When you can’t see the forest for the trees…

Donna Sollenberger, EVP & CEO, UTMB Health SystemThe evening before Valentine’s Day, my son, Brad, and his wife, Maureen, went out for a nice dinner at a small bistro in Coronado, California, which is a beautiful resort town near their home. As they were looking over the menu, Brad noticed flames suddenly flickering over the top of his menu. He put down his menu and looked across the table at Maureen, who was studying the bottom of her menu so carefully, she didn’t notice the top was dangling above the candle on the table and had caught on fire.

“Maureen, your menu!” Brad alerted her. She looked up, screamed and dropped her menu on the table, which then caught the table cloth on fire. The couples at nearby tables immediately grabbed their glasses of water to toss on the fire and extinguish the flames. Needless to say, I’m sure this was a Valentine’s Day Brad and Maureen will never forget!

Aside from sounding like a scene from a romantic comedy, this scenario made me think about how sometimes, we become so focused on something we are doing that we miss detecting something that’s rather obvious or unexpected (like your menu being on fire). Or, at other times, we can become so distracted by a single task or detail, we fail to look at the situation as a whole.

When it comes to being focused on a task, we commonly mean thinking about one thing while filtering out distractions. So, it makes sense that if you give your full attention to one task at a time rather than trying to do several things at once, you’ll have higher quality results. But in reality, we have all learned to function well while multitasking. In fact, we can even become overwhelmed at times by information, a load of projects, or technology to be used. Trying to focus on too many things at once can easily open the door to mistakes. As the Nobel Prize-winning economist Herbert Simon wrote, “Information consumes the attention of its recipients. Hence a wealth of information creates a poverty of attention.”

There are a couple of big ways not being focused, whether on our environment or on a task at hand, can have an impact—like on Best Care, for example.

Here’s a possible scenario. Two boxes of medications are packaged very similarly. While trying to perform more than one task, like answering the phone, I might accidentally grab the wrong box, expecting that I have the correct one. After all, it’s a medicine I administer almost every day! That could be a costly mistake for my patient! Fortunately, we have a bar code medication administration system which, when used properly, can catch my error.

Here’s another example. I am having a pretty good day, but very busy. I am walking down the main corridor of Jennie Sealy Hospital and checking an email on my phone. While I am trying to also watch where I walk, I fail to notice the expression on the face of a distraught family member who is trying to find the intensive care unit to visit their loved one. Or, I may even simply pass someone who is lost and trying to get to their clinic appointment on time. Let’s put down our phones and focus on our surroundings when we are traveling throughout our campuses and health system complex. No matter what our role, we all have a job to do in assisting visitors and patients who may be lost or confused trying to navigate our large system of facilities. Some of you have asked me how you can help achieve Best Care. This is one way you can do that.

To err is human—we all are capable of missing details. That’s why realizing we are susceptible to filtering out incoming information in our environment is important. Because we work in a fast-paced, demanding environment, we must practice awareness and remain vigilant about the safety and quality of the care and service we deliver.

Here’s another perspective on our Best Care focus. There are different ways of thinking about Best Care—there are the simple things we can all do each and every day that contribute to a positive patient experience, some examples of which I described above. But there is also the technical side of the coin, where we are collecting different forms of data to understand and track our performance in delivering care. We collect information on the cost of care, and we also use clinical documentation to reflect how ill our patients were and to record the processes of care we used to treat them. Together, this information determines our ranking for certain quality measures, like mortality or efficiency. So, it is possible to be so focused on moving the needle—improving Best Care—that we could lose sight of the fact that the ultimate goal of it all is to always do the right thing for our patients. Best Care means we are honoring patient-centeredness and delivering on outcomes that matter to patients and their loved ones!

In closing, I’d like to share a short video. Please watch it and follow these instructions: In the video, there are two teams of three persons each, one dressed in black and the other in white, revolved around each other and passed basketballs to their teammates. Count the number of times the ball is passed among the players in white.

This was a study conducted in 1999 by psychologists Daniel Simons and Christopher Chabris. They discovered that consistently, about 50% of their study participants failed to notice the gorilla. Whether or not the individuals saw the gorilla was not an individual difference trait. And interestingly, those who did see the gorilla could not believe that others actually failed to see it!

It just goes to show the importance of “avoiding distractions, paying attention to what others might notice, remembering that looking is not the same as seeing, and realizing just because your eyes are open, it doesn’t mean you’re seeing something!”*

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*Mike Lyles, Quality Engineering Program Manager

Why tread water when you can float?

