PAULETTE J. THABAULT, DNP, APRN, JD

Transcription

1 PAULETTE J. THABAULT, DNP, APRN, JD EDUCATION: 2014: Northeastern University, Doctorate of Nursing Practice 1994: New England School of Law, Boston, MA, J.D. 1984: Simmons College, Boston, MA, M.S.N., Adult Nurse Practitioner. 1980: University of Washington, Seattle, WA, B.S.N. 1974: University of Vermont, Burlington, VT, A.S.N. BAR ADMISSION & AFFILIATIONS: American Nurses Association American Association of Nurse Practitioners American Association of Nurse Attorneys Massachusetts and Vermont Bar Admission American Bar Association Vermont State Nurses Association, Membership Committee (2012, 2013) Board Member at Large, Vermont Nurse Practitioner Association PROFESSIONAL LICENSES and other PROFESSIONAL ACTIVITIES: ANCC Certified - Adult Nurse Practitioner License VT, Registered Nurse License, MA and VT Licensed Attorney - MA and VT Motivational Interviewing Trained HEALTHCARE DELIVERY, EDUCATION, MANAGEMENT & REGULATORY EXPERIENCE: 1/2014 present: Northeastern University, Associate Clinical Professor of Nursing, Program Director, Direct Entry Nursing (Hybrid), Burlington Campus. 1

2 Utilizing a hybrid format combining online courses with on campus laboratory experience and clinical experiential learning in Boston and surrounding hospitals and health care facilities, The NEU hybrid program prepares second-degree students in advanced practice nursing. Responsible for coordinating recruitment, admissions and learning in conjunction with education partner and on-campus faculty to ensure consistent high quality education for graduate nurses. 3/2013 present: Clinical Practice and Health Care Consulting, South Burlington VT. Developed and implemented Intensive Behavioral Therapy (IBT) for Obesity program at GoodHEALTH Primary Care practice in South Burlington, including counseling protocol, provider education and provider outreach in adult primary care practice. Ongoing clinical practice for IBT and primary care. Health Care Consulting: Independent health-care consulting on transformational health and wellness initiatives including: Consulting for Northeastern University, School of Nursing for on-line education programs, facilitating communication and program implementation with operations partner, ensuring seamless experience for students and program excellence. Developed Wellness Open House Series for BlueCross/BlueShield, VT Developed Patient Centered Medical Home (PCMH) clinical services integration program for the GoodHEALTH Primary Care Practice. Evaluated Advanced Practice collaboration agreement for Nursing Home patients 8/2013-1/2014: Instructor, University of Vermont, Leadership and Management in Healthcare: On-line format - examines operational aspects of health care management, leadership and policy including process improvement, management methodologies, transformational leadership and healthcare policy : CVS/Caremark, MinuteClinic, Chief Nurse Practitioner Officer, Woonsocket, RI. Key responsibilities: As the senior clinical nurse practitioner leader, I oversaw a clinical team of regional directors, managers and 1,700 nurse practitioners and physician assistants in the delivery of accessible, affordable, high-quality patient care in retail health settings across 26 states. Notable tasks and outcomes: Served as an integral member of the senior management team, charged with developing and implementing overall strategic and operational direction for the company. I represented MinuteClinic within the CVS/Caremark enterprise and nationally and worked to position the company for success in a rapidly changing healthcare environment. 2

