Tuesday, May 17, 2016

Do You See the Clutter?

February 2015
Making It Easier (and Safer) to Get the Work Done on an Inpatient Unit
July 2013
It’s easier to get the job done when everything is in its place - 5 (or 6) S's revisited
August 2012
5 or 6 S: Having a Prepared Work Space to Get to Higher Reliability & More Joy on the Job http://ahealthydialogue.blogspot.com/2012/08/5-or-6-s-having-prepared-work-space-to.html

I have written about the concept of 6 S's in this blog three times previously. So last week, when I was returning a wheelchair, to a wheelchair storage area, I wondered how many of my colleagues had walked by that wheelchair and had not returned it to where it belongs. I began to reflect on the reasons why things get out of place.

When I walk through the halls of GBMC, I often find stretchers, chairs and other things where they don’t belong. We don't want to put clinicians in the position of having to do work-arounds to meet patient care needs because they cannot locate the proper equipment. Things get out of place for many reasons. Sometimes we are doing something and feel rushed to get on to the next task that we leave an item anywhere we can just to quickly get on with our work. In these instances, we sometimes tell ourselves that we will put the thing anyway later, and then we forget. Sometimes things need to be returned to a place off our unit or department and we need to call transport to retrieve it which takes time. Sometimes we don’t know where something truly is stored.

When something is already out of place, like the wheelchair I found, there are many reasons why they don’t get returned. Sometimes we are in a hurry and feel we don’t have the time to return something to its correct place. Some people believe that it isn’t their job to replace things that they did not displace. I also think that we get immune to clutter and we begin to not “see” it. It becomes the usual to have “stuff” everywhere. Then there is the concept of “hoarding”. Sometimes we keep things where they don’t belong because we are afraid that if we put it back where it belongs (especially if it is stored at a distance from our workplace) that we won’t be able to get it back when we need it. This, of course, guarantees that someone won’t get it when they need it if no one else knows where it is. This is why we created an equipment hub in 2012. When people don’t trust the equipment storage system and they hoard, they unwittingly make the system less reliable.

Why should we care? I think there is a true hierarchy of reasons why we should not accept clutter. The first is patient and staff safety. I told the story in this blog of being in a hospital that had a fire and patients needed to be moved quickly. Beds, stretchers and other things in the hallway were a true safety hazard that day. The second is patient engagement. No one thinks well of a cluttered hospital. The third reason is it makes it harder for us to get our work done if we can’t find what we need or have to work around things that don’t belong where they are.

We need to create better accountability for our facilities staying in 6S condition. So, in case you have forgotten the 6S’s, they are:

1. Sort: eliminating everything not required for the work being performed.
2. Separate: efficiently placing and arranging equipment and material.
3. Shine: tidying and cleaning.
4. Standardize: standardizing and continually improving the previous three.
5. Sustain: establishing discipline in sustaining workplace organization.
6. Safety: creating a safe work environment.

All managers must own their workspace and audit for clutter at some regular interval. They must enroll their people in keeping the department or unit clutter free. Our performance improvement colleagues will be happy to help managers create a system to make it easier to keep your space ready for business.

But we as individuals must avoid leaving things where they don’t belong and also help and remove clutter as we find it. If we all commit to this, it won’t be so hard because it will become much less frequent to find something that isn’t in its place.

What do you think?

Thursday, May 12, 2016


Sunday marked the beginning of National Hospital Week, the celebration of which dates back to the early 1920s. According to the American Hospital Association, the week is “a celebration of the history, technology and dedicated professionals that make our facilities beacons of confidence and care.”  This year’s theme is “Health Care from the Heart,” something that our committed GBMC staff – over 4,0000 employees across the system --does daily.

We have excellent facilities and technology within GBMC HealthCare, but, a hospital is always more than a building and equipment.  It is made up of physicians, nurses, volunteers, therapists, food service workers, surgeons, analysts, counselors, and administrators — men and women who are committed to providing everyone with the care they want for their own loved ones. At all hours of the day and night, all year long, GBMC and its dedicated staff are there to serve our community in our mission of health, healing and hope.

I am very grateful for all that our hospital team does every day. Thank you to all!

I hope that all of my colleagues will take some time to focus on their own health. Please attend our Employee Health Fair in the Civiletti Conference Center TODAY (Thurs., May 12) from 11 a.m. - 3 p.m. Visit a variety of vendors, learn about health, wellness, and benefits, receive giveaways and be entered for raffle prizes. Winners will be announced on the InfoWeb.

