The Healthcare Experience
What's it like to feel like the new person after years of service? Just try moing to a new information system and you will find out. Last week, our organization switched to a new information syste, it is an incredible system - that said, the first fewdays make you feel new all over again. Here is what I shared with your team...
We all know the feeling of wearing the "green badge." It reflects we are "newbies" to the system (worn the first 90 days on the job) and hope you will help us when we look lost – and that happens regularly. With Epic, one of our nurses asked if we could all go back to green badges! The fact is that we have a sea of blue known as Epic Super Users who have been here to make sure this transition happens smoothly. Last week I felt like we were all wearing the green badges and starting fresh…the great energy that was present, the many extra people throughout the hospital to give us support, and the immediate action on issues. This week, I sensed the high energy and now the comfort as we are settling into our new system and addressing needed workflow adjustments. The transition and the Epic system has been very user-friendly from an administrative perspective as well.
Thank you to the IS (Information System) team, Super Users and the Epic team for their countless hours. Thanks to Wendy Piascik and the entire IS Leadership team for their amazing leadership on this project.
We will continue to work with our system leaders in sharing best practices across the system.
So this morning I woke up and went outside on the way to gym and then work. It was "freezing" down here in southwest Florida. I went back and put on a jacket (granted, I did have on shorts). Entering the gym, I noticed people walking in with sweaters, jackets, etc. Everyone acknowledging winter had hit and it was just "freezing' today. The comments continued as I made my way into the hospital this time seeing many more jackets, boots, scarves. Finally, I had to check the actual weather - what happened to cause this cold front...ouch, it is 49 degrees!
I looked up Barrow, Alaska hovering at 1 degree. Suddenly it seemed warm again...all a matter of perspective.
GOOD MORNING CAPE CORAL FAMILY:
So, how is everyone doing? Just last week we kicked off our new Epic System. Overall, there has been very positive feedback from all over the Health System. That being said, we have focused our efforts based upon your feedback – both, what is working well and what needs improvements? Please continue to provide your questions and feedback to your mangers and Epic Superusers. The daily discussion on Epic, our work and patient flow is invaluable to all of us involved.
Your help in successfully implementing Epic plays a significant role in our FY 12 goals:
- Reduce the number of serious patient safety events at CCH to zero over next 12 months
- Improve HCAHPS one quartile per year until achieve and sustain 90Th percentile performance
- Close the gap in Core Measure performance by 25% per year
- Improve Employee Engagement Trifecta one quartile per year until achieve and sustain 90Th percentile performance
Improve Medical Staff Engagement one quartile per year until achieve and sustain 90Th percentile performance
Improve process efficiency to perform at a total government reimbursement model and grow new inpatient and outpatient business at Cape Coral Hospital
During our recent leadership retreat (Advance), we discussed our Purpose to "serve as the premier hospital and role models of health and wellness for our patients." Take a look at a few of our staff who set the pace…CONGRATULATIONS!
- Colleen Higgins, Senior Decision Support Analyst, took 2nd place in her age group for last weekends River Run. (6.2 miles)
- Diane Sobel, Director of Respiratory Therapy and Carol Simonds, System Director Leadership Development, took 1st and 2nd place respectively in their age groups during our Thanksgiving Turkey Trot.
Share your stories and le me know if you have examples on role modeling health and wellness.
Thank you for your continued support of our mission. I look forward to hearing from you.
Good Morning Cape Coral Hospital Employees, Physicians, Volunteers and Auxilians:
With 1 week left until our EPIC Go Live, we are prepared and ready! Please remember to check with your Epic Superuser or Manager if you have any questions. A big "Thank you" to our Epic Team for all your support!
Last week, I sent the following update to our leadership team. Just wanted to share it once again…
Great outcomes and our efforts are showing. Please review the favorable trends and downward trends to understand the key focus areas. Please share with your team.
Some highlights from our October Patient Satisfaction Outcomes (Based on Top Box 9 or 10):
- Rate this hospital 0-10 - 74%, our highest in over one year and 72
nd percentile nationally. Why is this significant? During the prior 12 months, we averaged 14th percentile in the nation. This is a significant change based on all of our efforts.
