number-one driving factor in why to attend,” she explained. “It’s not about ‘did I lose a pound or 10 pounds in so much time’; instead, it’s about ‘I was able to join in with other people like me and with some leadership that cares. And it was fun, I learned something, and I was engaging with people.’”

In short, the center and its programs are designed to educate and inspire commitment to getting healthy and staying healthy.

Which brings us back to Lamont.

“I started going to the wellness center once or twice a week, and I could really see myself making changes in my health,” he recalled, returning to the days and weeks after his cancer surgery. “I started to regain some strength and stamina, and from there I took it to another level; I started getting out to the park and running three or four miles a day, every other day. And I started working out at the wellness center four times a week.”

As he continued to grow stronger health-wise and become a role model, Lamont was advised by his doctor to become involved with a movement known as MOCHA — Men of Color Health Awareness, a name that goes a long way toward explaining what it is and does.

“Men of color have issues with going to the doctor and talking to the doctor, and that’s why a lot of us are dying today,” he said, adding that, as part of his participation in MOCHA, he gave a speech on this subject on the steps of Springfield City Hall.

He credits the Caring Health Center with saving his life when he had cancer, and now he gives back to the center through his role as a certified group exercise instructor and overall work to help others become actively engaged in their health and wellness.

“When it comes to stress, nutrition, getting off the couch and working out two or three times a week … all these things I learned from here,” he said, referring to the CHC and its wellness center. “I learned how to be proactive in talking to my doctor when things are going on and having a conversation.”

From a big-picture, community-health perspective, this is exactly what Huebner Torres had in mind when she blueprinted the Wellness Center a decade ago based on community and patient input.

Practicing Patience

In nominating Huebner Torres as a Healthcare Hero for innovation, Barber listed a number of attributes, all quite necessary for this kind of work.

For example, “Cristina demonstrates respect, consistency, and graciousness toward everyone she encounters. She listens well, speaks directly and honestly, and displays a quiet, well-timed sense of humor … she is intelligent, patient, and calm under pressure, and widely admired by those around her.”

When asked which of these is perhaps her strongest trait, Huebner Torres didn’t hesitate in saying ‘patience,’ adding that it’s more than a virtue when dealing with the complex issues she addresses every day — it’s a necessity.

“The other key factor — and perhaps most important of all — is partnership,” she said. “All of these initiatives are innovative and successful because of the team at CHC, the community, the patients, partner organizations and investigators, and the funders who have supported our efforts.”

“Nothing happens overnight — you have to be able to stick with it over time,” she went on.

Throughout her career, she has shown an ability to do just that, and the nutrition classes and group workout sessions at the Wellness Center are evidence that, when you do stick with it, you can bring about positive change in the lives of individuals — and in a community.

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

Healthcare Heroes

This Nurse Midwife Gave Birth to an Intriguing Concept in Care

Amy Walker


After pausing to give the matter some thought, this was the word a woman who chose to be identified only by her initials — S.M. — summoned when asked about what the New Beginnings program at Cooley Dickinson Health Care has given her.

There were other things on that list, to be sure, she said, listing camaraderie, friends, ongoing education, and even role models of a sort. But accountability, on many levels, was what was missing most from her life, and New Beginnings, which supports pregnant women with an opioid-use disorder with education, skills development, peer support, and goal setting, helped her develop some at a time when she needed it most.

“I wanted to come even though I was struggling to stay sober,” she said, referring to the regular group meetings attended by mothers facing similar challenges. “I didn’t have to come, but I wanted to; it’s hard to explain, but it was the beginning of me being responsible and accepting the fact that I was pregnant and here with the other women in the same situation.”

These sentiments speak volumes about why Amy Walker, a certified nurse midwife at Cooley Dickinson Hospital (CDH), created the program in 2018, and also about its overall mission.

“We want to empower women to be successful mothers,” said Walker, whose efforts to create New Beginnings have not only filled a critical need within CDH’s broad service area but earned her the Healthcare Heroes award in the ultra-competitive Community Health category.

She said the foundation of the program is a group approach, which is nothing new when it comes to expectant mothers, but it is new when it comes to this specific at-risk population, which makes New Beginnings somewhat unique and innovative.

“I wanted to come even though I was struggling to stay sober. I didn’t have to come, but I wanted to; it’s hard to explain, but it was the beginning of me being responsible and accepting the fact that I was pregnant and here with the other women in the same situation.”

“There are a couple of other places in the country that are doing this,” she explained. “There’s not a lot of studies on this yet, but it made sense, because it works so well in general and has these added benefits of providing community and more education, that it seemed like the way to go.”

While the program is still in its relative infancy (pun intended), it is already providing some rather dramatic, and measurable, results. Indeed, since the initiative was launched, 10 women with substance-abuse disorders who have participated in the program have delivered at the Childbirth Center at CDH, and nine of the 10 babies went home with their mothers. Walker believes that number would have been much lower had it not been for New Beginnings.

To send more mothers suffering from opioid-abuse disorder home with their babies, New Beginnings provides the many things these women need at this critical, and vulnerable, time in their lives. That list includes what amounts to a support network at a time when family and friends may be unable or unwilling to fill that role.

Indeed, S.M. told BusinessWest that, while her mother was quite supportive during her pregnancy and the period to follow, her friends were still using drugs, and thus, she didn’t want to be around them.

Support is provided in the months and weeks prior to delivery, during delivery, and then during the post-partum period, said Walker, adding that, while post-delivery is a challenging time for most all mothers, it is especially so for those suffering from opioid-abuse disorder.

“The riskiest time for relapse is in the post-partum period,” she explained. “We find that many women are able to maintain sobriety during pregnancy, but of course, the stresses of parenting, and sometimes parenting with limited resources, can be a triggering factor when it comes to relapse.”

The program also provides education and help to mothers with babies diagnosed with neonatal abstinence syndrome (NAS), the incidence of which is growing as the opioid crisis continues, said Walker.

Such babies are fussy, cry a lot, and are hard to soothe, she went on, adding that many remain in the hospital for several weeks. New Beginnings addresses these needs through something called the ‘eat/sleep/console’ method of evaluating and treating newborns with NAS, an initiative that results in shorter hospital stays and less opioid use for the newborn.

Above all else, New Beginnings provides a judgment-free zone that offers both compassion and quality care, said Walker, adding that all three ingredients are needed to properly provide for both mother and baby.

Pregnant Pause

Flashing back to her first New Beginnings group session roughly 16 months ago, S.M. remembers feeling relatively calm, but also a little uneasy about what she was getting herself into.

“I think was kind of numb and a little nervous,” she recalled, adding that she was struggling with sobriety at that time, when she was on methadone. “But at the same time, it felt comforting knowing what it was for; it was for women with addiction problems who were having babies. It was exactly what I needed at that time.”

S.M. said she was referred to New Beginnings several weeks earlier, about three months into her pregnancy and while she was still using heroin, which she described as her “drug of choice.” She said she was experiencing a number of emotions, but mostly anger — directed at herself.

“I was going through a really tough time accepting that I was pregnant,” she told BusinessWest while sitting in the same small room where the group sessions are held. “I couldn’t face the fact that I was using while I was pregnant, because I was really mad at myself. I came here because I wanted to do everything I could to try to do my best and get my life in order.”

Amy Walker says the New Beginnings program provides a critical judgment-free zone for pregnant women and new mothers battling opioid addiction.

In most every case, these emotions, these sentiments, and this particular drug of choice make S.M. typical of a growing number of women who are going through pregnancy while still using opioids or struggling with sobriety, usually through medication-assisted treatment such as methadone or Subutex, said Walker. She added that this growing demographic is an intriguing and sometimes overlooked aspect of the opioid epidemic — one that has now become a focal point of her work as a certified midwife.

And in many ways, this work reflects the values and passions (that’s a word you’ll read often) that brought her to the rewarding profession of midwifery — and will her bring to the podium at the Healthcare Heroes gala on Oct. 17 to accept the award in Community Health.

Our story begins during her undergraduate work when Walker took a job with Planned Parenthood in Gainesville, Fla. She worked at the front desk, selling birth-control pills and checking people in for their appointments.

“I was really inspired to grow in women’s health,” she explained. “I met nurse midwives and nurse practitioners who worked there, and started working in the Health Education department there, doing sex education, HIV-prevention outreach, and more, and from there I decided I wanted to go to midwifery school.”

She would earn her degree at Columbia University and, while doing so, see her career ambitions crystalize.

“My roots were really in gynecological care, but then I developed a love for caring for women and families during pregnancy and birth,” she explained. “I found that I love that intimate connection that you make with families.

“Meanwhile, one of my biggest passions was caring for underserved populations — people who maybe didn’t have access to all the care options,” she went on. “I wanted to provide them with the same type of care as someone who was more able to select what kind of care they wanted; that was really important to me.”

These twin passions have come together in a powerful way with New Beginnings, which Walker conceptualized several years after coming to CDH in 2014 after stints at Leominster Hospital and in St. Croix.

Tracing the origins of the program, she said it was one of many strategic initiatives that sprang from the work of an opioid task force created by CDH in 2016. That group’s work revealed that there were many unmet needs and, overall, that services needed to be better-organized and better-focused.

“I really wanted to be involved with that task force because I felt that the care we were giving to patients with substance-abuse disorders wasn’t really poor care, but it was all over the map,” she told BusinessWest. “There was no consistency in the messages that patients were getting and the education they were getting, and I knew that we could do better.”

One of those many efforts to do better is New Beginnings.

Delivering Results

At the heart of the program and its group sessions is the belief that women going through pregnancy while using opioids or trying to stay sober can benefit from being in the same room together, talking about their experiences, their emotions, their fears, and their hopes for the future.

And S.M.’s story, and her recollections of her year in the program, provide ample evidence that these beliefs are well-founded.

“It was really helpful coming here and knowing that there were other pregnant women who were either going through the same thing or had been there,” she said. “There were other women I’d met through New Beginnings who had kids and had them taken away. That made me feel … I don’t want to say better. It made me feel … well, not as mad at myself, knowing that someone else had been through this and had struggled with being able to have their kids in their life because of their addiction.

“I also came to know the risks of actually having her taken away,” she went on, referring to her daughter, who was playing with other children in the middle of the room as S.M. talked. “And knowing how mad I was just for using, that made me want to just do everything I could.”

These sentiments speak to that goal of empowering women to become successful mothers, said Walker, adding that empowerment comes through accountability and being responsible, but also through education.

And from the start, education has been one of the main focal points for New Beginnings, said Walker, who cited neonatal abstinence syndrome as an example.

“We expect it, and it’s treatable, but it can be challenging, because that baby may need a lot of soothing care, and sometimes needs to be held or soothed or rocked 100% of the time,” she explained. “All this could be challenging for anyone, but if you are someone with your own chronic illness who may not have a lot of support … all those things add up to make it really challenging.

“So if someone was coming into that without having any knowledge of how to care for their baby or what to expect from their hospital stay, that can be really shocking,” she went on. “I felt that we could do a better job of providing that educational prenatally, and there needed to be an avenue for that.”

Elaborating, she said that, typically, most pre-natal visits (for all women) run only about 15 minutes or so. This isn’t much time for women to learn or be supported. In response to this, she created two-hour group prenatal sessions for those involved with New Beginnings. The first hour would be the physical exam, she noted, while the other 90 minutes would be spent providing education and support in a group setting.

“We can cover so many more topics in that amount of time, as opposed to the 15-minute sessions, and you’re also speaking to many patients at a time,” Walker said. “And one of the great things about group prenatal care is that patients are able to hear from other patients and get their perspective.”

As noted earlier, the group sessions can extend to the post-partum period, which, as Walker said, is an extremely vulnerable time for those trying to stay sober.

“What we’re finding statistically is that the biggest risk for relapse is in the six- to 12-months post-partum time,” she noted. “Initially, in the first six months, there’s still a lot of that new-baby glow — even though it’s a hard time, there can still be sweetness. As they get older, it can get more draining; as one patient, who framed it in a good way, told me, ‘the newness wears off.’”

Only a year or so since working with its first participants, New Beginnings is generating measurable results.

Changing Room

S.M. told BusinessWest that the post-partum period was, indeed, a difficult time for her as she worked to keep sober amid the many changes and challenges that came into her life with motherhood.

She said she kept coming to group sessions staged by New Beginnings not because she had to, but because she wanted to — and needed to.

“I was having a hard time, but I just kept holding myself accountable,” she said. “There were days when I wanted to stay home and watch TV, but I made myself come to those meetings.”

She still struggles with being a mother — and with staying sober — but she knows she doesn’t have to face these challenges alone.

And that’s what New Beginnings is all about.

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

Healthcare Heroes

This Assisted-living Facility Manager Leads by Example

Emily Uguccioni

It’s safe to say that, at the age of 13, most people don’t know what they want to be when they grow up.

But Emily Uguccioni thought she had it all figured out; she wanted to be an attorney or judge — a figure in the courtroom. At the very least, she knew what she did not want to do — work with the elderly.

But a volunteer position at the Alzheimer’s Resource Center in Connecticut changed her perspective. The facility, right across the street from her middle school, became the foundation for what would become a career she completely fell in love with.

“I wanted an assignment anywhere not near an old person,” noted Uguccioni when explaining her decision to volunteer at a nursing home, but not work with or near those living there.

All her friends read to residents or took them to activities, but she wanted no part of that; instead she got a job in the library organizing all the books. One day, she was instructed to bring a paper to a nurse on one of the units, and upon her arrival, she ran into an old woman.

“This lady said, ‘I’ve been here for four days, and no one has come to pick me up,’” Uguccioni recalled, adding that she did not realize at the time that people with dementia have a disassociation from time. This women had actually been living at the facility for several years.

Feeling bad for the confused woman, Uguccioni said she would try to resolve her issue and offered to get her a drink from the juice cart. Together, they sat and talked for a while until a nurse came by.

“I pride myself in knowing all the residents and all the family members here by name. I pride myself in knowing all the staff by name. I think I know a lot about the residents themselves in terms of what they like, what they dislike, and what might be a concern for them or their family, which is sometimes very different things.”

“She said, ‘you’re the only person in a week that has been able to get her away from that door,’” Uguccioni recalled, adding that, when word got back to the activities director that she was able to do that, she was promptly transferred from her library job and to a position as a resident volunteer.

Fast-forward to today, as Uguccioni sits as executive director at Linda Manor Assisted Living in Northampton, a facility she has put on the fast track when it comes to growth, vibrancy, and recognition.

Indeed, since arriving in 2015, she has doubled occupancy from 40 to more than 80, and there is now a waiting list.

Meanwhile, Linda Manor has been named the best assisted-living facility in Northampton by both the Daily Hampshire Gazette and SeniorAdvisor.com. Under Uguccioni’s direction, the facility has twice won the Silver Honor Affiliate Excellence Award through Berkshire Healthcare Services.

But it’s not so much what she’s accomplished as how that has earned her the Healthcare Heroes award in the category called Health/Wellness Administrator/Administration.

The ‘how’ boils down to a lead-by-example style and an ability to make each and every team member feel not only valued but a key contributor to the health and well-being of all the residents at Linda Manor.

Nicole Kapise-Perkins, Human Resources manager at Linda Manor, summed this up effectively and poignantly in nominating Uguccioni for the award.

“Emily’s fairness and open, engaging manner has had a huge impact on employee morale, and as a result, the services we provide to our residents and families is rated the best in the Northampton area,” Kapise-Perkins wrote. “She lets her staff members know they are appreciated, and they give 110% on the job.”

Manor of Speaking

One of the first things Uguccioni did when she came to Linda Manor was relocate her office.

She moved it out of the administration “suite,” as she called it, and into an office that any person can see the moment they walk into the lobby. This seemingly innocuous change is an effective representation of one of Uguccioni’s biggest personal goals as both a manager and a leader: visibility.

On any given day at Linda Manor, one could find her chatting with residents at breakfast, meeting with staff members to get updates about how they are doing, or attending a check-in meeting with residents and their families, an important time for both constituencies.

“I pride myself in knowing all the residents and all the family members here by name. I pride myself in knowing all the staff by name,” said Uguccioni, noting that there are more than 80 people working with her (not for her). “I think I know a lot about the residents themselves in terms of what they like, what they dislike, and what might be a concern for them or their family, which is sometimes very different things.”

This doesn’t sound like the 13-year-old who took a job in the library because she didn’t want to work around old people.

And it’s not.

As noted earlier, that chance encounter with the woman looking for someone to pick her up changed the course of Uguccioni’s career — and her life.

Emily Uguccioni’s goal is to make every team member know they are valued and a key contributor to Linda Manor’s success.

The volunteer experience she embarked upon after transferring out of library lasted three years until she was hired to be an activities assistant, where she worked at night and on weekends.

“When I was there, I got to see the operations of a nursing home, and I got to see what nurses do and how you interact with the residents and how important a long-term care facility is,” said Uguccioni, adding that this prompted her to explore options in healthcare degrees for her college education.

She graduated from Springfield College in 2006 with a degree in health services administration, knowing she wanted to end up at a higher-level administration or perhaps an executive-director position.

After graduation, she served as a therapeutic recreation director and managed the activities department in various assisted-living homes in Connecticut. Most recently, she worked as director of Operations and Services at Seabury Active Life Community in Bloomfield, Conn., a position she was offered when her previous boss left.

She came to Linda Manor just a year after it opened in 2014, and immediately commenced changing its fortunes.

The facility sits next to Linda Manor Extended Care Facility, also affiliated with Berkshire Healthcare Services, which opened in 1989, and Uguccioni immediately recognized opportunities to create synergies and potential growth for both facilities.

“My vision was to create community and to build a campus concept with the extended-care facility so that the community as a whole saw this campus as a place where housing meets healthcare, a unique concept without a buy-in fee that many of the competitors have,” she said. “Because we are not a ‘life-care community,’ the referral flow and process were not already built into the campus of care with a blink of an eye.”

Elaborating, she said that, while a strong, mutually beneficial relationship between the two facilities seemed like a natural outcome, it took time, patience, and diligence to make it work.

This meant months of working with Mark Ailinger, administrator at the extended-care facility, and his team to build a solid relationship.

“That [relationship] was missing, and I could see that right when I got here,” said Uguccioni, adding that was a problem that could have affected several facets of both facilities had it continued. In order for facilities like Linda Manor to be financially stable, Uguccioni told BusinessWest, maintaining a consistent resident census at or above the target, as well as managing controllable operating expenses, are crucial. But, in order to accomplish this, facilities need solid referral sources, and wellness programs and models for the residents. All this comes much easier when you can utilize the resources at the extended-care facility right next door.

So Uguccioni and Ailinger worked together to build trust between the two buildings so that the extended-care facility could become a consistent referral source at the assisted-living facility, and vice versa.

“It is one of my proudest accomplishments since my tenure here,” she said.

At Home with the Idea

But there have been many accomplishments since Uguccioni’s arrival, including those ‘best-of’ awards.

They are generally a measure of customer service, and Uguccioni said she believes quality in this realm is a function of having a staff that knows it is valued and appreciated.

Indeed, it takes a village to run a successful assisted-living facility that leaves residents and their families happy, and Linda Manor does that well by putting an emphasis on relationships.

To help staff members accomplish this, Uguccioni helps them realize the impact they have on residents, and the value they have in affecting their lives.

For example, she said a certified nursing assistant providing daily services to a resident, like giving medication or offering assistance in the bathroom, translates into much more than completing a simple task.

“You’re really here to be an integral part of that person’s day,” Uguccioni said. “You’re the first person that they see in the morning, and, therefore, their interaction with you really shapes how their day might be.”

This, she says, is the key to running a successful assisted-living community.

“If you don’t have a staff that’s committed and engaged, you don’t have anything,” she said. “I think that it’s really important that you have people and staff in general that are invested in their role and they realize the value that they have in assisted living, and what they mean to the people that live here.”

But building a strong, caring team is not an easy task in this employment environment. Uguccioni says one of the biggest challenges in running an assisted-living facility is that not many people seem to want to be aides.

“There’s a lot of open positions in healthcare for certified nursing assistants, and we don’t find as many people seeking that out as a desired level of employment,” she said, adding that she puts staff satisfaction high on her list in order to reduce turnover.

“I don’t ever want someone here to feel like ‘oh, I just work in housekeeping,’ or ‘I’m just the server in the dining room; what do I know?’ Everybody here knows a tremendous amount,” Uguccioni added. “It’s not just me that runs the building, it’s all of us. If one person could do it, I wouldn’t have everybody else that works here.”

This attitude has helped Linda Manor to continue to be recognized as one of the best assisted-living facilities in the area, and Uguccioni is always thinking about ways to improve.

“I’m always looking at how we can positively affect someone’s life through the residents and the families,” she noted, adding that she has positive experiences every day that remind her why she does what she does.

She recalls one instance from a few years ago, while she was covering for someone in the Admissions department while they were on vacation. A woman walked in looking for a place for her mom to live. The minute she sat down in Uguccioni’s office, she began to cry.

“This woman was in a terrible predicament. Her mother lived in a totally different part of the country, and she didn’t know how to talk to her to tell her she couldn’t live alone anymore,” she said.

