December 20, 2013 Volume 2, Issue 21
2013: The Big Picture
BMC worked hard this year, making significant progress on its QUEST quality, safety and satisfaction goals. The hospital continued to prioritize its work guided by the Be Exceptional Strategic Plan, opening a new retail pharmacy in Shapiro and an observation unit and receiving Patient-Centered Medical Home certification. Along the way, the hospital earned awards and accolades and national acclaim for its response to the Boston Marathon tragedy. Here’s the big picture of Boston Medical Center in 2013.
- BMC Pediatrics pioneered an innovative technique to manage pain in sickle cell patients by using intranasal fentanyl, a pain medication that is sprayed into nasal passages. The treatment alleviates patients’ pain within 22 minutes of their arrival in the Emergency Department, a reduction from 70 minutes in 2012. The protocol developed here could potentially change the standard of care for sickle cell patients across the country.
- As part of BMC’s strategic plan work to Provide the Right Care to Every Patient, the hospital overhauled its radiology patient scheduling system to streamline the process of booking imaging tests. By expanding clinical access to the Radiology Information System (RIS), BMC enhanced the overall patient experience, increased efficiency and decreased the number of patients who did not show up for appointments.
- BMC received Level 1 Patient-Centered Medical Home (PCMH) designation for its Family Medicine and General Internal Medicine practices. A PCMH is a health care delivery model that is designed to improve patient outcomes and promote the most effective use of resources. It is considered a national best practice within the health care industry and benefits 41,000 BMC patients.
- BMC rolled out its revised behavioral attributes, called RESPECT. RESPECT stands for Responsibility, Empathy, Service Excellence, Problem Solve, Take Action, Efficiency, Cultural Competency and Teams Work. RESPECT is the commitment all staff, physicians and residents make to one another and to patients about how they conduct themselves. The attributes have been incorporated into a wide range of BMC’s daily business processes, including recruitment and on-boarding of new employees, staff development activities and recognition programs, and the hospital’s annual performance management process.
New signage in the Menino Pavilion.
- BMC updated its wayfinding signage on campus. The goal was to create universal, easy-to-understand directional signage that helps patients and visitors navigate the hospital campus. New signs were installed in the Menino, Moakley, Yawkey and Dowling buildings.
- BMC was honored with the Department of Health and Human Services’ Medal of Honor for Organ Donation. The medal is awarded to hospitals for achieving and sustaining national goals for donation, including a donation rate of 75 percent or more. There were 686 hospitals eligible for the award; 404, including BMC, met the donation rate goal.
- BMC was re-accredited by the Joint Commission (TJC) and achieved a near-perfect survey. The hospital achieved 99 percent compliance on 3,700 standards, receiving TJC re-accreditation for the next three years and glowing reviews from the surveyors.
- BMC was ranked No. 2 out of 17 large-volume hospitals in the state for its delivery of stroke care by the Stroke Collaborative Reaching for Excellence (SCORE), a voluntary statewide quality improvement initiative collaborative administered by the Massachusetts Department of Public Health. BMC received the award for providing “defect-free care to a minimum of 80 percent of patients;” 94 percent of BMC patients receive defect-free care.
- BMC opened a new, 12-bed observation unit on Menino Pavilion 2 dedicated to “observing” patients who are expected to be discharged with 24 hours. Patients are admitted to the unit from the Emergency Department with the expectation that they may need additional testing, imaging or observation before they can be safely discharged.
- BMC kicked off the transition to eMERGe, the hospital’s new electronic health record (EHR) system. eMERGE stands for Electronic Medical Records Generating Excellence and is the name chosen by hospital staff for the new system. eMERGE, an Epic system, will strengthen the quality of care delivered to patients and improve the integration of services across the organization. The system goes live for inpatients in May 2014 and ambulatory in February 2015.
- BMC’s second annual Multicultural Week honored diversity with music, dance and traditional cuisine. Performances from a variety of countries peppered the lobbies throughout campus during the week of March 18, and culminated with the signature Multicultural Fair where staff displayed mementos reflecting their own heritage, turning the Shapiro lobby into a cultural epicenter. During the week-long celebration, the Menino, Newton and Shapiro cafeterias featured ethnic cuisines from Caribbean jerk pork to Persian lamb stew, each day highlighting a different culture.
