A Year in Review: Reflections from 2023 and Looking Ahead to 2024

There are only a few days left of 2023, and what a year it has been. We have certainly had our ups and downs. I can’t deny that we experienced significant financial challenges; however, thanks to our incredible leaders and workforce, we are in a much better position now. 

In November, we opened our Louis and Phyllis Friedman Building, which is a wonderful symbol of GBMC’s bright future! As things have gotten underway in the new building, we’ve continued construction on the Sandra R. Berman Pavilion, the future home of the Sandra and Malcolm Berman Cancer Institute. As we have been modernizing and making improvements to our campus, we have remained steadfast to our commitments to advanced primary care and improving access to care in underserved communities. We have made such strides in quality improvement that we were recognized nationally by the president and chief executive officer of the Institute for Healthcare Improvement this month. 

In addition to the highlights above, I wanted to take a moment to share some of our other significant recognitions and accomplishments this year: 

• Baltimore Sun – Best Hospital 
• Baltimore Style – Best ER/Hospital 
• Baltimore Style – Best Vein Center 
• Baltimore's Child – Best Place to Deliver Your Baby 
• Baltimore's Child – Best ER for Kids 
• Baltimore's Child – Best Pediatric Hospital Runner Up 
• Baltimore Jewish Times – Best ER/Hospital 
• Baltimore Jewish Times – Best Vein Center 
• Forbes – America's Best Employers 
• Newsweek – America's Best Maternity Hospitals 
• HIMSS – EMRAM Stage 7 Revalidation  
• Global Healthcare Exchange (GHX) – Best 50 Healthcare Provider  
• American Hospital Association – One of four finalists to receive the Foster G. McGaw Prize for Excellence in Community Service national award 
• Baltimore Magazine – Eight Excellence in Nursing winners 
• Newsweek – America's Greatest Workplaces 2023 
• The Luminis Health Gilchrist Lifecare Institute – Gilchrist’s joint venture with regional healthcare provider Luminis – began to offer elder care and hospice care in Prince George’s County, Maryland’s second most populous subdivision with nearly one million residents. Through this innovative partnership, we are extending our reach to provide the highest quality counseling, support, and care to even more Marylanders with serious illnesses so they may live life to the fullest. 

I’m proud of the groundwork we have been laying for over a decade and of what we have accomplished at GBMC HealthCare in 2023. We look forward to what 2024 will bring! Thanks to the entire GBMC family and Happy New Year! 

Warm Wishes

As we enter into the Christmas holiday, I send you all warm wishes and hope that you have the opportunity to enjoy well deserved downtime with those closest to you. In the spirit of the season – which transcends religious and cultural boundaries – I extend my heartfelt gratitude to our remarkable staff, volunteers, patients, and the community we are privileged to serve.

As we go about our festivities, let this be a time of giving back, of extending kindness to one another, embracing the true essence of community, and being a source of comfort to those around us. 

To our extraordinary staff, your dedication is the bedrock of our success. In this season of giving, your daily contributions make a lasting impact on the lives of those we serve.

To our volunteers, your selflessness embodies the spirit of community.

To our resilient patients, your strength and trust inspire us. May this season bring you comfort and moments of joy.

Wishing you all a season filled with goodwill, shared laughter, and the joy of making a positive difference in the lives of those around us.

Showcasing Our Excellence in Quality Improvement

GBMC HealthCare was honored to have been highlighted during this week’s 2023 Institute for Healthcare Improvement (IHI) Forum. During his opening address on Tuesday, Kedar Mate, MD, President and CEO at IHI, called out GBMC as a model of whole system improvement. He specifically pointed to the way our teams have embraced our lean management system (LMS) as part of our culture, referring to it as “embedded quality.” 

Our teams with Dr. Mate during his October visit.

We had the privilege of hosting Dr. Mate for Grand Rounds in October. During his time with us, he got to see LMS in action. He witnessed firsthand our commitment to learning and continuous improvement. This is part of what he highlighted during his keynote. He recognized that as part of our LMS process, senior leaders actively participate in daily team huddles where impediments to providing optimal care are identified and addressed using problem-solving tools. Our front-line teams proactively assess failure modes, collaborate with colleagues across the health system to create data visualizations, and foster ingenuity, leading to a seamlessly embedded operating system that has become second nature to the individuals involved. 

In his remarks, he described our systems as “habitual” – so engrained that we don’t know we do them anymore – it's just the way we work. 

I’m grateful to each and every member of our staff who has adopted a mindset for continuous improvement. We are fortunate to have the expertise of Carolyn Candiello, our Vice President of Quality and Patient Safety, who is leading the charge on this work, and our Quality and Safety team members, like Michele Patchett, MSN, RN, Director of Process Improvement/Innovation; Kerrie Walsh, RN, BSN, CPHRM, Patient Safety and Accreditation; Sarah Muslim-Lefebvre, Senior Program Manager for System Improvement; and Katie Koestler, BSN, RN, CEN, whose efforts support LMS and build capability and capacity in the workforce. 

It fills me with pride that our health system is being recognized at the national level. It is extremely meaningful that the innovation and best practices of our own GBMC HealthCare family was highlighted among 5,000 peers who really know and care about quality improvement, and I appreciate Dr. Mate acknowledging our successes. 

And later that day, Dr. Mate gave a virtual address at the open meeting of the Health Services Cost Review Commission, and he called out GBMC as a model to be emulated by others! I am so grateful to all on our team for embracing continuous improvement as our business model. It is clearly pushing us faster towards our vision of being the community-based true system of care that is capable of treating everyone as we want our loved ones to be treated! 

