Tuesday, October 16, 2018

52 Clicks

During this past Friday’s Lean Daily Management rounds, I learned that a nurse doing a complete neurological check on a patient after spine surgery had to click 52 times in the electronic health record to document his or her assessment. I was stunned by this assertion. I have been very concerned about creating unnecessary work for our nurses who already work so hard. This example made me concerned that in our zeal to get to high reliability (what should happen happens and what should never happen doesn’t) by creating standard work, perhaps we had created a system that is not sustainable.

Checking on the neurological status of a patient who has just had spine surgery is very important to make sure that we do not miss a serious problem in the making. Documenting our check is important to our colleagues, in this instance especially the operating surgeon, can see the result of our neurological exam. But does it have to be so hard?

Before the reader races to blame the electronic record let me point out that the paper world left room for error as well. With a blank piece of paper, it was easy for the clinician to write Neuro: WNL, meaning the entire neurological exam was normal. This would always raise the question of whether an entire exam was done. We also had the problem of illegibility with some handwriting.

This is an instance where we healthcare leaders need to avoid the “either, or” trap. Either the documentation will be complete, or it will be efficient. We need “both, and” solutions that will allow for documentation that is both complete and efficient. Wouldn’t it be nice if as the nurse was doing the exam the documentation just happened? How about voice recognition software that would allow the nurse to speak the results of the exam as it was being done?

I am sure that we can come up with a system that would be better than the 52 clicks. Do you have an idea? Please share it.

Tuesday, October 9, 2018

A New Dynamic Dyad

The GBMC HealthCare System gets better every day at delivering on our four aims and the areas where we make the most improvement are where we have our best leaders. I have been teaching our leadership model in GBMC University classes a lot recently.

During our last GBMC HealthPartners meeting, Shannon Littleton, the Joppa Road Patient-Centered Medical Home Practice Manager, and Dr. James Baronas, the Physician Lead, presented some of their most recent results in patient engagement scores. This dynamic duo took over the leadership of the practice in the summer of 2017. Since then, they have reviewed the GBMC mission, vision, and values with their team and shared performance data. They redesigned their work to improve scheduling, the use of MyChart, phone answering, and office flow. At every step, they thanked their people and encouraged them to make further improvements.  Their results are remarkable!

We are so fortunate to have smart, caring, young leaders in our organization. Thank you, Shannon and James!

This year, during Domestic Violence Awareness Month, we are teaming up with WMAR 2 News (ABC – Baltimore) as a proud sponsor of the Fill the House for House of Ruth initiative to collect everyday necessities for this partner in care.

House of Ruth provides services to nearly 9,000 women annually who are victims of intimate partner violence (IPV). The work that the House of Ruth performs is closely aligned with our work in the community. Our Domestic Violence (DV) Program has provided services to more than 800 individuals such as support, education, safety planning, referral to community resources and follow-up.

Various drop-off boxes (see picture) have been set up throughout the GBMC campus including the GBMC Pediatric Group, Human Resources, Oncology Support Services, Spiritual Support Services, Volunteer Services, and Family Care Associates. They are also at each of our 10 off-site primary care locations along with Active Life & Sports in Nottingham and Karma Consignment Group in Timonium. Another way to donate is through our Amazon Wishlist. All items purchased through this link will be shipped directly to the GBMC Marketing department, so you don’t have to worry about dropping anything off.

Some of the House of Ruth's greatest needs include diapers, women's and children's undergarments, pillows, twin-sized sheets, comforters, and blankets along with personal care products — deodorant, shampoo, conditioner, bar soap, etc...The drive will run through Monday, October 15 and all items must be new and unopened.

Again, your donations meet the basic needs of victims — things we often take for granted — so please help the House of Ruth and victims of IPV.

Fun in The Sun for A Great Cause
The 18th annual Legacy Chase at Shawan Downs was a huge success! Approximately 8,000 attendees came together for great weather, beautiful horses, and time spent with family and friends. The more than $200,000 raised will go toward oncology services at the Sandra & Malcolm Berman Cancer Institute.

Hats, Horses, and Hope was the theme again this year to celebrate cancer survivors. Many of the annual crowd-pleasing traditions continued— such as the G. Leslie Grimes Memorial Stick Pony Race for kids — and GBMC added some exciting new components to help make the event a success. Brand new this year, was the Archway of Hope, which allowed volunteers and friends of our Cancer Institute to decorate and personalize wide-brimmed hats, which they placed on the arch. Each of the hats create a sense of comfort and strength for cancer patients and their families. Children also came dressed as their favorite superhero to show their support for the fight, while some guests boasted their best hat to show support for oncology patients.

Legacy Chase gives us an opportunity to engage with the community, employees, donors, and local businesses in the work of our healthcare system. We are proud to receive tremendous support from the community-at-large and our family here at home. 

I also want to thank the more than 150 volunteers who helped make this such a great event.

Tuesday, October 2, 2018

A Visit to a Team That is Doing Great Things

The opioid epidemic is getting a lot of press lately. We healthcare providers realize the role that we have played in causing the epidemic with our liberal use of narcotics for pain management. We are now acting to reduce this use and we are making great strides. Unfortunately, it will take a long time to reduce the number of those who have become addicted.

A few months ago, Dr. Andrey Ostrovsky, a pediatrician and the Chief Executive Officer of Concerted Care, LLC, an organization that treats addiction, came to visit GBMC with several of the members of his leadership team. They went on our Lean Daily Management walk with us and we spent some time learning from each other about care improvement. 

Last week, several of us from GBMC went to see the Concerted Care operation in Baltimore City on 25th Street. We were extremely impressed with the system of care that they have created for hundreds of addicted Baltimoreans. They prescribe and distribute methadone and they provide individual and group counseling for their patients. Dr. Ostrovsky also showed us some houses that they rented to provide living quarters for some who were also homeless.

We spent time with them in a team-building exercise called “The Marshmallow Game,” which is designed to create innovative thinking. As much as Concerted Care is doing, they believe that they could do even better, but it will require new ways of doing their work.

I left Concerted Care reflecting on how fortunate we are in Baltimore to have such dedicated people to care for those with tremendous medical and social needs. Rather than lament the difficulty of their work, they had found the energy to continually improve. We salute Dr. Ostrovsky and his team for all that they are doing to help our community!

Friday, September 21, 2018

Going LIVE…

Back in July, I discussed how our healthcare system has been growing its presence on social media channels like Twitter, Instagram, LinkedIn, and Facebook (more on this below). Social media has been a great way to promote subjects and specialties that don’t often receive coverage on local and regional broadcast news or print. For more on our social media strategy and how it encourages two-way communication between our workforce and customers, click here.

Last week, I was part of our monthly Facebook LIVE program, “To Your Health,” which allowed me to connect with a studio audience and Facebook viewers to talk about patient safety. If our patients are not safe when receiving our care, we will not achieve the care we want for our own loved ones because they will not have a good health outcome. To watch the interview, please click on the icon below.

I am very proud of the GBMC HealthCare System because we stay focused on our vision, but I am frequently asked: “How can we do a better job of getting the word out about our vision and how we are different?” The use of social media like Facebook LIVE is one way. Can you suggest others?

Be A Part of Our Celebration...

On Saturday, September 29, we will have our 18th annual Legacy Chase steeplechase event at Shawan Downs in Hunt Valley. This year’s race will again benefit GBMC’s Oncology Services at the Sandra & Malcolm Berman Cancer Institute.

