Tuesday, November 23, 2021

Grateful for All of You!

Thanksgiving is a time for reflection. Over the last several days, I have been reflecting on all that we have accomplished together. We have created a true community-based system of care with the capability of caring for someone from birth to death, in a way that we would want our own loved ones cared for. Our system is not perfect, and we still have work to do, but it is very good. 

In addition, we have committed the GBMC HealthCare System to be a part of the solution for the city of Baltimore. Our work at the Helping Up Mission and at the Gilchrist Center Baltimore is exemplary and we have only just begun to bring outstanding primary care to people who have been marginalized by the healthcare system, at our GBMC HealthPartners Jonestown patient-centered medical home. 

The work of our doctors, nurses, other clinicians and support staff including our volunteers at our fabulous hospital has been outstanding, especially given the challenges of the pandemic and the cyberattack. 

So, let me thank all my teammates in our system for all that you do every day. I am honored to work with you towards our vision. Please enjoy Thanksgiving with your families and reflect on all that we have to be grateful for. 

Transgender Day of Remembrance

Last Friday, we held a ceremony honoring the memory of the transgender people whose lives were lost in acts of violence over the past year. Transgender Day of Remembrance (TDOR) is an annual observance on November 20.

Transgender people often experience prejudice when accessing healthcare services. Understanding the unique needs of our patients can help improve their healthcare experience.  Their needs include transition-related or gender-affirming medical care designed to align physical characteristics with gender identity. Transgender individuals may also have unique health needs in reproductive care, gynecologic and urologic care, and mental health.  By taking time to learn more about the transgender experience in health care, you can play a part in bettering the lives of others.

I want to thank our Diversity & Inclusion Council for putting together this ceremony. I would also like to thank all the attendees who took the time to join and to reflect on the lives we’ve lost to transphobia.

Friday, November 19, 2021

The Malcolm Baldrige Quality Award, One Year Later: What Have We Learned?

This coming Wednesday, Nov. 24, will be the one-year anniversary of our achieving the Malcolm Baldrige National Quality Award, the highest level of recognition for performance excellence in the nation. 

Our accomplishment represented the first time that the Baldrige was awarded to a healthcare company in Maryland. We were one of only five organizations nationwide to receive the award in 2020 and one of only 29 healthcare recipients in any state in two decades of the award’s history. 

A few months prior to the announcement a team of highly-skilled and dedicated volunteer examiners reviewed all three of our work systems: Greater Baltimore Medical Center, Gilchrist, and GBMC Health Partners. During their virtual visit (due to the COVID-19 pandemic), these examiners validated the information we submitted in our application. Following the site visit, the examiner team scored our performance and submitted a report to the Board of Judges who ultimately determined that we had achieved the award. 

The purpose of the award is to get leaders of organizations to implement the Baldrige criteria to drive the creation of reliable systems and to work to continually improve those systems. The criteria stem from the work of people like W. Edwards Deming and Walter Shewhart dating back to the early and mid-twentieth century. Their work explains how almost all people are well trained, work hard, and are trying to do a good job. They were able to also realize that when things go wrong it is almost always because the system was not well-designed. GBMC’s achieving the award is recognition that we get it; that we cannot rely on hard work and good intentions alone, but that we must design reliable systems to get to excellent performance.  

We did not receive a perfect score when we achieved the award- no one ever does- and achieving the Baldrige was not the end of our improvement journey. We have continued to study the criteria, further deploy our standard work, and test changes to our system over the last year. Continually improving our implementation of the Baldrige criteria has helped us move faster toward our vision of being the community-based true system of care that can deliver to every patient, every time, the care we want for our own loved ones.

The ongoing use of our Leadership System helps us improve our performance every day. And we move even faster when we integrate our Leadership System with our Performance Review Process (our daily Lean Management System walk is an example of this) and our Performance Management System. 

So, let me once again thank all my colleagues in the GBMC HealthCare System for the achievement of this award and for your outstanding implementation of the criteria and continual improvement of our systems as we drive toward our vision!

Farewell Dr. Kuchar!
Earlier this week, I attended a farewell celebration for Dr. John J. Kuchar. After 32 years of patient care at GBMC and serving as GBMC's Chairman of Anesthesiology for the last five years, Dr. Kuchar is departing GBMC to pursue new opportunities. 

The department flourished under Dr. Kuchar’s dedicated leadership. Throughout his career, he has mentored countless anesthesiologists and contributed substantially to the professional development of many others.  

Please join me in thanking Dr. Kuchar for his many years of service and important contributions. He has truly left an indelible mark, and we wish him all the best in his next endeavors.

Friday, November 12, 2021

Top Docs Once More!

GBMC has always been recognized for the quality of our medical staff, which was again confirmed when 131 of our physicians, in 69 specialties, were named in the Baltimore magazine “Top Doctors 2021” issue. Several of those medical staff members were recognized in more than one category, and some have been recognized many years in a row! 

This year, the magazine featured Dr. Mei Tang, medical oncologist and hematologist with the Sandra & Malcolm Berman Cancer Institute. She was one of six physicians, from a pool of hundreds in the Baltimore area, selected to be profiled.

Being recognized as a “Top Doctor” is an extraordinary honor because it is a selection by peers. We are so fortunate to have outstanding surgeons, internists, pediatricians, family physicians, and other wonderful specialists. Congratulations to Dr. Tang as well as the others who were named 2021 Top Docs.

To view a listing of our “Top Doctors” and to learn more about who they are, please visit here

Since we are on the topic of Baltimore magazine, I wanted to point out that the publication is still collecting votes for its Excellence in Nursing issue. The deadline for nominations is Wednesday, Dec. 1st  and can be submitted by visiting here

GBMC Thanksgiving Day Turkeys and the Community
As part of our time-honored tradition, GBMC provides turkeys for our employees and volunteers across our healthcare system at Thanksgiving. 

This week, approximately 4,000 turkeys were given out to staff in appreciation for the hard work they do daily. Some of our people take their turkeys home to enjoy with their families, while others choose to donate their turkeys to local charities. I want to thank Richelle Tighe, Executive Assistant to Anna-Maria Palmer, our Vice President and Chief Human Resources Officer, and Chaplain Joe Hart and their teams along with our community partners who forge relationships of support during various occasions and holidays throughout the year. Thanksgiving is a season when we donate turkeys to St. Francis of Assisi Church, William S. Baer School, Assistance Center of Towson Churches and elders/seniors and their families at Stadium Place. These agencies have food assistance programs and our turkey donations assist in supporting families in need. I also want to thank Ericka V. Easley, MHA, Primary Care Service Line Administrator, and our staff at GBMC Health Partners Primary Care at Jonestown who will partner with the Mack Lewis Foundation this weekend to give out Thanksgiving baskets in Baltimore city. The foundation feeds about 350 families at this time of year and GBMC is donating 350 turkeys to go along with the holiday baskets.

In this season of gratitude, we are thankful for our staff and volunteers who support our community in so many ways.

Celebrating Nurse Practitioner Week
There are over 325,000 nurse practitioners nationwide who provide care to millions of Americans. We have excellent nurse practitioners working in our hospital, in our physician practices, and in Gilchrist. Please join me in celebrating them this week. They help us move toward our vision of a patient-centered system of care every day. 

Recognizing Colleagues: Radiologic Technology Week & Forensic Nurses Week
This week is also “Radiologic Technology Week” and “Forensic Nurses Week” and I would like to thank all our registered technologists (RTs) and our forensic nurses for their service to our patients. RTs perform diagnostic imaging examinations and administer radiation therapy treatments. They are educated in anatomy, patient positioning, examination techniques, equipment protocols, radiation safety, radiation protection, and basic patient care. They are the teammates of our radiologists and radiation oncologists.

Forensic nurses are specially trained and certified examiners who care for victims of sexual assault. They complete a full assessment of the patient, obtain potential forensic evidence, and provide therapy, emergency contraception, and resources for crisis counseling and support services in GBMC’s SAFE Program.

