David Quackenbush (Host): Hello everyone, and welcome to the Golden Voices Podcast. It's the podcast of Golden Valley Health Centers. Today, we are here with Danielle Tejeda, our Clinical Operations Training Manager, even though she's had several titles. And if I am not wrong, I believe this is her second stint at Golden Valley. She has a vast experience that we'll hear from.

She took the trouble of putting a bio together, so I think it's appropriate that I try to read some of this bio. And, yes, I am reading the bio. So, Danielle's over all of our training. She'll talk much more about that, but it's very important with Golden Valley being—you know, we have 50 locations, 1,500 staff. Training is very important, and we've focused even more on training and more resources on training. And part of the training is she specializes in translating complex processes into clear, engaging training experiences that empower teams. You know, we are pretty innovative here at Golden Valley, and we have Epic, which is our electronic health record, and we're adopting additional AI capabilities, and so training is becoming that much more important.

And Danielle brings a thoughtful, people-centered approach to her work, combining instructional design, operational insight, and continuous improvement. And Danielle's over our training team. And how big is the training team now, Danielle?

Danielle Tejeda: We just added two new members, so we are a total of 10 members, including myself.

Host: Yeah. So, that's a sizable team that's rresponsible for pretty much all of our clinical training, which is a lot. So, Danielle, thank you for joining us. I want to start kind of at the beginning. How did your journey into working in the healthcare field begin?

Danielle Tejeda: So, I'm very transparent with my history. And as a part of that, I'll be sharing my mother had cancer when I was really young. When we would come to get our medical care, Golden Valley was our healthcare home. And as such, we would come to the doctor often to get checked for various things. And the staff was very, very kind to her. They were very empathetic towards her. I always seen them be very professional, and I wanted to provide that same type of care that my mother got here, and I wanted to be able to give that to my patients. So unfortunately, I did lose my mom to cancer. And that was my goal, was to be able to be that type of healthcare home where we received that care, which is at Golden Valley.

I started off as a medical assistant here, and it was the only medical assistant job I ever had because I knew I wanted to be here. And I was very blessed to have, you know, some great supervisors that could see that, take me under their wing, and teach me everything that they knew. And so, I continued that here, and I'm very glad that I was given that opportunity, and I'm very glad that I can instill that into some of my trainers.

Host: Let me have you catch your breath. I appreciate you sharinghow this is personal to you. It's amazing because, you know, I mentioned we have 1,500 staff. And it's really regardless of the job our staff have, and you know this with your colleagues. So many of them have this .....personal connection to Golden Valley, which always amazes me. You know, they have these stories of coming when they were children with their parents or coming as, you know, patients themselves. And that's the thread that I think ties a lot of us together. And it really doesn't even relate to the actual jobs because, you know, we have administration jobs and billing jobs, and then we have folks that touch patients every day being clinicians or nurses or what have you. But all of us are here for the same reason. And it's amazing to have those stories—I keep hearing more and more of those stories, and it's very personal to a lot of us.

And starting as a medical assistant, which is probably one of the most difficult jobs we have because medical assistants deal with all kind of patients and all kind of patient complexity and patient behavior. It's a very, very difficult job, and it's frontline. So after becoming a medical assistant, because you've been promoted a couple of times, why did you decide to kind of keep exploring other opportunities in healthcare? And take us a little bit about the journey, how you went from medical assistant to your role today.

Danielle Tejeda: Absolutely. So, I started off as a medical assistant, and I did it for probably about five years, but I knew that I wanted to grow. I had pretty much done everything that I could do as a medical assistant. I did day clinic, I did night clinic. I worked at the Little O'Banion Clinic for a little bit as well, which even though it's a part of Golden Valley, it's a little bit separate because it felt like a private office, right? And so, when I did everything that I could possibly do, pushing my scope as far as I could push it, I applied for the patient service navigator position that we had. That role was redirecting emergency care back to primary care. And I got to learn my patients, and I got to connect with my patients, especially those repeat offenders that would often go to the emergency for things that we could handle in-house, right? They started calling me directly. And so, I started building those connections.

