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NORTHAMPTON — Dr. Lynnette Watkins, the new president and CEO of Cooley Dickinson Health Care, announced the receipt of a $1 million gift from John and Elizabeth Armstrong of Amherst to support the hospital’s Emergency Department.

“It has been an honor and a pleasure to talk to the Armstrongs about their commitment to the Emergency Department,” Watkins said.

The Armstrong’s gift will support Transforming Emergency Care: Campaign for the Cooley Dickinson Emergency Department, a $15.5 million expansion, reconfiguration, and renovation which will allow the hospital to meet the ever-evolving emergency medical needs of community members, from infants to older adults.

For John, whose accomplishments include a 30-year career at IBM and serving as a presidential-appointed member of the National Science Board, supporting the hospital fits in with his and his wife’s philosophy of giving. “Lise and I are blessed to have resources, and one of our main criteria for giving is to help out right where we are,” he said.

Their reasons to support Cooley Dickinson are born of direct experience. “I’ve seen firsthand the growing pressures on the Emergency Department,” John added. “I have been admitted to the ED on at least three occasions, and I’ve witnessed the increasing number of patients relying on the department. Each time, I received excellent care and service despite the fact that the ED can be overcrowded.”

Elizabeth added that “we live in a retirement community with 115 other elderly people, many of whom need Emergency Department services. For their sake, as well as for our own possible future needs, we’re glad to have a role in making the Emergency Department as efficient and up-to-date as possible.”

Cooley Dickinson’s Emergency Department is 40% undersized to meet the community’s needs and cares for many patients who require critical medical attention. The number of patients visiting the department has grown from 17,000 annually in the 1970s to nearly 34,000 in recent years. For those patients, Emergency Department teams treat approximately 300 traumatic injuries per year; last year alone, over 6,000 patients needed to be admitted for further care.

The Armstrongs recognize the urgency of expansion and renovation. They also recognize that hospitals everywhere are financially challenged, due to changes, beginning in the late 1980s, in state and federal reimbursements. More recently, the COVID-19 pandemic, which led to a dramatic slowdown in volume of patients and in revenues, has put the importance of philanthropy into sharp relief.

“Cooley Dickinson is grateful to John and Lise Armstrong for their generosity and for understanding that charitable giving is a critical resource to provide access and deliver the range of healthcare our community needs, demands, and deserves,” Watkins said.

Gifts to the Emergency Department will support more and better designed spaces and increased privacy for patient care, faster access to computerized tomography (CT) scans, improved coordination of care to allow face-to-face communication between providers and nurses, and more patient rooms.

Other planned improvements include enhanced geriatric care, a larger behavioral-health pod, a pediatric observation unit, and a streamlined admission process.

The groundbreaking for the Emergency Department renovations is expected to occur at the end of 2022.

Health Care

‘A Wonderful, Wonderful Fit’

 

Dr. Lynnette Watkins says she is most definitely her father’s daughter.

By that, she meant she is a second-generation ophthalmologist, following the lead set by her father, L.C. Watkins, who is one of the first African-Americans practicing in that specialty in St. Louis.

“When I say that I stand on the shoulders of giants, I don’t take that lightly, and first and foremost is my dad,” she noted. “He’s been my biggest supporter, mentor, and point of light.”

But there were other influences as well, including her mother, an educator, and, more specifically, an early-childhood-development administrator, who was one of many who taught her the importance of giving back.

“It was always expected that, with the privileges and opportunities that were afforded to me, there was an expectation to serve and to give back,” she said. “Which is why, with each position and opportunity that I’ve pursued, I’ve always had that mindset first and foremost in my mind; it’s why I wanted to have a career in healthcare.”

This is the philosophy Watkins brings to her latest assignment, as president and CEO of Cooley Dickinson Hospital in Northampton. 

She takes the helm at CDH after a lengthy stint as chief medical officer for the Baptist Health System/Tenet Healthcare – Texas Group, and arrives at an obviously stressful, tenuous, and uncertain time for all healthcare providers, one still dominated in every way by the COVID-19 pandemic and its latest surge.

“While there’s been a lot of challenge and a lot of sadness during the pandemic, there’s also been some wonderful lessons and teachings in the resilience of people.”

