The BMC Brief

July 18, 2012 Volume 1, Issue 28

• Editor’s Note
• Update on QUEST Goals
• Brought Together by Shared Disease, Two Cancer Survivors Finally Meet at BMC
• What Do You Do, Chris Cusack?
• In Their Words
• News of Note
• Awards and Accolades

Editor’s Note

Thank you for taking the recent BMC Communications survey. More than 1,800 of you responded, telling us how often you read the BMC Brief and use the intranet, rating the effectiveness of new communication tools like the digital signage TV system and the huddle card, and informing us about how you learn about BMC and its activities. Overall, you gave us positive feedback about the hospital’s communication efforts, but there is room for improvement. For example, you told us that you want to read more patient care stories in the Brief and would like the huddle card to be more relevant to your day-to-day work. We have heard you and are working to enhance these publications and the effectiveness of all our communications efforts.

We appreciate receiving feedback from you, and welcome all suggestions and story ideas for the Brief; please feel free to send them to us at communications@bmc.org.

Marcia Emerson
Editor

Go to Top ^

Update on QUEST Goals

BMC is now three quarters through the fiscal year, with work continuing on the hospital’s 2012 QUEST goals (Quality, Efficiency, Satisfaction and Total Revenue). Below is an update on BMC’s performance in the third quarter.

1. QU: Quality
   • Improve performance on the University Health Systems Consortium (UHC) mortality index to current UHC median of .97.
     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.

     “BMC continues to see improvement in its mortality index and has been performing better than the QUEST goal for the past two months,” says Stanley Hochberg, MD, Senior Vice President, Quality, Safety and Technology. “BMC staff continue to do great work to improve care for patients with life-threatening conditions. As part of this multipronged effort, we recently oriented all new residents to our 'CALL' initiative to improve attending physician notification when there is a significant change in a patient's condition."

   • 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.

     "While we continue to exceed last year's total clinic visit volume by close to 5 percent, we are not meeting our goal of scheduling more new patients within 14 days as compared to last year,” says Peter Healy, Vice President, Professional Services. “In many specialty departments, we are seeing more new patients than we saw last year, but not scheduling 10 percent more within two weeks. In response to these results, the ambulatory operations group is continuing to work with practice managers and physician leaders to increase the timeliness of new patient appointments for the fourth quarter.”

2. 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 has been diligent in its spending this year, keeping costs below $605 million for the first three quarters, and spending $3.2 million less than expected. These savings were achieved by containing wage and benefits and supply costs.

     “By consistently managing costs, BMC has stayed below budget, which is key to our financial stability,” says Richard Silveria, Vice President, Finance and Chief Financial Officer.

3. 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, departments have created action plans to address improvements in their areas. Examples include:

     Walk in My Shoes: In October, Clinical Operations launched Walk in My Shoes. The program gives participants two hours to shadow employees in other units to learn what they do, with the aim being to improve communication and collaboration across departments. Since its launch, five Walk in My Shoes days have occurred, with positive feedback from staff each time.

     “These sessions are always enlightening to participants,” says Janet Means, Administrative Director, Pathology and Laboratory Medicine, and creator of the program. “People often say how they are surprised at the number of interruptions employees deal with while trying to get their work done, or how many steps it takes to process a task, and how even one small step performed incorrectly in a process, such as labeling a specimen incorrectly, can mess up or slow down the entire work flow.”

     Means says works continues to improve the program, with the hopes of getting various shifts involved and connecting departments that work frequently together, such as Pathology and Laboratory Medicine and Nursing.

     Department Newsletters: Work groups, such as Support Services and Finance, have rolled out newsletters to their staff that highlight department happenings, employee excellence, birthdays, anniversaries and fun facts. “Environmental Services has created a monthly newsletter that is all about collaboration, unity and recognition,” says Dave Maffeo, Senior Director, Support Services. “Through the newsletter, more than 25 employees have been recognized for their excellence.” Based on the success of the newsletter, Maffeo says the Patient Transport group plans to launch its own edition soon.

     Employee Recognition: Managers are using recognition kits to support and encourage employee performance and continuous improvement. Managers are hand-writing thank you notes, a tool in the kit, and handing them to employees on the spot or mailing them to their homes.

   • 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 69 percent, just shy of the 70 percent goal. Progress on the following initiatives continues as BMC works to improve the patient experience.

     Room-a-Day: In November 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 is 25 percent through the organization, having refreshed 85 rooms. In addition, all 17 rooms on Newton 8W have been updated. The program remains on schedule to complete all 336 inpatient rooms by the end of the year.

     New cafeteria menu: In May, Dining Services introduced a healthier menu in the Menino and Newton Pavilion cafeterias. Seasoned salmon, steaks and chicken are now grilled to order each day, with customers choosing sides like grilled vegetables and roasted potatoes to add to their meals. The salad bar was enhanced to include more options, while the demonstration area offers “themed” foods such as southwestern meals or made-to-order tossed salads.

