Happy Doctor’s Day 2022

In celebration of this year’s Doctors’ Day, I would like to thank all of our physicians for their hard work and commitment to our vision and our patients. You have stood up to the pandemic and every other challenge to get the job done.  

GBMC is so fortunate to have such a dedicated and talented medical staff, and we see this every day in our clinical outcomes. 

We gave red carnations, the national symbol for Doctors' Day, to hospital physicians as a token of our appreciation. Anyone who would like to participate in the Doctors’ Day celebration can do so by honoring your GBMC physician with a donation to GBMC or a message of gratitude here. This is an opportunity for members of the community to acknowledge the tireless efforts of our doctors and their commitment to your health. 

Waiting To Hear…
Last week, during Lean Management System (LMS) rounds, I was joined by Jodie Bell, MSN, RNC-LRN, IBCLC, Assistant Director of Women’s & Children’s Services, and we discussed the visit of The Joint Commission (TJC), the nation’s largest independent healthcare evaluation organization, in a re-certification survey. In 2020, we became the first hospital in the state to earn the Joint Commission Advanced Certification in Perinatal Care, and it was time to be reassessed. 

Jodi assured me that our perinatal team remains focused on continually improving our processes to enhance patient care for mothers and their newborns and that the surveyor gave her every indication that we had a successful evaluation and should be recertified.  

It is important to point out that the perinatal care certification process is a rigorous onsite review that involves an analysis of compliance with national standards, clinical guidelines, and outcomes of care for newborns and their mothers. As part of the recertification process, we submitted data on core performance measures, which demonstrated continual decreases in maternal complications and early deliveries; decreased prematurity rates; a significantly decreased C-section rate; an improved rate of exclusive breast milk feeding; and zero bloodstream infections in newborns. Certification is voluntary and is a sign of excellence.  

We will be notified by the end of May about our status. I am quite confident that we will be recertified given the focus of our team and the excellence of our care.

Designing Our New Facilities to Better Meet the Needs of our Patients and the Care Team

This week I want to provide you with another update on The Promise Project. I am glad to report that we are on schedule with the construction of the three-story inpatient addition, parking garage, and the Sandra R. Berman Pavilion. We have completed the demolition phase of the project and have welcomed the tower crane that is doing all the heavy lifting of materials to build the addition.

When GBMC opened in 1965, private patient rooms were a novelty. Since then, these same patient rooms have become too small to meet the needs of patients, their families, and the care team. The three-level addition will add 60 new patient rooms that are designed for collaboration while providing a quiet space for medical patients to rest and heal. Patient rooms will include ample space for medical equipment and advanced technology, room for medical teams to gather and deliver care, and space for loved ones to visit comfortably. They will have advanced sound proofing to facilitate the rest and healing process. 

The rooms won’t just be larger; they are also designed with the lessons we learned from the COVID-19 pandemic, incorporating more isolation capacity for patients with infectious diseases. 

Joining me this week is Rhonda Wyskiel, our Senior Director of Performance Improvement and Innovation, as we discuss the new clinical workspace and how it will make it easier for clinicians to get their job done. 

The new inpatient facility will have a computer in every room. Can you give us an idea what that will mean to the patients and clinicians? 
We are laser focused on providing an exceptional patient experience at GBMC, and that means we design our process/workflows/ and technology to be patient centered. The Institute of Medicine defines patient-centered care as “care that is respectful of and responsive to individual patient preferences, needs, and values.”

Consider this scenario: Clinicians walk into the room and initiate a discussion, working through the history of present illness, past histories, medications, and allergies, doing all of this while trying to commit to memory every detail. Next, they exit the room and scurry to the nearest computer, sit down and re-enter the patient’s information into the chart. Invariably uncovering something that wasn’t discussed. “Oh, it says the patient is on aspirin; I forgot to ask if he is still taking that,” or, “the ER note says she fell and hit her head two days ago; she didn’t mention that to me.” Having a computer at the bedside enables us to verify or dive deeper into these issues. This improves patient safety and patient satisfaction, preventing an unnecessary return to the patient’s room, asking later, or not addressing the issue at all.

All in all, this will provide an improved experience for everyone, allowing clinicians to look things up in the EHR at the point of care. Patients like it when you show them things. Placing orders in the patient rooms creates more efficiency and a better care experience. 

