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November 20, 2013 Volume 2, Issue 20


BMC Makes Progress on FY13 QUEST Goals; Announces FY14 Goals

BMC made progress on its QUEST goals during the past fiscal year. The four goals  – Quality, Efficiency, Satisfaction and Total Revenue – reflect BMC’s commitment to continually improve in key areas like quality of care, the patient experience, employee engagement, and efficient use of resources, which are all major components of the Be Exceptional Strategic Plan.

QUEST logo

“We worked hard this year and that work is reflected in the achievement of many of our QUEST goals. Thank you,” says BMC President and CEO Kate Walsh.

Below is BMC’s performance on the FY13 goals and the goals for the 2014 fiscal year:

  1. QU: Quality
    • 2013 Goal: Achieve a mortality index that puts BMC into the top third of hospitals in the University Health Systems Consortium (UHC).
      The mortality index is a standard measure of BMC’s mortality performance adjusted for the illness level of our patient population. BMC shares quality data with the UHC and uses UHC benchmarks for evaluating performance and setting quality goals.

      2013 Result: BMC significantly surpassed this goal. Based on the 12-month performance on UHC risk adjusted mortality, in September BMC became the top UHC academic medical center in Massachusetts and in the top quartile among large academic institutions nationwide. All staff should be very proud of this performance.

      2014 Goal: Achieve a mortality index that puts BMC into the top 25 percent of hospitals in the UHC.

    • 2013 Goal: Schedule 70 percent of new primary care patients and 45 percent of new specialty patients to be seen within in 14 days.

      2013 Result:
      Primary Care – BMC met this goal, scheduling 73 percent of new primary care patients to be seen within 14 days.

      Specialty Care – BMC did not meet this goal, missing it by 5 percent. The hospital scheduled 40 percent of new specialty care patients to be seen within 14 days.

      2014 goal:
      Schedule 75 percent of new primary care patients to be seen within 14 days.
      Schedule 45 percent of new specialty care patients to be seen within 14 days.

    • 2013 Goal: Achieve 90 percent staff influenza vaccination.

      2013 Result: BMC achieved a 95 percent universal staff flu vaccination.

      2014 Goal: Achieve 90 percent staff influenza vaccination.

  2. E: Efficiency
    • 2013 Goal: Achieve an expense budget of $12,192 per patient discharge, which includes the costs of wages, benefits, physician services, drugs, supplies and utilities.

      2013 Result: BMC did not meet this goal.

      2014 Goal: Achieve the expense budget of a cost per adjusted weighted discharge (CPAWD) of $11,196, which includes the costs of wages, benefits, physician services, drugs, supplies and utilities. The cost per adjusted weighted discharge reflects both inpatient and outpatient activity.

  3. S: Satisfaction
    • 2013 Goal: Increase the commitment score on BMC’s 2013 Employee Engagement survey by 5 percent.

      2013 Result: BMC administered the Employee Engagement survey in October, achieving a 75 percent response rate, up from 73 percent the year before. The results of the survey will be available shortly.

      2014 Goal: Increase the commitment score on the 2014 survey 5 percent above the results on the 2013 survey.

    • 2013 Goal:
      Inpatient: Increase the HCAHPS percent of patients who give BMC a 9 or 10 on "Overall Rating of Hospital" to 70 percent, by achieving an FY13 average score of 70 percent or higher or a score of 70 percent or higher during 4 of the last 6 months of FY13.
      2013 Result: BMC achieved this goal.

      Outpatient: Increase the composite Outpatient surveys score for the question “Likelihood to Recommend” to 75 percent (Very Good), by achieving an FY13 average score of 75 percent or higher or a score of 75 percent or higher during 4 of the last 6 months of FY13.
      2013 Result: BMC missed this goal by 2 percent (achieved 73 percent).

    • 2014 Goal:
      Inpatient: Achieve 70 percent of patients giving BMC a 9 or 10 “Overall Rating of Hospital” on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey.

      Outpatient: Achieve a 75 percent score on the question “Likelihood to Recommend” on the Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CGCAHPS) Medical Practice survey.

