Healthy Holidays!

Donna Sollenberger, EVP & CEO, UTMB Health SystemIn just a couple of days, on December 21, the North Pole will be tilted its furthest distance from the Sun, and the Northern Hemisphere will experience the Winter Solstice. This will be the shortest day and the longest night of the year, and it is also considered the first day of winter. In the past, people celebrated this time period with rest, reflection and thoughtful planning before daylight hours increased and a New Year began.

This time of year also coincides with many religious observances and cultural holidays. Although the traditions are many, there is a common thread among them—nearly all incorporate light for different symbolic reasons. Light helps things grow. It signifies knowledge, wisdom and innovation. It brings happiness and symbolizes warmth and goodness. It is a symbol of unity, collective work and purpose. It is sometimes even a guiding light for others.

It is a season celebrated with light, and its many symbolic meanings seem to also represent our common bond at UTMB—we work together to work wonders for our patients and their families. We embrace diversity, because it is what makes each of us unique—we all bring special gifts to this organization that collectively enable us to care for others in extraordinary ways. Through innovative thinking and the pursuit of lifelong learning, new discoveries are made each day to improve the health of people in our communities and around the globe. We demonstrate compassion and respect to everyone we meet, and we always work with integrity. Together, we will define the future of health care.

There is a special feeling this time of year, and as we celebrate the holidays and our many accomplishments, I would like to express my gratitude to each of you working on behalf of the UTMB Health System. Every individual at UTMB plays an important role in ensuring our patients and families receive the best care and service, and I hope you will take this time to reflect on the positive impact you have made for others and through the light you shine.

On behalf of the UTMB Health System, thank you for the work you do. May health and happiness greet you all throughout the holidays, and best wishes for a bright New Year!

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Lifelong Learning: An Ongoing Experience

Donna Sollenberger, EVP & CEO, UTMB Health SystemThe diversity of outstanding work accomplished and innovative discoveries made at UTMB never ceases to amaze me. Our organization is composed of remarkable individuals, who excel in their career fields and personal ambitions, and each day, I read stories in the news and in messages I receive about your successes.

Whether it’s bringing groundbreaking research discoveries to the patient’s bedside, developing new devices and processes to improve the safety and quality of patient care, or simply leading others in the pursuit of knowledge, the list of achievements is remarkable. Even the ways in which the organization has demonstrated its ability to respond to changes and challenges is something special. Lifelong learning is a core value at UTMB for these very reasons—we promote excellence and innovation through lifelong learning.

Lifelong learning makes us successful, no matter what our definition of success may be. We grow as a person through learning, and when we master a subject through continuous learning, it brings great personal satisfaction. Lifelong learning enables us to be confident, competent and knowledgeable; it increases our ability to be productive and effective at what we do, and it makes us better leaders.

I recently read an article, Extreme Exposure, in TMC News last week, about two UTMB aerospace medicine residents—James Pattarini, MD, MPH and Natacha Chough, MD, MPH—who are braving the cold during a clinical rotation in Antarctica. Written by Alex Orlando, the piece was an excellent example of how lifelong learning, through new training and experiences, helps us flourish in our individual roles, benefits our colleagues and our organization, and helps pave the road ahead for the future.

The goal of the training program, which is managed by the Center for Polar Medical Operations (CPMO) at UTMB, is to train physicians to deliver specialized care to patients that live and work in aviation and space environments. CPMO was established to manage health services at the three Antarctica stations operated by the National Science Foundation’s U.S. Antarctic Program—McMurdo Station, Amundsen-Scott South Pole Station and Palmer Station—as well as numerous seasonal field camps and two marine research vessels operated year round.

In the article, Pattarini describes his experience practicing medicine in the South Pole. It’s not a traditional care environment, so he must adapt by performing tasks he might not otherwise do: “An obvious, off-the-cuff thing is that for basic blood work, we’re doing it ourselves—there is no such thing as sending it to the lab and having them send it back. You’re going to draw the blood, take it into the back room, boot up the machine, load it in the cartridge, and then run it yourself and wait for the results to spit out. There’s no middleman.” In addition, nursing staff is limited—they are present, but often busy seeing their own patients.

I think it goes without saying that practicing medicine in the South Pole is an amazing opportunity, especially for our UTMB residents. They have a chance to study in a place on Earth where so few have traveled, and they will be able to directly apply their experiences to their work in the future. But it is also a valuable opportunity to experience firsthand the responsibilities of other roles on the care team and, in turn, gain a greater understanding of not only the whole process of patient care, but its nuances as well. In my experience, one of the greatest lessons I have learned, especially as I have taken on leadership roles, is to appreciate the work of everyone—each person’s contribution is needed to assure that we can provide great care to our patients.

