STANFORD HEALTH CARE
A PUBLICATION FOR EMPLOYEES OF STANFORD HEALTH CARE
HEALTHY STEPS C-I-CARE AT 5 ROSE THE ROBOT
AROUND SHC Tammy Griffin (left, blue shirt) had the rare opportunity to hear her heart beat in another person’s chest. Griffin had donated her heart to Linda Karr (left, white shirt) after receiving a new heart and lungs from a third donor in an exceptionally uncommon procedure known as a heart-lung-heart domino transplant…Stanford Health Care employees from 11 departments donated 1,019 work attire items to Wardrobe for Opportunity. Jody Leeds, Terri Train, Laura Bravo and LeAnna Fries from ITS are pictured (top row, left) with some of the donations….The Golden State Warriors and College Track partnered with SHC to launch a new mentorship program. SHC employees are mentoring a small group of high school students who are part of the College Track program. Barbara Mayer, PhD, RN, Director of Nursing Quality (top row, middle), is pictured with Warriors player, Andre Iguodala….The UHA Employee Recognition Team (top row, right) sorted and bagged 15,000 pounds of apples to help the Alameda County Community Food Bank get healthy food to those in need.
from the CEO Dear Colleagues, This issue of SHC People marks the five-year anniversary of C-I-CARE being introduced at our organization. More than a communications framework, C-I-CARE has become a way of life here, and I am so proud of what we have accomplished. It is a privilege to hear from so many patients, colleagues, community members and supporters that they see and experience a real difference.
Matching the highest quality care for which Stanford has long been recognized with equally outstanding patient experience has required the active involvement of everyone at Stanford Health Care. When we embarked on this journey, that level of engagement seemed like a huge challenge. Now five years later, the results speak for themselves. From achieving top-tier patient satisfaction scores to actively identifying, monitoring and communicating improvement opportunities, C-I-CARE reflects a widely shared commitment. Our expanding network of partners not only support C-I-CARE but are eager to introduce it to their settings so that caregivers and patients alike can benefit. Being mindful and attentive to how we communicate with patients, families and
STANFORD HEALTH CARE PEOPLE is a publication of the SHC internal communications department: Gary Migdol, Director; Katie Lipovsky, Manager. Photography by Norbert von der Groeben. Jana Chow, Grace Hammerstrom, Sara Wykes, writers. Send comments to email@example.com.
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each other elevates the experience for all of us. I am so appreciative of everyone who contributes to this and am inspired every day to be part of it.
Sincerely, MARIANN BYERWALTER INTERIM PRESIDENT & CEO
ON THE COVER: Racing Hearts organizers Jennifer Navat, Heidi Salisbury and Colleen Caleshu (L to R) of the Stanford Center for Inherited Cardiovascular Disease lead the team from cardiology. All employees who participated in Racing Hearts earned HealthySteps wellness points.
EVERYONE Stanford’s HealthySteps to Wellness Program
W THE HEALTHYSTEPS WAY: THE WELLNESS CHAMPIONS FROM IMAGING SERVICES INCLUDE (TOP ROW, L TO R): DEBORAH WILLIAMS, AUDREY STRAIN, SHEILA GALUPPO, ALISSIA FORRISTAL, ELIZABETH SHERIDAN, TERESA NELSON; MEMBERS OF F GROUND (TOP ROW, RIGHT) PRACTICE RESILIENCY AND STRESS-REDUCING EXERCISES; KURENE FONG TAKES A BLOOD PRESSURE READING FROM CHARLENE RILEY AS PART OF HER ANNUAL BIOMETRIC SCREENING (ABOVE); AND A TEAM FROM CARDIOLOGY (BELOW) GETTING READY FOR THE RACING HEARTS WALK/RUN.
HEN NERY DIAZ COMPLETED HER ANNUAL BIOMETRIC SCREENING, SHE LEFT THE HOSPITAL’S ATRIUM IN SHOCK. HER WEIGHT HAD PUT HER AT RISK FOR DEVELOPING TYPE 2 DIABETES AND HEART DISEASE. RATHER THAN TRY TO LOSE WEIGHT ON HER OWN, SHE ENROLLED IN PREVENT, AN ONLINE HEATH IMPROVEMENT PROGRAM OFFERED TO EMPLOYEES THROUGH THE HEALTHYSTEPS TO WELLNESS PROGRAM AT STANFORD HEALTH CARE.