- In the aftermath of the Boston Marathon tragedy, the BMC community came together to heal as one and celebrate its collective strength at “BMC Strong: A Program of Hope and Healing.”
- The inaugural Be Exceptional Awards honored 20 winners from all corners of the hospital. The winners were selected for their exceptional performance, initiative and teamwork, and for embodying BMC’s RESPECT behavioral attributes.
- National Nurses Week, celebrated May 6-12, marked the 15th Annual Excellence in Nursing Awards at BMC. The ceremony honored 13 nurses who were chosen for the passion, dedication and care they provide to patients and colleagues.
BMC staff at the Gala
- The annual BMC Gala, held at the Seaport World Trade Center, raised more than $2.4 million for the programs and services BMC provides to the Greater Boston community.
- BMC earned an “A” Hospital Safety Score from the Leapfrog Group, an independent national nonprofit run by employers and other large purchasers of health benefits. It was the third consecutive year that BMC has received the A score for achieving excellent performance on preventing medication errors and infection, appropriate intensive care unit (ICU) staffing, taking steps to avoid harm and managing serious errors.
- BMC Information Technology Services (ITS) rolled out a new Help Desk, called Service Desk. Benefits of the new online system include improved ITS response time and the ability to track the status of each request in real time.
- BMC co-hosted the Boston Health and Fitness Expo, a free community event, with WHDH Ch. 7 and CW56. The two-day event attracted 60,000 people from the Greater Boston area and showcased the best of BMC’s clinical services. More than 500 BMC staff performed more than 5,000 health screenings and assessments, which included blood pressure, pulmonary function, skin, thyroid, hearing and glaucoma. Many visitors booked follow-up appointments right on the spot.
- BMC hosted its second annual Catwalk for Cancer Care. The event attracted 300 guests and featured six designers and one stylist who created unique looks for models who included modeling professionals, local celebrities and BMC staff and patient cancer survivors. The event raised awareness and funds for BMC Cancer Care.
- BMC was named by U.S. News & World Report as among the best hospitals in the region and a high performing provider – in the top 25 percent of hospitals across the country – in the areas of cancer; diabetes & endocrinology; geriatrics nephrology; neurology and neurosurgery; pulmonary and rheumatology in Best Hospitals 2013. In addition, BMC was ranked 10th in regional rankings covering all of New England and 8th in the Boston metropolitan area, which covers a wide geographic area south and north of the city. Only 15 percent of all hospitals nationwide are recognized for their high performance as among their region’s best and only 3 percent of all hospitals nationwide earn a national ranking in any specialty.
- BMC established employee resource groups (ERGs) to connect staff and build community engagement. With BMC’s support, ERGs enable small groups to meet to discuss pertinent topics and plan events relevant to their common area of interest.
- Four BMC leaders were named 2013 Champions in Healthcare by the Boston Business Journal. They include Latchman Hiralall, Manager, Preventive Food Pantry; Martha Vibbert, PhD, Director, SPARK Center; Clare Wohlgemuth, MS, RN, GCNS, Director of Nursing, Geriatrics and Lisa O'Connor, RN, BSN, former BMC Senior Vice President, Clinical Operations and Chief Nursing Officer.
- BMC was included in the 2013 InformationWeek’s 500, an annual ranking that recognizes the country's most innovative users of business technology, for its innovative work to combat telemetry alarm fatigue.
- The Carl J. and Ruth Shapiro Ambulatory Care Center won a Modern Healthcare 2013 Design Award. The Design Awards program recognizes excellence in the design and planning of new and remodeled health-care facilities and includes hospitals, extended care facilities, hospices, ambulatory care centers and medical office buildings.
Team BMC Gets Ready for the Rodman Ride
- For the fifth consecutive year, Team BMC members supported BMC Pediatric Programs when they cycled up to 100 miles in the Rodman Ride for Kids.
