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.


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 . 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?

Top 10 Most Interesting Facts about the 4th of July

Lately, I have been writing the blog about some serious topics. I thought I would take a break and share the most interesting facts I found about the 4th of July holiday. So through the magic and convenience of the internet, here is what I found most fascinating:

1. America didn’t declare its independence on the Fourth of July1

Perhaps the greatest misconception of this holiday lies in the name and its equally iconic date. The true “Independence Day” depends on your definition of when such an official declaration was made. It’s widely believed that America’s first Continental Congress declared their independence from the British monarchy on July 4th, 1776. However, the official vote actually took place two days before and the “Declaration” was published in the newspapers on July 4th. Which leads us to #2 on the list.

2. John Adams thought ‘the Second of July’ would become Independence Day1

John Adams, a Founding Father and future president, wrote to his wife, Abigail, about the events that led to the nation’s founding. In one, he famously predicted, “The Second Day of July 1776, will be the most memorable Epocha, in the History of America.”

3. The Declaration of Independence wasn’t fully signed on the Fourth of July1

Declaration of Independence, John Trumbull

Declaration of Independence by John Trumbull

Another misconception is that when the vote was made official, everyone signed it at that time – a moment that’s often portrayed in popular paintings. However, it took an entire month to get all 56 delegates together to put their “John Hancock” on the document. In fact, the only person to sign the document on July 4th was also its first signer: John Hancock.


4. Three successive presidents died on the Fourth of July1, 2

US Presidents, and Founding Fathers, Thomas Jefferson and John Adams passed away on July 4th. The even more amazing coincidence is that both died on the same day in the same year of 1826 by a difference of five hours with Jefferson passing first at age 82 and Adams at age 90. Our fifth president, James Monroe, died a few years later on the Fourth in 1831.

30th President, Calvin Coolidge

30th President, Calvin Coolidge

5. Calvin Coolidge was born on the Fourth of July2

Calvin Coolidge, the 30th president, was born in 1872 on the Fourth of July in Plymouth Notch, Vermont. Malia Obama, our current president’s eldest, was also born on July 4, 1998.

6. The Fourth of July was originally celebrated with a lot of greenery instead of red, white and blue1

Fourth of July celebrations these days are filled with fireworks, clothes and ornaments covered in red, white and blue. Such colors weren’t widely available for decoration in the shadow of the nation’s birth, especially in the heat of battle during the Revolutionary War. The first few Independence Day celebrations used greenery as decorations instead. They also fired artillery used in battles following the completion of the war for the Fourth of July, but the practice waned as cannons fell apart and were slowly replaced with fireworks.

7. The USA isn’t the only country to celebrate our independence2

Even though the Fourth of July is America’s birthday, we’re not the only ones who celebrate it. Denmark began celebrating our Independence Day in 1912 after thousands of Danes immigrated to the USA. Thousands of Danish Americans and U.S. military personnel stationed in Europe celebrate Independence Day at the annual outdoor festival in Rebild, Denmark. The Danish tourism office bills it as the largest Fourth of July celebration outside the United States.

8. A country gained its independence from the US on the Fourth of July3

In 1946, on July 4th, the Philippines gained their full independence from the United States through the Treaty of Manila. However, they celebrate their Independence Day on June 12th which is when they gained independence from Spain in 1898.

9. The song ‘God Bless America’ stayed in Irving Berlin’s rejection pile for 20 years1

Irving Berlin was drafted into the military in the early 1900s and helped to draft a musical comedy for his fellow troops in which he composed the song for its final number — a tune inspired by a phrase his Russian mother would often utter after escaping to America from underneath the iron fist of the bloody Russian empire. However, the composer didn’t think it would fit in the show and kept it in his file for 20 years until singer Kate Smith wanted a patriotic song to sing on the radio as war broke out across Europe. The song became one of the most requested patriotic ditties almost overnight and a staple in American songbooks.

The flag of the United States of America

The flag of the United States of America

10. The modern flag was designed by a high school student as part of a class project1

High school student Robert G. Heft of Lancaster, Ohio was assigned to create a new “national banner” for America that would recognize the statehood of Alaska and Hawaii. Heft simply added two extra stars to the flag to give it an even 50 and stitched his own design. His teacher only gave him a “B-minus” for his effort, so he sent his project to President Dwight D. Eisenhower for consideration and a change of grade. Eisenhower chose his design personally and the new flag was officially adopted in 1960. His teacher changed his grade to an “A”.

I hope you all have some time to spend time with your family and friends at some point this holiday weekend. Be safe.


Read more interesting facts about the Fourth of July:

110 Things You Didn’t Know About the Fourth of July |

2 Nine Things You Never Knew About the Fourth of July |


Anthem, Bon Secours, & HCA

If you are a reader of the newspaper in Richmond or are associated with the healthcare field, you have likely heard about the very public contract dispute between Anthem Blue Cross/Blue Shield and the Bon Secours Health System. Negotiations between health insurance companies and hospitals are usual and customary to establish payment rates. However, in my career I have not seen such a public breakdown in negotiations as is occurring now in our community. It strikes me as an important issue to give my perspective.

