Thanks for Helping Save the Lives of Babies

We frequently talk about GBMC’s top-rate cancer care, women’s services and our Emergency Department, but we don’t laud our pediatrics department as often as we should. Pediatrics is an important part of GBMC, meeting the healthcare needs of the children of our community. A critical part of pediatrics and our organization is our Neonatal Intensive Care Unit (NICU), and 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 born too small, too sick or too soon.  While many people expect to find large NICUs in the big academic medical centers, isn’t it good to know that one of the area’s leading NICUs is right here in the community – at GBMC? The vast improvements that have been made in neonatal care through the years have certainly been extraordinary. We can care for babies born weighing a mere two pounds or less and help them thrive.

I had the opportunity to meet many of the “graduates” of our NICU at GBMC’s 23^rd annual Father’s Day 5K last weekend. The outpouring of community support was incredible. It was great to see so many parents of former NICU babies, as well as so many dedicated members of the community and the GBMC staff come out and run for this terrific cause – raising money for the NICU and the technological needs that help us care for so many babies. I’m proud to report that this year’s event raised more than $97,000 for the NICU, which is phenomenal! I thank everyone involved for your outpouring of support.

Last year was my first Father’s Day 5K race (within only five days of arriving at GBMC) so this year I knew the drill! Not only did I get to meet our long-time MC Denise Koch from WJZ-TV, who is also a former GBMC NICU parent, but I met so many wonderful people, handed out awards and truly felt so much pride for the wonderful volunteers as well as GBMC’s NICU doctors, nurses, technicians and others who dedicate their lives to the health of babies.

I ran again in the race this year too…I’m not divulging my time, but will say I’m grateful that running with me was with C.J. Marbley, our wonderful clinical nurse manager in the medical intensive care unit and Dr. Jeff Sternlicht, our Chairman of Emergency Medicine! I knew I was in good hands with the two of them by me if anything went awry during my race!

I also want to mention our mock Joint Commission survey that was held last week… not only do these mock survey exercises help us to be continually ready for a joint commission visit, but proves that GBMC is constantly working toward improving how we deliver healthcare to everyone’s loved ones. I’ve been in healthcare a long time and used to fear surveys by the Joint Commission.  I don’t anymore. I realize that these surveys are a mark of approval and that we must be ready all the time. GBMC is continually improving and we are at the ready for our next survey. 

Graduations Serve as a Reminder of the Importance of Education

‘Tis the season for graduations and end-of-the-school-year celebrations. Many of us have a personal connection to graduation this year. Perhaps you have a loved one graduating from high school, college or even preschool. Maybe you are the one celebrating this special milestone in your life. One of my sons just graduated from college and there is no way to express the pride a parent feels at such a momentous occasion. Every year, GBMC celebrates and applauds graduates for their accomplishments in the Greater Connections Honors Graduates edition – don’t forget to check it out when it hits publications stands and the InfoWeb in a few weeks.

Speaking of education and milestones, GBMC takes continuing education for staff very seriously. The tuition assistance program is just one of the ways in which our employees can get help with pursuing a degree. We also offer educational assistance through the T. Rowe Price Family Education Fund, the Physician Education Fund, 1199 Service Employees International Union (SEIU) Training and Upgrading Fund, as well as partnerships with Drexel University Online, Kaplan University and Stevenson University for nursing. This allows employees to either increase their expertise in their current field, or explore a whole new career in healthcare. What it comes down to is this – we are invested in our workforce and believe that knowledge is important, especially for healthcare professionals and especially for those of us who want to make our current system better.

Sarah Schwarzmann is a great example of an employee pursuing educational opportunities. Sarah, a User Support Specialist in the MIS Department, is working towards a nursing degree thanks to the T. Rowe Price Family Education Fund.  Chris Cooper, an Accounting Specialist in Corporate Finance, is also advancing his education through the fund. Currently studying Accounting at Carroll Community College, he plans to continue with graduate studies at University of Baltimore.

As humans, we often look for ways to continue to grow and better ourselves as we age, and I can think of no better way to do this than through education. Take advantage of all that GBMC’s tuition and educational programs have to offer. You’ll be glad you did. Have you earned a degree thanks to GBMC’s education programs? I’d love to hear about your experience.

