Smilow Cancer Hospital Town Hall | September 27, 2023

September 28, 2023

Information

Cancer Center Support Grant Submission

Eric Winer, MD

Clinical Announcements and News

Kevin Billingsley, MD, MBAKim Slusser, RN, MSN

Addressing Patient Wait Times

Michele Kelvey-Albert, MPHTara Sanft, MD

ID10747

To CiteDCA Citation Guide

00:00Yes, welcome everyone to our Smile
00:04of Town Hall here in late September.
00:08I hope everyone is enjoying the fall weather.
00:11Is I now in After several days of
00:15what seemed like not fall weather?
00:17So thank you for making time to join us.
00:20We have a great agenda tonight.
00:23You know Doctor Weiner and Lori will
00:26kind of make a couple of announcements.
00:29And I think one of the things that
00:32is really the heartbeat of our
00:34organization as a Cancer Center is the
00:37work we do around our Cancer Center
00:40support Grant and Doctor Weiner will
00:43share that information with us is
00:45that we just recently submitted that.
00:48Kim and I will be talking about it
00:52a number of clinical announcements
00:54and appointments and recognitions
00:56that we're excited about.
00:57And then Tara, Doctor,
01:00Sam and Michelle, Kelvi.
01:02Albert will be spending some time
01:06with us talking about one of the
01:09many endeavors we have underway as
01:12we work on continuously improving
01:14our patient experience here.
01:15That's Milo.
01:16And then of course we will have
01:18time for exchange and Q&amp;A.
01:21So with that,
01:22I think I'll turn it over to Doctor Weiner
01:25and with a backdrop of Closer to Free.
01:30So thank you. Thank you, Kevin.
01:33The first thing I'm going to say is
01:35you don't have to call me Doctor Weiner
01:38because I actually am a believer in in
01:40in non hierarchical titles and unless
01:42I'm going to start calling Lori Miss
01:45Pickens when I refer to her here.
01:48I think none of you should talk
01:50call me Doctor Weiner on these
01:52calls or when you see me.
01:54So having I'll get off my soapbox just
01:57want to make a comment about closer to
02:00free So now I guess it was 2 weeks ago
02:05closer to free took place on Saturday.
02:10It was a great event.
02:11They were just under 2000 cyclists riding
02:1910254065 or 100 miles.
02:21I think one of the great things
02:23about the ride is that there
02:25are many different options.
02:27I will confess that I used to
02:29be critical of all those options
02:30and I thought it was too fussy.
02:32But I think it really works.
02:34And one of the things that it does in
02:36in comparison to rides that I've been
02:39on before is that it means that not
02:42so many people are on any one route.
02:45And the result is you don't have all
02:47these bicycles bunching up all the time.
02:51The route itself, in fact,
02:53all of the routes are really,
02:54really beautiful.
02:57They're just through rolling
03:00Connecticut countryside.
03:02I will confess that I was told that
03:04there were no hills in the last 30 miles,
03:07only to confront several relatively large
03:12hills in in in Guilford and in Brantford,
03:16which really surprised me just a bit.
03:20But I really thought it was great.
03:24My son came down with two of his friends,
03:27and with one of his friends he did 100
03:30and then the other friend and I did 65.
03:33And I know I think Kevin you did 65 too,
03:37but there are people who did more,
03:39people who did less and we're
03:41happy with any anything,
03:42anybody does and of course there
03:44are huge number of volunteers.
03:46So you just want to encourage
03:48everybody if you feel up to it to
03:50think about doing it next year if
03:52you've been doing it for years,
03:54thanks for doing it and it's really great
03:57and I suspect next year will be even better.
04:02I will mention that Lori
04:06also rode in closer to free.
04:10She was there when I came in she was there.
04:13She she hadn't left and was at least
04:16she said she was waiting for me but
04:19and I was it was it was it was nice
04:22to see her and and it's it's really
04:25a whole group event and I'm going to
04:28turn this over to Lori for few comments
04:31about the employment engagement survey
04:32I believe and then I'm going to talk
04:35a little bit about the CCSG before
04:36turning it back to Kim and Kevin.
04:38Well before I go off of the closer to
04:41free theme Kevin Billingsley will attest
04:43to the fact that I was waiting for you
04:48all over for you. We even have our
04:52photograph together because Neil
04:53came running with his camera to
04:55take our picture and it is proof in
04:59several Facebooks and whatever else.
05:01So yes, however, I will tell
05:04you that I only rode 25 miles.
05:07I have not been on a bike in forever.
05:09I took the bike off the wall of my
05:12garage a few days before and I rode
05:15it around the driveway once and then
05:18crazily went out and tried to ride 25 months.
05:21It was it was a lot of fun.
05:23I'm glad I did it.
05:25But Eric, I've got some work to
05:26do if I'm going to.
05:27There it is.
05:29Laura is the one who
05:30looks way better than me.
05:31I look like I'm in like
05:33significant distress.
05:34Laurie looks, you know,
05:36tanned and and great.