Keep up your wonderful leadership and let’s stay steady on our tactics towards our ultimate Goal of over 90
Keep up your wonderful leadership and let’s stay steady on our tactics towards our ultimate Goal of over 90th percentile in the country. We are on our way!
Thank you for all you do to support our patient experience and employee engagement. We are truly showing the results of our efforts as the premier hospital serving as role models of health and wellness.
REMINDER – Bike, Run, Walk
Join us for our Walk with Leaders today at 12:05 where we will have the drawing for our Bike giveaway. Don’t miss it. We are expecting our biggest draw today with a goal of 60 participants…help us hit our record day! And, of course, join us for the Turkey Trot on Thursday morning in front of the hospital.
I want to wish you and your family a very Happy Thanksgiving!
This afternoon, I hada an enjoyable time getting to know our FMC Radiology tea, They all shared what inspired them to get into this field...some had family in the medical field, others because that's where the paying jobs existed, the need to support their family, my mom recommended this! and most of all the love of patient care.
Great stories and always good to take a step back and remind ourselves why we went into our field and how we stay inspired.
Enjoy the team pictures from Rendy Petrin, System Director and Photographer...
Good Afternoon Cape Coral Hospital Employees, Physicians, Volunteers and Auxilians:
With 2 weeks left until our EPIC Go Live, you can feel the excitement in the air… can’t you?
I know this transaction is a massive undertaking and can be nerve wracking to say the least. Please know you have great support from our Information Technology Team, EPIC Superusers and colleagues from across Lee Memorial Health System. There is no doubt that we will have a successful transition. Please make sure to share your questions with your respective Managers and Epic Superusers. If you do not know who your Superuser is, please check with your Manager.
Epic will allow us to deliver more effective and efficient care to our patients and those we serve. I am pleased to see the energy and timing of EPIC coincide with our continued effects on our safety journey and patient experience.
- We have started leadership rounding with patients and have received very positive feedback from our patients.
- We are reinforcing our "No Pass Zone"
- Our Emergency Department Team (ER Staff, Physicians, Admitting/Registration) took one week to map out a more affective patient flow with a goal of decreased length of stay and improved patient satisfaction. The new and improved process begins on December 1 at 7a.m. – Great work Mary Paredero, Dr. Schultz, Dr. Dougherty and the entire "Kaizen" team.
Safety is our number on core value and you play a significant role:
- Our HCAHPS are evaluated on our "Top Box" (9 & 10) score for the following areas:
- Nurse Communication
- Doctor Communication
- Responsiveness of Hospital Staff
- Pain Management
- Communication about medication
- Cleanliness and Quietness
- Discharge Information
- Overall Rating
Please contact your manager if you have questions regarding your role in improving our HCAHPS.
Thank you for all you do to support of our mission, vision and values of Cape Coral Hospital and LMHS.
This week, we started leadership rounding in our hospital. This means we have our managers and directors from each areas meeting with a designated amount of patients. We are starting with 5 for the next two months. Once we complete our new information system install, we will move to 10-15 per week. This is in addition to regular patient rounding completed hourly and daily by staff and department managers.
There is no doubt this will have an impact on our patient's experience. The other benefit as managers, is to get a fresh look at what's going on in your area and other departments. It is certainly not easy looking at things with a fresh set of eyes every day. If you don't, you start to outdate yourself.
What do you do to make sure you look at things with a fresh set of eyes?
Good morning CCH employees, volunteers, auxilians and physicians-
We do great work and show our passion for our patients each and every day. This note was sent by a patient who agreed we could share his story with you. What a great example of a high performance team in action. This letter reflects the strong patient experience and kind words which certainly reflect on our employees, volunteers and physicians.
To the Staff of the Neuro Progressive Care Team of Cape Coral Hospital:
I wasn’t sure if my message would fit inside the card I chose to send your team. My name is David Janis. I was a patient in your October 5th and 6th
. I had the left arm decompression at the elbow as well as some work done on C5, 6, and 7.