Watkins, who arrived at the hospital on Sept. 27, brings to this challenge, and CDH, a wealth of experience. Like a growing number of those leading hospitals and healthcare systems, she has made the transition from direct patient care to managing those who provide that care. For her, it was a seismic but, in many ways, natural change.

“Many people have asked if the transition was difficult, and I’ve said that it was not,” she explained. “That’s because I found myself at peace moving from a clinical role to one that still has clinical elements, but instead of being the one-on-one patient-physician relationship, which is incredibly treasured, it’s one where I have the ability to impact multiple patients and improve the working lives of staff, medical staff, and other providers. I can make a bigger impact on a broader scale.”

She said there were many factors that went into her decision to come to CDH, summing them up with that often-used phrase “it was a perfect fit.” Elaborating, she said the area served by Cooley Dickinson, mostly Hampshire and Franklin counties, is one with a great deal of need, and she has experience working with such populations, as we’ll see.

Beyond that, she said this opportunity allows her an opportunity to take what she has learned at many different stops during her career and apply them to what will be a different — and obviously significant — challenge.

Lynnette Watkins says one of her first priorities will be meeting with as many community leaders and constituencies

Lynnette Watkins says one of her first priorities will be meeting with as many community leaders and constituencies — as well as frontline caregivers and hospital staff — as possible.

Watkins said the learning process has continued through COVID, which she believes has brought out the very best in those working in healthcare, while also putting an even greater focus on teamwork, collaboration, and innovation.

“While there’s been a lot of challenge and a lot of sadness during the pandemic, there’s also been some wonderful lessons and teachings in the resilience of people, resilience of systems, the importance of self-care and downtime, and the importance of working with others and understanding that it’s OK to say, ‘I need help,’” she explained. “What this has also done is challenged us to innovate, whether it’s in processes, such as supply-chain initiatives with PPE or the distribution of vaccinations and other pharmaceuticals such as monoclonal antibody infusions, or working together in groups to really take care of our community.

“That resilience, that collaboration, that innovation, that devotion to self and others have really been positive,” she went on. “The patience and working with a team have really helped me grow — as an individual, as a physician, and as a healthcare leader.”

For this issue, BusinessWest talked at length with Watkins about her latest assignment, why she came to CDH, and … how being her father’s daughter will help her as she takes on this latest career challenge.

 

Background — Check

In some ways, Watkins said, coming to CDH is like coming home — or at least coming back to that part of the country where she did her residency.

Specifically, that would be Mass Eye and Ear in Boston. But she did get out to the Northampton area on several occasions during those residency years, so she’s not a total stranger to the 413.

There were several career stops between Boston and CDH, including a lengthy stint back at Mass Eye and Ear, where, from 1999 to 2004, she directed the Emergency Ophthalmology Service and walk-in clinic and was an attending physician in the Ophthalmic Plastic Surgery Service. And Watkins said all of them have helped her grow as both a provider of care and a manager of people. And she intends to put all of that experience to work at CDH.

Our story starts in Missouri, where Watkins, as noted, became intent on following her father into the medical field and earned her undergraduate and medical degrees at the University of Missouri – Kansas City and an internship in internal medicine at Truman Medical Center in Kansas City.

“I grew up wanting to go into medicine, and I was asked quite often if I was going to be an ophthalmologist like my father,” she recalled. “Candidly, I got tired of the question. It was through a series of rotations and the fact that I needed money for car insurance that my father said, ‘why don’t you come work for me in my office?’

“I did, and I liked it,” she went on. “I didn’t tell him for a while, but I did make that transition, and eventually declared that this was the specialty I wanted to be in.”

This decision brought her to Mass Eye and Ear in 1995 for her residency and stint at the at the walk-in clinic and Ophthalmic Plastic Surgery Service. She was there during 9/11, a moment in time and her career that convinced her to be closer to family and, in her words, “focus more on family.”

Elaborating, she said she went into private practice in Indiana and eventually became managing partner of a multi-specialty group, one with a large geographic footprint.

