Warm Wishes

As we enter into the Christmas holiday, I send you all warm wishes and hope that you have the opportunity to enjoy well deserved downtime with those closest to you. In the spirit of the season – which transcends religious and cultural boundaries – I extend my heartfelt gratitude to our remarkable staff, volunteers, patients, and the community we are privileged to serve.

As we go about our festivities, let this be a time of giving back, of extending kindness to one another, embracing the true essence of community, and being a source of comfort to those around us. 

To our extraordinary staff, your dedication is the bedrock of our success. In this season of giving, your daily contributions make a lasting impact on the lives of those we serve.

To our volunteers, your selflessness embodies the spirit of community.

To our resilient patients, your strength and trust inspire us. May this season bring you comfort and moments of joy.

Wishing you all a season filled with goodwill, shared laughter, and the joy of making a positive difference in the lives of those around us.

Showcasing Our Excellence in Quality Improvement

GBMC HealthCare was honored to have been highlighted during this week’s 2023 Institute for Healthcare Improvement (IHI) Forum. During his opening address on Tuesday, Kedar Mate, MD, President and CEO at IHI, called out GBMC as a model of whole system improvement. He specifically pointed to the way our teams have embraced our lean management system (LMS) as part of our culture, referring to it as “embedded quality.” 

Our teams with Dr. Mate during his October visit.

We had the privilege of hosting Dr. Mate for Grand Rounds in October. During his time with us, he got to see LMS in action. He witnessed firsthand our commitment to learning and continuous improvement. This is part of what he highlighted during his keynote. He recognized that as part of our LMS process, senior leaders actively participate in daily team huddles where impediments to providing optimal care are identified and addressed using problem-solving tools. Our front-line teams proactively assess failure modes, collaborate with colleagues across the health system to create data visualizations, and foster ingenuity, leading to a seamlessly embedded operating system that has become second nature to the individuals involved. 

In his remarks, he described our systems as “habitual” – so engrained that we don’t know we do them anymore – it's just the way we work. 

I’m grateful to each and every member of our staff who has adopted a mindset for continuous improvement. We are fortunate to have the expertise of Carolyn Candiello, our Vice President of Quality and Patient Safety, who is leading the charge on this work, and our Quality and Safety team members, like Michele Patchett, MSN, RN, Director of Process Improvement/Innovation; Kerrie Walsh, RN, BSN, CPHRM, Patient Safety and Accreditation; Sarah Muslim-Lefebvre, Senior Program Manager for System Improvement; and Katie Koestler, BSN, RN, CEN, whose efforts support LMS and build capability and capacity in the workforce. 

It fills me with pride that our health system is being recognized at the national level. It is extremely meaningful that the innovation and best practices of our own GBMC HealthCare family was highlighted among 5,000 peers who really know and care about quality improvement, and I appreciate Dr. Mate acknowledging our successes. 

And later that day, Dr. Mate gave a virtual address at the open meeting of the Health Services Cost Review Commission, and he called out GBMC as a model to be emulated by others! I am so grateful to all on our team for embracing continuous improvement as our business model. It is clearly pushing us faster towards our vision of being the community-based true system of care that is capable of treating everyone as we want our loved ones to be treated! 

The Employee and Volunteer Holiday Meal – A Time-Honored Tradition

When reflecting on what sets GBMC HealthCare apart, my thoughts instinctively turn to our remarkable people. Considering the substantial time we invest in our workplaces, having colleagues who share our passion and treat us like family is truly invaluable. It's our exceptional workforce, comprising both employees and volunteers, that has cultivated a culture akin to a close-knit family over the years—this is the essence of the GBMC difference. 

Each year, I look forward to the annual Employee and Volunteer Holiday Meal because it gives us another chance to express our gratitude to those who help bring us closer to our vision of providing the care we would want for our loved ones each day. This year’s meal was held on Thursday, and I want to thank the Human Resources team for their invaluable support in orchestrating this event and our Food and Nutrition team for preparing the delicious food. As always, it was a wonderful way to embrace the holiday spirit and acknowledge the dedication of our GBMC family. 

Helping Another Organization in Providing the Care We Would Want for Our Own Loved Dogs! 

Our friends at the Maryland Society for the Prevention of Cruelty to Animals (MDSPCA) called us on
the day before Thanksgiving to see if we had any cloth gowns that they could have. You may have read that there is a viral epidemic that is affecting dogs, and the MDSPCA had to send the dogs in their shelter to foster care until the epidemic subsided. They wanted to help the volunteers who would take the animals into their homes by giving them reusable gowns. Brian Riemer, our Executive Director of Supply Chain, provided some gowns from our warehouse since we use disposable gowns. Rodney Thomas, Material Handler and Shift Lead, helped us get the gowns from the warehouse and hand them off to the MDSPCA. I decided to give Rodney a small token of my appreciation, a NY Giants cap, for helping us in a pinch! (I was also kidding Rodney since I know that he is a die-hard New England Patriots fan!) 

