Maui Memorial shuffling
management again

---

Lyn Danninger
ldanninger@starbulletin.com

Maui Memorial Hospital is in the midst of another organizational shake-up designed to restore employee morale at the facility and more fully include doctors and nurses in the decision-making process, said officials.

Earlier this year, the hospital announced a series of changes meant in part to improve efficiency and profitability.

But not all the changes were well received by physicians and staff. Particular complaints included a higher ratio of patients to nurses, longer pharmacy hours and lack of communication from management about the changes.

The current reorganization was suggested by a pair of consultants brought into interview 169 physicians and staff members at the facility.

The report by the consultants was not released, but a summary of the recommendations was distributed to employees.

They included: Restore the position of director of nursing done away with earlier this year, eliminate the position of medical director and re-shuffle some senior management oversight duties.

Troubles begin

Some of Maui Memorial's problems began last year when a long-anticipated $38 million revenue bond to be used for facilities expansion was put on hold after the hospital recorded unexpected losses.

Previously, the facility had been one of the most profitable in the Hawaii Health Systems Corp., the quasi-independent oversight organization set up to administer the state's hospitals.

An imperfect solution

To improve the hospital's bottom line and expand needed services, hospital administrator Boyd Kleefisch embarked on a series of changes. They included the elimination of the director of position held by long-time MMH employee, Elaine Slavinsky.

Slavinsky's duties were assumed by Leann Strasen, also a nurse but appointed to the newly-created position of chief operating officer.

When the initial organizational shake-up took place, the Hawaii Government Employees Association, the union covering hospital employees, was willing to go along with the changes as long as they were consulted and kept informed about what was taking place.

HGEA senior agent Lee Matsui said he had been receiving an increasing number of staff complaints over the last few months and the union had been thinking about filing a grievance.

"I was getting concerned calls just about every day," he said.

But the latest changes should bring improvement, said Matsui

"I think things are for the better. This will produce a more harmonious environment for everyone," he said.

A new plan

Under the new plan, the hospital will restore the director of nursing position under the title of director of patient services and remove the nursing department oversight from the chief operating officer.

The new nursing directorship will also include supervision of the physical therapy, occupational therapy and respiratory therapy departments.

That position will be assumed by Karen Oura on an interim basis until a permanent replacement can be found, hospital officials said. Oura was an assistant to former director of nursing, Slavinsky.

HGEA's Matsui said he believes the reshuffling of senior management duties, especially the creation of the director of patient services position, will go a long way to helping to address staff complaints .

The title of chief operating officer, the position now held by Strasen, will be changed to chief administrative officer and director of environment of care. Housekeeping, food service, maintenance, laundry and security will continue to be overseen by Strasen.

Assistant Administrator Gerald Matsui will add oversight of the pharmacy, previously under Strasen, to his existing duties overseeing laboratory and radiology.

The hospital also plans to create the new position of chief medical officer to replace the medical director position now held by Dr. Jonathan Weisul.

Weisul, another long-time MMH employee and an emergency room physician, will continue to serve as director of medical services for Maui County, a state Department of Health position. Whether Weisul will apply for the new chief medical officer position is not clear.

The new chief medical officer will have dual reporting responsibility to both the hospital and physicians, hospital administrator Boyd Kleefisch said.

Other changes suggested in the consultants report relate directly to the problem of sagging employee morale at the facility.

Among the recommendations are:

>> Include doctors and nurses in key decision-making activities.

>> Use mediation to resolve differences with medical staff over legal and financial relationships.

>> Work toward creating a spirit of collaboration and respect among all employees, medical staff and management.

>> Investigate allegations of inappropriate behavior and take appropriate action.

>> Make regaining the revenue bond a top priority.

Looking ahead

In the meantime, the hospital is continuing with some of the planned renovations and long-needed additions to the facility, Kleefisch said.

Financially, it is also in better shape, he said.

"Financially we are doing well although we did have some big concerns when tourism numbers dropped," Kleefisch said.

While the hospital is not dependent on tourism, visitors make a significant contribution to the hospital's bottom line.

As much as 40 percent of emergency room admissions come from the visitors to Maui, he said.

But the hospital remained full in September and similar encouraging numbers continue to be seen, Kleefisch said.

The hospital is also planning to combine with Maui Radiology Consultants in a joint venture to purchase a new MRI and is going ahead with a planned second endoscopy unit and renovations to its lobby, Kleefisch said.