We first met Dr. John Toussaint in the fall of 2005 at an Institute of Healthcare Improvement meeting in Boston.  After hearing a presentation by John on ‘Lean’ principles we shared a cab ride back to the airport.  John invited McLeod to visit ThedaCare in Appleton, Wisconsin.  So, in the spring of 2006, we sent a team to observe the use of rapid improvement events and ‘lean’ principles in action.  It was helpful to see a healthcare organization applying ‘lean’ principles of improvement that we had seen in Florence manufacturing organizations like ESAB and GE Medical.

We began ‘lean’ training in the fall of 2006 with our first rapid improvement events in January 2007.  Like ThedaCare, Simpler Consulting provided McLeod the education and support infrastructure.

As the McLeod team reads the pages of On the Mend, we will see ThedaCare’s Improvement System in the DNA of our work at McLeod Health.  We are grateful for John’s willingness to share ThedaCare’s work with us so that we might continue to improve the quality and safety of the care we provide to patients.

I hope you will enjoy the book.

Thanks,

Rob

Dr. Phil Wallace, Medical Director of Clinical Effectiveness, Jeanne Hill, LPN, Candice Tyler, LPN, and Joan Ervin, RN, Associate Administrator of Clinical Effectiveness.

McLeod Dillon reached a new milestone in its journey to pursuing perfection in the delivery of patient care. In May, each of the 58 patients with pneumonia, heart attack, heart failure, and/or those having surgery received “perfect care” based on the core measures as reported to The Joint Commission and CMS. By focusing on these specific diagnoses, 310 of the evidence based quality indicators were met in May by those providing care to these patients.

These outcomes are the result of the team’s diligence and attention to both clinical requirements and documentation. Perseverance and focused teamwork among the physicians and staff resulted in helping the McLeod Dillon reach their goal. Relying on physician-led, evidenced based and data driven care, caregivers at McLeod Dillon are providing high quality care in which patients seeking care in Dillon have confidence. This demonstration of ‘The Value of Quality’ results in a higher quality of life for the citizens receiving care in Dillon County and the surrounding areas.

We are pleased to see that our team in Dillon receives scores higher than national averages, especially for those factors that are most closely correlated to quality of care. Your hard work and dedication continue to pay off.

I want to thank Dr. Phil Wallace of Dillon Internal Medicine, who is our Clinical Effectiveness Medical Director in Dillon, and Joan Ervin, RN, MN, CPHQ, our Associate Administrator, Clinical Effectiveness for their leadership with the team in Dillon. I also would like to thank the caregivers at the patient’s bedside that are delivering the care with professionalism and excellence each day.

Thanks,

Rob

Rob,

Please join me in congratulating the Laboratory Staff, Sandra Bridgers, Dr. Robey and the Pee Dee Pathology Physicians for an outstanding CAP Accreditation survey at MRMC. This unannounced survey is conducted every two years by the Commission on Laboratory Accreditation of the College of American Pathologists (CAP). Six inspectors of different laboratory disciplines examined the laboratory’s records and quality control procedures for the preceding two years. They also examined staff’s qualifications, lab equipment, facilities, safety program as well as overall management of the laboratory.

Many thanks to those throughout the hospital that assisted the Lab during this survey process.

Congratulations to all of you!

Judy Bibbo
Vice President of Patient Services

Thanks for your dedication,

Rob

“Please join me in congratulating Madge Hamer, Director of the Laboratory and the entire McLeod Medical Center Dillon hospital team for an excellent 2 day Joint Commission Lab Accreditation Survey.

The surveyor was very complimentary of the evidence of team work between departments and the focus on the quality of care and safety of our patients.
Thank you to everyone from across the McLeod organization who helped Dillon prepare for this survey result … through practice surveys, IS and biomedical support, and education and training to stay ’survey ready.’ I especially want to thank Linda Duncan, Director of Survey Readiness, for her coaching and continuous support in survey process..

Congratulations!

Debbie Locklair
Administrator
McLeod Medical Center Dillon”

Thanks Debbie, Linda, and the McLeod Dillon team for your daily work to keep our services safe and of high quality.

Thanks,
Rob

http://www.newyorker.com/reporting/2010/08/02/100802fa_fact_gawande?printable=true

Gawande (born on November 5, 1965 in Brooklyn, NY) is a physician and journalist. He serves as a general and endocrine surgeon at Brigham and Women’s Hospital in Boston, Massachusetts and associate director of their Center for Surgery and Public Health. He is also an associate professor at the Harvard School of Public Health and an associate professor of surgery at Harvard Medical School. He has written extensively on medicine and public health for The New Yorker and Slate, pieces which have been collected in his books Complications and Better.

