Wednesday, May 4, 2011
Could having mayo packets improve the patient experience? Clearly mayo is part of the support cast for a broader meal!
We always strive to create an incredible experience for our patients and families. Many times it comes down to the little things we do.
Yesterday, I saw a man walking around the corridors outside the nursing unit. I asked if I could help him. He looked at my name badge and I could clearly see that he felt the CEO could not help this situation! He then gave it a shot and said that he just needs some mayo packets. He was right, I was going to struggle on this one as I did not have the code to our food galley (per policy, that was ok). I went and found Kellie Israel, one of our Food & Nutrition Associates. When I asked for the code to the galley she politely said that she would get the mayo for me out of the galley (again per policy - great work Kellie).
While I waited with the man, he let me know that the care was great and his wife enjoyed the food. He just needed mayo. He then let me know that his wife was had terminal cancer and he was just trying to spend as much time with her as possible before she dies. And it hit me as I thought about it...he left her side to get the mayo which took him away from his wife. Even if just for a few minutes, I knew and could tell he wanted that time with her.
These are times that I reflect on the ability for all of us to impact the experience for our patients, families and each other for that matter.
When we find ourselves in these situations, we need to continue to mine for ways that we could improve, enhance or just change a process to get the outcomes and experience we expect.
For those of us in healthcare, we each can play a critical role in in supporting each other and supporting our patients & families. All of us have the ability to make the difference in the lives of others and each other. Just those little things that make the difference.
Monday, May 2, 2011
What inspires you? Who inspired you recently?
Today, I received a letter from a family bragging about the care and compassion provided while her husband was here. Specifically she wrote, "my husband had a heart attack and was quickly taken to the Cath Lab where we encountered four fabulous nurses; Kim Bruno, Kim Graham, Christine and Catherine (the PILLOW fluffer). From the minute we arrived they helped to put us at ease with their compassion, professionalism and friendliness. My husband (the typical Macho Man) had never been so scared in his life and they were all able to calm him with understandable explanations about everything that was going on and about what would be happening. They did this with continual cheerfulness and thoughtfulness. We are sure that they do many procedures each day yet they made my husband feel as if his was the most important one they had ever done or will ever do. There was nothing routine. They were caring, cheerful and simply perfect in every way."
Last week, we held our April Associate of the Month reception honoring Pam Hazen, RN on our CCU. One way I would describe Pam would be her welcoming approach. As I round the hospital it is easy to see when areas are very busy. What I do look for is the welcome we provide each other no matter how busy we are through our day. Isn't that the acknowledgment we all enjoy from each other?
This morning, Joseph Jones from Environmental Services greeted me with a simple "Good Morning!" He was truly present when greeting me. As basic as it is, sometimes we lose sight of that simple "Good Morning" or "Good Afternoon." Those statements are actually a blessing and not just an evaluation of the day.
The welcome and greeting we provide each other, our, patients and families is one way that we make St. Joseph Medical Center and Carondelet Health a better place for our patients. This is part of the culture of who we are and the mission we serve. Hospitals can be scary places when you are the one feeling vulnerable. Many times our patients and families have a lot of questions and that calls for us to welcome them even more often.
In addition, during our Safety Huddle, one of our managers noted that there are times when a patient is waiting to get on an elevator but it is full. It was requested that we step off the busy elevator to allow room for the patient and we all agreed. That is just one more thing I love about our culture...our willingness to quickly adjust as needed to better serve our patients, each other and our mission.
Wishing you all a great week.
Saturday, April 30, 2011
Friday, April 29, 2011
Thursday, April 28, 2011
Today, I completed my re-certification in Basic Life Support (BLS). There are a few changes noted. In fact, the American Heart Association made their most drastic changes in 40 years.
According to the AHA, for nearly 40 years, CPR guidelines have trained people to follow these simple A-B-C instructions—tilt the victim's head back to open the airway, then pinch their nose and do a succession of breaths into their mouth, and finally perform chest compressions. But now, the AHA says starting with the C of chest compressions will help oxygen-rich blood circulate throughout the body sooner, which is critical for people who have had a heart attack. With this shift, rescuers and responding emergency personnel should now follow a C-A-B process—begin with chest
compression, then move on to address the airway and breaths. This change
applies to adults, children, and babies, but does not apply to newborns.
During training, we were told if you need to call for help, think about calling a cab or C-A-B! Not necessarily a great example but certainly one easy to remember.
