Walk in My Shoes: Celebrating Nurses Week

May 10, 2012

This week, the nation is celebrating the nursing profession and the countless talented, hardworking and compassionate nurses who provide care to those in need.

To express my appreciation and gratitude to the nurses at Henry Ford Hospital, I thought it would be fitting to have a Walk in My Shoes dedicated to nurses.

So I decided to shadow not one, but three nurses: one inpatient, one outpatient and one intensive care unit.

My experience began with Vince Lehmann, R.N., nurse manager of the Pain Clinic, who invited me to his unit to visit patients and see him in action.

The patients in the Pain Clinic often are frequent visitors, which is reflected in the patient/caregiver relationship. I especially enjoyed talking to a patient who had only positive things to say about the Pain Clinic team.

Vince stressed the importance of the patient/caregiver relationship within the clinic and consequently, the ability to effectively manage service recovery .

Vince’s responsibilities don’t end there. He also does the scheduling, marketing, education, policy development and standardization of processes across all Henry Ford Pain Clinics. Even with his busy schedule, he always makes time to deliver great patient care.

Next up was Bob Stine, R.N., charge nurse of the Surgical Intensive Care Unit. A 40-bed unit, Bob has a multitude of responsibilities, including managing the beds in the unit, determining which beds are open, and which patients need to be transferred.

In the time I spent with him, I was able to meet a variety of his teammates, including case managers, physicians, residents and nurses. It is clear that Bob’s ability to communicate effectively with his team is imperative to patient care. Continue Reading »Walk in My Shoes: Celebrating Nurses Week

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The Power of Habit

May 1, 2012

How’s that New Year’s resolution going so far? Still carrying those extra 10, 15 or 20 pounds?

Certainly, if we resolve to do something and put all of our effort behind it, we should be able to do it, right? This type of “free will” is a great part of our traditional view of how we change or conduct our lives and business.

Unfortunately, it is not as simple as that.

I recently read an opinion piece by David Brooks in the New York Times that highlighted a book written by Charles Duhigg called “The Power of Habit.” In the book, Duhigg, who’s also a reporter at the Times, explores research about how our habits determine our actions.

As much as we think free will overcomes all, much of our actions and behaviors are driven by unconscious habits. Duhigg notes that researchers at Duke University calculated that 40% of our actions are governed by habit, not by conscious decisions.

So much for free will!

According to Brooks’ article, researchers have also come to know the structure of habits. Cue, routine, reward is how habits become ingrained.

Duhigg highlights several examples of how people have learned to replace bad habits with good ones, or create new habits.

From the routine use of toothpaste to football coaches creating practice drills to Starbucks baristas, creation of habits will dictate how one responds to a situation even more quickly and routinely.

Changing your neural network not merely based on forming routine or common triggers. These are instead fortified by emotions and strong desires, like the commitment to a higher purpose or gaining admiration.

What does this have to do with Henry Ford Hospital? 

We are going through a world class service training exercise called by the mnemonic, AIDET (Acknowledge, Introduce, Duration, Explanation, Thanks).

The habit that we wish to create is a common greeting and dialogue that forms the basis of our service culture.

I have heard from many that say they already do this in their patient interactions. Me too, except sometimes I do A, I and E, or I, D and T, but not the habit of routinely doing all the elements. I have a hunch you are no different. Continue Reading »The Power of Habit

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Dr. Clean: Shadowing an OR Custodian

April 24, 2012

If there’s one thing that Walk in My Shoes proves, it’s that every one of our employees at Henry Ford Hospital plays an important role in patient care. Not to mention, it really highlights what an incredibly talented and customer service-orientated team we have here.

This time around, I had the opportunity to shadow one of our dedicated operating room custodians, Katrina Walker.

Wasting no time, Katrina put me to work.

Mop in hand, Katrina showed me the proper cleaning techniques used in the OR. (I just hope my wife doesn’t see this and get any ideas).

In all seriousness, I hope everyone understands how hard this work is, physically demanding, on your feet, and orchestrating all the activities to keep the operating room flowing.

Similar to the actual surgeries, each case is treated differently, with different equipment and techniques used to clean each time. Katrina and her team religiously scrub each room for infection control purposes, giving repetitive attention to each crevice and necessary detail.

