Home Posts tagged Healthcare Administration

Alexa Mignano

By
Healthcare Heroes

Healthcare Administration

Director of School-Based Clinical Services, River Valley Counseling Center

As a Leader, She Makes Sure Team Members Are Heard — and Valued

Alexa Mignano

Alexa Mignano

Like many in healthcare who have traded direct interaction with patients for roles in which they manage others who provide that care, Alexa Mignano found the transition somewhat challenging; stepping away from direct care is never easy.

But to say she has managed and is flourishing in her current role would be a real understatement.

As the director of School-Based Clinical Services (SBS) for River Valley Counseling Center, she now leads a team of more than 85 people. Since taking the helm in 2019, she has expanded the SBS program in dramatic fashion, taking it from two school districts to 11, providing behavioral healthcare to more than 1,600 students in more than 70 schools.

And this growth comes at a critical time.

Indeed, COVID-19 had a significant impact on the behavioral health of society as a whole, and especially young people. It also comes at a time when many young people are experiencing trauma and its many side effects, and when there are simply not enough clinicians, especially in non-school settings, to meet this need.

But behind the numbers, and these sentiments on growing need for behavioral-health services among young people, are the traits that Mignano brings to her role — traits that make her a Healthcare Hero in the Administration category.

“There are really difficult things that we hear about in this work that happen to children. And to be able to create some change and help them heal, and help families heal, is a way to give back to my community.”

These include passion for her work, strong leadership skills, an ability to build teamwork and camaraderie, a willingness to listen and maintain an open mind, and the ability to inspire others to reach higher and deeper as they go about their work and serve this important constituency.

These are traits that come clearly into focus in the thoughts of team members and others who came together to nominate her for the Healthcare Heroes award.

“The SBS is a connected, warm, passionate, and energetic team, which has accomplished amazing things in our school system,” said Elaine Campbell, assistant executive director and clinical director at River Valley. “This team is spread out across Hampden, Hampshire, and Franklin counties, and Alexa brings them together and unifies them as a collaborative unit. Alexa engages the team and brings them together for various events and trainings throughout the year to build support and community amongst the team.”

Alexa Mignano says trained clinicians offering care right in the schools

Alexa Mignano says trained clinicians offering care right in the schools provides consistency for the kids, which translates into better care.

Emma Cohen, an SBS clinician, added that “Alexa is — and consistently has been — an amazing leader. She always manages to support our whole team, work hard to help each and every one of us, and make sure we’re providing the best care we can to our clients.

“Alexa truly makes our program great — she is always open to new ideas, makes sure everyone has space to feel heard, and helps us make a large and complex program run smoothly,” she went on. “Alexa is an incredible example of a leader, an advocate for both her employees and the people we serve, and an overall wonderful person to work for.”

If one looks up the definition of ‘leader,’ especially in a healthcare sector, these are the words and phrases that will come up. And that’s what Mignano has become — a true leader.

And while she misses providing direct care to clients, she said that, as a manager, she can actually have a bigger impact and touch the lives of more young people in need of critical help.

“What’s so cool about what we do, the schools that we’re in … the kids know us, therapy’s cool, and more kids want to come see us. They’re not afraid to get help.”

“This is the classic very rewarding job,” she told BusinessWest. “There are really difficult things that we hear about in this work that happen to children. And to be able to create some change and help them heal, and help families heal, is a way to give back to my community.”

Such sentiments explain not only why she loves what she does, but why she’s a Healthcare Hero.

 

Taking the Lead

Since the Healthcare Heroes recognition program was created in 2017, its Administration category has been perhaps the most competitive.

There are several nominations each year, and to stand out in these crowded fields, one must be more than a manager. He or she must also be a leader, someone who displays those skills and traits mentioned above.

In short, those that prevail in this category, often providers of care themselves at various points in their careers, are able to motivate and, for lack of a better phrase, get all the members of a team to row in the same direction. And their strongest trait might be an ability to not only listen, but make team members understand that they are being heard.

Mignano brings all this and more to a role she’s grown into after taking a somewhat winding road into healthcare and, more specifically, behavioral healthcare.

Indeed, this is a second career for her. She was working at UMass Amherst, doing academic advising and first-year-experience work. She enjoyed that role, but with a young daughter, she needed something that provided more flexibility.

“So I decided to go with what my degree was originally in, which was mental-health counseling,” she said. “And then I fell in love with it.”

That’s another understatement.

Eventually, she started providing therapy to children in schools, was hired by Holyoke-based River Valley Counseling Center, and worked at Holyoke High School and Kelly Elementary School. She ended up going back to school so she could get licensed.

“It was a perfect match for what I wanted,” she went on. “And I felt like I was good at it; I was very interested in how children’s brains change over time, especially when they’ve been exposed to trauma, and how you can heal that and shift that.”

