The BMC Brief

September 13, 2012 Volume 1, Issue 30

• Long-Term Staff Honored at Employee Recognition Event
• BMC Launches Employee Engagement Survey
• Public Safety Offers De-Escalation and Safety Classes
• Leadership Corner: Tom Traylor, Vice President, Government Programs
• What Do You Do, Daniel Remick?
• In Their Words
• News of Note

Long-Term Staff Honored at Employee Recognition Event

Many started in 2006 and 2001. More than two dozen started in 1991. Almost 50 started in 1981. And a handful started in 1971.

Honorees at the recognition ceremony

But back in 1966, it was four long-term employees who began their careers at Boston City Hospital or University Hospital (now Boston Medical Center). They, along with 721 of their colleagues, were honored Sept. 6 for their years of service to the hospital as part of BMC’s annual Employee Recognition Program.

The event, held under a tent on the Moakley green, was hosted by BMC President and CEO Kate Walsh.

“Each and every one of you makes it possible for us to deliver great care. And no one does a better job than you do of taking care of the patients we serve,” Walsh told the crowd. “Thanks to you, together we’re tackling challenges head on, and we’re building a solid foundation to make sure we’re strong and thriving for the patients who need us. On behalf of everyone in senior management and the millions of patients and families whose lives you’ve touched, thank you for many years of hard work and commitment. You do us proud.”

Attendees watched TV screens positioned around the tent as Walsh took the crowd back five to 45 years, highlighting significant events from each era, including music, movies, health advances, politics and sports. The interactive portion of the ceremony included a group dance to the song “Macarena,” which debuted in 1996.

Following the highlights, members of each class stood to be recognized by their peers, to a thunderous chorus of clapping, noise makers and cheers.

Two employees were recognized for their 45 years of service to BMC.

Catherine Cooper started as a clerk typist at Boston City Hospital in 1966. Over the years, she worked as head clerk in Housekeeping and the Department of Health and Hospitals. In 1985, she became the administrative secretary in the Yawkey Administration Department, and since 1997, has served in her current position as receptionist at the Moakley information desk.

Walsh with 45-year employees Sheila Ryan (L) and Catherine Cooper (R)

Says Cooper’s manager Bill Gibbons, Assistant Director, Public Safety: “Cathy’s role puts her on the front line of the patient experience. She is responsible for assisting patients and visitors with everything from campus directions to clinical appointments to connecting them with their loved ones on the inpatient units. Cathy greets everyone in the Moakley lobby with a warm welcome and a heartfelt smile. She truly understands the importance of an exceptional patient experience.”

Cooper accepted a floral bouquet from Walsh while her favorite song, “I Believe I Can Fly,” played in the background.

Sheila Ryan started at University Hospital in December 1966 as a Medical Technologist in the Lab Medicine Department. She never left home; she continues to work in the Microbiology Lab today.

Says Ryan’s supervisor Beverly Orr: “Sheila is a ‘dynamo" in the microbiology lab. She has never said ‘not in my job description’ and she remembers the days when there was no electronic medical record and everything was done by paper and charted several times a day. Sheila says she loves her job and loves life.”

Walsh presented Ryan with a floral bouquet while her favorite song, “Round Midnight,” played in the background.

In closing, Walsh thanked all honorees for their combined 9,300 years of service.

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BMC Launches Employee Engagement Survey

BMC is launching its second confidential, hospital-wide employee engagement survey September 24-October 5. It’s an opportunity for all staff to make their voices heard by telling BMC what it’s like to work here.

The purpose of the survey is to take the pulse of the medical center to learn what is working and what’s not, which will help guide future changes and improvements.

“Our goal is a workplace where everyone clearly understands how their contributions and commitment directly link to BMC’s success and to achieving our goals,” says BMC President and CEO Kate Walsh. “This survey is a way to measure how we’re doing.”