The Employee and Volunteer Holiday Meal – A Time-Honored Tradition

When reflecting on what sets GBMC HealthCare apart, my thoughts instinctively turn to our remarkable people. Considering the substantial time we invest in our workplaces, having colleagues who share our passion and treat us like family is truly invaluable. It's our exceptional workforce, comprising both employees and volunteers, that has cultivated a culture akin to a close-knit family over the years—this is the essence of the GBMC difference. 

Each year, I look forward to the annual Employee and Volunteer Holiday Meal because it gives us another chance to express our gratitude to those who help bring us closer to our vision of providing the care we would want for our loved ones each day. This year’s meal was held on Thursday, and I want to thank the Human Resources team for their invaluable support in orchestrating this event and our Food and Nutrition team for preparing the delicious food. As always, it was a wonderful way to embrace the holiday spirit and acknowledge the dedication of our GBMC family. 

Helping Another Organization in Providing the Care We Would Want for Our Own Loved Dogs! 

Our friends at the Maryland Society for the Prevention of Cruelty to Animals (MDSPCA) called us on
the day before Thanksgiving to see if we had any cloth gowns that they could have. You may have read that there is a viral epidemic that is affecting dogs, and the MDSPCA had to send the dogs in their shelter to foster care until the epidemic subsided. They wanted to help the volunteers who would take the animals into their homes by giving them reusable gowns. Brian Riemer, our Executive Director of Supply Chain, provided some gowns from our warehouse since we use disposable gowns. Rodney Thomas, Material Handler and Shift Lead, helped us get the gowns from the warehouse and hand them off to the MDSPCA. I decided to give Rodney a small token of my appreciation, a NY Giants cap, for helping us in a pinch! (I was also kidding Rodney since I know that he is a die-hard New England Patriots fan!) 

Happy Chanukah! 

Chanukah began at sundown on Thursday, and I want to wish all those of the Jewish faith a Happy Chanukah. All are invited to join GBMC Spiritual Support Services and Rabbi Benjamin Shalva for a celebration on Monday, December 11 at 4:00 p.m. in the new Yvonne Kahlert Chapel in the Louis and Phyllis Friedman Building. We’ll have a spirited and soulful celebration lighting Chanukah candles, singing songs, telling stories, and learning about the deeper significance of this joyous holiday. 

Recognizing Our Pediatric Emergency Department 

In case you missed it, our very own Theresa Nguyen, MD, MS, FAAP, Chair of Pediatrics at GBMC, shared important information about what we need to know about RSV and the RSV vaccine on NBC Nightly News with Lester Holt. I’m proud of our team for being a voice to speak broadly on this issue. 

Advancing Healthcare Transformation at the State Level

The U.S. healthcare system has the best trained physicians, nurses and other clinicians in the world, and they work very hard, but as I have written many times, they work in a system that is in desperate need of transformative redesign. The payment system has fostered our “traditional” model, which is a bit like a game of Whack-a-Mole, with well-intentioned smart people addressing acute problems as they arise without a commitment to being accountable for improving the individual's health over the long run. The traditional fee-for-service approach means more visits completed and more procedures performed equals more profit. It is a sobering statistic that we spend 40% more per capita on healthcare than any other industrial country, and our outcomes for chronic illness are not as good. And now we have the added problem of medical debt, which has become the biggest single cause of bankruptcy in the United States. 

We know that it is much better for all involved if we build relationships with patients in the primary care setting and remain committed to helping them stay healthy and out of the hospital. Treating patients only when they are sick or seeing them in a hospital setting for preventable issues is not doing them any favors and is costly to the country. 

That is why Maryland implemented “global budgets” within its “All Payer” Model and waiver with the Centers for Medicare and Medicaid Innovation Center. This reimbursement system gives hospitals a fixed amount of revenue each year, encouraging them to reduce unnecessary hospitalizations, procedures, tests, and more. GBMC HealthCare had already committed to holding ourselves accountable for the improved management of chronic disease and for keeping patients out of the hospital, so we quickly accepted the concept of the global budget when it was introduced in 2014. Then, when the voluntary Maryland Primary Care Program (MDPCP) was introduced to support the delivery of advanced primary care throughout the state, we eagerly decided to participate, since this would provide new resources to cover the cost of the patient-centered medical home.  

We have been supporters of the global budget and MDPCP because at their core, they are focused on doing the right thing – being accountable with patients for their health and successfully managing (or preventing) chronic conditions in the outpatient setting. Now, I am intrigued by a new program being introduced by the Centers for Medicare & Medicaid Services (CMS). It is still in its infancy but seems like it could be the next critical step in healthcare transformation towards better value. 

The new program is called the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model and aims to work with states in controlling healthcare costs, improving population health, addressing social determinants of health, and promoting health equity. This program involves a voluntary, state-driven approach where states as a whole can apply to participate. This differs from MDPCP because with that program, individual healthcare organizations within the state could decide whether to participate. That meant that transformation was only happening in silos since not all our healthcare institutions within our state were required to embrace this approach to care delivery. The AHEAD Model better marries the concepts of the global budget and MDPCP in a way that would more effectively force transformation uniformly. 

Unless there is a broader scope of adoption of the advanced primary care mindset with a focus on providing accessible and equitable healthcare opportunities to all, the system will remain broken. Medical debt will continue to cause bankruptcy, and many people will continue to not have access to the care they need when they need it, in the most appropriate setting. 

We do not yet know which states will opt for the AHEAD Model. But, if Maryland opts in, I feel confident that GBMC HealthCare is well positioned for success because we have laid so much groundwork over the past decade. I am excited to see how this new program might move the nation toward a better healthcare system.