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A PUBLICATION FOR EMPLOYEES AND STAFF OF THE MASSACHUSETTS GENERAL HOSPITAL

AA pAtient hAs been recovering on White 7 following surgery. His scheduled discharge date – marked on the whiteboard in his room and on an electronic whiteboard at the nurses’ station – is approaching. The patient’s nurse wants to make sure he and his family will be ready for discharge and answers questions while one family member jots down notes in their “Patient and Family Notebook.” As they talk, the unit’s attending nurse stops by and listens to the patient’s concern about the side effects of a pain medication he’ll be taking once at home. Using her specially programmed Voalté phone, the attending nurse sends a text message to the attending pharmacist and physician. The team plans to meet and discuss the issue with the patient and his loved ones.

This scenario offers only a glimpse into some of the cutting-edge practices and technologies being implemented on the 12 inpatient units selected as Innovation Units (see below for a list of participating units). Led by Patient Affordability Direct Care team leaders – Jeanette Ives Erickson, RN, DNP, senior vice president for Patient Care Services and chief nurse, and W. Scott McDougal, MD, chief of Urology – the Innovation Units project

officially launched March 19. The kickoff is the culmination of months of in-depth planning and preparation, during which top-priority interventions were identified by interdisciplinary teams with helpful input from patients and their families.

As part of the Patient Affordability and Care Redesign initiative at the MGH and Partners HealthCare, the 12 units are now testing grounds for promising new strategies to improve clinical outcomes and enhance patient, family and staff satisfaction – while reducing costs and length of stay. The success of the interventions is being evaluated based on a series of set metrics. The interventions include:

Implement a new attending nurse roleThe attending nurse is a staff nurse who collaborates with the attending physician to ensure each patient’s consistent and timely progression on a unit from admission to discharge. Working eight hours a day, five

days a week, the attending nurse is a constant presence and a resource for both patients and staff.Improve handoff communicationUse of the SBAR (situation, background, assessment and recommendations) tool is now standard practice when a change in a patient’s care team or care plan is necessary – whether internal, such as transitioning a patient to the night-shift nurse, or external, when a patient is transferring to another facility or returning home.

Collect additional preadmission dataA revised admitting face sheet offers more detailed information – including an anticipated discharge date and where a patient will go after discharge – to better inform the care team.

Encourage patient-provider dialogueThe newly developed “Patient and Family Notebook” educates patients and their (Continued on page 2)

Innovation is the new standard12 Innovation Units launched at the MGH

CARING PARTNERSHIP: Michelle Anderson, RN, an attending nurse on White 7, reviews the new “Patient and Family Notebook” with patient Gerald Marcoux.

The 12 Innovation Units

Lunder 9 Oncology

Bigelow 14 Vascular

White 6 Orthopædics/Maxillofacial

White 7 Surgical

Ellison 9 Cardiac ICU

Ellison 16 Medical

Ellison 17 and 18 Pediatrics

Blake 10 Neonatal ICU

Blake 11 Psychiatry

Blake 12 ICU

Blake 13 Obstetrics

– Innovation(Continued from page 1)

loved ones about the different members of their care team while encouraging them to take a more active role in their health by asking questions and taking notes.Begin interdisciplinary team roundsImplementing interdisciplinary rounds provides a formal opportunity for all members of the care team to meet daily in order to ensure seamless, integrated care delivery. To make these rounds as effective as possible, each discipline – including Nursing, Physical Therapy, Occupational Therapy, Social Work, Speech-Language Pathology and the Chaplaincy – is reviewing and updating its domain of practice.Enhance communication with cutting-edge technologyStaff are equipped with specially programmed iPhones (also known as Voalté phones) that allow instant and discrete communication with other team members. Staff also have access to portable, durable laptops that provide secure access to shared information. Computerized whiteboards at the nurses’ station and whiteboards in patient rooms offer another clear and consistent method of communication.Improve discharge readinessA new discharge toolkit for patients and families, as well as a discharge follow-up phone call program, better prepares patients and families for discharge and help reduce hospital readmissions. Phone calls are made within 48 hours to all patients who agree to participate in the program. Incorporate relationship-based care into hospital cultureThe philosophy of relationship-based care emphasizes the importance of cultivating the relationship between the caregiver and the patient and family; the caregiver’s relationship with colleagues; and the caregiver’s relationship with him or herself. Many of the other interventions link back to this concept.

