Smilow Cancer Hospital Town Hall | September 27, 2023

Transcript

• 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&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&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&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&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.