GO-LIVE IS FINALLY HERE!!!

One patient, one record…this phrase has been on the tip of my tongue now for more than 20 months. We are less than 24 hours away from implementing Epic, our new clinical and administrative information system, going from an idea to a reality. I am very excited about this implementation because each patient will have only one record in our system, and it will make it easier to treat everyone the way we want our own loved ones treated.

The road to this day started a couple of years ago, when we realized that it was not possible to coordinate care for our patients when their information was in multiple places, electronically and on paper. We met with several vendors, and after a thoughtful process we chose Epic. 

In early 2015, I traveled with members of our team to Epic headquarters in Wisconsin and had the privilege of meeting Judy Faulkner, principal owner and founder of Epic. We met with many people who explained to us the capabilities of the software and the importance of building it for GBMC in a way that would allow us to get the most out of it. We got a “test drive” of the software and we were all really impressed.

Technology cannot create a vision or change a culture, but it certainly can accelerate the rate of change toward a vision. I can’t stress enough how 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 and Epic provides the tools that will make it much easier for our patients to communicate with us and be involved in their care.

  

Getting to go-live with our new electronic medical record system has required a phenomenal effort and many hours of hard work by thousands of our people. Getting us to one patient, one record for all served by our employed and GBHA aligned physicians, our hospital and our hospice, clearly has not always been easy. Yes, there is no doubt that there will be much to do and issues to be addressed even after launch, but, we have so many smart, hard-working people who are ready to help us during and after Epic implementation.

I want to take a moment to thank Cindy Ellis, Epic Project Director, and Dave Hynson, GBMC’s Chief Information Officer, who oversaw the entire design, testing and education process, and their Epic team for all their hard work in getting us ready to go live.  

Also, I want to thank all of our physicians, those employed by GBMC and in private practice, all of our nurses, all of our nurse practitioners and physician assistants, all of our other clinicians, patient access representatives, billing personnel and every GBMC family member who has helped build the system, test it and get us to this point of readiness. I know how hard you have all worked and I am very grateful for all of your efforts. I am also grateful for the hard work and expertise of our colleagues from Epic. 

Lastly, I want to express my gratitude to all those who worked in PP North and also at our Owings Mills site, entering several thousand appointments from the hospital and our physician practices into Epic. Recently, our team worked very hard on the schedule and registration conversion from Meditech and eCW. They posted more than 6,000 original Meditech appointments into Epic and an estimated 22,000 appointments from eCW. The team also completed an estimated 10,000 total registrations! Gilchrist Hospice manually converted the records of more than 750 patients.

Thank you all!

Some Records Are Made To Be Broken…

And boy did we break one! In case you didn’t know, GBMC Healthcare set the Guinness World Record for the longest ever awareness ribbon measuring 7,593 feet and 1 inch – more than 1.5 miles – during the 16th annual running of Legacy Chase steeplechase event at Shawan Downs last weekend. The lavender ribbon is a symbol of GBMC’s commitment to continually reduce the scourge of cancer.

Beyond breaking the record, this year’s event was a huge success. Cool weather, beautiful horses, a picturesque countryside setting and many family and friends – there were approximately 10,000 attendees this year – coming together equaled a spectacular time.  And it was all for a good cause, as the money raised benefits oncology support services at the Sandra & Malcolm Berman Cancer Institute. The Institute is the only comprehensive community cancer program certified with distinction by the American College of Surgeons Commission on Cancer in the Baltimore region. GBMC has invested in talent and technology to provide the best for oncology patients. Whether they are in need of outpatient, inpatient, home care, hospice or survivorship services, the more than 2,000 new cancer patients annually at GBMC get the best care.

This wonderful event would not have been successful without the support of our loyal volunteers, who helped us break the record and really made this year’s event very special. I thank all those who attended and all those who donated time or treasure. Special thanks to the GBMC Philanthropy and Marketing Departments, who worked so hard in putting the event together and for helping us break the record!

We Will Break the Record!

This coming Saturday, Sept. 24, we will have our 16th annual Legacy Chase steeplechase event at Shawan Downs in Hunt Valley.  This year’s event will again benefit GBMC’s oncology support services at the Sandra and Malcolm Berman Cancer Institute.

