Friday, May 27, 2011

GBMC HealthCare System – Our New Vision, Our New Plan to Get There

Shortly after I joined GBMC HealthCare, Inc. as President and CEO just about one year ago, I was challenged by GBMC’s Board of Directors to answer, in what direction should we go to keep GBMC strong well into the future?
We have taken this question quite seriously and I want to share our answer with you.
We’ve just finalized GBMC’s three-year strategic plan (FY ‘12 – FY ‘14), a huge undertaking that solicited the input of many people throughout the system. A new vision for GBMC has been created and I’m pleased to share that our long-term strategic plan is quite different from past plans and is unique in our region. It’s not about edifices and how big of a new patient tower we can build. Rather, it serves as the foundation for a solution to what ails the current national healthcare system, focusing on what the people in our community truly need and want to stay healthy, or become healthier. 
In creating our plan, we first needed to assess where we were as an organization and identify the things we were doing well. We next needed to ask ourselves where we were missing the mark through the eyes of our patients.  This process started with our Board of Directors’ strategic visioning retreat where we began shaping the organization’s new path.  We discussed how America has the best trained doctors and nurses in the world, yet we are in a deep mire. Our system is very costly and is financially unsustainable. In addition, our care is frequently disjointed and the ever-increasing number of people with chronic disease is frequently not well served. The Board challenged themselves to think of a better system that they would want for their own family members. Thanks to the leadership of the Board’s strategic planning committee, led by Chairman Jim Stradtner, we developed a vision of a more patient-centric system where the patient’s needs could be better met.  
So today, GBMC is moving into the future with renewed energy and increasing insight with our new vision as our guiding light. The more lengthy vision statement is summarized in the phrase:
“To every patient, every time, we will provide the care that we would want
 for our own loved ones.”

[Read the full version of GBMC's new vision as well as the strategic plan summary on the GBMC website - ]

With our new vision taking shape, we forged ahead with creating the plan to get there, working with the clinical department Chairmen throughout GBMC to find out what they needed to get us to this vision. We took their valuable feedback and used it to begin developing the specific areas of focus and tactics of our plan. The process was guided by the strategic planning committee and overseen by John Ellis, Senior Vice President of Corporate Strategy and Business Development, and Colin Ward, who as part of the plan has been named Executive Director of the Greater Baltimore Health Alliance. Once the committee sanctioned the plan, we took it to our full Board earlier this month and they approved it.
So, as we begin to roll out our new vision for the future, I felt it was critically important for everyone to know where we are going and how we will get there, with the ultimate goal of providing the very best care for the people in our community.
 At the heart of our strategic plan are five pillars that encompass the work to get us to our new vision:
1.   Create an enterprise-wide IT solution, e.g. Information technology, specifically Electronic Medical Records (EMR), that will provide a seamless information network between outpatient and inpatient records
2.   Improve operational performance
3.   Improve clinical outcomes and the patient experience
4.   Build a provider network to achieve the mission of developing a model system for delivering patient-centered care
5.  Create new organizational capabilities to support our new strategies

What the Future Will Hold
Moving forward, GBMC will provide the kind of care that will keep people from getting sick, or sicker, rather than just taking care of someone episodically (like when they come in with a sore throat, infection, or even complications from a chronic disease that has not been managed correctly).  This type of comprehensive care requires much more attention on prevention and a greater focus on primary care as a way to mitigate disease. We see primary care physicians and their teams as the integrators of services across the continuum. This is why our primary care practices in our employed group, Greater Baltimore Medical Associates (GBMA), have undergone a significant transformation over the past year, moving toward a patient-centered medical home model that includes extended office hours to better meet the needs of our patients, as well as e-mail communication, patient registries, the electronic record, group education for specific chronic diseases and more – this is all part of the transformation of healthcare that GBMC is leading for our community.
In fact, we have a really good example of integrated care embodied by Gilchrist Greater Living, GBMC’s geriatrics group, led by Dr. Tony Riley. This team of physicians manages the care of frail elderly from their home, to the physician office, to extended living facilities, to nursing homes, to the hospital, to hospice and between these different sites.