Legacy Chase has become a signature event for GBMC HealthCare, combining the excitement of steeplechase racing with a celebration of our patients and the services we provide to the community. There’s more to the event than great horse racing and there is something for everyone. Many of the crowd-pleasing traditions continue this year, such as the kids’ Stick Pony Race, and we have added some exciting new components to help make the event another memorable success.

The Sandra & Malcolm Berman Cancer Institute is the only comprehensive community cancer program certified with distinction by the American College of Surgeons Commission on Cancer in the Baltimore region. GBMC has invested in talent and technology to provide the best care for oncology patients. We coordinate care across the continuum for more than 2,000 new cancer patients annually!

Make this year’s event a family affair and come and enjoy a day in the country. For more information visit https://legacychase.org/. I hope to see you there!

Cancer Program Gets National Recognition…Again!

Congratulations to our team at the Sandra & Malcolm Berman Cancer Institute, who recently earned the Accreditation Award with Commendation from the American College of Surgeons Commission on Cancer (CoC). In each of the last four surveys, the CoC recognized The Berman Cancer Institute for treating every cancer patient as if they were a loved one.

Accreditation indicates that a cancer program has met or exceeded 34 standards of quality measurement, while Commendation is awarded only to programs that exceed all required standards, plus 7 out of 7 commendation standards at the time of its triennial survey. Of the 1,500 CoC-accredited cancer programs nationwide, fewer than 40% earn Commendation.

Please thank our cancer team and congratulate them on this recognition of their excellence!

Wednesday, September 19, 2018

Saving Lives and Leaving Great Impressions

Last week, we had the formal grand opening of our new Neonatal Intensive Care Unit (NICU), Dr. Timothy Doran, our Chair of Pediatrics, also shared with me an email from grateful parents of babies who were recent patients in our NICU. The email reminded me that I am very fortunate to be the CEO of the GBMC HealthCare system. I get so many wonderful letters, emails, or thank you cards about members of the GBMC family who do marvelous things for our patients. The family had twins, but unfortunately each baby required special care. Happily, after almost eight weeks in the NICU, mom and dad have both babies at home.

Here is an excerpt from a letter I received this week: 
I never in my wildest dreams would have guessed just how big of a role the NICU would play in our lives. When you become pregnant, you imagine a chubby little bouncing baby, healthy as can be. You don’t ever expect that your baby (or babies) will need any extra help after they’re born. When I was told that my babies were going to the NICU, I was sad of course, but I felt content knowing that my little ones were in the best hands possible. We had met with Dr. Pane before they were born, and we trusted her and knew that the team upstairs were more than capable and knowledgeable. I didn’t realize just how much help we would be getting from the GBMC NICU staff. I didn’t realize just how much they had to offer and just how much they could do to help not only these tiny babies, but us parents, too…

I want to thank every single doctor, nurse, nurse practitioner, physician assistant, student, tech, secretary, respiratory therapist, lactation consultant, milk donor, social worker, speech pathologist, volunteer, and even housekeeper that we have had the joy of crossing paths with.

“Thank you” doesn’t even cut it when it comes to how completely grateful I am, but here it goes anyway: Thank you for your knowledge, compassion, understanding, and empathy.

Thank you for always asking how we’re doing, for explaining things in ways we can understand, for answering our questions, for taking our concerns and suggestions seriously and even implementing them in treatment, for always making sure we had everything we needed, and for being a shoulder to cry on/someone we could vent to.

I thank God, every day for the individuals that saved my baby and I thank modern technology and medicine that gives you all the ability to do what you do. I don’t know how you all do it, but I can tell that every single one of you is passionate about these tiny fragile babies and their families.

There will always be a place in our hearts for every single person that we’ve grown to know and love. God bless all of you, and thank you a million times over. ❤️”

Over the last eight years, we’ve been working hard to drive towards our vision. In 2010, we made a clear decision that we would become the healthcare system where everyone, every time, got the care we would want for our own loved ones. Our vision statement talks about physicians leading teams to deliver this. We have had a dialogue among us in the GBMC family that we want the best health outcome and the best care experience with the least waste of time and money, and with the most joy for those providing the care. Our vision is about a relationship between a physician, his or her team, and a patient. It is about a promise to that patient to work with him or her to maximize his or her health. It is about having the time to reflect on patients’ health between visits, to make sure that they are getting what the evidence says will keep them well.

The letter above is a great example of teamwork and rallying around a patient and her family! We need to continue our work to make this happen for every patient, every time. I am very grateful for all the nurses and technicians that this patient thanked and Dr. Maria Pane for exemplifying the kind of expert, compassionate care that we would all want for our own loved ones. I know how hard their work is and I am very, very grateful to them for not forgetting why they do what they do. Our NICU team is moving us closer to our vision. Let me add my thanks to all our GBMC colleagues who are moving us closer every day to our vision.

Neonatal Nurses Day… 
Last Friday (9/15) was Neonatal Nurses Day. It’s a time where we honor our nursing colleagues and celebrate their hard work and dedication. With more than 4,500 babies born at GBMC annually, we are very fortunate to have such a high-level NICU to care for those babies who are born too small, too sick or too soon. Our NICU has an exemplary group of nurses and I want to thank them for all they do.

Environmental Services Week…
Last week was also Environmental Services (EVS) & Housekeeping Week (Sept 9--15) and I want to take time to recognize the contributions of our EVS staff. Cleanliness is everyone’s job at GBMC, but, our EVS staff members are the experts in cleaning who work tirelessly to get the job done. They spend countless hours in their vital role in keeping us clean and helping to prevent infections. There are more than 100 EVS associates working around the clock at GBMC in a variety of roles, servicing over 1.2 million square feet of facility. So, please join me in honoring all the men and women of EVS.

Monday, September 10, 2018

Kosher Pantry Grand Opening

Last Thursday, we held the dedication ceremony for our new Kosher pantry, located near the main entrance of the hospital. The pantry was built to meet the dietary needs of members of the observant Jewish Community.

The pantry was made possible through the hard work and commitment of our Chaplain, Rev. J. Joseph Hart, M.Div., BCC, and Rabbi Pinches Rabinowitz, with the help of Bikur Cholim of Baltimore, a non-profit organization dedicated to meeting the needs of the observant Jewish Community in healthcare settings. Bikur Cholim will stock the room with kosher meals and snacks. There is no charge for the food and observant family members will have special access to the locked pantry.

Kosher Pantry Ribbon Cutting
The pantry has a refrigerator and freezer, separate dairy and meat microwaves, and disposable utensils. It is stocked with non-perishable foods including fresh food options that will be double-wrapped in the refrigerator for Shabbot each Friday. Other amenities include two sinks, kitchen cabinets, a dining table with four chairs, sofas, and lighting fixtures, and prayer/faith and life books.

GBMC has always been welcoming to all members of our community, but we realized over the past few years that we had no options for nutrition of the family members of our observant Jewish patients. It is fitting that we had the grand opening last week as Rosh Hashanah started last night and Yom Kippur is next week.  I want to wish a Happy Rosh Hashanah to our family and friends who are celebrating!

WOW!! What a surprise…
A couple of weeks ago, I talked about our SAFE (Sexual Assault Forensic Examination) program receiving tremendous support from the band Breaking Benjamin. Each member of the group was seen during a recent concert wearing t-shirts that highlighted our program, giving it the visibility it deserves on a big “stage.”

Much to my surprise this week, I was given two electric guitars, signed by each member of the band, from Laura Clary, BSN, RN, FNE-A/P, SANE-A, CFN, CPEN, Clinical Manager of our SAFE program, and Ashley McAree, RN, FNE-A/P, CFN, forensic nurse examiner with our SAFE program. Now, I know what you’re thinking, “Why does he need two?” No worries, I plan on giving one to my son, Mike, who is a huge Breaking Benjamin fan. It’s the least I can do after he invited me to the band’s concert last month.

