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.

Bob also works with the rapid response team and helps train new residents. I guess you could say Bob is the definition of a “team player” with his engagement and involvement with the SICU staff.

Last, but certainly not least, I spent some time walking in the shoes of Andrea Monroe, R.N., a general medicine nurse on B1. I watched as Andrea greeted her first patient, carefully covering the entire AIDET process.

It seemed effortless as she spoke with her patient and put him at ease.

And I should mention that this particular patient told me how much he not only loved Andrea, but her entire team, from the doctors, nurses, housekeeping, and medical assistants. It’s why he chose Henry Ford Hospital over the “other” hospitals he passes on his way downtown.

Andrea discussed how nurses juggle patient care with charting and collaborating with other care providers. There’s no doubt that time management is key to Andrea’s success.

While there are many differences between the roles each nurse plays in his or her unit, after spending time with Vince, Bob and Andrea, I saw a great deal of commonalities. All three nurses felt service excellence, team collaboration and time management were important aspects to nursing.

When asked why they chose the nursing profession, I was not surprised when all three said they became nurses to help people.

Their passion, heart and dedication is evident in their work, whether it be in the Pain Clinic, SICU or B1.

I would like to say “thank you” to not only Vince, Bob and Andrea, but to each and every nurse who works tirelessly day in and day out.  You are the heart and soul of Henry Ford Hospital.

We could not do it without you.

The above video is a recap of my experience shadowing Vince, Bob and Andrea.

If you’d like to send your “thanks” to the amazing nurses at Henry Ford Hospital, please do so in the comments section below.

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.

What we hope to achieve is that we all form a habit of AIDET, each time, every patient, every encounter.

Our emotional reinforcement to AIDET is greater satisfaction with  patient encounters, for ourselves and our patients.

We need to do this until it becomes an unconscious act created by the cue of a patient interaction, a routine interaction with AIDET, and the reward of how patients (and we as providers) will benefit from the positive responses of our patients.

And for those with lingering New Year’s resolutions to lose weight: Put those running shorts and shoes on the floor at night so they will cue your activities in the morning, then substitute a walk for the cue of snack craving, and brush your teeth twice a day.

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?

And Katrina’s job is not limited to cleaning.

With the help of Katrina and her teammates, each OR is fully stocked and ready to go with equipment needed by the nurses, surgeons, and operating team.

Katrina and the Environmental Services team play an incredibly important and vital role in the success of each surgery performed at Henry Ford Hospital.

The above video offers a glimpse into my experience with Katrina.

If you have a question for Katrina about her job, please post it in the below comments section.

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.

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. 

Of note, this patient was transferred to Henry Ford at a time when we recorded the highest number of admissions in our history, when the Emergency Department was backed up to record levels. 

It is the reason we all go the extra mile, to be there for patient who needs us and our skills. 

It is the responsibility that we hold for being the great hospital that we are.

And it shows who we are and what we do.  

We are very proud of all of you.

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.

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.

– There are no mulligans in medicine. Not too many surgeons approach their surgical incisions with a thought of being able to do it again.

– Just like patients, all of the courses are different and even the same course changes from day to day.

– All golfers want the latest driver. All radiologists want the latest CT and MRI scanners.

– Often times, winners and losers are determined by handicaps and not by performance; the games are lost on the first tee.

– Showy drives do not determine your score as much as the more frequent and less dramatic short game and putting.  Showy clinical programs do not determine your success as an organization as much as excelling at day to day patient care activities.

– Rules are just as likely to help your game as they are to cause penalties.

– Special clothes are often required and define who you are, as well as what you do. If they didn’t, why do operating room personnel wear those bonnets outside of the OR?  And, as for those plaid shorts and pink polos…

– No one wants to carry their own clubs. Everyone wants a caddy.

As for the differences: Golf is not about life and death. Check that, maybe it is.

Even if you are not a golfer, enjoy spring and Earth’s renewal whether you are hitting the small white ball or not.

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.

What I saw next should keep us all feeling good about those who work at Henry Ford. 

The triage nurse calmly talked to the patient and family, explaining how important it was, given the patient’s symptoms, to be seen.

She went on, in a caring and soothing voice, saying that if the patient was her mother, she would want her to stay to make sure she didn’t have a major problem. The nurse then checked the point in the triage and the anticipated time the patient would be seen, and calmly reassured the patient and family.

Many faced with the stress imposed by this type of chaos respond with anger, craziness, or both.  This triage nurse responded with care, explanation, and warmth.

We cannot express enough our thanks to each of you for the extra efforts you are giving, and the continued acts of kindness that you exhibit while providing some of the best health care.

Thank you for being here.

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.

Like so many at Henry Ford Hospital, Rebecca infuses service excellence into each and every patient interaction.

You may be noticing a pattern here.

Similar to previous Walk in My Shoes participants, Rebecca is all about the patients and their care. She has a positive attitude and is consistently striving to deliver the best possible care to our patients. 

So how does she do it?

Rebecca says she always pushes herself to learn more, utilizing the many educational resources available to everyone at Henry Ford Hospital.

By broadening her knowledge and education, Rebecca says she’s better able to evolve and adapt to the needs of our patients.

And teaching – which Rebecca does with students on a daily basis and through regular interactions with employees, patients and guests – has also proven to have many benefits.

Finally, she works with the team of care providers and interacts with all of them multiple times per day.

Patient care, teaching, team work, just like most of what we do at The Henry Ford Hospital.

Rebecca’s positive attitude, passion for service excellence, and respect for her fellow team members and students are all evident in the above video.

If you have a question for Rebecca about her job, or how she strives for service excellence, please post it in the below comments section.

All that makes me hungry.

How about a chocolate donut, I mean, a few apple slices?

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. 

The greetings, the explanations, the thank you’s, the acts of kindness, the hand washing, the diligent documentation, the instruction for care, and the activities that fill our days.

These add up to how we are perceived by our patients and families, our providing of safe and high quality care, and creating the welcoming and healing environment that is so important to our patients as well as our care providers.

So let’s celebrate the remarkable achievements that we perform, but remember the importance of each of the little things we do on a daily basis for our patients and each other. 

Let’s strive to meet the challenges and our goal of providing these each time, every time, every patient, every encounter.