Legacy Chase has become a signature event for GBMC HealthCare combining the excitement of steeplechasing with a celebration of our patients and the services we provide to the community. There’s more to the event than great horse racing and there is something for everyone.  Past events have attracted more than 7,000 equestrian fans, friends, and families from across the region who’ve enjoyed the rail-side tailgating, live music, great food, and family-friendly activities. Many of the crowd-pleasing traditions continue this year—such as the kids’ Stick Pony Race, — and we have added some exciting new components to help make the event another memorable success.

This year we will celebrate our commitment to fight all cancers with an attempt to break the Guinness World Record for the longest cancer awareness ribbon—right in the infield of Shawan Downs.  Stretching a mile and a half long, the lavender ribbon is a symbol of GBMC’s commitment to continually reduce the scourge of cancer.  I’m really excited about this and I am sure with everyone’s support we are going to make it happen!

GBMC HealthCare has worked to perfect cancer care over the last 51 years.  The only comprehensive community cancer program certified with distinction by the American College of Surgeons Commission on Cancer in the Baltimore region, GBMC has invested in talent and technology to provide the best for oncology patients. Whether they are in need of outpatient, inpatient, home care, hospice or survivorship services, the more than 2,000 people with newly diagnosed cancer that GBMC diagnoses and treats annually receive the best care possible. 

I want to thank all those who’ve donated time or treasure and to the GBMC Philanthropy and Marketing Departments who’ve worked so hard in putting together the event and for taking a run at the record!

So, make this year’s event a family affair and come and enjoy a day in the country.  I hope to see you there!

Working Very Hard to Get Ready for October 1

We are less than THREE weeks from our Epic go-live date of October 1. Last weekend, I was really impressed to see so many of my GBMC colleagues working in our command center in the North Pavilion and also at our Owings Mills site to enter appointments from both the hospital and our physician practices into Epic. Our team worked very hard on the schedule and registration conversion from Meditech and eCW. They posted 6,881 original Meditech Appointments into Epic and an estimated 21,052 appointments from eCW. The team also completed an estimated 10,000 total registrations! Gilchrist Hospice began manually converting the records of approximately 750 patients yesterday.

These phenomenal efforts are only the most recent example of the many hours of hard work that literally thousands of our people have done to move us to one patient, one record.  It clearly has not always been easy and we are not yet done, but, I am humbled by the efforts of our family. They have collectively worked through many barriers and completed countless hours of training to get us to this point. The transition will be hard, but once the hospital, our hospice, and all of our employed and GBHA affiliated physicians and other providers are using this system, it will be easier for us to move towards our vision faster. Please let me thank all of our physicians, both employed by GBMC and in private practice, all of our nurses, all of our nurse practitioners and physician assistants, all of our other clinicians, patient access representatives, billing personnel and every GBMC family member who has helped build the system, test it and get us to this point of readiness. I know how hard you have all worked and I am very grateful for all of your efforts. I am also grateful for the hard work and expertise of our colleagues from Epic. Thank you all!

Healthcare Environmental Services Week
This week is Healthcare Environmental Services (EVS) & Housekeeping Week (Sept. 11—17) and I am proud to acknowledge the dedication and professionalism of our EVS staff as we celebrate them.

Cleanliness is everyone’s job at GBMC, but, our EVS staff are the experts in cleaning who work tirelessly to get the job done. They spend countless hours in their vital role in preventing infections, patient safety, and patient satisfaction, maintaining sustainable buildings, lending a helping hand and working to ensure that our healthcare facilities are always presentable and ready for business.

There are over 100 EVS associates working “around the clock” at GBMC in a variety of roles servicing over 1.2 million square feet of facility. Their work is vitally important to the health and safety of our patients, so, please join me in honoring all the men and women of EVS.

A Collaborative Effort for Better Care

GBMC is a fabulous place to have a baby and everyone knows it. Our clinical outcomes for mothers and newborns are excellent!  While our patient satisfaction scores for maternal and newborn are always among the best in inpatient units in Maryland, there is always room for improvement especially if we compare ourselves to hospitals in the Midwest and West. In these comparisons, we are still very good as we find ourselves in the top 25 percent.

