Hunting for Wabbits

This past weekend I participated in an Indoor Triathlon. Sandy C., the prior winner of this event for several straight years, stated after taking second place, "these are always humbling events".

Each of us challenging ourselves and one another. All trying to better ourselves - that could mean over a prior race, the accomplishment of finishing, the challenge of going against long time favorites, etc. In a many ways, it felt like we are "Hunting for Wabbits" as they used to say on Bugs Bunny. The constant challenge of wanting more and the desire to be better than yesterday. Needless to say there were a lot of fast rabbits that day...I was just one of the dogs chasing the rabbits.

In our professional world, hospitals are very similar. It is that constant journey of challenging ourselves to do better than the day, the week, the year before. As we follow our mission and key strategies, we have a constant tension and balance among the competing priorities - all while staying true to our core purpose.

It made me think of the following article, Enterprise is Better Than Ease by Jim Rohn.

If we are involved in a project, how hard should we work at it? How much time should we put in?

Our philosophy about activity and our attitude about hard work will affect the quality of our lives. What we decide about the rightful ratio of labor to rest will establish a certain work ethic. That work ethic - our attitude about the amount of labor we are willing to commit to future fortune - will determine how substantial or how meager that fortune turns out to be.

Enterprise is always better than ease. Every time we choose to do less than we could, this error in judgment has an effect on our self-confidence. Repeated every day, we soon find ourselves not only doing less than we should, but also being less than we could. The accumulative effect of this error in judgment can be devastating.

Fortunately, it is easy to reverse the process.

Any day we choose we can develop a new discipline of doing rather than neglecting. Every time we choose action over ease or labor over rest, we develop an increasing level of self-worth, self-respect and self-confidence. In the final analysis, it is how we feel about ourselves that provides the greatest reward from any activity. It is not what we get that makes us valuable, it is what we become in the process of doing that brings value into our lives. It is activity that converts human dreams into human reality, and that conversion from idea into actuality gives us a personal value that can come from no other source.

So feel free to not only engage in enterprise, but also to enjoy it to its fullest along with all the benefits that are soon to come!

TJC Day 4 Wrap-up: Our Patients are in Great Hands

A note I shared today with our associates, volunteers and medical staff:

Day 4 of our Joint Commission survey has come to an end.

Wow...we did exceptionally well. Kudos to all of our associates, physicians, Board members and volunteers. The surveyors shared that our team should be extremely proud of the work we have done over the past three years. They were very impressed with everyone they met. This is great cause to celebrate and continue to manage to our high standards.

We still have our Life Safety Survey pending. This will also be unannounced. Once that survey is complete, we will know how we did overall.

Again, congratulations on your amazing work. I am so proud and appreciate all that you do to live out our mission. Our patients are in great hands at St. Joseph Medical Center & Carondelet Health.

Rachelle, Susan, Lindsay, Larry, Cynde, Jane and Nan - thank you for your non-stop leadership and guidance leading up to and through this week!

Do We Get To See a Real Heart?

What an amazing day we had with the 4th graders from Prairie Star Elementary. Due to weather (our 8th snowstorm), Lone Jack Elementary was unable to attend. The kids learned about eating healthy, how we take care of patients, how they can take care of themselves and a crowd favorite...they had a chance to see an animal heart. This was put on by the Carondelet Heart Institute and Kansas City Heart Foundation. Thank you Barb L. and Dr. Eric H. for leading a great event.

Details went out in a press release:

Children Learn about Healthy Hearts at the Carondelet Heart Institute

What’s an echocardiogram? What does my heart sound like through a stethoscope? What is “blood pressure” and what does it mean? Fifty students from Lone Jack Elementary School and 100 students from Prairie Star Elementary will be learning the answers to those questions, and a lot more about heart health during the Kansas City Heart Foundation’s Your Healthy Heart event at the Carondelet Heart Institute at St. Joseph Medical Center on Friday, February 25, 10-11:45 a.m.

