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The BMC Brief

January 26, Volume 6, Issue 1

January 26, 2017

The Year Ahead: A Q&A with Kate Walsh

The BMC Brief sat down with Kate Walsh, president and CEO, to talk about BMC’s successes in 2016 and what’s ahead for the hospital in 2017 and beyond. Read on to find out about Walsh’s goals for BMC, the clinical campus redesign, her personal new year’s resolutions, and more.

What do you see as the top issues and/or challenges in the upcoming year?
I think that 2017 is going to be a very interesting and dynamic year here at Boston Medical Center, largely propelled forward by the changes MassHealth is making statewide to ensure providers are held more directly accountable for the health of the patients they serve. I see this is as a great opportunity for our hospital and health system. We’ve been thinking about our patients’ health needs in a very comprehensive way for decades and now hopefully the payment systems will be aligned with our health aspirations for our patients and with how we deliver care.

Even if there weren’t transitions at the federal level, we’d still be very busy. Those just add a layer of complexity and uncertainty, but we’re very certain we’re on the right track. We think that if we do the right thing, we’ll be able to keep moving forward in a way that we hope supports our patients and their families for many years to come.

Working with the Baker administration, we’ve secured a five-year agreement, known as a “waiver,”which creates a stable financial platform for this work to continue We’re in a good position, but we need to do everything we can to protect this agreement, and we’ll be working with our state officials and our Congressional delegation to make sure it persists.

There will also be a lot of changes on our campus with our ongoing redesign project and we’re committed to making sure all our staff get through these changes. There are lots of moving parts, but the end result is going to be great for our patients and as important will mean BMC will continue to be a great place to work.

What’s your biggest goal for BMC in the coming year?
2016 was a great year, and we have a lot ahead of us in 2017. We did really well in our three priority areas last year and I’d like to see more of the same, which I know we can do thanks to the great work our staff does every day. I’d like to make sure that we continue to make progress against the goals of making sure BMC is the safest place to be a patient, improving patient experience, and growing BMC’s volume. In 2017, we’ll refine and raise the bar on many of those measures so that we continue to improve.

BMC’s work as an accountable care organization will be expanded in 2017. What does the ACO mean for care at BMC? How will it affect how we work as a system?
The most important word there is “system.” The accountable care organization framework, which is the centerpiece of MassHealth reform, really obligates us, requires us, and inspires us to work together as a system.

So much of what we’ll do as a hospital and health care delivery system will be fueled by the strength of our Medicaid insurance plan, Boston Medical Center HealthNet Plan, which has provided access to health care for patients across the state for almost 15 years. As we move forward, we’ll be relying on our health plan colleagues to help us understand where health care dollars are spent and how to spend them more effectively so that our patients get better and stay well.

Day-to-day work won’t necessarily change for most employees, as BMC has already been a leader in caring for the whole person. But we’ll be expanding that work, and staff will need to work within BMC and with our community health centers and the communities we serve to ensure that patients get the care and resources they need.

We recently launched a BMC culture initiative, with a set of three values embodied at the hospital. How can these values guide and reinforce our work at BMC?
The work that we did was not to create new values, but to pinpoint what makes BMC great and put words around it that resonate with people, then frame our goals and work in those terms. This gives us common language to talk about how we’re going to move forward. I think of it as pulling out what’s already inside us, putting it in front of us, and saying this is what BMC looks like on its best day and this is how I can contribute to that.

These values give us a way to talk about what we’re trying to achieve. Remember, our vision focuses on the health of the patients we serve, to make Boston the healthiest urban population by 2030. To do that, we’ll have to be built on respect and powered by empathy, move mountains, and celebrate our diversity. We’ll get there because of how great our team is, and we’ll continue to work together to do the right thing for patients.

BMC is approximately halfway through the clinical campus redesign. What will the next two years look like? Are we on track to finish on schedule?
A lot will happen in the next two years, but we are on track. We embarked on campus redesign in response to trends in the health care industry and even as we are in the midst of this project, we are adapting our design somewhat to new trends. However, the overall project is on track for us to all physically be on one side of the campus by 2018.

