Friday, August 28, 2020

With Liberty And Justice For All
The recent shooting of Jacob Blake once again raises the question of equity and justice in the treatment of African Americans in America. We must all stand united in eliminating injustice in our country. We must hold our elected officials accountable to make the changes necessary so that all Americans are treated fairly. 

Within our span of control in the GBMC HealthCare System, our vision is to treat everyone as if they were our own loved ones, not just someone we would meet in passing. Every day I see wonderful examples of us living out this vision, but if anyone sees examples where we have not done this, please bring them to my attention.

We cannot achieve our vision unless everyone on our team feels respected and included. Our Diversity and Inclusion Council will be interviewing experts to help us take our workplace inclusion efforts to a new level. I will update readers of the blog on these efforts as we move forward. 

Our nation is clearly hurting, and I am saddened by this latest episode. I am encouraged by media reports that Jacob Blake is recovering, and I hope that the calls for peace and peaceful protest from his family are listened to.

Certificate of Need Approved
In 2019, we updated our master facilities plan and submitted a certificate of need (CON) application for a three-story hospital addition known as The Promise Project. Last week, we received approval of our CON, which is a critical next step in the project. 

We now have the permission of the Maryland Health Care Commission to build an addition in front of our main lobby. Within the expansion, there will be 60 state-of-the-art medical patient rooms and additional patient and family amenity spaces, including wellness and patient support areas.

In particular, I want to thank Laurie Beyer, Executive Vice President and Chief Financial Officer, Stacey McGreevy, Vice President of Support Services, and Russ Sadler, Manager of Capital Resources, for their work in getting us over this hurdle.

Our plan is to break ground during the summer of 2021!

Congratulations are in Order!
I am proud to let you know that EIGHT of our colleagues were chosen by their peers from thousands of nurses in the Baltimore region. These phenomenal clinicians have been recognized as Baltimore Magazine’s 2020 Excellence in Nursing winners! Please join me in congratulating the following nurses:

First row (left to right): 
•Jennifer Babcock, BSN, RN, CHPN - Gilchrist Center Baltimore
•Theresa Breitenbach, RNC, BSN - Neonatal Intensive Care Unit (NICU)
•Jennifer Nicole Chen, RN - Gilchrist Center Towson
•Laura Clary, BSN, RN, FNE-A/P, SANE-A – SAFE
Second row (left to right):
•Melissa Cross, BSN, RN, FNE-A/P, CEN – SAFE
•Carolyn Keller, MS, RN, NE-BC – Unit 36
•Kelly Lucas, MSN, RNC-OB – Labor & Delivery
•Corin Mauldin, BSN, RN – NICU

This month’s “Best of Baltimore” issue is already on newsstands. Grab a copy to learn more!

Way to go!
Baltimore's Child Magazine recently unveiled its list of 2020 Reader's Choice winners. GBMC was named as the “Best Place to Deliver Your Baby!” by their readers. I am very proud of this great accomplishment and I am very grateful for everyone who has made this recognition possible.

Friday, August 21, 2020

Taking Continuous Improvement to the Next Level

Back in 2013, we realized that GBMC was making progress towards our vision by using continuous improvement as our business model, but we were concerned that we were not moving fast enough. We engaged consultants who were experts in the use of Lean techniques in manufacturing, and their leader, Mike Holland, said to me, “You need to do Lean Daily Management.” I said to him, “Great, Mike. What’s that?”

Mike started our education with the “why?” He pointed out to us that all managers wanted to improve the performance of their unit or department, but they often pushed improvement work to the future because they were caught up in fixing the problems of the day. By creating a daily system for reporting and accountability, we would see an acceleration of meaningful change. Mike then taught us how to design Lean Daily Management (LDM). We started small, with one route and a few stops. As we got better, we built it out to five routes with six to seven stops each, and a walk on the weekend as well. 

Well, here we are seven years later. We have made so much progress! We have improved so many things under our Four Aims from the reduction of missing medications and employee injuries, to moving urinary catheter insertion to standard work and the resulting reduction in CAUTI’s, and on and on. So, now it’s time to take process improvement and our core competency, redesigning care, to the next level.

Under the leadership of Rhonda Wyskiel, Director of Performance Improvement and Innovation, we are rolling out what you might see as LDM 2.0, the Lean Management System (LMS). You will learn more about this over the next few months. The Lean Management System builds on LDM. It requires the creation of standard work, a process for teaching the standard work, and checking back to see that it is being done correctly. LMS also adds increased accountability through the chain of command. 

Rhonda and her team have begun rolling out LMS on medicine inpatient units, starting with the technique of purposeful rounding, to assure that scheduled check-ins with the patients meet the patients’ needs. This work has already led to significant increases in our HCAHPS overall score! The team is also working with the support systems of EVS, Transport, and Food and Nutrition. Stay tuned!

Wonderful Recognition for Our Pharmacy
GBMC is the recipient of the 2020 Minogue Award for Patient Safety Innovation from the Maryland Patient Safety Center (MPSC)! This award was created by the MPSC’s Board of Directors to recognize an organization within our state that has made a demonstrable difference in patient safety through an innovative solution. GBMC was chosen from over 70 submissions by a panel of independent judges, who are leaders in the Maryland healthcare community.

