Many of you know I was in the Marine Corps, what many of you may not know is where the Marine Corps started. The Marine Corps Birthday is 10 November 1775. Since that time and even in modern times, Marines gather to celebrate the birth of the Corps. So, where was the delivery room? It was in a Bar. The Tun Tavern in Philadelphia. Perhaps an auspicious start to what many consider, especially Marines, the best fighting force in history.
So, with the premise that good things can happen at drinking establishments and with a little exaggeration on my part, let me tell you what will be happening at a modern day Tun Tavern. This Friday evening we will be having a Nurse Anesthesia Graduation Party at Larkin’s Sawmill.
When it comes to Academics in Greenville, much has happened these last 100 years and in particular, the last couple of years. A lot of energy and excitement has been generated about the USC School of Medicine Greenville and our first class is on track to arrive this summer. But, there is this is small group that is making history now.
Here is what Richard Wilson, the Nurse Anesthesia Program Coordinator let me know: Prior to January 2010, we were an affiliated site for the USC Nurse Anesthesia Program. In January 2010, we became a primary training site for the USC Nurse Anesthesia Program as part of a workforce development project and to strengthen our collaboration with USC. The Nurse Anesthesia Program, on the GHS campus, is the first program where the students complete their entire training – classroom and clinical – at GHS.
This year 5 students graduated from the program and 3 of them will come work for GHS. Why I love this story is that we not only address clinical needs for our hospital, but we train nurses, therapists and physicians that help other hospitals in the state and the region.
The Marine Corps Motto is Semper Fidelis (Always Faithful), perhaps when I drop by this Friday I will toast the Graduates with Semper Primus (Always First).
Periodically, we get reviewed by the various rating agencies – Moody’s, S&P, and Fitch and, appropriately, they want to know who is in charge. I thought you may want to see some of the senior leaders at GHS as well as read what we think we are about from a management perspective. I think this is a talented group of leaders – the best I have worked with.
The following is part of the write up we submitted to the Agencies.
MANAGEMENT
The President of the Greenville Hospital System, as the Chief Executive Officer responsible to the Board, has been delegated the authority by the Board to organize, manage, direct, plan, coordinate and implement all activities, services and programs of the System.
Management of the System is provided principally using a team based approach consisting of clinical and administrative leadership. The System is committed to being a physician led organization, with the overall senior physician leadership as well as the Chairs of the various clinical departments having an active voice and role in the establishment of strategic direction and operational decisions. Three Councils have been established which provide strategic and operational leadership and resource prioritization direction. Membership on the Councils varies with each having a strong contingency of clinical, academic and administrative executives. The following is information concerning the President and Chief Executive Officer and certain other management personnel of the System:
MICHAEL C. RIORDAN (53), President and Chief Executive Officer, joined the System in 2006. Prior to joining the System, he served as president, CEO and trustee of the University of Chicago Hospitals and Health System and as senior associate hospital administrator and then COO of Emory University Hospital and Crawford Long Hospital in Atlanta, Georgia. He also served three years in the United States Marine Corps as a lieutenant. Riordan currently serves as an assembly representative for the Association of American Medical Colleges and is on the administrative board of the Council of Teaching Hospitals and Health Systems. He is chairman of the Greenville Chamber of Commerce and serves on the governing boards for Health Sciences South Carolina and, as of July, Furman University. In addition, he is on the advisory board for Clemson University’s Robert J. Rutland Institute for Ethics. Riordan earned a bachelor’s degree in liberal arts/English and a master’s degree in education/psychology from Columbia University in New York, as well as a master’s degree in health systems from the Georgia Institute of Technology.