Please join me in thanking our colleagues for all their hard work and for their important roles in caring for our patients.

Thank You to our Veterans!
On Thursday, we commemorated Veterans Day and took the time to remember the millions of American military personnel who have served to protect us. I want to thank our Diversity & Inclusion Council for sponsoring our organization-wide Veterans’ observance. This was a great way to honor our employee and volunteer Veterans on our main campus, physician practices, and Gilchrist. I know that I speak for all of us at GBMC HealthCare in offering our sincere gratitude for the personal sacrifices, past and present, of all our service men and women.

Friday, November 5, 2021

What Do People Want at the End of Their Lives?

November is National Hospice and Palliative Care Month and I would like to recognize my Gilchrist teammates for all they do every day to assure that people are getting the care that they want at the end of their lives.  

Gilchrist is a wonderful eldercare company that includes the largest hospice in Maryland and is repeatedly recognized nationally for its work. Annually, Gilchrist provides in-home primary care to approximately 900 individuals, hospice care to 6,736 people, and grief counseling and bereavement services to thousands of family members. The organization also counsels individuals on care planning, guiding them through decisions about their treatment and helping them make informed choices for their advanced chronic disease.

Our first aim is the best possible health outcome. But we recognize that restoring patients to health is not always possible. In end of life care, we must do our best to minimize pain and suffering and make sure that we focus on what the patient truly wants. 

Surveys of the American people show that most of us would prefer to die at home surrounded by our loved ones in as little pain as possible. Unfortunately, today the majority of Americans are dying in the hospital - clearly not what they want. We must ensure that every person is asked what they want in end-of-life care. The conversation needs to happen when the person is still up to the conversation and not in the last hours before death. 

As we celebrate National Hospice and Palliative Care Month, I've asked Cathy Hamel, President of Gilchrist and our system’s Vice President of Continuing Care, to talk about palliative care consults and the vital role they play in delivering the care that the person wants. 

Cathy says:
In recognition of National Hospice & Palliative Care Month, I’d like to highlight the critical work of our Integrative & Palliative Medicine teams. 

As medical professionals, we are often focused on treatments and cures above all else. But in some cases, that’s not what patients want. As a person’s disease progresses, sometimes more treatment leads to diminishing returns. Particularly for frail and elderly patients with serious illness, interventions such as surgery, hospitalization, chemotherapy, or radiation may not be effective and may even be harmful. 

For some, the burdens of treatment outweigh the benefits. If informed of their options, a person who is unlikely to get better may wish to spend more time at home with family and friends rather than in the hospital or pursuing long-shot treatments.

People with serious and terminal illnesses may experience untreated pain and other symptoms, and lengthy hospitalizations involving costly and often futile treatment. And sadly, while more than 80% of Americans would prefer to die at home, only 20% actually do, while 60% die in the hospital.

Palliative care is a solution. Palliative care allows patients to choose the kind of care they want rather than having others choose for them. It is centered on meeting the needs and preferences of each patient. Gilchrist’s palliative teams are experts at having frank conversations with patients about their treatment options and goals of care. They help patients understand the likely progression of their illness and what to expect. As a result, patients can receive the kind of treatment they want and avoid the treatments they don’t want. 

Once a care plan is established, Gilchrist’s interdisciplinary team consisting of palliative nurse practitioners, physicians, a social worker, mind-body specialist, acupuncturist, and music therapists helps ease symptoms such as pain, anxiety, nausea, and stress, while focusing on quality of life.

As a health system, GBMC is doing a far better job of integrating palliative care than most. In our hospital, 19.6% of medical/surgical admissions are referred to Integrative and Palliative Medicine, compared to the national average for similar size hospitals of 6.9%. Our Gilchrist palliative teams consult on about 145 new patients a month throughout all departments in the hospital. Last year, the team consulted on a total of 4,509 patients. 

In addition to leading to a higher quality of life, palliative care saves money. Palliative consults for GBMC patients resulted in a reduction of nearly $23,000 in charges per patient per month, one-month post-consult.

The reason we have been so successful is because we work hard to educate everyone about the importance of palliative care, from staff to patients and families. Studies show that once people are informed about palliative care, 92% report they would be highly likely to consider palliative care for themselves or their families.

Palliative care is not about giving up. It’s about shifting the focus of care to what is most important to the patient. Good medicine is about treating the whole person—not just the disease. Asking about and documenting a patient’s wishes is the key. 


Our community is so fortunate to be served by Gilchrist. I want to express my deepest gratitude to Cathy and Dr. Tony Riley, Chief Medical Officer of Gilchrist, and their entire team for their devotion to making the end-of-life journey a peaceful and positive one for so many families throughout the years.  You can also read more about the fantastic work of Gilchrist in The Gilchrist Blog.

National Medical Staff Services Professionals Awareness Week
This week is National Medical Staff Services Awareness Week, and I would like to recognize the important role that our medical services professionals play in our healthcare system. Often called the “gatekeepers of patient safety,” medical staff professionals are critical to our system’s high safety and quality standards. They work behind the scenes to ensure our providers are properly credentialed, licensed, and trained in their respective specialties. Please join me in thanking them this week.

Friday, October 29, 2021

Testing a New Tool for Keeping Staff and Patients Safe in the Pediatric Emergency Department

This week I would like to highlight some outstanding work being done in our pediatric Emergency Department led by Mark Fisher, MSN, RN, CEN, TCRN, Senior Nurse Manager of Emergency and Pediatric Services.  

Our Pediatric ED team is actively redesigning care to improve the experience of behavioral health patients and their families. 

Because of an increase in violence in Emergency Departments, particularly against nurses and nursing assistants, de-escalation techniques are being used to manage aggressive and agitated patients.  Triage nurses, who are charged with assessing the patient, use screening tools to identify the patient who may become aggressive.  One of these tools is STAMP (Staring, Tone and volume of voice, Anxiety, Mumbling, and Pacing). Knowing when a patient is likely to become violent is imperative to enacting de-escalation strategies. 

Using the tools of our Lean Management System (LMS), the Peds ED is testing the implementation of STAMP as one of their areas of focus (Include pic of chart). Mark recently responded to some questions to give us a better idea of their work and what they are learning.  

Q:  How did you hear about STAMP and how long have you been using it in the peds ED?
A:  We performed a literature review on the best predictive tools for pediatric violence in behavioral health. In addition, we reviewed Joint Commission materials for best practices and they showed STAMP as a validated tool. We are using the Model for Improvement to test its value.

Q: What are some of the lessons you have already learned since its implementation?
A:  The tool allows for easier end-user interpretation of current behaviors of the pediatric patient.  

Q: As part of LMS what are you measuring when it comes to STAMP?
A: Our goal is to predict potential violence to better place our patients within our care settings for safety.

Q:  As part of your improvement work, are you comparing STAMP to what you had been using previously?
A:  Our current standard work includes using the Broset violence score, which is intended for use in adult patients. We identified this gap in practice using LMS and therefore we are on this journey of improvement. 

I want to thank Mark and his team for their hard work and their test of change. We look forward to the results after they have been analyzed.  

Let’s thank… 
This week is Pastoral/Spiritual Care Week.  Please join me in thanking Chaplain J. Joseph Hart and all the members of our Spiritual Support team for their hard work and dedication to meeting the spiritual needs of our patients. No matter the faith, our Spiritual Support team is always there to provide compassion and comfort to patients and their families as they face a serious illness or life-threatening injury. To learn more about our Spiritual Support Services, please visit their web page.

Friday, October 22, 2021

Greater Baltimore Health Alliance Leads the Pack in the Maryland Primary Care Program

This week I would like to highlight the fantastic work being done by our Patient Centered Medical Homes led by Dr. Gregory Small, Medical Director of GBMC Health Partners Primary Care.

