Friday, September 15, 2017

A Conversation With GBMC HealthCare’s Director of Diversity and Inclusion

The GBMC HealthCare System is committed to having a workforce that mirrors our community. In order to achieve our vision, we need to be welcoming to all. We need to celebrate our racial, cultural, and other differences to help us become more unified as a team. GBMC recognizes the need for it to be more deliberate in its actions to achieve inclusivity. Towards this end last year, we hired a new Director of Diversity and Inclusion, Jennifer Marana. Jennifer has been leading our Diversity and Inclusion Council and I asked her to guest author this blog.

Jennifer has over 15 years of experience in diversity. Her primary responsibilities, in her previous places of employment, have included diversity and intercultural communication training, facilitating focus group discussions and data analysis that help to develop diversity initiatives and strategies. I believe that Jennifer’s skills and experience are just what we need to help us become even more inclusive. Jennifer believes our commitment to providing a Just Culture and developing an inclusive community resonates with her personally and professionally.

Please join me in welcoming Jennifer if you haven’t already!

Can you tell me a little more about your background?
I have worked as a diversity and inclusion professional for more than 15 years, directing strategic diversity initiatives at institutions of higher education such as McDaniel College, Claremont McKenna College, and Bard College. One of my most poignant experiences related to diversity and inclusion has been raising a child with special needs. My 13-year-old son has cerebral palsy among other health-related challenges. While I was already steeped in diversity work before he was born, my experience with him brought a new meaning to my work. My empathy for those who are different from myself has deepened and I have become more fervent about teaching and training to assist others with expanding their understanding and connection across difference as well.

What brought you to GBMC?
I was interested in bringing my knowledge, skill, and experience with diversity and inclusion into a new environment.  When I learned more about GBMC’s needs related to diversity and inclusion, I knew I could make a difference.

As the director of Diversity and Inclusion, what is your role and primary focus?
The diversity and inclusion mission of the GBMC HealthCare System is to create a more diverse workforce and foster an inclusive workplace. This will allow us to better achieve our vision by providing culturally competent care. This mission guides my work as I develop training, multicultural programming, dialogue facilitation, and provide overall leadership and support for GBMC’s strategic diversity goals.

Diversity is a very broad subject. Do you have a simplified definition of diversity?
Diversity is the combination, inclusion, and acceptance of the identities, experiences, and knowledge that make us who we are.

What is the most common mistake in our thinking about diversity?
I believe that some people think too narrowly about diversity.  They see it solely about the numbers – the racial/ethnic demographics.  As a diversity practitioner, I am intentional about coupling the word diversity with inclusion so that we address diversity in terms of race/ethnicity, sexual orientation, religion, and other aspects of our identity while creating spaces for mutual respect, learning, and understanding that comes with bridging the divides that may result from these differences.    

What does the role Director of Diversity mean at GBMC Healthcare and how do you see your role enhancing the GBMC community?
The role of Director of Diversity & Inclusion is a testament to GBMC’s commitment to its diversity and inclusion mission.  In some organizations, diversity and inclusion work is assigned as an additional task for the Learning & Organizational Development Director or other professional.  In these cases, diversity and inclusion work is not given the attention it deserves.  There is great value in having someone spearhead diversity and inclusion efforts.  This requires dedication and work from all employees, it requires a leader to guide the way.

Last month, your department facilitated an “Inclusivity Learning Forum” that you were particularly excited about, can you tell us who showed up to your forum and what the outcome was?
I have actually been excited about every single one of the Inclusivity Learning Forums (ILF) that the Diversity & Inclusion Council has hosted.  The Inclusivity and Learning Forums (ILF) are monthly educational seminars on topics that foster, promote and facilitate dialogue about diversity and inclusion.  Up to this point, we have addressed topics related to our Muslim, Jewish, LGBTQ (lesbian, gay, bisexual, transgender, queer) communities and even hosted a discussion on how to “Teach a Child about Diversity.” They provide a vehicle for learning about the diverse cultures, religions, and experiences that make up the GBMC employee and patient population.

The August Inclusivity Learning Forum was on the topic of “Judaism and GBMC.” panelists shared what it means to them to be Jewish and practice the Sabbath (if they do so), how their faith influences their work, and what we can do to make GBMC a more inclusive place to work.  Their responses illustrated the commonalities they shared in their faith as well as the diversity of their practices. We discussed what resources employees can access on the Sabbath and/or Jewish holidays if serving a Jewish patient who may refuse specific care.  Because many of our Jewish friends and colleagues may not be accessible on these days, Dr. Frankel shared a related story and taught attendees the term “Vechai Bohem,” words from the old testament that basically mean "to live by them."  Therefore, if someone comes to the hospital on the Sabbath or on a Jewish holiday and they refuse specific care, all we need to tell them is..."Vechai Bohem,” conveying that life is of utmost importance.

What is the WISER movement?
WISER is Working In Sync to Enhance Resiliency at GBMC.  Resiliency is the ability of employees to recover and remain engaged even in challenging work environments.  It is the opposite of burnout. The WISER team is made up of a group of GBMC colleagues who care for others while caring for themselves.  The team develops resiliency initiatives to support GBMC employees’ ability to engage patients and others as individuals and derive intrinsic value form work (at work) and disconnect and “recharge” (outside of work).  

What are some other programs or workshops your department has started and how can GBMC Healthcare employees get more information?
In addition to the monthly Inclusivity Learning Forums and WISER program, you will find the “Diversity & Inclusion Corner” of monthly cultural and religious observances and holidays on the Infoweb.  We have expanded the annual Black History Month celebration to include weekly activities throughout the month of February.  For more information, email diversity@gbmc.org

What would you like people to know about the council and future initiatives for employees?
The Diversity & Inclusion Council is committed to creating a framework that reflects our vision of creating an organization that attracts, retains, and leverages the diversity of our staff to meet the needs of our workplace and the populations we serve.  Future initiatives include religious and cultural celebrations, holidays, and upcoming GBMC diversity and inclusion events, a talk Line that employees can call if they feel as though an event, interaction, or encounter has left them feeling uneasy, disrespected or excluded from a diversity and inclusion standpoint.  Professional development opportunities related to developing inclusive work environments and engaging in bold conversations about diversity and inclusion.

Friday, September 8, 2017

Lights! Camera!....

On Thursday morning, you might have seen a video crew following our teams during the daily Lean Daily Management (LDM) walk. They were here filming LDM because of our national patient safety award, from the American Society for Healthcare Risk Management and Datix, that we received last year.

We were honored with the inaugural ASHRM Patient Safety Award for our use of LDM to improve health outcomes for patients and reduce preventable harm such as infections, falls with injury and hospital-acquired pressure ulcers.


Since we started LDM, we have seen a significant reduction in not only patient harm but employee injuries as well. We have also used this technique to reduce waste and improve patient satisfaction. We measure our progress towards achieving our vision by our results in each of our four aims of the Best Health Outcome and the Best Care Experience with the Least Waste of resources and the Most Joy for those providing the care.



In winning the award, we demonstrated how LDM principles, applied in a health care setting, improved patient safety. Some examples of the improvements through LDM included a reduction in catheter associated urinary tract infection (CAUTI) of 92 percent, surgical site infections (SSI) by 85 percent along with a reduction in readmissions rates for patients, fewer instances of missing medications, fewer employee injuries, better hand hygiene and an overall improved patient experience as measured by HCAHPS.

The ASHRM Patient Safety Award recognized our organizational excellence in patient safety and celebrated our efforts in risk management and in promoting patient safety across our health care system. Receiving this recognition from an external authority, like ASHRM, is a confirmation of the work we're doing to move us towards our quadruple aim.

This award was the result of the hard work and dedication of the entire GBMC family. I am so grateful that the crew was here to document LDM so it can be shared during this year’s ASHRM annual meeting next month in Seattle. We will also receive a video that we can use to teach new employees about our process.

We should all be very proud of our achievements in moving closer towards our vision.

Friday, September 1, 2017

The Summer is Ending

I hate the winter. When I tell people this they often point out to me that I moved to Baltimore from Boston where it is much colder. I am very grateful that I now live in a warmer place but I still wish that summer lasted all year long. I guess I just have to get over it.

