It is not the ship so much as the skillful sailing that assures the prosperous voyage.

Donna Sollenberger, EVP & CEO, UTMB Health SystemWhen I got home from work Tuesday night, my husband motioned to me to come to the window. We live in a condominium and have a view of the Gulf of Mexico from many floors up. When I walked out on the balcony, I saw a sailboat about 50 yards from the beach that was tipping at about a 45 degree angle to the water’s surface. The sailboat had gotten too close to the shore, so much so that the keel got stuck in the sand. For those of you, like me, who may not know much about sailing, the keel is the flat blade sticking down into the water from the boat’s bottom that prevents it from being blown sideways by the wind, and it holds the ballast that keeps the boat right-side up. With the keel stuck solidly in the sand, the boat was now at the mercy of a considerable wind.

I watched for the next several hours as five trucks, chains and many workers painstakingly tried to pull the boat to shore. In all, it took about six hours and many people to free the boat. During this time, I began to wonder about those sailing the boat and how they found themselves in this predicament. Did they not have a depth finder? Was it broken? Was the wind so strong that they could not overcome its intensity? Were these novice sailors, unfamiliar with navigating their boat? Many possibilities ran through my mind as I watched this scenario unfold.

I observed how carefully the workers orchestrated each move to secure the boat and bring it to shore. They did not rush the rescue. Instead, their moves were slow and calculated. It was clear that they had a strategy to free the sailboat, but they did not rush their work. Meanwhile, a crowd of observers had slowly gathered on the beach during the rescue. I was amused that some set up “camp” and brought beach chairs and refreshments. Others walked up, watched for a while and then moved on. Everyone remained respectful of the team that assembled to rescue the sailboat.

Throughout this situation, I thought about the importance of having the right experience, expertise and most importantly, having a solid plan. Through our many efforts in support of Best Care, we have already shown that we can generate good patient outcomes, and we must remain dedicated to continuing this success. The next step toward becoming the premier health system in Southeast Texas, with a national reputation for excellence, in an environment that supports the delivery of Best Care to every patient, every time, is to become a destination for care by showcasing our clinical expertise.

UTMB’s Clinical Strategic Plan (CSP) is our map to this goal. Since unveiling the CSP earlier this year and discussing our plan with faculty and staff, many have asked why and how we formed the plan. Health care is an ever-evolving environment, and it can sometimes feel a little like navigating uncharted waters. No sailor can control the wind, but they can adjust their sails to get to their destination. That’s why carefully charting one’s course is so important. You can’t always get from point A to point B in a straight line, so it’s important to know where you’re headed. It is also important to carefully assess the waters and study the currents to identify the direction in which they flow.

We charted our course by performing an analysis to determine which service lines should receive targeted focus to ensure future growth. After all, it doesn’t matter how fast you sail, if you’re not sailing in the right direction! By organizing, integrating and delivering a comprehensive set of services around a major disease entity, age group or patient population, we are not only able to promote efficiency and cost effectiveness, but more importantly, we strengthen our commitment to our patients – this is critical in today’s challenging health care environment.

Our analysis allowed us to hone in on programs that most closely met select criteria, including alignment with the Research Strategic Plan. This was an important factor because through cutting-edge discoveries, we are not only able to provide patients with the best evidence-based care, but also clinical trials, which is something that makes UTMB unique. We also considered areas in which we had significant experience and expertise, clinical productivity, opportunities for growth, and market need and opportunity.

Working together with physician advisors, employee advisors, and patient and family advisors, UTMB determined that our plan will begin with focused investment in two UTMB Health Service Lines: an Integrated Neurosciences Service Line and an Eye & Ear Institute. There is a need in the market for these services, and they provide opportunity for future growth, because many times patients who see us for one reason have additional conditions that require use of other specialties.

For example, we learned in our research that patients who see us for neurosciences services have a greater need for musculoskeletal and heart services. Thus, not only will the neurosciences program grow, but additional services will benefit. Because visual impairment and hearing loss often occur together, particularly among older adults, we chose Eye & Ear as our second targeted service line. This will help grow ophthalmology and otolaryngology specialties on both the mainland and the island. Primary care will also remain an important focus in the communities UTMB serves.

