Louis A. Damiano

• Of a large non-profit community-based hospital in Maryland with three hundred and forty licensed beds and 2200 staff members
• Responsible for day-to-day operations, workforce development, fiscal management, graduate medical education programs and physician enterprise
• Holy Cross Health Board of Directors and Executive team member, responsible for strategic planning, governance, and system operations

Hospital President scope of responsibilities include:

• Healthcare Operations-Oversaw daily operations for three hundred and forty licensed bed acute care hospital with largest labor and delivery unit in Maryland with over 8,500 births/year, largest emergency department in Maryland with over 65,000 visits per year, 25,000 IP discharges/year and 20,500 outpatient discharges per year and surgical volume of 9,500 cases/year
• Fiscal management -Maintained positive year over year operating margin from 2017- 2021
• Balanced budgets by regulating labor and non-labor expenses that ensured positive operating margin and operating cash flow margin against fixed annual revenue allocated by HSCRC
• COVID Pandemic Emergency Management Response-Led Holy Cross Health's COVID pandemic's Incident Management Center (IMC), modeled after FEMA disaster response centers
• Aligned Holy Cross Health's public health response and policies with Federal, State, County and Trinity Health's guidance
• Coordinated clinical, administrative, financial, workforce, supply chain, community response during COVID pandemic daily for two years
• Planned, coordinated, and executed following projects in response to COVID pandemic; alternate care sites, antibody screening protocols, converted four decommissioned units into two intensive care and four medical units, set up vaccination clinics for staff and local community, initiated strict visitor restrictions with video conferencing for family members and capitalized on telehealth visits for outpatient clinics
• Electronic Health Record-Served as accountable executive for Electronic Health Record (EHR) conversion in 2021
• Organized Holy Cross Health's clinical training, preparation, integration, and transition from a legacy EHR to EPIC, a new common platform for Trinity Health
• Coordinated EHR training of over 3,000 colleagues, 1,500 medical staff and over 400 EHR super users
• Directed cutover process, which included appointment conversions and backloading of clinical notes and order sets for four hundred inpatients and thousands of outpatients
• Established incident management center for actual go live event and maintained it for two weeks until Epic transition ended
• Workforce Management- Responsible for oversight of 2,200 colleagues
• Instituted workforce management programs that maximized colleague performance, forecasted workload and overall performance of organization
• Focused human resource management goals on recruitment and retention of our colleagues
• Utilize colleague engagement surveys and weekly electronic check-ins to capture colleague feedback and suggestions for improvement.