I want to thank Laura, Ashley, and the members of the band for these special gifts, but most importantly, I want to express my appreciation to all members of our SAFE and Domestic Violence (DV) programs who do so much for victims of sexual assault and domestic violence and in educating the community to reduce these attacks.

Speaking of our SAFE program…
I want to congratulate Valerie Weir, BSN, RN, FNE-A/P, CMSRN, who has been named the new Domestic Violence Coordinator for our DV Program. Valerie has been part of the GBMC family for 17 years and has held many positions across the organization. According to Laura Clary, Valerie brings a unique perspective to her new role as she is certified to care for patients of all ages, who have been victims of sexual assault, rape, child abuse/neglect, intimate partner violence, and human trafficking.  She has been a great asset in aiding the SAFE and DV Programs in expanding their pediatric resources. She is an active member of the Baltimore County Sexual Assault Response Team (SART), as well as the Maryland Child Abuse Medical Providers (CHAMP).

Please join me in welcoming Valerie into her new role!

I would also like to thank Colleen Moore for her many years of service at GBMC. Colleen did an outstanding job in victim advocacy and other support services. Thank you, Colleen, for all your hard work at GBMC and in the community.

Friday, August 31, 2018

The Next Generation of Nurse Leaders

This week, I was very excited to attend the graduation ceremonies for our nurses in the residency program. Twenty-five nurses finished the one-year long program, which was capped off by the presentation of their evidence-based nursing research projects. It was wonderful to see so many smart, well-trained, and dedicated young people who have committed to a career of service to others.

The GBMC HealthCare System is committed to being a learning organization. This requires that we have people, with profound curiosity, who are ready to deeply study our processes and to adjust them based on what they learn. This is the fundamental reason why we do Lean Daily Management every morning. I was so happy to see these young nurses already displaying their profound curiosity. Their projects ranged from ways to optimize scheduling and decrease errors during shift changes to developing best practices for patient bathing to minimize infection. They used evidence-based research to find ways to improve parental-infant bonding in the delivery room and to reduce alarm fatigue.

Sharon M. Rossi, MS, RN, CSSM, Director of Perioperative Services, gave a wonderful keynote address in which she encouraged the graduates to be life-long learners. Sharon also pointed out the need to find time to “recharge” and to never forget to be kind.

There are many careers that are “easier” than being a nurse…but there are few as rewarding. I left the graduation ceremony proud of all the graduates and assured that their futures are bright. The GBMC HealthCare System’s future is bright as well, in large part because they are with us!
Labor Day
As our country celebrates the hard work of the American people this Labor Day holiday, some of us will enjoy a three-day weekend. But, many of our colleagues will be working. Please let me thank all the phenomenal people of the GBMC HealthCare System for their labor towards our vision. 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 to serve others!

Thursday, August 23, 2018

Support from an Unexpected Source

Many people at GBMC know that I am a huge Steely Dan fan. I love jazz and Steely Dan brought the harmonics of jazz to rock and roll music beginning in the 1970’s. What those same people don’t know (and may not believe) is that I have become a big supporter of the band Breaking Benjamin.

My son, Mike, is a huge Breaking Benjamin fan. Mike invited me to go with him to see them at an outdoor venue in Massachusetts, the Xfinity Center, last Saturday. Suffice it to say that Breaking Benjamin is a very high energy metal band and I stood up for all 90 minutes of the concert. I enjoyed the show, but it wasn’t until this week when I learned that Breaking Benjamin are big supporters of GBMC’s SAFE (Sexual Assault Forensic Examination) program that I became a real fan.

Laura Clary BSN, RN, FNE-A/P, SANE-A, CFN, CPEN, Clinical Manager of our SAFE program, told me that recently the members of Breaking Benjamin were seen during a concert wearing t-shirts that highlight our program. These shirts call out the wonderful work that Laura and her team do for the community.

Our SAFE and Domestic Violence programs do so much for the victims of sexual assault and domestic violence as well as educating the community to reduce these attacks. The assessment and treatment of victims of sexual assault is very complex. Expertise and caring are required not only to address the medical and psychological needs of the patient but also to complete the forensic work necessary to aid law enforcement in the identification of the perpetrator to see that justice is served.

I am glad to see our program get the visibility it deserves on such a big “stage.” Many of us are guilty of stereotyping celebrities as being self-centered and uncaring. This certainly is not the case for Breaking Benjamin!

Thursday, August 16, 2018

Level 2 Mistake Proofing

On Lean Daily Management rounds this week we learned of a test of change to improve the rate of washing in and washing out of every Emergency Department room. We have been working on hand hygiene in the inpatient units for some time. We have greater than 90% compliance and we have now begun auditing our performance in the ED.

All the physicians, nurses, and other clinicians know that they should clean their hands upon entry and exit, but sometimes they forget. This has come up as a common cause of the lack of hand cleansing, so Mark Fisher, RN, the Nurse Manager, Shannon Barry, RN, and Amanda Icenroad, RN, Clinical Nurse 4’s, started thinking about how they might improve their team’s performance.

A common action for health care leaders when they see that someone is not doing what they need to do is to re-educate the individual on the process. Re-education is called level 1 mistake proofing. Re-education is a good tool if the person doesn’t know that they are supposed to do something. But if the problem is forgetfulness, then re-education is not of much value.

Mark and Shannon thought long and hard about level 3 mistake proofing. Level 3 mistake proofing occurs when the system makes it impossible not to do the required action. An example of level 3 mistake proofing is when you order something online and the seller needs your 3-digit security code from your credit card. You hit “enter” after putting in your credit card number but not your security code and what happens? You get a screen telling you that you must put in your security code. It is impossible to get to the next step without it. This is also called a constraint or a forcing function. In high-risk endeavors where errors my cause serious harm, engineers always look for level 3 mistake proofing. For example, after some fatalities that occurred when people inadvertently put their car in drive when they meant to put it in reverse, vehicles are now engineered so that you cannot start your car without your foot on the brake.

Mark, Shannon, and Amanda could not come up with a doable level 3 idea that would prevent you from entering or leaving a room without cleaning your hands, so they went to the next best thing — level 2 mistake proofing. Level 2 is not as powerful as level 3, but it is more powerful than level 1. Level 2 mistake proofing provides a reminder in the moment. These reminders are also called affordances. Mark, Shannon, and Amanda decided to create a very colorful sign of dirty hands to put on each ED bay door.

This way when busy, hard-working people are about to enter a room, they have a visual reminder to clean their hands. We applauded them for their thoughtful test of change and we look forward to their results!

Do you have examples of level 2 or level 3 mistake proofing from your unit or department? Please share them below.

Breast Center Earns Three-Year Full Re-Accreditation

Congratulations to the staff of The Sandra and Malcolm Berman Comprehensive Breast Care Center and the Advanced Radiology Breast Imaging Center, which recently were awarded a full three-year re-accreditation by the National Accreditation Program for Breast Centers (NAPBC). This is the center’s fourth consecutive NAPBC designation since it was first accredited in 2009.

The full accreditation program, administered by the American College of Surgeons, is only awarded to centers that voluntarily undergo a rigorous process that includes site visits by experts from the NAPBC, as well as an intensive review of the center’s records. Earning this accreditation means that our Breast Center is held to the highest standards for the quality of care we provide for patients with the full spectrum of breast disease and that we offer patients a multidisciplinary team approach to diagnosis and treatment and state-of-the-art treatment options.

