Your silence gives consent. (Plato)

Donna Sollenberger, EVP & CEO, UTMB Health SystemMy passion for history began in middle school. In fact, much of my elective reading has always been about important historical events or the lives of famous people. Most of all, I really enjoy reading about the lives of presidents. Given the fact that I grew up in Springfield, Illinois, it probably would not surprise you to find out that I love to read about Abraham Lincoln. As a child, I grew up visiting Lincoln’s home and tomb, the Old State Capitol where the Lincoln/Douglas debates were held, and New Salem where a young Abraham Lincoln studied law by candlelight. Perhaps it also is not surprising that I love to read about President John F. Kennedy. When President Kennedy was shot, I was in middle school. That day was a defining moment in my youth. Even now, I read as much as I can about these two presidents.

Traveling a couple of weeks ago, I had forgotten my book. (I have a Kindle, but I still love to turn pages!) In the airport, I saw a paperback book called “Killing Kennedy: The End of Camelot”, written by Bill O’Reilly. I decided I would buy it, and I read it on the plane. To me, the best part of the book was about John F. Kennedy’s time in the Oval Office. In particular, I was fascinated by the account of the Cuban Missile Crisis and the Bay of Pigs.

In April of 1961, President Kennedy had made the decision to authorize the invasion of Cuba. First, however, he wanted to hear from his top advisors to determine if this was the best course of action. At the time, his Secretary of State was Dean Rusk, an Oxford-educated Rhodes Scholar who had served as a chief of war plans during World War II. He was experienced in organizing covert missions similar to this.

Dean Rusk had not been President Kennedy’s first choice as Secretary of State, and Secretary Rusk knew that. Consequently, he was not confident of his relationship with the new President. In a time when the President truly needed his advice, Secretary Rusk felt he should remain silent, despite the fact that he had shared with others that this operation was misguided and that it had a “snowball’s chance in hell” of succeeding.

Secretary Rusk was not the President’s biggest problem. His largest problem was that not one of his advisors was willing to give him their advice, because it was contrary to what the President wanted at that time. As a result, Kennedy gave the go-ahead on April 14, 1961 to proceed with the invasion. Almost immediately, the invasion was a disaster. Fidel Castro, who had recently overthrown Cuba’s American-backed president, had learned about the attack in advance from informants; meanwhile, the operation of attack did not go as planned. As a result, the Bay of Pigs invasion failed, and after less than a day of fighting, 110 men on the American side were killed and nearly 1,200 were taken prisoner.

This story resonated with me because perhaps the outcome of all of this could have been avoided if the people surrounding the President had been willing to speak up. But when they did not, many people paid the price for that decision.

Sally Hogshead, an author and professional speaker, once stated, “You will not make a difference by being quiet. You will make a difference by being heard.”

As a leader, I want people to challenge my thinking. It may not change my decision, but good decisions are made when all perspectives are heard. This does not mean the leader will always change his or her mind, but it does mean that all voices have been heard and considered.

Best Care requires that we speak up when we see something that can or may result in patient harm, and it requires that the person receiving the message listen carefully to what is being said. At UTMB Health, we are dedicated to serving others and improving the patient and family experience. We achieve this through demonstrating respect for our patients, their loved ones and our colleagues. When we respectfully offer constructive feedback, we do so with the intent to offer information that calls attention to a problem or prevents a potential problem. The objective is to have a conversation that leads to the best solution or course of action. Whether you are the individual receiving the feedback or the person delivering the message, maintaining a spirit of mutual respect and learning is of paramount importance.

As the person speaking up, we need to remember the following:

  • Whenever possible, convey your positive intent by choosing a good time to talk, when the other person can listen and respond thoughtfully. In instances when you are caring for patients, you may have to speak up at that moment in order to avoid patient harm.
  • Let the person know that you respect his or her position/role, and that is why you are willing to share this feedback. It is always best to discuss concerns directly with the other individual—avoid communicating through a third party. Take care with your words—focus on the behavior or action that needs improvement, not on the person. It is helpful to link the behavior or action to patient safety or other important business needs.
  • Maintain an objective tone. Listen objectively, as well.
  • Try to keep your message brief and concise. When possible, consider picking out one or two significant consequences of the action and discussing them.
  • Be sure to include specific descriptions as part of the conversation. Facts generally point toward a solution.
  • Leave the responsibility for action with the other person. If there is still the possibility for patient harm and the appropriate action is not taken, escalate the concern immediately.
  • Always thank the other person for their time, and ask them to reflect on the message, if that is possible.