In the article, Pattarini also explains that it’s often necessary to take innovative approaches to standard problems; flexibility is important. For example, his access to special equipment, like advance imaging devices, is limited, so he has to make do with the options he does have. He must also give very careful consideration to patient care decisions, because of the harsh climate and the impact such transitions in care may have on other members of the team, from both logistical and safety points of view. For example, it might become necessary to transfer someone to New Zealand for more acute care, he explains, “Our responsibility extends beyond the risk to the patient—it encompasses the risk to our emergency responders and aircrews in the event that an emergency evacuation is called for.”

Chough describes her experience: “All of us come from a pretty broad foundation, and when we train in this secondary specialty of aerospace medicine, we have to integrate our medical knowledge with a lot of components, such as working in extreme environments, interfacing with engineers and hardware, and the politics of space flight from funding to management—even the organization of the mission as a whole. It really challenges me to think about everything from a big picture standpoint while also having to care for the patient.”

Reading this story, I thought of a saying that is attributed to Confucius. It captures the transformation of experience into knowledge: “I hear and I forget. I see and I remember. I do and I understand.” Although the South Pole is inarguably a unique care environment with very apparent challenges and limitations, in a contemporary health care environment, there are also unique situations in which the knowledge we have gathered must be applied in actual practice and to unanticipated situations—navigating those more challenging instances requires experience and innovative thinking!

It is through a passion for learning that we are able to thrive during times of challenge and change. Our body of knowledge in health care—and beyond—is always growing and developing, and through innovative thinking and the exploration of ideas, we not only gain new knowledge, but we are able to contribute to that greater body of knowledge.

Lifelong learning empowers us to be adaptable and flexible, to remain open to new approaches in our work and to the ideas of others, to recognize when processes aren’t working and then to develop creative solutions, and to effectively and efficiently utilize our resources. Most importantly, lifelong learning helps us set goals that are not based on where we are, but based on where we want to go.

“Education is the kindling of a flame, not the filling of a vessel.” ― Socrates

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!

We make a living by what we get. We make a life by what we give.

Donna Sollenberger, EVP & CEO, UTMB Health SystemThe temperature has finally dropped, and the “other” season we experience in Texas has arrived—it’s no longer blazing hot! This change in weather also means that the holiday season is nearly here, and although it is a little hard to believe, the time has arrived—next week, we celebrate Thanksgiving.

Each year, I like to begin the holidays by reflecting on the spirit of the season. Thanksgiving is one of my most beloved holidays of all. It means a break from work, an opportunity to spend time with family and friends, lots of food, and a full day’s worth of football—and of course, countless, creative ways to enjoy the leftovers.

This is the norm for many people, but it’s not always the case for others, and I hope we all keep this in mind throughout the holiday season. Many of our patients will need to spend the holiday in the hospital, and many UTMB providers and staff will unselfishly give up time with their own families and friends, or rearrange their holidays, to provide the very important care and services our patients and families need. To those of you who will be here to serve our patients and families over the holiday, thank you for your service.

Meanwhile, as many of us are busy researching recipes and preparing to enjoy Thanksgiving with friends and family, we should also keep in mind those who are less fortunate in our communities. Some are going through difficult or adverse situations; others face daily challenges simply meeting basic needs.

I know many of you remember these individuals all throughout the year. It lifts my spirit and warms my heart to hear so many stories about how members of the UTMB community go above and beyond to help our patients, families and community members each year. The level of kindness and generosity never ceases to amaze me.

Just this week, Karen Chapman, director of Rehabilitation Services, shared a story with me about Senior Physical Therapist Assistant, Keith Wright, who did something truly special for one of our trauma patients. As Karen met with the patient to discuss his discharge plans, he showed her the jacket, shoes and clothes Keith had provided to him (the patient’s clothes had been destroyed as a result of his accident). The patient was incredibly grateful for this act of kindness and generosity, and wanted to be sure this story was shared.

Hearing this made me think of something I had recently read: “Little things, be they gestures, actions or words, are the small things we do every day that naturally express our heart. They are not the result of calculations or intentions, but are rather spontaneous expressions of what we feel moved to do.” Keith exemplifies the spirit of everyone at UTMB who sees a need and quietly meets it.