Not only do I admire Katrina’s dedication and spirit, but also the pure speed and efficiency at which she is able to work.

Did you know the custodians only have 3 to 5 minutes to turn over a room in the OR? Continue Reading »Dr. Clean: Shadowing an OR Custodian

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Doc in the DC

April 17, 2012

 

Congratulations to the employees of Henry Ford. This award was won by each and every one of you…

Nancy Schlichting and Bob Riney receive the Malcolm Baldrige National Quality Award in Washington, DC.

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The Stanley Cup of Patient Care

April 13, 2012

I spend a fair amount of time going “South of the Border,” talking to hospital and academic leaders, physicians and others about Henry Ford Hospital - the great doctors, nurses and programs of the Flagship.  

We are very respectful of the Canadian health care system and the great care it provides. When alternatives cannot be provided from Canadian resources, Henry Ford Hospital is there to provide the best of care to the sickest of patients.

As such, we provide clinical support for this extraordinary patient care, at the request of the doctors and providers in Windsor and Essex County, whenever it is needed. 

Most notable of this clinical support is the work that we have done in cardiovascular disease, especially in acute myocardial infarction.

No amount of my discussions of the value of our partnerships compares to this story, especially the video of a true “Miracle on the Boulevard.”

To our cardiovascular surgical team, the surgeons, the anethesiologists, the nurses, and the technicians: This story is better than winning the Stanley Cup.  Continue Reading »The Stanley Cup of Patient Care

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Work Beyond Our Walls

April 9, 2012

If you follow Doc in the D, you know that I talk a great deal about Henry Ford Hospital being “more than a hospital.”   

In my talks about Henry Ford, I often speak of the academic health sciences center that we represent. The values that are deeply imbedded in Henry Ford are learning and innovation.

Over the last several years, we have created a great deal of the underpinnings to support those values. 

Our relationship with Wayne State University, especially our major affiliation with its School of Medicine, has allowed us to tap into the creativity, enthusiasm and the academic culture driving a learning organization such as ours. 

The Henry Ford Innovation Institute was born from an idea, with our imagination as the only limitation of what can be created. 

It asked the question of all of us at Henry Ford:
“What would you build for the world?”

The short video posted above from the World Health Student Organization of Wayne State University School of Medicine shows the power of learning and innovation, as well as the importance of Henry Ford serving as a facilitator of great work beyond our walls.

In the video, you’ll see how a donation of Aquapaks from the Henry Ford Innovation Institute to the World Health Student Organization made an incredible impact on the village of Agua Blanca in Ecuador.

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Medicine and Golf

April 2, 2012

It’s April and it’s time for the Masters.

The greatest golf tournament, not because it is the hardest or has the greatest field, but because it is the most magnificent venue in golf.  It also is the official start of spring.

I love golf.

At the annual HFHS golf outing with Dave Hill, President and Owner of Superior Ambulance; Rich Montefusco, Executive VP of Siemens Enterprise Communications; and Bob Riney, President & COO, HFHS.

No, not because it is the only game a 62-year-old CEO can continue to play at his late age. I love golf because it is my stress relief, my yoga.

There is something primordial about hitting a projectile and landing it where you intend. Of course, not always; sometimes, not frequently at all, but enough times to keep you coming back to hit the ball again.

Golf is also a great metaphor for life.

For example, the golf movie “The Legend of Bagger Vance,” starring Will Smith, Matt Damon and Charlize Theron, is roughly based on the Hindu sacred text the Bhagavad Gita, where the Warrior/Hero Arjuna refuses to fight.  It is a story about the challenges we all face to be true to ourselves.

Another example is the movie “Caddy Shack,” which is based on the lives of several of my friends at Red Run Golf Club.  It is a story about the challenges we all face when we are true to ourselves. (Frightening, in an odd way.)

I am often asked how medicine is like golf, or how it differs.

Here is my take on the similarities:

– There is no substitute for practice and repetition, in golf or in medicine.

– In both medicine and golf, a great teacher/mentor can get you better faster than new technology, although some technology can revolutionize the practice and the game. Continue Reading »Medicine and Golf

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Drinking from the Fire Hose

March 14, 2012

I am not sure exactly what is going on in the world to have caused the major increase in emergency visits and hospitalizations at Henry Ford Hospital over the last several days (or weeks or months). 

