2017: Another Great Year for Our System of Care

As we come to the end of 2017, I would like to highlight some accomplishments of the GBMC HealthCare System this year.

There’s no doubt that we continued to move towards our vision of becoming the community-based health care system where every patient, every time, gets the care we want for our own loved ones. 

I realize that the video below only mentions a small fraction of what the GBMC family did in 2017 to move us closer to our vision. What others do you want to mention? Please share your thoughts.

Best wishes to you and your loved ones for a Happy & Healthy 2018!

Meeting a Humble Leader

Last week, I was at the Institute for Healthcare Improvement (IHI) National Forum and I had the wonderful opportunity to hear General Stanley McChrystal give a plenary address on leadership. General McChrystal graduated from West Point in 1976, became an Army Ranger and rose through the ranks. In 1990, he became an action officer for Army Special Operations, working in Joint Special Operations Command (JSOC). In 1991, he saw action in the Desert Shield and Desert Storm tours. His last assignment was as Commander, International Security Assistance Force (ISAF) and Commander, U.S. Forces Afghanistan (USFOR-A). He previously served as Commander of JSOC from 2003 to 2008, where he was credited with the death of Abu Musab al-Zarqawi, leader of Al-Qaeda in Iraq.

General McChrystal spoke about the need to communicate quickly and up and down throughout the ranks in order to get the job done as leaders. He explained how JSOC was able to defeat Al-Qaeda in Iraq by changing the existing top-down communication system and getting the whole team involved in decision making. I reflected that we do not work under such a continually high pressure, high stakes environment, but to get to our vision, we could learn a lot from General McChrystal’s work.

HITTING A HOME RUN FOR THE HOUSE OF RUTH!!
As many of you know, this year GBMC has teamed up with WMAR-TV ABC2 to collect hundreds of needed items for the Fill the House initiative for the House of Ruth. Recently, we added a different twist. Instead of collecting parking fees, we handed out flyers asking visitors to "pay it forward" by donating much-needed items to the House of Ruth. Many visitors opted to “open their wallets” and gave money on the spot to help the cause. I am happy to announce that we collected over $4,000.00 for the House of Ruth. I want to thank all members of The GBMC leadership team who worked the parking booths along with the many people who helped with the campaign.

HOLIDAY SPIRIT

I know that you who attended this year’s annual Employee Holiday Meal enjoyed the good food and festivities. This is a system tradition that draws many GBMC HealthCare employees. Music filled the air at the meals as members of the GBMC Holiday Choir put on a wonderful lunch-time concert. Thanks to all who did their part to make sure this year’s event was a success and I wish you all Happy Holidays!

HAPPY HANUKKAH
Wishing all those who celebrate the Festival of Lights a very Happy Hanukkah.

“Brand” vs. “Evidence”

Recently, I’ve been thinking a lot about a big dilemma in the U.S. healthcare system. Patients are generally unaware of facts and rely instead on reputation when they choose a hospital or healthcare provider. They often don’t know if they’ve chosen a hospital of lesser value because they’ve assumed quality based on common wisdom or “brand.” Unfortunately, this can lead to patients receiving subpar treatment because they were unaware of facts when they were choosing their provider.

At their meeting this week, The GBMC HealthCare Board Quality Committee was reviewing the phenomenal performance of our orthopedics and spine surgical teams. Under the leadership of Joy Reynolds, RN, the Unit 58 nurse manager, Lee Schmidt, MD, the chief of orthopedics, and Bimal Rami, MD, the chief of neurosurgery, they’ve improved everything from evidence-based pre-op care in the physician offices, to outstanding performances in the operating rooms and phenomenal immediate post-op rehabilitation with GBMC’s sensational physical therapists. 

This improvement work has led to outstanding outcomes as evidenced by near-zero wound infection and readmission rates and the patient engagement scores for Unit 58 (where patients go from the operating room). These are among the highest in Maryland (with the best care experience). GBMC’s prices for the procedures are significantly lower than many, if not most, other hospitals in our region (with the least waste).



Our teams serve many patients but we would like to grow our programs. I would love to hear your ideas about how to get consumers to choose value over a brand.

In The Spirit of the Holidays, Please Donate ...
This year, we are a proud sponsor of the Fill the House for House of Ruth initiative to collect everyday necessities for this partner in care. This is the first year of the campaign and the items collected will help thousands of women and children to recover from abuse and to rebuild their lives. The work that the House of Ruth performs is closely aligned with our SAFE program.

