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

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

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

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

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

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

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

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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Nursing is an Art

Donna Sollenberger, EVP & CEO, UTMB Health SystemUTMB celebrated National Nurses Day on Wednesday, May 6, with a number of events held throughout the day, including a Health Walk & Zumba, a blood drive, a nursing history display and more. One of the events I look forward to each year is the Showcase of Nursing Excellence, a presentation of research posters on a variety of topics. The posters are displayed in Café on the Court and on Wednesday, representatives from the project teams were present to share their findings with visitors.

As I walked the perimeter of the cafeteria, interacted with these nurses and learned from their posters, I was reminded that nursing is a fabric of many threads, all woven together for a single purpose: to provide the best possible care for patients. This made me think of the famous Bayeux Tapestry, which I’d had the opportunity to see four years ago in France.

The Bayeux tapestry was commissioned by William the Conqueror's half-brother Odo to celebrate victory at the Battle of Hastings. Photograph: David Levene

The Bayeux tapestry was commissioned by William the Conqueror’s half-brother Odo to celebrate victory at the Battle of Hastings. Photograph: David Levene

The tapestry is a band of linen nearly 230 feet long, consisting of nine panels sewn together to depict more than 70 scenes from the Norman Conquest, which culminated in the Battle of Hastings in 1066. The tapestry is embroidered with 10 colors of yarn and four types of stitches. Its conservator considers it one of the supreme achievements of the Norman Romanesque period, and the fact that it has survived intact for over nine centuries is “a little short of miraculous—its exceptional length, the harmony and freshness of the colors, its exquisite workmanship, and the genius of its guiding spirit combine to make it endlessly fascinating.” What makes it even more fascinating is that the ending of the tapestry has always been missing.

In many respects, nursing is like a tapestry. The same year Florence Nightingale started the first school of nursing at St. Thomas Hospital in London in 1860, she published a 75-page booklet, “Notes on Nursing: What It Is and What It Is Not.” Much of her work focused on hygiene, consideration for patients’ feelings, and the importance of a quiet environment for healing. Much of her advocacy is still relevant today—think of our work in hand hygiene, patient- and family-centered care, patient safety, and our efforts to make the hospital a beautiful, healing and serene environment. These are all aspects of patient care addressed 145 years ago by the founder of modern nursing.

It is within these contexts that nursing today has evolved. While our primary focus continues to be on patient needs and direct care of the patient, nurses today have become very specialized, often spending their career in a particular field of nursing and achieving specialty certifications or advanced degrees that set them apart in their knowledge and skill. And not all nurses today work at the bedside, as they did in the early days of nursing. Today, nurses can be found in settings ranging from clinical care to care management and research, they are found working in operating rooms, patient access centers (call centers), conducting nursing education, working in administrative roles, or even in information technology. There are countless environments in which they contribute to the growing body of nursing knowledge. Although the tapestry of nursing has many more “colors” than the Bayeux Tapestry, all nurses, whatever their roles, are brought together in a single, outstanding masterpiece through their passion for exceptional patient care.

Like the Bayeux Tapestry, our tapestry of nursing at UTMB also tells a story. The scenes it depicts include accounts of nurses who have gone above and beyond the expectations of their job to care for patients, and nurses who pitch in to help one another when the census is high in their department or unit. Our tapestry tells the stories of nurses who see a need and do what they can to meet it—the stories of compassion for patients and for one another is exceptional.

Imagine our tapestry. Each panel tells a story of remarkable patient care, innovation and teamwork. The first panel we observe depicts a story of the nurses on the Blocker Burn Unit, who cared for patients injured in a refinery fire near Beaumont earlier this year. Alongside the burn unit nurses were nurses from the PACU and SICU, who knew what needed to be done and helped provide additional staffing support and care for these critical patients.

Another section of the tapestry tells the story of a nurse who worked this past Christmas Eve. She also volunteered to work on Christmas Day, because she did not have family nearby and was not planning to travel home for the holidays. She wanted to stay and work so other nurses on the unit could be home with their families and children on Christmas Day.

And yet another panel of the tapestry shows a nurse in the Cardiac Catheterization Lab, working to improve the procedure of radial artery catheterization in the left arm. In one scene, she is shown working at home, night after night until she creates a successful “arm board” for the procedure. She names the device after the physician who performs the procedure. In the next scene, the entire patient care team celebrates her invention, as it makes the procedure easier for the physicians and more comfortable for patients. Even MIT expresses interest in working with UTMB on perfecting the innovative support device.

