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November 12, 2015

Moakley Addition Opens

The clinical campus redesign process at BMC began in 2014 and has already transformed many aspects of the hospital, from the way we navigate the campus to how patients access the hospital. While construction continues in earnest, BMC recently finished one major project – the Moakley building addition, which officially opened with a ribbon cutting on October 29.

“This project is the foundation for all we’re doing to prepare BMC for the future,” said Kate Walsh, President and CEO. “We’re investing in our campus and in our most important resource – you and your colleagues. That’s what this project is all about, and I’m really looking forward to gathering together again in the months ahead as we reach more milestones on the project.”

The first department to move into new space was the Center for Digestive Disorders, which is consolidating its services under one roof for the first time, followed by the Alan D. Solomont and Susan Lewis Solomont Clinical Simulation and Nursing Education Center, Otolaryngology, Oral and Maxillofacial Surgery, and the Command Center. Currently, a build-out of the future endoscopy suite, which will be moving from the Menino building, and new post-anesthesia care unit (PACU) space is ongoing.

Some of the biggest changes are for the Alan D. Solomont and Susan Lewis Solomont Clinical Simulation and Nursing Education Center, which has a more efficient space and new equipment to assist departments in their training. New features of the space include five independent control rooms to monitor simulations (the previous facility had two rooms) and a new medical-surgical/ICU simulation two bed unit. The Center also has increased capability to record sessions, including hallway recording and live streaming video in the operating rooms.

“Our new space and location is great,” says Ron Medzon, MD, Director, of the Alan D. Solomont and Susan Lewis Solomont Clinical Simulation and Nursing Education Center. "Our equipment is state-of-the-art, and we were able to add new rooms for simulations. The other bonus is that we are now just 20 yards from the entrance to the hospital, which will eventually be the main entrance to the Emergency Department, and this will hopefully make it easier for all departments at BMC to access and use the center. We can create and run programs with any department in the hospital, and at no charge to the departments, so we hope to see every single department eventually involved with the Simulation Center.”

Despite a challenging winter, support from Shawmut Design and Construction, Tocci Building Companies and the BMC facilities team ensured that the Moakley addition was completed on time and on budget.

“We are very excited that the Moakley addition is finished and by how great it looks,” says Jennifer Heikkinen, Senior Project Manager of the Moakley addition, and an employee of Tocci Building Companies, the group overseeing the clinical campus redesign. “In addition, finishing this project allows us to move services and open up space in Menino to get the rest of the campus redesign project underway.”

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Accessibility Committee Works to Make BMC Inclusive for All

Walking around campus or getting yourself on an exam table might be easy for many patients, but for some, particularly patients with disabilities, small tasks associated with receiving care are much more difficult. At BMC, the Accessibility Committee is working hard to ensure that all patients, regardless of ability, are able to receive the care they need.

The Accessibility Committee was formed in 2013 to create a comprehensive assessment of the access that BMC’s patients with disabilities have to health care, including the physical buildings, the availability of accessible medical equipment, policies and procedures, employee training, communication development, aids, and services, and community outreach. The goal was to examine BMC’s level of accessibility for patients with disabilities and undertake the work necessary to improve that access.

“It’s important to ensure that all patients have equal access to care and that we can meet the unique needs of our broader patient population,” says Kristen Kremer, MPH, Manager of Patient Experience and Co-Chair of the Accessibility Committee.

Since the committee was founded, it has made numerous strides to improve the accessibility of BMC for patients with disabilities. In addition to the review of campus accessibility, the committee has implemented wheelchair return locations, updated policies and procedures related to patients with disabilities, held trainings on improving the care experience for patients with disabilities, and is working with the campus redesign team to ensure that BMC’s new spaces are accessible for everyone.

In order to ensure accessibility concerns were addressed in the campus redesign, the committee worked with external surveyors to determine Americans with Disabilities Act (ADA) compliance in BMC’s buildings and then worked with the redesign and construction teams to incorporate these findings into the new buildings. The survey identified 2,015 barriers to accessibility at BMC, ranging from door handles that are difficult for patients with disabilities to use to wheelchair shortages. In the early phases of campus redesign, 365 of these barriers – more than 18 percent – have been removed and almost 400 more will be eliminated when the Yawkey Women and Infant’s Center is completed.