Then, just two days later, I learned that our friends in Information Services had sponsored a food drive at their Thanksgiving Lunch on November 18. Through the generosity of its team members, Information Services was able to donate a total of 543 pounds of food and $798 in cash to the Galveston County Food Bank. This is a wonderful example of how giving doesn’t always have to be an expensive or grand gesture to truly make an impact. The efforts of many can often make a huge difference when combined!

That’s why each year I look forward to seeing what UTMB will give through its State Employees Charitable Campaign (SECC). It’s a small way we can all offer our help. One aspect about the campaign I appreciate is that I have an opportunity to review numerous charitable organizations that conduct very important work in our communities, and then choose which will benefit from my contribution over the next twelve months.

This year’s theme is “We Know You Have a Heart,” inspired by the Tin Man in the “Wizard of Oz”. Through the campaign, we hope to raise at least $500,000 and reach at least 30 percent participation across our institution. As you may know, charities rely heavily on donations from the SECC in order to fund their good work. In the past, in the Galveston area alone, the generous giving by UTMB employees has amounted to about half of all money raised for local and regional charities.

Alongside employees from across the region and state, our impact is far reaching. UTMB’s long legacy of kindness and caring provides food, shelter, health care and varied forms of support and encouragement for people in great need and causes worth supporting.

So far, we’ve reached a major milestone of raising more than $300,000. To the generous employees who have already supported SECC and the great work it makes possible, thank you—your gifts are appreciated! To those who’ve not yet supported SECC, please consider making your pledge for any amount today. It’s a wonderful way to show thanks for all our blessings, in anticipation of the Thanksgiving Holiday.

Today, I encourage each of you to give to the SECC. To sweeten the deal, our 2014 SECC Chairman, Todd Leach, has put an exciting incentive to give on the table, called “100 MBs for 100 Percent”. For each area reaching 100 percent participation, each individual in the department will receive an additional 100 megabytes of storage for their email accounts—I know this will come in handy for my inbox!

No amount is too small. I believe it is not the amount we give, but more importantly, the fact that we have given. One-time contributions can be made via cash, check or online, or pledges can be made through payroll deduction (monthly or a single gift). Please visit the SECC website at http://www.utmb.edu/secc to begin the process of making your donation today. The deadline to contribute to the campaign is December 5, 2014.

Let’s see if the entire Health System can reach 100% participation!

Perception is Reality

Last weekend, I had the chance to go to the Georgia Aquarium in Atlanta with my cousin and her grandson. I have always loved going to the aquarium. The vibrant colors in nature, like the intense yellow of the angel fish, amaze me. I enjoy watching the sea otters as they play together and swim through the water. My favorite habitat at the aquarium, though, is that of the penguins. I always laugh at their silly waddle and the way they flop forward onto their belly and then slide right into the water—they’re comical on land, but such fast and graceful swimmers.

11-15-14 seeing thingsAs I watched my cousin’s grandson, Cole, observe these sea animals for the first time, I felt almost like it was my first visit. I watched him as he scrutinized each creature’s movements; he laughed as the otters swirled and glided through the water, and he eagerly pointed out a whale shark as it passed over us in the glass tunnel. I have no doubt there will be many more visits in his future!

Watching Cole carefully examine each creature and point out every detail about them made me realize something—as we become more familiar with our surroundings and activities, we often miss the small details. We end up taking what is in front of us for granted, because it becomes a common experience to us.

This is an actual phenomenon, which psychologists refer to as “habituation”. Simply put, it is a decrease in response to something after repeated presentations—the more often we see something, the less we notice it.

This made me think about health care settings, and the fact that as caregivers and employees, we eventually become accustomed to our patient care environments. We become so used to seeing the same setting every day, we may hardly notice when something is out of place, something has collected a little dust, or that a new, unsightly blemish has appeared on a wall, a piece of equipment or furniture.

Because providers and staff are busy focused on patient care, these small details might be easily overlooked; however, patients are looking. I know from my own experience as a patient, when I’m waiting in an exam room, I usually have enough time to give it a thorough inspection. Small details and first impressions have the potential to create a powerful set of assumptions. If patients see something askew or neglected, it may plant seeds of doubt in their minds about quality of care. As an inpatient, one has even more time to examine the details of a room. If something is not working or doesn’t look clean, it may signal to the patient that we don’t care, which is certainly not the case.

Perception is reality to our patients and their families. That’s why as providers and employees we have to practice seeing every aspect of our interaction with patients from their perspective—it’s more important than most of us think.

