Create a culture in which excellence can flourish.

Donna Sollenberger, EVP & CEO, UTMB Health System“Whatever you or the public may consider quality to be, this definition is always a safe guide to follow: Quality is never an accident; it is always the result of high intention, sincere effort, intelligent direction and skillful execution; it represents the wise choice of many alternatives.” ~Will A. Foster

Each New Year is a chance to commit to what we hope to achieve in the future. Last week, we established four areas in which we will focus to be successful this year: continued investments in our people, quantum leaps in quality and safety, transparency with our outcomes, and the wise use of our resources. In this first Friday Flash message of FY16, I’d like to explore our focus on quality.

Quality is defined as the standard of something measured against other things of a similar kind—the degree of excellence of something. It can mean everything from caliber or condition, character or worth, and it can be good or poor. Defining health care quality, however, is a little more technical. In fact, if you conduct an internet search for the words “health care quality” you’ll find a long list of organizations working to promote health care quality in hospitals, and you’ll also see numerous guides on how to improve in areas like patient outcomes, 30-day readmissions, and healthcare-associated infections. You may even find an infographic or two on reimbursement calculations!

To make a long story short, much of what is out there is written by the health care industry for the health care industry—and it is complex! As an industry, we even have had to find a way to state it simply to steady our focus. The Agency for Healthcare Research and Quality (AHRQ), the federal government’s leading agency, defines quality health care as “doing the right thing for the right patient, at the right time, in the right way to achieve the best possible results.”

But what do our patients and their families think “quality” health care means, and what do they expect of us when we say that we are committed to quality? Several years ago, in an issue of the Journal of the American Medical Association (JAMA), Dr. Allan Detsky, an internist and health policy expert at the University of Toronto, identified criteria that patients expect when asked what they really want from health care.

He found, as one would expect, that patients want the best health care—they want to know that their care team is highly qualified and experienced, and they want to know the care they will receive is reliable, based on feedback from people they know, a referring physician, or other patients. This is not to say that patients don’t value statistics—our quality performance is currently publicly reported, so patients can compare us against other providers and know whether or not we are an excellent place to come for health care. It’s simply that they are more focused on whether the treatments they will receive will work in their specific case or condition.

The list of criteria is long, but the following are the most important aspects of care patients identified:

  • Timeliness. Patients desire access to services in a timely fashion.
  • Kindness. Patients want to be treated with kindness, empathy, and with respect for their privacy.
  • Hope and certainty. Even in dire situations, patients want to have hope and be offered options that may help. Patients and families are uncomfortable with uncertainty about diagnoses and prognoses. Therefore, they want to feel well informed, participate in decision making, and prefer active strategies.
  • Continuity, choice, coordination. Patients want continuity of care and choice. They want to build a relationship with a health care professional or team in whom they have confidence and have that same person or team care for them in each episode of a similar illness. They want the members of their health care team to communicate with each other to coordinate their care.
  • Privacy. Patients want to be hospitalized in their own room with their own bathroom and no roommate (this is something we proudly offer our patients at UTMB).
  • Low out-of-pocket costs. Patients want to pay as little as possible from their own pocket at the point of service delivery.
  • Medications and surgery. Patients prefer treatments that they perceive will require little effort on their part. Essentially, they want to feel “well taken care of”.

There is a much more important, patient-focused reason for making quality improvements: it’s the right thing to do. When we safely heal people and they have a positive experience in our care, they are more likely to follow through with their doctor’s advice and manage their disease processes, which leads to better patient outcomes and healthier patients in the future.

So, let’s focus on our patients’ experiences, with the understanding that they already trust us to do the right thing by delivering safe, evidence-based care and they trust us to monitor our own performance, much in the same way that we all trust airlines to make sure the plane is functioning well before takeoff!

