Not All “Innovation” Adds Value for the Consumer

On Tuesday, I had the honor of participating in this year’s JMore JBiz “Innovation in Health Care” panel discussion.  

The program was moderated by Gary Stein, and I was joined by Jon Hershfield, MFT, Director of The Center for OCD and Anxiety at Sheppard Pratt; Dr. Helen Hughes, Medical Director for Johns Hopkins Medicine’s Office of Telemedicine; Alan H. Shikani, MD, FACS, Chief of Otolaryngology-Head and Neck Surgery at LifeBridge Sinai Hospital, and Adam Silverman, DPM, Wound Care Medical Director for MVS Wound Care & Hyperbarics.

The main topic was the current state of health care in this country and highlighting some new advancements in various medical fields and the challenges each of the panel members envision for the next couple of years.  

I highlighted our use of the patient-centered medical home and the accountability we have with our patients, especially those with chronic disease, to maximize their health outcomes and care experience. 

What people want from their care providers is expert care to maximize their health outcome and also to have the best possible care experience. Since most patients are not scientists, it is hard for them to know if the care they receive is truly driving their health outcome. But they can judge their care experience, especially regarding timeliness. Care that did not actually follow the evidence and drive a better health outcome may actually be judged favorably by the patient because it was fast. An example of this would be the patient who is efficiently seen and receives an antibiotic for a viral respiratory tract illness. The patient is receiving care that is not of high value but is perceived as high value by the patient because it was easy. In this case, a system that is seen as “innovative” by the patient because it is faster than other care settings is not actually a value-added improvement.

I enjoyed all of my colleagues’ presentations and I was convinced that their work was truly innovative. The one that interested me the most was that of Dr. Hughes. She described the success of Johns Hopkins in using telemedicine prompted by the pandemic and health insurers lowering the barriers to implementation. We will reach out to Dr. Hughes because GBMC has a lot to learn from her experience. 

If you are interested in watching the discussion, please visit here.

Let’s Thank...
This week, we are celebrating Pastoral Care Week (Oct. 23 – 29). This national celebration provides the opportunity to acknowledge our spiritual caregivers and their ministry with our patients.

Chaplain J. Joseph Hart and all the members of our Spiritual Support team are dedicated individuals who work very hard to meet the spiritual needs of our patients.  I would like to extend a sincere thanks to all members of our Spiritual Support Team, and our spiritual community partners, for always being 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.

Our Emergency Department Staff Demonstrates Their Resiliency
Over the last few years, our adult and pediatric emergency departments have been stretched to their limits. In the face of the pandemic, cyberattack and, now, workforce shortages and the surge of viral respiratory illness, our staff has demonstrated their professionalism and dedication. They have been tireless in their work to serve the community in the face of incredible adversity.

The latest increase of visits by pediatric patients with RSV and other respiratory illnesses has tested our resolve. Our peds ED and inpatient team has done a tremendous job of providing children with great care.  

I want to extend my gratitude to Theresa T. Nguyen, MD, interim Chair of Pediatrics, for communicating with the community by doing many interviews with the media. Laura B. Scott, MD, FAAP, our Director for Pediatric Inpatient & Emergency Medicine and her team have stood up against the surge and provided expert care. I also want to acknowledge Cate O’Connor-Devlin, RN, BSN, Director of Emergency Preparedness, Safety, and Security; Angela “Angie” Feurer, RN, MSN, NEA-BC; interim Chief Nursing Officer, and Mark Fisher, MSN, RN, CEN, TCRN; Senior Nurse Manager for Emergency Services, for their great leadership. Way to go team!

Get Moving to Stay in Good Health

Readers of the blog may recall that I got concerned about being overweight a few years ago when I had a high blood pressure reading. As it turned out, my blood pressure was normal. It had measured high because I had raced to give blood and I was stressed and had not taken enough time to calm down before the measurement and it was not repeated. 

