Thursday, October 29, 2020

Being Ready for Your Loved One to be the Patient

GBMC will receive a site visit from the Joint Commission for our triennial accreditation survey in the next few weeks. In the old days, when a hospital thought that the Joint Commission was on the way, it was time to get ready and be on our best behavior. Thankfully, this is no longer the case.

We now realize that accreditation standards are the minimum that an organization needs to meet to deliver good care to those it serves. We all know that GBMC is moving towards its vision of being a community-based system of care that can deliver the best health outcome and the best care experience with the least waste of resources and the most joy for those providing the care. We do this for every patient, every time. This is the care that we want for our own loved ones. So, it is clearly necessary for us to be ready all the time for an accreditation group to give us a check-up. If all our leaders are following our Leadership System, we should always be ready for a Joint Commission Survey. I am very interested to see what we learn when the Joint Commission comes. I am sure that the surveyors will find some areas where we might improve but I am sure that we are ready as an organization. 

This Monday, on the Lean Daily Management walk, I visited the Women’s and Outpatient Surgery Center, the Sherwood General Operating Room, the Post-Anesthesia Care Unit, and the Kroh Endoscopy suite. At every site, these perioperative leaders told me what they were doing to take their units further along the journey towards high reliability. My colleagues were so far away from the old days of having to get ready to meet a minimum standard. On the contrary, it was so exciting for me to hear how highly they were performing and how they were setting the bar higher every day to move us towards our vision. I am humbled by the work of Jack Flowers, MD, Sharon Rossi, RN, John Kuchar, MD, and all their colleagues. They don’t need to be told to “get ready.” They, like their other GBMC colleagues, are ready.

Stroke Center Award
I want to congratulate our Primary Stroke Center which, under the leadership of Michael Sellman, MD, and Aaliyah Franks, RN, was recently selected for the 2020 AHA Gold Plus and Target: Stroke Honor Roll Elite and Type 2 Diabetes Honor Roll

These awards recognize our Stroke Center’s commitment to assuring evidence-based stroke care. Great work and congratulations!

Friday, October 23, 2020

Experts Should Be Trusted & Listened To

GBMC uses principles of high reliability to move closer to our vision every day. What does high reliability mean? A simplified version is that what should happen…happens and what shouldn’t happen…doesn’t happen. 

Academicians have studied highly reliable organizations and have found that these entities follow five principles. They are: sensitivity to operations, commitment to resilience, reluctance to simplify explanations of successes and failures, preoccupation with failure, and deference to expertise.

Leaders are in the position to make decisions. Being human, a leader can’t know everything. Smart leaders reflect on their knowledge and capabilities and seek the help of experts when they must make a decision. Governor Hogan should be commended for his work at the beginning of the pandemic. He sought the advice of epidemiologists from Maryland’s universities because he recognized that they had expertise that he did not have. He listened to them and took their advice in crafting Maryland’s plan for confronting the pandemic. Because of this, Maryland has done fairly well in confronting the coronavirus compared to other states where governors made decisions that were not informed by expertise.

Recently, I had an experience in my personal life that underlined for me the importance of seeking the input of experts. I was sitting at the dinner table when I heard a noise coming from the basement. I went downstairs to see what was happening and there was a loud “clicking” sound coming from our heating unit. 

I had no idea what I was hearing, or for that matter, what I was looking at in the component parts of the system. So I reached out to an expert – our Director of Facilities Jim Keyzer. Over the past few years, I have had many conversations with Jim about physical plant issues. I have been in awe of the depth of Jim’s knowledge about heating, plumbing, electrical works, and everything to do with building maintenance. So, I took out my phone and took a video of the heating unit. I then texted the video to Jim. Within minutes, I had a reply from Jim telling me that the noise was coming from the water pump and the most likely broken part that was causing the noise. The next day, I called a heating technician who came, validated Jim’s suspicions, and fixed the problem. 

This incident again reminded me how little I know about so many different topics and how important it is to reach out to experts and follow their advice. Giving deference to expertise is what helps us improve our situation as individuals, as organizations, and as countries. 

When leaders make decisions based on their own beliefs that may not be informed by truth and logic, things don’t go well. 

We are giving deference to expertise in our daily work at GBMC and our progression in achieving our Four Aims is evidence of this!

One family’s work in helping GBMC
Since the start of the COVID-19 pandemic, volunteers have sewn and donated more than 3,900 cloth face masks to GBMC for use by our staff. More than a quarter of these masks have been made by one volunteer – Rita Siwinski! A few weeks ago, Rita reached the 1,000 masks donated mark, which represents about 500 hours of work, not to mention the cost of materials which Rita so generously purchased. I wanted to make you aware of her efforts because she has truly demonstrated what it means to “give back.” During one of the most challenging periods in recent history, Rita’s example has been a bright star for all of us. What is also amazing is that Rita, a former employee, volunteers in the Pharmacy and her husband, Stephen, also volunteers in Spiritual Support. When you see them, please thank them for their ongoing commitment to GBMC!

