July 2017

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MGH Seeks Big Ideas as Planning Begins for the Next Capital Campaign

Big ideas have long been the lifeblood of the MGH. More than 200 years ago, our founders created a medical institution unlike any other, and ever since, this hospital has continued to push the boundaries of medicine.  Bold innovation has attracted some of the greatest minds in science and medicine to join this vibrant community.  Similarly, innovation has fostered and informed the exceptional care that brings patients – many with the most complex disorders – to our doors.  The willingness to pursue big ideas and the progress such ideas can spawn are why so many visionary donors trust that their philanthropic support of the MGH will have a deep and enduring impact.

In the life of an institution there are moments when it makes sense to pause and reflect on what it will take to move to the next step, to make a meaningful difference, to push boundaries. For the MGH that time is now. We are laying the groundwork for a fundraising campaign that will shape the MGH and the way it will touch patients for decades to come.  Departments, centers and clinical programs, research, teaching and community health efforts all will be grateful stewards of gifts of all sizes, all ultimately benefiting our patients, the community and society at large. A campaign like this presents an opportunity to showcase ideas that are truly broad and transformative.  Now is a time to put forth ambitious proposals that examine how we can realistically leverage our many world-class skills to achieve goals that once seemed beyond reach.

The Home Base program, for example, was a bold initiative that emerged from the last campaign. This collaboration between the Red Sox Foundation and the MGH has become a national model for successfully helping military veterans and their families heal from the invisible wounds of war. Also forged during the last campaign was MGH’s multi-faceted substance use disorder initiative, which continues to expand its reach into both hospital and community and to touch more and more lives.

The strategic plan that Mass General developed several years ago maps out priorities for the future, and some of these areas are likely to be keystones of the upcoming campaign. But are there new priorities that MGH should embrace?  Are there big ideas that the hospital should consider as it looks to the future?  These questions are too important to leave unanswered.

We want everyone in our hospital family to think about what this institution might do that could be truly transformational.  We want your big ideas – ambitious and grand suggestions that have the potential to have a deep impact on health care and medicine. These ideas will help us define and shape the campaign that lies ahead.  In a few weeks, we will provide details about how every member of the MGH community can participate by offering thoughts, suggestions and big ideas.

Every day at the MGH lives are being improved and saved by innovations that began long ago as the germ of someone’s idea. If we can continue to think creatively and boldly, then decades from now a new generation of patients will benefit from the big ideas that we will begin to pursue in the months and years ahead.

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MGH Welcomes New Board of Trustees Members

This month, the MGH Board of Trustees welcomed three new members: Adelene Perkins, chair and CEO of Infinity Pharmaceuticals; Renée Landers, professor of Law at Suffolk University Law School, and Katrina Armstrong, MD, MGH physician-in-chief and chief of the Department of Medicine. The MGH is fortunate to have such a strong group of engaged and talented volunteer leaders on its board who provide strategic direction and oversight to hospital leadership and serve as ambassadors for the MGH within the community. As we welcome these three new trustees, I want to extend appreciation to Jerry Rosenbaum, MD, chief of Psychiatry, who stepped down from the board after nearly 10 years.

Home Base Hosts Successful Run, Extends Care to More Veterans

The eighth annual Run to Home Base raised nearly $2 million to support key programs to help veterans with invisible wounds of war. I thank everyone who participated as well as those who donated funds to support the 2,900 runners and walkers. This year was especially poignant as retired Brig. Gen. Jack Hammond – executive director of Home Base, a Red Sox Foundation and MGH program – offered a moving welcome to more than 1,400 Vietnam veterans and their loved ones gathered at Fenway Park.  The Home Base program, which since its inception has focused on veterans of post-9/11 conflicts, announced that it was expanding its scope to offer care to all veterans and their families. I want to offer my sincere appreciation to those who helped make this expansion possible, including Hammond; Michael Allard, Home Base chief operating officer; Ross Zafonte, DO, MGH chief of Physical Medicine and Rehabilitation; Jerry Rosenbaum, MD, MGH chief of Psychiatry; Joan Sapir, MGH senior vice president; and Joy Rosen, vice president for Psychiatry and Community Health Initiatives.

MGH Endowed Chair and Scholar Program Achieves Milestone

The MGH reached a milestone this month with the establishment of the 100th award in the MGH Endowed Chair and Scholar Program. This hospital program was founded in 2011 to honor and fund the work of outstanding researchers and clinicians. Being named an endowed chair recipient or a scholar is one of the highest honors an MGH staff member can attain. This recognition provides valuable resources to sustain innovative teaching and groundbreaking research for years to come. The most recent gift established the Minehan-Schiff Endowed Scholar in Obstetrics and Gynecology to honor the work of Isaac Schiff, MD, chief emeritus of the MGH Vincent Obstetrics and Gynecology Department. Thank you to the generous donors throughout the years for making this program possible, and congratulations to the extraordinary individuals who have earned this distinction.

The Joint Commission Survey Window is Open

Every three years, surveyors from The Joint Commission visit the MGH to conduct a comprehensive hospitalwide review of our patient care practices. The window for the organization’s upcoming survey recently opened, and the team’s unannounced visit will occur sometime between now and April 2018. Our staff is prepared – every single day – to highlight the dedication, commitment and drive to providing the most compassionate, safest and highest quality care to our patients and their families. At the same time, we know there is always room for improvement and growth. Several teams within our Quality and Safety and Excellence Every Day programs are currently in the process of creating materials to educate staff about National Patient Safety Goals and to ensure that our policies, procedures and systems of care enable us to meet and exceed all of the standards set by The Joint Commission.

