Friday, December 30, 2011

Better Care

Something exciting is happening at GBMC.

Our vision is to become the healthcare system where everyone, every time, is treated the way we would want our own loved ones treated. We say that this includes: the best health outcomes (better health), with the best satisfaction with the way the care is delivered (better care), with the least waste (lower cost), and the most joy for those providing the care.

So what is the exciting thing that is happening? The November monthly patient satisfaction survey shows an overall 87.6 inpatient satisfaction score, the highest score ever for our hospital!

More than 40 percent of U.S. hospitals utilize the company Press Ganey to measure patient satisfaction. Each month, a random sampling of inpatients from units across the hospital are surveyed by Press Ganey and asked to score their patient experience in a variety of areas, on a scale from 1, equaling “very poor” (score of “0”), to 5, equaling “very good” (score of “100”). Press Ganey than converts respondents' ratings to a mean score for hospitals in various areas such as nursing care or meals.

Since about the beginning of 2011, GBMC’s overall monthly inpatient satisfaction scores have been improving; marking real change as opposed to random peaks and valleys. If you look at the scores of most other hospitals or health systems you are not going to see this. (You actually can compare hospitals by going to and compare HCAHPS scores but the data are only published yearly and what you find today is from December of 2010.)

This most recent survey score of 87.6, places us in the 82nd percentile for hospitals with 300 beds, which is our peer group in the Press Ganey database.  The percentile ranking means we scored higher than 82 percent of comparably-sized hospitals. We’ve certainly made significant improvement, considering that in 2007 we were at the 35th percentile for hospitals in our peer group.  We were at a plateau from about early calendar year 2010 until essentially this year and have started moving our scores higher and higher.  We are making true measurable progress.

I have been in healthcare a long time and I have seen many organizations measure patient satisfaction. Every month the score would come out and people would try to explain the result. Rather than get in action on implementing change, we were wishing that the score would improve.

Today, at GBMC we are now using continual improvement as our way to manage our organization. In more and more areas of our system, leaders are asking the question: “How can we do it better?” and then getting their team in action on change!

So what changes have brought our score up? There are too many changes to talk about them all but let me give you a few.

In February and April of this year, we had fallen to a score just under 77 in patient satisfaction for meals, which ranked GBMC at the 10th or 15th national percentile, which is well below average. We are not a well below average system….but that’s where we were scoring.

Nurses were telling us that a mistake was made when the structure of meal delivery was changed and we needed to return to the system where foodservice workers were assigned to a specific unit.  So we made that change, and have seen a statistically significant improvement in our meals score since doing so. The arrow shows when we implemented this change. There is still room for improvement in our overall meals score, but patients are voting that we have improved.

Meals Section Score

We have also improved our score in room cleanliness. We know that people don’t like a dirty hospital, insensitive staff, cold meals, or waiting. And we are working on initiatives around these issues. Press Ganey scores show that the hospital is getting cleaner through the eyes of the patient, which is who matters the most. You can see from the scores that we are still working to standardize our new processes and make them happen reliably and everywhere.

Room Cleanliness Score

Our nurses are working hard to improve communication with patients. They have begun to standardize when and how they communicate to reduce the chance that the patient feels left out. One of the tools that nurses are using is called AIDET. The AIDET model is a helpful framework comprised of:

§  Acknowledge - Greet people with a smile and use their names if you know them.
§  Introduce  Introduce yourself to others politely. Tell them who you are and how you are going to help them. Escort people where they need to go rather than pointing or giving directions.
§  Duration — Keep in touch to ease waiting times. Let others know if there is a delay and how long it will be. Make it better and apply service recovery methods when necessary.
§  Explanation — Advise others what you are doing, how procedures work and whom to contact if they need assistance.
§  Thank You — Thank somebody. Foster an attitude of gratitude. Thank people for their patronage, help or assistance. Use reward and recognition tools.

Another area of standardized work that nurses are testing is called hourly rounding. This technique schedules a member of the nursing team to do a formalized check-in with each patient once per hour during the day (and less frequently during the night when patients are sleeping.) Below you can see the effect of nursing standardization of these tools on the patient’s response to the question of whether or not nurses kept them informed.

Nurses Kept You Informed

Standardizing the work gives us a better shot of getting to the desired outcome than if we are just relying on the hard work and good intentions of our staff alone.

We’ve made a lot of real changes and I am very grateful to all of our hard-working staff who have made them.  We must stay in action by reviewing what our patients are saying, asking ourselves what changes we can try, and then testing those changes. Once we find a change that works, we need to implement it throughout our system. This is how we will get to Better Health, Better Care, Lower Cost, and More Joy.

We are using Continuous Improvement as our business model.  One of the tenets is design, and right behind that is measurement.  The examples above show that we are redesigning systems, and we are measuring the performance of these redesigned systems, and I’m very proud of all of our people for doing this.

So, right now we stand at a patient satisfaction score of 87.1, with room to improve.  What idea do you think your team could test in your area to get better and to foster continual improvement?  Please share your thoughts below.

Friday, December 23, 2011

2011 – A Year Of Great Accomplishments for GBMC HealthCare

2011 was a year of tremendous accomplishment for the GBMC HealthCare system.  In this week’s blog I wanted to look back at what we’ve been able to achieve throughout the year.

At the top of the achievement list for 2011 is rolling out the organization’s new strategic plan "GBMC HealthCare System – Our New Vision, Our New Plan to Get There" and new vision phrase, "To every patient, every time, we will provide the care that we would want for our own loved ones."

These aren’t just words, but rather are the guiding principle behind all of our actions – whether they occur at the bedside giving patient care, in the hallway providing directions, or on the phone offering guidance.

We have committed as an organization to Better Health, Better Care, Lower Cost and More Joy and our system is working to dramatically transform healthcare delivery.  We recognize that the healthcare system as we know does marvelous things everyday but it is too fragmented. We are working to be a part of the national solution by building continuous, reliable, and integrated care.

This year, we have moved toward a system that is more patient-centered, and evidence-based using the medical home model where physicians and their care teams focus on a patient's overall wellness rather than just focusing on episodes of illness. To accomplish this, we have made significant investments in healthcare information technology and are building a network of hospital and community-based healthcare providers (Greater Baltimore Health Alliance) to oversee the integration and coordination of that care.

In 2011, we finished the implementation of a Computerized Provider Order Entry (CPOE) system, that has already significantly improved patient safety by significantly improving the turnaround time of orders, and launched our electronic medical records system using eClinicalWorks, which will help to better integrate care, reduce unnecessary testing, improve the underuse of necessary testing, increase efficiency, reduce costs and improve communication and sharing of information among providers.  At our Greater Baltimore Medical Associates at Hunt Valley practice, we launched our patient portal pilot, a personalized and secure communication link between the patient and physician’s office that provides convenient 24-hour electronic access to an individual’s health information.