The day is the highlight of a week-long program sponsored by the Kansas City Heart Foundation. In the days preceding the field trip, nurses and other health professionals visit the classrooms to teach the students about the anatomy of the heart, risk factors for developing heart disease and how to reduce those risks.

During Your Healthy Heart at St. Joseph, the students will visit eight interactive stations covering topics such as cardiac rehab, pacemakers/stents and blood pressure and EKG checks. Students will also learn how to prepare easy, heart healthy snacks.

“Heart disease is the number one cause of death in the United States,” says Eric Hockstad, MD, cardiologist and president of the Kansas City Heart Foundation. “By educating children on the importance of heart health we can show them how to develop habits now that will help prevent heart disease later in life. We’ve received a lot of positive feedback from the parents of students who have participated in this program in the past. They tell us that the information their children have brought home has inspired the whole family to take better care of their hearts.”

Thank you to the many volunteers, physicians, nurses, staff, Kansas City Heart Foundation and Prairie Star's Principal Farthing for making today event possible...and a major success.

Check out the great pictures from the event as Seen in the Kansas City Star.

Still Smiling After the Kaizen Event

Attendees:

Cynde Gamache, Collette Culver, Yolanda Ross, Carolyn Stewart, Abby Kurtz, Angela Dreckmeier, Catherine Gieseke, Denise Camacho, Linda Fleeks, Vikki Hinkle, Donna Sumner, Susan Ward, Lindsay Alexander, Rachelle Babin

Thank you Lean Team...a picture from the Kaizen Event team:
Discharge Room Turnover Process

This team redesigned our process making the it so much smoother as patients flow through our system. The team identified a plan to reduce the bed turnover time by 70%. This helps our ability to place a new patient needing an inpatient bed. Just amazing work.

Thank you to all who participated. This was a huge undertaking.

The Fit Execs and Companies of Kansas City

It's that time of year again...Ingram's second annual Fittest Execs and Fittest Companies Challenge. The "fittest" individuals, "fittest" teams and "most improved" teams are posted above.

A special acknowledgment to the high scores in each category:

- Dermatology & Skin Care Center

- A. Zahner Co.

- Glen Posladek

- Eileen Mertz

- Scott Strohm

- Joyce Goldstein

And of course, a special shout out to the team members who represented us at St. Joseph Medical Center under Cynde G., our CNO's leadership. This year, the SJMC team placed 9th on overall improvement out of 40 teams. Larry R. and Cynde G. both placed in the Top 10 most improved for their age category...amazing work!

Congratulations to everyone who participated. As a community we can continue to promote health and learn from each other.

Go Lean Team....Graduating Class Celebrates

Today we had the graduation of our first Lean Six Sigma graduates who all received their Green Belt certification today. Our training was in collaboration with Johnson County Community College - thank you JCCC! The Graduates reporting on 5 projects that will positively impact our quality, safety, patient flow, satisfaction, growth and financial improvement. We will continue to build on our culture of high reliability. Congratulation Graduates:

- Lisa M.
- Jesse A.
- Amy M.
- Jeff K.
- Mindy C.
- Faith P.
- Lee V.
- Jenn L.
- Brad S.
- Andrew B.
- Lori B.
- Barbara B.
- Cynde G.
- Susan W.
- Vikki H.
- Donna S.

Thank you Lindsay, Rachelle, Russ and the JCCC Leadership team. Amazing work by everyone.

TJC Day 2 - Sharing Our Story

Surveys by any regulatory agency can add stress to the day. I met with our TJC surveyors this morning and they shared observations, recommendations and best practices from yesterday. The common theme - when we share our story, why we provide the care the way we do and how we go about providing it, those are best practices. And the key is not only learning from the surveyors. We keep learning from other departments across the hospital and from other hospitals.

