Headlines CaringMay 7, 2015 Rolling out the red carpet for the SServiceervice ExcellenceExcellence AwardsAwards

See story on page 6

Staff of the Ambulatory Practice of the Future make their way down the red carpet to accept award for achieving highest rating in provider explain and staff courtesy. The newsletter for PPatientatient CCareare SServiceservices Massachusetts General Hospital Jeanette Ives Erickson

TThehe JJointoint CCommissionommission vvisitisit survey characterized by a mutual desire to improve patient care

t’s one thing to practice Excellence Every Day. It’s another to be able to articulate your practice in a way that conveys your knowl- edge, skill, and compassion. And it’s some- Staff throughout thing else entirely to describe your practice to Joint Commission surveyors who are here MGH articulated to assess our ability to provide high-quality care in a safe, clean environment. But that’s their practice to exactly what staff throughout MGH did the week of IApril 20th when a team of hospital and lab survey- Jeanette Ives Erickson, RN, senior vice president for Patient Care and chief nurse Joint Commission ors arrived for our triennial Joint Commission sur- vey. I was so proud as I witnessed fi rst-hand and one occasion identifying an MGH system or process surveyors... I heard reports of how eagerly and passionately staff as a best practice, suggesting we publish it in the was so proud showcased their practice. Joint Commission’s on-line library for other hospi- Surveyors visited numerous inpatient units on tals to see. as I witnessed the main campus as well as the Cath Lab, operating Perhaps the best way to appreciate the survey- rooms, the Emergency Department, Pediatric Hema- ors’ assessment of the MGH environment is through fi rst-hand and tology/Oncology, Internal Medicine Associates, and their own words. These are just some of the com- satellite locations, including, Mass General/North ments we heard: Life safety specialist, Lanny Wier, heard reports of Shore Center for Outpatient Care in Danvers, MGH observed, “Your employees really know the fi re pro- Charlestown, the Revere HealthCare Center, and cedures cold. Your buildings are exceptionally well- how eagerly and other locations. They conducted individual patient maintained. Everywhere I went was incredibly tracers, reviewed our environment of care, and assessed clean.” passionately staff our practices in medication-management, infection- Surveyor, Mark Williams, RN, commented, prevention, data-management, emergency manage- “There was no need to complete an infection-con- showcased their ment, severe weather readiness, and so much more. trol tracer because during my observations, I saw Throughout all practice settings and disciplines, perfect adherence to isolation precaution practices practice. surveyors saw dedication to excellence and a com- including the identifi cation of patients, readily mitment to ongoing learning and improvement. available personal protective equipment, and cor- They were generous with their praise, on more than rect use of that equipment by all staff.” Mr. Williams continued on next page

Page 2 — Caring Headlines — May 7, 2015 Jeanette Ives Erickson (continued)

went on to say, “Your nurses are the best. I was a It would be inconceivable for a hospital of our size critical care nurse at the Cleveland Clinic. We and complexity not to have some areas where im- took care of very sick patients there, but not to provement is warranted. And indeed, surveyors did Overall, the the magnitude I’ve seen here this week at MGH.” identify a number of issues, which we’ve grouped in four Said surveyor, Kathleen Ostrowski, RN, “Your broad categories: Joint Commission clinical tracer program focusing on National • Record of care (medical record documentation) Patient Safety Goals is remarkable. It’s very un- • Environment of care visit was thorough, usual for a large academic medical center not to • Infection control receive fi ndings in this area.” • Laboratory quality systems assessment informative, and Surveyor, Rosemarie Pierce, RN, shared, “Mass- Many of the fi ndings were minor; some have already achusetts General Hospital has shown that it is been corrected; others will be addressed in the coming extremely positive; committed to becoming a high-reliability organi- weeks. We’re in the process of clarifying and fi nalizing zation. Your entire workforce welcomed our sug- all fi ndings and will work within the allotted time frame it was the most gestions with enthusiasm.” And, “Your behavioral to develop and implement corrective action plans. health program is the best I’ve ever seen. Patients I think our colleague, John Belknap, director of collaborative are treated with dignity and respect. Best in the Compliance, put it best when he said, “This Joint nation.” Commission survey was successful, not because of the Joint Commission Overall, the Joint Commission visit was thor- complimentary comments we heard from surveyors, experience of my ough, informative, and extremely positive; it was but because of the great insights they shared about the most collaborative Joint Commission experi- how we can improve practices in some areas. I know entire career. I ence of my entire career. I was happy to see a con- we’ll take that feedback and use it to make the excel- structive, respectful exchange of ideas with in- lent care we provide even better.” was happy to see stances where we learned from them and instances Over and above participating in a rigorous accredi- where they learned from us — exactly what an ac- tation process, the Joint Commission survey was a a constructive, creditation survey should be. They were impressed valuable learning experience. It was overwhelming with our knowledge of and adherence to National validation of our Excellence Every Day philosophy and respectful exchange Patient Safety Goals, blood transfusion practices, a reminder of why I’m so grateful to work with the best plan of care, PRN pain model, inter-disciplinary clinicians, support staff, and administrators in the of ideas with team approach, and most importantly, the fact world. Thank-you for your service to our patients and that our care is driven by ‘knowing’ the patient. families. instances where we learned from them and instances where In this Issue

they learned from Service Excellence Awards...... 1 The Molly Catherine Tramontana Award ...... 10

us — exactly what Jeanette Ives Erickson ...... 2-3 Fielding the Issues ...... 11 • The Joint Commission Visit Hospital Survey on Patient Safety an accreditation • Clinical Recognition Program ...... 4-5 Professional Achievements ...... 12-13 survey should be. • Review Board Presentation Announcements ...... 14 Service Excellence Awards...... 6-7 Timilty Science Fair ...... 15 Clinical Narrative ...... 8-9 • Casandra McIntyre, RN HCAHPS ...... 16