Our nursing tapestry is filled with stories of innovation and creativity of nurses who provide outstanding care for our patients. Later today, I will attend the Silent Angel Awards (held from 2 p.m. to 4 p.m. in Research Building 6, Room 1.206), where I will hear more stories of nurses whose compassion, caring and advocacy have made a difference in the life of a patient, family or friend.

Like the Bayeux Tapestry, the principles of nursing founded by Florence Nightingale have remained intact, standing the test of time; and today the harmony of nurses and other team members working together to care for our patients remains a fresh and vibrant story. UTMB’s nursing tapestry has been sewn with exquisite workmanship by highly skilled nurses, guided by the spirit of Florence Nightingale.

Nurses are drawn to their profession so that they can give back to others and care for people in their greatest time of need. Like the Bayeux Tapestry, our nursing tapestry is not yet complete—but this is a good thing! We can look forward to thousands more stories that will exemplify the compassion, innovation and skill which intersect to create the caring environment of nursing at UTMB.

To all UTMB nurses, regardless of where you work within our system, we celebrate you and your achievements. Thank you for all you do to make patient care at UTMB exceptional.

nursing is an art

Honoring our past, embracing our future…

Donna Sollenberger, EVP & CEO, UTMB Health SystemThis week, I was honored to welcome attendees to the 2015 Neuro Nurses’ Day Conference, an opportunity for practicing clinical nurses to share and explore recent advances in Neurology and Neurocritical Care. The daylong event was held in the Ashbel Smith Building, which many of you know affectionately as “Old Red”.

As I approached the front steps of Old Red, I thought about what a perfect setting this was for a conference about innovation and advances in health care, because this is where nearly 125 years ago, 23 students and 13 faculty members began UTMB’s legacy to advance health care education, research and patient care. Just five years later, UTMB’s School of Nursing opened as the first university-affiliated nursing school in the U.S.

UTMB was founded as a center for scientific inquiry, a training ground for the future of medicine, and a catalyst for improving the health of society. Since that time, we have earned a reputation for graduating health care professionals who share a deep commitment to excellence, a desire to blaze new trails, and an unsurpassed willingness to leverage their extraordinary expertise to improve the health and well-being of others. Today, UTMB continues its legacy and builds on its rich history. This made me think of a principle that a former mentor had shared with me: Respect all that is good about the past while looking forward to the future.

As we embark on our journey to increase the value (cost + quality) of patient care, we must ground those advances in the history of UTMB that has served us well over the past 125 years. The work we do for our patients is incredibly diverse and often complex. We care for patients from all backgrounds, ranging from the most critically ill to those who seek routine preventive care to stay healthy.thumb_972D434E3BF7486F824579B8DCD36448

Therefore, the work that we do for our students and trainees is also diverse and complex, and it is why we recognize lifelong learning as one of our core values. Despite the complexity and challenges of an ever-evolving health care landscape, UTMB is continually recognized for its exceptional achievements.

Innovative approaches to education, like online courses, are helping us offer students alternatives to traditional classroom learning. Thinking back, I remember after Hurricane Ike, I was so impressed to learn that almost all of our SOM and SON curricula were placed online so students could continue their studies without having to physically be on campus. Now, we offer educational outreach methods on an ongoing basis, like the UTMB School of Nursing’s RN-BSN program, which allows current registered nurses an opportunity to advance their education by earning a Bachelor of Science in Nursing (BSN) degree in a 30-hour, two-semester online program; these innovative approaches to education continue to blossom.

This year alone, nearly 1,000 total faculty members are preparing a diverse student body of more than 3,000 individuals across the fields of medicine, nursing, health professions and biomedical research for a bright future; more than 1,300 of those future leaders will graduate this year.

As I think about our future at UTMB, regardless of the department in which we work, we all have many opportunities to work together collaboratively to make a difference —not just within our own department, but across the entire organization. We continue to seek ways to provide the highest quality of care in every patient interaction. We embrace lifelong learning to grow professionally and take advantage of special educational programs, just like the 185 attendees at this week’s Neuro Nurses’ Conference. We explore ways to share our knowledge and expertise both with our UTMB colleagues and with others who share our commitment to and passion for exceptional patient care.