Successfully integrated two hospitals into a single acute care service line

• Consolidated the organizational structure under a single President and a newly integrated senior leadership team
• Rebalanced the size, scale, and scope of the organizational structure and improved operational efficiencies
• Guided Holy Cross Health's financial recovery in FY 22 and 23 with the merger of two hospitals, a reduction in force, a significant cut in contract labor cost and an eight-million-dollar reduction in non-labor spend.
• The scope of responsibilities as the Hospital System President include
• Strategic planning-Aligned Holy Cross and Holy Cross Germantown's mission, vision, and core values with Trinity Health's
• Crafted an annual operating plan to meet People, Purpose, Performance and Portfolio balanced scorecard targets established for Regional Health Ministry (RHM)
• Focused efforts on healthcare market key differentiators, service line excellence and member experience
• Drove operations and workforce around key service lines to capture market share and grow volume and a total cost of care environment
• Healthcare Operations-Directed the day-to-day operations for both hospitals, included four hundred and twenty-eight licensed beds, 32,500 inpatient discharges, 139,300 outpatient visits, 87,106 emergency room visits, 10,483 deliveries and 11,200 surgeries per year
• Financial Management-Collaborated with CFO and CEO to meet the challenges of Maryland's All Payer model and waiver
• Maryland's Health Service Cost Review Commission (HSCRC) sets the annual revenue allocations for Maryland's hospitals and adjust them based on performance, market shift and demographics
• The HSCRC annual revenue allocation accounts for 95% of Holy Cross Health's annual revenue of $670 million dollars
• As the operational lead for both hospitals, I was responsible for balancing labor and non-labor expenses against a fixed annual revenue target, forecasting changes and closely monitoring volumes
• Capital Planning-Completed a pro forma, request for proposal and the design phase for two major capital renovations, the emergency department at Holy Cross Hospital and a buildout of shell space for a new medical unit at Holy Cross Germantown Hospital in FY 22
• Opened the new radiation treatment center in FY 23, the first phase of Cancer Center
• Completed three other minor capital projects, MRI, CT, and Cardiac Catheterization lab renovations in FY 24
• Managed capital contingency requirements annually
• Workforce Management- Crafted a workforce management plan for 2,300 employees
• Optimized staffing models and improved productivity
• Eliminated seventy-five contract staff, improved recruitment, retention and decreased annual turnover rate to less than twenty percent in FY 22-24
• Improved participation rate in colleague engagement surveys by nineteen percent in FY 24
• Developed colleague engagement action plans and follow up on identified improvements
• Innovation-Implemented a virtual nursing program at both hospitals that covers one hundred and twenty beds at Holy Cross and Holy Cross Germantown hospitals
• Advanced DaVinci and Rosa robotics program, navigational bronchoscopy program, stereotactic surgical capability and teleradiology programs
• Hospital-based physician groups-Managed hospital-based physician group, which included over one hundred and twenty on call, medical director, and hospital-based group contracts
• Completed two requests for proposal within eighteen months to replace legacy anesthesia and radiology groups
• Experienced with private equity backed physician owned national groups
• Medical Executive Committees-Advised physician leadership on governance, bylaws, fair hearings, and peer review
• Compliance-Led Holy Cross and Holy Cross Germantown Hospital successfully through several external regulatory agency inspections and achieved Healthgrades recognition as one of America's Top 100 hospitals in 2022
• Community Engagement-Represented Holy Cross Health on two local Hospital Associations
• Served on the Legislative and Regulatory Committee of the Maryland Hospital Association and served in various leadership roles on The Health Care Council/Shared Source, a metropolitan Washington DC hospital association
• Governance-Served on three Boards, Infinite Legacy (Organ Procurement Organization), HealthCare Council/Shared Source Board and the Holy Cross Health Board.
• Managed crisis situations effectively while minimizing disruption to daily operations.
• Drove revenue growth by expanding product offerings and identifying new market opportunities.
• Cultivated strong relationships with external partners to foster collaboration and maximize resources.
• Established a culture of accountability by setting clear expectations and holding individuals responsible for results.

