The Fixer

As new chief at the Memphis VA, Dr. Diane Knight stresses stability and creative change as keys to success.



photograph by palto | Dreamstime

Three years ago, when the Memphis VA Medical Center experienced troubles in its Intensive Care Unit, Dr. Diane Knight was invited to tackle the problems revealed by the Inpatient Evaluation Center, which tracks quality of care. She’d been successful at another VA facility in dealing with similar problems, so she came to Memphis and told the staff, “Don’t be discouraged, but it will take an entire year to turn these numbers around.”

Today, as director and CEO for the Memphis center, she smiles remembering how the staff responded. “They turned things around in two quarters,” says Knight, “and they’ve sustained those improvements for three years. We have a great mortality rate and ICU transfer rate. That was my first taste of what good work these people do.”

The Laurel, Mississippi, native who describes herself as a “fixer” brings a wealth of experience to the job she accepted in July after an eight-month interim stint: she was primary care physician and chief of geriatrics and extended care at the Biloxi VAMC; medical director at the Armed Forces Retirement Home in Gulfport; and, in 2009, deputy chief medical officer for VISN 9, the network of VA hospitals that includes Memphis and Nashville, among others.

While in Nashville she was sent to Memphis to identify weaknesses and recommend strategies to correct them. One major weakness was lack of stability and leadership at a facility that had six directors in five years. “I said, ‘All we need is a good leader; let me be on the interview team to find one.” During that time she was asked why she couldn’t stay; she responded that she had family in Nashville. “The turning point came when we received the report from the Joint Commission [which accredits and certifies hospitals]. It just blew me away — the best we’d had in terms of quality of care. I realized then I was giving excuses, not reasons for not staying, and I knew I really wanted to be here. I applied for the director job and was fortunate to be selected.”

 

Dr. Diane Knight

Since then she has stressed the importance of sticking to budgets, which means “trying hard not to shove money out the door, and also to bring it in.” With her team’s efforts the VA has been able to add new beds and radiology equipment. She also emphasizes the use of home-based primary care nurses to check on veterans with chronic problems in their homes, “to keep him or her healthy so they won’t need emergent and urgent health services often.” For those in rural areas she has started telehealth initiatives so that veterans can talk face-to-face with experts here via video monitors.

She also strives to “improve processes in ICU so we can get patients in, take care of their needs, and increase patient flow so we don’t have to turn anybody away,” says Knight. To enhance this flow is a step-down unit right off the ICU with “unique staff to care for patients who aren’t quite ready to go to the floor,” she adds.

Also in Knight’s game plan is an “informatics” department to identify all employees who are savvy about information technology. “We have a wonderful IT support system of people who know how to retrieve and interpret data,” Knight says. “We need to know who they are and get them in one place.”

One way she knows she’s seeing progress is from the quality of job candidates the VA is receiving. “We work closely with UT Health Science Center to get teaching appointments for doctors, because high-caliber candidates want to do research and teach as well as take care of patients.”

During the time she’s spent here, both as interim and director/CEO, Knight has seen the enthusiasm employees bring to the VA’s mission: “We empower them to help the veteran, regardless.”

She’s also discovered the same enthusiasm about Memphis, she says. “I see that young people and community leaders really want to build it up and make it the diamond, the showcase that it is. Everybody wants to be on a winning team. I like that.”

 

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