Donna Sollenberger, EVP & CEO, UTMB Health SystemAs you already know from some of my prior Friday Flash reports, my grandson, Jack, is a swimmer. However, he is also only 10 years old, so he can be somewhat forgetful or disorganized when it comes to swim practice.

I am not a swimmer, so I am always fascinated by what the swim team does at practice. I have learned from Jack that one of the techniques his coach uses to help the swimmers gain upper body strength is to hold a flotation device, called a pull buoy, between their legs while swimming. The buoy helps keep the swimmers’ legs stationary and afloat as they swim through the water. This is an extremely important part of training, because it helps the swimmer focus on their arm movements, which is particularly beneficial for a swimmer who does the butterfly and breast strokes, like Jack.

Two weekends ago, my daughter, Jack’s mother, and I were having dinner when she told me an amusing story. For about three practices in a row, Jack had forgotten his buoy. His coach was not happy when he arrived at the third practice without it. So, to make a point, the coach told Jack that if he forgot it again, she was going to tie his ankles together and make him do the exercise that way—it must have made a point, because he hasn’t forgotten his buoy since.

As I thought about the prospect of trying to swim with my ankles secured together without a buoy, I thought about how we sometimes make work harder for ourselves than it needs to be. There are times when we are confronted with challenges, but we don’t remember to use our “buoy” for support, be it our co-workers, technology or available equipment. For example, do we ask others for help when feel overwhelmed with too much work? I know it is sometimes hard to ask for help, yet it is sometimes the best thing we can do.

I had a chance to meet a nurse recently who has worked at UTMB for about five years. She came to UTMB from a competitor hospital up the freeway, so I asked her what attracted her to UTMB. She told me that she had worked here per diem while she was a full-time nurse at the other hospital, and she noticed in her shifts at UTMB that if she had two new patients to admit at once, the other nurses on the unit always checked with her to see if she needed help. She told me that never happened at her full-time job. So when there was a full time opening at UTMB, she decided to quit her job at the other hospital and work here. I asked her if she felt free to ask for help if she needed it, and she told me, “Absolutely.”

I admire this nurse. Instead of struggling under a spike in workload and trying to do the job alone, she asked for and accepted help. Just like my grandson, Jack, she had decided it was easier to accomplish her work with a buoy as her lifesaver rather than trying to do the job with her “ankles tied together.”

Here’s another example. Most of the time, we have technology available to help us do our work more precisely, but we opt to take a shortcut to save time and don’t use the technology that helps make our work easier or safer. Not too long ago, we implemented a bar code system to help make giving medication to our patients safer—the nurse scans the patient’s wrist band, and then scans the bar code on the medication packet. This technology is a “buoy” that helps assure that the nurse is giving the right medication to the right patient, at the correct dose at the right time. If any of these variables are not correct, the technology then alerts the nurse that if they continue, there could be an error. Using the system literally can be a lifesaver, because it reduces the likelihood of a medication error. Although this cannot eliminate medication errors entirely, nor can it replace the diligence and critical thinking of the nurse, it is safer way for UTMB to provide high quality care for our patients in environments that have frequent distractions and elevated levels of stress.

What buoys do you have in your job that make your work easier? Are you using all of the tools you have to assure you are being as effective in your job as possible? Do you offer help when you see others need it, too?

Health care is a fast-paced environment. Asking for help and using the tools designed to make our work more efficient and processes more reliable equates to safer patient care and a positive patient experience. And sometimes, we can really benefit from the skill and expertise of our teammates. Asking for help isn’t always easy. But, sometimes it’s downright essential!

Accept yourself, your strengths, your weaknesses, your truths, and know what tools you have to fulfill your purpose. –Steve Maraboli

Today, I will learn something new.

Donna Sollenberger, EVP & CEO, UTMB Health SystemI am left-handed—at pretty much everything. I write left-handed, and when I played softball, I pitched left-handed. The only thing I really can do with my right hand is iron, and that is because my right-handed mom always left the ironing board set up in the utility room the way she liked it, ready to turn on. (I was too lazy as a kid to unplug the iron, collapse the ironing board, turn it around and set it up again, so that is how I learned to iron.)