Tuesday, April 26, 2011
Healthcare management and healthcare in general involve a lot of time at work (so you want to enjoy what you do). There are times that people just need to get away to handle personal items during the day. This funny story came to me by a healthcare manager (who I'll call Susie) just trying to keep some balance in her life...
I was introduced to a gentleman through friends last week (email introduction…wonderful world of cyberspace and dating) and have met him twice for coffee. He is busy with kids/job as am I so it’s tough to find time…so today at 10:45 we were able to meet for a coffee.
First I show up @ Dean and Deluca and some woman is on the ground with one person assisting her…she passed out after giving blood. Made sure she was okay…no hitting of her head, not nauseated, good strong pulse etc…and 911 had been called. Perfect start….might I add she was right in front of the place to order salads and sandwiches!
Next I hear “hi Susie” and it’s your spouse. She was very sweet but I’m sure was wondering “what is Susie doing here at 10:45”. I told her meeting someone for coffee… next I run into one my prn staff, shopping with her baby boy….again, have to explain why the one day I sneak out for an early coffee I’m not AT work….
Next I run into another colleague who was on vacation this week…again…the winking and implication that I’m doing something “illegal”.
What I learned…someone is always there…how far do I have to drive?
A special thanks to the leadership and direction of Dr. David Burkart, Jane Falk and Derek Dinoni. Our first patients were seen today!
Seen above: Dr. Burkart (top left) and the Interventional Radiology Team. Bottom picture: Me and Annette Small, our Chief Executive Officer of St. Mary's Medical Center who joined us for the event.
I am very appreciative of all the work of our healthcare providers. We provide the compassion and care needed during very vulnerable times. We all know this and yet there are days like I had today where it is even more clear.
Monday, April 25, 2011
Sunday, April 24, 2011
Friday, April 22, 2011
I had a chance to see the note informing Mindy of the good news:
I am writing to inform you that you have been selected as this years KCDA's Recognized Young Dietitian of the Year for Missouri. Congratulations! It is quite an honor to be recognized by your peers in such a public way. Your commitment, dedication and talent in the field of Dietetics are an asset to the profession!
Way to go Mindy. We are so proud to have you on our team.
Thursday, April 21, 2011
In the hospital, we focus on some basic needs for patients which the StuderGroup names the 3Ps (Pain, Potty and Position) Protocol. Other obvious focus areas on basic needs include nourishment, medical attention and compassion with thousands involved directly and indirectly to provide this support. The same held true at the marathon.
When entering a hospital for surgery, a patient shows up a couple hours in advance, gets prepped for surgery, enters the operating room, goes through surgery and takes a few days to recover.
When entering the Boston Marathon, runners register, show up early to catch the bus to the start, take care of "potty" needs. There are medical tents to help any "pain" needs and you enter into a certain corral based on your qualifying time so you are "positioned" correctly with people similar to your speed in the race. During those 26.2 miles it felt like many of the same hospital basics were covered...bathrooms; medical tents; nourishment stations every mile; millions of "friends and families" providing cheers, compassion and encouragement along the whole route.
Even at the end, the "marathon case managers" get you safely to your belongings, provide more nourishment before you leave and offer last minute medical tents if you need to see the doctor before you leave. Some even leave the marathon in a wheelchair however that is not an ideal way to depart! From there, you are discharged home with a plan to recover over the following days.
If Boston Marathon Ran Your Hospital...you would be proud of them and pleased with your experience.
Thank you to the thousands of volunteers and staff in our hospitals and the Boston Marathon and thank you to the millions of families and friends who support us when we are patients or race participants.
Congratulations to Geoffrey Mutai (pictured above for his marathon record breaking time of 2:03.02 (that's an averag of 4:42/mile)!
Tuesday, April 19, 2011
Saturday, April 16, 2011
Friday, April 15, 2011
Thursday, April 14, 2011
A few of his proposal points included: "Medicare and Medicaid Savings of $480 Billion by 2023 and At Least an Additional $1 Trillion over the Subsequent Decade, Providing Better Care at Lower Costs:
Building on the Affordable Care Act, the President is proposing additional reforms to Medicare and Medicaid designed to strengthen these critical programs by reducing waste, increasing accountability, promoting efficiency, and improving the quality of care, without shifting the cost of care to our seniors or people with disabilities.
The framework will save $340 billion over ten years and $480 billion by 2023 (including the proposals already included in the President’s Budget). Over the subsequent decade, the President’s proposal will save well over $1 trillion by further bending the cost curve, doubling the savings from the Affordable Care Act.
