Friday, September 21, 2018

Going LIVE…

Back in July, I discussed how our healthcare system has been growing its presence on social media channels like Twitter, Instagram, LinkedIn, and Facebook (more on this below). Social media has been a great way to promote subjects and specialties that don’t often receive coverage on local and regional broadcast news or print. For more on our social media strategy and how it encourages two-way communication between our workforce and customers, click here.

Last week, I was part of our monthly Facebook LIVE program, “To Your Health,” which allowed me to connect with a studio audience and Facebook viewers to talk about patient safety. If our patients are not safe when receiving our care, we will not achieve the care we want for our own loved ones because they will not have a good health outcome. To watch the interview, please click on the icon below.



I am very proud of the GBMC HealthCare System because we stay focused on our vision, but I am frequently asked: “How can we do a better job of getting the word out about our vision and how we are different?” The use of social media like Facebook LIVE is one way. Can you suggest others?

Be A Part of Our Celebration...

On Saturday, September 29, we will have our 18th annual Legacy Chase steeplechase event at Shawan Downs in Hunt Valley. This year’s race will again benefit GBMC’s Oncology Services at the Sandra & Malcolm Berman Cancer Institute.

Legacy Chase has become a signature event for GBMC HealthCare, combining the excitement of steeplechase racing with a celebration of our patients and the services we provide to the community. There’s more to the event than great horse racing and there is something for everyone. Many of the crowd-pleasing traditions continue this year, such as the kids’ Stick Pony Race, and we have added some exciting new components to help make the event another memorable success.

The Sandra & Malcolm Berman Cancer Institute is the only comprehensive community cancer program certified with distinction by the American College of Surgeons Commission on Cancer in the Baltimore region. GBMC has invested in talent and technology to provide the best care for oncology patients. We coordinate care across the continuum for more than 2,000 new cancer patients annually!

Make this year’s event a family affair and come and enjoy a day in the country. For more information visit https://legacychase.org/. I hope to see you there!

Cancer Program Gets National Recognition…Again!

Congratulations to our team at the Sandra & Malcolm Berman Cancer Institute, who recently earned the Accreditation Award with Commendation from the American College of Surgeons Commission on Cancer (CoC). In each of the last four surveys, the CoC recognized The Berman Cancer Institute for treating every cancer patient as if they were a loved one.

Accreditation indicates that a cancer program has met or exceeded 34 standards of quality measurement, while Commendation is awarded only to programs that exceed all required standards, plus 7 out of 7 commendation standards at the time of its triennial survey. Of the 1,500 CoC-accredited cancer programs nationwide, fewer than 40% earn Commendation.

Please thank our cancer team and congratulate them on this recognition of their excellence!

Wednesday, September 19, 2018

Saving Lives and Leaving Great Impressions

Last week, we had the formal grand opening of our new Neonatal Intensive Care Unit (NICU), Dr. Timothy Doran, our Chair of Pediatrics, also shared with me an email from grateful parents of babies who were recent patients in our NICU. The email reminded me that I am very fortunate to be the CEO of the GBMC HealthCare system. I get so many wonderful letters, emails, or thank you cards about members of the GBMC family who do marvelous things for our patients. The family had twins, but unfortunately each baby required special care. Happily, after almost eight weeks in the NICU, mom and dad have both babies at home.

Here is an excerpt from a letter I received this week: 
I never in my wildest dreams would have guessed just how big of a role the NICU would play in our lives. When you become pregnant, you imagine a chubby little bouncing baby, healthy as can be. You don’t ever expect that your baby (or babies) will need any extra help after they’re born. When I was told that my babies were going to the NICU, I was sad of course, but I felt content knowing that my little ones were in the best hands possible. We had met with Dr. Pane before they were born, and we trusted her and knew that the team upstairs were more than capable and knowledgeable. I didn’t realize just how much help we would be getting from the GBMC NICU staff. I didn’t realize just how much they had to offer and just how much they could do to help not only these tiny babies, but us parents, too…

I want to thank every single doctor, nurse, nurse practitioner, physician assistant, student, tech, secretary, respiratory therapist, lactation consultant, milk donor, social worker, speech pathologist, volunteer, and even housekeeper that we have had the joy of crossing paths with.

“Thank you” doesn’t even cut it when it comes to how completely grateful I am, but here it goes anyway: Thank you for your knowledge, compassion, understanding, and empathy.

