Good is the Enemy of Excellence

Donna Sollenberger, EVP & CEO, UTMB Health SystemA couple of weeks ago, I shared a little about my experience recovering from knee surgery. It has been a little more than two months since my journey began, my progress has been steady, and each day I have less and less pain. Immediately following the surgery, I was diligent in every aspect of my rehabilitation program, because I wanted to keep the swelling down, return to my full range of motion, and be able to walk without pain as soon as possible. Now that I am much more mobile and the swelling is minimal, I admit I have had a tendency to fill the time I should be doing my rehabilitation exercises with other things “I need to do”. After all, my range of motion and flexibility seem “good enough.” But is this really true?

There are many things I will want to do in the future that will require my full recovery from the surgery. Although I am in the process of healing, in the end I want to be in even better condition than I was before. If I don’t stick with my plan of care, my ability to do everything I want to will be limited. This means I must get back to aggressively rehabilitating my knee. In order to do this, I need to take the thought that I’m doing “just good enough” out the picture and settle for nothing short of full recovery of the use of my knee.

When I think about my journey so far, it feels a little like I’ve been running a marathon. At the starting line, I had been pumped and ready to go with my rehabilitation plan, my ambition was high and I was ready to cross the finish line in front of a cheering crowd on my new knee. But as the time passed and the miles accrued, I grew a little tired of doing the work. As I let myself slow down a little, it became tempting to let up even more—but if I were to stop, I’d be short of my destination. Looking back at how far I’ve already traveled, and looking at the little distance I have remaining, I realize I have to push through just a little longer to achieve true functional excellence.

Laurence McKinley Gould has said that “good is the enemy of excellence.” Others have modified the phrase to be, “good enough is the enemy of excellence.” Either way, being “good enough” implies that we are ready to accept some degree of mediocrity. As I think about my knee and rehabilitation in that light, it is clear to me that instead of charging ahead with my aggressive rehabilitation, I have recently chosen to travel the road of mediocrity. However, I know that I want to be on the road to excellence, not mediocrity!

Of course, this motto applies to many things in life, doesn’t it? Sometimes when we have a lot on our plates and we’re working on so many big projects/task, it can be tempting to feel that something is “good enough” so we can check that item off our to-do list and move onto the next task at hand. But if we truly want to achieve real excellence, we have to hang in there, giving it our all until we reach our goal.

At UTMB and in the health care industry, we realize the pace of progress can sometimes feel intense. We’re wrapping up the budget in a new system. Meanwhile, initiatives are underway to improve access and expand services for our patients. We’re building and renovating facilities, redesigning processes, optimizing the Epic EMR, and so much more. We’re even almost done planning our strategy for the coming year. Progress is continual, but every goal we set for ourselves is designed with one ultimate aspiration in mind: to be the best!

Excellent patient care and service starts with us. Our endeavor to be a patient-centered, highly reliable, value-driven organization; the first choice in the region for patients, physicians and employees; an exceptional value to payers and businesses; and a state and national leader in care delivery—well, it’s no small feat.

To be the best, we have to remember our passion for what we’re doing. When we start to feel like we’re doing just “good enough”, that’s when we need to remember why we began the journey. We each have different roles to play in achieving excellence as a health care provider, but whatever our part, whether we’re helping our patients, their families or our colleagues, we want to make a difference. And remember, you ARE making a difference! Don’t forget to look back and see how far we have come as an organization—everyone working together has made outstanding progress. Celebrate milestones. Take the time to recognize those involved who have helped make team accomplishments a reality.

It’s sometimes easy to lose sight of the big picture when you’re in the midst of day-to-day tasks combined with long-term projects. It’s understandable that we may sometimes feel as though we’re in a “just run fast continuously” environment. But keeping the end goal on our radar screen and remembering why we are dedicated to excellence will go a long way towards ensuring we remain inspired to reach the finish line.

 “Excellence is the result of caring more than others think is wise, risking more than others think is safe, dreaming more than others think is practical, and expecting more than others think is possible.”
― Ronnie Oldham

Finishing line

Aloha Spirit, UTMB Spirit

Donna Sollenberger, EVP & CEO, UTMB Health SystemMy husband and I took a vacation earlier this month to unwind and spend some quality time with our son, his wife and their eight-month old daughter, who currently live in California. We traveled to Kauai, the oldest and northernmost of the Hawaiian Islands. Kauai is sometimes called the “Garden Isle,” which is an entirely accurate description. It’s covered by lush, emerald green valleys, rainforests, breathtaking mountains and waterfalls. Aside from the fact that the island is inarguably one of the most beautiful places on Earth, one of the most interesting things I noticed was the very warm and welcoming nature of our interactions with the native Kauaian people.

What stood out to me most was that people from the island almost always made eye contact and greeted us in a way that we felt they were genuinely happy to see us. The pace of life there is also different, in a positive way. Nothing is rushed. Meals, car travel, and the beginning and end of the day were always taken in a relaxed manner. Even when people were working, there seemed to be this underlying attitude that life is not about work—people got their work done, but there was less intensity about it. As the week progressed, I noticed my inclinations to hurry my meals, honk at the slower moving car in front of me, and ensure all of my waking hours were scheduled doing “something productive” subsided. I was truly able to experience what the Hawaiians call “The Aloha Spirit.”