The committee is also spearheading the selection of ADA compliant exam tables and chairs for the hospital. To inform the selection process, BMC held a fair on November 12 where three vendors showed their ADA-compliant exam tables and chairs in simulated exam rooms. The tables can be lowered to make it easier for patients in wheelchairs to get on, have higher weight limits and are wider, and have armrests to help patients stay upright. These features make exams easier not just for patients, but also for staff members. Fair attendees voted for the equipment they liked most, and BMC will incorporate that feedback in choosing a vendor for accessible exam equipment.

“If patients cannot get out of their wheelchairs, they might not be able to get a good exam,” says Jane Grana, Director of Clinical Value Analysis and a member of the Accessibility Committee. “These new tables and chairs will allow clinicians to more easily give patients with disabilities the same level of exam as other patients and make exams more comfortable for patients. The committee is also looking at exam room configurations to make them more accessible for patients in wheelchairs, and at equipment that will help providers weigh patients more accurately.”

The Accessibility Committee works in partnership with the Boston Center for Independent Living (BCIL). This partnership began in January 2014 with a memorandum of understanding aimed at making BMC the most accessible hospital in Boston. With BCIL, the Accessibility Committee received a Workforce Transformation Fund training grant from the Commonwealth Corporation and has created a video for staff that shows how to serve patients with disabilities, specifically focused on communication. The video will soon be rolled out to select Ambulatory clinics as a pilot. The ultimate goal is to appropriately train all staff members in how to communicate with and care for patients with disabilities and empower these patients to take part in their own care.

“Our partnership with BCIL is unique,” says Kremer. “Because of their work, we are able to learn about best practices and hear more voices of patients with disabilities. Their expertise helps us think through barriers to care and what works or doesn’t work to overcome these barriers. We are also working to bring a patient onto our committee, to ensure that the patient voice is fully present in our work.”

If you have concerns or suggestions about accessibility at BMC, contact the Accessibility Committee at [email protected]

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BMC Celebrates Third Annual Quality, Safety, and Patient Experience Week

On October 19, David Bates, MD, MSC, SVP and Chief Innovation Officer at Brigham and Women’s Hospital and Director of The Center for Patient Safety Research and Practice kicked off the third annual Quality, Safety, and Patient Experience Week at BMC with the 11th annual Raphael Miara Patient Safety Symposium, entitled "Using Big Data to Improve Quality of Care and Patient Outcomes.” The Miara lecture is an ongoing commitment by Boston Medical Center to confront mistakes and learn from them, so something good can come of them.

Bates began with an overview of big data analytics, which uses massive amounts of data to help solve problems that “can’t be figured out just with a group of smart people.” In health care, the use of big data is heavily hyped, and encompasses electronic health records, imaging, genomic data, wearables, and the many other data points we measure in the course of caring for patients or that patients themselves measure in their daily lives.

There are many ways in which big data has been useful in health care, said Bates. For example, it is a key approach in solving scientific problems through research, and many hospitals and research organizations are collaborating by sharing data.

Big data can also help identify high-risk or high-cost patients, and help triage patients and prevent readmissions or adverse events. “Five percent of patients account for 50 percent of spending,” said Bates. “In order to identify and help these patients, we need not just medical data, but also socioeconomic data and mental health data to help identify their specific needs.”

With all this data, “safety is an area likely to bear fruit early,” said Bates. With big data, hospitals will be able to predict decompensation, create visualizations of who is or isn’t doing well, predict patient trajectory, predict adverse events, and practice pharmacovigilance.

“A big data approach can be as transformative as the internet,” said Bates. While most organizations have not yet figured out how to leverage data, and the federal government has been relatively silent about how to do so, data has great power to improve organizations and help create more efficient tools and monitoring that will help everyone from nurses to doctors to patients.

After the lecture, the audience moved to the Heibert lounge for the Quality, Safety, and Patient Experience poster ceremony and reception. Poster displays are an integral part of the week’s celebration, providing an opportunity for departments and teams to share their improvement strategies and celebrate their successes with the BMC and BUSM community. Over 40 posters highlighted the quality and patient safety initiatives undertaken by BMC employees this past year to make the hospital safer for patients. Awards were given for projects in five different categories: Quality Improvement, Patient Experience (for the first time), Patient Safety, Innovative Quality and Patient Safety Curricula, and House Staff. Nine projects that were felt to be exemplary and deserve top ranking were recognized:

