Plate Spinner Extraordinaire!

Donna Sollenberger, EVP & CEO, UTMB Health SystemThere is an old episode of the Ed Sullivan Show I’ve thought of often, lately. It features a man who may quite possibly be the most famous and skilled multitasker that ever graced the show—a man from Austria, Erich Brenn—plate spinner extraordinaire.

Brenn was a master at the art of plate spinning. His routine consisted of spinning five glass bowls on four foot-long sticks all while spinning eight plates on the same tables. Intermittently, he also managed to balance a tray carrying glasses and eggs and in one swoop would remove one of the trays causing an egg to fall into each glass.

He would also carry a separate tray lined with glasses and spoons in front of them. With a simple flip, every spoon would magically fall into a glass. All of this, of course, was done while keeping those glass bowls spinning atop their sticks. As some sticks began to slow down, it would cause the glass bowls to wobble uncontrollably—often getting a rise out of audiences thinking the bowl would soon smash to a million pieces. Just in the nick of time, Brenn would run in and save the day!

Erich Brenner spinning bowls and plates on the Ed Sullivan show. View the video below.

Erich Brenn spinning bowls and plates on the Ed Sullivan show. View the video below.

With so many initiatives underway as a result of a reforming health care environment and the progressive work taking place at UTMB, I often feel like we are spinning plates and bowls ourselves! Every day, our health care teams work hard to ensure our patients and families receive the highest quality care, and they are continually working to develop more efficient processes and new models of care. Meanwhile, many others are looking at ways we can improve access to our system and enhance communication with our patients and families—all multifaceted initiatives. Other projects include the improvement of documentation and reporting, so we can better understand how to improve care delivery and reduce readmissions. With the time we have left after all of this, we are garnering new accreditations, maintaining current accreditations and preparing for our upcoming Joint Commission reaccreditation survey—just to cite a few examples.

But wait, there’s more! (It’s time to add a little more suspense to our spinning act.) At UTMB, we are working hard to become the preferred health care provider in the region for our patients, partners and referring physicians. Our entire organization is buzzing with new construction and facility renovations. Meanwhile, we’ve been working around the clock to prepare for the launch of our new partnership with Angleton Danbury Medical Center, an exciting opportunity that will help us bring a number of important services to patients throughout our region. Our colleagues in Revenue Cycle Operations have collected over $10 million in additional cash beyond our targets this year. Many of you are involved in Medicaid 1115 Transformation Waiver program projects, and there are many end-of-year tasks to complete, like navigating our way through a new performance evaluation tool, completing annual compliance training and wrapping up the budget.

Just like Erich Brenn spinning plates and bowls on the Ed Sullivan Show, it can sometimes seem like a true marvel that we have accomplished so much at UTMB. Sometimes the plates spin a little faster, sometimes a little slower, but I can certainly say that, whatever challenges we accept, you all rise to the occasion, managing these tasks with grace under pressure and incredible skill. Just as importantly, you do it all through teamwork and realize that we are in this together for the ultimate benefits of our patients and families. Because we move forward with such momentum, I think sometimes it can be easy to forget to reflect on all that we have accomplished within the course of just one year—it is tremendous. With this in mind, I want to be sure you all know that UTMB’s executive leadership and I realize how hard you all work to help UTMB be successful. We thank you for everything you do!

New Year’s Resolutions

Donna Sollenberger, EVP & CEO, UTMB Health SystemEach New Year presents new opportunities—opportunities to learn new things, to focus on what we hope to achieve in the future and to treat one another and ourselves better. As we bring one year to a close and embark on a new stage in our journey, it is important for each of us at UTMB Health to reflect on the changes we want (or need) to make, set our sights on what we’d like to achieve in the next 12 months and resolve to follow through on those changes.

On an individual level, we can choose what we want for ourselves in the New Year; on an organizational level, we share in many of our goals, and we are guided by core values that help to define our culture. As an academic medical center, faculty members, health care providers, staff and students all share in the responsibility of caring for our patients and improving health in the communities we serve. Sharing a common vision keeps everyone moving forward. Teamwork and collaboration are the very basis for the great accomplishments that we will achieve.

If we resolve to place the patient at the center of everything we do and to abide by our core values in all of our endeavors, we will meet with success in not only achieving our goals, but ultimately by providing the best care for our patients and their families. We’ll also go a long way toward creating a safe and positive work environment for everyone at UTMB.