I really appreciate all of the incredible work our staff have done to make the work we’ve done so far such a success. I know we can count on the same commitment going forward, and I’m really excited by the way the work is shaping up. I think this is great for our campus and another example of how bright our future is.

Do you have any personal new year’s resolutions for 2017?
I have the usual resolutions, like be on time for things, be healthier, and be more mindful. But my new resolution for this year is to give myself a break when I don’t meet my resolutions. I encourage everyone to do the same.

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Despite Difficult Diagnosis, a First Birthday to Celebrate 

For Evelyn Chodrick’s first birthday next month, she’ll be having a big party featuring Minnie Mouse, her favorite thing. Loving Minnie Mouse may be typical for an almost-one-year-old, but Evelyn isn’t your typical toddler. She is one of the approximately 70,000 people in the United States with spina bifida, a birth defect in which a baby’s spinal cord doesn’t develop properly in the womb.

In October 2015, Evelyn’s mother, Gena Chodrick, went for a routine ultrasound at Boston Medical Center. Gena and her husband Dale had an obstetrician in Swampscott, close to their home, and only came to BMC for the ultrasound for insurance reasons. However, it soon became clear that this appointment was anything but routine.

“After the ultrasound, a lot of different doctors kept coming in and out of my room, so I had a feeling something was wrong,” says Gena. “Finally, they explained that they saw an issue on the sonogram, and from then on it was just a black hole – it’s all a blur. It was the most devastating time my husband and I had experienced. We had no idea what we would walk into after our daughter was born, but we knew she was our daughter no matter what.”

The Chodricks met with a genetic counselor to find out what the possibilities were for their baby. A few days later, Gena underwent an ultrasound to find out exactly that type of spina bifida Evelyn had, but after that, all they could do was wait and see how much brain function and limb movement Evelyn would have after she was born.

That day came sooner than expected, when another routine test at 37 weeks showed that due to Gena’s preeclampsia, Evelyn was in distress and had to be delivered.

“After delivery, it felt like only a minute went by before Evelyn was taken to the neonatal intensive care unit (NICU),” says Gena. “It was the most heart-wrenching feeling to kiss her goodbye because I knew she would have to have surgery within 24 hours, but I was also excited because I knew the surgery would lead to Evelyn being healthy.”

Evelyn’s first surgery was to repair the myelomeningocele, an opening that the spinal cord protrudes through. A week later, she had a shunt put in her head to drain excess cerebrospinal fluid. Evelyn spent 15 days in the hospital after she was born – on the ninth day, Gena and Dale finally got to hold their daughter.

“Spina bifida comes in many forms, but in all cases some aspect of formation of the spine and spinal cord has wandered off course during intrauterine life,” says James Holsapple, MD, chairman of the Department of Neurosurgery and one of Evelyn’s doctors. “In Evelyn’s case, the result was a large opening in the lower back that exposed her spinal cord and nerves to her legs and bladder. We successfully repaired that opening and returned the spinal cord and nerves to their proper locations inside her body. Fortunately, Evelyn recovered well from this procedure and appears to have good use of her legs.”

Gena credits support from their family, friends, and team at BMC for getting them through Evelyn’s hospitalization and beyond.

“The NICU team was absolutely amazing,” she says. “In the darkest times, they made it seem lighter. The nurses not only took care of Evelyn, but took care of us in so many ways. I also can’t stress enough how amazing the entire neurosurgery team is. They took care of Evelyn like she was their own, and we’re grateful for them.”

Since being discharged, Evelyn has received early intervention services, such as physical therapy. She has full functioning of her legs and is able to pass urine on her own – functions that doctors gave her a 50/50 chance of having.

“We are all very pleased with Evelyn’s progress” says Holsapple. “She has grown into a happy and highly interactive one year old. There is no greater satisfaction that nudging along the life of someone like Evelyn and watching her parents express their growing pride and love. Such is the true magic of medicine.”