3 Responsible for the delivery of consistent, high-quality patient care services at 645 walkin MinuteClinics within select CVS stores and helped develop and manage the annual budget. Directed the MinuteClinic Quality Committee, which included five subcommittees: Health and Safety, Policy and Procedure, Clinical Guidelines, Credentialing, and Risk Management. To make better use of data, I revised our Clinical Dashboard tool to identify new clinical quality measures and implemented a cascading communication plan to share performance data and identify opportunities for improvements and adjustments to emerging trends. Joint Commission preparedness and accreditation were among my core responsibilities. Achieved full JC reaccreditation during my tenure. Led the division s Employer of Choice initiative, which included a plan and timeline to achieve ANCC magnet status and attract the most professional and qualified staffing possible. I managed and supported an array of professional development opportunities for clinical staff, including continuing education and research. To address the critical issue of work-life balance for healthcare workers, I improved communication with staff to better understand and address employee concerns. Enhanced customer satisfaction by working with Press Ganey to develop a customer survey that better captured data to improve the ability to understand the MinuteClinic patients experience. Maintained customer satisfaction results of 95% across all areas of MinuteClinic and a net promoter score of 82%. Directed efforts to reduce provider turnover by implementing a job shadow program, getting better analysis from exit interviews, ordering more training for hiring managers, and developing a closer association with nurse practitioner schools. As a result, turnover rate decreased steadily over four quarters from 25% to 19%, Successfully piloted a NP Residency program for new graduates at MintuteClinic that included partnering with Northeastern University to provide enriching educational components to support the primary objective of successful NP transition to independent practice. Analyzed market data for underperforming MinuteClinics and developed a challenged clinic strategy, first implemented as a pilot in the California market. This targeted initiative included improving communication and outreach to in-store teams and establishing relationships with the local communities. This successful strategy grew the California challenged clinic market 33% in six months and the project was implemented enterprise-wide. Led an effort to engage key national organizations and leaders including the American Nurses Association, the American Association of Nurse Practitioners, the Convenient Care Association, and the Primary Care Collaborative to plan education initiatives, address regulatory issues for multi-state service providers and identify innovations for efficiency, quality, and patient safety. 3

4 : State of Vermont, Commissioner, Department of Banking, Insurance, Securities and Health Care Administration (BISHCA), Montpelier, VT. Key responsibilities: As state commissioner, I was appointed by Governor Jim Douglas to regulate Vermont s broad spectrum of banking, investment, and insurance industries along with the states hospitals and other healthcare businesses and organizations. Notable tasks and outcomes: Managed a $15 million budget, 114-person team housed in five divisions, each with its own deputy and organizational culture. I took on a key challenge to improve morale and team collaboration in the department. In one division I made high-level staff changes and attracted new, talented managers and health care attorneys who were able to function as true partners while regulating health care entities. As Commissioner, my strategy to oversee and approve annual budgets for Vermont s 14 hospitals was to open a new dialogue with hospital leaders to arrive at rate increases adequate to support hospital budget while balancing legislative directive to limit increases. I restructured the budget hearing process to provide for deeper understanding among hospital leaders and regulators of key cost pressures and revenue constraints, many of which are unique to Vermont, including: substantially lower Medicaid payments from Vermont and New York State, disproportionate share impacts, payer-based referral patterns, declining Medicare reimbursements, increasing informatics and other infrastructure costs, employee salary and health care cost pressures including aging facilities. Conducted numerous hearings with the governor-appointed, 12-member Public Oversight Commission regarding Certificate of Need (CON) applications, and ultimately making the final decision and order for approved projects. The CON process looks at health care projects meeting statutory cost thresholds (capital projects, equipment purchases, operating costs) and involves entities and services of all types and sizes across the state: home care services, ambulatory surgery, electronic health records, radiology equipment and related services, infrastructure and system upgrades. The CON process can lead to difficult decisions, but always adds knowledge about factors affecting the costs of health care services and the pressures each institution faces. Collaborated with legislators and key stakeholders to update CON rules and invited opposing party comments for crafting orders that addressed concerns such as providing charitable care. Recognizing the potential of electronic health records, approved the Fletcher Allen Health Care (FAHC) $57 million application for a new electronic health record system. Other important reviews under my tenure include: the DaVinci Robotic Surgical System 4

5 and the Fresinius Outpatient Renal Dialysis application from FAHC; the Brattleboro Hospital Ambulatory Surgical Care Unit Renovation Project; the BAART Mobile Methadone Services in Danville and an additional fixed site in Berlin; and the Radiation Therapy Center at the Central Vermont Medical Center. Served as a key leader for the governor s healthcare cabinet. Coordinated state planning for federal reforms, including creating implementing a multi-payer all-claims database, a key information resource that will allow Vermont to gain a greater understanding of health care costs and trends; regulating public-private rates and benefits for the Catamount Health Plan insurance program; and providing numerous consumer publications for public outreach. Led BISHCA-supported grant applications and legislative committee work focused on establishing a center for transformational research at the University of Vermont College of Medicine. This work and other research-focused endeavors are critical for continuing to attract high-quality researchers and clinicians to foster the missions of UVM and FAHC. Represented the administration and Vermont s interests at many venues local to national including interviews for television, radio, and print media. I also testified many times at the Vermont Legislature to explain or defend the administration s positions on finance and health care. Participated in revising and updating, Rule 10 Vermont s Consumer Protection Act, in response to insurer and institutional concerns. I additionally directed an investigation into the compensation of the retiring CEO at Blue Cross/Blue Shield Vermont (BCBSVT) and ultimately directed the company to return $3 million to the company s Vermont ratepayers in the form of reduced premiums. Streamlined processes and implemented programs that helped consumers and saved Vermonters money and time as the Commissioner overseeing a broad array of financial services impacting Vermonters : State of Vermont, Deputy Commissioner of Health Care Administration for the Department of Banking, Insurance, Securities and Health Care Administration, Montpelier, VT. Key responsibilities: As director of the healthcare oversight division, I led a strong team in service areas including health care data management, health insurance regulation, quality compliance and rates/forms filings, consumer services, and cost containment. Notable tasks and outcomes: 5

