Do the Sick No Harm

This afternoon I attended an open house at the Belton Community Center. Specifically, our family was interested in seeing Dave Kraft a good family friend and Strong Man Champion! We were hoping he would just provide a tour. However, he had other things in store for us and had us join him in a conditioning circuit. Between moving tires, using a sledgehammer, shaking oversized ropes and pushing a medal sled across concrete, we were exhausted. Dave made sure we all understood how to safely perform each exercise and watched us prior to getting started with the circuit. There was no question that safety was his number one concern for us.

As always, the same applies in our healthcare system. Thank you Jane Falk, our Executive Director, for passing the following quote to me from Florence Nightingale. She was doing some research in preparation for nurses week and was reviewing quotes by Florence Nightingale, she found the following quote and it struck me as I realized this was stated in 1859....she thought it spoke to our safety journey, that safety is the very first requirement in a Hospital. A journey we continue to follow for over 152 years.

It may seem a strange principle to enunciate as the very first requirement in a Hospital that it should do the sick no harm.

- Florence Nightingale

Pam Hazen, RN - Associate of the Month

Congratulations to Pam Hazen, RN from the Cardiac Care Unit. Pam is our April Associate of the Month.

Well deserved Pam!

The New C-A-Bs of CPR

Have you ever seen CPR performed. Were you the one who had to perform it or were you the one just staring helplessly because you had no idea how to help. I do not want to be that guy!

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.

Living in a Fishbowl...Finding Balance

How do I find balance during my busy schedule....

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...

Scott-
Funny story…

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?

Bi-plane Vascular Suite Blessing

We had a great time last night at our Bi-plane Vascular Suite blessing and opening. This technology helps us advance our efforts with our neuroscience and vascular services. The Bi-plane Vascular Suite will be used to provide the kind of precise anatomy delineation and visualization needed to provide comprehensive Stroke Care. Thank you to all who attended the event and supported this expansion.

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.

The Visitor

This morning I went to visit a friend of mine in another area hospital. I spend thousands of hours each year in a hospital however it is always humbling when I am the visitor or patient. It is then that I take even more notice of the long hallways, signage, the environment, the interaction of staff with each other and with me. These experiences from time to time, are very difficult emotionally. However, they really do help me open my eyes even wider to my own surroundings and the experience we provide to our patients, community and each other.

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.

Visionary Award Winner - April

Congratulations to the Volunteers & Auxiliary, April's Visionary Award winners. The Volunteer and Auxiliary Services provides thousands of hours in community service and major contributions impacting the medical center's quality outcomes, growth, compliance and safety and patient satisfaction. The Volunteer & Auxilary are led by Jeri Grimes, Director and Mary Ann Nagy, President.

Happy Easter

Happy Easter!

I enjoyed rounding the hospital this afternoon with my 3 Easter bunnies...my 3 kids. First, I was reminded that the Birthing Center had requested chocolates for this visit. So we started there! Carmen, one of our RNs has requested S'mores for next visit.

My kids had a great time getting around the hospital with me (and giving me tips along the way). As long as they received one candy treat per floor, they stayed energized (we have 5 floors). Twix bars followed by Peanut Butter M&Ms were the crowd favorites this year.

It is always a fresh perspective seeing the eyes of your hospital through your kids. They definitely took advantage of all the handwashing stations throughout the hospital and enjoyed our new floors.

Thank you to all of you who worked this holiday.

Mindy Hamilton - Young Dietician of the Year

Congratulations to Mindy Hamilton who was selected as Kansas City's Dietetic Association's Young Dietitian of the Year!

I had a chance to see the note informing Mindy of the good news:

Hello Mindy,
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.

If Boston Marathon Ran Your Hospital...

It has been a few days since running the Boston Marathon. The fog is starting to clear and I wanted to share my perspective as I try to view the marathon from a patient perspective...

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)!

Goal Setting

This morning we are heading back from Boston. Many people are walking around doing the "marathon shuffle." This well known shuffle is seen when walking after a race (very slow walk) and definitely when going up/down stairs. Handrails have never been used more than after a race. Similar to the hospital world, there was a lot of talk about goal setting and how everyone performed relative to their goals. Many debriefing on the race, discussing what they did well and areas for improvement. I see this a lot during patient handoffs when the staff discuss how their patient is doing as the staff come on/off shift. The goal to keep our patients safe starts with understanding the goals of care. In many ways, our life in the hospital is like a marathon - times that we are going fast, times we are struggling and need encouragement and times that we are just thrilled with how things are going. Marathons involve long term planning with short term goals along the way. In hospitals, we are on our feet 8, 10 and 12 hours a day...more than any one on their feet in a marathon.

Small Innovations

Jenny (my wife) and I just landed in Boston for the marathon on Monday. It was interesting hearing different stories on proven training techniques. All stories having the same theme of discipline, focus and the drive for continuous improvement. It was enjoyable to watch these collaborations among runners and supporters. On a similar improvement note, Jenny let me know that at Hen House, a Kansas City grocery chain, they changed their deli flow after years of the same process. Customers value their time and cost. Hen House values its customers. A simple innovation took place...bringing the scale to the carving machine, the employees weigh the meat/cheese as they are cutting it ensuring minimal waste, less travel time back and forth to the scale and getting customers the exact amount the customer wanted. Driving value to their customers by improving quality and service also helps the company improve employee engagement, safety (less back and forth action), quality (less waste due to unwanted product). These improvements lead to better financial benefits for customers and the company. Small innovations are happening everywhere and make huge cumulative advancements for an organization.

