Happy (Fiscal) New Year

This week marked the end of our fiscal year 2014 and the beginning of our new year. We set our goals according to the fiscal year so how did we do and what’s in store for this year?

Our system scorecard is not yet complete but it is clear that we had a great year. When we talk about our 4 aims, we always say that the goal of better health is the most important one. If the patient is your loved one, the most important thing is that she gets evidenced based care that gives her the best chance of returning to or maintaining her health. We finished the year with six serious safety events and beat of goal of 10. Two years ago we had 21. The only ethical stopping point is zero, but we have made great progress! GBMC has moved to higher reliability. We are now much more likely to be following standard designs to keep people safe. We use checklists because we know that we will get distracted and forget things and we are working better as a team. Our people are more likely to speak up when they see something that is not right. This is in part because of our work in creating a Just Culture. We continue to do well at reporting great catches and near misses and then learning from what we find.

In FY ‘14 our clinicians, especially our nurses, made marvelous improvements in reducing hospital acquired conditions like patient falls and catheter associated urinary tract infections. We went an entire fiscal year without a stage 3, 4, or un-stageable pressure ulcer! In fiscal ‘15, we will continue to improve by focusing on more of the Maryland Hospital Acquired Conditions, MHAC’s.

In the area of better care, we are making very good progress even though we will not achieve our inpatient HCAHPS goal. For this metric, the patient is asked to rate their hospital stay on a scale of 0-10, with 10 being the best. The percentage of patients giving us a 9 or a 10 is what is measured and reported. The attached graph shows that we have made progress through the years but we still have work to do.

GBMA has made exciting improvements in care over the past few years. They have achieved their annual overall satisfaction goal. They have become much more responsive to their patients’ needs as they have implemented the patient-centered medical home.

Lean Daily Management has been a wonderful success story to help us drive out waste especially in helping us get to get to better patient flow. We achieved our goal for ED throughput; the average admitted patient now waits 90 fewer minutes to get to an inpatient bed! And, it appears that we achieved our system operating margin in a very difficult financial environment.

Under our aim of More Joy, we have come a long way in keeping our people safe. In FY ‘14, our executive team studied employee injuries on a daily basis and we reduced them significantly. I am most pleased by our efforts to reduce blood-borne pathogen exposures. We have nearly eliminated splash injuries to the eye because we are now reliably wearing protective eyewear when we should. GBMC leaders have done much to respond to both the employee satisfaction survey and also the physician survey. These surveys will be repeated soon and I believe that we will achieve those goals. We will talk about these when the results are in.

So, it was a great year. We are progressing well toward our vision of being the community-based healthcare system where everyone gets the care always that we would want for our own loved ones. We are safer and more patient-centered. We are more efficient and our patients are reaping the benefits. Let me thank everyone in the GBMC family for your hard work and well-earned accomplishments. 

Happy Birthday to Us!

July 4th marked the birthday of our great country…the land of the free and the home of the brave. Let's take some time to reflect on what we can each do to make our country even better than it is today.

July 4, 2014 was also the 75th anniversary of Lou Gehrig’s remarkable retirement speech. Gehrig was a wonderful example of a very talented and hard working individual who in a moment of major adversity, as he was retiring from baseball due to having been diagnosed with a terminal illness that now bears his name, found the courage and grace to call out his joy for having  been given so much in life. You can hear Mr. Gehrig’s speech here.