“In the coming weeks and months, we will learn a lot about health care innovation as we assess the impact of these interventions,” says Ives Erickson. “During the process, our best teachers will be our patients and families as they share with us how we can best align our care practices to meet their needs and expectations.”

For more information about the Innovation Units, visit www.mghpcs.org/innovation_units. n

Enterprise Clinical System progressesthe work being done to implement e-chart at the MGH and BWH will serve as a bridge to aPartnerswide clinical information system, called the Enterprise Clinical System, which will unify disparate systems across all Partners HealthCare entities. Once completed, the Enterprise Clinical System will help clinicians better coordinate care, enhance their ability to measure and report on quality and efficiency, and help engage patients more closely in their own care.

The most recent milestone in the Enterprise Clinical System project was the review day held March 15, which offered an in-depth overview of the progress made since the project launched last May. The information reviewed during the event will guide the final decision between two potential system vendors, Epic and Siemens.

Through a series of panel discussions, approximately 250 individuals from across Partners – with an additional 200 watching via live streaming video – were brought up-to-date on demonstrations given by both vendors in January; clinical and technical site visits to other U.S. hospitals where these systems already are in use; and the results of reference calls about and external research into both vendors’ products. The panels were followed by an open commentary session.

“Our goal from the start has been to approach this journey of discovery with openness, thoroughness, objectivity and a commitment to keeping our promises,” says Partners Chief Health Information and Innovation Officer David Blumenthal, MD. “We are very grateful for the commitment shown by all those involved thus far, and we look forward to the next major milestone: making a decision on which vendor to choose.”

To view a video of the event, visit http://healthcare.partners.org/streaming/Live/PartnersIS/2012.03.15_IS_ReviewDay.html. n

TREkkING AHEAD: Keith Jennings, chief information officer for the MGH and MGPO and a member of the project’s steering committee, listens to panelists during review day.

Mass General website goes mobilewhether An iphone, blAckberry or Android, it seems almost everyone owns a smartphone – a device that can be used to check email, browse the Web and download applications. A newly launched mobile version of the hospital’s website, www.massgeneral.org, now allows smartphone users to access key information more easily than ever before.

When users type the web address into their phone or visit the site via search engine, the site automatically detects that they are on a mobile device and redirects to the mobile version. Once on the mobile site, users may access reformatted versions of the most

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MGH helps fight South Sudan medical education crisisimAgine cAring for A nAtion of more than 10 million people with fewer than 50 physicians. Imagine learning biochemistry by drawing images in the dirt with a stick. For South Sudanese medical students in 2011, that didn’t require much imagination – it was reality.

After decades of civil war and political strife, South Sudan gained independence, making it the world’s newest country. With that came a host of challenges, including a severe lack of medical infrastructure, resources, training and education for would-be physicians. This crisis, the students experiencing it and the work of the MGH Emergency Medicine’s Division of Global Health and Human Rights to alleviate their struggle is the focus of a new documentary film “Between the Earth and Sky,” which premiered March 15 at the Sun Valley Film Festival in Ketchum, Idaho.

“Between the Earth and Sky” follows Thomas Burke, MD, chief of the MGH division and leader of its Southern Sudan Medical Education Collaborative, as he and his team recruit instructors from Boston and beyond to work alongside Sudanese counterparts to teach 400 medical students who dream of becoming the first generation of South Sudanese doctors.

Shot on location at Juba University, the film transports viewers to the sub-Saharan nation and chronicles the humble beginnings in which these young medical students began their journey. It highlights individual stories of some students, including Chol Makur Aciek, who never saw a doctor during his early years growing up during the war, and Emmily Koiti, who recalls meeting a female Australian doctor and realizing that women could become physicians.