     Music in lobbies: Instrumental music is now playing in the lobbies of the Menino and Newton Pavilions, Moakley and Yawkey buildings. The light, soothing tunes are meant to welcome and relax patients, says Rebecca Blair, Executive Director, Patient Experience.

     “Patients have told us they sometimes experience anxiety while waiting for their appointments,” says Blair. “The addition of soothing soft jazz in the lobbies supports a calm environment that helps reduce that anxiety.”

     Other initiatives include the roll out of BMC’s new Patient Experience Awards, says Blair. The awards recognize outstanding achievements in improving the patient experience as part of the Be Exceptional Strategic Plan’s work to Provide the Right Care for Every Patient, No less, No more. The Patient Experience Awards are given quarterly to the teams who provide an excellent patient experience, as measured by patient satisfaction surveys and other significant, tangible achievements. The winners this quarter are Radiation Oncology, Urology, Newton Pavilion 8W and the Primary Care Call Center.

4. T: Total Revenue
   
   • Achieve patient service revenue of $854 million

     Despite an ongoing decrease in inpatient volume, a trend Boston hospitals continue to experience, total patient service revenue for the first three quarters was $652 million, $17 million above budget.

     “Our Medicare case mix (measure of BMC’s expected resource utilization based on a patient’s diagnosis) during the past nine months was strong and tracked better than budget, an ongoing trend,” says Silveria.

Visit the BMC intranet to learn more about the QUEST goals.

Go to Top ^

Brought Together by Shared Disease, Two Cancer Survivors Finally Meet at BMC

Melissa “Missy” Jackson and Michele Bloomer have a lot in common. They both are lively and warm women. They both have caring husbands and each has three children to whom they are devoted. They also are survivors of a rare cancer – adenoid cystic carcinoma (ACC) of the salivary gland and have both been treated by Andrew Salama, DDS, MD, Oral and Maxillofacial Surgery.

After almost two years of “talking” on Facebook about living with a devastating and frightening form of cancer, the two women met for the first time last week at BMC when Missy came to the Oral Surgery clinic for a checkup and Michele was in town visiting family. They admitted to crying upon seeing each other.

“It was so exciting,” says Missy. “I posted on Facebook all about it.”

Missy Jackson and Michele Bloomer met for the first time at BMC

Missy, 36, a native of Gardiner, Mass., is a current patient of Salama’s who was diagnosed with ACC in 2010 and referred to BMC as the best place for treatment because of Salama's expertise. Michele, 43, a native of Baltimore, is a former patient of Salama’s who was treated by him for the same cancer in 2007 when he was at the University of Maryland.

The parallels between the two women inspired Salama to suggest that they make contact with each other, as Michele could be a resource and support for Missy as she navigated the surgery and follow-up radiation.

“He called her my doppelganger,” says Missy. “I couldn’t find much online about my cancer so just making contact with Michele, who had already been through all of this, was great. I was diagnosed in October and by November we were already talking on Facebook."

“The most amazing part of their story is that they have bonded in way that I have not seen before in patients,” says Salama. “Michele told me she wished that she had had someone with the same diagnosis who she could have turned to for help. They are incredibly thoughtful of each other.”

ACC generally emerges in the head and neck region predominantly in the salivary gland, progresses slowly, and spreads along nerve tracts with metastases typically to the lungs, liver and bones. Surgery is the standard treatment followed by radiation. According to the Adenoid Cystic Carcinoma Research Foundation (ACCRF), approximately 1,200 new cases of ACC are diagnosed each year and are more prevalent in women than men with a median age of 43 at diagnosis.

“At first I was careful about what I said to Missy because my experience wouldn’t necessarily be hers” says Michele. “I was a recluse after my surgery. Missy opened the door for me and through her, I found on Facebook that there is always someone to talk to who can offer some kind of help.”

Both women say they hold Salama in very high regard.

“He is always there,” says Missy. “If I have a question or have a concern he always responds quickly and wants to know what my concerns are.”

The women have shared much in the almost two years they’ve been in contact, but had never actually spoken to one another. The results of Michele’s surgery have made her speech somewhat difficult to understand so she does not like talking on the phone. Face-to-face, however, the connection between them is obvious and they have an easy and affirmative understanding of each other and what the other is going through.

The two also have developed a Facebook ACC support group of people from around the world. Next spring a Facebook correspondent and cancer survivor from Australia will  travel to the U.S. and Missy and Michele will meet her. The two also will meet again next month in North Carolina when the ACCRF holds a Run for the Cure that they both plan to attend with their families.

Go to Top ^

What Do You Do, Chris Cusack?