How will the nursing stations in the new inpatient facility differ from the ones currently in our hospital, and what are some of the advantages for both the clinician and the patient?
The nurse station is the fulcrum of activity on the inpatient hospital floor. At some point, virtually every hospital function intersects at this critical junction, often simultaneously, with various meetings occurring among a wide cross-section of hospital staff. It serves a diverse array of purposes, one being that it acts as a space for communication and interprofessional collaboration. Studies have shown that the design of the nurses’ station alone can impact aspects of patient and staff privacy, walking distance, and access to resources. In the Promise Project design, the nurses and other clinical and non-clinical staff will work together in a central location. Quick access to peers paves the way for learning, mentoring and efficient communication. Resources can be consolidated, and efficiency will be gained.  

In the design phase of the nurses’ station, we considered the context of providing patient care as a functional workspace. Clean, beautiful aesthetics contribute to the healing environment, but this space, maybe more than any other in the hospital environment, needs to be highly functional. This thoughtful design has the potential to reduce staff stress and fatigue, increase effectiveness in delivering care, improve patient safety, reduce patient and family stress and ultimately improve outcomes and overall healthcare delivery quality.

The new patient rooms will be replenished with supplies from the outside and “off-stage” areas. Can you explain how this will lead to a better patient and provider experience?
Stocking, re-stocking, and rotating supplies for patients is just one of the many tasks of nurses and other hospital staff, who need to provide quality patient care while managing hospital supplies and time efficiently. Pass-thru patient room nurse server cabinets are a secure and efficient solution for exchanging medical supplies, linens, drugs, liquids, bandage materials, and other items from outside the patient room. Now, more than ever, infection prevention is top of mind for all of us. Ensuring we create workflows to reduce the need for tasks to occur in a patient’s room that are able to be facilitated safely from outside the patient room is truly an innovation mindset. 

The cabinet can be accessed from the hospital unit corridor for quick re-stocking without needing to enter the patient’s room. From inside the room, the cabinets are stocked with patient supplies for staff to easily access them. The cabinet is customized with a wide variety of full extension bi-directional trays, shelves, linen hampers, and locking medication drawers. Storage can be accessed from either side for re-stocking. After a patient has been discharged, the trays can easily be swapped out of the cabinet and exchanged with fully stocked trays.

Cabinets will be equipped with keypad locks to secure stored materials and medications when not in use and to control access to medical supplies.

I am very proud to be at the forefront of innovation with our new patient rooms that will support the extraordinary work of our physicians, nurses, and other staff. This is an investment to move us closer to achieving our vision phrase – to every patient, every time, we will provide the care we would want for our own loved ones. I want to thank Rhonda for the work of her team and her leadership. I also want to thank all my colleagues for helping us get to this point in the construction process. For more information on our progress, please visit here. 

Getting Ahead of Colon Cancer

Annually, colon cancer claims more than 50,000 American lives, making it the second leading cause of cancer deaths in our country.  March has been designated as National Colorectal Cancer Awareness Month, and it offers us an opportunity to educate the community about how to protect themselves. 

Colorectal cancer can afflict anyone, and research has shown that the risk of death from colon cancer decreases dramatically when it is caught early. Lives can be saved by highlighting risk factors and increasing awareness about routine screening. 

I asked Niraj Jani, MD, Chief of Gastroenterology and Director of GBMC’s Kroh Center for Digestive Diseases, to discuss colon cancer, how to reduce risk, and how to detect colon cancer.

How is colon cancer diagnosed and why is screening for colorectal cancer important? 
There are multiple ways to detect colon cancer, including stool-based tests, imaging such as CT scan, MRI or colonoscopy.  Early detection is key to cure and increased survival. The gold standard test is colonoscopy, which allows for the detection of early lesions, such as polyps, which are the precursor to colon cancer. If a polyp is detected during colonoscopy, it can be either biopsied or entirely removed, thereby eliminating the chance it could develop into cancer.

How important is it for people to get screened now, since they might have put it off due to the COVID-19 pandemic? 
It is especially important to get screened starting at age 45 for routine screening or earlier if you have symptoms or a family history of colon cancer. Delay of screening procedures due to COVID has led to delay in diagnosis and detection and, unfortunately, finding more advanced disease. Symptoms of colon cancer are vague and often don't occur until disease has advanced. These may include blood in the stool, change in bowel habits, abdominal pain, and/or fatigue.

How does someone know which colon cancer screening is right for them?
A colonoscopy still remains the gold standard for colon cancer screening.  For a patient who may be high risk or have multiple other health problems, other less invasive alternatives to colonoscopy exist. One example is Cologuard, a stool-based DNA test. It is a very sensitive test, but it has a high false-positive rate of 13 percent. In select patients with difficult anatomy, prior surgeries, or radiation, virtual colonoscopy through a CT scan is also a good option.

