Tuesday, April 16, 2013

Brigham and Women's Hospital team: "Glad to know you"

When bombs went off near the finish line at the Boston Marathon, runners and spectators grabbed their loved ones and scrambled to get out of the way.

Joshua Kosowsky and Heidi Crim scrambled to get closer.

Joshua is Clinical Director of the Emergency Department at Brigham & Women’s Hospital in Boston. Heidi is Nursing Director. Both were sitting with me at a conference room in Maryland when the horror of Monday’s carnage entered our consciousness through texts, Twitter and emails. We had a moment of silence for the victims. Moments later Joshua and Heidi were threading their way to the exit doors, en route to the airport, back to Boston and their hospital. They would join their colleagues who were now working on 31 of the 140 people injured in the blasts. Hours later more of the Brigham team would head back to Boston, with those left behind on alert to see if and when they were needed.

For the past couple of days we’ve all been together at the Institute for Patient- and Family-Centered Care (IPFCC) seminar in Annapolis. We patient advocates are here to work with some of the best and brightest people—or at least those actively striving to be the best-- who deliver care at the nation’s hospitals. Our collective mission: to see what we can learn from each other.

Yesterday morning Joshua, Heidi and other clinicians and administrators from “The Brigham”, as it’s called, were assigned to a small work group of 15 people. There were 14 from the Brigham, plus a facilitator from the IPFCC-- and me. The Brigham team had brought along their own Senior Patient and Family Advisor, Martie Carnie (I quickly saw that the team appreciates and relies on her.) So what made me the “lucky one”, the lone non-Brigham person there? Maybe it was pure geography (I’m from Rhode Island). Whatever. I felt lucky to literally have a seat at the table with folks from one of the best hospitals in the world. As to how they’d feel about having me there, I had no clue.

We went around the table introducing ourselves. Maureen Fagan, Executive Director of Brigham's Canter for Patients and Families, set the tone—the Brigham was here for ideas on tackling a challenge: treating people who come in through the Emergency Room with the same embracing welcome they’re known for giving patients who have the advance time to plan their admission. As she concisely explained things, Maureen looked me in the eye. She used my name. I felt “seen”, and included. It encouraged me, as the session continued, to offer my two cents here and there. Joshua asked how we could make clinicians accountable when they do stuff like not wash their hands…the times it’s out of arrogance, not forgetfulness. I had some thoughts on that, too, and he seemed to listen to me. Heidi described what the Brigham “welcome” should feel like. “When you come to us, through whatever route, we need to tell you, to make you feel, that you are ours.”

Later, after more key team members had left for Boston and the rest of us found a television and could begin absorbing the monstrous images, members of her team told us what a great leader Maureen is, and what clarity she brings to their work. They told me that Joshua was really one of the
Janet Razulis & Julie Celano of The Brigham conferring
good guys. That he’d written a tremendous book to help patients navigate their care in the hospital.

Today, the “day after”, our now-smaller group gathered to pick up where we had left off. Power cords snaked from phones whose charges were depleted by the morning’s non-stop texts and emails. The team gathered around iPads to watch as their CEO answered TV  news anchors’ questions calmly and thoroughly. In a world of chaos and unpredictability, the Brigham staff here in Annapolis exuded a quiet confidence…that their team was in place, doing what it was trained to do.

We’re here at this conference looking for tools and allies to achieve a more functional, responsive and patient/family-centered culture of medical care. Yet despite its dysfunction, its imperfections (and yes here are many), there is also this stunning excellence—the culmination and embodiment of massive compassion, training, service and practice. It truly is a beautiful thing.

At its heart, the root of good medical care is compassion. As Martie, the Brigham advocate, says, “we can’t always control the outcome, but we can control the experience”.

Somehow, I think the people going into the Brigham-- yes, even those who never expected to go there and entered through the Emergency Room-- will know just what she means.
Left to right, Shelita Bailey, Lynne Blech, Maureen Fagan, Rosemary O'Malley, Kristen Koch...some of the Brigham team

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