The Exec: CMO Playing Key Role in $200M Hospital Expansion

The expansion of Williamson Medical Center will add 50 beds to the hospital.

The $200 million expansion of Franklin, Tennessee-based Williamson Medical Center includes medical staff and service line growth, says Andy Russell, MD, MBA, chief medical officer of Williamson Health.

A board-certified emergency medicine physician, Russell was named CMO of Williamson Medical Center in 2018. He served as an emergency medicine physician at Williamson Medical Center starting in 2004 and was promoted to medical director of the hospital's emergency department in 2010.

HealthLeaders recently talked with Russell about a range of topics, including the challenges of serving as CMO of Williamson Health, safety and quality, and issues related to the expansion of Williamson Medical Center. The following transcript of that conversation has been lightly edited for clarity and brevity.

HealthLeaders: What are the primary challenges of serving as CMO of Williamson Health?

Andy Russell: The biggest challenge but also the most fun challenge is working in the constantly changing landscape of healthcare. The speed at which things were changing during the pandemic was unlike anything I had experienced before. That experience gained during the pandemic combined with the rapidly evolving technological advances means that the fast pace of a continually changing healthcare environment is here to stay.

At this point, my days are filled with projects focused on continual improvement to our patient safety initiatives such as hospital-acquired infections and fall prevention. We are developing new and higher-acuity service lines. We are incorporating more technology in areas such as telemedicine. We are onboarding new physicians and much more. No two days are the same.

HL: How do you rise to the challenge of a rapidly changing healthcare landscape?

Russell: You must remain flexible and nimble. I'm constantly participating in webinars and attending presentations to learn about the newest technology to help keep us at the forefront of an ever-changing landscape.

HL: In what ways are you focusing efforts on safety and quality now that the crisis phase of the coronavirus pandemic has passed?

Russell: We never lost focus on safety and quality during the pandemic. Safety and quality were at the forefront of everything we did during the pandemic, but we did have to shift and modify policies frequently throughout the pandemic as things changed. Obviously, COVID was a novel disease—something we had never dealt with before. While we had policies in place to deal with various infectious diseases, we were constantly having to shift and change as new information about COVID came out. Some of our policies and procedures that we had in place for years had to be modified.

Coming out of the pandemic, we now have many new staff members who do not know how we did things prior to COVID. We are constantly re-evaluating our quality and safety metrics. We are looking at where we were historically and where we are now, and we are continually adjusting where needed.

Over the past few months, we have put in initiatives and protocols for hand hygiene, central lines, urinary catheters, and order sets for pre-operative and post-operative care. These efforts have been focused on reducing infections within the hospital and making this a safer place for the patients.

HL: You have been involved in a $200 million expansion project for Williamson Medical Center. How is the expansion project impacting recruitment of medical staff?

Russell: The expansion project has brought a whole new energy to the hospital, which has been fantastic coming out of the pandemic. It's nice to have something new and positive for everybody to experience. Staff are excited to come to the hospital.

We have been focused on expanding several service lines, including cardiology, obstetrics-gynecology, the neonatal intensive care unit, critical care, and the emergency department. We are growing our primary care clinics as well as our orthopedic group. We have hired several doctors in each one of those specialties.

The mission of our health system sells itself to new physicians. Franklin is a great place to live and a great place to work. People want to come here and work in the community they live in and take care of the patients they see every day in the community.

We have two new orthopedic surgeons joining this year. We have brought in three new cardiologists. We have three new OB/GYN physicians. We have two new neonatologists and new neonatal nurse practitioners who have started in the past year. We will be bringing on two new providers in the emergency department by the end of the year. With the growth of the hospital, we must expand the medical staff to keep up with the patient volume.

HL: With a healthcare workforce shortage across the country, how have you risen to the medical staff recruitment challenge?

Russell: That is an ongoing process. While we have better staffing levels than we did a year ago, we are still not where we want to be. We have been rising to the challenge with increased salaries, improved benefits, flexible scheduling, and promoting our vision and expansion project.

Andy Russell, MD, MBA, chief medical officer of Williamson Health. Photo courtesy of Williamson Health.

HL: You mentioned service line growth. How has the expansion project affected service line development?

Russell: We are expanding our bed count by more than 50 beds, and we knew we were going to have to increase the staff to handle the increase in patient volume. Obviously, with the expansion and increased staffing there is increased cost, and we must increase revenue to cover those costs. Some of the service lines grow themselves such as the emergency department. With the continued growth of the community, emergency room visits have increased, and we have had to hire new emergency physicians.

At the same time, with more people in the ER, you have more patients with conditions such as chest pain who need cardiology services. There are more pregnant women who need obstetrics services. There are more patients who need surgical procedures. With the increased population in the area, that drives volume throughout the hospital, and we are trying to meet the needs of the community. We have been developing service lines to meet those needs.

HL: You have served on Williamson Medical Center's Medical Executive Committee. How does the committee function?

Russell: I have been involved in the Medical Executive Committee for about 15 years. For the first 10 years, I was involved in the MEC as a function of my role in the emergency department. Since I have moved into the CMO role, I have been involved in the MEC in more of an administrative capacity.

Williamson Medical Center is a physician-driven and physician-directed hospital. The MEC sets medical policies and procedures. The committee oversees the medical credentialling of clinical staff. The MEC reviews the professional practice evaluations of all new physicians as well as ongoing professional practice evaluations to make sure that our staff is up-to-date on the latest advances in medical care. The MEC also serves as the disciplinary board for our medical staff.

HL: What role do physicians play on the MEC?

Russell: The committee is made up of 100% physicians. Our chief of staff is the chair of the MEC. The CEO and I are non-voting members of the committee. The physicians on the committee are the ones setting medical policies and standards for the hospital.

HL: You have a clinical background in emergency medicine. How has this clinical background helped you serve in the CMO role?

Russell: Working in the ER, you get to know everybody in the hospital. I worked in the ER last night, and I worked with general surgeons, I worked with obstetrics, I worked with internal medicine doctors, and I worked with cardiology. I had to go to two different floors in the hospital to take care of patients who were not doing well, so I get to work with staff all over the hospital.

In emergency medicine, you learn about how the different hospital departments work together to make one, unified organization. In my time working in the emergency department, I have developed a network of colleagues across all of the specialties in the hospital. It has taught me how to work together and develop compromises. When I am in the ER, I am constantly calling doctors, and it is almost always with bad news. I need them to come to the ER to see a patient, or I need to admit a patient they need to work with the following day. I must be able to explain situations to them, so they understand the patient's needs. I have learned how to have difficult conversations.

Moving into the CMO role, I must bring people together and bring different departments together. I am continuing to build relationships and allowing everybody to work together for the greater good of the hospital.

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