Stanford Health Care People by Stanford Health Care

STANFORD HEALTH CARE

A PUBLICATION FOR EMPLOYEES OF STANFORD HEALTH CARE

ISSUE EIGHT / SUMMER 2014

THE PATIENT EXPERIENCE KUDOS GOOD WORKS

from the CEO

OUR NEW NAME:

Stanford Health Care In July, we launched our new website and introduced our new enterprise name—Stanford Health Care. We created this new name because as we have grown, Stanford Hospital & Clinics no longer best communicates the depth and breadth of the organization. Stanford Health Care reflects the range and focus of our organization and our commitment to healing humanity through science and compassion, one patient at a time.

Dear Colleagues, When we talk about improving the patient experience at Stanford Health Care, we refer to the entire continuum of care, from the patient’s very first contact with us, through his or her treatment and follow-up visits, and ending with the completion of the financial transaction. That covers a broad range of interactions, some clinical, some administrative, and many that are highly personal. Which is why our efforts to improve the patient experience are so important and multifaceted. Our C-I-CARE program is at the core of our efforts to improve the patient experience and supports the development of relationship-based care approaches. In this issue you’ll learn about a few new patient-focused initiatives underway that are building on C-I-CARE, including projects in Health Navigation Services and Empathy Mapping, and one called the Voice of the Patient. Inside you will also learn about some colleagues whose volunteer efforts are helping people in distant lands and others with some very creative talents. I hope you enjoy this issue and thank you for all you do to support leading edge and coordinated care. Sincerely, AMIR DAN RUBIN PRESIDENT & CEO

Stanford Health Care encapsulates our entire health system, including: Stanford Hospital; Stanford clinics; Stanford specialty centers such as our cancer, heart and neuroscience health centers; University HealthCare Alliance medical groups, virtual care and patient navigation offerings; our Stanford Health Care Alliance health plan; and all other departments and aspects of our organization. We also revised our logo. This change was made to reflect our new name. Our logo is an important symbol of our organization. It helps build recognition and awareness of our name. It’s often the first impression

of our organization and helps consumers recognize us within a very competitive health care market. In addition to our new name and logo, we also launched our allnew website and a multimedia advertising campaign. The new website is designed to be extremely patient-friendly and includes many improvements that will help us meet the expectations of today’s digitally empowered consumer. The advertising campaign is an exciting concept that focuses on our world-class team and will truly differentiate Stanford Health Care. As we continue to expand our footprint, the new enterprise name better represents our organization and the strategic path we have embarked upon. Over the next several months, you will hear more about the new name and how we will start using it throughout the organization. Stay tuned for more information.

STANFORD HEALTH CARE PEOPLE IS PUBLISHED BY

SHC OFFICE OF COMMUNICATIONS GARY MIGDOL EDITOR, DIRECTOR OF INTERNAL COMMUNICATIONS KATIE LIPOVSKY COMMUNICATIONS Specialist ASHLEY GEORGIAN MEDIA RELATIONS MANAGER GRACE HAMMERSTROM CONTRIBUTING WRITER JAMES LARKIN DIRECTOR OF CORPORATE COMMUNICATIONS/PR SARA WYKES CLINICAL AFFAIRS WRITER NORBERT VON DER GROEBEN PHOTOGRAPHY

Send comments and story ideas to communications@stanfordmed.org

STANFORD HEALTH CARE PEOPLE / ISSUE EIGHT 2014

On the cover: (l to r) – Brittany Davis, Guest Services; Max, PAWS; Phillip Paredes, City Park; Timothy Due, Foodservice and Dietary Department; Virginia Kroening, Guest Services

THE

PATIENT EXPERIENCE New programs built on the C-I-CARE philosophy will widen its reach to every aspect of patient care.

N THE LAST FEW YEARS, ANYONE WHO WORKS AT STANFORD HOSPITAL HAS BEEN A PART OF THE C-I-CARE PROGRAM,

CREATED TO INCORPORATE BEST PRACTICE COMMUNICATION TO HELP PEOPLE WHO COME TO SHC FOR CARE AND TO ENHANCE INTERACTIONS BETWEEN SHC COLLEAGUES. Earlier this spring, senior administrative and clinical leadership collaborated to define what additional efforts could be made to expand those previous programs to CONTINUED ON PAGE 4

Chief of Staff Mark Welton, MD, shares his enthusiasm for C-I-CARE at a recent SHC workshop.

