CONNECT JOHN MUIR HEALTH
Spring 2015
We do amazing things together
Straight Talk CEO Cal Knight fields questions Off-Duty Heroics Nurse saves ballplayer’s life Are We Doing the Right Thing? Concord staff meet to discuss tough cases
Health Care— the Remix Reforms are benefiting patients and improving the way we work
Perspectives
Just for Us Welcome to JMH Connect, a new magazine dedicated to providing John Muir Health physicians, staff and volunteers with unique and inspiring stories that celebrate our extraordinary culture and connect you with your colleagues throughout the health system. As health care and John Muir Health continue “As health care to evolve, it’s more important and John Muir than ever that we stay connected to one another and maintain our culture. Health continue Through surveys and focus groups, you to evolve, it’s expressed a desire to know more about what is happening in parts of the health more important system beyond your work location. You than ever that we also expressed a need for news to be delivered in a variety of ways. stay connected Given the nature of the work we do, to one another we know not everyone is able to check email or the intranet regularly. That’s and maintain our why JMH Connect is being printed and culture.” mailed to your home every quarter. A printed publication sometimes — Cal Knight raises concerns about cost, especialJohn Muir Health ly as we all work to ensure John Muir President and CEO Health is a more affordable choice for our patients. We’re being good stewards of our resources and producing the magazine cost consciously, while also balancing the importance of reaching you and featuring your great work. We hope you enjoy hearing about your colleagues, news around the health system and how everyone’s work contributes to a healthier community, as well as achieving Vision 2022. We look forward to your feedback.
Let’s All Talk—and Listen Give your feedback, speak your mind, talk up, chime in: However you put it, your contributions are needed and appreciated. JMH Connect can only be as good as all of our ideas and suggestions. To make your connection, email internal.commu nications@johnmuirhealth.com or call (925) 947-5384.
JMH CONNECT Published by the Corporate Communications Department. Send us an email at internal.communications@ johnmuirhealth.com. John Muir Health 1400 Treat Blvd., Walnut Creek, CA 94597 Produced by DCP.
Enjoy JMH Connect!
O N T H E COV E R :
Cal Knight John Muir Health President and CEO
J O H N M U I R H E A L T H | johnmuirhealth.com
Among John Muir Health’s ACO team (left to right): Gabriella Avina, R.N.; Terri Jagow, R.N.; and Dr. Kenneth Bowers. Cover photo by Steve Babuljak.
MIKE MCEUEN
2
3
Who We Are
Why Do You Love Your Job? @JMH
5,840 “Every day I witness something remarkable that one of my co-workers has done for a patient or one another. You just don’t get that in many places of employment; it’s a really awesome thing to be part of!” —Pam Heuser
R.N., Outpatient Chemical Dependency Program for Recovery, Behavioral Health Center
“I love coming to work every day because of the energy, camaraderie and sense of purpose that come from being part of a great team. ... We work so well together that you never need to ask for help; everyone just seems to know when to step in or take charge.”
employees
20%
“It was a personal experience as a John Muir Health patient in Concord back in 2006. The way I was treated really stuck with me, and five years later, I resolved to be an employee here. I know this is the place where I will retire. I love everything about working here, from the friendliness of the staff to the emphasis on quality patient care.” —Laurin Stamps
80%
Percentage of female vs. male employees
1,000+ doctors
1,600+ volunteers
Patient Relations Department secretary, John Muir Medical Centers
“I come from a large family [that] taught me to include everyone and understand others’ perspectives. At [John Muir Health], we have to rely on other team members to get the goals accomplished. That is what I love about JMH—it is like working with your family.” —Mauricio Cordero
Nurse assistant, John Muir Medical Center, Concord
— L u z Va z
Medical receptionist/interpreter, John Muir Physician Network
J M H C O N N E C T | Spring 2015
4
Straight Talk
Q&A: Cal Knight J o h n M u ir H e a l t h p r e si d e n t a n d CEO si n ce A p ril 20 11
Why did you get into health care in the first place? What keeps you in it? I started out as an audiologist and was always fascinated by the science of sound and hearing, which led to opportunities for me to apply my skills in the care of people with hearing impairments. To this day, I‘m inspired by the power of individuals in health care coming together to improve the quality of life in our communities, for our friends and families, for everyone. What’s your average workday like? How do you balance it with family commitments? I really don’t have an average day—they’re all different, with so many interesting things going on. My days tend to be long, but they go by much too fast! I have meetings most nights but always keep one weekday night open for dinner with my wife of 38 years, Maureen. I‘m fortunate my family feels part of the JMH team and is very supportive of my passion for health care and the hours required.