Worthwhile goals are rarely attained via short routes. This is why the Clinical Strategic Plan is a long-term, five-year plan. While these two leading service lines will receive the majority of investments in the initial years of the plan, other programs and specialties will receive investments, as well. These investments will occur throughout the term of the plan via “incubator” opportunities and existing program expansion. For example, we are already planning to develop an Oncology Service Line plan in preparation for the opening of the MD Anderson Cancer Center outpatient facility on the UTMB Health League City Campus in the summer of 2018. Other services with high potential for future service line development include gastroenterology, musculoskeletal, and heart, thoracic and vascular services. We must build on our growth (i.e., planning for next services) as we implement initial service line plans. We will carefully track our progress and make course corrections as needed along the way.

There is a quote, “It is not the ship so much as the skillful sailing that assures the prosperous voyage.” Growth and partnerships, patient experience and operational excellence are all important parts of UTMB’s vessel, and successfully sailing a large vessel like our clinical enterprise requires a skilled, dedicated and passionate crew. At UTMB, we are a strong, innovative and diverse team, and we are passionate about working together to deliver the Best Care to every patient, every time. With success, we will arrive at our destination, achieving increased patient volume and revenue, and securing UTMB’s financial health and reputation, both regionally and nationally.

Attitudes are contagious. Make yours worth catching.

Donna Sollenberger, EVP & CEO, UTMB Health SystemI have always considered myself an optimistic person. Even when things are not going well, I generally try to see the positive side of the situation. Although I can’t always see the positive benefits at the immediate moment something is happening, I’ve learned that with time, lessons will surface from whatever it was that caused me concern or discomfort, giving me a better perspective.

A few years ago, I told you all the story of how I fought my wet kitchen tile, and the tile won. I had started my morning the way I usually do. I got up, got ready for work, and went into the kitchen to grab my lunch from the refrigerator. As I rounded the corner, I was greeted by small bugs all over my kitchen floor, so I sprayed them with insect spray. Afterward, I mopped up the mess. With the chore completed, I picked up my keys and briefcase, then I started walking across the kitchen floor again to get my lunch, even though I knew it was risky to walk on a slick floor. And guess what happened? I slipped and broke my leg!

I was devastated to learn that the type of fracture I had meant that I would not be able to put any weight on my leg for two months. I was grateful I did not need surgery, but I could not imagine how I would survive for two months stuck in a chair or lying down. On top of that, my injury meant that I would have to cancel a long-planned trip that had been on my bucket list. This dampened my spirits at first, but once I realized that my attitude was not helping my family and friends who were trying to help me, I decided I immediately needed to change my attitude. I cannot control everything that happens to me, but I can control how I react to it!

There is a quote that I like: “Attitudes are contagious. Make yours worth catching.” It’s really true. There are certain people that I love being around, because they always lift my mood. My husband is one of those people. He smiles all the time. Even when I want to be mad at him for something, he smiles, and I can no longer be angry. This really used to annoy me! When I asked him why he always does this, he reminded me that it is hard to stay mad at a person who is smiling. It’s true, his positive attitude is contagious!

I think it is also important to remember that our attitude is not only conveyed with words. Attitudes can be conveyed by facial expressions, body language or even the tone of one’s voice. Usually, even if you think you are masking the fact that you are in a poor mood, you probably are not—people tend to pick up on these subtle, non-verbal clues. When we aren’t in the best of moods, sometimes simply taking a few deep breaths or going for a short walk can help us get back into a better state of mind.

When it comes to speaking with others, I generally try to put myself in the other person’s shoes, particularly when I feel as though someone is asking a lot of me, they are being very demanding, or I am speaking with someone who is dealing with something very difficult. I try to project a positive attitude in these situations, because I have found that this helps others feel more positive about whatever reason they have come to me. On the other hand, I have noticed that when I am in a bad mood, that has an influence on the mood of those around me. This is why I believe in the importance of starting every day with the intention of bringing a positive attitude and positive energy to the workplace.