Diaz is not alone. Jackie Pierson uses HealthySteps to help her young daughter maintain a healthy weight. Robert Fano tracks his steps as part of Imaging Services’ FitBit Challenge. Greg Ciurczak uses the discounted gym membership to maintain his 160-pound weight loss. Nurses from F Ground and the ITA learned self-care techniques to strengthen their resilience and reduce burnout. A team from cardiology earned incentive points by participating in the Racing Hearts event. Employees at every level of Stanford’s vast network of care are participating in the health and wellness activities offered through HealthySteps. Created in 2011, the comprehensive employee health and wellness program is available to all Stanford Health Care and Stanford Children’s Health employees. CONTINUED ON PAGE 4
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“Our mission is to create a culture of care for patients and employees,” said Mary Spangler, Administrative Director, Occupational Health Services, which partners with the benefits department and the University’s Health Improvement Program to deliver HealthySteps. “We try to bring innovative programs and different options to our employees, so that they find something that will work for them and inspire them.”
Eat. Move. Sleep. The goal of the program for 2016 is to have employees come to work “fully charged,” said Wellness Manager Patty de Vries. The theme draws on the work of author Tom Rath, whose books Fully Charged and Eat Move Sleep, outline a path to wellness that starts with eating well, exercising and getting a good night’s sleep. The programs offered through HealthySteps help support these goals. They include discounted gym memberships, health and fitness classes, as well as fitness challenges and quizzes on health and nutrition. For employees who want additional
support to meet their health improvement goals, HealthySteps offers life coaching, counseling and programs that partner employees with trained professionals and peers to help them lose weight, quit smoking, prevent diabetes, and improve their nutrition and fitness. “Employees are our most precious resource, so it is imperative for us to help them optimize their health and well-being,” said Kety Duron, Vice President of Human Resources. “If our employees aren’t feeling at the top of their game, and not taking good care of themselves, they really aren’t present to take care of anybody else.” This year, HealthySteps uses the interactive Keas platform to enable employees to track their personal health goals and activities. Employees can monitor their health and complete fitness and nutrition challenges, and then share their progress and encourage others on the news feed. Available online or through a smartphone app, Keas also allows employees to form teams with work friends and compete against colleagues from other departments. To date, nearly 44 percent of all employees have registered on the Keas platform. “Research shows that it’s the connection with others that often enables or inspires us to make changes,” said Duron.
When Nery Diaz went for her annual biometric screening, she was shocked by the number on the scale. “I had lost weight on my own in the past, but this time I thought I could use some help,” said Diaz, a Senior Bone Marrow Transplant Technologist. So she enrolled in Prevent, an online program to help participants lose weight and reduce their risk of developing type 2 diabetes and heart disease. The program connected Diaz with a personal health coach, sent her a wireless scale for daily weigh-ins and a pedometer to track her activity, and paired her with Prevent members with similar goals. Each week, she completed educational modules on nutrition and exercise, and got feedback from her coach. Diaz lost 16 pounds in 16 weeks.
As a contestant on The Biggest Loser, Jackie Pierson has made great strides in improving her own health. But when she found herself slipping into unhealthy habits and struggling with what to feed her two young daughters, she enrolled in Kurbo, a family-focused weight loss program for dependent children. Each week, a Kurbo coach teaches Jackie’s seven-year-old daughter about exercise and healthier eating habits. The program includes a mobile app where she can track her food choices and activities, play fun games that reinforce healthy lifestyles and participate in weekly challenges. “Kurbo has a way of explaining how to be healthy in a way that both my young girls can understand,” said Pierson, an Intake Coordinator in Outpatient Psychiatry.
Five years ago, Greg Ciurczak was diagnosed with type 2 diabetes and high blood pressure. At 360 pounds, he underwent bariatric surgery in 2014. When he returned to work, Ciurczak joined the HealthySteps program to support his weight-loss journey. He joined a gym, completed his health assessment and now uses the Keas app to track his progress. “The HealthySteps app has given me a lot of information about healthier thinking and health awareness,” he said. “It inspires activity and participation.” Today, Ciurczak exercises three to five days a week, eats more nutritional foods and is 160 pounds lighter. He also helps promote HealthySteps programs at the Outpatient Center in Redwood City, where he works as a Regional Manager for Site Support Services.