Thank you for always asking how we’re doing, for explaining things in ways we can understand, for answering our questions, for taking our concerns and suggestions seriously and even implementing them in treatment, for always making sure we had everything we needed, and for being a shoulder to cry on/someone we could vent to.

I thank God, every day for the individuals that saved my baby and I thank modern technology and medicine that gives you all the ability to do what you do. I don’t know how you all do it, but I can tell that every single one of you is passionate about these tiny fragile babies and their families.

There will always be a place in our hearts for every single person that we’ve grown to know and love. God bless all of you, and thank you a million times over. ❤️”

Over the last eight years, we’ve been working hard to drive towards our vision. In 2010, we made a clear decision that we would become the healthcare system where everyone, every time, got the care we would want for our own loved ones. Our vision statement talks about physicians leading teams to deliver this. We have had a dialogue among us in the GBMC family that we want the best health outcome and the best care experience with the least waste of time and money, and with the most joy for those providing the care. Our vision is about a relationship between a physician, his or her team, and a patient. It is about a promise to that patient to work with him or her to maximize his or her health. It is about having the time to reflect on patients’ health between visits, to make sure that they are getting what the evidence says will keep them well.

The letter above is a great example of teamwork and rallying around a patient and her family! We need to continue our work to make this happen for every patient, every time. I am very grateful for all the nurses and technicians that this patient thanked and Dr. Maria Pane for exemplifying the kind of expert, compassionate care that we would all want for our own loved ones. I know how hard their work is and I am very, very grateful to them for not forgetting why they do what they do. Our NICU team is moving us closer to our vision. Let me add my thanks to all our GBMC colleagues who are moving us closer every day to our vision.

Neonatal Nurses Day… 
Last Friday (9/15) was Neonatal Nurses Day. It’s a time where we honor our nursing colleagues and celebrate their hard work and dedication. With more than 4,500 babies born at GBMC annually, we are very fortunate to have such a high-level NICU to care for those babies who are born too small, too sick or too soon. Our NICU has an exemplary group of nurses and I want to thank them for all they do.

Environmental Services Week…
Last week was also Environmental Services (EVS) & Housekeeping Week (Sept 9--15) and I want to take time to recognize the contributions of our EVS staff. Cleanliness is everyone’s job at GBMC, but, our EVS staff members are the experts in cleaning who work tirelessly to get the job done. They spend countless hours in their vital role in keeping us clean and helping to prevent infections. There are more than 100 EVS associates working around the clock at GBMC in a variety of roles, servicing over 1.2 million square feet of facility. So, please join me in honoring all the men and women of EVS.

Monday, September 10, 2018

Kosher Pantry Grand Opening

Last Thursday, we held the dedication ceremony for our new Kosher pantry, located near the main entrance of the hospital. The pantry was built to meet the dietary needs of members of the observant Jewish Community.

The pantry was made possible through the hard work and commitment of our Chaplain, Rev. J. Joseph Hart, M.Div., BCC, and Rabbi Pinches Rabinowitz, with the help of Bikur Cholim of Baltimore, a non-profit organization dedicated to meeting the needs of the observant Jewish Community in healthcare settings. Bikur Cholim will stock the room with kosher meals and snacks. There is no charge for the food and observant family members will have special access to the locked pantry.

Kosher Pantry Ribbon Cutting
The pantry has a refrigerator and freezer, separate dairy and meat microwaves, and disposable utensils. It is stocked with non-perishable foods including fresh food options that will be double-wrapped in the refrigerator for Shabbot each Friday. Other amenities include two sinks, kitchen cabinets, a dining table with four chairs, sofas, and lighting fixtures, and prayer/faith and life books.

GBMC has always been welcoming to all members of our community, but we realized over the past few years that we had no options for nutrition of the family members of our observant Jewish patients. It is fitting that we had the grand opening last week as Rosh Hashanah started last night and Yom Kippur is next week.  I want to wish a Happy Rosh Hashanah to our family and friends who are celebrating!

WOW!! What a surprise…
A couple of weeks ago, I talked about our SAFE (Sexual Assault Forensic Examination) program receiving tremendous support from the band Breaking Benjamin. Each member of the group was seen during a recent concert wearing t-shirts that highlighted our program, giving it the visibility it deserves on a big “stage.”

