January

Portrait of Tara Madison
Patient Placement staff let their manager, Tara Madison, know exactly what they think of her with this message attached to her office door.
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People of the U: Tara Madison

Published on Wednesday, January 27, 2021

By: Bruce Coleman, bcoleman@umc.edu

Editor's Note: People of the U is part of an ongoing series featuring UMMC's faculty, staff and students. See more People of the U features.

During “ordinary” times, Tara Madison manages a department that is charged with one of the most important – and hectic – responsibilities on campus.

But these are certainly not ordinary times.

Patient placement manager at the University of Mississippi Medical Center, Madison is no stranger to a highly pressurized environment. A skilled registered nurse, she has cared for patients on every adult floor of University Hospital during almost 20 years at the Medical Center, save one – psychiatry.

That vast array of experience has stood her in good stead while she has skillfully overseen what essentially is the Medical Center’s robust clinical “circulatory system” – the inflow and outflow of patients among most of the institution’s hospitals and clinics – during a worldwide pandemic few could have imagined less than a year ago.

“I like to say Patient Placement is the brains and the arms of the health care institution’s body,” Madison said. “We look at every patient coming into the institution from every portal of entry and make decisions to assign patients to their required service units. We make accommodations for outside providers. We’re like air traffic controllers – we move the patients in and help them move out.

“We have to make vital decisions about which patients take priority over others based upon their acuity level, our capacity at the time and other factors. We work closely, not just with nursing and ancillary staff, but also with physicians and administrators regarding patient flow. We want to make sure everybody is taken care of.

“We have to keep them moving, because if at any time they stop, it causes a delay somewhere else. Once we get in a jam, things can happen that aren’t good.”

Securing accommodations for COVID-19 patients at the Medical Center – not to mention the “regular” patients who have been displaced by the virus’ victims – has taxed her strength. It has taxed her perseverance. It has taxed her creativity.

And it has taxed those professionals she directs and the administrators and clinicians whom she advises. Yet she endures – if not thrives – despite having just climbed into the executive’s chair less than one year ago.   

“During the pandemic, like all the other areas at UMMC, we have had to adjust staffing in addition to just being overwhelmed at times by the increase of patients coming in,” she said. “We have seen our Emergency Departments be at capacity, which is something I have never seen in all my years in patient placement. At times, we’ve had to shift our mindset to accommodate certain patients in different areas of the hospital.”

For example, “We have had patients staying overnight in our Post Anesthesia Care Unit. That’s not something we would do on an ongoing basis. The tone in our phone calls and conversations with outside facilities trying to accommodate their patients by getting them placed here has changed. When they’re successful, it’s almost like winning a lottery – it’s like they hit the jackpot.”

Jason Zimmerman, associate chief nursing officer in Adult Nursing Services for University Hospital, likened the placement of patients during the pandemic to a game of chess. 

Portrait of Jason Zimmerman
Zimmerman

“The ‘game’ is always changing, and you are always trying to stay a few moves ahead,” Zimmerman said. “As cases and hospitalization demands have changed, we have had to adapt to them by flexing the types of care that we can provide on a routine basis.

“Tara and her team have been instrumental in managing these things and adapting to the many bed resource demands that a pandemic brings.”

Madison admits the pandemic has increased her responsibilities’ degree of difficulty considerably.

“Patient Placement is a 24-hour, seven-day-a-week job, so the pandemic does bring on a little more stress,” she said. “Especially when it comes to making sure patients are placed appropriately, compared to when I started.”

Originally from Alexandria, Louisiana, Madison came to Jackson by way of Hattiesburg, where she graduated from Hattiesburg High School. She attended Jones Community College, did her clinical work at Children’s of Mississippi and earned her licensed practical nurse degree. Then it was off to Forrest General Hospital in Hattiesburg to begin her nursing career in the nephrology department.

She moved to Jackson in October 2001 and began her career at UMMC in the night shift in the old 2 South Unit. She went to the Intensive Care Stepdown Unit in 2003 and did float pool work. When the new University Hospital opened in 2009, she went to the transplant floor on the new 2 South. While working in the Progressive Care Unit on 4 North later that year, she obtained her registered nurse credential.

Rhonda Kennedy recruited Madison to Patient Placement in 2011. She sold the versatile nurse on the side of health care the department provided – non-direct patient care. It was a fit that has lasted close to a decade.

“We were expanding the department by adding more R.N.s to provide 24-7 R.N. coverage,” Kennedy said. “I was the manager of Patient Placement at that time and tasked with hiring into those positions. I knew I needed strong nurses that exhibited excellent critical thinking skills.