This week, GBMC HealthCare is participating in Decision Health’s 8th Annual Care Coordination Summit.  The summit showcases new models of care and innovative processes that are transforming the healthcare system leading to improved patient outcomes and appropriate use of healthcare resources.

During the three-day summit, Dr. Robin Motter-Mast, chair of the family medicine department and who leads population health and our Patient Centered Medical Homes, Melanie Miller, manager of Population Health Coordination Services who manages and trains the care coordinators within all GBHA primary care practices, and Megan Priolo, chief operating officer of GBHA who has direct oversight of ACO and population health activities, all presented our work that has resulted in a better health outcomes, better care experience including better access and reduced healthcare expenditures for our community.  They did a fantastic job in representing our healthcare system and educating the public on our population health initiatives.

We were nominated as finalists for the Case in Point Platinum Awards for our exemplary work and aim to continue providing improved healthcare to the people we serve.  The Case in Point Platinum Awards recognize population health management programs that successfully deliver efficiency and effectiveness across a variety of disciplines and settings in the continuum of care. Now, I am proud to announce that GBMC won awards in the following categories:
Community Care Settings--Community Care Programs; Health Information Technology Systems and Transition Care Programs.

I want to extend congratulations to the Gilchrist Inpatient Care Management team, director Joanne Parr, utilization review manager Yanting Zhu and manager of care transitions Kathy Eiseman-Brock for their part in securing our Transition Care Programs award.

With the May 16th deadline quickly approaching, I wanted to kindly remind you all to do your part and complete our annual Employee Engagement and Safety Survey.  The survey can easily be accessed through the icon on any GBMC desktop computer (see pic on right).

So far, 42 percent of our colleagues have responded. We need your opinion.  The survey is anonymous to GBMC and confidential. We work with a third party vendor, Press Ganey, who compiles survey data for us. We at GBMC never see individual responses.

Please don’t be silent and complete the survey so that we can identify opportunities for further improvement, to judge the value of changes we made since the last survey and to make GBMC an even better place to work and a safer health system for our patients.

If you want to be included in a weekly drawing for a $100 prize, be sure to enter your name after you complete the survey.  As a thank you to completing the survey, Press Ganey also conducts a prize drawing each week.  For just providing your honest opinion, you could be entered to receive $100 extra in your paycheck or two tickets to GBMC Employee Night at Camden Yards.

I would be remiss if I didn’t mention the 28th annual GBMC Golf Tournament that was held on Monday at Turf Valley Country Club.  Hats off to the entire golf committee, the many employees who helped with the event and to Jenny Coldiron and the GBMC Foundation staff, all of whom worked together for a great event. We had over 45 foursomes sign up – that’s almost 200 golfers supporting our efforts.  It was clear that countless hours were spent preparing for this great day that grossed more than $180,000 to benefit GBMC. I had the opportunity to golf with Sam Heffner, the Chair of the HealthCare Board’s Philanthropy Committee and Delbert Adams, the Board member who along with his wife, Gina, oversaw our phenomenal 50th Anniversary Gala. Sam and Delbert carried our Team….I wasn’t much help but I had a great time!

Thursday, May 5, 2016

Nurses are the Mainstay of our HealthCare System

The Oxford dictionary defines backbone as the chief support of a system or organization; the mainstay. Nurses are the mainstay of our health care system. Without nurses, the system would quickly fall apart.

Annually, GBMC celebrates National Nurses Week and National Nurses Day. National Nurses Week is celebrated yearly starting on May 6, also known as National Nurses Day, through May 12, the birthday of Florence Nightingale, the founder of modern nursing.
During this week, we take the time to reflect on the profession of nursing and what our nurses mean to us and to also express our gratitude for their care and caring. It’s no secret that nursing requires self-sacrifice and dedication.

The 1,200+ nurses across the GBMC HealthCare system work very hard.  Caring for patients with many needs requires physical and mental stamina. It is not a profession for people who have difficulty focusing on others. Dedication to helping others is a key trait that defines nursing. Our nurses are smart, well-trained and resilient. Their work is not predictable. I am so grateful for their ability to adapt to the variability in demand for their services from day to day and sometimes from minute to minute.

