A Titan Moves from Management to Governance

This coming Thursday (June 29), Dr. John Saunders will retire as the chief medical officer (CMO) of the GBMC HealthCare System.

John came to GBMC in 1979, as a fellow in head and neck surgery from Walter Reed Army Medical Center, to work with Drs. Robert Chambers and Darrell Jacques. He joined the medical staff and after 10 years in private practice, Dr. Saunders became the medical director of the Milton J. Dance, Jr. Head & Neck Center. Under John’s direction, the Dance Center became the premiere community-based program for head and neck cancer surgery and rehabilitation, and voice disorders.

John retired as an active surgeon in 2012. He served as GBMC's chief of staff from 2004 to 2010 and as interim Chief Executive Officer in 2010.

I was most fortunate when John agreed to take on the role of CMO in 2010 and has served in that capacity until this day. In his role as CMO, John has been responsible for the clinical quality of our healthcare system and has served as the designated institutional official (DIO) at GBMC for the Accreditation Council of Graduate Medical Education, overseeing all of our residency programs and working closely with the Graduate Medical Education Committee.

We all know that John is an icon at GBMC. There is no more respected individual in our system than John Saunders. Patients know John Saunders as a great doctor with an outstanding bedside manner. Clinicians know him as an extremely talented surgeon, who was very calm in the most difficult situations. Residents and medical students knew him as an outstanding teacher who was always kind but firm. Members of the senior team know John for his wisdom, his insightful guidance, his wonderful sense of humor and his outstanding storytelling capabilities.

John and Carolyn Candiello, GBMC’s vice president for Quality and Patient Safety built an excellent structure that is second to none and both have overseen the cultural and performance change that has put GBMC in the quality limelight locally and nationally. John has presented patient stories monthly for seven years. These stories have educated many about the complexities of caring for patients and about a model to make things better.

Everyone knows John for his humility and self-deprecating humor. I have come to know John as an outstanding family man, who along with his wonderful wife, Betsy, have raised three great children and is now helping to raise his grandchildren. John plays the piano and at his retirement event I asked him to play a few numbers but he refused when I told him he had to play at least one Steely Dan song.

All kidding aside, John has become a dear friend and I will miss him on our senior team. I don’t know anyone who can imagine the GBMC HealthCare System without John Saunders. The good news is that John is not leaving us as he has agreed to continue to serve as a director on the GBMC HealthCare Board. Congratulations, John and thank you for everything you have done through the years for GBMC and our patients!

Cause For Celebration
Earlier this month, more than 300 cancer survivors, their caregivers, friends and family members celebrated life at our annual Cancer Survivorship Celebration.

Over the last 26 years, we’ve held this event for GBMC cancer patients and their caregivers as an opportunity for cancer survivors, loved ones and staff to join together, renew acquaintances and celebrate both survivors and their caregivers. It provides us the opportunity to commemorate our patients’ courage and our caregivers' commitment to their treatment. More than 2,000 individuals annually turn to the experts at The Sandra and Malcolm Berman Cancer Institute at GBMC when faced with potentially life-changing medical diagnoses. Our Berman Cancer Institute is not only locally recognized, but nationally as well and is fully accredited by the American College of Surgeons Commission on Cancer.

The number of people who attend this event continues to grow. Congratulations to our survivors, their families, and our caregivers!

Happy 100th Anniversary! 

This year The American Occupational Therapy Association (AOTA) is celebrating its 100th Anniversary.

The AOTA, originally called the National Society for the Promotion of Occupational Therapy, was created in 1917 by a small group of pioneers in the profession.Today, there are more than 213,000 occupational therapy practitioners nationwide that help people of all ages gain or maintain capabilities that help them live life to the fullest.

Our therapists and therapy assistants provide functionally oriented treatment that helps individuals of all ages after an injury, illness or medical procedure. Their work promotes healing, increases strength and endurance and teaches patients how to prevent further pain or injury. Their specialty care can help their patients achieve a higher level of independence.

I want to sincerely thank all the OTs and OTAs for their incredible work and for their unwavering dedication to our patients!