Any hospital or program can say it provides excellent care, but with this accreditation, we have earned this designation for excellence under the scrutiny of experts, which speaks volumes about the high quality of care all members of the Breast Center and Breast Imaging Center teams provide for our patients with breast disease. And that’s great news for GBMC and for the community we serve.

Dr. JoAnn Z. Ioannou Delivers Hopkins School of Nursing Graduation Keynote Speech

It’s not every day that a world renowned top academic nursing program invites someone from a community hospital to speak at graduation, but the Johns Hopkins School of Nursing clearly shares our admiration and respect for JoAnn Z. Ioannou, DNP, MBA, RN, NEA-BC, our Senior Vice President of Patient Care and Chief Nursing Officer. Dr. Ioannou was the keynote speaker at the August 6 degree completion ceremony for students who had earned advanced degrees in nursing.

A graduate of Hopkins’ Doctor of Nursing Practice program, as well as the university’s MBA and MSN programs, Dr. Ioannou worked in a wide range of nursing roles at Hopkins for 23 years before she joined us at GBMC three years ago. In her speech, she shared the story of her journey from the bedside to nursing leadership, how her mother inspired her ongoing commitment to education, and the many challenging and rewarding paths that the graduates could choose to follow—direct care provider, nurse educator, nurse researcher, and nurse leader. In her closing remarks, she encouraged the graduates to “…continue to collaborate to improve the field of nursing any way you can” and reminded them “…doors will open when you persevere…You will be solving problems that don’t even exist yet.”

You can watch the whole speech here.

The Daily Record Recognizes GBMC

GBMC was recently recognized by The Daily Record in its 2018 Reader Rankings in the categories of Best Hospital and Best Health System. Readers of the publication cast more than 12,000 votes in 60 categories. We’re grateful that the community members we serve are pleased with the care and compassion that our staff shows to all our patients and their families.

Friday, August 10, 2018

“Well, Usually” Revisited

I have been reflecting recently on how far we have come in the quest to achieve our vision of providing the care we would want for our loved ones to every patient, every time. This goal is lofty, and I must keep reminding myself of this. With the aging of the population, people’s needs are growing, and we do not control the entire system of care – we struggle to meet the needs of those with serious behavioral health problems. We have designed so many improved processes like Gilchrist’s entire elder care system, our patient-centered medical homes, our ERAS (Early Recovery After Surgery) program, and so many more.

But we still have work to do. Recently, I was with a clinician and I asked her the “how do we do it” question when I wanted to learn more about one of our processes that did not seem to be highly reliable. My colleague started her response with “Well, usually we …” I knew immediately that we did not have standard work and that many hard-working people were doing it whichever way felt right to them. In a tightly coupled, complex system, a small deviation in one area can cause huge problems downstream. Many of us, including myself, were not trained in the importance of following system design so that we get predictable results. Instead, we learned to do whatever felt right to us in the moment. Standard procedures don’t always work for every patient, but when possible, processes must be standardized and followed. This is critical to creating consistent results for our patients.

Do you know the song This is how we do it, by Montell Jordan? (No, I’m not talking about partying). We need more of us able to state, “this is how we do it” when asked how we complete a task. Then we will move faster towards our vision!

New Parking Rules in Effect on Monday, August 13th
Starting this Monday, August 13th, the decentralized parking model will take effect and all new gates at the garages will be activated. All GBMC employees have been assigned a home lot or garage and will be able to “tap and go” their badges to enter and exit our medical campus. Your GBMC ID badge will be automatically programmed to function at your assigned parking lot or garage’s reader, and stickers will still be issued to monitor compliance at free parking areas such as the Bluebell and the Labor and Delivery parking lots, which will remain patient-only parking.

I want to remind all staff to tap their badge on the card reader at their assigned garage prior to Monday. If the card reader light does not turn green after you tap your badge, please contact Robert Cole at rcole@gbmc.org and Karalyn Stitcher at kstitcher@gbmc.org from the badging office. If your badge is not active prior to August 13, you will need to use a ticket and contact the badging and parking office. The following parking assignments will be in effect:
All offsite staff, volunteers, physicians, and board members may park in any garage or parking area, EXCLUDING “patient only” spaces.
All employees may park in Tulip (PPN) or Lily (ED Garage) at any time, any day of the week, EXCLUDING “patient only” spaces.
All employees may park on Farmhouse Hill at any time, any day of the week.
All employees working in PPE may park in PPE, EXCLUDING “patient only” spaces.
All employees working in PPW may park in PPW, EXCLUDING “patient only” spaces.
Only employees working in South Chapman may park in South Chapman (between the hours of 6 am to 5 pm).
After 4 pm, all employees may park in all garages.
On Saturdays, PPE and PPW will be open to all staff.
On Sundays, all gates are up on all garages.
Complimentary passes will continue to be accepted.

Again, employees should never park in Rose park or Bluebell park or park in "patient only” spaces. Any employees found parking in these lots will be towed.

These changes are needed to make the entrance to our campus safer for vehicular traffic and to reduce delays when entering and exiting from our grounds. They will also improve parking accessibility for our patients. I want to thank Stacey McGreevy, our Vice President of Support Services, and her team for working very hard to make the transition as easy as possible for our people.

Thursday, August 2, 2018


Last week, I talked about our summer Town Hall meetings, what their purpose is, and why it’s important for our workforce to be informed about what’s happening in our healthcare system. This week, I want to outline some of facility improvements here at our hospital as well as some other changes happening outside of our medical campus.

Over the last several months, the top two floors of the William E. Kahlert Physicians Pavilion North have been under major construction as we prepare to make it the home for a large physician practice and an ambulatory surgery center for Chesapeake Urology. The surgery center on the sixth floor will be up and running in a few months, and the practice will have a brand-new office suite on the fifth floor. The practice currently has three doctors on our campus and this expansion will allow them to increase to 10 to 15! This is a great step forward for our medical campus.

The new NICU officially opened in June and if you haven’t stopped by to look, I highly recommend that you do so! I am extremely proud of the NICU team, who worked incredibly hard, was very patient with leadership, and collaborated with the architects to design the space. The new NICU provides individual, private spaces for babies and their families. Each of our new 13 rooms will allow for an individualized environment in terms of lighting, temperature, and sound. For more information, check out one of my recent blog posts. It took us a while to finish this project, but I believe the final result was worth the wait. 

Speaking of new, we have a modern and beautiful Orthopaedics office, located on the seventh floor of our Physician Pavilion West. It’s modeled after our Family Care Associates Practice in Pavilion North and it allows us to take walk-in patients, during weekdays and evenings, for injuries. So, let’s say one evening you twisted your ankle and you don’t want to go to the emergency department (ED), now you can go straight to the Orthopaedics office.

Recently, we also signed a contract to partially own a one-room ambulatory surgery center (ASC) in Cockeysville. We’ve been fighting the impetus to create a free-standing ACS because we want to do the right thing by the community — Baltimore has plenty of operating rooms, with one on almost every street corner.

We are becoming part-owners in the surgery center because we do not receive additional revenue when we do more surgery at the hospital and because the patients don’t want to pay higher hospital rates when they can get the surgery for less in an ASC.

Our OR Simulation Lab is a recent addition that is greatly beneficial to our surgeons and patients. The lab is a comprehensive training center, which consists of a lab focused on task-based training and replica hospital rooms created to imitate real-life settings. Participants can train for almost any medical situation from inserting an IV, to performing complex surgery, to practicing difficult conversations with patients. The Simulation Center is a critical part of GBMC Healthcare System’s continuing education program which helps the staff grow their skills and adapt to evolving medical techniques and technology.