Mignano worked as a counselor for eight years before transitioning into administration, first in a few school districts and, eventually, as director of School-Based Clinical Services.

This is a position with a broad job description that includes everything from overseeing partnerships with school districts and charter schools in the area to hiring, training, and, most importantly, supporting the clinicians that go into schools and provide outpatient therapy to young people coping with a wide array of issues and conditions.

“There’s a lot of trauma,” she noted. “I’d say about 25 to 30% of our cases are focused on trauma. There’s depression, anxiety, ADHD … there’s really a wide range.”

As they help students deal with these issues, the counselors become trusted and accepted, and at a time when students need help, they seem increasingly willing to embrace it.

“I have been in the field for more than 20 years, and Alexa is the most caring, supportive supervisor I have ever had.”

“What’s so cool about what we do, the schools that we’re in … the kids know us, therapy’s cool, and more kids want to come see us,” she told BusinessWest. “They’re not afraid to get help. The stigma is removed quite a bit, especially in the younger grades. When they get to high school, they want to feel a little bit more private, but even there, we’ve become part of the school, and part of what happens at school is that you also get help for your mental-health problems.”

And dissipation of this stigma is an important step forward, she went on.

“Kids are not afraid to say they need support,” she noted. “I mean, I think there’s a lot of emphasis on that in social media — that it’s OK to speak out and say what’s going on and ask for help. But they also get to see it in their school environment, and it gets normalized. It’s not some random place they go to get services and to get support. They do it in a place they’re really familiar with, and I think that helps with breaking down some of the shame or embarrassment that they might feel about getting support; their friends are getting help.”

 

School of Thought

In short, school-based services are enjoying large levels of success. And thanks to Mignano’s leadership and drive, they are enjoying success in many more ZIP codes.

“I wanted more people to focus in on treating children, so I started supervising and providing support to other clinicians doing the work,” she said, adding that she initiated efforts to coordinate a contract with the Easthampton School District and oversaw the program there before becoming director of all school-based services, with a commitment to continue adding more districts.

“We started with a few, and then I was like … no, we can do more,” she went on. “And the word started to spread, so I started meeting with different superintendents and principals and talking about what we do. And then, a real focus of mine became cultivating a group of therapists that really wanted to be child-focused or adolescent-focused, supporting them in that work. And it’s just a win-win for everybody in terms of how it’s set up.”

As noted earlier, there are now 11 districts in the fold, and Mignano believes there is room for more expansion, especially since the hiring challenges brought on the pandemic are mostly in the rearview mirror.

“I always say we’re done, and then a principal calls,” she said. “I’ve always wanted to expand responsibly; whenever we add a new school district, we add the infrastructure to support the consistency, the supervision, the communication … that’s critical in making these programs work.”

Beyond these expansion efforts, her leadership has brought consistency and steady improvement to existing programs, with the school setting becoming an increasingly effective place for young people to receive therapy because it removes barriers to care.

“I know I’m biased, but I’ve seen it work,” she said. “As a clinician, I’ve seen it work incredibly well, and now I see it at this end. It works for the kids, it works for the schools because they have some added support, and it works for the clinicians who want to focus on kids, but they don’t want to necessarily work every single evening to do that. They get to have a normal schedule too, so it works for everybody.”

And Mignano is committed to making sure it works for everybody.

“As an administrator, I’ve really been focused on how to create a work environment for mental-health professionals that feels really supportive, so they feel challenged, they feel valued, because ultimately that is the foundation of retaining clinicians,” she explained. “Because we get to train them, they get to grow clinically with us, and that translates into consistency for the kids, which translates into better care for the kids. As an administrator, I focus a lot on that — what type of environment are we creating? And people stay with us.”

Which brings us back to some of the team members who nominated her — and why.

“Alexa is an incredible leader, clinician, advocate, and supervisor,” said Catherine Vaughan, assistant director of School-Based Services. “She is truly passionate about the work we do and gives her all in everything that she does. She also encourages her co-workers to go outside their comfort zones with their work, and she is always there supporting and guiding them along the way. I am so grateful to be a part of her team.”

Lisa Smith O’Connor, an SBS clinician, agreed. “I have been in the field for more than 20 years, and Alexa is the most caring, supportive supervisor I have ever had,” she said. “She is an expert in our field, but also an amazing supervisor. I agreed to become a supervisor and commit to this agency long-term due to her caring and thoughtful support and guidance.”

All that certainly helps explain why Mignano has earned another title: Healthcare Hero.