In this instance, Uguccioni advised the woman not to tell her mom why she couldn’t live alone, but explain how living in an assisted-living facility would help her live an easier, happier life.

The next week, the woman got her mom on a plane and moved her into Linda Manor.

“Being able to help her, I really do feel like I have a pivotal piece to that,” Uguccioni said. “Every time I see her when she comes in, she says, ‘I thank you every day.’”

Live and Learn

When she reflects back to that experience she had at the Alzheimer’s Resource Center as a 13-year-old girl, Uguccioni is grateful that the nurse sent her to deliver that paper, because it put her on a path to a career she loves every day.

“If I hadn’t had that volunteer experience doing something that was completely out of my comfort zone, I would never have what I have today,” she said. “I would never be in this field at all.”

But she did go down that path, and doing so started her on her journey to be a Healthcare Hero.

Kayla Ebner can be reached at [email protected]

Healthcare Heroes

She’s Forging Pathways to Help People Overcome OCD and Hoarding Disorder

Tara Ferrante

To illustrate one of the many ways obsessive-compulsive disorder, or OCD, can manifest itself, Tara Ferrante said everyone has stood at a rail atop a high building, looked down, and thought, what if I jumped? It’s a little scary, and basically harmless.

“But with OCD,” she continued, “you actually evaluate that thought and think it could happen, and then, ‘I must be a terrible person to have that thought.’ Or it creates anxiety because that thought means something, and you have to do something to feel better.”

OCD often begins as an intrusive thought, she explained, and everyone has intrusive thoughts. What sets OCD sufferers apart, though, is their response to those thoughts. “Sometimes it’s a compulsion, sometimes avoidance — ‘I can’t be in tall places,’ or ‘I can’t be around knives, because I imagined myself stabbing someone once, so I must be a dangerous person. What person must think something like that? I must be a horrible person. People shouldn’t be around me.’”

But while avoidance — or whatever compulsive, repetitive action helps to mitigate that intrusive thought — might bring temporary relief, it also reinforces the initial evaluation of that thought, she went on, “so the next time that thought comes up, you’re stuck in that same cycle where you have to do something to feel better.”

Then there’s the behavior known as hoarding, which buries people, both psychologically and literally, in their own possessions because they’re unable to get rid of anything — presenting a wide variety of dangers.

“It can be a fire risk, or it can be a fall risk, especially as people get older, or someone may have other health issues and the path’s not wide enough for a gurney to get into their house for emergency support,” Ferrante said.

“It also causes people to isolate more — they’re afraid to have people in the home, or to reach out to people,” she went on. “There’s a thing called clutter blindness, where they might not see all the clutter, but when another person is there, it’s striking. There’s the shame and the guilt and everything else that comes up around that, so a lot of people do isolate more because of the clutter.”

Ferrante is program director of the Holyoke Outpatient Clinic at ServiceNet, one of the region’s largest behavioral-health agencies, and treats patients with a wide range of behavioral-health conditions. But it’s her work leading ServiceNet’s OCD and Hoarding Disorder Program that earned her recognition as a Healthcare Hero in the category of Emerging Leader.

To be sure, Ferrante doesn’t see herself as a hero — just someone passionate about helping people overcome behaviors that range, depending on the patient, from mildly annoying to completely debilitating.

“It feels so good to see people thriving in their lives who wanted to die at points,” she told BusinessWest. “While their lives may not be perfect by any means, they’re able to live their lives the way they want to, with much more ease.”

Starting the Journey

Ferrante’s journey in this specialized field began while working with a client who was experiencing extreme distress from OCD symptoms. She had read about emerging OCD treatments, learning that the most effective approach seemed to include a mix of structured clinical treatment and home-based and peer support.

So, two years ago, when ServiceNet’s senior leadership proposed the launch of an OCD program in Western Mass., she jumped at the opportunity to lead the program.

“They saw this area as a kind of desert in terms of people who can really specialize and are able to provide good care to people with OCD and hoarding disorder,” she explained. “I was super interested, and I expressed interest in overseeing it.”

“It feels so good to see people thriving in their lives who wanted to die at points. While their lives may not be perfect by any means, they’re able to live their lives the way they want to, with much more ease.”

Before launching the program, Ferrante and fellow clinicians first completed four days of training in OCD and hoarding disorder, then conducted a series of consultations with two nationally recognized experts on these conditions: Dr. Randy Frost, a professor of Psychology at Smith College, and Denise Egan Stack, a behavioral therapist who launched the OCD Institute at McLean Hospital in Belmont, a Boston suburb.

“We’ve been so lucky,” Ferrante said. “People have invested so much time and energy in our program to get it off the ground and get it going and helping me as a leader. It’s been really great.”

Currently, six ServiceNet clinicians provide specialized OCD and hoarding-disorder treatment at the agency’s Holyoke, Greenfield, and Northampton clinics. The program’s model continues to evolve, but several facets have crystalized, including the use of Smith College students as interns in the program. Frost trains the students for adjunct work in the community, such as conducting ‘exposures’ with clients battling OCD, Ferrante explained.

“They’ll give emotional support to people [with hoarding disorder] as they are sorting and discarding, or as they go out and practice non-acquiring — going to a store where they like buying things, and then not getting anything, sort of building up the tolerance of resisting that urge.”

Tara Ferrante says people with OCD and hoarding disorder span all ages and demographics.

The student collaboration has been valuable and productive, she noted. “We’re limited in how much we can get out into the community or into the home between sessions. The introduction of the interns has helped create steady progress.”

The term ‘hoarder’ is actually out of fashion, she noted, having taken on a stigma in recent years, thanks partly to TV shows that often vilify those who struggle with the condition. Frost has written extensively about the reasons people hoard; some call themselves ‘collectors’ or ‘finders-keepers’ because they see value in every item in their cluttered homes.

“That’s a strength, to be able to see value where other people don’t, or to see beauty where other people don’t,” Ferrante said. “But it’s a strength that’s gone too far, and that can make a hindrance in being able to get rid of things. Also, people don’t want to be wasteful, they don’t want things to go into landfills, and again, that’s really a wonderful quality — but it then impedes their quality of life.”

Hoarding is also a form of perfectionism, at least in the eyes of collectors, she went on. “You want to use something to its full ability, or it needs to go to the just right place. Or, if it’s going to be given away, it needs to be given to just the right person who’s going to love it fully, and if you can’t find that person, then you’re just going to keep it, and that can stall progress sometimes.”

As for OCD, like many mental-health conditions, it can differ in severity from one person to another, Ferrante said.

“Sometimes people can function pretty well, but even for those people who aren’t seeking treatment, it can affect their ability to have relationships, to get to work on time, even to leave their house,” she explained. “There are so many ways it can make people’s lives difficult. And even if they can function sometimes, they’re living in this constant state of anxiety and panic, which is really unpleasant.”

Then there are the more severe cases — stories of people unable to touch their children or their partners for years, or unable to leave their home, hold a job, or participate in life in any way.

The standard treatment in Ferrante’s program is known as exposure and response prevention, a form of cognitive behavior therapy.

“We form a relationship and create situations where they get exposed to the anxiety, the intrusive thought, and we don’t do the compulsion,” she explained. “We do it in a supported way at first, in session, and then we have the interns who can do that out in the community, and eventually we want people to do it on their own. We make exposure part of life — this idea of, ‘let’s turn toward anxiety rather than away from anxiety.’ It takes the power out of it, and they’re able to really start living their lives the way they want to be living.”

Many patients are treated with a combination of therapy and medications, often anti-depressants. “But not everyone needs meds,” she said. “I see a lot of positive outcomes with just exposure and response prevention on its own.”

Breaking Through

The ServiceNet program runs a series of support groups called Buried in Treasures, named after a book Frost co-authored. Ferrante also sits on the board of the Western Massachusetts Hoarding Disorder Resource Network, which puts on conferences that focus on what resources are available in the community for those who struggle with the condition. ServiceNet also brings in experts for lectures where mental-health professionals can earn CEUs for learning more about hoarding and OCD.

All this training is aimed at broadening resources for a patient population that cuts across all socioeconomic barriers and cultures around the world. Hoarding, in particular, is often seen as an older person’s condition, but that may be because they’ve had more time to accumulate, so the signs are more readily apparent.

Progress in overcoming a compulsion to hoard can be slow, Ferrante added. “That stuff didn’t get in the home overnight, and it’s not going to get out overnight. I mean, it can get out of the house overnight, but that generally is going to make things worse — it creates a trauma, it makes the person treatment-resistant, and doesn’t actually address how it all happened.

“It’s almost a guarantee, if someone has a forced cleanup, they’re going to fill their space up again,” she went on. “So we take a slower approach that looks at what got someone there and creates the skills they need to declutter on their own, and not have it return.”

While people who hoard often struggle with stigma, OCD sufferers are plagued with the opposite: the many Americans who think they have OCD because they have certain routines, and proclaim it with an odd sense of pride.

“They say, ‘oh, I’m so OCD,’ and it really minimizes it for people who are suffering,” Ferrante explained. “It’s not just being really clean or wanting things in a certain order. If those things are torturing you and you can’t function, sure, but people can have certain obsessions or compulsions and not have OCD. The ‘D’ part of OCD is that it’s impairing your ability to function, and most people who say, ‘I’m a little OCD’ … well, they’re not.”

On the other hand, it’s also frustrating for someone with OCD to be misdiagnosed, she added.

“I get calls from people saying, ‘I’ve been looking for help forever; no one knows what I’m talking about.’ Sometimes, when people think they’re dangerous because of an intrusive thought, then a therapist buys into that because they’re not sure what this is, and it reinforces that belief. But even suicidal thoughts can be OCD. People can get hospitalized when that’s not the right intervention. You want an expert making sure you’re making the right call there.”

Outside of her OCD and hoarding work, Ferrante continues to manage all the clinicians at the Holyoke clinic, and handles a caseload of about 15 patients at a time, dealing with a wide range of mental-health concerns, from substance-use disorders to trauma, anxiety, and depression. In that sense, she and her team were already doing heroic work before launching the OCD and Hoarding Disorder Program.

But since that launch, she’s been able to help a patient population that often finds it difficult to access resources — and wind up suffering in silence, and often falling prey to other conditions; in fact people who hoard are 80% more likely than the general population to develop depression.

“It’s amazing to see people get better,” she told BusinessWest, whether progress occurs quickly or not. “It’s not always simple — sometimes there’s more than just OCD going on, and it’s more complicated. But if people are coming in, they’re already motivated to do the work, and progress can be pretty quick.”

She thinks of the client who inspired her interest in OCD research, and said “it blows my mind” how far he’s come.

“It’s so, so great when people graduate and don’t need therapy anymore. To see even small progress — people being able to do things they couldn’t do before — makes my job totally worth it.”

Joseph Bednar can be reached at [email protected]

Healthcare Heroes

She’s One of Many Improving Quality of Life for People with Dementia

Carol Constant

As director of Community Engagement at the Loomis Communities, Carol Constant has developed a number of ways residents of the three sites — Loomis Village in South Hadley, Loomis Lakeside at Reed’s Landing in Springfield, and Applewood at Amherst — can be, well, engaged with the world outside their walls.

“It’s not a silo — we’re out supporting the community, and the community is invited to be a part of what we do,” she said, citing examples like supporting awareness walks, food drives, and other events relevant to area seniors.

But it was a resident of Loomis Village, named Rachel Tierney, who got her thinking about the concept of engagement in a new, broader way.

“She had been a long-time caregiver for her husband, and she’s a retired psychiatric nurse,” Constant said. “She had heard about the dementia-friendly movement, and when she saw my title, she approached me and said, ‘hey, do you want to think about this?’”

Constant did. In fact, the idea of dementia-friendly communities — a movement that aims to teach first responders, municipal workers, and business owners how to interact with people with dementia — appealed to her, so she was pleased when her first meeting in South Hadley, in March 2015, drew a wide range of stakeholders: fire and police chiefs, the town administrator, a librarian, the senior-center director, and Chamber of Commerce members, to name a few.

“They’re going to the bank, they’re going to the grocery store, they’re out in the community. So how can we, as a broader community, recognize it and be helpful to them?”

“We sat them down in a room and said, ‘we have this idea about educating and raising awareness about dementia. How have you experienced dementia in your daily lives?’” she recalled. “These are busy people, and we promised to take only an hour of their time, but just going around the room hearing the stories took an hour. Everyone had a story.”

That’s because, of the approximately 5.3 million Americans currently living with Alzheimer’s disease or some form of dementia, 70% are living in the community, rather than assisted living or nursing care — and 30% of that group are living alone. Going by these estimates, approximately 8,460 individuals with dementia in the Pioneer Valley are living in their homes, and 2,538 are living alone.

“They’re going to the bank, they’re going to the grocery store, they’re out in the community,” Constant said. “So how can we, as a broader community, recognize it and be helpful to them?”

More than four years after that first meeting, the loose coalition known as Dementia Friendly Western Massachusetts (DFWM) has drawn the support of dozens of area organizations, sponsored myriad awareness and education events, and, most importantly, made area communities better places to live for people with dementia.

It’s an effort that will only become more important as Baby Boomers continue to march into their senior years, living longer, on average, than previous generations. The number of Americans with Alzheimer’s is projected to rise by 55% by 2030, and by 2050, the Alzheimer’s Assoc. estimates the total number could explode to nearly 14 million.

Proponents of the dementia-friendly movement say greater public awareness and support programs will reduce the stigma of dementia and improve the quality of life for these individuals and their families. In addition, greater public awareness may lead to earlier detection and earlier treatment.

“There’s a huge stigma around dementia,” Constant said. “How can we make people recognize that there’s no shame in it, that nobody who has dementia did something bad? One of the goals is to destigmatize it because people get worried they’re going to embarrass themselves.”

It starts with small steps, she added. “Just check yourself. You may be in a hurry at the store, there’s a long line at the register, and this person is having a hard time counting their money. So slow down and recognize what’s happening and how to be helpful.”

For taking those steps along with a raft of like-minded individuals and organizations, Constant is positively impacting an often-forgotten population, and teaching entire communities that there’s plenty of work left to do.

Knowledge Is Power

The work of Dementia Friendly Western Massachusetts includes several basic activities, including:

• Education and training for those who might encounter an individual with dementia, including fire and EMT first responders, faith communities, and frontline workers in banks, retail stores, and restaurants;

• Development of support groups, memory cafés, and other programs that support individuals and their families; and

• Development of a website and materials that provide a calendar of events and resources available to families the region.

These supports are critical, Constant said, as research shows that supportive care helps people living with dementia and their caregivers experience less physical and emotional stress, better health, fewer hospitalizations, and less time in long-term-care facilities. Additionally, caregivers need support, as caring for someone with dementia puts a strain on their physical and mental health as well as relationships with other family members. Finally, educational programs that build awareness of the challenges faced by these individuals and their families will help assure that, when they are in the community, they are treated with respect and dignity.

To Constant, much of this work comes down to one question. “How can we be supportive of people in the community and destigmatize dementia? When they get embarrassed and shamed, they isolate and become depressed, and that does not help — that further exacerbates the problem for them. This is a movement to raise awareness and destigmatize dementia, in addition to providing education and support for people in the community about dementia.”

Carol Constant says many people with dementia are out in the community, and the community needs to know how to interact with them.

Take memory cafés, for example — places where people with dementia and their loved ones and caregivers can hang out and relax, free from the stress that often accompanies other community outings, because everyone knows everyone else in the room understands their experience.

“So often, we get caught up with caregiving, and we forget to have fun with the person we’re caring for,” she explained. “So it’s an hour, hour and a half where people can meet someone in a similar situation, hang out together, relax, and have fun.”

Memory Cafés have been established at Armbrook Village in Westfield and councils on aging and senior centers in Holyoke, South Hadley, Belchertown, Hampden, Greenfield, and Shelburne Falls. Heritage Hall East in Agawam is in the process of starting one.

Meanwhile, dementia support groups have been established at Armbrook Village, Heritage Hall East, Loomis House, the Holyoke Soldiers Home, and the Belchertown, Holyoke, and South Hadley councils on aging and senior centers.

Constant is gratified to be recognized as a Healthcare Hero, especially considering the category — Collaboration in Health/Wellness. On several occasions during her interview with BusinessWest, she emphasized that she can’t take credit for all this work; it’s about creating partnerships with area agencies that serve older adults. “We got the right people together in the room, and we started programming.”

Those partners in Dementia Friendly Western Massachusetts include the Alzheimer’s Assoc.; the communities of South Hadley, Holyoke, and Springfield; the Department of Elder Affairs; Holyoke Medical Center; WestMass ElderCare; Greater Springfield Senior Services; Holyoke Community College; Chapin Center; A Better Life HomeCare; Springfield Partners for Community Action; Grupo de Apoyo de Demencia at Baystate Medical Center; the Public Health Institute; PeoplesBank; O’Connell Care at Home; Massachusetts Councils on Aging; Silverlife Care at Home; River Valley Counseling Center; Safe Harbor Adult Day Services; UMass College of Nursing; Springfield College; and the Holyoke VNA.

The purpose of their collective efforts, simply put, is to build broader community awareness of the issues around dementia, not only through the website and materials promoting support resources and programs, but by encouraging and training organizations, agencies, and towns in the region to become involved in the dementia-friendly movement.

First Response

To date, DFWM organizations have established and led hundreds of educational programs across the region, including educational programs to a wide array of audiences, including first responders, city and town employees, nursing homes, rehabilitation centers, councils on aging, schools and colleges, hospitals, nursing homes, home healthcare agencies, chambers of commerce, businesses, Rotary clubs, faith communities, retirement communities, civic organizations, elder-law programs, and local and national conferences.

Each target audience has different needs and different ways to connect. For example, first responders often feel frustration when encountering people with dementia, because their role is often to stabilize a situation and then move on. When they encounter a situation where it’s obvious that someone in a home is struggling with dementia and may not have the supports they need, they often feel there’s not much they can do, Constant said.

With that in mind, Dementia Friendly Western Massachusetts developed a visual resource, the size of a business card, that’s printed, in both English and Spanish, with the contact information of organizations that can provide dementia-related resources to families. First responders can leave this card with a family when they feel it’s warranted.

“First responders rush in and rush out — assess the situation and get everyone safe. Then they leave,” Constant said. “There’s a sense of frustration when they know the situation is bigger than ‘we got the fire out.’ This is something they can hand to the family member.”

Or, when police arrive at a home, they might encounter someone who’s agitated and on edge, but not dangerous or mentally ill — they simply have dementia and are trying to navigate a stressful situation.

“Maybe we need to slow it down a little bit, make eye contact, get at their level,” she said. “When I talk to first responders, I see and hear that they do this naturally, but a little layer of education around it is also really helpful. And I’ve heard that from police chiefs in all the communities we’ve been working in.”

It’s just one way she and the other coalition members are changing the conversation around dementia — right down to the very words people employ.

“So much of the language we use around dementia is ‘afflicted,’ ‘stricken,’ ‘the tsunami’ — all this negative language,” she noted. “No wonder it’s stigmatized. So, how do we make people feel not ashamed, not embarrassed about it, and not isolated?”

The community education goes beyond words, as well, and gets to the heart of how people with dementia are treated. For instance, people will sometimes stop talking to an individual with dementia altogether — instead always addressing their companion — even though there’s often many years between diagnosis and the time when someone becomes so debilitated they can’t go out anymore.

“The essence of that person is still there,” Constant said, citing a Maya Angelou quote — not first uttered in reference to dementia, but nonetheless applicable: “people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”

“They can still experience joy; they can still experience humor,” she went on. “So what are we doing when we say, ‘you are no longer able to cognitively keep up with this fast-paced conversation, so sit in the corner by yourself.’ One of the goals of all this work is to improve quality of life.”

That goes for everyone — individuals with dementia, their care partners, and the community as a whole.

Filling the Room

Constant is grateful the Loomis Communities gives her a “long leash” when it comes to her work with Dementia Friendly Western Massachusetts, but not surprised, as it’s really in Loomis’ best interest.

And she’s also thankful for the individual moments that demonstrate the value of engaging people with dementia fully in society.

“Having someone who’s living with dementia come up and talk to you and start a conversation and share their experience and that of their care partner, it’s wonderful to see,” she said. “If we can do one thing to make the quality of life for someone better, why wouldn’t we?”

When her mother-in-law was diagnosed with dementia 30 years ago, she added, she didn’t have the resources available today; no dementia-friendly initiatives existed back then. But she wishes they had. “I learned all my lessons the hard way. I wish I had known as much about it as I do now.”

Still, there’s a lot to learn, she added, and a lot of passionate people — again, this is certainly a collaborative award — working on improving quality of life, one person and one community at a time.

“It’s been great making these connections, and that’s really powerful,” Constant concluded. “If it was up to just one person to do this, it wouldn’t happen. It’s all about getting all the right people in the room.”

Joseph Bednar can be reached at [email protected]

Healthcare Heroes

3rd Annual Healthcare Heroes Awards

HERO (n.) a person who is admired or idealized for courage, outstanding achievements, or noble qualities.

