Christina Giles was born to teach. From the time she could walk and talk, Giles played school. “The best Christmas presents my father ever gave me were a teacher’s pointer and silky chalk,” she recalls.
While she attended college intending to become a French teacher, her teaching career sputtered and came to an abrupt halt. “I married my Navy husband soon after college, and couldn’t get a job,” she says. At his last duty station, she landed a position, and then found out she was pregnant. “I taught half a year and then left.”
Little did Christina Giles know that she would become a lifelong teacher, even if the setting wasn’t a traditional classroom and the subject wasn’t French. After holding a variety of administrative assistant positions when her children were young, in 1981 a freshly divorced Giles applied for a position in the Chief of Staff’s office at a university. “I interviewed with the woman who would become one of my closest friends,” she says. “ I became the Assistant for Professional Affairs, but knew nothing and learned by doing.”
Giles chuckles, recalling that the person she replaced simply couldn’t handle the pressure of the job. “There were very few books and newsletters, no webinars, and no education other than NAMSS,” she says. She attended her first NAMSS conference in San Francisco, though she was initially more excited about visiting California than the educational opportunities provided at the conference. That quickly changed. “I became a full supporter of the profession, and was one of five people who founded the Massachusetts Association of Medical Staff Services,” Giles says.
Advancing the Profession
As a single mom working full time, Christina Giles had her hands full juggling personal and professional commitments. NAMSS held its annual meeting in Boston the year Giles was president of MAMSS. “I recruited speakers, was the conduit with the hotel, planned the host chapter’s cocktail party, and did my first national presentation at that meeting,” she says. “I remember thinking, ‘I’m not going to make it.’”
But make it she did – and then some. Giles worked in virtually every hospital in Worcester, Massachusetts, becoming proficient in credentialing, privileging, and other MSP skills. “There’s a file with my name on it in every hospital,” she quips. Along the way, Giles learned that sitting in an office wasn’t her forte. Educating others in the profession was her passion.
Together with a handful of other medical staff services pioneers, Giles created educational programs for NAMSS and became one of its first faculty members. One of those pioneers was Carol Cairns, with whom she became lifelong friends. “We’re competitors, colleagues, and friends,” Giles says. “We started our consulting companies at the same time, and have traveled the world together.” In addition, the two have periodically worked for The Greeley Company as independent consultants and have served as HCPro advisory board members.
After launching her firm, Medical Staff Solutions, Giles co-founded Edge-U-Cate, which was an early entrant in delivering MSP education via webinars. “We did onsite teaching at the state level and designed programs for both state organizations and corporate healthcare systems,” she says. After taking leave from Edge-U-Cate, Giles is back teaching credentialing courses three times a year around the U.S. She has also found time to co-author three books on credentialing and risk management, and has relaunched her firm with a new name: C. Giles & Associates.
The Past and the Future
Christina Giles has witnessed a number of changes over the 30 years she’s been working in the medical staff services profession. Chief among them is the way credentialing has seeped into a variety of environments. “The people who come to be educated are not just from hospitals – where the field started – but are also from physician groups, the Indian Health Service, federally qualified health centers, and staffing companies,” she says.
She also notes that the shift to health systems is a sea change in healthcare. “When there are many hospitals in a health system, the result is the centralization of functions,” Giles says. “As a result, there’s a need to develop a centralized credentialing department that provides services to multiple hospitals.” She notes that, with different medical staff bylaws and rules, credentialing becomes much more complicated.
Looking to the future, Giles believes that Arkansas’ precedent of housing a credentials verification service within the state licensing board will take hold in other states. “Someone is going to develop a centralized database with all relevant credentialing information,” she says. Noting the need to develop better mechanisms for assessing clinical skills and competency, Giles says, “That’s the weakest part of our system right now.”
Giles also foresees that MSPs will need to be better educated about statistics and quality performance improvements. “Our job duties are expanding, and we’ll need to have broader knowledge than was required for our more traditional role,” she says.
While Christina Giles credits popular technology with leveling the learning playing field, she also cautions that not all sources of knowledge are equal. “When he was ten years old, my grandson learned to knit from YouTube,” she recalls. “He climbed into bed with me and said, ‘Come on Nana, let’s knit!’”
The flip side of that is the potential for YouTube videos to disseminate false information. “We do a ‘Truth or Myth’ program that provides examples of incorrect information we’ve found on the internet,” Giles says. As an example, she notes that in a primary source world, the accrediting body says which specific sources you can use. Currently no accrediting body requires or suggests that healthcare facilities google an applicant. “Yet, when we ask if MSPs google applicants, everybody says yes, and that if they find something, they add it to the file” she notes. If that step is not in the bylaws, it needs to be documented in a policy and procedure. “Otherwise, you could be challenged with being inconsistent, or adding a step to the process that is not documented,” Giles says.
Advice for the Next Generation
Giles recommends that those in early and mid-career positions take advantage of opportunities to enhance their relationship-building skills. “I wish that I would have had more leadership training at the beginning of my career, as well as more skill in dealing with difficult people and situations,” Giles says. “You may have all the knowledge you need to be successful, but you don’t necessarily have the ability to work with the people you need to work with.”
With a CPMSM® certification, an MS in Human Service Management, and having been inducted into the NAMSS Hall of Fame in 2017, Giles sees a bright future for the MSP profession – providing it adapts to the industry’s ever-changing needs. “I refer to the position as ‘information manager,’” she says. “MSPs have to be much more technically capable, aware of what information can be shared, and create the meaningful reports that will help the decision makers.” Noting that the information collected can be useful to a healthcare organization’s strategic planning initiatives, Giles says, “We have to reinvent ourselves and become leaders – just like a department head or vice president of any other part of the hospital.”
While her wooden teacher’s pointer has been replaced by a laser pointer and her silky chalk has been set aside, Giles continues to leverage her love of teaching and her experience to guide a new generation of MSPs into the field she’s helped to build.