Top 5 Life Lessons I Wish I Knew When I Was Young.

I often ask my young kids what they want to be when they grow up. Afterwards, I have a slight sense of guilt because it feels like I am trying to rush them through their childhood – but that isn’t really what spurs the question. What is on my mind is the old adage, with maturity comes clarity, and I wish I had some of that knowledge in my formative years. The truth is I was one of those kids who had some ideas about possible careers and life goals but very little idea how to get there. I am pretty sure my guidance counselors never encouraged me to think of actions I could take to be more purposeful in the direction I was headed.

Thinking about this lead me to wonder – if I could give my boyhood self any advice, based on all I have learned through the years, what would I say? Had I approached school, career, and life decisions with this knowledge I might have made a bigger impact. Some decisions might have led me in different career directions but I suspect many would have just made me a more well-rounded adult (I wish I had taken 6 years of Spanish classes seriously).

So here is the advice I would give my younger self.

  1. You don’t know it all so listen first and talk last. It isn’t hard to have a strong opinion. That doesn’t make it the best one. Force yourself to let others share their perspective first. This will allow you to see their side of the situation and better formulate your opinion. People will appreciate that you listened and they will respect your opinion more.
  2. Building a few strong, meaningful relationships is more important that building a voluminous network. Today, I see people trying to maximize the number of connections on social sites like Facebook and LinkedIn instead of fostering relationships with a handful of people who they can really trust and collaborate with in meaningful way. Casually knowing a lot of influential people won’t benefit you nearly as much as these deeply meaningful relationships will.
  3. What others think of you matters but it matters less than what you think about yourself. Like many people, I am my harshest critic. Figuring out what you can control and what you can’t is critical. Learn from your mistakes while also having a thick skin. Lots of people have an opinion on how you could be better. Your attitude and approach has a compounding effect on your success in life and in work.
  4. Change is always hard so how you approach it matters. It is incredibly difficult to change the real flaws of our character or the imperfections of our life. No matter how much I envy people who are laidback, Type-B individuals, I will never be one of them. Focus on modifying your actions and adapting in a reasonable and measurable way. Lasting change will happen when the improvement is a habit (e.g. it takes 28 days of action to make exercise and healthy eating a routine).
  5. Reach out of the box and be bold. Just because someone achieved success one way doesn’t make it the only way. The most innovative, successful people in history had a lifelong commitment to trying something new despite what all the naysayers said. Take chances on going after the tough jobs and assignments because, if you don’t, someone else will and you will find yourself right where you were.

What is the advice you wish you knew when you were 18?

Ethics Drives Everything

If you are a Virginian, you likely felt disheartened by the conviction of former Governor Bob McDonnell and his wife on twenty counts of corruption. Hearing the sordid details of their poor decision making and selfish acts was reminiscent of trials and sentences of the past in areas like Chicago and New Orleans. Thankfully, this was the first, and hopefully last, high level egregious case in our state’s history. If there is any light to this dark period, I am optimistic that it will lead to stricter laws and greater compliance to commonsense rules of business.

As a company, HCA and Chippenham & Johnston-Willis Hospitals have made a significant long-term investment and commitment to building a sustainable culture rooted in strong ethics. The ethics and compliance program is designed to offer a number of avenues both onsite and telephonically to give employees the opportunity to share their concerns. Betsy Blair serves as CJW’s ethics and compliance officer supported by Brian Lundblad as the assistant ethics and compliance officer. A toll free number is also available to express your concerns (800-455-1916). Our broader leadership team and human resources are always available to listen, research, and respond to issues that come to light. Our hospitals utilize an ethics and compliance committee to oversee our program and ensure its effectiveness. If you aren’t sure whether something you are seeing or hearing is at the highest ethical benchmark, please bring it to someone’s attention. For all of us the safest thing to do in our business is to never operate in a gray area.  Our company has also required all employees take an annual code of conduct training module on Health Stream. This course gets refreshed each year and offers real life examples of navigating difficult situations.

It was a hard lesson for the former Governor to learn in such a public fashion but hopefully our elected officials will take meaningful action and limit the temptation of others to abuse the power and influence of their roles.

Senior Leadership’s Response to Employee Feedback

In May we conducted our annual employee satisfaction survey which had over 90% participation. We appreciate the feedback and value the chance to respond to the opportunities highlighted. There have been many steps taken to ensure that we are meeting the organizations needs both today and tomorrow. I want to highlight a few of those steps as outlined by the specific areas rated in the survey. Brandon Haushalter and I will be sharing more detail at the town hall meetings next month.

