Wednesday, November 23, 2016

So Much to Be Thankful for...Especially Some Unsung Heroes

We all know that Thanksgiving is a day for reflection of all that we have and cherish. I am a very fortunate man and I have so much to be thankful for starting with my loving family. I am so lucky to be the President of GBMC and I am very grateful to have thousands of phenomenal colleagues who give of themselves every day to help others and especially those who work on Thanksgiving and all the other holidays. I am truly blessed.

This year, I have a special group of dedicated people to be thankful for. Let me tell you a story….

I was the Senior Team member on call for the weekend of November 5th and 6th. Being “on” entails coming in for Lean Daily Management Rounds each day and being available to the administrative coordinator if any issue comes up that they cannot handle on their own. The administrative coordinators are a blessing in themselves; they are so good at what they do that we hardly ever get called. So I was surprised when Michelle Patchett, RN, called me on Sunday evening with a problem.

A man had come to the Emergency Department very sick and he needed to be admitted to the Intensive Care Unit. But the man had a “service dog” who I will call “Fluffy”. The man said that he had no friend or family member who could care for Fluffy. The intensive care unit is not a place for animals so our problem was what to do with Fluffy? This was clearly a “special cause” in quality improvement parlance, because most people with a dog will have a friend or neighbor who will be willing to care for their dog for a day or two but this man did not. GBMC did not have a procedure in place for this situation. Michelle called the Baltimore County Animal Control people but they had no answer for us.

I knew of the Maryland Society for the Prevention of Cruelty to Animals (MDSPCA), but I had no idea if they would be able to help. We got in touch with the Board President of the MDSPCA, Elizabeth Drigotas who asked us to call their Director of Community Affairs, Katie Flory. While it was clear that they too did not have a process in place specifically for this issue, Katie did not hesitate to offer her help. She essentially dropped what she was doing (at the dinner table with her family on a Sunday evening) and drove to GBMC and picked up Fluffy. Nichole Miller, the MDSPCA Director of Operations, met Katie and Fluffy at the shelter. The MDSPCA treated Fluffy with tender loving care at their shelter for one night until the patient was released from the ICU. Fluffy was then reunited with him the next day on an inpatient unit. But the work of the MDSPCA did not end there! Katie brought food, bowls, treats, blankets, and toys for Fluffy. For the next 9 days, Katie travelled to GBMC and walked Fluffy in the morning and Nichole came and walked him in the afternoon. They were aided by Amy Gonzalez, a GBMC employee, and an MD SPCA volunteer who walked him on the last couple of days. My wife, Tracey, and my daughter, Caroline, walked Fluffy every evening (They love animals and they really loved Fluffy! I see a dog in our future to go with our cats, Bonnie and Clyde).

So I have so much to be thankful for, but this Thanksgiving I am asking you to join me in thanking some “unsung heroes,” Katie, Nichole, Amy, Tracey, Caroline and all of the Team at the MDSPCA, who truly helped us and Fluffy’s owner and who help thousands of animals and people every year. The mission of the MD SPCA is to improve the lives of pets and people in the community by fostering healthy animal-human relationships.  The Maryland SPCA is a private, non-profit, independent organization which operates primarily in the Greater Baltimore Metropolitan area.

My family will be making a donation to the MDSPCA in honor of Katie, Nichole, and Amy. Please consider making a gift as you are able to this wonderful organization. You can do it at Thank you and Happy Thanksgiving to all!

Thursday, November 17, 2016

Continuing Our Work Towards a Better Healthcare System

The GBMC HealthCare system has been transforming itself for more than 6 years to deliver better health and better care at lower cost with more joy for those providing the care. We have been very successful so far. The health outcomes of our care have improved. Our patient engagement scores are up, especially in our advanced primary care sites. We have reduced the total cost of care for the Medicare beneficiaries served in those sites by more than 7 percent, and our people are delighted to have the support they need to better manage those with chronic disease.

Over the last week, I’ve been asked many times, “What effect will the presidential election have on our work?” Truthfully, I don’t really know. What I do know is that every American wants a healthcare system that is less costly, delivers better health outcomes and is more focused on the patient. Republicans and Democrats realize that we cannot return to a system that only financially rewards the number of services provided without regard to whether or not those services actually helped the patient and were provided in the most efficient manner possible. The move toward value is well under way and payers are not reverting to the old ways that had healthcare costs rising by 7-10 percent annually. Also, Republicans and Democrats know that even though we have made progress, we are still spending 40 percent more per capita on healthcare than any other country in the world and our industries are less competitive because of this.

The Affordable Care Act (ACA, Obamacare), in my opinion, has been very successful. More than 10 million Americans now have health insurance who did not have it before. People who were born with a disease now can buy insurance when they couldn’t before. Children can stay on their parents’ plan until they are 26 years of age. Medicare has seen the lowest annual cost increases in decades, and employers have benefited from lower increases to their plans.

The one area where the Act needs improvement is in controlling premium increases for individuals buying insurance on the exchanges. Before the ACA, people who were already sick (like someone I know who was born with epilepsy) could not get health insurance. Therefore, the price of insurance for individuals was lower than it is now because the insurance companies were only insuring well people. The ACA “mandates” that everyone not covered by their employer, Medicare, the Veterans Affairs or Medicaid buy insurance. You need the healthy people in the plan to spread the cost of the people with a disease over more policies to keep the price low. Well, too many healthy people are not buying the insurance and, therefore, the price has gone up significantly. This is the classic “chicken and egg” situation. People are not buying the insurance because the price is too high, and the price is too high because people are not buying the insurance. Medicare works pretty well for America’s senior citizens because it is paid for by the Medicare tax, and the younger beneficiaries don’t consume much while the older ones do. Medicare doesn’t make the sicker patients pay more. By the way, Medicare only spends about 8 percent on administration, the other 92 percent goes to pay for care. Before the ACA, private insurance companies were spending 70-80 percent on care and the other 20-30 percent was going for administration and profit. The ACA limits the percentage for administration and profit to 18 percent. If the act is repealed, this limit will go away.

