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New Breast Center Streamlines Services for Patients
The new Breast Center, opening in the hospital’s Weinberg Atrium, brings together world-class staff and the most advanced, all-digital screening and diagnostic technology available. Their “village” will be the pleasant, custom-designed space where they can see their patients and collaborate with each other face-to-face. “This new state-of-the-art facility located in the center of the beautiful Weinberg Atrium will be wonderful for our patients,” says Katherine Tkaczuk, MD, director of the Breast Evaluation and Treatment Program at UMMC, and associate professor of medicine and oncology at the University of Maryland School of Medicine.
“This new location will make it much easier for women to access the screening and diagnostic mammography, ultrasound and MRI,” Tkaczuk says. “In addition, patients undergoing breast surgery will have direct access from imaging in the Breast Center to the operating rooms of the hospital, without the need to be transferred from the faculty practice radiology offices. It will be a more streamlined process for the patient.” The new center will be home to Breast Imaging and to the Breast Evaluation and Treatment Program. This program provides evaluation and genetic counseling for women who are at high risk for breast cancer, as well as evaluation and treatment for non-malignant disorders such as breast pain. “This consolidation of services is yet another example of the culture of service excellence that we continue to build here at UMMC,” says Jeffrey A. Rivest, president and chief executive officer of the Medical Center. “We will celebrate the opening of the Breast Center during October, which is National Breast Cancer Awareness Month. The new center will be available for any patient, including employees who wish to learn more about breast-cancer screening.” Between 40 and 70 patients a day are expected to visit this full-service center, which is in remodeled space in theWeinberg Atrium that once held the Learning Center. In the future, an image recovery center for patients who have had breast surgery, such as mastectomy, will open across the hall. The technology in the Breast Center is the most advanced available, and may soon include nuclear medicine and possibly research into using tomosynthesis, an imaging method based on computerized tomography (CT) scanning. The new Breast Center features technology including:
One of the distinctions of the center is that mammograms will be all digital, rather than developed on film. The technologist no longer has to wait to develop the film to confirm the image quality. The images can be viewed instantly on a computer screen, by both the technologist and the physician. As a result, the patient’s waiting time is greatly reduced. The goal is to complete the screening visit in less than 15 minutes. Patients who come to the Breast Center for diagnostic imaging will receive a report from the radiologist before they leave. Further, when the radiologists study the resulting images, they will use computer-assisted detection software that provides a “second pair of eyes,” says Reuben Mezrich, MD, PhD, chief of diagnostic radiology at UMMC and chairman of the Department of Diagnostic Radiology at the School of Medicine. “This computer program can detect micro-calcifications that form in tissue in half of women with breast cancer, often before tumors can be seen any other way,” Mezrich says. “The computer doesn’t say ‘this is cancer,’ but it does tell the radiologist where to look more closely.”
Women who have had mammograms at the University Imaging Center in the Professional Building at the corner of Redwood and Paca streets will have their previous films digitized, so they can be compared with their new digital mammograms. Mammograms will no longer be done in the Professional Building. Mezrich also emphasized that the Breast Center radiologists specialize only in breast imaging, and therefore have a great deal of experience and skill in analyzing images from that area. Deirdre Coll, MD, is director of breast imaging at UMMC and associate professor of diagnostic radiology at the School of Medicine, and JeanWarner, MD, is a breast imaging specialist at UMMC and assistant professor of diagnostic radiology at the School of Medicine. “Being part of the multidisciplinary team allows us to follow our patients’ progress from diagnosis through treatment and long-term follow-up with the specialists from surgery, oncology and pathology,” Warner says. “This team approach helps us to make the best use of this new technology for our patients.” Patients whose screening and diagnosis reveals cancer would have access to world-class treatment at the University of Maryland Marlene and Stewart Greenebaum Cancer Center. “The Greenebaum Cancer Center has pioneered important changes to the treatment of breast cancer, and we are delighted that this new facility will help us serve our community more effectively,” says Kevin J. Cullen, MD, director of the Greenebaum Cancer Center and professor of medicine at the School of Medicine. “What makes our Breast Center unique is the level of multidisciplinary collaboration we have, combined with the technology and the specialized experience that these physicians have in their fields,” Mezrich said. “We have an awesome staff.” Nazanin Khakpour, MD, director of breast surgery, director of the Breast Multidisciplinary Cancer Program at UMMC and assistant professor of surgery at the School of Medicine, says the new Breast Center will enhance the collaboration among the team of practitioners. “The patients with newly diagnosed breast cancer will have their mammograms and pathology slides reviewed by a multidisciplinary team that will give the patient a recommendation on the same day,” Khakpour says. “This helps to expedite patient care and treatment plans for the best outcomes.” The quality of technology and skill is high, but so is the level of compassion. Members of the team of physicians, nurses, technologists and other practitioners have been caring for women for years. Last year, imaging staff at the University Imaging Center provided more than 8,000 screening and diagnostic mammograms, 1,400 breast sonograms and 300 breast MRI studies to patients from throughout the Mid-Atlantic. And with the opening of the new Breast Center, even more patients are expected in the future.