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“Since we spend a lot of our time at work, it makes sense to set up programs to support our employees here.”
Have You Completed Your Biometric Screening Today? At the beginning of each year, biometric screening is the first opportunity employees have to personalize their wellness profile, said Lauren Walker, Assistant Program Manager. The 10-minute screening includes measurements of height, weight, blood pressure and waist circumference, and a finger-stick blood test to measure cholesterol and glucose levels. More than 5,000 employees completed their biometric screening in 2016. The second step in completing a wellness profile is to take the health assessment questionnaire. Results from both of these screenings can help identify current or emerging health risks, as they did for Nery Diaz, and let employees see areas where their health is thriving. Sometimes these results alone are the incentive employees need to make a change in their health habits. But HealthySteps also offers financial rewards for getting healthier. Employees enrolled in a hospital-sponsored medical plan can earn credits by completing fitness and nutrition quests and health challenges on the Keas platform. Those credits translate into wellness incentive
dollars that can be contributed to their Health Savings Account (HSA) or Health Incentive Account (HIA). To qualify, employees must be actively employed at the time funds are deposited. In a unique partnership between HealthySteps and the Department of Cardiovascular Medicine, employees who participated in the Racing Hearts 5K or 10K earned 10 incentive points.
Building Resiliency Beyond programs that support physical health, HealthySteps also offers mind, body and spirit workshops to build personal and professional resiliency and help address the burnout and fatigue that can be common among health care workers. When Wellness Manager Patty de Vries was invited to speak at a three-day retreat for ITA nurses, she put together a program to give nurses coping techniques they could use to reduce stress and manage difficult situations. She also conducted compassion cultivation training to improve their sense of well-being and connectedness to others. “I wanted to give my staff tools they could use to take care of themselves,” said Torey Benoit, RN, Nurse Manager of the ITA. “If we don’t take care of ourselves, we can’t take care of our patients.”
Practice Care Coordinators Nadine Massey and Aimee Phy (above) from Los Altos Primary Care are on a mission to get fit and healthy. As HealthySteps Wellness Champions, these two women have rallied their tight-knit group of coworkers to begin a health and wellness journey together. This motivated group now shuns the fast food restaurants near the clinic, opting instead to pack healthy lunches. They also traded in their sugary drinks for water and started working out together at lunch. Their conference room has been converted into a studio for yoga classes, and Massey leads them in a seven-minute workout during their breaks. “We’re all eating healthy together, exercising together and encouraging each other,” said Phy.
Sometimes the best ideas for health and wellness come from employees. That’s why the HealthySteps program began offering grants two years ago to fund departmental wellness efforts. Imaging Services Marketing Manager Sheila Galuppo applied for one of these $500 grants to create an employee wellness program for her department. The FitBit Challenge lets employees like Kandice Garcia (above) track their steps and activities and compete against their Imaging Services colleagues. Each month, the top 10 movers vie for monthly prize drawings for massage gift certificates and movie tickets. “It’s a fun way to connect the employees at all of our 10 sites,” said Galuppo, “and it encourages us to move.”
