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.

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If I bought a thank you card to match the size of my appreciation, it wouldn’t fit in your mailbox!

As we approach the end of Nurses’ Week & Health System Week, I want to remind each of you of how important you are to UTMB Health. Our success as a healthcare provider depends on the positive interactions you have each day with our patients and visitors, your willingness to do what is in the best interest of the patient, and your unrelenting quest to deliver the best care to our patients.

Last week, I had a firsthand opportunity to witness the wonders you work every day when one of my family members became a patient. The week became one of comparison and contrast. Our experience started out at another hospital about an hour away. Without going into the details of that experience, I will say that there was a point where my family member wondered out loud if the nurses, technicians, doctors and other staff even cared about the people who were there to receive care.

I asked my family member why they felt that way, and I wholeheartedly agreed with their response. In a waiting room jammed with people, there was no communication. Staff sat around and visited or looked at their phones and never communicated with the patients who were waiting to be seen. It took almost six hours to get to the exam room from the waiting room. During that time, the only communication we had with anyone was when someone from our family actively went up to the desk to ask when we might be seen. Each time the answer was the same: “I have no idea. It’s busy tonight.” It was true—the place was so busy, patients were being placed in rooms that had not even been cleaned. In short, it truly seemed like no one cared about the patients or even cared about their job.

The next morning, we chose to come to UTMB, and in contrast, my family member’s experience was light-years apart from the experience of the night before. After we got the patient settled into the room, several nurses, physicians and residents came into the room to get things started. My family member commented to me that they were so relieved to be at UTMB: “It is obvious that they really care about their patients. I always feel well cared for and safe when I am here.”

Naturally, I could not help but wonder if the fact that my name was “Sollenberger” was part of the reason for this service, but as I watched other patients in the area, what I witnessed makes me feel certain that the staff members here treat all patients alike—with respect, compassion and concern for their privacy and safety.

To me, it is odd that a patient would even have to be concerned about whether or not other people are eavesdropping in on what they are telling their caregivers. It is odd to me that a patient would ever have to worry about their safety while in the hospital. It is concerning to me that a patient should have to be concerned about acquiring an infection from dirty rooms, soiled linens, or from people entering their room without washing their hands. It is concerning to me that a patient would have to worry about whether or not they have a voice in their care.

At the other hospital, all of these concerns were valid. At UTMB, they were not. At UTMB, each person treated our patient with the utmost courtesy and attention. Each person who came in contact with our patient followed the proper protocols for patient identification, each person performed hand hygiene, and each person explained in detail what to expect and asked if the patient had any questions. Each interaction with a nurse or physician made it clear that we were at the center of their work and decision-making. As support staff interacted with the patient—whether when cleaning the room, transporting the patient, or delivering meals—it was clear that they genuinely cared about the patient and took their role in the care process very seriously.

Fortunately, we were able to leave the hospital last Friday. We are so relieved that our family member is on the mend. However, we simply cannot forget the feeling of care and compassion that each person with whom we interacted demonstrated as they went about doing an exceptional job. What will not leave us is the sense of confidence we had in the total care experience. It simply was the BEST!

So, to every person who cares for or interacts with our patients, THANK YOU! Thank you for blending compassion with your care. Thank you for showing respect for the patient, regardless of circumstances. Thank you for stopping to listen, even when you are busy beyond belief. But most of all, thank you for treating your work at UTMB as more than a job or a paycheck. You are setting the bar high for all healthcare professionals in the Greater Houston area. You are making UTMB known as a place where everyone truly works together to work wonders.

HAPPY HEALTH SYSTEM WEEK! HAPPY NURSES’ WEEK! And because I cannot say it enough, thank you!

Thank You

Never underestimate the healing effects of beauty.

Donna Sollenberger, EVP & CEO, UTMB Health SystemIt has already been one month since I moved into my office in Jennie Sealy Hospital. It seems like time is flying! I am starting to feel at home in our new space, even as activation of the building continues and preparations are ongoing to prepare to greet and care for our first patients. I have truly enjoyed being in the new hospital and am impressed by and proud of its features.

wiley

“The Fab Four,” by Rene Wiley-Janota. Rene Wiley-Janota, of Galveston, is known for her paintings of a variety of local subjects including historic Galveston’s magnificent architecture, Texas seabirds and songbirds, and dramatic landscapes of the harbor, estuary marshes and beaches.

