January 2014
From the Medical Staff Office

I want to thank Dr. Robert Folman for the many hours he gave to the Medical Staff Executive Committee (MEC) over the past six years, particularly in his roles as its president and immediate past president.

It is not an especially glamorous job for the most part and requires a lot of time and effort to do it well. Bob did it very well.

I also want to acknowledge the efforts of Dr. Greg Marrinan and Dr. Robert Chessin, our departing Medical Executive Committee members, for their contributions to the hospital’s health during their time on the MEC. The December meeting was also Dr. Peter Tortora’s last meeting as MEC president. He will transition to the immediate past president role. Peter led us admirably in a time of great change and deserves our gratitude.

In 2014, we continue our journey toward becoming a safer, high-reliability hospital by continuing to participate in the Connecticut Hospital Association initiative with Healthcare Performance Improvement (HPI), a consulting group that provides hospitals with specific tools to enhance patient safety. At last year’s Physician Summit, Kerry Johnson, the leader of HPI and a nuclear engineer by training, talked to us about high reliability and safety.

A key feature of safer hospitals is that all of their staff members feel free to speak up if they identify a safety concern. This is a difficult thing to pull off in a very hierarchical structure like a hospital.

We are organized such that patient care technicians and nurses spend much more time with the patient than physicians do, but they may hesitate to speak to the physicians caring for the patient about their concerns because they are intimidated by us. To be a safer hospital, we need to encourage them to bring any significant concerns to us when the occasion arises. The key to obtaining their insight is to recognize that they are an important member of the team and treat them as such. For most physicians this is not a problem, but for a handful of us, this is a real challenge. Unfortunately, the actions of those few make it less likely that staff members will bring their concerns to any of us. That dynamic has to change. I have good reasons to believe we can do this.

First, other more hierarchical systems accomplished this: nuclear submarines, civilian nuclear power plants, commercial airlines and U.S. Navy aircraft carriers. Second, in health care we have one of the best educated workforces in the world. Third, transparency is here and increasing, and an inability to continue to become a safer hospital will be obvious and not sustainable. Fourth, there is greater understanding that the justification that we were trained that way no longer holds much weight; the world has changed. Failure to adapt to the changing environment is not an option.

The good news is that we have made progress. I think that the successful implementation of the time-out in our procedural areas is proof of our progress. However, there remains plenty of opportunity.

For example, everyone gets frustrated, but we should be mindful not to shoot the messenger. When staff members contact us, they are trying to do the right thing for the patient and they certainly aren’t looking to irritate us, so don’t yell at them or use profanity and please try to be patient.

Go out of your way on occasion to get their opinion about a patient. Treating the staff with that level of respect will pay off for you and your patients.

Michael Ivy, MD
Chief Medical Officer