Every Patient, Every Encounter, Every Time

Donna Sollenberger, EVP & CEO, UTMB Health SystemI learned long ago that mistakes are most often made when we deviate from the plan. Sometimes we deviate because we don’t think it is important to stick to the plan, or that we can do something better than the plan someone else has laid out for us. At other times, we deviate because we have become so familiar with what we are doing, we don’t pay strict enough attention, or we fail to think carefully about the steps we should be taking. Sometimes, we don’t follow the plan because we are too tired, or we are trying to handle too much.

In certain situations, plans are critically important because it’s necessary that everyone carry out a certain set of actions in the same way. In these cases, variation can cause harm. My role, and the role of the Health System Executive Team, is to provide those plans to you as they become available. Your role is to follow the plan exactly—every patient, every encounter, every time. Thus, your role is vital to everyone’s success.

When someone on the team does not follow the plan, that individual essentially becomes the weak link; and by the same token, I become the weak link if I fail to give you the most current information and plans we have. In the case of the spread of Ebola, we don’t have all of the answers yet. However, we are sharing information and our plans through various communication vehicles, such as the Friday Flash Report, today’s Town Hall meeting, and other methods, as soon as we have them. Our top priority is to always assure that our patients and staff are safe and that our patients always receive the best care.

Because of employee concerns about Ebola, our team of executives, senior leaders, directors and managers have been rounding and meeting with many people this week to help you understand the plan that is developed to-date, as well as to hear your questions and concerns. This activity will continue until we are comfortable that each person knows what they are to do regarding screening and isolation of any patient who presents with symptoms of Ebola, has traveled to a CDC-identified country with widespread Ebola transmission, or has come into contact with a patient diagnosed with Ebola and the 21-day incubation period is not over.

Currently, the greatest concern we have heard from our employees is that not everyone in the clinical settings has been trained: “Will I have to care for someone if I am not trained?”  The answer is no. A select number of individuals been identified, volunteered, and have been specially trained to care for such a patient. A decision has also been made to limit the number of people who would treat a patient, if we receive one, who is diagnosed with Ebola. The rest of our staff will continue to do the good work that they do for our other patients, will be trained to screen for the virus, and to support those who are on the front lines of providing care.

For all points of entry for our patients, whether it is by phone, as they arrive in a clinic or ambulatory setting, or come to our Emergency Department, the people who first encounter the patients must screen each and every patient with the screening tool that is now available in Epic (the tool will be activated once a patient’s chart is opened). For areas not currently on Epic, the same screening protocol applies, only they will conduct the process by paper. This protocol includes asking a series of “symptom” questions, and if the patient’s symptoms are consistent with Ebola, we will then ask a question related to their travel history and/or their potential exposure to anyone diagnosed with Ebola. If the answer to the second question is “yes”, we will strictly adhere to the following steps, without deviation:

  1. We isolate the patient.
  2. We put on our personal protective equipment (PPE).
  3. We immediately call Healthcare Epidemiology at 409-772-3192 (department) or 409-643-3133 (24/7 pager).

A detailed policy regarding patient calls has been distributed by Ambulatory Operations, and it will be reviewed with staff.

If you encounter a patient who has not yet been screened, please do so. If a patient asks why we are doing this every time they call or every time we see them, please politely explain to them that it is important for their safety, the safety of other patients, and the safety of our staff.

If a decision is made to transfer an infected patient to the UTMB-Galveston Emergency Department by ambulance, we have the necessary plans in place, as we have collaborated with Galveston EMS and Windsor Ambulance services—the two EMS agencies that serve the UTMB Health Galveston Campus and the UTMB Health  Angleton Danbury Campus most often. We are currently in the process of identifying and working with other ambulance providers for our Regional Maternal Child Care Program (RMCHP) clinics. And, Correctional Managed Care (CMC) is working collaboratively with the Texas Department of Criminal Justice to finalize their plans.

I know that many people are anxious about Ebola in Texas and elsewhere. But please rest assured that our world-renowned infectious disease experts at UTMB have been working with this virus for ten years without any infections. We are home to the Galveston National Laboratory, the highest level biocontainment facility, which also serves as the nation’s training site for Biocontainment Safety. We have more expertise and experience with this disease than most, if not all, academic medical centers in Texas.

We are all very concerned about the people affected by this disease. However, let’s make sure that we maintain our calm and steady leadership through this time, and take comfort in the fact that working together, we are more prepared than most organizations to manage this disease.