(Cover photo by Brian Wilson; photo on page 8 by Wally Reeves)

May 7, 2015 — Caring Headlines — Page 3 Clinical Recognition Program

CClinicallinical RRecognitionecognition RRevieweview BBoardoard PPresentationresentation — by Christine McCarthy, RN, staff nurse, and Ann Jampel, PT, clinical education coordinator

hey seemed really nice,” said nized as advanced clinicians and clinical scholars. one clinician after the April Co-chairs of the Review Board, Ann Jampel, PT, 1, 2015, presentation of, “Be clinical education coordinator for Physical Therapy, Not Afraid of the Clinical and Christine McCarthy, RN, medical staff nurse, Recognition Program Review were joined by other members of the Review Board Board.” That same clinician to discuss the application process and offer advice had previously expressed trep- on how to develop a portfolio that truly refl ects the idation at the prospect of ap- applicant’s level of practice. pearing before the Review Board as part of the Clin- Some of the questions asked were: ‘‘‘T‘Tical Recognition Program (CRP) review process. What is the role of the Review Board? The presentation and discussion that followed were The Review Board is a multi-disciplinary board an opportunity for members of the Review Board to charged with making decisions about clinical recog- explain their role in reviewing portfolios, interview- nition. They do this through an in-depth process of ing candidates, and deciding who should be recog- continued on next page Co-chair of the Clinical Recognition Program Review Board, Christine McCarthy, RN (far right), with members of the Review Board (l-r): Brenda Pignone, RN; Barbara Cashavelly, RN; Joy Williams, RN; Lisa Scheck, LICSW; Julie Cronin, RN; and Carolyn LaVita, RRT.

Page 4 — Caring Headlines — May 7, 2015 Clinical Recognition Program (continued)

reviewing portfolios and evaluating them against estab- Whom should I ask for letters of support? lished criteria; interviewing applicants; and discussing Ask someone with whom you work who knows your information in an attempt to fully understand the clini- practice. And when you ask, be specifi c about what cian’s level of practice. you want them to talk about. For example, Would you Does the Review Board return my portfolio if it’s not at the write about my care of Mr G?” or “Can you talk about level I’m applying for? that clinically challenging patient we cared for?” or The Review Board returns portfolios if they don’t in- “Can you share how we worked together on that ini- clude evidence of all the themes. That’s why it’s impor- tiative?” It’s also helpful to give them a time frame: “I tant to make sure all themes and supporting criteria are need the letter in two weeks so I can submit my portfo- represented in the portfolio before it’s submitted. lio.” Always ask for more letters than you need, so you have options. What happens during the interview? Can you describe the blind review process? Interviews take place in the Refl ection Room on The blind review process is where former Review Founders 3. The interviewing team is comprised of three Board members give anonymous feedback about your board members; the lead interviewer is always a member portfolio prior to submitting it for actual consideration. Co-chair of the of the applicant’s own discipline. Interviewers are there Clinical Recognition They provide feedback about its strengths or weaknesses to talk about and gain understanding of your practice; Program Review in representing each theme. This process only happens it’s not an interrogation. They ask questions to fi ll in any Board, Christine once prior to applying, and it takes about seven to ten gaps they may fi nd in your portfolio. If you have ques- McCarthy, RN days to receive feedback. To take advantage of the tions or aren’t clear about their questions, they encour- (far right), with blind review process, e-mail any or all elements of your age you to ask for clarifi cation. You’re free to bring members of the portfolio to [email protected]. Review Board (l-r): notes, but most applicants fi nd they don’t need them. Brenda Pignone, RN; How many letters of support do you need? Where do I submit my portfolio? Barbara Cashavelly, Three letters of support are required: one from your de- Portfolios can be dropped off at Founders House 330, RN; Joy Williams, partment leadership; one from a colleague within your to the attention of Mary Ellin Smith, RN, or sent elec- RN; Lisa Scheck, tronically to [email protected]. LICSW; Julie Cronin, discipline; and one from a colleague outside your disci- RN; and Carolyn pline (in Nursing this could be a nurse practitioner, Where can I get more information about the Clinical LaVita, RRT. nurse anesthetist, or nurse midwife). Recognition Program? Visit the Clinical Recognition Program website at: http://www. mghpcs.org/ipc/pro- grams/Recognition/ Index.asp, or call Mary Ellin Smith, RN, pro- fessional development manager, at 617-724- 5801. To paraphrase the clinician from the opening paragraph, the take-away message from the April 1st presenta- tion was that contrary to popular belief, Review Board members aren’t scary. They’re actually really nice!

May 7, 2015 — Caring Headlines — Page 5 Service Excellence

Second annual MGH Service Excellence Awards — by Cindy Sprogis, senior project manager