In Hawaii, it is common for people to use the word “Aloha”, which in the Hawaiian language usually means both hello and goodbye. The word Aloha is used in a combination with other words, such as Aloha kakahiaka, which means good morning; Aloha auinala which means good afternoon; and Aloha ahiahi which means good evening. But the literal meaning of Aloha is actually “the presence of breath” or “the breath of life.” It comes from “Alo,” meaning presence (front and face) and “ha,” meaning breath.

Aloha is more than a word. Hawaiian culture believes the word Aloha holds within itself all one needs to know to interact rightfully in the world. It is a beautiful concept that is taught from one generation to the next; it is a way of living and treating each other with love and respect. In the contemplation and presence of Aloha, harmony, pleasantness, and patience are also a part of the “Way of Aloha.” The people of Hawaii try and serve with Aloha at work, speak with Aloha to others, and live Aloha every day. It’s even considered a state law!

Aloha Spirit State Law is defined in Hawaii Revised Statutes as the coordination of mind and heart within each person. Each person must think and emote good feelings to others. Its main purpose as a state law is to serve as a reminder to government officials that while they perform their duties, they should treat people with compassion and respect. By learning and applying this lesson to real life, everyone in the community can contribute to a better world—a world filled with Aloha.

So my question to you today is how can we further the Aloha Spirit at our own organization? Better yet, in what ways can we demonstrate the “UTMB Spirit” each day?

With each and every interaction we have with others, let’s try to live and embrace the UTMB Spirit. Let’s demonstrate our core values and hold their meanings in high regard. Think of the picture we’re painting when we treat others with warmth and sincerity, and demonstrate compassion and respect to others. By being mindful of the life events of others—patients, families, visitors and colleagues alike, we make a difference. When we respect others, we value their feelings, wishes and rights; we recognize that they are human beings, and we care about how we treat them. Just as with our core value of integrity, when we respect others, we do the right thing by them because we know it is what should be done.

This year’s Nurses Week and Health System Week is winding down, but we should remember the theme chosen by our nurses for the week year-round: “It’s all about the patient.” Delivering excellent patient care is our mission in the Health System, but what we should emphasize is that every action and every decision we make must be made with the patient and family at heart. If we always remember this, we will never doubt what the right decision should be.

When we work together to identify and embrace the qualities that appeal most to our patients and families, and when we hold ourselves accountable to those practices daily, we build a culture that delivers a consistently outstanding experience to them and to one another. It is up to us to deliver what every patient, family member and employee deserves—the best possible care and a caring environment. And we are rewarded in turn. As the Hawaiians say, “Life is good when you live doing the right thing.” For all Aloha that is given, Aloha will be received!

I hope each and every one of you will demonstrate the “UTMB Spirit” to our patients, each patient, each encounter, every time.

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Nursing is an Art

Donna Sollenberger, EVP & CEO, UTMB Health SystemUTMB celebrated National Nurses Day on Wednesday, May 6, with a number of events held throughout the day, including a Health Walk & Zumba, a blood drive, a nursing history display and more. One of the events I look forward to each year is the Showcase of Nursing Excellence, a presentation of research posters on a variety of topics. The posters are displayed in Café on the Court and on Wednesday, representatives from the project teams were present to share their findings with visitors.

As I walked the perimeter of the cafeteria, interacted with these nurses and learned from their posters, I was reminded that nursing is a fabric of many threads, all woven together for a single purpose: to provide the best possible care for patients. This made me think of the famous Bayeux Tapestry, which I’d had the opportunity to see four years ago in France.

The Bayeux tapestry was commissioned by William the Conqueror's half-brother Odo to celebrate victory at the Battle of Hastings. Photograph: David Levene

The Bayeux tapestry was commissioned by William the Conqueror’s half-brother Odo to celebrate victory at the Battle of Hastings. Photograph: David Levene

The tapestry is a band of linen nearly 230 feet long, consisting of nine panels sewn together to depict more than 70 scenes from the Norman Conquest, which culminated in the Battle of Hastings in 1066. The tapestry is embroidered with 10 colors of yarn and four types of stitches. Its conservator considers it one of the supreme achievements of the Norman Romanesque period, and the fact that it has survived intact for over nine centuries is “a little short of miraculous—its exceptional length, the harmony and freshness of the colors, its exquisite workmanship, and the genius of its guiding spirit combine to make it endlessly fascinating.” What makes it even more fascinating is that the ending of the tapestry has always been missing.

In many respects, nursing is like a tapestry. The same year Florence Nightingale started the first school of nursing at St. Thomas Hospital in London in 1860, she published a 75-page booklet, “Notes on Nursing: What It Is and What It Is Not.” Much of her work focused on hygiene, consideration for patients’ feelings, and the importance of a quiet environment for healing. Much of her advocacy is still relevant today—think of our work in hand hygiene, patient- and family-centered care, patient safety, and our efforts to make the hospital a beautiful, healing and serene environment. These are all aspects of patient care addressed 145 years ago by the founder of modern nursing.