The high measurement, however, had a positive effect on my health because it caused me to reflect on my weight. I was the heaviest that I had ever been in my life and my body mass index (BMI) showed that I was overweight. 

We know that being overweight, obese, or morbidly obese shortens your expected life because being overweight leads to health problems like diabetes, kidney disease, and heart disease to name just a few.

I realized that I was taking in too many calories for the amount of exercise I was getting. As for the calories, I committed to reducing my intake (but not very much because I love to eat) and I committed to getting regular exercise. My problem was that I got up early and went to work and I had many evening work commitments, so I was not getting enough exercise. The pandemic actually helped me because I had many fewer evening work commitments so I could go for a jog before dinner. If I had an evening commitment, I got up earlier to run before work (ugh). This discipline helped me lose 25 pounds and get back into a normal weight for my height. 

We should all be concerned about the obesity epidemic in our country. Our average lifespan is already going down because of the increased rate of suicide and substance abuse (coupled with the effects of COVID-19). If we don’t reduce obesity with its increased rates of chronic disease, our lifespan will go down further. 

I know that it is much easier for me to commit to exercise than it is for people with less resources, young children to care for, longer commutes, and many other valid reasons, but we must find simple ways to stay active.

So, this Saturday we are starting our Walk with a Doc program at City Springs Elementary/Middle School. This free program is for people of all ages and abilities. During each Walk with a Doc session, a GBMC doctor will provide a brief overview of a health topic and the remainder of the time they will spend time walking with patients and enjoying fun conversation. It will be a fun and safe way to go for a walk, learn about health, meet new friends, and burn more calories. Walking is something that most of us can do if we figure out how to build it into our daily schedule.

For our inaugural walk, I will be joined by James Baronas, MD, Medical Director for GBMC Health Partners Primary Care—Jonestown, along with his colleague, Priya S. Little, MD, a family medicine physician, and Wayman Scott MS, MTS, LGPC, Associate Director of Diversity, Equity, Inclusion, and Community Relations at Gilchrist.

We are partnering with primary care in this program because each physician, within our 12 advanced primary care practices, is accountable with you for your specific health goals, and they want to help. Our teams manage chronic diseases, but they would prefer to practice preventive medicine to help you avoid chronic disease in the first place.

If you are interested in taking steps for a healthier lifestyle and learning about a current health topic from a GBMC healthcare provider, then come out this weekend and spend some valuable time enjoying a healthy walk and fun conversation.

Hope to see you on Saturday. Keep your eyes out for information on future GBMC Walk with A Doc opportunities. 

Passing of A GBMC Giant
Earlier this week, many of us were saddened to hear about the passing of Benjamin R. Civiletti, former U.S. Attorney General (AG) and former Chair of the GBMC HealthCare Board of Directors, and for whom our Civiletti Conference Center is named.  

Ben brought a keen intellect and concern for others to both his work as AG and as a leader of our healthcare system. He became involved with GBMC due to his legal expertise and commitment to the local community. Under Ben’s leadership, GBMC expanded to better serve the community. His vision of service continues to this day as we seek to provide the care we would want for our own loved ones. 

There is no doubt that we have lost someone who was very special and a great friend to GBMC.  We will always be thankful for what Ben did for GBMC and we are truly going to miss him.

Please join me in offering our condolences to Ben’s family and friends.

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. Our pharmacists work with our physicians, nurses, and advanced practitioners to help maximize the health outcomes of our patients. In this era of dramatically increased drug costs, they help assure that we are not wasting resources by using expensive drugs when less costly ones will get the same outcome. Please join me in thanking them for all that they do to drive us closer to our vision.

Stepping Up to Get the Job Done

All industries continue to deal with workforce shortages. Hospitals and other healthcare providers are dealing with staffing as well. Most other industries can produce less product or shorten their hours of service. In healthcare, especially in hospitals, this is not an option. The hospital needs to be open 24 hours a day, every day.

