Dealing With Financial Challenges

America’s hospitals are going through a difficult time due to workforce shortages and the lingering effects of the pandemic. Every day, we hear of another healthcare company declaring huge financial losses. Kaiser Permanente posted a $1.3 billion loss in the second quarter of this year.

GBMC is not immune to the forces in the healthcare market. Happily, we have been governed and managed well over the decades, so we have financial resources to help us weather the storm. However, our teams are working together to reduce waste and serve more patients to bring us back to a stronger financial position. 

I know that many of our colleagues are nervous, so it did not surprise me that at a recent GBMC Town Hall, I was asked a question about how we were going to get back in the black. The truth is that we are studying every expense to see if it is really required to deliver better health and better care to those we are serving. Is there a vendor who could provide the same quality of service as a vendor who is charging us more? Is there a manufacturer who could give us the same or better-quality supplies at a lower cost? We should be eliminating this waste every day to make our care more cost-effective and move toward our vision, independent of our immediate financial situation. We are working to hire clinical staff, so we can eliminate the exorbitant costs of premium labor when we use external agency staff. 

As people leave non-clinical positions, we are assessing that position. We are trying as hard as we can to protect people’s jobs. 

On the revenue side, as an example, we are trying to get people to use our joint venture with Advanced Radiology imaging center in Physicians Pavilion East, rather than choosing other imaging sites. 

We are studying further mergers and acquisitions like Gilchrist’s recent joint venture with Luminis Health Care, which is expanding access to important palliative medicine and hospice services to Anne Arundel and Prince George’s County. It will also help Gilchrist recover from challenges caused by the pandemic, such as the increased COVID-19-related mortality rate in frail elders, which resulted in fewer people utilizing end-of-life services. We have no intention of merging with a large hospital company as all hospital companies are dealing with the same need to cut costs as we are. 

So, let me thank all my colleagues for your hard work and your ideas. We will get through this together as we make the GBMC HealthCare system even better and continue to move toward our vision of being the community-based true system of care that is capable of providing every patient, every time the care that we would want for our own loved ones. 

Taking it all in
Last week, I joined other members of GBMC leadership for a walk-through of the Louis and Phyllis Friedman Building. It was great to see how far we have come since our groundbreaking ceremony approximately 13 months ago. 

Here are a couple of photos from our walk last week that show our progress. I would also like to mention that the "topping off"—or placement of the last beam—will take place next month and that the entire exterior of the structure is expected to be enclosed by the end of the calendar year. These steps will then allow us to start working on the interior of the building and ultimately to install the furniture and equipment. 

I want to thank Stacey McGreevy, Executive Vice President of Hospital Operations; and Russ Sadler, Director of Facility Planning, Design, and Construction; for their oversight of the construction and for all their work in getting us to the point of welcoming our first patient in the new space in the Fall of 2023. 

Survey Says… 

Please complete our annual Employee Engagement Survey.  The survey is open through Friday, October 7 and can be accessed by clicking here and entering your employee ID number. You can also complete the survey via the link you received in the email sent to you by Gallup, our survey vendor. The email from Gallup included a link unique to you that doesn’t require you to enter an employee ID. 

The survey is completely CONFIDENTIAL. We use a third-party vendor to ensure confidentiality. The vendor collects the data and provides it to departments as aggregated scores. Your individual responses to the questions will not be shared! If you do, however, choose to include additional comments, these will be shared with your manager, but your name will not be given. 

Please complete the survey so that we can learn what we can do to make the GBMC HealthCare System an even better place to work. Thanks!

Thank you! 

I am pleased to announce that GBMC was recently recognized by the readers of The Daily Record as the Best Hospital in Maryland. I want to thank their readers for voting for us and recognizing the excellence of our staff. 

Happy New Year!
The Jewish community is celebrating 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 those of the Jewish faith focus on repentance. L’Shana Tovah!

Helping the Patient Make an Informed Decision on the Cost of Care is Hard

Recently, GBMC was recognized among the 16 percent of hospitals nationwide to be fully compliant with the federal hospital price transparency rule.  

According to the semi-annual hospital transparency report by PatientRightsAdvocate.org, GBMC was one of 319 hospital websites across the country, and one of only two in Maryland, to be fully compliant with federal price transparency rules.