05:38Well, I don't know about that,
05:39but thank you.
05:41I'll thank you anyway.
05:42But yeah, I've got. I'm going to,
05:44I'm going to do better next time.
05:45I might even try to do the 40 miles,
05:47but I I'm going to have to ride
05:49a few times before I try that.
05:51And then Kevin Billingsley.
05:53I have to say I I I decided to
05:56indulge myself after 25 miles on
05:59a really fattening grilled cheese
06:01sandwich from one of the food trucks
06:04that I forced Kevin Billingsley
06:06to at least have a few bites of.
06:09It was good. It was really good.
06:12But anyway,
06:13enough said about closer to Free
06:15and all of the things that we are
06:18confessing to right now and all I
06:20want to do is just thank everyone
06:23that did participate and complete
06:25the recent employee engagement
06:28survey that is put out by Glint.
06:32It's for those who are not familiar with it.
06:34It is a health system wide survey
06:37that is done on an annual basis and
06:41it is done through a outside vendor
06:44called Glint and it's over a two
06:47week period and and it's really,
06:48really important to the organization
06:50to receive the feedback.
06:52We know there are challenges but
06:53we also know that there are great
06:55highlights and spotlights that we
06:56need to be recognizing as well.
06:58And we look forward to reviewing the
07:02the data and the results of that over
07:04the coming probably it's probably
07:05going to be a couple months for
07:07it to to go through the analysis.
07:09But we will be circling back with
07:12all of the teams to talk about
07:14what came out in the surveys and
07:17developing any action plans that make
07:19the most sense for us in leadership
07:22and and our teams to address.
07:25So thank you very much.
07:27Appreciate the time that you took
07:29to provide us with that feedback
07:31and that's all I have. Thank you.
07:35Okay, you want me to talk a
07:36little bit about the CCSG,
07:38Okay, So the CCSG stands for
07:41Cancer Center Support Grant.
07:44This is a renewal of the grant.
07:47The Cancer Center has had a CCSG
07:51grant since 1974 or all of 49 years.
07:55Next year is our 50th anniversary
07:58and this is what allows us to call
08:00ourselves a comprehensive Cancer Center.
08:03It has to be submitted every five years.
08:05We got an extra year this year because
08:07I was new and they they don't,
08:09they're not so mean as to make a new
08:12Cancer Center director submitted within
08:13the first six months of being on the job.
08:16And it is something that many
08:18of us spent the better part of
08:21the year getting ready for.
08:23And I will say that probably 10 of
08:27us did almost nothing but work on the
08:30grants for the past four to six weeks.
08:33The grant is structured so that such
08:36that we have 6 research programs.
08:38Four of them are really very much
08:41based on laboratory science.
08:42Then there's the, the, the
08:48CPC program or the cancer
08:50prevention and control program.
08:52And finally, a developmental therapeutics
08:54program that really focuses on
08:56trying to take discoveries from the
08:58laboratory and move them to the clinic.
09:01And years ago, those kinds of programs
09:03were really just about all that
09:06was in the Cancer Center support
09:08grant grants apart from some funding
09:11for the clinical trials operation.
09:13But what has changed is that
09:15now there's very much a focus on
09:18how we serve the catchment area,
09:20which for us is the state of Connecticut.
09:23And from the National Cancer
09:26Institute's standpoint,
09:27they're giving us a fair amount of money,
09:30not nearly as much as I think they should.
09:33And I that that sentiment is echoed by
09:36virtually all Cancer Center directors,
09:38but they are giving us a fair
09:40amount of support and they expect
09:42us to be serving our community.
09:44And in this case our community
09:46again is defined as Connecticut.
09:48So one has to show in this grant
09:50how it is that you're going to
09:53address the needs of Connecticut,
09:54how the how cancer in Connecticut
09:57may or may not be different from
09:59the rest of the country and how
10:02those differences if they exist are
10:05going to be part of your your plan.
10:08The other three very important pieces
10:11of the Cancer Center core grant are one,
10:15community outreach and engagement.
10:16So in addition to serving the catchment area,
10:19they want you to reach out to the community,
10:22involve the community members of the
10:25community in the research that you're doing,
10:27get ideas from them and really have
10:31bidirectional communication between
10:33members of the community and and
10:36and researchers and clinicians in
10:39the Cancer Center.
10:41Second piece of those 3 is that there
10:44is a new section that is called the
10:47program to enhance Diversity and
10:50that is essentially DEI diversity,
10:52equity and inclusion.
10:54And there needs to be a whole plan
10:57on how you are going to make your
11:01staff a an inclusive and diverse
11:06group of individuals.
11:08Much of that is because of course
11:10it's the right thing to do.
11:12The other piece of it is that of course
11:14it's not only the right thing to do,
11:16but it also helps us serve our
11:21our population better.
11:23And then finally a a large part
11:25of it is also about education and
11:27training the next generation.
11:29So thankfully it's done.
11:32It was submitted at 12 minutes
11:35past four on Friday afternoon.
11:37I was very pleased to see that time stamp.