BusinessWest and Healthcare News have created Healthcare Heroes to honor those who live up to that word’s definition. This region’s health and wellness sector is large, diverse, and dominated by heroes of all kinds. They’re on the front lines, in the administrative office, the research lab, the neighborhood clinic, the family dentist’s office, the college health and science building. They’re making real contributions to the quality of life in our communities, and it’s time to recognize their efforts!

3rd Annual Healthcare Heroes Gala
Thursday, October 17, 2019
5:30 p.m.-8:30 p.m.
Sheraton Springfield One Monarch Place Hotel
$90/person; $900/table of 10


Submit nominations for 2020 consideration HERE

Deadline to submit nominations is July 10, 2020, 5 p.m. NO EXCEPTIONS.

Presenting Sponsor

Partner Sponsors

Supporting Sponsor

2nd Annual Healthcare Heroes Awards

Healthcare Heroes

Healthcare Heroes Tickets

  • Price: $90.00 Quantity:
  • $0.00

Presenting Sponsors

Partner Sponsors

Supporting Sponsors

Healthcare Heroes


Helpful Tips for Nominating

As you consider the award categories, please keep in mind the following guidelines in preparing your nomination:

  • Criteria: The criteria for the award and how the nominee fits the criteria for the chosen category
  • Accomplishments: What is/are the nominee’s specific accomplishment(s) and how were they achieved
  • Impact: What measurable impact the nominee has had on the population served in the health and wellness community
  • Unique: Is there anything else that makes the nominee exceptional or unique? Provide any other information that will aid in the judges’ consideration of the nomination

If using mobile device to submit nomination, please make sure your phone is in Portrait view mode.


(Click on each category to go to it’s nomination form)


The judging process will commence July 2019 and be completed by end of July 2019. If more than one nomination is received for a particular nominee, BusinessWest, in its sole discretion, may consider any or all of the nominations for that individual in the judging process. Nominees cannot serve as awards judges.

All eligible nominations received will be judged by a panel of health care industry experts whose evaluations will determine winners of the “Healthcare Heroes” Awards from among the nominees under consideration. The selection of award winners will be final and binding and are not subject to appeal or reconsideration of any kind.


Nominations must be submitted via the designated online form. Mail-in nominations will not be accepted. Nominations may be submitted beginning January 2018 and must be received no later than 5 p.m. Eastern Standard Time on Friday, July 12, 2019. BusinessWest will verify the factual basis of the submitted nominations and may request substantiating information from nominees or others. BusinessWest reserves the right to request and require additional information from nominees in order to have their nomination considered. False, deceptive, or unsubstantiated nominations or acts may render a nominee ineligible. All nomination forms become the property of BuisnessWest and will not be returned.

Notification and Recognition

BusinessWest plans to notify the winners of the “Healthcare Heroes” Awards by July 31, 2019 and will be profiled in the September 2 edition of BusinessWest and September issue of Healthcare News. Winners will be invited to attend the “Healthcare Heroes” Awards gala scheduled for October 17, 2019 at the Sheraton Springfield One Monarch Place Hotel. 


  • Nominees must work in either Hampden, Hampshire, Franklin, or Berkshire county and organization nominees must have offices in Hampden, Hampshire, Franklin or Berkshire county (may be for-profit or not-for-profit).
  • Nominations may be self-nominated or nominated by another person.
  • Nominees cannot be a member of the judges’ panel or member of the judges’ immediate family.

Award Category Descriptions

(Click on each category to go to it’s nomination form)

Patient/Resident/Client Care Provider

Who is eligible: Company or organization which has shown leadership and excellent service over a sustained period of time by providing quality care, and is considered exemplary by patients and peers.

Judging Criteria: The judges will be looking for evidence of high quality care and continuous improvement. Successful submissions should also demonstrate an area of going above and beyond in terms of training, new programs, best practices, and staff/service user engagement.

Innovation in Health/Wellness

Who is eligible: A company, organization, individual, or group of individuals responsible for development of a new procedure, treatment, program or service that can save lives or improve quality of life. The award may be given for either new innovations or for the refining of existing procedures, treatments, programs or services.

Judging Criteria: The innovation should be expansive in scope so that it now, or could in the future, affect many people’s lives. The application should provide information on the size of the target population and the potential dollar value of the market.

Community Health

Who is eligible: Company, organization, individual, or group of individuals responsible for promoting healthy living, bringing attention to a health/wellness issue, or solving a problem through community outreach.

Judging Criteria: Impact on the community, fulfilling a need otherwise not met in the community.

Examples but are not limited to: Community education efforts, donation of facility resources for community use, outreach to at-risk youth, volunteer service projects, events and activities designed to address local community needs.

Emerging Leader

Who is eligible: Individual, early in their career, who is making a significant impact in the health/wellness industry, exemplifying true leadership, and acting as a role model for others.

Judging Criteria: The judges will be looking for an individual who is rising through the ranks and establishing themselves as future leaders in the health/wellness industry. The winner of this award will be someone who outshines their peers in many ways and helps their organization surpass the competition.

Collaboration in Health/Wellness

Who is eligible: Two or more entities which demonstrate creative and effective collaborations for the purpose of addressing significant health and wellness needs or common problems and standards in community.

Judging Criteria: The judges will be looking for evidence of excellence in strategic collaborations promoting cooperation, sharing of resources and expertise and mutual support with a focus on outcomes, value and initiatives. Effective elimination of organizational silos and promotion of more holistic approaches to care and service.

Health/Wellness Administration/Administrator

Who is eligible: Individual, or group of individuals, whose performance, care and leadership is considered exemplary by patients and peers.

Judging Criteria: Increased efficiency in the delivery of services, increased employee morale, improved profitability.

Lifetime Achievement

Who is eligible: Individual who has dedicated their career to improving the quality and delivery of healthcare in the Western Mass. community. This person should have at least 20 years in the health/wellness field.

Judging Criteria: A lifetime career in the health care field, making an impact through care, either by the number of people affected or the scope of his/her contributions, dedication to his/her field.

Submitting multiple nominations does not enhance your chances of winning.

Cover Story Event Galleries Healthcare Heroes

Scenes from the Healthcare Heroes 2018 Gala

Passion is the word that defines these heroes. And it was on clear display Oct. 25 at the Starting Gate at GreatHorse in Hampden, site of the Healthcare Heroes Gala.

This was the second such gala. The event was a huge success, not because of the venue (although that was a factor) or the views (although they certainly helped), but because of the accomplishments, the dedication, and, yes, the passion being relayed from the podium.

There are seven winners in all, in categories chosen to reflect the broad scope of the health and wellness sector in Western Mass., and the incredible work being done within it. Go HERE to view the  2018 Healthcare Heroes Program Guide

The Healthcare Heroes for 2018 are:

• Patient/Resident/Client Care Provider:

Mary Paquette, director of Health Services/nurse practitioner, American International College

• Health/Wellness Administrator/Administrator:

Celeste Surreira, assistant director of Nursing, the Soldiers’ Home in Holyoke

• Emerging Leader:

Peter DePergola II, director of Clinical Ethics, Baystate Health

• Community Health:

Dr. Matthew Sadof, pediatrician, Baystate Children’s Hospital

• Innovation in Health/Wellness:


• Collaboration in Health/Wellness:

The Consortium and the Opioid Task Force

• Lifetime Achievement:

Robert Fazzi, founder, Fazzi Associates.

American International College and Baystate Health/Health New England are presenting sponsors for Healthcare Heroes 2018. Additional sponsors are National Grid, partner sponsor, and Elms College MBA Program, Renew.Calm, Bay Path University, and Trinity Health Of New England/Mercy Medical Center as supporting sponsors.


Photography by Dani Fine Photography

Meet the Judges

There were more than 70 nominations across seven categories for the Healthcare Heroes Class of 2018. Scoring these nominations was a difficult task that fell to three individuals, including two members of the Class of 2017, with extensive backgrounds in health and wellness. They are:

Holly Chaffee

Holly Chaffee

Dexter Johnson

Dexter Johnson

Dr. Michael Willers:

Dr. Michael Willers:

Holly Chaffee, MSN, BSN, RN: Winner in the Healthcare Heroes Health/Wellness Administrator/Administration category in 2107, Chaffee is president and CEO of VNA Care, a subsidiary of Atrius Health. Formerly (and when she was named a Healthcare Hero) she was the president and CEO of Porchlight VNA/Homecare, based in Lee.

Dexter Johnson: A long-time administrator with the Greater Springfield YMCA, Johnson was named president and CEO of that Y, one of the oldest in the country, in the fall of 2017. He started his career at the Tampa Metropolitan Area YMCA, and, after a stint at YMCA of the USA, he came to the Springfield Y earlier this decade as senior vice president and chief operating officer.

Dr. Michael Willers: Winner in the Patient/Resident/Client-care Provider category in 2017, Willers is co-owner of the Children’s Heart Center of Western Mass. Formerly a pediatric cardiologist with Baystate Children’s Hospital, he founded the Children’s Heart Center of Western Mass. in 2012.


Cover Story Healthcare Heroes

Healthcare Heroes to Be Saluted on Oct. 25



If one were challenged to describe the Healthcare Heroes for 2018 — or any year, for that matter — with just a single word, this would be the one.

It is a common character trait within any healthcare profession, but it is certainly necessary to rise above the tens of thousands of men and women in this field and earn that designation ‘hero.’

And it is certainly a common denominator in the remarkable and truly inspiring stories. The passion comes to the fore whether that story is about a career emergency-room nurse who shifted to work at college wellness centers and completely transformed the one at American International College, or about a nurse administrator at the Soldiers’ Home in Holyoke who is transforming care there while also serving as a mentor and role model for other team members. It’s the same when the story is about a large, multi-dimensional effort to battle opioid and heroin addiction in rural Franklin County, or about a pediatrician dedicated not only to the residents of a community, but to making that community a healthier place to live.

Fast Facts

What: The Healthcare Heroes Gala
When: Thursday, Oct. 25, 5:30-8:30 p.m.
Where: The Starting Gate at GreatHorse, Hampden
Tickets: $90 (tables of 10 available)
For more Information: Email [email protected]

That we said, passion is the word that defines these heroes. And it will be on clear display on Oct. 25 at the Starting Gate at GreatHorse in Hampden, site of the Healthcare Heroes Gala.

This will be the second such gala. The inaugural event was a huge success, not because of the venue (although that was a factor) or the views (although they certainly helped), but because of the accomplishments, the dedication, and, yes, the passion being relayed from the podium. It will be same in about seven weeks.

But first, the stories that begin on the facing page.

There are seven winners in all, in categories chosen to reflect the broad scope of the health and wellness sector in Western Mass., and the incredible work being done within it:

The Healthcare Heroes for 2018 are:

• Patient/Resident/Client Care Provider:

Mary Paquette, director of Health Services/nurse practitioner, American International College

• Health/Wellness Administrator/Administrator:

Celeste Surreira, assistant director of Nursing, the Soldiers’ Home in Holyoke

• Emerging Leader:

Peter DePergola II, director of Clinical Ethics, Baystate Health

• Community Health:

Dr. Matthew Sadof, pediatrician, Baystate Children’s Hospital

• Innovation in Health/Wellness:


• Collaboration in Health/Wellness:

The Consortium and the Opioid Task Force

• Lifetime Achievement:

Robert Fazzi, founder, Fazzi Associates.

American International College and Baystate Health/Health New England are presenting sponsors for Healthcare Heroes 2018. Additional sponsors are National Grid, partner sponsor, and Elms College MBA Program, Renew.Calm, Bay Path University, and Trinity Health Of New England/Mercy Medical Center as supporting sponsors.

Photography by Dani Fine Photography

Tickets to the Oct. 25 gala are $90 each, with tables of 10 available for purchase. For more information or to order tickets, call (413) 781-8600, or email [email protected]


Meet the Judges

There were more than 70 nominations across seven categories for the Healthcare Heroes Class of 2018. Scoring these nominations was a difficult task that fell to three individuals, including two members of the Class of 2017, with extensive backgrounds in health and wellness. They are:

Holly Chaffee

Holly Chaffee

Dexter Johnson

Dexter Johnson

Dr. Michael Willers:

Dr. Michael Willers:

Holly Chaffee, MSN, BSN, RN: Winner in the Healthcare Heroes Health/Wellness Administrator/Administration category in 2107, Chaffee is president and CEO of VNA Care, a subsidiary of Atrius Health. Formerly (and when she was named a Healthcare Hero) she was the president and CEO of Porchlight VNA/Homecare, based in Lee.

Dexter Johnson: A long-time administrator with the Greater Springfield YMCA, Johnson was named president and CEO of that Y, one of the oldest in the country, in the fall of 2017. He started his career at the Tampa Metropolitan Area YMCA, and, after a stint at YMCA of the USA, he came to the Springfield Y earlier this decade as senior vice president and chief operating officer.

Dr. Michael Willers: Winner in the Patient/Resident/Client-care Provider category in 2017, Willers is co-owner of the Children’s Heart Center of Western Mass. Formerly a pediatric cardiologist with Baystate Children’s Hospital, he founded the Children’s Heart Center of Western Mass. in 2012.


Healthcare Heroes

This Compassionate Leader Has Transformed Health and Wellness on the AIC Campus

Mary Paquette

Mary Paquette

‘Sex and Chocolates.’

Sounds like one of Hollywood’s late-summer releases. But instead, it’s one of the many intriguing new programs and initiatives launched by Mary Paquette, MS, FNP, in her role as director of Health Services at American International College.

And now that we have your attention — and we almost certainly do — we’ll tell you about it.

Not long after arriving at the college in 2012 to accept the challenge of resuscitating a moribund health-services facility that few students knew about or ventured to (for a host of reasons we’ll get into later), Paquette decided she needed to do some serious outreach.

And it would be undertaken with a number of goals — from introducing (or reintroducing) students to the health facility (known as the Dexter Center) to providing some education, to gaining some insight into the many issues and challenges confronting AIC’s diverse population, many of them first-generation college students.

“There were questions on everything from STD education to things you would think of with Dr. Ruth; I learned some things from these students, and it ended up being a lot of fun.”

So, as part of this outreach, Paquette and Millie Velazquez, office manager and medical assistant at the center, went into one of the female freshman dorms with a large fishbowl containing some questions they had already put in, some chocolates, and a thirst for more questions about sex from the students they greeted.

“If they were brave enough to ask a question, they got a chocolate,” said Paquette, who recalled, with a large dose of pride, that she and Velazquez left with considerably fewer treats than they arrived with. “There were questions on everything from STD education to things you would think of with Dr. Ruth; I learned some things from these students, and it ended up being a lot of fun.”

As noted, Sex and Chocolates is just one of many initiatives Paquette has introduced since arriving. Overall, she has taken the campus service that was traditionally ranked dead last in surveys of students and made it one of the more highly scored.

Far more importantly, she has taken health and wellness to a much higher plane on the AIC campus, providing not just Band-Aids and Tylenol — which is about all the ‘old’ center was known for — but also a welcoming, non-judgmental environment that has improved quality of life on the campus in myriad ways.

For all that, Paquette was named the Healthcare Hero in the category of Patient/Resident/Client Care Provider, which is among the most competitive, with nominees from across the broad spectrum of healthcare.

Mary Paquette and Millie Valazquez, office manager and medical assistant at the Dexter Center

Mary Paquette and Millie Valazquez, office manager and medical assistant at the Dexter Center, have changed attitudes about the center, and created a healthier campus community, through programs like ‘Sex and Chocolates.’

And it’s a category Paquette has essentially devoted her life to, with AIC being only the latest stop in a 35-year career that has seen her take on a variety of roles in a host of settings. These range from director of Nursing at Ludlow Hospital to per-diem hospitalist at in the GI Department of the Eastern Connecticut Health Network, to assistant director of Health Services at Western New England University — the job that became the springboard to her post at AIC.

And there is a huge amount of overlap when it comes to the lines on her résumé, which Paquette explained quickly and effectively.

“I have a lot of energy, and I like to keep busy,” she said in a classic bit of understatement.

Indeed, she does, and at AIC this energy has translated into profound and very positive change, which was summed up by Robert Cole, the college’s vice president of Marketing & Communications, as he nominated Paquette to be a Healthcare Hero.

“Since arriving in 2012, Mary has almost single-handedly transformed the capabilities and perception of AIC’s Dexter Center for Health and Counseling Services,” he wrote. “She has worked tirelessly and passionately to reach students through new, campus-wide health programming and healthy-living promotion; expanded the scope and availability of Dexter’s services; and routinely works off hours to meet the emergency needs of students, student-athletes, faculty, and staff. She has done all this with limited medical staff and budget, and unlimited dedication, compassion, and extraordinary patient care and customer service.”

With that summation as the backdrop, we’ll explain how this transformation took place and what it means for all those — and we mean all those — on the AIC campus.

Sweet Success

The large Victorian home on Wilbraham Road that houses the Dexter Center has enjoyed a long history at the college and filled a number of roles.

It was once the president’s home, for example, and it has housed classrooms, a photography lab, and other facilities.

But when Paquette first saw it in the summer of 2012, she simply couldn’t believe that its role at that time was home to health services.

“It was falling down, the floors were this awful purple tile, it was filthy … I told Mark, ‘I wouldn’t come here for healthcare,’” she recalled, referring to Mark Berman, then vice president of Administration, who has since passed away. The building was in such poor condition that it was almost a deal breaker when it came to the position she was being offered.

Berman was neck deep in getting the dormitories ready for fall, but he promised Paquette that by October, she would see radical improvement in the Dexter Center. He made good on that pledge, but Paquette spent every weekend her first month on the job cleaning it out herself.

“There were ACE wraps that were disintegrating because they sat on shelves for long,” she recalled, adding that dirt on the floor wasn’t the only thing she cleaned out. There was also the receptionist on duty at the time who was so unfriendly, students hated coming to the facility.

But tidying up the Dexter Center and making it a far more welcoming — and less purple — place were only the first steps in a multi-layered process, and only the latest chapter in a long and quite rewarding career in healthcare.

So before returning to Sex and Chocolates and other endeavors at AIC, let’s go back … to the former Ludlow Hospital.

That’s really where the story starts, because, well, Paquette was born there and grew up only a few blocks away. She worked there as a nurse’s aide when she was 18 and in the ER while in college, and, after earning her bachelor’s degree in nursing at Elms College and spending the first several years of her career in the Boston area, that’s where she returned to.

She would eventually become the last director of Nursing at the facility, which would close its doors in 1994. But Paquette has never forgotten the mentorship she received there or the many connections she made that continued to benefit her throughout her career.

Ludlow’s closing prompted her to go back to school and earn her master’s degree in the Family Nurse Practitioner program at UMass Amherst in 1999, and, as noted earlier, she would put it to use in a number of settings over her long career as a care provider. They include Noble Hospital in Westfield, the Johnson Occupational Medicine Center in Enfield, Johnson Memorial Hospital in Stafford Springs, Hartford Hospital, and Mercy Medical Center.

Starting in 1999, though, her main employer would not be a hospital or medical center (although she would continue to work for several of them), but an institution of higher learning.

Wilbraham Road that housed the Dexter Center

When Mary Paquette first saw the facility on Wilbraham Road that housed the Dexter Center, she couldn’t believe people came there for healthcare.

At Western New England University, she started as a provider — and there was only one at the health center at any given time. “So you just put the pedal to the metal,” he recalled. “But for me it was OK, because it was just like the ER atmosphere … you just go, go, go and see one patient after the other. The trick in that is being able to be efficient, but also make patients feel like you’re listening to them and not rushing them.”

Remember that thought later.

At WNEU, she was mentored by the director of Health Services there, Kathy Reid, who, Paquette said, “was open to anything and everything I wanted to do.”

That meant such things as adding IVs to the list of services, as well as suturing and other initiatives. “Over the course of 13 years, we built Western New England’s facility into an amazing clinic. And when they built the new Pharmacy building and they added a new health services [facility], we even had a little surgery suite … we took off more toenails in the fall from turf toe.”

Remember those thoughts as well.

Paquette said she loved her time at WNEU and had no desire to leave. But then, Brian O’Shaughnessy, then AIC’s dean of students and now vice president for Student Services, hired Reid as a consultant to evaluate an underperforming health-services department — what Paquette described as a glorified (maybe) “high-school nurse’s office” — and recommend changes.

In her report, Reid said, in essence, that the school needed to hire a director of Health Services. And she had the perfect candidate — her second in command — in mind.

Something to Chew on

As noted earlier, the Dexter Center simply wasn’t a popular, or busy, place before Paquette arrived. Summing up why, she said simply, “one, it wasn’t marketed, two, it didn’t offer much care beyond Band-Aids and Tylenol, and three, the it had a secretary who was a real grouch.”

So … she set about changing all that and more. One of the first things she did was hire Velazquez (a referral from her mentor, Reid) and broaden that position to one of office manager and medical assistant.

Through what Paquette described as “an over-the-top friendly personality,” Valezquez has changed the atmosphere in the center, making it more welcoming, more efficient, and far-more visitor-friendly.

Meanwhile, the two have together gone about greatly adding to its roster of services and doing that marketing that was a big missing piece.