Staff will receive an email Sept. 24 with a link to the survey. Paper copies will be available in Human Resources for those who have limited or no computer access. All responses will be anonymous and collected by a third-party vendor.

BMC launched its first survey in 2011. Sixty percent of staff responded, citing facility cleanliness, leadership development and communication from senior leaders as opportunities for improvement.

Changes have been made on both the unit and organizational level. These changes include:

Organization:

• Room-a-Day Program: The program takes two inpatient rooms out of commission each day of the week to “refresh” them, which can include painting the walls, waxing the floors and maintenance work on heating and cooling systems. The program has refreshed 95 rooms thus far.

• Management Development Program: A new professional development program for managers offers workshops focused on developing key competencies, promoting consistency of management practices throughout BMC and supporting employee and manager engagement.

• Senior Leadership Rounding: Members of senior management now walk units and floors each week to chat with staff and address any questions or concerns they have. The schedule is posted on the intranet each week.

• Huddle Card: Each week managers and directors share need-to-know hospital information in person with their staff.

• Town Hall Meetings: Meetings are now held quarterly by President and CEO Kate Walsh to inform the BMC community of important happenings.

• Digital Signage System: Ten flat screen monitors have been installed in lobbies and cafeterias to share information campus wide.

• Recognition Committee: The committee, comprised of staff from around BMC, plans hospital-wide events, like lobsterfest in August and Hawaiian shirt day in June.

Departments/Units:

More than 200 actions plans have been created and implemented by departments and units to enhance their work environments. Examples of initiatives include:

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

• Department newsletters: Work groups, such as Support Services and Finance, have rolled out newsletters to their staff that highlight department happenings, employee excellence, birthdays, anniversaries and fun facts.

Learn more about the staff survey by visiting the BMC intranet.

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Public Safety Offers De-Escalation and Safety Classes

A patient’s family member arrives at the hospital and learns that he is not on the visitor list. When told by staff that he is unable to see the patient, he becomes very aggressive. How should staff respond?

Training Specialist Eric Anderson

Scenarios like this can be common at hospitals. The Department of Public Safety offers de-escalation and safety classes to all staff that provide effective tools for handling these types of situations.

The four-hour classes are offered monthly and teach participants to recognize and assess danger signs, provide instruction on verbalization skills, personal safety strategies and basic self-defense techniques. Classes are taught by Eric Anderson and Stephen Taranto, veteran “safety” trainers who have been teaching this and similar courses for more than 20 years at hospitals throughout New England.

“Hospital employees can encounter ‘escalated’ or volatile individuals who need to be de-escalated to make the situation safe for them to provide medical care,” says Anderson, Training Specialist, Public Safety. “Staff may also encounter a patient’s family members who, under the influence of heightened emotion, use aggression or violence. The safety rule of thumb is that we cannot help others if we are injured, so personal safety is a top priority.” Anderson notes that since violent behavior is not tolerated in hospitals, de-escalation and safety courses are requested often by employees.

Course objectives include establishing a personal safety plan for use at work and as a life skill, learning assessment techniques to identify potential danger signs and pre-attack indicators, developing de-escalation skills, and as a final option, gaining the ability to employ effective and reasonable physical defense options. This short, basic, hands-on self-defense segment offered at the end of the training is for use if all other de-escalations techniques employed are ineffective.

“Staff who have attended the classes are extremely positive about the quality and relevance of what they learned and the integration of it to their work environment and daily life,” says Connie Packard, Director, Public Safety. “I often hear from them months or years later about how the skills and scenarios Eric and Steve have taught them continue to be effective in managing challenging situations. We are pleased to offer this program to the BMC/BUMC community as part of our mission to ensure a safe medical center.”

Classes are offered Monday, Sept. 17, 3–7 p.m.; Wednesday, Oct. 17, 1–3p.m.; Wednesday, Nov. 14, 7–11a.m.; and Wednesday, Dec. 5, 7–11 a.m. at 85 East Concord St., 4th Floor, Nursing Classroom. Registration is limited to 15 students.

