Friday, July 12, 2019

Celebrating under the Summer Sun

Every single day throughout the year, our doctors, nurses, technicians, and all employees at GBMC work to move us closer to our vision to serve everyone the way we want our own loved ones served. This week, we took time to have some fun and thank our staff at our Employee and Volunteer BBQ for everything they do day-in and day-out in our system of care. The annual event allows our staff to step back, relax, and spend time with coworkers in a casual setting. This year, we also celebrated with a special Western theme.

As always, the festivities kicked off in the morning for our day-shift staff, with a continuation of the party in the evening to allow our night-shift staff to be recognized as well. Everyone enjoyed watching their coworkers sing karaoke and cool off with snowballs from the Kona Ice truck, all while fitting with the Western theme of playing horseshoes, lasso roping games and new this year – riding a mechanical bull. I hope everyone had the chance to try to stay on the bull for 8 seconds! I had a hard time getting on, but I made it through 52 seconds. I was glad that I was still in one piece after I fell off!

We also once again hosted a Legacy Chase Ribbon Contest in which departments, units, and practices decorated 3ft x 2ft three-dimensional awareness-shaped ribbons for the chance to win a pizza party. A round of applause to all the teams who participated! All ribbons were judged and the following teams were declared the winners of the three groups:

  • Best Departmental/Unit Theme:  X-Ray
  • Best Legacy Chase Theme: Quality and Patient Safety
  • Best Cancer Awareness Theme:  Oncology Support Services

I also want to give a special thanks to our Philanthropy Team, led by Jenny Coldiron, our Human Resources Team, led by Anna-Maria Palmer, and our Marketing and Communications Team, led by Greg Shaffer, whose planning made the fabulous employee BBQ possible for all of us once again. Your hard work brings us all together to move closer to our vision to provide the care to every patient, every time, that we would want for our own loved ones.

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ICYMI: I talked to the Daily Record recently about how we can do even better in U.S. healthcare. Below is an excerpt, but you can read the full version here.

Before Dr. John Chessare took over as president and CEO of Greater Baltimore Medical Center nine years ago, the hospital’s board asked him whether GBMC could remain independent at a time when other hospitals across the state and the country were consolidating.

Chessare told them that it could, but it would require the hospital to commit to a transformation of how it cared for people, including an increased focus on treating people before they ever came to the hospital.

“My basic premise is the average man on the street in Baltimore has no idea, has no idea that health care could be so much better if we could just redesign care to get closer to what the patient actually needs,” Chessare said. “There’s no doubt (we) do a great job in the hospital, but we are not doing what we need to do in the management of chronic disease.”

Tuesday, July 2, 2019

One Patient One Record – An Update

It’s been close to three years since we went live with Epic as our electronic medical record (EMR), a “big bang” across the entire GBMC HealthCare System. And, I will admit that there were many “growing pains” along the way. Today, patients truly now have only one record at GBMC. It is without question that our success has been based on much hard work over the years and a big team effort.

That effort was recognized two years ago when we were presented with the Healthcare Information and Management Systems Society (HIMSS) Analytics Stage 7 Award; we became one of only two organizations in Maryland to achieve this for both the inpatient and ambulatory settings. This accomplishment was due to the commitment and the hard work of the GBMC staff, including our highly skilled team of physicians, nurses, other clinicians, and IT professionals.

We have now been recognized again. Epic recently awarded us with Magna Cum Laude status in its Honor Roll Program. The recognition program is based on achieving continuous improvements in patient outcomes, quality of care, workflow efficiency, and financial performance. This is a unique distinction that is not held by many across the United States.

To talk about the award and what it all means, I've asked Dave Hynson, our Chief Information Officer, to discuss this with me in this week’s blog.

Dave, first let me start off by congratulating you and your team! Briefly tell us more about this award and why is it significant for our healthcare system?
Thank you, Dr. Chessare, for your kind words and for highlighting our recognition from the Epic Honor Roll program.  This achievement was truly a team effort.

Reaching Honor Roll status is based on strategies, lessons learned, and best practices distilled from Epic’s experience serving healthcare organizations There are three levels of program achievement based on the number of components completed: Cum Laude, Magna Cum Laude, and Summa Cum Laude. The GBMC Epic team participated in this program in March and successfully obtained Magna Cum Laude! GBMC is now one of the three Epic organizations to date to have received this award for 2019.

