Dealing with the financial realities of today

Healthcare organizations locally and nationally have been experiencing hardships since the onset of the COVID-19 pandemic. The pandemic brought with it financial challenges that have persisted through today and have been amplified by an uncertain economy.

Unfortunately, the GBMC HealthCare system is not immune to these challenges. Like our peers, we’ve seen a dramatic increase in the cost of labor and certain contracts and are greatly impacted by inflationary increases to the prices of critical supplies and services.

While our healthcare system has a strong foundation of financial assets and tremendous community support, we are operating in an unexpectedly higher-cost business climate and we must take actions to remain successful in this new environment. 

We have initiated many efforts aimed at reducing expenses and increasing revenue. In addition to these ongoing efforts, we announced a new Labor Expense Optimization Plan this week that will allow GBMC HealthCare to once again be profitable by January 1, 2024, at the latest. 

Some key elements of this plan include:

• Aggressively recruiting nurses to ensure we have enough employed nursing staff and rely less on agency nursing support

• Scrutinizing open positions and redesigning workflows for efficiency and cost reduction

• Implementing a Voluntary Severance Plan (VSP) that enables a certain number of eligible employees in designated administrative and operational roles to volunteer for separation, while receiving a severance package to support their employment transition

If employees have questions regarding our Labor Expense Optimization Plan overall, they should follow their chain of command. 

I want to reassure you that we will overcome this challenge! Our board of directors and I are committed to ensuring GBMC HealthCare remains independent. We have held strong for nearly 58 years, and we’ll continue to do so. I am thankful for our incredible leaders, staff, and volunteers for standing united with us through difficult times. I’m also eternally grateful to our generous donors who believe so strongly in us that they help in every way they can.  

Through all of this, please know our promise to the community doesn’t change. We will continue to hold steadfast to our vision of providing every patient, every time with the care we would want for our own loved ones.

How Far We Have Come

The word "progress," by definition, means "forward or onward movement toward a destination." Over the years, LMS (and its predecessor LDM) has provided members of our leadership team various opportunities to see and applaud the work of our clinical and non-clinical staff in improving our healthcare system.  

For us to achieve our vision, leaders must have a curiosity about how things are actually working and to create the capability to learn from defects. 

Let me highlight the great work of our Department of Pathology and Laboratory Medicine. They already function at high reliability, but nearly perfect is not good enough for them.   

Our laboratory is comprised of two specialized areas of testing: the Anatomic Pathology Laboratory and the Clinical Laboratory. Often, specimens are received by Specimen Receiving/Processing that require testing from multiple areas of the Laboratory. These specimens are considered “shared specimens.” An example of a shared specimen might be a cerebral spinal fluid requiring a cell count and differential (Clinical Laboratory - Hematology) and cytology studies (Anatomic Pathology Laboratory - Cytology). 

When the Laboratory was considering a project for LMS, one opportunity for improvement was the process of how these specimens are shared between departments. During calendar year 2021, the Laboratory documented 18 instances, out of thousands (a very highly reliable process indeed!), when one or more laboratory sections required additional time locating misplaced specimens. Worse, if the process wasn’t improved, an irreplaceable specimen could be misplaced, resulting in a poor outcome or delay in patient care.

Over the course of 2022, our lab staff implemented several process changes including:

• Creating an over-arching shared specimen procedure to instruct all areas of the Laboratory on exactly how to handle such specimens.
• Improving an outdated specimen routing sheet to include the exact types of specimen containers received and, if applicable, the volume of specimen received.
• Improving the handling of shared specimens in the Clinical Laboratory areas to document exactly who received the specimens and at what time
• Organizing and providing visual cues at refrigerators that store specimens to instruct staff exactly where to place specimens after testing
• Improving handoff systems between the Anatomic Pathology Laboratory and the Clinical Laboratory

The result of these process improvements was a decrease from 18 delays during 2021 to only 3 in 2022. However, the Department of Pathology and Laboratory Medicine continues to scrutinize workflows by employing process confirmations to reach a goal of zero shared specimen delays. By utilizing improved systems, including high level mistake proofing tools such as the routing sheet, organized and clearly labeled storage areas and visual cues, the laboratory has realized an 83% improvement, punctuating the success of the Lean Management System.