Finally, on an unrelated note, I just returned from a business trip with Eric Melchior, Executive Vice President and Chief Financial Officer, and Susan Martielli, General Counsel, to speak with the companies that sell us catastrophic malpractice insurance. We have to convince our reinsurance companies that we are doing the right things to make our care as good and safe as we can make it. I want to thank you all for your continued diligence in standardizing the work we do and your focus on providing quality care in a safe environment. When we make our healthcare system more reliable, it helps us to minimize risk and contain insurance costs. Money saved can then be dedicated to other areas of importance.

P.S. – The InfoWeb and our Human Resources Department can provide more information about educational opportunities at GBMC.

• Tuition Assistance and T. Rowe Price Family Education Fund are featured on the Human Resources pages, under “Organizational Development and Training.” Or contact Sharon Croghan at ext. 3074.
• Physician Education Fund information can be found on the Nursing page, under “Educational Offerings/Scholarships.” Interested in Nursing school at Stevenson? Contact Jami Hohner, School Affiliate Liaison, at ext. 3704.
• To find out more about the 1199 Service Employees International Union (SEIU) Training and Upgrading Fund, stop by Human Resources to pick up a form.

Why Do Patients Wait in the Emergency Department?

I frequently receive letters from annoyed patients who had to wait to be seen in the Emergency Department. The writers often accuse me of not caring about their pain or their time and suppose that I have never gone to the ED myself to see what happens there. Nothing could be farther from the truth.

I often go to our Emergency Department to see how things are going and to thank our marvelous nurses, physicians, technicians, patient access reps, and others for their wonderful hard work, skill, caring, and perseverance. I have been a patient in an overcrowded emergency department, I have accompanied loved ones in overcrowded ED’s, and I have worked as a doctor in an overcrowded ED. When my loved one has an urgent or emergent medical need, I want them to be seen right away. I want this for everyone’s loved one.

The main cause of waiting in any Emergency Department is the bottleneck created by patients who need to be admitted to a floor of the hospital when there are no beds. Our largest fixable source of this problem is the artificial variability in scheduling elective surgeries. Hospital administrators own this problem and we are fixing it at GBMC. We must get better at scientific management to reduce delays in all of our care processes.

I get very frustrated with the letter writers who are complaining about the delays, not because I shouldn’t hear about the problem, but because the writers accept no responsibility for the problem. Patients are, in part, responsible for the second biggest reason for waiting in the Emergency Department - a healthcare system that is poorly designed to meet the needs of the patient. You see, our system is pretty good if you have an appointment with your usual provider of care. But if you have an acute need or a flare up of a chronic problem and your doctor’s office is closed or cannot accommodate you, there aren’t many good choices other than the ED.

ED waiting is nothing more than a characteristic of a system in desperate need of improvement. Emergency Departments were designed to take care of emergencies and we have now made them the path of least resistance, the catch-all for everything that is inconvenient for the rest of the system. This system would get redesigned much faster if people would demand better care! Ask your physician what he or she is doing to make care more accessible.

I laugh when I see billboards announcing shorter ED waits or a place you can check the wait online. If you have time to wait…you don’t have an emergency by definition! Our society is not well-served by driving patients who shouldn’t be there to the Emergency Department. We need better access to teams of healthcare providers who know us and our problems, who have our records and who have designed systems that can accommodate us when we need them!

At GBMC HealthCare we are racing to redesign our systems to give people in our community the care that we want for our own loved ones. We are working hard to eliminate waits and delays. We want to get to a new world where your primary care practice is the place you turn to, your medical home.  And while our physician offices won’t be open at 2 a.m., we will be open into the evening and earlier in the morning to better accommodate patient schedules so that you won’t need to go to the ED and wait. And, our primary care practices will have your electronic medical records so that if you do need to visit our ED, we’ll have access to your medical history to better care for you. It’s what we call integrated care. We’re working hard to advocate for true reform of our community’s healthcare system.

Is finding an Emergency Department with short wait times an illusion? I believe so. It’s really up to the community as a whole to be a part of the solution to the overarching issue of long ED wait times. Are you ready to get in action with us to create a system of better care? Please do your part.

At the Ready to Serve Our Community…with Fortitude and Compassion (and Fresh Fruit!)