The administrative leadership of that group would later put it in “a significant financial disadvantage,” as Watkins put it, adding that she was thrust into the role of interim CEO. She said she would eventually wind down the two parent companies into multiple spinoffs, which are still ongoing today, an experience she described as both challenging and rewarding, and  one that would in many ways inspire her transition into management and leadership roles.

“We were able to keep patients seen, keep people employed, and move colleagues forward so they were able to practice — it was a huge, huge learning experience,” she told BusinessWest. “I joined one of the spinoff groups, but found myself wondering why I went through that experience.

“And it was actually a couple of colleagues, neither of whom had medical backgrounds but did have healthcare-industry backgrounds, who said, ‘this happened to you for a reason; you have this knowledge — why don’t you consider leading a hospital or healthcare system and pursue healthcare administration?’”

She thought about it and talked with family members, especially her father, to get buy-in and support. After securing it, she started pursuing healthcare administrative positions.

Her first stop was at Trinity Health in South Bend, Ind., and from there she joined Tenet’s Abrazo Community Health Network in Arizona as chief medical officer.

When that position was one of many eliminated in a round of budget cuts, she used connections she’d made to land a job as chief medical officer and chief operating officer at Paris Regional Medical Center in Texas, a system that was and is surrounded by some of the poorest counties in Texas and neighboring Oklahoma. Her time there was another important learning experience.

“One of the great joys of working there was working with people who keep in mind the individual who has limited access, limited transportation, and limited resources,” she said. “And in rural facilities where often there is one specialist or one type of provider, and there is limited access, having a high level of collaboration, particularly with the medical staff and the provider staff, is very important.

“Overall, that was an incredible learning experience, understanding the intricacies of running a facility that’s technically complex,” she went on, adding that, as chief medical officer and chief operating officer, she had oversight over just about everything except nursing, finance, and HR.

 

Right Place, Right Time

The learning experiences continued at the Baptist Health System/Tenet Health Care, where that system confronted not only COVID, but the severe — and highly unusual — weather pattern that visited most of Texas near the end of February.

Some called it ‘Snowvid,’ said Watkins, adding that healthcare systems had to confront not only the pandemic, but extreme cold that knocked out power and water to many communities.

“We had COVID patients, we had no electricity, we were on generators, and we did not have water, she recalled. “Managing through all that was a challenge, although what each of these events has shown is that it has not changed why we do what we do, but it does force us to change how we do it.”

Elaborating, she said some recent developments or trends will continue for the foreseeable future, including telehealth, which she described as a game changer for both the inpatient and outpatient sides of the equation. This became evident in Texas, as well as the hospital that would become the next line on her résumé.

Watkins told BusinessWest that the position at CDH came to her attention through a recruiter, and after more talks with family and friends, she decided that managing a smaller community hospital would be an appropriate next step on her career journey.

“It’s a wonderful, wonderful fit,” she said of CDH, adding that her views on the delivery of healthcare and areas of focus are in sync with those of the hospital and its staff. “First and foremost, I’m a physician, and I want to make sure that we’re delivering safe, high-quality care and that we’re great stewards of resources, whether it’s finance or personnel or capital, and that’s what Cooley Dickinson does.”

Elaborating, she said the opportunity to lead a hospital that is an affiliate of the Mass General Brigham system, formerly Partners Healthcare, was also appealing.

When she talked with BusinessWest before her arrival, Watkins said one of her first priorities is to familiarize herself with the community and meet with many different leaders and constituencies — in whatever ways COVID will allow. Which means a lot of Zoom meetings, some phone calls, and, when possible and appropriate, in-person gatherings.

“My goal is to get out there and meet the community where they are at as quickly as possible,” she said. “I think it’s also important that I meet the team; meet our front-line caregivers, staff, and providers; and understand what’s working well and where we have opportunities.”

Returning to her thoughts on the lessons learned from the pandemic, Watkins said that  managing through this crisis has enabled her to grow and mature as a leader — out of necessity.

“Physicians inherently have trouble delegating,” she told BusinessWest. “And I fully disclose that I am one of those physicians. It’s been a journey, but the pandemic has really helped me to leverage and trust the team and be a better partner, a better collaborator, and a better support.

“One of the things I work hard to do is listen and gather information before executing,” she went on. “And that’s been incredibly important during this time.”