I know many of you have questions, and even if you are not included in the care of the patient, you want to know the answers. We are currently collecting inquiries and working with individuals in the institution to gather the responses to your questions and concerns, which will be posted on our intranet once they are prepared. Please share your questions with us. You may contact us at health.system@utmb.edu or using the Health System Q&A form.

Ch-ch-ch-changes…

Donna Sollenberger, EVP & CEO, UTMB Health SystemIf the news during the past few weeks has taught us anything, one thing is evident about working on the frontlines of health care: it’s ever-changing and at times, unpredictable. It’s also more than a job—it’s a calling, a passion that motivates us to do whatever we can to help others in a time of need.

Author Charles de Lint once said, “I don’t want to live in the kind of world where we don’t look out for each other. Not just the people that are close to us, but anybody who needs a helping hand. I can’t change the way anybody else thinks, or what they choose to do, but I can do my bit.” I think this sentiment is in the hearts of many in health care, and most certainly in the hearts of our team members across UTMB Health.

We all have an important role to play in assuring that our patients and families receive the best possible care. Yet, we also realize we are working in a changing health care landscape. While it’s nearly impossible to always anticipate just what to expect and when, we must always be prepared, knowledgeable and flexible in our jobs. There are already many everyday challenges, like new and changing technology, to which we must adjust, but there are also often surprises around the corner.

This week, we celebrated Emergency Nurses Week, and the Emergency Department team decided to extend the observance to recognize every individual on the team, including health unit coordinators, patient service specialists, ED techs, faculty, social workers, campus police, and others. I couldn’t help but think about some of the challenges our team in the ED faces today and will face in the future, not only in terms of screening patients for different illnesses, but also in terms of their own personal health safety, helping manage patients’ care, working with new technology, and many other aspects.

ER STAFF WEEK 2014While our ED team certainly works in a unique care delivery environment, all of our jobs at UTMB are unique in their own way. We are all bound together as interdisciplinary health care teams. Whatever our role, whether a nurse, physician, pharmacist, food services employee, physical therapist, patient services specialists, security, materials management or any other employee, we are all affected by these changes and new challenges.

We’ve recently seen how the globalization of society could potentially impact health care. With the ease of international travel, and the growth of multinational corporations, the spread of illnesses and emerging diseases are very real concerns. Globalization also means an even greater emphasis on cultural diversity. At the same time, changing demographics like our aging population and differences in health care preferences, such as alternative therapies, also impact how we must think about health care delivery.

We’ve also recently seen how the latest advances in health care, like new treatment methods, may be quickly applied. We’ve seen the pace at which new technology and devices, like infrared thermometers and external biosensors for point-of-care diagnostics, are being integrated into care delivery models or are already in use. The growing world of information technology has already had a radical impact on health care delivery; there have been many tremendous improvements, like new methods of observation and communication. Meanwhile, our patients are also utilizing new advancements, as they are asked to play a more active role in their own health care decision-making and management.

As we learn about new illnesses and treatments and how we will respond to health care demands in the future, we also must work together to better manage our patient’s care in general. This requires innovative thinking in terms of different types of care settings and systems of care across the health care continuum. The emphasis in health care has shifted from addressing episodes of care with an acute orientation to addressing overall care management. Now and in the future, we will need to focus on the comprehensive needs of our patients and populations.

There isn’t a single job position at UTMB Health that doesn’t play an important role in providing the very best care and service to our patients and their families. This is why, moving forward, our values of diversity and lifelong learning will be crucial as we travel down The Road Ahead.

As we strive to be the best in all our endeavors to improve health for the people of Texas and around the world, we must keep our eyes on the future—it may be here sooner than we think—and develop strong partnerships to ensure continual improvements in knowledge transfer between cultures and health care systems. Compassion, integrity and respect will make all the difference in the care and experience of those who come to us in need.


In addition to Emergency Nurses Week, the month of October also recognizes National Breast Cancer Awareness Month, National Physical Therapy Month, Health Literacy Month, Mental Illness Awareness Week, Bone and Joint Health National Awareness Week, National Health Education Week, International Infection Prevention Week, Respiratory Care Week, Physician Assistant Week, and many additional observances.

Thank you to everyone on our health care teams at UTMB for your dedication, service and commitment to our patients and communities. Together, you work wonders everyday!