As we embrace our value of lifelong learning and spirit of innovation, let’s strive to:

  • Reach our fullest potential, personally and professionally.
  • Be adaptable and flexible in our approach to our work so that innovation is a natural outcome of the way we work.
  • Remain open to new approaches and practices in our work.
  • Value the ideas of others and respond in positive ways—this does not necessarily mean we must embrace every idea we hear, but it does mean that we support a culture where new ideas and innovation are welcomed and freely explored.
  • Commit to putting our patients and families first, so that we advance patient- and family-centered care.

UTMB has an unparalleled legacy of service because of the caliber of its people, and in true UTMB spirit, we are thinking boldly about how we can expand the impact of our excellence nationally and globally. Each of us at UTMB Health can best honor our rich history of accomplishment and service by staying focused on our future. We commit to excellence in all that we do as we work together to work wonders for our patients.

Teamwork divides the task and multiplies the success

Donna Sollenberger, EVP & CEO, UTMB Health SystemOne of my favorite weekends of the year starts tomorrow. Why? Because it is the NCAA Men’s Regional Final Four Basketball Tournament! This year, I am especially excited, because two Big 10 teams are in the quest to become the 2015 NCAA Championship team. I have a college and alumnae allegiance to the University of Illinois, but I am really a Wisconsin Badger fan, because of the eight years we lived in Madison.

When my family moved there, Wisconsin was not known as a basketball powerhouse, but March Madness of 2000 changed that when Coach Dick Bennett took the Wisconsin men’s basketball team to the Final Four. As I watched Wisconsin play Arizona last Saturday night, I thought of all the lessons we can learn about leadership and teamwork exemplified by this Wisconsin team.

I suppose one has to first live in Wisconsin to truly understand that people there don’t really wish to stand out, individually. For the most part, they are understated people who usually go about doing the work that needs to be done—no fanfare, no need for individual praise; they just want to get the job done, and there’s no feeling that any one job is more important than another.

As I watched the tournament game last weekend, I was struck by the fact that the players’ uniforms all have the classic Wisconsin motion W, but there are no names on the uniforms. As a newbie to Wisconsin basketball in 2000, I asked someone about this. Without hesitation, my friend told me that in Wisconsin, the emphasis is on the team, not the individual. No one player is more important than the other.

As I mulled over that response, I decided that the University of Wisconsin Health System would take the lead from the Wisconsin men’s basketball team, and we eliminated titles from our doors and from our employee badges. I always knew where people worked without these identifiers, because we kept the department name on the badge; but without titles on our badges, it was emphasized that no one position in our organization was more important than any other. We all were important parts of a team.

The other thing I noticed about the Wisconsin team is that if one player was not doing well that night, the team rallied and found someone who could get the baskets needed. Although Frank Kaminsky is a great basketball player, the last two games have not been his very best. Fortunately, Sam Dekker stepped up, and along with the other forward and guards, made the difference between winning and losing. When the opponent finds a weakness, the Wisconsin team adjusts and continues to play.

It’s the same in the work we do at UTMB. We all have our strengths and our weaknesses, but we must magnify the strengths of the team to get the work done. Sometimes the usual leader is not up to a particular job at that moment, so others on the team step up to help and get the job done. During the past two weeks as I have recovered from knee surgery, this has certainly been the case with the leadership team that works with me. They have stepped up and kept everything going exceptionally well to allow me the time I needed to mend.

If you watch the games this weekend, take note of another thing: most of the coaches are running up and down the sideline signaling or calling out plays to the players. The Wisconsin head coach, Bo Ryan, rarely does this. Why? Because he and the team have practiced and practiced and practiced to the extent that he trusts his team to continue to move the ball and make the plays that they have practiced time and time again. They are prepared. And so it should be with us.

One great example at UTMB is that while we have not yet needed to care for an Ebola patient, our nurses, physicians and other employees who will be at the front line of care, should this ever occur, have trained and trained and trained so that they are prepared. There are so many more examples of teams preparing throughout the organization. Have you thought about how you contribute to your team to care for our patients? Even if you don’t directly care for a patient, your supportive work, whether it is filling the Omnicell or greeting families and visitors, contributes to the team’s overall effort to take good care of our patients.

As a leader, it is apparent that Bo Ryan completely supports his team. When he came out of the locker room after halftime in a game where Frank Kaminsky did not have a stellar first half, one of the sports announcers asked what Coach Ryan had said to him team, which was losing at the time. Coach Ryan didn’t take the bait. Instead, he simply said, “I told the team to keep doing what they were doing.” The announcer then tried to get him to comment on Kaminsky’s performance, but Coach Ryan rattled off Kaminsky’s first half statistics and said he thought Kaminsky was having a good game. There it is: Coach Ryan always supports his team. He may privately talk to them about what they need to improve, but publicly, he always supports their efforts. Do anything else, and you erode the team.