If someone’s recent colonoscopy showed a few polyps, should they be worried?
If a prior colonoscopy detected polyps, surveillance colonoscopy should be done earlier than the normal 10-year interval. The screening interval depends on the pathology and number of polyps. If you had polyps before, that does not always mean another polyp will be detected on subsequent colonoscopies.

How is colon cancer treated?
If you’ve been diagnosed with colon cancer, your treatment team may include medical oncologists, surgeons, and radiation oncologists. They will all work together to develop the best treatment plan for your condition.

Colon cancer treatment depends on how early the cancer is caught. Sometimes, polyps can be removed during a colonoscopy and no additional treatment is necessary. Alternatively, surgery and/or chemotherapy may be needed.

How can you prevent colon cancer?
Tools that may prevent colon cancer include a diet that is low in saturated fat, eating high fiber plant-based diets and getting routine screening. 

For those individuals who are at high risk for colon cancer, some medications have been found to lower the chance of precancerous polyps or colon cancer. Some research has shown a reduced risk of polyps and colon cancer from the regular use of aspirin or aspirin-like drugs. However, dosage and the length of time needed to reduce the risk of colon cancer is still in question. Consuming aspirin daily has some risks, including gastrointestinal bleeding and ulcers. 

Again, there isn't enough evidence to recommend these medications to people who have an average risk of colon cancer. If you have an increased risk of colon cancer, discuss with your doctor your risk factors and if preventive medications are safe for you.

As with so many diseases, the best defense against colorectal cancer is early detection. The COVID-19 pandemic disrupted our lives, including, for many, evidence-based screenings, like colon cancer screening, that are vital to guarding against disease. 

As Dr. Jani mentioned, colon cancer is one of the few cancers that can be prevented through timely screening and removal of pre-cancerous polyps. I urge people to take the precautions to stay vigilant against cancer — don’t delay your recommended screenings, doctor’s visits, and treatments. I want to thank Dr. Jani for his participation this week. Please remember to schedule your colonoscopy when you are due. Thank you!

Seeing Blue!
You may have noticed the blue wall lighting coming down the concourse from the Lily Garage into the hospital and a shade of blue shining on our main sign on Charles Street. This was done in conjunction with the American Cancer Society (ACS), Colon Cancer Coalition and Fight Colon Cancer, in recognition of Colorectal Cancer Awareness Month to support patients, raise awareness, increase screening rates, and save lives. 

I want to thank Brian Fitzpatrick, our Energy and Facilities Manager, and his crew for turning our lights blue. Again, I hope it encourages people to get screened when they are due!

Thank You!!
This week has been designated as Human Resources in Healthcare Week and Pulmonary Rehabilitation Week. 

Our human resource professionals work hard to develop policies to recruit and retain great people for our team. Our pulmonary rehab staff  help our patients, who suffer from lung disease, acquire increased endurance, strength, and a better quality of life and to take on and complete daily tasks that can be strenuous to someone living with shortness of breath.

Please take the time to thank our human resources team and our pulmonary rehab staff for all that they do to move us closer to our vision!

Exemplary Work in Making Sure Our Clinicians Have the Supplies They Need

GBMC HealthCare was recently recognized by healthcare supply chain leader Global Healthcare Exchange (GHX) as a “Best 50” healthcare provider. For the past 14 years, GHX’s annual “Best 50” award has spotlighted the top North American hospitals based on their ability to improve operational performance while driving down costs through supply chain automation. 

Honorees are selected from a pool of more than 4,100 provider organizations connected to the GHX digital trading platform that scored highest in areas such as maximizing document automation, exchange utilization and trading partner connections during 2021.

I’m extremely proud of the effort by our system team, led by Brian Riemer, Director of Supply Chain, who worked hard when the COVID-19 pandemic posed so many challenges in securing adequate supplies of personal protective equipment (PPE) for our healthcare workers. The team put in long hours to make sure that we met our system’s supply chain needs. Brian has always worked closely with suppliers to secure materials and with our logistics partners to manage and mitigate any potential disruptions to the delivery of supplies. This work was even more difficult during the COVID-19 crisis, making this award an amazing accomplishment during very difficult times in supply chain. 

When I spoke with Stacey McGreevy, Vice President of Support Services, about this important recognition, she was not surprised and offered these words about Brian and his team:
“Brian empowers his team to reach their goals and improve results through his visionary leadership and “systems” thinking.  As the supply chain leader for GBMC, Brian and his team have encountered many barriers this past year, including massive price increases and product substitutions and delays. Despite the challenges, Brian and his team continued to ensure that GBMC was well equipped with what was needed to provide safe patient care. I am in awe of the entire Supply Chain team for their collaboration, communication and focus on continuous improvement to move us further to our vision.”

