In January 2004, Dedie Wieler, a nurse at Boston Children’s Hospital, interviewed for a job as Martha’s Vineyard Hospital’s (MVH) chief quality officer. It was winter, a bleak time of year, but when she visited for the first time, she instantly fell in love with the Island.
“My husband was shocked when I told him I was actually going to take the job,” she said in a recent conversation with The Times.
Ms. Wieler rented a cottage on the Island where she lived during the week. Her husband, Jerome, remained at their home in Brookline to continue his career in computer data and financial support at Boston Children’s Hospital. Their son, Zack, was 23 at the time.
Over the last decade, the couple spent weekends and holidays together, alternating between Martha’s Vineyard and Brookline. “We went from pretty much never being apart — we got married when we were 22, in 1969 — so it was quite the change,” Ms. Wieler said.
Things are about to change again. Her husband, who last year, is very happy about her retirement.
“We’re a little intimidated now, because it’s been ten years since we’ve been living together, day and night; we’re wondering how that’s going to work,” she said with a laugh.
Despite the challenges, Ms. Wieler said her job at Martha’s Vineyard Hospital was the best in her career. Last week, in response to questions emailed from The Times, Ms. Wieler, who retired last week, shared her reflections on her job and the changes she witnessed over a decade in which the small, locally owned community hospital became one of a group of hospitals owned by Partners HealthCare System, a $6 billion nonprofit founded in 1994 by Massachusetts General Hospital (MGH) and Brigham and Women’s Hospital.
Was hospital administration your career goal when you graduated?
I grew up in York, Penn., and graduated from the York Hospital School of Nursing. Administration initially never crossed my mind: my goal was simply to help people and, given the relatively limited range of career options for women in the 1960s, I chose nursing. I spent the first 15 years of my nursing career at Boston Children’s Hospital. There I gradually realized that a leadership position would have a broader influence and I would be able to champion positive changes for patients and their families hospital-wide.
When and why did you come to Martha’s Vineyard?
It all started with a call from a recruiter looking for a nurse with a background in quality improvement. I had never been to the Vineyard and curiosity led me to the job interview. I simply fell in love with the Island, in the pouring rain, in the dead of winter. I remember thinking there had been a power outage in Oak Bluffs because so many houses were dark around Ocean Park, which demonstrates how naïve I was about Island life. I accepted the job and moved to the Vineyard the weekend before my first day of work. That was on January 26, 2004.
What were your job responsibilities?
I was responsible for the hospital’s Quality, Patient Safety and Risk Management programs. This included reporting requirements to the Board of Registration in Medicine, the Department of Public Health and the Joint Commission. I had direct oversight of the patient safety coordinator, case management director, social worker, patient advocate, substance abuse counselors, medical records/coding and, in the past, medical staff credentialing and housing.
About two years ago I was designated as the hospital’s corporate compliance officer and I developed the hospital’s corporate compliance program working with MGH and Partners.
Please describe some of the changes you saw over those years and how your job may have changed.
The two most obvious changes were the affiliation with MGH and the building of the new hospital. But there was much more: doubling the number of primary care physicians on Island, bringing in an additional OB/GYN physician and an additional orthopedic physician. Moving to an electronic medical record in the physicians’ offices. Working with Partners to participate in the inpatient and outpatient quality indicators, reporting to Medicare and third-party payors. Contracting with MGH Anesthesia Services, bringing MGH oncology services on-Island, and expanding the telemedicine program.
What were some of the more rewarding moments of your time at the Martha’s Vineyard Hospital?
Within the hospital walls: Being a part of building a new hospital, from fundraising to moving day, that was a career first for me. Creating and being a member of the Patient and Family Advisory Council which provides a forum for the Hospital to get insights and feedback directly from former patients and family members.
Representing the hospital at the Duke’s County Health Council, which enabled me to work closely with other island healthcare providers over the years, in many forums, all geared to improving or providing new viable programs on the Vineyard.
The Health Council played a lead role in identifying the focus for the hospital’s Community Health Initiative Grants and selected the four community members who with me, as the hospital representative, formed the review team that picks the grant winners each year. Participating in the yearly Rural Scholar projects with the students of UMass medical/graduate nursing.
What were some of the more difficult moments?
It was very difficult participating in the decision process that determines what sustainable programs the hospital can offer and what programs are best provided off Island. Patient safety and physician specialty expertise are key reasons we need tertiary and specialty hospitals for certain diseases.
What do you think Island residents should know about the hospital that is not readily apparent?
There is a misconception that everything related to health care should be offered by the hospital. Not all health care programs belong in a hospital setting. An example would be cataract surgery. Off Island it is almost exclusively performed in surgi-centers, not at hospitals, because the cost would be much higher.
There is no “free” money from Partner’s or MGH. Our hospital pays, whether it is for Partner’s computers or contracted services like the MGH anesthesia, oncology, or telemedicine services.
From time to time we hear complaints about wait times in the ER as well as complaints about treatment received. It was your job to follow up on those complaints. How did you do it and what did you do when the complaints had merit?
The goal of quality and patient safety is to improve care and the processes in place to provide that care. Complaints and satisfaction surveys provide us with valuable information which the hospital staff can use to constantly improve. The patient advocates work with departments to understand what happened, but the departments themselves design and institute the improvements. So much more can be accomplished by focusing on getting better instead of pointing fingers or finding someone to blame.
Human nature
Ms. Wieler noted that MVH has gone through more major changes in the past 10 years than any other hospital she worked at during the previous 30-plus years of her career.
“Human beings seem to be wired to resist change, but given the broad scope and rapid pace of all the transformations, the entire hospital staff, with the support of the community, stepped up to the plate,” she wrote. “I lucked out again, I saved the best job of my career for last. Thank you, Martha’s Vineyard Hospital!”
When asked what she plans to do in her retirement, Ms. Wieler, who still has her Island cottage, said, “I keep telling people, first I just want to know what it feels like not to have to go anywhere every day.”
However, she did rejoin the YMCA last week, with a goal to swim every day. Ms. Wieler said she also looks forward to reading many mystery books, which are her favorites, as well as a few history books she never got around to. She also plans to go on more walks with her dog, Suzy, a 10-year old black Lab mix.