As a lover of art, I cannot help but tell people how much I am enjoying the collection we selected. As I walk the hallways traveling from unit to unit in the hospital, I still find it remarkable how the art collection transformed the patient care and public spaces. If you had an opportunity to tour the hospital during the dedication events held last month, you may have seen some of the beautiful prints and framed photography on each floor. I have noticed how the natural light that pours through the windows illuminates the different pieces and brings out different shades and tones in the art at different times of the day. It is also fun to know that many of the scenes in the art can be seen in real time, just by looking out the window!

I recall from my own experience as a patient, a hospital experience is an inherently stressful one—even for someone who came to get well. (I know I’d personally rather be at the beach!) So as I visit the units, I have also spent a lot of time trying to imagine how patients and their loved ones will experience the new hospital. Jennie Sealy Hospital is UTMB’s gift to Galveston Island, and it is the setting in which our patient care teams and staff will care for the people of the communities we serve. I feel as though the art we chose offers a beautiful depiction of what those who live in Galveston experience, as well as what tourists and visitors see of the area.

The large photographs on canvas in the main hallways give the viewer a sensation of almost actually “being there” on the beach and watching the waves come in under a beautiful sky, while reproductions of paintings by local artists like Rene Wiley-Janota and Randall Cogburn offer impressionist views of seabirds, dramatic landscapes of the gulf, and scenes from the beaches of Galveston. Photographs of local landmarks offer glimpses into the history and seaside ambiance of the island, and close ups of natural objects like plants and seashells convey the texture of surfaces so vividly, that one feels as though they might actually reach out to touch the object itself.

In my Friday Flash Report last week, I discussed some of the evidence-based design elements that were incorporated into the hospital that would help provide a safe patient care environment and healing atmosphere. Incorporating natural light and elements was one of our guiding principles. Using art as a positive distraction was also an important factor.

cogburn

“Near Shore,” by Randall Cogburn. Randall Cogburn, of Alvin, describes himself as someone who grew to love going to places to sketch and paint as a way of getting outdoors and enjoying life.

Art as a positive distraction means that it is something—an environmental feature—that elicits positive feelings, holds the viewer’s attention and interest, and therefore, reduces stressful thoughts. It offers the viewer something else to think about beyond the fact that they are in a hospital environment. It also helps make the environment feel more homelike by “deinstitutionalizing” the hospital setting into a place that is more comfortable and uplifting. Conversely, when patient care environments lack positive distractions, it may cause patients to focus increasingly on their own worries, fears or pain.

After Cleveland Clinic conducted a survey among patients of their art collection in 2014, they discovered it had measurable positive effects on patients’ moods, comfort, stress and overall impression of their visit to the hospital. In fact, more than 60 percent of patients reported a reduction in stress from the hospital’s art collection. For some patients and visitors, the art offers a natural focal point or incentive to walk down the hall. For others, it provided an opportunity to peacefully reflect.

A 2011 University of London study found that blood flow increased 10 percent to the “joy response” part of the brain when subjects saw a beautiful painting – just like when you look at a loved one. Additional research suggests that art showing views or representations of nature can actually help promote restoration, particularly when it features calm or slowly moving waters, plants and flowers, spatial openness, and birds or other wildlife. (I found it interesting to learn that studies suggest patients favor shades of blues and greens in landscapes and nature scenes.)

Florence Nightingale is quoted as saying, “Never underestimate the healing effects of beauty.” Looking at the entire collection of art throughout the hospital, I believe patients and visitors will respond positively to the healing atmosphere of UTMB’s new Jennie Sealy Hospital. The art throughout the building will surely promote conversation, offer a pleasant visual experience, and create a relaxing atmosphere. I hope our patients enjoy the collection as much as I have!

Jennie Sealy Hospital: Opening Soon!

Donna Sollenberger, EVP & CEO, UTMB Health SystemOn Monday, January 18, I received a message from Mike Shriner, Vice President of Business Operations and Facilities, confirming that the Jennie Sealy Hospital had reached substantial completion. He also confirmed that all of the life safety and mechanical systems had been tested and passed inspection. Substantial completion is a big deal in a construction project, because it is the day that responsibility for the building changes from being that of the contractor to that of the owner. Jennie Sealy Hospital is now officially UTMB’s! I breathed a sigh of relief when I received this text, because it means we are in the home stretch to opening the building for our patients and their families.

