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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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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]