To register or for more information, contact Karen Proctor at 617-638-580.

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Leadership Corner: Tom Traylor, Vice President, Government Programs

Tom Traylor, Vice President, Federal, State and Local Programs, oversees the government funding BMC receives through Medicaid and Medicare.

BMC Brief staff recently spoke with Traylor about how BMC and its funding are impacted by the recent health care legislation.

State and federal health care funding is changing. What has changed in the way BMC is paid for providing Medicaid services and what opportunities and challenges does that present to BMC?
BMC has historically received supplemental federal funding targeted to hospitals that care for large numbers of Medicaid and uninsured patients. These funds help fill the gap between the cost of providing the care and the lower rates of reimbursement paid by Medicaid. Under the new Massachusetts Medicaid waiver, the state and the federal Centers for Medicare and Medicaid (CMS) required that BMC and other Massachusetts safety net hospitals develop and implement initiatives that would support the transformation of health care delivery away from a fee-for-service model, where providers are paid each time a patient receives care, toward a system where payments are tied to patient outcomes. Instead of being paid for simply providing care to Medicaid patients, BMC now must meet certain quality goals and metrics in implementing seven transformative initiatives aimed at delivering coordinated, high quality, cost-efficient care. These projects are aligned with the work BMC is undertaking under the Be Exceptional strategic plan.

What projects are tied to this funding?
There are seven projects tied to the funding. The first is to achieve National Committee for Quality Assurance recognition for the creation of patient-centered medical homes (PCMH) for the General Internal Medicine and Family Medicine practices. These practices collectively care for 35,000 of our BMC primary care patients. The PCMH model is designed to promote comprehensive, coordinated, patient-centered care delivered by teams of primary care providers, including physicians and nurses. In a patient-centered medical home, a primary care provider and members of his/her team coordinate all of a patient's health needs, including management of chronic conditions, visits to specialists, hospital admissions, and reminding patients when they need check-ups and tests.

The second project is to operate a support center to handle scheduling and administrative issues for BMC’s 30,000 General Internal Medicine and Women’s Health patients. BMC has begun this process with the creation of its Patient Care Support Center.

The third project is the Solomont Clinical Simulation and Nursing Education Center. BMC opened the Center in March to improve the communication and clinical coordination skills of multi-disciplinary teams.

The fourth project is to implement a Rapid Diabetes Referral and Follow-up program for diabetic patients who seek care at our emergency department. BMC is designing and implementing a program to coordinate care for patients who present with diabetes in the emergency room. The program’s goal is to reduce unnecessary hospital admissions by connecting patients with more appropriate care settings, allowing them to better manage their diabetes.

The fifth project is to implement Project RED to reduce re-admissions for Family Medicine patients and BMC patients who are members of Boston Medical Center HealthNet Plan (BMCHP). Project RED is a BMC pilot program that works to improve the hospital discharge process in a way that promotes patient safety and reduces re-hospitalization rates. BMC plans to expand this pilot and standardize and personalize the complex hospital discharge process and focus on reducing unnecessary re-admissions and emergency department visits within 30 days following hospital discharge.

The sixth project is to move toward the development of an Accountable Care Organization (ACO) which allows BMC to become a leader in the delivery of integrated care. We will continue to work with the Boston HealthNet Plan (BHN) and BMCHP to develop an operating plan in preparation for establishing an ACO to coordinate all care for enrolled patients, increase the quality of care delivered and manage financial risk.

Lastly, the BMC will participate in a learning collaborative with other hospitals to support transformational goals.

What impact does Massachusetts Payment Reform legislation have on BMC?
The legislation is meant to lower medical costs and improve care and sets an overall cost growth benchmark. The legislation encourages insurers, and Medicaid, to move away from fee-for-service reimbursement, where providers are paid each time a patient receives care, to other methods of payment that reimburse for the total cost of patient care per year. In doing this, the intent is to focus more on primary care and preventative services in an effort to keep people out of the hospital and healthy. This is not an overnight change, but will be a continued focus at the federal and state levels with both government and private payers alike.

