Knox's Blog

At our last Inova Learning Institute, we discussed the three questions most folks want answered at work. Watch to find out what they are!

For nine years no one was able to beat the four minute mile and the world record remained at four minutes 1.4 seconds. It seemed impossible to break.

Hospital readmissions have stayed at the same 19 percent for the past five years.  And now, due to policy changes, everyone is learning to improve communication skills with patients and their families to improve coordinate care once a patient is released. A recent study shows that readmission rates have dropped to 17.8 percent.

Goals were set. Those goals were divided into manageable pieces. Teams stepped forward to study different ideas and suggestions. Plans were implemented and shared with others. Everyone stayed focused on the goal and the needle moved. Goals give us an end to work towards. Without goals we would wander aimlessly never achieving much of anything. Instead we save money for vacations, college, homes and future needs. The one secret to successfully achieving goals is to imagine a positive outcome. If each one of your vacations turns into the cruise that goes nowhere, you might want to expect better and listen to the words you speak. We get what we ask for so expect sunny weather and smooth sailing. Great athletes spend hours visualizing their moves. They expect to win and they expect to set world records.

Breaking a sports record is a want. Remaining competitive in a business market is a must. To achieve a goal we must focus and all be pointed in the same direction. Our Inova compass is pointing to what we call our “true north.”  Our operating units can focus on the system goals and break those into smaller tasks. These are filtered out to the various departments where teams of experts and motivated problem solvers will then tackle the specifics and together we will all benefit.

So thank-you Roger Bannister for pushing us past our beliefs of what is possible. We tend to remain stagnate until someone motivates us to change our attitude. Nothing is guaranteed in life but it certainly helps to face it fully prepared and geared for success. Let go of old beliefs and remember each day that life is what you make of it so make the best!

What did you once think impossible that you were able to achieve?

Our Vision 2015 strategy is racing along at record pace and I’m thrilled that part of our strategy is to offer Medicaid insurance. Our commitment to community-based coordinated care is now further enhanced with the acquisition of Amerigroup of Virginia, a health insurance company that serves approximately 55,000 people throughout Virginia. Amerigroup’s mission has been to manage publicly funded health programs for our nation’s most vulnerable population.

What? Innovation Health, Medicaid … okay, now this is getting confusing. To re-cap, Inova formed a partnership with Aetna that enables us to provide more affordable, quality health care with each organization bringing best-in-class services. By now, you’ve all received your new Innovation Health member cards. This new partnership will help to provide clinical integration of the health care community. Offering insurance products was part of the growth goals for Vision 2015. Our mission is to improve the health of the diverse community we serve and we can best do this by having products that gives colleagues and consumers access to less expensive, more coordinated and more integrated health care. In partnership with community physicians, we will continue to focus on promoting wellness and prevention.

The Amerigroup of Virginia acquisition accelerated Inova’s ability to jump start our goals quickly. To support a smooth transition for both plan participants and physician providers, the managed Medicaid plan will continue to operate under the Amerigroup name for now. Our 70 new colleagues will continue to work from their current Amerigroup locations throughout Virginia. I look forward to meeting and mingling and learning more about how they have worked to create healthy individuals, healthy communities and healthy neighborhoods. Please join me in welcoming our newest team members!

Our guest poet-blogger today is Madelyn Grace Webb, who works in Telecommunications at Fair Oaks Hospital. Madelyn has a real gift that speaks so eloquently to the human dimension which volunteers and staff bring to our patients and their families.

One time while working at Fairfax Hospital, she noticed a young child in the lobby playing with two bottle caps driving them around like cars. He and his father were waiting in the lobby and didn’t appear to be leaving anytime soon. Madelyn ducked into the gift shop, bought a little toy fire truck and ambulance and with permission from the father gave them to the child. “Oh, he was a happy little camper,” she said. Madelyn quickly shrugged off the story though as being no big deal. “I see things like this all the time. I feel that the people that work at Inova seem to be exceptional. I don’t know if it’s that way at other places, but I see it everywhere here.”

Thanks Madelyn, I think you’re exceptional too! You know you’re at Inova when everyone you encounter treats you like family! Enjoy Madelyn’s creativity!

Privileged to Serve You

Welcome to my world, please come in
I am never too busy to greet a friend

Can I assist you in any need?
May I direct you to your destination?
Would it be better if you followed my lead?