In fact, a number of studies link a range of aspects of the physical environment to patient safety, patient and family stress and healing, improved overall health care quality and cost, and even staff stress and effectiveness. The physical environment shapes every patient experience and all health care delivery, including those episodes of care that result in patient harm, according to the Agency for Healthcare Research and Quality (AHRQ). According to the NIH, various studies conducted at ambulatory care centers also show the physical environment has been associated with favorable patient outcomes.

The lists of physical features in care environments that are associated with positive patient experiences can be quite comprehensive, but some of the principle demands are an environment that:

  • Promotes safe behavior by patients, staff and visitors – for example plentiful, visible hand washing and hand disinfection stations.
  • Prevents accidents – for example ensuring spills are promptly cleaned up to prevent slips and falls.
  • Encourages patients and staff to feel reassured – through adequate interior and exterior lighting, visibility of security personnel, and, in the case of inpatient care, secure storage for personal items such as glasses, keys and money.
  • Reduces stress, anxiety and aggression – through the provision of pleasant, comfortable waiting spaces, feedback and communication on waiting times and priorities, attention to ambient temperature, light and noise, etc.

These aspects can be further supported by robust monitoring and reporting, demonstrating a Culture of Trust, and having a sense of personal responsibility and willingness to admit safety concerns and report mistakes, should they occur.

On a regular basis, take an unbiased look at your patient care or service environment. Try seeing it from the patient’s perspective. What would be your first impression of the waiting area? Does furniture or equipment need repair? Is it dirty or scuffed? What does the front desk look like? Is there excessive or old signage? Are patients and family members warmly greeted on arrival? What do the exam rooms and/or inpatient rooms look like? Are ceiling tiles damaged? Is the work area cluttered? Is paint peeling or scuffed?

These are just some examples of things of which we should remain aware. I believe we do a wonderful job at UTMB of providing an excellent care environment, but we should always be vigilant. We need everyone’s help!

  • Report facilities issues that need maintenance; if the problem does not get fixed or you don’t have a response within a week, escalate it to your supervisor
  • Keep clutter out of the hallways
  • Assure all supplies are not expired and that they’re properly stored
  • Check for expired supplies and medications
  • Ensure refrigerator temperature monitoring, proper food labeling, and cleanliness
  • Make sure linens are covered
  • Eliminate dirty, cluttered work areas

It’s very easy to quickly resolve issues that impact patient care by dialing one number: 2-4040. Requests may also be made with each area’s designated Zone Mechanic. Calls will be routed to the UTMB Service Response Center, which has expanded its service to act as the single point of contact for all clinical support services in the following areas: Environmental Service, Pest Control, Food and Nutrition, Clinical Equipment, Nursing Unit Support, Maintenance, Utilities, and In-house Construction.

More information on these topics can also be found on UTMB’s internal web site, The Joint Commission: http://intranet.utmb.edu/qhs/TheJointCommission/default.asp

Thank you for the part you play in keeping UTMB hospitals and clinics beautiful and safe for our patients and our staff!

Repack your bag; lighten your load

“Aside from Velcro, time is the most mysterious substance in the universe. You can’t see it or touch it, yet a plumber can charge you upwards of seventy-five dollars per hour for it, without necessarily fixing anything.” – Dave Barry

Donna Sollenberger, EVP & CEO, UTMB Health SystemTwo weeks ago in my Friday Flash message, we affirmed that we all play an important role in assuring our patients and families receive the best possible care. At the same time, however, we acknowledge that in health care, it’s nearly impossible to always anticipate just what to expect and when. Thus, there is importance in being prepared, knowledgeable and flexible in our jobs, because we never know when there will be a new challenge around the corner.

That was the case over the past couple of weeks, as UTMB Health prepared to proudly step forward as a leader in Texas for the management and treatment of infectious diseases like Ebola. Our teams in Epidemiology, Facilities, Nursing, the Galveston National Lab, Infectious Diseases, the Emergency Department and countless other areas rose to the occasion as they worked diligently to prepare for the care of any potential patient. While this scenario fortunately did not come about, we were given a very important opportunity as an organization to prepare for future possibilities and to be recognized as a state, national and global resource in the fight against and treatment of infectious diseases.