Last week I met with several large health systems to discuss new and "better" practices towards improving the healthy food and drink options in each of our facilities (e.g., "Fryless" Fridays). Even though a few of us are competitors, we found common ground and were able to discuss ways that we could help improve the health of our own workplaces and our communities as a whole.

The Joint Commission survey allows another forum for those shared ideas and practices.

Day One Wrap-up - TJC Survey

The TJC Survey is going well. We had amazing support throughout the day. During the opening session, I provided a prayer/reflection as this is part of our tradition in Catholic healthcare. Our Sisters put together the "Safety Prayer" that was handed out to our leadership team this past summer. This is a traditional prayer we utilize in our Daily Safety Huddles. I had chills and truly felt lifted off my seat when I started the prayer and everyone, without prompting, joined in with me. It was an amazing feeling of collaboration and support of each other. Lots of great sharing of best practices throughout the day.

Rachelle, Lindsay and Susan - thank you for your leadership. You all were amazing leaders today.

Our team truly represented our mission, values and community well.

Excitement in the Air

Excitement in The Air - Today marks the start of our TJC Survey. The survey allows us the opportunity to learn where we could improve and showcase our great Programs and Services.

First Time in Years

I get asked regularly when the change will stop or slow down. We know change is inevitable. Certainly the challenge is changing in a sustainable fashion. How do we talk through the change so we are continuously ready for the potential unknowns?

Just recently, I read of several "first time" events or "first time in --- years:"

- In NFL news back in January, it was the "first time in 10 years" that both conference championships were decided by a touchdown or less

- In Colorado Springs: Commercial real estate values plunge for the "first time in 20 years"

- In Boston, "it was the first time (in 30 years) since 1980 that Boston Marathon qualifying times have changed.

And in North Carolina, the General Assembly reconvened in January with a new Republican leadership - the first Republican-controlled state legislature since 1898..."first time in over 100 years".

In our healthcare world, back in January, McDermott Will & Emory shared:

The Centers for Medicare & Medicaid Services (CMS) published a proposed rule that would reward hospitals for providing safe and high quality patient care. The proposed rule, required under Section 3001 of the Patient Protection and Affordable Care Act, would provide higher payments to hospitals that perform well on certain quality measures relating to both clinical process and patient experience of care. The head of CMS, Donald Berwick, says the proposed rule would constitute “a huge leap forward in improving the quality and safety of America’s hospitals for both Medicare beneficiaries and all Americans.”

This program, known as the hospital inpatient value-based purchasing program, would apply to Medicare payments under the Inpatient Prospective Payment System (IPPS) for inpatient stays in more than 3,000 acute care hospitals beginning in FY 2013 and applicable to payments for discharges occurring on or after October 1, 2012. The incentive payments to acute care hospitals would be based either on how well a hospital performs on certain quality measures or, alternatively, how much a hospital’s performance improves on certain quality measures from their performance during a baseline period. The higher a hospital’s performance or improvement during the performance period for a fiscal year, the higher the hospital’s value-based incentive payment for the fiscal year would be.

Without a doubt, things will continue to change. It could be days or many years. The key will be the way we work together towards impacting those changes. Certainly there will be times when we don't get it right and other times where it could not have been smoother. I am always impressed when groups get back together to work through ways it could be better when things don't work out the "planned" way. That is the future I predict - one that encourages constant dialogue on the possibilities with change - both good and bad - and the ways we plan on impacting and influencing our own destinies.

Have any "first time in years" stories you care to share?

Creators & Dependents

Did you check out the moon this morning. It was really amazing and made me pause to take it in today. Sure, I have seen many full moons. For some reason today it really struck me. I knew I was on the way to a good start of the day.

This morning, I rounded on some patient care units. This is one of the most enjoyable parts of my job. Every day brings new energy. It gives me a chance to stay present and get a sense of what's working well along with top priorities in each area. We really do amazing things in healthcare. I even had the opportunity to see a patient playing a guitar to stay relaxed through his treatment.

