Warmly Greeting and Thanking Our Anesthesia Team

GBMC has always had a very strong medical staff, comprised of a mix of private practicing and employed physicians and advanced practitioners. We are thankful for all our providers. Over the years, we have needed to employ more of our staff, as the economics of delivering care have changed.   

Today, I’m excited to talk about the latest specialty we have added to our group of employed providers: Anesthesiology. Often in healthcare, anesthesia services are contracted out, meaning a hospital works with another company to meet the anesthesia staffing needs of its operating rooms and procedural areas. GBMC had difficulty with staffing our operating rooms last summer and we decided to move to an employed model.  

Canceling or delaying surgeries has many negative impacts for patients, providers, and the healthcare system as a whole. If it were our loved one, we would want them to be able to get their surgery as planned, as soon as possible. We want the surgeons who use our facilities to rest assured that our staffing is adequate so that their cases continue according to plan. And our healthcare system relies on our surgical services running smoothly to thrive and continue caring for the community. 

We needed to build a new group, starting with about 10 anesthesiologists and nurse anesthetists who were already working at GBMC and who wanted to continue to become employees. Under the guidance of our Chief Medical Officer, Dr. John Flowers, we worked with a consultant whose expertise was in   anesthesia start-up. We appointed Sanjay Trivedi, MD, as our interim Chair of Anesthesia. Dr. Trivedi worked closely with Meghan Chan, Senior Director of Surgical Services, to bring in temporary help through a locum tenens company and then hired new permanent providers. We are pleased to now have more than 40 employed anesthesiology physicians and CRNAs (Certified Registered Nurse Anesthetists). And, as of September 1, we will no longer need to use contracted anesthesia providers to fill in any gaps within the schedule! 

As I reflect on the undertaking, this is a change that has truly touched all four of the aims that guide us at GBMC HealthCare:  

• Better health: We can reliably continue providing surgical services with a focus on safety and positive outcomes. 
• Better care: We can consistently provide surgical services in a timely manner, canceling fewer surgeries, leading to a better experience for patients. 
• Least waste: By eliminating high-cost contract labor and decreasing the number of canceled surgeries, we reduce financial risk to the health system (and reduce downstream cost to the consumer). 
• More joy: Those who provide the care are more satisfied knowing that staffing needs are being met and that they have the resources to do their jobs. Our anesthesia group’s morale is high, and they feel a sense of inclusion within the health system. 

Many people have helped us get back to having an exceptional Anesthesia team but in particular, I need to thank Dr. John Flowers; Dr. Sanjay Trivedi; Meghan Chan; Ken Griffith, lead nurse anesthetist; Dr. Joel Turner, Chair of Surgery; and all the anesthesia providers who have contributed to this successful transition!

Happy Women in Medicine Month!
September is Women in Medicine Month! I am grateful to the many talented women physicians, residents, and medical students, who are working to make healthcare more equitable! Please join me in honoring them during Women in Medicine Month. Be sure to follow GBMC's social media channels as we recognize our women physicians throughout September.

When Nonclinical Details Impact the Healthcare Experience

I was struck by a thank you note I recently received from a grateful family member of a patient who visited our Emergency Department. It caught my attention because it was not focused solely on the clinical care provided by our team, but instead also highlighted the way in which a team member went beyond their role and responsibility to help them with a non-medical issue after discharge. 

This particular person came to the Emergency Department (ED) to support their loved one. During this time, the grateful family member wrote that they appreciated the care and attention of ED nurse Shannon H., RN, noting her understanding, sympathy, and guidance. Fortunately, everything checked out fine with the patient, who was discharged at about 1:30 in the morning.  

The writer of the thank you note was understandably very tired by that time, and as he was paying for parking did not realize the pay machine was turned off when he inserted his credit card. The machine took the card but did not return it. When he went back into the ED for help, Shannon quickly came to his aid to troubleshoot the situation. Knowing he was tired, she instructed him to go home and assured him that she would stay after her shift ended so she could personally talk to the pay booth operator, and he could get his card back as soon as possible. She kept her word, staying on campus after her shift to help coordinate the safe return of his card and alleviating the stress of him having to cancel his card and request a new one. 

This behavior models our vision because it is the exact type of consideration we would want for our loved ones! This story is a reminder of the stress involved in healthcare – both for the person who is sick and the person who is there to support. They shoulder many worries, are juggling complicated information, and navigating unfamiliar places. I noted a similar sentiment in my recent blog about navigating our campus, but I believe it is so important to remember that sometimes it’s the nonclinical details – the little things we take off someone’s plate – that can make a lasting impression.  