Special Grand Rounds Presentation: Innovation

Roy Rosin, Chief Innovation Officer, Penn Medicine

Friday, October 10, 2014 at 11 a.m. in Levin Hall Main Auditorium

RoyRosinWe have a special guest with us today at UTMB. I hope you will join us during Grand Rounds at 11 a.m. in Levin Hall Main Auditorium to hear Roy Rosin, Chief Innovation Officer at Penn Medicine, for a very special presentation about the innovative work currently underway at his organization to transform ideas into measurable results in areas of health outcomes, patient experience and new revenue streams.

Prior to his position at Penn Medicine, Mr. Rosin was the first Vice President for Innovation at Intuit, a leading software company best known for Quicken, Quicken Books and Turbo Tax. He spent 18 years with Intuit. Mr. Rosin received his MBA from Stanford University’s Graduate School of Business and graduated with honors from Harvard College.

The presentation is open to everyone, and will also be streamed live, online. For more information, please visit http://intranet.utmb.edu/healthsystem/special-presentations/RoyRosin.asp or download a flyer here: https://ispace.utmb.edu/xythoswfs/webview/_xy-8030657_1

Lollipop Moments

Donna Sollenberger, EVP & CEO, UTMB Health SystemWe all work in teams at UTMB, and we’re all leaders when it comes to the business of offering the very best care and service to our patients and their families. Our success as leaders, colleagues, teachers and friends is dependent on our ability to create an environment that brings out the best in people. Whoever you are, wherever you might be, there are talents to be uncovered in people around you.

If you want to bring the best out of someone, you must look for the best that is in them. As a leader and colleague, one of the most effective things we can do to bring out the best in others is to recognize the achievements and efforts of those on our teams and to share and applaud their accomplishments. Who on your team has helped make your day better, or helped you do your job more effectively? Take time to thank others for the great things they do. Appreciation is something anyone can do and everyone needs.

To that end, small efforts go a long way. Writing a thank you card, sharing some chocolates, or remembering someone’s birthday can help people feel valued for what they bring to the table as part of a team and respected for who they are as an individual. Be present for your co-workers; listen to them, understand the challenges they face, acknowledge their efforts, help them overcome disappointments, and commend them for their successes.

There’s a story I often think of called “Lollipop Moments”, told by Drew Dudley, an expert in leadership development. He often shares his story to illustrate that it is through the small things we do that we can have a great impact on those around us.

The story begins on his last day at college. On this day, a girl came up to him and said, “I remember the first time that I met you.” She then told him the story that happened four years earlier.

On the day before she started college, she was sitting in her hotel room with her parents. She was scared and convinced she couldn’t go through with going off to school. But her parents were very supportive, and whether or not she chose to go to school, they understood. The next day, as the girl stood in line with her family to register for classes, her anxiety grew, and she was about to tell her parents she wanted to quit.

At that moment, Drew came out of the student union building wearing the most ridiculous hat she had ever seen in her life—it was awesome. He had a bucket full of lollipops that he was passing out to people in line and talking about the cystic fibrosis charity he had long supported. When he got to the girl, he stopped. And then he looked at the guy next to her, smiled, and handed the young man a lollipop.

Drew said to him, “You need to give a lollipop to the beautiful woman standing next to you.”

“I have never seen anyone get more embarrassed faster in my life,” she said. “He turned beet-red and wouldn’t even look at me. He just held the lollipop out like this,” shyly offering the lollipop. “I felt so bad for this guy that I took the lollipop, and as soon as I did, you got this incredibly severe look on your face and you looked at my mom and my dad and you said, ‘Look at that. Look at that. First day away from home and already she’s taking candy from a stranger!’”

And she said, “Everybody lost it. Twenty feet in every direction, everyone started to howl. And I know this is cheesy, and I don’t know why I’m telling you this, but in that moment when everyone was laughing, I knew that I shouldn’t quit. And I haven’t spoken to you once in the four years since that day, but I heard that you were leaving, and I had to come up and tell you that you’ve been an incredibly important person in my life, and I’m going to miss you.”

As she walked away, she turned around, smiled and told Drew that she was still dating that guy four years later. A year and half later, Drew received an invitation to their wedding.

Here’s the kicker—Drew doesn’t even remember the encounter at all. Although it seemed like the smallest of acts, to share a lollipop, his action had made a great impact on another person.