Healthcare Administration: Dr. Mark Kenton

By
Dr. Mark Kenton
Healthcare Heroes

Chief of Emergency Medicine, Mercy Medical Center

He Considers Listening His Strongest, Most Important Talent

Dr. Mark Kenton

 

As a general rule, physicians working in the emergency room don’t get to know their patients as well as those in primary care or other specialties, who see their patients regularly and over the course of years and, sometimes, decades.

But Dr. Mark Kenton makes it a point to get to know those who come to his ER, the one at Mercy Medical Center. Indeed, he said he always looks to make a connection by listening to each patient and learning about what they are interested in and passionate about.

In addition to making these connections, he tries to get involved and make a difference, in ways that go beyond providing medical care.

“Sometimes, the best medicine you give someone is not actually medication,” he told BusinessWest. “It’s just listening. Everyone has a story.”

He was listening as one patient, a veteran named Homer who was going into hospice care, expressed regrets about never making it to the World War II Memorial in Washington, D.C. So Kenton researched the Honor Flights program and worked with the patient’s family to help make arrangements for him to visit the stirring memorial. Later, he received a letter from that family.

“They said he died two weeks before he was scheduled to go, but he died knowing that he was going, and it meant a lot to him,” Kenton recalled. “That stuck with me.”

He was also listening to another patient who was near the end of his battle with cancer and came to understand that the two shared a love of baseball and the Red Sox. Kenton arranged a phone call to the patient from former catcher Rich Gedman, whom Kenton had come to know well from his participation in Red Sox fantasy camps.

“Sometimes, the best medicine you give someone is not actually medication. It’s just listening. Everyone has a story.”

“He said, ‘I can’t believe Rich Gedman actually called me,’” Kenton recalled, adding that the conversation had a lasting impact.

This ability to listen, and act on what he hears, is one of many traits that has made Kenton a Healthcare Hero for 2023 in the Healthcare Administration category — annually one of the most competitive categories within the program.

He stood out amid a number of others nominated for the award for his ability to act upon what’s heard — in a variety of different settings — and generate needed dialogue, which has sometimes led to real change.

This includes the ER at Mercy, where he has worked with others to improve flow, shorten wait times, and reduce the number of patients who leave the ER without being seen, battles that have become even more difficult amid critical shortages of trained professionals, especially nurses.

One of Dr. Mark Kenton’s passions is baseball

One of Dr. Mark Kenton’s passions is baseball and Red Sox fantasy camps, something that has become a family affair, as in this scene at Jet Blue Park in Florida with his sons (from left) Mark, Davin, and Jacob.

But it also includes the national medical stage, as we’ll see. Indeed, a letter posted on Facebook from Kenton to the CEO of Mylan juxtaposed the CEO’s salary against the sky-high cost of EpiPens and thrust the debate about the rising cost of pharmaceuticals into the national spotlight.

In Massachusetts, Kenton played a strong role in the passage of a bill that would allow EpiPens to be purchased in the same manner as Narcan for municipalities, whereby the state would purchase them at something approaching cost.

Kenton has also advocated for increased protection from workplace violence in hospitals, testifying at the State House after a colleague at Harrington Hospital suffered a near-fatal stabbing. Those efforts have been less successful in generating change — a result he blames on the high cost of measures such as metal detectors — but he continues to push for legislation that might prevent such incidents.

For his ability to listen and effect change — in his ER and many other settings as well — Kenton is certainly worthy to be called a Healthcare Hero.

 

A Great Run

The art hanging on the walls of Kenton’s office certainly helps tell his story.

Most of the pictures are baseball-themed — he played in college, has attended the Hall of Fame induction ceremonies in Cooperstown since 1981, and has more than 7,000 baseball autographs, by his estimate — including photos from the fantasy camps he’s attended, with his children prominent in many of them.

“I’ve been going for 13 years now, and it’s been a pretty amazing experience,” he said, noting that he’s been on the same field as many Red Sox legends. “Now, it’s more about going back and playing with friends than seeing the Red Sox — but they’ve become friends, too.”

But there’s also a framed photo of the cast members of The Office, a gift from his children. He is a huge fan of the show, and notes with a large dose of pride that he’s met several of the cast members and possesses a suit jacket that Steve Carell wore on the show.

While Kenton spends a good amount of time in this space, his true office, if you will, has always been the ER, and especially the one at Mercy. He arrived there in 2003 and became chief of Emergency Medicine in late 2019, three months before COVID hit and turned the healthcare system, and especially the ER, on its ear.

The trajectory for this career course was set over time, and Kenton believes his passion for helping others began when he watched medical dramas on television with his mother and became captivated with what he saw.

“My mother had cancer as a child; she spent a lot of time in hospitals and always had a fascination with healthcare,” he recalled. “She was always reading medical books, and we watched every show you can think of — Quincy; Trapper John, M.D.; St. Elsewhere; you name it.”