Building a Strong Provider Network and Capitalizing on Our Historic Strengths is Essential
In addition to an emphasis on primary care, our plan will build on our wonderful areas of excellence in specialty care. We cannot lose sight of our historic strength in Surgery, Women’s Health, Cancer, and many others. In order to be a vibrant healthcare system we will no doubt need to do surgery even better, more efficiently and with greater patient satisfaction than ever before, which is why surgery (and the success of all of our surgeons) is another main focus of our strategy for the future. We will place even more emphasis on the measurement of outcomes – and recognize that there will be an increased need to document the medical necessity of procedures to ensure that we are practicing evidence-based medicine. Dr. Jack Flowers, GBMC’s Chairman of Surgery, is leading the charge to have us report and record data so that we can be ahead of the curve when it comes to documenting our superb surgical outcomes.
We must create a more integrated healthcare system from our existing model, which must include wonderful private practicing physicians in the community as well as those physicians who are employed by the system. This vision of building an alliance of physicians is now becoming a reality with the establishment of the Greater Baltimore Health Alliance (GBHA). GBHA will be a physician governed organization comprised of employed and private practicing physician partners tied together by a common commitment to better health, better care, and lower cost and a common electronic record system that will facilitate the exchange of health information, and  help coordinate care among the practices, the hospital, Gilchrist Hospice Care and other future community partners.
In building a strong provider group, we realize that GBMC doesn’t need to employ all physicians. Across the country, the organizations that seem to integrate care well have mostly employed physicians. At GBMC, we want to build on our historic strength of outstanding private practicing doctors by aligning them tightly with our employed physicians.  This type of combined medical staff has certainly served us well over the history of GBMC. We need to build up from this area of historic strength.  
Integration is a Key Tenet to our Strategic Plan
In order to integrate care through eyes of the patient, we must have a sophisticated electronic medical record system. All GBMA primary care physician practices now have the EMR in place. We will have all of our employed specialists on the record over the next few months. And our partners through GBHA will also be helped to implement the EMR technology. Patients often get nervous and frustrated when clinicians ask the same questions and don’t have access to tests they have already taken, which results in the waste of repeating tests. This type of fragmented care is a characteristic flaw of our existing system and GBMC is leading the way in eliminating this flaw.
Healthcare Reform in Our Own Backyard
What GBMC is looking to achieve is a true reform of our community’s healthcare system. We are doing the right thing to better serve our patients. We’re focusing more on the specific needs of each patient and the health of the community. Some may worry that we could find ourselves going down a path that causes us to lose money because the payment system may not be able to keep up with the rapid changes in the way we deliver healthcare. However, being an independent, community hospital makes it much easier for us to adapt quickly as change comes. And, we have time to make the transition because all of the change isn’t going to happen overnight. It is also helpful that we are beginning from a strong financial footing; we do not have the huge debt associated with large new buildings.
It’s so important to have this plan in place for the healthy future of our organization as well as of our community. And as you can see, we’ve adapted our vision and we are now ready to be the healthcare system that “To every patient, every time, provides the care that we would want for our own loved ones.”
I welcome your thoughts and comments as we move into this new era of healthcare at GBMC…

Monday, May 23, 2011

EMS and GBMC – True Partners in Caring for a Community

Last Tuesday, I was transported by the emergency medical system.
Thankfully, not as a patient, but as a guest of Captain Chuck Vaughn of Baltimore County Fire Department EMS 1 during National EMS week. I was fortunate to receive a firsthand look into the world of EMS workers during my ridealong and how first responders and hospitals work together to ensure superior care for patients.

I enjoyed my two-hour ride with Captain Vaughn, a very well-trained and humble man who explained that the largest part of the fire service in Baltimore County is EMS, with approximately 75 percent of the calls. I also found the relationships between career and volunteer firefighters and paramedics, and how they all cover for and help one another, to be an example of teamwork at its finest. Captain Vaughn explained to me that his people are so dedicated to their jobs that when some of them come off duty, they then report to the volunteer fire station – because they love what they do.

