Healing with Baltimore

Following the events in Baltimore over the past week, UMMC and UMMC Midtown Campus President and CEO, Jeffrey A. Rivest, expressed his gratitude to all those UMMC employees who helped keep the Center’s mission in mind during such a difficult time. UMMC plays an integral role in the Baltimore community and will continue to work for the betterment of the city and the nation moving forward.

Read his message to all UMMC employees:

Dear Colleagues,

The past week is one we will never forget. Today, our city begins to recover and heal. But while we begin the healing process, let us not forget the valuable lessons we have learned about the need for all who live and work in our city to be partners for change.

FB-OneBaltimore_1While we begin a long healing process, let me thank you again for your unwavering dedication to our mission and to our role in supporting quality of life through taking care of people in their time of need. Many of our colleagues did not miss a single hour of work, despite their need to plan for the safety of their families. They faced difficulty in getting to and from work, and for some, there was no ability to reach their homes safely. Yet while the city was in crisis, each of you remained fully committed to the needs of our patients. Despite enormous challenges, we continued to operate all hospital services normally, and most importantly, were here for those in our community who needed us.

Our ability to stay united around the singular mission of caring, despite high emotions and differences of opinion, speaks to the core of who we are and what we do. I am grateful to each of you and I am inspired by your dedication to make life better for others. We are all fortunate to have this opportunity and once again, all here at UMMC showed tremendous teamwork, respect, civility and professionalism.

I also offer my sincere thanks to our hospital Security team and our Incident Command team who worked tirelessly for over six days to support all of us, keep us informed, and keep us safe. This team exemplifies professionalism, adaptability and a commitment to serve.

It is a new week in Baltimore. The city-wide curfew has been lifted, National Guard troops are phasing out, and we can be energized by the wonderful examples of love and community we witnessed in our city this weekend. This gives us hope. However, there is a long journey ahead, and many things in our culture must change–here in Baltimore and in our nation.

Later this week, I will provide you additional information about UMMC’s essential role in the recovery and the rebuilding of the fabric of our community. As one of Baltimore’s largest employers, we have been deeply involved in our community and its challenges and successes. We have all learned lessons this past week and together with others, UMMC will recommit to providing critical partnerships for job readiness, skill development, community health, and career opportunities. While we have done much, our city and our neighborhoods need much more. We must be a part of doing more and doing it better.

rivest_jeffrey

Thank you again for all you do here at UMMC.

Sincerely,

Jeffrey A. Rivest
President and Chief Executive Officer

Super Staff Beats Super Storm — Every Time

The forecasts and predictions around Hurricane Sandy had much of the eastern third of the country braced for disaster. Baltimore saw heavy rains, wind and flooding. But the University of Maryland Medical Center didn’t skip a beat, thanks to the dedication of staff members who planned ahead or braved the elements to get to work. Their inspiration: hundreds of patients and colleagues were depending on them.

 We heard about staff taking extraordinary steps to be available for patients and to one another. If you have a story of your own, or you know of something that somebody else has done, drop us a line at communications@umm.edu.

 In the meantime, here are a few:

 From Karen E. Doyle, MBA, MS, RN, NEA-BC, vice president for nursing and operations at the R Adams Cowley Shock Trauma Center and for emergency nursing at UMMC:

“While I was making rounds yesterday [Oct. 29], I stopped and spoke to Darlene Currin, a housekeeping staff member in Shock Trauma working on 6 North.  I thanked her for being here, and told her that her work was really important.  She told me that she had just arrived (it was around 10:30 or 11:00 a.m.).  Darlene had walked all the way from East Baltimore to UMMC.  But, she knew she was needed and made the trek anyway.  Really unbelievable.  I was so inspired.”

 Currin (pictured above) said she doesn’t think she did anything that most of her colleagues wouldn’t do. “We all work here, we know it’s 24/7,” she said. On Monday morning, she was unable to get a taxi or sedan service (public transportation was shut down), so she decided to walk. It took her about 90 minutes.

 “I was soaked when I got here,” Currin said.

 From Monika Bauman, MS, RN, CEN, nurse manager for women’s and children’s ambulatory services:

“The hospital-based clinics officially closed on Tuesday due to the storm, but Ometriss Jeter, a scheduling and preauthorization coordinator who works in Pediatric Hematology and Oncology, reported for duty Tuesday morning at about 6 a.m.  She rounded in all of the outpatient registration areas offering her services and making sure they had adequate staffing for the day. Once she determined all was well, she reported to our clinic, even though it was closed, to be sure we were ready for operations as usual for tomorrow [Wednesday].”

