January 27, 2012 Volume 1, Issue 18
BMC Celebrates Martin Luther King, Jr. Day
More than 150 members of the Boston Medical Center and Boston University Medical Campus community gathered Jan. 18 to celebrate the life and legacy of Rev. Martin Luther King, Jr.
Rafael Ortega, MD
Rafael Ortega, MD, Vice Chair of Anesthesia and Associate Dean of Diversity and Multicultural Affairs at BUSM, moderated the panel event. “I came to the United States as a teenager and lived with a black family in North Carolina in 1968, the same year Rev. King was assassinated,” said Ortega in his welcome address. “The family was active in the Civil Rights Movement and Martin Luther King’s death left a tremendous impression on me. I’d like to start our celebration today with his words.” Ortega then played a segment of King’s “I have a dream” speech for the audience.
The event featured a panel of three campus physicians who spoke of the influence Rev. King has had on their lives: Greg Antoine, MD, MBA, Chief, Plastic and Reconstructive Surgery, Thea James, MD, Emergency Medicine, and John Polk, MD, Assistant Dean, BUSM Office of Student Affairs.
Polk shared a video slideshow as he spoke of his time growing up in segregated Mississippi during the Civil Rights era, a time when black people were not allowed to use beaches or other public accommodations. His two eldest brothers were involved in the movement and knew and worked with Rev. King.
“The leadership role played by black physicians in the Civil Rights struggle inspired me to become a physician,” he told the crowd. He chose to attend Boston University School of Medicine because it was one of the first schools in the country to recruit students of color.
Antoine spoke of growing up on a military base in Mississippi and taking separate buses to attend separate schools. As he grew older, King was a key influence.
Panelists Antoine, James and Polk
“I turned 18 in 1968, the year Rev. King was killed, Robert Kennedy was killed and Vietnam was happening. I was at Jackson State University when two black students were shot and killed by the Jackson Police Department and the Mississippi Highway Patrol. I was part of an angry, bitter group of young men and if it wasn’t for Dr. King, I wouldn’t be here today. King was a big inspiration to me.”
James, who was raised in the Virginia/DC area, said she remembered feeling like “America was on fire” during the Civil Right Movement. When she arrived at medical school at Georgetown University, it was the first time she felt like she didn’t belong, but she was determined to get through.
“Everything came together when I came here [BMC] to train,” she said. “Now I am able to actively provide and participate in opportunities for my patients, students, residents and colleagues through empowerment. I attempt to empower students and residents by helping them find the keys they possess to unlock whatever internal barriers stifle them. And I tell them the truth.”
All three panelists stressed the importance of Rev. King’s legacy and expressed their gratitude for his contributions to the U.S.
The event concluded with a classical piano recital sponsored by the Boston University College of Fine Arts.
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A Progress Report on QUEST Goals
Last fall, BMC announced its 2012 QUEST goals: Quality, Efficiency, Satisfaction and Total Revenue. Since then, progress has been made on all four goals. Here is an update on how the hospital is performing as of the close of the first quarter of the fiscal year.
- QU: Quality
- Improve performance on the University Health Systems Consortium (UHC) mortality index to 0.79.
The mortality index is a standard measure of BMC’s mortality performance adjusted for the illness level of our patient population. BMC shares quality data with the UHC and uses UHC benchmarks for evaluating performance and setting quality goals.
The UHC has adjusted their expected mortality models to give more appropriate weight to specific pediatric conditions, cancer and other morbidities.“In this new model BMC has moved closer to its target of the UHC median performance,” says Stanley Hochberg, MD, Vice President, Patient Safety and Quality. “The mortality team continues to meet monthly and focus on improvements to critical care coverage, post-operative care and sepsis.”
- Schedule 80 percent of new primary care patients to be seen within 14 days; improve the number of new patients seen in all other specialties combined within 14 days by an average of 10 percent.
During the first quarter, 55 percent of new primary care patients were seen within 14 days. Specialty numbers are currently being validated but each specialty is working to achieve a 10 percent improvement over fiscal year 2011's fourth quarter access results.
“More than half of our new primary care patients are being seen within two weeks during a time when many primary care practices across the city are closed to new patients,” says Peter Healy, Vice President, Professional Services. “Our goal is to get 80 percent and a new Ambulatory Redesign project is kicking off to achieve that.”