We received the award for our program: One Insulin Pen for One Patient, which was designed and implemented at GBMC under the leadership of Vaishali Khushalani, Pharm D., Medication Safety Officer, and Yuliya Klopouh, Pharm D., Director of Pharmacy Services. The program was created to reduce the risk of administering insulin with a pen from a different patient. After examining the possibility that an insulin pen from one patient could have been used on another patient in 2018, the pharmacy team was challenged to redesign the process for dispensing insulin pens. They studied the existing system and leveraged technology in a new safer system. Subsequently, GBMC has seen a decrease in missing insulin doses due to the redesigned process.

Our pharmacy is a leader in continuous improvement at GBMC and I am very proud of them. Please join me in congratulating them for getting this well-deserved award!

Tuesday, August 18, 2020

A Conversation with Erlene Washington

Last month, I highlighted our soon to be new advanced primary care site at Padonia Station. The practice will serve the entire family, from newborns to elders. It will be staffed with a team of physicians, advanced practitioners, nurse care managers, care coordinators, and support staff. We are looking forward to adding urgent care early next year.

GBMC Health Partners at Padonia only one of many exciting new initiatives and changes taking place within our physician company. Recently I caught up with Erlene Washington, CPA, vice president and chief operating officer at GBMC Health Partners, to get an update. Erlene joined GBMC in the Spring of 2019 and she has been a great addition to our team bringing her experience and insight in physician practice management.

Q: How did your background prepare you for this role?
A: I have a strong financial background, and this has helped me to understand the “why” and to find solutions to problems with optimal results, both from an operational and a bottom-line perspective. 

Q: How’s the job going so far and what were your first impressions of GBMC and GBMC Health Partners?
A: So far, I have thoroughly enjoyed working at GBMC. The best part of the job is the concentration on the Four aims (Better Heath, Better Care, Least Waste and More Joy). These aims guide my work every day. It has been wonderful working with various teams and colleagues from across GBMC Health Partners and the GBMC HealthCare System. I look forward to sharing ideas and working side by side with my team daily.

Q: What have been some of the toughest challenges during this COVID-19 pandemic?
A: The toughest challenge has been keeping our patients and staff safe, while still providing outstanding care. We have been able to overcome this by using a combination of telehealth, social distancing, and Personal Protective Equipment (PPE), while working to secure supplies such as masks, gowns, and wipes, which have been in high demand worldwide. 

Q: What can you tell us about our soon to be Patient Centered Medical Home Model at GBMC Health Partners at Padonia and how is this location going to be different than the others within the GBMC Health Partners family?
A: Our Padonia office is a 14,123-square foot, state-of-the-art, multi-specialty facility housing primary care, urgent care, gynecology, urogynecology, and orthopaedics, with the opportunity for more subspecialties. The facility will offer Imaging and Labs along with 23 exam rooms with interactive 47-inch touch screen monitors using voice activation. As in our Family Care Associates office, we will utilize The Virginia Mason model with no waiting room and on- and off-stage rooming. Patients have the option of checking in using geo-referencing check-in technology (Hello Patient) and self-cleaning kiosks. 

Q: What is the one major aspect of GBMC Health Partners at Helping Up Mission (HUM) that you would want potential patients from the community to know?
A: If you are in need of a provider, GBMC Health Partners at Helping Up Mission is a great place to get your care right within your own community. Patients have access to in-office appointments with Baltimore's best specialists at GBMC, and 24-hour patient access to their medical records via their phone or personal computer. At GBMC Health Partners at Helping Up Mission, we will be accountable with the patient for their health. The physician-led team will deliver immunizations, cancer screenings, and physical exams as well as personalized care coordination to manage acute and chronic illnesses. 

Q: What do you see in the future for GBMC Health Partners?
A: We will work hard to see that GBMC Health Partners continues to grow, offer the best care to our patients, and provide the most joy to our staff. 

Friday, August 7, 2020

COVID-19 Fatigue

People are becoming tired of the COVID-19 pandemic, and I am on the list of those suffering from the COVID-19 pandemic fatigue. It bothers me that I can’t socialize without physical distancing, and it really bothers me that the jazz venues are all closed to live shows. Baltimore has fabulous jazz venues like Caton Castle, Andie Musik, and Keystone Korner. We have performances in the outstanding auditorium at the Baltimore Museum of Art hosted by the Baltimore Chamber Jazz Society, whose president is our own Bill Murray. And the Peabody Conservatory has a fabulous jazz program where the leader is none other than Sean Jones, one of the foremost trumpeters in the world. My wife, Tracey, and I really miss going to Peabody to hear the students play under the tutelage of Maestro Jones. 

Okay, that’s enough of me moaning. I know that this will come to pass, and I will get to do the things that I enjoy doing in my spare time again. More importantly, however, I see fatigue in the eyes of our physicians, nurses, and other clinicians who have now been standing up against COVID-19 for the past five months. I cannot overstate the value of their hard work and tenacity in service to the community. While they are tired, they are not shirking their responsibilities. I am so proud of them and truly am grateful that they come to work every day even though it can be draining. 

I am thankful to all our leaders, our chaplains, Joe Hart and Sandy Rector, in the hospital, and our many wonderful Gilchrist chaplains, for helping our employees mourn the loss of patients and to gain resilience by reflecting on how their teamwork has helped so many patients manage their symptoms and recover. 

I am happy that patients are returning to get care that they have put off during the height of the pandemic; however, the return of non-COVID patients has put extra stress on the clinical staff. We can’t forget that we were in a nursing shortage before the pandemic, which is now being exacerbated by school closings and child care issues. 

So, if you, too, are suffering from Pandemic Fatigue Syndrome, please stop and reflect on how it is affecting others and see if there is some way that you can lessen their burden. After all, we are all in this together.