So let us begin 2014 by reaffirming the values which serve as the cornerstone of UTMB’s reputation as a leading academic health center and an institution deserving of the trust that our patients and their families place in us:

We demonstrate compassion for all. The letters I receive daily from our patients reflect that compassion is alive and well at UTMB. Caring for others is why we are here! In 2014, may we always maintain an awareness of others and consider what life may be like after walking a mile in their shoes. Many of you may have seen the video “What if you could read their thoughts?” in which Cleveland Clinic explores what empathy really means and explores how our interactions with others would change if we knew what they were feeling and thinking. In a hospital, empathy underpins human relationships, and I encourage you to view the video if you haven’t already.

We always act with integrity. Everyone plays a part in creating a safe and reliable care environment. Each of us holds ourselves accountable and each of us expects one another to do the same. As the saying goes, “Character is who you are in the dark.”  When no one’s looking, we are the ones to whom we answer. Having integrity means we believe in what we do and why we do it, and essentially, we trust one another to do the right thing. Moreover, our patients and their families trust us do the right thing. They trust us to be honest, qualified, knowledgeable and to not only have one another’s best interests at heart, but to especially have at heart what is in their best interest.

We show respect to everyone we meet. It is widely acknowledged that there are different kinds of respect. Respect can be defined simply as a behavior or it can be defined as an attitude or feeling. However, respect is always directed toward, paid to, felt about, or shown for another person. We can show respect to others by valuing and appreciating them as unique individuals and when in the work environment, also treating them as esteemed colleagues. We show respect by listening and engaging during discussions and meetings. We value the thoughts and opinions of others, even when we may think or feel differently. Finally, we regard one another not merely as a means to serve a purpose, but as valuable human beings. Therefore, we should all work in partnership with one another because we are all here at UTMB, in whatever our role, to serve a single purpose: to provide the best service and safest possible care for our patient and their families.

We embrace diversity to best serve a global community. The concept of diversity encompasses acceptance and respect. It means understanding that each individual is unique and recognizing our individual differences, including dimensions of race, ethnicity, gender, sexual orientation, socio-economic status, age, physical abilities, religious beliefs, political beliefs, or other ideologies. It is the exploration of these differences in a safe, positive, and nurturing environment. It is about understanding each other the best we can and moving forward in our encounters with respect of those differences, including how we communicate, educate and provide patient care. We should embrace and celebrate the rich dimensions of diversity contained within each individual.

We promote excellence and innovation through lifelong learning.  Through innovation and by exploring new solutions, we not only gain knowledge, but we are also then able to contribute to the greater body of knowledge. Lifelong learning makes us successful, no matter what our definition of success may be. We grow as a person through learning and when one masters a subject through continuous learning, it brings satisfaction. Lifelong learning enables us to be confident, competent, and knowledgeable; it increases productivity and makes us better leaders.

I’ve said it before, but I am proud to be part of an organization like UTMB and to work alongside each of you. Everyone is doing a truly remarkable job, both by helping one another and going the extra mile to serve our patients and families. So this year, let’s embrace the values of compassion, integrity diversity, respect and lifelong learning and embark on the beginning of a very successful 2014!

Be sure to share the great achievements you and your teams accomplish along the way!

The Greatest Accomplishments are Achieved Through Teamwork

Donna Sollenberger, EVP & CEO, UTMB Health SystemIn the world of health care today, it’s hard to go anywhere without hearing about the necessity of teamwork or that the greatest accomplishments are achieved when people work in teams. Teamwork requires constant attention, communication, inclusion and collaboration.

One of my favorite sports is basketball, and one of the all-time greats and holder of six NBA championship rings, Michael Jordan, once said the said the following: “Talent wins games, but teamwork and intelligence win championships.”

Think about it. We have so many talented and intelligent people who work at UTMB, but Jordan’s sentiment about teamwork is the essential ingredient for ultimate success. At UTMB, we have to work together to benefit the health and care of patients. Just before the holidays, I took some time to review everything that we had collectively achieved over the past year, and not only was it clear to me that we are all passionate about being the best possible place for patients to receive care, but I was amazed by all that we had accomplished as a result of this teamwork!