Happy Chanukah! 

Chanukah began at sundown on Thursday, and I want to wish all those of the Jewish faith a Happy Chanukah. All are invited to join GBMC Spiritual Support Services and Rabbi Benjamin Shalva for a celebration on Monday, December 11 at 4:00 p.m. in the new Yvonne Kahlert Chapel in the Louis and Phyllis Friedman Building. We’ll have a spirited and soulful celebration lighting Chanukah candles, singing songs, telling stories, and learning about the deeper significance of this joyous holiday. 

Recognizing Our Pediatric Emergency Department 

In case you missed it, our very own Theresa Nguyen, MD, MS, FAAP, Chair of Pediatrics at GBMC, shared important information about what we need to know about RSV and the RSV vaccine on NBC Nightly News with Lester Holt. I’m proud of our team for being a voice to speak broadly on this issue. 

Advancing Healthcare Transformation at the State Level

The U.S. healthcare system has the best trained physicians, nurses and other clinicians in the world, and they work very hard, but as I have written many times, they work in a system that is in desperate need of transformative redesign. The payment system has fostered our “traditional” model, which is a bit like a game of Whack-a-Mole, with well-intentioned smart people addressing acute problems as they arise without a commitment to being accountable for improving the individual's health over the long run. The traditional fee-for-service approach means more visits completed and more procedures performed equals more profit. It is a sobering statistic that we spend 40% more per capita on healthcare than any other industrial country, and our outcomes for chronic illness are not as good. And now we have the added problem of medical debt, which has become the biggest single cause of bankruptcy in the United States. 

We know that it is much better for all involved if we build relationships with patients in the primary care setting and remain committed to helping them stay healthy and out of the hospital. Treating patients only when they are sick or seeing them in a hospital setting for preventable issues is not doing them any favors and is costly to the country. 

That is why Maryland implemented “global budgets” within its “All Payer” Model and waiver with the Centers for Medicare and Medicaid Innovation Center. This reimbursement system gives hospitals a fixed amount of revenue each year, encouraging them to reduce unnecessary hospitalizations, procedures, tests, and more. GBMC HealthCare had already committed to holding ourselves accountable for the improved management of chronic disease and for keeping patients out of the hospital, so we quickly accepted the concept of the global budget when it was introduced in 2014. Then, when the voluntary Maryland Primary Care Program (MDPCP) was introduced to support the delivery of advanced primary care throughout the state, we eagerly decided to participate, since this would provide new resources to cover the cost of the patient-centered medical home.  

We have been supporters of the global budget and MDPCP because at their core, they are focused on doing the right thing – being accountable with patients for their health and successfully managing (or preventing) chronic conditions in the outpatient setting. Now, I am intrigued by a new program being introduced by the Centers for Medicare & Medicaid Services (CMS). It is still in its infancy but seems like it could be the next critical step in healthcare transformation towards better value. 

The new program is called the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model and aims to work with states in controlling healthcare costs, improving population health, addressing social determinants of health, and promoting health equity. This program involves a voluntary, state-driven approach where states as a whole can apply to participate. This differs from MDPCP because with that program, individual healthcare organizations within the state could decide whether to participate. That meant that transformation was only happening in silos since not all our healthcare institutions within our state were required to embrace this approach to care delivery. The AHEAD Model better marries the concepts of the global budget and MDPCP in a way that would more effectively force transformation uniformly. 

Unless there is a broader scope of adoption of the advanced primary care mindset with a focus on providing accessible and equitable healthcare opportunities to all, the system will remain broken. Medical debt will continue to cause bankruptcy, and many people will continue to not have access to the care they need when they need it, in the most appropriate setting. 

We do not yet know which states will opt for the AHEAD Model. But, if Maryland opts in, I feel confident that GBMC HealthCare is well positioned for success because we have laid so much groundwork over the past decade. I am excited to see how this new program might move the nation toward a better healthcare system. 

Sharing Gratitude to Our Volunteers and Wishing All a Happy Thanksgiving!

Earlier this week, I had the privilege of honoring our dedicated volunteers during a special reception. This event was held on Monday, which marked the 60th Anniversary of the Volunteer Auxiliary’s very first board meeting in 1963. It was during that meeting that volunteers made a promise to help build a hospital for this community. Celebrating this anniversary as we lead into the Thanksgiving holiday seems very fitting – the generosity our volunteers have shown over the past six decades gives us much to be thankful for.