It is within these contexts that nursing today has evolved. While our primary focus continues to be on patient needs and direct care of the patient, nurses today have become very specialized, often spending their career in a particular field of nursing and achieving specialty certifications or advanced degrees that set them apart in their knowledge and skill. And not all nurses today work at the bedside, as they did in the early days of nursing. Today, nurses can be found in settings ranging from clinical care to care management and research, they are found working in operating rooms, patient access centers (call centers), conducting nursing education, working in administrative roles, or even in information technology. There are countless environments in which they contribute to the growing body of nursing knowledge. Although the tapestry of nursing has many more “colors” than the Bayeux Tapestry, all nurses, whatever their roles, are brought together in a single, outstanding masterpiece through their passion for exceptional patient care.

Like the Bayeux Tapestry, our tapestry of nursing at UTMB also tells a story. The scenes it depicts include accounts of nurses who have gone above and beyond the expectations of their job to care for patients, and nurses who pitch in to help one another when the census is high in their department or unit. Our tapestry tells the stories of nurses who see a need and do what they can to meet it—the stories of compassion for patients and for one another is exceptional.

Imagine our tapestry. Each panel tells a story of remarkable patient care, innovation and teamwork. The first panel we observe depicts a story of the nurses on the Blocker Burn Unit, who cared for patients injured in a refinery fire near Beaumont earlier this year. Alongside the burn unit nurses were nurses from the PACU and SICU, who knew what needed to be done and helped provide additional staffing support and care for these critical patients.

Another section of the tapestry tells the story of a nurse who worked this past Christmas Eve. She also volunteered to work on Christmas Day, because she did not have family nearby and was not planning to travel home for the holidays. She wanted to stay and work so other nurses on the unit could be home with their families and children on Christmas Day.

And yet another panel of the tapestry shows a nurse in the Cardiac Catheterization Lab, working to improve the procedure of radial artery catheterization in the left arm. In one scene, she is shown working at home, night after night until she creates a successful “arm board” for the procedure. She names the device after the physician who performs the procedure. In the next scene, the entire patient care team celebrates her invention, as it makes the procedure easier for the physicians and more comfortable for patients. Even MIT expresses interest in working with UTMB on perfecting the innovative support device.

Our nursing tapestry is filled with stories of innovation and creativity of nurses who provide outstanding care for our patients. Later today, I will attend the Silent Angel Awards (held from 2 p.m. to 4 p.m. in Research Building 6, Room 1.206), where I will hear more stories of nurses whose compassion, caring and advocacy have made a difference in the life of a patient, family or friend.

Like the Bayeux Tapestry, the principles of nursing founded by Florence Nightingale have remained intact, standing the test of time; and today the harmony of nurses and other team members working together to care for our patients remains a fresh and vibrant story. UTMB’s nursing tapestry has been sewn with exquisite workmanship by highly skilled nurses, guided by the spirit of Florence Nightingale.

Nurses are drawn to their profession so that they can give back to others and care for people in their greatest time of need. Like the Bayeux Tapestry, our nursing tapestry is not yet complete—but this is a good thing! We can look forward to thousands more stories that will exemplify the compassion, innovation and skill which intersect to create the caring environment of nursing at UTMB.

To all UTMB nurses, regardless of where you work within our system, we celebrate you and your achievements. Thank you for all you do to make patient care at UTMB exceptional.

nursing is an art

Staying the Course

Donna Sollenberger, EVP & CEO, UTMB Health SystemAbout two months ago, I underwent knee surgery. Today I am still in the process of recovering, but doing very well. The day I was finally off my crutches was an exciting day, and not long after that, I was able to walk completely on my own again. I still see my physical therapists, Patrick and Lindsay, here at UTMB on a regular basis. During a recent therapy session, Patrick told me that I am indeed making great progress, but now I needed to begin working on my gait.

I thought, “My gait? This is how I’ve walked my entire life!” He explained that because I was recovering from surgery, I had naturally compensated for my recovering knee by leaning a little to one side as I walked—I now needed to focus on centering my body more evenly above my hips, think about the amount of weight I put on each leg as I walked, and I should push off from my big toes. There were many instructions!

As I tried to remember each correction, I realized I actually had to concentrate to walk with proper posture and gait. Although I’m not entirely certain how I’ll change these long-time habits, I know I have to stay the course to improve so I can be in the best physical condition. It’s going to take time and effort!

After my therapy session, I attended a special presentation by Dr. David Henderson, primary author of the Society for Healthcare Epidemiology of America Guidelines, who presented valuable information on the prevention and treatment of bloodborne pathogen exposures.

After the lecture, I walked back to my office from Levin Hall Auditorium, and I decided to stop in the cafeteria and quickly grab something for lunch. There, I saw Karen Chapman, director of Rehabilitation Services. I took the opportunity of our chance meeting to tell her that I could never have recovered so quickly without the help of all the wonderful physical therapy staff members, and that I am very grateful for the excellent care I have received.

Karen told me that she was very pleased I had a good experience, but she had noticed as she walked behind me after the lecture that my knee might be better, but now it was time to work on my gait. “Seriously?” I thought. “Why is everyone so interested in my gait?”

Back at my desk, I thought about my morning appointment and the conversation I had with Karen, and it reminded me that it is much harder to learn to undo something you’re used to than it is to learn something new. It is also easy to slide back into the old way of doing something if we don’t maintain our focus. For example, I noticed that when I concentrate only on walking properly, I can walk as I am supposed to walk; but as soon as I am distracted, I slide right back into my old gait.