When I was in elementary school, we were taught to write in cursive. Our lessons began in fifth grade, and by sixth grade, we were to use cursive exclusively. I wrote as most left-handers do: my left hand bent at the wrist, pen on the paper, dragging my hand across the ink, often smudging it across the page. At least, that’s how I wrote until Miss Bell became my sixth-grade teacher…

I remember the first time we were practicing cursive in the classroom. Miss Bell walked toward my desk, watched me write and then said, “You will not pass handwriting in my class unless you learn to write so it appears you are right-handed.” She then proceeded to show me how to do that, which involved turning my paper the opposite way and then writing without bending my hand at the wrist. I was mortified as all of the kids in class watched me. I was struggling. It felt so foreign to try to write that way.

I spent the better part of three months working and working on doing something differently than I had learned to do it for an entire year. I have to admit, it was really challenging. However, once I got the hang of it, cursive writing became easier and easier. Over the years, I have had people tell me that my writing looks as if I am right-handed, and most people who have seen my handwriting are surprised that I am left-handed.

I recall this part of my life now because the other day, my husband took a note I had written down to the front desk at the condominium building where we live. He came back amused that the two ladies at the front desk had asked him if he wrote the note. He told them that he did not; his wife had written it. One of the ladies asked him if I had ever won any awards for hand-writing! Now, I was laughing!!

The memory of trying to change something I had done for months, which had now become habit, made me think of the changes we are having to make to achieve Best Care. At first, we heard the goal and thought it really wouldn’t be possible. However, we also know that failure is not an option. We even have the University of Texas System Chancellor urging us on, and most importantly, we have patients who depend on us to give them the Best Care, every encounter, every time. So, some of us have to change the way that we have approached patient care, sometimes for years.

But change we must. So we begin by trying a new approach, one that we believe will get us the results that we were not getting before. For example, the way physicians document in the medical record the care they have given to a patient and the way they describe the patient’s illness can be the difference between being rated as a very high-quality or lower-quality academic medical center. Many physicians are having to learn to document differently than they have for years. It is hard to make the change, yet it is necessary so that we are recognized appropriately for the work we are doing.

In other instances, people who were trained step-by-step on how to document in the Epic medical record (because following that particular process helps ensure we are adhering to the recommended processes of care and that we are capturing all of the information we need) are then sometimes told once they are on the unit, “Oh, there is a easier way. Just do it like this.” And before you know it, the trained behavior is left behind because “there is an easier way.” Unfortunately, the easy way may actually make things more complicated for others who have to use the record further down the line. We may make the change to make our own work easier, but as a consequence, we unintentionally make work harder for someone else.

Can you think of a time when someone changed how they did their work, and that made your job harder? That is why, as we change our system and learn new ways of doing things, we need to do our part according to the way the process was designed. If the process needs improvement, let’s work on that together. Changing just our part may actually make it unsafe for the patient somewhere else down the line.

So, just like I practiced and practiced my handwriting until what I was doing became a habit, we must practice the changes we need to make in order to help us achieve Best Care. Whether you work on the loading dock, run blood tests in the lab, or develop work-flows to be implemented in the electronic medical record, let’s all work together, make sure we understand our role in the process, understand why we do something the way we do, and how our work impacts others. It is then that we have the greatest opportunity to achieve Best Care.

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They will never forget how you made them feel.

Donna Sollenberger, EVP & CEO, UTMB Health SystemI remember one year growing up in Springfield, Illinois, my uncle developed a chronic illness which, I believed and was wholeheartedly convinced, required a specialist. I attempted to persuade him to see a physician who specialized in his chronic condition. It would be easy, I told him, because I could arrange the appointment. However, my uncle declined. He wanted to stay with his current physician.

Not one to let things lie, I probed more closely. Why would he prefer to stay with his current physician and decline seeing the doctor that specialized in the chronic condition? His response interested me. He said that his current physician delivered a great quality of care for him. Why would he change now? So, I continued my probe.

How did my uncle know that his physician delivered great quality of care? His multi-faceted answer was even more insightful. It seems my uncle assessed the quality of care he received from his doctor in a way that most non-clinical people do, even today—they base it on the quality of their experience. To my uncle, a quality patient experience was about the following:

  • My doctor and his staff know me, so I can always get through when I contact them and get my questions answered or my needs met.
  • They always call me back within the day.
  • They are close to my home, so it is easy for me to drive there.
  • If I am sick, they always work me in that day.
  • Parking is easy and free.
  • My doctor’s office is new and pretty.
  • My doctor always has time to listen to me.

