Visionaries and Educators

Lessons learned in the Marines

A helicopter crash taught me to be a better practice administrator.

By Zachary Smith, MHSA

In February 2013, I was the director of Medical Support for the 31st Marine Expeditionary Unit based in Okinawa, Japan. During Exercise Cobra Gold, a training mission in northern Thailand, one of our CH-46 helicopters clipped a tree while attempting to land on a mountainside. It crashed in flames. All four crewmembers were injured, but the pilot, Maj. Brian Forney, was in critical condition. He had second- and third-degree burns on nearly 60% of his body and needed expert care immediately or he would not survive.

I was the casualty evacuation coordinator for the exercise. My team was responsible for getting Maj. Forney and his crew transported quickly, and for ensuring that they received appropriate medical care.

The following days were the longest of my professional life as we worked to move Maj. Forney from the crash site to Brooks Army Medical Center in San Antonio, Texas, via two smaller Thai hospitals and specialty facilities in Bangkok and Singapore.

Over the past 18 months, since becoming an ophthalmic practice administrator, I’ve discovered remarkable parallels between that brief but intense experience and my current daily challenges.

Lt. Smith poses with a Thai child during a humanitarian assistance event.

Maj. Forney with his children several months after the crash.

PARALLEL #1

1. Craft a detailed plan.

Casualty evacuation plans for exercises like Cobra Gold are drawn months in advance. Critical data, to be shared with all team members, are researched and compiled before the exercise starts, such as hospital locations and their capabilities, air and ground transport resources, evacuation routes and key points of contact: these include phone numbers, e-mail addresses and radio frequencies.

In like fashion, our leadership team at Evergreen Eye Center drew a detailed plan for our practice’s future. During several strategic planning meetings, we decided on our organizational philosophy; laid out a vision for the organization, including roles and responsibilities for management team members; and described the contribution of each department to the company’s overarching goals. We even crafted what we call a defining statement: “We provide patient-centered care.” These words now guide everything we do.

2. Trust your plan.

No plan is perfect; however, if you take the time to plan carefully, you should stay confident in your blueprint and avoid retreating to the drawing board unnecessarily — especially when facing adversity. When we received word that the helicopter had crashed, we almost rushed into a flurry of activity that could have been unproductive. Because we followed the plan, though, and executed it effectively, we rescued these four men, including transporting Maj. Forney halfway across the world to a specialty burn facility. We also easily tracked the recovery of all four Marines based on communication protocols previously established.

Similarly, Evergreen is striving to effectively carry out our plan despite various challenges. Our department heads use the overarching goals established in our strategic planning sessions to set more immediate quarterly goals. Management team members use both quantitative and qualitative metrics to assess timeliness of completion and quality of results. Communication protocols among our management team dictate when an e-mail will suffice, when a phone call is helpful and when an in-person meeting is necessary. This dedication to our plan has resulted in better scheduling in our clinics, more efficient internal processes and greater customer satisfaction.

PARALLEL #2

3. Know when to be flexible.

Our first objective after the crash was to move the Marines from the crash site to a local hospital. Our evacuation plan called for movement by air or ground using Marine Corps transportation assets. Because crewmembers were stranded on a small ledge partway up a mountainside, we could not get to them with our available resources. So, we adapted the plan and involved outside parties. Luckily, U.S. Army Blackhawk helicopters operating nearby were available to safely land and help us extract the injured crew.

We’ve also had to “adapt and overcome” at Evergreen to achieve our objectives. One good example is our approach to payroll processing. When I first joined the company, we handled our payroll internally using a series of interconnected spreadsheets. Because of the cumbersome nature of this process for such a large organization, we decided to move to a third-party payroll provider. However, almost a year after this move, we still had some significant issues. In spite of the difficulty and expense of switching providers again, we determined this was the best course of action. Since then, our payroll process has been substantially easier and more manageable with far fewer errors.

CONCLUSION

In responding to extreme circumstances, we can build character and experience growth that leads to unexpected benefits later in life. When I joined Evergreen Eye Center in early 2015, I could not have anticipated how much the lessons learned during the helicopter crash would impact my approach to leading this organization, but in retrospect it’s been profound. Team Evergreen isn’t perfect — no organization is — but we know exactly what we want to become, and we’ve made great progress thanks to detailed planning, attention to execution and the ability to adapt when necessary. OM

Zachary Smith is the chief operating officer at Evergreen Eye Center in Federal Way, Wash. He is also a Medical Service Corps officer in the U.S. Navy Reserve.