Over the course of the two hours, I visited with firefighters at Station 1 in Towson, stopped at Fire Department headquarters and met with Fire Director Wayne Tome, who supervises EMS operations for the Fire Department, and finally visited with firefighters at Station 11 in Hillendale. 

But just as we were getting ready to return to GBMC, a call came in reporting a person stabbed (or shot, it wasn’t immediately clear) at a supermarket on Loch Raven Boulevard. Things just got exciting, I thought, as we rushed to respond to this call!  Once at the scene, police cleared us to go in and the stabbing victim, who sustained a minor laceration to the arm, was transported to GBMC where he was handed off to the very capable hands of our Emergency Department physicians, nurses and staff.  When my heart slowed down a bit, I realized just how well designed this emergency system was – when the call comes in, paramedics, fire and police are all dispatched, yet the police officers make sure the scene is safe before the unarmed firefighters and paramedics go in to care for the victims. I felt a great source
of pride to be part of an even larger community system that is there for your loved one when needed. What if it were your uncle or brother who was just stabbed? You’d want to be sure there was a system there to help him. This was certainly an experience I won’t soon forget!
I would be remiss if I didn’t mention the annual GBMC Golf Tournament that was held last Monday at Turf Valley Country Club. From Jan Emerick and the Foundation staff to Dr. Rob Stoltz, Mike Forthman and the entire golf tournament committee, it was clear that countless hours were spent preparing for this great event that grossed more than $200K to benefit GBMC. I had the opportunity to golf with Dr. John Saunders, Dr. Neri Cohen and Dr. Frank Lee, and had a few good shots and a lot of not-so-good shots! But a great time was had by all and it was evident that so many community members and supporters of GBMC are truly dedicated to our future success.
There are some truly great members of our GBMC community- staff members, emergency workers, supporters and donors and many others – let’s take a moment to say thanks…

Friday, May 13, 2011

The Nearly New Sale and Three Black Tie Events

This past weekend, I had the opportunity to attend a whirlwind of gala events and dinners that celebrated excellence and recognized the spirit of community commitment. Of course, this wasn’t a typical weekend for me, and my social activities are not usually so glamorous, but when the events were all over and I had a moment to reflect back on all of the people involved, I realized just how many individuals at GBMC and in our communities give of their own time for some worthy cause.
My event-filled weekend started on Friday evening at the House Staff recognition dinner. This is truly a wonderful event because it recognizes GBMC’s residents and resident award-winners, as well as GBMC faculty members, award winning physician teachers, and those physicians who lead our residency programs. This event really spotlights a piece of our mission that doesn’t typically receive a lot of air time, which is the teaching and the preparation of the next generation of doctors and healthcare providers. The focus of all of the individuals who presented at this reception, including Dr. Mark Ellerkmann, chairman of GBMC’s graduate education committee, Dr. John Saunders, Chief Medical Officer and Dr. Hal Tucker, our Chief of Staff, was that the opportunity to mentor and teach our future doctors is what helps keep all of our attending physicians in the learning mode. It’s really a win-win for all – our residents and our attending physicians. GBMC is fortunate to have many faculty members who are so giving of their time, volunteering to teach our residents to ensure better care for our community in the future. 
On Saturday night, I had the opportunity to attend another black tie event with my wife, Tracey, at Baltimore Centerstage’s gala as guests of GBMC’s incoming Chairman of the Board, Harry Johnson. The event, which benefits the theater’s artistic and education programs, demonstrates how valuable arts programs are in the Baltimore community and the importance of community support.
I had Sunday off from galas and events but was right back in the saddle on Monday night at my third black tie event in four nights as one of the hosts for the Daily Record’s Top 100 Women in Maryland event.  GBMC was the Circle of Excellence sponsor for this year’s event and I had the honor of presenting the Circle of Excellence winners with their awards. This inspiring event recognizes Maryland women who are making an impact through their leadership, community service and mentoring. 
You can see a trend in all of the events I attended – recognizing those in our community who make an indelible impact in the lives of others. So, I would certainly be remiss if I didn’t tell you about what I did last Friday afternoon, before my weekend of galas even began. On this beautiful spring day, I walked up to Farmhouse Hill to GBMC’s Nearly New sale. It was amazing to me just how many hours so many of our volunteers put into creating this wonderful event. Not only does this sale benefit the programs and services right here at the hospital, but I realized that there are so many members of our community who also truly benefit from being able to buy a wide array of items at this sale.
I too benefitted from the many gems that can be found at this bi-annual sale! I picked up some great jazz CD’s and then came across one of my favorite movies, October Sky.( It’s a great movie about young men who attempt to launch their own rocket after the launch of Sputnik in 1957. But what really draws me to the film is how the young men go through a series of failures, learn from their mistakes, test, make changes and then try again, until they achieved success. This cycle of learning, Plan-Do-Study-Act, also called the Shewhart cycle, is a key tool of continuous improvement. We in healthcare must fully commit ourselves to this spirit of testing, learning, and continuous improvement.)
Oh, and while at the Nearly New sale I also purchased the book, The Complete Idiots Guide to Being Psychicso watch out everyone!
But seriously, we work and live among some truly amazing and giving individuals both at GBMC and in our own communities. I was proud to be among all of these great people and hope that their giving spirits inspire others to continue down the path of volunteerism and philanthropy.