And I was grateful to have that opportunity, but then another opportunity outside of Golden Valley fell in my lap, which was training medical assistants how to be medical assistants. And so, I was doing both of those roles at the same time. I was doing my PSN position during the day. And then, I was doing, like, training in medical assistance during evening. I was working 14-hour days, and it just got to be a little bit too much, so I had to let one go. And so, I let Golden Valley go, and I did it for three years. And even though I was very grateful for my time to go and learn how to train, I was always trying to get my foot back into Golden Valley because it was home to me.

So then, eventually, I made the decision to come back. And when I came back, I came back as a clinical supervisor. And it was funny because it was at Merced Suites, and that's where I was a medical assistant for so long. And then, eventually, I became the operational staffing supervisor, which is the float supervisor, and I got to love my staff doing that. But training was still calling my name. I wanted to get back to it. So then, I took the leap and, went back to the Epic training team. And then, I, within a year, became the Epic lead, and then eventually the Epic manager. And now, it's referred to as the clinical and operational training team. And I love it, but I love it for different reasons. I did always want to do patient care, but I can still provide that for our new hires that are coming on board because I feel like I can instill that into my trainers so that they can train our incoming staff on how to be empathetic and how to be caring and how to connect with their patients, like I felt like our staff did for my mom, right? I always wanted to give that back, and I wanted to get that back. And I feel like I do that now. So, I feel like I've come, like, full circle almost.

Host: Yeah. And I want to talk more about how you impact your team, because being over training and your team being, you know, the training group that goes out to all of our sites, it's very impactful to what we do. But I have a question that you have a very interesting insight to.

So, Epic is our electronic health record. And, you know, Golden Valley prides ourself on innovation and trying to be cutting-edge, and we're trying to maximize the use of our electronic health record. We're doing a lot of AI work. We're trying to be out front on implementing different AI solutions. But you were here when we were paper.

Danielle Tejeda: Oh, yeah.

Host: And now, you're here when we're primarily, you know, all electronic, but we're still evolving our work with that. Tell us about—I mean, your whole kind of job and world changed, right? Training, training on paper, now training on the EHR. Tell us about just your perspective on how going to an electronic health record has changed patient care, but also changed Golden Valley as an organization.

Danielle Tejeda: Absolutely. So back when we had paper charts, right? And there are so many times where we would need, like, the paper chart to actually come down. And unfortunately, you know, with paper charts, they can get lost, unfortunately. And my provider would be like, "Man, I need this chart. Tell them I need this chart." So, I'd be calling upstairs trying to get the medical records to, like, get me the chart, and occasionally even having to go up there myself and trying to, like, see if it was misfiled, right? Because misfiles do happen. It was a struggle. It was definitely a struggle, and it wasn't great to patient care. I mean, we did the best that we could. But if you have a missing chart, then you have missing labs, you have missing referral notes that could've been in that chart that we obviously needed.

When we went to electronic, nobody likes change. Nobody likes change, even if it's for the good, right? We missed writing our notes. We missed doing that. But at the end of the day, like, it was so beneficial to be able to have that chart at the tip of your finger, right? Being able to pull it or summon it or summon a record that you really needed. And now, Epic, I love Epic, but I didn't always love Epic . I was so accustomed to NextGen that that's what I was used to and that's what I wanted to use.

But moving into Epic, the capabilities, they're endless. There's a lot of things that we can do with it, even the AI dictation that you spoke of. When I first learned how to do Dragon or how to do DAX, like, being able to prompt or use an AI service to be able to dictate for our providers showed us how much time it really does save and how much we can really get done with such a short amount of time.

So yeah, I love that we have this system. I love that there's endless possibilities of learning to do, but also being able to provide for our patients as well.

Host: It's just amazing when you think about it, where we average around 55,000 visits a month. There's just no way you could do that on paper, even though we are doing probably 30,000 to 40,000 patient visits a month on paper. And so, just thinking about—and really, it's been six years since we first implemented Epic. But it's taken, you know, four, five, six years to really maximize it. And we still learn. And Epic, like any good technology company, is always improving and adding. And so, you know, it's an ongoing process. But just the thought of not having the paper, there's just no way we could do it. And literally, being on paper prevented us from increasing the access that we're able to increase today. We would just not be able to with the manpower. And even something as simple as, you know, space for medical records. You know, we've come such far way, and I think it's really important for us to remind ourselves that we have really come that far.

And then, with you having this influence over your trainers and, you know, the training department has this reputation about—I don't know if I should call it reputation or not—but I mean, correct me if I'm wrong, but every one of our trainers worked at a different job within Golden Valley at some point.

