Monday, March 27, 2017

A Three Year Checkup for the Patient Centered Medical Home at GBMC

I am a pediatrician and all good pediatricians know the importance of checking the child’s development at regular intervals. So, you may remember that I interviewed a few patients on their perception of our advanced primary care patient-centered medical homes three years ago and included the interviews in the blog.

http://ahealthydialogue.blogspot.com/2014/03/what-do-our-patients-really-think-about.html   
Well, I think it’s time for another checkup.

The patient- centered medical home is our design for being accountable along with the patient for his or her health. We began building them when we created our transformational vision in 2011. At that time, we knew that we had to change our design of primary care if we wanted a different outcome. We wanted everyone to get what we wanted for our loved ones: the best health outcome with the best care experience at the lowest cost (with the least waste) and with the most joy for those providing the care.

So now in 2017, what do our patients think about our patient-centered medical homes?

Earlier this week, I interviewed Dale Cernik. For more than a year now, Dale has been a patient of Dr. Peter Burkill and his team’s nurse care manager, Anne R. Conrad, at Family Care Associates, our advanced primary care office in the North Pavilion on the GBMC campus. Dale, 66, came to us with symptoms of increased thirst and urination. He said that “basically I felt like my body was out of sync.” There was no history of diabetes in his family, but Dale did have a history of high blood pressure.

Dr. Burkill diagnosed Dale with diabetes and he prescribed medication and connected Dale with Anne. She began to check in with Dale by phone two times per week to make sure that the symptoms were improving and that Dale understood and was following his diet and exercise plan. Dale made lifestyle changes and followed the plan.Today, Dale’s blood sugar levels are normal, his high blood pressure is under control and he is now exercising six times a week!  Dale now feels that because of the care he has received from Anne and Dr. Burkill he’s been able to get his life back.

We had a nice conversation and Mr. Cernik made it a point of letting me know how happy he was to tell his story and how the “FCA staff is professional, kind and caring and how everybody is sincere in their actions.”

Click the video below to hear what else Dale had to say about his care from the team at Family Care Associates.





I am so proud of Dr. Burkill, Anne and the rest of the FCA team including the care coordinators, medical assistants, and patient service assistants. They are all willing to be held accountable to working with patients, like Dale, to help them improve their health.

I think our patient-centered medical home passed the checkup with flying colors!

I want to also express my gratitude to Mr. Cernik for sharing his experiences and story with me. The GBMC HealthCare System is moving closer to our vision of providing to every patient, every time, the care that we would want for our own loved ones.

Wednesday, March 15, 2017

Highlighting Our Work When It Comes To Patient Safety

This week is National Patient Safety Awareness Week and for this reason, I want to take the time to recognize the important achievements we as a healthcare system have made when it comes to the safety of our patients. I’ve asked Carolyn L. Candiello, Vice President for Quality and Patient Safety with GBMC HealthCare, to be a guest blogger this week. I hope the readers of this blog will find Carolyn’s observations on our patient safety work as illuminating as I did. 

Carolyn writes….

This Sunday, marked the beginning of National Patient Safety Awareness Week.  This year’s theme is “We are all Patients!” and if you think about it, it’s very much in line with our own vision – that we treat everyone the way we would want to be treated.

As I reflect on this week, I think it is a good time to pause and consider what we all (nurses, techs, providers, support staff, volunteers, and leaders) have accomplished so far and to recommit to following safe practices for patient safety. Earlier this month, The Joint Commission issued their 57th Sentinel Event Alert which discusses the essential role of leadership in patient safety. I am so proud to be part of an organization where safety starts at the highest level. In 2010, our Board of Directors made a commitment to improve patient safety and together we have all been working tirelessly to achieve highly reliable care for our patients! 

The results have been remarkable --in 2011, GBMC had 21 serious safety events. So far, in FY 2017 we have had one.  We have seen other improvements just as remarkable – reducing catheter-associated urinary tract infections from one every week to just under one every other month.  Having gone over a year without an event, I consider that we have virtually eliminated serious hospital-acquired pressure ulcers, ventilated associated complications, infections related to hip and knee replacements and are well on our way to achieving reliability in many other areas. This didn’t happen by “wishing and hoping” it happened as a result of several changes we made.