But the change of seasons is a good time to reflect. I’ve been thinking recently about how much we have changed over the past seven years. I was reminded this morning on Lean Daily Management Rounds of one big change that we have made. When we were at the LDM Board in Family Care Associates, I asked the team if everyone had plans for the weekend and Dr. JoAnne Wills said: “I’m working”. Why will Dr. Wills be working as a primary care physician this weekend? Well, what if your daughter was sick and needed to be seen for something that wasn’t an emergency? Wouldn’t you want her to be seen in a timely way by a team that knows her and has her medical record, will treat her with kindness and won’t generate a very large bill? This is why Joanne will be working and it shows that we have changed and become truly more patient-centered in our advanced primary care offices. Thank you Dr. Wills!

We all know that just about every clinical outcome that we measure has improved over the last seven years because of our adoption of continuous performance improvement as the way we do our work. We are not perfect, but we get better at getting better every day. So maybe it’s good that the summer is ending and I will be spending less time outside…I’ll have more time to work on helping our healthcare system move faster towards our vision.

Labor Day
As our country celebrates the hard work of the American people, this Labor Day holiday, many of us will enjoy a three-day weekend.  But, many of my colleagues (like Dr. Wills) will be working. Please let me thank all of the phenomenal people of the GBMC HealthCare System for their labor towards our vision. Let me thank all of them for what they will do this weekend and every day to serve our community. Let me give a special shout-out to everyone who works in the Emergency Department for all that they do especially dealing with the opioid and mental health crises in the face of a nursing shortage. 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 and work hard serving others. Thank-You!

Tragedy in Texas
Our thoughts and prayers are with all those that have been affected by Hurricane Harvey. Watching the news, you can’t help but feel sorry for all the people who were harmed by the storm, lost loved ones or who had devastating property damage.  It is very sad to see so many homes destroyed. We Americans, the descendants of people who built this country often under adversity, are a resilient lot. I have no doubt that all the cities affected by Hurricane Harvey will rise up again.

Please join me in donating online using this link. You can also text “HARVEY” to 90999 to make a donation of $10. The GBMC HealthCare System is very good at helping those in need…let’s show the people of Houston and the other affected areas that we stand with them now! Thank you.

Wednesday, August 23, 2017

GBMC: the only healthcare system in Maryland to reach HIMSS 7 for both Inpatient and Ambulatory Care

Back in early June, we had representatives from the Healthcare Information and Management Systems Society (HIMSS) evaluating our healthcare system on the use of electronic health records. As you know, GBMC has been utilizing the Epic system since this past October.

I am very pleased to announce that GBMC HealthCare has achieved Stage 7 on the HIMSS Analytics Electronic Medical Record Adoption Model (EMRAM) for our inpatient care and ambulatory care! This award represents a lot of hard work to eliminate paper records and get all of our patients' information in one electronic file.

EMRAM is a methodology for evaluating the progress and impact of electronic record systems and includes eight stages (0-7) that measure a hospital’s implementation and utilization of IT to optimize the care that patients receive. Stage 7 represents the most advanced patient record environment. HIMSS Analytics developed the EMRAM as a tool to compare information technology maturity in health care organizations. Less than 5 percent of hospitals in the United States have achieved Stage 7 certification.

This accomplishment is due to the commitment and effort of the GBMC staff which includes our highly-skilled team of physicians, nurses, other clinicians and IT professionals. I want to thank all of my GBMC colleagues for this achievement especially Dr. Fred Chan, our Chief Medical Information Officer, Cindy Ellis, Epic Project Director, Dave Hynson, GBMC’s Chief Information Officer, Chase Roberts, Finance/Operational Efficiencies Manager and Mary Swarts, the Epic Nurse Champion, who all played an integral role in getting us to this point.

Achieving this recognition is something we all should be proud of.  It exemplifies our true commitment to ‘one patient, one record.’ Without this, we cannot reach our vision of being the community-based health system where every patient gets the care that we would want for our own loved ones.

Congratulations Dr. Kline!
Recently, I learned that Dr. Antonie “Tonie” Kline, the director of our Pediatric Genetics at the Harvey Institute for Human Genetics, will receive the RARE Champions of Hope in Medical Care and Treatment Award for her development of the Multidisciplinary Cornelia de Lange Syndrome (CdLS) Clinic Program. This award honors physicians for their notable efforts in rare disease advocacy, science, collaborative medical care, and treatment.

CdLS is a developmental disorder that affects many parts of the body. The features of this disorder vary widely among affected individuals and range from relatively mild to severe. An estimated 20,000 people in the U.S. have CdLS but remain undiagnosed and without support services.

Dr. Kline has coordinated free bi-annual Multidisciplinary CdLS Clinics for Adolescents and Adults at GBMC. During these small clinics, patients meet with Dr. Kline and a group of volunteer specialists. Patients and families are provided with behavioral plans, treatment protocols and valuable information on expectations for the individual’s current stage of life. This service helps families in knowing what to expect as their loved one with CdLS ages, and they are able to bring these protocols back to their personal physicians, educators, and caretakers.

As the medical director for the CdLS Foundation, Dr. Kline is also involved in both national and international research related to the condition. Over the years, she has established other clinics throughout the country; provided consults to roughly 300 children at biennial CdLS National Family Conferences; raised approximately $85,000 and has organized the Foundation's running group, Team CdLS Baltimore.

Please join me in congratulating Dr. Kline on her recent achievement and for her efforts to help people with CdLS.

Baltimore City Fire Department Gives To GBMC
Last Friday, Baltimore City Fire Department Chief Niles R. Ford and members of the Local Unions 964 and 734, visited our Sandra and Malcolm Berman Comprehensive Breast Cancer Center and kindly presented us with a generous monetary donation.

From the sales of a few hundred pink Baltimore City Fire Department t-shirts, they were able to raise $8,500 which will be used by our breast cancer center in providing holistic breast cancer support; such as breast surgery aftercare kits, therapy, and other recovery options.

We are truly honored that these men and women of valor chose us to be the recipients of their efforts to bring awareness and aid in our fight against breast cancer. I want to thank all the firefighters, not only for their generosity and caring but, for what they are doing for our community.

Thursday, August 17, 2017

Are we following the standard work…the design?

Earlier this week, at the executive Lean Daily Management board, we learned of three cases of patient falls at GBMC where the individual sustained minor injuries. Our people, especially our nurses and nursing support technicians, have done a remarkable job at reducing falls within our system. I believe that frail elders are now safer at GBMC than they are in their homes. Let me make the statement that I don’t think we will ever get to zero falls because to do this we would have to rob patients of their freedom and we will not do that. But as smart, caring professionals we need to always be learning from falls and changing our systems to move closer to zero.

So when three falls get reported what should our first question be? Our first question should be “did we follow our standard falls prevention work?” That standard work includes assessing the patient’s falls risk, educating high falls risk patients about how we will act and how they should act to protect themselves, and then implementing measures, like red socks, to alert others to the high falls risk, and using the bed and chair alarms.

The Swiss Cheese Model of error informs us that we should not expect to find one cause of a fall. In large complex systems, it is usually a series of factors that result in the bad event. One category of “holes” in the Swiss Cheese is that leaders need to be aware of managerial failure. One type of managerial failure is knowing that the standard work (in the case of falls prevention it is standard safety work) is not being followed and not doing anything about it.

If you are a very busy nurse on a medicine unit caring for a number of sick elderly patients, you have a lot to do. Setting up the bed alarm and making sure that it is turned on is one of your tasks. It should come as no surprise that a very busy nurse will sometimes get called away to urgently help another patient and forget to turn on a bed alarm. At GBMC we have, as part of our every two-hour rounds, a safety checklist that is done in part to check that the appropriate safety measures are in place and turned on. But what if we are not doing the safety checks as designed? If we are not, then that is a hole in the Swiss Cheese that is waiting to line up with a busy nurse getting distracted and forgetting to turn it on that might then lead to a patient fall.