  • Quality Improvement: Projects addressed quality improvement undertaken within the last year which demonstrated measurable improvements and sustainability over time.
    • Pulse Oximetry Alarms: Can We Take Alarms Down Another Notch? Implementation of a MICU Early Mobilization Protocol
      By Mary Doherty; Christina Butler; Amanda Rubenstein; Kellie Smith; Andrea Forman; Kim Costello; Karin Sloan; James Piepenbrink; Deborah Whalen
    • Improving the Emergency Department Triage Process, a Local Improvement Project
      By Sarah Carignan; Pearl Cunningham; Lauren Nentwich; Catherine Fanning; Barbara Dwyer; Donna Kenney; Christine Bertolino; Susan Griever; Mirinda Tyo Brown; Gloria Burrill; Deed McCollum; Cindy Gonzalez; Jesse Schafer; Deborah Gregson
    • The Multidisciplinary Initiative to Solve Serious Errors Due to Medication Delays (MISSED MED) in Adult Intensive Care Units Quality Improvement Project
      By William R. Vincent, III; Joy Vreeland; Kevin J. Horbowicz
  • Patient Experience: Projects addressed improvement in the patient’s experience undertaken within the last year which demonstrated measurable improvements and sustainability over time.
    • Improving Wait Time Communication in the Pediatric Primary Care Clinic
      By Elise Petersen; Kathleen Masters; Ann Johnson; Soukaina Adolphe; Carole Moloney; Rebekah Kahal; Nilza Vieira; Emily Dechambeau; Carlos Arellano; Kristen Kremer; Sabrina Mason; Morgan Minogue; James Moses
  • Patient Safety: Projects with a focus on improving patient safety. The project include those that may have been the result of a near miss, adverse event or from an identified risk.
    • I-PASS with SAFETY: Standardized Nursing Bedside Handoff
      By Nicole Lincoln; Katherine Scanlon; Kristen Kremer; Karen Villanova
    • Decreasing Decision to Incision time for Emergency Cesarean Sections
      By Ronald Iverson; Abigail Paul; Tirah Samura; Lynne Lambert; Kristin Decosta; Mark Norris; Eddie Feliz; Sarah Lambeth; Mayra Mieses
  • Innovative Quality and Patient Safety Curricula: Projects that are educational in design and approach. Projects submitted should be tied to improving specific knowledge and skills tied to quality improvement and patient safety in trainees (students, residents, and fellows) and/or clinical and non-clinical staff.
    • Increasing Surgery Resident Adverse Event Reporting: A Resident Led Initiative to Improve Patient Safety
      By Ryan Macht; Alejandra Balen; David McAneny
  • House Staff Award: This award is in special recognition of a resident/fellow led effort, coming from any one of the five categories.
    • Curricula: Improving Care Among Stroke Patients Through a Resident-Based Neurology Handbook
      By Chantale O. Branson; Lindsay Beamon; Cigdem Isitan; Benjamin Saunders; Judith Clark; Hugo J. Aparicio
    • Patient Safety: Reducing Errors During the Emergency Department to Surgical Service Transition of Care by Implementing a Transfer Checklist
      By Feroze Sidhwa; Ryan Macht; Kerry McCabe; Jordan Spector; Tracy Dechert; Chaitan Narsule

Throughout the week, numerous events were held for staff members to learn about and celebrate quality, safety, and patient experience at BMC. These included department lectures and presentations, a special edition of the Nurse Practice Council, a tour of BMC’s state-of-the-art laboratories, and multiple screenings of Chasing Zero, a film about preventable harm.

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What do you do, Latchman Hiralall?

Name: Latchman Hiralall
Titles: Food Pantry Manager
Time at BMC: 29 years

What brought you to BMC?
BMC was my first – and has been my only – place of employment after I emigrated from Guyana, in South America. I started in Nutrition and Food Services, then I got promoted to supervisor, and while I was there I got my degree in food systems management and became a registered dietetic technician. Then I became the assistant dietitian. I worked my way up the ladder and then was offered this position. The Food Pantry was new and no one knew exactly what we were doing, since no other hospital had done something like this before, but I said I would give it a try. I took on this role and built the Food Pantry from scratch.

What do you do here?
I spend most of my day helping to give food to patients. Patients get referred by their clinicians and we provide food to families and individuals based on dietary restrictions and the number of people in their household. Most of the day I’m signing in patients, signing up patients, helping the rest of the staff put together the customized bags for each patient, and updating patients’ medical records each time they pick up food. We serve an average of 7,000 patients per month. I also order the food for the pantry. Each week, we bring in about 12,000 pounds of food from the Greater Boston Food Bank and receive donations from other sources, such as Ocean State Job Lot. We only accept healthy food to help reinforce what patients are learning in the clinics.