When Judy Berry-Price came to F Ground as the interim Patient Care Manager in November 2014, she sought to improve her team’s engagement by cultivating a healthy work environment that focused on mind, body and spirit. She consulted with HealthySteps to conduct team-building and resiliency training for her staff. During a three-day retreat, nurses were guided in self-care and resilience-building techniques such as 4-7-8 breathing, mindfulness, meditation and stretching. The HealthySteps team also put together a scavenger hunt to build camaraderie and encourage nurses to have fun. “We partnered with HealthySteps to improve the sense of well-being among our staff,” said Berry-Price, and those efforts have led to much-improved staff engagement scores. STANFORD HEALTH CARE PEOPLE / 5
Five Years of C-I-CARE HERE ARE FIVE WAYS C-I-CARE HAS TRANSFORMED OUR CULTURE
In the five years since C-I-CARE was launched, it has driven dramatic cultural change at SHC and contributed to a rise in employee engagement and patient satisfaction scores. “It has engaged our entire organization,” said Nancy Lee, Chief Nursing Officer and Vice President of Patient Care Services.“Everyone is now focused in the same direction, taking pride in the results,” she said. C-I-CARE was introduced at SHC in 2011, and has remained at the heart of how employees and caregivers communicate and interact with each other, and with our patients. As our organization has grown, so has the impact of C-I-CARE—and everyone has noticed. “C-I-CARE is our shared framework for behaviors and interactions, all of which establish trust with patients and families and among our staff,” said Alpa Vyas, Vice President of Patient Experience. “It has helped us to uncover unmet needs and design solutions or improve processes to help meet those needs.” One example of how C-I-CARE has grown with our organization is the 6 / STANFORD HEALTH CARE PEOPLE
increase in the number of management rounds. In 2011, management rounds were conducted at 62 locations and included 450 leaders. Today, there are 216 locations across 14 campuses, and nearly 1,000 leaders are involved in monthly management rounds. C-I-CARE has become central to SHC’s culture. It has given us a common language and common goals. Although there are many examples, we came up with five ways in which C-I-CARE has transformed our culture.
C-I-CARE Has Facilitated a Culture of Recognition
C-I-CARE has given us tools to reward and celebrate staff. Through the monthly Service Spotlight award, C-I-CARE thank-you notes, and C-I-CARE Reward cards, staff is recognized for putting others first and going above and beyond with acts of compassion. When Elicia Mendoza-Torres, a new patient coordinator for the Hematology/ Oncology group, received a Spotlight Award last summer for her role supporting a family facing a cancer diagnosis, she was surprised to receive the award. In her mind, she was just doing her job. “I have always been an advocate for trying to make life better for any patient I cross paths with,” she said. “But I was glad to show others that even the littlest thing can make a huge impact on somebody’s life.” Recognitions have a positive impact on staff morale. “Prior to C-I-CARE, the lab customer service department’s shifts did not have great rapport with one another,” said John Christopher, Administrative Director Anatomic Pathology & Clinical Laboratories. “Once thank you cards were introduced and encouraged, there was a dramatic change in employee satisfaction and performance.”
C-I-CARE Has Created a Culture of Empathy, Where We Put Others First
Empathy is central to C-I-CARE. Through wayfinding assistance, Service Recovery, and the Engaging Empathy program, which helps participants foster stronger connections with patients, families and colleagues, C-I-CARE encourages staff to look out for anyone who needs help. Lee recently overheard a transporter ask a patient leaving the hospital if he or she would like coffee for the road. She watched the transporter take the patient into the cafeteria, and he paid for the coffee. For Lee, this act of empathy demonstrated what C-I-CARE is all about. “From the minute patients walk in until they leave, we want to make sure we don’t contribute to their anxiety,” she said. “We have a responsibility to support healing.”
C-I-CARE Has Improved Likelihood to Recommend Scores
Today, many Likelihood to Recommend scores are over the 90th percentile, up significantly from where they were when C-I-CARE was launched five years ago. With C-I-CARE, staff is encouraged to pay constant attention to service, display patient satisfaction scores and
C-I-CARE IN REAL TIME. ELICIA MENDOZA-TORRES (LEFT), A C-I-CARE SPOTLIGHT AWARD WINNER; PORTOLA VALLEY PRIMARY CARE CLINIC (CENTER) CELEBRATING THEIR LIKELIHOOD TO RECOMMEND SCORES; AND PATIENT KRISTEN TERLIZZI (RIGHT), WHO EXPERIENCED C-I-CARE FIRSTHAND.
individual comments on visibility walls, and turn patient feedback into actionable solutions. “Likelihood to Recommend scores have a large focus on human-to-human interactions in a business like ours, which is exactly what C-I-CARE promotes,” said Jose Gutierrez, manager of Patient Experience programs. “C-I-CARE encourages staff to think about the patient beyond their medical record number—to think of them as a human being, a parent, a sibling, a son or daughter.”