“New parents have to learn the quirks of their child’s personality and we’re learning this one is a spitfire,” says Gena. “In Evelyn’s first year of life, she’s been through more than most people ever go through, and she’s overcome all the obstacles thrown at her. This kid is the definition of a miracle.”

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New Year, New You

The new year brings resolutions for 2017, and for many that includes taking better care of themselves. Whether you want to lose weight, exercise more often, or feel less stressed, BMC offers a variety of programs, benefits, and discounts to help you achieve your goals.

Eat right

  • The Nutrition Resource Center provides a series of healthy cooking classes for BMC patients and employees. Participants learn how to make healthy meals and snacks, such as soups and stews, delicious vegetarian options, and healthier desserts. All classes are held in the Demonstration Kitchen in the Yawkey cafeteria. To view the class schedule and reserve a spot, visit the website or call Tracey Burg, Registered Dietitian and Chef, at 414-3840.
  • Interested in losing weight? Weight Watchers can help you form good habits, eat smarter, and get more exercise, without making any food off-limits. Group meetings will help you stay accountable and allow you to share your experience while you achieve your weight loss goals. The group meets monthly on site and some insurance plans will refund part of the cost. New members are welcome. Contact Tanya Crews at [email protected] for more information.
  • Eat right tip: Eating healthy during a busy week can be hard. By preparing food for the upcoming week over the weekend, you’ll save yourself time during the week and help ensure that you always have something good to eat. This way, you’ll be less likely to give into the temptation of the vending machine or picking up a pizza on the way home. Try cutting up fruits and vegetables to pack for snacks, hard boiling a batch of eggs, making multiple servings of a healthy such as brown rice, or making soup to freeze.

Get fit

  • With more than 30 locations in the Boston area, Boston Sports Club offers a wide array of classes and the latest equipment at a discounted membership rate of $49.95 per month, with no joining fee. There is an additional annual fee of $49.95. If the BMC employee is a member, family members may also be added on for the same discounted rates. For more details, call 800-611-9833, option 2.
  • The BURN Fitness Studio in the South End offers specialized group exercise classes, including indoor cycling and rowing, yoga, boot camp, and personal training. BMC employees can receive a 20 percent discount on memberships with unlimited classes and class packs. Family members be added to an employee’s membership at the same discounted rate. To take advantage of this offer, email [email protected] from your BMC email address and they will provide you with a discount code and instructions on how to purchase your membership or class packs on their website.
  • The four HealthWorks Fitness Centers in the Boston area offer fitness equipment, personal training, group classes, and spa services for specifically for women. BMC employees receive a $10 discount on the monthly membership rate. New members also receive two complimentary personal fitness sessions, a small group training session, a 25 minute massage, and a 30 minute nutrition session. To learn more, contact Perry Smizer at [email protected] or 617-731-3030.
  • South End Fitness Center, a fitness and wellness center located two blocks from the BMC campus, offers a discounted rate of $310 for a year-long membership when employees show their BMC ID badge at time of sign up.
  • Fitness Together, which provides personal training and nutrition services, offers a 15 percent discount on all training programs and nutritional counseling to BMC employees at their Cambridge location. Your first session will be free! Contact Dan Parcell at [email protected] or 617-547-4244 to register.
  • Weymouth Club, which features a pool, tennis courts, personal training, group fitness classes, and spa services, offers a 10 percent discount on membership to BMC employees and discounted mind body services. Call Membership Services at 781-337-4600 or visit their website for more information.
  • BMC employees are eligible for a 10 percent discount off memberships at the Greater Boston YMCA. Membership includes unlimited use of fitness and aquatic centers, free group exercise classes, two free sessions of Get Started coaching, free babysitting during workouts, reduced rates on youth and adult programs, personal training, and the use of most YMCAs in New England. Existing Y members are welcome to receive the monthly discount. Just bring proof of employment to the welcome center desk of the branch you originally joined. Visit your local YMCA in person with a government ID and your BMC ID badge to sign up and receive the discount.
  • Need some motivation? Whether you’re trying to lose weight or train for a 5K, a free wellness coach can help and is available through BMC’s employee assistance program (EAP). This personalized five-session wellness coaching program takes place over the phone and begins with an individual assessment to explore your concerns and help you create achievable goals. During the follow-up sessions, you and your coach will work together to address hurdles and maintain focus throughout the process. Contact BMC’s EAP at 866-695-6327.
  • Get fit tip: If you already have a fitness routine, you might prefer to do that by yourself. But if you’re trying to build a new routine or reach a specific goal, working out with a friend can help get you there. Partnering up can help make sure you actually show up for your workouts and you and your friend can motivate each other when things get tough.