11:42And the next step is that we have
11:44a site visit where about 20 people
11:46come and assess us,
11:48which will be the end of February
11:49and then we get our score.
11:51I think most people believe that
11:53it's almost inconceivable that we
11:55would lose the grant.
11:56We certainly hope we will do far
11:58better than lose it and I think
12:00most of us feel like we we really
12:03tried hard and put together a very
12:07solid grant and I'm happy not to
12:10have to do it again
12:12for five years and and to get back
12:15to the the the work of every day.
12:17So that's really it.
12:20And for all of you who were
12:23intimately involved, thank you.
12:25For those of you who weren't but
12:28were supportive in other ways by
12:30just carrying on business as usual
12:32while some of us ended up spending
12:34a lot of time on on on the grant.
12:36Thank you as well.
12:37And with that, I'm going to turn
12:40it back over to Kevin and Kim.
12:43Eric and we, I just want to
12:45remind everyone on the town hall,
12:47thank you for being here and you can
12:50at any time put comments in the chat or
12:53the Q&amp;A and we will either get to them
12:56throughout the town hall or or at the end.
12:59I think because we were not as jam
13:01packed like we were last month.
13:02I think we'll actually have some time for
13:04Q&amp;A that will be really great if we do today.
13:07So I'm just going to go ahead and share my
13:10screen again and go over a few highlights.
13:13We are such a large organization
13:16and sometimes you know all there's
13:19many things that are happening and
13:22that others may not know about.
13:24And so we always like to take the
13:25time to recognize good things
13:27that are happening out there.
13:28And so Yale, New Haven Hospital every year,
13:33they started this a few years ago,
13:35they give out two awards,
13:37the Impact award and the Elevate
13:40award for our nursing professional
13:41development specialist.
13:42And again this is across the
13:45entire hospital at Yale,
13:46New Haven and and they give two of
13:49these awards out for each award.
13:52Two people win the Impact award and
13:55two are awarded the Elevate award.
13:57And I am just so pleased and excited
14:00to let everybody know that out
14:02of those four recipients,
14:04two of them were from Smilo,
14:06Kylie Cook and Christina Matuszic,
14:09both represented Smilo very well
14:11and were awarded.
14:13Kylie Won was awarded the Impact award
14:16and Christina received the elevate award.
14:18I couldn't be more proud that
14:20out of the four,
14:21two were from our Smile oh nursing team.
14:24And I want to say thank you to those
14:26that nominated Kylie and Christina and
14:29recognize them for the work that they
14:32do and and definitely congratulate
14:34and thank Kylie and Christina for
14:37all they do to support our nursing
14:39teams and our interdisciplinary
14:41teams and moving our care forward.
14:44So thank you so much.
14:48And also I'd like to take opportunity.
14:50We have two new nursing leaders joining
14:54the SMILO nursing leadership team,
14:57Danielle White and Elizabeth Casanova.
15:00They have both been promoted to
15:03Assistant Patient Services Managers.
15:04Danielle will be supporting our
15:07night shift teams on NP14 and 15 and
15:11Elizabeth will be supporting our
15:13our teams at night for NP11 and 12.
15:16And I just can't say how important it
15:18is for us to have leadership support
15:21on our night shift for our teams,
15:23so many of our nurses on night shift,
15:25our new graduate nurses.
15:27And it just it's it's really,
15:29really important that we support
15:31our night shift in the care of the
15:33patients at night in the same way
15:35that we support them during the day.
15:37So Danielle and Elizabeth,
15:38welcome and we're excited that
15:40you have joined the team.
15:42I'm going to turn it over to Kevin now
15:44to go over new faculty appointments.
15:46We have a lot of activity happening.
15:52Thanks Kim. Nothing excites me more
15:56than sharing the news about new
15:59faculty coming into our Cancer Center
16:03and joining our programs across
16:05the entire clinical enterprise.
16:07You know, I I want to take a minute
16:10to thank our faculty leaders who do
16:14the really hard work of reaching out,
16:17developing relationships across the
16:19country with different fellowships,
16:22different organizations to not only
16:25develop our own internal faculty talent,
16:28but the forge the relationships that
16:30bring great clinicians and researchers
16:32to us from from across the country.
16:35And that's people like my colleague Dr.
16:38Roy Herbst,
16:41Alfred Lee, Stephanie Helene,
16:44Jen Capo, Antonio Amuro,
16:47a host of surgical leaders
16:49including Sarah Mara, Mara Gulshan,
16:52Nita Ahuja, Ben Judson, Kiran Taraga,
16:56not just to mention a few as
16:59well as the leadership of the
17:02Department of Therapeutic Radiology.
17:04So you know to start off with,
17:06it's just terrific to welcome
17:08Doctor Ash Alpert.
17:10They come to us from Brown University
17:13and they are joining the the
17:16division of Hematology and have a
17:19significant research background as
17:21well as a ASH will be a an active
17:25participant in our hematology programs.
17:28It was really a delight for me to
17:31see Doctor Chang join our faculty.