The President’s framework offers a stark contrast with the House Republican plan that would increase seniors’ health costs by $6,400 annually starting in 2022, raise health insurance premiums for middle-class Americans and small businesses, cut Federal Medicaid spending by one-third by the end of the decade, and increase the number of uninsured by 50 million.
Yes, the Medicare and Medicaid plan calls for saving $480 billion by 2023 - just 12 years away - and another $1 trillion the following decade. If we just estimate that savings across roughly 5,000+ hospitals, it comes to $8M improvement per hospital over the next 12 years for a cumulative savings of $96M/hospital by 2023.
We can do it as a healthcare industry. It will not be easy, however, as we leverage the knowledge we have within and across health systems, we will continue to improve our quality and safety efforts, enhance our patient experiences and reduce costs. How are we mining for ideas formally and informally? Certainly, formal ways need to exist to measure, manage and advance efforts. How are you informally getting those ideas from people closest to our patients? I still enjoy the high students who shared their brainstorming sessions:' - I hate it when... - I wish I could... Then, they prioritize based on the goals of their project and the estimated resources needed. Sounds simple yet it is something we could do even better in healthcare - the mindset of continuously improving even with fewer resources as we have already seen these past 20 years.
So, should the future of healthcare concern us? Of course. Our industry is very challenging and I am very positive about the future because it is in our hands to make the necessary changes needed within the resources provided. So let's continue to work together and learn from each other so we identify even the little things that we could change that will make a big cumulative impact in years out. What's one change you and your organization could make starting next week that would add value to your patients and further the organization's mission?
Monday, April 11, 2011
I thought you might enjoy reading about one of many times when eight or more departments worked together well to make a successful day happen on 5 North. Hope it's ok that I'm doing so in an email. As the Unit Secretary for 5 North - I get to see when many different people come together to do great things, and for that I'm truly grateful to be working exactly where I am. :)We had three admits yesterday afternoon that ended up all needing to come at once. A great number of people made that happen seamlessly.
First, Paulette Johnson in Environmental Services did four STAT cleans, all on her own, as her co-worker, Yolanda Ross made several trips to get extra materials - when we had to move people around on our floor to accommodate three new patients.
Next, Ginger Taylor (Virginia) performing a newer role today as stand-in Admitting Liaison - made sure all orders were done correctly and completely, contacted all necessary physicians and insurance companies, helped sort out which nurses would take which patients, and just dove in so many times to help any of us who needed it.
Both Shirley Graham and Linda Carmona in Patient Access kept pace with 5 North as we moved patient rooms, asked for pre-admitting status, and then got them all at once (lots of paper work!)
Loretta Lackey in Central Services made sure we had everything we needed from CS as our needs kept changing - she even ran some mepilexdressings to us by hand.
Georgie Agim and Linda West - both 5N RN's - were able to do their usual "magic" in patient care with full patient loads, a shift change, and three new, consecutive admits. The nurses on 5 North are truly amazing, and they were able to give patients the attention they deserve because everybody worked together so well to make it happen.
Sherri Britt, 5N PCA, deserves special mention. One of our three new admits decided she was no longer interested in staying at the hospital. Ginger and Sherri gently talked to the patient who was irate. It was brilliant, helpful, kind and perfectly timed.
Courtney Scanlon, our pharmacist for the day, checked on us all day because she knew we would be receiving several patients at once. The Pharmacy staff that stays on the 5th floor are always so helpful at providing immediate order entry as well as pharmaceutical information.
Finally, we have our three therapy teams who are the jewels of the Rehab floor: Janice Balke, our PT Tech, made sure each new admit had the proper equipment, as she was also keeping up with our current patients for Group therapy today (when even your wife Jenny got to see how busy we all were!)
Both Marta Sanorand and Jacob Neece(PT) took care of several delicate patient situations in their calm, professional manner and still squeezed in their new evals.
Penny Murphy and Juliet Arndt in OT did their own magic for their departments, while Melissa James and Cathy Burns in Speech Therapy worked to figure out how to get more evals done when we were a few Speech therapists short today.
What I hope I've done is show how during a mere five-hour time slot so much cooperation and teamwork truly happens in this hospital and especially on 5North. Our management team of Jeff Lee, Coco Gonzalez, and Jennifer Leonard are always available and right there with us as we work together to get everybody the best care possible. They lead by example, have the respect of their staffs, and jump in to help us all the time. We all work so well together because of decisions they are constantly making.
I was just so proud to work here yesterday. Yesterday was true teamwork at its best. A healthcare multi-disciplinary team is what any of us would want for ourselves and our own families. Several people like to call 5North"the Miracle floor" - and in so many ways, it usually is.