As the person receiving the message, we need to make sure that we:

  • Focus on the content of the message, not on the person.
  • Realize and be appreciative that someone is making sure every action taken is being done in the best interest of our patients.
  • Listen calmly and attentively. Try not to plan a response while the other person is speaking (we are not really listening when we are busy thinking of how we will respond).
  • Listen with an open mind and acknowledge the other person’s concerns.
  • Ask questions to confirm your understanding.
  • Try not to take offense—instead, welcome suggestions.
  • Maintain an awareness of your feelings, but also try to suspend judgment or reaction until you have had time to consider the suggestions that were offered. Truly consider what is being said.
  • Respond respectfully, and thank the other person for expressing their thoughts or concerns.

The story of Secretary Rusk and President Kennedy is a great reminder of why every member of the team must be willing to speak up and be heard. It is only when we do this that we will achieve Best Care!

“If we remain silent, we are guilty of complicity.” – Albert Einstein

One person can make a difference, and everyone should try.

Donna Sollenberger, EVP & CEO, UTMB Health SystemBefore I share the patient letter I recently received, I wanted to begin with a story. Written by Loren Eiseley, I thought it was a great example of how each of you, through your everyday service and care of our patients and their loved ones, make a big difference. Although you may not always immediately see or hear about how the work you did impacted someone else’s life, your efforts often carry a significance far greater to others than you may realize.

“Once upon a time, there was a wise man who used to go to the ocean to do his writing. He had a habit of walking on the beach before he began his work.

One day, as he was walking along the shore, he looked down the beach and saw a human figure moving like a dancer. He smiled to himself at the thought of someone who would dance to the day, and so, he walked faster to catch up.

As he got closer, he noticed that the figure was that of a young man, and that what he was doing was not dancing at all. The young man was reaching down to the shore, picking up small objects, and throwing them into the ocean.

He came closer still and called out “Good morning! May I ask what it is that you are doing?”

The young man paused, looked up, and replied “Throwing starfish into the ocean.”

“I must ask, then, why are you throwing starfish into the ocean?” asked the somewhat startled wise man.

To this, the young man replied, “The sun is up and the tide is going out. If I don’t throw them in, they’ll die.”

Upon hearing this, the wise man commented, “But, young man, do you not realize that there are miles and miles of beach and there are starfish all along every mile? You can’t possibly make a difference!”

At this, the young man bent down, picked up yet another starfish, and threw it into the ocean. As it met the water, he said, “It made a difference for that one.”

Each day, when you do something special for a single patient, for all of our patients as a whole, or even in support of a colleague, it matters. The letter that follows, which was written by a patient’s wife, provides a powerful example of how one of our employees, Care Manager Mary Jacinto, made this sort of tremendous difference in a family’s life.

As you know, a key strategy of UTMB’s Best Care initiative is to manage our patients’ care, not only while they are in the hospital, but also after they are discharged. For many patients, this is to help prevent readmission (for example, the care manager may follow up to make sure the patient is taking their prescribed medications); for others, the goal is to help patients transition to another level of care or to help them find the resources they need to continue their care plan once they’re home. This letter tells the story of how, through Mary’s actions, she helped save a patient’s life:

“We want you to know how Mary Jacinto helped save my husband’s life. Back in September 2015, Michael [patient’s name is used with permission] got sick and was admitted to UTMB Galveston. Michael had cirrhosis with ascites, an enlarged spleen, an aortic aneurysm, hepatitis C and chronic obstructive pulmonary disease (COPD). After Michael was discharged, this is where Mary came into our lives as Michael’s Care Management Nurse.

We didn’t have insurance and little money. Mary got Michael lined up with the Freeport Clinic, so he could get the medical attention he needed. He wasn’t getting better and needed further medical attention. Mary used her resources and got Michael set up as a casebook study at UTMB.

In May 2016, we found out Michael had liver cancer and without a transplant, he only had a year to live. We still did not have insurance. I had tried several times to get insurance and wasn’t successful. Mary took the time to sit with me, and we did a conference call with the Health Market Place. We got insurance, effective June 1, 2016.

Then, Mary got Michael set up with the Liver Transplant Clinic. On August 8, 2016, Michael got a liver transplant at UTMB Galveston. He is doing fine and is very thankful to be alive. Because of Mary’s persistence, perseverance and caring ways, Michael is alive today! She is a very special person! We call her our angel! We want Mary to get the recognition she deserves.”