Much to my surprise this week, I was given two electric guitars, signed by each member of the band, from Laura Clary, BSN, RN, FNE-A/P, SANE-A, CFN, CPEN, Clinical Manager of our SAFE program, and Ashley McAree, RN, FNE-A/P, CFN, forensic nurse examiner with our SAFE program. Now, I know what you’re thinking, “Why does he need two?” No worries, I plan on giving one to my son, Mike, who is a huge Breaking Benjamin fan. It’s the least I can do after he invited me to the band’s concert last month.

I want to thank Laura, Ashley, and the members of the band for these special gifts, but most importantly, I want to express my appreciation to all members of our SAFE and Domestic Violence (DV) programs who do so much for victims of sexual assault and domestic violence and in educating the community to reduce these attacks.

Speaking of our SAFE program…
I want to congratulate Valerie Weir, BSN, RN, FNE-A/P, CMSRN, who has been named the new Domestic Violence Coordinator for our DV Program. Valerie has been part of the GBMC family for 17 years and has held many positions across the organization. According to Laura Clary, Valerie brings a unique perspective to her new role as she is certified to care for patients of all ages, who have been victims of sexual assault, rape, child abuse/neglect, intimate partner violence, and human trafficking.  She has been a great asset in aiding the SAFE and DV Programs in expanding their pediatric resources. She is an active member of the Baltimore County Sexual Assault Response Team (SART), as well as the Maryland Child Abuse Medical Providers (CHAMP).

Please join me in welcoming Valerie into her new role!

I would also like to thank Colleen Moore for her many years of service at GBMC. Colleen did an outstanding job in victim advocacy and other support services. Thank you, Colleen, for all your hard work at GBMC and in the community.

Friday, August 31, 2018

The Next Generation of Nurse Leaders

This week, I was very excited to attend the graduation ceremonies for our nurses in the residency program. Twenty-five nurses finished the one-year long program, which was capped off by the presentation of their evidence-based nursing research projects. It was wonderful to see so many smart, well-trained, and dedicated young people who have committed to a career of service to others.

The GBMC HealthCare System is committed to being a learning organization. This requires that we have people, with profound curiosity, who are ready to deeply study our processes and to adjust them based on what they learn. This is the fundamental reason why we do Lean Daily Management every morning. I was so happy to see these young nurses already displaying their profound curiosity. Their projects ranged from ways to optimize scheduling and decrease errors during shift changes to developing best practices for patient bathing to minimize infection. They used evidence-based research to find ways to improve parental-infant bonding in the delivery room and to reduce alarm fatigue.

Sharon M. Rossi, MS, RN, CSSM, Director of Perioperative Services, gave a wonderful keynote address in which she encouraged the graduates to be life-long learners. Sharon also pointed out the need to find time to “recharge” and to never forget to be kind.

There are many careers that are “easier” than being a nurse…but there are few as rewarding. I left the graduation ceremony proud of all the graduates and assured that their futures are bright. The GBMC HealthCare System’s future is bright as well, in large part because they are with us!
Labor Day
As our country celebrates the hard work of the American people this Labor Day holiday, some of us will enjoy a three-day weekend. But, many of our colleagues will be working. Please let me thank all the phenomenal people of the GBMC HealthCare System for their labor towards our vision. What makes a healthcare system truly outstanding is not the technology or the facilities, but the people. I want to thank all of you who make our health system strong because you go to work every day to serve others!

Thursday, August 23, 2018

Support from an Unexpected Source

Many people at GBMC know that I am a huge Steely Dan fan. I love jazz and Steely Dan brought the harmonics of jazz to rock and roll music beginning in the 1970’s. What those same people don’t know (and may not believe) is that I have become a big supporter of the band Breaking Benjamin.

My son, Mike, is a huge Breaking Benjamin fan. Mike invited me to go with him to see them at an outdoor venue in Massachusetts, the Xfinity Center, last Saturday. Suffice it to say that Breaking Benjamin is a very high energy metal band and I stood up for all 90 minutes of the concert. I enjoyed the show, but it wasn’t until this week when I learned that Breaking Benjamin are big supporters of GBMC’s SAFE (Sexual Assault Forensic Examination) program that I became a real fan.

Laura Clary BSN, RN, FNE-A/P, SANE-A, CFN, CPEN, Clinical Manager of our SAFE program, told me that recently the members of Breaking Benjamin were seen during a concert wearing t-shirts that highlight our program. These shirts call out the wonderful work that Laura and her team do for the community.