Nurses and nursing technicians are the largest segments of the workforce of any hospital. At GBMC, we are fortunate to have so many expert, dedicated staff members who pull together no matter what the challenge to treat every patient as if they were their loved ones. Addressing the nursing workforce shortage requires a multifaceted recruitment and retention approach.  

In July, Angela “Angie” Feurer, RN, MSN, NEA-BC, stepped into the role of Interim Chief Nursing Officer. A seasoned nurse leader of 24 years, Angie has been the Director of Nursing for the Emergency Department, Intensive Care Unit, Medicine, Telemetry, SAFE, and the Stroke Program. She also played a critical role as an Incident Commander during the cyber-attack and COVID-19. Angie has excelled at transitioning into this role while earning her Doctor of Nursing Practice at the University of Maryland. 

The nursing shortage is a major focus of Angie’s work. The nation was already experiencing a shortage of nurses and the pandemic exacerbated the problem, with people leaving the bedside for many reasons: retiring early, needing to care for a family member, experiencing burnout, or looking for remote work opportunities. As an independent community-owned system of care, GBMC is agile enough to quickly implement innovative solutions to ensure we are recruiting and retaining top nursing talent. Here are just a few of the ways we're attracting (and keeping) the best nurses within the GBMC HealthCare System:

• Supporting our nurses as lifelong learners. We're encouraging nurses to further their education and easing their financial burden with tuition assistance, loan forgiveness, tuition discounts, scholarships, as well as reimbursing for credentialing, conferences, and certifications.  

• Pay incentives. In addition to regular market adjustments to ensure our rates of pay are competitive, we've revamped our supplemental/ASAP nursing program -- nurses who "float" to different units -- to account for a nurse's years of experience and adjusted pay rates accordingly. There are also other new pay incentives for nurses who precept new nurses, run charge, and take on-call shifts. 

• Referral bonuses for employees who refer nurses to us. If a full-time nurse is hired, the referring employee gets $5,000!

• Investing in wellness. Nursing at the bedside is physically, mentally, and emotionally exhausting! GBMC nurses have access to free on-campus massages, an "Oasis Room" in the Civiletti Conference Center with massage chairs and virtual meditation headsets; free yoga classes (virtual or in person); on-site acupuncture, our employee fitness center, and more opportunities for self-care. 

• Growing nursing leaders. When we recognize a talented nursing leader, we want them to stay with us. We have created clear pathways to help nurses who have furthered their education and demonstrated a commitment to GBMC ascend into hospital leadership. Tracks in the Professional Excellence Model are focused on administration, quality and safety, or education.

The nursing shortage is not a challenge we can solve overnight, but I am grateful to Angie who is working closely with our colleagues in Human Resources, Nursing Leadership, Marketing, IT, and Finance to ensure GBMC remains a premier company for nursing careers. 

One outstanding nursing career to highlight is that of Kristan Zylka, BSN, RN, who has been welcoming babies into the world at GBMC for nearly 20 years. I love seeing the sheer joy Kristan clearly takes in her nursing practice. Check out this video of her and adorable baby Amir. 

Domestic Violence Awareness Month
October is Domestic Violence (DV) Awareness Month. We shine a light on domestic violence to help women and men get through challenging and frightening circumstances, educate others about those challenges, and share resources to ensure survivors get the support they need. Under the leadership of Laura Clary, RN, FNE-A/P, SANE-A, our SAFE & DV program, serves survivors of domestic violence, including survivors of Intimate Partner Violence (IPV). Sexual assault and domestic violence patients not only get quality medical-forensic treatment, but also receive crisis intervention and safety planning. Our SAFE team has worked hard to expand across our healthcare system and into the community, and our primary care and emergency department teams have been trained on the signs of abuse and the steps to take when they see red flags.  Let me thank them for their hard work and expertise, and for educating our community.