 From Karen Cossentino, MS, RN, CCRN, senior clinical nurse II and charge nurse in the Cardiac Care Unit:

“I was in charge in the Cardiac Care Unit on Monday, Oct. 29, and it was an exceptionally busy day. So I would like to thank all the staff for working together. Two nurses deserve an extra thank you, but they asked that I not use their names. One of them had a vacation scheduled this week but offered to work for a nurse who is a new mother who would not have been able to get home after work on Monday to her 3-month-old baby.  Another nurse from Professional Development came to the unit and asked if we needed any help. I immediately took her up on her offer and she stayed most of the day and went from room to room and nurse to nurse and offered her assistance.”

From Rehana Qayyumi, MLS (ASCP), medical lab scientist, Microbiology Laboratory:

After making up my mind to stay [at work during the storm] on a very busy Monday, I did not have time to think about where I would stay after my shift. Then, our wonderful Microbiology Technical Specialist Donna Cashara, MLS(ASCP), asked me what I was  going to do.  I just told her, ‘Yes, I’m staying somewhere,’ while very busy with my assigned work.  Anyway, she personally walked two blocks away to the Marriott [as phone calls were not helpful] and reserved a room.  She was like an angel for me when I finally reached the room around 7 p.m. and took a shower and my medicines and bowed my head down for my unexpected landing in full luxury. Did I deserve it? Yes, I think all of us who decided to pay for comfortable accommodations to be ready for the next busy day deserved it.  We deserve all the best to provide the best services. TeamWORK works!”

Rehana Qayyumi and Donna Cashara

Rehana Qayyumi and Donna Cashara

Cashara said it was tough to get a room at an affordable rate that night at the downtown hotels, but the Marriott finally came through. She said many other seasoned lab staff know when storms are coming, they need to look out for each other. She and another staff person led a department-wide effort to make sure the hospital had enough lab staff and that those employees had either safe passage home or a place to sleep. The hospital provides dorm-like accommodations, but some staff prefer to split the cost of a nearby hotel room.

From Cassandra Bembry, MLS ASCP, outreach customer service supervisor for the Clinical Pathology Laboratory:

Jamillah Johnson, my front-end coordinator of the Clinical Pathology Laboratory (a.k.a. “Accessioning”) volunteered late Sunday night to pick up more than 80 percent of our day-shift staff for Monday who rely solely on public transportation.  She also took these employees home and picked up our evening shift crew.  Jamillah has consistently shown a great deal of care and concern for our staff that is unparalleled, in my opinion, and acts of this nature are routine for her.” 

 From J.V. Nable, MD, NREMT-P, clinical instructor and chief resident in the Department of  Emergency Medicine:

“The [physicians in the] UniversityofMaryland Emergency Medicine Residency met the challenges posed by Hurricane Sandy head-on. Despite the incredibly inclement weather, residents continued to provide vital services at emergency departments and other hospital units throughout the region, including: UMMC, the Shock Trauma Center, the Baltimore VA Medical Center, Mercy Medical Center, Bayview Medical Center, and Children’s National Medical Center in Washington, DC. Because some residents have lengthy commutes, those who live near the medical facilities invited them to their homes for dry and safe shelter during the storm. Many residents volunteered to rearrange their schedules, taking extra shifts to cover for those stranded by the storm. As part of the backbone of clinical services at UMMC, emergency medicine residents demonstrated unwavering dedication throughout this unprecedented event.”

From Shawn Hendricks, MSN, RN, nurse manager for 10 East (Acute Medicine Telemetry Unit) and 11 East (Medicine Telemetry Unit):
 
During Hurricane Sandy, the dedicated staff on 10 & 11 East showed up ready to work, with smiles and a determination to provide excellent care despite the weather outside. I gave personal thanks to patient care technicians Theresa Hicks and Danielle Brown for coming to assist with the patients on 11 East after completing their care on 10 East, until help arrived from Monique Thomas, a student nurse who had been off duty but came in to help. And, also, to Jocelyn Campbell, one of our unit secretaries, who came in even when she wasn’t scheduled, to help with secretarial duties and other tasks on 11 East. Finally, a big “Thank you” to all my staff who stayed late or came early to ensure the shifts were covered! These staff members showed loyalty, teamwork, and caring when it was needed the most!

UMMC Using New ID Application to Check Crash Carts

By Sharon Boston, UMMC Media Relations Manager

 

You may know RFID (radio frequency identification) as a theft prevention system in libraries and stores. It’s also used for key cards and to check the stock of some hotel mini-bars.