I also help other hospitals who are looking to set up their own food pantries, using our method as a model. Our Food Pantry has won several awards and Dartmouth-Hitchcock Hospital made a short documentary about us for a national award we won. Since the video went online, we have been getting calls from all over the country from hospitals who want to set up food pantries. Some come to see us in person, and some people I just talk to on the phone.

The Food Pantry is moving into a new space soon. What will this mean for your services?
We’re anticipating more referrals from providers, since our location will be more accessible and we’ll have a bigger space, which means a lot to us. When this Food Pantry was built, we thought we would serve 500 patients a month, but we’re serving 7,000, so as you can imagine, we run out of space quickly. We’ll have our own walk-in freezer and refrigerator – we’re currently using the one in the main kitchen – so both the Food Pantry and the main kitchen will have more space for perishable food. We’ll also generally have more storage space. Right now, we have to break down pallets of food as soon as they come in, but in the new space, we’ll be able to store the pallets whole, which is a lot less work. It will also be easier to bring food into the basement. We’re all very excited about the new space.

Thanksgiving is coming up. Can you tell us about the Food Pantry’s work during Thanksgiving? How can staff members help?
We give out food the Friday, Monday, and Tuesday before Thanksgiving. Starting the day before we give out food, we fill up bags with the fixings, like stuffing, cranberry sauce, squash – whatever we have. We fill up over 800 bags and last year we gave out 840 bags. If we have bags left over, we’ll hand them out on Wednesday too, but we’re usually out by then.

This year, there’s a turkey shortage because of avian flu, so we only got half the amount of turkeys we usually do from the Greater Boston Food Bank, but we’ve managed to get more from other programs, such as Lovin’ Spoonful and ThermoFisher, and we should be able to get about 800.

We have a lot of volunteers come in to help, especially to fill the bags. If staff members are interested in helping, they should contact me so I can schedule them. Any amount of time they can come help, even half an hour, is helpful.

What’s one thing about working at the Food Pantry that people might not guess?
It’s a lot of work, but it’s very rewarding work. We take a lot for granted. People don’t talk a lot about hunger, but when you see people’s reactions when they pick up the food, the work is all worth it.

What do you like most about working at BMC?
I’m very thankful, because BMC has given me a lot of opportunities and I took those opportunities to elevate myself. I was able to move to supervisor, get my degree, become BMC’s first assistant dietitian, and become a manager, which is what I always wanted. I always wanted to work for BMC instead of a contract company, which is what often happens in food service.

I also have a great group working with me. They make my life easier because I don’t have to tell them what to do. They all know what to do and when to do it. They’re a well-oiled machine. To sign a patient in, pull their chart, get the cart set up, and bag the food takes three to four minutes per patient.

What do you do for fun outside of work?
II’m the secretary of a Hindu temple in Dorchester, so that keeps me busy. During the summertime, I love cricket. I used to play, but now I just watch. I love watching all sports, whether on TV or at the park, and I socialize with friends when I can.

Do you know a staff member who should be profiled? Send your suggestions to [email protected] .

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Awards and Accolades

BMC Named a Top Woman-Led Business in Mass.
BMC was ranked number 22 on the 2015 Boston Globe Magazine and Commonwealth Institute list of top 100 women-led businesses in Massachusetts. The annual list includes both for-profit and non-profit organizations, which are ranked by variables including revenue/operating budget, number of full-time employees, workplace diversity, and innovative projects. BMC HealthNet Plan was also featured on the list, at number nine.

BMC Honored as an Exemplary Employer
BMC was named an Exemplary Employer in 2015 by Career Collaborative, a workforce development organization that provides assistance and services to low-income clients. The award honors BMC’s retention rates, high median wage, and employee development programs.

BMC Wins Cybersecurity Award
BMC was named a winner at the Center for Digital Government’s fifth annual Cybersecurity Leadership and Innovation Awards for the hospital’s Security Risk and Compliance Program, which saves $1.3 million annually. The award recognizes cybersecurity achievements and demonstrations of leadership, innovation, and creativity in this area in the past two to three years.

c-moakleyribboncutting.jpg = Moakley Building Ribbon Cutting

c-chairfair.jpg = Fair attendees voted for their favorite ADA-compliant equipment

c-qspe.jpg = Quality, Safety, and Patient Experience Week recognized nine projects

c-staffid_latchman.jpg = Latchman Hiralall