For a health care professional, it might seem odd that there is nothing in the above assessment regarding the training and experience of the physician, the access to other physicians for consultation, the way in which the chronic condition is managed so that it is under control—even in remission. There is nothing in his preferences about access to the best equipment, use of evidence-based guidelines in the patient’s treatment, or about the outcomes of other patients. My uncle’s entire assessment of the quality of his care was based solely on the experience he had as a patient visiting his physician. And yet, my uncle believed the quality of his care was outstanding.

Over the years, I have come to learn that the value of the patient experience cannot be underestimated. As a provider, we can do everything well in terms of the patient care delivered and the care interventions we make, but if the patient does not feel that they were treated with compassion and respect, or if they do not feel that we were responsive to their needs, or if they have trouble getting access to an appointment time that was convenient or timely for them, or if they felt they were not being listened to because the physician and/or staff never made eye contact with them or the conversation was rushed, the patient will not perceive that she or he is getting the quality of care s/he deserves. In short, the patient experience is crucial to the patient feeling as if they are receiving quality care.

In the past months, we have been focused on Best Care, which means we are upholding our unwavering commitment to deliver the right care, at the right time, in the right way, for the right person – and achieve the best possible results – for every patient, every time. One of the components of Best Care is patient-centered care, which means “providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions” (Institute of Medicine, 2001).

Every employee at UTMB in some way impacts how well we perform in the areas mentioned above—whether that contribution is direct or indirect in terms of the patient. It is true, sometimes in a large organization like UTMB, an individual who doesn’t directly “touch” a patient might not immediately realize how what one does truly helps or impacts the patient. If you feel that way, just think of a line of people passing buckets of water from one to the other from a source of water to be poured into a large water tank. An individual in the beginning or middle of the line may not be able to see the end result (i.e., the water being thrown into and filling the water tank), but the contribution of the individual is indispensable to the final outcome.*

Every interaction a patient has with our system influences their experience!

At UTMB, we are dedicated to providing an exceptional experience with excellent outcomes to all patients, no matter who they are, what their background is, what age they are, what their gender, race or ethnicity is, or how much insurance coverage or ability to pay they may have—this is equity of care, another focus of Best Care.

So, what can each person at UTMB can do to contribute to the patient experience? The following are just a few easy things we can all do, but there are ultimately countless actions we can take, and I encourage you to think about how you make a difference in your own important role:

  • Always warmly greet and assist patients and visitors—and one another.
  • Treat all patients and visitors with respect.
  • Be aware when someone looks lost or confused and offer to help them to their destination or point them to someone who can assist.
  • Assure equipment, supplies and medications are available for all patients at all times.
  • Conduct timely equipment inspections.
  • Provide language interpreters and interpreters for the hearing impaired; you can receive certification to assist in this endeavor through language services.
  • Attend training to increase ability to care for diverse groups of patients.
  • Work in teams and as a team.
  • If your personal finances permit, contribute to programs like the UTMB Good Neighbor program.

There is a quote attributed to speechmaker Carl W. Buehner (and a few others) that says, “They may forget what you said—but they will never forget how you made them feel.” This can certainly be applied to the patient experience—whether you deliver patient care, respond to the patient’s concerns, ensure supplies and lab samples are delivered, help patients access our system, help them find the resources they need, or you create a warm, welcoming environment, you all contribute to the feeling of being well cared for at UTMB Health. I appreciate everything you do to create an excellent patient experience and to contribute to Best Care.


*Concept adapted from Grant Bright, Former Project Lead, IBM

**In addition to patient-centeredness and equity of care, the remaining areas of focus for Best Care include effectiveness of care, efficiency, patient safety and mortality, as measured by the Vizient Quality & Accountability Study.

Best Care Update

Donna Sollenberger, EVP & CEO, UTMB Health SystemAs you all know, we experienced a fire in John Sealy Hospital last week. Although some of our teams are now working in temporary locations until the hospital can be restored, we have resumed normal operations. So this week, I am again looking ahead to Best Care and what we need to do to assure that we will rank in the highest quartile of performance as measured by the Vizient Quality & Accountability Study.

We have done much work since June when we began working in earnest to improve outcomes of care for our patients. As a result of that work, we are starting to see improvements in our performance. We all remember that when we began the Best Care initiative, we ranked in the top 20 out of 102 academic medical centers in both equity of patient care (this means that our patients get the same care, regardless of their race, ethnicity, sexual orientation, economic status, etc.) and in patient-centered care.