With the former, they’ve added IVs and suturing, as happened at WNEU before, and also STD testing, safe-sex education, a bowl filled with condoms in the waiting room, counseling, ongoing education into how the healthcare system works, and, most importantly, no judgment.

Overall, Paquette said she wants to make students better healthcare consumers.

“I feel that a large part of my job is teaching students how to be good healthcare advocates,” she explained. “I want them to leave AIC with a better understanding of their own health and the tools they need to navigate the world of healthcare.”

Regarding the latter, Paquette knew it wouldn’t do any good to make all those other changes if students and other constituencies didn’t know about them. And she knew from her time at WNEU that the place to start was with the resident advisors in the dorms.

With their support, she went about creating what she called silly but also effective programs. Like Sex and Chocolates.

“When you’re doing a dorm program in the evening, you have to be entertaining,” she explained. “The healthcare piece of it … you slip that in when they’re not looking. It was more about them, the students, seeing Millie and I, and seeing that we’re friendly and we’re non-judgmental, but we also know what we’re doing.”

Paquette and Velazquez have initiated other programs with the same goals and underlying mindset, including ‘Cards Against Humanity; AIC Edition,’ a takeoff on the popular party game. Sprinkled in with the offensive, risqué, and politically incorrect ‘answer cards’ are several related to birth control, STDs, the Health Services department, and more.

“You sort of slide those questions in, the students get them, but they’re having fun, and they don’t realize that you’re educating them,” Paquette explained. “We’ve created lots of fun games like that.”

But there were other constituencies to connect with, she went on, starting with the athletes on campus. Each team has trainers, she noted, but there was a disconnect, if you will, between the students, trainers, and health services.

That’s ‘was,’ because Paquette set about improving communications and building bridges. And soon, athletes were finding the Dexter Center for suturing, screenings, and other services.

“I feel that a large part of my job is teaching students how to be good healthcare advocates. I want them to leave AIC with a better understanding of their own health and the tools they need to navigate the world of healthcare.”

“We have rugby here,” she noted. “In those first two years, I’d come in at least a dozen times at night, go to the athletic trainers’ room, throw some stitches in a kid’s head, and go home. My deal with the trainers was, they all had my cell phone, they could call, and as long as I wasn’t working one of my ER shifts, I’d come in; that’s how we won over athletics.”

Paquette and Velazquez have also won over commuting students, college employees, students who remain on the campus during the summer, and other constituencies. The health and wellness center that no one visited is now the facility everyone visits.

Stitch in Time

Paquette doesn’t just work at AIC; she has become, for lack of a better term, a huge booster.

On top of the cabinet in her office sit three large wooden block letters — ‘A,’ ‘I,’ and ‘C.’ And she has much more swag, as she called it, all bearing the school’s letters, logo (a muscular, mean-looking yellowjacket), and color — yellow (obviously).

The item she’s most proud of, though — perhaps even more than a full bowl of questions during a presentation of Sex and Chocolates — is a T-shirt given to her by the rugby team signed by all the players, many of whom had seen Paquette for some stitches.

Maybe more than anything else, that T-shirt shows just how much the health and wellness center has grown since Paquette arrived, and how it has ceased being a college service and instead become a powerful force on campus.

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

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]

Healthcare Heroes


2nd Annual Healthcare Heroes Awards

HERO (n.) a person who is admired or idealized for courage, outstanding achievements, or noble qualities.

BusinessWest and Healthcare News have created Healthcare Heroes to honor those who live up to that word’s definition. This region’s health and wellness sector is large, diverse, and dominated by heroes of all kinds. They’re on the front lines, in the administrative office, the research lab, the neighborhood clinic, the family dentist’s office, the college health and science building. They’re making real contributions to the quality of life in our communities, and it’s time to recognize their efforts!

Event Date: Thursday, October 25, 2018
Event Time: 5:30 p.m.-8:30 p.m.
Location:  Starting Gate at GreatHorse, Hampden

Nominations can now be submitted for the 2018 Healthcare Heroes awards. Deadline for nominations is Friday, June 15 at 5 p.m., NO EXCEPTIONS. Winners will be profiled in the September 3 issue of BusinessWest and the September issue of Healthcare News. Winners will be invited to attend the “Healthcare Heroes” Awards gala scheduled for Thursday, October 25, 2018.

Click on one of the following categories to submit a nomination:


Presenting Sponsors

Partner Sponsors

Supporting Sponsors


Health Care Healthcare Heroes Sections

Nominate a Healthcare Hero

Only a few minutes into the first meeting of an advisory board created by BusinessWest and its sister publication, BusinessWest, to provide needed insight as they launched a new recognition program called Healthcare Heroes, the expected question was put forward.

“How do you define that word ‘hero?’ asked one of the panel’s members, addressing the magazines’ decision makers.

The reply, and we’re paraphrasing here, was something to the effect of ‘how we define ‘hero’ is not important — it’s how you define it.’

And by ‘you,’ Kate Campiti, associate publisher of the two publications, essentially meant anyone who would nominate an individual or group to be named a Healthcare Hero in one of seven categories that first year.

Those who did so came up with their own definitions, used to highlight the nominations of a unique class of individuals and groups that would include Sr. Mary Caritas, SP, former president of Mercy Medical Center, in the Lifetime Achievement category; Dr. Michael Willers, owner of the Children’s Heart Center, in the Patient/Resident/Client Care Provider category; Dr. Andrew Dobin, an ICU surgeon, in the Innovation in Health/Wellness category; and the Healthy Hill Initiative in the Collaboration in Health/Wellness category.

“Generally, ‘hero’ means someone or some group that stands out and stands above others in their profession, in their service to others, and in the way their passion for helping those in need is readily apparent,” Campiti said. “And we saw this in our first class of honorees. If there was one word that defined all of them, beyond ‘hero,’ it was ‘passion.’”

A panel of judges will be looking for that same passion as they weigh nominees for the class of 2018.

Nominations are currently being accepted, and will be until the end of the day on June 15. Nomination forms can be found on both publications’ websites — www.businesswest.com and www.healthcarenews.com.

Nominations are being accepted in the following categories:

Those nominating individuals and groups are urged to make their submissions detailed and specific, giving the judges who will review them all the information they need.

The honorees will be chosen this summer and profiled in the Sept. 4 edition of BusinessWest and the September edition of BusinessWest.

The Heroes will then be honored at a gala set for Oct. 25 at the Starting Gate at GreatHorse in Hampden.

Rounding out the class of 2017 are:

Lifetime Achievement: Sister Mary Caritas, SP;

Patient/Resident/Client Care Provider: Dr. Michael Willers, owner of the Children’s Heart Center of Western Massachusetts;

Emerging Leader: Erin Daley, RN, BSN, director of the Emergency Department at Mercy Medical Center;

Health/Wellness Administrator/Administration: Holly Chaffee, RN, BSN, MSN, president and CEO of Porchlight VNA/Home Care;

Community Health: Molly Senn-McNally, Continuity Clinic director for the Baystate Pediatric Residency Program;

Innovation in Health/Wellness: Dr. Andrew Doben, director of the Surgical Intensive Care Unit at Baystate Medical Center;

Innovation in Health/Wellness: Genevieve Chandler, associate professor of Nursing at UMass Amherst; and

Collaboration in Healthcare: The Healthy Hill Initiative.

For more information on Healthcare Heroes, visit www.businesswest.com or www.healthcarenews.com.

Event Galleries Healthcare Heroes

Scenes from the October 2017 Gala

Photos by Dani Fine Photography

healthcareheroeslogo021517-pingThere were more than 70 nominations for the inaugural Healthcare Heroes class, and each one of them was truly worthy of that word ‘hero.’ Each one is to be considered a winner in some respect.

On Oct. 19 BusinessWest and The Healthcare News recognized the inaugural Healthcare Heroes class. Collectively, they are pioneers, and were celebrated at the Starting Gate at GreatHorse in Hampden. Each one is to be considered a winner in some respect.

American International College and Trinity Health are the presenting sponsors of Healthcare Heroes. Partner Sponsors are Achieve TMS, HUB International New England, and Health New England. Additional sponsors are Bay Path University, Baystate Health, Cooley Dickinson Health Care, Elms College, and Renew.Calm. Tickets to the event are $85 each, with tables available for purchase. For more information or to order tickets, call (413) 781-8600.


Their stories reveal large quantities of energy, imagination, innovation, compassion, entrepreneurship, forward thinking, and dedication to the community.

There were eight winners in this first class, with two in the category of ‘Innovation in Health/Wellness,’ because two candidates were tied with the top score. The Heroes for 2017 are:

Lifetime Achievement: Sister Mary Caritas, SP;

Patient/Resident/Client Care Provider: Dr. Michael Willers, owner of the Children’s Heart Center of Western Massachusetts;

Emerging Leader: Erin Daley, RN, BSN, director of the Emergency Department at Mercy Medical Center;

Health/Wellness Administrator/Administration: Holly Chaffee, RN, BSN, MSN, president and CEO of Porchlight VNA/Home Care;

Community Health: Dr. Molly Senn-McNally, Continuity Clinic director for the Baystate Pediatric Residency Program;

Innovation in Health/Wellness: Dr. Andrew Doben, director of the Surgical Intensive Care Unit at Baystate Medical Center;

Innovation in Health/Wellness: Genevieve Chandler, associate professor of Nursing at UMass Amherst; and

Collaboration in Healthcare: The Healthy Hill Initiative.


Healthcare Heroes

Healthcare Heroes 2017

healthcareheroeslogo021517-pingThere were more than 70 nominations for the inaugural Healthcare Heroes class, and each one of them was truly worthy of that word ‘hero.’ Each one is to be considered a winner in some respect.

On Oct. 19, BusinessWest recognized those who stood out the most in the hearts and minds of an esteemed panel of judges. Collectively, they are pioneers, and they will continue in that vein at the Starting Gate at GreatHorse in Hampden as they become the first individuals and organizations in the region to accept the Healthcare Heroes award.

Their stories reveal large quantities of energy, imagination, innovation, compassion, entrepreneurship, forward thinking, and dedication to the community.

There are eight winners in this first class, with two in the category of ‘Innovation in Health/Wellness,’ because two candidates were tied with the top score. The Heroes for 2017 are:

Lifetime Achievement: Sister Mary Caritas, SP;

Patient/Resident/Client Care Provider: Dr. Michael Willers, owner of the Children’s Heart Center of Western Massachusetts;

Emerging Leader: Erin Daley, RN, BSN, director of the Emergency Department at Mercy Medical Center;

Health/Wellness Administrator/Administration: Holly Chaffee, RN, BSN, MSN, president and CEO of Porchlight VNA/Home Care;

Community Health: Molly Senn-McNally, Continuity Clinic director for the Baystate Pediatric Residency Program;

Innovation in Health/Wellness: Dr. Andrew Doben, director of the Surgical Intensive Care Unit at Baystate Medical Center;

Innovation in Health/Wellness: Genevieve Chandler, associate professor of Nursing at UMass Amherst; and

Collaboration in Healthcare: The Healthy Hill Initiative.

American International College and Trinity Health are the presenting sponsors of Healthcare Heroes. Partner Sponsors are Achieve TMS, HUB International New England, and Health New England. Additional sponsors are Bay Path University, Baystate Health, Cooley Dickinson Health Care, Elms College, and Renew.Calm. Tickets to the event are $85 each, with tables available for purchase. For more information or to order tickets, call (413) 781-8600.


Healthcare Heroes

At 94, She’s Still Finding Ways to Lead, Fight, and Inspire

 Sister Mary Caritas, SP

Sister Mary Caritas, SP

Sister Mary Caritas, SP says that many of the assignments during her remarkable 70-year career in healthcare, civic service, and work with the Sisters of Providence were unplanned, unexpected, and, in some cases, well, untimely — at least initially.

By that she meant that, by and large, when she was informed that her role would be changing — and that happened more than a few times — she was very much enjoying what she was doing, making a difference in that role, and looking forward to going on in that way. Meanwhile, in most cases, she considered herself totally prepared for the new challenge to which she was assigned.

That was true when she was told early on by her superiors that she would focus her career pursuits on dietary science rather than nursing, a profession she fell in love with, and again when she was told, after serving several years as a dietitian, that she would become an administrator at St. Luke’s Hospital in Pittsfield, and again when she was named president of the Sisters of Providence.

But in each case, she accepted what was to come next with enthusiasm and a mindset to make the very best of that situation — for her, but also, and especially, for the constituencies she would be serving.

She loves to fight for a good cause; she’s energized by it, and she communicates that enthusiasm or concern or passion to others. And when she gets in that mode, she’s unstoppable; she’s a remarkable woman.”

“Several times, I was doing something I loved doing, and then I was quickly moved somewhere else,” she told BusinessWest. “But each time I had that experience, new doors opened for me; new opportunities came my way. There were many occasions when I happened to be at the right place at the right time.”

There are countless people who would no doubt say the same thing. And those sentiments — not to mention a seemingly endless list of accomplishments and tireless work within the community — go a long way toward explaining why Sister Caritas, who turned 94 on August 22, was the clear winner in the Lifetime Achievement category for this inaugural class of Healthcare Heroes. In fact, she was the top scorer among the more than 70 nominees for the program’s seven categories.

When looking over her résumé, it’s easy to see why.

That document goes on for several pages and includes a long list of professional appointments, including a nearly two-decade-long stint at Mercy for which she is perhaps best known.

It also chronicles a host of church-related activities and appointments, including a nine-year tenure as president of the Sisters of Providence that preceded her time as Mercy’s president, as well as stints on the executive council of the Sisters of Providence, the Catholic Charities board, and many others.

And it also includes a lengthy list of civic activities and work within the business community, including everything from decades of service to the Easter Seals to her memorable role as chair of the task force on Bondi’s Island in the mid-’90s; from a decade of service as chair of the United Way of Pioneer Valley to a five-year stint as chair of the Springfield Council on Aging.

Now 94, Sister Mary Caritas shows no signs of slowing down

Now 94, Sister Mary Caritas shows no signs of slowing down, and clear signs of only adding new chapters to a nearly 70-year career in healthcare and service to the church.

She served on the board of two area colleges — Elms College and Western New England University — and also a few banks, including the former Springfield Institution for Savings and the former Community Savings Bank in Holyoke. She served on the Spirit of Springfield board for 16 years, and still serves on the Economic Development Council of Western Mass.

And then … there’s her service to dozens of healthcare organizations. That list is way too long to print in anything approaching its entirety, but it includes the Sisters of Providence Health System, Catholic Health East, and Trinity Health New England (all parent companies to Mercy at different times), but also Partners for a Healthier Community, Cancer House of Hope, Holyoke Hospital, the American Hospital Assoc., the Mass. Hospital Assoc., the Academy for Catholic Health Care Leadership, and many more.

But despite all that this résumé conveys, it’s still only part of the story.

The much bigger part is the energy, entrepreneurial spirit, and innovative nature she brought to those assignments — or continues to bring; indeed, a good number of those listings have a starting date, then a hyphen, and then the word ‘present’ — and also her ability to inspire others.

Sister Kathleen Popko, current president of the Sisters of Providence, who has worked beside and been friends with Sister Caritas for a half-century, summed it all up this way:

“She loves to fight for a good cause; she’s energized by it, and she communicates that enthusiasm or concern or passion to others, and they join with her, whether it’s for Bondi’s Island stench or fluoridation or reaching out and advocating for those who are are poor and underserved.

“And when she gets in that mode,” Sister Popko went on, “she’s unstoppable; she’s a remarkable woman.”

Heart and Soul

Sister Caritas was doing quite well in her efforts to mask some frustration.

As she talked with BusinessWest, she was awaiting word on the scheduling of what she called minor heart surgery — and coping, if that’s the right word, with a list of things her doctor told her she shouldn’t be doing. (Editor’s note: That surgery went well, and she has been cleared to do pretty much anything she wants.)

At the time, the refrain-from list included golf, a pastime she’s enjoyed for decades (her record includes a hole in one at East Mountain Country Club’s 10th hole), as well as pilates.

While somewhat disappointed that she had to take it rather easy, Sister Caritas took the marching orders in stride. There were, after all, plenty of other things to keep her busy.

But understand that it takes nothing short of orders from a doctor to in any way slow down this energetic leader, who has been keeping a full calendar (whether it be the printed variety in a binder or her cellphone) since just after World War II ended.

Our story begins in Springfield, where she was born and raised. Her father had designs on her being his secretary, and her classes at Commerce High School, which she didn’t like at all, had her on that path.

Things changed after she met a woman in training to be a nurse. “I got so excited and so enthusiastic, when I came back, I told my mother I wanted to be a nurse,” she recalled, adding that these sentiments were not received warmly by her mother, who warned her that she would spend a career emptying bed pans.

But the young Mary Geary was determined — we’ll see that word repeatedly in this discourse — and enrolled at Technical High School, focusing on the sciences, with the goal of entering the nursing profession.

Upon joining the Sisters of Providence — another decision that did not sit well with her mother — she was sent to St. Vincent’s Hospital in Worcester as a nurse. But upon making her final vows after her fifth year, in 1949, she was sent to Mercy Hospital in Springfield, a move she was thrilled with until she found out that, instead of nursing, she would focus on dietary services, a decision made by the reverend mother.

Fast-forwarding a little, after receiving a master’s degree in nutrition education at Tufts University and undertaking a dietetic internship at the Francis Stern Food Clinic at the New England Medical Center in Boston, she was assigned to be administrative dietitian at Providence Hospital in Holyoke.

“I had the happiest time of my life for the next seven years,” she recalled employing a tone that made it clear that such happiness had an expiration date. “December 23, 1966, I was busy preparing a party for the sisters when I got a call from the Mother House. With no preamble, and with no explanation, the reverend mother simply said, ‘little sister, as of January 2, you are the administrator at St. Luke’s Hospital.’”

When she replied that she didn’t know anything about hospital administration, her superior responded with a simple ‘you’ll learn,’ which she did.

After St. Luke’s and Pittsfield General merged in 1969 to become Berkshire Medical Center, Sister Caritas served briefly as associate director of that facility. That’s briefly, because her life and career were soon to change abruptly — again.

Indeed, she was chosen to lead the Sisters of Providence and take the title superior general, a title that intimidated her about as much as the long list of responsibilities that came with it.

“I was totally unprepared for this,” she said, adding that, as she did with other stops during her career, she learned by doing.

A Fighting Spirit

And that ‘doing’ included work to create a new Mercy Hospital, a facility that would replace a structure built by the Sisters of Providence in 1896 and open its doors in 1974.

In another strange career twist — yes, there have been several in this narrative — Sister Caritas would succeed the woman she chose to lead the new Mercy (Sister Catherine LaBoure) after Sister LaBoure was in turn chosen to lead the order.

While Mercy had a new facility, it remained what Sister Caritas called “the little kid on the block,” much smaller than its rival just a few blocks away, Baystate Medical Center.

Sister Caritas (a.k.a. ‘little sister’), front row, center

Sister Caritas (a.k.a. ‘little sister’), front row, center, says she likes creating new things and getting things started. “Those are the kinds of things that energize me.”

But in its smaller size, Mercy’s president saw nimbleness and an ability to fill recognized niches, while also taking some bold, innovative — and, yes, entrepreneurial — steps.

Such as an in-hospital surgery center that has a story behind it that provides some insight into Sister Caritas’ determination and desire to fight for something she wants and believes in.

“I was going to buy a surgery center down on Maple Street,” she recalled. “Everything was moving along smoothly, but the night before the sale was to go through, they called and said they changed their mind. I was naturally terribly disappointed, but disappointed was hardly the word for it. I was mad; I was furious.

“So I said, ‘we have some space; we have some extra operating rooms,’” she went on. “So we created the first in-hospital surgery center.”

Other innovations and expansion initiatives would follow, including an eye center created at the hospital, an intensivist program, one of the nation’s first hospitalist programs, creation of the Weldon Center for Rehabilitation, the Family Life Center, the Healthcare for the Homeless initiative, and much more.

The common denominators with each of these efforts were common sense, expediency, and a desire to better serve patients and families, said Sister Caritas, citing the hospitalist program, now a staple in hospitals across the country, as an example.

“It was never really my intention to start a hospitalist program — I just wanted to create opportunities for more surgery,” she explained. “My whole life has been taking advantage of opportunities that present themselves; when I’m open to something and think it’s a good idea, I move with it. And I like nothing more than creating new things and getting something started. Those are the kinds of things that energize me.”

But while Sister Caritas has always been entrepreneurial, the word most-often used to describe her is compassionate.

“What’s truly impressive is the breadth of her engagement, from the national level all the way down to the individual,” said Sister Popko. “She’s been on many national and regional boards and continues to serve on several — she has that dimension. But at the same time, and simultaneously, she has extraordinary compassion and a big-hearted, magnanimous response to the needs of the individual, whether it’s helping someone find a placement for their mother in a nursing home or reaching out to an individual who’s looking for a job or is in trouble.

“If you know her, you know her thousand closest friends,” she went on. “She just knows everyone.”

U.S. Rep. Richard Neal, who was mayor of Springfield during Sister Caritas’ tenure as president of Mercy, agreed.