Jennie Sealy Hospital Groundbreaking Ceremony, April 20, 2012

Jennie Sealy Hospital Groundbreaking Ceremony, April 20, 2012

On Wednesday, I had the opportunity to tour the new facility with the Board of Directors of The Sealy & Smith Foundation, who generously contributed $170 million toward the construction of the new hospital. A little less than four years ago, on April 20, 2012, we broke ground on the new hospital together, so it was quite an experience for all of us to finally be inside of the building. Although access to the hospital is still restricted and the building is not open to staff for tours until February 25, I can share that it is a very exciting experience to finally stand inside UTMB’s beautiful new hospital, and the reality that we will soon be welcoming our first patients on April 9, 2016 has really set in!

The day of our tour, the building was teeming with activity. One of the first things I observed were workmen who were going through the punch lists. Punch lists are documents that list small (and sometimes a little bigger) corrections or repairs that need to be made before the building can be occupied. Seeing this activity reminded me of the time my family built our home in Wisconsin. Before we moved in, we walked through the house and used blue tape to mark areas where additional work was needed—on walls, doors and tiles, we had blue tape everywhere from floor to ceiling! We were so excited about finally moving into our new home.

Other workmen throughout the hospital were busy hanging artwork. We developed a small committee to choose the art, and we spent hours doing so. When we chose the different pieces, we made our selections with patients and visitors in mind. Our goal was to create a welcoming environment by providing a connection to nature. Because the hospital is located on Galveston Island, we chose a coastal theme. When you see the art, you will recognize that many of the images depict scenery around the island; in fact, 20% of the collection was purchased from local artists.

As a lover of art and as someone married to an artist, I appreciate how much art can define a space and give it a sense of character. Much of the art selection process was conducted online, so when I finally had the chance to see everything we had selected hung on the wall, I was amazed by how it transformed the space. I was struck by how the pieces were so beautifully illuminated by the natural light in the foyer, creating a very calm and relaxing atmosphere. I definitely have some favorite pieces, and I’m so excited for you all to see them, too. I will be interested to know what your favorites are when you have the chance to tour the hospital.

Throughout the tour, I was very impressed with the new workspaces and how well they are designed to support the work we do. Between every two patient rooms, there is a work area that gives clinicians a direct line of sight to the patient. Each unit also has an employee break room, and there are spaces on each floor for teaching rounds or small meetings. Each patient room has a space for the care team to work and access a computer. There is also an area for the family members to sit and, if they wish, use a laptop or do work on the sofa. If a family member or friend would like to stay overnight in the room with the patient, the sofa turns into a twin-sized bed, and there is a small television in the visitor alcove that allows them to watch television without disturbing the patient.

I must admit, however, that the best part of the hospital is the breathtaking view of the Gulf of Mexico from the patient rooms. I am convinced that these views alone will provide a sense of calm that will contribute positively to the experience of patients and their families and will help the healing process.

view

I am so excited for our patients, visitors and you to see and work in this space. I arrived at UTMB one year after Hurricane Ike, and I know so many of you were here before, during and after the storm. You all helped make it possible for UTMB to rebound and become the incredible organization it is. As I look at the new Jennie Sealy Hospital, I recall so many of the stories I heard about the struggle to get the support to rebuild UTMB on the island. I recall stories of people who told UTMB President Dr. David Callender that it would not be possible to rebuild the campus and that UTMB should be closed.

Texas Governor Rick Perry signing House Bill 4586 (photo compliments of the Governor’s Office)

Texas Gov. Rick Perry signing House Bill 4586 (photo compliments of the Governor’s Office)

Despite the challenges faced, UTMB’s importance to the state was recognized and it was decided that the Galveston campus would be rebuilt. In July 2009, the UTMB community and its supporters watched the historic moment when Texas Governor Rick Perry signed House Bill 4586, the supplemental appropriations bill that included $150 million in funding to help the University of Texas Medical Branch at Galveston recover from Hurricane Ike.

As I look out my office window at the Jennie Sealy Hospital today, I am reminded that this hospital is a symbol of the resilience, tenacity and hard work of so many people at UTMB, of the Galveston community, and many individuals across the State of Texas who never gave up on UTMB Health. Thank you to everyone who has worked so hard to create the new Jennie Sealy Hospital. It will be an honor to care for our patients and their families in this beautiful new facility.