Moving forward, we needed to remain a top performer in both of these categories, and to date, we have accomplished this. For example, our goal in patient-centeredness for the first quarter of the fiscal year was to have 76.4 percent of our patients rate us on the patient satisfaction survey as a nine or ten (on a scale of one to ten) for their overall experience of care. And there’s good news—for the first quarter of FY17, 81.6 percent of our patients rated us at the top of the scale! This is excellent work, and we need to keep it up!

Our work to increase patient safety has also been exceptional. For this measure, we use a rating called the Patient Safety for Selected Procedures Composite Score (a measure developed by the Agency for Healthcare Research and Quality), otherwise known simply as PSI-90. Patient Safety Indicators (PSIs) reflect the quality of care inside hospitals, but focus on potentially avoidable complications and adverse events following surgeries, procedures and childbirth. These types of events include, but are not limited to, the rate of pressure ulcers, falls in the hospital resulting in hip fracture, the rate of hemorrhage or hematoma after surgery, and the rate of postoperative sepsis (a severe bloodstream infection resulting in decreased organ function). We are doing exceptionally well with this measure. Our target score for the first quarter was 0.91 and we scored 0.65 (lower numbers are better, in this case). Our target for next quarter is 0.80, so we need to keep up this excellent work and do all we can to do even better!

For preventable readmissions within 30 days of discharge, we exceeded our first quarter target of 13.6 percent—our performance was 12.5 percent (again, lower numbers are better). This means that we did a good job of managing our patients once they left the hospital, we followed up with them to make sure they were following their care plan, and/or we managed their health in our clinics so they did not come back to the hospital within the 30-day time frame. While this is excellent work, we increase the challenge to meet our targets each quarter so that we have to continually improve. For the next quarter, our goal for the 30-day all-cause readmission rate is set at 12.58 percent or less, so we have to keep improving!

We also met our goal to reduce our mortality rate, which is described as a ratio that compares how many patients passed away, in total, compared to how many were expected to pass away while in the hospital based on how sick they were. A significant part of the effort to improve our rate has been rooted in clinical documentation improvement, because the more specific the documentation is, the more accurately the patient’s severity of illness is reflected. Additionally, if we do not document the care we deliver to our patients well enough, our performance appears worse than it actually is—even if the care was excellent and the patient had a good outcome. To help support our providers in this endeavor, we have been working to optimize our electronic medical record (Epic), and we are also offering documentation training to physicians on our inpatient units—for example, providers should not use symbols when documenting, and it is important to use special and specific wording when describing the patient’s condition.

For the mortality score, a score of less than 1 means that more patients survived than were predicted to. A score of more than 1 means that more patients passed away than were predicted to. So, a lower score is better. This quarter, our mortality observed/expected rate was 0.91, where our target was 0.99. Since lower numbers are better, this means we met our goal. For the next quarter, however, our target is 0.90, so we have some more work ahead of us.

The last major measure we are tracking is length of stay (LOS). This falls under the Vizient Quality & Accountability Study’s category of Efficiency, which measures how well we are using our resources compared to how ill the patient is. This measure is case mix index adjusted, which essentially means that it takes into consideration the diversity, clinical complexity and resources needed to care for our total hospital patient population. Our goal for this first quarter’s LOS at the Galveston campus was 2.85 days. At 2.96 days, we missed our goal. We have a significant amount of work to do, because for next quarter, our goal will be 2.81 days.

I know many of you have asked me how we are doing when it comes to achieving Best Care. If I were to summarize, I’d say we are on the right track and moving in the right direction. But to meet the goals we have for the end of this fiscal year, we have stay focused and maintain our absolute resolve to meet our Best Care goals.

I want to thank each of you for our improvements made since June. I know this requires a lot of work, but if we can make these improvements stick, ultimately, our work will become easier. And even more importantly, our patients will receive the Best Care.