Homeowners insurance wouldn’t work if you could wait to buy it until your house caught on fire. The same is true of health insurance. The risk must be spread over the entire population, including the healthy, for it to work. So it’s the “individual mandate” part of the Affordable Care Act that isn’t working well, and everyone agrees on this.

How will the new administration deal with this? No one really knows. But it is clear that we must continue to work to create a better system. We in the GBMC HealthCare system must deliver even better health and even better care at even lower cost by driving out the waste. We must educate citizens on the facts. We must make prices more transparent so it is easier to see one source of the waste in healthcare. We must recommit to working both in our state and with the new federal leaders to deliver better value to the American people.

Celebrating Nurse Practitioner Week
Please join me in celebrating GBMC’s outstanding Nurse Practitioners (NP) this week. Across our nation, there are more than 220,000 NPs who provide care to millions of Americans.

We have excellent Nurse Practitioners working in our hospital, in our physician practices, and in Gilchrist Services. They help us reach our vision of a patient-centered system of care every day. Please join me in thanking them this week!

Friday, November 11, 2016

What a Great Party!

I would like to thank everyone involved in our very successful Art of Nursing celebration last week. The event’s emcee, Ron Shapiro, did a great job overseeing the event that featured presentations by our Board Chair, Bonnie Stein, our Chief Nursing Officer, JoAnn Ioannou, and a panel of physicians, which included Chief of Staff Dr. Melissa Sparrow, Chair of Surgery Dr. Jack Flowers and Chair of Emergency Medicine Dr. Jeff Sternlicht.  Each of them spoke about what nursing had meant to them in their careers. Two of our patients also recognized a nurse who had helped their families cope through the loss of their loved ones. This year’s winners of our nursing awards, Roxann Cavey, BSN, CCRN, RN, Samantha Clayton, MA, Alejandro Maynard, RN, Marcus Nicholson, MSN, MBA, RN, Nicola Wagner, RN, Delores Williams, AA, RN, Linda Young, CNOR, RN were all recognized.

When the formal program was over, Dionne Figgins, accompanied by our own Lisa Griffee, Director of Performance Improvement, Carolyn Keller, Nurse Manger of Unit 36 and Rachel Ridgely, Clinical Unit Coordinator of the MICU, got the place jumping with their rendition of “Stand By You.” This was followed by dancing to the tunes of DJ Mikey V.

It was a great opportunity to thank all of our nurses for all that they do for GBMC and our patients every day and to have some fun!

Recognizing Colleagues: Radiologic Technology Week & Forensic Nurses Week
This week is both “Radiologic Technology Week” and “Forensic Nursing Week” and I would like to thank all of our registered technologists (R.T.s) and our forensic nurses for their important roles in providing care and serving our patients as if they were their loved ones.

R.T.’s perform diagnostic imaging examinations and administer radiation therapy treatments and may specialize in a specific imaging technique such as bone densitometry, cardiovascular-interventional radiography, mammography, MRI, nuclear medicine, sonography or general radiography.  They work closely with our radiologists and radiation oncologists.

Forensic nurses are specially trained and certified examiners who care for adolescent and adult victims (ages 13 and older) of sexual assault.  Forensic nurses complete a full assessment of the patient, obtain potential forensic evidence and provide antibiotic therapy, emergency contraception, and resources for crisis counseling and support services.  Our forensic nurses, as part of our Sexual Assault Forensic Examination (SAFE) Program, are also an instrumental part of the Baltimore County Sexual Assault Response Team (SART) and work closely with local law enforcement agencies in cases of sexual assault in our community.

Please join me in thanking Phil Komenda, our Director of Imaging and Cardiac Services, and Laura Clary, RN, FNE-A/P, SANE-A, CPEN, our Clinical Program Manager for the SAFE Program, and their teams for all their hard work and for their important role in caring for our patients.

Thanking Our Veterans on Veterans Day and Every Day
Today, we honor the millions of American military veterans who have given of themselves to protect us. Let’s pause and salute all who have served and honor the tremendous sacrifices made by members of the U.S. armed forces and their families to preserve our freedom. I know that I speak for all of us at GBMC in offering our sincere gratitude for their personal sacrifices, past and present.

Thursday, November 3, 2016

In Grand Celebration of Our Nurses

It has often been said that nurses are the backbone of a hospital, and that is clearly true at GBMC. The more than 1,000 nurses, across the GBMC HealthCare system, work very hard to deliver to all the care that we would want for our own loved ones. Without them, we would have no system.

I often write in this blog of all of the things that we are working to fix in our national healthcare system but nursing is not one of them.  I am a firm believer that the United States has the best prepared and hardest working nurses in the world.

GBMC’s nurses have been known for outstanding care at the bedside, but now they’ve also become leaders in quality improvement. Just look at our patient falls rate, our CAUTI rate, or our patient satisfaction scores.

Our nurses have done an outstanding job collaborating marvelously well with their physician colleagues and others to help us achieve our four aims.  And we cannot forget all of their contributions towards making our Epic implementation so successful.

Caring for sick patients with many needs requires physical and mental stamina. 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.

I am so grateful for the commitment, compassion, and expertise that our nurses bring to their work.  We will be celebrating The Art of Nursing this Friday night and I look forward to seeing many of our nurses at the event.  I am very proud of all of them and honored to call them my colleagues.