In this picture I'm joined by Jessica Schlee,
Assistant Director of Volunteers; Carmen Baeza,
Director of Volunteer Services; and Shirley Lewis,
Spiritual Support volunteer and pianist.

Not only did our volunteers keep the promise they made in 1963. But they have also continued to build upon it in remarkable ways. Collectively, they have provided more than 3 million volunteer hours of service. Time is precious, and I could not be more thankful that our volunteers have selflessly given so much of their time to us.

In addition, the Volunteer Auxiliary has donated more than $30 million dollars to our health system, including a $3 million lead gift, which was paramount to the success of our Promise Project. Without that support, our newly opened Louis and Phyllis Friedman Building would not have been possible.

Reflecting on the fact that more than 500 individuals actively choose to support what we do at GBMC HealthCare, I am filled with gratitude and pride. Their commitment has translated into countless hours of care, support, and comfort for our patients and their families.

GBMC HealthCare could not be the system of care, treating patients like our own loved ones, if not for the service of our volunteers.

Once again, thank you to our incredible volunteers; and Happy Thanksgiving to all! 

Transgender Day of Remembrance 

Transgender Day of Remembrance is a national observance held annually on Monday, November 20. It was started in 1999 by transgender advocate Gwendolyn Ann Smith as a vigil to honor the memory of Rita Hester, a black transgender woman who was killed in 1998. On Monday, our Diversity, Equity, and Inclusion Committee/Greater Pride employee resource group hosted a vigil where we honored the memory of the transgender people whose lives were lost in the last year due to acts of anti-trans violence. Click here to view a list of names in remembrance of the lives lost. 

Those of us in healthcare play an important role in bettering the lives of transgender individuals, who often encounter prejudice when accessing medical services. Understanding and supporting their unique needs can significantly improve their healthcare experience. 

Welcoming the First Patients to the Friedman Building

This week, we welcomed our first patients to units 42 and 52 in the newly opened Louis and Phyllis Friedman Building.

I’m pleased to report that thanks to all the preplanning, process development, and adherence to the process (with minor adjustments along the way), the transfer of patients was smooth and successful, with patient safety being the highest priority throughout. 

On Tuesday, November 14, a total of 52 patients were moved onto the new units in fewer than six hours, beginning with a team huddle at 7:30 a.m. and ending with the transfer of the final patient to Unit 52 at 1:10 p.m. This was the culmination of an extremely detailed planning process, complete with a practice run to estimate timing and anticipate challenges. 

A tremendous amount of cross-functional collaboration, led by members of the Emergency Preparedness and Promise Project Operational Readiness teams, made this achievement possible. In a true show of unity and teamwork, approximately 70 volunteers from departments of various disciplines across GBMC pitched in, going beyond the scope of their usual roles to make the day successful. It was inspiring to see so many staff members leaning in to help others when needed – it was truly an all-hands-on-deck effort. 

I was also thrilled to hear about the positive response from the patients who were admitted to the units– because the patients are our purpose. The picture accompanying this blog post shows one of the first patients transferred. To enhance the element of surprise, he covered his eyes with his blanket until he was in the room for the final “reveal.” He was ecstatic about the size of the room! Knowing that patients expressed this level of excitement to be part of GBMC’s history underscores the value of these new units and how they will allow us to better serve the community. 

Thank you to the teams who made this happen and to all the patients and their loved ones who were so understanding during the move! 

Submit a Compassionate Caregiver Award Nomination 

We are accepting nominations for the 2023 Nancy J. Petrarca Compassionate Caregiver Award through December 31, 2023. This award recognizes individuals who listen to, support, advocate for, and understand what patients and their caregivers are going through. We welcome nominations from anyone – whether from the community, our workforce, or volunteers. I’d also like to point out that any staff member or volunteer with GBMC Hospital, GBMC Health Partners, or Gilchrist can be nominated, whether they work in clinical or non-clinical roles 

Click here to submit a nomination. Thank you for taking a moment to recognize our staff and volunteers! 

Recognizing Staff 

This week honors several occupations within healthcare nationally. Please join me in recognizing our Nurse Practitioners, who order, perform and interpret diagnostic tests; diagnose and treat acute and chronic conditions; prescribe medications; and educate and partner with patients in making healthy lifestyle changes. Thank you also to our Perioperative Nurses for their essential roles in caring for patients before, during, and after surgical procedures. I’d also like to share gratitude to our Home Care Aides and expert partners with Avila Home Care for helping our patients thrive in their homes with supportive services including companionship; light housekeeping; meal preparation; transportation; assistance with bathing, dressing, skin care; and more. 