Name: Chris Cusack
Title: MRI Technologist
Department: Radiology
Years at BMC: 21

Chris Cusack

What brought you to BMC?
After I graduated from North Shore Community College I wanted to work at a teaching hospital in the city to gain experience. I looked into potential MRI jobs in Santa Barbara, Calif. for a change of scenery, but I came to BMC instead and have been here since.

What do you do here?
I scan MRI patients. This can involve anything from inserting an intravenous catheter for injecting contrast to going over a patient’s MRI and contrast screening forms with them before they are scanned. I’m the lead technologist, which means I’m also responsible for staff scheduling and ordering supplies. The most important part of my job is making sure the patient is comfortable throughout the scanning process, and that the images are sent to the Radiologist to be read.

What’s your favorite thing about being an MRI technologist?
The patients I meet every day. I also work with an excellent group of people and we enjoy our work. I also have a passion for MRI, and with the technology constantly changing, it never gets boring.

How does your job contribute to the patient experience?
Our department recently took a class called “Comfort Talk,” which taught us skills in communicating with patients. The goal is to make them feel as comfortable as possible throughout their MRI. For example, many patients are claustrophobic, so I would tell them to imagine a place where they feel happy, like the beach, and talk them through the procedure.

Next week is MRI Safety Week. Why should people know about MRI safety?
BMC has made patient safety, including MRI safety, its top priority. We have standardized MRI safety across the hospital, with outside doors being installed in the front of MRI rooms and the rooms being secured with ID card readers to ensure appropriate access. Screening forms, which patients use to report past procedures, implanted devices, and health conditions, are now mandatory. This is to prevent any adverse effects from the magnetic field. Many people don’t realize that the scanner is always on and that we don’t turn the magnet off between patient screenings. This is the reason we are always vigilant when someone enters the scanner room.

Do you know a staff member who should be profiled? Send your suggestions to communications@bmc.org.

Go to Top ^

In Their Words

Patients share their BMC experience

Dear Boston Medical Center staff,

This letter will never express or convey my feelings of gratitude, relief, peace and amazement at what human beings who are dedicated to their work and a sense of higher purpose are capable of.

My wife returned to Boston from Russia after a two-year hiatus. She told me she was under great stress while there.

At first I noticed some changes in her behavior and as time passed, it became evident that she was exhibiting symptoms of psychotic behavior – behavior that not only had I never witnessed from her but from any individual. Extreme paranoia, bipolar swings and delusions were the primary symptoms with periods of rambling random thoughts and incoherencies.

My wife was admitted to the emergency room at another Boston hospital and released without any recommendation other than rest.

After a deepening and aggrandizement of the symptoms, I finally went to the police for help.

They recommended the BMC Department of Psychiatry's Boston Emergency Services Team (BEST) who helped get my wife into BMC's emergency department.

What I witnessed over the next few days was miraculous. My wife’s behavior progressed from the insane to subdued acceptance to appreciation to the staff for their work. In approximately four days, she was released without medication. I had been convinced that she would need to be hospitalized in a psychiatric unit for weeks, at least!

It has been four days now and I am experiencing the woman that I fell in love with and have known over the past seven years. Again, truly miraculous! I realize that it is too soon to predict long-term results, but it is a respite to see her move from the insanity and pain she experienced to the calmness, peace and joy that she expresses now.

The short-term effect of your care is a human being who appreciates the professionalism, care, attention to detail, kindness, compassion and humanity of a staff that went above and beyond to restore her to health.

My wife told me about the frequent visits of the psychiatrists, nurses and others who inquired incessantly about her condition and any previous history and symptoms she had, and the phone calls to Russia caregivers made to speak with my wife's mother and the doctor who had been treating her there.

Such attention to detail, thoroughness and concern for the proper and optimum outcome for someone in need of medical attention can only come from the paramount of teams and professionals.

My wife expresses her appreciation to the entire staff and many individuals who came to her rescue. This experience has confirmed her belief that America is truly a great country with inspired, intelligent, compassionate, giving and loving individuals who truly care for each other’s health and well-being.

I can never express my appreciation with words. I have seen, first hand, why Boston is the medical center of the world. Boston Medical Center exemplifies that tradition by leading the field of consummate institutions that have built this stellar reputation in the greatest of cities in the world. Your institution, and its entire staff, is world class!

I wish all of you the greatest success and rewards as you continue to strive to provide the greatest health care in the world. You truly represent your brilliant axiom: Exceptional care, without exception.

Boston

Go to Top ^

News of Note

A Catwalk for BMC Cancer Care model on the runway

BMC hosts first-ever fashion event
BMC hosted its first-ever fashion show, Catwalk for BMC Cancer Care, June 28 at the State Room to raise funds for the hospital’s cancer programs. BMC staff and patients who are cancer survivors and local celebrities strutted their stuff on the runway for the cause. The fashion show featured creations from six local designers worn by Farrah Lester, wife of Red Sox pitcher Jon Lester; Katie Boyd of the Style Network reality series “Wicked Fit;” Lacey Wilson Bates, Miss Massachusetts 2010; and Monica Pietrzak, Miss Connecticut 2009. The event, which raised $37,000 for BMC’s Cancer Care Center, was produced in partnership with Open HeARTS, Inc., a non-profit arts and event planning organization that supports community organizations through fundraising and charitable donations.