I’ve been promising a gym on the campus for several years and this week we held an open house for our new Fitness & Wellness Center. Some of you remember that we had a gym on our campus many years ago, which was converted to a surge center. Now it’s been converted back into a gym. Starting August 6, this facility, located by the South Chapman building, will be open 24/7 and is for employees ONLY at a cost of $9.00 per pay period. In the past, many employees said that they would like a place to exercise before or after work. We heard you and I want to thank Anna-Maria Palmer, Vice-President of Human Resources, and Stacey McGreevey, Vice-President of Support Services at GBMC HealthCare, for making this happen. 

We are officially opening our Kosher Hospitality Room this September. The pantry, located by the main entrance of the hospital, was built to meet the dietary needs of Observant Jews who follow a Kosher diet and who have come to the hospital to visit a loved one. It’s evident that GBMC serves many Orthodox and kosher-observant Jews and the main goal of the on-premises kosher food pantry is to help ease the hunger and lift the spirits of concerned family members whose relatives are suffering from illness or injury.

Lastly, we’re thrilled about the grand opening of the new Kroh Endoscopy Center, slated for next year. The Center will be located where Sherwood Surgical Center was previously situated. It’s still under construction. There will be more to come on this as we get closer to the grand opening in January 2019.

It’s safe to say that it’s been a busy year.  I hope you are as excited as I am about the changes taking place with our healthcare system.  Let me know what you think.

Play Ball!!!!

Despite the inclement weather, we held our third annual GBMC Night at The Yard Event. I hope all of those who attended the event had a lot of fun! Having the Orioles win that night, with Tim Beckham (our special guest for our Birdland Social Media Night) hitting a home-run added more joy to an already festive event.

Friday, July 27, 2018

Highlighting Our System of Care at Town Hall Meetings

Since late June, we’ve been doing Town Hall meetings. These meetings are an attempt, as I mentioned in this blog a few weeks ago, to narrow the gap between what the frontline staff knows and what the front office knows. The meetings are meant to be two-way communications, a sharing up and down of information.

As part of my presentation, I discuss that we have built a community-based system of care that the patient experiences as a system. It is not perfect, but we should be proud of what we have accomplished. A core building block of our system is the patient-centered medical home. The medical home delivers advanced primary care. Advanced primary care is different than typical primary care. In both models, there are excellent physicians and advanced practitioners and other office staff who care about you and work hard. But advanced primary care is designed to be accountable with you for your health. In advanced primary care, the team, led by a physician, commits to overseeing your health over time. It’s not about a visit, it’s about a relationship. The team includes a nurse care manager, who helps the team stay focused and manage those with chronic disease. The team reaches out to patients to make sure they have a plan and are following the plan. The team connects the patient to specialists when needed. In advanced primary care, there are extended hours of operation, disease-state registries, and many processes designed to check back with the patient (like a phone call after every visit to an emergency room or after an inpatient hospital stay). In advanced primary care, there are also addiction specialists, master’s-prepared behavioralists, and psychiatrists as part of the team. None of this is available in typical primary care. Once again, the physicians and the rest of the office staff in typical primary care are wonderful and work hard, but they don’t have the resources and they are not designed to operate like advanced primary care. In typical primary care, you are more likely to be on your own if you are sick and the office can’t accommodate you. This is when you are left with the choice of going to an Emergency Department for a non-emergency or to an urgent care center, where people will not know you and you will not know them and it is unlikely that they will have your medical record. In advanced primary care, there is a commitment to see you when you are sick. We should all be very proud of advanced primary care!

The State of Maryland is embarking on a new plan to help more primary care physicians get closer to advanced primary care. The program, called the Maryland Primary Care Program https://health.maryland.gov/mdpcp/Pages/home.aspx, will allow primary care practices to enroll and get help from care managers and others, to do what we have been doing in our system. The support for physicians who don’t have the resources to do it themselves will come from new entities called Care Transformation Organizations (CTO). GBMC, through our Greater Baltimore Health Alliance, is applying to become a CTO. Stay tuned!

Congratulations to our Diabetes and Nutrition Center!
Hats off to our Geckle Diabetes & Nutrition Center for being recognized by the American Diabetes Association (ADA) for meeting the national standards for diabetes self-management education. This program has been in existence for over 25 years and has provided patients with education about the disease and how to properly manage symptoms to improve their physical and emotional health.

The ADA Recognition is a four-year certificate awarded to programs that offer high-quality diabetes education services. All approved diabetes education programs cover information relating to the disease, including: nutritional management, physical activity, medication management, and the monitoring, preventing, detecting, and treating acute and chronic complications.

According to the ADA, patient self-care is an essential component of diabetes treatment. Through the support of the healthcare team and increased knowledge and awareness of diabetes, the patient can assume a major part of the responsibility for his or her diabetes management. Unnecessary hospital admissions and some of the acute and chronic complications of diabetes may be prevented through self-management education.

The Geckle Diabetes Self-Management Education Program is available for anyone with diabetes who wants to learn how to manage their new diabetes diagnosis or better manage their current diabetes status.

Congratulations again for this achievement!

Friday, July 20, 2018

Getting the Word Out about the GBMC HealthCare System: It’s Not Your Father’s Marketing Plan

Over the last few years, our marketing department has done an excellent job promoting the GBMC HealthCare System on social media channels like Twitter, Instagram, LinkedIn, and Facebook (more on this below). You may not think about a hospital having a significant social media presence, but GBMC HealthCare is trying to change that for our patients, employees, volunteers, and other members of the community.

Facebook Live is the largest live streaming social media platform with over 1.7 billion Facebook users worldwide. In the last 18 months, GBMC has produced more than 100 Facebook Live shows, which serve as valuable content on our redesigned website, GBMC.org. The shows originate on Facebook and feature a variety of GBMC experts, services, and volunteers. GBMC’s marketing team has established partnerships with local television and radio media to produce content that highlights the great work being done at GBMC. This platform has enabled our healthcare system to build a bigger audience by making professional broadcasts that are richer in style and content. The key here is to go where people’s attention is and include them in the conversation. We’ve used the many advantages of Facebook Live to engage hospital patients and our followers through active listening, real-time feedback, and viewer participation.

We have monthly programs called “To Your Health” and “Greater Living Live,” which provide Facebook viewers and live-studio audience members with information on clinical and surgical services as well as other health and medical initiatives within the GBMC HealthCare System. It’s been a great avenue to promote subjects and specialties that don’t often receive coverage on local and regional broadcast news or print. I encourage you all to watch our previous shows by visiting https://www.youtube.com/user/GBMCMedia and to look for future shows on the GBMC Facebook page. I am sure you will enjoy them and learn more about GBMC!

One unique aspect of our social media strategy is the monthly “Healthy Cooking Demonstration,” featuring Mike Salamon, a chef who is also a bariatric surgical patient, and Jana Wolff, RD, LDN, the Director of Nutrition from GBMC’s Comprehensive Obesity Management Program. Mike and Jana prepare a healthy meal on their show and encourage viewers to post questions and feedback throughout the thirty-minute demonstration. The recipes are then posted on https://www.gbmc.org/greater-living for anyone who would like to refer to them.

In addition to a significant Facebook presence, GBMC’s second most popular social media platform is LinkedIn. LinkedIn provides a great opportunity to share departmental and staff accomplishments with potential job seekers and employees alike. GBMC is also very active on Twitter and Instagram, delivering messages to help guide patients to our services, provide helpful health information, and recognize our talented staff and volunteers.