Finally, when the Wisconsin team gets behind, they don’t panic. They generally don’t make “dumb shots” or “bad passes”. You win the game (you get where you need to go) if you are prepared and don’t panic. So far that has worked for Wisconsin. The team has two more games to go, and my hope is that they emerge as the champion; if they do not, I am still proud to support them, because for me, they exemplify all that is good about leadership and teamwork.

I know we are faced with much change and many challenges in health care today. The future is riddled with one proposed cut after another from our payors. I know you have heard about our challenge to improve our margin by $100 million over the next five years, and that seems like daunting feat to many. But, if we do not panic, and if we create a detailed game plan for addressing this challenge, then we can systematically work the plan, and we will be successful.

Just as I am confident and proud of the Wisconsin team, so I am confident about UTMB’s future because we have the right team of people and, under the leadership of UTMB President Dr. Callender, we have the right leadership to face future challenges and emerge a stronger UTMB.

 

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

 

Working Together Is Success

Donna Sollenberger, EVP & CEO, UTMB Health SystemIn my recent post, “Your own resolution to succeed is more important than any other”, we explored how UTMB’s vision for the future forms the basis for our goals moving forward, both in the present year and in the years to come. We also affirmed that the key to our success is working together to be the best academic health center. This week, I’d like to talk about why working together as a team, cooperating and forging relationships, is so important to our future.

There is a line in a poem by John Donne: “No man is an island entire of itself; every man is a piece of the continent, a part of the main.” Many of the great things worth doing probably can’t be achieved in isolation, and working together often allows an organization to achieve something that an individual working alone cannot. At UTMB, we want to become the preferred, integrated health care provider in the region for our patients, partners and referring physicians. Simply put, we want to be the best. Therefore, our goals and strategies must also be integrated in as many ways as possible. Through teamwork, we can achieve higher quality outcomes that are more efficient, thoughtful and effective. By doing so, each individual and team at UTMB can garner great support and achieve a great sense of accomplishment.

Success in the modern health care environment is complex and continually presents new challenges. At UTMB, we’ve been progressive in our work and our goals must be ambitious in order to remain competitive and truly become the best. We have a lot on our plates as we take major strides to improve patient satisfaction, patient and family engagement, and the quality of care, all the while lowering costs and improving efficiency. Our resources are limited, and this means we must find ways to team up and streamline our work. As a health care provider, or even as a business, we are not alone in this—today companies, on average, set six times as many performance requirements as they did more than 50 years ago.

However, challenges also present great opportunities for success. The key lies in how we will respond to the challenges. As we strive to develop more efficient processes and new models of care, improve access to our system, and enhance communication with our patients and families (all of which are multifaceted initiatives), we must create an environment in which our providers and staff can work with one another to develop creative solutions to complex challenges. We must be innovative and adaptive. Our solutions don’t have to be sophisticated or perfect, but they have to create greater value. The solutions must be developed by and integrated among teams who work together and depend on one another.

When people cooperate, they use fewer resources; conversely, when we don’t cooperate we need more time, equipment, systems, teams and resources. Staff must compensate for a lack of cooperation, and often, even safety risks can result. Teamwork involves removing barriers that make us self-sufficient. Sharing resources is a good way to make people more dependent on, and more cooperative with, one another. Without such buffers, our actions have a greater impact on one another’s effectiveness. By creating overlaps, streamlining activities, partnering with our partners and affiliates increases the mutual value of our work.

But teamwork is more complicated than cooperation alone. While cooperation is usually for the sake of a common goal that the entire team is working toward—some measurable outcome, a willingness to cooperate stems from relationships that develop between coworkers and leaders. What are the connections, the interactions, and the synapses? Teamwork cannot exist without relationships, even if the extent of the relationship is minimal. Teamwork does not occur if each person does their own thing separately from their work relationships.

To respond to complexity intelligently, people have to really understand each other’s work: understand how each person on the team contributes to the overall process of accomplishing a goal, the goals and challenges others have to meet, the resources they can draw on, and the constraints under which they operate. People can’t find this kind of information in formal job descriptions; they can learn it only by observing and interacting. Without this shared understanding, people might blame problems on other people, and not where it actually should be, like broken or inefficient processes, for example.