What is BMC discussing with the government in terms of how the hospital might operate as an Accountable Care Organization (ACO) going forward?
BMC, several of our BHN health centers, our physician practices and BMCHP have begun work to transition our integrated delivery system into an ACO, which is a system that is fully accountable for all of the care, and associated costs, of our primary care patients, whether that care is received at the primary care site, the hospital, specialist’s office, behavioral health facility, nursing home or other sites of care. Payment for the full cost of care per patient per year would be linked to quality performance. Over the next several years, the BMC/BHN/BMCHP delivery system is well positioned to make the transition to an ACO and to become a national model for transformation of a safety net delivery system.

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What Do You Do, Daniel Remick?

Name: Daniel Remick, MD
Title: Chief and Chair
Department: Pathology and Laboratory Medicine
Years at BMC: 6

Daniel Remick, MD

What brought you to BMC?
I was working at the University of Michigan when I was recruited as the Chief and Chair of Pathology and Laboratory Medicine. This was an exciting position since there was a commitment by both BMC and Boston University School of Medicine (BUSM) to provide new resources to further the growth of Pathology.

What do you do here?
I have responsibility for the three core missions of the Department of Pathology: promote education, research and clinical services by ensuring that the clinical laboratories provide the timely and accurate results. As the leader of the department I help to set the direction for defining our vision. I am also chair of the Finance Committee of the Faculty Practice Plan where I work closely with all BMC departments to ensure the success of the hospital. My teaching responsibilities at BUSM include presenting lectures to graduate students, medical students and pathology residents. I am also the principal investigator on a grant from the National Institutes of Health (NIH) that trains the next generation of physician-scientists.

How does your job contribute to the patient experience?
Pathology is a critical aspect of patient care. Our staff can be found both behind the scenes as well as interacting with patients in the blood bank or the phlebotomy area. For instance, all laboratory tests done in the hospital are performed by Pathology laboratory professionals, and any biopsies or surgical resection specimens are sent to Pathology for diagnosis.

What projects are you working on now?
My research lab studies the body’s inflammatory response, and we recently developed a model in which we found that asthma can be triggered by drinking alcohol. This is an exciting discovery because it indicates a new pathway for how asthma occurs. We also have developed a biospecimen archive research core (BARC) that freezes samples of tumors obtained from patients. These samples then are made available to other institutions for use in their research work.

What do you like about working at BMC?
I like the variety of work. My position allows me to teach, do research, and perform administrative responsibilities. I also greatly enjoy working with the committed professionals at BMC who are dedicated to the hospital’s mission.

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

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In Their Words

Patients share their BMC experience

My family and I appreciate the hard work BMC gave to my dad and all who walk through its doors. Boston is truly lucky to have such an outstanding medical facility.

Jan Tozier is a remarkable human being and a wonderful, wonderful nurse. She showed excellent care, kindness and compassion not only to our dad, but to my father’s eight children and their families during his time in the hospital.

South Boston

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News of Note

Wellness Program website

BMC launches Wellness Program website
BMC has launched a Wellness Program website as a resource for BMC staff. The site provides information on existing BMC programs and wellness and health resources, such as dealing with stress and burnout in the workplace, nutrition, sleep and spirituality. The site was developed by BMC staff for BMC staff in response employees’ feedback on the 2011 staff survey.

“The website is a great way for members of the community to share their expertise on wellness with their colleagues,” says Jane Liebschutz, MD, Primary Care, who oversaw the development of the site. “We are open to suggestions for improvement and ways to make it most useful to the BMC and BU community.”