JERRY R. YOUKEY, M.D. (64), Executive Vice President, Medical and Academic Affairs and Dean of the University of South Carolina School of Medicine-Greenville. Prior to joining the System, Dr. Youkey served as Chief, Department of Surgery, and Director, Peripheral Vascular Fellowship program, at Geisinger Medical Center, Danville, Pennsylvania. Dr. Youkey earned a medical degree from Medical College of Wisconsin in Milwaukee and a bachelor of arts degree from Stanford University, Palo Alto, California. He served a rotating internship and general surgery residency at William Beaumont Army Medical Center, El Paso, Texas and a fellowship in peripheral vascular surgery at Walter Reed Army Medical Center, Washington, D.C. Dr. Youkey served 11 years in the United States Army and was honorably discharged in August 1984 with the rank of Lieutenant Colonel, Medical Corps. Dr. Youkey is certified by the American Board of Surgery in general vascular surgery. He is a member of numerous professional societies and is widely published in his specialty field of general vascular surgery, having authored books, abstracts and journal articles. Dr. Youkey holds the academic appointment of Professor and Dean at the University of South Carolina School of Medicine-Greenville.
GREGORY J. RUSNAK (51), Executive Vice President and Chief Operating Officer, joined the System in 1996. Prior to joining the System, Mr. Rusnak held senior executive level positions with Sutter Health, a major health system serving Northern California. Before that, Mr. Rusnak was a hospital administrator with the University of Texas M.D. Anderson Cancer Center in Houston. Mr. Rusnak earned a master in health services administration degree from The George Washington University, Washington, D.C., and a bachelor of science degree in biology from Gannon University, Erie, Pennsylvania. He is a Fellow with the American College of Healthcare Executives and a Member of the South Carolina Hospital Association.
SPENCE M. TAYLOR, M.D. (54), Vice President for Academics and UMG Executive Medical Director joined the Greenville Hospital System University Medical Center (GHS) in 1992. He was named Chairman and Program Director in 1998. He stepped down as Surgery Chair in June 2010 to chair the LCME Institutional Self-Study Task Force and to edit and co-author the documents supporting the Preliminary Accreditation of the USC School of Medicine-Greenville. Dr. Taylor is certified by the American Board of Surgery in general surgery, general vascular surgery, and is a registered vascular technologist. He is a member of most major surgical organizations and has held offices in several. He is a Director on the American Board of Surgery. He has authored numerous book chapters, abstracts, and journal articles. In addition, he holds the academic appointment of professor at the University of South Carolina School of Medicine. Dr. Taylor earned a bachelor’s degree in Biochemistry from Clemson University and a medical degree from the Medical University of South Carolina in Charleston, South Carolina. He did his internship and general surgery residency at the Medical University of South Carolina in Charleston and a residency in peripheral vascular surgery at Baylor College of Medicine in Houston, Texas.
ANGELO SINOPOLI, M.D. (56), Vice President for Clinical Integration and Chief Medical Officer, joined Greenville Hospital System University Medical Center (GHS) first as a resident in 1982. After completing his residency here in 1985 he returned in 1987 as a member of the Pulmonary Critical Care faculty. Dr. Sinopoli is Board certified by the American Board of Internal Medicine, Pulmonary Medicine and Critical Care Medicine. He is a member of several professional societies, has authored numerous abstracts and journal articles, and presented at multiple conferences. He holds a professorship position at the University of South Carolina School Of Medicine. He has earned several teaching awards from the Medical School. Dr. Sinopoli earned a bachelor’s degree in biology from the University of South Carolina and a medical degree from the Medical University of South Carolina. Following his internship at GHS, he completed a fellowship in Pulmonary and Critical Care Medicine at the University of South Carolina School of Medicine.
MALCOLM W. ISLEY (48), Vice President, Physician and Strategic Services, joined the System in 2007. Prior to joining the System, Mr. Isley was at Duke University Health System where he was the executive responsible for business and network development for hospital and physician services. Mr. Isley earned a master in health administration degree from Duke University, Durham, North Carolina and a bachelor of arts degree from North Carolina State University, Raleigh, North Carolina.
