The Appearance of Callousness Revisited

GBMC is an outstanding healthcare system. We have made such great progress in improving the health outcomes of our patients. We have many, many great examples of care and caring. Just a few weeks ago we celebrated our compassionate caregivers and the stories of love and kindness abounded. But, we are not perfect and our HCAHPS scores (The Hospital Consumer Assessment of Healthcare Providers and Systems survey), the first national, standardized, publicly reported survey of patients' perspectives of hospital care, are just about average. https://www.medicare.gov/hospitalcompare

A few years ago I got myself into trouble when I wrote a blog called “The Appearance of Callousness.”  Although I did not mention where the upset patient was treated, the staff in that area got upset.  They thought that I did not appreciate their hard work or their intentions. I sincerely did appreciate how hard they worked and that no one intended to get the patient upset. I was just trying to get them to reflect on what the patient was upset about. If we truly believe that we are here to treat everyone, every time the way we want our own loved ones treated then we have to be big enough to reflect on our behavior…even if it was a one-time lapse on our part or even if we had the best of intentions. So today, I received a letter from a man who began by praising GBMC and three staff members in particular for the great care given his wife, but, then he added:

“However, there was one problem. One evening during her stay I was returning to visit her. Forgetting the location of my wife’s room, I approached the desk on the unit and asked a person seated there where she was. Before I could even speak, he/she said ‘wait a minute’ while he/she leisurely worked on some sort of report. I stood there five minutes while he/she ignored me, slowly filling out both sides of a sheet of paper. Exasperated, I finally left, asked someone else where my wife was and found her room. I was concerned about my wife’s condition and this person’s rude behavior did not help matters.”

What do you think? I bet the staff member who this man interacted with was doing his or her job and may have felt pressured to get some important work done. He/She may have treated the previous 50 family members that approached with kindness and respect but this husband felt disrespect.

What can we do as the GBMC family to minimize the chance that someone thinks we have been rude to them? I would love for you to comment on this blog...but I would like even more if you would discuss this with all in your department, unit, or office.

As I am asking this question, I know that there are many, many wonderful interactions with patients and family members but as caring adults, we must still reflect on the few perceived negative interactions. Thank you very much!

THANKS TO ALL FOR PARTICIPATING in the FATHER’S DAY 5K

This past Sunday, I spent part of Father’s Day running the 28th annual GBMC Father’s Day 5K. It was a beautiful day and it was great to see so many families on our beautiful campus.

This event has been helping to raise much-needed funds for GBMC’s Neonatal Intensive Care Unit (NICU). Over the years, funds raised through this event have helped purchase lifesaving technology and services for our NICU babies and their families.

I want to thank the close to 900 participants who spent part of their Father’s Day with GBMC and helped raise approximately $140,000. In 28 years, the 5K has raised close to $2 million for critically ill and premature babies.

Let me also thank the amazing volunteers as well as GBMC’s NICU doctors, nurses, technicians and others who dedicate their lives to the health of babies.  I also had the opportunity to meet some of the “graduates” of our NICU and their parents and so many other wonderful people. I also want to congratulate the more than 100+ weight loss patients, a.k.a Team #COMPto5K , that completed in their first Father's Day 5K and to Cody and Selena Staab, 8-year-old twins and 2007 NICU graduates, who gave back to GBMC by selling their bracelets during the Father’s Day 5K.

Lastly, I want to thank everyone involved in our community Wellness Fair which featured health-related vendors. Additionally, MIX 106.5 Radio was on-site with its Friends and Neighbors van playing music and sharing prizes. The Maryland Zoo in Baltimore was also present with fun animal friends in the kids’ area. Great work everyone!!!

Support for Our Tiniest Patients

It’s that time of year again for one of our biggest annual events for the GBMC HealthCare system.  This coming Sunday we’re holding the 28th Annual GBMC Father’s Day 5K  & 1 Mile Fun Walk at the GBMC campus to benefit the hospital’s Neonatal Intensive Care Unit (NICU).