6 Directed a multi-stakeholder advisory group in developing the 2005 State of Vermont Health Resource Allocation Plan (HRAP), a comprehensive plan that inventoried all service categories and identified important gaps in care. This document provided a multitude of potential next steps ultimately addressed in the 2009 HRAP update, which identified specific steps to improve coordination and penetration of vital health services. Oversaw the forecasting of one- and three-year health care costs in Vermont and assisted legislators in reviewing results and forecasting assumptions in service to the Vermont government s goal of healthcare cost containment. Reviewed applications, developed questions for hearings, and recommended final decisions and orders for the commissioner to consider for the statewide Certificate of Need (CON) program. Led the development of consumer publications to assist Vermonters in making health insurance purchasing decisions, including managed care comparisons. Oversaw statewide hospital community needs assessment and collaborated with hospitals and legislators to establish hospital quality performance measures for public reporting. Played a central role in developing and shaping Vermont s Blueprint for Health initiative, a system reform program to better address chronic disease management and population health management. This initiative placed Vermont in the national spotlight and positioned Vermont to adeptly respond to requirements for new programs such as Patient Centered Medical Home, NCQA certification, Medicare Meaningful Use and Accountable Care Organizations. OTHER HEALTHCARE EXPERIENCE: 2005 Present: Fitness Options, Inc., South Burlington, VT. Started a small business emphasizing fitness training and nutrition programs to provide hands-on health activities that are enjoyable and productive for people. Our nutrition counselors, on-site physical therapist, and certified personal trainers help people manage chronic health conditions including obesity, hypertension, high cholesterol, and diabetes : Independent Consulting, South Burlington, VT. Assisted organizations including the Vermont Department of Health, Blue Cross/Blue Shield of Vermont, and the Vermont Veterans Nursing Home in preparing their project applications and presenting their case to regulators, using my experience with Vermont s Certificate of Need (CON) process for new capital-intensive health care projects. 6

7 2003: Home Instead Senior Care, Burlington, VT. Established and co-owned a firm that hires and trains caregivers to provide non-medical services to the elderly in their homes. Home Instead operates today as a highly successful company, : Health Care Consulting, VT: Worked on issues and projects such as disease management (asthma and diabetes), strategic planning, regulatory compliance, and others for clients such as the State of Vermont and Blue Cross/Blue Shield of Vermont : The Vermont Health Plan (TVHP), Vice President for Clinical and Legal Services, Colchester, VT. Served as a key leader in developing and implementing a strategic plan for identifying and achieving optimal quality, utilization, and financial targets. Developed and managed TVHP s $1.5 million care management budget. Responsible for the annual quality improvement plan and meeting requirements of Rule 10 (Vermont Consumer Protection Act), oversight of statewide-delegated entities, developing medical policies, quality initiatives and disease management programs. Worked with the BCBSVT senior management team and its Board of Directors to integrate these innovations across the Blue Cross/Blue Shield of Vermont (BCBSVT) enterprise : Massachusetts General Hospital, Boston, MA : Nurse practitioner, Internal Medicine and Women s Health Associates Primary Care Practices. Gained experience in a collaborative, clinical practice with billing goals and productivity targets : Massachusetts General Physicians Organization (MGPO), Inc./Massachusetts General Hospital, Director of Contracting, Boston, MA. Responsible for all aspects of managed care contracting and related program implementation at a time when managed care and risk contracting was an emerging strategy for payers and providers in an attempt to control costs and improve quality. Acquired the skills to effectively evaluate, negotiate, and manage risk contracts for a multi-specialty physicians organization and major academic medical center. 1994: Massachusetts General Physicians Organization (MGPO), Inc, Health & Hospital Law Intern, Boston, MA. Worked as an intern at Mass General, researching managed care issues for the executive director of the MGPO, while in law school and working as a nurse practitioner. Gained an understanding of the operational and legal realities of managed care contracting and the impact contracts have on programs. CLINICAL EXPERIENCE: present: GoodHealth, PC, South Burlington, VT. Adult nurse practitioner in a busy independent primary care practice of three physicians and two nurse practitioners. 7