Your Opinion Matters
Results of the Survey Help Leaders Set Priorities It’s time for the annual check-up, but this “patient” is going to be examined by about 6,000 members of the Medical Center staff. The patient is, in fact, the Medical Center, and the annual check-up we’re talking about is the 2007 Employee Opinion Survey, which every single employee will be asked to complete Oct. 8-19. Last year, a record 70 percent of employees completed the survey. The goal this year is for at least 75 percent participation. The more people who complete the survey, the more valuable the information will be for making important decisions. “Our success in moving forward depends on direct participation from all employees,” says Jeffrey A. Rivest, president and chief executive officer of the Medical Center. “Completing the Employee Opinion Survey is an important step that takes just a few minutes but has tremendous impact.” Staff will take the survey electronically, from work or from home computers. It should take less than 20 minutes. For any employees who do not use a computer at work, supervisors will make sure they have access to one for the survey. The survey is completely anonymous. Filling out the survey is one of the most important tasks each staff member can do, because it has direct impact on how the Medical Center invests its resources in the future. The survey is a primary tool in encouraging a culture that thrives on feedback from employees, and in making the culture change to a Commitment to Excellence, also known as C2X.
CCU Among High Achievers “I advocate for the staff in many ways and stand up for what I believe is the right way to treat people,” Amig says, summarizing her approach. “For example, I work non-routine hours to make sure all staff needs are met. I encourage my staff to get involved in task forces throughout the Medical Center, so they feel a sense of value and ownership. This energizes and engages them.” Amig says she also tries her best to be flexible in scheduling, to help staff members meet their family and personal needs, without compromising patient care on the unit. PACU: Empowerment “Be an advocate for them like you expect that they are an advocate for the patient,” Green says. “I believe in empowering the staff because I trust in their skills and judgment. We set clear expectations and a high standard of care.” Other advice Green has is to focus on good communication and spend time with employees one on one, stepping outside the box when necessary to meet their needs. The Employee Advisory Council was created last year because past surveys had indicated that employees wanted to be more involved in decisions. The 60 council members are appointed from various departments in the hospital, and meet once a month with senior leaders. The Employee Advisory Council, Staff Nurse Council, Diversity Council and many other task forces that employees serve on are all designed to foster a culture of participation and feedback. Still, the Employee Opinion Survey stands out – every employee, in every department, gets to complete it. Take a few minutes to make sure your voice is heard Oct. 8-19.
Measuring Steps on the Journey to ExcellenceThe journey to excellence has begun. The question: How do we know when we get there? The answer is to measure and analyze our progress, with special emphasis on Patient Satisfaction Survey Results.
Some departments are already achieving the kinds of patient satisfaction results the leadership wants to see in every area of the hospital. For example, the Medical Center goal is to be in the top 10 percent nationally in terms of patient satisfaction. While some departments are within range, many have a lot of room for improvement, says Dana Farrakhan, director of planning and program development, and team leader for the Measurement Team. “As a health care organization, in order to satisfy our customers, first we have to identify who our customers are, listen to what they expect from us, ensure that their voices are being heard, and use their input to make real change happen,” Farrakhan says. “This is the true essence and hard work of, as we call ourselves, the Magnificent Measurement Team.” “We deliver world-class care, but not always with the ‘soft touch’ patients need,” says John Spearman, vice president for Shock Trauma Center and the executive sponsor of the Measurement Team. “The Measurement Team’s job is to find out where our inconsistencies are, and then to communicate our findings so that we can take action to improve and excel in every area of the Medical Center.” The Measurement Team will emphasize three areas as it focuses on patient satisfaction measurement: communication, education and recognition.