“Her legacy is one of lasting kindness, compassion, and care for all,” he said. “She vowed to ensure that everyone who came through her doors were taken care of, and she fulfilled that promise. She has truly fulfilled the Sisters of Providence pledge to pay particular attention to the cries of the poor and oppressed.”

Small Wonder

Sister Popko told BusinessWest that Sister Caritas, a.k.a. ‘little sister,’ insists that at one time she was at least 5 feet tall, and maybe a full inch over that mark.

Not anymore.

Not that it matters, or has ever mattered.

“She has such a large presence even though she’s a very small person,” Sister Popko noted. “When she walks into a room, everyone recognizes her and wants to speak to her. She has an indomitable spirit, is very courageous, and is outspoken when it’s called for.”

Such comments evoke Mark Twain’s famous and often-borrowed line: “It’s not the size of the dog in the fight, it’s the size of the fight in the dog.” And with many matters, and in many arenas, Sister Caritas has displayed plenty of fight.

Perhaps the most celebrated example was her lengthy battle to win approval from the Mass. Department of Public Health for a cobalt unit for cancer treatment at Mercy Hospital. She first filed an application in 1978, and it was denied. Applications could only be filed biannually, so she tried again in 1980. And 1982. And 1984. And 1986. You get the idea.

“They said I couldn’t demonstrate that there was enough need for it,” she recalled, with exasperation still evident in her voice nearly 40 years after she was first turned down. “I couldn’t believe it.

“But over the next 14 years, I applied every two years,” she went on, adding that the seventh application was to be her last — at least as president of Mercy — because she had informed her board that she would be retiring.

That seventh time was the charm, and the cancer center that was started but not completed during her tenure now bears her name.

In keeping with her character, however, she said that getting the center approved and built were not the real accomplishments.

“It’s one thing to build something, but it’s the quality of the service, the compassion of the people, and the love they have for their patients that really makes the difference,” she told BusinessWest. “While it’s a beautiful center, it’s nothing without that compassion.”

That compassionate, fighting spirit remains today. Indeed, while the word ‘retire’ was officially attached to the end of her tenure at Mercy, she prefers to say that her energies were simply “redirected.”

Toward Bondi’s Island, for example, and the odor problems that had plagued that facility for years, but in many other directions as well.

She still sits on a dozen boards and continues to look for ways to innovate and serve the historically underserved. Both those missions come together in an ongoing project to create senior housing for lower-income individuals on the former Brightside campus.

The Sisters of Providence are seeking additional funding support (state grants have already been secured) for a 36- to 40-unit facility that will be a demonstration project that will tie in with the PACE (Program for All-inclusive Care for the Elderly) initiative already operating at that site.

“We want to demonstrate the relationship between supportive housing and people’s ability to remain independent,” she said of the project called Hillside at Providence. “And that’s exciting.”

As she talked about the Hillside project and the countless others she’s been involved with over the years, Sister Caritas was persistent in her efforts to make it clear that, with each one, she was only working as part of a team.

Indeed, when asked to consider identifying what she considers her greatest accomplishment, she said flatly, “I don’t think I’ve had any great accomplishment.”

Rather, “when I think about all the people who I’ve worked with and the people who have supported me, and the network needed to get things done … there’s not anything that I’ve done by myself,” she went on. “With other people, though, we’ve done some great things.”

Cause and Effect

As she was concluding her talk with BusinessWest and thus getting on to other items on her busy schedule, Sister Caritas took a few minutes to talk about Mary Elizabeth O’Brien, now serving as interim president of Mercy Medical Center.

“She’s someone you can believe in,” Sister Caritas remarked. “And that’s what you need in a leader, someone you believe can get it done.”

Ironically, generations of area residents, including those who have worked beside her, those who have benefited from her many initiatives, and even those working in competing hospitals have said the same of Sister Caritas. And at 94, they’re still saying it.

As her friend Sister Popko noted so eloquently, she loves fighting for a good cause.

And yes, when she gets in that mode, she is unstoppable. Still.

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

Healthcare Heroes

This Physician Always Has His Patient’s Interest at Heart

Dr. Michael Willers

Dr. Michael Willers
Dani Fine Photography

Dr. Michael Willers calls it simply “the look.”

When asked to describe it, he said it was somewhat difficult to put into words. What certainly wasn’t is his opinion that generating this look may well be his favorite thing about his work as owner of the Children’s Heart Center of Western Massachusetts.

It comes when a young patient finally comes to the realization that he or she is there at the home on Northampton Street in Holyoke to receive medical care — and not just play on the rug with LEGOs or a stuffed animal.

“I’ll be talking to the parents and I’ll be talking to the kid … and then I get my stethoscope out, and I sit down on the floor with the kid with my stethoscope,” Willers explained. “And it dawns on the kid at that moment that this is not just hanging out on the floor at some friend’s house. There’s a stethoscope involved, and they’re in a doctor’s office … and the kid’s thinking, ‘wait a second … I may have been duped.’

“They have this really surprised look on their face,” he went on. “Then I say, ‘it’s all good … we’re just going to have a listen, and maybe you want to listen, too.’ So we’ll listen to their heart together.”

Willers’ ability to prompt ‘the look’ doesn’t completely explain why he was chosen as the winner in the category of Patient/Resident/Client Care Provider, but it goes a long way toward getting that job done. He and his partners, Drs. Cyrus Yau and Meaghan Doherty, have created an environment that looks and feels far more like a home than a place where pediatric cardiologists would typically do their work.

And they run a practice where parents, often very anxious about bringing their child to a cardiologist to begin with, leave with all their questions answered and their fears, in most cases, anyway, put to rest.

Willers told BusinessWest that, unlike most healthcare operations today, this is not a volume business — or, to be more precise, not a business consumed with volume. Indeed, the three physicians generally book only seven appointments a day and spend an hour, on average, with each patient and their parents.

Taking care of kids and being with them … I could do that all day long and not get tired of it. It picks me up every time.”

And while his work is cardiology, Willers says he and his partners regard themselves as experts in stress reduction, especially when it comes to the parents of the children they see.

“I’ll often tell people that we specialize here in anxiety and worry,” he explained. “Our specialty is helping parents who are anxious or worried or scared. We take pride in tuning into that and understanding where parents are coming from and helping to unravel that anxiety and figure out exactly where their anxiety lies.”

But it’s not simply how much time is spent with patients and their families, or all this work in stress reduction that sets Willers apart. It’s also how that time is spent, which, in his case, means getting down to the patient’s level — quite literally.

“When I went to medical school, I knew I was going to get into pediatrics,” he said while explaining how he chose this line of work, or it chose him, as many working in healthcare opt to phrase things. “I love the social aspect of it, to be honest with you. There’s nothing like walking into an exam room and having a chance to get on the floor and play LEGOs with kids, talk to them about their lives and about what they enjoy.

“Pediatrics is intellectually interesting,” he went on. “But socially, it’s invigorating. The real reason I went into pediatrics as opposed to internal medicine or something else was purely social and emotional reasons. Taking care of kids and being with them … I could do that all day long and not get tired of it. It picks me up every time.”

The Pulse of His Practice

Willers isn’t sure of the exact date, but he believes that the home at 1754 Northampton St. in Holyoke is, like most of the others in that vicinity, not quite a century old.

It is large and comes complete with many nooks and crannies. For example, each of the examination rooms on the second floor has a short, narrow closet in one corner, the dimensions of which are determined by the structure’s sloping roof.

The waiting room at the Children’s Heart Center looks more like a living room, which is exactly what it was for roughly 90 years.

The waiting room at the Children’s Heart Center looks more like a living room, which is exactly what it was for roughly 90 years.

Each closet is filled with a trove of stuffed animals and toys, and on occasion, Willers won’t just go into the closet for something, he’ll actually emerge from it to greet a patient. To get his point across, he gave a demonstration.

“They’ll be looking for me to come in the front door, but once in a while I’ll get down in here,” said the 6-foot, 3-inch Willers as he squeezed in and closed the door behind him. “And then I’ll pop out like this and say, ‘hi, guys.’”

This demonstration, and the enthusiastic commentary that accompanied it, speak volumes about not what Willers does, but something at least equally important — how he does it.

Before we get into that in more depth, though, we need to first explain just how Willers arrived in that closet. It’s an intriguing story, and it really begins back at Wesleyan University, where he was finishing his work toward earning a degree in biology.

He wasn’t considering medicine at that time — he was leaning toward getting a Ph.D. in ecology or evolution — but a week spent with a group of internal-medicine residents at St. Vincent’s Hospital in New York changed all that.

“Six months before senior year, I decided I wanted to go to medical school,” he noted, adding that he enrolled at Dartmouth and, while working toward his degree, developed two passions — working with and for the underserved, and taking care of young people, for all those reasons mentioned above.

After completing his residency in pediatrics at Cornell Medical Center – New York-Presbyterian Hospital, Willers went to work at the Fair Haven Community Health Center in New Haven, Conn., an experience he described as the best of both worlds — taking care of an underserved, largely Spanish-speaking population, and also having teaching and hospital privileges at Yale-New Haven Hospital.

Desiring to narrow his focus to pediatric cardiology, he undertook a fellowship in that specialty at Yale School of Medicine, and upon completing it, he went to work at Baystate Children’s Hospital as a pediatric cardiologist, one of three on staff, while also serving as director of the Pediatric Exercise Physiology Laboratory.

Seeking to provide care in a different setting and in a different manner, he founded the Children’s Heart Center of Western Massachusetts in 2012.

“I wanted to be able to take care of people in a way that focused on patients as individuals, and their families,” he explained. “And spending time with them, answering questions, addressing their concerns, understanding their lives and how their heart problems impacted their lives, and how their lives impacted their heart issues.

“I wanted to do it in a way that wasn’t like a lot of hospital-based outpatient practices,” he went on. “There’s a lot of overhead with those facilities; you have to pay for the fancy waiting rooms, and you have to pay the CEOs and the vice presidents and the middle managers, and a lot of the money goes toward things not directly related to good patient care. And what that means is that the volume of patients you need to see in a hospital-based practice just to keep the boat floating is enormous, and that means spending less time with patients.”

He started in that home in Holyoke with an operating philosophy that minimized those overhead expenses and called for seeing seven patients a day for an hour each, as opposed to 30 patients a day for 15 minutes each.

When asked how this was doable in this modern age of healthcare, where volume is such a critical factor in a practice’s success, he paused for a moment before responding.

“It’s our priority,” he explained. “In any endeavor in life, if you prioritize the right things, then you can make it work. And we prioritize the relationships with patients and families. We don’t prioritize mahogany desks, and we don’t prioritize over-management.”

As the practice grew, thanks in no small part to a very receptive response from the region’s community of pediatricians, it expanded, both with additional cardiologists (Yau and Doherty) and with satellite offices in Amherst and Great Barrington.

Hardly a Murmur

As he offered a quick tour of the Holyoke office, Willers pointed out a number of design elements and choices regarding décor that were chosen specifically with the goal of making young patients and their parents feel comfortable and, well, at home.

These include the couches chosen over traditional plastic chairs seen in most physicians’ offices, oriental rugs, soft, padded examination tables, toys and games seemingly in every room, and patients’ exploits in coloring between the lines decorating one full wall at the front entrance.

Even the terminology reflects this operational philosophy, if you will.

Indeed, upon arrival, visitors are asked to sit in the ‘living room,’ not the ‘waiting room,’ because while the latter phrase effectively describes its official function, it certainly looks more like the former — because, for roughly 90 years, that’s exactly what it was.

But the friendly, patient- and family-focused tone of this practice goes well behind furniture and phraseology. It also involves everything from the considerable amount of time spent with a child and his or her parents, to the attention paid to the communication process.

To explain, Willers chose as his subject matter the heart murmur, a term that most parents don’t fully understand and one that usually generates far more fear and anxiety than are actually warranted.

So Willers said he starts off by focusing on the child, not the word ‘murmur,’ and moves on to making it clear to parents that, in the vast majority of cases, murmurs are normal and not life-altering.

Dr. Michael Willers

Dr. Michael Willers says his favorite toy is whichever one his patient happens to be playing with at the time.

“I’ll tell a parent that there are seven different kinds of normal murmurs, and say, ‘let me tell you about the one your child has,’” he explained, adding that, for this exercise, he referenced the Still’s murmur, a common type of benign murmur named after the man who first described it, Dr. George Frederic Still. “And I’ll draw them a picture of a heart, explain what causes this murmur, and then tell them, ‘this is a totally normal murmur in completely normally healthy kids, something that develops around the age of 2 or 3 and lasts until the kid is 12 or 13 or 14. But it eventually goes away on its own and never turns into anything bad, and you never have to worry about it again.’”

Overall, Willers said he and his partners work hard to effectively communicate with patients and their parents to ensure they have a solid understanding of what’s happening with the heart in question.

“Some cardiologists will say, ‘your daughter has a heart-valve problem; she’s going to need a procedure on down the line — we’ll talk about it more later,’” he explained. “When we sit down with patients, our discussions are usually 20 or 30 minutes long; we draw pictures, we take notes, they go home — we intend for them to go home — with a really solid understanding of what’s going on with their kid, or with them if they’re an older person.

“In my experience, there’s nothing like uncertainty to breed anxiety, and there’s nothing like anxiety to disrupt the joy of parenting,” he went on. “And so we really try to get rid of the uncertainty and give people definitive answers in terms that are in plain English so that they can home with an understanding and a reassurance, and they don’t have to feel anxious.”

The Internet and all the information available on it has acted to fuel this anxiety, Willers said.

“They’ll hear something or read something on the Internet, and they’re really worried that their kid is going to die for X, Y, or Z reason, but they don’t really want to say it,” he went on. “So unless you can tune into their emotions and be on the same wavelength, you can’t really put their fears to rest.”

But getting on the same wavelength with parents is just part of this story. Getting there with children is what Willers probably enjoys most.

And while the methods for doing so vary with the age of the patient, the common threads are communicating and connecting.

“The first five minutes of every visit isn’t ‘so what brings you here today?’” he explained. “It’s ‘how’s your summer going?’ or ‘what was camp like?’ or ‘dude, how’s it going with your little sister?’ You spend five minutes connecting like that, and it brings a certain energy to that visit.”

A Different Beat

When asked if he had a personal favorite when it comes to kids’ toys and games — remember, he gets right down on the rug to play alongside his patients — Willers gave an answer that neatly sums up how this practice operates, and why.

“Whatever the kid is playing with at that given moment — that’s my favorite,” he told BusinessWest.

Such an attitude explains not only why Willers was chosen to be a hero in the Patient/Resident/Client Care Provider category, but also why he loves to create ‘the look’ and can’t wait to see it again.

Like he said, he can do this all day, and it picks him up every time.

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

Healthcare Heroes

Emergency Department Director Creates Efficiencies — and a True ‘Front Door’

Erin Daley, RN, BSN

Erin Daley, RN, BSN
Dani Fine Photography

Almost from the first moment she stepped into the emergency room at Cooley Dickinson Hospital as a nursing student at UMass Amherst, Erin Daley knew this was the environment in which she wanted to work — and maybe spend a career.

“The ER is one of those places where you either love it immediately or you know it’s not for you, and it’s always been a place I absolutely loved,” said Daley, who, when asked what prompted the fast, deep embrace of this setting, said simply, “everything about it.”

“It’s that ability to be reactive,” she went on, as she went into some detail about what she meant by ‘everything.’ “And be able to change priorities at a moment’s notice. It’s unique, challenging, but not in a negative context, and there is nothing routine about it.”

These sentiments are reflected in the way Daley talked about everything from a much-needed return to the ER at CDH after a stint as a telemetry nurse at Baystate Medical Center to broaden her horizons, as she put it — “even though I learned a ton, I knew labor and delivery were not for me and I needed to get to the ER” — to the enthusiastic manner in which she relayed her affection for the work involved with being a ‘charge nurse’ in the ED at Mercy Medical Center.

“You have to know everything about everyone at all times in order to fit the puzzle pieces together,” she explained. “It’s this constant juggling act.”

And her affection for this setting was clearly evident when she talked about how much she misses being directly on the front lines, if you will, in her current role as director of Emergency Services at Mercy.

“I loved being an emergency-room nurse,” she said, expressing clear regret at having to use the past tense. “On days that they’re really busy and if there’s things I could skip, I’d gladly do that to jump in, even if it’s just to help transport patients; most of the day to day does not allow me to be out there anymore.”

But while there is that drawback to her current position, if one chooses to call it that, there are nonetheless many different kinds of rewards — everything from orchestrating strong improvements in the overall efficiency of the Mercy ER to working with a host of other players to help stem the tide of the nation’s opioid crisis.

Her boundless energy has gained her the reputation of being a go-getter, one who gets things done, and overall future leader for our healthcare system and community. She is both an emerging leader and one who has emerged.”

For her achievements in all these realms, Daley was the top scorer amid a strong field of candidates within the Emerging Leader category for these inaugural Healthcare Heroes Awards.

To put her efforts into proper perspective requires liberal use of numbers. For example, she oversees an ER with nearly 80,000 annual patient visits, making it one of the busiest in the state in terms of visits per bed. She oversees a staff of 160 and a budget of $65 million. More numbers are needed to chronicle the process improvements she and her staff have orchestrated with several key measurements of care. For example, the Mercy ER has:

• Decreased the ‘left without being seen’ rates from 5% to 2%, thus improving revenues;

• Decreased overall ‘door-to-door’ time, as it’s called, by 57 minutes;

• Increased patient-satisfaction scores by 40%; and

• Improved employee-engagement scores by 33%.

However, words and phrases are needed to convey how all this was accomplished — phrases like ‘whole-person care,’ used to describe an approach that views health for ED patients as a segue into engaging them in better health — and ‘care map,’ an aptly named initiative that charts a course for individual patients, especially frequent visitors to the ER.

First, though, some words and phrases from Doreen Fadus, vice president of Mission Integration and Community Health at Mercy Medical Center, who nominated Daley, are in order.

“Her boundless energy has gained her the reputation of being a go-getter, one who gets things done, and overall future leader for our healthcare system and community,” she wrote. “She is both an emerging leader and one who has emerged.”

Volume Business

As she talked about her staff’s efforts in the broad realm off efficiency, or process improvement, Daley told BusinessWest that they are driven largely by necessity.

Indeed, the Mercy ED has 36 beds (just over one-third the number at Baystate Medical Center, by way of comparison), which she described as both a blessing and a curse.

“We’re very spacially constrained considering the volume that we have — 36 beds for just shy of 80,000 patients,” she explained. “That’s driven us to be so efficient; it’s made us relook at how we do things, look at our data all the time, and undertake process-improvement initiatives, because we don’t have the luxury of having a lot of beds.

“We look at every aspect of how a patient moves through the system,” she went on. “And if there’s any means for reducing waste and redoing processes, we’ll find it. If there’s 10 extra steps that a staff nurse has to take to do a particular task, taking that waste out of their day puts their attention where it needs to be — back on the patient.”

How Daley came to be directing these efforts at improved efficiency is an intriguing story, one of moving progressively higher in the ranks in terms of responsibility within that environment she came to love.

After her stint at CDH, she came to the Mercy ED in 2004. She told BusinessWest she was attracted by its reputation for being a nurse-driven environment, a description she found to be certainly accurate, and a foundation she would only build upon.

She started as a staff nurse, taking care of patients at the bedside, and remained in that role for eight years, eventually assuming charge-nurse duties, which, as noted earlier, she found quite rewarding.

Mercy Medical Center

Erin Daley says the emergency room, and especially Mercy Medical Center’s, is a unique environment she described as a ‘constant juggling act.’

“It’s probably my favorite job,” she said. “You’re really trying to manage throughput, and it’s a gigantic puzzle with all these moving parts. It’s about how you have to think about the ED; there’s a certain number of beds, ‘X’ amount of patients you’re trying to get through, you’re trying to allocate resources and potentially pull resources from one area to another area to always have throughput in mind, with the patient at the center of it all.

“You’re like an air traffic controller,” she went on. “One’s coming in, one’s going out, and you’re having to reassess that constantly in order to optimize the space that you have.”

In 2010, Daley became clinical nurse supervisor in the Mercy ED, and in that role was directly responsible for the supervision of the department, with specific duties ranging from staffing to scheduling; from compliance to being what she called a “real-time resource,” meaning she was still in the trenches. In 2015, she became nurse manager of the ED, assuming responsibility for productivity and throughput metrics.

And just over a year ago, she was named director of Emergency Services, meaning oversight of the department and all its personnel and not being in the trenches, as she noted earlier.

But it does mean bringing a higher level of efficiency to those front lines, while also bringing new meaning to the notion that the ED is a hospital’s ‘front door’ and a resource for the community beyond emergency care.

“I want to know what’s happening in the community and how I can be a supporting influence,” said Daley, noting that she is involved with everything from the region’s opioid task force to a committee battling human trafficking.

That phrase ‘supporting influence’ gets to the heart of both Daley’s management style and the philosophy that she and her staff members embrace when it comes to what an ED should be and how it should function.