Can you tell us how we were able to achieve this recognition?
The GBMC Epic team reviewed the Honor Roll requirements and created a workgroup that established leads for each portion of the Honor Roll checklist. Action plans were then created, and meetings held with key operational stakeholders to review the criteria and evaluate the benefits to GBMC and align the work with our quadruple aim. Through strong collaboration and communication, we implemented functionality within Epic that streamlined care delivery for our patients and enhanced end-user workflow. In addition, we further engaged patients as active members of their care team with tools that allowed them to self-schedule appointments, review their test results, and read notes from their providers in MyChart.

What are some of the next steps to help us receive the Summa Cum Laude distinction?
As we continue to leverage the Epic software, one of the main components is the infrastructure and meeting the standards for system response time and performance. Fast system response time and downtime preparedness increases productivity and better care delivery for our patients. By maximizing the performance of the system, the team can ensure that it is built for user efficiency and patient safety, so the focus can remain on our four aims. 

What are some helpful changes for our staff and patients, or important upgrades to Epic that might be taking place in the near or distant future?
We have moved to quarterly upgrades that allow us to incorporate enhancements and refuel the system more regularly. We have an upgrade planned for October 23rd of this year and new features will be introduced at that time. The team is working to identify the enhancements now and then will partner with operations to create a roadmap for development, conduct end-user testing, and offer any training necessary before implementing the changes.

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I sincerely thank Dave and his entire team for all they do every day to reach our vision of being the community-based health system where every patient, every time gets the care that we would want for our own loved ones. I applaud them for their commitment and their excellence!

Accolades from Near and Afar
I am proud to announce a couple of significant recognitions from two print media outlets – one local and another national.

GBMC HealthCare was recently included in the inaugural Forbes list of America’s Best-in-State Employers 2019! GBMC was one of seven healthcare systems being recognized in the state of Maryland. The selection process was based on an independent survey from a vast sample of more than 80,000 U.S. employees working for companies employing at least 500 people in their U.S. operations. Employees were asked to rate their willingness to recommend their own employers to friends and family; participants were also prompted to evaluate other employers in their respective industries that stood out either positively or negatively.

The Baltimore Jewish Times also unveiled its list of “Best of Jewish Baltimore 2019” last week. GBMC was named “Best Hospital” by the readers of the Jewish Times.  I am truly proud of the great reputation we have among the Jewish community and for their trust in GBMC to meet their healthcare needs.

Stroke Center Award
I also want to congratulate our Primary Stroke Center which, under the leadership of Michael Sellman, MD, and Aaliyah Franks, RN, was recently selected for the 2019 AHA Gold Plus and Target: Stroke Honor Roll Elite.  This award recognizes our Stroke Center’s strong commitment to quality stroke care according to nationally recognized, research-based guidelines built on the latest scientific evidence.

The award is given by The American Heart Association (AHA) in recognition of hospitals that met specific quality achievement measures for the diagnosis and treatment of stroke patients at a set level for a designated period. These measures include evaluation of the proper use of medications and other stroke treatments aligned with the most up-to-date, evidence-based guidelines with the goal of speeding recovery and reducing death and disability for stroke patients. Before discharge, patients should also receive education on managing their health, get a follow-up visit scheduled, as well as other care transition interventions.

This award is the result of the hard work of our entire stroke team and demonstrates GBMC’s high level of commitment and expertise in caring for stroke patients. With an aging population, we are at the ready to provide superior care to all GBMC stroke patients, day in and day out. Great work & congratulations!

Happy Birthday to Us! 
I want to wish everyone in our GBMC family a safe and happy fourth of July. The Independence Day Holiday is the birthday of our great country..the land of the free and the home of the brave. Let's take some time to reflect on what we can each do to make our country even better than it is today.

Friday, June 28, 2019

Telling GBMC’s Story

One of the great things that I get to do as the President of GBMC HealthCare is to educate the community about our work and our vision. Last week, I addressed our malpractice reinsurance carriers along with our Vice President for Legal Services and General Counsel, Susan Martielli. Susan and I had a great story to tell about how we have made our care measurably safer through designing better systems and by holding ourselves accountable to standard work. The insurance executives were impressed by our reductions in hospital acquired infections, our work to make the medication delivery system more reliable through our use of barcode scanning, and the elimination of unreadable barcodes on medications. They were also impressed with our work to reduce non-emergent overrides in our drug dispensing cabinets.

Earlier this week, I met with two key members of the editorial staff at The Daily Record, Tom Baden, Editor, and Tim Curtis, Business Reporter. The Daily Record is a daily print publication that reports on commerce, business, and finance with a focus on Baltimore City and Baltimore County. During our meeting, we discussed national healthcare issues such as the current challenges facing our nation’s hospitals and the opioid addiction crisis as well as local issues like the behavioral health/mental health challenges in our state and our partnership with Helping Up Mission. In both instances, I was so proud to tell the GBMC story and to reflect on how far we have come as an organization in moving towards our vision.