The New Jennie Sealy Hospital - Opening April 9, 2016

The New Jennie Sealy Hospital – Opening April 9, 2016

Employee Tours of the new Jennie Sealy Hospital will be held Thursday, February 25, 2016 from 4:30 p.m. to 8:30 p.m. More information on the opportunity to tour will be available to you in the next few weeks.

 

Create a culture in which excellence can flourish.

Donna Sollenberger, EVP & CEO, UTMB Health System“Whatever you or the public may consider quality to be, this definition is always a safe guide to follow: Quality is never an accident; it is always the result of high intention, sincere effort, intelligent direction and skillful execution; it represents the wise choice of many alternatives.” ~Will A. Foster

Each New Year is a chance to commit to what we hope to achieve in the future. Last week, we established four areas in which we will focus to be successful this year: continued investments in our people, quantum leaps in quality and safety, transparency with our outcomes, and the wise use of our resources. In this first Friday Flash message of FY16, I’d like to explore our focus on quality.

Quality is defined as the standard of something measured against other things of a similar kind—the degree of excellence of something. It can mean everything from caliber or condition, character or worth, and it can be good or poor. Defining health care quality, however, is a little more technical. In fact, if you conduct an internet search for the words “health care quality” you’ll find a long list of organizations working to promote health care quality in hospitals, and you’ll also see numerous guides on how to improve in areas like patient outcomes, 30-day readmissions, and healthcare-associated infections. You may even find an infographic or two on reimbursement calculations!

To make a long story short, much of what is out there is written by the health care industry for the health care industry—and it is complex! As an industry, we even have had to find a way to state it simply to steady our focus. The Agency for Healthcare Research and Quality (AHRQ), the federal government’s leading agency, defines quality health care as “doing the right thing for the right patient, at the right time, in the right way to achieve the best possible results.”

But what do our patients and their families think “quality” health care means, and what do they expect of us when we say that we are committed to quality? Several years ago, in an issue of the Journal of the American Medical Association (JAMA), Dr. Allan Detsky, an internist and health policy expert at the University of Toronto, identified criteria that patients expect when asked what they really want from health care.

He found, as one would expect, that patients want the best health care—they want to know that their care team is highly qualified and experienced, and they want to know the care they will receive is reliable, based on feedback from people they know, a referring physician, or other patients. This is not to say that patients don’t value statistics—our quality performance is currently publicly reported, so patients can compare us against other providers and know whether or not we are an excellent place to come for health care. It’s simply that they are more focused on whether the treatments they will receive will work in their specific case or condition.

The list of criteria is long, but the following are the most important aspects of care patients identified:

  • Timeliness. Patients desire access to services in a timely fashion.
  • Kindness. Patients want to be treated with kindness, empathy, and with respect for their privacy.
  • Hope and certainty. Even in dire situations, patients want to have hope and be offered options that may help. Patients and families are uncomfortable with uncertainty about diagnoses and prognoses. Therefore, they want to feel well informed, participate in decision making, and prefer active strategies.
  • Continuity, choice, coordination. Patients want continuity of care and choice. They want to build a relationship with a health care professional or team in whom they have confidence and have that same person or team care for them in each episode of a similar illness. They want the members of their health care team to communicate with each other to coordinate their care.
  • Privacy. Patients want to be hospitalized in their own room with their own bathroom and no roommate (this is something we proudly offer our patients at UTMB).
  • Low out-of-pocket costs. Patients want to pay as little as possible from their own pocket at the point of service delivery.
  • Medications and surgery. Patients prefer treatments that they perceive will require little effort on their part. Essentially, they want to feel “well taken care of”.

There is a much more important, patient-focused reason for making quality improvements: it’s the right thing to do. When we safely heal people and they have a positive experience in our care, they are more likely to follow through with their doctor’s advice and manage their disease processes, which leads to better patient outcomes and healthier patients in the future.

So, let’s focus on our patients’ experiences, with the understanding that they already trust us to do the right thing by delivering safe, evidence-based care and they trust us to monitor our own performance, much in the same way that we all trust airlines to make sure the plane is functioning well before takeoff!