Thanks for your time in reading this Giant ICU. I just believe that when people come together to do great things - it's a crime not to call attention to it. Have a good rest of your week, Scott! (If someone could pass this on to supervisors in CS, Pharmacy, ES, and Inpatient Admitting, I think they'd like to hear how their staff positively affects 5 North too - thanks.)
Thursday, April 7, 2011
"Last week, we had nine Town Hall meetings to accommodate the different shifts and days. It is not always easy for people to break away for a Town Hall or come in on their off time. You have a Voice in our organization and we want to ensure that SJMC is the place where you prefer to practice medicine. One thing is certain; all your efforts are so greatly appreciated. Our work is hard and our patients need us more than ever before. It is our job to keep mining for ways that we can care for those we serve and ensure that our health care system is focused on providing quality care in a compliant, safe, cost effective and service oriented manner.
The following summarizes some of the key themes we discussed: We have seen a lot of great improvements at St. Joseph Medical Center over the past year. One thing is for certain: changes in health care are constant and will continue across the country for years to come. Healthcare Reform will impact St. Joseph Medical Center by approximately $50 million over the next 10 years. It is imperative for us to look at our organizational goals and understand how we contribute to these goals and how we can make the greatest impact.
The Organizational Goals in line with our mission, vision and values include the following.
· Quality Care
· Compliance and Safety
· Market Growth & Operating Effectiveness
· Patient Satisfaction
So how will we support these goals moving forward? This is where we need everyone to understand their role in achieving the organizational goals above and help foster priorities for improvement and innovation.
Other Town Hall updates included:
· We have seen continued growth this year in the following areas: overall admissions, neurosciences, cardiology, women's services, general surgery, orthopedics, rehab unit, endoscopy, inpatient surgery and our outpatient center, South Kansas City Surgery Center.
· Our focus will continue to be 100% private rooms. We are opening 3 North in May with 16 additional Telemetry beds. This will allow us to take one of the units on the 4th floor and convert from 24 beds to 16 private. In all, we will have eight additional beds in our system with 32 of them being private.
· Later this month we will celebrate the opening of our neurointerventional Bi-Plane suite.
· We opened a Cardiac PET scanner last month along with our Cardiac Device Clinic.
· SJMC was approved for an eight-bed Intensive Care Unit with a focus on Neurosciences. This will include a domino of moves - the planning is underway with an expected opening date of July 2012. This addition will allow us to focus on CCU as all Cardiac and convert the remaining semi-private rooms into private.
· Our associate turnover rate did go up a year ago and has been on a downward trend for the last six months with our lowest nursing turnover in years this past February.
· Our inpatient and outpatient satisfaction scores are on the rise since we focused on three questions and three behaviors per area.
· We have implemented Safety Huddles in an effort to reduce any harm or potential harm to patients and those we serve.
· Our last Joint Commission survey was the best we have done in many years. That took all of our efforts and we should be extremely proud.
Thank you for serving our mission and for your continued support of St. Joseph Medical Center and Carondelet Health. This is our health system and we all play a major role in achieving our organization's goals."
Wednesday, April 6, 2011
Tuesday, April 5, 2011
Sunday, April 3, 2011
This past week, I held nine hospital Town Hall meetings to accommodate the different shifts and days. It is not always easy for people to breakaway for a Town Hall or come in on their off time. Tonight, we discussed ways that each of us could impact our organization's goals. These goals are in line with our mission and include:
- Quality Care
- Compliance and Safety
The people attending the Town Hall meetings had a lot of great ideas. One thing we could improve upon is how we mine for these ideas and close the loop with those who provided the idea. When we follow-up with those people with the ideas, we foster even more innovation. At SJMC alone, we could implement 4,600 improvements every year if every employee, volunteer and physician brought forward just 2 ideas which we planned for and implemented. They do not have to be big ideas. A lot of them could be kept simple and have a great impact on our goals.
Thursday, March 31, 2011
Wednesday, March 30, 2011
- Believe (thank you for adding this one Kathy Gutteridge - so true!)
Priscilla Smith-Wren...thank you for our conversation today on being inspired and inspiring others. While cleaning patient rooms, Priscilla has been known to sing a song or two. She shared the story on how her singing brings joy to our patients and in turn inspires her.
There is no “I” in “team” (or so the saying goes). Never has it been more apparent to me than just this past month as SJMC excelled in the recent visit from The Joint Commission. We accomplished a great deal with our success in The Joint Commission review. This achievement is no small feat and would not be accomplished without the required necessary teamwork.