The full list of 2021 winners and past winners can be found here. Please join me in congratulating Brian and his team and in thanking them for all they do!

Weighing Heavily on Our Minds
Over the last few weeks, we have been watching the disastrous and unprovoked attacks on Ukraine and I am truly saddened by the acts of aggression and violence against the Ukrainian people. 

We have seen in the news the rising number of refugees and dislocated families. I am thinking of the people who are right now in harm's way and joining all those calling for peace.

The images, videos and personal stories of the crisis can be overwhelming and can take a toll on a person’s mental health. 

GBMC Health Partners patients who feel a sense of unease, distress, sadness or even anger, can seek assistance by reaching out and talking to their primary care provider. Each GBMC HealthCare primary care practice is part of a collaborative care program that has behavioralists and psychiatrists who are available for assistance for our patients. 

For our employees, who are in need of support, I want to remind you of these free and confidential resources which include: the Employee Assistance Program, Spiritual Support Services and GBMC CARES.  You can visit the Infoweb for more information on how to utilize those resources.

Please continue to keep the people of Ukraine in your thoughts and prayers. Thank you!

Cybersecurity Update
Just a reminder that in response to the current international conflict, the GBMC IT team is operating under the Cyber Code Yellow phase, in accordance with the GBMC Cybersecurity Defense Conditioning protocols. Cyber Code Yellow is our mid-level threat stage that can be triggered by internal alerts, staff detections, and as in this case, external agencies such as The Cybersecurity & Infrastructure Security Agency (CISA), the National Security Agency (NSA) and the Federal Bureau of Investigations (FBI). 

While there are on-going efforts to assess and improve GBMC systems and our response, we encourage everyone to be vigilant when it comes to cyber security. Always follow these basic guidelines: Don’t click links unless you are sure they are safe, don’t go to websites you aren’t familiar with, and ask IT for guidance if something doesn’t quite “seem right.”

Together, using simple internet safety precautions, we can help GBMC ward off attacks. I want to thank Dave Hynson, GBMC’s Chief Information Officer, and his team for all their hard work.

Happy International Women's Day!
Tuesday was International Women’s Day, and it was an important opportunity to recognize and praise our female colleagues and their achievements. International Women's Day (IWD) is a worldwide, annual celebration that takes place on March 8, celebrating the accomplishments of women throughout history and their contributions to society.

This year's International Women's Day campaign theme was #BreaktheBias, a call to action for all of us to challenge, call out, and stop gender stereotypes, discrimination, and bias. 

In the more than 56-year history of our hospital, we’ve had much to celebrate in terms of internal launches and successful firsts where our female colleagues (currently at 83 percent) played a significant role in making our system a great place for the community to receive care – and for the nurses, physicians, and staff to work, learn and develop.

Much progress has been made on the path toward gender equity for all, but there is more work to be done. So, let us join in the collective effort to break the bias and work toward gender equity within our organization and beyond.

Hey! What’s that thing doing there?
This past Saturday, we took another major step for the Promise Project construction as we installed the tower crane. The tower portion of the crane reaches more than 130 feet. The crane installation marks significant movement forward in the construction process. The crane will do all the heavy lifting of key materials to bring the new three-story addition to fruition.

COVID-19…TWO years later

Tomorrow (Saturday, March 5) marks the two-year anniversary of Governor Hogan announcing our state’s first cases of COVID-19 and declaring a State of Emergency. So, it is very exciting to have the test positivity rate in Maryland drop below 2% and to have fewer than 350 people hospitalized with COVID-19 in Maryland. Our team needs a break!

The pandemic has dramatically affected everyday life and has slowed down our progress toward our vision. Our focus has been on combatting the coronavirus. My hope is that we do not see a new variant emerge for which we are not protected by having contracted the disease or by vaccination. Then, COVID-19 will become like other respiratory pathogens that exist in the environment and can create epidemics in the unvaccinated but will no longer be the scourge that it has been. We need to be totally focused on building our community-based system of care that can be held accountable for the health of those we are serving and treat everyone the way we want our own loved ones served.

One of the most striking takeaways from the pandemic was the resolve and collaboration demonstrated by our clinicians, all of whom were put into a situation where they had to learn about COVID as they were trying to treat it. It was truly encouraging to see our team using our core competency of redesigning care every day. This is something I will always remember.

Thank You to Our Social Workers!
March is National Social Work Month, and I would like to thank the devoted group of social workers who serve GBMC. We know how important social workers are and the difference they make in the lives of individuals and families.  Please join me in thanking our social workers for all that they do.