If it doesn’t challenge you, it doesn’t change you.

Donna Sollenberger, EVP & CEO, UTMB Health SystemI read online that viewership of the 2016 Rio Olympics is down. That was news to me, since I have been glued to the television during all of the swimming, diving and gymnastics events. I don’t read the spoiler alerts on the news and in social media, because I want to watch each event with nervous anticipation and hopefulness. I love to be surprised by the results!

As you know, swimming is a favorite sport of mine – more so lately because my grandson, Jack, participates in the sport. In my last two Friday Flash reports, I told the story of his most recent meet, as I watched him swim in adversity and finish his first race with his goggles lodged between his nose and mouth; then, I had a chance to see him finish in fifth place for his 100-meter backstroke event. He had told me all about his strategy to improve his time, and in his last race, the 200-meter freestyle, I learned even more about Jack as he once again put his strategy to work—he shaved a full 15 seconds off his personal best time and finished in fourth place!

Last week, I used Jack’s story to talk about our own strategy for success when it comes to Best Care. Our vision is to not only deliver the safest care to every patient, every time, but we are also challenging ourselves to rank among the top 20 academic medical centers for quality and patient safety*. This week, something happened to reassure me that we can and will meet this very aggressive goal.

As a participant in the Medicaid program, which provides medical coverage for more than 4 million low-income Texans, UTMB takes part in its pay-for-performance program. Simply put, the program has two basic elements upon which we are rated: potentially preventable readmissions (PPR) and potentially preventable complications (PPC).

The penalties are not insignificant. When the program began three years ago, UTMB had $3.5 million of its Medicaid payments withheld due to unplanned readmissions and complications. We were astonished. But, as we looked into the data, it became clear that a good deal of the reimbursements were withheld not because of the quality of the care provided, but rather because our documentation and coding was not sufficient; therefore, it did not accurately reflect the degree of our patients’ illnesses or the specificity of their complications. In response, we set out on a mission to improve our documentation and coding, as well as to review every unplanned readmission.

The results the following year were incredible—instead of the $3.5 million figure being withheld, we had reduced the amount to a $2.5 million—all from readmissions. Following this significant improvement, we planned to further reduce this amount in FY16 by at least another million by sustaining our gains in reducing readmissions and focusing on preventing complications.

Because our Medicaid population is heavily represented by mothers and children, we talked to the department leaders, we rolled up our sleeves and reviewed OB charts with identified complications, brought in experts in the 3M PPR and PPC algorithms, and shared findings and recommendations with faculty and residents, informing them of the implications for their ongoing documentation.  As a result of that work, a physician leader reviewed each case forwarded by hospital coders. The physician then communicated clarifications to the individuals involved in that patient’s care and medical record, and provided any overall messaging that would be useful in guiding the entire department.

While documentation and coding were certainly high contributors to the outcomes, there were also some process changes that helped us turn the information into actions that improved our overall care. The team engaged partners in Information Services to make changes in the Epic EMR infrastructure that would better facilitate the identification of the complexity and co-morbidity of OB patients, and to guide the assignment of observation status as appropriate (thereby avoiding an inpatient readmission).

The result? This week, we received our report from Medicaid outlining our results for the 2015 performance period, which go into effect September 1, 2016. We had zero deductions for unplanned readmissions and zero deductions for unplanned complications of care. That’s right—we exceeded our plan, and we did not incur ANY of the potential $2.5 million penalty!

This outcome reinforced several things for me:

  • We need a plan that we follow without exception.
  • We need people to be engaged in this effort to help us identify problem areas, develop solutions to those problem areas, and be willing to assist in teaching and educating our providers and staff to help us achieve our goal.
  • We can achieve lofty, seemingly impossible goals, if we have a plan, execute it and stay singularly focused on achieving it.

While I would like to think that the large amount we retained will help our budget next year, we also learned that some of our funding from other various sources will be reduced more than we had anticipated. So while the latter is disheartening, it is another reason why we are so focused on Best Care—safer care is not only better for our patients, but it costs less, too.

If we remain focused on meeting the performance benchmarks for academic medical centers, increase our efficiency, reduce variation in care, and improve our quality, everyone wins. We lower our costs, see greater reimbursement, and most importantly, our patients get the best possible care—this is our ultimate goal.

We have a tremendous opportunity to showcase our talent and expertise through this endeavor. Thank you all for everything you are doing to help UTMB Health achieve Best Care for all of its patients!

*As measured by the Vizient Quality & Accountability Study.

Commit to Excellence

Donna Sollenberger, EVP & CEO, UTMB Health SystemLast week, I shared a story about my grandson, Jack, who recently competed in a swim meet. During one of his races, he swam four laps with his goggles between his nose and his mouth after they were dislodged upon diving into the pool. Despite this obstacle, Jack finished the race. I thought this story was a great example of the importance of staying the course to achieve our goals, despite the obstacles we may encounter along our way.