GBMC has always been known for our outstanding nursing care at the bedside of individual patients. More recently, our nurses have become leaders in quality improvement. Just review any of the myriad of metrics that we display at gbmc.org/quality. You will see reduced infection rates, falls, and serious safety events among others. Nurse have frequently been the leaders on the teams that have achieved these heightened levels of performance. They have collaborated marvelously well with their physician colleagues and others to move us closer to our vision every day.

We in the GBMC HealthCare system are blessed to have phenomenal nurses in our inpatient units, in our operating suites, in our outpatient areas, our physician practices, and in our hospice. I am very proud of all of them and honored to call them my colleagues.

I also want to highlight the great work by our nursing administrators and educators for their ability to recruit young nurses, train them well and mentor them, making GBMC a great organization for nurses.

So during Nurses Week, please join me in thanking our nurses for all that they do.

How has your life, professionally or personally, been touched in a positive way by a nurse?  Please share your comments below and show our nurses how valuable they are.

Hand Hygiene 
Practicing hand hygiene is a simple yet effective way to prevent infections. Cleaning your hands can prevent the spread of germs, including those that are resistant to antibiotics and are becoming more difficult to treat.

This Thursday, May 5th was declared, by the World Health Organization (WHO), as “World Hand Hygiene Day.”  The day has been designated to remind healthcare workers and to encourage patients and their families to practice good hand hygiene.  It’s no secret that many patients in the United States are affected by healthcare-associated infections and many of these situations could have been prevented by caregivers properly cleaning their hands at key moments in patient care.

So, to celebrate the day and to remind us all of the importance of hand hygiene, members of our Infection Prevention Team, led by Laurie Hart, RN, will be going around the hospital to educate our staff on the proper handwashing techniques and the “5 Moments of Hand Hygiene.”  Thank you very much for washing your hands!

Wednesday, April 27, 2016

Leaders in Their Field

Last week, I was delighted to attend the second annual BALTIMORE Magazine Top Nurses event. I was so proud of my six colleagues who were chosen by their peers from among thousands of wonderful nurses throughout the Baltimore region. These outstanding professionals were selected in five different specialties and represented 11% of all winners! These facts supported what I already knew – the GBMC HealthCare System has the best nurses!

Please join me in congratulating those recognized for their excellence:
Justine Kellar, RN, BSN, Management/Nurse Executive Category
Shannon Isaac, RN, Orthopedics Category
Joseph Henry, RN, Pediatrics: Neonatal Category
Laura Clary, RN, FNE-A/P, SANE-A, CFN, CPEN, Women’s Health Category
Sherry Pearson, RN, Women’s Health Category
Erin Batton, RN, Hospice/Home Health/Palliative Care Category

Our nurses and nursing support technicians are the backbone of GBMC. They spend the most time with our patients and are critically important members of the healthcare team. Their untiring work at the bedside and in improving patient safety and redesigning systems to improve care has been remarkable. We frequently have visitors with us on our Lean Daily Management (LDM) walk and I often brag about the accomplishments of our nurses. Recently, I was telling representatives of the company that provides malpractice reinsurance to GBMC that Cele Gayhardt, RN, and her team on Unit 48 had been instrumental in implementing evidence-based standard work for the use of urinary catheters and had helped reduce our rate of catheter-associated urinary tract infections to zero! This is just one example of the intelligence, skill, dedication and hard work of our nurses. It is marvelous to see members of our team called out for their outstanding contributions.

The second annual “top nurses” issue hit the newsstands on Friday, Apr. 29.  Don’t forget to pick up your copy!

Speaking of BALTIMORE Magazine: Physicians….It's that time again - BALTIMORE Magazine is collecting votes for its TOP DOCTORS issue. Docs, please vote for the colleagues you most respect! This year, the magazine will only utilize online voting for TOP DOCS and no hospital codes are being used. The survey may be found at: http://www.baltimoremagazine.net/about/top-doctors-survey

Another Well-Deserved Award

Congratulations to Laura Clary, RN, FNE-A/P, SANE-A, CFN, CPEN, clinical manager of our SAFE program!  Laura was recently awarded the Henry Gleim Memorial Award by the Governor’s Maryland State Board of Victim Services.  The award recognizes her outstanding contribution to the field of victim services and for her work in the area of victim advocacy. Thank you, Laura for all your hard work at GBMC, as well as out in the community. This recognition is well deserved!