  4. T: Total Revenue
    • 2013 Goal: Achieve a revenue budget of $886 million.
      2013 Result: BMC met this goal.

    • 2013 Goal: Achieve 25,108 inpatient discharges.
      2013 Result: BMC met this goal.

    • 2013 Goal: Achieve 698,715 outpatient clinic visits.
      2013 Result: BMC did not meet this goal.

    2014 Goal: Achieve a revenue budget of $906,089,000.

“Our 2014 QUEST goals continue to reflect our ongoing focus to take the best care of our patients that we can, use our resources wisely,” says Walsh, “and make sure BMC is a great place to work and receive care so we can thrive long into the future.”

Visit the BMC intranet to learn more about the QUEST goals.

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Research Spotlight: BMC Study Highlights Improved Septic Patient Outcomes

BMC physican Allan Walkey, MD, MsC, Pulmonary, Critical Care and Allergy Medicine, recently conducted a study that showed reducing the incidence of severe sepsis can be accomplished by improving the process of delivering care. More specifically, Walkey’s study showed that despite the lack of novel drugs and technology available on the market to treat sepsis, patient mortality has decreased by almost half over the past 20 years.

Blood cells

Severe sepsis is a life-threatening illness that occurs when the effects of an infection cause organs distant from the infection site to fail. It affects an estimated one million Americans each year and has long been a scourge in the medical field, with doctors and researchers searching for treatments to reverse this life-threatening illness that ultimately ends the lives of one in three affected patients.

“Even without new drugs or technologies to treat severe sepsis, our study suggests that improving the ways in which we recognize and deliver care to patients with the condition could decrease mortality rates by a magnitude similar to a new effective drug,” says Walkey. “The results of this study show that taking the medications we have and finding better ways to use them may improve clinical outcomes.”

The study, published online in Critical Care Medicine, looked at data from patients with severe sepsis enrolled in 36 multicenter clinical trials from 1991-2009. Despite the fact that none of the clinical trials studied has yet produced a new therapy, and that there was no change over time in the severity of illness of the patients with severe sepsis, mortality rates declined significantly over 20 years. With confirmation that resolves the often-debated question about whether or not septic patient outcomes have improved, the next steps include delving into the reasons why researchers have seen such a vast improvement.

“To speculate on reasons for the improved outcomes based on prior research findings: perhaps better recognition of sepsis on the part of the caretaker due to educational campaigns may have led to earlier antibiotic intervention and improved patient outcomes over time,” says Walkey. “In addition, we can possibly make a difference by improving the way we deliver basic interventions such as intravenous fluids, or a mechanical ventilator or even simply by increasing the number of critical care physicians.”

Now that Walkey has established this foundation, future research will focus on exploring these unresolved questions about the specific reasons for the mortality decline, in hopes of further improving outcomes of patients suffering from sepsis.

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What’s for Dinner?

Thanksgiving is just around the corner! If this is your first year cooking dinner or if you are looking for a new approach, check out these tips from the BMC Demonstration Kitchen’s Tracey Burg!

Freedom from Want by Norman Rockwell

Roasting a turkey is one of the most popular methods for preparing the Thanksgiving bird for an army of loved ones. Check out the tips below to learn how to serve a moist, flavorful turkey dinner.

How to Roast a Turkey:

  • To prepare the turkey for roasting, first remove the giblets (and save for gravy or stuffing). Next, rinse the bird inside and out and pat dry with paper towels.
  • Turkey stuffing: For optimal safety and uniform doneness, cook stuffing separately. However, if stuffing a turkey, it's essential to use a food thermometer to make sure the center of the stuffing reaches a safe minimum internal temperature of 165 degrees F, stuff it loosely, allowing about 1/2 to 3/4 cup stuffing per pound of turkey.
  • Brush the skin with melted butter or oil. Tie drumsticks together with string (for stuffed birds only).
  • If using a meat thermometer, insert it into the thickest part of the thigh. The thermometer should point towards the body and should not touch the bone.
  • Place the bird on a rack in a roasting pan, and into a preheated 350 degrees F (175 degrees C) oven. Use the following chart to estimate the time required for baking.
  • Bake until the skin is a light golden color, and then cover loosely with a foil tent. During the last 45 minutes of baking, remove the foil tent to brown the skin. Basting is not necessary, but helps promote even browning.
  • The turkey is done when the internal temperature reaches 165 degrees F (75 degrees C) at the thigh, using a food or meat thermometer.