Maybe it’s solar winds, sun spots, loss of insurance, inadequate access to primary care, excessive co-pays or the leap year effect? It’s probably a combination of all of the above.

Maintaining high volumes of admissions by and large is good for the hospital. Better than the opposite. 

It’s a bit like: drinking water is good, while drinking water through a fire hose has its problems.

I do know that the teams of nurses, doctor, and all other employees at Henry Ford Hospital have been working at levels that have not been present for almost a decade. 

In the last few months, we’ve had the highest admissions of any January in 11 years, the greatest number of admissions (over 180) and the greatest number of discharges in our recorded history. 

It doesn’t matter if you are working on the front, middle or back end of hospitalization; you are experiencing high work loads, significant stress and strained processes.

Thank you for being here.

I was walking in the emergency department with Ronnie Hall, our COO, who I have worked with for over 25 years. Patients in CAT 1 were very sick, and triage patients, to our surprise, looked even sicker.  

Patients and their families were patient, but weary. Being sick and feeling poorly, waiting in a wheelchair or stretcher to be seen, is no way to spend a beautiful March afternoon.

In the midst of a sea of patients in triage, one of the patients wanted to leave before service could be provided. She was tired and just wanted to go home. Continue Reading »Drinking from the Fire Hose

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Eat This, Not That: Shadowing a Henry Ford Hospital Dietitian

March 7, 2012

It’s no secret that health and wellness is a hot topic of discussion, especially on Doc in the D.  Seems like a lot more of our employees and others are becoming more “engaged” in establishing new and healthy habits. 

So I thought it would be interesting to walk in the shoes of an expert who deals directly with health, wellness and one of our favorite topics on this blog…food.

I recently shadowed Rebecca Trepasso, a registered dietitian at Henry Ford Hospital, who cares for some of our sickest patients in the Cardiovascular Intensive Care Unit.

Rebecca is another great example of Henry Ford employees – committed, professional, expert and funny.

(I still am working on convincing her that pizza does have all major food groups represented and truly is the perfect food.  Once I do that, it is on to Buffalo wings and fries.)

But seriously…

Rebecca works daily with patients to educate them on their dietary needs and how to best follow the dietary plan created by their health care team.

She’s also a preceptor in the Henry Ford Hospital Dietetic Internship Program, mentoring promising students within the Dietary Department.

During our time together, Rebecca showed me how she uses information technology in caring for her patient case load, the many processes and steps she goes through daily to educate her patients, and how she supports students.

But her work doesn’t end there. Continue Reading »Eat This, Not That: Shadowing a Henry Ford Hospital Dietitian

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It’s the Little Things (and the Routine Things) That Count

February 28, 2012

Every day I hear a patient care story at Henry Ford Hospital that absolutely inspires me and fills me with pride. 

Henry Ford Hospital teams work to bring water into the hospital during the August 2003 power outage.

These are often heroic efforts of clinical expertise and team work, with many of our people working against all odds to perform care that saves a patient from what appears to be an impossible situation. These “miracles on the Boulevard” seem almost routine.

Times of crisis also seem to bring out the best in Henry Ford. 

I noticed this years ago when we lost electricity on Campus on two occasions. 

You could not have had a group of people working together more incredibly to overcome not only the obstacles of minimum electrical power, but the even greater challenges of inadequate water so needed for thirst and cleanliness.

I sit back in awe of our people at these times.

Where do we falter?

What is remarkable is that when we fail, it is in the little things or the routine things that we need to perform on a daily basis. The concentrated efforts and energy during a crisis do not always translate as well to our daily tasks.

Not that it is easy to have these bursts of focus at all times. 

As a physician once told me, you can sprint for periods, but you can’t run a marathon by sprinting. It takes a different approach and mindset.

Much of health care is a marathon. Repetitive, frequent, routine, if you will. 

No fan fare in our employee newsletter and no flurry of congratulatory emails on a remarkable effort.

Our true business challenge is to relentlessly focus on day-to-day patient care and to do it as well as it can be done.  It is the most important element to ensure our success as a hospital.

Yet these daily acts – the ones that we must do – count just as much as all of our photo-op moments.  Continue Reading »It’s the Little Things (and the Routine Things) That Count

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