C-I-CARE Has Created an Environment Where Patients Feel the Difference
Kristen Terlizzi came to SHC at the scariest time of her life. She was pregnant with her second son, diagnosed with a condition called placenta percreta, a potentially lifethreatening pregnancy complication. The severity of her case required that she stay at SHC and Stanford Children’s Hospital for two months postpartum, with care providers from both
C-I-CARE THEN & NOW pre-
61% 62 22nd PERCENTILE
2015 LTR Inpatient
Locations for Management Rounds
LTR Cancer Center
organizations. “When my complications came to light, I felt very unlucky,” she said. “I felt equally privileged to have the care team that I did.” As a patient, Terlizzi didn’t know what C-I-CARE was, but she felt the genuine empathy and compassion of her care team. “When I look back upon my two months at Stanford, it’s those human experiences that leave me in awe. They enabled me to keep my spirit and resilience.”
C-I-CARE Has Created an Environment Where Staff Feel the Difference
C-I-CARE emphasizes respect, positive communication, and continuous improvement, and this has had a tremendous ripple effect in teamwork and engagement. Employee engagement scores have improved each year since C-I-CARE was introduced at SHC, from 61 percent in 2011 to 75 percent in 2015. Bob Pulliam, Clinical Coordinator for Clinic Administration, has worked at SHC for more than 35 years, and he has seen a dramatic change in staff interaction. “Employees are more engaged in asking how things are going,” he said. “Coworkers seem to be asking more thoughtful questions about work and life outside of work. It’s just a friendlier, caring atmosphere.”
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FOCUS ON Occupational Health On any given morning, a small line forms outside Room H0124 on the Ground Floor of Stanford Hospital—an injured night shift worker seeking medical attention, a new hire requiring a physical, a traveler in need of an N-95 fit test, a resident with a needle stick. All of these individuals rely on the care and attention of a small group of medical professionals in Occupational Health Services (OHS). This team of 28 is responsible for the health and well-being of employees at both SHC and Lucile Packard Children’s Hospital Stanford. “We’re here to protect employees from illnesses and injuries that are common in the health care setting,” said Mary Spangler, Administrative Director of OHS. “We do that through regular surveillance and injury care.” Much of the work done by Occupational Health Services is to ensure that Stanford
complies with mandatory guidelines such as annual flu vaccines and TB screenings for health care workers, as well as physicals for all newly hired employees, including faculty and residents, but its scope is much broader. Occupational Health Services treats individuals who are injured on the job and helps to return them to work as soon as possible. Construction workers injured at nearby hospital job sites are also seen by the Occupational Health medical staff. Even the junior volunteers who arrive at Stanford every summer must first be screened by Occupational Health. “For new employees, Occupational Health is their first introduction to Stanford,” said Minal Moharir, MD, Medical Director of the OHS Clinic. In 2015, Occupational Health Services cared for more than 16,000 employees. Its team conducted more than 5,000 new-hire physicals and administered more than 15,000 flu shots. The Stanford clinic is staffed with one physician, three physician assistants, case managers, nurses, medical assistants and a physical therapist. There are two additional OHS clinics at the Outpatient Center in Redwood City and at Cancer Center South Bay. “Occupational Health Services is a very unique clinic,” said Sara Tien, RN, Infection Control Nurse. “We are one of
OCCUPATIONAL HEALTH SERVICES TOUCHES ALMOST EVERY EMPLOYEE AT SHC IN SOME MANNER. ONE WAY IS THROUGH N-95 FIT TESTING, DONE HERE BY FLORENCIA ARNETT (L) AND VANESSA L. REYES (R). THE OHS LEADERSHIP TEAM ALSO HUDDLES EACH DAY TO REVIEW CURRENT WORK
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“Occupational Health Services is a very unique clinic. We are one of the only departments within Stanford that sees almost everybody in the hospital.” the only departments within Stanford that sees almost everybody in the hospital.” In addition to providing care after injury or exposure, the medical staff in Occupational Health is also involved in environmental health and injury protection.
Rapid Return to Work When an employee is injured on the job, the OHS clinic works much like a sports medicine clinic, said Spangler, getting employees seen quickly and providing physical therapy on site to help them begin their recovery as soon as possible. “We make every effort to get employees back to work as soon as we can, and to help them maintain their original level of activity.” When an injury prevents an employee from performing his or her current job, the Transitional Return to Work Program helps to keep the employee working in a position that fits his or her level of ability. Marianne Lee, RN, has firsthand experience with the program. A former floor nurse in the ICU, Lee was injured on the job and treated by Occupational Health Services. Because she was confined to crutches and a knee scooter, the Transitional Return to Work Program placed her in the OHS Clinic and then in Nursing Administration while she recovered. That experience led Lee to her current position as Clinic Manager for Occupational Health. “With the Transitional Return to Work Program, you get to use the skills you have but on a different level,” said Lee. “I was able to use my clinical skills and knowledge from the nursing floor to help in nursing administration.”