he second annual MGH Service Excellence Phillips 21, Gynecology, Adele Keeley, RN, nursing director Awards were held April 1, 2015, to recognize • Achieved 90th% for pain management teams and individuals for their extraordinary • Achieved 90th% for quiet at night achievements in improving the patient experi- MGH Intensive Care Units ence at MGH. The red carpet was (literally) • Blake 10, NICU, Peggy Settle, RN, nursing director rolled out for award recipients in two broad cat- • Blake 12, ICU, Mary McAuley, RN, nursing director egories: nomination-based awards and awards • Blake 7, MICU, Jeanette Livelo, RN, nursing director Tbased on scores for service excellence across the continuum. • Blake 8, CSICU, Vivian Donahue, RN, nursing director Rick Evans, senior director and chief experience offi cer for Ser- • Ellison 4, SICU, Sandra Muse, RN, nursing director vice Excellence, presided over the celebration. He was joined by • Ellison 9, CICU, Vivian Donahue, RN, nursing director Greg Pauly, chief operating offi cer for the MGPO; senior vice presi- • Gray/Bigelow 6, PICU, Arlene Kelleher, RN, nursing director dent for Patient Care, Jeanette Ives Erickson, RN; and senior vice • Lunder 6, Neuro ICU, Tara Tehan, RN, nursing director president and medical director for the MGHP, Alexa Kimball, MD. • Achieved 90th% for pain-management and staff responsiveness Said Pauly, “I’m here to congratulate all of you. It’s our privi- Target achievement awards: lege to help patients and families through diffi cult circumstances, Awards for most improved in pain management: but there’s always room to improve.” White 8, Medical, Colleen Gonzalez, RN, nursing director Kimball observed, “Our founding documents say, ‘When in dis- White 10, Medical, Jennifer Mills, RN, nursing director tress, everyone is our neighbor.’ Today we celebrate all of the ways the people of MGH bring this phrase to life every day.” Award for most improved in staff responsiveness: Said Ives Erickson, “You are pioneers. You’re doing exceptional Lunder 8, Neurosciences, Ann Kennedy, RN, nursing director work taking exceptional care of our patients. We’re thrilled to Awards for most improved in quiet at night: have this opportunity to say, Thank-you.” Ellison 7, Surgical, Joanne Empoliti, RN, nursing director For space reasons, the following is an abridged list of Service Ellison 12, Medical, Melissa Joseph, RN, nursing director Excellence Award recipients. Awards for exceeding the 90th percentile in pain management: Inpatient awards: Lunder 9, Oncology, Barbara Cashavelly, RN, nursing director Bigelow 14, Vascular Surgery, Sharon Bouvier, nursing director Lunder 10, Oncology, Ellen Fitzgerald, RN, nursing director • Achieved all targets Bigelow 9, RACU, Maria Winne, RN, nursing director • Most improved score for staff Blake 6 Transplant, Tony DiGiovine, RN, nursing director Award for exceeding the 90th percentile in quiet at night: • Achieved all targets Ellison 13, Obstetrics, Lori Pugsley, RN, nursing director • Most improved score for staff responsiveness Outpatient Awards: Blake 13, Obstetrics, Laura Pugsley, RN, nursing director Ambulatory Practice of the Future, Jane Maffi e-Lee, RN, clinical • Achieved all targets program director • Achieved 90th% for pain management • Highest rated score for staff courtesy • Achieved 90th% for quiet at night • Highest rated score for provider explain continued on next page

Page 6 — Caring Headlines — May 7, 2015 Service Excellence (continued)

Target achievement awards: Nomination-based individual awards: Awards for most improved in provider explain: Diane Levis, physician assistant, Ellison 6 Urology Physical Medicine and Rehabilitation, Ross Zafonte, MD, chair Samia Nacera Alimoussa, patient services coordinator, Revere Sleep Disorders, Matt Bianchi, MD, director Health Center, Imaging Melissa Ghiringhelli, speech-language pathologist, Chelsea and Awards for most improved in staff courtesy: Revere Health Centers Neurobehavioral, Zaida Ortega, practice manager Ray Williams-Carr, ambassador, Revere Health Center Pedi Urology, Julie Hennigan, administrative director Kelli Nelson, medical assistant Awards for most improved in staff helpfulness: Thomas Furlong, associate director of Veteran Outreach, Home Epilepsy, Mallory Davis, administrative manager Base Program, Department of Psychiatry Medical Walk-In, Mary Sullivan, nurse manager Leadership awards: Awards for exceeding the 90th percentile in provider explain: Sharon Bouvier, RN, nursing director, Bigelow 14, Vascular Pedi Cardiac, Oscar Benavidez, MD, chief Surgery Pedi Pulmonary, T. Bernard Kinane, MD Stephanie Cooper, associate director, PCS Clinical Support Services Awards for exceeding the 90th percentile in staff courtesy: Rebecca Fishbein, PT, clinical director, Outpatient Physical Pedi Allergy/Immunology, Barbara Murphy, practice manager Therapy Endocrine Thyroid Unit, Jessica Upham, administrative manager Bessie Manley, RN, nursing director, Phillips 22 Awards for exceeding the 90th percentile in staff helpfulness: Sharon McKenna, RN, nursing director, Cardiac Cath and Pedi Hematology/Oncology, Ellen Silvius, RN Electrophysiology Labs Voice Center, Alicia Francois, offi ce manager A complete list of recipients, including honorable mentions, Nomination-based team awards: can be found on the big-screen TV across from the MGH Gift Pain Tiger Team Shop. For more information, call Care of Behaviorally Deregulated Children Cindy Sprogis, senior project Team manager, at 617-643-5982. Orthopaedic Day Surgery Turnover Team PT/OT Revenue Cycle Implementation Rick Evans, senior director and chief experience offi cer for Ser vice Excellence; Team Greg Pauly, chief operating offi cer for the Information Desk Associates Team MGPO; and Jeanette Ives Erickson, RN senior vice president for Patient Care, present Pneumonia Care Redesign Team awards to (clockwise from top): Information Neurology-Oncology Practice desk associates for nomination-based team recognition; ICU staff for achieving 90th% in Chelsea/Revere Speech-Language pain-management and staff responsiveness; Swallowing Disorders and Reading and staff of Blake 6 for achieving all targets and most improved in staff responsiveness, Disabilities Departments and Ellison 14 for achieving 90th% in pain- Radiology Oncology Agility Upgrade Team management and staff responsiveness.