I want to thank the entire team for such great care. I have had 13 previous surgeries and have never experienced such wonderful care during a hospital stay. I enjoyed my conversations with many of you as well as some great bantering. You made a stay in the hospital as good as it could get. Let’s face it other than having a baby; there is just no good time to be hospitalized.
I taught school for 37 years in a very inner city situation north of Chicago. The day before I retired, I called personnel to look at my file. I had never looked at it, and was shocked. Upon entering the office I saw four big folders. One was just my evaluations over the years. The other three were full of letters from parents over the years thanking me for doing such a great job with their kids. I never knew these existed. I went to the superintendent quite upset. I told him that had I ever done something wrong, I would be told to go to Home Depot, buy some lumber, and build my own cross so I could be crucified. He got the point, and from that time any letters were forwarded to teachers…not hidden away in some folders.
From that day, I have always made a point of recognizing great service and care whether in a restaurant, store, and in this case, Cape Coral Hospital. I called Ellen Eaton and left her a message. I did a follow up call and spoke to her. I just wanted to make sure that she did pass on my comments to all of you. Outstanding performance needs to be recognized. It’s not something that occurs very often. Only negative things seem to get shared with staff.
Once again, thank you for such great care. I hop the other teams of the hospital are run as well as yours. You truly set the standard for medical, professional and personal care. Thank you for being such a wonderful team. I wish you all the best in the future and your careers.
Please send your stories so we can share our experiences. Thank you for all you do to serve our mission.
This afternoon, our PBX/Switchboard Operators showed me the ropes...Pam Beer, Ileana Diaz and Sheila Frazier were on hand to get me started. Needless to say, they were all pros and my nerves were showing! We pride ourselves on ensuring a great patient experience and first impressions are key to this. We receive over 1,300 calls each day. This provides a major opportunity for a first and very lasting impression of an organization.
I certainly did not want to hang up on anyone or make a bad first impression. And then there was the pressure of the overhead page. You press one button to overhead page and if you forget to turn it off, everyone in the building gets to enjoy the remainder of your conversations.
On a separate note, I am interested in your perception or need for overhead paging in a hospital. It certainly contributes to an additional noise level.
Thank you again to our PBX team and as you trained me..."it was my pleasure."
I'm heading off to the Florida Hospital Association annual conference. Here's my Wednesday note going out to our team in the morning...
Good morning Cape Coral Hospital employees, physicians, volunteers and auxilians:
Last week, I met with representatives from across our health system to review Cape Coral Hospital's current state of performance. We also discussed our operational and strategic priorities in line with the LMHS strategic plan. We called it the "Advance" (opposite of "retreating" - thank you for that reminder, Dr. Dirk Peterson).
The discussions were both respectful and challenging as we decided the key focus areas across all areas in the hospital. I've included key summary points below. A copy of notes and the entire presentation will go out to all leadership so you can review and apply in your respective areas.
The Ultimate Goal: Every single employee, physician, volunteer and auxilian understands their role and their measurable contribution towards our organization's goals.
This weekend, I was reading excerpts from Jim Collins (author of Good to Great) new book, Great by Choice: Uncertainty, Chaos and Luck - Why Some Thrive Despite Them All. Sound familiar to our challenges in healthcare? The companies he writes about all showed a "triad of care behaviors: fanatical discipline, empirical creativity and productive paranoia." All showed "self control in an out of control world." He also referenced the importance of keeping pace - the 20 mile march over 3,000 miles, staying on course with 20 miles each day through good and bad times. According to Collins, this provides the "discomfort of unwavering high performance in difficult conditions and the discomfort of holding back in good conditions."
These challenging times will continue and we need to look at ourselves and one another and determine how we are going to meet and exceed the healthcare needs of our communities.
Here's a brief overview of our Advance summary. Please let me know your thoughts and how your department(s) will continue to help us all achieve these outcomes:
The Cape Coral Hospital shared vision and operational plan provides a big-picture perspective of who we are, what we do, and where we are going. The plan provides the strategic and operational priorities in alignment with Lee Memorial Health System’s strategic plan. It leaves no doubt about Cape Coral Hospital’s long-term direction and where leadership, physicians, employees, volunteers and auxilians intend to take the hospital.