This law is intended to make the costs of services such as X-rays, medical tests, or procedures clear to patients before they get the service. The law requires hospitals to list the cash prices for procedures on their websites in two forms: one that is easy for patients to access and that includes a cost estimator for the 300 most common services, and another that is machine-readable — essentially a spreadsheet. All of this allows patients to know what they will be billed and lets them see how much their insurance will pay and how much they will have to pay out of pocket.

Many Americans face financial hardship because they don’t have the money to pay their medical bills. In trying to fix this, our legislators want to make people aware of the costs before they get the services. This may help with elective services, but no one is going to wait to look up prices before getting care if they have an urgent or emergent problem.

A major hurdle in trying to let the patient know what he or she will have to pay is that we literally have hundreds of insurance plans in our country, and the plans have different co-pays and deductibles. On top of that, outside of Maryland, hospitals and physician groups negotiate rates with the insurers. In Maryland, we only negotiate payment rates for physician/provider bills, but hospital prices are set by the Health Services Cost Review Commission for each hospital. 

We firmly believe that transparency is needed across the healthcare delivery system allowing patients to make more informed decisions. The patient and the insurance company should pay for value. The definition of value is health outcome + care experience.

                                                                 Cost

If hospital A provides the same outcome for a clinical procedure with the same care experience as hospital B, but the care at hospital A costs twice as much as hospital B, then it only makes sense to get care at hospital B, because hospital B will be providing twice the value of hospital A.

GBMC works tirelessly to drive the waste out of healthcare, and we are a lower cost hospital than most in our market. We are also proud to make prices more transparent for our patients. I take immense pride in knowing that we are among those at the forefront of transforming healthcare in this country and that we are among our nation's transparency leaders.

Our Great General Surgery Group
I have been reflecting recently about the excellence that we have within the GBMC HealthCare system and I want to comment on a group that does outstanding work and does not get the credit it deserves. I firmly believe that GBMC has the best general surgery group in the region.  

Our group within GBMC HealthPartners, goes by its historic name: Finney Trimble Surgical Associates, named after its founding members. The two most senior members of the group, Francis S. Rotolo, MD, FACS, division head of General Surgery at GBMC, and Laurence H. Ross, MD, are incredibly talented people who have been leaders in their field for more than 25 years. Other members of the practice include John L. Flowers, MD, who is also our healthcare system Executive Vice President and Chief Medical Officer and the leader of GBMC Health Partners; Joel A. Turner, MD, Chair of the Department of Surgery and Chief of Minimally Invasive Surgery; and Timothee J. Friesen, MD, FACS, bariatric and general surgeon and Medical Director of the GBMC Comprehensive Obesity Management Program. 

As we are celebrating Women in Medicine Month, I would also like to recognize Finney Trimble’s two fantastic female surgeons, Shauna M. Costinett, MD (left), and Emily J. Watters, MD (right), who joined the practice within the last two years. Both are board-certified general surgeons and members of our Comprehensive Obesity Management team. In a field historically dominated by men, Drs. Costinett and Watters have demonstrated their excellence since joining us, and we are delighted to have them on our team. I am also pleased to announce that a new member, Beatriz Briones, MD, a general surgeon who will practice general and bariatric surgery, will join the practice next month.  

Thank You…
On Monday, our Department of Ophthalmology hosted the 2022 Hoover/Naquin Symposium. We were honored to have Tamara Fountain, MD, delivering the Hoover Lecture, titled “Pilots and Physicians, Passengers and Patients – Maintaining Situational Awareness When Stakes Are High” and Megan E. Collins, MD, MPH, giving the Naquin Lecture, titled “Advancing Health Equity in Pediatric Eye Care.” We were pleased that Dr. Richard Hoover’s widow, Lydia, was able to be present for the lecture named in his honor. 

Dr. Fountain served as the President of the American Academy of Ophthalmology in 2021 and was named to the board of directors of the American Board of Ophthalmology in January 2022. She is a former President of the Illinois Society of Eye Physicians and Surgeons. Dr. Collins is The Allan and Claire Jensen Professor of Ophthalmology at the Johns Hopkins Wilmer Eye Institute and specializes in pediatric ophthalmology and adult strabismus. She is the Co-founder and director of the Johns Hopkins Consortium for School Based Health Solutions.

