Benefits of "Walkmeeting"

More and more, I am trying to see how we could manage hospitals similar to how we manage our own personal lives. It typically involves having a plan that can be managed monthly, weekly, daily and even hourly. Financially, it may be a matter of ensuring that you have money tucked away to make your house or car payment. From a health standpoint, it is a matter of what you eat and how much you exercise. From a family standpoint, it reflects how much time you spend with family.

Hospitals and other businesses typically have "scorecards" to reflect their expected outcomes. The challenge continues to be understanding the "Plan" to ensure these outcomes.

Obviously to have a healthy organization we must start by having associates, volunteers and physicians who are healthy in mind, body and spirit.

One of our Radiologists, Dr. Luke, was sharing his fitness plan with me the other day and called it his POE (Program of Excellence). He indicated that all our progress at work, at home and in the community revolves around an individual's commitment to the 5 "Ds:"
- Dedication
- Determination
- Discipline
- Drive
- Desire

So I have been thinking of ways I could help contribute to our overall health and hope others will do the same considering the 5 "Ds" above.

This week, I had close to 50 hours of "meetings." While these meetings focused on our strategic direction, operational improvements and community outreach, they also were "sitting meetings." Starting this week, I have started to add "walking meetings" which are easy to do when meeting with one or two other people. It helps keep us visible and active. In addition, even though we may see others along the way, it is usually no more than a one-minute stop which may save you from adding other meetings and may resolve issues in a more timely manner. This week, I had a chance to walk with Jeri, the head of Volunteers and Auxiliary and Cheryl, the head of Radiology. First, Jeri told me I needed to pick up the pace so I was more prepared when walking with Cheryl. While Cheryl and I were "walking and meeting" (perhaps we should call this "Walkmeeting" for simplicity's sake), we came across another manager we needed to see in order to resolve an issue. It was addressed immediately (thank you Ben).

As many of us know, there are great benefits associated with brisk walking (source: iloveindia.com):
-It helps to fight against stress, by providing complete relaxation to your mind.
-It protects you from the clutches of diseases like osteoporosis, colon cancer, constipation etc.
-It increases the longevity of your life, by maintaining your fitness.
-It helps in reducing the problem of depression, thus enabling you to derive mental peace.
-It relieves you from backache trouble and also acts as a great remedy for arthritis problem.
-It helps in increasing your flexibility, by strengthening your muscles, bones and joints, thereby toning your body.
-It ensures that you have a proper sleep at night.

Also, I checked out and am now a regular on myfitnesspal.com (there is even a free iPhone application). This allows you to add your health goals and includes tracking your eating and exercise to achieve these goals. It is a great site. By walking an hour while meeting, the average person will burn at least 200 calories. Just consider having the discipline of adding Walkmeetings 3x/week over 48 weeks (allow for vacation and holiday time). This would burn an additional 600+ calories/week or 28,800 calories. This would allow the average person to lose an additional 8+ lbs during the year in addition to their regular fitness and health regimen...this includes throwing in one piece of cheesecake on New Years (according to #6 in my office) or three pieces of birthday cake. Not bad for changing how you meet with no additional time added. Plus, it sets a great example for our kids and our future. After all, once we set the example for our kids, they will be the ones taking care of all of us later in life.

Enjoy your weekend.

It's Not Just About the Rubber Bands

In my December 5, 2009 entry, I talked about our efforts at SJMC to reduce the costs of office supplies and our associate Chanda who sent out a call for rubber bands.

The other day, our Director of Volunteer Services, Jeri, came to my office for a standing meeting. She walked in with an enormous bag (I'm not exaggerating - it could have easily carried a watermelon) of rubber bands and a big smile. There were several thousand rubber bands. She told me that one of our volunteers had heard about the need for them, and collected all she had and gave them to Jeri "for the cause."

I think I've mentioned before that we have the best auxiliary in the city and this is exactly why. Our volunteers take great pride in "their" hospital.