After this race, Jack had a little bit of time for lunch before he swam in his next two events. As the time approached for the 100-meter backstroke, he sat down next to me. Instead of asking him if he was nervous, I asked about his goal for his heat. He told me that he wanted to improve his time and finish in the top eight, which would earn him a ribbon.

“So, you have a plan?” I asked.

“Yes,” he said. (He is a boy of few words – or maybe it is just that he is 10!)

“How did you get that plan?” I asked. (Jack thinks his Nana asks a lot of questions, but I tell him I had many years of practice when his mom was young!)

“I worked with my coach.” He said. “She had me practice my dive into the water and my turns. My coach and I talked about what I needed to do to improve my stroke, and we talked about my plan for swimming the race.”

Then he told me about how he would try to get a good entry into the water, move under the water as long as he could, swim hard the first lap, pace himself, and then give it all he had toward the finish.

“Do you feel it is a good plan, one that will work for you?” I asked.

Jack nodded.

“Then go do it, Jack, because I know you can.”

As he dove into the water a few minutes later, I held my breath, hoping that his plan would pay off and he would meet his goal. A few minutes later, Jack had finished in the top five!

I thought about what Jack had done – how he had prepared for and swam his race. I realized how similar this is to what we are doing in the next twelve months to achieve our Best Care goal:

  • We have selected the races that will help us rank among the best. In other words, we have identified several areas of focus in quality and safety – mortality, readmissions, length of stay and patient safety – that will help us improve the most and place us among the best academic medical centers in the country, as measure by Vizient’s Quality & Accountability Study. We also know we must maintain our success in patient-centeredness and equity, as well as remain focused on clinical documentation improvements and enhancing the Epic EMR to be successful.
  • We have set challenging but achievable targets. Working together, Health System leadership, the Provost & Dean of the School of Medicine, and the Clinical Chairs identified measurable goals that we believe we can achieve within the coming year—as long as we work together and maintain our commitment, dedication and focus. Learn more about these measures on the Best Care website.
  • We will coach ourselves so we always know how well we are performing and where we need to increase our focus to improve. Teams across the Health System have created reports that can be accessed on the Process Improvement Dashboard to help us track our progress. Clinical Chairs and unit leaders can access these reports, identify areas for improvement on an ongoing basis, and help lead their teams to success.
  • We believe we can do it! Above all, we believe we can be the BEST, because know at UTMB Health, we have the talent and expertise – and most of all, we have the passion – to deliver a safe, reliable care environment and an excellent patient experience to every patient, every time.

“Desire is the key to motivation, but it is determination and commitment to an unrelenting pursuit of your goal – a commitment to excellence – that will enable you to attain the success you seek.”

—Mario Andretti

Just Keep Swimming: Facing Adversity and Finishing

Donna Sollenberger, EVP & CEO, UTMB Health SystemSeveral weeks ago, my grandson, Jack, swam in a large meet in the Houston area. Jack has been a swimmer for almost two years, and he swims in the 10-year-old category. This particular meet was very illuminating to me, because what happened to Jack told me something about his character.

This particular Saturday, Jack was scheduled for three events: the 100-meter freestyle, 100-meter backstroke and 200-meter freestyle. His first event, the 100-meter freestyle, should have been his best. However, as he dove into the pool for his heat, his goggles were not on tightly enough and they ended up just below his nose with his mouth partially covered by them.

I could tell from where I sat that he was upset and struggling. The same thing happened to another swimmer in the heat. Jack swam four laps in the 25-meter pool and finished in 14th place out of 53 swimmers. The other swimmer whose goggles had also slipped pulled himself out of the pool after the first lap, and in a fit of defeat, threw his goggles into the practice pool.

When Jack got out of the pool, he was also very upset. This was his best event, and he knew if the goggles had stayed in place, he would have placed in the top eight in this event—practice after practice, that had been his goal. Now, he did hadn’t even placed in the event.

A little later, as we were waiting for Jack’s next event, I talked to him about his experience and told him he should be proud of what he accomplished. While the other swimmer had given up, Jack finished his race despite the obstacle in his way.

What happened to Jack caused me to think about how many times we have to keep going despite adversity so that we can finish, and at times, finish strong. This is true in the workplace, in our personal lives, and it’s true for our patients and their loved ones. Every day, we each have a choice as to how we will meet our challenges. We have a choice as to whether or not we are willing to overcome the barriers that get in our way, or if we will give up, even despite all of the hard work we have put in so far.

When it comes to Best Care, we have set the bar high, and we have some tall orders ahead of us when we consider we have to simultaneously improve in mortality, readmissions, length of stay and patient safety events. At times, it may be tempting to throw in our goggles after one bad race, but that doesn’t mean giving up is the right thing to do—for ourselves or our patients. We make a choice each day to keep swimming and finish the race!