17:33Any of you know Eric Chang already he
17:36has come up through the the fellowship here.
17:38Eric is a classical hematologist
17:40and one of the things that is
17:43really exciting is that he's going
17:45to be seeing patients at Waterbury
17:47as well as in New Haven,
17:49strengthening our integration
17:50and our clinical programs across
17:53the entire organization.
17:55During his time as a fellow,
17:57Eric provided invaluable assistance
17:59to us and evaluating the clinical
18:02needs of the HEEM program and
18:04helping us tailor the growth program
18:06across all of our sites.
18:08Susan Gable is a radiation oncologist
18:12who also came up through our training
18:15programs and Susan has jumped in
18:17to the GI program in the deep end,
18:20very happy to be sharing patient
18:22patients with her,
18:23seeing her every week on the GI tumor board.
18:26So welcome Susan.
18:28Next slide please.
18:31Adriana Kahn is another fabulous
18:33recruit who's come up through our fellowship.
18:37Adriana is a breast medical oncologist
18:39and will be a clinical trialist
18:42and researcher and I think it's
18:45already started seeing patients.
18:47James Laird, radiation oncologist.
18:51James is joining our program and will
18:53spend a lot of his time at our very
18:57busy clinical site and Waterford,
18:59I think he will have a variety of
19:03clinical activities and delighted
19:05to have James join us.
19:08One of the things that is most
19:10exciting is to see the growth
19:13across the disciplines that support
19:15the care of our cancer patients.
19:18As many of you know,
19:20we've had a acute need in breast
19:24imaging and it gives me a lot
19:28of pleasure to welcome Doctor
19:30Perissa Lotfi to the faculty. Dr.
19:33Lafi has a sterling pedigree.
19:36She's practiced in the Harvard system
19:38in Boston as well as more recently
19:41here in Connecticut at Stanford
19:43and she brings a wealth of clinical
19:46and program building experience
19:48to our breast imaging program.
19:51Next,
19:51we've had incredible growth and head
19:54and neck surgical oncology under the
19:58direct directorship of Doctor Sarah Mera.
20:01We're glad to have Doctor
20:04Suresh Mohan join us.
20:06Suresh comes from Harvard as well
20:09as more recently the University
20:10of California at San Francisco,
20:12where he's just completed a fellowship.
20:15I'm going to skip Doctor O'Neill
20:17for a minute and carry on with the
20:19theme of growth at head and neck.
20:21Doctor Sarah Pye is a surgeon scientist
20:24who is not only a brilliant clinician.
20:27But a enormously funded scientific
20:31investigator, R 01, funded and will
20:35bring her scientific program to the
20:39Division of Autoergology and Department
20:42of Surgery in the Cancer Center.
20:45Doctor Dan O'Neill has actually been
20:47with us for several months, so he's
20:50become a bit of a familiar face already,
20:52but he is the new faculty member this year.
20:55Dan is a breast medical oncologist
20:58and a global health researcher,
21:01and Dan is a Northeast native,
21:02but returns to us from several
21:05years at the University of Miami.
21:08Next, Justine Rue is a hematologist who
21:12will be joining us and practicing at
21:15Orange and a variety of our other sites.
21:17Justine's coming from Boston.
21:20Adriana Ramirez is an endocrine
21:23surgeon who is joining the division
21:26of Surgical Oncology Department of
21:28Surgery and will support the fabulous
21:31program of Doctor Ogilvy and Dr.
21:34Gibson.
21:35Really rapidly growing program and very
21:39happy to have Adriana join us from Emory.
21:43Again, additional faculty strength and
21:45head and neck with the addition of doctors.
21:48Zafar, Syed.
21:49Dr.
21:49Syed's been in practice for
21:52several years in Nebraska and had
21:55a super busy clinical practice
21:58and did clinical academic work.
22:00Very pleased to lure him
22:02back to the East Coast.
22:03And then Dr.
22:05Schoenfeld has been here
22:09in several for several years,
22:11but now joins the faculty in
22:14Melanoma as an instructor.
22:17And again, great to have people coming up
22:20through the ranks to join the faculty here.
22:22So it's really an incredible group of people.
22:27The strength of our organization
22:29turns on the dedication,
22:31quality and commitment of our faculty,
22:33nurses and staff.
22:34So this group of people coming in
22:37really bodes well for the future.
22:40So great to share.
22:42Thank you.
22:51I think actually, Kim,
22:54no. Are you am I introducing them?
22:56Yes. Yes. You're going to be. I am.
22:58Our practice didn't work. OK.
23:04I'm sorry for that glitch.
23:06I get to have more fun and introduce
23:09two of my most favorite people.
23:12Tara Santh, Dr.
23:13Santh and Michelle Kelvi. Albert.
23:15Neither of them really needs
23:17any introduction to this group.
23:20Tara is our Chief of Patient Experience.
23:24She wears a number of other hats
23:27including breast medical oncologist,
23:29physician, Wellness advocate and mom.
23:32Michelle is our Director of Quality and
23:36Safety and one of the many initiatives
23:39that we are working on in the patient
23:43experience realm is around patient wait time.