In fact, I recently read an article that said the mood in which we first come to work can affect our entire job performance. When we are in a good mood, we have more energy, we are more focused, more articulate, and we are open to new ideas. However, when we are not in a good mood, we are more easily distracted, less focused and less creative. For example, consider how this comes into play when working with others to solve a problem. Here are a couple of scenarios:

Scenario 1: Have you ever brought a problem or an idea to a team for discussion? Imagine the responses you received were something along the lines of the following: “Things are different here. It won’t work,” or “We’ve tried that before, and it doesn’t work,” or, “If it’s not that broken, don’t fix it,” or “Just try to fit in and ignore it. Maybe the problem will go away.” How would you feel after that type of encounter? Disappointed? Discouraged? Frustrated? After you left that meeting, you might remain focused on those feelings, and this would likely show through in your attitude. Meanwhile, the team members who did not have a positive attitude about finding a solution to the problem potentially missed out on an opportunity to make a beneficial change; additionally, they may very well have stifled the creativity of the group in the future.

Scenario 2: Now, let’s take the same situation, but this time, the types of responses you heard were, “It will be hard, but if we put our heads together, surely we will find a solution,” or, “We have tried that here in the past, but times are different now, so let’s see if it will work,” or, “I think it is a great idea to try and solve this, but there may be a step or two we have to complete first in order to tackle this.” How might this make you feel? Hopeful? Confident? Valued? All of these feelings can also show through in your attitude. And on the other side of the coin, the team is building a culture that welcomes the exploration of creative solutions.

I know that for me, I definitely want to work with the supportive individuals in the second scenario. I would much rather be surrounded by people with a “can do” attitude. I also prefer to be around individuals who want me to be engaged, work with me as part of a team, and desire to solve problems or make necessary changes.

I remember once many years ago, a friend I worked with who was a very successful researcher came into my office with a problem. He told me he was certain I would never be able to help him solve it, but he wanted me to help him change his perception of the problem.

I told my friend, “You know, I am an optimist. I think everything can be solved. We just need to keep looking.”

“Do you know the problem with being an optimist, Donna?” he asked. “The problem with being an optimist is that you are never pleasantly surprised.”

To this day, I disagree with my friend! I do not believe that I should change my whole attitude to one of doubt just so I can be surprised when something does go right. I choose to remain optimistic about my life and my work! When I am positive, I see more possibilities than problems. When I am optimistic, I connect better with those around me. This is because we all feed off positive energy.

In the coming week, let’s all try to focus on bringing positive energy to UTMB. Even when we are not in as good a mood as we could be, let’s try to refocus our energy in a more positive direction. Whether as an individual or as a team, a positive attitude makes a big difference, and most of all, it helps us better serve our patients and their loved ones. If we all give this a try, and we notice how our good mood affects our interactions with others, we will find our positive attitude has been contagious, and we will be surrounded with positive, “can do” people!

Wisdom is knowing the right path to take. Integrity is taking it.

Donna Sollenberger, EVP & CEO, UTMB Health SystemAs many of you know, I grew up in the Midwest with wonderful parents who taught my two siblings and me many important values that have served us well throughout our lives. Our parents were always clear about their expectations of us, and my brother, sister and I tried to live up to those expectations. My dad also had some pretty strong opinions about education, work and integrity. To my dad, honesty and integrity were essential to making and keeping strong and trustworthy relationships.

We lived in Springfield, Illinois, and my parents did all they could to make sure we were safe and that we made good decisions about personal safety. My dad was not a fan of motorcycles, based on some past history of a friend who had a very bad experience while riding one. As a result, one hard and fast rule of my father’s was that we were never to ride on a motorcycle. While there were some shades of gray in a handful of his expectations of us, there was no gray area in this rule—you either rode on a motorcycle or you didn’t, and it was clear that our dad expected the latter.

One weekend during the summer between my junior year and senior year of high school, I was invited to a friend’s birthday party. I remember we were all enjoying music and the night air when my friend, Steve, arrived. He approached me and told me he wanted me to see something new. We went to the street in front of my friend’s house, and there sat a beautiful black and chrome motorcycle.

“Let’s take it for a spin!” Steve said.

“Oh, I can’t,” I responded.

“Why?” asked Steve.

“My dad forbids it,” I explained. “You have no idea the trouble I would be in if he ever found out that I rode on the back of a motorcycle.”

I think Steve could sense that he might still be able to convince me. “It’s Friday night. Your parents never go out, and we are a good ten miles from your house. They’ll never know,” he persuaded.

I was at the crossroads of an important decision. Steve was right—my parents would never know. They never went out because they always stayed home with my younger brother and sister unless I babysat for them.