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*Lower numbers are better

Everyday Heroes

Donna Sollenberger, EVP & CEO, UTMB Health SystemMost of you already know that I was not here for Hurricane Ike. I arrived to work at UTMB one year and a day afterward. My first day of work at UTMB, I remember standing in the grassy area in front of John Sealy Hospital during the Hurricane Ike Commemoration Ceremony. Dr. Callender was surrounded by a small group of employees who listened to him talk about the progress the organization had made over the past year, and he reflected on the experiences of the first days after the storm. He recalled the extraordinary effort of some of our facilities colleagues who made sure the UTMB sign on John Sealy Towers was lit. Then, the ceremony ended, and the UTMB flag was raised by two of our students. I stood at the back of the small crowd, listening and watching the emotions of the people there. It was obvious that the memories of this experience were still quite vivid and emotions were still raw. There was still much healing to be done.

About two years ago, UTMB had the opportunity to host the University of Texas System Board of Regents and members of UT System leadership at a dinner reception. That evening, Dr. Joan Richardson, chair of the Department of Pediatrics, spoke of her love of heroes when she was a girl. She told us that she had always wanted to know a hero, but had not had a chance to know one—that is, until September 2008. As she described the work of hundreds of people who rode out the storm and the many others who came back to work tirelessly to reopen UTMB, she said that she realized she knew hundreds of heroes. They came from every walk of life, and they all had one thing in common—their resolve to reopen UTMB. UTMB stopped for no storm.

I remember the absolute silence that evening as the audience sat mesmerized at the story of the heroes at UTMB. There were few dry eyes in the room when Dr. Richardson finished her story. I remember thinking how lucky I was to work with people who made sure that UTMB, like the mythical phoenix, rose again from Hurricane Ike’s devastation.

Houston Fire Department to the rescue!

Houston Fire Department to the rescue!

This past Wednesday, I experienced what Dr. Richardson described. I was walking toward the Administration Building on the Galveston Campus when I saw a fire truck and two escort cars arrive in the front of John Sealy Hospital. It is not unusual to see an emergency vehicle or two in front of the hospital from time to time, and it generally is not a serious issue. But as I watched two of our police officers run past me and into the east entrance of John Sealy Hospital, I realized something serious was happening. Within minutes, we learned that a fire, yet uncontained, had broken out on the second floor and that smoke was in the stairwells and moving throughout the building. We declared an emergency at UTMB.

Transportation staff in action

UTMB Transportation staff in action, waiting in front of Jennie Sealy Hospital to transfer patients.

Working with local fire departments, a decision was made to evacuate the 110 patients, their visitors and our staff in John Sealy Hospital. Although this was an intense situation, our staff, physicians and managers remained calm and focused on getting everyone out of the building. As the patients were being safely transferred out of the building, we simultaneously needed to decide on where to place the patients. Administrators, doctors and managers worked together under pressure to identify the best places to continue care for our patients in our care facilities. I applaud every one of you who helped moved our patients to new locations, got them settled in, and worked to assure that their needs in these new areas were met. It was a challenging situation, but everyone problem-solved and worked together to get what was needed to help our patients.

A hero is defined as someone who makes a personal sacrifice in order to benefit others or someone who is noted for their courageous action. I now know from my own personal experience what it is like to work with hundreds of heroes. To everyone who made the safe evacuation of 110 patients possible on Wednesday, you are the heroes of UTMB! Thank you for the personal sacrifice and the risks that you took to benefit so many others!

Thank you to the Galveston Firefighters, the Galveston County Health District EMS, the Galveston Police Department, Island Transit, the Houston Fire Department, and Santa Fe Fire & Rescue for coming to UTMB’s aid!

Holiday Traditions

Donna Sollenberger, EVP & CEO, UTMB Health SystemGrowing up in the Midwest, I always wished for snow during the winter holidays. As you know, our family celebrates Christmas, and snow on Christmas Day meant two things. First, I got to play outdoors with all of my cousins, and, if the snow was moist enough, we could make snowmen. Second, after dinner with all of my aunts, uncles and cousins, all of the children would wait patiently (as patiently as we could, that is) until dusk, because it meant that my mom’s cousin would hook up the horses to the sleigh, and we would all be treated to sleigh rides around the snow-covered countryside. It was especially magical if the snow was still falling and fresh on the ground, because the sleigh would glide silently along with only its lights to help show the way. Just writing about those sleigh rides now, I re-experience the warm feelings of Christmas days past.sleigh

Determined to create our own traditions once we were married, my husband and I decided to give each of our children a traditional gift that they could count on each Christmas. Each year, we gave our daughter a bell ornament. Each of our twin sons received nutcrackers. These were small gifts, but they became significant in the lives of our children. I recall one particular Christmas evening, I was tucking one of the twins into bed, and I asked him what his favorite present had been. He had a particularly bountiful Christmas, getting a fishing rod and reel, a Game Boy, and some other smaller toys.