James named Assistant Dean of Diversity and Multicultural Affairs
Thea James, MD, Emergency Medicine, has been appointed an Assistant Dean in the Boston University School of Medicine (BUSM) Office of Diversity and Multicultural Affairs. James is the current President of the BMC Medical and Dental Staff. Throughout her 20 years of service at BMC and BUSM, James has lectured internationally and received numerous awards for her work in violence prevention, health care disparities, multiculturalism and health care delivery.

Robert Nicoletta, MD

Robert Nicoletta joins BMC
Robert Nicoletta, MD, will join BMC and Boston University School of Medicine (BUSM) as an Assistant Professor and Co-Director of Sports Medicine in the Department of Orthopaedic Surgery Aug. 1. Nicoletta is a board certified, fellowship trained orthopaedic surgeon with specialty training in the field of sports medicine. He earned his medical degree from Syracuse University and completed his internship and orthopaedic surgery residency at the University of Buffalo. Following a fellowship in sports medicine and arthroscopic surgery at Boston University, he served as the Director of Sports Medicine at the Cambridge Hospital and Chief of Sports Medicine at St. Elizabeth’s Medical Center.

Nicoletta has been the head team physician for numerous local high schools, collegiate and professional athletic teams. Most recently he served as a team physician at Boston College, and as head team physician for the Boston Cannons Men’s Professional Lacrosse and the Boston Breakers Women’s Professional Soccer. He has served as the head team physician for Newbury College, Fisher College, Pine Manor College, Lesley University, and UMass Boston Intercollegiate Athletics. He was recently named to the national list of 65 Outstanding Shoulder Surgeons and Specialists by Becker’s Orthopedic and Spine Review.

Nicoletta will be seeing patients at both BMC’s Shapiro Center and at the Ryan Center for Sports Medicine and Rehabilitation at Boston University.

Go to Top ^

Awards and Accolades

BMC has been recognized by a U.S. News & World Report survey as high performing – in the top 25 percent of hospitals across the country – in cancer, diabetes and endocrinology, ear, nose and throat, gastroenterology, geriatrics, nephrology, neurology and neurosurgery, pulmonology and urology.

The rankings, now available online, will be published in the magazine's annual America's Best Hospitals guide, which will appear in the August issue.

Martha Griffin, PhD, RN, PMHCNS-BC

Martha Griffin, PhD, RN, PMHCNS-BC, has been selected to be inducted as one of 176 fellows to the American Academy of Nursing during its 39th annual meeting and conference Oct. 13. The Academy comprises more than 1,800 nurse leaders in education, management, practice, policy and research. Selection criteria include evidence of significant contributions to nursing and health care and sponsorship by two current Academy Fellows. Griffin is the first nurse from BMC inducted into the Academy and one of eight nurses being inducted from Massachusetts.

“Selection for membership in the Academy is one of the most prestigious honors in the field of nursing,” says Lisa O’Connor, RN, BSN, MS, NEAA-BC, Senior Vice President for Clinical Operations and Chief Nursing Officer. “It celebrates Martha’s contribution to the advancement of the nursing profession and is an incredible honor for her and for BMC. I am very proud to count Martha as a colleague.”

Four BMC groups recently won inaugural Patient Experience Awards. The awards recognize outstanding achievements in improving the patient experience as part of BMC’s Be Exceptional Strategic Plan’s work to Provide the Right Care for Every Patient, No less, No more. The Patient Experience Awards are given quarterly to the teams who provide an excellent patient experience, as measured by patient satisfaction surveys and other significant, tangible achievements. The winners are Radiation Oncology, which achieved a 90 percent survey rank, Urology, which achieved an 83 percent survey rank, Newton Pavilion 8W, which achieved a 94 percent survey rank, and the Primary Care Call Center, which improved performance on the percentage of abandoned calls to a rate of just 3 percent.

Kermit Crawford, PhD, Psychiatry, is the recipient of the American Psychological Association Minority Fellowship Program’s 2012 James M. Jones Lifetime Achievement Award. Crawford was selected for his outstanding scientific contributions and the application of this knowledge toward the improved mental and physical well-being of people of color. He will receive the award at the upcoming American Psychological Association meeting in Orlando, Fla.

BMC’s evaluation and measurement initiatives were showcased recently by the Massachusetts Board of Registration in Medicine as exemplifying one of the four habits of high-value health care organizations. You can read the full article on the BMC intranet.