Our social media strategy encourages two-way communication between our workforce and customers, who are encouraged to “join the conversation” virtually through Facebook Live events or in-person by attending live studio audience opportunities.

We are excited about the future of GBMC’s social media presence and we invite you to follow us on all of our social media platforms!

Facebook: @gbmcmedia
Instagram: gbmchealthcare
LinkedIn: gbmchealthcare
Twitter: @gbmchealthcare
Pinterest: gbmchealthcare

Thursday, July 12, 2018

Good Food, Hula Hoops, and Karaoke

On Tuesday, we had the 2018 Employee and Volunteer Appreciation Luau. This event was a great opportunity for the GBMC family to come together and celebrate what we’ve accomplished as a healthcare system while also having some fun! We cannot reach our vision without a fully engaged workforce, and can’t have a fully engaged workforce unless people feel appreciated. Our fourth Aim  ̶  More Joy — requires that we take time to have some fun. There’s no doubt that the work of healthcare is hard and requires self-sacrifice and dedication.

The luau came in the middle of GBMC Spirit Week, a time for us all to show the pride we have in our organization and our caring for each other. This year, to accommodate all members of our workforce, we started the festivities earlier than usual and we made sure that we offered similar activities to our hospital night shift employees, Gilchrist, and our off-site locations.

The barbecue began at 11 a.m. and hamburgers, hot dogs, veggie burgers, BBQ chicken, watermelon salads, desserts, and beverages were served by Rouge Catering. The Kona Ice truck was also on site providing shaved ice for a cool treat.

Everyone enjoyed the music, good food, luau-themed games, a surprise visit from the Oriole Bird, and having a relaxing time with friends and colleagues. Many enjoyed participating in or watching the hula hoop contest, relay race, egg toss, and the flamingo ring toss. We assembled again from 10 p.m. until midnight to BBQ and play games with the night shift staff.

We also hosted a Legacy Chase Hat Contest in which teams decorated wide-brimmed floppy hats to show support for Legacy Chase and the Oncology department. A huge thank you to all the departments, units, and practices who participated! There were 27 hats submitted, and attendees voted on their favorites in three categories: Best Legacy Chase (Equestrian) Theme, Best Cancer Awareness Theme, and Best Department/Unit Theme. I hope many of you voted for your favorite!

Here are the winners in each category, pictured below from left to right:

From left to right: Best Legacy Chase (Equestrian) Theme submitted by Nursing Education; Best Cancer Awareness Theme submitted by The Milton J. Dance, Jr. Head & Neck Center; Best Department/Unit Theme submitted by The Emergency Department

We also had raffles and games sponsored by departments raising money to win a tent at Legacy Chase!

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 event! Special thanks to Kim Davenport from Marketing, Shannon Baumler from Philanthropy, and Tina Hughes from Human Resources for their hard work on this event, beginning early in the morning and stretching all the way through the night shift.

It was a great opportunity to celebrate together and leave our work behind, even if only for an hour or so. I am honored to be a part of the GBMC HealthCare family and I am very grateful for all that our people do. I am delighted to show my spirit. 

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

What did you think about the luau?

Congratulations to Dr. Celano!

As we celebrated at the GBMC employee and volunteer recognition luau, I am pleased to share some wonderful news from a donor who also recognizes the hard work that you do. In July, the Samuelson Foundation made a generous pledge to name in perpetuity the Herman and Walter Samuelson Medical Director of The Sandra and Malcolm Berman Cancer Institute held by Dr. Paul Celano. The trustees of the Samuelson Foundation made this gift to show their appreciation for the remarkable job that physicians, nurses, and the entire staff of GBMC does to provide cancer patients with evidence-based and compassionate care.

Friday, July 6, 2018

Summer Reflections

I was very fortunate to be on vacation this week, spending time with extended family members and friends who I hadn’t seen in a while. On the Fourth of July, I was thinking about the Declaration of Independence and that “all men are created equal with certain inalienable rights, among them Life, Liberty and the pursuit of Happiness...” I believe that healthcare is a right that allows us to live life to the fullest and to pursue happiness.

When we gather with friends and family, we discuss all the happenings since our last visit, - both good and bad. Inevitably we discuss illness, who was just diagnosed with what disease and how they are coping. These conversations always bring me back to GBMC HealthCare and our vision of being the community-based healthcare system that can deliver the quadruple aim to every patient, every time.  It is a very noble cause, which I am so fortunate to be part of along with my 3,000+ colleagues.

So, I am going to spend a few more days away enjoying family and friends, the beach, some good meals, good music (of course Steely Dan and the Doobie Brothers), and then return to GBMC recommitted to help move us closer to our vision.

Friday, June 29, 2018

Communicating in a “Large” Company

I think of our healthcare system as being small, which is good because we can change faster than bigger companies in our industry. On the other hand, with more than 3,000 employees, we are a pretty big organization and trying to make sure that all of our people know what we are trying to do and what is changing is really difficult. There is no one good way to communicate. So, we use many methods. One of those methods is the Town Hall Meeting.

This week, we started our summer Town Hall Meetings. These meetings attempt to narrow the gap between what the frontline staff knows and what the front office staff knows. The meetings are meant to be two-way communications, a sharing up and down of information. The bigger the group, the harder it is to make this happen.

One of the goals of holding these Town Hall Meetings is for our employees to come away feeling informed about our healthcare system and what is going on around it. These meetings are a place to learn more about your role in moving us closer to our vision and are one of your opportunities to have your opinion heard.

We welcome everyone to come with questions and ideas, and I encourage all GBMC staff members to attend at least one of the 12 scheduled meetings that run through August 14 on the GBMC campus, in Owings Mills, and at the Gilchrist headquarters. I am willing to come at other times and to other locations. If you wish to schedule a session, please call Tina Hughes at ext. 2495.

Some of the important topics we will be covering include:
An update on our system performance
The results of our recent employee engagement survey
Facilities improvements
The new fitness center on campus

The detailed schedule is available on the GBMC HR’s InfoWeb page.

Again, these meetings provide an opportunity to ask questions, raise issues, share information, and clarify key objectives. If you would like to submit a question prior to the meeting, please submit it via email to Tina Hughes at cdhughes@gbmc.org

All are encouraged to attend!  The value of these meetings is directly related to your participation, so we look forward to seeing you there!  Please mark your calendars!

New NICU Opens Its Doors
On Wednesday, we officially started treating patients in our new NICU. Here are a couple of photos from Day One. Again, I want to thank Howard Birenbaum, MD, the NICU medical director, Drs. Maria Pane and Sabah M. Helou, and our incredible nursing staff, led by manager Kristin Trawinski, as well as our pediatricians, nurse practitioners, and talented and dedicated therapists who provide the best care to our tiniest patients.

Tragedy In Annapolis
We are all sad to hear about the tragic event that took place at The Capital Gazette newspaper in Annapolis. We extend our deepest sympathies to the family, friends, and colleagues of those killed and injured in yesterday's event.

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. 

Friday, June 22, 2018

Helping the Tiniest of Our Patients

For years, GBMC has been called “the baby hospital.” We are known as a premier birthing center, but we are also an outstanding center for the care of premature and sick babies. Our Neonatal Intensive Care Unit (NICU) treats roughly one in ten of the 4,000 babies born at GBMC annually.

On Tuesday, June 26, GBMC will officially open the doors to a new NICU that will allow us to continue to achieve excellent clinical outcomes in a state-of-the-art setting.