Be well

  • BMC’s Employee Assistance Program (EAP) provides confidential assistance for employees and their families, with 24-hour, 7-day a week telephone and web access. Services include up to 5 face-to-face counseling sessions per issue, wellness coaching for weight loss and smoking cessation, referrals to legal and financial consultations, and access to information and resources for child and elder care concerns.
  • The Working Well Clinic has a resiliency coach/trainer, Beth Milaszewski, LICSW, who can provide individual employees and teams across the hospital direct support as it relates to stress management, addiction, anxiety, work conflicts, difficult patient encounters, traumatic events and situations, interpersonal skills, difficult team dynamics, assistance with booking behavioral health appointments, and more. Beth is available for employee consultations, as well as department/team sessions. To book an appointment call 638-8400 or visit the Working Well website to learn more.
  • Taking care of others can make it harder to take care of yourself. BMC employees can get help with services from Care.com, which provides a listing of pre-screened high quality caregivers for a variety of child, adult, pet and household services. To learn more call 855-781-1303 or visit bmc.care.com. 
  • Effective time management can help you find the time to be well. Circles can help you manage your time and take care of your to-do list. Circles will research and provide information on anything you need, from finding an electrician to planning a vacation to joining a gym. To register, visit members.circles.com/BMC and use code circlesBMC.
  • Various resources are available to employees who are looking to quit smoking. You can choose from wellness coaching by phone through BMC’s EAP, attend a session at the Tobacco Treatment Center held weekly in Shapiro, or the Smoking Cessation Program through BMC’s Division of Psychiatry. Find out more here.
  • Looking to improve your sleep? BMC has partnered with Sleepio to make their sleep improvement program available to employees. Take a two-minute test to discover your sleep score and how to improve it at www.sleepio.com/work/bmc.
  • BMC employees and their family members who are enrolled in a BMC health plan through Harvard Pilgrim Healthcare now have access to a diabetes support program. In addition to better health, participants who meet all program requirements will receive their diabetes medications and supplies for free through a BMC pharmacy. Visit GoodHealthGateway.com, or call them at 800-643-8028 to learn more.
  • If you’re a caregiver who has experienced a stressful patient event, you can call BMC’s new peer support group, which provides confidential, compassionate, and timely support for BMC caregivers. To connect with one of over 40 trained peer counselors, call 617-638-7910, email [email protected], or visit the Peer Connection intranet site.
  • Be well tip: Did you miss your goal for the day? That's okay! If you're too hard on yourself, it will make it harder to accomplish any of your goals. So if you missed your workout or stayed up late today, try again tomorrow. Any progress is better than nothing, even if you don't quite meet your goal.