In many cases, understanding what people do by shadowing them will provide insights into where and how cooperation is breaking down. Identify individuals in your work area who are already interacting with multiple stakeholders (patients as well as internal partners). These people can act as integrators, helping the teams obtain from others the cooperation needed to deliver more value.

Finally, bring the best out of one another. Know and recognize the strengths of others in your teams and encourage one another to leverage those strengths. Everyone is empowered to use their judgment and intelligence, and feedback is important so we can all understanding where we are performing well and where improvement is needed. Stay tuned into how your team is performing. Don’t be afraid to speak up when you see something that feels unsafe, if you feel concerned, uncomfortable, or think the team should stop and reevaluate a situation. Reward those who cooperate, and don’t fail to ask for help when you need it!

“Coming together is a beginning; keeping together is progress; working together is success.” —Henry Ford

This entry was based on “Six Simple Rules: How to Manage Complexity without Getting Complicated” by Yves Morieux

Every Kindness We Do for Others

Donna Sollenberger, EVP & CEO, UTMB Health SystemRecently, I received a moving story that illustrated the team spirit and value of compassion that are so prevalent at UTMB. The story was shared by Rachel Murphy, one of our nurses in the surgical intensive care unit (SICU), an area in the hospital that treats some of the most complicated patient cases.

In her message, Rachel described an evening in the SICU and the countless acts of compassion and teamwork that were demonstrated by individuals throughout John Sealy Hospital as they came to the aid of a family in need.

On this particular evening, a patient in the SICU was very ill and required numerous hands involved in her care. Her spouse remained at the bedside the entire time, but did not have any family members in the area to help watch their three children, who had been up for a full 24 hours at one point waiting on their mother’s improvement. The three children were too young to be left alone in the waiting area outside of the unit and needed a safe place to stay while at the hospital. This created a very unique situation, because normally children under the age of 14 are not allowed in the SICU due to visitation restrictions.

Seeing this family’s plight and the father’s distress, the staff of the SICU decided to turn the conference room into a makeshift waiting area where the children could stay. The conference room was near the patient’s room, so the father could check up on his children and feel reassured knowing they were close by, yet sheltered from the activity of the ICU.

Margaret Matthews, another SICU nurse, came in to help calm the children for several hours by sitting with them. Fortunately, the staff had crayons on the unit for coloring to occupy the children’s time; meanwhile, another staff member lent the family a computer tablet with Disney movies on it.

Chaplain Daryl Ervin came in during the night; he spent much of his time in prayer with the family. When the kids wanted orange soda and snacks, Vicki Romero, clinical operations administrator, donated money to get sodas from the vending machine, and Nurse Audriana Sais gave the kids the popcorn she had stashed away for her break. Dr. Casey Duncan, who was sitting outside the conference room attending to the patient, took time away from her duties as Chief Resident to help Margaret and Rachel take the kids to the restroom.

Mark Rosenfelder, from the cardiac care unit (9A), also heard about the family, and he helped find a cot and pillows that the kids could sleep on. When they realized that the conference room lights needed to be dimmed, but not turned off completely, David McDaniel, who works in the recovery room, and his nursing student devised a solution to lower the lights so the children could rest properly.

These acts of kindness are just a few examples of the teamwork that took place on the unit that night, Rachel remarked, and this was especially moving, because so many individuals made time to help out this family despite being very busy.

Special thanks to Ryan McKimmy, the patient’s primary nurse, and the following staff members, who helped pitch in and ensure this patient, her family, and all other patients on the unit were well cared for: Mark Rosenfelder (9A), Jodee Brown (MICU), Cynthia Rynearson, Stephanie Osizugbo, Gwen Franklin, Jenilyn Fowzer, Margaret Matthews, David McDaniel (PACU), Lacey Lebrun, Vicki Romero (COA, aka fearless leader), Carolyn Johnson, Ashley Bennett, and Audriana Sais.

“Everyone truly showed what UTMB is about: family,” Rachel concluded. “Without everyone’s hard work, I’m not sure that this very difficult situation for the family would have had such a silver lining of compassion and empathy. We were able to truly take care of all of the family’s needs, and help the patient’s husband focus on making vital decisions in his wife’s care. I am truly inspired and proud to work along side you all.”

