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Reflection Paper

Taylor Van Tassel

KINS 4306: Internship in Public Health

Dr. Jim Lindstone & Dr. Ernie Kaninjing

20 April 2019
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Introduction

My name is Taylor Van Tassel. I am currently interning with Habersham Medical Center

in Demorest, Ga. Habersham Medical Center is only 80 miles north of Atlanta and serves

approximately 80,000 Northeast Georgia residents. The hospital is a 53-bed not-for-profit acute

care facility. Habersham’s mission statement “is to provide quality and safe patient care in a

compassionate, professional and economical manner to all persons in Habersham and

surrounding counties including: emergency and acute inpatient and outpatient care to its

community, an integrated program of long-term care for aged and chronically ill persons,

cooperating with physicians, employers and various agencies to provide a coordinated program

of health care and meet community needs; and programs to prevent illness and injury and to

promote health.” Habersham Medical Center has won five Quality and Patient Safety Awards

from the Georgia Hospital Association’s Partnership for Health and Accountability. They are

also recognized as a Certified Primary Stroke Center by The Joint Commission. Habersham

Medical Center approximately employs more than 600 staff and has an annual operating budget

of $42 million and more than $75 million local economic impact on the community. They

currently have more than 35 physicians on the medical staff with specialties in obstetrics,

urology, ophthalmology, sports medicine, orthopedics, general surgery, and internal medicine.

With the constant growth in the area, the hospital recently underwent a $38.6 million expansion

incorporating a new emergency department and 24-bed outpatient surgery center in 2008. I

primarily worked in the Med/Surg and ICU unit. The hospital served majority of the elderly

population and uninsured population. The ER frequently notices a trend in the Hispanic

population. Many of the nursing staff in the Med/Surg unit are fresh, new nurses that just

graduated from college. I noticed that they have an extremely high turnover rate in the nursing
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staff. Habersham Medical Center partners with Accountable Care Organization which is

contracted physicians. They currently rotate every week in the Med/Surg unit.

Description of Experiences

My supervisor, Tyler Williams, is the Vice President of Strategy and Business

Development. He primarily works in administration. My first day working at Habersham

Medical Center, he asked me what career path I would like to take. I decided to intern at the

hospital because I enjoy the setting and felt that I could receive all different type of perspectives

within the medical setting. I felt as though this experience would allow me to narrow down what

exactly I would enjoy doing the most. Originally, I wanted to become a nurse. Therefore, Tyler

placed me with case management and I shadowed them for approximately a week. While I

shadowed them, I researched the demographics and identified a constant problem that they

continuously fight. HMC is the highest penalized hospital in the state of Georgia in the 30-day

readmission penalty. With that being said, I decided to focus on ways that we can improve the

readmission rate. This will be a very challenging project because it is difficult to track the

improvements made because it is tracked every three years. Unfortunately, HMC is currently

paying penalty fees for 2014 to 2017. During that time, their readmission rates were horrendous.

The percentage of readmissions were approximately 17% and currently they range around 6-7%

which is considered our baseline. I was given the opportunity to shadow nurses. They gave me

insight into what flaws the system currently obtains. Once I shadowed the nurse, I realized that

the nursing career path is not for me.

The most beneficial part of my internship was understanding patient safety and working

with patients first hand to understand their perspectives of the hospital and the best quality of

care. I had the opportunity to assist case managers in improving and maintaining quality of care
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for patients before discharge. This was very rewarding. I had created a community resource

guide for case management. I had the opportunity to use my manual first hand by providing

patients with placement for once they depart the hospital. The most challenging was my project.

I had concluded that one of the main reasons we could improve readmissions was nurse

satisfaction and nurse to patient ratio. The nursing staff in the Med/Surg unit are highly

dissatisfied with their jobs. This directly correlates with quality of care and patient education. I

personally could not fix this problem and improve the nursing staff alone or during my time at

HMC. It is difficult to evaluate whether or not my ideas about reducing readmissions will benefit

the hospital. However, I am motivated to bring to light the problems that the hospital does not

necessarily see on a daily basis. Even though, I personally might not be able to fix this revolving

problem. My hope is that Tyler and other managers will take the initiative to improve these

problems.

Perception and Evaluation of the Internship

Habersham Medical Center highly exceeded my expectations. I am impressed with the

variety of tasks that I was given throughout my internship. There were days where it was slower

than others, however, that is expected at any work place. I created a diverse network with

hospitalists, nurses, administration, human resource, and many more highly sophisticated people.

I was not expecting to have the opportunity to work in any setting within the hospital. The staff

and mangers were always very encouraging of shadowing and expanding my knowledge in the

hospital. They supported and gave feedback to every idea. The organization welcomed me with

open arms. My supervision was very effective. Every question and concern that I had voiced to

Tyler, he would always answer immediately. Majority of my time, I worked with case

management, therefore, Miriam Duncan, case management supervisor would also provide
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supervision and daily tasks for me to conquer throughout the semester. On a weekly basis, I

would stop by Tyler’s office to check in with him and go into detail the tasks and observations

that I have been obtaining throughout the week.