Visit the site at www.bumc.bu.edu/wellness. After you reviewed it, click on the Scavenger Hunt tab to take a quiz. Winners will receive an iPad2 or massage through BMC’s Integrative Medicine Program.

Peterson named Vice President for Information Technology and Chief Information Officer
David Peterson, MBA, will join BMC in late October as Vice President for Information Technology and Chief Information Officer. Peterson is currently the Interim Chief Technology Officer at Catholic Health Initiatives, a multi-hospital system that includes 85 hospitals and 42 long-term care facilities located in 19 states. His prior experience includes Vice President and CIO in the University of Maryland Medical System, and CIO of the National Naval Medical Center, recognized as The President's Hospital and a worldwide U.S. Navy referral center. Peterson brings a wealth of experience in the technical management of academic medical centers and the implementation of large scale electronic systems.

Poon named Vice President and Chief Medical Information Officer
Eric Poon, MD, MPH, joins BMC this month as Vice President and Chief Medical Information Officer. Poon currently serves as Director of Clinical Informatics at Brigham and Women's Hospital (BWH). He is a practicing internist at BWH’s Jen Center for Primary Care and an Associate Professor at Harvard Medical School. Poon and his team have developed and deployed many advanced features and functionalities into BWH’s electronic medical record system and created a clinician-driven decision making process within Information Technology. Poon is the author of more than 50 peer-reviewed original articles, and was named as a top 25 clinical informaticists by Modern Healthcare. He was named a Clinician of the Year by the New England Chapter of the Healthcare Information and Management Systems Society in 2010.

McPhee joins BMC
James McPhee, MD, joined BMC’s Division of Vascular Surgery and Boston University School of Medicine (BUSM) as an Assistant Professor of Surgery this month. McPhee is a graduate of the College of the Holy Cross in Worcester, and the University of Massachusetts Medical School. He completed his residency at UMass Memorial Medical Center, and a fellowship in Vascular Surgery at Brigham and Women’s Hospital. He is board certified in general surgery.

Cory Edgar, MD

Edgar joins BMC
Cory Edgar, MD, Assistant Professor of Orthopaedic Surgery at BUSM and Team Physician for Boston University athletics, joined BMC in the Department of Orthopaedic Surgery Sept. 1. Edgar earned his medical and doctoral degree in a combined program at BUSM. He continued his orthopedic training in the BU/BMC Residency Training program. Edgar’s clinical interests and expertise include primary and revision ACL reconstructions, multi-ligament knee injuries, meniscal transplantation, complex shoulder instability with bone loss, revision rotator cuff surgery, AC joint injuries, and ankle instability. Edgar is seeing patients in BMC's Shapiro Center and at Boston University’s Ryan Center for Sports Medicine and Rehabilitation.

Tannoury joins BMC
Chadi Tannoury, MD, joined BMC Sept. 1 in the Department of Orthopaedics. Tannoury earned his medical training at the Lebanese University of Beirut, and completed his orthopaedic residency at Thomas Jefferson University Hospital in Philadelphia and his fellowship training in spine surgery at RUSH University Medical Center in Chicago. Tannoury is trained to treat a wide spectrum of spinal pathologies including, but not limited to, minimally invasive spine surgery, spinal surgery for degenerative conditions, reconstructive spinal surgery for deformative conditions, and surgery for spinal trauma. Tannoury is seeing patients in BMC's Shapiro Center.

Silvia joins BMC
Brian Silvia, MD, PhD, will join BMC’s Department of Orthopaedic Surgery in October. Silva is an Assistant Professor in the Department of Orthopaedic Surgery at BUSM. He earned his medical degree at the University of Connecticut where he also completed a PhD in the Department of Genetics and Developmental Biology. After completing his internship and orthopaedic residency at the University of Massachusetts, Dr. Silvia continued his training in adult reconstructive surgery at Glasgow Royal Infirmary in Scotland. Silva specializes in hip and knee replacement surgery and is accepting new patients.

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