The BMC Brief Volume 6, Issue 5May 17, 2017
Ken Murray had been feeling tired and run down for months, but problems with his vision eventually drove him to the doctor. In April 2014, he noticed a rapid decline in vision and went to an ophthalmologist. During the exam, the doctor checked Murray’s blood pressure, which was so high that he immediately sent Murray to the emergency room at South Shore Hospital.
At South Shore, Murray was diagnosed with stage four kidney failure and told that the damage to his kidney was irreversible. He would need a kidney transplant, and his doctor recommended BMC as the place to have this operation.
“I thought I would be there overnight, but I was there for ten days,” says Murray. “Looking back, I had a steady decline, so it was hard to see how bad things had gotten at the time. But I trusted my doctor when he said that BMC was the best place for my operation.”
Luckily, Murray had several family members who were willing to donate a kidney if they were found to be a match, including his sisters Linda Noyce and Sharon Coon. Approximately eight months after Murray was told he needed a transplant, his younger sister Noyce began the process of preparing to donate, which she says happened by “default.”
“Our mom and I went to donate blood and find out what blood type we are, but her blood pressure was too low that day and she couldn’t donate,” says Noyce. “Our other sister, Sharon, was very busy with work, so she was going to get tested after us. But when they tested my blood, they found out I was a good match, so I went ahead with the donation process.”
After Noyce had gone through several months of the process necessary for her to donate, she began to feel anxious.
“I love my brother and of course I wanted to donate for him, but I began to get worried about carrying the burden of the procedure myself,” says Noyce. “I was trying to act strong, but eventually I told Sharon what I was feeling and asked her to be tested.”
The family didn’t know that only one person could be go through the donation process at a time, but Noyce’s process had to be put on hold while Coon was tested. She ended up being the best match and the family decided that therefore Coon should donate instead.
Things continued to go smoothly until April 2016, when Coon was screened for cancer as part of the process. During the mammogram, which Coon says she was two years overdue for, doctors discovered that she had stage one breast cancer.
“Linda’s apprehension saved Sharon’s life,” says Murray. “Her cancer was stage one with clean margins, but if she didn’t have to get a mammogram then, she probably wouldn’t have noticed anything until it was a bigger problem.”
Murray, Coon, and Noyce, along with other patients, reunited with their doctors recently at BMC's Living Donor Reception on April 28. "Choosing to donate an organ to a friend or loved one is one of the most selfless acts an individual can choose to undertake," said Greg Bloom, operations manager for transplant surgery at the reception. "The devotion and sacrifice required for such a process is virtually unmatched, which is why from day one of your evaluation, you are all heroes. This event is but a small token of our appreciation for your colossal un dertaking, which is why this afternoon, we honor you."
Coon was soon treated at BMC, receiving radiation and undergoing surgery to remove the cancer. After Coon’s diagnosis, Noyce went ahead with the donation process and donated her kidney to Murray in May 2016. All surgeries went smoothly and everyone in the family now has a clean bill of health.
“Being at BMC was a blessing for the whole family, from beginning to end,” says Murray. “All our nurses, doctors, and everyone else who took care of us were great. I would recommend BMC to anyone”
“I didn’t even want to leave!” says Noyce. “When they said I could go, I tried to stay another day. Everyone was so friendly, from the doctors to Food Service workers. It’s really about the quality of the people working here. They treat you like a person, not just a number.”
“It makes you look at life different,” says Coon. “This is a good reminder to take better care of yourself. BMC gave us a second chance to do so.”
Boston Medical Center is taking its reputation as the greenest hospital in the Boston quite literally, as work is currently underway to transform the once desolate roof on top of the power plant building into the largest rooftop farm in the city. This growing season, approximately 15,000 pounds of food are expected to be harvested, most of which will go directly to BMC patients.
“The goal with what we grow is to reach as many of our patients, employees, and community members as possible,” said David Maffeo, senior director of support services. “We expect food grown on the rooftop farm to make its way to the Preventive Food Pantry, Demonstration Kitchen, cafeterias across campus, patients’ plates and if is there is enough left over, we could host BMC’s own farmer’s market.”
Maffeo recruited a group of volunteers to plant across the 7,000 sq. feet of rooftop in late April. By mid-June, some of the food will be ready for picking, with bigger crops such as tomatoes, eggplants, cucumbers, summer squash, and peppers ready for harvest in mid-to-late July.
The rooftop farm supports BMC’s green initiatives and reduces the hospital’s carbon footprint by increasing green space, adding carbon-breathing plants, reducing the building’s energy use and runoff water, which can help prevent pollution in waterways.
The brainchild of Maffeo and Robert Biggio, senior vice president of facilities and support services, with the support of Alix Carey, deputy director of family philanthropy, and Norman Stein, senior vice president and chief development officer, the rooftop farm project was a year and a half in the making. Maffeo worked with Lindsay Allen and John Stoddard of Higher Ground Farm to find a rooftop and growing system that would work best for BMC’s needs. Before the power plant’s rubber roof could provide the first plant with its new home, a protection barrier consisting of two layers of boards and turf was installed.
