Partnering with Niagara Falls Memorial Medical Center

on Emergency Department Utilization Improvement Initiative

Tammy Fox, Director of Project Management and Saralin Tiedeman, Post-Acute Care Manager

Following completion of a recent Medicaid Accelerated eXchange (MAX) Series “Train-the-Trainer” (TTT) program; Tammy Fox, Director of Project Management and Saralin Tiedeman, Post-Acute Care Manager, and are set to deploy as Facilitators in support of Millennium partner efforts to improve performance measures.

Sponsored by the New York State Department of Health, an intensive “Train-the-Trainer” program was run alongside the current MAX Series initiative, consisting of multiple full-day sessions working alongside Niagara Falls Memorial Medical Center’s (NFMMC) Action Team and facilitation teams from consultant KPMG.

Performing Provider System (PPS) team members from across the State — including Saralin and Tammy – participated in the six month program with the primary objective of learning new facilitation techniques that will now enable them to assist teams across the Millennium PPS’ network who are working to enhance performance measures. Their training efforts were supported by Al Hammonds, Executive Director, Millennium Collaborative Care and Millennium Executive Sponsor for the MAX Series; and Dr. Anthony Billittier, Chief Medical Officer and Millennium Champion for the MAX Series.

As trained facilitators, Saralin and Tammy will now be deployed to help partners identify and develop key goals within their facility; and then support their brainstorming efforts to identify solutions to obtain these goals.

“It’s all about sustaining positive change into the future,” explained Saralin. “I am looking forward to using this knowledge and skillset to facilitate real change and do something different for our WNY population,” she added. “Extending the plan of care into the community, bridging gaps between providers, and keeping the patient at the center will ensure quality care that goes beyond the four walls of the hospital and gets to the heart of the true issues at hand.”


Per Tammy Fox, the MAX Series is a Rapid Cycle Continuous Improvement (RCCI) program that brings significant care providers together to redesign the way care is delivered.

“’Train-the-Trainer’ participants are instructed in the RCCI technique and co-facilitate MAX series Workshops,” explained Tammy. “Trainers assist hospital teams as they engage in three full-day, intensive workshops over an eight-month period where they develop a detailed action plan for process improvements to improve patient care and delivery. “


Saralin and Tammy have been working with NFMMC since October 2016 on the current Max Series initiative. As new facilitators, their objectives are to work with the NFMMC hospital team to help them achieve their goal of reducing avoidable hospital readmissions for the high utilizer population.

To date, NFMMC has already made great strides, starting with the formulation of two primary objectives:

  • Identify patients that have been admitted four or more times within a 12-month period.
  • Understand what is causing these “drivers of utilization” to continuously come into the hospital.

“With these objectives identified, the team has begun working with internal and external providers to coordinate a care plan for patients that will be successful in keeping the patient out of the hospital,” explained Saralin. “Transitioning the patient back into the community after discharge and ensuring the plan of care is patient-centered and followed by all care providers is key to a patient’s success.”


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