Trust: The Most Essential Ingredient

Donna Sollenberger, EVP & CEO, UTMB Health SystemLast Friday, I began physical therapy to rehabilitate my knee. On my way to the appointment, I was incredibly nervous. I had been told by my doctor that any slight movement could cause the patella to slip, and if it did, I would face the potential of surgery.

As I got myself into the passenger seat of the car, I started worrying about all sorts of things. What if we got into an accident and I injured my knee? What if I started movement of the knee at therapy, and the patella slipped?

Once in the treatment room, my physical therapist, Patrick, began explaining to me that we would start out by “loosening” the knee, seeing how far we could bend it, and we would end the session with trying to ride the stationary bicycle (only using some simple back and forth motions, not full rotations).

To say I was reluctant to let Patrick begin therapy on my knee was an understatement! I am so used to being in control, and at that moment, I was anything but in control. As I halfheartedly let Patrick begin therapy, I realized that in order for this to work, I had to follow his lead and completely trust him with the process. Without trust, this situation was not going to get any better. He was the expert; I was not.

Then, I remembered a quote by Stephen Covey about trust: “Trust is the glue of life. It is the most essential ingredient in effective communication. It is the foundational principle that holds (together) all relationships.”

As I did the exercises over the next hour, I began to think about how many times we are called upon in our lives to trust one another. Why was I so quickly able to trust Patrick in this instance? I trusted him because he had been my therapist four months earlier after a previous surgery, and the results were exceptional. I developed trust in his work, and the outcome of that trust was a well-functioning knee. I remember so many people commented on how well I was walking, they couldn’t even tell that I had surgery.

In many respects, developing trusting relationships is not unlike the work we do at UTMB, particularly in patient care. Our patients trust us to help them and to do the right thing. For that to happen, we must effectively communicate with any number of individuals on the care team. Creating a culture of safety requires trust and respect of all people working together on behalf of the patient.

A culture of safety does not happen when people are afraid to speak up. When people don’t speak up, there is no trust, and that has the potential to be harmful. We all have a responsibility to speak up when we see that shortcuts are being taken, rules are being bent, or that the system or process has the potential to do harm. As a member of the team, we must be ready to graciously welcome the feedback, because we realize that concerns are being voiced purely out of concern for someone’s safety and well-being.

Anytime a person speaks up and they are responded to with disrespect or disregard, trust is eroded, and the person who spoke up will be much less likely to speak up in the future. The person who will be harmed in such a scenario is innocent: the patient. That is not at all what we want.

In a culture of safety, the person who speaks up also has a responsibility to do so in a caring and respectful manner. It is hard to admit one is wrong or about to take a risky shortcut, so if the communication is not handled respectfully and tactfully, a loss of trust is also at stake. It is important not to point blame at the receiver of the message—no one wants to feel blamed; rather, the concern is being voiced in the context that it is helping to avoid a potential mistake.

I recently read an article about why people are reluctant to speak up, and I can relate to each reason:

  • Confronting people is difficult; too many people prefer to avoid conflict rather than respectfully addressing the issue
  • Others feel that speaking up is “not their job”
  • Some are not confident that speaking up will do any good
  • And other obstacles are time and fear of retaliation

My physical therapy has shown me the importance of trust in carrying out my plan of care, but I also feel I have a responsibility to speak up if any of the therapy movements are causing me pain or I do not “feel right”. The saying, “no pain, no gain” may be true in some instances, but it is better that I speak up and let Patrick consider if we should continue or not. If I do not, I am not being a responsible participant in my care.

I hope as we go about our work this week, we will think about our personal responsibility to create a culture of trust and safety by respectfully speaking up, or if we are on the receiving end of the message, to graciously accept our colleague’s message.

Always Trust your Instincts

Donna Sollenberger, EVP & CEO, UTMB Health System“Always, always trust your first gut instincts. If you feel something’s wrong, it usually is.”

It was a Thursday morning three weeks ago, and I had started my morning the way I usually do – I got up, got ready for work, and went into the kitchen to grab my lunch from the refrigerator before leaving the house. As I rounded the corner, I was greeted by small bugs all over my kitchen floor! I immediately grabbed the insect spray and started spraying. The bugs were exterminated, but now the floor was very slick. I knew it was too dangerous to leave it that way, so I grabbed a mop and began cleaning the floor.

