Friday, March 30, 2018

Improving Parking on Our Campus

We've recently started communicating with the GBMC family about changes to our traffic flow and parking on our campus. We have begun to put gates on our garages and lots. In June, we will remove the gatehouse and install ticket dispensers and “tap and go” readers at six locations: Rose Lot (Visitors Only), Daffodil Garage, Iris Garage, Lily Garage, Tulip Garage, and South Chapman.

These changes are needed to make the entrance to our campus safer for vehicular traffic and to reduce delays when entering and exiting from our grounds during peak hours while also improving parking accessibility for our patients. Stacey McGreevy, our Vice President of Support Services, and her team have been working hard to make the transition as easy as possible for our people. As we implement this decentralized parking model, we are conducting periodic studies of our parking capacity to make changes in employee assignments. Our goal is to allow employees to park as close to their work site as possible with the caveat that capacity for patients and visitors is our number one priority. If there are changes to your parking assignment, employees will be notified in May.

All GBMC employees will receive an assigned home lot or garage and will be able to “tap and go” their badges to enter and exit our medical campus. Your GBMC ID badge will be automatically programmed to function at your assigned parking lot or garage’s reader and stickers will still be issued to monitor compliance at free parking areas such as the Bluebell and the Labor and Delivery parking lots, that will remain as patient-only parking. We will not be erecting parking gates at these lots as parking will be free for our patients. Any employees found parking in these lots will be towed. Employees who work at locations other than the GBMC Main Campus, such as Gilchrist employees and our primary care off-sites, will have open access to park in any garage due to the infrequency of visits to the campus.

Patients will use pay-on-foot stations, which will be installed at high-volume pedestrian locations or pay from their vehicle using cash or credit at garage gates. To ensure a smooth transition there will be attendants stationed at gates during the initial rollout. Patients and visitors will have four payment options:
1. Pay with cash or credit at a pay station, receive a ticket, and put the validated ticket in the ticket reader at the gate from their vehicle.
2. Pay with cash or credit at the gate pay station from their vehicle.
3. Pay the gate attendant with cash or credit.
4. Use a discounted or free parking ticket, if they received one, at any of the above payment location options.

Thank you for complying with our parking rules so that parking spaces are always available and accessible for our patients. All existing passes will be used during the transition. The booths will be staffed, and the existing passes will be accepted. Once existing passes have been exhausted, new passes will need to be purchased.

Doctors' Day
Today is National Doctors' Day across the United States. Because this year March 30th is a holiday in multiple religions, we are celebrating on Monday, April 2. We are very fortunate to have a wonderful medical staff, who work very hard and do marvelous things. Our physicians throughout the healthcare system make a tremendous difference in the lives of patients every day. I am glad that at least one day a year we reach out and thank physicians for all the things they do 365 days a year.

In honor of Doctors' Day and your physician, please share your thoughts and inspiring stories of patient care here… 

Happy Holiday
On a final note, the GBMC HealthCare family sends its best wishes to everyone celebrating Passover and Easter this Sunday.

Tuesday, March 20, 2018

The Calling of Gilchrist Kids: End of Life Care for Children and Support for Their Families

The recent rebranding campaign for Gilchrist was designed to inform the community that it is more than hospice. Gilchrist provides outstanding elder care for fully active seniors, patients with chronic disease and frailty, and those nearing end of life. Annually, Gilchrist delivers elder medical care to 7,500 individuals, hospice care to 5,400 patients, and grief counseling and bereavement services to 6,500 people. The organization also counsels people on advance care planning, guiding them through decisions about their treatment and helping them make informed choices about their end-of-life care. They truly are living up to being “more than hospice.”

What many people do not realize is that Gilchrist also has a pediatric hospice program, which provides all-inclusive end-of-life care for infants, children, and young adults with life-limiting illnesses. It is the only facility in the state with inpatient children’s hospice beds. Gilchrist Kids cares for children dying from cancer, cardiac disease, untreatable infectious disease or blood disorders, life-limiting genetic or congenital diseases, and other conditions. The program also offers perinatal support for parents-to-be who have learned that their unborn child may have an incurable illness, as well as respite care, which is critical in improving the quality of life for terminally ill children and their families.

Gilchrist opened over 20 years ago as a small hospice organization serving a few dozen people It has grown to now serving thousands of individuals throughout Central Maryland—in homes, in skilled nursing and residential care facilities, and in three inpatient hospice centers in Towson, Howard County, and Baltimore.

To find out more about Gilchrist kids, I encourage you all to watch the following two interviews with staff members from Gilchrist Kids from the shows “To Your Health” and “Greater Living,” which were broadcasted last week on the GBMC Facebook page. I think you will find them very enlightening and you will be very proud of all that they do.

To Your Health

Greater Living

Thursday, March 8, 2018

Learning Together with Our Colleagues from the Centers for Medicare and Medicaid Services

On Monday, we were delighted to host my dear friend and colleague, Dennis Wagner, the Director of the Quality Improvement and Innovation Group at the Centers for Medicare and Medicaid Services (CMS), and several of his colleagues from CMS on our Lean Daily Management rounds.