We began 2013 by breaking ground on the Victory Lakes expansion, an exciting project that will allow UTMB to provide more services and convenience to our patients in the Bay Area while also offering a more integrated system of care. Meanwhile, we built mock-up rooms of the new Jennie Sealy Hospital to allow staff and community members a chance to provide feedback; we made modifications based on that input and then conducted patient simulation drills to ensure the design would be as refined as possible for our patients, their families and our patient care teams.

We made a collective commitment to engage our patients and their families in every stage of their care by placing them at the center of their care team. We also went live with utmbConnect, which enabled us to offer our patients the convenience of a single electronic medical record and a combined bill for all of their encounters at UTMB. And speaking of the utmbConnect project, UTMB recently received news that we were rated an “A+” top-tier performer by Epic—what an outstanding achievement! We could not have been as successful without a tremendous amount of teamwork across all areas of the institution.

In 2013, it seemed as though awards came in one after another. We became first hospital in Texas to receive American Health Association’s Get with the Guidelines®-Resuscitation Silver Quality Achievement Award and became one of four centers Texas and one of 44 in the U.S. to be designated as an AAGL Center of Excellence Distinction for Minimally Invasive Gynecology. We also received certification from the American Association of Cardiovascular and Pulmonary Rehabilitation, and these are only a few examples of recognitions—don’t forget the SICU’s recent Gold-level Beacon Award from the American Association of Critical-Care Nurses and Family Medicine’s recognition as an NCQA Level-3 Patient Centered Medical Home. This was quite a year for UTMB!

We also developed great partnerships, such as the shared pilot program between the UTMB Emergency Department and Galveston EMS that reduces the time it takes to get a stroke patient to a CT scan after reaching the ER entrance from 20 minutes to 2 minutes—this is valuable time saved for a stroke patient, who may lose 10 percent of salvageable brain function for every 15 minutes they go untreated.

I could fill an entire book with all the great accomplishments over the past year, and I assure you, these are but a handful of the highlights. I am excited to share all that we will accomplish through teamwork in 2014. If you have stories that you would like to share, please send them to me at health.system@utmb.edu

Thank you for your teamwork. I am proud to work with each of you and to be part of the UTMB team!

Making a Pound of Honey

Donna Sollenberger, EVP & CEO, UTMB Health SystemI have always been fascinated by honeybees. I often observed the bees as a child, and although I’d occasionally get too close for their comfort and was stung, I was still very intrigued by how synchronized they were in their work and how each bee seemed to have a certain role.

During a honeybee’s short lifetime, which lasts about two months, it will visit millions of flowers and travel a distance equivalent to twice around the earth, while only producing one-twelfth of a teaspoon of honey. Thus, it requires anywhere from 20,000 to 60,000 bees to make a single pound of honey. From the queen bee to each and every worker bee, the entire hive must work together in their roles to achieve their life’s purpose of making honey.

This past week, I thought of the bees and the magnitude of their collaborative effort when I heard about two outstanding recognitions achieved at UTMB—these accomplishments could not have been possible without a tremendous amount of teamwork!

News of the first recognition came last Friday, when David Marshall, our chief nursing and patient care services officer, sent out an announcement that UTMB’s Surgical Intensive Care Unit (SICU) was awarded the American Association of Critical Care Nurses (ACCN) Beacon Award.

The Beacon Award recognizes individual units that distinguish themselves by improving all aspects of patient care. It also signifies that UTMB patients who are admitted to our SICU experience better outcomes and are more satisfied with their overall experience.

For our nurses, this award means that generally, there is a positive and supportive work environment with a greater degree of teamwork and collaboration between all caregivers, higher employee morale and lower turnover rates. What an outstanding accomplishment that exemplifies the phrase “win-win” for both our patients and the staff of the SICU!

In addition, earlier this week, Dr. Barbara Thompson, professor and chair of the Department of Family Medicine, received the news that all three of our Family Medicine practice sites (Island West, Island East and Dickinson) were awarded Level 3 Patient-Centered Medical Home (PCMH) status, the highest level recognized by National Committee for Quality Assurance (NCQA). Only a little more than half of NCQA-recognized practices have achieved the Level 3 status.