Shannon's example was exceptional in that a nurse stayed after clocking out of her shift to help in a capacity outside of her job function. But there are a multitude of meaningful actions we can all take to make a difference, whether it means walking a patient or visitor to their destination, having a kind conversation in the hallway, or connecting someone to a resource they didn’t know about. 

What are some nonclinical actions that you think make the biggest difference in the healthcare experience? 

Thanking Our Promise Project Workers 

A DPR Construction worker appreciation event was held on August 25 to thank our construction workers and to commemorate the topping out of the concrete structure of the Promise Project’s Sandra R. Berman Pavilion (future home of our Sandra & Malcolm Berman Cancer Institute). 

During the event, we showed our appreciation for all those currently working onsite for both the Sandra R. Berman Pavilion and Louis and Phyllis Friedman Building projects. I’m so thankful to all the onsite personnel who have gotten us to this point through their hard work and commitment over the past two years. It’s been incredible to see the progress, and we couldn’t have done it without these dedicated individuals!  

Planning the Finishing Touches

We are now fewer than 30 days away from finishing construction on the Promise Project’s Louis and Phyllis Friedman Building! This project is the epitome of thoughtful planning and attention to detail. Before we even broke ground on construction in September 2021, cross-functional teams of staff as well as architects were carefully considering how to design the new facilities to best meet the needs of patients, their loved ones, and staff alike.

Now, operational readiness teams, led by Rebecca Stover, MSN, RN, PMP, Director of Project Management at GBMC HealthCare, are shifting focus from building design to the minutiae of details involved in running the building, with the goal of smooth transitions for patients and staff. 

Discerning the various day-to-day needs and most efficient processes necessary to operate two brand new state-of-the-art medicine/telemetry units is no small feat.

The team is exploring and answering numerous questions, including:

• What are our overall staffing needs?
• What quantities of supplies will need to be stocked on the new units?
• How long does it take our environmental services team to clean one room on the new unit? Remember, the rooms are twice the size of those on the previous units and include new features and equipment to learn.
• What are the fastest and safest routes from the units to other key areas of the hospital, like the ICU, in the event of emergencies?

In addition, a very detailed plan related to move-in day on November 14 is underway. This effort is being led by Cate O’Connor-Devlin, MSN, RN, Director of Emergency Preparedness, Safety, and Security, who is collaborating with a cross-functional team of administrative coordinators, nurses, transporters, greeters, and the Incident Command Center. 

This team is using past experience with smaller-scale unit relocations to make decisions and anticipate challenges. They are thinking through the best way to batch patients for transfers, how to prepare for transport based on the complexity of each patient, how long it will take to move a patient from the old unit to the new unit, how to best communicate with patients and families throughout the move, how to support staff and patients as needed throughout the process and troubleshoot issues from simple to complex.

It is exciting to know that the building is almost finished, and I'm also thrilled to share that we are now under 100 days until we welcome our first patients into the building. Stay tuned for more updates as we continue through the process and save the date for the Louis and Phyllis Friedman Building’s Community Grand Opening Celebration on Saturday, November 4 from 10 a.m. - 1 p.m. in the new GBMC Atrium! Bring the whole family and celebrate with tours, food, fun, games, and prizes!

Supporting Our Employees through Higher Education and Professional Development

Our employees are the key to the GBMC difference. We are fortunate throughout the GBMC HealthCare system to have staff who are truly passionate about what they do and believe in our vision of providing the care we would want for our own loved ones. They are high performers who are dedicated to continuous learning. 

Because we value our workforce family, we are committed to supporting them with their professional goals and their pursuit of higher education in many ways. 