Well, you can guess what happened. Yep, I rode on the back of Steve’s motorcycle. We took a quick spin down McArthur Boulevard, rode through Dairy Queen and then back to my friend’s house. It had only taken me a mere thirty minutes to break one of Dad’s strictest rules.

The next morning, I was in the kitchen when my father came in for breakfast. “Were you riding on a motorcycle through Dairy Queen on McArthur Boulevard last night?” he asked.

At that moment, all I could wonder was how on earth he could possibly know. “Why are you asking that?” I could feel my face getting flushed with guilt, but I kept my composure.

“Because our friends, Lilly and Jim, were at the Dairy Queen last night, and Jim called me this morning to say they had seen you drive through the parking lot on the back of a black motorcycle driven by a young man,” he said.

Okay, this was the moment of truth. Did I tell him what he thought he already knew and confess, or would I deny the whole thing? Then I blurted out, “I was at Roxy’s all night. I don’t know who Jim and Lilly saw, but it wasn’t me.”

“Are you sure?” asked Dad.

“Positive.”

And then, the next four words that tumbled out of my mouth would haunt me for the rest of the day. I said it again, “But it wasn’t me.” Those. I had just been dishonest with my dad. I felt terrible the rest of the day and hardly slept that night.

The next morning in church as I sat next to him, the sermon was about being honest in your dealings with your fellow man. Honestly, I squirmed all the way through church that day. Later that afternoon, I could stand it no more. I went to my dad and confessed what I had done. I was expecting the worst.

Dad asked me why I told him, and I said that I felt so terrible about not telling him the truth that I would rather face the consequences of my bad choice than to be dishonest with him. Fortunately, he accepted my apology and asked me not to be dishonest with him ever again. It was a great lesson for me, because I not only learned how important integrity is, but I also learned how terrible it feels to not demonstrate it. I also learned another great lesson from my dad—he knew how terrible I felt and believed that was punishment enough.

One of our core values at UTMB is integrity, which means that we are always honest in our dealings with our colleagues and our patients. It means that even when it is difficult, we must hold ourselves accountable for our actions and words. We must demonstrate honesty in all dealings. It is a critical value, because it is the foundation on which strong and lasting relationships are built. Without integrity, there can be no trust.

Many of you may have heard the saying, “Character is who you are in the dark.” Integrity is a quality of character that can’t outwardly be seen by others; it’s how we would act if no one was looking. People with integrity do the right thing whether or not they will be recognized for it. Integrity is also fundamental to our personal peace. When we are honest with ourselves and others we also are at peace with ourselves.

A good friend of mine once told me that she might not have a lot, but she would always have integrity. As I think about it, my friend actually had everything because she had integrity. I hope as we reflect on all of our core values at UTMB, that we all remember the importance of integrity. We trust one another to do the right thing, and moreover, our patients and their families trust us do the right thing. We cannot have a safe, reliable environment without integrity! Integrity is the key to having a culture in which we always offer the very Best Care and service!

 


Reminder! Next week is UTMB Nurses and Health System Week (Monday, May 8 through Friday, May 12). Check out the schedule of events below!

Monday Kick off with Balloons & Banners

  • 6:00 a.m. – 9:00 a.m. TDCJ Hospital Breakfast (Second Floor, TDCJ Cafeteria)
  • Walk a Mile in Our Shoes Executive Leadership Shadowing Nurses
  • Blessing of the Hands

Tuesday

  • 6:30 a.m. – 9:30 a.m. Hospital Admin Breakfast Jennie Sealy 4th Floor, League City and Angleton Danbury Campuses
  • Ambulatory Breakfast Delivery
  • 7:30 a.m. – 8:30 a.m. Nursing Research Journal Club, Jennie Sealy Rm 2.410D
  • 10:00 a.m. – 4:00 p.m. Blood Drive Jennie Sealy 4th Floor
  • 2:00 p.m. – 3:00 p.m. Nursing Research Journal Club, Jennie Sealy Rm 2.506B
  • Walk a Mile in Our Shoes Executive Leadership Shadowing Nurses
  • Blessing of the Hands