STANFORD HEALTH CARE PEOPLE / ISSUE EIGHT 2014

CONTINUED FROM PAGE 3

every aspect of care within patient experience. These

the patient experience, as well as initiatives that bring

additional efforts include several engagement strategies:

C-I-CARE to every interaction in the hospital, she said.

physician and resident service and communication

“We know that patients are more satisfied and that people

training, expanded involvement of SHC’s patient advisory

feel better at work when we follow its principles.”

councils and patient speakers, empathy mapping, and a

Input and feedback from patients, acknowledged as a valuable guide for improving patient experience, is being

broadened application of C-I-CARE. “Tying together all these ideas and concepts of care is

further explored through a pilot project at the Cancer

a recipe for success. We have to do it all,” said Christina

Center that will encourage patients and their families to

Saint Martin, Vice President, Patient Experience. “Empathy

call and share their stories, instead of that information

mapping, for example, is a powerful tool that puts us in

being gathered with a more traditional question-asking

the shoes of our patients. We can all develop the ability

approach, said Joan Forte Scott, MBA, BSN, RN,

to see what they see, feel what they feel, hear what they

administrative director, Patient & Community Engagement.

hear and smell what they smell. It’s a tool that allows us to

“We’ll do a qualitative analysis of that feedback as a basis

appreciate what our patients are experiencing and to use

for responsive change. We are expecting to learn things

that knowledge to change and improve.”

we haven’t thought about.”

Empathy mapping has been added to the existing

SHC’s bigger vision for patient experience continues to

overall improvement effort and is now part of space

draw on many services that have long been a part of the

design for new service areas and orientations for new

hospital’s philosophy that health care means more than

employees and leaders. Empathy mapping is also an

medication and procedures. This commitment to patient

extension of C-I-CARE, said Bryanna Gallaway, manager

experience includes the art program, with its in-service

of Patient Experience programs at SHC. More robust data

art sessions and impressive art collection visible in many

and deeper analysis will be added to the overall view of

hallways; the Pet-Assisted Wellness at Stanford program

THE PATIENT EXPERIENCE IS THE SUM OF ALL INTERACTIONS, SHAPED BY AN ORGANIZATION’S

Patient Advisory Councils

MUSIC PROGRAM

Pet Assisted Wellness at Stanford (PAWS)

Serving in an advisory and advocacy role to enhance the patient experience, Patient Advisory Councils include patients, families and staff.

The Music program hosts weekly concerts in the Atrium and its musicians travel to patient rooms.

PAWS matches well-trained, carefully selected dogs, cats and bunnies with patients who would enjoy a friendly visit.

STANFORD HEALTH CARE PEOPLE / ISSUE EIGHT 2014

vital part of helping people in difficult circumstances,” she said. “We want people to feel as comfortable as possible,

“ We want to find ways to improve and facilitate communication and empathy between physicians and other health care providers with our patients and their families” .

even when they’re under the intense stress of waiting for their loved ones.” To help her colleagues, Kroening was part of a group that compiled an operations manual for navigators so everyone can understand the standards developed through years of experience. Communication at all levels will also now be a

(PAWS), bringing dogs, cats and bunnies to visit with

focus. Jonathan Berek, MD, Chair of the Department

patients; and the music program, with a concert series

of Obstetrics and Gynecology and director of the

in the Atrium and musicians who travel to patient rooms.