So, as leaders at GBMC, we owe it to our patients, our staff and ourselves to assure that those safety checks are being done correctly. As we work to improve our care and get to even higher levels of reliability, we accept the fact that people will make mistakes and we must be preoccupied in catching the mistakes before they might result in harm.  So, we set up audits or checklists, but if we don’t follow the standard work of the check itself we miss our opportunity to find the mistake and fix it.

All leaders at GBMC have to unite NOT on ‘re-educating’ our staff on the importance of not forgetting, but, unite on ways of making sure that the standard work is followed when we are doing the safety checklist.  Only after enrolling all of their team members in the standard work should leaders decide how to hold their people accountable.  Leaders must take ownership as well.  If we know that the standard work is not taking place, as leaders we can’t wait until there’s an event, we must immediately work to close the hole in the Swiss Cheese and prevent the event from happening.

Please share your thoughts with me. 

Thursday, August 10, 2017

The Affordable Care Act was not repealed. What next?

In light of the vote against repeal of the Affordable Care Act (aka Obamacare) two weeks ago in the Senate, it’s a good time to continue the dialogue about the successes of the Affordable Care Act, its problems, as well as reflect on what the future may hold.

While I won’t go into the politics of healthcare, I believe it is important that the public remain educated and informed on how we arrived at this major crossroads in the American healthcare system.

The Two Main Components of the Affordable Care Act
First, did you know that there are actually two major bodies of work within the Affordable Care Act? The first has to do with health insurance. By far, covering Americans with health insurance was the biggest draw of this healthcare bill. Before the ACA was enacted, roughly 50 million citizens were uninsured. Since the ACA was passed, that number has been cut roughly in half.

The other component of the ACA focuses on the actual health care delivery system. As you know, even though we don’t cover all of our citizens with health insurance, we still spend 40 percent more per capita on healthcare than every other advanced nation and we don’t have outcomes for chronic disease that are as good as those other countries. So the ACA began changing incentives to meet the triple aim of improved health outcomes, better care delivery, and lower cost. This part of the ACA has been successful. We’ve seen annual Medicare cost increases lower than ever before and new programs set in motion that incentivize hospitals, physicians, and nurses to drive better health care value that has also kept employer-based health insurance cost increases relatively low. We’ve been experiencing the success of the ACA and the incentive programs at GBMC.

Of course, no bill, no matter how well designed, is without its problems. Yes, the ACA significantly increased the number of low-income individuals and families who qualified for Medicaid coverage to the tune of about 20 million Americans. It also made it easier for middle-class Americans to buy individual policies when they did not receive employer sponsored insurance, accounting for about 15 million more Americans who could purchase and choose their own plans on the newly created healthcare exchanges.

Why was this a big deal? Because prior to the ACA, people could buy individual policies from insurance brokers – if they were healthy. Because only healthy people could qualify, the rates for these policies were relatively low. People who were sick or had a pre-existing condition (such as epilepsy, diabetes, or even cancer), however, were deemed uninsurable. The pre-existing condition clause in the ACA opened up health insurance to a whole new pool of individuals who were no longer discriminated against by the insurers. This was a great win for millions of people.

But, once you create a market for sick people to buy insurance, the healthy people must also be required to buy insurance to balance out the costs.

This is the part of the ACA that is not working.
The incentives for healthy people to buy coverage were just not enough for many. Every time a healthy person decides to forgo health insurance pays the penalty, and takes their chances that they won’t wind up with a major illness or accident, the cost of insurance goes up…and up, and up.  And every time the cost of healthcare insurance goes up, more and more young and healthy people decide to roll the dice, take the risk, and not buy insurance, leaving a yet higher percentage of sick individuals in the insurance pool which drives costs up further. In some states across the country, this is causing insurance companies to stop selling policies to individuals. In these states, the exchanges are at risk of failing.

Going forward, we need to figure out how to make these exchanges work. We need a bipartisan effort to fix this part of the ACA, whether that means steeper penalties for healthy people who don’t buy health insurance, or more significant incentives for the healthy to enroll in coverage to keep costs lower for everyone. I am hopeful that the bipartisan work that started in Congress last week will come up with some good ideas to help fix this. Remember, the goal is better health outcomes with better care experience at lower cost. I don’t know anyone…Republican, Democrat or Independent…who is against this. 

As a result of this turmoil, many people are now considering a single payer system for the first time in our healthcare history. This would eliminate the problem of pre-existing conditions and differing policy costs because every citizen would be covered in the same huge pool of people.

This doesn’t mean socialized medicine or total government control of our healthcare system. This is the misperception that is hindering our efforts to even discuss this as an option.

Think about this: There is a single payer system in Canada. In Canada, it’s like Medicare for all, where Canada (like Medicare), is just paying all the bills, not providing the care. Actually, it is the U.S. government that provides more care than the Canadian government. The Veterans’ Administration is government-delivered care (is the VA socialized medicine?). Because of the single payer system, Canada spends about five cents on the dollar on insurance administration. In the U.S., we spend about  18 cents on the dollar on administrative costs and profit (which is actually lower than the previous 22 cents on the dollar the U.S. spent before the ACA). The difference between that 18 percent and five percent is billions of dollars! Many Americans believe this is pure waste.

A single payer system does not mean government provided healthcare. In all of the debates and discussions about the future of our healthcare system, Americans need to stay calm and listen to the dialogue about what single payer actually means.

There are pros and cons of all of the healthcare systems in the world. There is no perfect system…our goal as a nation should be to make our system better. We can make great progress even without a single payer system but we must come together to truly explore the evidence and our options.

We have a long road ahead of us to get to where we need to be with our healthcare system in this country. Staying educated and informed is vital to keeping a smart dialogue moving forward.

Thursday, August 3, 2017

Studying Defects to Learn and Improve at GBMC

I and other members of the senior team have really been impressed with what Kendrick Wiggins and Kevin Edwards and the materials management team have done to improve their work and make sure that our nursing units always have everything that they need to care for our patients. They have significantly reduced calls from nursing units for all types of supplies. Our nurses are spending much less time looking for supplies and calling to get things that they need that should already be present on the floor. At the same time Kendrick, Kevin and their colleagues have reduced the waste of having too much supply on the unit that can then expire and have to be discarded or reprocessed. Kendrick and Kevin have made their processes much more reliable.

This Tuesday morning on LDM rounds, Kendrick presented the learning on calls for missing linen from the day before. Kendrick had received a call that Unit 36 needed more linen. After directing the delivery of the needed things, he began to investigate. He asked the first why: Why did the unit run out of linen? He learned that the daily cart that replenishes the supply according to the predicted usage had not been delivered to the unit. He then asked the second why: Why had the cart not been delivered? And he learned that the vendor had not delivered the cart for that unit to GBMC. He then asked the third why: Why had the vendor not delivered the cart to GBMC to be brought to that unit? Kendrick called the vendor and found that they had not followed their standard delivery work. He asked them to problem solve and to create a final check of their delivery and to alert materials management when they did not deliver what was needed. The process that Kendrick followed is called the 5 Why process because it frequently takes asking the why question 5 times before you get to the fixable cause of the defect. Kendrick got all of the information that he needed in this case by asking just 3 why’s.

For LDM to be of value, the local leader must have a curiosity about how things are actually working. He or she must avoid the trap of assuming that they already “know” before going to study the actual event. On rounds when we hear people responding to the “what happened” question with “usually” or “sometimes” we know that the person has not actually investigated the event and done a 5 why’s. Tests of change that come from someone assuming what went wrong are not likely to be helpful. Engineers that are trying to improve something always start by going and watching the existing process. Only when they have observed and learned as much as they can about how a process fails do they test a change.

Another point that the leader must understand is to not stop the 5 why process too soon. On rounds we often hear “the chair alarm was not on.” The first ‘’Why was the chair alarm not on?” results in the answer, The nurse did not turn it on.” At this point we often hear that the leader has assumed education is the answer and that he or she is going to reeducate the nurse about the importance of turning on the chair alarm. If the leader had asked the second why, “Why didn’t the nurse turn on the chair alarm?” he or she may have gotten the answer that the nurse forgot. Very hard working and well trained people forget things from time to time, especially when they are under pressure and have many things to get done. Forgetfulness is better fixed by some kind of reminder in the moment (like a sign) or by some kind of constraint to make it impossible to get to the next step without completing the preceding step (you can’t order anything online until you have put in all of your credit card information) or by eliminating the step (like having the chair alarm reset itself). Leaders who stop the why process too soon don’t make as much improvement as those who learn as deeply as they can.