In health care, we have so many changes hitting us all at once. No wonder people feel stressed and overworked. The pace of change is unlike any I have seen before. It makes sense that we have a hard time making real and sustained change. However, I know that if we prioritize our work and stay focused on the highest priorities, we will eventually reach the point where we will have real and sustained change. This is why everyone in the Health System is working very hard right now to narrow the list of new priorities for the coming year so we can remain focused on opening the new Jennie Sealy Hospital, making the new League City Hospital a success, and most of all, taking great care of our patients.

It is truly amazing to see how much progress we’ve made just in the last few years, and it is very exciting to know we’ll soon be caring for and supporting our patients and their families in these amazing new facilities. I remember when we first began planning for our new future, the many projects at hand seemed daunting. At the time, opening day of the new buildings seemed far away in the future.

From that point forward, everyone at UTMB understood that we would have to stay focused, and we had to remind ourselves regularly that achievements of this magnitude could only be made by taking the process one day at a time. And here we are today–it’s the first day of May 2015 and we are starting the move into the new Clinical Services Wing, preparing to open the new League City Hospital early this fall, and by next year at this time, we’ll be in the new Jennie Sealy Hospital.

While it seems that new initiatives arise just as previous initiatives are completed, there is something I can say with certainty: our accomplishments are remarkable. Every single individual at UTMB Health has played an important role in that success and should be proud of their contributions.

There is a quote by author Marabel Morgan: “Persistence is the twin sister of excellence. One is a matter of quality; the other, a matter of time.” With steady focus and determination, new changes not only get easier with time, but before we know it, we have reached our goal, and we are better and stronger than before we began!

Thinking Beyond Boundaries

Donna Sollenberger, EVP & CEO, UTMB Health SystemIn an earlier Friday Flash Report post, “What we really do for a living”, I shared my thoughts about what we really do for a living. What we actually do at work is much more than a job title, and much more than a job function. What we really do for a living is what motivates us—it’s what makes us want to give it our all.

After all, merely fulfilling the function of our job isn’t necessarily what helps us get through tough days, and it’s probably not why we’ll stick around for the long haul. Most of us need something more—more than just a paycheck or a job function to feel good about our jobs and more importantly, to feel a sense of purpose in our work. We need to feel meaning!

When we overcome challenges or solve problems, we know it means we’ve made progress; that feels good! And, we all enjoy opportunities to be creative and innovative, because it gives us a sense of ownership and pride—it feels good to know that we played a part in achieving something great.

Each and every job role at UTMB Health is important and helps us achieve our mission. Our patients and families count on us. And, just as I talked about in my recent posts on teamwork, our colleagues count on us to be there when they pass us the ball, because otherwise, we not only fail our team, but we fail our patients.

Questions we often reflect on, and should continue to reflect on every day, include: How can I help make a difference for a patient or their family member today, whether from the front line of patient care or from behind the scenes? How can I help make a colleague’s day brighter or their work go more smoothly, so they, too, can make a difference for our patients and their families?

Today, I want to reflect on a new question: how can we think beyond our boundaries to meet the needs of our patients, their families, our teams and colleagues? In a challenging health care environment, this will be a question we will face daily. It requires our creativity, innovation and a desire to gain new knowledge. We may not always have every resource we desire to meet the needs we wish we could fill. It means we will need to work together collaboratively within our teams and across departments and mission areas to successfully fill those needs. We must share our knowledge and expertise both with our UTMB colleagues and with those outside our organization, who share our commitment to excellence and passion for exceptional patient care.

Brilliant solutions are easy to see in hindsight. But, having the foresight to come up with one is something completely different. Smart, innovative ideas require unconventional thinking. Sometimes it is necessary to find creative solutions. Sometimes we must be the ones to find a better way.

I recently received some exciting news about how one of our employees, Rachel Murray, business manager for Transplant Services, worked together with the Office of Development to secure a $50,000 grant from the JLH Foundation, which was established according to the wishes of John L. Hern to support the financial needs of transplant patients and their families, and to promote the need for organ donation.

In her proposal, Rachel and the Development team described how the transplant process is one that bears considerable challenges for patients as well as their families. For many, the financial strain can be just as exacting as the physical toll of the procedure. With these new funds, UTMB will be able to help support transplant patients in need by assisting them with temporary housing, travel, prescription medication and transportation services while they are at UTMB for their procedure and aftercare.

Meanwhile, I received another note of good news, when I learned that Richard Foy, program manager in the Department of Neurodiagnostics (formerly the EEG/EP Lab), had an article published in the April 2015 issue of The Neurodiagnostic Journal, “PartnerSHIPS: Aligning Your Department with Administration for Smooth Sailing”.

His article describes the great work done in his area over the course of a two-year period that led to improved patient care outcomes. This achievement was made possible because of the remarkable collaboration that took place between neurodiagnostic technologists and hospital administration. The team worked together to identify barriers to success, improve processes, and identify ways to improve cost and utilization management. Additionally, they implemented a cross-training program among team members and identified professional development opportunities for staff so that they could not only meet operational and financial goals, but most importantly, increase the quality of care.