This recognition acknowledges an undertaking that began in the fall of 2011 to prepare our clinics to operate under a special model of patient care that is designed to strengthen the relationship between the patient and their care team. Each patient has an ongoing relationship with their care team, which consists of their physician, a medical assistant, nurses, patient care technicians and other clinical and administrative staff, at a single location. The team takes collective responsibility for the patient’s care, providing for his/her health care needs and arranging for appropriate care with other qualified clinicians. The medical home is intended to result in more personalized, coordinated, effective and efficient care. This is the epitome of teamwork, and having this recognition positions UTMB well for the future of health care reform!

Each of us works on a team that in some way, shape or form impacts our patients, and we all have an important role to play in assuring that our patients receive the best possible care. Our individual contributions to the team on which we work are critical to achieving UTMB’s vision of “working together to work wonders as we define the future of health care and strive to be the best in all endeavors.”

Thank you for your individual contributions to the team. Your work truly does make a difference in patients’ lives!

Aiming for the Top in Quality and Accountability

Donna Sollenberger, EVP & CEO, UTMB Health SystemSeveral weeks ago, I attended the annual University HealthSystem Consortium’s (UHC) Quality Forum. As I reviewed UTMB’s performance in the latest Quality and Accountability Study, I felt proud of how far we have come in terms of quality improvement. Yet, I also realized just how far we still must go to make sure our patients are always receiving the best possible care.

Reading the report, I thought of how the emphasis on quality in health care has increased in the last decade, and that it will continue to be emphasized as patients have more responsibility for the cost of their care—they will expect the best outcome at the best price, which equates to the best value.

My thoughts took me back to 2009, a time that is memorable to me for many reasons. Not only had I just arrived at UTMB Health that fall, but I had also received the UHC Quality and Accountability results for UTMB for the first time. The report typically includes approximately 110 academic medical centers that submit data on areas such as patient satisfaction, hospital acquired conditions (infections), mortality rates (deaths that are not expected), and cost. The centers are then ranked based on their performance using a five-star system, with five stars being the best. That year, we were only a two-star hospital, ranking in the bottom quartile of the list of reporting hospitals.

This year, I was pleased with the news that we are now solidly a three-star hospital and performing at the median of the reporting hospitals. We did very well in the measures of mortality (27 out of 112 reporting), equity of care (we ranked first of all the reporting hospitals), and patient-centeredness, which includes our performance on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) measures.

The more challenging news, however, is that our performance in several other areas needs improvement. In the category of effectiveness, which includes data for all-cause 30-day readmissions and core measures, we ranked 76 out of 112. For safety, which includes measures on postoperative hemorrhage and hematoma, we ranked 53 out of 112. In efficiency, we ranked only 94 out of 112. The latter means that we have a long way to go in managing our inpatient length of stay, as well as our cost of care for certain services.

While we have done an excellent job in many areas, my goal is that UTMB Health continues to improve its performance in this important study. During the conference, I sat next to a friend whose hospital has been in the Top 10 of the Quality and Accountability Study for four years in a row. I firmly believe UTMB can also achieve this if we continue working hard to improve. This means we must always place the best interest of our patients as our top priority. We can achieve this by focusing on patient satisfaction, patient safety, and the effectiveness and efficiency of patient care delivery.

Here are a few things to consider as each and every one of us work to improve our patients’ experiences while at UTMB Health:

  • Are we communicating with and meeting the needs of our patients?
  • Are we creating an environment where patients have the best opportunity to have the best possible outcome?
  • Do we have the correct and necessary supplies we need for patient care? Are any supplies expired?
  • Are patient rooms available in a timely manner? Are they thoroughly cleaned so that the patient’s risk of infection is minimized?
  • Are our physicians and residents working closely with care management to assure that the patient’s length of stay does not exceed what would be expected for that condition?
  • Are all health care employees effectively and efficiently using the resources required to deliver patient care in a manner that helps ensure the cost of care does not exceed what would be expected for a patient with a particular diagnosis?
  • Are our systems and processes streamlined to minimize cost and increase effectiveness?
  • Are we washing our hands or using gel each time we enter and leave a patient’s room?
  • Are our physicians sitting down at eye level to the patient each time they enter a patient or exam room?

I know we can continue to excel in this study by focusing on these measures—we have come so far already! Thank you for everything you do to make a difference in the quality and safety of patient care at UTMB Health. I look forward to working with each of you as we continue our journey to be the safest and highest quality hospital for our all of our patients.