Another important highlight during 2011 was the re-launch of the Board of Directors Quality Committee, which is a recognition by the organization’s governing body of our true mission.  We have always talked about Health, Healing and Hope but frequently we’ve acted as if it were enough to be a financially successful organization. While that is important, if the board is not directly and deeply scrutinizing the quality of the product which is generating Health, Healing and Hope then they are missing an important part of their job.  The board embraced this notion and quickly got together an action plan, led by Bonnie Stein who was appointed as the quality committee’s first chairperson.  We had a board retreat dedicated to quality issues, and members all read the book “Why Hospitals Should Fly”, an essential look at patient safety and service quality.  Board members now have a much deeper understanding of the product and what they need to do to better oversee the fulfillment of our mission.

We also created the positions of medical directors for the hospital’s inpatient units – effectively creating a leadership team on each unit.  It goes back to the concept in service that you don’t achieve outstanding performance in a large complex company by having brilliant people in the front office. You get to outstanding performance through the leadership at the smallest replicable unit, which in healthcare is the inpatient unit or the physician’s office or other clinical area or department.  We have always had nurse managers of our inpatient units who do a marvelous job every day but frequently we have lacked physician leadership on our units so that it was difficult for us to present to the patient as a team. We have had units where doctors come and go – working hard but not connected to the goals of the unit.  Now the appointed medical directors will work hand in hand with the nurse managers to help achieve the quadruple aim of better health outcomes, better care experience, at a lower cost with more joy for those providing the care. 

Accomplishments during 2011 also included:
  • Unveiling of the Pink Ribbon Cancer Garden at the Sandra & Malcolm Berman Cancer Institute.
  • 104 members of GBMC’s medical staff in 69 different specialty areas were recognized in the annual Baltimore Magazine Top Docs issue.
  • Two new members joined the organization’s senior management team – Jenny Coldiron, who joined in May as Vice President of Development and President of the GBMC Foundation, and Deloris Simpson Tuggle, who joined in December as vice president of human resources and organizational development / chief human resources officer.
  • Janet Sunness, M.D., medical director of Greater Baltimore Medical Center’s Richard E. Hoover Low Vision Rehabilitation Services, was recognized with the prestigious academic medical recognition, the 2011 Macula Society’s J. Donald M. Gass Medal.
There were also several significant accomplishments in 2011 for Gilchrist Hospice Care, including being recognized with the Circle of Life Award by the American Hospital Association; opening Gilchrist Center Howard County, the first-ever acute care inpatient hospice facility in Howard County and being recognized by FHSSA (formerly the Foundation for Hospices in Sub-Saharan Africa) in honor of their work with its partner in Tanzania, Nkoaranga Lutheran Hospital, to sustain quality palliative and end of life care in Africa.

I know there are lots of accomplishments that we’ve had throughout the year.  What others do you want to mention? Please share your thoughts below.

Happy Holidays

On behalf of the organization, I want to extend best wishes for a safe, healthy and happy holiday season for those celebrating Christmas, Kwanzaa or Hanukkah.  Enjoy your time with family members and think about the things that are important in your lives.  For those staff members working during the holidays, a special “thank you” for taking care of those who aren’t able to be at home during the holiday season. I am blessed to work with all in the GBMC family and I am very grateful for this. 

Friday, December 16, 2011

Improving Patient Flow: The Concepts of Natural and Artificial Variability in Demand

Those of us old enough to remember “I Love Lucy” remember the Candy Factory episode where Lucy and Ethel take a job at a candy factory and attempt to wrap candies as they progress down the belt. When the speed is slow enough they manage to keep up with the work, their boss orders that the belt be increased in speed and the demand is too much for Lucy and Ethel to keep up with. This episode is a humorous way to demonstrate how varying the demand affects a system. In healthcare, the mismatch between the supply of caregivers and the demand for their services is the major cause of waiting and delays in care.

It’s not a secret that services like the Emergency Department get overwhelmed at times of peak demand. In the ED, we never know precisely how many patients will arrive in a given day. Our operating rooms are very busy on some days and not so busy on others. As a practicing physician, I used to think that peaks and valleys in demand were just a fact of nature. You just had to “suck it up” if you were busy and then you were owed the break you got when business was slower. I now know that things are not quite so simple. 

Deeper study of the peaks and valleys in patient volumes shows that there are actually two kinds of variability affecting patient demand. 

The variability due to the amount of illness in the community at any moment in time is called natural variability. For example, we know we get more patients coming to the Emergency Department in the winter with fevers and colds and coughs than we do in the summer, and we know we get more patients coming in with trauma and outdoor related injuries in the summer than we do in the winter. Based on historical data, trends, etc. we know approximately how many patients we are going to get every day of the week in the ED. Although we don’t know the exact number, the variability from day to day is due to natural causes beyond our control. Natural variability cannot be controlled; we just have to manage it. We generally need to have a bit more capacity then we will use on average to be able to deal with the peaks in demand. The mathematical science called Queuing Theory helps us staff efficiently when demand is varying naturally.

The second source of variation is called artificial variability. In artificial variability, the cause is man-made. Like in the candy store episode, the manager was controlling the speed of the conveyor belt. The concept of batching is the opposite of continuous flow. Generally individuals or subsystems batch things to reduce their own personal inefficiency. What they generally do not realize is that batching generally makes the larger system inefficient. 

When I was a pediatric resident we knew that if we ordered a lead test on a child, we wouldn’t get it back until later in the week because the lab waited to get a number of blood specimens before running the test in an effort to save money and run them all on one day. The lab director was trying to do the right thing but was not really thinking about the waits and delays for pediatricians or the rework required to get the results later and deal with the patient on another day. Physicians and nurses generally batch discharge work until later in the day because they sense that they need to deal with new admissions and the work of seeing sicker patients first. After all, the patient who is ready to go home is safe, so it feels like batching discharge work is a good thing. However when discharges all happen late in the day, admissions backup at other places, like the ED and the PACU waiting for the beds of the patients who are to be discharged. The largest single source of batching between days at GBMC is the elective surgery schedule. On some weekdays we do many more elective surgeries than on other weekdays. You can imagine how difficult it is to staff Unit 48 or Unit 58 efficiently if they are going to get 10 new patients on Tuesday and 3 or 4 on Wednesday. 