• Level 3 perinatal referral center designation by Maryland institute of emergency medical services
• Started the “Tiny baby” program for extremely low birth weight babies
• Host site for the George Washington University OB/GYN residency program and multiple other medical school rotators
• Surgical Services
• Largest number of inpatient surgeries in Montgomery and Prince George's Counties
• Numerous quality designations including Spine Surgery, Total Knee Replacement and Total Hip Replacement certifications from The Joint Commission and accreditation by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program from the American College of Surgeons
• A leader in advanced technology – Rosa robotic knee replacement surgery and the O-Arm for spine surgeries, 2 DaVinci Xi robots for advanced multi-specialty care
• Comprehensive surgical support services including pre-admission testing, specialty inpatient care units, care management and discharge planning services
• Neurosciences
• Second-largest provider of inpatient Neuroscience services in Montgomery and Prince George's Counties; second highest volume of neurosurgeries and the most comprehensive neurosurgical program in Montgomery County, including sponsoring the George Washington University Neurosurgery Residency Program
• Primary Stroke Center designation by The Joint Commission and MIEMSS: Thrombectomy-capable; Treatments for AVMs and aneurysms
• Neuro-Critical Care Unit and Neuro Step Down/Epilepsy Monitoring Unit – a high level of care for complex patients comparable to regional academic centers
• Cancer
• Largest provider of inpatient Cancer care in Montgomery and Prince George's counties, including the highest volume of GYN oncology surgeries in Maryland
• Comprehensive Community Cancer program accredited by the American College of Surgeons Commission on Cancer, Breast Cancer Center of Excellence by the National Accreditation Program for Breast Centers
• Teaching hospital with virtual tumor boards and robust research program in a community setting
• Relocated and expanded the Radiation Treatment Center, featuring the Varian Edge linear accelerator technology
• Emergency Services
• One of the busiest emergency departments in the State of Maryland in FY24, with over 65,000 patient visits
• Cardiac Interventional Center and Primary Stroke Center designations by Maryland Institute for Emergency Medical Services System (MIEMSS)
• Funded by Health and Human Services as Special Pathogens Assessment Hospital
• Dedicated Pediatric Emergency Center and proudly developed the nation's first Seniors Emergency Center
• Health Profession Education Directed a robust community hospital graduate medical education department that sponsored medical students, interns and residents from George Washington University, Children's National Medical Center, Walter Reed National Military Medical Center, and Howard University
• Established at Kaiser Permanente Internal Medicine Residency program in 2019
• Sponsored dozens of allied health professional programs with three local community colleges
• Member of the Holy Cross Hospital Senior Leadership team
• My responsibilities included aligning the Medical Staff with Trinity Health's strategic “People Centered Health System” initiatives, optimizing the Medical Staff Office functions, strengthening key physician partnerships, clinical service line development, promoting quality and patient safety, and enhancing the value of care, cost control and revenue optimization
• Projects and accomplishments:
• Aligned the Medical Staff with Trinity Health's strategic “People Centered Health System” initiatives
• Perioperative Surgical Home initiative- worked to improved first case start times, utilization rates, and created an end of day management program
• Supported our Medical Director of the Operating Room and empowered them to collaborate with the surgeons and OR nurses to improve both efficiency and effectiveness in the Operating Room
• Physician Wellness and Resilience initiative-program is part of our physician action plan
• CHF initiative- engaged our Cardiology Medical Director to establish atrial fibrillation and chest pain protocols for our Observation Unit
• Optimized the Medical Staff Office functions and strengthened key physician partnerships:
• Integrated the Medical Staff Office at HCH and HCGH
• Supported the Medical Executive Committee and improved governance
• Improved initial credentialing and privileging process with a 35-day turnaround time
• Redesigned the reappointment process based on birth month
• Improved Peer Review reporting process increased the use of external peer review and revitalized the surgery and anesthesia peer review committees
• Improved compliance with medical record discrepancies
• Created a monthly dashboard for the Medical Executive Committee and Department Chiefs to track key administrative and clinical processes
• Supported physician engagement and alignment
• Designed a Physician Action Plan, based off the 2016 Press Ganey Physician Engagement Survey
• Collaborated with the Medical Executive Committee on key Medical Staff Bylaws changes designed to increase physician participation with hospital committees
• Supported the development of the following clinical service lines at Holy Cross Hospital
• Cardiology/STEMI-Improved the compliance parameters for door-to-balloon time of 90 minutes or less for 75% of the patients in this Quarter
• Median time CY17 was 72 minutes
• Awarded the Silver 2017 Quality Achievement Award 2017 Mission Lifeline from the American Heart Association
• Neuroscience/Stroke-Improved the compliance of door-to needle time for TPA with greater than 80 % compliance under 60 minutes and established a new goal of 45 minutes
• American Heart Association and American Stroke Association awarded the Gold Plus Achievement Award to HCH for stroke care
• Also awarded the Target Stroke Honor Roll for Get with the guidelines-Stroke
• General Surgery-Implemented a Surgicalist program for HCH and HCGH
• Blood Bank-Designed and implemented a new massive transfusion program for HCH and a new consent for the administration and refusal of blood products
• Transplant-implemented a Donation after Cardiac Death policy in collaboration with the Washington Regional Transplant Center
• Endocrinology-implemented insulin pump policy and protocol for inpatients at HCH
• Sustained and enhanced Holy Cross Hospital Quality performance and Patient Safety programs
• Restructured Patient Safety Committee to include Environment of Care Committee
• Championed the CUSP team in the ICU to decrease CLABSI, VAP and CAUTIs rate for the unit
• Championed the Root Cause Analysis for Retained Foreign Instruments in the operating room and communicated the "Pause for the Gauze" and "Show Me", key protocols to the physicians
• Improved the communication between the Emergency Department and the STEMI and Stroke physicians with the use of Doc Halo
• Redesigned the process for responding to in house STEMI's
• Collaborated with surgeons on the enhanced recovery after surgery protocols
• Enhanced the value of care, cost control and revenue optimization:
• Completed a physician payment compliance audit- worked with legal and compliance to correct a significant amount of physician overpayments in the preceding five years
• Improved the integrity of physician payments-initiated an all-electronic invoice process for physician on call and Medical Director Payments for Holy Cross Health
• Process tracks physician contract burn rates, delinquencies with invoicing and rate of accruals
• Improved revenue capture for professional services- led a small working group with revenue cycle management to improve for the surgical physician assistants
• The group reviewed the revenue cycle for the surgical PAs and made recommendations to improve compliance with documentation, reduce delays in timely filing and identify opportunities to decrease operational write offs
• Cost savings via value analysis-worked with the value analysis team to identify savings with joint and spine and cardiac implants
• Cost control-managed the surgical physician assistants to reduce overtime and fill vacancies.