With the chore completed, I picked up my keys and briefcase, but I remembered I still had not grabbed my lunch. As I started carefully walking across the kitchen floor, it occurred to me that doing this was probably not a good idea—what if the floor wasn’t completely dry and I slipped, or worse yet, fell? The moment after I had that thought and yet took another step, my left leg slipped forward, my right leg bend backward, and I heard something snap. You guessed it; I broke my leg.

I cannot tell you how many times I have replayed that split second in my mind. Each time I think: “What if I had listened to my gut? I knew better, but I did it anyway!” We all have an internal alarm system that alerts us when a situation feels wrong. I ignored my instincts, and now I am dealing with the consequences.

In many ways, this reminds me of conversations we have had about patient safety and our own efforts at UTMB to create a safer environment for our patients and employees. Our culture of safety demands that we should always speak up and stop what we’re doing if we see or even instinctively feel that something could have the potential to harm a patient.

Last week, the National Patient Safety Foundation released a report entitled, “RCA2: Improving Root Cause Analyses and Actions to Prevent Harm.” The report asks hospitals and health care providers to approach close calls or observed systemic flaws with the same rigor that they do when a major safety event occurs.

The report says that even though the use of the term “culture of safety” is common in health care today, as an industry we have not really made the necessary progress, because creating this culture involves “hard, continuous work and can challenge the status quo.” The report points out that often, safety event reporting systems like our Patient Safety Net (PSN) are used to report what has already happened, not what could have happened, simply based on the system’s design.

As health care providers, we must constantly evaluate the systems in which we are delivering care, and when we are concerned that any system may have flaws, we need to act on those instincts. If we do not, we may be putting our patients at risk.

Once, in a hospital at which I’d worked, a nurse submitted a PSN report to document that the new tubing we had transitioned to for IV delivery was occasionally crimping, thus slowing the delivery of the patient’s medication. Our safety team went to the unit, looked at the new tubing, and realized the nurse was correct. They immediately ordered new tubing, replaced it throughout the hospital, and addressed the problem.

In this instance, the nurse’s instincts were right, and she acted on her instincts. Although we will never know the actual number of patients’ lives that were positively affected by this nurse’s decision to act on her instinct, what we do know is that we were able to correct a system flaw before any patient’s well-being was compromised.

I am certain there are countless stories we could tell of nurses, physicians, residents and other health care staff who have acted on their instincts to keep patients safe. The point is that they acted.

As we go about our important work, let’s be conscious of any system design that may potentially cause harm if we do not identify the flaws and fix them before a patient is affected. Let’s act on our instincts. I certainly wish I had three weeks ago!

Positive Moments, Healing Moments

Donna Sollenberger, EVP & CEO, UTMB Health SystemAlong a patient’s journey, she or he will encounter many different representatives of UTMB. From our website to the access center, from parking attendants to the hospital welcome desk, then on to registration, waiting rooms, nurses, physicians and more. There are so many people and settings making first impressions that can affect a patient’s experience, and the sum of all parts creates their overall impression of UTMB Health.

While the ongoing improvement of our processes will always be an aspect of enhancing the patient experience and improving the quality of care we deliver, there is one simple thing we can all do to help our patients and families feel better—radiate positive energy and compassion.

Patients want to be cared for by a team of caregivers who show an interest in them as individuals. This isn’t only important in terms of what we consider to be the “surveyed” patient experience, either. When patients feel comfortable with their care team and trust them, they are more likely to follow through with care instructions, which means fewer readmissions and an overall improved quality of life for many patients.

As a caregiver, if you walk into the room and appear pre-occupied, in a hurry, and start out by using downbeat comments, you will radiate negativity. If on the other hand, you start out with a smile and a nice compliment directed toward the patient, they will begin to feel comfortable interacting with you and will appreciate having you as their physician, nurse, or tech. Hippocrates said this so well over 2000 years ago: “Where there is love of humanity, there will be love of the profession.”

Do you remember the last time you were sick or injured? Did you feel as though you needed to stay in bed or you were told to stay in bed? To an extent, this is good as we heal, but over a period of time—even days, we might begin to feel depressed, because we are no longer active; or we may begin feeling discouraged, because we miss our regular ability to move around and perform our daily routine.