This is just one example, but this sort of amazing care takes place every day at UTMB. I can go on and on with examples of how individuals and teams across UTMB contribute to Best Care. In fact, just the other day, after a power outage in League City, individuals from Clinical Equipment Services, Nursing Services and many other areas discovered and preempted a potential patient safety issue with back-up batteries and emergency power. They then immediately took action to resolve the problem in a single evening. Some of the individuals who helped weren’t even on schedule that night, or they came in early the next morning to ensure everything had been addressed. To me, this sort of teamwork is outstanding and it proves that often, it is not one person or one action that makes the difference; it is the collective efforts of many who are working together toward a common goal.

As we continue the Best Care initiative and receive feedback from groups across the organization, leadership has learned that many people still aren’t sure how they impact Best Care. Although Best Care is largely focused on some areas for improvement that are difficult to impact for those who do not deliver direct patient care, I want to emphasize that each of you plays a very important role to the overall Best Care initiative. When it comes to helping patients navigate the health care system, ensuring they have a positive experience, or making sure needed supplies are delivered and facilities are operational, through your collective service, you make an impact.

Never doubt that one person’s efforts can make a difference. It did for Michael and will for so many others.


November 11 is Veteran’s Day.

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Save

It is in the shelter of each other that the people live.

Donna Sollenberger, EVP & CEO, UTMB Health SystemThere is a proverb that says, “It is in the shelter of each other that the people live.” Have you have been in a position at some point in your life when you had to rely on the generosity of others? I would guess that most of us have. I know it has been true for me.

When I was 15 years old, my father unexpectedly lost his job. With three children and a wife to support, he was devastated and very worried about our family’s future. Fortunately, two things happened which made it possible for our family to transition through this challenging time until he got a new job.

First, my parents decided that my mother should return to work. In the mid-1960’s, a mother working outside the home was not the social norm. Nevertheless, my mom had been an exceptional legal secretary before she decided to stay home to focus on raising me, and eventually, raising my brother and sister. Fortunately, she had stayed in touch with her former employer during this time. So when my dad lost his job, my mom made an appointment to meet with her former agency to see if they had any job openings. Fortunately, they were hiring, and they offered her a job on the spot.

I remember there were tears of relief when my mother came home to say she would start working the following Monday. Because I was the oldest, my mother sat down with me to ask for help. She would need someone to be home for my brother and sister when they returned from school, and she would need me to cook dinner. I was so relieved that she would be able to help my dad and our family that I quickly agreed to do as she asked, even though it meant I would be giving up some of my after-school activities. To me, it felt like a small price to pay for my family’s future.

The other source of help we received came from my grandparents. I am not sure if my parents ever realized that I had overheard them asking my grandfather for a loan until we could get back on our feet. Fortunately, this is something my grandfather was able to do, and he told my parents not to worry about paying him back until they felt they were in a position to do.

This period of my life taught me a lot. First, the example of my mother’s former employer hiring her back on the spot taught me that it is important to stay in touch with people with whom I have worked in the past, as well as the importance of doing the best job possible while in their employ. Whether this relationship results in receiving a good reference or in assistance getting another job when the time is right, former employers and supervisors can be invaluable in helping us find future opportunities, should we ever need their assistance.

Secondly, and most importantly, I learned about the generosity of others and how it can make a tremendous difference in another person’s life when they need help. Whether the difficulty is losing a job, coming down with a serious illness, or any number of unfortunate and unforeseen circumstances, anyone can experience a situation in which they may someday need to rely on the help of others. This is the lesson foremost on my mind this week as we approach the close of this year’s State Employee Charitable Campaign (SECC), which ends on November 14.

Because of my experience as a 15-year-old, I have always supported organizations I believe in, such as the more than 300 charities represented by SECC. I have found that there are few things in life as satisfying as giving generously to help others, even though we may never know who has benefited from our gift.

For those of you who have already given to SECC, thank you! To those of you who have yet to donate, I hope that you will do so today. No amount is too small, and it is so easy to give. You can write a check for a one-time donation, or you can make a one-time or monthly gift through a payroll deduction. I know that some of you may not be in a position to give, but for those who are, please donate today. And remember, no gift is too small—we are harnessing the power of collective giving. Together, UTMB’s contributions will go far!

giving-donnas

Happy National Radiologic Technology Week (Nov. 6 – 12). Thank you for everything you do to deliver excellent patient care and promote healthcare safety!