Wednesday

  • 7:00 a.m. – 8:30 a.m. Coffee with David Marshall, Jennie Sealy Room 2.506A
  • 12:00 p.m. – 1:00 p.m. ANA Webinar, Nursing: The Balance of Mind, Body and Spirit, Jennie Sealy Room 2.506A
  • 1:30 p.m. – 3:00 p.m. Coffee with David Marshall, Jennie Sealy Room 2.410D
  • Walk a Mile in Our Shoes Executive Leadership Shadowing Nurses
  • Blessing of the Hands

Thursday

  • Nurse Leadership Appreciation Lunch
  • 2:30 p.m. – 4:00 p.m. Awards Ceremony, Research Building 6, Room 1.206
  • 4:30 p.m. – 7:30 p.m. Pet Therapy, Jennie Sealy Room 2.506B
  • Walk a Mile in Our Shoes Executive Leadership Shadowing Nurses
  • Blessing of the Hands

Friday

  • Noon – 2:00 p.m. Cake and Ice Cream for Florence Nightingale’s Birthday, Jennie Sealy 4th Floor, League City and Angleton Danbury Campus
  • Cakes to Ambulatory
  • Ice Cream Distribution for Night Shift
  • Walk a Mile in Our Shoes Executive Leadership Shadowing Nurses
  • Blessing of the Hands

Celebrating our first year in Jennie Sealy Hospital

Donna Sollenberger, EVP & CEO, UTMB Health SystemThe ninth of April marks our first anniversary in Jennie Sealy Hospital! I can hardly believe how quickly time has passed since the day we officially opened. I remember it was hard to contain our excitement as we moved into the new hospital. It was like taking the first step into a bright and vibrant future, bringing along with us a 125-year legacy of patient care, education and research.

I recall that of the 185 patients we safely transported to our new hospital that day, our first and last patients were both former faculty members who had worked at UTMB many years ago. The last patient had even met his wife, a nurse working in John Sealy Hospital at the time, while he was a medical student here—to me, it was a perfect example of how the threads of our past are so tightly intertwined with the fabric of our future.

The weeks before we opened the hospital were quite an amazing experience. I remember the feeling of finally being inside the building that I had watched being constructed over the years. I remember being awed by the beauty of the light pouring in through the windows of the foyer and the stunning view of the Gulf of Mexico from the 11th floor. I also remember the day they hung the art throughout the hospital and how it truly transformed the space. In the words of Florence Nightingale, “Never underestimate the healing effects of beauty.” I couldn’t wait to see the reactions of patients and visitors as they stayed with us in our beautiful new hospital.

Today, Jennie Sealy Hospital is buzzing with activity. Our students are receiving their education in this state-of-the-art facility. Our faculty and staff, who have a tremendous passion for patient care, are busy performing remarkable work each day. As of this anniversary, more than 12,000 patients will have been discharged from Jennie Sealy Hospital. Every day, I am touched by patient testimonials and amazed by the talent and expertise of our people. We could not fulfill our missions of patient care, education and research without you! Each of you is an important thread that creates the fabric of UTMB as we work together to work wonders.

That said, I want to thank all of you for meeting and exceeding the expectations of our patients and their loved ones. UTMB could not work wonders without you, Jennie Sealy Hospital would not be a wonderful place to receive patient care without you, and words can’t really express how much I appreciate everything you do to make sure our patients are well cared for. Congratulations to all on one year in Jennie Sealy Hospital!

one-year-in-jennie

Going above and beyond

Donna Sollenberger, EVP & CEO, UTMB Health SystemYesterday, I received a letter from one of our patients, and I wanted to share it with you all today, because I think it is a wonderful example of how when we do just a little more than is required for our patients, and we do so genuinely, we lift them up. Going the extra mile for our patients doesn’t always require being faced with a patient who has dramatic needs or challenges. Sometimes we can demonstrate care for our patients through a simple act of kindness or comfort, or finding a way to make the patient’s experience and process of care as convenient as possible for them. That’s exactly what happened in this case, and it helped make one of our patients feel truly cared for:

I am writing this letter to recognize the outstanding service that I received on March 21st and March 22nd from two of your employees. I had a doctor’s appointment at the Harborside Medical Group office and came in contact with Alina Valdez. When I arrived and checked in, the first receptionist could not get my parking ticket validated. She handed it off to Alina and after 10 attempts she was able to obtain a validation code.