Celebrating Life!

Earlier this month, I was delighted to be with 500 cancer survivors, their caregivers, friends, and family members as they celebrated life at our annual Cancer Survivorship Celebration.

This event provides an opportunity to recognize our patients’ courage and our caregivers' commitment to their treatment.

Every year, more than 2,500 individuals turn to the experts at The Sandra and Malcolm Berman Cancer Institute at GBMC when faced with life-changing medical diagnoses. Our Berman Cancer Institute is not only locally recognized, but nationally as well, and is fully accredited by the American College of Surgeons Commission on Cancer.

The number of people who attend this event continues to grow. Congratulations to our survivors, their families, and our caregivers!

Thursday, June 20, 2019

Back Where We Started

For more than eight years, GBMC HealthCare has been committed to the vision of becoming a community-based system of care that the patient experiences as a whole. A core building block of our system has been advanced primary care, through our patient-centered medical homes in Baltimore and Harford Counties. These practices are designed to be accountable with our patients for their health. 

In the advanced primary care model, it’s not about visits, it’s about a relationship. The team manages those with chronic disease and reaches out to patients to make sure they have a plan and that they are following it. The team connects the patient to specialists when needed, including master’s-prepared behavioral health consultants, substance use consultants, and psychiatrists. Now, we are taking the advanced primary care model to Baltimore City — back to where we started.

In partnership with Helping Up Mission (HUM) – a nonprofit located in historic Jonestown whose mission is to provide comprehensive recovery services for men fighting addiction, poverty, and homelessness in Greater Baltimore – GBMC will deliver advanced primary care to 500 of their clients with significant healthcare needs and more than 1,500 alumni who are encouraged to maintain their recovery and remain accountable through the HUM Alumni Program.

Last week, Dr. James Baronas, the medical director for GBMC at HUM, and Erika Thompson, our practice manager, officially started serving HUM clients. HUM needed a partner that would be able to care for their growing number of clients. Most of the men who come to HUM have not had adequate healthcare for many years and many have lived on the streets for long periods of time. They have not had continuity in their care.

There is also a great need for primary care services in the larger community. Jonestown residents experience higher rates of unemployment and poverty than in other neighborhoods in the city. Our team looks forward to opening the doors of the practice to those most in need.

What makes this relationship even more special is that it brings GBMC, quite literally, back to where it started. The site of GBMC at Helping Up Mission once housed the Presbyterian Eye, Ear & Throat Charity Hospital, one of GBMC's founding institutions.

For more information about GBMC at Helping Up Mission, check out this brief interview with Dr. Baronas on a recent edition of “To Your Health,” as he talks in detail about our partnership today and in the future.

Recognition from the American Hospital Association
Last week, I had the honor of accepting an award on behalf of the GBMC HealthCare System from the American Hospital Association (AHA).

GBMC was presented with the AHA’s Membership Milestone for 100 years. This award was presented to us for reflecting the AHA’s mission for the last 100 years of “continuing their passion for improving health and community engagement.” 

GBMC, as it is known today, is the result of two Baltimore City hospitals merging and relocating to Baltimore County: The Hospital for the Women of Maryland, of Baltimore City (Women’s Hospital) and Presbyterian Eye, Ear & Throat Charity Hospital. GBMC HealthCare was incorporated in 1960 by consolidating the operations of these two specialty Baltimore hospitals, and GBMC opened its doors in 1965 as a regional medical center.

The timing of this award couldn’t have been more appropriate given that we started our work at HUM last week.

I want to thank the AHA for recognizing our rich history and ongoing commitment of health, healing, and hope.

Thank You!
In my previous blog post, I talked about my commitment to better health. Well, this past Sunday, I ran along with more than 900 participants in the 31st annual GBMC Father’s Day 5K and 1-mile Fun Walk. It was great to see so many members of the community and the GBMC staff come out and run while raising money for the Neonatal Intensive Care Unit. 

Every day, moms and dads turn to GBMC’s highly-trained healthcare professionals to care for their sick or premature babies because we provide the same care that we would want for our own loved ones. I am happy to report that since announcing our NICU renovation project at last year’s 5K, the community has come together to raise over $1.6 million to help support the NICU Renovation Capital Campaign. With everyone’s help at this year’s event, we raised over $90,000. I want to thank everyone who helped us have another amazing Father’s Day 5K. 