JOSEPH J. BLAKE JR. (62), Vice President, Legal Affairs and General Counsel, joined the System in 2007. Prior to joining the System, Mr. Blake was a shareholder and former managing director of Haynsworth Sinkler Boyd, P.A., a law firm located in South Carolina. Mr. Blake earned a bachelor of arts degree in economics from Washington & Lee University, Lexington, Virginia and a juris doctorate from Emory University in Atlanta, Georgia. He is a member of the South Carolina Bar and the American Health Lawyers Association.
TERRI T. NEWSOM (47), Vice President Financial Services and Chief Financial Officer, joined the System in March 2011. Prior to joining System, she was the Associate Vice President for Ambulatory Care Finance at Duke University Health System and the Divisional Chief Financial Officer of Duke Raleigh Hospital. Newsom has been involved in healthcare since 1991 when she joined Duke University Hospital as a senior budget & financial analysis analyst. While at Duke, she served on the boards of community and civic organizations and was also a member of the North Carolina Chapter of the Healthcare Financial Management Association. She earned a bachelor’s degree in accounting from Appalachian State University and is a certified public accountant.
Every 90 days since I have been at GHS we have done Town Hall Meetings. Time has gone quickly and we are about to begin the 23rd series of quarterly Town Hall Meetings.
This is one of our routine methods for connecting with front-line staff. The meetings allow me, along with our Campus Presidents, the opportunity to communicate progress on organizational goals and to provide updates on other topics of general interest to employees. My sense is the broader community may like to see and hear what is going on.
This quarter, we are highlighting:
(1) Progress on reviewing our values statement;
(2) Results of our 2012 Employee survey; and
(3) Other system-level goal updates
Below is a copy of the PowerPoint slides that will be presented at the Town Hall. If you cannot see the presentation, CLICK HERE to download a PDF of the presentation.
Also, below is a video of this quarter’s GHS 360 News – the video update of news around the system connected to our six Pillars of Excellence.
If you cannot view this video above, CLICK HERE to open the YouTube video.
Last night, May 3rd, I had the opportunity to attend the GSA Business Health Care Heroes award event. Let me explain what I mean when I said, “I had the opportunity to attend.” In fact, I whined about going to my assistant, co-workers, family and anyone else who would listen. The one positive was that I did not have to make any remarks…I was talked out. In addition, I had been out several nights already. Our middle daughter was getting back from college this evening. My in-laws were in town and, surprising to some, I do enjoy being with them. You get the picture, I was the complainer refusing to take responsibility for my self, even my wife said I was acting like a “victim.” That little jab actually helped get me back on track.
So, I went to the event, awkwardly interacted during the social hour, got my picture taken, was given instructions on where to sit and how the evening would go and told I had 2 minutes in which to make comments. That last bit of news prompted to start whining again, I did not think I had to get up in front of the group…I didn’t even wear a suit that day. Then a shift occurred. I saw Melinda Hudson Gillespie and Linda Rettew, both employees at GHS, and discovered they were also nominees. There were several categories of nominations: Physician, First Responder, Nurse, Community Outreach, Health Care Professional, and Volunteer. The GHS nominations were: Linda Rettew for Nurse, Melinda Hudson Gillespie for Community Outreach and me for Health Care Professional.
As the dinner portion of the event ended, the awards part of the program began. The finalists were called up to the podium as Carol Goldsmith from WYFF read the nomination. They each received the plaque and made some brief remarks. The last person called up in each category was the Health Care Hero. Hearing Carol read the accomplishments of all the finalists was wonderful and, for me, made the night worthwhile. In case you are wondering, I was not selected as the Health Care Professional Hero (more about that later), but I did have an opportunity to make some comments: I told the audience that I was grateful and accepted the award on behalf of the Upstate Community, Staff, Clinicians, Physicians and Patients. I also thanked our Marketing Department for buying the Gold Sponsorship and thereby assuring my nomination – that did get a chuckle. Finally, I spoke to the other finalists and thanked them for connecting me back to purpose and love in our shared calling. Little did they know how dramatically I shifted from where I was when the night started, to where I was as I listened to their stories.
