You can do it... we can help.

Have it your way... no, really.

A few weeks ago, I had the pleasure of connecting with an outpatient nurse, named Holly, for a day. It's hard to beat a richer experience than working alongside a nurse for the day. They remind me of Mr. Fix-it, the jack-of-all-trades pretty much. Knowing that my passion is in informatics, she geared the whole day in that regard. As we walked through Holly's daily routines, I reiterated to state the process as is, be 100% honest, and highlight all aspects of IT and informatics within these processes. And boy, did she ever! Before long i had 5 pages of process notes, many of which were highlights of areas for improvement. Many of her process, as I learned, were doing the trick, but it was extremely inefficient. This is because different teams were tasked with creating various widgets/tools, and they weren't interoperable in the end. The result? 378 IT systems across the university. Interface much? Sheesh. By the end of the day, I had a huge tally of process improvement projects to forward on to the hospital strategy and innovation council for consideration. As I've found in the past, some of the best ideas come from a newbie with a neutral mindset... who isn't afraid to speak his/her mind.

Anything you can do i can do betteeeeer.

Working at a massive AMC, I never thought I'd experience stiff internal competition. I gotta tell ya--- things are pretty fierce around this joint. And while it sometimes can work to your advantage in creating innovation and constructive conflict, this definitely isn't the case. So i'm helping to manage a project on anticipatory patient care, and naturally, I took a scan of fellow projects across the health system. While none were identical to what I was partaking in, at least 5-6 were, in some way, shape, or form,  related to or in parallel with our project. It's taken the last 3 months to convince the leadership to have these projects dotted-lined to one another! The result? Saving many months of duplicative work with potentially very similar outcomes. I've started a spreadsheet of both duplicative initiatives/projects and related/parallel projects, with plans to soon share with leadership in hopes of merging efforts. And we wonder why so many projects fail-- lack of communication.

Does that come in platinum?

Being a big bro has been eye-opening these last few months. I think above all else it's made me realize that many kids of Gen-Z have a defining sense of entitlement. An extremely generous donor gave us 2 tickets to the Titans game a few weeks ago-- on the 2nd row back!! We could practically touch the players. So as we left, I asked Andre if he enjoyed the game. He explained how it was okay, but in his thank-you to the donor (which i have him write to every donor/supporter) he was going to request that he get us box seats for next year because these weren't good enough. Wha?! The flipside of this experience has taken a while for me to build but i'm seeing it like so-- people of all types walk this green Earth. Regardless of upbringing, people have different desires in life. My goal is to teach Andre that nothing is free and he must work for it. I want him to see not only the value of a dollar for all people but also the importance of appreciation. A few weeks ago, he told me at the end of a trail hike that I 'am the best big brother ever'. That definitely makes it all worth it... over one hill and on to the next. I guess this is what 'making a difference' is all about...

Multiplicity

Ever been working on something only to later find out someone else was doing the same thing? D'oh! Working in a large decentralized organization definitely presents its challenges. Over the last few months i've been previewing many different parts of the health system and have been exposed to some really cool things. Given that i'm seeing so much in such a short time, and covering so much ground at that, I've started mapping out exactly what i'm experiencing, in the form of observations and themes. It reminds me a lot of scribing your dietary intake or monthly spending habits. You don't realize what's actually happening until you put pen and paper to it. So i started writing down every instance of a project or idea and tagging a person/dept to it. Ever since, i've started putting teams/people in touch when they had similar ideas and/or had already started on a project to address the same issue/challenge. It's amazing how much better outcomes turn out when a more diverse group of heads come together. A nurse brings up different points than a physician, a med tech, a statistician, researcher, analyst, intern, environmental services, and so on. So often only HiPPOS (highest-paid person's opinion) are leveraged for scaling and/or approving major changes at an org. But i often wonder-- why aren't the people on the front line who are most knowledgeable in specific scenarios leveraged more? Why is it so often up to the C-suite to implement change that effects an entire org or dept, when they have no idea of what is actually going on at the front line or the downstream impact(s)?

Some of the most memorable Nashvegas experiences to date? On the city bus. In so many ways, it's opened my eyes to many aspects of life. Intellect, appreciation, open-mindedness, mental health, socioeconomics, respect, patience, time management,  conflict mgmt. What i love most about public transportation, just like subways, is it's classless arrangement... a physician standing next to a disabled military vet, sitting next to a single mother with 3 kids, and 2 broke undergraduate students riding to Broadway. A melting pot, that's for sure!