  • We may face adversity when it comes to helping a patient with multiple illnesses get well enough for discharge.
  • It may be a challenge to help patients who will require some level of care outside of the hospital setting; however, they may not have the resources to acquire that care.
  • It may be a challenge to help some patients learn about healthy lifestyle choices or to help them find the resources they need to avoid readmission.
  • We may do everything in our power to create a plan of care that meets all of a patient’s needs, but they may have trouble following their care plan or will simply not comply.
  • Not all patients and families begin at the same starting line—even though there may be a patient whose length of stay extends beyond what we hoped, we know we must stay the course until that patient is well enough to go home, because it’s the right thing to do.
  • We will face challenges on our own teams at times—perhaps there will be disagreement among team members or lapses in communication.

It is said that when beginning a journey, start by doing what’s necessary; then do what’s possible; and suddenly you are doing the impossible. Whatever challenges may come, we must stay focused and remember to break these large areas of focus—readmissions, mortality, length of stay, and patient safety events—into effective and manageable tasks, like using the 8 Ps, working together during progression of care rounds, and improving our use of the medical record. All of these seemingly smaller efforts will begin to align and will get us to our goal more quickly than waiting for one big opportunity to come along.

Remember: Determination, patience and courage are the only things needed to improve any situation! Whatever our obstacles to Best Care may be, let’s continue to work together, focus on our goals, and finish our race strong!

You can’t serve from an empty vessel.

Donna Sollenberger, EVP & CEO, UTMB Health SystemLast week, we explored the importance of working together effectively on our teams and addressing challenges in a positive way, particularly as we embark on our journey towards achieving Best Care at UTMB. In my post, I mentioned the importance of stress management, because when we operate under stress, we may not always be able to contribute to our teams in a positive way, or we may create a situation where our environment could potentially become unsafe. Over time, stress can even begin to affect our health.

This reminded me of a talk I have given in the past to different groups of caregivers and leaders about the importance of self-care. I was often asked during these discussions about how I managed to effectively juggle family and career—how did I manage to “have it all”?

That question always made me laugh, because I am not sure anyone ever “has it all”.  What we do have is the outcome of the choices we have made in life that best suited us, our family, and our career. The outcome largely depends on how we set our priorities, and there really is no single answer for how we should go about doing this. We make the best decisions we can based on the knowledge we have at the time. In fact, I believe we have to approach most problems and solutions on a case-by-case basis, because our priorities can shift with time and depend on where we are in our current stage of life.

From a personal perspective, I realize managing stress isn’t always easy to do, especially when one has a great deal of dedication to those for whom they care and for the work they do. Over the years, however, I’ve learned that I must carve out time in my schedule for myself to ensure I can continue putting my best foot forward.

When I have led my talk on self-care, a visual aid I often used was a Mrs. Butterworth’s syrup bottle, which I washed out and filled with rice. I would begin by talking about the many important priorities and obligations we have in our lives, and how in the process of putting so much of oneself into fulfilling these tasks and into caring for others, little things begin to drop off our radar when it comes to our own well-being. These little things can add up to have a significant impact.

As I continued the talk, I would shake a little rice out of Mrs. Butterworth as I went through the tasks of a “typical” day in the life of a career person with a family. Each time the responsibilities of the job or family required “action” on the part of Mrs. Butterworth, I would shake out a little rice.  I did this over and over in the talk until we got to the end of the “typical” day.  At this point, I shook and shook the bottle, but nothing came out—Mrs. Butterworth had expended all that she had by the end of the day with nothing left for herself to replenish or recharge.

I think that this is probably true of many of us. We love and are committed to what we do at work and the role we have within our family. However, after a busy day, we often forget to make time for ourselves and we have depleted our “reserves” over time. As a result, we can overlook important details, become forgetful or less productive, or feel irritable and incredibly stressed.

As we work together in a positive manner and navigate the challenges we encounter along the road to achieving Best Care, it is important to remember that in addition to being positive with others and maintaining a focused and optimistic outlook, we also need to take care of ourselves. No one can go on endlessly doing for others without also recharging their own batteries. There are some simple things we can do each day to help re-energize ourselves:

  • Outside of work, take time to look at your daily activities and determine which ones help you feel your best. Add these activities to your calendar. If you plan them, you are more likely to actually have time for them.
  • Check-in with yourself regularly to see if your routine needs to be changed. Sometimes we forget to ask ourselves the most obvious questions, like “Am I tired?” or “Am I happy?”
  • Go for quality not quantity. Even though you may like watching TV, and can spend several hours doing that, aren’t there other things that would be better for you?
  • It can be okay to say “no”. If you’re taking on so many commitments that you’re left feeling exhausted, it’s time to start prioritizing. Whether you decline an invitation permanently or simply take a rain check, saying “no” is sometimes exactly what your body needs.
  • Take a break. If you’re passionate about your job, you might feel reluctant to take a vacation. However, if you don’t take breaks, not only are you not taking care of yourself properly, but you may eventually end up undermining your performance. Working more does not mean you will maximize productivity. In fact, just the opposite is true.
  • In addition to feeling like you don’t have time for a vacation, having a hectic life can also give you a sense that you need to let your hobbies slide. Consider setting aside an hour a week that is only ever to be used for those activites.
  • People with busy lives can often forget just how valuable self-reflection can be. If you don’t spend time thinking about how you’re feeling about what you’re doing each day, you risk losing touch with what you really want from life (and reduce the chances you’ll feel grateful for all the good things in life). If you have 15 minutes of free time a day, then you have time to keep a journal. Reflecting on what happened in your day and how you’re feeling can help you understand you get a better sense of your needs.
  • Stay focused on the present moment. Practice mindfulness and use basic breathing exercises to get your mind into the right zone for creative visualization. Spend time listening to your favorite music, keep up with hobbies that help you feel fully in tune with your body (such as yoga, walking, swimming or cycling).
  • Finally, never underestimate the benefits of laughter! It releases a flood of feel-good endorphins that boost your mood and help you to relax. So, surround yourself with family and friends that make you laugh!

A challenge only becomes an obstacle when you bow to it.

Donna Sollenberger, EVP & CEO, UTMB Health SystemThis week, I was reminded of a time in the past when I worked on a leadership team that did not function as well as it could have. We were a diverse group of people from many different backgrounds with a wide array of professional expertise. Individually, we were all really good at what we did, and we all accomplished a lot within the departments we directed. As a leadership team, we even had a pretty clear idea of what our individual responsibilities were; however, we did not work well together to accomplish our shared goal.

We all knew what we were working toward, but we became frustrated when we did not progress quickly enough to the end result. So, we each started doing our own thing, according to our own leadership styles. Pretty soon, everyone was confused because there was so much duplicative work. No one seemed to know what the other was doing, and as a consequence, teams across the organization didn’t know what they needed to do to contribute to the goal or who was supposed to be doing what. I knew in my heart that the employees’ frustration was justified. So, I made a decision—I could allow this lack of coordination to continue, or I could try reshaping the team so that we worked together more effectively. I decided to do the latter.

As the team worked hard to come to an agreement, we conducted an exercise that involved completing a questionnaire to help identify our preferred working styles. It also honed in on how we each responded to stress in the workplace. Many of you have probably taken similar questionnaires, and you were categorized as a combination of letters or a certain color, like yellow, blue, green or red, which defined how you normally acted, as well as how you acted under stress. For example, if you were categorized as yellow, it meant you were generally process driven—a sequential thinker. If you were categorized as blue, it meant you were a “people person” who generally tried to understand everyone’s point of view and tried to get people to work together. Green meant you were a planner and strategist who was easily bored with details. If you were red, you were a detail-oriented person.

When our team shared their predominant color for our normal work mode, we had a great blend of the colors—something all teams should have. We had a people person, a planner, the process-oriented person, and detail-oriented team members. But what happened when we were under stress was really interesting. We were all in the red category. This meant that under stress, we all approached our work from the same point of view, and we didn’t have the important input from the sequential thinkers, the planners or the outgoing people with strong communication skills.

To really emphasize to our group how the organization was affected when this happened, I put tape on the floor so that we had four clear quadrants. I then asked everyone to stand in their respective color quadrant, exactly as the survey tool had placed us in “normal mode”. The closer someone was to the center, the more they reflected traits from multiple quadrants; the further away one was, the more strongly they reflected a single working style.

Under normal circumstances, we were all pretty well distribute across the colors. But when I asked everyone to occupy their stress quadrant in the exact placement the survey depicted, the result explained everything—we were all deep into the red, trying to occupy each other’s space. No wonder the employees said they were confused! In stress mode, our leadership team each tried to take charge, and to the organization, this seemed as if no one was in charge.

Why do I tell you think story? If we are going to achieve Best Care, we need everyone in the organization to contribute their unique talents and working styles to the team. Whether you are mostly a planner, a people person, a strategist or an operational process person, we need all of you contributing to reaching Best Care by August 31, 2017.

So what can you do?

  • Make sure that you understand your primary role on the team – whether you are on a patient care team or an operational team. Your position description provides guidance on your job, but what is your role on the care team? If you are not sure, your manager or leader should help you better understand your role and the contribution you can make to Best Care.
  • If you are a manager or leader, your job is to have clarity about how your area can most effectively contribute to Best Care, and then make sure that everyone knows they are on the team and what their role should be.