When asked about the management style she brings to CDH, Watkins started by saying she is an optimist by nature, and she believes this is an important trait in this business.

“We have the singular privilege of being able to take care of patients and the community, whether it’s one-on-one or on a larger scale,” she explained. “And from that optimism, I assume good intentions and assume that those who chose this profession want to take care of people as well. We will have challenging conversations, and it will be important to challenge and push each other to do better and innovate, but I would like to consider myself to be collaborative, open, very much driven, direct, and someone who feels it’s important to have fun at work. That’s because this work makes for long days, and there needs to be some form of celebration, some sort of fun.”

 

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

Healthcare Heroes

Innovation In Health/Wellness

Director of LGBTQ Services, Cooley Dickinson Hospital

J. Aleah Nesteby

J. Aleah Nesteby

She Pioneered Appropriate Care for a Population That Sometimes Lacks It

By Mark Morris

Healthcare was Aleah Nesteby’s second career goal.

“My first career goal was to be a standup comic, but I eventually realized I didn’t have the stomach for all the rejection that involved,” she said.

As it turned out, comedy’s loss was healthcare’s gain. For the past several years, she has been a family nurse practitioner and director of LGBTQ Health Services at Cooley Dickinson Health Care — and is now beginning a new career at Transhealth Northampton.

In doing so, she will continue her pioneering work providing culturally sensitive healthcare for often-marginalized populations — work that many health organizations have since adopted, long after Nesteby became an early pioneer in this region — and a true Healthcare Hero.

“I thought, if my friends can’t access good care in San Francisco, is there anywhere they can? I also thought, well, I could do that.”

According to the Centers for Disease Control and Prevention, members of the LGBTQ community face an increased risk of health threats due to discrimination and stigma. In her role with Cooley Dickinson, Nesteby has worked to bring more equity and compassion to healthcare for the LGBTQ community. As a practitioner, she has maintained a patient panel of about 500 people, many of whom are transgender.

It’s a passion that predates her medical career, to be sure. Since college, Nesteby has had an interest in healthcare among marginalized populations, but at the time, care focused specifically on LGBTQ people didn’t exist. In the early 2000s, while in San Francisco, she learned that some of her LGBTQ friends were not able to access healthcare.

“I thought, if my friends can’t access good care in San Francisco, is there anywhere they can?” she said. “I also thought, well, I could do that.”

So she did. And for her years of cutting-edge advocacy for this broad and sometimes misunderstood population, Nesteby certainly merits recognition in the category of Innovation in Healthcare.

 

Training Ground

In addition to treating patients, Nesteby’s responsibilities include training providers and staff on how to make medical facilities more welcoming and inclusive.

Much of the training I would call LGBTQ 101,” she said. “It’s a discussion on how to treat people respectfully and how to engage them in language they would like you to use.”

After years of pioneering work at Cooley Dickinson, Aleah Nesteby is taking her passion and talents to Transhealth Northampton.

After years of pioneering work at Cooley Dickinson, Aleah Nesteby is taking her passion and talents to Transhealth Northampton.

One common question — she’s heard it countless times — challenges why LGBTQ patients should be treated differently than anyone else. She explains that everyone has unconscious biases that play into their decisions about treatment for people.

“I try to help providers understand that, even though they think they are treating everyone the same, some of what they are saying isn’t being received by the patient in the way it might have been intended.”

For instance, microaggressions are a common issue — those backhanded compliments and minor comments that might not be insults, per se, but add up in a negative way to the person who hears them. A gay or lesbian person might be told, “I couldn’t tell whether you were gay or straight,” and a transgender person might be asked what their old name was.

“It’s these low-level, unpleasant interactions that many medical folks aren’t even aware they are doing,” Nesteby said, emphasizing that training should include all employees in the medical setting, not just direct care providers. For example, a visitor to the doctor’s office typically first speaks with someone on the front desk, then a medical assistant or nurse, and, finally, with the physician or nurse practitioner.

“Even when all the providers are trained and great to be around, if the staff aren’t trained, it can still be a negative experience for some,” she explained.