Later that day, associate Margaret shared some information about our "Rubber Band Angel"-coincidentally, her name is Angie.

Angie is 95 years old. She came to us in 1995 and has given more than 7,600 hours in service - mainly working in the gift shop evenings and Saturdays. She should have more hours than that but she volunteers at a nearby church, unlocking the doors every morning. Then she goes to volunteer at one of several other organizations daily.

During World War II, she was a WAC (Women's Army Corps), joining the WACs to see the world. Last year we asked our veterans to submit information about their military experience. Here's part of her biography:

"Going overseas we flew in a small plane with 6 of us and over the ocean nearing the Netherlands there were bolts of fire and I thought it was a greeting to the American plane but the sergeant said 'Lady, those are the Germans shooting at us.' "

She's quite a woman.

A Lesson On Pressure Ulcers and Split Pea Soup

So I decided to bring in some split pea and barley soup from California Pizza Kitchen (low fat only 240 calories for those of you watching your health) for my lunch. I think one thing that always pops up in people's minds when thinking about split pea soup (for those born before 1973) is the famous scene in the Exorcist. Watch the movie for more details. Or don't. It's really scary.

While I was taking the soup over to the microwave, it slipped and splashed all over the carpet (and my suit). I did my best to clean it up only to notice that today, the stain was back on the carpet.

This incident reminded me of a demonstration we saw last week on bed pads when Kevin, our Regional Director of EVS & Linen literally started pouring water over three types of pads.

Kevin shared the following:

Improved Outcomes:

This initiative will provide for enhanced patient care, providing much greater comfort, and a reduction of patient skin care issues; pressure ulcers, likely to occur anytime when a patient is confined to bed care over an extended period of time, usually greater than (4) days.

Improved Comfort:

Through an actual demonstration it was clearly observed that the current linen bed pads only puddle the void a patient may have due to incontinence. The comfort of the patient is greatly compromised in view of this void not being absorbed by the linen bed pad.

This same demonstration revealed how the proposed disposable linen bed pad totally absorbs the void of the patient, allowing the patient to remain in a comfortable state until this pad can be changed.

Further, a positive micro climate is created by the disposable bed pad due to the air flow that is able to reach the patients skin. The current linen bed pad does not have this air permeability, and a condition is created where by the patients skin is susceptible to sores, (Pressure Ulcers) promoted by the bacteria growth that is conducive to the climate that is created by the linen bed pad.

This same linen bed pad too creates various pressure points to the patients skin do to the thickness of the material, these pressure points exacerbating or causing current skin sores or pressure ulcers, where these points of pressure are meeting the patient’s skin.

Improved End of Life Care:

All of these issues are even more prevalent concerning end of life stays, as the patient in these cases has been confined to total bed care for an extended period of time; during these final days, we owe it to our patients and their families to further provide as comfortable an environment as possible, and too, their family can clearly see and be at peace that we are providing for this need. As described, the linen bed pads clearly inhibit this goal.

Costs:

From a cost standpoint, the initial costs of these disposable bed pads will be absorbed through the reduction in linen bed replacement and laundering. In addition, hospitals would reduce the costs associated with treating stage 1 & 2 pressure ulcers. It is worth noting that the average hospital spends between $400,000 to $700,000 in direct costs to treat pressure ulcers.

This is a great example of improving the care to our patients in a cost effective manner. Thank you Kevin and our nursing departments for your guidance and demonstration in making SJMC a better place for patients.

I look forward to hearing from you.

Controlling Your Destiny

Last week I attended Leawood Mayor Peggy Dunn’s State of the City Address. Mayor Dunn spoke of the challenges the city of Leawood faced in 2009. While the City was 3% down in revenues, they controlled their destiny and managed expenses to match the revenue drop. They held their Board Rating through Moody’s which is only held by two cities in Kansas.