23:47If you listen to patients carefully,
23:50waiting for care is one of the things
23:54that is often most distressing.
23:57And unfortunately they wait
23:59at almost every turn.
24:02And it is an area that we feel like we have
24:05much opportunity to improve experience.
24:07And I think as Tara,
24:11Michelle Kim,
24:11Scott Huntington and I thought about this,
24:15we realized that we may not be able
24:17to eliminate waiting completely,
24:19but there's a lot we can do as
24:22clinicians and staff to mitigate the
24:26negative experience around waiting.
24:28And I think that's what Tara and
24:30Michelle are going to share with us.
24:32So I'll kick it over to both of you.
24:37Thank you. Kevin and Michelle and I
24:39are prepared to go last on the agenda.
24:42And so we've kept this very short and
24:46it's so nice to see so many familiar
24:48people on the town halls tonight.
24:51You know, I think it's important to start
24:53out by saying that there is no one way
24:56to point and say This is why patients are
24:59waiting or this is what the problem is.
25:02And but certainly solutions that are what
25:06we call low hanging fruit have always
25:08been attractive to me and Michelle and
25:12Kevin because they take very little
25:14extra resource and can make a big impact.
25:17So tonight I'm sharing with you on the
25:20early side some data that we've analyzed
25:23and just to start the conversation
25:25on how we can communicate wait times
25:29more effectively and compassionately
25:34before I launch into that.
25:35Many people are on the town hall
25:39tonight who are in the sections of
25:42the Cancer Center and met on Kemonk,
25:45Neuro, Aunt and palliative care.
25:48We have always been collecting
25:51presagaini surveys for many, many years.
25:55It has been very difficult to share
25:59any individuals comments and results.
26:02So if you came to me and said if
26:04Doctor Billingsley said you know what
26:06is my Prescani scores look like it
26:08in a prior iteration of the survey,
26:10it did not track easily to
26:13Doctor Billingsley.
26:14So we have spent the last year revamping
26:18the Med Practice survey so that it is
26:22much easier to track it to your clinic.
26:26And again as you'll see tonight,
26:2980% of the comments are very positive
26:32and I feel like it's been and the
26:35effort of transparency very important
26:36to be able to share those with you.
26:38And prior,
26:39if the patient didn't say your
26:41name in a comment,
26:42it was very hard to understand
26:44who they were talking about.
26:47So all of that is to say that
26:50every quarter you will be getting
26:52your own results sent to you on
26:56an attachment e-mail and this is
26:59essentially what it will look like.
27:01It's about a two to three page
27:03PDF with your overall scores and
27:07comments for your own review.
27:10And again this is in transparency to
27:13share with you all the things that
27:16patients are saying if there are concerns.
27:19Obviously as we start this process
27:21we want to hear from you and and
27:24get your feedback.
27:25You will be getting the next report
27:28on October 15th and if you do not
27:30get the report please let us know.
27:32We've put in a tremendous amount of
27:34time updating the the list of providers.
27:37This will include MD's and APP's
27:40in the four sections and Tara,
27:42if I could just add just
27:45one other piece on that.
27:47So we also along with the as as Tara
27:51mentioned you know providing this scorecard
27:54for for the physicians and the APP's,
27:58we still have worked with all the sites
28:02and you're still able to get your site
28:07kind of report card breakdown scorecard.
28:09So we've worked with all the
28:11ambulatory sites to make sure
28:13that's available to you as well.
28:15So it's we haven't changed,
28:17we've just added, just wanted to
28:19make sure everybody remember that.
28:21Thank you.
28:22Thanks Michelle.
28:24I'm going to read a quote that that
28:28I think is very detailed and so
28:31it's worth it just expressing here.
28:34I'm from a patient who wrote into Preskini.
28:37I got there 1/2 hour before I
28:38was to be there. I checked in,
28:39I filled out a form on a clipboard
28:42that they gave me and then I waited an
28:44hour and 15 minutes before I had to ask
28:46when they were going to Call My Name.
28:48The girl at the registration
28:49desk stated I did not check in.
28:51I said I did, and you even gave
28:53me a clipboard to fill out.
28:55She never told anyone I was there
28:57and then tried to blame it on me.
28:59I was not happy sitting there for
29:01that length of time and then for
29:02them to say I did not register.
29:04How did I get the clipboard then
29:06if I did not check it?
29:11So the vast majority of comments that
29:13are written into Prescani are positive.
29:16About 15% are negative and if any
29:18of you have gone to the patient
29:21experience forum on a monthly basis,
29:23you'll know that we routinely review
29:26all of the positive and negative
29:29comments and there is a platform
29:32that divides them into themes.
29:35The most strong heat map on negative
29:39themes is around wait times.
29:41And so we've spent the past few
29:44months analyzing these data to
29:47understand better what is the
29:49sticking point in wait times.
29:51Is it the wait time itself or is it
29:54the communication around wait time?
29:57And we've noticed that there has
29:59been a theme of unsatisfactory
30:02first impressions from teams.