(Photos by Brian Wilson)

May 7, 2015 — Caring Headlines — Page 7 Clinical Narrative

SSmallmall vvictoriesictories hhaveave bbigig mmeaningeaning fforor GGYN-ONCYN-ONC nnurseurse

y name is Casandra McIntyre, and I am a nurse on the Phillips 21 GYN-ONC Unit. ‘Samantha’ had been my patient dur- ing two prior admissions. She’s one of our oncology I learned that patients who has tumors Casandra McIntyre, RN, staff nurse throughout her abdomen that cause her tremendous Phillips 21 GYN/ONC Unit Samantha had Mpain and almost constant nausea. On her last ad- tubes.’ In the past, the team had approached Saman- returned and was mission, our Gyn-Onc and palliative care teams tha about the possibility of having a venting G-tube had gotten Samantha’s pain under control using a placed to relieve her nausea and vomiting, but she not doing well. She high-concentration PCA (patient-controlled anal- had adamantly refused, not wanting any more tubes. gesia), which she kept when she was discharged This time, the team feared that a venting G-tube was experiencing home. I learned that Samantha had returned and was no longer an option since it was diffi cult for was not doing well. She was experiencing nausea Samantha to lie fl at for the imaging necessary to nausea and and vomiting, and there was talk of transferring her place the tube. They offered her a nasogastric tube to inpatient hospice. Samantha was 35. Her mother, (NG) tube instead, but again Samantha refused. vomiting, and ‘LeAnne,’ was wonderfully supportive and spent She was on anti-emetics around the clock, but hours at Samantha’s bedside. During Samantha’s nothing seemed to help. there was talk of prior admission, she had spent every night in the The night nurse who gave me report was almost room with her on the couch. I had developed a nice in tears as she described what was likely the worst transferring her to rapport with both mother and daughter. night in Samantha’s life. She had vomited nearly During her inpatient stays, Samantha’s biggest every ten minutes, and the nurse had been in her inpatient hospice. complaints were ‘all the wires and tubes’ she was room the entire night. Neither Samantha nor her hooked up to. Every time she got up to walk, she’d mother had been able to sleep. Samantha was also Samantha was 35. complain about the IV line for the PCA, the TPN confused and having trouble fi nding words. We (total parenteral nutrition) line, the IV line for peri- were unsure whether this was due to sleep depriva- odic medications, and the electrical cords for the tion, the medications she was on, or her advancing pumps. The lines were a constant reminder of her disease. What we did know was that her confusion illness, and I understood her frustration with ‘all the was distressing to the family. The team had again continued on next page

Page 8 — Caring Headlines — May 7, 2015 Clinical Narrative (continued)

offered an NG tube the day before, but it was re- LeAnne. Samantha was able to follow our com- fused, this time by LeAnne wanting to honor her mands as Sarah placed the tube. It went beautifully. daughter’s wishes. Nothing we did was able to con- Once in place, the NG tube immediately started trol Samantha’s vomiting, and she was miserable. draining. Both Sarah and I felt a sense of victory, Before I went into her room, I clarifi ed with the as we knew this was going to improve Samantha’s nurse practitioner that an NG tube was still an op- quality of life. tion and that the team still wanted Samantha to Samantha didn’t vomit one more time that day, Helping LeAnne have one. She assured me it was, but she was cer- and in the two and a half weeks that followed she tain it would be refused as it had been so many only had a few more bouts of nausea and vomiting: and Samantha times before. Hoping to take advantage of how bad a dramatic improvement. Her mental status cleared the night had been, I went in to see Samantha and and in the following weeks she was able to interact see the benefi ts LeAnne along with the night nurse (we do report with her family, express her needs, and was rela- at the bedside now as one of our new innovations). tively comfortable for many days. Her pain was con- of an NG tube In the short time it took us to do report, Samantha trolled with a PCA, and the NG tube controlled vomited twice. She had an emesis basin, but be- her nausea. We were able to take her off all the was a victory for cause the vomiting was so persistent and she was so anti-emetics, and she only required a few PRN tired, she wasn’t able to catch it, and it soiled her doses during her last week. Helping LeAnne and me. There are so johnny. And so it had gone all night. Samantha see the benefi ts of an NG tube was a vic- LeAnne looked exhausted and was on the verge tory for me. There are so many victories like this on many victories like of tears. This was my chance. After the night nurse our unit, fi nessed by the skilled and caring nurses of left, I said quietly to LeAnne, “I don’t want to Phillips 21. They’re not the kind of victories most this on our unit, sound like a broken record. I know many other peo- people think of. But they’re victories nonetheless. ple have talked to you about this, but I want you to Nursing on Phillips 21 can be incredibly sad. We fi nessed by the consider one more time, allowing us to put in an see families lose loved ones, often the center of NG tube. We’re giving Samantha everything we their families: mothers, wives, sisters. This was the skilled and caring have for nausea, and nothing is working. An NG fi rst time I had seen a mother lose her daughter. We tube is the only thing that might help.” all feel the loss when a patient dies, sometimes very nurses of Phillips LeAnne looked at me wearily and said, “Can deeply. What keeps me and the incredible group of 21. They’re not the you explain again what an NG tube is?” nurses I work with going, is the honor of caring for I slowly explained what an NG tube is and how these families in times of such deep sorrow. We fi nd kind of victories it’s placed. Samantha started to listen, so I included solace in these small victories. This is the power of her in the conversation explaining how I’d hold her nursing: being a calming presence, bringing comfort most people head while the tube was inserted. I told them it and peace to ailing patients. Somehow, the victories wasn’t pleasant, that placement often makes patients temper the sadness, allowing us to keep doing the think of. But gag, but once it’s in, it often stops the vomiting. hard and important work of oncology nurses. LeAnne looked at Samantha and said, “Honey, Comments by Jeanette Ives Erickson, RN, they’re victories you want to give it a try?” senior vice president for Patient Care and chief nurse Samantha nodded weakly. nonetheless. LeAnne turned to me and said, “Let’s do it.” What a beautiful narrative. When longevity of life I immediately went to our nurse practitioner, can no longer be the priority, quality of life becomes Sarah Stowell, and told her we had permission to so important. Casandra knew that the NG tube place the NG tube. I requested that our most expe- would bring Samantha relief, but she understood rienced practitioner be the one to place it. I knew the fear, frustration, and sense of surrender that we only had one shot to get it right; if we failed kept Samantha from consenting to have one. It was they’d likely refuse another attempt. the delicacy and empathy of Casandra’s ‘ask’ and Sarah offered to call the resident or fellow to do the trust she had accrued over multiple admissions the placement, then said, “But honestly, I do more that allowed Samantha to ultimately agree. This of these than anyone else on the team.” So Sarah was, indeed, no small victory. and I went into the room with all the supplies and Thank-you, Casandra. again described the process to Samantha and