The Maryland Primary Care Program (MDPCP) was created by the Centers for Medicare and Medicaid Innovation and the State of Maryland to improve health outcomes and the care experience while reducing costs for Medicare beneficiaries. MDPCP provides funds to practices which, for example, hire care managers to work with providers to improve health outcomes. Since 2019, the program has helped create more advanced primary care practices that are better equipped to keep patients with chronic diseases, such as diabetes, out of the hospital and as healthy as possible.

The run chart demonstrating the performance on diabetic outpatient management (Hemoglobin A1C rate out of range), an internal measurement across all practices for diabetes control, demonstrates that we are doing very well against national comparisons. Also, six out of the 10 GBMC primary care practices that participated in the MDPCP in 2020 were at or above the 75th percentile for diabetes control compared to all the other practices in MDPCP – now numbering approximately 400.

Dr. Small attributes this success to the development of a dedicated diabetes care pathway. Spearheaded by a diabetes committee in which he chairs, the pathway outlines how to approach a poorly controlled diabetes patient and deploy a care team, specifically our RN care managers. Our care managers are important partners on the team with physicians, advanced practitioners, and medical technicians, working with patients to ensure the necessary care and  that they are following evidence-based protocols to maximize their health.

The team also leverages technology to increase patient engagement. Tools including electronic  flowsheets that are visible to patients and the care team allow for more effective communication beyond what happens during office visits. 

Blog readers know that advanced primary care is a fundamental building block of the GBMC HealthCare System. The PCMH is critical to preventing disease and coordinating care for people who already have chronic disease. Let me thank Dr. Small and all of our primary care teams!

International Infection Prevention Week

This week is International Infection Prevention Week (Oct. 17-23). This is  a time to highlight the importance of infection prevention and raise awareness of everyone’s role in protecting the public from healthcare-acquired infections. Infection prevention initiatives include hand washing, employee education related to safety and infection control, sharing best practices, and tracking improvements in performance.
GBMC is fortunate to have an incredible Infection Prevention Department and they have been tremendously important during the pandemic.

I want to thank our Infection Prevention team members for all they do every day!

GBMC Team…Please get your flu shot!

Studies have shown that as many as 1 in 2 infected people never show classic flu symptoms but can shed virus for 5-10 days. This means that asymptomatic personnel can unknowingly spread influenza to a patient, co-worker, and personal contacts. If an employee contracts influenza they put patients, fellow staff, and their own family at serious risk.  For this reason, the annual flu vaccine has become a standard of care for healthcare providers. 

GBMC employees and volunteers are required to be immunized (those few who are not required to be immunized are required to wear masks during the flu season) to protect ourselves and our patients.  Getting your flu shot is even more important as the challenges of the COVID-19 pandemic remain.

The deadline for influenza vaccination for all employees, contractors, volunteers, and students is Friday, Oct. 29.   We have two vaccination events coming up:

  • Sunday, October 24: 2:00 p.m. - 10:00 p.m., EHS Clinic, Room 4904
  • Friday, October 29: 7:00 a.m. – 3:00 p.m., Civiletti Conference Center

A valid GBMC ID badge must be presented at all flu vaccination events.

October is National Cyber Security Awareness month 

Our ITS team continues to do an outstanding job in defending our networks while preserving the efficient delivery of healthcare services.

We learned a lot from last year’s cyber-attack and we will continue to become stronger because of it. Please remain vigilant and do not click on links unless you are sure they are safe. Please remember to always bring a questioning attitude to your use of e-mail, the electronic record, and other applications. Do not click links unless you are sure they are  safe, do not go to websites you aren’t familiar with, and ask IT for guidance if something doesn’t quite “seem right.” The cyber-attack we experienced started with a phishing email, so it is critical to report any suspicious emails to IT. Together, using simple internet safety precautions, we can help keep GBMC safer from cybercrime.

I want to thank Dave Hynson, GBMC’s Chief Information Officer, and his team for all their hard work in addressing the issues and keeping our systems safe.

Monday, October 18, 2021

GBMC Meets Our Mission with Outstanding Support from the Community

Last Wednesday, patients at the Sandra and Malcolm Berman Cancer Institute at Crossroads were given cupcakes by the owners of Saffer Plumbing, Heating, and Electric.  This special treat was to commemorate Breast Cancer Awareness Month and was well received by our patients and staff.  And, the company’s generosity doesn’t end there!

Saffer Plumbing, Heating, and Electric, with the help of their specially decorated pink truck, is donating a portion of their business revenue to our Oncology Support Services to help our cancer patients meet travel-associated expenditures. Unfortunately, many of GBMC’s cancer patients need a ride to receive their scheduled treatments but lack consistent means of transportation. National statistics show that more than 60 percent of cancer patients missed or were late to an appointment because of transportation issues.

Under this new partnership, Saffer will donate about $5,000 a year to GBMC. The Saffer family chose GBMC because of close connections that include the hospital being the place where their children were born, and they have a family member who was a longtime physician at GBMC.

Brandon Costantino, manager of our Oncology Support Program at GBMC’s Sandra and Malcolm Berman Cancer Institute, recently answered some questions regarding this wonderful collaboration and its importance to our cancer patients.

Q: Can you give some details about our Oncology support program and how it helps our patients?
A:  Our Oncology Support Services department provides a wide variety of assistance including helping our patients get to and from their treatments. We also offer free counseling, education, and connections to organizations that can help patients and families shoulder the burden of treatment. Our goal is to reduce barriers to care. We want patients to be able to get their treatments on time, as scheduled, to achieve the best health outcomes possible. 

Q: What is the average cost for our patients who turn to public transportation or rideshare companies to get to their appointments?  How will this partnership help our cancer patients meet some of their transportation costs for coming to and from scheduled treatments?
A:  Some of our patients turn to public transportation or rideshare companies to get to and from their treatments.  The average cost per ride is $23.02, meaning that patients can spend an average of about $46.00 per visit. The average GBMC cancer patient requires at least 14 rides monthly. Most of us have had a family member, friend, or someone close battling cancer. Treatment is never easy, and at times the financial toll is overwhelming. 

The funds donated by Saffer Plumbing go into a restricted fund and can only be used for transportation. We then use those funds to provide rides to breast cancer patients who need transportation.  This donation will help provide over 200 rides to breast cancer patients. Again, we want to do everything we can to help meet basic financial needs, decrease stress levels, and allow patients with cancer to focus on healing. A donation like this makes a huge difference in our patients’ lives. 

Q: Whose idea was the pink truck?
A:  The pink truck belongs to one of the company’s plumbers whose grandmother is a breast cancer survivor.  When asked to participate in this endeavor he was honored.  One of his recent customers, when informed that part of the proceeds from that day’s work would go to helping breast cancer patients, was really touched.  It meant a lot to her being a cancer survivor herself.  This truly shows the value of this initiative.

Thank you, Brandon, for the valuable information and my gratitude to Saffer Plumbing, Heating, and Electric for doing what they can to help our patients get to their cancer treatments. 

Another Group Helps Our Cancer Patients
Recently, members of the Alpha Kappa Alpha Sorority, Inc. - Upsilon Epsilon Omega Chapter, donated chemo care packages to our patients. The care packages included a journal, lotion, Queasy Pops, hand sanitizer, socks, snacks, and more! 

People living with cancer benefit from the power of human connections. These carefully selected products are geared to help ease the short-term side effects of treatment and brighten a cancer patient’s day.

I would like to thank Dawn C. Stefanik, AA, MLT, BSN, RN, OCN, Nurse Manager- Infusion & Infusion Pharmacy at our Sandra & Malcolm Berman Cancer Institute, for helping to coordinate this work.

Again, we are so grateful for the generosity of the community and truly appreciate their help in brightening the day for our cancer patients. 