Have you or a loved one ever been a patient in the hospital? Did you understand everything the clinicians said to you? I have heard many patients and family members express how just a few words of encouragement helped them through a difficult time, or a care team member spent some time listening to the patient, and it made all the difference in that individual’s experience.

When a patient senses a positive and encouraging attitude from their care team, they will feel more motivated to push through challenging times in their recovery. A great example of this came directly from a patient advisor as she recounted her recent experience at UTMB: “My care tech was motivational, positive and cheerful, and that really made me want to get out of bed and get moving so I could get better.”

Beyond a doubt, patients want to be engaged in their care and to understand what procedure is being performed and why; they want to know the identity and role of each individual who enters and exits their room. They want to know what to expect while they are in our care and what they can do to heal better and faster. But they also want to feel as though they are cared about, not just cared for.

Making a positive impression on our patients and families can be achieved in just a few simple ways:

  • Smiles are powerful, so smile!
  • Take a deep breath before entering each patient’s room and exhale slowly if you’ve been rushing about. This allows you to leave the stress at the door and enter the room with a positive attitude.
  • When speaking, try to do so slowly and clearly—research shows that individuals who do so are perceived to sound more credible than those who speak quickly.
  • Allow patients and families the chance to ask questions, listen to their questions and concerns, and ask them to verbalize their care instructions.
  • Maintain a friendly, open and engaged demeanor. This includes your body language as well as your verbal language.
  • Make eye contact. It clearly demonstrates that you are actively listening to the patient, which they will appreciate.
  • Acknowledge others in the room, such as a family member. Be sure to get their name, and shake their hands, if appropriate. This acknowledgment is very important since you want to create a positive impression with the family members—they will play key roles in the patient’s compliance; and keep in mind, the family member is also going back to the community to share their experiences.

I hope you will take a moment to watch the following five-minute video, shared by the Institute for Healthcare Improvement. It is the story shared of Gilbert Salinas, a patient who was inspired to become a patient advocate because of the wonderful care he received almost 20 years ago. It is the story of a nurse holding a hand, a physician pulling up a chair, and a therapist helping a paralyzed man reclaim a life. It is a story full of positive energy – and lessons for students and health care professionals everywhere.

Whatever your role at UTMB, how do you contribute to a better patient experience? How do you want the UTMB Health System to be perceived by our patients and families? The little things we say and do speak volumes, symbolizing our attitude toward patient care and the medical services we offer. Our compassion and the positivity we radiate can make a big impact in someone’s life!

 

Working Hard: Allow Your Purpose to Be Your Passion

Donna Sollenberger, EVP & CEO, UTMB Health SystemIn the past couple of years, I have started using social media, because I have found it to be a great way to keep in touch with family and friends, whether they are nearby or living across the country. Most often, my social media platform of choice is Facebook, because it is a terrific way to see pictures of my grandchildren each day and watch them grow.

I also enjoy seeing people’s posts of their favorite sayings. Even though the sayings do not always resonate with me on a personal level, from time to time, I come across a saying that really strikes me. This happened a few days ago when someone posted: “Working hard for something we don’t care about is called stress. Working hard for something we love is called passion.” How true!

Years ago, my daughter, Shannon, was in the final stretch of completing her MBA program, and she had started interviewing for jobs. She was considering offers at several big consulting firms, as well as a large energy provider. She called me one evening to talk about her dilemma. While the amount of money she could make if she chose to work at one of the consulting firms or the energy company was appealing, she kept thinking about an interview she’d had with United Way.

She told me that she really wanted to take the job offer with United Way, because she felt she would make a bigger impact in other people’s lives than she would at a consulting firm. Making an impact was really important to her. Yet, her friends kept telling her it would be a mistake to choose a non-profit organization, because she would never make the money there that she could earn in the private sector.

She and I talked about this for a while, and then I gave her my advice: We will all spend many hours at work, which will add up to a good part of our lives—we will often spend as much time with our work colleagues as we do with our own families, if not more. Thus, we should love what we do, so that when we get up each morning, we are energized at the possibilities that are before us at work.

My daughter eventually took the job with United Way and has not looked back. For Shannon, she put her business degrees to the best use by making the business case for individuals to give to those who are not as fortunate as many of us.

I’ve had the opportunity to work with many master’s prepared students over the years, and in the capacity as their preceptor, I have been able to provide career guidance. My message to them as they consider the various areas within health care they could work is to choose their passion. If you are passionate about your work, you will always love what you do.