The University of Maryland Medical Center is now the first hospital to use a new application of RFID technology to scan the content of hospital crash carts, which carry medications that are critical during life-threatening emergencies.

The system, called Kit Check, scans an opened crash cart tray in about 10 seconds, identifying medications that are missing or will expire soon. The pharmacist then restocks the tray and scans it again in the specially designed scanning station (which looks a small cabinet or pizza oven) to verify that all items are present and up-to-date.

Want to see it in action? Check out the video at the top of this post.

Each medication has an RFID tag, allowing the entire tray to be scanned and verified quickly, virtually eliminating the chance for human error and removing the need to hand-check each tray twice.

How Cool is That?

Being chosen as a Leapfrog “Top Hospital” for quality and safety six years in a row is so cool that the only way to celebrate was with ice cream.

UMMC is one of only two hospitals in the country to meet the increasingly stringent criteria for this list every year since it was initiated by The Leapfrog Group.

To thank the entire staff for the effort that makes UMMC a top hospital, President and CEO Jeffrey A. Rivest invited everyone to take an ice cream break during their shifts and to savor the moment. In the Weinberg Atrium, members of the Employee Celebrations Team handed out ice cream bars and cones and frozen-fruit bars to staff – as well as to several patients and visitors who happened to be in the right place at the right time.

“UMMC has earned this continual recognition by The Leapfrog Group because of the multidisciplinary teams that define us and the invaluable members who comprise these teams — doctors, nurses, pharmacists, therapists, technicians, support staff and leaders at all levels,” Rivest said. “Thank you for the role you play in continuing to make safety and quality a top priority and for giving all of us yet another reason to be proud. Take a moment to celebrate your part in earning this award for the Medical Center.”

Grateful Father Organizes Concert to Benefit University of Maryland Children’s Hospital

By Daniel Purdie and Cynthia McClain Purdie

Last year, our healthy, vibrant 2-year-old son Adam suddenly began having convulsive seizures. Another emergency facility thought they were caused by a fever or an allergic reaction, but the University of Maryland Medical Center soon ruled that out. They performed thorough exams and Adam spent several nights in the PICU while we wondered, worried, and waited by his side. We knew he was getting the best care possible, because we have trusted the University of Maryland Children’s Hospital with our family’s health care for more than a decade. But that didn’t mean we weren’t afraid and nervous about what was happening with our baby.

Drs. Kathleen Currey, Jack Gladstein and the entire team at the Pediatric Epilepsy Center were attentive and addressed all our concerns when they diagnosed Adam with epilepsy (seizure disorder).  At first, we were disappointed about the extent of his treatment — our healthy 2-year-old would suddenly need to take medications twice a day for at least a year.  We thought there was a cure! But we were relieved that he had not suffered any brain damage or injuries, which could have happened over time had we not caught the problem.  Now, our son is 3 and we are happy he is responding well to treatment and has not had a seizure in a long time.

We wanted to thank the team at UMMC for the special kind of care they give to children and families, and to raise awareness about epilepsy in our community. Daniel is a performer and the second closest thing to his heart after family is music. He decided a benefit concert was in order and called it ‘AFAC: Applause for a Cause, Baltimore.’  He put the plans in motion and gathered support from fellow regional and national artists who donated performances.

The concert was held on campus at the Community Colleges of Baltimore County, Catonsville on October 14, 2011 and we had a great time. We were able to raise some money and share information about the great team at the Children’s Hospital. Plans are underway for an AFAC Baltimore Web site and a spring fundraiser. We want to continue to support the UMCH Pediatric Epilepsy Program.

Hospital of the Decade an Honor Worth Celebrating

By Chris Lindsley
Blog Editor

UMMC Receives Leapfrog Top Hospital of the Decade Honor
UMMC CEO Jeffrey Rivest (far left) and COO Herbert Buchanan (second from right) with the Leapfrog Top Hospitals of the Decade and Top Hospitals 2010 awards presented last night. Also pictured are Leapfrog CEO Leah Binder (far right) and Leapfrog Board Chair David Knowlton.

Talk about having a reason to celebrate!

Last night at the Leapfrog Group’s 10-Year Anniversary Gala in Washington, DC, the University of Maryland Medical Center was recognized as a Leapfrog “Top Hospital of the Decade” for patient safety and quality of care, one of only two U.S. hospitals so honored.

This award recognizes UMMC’s inclusion on the Leapfrog Top Hospitals list every year since its inception in 2006, including in 2010.