I feel as though my experience could have been improved if I had an office within the

hospital. I am extremely grateful that I had my own office, however, it became challenging at

times when trying to complete post-care call backs, assist in Medicare Right letters, and observe

the nursing staff when my office was not connected to the hospital. I would recommend this

setting for future interns. This was a great experience for my first time entering the professional

world. It really gave me different perspectives into the unlimited number of career paths that I

can endure in the hospital setting. Majority of students believe that the hospital setting requires a

clinical degree. Fortunately, there are plenty of job opportunities one can obtain without a

clinical degree and still be able to provide patient safety and interact with the community. My

goal after graduation is to obtain a degree in Master of Healthcare Administration and work

within a setting such as Habersham Medical Center. However, I would prefer a rather larger

hospital setting.

Internship Preparedness

I feel as though majority of my internship, I was academically prepared for the tasks and

challenges that I was given. My supervisor has a background in business management, therefore,

at times we both had a different point of view. I was searching for ways to improve the

populations overall health. On the other hand, Tyler was looking at the dollar sign and ways to

improve the hospital as a business perspective. I was not prepared academically from a business

stand point. I wish I had taken some business classes as my electives throughout the years. Now
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that I have discovered the career path that I would like to pursue in healthcare administration; I

must have a business background.

Throughout the semester at HMC, I had the opportunity to apply a lot of material from

previous classes to certain tasks. When I was developing my project plan, I had to use my

S.M.A.R.T. goals from Health Promotion, Programming, and Planning. One of my electives,

Pharmacology, enabled me to understand the medications and how they affect the body when the

physicians and nurses would meet for the 2 o’clock meeting every day to discuss each patient in

depth. Throughout my time at HMC, I noticed a trend in the lack of physical activity with

patients. When conducting an Excel spreadsheet with the demographics within the county, the

lack of physical activity was extremely high. My Personal Health & Fitness class allowed me to

correctly and efficiently encourage patients to be physically active and the importance of

physical activity and how to prevent injuries. HMC partners with a company called New Vision.

New Vision is a medical stabilization program for recovering addicts. I was able to apply my

knowledge from Substance Use & Abuse class to discuss recovery options for patients and how

each drug plays a role in the individual’s life. It was very rewarding to know that majority of my

classes that I took gave me the opportunity to apply the material in real-world situations.

However, the Health Promotion, Programming, and Planning seemed to be the most helpful with

my internship overall. This class enabled me to create a community resource manual and

properly plan a project that will hopefully have a significant impact on the readmission rates.

The School of Health and Human Performance did an excellent job preparing me for my

internship and transition into the real world. However, I feel as though I wish we had more

guidance into the best practices when applying for jobs and what to expect when being

interviewed. The interview stream is a great tool for practice. Unfortunately, I did not feel it was
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realistic to me. I really enjoyed the reverse classroom approach that Dr. Lindstone applied to the

Health Promotion, Programming, and Planning class. It was extremely helpful because we had

the opportunity to apply our knowledge to real situations.

Internship Performance

I had acquired many new skills and knowledge during my time at HMC. One main skill

is communication and how to properly communicate with all networks. Once I completed one

task, I would take the initiative to work on something else. There is something to always be

improved on. I acquired new knowledge into the business world and how to take a different,

sophisticated approach to the healthcare realm. My time management had improved throughout

the semester. Over the course of the semester, I had been given a variety of tasks to complete by

the end of the day or week. I always felt that I went above and beyond the requirements. I

learned how to audit Medicare letters that were given to patients during their stay. My teamwork

and use of collaboration with case management never fell short and we always assisted each

other in all challenges.

I am satisfied with my performance on assignments and projects at Habersham Medical

Center. I used my time management efficiently and effectively. I would rate my overall quality

of work at an 9 out of 10. I did have a difficult time with my complex project because it is

difficult to evaluate the results. My community resource manual can always have more resources

added the it in the future.

Leadership is one of the main skills I need to develop in order to be a successful

healthcare administration. I have had some opportunities throughout my college career to apply

leadership skills, however, never in a professional setting. My interpersonal skills could be

sharpened. I have to be able to identify an individual’s wants and needs and recognize different
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perspectives. Luckily, my supervisor gave me different perspectives. Miriam Duncan has a

background in social work, therefore, she had perspectives into the quality of care for patients.

Personal/Professional Insights/Benefits

My internship has impacted my professional and academic goals. Originally, I intended

on going back to school for nursing. I chose a hospital setting to assist me in my decision on

what professional path I found most interesting. I have concluded that I would like to go back to

school to receive a degree in Master of Healthcare Administration. I do not find nursing as

interesting as originally intended. I thoroughly enjoy working in the hospital setting, however,

the nonclinical side is what spikes my interest the most. I have gained more confidence in myself

and improved in my communication skills tremendously. At the beginning of my internship, I

created my own demographic spreadsheet comparing Habersham county to surround counties

and the state averages. I found some data to be shocking, such as, the lack of physical activity,

large Hispanic population, and high percentage of uninsured. In previous classes, I was taught

about services for elder and disabled, such as, hospice, home health, and skilled nursing

facilities. However, I did not quite understand how they operated and to what degree. As a result

of working with case management, I had the opportunity to work with all of these services for

seniors and disabled. I took the initiative to shadow home health. We had to visit each patient in

their home environment. This spoke volumes to me and provided me with a new perspective in

the medical field.

Overall, this internship site was very rewarding on all levels. I feel as though my

presence was worthwhile and provided administration with loads of information into ways they

can improve their readmission rates. I had the ability to apply my knowledge from previous
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classes in this setting. I would recommend this site to any future intern. My supervisor gave me

lots of insight and guidance. This experience has prepared me for my professional career path.