Regarding the former, she said she is a mentor as well as a manager, one whose simple ambitions when it comes to her team are to “inspire, uplift, and motivate.”

And as for the latter, she said the ED cannot only be a place to receive emergency care. In the whole-person-care model, it is also a vehicle for engaging individuals in better health, through such things as medication-management discussions, assistance with setting up post ED visit primary care, behavioral-health services, and more.

As an example, she cited the drug-overdose victim who arrives at the emergency room.

“If someone comes in that has overdosed on opioids … we could be that last line of support to reach out to them,” she explained. “They may have burned bridges everywhere with their family, with their friends, and we could be that last line to reach out to them.”

Elaborating, she said those in the ED, through the unit’s Complex Care program, strive to be more proactive with those who overdose, for example, and not simply treat them and move them through.

“We follow up with phone calls and try to reach out and talk with these individuals after they’ve had a chance to recover,” she explained. “It’s a traumatic experience, that whole overdose process … you’re given Narcan, now you’re in acute withdrawal; it’s incredibly traumatic.”

Erin Daley

Erin Daley says her management style encourages teamwork and solving common problems together.

Fadus may have summed up Daley’s ‘front door’ approach best, noting that “her understanding that the ED can provide the entry way to both providing medical services and the guidance of health education has led to many patients experiencing healthcare through a system rather than rely on services mainly through the venue of the ED.”

By the Numbers

As noted earlier, there are many numbers, or metrics, involved with an emergency department, and all through her career and especially in her current capacity, Daley has been involved with bringing specific numbers higher or lower — whichever translates into improvement.

In the case of patient satisfaction, an upward trajectory is obviously desired, while, when it comes to the ‘left without being seen’ category, downward movement is the goal, because individuals are leaving generally out of frustration with the time they’re spending in the ER waiting room. And when they leave, valuable revenue is lost, and, more importantly, these individuals may be endangering their health.

To achieve improvement in that ‘left without being seen’ category, and all others, the Mercy team embodies ‘lean’ strategies commonly used on the manufacturing floor and other settings, said Daley, adding that the goal is always to remove waste and improve efficiency. But while doing so, patient care cannot be compromised.

And Mercy has managed to do this with what is perhaps the most-watched ER statistic, the one focused on door-to-door time (from when they check in until they are discharged), which Mercy has managed to reduce by nearly an hour — 57 minutes to be exact — to 157 minutes.

This was accomplished with something called a split-flow model, which, as that name suggests, splits those arriving in the ER into ‘lower acuity’ and ‘higher acuity’ categories. “If you can keep vertical patients vertical, the ease of them getting through the system improves, and you can decrease length of stay dramatically by not even putting them in a hospital bed.”

Elaborating, she said the ED took one of its triage rooms and created the aptly named ‘rapid medical exam’ (RME) room. There, patients deemed to be low-acuity are triaged, seen by a provider, and discharged, all from that one room.

“If all of those patients that are of that lower acuity never hit the back of the ER and never take up a bed, you increase your capacity for sicker patients,” Daley explained. “You increase capacity, not because you’ve added beds, but because you’ve added bed hours.

“When we piloted this on our busiest days, it was incredibly successful, and over the next few years, we went from Monday and Tuesday to Monday through Friday, and then, as our volumes grew, we expanded it to every day of the week,” she explained, adding that the RME model has also had a huge impact on the ‘left without being seen’ numbers as well, because of the additional bed space.

These improvements have come about through that lean approach to operations, learning from best practices, and working together as a team to solve problems and achieve continuous improvement, said Daley, adding that her management style encourages all this.

“I’m successful because I have an amazing team of people that I work with — everyone who’s in a leadership capacity in this department is an over-achiever and a go-getter,” she noted. “I’m not the kind of person who micromanages at all; I like to be collaborative and make a goal together.

“How each individual person gets there … I don’t micromanage that,” she went on, “because everyone has their own style, and they do better working their own project in the way they feel comfortable. But we all have the same goals in mind, and they are lofty goals.”

Looking ahead, Daley, now pursuing an MBA at Elms College, is focused on building upon both her leadership skills and her grasp of the many financial aspects of her position and others within the higher ranks of healthcare management.

“I want to be very knowledgeable about how my business, meaning my department, runs, and feel confident about that,” she explained. “From there … I’m not quite sure what the future holds.

“I like operations a lot — fitting those puzzle pieces together,” she went on. “I can see myself overseeing operations on a larger scale. But I also love the work I do in the community.”

Bottom Line

For now, she will continue to oversee the air-traffic controllers and others in the ED, create more process improvements, and, in general, go on being a ‘supportive influence’ — there’s that phrase again — with her staff, in the ED, and within the community she serves.

As Doreen Fadus noted, Daley is both an emerging leader and an energetic administrator who has, in many ways, already emerged.

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

Healthcare Heroes

Porchlight’s Leader Has Some Illuminating, Innovative Ideas

Holly Chaffee, MSN, BSN, RN

Holly Chaffee, MSN, BSN, RN
Dani Fine Photography

Holly Chaffee says her husband has a line — perhaps it falls into the category of ‘joke’ — that he’ll throw out on a fairly regular basis, like almost every night.

“He’ll say ‘OK, who are we having dinner with this evening?’” said Chaffee, president and CEO of Lee-based Porchlight VNA/Homecare, adding that he says this because there’s a decent chance that dinner between the two will include a phone call — or several — from a colleague looking for some direction, advice, or a much-needed answer.

“The phone seems to always ring when you sit down to dinner,” she said with a laugh, adding that she always answers it. “We’re a 24-hour business; there’s always someone on call, and there’s always someone backing up calls. You have to be there for people, because they’re relying on you.”

This sharing of dinner time goes a long way, sort of, toward explaining why Porchlight VNA/Homecare is the only agency of its kind in this region to receive what’s known as 5-star status from for the Centers for Medicare and Medicaid Service (CMS).

It will take much more to explain those high scores, which ultimately determine how an agency is reimbursed, and we’ll do that in a bit.

Those phone calls during the evening meal also help explain why Chaffee was the top scorer in an extremely deep field of contenders for the Healthcare Heroes category called Health/Wellness Administration/Administrator. But again, many more supporting words and numbers are needed, starting with this summation from Kurt Toegel, chair of the board at Porchlight.

“Holly is known as an innovator in the home-care arena,” he wrote. “As an administrator and CEO, she has not only the drive and motivation it takes to be successful, she has the leadership skills to develop the work products necessary to be successful.

“Holly has true heart,” he went on, “and compassion for the work she does. She is collaborative and is always willing to share her knowledge.”

I believe it starts with your heart — you have to love what you do. And if you love what you do, it’s going to show from the top down; you all have to be invested in what you’re doing in your job.”

‘Innovative,’ ‘collaborative,’ ‘compassionate,’ ‘motivator’ … these qualities and others become apparent as one looks at the long list of accomplishments accredited to Chaffee and her team since she arrived at what was then known as the Lee Regional VNA andBerkshire Home Care in 2009. These include:

• Changing the existing electronic medical record to improve efficiencies;

• Orchestrating a merger with Chicopee VNA and Great to Be Home Care in 2014;

• Implementing a branding campaign and new company name (Porchlight), as well as oversight and the development of a new website to increase visibility of the service areas;

• Effectively creating a continuum of care (from acute to chronic care) by developing an internal conversion system;

• Designing and implementing a productivity system that increased productivity from 3.25 to 5.75 visits per eight-hour day;

• Operationalizing the accounts-receivable collection;

• Hiring new management-team members with clinical expertise, leading the agency to a deficiency-free survey in 2012 under a new survey process;

• Piloting a childhood-obesity program in schools in Berkshire County; and, perhaps most importantly,

• Empowering staff to lead in their areas of expertise.

Slicing through all of these and countless other bullet-pointed lines from her CV, Chaffee said she and her team have created an environment marked by innovation and calculated risk taking, one that has enabled Porchlight to succeed — and blaze some trails — in a constantly changing and ever-more challenging home-care landscape.

“Porchlight’s leadership is known for not being afraid to take a risk, to try something new,” she explained. “Seven years ago, for us to embrace the medical record that we did, that was a huge step — that was innovative. And there have been many other examples of that kind of thinking.”

Holly Chaffee, center

Holly Chaffee, center, says she and her team at Porchlight have created an environment of risk taking that has led to its 5-star status.

As for those 5-star ratings, they are a reflection of how the agency is responding to these changing times, which require ever-higher levels of accountability and measurable outcomes.

Porchlight is the only Western Mass. agency given such elite status in the most recent ranking, one of two in Massachusetts, and one of only about 200 across the country.

That benchmark is the result of what Chaffee calls the ‘triple aim’ — low cost, high quality, and patient satisfaction.

“We were able to attain that status with boots on the ground,” she said, attributing the accomplishment to solid teamwork. “We have a superior staff of nurses, home health aides, physical therapists, occupational therapists, social workers … all those people are out there creating the 5-star status we have through their encounters with the patients.

“Our goal is keep patients at home and families together,” she went on, adding that the agency’s tagline — and her life’s work — is enabling individuals to live “life as you know it.”

Shedding Light on the Subject

As she talked about that aforementioned rebranding initiative and the new name Porchlight, Chaffee said that, as one expect, there’s a story behind it.

It begins with the original name over the door, Lee VNA, which led many people to believe that the agency served only people in that community, which was not the case. The name was changed to Lee Regional VNA, but it still wasn’t clicking, said Chaffee.

To come up with something that did, she turned to the advertising and marketing agency Darby O’Brien, which had developed a niche in rebranding efforts. The firm eventually came up with ‘Porchlight,’ which resonated with Chaffee and her board chairman, who both conjured up images of front porches with lights blazing (for Chaffee, it was at her parents’ home in New Jersey) when they heard it.

But … there’s usually a ‘but’ in these cases, and there was here as well.

“When you change the name of a 100-year-old agency, there’s a lot of controversy, and we needed to overcome that,” Chaffee told BusinessWest, adding that help came from a board member, then in her 90s, who had served in that capacity for a half-century.

The new name was presented to her by O’Brien, Chaffee, and others, and the response helped dissipate that controversy.

“She told us that when her husband, a doctor, would leave the office, he would tell people, ‘if you need me to stop by on my way home, leave the light on,’” Chaffee recalled. “There couldn’t have been a better entrance for the name ‘Porchlight’ than that, and we were very excited about that response; the name caught on.”

Putting the new name and accompanying logo on signs, letterhead, and the website was far from the most challenging of assignments on Chaffee’s portfolio at her agency, but, like the others, it sheds needed light — pun intended — on those many qualities listed or implied by Toegel in his nomination. They include imagination, forward thinking, teamwork, and, perhaps most important, a willingness to listen and the will to act upon what she hears.

And Chaffee has honed these various careers through a nearly 40-year-long career in healthcare and healthcare administration that might not have happened (well, it probably would have happened anyway) had the market not been flooded with teachers back in the late ’70s, as she was graduating from high school, prompting her to look in another direction career-wise.

“I was talking with my parents,” she recalled. “I volunteered at the hospital as a candy striper, and my father said, ‘you love people, you love helping people … why don’t you think about going to nursing school, because you can do those things and also teach?’”

She thought about it, and then did it, at Skidmore College in New York. Her career in healthcare began in New York (she commuted from her parents’ home) at a pediatric tertiary-care unit, working with children with neurological impairments and kidney disorders. She and her husband would first settle in upstate New York and then relocate to Enfield, after which Chaffee took a job in the pediatric intensive-care unit at Hartford Hospital.

Her career would take a sharp turn, however, after the couple had two sets of twins in a 15-month span.

“That’s when I started my home-care life,” she explained, adding that, while working at Hartford Hospital, she “dabbled” in home care, taking care of a few children on ventilators. She enjoyed that work and, after having her two sets of twins, worked weekends as a home-care nurse, essentially launching a new career that would see her hold essentially every position in that healthcare realm.

Subsequent stops would take her to the Enfield Visiting Nurse Assoc.; Ander-Care Inc. in Springfield, a home-health agency; Special Care Home Health Services in Wethersfield, Conn.; Noble Visiting Nurse Assoc. in Westfield; UConn Medical Center, where she served as a staff nurse and assistant head nurse in the UConn Bone Marrow Transplant Unit; the Enfield Adult Day Center; and Masonicare in Wallingford, Conn., a nonprofit integrated health system, where she directed Masonicare at Home.

In 1999, she also launched her own venture (one that took her maiden name) — Vannucci Consultants, which started as a nursing consulting company that later expanded to include consulting to startup adult day centers and home-care agencies.

In 2009, she was asked to interview at Lee Regional VNA and was chosen as its next president. And with that hiring, the board, taking her vast skill set into account, decided to merge the VNA with a separate company, Berkshire Home Care, and have Chaffee lead both.

Progress Report

Chaffee arrived at LRVNA and Berkshire Home Care in December 2009, roughly six months later than CFO Pat Lamonte. Together, the two have led the organization through a continuous run of growth, innovation, and success — by a number of measures.

“She came from the hospitality industry, was a quick study, and a did a wonderful job of managing the finances,” Chaffee said of Lamonte, adding that one of the first assignments the two took on was implementing a new electronic medical record (EMR) system.

“When I arrived, the staff was using a particular electronic medical record, but they weren’t utilizing it the way they needed to,” she explained. “So I had to look at the operations and change everything that was happening so that things could be efficient and we could get on track financially.

“I went and viewed an electronic medical record called Home Care Home Base out west at a company called Residential Care,” she went on. “I said ‘wow, this is amazing; it gives everyone accountability, internally and externally,’ and so we adopted that system and did the implementation, which was as big change, because everyone’s role changed internally. But we needed to put those efficiencies in place to be sustainable as we are today.”

In many respects, the improvement of the EMR system, as well as the process for doing so — meaning everything from the due diligence to the adaptation of best practices to the quest for new efficiencies — goes a long way toward explaining why Porchlight is a 5-star facility.

The EMR improvements enable the facility to more effectively document information concerning the care of specific patients, she explained, and the process of making that change reflects the environment of innovation and risk taking that she has created.

And these qualities are necessary in this changing environment in home care, one where there is ever-more emphasis on outcomes and measuring them.

“There’s a culture change out there,” said Chaffee. “If someone had home care 20 years ago, they were used to ‘oh, you’re going to provide home care; someone’s going to be in my house for eight hours a day and take care of my mom while I’m at work?’

“It did happen like that 20 years ago if someone had complex medical needs and they were at home,” she went on. “That’s not the way it is anymore — that type of care is not delivered anymore; its been scaled back. Now, you go in, and you’re focusing on the problem you’re there to see that patient for — now, today.”

How agencies fare in those specific assignments is what the CMMS is measuring as it goes about the task of awarding stars.

As Chaffee showed BusinessWest Porchlight’s latest scorecard, if you will, she said scores shaded in light green (in the 60th percentile and higher) were good, and those in dark green (80th percentile and higher) were very good.

With five stars at the top of the card, one would expect lots of dark-green boxes, and there are, in such categories as ‘pain intervention,’ ‘improvement in pain,’ ‘timely initiation of care,’ ‘improvement in management of oral meds,’ and ‘diabetic foot care & education.’

When asked what makes all that green possible, and, in essence, what separates a 5-star operation from one that strives for the rating and falls short, she said there are many factors, many ingredients in the recipe for success.

“I believe it starts with your heart — you have to love what you do,” she explained. “And if you love what you do, it’s going to show from the top down; you all have to be invested in what you’re doing in your job.

“And it’s not just a job — it’s a career, it’s a lifestyle,” she went on. “To be a home-care nurse is a lifestyle, because you have to be invested in your patients. It’s not like you can go to your office at 4:30, click the light off, and it’s done. We’re a 24-hour business.”

Which brings her back to dinner with her husband and the phone calls that can — and often do — interrupt those meals.

And Chaffee is never sure who might be on the other end of that call.

“You might have a manager who wants to run a scenario by you — something they’ve never come across before,” she explained. “You may have a home-health aide you’ve established a long-term relationship with; I’ve had aides follow me from my other jobs into Massachusetts. They’ll call and say that their patient passed away, and they want to discuss how they’re feeling about that.

“I have an open-door policy — all my staff has my cell-phone number,” she went on. “Anybody can call me at any time; sometimes, they just want to check in, and that’s fine with me.”

Bright Future

It may not be an official measure of success in business, but the number of people who want to see what your operation has done, and take best practices from it, is certainly an important statistic — if anyone actually keeps a real number.

Chaffee said she doesn’t, but she acknowledged that many people in her business look to the Porchlight operation as a standard bearer in many respects. The consistent 5-star ratings will do that for a company.

Those who call and visit are essentially looking to know how that mark of excellence was achieved, how a team can be motivated to constantly raise the bar and then clear it, and how a company can excel with that triple aim.

Put another way, they want to know why neither Chaffee nor her husband minds it when he says, ‘who are we having dinner with tonight?’

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

Healthcare Heroes

This Pediatrician Has Escalated the Fight Against Toxic Stress

Molly Senn-McNally

Molly Senn-McNally
Dani Fine Photography

Dr. James Li remembers his heart rate quickening as the “police officer” moved toward him and his two “siblings.”

That’s how real it all was, he told BusinessWest.

But those words are within quotation marks because none of this actually was real; rather, it was a simulation — a poverty-simulation seminar, to be more precise.

Li, a general pediatric resident working at the Baystate High Street Health Center, was playing the middle child in this exercise. His “family,” like many in Springfield that actually come under his care, was living below the poverty line — well below it. And one of the things Li learned very quickly as he acted out his role was that, when the police enter the picture, bad things are probably about to happen — such as children being taken away for suspected neglect.

And that’s why he felt his heart rate spike when a man who was just playing his role as a police officer moved onto the scene.

“I actively told my quote-unquote siblings that maybe we should walk this way to get away from the police officers,” Li recalled while gesturing with his hands to show what he meant. “That was the moment when the simulation became real for me.”

Making such experiences as real as possible is now part of the broad job description for Dr. Molly Senn-McNally, a pediatrician, Springfield’s school physician, and continuity clinic director for the Baystate Pediatric Residency Program. She has made the poverty simulation part of the orientation for Baystate residents, and also part of very comprehensive efforts to help young physicians better care for people living in poverty by making them fully cognizant of all the challenges facing those in this constituency.

Molly is dedicated to the care of children and families who live in poverty-stricken areas of Springfield.”

And that’s only one of many initiatives she’s involved with that so impressed the judges that Senn-McNally was the high scorer in the Healthcare Heroes category known as Community Health.

Others include everything from the introduction of substance-abuse screenings in Springfield schools to an integrated behavioral-health system at the High Street clinic, to ongoing efforts to establish a diaper bank at that facility to assist those struggling mightily to make ends meet.

“Molly is dedicated to the care of children and families who live in poverty-stricken areas of Springfield,” said John O’Reilly, chief of General Pediatrics at Baystate Health, who nominated her. “She understands that social determinants of health have a great impact on the health and well-being of our families, and she has been working hard to decrease the impact of toxic stress.”

Such stress, which is receiving ever-more attention in the healthcare and social-service communities, occurs, according to the Harvard Center for the Developing Child, in response to the strong, frequent, and/or prolonged activation of the body’s stress-response system without adequate protective relationships and other mediating factors (Li’s spiking heart rate when police appeared on the scene, for example). Stressors may include individual experiences of adversity, as well as family and community circumstances that cause a sense of serious threat or chaos.

Reducing such stress and minimizing its impact has become, in many ways, Senn-McNally’s life’s work. And a big part of it is compelling young doctors, through exercises like the poverty- simulation seminars, to understand how those social determinants of health directly impact the patients they see every day.

“These are things that are non-medical, but certainly impact people’s health and wellness — where they live, where they go to school, whether they have transportation, whether they have access to resources,” she explained. “Through their participation in the simulation seminars, residents and medical students get some empathy around when patients show up late, and they start to understand that health and wellness happens, really, outside the clinic and not only inside those walls. And they begin to understand the stress of living in poverty.”

If one listens to Li and other residents who have taken part in such simulations, Senn-McNally is succeeding in transforming this empathy, this understanding, into better care for this at-risk population.

Dr. James Li

Dr. James Li says the poverty-simulation seminar he took part in gave him greater appreciation of the challenges facing many of the patients he sees.

“The simulation and what I learned from it allows me to take things a step further,” said Li, a graduate of the medical school at Florida International University. “I know what the book says in terms of what these patients need. But now, I’m thinking more about how I can go outside the box to actually make it work for them.”

Dr. Shubham Bakshi, who has also taken part in a poverty-simulation seminar, agreed.

“The simulation has given me a different perspective on how to make sure individuals get the right amount of help, and that we match them up with the resources that are available in our community,” he told BusinessWest. “We take things for granted that we shouldn’t take for granted. That’s what this simulation has shown me, and it will make me a better doctor.”

Ready to Act

Bakshi, a native of India and graduate of Ohio State University and then Northeast Ohio Medical School, said he was obviously not experienced in what it’s like to be a 14-year-old girl, especially one in a family living in poverty.