May 7, 2015 — Caring Headlines — Page 9 Recognition

TThehe 22015015 MMollyolly CCatherineatherine TTramontanaramontana AAwardward — by Michele O’Hara, RN, nursing director

he Molly Catherine Tramontana ilies when there’s a loss or unexpected outcome. Award for Outstanding Service and Lois’ gentle approach, reassuring words, and kind Patient Care was created in memory demeanor are a source of support for patients and of Molly Catherine Tramontana to providers alike.” acknowledge and recognize the ex- In her letter of support, Penelope ‘Pen’ Herman, emplary care and dedication of nurses RN, wrote, “Lois whole-heartedly embraces her spe- on the Labor & Delivery Unit. The cial role in patients’ lives and believes completely This year’s award is made possible through the in the healing power of her profession. No one recipient of the generosity of Tramontana’s parents, Jennifer and Mark, shines brighter for nursing, cares more deeply for Molly Catherine Tand the support of her friends and colleagues. The award her patients and co-workers, or lives life more fully Tramontana Award, recognizes a labor & delivery nurse nominated by his/ than Lois.” Lois Richards, RN (center), with friends, her colleagues and/or patients. Said Mona Hemeon, RN, “Lois has been a nurse colleagues, and Lois Richards, RN, was selected as the 2015 recipient for more than forty-fi ve years. I hope I can continue members of the of the Tramontana Award. One letter of support for my career as she has — loving her job and making a Tramontana family. Richards noted, “A primary nurse cares for grieving fam- difference not only in her patients’ lives but her colleagues’ lives, we well.” Andrea Hennigan, RN, was the recipient of the Bereavement Conference scholarship this year. In her application, Hennigan wrote, “Taking care of women and their families who are experiencing a loss is a diffi cult part of our jobs as labor & delivery nurses. I feel we have an opportunity to develop a truly meaningful therapeutic nursing relationship and help families in these unfortunate situations.” The Tramontana Award selection committee was composed of past recipients, Robin Azevedo, Pen Herman, Jen Bernard, Mona Hemeon, Susan Cahill, Carrie Quinn, Laura Sanders, and Susan Holuk. Congratulations to Richards and the other nom- inees: Rita Marie Testa, RN; Paula Nelson, RN; and Suzanne Botelho, RN. Tramontana’s loving spirit lives on in all those who were nominated. For more information about the Tramonta Award, contact Michele O’Hara, RN, at 617-724-1878. (Photo by Paul Batista)

Page 10 — Caring Headlines — May 7, 2015 Fielding the Issues II

AAdvancingdvancing a ccultureulture ooff ssafetyafety the 2015 Hospital Survey on Patient Safety

Question: What is a culture of patient safety? Question: Who is being surveyed? Jeanette: Any organizational culture refl ects the attitudes Jeanette: All providers and employees whose work directly im- and behaviors exhibited by leadership toward front-line staff. pacts patient care have been contacted via e-mail from support@ A culture of safety exists when there’s an inter-disciplinary, team- pascalmetrics.com with a link to complete the survey. To be eligi- oriented environment that fosters continual learning and im- ble, employees must have worked in their current location for at provement through discussion and transparency around errors least four weeks, and they must work at least 20 hours per week. and issues.

Question: What topics are covered in the survey? Question: Why is it important to perpetuate a culture of Jeanette: The survey is designed to measure patient safety patient safety? across twelve domains such as communication and learning from Jeanette: There is a correlation between high culture-of-safety errors. This year, MGH added four more areas of focus: hand-offs scores and positive outcomes, such as, reduced length of stay, and transitions; non-punitive response to errors; communication fewer medication errors, higher employee morale, lower staff openness; and overall perceptions of patient safety. burn-out, higher staff retention, and improved patient satisfac- tion. Question: Have we made any changes based on past surveys? Jeanette: Since the last safetyculture survey in 2012, we’ve im- Question: Can a hospital’s patient safety culture be measured? plemented I-PASS to make hand-overs safer and more effi cient; Jeanette: Yes, the science of measuring safety culture in we’ve held sessions and simulations to encourage staff to speak up health care is well established. Regular safety-culture assess- when they see a safety concern; and we continue to promote a ments are recommended by the Joint Commission and the ‘just culture,’ a culture that avoids blame and balances the need National Quality Forum. for improved systems with individual accountability.

Question: Have we assessed our patient safety culture in the Question: What can I do to help? past? Jeanette: You can help by completing the confi dential Hospital Jeanette: Yes. In 2008 and again in 2012, MGH took part in Survey on Patient Safety and encouraging others to do so, too. the same comprehensive survey of our patient safety culture. The results will help us focus our patient-safety efforts where And we’re in the process of administering the Hospital Survey they’ll do the most good and have the greatest impact on patient on Patient Safety again right now (from April through June, safety. 2015; the Medical Offi ce Survey on Patient Safety will be con- For more information, call the MGH Center for Quality & ducted in early 2016). Safety at 617-726-9282.