Thank You!
There is no question that Emergency Department nurses have some of the hardest jobs and make an immense difference when every second counts. They have the expertise in caring for all emergencies, across all stages of life, and they work very hard. 

Last week we celebrated Emergency Nurses Week. I want to thank our ER nurses for making a difference in the lives of people every day, every shift. Now more than ever, it’s important to recognize and appreciate their commitment in caring for our patients.

Friday, October 8, 2021

Celebrating Gilchrist’s New Home in the City

Last week I had the pleasure of attending the ribbon cutting ceremony at the Gilchrist Center Baltimore’s new Inpatient Hospice facility at Stadium Place. 

By the end of October, we will start to provide respectful end-of-life care to many in need in the city of Baltimore. The new center will continue to be the only residential hospice in Baltimore and the only pediatric inpatient hospice unit in the state. 

The 30,000 square-foot William L. and Victorine Q. Adams Gilchrist Center Baltimore will contain 18 private adult rooms and four pediatric rooms for inpatient residential hospice and respite care. The center has been designed with the warmth and comfort of Gilchrist’s other inpatient centers in Towson and Howard County, with home-like areas for families who are visiting. Each patient will have access to the full spectrum of hospice care, including medical, emotional, spiritual, and personal care, with a focus on quality of life. Music therapy, veteran salutes, counseling, and bereavement services will also be available free of charge. 

My deepest gratitude to Cathy Hamel, President of Gilchrist and Vice President of Continuing Care at GBMC HealthCare, and Dr. Tony Riley, Chief Medical Officer of Gilchrist, and their entire team for their devotion to their patients and families. I congratulate them once again for this milestone occasion.  

Thank You!
Earlier this week, we had an unfortunate incident on our medical campus.  Thankfully no one was physically injured or harmed. The safety of our staff, patients, and entire GBMC family is of the utmost importance. I want to thank our security team and incident command center for their quick response and action to protect our staff, volunteers, patients, and visitors. 

Last Thursday, we held our annual employee and volunteer barbeque. Normally, we hold this event during the summer, but we thought that having it in September would be a welcomed change, especially given the pandemic. The great weather and the spectacular karaoke performers and bean toss participants helped make it a really a fun time!

I would like to acknowledge our Human Resources Team, led by Anna-Maria Palmer,  Vice President of Human Resources and Chief Human Resources Officer, and her executive assistant, Richelle Tighe, as well as the Marketing and Communications Team and our Philanthropy Team, led by Jenny Coldiron, for putting on a fabulous day-long barbecue! I also want to give a special shout out to Cristie Nickel, Community Relations and Events Specialist, and Kim Davenport,  Director of Communications and Event Management Strategy, for their hard work on this year’s events.

October is American Pharmacists Month
At GBMC, we have always had outstanding pharmacists and technicians who really care and work hard. Over the years, our pharmacy team, led by  director, Yuliya Klopouh, has done an outstanding job at making our medication delivery highly reliable. They were phenomenal after the cyber-attack. They really showed their expertise at redesign. Please join me in thanking them for all that they do to drive us closer to our vision. 

Happy Anniversary, Times Two!
Last Friday (October 1st), we hit two major milestones. It was GBMC’s 56th anniversary and it was also the five-year anniversary of going live with Epic – our electronic medical record (EMR) across the GBMC HealthCare System. I can’t believe how time has flown.  It is clear that “one patient, one record” has been a major benefit for our patients and for the GBMC HealthCare System.

Thursday, September 30, 2021

Remembering and Honoring A Legendary Physician

"If you’re going to live, leave a legacy. Make a mark on the world that can’t be erased.” - Maya Angelou, author

Last week the GBMC family lost a legend and a GBMC Physician Titan.  Dr. Rudiger “Rudy” Breitenecker was a true icon and a pioneer for his work in forensic pathology. 

Before becoming a member of GBMC's Department of Pathology in 1967, Dr. Breitenecker was a state medical examiner. A realization that rape victims were not always achieving justice prompted him to found GBMC's Rape Care Center – the precursor to our current Sexual Assault Forensic Examination (SAFE) Program. Here Dr. Breitenecker applied the knowledge he gained while collecting evidence for city homicides to the collection of evidence in rape cases.

Dr. Breitenecker was trained as a forensic pathologist and he froze samples of fluid from each case, preserving the evidence for the future. His decision to save samples, plus Maryland's no statute of limitations on rape, helped many women get closure on their cases even years later. 

A pioneer in sexual assault forensics, Dr. Breitenecker participated in more than 2,000 rape cases and was often the only physician to testify in court. Although he retired in 2008, he remained active in the field and consulting as an expert witness.

His work helped the Baltimore County Police Department become one of the first departments to access clinical evidence from a hospital in cases of rape. Department Sergeant Rose Brady, said, "Dr. B. absolutely deserves all the honors that are given him."

I am honored to have known Dr. Breitenecker and I am thankful for his innovative work.  Please join me in remembering Rudy’s life and legacy. And please share your memories of him here.


Please join me in congratulating Joel Turner MD, FACS, as the new Chairman of the GBMC Department of Surgery and head of the Surgery Service Line.  

Joel came to GBMC after he finished training in General Surgery and he has been a member of Finney Trimble Surgical Associates since that time.  Dr. Turner previously served as Vice Chair of the Department of Surgery and Chair of the Surgical Value Analysis Committee.

I am grateful for Joel’s stepping up as Chair and I look forward to his leadership of our surgery program. 

Congratulations also to Rebecca “Becky” Stover, RN, on her promotion to Director, Project Management for the hospital work system.

In this new position, Becky will support hospital-wide projects including the Promise Project.

Since starting at GBMC in 2009, she has managed Safety Officer training and our annual Art of Nursing event. Becky has done an exceptional job in managing these and other projects and we look forward to her leadership in helping us complete the many initiatives underway and those coming in the future.

Friday, September 24, 2021

The Hospital: A Very Expensive Pathway of Least Resistance for Broken Systems

Recently, we discharged an, intellectually disabled patient after a stay of 257 days in the hospital. 

The patient, who was over 50, originally presented to the Emergency Department with her group home caregiver. In the several months prior she had been in and out of the hospital and psychiatric facilities with behavior related issues such as throwing herself on the floor. The reason for her admission to the hospital was that she was acutely unable to walk. She was sent to our Integrative Care Unit with a diagnosis of an infection. 

Her infection was treated, and she returned to her previous state of health after a few days of care- the work of our Integrative Care Unit was done. 

And then the waste began since she no longer needed to be in the expensive setting of the acute care hospital. GBMC has no inpatient psychiatric unit to provide treatment to a patient like this. For the next step in discharge, the question then became whether she would go to subacute rehab, long term care, or back to her group home. She is financially supported by the State, through the Maryland Developmental Disabilities Administration, since she is not capable of supporting herself.  

During her hospitalization the patient would frequently act out, screaming, cursing, and exhibiting other attention seeking behaviors. Due to her high acuity behavioral needs, she was initially recommended to go to a neuropsychiatric disorder unit, but a bed was not available. Then the care team learned that she had exhausted her lifetime Medicare days but that her Medicaid benefit had not yet kicked in. By the time she became Medicaid eligible roughly two months later, the team learned that she could not go to the neuropsychiatric unit and she would have to be admitted to a state operated facility. 

We know that the longer someone remains in the acute care hospital, the more at risk they are for hospital acquired conditions. This patient developed a hospital acquired condition and was transferred to another unit where she stayed for 36 days. She was then transferred back to the Integrative Care Unit.

During this time, planning for her discharge continued. Her family was hoping for a group home placement closer to where they lived. Over the next few months, the patient was declined by several facilities as they were not able to accommodate her needs. 

During her sixth month of hospitalization a facility reviewed her case and subsequently approved her for admission. However, the facility had not yet been approved by the Developmental Disabilities Administration, so the team continued to wait. It was only recently that the team learned that the facility had been approved and they were finally able to plan for her discharge. 