FOCUS ON Trauma Services In May, as the SHC Trauma Service celebrates its 30th anniversary, trauma surgeon David Gregg, MD, who led the service from 1986 to 2001, will have a special perspective. High-level trauma care is taken for granted now. Thirty years ago, when Gregg helped to organize what had been an unofficial group into a fast-acting, highly skilled team of doctors and nurses, the concept of nationally recognized protocols for trauma care was just emerging. “The way trauma care had been managed in most local hospitals was in an emergency room that would be open to take trauma patients,” Gregg said. The lack of training, the lack of national standards, the lack of any standardized verification process, he said, was failing patients. SHC’s Trauma Service has remained a leader in the development of this multidisciplinary medical specialty. Since 1998, the program has been verified as a Level 1 provider, the highest level of trauma care recognized by the American College of Surgeons. SHC’s Level 1 adult trauma program is one of just 12 in the state and the only one between San Francisco and San Jose. It also serves as one of three Level 1 pediatric trauma services in Northern California. Last year, SHC’s trauma team treated more than 2,600 patients from its coverage area of the Peninsula’s 2.6 million residents. Many might not consider that trauma care is distinct from emergency medicine, but traumatic injuries are distinctive: Penetrating and blunt force
CELEBRATING 30 YEARS OF SHC’S TRAUMA SERVICES UNDER THE LEADERSHIP OF CURRENT DIRECTOR DAVID SPAIN, MD (LEFT), AND FORMER DIRECTOR DAVID GREGG, MD (RIGHT).
injuries, airway obstruction, fractures and paralysis are included in the list of defined traumas. The first goal of every day is to treat trauma patients, but supporting that care is an ongoing aim toward improvement. “We pride ourselves on trying to figure out better ways to take care of our patients,” said David Spain, current director of the Trauma Service. He took over the service’s leadership in 2001. He has guided many improvements, including new technologies for imaging and information sharing, new ways for SHC to be a resource for all the state’s trauma patients and new approaches to care based on outcomes analysis. The program’s greatest test was the 2013 crash at San Francisco International Airport of an Asiana Airlines flight with 307 people aboard. Of the two Level 1 trauma centers within 25 miles of the airport, only SHC had a helipad. Within 30 minutes of the crash, SHC trauma had paged the staff: More than 150 would be engaged in treating 55 patients. The team aimed at treating as many people as possible within “the golden hour,” said Patrice Callagy, RN,
director, Emergency Services, Nursing. She has been at SHC for nearly 25 years and well knows that that first hour is when as much treatment as possible should be given. “We also know that if you are treated at a Level 1 trauma center, you have a 25 percent greater chance of survival,” she said. SHC’s Trauma Service Manager, Shelly Woodfall, sometimes has to explain to outsiders that trauma care is delivered by a large team: surgical specialists and advanced practice providers from different areas of the hospital, working with nurses with advanced training in trauma patient assessment and management, imaging technicians, and care coordinators, including social workers and case manager. “We have a standardized approach to identify injuries and get those quickly and appropriately treated,” said Woodfall. “Sometimes people will go immediately to the OR, sometimes to the ICU.” “The team’s research on care improvement continues,” said trauma team surgeon Thomas Weiser, MD. “We have to be prepared for what happens not just today, but 5 or 10 years from now.” STANFORD HEALTH CARE PEOPLE / 9
GOOD WORKS Courageous Care Club D1 Unit Chair Lauren Reifsnyder, RN, BSN, grew up in a house of healing. Her mother, a holistic nurse, taught her about relaxation and breathing techniques, guided imagery, massage and aromatherapy, and Reifsnyder applies this knowledge in her own nursing practice. “I’ve always done these things with my patients before pulling out pain and anxiety medications,” she said. “And a lot of nurses on my unit started coming to me to learn some of these techniques for themselves.” So Reifsnyder created the Courageous Care Club, a drop-in space where nurses could come once a month to learn better coping mechanisms for themselves and for their patients. On her days off, Reifsnyder sets up in a conference AS PART OF THE COURAGEOUS CARE CLUB, LAUREN REIFSNYDER, RN, BSN (LEFT), GIVES FELLOW NURSES LIKE HYEUN SOOK CHON, RN, A REFLEXOLOGY MASSAGE.