The new NICU will provide individual private spaces for babies and their families. Each of our new 13 rooms (10 single and 3 multiple-birth rooms) will allow for an individualized environment in terms of lighting, temperature, and sound.

Now, with this new NICU, we will provide an enriched environment for the infant and family to complement the leading-edge care provided to these highly vulnerable patients. We anticipate that the new NICU will further promote the short- and long-term clinical outcomes we are proud of at GBMC. As a member of the Vermont Oxford Neonatal Network (VON), we can compare our own outcomes annually as well as with a universe of tens of thousands of low birth weight infants each year.  Here are some key examples:

  • Utilizing VON definitions, we have reduced our incidence of chronic lung disease in very low birth weight babies by 75 percent since 2002.  These improvements were the result of our group adopting a standardized approach to the initial support and management of these infants, avoiding intubation and mechanical ventilation, improving nutrition, and adhering to tighter parameters for the provision of oxygen. For several of the past years, none of our babies were discharged home on supplemental oxygen therapy.  These quality improvements have been published in Pediatrics and other journals, and continue to be referenced in other peer-reviewed publications.

  • Similarly, with our improvements, our length of stay has also fallen significantly during the same period, and on average about 10 fewer hospital days than that of VON.

We know we have outstanding neonatologists, including Howard Birenbaum, MD, the NICU medical director, and Drs. Maria Pane and Sabah M. Helou.  We are also fortunate to have an incredible nursing staff is led by manager Kristin Trawinski, pediatricians, nurse practitioners, and talented and dedicated therapists. None of this though would be possible without the phenomenal support of our community, which over the past 30 years, has provided us with the financial assistance to provide expert around-the-clock, comprehensive care to our tiniest patients.

This past Sunday, I ran in our 30th annual Father’s Day 5K. As always, it was great to see so many parents of former NICU babies, as well as so many other people from the community and the GBMC staff, come out and participate in this terrific cause.

This year’s event, once again presented by the GBMC Volunteer Auxiliary, was incredible because it raised $184,000 towards the $4 million cost of the newly renovated NICU!  I want to thank the more than 700 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.

Lastly, I want to thank everyone involved in our community Wellness Village, which featured health-related vendors. Additionally, MIX 106.5 Radio was on-site with its Friends and Neighbors van playing music and sharing prizes. Great work, everyone!!!

Thursday, June 14, 2018

Do you see the clutter?

On Wednesday, we were walking through the Pediatric Department and we saw the 6S that was going on in the supply room. You will recall that 5 (or 6) S stands for sort, separate, shine, standardize, sustain, and (#6) safety. Everything was in its proper place, beautifully labeled, and easy to find. Having items arranged and organized is fundamental for a high-performing unit or department. When things are not in their place, people waste time and effort looking for them. In addition, when spaces are cluttered, various items may be in the way, which can potentially lead to harm. 

Last week, one of our employees was injured after crashing into a chair that was obstructing her path. This injury could have been avoided if the chair had been placed where it belonged.

When things are routinely left in random places, we get “immunized” against seeing the disarray…we begin to accept it. On the same day, I was walking on another unit of the hospital and found two stretchers in the hallway. This hallway would be an exit route from the unit if there was a fire! I informed the local manager who told me that he would have them moved immediately, but this was not the point. I wondered who had left the stretchers there and how many people had passed them by without removing the safety hazard? Did people not “see” them? Or were some people leaving them there as hoarders because they did not trust the hub to send them back expeditiously when they were needed?

What do you think? Please let me know by commenting below. Thanks.

Congratulations Laurie Beyer!

Becker's Hospital Review has named its 150 Hospital and Health System Chief Financial Officers (CFOs) to Know, and our very own Executive Vice President and Chief Financial Officer, Laurie R. Beyer, BS, MBA, CPA, made the list. She has served as CFO for the GBMC HealthCare system since late 2017. According to Becker’s, the executives that were recognized across the country lead financial departments for large health systems as well as small community hospitals and play an integral role in their organization's strategic planning, growth and transactions. They have also been recognized by their peers and serve on the board of directors for community organizations.

Celebrating Survivorship

Last week, I was delighted to be with over 400 cancer survivors, their caregivers, friends, and family members as they celebrated life at our annual Cancer Survivorship Celebration.

This annual event provides an opportunity to commemorate our patients’ courage and our caregivers' commitment to their treatment. Every year, more than 2,000 individuals 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 recognized both locally and nationally 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!

Closing Time…

Voting for this year’s BALTIMORE Magazine: TOP DOCTORS issue is wrapping up soon. Docs, if you haven’t done so already, please vote for the colleagues that you most respect by NO LATER than Monday, June 18th! The survey can be found at: http://www.baltimoremagazine.net/about/top-doctors-survey

I’m sure your colleagues will greatly appreciate your vote! Thank you.

Monday, June 11, 2018

From Usually to Always

Imagine you are on a commercial flight from Baltimore to Chicago. The co-pilot comes out of the cockpit and you engage him or her in a conversation. You ask the co-pilot to tell you about the process for determining which runway to land on and the co-pilot says: “We usually get our instructions for the landing from the air traffic controller, but sometimes the captain likes to bypass the system and we pick the runway ourselves…it’s usually faster.” What would you think? Ok, I know that this is a ridiculous example of an unreliable system (reliability= what should happen happens and what should not happen, doesn’t). But you get the point.

Healthcare can be as high-risk as commercial aviation. It wasn’t too long ago that everything in healthcare was done the way that the most powerful person in the decision wanted it done that day. We are in a much better place today. As an example, we have nearly eliminated catheter-associated urinary tract infections by standardizing the process, according to the evidence of what works best, how a catheter is put in, how it is maintained, and when it comes out. There are some things in healthcare that shouldn’t be standardized because there is no one best way or there is no evidence as to what works best. Patients are not all the same and not everyone will benefit from the same therapy. But to leave time to make these more difficult decisions, we should standardize what we can.

On Lean Daily Management Rounds, we are often asking what is our standard work. When we get an answer that starts: “Well, usually…”, we know that we have not created standard work, people don’t know that we have created it, we have not properly enrolled them in the standard work, or we are not holding them accountable.

What examples do you have of what should be moved to standard work? Please let me know below. Let’s move more things from usually to always!

GBMC Wins Award for Diversity
I am proud to announce that the GBMC Healthcare System was a recipient of this year's Rouse Excellence in Diversity Award. The James W. Rouse Diversity Award is presented annually by the Chesapeake Human Resources Association (CHRA) to a local organization which best exemplifies an attitude and environment of acceptance and inclusion. James Rouse was dedicated to diversity and CHRA's Rouse Diversity Award was established to honor his memory and vision of building a better way to live and work through diversity, which was embodied in his many nationally known urban redevelopment programs.

At GBMC, we know the importance of being inclusive and welcoming everyone to join our family. We were selected for the award because of our Celebration and Education Initiative, which provides employees with experiences and resources that incorporate celebrating diverse cultures and learning about diversity and inclusion. Components of this initiative include: monthly cultural celebrations, a calendar of celebrations and events, an annual corporate competency, orientation presentations, and other learning and development initiatives promoting a diverse workplace.

I want to congratulate GBMC’s Diversity & Inclusion Council and our Director of Diversity and Inclusion, Jennifer MaraƱa, Ph.D., for their leadership and for receiving this award.

Decentralized Parking Project Update 
What’s Completed?
The utility rough-ins, concrete islands, and road work have been completed at the South Chapman lot(s), F-Lot/Valet lot, Tulip (PPN) Garage, Lily (ED) Garage, and Rose lot. Most of the new parking control equipment has been set at these locations but will remain inactive until all the parking areas are completed.