The Integrative Care Unit Team was incredibly resilient in caring for her. They took turns reading books to her. The patient loved our volunteer guitarist Chris Maggitti and would sing along when he played for her. Nurse Manager Carolyn Keller took her to our beauty salon in the West Pavilion twice for a haircut during her stay, which was challenging due to her behavior. Lisa Palmer, our hairstylist, was patient and compassionate. Dr. Rebecca Moore from psychiatry managed the patient’s medications which at times needed to be adjusted daily to control her behavior. Dr. Moore had a wonderful relationship with this patient. Dr. Rachna Raisinghani, the unit’s Medical Director, spent much time assisting to find a placement for the patient.  Sarah Sackett from social work worked tirelessly, day in and day out to advocate for her and to coordinate the safest and most appropriate placement. Our Hospitalist Team also deserves recognition for being there to support the patient through her entire stay and for attending to any issues that arose. The entire Integrative Care Team went above and beyond to provide kind and compassionate care to a patient who was incredibly trying to care for, as GBMC does not have the resources to provide inpatient psychiatric treatment or residential psychiatric care. 

The case underlines the need for redesign of the behavioral health system and for the simplification of our health insurance system. The acute care hospital is often used as the pathway of least resistance to care for behavioral patients and the public should demand that leaders step up to find a better way. 

Please join me in thanking everyone that cared for this patient. They were determined to make things as good as they could even though the patient was not in the right setting. We are indebted to all of them. 

Friday, September 17, 2021

Back to Life

On Tuesday afternoon, I had the privilege of being part of a special event with a grateful family whoselife-altering experiences played out right here at GBMC.   

Back in early July, Kathy Patten was slated to play golf with family and friends when she got the call that her daughter, Stacey Fifer, was going into labor at our hospital. Due to the easing of COVID regulations for a patient’s family and friends at that time, Kathy decided to join Stacey and her son-in-law, Richard Fifer, in our pre-birthing room.

After arriving to attend the birth of her grandchild at GBMC, Kathy started to not feel well. Stacey became worried about her mother, and she called her nurse Kiana Dowdy, RN, to have her mom checked out. Kiana evaluated Kathy, put her on a cardiac monitor, and called for the Rapid Response Team. The team decided to take Kathy to the Emergency Department for further evaluation.  As they were leaving Labor and Delivery, Kathy went into cardiac arrest. They began CPR and called for the Code Team.  Drs. David Vitberg and Ari Zaiman ran to Labor and Delivery with the rest of the Code Team. They were joined by Dr. Dov Frankel from the Emergency Department and they managed the Code. The Labor and Delivery charge nurse Michelle Lukehart, RN, along with Rebecca Rubin, NP, took on critical roles during the code and also in assuring that all of the patients in the Unit got excellent care. Melanie Dowell, the Parent Education and Doula Program Manager, stayed with Stacey to assure that she was OK. Meghan Shackelford, NP, the Director of Advanced Practitioners, assisted the code team in L&D and also followed the team to assist in ongoing stabilization in the ED. After 48 minutes of cardiopulmonary resuscitation (CPR), and just before the Team was going to end the Code, Kathy’s heart began to beat again, and she awoke. After further outstanding stabilization, by Dr Frankel and our ED team, Kathy was then transferred to the University of Maryland St Joseph Medical Center and there she received wonderful cardiac interventional care and was set on a pathway for cardiac rehabilitation. 

Despite her intense worry about her mother’s condition, Stacey’s baby was on its way into the world, and she continued with the delivery. Hoping to have a natural childbirth, the baby became stuck in the birth canal requiring an unexpected caesarian delivery and a neonatal resuscitation. After a relatively brief stay in GBMC’s Neonatal Intensive Care Unit (NICU), Alora is a happy, healthy baby girl. 

Kathy, who essentially came back to life following this astounding near-death experience, is now fully functioning and enjoying her life as a mom, grandmother and grateful former GBMC patient.  

At this week’s event, Kathy, Stacey, and other Patten and Fifer family members expressed their gratitude to the GBMC team that brought Kathy back to life and who served Stacey and Alora so well. Drs. Vitberg and Frankel reflected on the outstanding work of all involved, starting with our Labor and Delivery staff and including all those who assisted. Dr. Vitberg commented that our staff has been under so much stress since the beginning of the pandemic and following the cyber-attack and that this life-saving event was so helpful to replenish the energy and spirit of all the GBMC staff involved. 

This story further highlighted to me that the hard work of clinicians who care and are experts in their field is necessary for outstanding performance. Well-designed systems are also necessary, as is training as a team for infrequent and life-threatening situations like the one the team encountered with Kathy that day in July in Labor and Delivery. Dr. Vitberg and his team train regularly in our simulation center and GBMC recently earned the official designation as a Resuscitation Quality Improvement (RQI) Lighthouse Organization for our adoption and consistent use of an innovative CPR training program. GBMC is the first hospital in Maryland to receive this designation and to use the RQI system to train nurses and other clinical providers in CPR. This recurrent training and testing of CPR competency played a role in keeping Kathy’s brain oxygenated when her heart was not pumping for 48 minutes!

I am in awe of the entire team that was involved in saving Kathy and in serving Stacey and Alora as well. Great work and Thank You!

Thank-You EVS Team
This week, we are celebrating Environmental Services (EVS) and Housekeeping Week. After more than a year on the front lines of the COVID-19 pandemic, EVS and housekeeping professionals have served as a source of reassurance for patients unable to see loved ones, while maintaining rooms to the highest standards of cleanliness.  Our dedicated EVS and Housekeeping staff work day and night to keep our facilities clean and to prevent infections. They replace linens, remove regular and medical waste, and take care of unscheduled or emergency housekeeping services such as spills or event set-up. Please join me in thanking all our colleagues in EVS for their great work especially during these challenging times!

Neonatal Nurses Day
Last Wednesday (9/15) was Neonatal Nurses Day. We are very fortunate to have such a high-level NICU to care for those babies who are born too small, too sick or too soon. Please join me in thanking this exemplary group of nurses for all they do.

Yom Kippur
Yom Kippur, also known as the Day of Atonement, was this week and is the holiest day of the year for those of the Jewish faith. Yom Kippur has a unique place in the Jewish calendar. Following Rosh Hashanah – the Jewish New Year – Yom Kippur marks the end of the 10 days of repentance, which is a time to reflect on wrongdoings and pledge to do better as the New Year begins.

Friday, September 10, 2021

What about the Flu?

The 2021 influenza (flu) season is right around the corner. To predict how much influenza, we will see in the northern hemisphere, we look to the experience in the southern hemisphere. The good news is rates of the flu have been very low in the southern hemisphere just like last year. The biggest single reason for this is drop in cases is people are travelling less. They have also been wearing masks and practicing social distancing. So, there is a good chance that we will again see fewer than the average number of cases than we usually see in a year. 

However, experts worry that our antibody levels against influenza A in particular, may be low since we have not had much exposure to the virus over the past year or two. They are concerned, therefore, that we may have rapid spread of the flu virus once it becomes more widespread in the community. 

We can’t really know for sure what the flu season will be like, but we do know what we can do to limit the spread of the virus and keep ourselves healthy. Step 1 is to get vaccinated as soon as the influenza vaccine becomes available. Then, it will help to wear a mask, wash our hands often, and maintain social distancing if we do have outbreaks. Sound familiar?

Soon we will be announcing our 2021 employee influenza vaccination plan. I want to thank Sophia Powell, MSN, FNP-C, Occupational Health Director for the GBMC HealthCare system, for her hard work on the plan.  Next month we will be offering our employees their flu shots at several clinics to be held in our Civiletti Conference Center. Stay tuned for the specific clinic dates and times in the coming weeks.  