Nesteby also helps providers with more detailed training that addresses health issues specific to the LGBTQ community, such as hormone therapy for transgender adults and working with transgender children.

“I’ve also trained doctors on PrEP, a pre-exposure prophylaxis for HIV,” she said. “It’s a medication people can take before being exposed to HIV to help prevent transmission.”

In some ways, Nesteby has always been an LGBTQ trainer. She was studying to be a nurse practitioner back when the transgender health movement — commonly called trans health — was just beginning. Because it wasn’t included in the curriculum, she invited a lecturer to speak to her class about trans health.

“In the beginning, there were lots of things to learn and new ground to break,” she recalled.

Nesteby is now in demand as a speaker at conferences around the country, though her appearances during the pandemic have been virtual. She also participates in TransLine, an internet-based consultation service. “People can e-mail their questions about trans health to volunteers like me, and we answer them as they come in.”

As she became established and word got out that her practice included trans health, patients would travel from hundreds of miles away just to be seen by Nesteby. However, “as trans health has become a more accessible field and more providers have become comfortable with it, there’s less need for people to travel long distances.”

 

Continuing the Conversation

Reflecting on her work with Cooley Dickinson gives Nesteby a great deal of satisfaction. From training medical staff to policies to make the hospital more inclusive, she appreciates all the progress that’s been made so far.

“While there is still work to be done, there has been a cultural shift in Massachusetts on how we view our LGBTQ patients,” she noted.

Jeff Harness, director of Community Health and Government Relations for Cooley Dickinson, called Nesteby’s work critically important to the LGBTQ community.

“It is rare to find a primary-care provider who understands the unique health and social needs of LGBTQ patients,” Harness said. “It’s exceedingly rare to fine one who is so skilled, passionate, and caring.”

This month, Nesteby is leaving Cooley Dickinson to join Transhealth Northampton, a clinic that provides primary care for children and adults. Her role will be similar to her current one in providing primary care and hormone management for her patients. In her new position, she will continue to educate clinicians and will also focus on educating the general public about working with the LGBTQ community.

“I’m an advocate of asking people how they want to be addressed and what pronouns they use,” she said. adding that people often get nervous they might offend if they ask, but the conversation has to start somewhere. “If you are respectful and polite, people will usually respond in kind. They only get upset when someone is rude or asking for information that is gratuitous or not needed.”

In general, Nesteby would like to see a more welcoming and affirming atmosphere in medicine.

“Ideally, I’d like all providers to have some degree of knowledge about how to work with LGBTQ patients because within that there is more opportunity for people to specialize in that care.”

Harness credited Nesteby with making positive changes in the system while always providing excellent care to the person in front of her. “Aleah has improved her patients’ sense of well-being by showing them their medical provider cares about, understands, and welcomes them,” he said.

In her eyes, though, showing compassion is similar some ways to the old adage about a rising tide lifting all boats.

“If we are more open and understanding to folks in one group,” she said, “we tend to be more open and understanding to everyone — and that helps all of us.”

Daily News

NORTHAMPTON — Cooley Dickinson Hospital received a $30,000 gift from Thomson Financial Management to support the Childbirth Center project, which, when completed, will offer expanded services in a newly renovated space that includes an upgraded nursery, birthing tubs, and more home-like surroundings for moms and babies.

“We believe in access to quality healthcare and appreciate the opportunity to contribute to the birthing center at Cooley Dickinson,” said Renae Ransdell, senior vice president and wealth advisor at Thomson Financial Management. “I had two very different delivery experiences, and am immensely grateful for the care and support my children, myself, and even my spouse received on both occasions. Care for our community is one of our core values at Thomson Financial Management, and we hope our donation can contribute to the families of our community having experiences like the ones we are so grateful for.”

The renovation of the Childbirth Center includes refurbishing patient-care areas and support areas to make the space more comfortable for moms and babies, as well as creating a warmer, more home-like environment. In addition, the nursery will be upgraded to a Level 1B nursery to provide special newborns with extra care and attention. Once renovations are complete, Cooley Dickinson will be the only Level 1B nursery in Western Mass.