Stanford Women’s Cancer Center, will lead one of these

Spiritual Care Services, whose chaplains have been

communication programs. “We want to find ways to

a valuable resource over decades for patients, will be

improve and facilitate communication and empathy

broadened to include support for SHC staff. Another

between physicians and other health care providers

important change is the unification of several patient

with our patients and their families,” Berek said. The

support roles under one name—health navigator. That title

program will also confront how to have the most difficult

will now encompass many SHC employees with a variety

conversations of all, he said, “the ones that relate to

of jobs within Guest Services. One of those newly renamed

prognosis, palliative care and end of life.” This program

health navigators is Virginia Kroening. She has offered

has already held its first workshop, with oncology

information and reassurance to patient families in the surgery

specialists, and will continue as a series of workshops,

waiting area for five years, and she understands very well

symposia, seminars, presentations and videos. Coaching

the importance of the role she and others play. “We are a

and role-play will be part of this effort.

CULTURE THAT INFLUENCES PATIENT PERCEPTIONS ACROSS THE ENTIRE CONTINUUM OF CARE.

C-I-CARE

Art Program

Health Navigators

C-I-CARE is a framework for structuring best practice communications and developing relationship based care approaches with patients and colleagues.

The Art for Health Program offers art sessions designed to relieve patients’ stress and lift their spirits.

Health Navigators greet patients, families and guests with a warm welcome. They also provide assistance with navigation, information, support resources and programs.

STANFORD HEALTH CARE PEOPLE / ISSUE EIGHT 2014

FOCUS ON Infection Prevention and Control Excluding their medical director, the five employees of Stanford’s Infection Prevention and Control Department bring 94 years of experience in the field. It’s a good thing, too, because the job they do requires the sharpest of eyes and the deepest knowledge. This small team is responsible for the annual surveillance and detection of thousands of infections the hospital tracks, including those that arrive already active in patients and those that emerge after procedures. Everything from the technology the team uses to the philosophy of their discipline has changed dramatically, with most of the change occurring since the 1980s. “We used to feel that only two-thirds of infections could be prevented,” said Debra Johnson, RN, who joined this team in 2002. “Now, our target is zero.”

Rowena-Lynn Aseo, RN, conducting an in-house infection prevention and control training.

STANFORD HEALTH CARE PEOPLE / ISSUE EIGHT 2014

Debra Johnson, RN, CIC, with lab supervisor Eduardo Calderon; they work throughout the hospital to update employees on relevant protocols.

“ Our greatest challenge is getting our message out so these patient safety practices are embedded in the day-to-day practice of what we do, so we don’t think about it as a barrier to do our jobs.” That means a much tighter focus on simple behaviors known to be powerful prevention tools. “Hand hygiene is our cornerstone,” said the team’s director, Sasha Madison, MPH, CIC. “Ten years ago, infection control was seen as the IC department’s responsibility and that was it. Now, every person plays a part, from dietary all the way to the physicians.” Sometimes, the surveillance part of the job gives the impression that the team is police-like, and the team isn’t happy about that, “but when we make recommendations, we like people to

follow them,” Madison said. The team is continuously in education mode, whether it be videos, brochures, tearoff cards for patients, or in-service training and Epic-based protocols to standardize those procedures often associated with infections. “Our greatest challenge is getting our message out,” Johnson said, “so these patient safety practices are embedded in the day-to-day practice of what we do, so we don’t think about it as a barrier to do our jobs.” Those sorts of prevention practices are essential, Madison said, because the team’s job could be overwhelming without them. Every day, the team goes through hundreds of cultures from patients in isolation to determine whether that status can be changed; they review other cultures from all inpatients in order to catch any new infections early and then drill down to find the source of an infection. “We are busy all the time,” Johnson said, “but it’s exciting—there’s always something to study.”

FOCUS ON Patient Flow Value Stream Patient flow is not new terminology at Stanford. Figuring out how to make it easier for patients to move smoothly and efficiently through their care has been discussed and accomplished in many departments and nursing units throughout the hospital and clinics. However, those efforts did not systematically engage the entire organization. Now, a new project is taking shape to accomplish that goal. In what is likely the largest commitment to process change made in decades, SHC has launched the Patient Flow Value Stream. “The idea is to think about the totality of a patient’s experience from the time they arrive all the way through to discharge and postdischarge,” said the hospital’s Chief Operating Officer, James Hereford. “Whatever changes we make, we want them to be intentional and to harmonize the dozen different domains of knowledge and functional areas that affect a patient’s experience.” The project is designed to embrace every element of what patients experience at SHC. The data driving the project is motivating. “We do not want to turn away patients,” said Marlena Kane, executive director of the project. “We want to coordinate care in the most efficient and patient-centered way and to figure out how to advance our patients through their care as efficiently, seamlessly and safely as possible.” The first step has been to identify five process loops: best practice clinical pathways; visible, multidisciplinary plans of care; transfer services redesign;

Anthony Siniscal, RN, at a Patient Flow Value Stream design workshop with executive director Marlena Kane.