GBMC Team…Please get your flu shot!
This year, getting a flu shot becomes even more important as the challenges of the COVID-19 pandemic continue. All members of the GBMC workforce are required to be immunized (those few who are excluded for health reasons are required to wear masks during the flu season) to protect our patients. Our next FLU VACCINE EVENT is Monday, October 26, at Employee Health Services. Next week’s schedule is as follows:

Monday, October 26: 7:30 a.m. – 3:30 p.m.

Thursday, October 29: 7 a.m. – 3:30 p.m.

Friday, October 30: 7 a.m. – 3:30 p.m.

Fridays: 7 a.m. to 3:30 p.m.

Your GBMC ID badge must be presented at flu events. Vaccines are only available at the dates and times listed above, no walk-ins will be accepted at Employee Health Services unless specified above. The deadline to receive the influenza vaccine is October 30. 

Top Docs Again!
GBMC has always been recognized for the quality of our medical staff, which was again confirmed when 143 of our physicians, in 76 specialties, were named in the Baltimore magazine “Top Docs 2020” survey in the November issue. Several of those medical staff members were recognized in more than one category, and some have been recognized many years in a row! 

In preparing its annual list of “Top Doctors,” Baltimore magazine surveyed 13,000 area physicians and asked where they would send members of their own family for specialized care. This important question is at the very center of GBMC’s vision of providing each of our patients with care worthy of our own loved ones.

This year, the magazine also highlighted, Lauren A. Schnaper, MD, FACS, breast surgeon and our former Director of the Sandra & Malcolm Berman Comprehensive Breast Care Center. She was one of six physicians, from a pool of hundreds in the Baltimore area, selected to be profiled.

To all the “Top Doctors” at GBMC, congratulations from all of us! The rest of us in the family are very proud of you. To view a listing of our “Top Doctors” and to learn more about who they are, please visit here. 

I am delighted to announce that GBMC, was again a recipient of the Most Wired Hospital award from the College of Healthcare Information Management Executives (CHIME) for both our acute and ambulatory services. We were one of two hospitals in the state to receive two Level 9 Most Wired recognitions, which is no easy task. Many institutions have only been successful on the acute side.

Some of our IT advances include expansive telehealth services to accommodate the COVID-19 pandemic, a fully-integrated patient portal, and real-time data visualization tools. The electronic health record (EHR) can consume discrete data from multiple external entities to ensure continuity of care.

I am very proud of our IT Team in their recent achievement of the Most Wired Hospital award. Let me once again congratulate our information technology professionals and our clinicians on this fabulous accomplishment!

Thursday, October 15, 2020

A GBMC Icon Retires

This Friday, October 16, is Keith Poisson’s last day as our Executive Vice President and Chief Operating Officer. He will begin his well-earned retirement on that day. 

Keith came to GBMC in 2007, after serving as Chief Operating Officer at St. Mary's Health Care in Grand Rapids, Michigan, to oversee patient care and support services as Chief Operating Officer of our hospital.  

In 2010, Keith took on much more responsibility as he became Chief Operating Officer for the entire system. In this role, Keith has been the key designer of our system of care, accountable for the day-to-day operations of not only our hospital, but also GBMC Health Partners and Gilchrist. Among Keith’s many accomplishments is his development of the service line model that has put physician leaders, nurse leaders, and administrators in charge of large components of our system. Keith has overseen the strengthening of our strategic planning process and the creation of our strategy deployment process. This work has caused GBMC’s resurgence in surgery, the tremendous growth in the medical sub-specialties, especially in cancer, and the solidification of our position in the market in maternal and child health. With Keith’s calm demeanor and great depth of knowledge about care delivery, GBMC has moved steadily towards our vision. Achieving a second site visit (and potentially achieving the award!) for the Malcolm Baldrige National Quality Award is a fitting testament to Keith’s legacy at GBMC. We would not have gotten this far without Keith’s oversight of the creation of standard work and an accountability model to sustain it. 

Keith has mentored so many young leaders at GBMC and we can thank him for leaving us with the capabilities to keep moving forward as he departs. Keith has been a partner and friend to me and has often given me sage advice just when it was needed most. 

GBMC has been very lucky to have Keith as a leader. He will be missed dearly, and we wish him all the best. Keith is relocating to Hilton Head Island, South Carolina with his wife, Liz. We will welcome Keith back to GBMC for the groundbreaking of our three-story hospital addition, and in recognition of his outstanding contributions to our system, we are naming him as a member of the Promise Project Campaign Committee.

We will never forget Keith and his dedication to GBMC. Please join me in thanking Keith for all that he has done for GBMC, our staff, and our patients. 