- E: Efficiency
- Hold spending to the budgeted amount of $810 million for the expense categories of wages, employee benefits, physician services, drugs, supplies and utilities.
BMC not only achieved its goal of keeping costs below $201 million for the first quarter, but finished under it, spending $632,000 less than expected. Savings were achieved by primarily containing wage and benefits costs.
“We did a great job managing costs in the first quarter by spending every dollar as if it were our own,” says Richard Silveria, Vice President, Finance and Chief Financial Officer. “If we continue to operate in this manner, we will be on track to achieve similar costs savings in the second quarter.”
- S: Satisfaction
- Increase the commitment score on BMC’s Employee Engagement survey by 5 percent.
The commitment score reflects the degree to which employees feel committed to BMC and their willingness to recommend BMC as a good place to work and to receive care.
Since the March 2011 Employee Engagement survey, most departments have created plans of action to address improvements in their areas, says Tim Manning, Vice President, Human Resources. HR is continuing its ongoing work of overseeing the implementation of the plans. Other initiatives include:
Huddle Card: Each week managers and directors share need-to-know hospital information in person with their staff.
Management Development Program: This month HR launched a professional development program for managers. The mandatory program contains 20 workshops focused on developing key competencies, promoting consistency of management practices throughout BMC and supporting employee and manager engagement.
Senior Leadership Rounding: Members of senior management now walk units and floors each week to chat with staff and address any questions or concerns they have. The schedule is posted on the intranet each week.
Town Hall Meetings: Meetings are now held quarterly by President and CEO Kate Walsh to inform the BMC community of important happenings.
Employee Recognition Kits: Kits have been distributed to managers to support and encourage employee performance and continuous improvement.
Focus groups: HR will conduct focus groups this summer for staff to talk about lessons learned since the survey and share best practices. A second Employee Engagement survey will follow in the fall.
“Staff told us what we should do to improve our workplace and strengthen employee commitment and we are taking that input and implementing changes,” says Manning. “This will be an ongoing process and is how we will need to conduct our business going forward to improve employee engagement.”
- Increase the percentage of patients who rate BMC a 9 or 10 on the “Overall Rating of Hospital” to 70 percent for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, as measured by Press Ganey.
The most recent Press Ganey scores show BMC performing at 74 percent, or four percent better than goal. There are several initiatives underway to improve the BMC patient experience.
Room-a-Day Program: This month Facilities rolled out its Room-a-Day program. The program takes two inpatient rooms out of commission each day of the week to “refresh” them, which can include painting the walls, waxing the floors and maintenance work on heating and cooling systems. The program will refresh all 336 inpatient rooms by the end of the year.
Two new positions have been created to keep families of surgical patients informed of their progress and care. Operating Room Liaisons, Yvonne Girard and Polovna Laine, are based in Menino and Newton Pavilions.
“These and other programs will enhance the perception of BMC and greatly improve a patient’s experience here,” says Rebecca Blair, Executive Director, Patient Experience.
- T: Total Revenue
- Achieve patient service revenue of $854 million
Despite a decrease in inpatient volume, a trend many hospitals are experiencing, total patient service revenue for the first quarter was $211 million, $1.6 million above budget.
“Our Medicare casemix (measure of BMC’s expected resource utilization based on a patient’s diagnosis) during the past four months was strong and tracked better than budget, a trend we believe will continue” says Silveria.
Visit the BMC intranet to learn more about the QUEST goals.
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Researchers Clarify Link between Salt and Hypertension
A study by BMC/BUSM researchers debunks the widely believed concept that hypertension, or high blood pressure, is the result of excess salt causing an increased blood volume, which in turn exerts extra pressure on the arteries.
Irene Gavras, MD
The study, published online in the Journal of Hypertension, demonstrates that excess salt stimulates the sympathetic nervous system to produce adrenalin, causing artery constriction and hypertension.
The research was led by Irene Gavras, MD, and Haralambos Gavras, MD.
“The purpose of this paper is to correct an erroneous concept that has prevailed for many years, even though scientific evidence has mounted against it,” says Irene Gavras, a physician in BMC’s Hypertension practice.