So the next time you see Kendrick, Kevin or anyone from the materials management team, thank them for being excellent learners and for helping us move closer to our vision faster!

Wednesday, July 26, 2017

Alarm Fatigue

I remember being a Pediatrics resident in a Neonatal Intensive Care Unit during my training and hearing many alarms going off simultaneously. Team members were frequently slow to respond to the alarms or they just didn’t respond at all. This was because they went off all the time and it was usually because the leads had become disconnected from the baby or the alarm was set to go off for something that we knew was not really an emergency…. like a momentary high heart rate because the baby was crying.  This concept, not reacting to an alarm because we have learned that they go off for reasons that do not require immediate action, has been termed alarm fatigue. Can you imagine being on a commercial jet where the pilot and the co-pilot were suffering from alarm fatigue?

“False” alarms breed contempt for the alarm system and teach people to ignore the alarm.  Do you always leave a building as soon as you hear a fire alarm? Probably not, because you have witnessed fire alarms going off when there was no fire. If this is the case, you have begun to assume that the alarm is false and the alarm is no longer serving its intended purpose. At GBMC, our standard work is to announce the testing of a fire alarm before we test so as to not create alarm fatigue and put our people at risk.

When I was a Pediatrics resident I received no training in complex systems, human factors or the Swiss Cheese Model of error. I did not know about the high-reliability concept of preoccupation with failure. No one taught me to be aware of the so-called “weak signals” that a catastrophe was brewing. No doctor or nurse told me that if I ignored cardiac monitors long enough eventually some baby might get hurt. Today, I know better but only because I have been involved in some cases and have read about many others where smart, well-trained and incredibly hard working clinicians got caught in the trap of alarm fatigue. Allowing devices on a hospital unit to alarm and ignoring the alarms is a hole in the Swiss cheese that is just waiting for a sick patient and hardworking and smart but human staff members to create a real problem.

So, I am asking all of my GBMC colleagues to not ignore alarms. If you hear an alarm respond to it. If the device is defective, then work with your manager to get it fixed or replaced. If devices are alarming because we don’t have good standard work (e.g. the leads are off the patient because they’ve gone for a test, but no one has shut off the device) then create the standard work. If devices are alarming because we have set the device to alarm at too low or too high a rate…reset the device.  If alarms are going off frequently for no good reason, we have to reduce the number of times this occurs.

I know how hard everyone works in our health care system. We should also want to reduce the number of alarms to reduce the stress on us and our patients as well.

Thanks for everyone’s help on this. Please tell me what you think.

New Executive Vice President for Medical Affairs and Chief Medical Officer
Congratulations to Harold Tucker, M.D. who was recently appointed as GBMC’s Executive Vice President for Medical Affairs and Chief Medical Officer. He is replacing the retired John Saunders, M.D. Dr. Tucker has been an active member of the GBMC's medical staff since 1984 and in that time has taken on several important roles. He was the Chief of the Medical Staff for six years and did an outstanding job of advocating for physicians and advanced practitioners and helping to improve patient care. Dr. Tucker will also continue to serve as the President of Greater Baltimore Medical Associates. Please join me in congratulating him as he takes on this important position.

Thursday, July 13, 2017

Summertime Fun and a Celebration of Our People

Yesterday, we held our annual employee and volunteer BBQ, titled Camp GBMC HealthCare. This event was a great opportunity for all of the GBMC family to come together and celebrate what we have accomplished, while also having some fun! It is no secret that healthcare requires self-sacrifice and dedication and that the work is truly hard. We spend so much time working to achieve our vision, to provide the care to every patient, every time that we would want for our own loved ones, that at times we need to take a step back, reflect and celebrate what we have achieved, together as the GBMC team!

Everyone seemed to enjoy the music, the good food, camp-themed games, and having a relaxing time with friends and colleagues. I also noticed that there were several magnificent karaoke performers! Many enjoyed participating in or watching tug-of-war, Bingo, and the three-legged, potato sack, and egg and spoon races. It was a great opportunity to celebrate together and leave our work behind, even if only for an hour or so.

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, put on a fabulous BBQ! Special thanks to Kim Davenport from Marketing and Shannon Baumler from Philanthropy for their hard work on this event, beginning early in the morning and stretching all the way through the night shift. Lunches were delivered to offsite GBMA practices and Gilchrist homecare staff were given food coupons that they could use at their convenience. At 11 a.m., the barbecue began. Hamburgers, hot dogs, veggie burgers, BBQ chicken, watermelon, salads, and s'mores pops were served by Rouge Catering. The Kona Ice truck was on site providing shaved ice for a cool treat. We assembled again from 10 p.m. until midnight to BBQ and do some karaoke with the night shift staff.

This year, we hosted a fundraising tent called “Camp Hope,” where different departments hosted fundraising activities to benefit our Oncology program. The winners are announced in this week’s Pulse.

We also hosted a horse decorating contest, in which departments decorated papier-mâché horses to show support for Legacy Chase and the Oncology department. A huge thank you to all the departments, units, and practices who participated in the Camp Hope Legacy Chase Horse Decorating Contest! There were 34 horses submitted, and BBQ attendees voted on their favorites! Here are the winners in each category, pictured below clockwise: 

Legacy Chase Theme – Epic Team

Cancer Awareness Theme WINNER  – Oncology Clinical Trials

Cancer Awareness Theme RUNNER UP – (There were so many submissions and a close number of votes) – Inpatient Rehabilitation

Overall Theme – Oncology Support Services



All winners will receive a pizza party celebration.  Please contact Kim Davenport at kdavenport@gbmc.org to schedule.


All in all, we had a great day celebrating our employees! Check out the photos.

What do you think?


Friday, July 7, 2017

Spirit

I have had the good fortune of being away this week with my family. I have enjoyed seeing extended family members, celebrating Independence day and having fun. But everyone knows that the email does not stop coming.

I am very lucky to be the President of GBMC because the positive news hugely outweighs the negative. Among the messages I received this week was one from a GBMC colleague who had been admitted to the hospital after a holiday visit to her patient centered medical home. She was effusive in her praise of those who had served her.

Among the other messages was the notice that next week, July 9-15, is GBMC Spirit Week. This got me wondering about spirit. My first reaction was just how wonderful our marketing, human resources and philanthropy groups are. They are clever and tireless in their efforts to make the hard work of patient care and its associated tasks more rewarding and at times actually fun. I was then wondering which socks I would wear for ‘Crazy Sock Day’. (I don’t think that many who know me would be surprised by this. It is amazing how many comments I get at work if I am not wearing a dark suit, white shirt and a tie.) I also thought about karaoke at the barbecue this Wednesday….

But then my thoughts returned to my GBMC colleague who had been admitted to the hospital for July 4th. Her story awakened me to what spirit really is. Spirit is a rallying cry. It is what joins us together in our mission. Outside of work we have so many differences in our daily lives. But in the hospital, our physician offices or in a Gilchrist setting we are one Team. Teams are all imperfect because they are made up of humans who are imperfect. But spirit brings us together and makes us stronger together. Spirit helps us rejoice in our inherent differences and helps us see them as assets to make the Team richer and better. Spirit helps us look out for each other, celebrate together in good times and console each other and be resilient together in bad times.

So as I return to work I want to wish each and every one of my GBMC colleagues a Happy Spirit Week!

Tuesday, June 27, 2017

A Titan Moves from Management to Governance

This coming Thursday (June 29), Dr. John Saunders will retire as the chief medical officer (CMO) of the GBMC HealthCare System.

John came to GBMC in 1979, as a fellow in head and neck surgery from Walter Reed Army Medical Center, to work with Drs. Robert Chambers and Darrell Jacques. He joined the medical staff and after 10 years in private practice, Dr. Saunders became the medical director of the Milton J. Dance, Jr. Head & Neck Center. Under John’s direction, the Dance Center became the premiere community-based program for head and neck cancer surgery and rehabilitation, and voice disorders.