- BMC received the prestigious Peter F. Drucker Award for Nonprofit Innovation. BMC won the award for its efforts to ease patients’ transitions from hospital to home through Project RED (Re-Engineered Discharge), a comprehensive program that teaches patients how to care for themselves once they are discharged. The goal of the program is to discharge patients in a way that promotes patient safety and reduces re-hospitalization rates.
- BMC’s Mayo Bowl, a charity event where participants get a chance to bowl alongside celebrities, Patriots players and staff, raised more than $270,000 for BMC’s pediatric programs and Pitching in for Kids, a local charity that focuses on improving the lives of children in the New England Area.
BMC Accepted the Mayoral Prize for Innovations from Boston Mayor Tom Menino
- BMC unveiled its clinical campus redesign plan, which will consolidate the widespread BMC clinical areas to the Menino side of campus.
- BMC’s Office-Based Opioid Treatment program (OBOT) received the Mayoral Prize for Innovations in Primary Care in a health care setting for expanding access to addictions treatment.
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BMC’s Clinical Campus Redesign Construction Process First-of-its-Kind in Boston Health Care
This month 14 construction trailers will arrive at BMC as the hospital begins work on its clinical campus redesign project. Announced in October, the redesign will consolidate inpatient services on the Menino side of campus to better serve the needs of patients, families and staff. Construction will start in the Menino Pavilion in the spring, with Yawkey and Moakley to follow.
The trailers will take over the Power Plant parking lot, turning the space into a home base office for the 90 assorted contractors, engineers, architects and project managers who will oversee the redesign to its completion in 2018. Together the teams will work as one unit, utilizing a new construction model called Integrated Project Delivery (IPD).
Unlike more traditional silo’d approaches, IPD is a construction method where the key stakeholders – the architect and engineer who design a building, the general contractor who executes the work and the client who owns it – work together to optimize the project outcomes. Together the three groups agree on a project’s scope and overall budget and set a defined fixed amount of profit for each group. Rather than individual component budgets, the project’s funds are then centralized, with all three groups working from a common pool. If the project starts going over budget, the groups must dip into their individual profits, creating a strong incentive for all the stakeholders to stick within budget. The IPD process is designed to reduce waste, foster collaboration and trust among stakeholders, and maximize efficiency throughout all parts of the construction process.
IPD also utilizes the latest in construction technology. BMC and its IPD collaborators will work from a single, life-size, three-dimensional computerized building model, rather than each party working from its own two-dimensional models and paper blueprints.
The IPD method is relatively new to the East Coast, with Maine Medical Center being among the first hospitals in New England to use it. BMC will be the first hospital in Boston to utilize it, beginning with the new Menino Pavilion addition and interior renovations that start in April.
“This is the first project I’ve worked on where there’s been a strong common incentive for everyone involved to be thoughtful about money and spending it as wisely as possible,” says Bob Biggio, Vice President, Facilities Management and Support Services. “No one is trying to squeeze anyone else because everyone benefits from staying on budget. It’s a collaborative, accountable process.”
BMC has partnered with architect TRO JB to design the project, contractor Suffolk Construction to conduct the work and project management firm Tocci Building Company to oversee the campus redesign. Suffolk Construction has worked with BMC in the past, most notably when they built the Shapiro Ambulatory Care Center. As part of the IPD process, a significant portion of the final payment to the stakeholders is withheld and not disbursed unless quality metrics are met. At the conclusion of the redesign, an independent, third-party will assess the project to determine if it met the quality metrics the IPD collaborators agreed upon. If so, the final payment is then paid out. Biggio notes that this is a key element in the IPD process that ensures that the highest construction standards are met.
BMC senior leadership will advise on the project, with feedback provided to them by the Project Advisory Team (PAT). The PAT comprises clinical, support services and facilities representatives. Staff will be encouraged to provide feedback to their PAT representative or through the department user groups that are formed to facilitate the detailed design process. The membership of the PAT, as well as project schedule and design updates, will be posted on the intranet in early January.
When the redesign is completed in 2018, Biggio says that BMC will be one of the most modern hospitals in Boston.