Mayor Dunn also oversaw the development of Gezer Park, built to honor Leawood’s sister city relationship with the Gezer Region of Israel, which was established in September, 2003. Gezer is located about halfway between Jerusalem and Tel Aviv in an area that is rich in agriculture, quite similar to Kansas. The unique park reflects the contours of the State of Israel, with the Sea of Galilee on one end and the Dead Sea on the other – connected by a 700’ stone wadi that will carry water from the west to east end of the park.

The sculpture above entitled Avanim Vetseiadim (Stones and Steps) by internationally renowned artist Ilan Averbuch is a focal point of Gezer park. The sculpture resembles a ladder, a tool that is reproduced in nature, but also a metaphor for a route to overcome obstacles, a method of controlling one’s destiny.

As we embark on the first days of 2010, no doubt many of us have made resolutions for the new year. Whether it is a focus on our health, family or career, we look to our resolutions as guides or “ladders” to climb to the next goal in our lives.

I want to share some feedback from the most recent town hall meetings at St. Joseph Medical Center. Though it was obviously geared towards our hospital, it can apply to any of our business:

I encouraged associates to add one more resolution to their list of goals: determine how you can control your destiny and our destiny here at St. Joseph Medical Center & Carondelet Health. After all, St. Joseph Medical Center is our hospital. Our commitment and ownership of our destiny will ensure our long term success - through both the good and the challenging times.

What role do you play in bringing about the changes and/or successes you would like to see in our organization?

We all want to see St. Joseph Medical Center continue to succeed and it is up to each and every one of us to make sure it happens. Perhaps you would like to see our Net Promoter Scores increase, or a consistently full census or a process improvement in a particular area. It starts with trusting and looking after each other which, in turn, impacts how we look after the patients and families we serve.

Now ask yourself: How will I help ? What three things will I do to make this a reality?

We are striving toward ensuring the best patient experience. Every individual effort we make to provide the highest quality care and services will add up to 2010 being another successful year.

I look forward to hearing about your "ladders" to success.

Help for Haiti

AFP/Getty Images

AP Photo/Medecins Sans Frontieres, Stefano Zannini

More pictures from Port au Prince

As everyone is aware, Haiti’s strongest earthquake in more than 200 years struck the island nation Tuesday, causing widespread devastation. The 7.0-magnitude quake in one of the world’s poorest countries has destroyed thousands of homes and other structures, impacting an estimated 3 million people. While there is not yet a confirmed death toll, officials estimate that more than 100,000 Haitians have lost their lives.

The Sponsors of Ascension Health, the parent organization to Carondelet Health, have a strong presence in Port au Prince, the capital city of Haiti, located near the quake’s epicenter. They are helping the people most in need at this time.

Seton Institute, the international outreach arm of Ascension Health, is coordinating system-wide relief efforts to assist. Seton Institute also is working with the Catholic Consortium for International Health Care, which is made up of members from Catholic health systems across the United States, to generate a response to the needs in Haiti as well.

This morning Ascension Health President and CEO Anthony Tersigni sent out a system-wide memo inviting all ministry associates to support the Sisters in Haiti so they may continue to meet the immediate needs of the people and provide assistance as the nation recovers from this tragedy.

Cindy, our executive assistant, sent out a follow-up memo offering to collect monetary donations in our administration office and consolidate it into one check which we will send by overnight mail, since the need is so urgent. Our associates and volunteers and even patient family members have been stopping by all day to make donations, some large, some small, all greatly appreciated and all given with compassion and continued commitment to our Mission to serve all with special attention to those persons who are poor and vulnerable.

This afternoon I was privileged to speak to Joann from our business office and her husband Michael, who works for Bushnell here in Kansas City. Joann forwarded the email from Mr. Tersigni to Michael, challenging him to collect money in his office, and together they raised $620 in about 6 hours. We thank our new friends at Bushnell. Your generosity to our Sisters and the Seton Institute is truly an example of integrity, unity and compassion.

Should you wish to donate, checks may be made payable to Seton Institute and sent to: Seton Institute, P.O. Box 140182, St. Louis, Mo.,63114, Attn: Haiti Earthquake Relief.

