Inside:MassGeneral Marathon Team.. 1

Jeanette Ives Erickson ............ 2Staff Perceptions Survey

Fielding the Issues .................. 3Staff Perceptions of theProfessional PracticeEnvironment Survey

Recognition ............................. 4HAVE AwardOrren Carrere Fox Award

USA Educational Series .......... 5

Exemplar ................................. 6Germaine Lambergs, RN

Health Professions’Billing Project .......................... 8

Patient-Education Video ......... 8

Family CareProgram ........... 9

MedicalInterpreters ........ 10

EducationalOfferings ................ 11

Occupational TherapyMonth ....................... 12

Working together to shape the futureMGH Patient Care Services

CaringCaringMay 2, 2002

H E A D L I N E S

MassGeneral Marathon Team:fighting kids’ cancer... one step at a timeJennifer Roberts, RN, one

of 58 MGH employees to runthe Boston Marathon

this year as part of theMassGeneral

MarathonTeam, passes the20-mile mark on

HeartbreakHill.

The MassGeneral Marathon Teamwas started by Howard Weinstein,

MD, chief of Pediatric Hematology/Oncology, and has helped raise

more than $1.5 millionfor pediatric cancer

research since1998.

Page 2

May 2, 2002May 2, 2002Jeanette Ives EricksonJeanette Ives EricksonStaff Perceptions of the

Professional Practice Environmenta good-news story!

Jeanette Ives Erickson, RN, MS,senior vice president for Patient Care

and chief nurse

I don’t think I’vebeen shy abouttelling you howmuch I look for-

ward to the results of theStaff Perceptions of theProfessional PracticeEnvironment Surveyeach year. This year, Iwas especially pleased tosee a response rate of33%. That represents asteady increase in theoverall response rate ofPatient Care Servicesover the past two years,and a significant increasein the response rate ofnurses. Thank-you fortaking the time to parti-cipate in this survey thatplays such an importantpart in shaping our fu-ture.

I’d like to share someof the results with you so

you can see the wonder-ful progress we’ve madeand, according to yourfeedback, where we stillneed to do some work.

As you know, thesurvey seeks to measureyour impressions ofeight key organizationalcharacteristics, includ-ing:

AutonomyControl over practiceClinician-physicianrelationshipsCultural sensitivityCommunicationTeamworkConflict-managementInternal work motiva-tionI can tell you that for

every organizationalcharacteristic, there wasan upward trend in PCSstaff perceptions this

Purpose of Staff Perceptions SurveyTo offer clinicians an opportunity to parti-cipate in setting strategic direction of PatientCare Services and influencing the entireorganizationTo provide an annual assessment of organi-zational characteristics influencing clini-cians’ satisfaction with their professionalpractice environmentTo enable us to compare patterns of changerelated to organizational characteristicsTo identify opportunities to improve theenvironment for clinical practice

Our Strategic GoalsGoal #1 Enhance communication to promote

employees’ understanding of organizationalimperatives and their involvement in clinicaldecisions affecting their practice.

Goal #2 Promote and advance a professionalpractice model that is responsive to theessential requirements of patients, staff, andthe organization.

Goal #3 Assure appropriate allocation ofresources and equitable, competitive salaries.

Goal #4 Position nurses, therapists, socialworkers and chaplains to have a strong voicein issues affecting patient care outcomes.

Goal #5 Provide quality patient care within acost-effective delivery system.

Goal #6 Lead initiatives that foster diversity ofstaff and create culturally-competent carestrategies supporting the local and interna-tional patients we serve.

year as compared withdata from 2000 and 2001.And overall, cliniciansreport a significant in-crease in personal satis-faction with their workenvironment; more than89% of employees whoresponded reported thatthey were satisfied orvery satisfied with thecurrent professionalpractice environment.This is very good news.

In addition to theupward trend in the data,some of the themes thatemerged from respond-ers’ comments were veryhelpful. You told us that:

Leadership makes adifferenceGood staffing andcollegial support areimportant to a strongpractice environmentClinician-physicianrelationships areintegral to feeling likea partner in decision-makingEffective communica-tion enhances the workenvironment

Positive reinforcementfor a job well done isimportantAdequate supportservices are critical toa unit’s ability tofunction effectivelyAn informed staff ismore responsive tochanges within theunit and the organiza-tion as a wholeConflict-resolution isinfluenced by personaland professionalmaturity, honesty, andan ability to communi-cate effectivelyInterpreter servicesneed to be expanded tosupport quality carefor all patients

These are importantissues to acknowledgeand bring forward. I wantto thank you again forparticipating in the StaffPerceptions of the Pro-fessional Practice Envi-ronment Survey. Yourfeedback will be inval-uable as we craft newprograms for the future,and continue to improvethe systems we alreadyhave in place.