What we know now is that artificial variability is actually a BIGGER source of day to day variability in census and the stress caused by peaks in demand than natural variability is.  We also know now that healthcare workers who are overwhelmed are much more likely to make errors and potentially put patients at risk or much more likely to not be able to get to provide all of the care to each individual if they’ve got too many patients. 

So the goal is to reduce artificial variability caused by batching in order to reduce stress on our providers and make it safer for our patients. We also know that we can actually serve more patients in a more cost-effective way if we smooth the demand and try to get to continuous flow.   Once we have eliminated as much of the artificial variability as we can, we can then predict the natural variability and staff our hospital effectively. 

We’ve engaged some consultants from the Institute for Healthcare Optimization to help us do this work.  We are now in the midst of an initiative to smooth the elective surgery schedule, to keep the patients safer, to reduce waits and delays, to make the surgeons work more predictable and to make it easier to do even more surgeries. Under the leadership of Dr. Jack Flowers, our Chairman of Surgery and Dr. Lewis Hogge, our most recent block time changes have helped to begin the smoothing of patients by destination unit, Unit 48 or 58. 

Another part of our initiative to use science to manage flow and eliminate artificial variability is with our medicine service, under the guidance of Drs. Neal Friedlander, Paul Foster and Fred Chan, who have begun an initiative to smooth the discharge time of their patients to eliminate late afternoon batching. Their new mantra will be to discharge the patient as soon as he or she is clinically ready.  Most of us believe it’s unethical to send patients home in the middle of the night; we should have a relatively continuous flow of discharges from about 8 a.m. to 8 p.m.  Right now, we don’t.  We have a peak of discharges from 4 p.m. – 8 p.m. and we have very few patients going home before that, mostly because the system now has staff batching their work rather than trying to get to continuous flow. As they redesign the sequence of people’s work, or do discharges as a team, they will be helping to maximize the efficiency of the entire system. 

Interestingly, Israeli economist Eliyahu M. Goldratt examined this issue in his 1984 management-oriented novel titled The Goal, which focused on constraints and bottlenecks and how to alleviate them, and applications of these concepts in industry.  For example, Goldratt looked at the issue of why Japanese automakers were doing better than western automakers in producing vehicles, and noted that American manufacturers were focused on issues such as how often a machine was used rather than focusing on what the end goal was, how much product was coming off the assembly line. Required reading at Harvard Business School that was originally published nearly three decades ago and republished twice since, this book was a seminal work in American industrial thought that we can benefit from in healthcare today. Dr. Goldratt followed this novel with his book, The Theory of Constraints, another must-read for students of patient flow.

If it was your daughter, you wouldn’t want her waiting for long hours in the ED for a bed on the unit. We used to take care of this by always having a lot of excess capacity. Now no one can afford this so we have to use science to make the system work better. 

Do you have any thoughts on how we can improve patient flow and eliminate batching at GBMC? Please share your thoughts below.

Friday, December 9, 2011

The Triple Aim … in Baltimore County

As frequent readers of this blog know, I’m a staunch advocate of the Triple Aim of Better Health, Better Care and Lower Cost.  And there’s a growing recognition on the part of many that if we are going to achieve the Triple Aim we need to move “upstream” from healthcare delivery.  We need a coordinated approach involving community agencies, the patient and the patient’s family.

That’s why I was glad to be asked by the Baltimore County Health Officer, William Branch, M.D., to participate in the Baltimore County Health Coalition whose charge is to write an action plan to focus on several significant health issues including cigarette smoking, childhood obesity and low birth weight. I volunteered to participate in the subgroup that is focusing on childhood obesity.  As a pediatrician by training, this issue holds special significance to me.

Our first childhood obesity subgroup meeting was Thursday and I look forward to working with professional colleagues and lay people in the community to help us achieve a healthier community.  Soon, the greater GBMC family will need to be in action on this initiative beyond our walls, since the healthcare system can only do so much, we need to rely on “buy in” and commitments from faith-based groups, educators, county agencies, etc.

One individual who is an incredibly strong advocate for such changes is Donald Berwick, M.D., a mentor to me early in my medical career who recently was forced out as administrator of the Centers for Medicare and Medicaid Services after about 17 months on the job. “A Healthcare Icon is Forced Out of Service to Our Country”

I had the wonderful opportunity to be among a team of GBMC leaders who earlier this week attended the Institute for Healthcare Improvement’s 23rd annual National Forum on Quality Improvement in Healthcare, and who got to hear an incredible speech from Dr. Berwick just a week or so after his departure from CMS.

Carolyn Candiello, GBMC's Vice President of Quality and Patient Safety,
poses with Dr. Berwick at the IHI meeting.
Dr. Berwick noted that the Affordable Care Act was a majestic piece of legislation and reminded the 6,000 healthcare leaders from around the globe that in spite of his departure, CMS staff are still desperate and eager to be a part of the healthcare solution in this country. It was invigorating to again hear Dr. Berwick encourage us to reach for the Triple Aim and to see how he is rededicating himself to the goal of improving health, improving care and driving out waste and reducing costs to employers, governments and patients.

Of particular interest to me at the IHI meeting was seeing Cindy Ellis, BSN, RN, and Lynn Marie Bullock, DNP, RN, both members of GBMC’s Nursing Education team, who presented on a vital patient safety issue.

Cindy and Lynn Marie led a collaborative GBMC task force of frontline staff, pharmacists, nursing leaders, clinical engineering and information technologists who examined medication safety errors – which nationally cause 7,000 deaths per year – and found that by using smart infusion pump technology with safety software, IV medication errors are significantly decreased.  It was heartening to see their “Embracing the ‘Good Catch’” presentation on a national stage.
Dr Chessare (L) and John R. Saunders, Jr., M.D., GBMC's Chief Medical Officer,
with Cindy Ellis and Lynn Marie Bullock.
Holiday Decoration Safety and Celebrations

As you may have observed in walking around the hospital, there are no holiday decorations on the doors this year.  For many years, it was a holiday tradition for units to decorate the doors to their work areas, and volunteers would decide whose decorative inspirations had the most holiday spirit.  I had a great time last year going around the campus and helping judge the door decorations.

Contrary to some rumors around the campus, there is no “Scrooge” at GBMC this holiday season.  Rather, in order to ensure the safety of our staff, patients and visitors and follow Joint Commission protocols, we’ve had to eliminate the annual door decorating contest.

Environmental and safety rounds revealed physical damage to fire walls and doors and fire door closure mechanisms were de-activated due to decorations and tape. Fire alarm pull stations, fire extinguishers, sprinkler heads and medical air emergency shut off valves were also found to be obstructed by holiday decorations. So, to keep our patients and ourselves safe, we won’t be decorating doors this year.  Nontheless, I see many beautiful holiday decorations on our campus!