So what makes this award meaningful to consumers and the medical community?

The Leapfrog Group’s national survey measures hospital performance in a range of areas, including patient care outcomes, use of best practices and patient safety initiatives and measures of efficiency. It is the only national, public comparison of hospitals on key issues, including preventing medication errors and infections and standards for performing high-risk procedures. Each year, Leapfrog adds new, more stringent performance measures and expands the criteria for hospitals to meet its standards.

How credible is the Leapfrog recognition?

“Leapfrog has a great amount of credibility because it is founded on evidence-based practices and on actual clinical processes and patient care data, rather than relying substantially on opinions and reputations,” said UMMC president the CEO Jeffrey Rivest. “It is for that reason that we are especially proud of this national recognition.”

How we became a “Hospital of the Decade” is quite a story. View the short video below to find out.



Related Information:

UMMC Patient Advocates Take Proactive Approach to Identifying and Meeting Patients’ Needs

By Odetta James-Harlee
Supervisor, Patient Advocacy

The Patient Advocacy Department, previously known as the Patient Representative Department, was formed in 1988 in response to state regulations requiring that all Maryland hospitals have a formal program for addressing patient complaints.  Since that time, the Joint Commission and CMS have implemented more standards requiring formal complaint mechanisms and have focused on greater attention to patient rights.  Even without mandates, a patient advocacy process is beneficial to improving public image, improving quality of care, improving service and reducing risk.

Under the previous system, two patient representatives responded to all patient concerns in the Medical Center’s inpatient units as well as outpatient clinics. The patient representative operated more on a reactive basis and was known as the Medical Center’s “firefighter” instead of one who could educate staff about preventing these “fires.”  In 2002, the Medical Center recognized the need for change and the Patient Advocacy Department was formed as a result of new customer service initiatives.  We were finally able to take a more proactive approach to identifying any patient or family need.

Patient Advocacy functions have evolved somewhat since the establishment of the department; however, primary objectives and responsibilities have always been to provide prompt response to patient concerns, investigate these concerns by channeling information about patient care issues to appropriate departments and services so that corrective action can be taken and changes in policies and procedure can be made when indicated, and trend and report this data to senior leadership.  The patient advocate has always been able to serve as that neutral link between the patient and the Medical Center.  With assistance from physicians, nursing, and department managers, we are able to resolve concerns that include lack of communication, rude behaviors, long wait times and missing belongings.

In 2006, two medical interpreter positions were added to the Patient Advocacy Department.  We currently have one Spanish interpreter who provides interpretation services to help providers communicate with their non-English and Limited English Speaking patients and are recruiting for the second open position.

Since the department has grown, in addition to working with patients to resolve concerns, we are able to assist patients and families with their requests for hotel accommodations, obtain consents from living related kidney donors for recognition on the Wall of Honor located in the Medical Center, serve on the UMMC Commitment to Excellence’s Patient Experience Team, the Shock Trauma Patient Education committee and Surgical Intensive Care Unit Supportive Care Initiative committee.  Advocates rotate coverage of the interpretation pager, carrying it 24 hours a day to ensure that our deaf and LEP patients receive the sign and language interpretation they need.

To contact a patient advocate, please call:

  • 410-328-8777 or 410-328-7536 for main hospital, outpatient clinic, and general concerns
  • 410-328-1531 for Shock Trauma concerns
  • 410-328-2131 for Adult/Pediatric Emergency Room concerns
  • 410-328-2337, id # 8255 for interpretation requests

“Great Catch” Award Recognizes Staff for Patient Safety Efforts

By Fe Nieves-Khouw
Director, Quality Improvement

Raylyn Miller and Jonathan GottliebEven the best policies and systems to protect patient safety still rely on alert staff members to make a “great catch” when they notice something that could result in an error.

The University of Maryland Medical Center has consistently encouraged staff to report concerns that affect safety and quality. The “Great Catch” Award is an extension of this commitment and rewards staff for “catching” an error before it can affect the patient.

“Sometimes, the only thing standing between a patient and an adverse event is an alert employee who takes action to avert a potential disaster – a ‘great catch,’ ” says Jonathan Gottlieb, M.D., a UMMC senior vice president and its chief medical officer, who created the award and gives it out (above and below).

Seemingly minor errors can have major consequences for a patient, Gottlieb says. “The purpose of the award is to increase our focus on timely recognition and intervention to protect a patient from potential harm,” Gottlieb says. “Themes or patterns learned from these reports will provide another source of evidence from which to draw ways to improve quality and safety.”