Playing with silly putty

There's a med for that

Medications, whether over the counter or prescribed, often remind me of cars. It seems that we're forever trying to frame the next big breakthrough in pharmaceutical research without trying to utilize what's already in front of us by way of other products/industries. Have you ever wondered what current products and medications could actually treat and/or supplement treatment for an ailment or condition in which it was not initially intended for? It's no different than aloe vera on a burn or coke on your car battery. It's a practice called repurposing, something that is growing immensely at our hospital research labs. Investigators are targeting previously unknown benefits and uses for existing products. To give you a random example, the mapping process for repurposing could be as unexpected as prescribing prilosec (traditionally for GERD patients) to athletes to minimize exercise-induced asthma. The benefit (and goal) is to ultimately minimize R&D spending by pharmas, the single-greatest expense for medication costs themselves. This is clearly a major avenue for opportunity... stay tuned.

I think you said...

There may soon be an end to the nightmare of filling out 15 pages of the same shcrap when seeing a new doctor (referral or otherwise). Our team is piloting a new platform, whereby previously defined orders (things that doctors submit with "authorization", such as prescription, physical therapy, etc) are saved as templates for future entries. It remains to be seen whether this will be more beneficial for the provider (as a template) or for the patient (in preventing both adverse treatment and carpel tunnel syndrome from the duplicative forms).

Teach 'em early

My new goal for my Little (mentee) is to teach him the value of a healthy, balanced diet. He currently eats fast food numerous times a week, which is never a good sign for someone so young to fall into this track. The previous myth (and really still holding true in majority of America, sadly) was that every person must always clean their plate... seen sort of like the 'American way'. In the 3 weeks we've known each other, we've talked about eating 6-8 small meals per day, preferably using only small plates as a default limiter. I'm a big believer in education as a form of soft power as opposed to merely telling a kid what they can't do, because even if you tell them what they CANNOT do, how will they ever know what they should do? Andre has never been taught this nor the rationale/benefit of doing so, so this is a short-term goal of mine. Soon enough, we'll be talking it up about what he consumes. Baby steps...

Gimme 6 weeks... weeks?!

After getting my bearings for the first several weeks, I've since started working on a project related to recruitment waste. And while this is somewhat unrelated to my interest(s) in IT/informatics, it's a fantastic opportunity for me to make an immediate impact. Last week I led a quasi-kaizen event for nursing stakeholders. The purpose was to streamline the recruiting process for the dept. Why? It currently takes over 6 weeks just to post a position... post! Talk about quick reflexes... there is much work yet to do but the prelim findings are interesting. It's amazing what happens when you get people together to talk things out.

I've started mentoring a boy in the community as part of the Big Brothers Big Sisters program-- we'll call him Andre. It's something I've always wanted to do, so I decided to make it happen. I've only met with him twice yet i've learned so much about myself already. Most notably, appreciation for what I have and the opportunities I've encountered. He's experienced more as a 6th grader than I did as a high schooler; pretty amazing what your surroundings do to you (both of his parents are incarcerated). The highlight of this wknd was his fascination with hybrid cars. He couldn't quite grasp being able to turn on a car with a button OR having a car turn off automatically... blew him away! His curiosity is overflowing, though, that's for sure. I'm looking at how best to channel it for his benefit. Stay tuned...

Boost! Check it out-- a video to continue inspiring you to do good. Talk about passion...

http://www.ted.com/talks/giles_duley_when_a_reporter_becomes_the_story.html

Welcome to the Music City

I never thought music and nature could co-exist outside of Austin but apparently Nashville is from the same breed. Funny enough, the most dangerous thing of it all is that Chuy's is down the street! I've found my "secret" park for what i'd usually say people-watching... except it's sans people. Which is why it's "secret". Well, it's more so because it's downtown and most people live in the burbs. So i have this plush park/gardens all to myself 5 days a week. It's ridiculously nice and includes the state's history with some frilly gardens and a rolling water globe. The view is pretty alright... it's only a straight-on view of the capitol bldg and surrounding lawn. Maybe i'll continue reading there...

Learning the ropes of a new health system always takes time. It's always very interesting to compare different cultures and systems of organizations. I find this to be quite advantageous as i've transitioned across numerous organizations and regions, adapting rather easily to the changing climates. With marathons, music festivals, and various other events year-round, I definitely don't have to look far for things to do.

My brain is on overload with ideas for possible improvements and/or concentrations. I'm continually digesting the opps (stoked!) and will note more on what keeps me roaring in future posts.

Helpful physician review websites

Welcome to the first 'Good to the Last Dot' blog entry!

Because I get this question so often, here are some very useful links (albeit two of many) to use in your future health care exploration…

1. For comparing hospitals

2. For comparing doctors:

www.vitals.com

www.angieslist.com
www.ncbi.nlm.nih.gov/pubmed/

Note that for Vitals.com, I don’t recommend weighting the ratings too heavily, as these are commonly a sound-off for the extremely happy and extremely angry (among your typical selective audience). However, it’s a great reference for reviewing research credentials and industry prominence as you consider potential physicians/procedures. (and FYI, Angie’s List requires a small fee; Vitals.com is free)

For PubMed, you'll be limited to abstracts unless you have academic or research authorization, but it's all still quite useful.

Check back here frequently or follow this page for updates. And feel free to share the link with friends...