Happy New Year

Earlier this week was the beginning of Rosh Hashanah, the Jewish New Year. It is a holiday at the “head of the year” that comes at the close of the harvest, when the Jewish community of faith focuses on repentance.  L’Shana Tovah! Happy New Year 5782!

Remembering 9-11

As a nation, this coming Saturday we will recognize the 20th anniversary of the tragic events of September 11, 2001.  Like all Americans I was stunned by the events of that day and the great loss of life. I was somewhat buoyed by the phenomenal stories of those who gave of themselves for others in the days and months after 9/11.

As we look back at the terrible tragedy that occurred and the brave first responders who showed tremendous heroism in the hours and days thereafter, let us join together and work for peace and justice in the hope that events like these never happen again. Thank you! 

Thursday, September 2, 2021

A Big Day

Today is a day of celebration for GBMC and our community. After years of planning and changes to our master facility plan, with the realization that some of our inpatient beds were no longer meeting our needs, we finally broke ground on The Promise Project. You can watch the video from the ceremony here.

This construction project is necessary to move us towards our vision of being the community- based system of care that can deliver to every patient, every time, the care we would want for our own loved ones. The project exemplifies our commitment to the people we serve. 

The Promise Project will bring two historic advancements to GBMC—the replacement addition for inpatient beds, a new parking structure and the new home of the Sandra and Malcolm Berman Cancer Institute at GBMC.  These facilities will help GBMC continue to lead the way into the future of patient care in the Greater Baltimore community.

When GBMC opened in 1965, our medical center was marveled at by the community – private patient rooms were unheard of at the time.  Yet, 55 years later, these same patient rooms have lost their wow-factor. Out of a growing need for more spacious rooms on our medicine units that can accommodate team-based care, advanced technology, and visits from loved ones, we began planning for a hospital addition, and the Promise Project  began. 

Throughout the past decades, we have built a true system of care form birth to death, and our healthcare system is thriving. But now is the time for our campus facilities to be modernized. Because of the support of our community and elected officials, we can continue to improve our hospital and increase the services we offer. Now is truly the time for The Promise Project.

The road to today’s celebration, however, has been filled with a few challenges.  Much work and planning had to take place before the shovels hit the dirt.  First, a certificate of need application was created and approved, funding had to be secured, plans had to be developed, and numerous permits had to be filed. Of course, our team had to do this during the pandemic.

There are many people that have made today’s historic event possible.  I want to thank our chair, Frederick M. Hudson, and the Board of Directors who represent all the owners of GBMC, the diverse community cared for by our System.  I would also like to extend my gratitude to Dr. John Saunders, and all of those who have worked on fundraising, as well as longtime supporters Sandra and Malcolm Berman and the Volunteer Auxiliary for their leadership throughout this transformational campaign.  Let me also thank Stacey McGreevy, Vice President of Support Services, and Russ Sadler, Director of Facility Planning, Design, and Construction, for their oversight of the planning and actual construction, and Laurie Beyer and our finance team for their work in accessing the needed capital. I’d also like to congratulate our Vice President of Philanthropy and Marketing, Jenny Coldiron and her entire team for the overwhelming accomplishment of raising over 38 million dollars – 76 percent of our fundraising goal for the project. These funds are crucial in bringing the Promise Project to fruition.

Extending Gratitude Beyond Our Small Piece of the World
While GBMC is celebrating its past, present, and future, we cannot forget the servicemen and women who have made the ultimate sacrifice for our Country and our freedom. Our prayers go out to the families and loved ones of our fallen service members in Afghanistan. Our thoughts and prayers also go out to those who are struggling in the aftermath of Hurricane Ida. In times like these, we are all thankful for the support that surrounds us every day.

Friday, August 27, 2021

One Less Factor in Vaccine Hesitancy

Earlier this week, I was delighted to hear the Food and Drug Administration (FDA) granted full approval to Pfizer's COVID-19 vaccine for use in people ages 16 and older. 

It is clear the Pfizer vaccine—along with the Moderna vaccine—is safe, highly effective, and the strongest weapon we have to combat this virus. The FDA had already studied the early data before giving emergency use authorization, and has now gone through its full, rigorous process to grant full approval. The Pfizer vaccine is probably the best studied vaccine in the history of FDA approvals in that hundreds of millions of doses have been given around the world with very few significant side effects. 

This latest surge in COVID-19 patients we are experiencing in emergency rooms, outpatient clinics and hospitals across the nation is primarily due to unvaccinated people. This is very concerning since we are still not sure what the fall will bring with back-to-school activities and the potential spread of COVID-19 among our children. In a recent poll, 30 percent of unvaccinated people said they were holding off on getting the vaccine until the FDA had granted full approval, so we are hopeful this FDA approval will encourage those on the fence to get vaccinated to protect themselves and others.

With the Delta variant surging, there has never been a better time to get vaccinated. GBMC is requiring all GBMC HealthCare employees, contractors, independent medical staff members, volunteers, and learners without a medical or religious exemption to be vaccinated, and we have had to speed up this deadline after the Governor’s mandate that all hospital and nursing home employees be vaccinated by September 1. The GBMC HealthCare community is required to be fully vaccinated, or submit an exemption request, by October 1, 2021.

I want to congratulate our Primary Stroke Center which, under the leadership of Ellen Deibert MD, FAHA, Medical Director of our Stroke Center and our Chief of the Division of Neurology, and Aaliyah Franks, RN, recently achieved the 2021 American Heart Association’s (AHA) Get With The Guidelines® (GWTG)-Stroke: Gold Plus with Target: Stroke Elite Honor Roll and Target: Type 2 Diabetes Honor Roll. 

These awards recognize hospitals that meet specific quality measures for the diagnosis and treatment of stroke patients. Despite challenges in the last 18 months presented by the pandemic and a cyberattack, the Primary Stroke Center has been able to maintain extraordinary award levels with the American Heart Association for stroke and diabetic stroke patients.

The awards are a testament to our Stroke Center’s strong commitment to reliably provide care according to nationally recognized guidelines built on the latest scientific evidence.

I want to thank all our clinicians for their hard work and dedication in achieving this level of performance. Great work and congratulations!

Friday, August 20, 2021

More Changes on Our Campus

This week I want to provide you with another update about campus changes as we begin construction on The Promise Project

In June, we began with the creation of a temporary main entrance (until the new addition is complete) and we then continued with the closing of the Rose parking lot to address the need for a staging area for construction. 

On Monday, August 23, the main entrance of our hospital will close, and we will begin using the temporary main entrance in the Sherwood loop.  Since the three-story addition will be built in front of our current main entrance, we need to close it now. As we cordon off space in front of the main entrance, we will lose some handicapped parking spots. We have taken a number of steps to limit inconvenience to our staff and patients.

We have added another valet parking location (we added a valet attendant by the Daffodil garage last month) at the Sherwood loop. We have also added additional handicap spaces in the Sherwood Loop area and in our Lily Parking Garage. There are also additional wheelchairs and dedicated transporters to serve our patients and visitors with mobility issues. We recommend that our patients utilize the Tulip and Lily garages since they have abundant parking spaces. As I have pointed out in the past, the Lily Garage is closer to the main entrance than the Rose lot and is connected to the hospital to protect employees, patients, and visitors from the elements.
We have set aside many parking spots for our patients. Most of our staff have refrained from parking in those spots and historically we have not enforced our no-staff parking rule in patient spots. Sadly, some of our people have been parking in patient-only spots so now we have begun to enforce the rule.
In order to make it easier for folks to get around the campus, we added a new shuttle bus this past Monday. Current drop-off and pick-up locations include: the William E. Kahlert Physicians Pavilion North, Farmhouse Hill, Physicians Pavilion West Main Entrance, and the Sherwood loop.  Stops are every 15 minutes from 6:30 a.m. to 7:00 p.m. on weekdays.

The first two levels at our Daffodil Garage will remain closed until October 31. The garage is open for our patients, but we are asking staff to park in the Tulip garage. Thank you to all for your patience as we continue the repairs. 