Congratulations to Our Lactation Support Team
GBMC was acknowledged recently by the International Board of Lactation Consultant Examiners (IBLCE) and the International Lactation Consultant Association (ILCA) for excellence and dedication in supporting and promoting breastfeeding.

The IBCLC Care Award is reserved for hospitals and community-based facilities that are found to protect, promote, and support the clinical management of breastfeeding, provide regular training for staff members who care for breastfeeding families, and support evidence-based projects. This recognition validates the efforts being made by our multidisciplinary team of nurses, nursing support technicians, lactation consultants, obstetricians, advanced practitioners, neonatologists, pediatricians, and anesthesiologists to help mothers get off to a good start with breastfeeding during their hospital stay, and beyond discharge.

GBMC is one of a few hospitals in the Baltimore region to receive this designation and this is the fourth concurrent two-year cycle since 2014 that GBMC has received the global recognition. Congrats to Jodie Bell, MSN, RNC-LRN, IBCLC, Assistant Director of Women’s & Children’s Services at GBMC, and her colleagues for this achievement.

Thank you!!
Emergency Department nurses never know what patient with what ailment is about to walk through our doors, and they can see many patients in a shift. When a patient comes to our ED, our nurses deal with them quickly and professionally regardless of the patient’s age, illness, or injury.

This week is Emergency Nurses Week (Oct. 11 – 17) and this year’s theme Heart of Gold, signifies the incredible heart that every emergency nurse has and how vitally important they are to hospitals. This is more than evident during these challenging times of COVID-19. Please thank our emergency nurses for their often heroic and compassionate service and for having a “heart of gold."

2020 Healthcare Security and Safety Week
I want to thank all the members of our GBMC security staff, as this week is Healthcare Safety and Security Week (Oct. 11-17).

Each day, GBMC security officers help maintain a safe and secure workplace. They can be seen walking or stationed throughout our medical center from the emergency department to labor and delivery. 

They are vital members of the healthcare team and we cannot be successful without them. Please join me in thanking our security staff for their hard work and for the strong commitment and diligence they display in the practice of their profession. 

Friday, October 9, 2020

The Affordable Care Act is Again Under Attack

A family member of mine, who would have been uninsurable before the passage of the Affordable Care Act because of a pre-existing condition, recently received a check from his insurance company for $350. It is a small percentage of what he paid for his coverage in 2019, but still, how often does someone get a check from their health insurer?

Well, he got the check because his insurer spent less than 80% of what they collected in premiums paying providers for the care they delivered. And why did they have to pay the money back? Because of the Affordable Care Act (ACA)! 

People know so little about the ACA, called Obamacare by many who want to deride it. The legislation is imperfect, but it has been successful in many ways – requiring health insurance companies not to keep too much premium as profit is one of those ways. 

The future of the ACA is again coming into question with the Supreme Court in its new term, which started this past Monday, and with the Senate looking to act on President Donald Trump's nomination of federal appeals court Judge Amy Coney Barrett to succeed the late Ruth Bader Ginsburg.

For this reason, I wanted to take some time this week to point out the part of the Act that has to do with the medical loss ratio (MLR), or the percentage of premiums that the insurer spends on care. This is a protection for the buyers of health insurance. If an insurer spends less than 80% on care, it owes the insured a refund. 

The purchaser of the policy receives a rebate directly from the insurer through either a check or a reimbursement to the account (credit card, for example) with which the premium was paid. Unfortunately, very few people realize they may be due a refund, so they don't know to look for a check from their insurer. 

There is much more waste in our healthcare system than in most other developed countries, but at least the Affordable Care Act is providing some protection for citizens by keeping insurers from making too much profit at the purchasers’ expense. 

Most Americans support the part of the Act that protects them from being uninsurable for a pre-existing condition and they also like the fact that their children can stay on their insurance until 26, but what do you think about the 80% rule? Would you be upset if it went away? Let me know what you think.

Thank you!!
My sincere thanks to all of you for your role during our Baldrige survey last week. I think it went well, and all we can do now is wait as the examiners complete their work and submit their report to the program judges. The judges will then evaluate our application and determine whether we meet the criteria to be recognized as Baldrige Award recipients. It is possible that if we don’t receive the award we might be Category Best Practice recipients again. In mid-November we will be notified and in December, we’ll receive a comprehensive feedback report from which we can continue to learn and improve.

GBMC has been using the Baldrige criteria to build systems. Regardless of the outcome, I’m so proud of all of you! GBMC HealthCare is improving in all areas, which means we are getting closer to achieving what is embodied in our vision phrase: “To every patient, every time, we will provide the care that we would want for our own loved ones.”

Again, my sincere thanks again for all your hard work and dedication for the sake of our patients and the community.

Let’s celebrate our colleagues!!