8 : Harvard Community Health Plan, Brookline, MA. Nurse practitioner, Urgent Care Division : Massachusetts General Hospital, Boston, MA. Nurse practitioner, Internal Medicine and Women s Health Associates Primary Care Practices. Gained experience in a collaborative, clinical practice with billing goals and productivity targets : Belmont-Watertown (MA) Visiting Nurses Association. Visiting nurse : Group Health Hospital, Seattle, WA. Staff nurse : Women s Health Services, New Haven, CT. Community outreach nurse : Yale New Haven Hospital, New Haven, CT. Staff nurse. TEACHING: 2010: University of Vermont, Burlington, VT: Instructor, Health Care Management, Graduate Program-Business Management, spring session. Guest speaker 2011, 2012 and : Simmons College, Boston, MA: Associate Professor of Nursing, classroom teacher. Responsible for clinical placements, coordinating with a variety of providers : University of Alaska, Juneau, AK: Instructor in practical nurse education. Worked with the local community college, established a learning lab, and negotiated for clinical placements for my students. PUBLICATIONS AND PRESENTATIONS: 1. Thabault and Carr, Non-Hormonal Contraception, The Medical Care of Women, Carr and Freund, W.B. Saunders Company (1995). 2. Bauer, Thabault, Estok, et. al., (2000) Low-Dose corticosteroids and avascular necrosis of the hip and knee, Pharmacoepidemiology and Drug Safety. 3. Marcy, Thabault, Olson et. Al., (2003) Smoking status identification: two managed care organizations' experiences with a pilot project to implement identification systems in independent practice associations, Am J Managed Care. 4. Thabault, chapter submitted for publication (2011), Informed Consent Nursing and the Law, The American Association of Nurse Attorneys (anticipated publish date 2013). 8

9 5. Thabault, Mylott, Patterson (2013) Describing a residency program developed for newly graduated nurse practitioners employed in retail health settings The Journal of Professional Nursing (submitted for publication, under review). 6. Thabault, (2014) Evaluation of Intensive Behavioral Therapy for Weight Loss Program at GoodHEALTH Associates in Adult Medicine, National Nurse Practitioner Symposium, Poster Presentation (accepted) LEADERSHIP: Vermont Nurse Practitioner Association, Board Member at Large, Policy Committee Convenient Care Association, Board Member. Represented the interests of CVS/Caremark, Minute Clinic at industry association addressing quality, advanced practice, public awareness and regulatory barriers impacting the retail health industry. ( ) National Association of Insurance Commissioners, Secretary, Northeast Zone (elected). Represented the northeast zone states at the executive committee and served on several key national committees including the healthcare committee (2008) Interstate Insurance Product Regulation Compact, Chair, Rulemaking Committee. I represented Vermont s interests and used consensus-building skills in meetings of the multistate compact group to gain support of other states on issues important to Vermont, such as the inclusion of mental health coverage for disability policies offered in the member states, ( ) Snelling Center for Government, Graduate of the Vermont Leadership Institute program (2005). COMMUNITY SERVICE: 2014: Co-Chair, American Heart Association, Go-Red for Women Luncheon (Vermont) 9

10 2006 Present: Lund, Burlington, VT. Board Member. Committees: Finance; Program; present and past Chair Strategic Planning Committee ( ); Chair Annual Mother s Day Ride : Alzheimer s Association of Vermont. Development Committee : Community Health Center of Vermont, Burlington, VT. Member, past president, Board of Directors. Committees: Finance, Clinical Practice, and Executive Committee : Raising Healthy Children, Burlington, VT. Advisory Board. 10