Lastly, our new Ambulatory Imaging Center will open in mid-September in Physicians Pavilion East at the former location of the Kroh Center for Digestive Disorders.

The official groundbreaking for the Promise Project will occur on Thursday, Sept. 2. We will continue to update you on necessary changes to the campus as the construction progresses. 

Thank you!

Thursday, August 5, 2021

Outstanding Redesign Work in the Emergency Department

In the early 20th century, as medical care was progressing, and therapies became available that actually improved patient outcomes (like antibiotics and sophisticated surgical procedures), the Emergency Room became the place to go for serious injuries or acute medical problems. Later in the century, as medical care became more complex, and there was more specialization in medicine, the Emergency Department (ED) became a sort of “catch all” for anything that couldn’t be handled anywhere else in the system. If the doctor’s office was closed or the doctor was already too busy, patients were sent to the ED for real needs that were not truly emergencies. In 1965, with the advent of Medicaid and payments below what private practicing doctors would accept to cover the costs of running their practices, ED’s became the place where poor people went for care, not because they wanted to be there for non-emergencies, but because many doctor’s offices would not accept Medicaid. And finally, the aging of the population is another reason  Emergency Departments here, and around the country,  continue to be in high demand.

For the last few decades, ED’s have been under siege. The professionals working there are incredibly dedicated and well-trained. They work extremely  hard, but the system is not designed for efficient flow. 

The GBMC ED is operating under the same stressful situation as other ED’s. We, however,  have an advantage over most ED’s --  outstanding leadership. Dr. Jeff Sternlicht, Medical Director, and Mark Fisher, RN, Nurse Manager, have fully embraced our vision and have become quite proficient at redesign. With the help of our performance improvement advisors, they have redesigned much of the care of ED patients who don’t need to be admitted to the hospital.

There are three areas to focus on to improve patient flow in the ED:

1. Input: You can work to make sure that only patients with emergencies come to the ED. (This is the work of primary care, specialty physician offices, and other community providers.)

2. Throughput: You can work to reduce waste in the processes from check-in to discharge home. (Clearly the work of the ED team.)

3. Output: You can move patients to an inpatient bed as quickly as possible once you know they need to be admitted. (This is the work of the inpatient teams led by our hospitalists or inpatient specialists.)

Jeff and Mark have been happy to work with our patient-centered medical homes on reducing non-emergent visits and to work with our Department of Medicine in particular, to move admitted patients to the floor faster.  They have not wasted any time  getting in action to redesign the work of assessing and treating those who they think can be sent home – the throughput work. 

So, what have they done so far? 

Redesign of Triage:  They added a medical provider in triage to connect the patient to a provider sooner. This is allowing the Emergency Department to start care on entry, during busier times of the day. 

Implementing a Protocol Bay: This allows labs and IVs to be started right after triage. This gets blood sent to the lab sooner and test results back quicker for patients even before they get to a treatment space.

Implementing a Rapid Assessment Zone: This allows patients with lower acuity needs to have their care started in the waiting room even before they get to a formal treatment bed.

Yesterday on our Lean Management System rounds, Katie Koestler, RN4, presented the ED’s results so far. I am so proud of Jeff, Mark, and their team. They are doing phenomenal redesign work and moving us faster toward our vision. They are clearly improving the care experience and reducing wasted time in the ED. Please thank the members of the ED team when you see them!

Friday, July 30, 2021

Another First for GBMC

Science has taught us how to save individuals who are having a life threatening cardiac arrythmia. We also know that time is of the essence, so being well-trained in advance leads to better outcomes for the patients. 

Recently, GBMC became the first hospital in the state of Maryland to earn the designation as an RQI Lighthouse Organization because of our “adoption and consistent use of an innovative CPR training program.” We are the first hospital in our state to use the RQI system to train nurses and other clinical providers in cardiopulmonary resuscitation.

RQI training techniques have helped members of our clinical staff achieve sustained mastery of CPR skills. The hospital implemented the system, which is endorsed by the American Heart Association, back in 2016. During the training, the system provides live feedback, while the learner practices CPR skills with a manikin every three months.  These techniques came in handy a couple of years ago when one of our own staff members used his skills outside of a patient unit to save someone’s life.

While walking to lunch, Roel Tiberio, BSN, RN, CGRN, Endoscopy Nurse Manager with The Kroh Center for Digestive Disorders and one of our Art of Nursing Award recipients,  was having a conversation with a coworker when he heard a loud noise and turned to see that someone had fallen.  At the same time, two other GBMC HealthCare system medical staff members were leaving the cafeteria, and also saw the visitor on the floor.  They immediately ran to assist and found this person to be without a pulse and not breathing. Using his clinical training, Roel quickly delegated someone to call for a code and another to get an automatic external defibrillator (AED) while he began CPR. Roel followed the instructions which indicated that the visitor required a shock.  Roel proceeded to shock the patient as he and his colleagues continued CPR. When the code team arrived, the visitor was breathing on his own and was immediately transported to the Emergency Department.  After a full medical assessment, the patient was admitted for observation. Roel was relieved to learn that the patient had survived without complications.  

It is not uncommon for our clinicians to implement CPR on a patient, but it is not often that clinicians use these skills outside of patient care units. Roel’s quick actions were lifesaving and clearly shows the value of the RQI system. 

I want to thank Vanessa Velez, Director of Professional Practice, Education, and Research at GBMC HealthCare and Deborah Higgins, MS, RN, CHSE, our Simulation Manager and AHA Training Center Coordinator, for all their hard work to make sure that we are adopting best practices and continually improving our readiness for events like the one described above. I would also like to thank David Vitberg, MD, Director of our Medical and Surgical ICU, and Carolyn Candiello, our Vice President for Quality and Patient Safety, for working with RQI to bring this tool to our hospital.   

Diversity & Inclusion Assessment
Our vision at GBMC HealthCare is to become the community-based healthcare system that can deliver to every patient, every time the care we would want for our own loved ones.

We cannot achieve this vision unless our workforce mirrors those we are serving. Our diversity brings more new ideas and our inclusiveness magnifies this by empowering many more people to innovate. We need our entire team to be engaged to move us forward, faster. 

GBMC will be working with Cee Suite to conduct an assessment of the current state of Diversity, Equity, Inclusion & Accessibility in the GBMC HealthCare System. This assessment will help our organization identify what we are doing well and where we can improve. Cee Suite is a talent management consulting firm with a specialized focus in diversity, equity, and inclusion. They partner with organizations to develop sustainable DEI solutions.

After completing the organizational assessment, Cee Suite will provide leaders at GBMC with a roadmap to create a more diverse workforce and foster an inclusive environment for our staff and patients.

What should you expect?

--In the next 30 days, employees from various departments, roles, and backgrounds will be invited to participate in focus groups led by Cee Suite.  This participation will require a commitment of one hour.
--Over the next 3 to 6 months, we will share the feedback from the organizational assessment and an introduction to our organizational plan. 

If you have questions regarding this initiative, please send them to diversity@gbmc.org

Thank you.

Friday, July 23, 2021

The Maryland Waiver with the Centers for Medicare and Medicaid Innovation

It is a very complex topic, but readers of the blog know that the State of Maryland has an all-payer rate setting system. In Maryland, unlike in the other 49 states, hospital payments for services are determined by the Health Services Cost Review Commission (HSCRC), a quasi-governmental agency. In the rest of the country, hospitals negotiate payment rates with insurance companies and are told what the rates are by Medicare and Medicaid. Stand-alone hospitals, like GBMC, have little bargaining power in other states, so they are usually paid less than hospitals run by large companies. In Maryland, all payers, including Medicare and Medicaid, pay the same rate to the same hospital for the same service, and these rates are set by the HSCRC. In other states, Medicare usually pays below what private insurers pay and Medicaid significantly below what private insurers pay. GBMC gets paid less than many of the hospitals in our region for the same service, but we are protected by the all-payer rate setting system.