Surveyed Area: Senior leadership is available and approachable:

Senior leadership is increasing the frequency of rounds at both campuses including evening and weekend shifts. The purpose of rounds will be very much on hearing directly from employees about ways that we can best support them in their job. We will continue to see patients but we want to ensure that we are hearing your feedback directly. We are also setting up job shadowing by senior leaders throughout the hospital where we will spend quality time working with you to understand what your jobs are like day-to-day. In addition we will continue to hold monthly staff focus groups which allow a more casual conversation over breakfast or lunch. These focus groups are a randomly chosen group of people each month, however, if you would like to be included in one of these, please let either HR or administration know and we will get you on the schedule.

Surveyed Area: I believe actions were taken as a result of the last survey

All leadership, including administration and Department Directors, will set aside focused time in daily huddles and monthly staff meetings to talk about actions to address the top priorities your department identified in the survey. Each department’s issues are unique and we want to be sure that leaders are customizing their dialogue around those priority issues first. This will also be a checkpoint to ensure the action plan developed is in fact improving the problem identified. Please be sure to share your opinion. We will talk about broader hospital-wide issues in CEO town halls and other forums. In addition to the in-person discussions, we will maximize the use of the “Feedback Fridays” weekly e-newsletters to share updates on the steps being taken across CJW. Department leaders are also sharing with their colleagues best practices for improving the work environment each month at the leadership meetings. Our hope is that this education will spark impactful ideas throughout the organization.

Surveyed Area: Our Facility has a vision for the future that is inspiring

We will be broadening the CEO town hall as we know it is often hard to leave your department to hear one of the scheduled meetings. Brandon Haushalter or I are prepared to do an abbreviated version of the town hall in your department. Directors have been asked to invite us if this would be beneficial to your area. Please communicate to your leader if you would like to have this done. It is also a great way to share your feedback.

 

Thank you for all that you do to make Chippenham & Johnston-Willis Hospitals a great place to work and receive care. I welcome your feedback directly if you have other ideas of how senior leadership can best serve you.

What is Quality?

(This is a guest blog from the Chief Medical Officer of Chippenham & Johnston-Willis Hospitals, Dr. Michael Menen.)

There is a lot of talk about quality metrics, pay for performance, value-based care, and penalties for poor outcomes. Hospitals have been using a variety of strategies to improve quality for decades. In this regard, it’s useful to ask a basic question. What is quality? Well, it depends! It depends because many different factors make up quality, and many different perspectives.

Quality in healthcare may include, for example, the safe use of prescription drugs, the training of healthcare professionals, effective medical information technology, good processes, and top-notch medical technology. Quality may also include nice surroundings, efficient registration, good patient transport, and clean rooms.

We measure quality indicators like compliance rates, complications, and adherence to protocols, all of which are important in helping us improve patient care and safety. But at the same time, there are very important aspects of quality that cannot currently be quantified. For example, we have no yardsticks for technical expertise, critical thinking, fund of knowledge, good judgment, compassion, curiosity, or relentless determination to do best by each patient.

Quality also depends on your point of view. To an insurance company, low lengths of stay may indicate quality. A clinic manager likes providers who get patients seen more quickly and efficiently. Risk managers want no unnecessary testing, but also no missed diagnoses. Patients should get health care without delay, treatment without harm, and only the medical tests necessary for diagnoses.

Because there are so many competing quality interests and perspectives, the different elements of quality are sometimes difficult to reconcile In other words, if you want fewer missed cancers on chest X-ray, there will be more negative CAT scans for questioned findings on chest X-ray. Newer medications and technologies, often desired for their great promise curing disease, have shorter track records and may be more risky.

In many industries, enhancing quality is an effective strategy for improving financial performance. Companies that invest in quality can eliminate waste, gain market share, or command a higher price. Experts in quality improvement generally believe that improving quality in health care – despite the costliness of some approaches – will similarly result in improved financial as well as patient outcomes. In the current health care system, investments in quality – while producing net economic benefit for society – do not routinely translate into improved financial performance. The absence of evidence that health systems, providers, and others who invest in quality improvement will see a return on investment within a reasonable time frame is widely acknowledged to be one of the most important obstacles to improving health care.