Allen, who will serve as BMC’s first farm manager, also completed a light study of the roof to determine the feasibility of growing crops in the space. While the Shapiro Ambulatory Care Center provides a great view of the farm, the building and others nearby do not cast significant shadows on the roof, so the rooftop farm got the green light.
Without donors and other partners, including Recover Green Roofs and the Vermont Composting Company, Maffeo says BMC’s rooftop farm would not have been possible.
“I think one of our other important ‘harvests’ from the farm is the knowledge exchange that will happen around food, health and local food in relationship to the farm,” said Allen. “We are what we eat, so the more people we can provide, healthy, nutrient dense food to the healthier our communities will be.”
According to Stoddard, who has been a consultant on the project, rooftop farms function very similarly to ground level farms and generally can accommodate the same crops as other farms. The main constraints are soil depth, wind, and access – you cannot simply drive a truck right up to the farm for a compost delivery.
“Rooftop farmers sometimes need to get creative to adapt to these unique circumstances,” said Stoddard.
Plans continue to evolve regarding the farm. Maffeo is having two urban beehives installed on the rooftop in early June, and he believes having one or two apple trees on the roof is a possibility. There will be opportunities for employees to engage with the farm, volunteer, and help pick some of the crops.
“Everyone involved is very passionate about this project and the prospect of getting fresh, local food to our patients across the street. It’s going to be an exciting summer as BMC’s own crops really start to grow,” said Maffeo.
At BMC, our goal is not only to help patients with medical issues, but also to ensure that they have a positive experience in every interaction, every time they come to the hospital. This helps lead not only to better patient outcomes, but also to greater job satisfaction for employees, due to the positive encounter and closer bond between patient and provider.
One way BMC is improving patient experience is through physician champions, who observe and coach providers to help improve patient experience. The physician champions are also available to introduce providers to AIDET, a communication framework to help improve a patient's experience and reduce their anxiety. It stands for acknowledge, introduce, duration, explanation, and thank you, which are key building blocks of a positive patient experience at BMC.
Below are two of the many stories of the power of coaching and how BMC is providing positive patient experiences.
- “I now incorporate several things from AIDET that I did not use to do before we started the patient experience coaching program. First, I now make sure I use patients’ names every time I come into the exam room. I never thought much about it before assuming it was sufficient to introduce myself and be warm and inviting. I now think it makes a difference. The second thing I now do is use Google Images to provide pictures to supplement my explanations. I have seen people light up with understanding since doing this and am convinced it makes explanations more understandable. Finally, I say thank you for coming in at the end of the visit. It had never occurred to me before to do this and now that I have made it a habit, it feels good both for me and the patient.”
- Asher Tulsky, MD, physician in General Internal Medicine and patient experience physician coach
- “I had the opportunity to observe an ophthalmologist seeing patients. We entered the first exam room and I was surprised to observe the ophthalmologist speaking in an Albanian language to the patient and family of the patient. I asked the ophthalmologist if she comes from an Albanian family. She replied saying that she has no Albanian relatives but she learned enough of the Albanian language to conduct an eye exam speaking Albanian. When we went into the next exam room, the ophthalmologist started speaking Haitian Creole to the patient and family so I realized that she had learned enough Haitian Creole to be able to examine a patient's eyes and proceed through the office visit speaking the language of the patient. Of course, there was a Spanish-speaking patient in the next exam room and there, too, the ophthalmologist spoke in the language that the patient could understand. Finally, the ophthalmologist spent time with a patient who has cognitive challenges and various special needs. The ophthalmologist could not have been more kind or empathic with all of her patients. From what I saw, no one could have been more kind, caring, and respectful of patients than this wonderful physician. There are a lot of physicians like this one at the BMC - our patients are lucky to have as their caregivers such an empathic and skilled group of caregivers.”
- Kenneth Grundfast, MD, chairman of Otolaryngology and physician coaching lead
The patient experience team plans to continue physician coaching across ambulatory departments through the end of the year, to help ensure that all patients have a positive experience at BMC.
If you would like to meet the coaches or learn more about our coaching plan or AIDET, please reach out to Kristen Kremer, senior manager of patient experience, [email protected].
Name: Louise Fazakerley
Title: Operating room staff nurse
Time at BMC: 12 years
Q: What do you do at BMC?
A: I work as a nurse in the operating rooms, usually in either a circulator or scrub role.
Scrubbing in means that I assist the surgeon with the actual operation. As a circulator, I would run the operating room in terms of obtaining necessary items and making sure the operation goes smoothly for anesthesiologists and surgeons. The number one goal in these roles is to make sure everything is safe for the patient.
Other days, I float, which means assisting other staff members that are in rooms with the care of their patient. I get them equipment they need, assist with the patient’s needs, help lift patients, and even interview patients prior to surgery.
Q: BMC recently won an award from Practice Greenhealth for environmental practices in the operating room, which you helped lead. Can you tell us more about this initiative and why it’s important?