I know that we face many changes and challenges as an organization, yet each day, I am excited to come to work. While I cannot provide direct patient care, in my work, I can influence decisions that will directly and positively impact our patients. I also have the opportunity to hear each day about the ways each of you positively impacts our patients and their families. That, in itself, is enough to keep me motivated and passionate about what I do.

I started a habit many years ago. Each day as I drive home, I try to reflect on the biggest impact I made that day. This practice has helped me to remain focused on the positive, rather than on the things that I found stressful or non-productive. I end the day with a smile on my face and feeling good about the work I have accomplished.

I hope that each one of you will focus on the positive contributions you make each day at UTMB. I know as I hear from your colleagues, your patients and their family members, you are each making positive contributions to the overall success of UTMB Health. Let’s make a habit of starting and ending each day thinking about the positive possibilities and the positive work that we impact. In doing so, we will remain passionate about our work and its impact on others.

A Story of Care and Compassion

Donna Sollenberger, EVP & CEO, UTMB Health SystemThis week, I would like to share a letter from a patient’s family member, who was very complimentary of the level of patient care, compassion and professionalism the family experienced at UTMB.

Direct patient and family feedback is one of the most valuable ways we can identify areas in which we are performing well and areas in which we can improve. No matter how well we do, we should always strive to make the experience better. I admit, I became teary eyed as I read this letter, because I could tell how very much our patient care teams truly care, and I could empathize with how much it meant to this family during a very difficult time.

While the family of this patient was extremely grateful for all of the care and support they received, there were a couple of situations in which they suggested we could improve; I think that it is important to share that feedback, just as much as the positive aspects. For example, we must remember to always use discretion and confidentiality when discussing patient status—this is important not only from a privacy point of view, but also out of consideration of the patient’s and family’s emotional reactions to any news they receive.

Additionally, while we often have a tendency to explain things in full detail when everything is going well, we must also remember to disclose what is taking place behind the scenes, such as when unexpected wait times occur. When a family feels well-informed at all times, it can greatly reduce the anxiety they may be experiencing.

The following letter has been edited to protect patient privacy:

I’m writing you this letter to let you know of the wonderful care [my husband] received from February 26 until his passing on April 23, 2015. I apologize for the length of this letter, but I kept notes and tried to write down all of the wonderful things that happened. I have decided that I will just list all of the special people at the end of this letter. I hope that they and their supervisor are made aware of this letter. They all truly did “Go That Extra Mile” in [his] care. True care and compassion is not something that can be faked; if a person shows compassion, it is genuine.

My family and I have been involved with UTMB Galveston since moving to the island in 1992. I was even employed at the university for several years. Our family has watched UTMB transition through those years, and I can honestly say that the level of care my husband received exceeded all of our expectations. There have been times over this 20-year period where as a patient, you felt more like a project or an obligation. That is not the case now. The care that my husband received was professional and compassionate. There were so many times that the staff took time to include [the family] not only in his care, but to show genuine concern and compassion for us as well. This meant so much to us over our 57-day journey.

The continuity of his care was evident all along his stay, from the ER staff to the respiratory care team, the SICU staff and trauma staff. I saw firsthand how each team took time to explain to the oncoming shift what had happened and what was planned. One thing that truly impressed me was how a critically ill patient is transported to radiology or other procedures. It was always a comfort to know that my husband was never alone through all of this—he always had at least one person that was dedicated to him and his care. That means more than you can know to a family member.

I was with my husband from the first day to the last. I was anxious as it was explained to me what was wrong and what we were to expect. My anxiety became better controlled once I got to witness the trauma team and SICU staff in action. We were told that the first weekend was critical—of course, this was initially after the first surgery. I appreciated the physician’s reluctance to label my husband as critical; unfortunately, he was critical from the beginning to the end. We had a few days of consciousness—that was always a blessing to him with his eyes open. They did a great job of keeping him pain free.

There was one night shortly after his initial surgery that he developed a problem, and we all had to rush to the hospital. A wonderful nurse, Rachel Murphy, held my hands and told me that we were in a marathon, not a sprint. Those words were just what I needed to hear. I will be forever in her debt; those words helped me through this ordeal more than she will ever know.

