The Humble Task of Transforming Detroit

“I long to accomplish a great and noble task, but it is my chief duty to accomplish humble tasks as though they were great and noble. The world is moved along not only by the might shoves of its heroes but also by the aggregate of the tiny pushes of each honest worker.”
– Helen Keller

The beauty of the work at Henry Ford is we have people performing great and noble tasks as well as humble tasks as though they were great.  The beauty of what is transforming our city is the same, and here is an example of a great “humble task.” 

The following was sent to me by Patrick Irwin, vice president of Human Resources:

Students paint the train viaduct at Trumbull and Holden, near Henry Ford Hospital in Detroit.

On the way back from a meeting today, Kathy Macki and I ran into a group of amazingly enthusiastic and energized teenagers dedicated to making a difference in the “D.”

This summer youth volunteer group is part of an organization calledSummer in the Citywhich is based out of Southwest Detroit but does volunteer work across the “D.”

Predominately high school students, they are painting and fixing the “D” one viaduct, one graffiti wall, one over-grown field at a time.

In the above picture, the students are painting every inch of the train viaduct near Trumbull and Holden in the shadow of Henry Ford Hospital.  Continue reading

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The Henry Ford Violins: Where Medicine Meets Music

I would normally be concerned about privacy issues and other regulations regarding the sharing of clinical information about patients, but I am going to risk it to tell you about two recent and unique patients we examined at Henry Ford:  Mr. Stradivarius and Mr. Guarneri.

Actually these were not really patients but two extraordinary musical instruments: the 1709 Stradivarius and the 1744 Guarneri del Gesu.

These very rare violins – part of the historical artifact collection at The Henry Ford in Dearborn – weren’t here for the usual examination and blood work that we would recommend for 300-year-old patients.  They weren’t here for a tune-up either.

The Henry Ford, the museum and more which is one of the great treasures in the world, was hoping to make new discoveries about these “old world” musical instruments using some of our “high-tech” medical instruments, specifically the computed tomography equipment in the Department of Radiology.

So how do you use modern-day medical technology designed for humans to uncover the history of a 300-year-old violin’s design and repair?

Enter Henry Ford Hospital radiologist Dr. John Bonnett.

While his focus is on abdominal imaging at the hospital, he has made a hobby out of imaging non-human objects with the CT scanner – flowers, seashells, watches. Continue reading

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2-Year Anniversary, Part 2: Plans for the Future

View “Part 1” of the two-year anniversary video here.

So what do you think about the future plans for Henry Ford Hospital and our accomplishments during this past year? Share your comments below.

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2-Year Anniversary, Part 1: Celebrating What We’ve Accomplished

 

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The Affordable Care Act & Henry Ford

What does the U.S. Supreme Court’s ruling on the Affordable Care Act mean to Henry Ford Hospital and Henry Ford Health System, and our patients?

The law has been in effect for two years and Henry Ford has been meeting the necessary steps to comply with the provisions of the law affecting us and our patients.

Doc in the “DIV.” The end of this post includes links to my local news interviews about ACA.

The ruling on Thusday supported the constitutionality of the ACA.

Some of the most controversial aspects of the law are scheduled to be implemented in 2014. Two of these components, mandated insurance and extension of Medicaid, were major subjects of the Court’s ruling.

Mandated insurance was supported as part of the tax provision, that is, failure to adhere to obtaining or providing insurance will be subject to tax penalties.

Without the insurance mandate, the insurance exchanges or pools would likely have fewer healthier enrollees, meaning insurance rates for policies purchased through the exchange would need to be much higher to support costs.

Expansion of Medicaid was left to states wtihout Federal threat of withholding all Medicaid dollars for not extending.

The ruling has brought some “certainty” to the constituionality of the law. This is a certainty that must be looked at through the lens of continued political polarization, the fall elections, threats of repeal of the law in the 2013 Congress, business and personal reaction, and implementation at the state and delivery system level.

But, importantly, this ruling allows Henry Ford to continue to make positive reforms to the country’s health care system, through our efforts to integrate care, reduce costs, increase access and make advances in medical technology, treatment and hospital care.

The ACA means the possibility of extending Medicaid to the nearly 500,000 uninsured people in Michigan, as well as extending additional benefits to lower income familes through insurance exchanges.

The implementation in 2014 also strikes denial of insurance to those patients with pre-exisiting illness. Families will continue to cover their adult children on family policies up to the age of 26.