GBMC is a community-based system of care. We enjoy a lot of support from those we serve and because we are seen as the best place to have a baby in our region, we deliver more than 4,000 babies a year! About 1 in 10 of those babies spends some time in our NICU. We are very fortunate to be able to provide tertiary care to neonates at a high level for those babies born too small, too sick or too soon.  The equipment and staffing required to provide this care is expensive and our annual Father’s Day Run raises funds for the NICU and creates greater awareness of the strengths of our program and the wonderful expertise and commitment of our Team.

The annual event, presented by the GBMC Volunteer Auxiliary, has raised more than $1.75 million for the NICU over the past 27 years and offers GBMC employees, volunteers and the general public an opportunity to support the program. We are well equipped but there are always new technologies to incorporate and other things that need updating.

This year’s event will again feature a Wellness Village, open to not only race participants, but the entire community.  The Wellness Village will be open from 7 a.m. – 10:30 a.m. in the South Chapman parking lot and will include health-related vendors.  Additionally, the Maryland Zoo in Baltimore will also be present with fun animal friends for the kids’ area.

Though we never wish for babies to need our NICU, GBMC is grateful to be able to provide outstanding care to these precious infants and their families. Again, all proceeds from the event will benefit the GBMC NICU to help support specialized equipment, excellent facilities and experienced clinical staff.  It’s still not too late to pledge, and you can do so by visiting www.GBMC.org/5K

…also, Happy Father’s Day to all of the Fathers in our GBMC Family!

Making it Easier to Work as a Team on a Hospital Unit

It is easier to accomplish complex work involving multiple people when those people routinely work closely together. Teams that get to know one another generally do better than people who rarely work together and don’t know each other. At GBMC, it is no accident that Units with a close knit team of doctors, nurses, other clinicians and support people get better outcomes and generally have better employee, physician, and patient engagement scores than those who don’t work and reflect together daily.

On units where nurses work routinely but physicians, care managers, and others come and go because they have patients on many units it is very hard to get the communication- and therefore the care- right.

In order to achieve our vision of the care we would want for our own loved ones delivered to every patient, every time, we need an environment that supports optimal collaboration among clinicians, as well as multidisciplinary team member inclusion in daily care-planning.

So earlier last week, on the GBMC medicine inpatient units, we started using the Patient­-Centered Care Team (PaCT) model of care. Work spaces on each unit will offer physicians and care managers private areas to tend to documentation, while still being within reach should a patient care need or question arise. Having nursing, physicians and care managers located together on every medicine unit will allow for easier scheduling of multidisciplinary rounds and will enable additional care providers a chance to gather with the team to improve patient health outcomes.

Dr. Neal Friedlander, our Chairman of Medicine, has been a champion of “collocation.”  He has been concerned about how physicians were spending hours each day walking to different units and because of this not being readily accessible to their patients, nurses or other care team members. He has been concerned that there were preventable rapid responses called, and discharge planning was difficult because care managers and physicians were not in geographic proximity.

In order to accomplish keeping a patient with one team more commonly, we had to make telemetry available on most units to eliminate unnecessary patient transfers; physicians and case managers will now join their nursing colleagues on a single unit; multidisciplinary rounds will include all members of the care team by unit (simultaneous rounds); medical directors and their partner nurse managers are now accountable for the care on each unit.

Over time, other support services may be assigned to individual units. JoAnn Ioannou, DNP, MBA, RN, NEA-BC,our Senior Vice President of Patient Care Services and Chief Nursing Officer, told me how thrilled she is to witness some of the early benefits of the PaCT Model on our units, for both our patients and staff. case.

I am very grateful to Neal, JoAnn, Cathy Hamel, our Vice President for Post- Acute Care and to everyone who has helped us implement this change!

What’s on your mind about EPIC?
Last week, in my blog I discussed the production, B’MORE EPIC, and how It gave attendees a comedic perspective on how EPIC will help clinicians assist patients through the care continuum and make it easier for us to achieve our vision.

This week though, I want to hear from you.  If you have a question about EPIC or its implementation, please enter it here and we will address them in the last blog post for June. Thanks!