Remember to…
Don’t forget to RSVP for this year’s Employee & Volunteer Appreciation BBQ titled “CAMP GBMC Healthcare.” This year’s event, slated for Wednesday, July 12, will be a great opportunity for our staff and volunteers to come together to celebrate what we have accomplished, while also having some fun! Please join us! You have until Wednesday, July 5 to RSVP and can do so by clicking here. I look forward to seeing you there!

Happy Birthday to Us! 

Finally, I want to wish everyone in our GBMC family a safe and happy Independence Day. July 4th marks 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.

Running to Support Our Tiniest Patients

This past Sunday, I ran in our 29th annual Father’s Day 5K. This annual event, presented by the GBMC Volunteer Auxiliary, has raised funds for the NICU and has offered GBMC employees, volunteers, and the general public an opportunity to support our program. Over the past 28 years, the annual Father’s Day 5K has raised more than $1.75 million for the NICU.

We have a phenomenal NICU that achieves clinical outcomes as good or better than many bigger units. We have outstanding neonatologists, pediatricians and nurse practitioners. The staff includes incredibly talented and dedicated nurses and therapists. It is very expensive to staff the unit and keeps it updated with the latest equipment. The money raised by our annual Father’s Day Run is essential for the NICU. The event also creates greater awareness of the strengths of our program and the wonderful expertise and commitment of our NICU staff.

GBMC is a community-based system of care. The outpouring of community support at the race was incredible. It was great to see so many parents of former NICU babies, as well as so many dedicated members of the community and the GBMC staff, come out and run for this terrific cause.

I’m proud to report that this year’s event raised more than $127,000.00 for the NICU, which is phenomenal! I want to thank the close to 800 participants, who ran or walked, and who spent part of their Father’s Day with GBMC to help support the NICU babies and their families.

I also want to thank everyone involved in our community Wellness Fair which featured health-related vendors, as well as the “Baby Doll/Stuffed Animal Hospital” for injured dolls and bears to receive treatment and repairs as needed. Additionally, the MIX 106.5 Radio van was on-site playing music and sharing prizes. The Maryland Zoo in Baltimore was also present with fun animal friends for the kids’ area. Great work everyone!!!

GBMC Night at “The Yard”
I hope all of those who attended the GBMC Employee Night at Camden Yards, Tuesday evening, had a lot of fun. I was really pleased to see many of our people attend and enjoy time with their colleagues. The weather was really nice and what made the evening much better was the Orioles victory!

GBMC Recognized as a Leader in the Use of Information Technology to Improve Care

This week, we had guests from the Healthcare Information and Management Systems Society (HIMSS) evaluating the GBMC HealthCare System on our use of electronic health records.Today, I am excited to announce that GBMC HealthCare has achieved Stage 7 on the HIMSS Analytics Electronic Medical Record Adoption Model (EMRAM) for our inpatient setting and on a provisional basis for our ambulatory services! I am confident that we will receive full ambulatory certification at Stage 7 soon.

The award is recognition for operating in a paperless environment and representing best practices in implementing electronic health records. As you know GBMC has been utilizing the Epic system since this past October.

EMRAM is a methodology for evaluating the progress and impact of electronic record systems and includes eight stages (0-7) that measure a hospital’s implementation and utilization of IT to optimize the care that patients receive. Stage 7 represents the most advanced patient record environment. HIMSS Analytics developed the EMRAM as a tool to compare information technology maturity in health care organizations. Less than 5 percent of hospitals in the United States have achieved Stage 7 certification.

Make no mistake this accomplishment is due to the commitment and the hard work of the GBMC staff which includes our highly-skilled team of physicians, nurses, other clinicians and IT professionals. I want to thank all of my GBMC colleagues for this achievement. Deserving of special thanks are Dr. Fred Chan, our Chief Medical Information Officer, Cindy Ellis, Epic Project Director, Dave Hynson, GBMC’s Chief Information Officer, Chase Roberts, Finance/Operational Efficiencies Manager and Mary Swarts, the Epic Nurse Champion, who all played an integral role in getting us to this point.

Achieving this recognition is more evidence of our commitment to ‘one patient, one record.’ Without this, we cannot achieve our vision of being the community-based health system where every patient gets the care that we would want for our own loved ones.

We’re not perfect and there’s more work to be done. As we go into the Father’s Day weekend, please take a moment to be proud of what we have accomplished so far!