It is so important that we try to stay in our “normal” mode at work, because if we are operating under stress, we may not be able to contribute to our teams in a positive way, or we may create a situation where our environment could potentially become unsafe. Dr. Gary Grody defined stress this way: “Stress is defined as an inability, or the perception that you are unable, to take control of your life. If you feel in control, even if you’re not but you perceive you are, you won’t feel the stress.”

We all have high hopes for what UTMB Health can achieve over the next year as we work toward our goal of Best Care. We are already beginning to emerge as a leading academic medical center in many ways—we have experienced unprecedented growth and are performing better than most in many areas. Now, to deliver the Best Care to every patients, every time, we must remain focused on what we want to happen as an organization.

We will be rapidly moving toward our goal, so let’s remember to continue working together steadily as a team toward the goal, even in the face of challenges or frustration. Zig Ziglar says, “When obstacles arise, you change your direction to reach your goal; you do not change your decision to get there.” We must identify the areas in which we can make a change and come up with creative solutions to move the needle. We have an opportunity to become a model healthcare organization, and teamwork, focus and effective communication will be critical to improving the health and well being of all we serve!


Accountability is the glue that ties commitment to the result.

Donna Sollenberger, EVP & CEO, UTMB Health SystemOn Wednesday, I had the pleasure of speaking at a Lunch & Learn for Health System leadership about the importance of accountability for both individuals and members of leadership. I am sharing it today via the Health System Intranet for you to review. Whether you are a manager, director or individual staff member, there are worthwhile reminders in the presentation for all of us.

After the presentation, I began thinking about how important the principle of accountability will be to achieving our goal of Best Care this year. You will recall that Best Care is an initiative we are implementing in response to University of Texas System Chancellor William McRaven’s challenge that UTMB rank in the top 20 of academic medical centers by August 31, 2017 (as measured by the Vizient* Quality & Accountability Study).

In Stephen Covey’s book “The 4 Disciplines of Execution,” he contrasts an organization that thinks conventionally with one that thinks in terms of both individual and collective accountability. In the organization with conventional thinking, team accountability is always top down: “We meet with the boss periodically and s/he lets us know how we’re doing and what we should focus on next.” In the organization used for contrast, the individuals on the team collectively share accountability for achieving goals and results: “We make commitments and then we’re accountable to the boss; but more importantly, we are accountable to each other for following through.”

A culture of accountability is crucial to achieving goals, particularly when the storms of change and multiple priorities are whirling around us. Often in these types of environments, teams end up breaking apart because individuals decide to go off on their own to “just get it done”. The goal becomes increasingly difficult to achieve if, within the whirlwind, we are also trying to change the behaviors of a lot of people.

With this in mind, I started thinking about how much we have going on right now. We are really going to need to buckle down, prioritize our work, and maintain a steadfast focus on achieving Best Care, especially because reaching this goal will require changing the behaviors of many people and teams. Failure to achieve Best Care is not an option, because it is the right thing to do for our patients!

everstThe work that we must do to deliver on our promise of Best Care reminds me of the book, “Into Thin Air,” which tells the story of two teams of climbers who attempted to get to the summit of Mount Everest. The first team included the author of the book, Jon Krakauer. He wrote about the numerous adversities his team encountered as they tried to reach the summit. As blizzards, high winds and altitude sickness began to affect the team, certain members decided to split off on their own in an attempt to get to the top. Although each climber had the same goal, by setting out on their own, they abandoned the team and discarded discipline and accountability to each other. The results were disastrous as the weather conditions proved too much for eight of the climbers who ultimately lost their lives.

The second team of climbers included a blind climber, Erik Weihenmayer. If the group succeeded, Erik would become the first blind person to reach the top of Mt. Everest. The biggest difference between this group and first is that at the end of each day, they huddled together in what they called a “tent meeting” to talk about what they had accomplished and what they had learned. The team used the meetings to review their strategy, make needed adjustments in their approach to the climb, and define each member’s role. They also decided who on the team would go ahead to clear the path and secure the ropes so that Erik could climb.

Erik characterized the teamwork this way: “Our team stuck together and took care of each other, which gave me the courage to finish.” The result? On May 25, 2001, the team reached their goal, and Erik Weihenmayer became the first blind person to stand on the summit of Mt. Everest.

There are so many lessons to be learned from this story, but here are some of the critical ones that we will need to implement to ensure we achieve Best Care:

  • Form teams that have specific goals for achieving Best Care.
  • Make certain that the team has their specific goal, target and deadline assigned and understood.
  • Encourage the team to engage in developing the plan to achieve the goal.
  • Make sure that everyone on the team understands their role, including the role of the leader.
  • Hold each other accountable for making contributions to the team. Speak up in a kind and understanding way to help a team member who is not fulfilling their role on the team—encourage them, but also be firm about the fact that everyone on the team has to do their part in order to deliver Best Care to every patient, every time.
  • Meet regularly and make adjustments along the way.
  • Celebrate milestones and congratulate individuals who demonstrate exceptional effort along the way.
  • Most importantly, ensure that the patient and their loved ones are at the center of all decisions. This is not about “us” or “me”. It is about doing what is best and right for the patient.