Recognized for Their Compassion

On Wednesday, GBMC held its annual Dr. John Adams Compassionate Caregiver Awards. It is very important that we take time annually to recognize those who are outstanding at demonstrating their compassion. Remember that John Adams, MD, deceased former chief of pathology, started the Compassionate Caregiver Award at GBMC after losing a friend to cancer. His vision and philanthropy have created an endowment to underwrite the cost of the rounds that bear his name.

This year’s 15 nominees (Departments) included:
Cynthia Arnold, CRNP (NICU); Clara Anizoba, MD(Internal Medicine), Joanna Baird (Gilchrist), Lynn Beaver (Palliative Care), Nicholas Davenport (Care Management), Brittney Davis (Care Management), Daniel Fink (MICU), Cyril Gatewood (Emergency Department), Amanda Henderson (MICU), Donna Naslund (Gilchrist), Patty Nicholls (GBMA—Internal Medicine), Maria Pane, MD (Pediatrics/NICU), Mona (Eman) Soliman (Gilschrist), Zonda White (Environmental Services) and Brian Wilson (Gilchrist—Howard)

The winners were:
4th Runner Up - Donna Naslund, Gilchrist Volunteer
3rd Runner Up - Patty Nicholls, GBMA-Internal Medicine
2nd Runner Up - Nicholas (Nick) Davenport, Care Management
1st Runner Up - Cynthia Arnold, CRNP, NICU
Winner - Maria Pane, MD, NICU

We should all be very proud of all the nominees because they embody our second Aim of Better Care. In my remarks at the event, I pointed out that we move towards our first Aim of Better Health when we deliver evidence-based care. This is rather mechanical for scientist-clinicians. The second Aim is much harder to deliver. It requires that we get in the shoes of the patient and her family in the moment. This is very hard for clinicians to do always because we get caught up in the work of healthcare along with its stresses. It’s easy to come across as not caring when we are focused on our tasks. The nominees are special people who stay focused on the patient as a person with needs beyond the medical care.

After the large event in the Civiletti Conference Center, I attended a celebration at the NICU in honor of Dr. Maria Pane and Cynthia A. Arnold, CRNP for being nominated and winning their awards.

The celebration also highlighted our NICU Team for being nominated for this year’s Schwartz Center National Compassionate Caregiver Team of the Year (NCCY) award. The NCCY award recognizes health care professionals from across the country who exemplify extraordinary compassion in caring for patients and families. Winners of these national awards will be announced in November.  I would like to congratulate our NICU Team now even if the judges make a mistake and they don’t win the national award. They are outstanding examples of compassionate caregivers!

The Passing of Elsie Mildred Arnold
Speaking of compassionate caregivers, I was saddened to hear about the passing of Mrs. Elsie Mildred Arnold at the age of 94.  Arnold, a 1947 nursing school graduate, helped relocate patients from the Women’s Hospital to GBMC in 1965.  She continued to provide excellent care to our patients until her retirement in 1987 and subsequently served on the Women’s Hospital Foundation Board.
 
B’MORE EPIC
I believe in the old saying “work hard, play hard” and I know since March 2015 the EPIC team members have been working hard in the preparation for the implementation of EPIC.
 
The EPIC implementation is a strategic move for the GBMC HealthCare System. “One patient, one record” is critical for us to deliver the kind of care we want for our own loved ones to everyone. EPIC has wonderful tools to make communication between patients and caregivers easier as well.

I know how hard the EPIC team has been working.  Last week though, the EPIC Team showed their theatrical talents with their production called “B’MORE EPIC.”

Tickets were almost as hard to come by as tickets for Hamilton, but, I managed to get one and attended the sold-out matinee showing and I really enjoyed it.  It gave attendees a comedic perspective on how EPIC will help clinicians assist patients through the care continuum in our system.  Cindy Ellis, Project Director for EPIC, did an outstanding job as the producer of the performance and she did it with her usual outstanding style and exuberance.

There’s no doubt that we have a lot to do between now and October 1st, but, it was great to showcase the software and have some fun.  I want to thank all of those involved with this stellar production for bringing us some joy. If you didn’t see it, please visit http://infoweb/EPIC  Please share your thoughts of “B’More Epic”