Weight of Bird Roasting Time
(Unstuffed)
Roasting Time
(Stuffed)
10-18 lbs 3-3.5 hours 3.75-4.5 hours
18-22 lbs 3.5-4 hours 4.5-5 hours
22-24 lbs 4-4.5 hours 5-5.5 hours
24-29 lbs 4.5-5 hours 5.5-6.25 hours

Do you have a recipe that you would like to share with the BMC community? Send it to communications@bmc.org and we’ll feature it in a future issue of the BMC Brief!

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What do you do, Jamie Kirby?

Name: Jamie Kirby, RN
Title: Staff Nurse
Department: Nursing
Time at BMC: 8 years


Jamie Kirby, RN

What brought you to BMC?
I had been working in BMC’s acute dialysis unit for three years and decided to expand my knowledge by moving to a different unit. I liked the idea of working on the floor and interacting with the patients while gaining experience in another area of the hospital.

What do you do?
I work in the Intermediate Care Unit (IMCU) providing direct patient care to patients transferred from the SICU or PACU. First thing in the morning, I am briefed by the nightshift nurse, make a trip around the floor to do an assessment of my assigned patients, and then I start my daily care activities based on the patient’s individual needs.

What do you like most about working at BMC?
Aside from the great schedule and easy commute from the South Shore, I enjoy the people I work with. I also have the opportunity to work with a diverse patient population that is unique to BMC.

You are an Iraq War veteran. Thank you for serving our country. Can you tell us about your time overseas?
I served as an Army Reserves Captain Nurse on a medical/surgery ward for nine months in a Combat Support Hospital in Tikrit, Iraq, and spent an additional three months in a regional Air Force hospital in Balad. I provided care for coalition forces, civilians and detainees. I also served in Operation Desert Storm in 1991 as a heavy equipment operator as well as a chemical warfare specialist for a sixth-month deployment. Prior to deployment, I was my Reserve unit’s mobilization officer.

You’ve served in several different capacities of the military. What is your most memorable?
I wanted to experience as much as I could, so I jumped at opportunities to try new things. One of my most memorable roles was being a mobilization officer. It was a volunteer position and one of the most challenging of my career. I was essentially a military travel agent, planning the logistics of mobilizing 460 people from 36 states to get overseas. It was a five-month project and I was responsible for feeding, lodging and filling vacant positions in the unit with qualified soldiers from all over the United States for the hospital to be deployed.

BMC Veterans
BMC Veterans Bob Czarniak, Joe Blansfield, Jack Twomey, Mark Pomerleau and Jamie Kirby

Veterans Day was earlier this month. What does this holiday mean to you?
Veterans Day is a time to remember those who died in service as well as living veterans. Personally, it’s a time to reflect and reminisce with fellow veterans about our camaraderie, after attending a morning parade and wreath laying ceremonies. If I could go back in time, I would do it all over again.

What do you do to outside of the hospital?
When I’m not working, I’m spending time with my family or hunting in the fall. I don’t need to catch anything, I just enjoy being in the woods with nature. I also am in the process of having a book edited that I have written about my 21 years of service.

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


Dear Kate Walsh,

In this day and age, people are very quick to inform you of all the things that we have done wrong, about service that was not up to par or employees that were rude. I wanted to take a few moments to tell you about an experience I had this past weekend.