Strive to exceed the healthcare needs and improve the health status of the people of Southwest Florida
Serve as the Premier Hospital and role model for health & wellness for our patients
1. Improve HCAHPS one quartile per year until achieve and sustain 90Th percentile performance
2. Close the gap in Core Measure performance by 25% per year
3. Improve Employee Engagement Trifecta one quartile per year until achieve and sustain 90Th percentile performance
4. Improve Medical Staff Engagement one quartile per year until achieve and sustain 90Th percentile performance
5. Improve process efficiency to perform at a total government reimbursement model
6. Grow new inpatient and outpatient business at Cape Coral Hospital
7. Strive to achieve zero serious safety events over next 12 months
Thank you all for your continued support of our mission. I look forward to hearing from you.
What a treat I had today. Julia Hancock, our home health registered nurse took me on a home visit. All too often, it is easy to get stuck in just the hospital world when, in reality, we know the future is moving away from the hospital and into the home or outpatient setting. The patient was very appreciative of her care and especially Julia.
We will continue to see more of a push "home" including "phyisician house calls." Remember those? Just great to see. What will be interesting to see is whether the physician movement will go towards this effort or at least have an aspect of their practice providing home visits. Over the past 15 years, Hospitalist care has increased. However, in the past few years, several groups are reaching back to treat their own patients in the hospital or at least have someone dedicated to do this from their group. Certainly patients prefer seeing their own physician.
What do you think...will physician house calls become the practice of Home Healthists (aka Hospitalists) in the future?
My Wednesday day note. I'm interested in your perspective...
Good Morning Cape Coral Hospital Employees, Physicians, Volunteers and Auxilians:
- Manager addresses disruptive behavior
- Went home feeling good
- Manager keeps good employees
- Patient first, every time
- Work well together
- Better every day
Patient safety is our health system's overriding core value. One of the key safety behavious includes "Working Well Together." This means we make reliability a reality by working together as collaborative interative teams. We are all equals in patient care.
Here's a copy of my Wednesday note to our team:
Good morning Cape Coral Hospital employees, physicians, volunteers and auxilians:
Over the past couple of days, we have completed our Town Hall Meetings. A special thanks goes out to Wendy Piascik and Mel King who joined me for every session. The Town Hall Meetings are so enlightening and really give a sense of what's working well and what people want improved. Of course, more resources were a frequent request. We know we must work through these challenges together in an effort to transform the way we deliver care and prosper for years to come. It is important that we re-evaluate our current processes and change when necessary.
Many employees brought up the topic of communication including:
Ensuring each leader communicates key messages from hospital or system-wide meetings.
Challenge each other, including the leader hosting the meeting, to ensure that there is substance to our meetings. For example, as we discuss initiative, do we understand the true impact on our organization goals? If not, each of us are empowered to ask for clarification.
Address issues directly within your department and include you manager. It is important to follow the chain of command policy to provide the right people the change to address any concerns.
We need to be open with each other including the challenges we face and where we need each others support.
Recognize one another for the positive contributions made.
I am interested in hearing from you:
What are the most effective way(s) you receive updates/communication in your department?
What are other communication forums you would suggest?
What forums are expected in your department (e.g. everyone attends department meetings, emails, read communications/PI Boards)?
Walk with Leaders ("Hump Day Hustle") at 12:05pm today in the Lobby. Let's plan on heading outside today.
I look forward to hearing from you. Thank you for all your support of our mission and the service you provide each and everyday to Cape Coral Hospital and LMHS.
Let me know the most effective ways you communicate in your organization.
Hospital management provides so many interesting opportunities towards improving the health of a population and the overall patient experience for any of your patients. One of the big challenges, of course is setting the clear direction and engaging the entire organization towards achieving the same goals.
A few weeks, ago, I was asked how you start training for a half marathon (13.1 miles) and the person was interested in running the entire time. Not so tongue-in-cheek, I stated, "start by waking or jogging a mile tomorrow. This will give you a sense of the necessary training to complete a half marathon in 4, 6 or even 12 months." There are, of course, several key components - your actual running schedule; cross training; eating habits; sleep; stress management; balance with work, family and training; and the lost goes on...