Please don’t forget to donate items at various drop-off locations on the GBMC campus, including Family Care Associates and at each of our 10 off-site primary care locations. Some of the House of Ruth's greatest needs include diapers, women's and children's undergarments, pillows, twin-sized sheets, comforters, and blankets. The drive will run through Friday, December 15. All items must be new and unopened. An additional way to donate is through our Amazon Wishlist. All items purchased through this link will be shipped directly to GBMC Marketing so you don’t have to worry about dropping anything off.

Waste

When experts talk about our country’s health care delivery system they usually begin by stating that the U.S. spends 40 percent more on health care per capita than any other country in the world. This is usually followed by the claim that a large amount of this spend is wasted on things that don’t actually benefit patients’ health.

This is a big statement, so let’s try to bring it down to the level of someone actually working in health care. What does waste look like to them? This morning I learned of a situation in our medical center. One of our employees collected information about a patient, loaded it into the electronic health record, and then printed out some of the information. This paper later reached a co-worker who scanned the information back into the very electronic system that it was originally printed from! (I suspect that this occurred because no one redesigned the work during the Epic implementation and it used to be going from one computer system to another). In the language of Lean production, this is called overprocessing and is one of the seven key wastes. The others are:

• Overproduction (making more of something than necessary or before it is needed)
• Production defects 
• Movement or transportation (taking a material farther away from the process and requiring it to be moved back)
• Inventory (the storage of overproduction)
• Waiting
• Unnecessary motion

The efforts of our colleagues who printed from a computer and then scanned the same information back into the computer were wasted. It added no value to the patient or to GBMC. I am sure that these colleagues were well-intentioned, but it raises the question of how many other tasks are being done that do not add value to the patient. Our people have so much to do that actually does add to the patient, but how much of their energy is spent on wasteful steps?

Our leadership system requires that our managers teach their employees about these wastes and empower them to test changes to our processes to get rid of waste. Lean Daily Management is just one tool to help eliminate waste. Value stream mapping and kaizen events are other tools that can be used. In the example of scanning information into the computer when the information is already there, we should just stop doing it!

I have a challenge for everyone in the GBMC HealthCare System. There are things that are scanned that do add value in healthcare, like outside medical information brought to us on paper or insurance cards, but are there things that we are scanning that don’t actually add value? Are we overprocessing this information? Please study all scanning and let me know what you find by commenting on this blog. Thanks! 

Holiday Decorations

Don’t the holiday decorations on our campus look beautiful?  I wanted to say thank you to Stacey McGreevy and her team for transforming our hospital into an eye-catching winter wonderland.

Let’s Fill Up The House!

This year, we are teaming up with WMAR-TV (ABC 2 – Baltimore) as a proud sponsor of the Fill the House for House of Ruth initiative to collect everyday necessities for this important non-profit organization. I am hoping that I can count on your help!

The House of Ruth provides services to nearly 9,000 women annually who are victims of intimate partner violence. Donations are needed to help women and children recover and rebuild their lives. The work that House of Ruth performs is aligned with our SAFE program. 

Earlier this week, various drop-off boxes (see picture) were set up throughout the GBMC campus including the GBMC Pediatric Group, Human Resources, Oncology Support, Spiritual Support, Volunteer Services, Family Care Associates and at each of our 10 off-site primary care locations.

All items donated must be new and unopened. The items of greatest need are:

--Diapers (all sizes) – House of Ruth uses 1,000 diapers each month
--Women’s and children’s undergarments – Underwear, bras, and undershirts (all sizes)
--Pillows, twin-sized sheets, comforters, and blankets

Other needed items include:

--Air mattresses
--Washcloths
--Gender neutral infant clothing
--Socks (all sizes)
--Children's coats
--Children's shoes

Another way to donate is through our Amazon Wishlist, where the most-needed items can be purchased straight from your computer. All items purchased through this Amazon link will be shipped directly to GBMC and then will be delivered with all the other items to ABC2 for distribution. 

Please don’t forget to donate at any GBMC drop-off location.You have until Friday, Dec. 15th! Thank you in advance for your generosity and Happy Holidays!

Gratitude for Everyone in the GBMC Family!