2016 Employee Engagement and Culture of Safety Survey
Please complete our annual Employee Engagement and Culture of Safety Survey.  The survey is open through Monday, May 16 and can easily be accessed through the icon (left) on any GBMC desktop computer or by visiting https://engagement.pressganey.com/SESID=SV_8uDlnumnkZFnk1v&Q_TS_ID=TS_4Hm2rJuUy8oK1s9&Q_TS_RS=Self&Q_EE_ANON=1&Q_RSID=RS_b1OOKViWCUjGMKx

If you want to be included in a weekly drawing for a $100 prize, be sure to enter your name after you complete the survey.

The survey is completely CONFIDENTIAL, and your individual responses to the questions will not be shared! If you do, however, choose to include additional comments, these will be shared with your manager but your name will not be given.

Please complete the survey so that we can learn what we can do to make GBMC an even better place to work. Thanks!

Monday, April 18, 2016

The Passing of One of GBMC’s Greatest Friends

Last Friday, I attended the funeral of Mr. Joseph S. Keelty, who passed away at the age of 93 years.  As you can imagine, the church was packed. Father Timothy Brown, a faculty member at Loyola University and a personal friend of Joe’s, gave the homily and pointed out that all in attendance were mourning Joe’s passing collectively and personally. By that he meant that Joe had given so much to the community, but, that he had had a personal relationship of kindness and giving to so many individuals as well.  This really resonated with me. As the President of GBMC HealthCare, I realized that Joe Keelty was a force in giving of his time, talent and treasure to both Gilchrist Services and our hospital. And as an individual, I remembered how kind Joe had been to me when I first met him and at every interaction with him since then. He was the essence of humility. It was always clear that he did not want attention paid to his giving.  

A history of personal concern for others and “quiet philanthropy” were hallmarks of Joe Keelty’s life. Born into a family that began a homebuilding company in the early 1900s, Mr. Keelty helped to spearhead the family business and became a leader in the industry nationally, serving as an officer of the National Association of Homebuilders and the Homebuilder’s Association of Maryland.

His commitment to his church, education, the welfare of the disadvantaged and healthcare focused his philanthropy. Joe served as Chairman of the Gilchrist Board and was an emeritus member of that body at the time of his death.

The Joseph S. Keelty Society was named for him because of his life-long leadership and exceptional generosity to GBMC HealthCare. His vision of service is something we strive for each day and we are deeply indebted to Mr. Keelty for his support. The impact he made is beyond measure, but can be seen each day as we work towards our vision to provide to everyone the care we would want for our own loved ones.

There is no doubt that we have lost someone who was very special and a great friend to GBMC.  We will always be thankful for what Joe did for GBMC and we are truly going to miss him.

Look for more information honoring Mr. Keelty on www.gbmc.org and in future editions of GBMC publications.

For now, please join me in honoring his life and legacy by sharing your memories and thoughts of Mr. Keelty with our blog community.

Friday, April 15, 2016


This week we are celebrating National Volunteer Appreciation Week.  With over 900 volunteers in the hospital and at Gilchrist Hospice Care, GBMC has among the largest volunteer groups in the state.

Our volunteers perform numerous acts of kindness as they share their talents every day. We cannot achieve our vision without them. Since they are all accomplished members of the community they make it easier for us to stay focused on providing to every patient, every time the care that we would want for our own loved ones.

When I meet our volunteers throughout the system I am always amazed how personable they all are and how much they really enjoy helping others.  My spirits always rise when I leave my office and I am greeted by the smiling volunteers at the front desk of the hospital.

Since the birth of GBMC, our volunteers have donated more than 2.4 million hours of service and through various endeavors, like the Nearly New Sale events, have raised more than 20 million dollars to support patient care at GBMC!

Our volunteers are people with wonderful personal stories who could be doing something else with their time.  Instead, they come with a dedication to lessen the burden for our patients and their families, visitors and our staff.