Accountability is critical to any organization’s success. Even if we have all the goals, priorities and metrics set, without accountable leaders, teams and individuals, we cannot achieve our goal. If we commit to these actions, on August 31, 2017, we will have achieved our goal of Best Care.

*Vizient was formerly known as UHC.


Teamwork Makes the Dream Work

Donna Sollenberger, EVP & CEO, UTMB Health SystemAs we continue our focus on achieving Best Care at UTMB Health, I would like to share a recent story of teamwork that occurred among our nursing staff.

Earlier this week, there was a patient who needed a PICC line in order to be discharged that day. (For those who may not be familiar with this term, a PICC line is a peripherally inserted central catheter that can be used for a prolonged period of time to intravenously deliver medications, such as long chemotherapy regimens or extended antibiotic therapy, or for administration of certain substances/nutrition).

Inserting a PICC line requires special training; however, there was not a nurse on duty who could perform the insertion. The staff made one quick call for help to Josette Armendariz-Batiste, director, patient care services and assistant chief nursing officer. A few hours later, Nurse Manager Robert Hastedt arrived on campus from Galveston with the equipment. Quickly following behind him was Alain Medrano-Safores, the PICC nurse who was able to insert the line and discharge our happy patient.

What the League City team initially thought was going to be a difficult challenge was easily and willingly taken care of by Josette, Robert and Alain. Now, Robert is working with ED Nurse Manager Ed Smith to discuss offering training to League City nurses so they, too, can perform PICC line insertions when needed.

No matter what role your team plays, whether you provide direct patient care or you work in support of that care, we all bring unique talents and expertise to our teams. Those skills enable us to work together to work wonders—it is through teamwork and collaboration that we find opportunities to engage others and break through barriers to delivering Best Care.

There are a few additional pearls of wisdom we can take away from this story:

  • It doesn’t require anything but the right attitude to make a big difference in patient care. Let’s demonstrate our passion for delivering Best Care to every patient, every time.
  • When we demonstrate respect for patients and our colleagues, we do what is right, not just what is easy—even if no one is looking.
  • We must be prepared to deliver Best Care and take the time necessary to make sure care is safe, timely, appropriate and effective.
  • We should remember to serve others first and to be good stewards of people and resources.
  • We demonstrate integrity by holding ourselves and one another accountable to delivering Best Care; we demonstrate it through honesty, trustworthiness, and dependability.
  • We show respect to one another by building trust and honoring our words through our actions.
  • We also demonstrate respect by treating patients, their loved ones and our colleagues with dignity and compassion.
  • We live the value of lifelong learning not only by pursuing knowledge, but by sharing our knowledge with others.
  • We should proactively seek solutions to improve processes and implement new ideas.

These are values that are part of the fabric of our culture. If we all make a conscious effort to put these simple principles into practice, we are certain to create a culture that always delivers the Best Care, every patient, every time.

“There is immense power when a group of people with similar interests gets together to work toward the same goals.” ― Idowu Koyenikan

Fish don’t know they’re in water

Donna Sollenberger, EVP & CEO, UTMB Health SystemOne day, two young fish were swimming along, and they happened to meet an older fish swimming the other way. The older fish nodded at them and said, “Morning, boys, how’s the water?” The two young fish continued swimming for a bit. Eventually, one of them looked over at the other and asked, “What is water?”

This morning, I heard on the radio that tomorrow is National Fishing Day. But, that is not the occasion for this story. The reason I wanted to share this story is because the fish do not realize they are in water—they have always been surrounded by it.

The moral of the story: Sometimes, in order to realize one’s surroundings, it is necessary to step outside of that environment.

This is how it is with culture, also. Often, it is not until you travel outside of the area in which you live or change your routine that you realize you do actually live in a culture. Culture is most commonly defined as the way of life, beliefs and traditions of a particular group. However, culture can also exist in organizations—it is a way of thinking, behaving or working. And, we can become so used to a particular way of doing things, that it becomes very difficult to see that what we think are universal truths are just our local culture.

In last week’s Friday Flash Report, I introduced a new initiative we are implementing at UTMB Health called “Best Care”. I mentioned that while we are currently performing very well in terms of patient satisfaction, we have a lot of work to do in other areas, like reducing readmissions that occur within 30 days of a patient’s discharge and reducing length of stay, mortality rates, hospital-acquired conditions and patient safety events.