• With wide-ranging leadership experience and accomplishments in strategic planning, operations, fiscal management, workforce management, information technology, health profession education, medical staff administration and physician enterprise operations
• Led an acute care service consisting of two hospitals, a radiation treatment center, two outpatient dialysis centers with five signature service lines: women and infants, cancer, surgery, seniors, and neurosciences before during and after the Covid pandemic
• Diverse background with clinical and leadership roles in private and federal healthcare sectors
• Senior leadership positions with Trinity Health, Holy Cross Health, National Naval Medical Center, Walter Reed Army Medical Center and directed their merger into the Walter Reed National Military Medical Center
• Received an MD from the University of Maryland School of Medicine and an MBA from the University of Maryland
• Hold a BA degree in Biology from Catholic University.
• Instructed patients and families on medical diagnoses and treatment options.
• Collaborated with consulting physicians regarding care of patients.
• Developed strong rapport with colleagues and staff members, promoting teamwork within the workplace environment.
• Improved patient outcomes by developing comprehensive treatment plans tailored to individual needs.
• Coordinated patient referrals with specialists for optimal continuity of care throughout treatment process.
• Implemented evidence-based practices into daily work routine, enhancing overall effectiveness of clinical decision-making and patient outcomes.

• As a licensed Anesthesiologist on a
• Member of the American Society of Anesthesiologists Practice Management Committee

• Active as a senior management consultant in healthcare for strategic planning, healthcare operations, mergers, joint ventures, project design and program management
• Projects include:
• The National Intrepid Center of Excellence-Subcontracted by PricewaterhouseCoopers as a Senior Functional Analyst
• Provided critical input into the program design and management of the nation's first center of excellence for Wounded Warriors with traumatic brain and psychological health injuries
• The Walter Reed Army Medical Center Base Closure and Transition Project-Contracted by Walter Reed Army Medical Center (2011) as a Transition consultant to work with their Base Realignment and Closure Team, General Dynamic and Healthcare Relocations Co
• To close the hospital and relocate healthcare operations to the new Walter Reed National Military Medical Center at Bethesda and the Fort Belvoir Community Hospital.