Finding the Time to Give to Others

Many of us take the blood supply for granted. If your loved one had just had a serious injury or needed blood because of a significant disease, you would expect that blood would be available for him or her. We are very fortunate that blood is available when our loved ones need it…but it doesn’t happen magically. It happens because of the Red Cross and many, many dedicated and caring people.

GBMC has always participated in blood drives. Back in 2011, we were not collecting as many units as we could and we were called to do more. Under the leadership of Kim Davenport, our Community Relations and Events Manager, we put on our improvement caps and changed our system. We have now had 6 years of excellent results, yesterday being no exception! We collected 99 units of whole blood in a time of year when it is difficult to get people to donate.

I am so proud of the work of Kim and other GBMC volunteers who work closely with the Red Cross. When you see Kim, thank her for this great work and for helping GBMC to be leaders in blood donation. Also, if you are not currently giving, please consider this at our next drive.

Thank you!

Things did not go as they should. What did we learn?

We have been using the technique of  Lean Daily Management (LDM) now for four years. We started using LDM to accelerate improvement toward our vision of being the healthcare system where every patient, every time, gets the best health outcome and the best care experience with the least waste of resources and the most joy for those providing the care. LDM is designed to create a family of focused problem solvers. LDM, therefore, requires curiosity – the desire to know what actually happened. 

Thanks to the hard work of our pharmacists and nurses, we have much fewer “missing” medications than we used to. Our nurses and pharmacists work so hard and it is frustrating to them when a nurse goes to give a medication to a patient and the medication can’t be found on the unit. The nurse must then alert the pharmacy that he or she doesn’t have the medication and the pharmacy must stop what they are doing and send the missing dose to the floor.

We use the term defect to describe this situation. What should happen is the nurse goes to give a medication ordered by the physician or advanced practitioner and verified by the pharmacist and finds it where it should be and then administers it. If the nurse doesn’t find it on the unit, it’s a defect. We record defects in red on the LDM chart. When a defect occurs, the learner says to himself or herself: “That’s interesting, I wonder how this happened?” This is where the curiosity comes in and the learning starts. The learner must think like a detective or engineer and go and see what happened. The learner knows that the more time that passes the harder it will be for him or her to get the facts right. (By the way, as we have said in the past: red is not bad. Red is an opportunity for learning in order to get it right the next time. If we do not learn, the defect will come back. Not learning is what should be thought of as bad!)

When I started in healthcare, the prevalent thought was: “The medication should be here but it isn’t …who screwed up?” This approach to defects assumes that there is someone who doesn’t know what they are doing or doesn’t care to do their job right. This rarely is the reason behind a defect in a big complex system like the modern American hospital. The answer to the, ‘how did this happen?’, question is almost always that there were multiple system failures. The person trying to figure it out will only do so by asking a number of questions of those involved and/or by trying to reproduce the problem. It is in the study of the defect that we find opportunities to fix the problem. We can then test our fixes to see if they make the system more reliable. Our pharmacists and nurses have done this so well that we have many fewer calls to the pharmacy for missing medications. Let’s all become more curious about defects in whatever our work is to drive GBMC towards its vision faster!

Get some exercise on Father’s Day for a great cause!
Another fundraiser for the GBMC HealthCare system is coming up in a few weeks – on Sunday, June 18th, we’re holding the 29th Annual GBMC Annual Father’s Day 5K & 1 Mile Fun Walk on our GBMC campus to benefit the hospital’s Neonatal Intensive Care Unit (NICU).  This is a wonderful event where former NICU babies, families, staff members, community supporters and friends come out to have some fun and support our NICU.

Over the past 28 years, the annual Father’s Day 5K & 1 Mile Fun Walk has raised more than $1.75 million for the NICU. We operate a strong NICU with excellent clinicians, great care, and the latest equipment. With 12 rooms in the NICU, there is always equipment that needs updating, new technologies to incorporate and resources critical for these more fragile babies, who require 24/7 care. But again this fundraising effort helps a great deal.

There’s still time to register and support this wonderful event. Click here for all the information. I’ll be out there running, so please come join me! Remember that your support will touch more than 500 critically ill and premature babies cared for annually in GBMC’s NICU.

If you’re planning to participate in the Father’s Day 5K & 1 Mile Fun Walk, please feel free to share your story of why you help fundraise for GBMC.