I know that everyone at UTMB Health holds our values—compassion, integrity, respect, diversity and lifelong learning—in high regard, because they are part of our culture. I know you all believe in providing the best care and service. I also realize, however, that there are many pressures in health care today. We are caring for many patients and working in a fast-paced, highly productive environment. At the same time, we have already accomplished a great deal of work to make care safer by improving processes and implementing new technology. Taking it a step further, we have recently increased hand hygiene compliance to an outstanding rate of 98% in our inpatient units and nearly 100% across the board in our ambulatory locations. Nevertheless, Best Care is a big term that is made up of many specific efforts.

Therefore, we must not only focus on sustaining the improvements we have made, but we must continue to improve in order to provide Texas, the nation and the world with the finest health care possible. UTMB Health is a leader in many ways—so, let’s also lead the way by becoming one of the top health systems in the nation for providing Best Care.

To achieve our vision to be the best, we must wholeheartedly commit to always doing the right thing for the right patient, at the right time, in the right way. We must also acknowledge that there are still processes—and even general behaviors—within our current environment that need to change. However, we may not be able to recognize all of these different aspects right now, because we are surrounded by them.

What are the changes we will have to make to get to Best Care?

We must step back and see our care environment through the eyes of our patients and their loved ones. I know that many of you have been patients, and many of you have seen your loved ones hospitalized. Many of you have had excellent care experiences, and many of you have had experiences that were less than satisfactory. So you know from firsthand experience that receiving health care should never present an avoidable risk! Just as we trust that every safety measure has been taken when we board an airplane, our patients trust us to make sure the care we deliver is safe, and they trust that we will help them get better and stay well!

Even though we are working in a busy environment, we must be sure to take a little extra time to ensure safety, to accurately document the care we provide in the patient’s medical record, to run through our safety checklists, and engage our patients and their families in the plan of care. We must help them find the resources they need to take care of their health. To accomplish this, we must be supportive of one another and willing to stop each other when we see someone is not exercising patient safety. Inaction in the face of safety problems is taboo! We must also realize that if and when someone brings a concern to our attention, it is not directed at us as an individual; rather, it is being done with the intention of ensuring the Best Care for every patient, every time.

Recognizing the changes that need to be made and then making them will take some time, but the urgency to improve is immediate. It will require persistence and courage, because some of the changes we need to make may be counterintuitive to traditional processes. Best Care is everyone’s responsibility.

We are embarking on a journey, and there are many steps we must take to make it a success. Let’s not be like the two fish that do not know they are in water! Let’s commit to being aware of and understanding our environment and culture so that we can make the necessary changes to assure our patients receive the Best Care—every patient, every time.

best care logo-FINAL-OUTLINED


The Best Care: Every Patient, Every Time!

Donna Sollenberger, EVP & CEO, UTMB Health SystemOne of the things I like most about my office location in the new Jennie Sealy Hospital is that I have the opportunity to interact with our patients and employees more than ever before. I appreciate when people approach me and let me know about items that need attention or areas in which we can improve. I also enjoy the chance to hear firsthand about the good experiences people have had while receiving care at UTMB Health.

Today, for example, an employee approached me to tell me about a very positive experience their family member had while at UTMB. In fact, the experience was so positive that the patient will be switching all of their care over to UTMB. Isn’t that wonderful? I don’t know where the family member previously received their care, but it indicates to me that we are doing something right; it also proves that every interaction we have with our patients is meaningful and represents a chance to make a positive impression.

Many of us can say from personal experience that it is not lost on a patient when the care and treatment they receive is better than they have received elsewhere. It is important to remember that the impression they have of those care experiences is created by more than just the interactions they had with physicians and nurses.

Time and time again, when I hear raving reviews from patients, they describe their encounters with everyone they interacted with along the way. They remember the person by whom they were first greeted or the person who thanked them for choosing UTMB, the person with whom they spoke with on the phone, the person who gave them directions, and the person who transported them to their destination.

Often, they describe a technician who calmed their fears or someone who stayed to hold their hand during a procedure. They mention the person who delivered their meal, who cleaned their room or the person who helped them find the resources the needed. Their experience is also impacted by the teams who maintain the clinical equipment and facility infrastructure. Every single one of you makes a difference in the quality of patient care at UTMB Health.

In the months to come, you will hear a lot from me about a new initiative at UTMB we are calling “Best Care”. Some of you may wonder why I am so focused on improving the quality of our care we deliver at UTMB. After all, we receive many positive comments from our patients about their care, and our inpatient satisfaction scores have improved to the point where we are now in the top 20 among academic medical center peers. We are doing really well in terms of inpatient service and patient satisfaction.