Today, Drew calls these “lollipop moments”, or moments where someone said something or did something that fundamentally made life better for someone else. Drew believes one way we can redefine leadership is through lollipop moments, how many of them we create, how many of them we acknowledge, how many of them we pay forward, and how many of them we say thank you for.

We have all experienced our own lollipop moments. We all have likely even been the creator of some whether we remember it or not. I truly believe that sharing these moments with those that gave them to us can have a very positive impact.

Perhaps all these thoughts about showing appreciation and encouraging people boils down to a simple personal commitment—we need to acquire the attitude of believing in and supporting others. Give encouragement to the best you see in others. Let people know they matter.

I recently received news that over the past year, the Transportation Department improved their response time to requests by 8%. Overall, they now currently respond to requests within 20 minutes 82% of the time.

To thank them for this significant achievement, transportation leadership decided to reward the staff with covered cups that say, “Keep a smile in your voice.” What a wonderful reminder to this team that they truly have an impact on the patient and family experience and to their colleagues! In fact, I can recall many patient comments that call out individuals in transportation for their service: “[UTMB has] the best staff, nurses, doctors, transportation people and many others. It was first class all the way; one of the best hospitals I’ve ever been in.”

Pictures of transportation team members were also posted in the hallway beneath a banner that reads, “Attitude is a little thing that makes a big difference.”

Pictures of transportation team members were also posted in the hallway beneath a banner that reads: “Attitude is a little thing that makes a big difference.”

It’s great as a leader and colleague to feel positive about an achievement, but make sure others on your team feel elevated by what you have accomplished as well! The credit, the recognition and the idea of giving back once you have a success is what creates an environment in which you can do it again in the future.

Leadership is about something bigger than us—change one person’s understanding of their true impact. There are small things we can do every day—a compliment or encouraging word can help dreams and ambitions become reality, and help everyone at UTMB succeed as we travel down The Road Ahead.

The Smallest Gestures of Kindness

Donna Sollenberger, EVP & CEO, UTMB Health SystemLast week, we explored the impact of demonstrating a positive attitude in everything we do. After I posted the message, I made a personal commitment to have a positive attitude in every interaction I had with others. Although this is something I always try to do, I was amazed at the results of this special effort—it seemed not only like this made my own day brighter, but my own attitude put a smile on the faces of others, too.

While thinking of the power of small gestures like this, I began exploring the topic for this week. In the process, I came across a great story that touches on how acts of kindness that we do for others can also make a difference beyond measure:

Two boys walked down a road that led through a field. The younger of the two noticed a man toiling in the fields of his farm, his good clothes stacked neatly off to the side.

The boy looked at his older friend and said, “Let’s hide his shoes so when he comes from the field, he won’t be able to find them. His expression will be priceless!” The boy laughed.

The older of the two boys thought for a moment and said, “The man looks poor. See his clothes? Let’s do this instead: Let’s hide a silver dollar in each shoe and then we’ll hide in these bushes and see how he reacts to that, instead.”

The younger companion agreed to the plan and they placed a silver dollar in each shoe and hid behind the bushes. It wasn’t long before the farmer came in from the field, tired and worn. He reached down and pulled on a shoe, immediately feeling the money under his foot.

With the coin now between his fingers, he looked around to see who could have put it in his shoe. But no one was there. He held the dollar in his hand and stared at it in disbelief. Confused, he slid his other foot into his other shoe and felt the second coin. This time, the man was overwhelmed when he removed the second silver dollar from his shoe.

Thinking he was alone, he dropped to his knees and offered a verbal prayer that the boys could easily hear from their hiding place. They heard the poor farmer cry tears of relief and gratitude. He spoke of his sick wife and his boys in need of food. He expressed gratitude for this unexpected bounty from unknown hands.

After a time, the boys came out from their hiding place and slowly started their long walk home. They felt good inside, warm, changed somehow knowing the good they had done for a poor farmer in dire straits.

Kindness and empathy often go hand-in-hand. This story made me think about how being mindful of the life events of others—patients, families, visitors and colleagues alike—is also important. Whether the person who walks through UTMB’s doors arrived for a routine checkup, a minor ailment, a serious illness, or to visit an ailing loved one, we should always do our best to make their experience the best it can be—they may be fighting a hard battle we know nothing about, and our kindness and expressions of care may make a difference to them.