1. We adopted a Just Culture – a firm belief that every system is perfectly designed to get the results it gets.  When errors happen, our focus is not on the individual, BUT on the system and how we can fix our processes.
2. We adopted a Reporting Culture– we believe that it is important for each of us to speak up when something isn’t right and to report incidents of harm.  One of our goals for a few years was to increase reporting into Quantros!  We went from receiving only a handful of incidents each month to receiving hundreds!  We encourage everyone, regardless of position, to report incidents of harm or potential harm.
3. We have adopted a Learning Culture - We are open and transparent about learning from our experiences. We openly share our data with our community on our website.  When there is learning from our LDM report, we share it in the daily email.  Each week we share deeper learning in the Tuesday Pearl of Wisdom. Three years ago, we started Great Save Wednesdays where not only do we share learning, we highlight safe behaviors by so many of our front line staff.  Each month we share learning in the form of a patient story – the story is told at leadership and board meetings and is available on the Infoweb.  Every manager is asked to share these stories at their staff meetings.

While all of these things help to build a culture of high reliability in order to provide the care to every patient every time as we would our own loved one, we are not there yet! I ask that each of you to join me in recommitting to taking the National Patient Safety pledge.  I pledge to strive to implement and follow practices that increase the safety of my patients and my team!  You can pledge on their website or enter your commitment below!
  
Thank you for all that you do every day to make care safer – to provide the care we would want for ourselves and for our loved ones!


THANK-YOU!!!
Team GBMC again demonstrated its commitment to its mission of health, healing, and hope for the community. I witnessed the teamwork, camaraderie and “can do” attitude of our people first hand.

Our environmental and food service workers were extraordinary in their ability to keep our facility clean along with feeding our patients, staff, and volunteers. Our grounds crew did their usual phenomenal job of snow removal to make our campus safe and passable and our facilities team made sure that everything remained in working order.

Most of the nurses and nursing techs, worked over 24 hours, and many of our physicians came in despite the inclement weather, I truly appreciate your commitment. You all clearly displayed your dedication to treating all of our patients the way we would want our own loved ones to be treated, every time.

I also want to point out that our leadership team also did a fantastic job, led by Stacey McGreevy, our incident commander, who did a remarkable job coordinating everyone’s actions. Cate O’Connor-Devlin helped to coordinate and address nurse staffing for over 200 patients and Michelle Tauson exhibited their expertise in disaster management for the duration of the snow event. I want to thank all the staff members who helped in the hospital’s command center, answering phones, coordinating accommodations for employees who stayed overnight and ensuring that all units had the proper coverage to care for our patients.

Again, my appreciation to all who worked so hard to get the job done for our patients and our community during the snow storm.

Tuesday, March 7, 2017

Strategic Planning in a Time of Uncertainty

Last Thursday and Friday, I spent most of the day with our senior team, nursing leaders along with our service line physician leaders and administrators. We were together to review the findings of our SWOT (strengths, weaknesses, opportunities and threats) analyses and to begin the creation of our one and three-year goals and next year’s strategic operating plan to get us there.

John Ellis, Senior Vice President for Strategy and Business Development, and Amber Taylor, Director of Planning and Business Development took us through their analysis of changes in the local health care market, the results of their interviews with health insurance leaders and patients, and the results of surveys answered by our leaders and members of the Board. Cathy Hamel, Vice President for Continuing Care and President of Gilchrist, presented the strategy over the next few years for Gilchrist, and Harold Tucker MD, President of GBMA and Ben Beres, Chief Operating Officer of GBMA, presented their thoughts on strategic moves within our physician company.

Our service line leaders (Medicine: Neal Friedlander MD and Jessica Heslop; Surgery: Jack Flowers MD and Michael Finegan; Women’s: Victor Khouzami, MD and Susan Bowen, RN; Geriatrics and Continuing Care: Tony Riley, MD, and Cathy Hamel; Cancer: Paul Celano, MD, and Michael Stein; and Primary Care: Robin Motter, DO and Danielle DaSilva) presented their thoughts as well. The group considered all of the information and began the work of creating one and three-year goals to move us closer to our vision under our four aims.

The next steps will be to choose the final initiatives to work on and then create the annual operating and capital budget. Keith Poisson, Executive Vice President and Chief Operating Officer, has done an excellent job overseeing this process and he was ably aided by Amber Taylor and Lisa Griffee, Director of Lean Operations, who kept us on schedule and even made the process fun at times.

I am very proud of all of the people who have participated so far and I am grateful for their hard work. Even though we don’t know the fate of all of the provisions of the Affordable Care Act and if the country will continue its march towards the triple aim of better health and better care at lower cost, we will persevere in serving our community and each patient as if he or she was our loved one.

THANK YOU TO OUR SOCIAL WORKERS!!!
March is Professional Social Work Month and I would like to thank the dedicated group of social workers who serve GBMC. We are fortunate to have such a talented and hard-working group of social workers on our team. Our social workers and care managers have helped GBMC reach the lowest readmission rate in the state and have designed a system that assures that our patients with chronic and advanced illness receive the support they need. Please take the time to thank our social workers for all that they do to move us closer to our vision.