Volunteers Celebrate over 110,000 Hours this Year

Congratulations to our Volunteers and Auxilary. We celebrated over 110,000 hours this year under the exceptional leadership of our Director, Jeri Grimes and Auxilary President, May Ann Nagy. To put things in perspective, approximately 2,080 hours equals a full time employee.

Take a look at our heroes by the number of hours they have served over the years...

100 hours:

John Aloisio, Arline Arel, John Becker, Barbara Crabtree, Patti Davis, Jim Elleman, Suzanne FitzGerald, Glenda Honeycutt, Jerry Kesler, Robert Lehmann, Dora Muensch, Carrie Muldoon, Mary Murphy, Patricia Pronold, Carmen Rodriguez, Jeanette Sanders-Eagan, Tom Spencer, Ann Turgeon, Marilyn Wilson, Thomas Wilson, Teresa Witherspoon, Hilary Yost.

250 hours:

Hanna Beshe, Cindi Boles, Irene Broyles, Ann Chamblin, Janice Cline, Pat Cunningham, Jean Fecteau, Karen Fitzgerald, Patricia Foley, Rocky Hembree, Mary Lou Hoedl, Mildred Jefferson, Joan Jenkins, Gayle Johnson, Kae Kesler, Frank Lange, Kathy Madsen, Marlene Matthews, Marlene McGuire, Joann Moore ,Virginia Munoz, Patty Nolte, Thomas O’Connor, Dolores Pace, Joyce Pendleton, Martha Phillips, Esther Rudnick, Donna Sigler, Allison Strobach, Ed VanLeeuwen, Thomas Wynne, Karen Ziegler.

500 hours:

Mary Jo Axtell, Anita Basham, Teri Becker, Alice Douglass, Judy Gross, Larry Hodel, Li Jeang, Raymond Kline, Bill Knipp, Karen Major, Agnes Meyers, Bill Mohr, Virginia O’Donnell, Larry Pendleton, Bill Richter, Beth Serrioz, John Slayman, Shirley Voss, Shawna Webb, Barbara Wilkins.

750 hours:

Bunny Cox, Mary Alice Flemington, Edeen Martin, Mary Maskill, Vivian Norris, G.Cayce O’Kelley, John Purcell, Kathie Smith, Peggy Stewart, Elizabeth Villaume, Michael Weinrich, Kathy Wininger, Clarice Yetter.

1,000 hours:

Joseph Baumer, Rosemary Berberick, Millie Capers, Kenneth Corsini, Rita Gromowsky, Patricia Hanrahan, Linda Jennings, Mara Kelley, Jennifer Lynn, Robert Maskill, Donna Murray, John Norris, Mimi Powers, Patricia Seiter, Joyce Solomon, Amanda Thomas, Janie Thomas, Anita Uebelhart.

1,500 hours:

Susie Bolden, Marge Campbell, Myrtle Eisele, Jerry Fladung, Peggy Hembree, Nancy Kalesz, Ronny Lenzy, William McMahon, Clifford Miller, Fred Roberts, Mattie Steinline, Richard Stiles, Beth Taylor, Candy Warinner, Lavere York.

2,000 hours:

Nancy Canent, Dick Goos, Anna Herndon, Porter Hovey, Dorothy Johnston, Ruth Lang, David Long, Katherine Long, Ann Marino, Beverly McCann, Joyce Murphy, Jay Newton, Frank Petersen, Richard Poettgen, Dorothy Stover, Eleanor Swann, Mary Ann Weding, Dale Wolf.

2,500 hours:

Shari Boles, Joan Cody, Fran Graves, Donald Hougland, Helen Madsen, Fred Moeller, Mary Ann Olson, Mimi Sherwood.

3,000 hours:

Richard Deiters, Jr., Eleonora Donahue, Carole Dykes, Elisabeth Kanter, Myra Ladwig, Dorothy Lintz, Dusty Rhodes, Jr., David Stobie, Patricia Walsh.

3,500 hours:

Harriet Bennett, Deborah Dent, Myer Litwack, Annabel McInerney, Bonnie Morgan, Patricia Shannon, Eleanora Volz.

4,000 hours:

Don Bauer, Ellen Durbin, Dorothy Hauser, Sally Jarvis, Kaye Martin, Evelyn Slayman, Thomas Stevens.

4,500 hours:

Bill Akright, Jean Gray, Jerry Harvey, Marcella Morris, Joann Shannon, Lisa Smith.

5,000 hours:

Nancy Ferrett, Bernard Flucke, Sherry Harvey, Jean Mosimann.

5,500 hours:

Bruce Border, Mary Flucke, Robert Moss.