Every individual in every role at UTMB impacts the patient experience in one way or another. This is why we must all focus on making the necessary changes to create a culture in which excellence can flourish. Whatever our work entails, we should reflect on the following:

  • Do we work together as a team, and are we committed to a culture of trust and safety, in which we can express our thoughts and concerns and constructively think together?
  • Do we demonstrate integrity by always doing the right thing for our patients and their families?
  • Do we show compassion and respect to all, so we not only work well together, but so that we are able to comfort patients and families during challenging times, or support them so they are motivated to heal? Do we promptly respond to patient and family concerns, whether by phone or the call button? Are we willing to take the time to explain things clearly and answer all of their questions?
  • Do we value diversity so that we can understand patients’ perspectives and preferences and fully engage them and their families in making decisions about their care and treatment?
  • Are we committed to lifelong learning, so that we are able to apply new knowledge and always explore better ways to enhance outcomes while remaining vigilant to assure patients’ safety?

If we are firmly committed to quality, and we practice safety measures the same way, every patient, every time, we will not only improve our performance, but we will be better able to focus on the experience of our patients and their families. At UTMB, we should always be able to look people directly in the eye and say: “The care you will receive at UTMB Health will be the same care I would want my most cherished of loved ones to receive.”

If you aren’t in over your head, how do you know how tall you are?

Donna Sollenberger, EVP & CEO, UTMB Health SystemEarly in my career, I worked as the administrator in the department of surgery of a small medical school in Central Illinois. It was a wonderful setting to begin my administrative career, because I had the chance to experience many opportunities I wouldn’t have otherwise been given at a much larger medical school.

One of those experiences surfaced around the advent of the personal computer. Our chair of surgery decided he wanted to replace the institutional mainframe with a local area network (LAN) for the whole department. And that would not have been a problem, except for the fact that he wanted the department to manage it, not the chief information officer (CIO) for the school.

The chair assigned one of our researchers, an individual with a great aptitude for computers, to negotiate this change with the CIO. After three months of meetings, however, neither side wanted to budge on who “owned” the network.

At that point, the chair told me that he wanted me to “broker” this deal and get the CIO to concede the management of the network to the department. Because he was my boss, I agreed, but I have to tell you I was reluctant—I knew very little about computers and even less about personal computers and local area networks! The only thing that boosted my confidence was that I generally could get people to come together and reach an agreement, even when they had not been able to before.

At the first meeting, I let the researcher and the CIO do most of the talking. I asked them to tell me, from their perspective, how each envisioned the system would be configured and implemented, and what each thought the barriers were to reaching an agreement. As the talking continued, I remember thinking that the meeting might as well have been in a foreign language, because I was not fluent in half the terminology they used once they got into specifics. I left the meeting wondering what I could ever do to move this discussion along, and I was a little concerned about whether I could actually get these two gentlemen to agree.

Rather than accept defeat, I began reading everything I could about LANs and their configuration, the future of the mainframe in a world evolving to use personal computers, and how others had managed similar implementations. I knew that in order to accomplish the job I’d been assigned, I had to educate myself. Although I was daunted by the learning curve, I was also energized by the possibility of learning about something which was definitely going to change how we worked.

When the project ended two months later, I had successfully brought the researcher and CIO to an agreement. Today, the details of that agreement have faded from memory, but what I do remember is that the CIO agreed to support us in putting the LAN in the department as a pilot for the rest of the medical school, the researcher could define the configuration, and the system would be maintained by the CIO and his team. Meanwhile, I had become the “go to” person in administration for other departments as they each began to implement their own networks.

Albert Einstein once said, “The only source of knowledge is experience.” I had used an opportunity to increase my value to the organization and better prepare myself for a changing future. And, I had helped the departments involved maintain a positive relationship.

I believe that with the right attitude, we can completely reframe the way we experience challenges—we can take advantage of challenging situations to unlock our untapped strengths and abilities. Each time we do this, it will increase our confidence until we begin to see most challenges as opportunities to harness our personal power to an even greater degree.

I am reminded about this story each time we take on something new. We have a choice: we can either resist change or even try to keep the inevitable from happening; or, we can personally take the necessary steps and contribute to making the change a success. If you refuse to let challenges intimidate you or slow you down, you just might inspire and motivate others to do the same when they face obstacles of their own. Anytime you experience personal growth, you help the people around you in some way!