If you have questions regarding the GBMC Decorations Policy contact the Safety Department at

Holiday Spirit

We have many ways to get in the holiday spirit at GBMC, including our annual Employee Holiday Meal on Wednesday, December 14, which will be served from 11 a.m. - 2 p.m. (Dining Room &  Civiletti Conference Center) and from 5 p.m. - 7 p.m. and 11 p.m. – 1 a.m. (Dining Room only).

The GBMC Holiday Choir will be performing at the holiday meals at 12 p.m. & 1:00 p.m. in the Civiletti Conference Center and at 5:30 p.m. in the back of the cafeteria, as well as on December 19 in the OB Atrium Lobby at 12:30 p.m. and December 21 in the Main Lobby at 12:30 p.m.

Other festive holiday events include:

  • “In the Holiday Spirit” with Jim Albrecht on the keyboard, scheduled for December 14 at 12 noon in the OB Atrium, presented by The Elma Donovan Memorial Concert Series and GBMC Spiritual Support Services.
  • A traveling instrumental performance on December 21 by Robert Yin, M.D., GBMC gastroenterologist and friends, which will begin in GBMC's Physicians Pavilion East at 12 p.m. and make its way throughout the hospital spreading holiday cheer to employees, patients and visitors.
  • GBMC’s Asthma Sinus Allergy Program (ASAP) on the second floor of Physicians Pavilion North is a designated drop-off site for the United States Marines Corps Toys for Tots program.
  • Spiritual Support Services is coordinating adoption of more than 30 families through the auspices of the Assistance Center of Towson Churches.  Interested departments and individuals should contact Chaplain Joe Hart at x2056 if you would like to help.  Wrapped packages are due to be delivered to ACTC in Towson by December 20.
  • Volunteer Auxiliary Board members will be delivering poinsettias to patient rooms on Friday morning, December 23.

Do you have any special ways you celebrate the December holidays, or any ideas for how you would like to see GBMC HealthCare celebrate in the future? Please share your traditions and ideas below.  Also, please let me know how you are working on the Triple Aim in your community.

Friday, December 2, 2011

“A Healthcare Icon is Forced Out of Service to Our Country”

It’s rare that you find an individual who is really about a goal and not so much about themselves.  Donald Berwick, M.D. is someone who for decades has embodied a zeal for improving healthcare through the eyes of the patient.

In the summer of 2010, ironically just a few weeks after I joined GBMC HealthCare, my old mentor Dr. Berwick was named as a recess appointment by President Obama as administrator of the Centers for Medicare and Medicaid Services (CMS).  During his brief time at the agency, you could palpate the difference in the tenor of the CMS operation at headquarters because he bolstered the spirits of people working there and gave them new hope.

Dr. Berwick is the person best-equipped to have pulled off the redesign of our national healthcare system to meet the “Triple Aim” of Better Health, Better Care and Lower Cost but as of today he’s going to be gone from service to our federal government.

My professional relationship with Dr. Berwick goes back several decades to when I was finishing my chief residency at the University of Massachusetts in pediatrics. I had gone into the residency with the intent of becoming a community-based general pediatrician but then got turned on to academic medicine.  During my fellowship at Boston Children’s Hospital / Harvard Medical School in general academic pediatrics, I had the good fortune of being assigned Dr. Berwick as my research mentor.

Don is known today as a healthcare policy expert and the universe’s  leading authority in the area of healthcare quality improvement but when I was assigned to him in 1982, Dr. Berwick was a practicing pediatrician and vice president for quality-of-care measurement at Harvard Community Health Plan. He was exploring the work of people like Harvey Fineberg and Jack Wennberg who were writing about variation in medical care. Even back then, it was known that much of what we do in health care does not actually benefit the patient and that there is a broad gap between what the evidence says should be done and what is actually done.

Dr. Berwick studied the science of decision-making and became the  president of the Society for Medical Decision Making. He had a curiosity about the logic of using diagnostic information to help patients and how to help clinicians understand this logic. I had the good fortune of being present when Dr. Berwick dedicated the annual SMDM meeting to quality improvement and to Avedis Donabedian MD, the father of quality improvement in healthcare, who was given a lifetime achievement award.

Berwick began studying the history of quality improvement in industrial America and learning about the greats of the continuous improvement movement, such as W. Edwards Deming and Walter Shewhart, and realized that the tenets of industrial quality improvement were also applicable to health care.

Dr Berwick aligned with Dr. Paul Batalden, a pediatrician working for the Hospital Corporation of America, and they applied for a grant for a national demonstration project on quality improvement in healthcare.  They studied 16 different hospitals across the country and set out to redesign systems to get better outcomes for the American people.  The initiative was successful and spawned a book called “Curing Healthcare” and at the end of the project they used the momentum to start a new organization.  The Institute for Healthcare Improvement  (IHI) is now almost 25 years old and has been the international leader in improving healthcare, working domestically and internationally.

Dr Berwick got the idea a decade ago to borrow concepts from political campaigning to reduce harm in U.S. hospitals.  He started the 100,000 Lives Campaign and then moved on to the 5,000,000 Lives Campaign, both of which were very successful at improving care.  The federal government has learned from those initiatives and has grasped much of what he started even before he got to CMS. GBMC has participated in and learned from these initiatives. Our wonderful results in reducing central line associated bloodstream infections (CLABSI) are a direct offshoot of the work that Dr. Berwick began.

It was because of all of his wonderful accomplishments that President Obama invited Dr. Berwick to become the head of CMS and to implement the Affordable Care Act.  The fact that the most intelligent leader in healthcare who has accomplished the most internationally in improving health systems would be willing to join the federal government and take on a huge federal agency was a gift to the American people.

But now, sadly because of political payback, stupidity, and pettiness among elected officials who did not like the healthcare reform act, his term is ending prematurely and Dr. Berwick is going to have to leave before the  job is done. It is very disappointing that the American people don’t even know who he is or what he was trying to do. I believe the best person to fix our healthcare system is being thrown out by people who don’t understand healthcare or the American dilemma of spending almost twice what other developed nations spend on healthcare and having outcomes that are often not as good.

Donald Berwick has not spent one moment in his life in the “victim box”. He never focuses on the problem, instead he quickly gets in action on the solution. So, rather than lament Dr. Berwick’s departure from CMS, we must rededicate ourselves to the continual improvement of our healthcare system starting with what we control at GBMC. We must work hard and speed-up our transformation towards better health, better care, lower cost, and more joy for those providing the care!

Please share your thoughts on Dr. Berwick’s work or how we can make change happen faster in our system.