His response surprised me. Without stopping to think, he said, “My favorite present this year was my nutcracker.” This twin is now a grown man with a family of his own, but it warms my heart when I visit him right before the holidays, and among his family’s modest set of decorations, a line of nutcrackers from years past are lined up on the shelves in his living room. For him, they bring warm feelings of family. In a way, they transport him back in time across thousands of miles to many Christmas mornings.

I would like to think that everyone grew up with wonderful winter holiday traditions and memories, but we know that is not the case for everyone. Some families would not have gifts without the generosity of Secret Santas who “adopt” them through not-for-profit organizations. Others might not enjoy a nice holiday meal, were it not for generous donations made to food pantries, or for the volunteers who cook and serve those meals. Still many others struggle with health problems or are experiencing circumstances that make the holidays seem lonely or bring sadness or despair.

I know that many of you have been so generous this year by contributing to the recent UTMB Health Food Drive in support of Ball High School’s “Share Your Holidays Food Drive” (sponsored by ABC13). In fact, I learned that UTMB contributed nearly a ton of food to the Galveston County Food Bank. In combination with donations from all others throughout the area, this will provide 18,641 meals for our neighbors in need this holiday season.

Julian Ramirez, Larry Krcma, Sharon Lacy and Lori Blackwell load a van with food donations

Julian Ramirez, Larry Krcma, Sharon Lacy and Lori Blackwell load a UTMB catering van with food donations.

Many others of you are adopting families this year from organizations like the Salvation Army. And still many others of you will help fill the void of family as you care for our patients who will be hospitalized over the holidays. We deeply appreciate your contributions to the well-being of our patients and the sacrifices you make to assure that our patients will be receiving the very Best Care.

As we head into the holiday season, I hope that we will all be mindful of the needs of others around us. I have always believed that the true meaning of the holidays is found when we make things better for others.

The following are 10 easy ideas to brighten the holidays for someone else:

  1. Visit those who are lonely.
  2. Make a random act of kindness.
  3. Decorate someone’s home who cannot decorate for themselves.
  4. Adopt a family.
  5. Give what you can (you don’t have to spend a lot of money to show you care!).
  6. Give your time, whether simply sharing your company or through volunteering.
  7. Contribute to Toys for Tots or another toy drive.
  8. Help the homeless.
  9. Make a charitable donation.
  10. Pay it forward.

There are many traditions this time of year, but one thing is certain. This is a time of giving and sharing with those around us, and that sharing is not only limited to those that we love and care for. It is also for the person that we have never met and will never see.

The Simple Gift of Presence

Donna Sollenberger, EVP & CEO, UTMB Health SystemHave you ever gone somewhere with a friend or family member, and the other person who sat at the table with you was busy surfing the web or texting someone else on their laptop or cell phone rather than interacting with you?

Conversely, have you ever experienced a difficult time in your life when someone came along and offered support in such a way that you felt cared for? This person may have been calming, reassuring, easy to talk to, and—most importantly—they understood your struggles.

The simple gift of another’s presence can be healing.

We all want the Best Care for our patients—we want to be sure they are cared for in the safest, most effective and most compassionate way. In a fast-paced care environment, however, it may sometimes happen that we forget that patients can feel vulnerable and nervous when in the hospital (or even in a clinic setting). In a hospital in particular, there are times when a patient can’t care for themselves. At other times, if left unattended, the patient could become a safety risk to themselves or others. At these times, they need compassionate, one-on-one observation to remain calm, safe and secure. Being closely watched also helps ensure they receive the highest standard of care possible. This is one reason why there are windows that look into the patients’ rooms at every nurses’ station in our hospital units.

Positive regard for another as a human being with value is at the heart of true caring. Engaging with someone usually extends beyond the exchange of words. It means we share our presence, including our behavior and actions. The way we talk to patients and visitors, the way we look at them, the whole quality of our presence, can make them feel understood and help them feel at ease. These compassionate behaviors help foster feelings in the patient and their family that we truly want the best possible outcome for them. In turn, their sense of well-being can promote wellness—did you know that, according to the Centers for Disease Control and Prevention (CDC), higher levels of well-being are associated with better immune functioning and speedier recovery? Our potential to affect others by being present is both a great gift and a great responsibility.