After I finished my appointment with my physician at approximately 5:20 p.m., I went back to the reception area and the only one there was Alina. I told her the doctor ordered an X-ray and that I would need to make an appointment (I knew it was after 5:00 p.m.). Alina explained that she could get me over to the main hospital; she knew that Olivia Martinez in Radiology also stays late, and they could get my X-ray done that day so I wouldn’t have to make another trip or visit. I also needed to make another appointment to see a specialist, which Alina handled, scheduling my appointment for the next day at 11:00 a.m.

Alina made several follow-up calls and kept me informed. It is my belief that Alina went out of her way to assist and accommodate me for no reason other than I was a patient, and Olivia also was very helpful. They didn’t have to be.

I would greatly appreciate someone recognizing these two ladies for their care and dedication to both UTMB and me as a patient. I am truly impressed and know the value of dedicated employees. Please know that I am very appreciative of their service.

When we treat each patient the same way we would want to be treated, or as we would want a valued member of our family to be treated, not only are we doing what is right, but we are also distinguishing the patient experience at UTMB from all other providers. When we warmly greet and assist patients and visitors, and we find solutions for them, we show them that we respect them as human beings and we understand their time is valuable. When we work together to make sure the patient gets the test or appointment they need in a timely manner, we show that we care about their well-being. We can demonstrate care and respect by promptly responding to patients’ messages. We can follow up with them to make sure they are satisfied with their experience and that they have all the information they need.

When we consistently deliver an exceptionally good patient experience, and when we thank our patients and families for choosing UTMB, we set ourselves apart from the rest. Let’s be the kind of UTMB Health employee that always represents the kind of care we say we will deliver—the same care we would want for the most cherished of our loved ones. Going above and beyond is what providing excellent care and service is all about!

How do you go the extra mile for our patients?

Persistence is the twin sister of excellence

Donna Sollenberger, EVP & CEO, UTMB Health SystemWhen I was a sophomore in high school, my counselor signed me up for an advanced placement class: plane and solid geometry. I was excited because up to that point, school had been pretty easy for me. I was an overachiever (surprised?), and I wanted to take all of the classes I could that would prepare me well for college and make me a strong candidate for scholarships, which I really needed in order to attend.

I went to my first class. Mr. Gilmore was my teacher, a very nice man who seemed to explain the subject very well. However, each night when I got home and tried to do the homework, I could not do the problems. For some reason, the theory escaped me, and I received terrible homework grades those first few weeks.

One night as I sat at my kitchen table doing homework, I became visibly frustrated because I still could not do the homework problems. My dad came into the kitchen at the moment I was on the verge of tears. Dad was caught off guard by my display of emotion and wanted to know what the problem was. I told him about how I felt completely lost in the course, and that I didn’t think I belonged in it. I wanted to drop the class.

After several more nights of this, my dad became concerned enough that he called Mr. Gilmore. He told him that I was feeling very upset about the course. Mr. Gilmore reacted with what could be described as amusement. “Don’t worry,” Mr. Gilmore told my dad. “All of the students feel this way at this time in the class. In a few days, she will begin to understand it. It happens every year.”

As much as I didn’t want to, I stayed with the class. One day, the predicted happened—I finally understood plane and solid geometry and how to do the proofs! My grades improved dramatically, and I received A’s on my homework for the rest of the year.

Since that experience, I have often thought about how we react when things get tough or we are asked to do the seemingly impossible. Instead of buckling down and doubling the effort, we may be inclined to quit, believing our challenge is too difficult to tackle and accomplish.

I remember when we started the Best Care initiative last summer. Many people reacted with uncertainty and told me that our goals were not possible. After all, we had been trying for years to improve, and yet we were solidly stuck in the middle. How was this initiative going to be any different?

Today, I received the results from Quarter 2 of Best Care, and I am pleased to report that we have continued to improve in almost all areas. The results are as follows:

bestcare_q2summary3These are excellent results. While we still have much work to do as the upcoming quarterly targets will be more challenging, we are certainly on the right track. There may be moments in the coming months and weeks when you start to feel like we may not be able to continue improving to achieve our ultimate targets for the year; but, if you begin to think that way, just remember how far we have already come!