Our SAFE and Domestic Violence programs do so much for the victims of sexual assault and domestic violence as well as educating the community to reduce these attacks. The assessment and treatment of victims of sexual assault is very complex. Expertise and caring are required not only to address the medical and psychological needs of the patient but also to complete the forensic work necessary to aid law enforcement in the identification of the perpetrator to see that justice is served.

I am glad to see our program get the visibility it deserves on such a big “stage.” Many of us are guilty of stereotyping celebrities as being self-centered and uncaring. This certainly is not the case for Breaking Benjamin!

Thursday, August 16, 2018

Level 2 Mistake Proofing

On Lean Daily Management rounds this week we learned of a test of change to improve the rate of washing in and washing out of every Emergency Department room. We have been working on hand hygiene in the inpatient units for some time. We have greater than 90% compliance and we have now begun auditing our performance in the ED.

All the physicians, nurses, and other clinicians know that they should clean their hands upon entry and exit, but sometimes they forget. This has come up as a common cause of the lack of hand cleansing, so Mark Fisher, RN, the Nurse Manager, Shannon Barry, RN, and Amanda Icenroad, RN, Clinical Nurse 4’s, started thinking about how they might improve their team’s performance.

A common action for health care leaders when they see that someone is not doing what they need to do is to re-educate the individual on the process. Re-education is called level 1 mistake proofing. Re-education is a good tool if the person doesn’t know that they are supposed to do something. But if the problem is forgetfulness, then re-education is not of much value.

Mark and Shannon thought long and hard about level 3 mistake proofing. Level 3 mistake proofing occurs when the system makes it impossible not to do the required action. An example of level 3 mistake proofing is when you order something online and the seller needs your 3-digit security code from your credit card. You hit “enter” after putting in your credit card number but not your security code and what happens? You get a screen telling you that you must put in your security code. It is impossible to get to the next step without it. This is also called a constraint or a forcing function. In high-risk endeavors where errors my cause serious harm, engineers always look for level 3 mistake proofing. For example, after some fatalities that occurred when people inadvertently put their car in drive when they meant to put it in reverse, vehicles are now engineered so that you cannot start your car without your foot on the brake.

Mark, Shannon, and Amanda could not come up with a doable level 3 idea that would prevent you from entering or leaving a room without cleaning your hands, so they went to the next best thing — level 2 mistake proofing. Level 2 is not as powerful as level 3, but it is more powerful than level 1. Level 2 mistake proofing provides a reminder in the moment. These reminders are also called affordances. Mark, Shannon, and Amanda decided to create a very colorful sign of dirty hands to put on each ED bay door.

This way when busy, hard-working people are about to enter a room, they have a visual reminder to clean their hands. We applauded them for their thoughtful test of change and we look forward to their results!

Do you have examples of level 2 or level 3 mistake proofing from your unit or department? Please share them below.


Breast Center Earns Three-Year Full Re-Accreditation

Congratulations to the staff of The Sandra and Malcolm Berman Comprehensive Breast Care Center and the Advanced Radiology Breast Imaging Center, which recently were awarded a full three-year re-accreditation by the National Accreditation Program for Breast Centers (NAPBC). This is the center’s fourth consecutive NAPBC designation since it was first accredited in 2009.

The full accreditation program, administered by the American College of Surgeons, is only awarded to centers that voluntarily undergo a rigorous process that includes site visits by experts from the NAPBC, as well as an intensive review of the center’s records. Earning this accreditation means that our Breast Center is held to the highest standards for the quality of care we provide for patients with the full spectrum of breast disease and that we offer patients a multidisciplinary team approach to diagnosis and treatment and state-of-the-art treatment options.

Any hospital or program can say it provides excellent care, but with this accreditation, we have earned this designation for excellence under the scrutiny of experts, which speaks volumes about the high quality of care all members of the Breast Center and Breast Imaging Center teams provide for our patients with breast disease. And that’s great news for GBMC and for the community we serve.

Dr. JoAnn Z. Ioannou Delivers Hopkins School of Nursing Graduation Keynote Speech

It’s not every day that a world renowned top academic nursing program invites someone from a community hospital to speak at graduation, but the Johns Hopkins School of Nursing clearly shares our admiration and respect for JoAnn Z. Ioannou, DNP, MBA, RN, NEA-BC, our Senior Vice President of Patient Care and Chief Nursing Officer. Dr. Ioannou was the keynote speaker at the August 6 degree completion ceremony for students who had earned advanced degrees in nursing.

