Friday, April 1, 2011

This Spring, Look Ahead and Move Toward an Even Better Future

Spring is a time of rebirth, rejuvenation and reflection. And while it certainly hasn’t felt like spring this past week, the daffodils are indeed popping up and trees are showing signs of buds!  Healthcare systems have a doldrums period in late winter and I’ve witnessed this phenomenon in every place I’ve been. People, especially those of us who live in colder climates, get tired of the drab and cold. Winter also brings about the virus season and generally brings more sick patients to hospital, creating a sometimes overwhelming environment. And just in the nick of time, spring comes and people feel good again, flowers come out, more time is spent outdoors. Our moods swing upward and we begin to look forward to the opportunities that lie ahead.
Spring is a good time to really focus on where, as an organization, we are headed. So, as I reflect on the past several months and look ahead at the future, I can say with confidence that we are continuing to transform our organization and the state of healthcare. This week the state of Maryland has been discussing the future of the medical home project and GBMC is anxiously awaiting the results of the state legislative deliberations around healthcare and how we can be part of the solution. GBMC, on the forefront of change toward better health and better care, is already involved in the Care First medical home project. We need to continue to innovate to make the system better for our patients, our community, and ourselves.  
A prime example of change is our Hunt Valley primary care practice. I’ve talked a lot of this GBMA practice because they are among the first to pilot the medical home model of care and break out of the “way we’ve always done it” mold. And while we are certainly not the only organization changing the way healthcare is provided, we’re at the forefront of this movement, working to deliver better care at a lower cost with a focus on wellness, prevention and coordinated patient care. All of this change will serve us well as an organization, and serve our patients and our community even better in the long term.  A definition of insanity is doing things the same way as we have always done and expecting a different outcome. So, we should all be proud of our work to do things differently.
I know that I talk a lot about primary care (it must be the pediatrician in me). Recently a number of people have asked me why I don’t talk more about specialty care. We are blessed at GBMC with outstanding specialty care, and maybe some days I am guilty of taking it for granted. In last week’s blog, I pointed out that I had had surgery at GBMC and had taken advantage of our outstanding surgery capabilities, and the fine work of Dr. John Thompson. I neglected to thank my Anesthesiologist, Dr. Lewis Hogge. I am guilty of sort of taking anesthesia for granted. Many people do. In reflecting why, it’s because as a specialty, Anesthesiology was among the first to recognize the importance of system design to get to error free care. Anesthesia is delivered by very smart, very well-trained people who work in a well-designed system. The probability of error in Anesthesia in our country is so low, we take their wonderful work for granted. GBMC is a great surgical hospital because we have great surgeons, great nurses and technicians, and also, great anesthesiologists and nurse-anesthetists.
I’d also like to share with you a wonderful example of inter-departmental teamwork sent to me from Dr. Melissa Sparrow, Clinical Director of the Pediatric ED and Pediatric Inpatient Unit – just one example out of so many that takes place every day at our hospital:
A five-day-old baby was brought to the Pediatric ED for evaluation of vomiting. Upon arrival, the pediatric triage nurse, Anna Borchers, RN, quickly recognized the severity of the baby’s illness and brought the patient back to the inpatient pediatrics unit. Anna and Pam Spencer then worked steadily for the next hour to perform a sepsis work-up. When an IV was difficult to obtain, Steve Lebowitz, a PA from the NICU, came to the Unit and was able to place an IV. Dr. Sparrow felt the baby needed to be transferred to the NICU and the NICU team, including Dr. Podraza and respiratory therapist, Richard Vazquez, hurried down to Peds where the baby was rapidly intubated and transferred.  Once the patient was stabilized, he traveled to radiology for an Upper GI, which was performed by on-call radiologist, Dr. Loralie Ma, who came in from home to perform and read the study. Mid-gut volvulus was quickly diagnosed (A volvulus is a potentially life threatening bowel obstruction in which a loop of bowel has abnormally twisted on itself) and within an hour, Dr. Jeffrey Lukish, pediatric surgeon, repaired the volvulus. Thanks to the quick thinking and teamwork of all of those involved in the baby’s diagnosis and treatment, he was eating and drinking and ready to go home within two days! Our Team delivered the care that I would have wanted for my own loved one and I am very proud of them. 

Things are moving forward at GBMC…

Enjoy the April flowers.

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