The challenge – quality improvement lies in making stakeholders aware of the financial benefits of good care. The successful creation of an economic motivation to improve quality will most likely depend on the ability of theses stakeholders to come together, motivated not by short-term economics, but by a long-term commitment to an improved health care system. Making health care function will likely require ending business as usual, and will most likely include:

  • Expanding public access to performance data for different providers
  • Educating the public about what is included in excellent care
  • Better aligning the financial incentives of the system with improved patient outcomes
  • Decreasing the fragmentation of the health care system
  • Promoting a shared sense of public stewardship

Continued investment and attention to quality should be our greatest priority, as we strive to provide the best health care possible.

What does quality mean to you? Leave a reply for me here.

IMG_0701.JPG

Security and the Healthy Work Environment

At Chippenham & Johnston-Willis Hospitals, we are committed to providing a safe and secure environment to all members of the hospital community. The primary goal is to improve personal safety and security for anyone in our buildings through training, cameras, panic buttons, and access control to the facilities.

During the recent employee satisfaction survey, we asked questions about security to help us guide future steps to make our employees, patients, and visitors feel safe on our campuses. We are reviewing your feedback and making plans to address areas you identified. I want to share with you some important security upgrades that have been implemented in our two facilities in the recent months.

Emergency Phones

We installed emergency phones at both hospitals. At Chippenham Hospital, new emergency phone boxes can be found in the parking lots and deck. These visible “blue light” stations ring directly to the hospital switchboard as soon as someone pushes the emergency button. The blue light activates and a Security Officer is dispatched directly to the location by the switchboard operator. Johnston-Willis Hospital has added red emergency phones at the main entrance, loading dock, Thomas John’s Cancer Hospital front entrance, Surgery Center entrance, and Atrium entrance. 16 additional panic buttons were also added to the duress alarm system at Chippenham.

Video Surveillance Cameras:

The ability for Security Officers to view and retrieve camera information has also been greatly enhanced by adding a new digital Closed Circuit TV (CCTV) system. Digital CCTV allows for faster retrieval of information should a situation occur. Additional cameras were also added to bring the total numbers of recorded cameras to over 260 throughout the hospitals.

Card Access Panels:

We are in the process of implementing card access panels to replace keypad locks in many areas of the hospitals. These card access locks have been installed at Chippenham Hospital in Post-Partum, NICU, Pediatrics, and Labor and Delivery and are in process of being installed at Tucker, the Operating Rooms, ICU areas, the Emergency Department, and additional exterior doors.

Infant Security:

Security enhancements were added for the littlest ones we care for at Chippenham and Johnston-Willis Hospitals. A new state of the art Infant Abduction Prevention System was installed at both facilities to keep our babies safe.

Police:

We currently have round-the-clock police officers at both campuses. With the addition of the Tucker Crisis Triage Center in 2013, an additional employed police officer was added from 2 PM until Midnight, 7 days a week at Chippenham.

New security equipment will enhance the healthy work environment at Chippenham & Johnston-Willis Hospitals. But the most important part of any security program involves people much more than equipment. We can’t continue to improve the safety and security of our work environment without partnering with every employee at Chippenham & Johnston-Willis. Please report any security related events, including close calls, as soon as you can so they may be investigated. Together, we can continue to improve the safety and security of our hospital and provide a healthy work environment for everyone.

If you have additional ideas for security enhancements, please contact Mike Beshada at (804) 323-8754 or by email at mike.beshada@hcahealthcare.com.

Your Feedback Matters

Throughout May, 90% of our employees responded to the 2014 annual employee engagement/satisfaction survey. The confidential survey focused on 7 key areas: Leadership, Staffing, Voice, Rewards, Culture, Quality, and Outcomes.

Each department leader has the results of their respective departments and will be sharing those at staff meetings. This will allow you to see exactly your department perception in each of the care areas. We have asked department leadership fully engage staff collaboratively to develop action plans to improve the work experience at Chippenham and Johnston Willis Hospitals.

Today I want to share the high level hospital-wide results. While there were improvements in six of the seven major categories, there is still a lot of work to be done to take CJW to the next level and consistently exceed the expectations of our associates. While overall engagement improved 2% from last year’s survey, the results also showed opportunities for improvement regarding perception of senior leadership’s availability and approachability.  We are in the process of developing specific actions plans to improve in these two areas. Once these plans are finalized, I will be sending a letter to your home outlining the specific steps being taken to improve our workplace.

Based on your feedback here is the high level summary of employee perceptions of the top strengths and opportunities.