• Tuition Assistance (Prepayment or Reimbursement): Whether eligible employees are taking classes in-person, online, or hybrid, the Tuition Assistance Program provides financial assistance for career-related accredited academic programs. This can come in the form of prepaid tuition assistance (paid in advance of starting the class, greatly reducing the employee’s out-of-pocket costs) or tuition reimbursement after completion of a course. 
• Nursing Scholarship, Loan Repayment, and RN1 Last Semester Tuition Repayment: GBMC’s H. Norman and Jeanne Baetjer Center for Nursing Excellence Scholarship Fund offers tuition reimbursement and student loan repayment to support eligible nursing staff seeking higher education and professional development. 
• T. Rowe Price Family Education Fund: This funding supplements the tuition reimbursement benefit for eligible employees and can be used for expenses such as tuition, books, fees, and more. Applications for the 2024 fund are currently being accepted through midnight on September 1! Employees should check their email and the Infoweb for more guidelines and to learn how to apply. 
• GBMC University: These free courses are available to all health system staff, regardless of their role or responsibility, and allow employees to develop important skills for the workplace, view on-demand eLearnings, and access resources to assist with learning and development. Employees can browse GBMC University opportunities within NetLearning. 
• CORE Leadership Development Program through GBMC University: As part of this program, current and rising leaders complete courses alongside a cohort of colleagues to foster key leadership skills and build confidence. 

I encourage all employees to discuss continuing education opportunities with their local leaders and visit the Infoweb or PolicyStat to view the guidelines for the various programs.  

Join Our Family! If you are interested in becoming part of our workforce family, where you can also have access to these types of professional growth opportunities, please visit www.gbmc.org/careers.

A New Home for Spiritual Support Services

We are quickly approaching the grand opening of our Promise Project’s Louis and Phyllis Friedman Building later this fall. Each new component within the building was carefully designed by teams who considered how to best meet the needs of patients, their loved ones and staff alike. One of the many areas that will receive enhancements as part of the Promise Project is Spiritual Support Services. 

The new chapel in progress

As explained by Reverend Saundra “Sandy” Rector, M.Div., BCC, CCISM, Chaplain and Manager of Spiritual Support Services, these offerings are a critical part of the holistic care provided to our patients and their families, as well as our staff. She and her team of community clergy offer faith-specific as well as non-religious spiritual and emotional support to those who are walking through some of life's challenges, whether they are health-related or a result of issues arising from everyday life. Sandy explains, “We are available from birth, through life, to death to help people attain healing and peace through the hope that we bring.” 

Recognizing that healing goes beyond physical health, we are very grateful that the Friedman Building will feature multiple quiet, calm environments that are conducive to prayer, reflection, and respite. For starters, the relocated Yvonne Kahlert Chapel will be about twice the size of the former chapel to accommodate larger gatherings and services and will incorporate the previous chapel’s original stained glass. To make spiritual support as accessible as possible, the Chapel’s broadcast capabilities will allow individuals to tune in for various services, celebrations, and remembrances virtually.     

In 2018, GBMC opened its kosher pantry to meet the dietary needs of members of the observant Jewish community. A new and enhanced kosher pantry will continue to serve this purpose in the new building. A meditation room and outdoor meditation garden that is accessible from the Chapel will offer additional peaceful spaces for all who wish to use them. 

I would like to thank Sandy and her team for the spiritual and emotional support they provide to all those we serve. I’d also like to recognize Joseph Hart, M.Div., BCC, who recently retired as our Director of Spiritual Support Services, for his pivotal role in shaping our program and imagining the new chapel. 

World Breastfeeding Week 

August 1-7 is World Breastfeeding Week. Follow our social media accounts all week to learn more about our lactation team and get important information about breastfeeding support at GBMC. Remember, GBMC offers a telephone "Warmline" at 443-849-3428 seven days a week, 365 days a year, to help address breastfeeding-related questions. Leave a message, and one of our experts will be happy to return the call.

What Is a Specialty Pharmacy?

Many of us are used to hearing about maintenance medications – that is, medications that people take regularly to manage conditions like high blood pressure and high cholesterol. There are also common medications we are used to being prescribed when we are sick, such as antibiotics like amoxicillin or steroids like prednisone. We can just get these through our standard local pharmacy since they are common and typically readily available. 

However, you may be less familiar with the concept of specialty drugs, and, in turn, the specialty pharmacies that stock them. Specialty drugs are most commonly used to treat cancer and chronic diseases like rheumatoid arthritis, multiple sclerosis, ulcerative colitis, Crohn’s disease, and more. They may also be used during fertility treatment or in the field of endocrinology. By definition, they are drugs that require special handling, treat rare diseases, require ongoing clinical assessment or monitoring of side effects, and/or have a limited distribution and can only be filled at certain pharmacies. 