The article above is entitled “Letting Go: What to do when medicine can’t save your life.” In the article, Dr. Gawande uses his skills as a writer and physician to share some of the complexity involved in providing care in situations where there may not be a lot of options. While you may or may not agree with his suggestions, he is honest in sharing his experience in a respectful way. It is a long article and should provide information for a personal or family conversation about an important aspect of our lives.

Thanks,

Rob

“I visited with two patients on Thursday.  My conversation with the first included providing some words of care and comfort. We had a philosophical discussion regarding how and why things happen … and how our response to the circumstances of life can make the difference as to whether we use the experience negatively or positively.  The patient, a resident of a local community in the region, was involved in a traffic accident.  He fractured his hip which required surgery.  The recovery will include ‘non-weight bearing’ status for eight to twelve weeks. 

While many of us would view this period of illness or time with anger, sadness or helplessness, he sees it differently.  He has chosen to view this time as an opportunity to do some of the things life seldom allows for us.  For example, reading many of the classic books, especially by American authors.  Books we might have read long ago and have forgotten the beauty and meaning in the author’s words.  During his eight to twelve weeks, he is working through Mark Twain, John Steinbeck and William Faulkner.  He is reconnecting with friends from long ago with whom he had lost contact.  He is writing letters to his young grandchildren – - letters they will be able to read when they are older, so they will know him better as a man.  As I left him, I could not help but wonder if I could accept the challenges he has faced with the courage and strength of character he showed today.  I can only hope.”

Every day our lives are touched by interesting people we meet in our health care facilities.  Each one has a unique and interesting view and we want to respect their needs.  Stopping long enough to listen and learn while we are caring for them often leads to our own improvement in knowledge and perspective.

Thanks,

Rob

Governor Mark Sanford

We have received many letters of congratulations on McLeod receiving the 2010 American Hospital Association McKesson Quest for Quality Award.  We have letters and emails from from patients, family, physicians, industry leaders, hospitals who have visited McLeod, hospitals and organizations who have worked with McLeod on a quality project.  The letters have arrived from Massachusetts, Canada, Pennsylvania, Wyoming, Georgia, South Carolina and beyond.  I wish I could share them all with you.  Here is the text of a letter from Governor Mark Sanford.  We appreciate his note of encouragement.

“Congratulations to McLeod Regional Medical Center for being awarded the 2010 American Hospital Association-McKesson Quest for Quality Prize.  This is quite an achievement and has brought positive national recognition to South Carolina.

The medical center has proven its effectiveness in patient-centered care and its commitment to quality programs and services.  On behalf of the Palmetto State, thank you to the administrators, staff and medical teams for their hard work.  I wish each of you the best for continued success. 

Again, take care.

Sincerely,

Mark Sanford”

We appreciate the Governor taking time to write a note of thanks and recognizing the hard work of many on the McLeod team.  Please accept his thanks and this recognition of your work and service to others.  May we find encouragement to continue improving our services for patients and families.

Thanks,

Rob

I received a gentle reminder this week from Pam Elliott, RN, BSN, MHA, OCN. Pam is our Nursing Director of Inpatient Oncology. I appreciated the reminder and how it relates to Service Excellence.

I was headed to a meeting in the McLeod Tower, navigating the hallways. I was intent on making it to a meeting on time, and multi-tasking (on my blackberry phone) with a few of the many emails I see each day. However, I was not practicing being ‘present.’ While I was trying to walk, work and speak to people passing by on their busy day… I was not practicing Service Excellence.

Pam stopped me to speak and gently remind me of our purpose. I realized the opportunity I was missing and the need to stop the multi-tasking and connect better with the people we serve — our patients, our guests and each other.

Let’s remind one another and hold each other accountable to live by our standards of Service Excellence.

Thanks Pam,

Rob

Here is one of the standards that apply:

The Value of the Person

Service Excellence Standard of Courtesy: “We treat people with the respect we want our loved ones to receive.”

Behavioral Expectation: #1 “Make eye contact with and acknowledge each person you pass in hallways and public areas.”

It reminds me again of a quote from Paul Tripp in his book, A Shelter in the Time of Storm.

“Life as a Student – Do you think that you’ve arrived? Do you tend to think that you’ve learned what you need to learn and now know what you need to know? Do you see yourself as having more answers than questions? Do you carry around a hunger to know? Do you want to understand more deeply and more fully? Do you have a humble, open, and seeking heart? Are you approaching life with the mentality of a student?”

There is much to learn, much to accomplish as we seek to improve the health and well being of the people in our region. These are exciting times. These are challenging times. We will need everyone’s voice and effort.

We will also remain committed to ongoing improvement processes, care and efficiency for our patients, staff and guests.

Thank you for your part in this recognition.