A wonderful example is Sharon Barnes. She started volunteering at GBMC about six years ago. She decided to volunteer here because her mother was a GBMC volunteer and Sharon learned from her the value of volunteering and the importance of making a difference in someone’s day.
As a volunteer in the Family Waiting area of the General Operating Room, she greets patients who are coming in for surgery, takes them to the pre-op area and tells them what they need to do to prepare for surgery (how to put on the hospital gowns, etc).   Sharon also tells patient’s family members what to expect and keeps them informed on their loved one’s progress (when they get to the recovery room or when they are ready to go home).  Sharon is also the president of the Volunteer Auxiliary and conducts the Auxiliary Board meetings where they determine how to best deploy the money raised at the Nearly New Sales, the Corner Shop, and our Vendor Sales. She also represents the Auxiliary on the Philanthropy Committee, at various hospital functions during the year and at the fundraising activities conducted by the Auxiliary and by the hospital (Legacy Chase, Father’s Day 5K, Walk a Mile in Her Shoes). Sharon says that “it is an honor and a privilege to volunteer at GBMC”. For us, it’s an honor and a privilege to have volunteers like Sharon at our hospital.

Our volunteers don’t ask for much…actually they don’t ask for anything. They just give of themselves. They display selflessness. I am grateful for all that they do, from the smiles, to their daily work, and their commitment. When you meet a GBMC or Gilchrist volunteer this week please thank them.

Friday, April 8, 2016

What if it was your daughter?

It is a tragedy that one in every four women is a victim of domestic violence at some point in her life. What’s even more shocking is that according to the U.S. Justice Department on average every day three women are killed by their partners.

I am proud that GBMC has been a leader in helping the victims of sexual assault and domestic violence and in educating the community to reduce these attacks on women. The assessment and treatment of victims of sexual assault are very complex. Expertise and caring are required not only to address the medical and psychologic needs of the patient but also to complete the forensic work necessary to aid law enforcement in the identification of the perpetrator and to see that justice is served. At GBMC, we have a very sophisticated Sexual Assault Forensic Examination (SAFE) program.  A number of years ago and until her retirement, Linda Kelly was instrumental in educating and training our medical and nursing staff to better identify and respond to patients in need. Now, under the leadership of, Laura Clary, our SAFE program is growing and expanding in new directions helping us to better meet our mission of health, healing, and hope for those in our community and our vision of serving everyone the way we want our own loved ones served.
GBMC also serves survivors of domestic violence, including survivors of Intimate Partner Violence (IPV). The goals of the domestic violence program include providing 24/7 in-house victim advocacy response. Sexual assault and domestic violence patients not only get quality medical-forensic treatment but also receive much-needed crisis intervention and safety planning.

Recognizing another need in Baltimore County and Harford County, our forensic nurses have been working closely with the Crimes Against Children Unit and are now expanding the program to care for not only victims that are 13 and older, but also 12 and under. This way we can provide comprehensive services for victims of all ages.  Members of our SAFE program have also traveled to local high schools to educate students about healthy relationships, boundaries, internet safety and general information about how to help someone who has been a victim.

And our SAFE program has expanded its educational reach beyond Maryland. This past fall, we hosted a Forensic Nurse Examiner Course and trained 24 nurses from all over the world.  We recognize that violence against women is a global crisis, so training nurses not just for our program but for others around the world is very important. Among the students were nurses in the US Military being deployed overseas, and a nurse from Nigeria. We will be hosting another training at the end of this month.

Our program has received its share of accolades as Colleen Moore, our Domestic Violence Coordinator, recently won a Governor’s Award for Excellent Victim Services, Laura was selected as Baltimore’s Top Nurse (Woman’s Health category) and our SAFE Program was awarded a Citation from the Maryland General Assembly for excellent services provided to the citizens of Baltimore County.  And, Laura was personally invited by Vice President Joseph Biden to attend his visit to the Maryland State Police Forensics Lab a year ago. A clear example of how strong a reputation our SAFE program has not just locally or in the region, but nationally as well! To date, GBMC’s Domestic Violence Program has provided services to more than 800 individuals and our SAFE program sees approximately 140 patients annually.

We come nowhere close to covering the cost of these programs with health insurance billing. So, next weekend I will be participating in the Walk-A-Mile In Her Shoes event in support of Sexual Assault Awareness Month. As you might already know, GBMC is hosting the event, in which men walk a mile in high heels, as a way to educate the community and advocate for those who have survived sexual assault and domestic violence while raising money to support the SAFE and domestic violence programs.

Our SAFE and Domestic Violence programs do so much for our community and we are grateful for all the community support that is allowing GBMC to provide these necessary services for women across the community. I hope that you all see the value as well and consider walking with us and/or financially supporting the event. For more info., please visit:  https://www.eventbrite.com/e/walk-a-mile-in-her-shoes-tickets-20458939238