This week, I really got a taste for how important community partnerships are for GBMC. We have the opportunity to make quite an impact with the many things we do to help our neighbors as well as our own employees.

On Thursday I was fortunate enough to enjoy some time outdoors while touring the opening day of the GBMC Farmers’ Market. Thanks to Mike Forthman and Keith Sappington, who explained the genesis of the market, I had the opportunity to stop by and meet with some of the local vendors who brought their goods to our campus. I really got a sense for the importance of supporting our local community while also promoting healthy eating by bringing wholesome food right to our employees.

Keith explained that by providing our staff, as well as the local community, with the opportunity to buy local meat and produce, we are helping to reduce our carbon footprint. Events such as this really support GBMC’s vision for creating a healthy community by focusing on what people need to stay healthy, or become healthier. In this new era of healthcare, we’re focusing more on prevention and long term wellbeing, and eating nutritious foods certainly plays a major part in maintaining health.

Check out this short video to get a true taste for what the GBMC Farmers’ Market is all about: http://vimeo.com/24613209

Then, this morning, GBMC hosted the quarterly Towson 4 Facilities Managers Meeting which included facilities executives and managers from St. Joseph's Medical Center, Sheppard Pratt Hospital, Towson University and GBMC.  Dan Tesch and Mike Forthman provided an overview and gave tours of our Maryland Region III Alternative Care Site (ACS) and Training Center at GBMC, which is located in the former South Chapman Gym.

The intent was to share with them the capabilities of the ACS should an emergent situation like a natural disaster or other major catastrophic events develop in which any of the Towson 4 would need surge capacity. The ACS is equipped to hold upwards of 100 patients in an emergency situation and also has a back up command center for GBMC.   The site is also used as a training center for Emergency Management skill building by GBMC staff as well as members of Region III.

We’ve been thinking a lot about how to prepare for such major events and how to care for mass casualties, especially in the wake of the devastating tornadoes in the Midwest over recent months. The tornado that ripped through Joplin, Missouri, devastating that community’s hospital, certainly served as a wake-up call. When I heard about this tragic event, I couldn’t help but internalize it – what if this happened at GBMC or to one of our neighboring hospitals? Would we be ready to spring into action to help all those people in need? I believe the answer is yes. In fact, back in November 2010, I attended the signing of the Baltimore County Memorandum of Understanding (MOU) – an agreement between GBMC and six other local healthcare and educational institutions  that states, in the event of a community disaster we will be able to come together to provide life-saving medical care to all those affected. This is a prime example of community partnership forged for the benefit of the people who live here.

Finally, I would like to extend my congratulations and gratitude to internal medicine physician Dr. Hmu Minn, the recipient of this year’s Compassionate Caregiver Award, which I had the pleasure of presenting on June 1^st.

Dr. Minn was recognized for going above and beyond in the care of his patients and in the mentoring of GBMC’s medical residents. I believe this statement, which was part of the nomination letter submitted by 30 GBMC residents, really sums up the qualities that Dr. Minn brings to his profession:

“No one else but the people he has touched would really know his kindness and commitment he has towards all the residents and patients who come his way. Dr. Minn is an example of humility and compassion when it comes to patient care.”

   

I’d also like to congratulate and thank our staff members who were recognized for Honorable Mention for this year’s Compassionate Caregiver Award:

Elizabeth Bishai - Gilchrist Hospice Care volunteer, Abby Dentry, Neonatal Nurse Practitioner in GBMC’s NICU, Linda Henderson, RN,  Clinical Program Manager, Acute Care for the Elderly Unit and Debbie Johnston,  Clinical Social Worker, Women’s Services.

All of you exemplifying the kind of expert, compassionate care that we would all want for our own loved ones.

GBMC HealthCare System – Our New Vision, Our New Plan to Get There

Shortly after I joined GBMC HealthCare, Inc. as President and CEO just about one year ago, I was challenged by GBMC’s Board of Directors to answer, in what direction should we go to keep GBMC strong well into the future?

We have taken this question quite seriously and I want to share our answer with you.

We’ve just finalized GBMC’s three-year strategic plan (FY ‘12 – FY ‘14), a huge undertaking that solicited the input of many people throughout the system. A new vision for GBMC has been created and I’m pleased to share that our long-term strategic plan is quite different from past plans and is unique in our region. It’s not about edifices and how big of a new patient tower we can build. Rather, it serves as the foundation for a solution to what ails the current national healthcare system, focusing on what the people in our community truly need and want to stay healthy, or become healthier. 