A graduate of Hopkins’ Doctor of Nursing Practice program, as well as the university’s MBA and MSN programs, Dr. Ioannou worked in a wide range of nursing roles at Hopkins for 23 years before she joined us at GBMC three years ago. In her speech, she shared the story of her journey from the bedside to nursing leadership, how her mother inspired her ongoing commitment to education, and the many challenging and rewarding paths that the graduates could choose to follow—direct care provider, nurse educator, nurse researcher, and nurse leader. In her closing remarks, she encouraged the graduates to “…continue to collaborate to improve the field of nursing any way you can” and reminded them “…doors will open when you persevere…You will be solving problems that don’t even exist yet.”

You can watch the whole speech here.

The Daily Record Recognizes GBMC

GBMC was recently recognized by The Daily Record in its 2018 Reader Rankings in the categories of Best Hospital and Best Health System. Readers of the publication cast more than 12,000 votes in 60 categories. We’re grateful that the community members we serve are pleased with the care and compassion that our staff shows to all our patients and their families.

Friday, August 10, 2018

“Well, Usually” Revisited

I have been reflecting recently on how far we have come in the quest to achieve our vision of providing the care we would want for our loved ones to every patient, every time. This goal is lofty, and I must keep reminding myself of this. With the aging of the population, people’s needs are growing, and we do not control the entire system of care – we struggle to meet the needs of those with serious behavioral health problems. We have designed so many improved processes like Gilchrist’s entire elder care system, our patient-centered medical homes, our ERAS (Early Recovery After Surgery) program, and so many more.

But we still have work to do. Recently, I was with a clinician and I asked her the “how do we do it” question when I wanted to learn more about one of our processes that did not seem to be highly reliable. My colleague started her response with “Well, usually we …” I knew immediately that we did not have standard work and that many hard-working people were doing it whichever way felt right to them. In a tightly coupled, complex system, a small deviation in one area can cause huge problems downstream. Many of us, including myself, were not trained in the importance of following system design so that we get predictable results. Instead, we learned to do whatever felt right to us in the moment. Standard procedures don’t always work for every patient, but when possible, processes must be standardized and followed. This is critical to creating consistent results for our patients.

Do you know the song This is how we do it, by Montell Jordan? (No, I’m not talking about partying). We need more of us able to state, “this is how we do it” when asked how we complete a task. Then we will move faster towards our vision!

New Parking Rules in Effect on Monday, August 13th
Starting this Monday, August 13th, the decentralized parking model will take effect and all new gates at the garages will be activated. All GBMC employees have been assigned a home lot or garage and will be able to “tap and go” their badges to enter and exit our medical campus. Your GBMC ID badge will be automatically programmed to function at your assigned parking lot or garage’s reader, and stickers will still be issued to monitor compliance at free parking areas such as the Bluebell and the Labor and Delivery parking lots, which will remain patient-only parking.

I want to remind all staff to tap their badge on the card reader at their assigned garage prior to Monday. If the card reader light does not turn green after you tap your badge, please contact Robert Cole at rcole@gbmc.org and Karalyn Stitcher at kstitcher@gbmc.org from the badging office. If your badge is not active prior to August 13, you will need to use a ticket and contact the badging and parking office. The following parking assignments will be in effect:
All offsite staff, volunteers, physicians, and board members may park in any garage or parking area, EXCLUDING “patient only” spaces.
All employees may park in Tulip (PPN) or Lily (ED Garage) at any time, any day of the week, EXCLUDING “patient only” spaces.
All employees may park on Farmhouse Hill at any time, any day of the week.
All employees working in PPE may park in PPE, EXCLUDING “patient only” spaces.
All employees working in PPW may park in PPW, EXCLUDING “patient only” spaces.
Only employees working in South Chapman may park in South Chapman (between the hours of 6 am to 5 pm).
After 4 pm, all employees may park in all garages.
On Saturdays, PPE and PPW will be open to all staff.
On Sundays, all gates are up on all garages.
Complimentary passes will continue to be accepted.

Again, employees should never park in Rose park or Bluebell park or park in "patient only” spaces. Any employees found parking in these lots will be towed.

These changes are needed to make the entrance to our campus safer for vehicular traffic and to reduce delays when entering and exiting from our grounds. They will also improve parking accessibility for our patients. I want to thank Stacey McGreevy, our Vice President of Support Services, and her team for working very hard to make the transition as easy as possible for our people.