RACHEL SEAMAN, MD, SHARES HER MINDFULNESS AND MEDITATION PRACTICES WITH THE TEAM AT COLLABORATIVE PRIMARY CARE IN LOS GATOS.
room for three to four hours, makes tea, provides healthy snacks, gives hand and back massages, and leads nurses through guided imagery. Nurses stop in during their 15-minute break, learn techniques to help with their own resilience and coping, and then go to the floor and use these same methods with their patients. “Whether it’s just coming in for a cup of tea or coming in for a mini spa treatment, I think nurses appreciate that there’s this space to relax that’s not a break room with doughnuts and a TV,” said Reifsnyder, who conceived of the club as a way to help reduce burnout. “I thought nurses might be skeptical at first. But when they practice these techniques on themselves, they realize that they can really help, and they’re simple enough to use with patients or coworkers.”
UHA’s Physician Wellness Program As a young physician, Rachel Seaman, MD, hit burnout early in her career. Like most doctors who reach this breaking point, Seaman was able to find her way back to her professional calling. But that experience fueled her desire to make being a doctor a desirable and enjoyable profession 10 / STANFORD HEALTH CARE PEOPLE
again. When a vacancy opened to chair the Physician Wellness Committee at the University HealthCare Alliance (UHA), Seaman volunteered for the job. “I want to help create an atmosphere where physicians are thriving,” she said. “I don’t want others to feel like I once did.” As chair of UHA’s Physician Wellness Program, she’s working to prevent her colleagues from experiencing burnout, which affects 30 and 50 percent of physicians nationwide. “If I can help create happier, more fulfilled physicians, and they go on to each touch 2,000 more lives, it’s a win-win situation,” said Seaman, who is also Medical Director of Collaborative Primary Care in Los Gatos. Over the past six months, the Wellness Committee has developed a program that addresses the primary issues affecting staff fulfillment: ease of work, resiliency and peer support. The group held its first-ever physician retreat on mindfulness in April and is rolling out topical education and training on mindfulness, meditation, nutrition, physical fitness and compassion. “The goal is to create an atmosphere where physicians are thriving,” said Seaman, who spends as much time on physician wellness as she does with her patients. “I really believe that a healthy physician leads to a healthy team and a healthy organization.”
KUDOS January Patient Safety Star Award
CHRISTINA LIGHT Medical assistant Christina Light was scheduling an appointment over the phone with a patient who had been experiencing falls. During the conversation, the patient stopped responding to her. Light heard the television in the background and knew the call was still connected, but she became concerned about the patient’s well-being. Light made several attempts to get the attention of the patient. When the patient was unresponsive after several moments, Light called 911. First responders arrived at the patient’s home, found that she passed out and began providing immediate medical care. For her commitment to patient care and immediate action, Light was presented with a Patient Safety Star Award.
February Patient Safety Star Award MOLLY ACTON AND LISA IKUMA As soon as Molly Acton and Lisa Ikuma came out of the hospital after their shift was over, they noticed someone in trouble: a man in distress near a car parked in the wrong direction—and a woman he had brought to
the hospital was lying on the ground near him. Acton and Ikuma, both physical therapists, immediately helped. Acton started giving rescue breathing to the woman; Ikuma made sure a code was called to bring more help. As more assistance arrived, both Acton and Ikuma stayed with the two patients and provided comfort by talking with them and even offering a hug. Without hesitation, Acton and Ikuma responded to someone in need and showed great compassion, professionalism and strength.
that the man was having a heart attack. Mena showed compassion and concern for the patient and took immediate and appropriate action, earning her recognition as a Patient Safety Star Award winner.