I would like to wish a happy Thanksgiving to all of my GBMC colleagues. I want to thank you all for your expertise, hard work, and compassion that helps us move closer to our vision of being a community-based health system where every patient, every time is treated the way we would treat our own loved ones.  

This morning at the meeting of our Department Chairs, we were discussing the future of our HealthCare System. I was reminded of how wonderful our people are and how committed they are to serving others. I also reflected on how good we have become at change. I am so grateful for everyone’s commitment to studying our systems and learning from them so that we can deliver on our four aims. We are not perfect, but GBMC has really become a model for delivering patient-centered care. 

I also want to extend a special “Thank You” to all who will work on Thanksgiving, or who are working during the extended holiday weekend, caring for our patients and helping support their loved ones and visitors. 

What are you thankful for during this time? Please share your thoughts.

Congratulations!!!
Please join me in congratulating Monica Goetz, RN, our clinical nurse manager for the Medical Intensive Care Unit (MICU — Unit 57), who was recently honored with the “Advocacy and Service Award“ by the Living Life Legacy Foundation, the non-profit organ procurement organization for the state of Maryland.  Monica was nominated for her initiative in creating awareness for organ, eye & tissue donation.

Organ donation saves countless lives and improves many others, and these gifts were celebrated at the GBMC HealthCare system earlier this year. Monica was instrumental in the creation of the ‘Tree of Life.’ This is a permanent art installation close to the Emergency Department Concourse, that memorializes the selfless act of organ and tissue donation and represents the legacy created by those who give the gift of organs, and tissues at GBMC.  

Congratulations Monica!!!

Joint Commission Survey
Thanks to all who helped us learn from our Joint Commission unannounced survey last month and worked hard over the past 30 days to make our systems even more reliable. Yesterday’s follow-up survey validated the strength of our processes. 

Welcome to the New Members of Our Senior Leadership Team

I’d like to extend a warm welcome to our new Executive Vice President and Chief Financial Officer, Laurie R. Beyer, BS, MBA, CPA, who recently joined us. Laurie is an accomplished, results-oriented executive with more than 25 years of experience. She came to our HealthCare System from Union Hospital of Cecil County, where she served as Senior Vice President and Chief Financial Officer for 11 years. During that time, she developed high-performing finance and revenue cycle teams, facilitated the conversion to the HSCRC’s Total Patient Revenue System, and led the successful implementation of the hospital’s electronic medical record.

Please join me in extending a warm welcome to Laurie!


Congratulations to Stacey McGreevy 
Stacey McGreevy, CPA, was recently named Vice President of Support Services at GBMC HealthCare. During her more than 20-year tenure at GBMC, Stacey has held a number of important roles including Manager of Finance and Regulatory Compliance, Director of Internal Audit and Compliance, and Chief Audit, Compliance and Privacy Officer. She developed GBMC’s first Internal Audit Department and Compliance Program and facilitated the establishment of an independent Audit and Compliance Committee of the Board of Directors. Most recently, she served as GBMC’s Administrator for Ancillary and Support Services, a position that oversees a $50 million annual budget and is responsible for oversight of construction management. Her leadership in GBMC’s strategic deployment process resulted in over $2 million in savings in purchased services and pharmaceutical expenses over the past year and she has been instrumental in overseeing a vast array of major construction projects. In her new role as Vice President, she will lead the design of a new supply chain system and facilitate the updating of GBMC’s Master Facility Plan. 

Celebrating Nurse Practitioner Week

Nurse practitioners (NPs) offer vital and reliable care and from November 12-18th,  which marks National Nurse Practitioner Week, we are given the opportunity to reflect on the roles of nurse practitioners whose tireless efforts often go unrecognized.

Please join me in celebrating GBMC’s outstanding Nurse Practitioners this week. Across our nation, there are more than 200,000 NPs who provide care to millions of Americans. We have excellent Nurse Practitioners working in our hospital, in our physician practices, and at Gilchrist. They help us move closer to our vision of a patient-centered system of care every day. 

Another Successful Nearly New Sale
I’d also like to take a moment to recognize all of those involved in making the Fall 2017 Nearly New Sale an outstanding success.