  (Standing left to right: Tamara Fountain, MD, Mary Louise
Collins, MD and Megan E. Collins, MD, MPH) 

I want to thank Drs. Fountain and Collins for participating in the lecture series and I also want to extend my appreciation to Mary Louise Collins, MD, Chairman of the Department of Ophthalmology at GBMC, and her staff for putting together such a wonderful event.

Having Some Fun in the Sun

On Wednesday, we held our annual Employee and Volunteer Appreciation BBQ. I look forward to this event every year because it gives us the opportunity to thank our fabulous people for all they do and for us to spend some time together.  

The people in our system are taking care of patients around the clock, and our team works hard. We organize this barbecue across all shifts and all sites, so that all our people have an opportunity to get a short break, have a meal, and enjoy some camaraderie while being outside. We cannot reach our vision without a fully engaged workforce and we cannot have a fully engaged workforce unless our people feel appreciated. The barbecue gives us some time to let them know we appreciate them. 

Our fourth Aim — More Joy — requires that we take time to celebrate, as a team, the wonderful care we provide. During our hectic workday, it is difficult to find time to bond and reflect on the joy of helping others. 

Fun was clearly on display as everyone enjoyed the music, good food, games, and festivities while having a relaxing time with friends and colleagues. We assembled again later that night to BBQ and play games with the night shift staff.

I also want to give a special thanks to our Human Resources team, led by Anna-Maria Palmer, and our Philanthropy and Marketing and Communications Teams, led by Jenny Coldiron, whose planning made the employee BBQ possible for all of us once again. 

Thank you…
This week is Environmental Services (EVS) & Housekeeping Week and I want to take time to recognize the contributions of our EVS staff. I have a deep appreciation for the role of environmental services in the overall healthcare delivery process and I want to thank all the of our environmental services staff who spend countless hours keeping our facilities clean and helping to prevent infections. Cleanliness is everyone’s job at GBMC, but, our EVS staff members are the experts in cleaning who work tirelessly to get the job done. There are more than 100 EVS associates working around the clock at GBMC in a variety of roles, servicing more than 1.2 million square feet of facility. So, please join me in honoring our EVS team.

Yesterday was Neonatal Nurses Day (part of Neonatal Nurses Week) across our nation. It’s a time where we honor our nursing colleagues and celebrate their hard work and dedication. NICU nurses work around the clock year-round to provide the best care to the tiniest, most vulnerable patients in the hospital. I want to thank them for helping premature and sick infants grow and thrive. With more than 4,500 babies born at GBMC annually, 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.

Making Sure that Our Changes Stick

We have become adept at designing or redesigning processes in the GBMC HealthCare System. But how well are we doing at making sure that the changes we make are still around after the team that created them moves their focus to something else? 

On our Lean Management System walk this week, the Adult Emergency Department gave their monthly sustainability report. They have six processes that they check on in sustainability from redesign work since February 2020.

1. Patient Throughput
1. Provider In Triage (1 process)
1. Using evidence-based practice and national benchmarking, we reallocate provider resources, which has reduced the time patients spend waiting to see a physician or other provider. Since implementing this change, GBMC’s time to the first evaluation has stayed below the national average of 18 minutes.
2. Lab Turn Around Time (1 process)
1. Reducing the time from the order to the specimen collection to make the diagnosis faster. Our performance has been maintained from an order-to-collect median of 19 minutes. This reduction in wasted time has allowed the ED to implement and sustain an ED protocol bay and improves patient throughput.
3. PIVOT Nurse (1 process)
1. This process accelerates the complete and accurate data collection on patients and reduces the wait until the first medication pass for pain and comfort, prior to patients entering the waiting room.
4. Emergency Department (ED) to Inpatient (IP) Nursing Redesign (3 processes)
5. With collaboration from the Performance Improvement team, EPIC, and the Inpatient Nursing leaders, we were able to design an automated process for patient movement out of the ED. We have the patient ready to move when the bed is clean and the admission orders are in. We have sustained our improvement to move the patient within 10 minutes of the ready-to-move time.   

I am so grateful for our Performance Improvement Team that has designed a process for reporting on sustainability to help reduce the probability of drift back to “the old way.” And I am so proud of our ED team for sustaining so many redesigned processes!