One patient sitter at UTMB, Joe Romfeld, demonstrated just this sort of compassionate care for one of our patients. Of Joe, a colleague recently wrote:

“Joe was an excellent patient care technician/sitter today. He was very attentive to our patient. He made sure the bed had fresh linens and that the patient had a clean gown. He even went so far as to disinfect the entire mattress before he put the clean sheets on. He made sure that the room was neat, and he disinfected all the hard surfaces in the room.

The patient had several episodes of nausea and vomiting, and Joe was very caring and compassionate. He did not get on a cell phone once today, and he sat in the room with the patient and made the patient feel comfortable and at ease.

I tell you this because it was so refreshing! In some of my past experiences with sitters, if they are in the patient’s room, they are often on their phones. Sometimes, sitters sit outside the room and have little interaction with the patient. Every time I went in the room, Joe asked me how he could help.

He is such a hard worker! He should be starting nursing school this coming fall, as he is just finishing his pre-requisites. He would be a wonderful employee—kind, compassionate, caring and a very hard worker. I have known Joe for over a year and have had opportunity to work with him many times. He has always had a strong work ethic and always put the patient first. I feel like a better person because I got to work with him today.”

Our caring presence is a way we can all demonstrate Best Care at UTMB. Whether we deliver care or simply interact with patients and visitors, we can be mindful of how others may be feeling. Even a momentary interaction can make a difference. Let us all consider ways we can cultivate our attention and our ability to attend closely to those around us, and in this way, we can bring care and concern to others. Take some time to give others the gift of your kindness!

“Never worry about numbers. Help one person at a time and always start with the person nearest you.” —Mother Teresa

Compassion is a verb.

Donna Sollenberger, EVP & CEO, UTMB Health SystemOne year during the holidays in Wisconsin, I realized I had forgotten to get a greeting card to give to my father-in-law on Christmas morning, which my family celebrates. So my son, Blake, and I went to the local drugstore to find one.

While we were in the greeting card aisle, I noticed another lady who was also looking for a card. She reached the cashier just before we did. Standing in line behind her, we overheard her conversation with the cashier.

“That’ll be $5.99,” he said.

“Oh, I think it is only $1.99,” she replied.

The cashier double-checked the price. “No, it’s $5.99,” he said.

“But it was on the $1.99 rack. It’s for my daughter,” she replied.

The cashier then said, “No ma’am, I’m sorry. It must have been misplaced on the rack. It doesn’t matter where it was, it’s $5.99.”

Clearly disappointed, the woman exited the line to replace the card on the rack. My heart truly went out to her. After I had completed my transaction, my son and I waited outside of the store. I just had this feeling that I needed to do something to help, because I could tell she couldn’t afford the card. When she came outside, we handed her a twenty dollar bill.

“Please, go buy the card you wanted for your daughter. Get her a small gift.”

I don’t know if I can really describe my emotions at that moment, as the lady’s eyes welled up with tears. I just knew I had to do something to help this person in need.

I remembered this experience because we are in the midst of the holiday season, but I wondered if there was something special we could all do for someone else—and not only during the holidays. Every day is a day for practicing kindness, compassion and generosity. We have opportunities daily to help our patients and visitors—and it doesn’t have to cost a cent.

Recently, Laura Amos, a patient care technician in the Galveston Recovery Room, stopped to help a patient who was walking with her IV pole in a main corridor of Jennie Sealy Hospital. The patient looked as if she was about to pass out. Laura noticed this immediately and asked the patient if she was okay. When the patient replied that she felt weak and dizzy, Laura stayed with the patient while another employee got a wheel chair. Then, Laura assisted the patient into the chair and helped take her to transportation, who escorted her to her room.

We can always offer something of ourselves to someone else at any time, whether it is our talent or a skill, a little moral support, or a word of kindness. After all, “Generosity does not come from wealth. Wealth comes from the flowers of kindness and love,” says physician and author, Dr. Debasish Mridha.

Laura not only demonstrated compassion for this person, but by being observant and proactively interacting with this patient, she also helped prevent a potential injury to the patient if she had fallen. This is a wonderful example of Best Care, and a wonderful example of how, by simply being aware of those around us in our hospitals and clinics, we have a real invitation to brighten someone’s day.

“The best part of life is not just surviving, but thriving with passion and compassion and humor and style and generosity and kindness.” ~ Maya Angelou