For those of you that don’t know, there is much that has to happen to make this event a success. Twice each year, GBMC employees, volunteers, and the general public get an opportunity to buy everything from furniture, clothing, and jewelry to appliances, sporting goods, toys, and much more — all at nominal prices. Under the leadership of our Director of Volunteer Services, Carmen Baeza, the team collects donations, sorts and prices them, and stocks them on the shelves. As soon as the fall sale ends, volunteers begin preparing for our next sale in the spring. GBMC volunteers devote hundreds of hours to these events that benefit the programs in our HealthCare System.

I am proud to say that the fall sale raised approximately $144,000 in proceeds! I want to extend a heartfelt thank you to the co-chairs for Nearly New, Joanne Lynch and Dirck Ten Broeck, as well as Sarellen Levine, the Nearly New representative on the Auxiliary Board, and all of the volunteers at Nearly New who work so hard to prepare for each sale!

Turkey Distribution...
Thanksgiving spirit was in full swing during GBMC’s annual employee turkey distribution on November 9 and 10. About 3,500 turkeys were given out to staff as tokens of appreciation for the hard work you do daily to ensure that ”to every patient, every time we provide the care that we would want for our own loved ones.” Thank you!

Named Top Performer...

Congratulations Gilchrist!

Last week, it was brought to my attention that the Gilchrist Sub Acute Unit (SAU) was recently named a “Best Nursing Home” by U.S. News & World Report 2017-18. According to U.S. News & World Report, only 15% of nursing homes in the United States achieve the “Top Performing” status of 4.5 or higher. Gilchrist achieved a perfect 5.0 rating and we are truly honored that they were chosen and that they achieved the highest score possible.

U.S. News uses existing federal nursing home rating information and federally reported healthcare data to determine their rankings. Criteria such as annual state survey results, medical quality measures, staffing levels and rehabilitation outcomes are all considered in the scoring process.

We are truly honored to be in the top tier of providers in both the state and the nation.  Congratulations to Leana Hoover and our Gilchrist SAU staff!

Respect
During the past few weeks, the news has been filled with allegations of inappropriate workplace behavior at other organizations. While this news is disheartening, it serves as a call to remind us of our GBMC value of Respect. It is important that we continue to work together to foster a safe work environment and to comply with our Harassment and Discrimination Policy. This Policy can be found on the InfoWeb. Please contact our Human Resources department should you have any questions or concerns. I am grateful for the respectful behavior, teamwork, and camaraderie that I witness every day in the GBMC HealthCare System.

Recognizing Colleagues: Radiologic Technology Week & Forensic Nurses Week
Last week was both “Radiologic Technology Week” and “Forensic Nurses Week” and I would like to thank all of our registered technologists (RTs) and our forensic nurses for their very important roles in providing care and serving our patients.

RTs perform diagnostic imaging examinations and administer radiation therapy treatments. They are educated in: anatomy, patient positioning, examination techniques, equipment protocols, radiation safety, radiation protection and basic patient care. They are the teammates of our radiologists and radiation oncologists.

Forensic nurses are specially trained and certified examiners who care for adolescent and adult victims (ages 13 and older) of sexual assault. They complete a full assessment of the patient, obtain potential forensic evidence and provide antibiotic therapy, emergency contraception and resources for crisis counseling and support services.

Please join me in thanking Phil Komenda, our Director of Imaging and Cardiac Services, and Laura Clary, RN, FNE-A/P, SANE-A, CPEN, our Clinical Program Manager for the SAFE Program, and their teams for all their hard work and for their important roles in caring for our patients.

National Medical Staff Services Professionals Awareness Week
“National Medical Staff Services Awareness Week,” just concluded and I would like to acknowledge and thank all of our medical staff services professionals (MSPs) for playing a critical role in our healthcare system. MSPs credential and monitor ongoing competence of physicians and other practitioners who provide patient care services in hospitals managed care organizations, and other healthcare settings.

MSPs are dedicated to making certain that all patients receive care from practitioners who are properly educated, licensed, and trained in their specialty. They are experts in provider credentialing and privileging medical staff organization, accreditation and regulatory compliance, and provider relations.

Please join me in thanking our MSPs for their hard work and for their important role in helping us achieve our vision.

Thanking Our Veterans on Veterans Day and Every Day
On Saturday, we commemorated Veterans Day and took the time to remember and pay tribute to the brave men and women, of the U.S. armed forces, who have served in the past and those who are serving today. My sincere gratitude to all members of the U.S. armed forces and their families who have served and made the tremendous sacrifices to preserve our freedom.