What keeps you up at night about your work? Finding ways to keep our wonderful culture intact and at the same time drive the level of change that’s needed so patients can access us in the future. Great organizations figure out that balance. John Muir Health is an amazing organization, and we will continue to find that balance. What is Vision 2022 and why is it important? It’s our road map for the future—how we’ll be here to serve our patients; capitalize on creative partnerships; improve our patient experience; provide exceptional quality at a price patients can afford; remain an independent not-for-profit; and continue to build a highly skilled, collaborative team. We’ll deliver on Vision 2022 by doing what’s best for our patients and listening, explaining and working together as a team. We’re in a very strong place, and I feel very positive about John Muir Health‘s future. What do you hope this employee magazine will achieve? As John Muir Health continues to grow, it becomes harder for us to maintain that family feeling that makes us great. I hope this magazine will help all of us feel connected, engaged, informed and proud to work for John Muir Health.
J O H N M U I R H E A L T H | johnmuirhealth.com
TOP: MIKE MCEUEN; BOTTOM: COURTESY OF CAL KNIGHT
What appealed to you most about John Muir Health when you were considering coming here? The “deal maker” was the people and also the strong culture of excellence with a clear commitment to providing the best care. During my interviews, wherever I went, I also learned about the strong bond the community has with John Muir Health. This is a very special organization!
Music on my iPhone and car radio: Classic rock Favorite musicians: The Eagles, Fleetwood Mac, Heart Favorite movie: Madagascar (big fun watching it with my grandson) Favorite stress busters: Traveling and fishing (I throw back the ones I catch)
All-Stars
Lifesaving Hits the Road
MATT EDGE
Julie Olson was ready and able to put her AED training t o g o o d u s e a t h e r s o n’s b a s ke t b a l l g a m e
Commitment to the community starts on the job at John Muir Health. But it rarely ends there. Julie Olson, a nurse at the Behavioral Health Center in Concord, found that out in January at her 14-year-old son’s recreational basketball game, when a player running up the court collapsed. The coaches and referee ran to his side. Olson did too. “He wasn’t responsive,” she recalls. “I couldn’t feel his pulse. We knew he was having trouble breathing, but we didn’t know what was wrong.” She asked someone to get the automated external defibrillator (AED), used to restore heart rhythm. Using an AED wasn’t exactly routine for her. Though she had learned how to use it in training at John Muir Health, she had never needed to as the Behavioral Health Center’s director of quality and clinical effectiveness/utilization management. “It’s simple, as long as you keep a cool head,” Olson says. She needed a cool head because by the time the AED arrived, the boy had started to turn blue. While others started CPR, she hooked up the equipment. She was stunned when the device instructed her to hit the shock button because the child seemed so young for such drastic measures. She did it. “Then it said to continue CPR,” she recalls. “By that time, he had come to and the paramedics were there.” They whisked him off to the Walnut Creek ER. Olson later learned that the youngster had a heart disorder and the ER doctors said the AED had saved his life. Olson gives much credit for saving the boy’s life to the Darius Jones Foundation. In 2009, 15-year-old Darius Jones of Pittsburg suffered sudden cardiac arrest from an undiagnosed heart condition—also while playing basketball. But there was no AED on the premises, and he died. The foundation his family founded in his honor has since placed AEDs in schools and other locations throughout Contra Costa County. Olson says she’s grateful she could help give another child’s story a different ending. “I’m happy to see this young man be able to go back to school and live his life.”
J M H C O N N E C T | Spring 2015
5
Meet the Future of Health Care Your John Muir Health co-workers are teaming up in new ways with health plans and each other—and revolutionizing care of our sickest patients
Steve Babuljak
7
Meet the Future of Health Care
H
Among the pioneers of John Muir Health’s new ACO partnerships (opposite page, left to right): Terri Jagow, R.N., medical services director, Physician Network; Gabriella Avina, R.N., lead case manager; and Dr. Kenneth Bowers, primary care physician
ow are experts in primary care and outpatient case management improving quality of life for John Muir Health patients and saving millions of dollars while they’re at it, resulting in lower health care costs for patients? They’re part of accountable care organizations (ACOs)—special groups of hospitals, health plans, doctors and other health care providers that are being set up here and across the nation as a result of federal health care reform. Underlying the ACO concept is the “patient-centered medical home”—not a place, but a new model of health care delivery that emphasizes integrated teams (doctors, case managers, social workers and more); information technology; and more efficient use of resources. Like others elsewhere, John Muir Health’s ACO partnerships provide coordinated care for the sickest patients. We’re targeting the top 3 to 5 percent of our patients who have multiple medical conditions that lead to hospital stays and ER visits. Based on nationwide studies, we know that these patients can be responsible for up to 50 percent of health care costs. Here’s a glimpse of how things are going so far, from a few personal perspectives, as we work to achieve Vision 2022 through our triple aim of delivering high-quality care, safely, and a superior experience at an affordable cost.