“ The idea is to think about the totality of a patient’s experience from the time they arrive all the way through to discharge and postdischarge.” bedside rounds and discharge; and the movement of patients within the Emergency Department and the transition of patients from the Emergency Department to inpatient units. Recently, a multidisciplinary team under the leadership of Sam Shen, MD, and Patrice Callagy, RN, MSN, has been working in Redwood City in a mock-up of the new hospital’s ED to put to a practical test the improvement ideas generated so far. The core project

team includes hospital employees from several departments, patients, and patient family members who will work throughout its various phases. “We are asking people to change the way they’ve historically done things in order to meet the patients’ needs,” Hereford said, “and that’s why we’re engaging them in the process. We want to make this an inclusive process in order to find the best solutions.”

Members of the Patient Flow Value Stream core team: (L to R) Andrea Segura Swift; Julia Tam, RN; Michelle Suyehiro, project manager; and Stephanie Bowen, RN.

STANFORD HEALTH CARE PEOPLE / ISSUE EIGHT 2014

KUDOS April Patient Safety STAR Award ANNE JACOBS, RN Known by her colleagues on the BMT unit as a patient advocate, Anne Jacobs knows that safety is essential to the delivery of quality patient care. While double-checking the medication dose on a high-risk medication, Jacobs took the initiative to also review the patient’s labs. Based on the lab results, she recognized that the medication needed to be adjusted and brought her concerns to the treating team. When Jacobs met with resistance by the treating team, she continued to escalate her concerns through the proper channels, and the patient’s medication was adjusted appropriately.

April Service Spotlight Award

May Patient Safety STAR Award Lindsey Cinquini, RN; Clay Calangi, LVN; Corrine York, RN; and Kathy Keating, PSR When a patient walked into Menlo Clinic complaining of chest pain just as it was closing on a Saturday morning, Lindsey Cinquini, Clay Calangi, Corrine York and Kathy Keating jumped into action. They immediately began taking vital signs and started an EKG. After looking at the EKG, Rachel Seaman, MD, knew the patient was having a heart attack. Because they faxed the EKG to the ED, the hospital was able to coordinate the care needed when the patient

Eduardo Calderon and Claudia Peralta

arrived. The teamwork this group exhibited to coordinate care contributed to saving the patient’s life.

May Service Spotlight Award

Anthony Bertrand, MD, reminds us that outstanding patient care is not limited to standard medical treatment. Bertrand, a plastic surgery resident rotating on the Hepatobiliary Surgery Service, noticed that one of the unit’s patients was having difficulty coping with his illness. The patient had experienced multiple prolonged hospitalizations, and his lengthy treatment resulted in his not receiving a haircut for several months. Bertrand decided to solve the issue. He looked for a way to bring a barber to the patient but was unsuccessful. After his regular work was complete, Bertrand found a pair of scissors and a comb, sat down next to the patient and cut the patient’s hair himself.

Jessica Amaya

STANFORD HEALTH CARE PEOPLE / ISSUE EIGHT 2014

Sandra Burgess is well-known in the Infusion Treatment Area at the Cancer Center for being a caring and conscientious nurse. Burgess, who has been a nurse at Stanford Hospital for more than 25 years, was honored with the Patient Safety STAR Award in June. She noticed very subtle signs of medication withdrawal in her patient. Although these findings could be typical, she took immediate action to ensure the patient’s safety. The clinical skill Burgess demonstrated in this situation shows how she promotes a culture of safety at the Infusion Treatment Area.