Every individual in every role at UTMB impacts the patient experience in one way or another. This is why we must all focus on making the necessary changes to create a culture in which excellence can flourish. Whatever our work entails, we should reflect on the following:

  • Do we work together as a team, and are we committed to a culture of trust and safety, in which we can express our thoughts and concerns and constructively think together?
  • Do we demonstrate integrity by always doing the right thing for our patients and their families?
  • Do we show compassion and respect to all, so we not only work well together, but so that we are able to comfort patients and families during challenging times, or support them so they are motivated to heal? Do we promptly respond to patient and family concerns, whether by phone or the call button? Are we willing to take the time to explain things clearly and answer all of their questions?
  • Do we value diversity so that we can understand patients’ perspectives and preferences and fully engage them and their families in making decisions about their care and treatment?
  • Are we committed to lifelong learning, so that we are able to apply new knowledge and always explore better ways to enhance outcomes while remaining vigilant to assure patients’ safety?

If we are firmly committed to quality, and we practice safety measures the same way, every patient, every time, we will not only improve our performance, but we will be better able to focus on the experience of our patients and their families. At UTMB, we should always be able to look people directly in the eye and say: “The care you will receive at UTMB Health will be the same care I would want my most cherished of loved ones to receive.”

Positive Moments, Healing Moments

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

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

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

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

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

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

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

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

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

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

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

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

 

Aloha Spirit, UTMB Spirit

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

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

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

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

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

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

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

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

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

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

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Teamwork and Trust

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

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

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

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

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

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

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

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

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

An Act of Kindness Allows a Man to See Daughter Graduate

Donna Sollenberger, EVP & CEO, UTMB Health SystemI hope you all are familiar with the Health System’s Friday Focus Newsletter. The Health System publishes the newsletter for our employees each month to share exciting accomplishments and important news within and across the Health System. UTMB employees are always invited to suggest topics for the newsletter or to submit their own stories.

Last month, Dennis Santa Ana, patient care facilitator of Unit J9A CT Surgery/Vascular Surgery, also known as UTMB’s Dedicated Cardiac Care Unit, sent in a story about how his team came together to help a patient enjoy a special moment with his daughter. Upon reading the story, I thought it was so touching that I decided to save it for this Friday’s message!

The Dedicated Cardiac Care Unit is unique in that it is much more than a regular hospital patient unit. It is equipped with specialized monitoring devices like those found in an ICU, such as electrocardiogram (EKG) and atrial electrocardiogram (AEG). It is designed for patients who require specialized cardiac care, such as individuals who have recently undergone a heart transplant or have had a Ventricular Assist Device (VAD) implanted.

The comprehensive care the unit team fosters close relationships with patients. Dennis Santa Ana says, “Patients feel like we’re family and they know they can call any of us individually any time to get help. We’re here for them. We become more than health care providers; we are counselors and friends. We become their support system.”

That’s what Santa Ana’s story is all about…

An Act of Kindness Allows a Man to See Daughter Graduate
by Dennis Santa Ana

Recently, UTMB’s Dedicated Cardiac Unit (J9A) admitted a patient with advanced congestive heart failure, a condition in which the heart cannot pump enough oxygenated blood to meet the needs of the body’s other organs.

After a right-side heart catheterization, the primary care team determined the patient needed to be started on intravenous cardiac inotropic drugs, which would help improve his heart function by helping his heart beat more strongly. The team hoped this combination of therapies would allow him to be discharged home once he achieved hemodynamic stability (normal blood pressure or adequate cardiac output).

Despite these interventions, the cardiac drips only minimally improved his heart function, and after the results of additional diagnostic tests were received, the primary team concluded that a heart transplant would be his only hope for survival. The patient’s medical condition had deteriorated to the point that it would not be safe for him to wait at home for the heart transplant, and he would need to remain as an inpatient during the waiting period. From this point on, his life had changed—his prognosis was uncertain.

One day while receiving treatment, the patient told his nurses his greatest wish was to see his daughter graduate from college that month, but he feared this may only be wishful thinking, because he understood he was in no condition to leave the hospital for the ceremony.

His nurse shared his wish with the other members of the nursing staff during one of their informal discussions. The team began brainstorming for different ideas to help the patient and decided they could use the internet to Skype or FaceTime during the graduation ceremony. Several of the nurses coordinated with the family regarding the plan, and one of the nurses obtained the university’s website where the graduation would be streamed live.

On the day of the graduation, the nursing staff set up their conference room so they could stream the ceremony onto the large projector screen. One of the nurses even served popcorn for the occasion. The patient was able to watch the entire graduation ceremony, and thoroughly enjoyed it—he was happy and proud to see his daughter receive her college diploma. The patient was very grateful to the nursing staff in J9A for giving him this rare opportunity to witness a once-in-a-lifetime event.