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Honoring our past, embracing our future…

Donna Sollenberger, EVP & CEO, UTMB Health SystemThis week, I was honored to welcome attendees to the 2015 Neuro Nurses’ Day Conference, an opportunity for practicing clinical nurses to share and explore recent advances in Neurology and Neurocritical Care. The daylong event was held in the Ashbel Smith Building, which many of you know affectionately as “Old Red”.

As I approached the front steps of Old Red, I thought about what a perfect setting this was for a conference about innovation and advances in health care, because this is where nearly 125 years ago, 23 students and 13 faculty members began UTMB’s legacy to advance health care education, research and patient care. Just five years later, UTMB’s School of Nursing opened as the first university-affiliated nursing school in the U.S.

UTMB was founded as a center for scientific inquiry, a training ground for the future of medicine, and a catalyst for improving the health of society. Since that time, we have earned a reputation for graduating health care professionals who share a deep commitment to excellence, a desire to blaze new trails, and an unsurpassed willingness to leverage their extraordinary expertise to improve the health and well-being of others. Today, UTMB continues its legacy and builds on its rich history. This made me think of a principle that a former mentor had shared with me: Respect all that is good about the past while looking forward to the future.

As we embark on our journey to increase the value (cost + quality) of patient care, we must ground those advances in the history of UTMB that has served us well over the past 125 years. The work we do for our patients is incredibly diverse and often complex. We care for patients from all backgrounds, ranging from the most critically ill to those who seek routine preventive care to stay healthy.thumb_972D434E3BF7486F824579B8DCD36448

Therefore, the work that we do for our students and trainees is also diverse and complex, and it is why we recognize lifelong learning as one of our core values. Despite the complexity and challenges of an ever-evolving health care landscape, UTMB is continually recognized for its exceptional achievements.

Innovative approaches to education, like online courses, are helping us offer students alternatives to traditional classroom learning. Thinking back, I remember after Hurricane Ike, I was so impressed to learn that almost all of our SOM and SON curricula were placed online so students could continue their studies without having to physically be on campus. Now, we offer educational outreach methods on an ongoing basis, like the UTMB School of Nursing’s RN-BSN program, which allows current registered nurses an opportunity to advance their education by earning a Bachelor of Science in Nursing (BSN) degree in a 30-hour, two-semester online program; these innovative approaches to education continue to blossom.

This year alone, nearly 1,000 total faculty members are preparing a diverse student body of more than 3,000 individuals across the fields of medicine, nursing, health professions and biomedical research for a bright future; more than 1,300 of those future leaders will graduate this year.

As I think about our future at UTMB, regardless of the department in which we work, we all have many opportunities to work together collaboratively to make a difference —not just within our own department, but across the entire organization. We continue to seek ways to provide the highest quality of care in every patient interaction. We embrace lifelong learning to grow professionally and take advantage of special educational programs, just like the 185 attendees at this week’s Neuro Nurses’ Conference. We explore ways to share our knowledge and expertise both with our UTMB colleagues and with others who share our commitment to and passion for exceptional patient care.

As we embrace our value of lifelong learning and spirit of innovation, let’s strive to:

  • Reach our fullest potential, personally and professionally.
  • Be adaptable and flexible in our approach to our work so that innovation is a natural outcome of the way we work.
  • Remain open to new approaches and practices in our work.
  • Value the ideas of others and respond in positive ways—this does not necessarily mean we must embrace every idea we hear, but it does mean that we support a culture where new ideas and innovation are welcomed and freely explored.
  • Commit to putting our patients and families first, so that we advance patient- and family-centered care.

UTMB has an unparalleled legacy of service because of the caliber of its people, and in true UTMB spirit, we are thinking boldly about how we can expand the impact of our excellence nationally and globally. Each of us at UTMB Health can best honor our rich history of accomplishment and service by staying focused on our future. We commit to excellence in all that we do as we work together to work wonders for our patients.