TONE Monthly
April 2019

Highlights from the TONE Conference

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Highlights from the TONE Conference

The 2019 TONE Conference was a great success! Read about some of the highlights here, and check out the photo album HERE.

Thanks from Tim Howell
Thank you to all those who attended the Texas Organization of Nurse Executives (TONE) Conference on March 1. This year’s conference, “Strategies to Inspire Nurse Leaders: Designing, Engaging and Responding,” completely lived up to the title and delivered multiple strategies to engage and inspire nursing leaders. From effective communication skills in the pre-conference by Dr. Rene Thompson to our keynote on values-based leadership by Dr. Bob Dent and ending with an energetic self-reflection by Libby Spears, we were truly inspired by tactics and ideas to improve our personal performance.

The presentations on disaster preparedness and incivility in our organizations sharpened our skills for responding to real threats in healthcare organizations. Further, we heard exceptional updates on the opioid crisis and other current healthcare trends.

I heard many comments from conference attendees that they were energized by this year’s conference and were very pleased with the quality of presentations. Once again, as expected, the Education Committee led by Gretchen Hunt brought us an exemplary conference and made us proud to be a TONE member.

We sincerely appreciate the support of our management company, CMP, our vendor sponsors and the donated venue by Texas Health Presbyterian Hospital. The continued provisions for our conference helped the Education Committee focus on quality presentations, and we certainly enjoyed this year’s inspirational product.

- Tim Howell

Opening Keynote Presentation
The 2019 TONE Conference opened with a keynote delivered by Dr. Bob Dent, past-president AONE, titled The Heart of a Nurse Leader: Value-Based Leadership. Dr. Dent spoke about the need to overcome the toxic emotional negativity in an organization as it is the healthcare crisis within! The three essential elements of a Culture of Ownership are to be positive, self-empowered, and fully engaged. These can be accomplished by having no sour attitude, proceeding until apprehended, and being involved in professional organization/certifications/higher learning. He also spoke of the twelve core action values to be a value-based leader which include authenticity, integrity, awareness, courage, perseverance, faith, purpose, vision, focus, enthusiasm, service, and leadership!

Dr. Dent shared his journey of 30 years and lessons he has learned. He shared some practices that he is committed to that help drive the culture of ownership. It starts with being a life-long learner and sharing his leadership philosophy with all new leaders. It is important, as a leader, to know how to work with your team and for them to know how to work with you. Dr. Dent has a structured process of “Sacred 60” leadership rounds, Breakfast/Brunch with Bob, and Friday meeting free to have time for reflection. He closed with “The goals you achieve and the contributions you make are determined by the values that power your life.”

- Jane McCurley

State of Healthcare and Trends
Mr. Love started his presentation with a look at Medicaid in Texas and how 20 percent of Texans rely on Medicaid for their health insurance (about 4 million people). In 2016, 40 Billion was spent on Medicaid programs, but despite this, Texas still has the highest uninsured rate in the country (about 20 percent of Texans). Mr. Love explained the cost-shifting required to maintain financial stability of organizations using the example of a car dealer having to give away a 4th car for every 3 he sells. The dealer would have to sell the 3 cars at a higher price to make up the difference of the free car, and thus you have cost-shifting in the healthcare industry. Mr. Love explained the state of 1115 waiver in Texas to help offset some costs associated with not expanding Medicaid in Texas, and how the bulk of that work is going to mental health programs in many DSRIP projects in the DFW area. 1/3 of people seen in DFW EDs have a mental health issue. Mr. Love explained the potential of the Trump administration to increase the public charge, which could affect legal immigrants and their willingness to seek out public benefits including Medicaid. This would affect about 1.8 M kids in Texas and possible increase the uninsured rates.

Mr. Love then provided a rundown of State and Federal legislative agenda items that could affect healthcare, such as increased funding for outpatient mental health services and telehealth. Other items covered included preserving Medicaid funding, pain management, trauma funding affected by the Driver Responsibility Act, and local provider participation funds. On the federal level, items discussed included pharmacy costs, Right to try laws, price transparency and the publishing of charge masters, drug pricing, and removing barriers to care. Of note, the main question driving much of the political debate on all levels revolves around whether healthcare is a right or a privilege. There are many moral and ethical undertones that surround the legislation related to this question and there is no clear answer. We do know that without reform, we will continue to see overutilization of EDs. Furthermore, we need to help fix some of the social determinants of health to make healthcare more accessible and affordable. We spend less on social determinants of health than any other wealthy country.

- Kit Bredimus

U.S. Disaster and Public Health Emergency Preparedness: Uncertain Times and 21st Century Threats
Dr. Tener Veenema moderated this section and started off by reviewing 2017 disasters such as wild fires, mudslides, hurricanes and tornado’s. With the increase in terrorism, chemical and nuclear threats along with outbreaks of Zika, Ebola and more recently measles she stated that the profile of what Hazardous Events are is evolving and changing. In health care today we often function is a disaster mode on a daily basis due to decreased capacity and decreased provider and nurse availability. “What is the next pandemic”?

In the 21st Century what are the Public Health threats? What do we need to do? Develop a regional and national disaster Health Care system, beef up public health resources; define readiness- as the US is not really ready. “Nurses are a critical component in the healthcare workforce for disasters. Disaster response is event specific.


The panelists were Dr. Alexander Eastman, Kellie Kainer, MSN, RNC, and Shannon Holland, MSN, RN, NE-BC, CCRN-KC.

Holland and Kainer talked about living through the most recent hurricane in Houston at Texas Children’s Hospital. Both gave accounts of the processes before, during and after the disaster. Key to the experience was family and staff resiliency, and the anxiety/emotions felt by all. They spoke of what they changed after a long debrief and rebuild.

Dr. Eastman is not only a federal government employee but the CMO at the Dallas Police Department, and a trauma surgeon at Parkland in Dallas. He spoke about hospital violence increasing, how we prepare out staff and hospitals. Most recently he has spent time on the U.S.-Mexico border examining the crisis in those areas. Dr. Eastman stated that “the preparedness department should be as big as the quality department."

- Kathy Degenstein-Gartman

What’s Your Plan Be?

Libby Spears, of Bravo cc, provided an exceptional presentation on planning for success. Over a cup of coffee with a friend, she spoke about how she assisted leaders time and time again with developing a “Plan B” when their “Plan A” led to things not working well or delivering results. Often times, leaders implement a contingency plan to fix what is broken or achieve short-term results. Eventually, a team or organization will fall back into previous habits and processes and the cycle repeats itself requiring another contingency plan. Operating in a Plan A (“But this is how we have always done things!”) mindset which leads to the need for a Plan B is not a formula that is viable as a long term success strategy.

Plan Be is a different mindset in which we as leaders think about who we are and what we are trying to achieve. What will it take to get there? Who are we now, who do we need to Be and what do we need to do to narrow the gap for success? Libby challenges leaders to self-reflect and come up with their “Three Words” – three words to describe who they are as a leader. These words should instill confidence, courage and credibility as leaders. Know who you are as a leader, what strengths you possess and how you can use those strengths to develop your Plan Be!

- AJ Stephens


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