On a happier note, please join me in welcoming Deloris Simpson Tuggle to our family as the new vice president of human resources and organizational development/ chief human resources officer for the GBMC HealthCare system.  Deloris is an industry veteran with more than 20 years of experience in human resources and organizational development. Deloris will officially join GBMC on December 5.

Deloris Simpson Tuggle
As we continue our metamorphosis from an outstanding hospital into an outstanding system of health we need leaders who understand our vision and see their role as extended beyond the borders of our beautiful campus; Deloris is this type of person.

Deloris will have responsibility and oversight for planning, organizing and providing leadership and direction for the organization’s human resources functions including policy development, interpretation and administration; recruitment, orientation and retention of employees; compensation and benefits programs; performance management and competency assessment; employee relations and labor relations; and training and development programs.

Deloris comes to GBMC from the Dana-Farber Cancer Institute in Boston, Mass. where she spent three years in the roles of senior director of human resources and interim senior vice president of human resources for the Harvard Medical School-affiliated organization.  She also has worked for the May Institute in Randolph, Mass., Lifespan Healthcare Systems in Providence, R.I., The Housing Services Company in Boston, Mass. and Trans World Airlines.

Deloris has told me that living in the Baltimore area is “a wish come true.” She has an affinity for Maryland and has two brothers in the area. She is looking forward to moving to Baltimore. Please join me in welcoming Deloris.

Thursday, November 24, 2011

“All the things we have to be thankful for”

As we celebrate the Thanksgiving holiday, it’s important to take a minute and step back from our hectic everyday lives to think about to all the things we have to be thankful for. This is especially true if you are an organization or an individual in a time of financial hardship, when it’s much easier to focus on the problems than on the wonderful gifts that many have.

And the GBMC family needs to think about the wonderful gifts and abundance we have  - a beautiful campus, state-of-the-art technology, and great doctors, nurses, allied health professionals and support service staff. Generally we have nice facilities, although there are some areas we’re working to spruce up a bit.  Our GBMC family is very strong, with many longtime loyal employees, 36 of whom were recognized earlier this fall for careers of 30 years or longer here.

We’re serving a community who can pretty much access us and has the resources available that they need which is not true for all health systems, such as those who are serving underserved communities where people have phenomenal needs outside of healthcare.  While we do have some of that need amongst our community, the Health Services Cost Review Commission generally pays us less so they can apply more money to other organizations and provide resources where they are needed more.

I also want to extend a “Thank You” to the employees who worked on Thanksgiving, or who are working during the extended holiday weekend, caring for our patients and helping support their loved ones and visitors. Healthcare is a 24/7/365 business, and it can be especially difficult for people to be hospitalized during the holiday time.  I know our staff and volunteers went the extra mile to make sure our patients felt like they were being treated like family, and that is greatly appreciated and valued.

A “Thank You” also to all the GBMC HealthCare system employees who generously donated to the organization’s recently-completed United Way drive.  It’s too early for us to have a total amount of money raised, but with the various fund raising activities (candy sales, raffle, jeans days, basket bingo) we know that those who are less fortunate in our community will benefit from your generosity and support.

Finally, on behalf of GBMC HealthCare, I’d like to extend best wishes and good luck to our neighbor and Towson Four partner Towson University, whose football team takes on Lehigh University on December 3 in the second round of the NCAA Football Division I playoffs.  Go Tigers!

What are you thankful for during this time? Please share your thoughts below.

Friday, November 18, 2011

Celebrating the Life of Etna Weinhold, a GBMC Icon

ICON [ahy-kon] – a person or thing regarded as a symbol of a belief, nation, community, or cultural movement.

As many of you already know, GBMC lost one of its icons last week. Etna Weinhold, Clinical Manager of Units 25/26 – Postpartum, was a symbol of the GBMC community. Sadly, she succumbed to cancer on November 10.

I had the good fortune of knowing Etna, and although we didn’t work together closely for a long time, it was obvious to me from day one that she clearly and deliberately embodied GBMC’s values. And she did so for each of the 40 years that she worked here. I chose to dedicate this installment of the blog to Etna’s memory because her lifelong commitment to caring for so many – family, friends, fellow Americans, employees, patients and their families – was truly remarkable and, in fact, iconic.

A former field nurse in the United States Army Nurse Corp, devoted wife, mother of four and grandmother of eight, Etna literally touched the lives of thousands of people. In her role as clinical manager of the postpartum units, she helped revolutionize the way that new mothers at GBMC recovered from childbirth by making their rooms more comfortable, like home or a hotel. Improvements also featured accommodations that allowed fathers to stay in the recovery room with their wives and newborns, which many women consider a necessity today, and “hidden” medical equipment to create a less sterile atmosphere. These approaches made a big difference to women and their families.

Etna herself was a comforting presence to those on her unit. Her attentiveness and genuine interest in every patient was evident.

In a recent tribute to Etna, news reporter Kerry Cavanaugh summed up the feelings of many, saying, “I was one of more than 4,000 women to have a baby at GBMC that year [2008], but when Etna knocked on my door and introduced herself, she made me feel like the only patient on the unit.” I can say without hesitation that Etna worked tirelessly to provide the kind of care she would want for her own loved ones. There was also a beautiful tribute to Etna in today's Baltimore Sun.

At the funeral home on Monday afternoon, I was moved by the number of Etna’s colleagues who approached me to share stories about the impact she had on their careers and lives. By all accounts, she was always looking out for the best interests of her staff, her patients and GBMC, always enjoying her work and taking pride in it, always committed to serving others.

Keeping Etna in mind, I’d like for all of us to take some time to reflect on our own lives and the way in which we care for others. Let’s strive to follow her lead.

If you have your own stories or memories of Etna that you’d like to share, you are welcome to post them in the comments section.

I’d also like to take a moment to recognize the group of volunteers who made the fall 2011 Nearly New Sale an outstanding success. They, too, have made a significant commitment to caring for the community and GBMC.

Did you know that it takes 75 to 80 dedicated Nearly New volunteers (plus 30-40 extra “day” volunteers who help on the sale days) more than 12,500 hours to prepare for, hold and clean up from each sale? Under the leadership of Nearly New Chair Loretta Reynolds and Director of Volunteer Services Cynthia Fager, the team not only accepts donations, but sorts and prices them, stocks them on shelves/racks, sells them and counts the money, then starts the process over again.

At a special celebration event held at the Elkridge Club last Friday for the Nearly New volunteers, it was announced that the recent fall sale raised $143,140, topping all previous sales! This brings the total amount raised between spring of 2000 through fall of 2011 to an astonishing $2,930,540, which has all gone directly to GBMC’s Volunteer Auxiliary Patient Care Fund. A heartfelt thank you to everyone who participates in these sales.