June Service Spotlight Award

Anthony Bertrand, MD

June Patient Safety STAR Award Sandra Burgess, RN

A patient with a bilateral retinal detachment was sent by taxi to the Byers Eye Institute from the ED. When the patient, who only spoke Spanish, arrived, he met Jessica Amaya, a surgery scheduler. She spoke to him in Spanish and connected him with Patient Financial Services and Social Services. When Amaya received a phone call from one of the patient’s friends saying he was unable to give the patient a ride home, she arranged for her own children to be cared for so she could make sure he got home safely. She stayed with him until a taxi arrived and gave the driver detailed instructions.

A patient with a progressive terminal condition had transitioned to comfort care, and the patient’s husband, who had been with her throughout her hospital stay, needed to be treated for a potential infection. His primary care physician requested lab work, but he was hesitant to go to the emergency department because he didn’t want to be away from his wife. Allyson Rupp, the social worker who nominated Calderon and Peralta for the award, contacted Calderon, a Clinical Lab Preanalytical Supervisor, to ask if the lab work could be done in the patient’s room. Not only did Calderon agree to the unusual request, but he arrived less than an hour later and took the labs himself. Claudia Peralta, an Ancillary Registration Supervisor, gave Rupp her personal cell phone number so she could confirm registration after the lab work was completed. “The extra several hours they gave this gentleman to spend with his wife of over 40 years were priceless,” Rupp wrote on the nomination form.

SHC’S GOT TALENT Music Feeds His Soul and His Health Music has always been a part of Tim Engberg’s life. He started piano lessons at age 5, began writing music at age 8, learned guitar in high school and continued to take lessons while earning an undergraduate degree in nursing. But recently, music, especially playing the piano, took on a new role in his life—that of a therapy tool. Engberg was stricken last December with a serious epidural abscess in his neck and spine. The infection sapped the strength and dexterity in his arms and

hands, and very nearly caused him to become a quadriplegic. After three major surgeries over the past six months and nine weeks of intravenous antibiotics, Engberg is back at work part time as Vice President of Ambulatory Services. He is slowly regaining his dexterity and ability to speak beyond a faint whisper. And he is using music as part of his rehabilitation. “I started playing piano to get my hands going again,” says Engberg, who says for the first month he couldn’t play at all. And even

Lady Sings the Blues As a little girl, Ma Cecilia Pacete-Antonio was always singing, and her family was always telling her to stop. “I didn’t have any talent back then,” recalls Pacete-Antonio, an accounts payable supervisor at Stanford. But that didn’t stop her from entering and winning a singing competition in high school. That success, coupled with voice lessons, launched her singing career. After graduating from college, PaceteAntonio was asked to join a popular band in the Philippines, the 747 Band. When she moved to the United States in 2006, she found a new group of musicians through her church, and together they formed the Krimson Runes Band. The group performs regularly in Union City, San Francisco, San Jose and

though he can’t feel two of his left fingers, he can still press piano keys. “I’m so grateful to have it,” he says. “It beats working with putty.” Engberg is also taking voice lessons to regain his ability to speak publicly and sing again. Guitar, which had once been a passion, is still beyond his reach. But his physical limitations have opened the door to new passions, reading and writing poetry. “I’ve used it to help me process what I am going through and what I am feeling.”

“Every time I entertain people, it’s so fulfilling. It’s something I really enjoy doing.” Sacramento. She is the lead vocalist and rhythm guitarist for the group, as well as a songwriter. “I find music a great way to express my feelings,” she says. Pacete-Antonio also finds singing a perfect outlet for stress relief and an antidote to her very busy life. She works full-time and is a full-time single mother and caregiver for her

father, who was diagnosed with cancer. In the fall, she will also become a full-time student at Santa Clara University to become a CPA. With such a full plate, Pacete-Antonio remains devoted to her singing. “Every time I entertain people, it’s so fulfilling,” she adds. “It’s something I really enjoy doing.”