Honoring their Amazing Work
This week, we are proudly celebrating our emergency nurses during ER Nurses’ Week (Oct. 9 – 15). This year's theme of Standing Strong acknowledges that a nurse’s days in the emergency department are challenging and highlights their resiliency.  During the week, a few of our nursing colleagues were recognized for their great work this year.
--Hayley Kelly, RN, Unperilous  Hero of the Year 2022
--Jacob McNeal, RN, Adult ER Nurse of the Year 2022
--Rachel Arden, RN, Pediatric ER Nurse of the Year
--Laurie Taylor, RN, Unwavering Solider of the ER
--Robert Freund, RN, Atlas of the ER
Please join me in honoring and thanking them and all of our ER Nurses!  Pictured left to right:

Thank you!!

I want to thank all the members of our GBMC security staff, as this week is also Healthcare Safety and Security Week (Oct. 9-15). Our security officers are on the frontlines working in many locations around the hospital, including the emergency department, main entrances, and parking lots, to keep everyone safe. They work side-by-side with clinical teams in high-risk areas, employing de-escalation skills and interventions to ensure the safety of both our staff and our patients. Please join me in thanking our security staff for their hard work and for the strong commitment and diligence they display in the practice of their profession.

Care management professionals have always played a major role on our healthcare team, making a positive impact on health outcomes and cost containment. They work with patients and families, the healthcare team, and with payers, facilitating care and services while assuring that resources are utilized effectively. Although their role may be less visible than that of the direct, hands-on caregivers, care management professionals have an increasingly significant role in the health care industry. As expert advisors and advocates, they lead the patient through the often-overwhelming puzzle that is our healthcare system, finding the optimum value for the patient and assisting physicians through the identification of resources and services.  So, please join me during Case Management Week (Oct. 9-15) and thank our care managers for their hard work.

October is Breast Cancer Awareness Month

GBMC’s Sandra and Malcolm Berman Comprehensive Breast Care Center has provided evidence-based care with kindness and compassion to patients since its inception. The Center was designed to co-locate our breast imaging and radiology experts with our outstanding breast surgeons. The Center collaborates with other members of the GBMC Sandra and Malcolm Berman Cancer Institute, including social workers, integrative care providers, and oncology support staff. 

In the spirit of continuous improvement and to ensure that our Breast Care Center stays up to date, their leadership held an off-campus retreat earlier this year. Leaders from surgery, medical oncology, radiation oncology, pathology, genetics, nurse navigation and the tumor registry attended the retreat. This event helped standardize diagnostic and treatment recommendations and goals of care including recommendations for genetic testing, evaluation of cases with high-risk pathology, and management of disease that has spread to the axillary lymph nodes. There are plans to continue this discussion annually, as the science is progressing rapidly. 

This group of talented professionals have an extremely collegial working relationship and they hold themselves accountable for providing our patients with optimal cancer care.

Please join me in thanking Dr. Sara Fogarty, Director of the Center, and her entire team for all that they do for GBMC and our patients.

Much to Be Thankful For…
This week, during Healthcare Foodservice Week (Oct. 2-8), I would like to thank my colleagues who work hard to keep our patients and staff fed. This group does much of its work “behind the scenes,” but their work is vital. So, when you see members of our food service staff, please thank them!

Healthcare Supply Chain Week (Oct. 2-8) is also celebrated this week and applauds resource and materials management professionals for all they do to keep us stocked with what we need to get the job done. I am so grateful to Brian Riemer, our Executive Director, Supply Chain, and his team for all they do for GBMC and our patients. 

Our pediatric nurses are a special group of medical professionals who provide expert care and compassion to young patients. Pediatric Nurses Week (Oct. 3-7) calls attention to their critical work. I want to salute the efforts of our pediatric nurses this week and their impact on their patients, families, and communities.

Please join me in celebrating all GBMC physician assistants (PAs) this week during National PA Week (Oct. 6-12). This is the week that highlights the PA profession and showcases the value they bring to today’s healthcare team. Let me thank our PAs for their commitment to their patients and for all their hard work every day.

Again, my deepest gratitude to you all for everything you do for our patients and staff!