By expanded coverage for uninsured and low-income patients, the act may help to provide economic relief to Henry Ford’s growing burden of uncompensated care.  In the past eight years uncompensated care at Henry Ford has doubled, from $111 million in 2003 to $210 million in 2011. Continue reading

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Doc in the B (Beijing)

One of the great opportunities presented to us as a world class hospital and system are the multiple requests for us to share our knowledge and expertise around the country and the world.

Our international reputation has brought delegations from many countries to learn about our institution and to use that knowledge to improve care in their own environments.

Several months ago, a team from Wuxi, China visited Henry Ford Hospital and Henry Ford West Bloomfield Hospital to see how we approached our clinical care, wellness and general services. They had interest in developing facilities similar to ours and wanted to see firsthand the “Henry Ford Experience.”

In turn, several of us were invited to China to experience the health care system there, and better provide them with our opinions in how to transform lives and communities.

Before you say what a great little junket this was, I will let you know that three of us left on a Monday morning (after waiting eight hours at Metro Airport, only to have the flight delayed until the next morning), flew to Shanghai non-stop, traveled to Wuxi, flew to Beijing for one day, flew back to Shanghai (after waiting four hours due to a cancelled flight), got four hours sleep, flew to Tokyo and then back to the “D.”

I truly wasn’t sure if I was coming or going, and the jet lag seemed to last for the next week.

That being said, we established some great relationships, learned a great deal about health care in China and how this care is evolving.

All of this helps us to understand what our role can be in providing health care to our patients from the region, State, country, and beyond.

We had the opportunity to shoot a bit of video footage to give you a flavor of our trip, which is posted above.

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Planning a “Good” Death

Dr. Ken Murray, a retired clinical assistant professor of family medicine at the University of California, wrote a thought-provoking article earlier this year in the Wall Street Journal entitled, “Why Doctors Die Differently.”

The essential point of the paper was captured in the sub-headline, noting that doctors’ experiences throughout their careers teach the limits of treatment and reinforces the importance of the need to plan for the end.

In essence, physicians – and I would add other clinical care providers to that list – know all-too-well that medicine cannot fix all, especially at the end of life.

Murray quotes nursing professor Karen Kehl, who in the article called “Moving Toward Peace:  An Analysis of the Concept of a Good Death,” noted features of a graceful death, such as:

  • Being comfortable
  • Being in control
  • Having a sense of closure
  • Making the most of relationships, and
  • Having family involved in their care.

Unfortunately, in today’s world, many patients experience a death without these attributes. Physicians have seen this so frequently that it influences how they think about the end if their lives too.

Why the disconnect? 

To avoid what may be considered undo influence, physicians try not to impose their own views on the situation.

Providing hard clinical data to enable a patient to make a decision is generally believed to be the extent of the information a physician or care provider should offer.

When asked directly what they would do for themselves, physicians often deflect the question to ensure patients are not overly influenced by their answer:

“It is what you would want to do, not what I would do.” 

This is adherence to the medical ethical principle of autonomy, making sure that patients or their decision-makers make decisions for themselves and without coercion.

But perhaps we have lost something by the answer we provide.  Continue reading

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Lidstrom’s Leadership, Teamwork Set Example We All Should Follow

I woke up today and the sun was gone. The Ren Cen disappeared.
Nick Lidstrom retired.

Can a hockey player be a role model for us in health care? If anyone can, it is Lidstrom.

Credit: Josh Howard, Winging It In Motown and The Nightmare on Helm Street - An Unofficial Detroit Red Wings Blog.

Master what you do, show up everyday without self interest, go about your work with dignity, class, excellence and without fan fare, make every one around you better when they are on your team.

I bleed Henry Ford blue and I have an English D on my chest.

But the “Winged Wheel” has truly special meaning to me.

I saw Gordie, Fats and Terrible Ted play at Olympia in the glory days.  I experienced the darkness of Harkness.

Greatness followed by despair. A tale of hockey teams and of cities.

But for the last 20 years we have seen resurrection of our Wings, the resurgence shared by many but carried by this laconic Swede, the “so called” perfect human. A standard of excellence.

Hockey teams are not cities or organizations, but the talents to create these types of transformations are embodied by our Captain.

We may never see such a player again, and very few of us can achieve what he has in his craft.

But all of us can follow his example of approaching what we do the way he did.

If we do and we do this collectively, we will look back on our careers and do more than any of us can imagine.

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Walk in My Shoes: Celebrating Nurses Week

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

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The Power of Habit

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

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