This week is Healthcare Supply Chain Week (Oct. 4-10), which celebrates resource and materials management professionals for their important contributions to healthcare. We all benefit from the work of our entire supply chain team

I am proud to recognize the great work of our pediatric nurses as this week is also Pediatric Nurses Week (Oct. 5-9). Our pediatric nurses, to me, are a special group of medical professionals who provide care and compassion to young patients and do critical work to improve healthcare delivery. Pediatric nurses face many challenges; they have to speak with children, pinpoint their pains, and manage fears. If you’ve had young loved one in the hospital, then you can understand the challenges that can come with this career choice. So, thank you to our pediatric nurses that constantly deliver the care that we would want for our own loved ones no matter how challenging their work can become. 

It is also Healthcare Foodservice Week (Oct. 5-11). I would like to express my gratitude to the men and women who work hard to keep our patients and colleagues fed. 

Thanks to all GBMC physician assistants (PAs) this week during National PA Week (Oct. 6-12). This is the week when PAs celebrate their profession and showcase the value they bring to today’s healthcare team. I am so grateful for their hard work!

Friday, October 2, 2020

A Discussion with a National Hero

This morning, I had the honor of serving as the host for a virtual question and answer session, with Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases (NIAID) and member of the White House Coronavirus Task Force.

This was a unique opportunity to discuss COVID-19, our healthcare system, and our response to the global pandemic with Dr. Fauci, a world leader in infectious diseases. He addressed several issues ranging from updates about a vaccine and the possibility of other treatments for the coronavirus to the challenges schools have encountered due to COVID-19 and lessons learned in preventing future infectious disease surges. You can watch the video here.

I want to express my appreciation to Dr. Fauci for his participation in today’s event. Today also happens to be the 55th Birthday of the Greater Baltimore Medical Center (How cool is that?!). But most of all I want to thank him for his years of service to our country, most notably during the AIDS epidemic and for his guidance now during the COVID-19 pandemic. His calm reliance on the scientific evidence has been invaluable.

I would like to thank the GBMC community for providing the questions before-hand and for watching today’s event. I also want to offer my gratitude to Rebecca Barnes, one of our campaign project managers in our Philanthropy Department for securing Dr. Fauci’s involvement and to our marketing department for coordinating this incredible event. Thank you! 

One step closer?
This week we hosted a virtual site visit with examiners from the Malcolm Baldrige National Quality Award! This year, due to COVID-19, the process could not be done in person, yet despite this change, the examiners were able to speak with us to validate the information we submitted in our application. 

Like last year, they reviewed all three of our work systems: Greater Baltimore Medical Center, Gilchrist, and GBMC Health Partners. Everyone did a WONDERFUL job in telling them our story and for that I am so grateful and proud of all of you! I cannot name all of those who worked so hard to make the examiners’ visit a huge success, but I need to thank, Carolyn Candiello, Vice President for Quality and Patient Safety, Keith Poisson, Chief Operating Officer, Lisa Groff Reuschling, RN, Clinical Director Women and Child Health, Shelby Davis, Quality Outcomes Analyst, and Zebe Jacobson, Quality Improvement Resolution Specialist, who spent countless hours assuring that the survey went off without a hitch!

Now that the visit is over, the examiners will file a report that will be reviewed by the Baldrige judges, who will determine if we have achieved the award. This has been a tough year for all of us, and it would be great to have a celebration after we hear in mid-November. Until then, all we can do is wait and be proud of what we have accomplished together.

Epic Turns Four at GBMC
I can’t believe that this past Thursday (Oct. 1) was the four-year anniversary of our “flipping the switch” and going live with Epic – our electronic medical record (EMR) across the GBMC HealthCare System. It is clear that “one patient, one record” has been a huge change accelerator for us. 

Since 2016, our Epic program has received some of the highest honors possible. Earlier this year, I was proud to announce that we received the prestigious Summa Cum Laude designation, the highest level of achievement for Epic users in Epic’s Honor Roll Good Maintenance Grant Program, and we achieved a score of 9 out of 10 on the Epic Gold Star program. The Gold Star program exists to incentivize Epic users to get the most out of the software’s capabilities. In late 2019, we also achieved the Davies Award of Excellence, the highest achievement for the use of electronic records from the Healthcare Information and Management Systems Society (HIMSS), and for the first time the Surescripts White Coat Award. This award acknowledged our organization’s ability to positively impact patient safety, increase speed to therapy, and improve first-fill adherence and patient satisfaction by improving e-prescription accuracy.  

These are only a few of the recognitions we have received over the years that clearly illustrate our success with Epic. Without question, these achievements are due to the commitment and effort of the GBMC staff, which includes our highly skilled team of physicians, nurses, other clinicians, and IT professionals. I want to thank all my GBMC colleagues for so many achievements in such a short period of time.