Lin Hardy ,Nearly New Treasurer, announces the sale's total.

Friday, November 11, 2011

Experience The New "Greener" GBMC Dining Room

One of the most important things I can do as the head of GBMC HealthCare is listen – not only to our patients, but to our staff as well.  Our internal customers represent an important constituency and often have excellent ideas that will help us improve as an organization.

One such idea came from a SICU nurse last year, who shared with me her concerns about the length of time it took for her to get a meal in the dining room because of the long lines at the cashier, and that she barely had enough time to pick out something and eat it before she was due back on the unit taking care of patients.  The cafeteria management team got on it and installed faster cash registers and added new lines at peak times.

Now we have the opportunity to shave a few more seconds off the process by offering a payroll deduction option. Swiping your ID completes the transaction in about one second! Employees can fill out a form, available in the dining room, and within days they will be approved. I’ve signed up and encourage our employees to do the same.

This is just one of several improvements we’ve made recently in the dining room – we’ve come a long way toward making the dining experience more enjoyable for our guests and staff.  There are new menu items, combo meals, and sauté specials; we’ve increased the selection of healthy foods and beverages and are now offering Dunkin' Donuts coffee.  There is new furniture in the dining room, and paper menus have been converted to new electronic menu board monitors, which reduces the amount of paper, laminating sheets, sign holders and ink we would require to produce menus.

In addition to the electronic menus, there are a number of other zero waste initiatives recently completed in the dining room.  We’ve converted condiment packets to Heinz-branded pumps, introduced a coffee creamer pump, converted all medical intern / resident pink meal vouchers into reloadable cards, and are composting kitchen waste at a local facility and not placing with municipal waste.

This week, new recycled fiber Earth-friendly trays were unveiled.  Similar to the trays that many are familiar with from sports stadiums or concert venues, the trays are biodegradable and can be placed in regular trash when the customer is done eating.    Believe it or not, this will help us save thousands of dollars a year!

Of the 3,000 traditional hard plastic trays that Dietary purchased last year, there are only a few hundred left.   At almost $3 per tray, that’s a lot of money that literally just “walks away” every year when people take these trays from the dining room back to their work areas and don’t return them. So please remember – if you are talking “lunch to go”, take a new recyclable tray.  It will help the earth and help us save money.  Better yet, if you have just a sandwich and a drink, perhaps you can do without a tray to carry the meal back to your area.

Mike Forthman, L, with an older-style tray, and Dr. John Chessare, R, with one of the new recyclable trays.
Kudos to our “Green Team”, led by Mike Forthman, Vice President of Facilities and Support Services and to the Dietary team led by Matt Tresansky, Director of Food and Nutrition Services and Ryan O’Hara, the dining room’s retail manager, for implementing these changes which are designed to reduce waste, shrinkage, and cost while maintaining a high level of customer satisfaction. Be on the lookout for more improvements planned for the near future!

Do you have any ideas on how GBMC can become a “greener” or “leaner” organization? Please share your thoughts below.

Finally, my heart goes out to the members of the GBMC family who were injured “in the line of duty” when they were assaulted by patients recently while providing care. The safety of our staff, patients, and visitors is of paramount concern.  Unfortunately, incidents such as these are a problem across America’s healthcare system, with many studies reporting hundreds of healthcare workers being assaulted each month nationwide. In the past year-and-a-half, GBMC has implemented several strategies to make the environment as safe as possible, and in concert with our employees utilizing Safe Behaviors and following the designs for safety that have been set up, we are determined and committed to make our systems of care and our workplace safer. As a result of these attacks, we will again review our practices and policies and make changes to make GBMC safer.

Friday, November 4, 2011

GBMC Once Again Has Dozens Of “Top Docs”

We’ve always known that one of GBMC’s phenomenal strengths was the quality of its medical staff, which was again confirmed when more than 100 of our physicians were named in the just-released Baltimore magazine “Top Docs 2011” survey in the November issue.

In preparing its annual list of “Top Doctors,” Baltimore magazine surveyed more than 6,500 area physicians in Baltimore City and seven surrounding counties and asked where they would send a member of their family for care in a wide variety of specialties.  This important question is at the very center of GBMC’s vision of providing each of our patients with care in the same manner that we would want for our own loved ones.  

I’m proud to report that 104 physicians with GBMC privileges in 69 different specialties earned recognition in this prestigious listing, including four physicians who were each listed in two different categories.

It’s quite an accomplishment for these physicians. Patients generally rate their doctors on bedside manners because they really don’t have the ability to rate them on other factors such as diagnostic skills or therapeutic knowledge, but to be recognized by your peers as a quality doctor is really quite a statement and is something I would personally aspire to. 

I’d like to especially highlight our department chairmen, chiefs, and medical directors who were recognized by Baltimore magazine:

George Apostolides, M.D. (Colo-Rectal Surgery)
Fred Chan, M.D. (Medical Director, Inpatient Services)
Gary Cohen, M.D. (Medical Director, Sandra & Malcolm Berman Cancer Institute)
Neri Cohen, M.D. Ph.D. (Chief, Division of Thoracic Surgery)
Reginald Davis, M.D. (Division Head of Neurosurgery)
John Flowers, M.D. (Surgery)
Allan Genut, M.D. (Chief , Division of Neurology)
Harold Goll, M.D. (Anesthesiology)
Francis (Bing) Grumbine, M.D. (Gynecology)
Brian Kaplan, M.D. (Otolaryngology)
Victor Khouzami, M.D. (Obstetrics)
Peter Liao, MD. (Medical Director, Comprehensive Obesity Management Program)
Alexander Munitz, M.D. (Diagnostic Radiology)
John Saunders, Jr. M.D. (Chief Medical Officer)
Lauren Schnaper, M.D. (Medical Director, Sandra and Malcolm Berman Comprehensive Breast Care Center
Melissa Sparrow, M.D. (Clinical Director, Pediatric Inpatient and Emergency Services)
Jeff Sternlicht, M.D. (Emergency Medicine)
Harold Tucker, M.D. (Chief of Staff)

In addition, the Baltimore magazine “Top Docs” issue highlights several other GBMC physicians – including Sudeep Pramanik, M.D., an ophthalmologist whose expertise helped restore vision for a woman who had undergone 13 unsuccessful surgeries and hadn’t seen properly in four decades.

A full list of GBMC “Top Docs” is available at Top Docs.  To find a physician that is right for you and your loved ones, simply click the “Find a Doctor” link on our homepage or call 443-849-GBMC (4262).

Please share your thoughts below about your experiences with GBMC physicians, especially any of our “Top Docs.”