Relax and rejuvenate

  • Acupuncture is available for employees on Monday evenings from 4:30-7:30 p.m. in the Family Medicine Clinic. Appointments last approximately one hour and the cost is between $25-40. Once a staff member starts acupuncture treatment, recurring appointments are guaranteed every other week at the same time for eight weeks. Contact Danny Ishak at [email protected] or 414-6264 to schedule an appointment.
  • Yoga is a gentle exercise that combines different postures/stretches with meditation and breathing exercises. It can help health conditions such as back pain, as well as relieve stress and anxiety. All BMC patients and employees are eligible to attend free yoga classes on Tuesdays from 6-7:15 p.m. and Thursdays from 4:30-6 p.m. in the lower level of the Moakley Building. Classes are suitable for all levels and no registration is required. More information can be found here.
  • Qigong/tai chi is a Chinese practice that utilizes slow, graceful movements and breathing exercises to promote the circulation of “qi,” or life force, within the body. It can increase balance and flexibility, as well as reduce stress and improve overall well-being. All BMC patients and employees are eligible to attend free tai chi classes on Wednesdays from 4-5:30 p.m. in the lower level of the Moakley building. Classes are suitable for all levels and no registration is required. More information can be found here.
  • Meditation sessions, led by Bill Crane from the BMC Office of Spiritual Care, are held Mondays from 12:30-1:15 p.m. in the Newton Chapel. Each session includes instruction (intended to guide beginners and support more experienced practitioners), then a period of silent meditation practice, followed by a brief opportunity for questions and discussion. The meditation sessions are offered on a drop-in basis to all hospital staff and patients, as well as members of the public. People can come late or leave early if needed.
  • Massages are available to employees through the Family Medicine Department. An hour long session costs $10-50, and is determined on a sliding scale. Sessions are available from 10 a.m.-1:15 p.m. on Wednesdays and 10 a.m.-2:15 p.m. on Thursdays. Contact Danny Ishak at [email protected] or 414-6264 to schedule an appointment.
  • Relax and rejuvenate tip: At the end of each day, note a few things that you were grateful for the day, whether it’s as small as a cup of coffee or as big as finishing a project at work. This will help you take a few minutes to reflect and focus on the positive in your life, which in turn will make you happier and more relaxed.

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In Celebrating Martin Luther King Jr, Valuable Lessons on Understanding Differing Views

As Martin Luther King Jr.’s “I Have a Dream” speech played in the background, members of the Boston Medical Center and Boston University School of Medicine communities gathered to reflect on King’s messages. This year’s featured speaker was Kenneth Elmore, JD, associate provost and dean of students at Boston University, who began by expressing his pride in getting an opportunity to publicly honor King.

“There are so many people who fought so hard for me to be here today,” said Elmore. “I never thought this is something I would get the chance to do, just as I never thought I’d see a Barack Obama or Hillary Clinton. It shows there is progress.”

Elmore then turned to King’s ideas of chaos and community, saying that a little chaos and a little community are both good for us and enable us to changes such as economic growth, housing, and social change. In order to achieve those things, Elmore said that we can’t be afraid to be who we are.

“King said that we must all develop within ourselves a sense of ‘somebodiness’ in the face of an ambivalent nation,” said Elmore. “That idea still resonates in today’s world.”

Recently Elmore was feeling despair about the social and political climate in the United States and found himself engaging with people in a different way than usual. He went into churches and bars to listen to others, and talk to people he wouldn’t normally talk to, about hard subjects. This allowed him to come to grips with his own fundamental values and learn where he could understand the other side.

“Understanding the other side is a hard thing to do, especially at this juncture in our country,” said Elmore. “For example, I believe that people deserve human dignity despite the color of their skin, who they love, or how much money they have, and I find it hard to sit with someone who believes otherwise. But we have to do it.”

Those unusual conversations led him to five lessons. The first is that we cannot forget history.

“When you live with history in your mind, it feels better,” said Elmore. “You can see progress and the people who have fought and are fighting for it.”

Second, everyone has to do their own work in their own way, engaging with the culture that feels more useful and pertinent to them in the moment. For Elmore, this was artists such as Nina Simone, John Coltrane, and Toni Morrison, along with many others. Related to this is the third lesson Elmore learned, which is that he had to understand that he was deeply affected by what was happening and that he was afraid, particularly for his children and other people’s children.

The fourth lesson is to find affinity groups to sit with and have the conversations you feel you need to have. While understanding what bubbles you’re in is important, there’s nothing wrong with getting together with your group and talking openly and honestly. When in those groups, you can work on Elmore’s last lesson, which is to get better at listening and being open to the notion that you’re wrong.

Elmore ended his talk by coming back to the words of a traditional song that has stuck with him since it was sung to celebrate big life changes in his childhood church:

Ain't gonna let nobody turn me around 
Turn me around, turn me around 
Ain't gonna let nobody turn me around 
I'm gonna keep on a-walkin', keep on a-talkin' 
Marchin' up to freedom land.