Excellent patient care is treating the whole person, mind, body and spirit. It’s more than providing the best medical care possible for our patients. It is also about providing that care in an atmosphere of kindness and compassion. I’d like to thank Dennis Santa Ana for taking the time to share his team’s story and to give special thanks to the nurses of J9A for exemplifying excellence, compassion, teamwork, advocacy, critical thinking and patient- and family-focus!

“Love and kindness are never wasted. They always make a difference. They bless the one who receives them, and they bless you, the giver.” —Barbara de Angelis

 

Recognizing Team Accomplishments, Sharing a Vision

Donna Sollenberger, EVP & CEO, UTMB Health SystemThis week, I came across a posting of monthly clinic stats for the PCP Pediatrics Clinic developed by Practice Manager Ashley Dusek. The creative style she used to help inform her team of the most recent numbers for completed patient appointments really stood out to me. She did much more than simply reveal the data—she helped her team understand why the work they did during the month of February mattered to the 1,421 patients they served.

The post began, “Total Number of Completed Appointments 1,421. Why do I care you ask?” The communication continued:

“Because of you…1,421 patients were reassured their vitals were stable and that their lab work, which you drew, would be processed in a timely manner.

Because of you…1,421 patients were able to receive specialty care, immunizations, or just a simple reassurance by having their medical questions answered.

Because of you…1,421 patients were examined and given the right medications to make it all better!

Because of you…8,943 patient phone calls were answered. They were able to make appointments, ask questions, get test results, get prescription refills and know that we were there to answer and help with whatever they needed.

If you got to the end of this and you still believe you are too small to make a difference, Try sleeping with a mosquito!”

Ashley acknowledged the work her team had accomplished and also recognized that their efforts had positively impacted the patients’ experiences.

When I speak with individuals across the institution, whether their role is in direct patient care or they work behind the scenes, it is clear to me that as an organization, we believe we are ultimately here to serve our patients and their families. We find the greatest satisfaction in our roles when we know that we have provided good service to them and that we have truly made a difference.

Several months ago, when Sharon Johnson, a senior radiation therapist at UTMB, was asked how she felt she impacted the patient experience, her response wasn’t made in reference to the tasks she performs daily to deliver patient therapy alone. Instead, she answered, “I just try to be who they need me to be at that moment. Sometimes it’s a shoulder to cry on, sometimes they need a sister or a mother figure, sometimes it’s just a friend to hold their hand. I give a little piece of myself to the patients and I gain so much in return.”

While we all do what we do at UTMB because we receive the intrinsic reward of helping our patients and families, it also feels good to receive direct feedback that affirms we have made a difference. When our patients are satisfied, we feel satisfied with our performance. However, it can sometimes seem that we more frequently receive feedback about the areas in which we have yet to improve, and perhaps less frequently that our names are called out in a moving patient testimonial that so eloquently describes the true impact that we have made.

That is why, as team leaders, we must be supportive of the work our teams do. It is not always just about celebrating the major milestones; it is also about celebrating the small successes we have made along the way. When we feel good about what we do, we also develop a desire to continue that success—we have a sense of pride and ownership. Therefore, even when we do identify areas needing improvement, we must take care that we are constructive in our approach to both delivering and receiving the message. We want to emphasize fixing our processes, not assigning blame—that is a Culture of Trust.

Much of the work we do in health care today takes place under an umbrella of a changing health care environment. While this change is sometimes difficult, many of the best components of these changes are embedded in improving the quality and efficiency of care as well as the experience of the patient. It will take teamwork to be successful, and this means we are all involved, at all levels of the organization. This is a positive process! It’s important that we share information, celebrate accomplishments and provide timely, consistent and authentic feedback. Our focus of discussion is on how we can build on strengths and past positive experiences. We must do more than identify what is already working well; we need to identify what else can be done to enhance this work.

Tom Morris, author of If Aristotle Ran General Motors: The New Soul of Business, explains that while the pace of change may be at an all-time high, the challenge of change has always been with us. Change is the condition for positive, creative growth. At UTMB, we must stand firm in our values of compassion, integrity, respect, diversity and lifelong learning. We share in the vision of the road ahead, and we will work together to achieve it. We are here to work together to work wonders for our patients and their families!

If you would like to recognize an accomplishment or creative solution, please share with it us! Email us at health.system@utmb.edu