John retired as an active surgeon in 2012. He served as GBMC's chief of staff from 2004 to 2010 and as interim Chief Executive Officer in 2010.

I was most fortunate when John agreed to take on the role of CMO in 2010 and has served in that capacity until this day. In his role as CMO, John has been responsible for the clinical quality of our healthcare system and has served as the designated institutional official (DIO) at GBMC for the Accreditation Council of Graduate Medical Education, overseeing all of our residency programs and working closely with the Graduate Medical Education Committee.

We all know that John is an icon at GBMC. There is no more respected individual in our system than John Saunders. Patients know John Saunders as a great doctor with an outstanding bedside manner. Clinicians know him as an extremely talented surgeon, who was very calm in the most difficult situations. Residents and medical students knew him as an outstanding teacher who was always kind but firm. Members of the senior team know John for his wisdom, his insightful guidance, his wonderful sense of humor and his outstanding storytelling capabilities.

John and Carolyn Candiello, GBMC’s vice president for Quality and Patient Safety built an excellent structure that is second to none and both have overseen the cultural and performance change that has put GBMC in the quality limelight locally and nationally. John has presented patient stories monthly for seven years. These stories have educated many about the complexities of caring for patients and about a model to make things better.

Everyone knows John for his humility and self-deprecating humor. I have come to know John as an outstanding family man, who along with his wonderful wife, Betsy, have raised three great children and is now helping to raise his grandchildren. John plays the piano and at his retirement event I asked him to play a few numbers but he refused when I told him he had to play at least one Steely Dan song.

All kidding aside, John has become a dear friend and I will miss him on our senior team. I don’t know anyone who can imagine the GBMC HealthCare System without John Saunders. The good news is that John is not leaving us as he has agreed to continue to serve as a director on the GBMC HealthCare Board. Congratulations, John and thank you for everything you have done through the years for GBMC and our patients!

Cause For Celebration
Earlier this month, more than 300 cancer survivors, their caregivers, friends and family members celebrated life at our annual Cancer Survivorship Celebration.

Over the last 26 years, we’ve held this event for GBMC cancer patients and their caregivers as an opportunity for cancer survivors, loved ones and staff to join together, renew acquaintances and celebrate both survivors and their caregivers. It provides us the opportunity to commemorate our patients’ courage and our caregivers' commitment to their treatment. More than 2,000 individuals annually turn to the experts at The Sandra and Malcolm Berman Cancer Institute at GBMC when faced with potentially 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!

Happy 100th Anniversary! 

This year The American Occupational Therapy Association (AOTA) is celebrating its 100th Anniversary.

The AOTA, originally called the National Society for the Promotion of Occupational Therapy, was created in 1917 by a small group of pioneers in the profession.Today, there are more than 213,000 occupational therapy practitioners nationwide that help people of all ages gain or maintain capabilities that help them live life to the fullest.

Our therapists and therapy assistants provide functionally oriented treatment that helps individuals of all ages after an injury, illness or medical procedure. Their work promotes healing, increases strength and endurance and teaches patients how to prevent further pain or injury. Their specialty care can help their patients achieve a higher level of independence.

I want to sincerely thank all the OTs and OTAs for their incredible work and for their unwavering dedication to our patients!

Remember to…
Don’t forget to RSVP for this year’s Employee & Volunteer Appreciation BBQ titled “CAMP GBMC Healthcare.” This year’s event, slated for Wednesday, July 12, will be a great opportunity for our staff and volunteers to come together to celebrate what we have accomplished, while also having some fun! Please join us! You have until Wednesday, July 5 to RSVP and can do so by clicking here. I look forward to seeing you there!

Happy Birthday to Us! 
Finally, I want to wish everyone in our GBMC family a safe and happy Independence Day. July 4th marks 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.

Wednesday, June 21, 2017

Running to Support Our Tiniest Patients

This past Sunday, I ran in our 29th annual Father’s Day 5K. This annual event, presented by the GBMC Volunteer Auxiliary, has raised funds for the NICU and has offered GBMC employees, volunteers, and the general public an opportunity to support our program. Over the past 28 years, the annual Father’s Day 5K has raised more than $1.75 million for the NICU.

We have a phenomenal NICU that achieves clinical outcomes as good or better than many bigger units. We have outstanding neonatologists, pediatricians and nurse practitioners. The staff includes incredibly talented and dedicated nurses and therapists. It is very expensive to staff the unit and keeps it updated with the latest equipment. The money raised by our annual Father’s Day Run is essential for the NICU. The event also creates greater awareness of the strengths of our program and the wonderful expertise and commitment of our NICU staff.

GBMC is a community-based system of care. The outpouring of community support at the race was incredible. It was great to see so many parents of former NICU babies, as well as so many dedicated members of the community and the GBMC staff, come out and run for this terrific cause.

I’m proud to report that this year’s event raised more than $127,000.00 for the NICU, which is phenomenal! I want to thank the close to 800 participants, who ran or walked, and who spent part of their Father’s Day with GBMC to help support the NICU babies and their families.

I also want to thank everyone involved in our community Wellness Fair which featured health-related vendors, as well as the “Baby Doll/Stuffed Animal Hospital” for injured dolls and bears to receive treatment and repairs as needed. Additionally, the MIX 106.5 Radio van was on-site playing music and sharing prizes. The Maryland Zoo in Baltimore was also present with fun animal friends for the kids’ area. Great work everyone!!!

GBMC Night at “The Yard”
I hope all of those who attended the GBMC Employee Night at Camden Yards, Tuesday evening, had a lot of fun. I was really pleased to see many of our people attend and enjoy time with their colleagues. The weather was really nice and what made the evening much better was the Orioles victory!

Friday, June 16, 2017

GBMC Recognized as a Leader in the Use of Information Technology to Improve Care

This week, we had guests from the Healthcare Information and Management Systems Society (HIMSS) evaluating the GBMC HealthCare System on our use of electronic health records.Today, I am excited to announce that GBMC HealthCare has achieved Stage 7 on the HIMSS Analytics Electronic Medical Record Adoption Model (EMRAM) for our inpatient setting and on a provisional basis for our ambulatory services! I am confident that we will receive full ambulatory certification at Stage 7 soon.

The award is recognition for operating in a paperless environment and representing best practices in implementing electronic health records. As you know GBMC has been utilizing the Epic system since this past October.

EMRAM is a methodology for evaluating the progress and impact of electronic record systems and includes eight stages (0-7) that measure a hospital’s implementation and utilization of IT to optimize the care that patients receive. Stage 7 represents the most advanced patient record environment. HIMSS Analytics developed the EMRAM as a tool to compare information technology maturity in health care organizations. Less than 5 percent of hospitals in the United States have achieved Stage 7 certification.

Make no mistake this accomplishment is due to the commitment and the hard work of the GBMC staff which includes our highly-skilled team of physicians, nurses, other clinicians and IT professionals. I want to thank all of my GBMC colleagues for this achievement. Deserving of special thanks are Dr. Fred Chan, our Chief Medical Information Officer, Cindy Ellis, Epic Project Director, Dave Hynson, GBMC’s Chief Information Officer, Chase Roberts, Finance/Operational Efficiencies Manager and Mary Swarts, the Epic Nurse Champion, who all played an integral role in getting us to this point.

Achieving this recognition is more evidence of our commitment to ‘one patient, one record.’ Without this, we cannot achieve our vision of being the community-based health system where every patient gets the care that we would want for our own loved ones.

We’re not perfect and there’s more work to be done. As we go into the Father’s Day weekend, please take a moment to be proud of what we have accomplished so far!

Friday, June 9, 2017

Finding the Time to Give to Others

Many of us take the blood supply for granted. If your loved one had just had a serious injury or needed blood because of a significant disease, you would expect that blood would be available for him or her. We are very fortunate that blood is available when our loved ones need it…but it doesn’t happen magically. It happens because of the Red Cross and many, many dedicated and caring people.