Although I did not win the hero award, which competitive Mike did not like, my ego was comforted by hearing Tracey Jackson from Piedmont Care speak about her organization – a deserving leader and organization that provides AIDS/ HIV care. We did have one Hero in the GHS ranks, however, Melinda Hudson Gillespie (doesn’t she know it is not good to do better than the CEO?). She was gracious in her acceptance and clear in her recognition, as she thanked God, first and foremost. I was grateful to be in the presence of Melinda and Linda that evening.
We’ve just launched our annual employee opinion survey. This is the sixth consecutive year that we’ve reached out to all our staff to tell us what they think about working at GHS. Recently, in my monthly letter to staff (The Riordan Report) that is published in our employee newsletter, I talked about the importance we place on this annual survey.
2012 Employee Opinion Survey
The February Riordan Report is one of my favorites. That’s because I get to talk about our annual employee opinion survey and to encourage all employees and physicians to participate in this important annual event. To me, the survey offers a great example of how we can connect to our values through our mission. The employee opinion survey allows us to measure what we value (e.g., honesty, integrity, trust) and it’s through regular and consistent measurement that we’re able to identify opportunities for improvement and to track our progress.
This year’s survey will take place from March 5th through March 19th. As in the past, all surveys will be completed on-line via the internet. Using an on-line process saves lots of paper and helps tabulate the results more rapidly. We’ll also continue the practice established three years ago of using a unique identification code to log in and take the survey. As always, all survey data is collected and maintained by our external vendor and individual survey results are completely confidential. Using the unique identification codes improves accuracy of departmental and demographic information and helps streamline the survey process. Since we’ve introduced these two features, our participation rate has continued to be strong, turn-around time for results has decreased, and we’ve “gone green” by not wasting paper on a printed survey.
This year we’ll be asking some new questions about how well some of our Commitment to Excellence practices are being implemented throughout the system and we’ve added an open ended question to solicit your feedback about improving communications between different levels of the organization. We’ll also be asking targeted questions to nursing professionals in support of our interest in Magnet recognition. Finally, we’ll continue to include employed and highly aligned physicians in the survey group to ensure that we provide physician leaders with the same type of information that other leaders throughout the system have about their work teams.
Your opinions about working at GHS are worth sharing. In recent years we’ve used the survey results to help guide decisions about many topics ranging from employee benefits to work environment, communications strategies and even leadership development needs to give just a few examples. The cover article of this issue of The View offers an array of examples of how we’ve been integrating employee feedback into plans and actions.
I’ve been talking about the coming survey at this quarter’s Town Hall Meetings and I have encouraged your managers to review initiatives related to your department’s 2011 results with you at staff meetings this month. I plan to circle back and report our 2012 results at the May Town Halls.
I hope you’ll plan to participate in this year’s survey. Your opinions are worth sharing. We want to hear from you.
Michael C. Riordan
President and CEO
The following link is from the most recent Town Hall Meeting. The second video, right after GHS360 News, is about our 100 year anniversary. I think it is terrific and I hope you watch it.
After that, if you are interested, you can get a feel for how we did last year with our goals and what we will be working on next year by watching the rest of the presentation. This was done for the night shift and took place on the Memorial Campus.
I welcome your feedback or thoughts.
Mike
The ladies from Cafe and Then Some are at it again. They are a very funny and somewhat irreverent comedy troupe from Greenville.
They pushed it a bit with the New Jersey humor, but if you have a couple of minutes, take a look at page 37 on the attached link. There is a video that made me chuckle and cringe!
http://emag.fetegreenville.com/
I do want to make one point or correction, lest something think I went back on my word. When we started publicly speaking about the School of Medicine, one of the core principles was we would not seek money from the legislature to support the School of Medicine in Greenville. The School of Medicine in Columbia and the Medical University of South Carolina, appropriately receive money from the state to support their schools. In fact, I promised the President of MUSC, Ray Greenberg, from the beginning that we would not look for that support from the state. I may be from New Jersey, but keeping that commitment is important to me!