February C-I-CARE Service Spotlight Award LAUREN CARDIN
March C-I-CARE Service Spotlight Award
A patient with breast cancer metastatic tumors in her skin came to Stanford for an injection of chemotherapy into those tumors. Nurse coordinator Lauren Cardin, learned that the patient and her family lived five hours from Stanford—and that they feared the patient would not have the energy to make it to the outpatient clinic to receive the injection. Cardin organized an effort to get the patient those injections while she was still an inpatient. She effectively brought the outpatient clinic to the patient and then stayed with the patient for hours after the procedure to make sure the patient’s wounds were clean and well protected for her journey home.
Maria Hutchison, Patient Testing Technician in the Urology Clinic, showed her dedication to patient-centered care when she stayed past her shift to assist Robert Kessler, MD, with a procedure on a patient who was experiencing discomfort. The patient was sent home about an hour and a half after the clinic had otherwise closed. Hutchison missed her bus and had to take the next one an hour later, although she had personal matters that required her to be home on time that day.“This is just another reminder of the excellent and thoughtful care routinely provided by Maria that we might sometimes take for granted,” said her colleague Mechele Wu, NP.
March Patient Safety Star Award
Congratulations to Stanford Health Care– ValleyCare for receiving full accreditation as a Breast Center of Excellence by the National Accreditation Program for Breast Centers (NAPBC). This accreditation is given to centers that meet rigorous standards and demonstrate a commitment to providing multidisciplinary, team-oriented care to patients in their battle against breast disease.
Parking Ambassador Jilma Mena was honored with the Patient Safety Award for her quick thinking and responsiveness in a critical situation. After Mena greeted a man at the Cancer Center South Bay, he told her that he was having chest pains. She immediately walked the man to a seat and alerted the front desk staff. Mena remained with the man while the patient access team arranged for help. When the EMS team arrived, they determined
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OUR PATIENTS NOW The robot’s movements are controlled by a surgeon who sits at a console near the patient. The tools do exactly what the surgeon would have done by hand, but they do offer extras. The robot’s imaging tool magnifies the area of the body where the surgeon works to 10 times human vision.
“Rose is working really hard. She’s saving a lot of lives. I can’t brag about that enough! And if I ever were to have surgery again, I want to have the robot.”
Introducing Rose, the Robot When she was scheduled for surgery at Stanford Health Care–ValleyCare, Roseline Miller had no idea that she would enter that hospital’s milestone list. She hadn’t really thought about what it might mean to be the first patient treated by SHC–ValleyCare’s first surgical robot in its first gynecological cancer program—until a few minutes before her surgery. “Someone asked me if I had a nickname,” she said. Rose was her answer. “That person went away and came back and told me, ‘We named the robot Rose!’” She briefly saw the robot as she went into the OR and doesn’t remember anything after that until she woke up after the surgery. Miller’s doctor, Trung Nguyen, told her at their first meeting that a robot would be assisting him at SHC–ValleyCare when he removed the cancer found in her uterus. Miller, 78, grandmother of four and great-grandmother of three, wasn’t bothered. “OK,” she said. “I’m ready.”
The advantages of robot-assisted surgery to patients are substantial, Nguyen said. “A patient will have less blood loss, less pain and fewer wound complications.” Nguyen’s experience in the treatment of gynecological cancer includes more than 300 procedures with a robot. Each of the robot’s multiple arms has a different instrument at its end point to provide light, imaging and the appropriate surgical tools for the type of surgery to be done. The arms are as slender as a pencil at the end, inserted into the patient through half-inch incisions.
Everything Nguyen had told her about the advantages of robot-assisted surgery was true for Miller. “I never had pain and I never had bleeding,” she said. She was able to walk a few hours after her surgery. She did enjoy her new claim to fame. “People came in to meet me and would introduce me with ‘Here’s the lady we named the robot after!’” Now fully recovered, Miller is very proud of her metallic namesake. “Rose is working really hard,” she said. “She’s saving a lot of lives. I can’t brag about that enough! And if I ever were to have surgery again, I want to have the robot.” The robot has also given her greater cachet with her great-grandchildren. On her abdomen, Miller has three scars from the incisions where the robot’s tiny arms were inserted. “One of my great-grandchildren always wants to see the three little scars she knows came from the robot,” Miller said. Find more patient stories at stanfordhealthcare.org/now.