In creating our plan, we first needed to assess where we were as an organization and identify the things we were doing well. We next needed to ask ourselves where we were missing the mark through the eyes of our patients.  This process started with our Board of Directors’ strategic visioning retreat where we began shaping the organization’s new path.  We discussed how America has the best trained doctors and nurses in the world, yet we are in a deep mire. Our system is very costly and is financially unsustainable. In addition, our care is frequently disjointed and the ever-increasing number of people with chronic disease is frequently not well served. The Board challenged themselves to think of a better system that they would want for their own family members. Thanks to the leadership of the Board’s strategic planning committee, led by Chairman Jim Stradtner, we developed a vision of a more patient-centric system where the patient’s needs could be better met.  

So today, GBMC is moving into the future with renewed energy and increasing insight with our new vision as our guiding light. The more lengthy vision statement is summarized in the phrase:

“To every patient, every time, we will provide the care that we would want
 for our own loved ones.”

[Read the full version of GBMC's new vision as well as the strategic plan summary on the GBMC website - www.gbmc.org/strategicplan ]

With our new vision taking shape, we forged ahead with creating the plan to get there, working with the clinical department Chairmen throughout GBMC to find out what they needed to get us to this vision. We took their valuable feedback and used it to begin developing the specific areas of focus and tactics of our plan. The process was guided by the strategic planning committee and overseen by John Ellis, Senior Vice President of Corporate Strategy and Business Development, and Colin Ward, who as part of the plan has been named Executive Director of the Greater Baltimore Health Alliance. Once the committee sanctioned the plan, we took it to our full Board earlier this month and they approved it.

So, as we begin to roll out our new vision for the future, I felt it was critically important for everyone to know where we are going and how we will get there, with the ultimate goal of providing the very best care for the people in our community.

 At the heart of our strategic plan are five pillars that encompass the work to get us to our new vision:

1.   Create an enterprise-wide IT solution, e.g. Information technology, specifically Electronic Medical Records (EMR), that will provide a seamless information network between outpatient and inpatient records

2.   Improve operational performance

3.   Improve clinical outcomes and the patient experience

4.   Build a provider network to achieve the mission of developing a model system for delivering patient-centered care

5.  Create new organizational capabilities to support our new strategies

What the Future Will Hold

Moving forward, GBMC will provide the kind of care that will keep people from getting sick, or sicker, rather than just taking care of someone episodically (like when they come in with a sore throat, infection, or even complications from a chronic disease that has not been managed correctly).  This type of comprehensive care requires much more attention on prevention and a greater focus on primary care as a way to mitigate disease. We see primary care physicians and their teams as the integrators of services across the continuum. This is why our primary care practices in our employed group, Greater Baltimore Medical Associates (GBMA), have undergone a significant transformation over the past year, moving toward a patient-centered medical home model that includes extended office hours to better meet the needs of our patients, as well as e-mail communication, patient registries, the electronic record, group education for specific chronic diseases and more – this is all part of the transformation of healthcare that GBMC is leading for our community.

In fact, we have a really good example of integrated care embodied by Gilchrist Greater Living, GBMC’s geriatrics group, led by Dr. Tony Riley. This team of physicians manages the care of frail elderly from their home, to the physician office, to extended living facilities, to nursing homes, to the hospital, to hospice and between these different sites.

Building a Strong Provider Network and Capitalizing on Our Historic Strengths is Essential

In addition to an emphasis on primary care, our plan will build on our wonderful areas of excellence in specialty care. We cannot lose sight of our historic strength in Surgery, Women’s Health, Cancer, and many others. In order to be a vibrant healthcare system we will no doubt need to do surgery even better, more efficiently and with greater patient satisfaction than ever before, which is why surgery (and the success of all of our surgeons) is another main focus of our strategy for the future. We will place even more emphasis on the measurement of outcomes – and recognize that there will be an increased need to document the medical necessity of procedures to ensure that we are practicing evidence-based medicine. Dr. Jack Flowers, GBMC’s Chairman of Surgery, is leading the charge to have us report and record data so that we can be ahead of the curve when it comes to documenting our superb surgical outcomes.