Are You Ready for Some Football!?!?!?
Today, our Pediatric Emergency Department treats about 900 children a month and our talented and dedicated physicians, nurses, other clinicians, and support staff, make sure that each patient is provided the care that we would want for our own loved ones. We are very fortunate to have such a great Pediatric ED team. 

Now to help them continue their work and to make sure that they have the appropriate resources to continue providing stellar care for their patients, GBMC is participating in a special promotion for you to see the Baltimore Ravens in action. Former left tackle and member of the Pro Football Hall of Fame, Jonathan Ogden, is helping us spread the word about our wonderful Pediatric ED and garnering financial support for it. 

Anyone who donates $8 (or more) will be entered for a chance to win two (2) club level season tickets and a parking pass for the Ravens 2022-2023 football season! Also, registrants will have a chance to win eight consolation prizes which are a pair of tickets to a Ravens home game.  You can help support this great cause by clicking here. Again, all proceeds will benefit our Pediatric ED.   

GBMC gets remarkable support from the community. I am sure that many will answer the call once again.  

Good luck to all participants and go Ravens!

Condolences for Queen Elizabeth II
We mourn the loss of Great Britain’s longest reigning monarch, Queen Elizabeth II. The Queen took over the crown in 1952, when Sir Winston Churchill was the Prime Minister, and her years included times of war, peace, scandal, and more. The Queen dedicated her life to public service, and throughout her long reign she was a passionate champion for her country. Our thoughts are with her family and all who loved her.

Our New Building Has a Name

We are thrilled to announce our three-story addition to the main hospital will be named the Louis and Phyllis Friedman Building. 

Our Promise Project Chair, John R. Saunders Jr., MD shared the following about this exciting announcement:

The Friedmans have been a part of the GBMC family for many years, and their $5 million pledge is a profound statement of their commitment to the health of the community. We are honored GBMC will bear their name at its main entrance. Alongside the Sandra R. Berman Pavilion, which will ease the burden of those battling cancer, the inpatient facility will dramatically improve the patient and family experience. The Friedmans' leadership takes us to 94% of our $50 million goal.

I share Dr. Saunders’ sentiment wholeheartedly and am so grateful that the Friedmans believe in our mission and vision strongly enough to support us so generously.

A Year in the Making …

Today marks one year since our groundbreaking on The Promise Project, and much has been accomplished in those 365 days. Our teams at GBMC, DPR Construction, and Hammes have been working collaboratively and efficiently to stay on track.

In fact, we’re approaching the important milestone of placing the final beam in the new building! Thank you to everyone who came out to sign the beam and be part of GBMC history this week.

The entire exterior of the structure is expected to be enclosed by October, and the tower crane for the Sandra R. Berman Pavilion will go up around the same time.

To keep you in the loop, below are some of the anticipated key dates for Promise Project construction. 

•  Inpatient facility tower crane removal: September 2022

•  Inpatient facility enclosed by October 1, 2022

•  Sandra R. Berman Pavilion tower crane assembly: Fall 2022

•  Construction of the Louis and Phyllis Friedman Building is expected to be complete in Summer 2023 with full occupancy in Fall 2023. 

•  The shell of the Sandra R. Berman Pavilion as well as the connecting garage will be complete in fall 2023.

You can learn more about the promise project by visiting https://www.gbmcpromise.org 

Level III Perinatal Referral Center Re-Designation
Last week, I congratulated our multidisciplinary perinatal team and ancillary departments for making our recent Maryland Institute for Emergency Medical Services System (MIEMSS) survey so successful. We immediately got great feedback from the surveyors. I’m pleased to share that we got official word from MIEMSS that GBMC has been re-designated as a Level III Perinatal Referral Center for a period of five years! Thank you to all who made this important re-certification possible!

GBMC HealthCare Noted as a Top Health System to Work For!
Forbes recently released its “America’s Best Employers by State” list, and a total of 262 hospitals and health systems were included. I’m excited that GBMC HealthCare was among Maryland’s top three! We appreciate our workforce family – thank you for choosing us as your employer! If you’d like to become part of the GBMC HealthCare family, visit gbmc.org/careers to browse opportunities.