GBMC has always participated in blood drives. Back in 2011, we were not collecting as many units as we could and we were called to do more. Under the leadership of Kim Davenport, our Community Relations and Events Manager, we put on our improvement caps and changed our system. We have now had 6 years of excellent results, yesterday being no exception! We collected 99 units of whole blood in a time of year when it is difficult to get people to donate.



I am so proud of the work of Kim and other GBMC volunteers who work closely with the Red Cross. When you see Kim, thank her for this great work and for helping GBMC to be leaders in blood donation. Also, if you are not currently giving, please consider this at our next drive.

Thank you!

Friday, June 2, 2017

Things did not go as they should. What did we learn?

We have been using the technique of  Lean Daily Management (LDM) now for four years. We started using LDM to accelerate improvement toward our vision of being the healthcare system where every patient, every time, gets the best health outcome and the best care experience with the least waste of resources and the most joy for those providing the care. LDM is designed to create a family of focused problem solvers. LDM, therefore, requires curiosity – the desire to know what actually happened. 

Thanks to the hard work of our pharmacists and nurses, we have much fewer “missing” medications than we used to. Our nurses and pharmacists work so hard and it is frustrating to them when a nurse goes to give a medication to a patient and the medication can’t be found on the unit. The nurse must then alert the pharmacy that he or she doesn’t have the medication and the pharmacy must stop what they are doing and send the missing dose to the floor.

We use the term defect to describe this situation. What should happen is the nurse goes to give a medication ordered by the physician or advanced practitioner and verified by the pharmacist and finds it where it should be and then administers it. If the nurse doesn’t find it on the unit, it’s a defect. We record defects in red on the LDM chart. When a defect occurs, the learner says to himself or herself: “That’s interesting, I wonder how this happened?” This is where the curiosity comes in and the learning starts. The learner must think like a detective or engineer and go and see what happened. The learner knows that the more time that passes the harder it will be for him or her to get the facts right. (By the way, as we have said in the past: red is not bad. Red is an opportunity for learning in order to get it right the next time. If we do not learn, the defect will come back. Not learning is what should be thought of as bad!)

When I started in healthcare, the prevalent thought was: “The medication should be here but it isn’t …who screwed up?” This approach to defects assumes that there is someone who doesn’t know what they are doing or doesn’t care to do their job right. This rarely is the reason behind a defect in a big complex system like the modern American hospital. The answer to the, ‘how did this happen?’, question is almost always that there were multiple system failures. The person trying to figure it out will only do so by asking a number of questions of those involved and/or by trying to reproduce the problem. It is in the study of the defect that we find opportunities to fix the problem. We can then test our fixes to see if they make the system more reliable. Our pharmacists and nurses have done this so well that we have many fewer calls to the pharmacy for missing medications. Let’s all become more curious about defects in whatever our work is to drive GBMC towards its vision faster!

Get some exercise on Father’s Day for a great cause!
Another fundraiser for the GBMC HealthCare system is coming up in a few weeks – on Sunday, June 18th, we’re holding the 29th Annual GBMC Annual Father’s Day 5K & 1 Mile Fun Walk on our GBMC 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 some fun and support our NICU.

Over the past 28 years, the annual Father’s Day 5K & 1 Mile Fun Walk has raised more than $1.75 million for the NICU. We operate a strong NICU with excellent clinicians, great care, and the latest equipment. With 12 rooms in the NICU, there is always equipment that needs updating, new technologies to incorporate and resources critical for these more fragile babies, who require 24/7 care. But again this fundraising effort helps a great deal.

There’s still time to register and support this wonderful event. Click here for all the information. I’ll be out there running, so please come join me! Remember that your support will touch more than 500 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.

Monday, May 22, 2017

Have we made the U.S. healthcare system safer?

There is a lot of evidence that patients are safer in American hospitals and health systems since the publication of the report from the Institute of Medicine (now the National Academy of Medicine) in 2000, To Err is Human. We have significantly reduced harm in the form of iatrogenic infections, falls, retained foreign objects and many others. To see how GBMC has done, you can go to our public website: www.gbmc.org/quality.

But it is clear that we still have work to do. Other high-risk industries, like nuclear power, commercial aviation, or the French high-speed rail system have error rates in the less than 1 per million range. The U.S. healthcare system still has rates in the 1 per hundred to 1 per 10,000 range. We can and must get even safer.

Dr. Donald Berwick, the President Emeritus and Senior Fellow at the Institute for Healthcare Improvement (IHI) gave the keynote address at the 19th annual National Patient Safety Foundation Patient Safety Congress. He applauded those who have generated these real improvements but he pointed out that we still have a lot to do. He listed seven areas of concern that health care leaders should pay attention to in the effort to continue the progress of the patient safety movement. They are in Dr. Berwick’s words:

1. Displacement by other concerns: "As we go to boardrooms around the U.S. and hear what is being discussed, there are two topics: a changing reimbursement system and workforce morale. I personally believe there’s a strong connection between safety and cost reduction, but that conviction hasn’t been firmly established in 20 years."
2. Illusion of completeness: "There’s an illusion that we’ve worked on safety — 'here are our scores on central line infections, pressure ulcers and here’s what’s happening on medication reconciliation' — on to the next problem. The concept of safety as a box-checking enterprise, where we start and finish, is lethal to patients of the future."
3. Incentive theory: "Most of the workforce is already trying as hard as it can. Until we become scientists and give up the incentive-oriented approach to safety, we won’t make the systemic progress we have been calling on for years."
4. Metrics glut: "In pursuit of incentives, we’ve glutted ourselves with metrics. I think we are way beyond a level of toxicity. It's not just safety.  We have to go on a diet."
5. Separation of safety from quality: "When people say 'quality and safety,' what I hear is 'fruit and bananas.' Quality improvement is the big tent. It’s the enterprise of constant improvement to everything we care about. The quality of my car is dimensional. It has safety, durability and fuel economy and so does health care. I think reuniting our endeavors is crucial to our future. We don’t have the resources to waste on tribalism. We have to think systemically."
6. System literacy: "We need to become literate about the systemic properties that produce improvement."
7. Academic attacks: "I’m not sure why, but I deeply regret that academic students who position themselves outside the safety movement have all too often become critics. Until our academic brethren join in the progression of safety instead of positioning themselves as critics of the good-hearted work going on, they’ll be riding the breaks."
We at GBMC will stay focused on our vision phrase and every day we will work to measurably improve the patient’s health outcome and her care experience while driving out the waste and increasing the joy for those providing the care.

THANK YOU to our Information Technology colleagues!
Ten days ago, a major cyber-attack brought disruption to the health system in England forcing many hospitals and doctors’ offices to turn away patients and cancel appointments. People in affected areas were being advised to seek medical care only in emergencies. As a result, the United States and countries around the world sought to manage the spread of the "WannaCry" ransomware attack immediately.  That was also the case here at GBMC.

Dave Hynson, GBMC’s Chief Information Officer, and his team went to work immediately to diminish risk as much as possible by implementing the most current Microsoft security updates, and best practices as defined by our vendor partners. They also did an excellent job of informing the GBMC HealthCare user community by asking them to be vigilant with unknown or suspicious attachments.

All of the patching was accomplished by Monday (May 15) afternoon, including our Citrix servers and systems for which Microsoft made a patch available. As of today, we still ask GBMC staff to continue to be vigilant regarding all email and help to ensure that GBMC remains safe from a cyber-attack.

I want to thank Dave and his team for all their hard work in addressing the issues and keeping us on normal operations.

Friday, May 12, 2017

Time To Reflect On Our Outstanding Nurses

This week is National Nurses Week (May 6 – May 12) – the time of the year where we thank our nurses for all that they do. Being a nurse is very taxing work. It is physically demanding and the expectations on them get greater all the time. We expect our nurses to maintain their competency with ever increasing diagnostic and treatment options that get more and more complex by the year. We also expect them to treat everyone with kindness and compassion even in the most challenging situations- like an Emergency Department full of behavioral health patients who can’t get out because there is no place for them to safely go.

GBMC HealthCare nurses meet this challenge daily and I’m always amazed at how they keep coming back. Why?  Because of their dedication to helping others in their time of need.