At work, we are starting our new fiscal year and we are planning for 1, 2 and even 3 years out. The task can really be quite overwhelming. Just pull together a planning session and you are bound to get a million ideas regarding what you should work on over the next few years. What I like to do is step back and ask, "what are the measurable goals we are trying to accomplish?" Then decide the tactics we will use to support to achieve your strategies and goals. You should have the dream and ambition of your vision and, of course, your mission - what you stand for and believe as an organization.
How will you lay out your plan so the vision is inspiring, the strategies are broad yet directional, the goals are ambitious and the tasks are manageable? Oh, and ensure the plan is shared throughout the organization so each department and employee can have their goals and tactics drive the overall organization's performance. Everyone needs to understand their role and contributions in your organization. In our hospital alone, that counts for over 3,000 employees, physicians, volunteers and auxilians. Certainly no small task however a lot of fun when the plan comes together. So start by walking or jogging...Understand the small measurable goals you need to meet today, tomorrow and this week in order to achieve your monthly, quarterly and annual goals.
Our hospital's Advance (aka, Retreat - one of our physicians suggested that we stop retreating and "Advance the organization") will be held about s week from now...I'll keep you posted on our fun.
Let me know how your organization completes their planning process and ensures all understand their role and contributions.
Shared with our team this mornng...
Good morning Cape Coral hospital employees, volunteers, auxilians and physicians -
Our system's mission states we will Continue to meet the health care needs and improve the health status of the people of Southwest Florida.
How can we do our part to reach our system and hospital's fullest future potential?
We will serve as the premier community hospital and our team will serve as role models of health and wellness in our communities. With over 9,500 employees and several thousand volunteers and physicians, we have many resources. It starts with each one of us doing our part and sharing our best practices with each other.
Last week, we were fortunate to have two presentations at our CCH management meeting:
"Radiology’s Road to Improving The Patient Experience" by Peggy Santos and Lynda Knox
"Reducing Patient Fall Rate" by Yvonne Lingard and Joany Odorizzi
Thank you to our presenters. Each presentation showed strong outcomes and a disciplined and focused approach towards achieving results. These practices will be put on our shared drive for all to access as a way to help leverage our system knowledge and reach our fullest future potential.
I would like to hear from you:
- Tell me about some of your best practices
- What great things are being done in your department?
- Would you like to present your practices at the next CCH management meeting?
Please share so we can all learn from each other. What better way to show the pride of The Cape and LMHS.
EPIC is coming to Cape Coral Hospital:
We are getting ready to launch our new information system on December 1st. This is very exciting - we will be able to use this software to enable our medical providers and staff to control the flow of medical data across our system. This will truly help transform how we provide care across our system. Training will take place over the next couple of months so please be sure to sign up for EPIC training at CCH. Talking about sharing practices, We have so much we can and will learn from Josh, Holly and our Gulf Coast Medical Center colleagues as we implement EPIC.
Enjoy your week.
This was shared with me by one of our employees. Thank you Peggy:
Hey, I am the Clinical Educator in radiology here at Cape Coral Hospital. I go by Peggy. I wanted to share with you the main reason I have been able to easily provide a great "Patient Experience" to every patient I come in contact with. It was a strong message I received years ago that I call "The George Clooney Experience." When I heard the "Great Patient Experience" when I was talking about Patient Satisfaction I knew it was time to share it.
Actually, don't laugh but it was somtehing as simple as an episode from the old television series ER. One episode was nothing but the camera looking out as the eyes of a patient being admitted through the Emergency Department and their travels through all test/treatment areas. The entire show, no plot, no serious issues, just eyes of a patient looking around and everything they saw and heard.
Sometimes ignorance from staff, staff laughing and telling stories and not sharing conversation. The different looks sometimes on eomployees faces (you actually felt the perception the patient was having). Fake smiles from staff, some very concerned employees. Rude doctors, and rude comments they heard when the staff thought they were being careful. The patients view looking up from the stretecher at everyone they came in contact with and even the ones that were just walking by. I could feel the silence the patient felt when they were left alone for long periouds of time...I could go on forever!!