Because of his love for baseball, Kenton initially considered a career as an athletic trainer, since he could combine both his passions, baseball and healthcare, and he attended Springfield College with that goal in mind.

He quickly realized that the life of an athletic trainer did not have a lot of stability. And after working as an EMT, a rewarding but also harrowing experience — “I remember going to shootings and the shooter was still on the loose” — he decided the emergency room was where he wanted to spend his career. He earned his medical degree at Lake Erie College of Osteopathic Medicine, with the goal of completing his residency in Baystate Medical Center’s ER, a path that became reality.

“I hand out my business card to patients, talk to them, and ask, ‘why are you here today?’ I do that as one more check to make we’re not missing something.”

As he talked about working in the ER, Kenton related what he told his students when he served as medical director of the Physician Assistant Program at Springfield College. “I would always say, ‘be a little scared every day when you walk in — never lose that. Have a little fear when you walk in, because you don’t know everything, nor should you know everything. You need to know what your resources are and how to utilize those resources. You also need to know that you’re going to be tested — every day.’”

 

Safe at Home

These days, most of Kenton’s work is administrative in nature — he does one clinical shift per week — and, summing it up, he said it’s about making this ER as safe, welcoming, efficient, and effective as he can.

It needs to be all of the above because the ER is the “front door to the hospital,” as he put it, and a safety net for many within the community.

“There are so many patients that don’t have primary-care doctors now or don’t have insurance,” he said. “The ER is what they turn to.”

As he works with his team to improve flow, reduce wait times, and improve the ‘leave without being seen’ numbers, Kenton relies on what might be the strongest of his many skills — listening. In fact, he’s in the waiting room every ‘admin’ day talking with not only patients, but their families as well.

“I hand out my business card to patients, talk to them, and ask, ‘why are you here today?’” he said. “I do that as one more check to make we’re not missing something. I tell them that we’re working hard to get people through the system, and we’ll work on getting you through as soon as we can. And then, I listen.”

This brings him back to his comments about how everyone has a story, and it’s important to know and understand that story.

Dr. Mark Kenton holds up a card with the name ‘Homer’ on it at the World War II memorial

Dr. Mark Kenton holds up a card with the name ‘Homer’ on it at the World War II memorial in Washington, fulfilling, in a way, a dying patient’s desire to visit the memorial.

“You can look at the medical problem, but if you look at them as just a patient, you kind of forget that behind that patient is a person who’s scared, a family that’s scared,” he said. “Some people have lived incredible lives and been very fortunate, and some people have not had very good luck, or they’ve made bad choices, or they haven’t had the opportunities that others have had.

“I’ve taken care of Tuskegee Airmen; I took care of a gentleman who told me he flew on the Enola Gay,” he went on, referencing the famed African-American fighter and bomber pilots who fought in World War II and the B-29 that dropped the atomic bomb on Hiroshima. “You learn from those stories.”

While listening, learning, taking care of patients and their families, and improving efficiency in the ER, Kenton has also become an advocate for needed change in healthcare. His open letter to the CEO of Mylan on Facebook was spurred by incidents in his personal and professional life.

Indeed, while on vacation with his family, his son had an allergic reaction to peanuts. He soon learned that a prescription for two EpiPens, the best treatment for anaphylaxis, would cost $600. Fortunately, that prescription was transferred to a pharmacy that would accept his insurance, bringing the cost down to $15.

But he understood that such good fortune would elude others. While working a shift in Mercy’s ED a few months later, he saw two patients suffering from anaphylactic reactions and gave them both EpiPens, knowing they wouldn’t be able to fill the prescriptions going forward because they didn’t have insurance.

His frustration with this matter prompted his letter, which garnered press across the country and a live interview on Fox Business. More importantly, it generated real change, especially in the Bay State. Kenton testified before the state Senate on a bill introduced by former Sen. Eric Lesser to make EpiPens available for purchase by the state, just like Narcan.

 

Stepping Outside the Box

Two years after Kenton received that letter from the family of that veteran who died before he could get to the World War II memorial, his wife was running in a marathon in D.C., and he made the trip with her.

He wrote Homer’s name on a piece of paper, took pictures of it in various spots at the memorial, and sent them to his family.

“I said, ‘your dad finally made it,’” he told BusinessWest. “From what he told me during that relationship we established in a really short period of time, that brought closure to me, that he made it there.

“There are things you can do beyond providing medication to someone — sometimes you just have to step outside the box a little bit,” he went on, using a baseball term to get his point across.

This ability to forge those relationships, listen to each patient’s and each family’s story, and go well beyond simply providing medication helps explain why Kenton stands out — in his field, in his ER, and in his community. And why he is being recognized as a Healthcare Hero. n