May 7, 2015 — Caring Headlines — Page 11 Professional Achievements

Robbins elected Campbell appointed Trefrey certifi ed Arnstein presents Christopher Robbins, RN, staff Elizabeth Campbell, RN, Brie Trefrey, RN, staff nurse, Paul Arnstein, RN, clinical nurse nurse, Endoscopy, was elected a infusion and IV therapy nurse, Dermatology, became certifi ed specialist, Pain Relief, presented member of the Board of Directors was appointed president of the as a dermatology nurse by the “Best Practices in Managing for the Society of Gastroenterology New England Chapter of the Dermatology Nurses Association Persistent Pain in Older Adults,” Nurses and Associates Infusion Nurses Society, in March, 2015. at Boston Medical Center, in February, 2015. in March, 2015. March 20, 2015.

Farrell certifi ed Convery presents Smith appointed Michael Farrell, RN, nursing Callahan presents Mary Susan Convery, LICSW, Stephanie Smith, OTR/L, manager of Pediatric, Plastic and Janet Callahan, PT, physical clinical specialist, Social Services, occupational therapist, was Burn Surgery, became certifi ed as therapist, presented, “ABCs of presented, “Working with Death appointed term lecturer at the an operating room nurse by the Vestibular Rehabilitation,” at and Dying: Parental Guidance for MGH Institute of Health Professions Competency and Credentialing the American Physical Therapy Talking with Children,” at the Social from January, 2015 to April, 2015. Institute in April, 2015. Association Conference at Service Department In-Service California State University in Training at Boston Medical Center, Long Beach, California, February 24, 2015. March 28–29, 2015. Whitney appointed Fitzgerald certifi ed Kevin Whitney, RN, associate chief Christine Fitzgerald, RN, staff nurse, nurse, was appointed director of Operating Room, became certifi ed Stieb presents the Metropolitan Boston Emergency as an operating room nurse by the Callahan presents Elizabeth Stieb, RN, MGH Food Medical Services Council Competency and Credentialing Janet Callahan, PT, physical therapist, Allergy Center, presented, “Bring in March, 2015. Institute in March, 2015. presented, “Differential Diagnosis Your Own Pediatric Food Challenge and Management of Brainstem Experience” and “Update on and Cerebellar Infarctions,“ at Performing Baked Milk and Baked the combined sections meeting Egg Food Challenges,” at the Cvitak certifi ed McClendon certifi ed of the American Physical Therapy annual meeting of the American Jill Cvitak, RN, staff nurse, Kelli Aileen McClendon, CST, Association in Indianapolis, Academy of Allergy, Asthma, and Operating Room, became certifi ed surgical technologist, Operating February 2, 2015. Immunology in Houston, as an operating room nurse by the Room, became certifi ed as a surgical February 21 and 22, 2015. Competency and Credentialing technologist by the National Board Institute in March, 2015. of Surgical Technology and Surgical Assisting, in March, 2015. Nurses present poster Julie Cronin, RN, clinical nurse White 12 honored specialist, Gynecology/Oncology; Patient Service employees of the Perioperative nurses Vanessa Gormley, RN, clinical nurse MGH Blood Transfusion Service on honored Scopa certifi ed specialist, Neurology; Elizabeth White 12 received a Patient Safety Joanne Ferguson, RN, director of Nicolette Scopa, CST, surgical Henderson, RN, staff nurse, Award from the Food and Drug Operational Planning and EOC, technologist, Operating Room, Burns/Plastics; Jennifer Clair, RN, Administration’s MedSun Medical Periop Services, and Maureen became certifi ed as a surgical clinical nurse specialist, Transplant; Product Safety Network Hemingway, RN, nursing practice technologist by the National Board Shannon Mahoney, RN, clinical in January, 2015. specialist, Operating Room, received of Surgical Technology and Surgical nurse specialist, General Medicine; the 2015 AORN Journal Writers Assisting, in March, 2015. Jacqueline Holmberg, RN, clinical Award for their article, “Boston nurse specialist, General Medicine; Bombings: Response to Disaster,” and Jessica Smith, RN, nursing at the AORN Surgical Conference practice specialist, Surgical Unit, and Expo in Denver, Arnstein presents presented their poster, “Investigating March 7–11, 2015. Paul Arnstein, RN, clinical nurse the Use of Clinical Instructional specialist, Pain Relief, presented, Videos on Social Media to “Evaluation and Mitigation Strategies Increase Effectiveness of Hands- for Extended Release and Long On Practical Applications,” at the Acting Opioids: Achieving Safe Use annual conference of the National While Improving Patient Care,” Association of Clinical Nurse at the Virginia Council of Nurse Specialists, in Coronado, California, Practitioners, in Roanoke, Virgina, March 5–7, 2015. March 28, 2015.

Page 12 — Caring Headlines — May 7, 2015 Professional Achievements (continued)