We were able to get through the first two quarters with excellent results, so I know we can continue performing well in the last two quarters. If we continue striving to deliver Best Care, we will reach our goal. When we do, it will be so wonderful for our patients and their loved ones!

There is a quote that says, “Persistence is the twin sister of excellence. One is a matter of quality; the other a matter of time.” To me, this describes our journey so far. Thank you for everything you are doing to help UTMB come this far toward achieving Best Care!

Seeing through our patient’s eyes

Donna Sollenberger, EVP & CEO, UTMB Health SystemSome of you will recall that I broke my leg almost two years ago. During that time, I was not allowed to put any weight on it, or my injury would have likely required surgery. During the 90 days I had to be completely off my leg, I really saw our Health System through the eyes of our patients, and that is something I hope you all try to do as you go about your work and travel throughout our facilities.

While I had many wonderful interactions during the time I was healing, and I received exceptional care at UTMB, I did experience one recurrent problem—many times, access to the patient pick-up and drop-off ramp was difficult to get to because employees’ rides or unattended vehicles were parked in front of the entrance. During that time, my husband always parked a bit down the road and waited for me to call him once I was on the ramp. But often, I still had to uncomfortably stand and wait on my crutches, holding my bags, because he couldn’t enter the ramp.

This comes to mind today, as I have noticed the ramp in front of Jennie Sealy Hospital has become increasingly congested lately—particularly during peak hours, like shift changes or the lunch hour. I have noticed multiple cars parked for up to a half hour in the lane intended for patient pick-up and drop-off, while our patients are forced to utilize the far left lane, which is meant for thru-traffic only. As a result, cars begin to pile up behind them, and as cars become trapped in the line, frustration mounts.

I think we all take it for granted when are able to easily move and get where we need to go, but navigating in a wheelchair or on crutches can be a lot of work, especially when you are in pain or not well, or you are being discharged and have other items to load into the vehicle. I couldn’t help but wonder what impression seeing our employees get into these vehicles must give our patients and their loved ones who are already stressed with getting their loved one in and out of the hospital or a clinic.

This may seem like a minor issue to some, but blocking the entrance for employee use does not communicate the message that we care about our patients’ and visitors’ needs. Since that experience, I have been passionate about assuring we have places where patients can be easily dropped off and picked up. I have asked people who are parked along the inside lane of the ramp who were waiting for employees to please exit and relocate to the lower right lane in front of Jennie, to help reduce traffic congestion on the ramp. I always ask politely and with a smile, but sometimes the responses I receive are not as polite. Nevertheless, I am committed to making sure our patients’ needs are met. At UTMB, we should always assure that the amenities intended for our patients’ convenience are readily available.

We have worked with Parking Operations and Facilities to help us in this matter. They have already painted the driveway curbs and labeled them to indicate that the right lane is for patient drop-off only and the left lane is for thru-traffic only. We also have designated a small group of 20-minute parking spaces on the east end of the building for employees, their rides, or delivery vehicles to utilize.

Unattended vehicles are prohibited on the ramp, and towing will soon be enforced. But even when several cars are attended by the drivers, yet stay on the ramp for a half-hour or more, it quickly contributes to creating traffic congestion on the ramp. (There is more to come in the way of signage for the Jennie Sealy Hospital ramp to help drivers more easily recognize the rules of the ramp.)

Many of you have asked me what you can do to contribute to Best Care. This is a simple way to contribute. Use of the Jennie Sealy Hospital ramp and/or the John Sealy Hospital circle drive by our employees is not prohibited. For example, if you have mobility challenges, we certainly understand that you need to be dropped off or picked up at the front door. I am simply requesting that all employees please respect the convenience of our patients and their loved ones by asking the people who are dropping you off or picking you up to be aware of the flow of traffic on the ramp and when it is busy, to not park and wait for you on the ramp unless you are ready to be immediately picked up (especially during peak hours like the lunch hour or shift changes).

Thank you for your understanding and cooperation in this matter. There should be no hesitation on our part to make the UTMB experience better for our patients and their visitors! This is an easy way you can contribute to Best Care.

“Empathy is about standing in someone else’s shoes, feeling with his or her heart, seeing with his or her eyes…it makes the world a better place”  —Daniel H. Pink

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!”*

change-blindness-ii

*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

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