But that was the role that the pediatric resident was assigned in his poverty-simulation seminar — “I didn’t volunteer” — and, like any good actor, he soon became immersed in his role, if you will. In this case, that meant coming to grips with all the sentiments, emotions, and, yes, toxic stress that such an individual would encounter as they are presented with a task, or scenario, as well as their assignment, which, as he put it, is to simply survive the environment they’d been placed in.

“The environment that I was given was that my dad had just left us, and everything fell to my mom, who was not educated and didn’t have enough skills to work in many jobs; everything fell on her to support us,” Bakshi recalled. “And being a 13- or 14-year-old, I was not able to get any jobs.

“It was eye-opening, because these are real experiences — these are real-life scenarios, as I later found out while practicing in Springfield,” he went on. “I knew that poverty was a challenging thing, especially with child care, but the simulation was very eye-opening; my mother was earning $30 a day, and our rent was $700 a month. It was really hard to make ends meet.”

Creating these eye-opening experiences and, more importantly, changing the way physicians think about how to properly care for those living in poverty is only the latest example of how Senn-McNally has spent much of her career working with and advocating for people at risk.

Indeed, her résumé includes stints with a host of community health and wellness organizations ranging from the New Beginnings Domestic Violence Shelter in Newark, Ohio, to the Franklin County Community Action Center for Self-Reliance, a homeless drop-in center in Greenfield.

Through those experiences and many others, including three years at Connecticut Children’s Hospital in Hartford working in its primary-care center, she brings a keen awareness of those aforementioned social determinants of health to work every day, and making others as aware is now a big part of her duties as a pediatrician and educator.

And in those capacities, she wears a good number of hats. She has her own practice, working at the clinic on High Street, which serves some of the poorest neighborhoods in Springfield.

And like many who work with children, she finds that work not only rewarding, but enjoyable.

“I love kids, and have moments every day where I say, ‘I’m so lucky to be able to spend time with kids and families all day long,’” she said. “A kid does something funny or silly, and we smile; I’m not sure that happens for people who are taking care of older folks.”

She also serves as Springfield’s school physician.

In that role, she works with the school nursing leadership as their healthcare consultant, and has worked with school officials on a number of initiatives, including substance-abuse screenings.

A pilot program involving seventh- and 10th-graders was launched last year, she said, adding that school nurses undertake what are known as SBIRT (screening, brief intervention, referral, and treatment) screenings designed to make the nurses resources in the ongoing battle to stem the tide of substance use.

“The nurses just have a conversation with the kids about substance use,” said Senn-McNally. “And one of the wonderful things about these conversations is that they are preventive; they’re an opportunity to talk with students about substances, hopefully before they’ve started using in the seventh grade, and emphasize the positive choices that kids are making if they haven’t starting using or if they’ve stopped, and see the school nurse as a resource.”

And she is also an educator, specifically associate program director for the pediatrics residency program at Baystate, another role with a host of rewards.

“I love working with residents and medical students,” she told BusinessWest, “because I really think we have a chance to shape how they are as physicians, what they value, and how they grow and treat patients.”

And the poverty-simulation seminars she oversees play a very big role in these efforts.

On a Role

Such simulations are taking place across the country, involving not only physicians and others in healthcare, but also elected officials, educators, business leaders, and other constituencies.

With each group, the goal is essentially the same — to create awareness of the myriad challenges facing those in poverty, and to see this awareness translate into positive change when it comes to how communities and individuals serve the poor and deliver services.

The simulations feature volunteers, perhaps 20 to 30 of them, who are residents of the community and either work with people in poverty or who have lived in or close to poverty, said Senn-McNally, adding that the ‘participants’ are medical residents or medical students who role play for an hour (four 15-minute ‘weeks’) living in poverty.

“They’re placed in families of varying types, maybe a single mom with several children, parents who may have lost their jobs, or an older single adult supporting themselves on disability, for example,” she explained. “And they have to complete a number of tasks over those four weeks; they have to pay their rent, they have to feed their families, and they have to keep the electricity on. And they really experience a small measure of what the families we take care of experience in their lives.”

After the simulation, there is a debriefing, she went on, adding that these sessions, where the participants, such as Li and Bakshi, discuss what they just experienced with the volunteers from the community, are quite compelling.

“The participants talk about how they felt during the simulation, and the community members have a chance to comment on what they saw, and whether the simulation was realistic, went far enough, or didn’t go far enough,” she explained. “And it’s such a powerful conversation, because the volunteers get to share their real-life experiences with our medical students and residents, who have typically grown up with more privilege than the people running the simulation.”

What happens after the seminars is obviously the most important part of this equation, though, said Senn-McNally, adding that the goal is to not only create an understanding of what it’s like to live in poverty, but better serve that population. And she believes the seminars are creating progress in this realm.

“The residents and medical students learn that people have to prioritize when they’re living in poverty,” she explained, “and that meeting their basic needs, food and shelter, may take precedence over their medical needs.

“They learn about why patients don’t always get an appointment when they’re supposed to — because they needed to take three buses or they didn’t have a car or they had to walk,” she went on. “And when they’re more empathetic, they’re able to be more understanding; they’re able to understand the importance of talking to patients about whether they have enough food, about their living situation, how school is going, and more. Doctors don’t typically ask about such things.”

Today, and in large part because of the poverty-simulation seminars, Li, Bakshi, and others are asking such questions, listening carefully to the answers, and using them to help improve their patients’ overall health and well-being.

With that, Li returned to that thought about outside-the-box thinking and going beyond what the book says.

Dr. Shubham Bakshi

Dr. Shubham Bakshi says his role as a teenage girl living in poverty certainly opened his eyes to the challenges facing that constituency.

To get his points across, he used the example of an extremely overweight patient.

“His BMI is in the 95th percentile, which means he’s overweight-slash-obese,” said Li. “You look at his diet history and you see that he’s eating at McDonald’s four times a week. It’s easy to say ‘you should stop that,’ but it’s harder to say that when you realize he’s eating at McDonald’s because it’s the cheapest way that they can get the calories they need to live and to function. I know I have to take it a step further than what’s obvious and telling him not to eat that food.”

Bakshi agreed, and said that before the seminar, he, like most others in his position, would make assumptions and take some things for granted, things he’s learned he shouldn’t do.

As an example, he cited a call he received from a woman living in a shelter concerned about a rash her child had developed.

“I said to her, ‘I’m a little concerned about that because you’re complaining of fever, nausea, vomiting, etc.; why don’t you go to the emergency room?’” he recalled. “Later, I realized she said she lived in a shelter and that it would be hard for her to arrange that transportation. Also, it was 10 at night.

“Now, in that same situation, I think my first question would be, ‘do you have reliable transportation?’” he went on. “Before, I just assumed they did; now, I have changed my perspective and the way I take such calls from these patients. I’ll say, ‘where do you live?’ or ‘who else lives with you?’ or ‘who is supporting you with taking care of the child?’ and ‘how are you making ends meet?’”

Part of the Solution

The gentleman who played the police officer in Li’s poverty-simulation seminar is a greeter at the High Street clinic. Li sees him almost every day.

His heart doesn’t race when he does. But it certainly did that day back during his residency orientation. That’s how realistic that exercise was in essentially bringing Li into a life of poverty and forcing him to somehow survive.

The toxic stress was very real. Also real are the changes in the ways that Li and others like him are looking at, talking with, and treating those who come into their care.

And Molly Senn-McNally has played a lead role in bringing about those changes.

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

Healthcare Heroes

ICU Surgeon Takes Cutting-edge Approach to Help Crush Victims

Dr. Andrew Doben

Dr. Andrew Doben
Dani Fine Photography

Dr. Andrew Doben has two real passions — beyond his family, of course.

Sailing and surgery. Not necessarily in that order, but probably.

They have been both pursuits and professions for Doben, and they are both well-represented on the walls and shelves in his small office at Baystate Medical Center.

Indeed, hanging next to his medical-school diploma is a poster from that famous (or infamous, depending on your point of view) 1983 America’s Cup, the one where Australia II, with its revolutionary winged keel, which Doben would describe in great detail, ended the New York Yacht Club’s 132-year hold on the cup. Not far from a shelf crammed with thick medical textbooks is a photograph of Doben and his children on his boat, a 41-foot Oceanis. And just across from a model of the titanium rib fixture he uses to save (and change) the lives of his patients, is another poster, this one complete with bits of sail flown by America3 in its successful America’s Cup defense in 1992.

“I know they’re genuine,” Doben said of these strips of sail, “because it looks like there’s some salt leaching onto the matting.”

Sailing and surgery; surgery and sailing. Doben can do more than talk about them with confidence and reverence in his voice. He can draw some stirring parallels and analogies between the two professions, as we’ll see. Together, they provide a window into how he views his work as director of the Surgical Intensive Care Unit at Baystate.

Which brings us back to that model mentioned earlier and a surgical treatment known as ‘surgical stabilization of rib fractures’ (SSRF), or rib fixation, which, as that name suggests, uses surgically implanted hardware to stabilize rib fractures. The procedure yields quicker recovery times, decreased mortality, reduced incidences of pneumonia, reduced use of ventilation after trauma to the chest, and less chest-wall deformity.

Doben explained. “With pretty much every bone in the human body, when you break it, you are, in some way, shape, or form, holding that bone stable while it heals, whether you put it in a cast, or you put some degree of fixation on it or through it — you stabilize that bone.

“And almost every bone in the body has had that to some degree, with the exception of the ribs,” he went on, adding that this is largely because they are always moving. “Fractures in motion will not heal.”

Years ago, surgeons would try casting or binding the ribs, Doben noted, but because they are so important to the respiratory process, this strategy is almost universally fatal. “People couldn’t take a deep breath, they got pneumonia, and they died.”

People trust a lot in you when you operate on them, and it’s very similar to the feeling you get when someone asks you to be their captain; they give you their boat, and they ask you to carry them through to safe passage; it’s very similar.”

Matters are further complicated by the fact that, if someone has endured an injury forceful enough to break several ribs, they have likely also damaged one or more of the organs that the ribs protect, he said, adding that for decades the hallmark of treatment of such patients was pain control, which led to slightly improved outcomes, with the emphasis on slightly.

Roughly 75 years of technical and medical developments, accelerated by several wars, have produced a fixation system, one that uses a combination of metal exoskeletal plates and pins to keep the ribs entirely immobile while damaged bone and tissue heal, resulting in reduced pain and a much shorter recovery time, as we’ll see later.

Doben’s emergence as one of the leading practitioners of rib fixation — he has performed the procedure more than 200 times, in his estimation — goes a long way to explaining why he is one of two winners in the Healthcare Heroes category called Innovation in Healthcare.

But that’s only part of the story. His tireless work to help make this surgical procedure more mainstream, thus saving more lives, is another big part. Indeed, while fib fixation is widely available in other countries, that is not the case in the U.S.; Doben is working to change that equation.

He noted that, while the number of rib-fixation procedures being performed in this country has risen, those numbers are skewed by the fact that most procedures are being undertaken at a handful of high-volume centers.

“Only a few dozen people in this country have performed as many as 100 of these operations,” he explained, adding that one of his goals moving forward is to create centers of excellence that will become referral centers for the treatment of people with such injuries and training centers for those who perform the procedure, with Baystate likely being one of the first of these centers.

Taking the High Road

As he talked about the start of his professional career — which saw him on the water, or ‘blue water,’ as it’s known to those who navigate it, and not in the OR — Doben made it clear that, while he misses some if not most aspects of that work, he has no regrets about wearing blue scrubs to work every day.

Nor does he have any regrets about not getting into finance, which would have been the most logical path to take with his degree in economics. Instead, he took, well, a different course, actually hundreds of them, as a professional sailor after being part of a nationally ranked sailing team at Connecticut College, a small liberal-arts school located across the street from the Coast Guard Academy in New London.

“I lived on boats and traveled all over the world,” he explained. “I was a captain and delivered sailboats; I did about 35,000 miles of open-ocean sailing prior to going to medical school.”

Elaborating, he said he was first employed by different companies that would lease out boats for sometimes lengthy excursions. It was his job to sail a boat back after a lessee was through with it.

“So someone might start in Tortola in the British Virgin Islands, and they’d finish in Antigua,” he explained. “Well … somehow that boat has to make it back to the British Virgin Islands. Someone has to have that horrible job of sailing that boat back.”

Later, Doben did well in the business of delivering sailboats to their owners. “Let’s say you live in New England and have a boat you keep in Newport, and you want it in the Caribbean for the winter, but you’re busy; you have a lifestyle where you can’t do it yourself. So you call someone up, and you pay them to bring that boat to you.”

They actually pay more than what he’s making now as a surgeon, Doben said with a smile on his face, noting that, while that life on the ocean sounds like something that would be difficult to leave, he did — and for several reasons.

For starters, life as a sailboat captain didn’t jibe with his ambitions for starting a family — “it’s a tough thing to step aside and say, ‘see you in 35 days,’” he noted. And despite the pleasing picture this lifestyle probably presents in one’s mind, reality is a little different.

“When you’re 600 miles from shore in 140 mile-per-hour winds wondering if your boat is going to sink, it’s not exactly the type of lifestyle most of us want to have in our mid-40s,” he told BusinessWest.

Dr. Andrew Doben

Dr. Andrew Doben can find many parallels between surgery and captaining a sailboat. In both cases, there is what amounts to a contractual agreement.

But, and this is a big but, he desired a lifestyle and a profession that would in many ways mirror what he found on the water.

“I wanted to find a career that was very dynamic, that was constantly changing,” he explained. “One of the things I love about being on the water and navigation is that you can study your whole life and still have things to learn about it.

“No matter what you think you know, things change so rapidly,” he went on, still referring to life on the ocean. “You can start out in the day in beautiful, sunny skies and finish in a tremendous storm, and you have to adjust to it. That dynamic part was something that was very important to me.”

And he’s found it in healthcare, and, more specifically, the operating room.

After going back to college and taking the requisite science courses, he enrolled in medical school at the University of Pittsburgh and quickly narrowed his focus to surgery. And in what couldn’t be considered an upset, he found some parallels between that specialty and being a sailing boat captain.

“I felt that there was a real connection to patients, and much more of what I would call a contractual agreement,” he explained. “People trust a lot in you when you operate on them, and it’s very similar to the feeling you get when someone asks you to be their captain; they give you their boat, and they ask you to carry them through to safe passage; it’s very similar.”

Current Events

Fast-forwarding a little, Doben came to Baystate and its 16-unit surgical intensive-care unit in 2010, a destination he chose because of the specific challenges and rewards it presented. And, once again, he can find similarities to life on the blue water.

“When I made the decision that I was going to this [surgery], I decided that I wanted to take care of the sickest of the sick,” he told BusinessWest. “I have the type of personality where … I was out with a friend sailing a few weekends ago, sailing in 40-miles-per-hour winds. I was having a blast.

“I’m not the sort who gets freaked out by bad things happening around me; I’m just sort of even-keeled,” he said, using terminology directly from his previous profession. “If something’s going wrong, I’m just going to focus and try to solve the problem.”

That phrase ‘sickest of the sick’ is often appropriate when taking about candidates for rib fixation. These are usually the victims of crush, fall, and explosive-force injuries and are often elderly, said Doben, adding that he considers himself at the forefront of efforts not only to perform this procedure, but to educate the medical community about its ability to save lives and improve quality of life, while dramatically reducing the overall costs of treating such patients.

“Most bones heal in six weeks, but with ribs, because they’re constantly moving, you’re talking about three to six months,” he said while explaining the many benefits to be derived from this procedure. “If you’re a contractor and you’re self-employed, and you have a raise a hammer over your head, six months to not be able to do that is a long time.

“Roughly 60% of the people who have a severe chest-wall injury remain unemployed for up to a year,” he went on. “We can get people back to work, full-time employment, in three to six weeks.”

He reports that some progress has been made in mainstreaming SSRF, but there is still considerable work to be done.

“In 2009, we wrote a paper on this during my fellowship, and we basically had tomatoes thrown at us when we were at the national meetings,” he recalled. “And now, we’re asked to come to the national meetings and talk about it; it’s been such a frame shift.”

Progress is reflected in the number of rib-fixation procedures being undertaken in this country, he went on, noting that there were maybe 100 cases performed in 2001; by 2014, that number had risen to more than 3,300.

But behind those statistics are some troubling trends, he went on, adding that there are only 20 surgical centers across the country that are performing this surgery more than 30 times a year.

“Most centers are doing one or two a year,” he explained. “And when you look at the patient pool and the injury-severity scores, meaning ‘how badly injured is this patient?’ the number is almost double at the high-volume centers. So the sicker patients are being treated at the high-volume centers, and the mortality is half what it is at the lower-volume centers. So the lower centers are seeing patients who aren’t as sick, with less frequency, and they’re having worse outcomes.

“And that makes sense,” he went on. “If you don’t do the operation a lot and you don’t have a lot of experience, your outcomes are not going to be the same. This is concerning to me, and we’ve been working on that.”

This work is largely focused on creating those centers of excellence he mentioned, adding that he and others with the Chest Wall Injury Society are working to establish the criteria for such centers.

And there is much more to this than having specialists who can perform the rib-fixation surgery, he explained.

“The operation is only one-tenth of the puzzle,” he explained. “The puzzle is the team that takes care of these people. The respiratory specialists, the ICU, anesthesia, the pain management, the post-op management, the physical therapists … it’s a whole host of people. The operation just helps accelerate that process.”

And while establishing these centers of excellence that the ill and injured can be referred to, Doben and others will work to greatly increase the number of surgeons who perform this procedure, with an eye toward improving care in currently underserved areas.

Elaborating, he said there are maybe two dozen facilities that may soon become centers for excellence, and most are clustered in the western part of the country, where there are higher incidences of motorcycling and skiing injuries. Other parts of the country are underserved, he went on, listing Boston, where there is only one surgeon who performs this procedure, as an example.

“There are many people who don’t even know this procedure is available,” he said, adding that his goal now is to not only change that equation, but make the procedure available to more people.

Stemming the Tide

Returning to his thoughts about why he chose surgery as a profession and the ICU as the place to call his professional home, Doben recalled something that a friend of his father and a cardiologist by trade once said to him — something that has obviously stayed with him.

“He said, ‘being a doctor is a great privilege, where you get to see people in their most vulnerable states,’ and there’s nothing more true about that than the ICU, both for patients and families. And I enjoy that relationship of being able to work with people to get them through all that, to get them to safe passage.”

“Sometimes they don’t get there; they don’t survive,” he went on, adding that helping people live out their final days and moments in dignity is often as rewarding as saving a life.

That reference to safe passage was yet another analogy to sailing, a profession Doben has left behind him. Yet the sailing mindset remains — to focus on the horizon and chart a course that will get where you need to go.

And with SSRF and the challenge of bringing that breakthrough technology to more of the people who can benefit from it, he has done just that.

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

Healthcare Heroes

Nursing Professor Helps Young People Build Resiliency

Genevieve Chandler

Genevieve Chandler
Dani Fine Photography

James Bowe Jr. had a few full-scholarship offers come his way during his senior year of high school in Miami, Fla.

But at 180 pounds, most of the elite football programs considered him too small to excel at his position — outside linebacker.

He chose to accept an offer from a school that he said stuck by him when others didn’t — UMass Amherst — but was soon to discover that being undersized was only one of many stress-inducing challenges he would encounter on and off the practice fields outside McGuirk Alumni Stadium after arriving in 2015.

“The biggest change for me coming out of high school was the speed of the game and how much you had to learn — we had to develop quickly, because there’s a lot of different plays and a lot of terminology you have to learn,” he said. “And along with my practice schedule, I had my classes and everything else; it was a lot for me to handle, and that affected me in the classroom.”

And there was still more that he needed to cope with, whether he knew it or not.

Indeed, as he would discover, the death of his sister not long before he arrived at UMass had left scars that hadn’t fully healed — there were feelings he needed to get off his chest and emotions that he had to confront.

And confront them he did, while also putting a huge dent in his stress level, thanks in large part to a unique program blueprinted by Genevieve Chandler, associate professor of Nursing at UMass Amherst. It’s called Changing Minds Changing Lives (CMCL), and it was created and piloted by Chandler on the basic premise that resiliency is something that can and should be taught, developed, and built.

“It’s long been thought that people were resilient or they were not resilient,” said Chandler, who so impressed the judges with her work on this subject to date that she became one of two winners in the category of Innovation in Healthcare. “But researchers concluded that everyone has resilience; the question is how much and what we can do about it. Researchers realized that we not only carried something inside, but we needed access to resources outside to build that resilience.”

Elaborating, Chandler said much of her career’s work has been in the realm of creating such resources, especially as they relate to adverse childhood experiences, or ACEs, as they’re called.

It’s not about what you don’t know, it’s about what you do know, and that makes it different from most classes. It’s not about deficits, it’s about strengths. I can’t teach you about you; you’re going to have to teach me about you.”

These include physical abuse, sexual abuse, emotional abuse, and the broad category of household dysfunction, which includes everything from substance abuse to incarceration; from domestic violence to divorce or death of a loved one.

That’s a long list, and a host of studies have concluded that perhaps 60% of the population has an ACE, or several, in their background, said Chandler, adding that studies have also shown direct links between these experiences and physical and mental illness.