These are great examples of ways that innovative thinking and information sharing can help us identify new resources, improve patient care and create value, all of which result in new and better programs. Individuals may identify those exciting new ideas, but more times than not, it requires teamwork to achieve our goals. Without this sort of approach, we cannot be as successful and we cannot help others be successful.

I recently read something interesting, written by Jim Canterucci, an author who focuses on personal success. He says he strongly believes that “individuals possessing a habit of innovation, coming together, will make an organization more innovative.” Sound familiar? This is how we truly work together to work wonders!

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Honoring our past, embracing our future…

Donna Sollenberger, EVP & CEO, UTMB Health SystemThis week, I was honored to welcome attendees to the 2015 Neuro Nurses’ Day Conference, an opportunity for practicing clinical nurses to share and explore recent advances in Neurology and Neurocritical Care. The daylong event was held in the Ashbel Smith Building, which many of you know affectionately as “Old Red”.

As I approached the front steps of Old Red, I thought about what a perfect setting this was for a conference about innovation and advances in health care, because this is where nearly 125 years ago, 23 students and 13 faculty members began UTMB’s legacy to advance health care education, research and patient care. Just five years later, UTMB’s School of Nursing opened as the first university-affiliated nursing school in the U.S.

UTMB was founded as a center for scientific inquiry, a training ground for the future of medicine, and a catalyst for improving the health of society. Since that time, we have earned a reputation for graduating health care professionals who share a deep commitment to excellence, a desire to blaze new trails, and an unsurpassed willingness to leverage their extraordinary expertise to improve the health and well-being of others. Today, UTMB continues its legacy and builds on its rich history. This made me think of a principle that a former mentor had shared with me: Respect all that is good about the past while looking forward to the future.

As we embark on our journey to increase the value (cost + quality) of patient care, we must ground those advances in the history of UTMB that has served us well over the past 125 years. The work we do for our patients is incredibly diverse and often complex. We care for patients from all backgrounds, ranging from the most critically ill to those who seek routine preventive care to stay healthy.thumb_972D434E3BF7486F824579B8DCD36448

Therefore, the work that we do for our students and trainees is also diverse and complex, and it is why we recognize lifelong learning as one of our core values. Despite the complexity and challenges of an ever-evolving health care landscape, UTMB is continually recognized for its exceptional achievements.

Innovative approaches to education, like online courses, are helping us offer students alternatives to traditional classroom learning. Thinking back, I remember after Hurricane Ike, I was so impressed to learn that almost all of our SOM and SON curricula were placed online so students could continue their studies without having to physically be on campus. Now, we offer educational outreach methods on an ongoing basis, like the UTMB School of Nursing’s RN-BSN program, which allows current registered nurses an opportunity to advance their education by earning a Bachelor of Science in Nursing (BSN) degree in a 30-hour, two-semester online program; these innovative approaches to education continue to blossom.

This year alone, nearly 1,000 total faculty members are preparing a diverse student body of more than 3,000 individuals across the fields of medicine, nursing, health professions and biomedical research for a bright future; more than 1,300 of those future leaders will graduate this year.

As I think about our future at UTMB, regardless of the department in which we work, we all have many opportunities to work together collaboratively to make a difference —not just within our own department, but across the entire organization. We continue to seek ways to provide the highest quality of care in every patient interaction. We embrace lifelong learning to grow professionally and take advantage of special educational programs, just like the 185 attendees at this week’s Neuro Nurses’ Conference. We explore ways to share our knowledge and expertise both with our UTMB colleagues and with others who share our commitment to and passion for exceptional patient care.

As we embrace our value of lifelong learning and spirit of innovation, let’s strive to:

  • Reach our fullest potential, personally and professionally.
  • Be adaptable and flexible in our approach to our work so that innovation is a natural outcome of the way we work.
  • Remain open to new approaches and practices in our work.
  • Value the ideas of others and respond in positive ways—this does not necessarily mean we must embrace every idea we hear, but it does mean that we support a culture where new ideas and innovation are welcomed and freely explored.
  • Commit to putting our patients and families first, so that we advance patient- and family-centered care.

UTMB has an unparalleled legacy of service because of the caliber of its people, and in true UTMB spirit, we are thinking boldly about how we can expand the impact of our excellence nationally and globally. Each of us at UTMB Health can best honor our rich history of accomplishment and service by staying focused on our future. We commit to excellence in all that we do as we work together to work wonders for our patients.

Teamwork divides the task and multiplies the success

Donna Sollenberger, EVP & CEO, UTMB Health SystemOne of my favorite weekends of the year starts tomorrow. Why? Because it is the NCAA Men’s Regional Final Four Basketball Tournament! This year, I am especially excited, because two Big 10 teams are in the quest to become the 2015 NCAA Championship team. I have a college and alumnae allegiance to the University of Illinois, but I am really a Wisconsin Badger fan, because of the eight years we lived in Madison.

When my family moved there, Wisconsin was not known as a basketball powerhouse, but March Madness of 2000 changed that when Coach Dick Bennett took the Wisconsin men’s basketball team to the Final Four. As I watched Wisconsin play Arizona last Saturday night, I thought of all the lessons we can learn about leadership and teamwork exemplified by this Wisconsin team.