30:05And again,
30:05I think that there there is no one way to
30:09point to this and say this is the issue.
30:12I think a lot of people have been on
30:14boarded since the pandemic has started
30:16and and maybe have missed some of the
30:19critical orientations to smile level care.
30:25So we reviewed comments over the
30:27course of one year and we chose six
30:31different sites across the network.
30:33This was included 21 different clinics.
30:37We did an exhaustive search in
30:41Prescany for patient comments and
30:44sentiments which are like embedded
30:47within comments about wait times.
30:50And then we analyzed this and also
30:53looked into what is out there in the
30:56literature on how to improve this.
31:00What we found was almost 400
31:03comments on wait times that were
31:07that mentioned wait times at all.
31:10About half of these comments were
31:12negative and 33% were positive
31:15and there was no site was exempt.
31:19There were a few sites that pulled in
31:23many comments about this and they are,
31:26as you might imagine,
31:27our highest volume sites.
31:31And not not to go over each of these,
31:34but I think the theme that I want
31:36to emphasize because I feel like
31:38it really is low hanging fruit,
31:40is the idea of updating
31:44patients on their weight.
31:47And you can see just in red here a
31:51few of the comments highlighted no
31:53staff came in to tell me my doctor was
31:56delayed and had a staff person just
31:58poked their head in and kept me up to date,
32:00it would have been easier to wait.
32:02And actually in that third of positive
32:06comments overwhelmingly patients
32:07say I don't mind waiting especially
32:10when people tell me what to expect
32:13about the wait or they offer me some
32:15water or they let me go get a coffee.
32:19So again I think that a recurring
32:21theme is a lack of communication
32:23that pertains to delays and and
32:25this includes that check in,
32:27in the waiting room,
32:29in the exam room and and off
32:32into infusion as well.
32:33There is no site that is solely
32:37responsible and and there is no site
32:39where we cannot I think take advantage
32:42of this low hanging fruit of of
32:45really explaining to patients what's
32:47happening and and what to expect.
32:49You know,
32:50and I I do think this is important
32:53because patients are so vulnerable and
32:57they're waiting in the room oftentimes
33:00undressed ready for an exam and and
33:03feeling really forgotten about.
33:05And and the data in the literature
33:07shows that you know starting
33:09within 10 minutes patients wonder
33:12have they forgotten about me.
33:14And and often times just a simple
33:16update your next on the list or
33:19it's going to be a little bit can
33:21I get you anything can really help
33:23quell anxieties and and reduce
33:25some of that vulnerability.
33:29So this is the beginning of the conversation.
33:32We are hoping to work with many of
33:36you stakeholders on developing an
33:38approach to how we might do this
33:41across the system and and to provide
33:43some training to include all of the
33:46new hires who maybe haven't been
33:47here for a long time and and also
33:50investigate EPIC tools that are
33:52already utilized in other areas.
33:54I'd like to stay tuned on that and
33:56and I appreciate Kevin and Kim for
33:59inviting us to come and give an
34:01update on this tonight.
34:03And I did want to add
34:04one other piece to this.
34:05You know Tara and I work
34:08with our Smilo P Fac.
34:10And so one other area is we've
34:13really asked our P fac members
34:15to help weigh in on you know,
34:18they're not only their experiences but
34:21any recommendations that they might have.
34:24And and I think the comments that
34:26we've been reviewing were consistent
34:28with some of the experiences,
34:30some of the P fac members,
34:32but you know they really felt the
34:35scripting and the importance of
34:37keeping somebody updated on what was
34:40happening and making that personal
34:42connection what felt right and was
34:45what we should start to be working on.
34:47So I just wanted to add that that
34:49we Tara asked that question of P
34:52fact and they were really willing
34:54to give us their feedback on that.
35:02So here there's a question
35:04in the chat will met.
35:06This goes back to the reports that
35:08you shared at the very beginning.
35:11Will the medical directors
35:12receive the satisfaction
35:14reports of the teams they lead?
35:17Thanks for that question.
35:19The, the division chiefs are the
35:23are included in the reports and as
35:26we get used to rolling this out,
35:28I think we'll have better ways to
35:32share the data across different
35:34clinics and across different sites.
35:371st, we just want to make sure each
35:39individual gets the information
35:41in a way that is digestible
35:43and understandable and then and
35:45that will include the individual
35:47themselves in the division Chief.
35:53And there is also a comment and I
35:55don't know any of us can probably
35:57take this one but there there is a
35:59comment about our teams just being
36:00stretched so thin and I think we can
36:03all recognize that and and and we
36:05know it has been very challenging.
36:08It's been a very challenging time for us
36:11in the entire health system and organization.
36:14And and I think we can all agree that it's
36:18it's not just about training our staff.
36:20And I think it is about us understanding
36:22each other and what what we're
36:25going through right now.
36:26And maybe we can come back at a future
36:28town hall and talk about some of the work
36:31that we're doing around our staffing.