Her work, and especially the CMCL initiative, is aimed not only at focusing attention on ACEs and their impact, but also at helping individuals move past these ACEs by teaching them resiliency.

How? Through a broad course of study that includes everything from deep-breathing exercises and yoga to group writing (lots of that, as we’ll see later) and storytelling.

These elements and this mindset came together in the pilot program, what Chandler called a “strengths” class offered at the university, one that attracted a broad mix of students, and, later, an expansion of the initiative to include those involved with Holyoke Community College’s Gateway Program for students who had dropped out of high school.

These successes caught the attention of Jim Helling, athletic counselor for the university, which led to a program involving incoming football players, all of whom, like Bowe, were dealing with a host of challenges and experiencing high levels of stress.

And Bowe is just one of many who can testify that CMCL has certainly helped in that regard.

“This class helped me get adapted to college, and taught me a lot of different ways to handle stress; it taught me to just breathe,” he said, saying that last word slowly for special emphasis. “We were taught to breathe and calm down during stressful situations. That next semester, after I took this class, I was able to get my GPA back to where I needed it to be.”

Breathing is just one of the lessons Bowe and teammate Martin Mangram, a safety from Buford, Ga., imparted upon a group of Springfield Central High School football players they mentored as they took essentially the same class offered to the incoming players at UMass in the latest, and apparently successful, expansion of the CMCL initiative.

Genevieve Chandler, seen here with incoming UMass football players

Genevieve Chandler, seen here with incoming UMass football players, says resiliency is something that can be taught or developed.

“We feel it was very successful,” Tad Tokarz, the school’s principal, said of the study, which involved a handful of players. “And speaking to students, they would tell you they’ve grown, and they can tell you how they’ve improved in recognizing emotions and building resilience.”

Course of Action

Helling, a psychiatric social worker as well as athletic counselor at UMass Amherst, was one of those offering instruction and insight to those football players at Springfield Central this summer.

And he said he started one of his presentations by putting up a picture of Charles Darwin on the screen at the front of the room and then focusing the conversation on the naturalist’s theory of ‘survival of the fittest’ — and in a way that hits at the heart of the CMCL initiative.

“The fittest does not mean the physically strongest,” Helling told BusinessWest. “The fittest means the best fit; it’s not the strongest or the biggest or the smartest that survives. The ones who survive are the ones who fit in best in their environment and meet the challenges that their environment presents to them.”

Helping young individuals become far more fit — in this respect — has become the focus of Chandler’s research, and life, in recent years. And this work in resiliency (technically defined as one’s response to adversity) continues what she said is a career-long focus on mental-health nursing, and, more specifically, what she called the “health and strengths aspects of one’s life, rather than the illness aspects.”

Elaborating, her approach has long been to focus on an individual’s strengths, rather than their problems, especially within the realm of ACEs, something she’s been studying for decades.

“I’m committed to using the notion of resilience to respond to the effects of adverse childhood experiences,” she told BusinessWest. “And I’ve learned how much ACE effects physical illnesses such as chronic lung disease, heart disease, anxiety, depression, and cancer; the higher the score for adverse childhood experiences, the higher the likelihood of biological and psychological illness.”

The resilience course Chandler has developed, number N297T in the university’s database, is officially called “Torchbearer: Stress Buster or Strength Builder.” (Actually, it likely does both).

The syllabus comes complete with a stated rationale — “identifying inherent strengths, developing agency, and managing stress to develop social connections and build resilience, promotes health and leads to success in college, community, and career” — as well as a course description, which reads:

“Build individual strengths to empower stress management and increase resilience. Research, mindfulness, and focused writing are applied to increase awareness of emotional responses to life’s challenges and facilitate social connections to increase leadership capacity.”

There are also several formal objectives. Indeed, upon completion of the course, the syllabus reads, the student will able to:

• Analyze individual strengths;

• Utilize health-promoting stress-management strategies;

• Foster a sense of community across lines of difference;

• Promote individual resilience;

• Negotiate a social-support network of mentors, role models, and peers; and

• Demonstrate strategies to facilitate individual leadership capacity.

The required text is just one thing, by Rick Hansen, subtitled “developing a Buddha brain one simple practice at a time.”

This is a different kind of college course in many ways, said Chandler, who explained what she meant by that.

“It’s not about what you don’t know, it’s about what you do know, and that makes it different from most classes,” she explained. “It’s not about deficits, it’s about strengths. I can’t teach you about you; you’re going to have to teach me about you, and that’s how we set up the class.”

Exercise in Resilience

Slicing through all that’s in the syllabus, Chandler said those taking this course essentially teach themselves how to become more resilient.

They do so through creation of a ‘strength plan,’ through a focus on what she called the ABCs of resilience:

• Active Coping, which could include exercise, medication, or yoga;

• Building Strength, which she said means focusing on one’s strengths and not one’s weaknesses or problems;

• Cognitive Awareness. “This means being aware of our thinking,” she explained. “So often, we get caught up in catastrophic ways of thinking, like ‘I’m going to fail a quiz’ or ‘I’m not going to be able to make a car payment;’” and

• Social Support, which, she said, involves understanding that people should call on their lifelines much sooner and build their social support so they have people they can lean on.

“Those are the ABCs, and that’s what we teach,” she told BusinessWest, adding that the course was first taught to essentially any student who wanted to take it four years ago, while the program for the incoming football players was started two years ago.

And that latter initiative is already registering measurable results, she went on.

“Half the incoming football players took it, and half didn’t. And then we measured what happened, and we saw a difference in their resilience, in their stress management, and emotional awareness — a big difference,” she said, adding that the results of that study were published, and the outcomes of a study on the second class of players were in the process of being sent to the Journal of American College Health.

“It’s incredible how fast 17- and 18-year-olds put this into their life,” she said of the football players and their embrace of the ABCs of resilience. “Most of them don’t sleep very well, and in two nights, they’re sleeping better.”

Mangram is among those getting more and better rest at night. He told BusinessWest that the class enabled him to respond better to adversity and to deal with stress, rather than let it accumulate, as he did before CLCM.

“This class really helped me realize that I’m not crazy for stressing, and it’s not abnormal to be going through what I’m going through,” he explained. “And it gave me ways to release stress rather than just recognize it, which is what I did in high school — just carrying it over day by day where it’s constantly pounding you down; this helps me start fresh every day.”

And while she spent a good deal of time talking about college football players and their efforts to build resilience, Chandler said the same theory, and the same practice, applies to just about everyone.

“People will say, ‘I’m taking deeper breaths now, and I don’t react as fast; I now respond to things instead,’” she told BusinessWest. “They say, ‘I think about things a little more, and I talk to a friend about things first about what’s going on with me.’ And this is resilience, and then they can thrive in college and in life.”

Gaining Ground

This has been accomplished through the combination of everything in the CMCL playbook, if you will, from deep-breathing exercises (something the Central students were taught as well) to the yoga poses, to the writing assignments and the discussions that followed.

Indeed, writing has become a big part of the CMCL blueprint, said those we spoke with, adding that these exercises ultimately help individuals open up, share challenges and emotions with others going through most of the same things, and, ultimately, release some of the stress that’s been accumulating.

Chandler said she has long been a strong advocate of the Amherst Writers & Artists (AWA) Method, developed by Pat Schneider, author of the book Writing Alone and with Others.

Jim Helling

Jim Helling evokes Charles Darwin as he talks about survival of the fittest from the perspective of being able to respond to adversity.

The ‘method’ is to encourage writing and provide a safe environment in which individuals can experiment, learn, and develop their craft through practice and helpful response from other writers.

Chandler has used the method in many classes she’s taught over the years. Participants generally write to a specific topic at each class, and in most all cases, the results have surprised and encouraged her, while providing more evidence that resilience can indeed be taught and built.

“In one class, they were asked to write about something they had as a child, but don’t have now,” she told BusinessWest, referring to a program at Springfield’s Putnam High School. “Two-thirds of the students wrote about their father. I thought they’d write about a bike or a toy. But that’s how fast people take to writing about what’s important to them.”

The same has proven true with those taking the Torchbearer course, she said, adding that the opportunity to write and then gain support from those who hear what you’ve written has proven to be a powerful force in efforts to become a stress buster or strength builder.

“What’s interesting is that, when you give people the opportunity to write about strengths,” she said, “they feel safe enough to write about problems, which we don’t ask for, but we listen to and focus our feedback on moment of strength within the problems that arise.”

The upshot of all this, when it comes to the football team, is that the players are bonding in a way they didn’t before, said Chandler, and they’ve become more supportive.

“They’ve said that this gets them to know each other better,” she went on. “And that builds a stronger team — they all believe they have each other’s back.”

Bowe concurred. “A lot of people are afraid to talk about stuff they’ve been holding onto for a while,” he said, adding that, for him, the death of his sister certainly fell into that category, and writing about her and then sharing what he wrote with others certainly helped in the healing process.

“When I wrote about that … it was very hard for me to do,” he told BusinessWest. “But we were asked to write about a time when we had to overcome adversity, and that’s what I chose to write about.

“None of my teammates knew about it, and that’s how they found out — that allowed me to get that off my chest,” he went on. “After that, my teammates came to me and comforted me at a time when I needed it most.”

In his recent role as mentor to the Central High School students, he said his unofficial assignment was to help the students open up as he did, and, in the process of doing so, cope with ACEs, focus on strengths, and become more resilient.

“I’m here to let them know that it’s OK to open up,” he explained, “and make it clear that are other people here who are going through the same things that they are.”

Mangram agreed.

“I enjoy being a mentor,” he noted. “It’s a fun experience and a very eye-opening experience. I think I’m making a difference with them — even if they don’t realize it right now.

Tackling Life’s Challenges

Bowe said he managed to get on the field for a few special plays during his first season with the Minutemen, and he’s looking to hear his number (13) called a lot more this coming season.

He’s put some weight on his 6-foot frame and is now officially listed at 192 pounds on the team’s roster. That’s still a little undersized for a linebacker in the FBS Division.

But as he copes with that challenge and the many others he faces, Bowe is certainly more fit than he was a few years ago — as Charles Darwin might say.

And as Genevieve Chandler would say. She’s the architect of the CMCL initiative, and a true hero when it comes to innovation in healthcare.

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

Healthcare Heroes

Partnership Brightens the Picture in a Springfield Neighborhood

The Healthy Hill Initiative

The Healthy Hill Initiative
Dani Fine Photography

Helen Caulton-Harris described Donna Blake as a pioneer of sorts.

Indeed, she was one of the first African-American women to take an administrative role with the city of Springfield. But beyond that, she was extremely active within the community, working at the Urban League for decades, serving as a parks commissioner, and always advocating on behalf of children and their well-being.

“She was a staple in the community,” said Caulton-Harris, commissioner of the Division of Health and Human Services in Springfield. “Everyone in the city went to Donna Blake for advice and guidance.”

So it’s only fitting, then, that the small park named in her honor has become a symbol of sorts for turnaround efforts in the Old Hill Neighborhood of the city, and one of the focal points of a multi-faceted initiative called Healthy Hill.

Not long ago, Donna Blake Park was a place to avoid — unless you were looking for drugs or trouble, which you could find easily and in large quantities. As a result, parents didn’t want their kids playing there. The park became a flash point, a symbol of everything that was wrong with that neighborhood, one of the poorest in the city — and the state.

Today, though, the park is, well, what it was created to be — a resource, a gathering spot, a place to exercise, a haven within the neighborhood, especially for its young people.

And it became all this largely because of the Healthy Hill Initiative, or HHI, as it’s known, an endeavor that epitomizes the term ‘collaboration,’ and was the clear winner in that specific Healthcare Heroes category.

HHI is one of 18 sites funded by the BUILD (Bold, Upstream, Integrated, Local, and Data-driven initiatives) Health Challenge, a national grant program created to improve health and well-being in low-income communities. With $2.5 million awarded over five years to the coalition, as well as matching grants, the Healthy Hill Initiative has been working to change the health landscape in Old Hill by focusing on what Frank Robinson, vice president of Public Health and Community Relations at Baystate Health and one of the initiative’s architects, called “the dynamic intersection of two social determinants of health — public safety and access to physical activity.”

It does this through a number of initiatives, from indoor fitness activities for seniors through a collaboration with the YMCA of Greater Springfield and the Springfield Housing Authority, to C3 police efforts designed to build trust and supportive relationships, to a hugely successful program called Let’s Play that has involved more than 65 young people who participate in physical-fitness activities at Donna Blake Park at least two Saturdays a month.

“Let’s Play has been really exciting,” said Sarah Page, senior vice president of Community Building & Engagement for Way Finders, one of the collaborating entities. “Lots of kids come out and play, and the police often come and play with them. And the police feel they’re building wonderful relationships with those young people, which can really make a difference.“

“Years ago, you felt that you were pretty much safer if you just stayed home. But over the years, things have changed, and the neighborhood is transforming itself.”

HHI is a large, very involved collaborative effort, with more than a dozen players. In addition to Way Finders (formerly HAPHousing), which took a lead role in the initiative, as did Partners for a Healthy Community, participating entities include Mercy Medical Center, Baystate Health, Revitalize CDC, the Old Hill Neighborhood Council, and six city departments, including Health and Human Services and the Police Department.

These agencies were all working toward improving Old Hill before HHI was launched, said Caulton-Harris and others we spoke with. But this endeavor took them out of their respective silos and brought them into the same room — literally — and the same fight for better outcomes.

Bur rather than talk about how it all came together and why, those involved were clearly more interested in discussing the many forms of progress it has yielded.

Awilda Sanchez, vice president of the Old Hill Neighborhood Council and a 25-year resident of that area, said the changes are palpable.

“Years ago, you felt that you were pretty much safer if you just stayed home,” she recalled. “I didn’t go out at night, and my children did not play in the public parks. But over the years, things have changed, and the neighborhood is transforming itself.”

Certainly one of the more poignant measures of improvement is the relationship between young people and the police, as related by Beatrice Dewberry, manager of Way Finders.

“Initially, when the police first began to interact with some of the kids who live in a public housing unit on Pendleton Avenue, a boy walked up to the sergeant and said, ‘I don’t like police; you guys arrested a family member and put him in jail for a long time, so I don’t like you guys,’” she recalled. “Now, each week, when we play, the same kid says to the police, ‘when are you guys coming?’ He can’t wait to connect and engage with the officers.”

Defining Moments

Webster defines collaboration as a willingness to “work jointly with others, especially in an intellectual endeavor.”

Those last few words take on new meaning in an age when the health- and wellness-related problems in society are large in scale, complex in nature, and require collaborative efforts if they are to be effectively addressed.

So much so that, as BusinessWest talked with a large and distinguished panel of advisors as it was bringing the Healthcare Heroes program to reality, those individuals made it clear that a category devoted to collaborative efforts should be established.

One was, and it drew a large and diverse mix of projects, all of which drive home the point that, when groups with common goals and ample amounts of energy, imagination, and persistence come together, powerful things can happen.

Nowhere is that more evident than in Springfield’s Old Hill neighborhood, a once-proud (it’s getting back there) enclave of roughly 4,300 residents.

Like many of Springfield’s neighborhoods, Old Hill, largely populated by Hispanics and African-Americans, has experienced years of disinvestment and complex challenges ranging from higher rates of poverty, lower graduation rates, an active drug trade, gang activity, higher rates of violent crime, and increased incidences of chronic disease and obesity, said Robinson. These matters were further complicated by the fact that the June 1, 2011 tornado tore across parts of Old Hill, causing considerable damage.

With an eye toward addressing health- and wellness-related issues in Old Hill, a host of local agencies and city departments came together behind a common vision, he went on, adding that, in many ways, Peter Gagliardi, president and CEO of Way Finders, was the catalyst by bringing attention to the direct correlation between housing and health and essentially inspiring a call for action.

Sarah Page

Sarah Page says the Let’s Play initiative has brought children — and adults — back to Donna Blake Park, which for decades had been a place to avoid.

“He pulled together 40 to 50 people in his office to talk about this connection,” said Caulton-Harris. “There was a recognition of the need to address this intersection of health and housing.

“There was work going on in that neighborhood involving housing and health,” she went on. “But they were separate initiatives; this effort brought them together.”

The effort she referred to took the form of a proposal for the BUILD Health Challenge that was worthy of all those adjectives that make up that acronym (again, they’re ‘bold,’ ‘upstream,’ ‘integrated,’ ‘local,’ and ‘data-driven’).

By way of clarification, those with the BUILD Health Challenge define ‘upstream’ this way: “partnerships that focus on the social, environmental, and economic factors that have the greatest influence on the health of a community, rather than on access or care delivery.”

And the Healthy Hill Initiative certainly fits that description, said Page, noting that the HHI was clearly focused on those social factors, including everything from housing to public safety to neighborhood infrastructure and facilities — or the lack thereof.

And the application efforts were certainly helped by the fact that there were already initiatives in place to help revitalize Old Hill, including a five-year strategic plan created after the tornado as well as Revitalize CDC’s plan to revitalize 10 blocks of the neighborhood over a 10-year period, an endeavor launched in 2012.

The initiative is also data-driven, said Jessica Collins, executive director of Partners for a Healthier Community, adding that her agency and others involved could look at maps of Old Hill and identify blocks where there were high incidences of asthma, obesity, and other problems.

“It was exciting for us to be able to look at that granular level of health data,” she explained, noting that it was necessary to apply for the grant. “We had never done that before.

“We had an amazing team working on data; information came from health clinics, the school system, and other sources, and then put through GIS,” she went on, adding that the Pioneer Valley Planning Commission and Baystate Health both worked to crunch the numbers.

And they revealed that considerable work needed to be done, Dewberry said, adding that the accumulated data was used, along with considerable feedback from the community, to develop specific strategic initiatives, especially in the realms of physical activity and getting young people back out in the parks.

Exercise in Collaboration

But for that to happen, residents had to be convinced that the park was safe, and this took some doing, said Sanchez, adding the park was known as a place for gang recruitment and a host of illegal activities.

Parental approval was required to get children to the park, she went on, adding that people went door to door to secure this approval.

The resurgence of the park has had a transformative effect on the rest of the neighborhood, said all those we spoke with, adding that the return of children playing, the interaction between young people and police, and other positive developments have helped convince Old Hill residents that change is in the air — and they should be out in that air.

“The playing, the physical activity, the public-safety piece, having a safe environment for children … those pieces are critical,” said Caulton-Harris. “And when people see activity in the neighborhood, it definitely makes residents feel it’s safe to come out of their houses, particularly the elderly.”

Dewberry agreed, and told BusinessWest that, beyond a greater overall feeling of safety, the various components of HHI have contributed to creating a neighborhood that is in many ways better connected, something it has certainly not been historically.

“We talk about social cohesion and building this unified, connected neighborhood,” she explained. “And a lot of what we’re doing with the Healthy Hill Initiative is working toward that end.

“Let’s Play is a great example of that,” she went on. “For example, an elderly couple that has custody of their grandkids, they didn’t let the kids come out, but now they do, and they come out as well, to engage with us and engage with the other kids. We have parents and guardians coming, as well as resident health advocates, who also come. We’re developing community and building that social cohesion that has proven to be effective in deterring crime and reporting crime.”

Meanwhile, Healthy Hill Initiative has become a leading-edge example of how healthcare providers, moving beyond a fee-for-service model and into an accountable-care model, are taking on new responsibilities with regard to the health of the communities, and embracing that role, said Doreen Fadus, executive director of Community Health and Well-being at Trinity Health of New England and Mercy Medical Center.

“From a hospital perspective, this initiative and others have changed the culture, especially of the leadership of the hospital,” she explained. “Instead of thinking that these are nice things that the hospital does, these are things we have a responsibility to do to make the neighborhood healthier.

“As we move away from fee for service and just treating people when they’re sick, the leadership is more focused on the social determinants of health. This is our mission; these are the things we should be doing in the community.”

As Sanchez surveys Old Hill today, she sees less blight, she told BusinessWest, a direct result of many of the initiatives taking place in that neighborhood to rebuild properties and clear vacant lots once used as dumping grounds.

But she also sees more green — in the form of flowers, new trees, and vegetable gardens — and, most importantly, more people, who obviously feel safe enough to walk, exercise, and get some fresh air.

And with all that, she’s seeing a lot of what she left behind when she moved here from Puerto Rico decades ago.

“In Puerto Rico, communities are people knowing each other on the block, helping each other … the kids are being cared for by everyone,” she explained. “That’s what I wanted to see in Old Hill, and we’re starting to see that. I can see the difference.”

It came about because of determination, imagination, and, most importantly, collaboration.

Developing Story

Returning to that story she told about the young boy living in the public housing project who once hated police but soon couldn’t wait to engage with them in the park, Dewberry said her agency has tons of pictures of police and young people playing together.

Perhaps more than anything else, these images tell the story of how Old Hill is experiencing change and progress. Not so long ago, this neighborhood, and the park that has been at the forefront of so much that has happened, were the picture of disinvestment, the picture of a neighborhood in crisis.

HHI has brought better times, and better health, into focus.

And Donna Blake would certainly be proud.

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