Anyway, I remember that episode sent a very strong message to me and as an educator I have wanted to get that out to my students and our departments' staff . I have often thought about making a video myself about a make believe patient's experience in Radiology through the eyes of the patient but I never had the resources to do so.
I have enjoyed sharing this with you.
Margaret Santos (RT)R
Thanks Margaret - let us know the support you need to get that video going!
My Wednesday update to our team:
Good morning to all CCH employees, volunteers, auxilians and physicians:
We all play a vital role in our system’s strategy to deliver safe, highly reliable and exceptional patient centered care. Recently, you may have heard that we are seeking proposals from hospitalist groups and providers to provide acute care for our patients. Our Hospitalists are critical for safe and cost effective inpatient care coordination for our facilities and help drive the patient experience. We are currently reviewing their proposals.
Are there things you do on a daily basis to contribute to our patient experience? Please share your stories with me. By continuing to share your knowledge and best practices, we can continue our goal to become the premier community hospital.
Just a few quick reminders:
Town Hall meetings are being scheduled on various dates and shifts over the next few weeks. Please let me (or Wendy Piascik) know if you have questions concerning a particular topic that you would like me to address.
Do the "Hump Day Hustle" every Wednesday at 12:05 p.m. Meet in the CCH main lobby for our "Walk with the Leaders." Bring your walking shoes and your coworkers for fun break in our busy day!
Have a great week and a big thanks to each of you for all the work being done in support of our mission and the patients we serve.
Welcome to Scott Nygaard, M.D., my colleague and today's guest blogger:
Describing Quality he wrote:
As a professional, it is incumbent on us to provide quality (service and clinical quality), the option of not putting our best foot forward and performing at a level of excellence our patients and community should expect is not an option to the claim of being a professional (see definition below). The thought that this is an option changes our profession from that of a professional to nothing more than a worker. The professional is called to the highest standard and is governed by ethical standards and is called to serve regardless of the one being served ability to pay and places interest of the client(patient) above self. In my opinion we have lost focus on the patient as the sole reason we exist and meeting their needs. We should use the following mantra to drive our care: "They give me the care I want (and need) exactly when I want (and need) it." Medicine could take a lesson from Rotary and apply the four way test to return to the foundations of professionalism.
1. Is it the TRUTH?
2. Is it FAIR to all concerned?
3. Will it build GOODWILL and BETTER FRIENDSHIPS?
4. Will it be BENEFICIAL to all concerned?
1. Do my patients have access to the care and information they need, when they need it?
2. Is the care I provide based on the evidence and do I provide all and only the care known to be effective?
3. Is my care motivated first and foremost by the best service to patients and meeting patient/family needs?
4. Is the interaction between the patient with my care team deep and personal?
Main criteria for professional include the following:
1. Expert and specialized knowledge in field which one is practicing professionally.
2. Excellent manual/practical and literary skills in relation to profession.
3. High quality work in (examples): creations, products, services, presentations, consultancy, primary/other research, administrative, marketing or other work endeavors.
4. A high standard of professional ethics, behavior and work activities while carrying out one's profession (as an employee, self-employed person, career, enterprise, business, company, or partnership/associate/colleague, etc.). The professional owes a higher duty to a client, often a privilege of confidentiality, as well as a duty not to abandon the client just because he or she may not be able to pay or remunerate the professional. Often the professional is required to put the interest of the client ahead of his own interests.
5. Reasonable work morale and motivation. Having interest and desire to do a job well as holding positive attitude towards the profession are important elements in attaining a high level of professionalism.
6. Appropriate treatment of relationships with colleagues. Special respect should be demonstrated to special people and interns. An example must be set to perpetuate the attitude of one's business without doing it harm.
7. A professional is an expert who is master in a specific field.
a. One who works at a particular occupation or activity: an office worker.
b. One who does manual or industrial labor.
2. A member of the working class.