The Richmond Times-Dispatch and others have reported that Bon Secours is terminating their Anthem contract effective November 7, 2014. Bon Secours’s leadership communicated this termination to all of the physicians that practice in their hospitals. This includes many doctors that also work at HCA hospitals in Richmond. The net impact of the termination is that Anthem patients will not be covered as “in network” if they seek care in one of Bon Secours’s four Richmond-based hospitals, their ancillary services, or their associated employed physicians. This has very significant financial implications and out-of-pocket costs to these patients.

The dialogue that has come to light has brought to question appropriateness and comparability of Bon Secours’s billing practices and payment rates. Through this negotiation, it appears that Bon Secours’s contracted rates are some of the most expensive in Virginia for outpatient services. At the same time their facilities have some of the highest average profit margins in the region. It is important to note that Bon Secours’s leadership suggests that by not getting rate increases from Anthem their financial future and their ability to provide care to those who need it most will be threatened. According to Virginia Health Information 2013 Industry Report, HCA’s Chippenham & Johnston-Willis Hospitals (CJW) and Henrico Doctors’ Hospitals each provide more charity care than Bon Secours’s largest facility, St. Mary’s Hospital.  In addition, HCA Virginia’s hospitals are the only for-profit or tax paying entities in Richmond which, in CJW’s case, means over $14 million was paid to the region and state last year.

HCA Virginia is proud to have a long-standing, strong, and stable relationship with Anthem and their patient base. We are confident and committed to providing uninterrupted coverage for the patients impacted by Bon Secours’s termination of their Anthem contract in our facilities. HCA Virginia takes pride in being the largest provider of health care services in the Richmond region serving more inpatients than any other health system. We can, and will, do more to serve all the needs of our community.

Part of the frustration communicated by Bon Secours’s leadership is that in 2013 it was announced that HCA Virginia would be the preferred provider for the Anthem patient covered under the Health Care exchange otherwise known as the Affordable Care Act (or “Obamacare”). This is notable because it is strong evidence of appropriate cost and high quality outcomes in our facilities. Our hospitals are committed to working with Anthem in finding ways to improve quality, lower cost, and provide value to patients and physicians. We score very highly on Anthem’s quality program called QHIP which evaluates hospitals based on patient safety, health outcomes, and patient satisfaction.

I encourage you to stay informed on this important issue and, most importantly, ask that Anthem patients give us the opportunity to show you what we mean when we say, “Our Patients. Our Priority.” We look forward to the opportunity to serve the healthcare needs of our community whenever that care is needed.

Unexpected Tragedy

Richard and his son, Little Rich

All of our jobs are, in one way or another, about preserving life. Often the work focuses on healing the sick. Unfortunately, there are times where the focus changes to preserving the dignity for those whose illness cannot be overcome. These occasions usually allow us time to plan for the loss. This week we weren’t given the luxury of time to plan for the passing of one of our own.

Richard Knowles was a 28 year old young man with a bright future. He worked in our Information Technology department since 2011 as a Service Desk Analyst. Most recently, he was also actively working towards his Master Degree in Information Systems with a goal of graduating in spring of 2015. He unquestionably had the promise of a great career with HCA. Unfortunately, Richard suddenly passed away this weekend while playing flag football with friends. His death is one of those occurrences that you would never expect as, by all public indications, he had a long life ahead of him.

Richard was also the primary caregiver to an 8 month old boy affectionately known as “Little Rich,” who carries on his name as the third generation. He took great pride in his role as a father.

Richard’s boss Jared Mabry shared it best when he wrote, “For those that hadn’t had the opportunity to meet him, Rich had an infectious smile and air of positivity that impacted every person he came in contact with. Rich’s positive nature and passion for life were an inspiration to all who knew him. Rich was a fierce friend, a devoted father, a trusted colleague, and above all else, Rich was a fantastic human being. “

His passing affects so many on our team and in our community. The grief felt brings up the uncomfortable discussion of how to cope with such tragedy.  We all know stress is a part of living but times like this call for extra support. As an HCA employee, we have resources to help with any crisis through our Employee Assistance Program (EAP). EAP can be contacted by calling 800-434-5100.

These programs are designed to assess the crisis, educate on techniques for dealing with the event, provide short term counseling and referrals where needed, and establish long-term support plans. I encourage you to take advantage of these services for tragedies like Richard’s passing or other crises you experience in life. No one who is exposed to sudden loss is untouched and we all cope and grieve in our own way. Please know that, as both colleagues and friends, our teams are here to support you in every way possible.

Richard’s passing is a great loss to our Chippenham & Johnston-Willis Hospital family. We will be holding a special memorial service at Chippenham at 2:30Pm today (June 12). Please feel free to share your memories or thoughts about Richard here as replies to the blog.

Refining our Vision

Over the last several months, we have spent a lot of time updating and refining our long term vision for Chippenham & Johnston-Willis Hospitals (CJW). During this process, a Ralph Waldo Emerson quote I read stood out to me to help define how we will continue to be a premier medical center in the metro Richmond area.