When I look around the hospital, I’m continually impressed by this very teamwork I see on a daily basis. As many of you know, I get to spend much of each day in the GI Endoscopy lab. What a great group! For over 16 years I’ve witnessed firsthand what can be accomplished when everyone is willing to pitch in and help get the job done. The staff is always looking out for the patient and striving to make the experience for not only the patients but the other staff both enjoyable and safe. I’ve also had the privilege of recently spending more time than I’d like (just kidding, Tara!) with the super folks in the outpatient Rehab Unit. These are superbly trained individuals that the surgeon can rely on. He or she can do a wonderful job with the operative repair but needs these enthusiastic professionals to affect a good clinical outcome.
Take the time to look around and appreciate your other team members in whatever area you work. Don’t ever forget that your expression of that appreciation to each of the other team members within this organization is recognized and welcomed. Imagine our therapeutic potential when we are all working together and fully engaged as members of the Health Care Team. So while there may be no “I” in “team” I believe you’ll agree that “teamwork” spells “success.”
Thank you Dr. Clement. Your leadership and support is absolutely appreciated.
Tuesday, March 29, 2011
Monday, March 28, 2011
When I look at the ongoing changes in healthcare and at our hospital, the need to be resilient certainly is needed. We can not look at things and expect them to be exactly the same next week, next month or next year. We need to speak openly about the direction of the organization, our priorities and each of our roles in helping the organization today and into the future. Change is ongoing and it should be as opposed to waiting for things to build up and then finding yourself in a position to make drastic changes all at once. Isn't it like that in our personal lives as well?
Thank you for your words this morning, Judy. Resilience provides continued hope and encourages each of us to stay engaged or get re-engaged. It builds a greater sense of trust, pride and inspiration.
So keep that in mind the next snowfall when you expect to see Spring!
Friday, March 25, 2011
Our jobs in healthcare and all of our organizations for that matter probably are stressful in many ways. My thought is that you should not be stressed everyday though. That would be a terrible way to come to work and certainly would make you ineffective.
Jenny (my wife) and I were talking about this last night. She mentioned having more "zen" or relaxation space at work. So I looked up zen in the office on Google and found a company, Ballantyne that has a "Zen Den". I think it is a great idea. As Ballantyne sees it, managing workplace stress has never been more important than it is in today’s economic climate. The Zen Den aims to help tenants find the balance with a room in which they can relax, reflect and rejuvenate. The room has been created to provide a soothing environment with soft lighting, comfy seating and even a water feature. “We’re constantly looking for ways to improve the work lives of our clients,” says Amanda Schüss, general manager of Ballantyne Business Centers. “The Zen Den provides a place for them to escape their e-mail and ringing phones and sit and relax for a few peaceful moments.”
Last year, we updated and renovated our healing garden outside. We do have space next to our cafeteria for a Zen Den concept.
I would like your thoughts...let me know what you think could make this a respite at work even if just for a few minutes a day.
Thursday, March 24, 2011
I really liked that balanced approach - advocating for her team and the organization. So I Googled Relationship Based Management just to see what I would find. The Centre for Innovation in Management described Relationship Based Management well. Although it is listed as a new philosophy, I think it has been an approach around for years with more recent acknowledgment of the long term benefits. They state:
While a new relationship-oriented management philosophy is evolving, command-and-control management still holds sway in the majority of our corporations. The CEO and executives see themselves as serving the interests and perspectives of all of the company's key stakeholders, not just investors. Management as a whole is focused on building strategically important relationships with stakeholders inside and outside the organization. The primary role of managers, rather than commanding and controlling corporate resources, is preserving and extending the relationships upon which the corporation depends.
Relationship-based management takes an integrated, long-term, company-wide approach to identifying and building relationships with strategically important stakeholders. Efforts are focused on creating opportunities for mutual benefit rather than buffering or protecting the company from the demands of stakeholders. Relationship building is directly linked to corporate values and business strategy.
Strong relationships can stimulate innovation, increase flexibility, reduce costs, and allow companies to respond quickly to changing customer requirements. A good reputation, based on sound relationships with customers and communities, means that companies can attract and keep the best employees. Enhanced loyalty and support from employees, customers, investors, and business partners translates into bottom line profits and long-term growth Relationships and the bottom line.
In the healthcare world, that means doing the right things for our patients in harmony with all our providers and key support areas. Thanks to Michelle and our other leaders for role modeling Relationship Based Management.