“When the work is finished, BMC will be one of the newest, full-service, academic medical centers in town,” he notes, “and our flagship building, the Menino Pavilion, will be a state-of-the-art clinical care facility.
“It’s always a challenge to conduct construction work within occupied buildings,” he continues. “We have worked hard to phase the plan so it causes minimal disruption to patients, employees and services. We ask staff for their continued patience as we begin work on this very exciting project.”
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Patient Experience: A Year in Review
BMC undertook multiple initiatives this year to improve the patient experience, which is a major component of the hospital’s strategic plan and an annual QUEST goal. Whether it was a hospital-wide effort or teamwork at the department level, staff worked hard in 2013 to improve the experience for all patients who come through BMC’s doors. Take a look back to review what BMC accomplished this year.
Goal: Improve how the campus looks and feels
- In March, BMC updated its wayfinding signage around campus. The goal was to create universal, easy-to-understand directional signage that helps patients and visitors navigate the hospital campus. New signs were installed in the Menino, Moakley, Yawkey and Dowling buildings.
- BMC continued the Room-A-Day program, taking 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, which began in 2011, has completed 190 rooms on campus.
- This year BMC introduced music therapy to patients. Each week Linda LaSalle, a music therapist, enters patients’ rooms to sit by their bedsides and strum angelic tunes on her harp. The music has had a profound effect on patients, from calming nerves before procedures to soothing crying infants to encouraging non-verbal patients to talk.
- In late 2012, BMC rolled out its Healing Paws animal visitation program. This month, two more dogs join the program, for a total of four dogs roaming the hallways of BMC to provide comfort and love to patients who need them.
- Work is currently underway to update the patient TV infrastructure and replace all inpatient TVs with new, flat screens. The TVs play a variety of channels, including BMC’s Care channel (Channel 3) which is dedicated to 60 hours of non-repetitive nature photos and soothing music. The channel is in use in many hospitals around the country and is known to have a calming effect on patients.
Goal: Create patient/family centered care cultural attributes and behaviors
- In an ongoing effort to be a great place to work and receive care, BMC rolled out its RESPECT behavioral attributes in February. The attributes stand for Responsibility, Empathy, Service Excellence, Problem Solve, Take Action, Efficiency, Cultural Competency and Teams Work. RESPECT is the commitment all staff, physicians and residents make to one another and to patients about how they conduct themselves.
“RESPECT will help us achieve our Quality, Efficiency, Satisfaction and Total Revenue (QUEST) goals to provide a consistent, exceptional patient experience, become a more engaged workforce and thrive in a highly competitive market,” BMC President and CEO Kate Walsh told staff in February.
- In 2012, BMC rolled out its customer service training, with 1,000 staff completing training. It has continued, with an additional 1,000 employees taking the course to learn how they can provide the best service possible to patients. By the end of 2013, more than 2,000 staff will have been trained.
One example is the Phlebotomy team. In the spring, the 45-member team underwent customer service training in the Solomont Clinical Simulation and Nursing Education Center. Since then, Phlebotomy’s patient experience scores have soared, with 91 percent of patients said they were treated in a professional and courteous manner (up from 68 percent a year ago), 89 percent of patients saying their discomfort from the blood draw was better than they expected (up from 66 percent) and 95 percent saying their specimen collection experience was “excellent” (up from 78 percent). Positive comments include, “Your service is much improved,” “Fast, efficient and friendly,” and “Love this place, wouldn’t go anywhere else.”
- Since the Phlebotomy customer service training, the Simulation Center continued to be used this year to train staff to interact with difficult patients more effectively. Staff were shadowed this summer and their real-life experiences were used to help create various challenging training scenarios.
Goal: Align ancillary/ambulatory patient resources
- In June, BMC rolled out CareNotes®, BMC’s primary site for patient education. CareNotes® provides more than 8,400 patient education documents in up to 15 languages on hundreds of medical conditions. The materials are written in a simple, accessible format that includes pictures. Caregivers search for a condition, diagnosis or medication and the site pulls up the corresponding document that can be printed and reviewed with the patient prior to departure from the hospital.
