Texas Institute for Surgery at Texas Health Presbyterian Dallas: Debbie Hay, President

by HCE Exchange on August 19, 2010

Texas Institute for Surgery at Texas Health Presbyterian Dallas (TIS) is a multi-specialty hospital with nine operating rooms, three treatment rooms, and nine inpatient beds. TIS is jointly owned by a group of Dallas surgeons and the not-for-profit hospital, Texas Health Presbyterian Dallas. The hospital opened in November of 2004 and has 160 employees and more than 300 physicians on staff.

Surgeons at TIS specialize mainly in orthopedics, pain management, spine surgery and ENT surgeries, but their work is not limited to these areas. “We have a mixture of different procedures, patients and surgeons working out of this facility,” says Debbie Hay, RN, BSN, CASC, President of TIS since its inception.

Prior to the opening of the current hospital, Hay worked with the Surgery Center Southwest, which closed its doors upon the opening of TIS. Her background is in nursing. Hay is also the chairman of the Texas Physician Hospital Advocacy Center. “I try to stay very active and informed about the legislative issues nationally and here in the state of Texas,” she says.

Pride in Physician Ownership

TIS has a quarterly 3% full-time employee turnover rate. “I think that’s credited a lot to the fact that physicians own this facility and care about the people who work here. They want to make sure that they attract outstanding employees and keep them because they realize that affects their efficiency and their ability to take care of their patients,” says Hay.

It also helps that respect is a two-way street at TIS. “From the physicians to the staff and from the staff to the physicians, we really value respect,” says Hay. “Because the physicians have ownership here, they feel a need to make sure the employees are well cared for and happy being here. We expect all of our physicians to show our employees the same respect that our employees show our physicians. I think that’s unique here.”

Hay feels her 30+ year nursing background in various areas has given her an advantage in management. “Because of the way I came up through the ranks of being a staff nurse at the surgery center, then the director of nursing, then the administrator—I’ve had to learn the business side as well as the clinical side of it.  Hay says, “In orientation, I say that there is nothing that is not in my job description.  That goes for everyone that works here.  If the need is there, we’ll do whatever it takes to get the job done.”

As a leader, Hay emphasizes the importance of honesty, respect, and getting back to people in a timely manner. “You may not agree with them, but you at least get them an answer and they know that they’ve been heard.  They know you care about them and you care about what’s going on,” she says.

“An administrator needs to be the positive force in an organization, because everyone is watching you to see how you react to situations. If it’s a negative or blaming approach, that’s how they are going to react, as well, but if your reaction is a positive, we-can-do-this, let’s-figure-this-out approach, then 99% of the time that is what their reaction is going to be too. I try to stay positive, stay honest, and get back to them as soon as I can.”  Because of this philosophy, TIS was selected as one of seven finalists for the Greater Dallas Business Ethics Award in 2009.

A Culture of Excellence

“We feel our culture of excellence is what sets us apart from all the others. We promote excellence in the physicians, the staff, the patient care, and by staying current with all the latest technology.”

TIS recently upgraded to high definition systems in seven operating rooms. “This was our single largest investment last year.  Since orthopedics is one of our main specialties here, it was important that the doctors have the latest technology available to do the job,” says Hay.

“TIS was the first hospital in Dallas that installed and utilized the wireless HD technology.  This has expanded our abilities to utilize this as a teaching tool and provided our surgeons with clearer images, thus improving patient care.”

They are also in the process of switching to electronic medical records. All nursing documentation now goes into electronic records and a portion of the physicians have switched over, as well. “You have to stay on top of these things because they change so quickly. If you don’t, they pass you by,” says. Hay.

The hospital maintains a green focus, as well. “We do have a Green Team and we have done the usual recycling and cutting down on energy. We’ve found a couple of unique ways to bring that in and one of them is  rather than printing out all the minutes and agendas for all the different meetings, we use a power point projector and project them on the screen so we can all view them. That’s one of the unique things we’ve done from a green standpoint.” TIS also uses a green courier that only uses hybrid cars.

Future Direction

When asked about the future direction of TIS, Hay laughs and says, “Ask me after health reform goes through,” In spite of the trend of legislators to view it otherwise, Hay believes the TIS model will continue to be relevant. “The physicians are very vested in what happens here and in patient care. By being part owner, that gives them even greater opportunity to say how the dollars are spent and how the patients are cared for. I think that’s a very positive thing.”

“We have a healthy organization,” she says. “We have the right mix of people and we have the right product—specialty surgery—to offer patients. With that combination, we will still continue as a leader in surgical excellence.”

-by T.M. Simmons

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