We also had the pleasure of meeting Janie Pietramale, the outstanding volunteer that handles the surgery waiting room. Janie took the time to get to know us. Her words were always comforting and filled with such genuine compassion. She deserves recognition for the positive impact she has on families at such a stressful time in their lives.

The parking garage staff of Garage 1 showed compassion beyond the scope of their jobs. When you are in the hospital for 57 days, you start making friends all over the place. When they would ask how that day went, I knew that it was sincere and not small talk. Many times, I was able to drive away with a little extra comfort from one of these beautiful ladies.

As with any situation, there is always room for improvement. There seemed to be a delay in medication as it was ordered and delivered. I know that logistically things have to be done, but more than once during our stay, my husband was waiting for medication to be brought up from the pharmacy. Hopefully this is something you can look into. There was also a problem and delay with his initial Wound-Vac. I am not sure of the problems or delays, but hopefully this can be corrected before another patient needs one.

I believe it would be beneficial for there to be a counseling room set up near the surgery waiting area. As it is now, physicians or staff come out to let the family know how the surgery went. It is discussed openly where everyone can hear. This was not a problem for me personally, but I did hear some comments about it being discussed so openly.

I want to close this letter with my sincere thanks to everyone involved in my husband’s care. Our final day came on April 23, 2015. Dr. Lance Griffin and his team and SICU staff did such a wonderful job in helping us through that final day. [My husband] was able to go peacefully and pain free with us by his side. This was their final act of compassion when we needed it the most.

The opportunities for improvement are welcomed comments as we look for ways we can make Health System operations better for our patients. I know that our pharmacy team is doing all that it can to minimize delays in medications arriving on the floor. The same is true for getting needed patient equipment to the floor. In addition, the comment about the counseling room speaks to the need for the new Jennie Sealy Hospital, because we have been able to incorporate sorely needed support spaces into the design that simply are not available in the John Sealy Hospital. While we do have a private consultation room near the surgery waiting area, it is clear that we need to do a better job of communicating this resource.

Letters like this are so important because they allow us to look at what we are doing well and do more of it. At the same time, it gives us a chance to see the care we deliver through our patient’s eyes and find ways we can improve.

A final word: in light of this week’s inclement weather, I’d like to thank each and every one of you who truly went above and beyond to ensure our patients and families received the very best care and service. They truly put their trust in us to do so, and I know this is a reflection of the work you do each day. Thank you for working together to work wonders!

 

At UTMB, we don’t just save our patient’s lives, we save the lives of our own!

Donna Sollenberger, EVP & CEO, UTMB Health SystemLast Saturday, I attended the annual American Heart Association’s Black Tie & Boots Gala. Each year, the event raises funds for research of a specific disease or condition, and a guest speaker—who is a survivor—tells the story of their own experience. In addition to cardiovascular-related research, donations raised at local American Heart Association events help fund clinician scientists who are leading the efforts in stroke research, and that is what the gala supported this year.

Every 40 seconds, someone in the U.S. suffers a stroke, and every four minutes, someone dies from a stroke. Stroke is a disease that affects the arteries leading to and within the brain; it occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts. When that happens, part of the brain cannot get the blood and oxygen it needs, so it and brain cells die. Stroke is the fifth leading cause of death and a leading cause of disability in the United States.

This year, Sharon Bourg, a UTMB nurse in the Emergency Department, was the guest speaker and shared her very moving personal story.

One day, while caring for a patient in the Emergency Room, Sharon had difficulty putting the blood pressure cuff on her patient’s arm. This was something she’d never had trouble with before. The patient noticed Sharon was having difficulty and that she did not seem well. The patient asked her if she was feeling okay, but Sharon didn’t realize anything was seriously wrong. She felt as though the words she spoke were coming out just fine. But they were not. A moment later, Sharon collapsed and was unable to speak or move. It was the patient who alerted the ER staff by hitting the nurse call button. Immediately Sharon was surrounded by her co-workers, who began working quickly to save her life.

Heart Gala 060615-4260 (1)

Christine Wade, ED Nursing Director, and Sharon Bourg, ED Nurse at the 2015 AHA Gala

Fortunately, today Sharon has no residual signs of her stroke, because she quickly received the necessary and very important care she needed. There is a saying: “Time is brain.” Once a stroke begins, neurons in the brain start to rapidly deteriorate, and victims lose 10 percent of salvageable brain for every 15 minutes that they go untreated. Therefore, limiting the extent of damage requires urgent, expert evaluation and treatment.