Friday, October 28, 2011

Who Are You Serving? Who Is Your Customer?

In order for a large complex system to work, everyone has to be thinking about their interrelationships with the other parts of the larger system. Everybody needs to get into the mindset of continual performance improvement, which begins with a focus on the customer and evaluating what patients or other customers need.

In early November, GBMC staff will be receiving an email about the organization’s 2011 Internal Customer Service Survey.  Staff will be asked to take a brief but important survey, which should take 10 minutes or less to complete. This is an important tactic in our effort to continually improve our service to each other.  The survey tool will be made available for a two-week period between November 7 and November 20 and is web-based and easy to access.  

Staff will be asked to evaluate departments with whom they have had regular interactions. The goal is to capture information that is needed for departments to improve their service and provide an opportunity for recognition.   The survey objectives include:
  • To provide a “service” metric for non-clinical departments that are not surveyed by Press Ganey
  • To emphasize the importance of “service” to our internal customers that ultimately impacts our patients’ experience.
  • To provide a snapshot of how departments are doing with promoting and living our Greater Behaviors.
  • For some departments, provide valuable data to compare to last year’s survey results.

As each department works to improve their level of service, we move closer to our vision of "Every Patient, Every if it was your loved one!” Thank you in advance for taking a few minutes out of your busy day to provide this invaluable information via the survey.
Do you have thoughts on areas of the organization that you work with?  Please share your comments below.

One employee who has been providing excellent service to our customers is Pat Blanding, a Nurse Support Technician on Unit 35.  On behalf of the entire organization I want to congratulate Pat, who was recently recognized by the National Gerontological  Nurses Association (NGNA) with the Excellence in Gerontological Nursing Award.  The award has been established to recognize excellence in individuals who provide care to older adults and is intended to honor a certified nursing assistant who has consistently provided outstanding care to older adults and has been an inspirational role model and mentor to other healthcare workers.  Pat was also the 2010 recipient of the Cynthia Steele Caring Hands Award presented by the Maryland/DC Chapter of NGNA which is designed to honor nursing assistants who strive to provide excellent, compassionate service and highlights the importance of the role of the nursing assistant in the care of older adults.

Unit 35 NST Pat Blanding (left) receiving the Excellence in Gerontological Nursing Award from NGNA President, Sue Carlson at the national convention in Louisville, Kentucky.

This theme of customer service extends to a topic that is likely on the minds of many of our staff – what is the future of our healthcare neighbor, St. Joseph Medical Center. As you might have read on this blog two weeks ago, Catholic Health Initiatives, owners of SJMC, has issued a request for proposals seeking a strategic partner.  We are exploring a possible response to that RFP, and board chairman Harry Johnson has appointed an ad-hoc subcommittee of the board to work with hospital management to oversee this process.

Unit 46 is ready for its HBO debut.

MICU nurse Michele Cox, RN, CCRN served as a medical consultant for the HBO filming.

Two extras on the set.

Ready to film.
I’ll end this week’s blog with some exciting news – we’re going to be on national television! A crew from the HBO network was at the hospital this week filming a scene for their new comedy show VEEP, which will premiere in early 2012.  The show stars Julia Louis-Dreyfus of Seinfeld fame (“Elaine”), who portrays a fictional United States vice president. Seinfeld is one of my all-time favorite shows, and Elaine in the show was from the Towson area, so it was a natural fit to film here.  It was amazing to see how “Hollywood” transformed one of our units into the set for “Our Lady of Hope Medical Center.” I’ll be sure to let everyone know when the episode is scheduled to air.

Friday, October 21, 2011

Healthcare Technology Talk with Maryland’s Health Secretary

As some readers of my blog may know, I spent a great deal of my healthcare career in the Boston, Massachusetts area, both as a practicing pediatrician and as a hospital administrator.  In January of this year, I was pleased to learn that a former colleague, Joshua M. Sharfstein, M.D. had been appointed as Secretary of the Maryland Department of Health and Mental Hygiene.  I served as Dr. Sharfstein’s preceptor while he was in residency training in pediatrics at Boston Children’s Hospital and Boston Medical Center, and I was eager to renew our connection.

Last week, I was pleased to host Dr. Sharfstein for a quick visit with Mark Lamos, M.D. at the GBMC at Hunt Valley practice, where as part of the “Triple Aim” goal of better health, better care and lower cost we have begun implementing our medical home model and transitioning from a “fee for service” healthcare model to a “fee for health” model.   

Some key components of GBMC’s medical home model:
  • While the primary care physician is “captain of the ship”, there’s a team approach to caring for the patient.
  • Access is one of the biggest differences – we have expanded our primary care practice hours, opening earlier (7 a.m.) and staying open later (7 p.m.) so care can be given during the hours a patient needs it. 
  • Patients with medical problems that traditionally have been referred to the Emergency Department can be handled at physician offices, enabling ED beds to be free for true medical emergencies.
  • The Hunt Valley practice is set up as a LEAN-based practice, where “PODS” are set-up and stocked in the exact same way (exam room layout, staff cross-trained in multiple skills) and staffing is done to best match the patient needs of a given day.
  • A dedicated team facilitates pre-visit planning via telephone with scheduled patients enabling lab work and other tests to be ordered in advance and expediting the patient’s visit.
  • Registries have been started for patients with chronic diseases such as diabetes and asthma.
  • Blood-drawing services are on-site.
In addition, we will soon be installing several computers in the waiting room, and implementing a patient portal to our electronic record, which will allow patients to check-in for appointments, access their medical records, share information with our clinicians about their current medical problem and review their past medical history.

The Hunt Valley practice handles about 1,600 patient visits per month and takes care of about 17,000 patients a year. The average patient visit lasts about 40 minutes.

The healthcare system in the United States remains one with much opportunity for improvement, but via transformational redesign like in our primary care sites GBMC HealthCare can help lead the way toward much-needed reforms and to providing healthcare the way we’d want our families to be cared for.

Dr. Sharfstein was appreciative of the time spent at Hunt Valley and emailed me afterwards: "Thanks for the terrific tour. It is great to see a healthcare system moving so quickly to redesign care and improve outcomes for Marylanders."

Do you have any ideas of how the healthcare system can be improved for patients? Please share your comments below.

Last week I also had the pleasure of being the guest speaker at the annual Volunteer Auxiliary Luncheon where I explained to dozens of our volunteers how we can’t achieve our vision without the wonderful and generous gifts of their time and effort.  

Shown enjoying the Volunteer Auxiliary Luncheon are (L-R): Ann Stiff - Executive Office and Medical Staff Office, Herb Stiff - Front Desk,  Git Merryman, Diagnostic Center and Martha Moyer, Spiritual Support. 