“The students that I met had been struggling for anywhere from one to three years here with essentially no instructors,” Burke says in the film. “And they described the evening that I first met them that they had one cadaver … and one teacher who only taught a third of the time. They had six books, no microscopes, no laboratory and essentially no classrooms.”

Despite the continued challenges in South Sudan, “Between the Earth and Sky” shares the students’ triumphs and the steady progress at Juba University – offering hope for both this new nation and its first generation of doctors.

“Despite so very many challenges, through the efforts of many extraordinary MGH faculty, fellows and volunteers, we continue to do all that we are able to support the education of the students and junior doctors in South Sudan,” says Burke.

GLOBAL GOOD: Burke, at right, listens to the heartbeat of a patient.

Chaplaincy changesimproving the quAlity And efficiency of spiritual care, enhancing patient satisfaction and strengthening relationships with patient care units are the core reasons behind the MGH Chaplaincy’s upcoming redesign.

Two significant changes to the MGH Chapel’s worship schedule will take effect April 1. Prayer services will now be offered every day at 12:15 pm, while Roman Catholic Mass will be celebrated on Sundays as well as Holy Days of Obligation at 4 pm. All services will continue to be broadcast on the in-house Channel 16. In addition, Catholic programming, including broadcasts of Mass three times daily, now will be offered on Channel 17.

Marianne Ditomassi, RN, DNP, executive director of Patient Care Services, and professional development managers Rosalie Tyrrell, RN, and Mary Ellin Smith, RN, both from the Institute for Patient Care, worked with members of the Chaplaincy for six months to identify opportunities for improvement.

“MGH chaplains are committed to providing spiritual care to our patients, their families and our staff,” Ditomassi says. “We have professionally trained staff chaplains available 24 hours a day, seven days a week. They can help identify and respond to the spiritual needs and concerns of people of diverse cultures, traditions and beliefs – including coping with illness, counseling and providing prayer and ritual.”

During the redesign process, the Chaplaincy redefined its vision and developed a new staff chaplain liaison model to ensure each clinical setting has a designated staff chaplain to work with. Lastly, the Chaplaincy team redesigned its website, which can be accessed starting April 1 at www.mghchaplaincy.org. For more information, contact the MGH Chaplaincy at 617-726-2220 or email MGHChaplaincy@partners.org.

MGHHOTLINE

commonly used features of the full website – including “Find-a-Doctor,” “New Patient Appointments,” “Maps and Directions,” “Visitor Info,” and “Contact Us.”

Several features now have interactive options. For example, individuals may mark physicians in “Find-a-Doctor” as “favorites” for easy reference at a later time, and “Maps and Directions” provides a way to pinpoint a building on campus and identify helpful locations nearby, such as a parking garage or eatery.

Mass General Marketing, which led the development of the mobile site, plans to add more features and interactive options in the future. Smartphone users should note that the full site will still be available via a link at the bottom of the mobile site homepage.

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LGBT film screening The MGH Lesbian, Gay, Bisexual and Transgender (LGBT) Employee Resource Group will host a screening of the movie “Beginners” starring Ewan McGregor, Christopher Plummer and Melanie Laurent on April 4 at 5:30 pm at 165 Cambridge Street, Suite 810.

Heart Center education classThe MGH Heart Center is hosting its monthly education class, “Food Choices, How to Choose and Shop Wisely When Living with Heart Failure,” April 4 from 10:30 to 11:30 am in the Yawkey Center, Room 4-820. The speakers will be Sandra Klemmer, MS, RD, of Nutrition and Food Services, and Anne Borden, RN, nurse case manager in the Cardiology Division. For more information or to register, call 617-726-7693.

edITorEmily Lemiska 617-724-2753

assIsTanT edITorColleen Marshall

617-726-0275

desIgnerAldona Charlton 617-726-7539

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W H AT ’ S H A P P E N I N G

03.30.12 MGHHOTLINE MGH Senior HealthWISEMGH Senior HealthWISE will host a lecture for seniors age 60 years or older, “Hope for One Person: An MGH Doctor’s Experience in Haiti,” April 5 from 11 am to noon in the Haber Conference Room with guest speaker Steven H. Gardner, MD, MPH, of MGH Primary Care. For more information, call 617-724-6756.