 

Engaging Patients with MyChart

Donna Sollenberger, EVP & CEO, UTMB Health System

One of this year’s Health System goals, as well as a goal in the future, is to be the preferred provider of choice for patients in our area. We have a variety of tactics planned to help us achieve this goal, including the improvement of patient access to clinic appointments, access to personal medical information, and effective communication between patients and their health care teams.

Recently, UTMB Health completed the utmbConnect project which provides our patients with a single electronic medical record.  Regardless of where the patient goes within the UTMB Health System, physicians and other providers are able to access that patient’s medical information.

In 2011, we implemented MyChart, a secure electronic way for patients to access their health information and communicate with their UTMB health care team. Since its implementation, 34,315 patients now have active MyChart accounts and 3,232 patients utilize the mobile app.

Patients using the system are able to make appointment requests online, link to their family’s accounts with proxy access, view their lab results (one of the most popular features), request medication refills, view their medical history and much more. It’s also an excellent method for patients and their health care teams to maintain contact with one another, and it improves the ability of physicians and staff to respond to patients’ questions in a timely manner. Perhaps the best feature of MyChart is the ability of patients to communicate with UTMB at their convenience, any hour of the day or night, for non-emergent requests.

All that’s necessary to get a MyChart account is to become a UTMB patient and sign up! By signing up as an employee, not only will you reap all of the benefits and convenience of the tool, but it’s also easier to explain the importance of the tool to our patients. Here are just a handful of testimonials from individuals who are already using the system:

“MyChart is a valuable and convenient tool. I would like to have even more information listed—the more informed a patient is about his/her medical status, the more involved that individual can be, and patient involvement is important.”

“The convenience of MyChart makes my health care needs transparent. I can get in touch with the majority of my physicians, request appointments and refill prescriptions without going through tons of staff.”

“I think this is a really great concept to keep patients better informed and also make it easier to communicate with the doctors at UTMB.”

“I like that I can use MyChart to make appointments or to request medication refills. I also like that I can email my PCP if I have any concerns or questions and will receive a response quickly. I appreciate being able to view and compare my lab results and look at the information regarding appointments past and upcoming as well as my hospitalization information. I love MyChart and wish that all my doctors used this system!”

“I think MyChart is one of the very best things UTMB could have done. I can get in touch with my doctor and he can reach me whenever anything is of concern to either of us. I have asked him a question on MyChart and he responded promptly. I think it is great.”

“I have found it convenient to be able to communicate with my doctor regarding my health. Given my busy schedule and the doctor’s busy schedule, it is difficult to communicate by phone.”

“I can’t imagine being satisfied with treatment at an institution that does not provide this service.”

“I really like having the information at my fingertips; current and historical.”

“I love using this – it makes me feel more in control of my health. I like the access that it brings to my doctors. As a patient, you don’t always have questions ready and it is nice to that that you can reach out to the doctor, should you have any.”

While 17 percent of UTMB patients currently have a MyChart account, we want to increase that number so that all of our patients can experience this exceptional tool. The first step to achieving this is to let them know about it and explain how it will add convenience to managing their health.

Beth Scribner, ambulatory Epic project manager, says she feels excited and privileged to be part of the team working to bring MyChart to UTMB patients. “I often have the opportunity to speak with patients about MyChart. Not only do they love the convenience of it, they say they feel more involved in their care and continually praise UTMB for making it available to them. Introducing MyChart to all of our patients, and having our staff use it routinely in their care, is the ultimate in patient engagement.”

Scribner suggests that when mentioning MyChart to patients, it’s helpful to first ask them if they use email; if yes, sign them up. She explains that patients may be more likely to decline if they’re simply asked: “Do you want to sign up for MyChart?” She also recommends that activating the patient in the system during the visit is the most efficient and effective way to assure the patient becomes a MyChart user—once they leave the clinic, even though they have an access code and instructions on their After Visit Summary (AVS) or Hospital Discharge Summary, they are less likely to actually activate their account.

MyChart is an excellent tool and a great way we can improve our patients’ experiences at UTMB Health. Visit the MyChart page on utmbhealth.com for more information and if you haven’t already, sign up today!

What are you and your colleagues doing to improve our patient’s experience and/or patient engagement and communication at UTMB Health? I would love to hear from you! Please send your examples to me at health.system@utmb.edu, and I will share your examples in future issues of Friday Flash Report.