The BMC Brief
October 29, 2013 Volume 2, Issue 18
Lucian Leape, MD, PhD, an internationally recognized leader in the patient safety movement, visited BMC recently to kick off National Health Quality week, telling an audience of doctors and nurses in Keefer Auditorium that the next major step in improving patient safety is creating a culture of greater respect among doctors, nurses, students and patients.
“The secret to caring for patients is caring for the caregivers,” said Leape who is a professor of health policy and management at the Harvard School of Public Health.
The Quality, Safety and Patient Experience Department welcomed Leape on Oct. 21 for the ninth annual Raphael Miara Memorial Patient Safety Lecture.
Leape cited a guiding principle of former Alcoa CEO and workplace safety leader Paul O’Neill. “Paul O’Neill said that everyone, everyday should feel respected, supported and appreciated—this sounds pretty good to me. This is doable. If we want to make health care safer, we need to focus on this.”
According to Leape, much of the success of the patient safety movement to date has been the result of a focus on fixing systemic problems rather than on individual errors.
“You shouldn’t punish the people who made the mistakes, instead find out why they made the mistakes and fix the underlying problem,” he said. “The systems approach looks to the future.
“Moving forward, hospital leaders need to continue to focus on efforts to make staff feel comfortable reporting errors and to encourage their staff to participate in patient safety initiatives.”
Addressing what he considers the “elephant in the room,” Leape cited a culture in health care that tolerates disrespectful behavior among doctors, nurses, students and patients as a barrier to patient safety. He told the audience that disrespectful behavior takes many forms, some blatant and some less immediately apparent.
“BMC’s RESPECT attributes are a real step forward,” Leape said, addressing the hospital’s recently revised RESPECT behavioral attributes. “I don’t know of other hospitals locally who have done something like that.”
Nearly two-thirds of the audience raised their hand when Leape asked who has, in some way, been part of or touched by the RESPECT attributes.
Benefits Enrollment for 2014 will begin Nov. 1 and run until Nov. 18. This is the time of year when employees select their benefits for the coming year. Below is an overview of key benefit changes. Detailed benefits information will be mailed home to staff this month.
“The 2014 BMC health plan changes will provide employees with options to ensure they can select a plan that best suits their needs and that of their families,” says Kerry Ryan, Director, Benefits.
“The health and wellness of our staff and their families are incredibly important to us,” says Lisa Kelly-Croswell, Vice President, Human Resources. “I am excited about the 2014 BMC benefit offerings and the enhancements that have been made to our program especially in today’s affordable care environment. Employees have a variety of benefits options to choose from to ensure they have the best plan for them and access to the best care possible.”
BMC’s Open Enrollment runs Nov. 1-18. To learn more about Open Enrollment, visit the Human Resources section of the intranet.
Six Months Later: Schwartz Rounds Tackles Healing Process of Caregivers in the Wake of Marathon Bombings
It has been six months since Marathon Monday, a day that in years to come will never be the same for many Bostonians. On Oct. 15, BMC’s Schwartz Center Rounds marked the anniversary and served as an opportunity for staff to gather as a community and assess its collective healing progress.
Schwartz Center Rounds are held in more than 200 facilities in 32 states and commemorate Kenneth Schwartz, a Massachusetts health-care lawyer diagnosed with lung cancer in 1994 who believed in nurturing the compassion in medicine. The rounds provide a forum where BMC caregivers from multiple hospital disciplines come together to discuss the emotional impact and challenges of patient care based on an actual case. The Oct. 15 rounds however, focused on a different theme; the events of the Boston Marathon tragedy and the importance of caregivers’ self-healing.