What’s in Progress?
Daffodil (PPW) Garage is currently closed for the parking infrastructure installation and is scheduled to be re-opened on Tuesday, June 12th. The installation of the equipment at the parking areas as well as the pay-on-foot stations inside of the buildings will continue throughout the month of June.

What’s Next?
Iris (PPE) Garage will be closing on Wednesday, June 13th for approximately 3 weeks to complete the utility rough-ins, concrete islands, widening of the entrance/exit, and installation of the equipment. As equipment gets placed throughout campus, work is also completed to connect the equipment to the hospital’s electrical, network, and security systems and test it for proper operation.

Friday, June 1, 2018

Global Budgets: A Way to Save Rural Hospitals?

This week, I participated in a conference at the Johns Hopkins Bloomberg School of Public Health (JHBSOPH) entitled: State Policy Academy on Global Budgeting for Rural Hospitals. I was invited along with three other healthcare leaders: Leslie Simmons from Carrol Hospital, Joe Ross from Meritas, and Barry Ronan from Western Maryland Health System. The conference included an address from the new Executive Director of the Centers for Medicare and Medicaid Innovation, Adam Boehler, and a panel discussion that included Donna Kinzer, the Executive Director of Maryland’s Health Services Cost Review Commission (HSCRC).

The goal of this meeting was to educate healthcare leaders from other states who are looking for ways to support their rural hospitals. My friend and colleague, Dr. Joshua Sharfstein, JHBSOPH’s Vice Dean for Public Health Practice and Community Engagement, gave a compelling argument in favor of guaranteed global budgeting for rural hospitals. He cited Maryland’s success with this strategy and the fact that there are over 800 rural hospitals in America at risk of closing. Small hospitals cannot withstand variability in demand for their services in a fee-for-service world, and yet our citizens need dependable access to healthcare.

We met with leaders from Delaware, Pennsylvania, New Mexico, Hawaii, Colorado, and several other states and told them about our ability to increase - funds to services and programs that are truly needed but are not reimbursed adequately in fee-for-service.

I learned a lot about the challenges of rural healthcare and I have great respect for people who are helping this underserved group of Americans. Pennsylvania will implement global budgets for rural hospitals beginning in January 2019. It will be interesting to see how this works and if other states also give it a try.

Stroke Center Award
I want to congratulate our Primary Stroke Center which recently received the Gold Plus Quality Achievement Award from the American Heart Association/American Stroke Association. This award recognizes us for our commitment to ensuring that stroke patients receive care based on the latest scientific evidence. We earned this recognition by meeting specific quality requirements for the diagnosis and treatment of stroke patients, which will increase their chances of maximal recovery and lower mortality.

We also received the Target: Stroke Honor Roll. To qualify for this recognition, we must meet quality measures developed to reduce the time between the patient’s arrival at the hospital and treatment.

These awards are the result of the hard work and expertise of our entire stroke team and demonstrate GBMC’s high level of commitment to caring for stroke patients. Great work, everyone!

Friday, May 25, 2018

GBMC Recognized for Excellence

The GBMC HealthCare team has recently received several awards. The American Association of Critical-Care Nurses (AACN), the world's largest specialty nursing organization representing the interests of more than a half-million acute and critical care nurses, recently recognized our Medical Intensive Care Unit (MICU) with a silver-level Beacon Award for Excellence. Our hospital is just one of five in Maryland to achieve this prestigious recognition.

This award recognizes the incredible contributions that have been made by the MICU staff members who are driving us towards our vision daily. They don’t rest on their achievements; they ask how they can make the clinical outcomes and care experience of their patients even better. It takes teamwork and a strong culture of improvement to earn this recognition.

I am truly honored by and proud of our magnificent MICU staff. Congrats to Rachel Ridgely RN, the MICU Nurse Manager, Monica Goetz, MSN, RN, CCRN, our Assistant Director, and all the MICU team!

Kudos to Our Lactation Support Team
GBMC was also acknowledged by the International Board of Lactation Consultant Examiners (IBLCE) and the International Lactation Consultant Association (ILCA) for excellence and dedication in supporting and promoting breastfeeding.

The IBCLC Care Award is reserved for hospitals and community-based facilities that protect, promote, and support breastfeeding. Specific criteria include having dedicated lactation specialists available five to seven days per week for breastfeeding families and having staff that is currently IBCLC (International Board-Certified Lactation Consultant) certified. This recognition validates the efforts being made by our multi-disciplinary team of nurses, nursing support technicians, lactation consultants, obstetricians, midwives, pediatricians, and anesthesiologists to provide breastfeeding mothers support prenatally, during their hospital stay, and beyond discharge.

GBMC is one of three hospitals in the Baltimore region to receive this designation until the year 2020!  Congrats to Jodie Bell, BSN, RNC, IBCLC, Assistant Director of GBMC’s Women’s and Children’s Services, and her colleagues for their strong commitment to our patients.

Gilchrist Named a Great Place to Work
Gilchrist was recently certified by independent analysts as a Great Place to Work®. Gilchrist earned this distinction based on feedback from their recent Great Places to Work/Best Workplace in Aging employee survey. Cathy Hamel, President of Gilchrist and Vice President of Continuing Care at GBMC, feels that being named a “Great Place to Work” is a ringing endorsement of the employee culture at Gilchrist. This award will greatly enhance recruitment efforts to attract more of the outstanding, compassionate employees that make Gilchrist so special. I couldn’t agree more. Well done, everyone!

ACR Ultrasound Accreditation
The American College of Radiology (ACR) recently awarded GBMC with a three-year term of accreditation in ultrasound. I am pleased to let you know that we passed with flying colors, and not one deficiency was noted on any of the cases submitted for review. Accreditation by the ACR is approved for 1st Trimester OB, Gynecological, General, Pediatric, and Vascular (Peripheral, Cerebrovascular, Abdominal, Deep Abdominal). This accreditation wouldn’t be possible without the commitment of our sonographers, who are required to maintain ongoing continuing education to ensure they are current in their field. I’d like to congratulate Tracey Stroosnyder, Clinical Supervisor, and her whole team on this accomplishment.

Great job, GBMC Ultrasound!!!

GBMC Awarded for Including Minority-Owned Businesses
Over the last year, our Construction Management Department has worked to improve our inclusion of minority business enterprises within our construction process. Last fall, we held a minority business fair and conducted interviews with several companies that had an interest in partnering with GBMC HealthCare. Because of this intentional work, we now have several minority-owned companies on our pre-approved contractor list. In recognition of our efforts, GBMC was awarded Best Healthcare Provider for Minority Business Enterprises from the Maryland-Washington Minority Companies Association. I want to commend Stacey McGreevy, CPA, Vice President of GBMC HealthCare Support Services, and Russ Sadler, GBMC Capital Resources Manager, for this noteworthy recognition.

Honoring Our Heroes
Monday is Memorial Day, a special day when we honor those who have given their lives during military service to our country. Many of our GBMC HealthCare System employees have family members serving in the armed forces. Some are veterans themselves. So, on this Memorial Day holiday, let’s make time to honor all our veterans and their commitment to safeguard our security and be mindful of our heroes — living and deceased. Let this be a moment to recognize our nation’s champions with appreciation and respect.

Tragedy Strikes Our County
Earlier this week, we were saddened to hear the news that a Baltimore County police officer was killed in the line of duty. Our condolences and prayers go out to the family of fallen patrol officer Amy Caprio and her fellow officers at the Baltimore County Police Department. As members of the community, we must remember and be thankful for all those who risk their lives to keep us safe.