We must create a more integrated healthcare system from our existing model, which must include wonderful private practicing physicians in the community as well as those physicians who are employed by the system. This vision of building an alliance of physicians is now becoming a reality with the establishment of the Greater Baltimore Health Alliance (GBHA). GBHA will be a physician governed organization comprised of employed and private practicing physician partners tied together by a common commitment to better health, better care, and lower cost and a common electronic record system that will facilitate the exchange of health information, and  help coordinate care among the practices, the hospital, Gilchrist Hospice Care and other future community partners.

In building a strong provider group, we realize that GBMC doesn’t need to employ all physicians. Across the country, the organizations that seem to integrate care well have mostly employed physicians. At GBMC, we want to build on our historic strength of outstanding private practicing doctors by aligning them tightly with our employed physicians.  This type of combined medical staff has certainly served us well over the history of GBMC. We need to build up from this area of historic strength.  

Integration is a Key Tenet to our Strategic Plan

In order to integrate care through eyes of the patient, we must have a sophisticated electronic medical record system. All GBMA primary care physician practices now have the EMR in place. We will have all of our employed specialists on the record over the next few months. And our partners through GBHA will also be helped to implement the EMR technology. Patients often get nervous and frustrated when clinicians ask the same questions and don’t have access to tests they have already taken, which results in the waste of repeating tests. This type of fragmented care is a characteristic flaw of our existing system and GBMC is leading the way in eliminating this flaw.

Healthcare Reform in Our Own Backyard

What GBMC is looking to achieve is a true reform of our community’s healthcare system. We are doing the right thing to better serve our patients. We’re focusing more on the specific needs of each patient and the health of the community. Some may worry that we could find ourselves going down a path that causes us to lose money because the payment system may not be able to keep up with the rapid changes in the way we deliver healthcare. However, being an independent, community hospital makes it much easier for us to adapt quickly as change comes. And, we have time to make the transition because all of the change isn’t going to happen overnight. It is also helpful that we are beginning from a strong financial footing; we do not have the huge debt associated with large new buildings.

It’s so important to have this plan in place for the healthy future of our organization as well as of our community. And as you can see, we’ve adapted our vision and we are now ready to be the healthcare system that “To every patient, every time, provides the care that we would want for our own loved ones.”

I welcome your thoughts and comments as we move into this new era of healthcare at GBMC…

EMS and GBMC – True Partners in Caring for a Community

Last Tuesday, I was transported by the emergency medical system.

Thankfully, not as a patient, but as a guest of Captain Chuck Vaughn of Baltimore County Fire Department EMS 1 during National EMS week. I was fortunate to receive a firsthand look into the world of EMS workers during my ridealong and how first responders and hospitals work together to ensure superior care for patients.

I enjoyed my two-hour ride with Captain Vaughn, a very well-trained and humble man who explained that the largest part of the fire service in Baltimore County is EMS, with approximately 75 percent of the calls. I also found the relationships between career and volunteer firefighters and paramedics, and how they all cover for and help one another, to be an example of teamwork at its finest. Captain Vaughn explained to me that his people are so dedicated to their jobs that when some of them come off duty, they then report to the volunteer fire station – because they love what they do.

Over the course of the two hours, I visited with firefighters at Station 1 in Towson, stopped at Fire Department headquarters and met with Fire Director Wayne Tome, who supervises EMS operations for the Fire Department, and finally visited with firefighters at Station 11 in Hillendale. 

But just as we were getting ready to return to GBMC, a call came in reporting a person stabbed (or shot, it wasn’t immediately clear) at a supermarket on Loch Raven Boulevard. Things just got exciting, I thought, as we rushed to respond to this call!  Once at the scene, police cleared us to go in and the stabbing victim, who sustained a minor laceration to the arm, was transported to GBMC where he was handed off to the very capable hands of our Emergency Department physicians, nurses and staff.  When my heart slowed down a bit, I realized just how well designed this emergency system was – when the call comes in, paramedics, fire and police are all dispatched, yet the police officers make sure the scene is safe before the unarmed firefighters and paramedics go in to care for the victims. I felt a great source of pride to be part of an even larger community system that is there for your loved one when needed. What if it were your uncle or brother who was just stabbed? You’d want to be sure there was a system there to help him. This was certainly an experience I won’t soon forget!