Finally, as an aside, for those of you that live in Greenville, there is often a misconception that we receive tax revenue from City of County Tax to care for the uninsured or underinsured, we do not. We do it because it needs to be done.
I have written before about the pitfalls of reporting systems and grades for hospitals. Here is an article I just read from a newsletter I received from PHTS – a risk management organization that we belong to. I was tempted to delete the last sentence, but I think this is a critical point. Self-reporting has some limitations and inherent conflict of interest, in that it can be self-promoting.
Leapfrog measures fall short. Hospitals that comply with safety standards pushed by the Leapfrog Group, and endorsed by the National Quality Forum, don’t necessarily have lower mortality rates or lower incidence of hospital-associated infections, report researchers in Archives of Surgery.
The authors reviewed outcomes in a nationally representative sample of level I and level II trauma centers. They report that neither the total score on the Leapfrog Safe Practices Survey, nor full implementation of computerized physician order entry, nor full implementation of intensive care unit physician staffing led to lower mortality or fewer hospital-associated infections.
“We did find, however, that a hospital disclosure policy for informing patients and families of systems failure or human errors leading to unanticipated outcomes is associated with lower mortality,” the researchers reported.
Earlier research on safe practices also turned up equivocal results. For instance, researchers found that computerized physician order entry and ICU physician-staffing levels improved outcomes for heart attack patients but not for patients with congestive heart failure or pneumonia. Another study found no correlation between a high score on safety practices survey and lower mortality.
Dr. Laurent Glance, who led the work, told Reuters Health the findings don’t indicate the safety practices aren’t effective. It could be the Leapfrog survey is falling short. “You can’t just rely on what the hospital executive says. You’d probably also need to have some sort of auditing in place,” he noted.
One of the requirements of a Medical Staff is to meet annually. In addition to fulfilling the responsibility outlined in the bylaws, it is also a good event for social interaction and education. I am usually given some time to give an update of some sort. The following is a copy of what I intend to speak to the group about. The level of physician leadership and involvement at GHS has steadily increased over the years. This talk gave me pause as I read it….I am struck by how engaged our physicians are. Perhaps it is one of the reasons this past year that, as a group, our physicians scored in the 99th percentile of engagement in our annual survey administered by Moorehead.
• Acknowledge
o Governor Tom Ridge, keynote speaker
o Medical Staff Officers
• Chris Wright, MD -President
• Marty Lutz, MD – Vice President
• Bruce Snyder, MD – Immediate Past President
• Thank Lee Van Voris, Shirley Crawford and all the staff responsible for tonight’s event.
• My assignment: Offer brief comments about the state of our system.
• Start with our goals – both the multi-year and annual goals. They offer a framework for understanding where GHS is heading – both near and long-term.
o MULTI-YEAR GOALS….Our Five Big Ideas:
1. Become a Total Health Organization.
2. Transform core organization structures and processes into a highly integrated delivery system.
3. Become an Accountable Care Organization.
4. Improve care and delivery and workforce development through innovation in academics.
5. Ensure a sustainable financial model that supports our vision and mission.
• …and our Annual Goals which center around six pillars of excellence:
1. People
2. Service
3. Quality
4. Growth
5. Finance
6. Academics
• Not enough time time to move through them one-by-one; but let me talk about one important theme that emerges for me when I think about these goals.
11-17-11
• Theme: The Role of Physician Leadership/ Engagement at GHS
o Highest level of physician engagement here at GHS compared to any other health care setting I’ve known.
o Examples
1. At the senior-most levels of the organization
• CEO Staff Meeting (Youkey, Taylor, Sinopoli)
• President’s Council (Youkey, Taylor, Sinopoli, Marshall, Diller)
• Operations Council (All Clinical Chairs)
2. At the unit level
• Physician/Nurse Manager partnerships addressing work-unit specific operational goals
3. In Practice Settings
• Physician leadership is critical – nothing new here
• In concert with the vision and larger goals of the system – that’s different today than ten or twenty years ago.
o What’s been possible as a result?