I worked with Dennis and learned so much from him when he was the director of  The Health Resources and Services Administration (HRSA) national initiative to increase organ donation and I was the national co-chair. Dennis is an expert in social marketing and leading groups to attain bold goals. He co-leads CMS’s Partnership for Patients collaborative, which has been incredibly successful in improving care in U.S. hospitals and in which GBMC participates. I previously visited CMS and participated in their LDM walk, so I was grateful that Dennis came to see ours.

We got some great insights from Dennis and his team that will only make our rounding better. Dennis was very impressed with the spirit of improvement that he found throughout our healthcare system.

Thank You to Our Social Workers!
March is Professional Social Work Month and I would like to thank the devoted group of social workers who serve GBMC. Our social workers help inpatients and outpatients navigate the complexity of the medical care world and prepare them for discharge along with our care managers. They’ve helped GBMC maintain one of the lowest readmission rates in the state. Please thank our social workers for all that they do to move us closer to our vision.

Left to right: Chris Greenawalt, MD &
Rekha Motagi, MD
New Director of our Hospitalist Program
Chris Greenawalt, MD, has been named as our new Director of the Hospitalist Program. Dr. Greenawalt has been a leading member of the GBMC hospitalist group since 2003.

He received his medical degree from Wake Forest University School of Medicine and is board-certified in Internal Medicine. He not only has vast experience in working as a hospitalist, but also in helping hospitalist programs flourish.

“Hospitalists” are physicians who specialize in hospital medicine and devote their time exclusively to caring for inpatients. They communicate during admission and discharge with the primary care physicians, assuring continuity of care.

During Dr. Greenawalt’s time at GBMC, he served as the Assistant Director of the Hospitalist Group for six years and participated in multiple committees, including the Credentials Committee. In addition to his new leadership responsibilities, Dr. Greenawalt will continue to care for patients in the hospital as an attending physician. I would also like to thank Dr. Rekha Motagi, who is stepping down as Director of the Hospitalist Program for her years of outstanding service. Rekha will continue to see patients in the Hospitalist group.

Thank you to Dr. Motagi and congratulations to Dr. Greenawalt!

Friday, March 2, 2018

Pulling the Andon Cord

It’s been two years since we discussed our work to assure that nurses always have the medication to give to patients when they need it. In January of 2016, we reviewed the tremendous reduction in “missing medications” that had been achieved because of the improvement work in the pharmacy and our inpatient nursing units.

This week, on Lean Daily Management rounds, Maxine Lawson, our Assistant Pharmacy Director, explained to us that there had only been one missing medication to Unit 34 out of the last 400 medications dispensed! Only one defect in the system for that unit. How did they accomplish this? Redesigning the system to get to high reliability has taken some time. We suffered a significant setback after Epic implementation as many sub-systems had to be recreated. Today, we have now returned to our pre-Epic implementation state by studying the misses as they happen, during the day, to find the root cause and fix it so it doesn’t happen again.

Toyota gets credit for being the first company to perfect the study of defects as they happen to learn the cause of the issue. Before that, auto manufacturers would either find defects as the cars came off the assembly line or when their customers found the problem. Toyota implemented the Andon cord (now a button that can be pushed), that immediately stops the assembly line and brings managers to the person who pulled the cord, so they could study what happened and find a fix.

Now when the nurses on Unit 34 are “missing” a medication they need, they do the equivalent of pulling the Andon cord…they call the pharmacy. Maxine and her team immediately (during the day) go to the unit and study what happened. They then use what they learned to test changes to their system to assure that the miss doesn’t happen again. What Toyota learned and what we now know is that it is much better to study one defect well when it happens than to get sophisticated reports of many defects over time before scheduling meetings to figure out what happened and what we should do about it. I am very proud of our outstanding pharmacy team and our smart and hard-working nurses. Together, they are driving us to ever higher reliability! They are happy to help any group learn how to use the immediate Andon cord technique to make things better.

A Wonderful Friend and Colleague Heads to Retirement 
This Thursday was George Bayless’ last day at GBMC.

George joined GBMC’s Executive Leadership team about 11 years ago as Vice President of Finance.  With more than 30 years of corporate financial experience in the public accounting and healthcare industries, he was responsible for the development, implementation, and maintenance of accounting systems that provide for the financial control of the entities of GBMC HealthCare. George was also responsible for system-wide financial planning and the annual operating and capital budget processes.

George recently assumed additional responsibilities when he took over as Interim Chief Financial Officer prior to Laurie Beyer’s arrival. That’s the George everybody knows. He’s a person who will do whatever it takes to help his colleagues and our healthcare system. George is great learner and teacher.

Congratulations, George, and thank you for everything you have done through the years for your colleagues at GBMC, for our healthcare system, and for our patients!

Kudos to Laura Clary (again!)

I want to also congratulate Laura Clary BSN, RN, FNE-A/P, SANE-A, CFN, CPEN, Clinical Manager of our SAFE program, who was recently named Baltimore County Woman of the Year by the Baltimore Commission for Women. This program honors female residents of Baltimore County who have made significant, unique, and lasting contributions to their community. I echo Dr. JoAnn Ioannou’s words that it’s no surprise that Laura is repeatedly given accolades because she is an extremely knowledgeable nurse, scientist, and phenomenal team leader. Congrats again, Laura!