In honor of Nurses Week, a former patient posted words of gratitude, on her Facebook page (pic right), on how the nurses cared for her during a near death experience. This is just one, of the many patient stories, that reminds me how fortunate we are to have a remarkable and dedicated nursing staff, in the hospital, in our physician practices, in patients’ homes, and in our inpatient hospice units. Please join me in thanking them.

Sunday also marked the beginning of National Hospital Week, the celebration of which dates back to the early 1920s. According to the American Hospital Association, the week is “a celebration of the history, technology and dedicated professionals that make our facilities beacons of confidence and care.” At all hours of the day and night, all year long, our team of parking lot attendants, grounds crew, patient access reps, and billing staff, to transporters, environmental services workers, food service workers, security personnel, social workers, care managers, advanced practitioners, physicians, nurses, therapists, volunteers, and all other non-clinical and administrative employees to serve our community in our mission of health, healing and hope.

So, as we observe National Hospital Week, I want to sincerely thank all the members of our staff, Board of Directors and volunteers and everyone who has helped us improve our care and make our system more reliable to move us closer to our vision: to every patient, every time, we will provide the care that we would want for our own loved ones.

PARTY ON!!!!
Last night, I had the privilege of attending the second annual Art of Nursing celebration. This was a special evening for our nursing staff, as we formally celebrated all that our incredible nurses give to GBMC and our patients. We highlighted the seven winners of the 2017 Art of Nursing Awards. They are:
Diversity in Nursing Award – Anton Panuela, BSN, RN
Clinical Assistant Support Award (Inpatient Award) – Dorothy Alexander, NST
Clinical Assistant Support Award (Outpatient Award) -- Irene Irby, CNA and Shartiya Boykin, Lead MA
Patient-and Family-Centered Care Award – Alexis Schultz, BSN, RN
Nursing Evidence-Based Practice Award – Rosalyn Berkowitz, BSN, RN, FNE-A/P
Mrs. H. Norman Baetjer Jr. Nursing Graduate of the Year Award – Almina Hrbinic, RN
Nurse Clinician of the Year Award – Rachel Ridgely, BSN, RN, CCRN

Congratulations to the winners and all those who were nominated!

I also would like to thank everyone involved in our very successful Art of Nursing celebration, especially our Marketing and Communications team and our Philanthropy team.

America’s Most Amazing Nurse Is In Our Hospital!
Speaking of our great nurses, and one who truly incorporates our vision is Laura Clary, manager of our Sexual Assault Forensic Examination & Domestic Violence Programs. Earlier today, during a very festive occasion in our Yaggy Atrium, Laura was announced, on The Doctors TV Show, as the winner of Prevention magazines nationwide search to find America’s Most Amazing Nurse.

Since November, Prevention magazine and The Doctors have joined efforts in a search across the country to find America’s Most Amazing Nurse. Each entrant or nominee had to have an active RN license or advanced nursing credential and must have been currently working in the nursing field. Laura was nominated by her husband and selected over hundreds of applicants and four other finalists because of her compassion, commitment, and expert care.

Our SAFE program cares for patients across the lifespan, with our oldest patient being 98 and our youngest under one-year-old. We have expanded the program, thanks to Laura, to not only care for adult victims of sexual assault but also victims of child abuse, human trafficking, intimate partner violence and non-fatal strangulation.

Barbara O'Dair, editor-in-chief of Prevention Magzine, said this about Laura: "Her extraordinary work embodies the true spirit of nursing." Laura is truly an example of how powerful nurses really are and how they're strong advocates in addition to being devoted and comforting caregivers.

We hope Laura’s honor inspires people in our community to acknowledge and appreciate the incredible contributions nurses, like Laura and her team, make in our communities every single day.

Congratulations Laura!  This recognition is truly well deserved!

Golfing for a good cause…
On Monday, the sun made an appearance and the weather was just right for the 29th Annual GBMC Golf Classic at the Turf Valley Country Club.  Over 200 golfers teed up to help raise funds for the GBMC HealthCare system.

I had a great time playing with John Maroon, CEO and founder of Maroon PR; Harry S. Johnson, former chair of the GBMC HealthCare Board of Directors, and an attorney with Whiteford, Taylor and Preston and Ronald M. Cherry, Esq, a partner in the law firm of Bonner Kiernan Trebach & Crociata LLP.

It was clear that countless hours were spent preparing for this great day that grossed approximately $200,000 to benefit GBMC. Money from this year’s event will aid various initiatives including the John E. Savage Medical Library which provides the medical staff, patients, visitors, and members of our community the most up-to-date medical information; and the Continuing Medical Education Department which provides programs offering medical education for our attending physicians, nurses, resident physicians and allied health professionals.

A great time was had by all and it was evident that so many community members and supporters of GBMC are truly dedicated to our future success. I’m very grateful to everyone who helped us raise the money and everyone who came out to play. Kudos to the entire golf committee, led by Chairs Rob Stoltz MD and Lisa Goodlett, our Chief Financial Officer and to Jenny Coldiron and the GBMC Foundation staff, and many of our nurse leaders all of whom worked together for a great event!

Friday, May 5, 2017

Health Care Policy is Back in the Forefront

On Wednesday, I had the honor of participating in an internet broadcast, titled “The High Stakes of Health Care Policy,” which was hosted by the Institute for Healthcare Improvement (IHI). The IHI is a leader in health and health care improvement worldwide and over the last 25 years, they’ve partnered with visionaries, leaders, and frontline practitioners to look at ways to improve the health of individuals and populations.

The program was hosted by Madge Kaplan, from the IHI, and I was joined by John E. McDonough, DrPH, MPA, professor of public health practice in the Department of Health Policy & Management at the Harvard T.H. Chan School of Public Health. The interview focused on the newest threat for cutbacks on the protections to people provided by the Affordable Care Act (ACA), whether through legislation or regulation. Yesterday, the House of Representatives passed the American Health Care Act by a vote of 217-212. The future of the health care law still remains unclear as it now moves on to the Senate. The Republican proposal that is being debated would diminish the protection to people with preexisting conditions.

Since the passage of the ACA, our nations’ hospitals, physicians, nurses and the rest of the healthcare team have generated significant improvements in care. Medicare has seen the smallest annual per capita cost increases in its history. Employers, like GBMC, have also seen annual health care cost increases that have been much lower than they were before the federal government started incentivizing the movement from “volume” to “value.” Much of this is a direct result of the ACA and the agency it created: The Centers for Medicare and Medicaid Innovation. Millions of Americans who did not have insurance before passage of the ACA now do and people who have preexisting conditions can now get insurance when before they could not.

No one disagrees that we must improve the part of the ACA that deals with the ability of individuals to purchase health insurance on the exchanges. Not enough healthy individuals are buying insurance, thereby making the premium cost go up for individuals to try to cover the cost of care for people who are already sick.

The President of the American Hospital Association, Rick Pollack released this message yesterday: “America’s hospitals and health systems are deeply disappointed in the House passage of the AHCA because it will jeopardize health coverage for millions of Americans.”

Despite last-minute changes, the proposal eliminates essential protections for older and sicker patients, including those with pre-existing conditions, such as cancer patients and the chronically ill. It does little to help the 24 million Americans who would be left without coverage following repeal and makes deep cuts to Medicaid, which provides essential services for the disabled, poor and elderly people in this country.

As the backbone of our nation’s health safety net, America’s hospitals and health systems — which include more than 270,000 affiliated physicians and 2 million nurses and other caregivers — believe it’s vital that Medicaid is protected.

We urge the Senate to restart and reset the discussion in a manner that provides coverage to those who need it and ensures that the most vulnerable are not left behind.”

So, what will the Senate do? Every major healthcare organization, including the American Medical Association and the American Public Health Association, have come out against the Republican bill.

I am one of those people who believe that health care is a right. In order to guarantee this right, however, those of us in health care positions of authority must drive the system toward the Triple Aim of better health and better care at lower cost, and the ACA has been helping us do this.