Stefancyk appointed Scott hosts webinar Waterhouse certifi ed Clinical Recognition Amanda Stefancyk, RN, former Katrina Scott, staff chaplain, Tracy Waterhouse, RN, staff nurse, Program nursing director of the White hosted the webinar, “Hospice Operating Room, became certifi ed Clinicians recognized 10 General Medicine Unit, was and Palliative Care Specialty as an ambulatory care nurse by the January- April 1, 2015 appointed chief executive offi cer of Certifi cation,” for the Association American Nurses Association in the Organization of Nurse Leaders, of Professional Chaplains, February, 2015. Advanced clinicians: in March, 2015. March 23, 2015. • Christina Connors, RN, General Medicine • Brian Cyr, RN, General Medicine Nurses present poster • Vanessa Dellheim, PT, Physical Arnstein publishes Whitney presents Brenda Miller, RN; Arlene Kelleher, Therapy Paul Arnstein, RN, clinical nurse Kevin Whitney, RN, associate RN; Diane Carroll, RN; and Kevin • Heather Evoniuk, RN, General specialist, Pain Relief, and Keela Herr, chief nurse, presented the keynote Callans, RN, presented two posters Medicine RN, authored the book, “Persistent address, “Nurses in All Roles during MGH Children Research • Brian McClosky, RN, Neuroscience Pain in Older Adults,” (University of Leading Change,” at the New Poster Day. The posters were the • Casandra McIntyre, RN, GYN/ Iowa Press) 2015. England Chapter of the Infusion only entries by nurses amid a fi eld Oncology Nurses’ Society, in Waltham, of 58 posters by physicians. • Jennifer Neveu, PT, Physical March 10, 2015. Therapy • Daisy Powers, RN, Pediatrics King presents Clinical scholars: Janet King, RN, staff nurse, GI Robbins petitions Robin Grossman, RN, Case Man- Endoscopy, presented, “Diffi culty Nurses publish Governor • agement Swallowing? Have You Considered Diane Carroll, RN, nurse Staff nurse, Christopher Robbins, Alexa O’Toole, RN, Newborn/ an Esophageal Motility Disorder?” researcher; Vivian Donahue, RN, • RN, petitioned Governor Baker Family Unit at the Maine Medical Center in nursing director; and CSICU nurses, to proclaim the month of March Portland, Maine, March 21, 2015. Donna Furlong, RN; Cynthia Finn, Colorectal Cancer Awareness RN; Diane Gay, RN; and Christine month. On February 26, 2015, the Gryglik, RN, authored the chapter, Governor signed the proclamation “Comparison of Temporal to making March Colorectal Townsend publishes Pulmonary Artery Temperature Cancer Awareness Month Elise Townsend, PT, physical in Febrile Patients,” in Dimensions in Massachusetts. therapist, authored the article, of Critical Care Nursing, January/ “Effects of AFO Use on Walking February 2015. in Boys with Duchenne Muscular Dystrophy: a Pilot Study,” in the Washington honored spring, 2015, Pediatric Physical Inter-disciplinary team Deborah Washington, RN, Therapy. director of the PCS Diversity publishes Program, was named the 2015 Kathleen Miller, RN; Emma Chad- recipient of the American Friedman; Vivian Haime; Darshan Organization of Nurse Executives’ Adams honored Mehta, MD; Veronique Lepoutre; prestigious Prism Award on April Jeff Adams received the 2014 JCEN Dinah Gilburd, LICSW; Donna 17, 2015. The award recognizes Innovation Award for his article, Peltier-Saxe, RN; Cally Lilley, RN; an individual who has advanced “Strengthening New Graduate Herbert Benson, MD; Gregory diversity efforts within the nursing Nurse Residency Programs in Fricchione, MD; John Denninger, MD; profession and the community. Critical Care: Recommendations and Albert Yeung, MD, authored the from Nurse Residents and article, “The Effectiveness of a Brief Organizational Stakeholders,” in the Mind-Body Intervention for Treating January, 2015, issue of The Journal of Depression in Community Health Continuing Education in Nursing. Center Patients,” in Global Advances The award recognizes excellence in Health and Medicine. in writing and the expansion of knowledge in the fi eld of nursing continuing education and professional development.

May 7, 2015 — Caring Headlines — Page 13 Announcements

ACLS Classes Still Alice: Make your Biomedical Certifi cation: understanding practice visible: submit Engineering Week (Two-day program Alzheimer’s a clinical narrative Each May, National Biomedical Day one: lecture and review Engineering Week is celebrated MGH Geriatric Medicine presents: Caring Headlines is always Day two: stations and testing) to recognize those who work “Still Alice: Understanding interested in receiving clinical in biomedical and clinical Day one: Alzheimer’s” narratives that highlight the engineering. June 15, 2015 speaker, Lisa Genova, author exceptional care provided by On Wednesday, May 20th, 8:00am–3:00pm clinicians throughout “I wrote Still Alice because I the department will host an Patient Care Services. Day two: am a granddaughter and a information booth to exhibit Make your practice visible. June 16th neuroscientist.” some of the equipment they Submit your narrative for 7:00am–1:00pm maintain throughout the hospital. (Note early start time) Tuesday, June 16, 2015 publication in Caring Headlines. reception, 5:30-6:-00pm All submissions should be sent via May 20, 2015 Re-certifi cation (one-day class): program, 6:00-7:15pm e-mail to: [email protected]. 8:00am–3:00pm May 13th O’Keeffe Auditorium For more information, Main Corridor 5:30–10:30pm call 4-1746. Complimentary book with RSVP. Meet Biomedical Engineering staff Locations to be announced. For more information, or to RSVP members and learn more about Some fees apply. (required) call 617-643-6302. the role Biomed plays in ensuring For information, contact Jeff MGH is a leader in quality care. Chambers at [email protected] Steps to Success Financing Your Education For more information, call To register, go to: Jean Johanson at 617 724-1333. http://www.mgh.harvard. Blum Center Events Workshop June 3, 2015 edu/emergencymedicine/ National Health Observances: assets/Library/ACLS_ 12:00–1:00pm “Language Development in Babies, Haber Conference Room registration%20form.pdf. Toddlers, and Pre-Schoolers” Senior HealthWISE Thursday, May 14, 2015 Representatives from the Harvard speaker, Jennifer Maietta, CCC-SLP, University Employees Credit events speech-language pathologist Union and the MGH Institute of All events are free for Free one-day Health Professions will discuss seniors 60 and older bereavement “Making Exercise a Habit” options for fi nancial assistance. Tuesday, May 19th “Constipation” program for children speaker, Mike Bento, head Education Fair Thursday, May 7, 2015 and families personal trainer, The Clubs at June 11th 11:00am–12:00pm Charles River Park 12:00–3:00pm Haber Conference Room MGH, in partnership with under the Bulfi nch Tent Speaker, Daniella Donoso Comfort Zone Camp (CZC), “An Overview of Osteoporosis One-stop-shopping for Pena, MD, geriatric fellow, will is holding a free one-day and How to Protect Your Bones” certifi cate, undergraduate, and discuss causes, symptoms, tests, bereavement program for children Thursday, May 28th graduate, clinical and non-clinical treatments, and the changes ages 5–17 and their families. speaker, Sara Schoenfeld, MD, programs, including nursing, in physiology that lead to Children who’ve experienced clinical fellow constipation. She will recommend the death of a parent, sibling, or research administration, inpatient coding, health care policy, and dietary and behavioral guardian are invited to register Shared Decision Making: interventions to help alleviate for a day of mentorship, support, “Coping with Symptoms of administration. Featured schools include Boston University, Bunker symptoms and improve quality and group activities. Parents are Depression” of life. encouraged to attend the parent/ Wednesday, May 27th Hill Community College, MGH guardian program held at the includes a video and discussion Institute of Health Professions, “Understanding and Caring for same location. with Paola Pedrelli, psychologist, Northeastern University, Simmons Our Hearts” College, Emmanuel College, and Thursday, May 21st Saturday, July 25, 2015 and John Matthews, MD, psychiatrist UMass Boston. 11:00am–12:00pm 8:30am–4:00pm Haber Conference Room MGH Institute of Health Presented by MGH Training & Professions Programs are free and open to Workforce Development. Speaker, Malissa Wood, MD, MGH staff and patients. cardiologist and author of Volunteers are also needed. No registration required. For more information, call 617-726-2099. Smart at Heart, a Holistic 10- (Call 781-756-4840) All sessions held in the Blum Step Approach to Preventing and Patient & Family Learning Center. For more information or to Healing Heart Disease for Women, from 12:00–1:00pm register on-line go to www. will explore how relationships, comfortzonecamp.org/MGH- For more information, workplace, media, and other CZC., or call Todd Rinehart, call 4-3823. factors affect weight. LICSW, at 617-724-4525. For more information, call 4-6756.

