Monday, March 25, 2013

What Does a Great Team Look Like in Health Care?

One day last week I spent some time in our Endovascular Lab at the invitation of Carter Freiberg, M.D. Although it’s clear that sending pediatricians (or worse, administrators) to operative areas may not be in the best interest of patients, I was glad to go and learn about state of the art vascular care at GBMC.

Dr. Freiberg welcomed me to the lab and told me about the lab’s capabilities, successes, and challenges. He then told me about the case that he was about to do. The patient was a man with a popliteal aneurysm found on exam who had poor blood flow to his foot. While Dr. Freiberg explained his approach to me, the rest of the team got the patient and the equipment ready. The Certified Registered Nurse Anesthetist, Kathleen Murphy, spoke with the patient and made sure that all of the monitoring equipment was set to go. Mark Stuckey, the scrub tech made sure that all of the surgical equipment was ready including the catheter to be used. Bill Barron, the radiology technician, checked that the contrast material was ready and that the ultrasound machine was setup and the screen was clearly visible from the operating field. Bill was assisted by Crystal McDaniels, senior radiography student. The supervisor of the Vascular OR staff, Marjorie Enriquez, RN, was standing in for her colleague who was on break, and she was getting the documentation of the case setup in the computer.

Dr. Freiberg scrubbed and gowned and went and said hello again to the patient. The timeout was then called, to assure that the team had the correct patient and all new the plan for the procedure. Dr. Freiberg then introduced a wire into the patient’s groin and threaded a catheter into the patient’s arterial system and took X-rays, documenting major arterial problems. The popliteal aneurysm was seen and the man’s right leg was getting blood flow only from collaterals. It was clear that the man was going to require both an open procedure and another catheter procedure to take care of his problems.

Dr. Freiberg broke scrub to go and speak with the man’s family and tell them what he had found. Mark assured that bleeding had stopped at the groin site and helped the rest of the team get the patient to the recovery room.

The procedure had gone very smoothly. Everyone knew their job and they interacted very smoothly. Dr. Freiberg told me: “We have a great team.” He then went on to tell me about how Mark and Bill, knew precisely what to do with almost any eventuality. They were not afraid to make suggestions or to ask clarifying questions. Later, while Dr. Freiberg was dictating, I asked both Bill and Mark about the team and the feeling was mutual. It was clear that they enjoyed working with Dr. Freiberg and they felt respected and realized how they were part of a high functioning team that had helped a lot of people. “I love my job”, Bill told me. Bill also made it clear to me that there were real challenges that the team faced but these were not insurmountable. In fact, the team surmounted them every day.  

I left the endovascular lab that day being very grateful for the work of this wonderful team. I also realized that it was my job, along with the rest of our leadership, to make sure that the endovascular team has what it needs to get the job done and to treat everyone who comes into the lab the way I want my own loved ones treated.

What would you do if……?
Last Wednesday, I was racing to a meeting at the Baltimore County Health Department. I got in my car in Tulip garage and went up one level headed to the employee exit. I came upon a very curious situation. There was an SUV that had clearly just bumped into the back of another car. The SUV had its driver door open and there was a woman next to the SUV who was on her cellphone and looked frantic. I rolled down my window and asked her if she needed help. The woman replied, “Yes, there’s a snake in my car!” It seems that she had come from Harford County to see her doctor in Physicians Pavilion North. After the visit, she got back in her car, backed out of her space, and as she was turning to drive out of the garage, she saw a snake on her dashboard and freaked out (as anyone would have!) She lost control of the car, bumped into another car in the lot and got out.

I called Security and our Head Groundskeeper, George Dillon. The woman (who was now calming down) and I took some pictures of the snake. The snake slithered from the dashboard, to the rear view mirror, and back to the dashboard before falling to the floor of the car. Then Security and George arrived. I went on my way and George spent about 20 minutes searching the inside of the car for the snake which he could not find. The woman called her husband and made him drive that car home. If it had been me, I think I would have traded the car in immediately.

Passover Celebration
Finally, on behalf of the entire GBMC HealthCare family, I want to extend best wishes for a Happy Passover to everyone celebrating the Jewish holiday this week.  The eight-day Passover holiday commemorates the emancipation of the Israelites from slavery in ancient Egypt. 


  1. Stephanie Kearns, RNMarch 25, 2013 at 11:04 AM

    Dr. Chessare, I enjoy your blog so much that I mentioned you and it in one of my Masters of Nursing classes last week. I know things at GBMC are not perfect, but I love the way they keep heading, especially with you and your team at the helm. So, as a fairly new employee, who hopefully has a long tenure at this hospital, thank you for caring enough to look into what everyone does, and for keeping it real everyday. Happy holidays to you as well.

  2. Love the snake story!!

  3. Thank you!
    I would also like to give credit to RENE ANGELES,RN who was working that day and CARA DUTTON,RN who is always dedicated to work in the Endovascular Suite.
    Again,Thank You!!


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