• Manager for $2B healthcare merger/consolidation of four military medical treatment facilities and construction of two new hospitals to form the new Walter Reed National Military Medical Center
• Personal accomplishments and completed projects include:
• Co-authored the organizational structure for the new Walter Reed National Military Medical Center and Fort Belvoir Community Hospital, which served as the backbone for the concept of operations, functional integration, transition planning, development of joint staffing documents, budgetary overlay and initial outfitting and equipping
• Managed 140 user groups composed of Tri-Service clinical and administrative leaders
• These user groups developed their concepts of operation for the new Walter Reed National Military Medical Center and Fort Belvoir Community Hospital
• The same user groups participated in the program design and design-build process
• Led a top to bottom validation process for all clinical and administrative concepts of operation, space allocations and staffing documents to ensure completion of all mission requirements for the new WRNMMC and FBCH
• Aligned the first military medical joint command, command and control elements with Walter Reed's and the North Atlantic Medical Commands via the creation of G and S codes that corresponded with the JTF CAPMEDS J-Directors
• Assembled a BRAC/Integration/Transition Team of twelve highly qualified experts to lead Walter Reed through the BRAC process
• Designed, implemented, and executed a Tri-Service selection process for sixteen integrated clinical Department Chiefs and sixty-five integrated Service Chiefs
• Created strategy maps and balanced scorecards for Walter Reed in 2008 and 2009, aligning them with the Army Medical Department's mission and vision.

• Responsible for the leadership administration and management of 342 officers, 324 enlisted and 339 civilian employees in thirty-nine clinical departments
• Accomplishments include
• Operationalized the command's strategic plan and executed the value of care model which maximized provider productivity, clinical access, and quality care for 33,000 beneficiaries
• In FY06, the MedSurg directorate generated 380,500 RVU's with a prospective market payment of $28 million dollars for outpatient visits alone
• Served as Annual Plan Goal Champion for the Quality goal and coordinated five objective teams to improve the quality of clinical care, graduate medical education, Joint Commission preparation, mission readiness and civilian issues
• Aligned the command's strategic plan and its goals of quality, access, and productivity with the annual plan of each of the thirty-nine clinical departments, in the Medical Surgical Directorate
• Each of the clinical departments drafted and executed an annual plan
• Spearhead project to improve Man-Hours reporting (MEPRS) in the MedSurg Directorate and increased compliance.

• Elected by NNMC's medical staff for a two-year term, presided over the Executive Committee of the Medical Staff and represented the clinicians on the Board of Directors as a voting member
• Performed all facets of quality improvement, credentialing, medical staff governance and bylaws, medical staff policy formulation and practice implementation
• Among my contributions:
• Created a Quality dashboard that incorporated HEDIS population health metrics, ORYX quality health indicators, AHRQ quality health indicators and the Committee on Cancer's quality reports
• This allowed the command the first opportunity to link patient outcomes and patient safety with healthcare operations
• Completed a business case analysis and started a Palliative Care Service at NNMC
• Created a Healthcare Provider Wellness Program
• Integrated four dental officers into the ECOMS and established a dental subcommittee shortly after the disestablishment of the Dental Corps
• Produced clinical guidance for the use of high-cost medications such as Tysabri and Factor 7.