These words, said Elmore, are a refrain that he uses to remind himself that we’ve come through a lot and will make it through whatever is ahead.

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What do you do, Alan Au?

Name: Alan Au
Title: Outpatient staff pharmacist
Time at BMC: A little over a year

What do you do at BMC?
The outpatient pharmacy dispenses between 1,500 and 1,600 prescriptions on an average day, so a lot of my job is ensuring that those prescriptions are correct and safe for patients. When a prescription comes into the pharmacy, it gets typed by a pharmacy technician, and then another pharmacist or I will make sure that what’s typed matches the prescription that came in. We’ll also check to make sure that the medication is okay for the patient to get – that there are no negative interactions with other medications they’re taking, that they’re getting the correct dosage for their height and weight, and any other safety concerns. Once we verify the prescription, another pharmacy tech will fill it, and then I’ll do a final verification to ensure the prescription is correct. This double check system is somewhat unique to BMC, and makes things safer for the patient.

I also work on a variety of projects around the hospital. For example, we do bedside delivery of medication for patients about to be discharged from Pediatrics and a few other inpatient units; the adult “meds to bed” program will be expanding soon. Approximately 35 percent of our prescriptions are mailed to patients, so I help fill prescriptions for that program. The final way we get prescriptions to patients and ensure they take their medications correctly is to prepare monthly blister packs for patients who have complicated regimens or problems with compliance. In addition, I help teach patients who have just received a diabetes testing meter how to use it to test their blood sugar.

What brought you to BMC?
I went to school with a few people who worked at BMC, and they all told me they enjoyed their job and liked the people they work with, so I decided to apply. I was working in a retail pharmacy but wanted the opportunity to work more closely with providers.

What’s something people may not know about Pharmacy?
One thing that people might not realize is that getting medication to patients is really a team effort. We might need more information from the provider or patient, such as insurance coverage, so please bear with us if it takes longer than you expect to get the medication out. However, BMC has a good communication system to help ensure we get the information we need.

Another thing that employees should know is that we offer outpatient pharmacy services for staff. There’s even a separate pharmacy entrance to help employees get their medication more quickly, and we pride ourselves on providing good service to staff.

What do you like most about working at BMC?
I work with a large group, but it’s close-knit, and I really enjoy that. I also like the growth opportunities available and the fact that management takes time to develop staff members. I’ve had the opportunity to work in all three pharmacies, which really helps me do my job more effectively.

What do you do for fun outside of work?
I like to travel with my family and friends, and recently went to Vancouver. I grew up in Vancouver and love snowboarding there. I also play a lot of basketball and chess.

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Awards and Accolades

Thea James Honored with the Jerome Klein Award for Physician Excellence
Thea James, MD, Vice President of Mission and Associate Chief Medical Officer, has been awarded the Jerome Klein Award for Physician Excellence. The award honors Klein for 50 years of service to Boston Medical Center and Boston University School of Medicine, and is given annually to a physician who has demonstrably improved the lives of his/her patients, has a track record of excellence, is an outstanding mentor, leads with a positive attitude, and is supportive of colleagues and other health-care providers.

“We have all felt her presence as she helps chart our journey to truly incorporate social determinants of health into today’s practice as well as guide our vision to make Boston the healthiest urban population in the world,” said Ravin Davidoff, MBBCh, Senior Vice President and Chief Medical Officer, who presented the award to James. “She exemplifies the values to which we are committing as an organization. There is no more qualified or appropriate recipient for this award and I am proud to present the Jerome Klein award to you as our sixth recipient.”

Adam Rose, MD, Receives a Presidential Early Career Award for Scientists and Engineers
Adam Rose, MD, a primary care physician at Boston Medical Center, has been named as a recipient of the Presidential Early Career Award for Scientists and Engineers, the highest honor bestowed by the United States Government on science and engineering professionals in the early stages of their independent research careers. Awardees are selected for their pursuit of innovative research at the frontiers of science and technology and their commitment to community service as demonstrated through scientific leadership, public education, or community outreach.

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