I participated in the interview to highlight the GBMC story and how federal incentives and initiatives brought about by the ACA have contributed to our recent success. I am glad to help in this endeavor by discussing our commitment to the transformation of the delivery system to better manage chronic disease and to prevent disease in those who are healthy.  I am hoping many more healthcare leaders join me and help in our fight to maintain health insurance access for all.  If you are interested in listening to the webcast, please click here.

Congrats to Dr. Sternlicht…
Jeffrey P. Sternlicht, MD, FACEP, chairman of our Department of Emergency Medicine, was recently appointed by Governor Larry Hogan’s office as a member of the Maryland Behavioral Health Advisory Council. This council consists of 28 members (or designees) representing state and local government, the Judiciary, and the Legislature along with 13 members, appointed by the DHMH Secretary, representing behavioral health provider and consumer advocacy groups; and 14 representatives that include a diverse range of individuals who are consumers, family members, professionals, and involved community members.

Improving Maryland’s behavioral health system is very important to Dr. Sternlicht and I am sure that he will bring new energy and ideas to the council.  Congrats again Dr. Sternlicht and thank you for your service!

Mark your calendars...
With the Monday, May 8th deadline right around the corner, I wanted to kindly remind you all to do your part and complete our annual Employee Engagement Survey. The survey can easily be accessed through the icon on any GBMC desktop computer (see pic on right).

So far, OVER 60 percent of our colleagues have responded. We need your opinion! The survey is anonymous to GBMC and confidential. We work with a third party vendor, Press Ganey, who compiles survey data for us. We at GBMC never see individual responses.

Please make your voices heard and complete the survey so that we can identify opportunities for further improvement, to judge the value of changes we made since the last survey and to make GBMC an even better place to work and a safer health system for our patients.  Thank You!

Also, don’t forget to be part of the festivities on Friday, May 12th, starting at 8:30 AM at the Yaggy OB Atrium, as we watch and find out if our very own Laura Clary, BSN, RN, FNE-A/P, SANE-A, CFN, CPEN, is named “America’s Most Amazing Nurse” by Prevention magazine on The Doctors TV show. Prevention and The Doctors received thousands of entries from across the country. We’re are really proud to have Laura as one of just five finalists. Click here to RSVP. We’re setting up a screen in the Yaggy OB Atrium so everyone can be part of the fun. Light refreshments will be provided. Regardless of the outcome, I agree with senior vice president of patient care and chief nursing officer (CNO), JoAnn Z. Ioannou,
DNP, MBA, RN, NEA-BC, that we have the most amazing nursing staff in the country!

Friday, April 28, 2017

GBMC is Grateful for its Fabulous Community Support

Earlier this week, I attended our annual Donor Recognition Dinner and was honored to spend time with patients and their families, donors, members of the GBMC, Gilchrist and the Joseph Richey House boards, philanthropy committee members and volunteer auxiliary members. Their gifts of time and treasure is truly invaluable to us.



During the dinner, I listened intently to the very powerful patient and family stories because they underlined all of the great work our system does for our patients and the community.  I am not just saying this just because I am proud, but because I truly believe that we have great physicians, nurses and other staff and volunteers who are always there to serve with their expertise and compassion to help patients and their families in bad times and celebrate with them in good times. Premiering at the dinner was also our “famous” Carpool Karaoke video. Click here to watch GBMC HealthCare team members performing with GBMC volunteer and former news anchor Don Scott. The video tells why these employees love working at GBMC HealthCare and also says thanks to our valuable donors.

I am very grateful that our donors have chosen to give financial assistance to support our mission. The programs and services, highlighted during the dinner, would not be possible without their gifts. Programs like SAFE (more below) and our child life program are entirely funded by donations. Gilchrist would not have been able to expand their programming to children and their families, or to the neediest in the inner city of Baltimore without donor support. The medical staff would not have unlimited access to the on-line evidence and decision support service, Up-to-Date, without their gifts.

I want to thank you all for investing not just financially, but supporting our team in other ways and allowing us to continue providing care during these challenging times as an independent, community owned and controlled healthcare system. We are grateful to all of you for being a part of the GBMC family and hope you will continue to make GBMC a philanthropic priority.

Thank You to Our Volunteers – National Volunteer Appreciation Week 2017
This week we are celebrating National Volunteer Appreciation Week. As you may know, with more than 900 volunteers in the hospital and at Gilchrist Hospice Care, GBMC has one of the largest volunteer auxiliaries in Maryland. National Volunteer Week was created in 1974 when President Richard Nixon signed an executive order establishing the week as an annual celebration focusing on the impact and power of volunteerism and service as an integral aspect of our civic leadership.

Over the last 51 years, our volunteers have donated approximately three million hours of service and raised more than 22 million dollars to support patient care at GBMC! Volunteering is an honorable choice that these special men and women have made for the GBMC HealthCare system. And so at this time of year, we’re proud to highlight our volunteers’ role in improving our patients’ care.

When you meet a GBMC or Gilchrist volunteer this week please take the time to say “thank you” for all they do.

…And it's Medical Laboratory Professionals Week!
This week is also Medical Laboratory Professionals Week. GBMC is so lucky to have the most highly reliable laboratory that I have ever seen. We are blessed with outstanding pathologists, technicians, phlebotomists, managers, administrative personnel and others on the Team. If you don’t believe me, click here to read the story on how one of our medical technologists was instrumental in saving the life of one our patients.  They are truly unsung heroes who we sometimes take for granted. Thanks to our lab personnel for all that they do!

Helping our SAFE & DV programs… 
I want to thank everyone who participated in our second Walk a Mile in Her Shoes®:  The International Men’s March to Stop Rape, Sexual Assault & Gender Violence. We had about 280 participants and we raised approximately $42,000 for our SAFE and Domestic Violence programs. Last Saturday, male and female participants walked a mile around GBMC’s campus in high heels (or red tennis shoes) to shed light on and show support for an extremely important issue for women and men of all ages.

Registered nurses in GBMC’s SAFE program are specifically trained and certified by the Maryland Board of Nursing to provide care for victims of sexual assault and domestic violence of all ages in a confidential, non-judgmental atmosphere. At no cost to the patient, these nurses focus on re-empowering survivors to begin the healing process, in addition to working toward ending Sexual Assault and Intimate Partner Violence in the community.

We understand the necessity of our Walk a Mile event and I am proud that GBMC continues to be a leader in helping the victims of sexual assault and domestic violence and in educating the community to reduce these attacks. I want to thank the GBMC Foundation office, our Volunteer Auxiliary and all parties who worked together to make this year’s event another success!

GBMC Is Well Represented In This Year’s Daily Record’s Top 100 Women
I am proud to announce that four influential women in the GBMC family were honored by The Daily Record as Top 100 Women. Bonnie B. Stein, Dr. Robin Motter-Mast, Dr. Michele Shermak and Faith Thomas (pic. from left to right) were all honored for being exemplary citizens, for exhibiting a commitment to their community, and for actively participating in future leader mentoring. Dr. Motter-Mast is a primary care physician with our GBMA Hunt Manor Medical Group and the Medical Director of our Primary Care Group; Dr. Shermak is a board certified plastic surgeon and a member of the GBMC medical staff; Bonnie. Stein is the chairperson of the GBMC Board of Directors and Faith Thomas is a member of the GBMC Board of Directors and Chair of the Audit Committee.  Bonnie was also inducted into the Daily Record’s Circle of Excellence, which means that she has achieved this award three separate times. Within the last year, Megan Maguire Priolo, Chief Operating Officer of GBHA, was selected as one of the publication’s Leading Women: Maryland’s Future. Congrats to all!

Nice Work!...
What an enjoyable afternoon we had this past Sunday at the first Spring Jazz Brunch to benefit Gilchrist Center Baltimore – Joseph Richey House.  Hosted at the Eubie Blake Jazz and Cultural Center in the city, 150 guests enjoyed good food and great jazz music provided by the Ian Sims quartet.  Most importantly, they learned the story of the Joseph Richey House and their dedication to serving the city’s most vulnerable residents.  We sold out this event and raised $65,000 which is critical funding for this 19-bed residential hospice.  I am grateful to everyone who supported the jazz brunch and helped us recognize the Joseph Richey House’s 30th year of service.