6,000 hours:

Mildred Thompson

6,500 hours:

Ann Clark, Mary Ann Nagy, Virginia Rudisel

7,000 hours:

James Poland, Elizabeth Stewart

7,500 hours:

James McInerney

8,000 hours:

Audrey Dusselier, Tricia Sandidge

8,500 hours:

Marilyn French

9,000 hours:

William Groll, Doris Pecoraro

9,500 hours:

Rebecca Hook, Eileen Krause, Shirley Noonan

10,000 hours:

Eileen Farnen, Jeannine Foley

11,000 hours:

Richard Duncan, Sherel Sands

12,000 hours:

Geraldine Duncan

17,500 hours:

Marietta Hedrick, Russell Watson

18,500 hours:

John Cottitta, Jr.

The Future is in Our Hands

Last night, President Obama discussed his plan to curb the growth of health care costs.

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?

The Miracle Floor - Teamwork at its Best

I just have to share...this note was sent to me last week by Stephanie Boresow,Unit Secretary on 5N - Rehab Unit:

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.)

Extra Extra Read All About It!

A friend from a competing organization let me know that he enjoys reading information I send out in our physician newsletter. I did not ask how he obtains the newsletter however we live in a small healthcare world. So, in the interest in getting the word out ahead of time, here is my update for our next edition:

"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."

Why Don't You Take a Breather...

This morning I went swimming with a Master's swim group. Swimming is certainly not a strength for me but I do enjoy the challenge and benefits of it. There is so much to focus on in order to stay safe and swim efficiently. Well today, I was passed by a swimmer Blake Cooper, MD. That was not a surprise as I had been told he would be lapping us on a regular basis...or at least he would be lapping me on a regular basis. The pleasant surprise came when he took a break and saw that I swallowed water, started coughing and then began to swim again. He quickly grabbed my shoulder and said, "why don't you take a breather." Now, I really do not know Blake except seeing him during practice. His commitment to safety was impressive. Yes, I almost went on but thought, it probably took him a lot to stop someone he does not know well and no doubt he was looking after my best interest. When I think about our roles in hospitals, it is so critical that we actively look for those safety moments, acknowledge when things are safe so we continue and quickly stop each other when we see a "potentially" unsafe situation. Blake was a true unwavering advocate, a phrase our fearless CNO, Cynde Gamache has coined in the past.

To Meet or Not to Meet

This morning I met with with Sister Rosemary Flanigan while going from one meeting to the next. She stopped me and said it seems like there are a lot of meetings today. I let her know that there were a lot of meetings and I really enjoy getting around the hospital so much more than just sitting around in meetings. Everyone agrees that we can accomplish so much more when we are out and about the hospital. However, today just must have been one of those days. Sister Rosemary provided great perspective..."one day, a young hospital administrator will come up to you and ask, what do you administrators do all day. And you could say we all went to meetings!." I am pleased to share that we have reduced hundreds of hours of meetings throughout the year. There are still the times to do the balance act and ensure that we meet when we know it will have an effective impact for the organization. Otherwise, I prefer my walking (running) shoes.

Has Anyone Seen the Bladder Scanner?

We spend a lot of time at work and there are things I really enjoy and things that do start to get to me. One of those things has been the overhead page looking for a bladder scanner. No, it does happen often, but when it does, I often wonder...did the overhead help? Did a group of individuals stop and say, "hey the bladder scanner is missing, let's go hunt for it."

Now in our continuous improvement mindset, we are exploring more effective options for finding what is missing or tracking those items prior to leaving the unit. Funny thing is that I must have mentioned this during one of my Town Halls or while rounding and here is a note I received from Georgia Zeller, one of our ER associates. It just cracked me up... "Scott, I’VE GOT IT!!! I know how you absolutely hate the overhead page for “the unit that has the bladder scanner, please return it to 4 East.” I just heard it again and had a brain storm. We could establish another secret code… code green, code blue, code gray Are you ready??? Code BS (bladder scanner). Visitors wouldn’t have a clue what the page was for, but they might think something worse than bladder scanner. What do you think?? So much for my inspiration this morning. Have a great day, Georgia"

Huddling for Safety

We have daily safety huddles in our hospitals. Thank you to Lisa Thacker for attending the Missouri Center for Patient Safety Annual Conference and sharing our poster presentation "Huddling for Safety."

Closing the Loop and Fostering Innovation

Working in healthcare means many people know what you and your organization are up to at all or at least most times. No doubt, we live in a "highly visible environment" and open ourselves up to guidance (sounds much nicer than criticism) on a regular basis. Personally, I really enjoy the fact that my words and actions are looked after - there is no greater perspective than getting a 360 degree feedback on a daily if not weekly basis. Actually, it makes it much easier to course correct and get things back on track. And let's face it designing systems to create and deliver value to your patients and organization is a never ending task.

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

- Patient Satisfaction

- Market Growth and Operating Effectiveness

So how will we continue to advance our efforts? This is where everyone needs to understand their role in achieving the organization's goals and help create the priorities for improvement and innovation. We discussed the importance of "kaizen" or continuous improvement on a daily basis.

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.

Let me know about the small and large innovations you've created to better your organization.