The BMC Brief
March 3, 2014 Volume 3, Issue 4
This spring will be a busy one at BMC as the organization kicks off clinical campus redesign construction activity in March and prepares for the launch of inpatient eMERGE, BMC’s new electronic health record system, in May. President and CEO Kate Walsh reviewed these major changes with staff at Town Hall Meetings held Feb. 26.
“eMERGE will help us Provide the Right Care to Every Patient by integrating all our systems into one, while the Clinical Campus Redesign will consolidate inpatient operations on the Menino side of campus to help us better serve the needs of staff, patients and families for years to come,” said Walsh. “Both are important projects that advance our key strategic plan initiatives."
Walsh noted that while BMC was an early adopter of electronic health record systems, its 11 separate systems have made managing patient care a challenge.
“At the time, each of these products were considered ‘best-of-breed’,” said Walsh. “While all the programs work great individually, they don’t speak to each other and that’s when it gets tough. eMERGE will change all of that by streamlining the programs into one electronic application.”
Staff training for inpatient eMERGE will kick off in March and run through May. During that time, 4,500 users will be trained. Walsh noted BMC is receiving a high level of support from Epic, the company that created the system, in the training and transition process. There also will be extensive testing prior to go-live, including “dress rehearsals” to ensure a seamless switch between programs when the time comes.
While BMC works to transition to eMERGE, it will also start construction on the Menino side of the campus in March. The long-term project that ends in 2018 will be the culmination of the Boston City Hospital/Boston University Medical Center Hospital merger that created Boston Medical Center in 1996.
Walsh and Bob Biggio, BMC’s Vice President of Facilities and Support Services, noted the following important construction events taking place this spring:
Walsh noted that signage about construction and clinic moves will be posted around BMC and additional ambassadors will be available to help guide patients to their appointments. However, the biggest thing staff can do, she explained, is to work together to inform and assist patients.
“We are going to make sure you have the information you need to help you and our patients find their way around campus,” said Walsh. “You are the ambassadors of our organization, so let’s work together to learn about these big changes and communicate them clearly to our patients.”
Lisa Kelly-Croswell, BMC’s Vice President of Human Resources, wrapped up the presentation with plans for how BMC will support staff during this period of change.
She noted that BMC will continue its senior leadership rounding and Town Hall Meetings to check in with staff and get feedback. New initiatives include focused planning sessions for departments that have expressed consistent employee engagement survey concerns; increased staff recognition; and a concentrated career advancement effort for BMC staff.
She also acknowledged there will be times when staff will be frustrated by the impact of the construction and renovation process, but said a positive attitude will go a long way when communicating with patients and with one another.
“Construction projects are not perfect and mistakes will happen. Things won’t always go the way they should. Sometimes it may feel like we have taken three steps forward and two steps back,” said Kelly-Croswell. “However, in order to move change forward, we will need to support each other through these challenges and remember that with progress comes a need for patience.”
Walsh echoed this sentiment, noting the long history of BMC’s predecessor organizations dating back over 100 years.
“Change is a part of life, a part of who we are and part of what makes us great as an organization,” she said. “We know a lot is happening and we will do our best to support you and make sure you are informed so you can assist patients, visitors and each other during this time of transition.”
Visit the intranet to learn more about eMERGE and the clinical campus redesign.
The room is quiet except for the hum of the ventilator and the serene music playing on the radio. Volunteer Monica Watson, an employee in Quality, Safety and Patient Experience, sits at the patient’s bedside holding his hand while she describes the blue sky and birds outside his window. She has been by his side for the past three hours as a quiet, reassuring presence.
“I feel blessed to be here. It is a gift for me to be able to be here for him,” she says.
Watson is a volunteer with Compassionate Companions, a new program that provides supportive end-of-life inpatient care at BMC. The program pairs volunteers with patients who are alone or whose families, friends or communities are unable to be present during their last hours of life to provide a comforting presence. BMC is the first hospital in Boston to provide this service.
Created in response to staff feedback that employees were saddened by how many patients died alone, the program is modeled after “No One Dies Alone” at Sacred Heart Medical Center in Oregon and the Compassionate Companion program at Milford Regional Medical Center in Massachusetts. Various BMC groups and departments provided input and guidance on the development of the program, including the Bereavement Committee, Nursing, Palliative Care, Pastoral Care, Social Work (Care Management) and Volunteer Services.
Overseen by the Bereavement Committee, Compassionate Companions began in August on various inpatient units, and has served 11 patients thus far.
“The goal of the program is to ensure that no one dies alone,” says Amanda Wright, MSW, LCSW, Care Management, Supervisor and Chair of the Bereavement Committee. “It has been extremely successful during its first six months and we’ve received feedback from families saying it is reassuring to know that someone is here to provide a comforting presence if they cannot be.”
Companions participate in bedside vigils in three-hour shifts. A thorough orientation and training is provided to all volunteers to ensure they are prepared, supported and will feel positive about the time that they have donated.
“Mr. C was unconscious the whole time. I spoke to him and let him know that he was not alone. I talked about how beautiful it was outside and just kept letting him know that I was still here with him. “ -From the Compassionate Companions journal
“What I've found as an ICU physician is that often after family and friends make the decision to pursue comfort-based treatment, they are exhausted by this process and really feel uncomfortable watching their loved one pass away. The Compassionate Companion program is a wonderful way to ensure that our patients will not die alone and without the ability to have human interaction if they would like it. The participants in the program have not been intrusive to patient care but are there solely to support the patients. Keep up the good work!” says Elizabeth Klings, MD, Medicine, Pulmonary Section.