Top Strengths

People in my work group demonstrate the skills needed to meet patient/customer expectations.

My work gives me a feeling of personal accomplishment.

My supervisor shows a sincere interest in me as a person, not just as an employee.

Top Opportunities

We have enough people in my work group to handle the workload.

I believe actions were taken as a result of the last employee survey.

I am satisfied with the amount of voice I have in the decisions that affect my work.

 Below you will see the results of the top 5 drivers of engagement which compare 2013 to 2014.

Capture

Our goal is to be the hospital employer of choice in Richmond by providing an environment that supports our mission of high quality, patient-centered healthcare. I look forward to sharing more details of the survey results along with our plans to continually learn and improve. I appreciate your willingness to participate in continued open dialogue with the leadership team regarding your satisfaction with employment at CJW. I am confident that this will help us find meaningful and lasting solutions to support a great culture in our organization.

Field of Dreams

You can’t watch the news without seeing another grim story on the declining healthy eating habits in our country. It is a crisis in every sector of our culture regardless of age, socioeconomic background, ethnicity, gender, and geographic location. So a year ago we decided to take active steps to make a difference. Chippenham Hospital partnered with Greg Riggs (more affectionately known as Farmer Greg), a local farmer who provides a mobile market to our hospital every Friday, 11:00AM to 5:00PM, near the cafeteria. The market sells everything that is seasonally available. Farmer Greg prides himself on selling fruits and vegetables from the field to his customers within 48 hours of being picked. He grows much of the product at his farm called Field of Dreams and also coordinates with other local growers for additional product.

Farmer Greg working in his farm, Field of Dreams

Farmer Greg working in his farm, Field of Dreams

I sat down with him to better understand what motivated him to start this business. He shared that he believes if people have a local source of good healthy food, they will lose weight and be less sick. Statistics also show that if companies can promote good nutrition, not only will the employee benefit, but so will the company through reduction of health insurance claims and a drop in absenteeism. Six years ago the Center for Disease Control (CDC) came out with a report that said for the first time ever younger generations will live shorter lives than their parents based on the lack of healthy lifestyles which have caused a spike in diabetes, obesity, and other poor nutrition driven illnesses.

At the time, Farmer Greg worked at Microsoft as a systems integration network provider but he felt a calling to do something about this crisis. He called the CDC to learn what he could do to impact change in our community. They told him about a program called Farm to School which had the goal of not only feeding school-age children better, fresher food but also teaching them the importance of a healthy diet.

Farmer Greg began his farm on a 3 acre lot and produced over 2,000 plants including tomatoes, peppers, cantaloupes, and watermelons among many other items. He then sold them to the Henrico County schools and provided educational talks about farming, fruits, and vegetables to elementary kids. Farmer Greg went on to open a series of 5 day camps called CHEF (Culinary Health Exercise and Farming) for ages 6-14. This summer he has over 150 kids learning about gardening and healthy living. He built a 150’ X 50’ garden for the camp which includes actively growing plants for harvesting and empty space for planting new seeds and seedlings. He teaches how to creatively use every day trash to create a vegetable garden such as a discarded tire, the shelf of a bureau, or an old pot. At the camp they also learn to pick their own food, cook it with one of many recipes they study through the week, and then cap off the week with a formal luncheon prepared for their parents. He shared with me that there is an “Ah ha” moment for many of the young kids where they learn the importance of farm-to-table. He is proud that 60% of the campers come back the next year and he knows when he teaches these important lessons, the kids will put pressure on their parents to grow some of their own food.

Because of his success, the CDC asked him to speak to a breakout session on the Farm to School program which was originally created by the USDA and Department of Agriculture to get more local fresh foods in the schools.

In 2013, Farmer Greg built an herb garden next to Chippenham Hospital’s Cafeteria which helps supply fresh herbs to the kitchen including oregano, dill, parsley, cilantro, and thyme. He is excited about the farmer’s market at Chippenham and knows that his loyal core of hospital employee customers miss him when he is not there because they appreciate the variety, especially in the summer.

Farmer Greg & Peg Peebles at the Chippenham Farmer's Market

Farmer Greg & Peg Peebles at the Chippenham Farmer’s Market

To learn more about Farmer Greg’s Field of Dreams Farm, you can visit his website http://www.fodfarm.com . But, for now, please be sure to show your support for his product by visiting him any Friday near the Chippenham cafeteria.

What ideas do you have for expanding our health lifestyle options at CJW?