Page 14 — Caring Headlines — May 7, 2015 Education/Support Published by Caring Headlines is published twice each month by the department of Patient Care Services at Massachusetts General Hospital Publisher Jeanette Ives Erickson, RN senior vice president for Patient Care Managing Editor Susan Sabia

Editorial Advisory Board Chaplaincy Reverend John Polk Disability Program Manager Zary Amirhosseini Editorial Support Marianne Ditomassi, RN TTimiltyimilty SSciencecience FFairair Mary Ellin Smith, RN Maureen Schnider, RN Medical Interpreters two-time science-fair-winning Anabela Nunes Materials Management mentor says learning science can be fun Edward Raeke Nutrition & Food Services and educational Donna Belcher, RD Susan Doyle, RD ongratulations to Cynthia Hydes’ project examined cell-phone use and Offi ce of Patient Advocacy Robin Lipkis-Orlando, RN Hydes, seventh-grader at driver distraction. Says Rizzo, “We looked at cell- Offi ce of Quality & Safety Timilty Middle School, and phone use and response time to a traffi c light turn- Colleen Snydeman, RN her science-fair mentor, Lori ing from red to green. To get the data, we stood Orthotics & Prosthetics Rizzo, RN, perioperative staff outside at an intersection near MGH for two hours Mark Tlumacki specialist. Hydes recent ly in the snow and frigid cold of one of the worst win- PCS Diversity took fi rst place in the middle school division ters in Boston history. It wasn’t easy, but it was Deborah Washington, RN C Physical Therapy of the Boston Public Schools (Massachusetts worth the effort.” Occupational Therapy Region VI) Science Fair and also earned rec- Hydes found that the average response time to Michael Sullivan, PT ognition as Raytheon’s choice for Top Middle the light change was signifi cantly longer for cell- Police, Security & Outside Services School Science Project. phone users versus non-cell-phone users, indicat- Joe Crowley ing some level of distraction Public Affairs Colleen Marshall for cell-phone users. All quali- Respiratory Care fying science projects were Ed Burns, RRT showcased at the Citywide Social Services Science Fair, March 7, 2015, Ellen Forman, LICSW at Northeastern University. Speech, Language & Swallowing Disorders and Reading Disabilities It’s worth noting that Rizzo Carmen Vega-Barachowitz, SLP was also mentor to last year’s Service Excellence science fair winner in the mid- Rick Evans dle school division, Mari Training and Support Staff Cabreja. Says Rizzo, “Many Stephanie Cooper nurses are natural mentors. The Institute for Patient Care Gaurdia Banister, RN Successfully mentoring mid- Volunteer Services dle-school students involves Jacqueline Nolan fi nding that balance between Distribution making the experience enjoy- Milton Calderon, 617-724-1755 able and instilling a sense of Submissions accountability. My mentees All stories should be submitted to: [email protected] learn that if they put in the ef- For more information, call: fort and strive for excellence, 617-724-1746 Next Publication they can achieve a lot and May 28, 2015 have fun doing it.” Mentor, Lori Rizzo, RN, perioperative staff specialist (left), with her Timilty Science Fair mentee, Cynthia Hydes, who’s sporting her fi rst-place medal.

May 7, 2015 — Caring Headlines — Page 15 HCAHPS IInpatientnpatient HHCAHPSCAHPS 2015 calendar year, to date

Our most recent patient-experience scores exceed 2014 scores for all indicators. While the volume of patients has been slightly lower, this is a good start toward achieving our 2015 goals.

Data complete through January, 2015 All results refl ect Top-Box (or ‘Always’ response) percentages Pull date: April 13, 2015

First Class US Postage Paid Headlines Permit #57416 aringMay 7, 2015 Boston, MA Returns only to: CVolunteer Department, GRB-B 015 MGH, 55 Fruit Street Boston, MA 02114-2696

Page 16 — Caring Headlines — May 7, 2015