STANFORD HEALTH CARE PEOPLE / ISSUE EIGHT 2014

GOOD WORKS In the Community Helping in Ethiopia. One Soul at a Time. When Obse Lubo, RN, grew up in Nejo, Ethiopia, she says, her parents provided everything she and her siblings needed. If one of them got sick, they went to the city to get medical care. But many children in Ethiopia are not so lucky, she says. Many die from treatable illnesses such as malaria and meningitis. In 2009, two years into her nursing career, Lubo, who was educated in Minnesota, traveled back to the Nejo, Oromia, region of Ethiopia for the first time in nine years to see her parents and volunteer at the hospital in her hometown. What she saw when she arrived changed her life. Nejo hospital serves about 500,000 patients with only six physicians. There was no ultrasound, echocardiogram or x-ray. There weren’t even thermometers.

Obse Lubo, RN, returns to her hometown in Ethiopia every year to offer medical assistance.

STANFORD HEALTH CARE PEOPLE / ISSUE EIGHT 2014

While she was there, a 10-year-old girl died of malaria, another from an asthma attack. “Right then, I knew I wasn’t going back to school,” says Lubo, a float nurse at Stanford who was set to start graduate school in preparation for medical school. “I don’t want kids to die of treatable diseases,” she says. “I want to prevent that, saving one city, one hospital, one soul at a time.” For the past four years, Lubo has returned to Nejo annually, each time taking medical providers who screen patients for disease, conduct surgeries, educate staff and bring medical supplies. In 2012, she created the East African Medical Relief Foundation and is currently fundraising to build the first diagnostic center in the western Oromia region of Ethiopia. When built, it will benefit an estimated 1.5 to two million people.

expertise. Serendipitously, they were looking for someone with just her skill set for their next mission. Gutknecht, Director of Business Operations for Ambulatory Care, traveled to Karawa Hospital and Clinics this past spring to learn about the hospital’s policies and procedures and identify ways they could be improved and supported. Gutknecht’s role was unique. It was the first time the organization brought administrative support to the Congo, along with its traditional medical relief efforts. “It was a wonderful collusion of events,” says Gutknecht, who met with administrators and medical directors from the five hospitals in the region, many of whom traveled by motorcycle Sandra Gutknecht provided administrative support to a hospital in the Congo.

African Dream Sandra Gutknecht had always dreamed of going to Africa. When she learned about the Paul Carlson Partnership, a group dedicated to supporting a health system in the Democratic Republic of the Congo, she spoke to the organization’s leadership to offer her administrative

for one or two days to meet her. This first trip was a fact-finding mission, she says. “My goal was to learn about their business processes, their pharmacy tracking, medical records, payroll, pricing and the gap between revenues and expenses.” In addition to rounding each day with the hospital’s doctors, she taught an introductory Excel class to the administrators. During her 12 days in the Congo, Gutknecht carved out a day for a personal mission—to meet a young girl she sponsors through World Vision. Gutknecht spent the afternoon visiting with the girl and her family, which, she says, was the highlight of her trip.

GOOD WORKS At SHC John Carper, MD, and medical assistant Vanessa Machuca helped design the new central supply area.

5S Transformation Stanford is bringing its process improvement efforts and lean principles to its University HealthCare Alliance (UHA) partners. Alameda Family Physicians (AMP), a member of the Affinity Medical Partners multispecialty group, was selected to be the Model Line Clinic for UHA to develop and test best practice systems and workflows that can be rolled out to other sites. AMP began its yearlong improvement process in May with a 5S reorganization and cleanup. The goal was to create a welcoming, organized environment to ensure a consistent patient experience. The clinic has been open for 14 years, with seven physicians, four physician assistants and 22 exam rooms, and its space had become cluttered and disorganized, says John Carper, MD, AMP’s Medical Director, who spearheaded the 5S effort. “Every drawer, cupboard and closet was packed, and no one knew exactly what was in them,” he says. Supplies were difficult to find. There was a lot of variation and waste. And rooms were restocked inconsistently. During a Rapid Process Improvement Workshop, the improvement team created a central supply area, which had never existed before, and developed a discrete inventory list for each exam room and inventory par levels that reduced unique items and waste by 30 percent. Today, all exam rooms are stocked in a standard fashion with clearly labeled supplies, says Carper. To maintain

order, medical assistants conduct daily supply audits. Over the next year, clinic staff will complete additional improvement projects on call management, appointment efficiency, flow of patient visits, physician/patient encounters and after care.