Let me also thank the volunteers as well as GBMC’s NICU doctors, nurses, technicians, and others who dedicate their lives to the health of babies. I want to congratulate the more than 250 patients from GBMC’s Comprehensive Obesity Management Program (COMP) and their supporters. This is the fourth year that a special group of members from The COMPto5K initiative, a six-month project designed to support and encourage COMP patients to incorporate exercise in their weight loss via a 5K training process, participated in the event. Many previous participants have continued their training after the Father’s Day 5K and participated in other area running events.

Lastly, I want to thank everyone involved in our community Wellness Fair which featured health-related vendors. Great work everyone!

Thursday, June 13, 2019

Starting with Me

Since I came to GBMC in 2010, I have tried to lead by example by donating blood at our blood drives. So back in February, I arrived early in the morning at my appointed donation time. I was stunned that day when I was rejected as a donor because my blood pressure was too high. I’ve never had an issue with my blood pressure! I immediately did an examination of conscience and I realized that I was at my highest weight ever. My body mass index (BMI) was in the overweight range. I’ve always been a person who loves to eat and my wife, Tracey, is an excellent cook. I have always exercised, by jogging, but in recent years I have not done this as routinely as I should. So, after a visit to my primary care physician and seeing that my blood pressure elevation was only transitory, I committed to losing weight. I promised myself that I would eat less and exercise more. I downloaded the Lose It! App on my phone and built daily running into my routine. I worked hard to get to 10,000 steps every day. I am happy to report that I have lost about 20 pounds and this week I reached a normal BMI.

So, why am I talking about this? Readers of this blog know that GBMC has moved upstream to keep people out of the hospital. We have started with those who have been diagnosed with a chronic disease and we have also improved our focus on disease prevention. Obesity is a trigger for vascular and heart disease and for adult-onset diabetes.

Cathy Hamel, President of Gilchrist and our system’s Vice President for Continuing Care, and Carolyn Candiello, Vice President for Quality and Patient Safety, oversee our community health needs assessment and their most recent report shows that obesity is a priority health issue in Baltimore County. According to the assessment, 36% of people are overweight (like I was), 34% of people are obese, and only 31% of people fall within a “normal” weight range. (To read the report click here). If we could get more active and taking in fewer calories, imagine how much healthier we could be!

So, as we celebrate Men’s Health Month along with Men’s Health Week (Sun.10th – Sat.15th) and Blood Donor Day (Fri.14th), please reflect on your eating and exercise habits. Don’t make it too hard. Eat better and exercise more. And please become a blood donor if you’re able. Thank you!

Get some exercise on Father’s Day for a great cause!
It’s that time of year again for one of the GBMC HealthCare system’s biggest annual events. This Sunday, June 16th, we’re holding the 31st Annual GBMC Annual Father’s Day 5K & 1 Mile Fun Walk on our campus to benefit the hospital’s Neonatal Intensive Care Unit (NICU).  This is a wonderful event where former NICU babies, families, staff members, community supporters, and friends come out to have fun and support our NICU.

GBMC is a community-based system of care and we are fortunate to have a fabulous NICU with excellent clinicians, great care, and cutting-edge equipment. It’s no secret that we enjoy a lot of support from those we serve because we are considered as the best place to have a baby in our region. We deliver more than 4,000 babies a year and approximately 400 of those babies spend some time in our NICU. The equipment and staffing required to provide this care is expensive — our annual Father’s Day 5K raises funds for the NICU and creates greater awareness of the strengths of our program as well as the wonderful expertise and commitment of our team.

There’s still time to support this event. Click here to register and learn more! I’ll be out there running, so please come join me! Remember that your support will touch more than 400 critically ill and premature babies cared for annually in GBMC’s NICU.

If you’re planning to participate in the Father’s Day 5K & 1 Mile Fun Walk, please feel free to share your story of why you help fundraise for GBMC.

…also, Happy Father’s Day to all the fathers in our GBMC family!

Celebrating LGBT Pride Month
June is Lesbian, Gay, Bisexual, and Transgender Pride (LGBT) Month in the United States and throughout other parts of the world, and it’s established to recognize the impact that gay, lesbian, bisexual, and transgender individuals have had on the world. This month offers an opportunity for all of us to pause and consider that, while progress has been made to afford equal rights to all, there is still much more work to do.

Inclusion has always been part of the GBMC culture. As a system, we feel that discrimination of any kind is unacceptable. Our policy of inclusion goes beyond employment practices and protections and celebrates the diversity of our workforce. At GBMC, we recognize that we must attract the best talent from around the region and create a culture where employees can bring their authentic selves to work every day. We will continue to be a leading voice in the push for diversity and inclusion in our communities.