To echo the sentiments of Christina Myers, nurse manager of the SICU and neurosciences critical care unit, the support multiple people showed in the care and support of this family is that for which we stand at UTMB—it’s why we come to work each day. This is why I, too, am proud to work for such a wonderful institution and with such wonderful teams.

Every kindness you do for others—no matter how small—enriches the world beyond measure, and together we can truly make a difference in the lives of our patients and their families. Thank you to everyone at UTMB Health who goes above and beyond each and every day!

Safety Doesn’t Happen by Accident

Donna Sollenberger, EVP & CEO, UTMB Health SystemGrowing up, I was somewhat of a rebel. My mother and father were often frustrated with me, because I didn’t want to follow their rules. I couldn’t understand why they got so upset about things like missing curfew, driving outside of town, and having a summer job. I was even more perplexed when they told me they established all of these rules to keep me safe. Really? I thought that sounded a lot like an excuse and not a reason!

But as I became an adult and had children of my own, I experienced what many of us have – I started sounding a lot like my parents when I started creating and enforcing “the rules”. When my kids pushed back, I cringed a little as I heard my own voice echo the words of my mom and dad: “These rules are meant to help you. They’re meant to keep you safe!”

I had to admit, my parents were right—it’s easy to think you’re safe from harm in your own backyard. It’s easy to underestimate that something harmful might happen to us  because the odds seem so small. We sometimes take our safety for granted, not realizing the potential hazards that can be present in our everyday activities. We feel a little overconfident at times, perhaps because we’ve done something so many times before, or we’ve become a little complacent and discount the risks—we think we’re being “safe enough”. However, taking risks and acting hastily are often the very elements that create an environment conducive for an error or accident to occur.

The same is true of safety cultures, and the longer I have worked in health care, the more I have come to appreciate the rules that are in place to keep employees and patients safe. We often emphasize the importance of safety in health care with the patient at the forefront, but the safety of our staff is equally important.

It’s easy to go through the motions of something as common as patient handling, drawing blood, or administering intravenous medications, but these are also some of the most common ways both health care workers and patients can be potentially harmed. Therefore, safety interventions, such as proper hand hygiene and safe lifting techniques, protect not only our patients, but our staff as well. This is why it’s important to practice these safety measures the same way, every time.

A perfect example of a safety intervention in place at UTMB is the barcode medication administration system we recently implemented. This is the system where the nurse scans his or her employee badge, scans the patient’s wrist band, and then scans the medication. Then, the system confirms for the nurse that they have the right patient, the right medication, the right dosage and it’s the right time for administration. Using this system is critical to assuring that we keep the patient as safe as possible. When we follow this process exactly, we almost completely rule out the possibility of a medication error, and that keeps the patient safe!

In areas where we do invasive procedures on patients, rules are in place to assure we are doing the correct procedure. If the procedure is a surgery, for example, the nurse asks the patient to confirm his/her name and birthdate to make sure it is the right patient. Then, the nurse or physician confirms with the patient the procedure they are about to undergo, and they mark the patient’s body on the correct side and specific location where the procedure will be performed. This process is repeated again once the patient is in the procedure room, when the physician calls a “time out”. Here, the physician again confirms the patient’s name and birthdate, the procedure to be performed, and the location. Then, anyone present may speak up to express concerns they have about any aspect of the procedure. These processes are in place to keep the patient safe and to assure that the staff proceed as planned.

If we watch other people on our team for “state to error” risk patterns, every time we see one, it will automatically make us think more about what we are doing. And if what we see is sensational enough, we’ll do more than think about it—we’ll actually react to it. This will not only protect our patients from harm, but we’ll also protect one another.

At UTMB, we work to do everything we can to create a safe and highly-reliable environment for our patients and employees. It is crucial all of our staff remain alert and work together as a team at all times to recognize and avoid potentially unsafe conditions and activities for the safety of all. Remember:

  • Everyone has a part to play in creating a safe and reliable care environment.
  • Slow down. Be methodical and mindful.
  • Support effective safety measures and demonstrate accountability at every step.
  • Report mistakes and system flaws — it is safe and valued.
  • Recognize individuals who act with safety in mind.
  • Speak up when you see something that feels unsafe, if you feel concerned, uncomfortable, or think the team should stop and reevaluate a situation.

Although health care settings are varied and present both common and unique safety issues, interventions to improve safety for patients also improve safety for employees. After all, safety doesn’t happen by accident!

“For safety is not a gadget but a state of mind.”  ~Eleanor Everet