How far we have come when our colleagues exhibit the knowledge on the levels of mistake proofing and our understanding of engineering the science of patient safety and eliminating errors and, in turn, improve patient care!  

Remembering Dr. Martin Luther King, Jr.

This past Tuesday, we hosted our annual Martin Luther King, Jr. Day celebration, which commemorated Dr. King’s life and vision. This year’s program, titled "Why We Can’t Wait," featured jazz trumpeter and composer extraordinaire Sean Jones, Professor and Richard and Elizabeth Case Chair at the Johns Hopkins Peabody Institute, along with live music from our very own Tiffany White, patient services assistant. 

After Jones’ speech, we presented the Spirit of King Award, which recognizes an individual who embodies the spirit and life's work of the late Rev. Dr. Martin Luther King, Jr. and who is dedicated to serving their local community. The winner of this year’s Spirit of King award was one of our volunteers, Pat King. Please join me in congratulating him and all the nominees!

I am grateful to Lisa Walker, our Chief Diversity and Learning Officer, and my colleagues on the Diversity and Inclusion Planning Committee for their hard work on this magnificent event!

GBMC is Recognized as a Great Workplace for Diversity

The GBMC vision is to be the community-based true system of care that delivers to every patient, every time, the care we would want for our own loved ones. To achieve this, we know that our workforce must represent the community we serve and that all our people must feel included and valued as members of our team.  

With this in mind, I am happy to announce that GBMC was recently named to Newsweek’s list of America’s Greatest Workplaces for Diversity 2023 as one of the top 1,000 companies in the United States. We still have a lot of work to do to maximize the benefit of our diversity and to assure that everyone feels included, but this recognition shows that we are on the right path.

GBMC was among the top companies whose employees said truly value a diverse workforce. Newsweek partnered with Plant-A Insights, a provider of market research, to carry out an independent study of companies identified to excel in diversity and inclusion efforts. The company then evaluated over 350,000 company reviews across six economic sectors and 36 industries to gather further knowledge. Through an unbiased, independent, and anonymous review, companies were ranked in the 2023 list.

I am grateful that the ratings of our people put us among the best, but we still have a lot of work to do. We are led in these efforts by Lisa Walker, our Chief Diversity & Learning Officer, and her team, who have done a fabulous job in a very brief period to accelerate our efforts. I am also grateful to all my colleagues on the Diversity and Inclusion Council for their work in helping us build a people-centered culture where differences are respected and all employees from diverse backgrounds can thrive personally and professionally.

Working Together to Recognize and Eliminate the Waste of Waiting

The former prime minister of the United Kingdom, Benjamin Disraeli, once said, “Change is inevitable. Change is constant.” We have become fairly adept within the GBMC HealthCare system at testing change and implementing what is shown to be an improvement. But when we are in times of challenge, a legitimate question is: “Could we move faster in implementing improvement?”

Recently on LMS rounds, a leader articulated that she was trying to test a change that would reduce a significant amount of wasted effort (over processing) within her department, but it required meeting with another department to enroll their leader in the change. She was told that the other leader could not meet for three weeks.

I must acknowledge that I believe that all our leaders are working very hard and prioritizing their work can be a challenge. However, when one of our colleagues makes a request for assistance in getting rid of waste, as leaders we should do what we can to help expeditiously and be fearful of waiting. We must work to reduce our time to action when we have identified an improvement. 

Our mission at GBMC HealthCare is to provide health, healing, and hope to all we serve in the community. It is our privilege to serve others, and it is our vision to provide the best health outcomes and care experience with the least waste of resources and the most joy for those providing the care. Leaders should always work to reduce waiting if it is slowing down our progression toward our vision.

Thank you to the Kroh Center

Yesterday, I had a screening colonoscopy at GBMC. My experience from start to finish of the procedure could not have been better (and the screening was negative). Before I left the Kroh Center, the attending anesthesiologist returned to say to me that he did not know that I was the President of GBMC. I want to thank Dr. Niraj Jani, the Medical Director of the Kroh Center and Roel Tiberio, the Nurse Manager of the Kroh Center and all their team for their dedication to evidence-based care and patient safety.