• Led anesthesia and perioperative services responsible for thirty-five anesthesia providers, 7200 operations/year, four thousand deliveries/ year and three thousand pain clinic visits/year
• Responsible for all didactic, clinical, research and professional development activities of 42 Army and Navy anesthesia residents
• Ensured the safe delivery of anesthesia and pain management to all NNMC's beneficiaries
• Completed projects:
• Implemented the Navy Bureau of Medicine and Surgery's Instruction 6550.7A, the Utilization Guidelines for Nurse Anesthetists despite very politically charged and hostile circumstances
• Critically reviewed and edited the Navy Bureau of Medicine and Surgery's Instruction 6320.66D, the Department of the Navy's Anesthesiology and Certified Registered Nurse Anesthetists core and supplemental privileges and made responsible recommendations for departmental, specialty, and facility specific criteria for initial staff appointment and reappointment with clinical privileges
• Managed Main Operating Room, met or exceeded civilian benchmarks for efficiency and maintained surgical caseload >7,200/year despite a 33% reduction in staff anesthesiologist and CRNA's
• Submitted a Business Case Analysis for the acquisition of 2 Individual Set Aside-Personal Contract Anesthesiologists
• Awarded both contracts in 2002
• Negotiated the first successful Resource Support Contract with Sierra Health Care System for a contract anesthesiologist in 2002
• Broadened the scope of interventional pain management services and opened a new Interventional Pain Management Clinic in April 2001
• Authored a market plan for the Interventional Pain Management Clinic and based on HCFA physician fee schedule demonstrating $666,369 billable revenue
• Designed and implemented NNMC's first Anesthesia Informed Consent document in 2001
• Revised in 2004 after a multidisciplinary meeting with NNMC attorney's and sent to Specialty Leader for Navy-wide dissemination
• Initiated the first Blood Utilization Review Program for NNMC's Anesthesia Department which tracks and trends for inappropriate transfusion therapy and documents compliance with JCAHO and ASA practice guidelines for transfusion therapy
• Introduced the Adverse Perioperative Event Protocol, a quality assurance project implemented to improve the response time to sentinel events and provide a structural framework for investigating unanticipated adverse patient outcomes
• Redesigned the anesthesia records, improved chart utilization reviews, rewrote the department's policy and procedure and orientation manual and improved the departments training records.

• Responsible for 17 Surgical Departments, 400+ staff members and a $14.5 million-dollar operating budget
• Managed all administrative and clinical issues as they pertained to the surgical services at NNMC
• Served as a voting member on the Board of Directors and the Executive Committee of the Medical Staff
• Chaired the command's Quality of Life Committee
• Accomplishments:
• Obtained narcotic dispensing machines for four separate patient care areas in the hospital including the operating room
• The addition of the SUREMED narcotic dispensers dramatically reduced the potential for narcotic abuse with its electronic recording system
• Championed a real time point-of-care blood testing system, ISTAT and procured funding for its implementation in all surgical care areas including the intensive care unit
• This multimillion-dollar project allowed anesthesiologist to obtain blood gases and chemistries at the bedside within minutes
• Completed the Short Stay Unit and the Ambulatory Procedure Unit projects and implemented single hemodynamic monitoring system throughout the surgical product line saving on maintenance and repair contracts., by the NNMC residents.

• Is directly responsible to the Program Director
• Areas of responsibility included day-to-day scheduling and management of 42 Navy and Army residents, derivation of an annual didactic schedule, weekly teaching conferences and oversight of administrative tasking
• Initiated the integration of the Anesthesia Residencies between NNMC and WRAMC in July 1997
• This entailed revising clinical rotations, restructuring the curriculum of both residencies, and preparing the RRC packages for a newly combined program
• Awarded the highest possible accreditation of three years without restrictions for a newly combined program by the American College of Graduate Medical Education
• Fall 1998, the National Capital Consortium accepted the NNMC-WRAMC integrated program for membership after passing the RRC
• Awarded Teacher of the Year

• Delivered the full spectrum of anesthesia care to include pain management
• Participated in graduate medical education, clinical research, quality assurance, utilization review, peer review and served as the Medical Director of the operating room
• Operation Smile-Anesthesiologist for a medical mission to Nanjing, China 1996
• Performed over forty pediatric anesthetics under austere conditions for children with cleft lips and palates
• Fleet Surgical Team Four-Anesthesiologist aboard the USS Wasp and USS Nassau, a rapidly deployed surgical team, which supported Navy and Marine Corps missions in the Mediterranean and North Atlantic
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