36:33But we know it's challenging and I
36:37think you know there's just no other
36:40way to say it other than that we
36:42recognize it and that we're really
36:43trying to support one another through
36:45through these difficult times.
36:50And we, you know, everybody wants
36:52to do their best for the patient
36:55and for each other and and you
36:57know our patients are feeling this
36:59because they're even telling us this.
37:01They're they're they're telling us
37:03that they know that we're stretched
37:05and I think we you know want to just
37:08try to do everything we can to improve
37:11that feeling and work on the staffing.
37:14I don't think it's a or I think it's
37:16A and and you know we're here to
37:18support the teams through all of that.
37:20Terry, I'm sorry I didn't mean
37:22to Oh no, I think it's so true Kim and you
37:25know I think it's it's been shown although
37:28the literature in Pandemic is limited.
37:30You know pre Pandemic when all staff focuses
37:37on relationship centered communication
37:39retention rates actually go up.
37:41And so I do feel like this is again
37:44low hanging fruit that think about how
37:48any of us feel when we have a good day
37:50with good interactions we feel more
37:52motivated to come back and do it again.
37:54It's a hard job. So you know, again,
37:58ideally this everyone's buying into this
38:02because we all feel good about this and
38:05and even though we're stretched thin,
38:07hopefully a warm greeting and looking
38:09patients in the eye is when we're
38:11talking with them and really trying hard
38:13to be as compassionate and attentive
38:15as we can under the conditions we're
38:17working is a priority.
38:21So I wanted to make sure
38:23people are seeing Dr.
38:23Chang's comment that as we
38:28continue to develop in the space
38:31of telehealth and telecare,
38:33there is an effort to to to start
38:36a pilot program with a virtual
38:38rooming and make sure that these
38:41kind of communication nuances and
38:45details are kind of followed through
38:48in that care setting as well.
38:51I think one of the things that
38:52we're really at risk for is patients
38:54sitting at home waiting for their
38:55telehealth appointment and many
38:58clinicians myself included mix
39:01telehealth with in person visits
39:03and you can get delayed and it
39:06is very you know disconcerting
39:08to be sitting on a looking at a
39:10blank screen wondering if you're
39:12really going to connect with your
39:14your your provider or not.
39:15So I think that that will be important work.
39:19You know,
39:19they have some other EPIC tools
39:22having that exist in terms of the
39:24updating families and patients on the
39:27status of their surgery for instance.
39:29And so we are actively looking
39:32into what those outpatient clinic
39:34options are with EPIC as well.
39:38You know, I, I, Tara and Michelle,
39:40thank you both for doing what
39:42I think is really important
39:44work in the organization.
39:46I know Kim and I both
39:52want to acknowledge this is
39:54not straightforward. You know,
39:56we have patients who are complicated,
39:59the needs are complicated and our staff,
40:01including our physicians are often pulled
40:05in multiple dimensions at the same time,
40:08including needs for documentation,
40:12medications, answering calls.
40:16But I have been impressed in my
40:19web is now many years of clinical
40:23practice that small gestures.
40:26Make a big impact in this arena.
40:32Just opening the door when people
40:34are waiting and saying I know
40:35you're there, I'll be there in a minute
40:37makes a big difference. And
40:43fundamentally, if we do not
40:45acknowledge that we are making people
40:48wait and even apologize for it,
40:51the message we send to our
40:53patients and families is that
40:55their time is not valuable.
40:56And I know that's not what we
40:59intend or what we mean.
41:02So small acknowledgements,
41:03small access service and
41:06efforts at service recovery in
41:08some of these difficult times
41:11make enormous differences. So
41:15I think that's a great point.
41:18I would add that you know if you don't
41:20want to apologize all day because
41:22many of us run chronically behind even
41:25thanking patients for their patience,
41:27thank you for waiting.
41:29I know you've been waiting.
41:31I'm I'm here to hear from you now
41:33patients say over and over and
41:35over again I don't mind the weight
41:38because I know when my doctor
41:40comes in they're listening to me
41:42they're listening to every word
41:43I say and but just acknowledging
41:45the weight and saying thank you.
41:47Thank you for being patient with me today.
41:49You know can I think to
41:50your point Kevin really
41:54lower any hard feelings or anxiety
41:56about having to to be in a room or in
41:58a waiting room for a very long time.
42:00And I think we've all said it but we've
42:03heard it over and over again just a smile.
42:06I I think we've heard from all of our our,
42:10you know the comments is just sometimes
42:14just smiling and making somebody feel
42:16at ease makes a huge difference as well.
42:21And I think if we can just recenter,
42:23I think going back Tara to your
42:25original point that I think it
42:28was 75% of our comments or 80%
42:32of our comments are positive.
42:34So you know we're getting
42:36this right a lot of the time.
42:38But the the theme that is coming
42:40out is where we aren't as consistent
42:43is how we communicate and make our
42:45patients feel while they're waiting.
42:47And that's why we wanted to bring
42:49it to this town hall and that's why
42:51we'll be really coming together to do
42:53that hard work over this next year.
42:55But we do it right a lot of the time.
42:58We do a lot of things right.
