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!

Safety Doesn’t Happen by Accident

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

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

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

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

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

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

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

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

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

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

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

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