Seton Institute will send 100% of every donation directly to the Sisters in Haiti.

We offer the people of Haiti our prayers, our hearts and our help.

Wash your hands

Sink cat says: "Do it anyway!"

Dr. Dan provided our annual infection control report to our Medical Executive Committee recently. I was pleased to see that our nosocomial (hospital-acquired) infections dropped by about 50% over the last year. Through a team effort, we have instituted some simple handwashing-enforcement techniques along with precaution signs cautioning all to wear gowns and/or gloves as indicated prior to entering a patient's room while he or she is in isolation.

We have not achieved our ultimate goal of zero nosocomial infections but have made great strides. It is a true journey towards excellence.

I look forward to hearing from you.

The Man Who Mistook His Gel for a Chapstick

Just about every morning, I get up at around 5 (my wife says the alarm goes off earlier which may be true) and I head off to the gym after gathering my belongings. Though I set out my "stuff" the night before, I miss some things from time to time. I keep the lights off not to wake up my wife (again, probably too late given the alarm clock situation) so I usually search for things in the dark.

A few days ago, I went through her dresser drawers to look for lip balm (in a small container). I have been using it for the past few days and have noticed that it smells funny and has not helped my chapped lips whatsoever. This morning I finally gave the lip balm a second glance. I noticed that it was actually a hair gel product.

It takes me to my hospital and our efforts to read labels, follow protocols, etc, to ensure the safety of our patients.

Here are a couple of safety examples which we highlighted in our December Highlights:

- Unit 4 South had zero falls in the month of November. Not coincidentally, 4 South also increases its patient satisfaction scores every time we measure them. Thank you to all the 4 South staff for their hard work in giving our patients the very best care and safety.

- Sheri Sander, PharmD, put together a poster for the Medical Staff Lounge on medication errors related to hydromorphone, a known high-risk medication. The poster shows a dramatic decrease in medication errors after we instituted multiple safety measures. There were many involved in producing these outstanding results, including pharmacy, nursing, P&T Committee and Safe Medication Practices Team. This poster is another great example of improving our patients’ safety.

On a lighter note, when I shared my lip balm incident during this morning's Town Hall meeting, someone reminded me that a) we should not be sharing medication and b) I should learn a lesson about taking my wife's belongings without asking.

(photo courtesy nataliedee.com)

A New Decade - Keep Those Resolutions Alive

New Years' has hit and the resolutions are in full force. The gyms are packed - even for the 5:30a crowd, the line for the soup and salad bar is longer than the burger line and people are still showing the post holiday spirit.

When I arrived at St. Joseph Medical Center in May, 2008, the hospital averaged around 80 hours per month of Emergency Room (ER) Diversion (not allowing patients to come to the hospital by ambulance - actually 'diverting' them to other hospitals). This trend carried through for over a year prior to this timeframe.

Our ER, like a healthy heart, is a major lifeline for our hospital. We made a resolution that we would reduce diversions and have been able to bring it down to 0 or just a few hours per month by the summer, 2008. Unfortunately, we started the New Year off with 12 hours of diversion in one day. This is our longest stretch in many, many months and matched our total diversion over the past 3 months combined. Certainly, this is not how we wanted the year to start in the ER. I am pleased to see that we were able to get off diversion and allow improved access to our hospital. We also learned some ways that we could improve our processes and communication. Whenever we are on diversion, we will have a leadership check-in at least every hour to understand what support is needed to get off diversion.

We get approximately 15-20 admissions per day through our ER. For every 16 admissions, we staff, across the hospital, approximately 2,000+ hours over the next 4 days (the average patient length of stay). On the flip side, we end up reducing around the same amount of hours over 4 days for every drop in census of sixteen.

By keeping our ER open, we improve access to care and better serve our community, our medical staff and associates.

I look forward to hearing from you and look forward to a prosperous and healthy 2010.