Professional Experience:

Roxanne's distinguished healthcare career includes achievements in emergency medicine: Under her oversight, the medic al helicopter system, Bayflite, expanded from one helicopter to six and is now one of the world’s best emergency transport services.

Guidehouse experiences include:

• Interim director emergency department at Sentara CarePlex Hospital in Hampton, Virginia.
• Performance improvement plan for emergency department operational, flow and ED throughput projects. Assessments and evaluations have spanned from various volumes Community Emergency Department such as St University Academic Hospital Systems. Clients such as Lake Hospital System in Ohio, University of Alabama Birmingham, and University of Chicago in Illinois, Sutter Eden Hospital, Oakland, California, Harris Methodist Hospital, Fort Worth Texas, and Geisinger Health System, Danville, Pennsylvania. Assessments have included ancillary support department of lab, registration, radiology, and EVS service which impact the emergency department. Staffing analysis of pattern and skill mix and recommended staffing patterns to meet patient demand patterns.
• Conducted comprehensive assessment for several trauma programs, ground and air medical programs. Recommendations developed to assist with operational excellence and to ensure “right sized programs.”
• Facilitated and completed an in-depth assessment of a Level 2 Trauma Center in readiness status for the preparation for an application for Level 1 Trauma designation at Alexian Brothers Medical Center, Elk Grove Village, Illinois. The assessment included ED, ED Physician, On-Call Physicians and Specialist, Trauma Surgeon and Trauma Department.
• Led several ED implementation projects have included mentoring and development of the ED Leadership Team. Developing work plans to implement new ED strategies and patient flow with capacity challenges. Conducted several types of Lean Rapid Cycle Lean Teams to assist clients through process changes. Implemented ED Joint Practice Teams to structure the ED governance in a multidisciplinary approach for over site in the ED operations with the development of metrics and goals. Clients include St. Clair’s Hospital, Pittsburg, Pennsylvania and Christus Shoreline Hospital, Corpus Christi, Texas, University of Arkansas for Medical Sciences, Little Rock, Arkansas, Genesis Health Care, Zanesville, Ohio and Cone Health ED in Greensboro, North Carolina and Cone Health – Alamance ED, Burlington, North Carolina

Cancer Care

• Interim director at the University of Arkansas for Medical Science Outpatient Chemo-Infusion Centers. The solid tumor center. There are two infusion centers at the UAMS with an average daily census for 310 patients. The 4th floor (ADC 135 patients) of the Rockefeller Cancer Institute focused on Myeloma, Lymphoma and Leukemia patients. This unit was also an outpatient bone marrow transplant center. The first floor clinic was focused on solid tumor chemo patients with an ADC of 175 patients.

• The focus of work was the day to day operations while implementing new processes to decrease patient throughput time.
• This work included creating daily huddles with the outpatient Oncology Nursing staff, pharmacy and infusion center charge nurse, to verify orders, cycle times and support medications needed. Ensuring chair time for the patient was scheduled appropriately and timely.
• Reviewed and edited and ensured staff competency to all FACT documents for compliance for the regulations.
• Re-designed the staff model with the charge leaders in each of the infusion centers. Reviewed and revised job descriptions for new staffing model.
• Designed a cross training program for staff to work on the BMT infusion area, solid tumor center along with the chair area staff for post BMT patients.
• Redesigned the lab draw area to include an RN at one station to draw patients who have ports/lines.
• Created a 4-chair rapid treatment area designed for patients with quick injections, IV therapy, or other procedures.


• Roswell Park Cancer Institute (RPCI) consulting engagement included a complete assessment of the Chemo-Infusion Center at Roswell Park and at the satellite infusion center at Elmhurst.


• The implementation of recommendations was focused on the main campus at the RPCI. This center sees all types of cancer patients in a 36 bed/chair unit with an average daily census of approximately 110 patients per 13-hour day.
  • Utilizing the lean process a lean team which was created to include the director, manager, charge nurses, staff RN, unit aide and scheduler/discharge clerk and 2 outpatient pharmacists (one representing the physician office practice and one representing the outpatient pharmacy.
  • The focus of the lean events was focused on patient throughput from entry into the center through discharge process.
• The results of the lean team was a streamlined patient process making sure
  
  • Created a patient focused throughput process with a registration clerk moving to the front door of the infusion center with an immediate greeting process/registration.
• Creating and implementing a new triage process.
  
  • Triage RN in a cubicle area to do immediate assessment of patients with abnormal lab, ill complaints from therapies and patients requiring lab draws from lines/ports.
• Assigned patient placement
  
  • Revised the charge nurse role from a medication order only tasks to being the throughput flow nurse in the unit.
  • Redesigned the pharmacy flow orders from the Physician clinics to the infusion center charge RN to flow directly from the Physician’s office to the outpatient pharmacy.
  • Initiated the work for the implementation an electronic tracker board system to be used center.
  • Implemented a bedside patient friendly discharge processes with the discharge clerk making appointments for future lab and infusion visits while the patient was receiving treatments. This eliminated stopping at the front desk after treatment completion.
• A member of the Clinical Assistance Team and the Clinical Advisor for Critical Care at King Drew Medical Center in Los Angeles

Additional experience includes:

• Director of Emergency/Trauma/Bayflite Services, Bayfront-St. Anthony’s Health Care
• Interim director & ARNP, Community Health Care Clinics of Pinellas County
• Interim director/manager Vassar Brothers Medical Center, Poughkeepsie, New York
• ARNP, Eckerd College Health Care Clinic
• Consultant Emergency Department, Presbyterian Hospital, Charlotte, NC
• Director of Nursing/Assistant Vice President, Mease Health Care
• Nursing Pool-Critical Care, Baptist Hospital, Pensacola, Florida.

Additionally, Roxanne is an accomplished author and presenter on Emergency Department Medicine and is a Board Member of the Emergency Medicine Learning Center, and Hospice of the Florida Suncoast.