I suppose one has to first live in Wisconsin to truly understand that people there don’t really wish to stand out, individually. For the most part, they are understated people who usually go about doing the work that needs to be done—no fanfare, no need for individual praise; they just want to get the job done, and there’s no feeling that any one job is more important than another.

As I watched the tournament game last weekend, I was struck by the fact that the players’ uniforms all have the classic Wisconsin motion W, but there are no names on the uniforms. As a newbie to Wisconsin basketball in 2000, I asked someone about this. Without hesitation, my friend told me that in Wisconsin, the emphasis is on the team, not the individual. No one player is more important than the other.

As I mulled over that response, I decided that the University of Wisconsin Health System would take the lead from the Wisconsin men’s basketball team, and we eliminated titles from our doors and from our employee badges. I always knew where people worked without these identifiers, because we kept the department name on the badge; but without titles on our badges, it was emphasized that no one position in our organization was more important than any other. We all were important parts of a team.

The other thing I noticed about the Wisconsin team is that if one player was not doing well that night, the team rallied and found someone who could get the baskets needed. Although Frank Kaminsky is a great basketball player, the last two games have not been his very best. Fortunately, Sam Dekker stepped up, and along with the other forward and guards, made the difference between winning and losing. When the opponent finds a weakness, the Wisconsin team adjusts and continues to play.

It’s the same in the work we do at UTMB. We all have our strengths and our weaknesses, but we must magnify the strengths of the team to get the work done. Sometimes the usual leader is not up to a particular job at that moment, so others on the team step up to help and get the job done. During the past two weeks as I have recovered from knee surgery, this has certainly been the case with the leadership team that works with me. They have stepped up and kept everything going exceptionally well to allow me the time I needed to mend.

If you watch the games this weekend, take note of another thing: most of the coaches are running up and down the sideline signaling or calling out plays to the players. The Wisconsin head coach, Bo Ryan, rarely does this. Why? Because he and the team have practiced and practiced and practiced to the extent that he trusts his team to continue to move the ball and make the plays that they have practiced time and time again. They are prepared. And so it should be with us.

One great example at UTMB is that while we have not yet needed to care for an Ebola patient, our nurses, physicians and other employees who will be at the front line of care, should this ever occur, have trained and trained and trained so that they are prepared. There are so many more examples of teams preparing throughout the organization. Have you thought about how you contribute to your team to care for our patients? Even if you don’t directly care for a patient, your supportive work, whether it is filling the Omnicell or greeting families and visitors, contributes to the team’s overall effort to take good care of our patients.

As a leader, it is apparent that Bo Ryan completely supports his team. When he came out of the locker room after halftime in a game where Frank Kaminsky did not have a stellar first half, one of the sports announcers asked what Coach Ryan had said to him team, which was losing at the time. Coach Ryan didn’t take the bait. Instead, he simply said, “I told the team to keep doing what they were doing.” The announcer then tried to get him to comment on Kaminsky’s performance, but Coach Ryan rattled off Kaminsky’s first half statistics and said he thought Kaminsky was having a good game. There it is: Coach Ryan always supports his team. He may privately talk to them about what they need to improve, but publicly, he always supports their efforts. Do anything else, and you erode the team.

Finally, when the Wisconsin team gets behind, they don’t panic. They generally don’t make “dumb shots” or “bad passes”. You win the game (you get where you need to go) if you are prepared and don’t panic. So far that has worked for Wisconsin. The team has two more games to go, and my hope is that they emerge as the champion; if they do not, I am still proud to support them, because for me, they exemplify all that is good about leadership and teamwork.

I know we are faced with much change and many challenges in health care today. The future is riddled with one proposed cut after another from our payors. I know you have heard about our challenge to improve our margin by $100 million over the next five years, and that seems like daunting feat to many. But, if we do not panic, and if we create a detailed game plan for addressing this challenge, then we can systematically work the plan, and we will be successful.

Just as I am confident and proud of the Wisconsin team, so I am confident about UTMB’s future because we have the right team of people and, under the leadership of UTMB President Dr. Callender, we have the right leadership to face future challenges and emerge a stronger UTMB.

 

Teamwork and Trust

Donna Sollenberger, EVP & CEO, UTMB Health SystemContinuing with last week’s theme of college basketball (and in honor of March Madness), I thought it would be interesting to talk about some of the different aspects of basketball that foster teamwork and trust. It is fascinating to me that a group of individuals can join together as a team, and even though many of the team members may have never played together in the past, they can become good enough over the course of two to four years that they can always count on one another to be at a particular place on the court during a set point in a specific play.

Practice after practice, the team drills the offensive and defensive plays developed by their coach to become consistent, and through this intense practice and repetition, the plays become second nature—the team develops an intense trust of one another and their coach, and decisions about passing and shooting become instinctive.

The one move that amazes me most is the blind pass, which occurs when the player with the ball looks in one direction but passes in another. This is done to confuse the opposing team’s defense. It is not an easy move, and it is definitely risky, but when it happens and works, it is truly remarkable. I remember the first player I ever saw do this with any regularity was Pistol Pete Maravich, but other greats such as Isaiah Thomas, Magic Johnson, Larry Bird, Steve Nash and Michael Jordan all also used this pass with some regularity. And most of the time, this type of pass successfully caught the other team off guard, resulting in points scored.