A: To start the initiative, I worked closely with Housekeeping to make sure that everything – paper and plastic – that can be recycled is recycled. To do this, we set up bins in every room to collect clean items that are recyclable.
The next step was to work on recycling for the pink and blue paper that the Central Processing Department (CPD) uses to wrap equipment in after it’s been sterilized. This is heavy-duty paper with a plastic coating on it. The Housekeeping team found a company willing to recycle this paper. At first, we recycled this paper separately, but we eventually found out we can recycle it with the rest of our paper and plastic. That helped get people on board with all this recycling, because it was only one bin to keep track of.
There are many people in the OR that believe in recycling. I’m very avid about it, but most people do want to help. Nurses in Moakley and Newton Pavilion have also been very involved in getting recycling efforts started in their operating rooms.
I really believe in the importance of recycling. My kids and the younger generation needs to have a clean world.
Q: What brought you to BMC?
A: I prefer working in city hospitals. The clientele and the whole functioning of city hospitals is different. I was also interested in trauma nursing, which BMC obviously has a lot of as a trauma center. BMC had an allure to it, and I also liked that it was affiliated with Boston University. I was already in OR nursing, so it made sense for me to continue in the OR here.
Q: What do you like most about working at BMC?
A: It’s a very educational environment. I’m always feeling stimulated to learn more, and the doctors and nursing leadership are very good about teaching us. I learn a lot from them.
Q: What do you do for fun outside of work?
A: I bike ride. We’re actually planning a group bike ride for nurses in Falmouth this month. I spend a lot of time up on the coast in Rye, New Hampshire, and I like to bike ride up there. I also like to spend time with friends.
BMC Named a Best Midsize Employer
BMC was named on Forbes Magazine’s 2017 list of best midsized employers in the United States. The list is based on an independent survey from a sample of over 30,000 Americans working for mid-sized or large institutions.
BMC Nurses Honored in Salute to Nurses
Nine BMC nurses were honored in the Boston Globe’s 2017 Salute to Nurses feature. Nurses are nominated by patients to honor their compassion, strong clinical skills, excellent communication, trustworthiness, and patient advocacy. The BMC nurses are:
- Donna Beers, RN, Primary Care
- Kathleen Cahill, RN, LICSW, Psychiatry
- Lynda Cohen, RN, SICU
- Mallory Coleman, RN, SICU
- Benjamin Henry, RN, SICU
- Beth Stevenson, RN, SICU
- Kristen Zetlan, RN
- Keri Fromm, RN, Emergency Department
- Christina O’Connor, RN, operating room nursing
David Center, MD, Honored with Breathing for Life Award
David Center, MD, a pulmonologist at Boston Medical Center and the Gordon and Ruth Snider professor of pulmonary medicine, associate provost for translational research, and chair of pulmonary medicine at Boston University School of Medicine, was honored with the 2017 Breathing for Life Award from the American Thoracic Society Foundation. This award is the highest honor given to an ATS member for philanthropy, scientific achievement, and commitment to mentorship.
Center is also the director of the Clinical and Translational Science Institute at BUSM. In 1982, he and William Cruikshank, MD, identified T lymphocyte-specific chemotactic factor, now known as Interleukin 16. Their research has opened doors for other researchers interested in allergic diseases, asthma, HIV, and cancer. In addition, Center’s weekly clinic is one of the longest-running at BMC.
StreetCred Founders Win Claneil Foundation Emerging Leaders Award
Lucy Marcil, MD, and Michael Hole, MD, BMC pediatrics residents and the founders of StreetCred, have been named the recipients of the Claneil Foundation Emerging Young Leaders Award. The award provides StreetCred with $60,000 a year for four years, plus $10,000 for professional development. StreetCred helps BMC patients file their taxes and benefit from the refunds they are entitled to. In April of this year, they reached $1,140,760 in tax refunds for patients.
Urban Health and Advocacy Track of Combined Residency Program Wins APA Teaching Program Award
The urban health and advocacy track of the Boston Combined Residency Program has won the American Pediatrics Society Teaching Program Award, the most prestigious teaching program award from the APA. The Boston Combined Residency Program brings together the pediatric training programs of Boston Children's Hospital and Boston Medical Center to train subspecialty and general pediatricians in both a distinctive and integrated manner.
Diane Hanley, MS, RN-BC, Named President of the American Nurses Association Massachusetts
Diane Hanley, MS, RN-BC, director of professional practice, nursing quality, and education at Boston Medical Center, has assumed the role of President of the American Nurses Association Massachusetts. ANA Massachusetts is the largest professional association of nurses across all specialties of practice in the Commonwealth. The mission of ANA Mass is to advance the profession of nursing and quality patient care across the Commonwealth through advocacy, leadership development, education and mentorship.
General Internal Medicine Team Publishes Article in Annals of Family Medicine
The hepatitis C team in General Internal Medicine published an article entitled "A Hepatitis C Treatment Program Based in a Safety-Net Hospital Patient-Centered Medical Home," in the May/June issue of the Annals of Family Medicine. The article details BMC’s unique and successful approach to treating patients with hepatitis C.