Our hospital and our hospice are blessed to have hundreds of volunteers in both clinical and non-clinical settings.  Each day these individuals are engaged in meaningful tasks – from providing directions to easing fears, from shuttling loved ones across campus to delivering flowers and smiles to patients – that allow our staff to spend time providing the care that we’d want our own loved ones to experience. 

Cynthia Fager, volunteer services director, said, “The volunteers walked away with a much better understanding of GBMC's vision and what has been accomplished to date to support the vision.”

Also on the volunteer front, this weekend is the opening of GBMC’s tremendously-popular Nearly New Sale, which is somewhat of a legend in Baltimore.  

Folks make travel plans around the sale dates, entire families get together, and many unbelievable deals and steals are found.  Twice each year, GBMC employees, volunteers, and the general public get an opportunity to buy treasures, trinkets, and necessities from furniture, clothing, jewelry and silver to appliances, sporting goods, toys and games, and much more -- all at nominal prices. GBMC volunteers devote hundreds of hours this event that raises more than $250,000 annually and contributes all of its proceeds to the Volunteer Auxiliary's Patient Care Fund.  Nearly New will be open this Saturday and Sunday from 9 a.m. – 5 p.m., and on four other days this next week.  Check Nearly New Sale for a full schedule of sale dates and times.

Finally this week we dedicated a special new healing environment on GBMC’s campus - the Breast Care Center’s Pink Garden.  Unveiled during Breast Cancer Awareness Month, the Pink Garden was funded through donations and is the result of a collaboration between the Roland Park Garden Club, Signature Landscape and the Sandra & Malcolm Berman Cancer Institute. Floeresn bushes and trees with pink flowers will bloom nine to 10 months a year and the garden includes a special water effect, a stone bed in the shape of the cancer ribbon with water constantly flowing over the stones. This welcoming garden will be special for all patients and visitors, especially breast cancer patients and the 16,000 women who come for mammograms at GBMC each year.  Surely this will prove to be a special place for patients, family members and friends who are on their cancer journey.

Friday, October 14, 2011

The Results Are In: Learning from our Employee Satisfaction Data and Making Improvements

Two weeks ago, I wrote about the loyalty of our employees and how nearly 500 colleagues were celebrated at GBMC HealthCare’s annual Employee Recognition Dinner. Today, I want to share highlights – some positive results and some areas where we have room for improvement – of another annual organization event, the Employee Opinion Survey.

Providing healthcare is a joyful profession. People allow us to enter into their lives at vulnerable moments in the hopes that we will make their loved ones better, or at least comfortable, and GBMC leaders need to be able to make sure that our people can feel that. One way we can do this is by making sure that we do whatever we can to make their work lives better. This is the reason why we do the Employee Satisfaction Survey each year. 

Nearly eight of every 10 GBMC employees participated in the 2011 survey, and in an organization with more than 3,000 employees, that’s good. Hopefully next year we’ll have closer to 100 percent participation, as the results we receive are very important and can effect changes for all staff.

Our overall average score was a 70 – a mixed blessing of sorts. The good news is that it didn’t go down from the previous year, but the bad news is that we had the same overall score last year.

I’m happy to report that our greatest area of improvement – an increase of eight percent – was for the question asking if employees trust executives (Senior Management). Our leaders have been working hard to say what we mean and then do what we say we are going to do.  Communication between the front office and the front line is critical. You build trust by delivering on what you say you are going to do.

As part of the senior management rounding process, leaders have been assigned units to visit and ask questions, such as if staff has the equipment and resources they need to do their job. We’re also inviting employees to share ideas with us; if someone brings forward an idea we owe it to them to have one of three responses: “Yes that’s a great idea we’re going to do that right away”; “Yes that’s a great idea but it may take us a while to accomplish that”; or “No, we can’t do that” and explain to them why it can’t be done.  Those are words, statements and commitments that we need to follow-through on which is how we’ll continue to build trust.

The management team exists to help make it easier for the people who are actually caring for patients to get the job done. Our people need to know that senior leaders do listen to them.  We expect that anything that can be fixed by a local manager and his or her team will be fixed by them. Anything that is beyond the scope of the local leader needs to be owned and addressed by senior leadership.

One area that did not receive a positive response was the question asking if employees are satisfied with pay increases, with a 14 percent drop from the 2010 result.

We get it. In a stressful economic period, people who maintain their jobs would like to get a substantive raise.  But with an operating margin of two percent, we have 2 cents of every dollar leftover after we pay all of our bills and it’s very difficult to give large raises.  We’ve been happy to give raises in the past that hopefully aligned with increases in the cost-of-living, and we know that in families where the GBMC employee may be the only breadwinner that it could be a difficult situation.  We are looking forward to giving a two percent raise again this year before the end of the calendar year, but this is a “call-to-arms” for all GBMC employees to pay attention to the organization’s waste reduction initiatives because that is where we would get the money from to give even bigger raises in the future. 

Do you have any examples of unit-specific improvements that have been made as a result of senior management rounding? Please share your comments below.

Some readers of this blog may have seen the recent news that Catholic Health Initiatives, owner of St. Joseph Medical Center, has issued a request for proposals seeking a strategic partner for our neighboring Towson hospital.

Unfortunately SJMC has experienced some difficult developments in the past few years.  Although we are “competitors” in the healthcare arena, GBMC and SJMC have traditionally been united in our quest to meet the healthcare needs of Towson and neighboring communities. Whatever the outcome of the SJMC situation, many believe that the result that would make the most sense is for there to be one strong system of care in Towson that is focused on better health, better care, and more joy for those providing the care at lower cost. One strong regional system increases the ability to maintain access to existing services with the possibility of adding additional services as they are needed. Healthcare leaders must realize that one united system has a better shot of creating efficiencies to ensure that people can continue to get the care they need close to home.

Finally, I encourage all GBMC HealthCare employees to consider participating in our United Way campaign which runs through November 18. You can pledge online here:   There are many options to choose from if you’d like to keep your donation “in the GBMC family” –the Sandra & Malcolm Berman Comprehensive Breast Care Center, Geckle Diabetes & Nutrition Center, Harvey Institute for Human Genetics, Gilchrist Hospice Care, Neonatal Intensive Care Unit, or Hoover Rehabilitation Services for Low Vision.  Unrestricted gifts can also be made to the GBMC Foundation or to support the hospital in general.  As an extra incentive to donate early, all employees who contribute by 8:00 a.m. on October 17 either electronically or by dropping off paper forms at Human Resources on the 5th Floor will be entered into a drawing for an iPad 2.