Friday, August 28, 2015

Make Sure Your Voice is Heard

With the August 31st 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) or by clicking on this link

This year, the survey company, Press Ganey, will know who completed the survey so that your response can be assigned to the appropriate unit or department. But Press Ganey will not give any identifying information to anyone at GBMC. 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.  Again, identifying yourself is important to ensure that your responses are appropriately linked to your department.

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.

Please complete the survey.  We use the information to see what we can do to make GBMC a better organization in which to work and a safer healthcare system for our patients. Thanks!

Tuesday, August 25, 2015

How Do You Want Your Mother’s Care to Be?

We are working towards our vision of becoming the healthcare system where everyone, every time, is treated the way we want our own loved ones treated. The most important thing that we want when our loved one is sick is the best possible health outcome. But the second most important thing we want is the best possible care experience. We want our loved ones to be well informed by people who care; we don’t want long waits and delays; and we want the care in a clean, respectful environment.

About a decade ago, the federal government began requiring hospitals to ask their patients a standard set of questions after discharge so that patient satisfaction could be compared across hospitals. This system is called the Hospital Consumer Assessment of Healthcare Providers and Systems or HCAHPS.

The HCAHPS survey asks discharged patients 27 questions about their hospital stay. The survey contains 18 core questions about critical aspects of patients' hospital experiences (communication with nurses and doctors, the responsiveness of hospital staff, the cleanliness and quietness of the hospital environment, pain management, communication about medicines, discharge information, overall rating of hospital, and would they recommend the hospital).

So, the HCAHPS scores are the answer to the question “Are we getting closer to our vision under the aim of better care?” Another way to look at it is “Would you bring your mother to GBMC rather than another hospital because the evidence was that she would be always treated with respect and kindness?”

Some people argue that we should not pay attention to patient satisfaction scores because they are not often correlated with outstanding clinical process and health outcome measures. I think that this is silly. Health outcomes and care experience are two separate dimensions. If for a given hospital they are not both excellent, it just means that the hospital is not effectively working in one or the other or both. It clearly does not mean that being excellent in patient satisfaction causes worse clinical outcomes!

So where do we stand? Well, our overall score has been about average over the course of the last fiscal year. We clearly have work to do because we don’t want our loved ones going to an average hospital. But it is not because our people don’t work hard or don’t care. Our staff works very hard and they do care. When our scores are not excellent it is because our systems need some work. One of our dis-satisfiers is waiting for discharge. Why do patients wait so long after being told that they are ready to go home? It is because we have not designed a system to get the work done expeditiously. The doctors and nurses are working very hard doing other things.

I don’t think that we have done a good enough job enrolling our people in this care improvement work. We have not clearly stated what we are trying to do and given our staff time to discuss it and declare after the discussion that they will be fully engaged in this work. This is our biggest obstacle to improving the care….having the staff not see it as a burden but as a way to not only make the patients happier but to also make their work easier.

We have begun to hold focus groups in our departments and units to foster the enrollment process. The staff is being asked questions like:  “What are the barriers you find when you are trying to provide care to the patient that you would want for your own loved one?”

It doesn’t take long in these discussions before someone raises the question about staffing. It is unreasonable to think that we can do the work well if we are overwhelmed. We must make sure that we have the right number of workers to get the job done. But, we also need to make sure we get rid of wasteful steps to make sure that we are not bringing in more staff to do rework. An example of this is the “missing medication” problem that we have made such great progress on. I am still concerned that nurses are spending too much time looking for medications that they need. If they are spending a lot of time on this, it is not a good idea to bring in another nurse so that we can get all of the nurse work done. It is much better to unburden the nurse of the rework of calling the pharmacy multiple times and then giving the medications late.

Please get involved in improving our care to patients. It isn’t about the HCAHPS score, it’s about giving everyone what you want for your loved ones. Thank you for your hard work and please let me know what you think.

Congratulations to our team at the Sandra and Malcolm Berman Cancer Institute, who under the direction of Dr. Gary Cohen, were among 20 accredited programs nationwide to receive the mid-year 2015 Outstanding Achievement Award (OAA) from the Commission on Cancer (COC) of the American College of Surgeons.

According to the COC, award criteria are based on qualitative and quantitative surveys conducted during the first half of the year and the purpose of the award is to raise the bar on quality cancer care, with a goal of increasing awareness about care choices for cancer patients and their loved ones. In presenting this award, the COC recognizes the outstanding quality of cancer services that the Berman Cancer Institute continues to provide to our patients.

Earlier this summer, our Sandra and Malcolm Berman Cancer Institute and Sandra and Malcolm Berman Comprehensive Breast Care Center along with its affiliated Advanced Radiology Breast Imaging Center were all given a three-year, full accreditation with commendation designation from the American College of Surgeons.

Please thank all of our team involved in the care of cancer patients and congratulate them on these deserved recognitions!

Friday, August 7, 2015

Making GBMC A More Diverse And Inclusive Company To Work In

Over the past nine months, a group of GBMC employees has been meeting to begin to discuss how to make our system an even better place to work. The Diversity and Inclusion Task Force, led by Deloris Tuggle, Vice President of Human Resources, Bonnie Stein, Chair of the GBMC HealthCare Board, and me, has been discussing how to make our workforce more diverse at all levels and representative of the community we serve. In addition, the group has been discussing how to make everyone feel “included.” The best companies not only hire people of diverse characteristics and backgrounds, they also work intentionally to make their people  feel welcomed and not isolated.

The Task Force has created a draft Diversity and Inclusion Plan for this fiscal year and is presently interviewing candidates for the Director of Diversity and Inclusion position within our Human Resources Department.

It is often said that an organization cannot achieve its vision without a fully engaged workforce. To get everyone fully engaged, everyone must feel included. You will hear more as we find our new Director and begin acting on the plan over the next few months.

We get what we tolerate.

I threw a temper tantrum on Monday morning. I was walking down the hall to our first stop in Lean Daily Management when I came upon a stained floor where something had clearly dripped from a trash bag or trash cart from Unit 38 all the way to a closet outside of Radiology. Many GBMC employees were walking on the dirty floor (and had walked on it for a number of hours from the looks of the stain). I was upset for two reasons: the first was that we have not learned to get rid of trash carts with holes in the bottom - or we were still transporting bags not in carts; and the second (and more concerning thing) was that many of my wonderful GBMC colleagues had walked on the floor after the spill but had not taken action to get the mess cleaned up. What if your mother was sick and you were escorting her to Radiology along that corridor and she had seen the filthy floor? How would you feel? How would she feel?

Whose job is it to get the floor cleaned up?

I went and found an environmental services worker who gave me a mop and I began to mop the floor. Within minutes many people came and told me that I should not have to clean the floor and an environmental services crew took over and made the floor look beautiful. I have no problem cleaning the floor and I don’t mind pitching in when everyone is busy. That is not the point. The point is that no one should walk by a dirty floor. The first action is to call housekeeping and expect that the floor is cleaned expeditiously. If it cannot be cleaned by EVS quickly, then I believe that everyone should be ready to grab a mop. If we look the other way when we find things that are not the way we want for our own loved ones, then we will get more of what we tolerate – in this case dirty floors. What do you think?

2015 Employee Engagement and Safety Survey

Please complete our annual Employee Engagement and Safety Survey.  The survey is open through Monday, Aug. 31 and can easily be accessed through the icon on any GBMC desktop computer (see pic on right) or by clicking on this link
And, 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.

Identifying yourself is important to ensure that your responses are appropriately linked to your department. 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!