I would imagine in order to effectively carry off the blind pass, each member of the team must understand everyone’s roles well, knowing they can count on one another to be where they should be at a specific moment and time, doing their defined job; they also have to believe their teammates are sufficiently capable. This is really the only way any team can optimally perform!

In many respects, we have our own blind passes in health care. For example, think about how important it is for each member of the team in the emergency department to know their own role as well as that of others on their team. They must trust and have confidence in one another. When seconds matter, as they often do in the ER, being able to act deliberately, consistently and predictably can mean the difference between life and death. And, it is the same in the operating room and on the inpatient units when acting decisively is critical to the outcome for the patient.

In the clinics, the pressure of time may not be as intense, but when a patient needs an appointment or calls with an issue they need to discuss with us, it is important for each member on our team to know their role and perform predictably. If not, we ultimately let the patient down, and our lack of responsiveness could mean we have lost the opportunity to intervene during a time when we could help prevent the patient from becoming increasingly ill and/or having to be admitted to the hospital.

Finally, a good blind pass requires great communication on the court—and, so it is with health care. As we work in teams, being able to be open and forthright with each other regarding the care of each patient is essential. It is critical that every member of the team respects one another and encourages each other to speak up when they are concerned about any aspect of the patient’s plan of care. After all, it is only in an environment of mutual respect and explicit trust that people feel comfortable speaking up. A team is not a group of people who merely work together; a team is a group of people who trust each other.

Phil Jackson is an American professional basketball executive, former coach and former player, who currently serves as president of the New York Knicks in the NBA. He says, “Good teams become great ones, when the members trust each other enough to surrender the ‘me’ for the ‘we’”.

So, how will WE work together to work wonders for our patients and their families today?

Success is the natural consequence of consistently applying the basic fundamentals.

Donna Sollenberger, EVP & CEO, UTMB Health SystemI admit it! I love college basketball. Not just any college team, however. I am an avid Kansas University basketball fan (the “why” is a story for another time). We are now about three weeks away from the beginning of March Madness, and other than work, it is hard for me to focus on anything other than watching the games in the evening and on weekends.

My love of the sport began in high school. My senior year, our high school team came in third in the state tournament. I remember walking into the Assembly Hall at the University of Illinois and being overwhelmed by the sheer size of the field house. Today, that experience reminds me of the movie, “Hoosiers”, when Gene Hackman’s team gets to the state tournament. As the team walks into the field house for the first time, Hackman’s character is aware that the team feels overwhelmed by the size of the venue. He asks the players to begin measuring the court. Little by little, they become aware that nothing about the size of the court has changed. What has changed is simply the size of the field house where they are playing.

In many respects, playing in a national or state tournament is a lot like working in health care. The magnitude of what we have to do seems greater than ever before, but the fundamentals of what we do, much like the basketball court, has not changed. Our job is to take the very best care of patients and families that we can. In our tournament, we strive to BE THE BEST!

When I lived in Madison, Wisconsin, the basketball players had to run the hills on the outskirts of the city. Day after day, up and down the hills the players ran. It was not exciting; in fact, it was probably very boring, but year after year, the Wisconsin Badger’s conditioning pays off. Through hard training and practice, under the leadership of Bo Ryan, Wisconsin has become a regular contender in the Road to the Final Four. Last year, they made it to the Final Four.

When I was at the University of Kansas, Coach Ted Owens made his players shoot free throw after free throw, and often it was their predictable free throw shooting that made the difference in their wins. Again, this repetition and daily practice wasn’t glamorous, nor as entertaining as racing down the court, crossover dribbling behind one’s back and dunking the ball, but it was the difference that made the win for the Kansas Jayhawks.

In health care, we condition ourselves through practice—doing the same thing, the same way, every time. That consistency is a must in health care. It is when we deviate from the plan, when we decide that we can do something better than the way we were trained, that we end up not doing well. As we practice doing something over and over, we get better at it, and therefore provide safer care to our patients. Whether it is calling time outs, or reviewing and signing patient histories and physicals, whether it’s gelling our hands before and after entering a patient room, or developing our budgets, training and consistency pays off for our patients and provides the underpinning to BE THE BEST.

As you think about your work this week, what do you need to practice or have your team practice to assure our progress toward the goal – TO BE THE BEST?

“I stick with the fundamentals. The basics.”

—Bo Ryan

 

Focusing on our Future

Donna Sollenberger, EVP & CEO, UTMB Health SystemWhen Bill Gates first met Warren Buffett, their hostess at dinner, Gates’ mother, asked everyone around the table to identify what they believed was the single most important factor in their success through life. Gates and Buffett gave the same one-word answer: “Focus.”

Focus is not just something you have—it is also something you do. This type of focus is not static; it is an intense, dynamic, ongoing, iterative process. When people are focused on just a few things, they are usually successful; but when they focus on too many things, the quality, value and timeliness of their work often suffers. Meanwhile, after someone achieves success, they often find themselves suddenly presented with many more new opportunities and options. However, this sudden influx of new opportunities can ironically become the very thing that diffuses what brought success in the first place: it becomes difficult to effectively focus!

