On Shaping His New Role
Andrew Mullenix applies his background as a triathlete to his job: What else can I do? How can I do things more efficiently? How can I meet my goals? For now, that means taking on the challenge of shaping a newly created position, director of the Pediatric Clinical Research Center (PCRC) and Research Nursing Service. One of his main responsibilities is to oversee PCRC operations. His dream was to ease into the job and observe how things work for several months, and then make some decisions and changes — but, because this is the real world, “we’re building the car as we drive it, then pausing and planning,” he says.
This leadership role is in place to advance the overarching strategic initiative of integrating clinical care with research. Specifically, he works with nurses, medical assistants and clinical research associates within the PCRC to determine clinical scope of practice and to promote the connection of research to clinical care among staff. In order to meet the goal of integrating research and clinical care, he views his role as being the glue that connects both worlds. “It’s my job to stay plugged into hospital and research initiatives so clinical research staff have the chance to offer patients the opportunity to participate in research,” he comments. Fiscal year 2017 will be a foundational year for the PCRC and Research Nursing Services. “I hope to understand and build the infrastructure needed to achieve our strategic goals. Examples of this include ensuring clinical research staff have the necessary competencies, building a nimble staffing model and ensuring the PCRC is included in the nurse residency program,” he explains.
On Finishing His MHA Degree
Mullenix just graduated from the two-year executive master of health administration (MHA) program at the University of Washington. “This program has been excellent. It brings together different perspectives within healthcare,” he says. Students complete a capstone project at the end of the second year that involves an analysis of a real-world issue in healthcare administration. Students tackle projects submitted within their healthcare organization and present recommendations back to the organization’s leadership. Mullenix’s team looked closely at Seattle Children’s use of the drug ondansetron (Zofran), a first-line anti-nausea medicine that has the highest accumulated direct costs within the cancer value stream at Seattle Children’s, accounting for $2 million per year in expenditures.
On Identifying Costs to Reduce
Through education and changes to the Clinical Information System (CIS) order sets for Zofran, the goal is to shift 10% of IV administration to oral. Reducing IV utilization reduces the risk of acquiring a bloodstream infection, and should save almost $160,000 per year in direct costs alone. Mullenix partnered with Seattle Children’s LEAN value-stream leaders and the Clinical Standard Work team to conduct a comprehensive analysis and literature review, and create monitoring tools to keep the project on track. Someone else will be identified to lead the implementation effort, because Mullenix is no longer working in the cancer care unit. “I truly believe that focusing redesign efforts on the clinical care process is critically important for the financial health of Seattle Children’s and our healthcare system as a whole. I’m really proud of this redesign work because it keeps our patients safer and reduces cost along the way,” he says.
Zofran is a medicine that Mullenix has administered a lot in his 13 years at Seattle Children’s, where he was a charge nurse and then a clinical practice manager in oncology. “I miss the cancer care team, and the kids we take care of are great,” he says with a smile, thinking back about working directly with children. His work in the hospital sparked him to realize that he wanted an MHA to be better equipped to problem-solve and apply data analysis to improve healthcare delivery. “In my work as a nurse, I relied on my experience and my gut when I made decisions. Analytical tools are an adjunct to clinical decision making, not a replacement,” he emphasizes.
On Remembering the Patient
His background as a nurse means that patient care is always in his mind. “I haven’t seen a patient in seven years,” he says, “but my job is to set the tone and culture that facilitates patient care and helps our clinical research teams do their best work. We provide great service, and you can’t do that if your staff isn’t happy. Staff members need support. We try to balance the seriousness of what we do with fun — people need that.”
On Running Fast
When asked what he does for fun, Mullenix shares that he is a triathlete. In the 2010 IRONMAN World Championship in Hawaii, in his age group, he placed third, top 10 amateur and first amateur from the U.S. “I missed my goal of breaking 9 hours by 21 seconds (9:00:21), but it was still an incredible experience,” he says with a grin. He channeled the time and energy he formerly devoted to training into the MHA program. Now that it is over, he looks forward to more time with his family and keeping on the go with his twin girls, who turn seven in October.
– E. Kuwana