Anything to make this visit better I offer you
Maybe it’s just a smile…or to listen for a moment or two
Whatever it may be, I’ll give to you

Over the time that I’ve been here
So much has been given to me
I have met the kindest people

I have witnessed joy…and sorrow
I have experienced life… both bitter and sweet
From the heights of happiness… to the depths of grief

More than once a baby has been placed on my knee
While the mother stepped aside, to shed tears…secretly
I have been hugged and kissed by new fathers
As they celebrated their fist encounter with
The wonder of birth

Each day is new with events and problems
To claim as its own
I try to be ready to respond
To the dynamics of what is going on

I am the look of compassion for those with heavy hearts
And the essence of empathy…comforting with a gentle touch
I offer encouragement… to those who have forgotten their strength

I sometimes sit in silence, nearby, where I can be seen
So you won’t be alone with your thoughts or needs
I am a hospital volunteer; it is my privilege to serve you

Kathy Hamilton, a nurse from T9 at Fairfax, sent me a poem she wrote for the holidays. Here are the first two stanzas:

Twas the week before Christmas and up on Tower Nine, 
HCAHPS were scoring, and all was not fine.

Directives, the advance kind, in charts were not found.
Nor were heights, nor were weights, not in inches nor pounds.

Auditing daily is little elf Jean.
Overseeing it all is our Santa Irene.

They know the nice. They know the naughty.
They know who has been following CAUTI.

Nine stanzas later, I was chuckling and wondering how difficult it is to write a poem. I certainly found it impressive that someone could rhyme CAUTI and was inspired to try my hand at this poetry thing too. Here goes:

The old year is gone, the New Year is here
And the need to refocus is certainly clear,
Cuz healthcare reform is just about near.

The EpicCare team is now in full motion,
It’s not just an idea or another new notion.

There’s a new paradigm coming our way,
Full speed ahead is getting closer each day.

Are you on board and ready to soar?
The future of health is behind the next door!

Okay, I tried. Back to my day job. Do you have a poem you’d like to share?  Made up or an old favorite, I’d like to read ‘em all!

Please welcome Tony Burchard, president of the Foundation, to our Inova family. Tony is working hard to reinvent the Foundation to align with Vision 2015. One of Tony’s goals in 2012 will be to cascade information about the important parts of what the Foundation is able to provide.

[gigya src="http://c.brightcove.com/services/viewer/federated_f9?isVid=1" flashVars="isUI=1&videoId=1305009107001&playerID=1253044380001&playerKey=AQ~~,AAAAACj07sU~,k64g1nVTFBiE_nPws0NlPjWz_gqud3NG&domain=embed&dynamicStreaming=true" width="480" height="320" allowFullScreen="true" allowScriptAccess="always"]

A key role for our frontline folks is to encourage patients that have had a really positive experience to share their story. We can use these stories to both learn what works well and to have one more active community member as an Inova fan and supporter.  Healthcare reform means that we have to find a more strategic way forward in resource development and we want you to be part of that journey.  What’s the most inspiring philanthropic project you’ve witnessed or been involved with at Inova?

I was rounding recently at Fairfax Hospital and a nurse said to me, “if we can, we do.” I love that attitude and it reminded me of Dr. Lynch, the CMO at Fair Oaks Hospital. He believes that you have to be prepared for most anything. When there’s not a process or plan in place, put a plan or process into place.

[gigya src="http://c.brightcove.com/services/viewer/federated_f9?isVid=1" flashVars="isUI=1&videoId=1258583468001&playerID=1253044380001&playerKey=AQ~~,AAAAACj07sU~,k64g1nVTFBiE_nPws0NlPjWz_gqud3NG&domain=embed&dynamicStreaming=true" width="480" height="320" allowFullScreen="true" allowScriptAccess="always"]

Well, that sure gives new meaning to our “No Drop Off Zones!” As our Fairfax nurse said, “if we can, we do,” Dr. Lynch could and did. The cool thing though was that just a month prior his team discussed the issue of what to do if a mom doesn’t make it to the OB suite in time. They put a plan in place and created the Dr. Stork code. It worked like a charm with the exception of one missing item, a blanket. You can now find a pack at the front reception desk which includes a blanket. Hooray for another Inova team preparing to expect the unexpected!

Over 85% of our patients think we are very good. That’s good, but that’s not excellent, which is where we want to land. It isn’t hard to be good from time to time. But the trick is to be excellent every day. So what does an excellent patient experience look like?

John Fitzgerald and his team are exploring ways to design our processes and align our system to consistently and sustainably achieve excellent patient experiences. That means we have to start by defining exactly what our patients want from us. If you were a patient, what would you expect? Please take a moment and listen to John’s take on another type of shopping experience.