So, all of our trainers have firsthand experience, typically at clinical sites, you know, helping to provide care to our patients. So, I mean, our training team is kind of this, this receptacle of all of this information and experience, which really benefits us. So, talk a little bit about what does training look like at Golden Valley and, you know, tell us about what your team does.

Danielle Tejeda: I like to pride ourselves with the fact that we try to tailor our training depending on the new hire, right? We tailor it to each individual. Now, we have several different trainings. For new hire, I'll kind of speak on that. But for provider, it's a three-day training. And what we do is we go over different scenarios that that particular provider may face on their day-to-day, right? We go through different scenarios that they may encounter. And then beyond training, we also go out to the sites, and we provide at-the-elbow support.

So at that elbow support, we're showing them how to go through their workflows, showing them, like, how to address their in-basket questions. And then, at the very end of our training, we always survey. And needless to say, like even myself as a trainer, the feedback that I always got was like, "Nobody does training like Golden Valley." Like, I feel like I've been set up for success. I feel like, you know, the training that I got before was just, "Here's the laptop. You figure it out." Whereas here, we go through, we take the time to answer their questions, we take the time to address any concerns that they have, and then we also connect them with resources beyond us, right? So, I would love to say we have all the answers, but we don't. So, I do connect them with individuals that can help them.

Now for MA, we previously had just three days with these MAs. We're proud to announce that we now do a two-week process, and now that's going to be evolving even into four-week process. And we're really setting them up for success as well. We're showing them real-life scenarios on what they would expect, like when they are working on individual scenarios, but then we show them from the very, very top to the very, very bottom of when they're discharging a patient. We role-play with them. We give them the different examples that they may face in a real-life situation.

Same with front office. Front office recently went through a revamp as well. We only had three days with them. Now, we are working with billing to do two weeks of training for them and really giving them the insurance portals while we have them, doing role-play, giving them the tools to be successful. And I feel like the feedback has been really great. Our new hires are saying that they're doing, a lot better. And when I say new hires, I should say that we did extend training to our supervisors as well, and those supervisors have mentioned that they feel now that they have the tools to be successful. And even though they're not in the front office every day, I feel their feedback is invaluable, and we are eager to hear more, like how we can support other teams as well.

Host: Who are you training?

Danielle Tejeda: We train everybody.

Host: Well, tell the audience, when we say everybody, what does that mean?

Danielle Tejeda: We train providers, we train medical assistants, we train dental assistants, we train dentists, we train CHWs, we train call center, we train registrars, we train everybody, nurses. At least one point or another, you will have come into contact with either myself or one of my trainers.

Host: And it's such a big job. And I like to remind folks how complex our system is, what we do. So, we, you know, at Golden Valley, we obviously do primary care, but we also do specialty care. We do dental, we have urgent care, we have 26 specialties in-house. What we do is very complex.

And so, you know, bringing on a new hire and throwing them in that environment, it's very, very complex. And you do the new hire training, but you also do ongoing regular training. How has the training changed? So, you've been in this industry for a while. You were an MA. You know, MAs nowadays, you know, they're different and they have different expectations. How has training changed over the years?

Danielle Tejeda: I can share with you that when I onboarded, David, like we literally went through new hire. We had maybe like one to two sessions with the nurse on how to do certain skills, and everything else we learned in clinic. So, we went from that to doing Epic with full two weeks of training. And we're partnering, we're collaborating with other departments to try to give them like more, more how else can we help you? Like, how else can we give you the tools to like, do your day-to-day? And, you know, it's evolved so much because going from two sessions of clinical training to now two weeks out and ongoing. So, we speak at the triad meetings, we speak at the center manager meetings. We speak at every opportunity given. And in addition to that, we're still going out to the sites.

We're checking on our new hires. We're looking at their skills, answering questions that they have, clarifying misunderstandings, just to make sure that we're giving them those tools. We want to make sure that what we're training them is what they're doing on their day-to-day. We want to keep our training relevant to what their daily workflows are.

Host: Yeah. Training's so important. It has to be ongoing. It has to be consistent, and then it has to evolve as we evolve. Tell us a little bit about your team. So again, I mentioned how the training team has a reputation of hiring people away from different departments, which obviously brings experience and expertise into training. So, tell us about what type of people are on your training team. What are their backgrounds kind of what their day-to-day looks like?