As I heard about the work everyone was doing, it reminded me of a dialogue I had with our leadership team. When are we creators/co-creators of our work (taking the lead) and when are we dependent (taking the lead from others).

For me, when I think about this I immediately go to the life at home and the life at work. At work, my natural inclination is creator/co-creator and at home, dependent!

Several months ago I launched Lean Six Sigma training with our Regional Director and Coordinator in the Quality & PI department. There is so much more work that still needs to be done as we become a more highly reliable organization on our journey towards becoming a Patient Safety Organization. This week, I sat in on a Kaizen event led by other executives in our organization with a multidisciplinary group working with them. I sat in and observed feeling present and truly dependent on their work for our success. It was actually an amazing feeling to be dependent on them and knowing the work would progress even better with them as the new "co-creators".

On a lighter note, at home, my spouse is the CEO, COO, CMO, CNO and Chief Safety Officer. Our family is dependent on her to shape and guide our family efforts. Now, please note that I do get to play Accountant in my home - my son is our CIO and daughters serve as dual VPs for Marketing & Fun. The one thing my kids let me keep - the creator of rides and funny stories in the evening.

As we all experience challenges in our organizations and outside of work, what could we learn from each other as creators and dependents?

Care 2 Share: Ongoing Generosity...

Front row: Millie W., Jan F., Lester S., Kathy F., Margie M.
Second row: Tinna M., Sister Laverne, Sheryl W., Jackie B., Joyce G., Sister Margaret, Lisa T., Carol N.

From our Foundation Office:
As a wrap up to our Care 2 Share Employee Giving campaign, we gathered a random group of longtime foundation donors. Together, this group of employees (along with the total list shown below) - who are holding the year they started giving - have contributed over $165,000.

Not only do these employees exemplify our mission, vision and values, they put it into action with a financial investment in St. Joseph Medical Center. Their donations support our patients and associates. Seventy-five percent of their gifts go back to fellow employees through the CARE Fund and education funds.

Thank you to all our associates who live our mission everyday and help sustain the healthcare ministry of St. Joseph Medical Center.

Combined Group:

Sr. Laverne Aufmuth
Rebecca Askew
Jackie Bailey
Lorraine Bennetts
Peggy Clear
Candy Brown
Dawn Coleman
Valerie Dame
Anita Davis
Sharon Dorsey
Jeanette Fletcher
Jan Foster
Kathy Frost
Kathleen Gee
Joyce Glasser
Kim Goodloe
Sharon Goudeau
Kathleen Gutteridge
Jeff Hibschle
Mary Hubert
Louann Huffman
Annetta Johnson
Joyce Kempf
Cyndi Scott
Pam Scovill
Jon Scribner
Gabrielle Smits
Lester Stevenson
Brad Struemph
Donna Sumner
Lisa Thacker
Lisa Thayer
Barbara Trester
Margaret Vincent
Susan Walker
Nancy Walrafen
Sheryl Willer
Millie Wyatt
Georgia Zeller

Kaizen Event

Check out Cynde G., (center-sitting) and Donna S. (center-standing) leading our Kaizen event to further improve our process from discharge to room turnover. This is part of a larger LEAN Six Sigma initiative to improve patient flow for patients admitted into the hospital. The group is made up of a multi-disciplinary team with people closest to the work.

Way to go Team. We can't wait for the report out on all your efforts.

Have a process change you are working on in your department? Let's hear about it.

Happy Valentine's Day

Happy Valentine's Day. I was surprised to find in the Kansas City Star today that marriage has dwindled to an all time low since tracking it 100 years ago. In addition, the average age for marriage is also at an all time high - 28 for men and 26 for women.

An interesting comparison to healthcare - we are realizing a higher percentages of "marriages" in the form of employment, professional service agreements and co-management arrangements. Similar to marriage, the hope is aligning common values toward a shared vision. And more physicians towards the end of their careers are finding themselves entering these "marriages" with the quick changing environment in reimbursement and pay for performance.

