Pamela Carlberg is a results based manager with Provider and Consulting career experience. Pamela is an expert in inpatient and outpatient department oversight, FTE analysis, process improvement, analysis and redesign, software purchase and implementation, program development, facility construction and redesign. She possesses a team-based leadership style with excellent interpersonal skills.

Education
- BSN, Nursing, Indiana University/Purdue, Indianapolis, Indiana
- MBA, Thomas More College

Memberships
Board Member: Redwood Rehab– Compliance Advisory Board, Cincinnati, Ohio


Speaking Events
-Health Care Business Association Forum 2008 Revenue Cycle Strategies and Best Practices
-Revenue Cycle Boot Camp 2008-Training course for national revenue cycle practice
-National CUE Conference 2004- Emergency Department Tracking Systems
-Computerized Physician Order Entry at Health Alliance Managers Conference
-Cincinnati Social Services-Health Alliance House Call Program
-VHA office managers-House Call Program
-VHA Directors-IV Access Programs
-VHA Directors-Bonus Structures and Lessons Learned
-VHA Directors-OB documentation systems


Manager/Clinical Specialist
Health Quest Health System- Charge Capture initiative for Emergency, Radiology, Pharmacy, Radiation Oncology and Cardiac Labs. Standardized CDM for 10 departments leaving process initiative for client to complete additional departments

Cleveland Clinic (11 hospitals), Catholic Health East (18 hospitals), Health Quest (4 hospitals)- Managed CDM Standardizations. Completed standardization for inpatient and outpatient departments. Developed implementation roadmaps for implementing new models across the organization. Identified capture opportunities. Completed price transparency analysis.

Kaiser Permanente- Lead Charge Capture Assessment . Completed comprehensive system assessment of current charge structures and analysis for revenue opportunities. Interviewed executives at 10 sites for potential revenue structure opportunities. Designed future state model for design of CDM.

Oakwood HealthCare- Managed and facilitated redesign of Care Management System. Paired with CNO and multidisciplinary core care management team to analyze and explore the care management process, and develop recommendations for the entitled state model. Facilitated accelerated design sessions using “straw models” to develop new design components for the care management model, identify the workflows, tools and resources required to support each design component. New model connected uninsured patients using the emergency department with clinics and care sources along with a reallocation process to maximize centralized staff and technology to add care management functions.

Mayo Clinic, Co-lead physician redesign. Assisted the Department of Internal Medicine in an evaluation of the current inpatient care delivery model outlining issues, concerns, strengths, and areas for improvement . Identified leading practice research and actual practices for transforming inpatient care delivery. Collaboratively developed a future state straw model for Inpatient Care Delivery where centralized physician staffing allowed for increased physician to patient caseloads and consistent RN support processes. Facilitated retreat for 160 department of medicine physicians.

Centura Health, CDM Standardization, redesign and implementation ED E&M Acuity. Managed initiative to standardize CDM and Acuity for 11 hospital system. Coordinated efforts between ED directors, CDM coordinators and HIM directors to achieve a standard acceptable to all facilities, creating criteria to meet CMS criteria and enhance revenues across the organization in the ED. Designed and conducted education for emergency department staff and physicians to implement new design and track outcomes.

Jackson Health System, Labor Management. Served as specialist for redesign in skill mix, Associate Nurse Manager “back to bedside” analysis, fixed cost center reductions, replacement of agency staff with hospital employed staff on patient care units, and premium pay reductions for fixed and flexed departments. Designed performance measurement and monitoring reports and a tracking tool development to monitor savings. Presented weekly executive leadership, progress reports, oversight of consulting staff, and development of standardized CDM, acuity criteria & standards, development of an educational tool and initiation of a tool for ongoing quality analysis. Created internal RN and PCA float pool to replace high utilization of agency staff.

Ascension Health, Emergency Department standardization and E&M redesign. Accelerated net revenue enhancements for procedures, supplies, and revenue opportunities in the adult and pediatric ED. Redesigned charge capture processes and tools providing consistency and efficiency for documentation of levels, procedures and supplies for 10 hospital system. Provided knowledge transfer to facilitate ongoing charge capture success by developing training materials and providing education to the ED staff.