Recently, the Centers for Medicare and Medicaid Services (CMS) published an evaluation of the first two years of the Maryland Total Cost of Care Model. Since January 1, 2019, CMS has been holding Maryland accountable for reducing the total cost of care for Maryland Medicare beneficiaries, not just for hospital costs, while improving the quality of care and patient satisfaction. The evaluation points out that Maryland reduced total Medicare spending in 2019 (relative to national trends) by $365 million — $88 million more than the spending reduction achieved in 2018, which followed the previous waiver model. The report concluded that global budgets remain the biggest financial incentive in the Model. 

Maryland has also embarked on a new program to incentivize better primary care called the Maryland Primary Care Program (MDPCP). The report says that primary care practices in 2019 made gains in the targeted domains: access and continuity, care management, comprehensiveness and care coordination, patient and caregiver engagement, and planned care. Blog readers know that advanced primary care is a fundamental building block of the GBMC HealthCare System, so you won’t be surprised to know that we are among the leaders in MDPCP.

It will also come as no surprise that our GBMC Health Partners primary care providers were recently acknowledged by readers of The Sun as the best in the Best General Practitioner (primary care) category. It’s nice to see that members of the community now understand that we are different and validate our excellence as we move towards our vision of being a community-based system of care that can deliver to every patient, every time the care that we would want for our own loved ones. 

Readers of The Sun did not stop the accolades with primary care. They also found GBMC to be the Best Hospital in our region! Our Audiologists were also found to be the best!

And we had others recognized as runners-up in the following: 

Best OB/GYN Practice

Best Audiologist - Presbyterian Board of Governors Cochlear Implant Center of Excellence

Best Pediatric Practice - GBMC Pediatric Group

I want to THANK the community for their support and all who voted for recognizing the hard work and dedication of our people.

Way to go!
I would also like to announce that Baltimore's Child Magazine recently unveiled its list of 2021 Readers’ Choice winners. GBMC was named: 

Best Hospital - Hometown Heroes - COVID-19 Pandemic Response

Best Place to Deliver Your Baby

Best Pediatric Vision Care - Dr. Allison Jensen, Eye Center at GBMC

And runners-up in the following: 

Best Pediatric Physician - Hometown Heroes - COVID-19 Pandemic Response, Dr. Theresa Nguyen - GBMC Pediatric Group

Best Medical Matters

Best ER for Kids

Congratulations to Drs. Jensen and Nguyen. I am very grateful for everyone who has made this recognition possible.

It is no secret that those of us in the medical field never stop taking care of people even when we’re not at work. David Vitberg, MD, Director, Division of Medical and Surgical Critical Care Medicine, is a perfect example.  

Recently, Dr. Vitberg was awarded the Maryland Star of Life Award for his heroic efforts to save a man who was trapped under a waterfall in Rocks State Park. The award, presented by the Maryland Institute for Emergency Medical Services Systems (MIEMSS), combines the organization’s symbol, the Star of Life, with its shared vision, “the elimination of preventable death and disability from injury or sudden illness.”

Dr. Vitberg, along with first responders and other EMS physicians, played an instrumental role and worked for hours to free a man – nearly having to amputate his leg. Fortunately, the water rescue team was able pull him out just prior to the procedure. The man was treated on the scene and then transferred to a local hospital with his leg intact.

We are all incredibly honored to have Dr. Vitberg as a leader at GBMC and congratulate him for this award! 

Friday, July 16, 2021

Getting Ready for the Construction on our Campus

Back in June, I talked about some changes that were forthcoming in terms of parking and other closures to accommodate the beginning of construction for the three-story addition, the new parking garage and the new Sandra R. Berman Pavilion, called The Promise Project. As we inch closer to our official groundbreaking on September 2, you will be hearing a lot more about this project, and we will work hard to keep you as informed as possible about the construction process and how it will affect employee workflow, visitors and patient access. 

The Rose Lot will close as of this Monday, July 19. This is necessary because the heavy construction equipment will park in this area, and it will also be a staging area for construction. Reducing parking spots makes people concerned about their ability to find a place to park. Tulip and Lily garages have abundant space to handle those who will no longer be able to park in the Rose Lot. And actually, the Lily Garage is closer to the main entrance and has a conditioned walking path to protect employees, patients and visitors from the elements. 

Thank you for your patience as we continue the repairs to the Daffodil Garage. From July 12 through October 1, we will be working on Levels 1 and 2 of the garage, affecting 60 total parking spaces. The garage will remain open, but we are asking employees to park in the Tulip and leave the remaining spots for patients and visitors. We are also adding a valet attendant on July 19 and will add another valet station at the former Sherwood Loop in early August to help with access and flow. 

Lastly, Human Resources has relocated! As of this week, nearly all Human Resources employees are working in the South Chapman Building. If employees have any concerns, questions, or are looking for anyone in particular, your HR business partner is a great place to start, but you are always welcome to visit South Chapman to find what you need. 

New Date for Employee and Volunteer BBQ
I would not want to miss an opportunity to thank and acknowledge our amazing employees, especially after the challenging year we have had. We have traditionally held our annual Employee and Volunteer Appreciation BBQ in July, but this year we are moving it to Thursday, September 30. More details are forthcoming, and I hope every employee plans to attend. This year was tough and threw us many curveballs. Each one of you handled it with grace, humility, and always with a focus on the patient. I look forward to celebrating with you on September 30. 

Friday, July 9, 2021

Congratulations and Thank You

Our triennial survey by the Joint Commission was completed last week and we did very well. I was not surprised because we have outstanding people and we have worked hard to create systems to help them do their job and provide highly reliable care. Let me thank all our team for their incredible efforts to deliver the care that we want for our own loved ones. Great job!

The surveyors found some opportunities for improvement but overall, they were very impressed. In many areas, they had no findings. In Maternal Newborn Health (MNH) the nurse surveyor from the Joint Commission reviewed eight charts and found no issues to correct!

Every Joint Commission visit to MNH starts with the review of a patient who has had a vaginal delivery and one who has had a cesarean section. There is also a chart review of a high-risk patient with an obstetrical or medical complication.

In 2020, the Joint Commission introduced two new standards to address complications related to maternal hemorrhage and severe hypertension. Our nurses, nurse educators, and Epic analysts worked together as a team to add functionality to Epic to meet the new standards. This was a collaborative process where input from all team members was invaluable. The goal was to assure patient safety and decrease the risk of complications, while ensuring seamless integration with the workflow. The surveyor focused on these new standards during the chart reviews in Labor and Delivery.

During the chart reviews, the Labor and Delivery nurses were able to highlight two new areas of build in Epic that address the new standards. The Labor and Delivery and Mother Baby staff now use a Postpartum Hemorrhage Assessment tool that identifies the patient’s risk of hemorrhage from admission through the postpartum period. One of the highlights of this tool is that once the provider enters the necessary documentation to calculate a hemorrhage risk score on admission, Epic continues to calculate the risk based on specific criteria in the background without the nurse having to re-enter documentation at set intervals. The score recalculates automatically and is highlighted in the Storyboard and several other areas in Epic.

The Labor and Delivery nurses were also able to highlight the care that they provided for a patient with a hypertensive emergency. The Epic team and clinical end users worked together to build a new comprehensive order set for this type of event as well as new patient assessments. The staff did a great job of navigating through this complex patient chart.

I want to congratulate Gretchen Bell, RNC-OB, C-EFM, our Application Coordinator/Analyst Team Lead EPIC, our Labor and Delivery nurses, and all members of our MNH team for this fabulous achievement, and for working together to continually improve patient care.

I also would like to thank everyone for their hard work, collaborative spirit, and commitment to patient safety.  It was evident to our survey team that GBMC is a highly reliable, patient-centered organization.