A Thoughtful Design that Enhances the Care Team’s Experience

We reached a significant milestone last week as we celebrated the grand opening of our new Louis and Phyllis Friedman Building. Next week, we look forward to welcoming our very first patients onto our two new 30-room units in the building: Fran and Mark Harris Patient Care Unit 42 Medicine/Oncology and William C. and Suzanne Eck Higinbothom Patient Care Unit 52 Medicine/Stroke. 

In light of the opening of the units, I wanted to share a bit about the thoughtful and very intentional design of the units and patient rooms within them. Before we started the construction process, we solicited feedback from patients, staff, volunteers, and donors. In mid-2021, we designed a mock patient room, and allowed employees, former patients, and volunteers to walk through and give their thoughts on the layout. We listened carefully and created a design that would offer comfort and convenience to patients and families, while also optimizing efficiency for staff and providing them with state-of-the-art equipment and technology, right at their fingertips. 

Top: Unit 42 team; Bottom: Unit 52 team

Employees that will be working on the units have expressed excitement about several amenities that will make their day-to-day work easier. Gone are the days of the workstation-on-wheels, which nurses previously had to roll from room to room. Each room on the new units has its own workstation, where staff can easily access patient records and input information. Rooms are also equipped with an Epic Monitor, which can be used as a review and/or teaching tool, allowing clinicians to review data and results and then share information in a patient-friendly way. Digital door displays positioned outside the patient rooms share critical care details, such as necessary precautions, vitals and fall risk level, before members of the care team enter. 

One very innovative feature of each room is the “patient server,” which is essentially a storage cabinet for necessary medical supplies, fresh linens, as well as linens that need to be cleaned. This server is accessible both inside and outside the room, meaning that staff does not have to exit the room to seek commonly used supplies, nor do they have to unnecessarily enter rooms for tasks such as removing linens to be cleaned. 

Caregiver stations on the units are centrally located and situated with visible sight lines to patient rooms. These stations allow our staff space to complete technology and communication tasks while still being within view of their patients. Additionally, because we know it is important for staff to have the opportunity to decompress, breakrooms are nearby but distinctly separated from the caregiver stations and patient rooms, meaning staff can have lunch and take breaks with minimal interruption. 

Staff members have shared their happiness that the new rooms will enhance the experience for patients and their loved ones. The new rooms are twice the size of our older patient rooms, with bathrooms that are also larger and designed for safety, complete with accessible showers and more. Patients’ loved ones will also have additional comforts in the space, as the “family zone” within the room includes a multi-purpose bench that can transform into a place to work, sleep, dine, and be a part of the healing process. 

Leapfrog rating 

We recently got the news that GBMC Hospital received a "B" grade in the Fall 2023 Leapfrog Survey. This "B" grade marks an improvement from our previous survey results and is a testament to the dedication and hard work of our exceptional staff. The Fall 2023 survey took into consideration process/structural measures, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results, and outcomes measures when assigning the grade. Thank you to all for your dedication to continuous improvement. 

Recognizing Staff 

While I am thankful to all our employees year-round for their essential services, I appreciate the opportunity to recognize them during various national healthcare worker observance weeks. This week, we are celebrating many! In honor of Medical Staff Services Awareness Week, I'd like to thank our medical services professionals for their expertise in areas such as medical staff organization, accreditation, provider enrollment, regulatory compliance, and provider relations in their vital role as gatekeepers of patient safety. As part of Allied Ophthalmic Personnel Week, please join me in celebrating our ophthalmology team for their commitment to improving the delivery and quality of eye care at GBMC. National Radiologic Technology Week is November 5-11. I am grateful to our medical imaging professionals for providing critical diagnostic and interventional imaging services for patient care and health care safety. 

This week we also recognize our Patient Transport team for their vital role in patient flow, patient care, and overall patient experience as well as our Forensic Nurses for their ongoing commitment to patient-centered, trauma-informed specialty care of patients impacted by violence. 

Last, but certainly not least, November 9 was Genetic Counselor Awareness Day. At GBMC, we are fortunate to have our team with the Harvey Institute for Human Genetics helping patients better understand the genetic testing process, identifying key information in patients’ family health history, and supporting patients through important medical decisions.  

Thanking Our Veterans 

Saturday is Veterans Day. Today, our Diversity Equity and Inclusion Committee led our annual organization-wide Veterans Day Ceremony to honor the millions of American military personnel who have served to protect us. I’m grateful to all those who have personally sacrificed to ensure our freedom and especially want to thank our GBMC HealthCare employees and volunteers who are veterans on our main campus, in our physician practices, and throughout Gilchrist.