Just imagine what would have happened to Ray Kroc, the salesman who turned McDonald’s into a franchise, if after opening twenty McDonald’s locations, he decided to get into the pizza business?

By now, you should all be familiar with UTMB’s new document, The Road Ahead, our institution-wide roadmap for the future and the plan that forms the basis for more detailed goals in each mission area: the Health System, Academic Enterprise and Institutional Support. UTMB President Dr. David Callender recently reviewed the booklet at our most recent Town Hall meeting, and as I’ve attended different meetings and conferences at UTMB, I’ve shared the document with our Health System and Correctional Managed Care teams, as well. If you haven’t seen the document yet, please visit http://www.utmb.edu/strategic_vision.

Why did we feel it was important to revise The Road Ahead? One of the greatest reasons for this change was leadership’s realization that we were trying to do too many things. By distilling our priorities down to the very essence of what we want to achieve, it will not only help everyone remember what we are focused on at UTMB, but it will also help our employees and faculty connect to what is essential to our success as we move forward. Therefore, in the new document we streamlined our strategic priorities, the foundation for our strategic vision to “be the best”, from a total of eight priorities down to four key priorities:  People, Value, Strategic Growth & Management, and Resources.

A while back, I read an article in Havard Business Review, written by Greg McKeown, about how in today’s society, we have a tendency to always take on more, more, and more. In doing so, the state of being overwhelmingly busy is sometimes perceived as possessing some sort of superhuman quality. But in reality, this sort of frenetic pace and perception of success can actually end up negatively impacting the quality of our overall performance—all of our endeavors, especially the most important ones, do not get the attention they deserve for successful outcomes. And we also diminish our own effectiveness as we jump from one thing to another.

McKeown compares the process of identifying our essential tasks and remaining focused on them with the great feeling we get when we box up the old clothes we don’t wear anymore and give them away. The closet clutter is gone. We feel freer. So, wouldn’t it feel liberating and energizing to clean out the closets of our overstuffed to-do lists and give away or eliminate the nonessential items, so we can focus our attention on the things that truly matter?

The pace of growth at UTMB is greater than ever. It’s a very exciting time, but at times it can also feel a little overwhelming—I’m sure every one of you can attest to this. On March 9, at my upcoming Mondays in March presentation, I’ll discuss how the Health System has progressed since FY2013, when it established its vision for the future. I’ll also talk about some of the specific things we’ll be focusing on in the coming year as they pertain to each of our strategic priorities. Then, we’ll talk a little about how each department, work unit and individual at UTMB can help support our goals.

As each of us begins to reflect upon how our work supports the Health System and UTMB’s Road Ahead, I want to encourage you all to remember something important: we can’t do everything, have it all or achieve it all without the ability to also know how to take care of ourselves, stay focused on what’s essential, and know when to say “no” to the opportunities that don’t support our goals as effectively.

This doesn’t mean we want to achieve less; it means we want to do the most important things better. So as we set our goals within our departments and on an individual level, let’s remember to keep our eyes focused on The Road Ahead. We must determine what is essential to our success and pause to carefully consider when something new comes along, whether it adds value to our work or if it can wait until a more suitable time in the future.

Directors and managers should help their employees connect with the goals by identifying and communicating specific actions and behaviors that either support or detract from our success. When each employee associates the work they do with the success of their work unit, they can also see how each person on their team adds value to the Health System and UTMB as an organization.

There are a few simple methods we can use to help ensure we are focusing on the essentials:

  1. Take time on a consistent, regular basis to think about what is essential and what is non-essential on your to-do list. McKeown recommends the “rule of three”: Every three months, take three hours to identify the three things you want to accomplish over the next three. We need time to think and process what we’re working on in order to see the bigger picture.
  2. Rest well to excel. There is a significant difference between good performers and excellent performers—this is not only the number of hours spent practicing, but research also shows that the second most highly correlated factor distinguishing the good from the great is how much they sleep. Self-care is important!
  3. When you hold a new event or complete a new project, keep in mind that although some activities should be continued, not every new activity has to become a tradition.
  4. It’s okay to say “no”—just because we are invited to do something, doesn’t necessarily mean that’s a good enough reason to do it. Although it may seem counterintuitive to say “no” to good opportunities, if we say “yes” to everything, then we won’t have the space to figure out how we really should be investing our time.

Should we really continue taking on more, more, more, or should we try to get more out of what really matters?

This year, we would like Health System employees to focus on the following:

  • For inpatient settings or ancillary department goals for all employees will center on:
    • patient satisfaction
    • a quality goal or a financial goal
    • employee satisfaction and retention
  • For ambulatory clinic settings, goals for all employees will center on:
    • patient satisfaction
    • overall patient access
    • employee satisfaction and retention

Any organization can have a vision and a strategic plan, and every department, unit and clinic can set individualized goals for the year, but that doesn’t guarantee anyone’s success. By focusing on the few things that are really essential, we’re able to make a more valuable contribution.

UTMB can best honor its long history of accomplishment and service by staying focused on its future. Thank you for everything you do to support UTMB’s vision of Working Together to Work Wonders.

“The real voyage of discovery consists not in seeking new landscapes, but in having new eyes.” – Marcel Proust