Kudos for Solid Organ Transplant Team When Debbie Mast submitted two poster presentations to the National UNOS Transplant Management Forum as she has done for the past four years, she never expected to win. She never had before. But at a luncheon on day one of the conference, Mast heard her name called, not just once but twice, and accepted first-place honors for both projects. “I almost fell off my chair when my name was called,” she says. “I knew we had done good work, but there was a lot of good work out there.” Mast, database administrator/financial manager for the Solid Organ Transplant/MCS Program, was part of two kidney transplant project improvement efforts, which she presented at the conference. In the first project, Mast chronicled the efforts of a Rapid Process Improvement Workshop (RPIW) team to reduce the time between referral to scheduling patients for a visit. During the weeklong RPIW, the team identified areas of waste and duplication of work, and created new streamlined processes and

standard work. Prior to the improvement work, referral to scheduling took 37 days. Since the RPIW, that timeframe has been whittled down to five days.

“I almost fell off my chair when my name was called. I knew we had done good work, but there was a lot of good work out there.”

Members of the Solid Organ Transplant program include: (L to R) Norma Guerrero, DebBIE Mast, Mojgan Harririfar and Michael Espinoza.

In the second poster presentation, Mast detailed the work done at Stanford to recoup charges for Histocompatibility Labs (HLA). Prior to December 2012, the team billed all of its HLA services to the Organ Acquisition Cost Center and did not bill payers. In the first eight months of billing for these services, the team recouped $1.2 million in HLA charges.

STANFORD HEALTH CARE PEOPLE / ISSUE EIGHT 2014

SERVING UP

gratitude and hope ONE CUP AT A TIME

“I

am the luckiest person in the world.” That’s the sentiment of Carmela Gries, a heart transplant patient at Stanford turned coffee entrepreneur. She and her husband, Eric, can be found outside Stanford Hospital every day with their ZoomCaffe van, serving up coffee drinks for providers, visitors and patients. The idea for the business percolated while Carmela was an inpatient at Stanford. So it seemed fitting to the couple that Stanford become their first client. “The people here are amazing,” says Carmela. “From the lady who cleaned my room to the doctors and nurses who helped me stand and be where I am now, it is very important to us to give back to the community that gave us so much.” Failing Health Five years ago, Carmela learned she had an irregular heartbeat during a routine annual exam. An active mother of three, an architect and a mixed martial arts devotee, she had always felt invincible. But even after

receiving a pacemaker to regulate her heartbeat, she grew more and more tired. A visit to Stanford brought a diagnosis of inherited cardiomyopathy, a disease that affects the muscles in the heart. Over the next four years, Carmela found herself in and out of Stanford Hospital, and on the list for a heart transplant. At one point, her heart became so weak it couldn’t pump enough oxygen to her organs. In 2011, she received a Left Ventricular Assist Device (LVAD), a mechanical pump to help support her heart function and blood flow. Then last August, she received the call that both delighted and frightened her—“Don’t have breakfast. We think we have a heart for you.” During her health crisis, she and Eric both left their high-stress careers and began dreaming about what they could do together. They landed on the idea of a mobile, high-end coffee business, and Carmela spent her down time designing the van. The couple purchased a cab and chassis, and built their new business from the ground up. That was more than three years ago.

On the Other Side Today, Carmela is almost a year post transplant. And though she takes multiple medications and is still regaining her strength, she can be found alongside her husband, talking with patients and families and serving coffee to the very people who took such good care of them during their time of crisis. The couple’s long-term goal is to be able to donate a portion of their profits to the Shumway Transplant Fund. “They do an angel’s job,” says Eric. “We are contributing what we can in our own little corner to show our appreciation for the care we received.” One of the byproducts of being at the fountain each day is the unexpected patient contact they have with others going through the transplant journey. “It really helps patients to see that there are people who have overcome the same health problems,” says Carmela. “We love what we do now,” adds Eric. “We go to work with smiles on our faces. And we come home with smiles on our faces. It’s very satisfying.”