The Power of One-to-Ones
They confer regularly with primary care doctors about their patients. Every case is vital and unique, including this blockbuster: a low-income hepatitis C patient who received a $111,000 regimen of a new drug—at no cost—after Avina referred him to Linda Slotnick in Senior Services, who arranged medical assistance. “There are days when it’s overwhelming, but overall it’s very comforting to know we have a team who’s here to help,” says Avina. “Patients feel you’re part of their lives. It’s extremely rewarding.”
If you ask Gabriella Avina, R.N., lead case manager, to describe the typical day for case managers in our ACOs, she’ll tell you it begins with investigation: checking their computer programs for notifications about any problems with the patients in their caseload who’ve been hospitalized or in the ER; reviewing work lists to identify who may need an initial or follow-up call about their condition; and prioritizing the needs of patients beginning with the most urgent. “Then our team starts making calls,” says Avina, “and that always brings up tasks to be done. This patient needs help getting an appointment. Another needs us to order equipment. Someone else needs a visit. Our job is to help patients stay in their home—and out of the hospital—as long as possible and be as healthy as they’re able to be.” As the lead nurse case manager, Avina supports other John Muir Health case managers and health care coordinators who are headquartered — Gabriella Avina, R.N., lead case at the Walnut Creek manager Outpatient Center.
J M H C O N N E C T | Spring 2015
“Our job is to help patients stay in their home—and out of the hospital— as long as possible and be as healthy as they’re able to be.”
8
Meet the Future of Health Care
The Right Care in the Right Place Keeping track of the accomplishments of our case managers and ACOs is one of many to-do items that land on the desk of Terri Jagow, R.N., medical services director for the Physician Network. She was on the steering committee formed in 2010
“We’re addressing health problems before they worsen, which is obviously better for the patient’s health and much less expensive in the long run.” —Terri Jagow, R.N., medical services director, Physician Network
to devise the health system’s strategy for embracing ACOs. “We researched evidence-based models across the country and determined what would be a good fit for our patient population and our culture,” she says. Already Jagow and her colleagues are seeing payoffs for their work in the separate ACOs that John Muir Health is involved with to serve Medicare, Health Net and Blue Shield patients. Our sickest, most vulnerable patients are supported through our patient-centered medical home program, working with a care manager in goal setting for improved self management, boosting self-motivation, and coordinating care with the broader health care team. The result: improved health management and health-related quality of life, including a 51 percent improvement in depression scores. “I feel like a trailblazer,” says Jagow. “We’ve made great strides in accomplishing integration, improving quality scores and how we work together to better serve patients. We’re addressing health problems before they worsen, which is obviously better for the patient’s health and much less expensive in the long run.” Like Jagow, Dr. Kenneth Bowers was in on the ground floor in developing ACOs at John Muir Health and has witnessed their achievements firsthand. His Benicia primary care practice enjoys the benefits of case managers and was part of the pilot
J O H N M U I R H E A L T H | johnmuirhealth.com
“Practicing medicine like this feels much more supportive and nurturing. It’s phenomenally exciting.” —Dr. Kenneth Bowers, primary care physician and ACO leader at JMH
program to test the model. Bowers is co-chair of John Muir Health’s Medicare ACO board and the ACO steering committee. He fully appreciates top leadership’s support and doctors’ efforts in driving the ACO agenda. He also insists “extenders” like case managers and care coordinators play a critical role in promoting positive changes. “Practicing medicine like this feels much more supportive and nurturing,” says Bowers, “and much more like I hoped it would be during medical school and residency. It’s phenomenally exciting.”