Thomas Barber, MD, Schwartz Rounds Physician Leader, and Carol Mostow, LICSW, Schwartz Rounds Facilitator, introduced the topic of remembering vulnerability, celebrating strength and integrating lessons for everyday work six months after the Marathon. Panel speakers included Jared Greer, Certified Radiology Technician; Doug Comeau, DO, CAQSM, FAAFP, Director of Sports Medicine; Jeffrey Kalish, MD, Director of Endovascular Surgery; and Elizabeth Dugan, LICSW, Manager, Violence Intervention Advocacy Program. Each panelist provided their unique perspective and experience of the April 15 tragedy.
Comeau told the audience that he was stationed in a medical tent at the Marathon finish line and spoke of the chaos that ensued following the bomb.
“The ground shook like fireworks were going off and there was complete panic. I didn’t know if my team, the people I had worked with for so many years, was alive,” he recalled. “That kind of vulnerability stays with you.”
Greer was working when the influx of patients from the marathon hit BMC.
“It was complete chaos,” he said. “But one good thing that came out of it is the renewed respect that I have for my colleagues. Everyone pulled together and my relationship with other departments was completely changed, in a good way, and it made me proud to work here.”
Kalish, as a member of the surgical team who operated on many of the most gravely injured patients, also spoke of the camaraderie.
“The usual hierarchy was gone. Everyone worked together and did whatever needed to be done. From nursing to transport to housekeeping, everyone pitched in and it created an extremely productive environment,” he said. “Quite frankly, this is a model that we should be using more often.”
Dugan offered insight on how violence affects many of the patients BMC sees every day and challenged the room to acknowledge their success in caring for the patients that day and carry it forward to future patients.
When the platform turned to the audience for reflection, the mood was hopeful as participants spoke about taking the time to focus on getting help to move past such a tragic event.
“One of the charges of running a marathon is the cheers you get along the way,” summed up Mostow. “By acknowledging the amount of tragedy we see, we are showing compassion for ourselves. Everyone needs to be cared for. Caregivers are no exception.”
BMC continues to offer a range of support services to staff as they heal. To learn more, visit the Human Resources section of the BMC intranet.
According to the American Cancer Society, more than 40,000 women die of breast cancer in the United States each year. Research has shown that the best chance of survival for those diagnosed with breast cancer is early detection, but what about women who don’t readily have access to care?
On Oct. 19, BMC did its part to ensure that homeless women in the Greater Boston area had access to screening, potentially saving lives. As part of Breast Cancer Awareness Month, Cancer Care Services hosted a free breast cancer screening event in the vibrantly pink-clad Moakley Building lobby.
In collaboration with Boston University, transportation was made available to homeless community members from the Pine Street Inn, Barbara McInnis House and Rosie’s Place, who may otherwise lack the resources to get to the hospital.
As the serene sound of harpist Linda LaSalle filled the room, attendees visited educational booths, spoke with providers and more than 40 women received screenings. The mammogram results were read to patients in real-time, so attendees would not have to schedule follow-up appointments unless further tests were recommended. In addition, BMC provided warm gloves as gifts to the women and served a hot breakfast to the crowd.
“The event was a huge success. All of the volunteers involved were happily surprised by the turnout of women who took advantage of such a wonderful opportunity,” said Holly Frank, RT, Manager of Breast Imaging and the mastermind behind this event.
Eligible patients received support from BMC’s Patient Financial Services and a B.J.’s Shopping Club donation to defray the cost of the care. In addition, T.J. Maxx generously donated bras, which BMC distributed to the local homeless shelters.
“From the moment we started planning the event, everyone from Cancer Care Services, Food Services, Public Safety and our own Breast Imaging staff were eager to volunteer,” says Frank. “We’re already looking forward to planning next year’s event!”
Autumn is in full swing and along with it, pumpkin season! Celebrate it with this easy, delicious dessert from the Demonstration Kitchen’s Tracey Burg.
This silky, smooth mousse is a healthier option for pumpkin pie that is just as tasty. Made with a handful of simple ingredients, this lighter-than-air dessert is the perfect sweet ending to your favorite fall meal!