Any BMC employee can make a referral to the program. To do so, contact Pager ID 2120 to reach the Compassionate Companion staff member on call. Once the staff member has been notified of a requested vigil, she contacts the volunteers, many of whom are BMC staff. They also will contact the patient’s nurse once the vigil has been activated.
“Thank you, the hospital staff and especially Jacob [volunteer], the wonderful young man who came to sit with my patient, Mrs. W, for whom, we were unable to locate family immediately. It was very gratifying just to see him sit there and be with her, knowing she wasn’t alone, until family arrived. I think this is a very beneficial thing for the patients, staff and I’m sure for the volunteers. Thanks once again,” says Sandy Whittaker, RN, MICU.
Volunteers already have donated 70 hours to the program. If you would like to volunteer or if you would like more information on this program, contact Amanda Wright at 414-5442.
More than 200 clinical and operational leaders came together Feb. 11 for inpatient eMERGE Clinical Readiness Day. The purpose of the half-day event was to review the system go-live in May and assess department and staff preparedness.
“Thank you for being here today,” Eric Poon, MD, MPH, Chief Medical Information Officer, told the crowd. “This is dedicated clinical time for us to review the system.”
Poon was joined by a panel that included Geralyn Saunders, RN, MSN, Chief Nursing Information Officer; Eric Podradchik, Director of Electronic Health Records; Tom Daigle, Senior Project Manager; Amy Hutchinson, Training Manager; and Lisa Martin, the Go-Live Planning Lead. Each spoke to their piece of the eMERGE project and took questions from the audience.
Hutchinson reminded the crowd that training for inpatient eMERGE starts March 24 and runs through the end of May. Much of the training will be offered in classroom formats in conference rooms around campus. The full training schedule, and conference room locations, can be found on the eMERGE intranet section.
Panelists noted that BMC also is receiving a high level of support from Epic, the company that created the system, in the training and transition process. The system will go through extensive testing prior to go-live, including “dress rehearsals” to ensure a seamless switch between programs when the time comes.
Clinical leaders then broke into groups to focus on their parts of the project. The leaders, or clinical readiness owners, are responsible for monitoring the needs of their areas and serving as a point of communication with each clinical area before, during and after go-live, and anticipating high-risk situations and working with the project leadership team to develop mitigation strategies.
Inpatient eMERGE will go live May 24-26. Outpatient eMERGE will go live in February 2015.
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While February was American Heart Month, we should always try to prepare heart-healthy recipes. Check out this recipe from the Demonstration Kitchen's Tracey Burg.
Whole grains are a great source of nutrients like iron, magnesium, B vitamins and dietary fiber. Eating whole grains may even reduce the risk of cardiovascular disease. Turkey meatballs are an excellent way to get lean protein into your diet without sacrificing flavor. By making a few simple switches, this classic dish takes a turn for the heart smart!
Whole-Grain Pasta with Turkey Meatballs
Sauce and Pasta:
Do you have a recipe that you would like to share with the BMC community? Send it to firstname.lastname@example.org and we’ll feature it in a future issue of the BMC Brief!
Patients share their BMC experience
My husband was a patient at BMC last spring. The seriousness of his illness made for a very difficult time for us. If it weren’t for the outstanding service, caring, compassion and support of the CCU nursing staff, it would have been an impossible situation. From the time he arrived, they made it a point to treat the medical and emotional aspects of his illness. They did an outstanding job of keeping me informed of every development and milestone along the way. During these intense situations, people who were strangers quickly became part of my support system. They provided outstanding medical care to my husband as well as personal support to me, adding a bit of humor along the way.
In particular, Carol and Sue from the day shift provided wonderful service. Katy, Solon, Rob, Betsy, Kristen and Cindy on nights allowed me to sleep a little better knowing my husband was receiving the highest quality of care possible. This was not our first visit to the CCU and were pleased to see familiar faces who recognized us from a previous stay in the unit.
When my husband transferred to 7North, he was greeted by many of the nurses who were on duty when his serious cardiac issues began. We were greeted warmly by Donna, Gina, Guina and others whose names we can’t recall, who assisted him through his initial night in the hospital. My husband also remembers Tho helping him through that difficult time as well.
It’s likely that we overlooked people and misspelled names, for which we apologize, however we thought it important that you hear directly from a patient and family of the value that we see in the BMC nursing staff. We are grateful for their skill, training, compassion and patience. They helped us get through 13 of the most difficult days of our lives.
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Lisa Kachnic, MD, Elected President-Elect of America Board of Radiology
Gopal Yadavalli, MD, Elected to Council of the Association of Program Directors in Internal Medicine
Five Teams Receive Patient Experience Winners
Inpatient teams Newton Pavilion 7East and Menino Pavilion Labor and Delivery won the awards for exceeding the threshold of 70 percent Top Box for the October-December 2013 timeframe. Outpatient teams Ambulatory Surgery on the Menino campus, Cardiac Testing and GCAHPS/Medical Practice – Radiation Oncology won the awards for exceeding the threshold of 75 percent Top Box composite score on the question “Likelihood to Recommend” for the same timeframe.