Director of Nursing Health Alliance of Cincinnati, The Christ Hospital Largest health system in Cincinnati, consistently rated by World News and Reports as one of the top 50 hospitals in the nation for Cardiac Care. Oversaw 21 diverse units including: Emergency, Cardiac, Obstetrical, Orthopedics, Transplant, Oncology, Women’s Health, Infusion Therapy, Ambulance Services, Patient Transportation, Rehabilitation, Behavioral Health, Dialysis, House Call program, Extended Care, RN & Nurse Aid float pools, and Chemical Dependency.
 

• Geriatrics-Created design for Geriatric Service line which included business plan, oversight of marketing and implementation of Geriatric House Call Program and associated Geriatric inpatient unit. Program Objectives: To improve quality of care and health for geriatric patients, reduce end of life costs, increase revenue to hospital, and establish a new market of hospital patients previously admitted to competitor. Program census, revenue, and hospital admissions exceeded business plan projections after 2 quarters.
• Cardiac-Oversaw development of Evidenced Based Medicine (EVM) care paths for cardiac surgery, angioplasty, and thorocotomy. Designs lead to an additional 150 EVM care paths for medical and surgical patients across the hospital allowing for increased quality outcomes and reduced length of stay.
• Emergency Department-Used six sigma approaches, participating as green belt and project sponsor, to redesign processes within hospital to reduce hospital Emergency department diversions from average of 150 hours per month to less than 8 hours per month. Resulted in increased patient and physician satisfaction scores, increased hospital admissions and emergency department visits. Also acted in lead administrative role for $75 million construction of new 36 bed department.
• Renal Transplant-Worked with Nephrologists and Transplant surgeons to move the kidney transplant program to a 100% laparoscopic program. Lead design of a unit with all private rooms, prevent cross contamination of patients post surgery. Also established a renal clinic to serve patients post surgery for necessary infusions and medication.
• Clinical Documentation Systems-Acted as executive sponsor for design and installation of major software systems
  • Physician Order Entry: Executive sponsor for CPOE design for 6 hospital system. Participated on weekly teams with physicians, staff, managers, consultants and executives to identify current flow, future flow, screen layout, identify marketing strategies, education, identify hardware. Acted as link for project to CEO. Presented monthly updates to management conference, physician quality meetings, and administrative staff.
  • Emergency Tracking: Lead administrator for software search to purchase ED patient tracking system for the Health Alliance. Became program sponsor for design of screens, software selection and implementation. Presented at national CUE conference outcomes for the Health Alliance on ED tracking systems.
  • Obstetrics: Acted as executive sponsor in selection of new software vendor and hardware to best meet the needs of 5 Health Alliance Hospitals. Participated in financial analysis, vendor demonstrations and facilitated group agreement for single vendor. Became liaison for project manager and IS&T during implementation phase.
  • Hemodialysis: Oversaw search for best software vendor to provide clinical documentation for hemodialysis unit at Health Alliance sites. Participated in vendor demonstrations, negotiated contract with vendors, purchasing, and risk management. Worked with managers at Alliance facilities, IS&T, and project manager to implement and educate on new software.
• Capital Improvements-Participated in design and opening of $150 million cardiac tower and $5 million Women’s Health unit and $2 million kidney transplant unit. Worked with architects to design space, supplied data for analysis for space requirements, worked with facilities and construction to coordinate state requirements for project outcomes.
• Rehabilitation-Completed financial analysis and developed RFP to outsource. Negotiated contract and oversaw new program implementation. Improved reimbursement by 50% and tripled average daily census.Inpatient Extended Care Facility

Conducted financial analysis for 21 bed acute hospital extended care facility. Identified profit margin comparing insurance payments against expenses. Based on analysis closed program redirecting patient to local outpatient ECF facilities with empty beds. Reallocated beds were utilized for medical patients, increasing gross revenues by $1,500/patient stay. 

Chicago: 440-842-6410
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