1. Consistently high results related to quality of care – CMS All Care Measures
2. Improvements in our culture of safety – still room to move forward here.
3. Year-over-year growth
• Access to care
• Volume
• Outpatient activity accounts for more than half of our revenue today
4. Strong system-level financial results in a very challenging economy
• Credit goes to the hard work of the Operations Council led by Greg Rusnak and Jerry Youkey
• Clinical Chairs and Campus Presidents working together to sort through difficult decisions
• Finance team willing to reinvent itself in collaboration with physician leadership
5. Measurable evidence of high levels of physician engagement
• Our employed and closely aligned physicians rank in the top decile of all health care works across the country – Morehead Workforce Commitment Index
6. Collaboration and innovation within the system and across the community
• YMCA PATH program focused on coordinated intervention for chronic conditions such as diabetes
• ITOR – bringing private sector research together within the delivery system…a vision of translational research and personalized medicine
• Nurse-Family Partnership – an evidence-based community health program
• Our Total Health philosophy influences many of these partnerships…
7. Significant movement toward higher and higher levels of system integration
• Care coordination throughout the system
• Information systems
o EMR
o Centralized Scheduling
o Acknowledge the growing pains…that are being felt across the country
8. Accreditation of the USC School of Medicine – Greenville
• The energy behind this achievement belongs to Drs. Youkey and Taylor and several others who were driving this process
• Our ability to even entertain the idea of a four year medical school was predicated upon the exceptional commitment to teaching and academics that exists within the GHS physician community – we had the foundation and it was you!
o These are just a few examples of what we’ve been able to accomplish with physician leaders who are highly engaged and aligned with the GHS vision and mission. There are many more examples.
• Thank you for what you do to put patients and families at the center of all we do; for the contributions you make and for your commitment to our mission to heal compassionately, teach innovatively, and improve constantly.
The University of South Carolina v. Florida is over for this year and USC came out on top. This is a game where at home, my position is to lay low. My wife Susan is a Gainesville Florida native. Susan and her family has attended, worked for and lived near the University of Florida for generations. We even have season tickets for UF football. We do not go very often, but we do make a lot of our relatives happy by giving the tickets away. I often joke that she is the Gator and I am the Gator-in-law. Truthfully, it has been a lot of fun to be a Gator these last couple of decades – on and off the field. Our daughter Clare, however, is a Gamecock….now do you see why I lay low? It has been fun to see those two navigate the love and competition that comes with college football and baseball.
College football is serious in the south…at least that is my experience. It can divide us and unite us – at home, office or in the stadium. What I want to talk about today is an example of how it unites.
Several weeks ago, one of the Vice Presidents at GHS, Howell Clyborne, entered the hospital after a time of quiet, prayerful reflection. He asked for some guidance on what he could do to make a difference today. As he entered the lobby, he met someone involved with hospice and palliative care. Hospice care is how we gracefully transition from a place of fighting illness with medical interventions to allowing the natural process of surrendering to our mortality. Done well, this is invaluable for the patient and the family during difficult times.
What Howell heard was the story of a man with cancer in hospice care. As it turns out, he was a huge Gator fan…not a majority position in the Upstate. After a brief conversation, there was a connection made to my wife Susan (Gator) and me (Gator-in-law) and whether or not we knew anyone in Gainesville. Howell spoke to me and I called a friend of mine Tim Goldfarb, CEO of Shands Healthcare, which is the Academic Medical Center at the University of Florida. I told Tim the story and he said he would get back to me. Over the weekend, I received a call from the loading dock that a box from Fed Ex was delivered with my name on it. One of our pharmacists signed for it and kept until Monday.
So, what was in the box? A helmet signed by Will Muschamp, the head coach of the University of Florida! Later that week the helmet was brought to the patient’s home. He was speechless, grateful and there were a few tears shed. For my part, I will always remember my friend Tim in Gainesville and how grateful I am to be a Gator-in-law. Football is just a game and so much more…..Go Gators, Go Cocks.
Mike