Sustainable Champion AwardsThe nomination period for the 2012 Partners Sustainable Champion Awards ends April 16. All employees and physicians are eligible to receive the awards, which are based on improving the health of patients and employees, reducing Partners hospitals’ impact on the earth and controlling health care costs by using resources more efficiently. For nomination forms or more information, contact Hubert Murray, manager of Sustainable Initiatives, at sustainability@partners.org.

Advance Care Planning boothIn honor of National Healthcare Decisions Day, the Patient Care Services Ethics in Clinical Practice group will sponsor an “Advance Care Planning” information table April 16 from 8 am to 3 pm in the White Corridor. The 12th annual initiative encourages patients to clarify their wishes regarding health care decisions, increases awareness among health care providers about respecting those wishes and emphasizes the importance of providing patients, families and staff with advance care planning information. George B. Murray Limbic Grand RoundsThe George B. Murray Limbic Grand Rounds, “What Doesn’t the Limbic System Do? Functional MRI and Intracranial Recordings of Cingulate Cortex,” will be offered April 19 from noon to 1 pm in the Ether Dome. The speaker will be George Bush, MD, MMSc, director of Neuroimaging Research at the Benson-Henry Institute for Mind Body.

Run-Walk to Home BaseThe 2012 Run-Walk to Home Base offers participants two ways to cross home plate at Fenway Park, the original 9K run and the new 3-mile

I N G E N E R A Lwalk option. Pre-registration and a minimum fundraising commitment are required to participate in the May 20 event, which raises funds for the Red Sox Foundation and MGH Home Base Program. For more information, visit www.runtohomebase.org.

‘Understanding College Funding’The Employee Assistance Program will host a seminar, “Understanding Financial Aid and College Funding,” April 24 from 12:30 to 1:30 pm in the Schiff Conference Center in the Yawkey Center. The guest speaker will be Tom Murphy, director of Student Services at the Harvard University Employee Credit Union. For more information, visit www.eap.partners.org.

Anne Klibanski, MD, chief of Neuroendocrinology at the MGH and the Laurie Carrol Guthart Professor of Medicine at Harvard Medical School (HMS), has been named chief academic officer of Partners HealthCare, effective April 1. In the reconstituted position, Klibanski will collaborate with leadership at all Partners institutions to guide scientific and educational missions, assume an academic dean role at HMS and strengthen innovative and productive relationships within the local and national scientific communities. She succeeds Dennis Ausiello, MD, chief of MGH Medicine, who has served as Partners’ chief scientific officer since 2008.

3D colon imaging technology wins Microsoft award the mgh is Among the 2012 recipients of the Microsoft Health Users Group Innovation Award in the “Health Collaboration” category. The honor specifically recognizes the 3D Imaging Research Group of MGH Imaging for joining forces with Vectorform, Microsoft and Intel to help make colon cancer screening more accessible and cost-effective through a technology called the Virtual Colonoscopy (VC) Cloud Viewer. Hiro Yoshida, PhD, director of the 3D Imaging Research Group, led the project and accepted the award on behalf of the hospital Feb. 23 during the annual Healthcare Information and Management Systems Society Conference and Exhibition in Las Vegas.

The VC Cloud Viewer virtually “cleanses” a patient’s colon and generates a three-dimensional model in real time, allowing physicians to navigate through the images with hand or finger motions on a screen or mobile device. Although it is not yet available to patients, when compared with traditional methods, the VC Cloud Viewer has shown the potential to streamline clinical workflow, improve diagnostic accuracy and reduce costs by as much as 80 percent.

AwARD-wINNING ADvANCE: yoshida, right, and Patrick samona of Vectorform, left, accept the Innovation Award.