42:59A lot of the times for our patients
43:01and our patients are so grateful and
43:03a lot of times all they want is a
43:05simple like thank you or you know
43:09apology or just keeping being kept
43:12updated and they really feel cared for
43:13by us when we when we do things like that.
43:16So and we usually do spend time.
43:19I do encourage anyone on this
43:21call that if you haven't joined
43:23a patient experience forum,
43:25please reach out.
43:26You know if if you're a leader,
43:29you should get the invitation.
43:30If you're a staff member,
43:32if you're one of our team members,
43:34please reach out to your manager.
43:35It's really open to anyone.
43:37It really is our our patient family
43:40Advisory Council members are also
43:42invited to our patient experience
43:45forums and and there's really a lot of
43:48great information that shared there,
43:50a lot of wonderful comments about
43:52the great work that that our teams do
43:55and I really would encourage anyone
43:58to come and be part of that forum.
44:01We meet monthly, right?
44:02Terry and Michelle,
44:03you guys
44:04first Friday of every month, happy to add.
44:08Anybody on to the invite, just let me know.
44:17There is a couple things in here.
44:19Do you? I guess I'll be the moderator.
44:22You guys can just chime in.
44:24Prior to the pandemic,
44:26we did a 510 strategy which was if
44:28a person was 10 feet away from you,
44:31you smile at them.
44:32If they are 5 feet away from you,
44:33offer greeting.
44:34Maybe we should encourage
44:36that strategy again.
44:37And then another person asked
44:39do we have an average like the
44:41time for visits per provider?
44:43Maybe our expected visit times are
44:45unrealistic and could be a struggle.
44:51I can make a a little
44:54comment about both of this.
44:56I I was a part of that campaign,
44:58the 510 strategy coming from the Midwest
45:01where you say hi to every person.
45:04This was the easy thing for
45:05me to get on board with.
45:07But I do agree that revamping
45:10or reigniting some of those,
45:12you remember the Cleveland Clinic
45:13video of if you were in their shoes,
45:16it's very powerful and I think
45:18it changes how you see people
45:20in the elevator for instance
45:22in terms of individual data.
45:24You know,
45:25I have to be honest with you that the
45:28the vast majority of the negative comments,
45:30while there are some standouts
45:33in terms of long wait times,
45:34it's really about the expectations
45:37or the communication around it.
45:39The person who wrote about the clipboard,
45:41for instance, you know,
45:44doesn't mention how angry she
45:47is about the 1 1/2 hour wait,
45:49or the one hour and 15 minutes she's
45:50really upset or I'm guessing at the sheet.
45:52I shouldn't probably guess that,
45:55but they are really upset that they didn't
45:57feel seen or heard or even checked in,
46:00even though they had the
46:02experience of checking in.
46:03So it's really those are the themes.
46:05And while yes,
46:06each individual person who
46:08chronically runs late,
46:09I think we can consider all of that.
46:11I do feel like wait times are built
46:13into a lot of what we do and we
46:15just need to do better at helping
46:17minimize the suffering around it.
46:29I guess I'll add to the discussion
46:31and and just say that I think the
46:34point about looking realistically
46:36at our templates is, is important.
46:39And I think that this is,
46:42this is one of the things that Sarah
46:45Shellhorn and Lisa Chomsky you're
46:47working on is as we work on access
46:52working with all of our clinicians
46:54across the clinical enterprise to
46:56standardize the template framework.
46:58And for many people that will
47:02be expanding the template time.
47:04And the answer to ADDONS is not squeezing
47:10more patients into the same time,
47:13but is to expand template availability.
47:17And and these are difficult tradeoffs,
47:19but I think that is going to be
47:21work that we we have to do with
47:23all of our clinicians.
47:24I also am a big fan of the 510 rule.
47:28Like Tara,
47:29I'm a transplant from probably a
47:34part of the country with a bit of
47:36a different culture and I think
47:37there's much to be said about
47:42working at friendliness because
47:44it is a it's a contagious emotion
47:51of anything to catch.
47:52I would love to catch friendliness.
48:00I don't think we have any more questions.
48:03I I just am so glad we had some
48:05questions this month and that
48:07we had time to do some Q&amp;A.
48:10I think that's wonderful.
48:11Kevin, any I guess we could
48:13get people a few minutes back.
48:15Terry, Michelle, any last comments or
48:18thank you for having us.
48:20Evan, do you want to close us out or
48:24anything you want to say at the end?
48:26I would just say I'm appreciate
48:28everyone being here.
48:30I do want to say a special
48:31thanks to Tara and Michelle for
48:33the work you're at leading.
48:35It is incredibly important.
48:38I talked earlier about my excitement
48:41for bringing new faculty in and
48:45clinical and scientific excellence is
48:47kind of the foundation of what we do.
48:51But without the caring element,
48:55we fall short and we just need
48:57to continue to keep our eye
48:59firmly on that. So thank you.
49:02Thank you everyone for joining
49:04and we will see you next month.
49:06Have a great evening
49:07for having us. Good night.