“Do not follow where the path may lead. Go instead where there is no path and leave a trail.”

Our organization has a track record for many firsts in the marketplace: first Heart Hospital with Levinson, first Cancer Hospital with Thomas Johns, first to utilize numerous cutting edge technologies and techniques across many of our surgical specialties. Outside observers will often focus on our additions of bricks and mortar construction as advancements or our acquisition of the latest technologies, such as the MAKO robot for orthopedic surgery, as progress towards sustaining our world class reputation. However, when you look deeper into these advancements, it is less about the capital dollars spent and more about the people who choose to be pioneers and leaders in their field. It is not hard to find many examples of physicians and employees on our team who have successfully bent the clinical curve to drive superior outcomes. This focus has, without question, driven better quality care for our patients. I continue to be encouraged by the quantifiable results indicating clinical success. For the past two quarters our hospitals have been in the top 10 percentile for compliance to Core Measures performance. This is an indication of close adherence to evidence based standards and protocols as determined by the Centers for Medicare and Medicaid Services for the delivery of clinical care.

Back to Emerson’s reflection about leading others and creating our own path. In the next 5 years we are building on our legacy by establishing the next generation of strategies to serve our community. While we will be working on all of our programmatic service-lines, I wanted to share four specific focuses on a few key areas with both our human resources talent and our financial resources.

Pediatric Services: We are the largest provider in Richmond of Pediatric ER visits. Our focus is to continue to expand and develop our pediatric services. We will build on our pediatric sub-specialties and leverage the quality of clinical care of our pediatric and neonatal intensive care units. We believe patients want high quality and easy access. Through our distributed pediatric HCA network of 6 hospital campuses and 2 free-standing ERs we can serve this vulnerable population well.

Cardiovascular: CJW is also the largest provider of cardiovascular services in the region. We have recently invested over $7M in expansion and renovation of our electrophysiology program including new arrhythmia care units and new electrophysiology labs. At the same time, we are integrating the latest technologies in both our angiography and cardiac catheterization services.

Cancer Services: The services offered at the Thomas Johns Cancer Hospital, which is embedded in our Johnston-Willis campus, will take cancer care to the next level. In collaboration with our physicians we will continue to explore new avenues from diagnosis to treatment to long term support. HCA Virginia, which includes Henrico Doctors’ Hospital and John Randolph Medical Center, provides more cancer care than any other system in the Richmond area.

Behavioral Health:  Our region is in crises and currently falling short of serving all the behavioral health needs of our community. We will be doing a major $4.5M expansion to Tucker Clinic with 24 additional child and adolescent beds. In addition, we will be opening intensive outpatient services for both adults and children. This will allow patients to get care to help them through their crises. This will allow them to be cared for during the day, while sleeping in the comfort of their own homes.

The future of Chippenham & Johnston-Willis Hospitals is bright. The road map for our long-term success is rooted in a continued collaborative approach working closely with our medical staff to develop best-in-market medical care. If you have additional ideas for our future, please feel free to contact me.

There Are Legends and Then There Are LEGENDS.

Tommy Byrd

Tommy Byrd

Chippenham Hospital in 1972

Chippenham Hospital in 1972

Chippenham Hospital Today

Chippenham Hospital Today

Tommy in 1972

Tommy Byrd in 1972

Tommy in retirement

Tommy Byrd in retirement

Tommy Byrd, Director of Facilities and Engineering, is the latter. He started working at Chippenham Hospital within months of the building opening in 1972. He worked his way up in the Plant Operations department and quickly became the official resident historian; he knows all the secrets of our building. Hard to believe but he has participated in every renovation and addition since Chippenham opened. The fact is he knows his trade well, but more importantly, he is known as a man of the people. One who built countless meaningful relationships with our staff and physicians and served our patients equally well.

Today is Tommy’s last day before retiring. When he told us he was stepping down we immediately went into our usual party planning mode and wanted to throw a retirement party to celebrate his long and distinguished career. He wanted none of that. His modest and practical approach has been the key to his success. When something needed to get done, he just did it without question. There are countless examples of Tommy saving the hospital from near disaster whether it was broken pipes, floods, broken air handlers (imagine Richmond in the high heat of summer with patient room temperatures rising quickly), or any other catastrophe. Whenever the next Administration came along and wanted to renovate an area of the hospital, he knew what was behind every wall and could tell you the personal preference of the last executives during the prior projects. During my orientation, Tommy shared with me the story of our Women’s Center ribbon cutting where Barbara Bush led the festivities.

I remember interviewing 2 years ago for my job. Tommy introduced himself and said he had worked for six other CEOs before me. I immediately assumed he would outlast me like he did all the others. So to say I was surprised that he was stepping down is an understatement. We all just assumed he would always be here. Unfortunately, the inevitable desire to enjoy all the other things that life offers became too tempting. I know he plans on hunting, fishing, and spending more time with his family. All well deserved.

So this week, I salute Tommy for his 42 years of dedicated service. He always made a difference. Thank you, Tommy.

If you have a comment or story to share about Tommy, please do so here on the blog.