Thanks,

Rob

Dr. William Boulware, Chief of Staff for McLeod Regional Medical Center, accepts the 2010 AHA-McKesson Quest for Quality Prize from (right) Rich Umbdenstock, President and CEO of the American Hospital Association and (left) Andrew Mellin, M.D., Vice President, Advanced Clinical Technology, McKesson Provider Technologies.

(San Diego, California) Dr. William Boulware, Chief of the McLeod Regional Medical Staff, accepted the 2010 American Hospital Association-McKesson Quest for Quality Prize™ on behalf of McLeod Regional Medical Center on Thursday, July 22. A team of staff, physicians and leadership is currently attending the 18th annual American Hospital Association/Health Forum 2010 Leadership Summit, where the award was presented.

“On behalf of McLeod Health, we thank our patients and community for entrusting us with their care. This achievement would not have been possible without our medical staff and our people who are dedicated to improving the quality of care we deliver to our patients and their families daily,” stated Rob Colones, President and CEO of McLeod Health. 

The McLeod Health team in California will continue to attend the weekend Leadership Summit, a national conference hosted by the American Hospital Association which brings health care leaders together to focus on quality and performance improvement. It is designed for senior executives, governing board members, leaders in hospitals, health systems and allied organizations providing health care. Educational content includes information on innovative leadership strategies that can affect the operational performance of organizations.

Along with recognized keynote speakers including Captain Chesley “Sully” Sullenberger, who presented the Quest for Quality Award to McLeod at the beginning of the event on Thursday, the Summit features educational tracks that address the critical issues important in today’s health care environment.

Sullenberger became a hero after skillfully landing distressed U.S. Airways Flight 1549 on the surface of the Hudson River in New York City, saving the lives of all 155 aboard. He is the author of the recently released: Highest Duty: My Search for What Really Matters.

Other well-known keynote speakers presenting at the Leadership Summit include Newt Gingrich, founder of the Center for Health Transformation and former Speaker of the House of Representatives; Dee Dee Myers, former White House press secretary and political commentator and analyst; Ken Burns, historian and film maker; and the Honorable Al Gore, 45th Vice President of the United States, Nobel Peace Laureate and author of An Inconvenient Truth and Our Choice by live video feed.

“On behalf of the AHA, congratulations to McLeod Regional Medical Center on winning the 2010 AHA-McKesson Quest for Quality Prize,” said Rich Umbdenstock, AHA President and CEO. “McLeod Regional Medical Center has made a real commitment to the Institute of Medicine’s six quality aims: safety, timeliness, effectiveness, efficiency, equity and patient-centeredness. Improving patient safety and quality of care is the top priority at McLeod Regional Medical Center — so much so, that every board meeting begins with a discussion of methods to improve care as the number one agenda item. We hope their quest for excellence will provide ideas and inspiration for others.” 

The 2010 American Hospital Association-McKesson Quest for Quality Prize™, is awarded annually to only one hospital in the country. McLeod is also the first hospital in South Carolina to receive this prestigious honor since the inception of the national Quest for Quality Prize in 2002.

McLeod was selected for the 2010 American Hospital Association-McKesson Quest for Quality Prize® by a multi-disciplinary committee of health care quality and patient safety experts from across the nation for the honor, based on the McLeod culture of quality and efforts to achieve the Institute of Medicine’s six quality aims for health care — by engaging physicians, staff and leadership in efforts to improve quality through safety, effectiveness, patient-centered care, timeliness, efficiency, and equity.

All U.S. hospitals are eligible for the annual American Hospital Association-McKesson Quest for Quality Prize. McLeod Regional Medical Center is the 2010 winner, Henry Ford Hospital in Michigan is the finalist and Queens Hospital Center in New York received the citation of merit.

In 2007, McLeod was recognized with a Citation of Merit by the American Hospital Association in the ‘American Hospital Association-McKesson Quest for Quality Prize.’ 

Among those hospitals recognized in the past are Bronson Methodist Hospital, Kalamazoo, MI; Beth Israel Deaconess Medical Center, Boston, MA; Duke University Hospital, Durham, NC; Cedars-Sinai Medical Center, Los Angeles, CA; Cincinnati Children’s Hospital Medical Center, Cincinnati, OH; Sentara Norfolk General Hospital, Norfolk, VA; and The Johns Hopkins Hospital, Baltimore, MD.

McLeod continues to receive visits by groups of international physicians and medical leaders from the United Kingdom, Canada and the United States who come to Florence to meet with members of the hospital staff to gain insights into the ways in which McLeod has approached its quality and clinical improvement efforts.

Please also see recognition of McLeod by the South Carolina Hospital Association, SC Hospital Executive Update.