Friday, May 6, 2011

Celebrating Nurses –True Heroes in Health Care

As we get ready to celebrate National Nurses Week, it’s important for all of us to take a moment and reflect on the magnitude of the nurse’s role in healthcare. Nurses are the heart and soul of GBMC, and any hospital for that matter.  As an intern in 1979, I still vividly remember the nurses who took me under their wing. It was from the very beginning of my medical training that I recognized that nurses bind the health care team together and keep the team focused on the patient. Particularly during Nurse’s week, we should all celebrate their work. 
Anyone who attended the special May 4 Schwartz Center Rounds received an up close and personal glimpse into the role a nurse plays in the life and care of a patient. Actress Megan Cole, who portrayed a woman dying of cancer in the Pulitzer Prize winning play, “Wit,” spoke to our healthcare professionals about the story of one woman dying of cancer, and the stories of countless people who shared with her their own experiences as a patient. What she heard was this – doctors and caregivers need to listen more and not get so caught up in the science behind the medical care that they fail to recognize what the patient really needs. The hero of the story was the dying woman’s nurse, the one care provider who never lost sight of her humanity. The nurse was the one who connected with the woman, related to her and helped her through the last moments of life.

On a personal level, I can recall the hospice nurse who cared for my dad in his last weeks of life. She was truly wonderful, always there for my dad and my mom first and foremost. She realized she had to connect and understand what my father and mother were going through and was a ray of hope every day when she walked into my parents’ house.
It was only several years ago that the entire nation realized just how significant the nursing profession was when we were faced with a dire nursing shortage. Some of you may remember the national campaign launched by Johnson & Johnson called Campaign for Nursing’s Future. This nation-wide campaign brought to the forefront that nursing is a great profession and there was a tremendous need for great men and women to pursue this calling. I’m happy to say this campaign was a success, and I’m pleased to see all of the young nursing students training with our seasoned professionals and new nurses joining our team. These nurses are our future. 
The fact of the matter is, nursing is hard work, both physically and mentally. A great nurse is someone who understands the scientific underpinning of medical care but never loses sight of the humanity of their role with the patient. At GBMC, our nurses epitomize the beauty of healthcare professions. In fact, they do what I’m asking everyone to do every day in their work – to take a moment to reflect on the beauty of serving others in their time of need.

I’m thankful every day for the commitment, the compassion and the expertise that our nurses bring to patient care. Please join me in celebrating and thanking all of our nurses, not just during Nurse’s Week, but every day.
How has a nurse touched your life, either professionally or personally? Share your comments here and show our nurses just how important they are to GBMC and our patients.
…also, Happy Mother’s Day to all of the Mothers in our GBMC Family!