The first two “Great Catch” winners are nurses in the Medical Intensive Care Unit: Raylyn Miller, (above, left), withheld an insulin injection that had been ordered by a physician and dispensed by the pharmacy when she noticed the patient was already receiving an insulin infusion.

Thea Epple and Jonathan GottliebThea Epple, (left), stopped a physician leaving the room of a patient with C. difficile colitis when she saw him use only an alcohol-based hand sanitizer, which in most cases would be sufficient. But hand sanitizers don’t reliably kill this particular bacterium.

“She stopped the physician and said, ‘You have to wash your hands with soap and water,’ ” Gottlieb said. “And the reason I know this is that the physician was me.”

The Nominating Process

Any UMMC employee may nominate someone (including oneself) for a Great Catch Award by describing an occurrence involving the care of the patient where harm or potential harm was prevented or averted.

Radiation Therapy and Patient Safety

By William F. Regine, M.D.
Chief of Radiation Oncology

Editor’s Note: In response to an article in the New York Times on January 24, 2010, about radiation injuries to patients, Dr. William F. Regine provided the following comment. Dr. Regine is chief of radiation oncology at the University of Maryland Marlene and Stewart Greenebaum Cancer Center and professor and Isadore and Fannie Schneider Foxman chair of radiation oncology at the University of Maryland School of Medicine.

An article in the New York Times highlights several cases of radiation over-exposure in cancer patients in several New York hospitals in 2005. We are concerned that the article could make some patients fearful of receiving radiation therapy. This would be disastrous, since radiation therapy is by far one of the safest and most effective forms of cancer treatment.

We want to reassure all of our patients that their safety is our number one priority. In fact, our hospital has been recognized as one of the nation’s best hospitals for patient safety and quality of care for the past four years in a row by the Leapfrog Group, a national public assessment of hospital safety and quality performance. We strictly follow the highest standards of quality assurance in providing radiation therapy to patients.

Radiation therapy actually has an extremely low rate of errors, due to the many checks currently in place to ensure patient safety. As noted in the article, an estimated 35 million treatments were administered last year on equipment made by Varian Medical Systems alone, with about 70 instances of mistakes that affected or nearly affected patient care. While this is a very low rate, even assuming significant under-reporting, even one such mistake is too many.

The errors described in the article were associated with the lack of quality assurance processes. At our center, we strictly follow a comprehensive set of safety rules. These include: 1) machine-related QA checks, including a daily check of the beam output and monthly physics checks of all equipment; 2) secondary calculations to verify the accuracy of the radiation dose calculated by our treatment planning systems; 3) a review of all treatment plans by medical physicists; 4) quality assurance checks of Intensity Modulated Radiation Therapy (IMRT) plans prior to treatment; 5) review by the therapist staff to verify agreement between the radiation dose in the treatment plan and the treatment console; and 6) verification of the physician’s written directive, the prescribed dose and the patient’s identity.

Since 2005, when the events described in the New York Times article occurred, two national-level professional meetings have taken place to specifically address errors in radiation therapy. A member of our faculty in the Department of Radiation Oncology was selected to serve on a special task force launched by the American Association of Physicists in
Medicine (AAPM)
to study safety processes in radiation oncology. Both the AAPM and the American Society for Radiation Oncology (ASTRO) continuously work to strengthen training, quality assurance and safety in radiation oncology.

All treatments pose risks, and patients should discuss them with their doctors. Our staff is committed to the very highest standards in the delivery of radiation therapy to our patients. Please feel free to discuss your treatment plan and our quality assurance processes with your radiation oncologist or with any member of our staff.

What is Leapfrog?

By Ellen Beth Levitt
Director of Public Affairs and Media Relations

Ever since 2006, I have asked dozens of people if they have heard of Leapfrog. The response has almost always been, “Isn’t it a children’s game?” Maybe. But to a hospital, and people who may need hospital care, Leapfrog has a different meaning. If you are a Leapfrog hospital, you are among a small group recognized as having key patient safety measures in place to provide the safest, highest quality care. UMMC was just named for the fourth year in a row to the Leapfrog list—among only 45 hospitals nationwide.

The current Health Care Reform debate has raised our awareness of the quality issue — and getting value for the health care dollar. As we become more educated health care consumers, I believe more of us will recognize that Leapfrog is more than just a children’s game.

To learn more about the Leapfrog Group, what this patient safety and quality award means for UMMC and its patients and more, watch this interview with UMMC Chief Medical Officer Dr. Jonathan Gottlieb.