#1 Crew

Dell Roach, Chelita Thomas, Jason Ziegler, Josette Armendariz, Neal Clayton, Kimberly Young, Robert Hastedt, Edwin Smith, Leon McGrew and Christine Wade

With all the work that had taken place during this time, I felt like this weekend I should take a moment to recharge my batteries and spend some quality time with my family. I know that I could work around the clock if I let myself, because my job is important to me—I always want to give it everything I’ve got! But at the same time, there are other very important parts of my life that make it meaningful. Sometimes the small things do matter! Good time management means making the time to do all of the things that are most important to me.

Being more balanced doesn’t mean a dramatic upheaval in our lives. It can simply mean changing the way we think about our situation. I know at times, we may tend to think of ourselves as standing in the middle of a big swirling circle of tasks, burdens, problems and responsibilities—I often refer to an old Ed Sullivan performer who was a master at the art of plate spinning when I think of these moments. At every second, we have a dozen different things to do, a dozen problems to solve, a dozen burdens to endure. After some time, we can feel like we’re on overdrive and overtired.

The timing of a story recently sent to me by a friend seemed appropriate to address the feeling of being under pressure. It was about a young lady who was leading a seminar on stress management. She confidently walked around the room with a raised glass of water, and everyone in the audience expected that she was going to ask the ultimate question: “Half empty or half full?” But instead, she asked, “How heavy is this glass of water?” Answers called out ranged anywhere from 8 oz. to 20 oz.

She replied, “The absolute weight doesn’t matter. It depends on how long I hold it. If I hold it for a minute, that’s not a problem. If I hold it for an hour, I’ll have an ache in my right arm. If I hold it for a day, you may need to call an ambulance!”

And that’s the way it is with stress. If we carry our burdens all the time, sooner or later, as the burden becomes increasingly heavy, we won’t be able to carry on. We have to put the glass of water—our stress—down for a while and rest before holding it again. When we’re refreshed, we can carry on, performing better each time.

Although feeling overtired and sometimes surrounded by our tasks and problems is a common mental picture, it is one that is totally false. No one of us, however crowded his or her life, has such an existence! Rather, it is how we think about the tasks, and whether or not we choose to put them aside from time to time.

What is the true picture of your life?

Another story I came across suggests that instead of thinking of our tasks and challenges as coming at us all at once, we should instead imagine an hourglass on our desk. The bowl at the top of the hour glass is connected to the bowl at the bottom with a tube so thin that only one grain of sand can pass through it at a time. That is the true picture of your life, even on a super-busy day. The crowded hours come to you always one moment at a time—that is the only way they can come! The day may bring many tasks, and sometime many problems, but invariably they come in single file.

The third thing that came to mind was a book I recently read (and recommend) called Repacking Your Bags: Lighten Your Load for the Good Life, by Richard J. Leider and David A Shapiro. One of the authors was inspired to write the book after a backpacking trip in East Africa. He had bought a giant, expensive backpack stuffed with hi-tech supplies for the trip. But his guide, a Maasai elder, carried only a spear and a stick. After a long day of hiking, the guide was curious about the backpack and asked to see the contents. The traveler unpacked his bag, proudly displaying all his possessions. Then the guide asks him a simple question: “Does all this make you happy?”

The author couldn’t answer his guide right away, or that evening, and even weeks afterward. Over the course of his trip, though, he ended up giving many of the things he was carrying to the local villages. It turned out he didn’t need many of the things he thought he had to have. In fact, he was happier without them.

Sometimes it is the things we think we need to carry around with us that are unnecessary. We become so consumed thinking about the weight of our backpack, we forget to look at the world with a sense of curiosity and a feeling of wonder.

Quite simply, we must continually unpack and repack our bags, and take a long, hard look at what we’re carrying and why—are they still helping us move forward, or are they weighing us down? And, we must continually repack. This is the ongoing and continuous activity of reflection and choice: rearranging our priorities; reframing our vision of the good life; and recovering a new sense of being alive.

What are some things you can do today to lighten your load and repack your bag?

Taking some time to put our worries aside and do the things we love will help us remain continually engaged in our life and work so as to stay vital, fully in the present moment, and hopeful for the future to come. I hope you take some time to do the things you enjoy over the weekend and come back next week feeling refreshed, renewed and reinvigorated!

Every Patient, Every Encounter, Every Time

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

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

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

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

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

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

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

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

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

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

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

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

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

Ch-ch-ch-changes…

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

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

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

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

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

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

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

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

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

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


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

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


Special Grand Rounds Presentation: Innovation

Roy Rosin, Chief Innovation Officer, Penn Medicine

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

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

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

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

Lollipop Moments

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The Smallest Gestures of Kindness

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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