Keeping Busy: MGH Hosts Students through Summer Jobs Program

Once again, the MGH has opened its doors and invited in bright young minds from Boston, Chelsea and Revere as part of the annual Summer Jobs Program. This year’s six-week paid internships are helping 198 students learn and work in departments across the hospital, enabling them to build confidence and expand their skill sets. By providing meaningful work opportunities to young people, the MGH is fostering scientific curiosity and interest in health professions among local students while encouraging their academic pursuits. MGH benefits from the energy and engagement of these students, who will have cumulatively logged 30,000 hours by the end of the program. I thank the many MGH staff members who make an impact on these young people’s lives through mentoring, teaching and making these work opportunities available.

Education is Key: Stopping Traumatic Bleeding

Emergencies can happen at any time, at any place. And when they do, trained medical experts are often not the first ones on scene. With some basic knowledge and some training, the non-clinicians who may be there when such an event occurs can take actions that may save lives. Earlier this month the MGH implemented a training program for all staff members in the proper use of tourniquets. David R. King, MD – trauma and acute care surgeon, who has provided tourniquet training for teachers, law enforcement personnel, and others – spearheaded this first-of-its-kind program in Massachusetts. Staff are invited and encouraged to take part in one of the upcoming open training sessions next month: Aug. 4 from 8 to 9:30 a.m. and Aug. 15 from 8 to 9:30 a.m. in the Thier Conference Room. To enroll, contact Christine Amore at camore@partners.org. Future sessions will be announced on the Apollo calendar of events. In conjunction with these trainings, MGH Police and Security and the Center for Disaster Medicine staff have placed tourniquet kits and accompanying yellow “Bleeding Control Kit Inside” signs in all automated external defibrillator cabinets throughout the main campus. As you walk through the hospital’s hallways, take a moment to locate these cabinets.

Cardiac Transplant Program Reports Record Numbers

The MGH Transplant Center recently completed its 29th cardiac transplant for the 2017 calendar year, surpassing the previous record of 28 heart transplants set back in 2008. The growth of this program reflects an institutional commitment to treating patients with advanced heart failure. Under the leadership of David D’Alessandro, MD, surgical director, and Greg Lewis, MD, medical director, the team has recruited medical staff to improve access to care. While availability of organs continues to be a challenge, this year’s increased activity reflects exceptional care, enhanced techniques to support patients with advanced heart failure waiting for organs, and a transplant team that is poised to perform transplants at any given moment. I know the patients and families who have benefited from the work of this outstanding team join me in thanking and congratulating the MGH Heart Transplant Program.

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I-PASS Program 

i-pass-acronym-imageInadequate and flawed communications among health care providers are among the most common causes of medical errors, preventable adverse events, Joint Commission Sentinel Events and malpractice claims. In teaching hospitals like the MGH with a highly complex case mix, the need for accurate communication about patients is even more critical. Resident work-hour restrictions have created the need for more frequent handovers, increasing the potential for communication errors.  Handovers are consistently identified as an area needing improvement on the hospital’s safety culture survey and in peer-reviewed publications based on MGH house officer questionnaires.

In 2013, the Mass General Handover Committee investigated all available handover systems and picked I-PASS, which was developed at Boston Children’s Hospital. Currently, more than 6,000 Mass General physicians, nurses and therapists have been trained in the principles and use of I-PASS. This training includes a robust multi-modality educational program developed by Nursing and Patient Care Services. I-PASS has also gained increasing national and international interest and recognition. This year it was awarded The Joint Commission/National Quality Forum John M. Eisenberg Patient Safety and Quality Award for its potential to improve health care quality and safety.

As shown in the chart below, physician observations over the past year demonstrate improving scores for incorporation of all I-PASS elements in the correct sequence during handovers. Phase 1 of I-PASS training at the MGH is complete, and our results and recommendations have been published in BMJ Quality and Safety. The Handover Committee is now beginning Phase 2. The goal of this phase is to seek more consistent adoption of I-PASS across all units and services, with the ultimate goal of embedding this technique into the MGH culture. The Housestaff Quality and Patient Safety Committee plays a leading role in these efforts, as residents and fellows perform a large proportion of all handovers. Mass General will also be collaborating in a CRICO handover grant and will serve as a test site for a variety of innovative web-based tools for I-PASS training and observations.

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I-PASS has rapidly emerged as the dominant handover system in health care, and MGH trainees will likely encounter this system wherever they practice. I encourage MGH providers to adapt the I-PASS system to their specific workflows to ensure we are providing the safest and best possible care to patients. Thank you to Dave Shahian, MD, vice president for Quality and Safety; Kayla McEachern, JD, senior consultant for patient safety; Merranda Logan, MD, assistant chief quality officer; and Gino Chisari, RN, director of the Norman Knight Nursing Center, for leading the MGH’s I-PASS initiative.
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June Update

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Population Health Management – Quarterly Progress Report

Providing better and timelier access to services for patients and preventing avoidable increases in costs of care are both critical to our mission. Indicators continue to show the success in these areas.  The rate of new patient specialty visits increased slightly during this past quarter compared with the same time last year. Ambulatory practices are continuing to work hard to improve access, many of them through innovations such as telehealth. The MGH is continuing to hold down the growth in costs of care for our commercially insured patients who see our primary care physicians. The trend in total cost of care for commercially insured patients was lower than the target benchmark. Although we strive to prevent avoidable hospital admissions through the use of population health management programs – such as the Mobile Observation Unit, SNF 3-day waiver program and Home Hospital – we have seen an increase in inpatient accountable care organization admissions this last quarter. This increase is mainly related to medical admissions, as surgical admissions remain the same.  Seasonality may be playing a part in the increase in medical admissions.

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Send questions, comments or ideas about this newsletter to the From the Desktop mailbox – “MGH From the Desktop” in the Partners e-mail directory. The address is FTMGH@partners.org.

Enjoy the rest of your summer!