Taking the High Road
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by: R aymond GAETA
There were countless ways for me to begin my first column as your medical staff president, but given the tragic events of the past month, I feel that it is most appropriate for me to begin with the sincere hope that all is well with your families, friends, patients, colleagues and others in your circles.
While we continue to reflect and respond to the national events, I think it is important that we move forward. Terrorists thrive on creating chaos among their victims. We must take the high road and show the world that we can recover with dignity, with efficiency and with compassion for our fellow citizens. And as physicians we must take a leadership role. The nation has shown a proclivity to join together in support. We can do no less.
Our mandate, in good times and bad, is to serve patients. And as your new staff president, I have some thoughts about how we might further that goal as we move forward.
Marty Bronk, my predecessor, worked very hard to become an important voice for physicians and to increase our leadership and participation in activities designed ultimately to improve patient care. I would like to continue that effort - making the role of president one of advocacy centered around patient care issues.
Since environment is crucial, we as a group must try to make this a hospital where we want to bring or send patients. The first step in making our hospital attractive is to identify and correct impediments. For example, surgery scheduling and prioritizing has been an issue for many years. Our interim hospital president and CEO, Mike Peterson, is working with physicians and other leaders to develop a full-time role for a physician medical director in the operating rooms.
I personally believe it is important to explore whether we should establish an urgent care center distinct from the emergency department. This is an initiative that has been used advantageously at other institutions to care more effectively for short-term patients with acute but not emergent problems.
I'd like to hear from my colleagues about what issues they think are important to improve our environment. We need input from a wide group, including hospital-based physicians and from those of you who refer patients to us.
While many problems can be solved with copious resources of time and money, the challenge is to make our hospital work better with judicious use of resources. If someone were to tell me that they would commit unlimited resources to complete a particular project, my first reaction is to say, "Let's be efficient with that money and complete two or three projects."
Overall, we are working against some tangible challenges. Certainly economic pressures have been tremendous. And certainly there has been a need to cut some costs, but we also need to look at decisions and be able to say, enough is enough. Some things are negotiable but good patient care is not. I want to make sure that as we go forward from here that we learn from our experiences. Change is good if it improves care efficiently. But change needs to be evaluated.
Some projects require patience and concerted effort. Right now we are in the midst of a comprehensive effort to convert our hospital to electronic medical records. Physician order entry touches so many areas and is undeniably a remarkable change for this institution. It has altered how some departments function, how nurses receive their work lists, and it will change the way we practice. Yes, there have been rollout problems, including a substantial learning curve for users. When I have felt frustration, I have reminded myself that the learning curve is worth it because of the benefits of never again having to search for a paper record. There are countless other benefits, but the bottom line, frankly, is that we cannot function in the year 2001 without an integrated electronic record system. We must make sure that we have the tools to take good care of our patients in-house or out-of-house, in real time.
Good physicians deserve recognition, and to that end, I'd like to solicit your ideas about a planned President's Award. The hospital is placing a high priority on service as a goal. I want physicians included in that paradigm.
Physicians who have demonstrated attributes of excellent service should be recognized quickly - not simply in a once-a-year ceremony. Details need to be worked out, but I would like to see specific recognition for those doctors who have tangibly contributed to excellent patient care or have provided particular service to a family. Nominations could come from colleagues, nurses and other caregivers and would probably be offered monthly - while the good works of our colleagues are still fresh in our memories.
Finally, I'd like to see a more active role for the monthly deputy chiefs' meeting which I chair. This meeting should be an active forum that provides credible and accepted feedback from the key, largely community-based, clinical physicians who attend.
The deputy chiefs' meeting should include more than the dissemination of information; it should be an active forum. We should be able to provide the concrete feedback our administration should expect.
Beyond that, I hope to elicit ideas for general staff meetings. These are wonderful opportunities to provide interchange among practicing physicians and hospital leadership. We should make the most of these opportunities several times each year.
I am anxious to hear from you about your concerns, your thoughts about hospital improvement, or any related topic that we as a community of physicians might consider. Please contact me by email or by phone at 725-5852l.
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