I would be remiss if I didn’t mention the annual GBMC Golf Tournament that was held last Monday at Turf Valley Country Club. From Jan Emerick and the Foundation staff to Dr. Rob Stoltz, Mike Forthman and the entire golf tournament committee, it was clear that countless hours were spent preparing for this great event that grossed more than $200K to benefit GBMC. I had the opportunity to golf with Dr. John Saunders, Dr. Neri Cohen and Dr. Frank Lee, and had a few good shots and a lot of not-so-good shots! But a great time was had by all and it was evident that so many community members and supporters of GBMC are truly dedicated to our future success.

There are some truly great members of our GBMC community- staff members, emergency workers, supporters and donors and many others – let’s take a moment to say thanks…

The Nearly New Sale and Three Black Tie Events

This past weekend, I had the opportunity to attend a whirlwind of gala events and dinners that celebrated excellence and recognized the spirit of community commitment. Of course, this wasn’t a typical weekend for me, and my social activities are not usually so glamorous, but when the events were all over and I had a moment to reflect back on all of the people involved, I realized just how many individuals at GBMC and in our communities give of their own time for some worthy cause.

My event-filled weekend started on Friday evening at the House Staff recognition dinner. This is truly a wonderful event because it recognizes GBMC’s residents and resident award-winners, as well as GBMC faculty members, award winning physician teachers, and those physicians who lead our residency programs. This event really spotlights a piece of our mission that doesn’t typically receive a lot of air time, which is the teaching and the preparation of the next generation of doctors and healthcare providers. The focus of all of the individuals who presented at this reception, including Dr. Mark Ellerkmann, chairman of GBMC’s graduate education committee, Dr. John Saunders, Chief Medical Officer and Dr. Hal Tucker, our Chief of Staff, was that the opportunity to mentor and teach our future doctors is what helps keep all of our attending physicians in the learning mode. It’s really a win-win for all – our residents and our attending physicians. GBMC is fortunate to have many faculty members who are so giving of their time, volunteering to teach our residents to ensure better care for our community in the future. 

On Saturday night, I had the opportunity to attend another black tie event with my wife, Tracey, at Baltimore Centerstage’s gala as guests of GBMC’s incoming Chairman of the Board, Harry Johnson. The event, which benefits the theater’s artistic and education programs, demonstrates how valuable arts programs are in the Baltimore community and the importance of community support.

I had Sunday off from galas and events but was right back in the saddle on Monday night at my third black tie event in four nights as one of the hosts for the Daily Record’s Top 100 Women in Maryland event.  GBMC was the Circle of Excellence sponsor for this year’s event and I had the honor of presenting the Circle of Excellence winners with their awards. This inspiring event recognizes Maryland women who are making an impact through their leadership, community service and mentoring. 

You can see a trend in all of the events I attended – recognizing those in our community who make an indelible impact in the lives of others. So, I would certainly be remiss if I didn’t tell you about what I did last Friday afternoon, before my weekend of galas even began. On this beautiful spring day, I walked up to Farmhouse Hill to GBMC’s Nearly New sale. It was amazing to me just how many hours so many of our volunteers put into creating this wonderful event. Not only does this sale benefit the programs and services right here at the hospital, but I realized that there are so many members of our community who also truly benefit from being able to buy a wide array of items at this sale.

I too benefitted from the many gems that can be found at this bi-annual sale! I picked up some great jazz CD’s and then came across one of my favorite movies, October Sky.( It’s a great movie about young men who attempt to launch their own rocket after the launch of Sputnik in 1957. But what really draws me to the film is how the young men go through a series of failures, learn from their mistakes, test, make changes and then try again, until they achieved success. This cycle of learning, Plan-Do-Study-Act, also called the Shewhart cycle, is a key tool of continuous improvement. We in healthcare must fully commit ourselves to this spirit of testing, learning, and continuous improvement.)

Oh, and while at the Nearly New sale I also purchased the book, The Complete Idiots Guide to Being Psychic…so watch out everyone!

But seriously, we work and live among some truly amazing and giving individuals both at GBMC and in our own communities. I was proud to be among all of these great people and hope that their giving spirits inspire others to continue down the path of volunteerism and philanthropy.