- The Orthopaedic Improvement Team introduced the model of a nurse practitioner who will serve as a dedicated inpatient resource to patients with unrelieved pain. The nurse practitioner will be working on inpatient floors, particularly Menino Pavilion 7East, beginning in January.
- A number of outpatient clinics have been working on interventions to reduce wait times. Metrics will be available in the New Year and best practices will be shared.
Goal: Improve Employee Engagement and Wellness
- In 2012, BMC launched its wellness program website that offers information on BMC programs and health and wellness resources. This April, BMC introduced a spring wellness campaign, under the theme “Be Exceptional. Be Well” to promote stress reduction among staff. As part of the campaign, staff picked up free pedometers to track the number of steps they walk a day and attended Stress Reduction and Mindfulness workshops.
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What’s for Dinner?
The holidays are here with the festivities involving a feast with family and friends. Whether you are charged with bringing a side dish to the family pot luck or cooking the whole meal yourself, try out this delicious recipe from the Demonstration Kitchen’s Tracey Burg and you’ll be sure to have a holiday hit!
This recipe for mashed sweet potatoes is a twist on the old favorite, your typical mashed potatoes. Simple and sweet, this dish is easy to whip up and adds much needed balance to an otherwise savory plate. Serve it with turkey, chicken, ham and any veggie you can think of.
Mashed Sweet Potatoes
- 3 medium sweet potatoes, peeled and cubed
- 1/2 cup orange juice
- 2 Tbsp brown sugar
- 2 Tbsp butter or margarine
- Boil potatoes for approximately 10 minutes or until soft.
- Drain water.
- Add orange juice, brown sugar, and butter.
- Mash with a potato masher until smooth.
Nutritional Information Per 1/2 Cup Serving:
- Calories: 84
- Total Fat: 3 g
- Saturated Fat: 2 g
- Cholesterol: 7.5 mg
- Carbohydrates: 14 g
- Dietary Fiber: 2 g
- Sodium: 40 mg
- Protein: 1 g
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!
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What do you do, Rylie?
Title: Certified Assistance Dog
Department: Therapeutic Animal Visitation Program, “Healing Paws”
Time at BMC: 2 Months
What brought you to BMC?
I come from NEADS (National Education for Assistance Dog Services) Program, a non-profit that provides canine assistance to people with disabilities as well as returning combat veterans. Through this program I was trained by an inmate at the Massachusetts Correctional Institution (MCI) Framingham and it was time to put everything I learned to good use! The Healing Paws program needed dogs like me and BMC was a great fit, so I’ve been here for two wonderful months!
What do you do?
I make people happy. My mom, Sheryl Katzanek, Director of Patient Advocacy at BMC, checks in with doctors and nurses to see if their patients are well enough for me to visit. I travel throughout the hospital getting to know patients and staff members by snuggling and giving them unconditional love. If I can make patients forget they are in the hospital and make staff smile on my visits, I know I’m doing a good job.
What do you like most about working at BMC?
I love all my free petting, chest rubs and treats! I especially like visiting my friends in pediatrics.
People get very excited when they see you around the hospital. How should they approach you?
It’s always a good practice to ask the owner of the dog if the dog can be touched and if she says yes, we like to sniff your hand first, like a handshake for humans. This is good to know because soon my colleague Dexter and I will have two new team members – Maestro and Pip! To schedule a visit with us, call Patient Advocacy at 414-4970.
What do you like to do outside of work?
When I’m not at work, it’s playtime. I’m a Retriever, so I like to fetch everything! I also like to go walking, hiking, swimming and take naps. I have two cat sisters, Lucy and Ethel, and sometimes when my Mom and Dad aren’t paying attention, I sneak their food.
Do you have any fun plans for the holidays?
I hope it snows because I love frolicking around in the cold weather. We went to Vermont for Thanksgiving and it was snowing, so my paws are crossed that it will be for Christmas, too!
Do you know a staff member who should be profiled? Send your suggestions to email@example.com .
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In Their Words
Patients share their BMC experience
I write you today to offer my praise to the CEO of Boston Medical Center, where my family and I have been utilizing the services of the wonderful doctors for more than 20 years!