Specialty pharmacies are becoming more of a necessity given the growing number of specialty medications. At GBMC, we are extremely fortunate to have a specialty pharmacy available onsite. Having our specialty pharmacy onsite allows us to take care of the patient comprehensively under one roof. The patient can get their medication while still on our campus. Many patients who need specialty medications are immunocompromised, and having one less place to travel helps to limit exposures that may lead to contracting viral/bacterial infections. By having our specialty pharmacy on campus, we are ensuring that our own providers and staff are caring for the patient from the time they arrive to the time they are discharged, using the same electronic health record. This allows for improved care coordination and better collaboration between all care team members. 

One of the challenges associated with specialty drugs is their cost. This can be a barrier to patients. I’m proud that our specialty pharmacy team has worked with Qualify Health to implement a financial advocacy process that identifies and helps patients with out-of-pocket expenses. These patients are connected to resources that range from copay cards and patient assistance programs to funding from various disease foundations and rebates from drug manufacturers.  

Thank you to Yuliya Klopouh, PharmD, Executive Director of Pharmacy Services, and her team for bringing this wonderful offering to fruition. Their efforts to make specialty medications more accessible to patients with same-day delivery, onsite delivery to appointments, and connection to financial resources is leading to better care experiences and is truly the type of care I would want for my own loved ones. I am excited to see this important work continue, especially as we expand our specialty pharmacy services into our new GBMC retail pharmacy that will open in the new Louis and Phyllis Friedman Building as part of the Promise Project. 

Baltimore’s Best Hospital; One of America’s Greatest Workplaces 

We are honored that GBMC was recently named Baltimore's Best Hospital by readers of The Baltimore Sun. This recognition is a testament to the dedication of the entire GBMC family who strives every day to provide the care we would want for our own loved ones. We take great pride in caring for our community, and I’m thankful to all who entrust us with their care. 

We are also thrilled to have been recognized as one of America’s Greatest Workplaces 2023 by Newsweek and data firm Plant-A Insights Group! We are proud of our workforce and strive to maintain a positive, welcoming, and inclusive work environment and are humbled to make this list.  

Navigating a Complex Campus

It's sometimes easy to forget that the stress related to healthcare goes beyond medical concerns. Not only must patients and their loved ones navigate complex diagnoses, treatment and the complicated world of insurance (and more), but they also must often navigate unfamiliar campuses just to find their appointments and access their care. 

Unfortunately, GBMC’s hospital campus is no exception to that rule... We are built into a hill and have a very horizontal layout with three medical office buildings rather than one tower with easy-to-follow guides for each floor. Nearly every day, I encounter patients and visitors who are lost, and I think most staff and volunteers who frequent the hospital can relate. 

As I help these patients get to where they need to go, even I sometimes need to refresh myself on practice locations and building numbers. If a patient asked you how to find 6565 N. Charles St., would you remember that is the address for Physicians Pavilion East? It’s not something that I necessarily have memorized, although it would benefit us all to have that information on the fly so that we can be as helpful as possible when people are lost and stressed. 

Given this, I want to remind staff who come to the hospital about a few simple resources readily available at your fingertips so you can more easily help people find their way on campus.  

• You can bookmark this link on your phone for easy access to the campus map and building address information in one location: https://www.gbmc.org/patients-and-visitors/maps-and-directions. 
• 
  I encourage employees to download the GBMC wayfinding app by clicking here. This way, if you ever happen upon someone who is lost, you can easily pull up the app, enter the location patients are looking for and follow real-time navigation prompts. 
• If you are able, try to memorize our building numbers on North Charles Street in case patients don’t have the actual building name information handy. (You can also access these on our website of course, as mentioned above.) 
• Main Hospital: 6701
• Physicians Pavilion East: 6565 
• Physicians Pavilion North: 6535  
• Physicians Pavilion West: 6569 
• South Chapman: 6545 
• Brush up on the most convenient parking locations for each building: Lily for the Main Hospital, Iris for PPE and Tulip for PPN. For patients going to PPW, there are limited spaces available in Daffodil due to necessary repairs, so Iris is the next best alternative. And patients can always consider using the valet services available at PPW or the Sherwood Loop. Once the Promise Project’s new parking structure is complete, there will be more options. 

Do you have any ideas on how we can improve wayfinding? Or do you have any success stories related to how you’ve guided patients to your practices and departments? I’d love to hear your ideas in the comments. 

Thank you to everyone who takes time to walk people who are lost to their destinations on campus each day. It is one small way we can help alleviate some of the stress that comes along with seeking healthcare, and I appreciate all who take the extra time out of their days to assist our patients, visitors, new employees, and anyone who is less familiar with our campus.