Please join me in celebrating LGBT Pride Month.

Friday, June 7, 2019

The Behavioral Health Crisis: On Being a Part of the Solution

Much has been written recently in the media about the mental health crisis, not just facing our state, but the entire nation. Stories have ranged from new research showing an alarming increase in the number of U.S. teenagers and young adults turning to the emergency department (ED) in times of mental crisis (click here), to a 24/7 clinic opening next week in Harford County with the goal of being an option for people who need immediate access to behavioral health and addiction services.

Recently, Mental Health America (MHA) released its annual State of Mental Health Report, which ranks all 50 states and the District of Columbia on several mental health and access measures. The report provides a snapshot of mental health status among youth and adults and tracks changes in the incidents of mental health issues and access to mental health care, with the hope of promoting policy changes to improve outcomes for individuals and families with mental health needs.

The dilemma is profound, but perhaps the biggest concern is the state of behavioral health care for children. The president and CEO of Mental Health America, Paul Gionfriddo, commented in the report: “far too many young people are suffering – often in silence. They are not receiving the treatment they need to live healthy and productive lives – and too many simply don’t see a way out.” I agree. So, what can we do about this?

Earlier this week, I met with Dr. Harsh Trivedi, President and CEO of Sheppard Pratt. GBMC is very fortunate to be contiguous to Sheppard Pratt’s main campus. Sheppard Pratt is one of the largest providers of behavioral health care and social services on the East Coast. We have had a partnership for many years. GBMC provides medical support for some Sheppard Pratt programs and in turn, it provides psychiatric support to our hospital and behavioral health services in our patient-centered medical homes.

Dr. Trivedi and I discussed our work in integrating master’s-prepared behavioral health consultants, substance use consultants, and psychiatrists into our advanced primary care offices. We are now screening patients in primary care for behavioral health issues and addiction, and with these new colleagues in our offices, it is easier to connect those in need directly to services. We reaffirmed our commitment to work together and move upstream in the disease process with early identification and therapy to reduce the probability of bad outcomes and speed up the recovery process from problems such as anxiety and depression. We also discussed how we can better work together to more quickly move patients in crisis out of our Emergency Department and into the required therapeutic setting. We are scheduling regular meetings to reduce waste in our system to improve mental health outcomes and the care experience for patients and their families.

We cannot solve the country’s behavioral health problems on our own, but we can become an even bigger part of a regional solution.

Related Sites For More Information:
Mental Health America report 
Crisis center in Harford County
Increase in teenagers and young adults ED visits/mental crisis 

Tuesday, June 4, 2019

A New Team to Help Those Most in Need

Last week I attended a meeting where I was excited to learn about the early successes of our new Complex Care practice. This team was created to help patients with repeated hospital admissions and visits to the emergency department. They work to identify and address the root causes of these patients’ high hospital utilization by creating patient-specific plans, which can involve longer, more frequent appointments, coordination with providers across multiple specialties, and access to social services.

The team is led by general internists Mark Lamos, MD, and Vaibhav A. Parekh, MD, both of whom have years of experience in managing patients with chronic disease. Nick Davenport, MSW, the social worker on the team, plays a critical role in helping patients resolve the social challenges that prevent them from getting the care that they need. Our Complex Care patients often have more than one chronic illness, which can lead to them being prescribed multiple medications. Our Lead Ambulatory Care Pharmacist, Susan Arnold, PharmD, is a valuable resource for our patients who may have trouble managing their new and existing prescriptions.

Complex Care patients are initially identified through CRISP (Chesapeake Regional Information Sharing for our Patients — the regional information organization) claims and Epic data or through direct referrals from physicians. The team first focused on patients outside of our employed primary care base but has expanded to include some GBMC Health Partners patients. If an identified patient wants to join Complex Care, the team does a thorough evaluation of his or her medical history and schedules an appointment to learn more about the patient’s current condition. They then develop a comprehensive care plan, which involves coordination across specialties and often includes a home visit. The team has quickly learned that each patient’s experience and challenges are unique, and they work incredibly hard to make sure that every patient’s needs are met.

The initial patient utilization results from before and after joining Complex Care can be seen below:
What an outstanding start! I am so proud of the team for delivering evidence-based care while also navigating the social determinants that make it difficult for patients to maximize their health and stay out of the hospital. Congratulations to Mark, Vaibhav, Nick, Susan, and their staff members for achieving such amazing outcomes for their patients!