Nutritional Information Per Serving:
Diabetic Exchange: 1 starch
Do you have a recipe that you would like to share with the BMC community? Send it to firstname.lastname@example.org and we’ll feature it in a future issue of the BMC Brief!
Name: Joanne Timmons, MPH
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Jeffrey Kalish, MD, Vascular Surgery, wrote this opinion editorial that was published in the Boston Globe on Oct. 16, to reflect on lessons learned in the wake of the Marathon tragedy. Below are his words.
Working at Boston’s largest Level One Trauma Center, the staff at Boston Medical Center care for patients with complicated medical issues every day. But as we all have come to understand, April 15, 2013, was not like any other day, and the events that our nation observed have forever changed the way many of us approach medicine.
All of us at BMC who were involved with Marathon Monday and its aftermath think about that day while moving forward with our daily lives and work. We all had different reactions and adjustments to the violence that transpired six months ago. While many of us are still working through our personal challenges associated with the tragedy, many more have likely placed the incident in a mental storage compartment in order to facilitate forward progress. However, not a day goes by when we do not think about the Marathon and how we can take the lessons learned and apply them to our future trauma victims and patients.
Like most hospitals, BMC spends a significant amount of time preparing for large-scale disasters. Detailed plans are in place for every department, and staff are trained for a wide range of events in order to facilitate a sense of clarity during the most chaotic of circumstances. As expected, and to the credit of all involved, the staff at BMC executed the tactics of those plans brilliantly on Marathon Monday. Because of this level of preparation and collaboration, we were in the right position to work together to save lives. Multi-disciplinary teams were created to provide the ideal care to every patient, and input was valued from all members of the extended care team. The renewed sense of partnership among colleagues, and a deeper sense of appreciation for the contribution of all of those involved in the delivery system, allowed us to provide the optimal experience and outcomes for our Marathon patients.
On Marathon Monday and the weeks afterward, this collaboration extended across the entire hospital spectrum, with staff joining together to do anything and everything to care for those who came through our doors. The examples are far beyond the limited specifics that can be detailed here: neurosurgeons pushed gurneys, nurses painted patients’ fingernails, nurse practitioners and physician assistants facilitated visits outside of BMC when patients and loved ones were at different hospitals, surgical residents and medical students brought in treats patients wanted just to help them push through one more arduous day, and dietary staff baked birthday cakes so special days did not go unrecognized.
The Marathon showed us what we do well, but also taught us things we can improve upon. In the Division of Vascular Surgery, where I work, one meaningful outcome was the creation of a multi-disciplinary collaborative team across various specialties and departments to coordinate the optimal care for future lower extremity amputation patients and their families. The team includes surgeons (Vascular, Plastic, and Orthopedic), nurses, physical therapists, rehabilitation specialists, pharmacists, psychiatrists and psychologists, social workers and patient advocates. Our goal is to enhance the outcomes and experiences for these patients as they make short- and long-term adjustments to their “new normal.”
On a personal level, the Marathon tragedy has linked patients and caregivers in a unique way because of the sheer magnitude of the event, the national attention, and the hopes and prayers from people all over the world asking us to help these patients heal and move on to what inevitably will be a very different way of living for them and their families. Without a doubt, the intensity of this experience created long-lasting relationships among the patients themselves, but unique bonds also formed between the caregivers and their patients.
All of us try extremely hard to provide exceptional care to our patients in a manner that we would expect for our loved ones, in an environment where patients feel supported both physically and emotionally, and where patients can be heard and become part of the care team. Unfortunately this model has not always been the norm as our health-care system has undergone dramatic change, and doctors and hospitals are under unprecedented economic pressures and time constraints. In an ideal world, it would not have taken something like this tragedy to wake us all up to our own collective shortcomings. But for many of us, Marathon Monday is now a powerful reminder of why we became doctors or caregivers in the first place, and has created a reinvigorated model of compassionate health are that will benefit all of our patients as we move forward into the future.
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