Inside Story
New PICU Opens T h e d e b u t of o u r p e d ia t ric i n te n sive c a r e u nit is a f ir st f o r t hi s a r e a — p l e a sing fa m ilie s a n d st a f f a like Nancy Pope-Angulo, R.N., always wanted to work with kids. “But in general care pediatrics, I was limited in how I could help when a child became really sick,” she says. Pope-Angulo is manager of John Muir Health’s new pediatric intensive care unit (PICU) at the Walnut Creek medical center, which offers the specialized care that critically ill children and their families need and often travel miles for. Thanks to John Muir Health’s partnership with Stanford Children’s Health, the unit is staffed by doctors and nurses who are expert in the field. All the nurses and respiratory therapists maintain certification in Pediatric Advanced Life Support. “I have worked in PICUs for most of my 29-year career as a nurse,” says Pope-Angulo. “Opening the first PICU in Contra Costa County is the opportunity of a lifetime—I get to share my pediatric experience with this community.” In addition to advanced training and technology, the team stands ready to give kids and their families emotional support as they navigate through a difficult time. Shana Hammers, M.A., a certified Child Life Specialist at John Muir Health, is avail-
9
able with a smile or comforting word. She might read a book with familiar characters like Elmo or the Berenstain Bears to help prepare a young patient for an upcoming medical procedure. Art or playtime (Wii games are very popular) can help children express their emotions—or just be a kid. “As adults, we never want to see a child hurt or sick,” says Hammers. “But I know I’m able to do something to positively impact that child during one of the hardest parts of their life.” The design of the new PICU, which opened April 15, promotes comfort too. “I’ve seen the unit go from completely gutted preconstruction, to the beautiful, — Nancy Pope-Angulo bright healing environment that R.N., PICU manager it is now,” Hammers says. “We thoughtfully selected the colors and the art, and we have murals in the patient rooms to bring cheer to children and their families. Nancy Pope “When I walk into our new PICU, I can’t help Angulo (in green but smile,” she adds. “I smile for the families that sweater) and will be given hope here. And I smile for the miracles Shana Hammers I know will happen.” bring specialized
“So many happy tears are shed when we look back at the journey our patients go through. These experiences are life-changing and help us appreciate every interaction with patients and their families, and see the humanity in everyone.”
MATT EDGE
skills/training to their PICU posts.
J M H C O N N E C T | Spring 2015
10
Grow Your Career
Talking About Tough Cases At S c hwa r t z Ce n te r Ro u n d s , Co n co r d m e d ic a l ce n te r st a f f s h a r e e xp e rie n ce s a b o u t pa tie n t c a r e a n d b u il d st r o ng e r t ie s in t h e p r o ce ss
To help Concord campus staff deal with such concerns, the Schwartz Center Rounds program was launched in September 2014. The bimonthly sessions give participating physicians, staff and volunteers a place to talk honestly about the most challenging emotional and social issues they face in patient care. Each session centers on a different thoughtprovoking issue and case. Created by the Schwartz Center in Boston, Schwartz Center Rounds take place in 350 U.S. medical centers. The idea to bring them to Concord was hatched over lunch by co-facilitators Cooper and the Rev. Birte Beuck, director of Spiritual Care Services in Concord. They then teamed up with emergency physician Hartwell Lin, M.D. “We all felt passionate about doing anything we could to help staff avoid compassion fatigue,” Beuck says. The trio also expected it to take a while for staff from different disciplines to feel comfort-
able speaking candidly. But each session has drawn a vocationally mixed crowd of 100 or more people. “It shows how deep the need for these conversations is,” Beuck says. Those who attend leave with a sense of closer ties to their fellow colleagues. “Having all these people in one room hearing one another’s perspectives helps us see how we’re all in this together,” Lin says. Attendees have praised the program for reminding them of the importance of supporting their co-workers, of understanding the patient’s point of view—and of why they became health care providers. Cooper says the program also helps care providers feel compassion for themselves and the difficulties they face. And that leads to a better environment for patients and staff. “When you are more compassionate toward yourself, you become more compassionate toward others,” she emphasizes. “It becomes part of the culture.”
J O H N M U I R H E A L T H | johnmuirhealth.com
Co-facilitators Dianne Cooper (left) and the Rev. Birte Beuck hatched the idea for the staff talks over lunch and then teamed up with Dr. Hartwell Lin (center).
MATT EDGE
Consider this: A young woman with a history of psychiatric illness is diagnosed with stage 4 cancer. She doesn’t want medical treatment—she is terrified of it. The patient is deemed to not have the capacity to make medical decisions for herself. Her guardian, however, decides to go ahead with treatment. Eventually, the young woman dies. But her death does not put to rest the anguish and concerns that treating a patient against her will have raised for some health care providers. “Every day, we work with people in such a state of fear and pain, and helping them is not always easy,” says Dianne Cooper, L.C.S.W., a palliative social worker at the Concord and Walnut Creek medical centers. “Every day, we have to look inside ourselves and ask whether we’re doing the right thing.”