I write today as both a business owner and as a patient who understands the complexities of dealing with people. I understand the needs of patients and the complexities of health care and related costs. I recently needed to have a cardio version at the Arrhythmia Center, which was arranged by Dr. Ravin Davidoff, who has been my cardiologist for more than 30 years, as well as Dr. Bhatt from the Center.
I need you to know the staff at the Center were wonderful, caring professionals and would like to extend a special thanks to the two nurses, Mark and Bob, who could not do enough for their patients.
I think it is important that I take the time to share this story and affirm the goal of “exceptional care, without exception!”
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News of Note
Press Ganey Conference Panel
Panel Represents BMC at National Conference
The 2013 Press Ganey National Client and Executive Leadership Conferences were held Nov. 18-20 at the World Center Marriott in Orlando, Fla. The theme for this year’s conference was “A Voice for Every Patient.” BMC staff, including Dexter the therapy dog , participated in a panel about providing patient and family centered care during the Boston Marathon bombings. Brian Jack, MD, Chief and Chair, Family Medicine, gave a presentation on Project RED and BMC President and CEO Kate Walsh presented on the turnaround of BMC.
BMC Physician Appointed to Commission on Cancer Position
Scharukh Jalisi, MD, FACS, received a three-year appointment as Cancer Liaison Physician for the cancer program at BMC. Cancer Liaison Physicians are an integral part of cancer programs accredited by the American College of Surgeons Commission on Cancer (CoC). They are responsible for evaluating, interpreting and reporting their facilities’ performance data through the National Cancer Data Base (NCDB) and facilitating quality improvement initiatives based on data findings. In addition, the Cancer Liaison Physician is responsible for leading CoC initiatives within the cancer program and collaborating with agencies such as the American Cancer Society on behalf of the hospital.
BMC Volunteers Helped Hand Out Hundreds of Turkeys to Needy Families
BMC Volunteers Spread Cheer This Holiday Season
This year, BMC Volunteer Services saw more than 500 volunteers donate their time and talent to BMC. In the season of giving, volunteers have been particularly busy. For Thanksgiving, volunteers went above and beyond, put in extra hours and came in on their days off to hand out hundreds of turkeys to BMC patients in need.
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Awards and Accolades
Edward Alexander, MD receives Jerome Klein Award from Ravin Davidoff, MD, Chief Medical Officer
Edward Alexander, MD, Receives Jerome Klein Award for Physician Excellence
Edward Alexander, MD, Nephrology, is the recipient of the 2013 Jerome Klein Award for Physician Excellence. The award, established in 2010 to commemorate Klein’s 50 years of service to BMC/BUSM, is presented annually to a physician who mirrors Klein’s commitment and service as a mentor, leader, teacher, researcher and clinician.
“Ed challenges those with whom he works to rise to their full potential and he ensures that every patient interaction deserves our full commitment and when we leave the patient or the discussion, we are all a little better for that interaction,” says Ravin Davidoff, MD, Chief Medical Officer, who presented Alexander with the award. “He uses the privilege we have as physicians and clinicians to really make a difference to many, many people – patients, families, co-workers, residents, students and others, and does this in an academic way so appropriate for a proud institution like BMC.”
Alexander is a graduate of Northwestern University Medical School. He has been with Boston Medical Center (formerly Boston City Hospital) and Boston University School of Medicine for more than 40 years.
BMC Physicians Recognized as "Top Docs"
Boston Magazine released its annual “Top Docs” issue for 2013. The issue recognizes top docs in their fields and includes 68 BMC physicians who practice in 32 different specialties.
Alik Farber, MD, Receives Grant Award from NIH
Alik Farber, MD, Chief of the Division of Vascular and Endovascular Surgery at BMC and Associate Professor of Surgery and Radiology at BUSM, along with colleagues at Brigham and Women’s Hospital and Mass General Hospital, have been awarded $25 million from the NIH to study the most effective treatment for patients with the most severe form of peripheral artery disease. The team will conduct a four-year randomized clinical trial to compare traditional bypass surgery with the less invasive alternative of endovascular treatment for patients with critical limb ischemia (CLI).