Sharon and other patients who come to UTMB are in good hands when it comes to stroke care—after all, at UTMB, we don’t just save our patient’s lives, we save the lives of our own! Precious moments awaiting treatment do not have to be wasted thanks to the expertise and training of the staff of our Emergency Room and the Stroke, Neurovascular and Neurointerventional team. In fact, UTMB is a Joint Commission Certified Primary Stroke Center, and the team is working hard to become a Comprehensive Center.

It is because of the importance of recognizing the signs of a stroke that Sharon agreed to share her story with the UTMB community, as well as at the AHA fundraising event. If you think you are having a stroke or notice the following signs in someone else, call 9-1-1 immediately. F.A.S.T. is an easy way to remember the sudden signs of stroke. When you can spot the signs, you’ll know that you need to call for help right away! F.A.S.T. is:

  • Face Drooping – Does one side of the face droop or is it numb? Ask the person to smile. Is the person’s smile uneven?
  • Arm Weakness – Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
  • Speech Difficulty – Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, like “The sky is blue.” Is the sentence repeated correctly?
  • Time to call 9-1-1 – If someone shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get the person to the hospital immediately. Check the time so you’ll know when the first symptoms appeared.

Since 2012, the American Heart Association (AHA) has raised over $1 million through donations in Galveston. In the video below, Christine Wade, ED Nurse Director, comments on the tremendous strides that have been made in the treatment and care of stroke patients over the years, thanks in great part to the funding received from organizations like AHA. Please take a moment to watch Sharon’s story and learn about the outstanding teamwork at UTMB that saved her life. If you’re interested in supporting the continued research efforts of stroke and heart disease, please visit the website of the American Heart Association or American Stroke Association.

If you want to run fast, run alone. If you want to run far, run together.

Donna Sollenberger, EVP & CEO, UTMB Health SystemAbout six years ago, my daughter, Shannon, decided she wanted to train for the Houston Marathon. Prior to this, she had never run even a half-marathon, so she knew she would need to start training a year ahead of time in order to be ready. She also asked her husband, who was a dedicated runner, to run alongside her the day of the marathon. When I asked her why she wanted Wes to run with her, she said she wanted him there to encourage her to continue when she reached the point in the race where she would want to quit.

The race went as planned, and about two-thirds of the way into it, she “hit the wall”. At this point, Wes encouraged her to keep going and continued to do so until the finish line of the race was literally in sight. They both finished the race! No records were set that day, but the personal satisfaction of finishing what she started has given Shannon a great sense of personal satisfaction. She later told me that had it not been for Wes, she probably would not have finished the race. Meanwhile, Wes told me the satisfaction he got from helping Shannon meet her personal goal was very satisfying to him, as well. Together, they were able to go far!

UTMB’s Chief Medical Officer, Dr. Selwyn Rogers, recently shared a quote that resonated with me. It’s an African proverb that says, “If you want to run fast, run alone. If you want to run far, run together.” Shannon’s vision to run and finish a marathon was supported by her strategy to surround herself by someone with whom she had a strong relationship and who she knew she could depend on for support during her journey to the finish line. Meanwhile, individual abilities like Wes’s endurance and supporting nature also contributed to their shared success in completing an amazing challenge together.

When we set out on a journey, whether it is in pursuit of something we wish to achieve individually or as a team, it’s easy to start off feeling very ambitious. But it’s also important to realize what will be required to sustain our progress. There are a couple of important things about success that Shannon’s experience illustrated to me: it’s important to prepare for our journey, whatever that may be, and recognize when we will need the help of others; and, if we don’t pace ourselves accordingly or don’t have the right support in place along the way, we may either run out of steam or feel like quitting before we reach our goal.

Discovering what we can accomplish as an individual (that is, our strengths and our talent) is something that we can use to support others on our team and encourage them along. Our own personal gifts can often help everyone go further and make the collective achievement even greater. Success is more than simply defining our goals and then determining how we can most rapidly achieve them with the greatest odds of success. It’s about constantly surrounding ourselves with amazing, talented people and building deep relationships with them along the way to success.

These are keys points to remember as we travel The Road Ahead!

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.

plumeria_sorbet1

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