Danielle Tejeda: So, I mentioned we have 10 members, including myself. Now, we have staff that came from the front end. Some of them started off as PSRs. they eventually moved over to the training team, and some of them are as seasoned as when we went live with Epic. We have others that were medical assistants. And as a medical assistant, you know, they did their daily medical assisting job, and then they moved up to being clinical supervisors. Like most of the members of my team, I can tell you that I've worked alongside, not as a manager, not as a supervisor, not as a lead, but alongside them.

And so, in doing so, like you see what skills they bring to the table, right? We are always trying to use that to get us a little bit better. We have Myra. Myra is a new member of our team. Myra started off in medical records. So in medical records, she used to work during the night clinic. I used to work as a medical assistant in the night clinic. Eventually, she decided that she wanted to follow up on her medical assistant skills. She applied for a medical assistant role. She got that role. When she got that role, she eventually decided that she wanted to move into OB-GYN as a medical assistant. I was the supervisor for SHAW, "acting supervisor," because I was still the operational staffing supervisor. And as such, Myra applied for the job for SHAW. She got it. And then, I moved over to my role, and now she applied for the training team. I knew she could do the job, so then she became a trainer. We also have Julie that used to be an operational staffing supervisor. So she used to work with the floats. She knew the front, she knew the back, and then she also became a trainer. We have Anna. Anna started off in billing and call center, and then she moved up to being a float, and then she became a trainer as well. I think we've pretty much covered it. Yes, my team has a, what did you call it? A reputation for stealing staff.

Host: A reputation.

Danielle Tejeda: But I think with the different departments that they've all worked, we've all come together to be able to say, "You're rich in knowledge that I don't have. Let me use your knowledge so that we can continue to grow our organization in a better way."

So, I'm always looking for, I don't want to say fresh meat, but I'm always looking for potential within staff to grow and to help us grow as an organization, right? Because what I don't know, they know. And what they don't know, I know. I like to say that my team is my family away from family, because honestly, that's how we operate.

Like, I try to work with them in a way that like, you know, nobody's higher than anybody else. Like you mentioned before, David, like nobody's higher than anybody else. We're all equals working for the same goal, which is patient access.

Host: Yeah. I mean, it really is what we're all doing. And it's interesting. Because the way your staff, your training team has evolved is kind of what we're trying to do here at Golden Valley overall. I mean, most of your folks have been promoted multiple times. You've been promoted multiple times. And, you know, we're trying to provide that opportunity and we're trying to provide, you know, a way for folks to grow in their career.

I'm in administration because I learned a long time ago that I'm better at helping people that help people as opposed to working directly with patients. You know, you've done it both, but I want to highlight or remind you, and you might think about this, and if you don't, I would encourage you to think about this. Do you have any idea how much impact you've had on this organization in general?

If you think about what you're doing, going back to why you work here in the first place. You know, you wanted to work at Golden Valley because it touched you and your family. You left and then, you know, learned better that you needed to come back. We have lots of folks that like to come back. But in your role and working directly with your team, I mean, you've had the opportunity to directly impact the entire organization.

Danielle Tejeda: I don't think I've really thought of it that way. I think I'm just doing my piece—my piece, right—in this organization to try to better us and to grow us and to make sure that I'm helping as much as I can. I'm a helper. But I think I'm going to have to look at that a little bit more and really contemplate that.

Host: I say that because this is why you came here in the first place, and this is what you're doing. And because training can be so chaotic and busy because it's, you know, you got folks going out to all the sites on a regular basis, and people are everywhere, and new hires twice a month. You have all these people coming in. This is my opportunity to remind you that you probably have a bigger impact on this organization than most because you're supervising all of these folks that are out in the sites teaching people how to take care of our patients. So, we appreciate what you're doing, and I'd just like to shine a light on you are having the impact that you wanted to have however many years ago when you first came here.

Danielle Tejeda: Thank you.

Host: So Danielle, again, thank you for joining us. Thank you for coming back, I guess. I guess I should thank you for leaving and then coming back. But I appreciate you sharing your story because, as you know, we have a lot of colleagues that have very impactful stories that have done a lot of good work here at Golden Valley. So, thank you for joining us. Thank you for being on the Golden Voices Podcast.