[gigya src="http://c.brightcove.com/services/viewer/federated_f9?isVid=1" flashVars="isUI=1&videoId=1251405124001&playerID=1253044380001&playerKey=AQ~~,AAAAACj07sU~,k64g1nVTFBiE_nPws0NlPjWz_gqud3NG&domain=embed&dynamicStreaming=true" width="480" height="320" allowFullScreen="true" allowScriptAccess="always"]

Well, that’s certainly a different way of looking at a trip to the hardware store! So how can we look differently at how we care for our patients? John and his team have been working to figure how we can build a culture of delivering excellent care every time. The team’s first draft reads, “At Inova Health System, every decision and action will meet the needs of each person we are privileged to serve, every time, every touch.” This concept will drive everything we do and requires that every person at Inova get onboard the patient experience bus.

One patient’s feedback was that numerous caregivers would say, “I’ll be right back,” then they wouldn’t return for hours. How disheartening to be let down so many times! Our patients are confused, overwhelmed, anxious, bored, helpless and a whole host of other adjectives I could throw in here. It is our duty to relieve them of as much fear and uncertainty as we possibly can. Let’s remember that while this might be our fourth procedure of the day, it might be our patient’s first. Ever.

So many thanks to John, his team, and all who are already engaged in improving the patient experience. Let’s face it, when our patients have a relationship with an Inova caregiver that is built on sincere concern and genuine trust, our patients are more likely to communicate openly and honestly, more likely to follow our advice, and more likely to remain a loyal Inova patient and community ambassador. Building these solid relationships is the single most important thing we can do to ensure a vibrant and healthy future. Do you have any great examples of an excellent patient experience to share? Any colleagues you’d like to recognize?

[brightcove vid=1235905015001&exp3=63202291001&surl=http://c.brightcove.com/services&pubid=687140549&pk=AQ~~,AAAAACj07sU~,k64g1nVTFBhmvE53cmh-9yMu5QNCpkH-&w=480&h=270]

While we are a large system, each unit is a village unto itself where bonds are developed and everyone is working together for a common purpose. I remember the story of a colleague whose house caught fire and all her co-workers stepped in with offers of food, money, clothes and shelter. She also received money from United Way’s Inova employee fund. I hear touching stories all the time from our social workers, chaplains and human resource team about our “above and beyond” actions.

I also heard about someone in anesthesia who took it upon himself to get to the bottom of blood pressure cuffs that didn’t work right each and every time. The inconsistency was driving everybody nuts, so he spent hours researching and making calls. He called the manufacturer, other doctors; I think he even talked with someone in Germany. His persistence paid off. The issue was resolved and he shared the solution with everyone across the system. We all have moments like this when we cross the line from our “day job” to working with drive and passion for the common good.

Being in the healthcare field provides us with a unique opportunity to make a profound difference everyday. Many times we care for patients and families when they are most vulnerable. Even those of us who don’t work directly in patient care often feel that same passion. I think that this is the difference between having a job and having a calling.

At a job, we expect to get more than we receive. A calling is a bit counterintuitive. A calling is striving to serve others who need us. It’s expecting to give more than you expect to get back. Why would you sign up for such a thing? I think the answer is that we are all attracted to the opportunity to make a difference in another person’s life.  At Inova, we have the unique opportunity to give people something they couldn’t get any other way – a connection with another human who cares.

W. Edwards Deming said, “All anyone asks for is a chance to work with pride.” I would add to that most folks also ask for the chance to work for something larger than our own self interest. Long term, we learn that if we give to others, we get a whole lot more back. This calling is the blessing we have to share, and in my mind, it’s the blessing we HAVE to share!

What is your unique personal story? When did you feel the warmth of giving to someone else?  When were you the recipient of a special measure of someone else’s caring touch, embrace or gesture?  I would like to hear about your passion, your calling and the “power of love”!

On today’s guest post, Richard Magenheimer, our Chief Financial Officer, provides his one minute take on healthcare costs in relation to our local economy.

[brightcove vid=1211343209001&exp3=63202291001&surl=http://c.brightcove.com/services&pubid=687140549&pk=AQ~~,AAAAACj07sU~,k64g1nVTFBhmvE53cmh-9yMu5QNCpkH-&w=480&h=270]

We’ve made great strides, but have a long way to go. Please share with me your favorite cost-cutting measures to date and or the ones that you are currently working or planning to implement.