“This generous gift will help moms and babies right here in our community, providing access to safe, high-quality birthing services in an environment that wraps each family with warm, compassionate care,” said Diane Dukette, Cooley Dickinson’s chief Development officer. “Thomson Financial has brought our fundraising efforts for the Childbirth Center over the $2 million mark. Their support will inspire others in our community to come forward to help fund this project that is made possible from the generosity of our community.”

HCN News & Notes

NORTHAMPTON — Given the ever-changing nature of the coronavirus/COVID-19, Cooley Dickinson Hospital is changing its visitor guidelines and restricting visitors, effective immediately. The new guidelines include:

• One visitor per patient at a time;

• No children under age 16;

• Anyone with upper respiratory symptoms, including fever, sore throat, or cough, regardless of travel history, should postpone their visit to Cooley Dickinson Hospital patients or staff until they feel better; and

• Anyone who has recently visited China, Iran, Italy, Japan, or South Korea, or other areas where coronavirus has been reported — or has been in contact with someone who is sick and who has been to one of the countries listed above — should postpone their visit to Cooley Dickinson Hospital.

Anyone who need to visit a loved one should practice good hand hygiene and follow the proper steps for cleaning their hands, which are on signs posted around the hospital. Specifically:

• Wash your hands often with soap and warm water, or use an alcohol-based gel;

• Avoid touching your eyes, notes and mouth;

• Cover your mouth when you cough or sneeze. Use a tissue or your inner elbow, and do not sneeze into your hands. Discard the soiled tissue in a wastebasket and clean your hands.

“At Cooley Dickinson, we take the health and safety of our patients, visitors, and community members seriously,” the hospital said in a statement. For the most up-to-date information, visit the CDC or Massachusetts Department of Public Health website.

Daily News HCN News & Notes

NORTHAMPTON — After a months-long project-planning review process, officials at Cooley Dickinson Hospital received approval from the Massachusetts Department of Public Health (DPH) to begin renovation of the hospital’s Childbirth Center.

The construction, which begins Tuesday, March 17, will take place in seven phases over approximately 70 weeks; the Childbirth Center will remain open during the project.

Once completed, the Childbirth Center will offer expanded services in its newborn nursery and more home-like surroundings for patients and families. Other improvements, such as the addition of a dedicated tub room for laboring and more comfortable beds for partners, will be completed earlier in the process so more patients can experience the benefits of the renovation project.

“For many months, staff at the Mass Department of Public Health have been involved in reviewing all aspects of our construction plans to meet their stringent safety requirements,” said Vice President of Operations Anthony Scibelli. “The DPH will continue to be involved as each phase of construction is completed and a new one begins.”

Scibelli says the renovation of the Childbirth Center includes refurbishing all patient-care areas and most support areas to make the space more comfortable for patients and families, as well as creating a warmer, more home-like environment. In addition, the newborn nursery will be upgraded to a Level 1B nursery to provide special newborns with extra care and attention before they are discharged from the hospital. Once renovations are complete, Cooley Dickinson will be the only Level 1B nursery in Western Mass.

“Now that the DPH has given us the green light, we are poised to make our vision for the Childbirth Center a reality,” Chief Development Officer Diane Dukette said. “We are grateful to those who have given. We hope to inspire others to support this center, which is so critically important to our community.”

Dukette noted that community members have already donated $1.7 million to underwrite the cost of the Childbirth Center renovation project, which has been named “Breathing New Life.”

Because the Childbirth Center will remain open during the project, staff will work to minimize noise and distractions as much as possible. Working with the construction company, staff will take the necessary steps to mitigate noise within the site. For example, renovations will be phased so the rooms that are under construction will be worked on as far away from patient care as possible. Noise-cancellation machines will be installed to help with noise reduction, and best-practice construction techniques are planned to ensure dust and debris are well-contained.

“As compared to home or commercial construction sites, hospital construction sites use specially designed construction barriers,” Scibelli said. “These are hard, airtight, temporary walls with a double set of temporary doors that workers pass through on their way in and out of the area that is under construction.”

The architect and construction firm have experience in healthcare, both at Cooley Dickinson Hospital and in the field of healthcare construction in general.

The Childbirth Center was last renovated in 1998. Nearly 600 babies are born in the center each year.

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