However, the Best Care requires more than patient satisfaction, and it is more than being patient-centered. It means patients healed well and stayed well; it means they did not acquire a preventable infection or injury; it means that their care was safe, timely and effective. The Best Care means we consistently deliver care that meets these criteria, every single time and for every single patient.

Unfortunately, there are some very important areas for Best Care in which UTMB does not rank among the elite list of top 20 academic medical centers. In fact, we are solidly stuck in the middle in areas such as efficiency, mortality, readmissions, hospital-acquired conditions and patient safety events. Because we want to deliver only the very Best Care at UTMB, we will need to make significant progress in these areas over the course of the coming year. At the same time, we must also sustain our patient satisfaction scores in order to move into the top tier of academic medical centers. That is my goal. In fact, it will be my singular focus from now on.

The distance we must make up to achieve this top tier ranking is considerable, and we are working toward this at a time when all other academic medical centers are also focused on improving. Some of you who have already learned about our Best Care initiative have asked me whether or not I think we should allow ourselves more time to reach our goal. Others have told me that they do not think it is possible to achieve this much improvement in a mere fourteen months. While I know that this is an aggressive target and it will take our intense focus throughout the year to achieve this goal, I ask you, “Is it all right to deliver ‘okay’ care?”

Think about it. Imagine you have a patient sitting in front of you right now—would you feel good about telling them that they will receive “okay” care while they are in one of our UTMB Health hospitals or clinics? Or, would you rather tell the patient and family that they will receive the Best Care when they are at UTMB Health? Shouldn’t Best Care always be our goal? It certainly is mine!

Some of you may be thinking, “I can’t make an impact on Best Care, because I don’t take care of patients.” Although you may not touch a patient, we all impact the patient’s care, their experience, their overall impression of UTMB Health, and in some cases, even their safety. Whether we work in Information Services, Business Operations & Facilities, Revenue Cycle, Human Resources, Materials Management, Clinical Departments, we are part of the patient experience.

Starting today, I want everyone to commit to the Best Care: Every Patient, Every Time! Whether you work in support of patient care in in one of our five hospitals—Jennie Sealy, John Sealy, Angleton Danbury, League City or Hospital Galveston, or in one of our correctional managed care, regional maternal child health, adult or pediatric primary and specialty care clinics, commit today to delivering the Best Care!

This is a big commitment for everyone, but it is one that we must make. From today forward, this will be the focus of my meetings, the focus of my rounds, the focus of our Friday Flash reports, and the emphasis of Friday Focus Newsletter. I look forward to the progress we will make as an organization and to the role YOU will play in assuring that we deliver the Best Care to Every Patient, Every Time!

Our Focus:

  • Efficiency: Decrease length of stay and direct cost as compared to our peers
  • Mortality: Eliminate all preventable deaths (i.e., early sepsis detection, clinical documentation improvement and coding, systems improvements, etc.)
  • Effectiveness: Accelerate reduction in 30-day readmissions and Emergency Department throughput
  • Safety: Eliminate all preventable patient safety events (i.e., postoperative sepsis; perioperative hemorrhage / hematoma; pressure ulcers; and central line-associated blood stream infections, etc.)
  • Maintain performance in patient-centeredness and equity

Do right. Do your best. Treat others as you want to be treated.

—Lou Holtz


Oh Baby, It’s a New Hospital!

Donna Sollenberger, EVP & CEO, UTMB Health SystemTomorrow we celebrate another historic moment at UTMB Health. On Saturday, June 4 at 8:00 a.m., we will open the new UTMB Health League City Hospital!

Everyone at UTMB has worked very hard this year, and wonders have been worked, indeed! It has been an incredible year of accomplishments, but without the teamwork and dedication that took place among UTMB employees, we could not have achieved such success. From new clinics to the opening of Jennie Sealy Hospital, from the new innovations our employees are developing daily to the outstanding care you deliver to our patients and their families, I think we can all unanimously agree—it takes a village!

The new 150,000 square foot facility is a welcome addition to the League City community. There are many UTMB patients in the area who already see UTMB physicians, but prefer to be hospitalized in the area, as well. Now, they can receive the care they need close to home, whether in our specialty clinics on the campus, our League City Urgent Care Clinic, or in the new 24-hour emergency department with full diagnostic capabilities. For patients who are admitted to the new hospital for an overnight stay following the delivery of a child or surgical procedure, they can now remain close to home and to their loved ones as they recuperate.

Meanwhile, for our patients who may require more acute care or who simply need access to primary care and services so they can stay well long into the future, they will also have continued access to a full complement of services throughout the UTMB Health System.

UTMB’s ongoing growth is possible because we have built a reputation for providing quality, patient-focused care, and we are delighted to have the opportunity to support the health care needs of the League City community. I would like formally thank everyone who has contributed to the activation and opening of League City Hospital for our patients in the area. Congratulations to all on the opening of our new hospital!