11
Share
Around the Water Cooler Things John Muir Health physicians, employees and volunteers are talking about— what’s up with you?
About Her Caring Hands H e a t h e r Ke nw a r d
Coordinator, Workforce Planning and Development “I started volunteering with Caring Hands in 2004, even before I came to work for John Muir Health. Currently, I’m working with the most amazing lady who had her 100th birthday in April and lives in Concord. “I love the idea of helping people have a better quality of life by staying in their homes. The three to five hours you give every week really make a difference. It can just be about one-on-one time with somebody whose family’s not in the area and they need someone to go out to lunch with, which is what we do. She introduces me to new places to eat out. When she needs a little pick-me-up, we go to one of her favorite places, Taco Bell! We even stay in sometimes to do puzzles. It makes me take a moment and relax.” For more info about Caring Hands, visit johnmuirhealth.com/ caringhands. Heather Kenward with Trudy W., age 100.
Pitching In Stacia Schroeder
TOP: COURTESY OF JOHN MUIR HEALTH; BOTTOM: MATT EDGE
D.P.T., physical therapist, John Muir Health Outpatient Center, Brentwood
The fine art of baseball pitching comes into play in Stacia Schroeder’s physical therapy practice and her research.
WHAT’S YOUR STORY? Proud of a project? Have a cool JMH experience to talk about? We want to hear from you. Just email internal.communications@ johnmuirhealth.com to share your own stories and tips.
“The folks at John Muir Health have been very supportive in letting employees develop programs to serve the community. I came on board in 2008 to start a pediatric and adolescent sports physical therapy program at the Brentwood Outpatient Center. Since then, I’ve become the principal investigator of a research project looking at the relationship between dynamic balance and pitching characteristics in youth baseball pitchers. “I have many inspiring stories. One of my patients, a baseball pitcher in his senior year of high school, was being courted by coaches at Division I colleges. He seriously injured his shoulder, and then all the schools, in his words, ‘dropped him.’ He went through a huge amount of rehab. I spent lots of time talking with pitching coaches and helping him get back into the sport. He ended up getting a scholarship to a reputable baseball program. It’s great to see patients who want so much to play in college get the chance to do just that.”
J M H C O N N E C T | Spring 2015
Non-Profit Org. U.S. Postage
PAID
1400 Treat Blvd. Walnut Creek, CA 94597
John Muir Health
Play and Win X L P H T A C E M T K B R U M O H H A J Z U S A S L F K X X Q U G Y P X I V P O A C J W T U G U K D P U S I T G W X J H L K R I A I R B P F G D E E H D O E T N C U L T U R E O F E X C E L L E N C E M W S G T Q B F N T U N P Y T B L K H V U P R R K E I P I T I O S O Z S E Q Y I I O X C E W A V V A E K G L B R F N D S R B S H C E O M L D I X P P W L F K Q I H X Z Y T O T P W L E I P M Y E X M M O E U R I T Z X N L O N A W E L I S T E N A F E M U E J E U R R H Q D R N K Q L V L B G A E E D X Y L L K Q P D I P M R H T A Q W A I B D Z I O Q X I I T E V E K H Z V A G K S J T O N V I U W X S N K C E A G K Y C G D U R K J J L Y K O F C U P C J T C E N N O C H M J D A O V R T E U Y W R R Q E C O V L B O F K X E H O S H
For Your Listening Pleasure: Bose Gear! Enter our drawing for free, noise-canceling headphones
Entering is easy! Just email a picture of your completed puzzle to internal.communications@john muirhealth.com. Or send your entry in inter-office mail to Corporate Communications Dept., John Muir Health, 1400 Treat Blvd., Walnut Creek. Include your name and phone number. One entry per person; all entries must be received by May 31, 2015.
S N A I C I S Y H P O B M F G C J Z B I V G H R T Y F I A N K B A J Y R U I E U
Find the following words on the chart above: C U LT U R E O F E XC E L L E N C E J M H CO N N E C T P H YS I C I A N S VO LU N T E E R S
E M P LOY E E S J O H N M U I R H E A LT H T E A MWO R K WE EXPLAIN
H I G H LY S K I L L E D PAT I E N T E X P E R I E N C E VISION WE LISTEN
J O H N M U I R H E A L T H | johnmuirhealth.com