Employee Opinion Survey data will be used by another team called the Employee Loyalty Team, which we will highlight in a future issue of UMMC Connections. The premise of C2X is to recognize that the Medical Center already has people who have always approached their work in the spirit of service excellence. One important measurement tool is to identify these people, recognize them publicly and hold them up as models. In the past, patients have singled out both excellent and deficient customer service by staff members or departments on the survey or on the drop-box cards provided in hospital waiting areas. Any negative comments are forwarded to the Patient Advocacy Department, where patient advocates call patients and try to learn more about what caused the dissatisfaction. Here is an excerpt from one hand-written card by the mother of a patient, written after she observed Gladys Fields, RN, perioperative customer service representative. “I was waiting for my daughter…when I witnessed Gladys Fields comforting someone whose loved one was injured in a motorcycle accident. Her love, compassion and concern touched me in such a way [that] I had to share this with you.”
“We can’t just file away satisfaction results,” says Sylonda Davis, planning project manager and a member of the Measurement Team. “We need to use the results to make constructive changes so we can be even better health care providers.”
“As we embark on the C2X journey, the Measurement Team wants to emphasize that this is not a program, but a new approach to achieving and maintaining improved customer satisfaction,” says Davis. C2X News:First Impressions Forums In September, all 6,000 employees of the Medical Center will be invited to attend a 50-minute session introducing Commitment to Excellence. The “First Impressions” forums will emphasize the importance of customer satisfaction to the success of our work and to the success of UMMC. All employees are to register for one of several sessions to be held in the Auditorium between Sept. 23 and Sept. 25, across all shifts. Registration tables will be set up at the entrance to the Food Court during breakfast (7-8 am), lunch (11 am-1 pm) and dinner (5-6 pm) at least three times a week leading up to the sessions.
Making Room for a Tidy Beginning Even at the height of summer, there’s nothing like a good spring cleaning. The neatest thing about Tidy Beginnings, the week-long drive to clean out unused equipment and supplies from hospital storage areas, is that this concerted effort by a motivated team of employees from various departments accomplished three goals:
A group of staff members conducted the project primarily during the week of Aug. 6-10, but it is something that hospital officials hope to continue on a regular basis, in order to store and use supplies more efficiently. Unit staff often held on to supplies in fear of a variation of Murphy’s Law: as soon as something is thrown out, it will be needed. But the accumulation of outdated items hindered the proper storage of more current supplies and equipment. So the point of Tidy Beginnings is to continually assess what should be kept and what has outlived its usefulness. Another goal of Tidy Beginnings is to support the hospital’s goal of being environmentally responsible, as an extension of the Medical Center’s commitment to the health of the community. To that end, the “Green Team” – a committee of Medical Center employees from different departments – has been formed to ensure that we go green efficiently and productively. The 12-member team monitored the Tidy Beginnings closet-cleaning so that as much material as possible was reused or recycled. Anything that could not be used anymore was disposed of in an environmentally sound way. “The key benefits are preserving the environment, helping the community – locally and internationally – and saving money,” says Deborah Mordecai, CNM, manager of Women’s Services. Much of what was cleaned out of the unit storage areas is still useful to other groups. For example, the supplies and equipment will be donated either locally to area charities, or to Project CURE (see www.projectcure.org). Project CURE (Commission on Urgent Relief & Equipment) is a non-profit, humanitarian relief organization whose mission is “to identify, solicit, collect, sort and distribute medical supplies and services according to the imperative needs of the world.” It is the largest distributor of donated medical supplies in the world. “Short of organ donation, this is the ultimate in medical donations,” Mordecai says. “We are sending life-saving equipment and supplies to people who need it and who otherwise would not be able to access the technology. As an academic medical center, we always want to use the most updated equipment to maintain a very high quality of care. It is an unavoidable consequence that we will have some equipment that, while outdated to us, could be used elsewhere to transform and save lives.” Tidy Beginnings was a joint project by the Green Team, the Facilities Department and Environmental Services, and was coordinated this year by Marcus Venison, an intern in Facilities working with Deborah Photiadis, director of customer service and project coordination. The items were loaded, moved and sorted with help from Harbor City Services, a self-supporting non-profit organization that has partnered with the Medical Center for years to provide records storage, moving and other services. “Everyone was helpful and cooperative as we worked our way through the building for this project,” Venison says.
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Employee Opinion Survey Gives Everyone a Voice
Department
Action Plans
Brown
is on the United Way of Central Maryland Board of Directors executive
committee. She also chairs the board’s marketing committee.