Enjoy your Valentine's Day.

Carondelet Heart Institute - SJMC's February Visionary Winner

Way to go Carondelet heart Institute (CHI). They are St. Joseph Medical Center's Visionary Award winner for the month of February.

CHI provides exceptional care and has realized tremendous growth this past year. Our patient satisfaction scores are excellent.

CHI is also in the process of expanding and adding new services. A new Cardiac PET (or cardiac positron emission tomography) was just installed along with the start-up of our Device Clinic.

I will keep you posted on the future expansion of the Heart Institute as plans progress.

The team is shown above with David I., CHI's Chief Executive Officer (center), Amy M., Director and Michelle M., Cath Lab Manager, holding the award.

Tradition!

Through my organization, I participate in a weekly on-line dialogue with several associates and physicians others across our system. This week has been interesting with a discussion on Tradition (in reference to Richard Gaillardetz's book, By What Authority).

Chapter three references four traditions that can be found in our lives - they could certainly be applied to our personal and professional lives:

- The "Literal" sense of Tradition (sense of stability over time that is dominant)

- The sense of Tradition as Development-in-Continuity (aspects of tradition that give evidence of significant growth and development)

- The sense of Tradition as a Reversal of Past Beliefs and Practices (the dramatic discontinuity or reversal of positions)

- The sense of Tradition as Novel (openness of new, not just preservation of the "old")

Are you aware of the traditions you will always follow? Are there traditions you challenge or want to develop? Are there Novel ones that will one day be the Traditions of Reversal?

How do we keep them all in balance when they are in a constant state of movement?

I-C-U baby...I-C-U!

So many great stories have been floating since our weather challenge the past couple days. I will give more details of the evening over the coming days.

Today, I shared with our team that Johnny, one of our nutrition services associates was at work Wednesday morning after the major storm. I thanked him for being there and he instantly turned to me and said, hey Scott, isn't that why we are all here, I-C-U baby...I-C-U (referring to our Values: Integrity - Compassion - Unity)!

Let me share just a couple of stories that came my way today. Please send your stories so I could share them as well.

_____________________

I didn't have to come to work yesterday but came today to hear how everyone pulled together to make everything work out for everyone. The employees who slept here overnight went so far to say they actually had "fun".

Thanks to all those who so well supported the staff and patients!

Kathy, RN

___________________________

My nurse, walked to work this morning….yep, walked!! She got her car stuck last night on the way home and was stranded until 1am and left her car and walked the rest of the way home. She knew she had to be at work this morning and so she just walked all the way here. She is new to St. Joseph (been here for only a few months) and her level of dedication to the patients and the organization is amazing. She is a hard worker and always a joy to be around. I just wanted you to know that this is another example of how awesome our employees are….I-C-U baby!!

Thanks,

Sarah, RN, MSN, CCRN

____________

So the next time your caught in a major situation with a need for all hands on deck, just remember why we do this: I-C-U baby...I-C-U!

State of Emergency Declared: Living our Values

Kansas City, Missouri has declared as state of emergency with our worst blizzard in years.

Our Values at St. Joseph Medical Center: Integrity - Compassion - Unity

I will tell you that today is just one of those days that stands out and makes me so proud. Our SJMC Team pulled together to ensure our a smooth day under very trying weather conditions.

Our collective efforts were just amazing. Since 7a the planning started with extended plans to get us through our shifts tomorrow - it was "All Hands on Deck." Everyone lending a hand to keep our patients safe....to keep each other safe. Tonight, we housed over 120 associates, volunteers and physicians who wanted to make sure we stayed safe to provide care and support for today and tomorrow. It's really impressive to see how many spaces were identified as overnight rest/sleep areas!

Days like today, are true tests of our mission and values. Without a doubt, our team rose to the occasion. A special thank you to the incredible associates, volunteers and physicians from St. Joseph Medical Center and Carondelet Health.