Good is the Enemy of Excellence

Donna Sollenberger, EVP & CEO, UTMB Health SystemA couple of weeks ago, I shared a little about my experience recovering from knee surgery. It has been a little more than two months since my journey began, my progress has been steady, and each day I have less and less pain. Immediately following the surgery, I was diligent in every aspect of my rehabilitation program, because I wanted to keep the swelling down, return to my full range of motion, and be able to walk without pain as soon as possible. Now that I am much more mobile and the swelling is minimal, I admit I have had a tendency to fill the time I should be doing my rehabilitation exercises with other things “I need to do”. After all, my range of motion and flexibility seem “good enough.” But is this really true?

There are many things I will want to do in the future that will require my full recovery from the surgery. Although I am in the process of healing, in the end I want to be in even better condition than I was before. If I don’t stick with my plan of care, my ability to do everything I want to will be limited. This means I must get back to aggressively rehabilitating my knee. In order to do this, I need to take the thought that I’m doing “just good enough” out the picture and settle for nothing short of full recovery of the use of my knee.

When I think about my journey so far, it feels a little like I’ve been running a marathon. At the starting line, I had been pumped and ready to go with my rehabilitation plan, my ambition was high and I was ready to cross the finish line in front of a cheering crowd on my new knee. But as the time passed and the miles accrued, I grew a little tired of doing the work. As I let myself slow down a little, it became tempting to let up even more—but if I were to stop, I’d be short of my destination. Looking back at how far I’ve already traveled, and looking at the little distance I have remaining, I realize I have to push through just a little longer to achieve true functional excellence.

Laurence McKinley Gould has said that “good is the enemy of excellence.” Others have modified the phrase to be, “good enough is the enemy of excellence.” Either way, being “good enough” implies that we are ready to accept some degree of mediocrity. As I think about my knee and rehabilitation in that light, it is clear to me that instead of charging ahead with my aggressive rehabilitation, I have recently chosen to travel the road of mediocrity. However, I know that I want to be on the road to excellence, not mediocrity!

Of course, this motto applies to many things in life, doesn’t it? Sometimes when we have a lot on our plates and we’re working on so many big projects/task, it can be tempting to feel that something is “good enough” so we can check that item off our to-do list and move onto the next task at hand. But if we truly want to achieve real excellence, we have to hang in there, giving it our all until we reach our goal.

At UTMB and in the health care industry, we realize the pace of progress can sometimes feel intense. We’re wrapping up the budget in a new system. Meanwhile, initiatives are underway to improve access and expand services for our patients. We’re building and renovating facilities, redesigning processes, optimizing the Epic EMR, and so much more. We’re even almost done planning our strategy for the coming year. Progress is continual, but every goal we set for ourselves is designed with one ultimate aspiration in mind: to be the best!

Excellent patient care and service starts with us. Our endeavor to be a patient-centered, highly reliable, value-driven organization; the first choice in the region for patients, physicians and employees; an exceptional value to payers and businesses; and a state and national leader in care delivery—well, it’s no small feat.

To be the best, we have to remember our passion for what we’re doing. When we start to feel like we’re doing just “good enough”, that’s when we need to remember why we began the journey. We each have different roles to play in achieving excellence as a health care provider, but whatever our part, whether we’re helping our patients, their families or our colleagues, we want to make a difference. And remember, you ARE making a difference! Don’t forget to look back and see how far we have come as an organization—everyone working together has made outstanding progress. Celebrate milestones. Take the time to recognize those involved who have helped make team accomplishments a reality.

It’s sometimes easy to lose sight of the big picture when you’re in the midst of day-to-day tasks combined with long-term projects. It’s understandable that we may sometimes feel as though we’re in a “just run fast continuously” environment. But keeping the end goal on our radar screen and remembering why we are dedicated to excellence will go a long way towards ensuring we remain inspired to reach the finish line.

 “Excellence is the result of caring more than others think is wise, risking more than others think is safe, dreaming more than others think is practical, and expecting more than others think is possible.”
― Ronnie Oldham

Finishing line

Aloha Spirit, UTMB Spirit

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

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

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

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

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

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

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

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

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

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

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Nursing is an Art

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

nursing is an art