Earlier this month I came into work and quickly started to feel quite sick. When I realized that the feeling was not going to go away, I decided to walk over to Occupational and Environmental Medicine (OEM) to be checked out. One of my colleagues walked over with me to make sure I was OK. Once in OEM, I was greeted and seen quickly. I was then brought to the Emergency Department (ED), again walked over personally by one of the nurses. I was triaged and a bed was found. As you can imagine, our ED was quite busy but every person that I came in contact with had a smile. The doctors, the nurses, the cleaners, the X-ray technician and lab technician were just amazing. Things were explained to me in detail and I never felt forgotten even though there were many patients to take care of. My manager came to check on me and we sat and listened to the sounds of the ED. The sounds from the patients ranged from very ill to almost comical, but from the staff you could hear compassion and concern and oddly, you could almost hear the teamwork.

I was transferred up to the observation unit and I really wish I could remember the names of the people that took care of me. The whole staff was not just doing their job; these people really care about their patients. They made me comfortable, talked to me, checked on me, smiled at me and these are the things that matter when you do not feel good. In a hospital you expect to get great medical care, which I did, but when you feel cared about, that sure is something. I cannot say enough wonderful things about the staff in the observation unit. Their manager should be very proud.

One could argue that I got this treatment because I work here, but I would disagree. From start to finish I heard and saw the same kind of care given to each patient, not just myself. There was not a difference in care from the ones that knew I worked here and the ones that did not.

I would like to give a big thanks to the Human Resources recruiters, department managers, directors and senior management for raising the bar and expecting greatness from our employees. It has certainly paid off.

A BMC Employee

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News of Note


CReM

Center for Regenerative Medicine (CReM) Unveils New Research Space
Recently CReM hosted an open house to showcase its new research facility located in the 670 Albany St. Building. The new space, resulting from a partnership between BMC and BUSM,  boasts more than 10,000 square feet of lab space complete with state-of-the-art laboratory equipment that will allow CReM to advance the vision of open-source biology and stem cell research. The space is the first physical location of a center devoted to studying regenerative medicine in the country and creates a unified location where the multidisciplinary research efforts can take place in a collaborative environment. Research at CReM focuses on advancing stem cell biology and regenerative medicine for a clinical setting.

Cumberland Farms Celebrates Grand Opening with Donation Program Benefitting BMC
This week, Cumberland Farms and BMC came together to celebrate the grand opening of Cumberland's newest location, and the beginning of a partnership between the hospital and the quick-service retailer. For the next 30 days, the Cumberland Farms location at 801 Massachusetts Ave. within the Crosstown Building, will make a donation of 10 cents to BMC every time a customer purchases a cup of coffee, iced coffee, or Chill Zone fountain drink beverage. Ari Haseotes, President of the Cumberland Gulf Group and Norman Stein, BMC's Vice President of Development, each spoke at the event noting the excitement of the partnership and how the funds raised will benefit BMC's clinical campus redesign.

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Awards and Accolades


BMC Accepted the Mayoral Prize for Innovations from Boston Mayor Tom Menino

Boston Mayor Tom Menino Awards BMC Mayoral Prize
Mayor Thomas M. Menino and Paula Johnson, MD, MPH, Chair of the Board of the Boston Public Health Commission, honored BMC and other recipients of the 2013 Mayoral Prize for Innovations in Primary Care at a reception hosted by the Boston University School of Medicine this week. BMC’s Office-Based Opioid Treatment program (OBOT) received the Mayoral Prize for Innovations in Primary Care in a healthcare setting for expanding access to addictions treatment. BMC’s OBOT, the largest such program in New England, provides medication-assisted treatment integrated into primary care and targets underserved hard-to-reach patients in a setting that also reduces the social stigma associated with substance abuse treatment. BMC’s model, which relies on physician-supervised nurse care managers, has dramatically improved access to addiction treatments. Within a year of opening, the hospital eliminated a treatment waiting list that exceeded 300 patients. Patients can now access treatment within 1-4 weeks of their first contact. OBOT is also available to all patients of BMC regardless of their ability to pay. The annual celebration, now in its fourth year, raises awareness about best practices for improving the delivery of primary care services in health care, community-based, and workplace settings.

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