“Tara was the first one to come to mind. I had worked with Tara in one capacity or another since 2006. I knew she had the fortitude it would take to be an R.N. in the world of Patient Flow and Throughput. I contacted her, and the rest is history.”

“Being in Patient Placement gives me the ability to look at all patients from all age ranges, from newborns all the way up to geriatrics,” said Madison, who joined the department as an R.N. transfer coordinator. “We see every kind of patient in this department, from birth to death, basically.”

In 2017, Madison was promoted to supervisor of patient placement. In 2018, she obtained her B.S.N. from the Mississippi University for Women. And just last year, she was named manager of Patient Placement.

Jacqueline Lewis, patient placement coordinator, said although the department of R.N. coordinators and patient placement coordinators may be small, Madison works hard to ensure the institution’s everyday patient care encounters flow as smoothly as possible.

“We make encounters for Adults and Pediatric Services, Air Care and the Children’s Cancer Clinic, and we make bed assignments for the entire hospital, Ultrasound and Nuclear Medicine,” Lewis said. “We take transfers from outside hospitals, etc. She makes sure that, if her staff is challenged with easy or hard duties, she takes call and tries to assist in any way she can. She can even handle challenges when she is forced to make a hard choice when she has to.

“She came into this position by first working as a nurse herself and learned the ‘ins and outs’ of the department. She tries to be fair in the face of many challenges. She has a wonderful team who is not recognized often, but they go on because they are UMMC Strong!”         

Madison said the additional responsibilities inherent in serving as a department manager brings an enticing set of challenges.   

“I like getting other people’s views, the different opinions from non-clinical staff, engaging in Q and A with staff about different reasons why we place patients in certain areas,” she said. “When I first arrived, I was basically focused on dealing with patient transfers from outside facilities to UMMC. Now as a manager, I’m not just focused on one select group of patients, but I see everything that goes on from the nursing side to the non-clinical side.

“I love engaging with staff and discussing how to improve our communication.”

Amishau Harmon, an R.N. transfer coordinator in Patient Placement who has worked alongside Madison for years, said she has demonstrated to her team that hard work truly does have rewards.

“She communicates with her staff well and builds a rapport,” Harmon said. “She is very approachable and goes above and beyond to make herself available, not just for her team, but she has said many times to others as well, ‘You can call me anytime on my cell.’

“She is always willing to listen and welcomes any ideas that can make the department better. She encourages collaboration and communication among team members within and outside of the Patient Placement Department. This makes it easier for employees to receive assistance from coworkers when they ask for it. It also encourages departments to support each other’ efforts.”

Madison said she isn’t afraid to “get her hands dirty,” so to speak.

“The best part about my role is that with my staff, I can still be hands on – I don’t have to just sit back and be in an office and give directions,” she said. “I can get beside my coordinators, be on the scene. I can actually be at the fire, not just at the fire station.

“Not all managers get to do that, be able to get out there and help their staff members on the floors, out in the open. But I enjoy it.”

Zimmerman, who has worked with Madison for many years to collaboratively manage capacity constraints relative to bed availability and patient placement, said her hard work and dedication have allowed the hospital system to coordinate the placement of inpatients successfully for years.

“Tara always goes above and beyond to meet the patient placement needs of our providers and systems,” Zimmerman said. “Tara has a work ethic that is second to none and she is a true ‘owner of her work. She has shown a strong ability to adapt and is resilient during the many changes that have to be considered when dealing with historical capacity challenges and, most recently, a pandemic.”

Nobody is an automaton, and Madison is no exception: With such heightened responsibilities and a grueling schedule, she admits the need to take a break every once in a while. To recharge, she spends time at home with her family.

“Away from UMMC, family time is relaxing time,” she said. “Having a ‘date night’ with my husband every Saturday, or spending time with my kids and grandkids, that’s my special time.”

Then it’s back to the grind, where she maintains the organization, rather than the individual, should remain at the forefront.

“She tell us often, ‘People don’t see individuals when it comes to Patient Placement, but the department as a whole,’” Harmon said. “With this reminder, we know how important it is for us to work together to get the job done.”         

Working together to build something greater than oneself is what has kept Madison engaged at the Medical Center for so long.

“What led me to UMMC, and what has kept me at UMMC, is the opportunity to grow,” she said. “This place is a hospital that is a teaching facility, but it is also a welcoming facility with opportunities to grow and to learn. Someone’s always got a nugget to deposit. Being in this role has really expanded my opportunity to gain knowledge from people.

“I enjoy this job. I love to do education, not just nursing education, but education from different aspects of patient placement. I want to get out there and educate areas about just what Patient Placement does. We’re like a hidden secret - everybody’s heard of us, but nobody really knows what we do.”


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