A patient story I received a while ago—also a 2014 Silent Angel nomination—immediately came to mind. The story took place almost a year ago, but it is still a great reminder that we can help lift others’ spirits just as much as we are able to care for their physical health:

Denise Turner, RN had noticed one of her oncology patients was very depressed and wanted to do something to cheer her up. While the patient was in dialysis, Denise and one of the patient care technicians on the unit decorated her room with flowers, including a giant sunflower. The expression on the patient’s face when she returned to her room was unbelievable. She was extremely happy and smiled the rest of the day. Although the patient passed away just two days later, flowers and decorations still in her room, there is no doubt that the smile Denise put on the patient’s face and the joy Denise brought to her patient’s heart was one of the last beautiful memories she had.

One of the best parts of my day is hearing stories of how our health care teams made a difference in the lives of our patients and their families. Kindness and compassion are alive and well at UTMB, but we should never take these values for granted or underestimate the magnitude of the impact they carry.

Some time ago, one of our Correctional Managed Care employees at the Skyview Unit, Radiologic Technologist Hector Coria, sent a nice quote in response to one of my Friday Flash Report entries, and I have been saving it for just the right post: “Even the smallest of gestures have in them the power to connect us to each other, and that connection is what makes the unbearable bearable!”

Every kindness you do for others—no matter how small—enriches the world beyond measure. You do not have to pull off a world-changing achievement in order to make someone’s world sparkle. So go ahead, be a diamond!

When we do our best at everything, the future takes care of itself.

Donna Sollenberger, EVP & CEO, UTMB Health SystemLast week, UTMB President Dr. David Callender gave opening remarks at the organization’s Annual Professionalism Summit. The summit is an opportunity for the UTMB community to join together to renew its commitment to an environment that supports and measures professionalism and holds one another accountable to each other and those we serve. In his remarks, Dr. Callender underscored the fact that only through professionalism can we achieve our mission and vision, while emphasizing that our vision (what we strive to become) is not about being the biggest academic health center or being the best-known academic health center—it’s about being the best.

There is something about being the best that is important to keep in mind, however—it is an ongoing pursuit of excellence.

In the late seventeenth century, three rural families dominated the musical instrument industry. Working in shops located side by side in the Italian village of Cremona, these families produced the finest violins. The Amatic family hung a sign outside their shop that read, “The best violins in all of Italy.” Not wanting their creations to go unnoticed, the Guarneri family posted a sign that read, “The best violins in all the world!” The famous Anton Stradivari, known to produce the very finest stringed instruments, boasted his worldwide renown by hanging a sign on his front door that simply read, “The best violins on the block!”

Zig Ziglar, an American author, salesman and motivational speaker, once said, “The greatest enemy of excellence is good.” These three Italian families were proud of and prominently advertised their product. They also understood the aggressive competition among them would never allow “good” to be their best.

Whether we proclaim that our care or services are the best in the country or in the world, remember, there might be someone on the block who surpasses us.

Would our patients and families want us to settle for “good enough”? Would we? Will settling for good enough ever make UTMB the best? Will it make each of us, as individuals, the best at what we do? This is why we must always strive to achieve excellence. It’s important to remember that excellence in any endeavor is not automatic. As Dr. Stephen Covey says, “Real excellence does not come cheaply. A certain price must be paid in terms of practice, patience and persistence—natural ability notwithstanding.” Go a step beyond the customary or ordinary. Give just a little more than normal.

But perhaps the most important part of becoming excellent is to possess the desire and the motivation to become the best. The great author, Charles Dickens said, “Whatever I have tried to do in my life, I have tried with all my heart to do well. What I have devoted myself to, I have devoted myself completely.”

However you define excellence, it is important to keep in mind that it is not a project, act, or job description; excellence is a way of life. It doesn’t mean we are asked to hang the moon. Rather, it’s the little things that make the big things possible. “Only close attention to the fine details of any operation makes the operation first class,” said the great entrepreneur, J. Willard Marriott.

When you feel a compelling, constant daily desire to do everything in your life as well as it can constantly be done, you will touch the borders of excellence. When people perform the common things in life in an uncommon way, the world will sit up and take notice. When we do our best at everything, the future takes care of itself.

I know that many of us are thinking about UTMB’s future – what is our plan? Why are we handling the many projects we have underway? What is my part? We will be discussing all of that in the coming year through many venues. However, as we are about to start the new fiscal year, I wanted to start out with a simple message – if each person at UTMB commits to excellence – to being the best they can possibly be and do the best job they possibly can for our patients, we will achieve our plans and, ultimately, we will be the best!