The term “volume-expanded hypertension” implies that excess salt leads to the retention of extra fluid within the arterial circulatory system, causing an increase in blood volume and added pressure on the arterial walls. However, research has shown that conditions characterized by the expansion of blood volume from other causes, such as the secretion of antidiuretic hormone or the excessive elevation of blood sugar, do not cause a rise in blood pressure because the extra fluid is accommodated by the distention of capillaries and veins.
“The body’s circulatory system is a highly flexible vascular system with the capacity to open up new capillaries and distend veins in order to accommodate increased fluid volume,” says Irene Gavras.
Through a review of numerous studies, the researchers demonstrated that hypertension results from the excessive consumption and retention of salt that stimulates the sympathetic nervous system in the brain to increase adrenaline production. The increased adrenalin being circulated throughout the body causes the arteries to constrict, which results in resistance to blood flow and a decrease in circulatory volume.
“The implication of our findings shows that the optimal treatment for hypertension, for cases associated with renal failure, should not only include diuretics but also the use of drugs that block the central sympathetic nervous system,” says Irene Gavras, MD.
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What Do You Do, Development?
What does the Development department do at BMC?
Development raises money for the hospital, particularly for programs that don’t have other funding sources, such as the Food Pantry and Demonstration Kitchen. The department also raises money for research, clinical activities and capital projects. The 20-member staff is grouped into four teams that focus on various fundraising areas: Family Philanthropy, Foundation and Government Grants, Cause Marketing and Operations. When the department was formed 13 years ago, the hospital raised $500,000 annually. Last year the department raised $35 million at a rate of just eight cents in administrative costs for every dollar raised, which is very competitive with industry standards.
What are some of BMC’s signature fundraising events?
One special event is the Food for Thought dinner, which was established 18 years ago to raise money for the Grow Clinic for Children and, later, the Food Pantry and Demonstration Kitchen. Last year the event raised $850,000. Our signature event is the annual BMC Gala, which draws a great deal of corporate support and funds various areas of the hospital. In 2011, the event raised $2.5 million and Development is hoping to exceed that amount at this year’s May 5 event.
What is Development focused on in 2012?
The department is looking to BMC’s Be Exceptional Strategic Plan as a guide for fundraising opportunities. Development staff are always reaching out to the BMC community and beyond to uncover new giving opportunities and forge new connections. One potential area for additional support is grateful patients who’ve had a great experience at BMC and are able and willing to support the hospital. Development is also focused on securing the necessary funds to maintain vital BMC programs and on completing the fundraising for new and expanded Endocrinology, OB/GYN and Geriatrics outpatient clinics.
How can BMC staff help?
There are many ways staff can give: through the Employee Giving campaign; by supporting a BMC staffer participating in an event with Team BMC; such as the Boston Marathon or Rodman Ride for Kids; and letting Development know if a patient has expressed interest in supporting the hospital by calling 638-8990.
Do you know a staff member or department that should be profiled? Send your suggestions to email@example.com.
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In Their Words
Patients share their BMC experience
Dear Dr. Lazar:
I have been thinking about you non-stop for the past two days. Two days ago was the one-year anniversary of the day you completed my bypass surgery and I wanted to contact you to let you know that I am physically doing very well. With your help I have managed, through my work, to help hundreds of Boston residents who were in danger of losing their homes to foreclosure and now they can continue to sleep at night and keep their home. I have prayed for your health and well-being, because yours is a special gift: the gift of continued life.
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News of Note
Suresh Agarwal, MD, FACS
Suresh Agarwal, MD, FACS, appointed to journal board
Suresh Agarwal, MD, FACS, Chief, Surgical Critical Care, has been appointed to the editorial board of The Journal of Surgical Research: Clinical and Laboratory Investigation, which publishes original articles concerned with clinical and laboratory investigations relevant to surgical practice and teaching. It emphasizes reports of clinical investigations or fundamental research bearing directly on surgical management that will be of general interest to a broad range of surgeons and surgical researchers.
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Awards and Accolades
BMC was ranked No. 7 in the state’s list of Top 10 Performers for Communication about Medicines for the fourth quarter, a key indicator of patient satisfaction. The ranking includes 35 Massachusetts health care facilities and is based on patient responses to two Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) questions: did staff “tell you what new medicine was for” and “describe the medicine side effect.” The collective scores positioned BMC as No. 7 in the state.