Recently, Jodie Bell, RNC, BSN, IBCLC, Clinical Director, Postpartum and Newborn Nursery, got together with leaders from food and environmental services, Kelly Bechtel, General Manager of Food & Nutrition Services and David Fatokun, Quality Assurance Manager with Sodexo, and through Lean Daily Management started studying the mothers’ beliefs about their care, how their room was being maintained and their thoughts about the food.  As a team, they have been working on courtesy and friendliness and auditing their performance. They have begun to study things like how a food tray does not always have what the patient ordered or why the food that is supposed to be hot is not always hot when it is delivered.

This new higher level of collaboration and inquiry has already begun to yield results! 

In August, patient surveys scored the courtesy of the person serving their food at 92.9 (99th percentile in MD and the 80th percentile nationally) and their room cleanliness score at 90 (97th percentile in MD and the 70th percentile nationally). On the so-called “overall” HCAHPS score, where patients are asked to rate their hospital stay on a scale from 0-10, where 0 is the worst hospital ever and 10 is the best, the Maternal and Newborn Health team, so far, are now scoring 86.7 (99th percentile in MD and 94th percentile nationally)! 

I am so grateful for all of their hard work and their learning and tests of change. When you see Jodie, Kelly, David or anyone on their team please congratulate them.

Designing Patient Flow

Patient flow in healthcare continues to be a daunting challenge. It is not the same as building a car. All patients are different and their clinical needs and rate of improvement vary. The hospital doesn’t get to choose how many patients it will serve in a day. It serves all who need care. Because of the variability in these inputs, it is very important that we approach patient flow the way an engineer would. We study the patient demand and try to have just the right number of clinicians and support staff to serve them. And we design the system of patient movement to minimize the waste of time and energy.

Previously in the blog, I have discussed the concept of synchronization.  It’s a change concept that brings the players or processes in a design into “harmony.”  When we synchronize processes in patient flow, we allow the operators to organize their work so they can be ready to act at a specified time. In order for success, all parties involved must align their work to be ready for the chosen time.

People do not like to feel overwhelmed in their job. When we don’t synchronize, we run the risk that the “downstream” function isn’t ready to accept the patient when we want to move them. An example of this is the emergency department calling an inpatient unit to move a patient to them but there is no nurse ready to accept the patient. The emergency department gets upset because they want to get the patient out so that they can see the next patient. The inpatient unit gets upset because they feel they are being ‘jammed’. Both groups feel that the other doesn’t respect them.

Synchronizing flow from one unit to the next begins with a conversation before the patient moves. Information is shared about the patient and a time is chosen with the input of the sender and the receiver with enough advance notice for both to be ready.

Monica Goetz, our clinical nurse manager for the Medical Intensive Care Unit (MICU -- Unit 57) and her team felt that the previous process for moving patients out of the MICU was leading to many challenges as well as dissatisfied and frustrated staff on both ends of the transfer.  This is why they redesigned the process and are now studying it during LDM rounds, helping them to focus on how best to complete the transfer they redesigned the process.

The MICU team redefined the term “ready to move” as when both the sending and receiving nurse could safely perform a patient inclusive bedside handoff. Now, when the patient’s room is ready, the ICU nurse calls the new unit to identify a time, within the hour, that they both will be prepared to meet.  This allows both nurses to plan their work to be ready. At the agreed upon time, they meet in the new room, perform bedside handoff, review the patient’s belongings & share the “getting to know you” form. The “getting to know you” form is a tool used by the MICU team to learn about who a patient is as a person; their hobbies, things they enjoy when they are not in the hospital, fun facts, and things they want us to know about them.  

Monica shared a recent story to illustrate how the new design is working;
We had a patient (87-year-old male), with many co-morbidities and more hospitalizations than he could count.  He has always hated hospitals, the feel of being in them, and how he is treated…until this hospitalization.  He went on to describe that the care he received was like a well-orchestrated symphony.  Everyone in tune and working in harmony.  From the conductor (manager) to the lead violinist (the charge nurse) ...all setting up to tune for the concert (the shift).  Everyone worked together to make the beautiful music that we call patient care.  

This story is a good example of the work that the MICU is doing with patient transfers…. moving our patients in “synchrony”.  Working together to find a time that is agreed upon (within the hour) and then performing the handoff at the bedside – making the transition not only safer but patient inclusive.  This design demonstrates improvement from the back and forth phone tag, impersonal phone report and leaving a patient in a room alone until someone on the new unit is able to greet them.   I am very proud of Monica and her team and all of the nurses and others who have designed this new system. Let’s hear it for synchrony!