UpdatesI am pleased to announcethat Mary Ellen Heike,RN, has accepted theposition of Women’sHealth staff specialist.

Kathy Hurley, RN,will be interim nursemanager for Bigelow 14during the search forDebra Burke’s perma-nent replacement.

Susan Kilroy, RN,has accepted the positionof clinical nurse spe-cialist for White 8 andWhite 10.

Catherine Grams,RN, has accepted theposition of clinical nursespecialist for the Trans-plant Unit on Blake 6.

Welcome all.

Page 3

May 2, 2002May 2, 2002

Staff Perceptions of the ProfessionalPractice Environment Survey

The Fielding the Issues section of Caring Headlines is an adjunctto Jeanette Ives Erickson’s regular column. This section gives the senior vice

president for Patient Care a forum in which to address current issues, questions orconcerns presented by staff at meetings and venues throughout the hospital.

Fielding the IssuesFielding the Issues

Question: Why do weconduct an annual sur-vey of staff perceptionsof the professional prac-tice environment?Jeanette: The survey isone of the most reliabletools we have to heardirectly from staff abouthow we’re doing. It’s a‘report card’ that helpsdirect our attention tomatters of concern iden-tified by clinicians. From

this survey, as well asother sources of informa-tion, we develop goalsfor the coming year.

Question: How will Ilearn about the results?Jeanette: There are sev-eral ways for you to hearabout the results. Mana-gers will review the re-sults at staff meetingsand provide opportuni-ties for discussion. Fromthese discussions you

may identify areas inyour own practice settingthat need improvementand initiate action steps.I will present the resultsof the survey at GrandRounds. This gives me achance to engage staffand talk openly aboutissues affecting the prac-tice environment.

Question: What exactlydoes the survey mea-sure?

Jeanette: The surveymeasures eight charac-teristics documented inthe literature as influen-tial in determining clin-ician satisfaction withthe professional practiceenvironment. These char-acteristics are: autonomy;control over practice;relationships with phy-sicians; teamwork; com-munication; conflict-management; internalwork motivation; andcultural sensitivity.

Question: How did wedo this year?Jeanette: First, I want tothank you for taking thetime to complete thesurvey. This year, more

than 33%of staffwithin

Patient Care Servicesreturned surveys. That’sa little better than 1 outof every 3 clinicians. Ialways hope for 100%,of course, but 33% rep-resents a good cross-section, and gives usgood insight into theperceptions of staff. Andthe discussions generat-ed by the survey at staffmeetings gives us anoth-er avenue by which tohear the opinions of staffon important issues. TheStaff Perceptions of theProfessional PracticeEnvironment Surveycontinues to be one ofthe most useful tools wehave for ensuring thatMGH remains an excel-lent place to practice anda world-class provider ofpatient care.

Sunday, May 5, 2002Staff Nurse Reception7:30–9:30amTrustees Room, Bulfinch 2

Monday, May 6, 2002Panel Discussion: “Using Adverse Eventsto Enhance Practice and Improve Systems”1:30–3:00pmShriners Auditorium, Shriners Hospital

Tuesday, May 7, 2002“The Power of Nurses”Howard Koh, MD, MPH, MassachusettsCommissioner of Public Health2:00–3:00pmO’Keeffe Auditorium (Reception to follow)

Wednesday, May 8, 2002Research Day: Scientific Sessions“Collaborating to Improve Pain Assessment: a Multi-Disciplinary Thoracic Oncology Team ImplementsJCAHO Pain Standards in the Ambulatory Setting”Barbara Cashavelly, RN, MSN,and Jennifer Tenhover MSN, RN,CS, AOCN“The Use of Respite Care Services by Parents ofChildren with Chronic Illness and Disability”Nancy Terres, RN, PhD10:00–11:30amO’Keeffe Auditorium

Wednesday, May 8, 2002Research Presentation“Nursing Research: ImprovingPatient Care Through ClinicalInquiry”Barbara Wolfe, RN, PhD1:30–2:30pmO’Keeffe AuditoriumReception to follow

Wednesday, May 8, 2002Advanced Practice NurseMillennium Series:“The Role of Reflective Practicein Advanced Practice Nursing”Hollie Noveletsky, RN, PhD5:30–7:00pmO’Keeffe Auditorium

Thursday, May 9, 2002MGH Nursing: the Journeyof a LifetimeJeanette Ives Erickson, RN, MS1:30–2:30pmO’Keeffe Auditorium

Thursday, May 9, 2002Staff Nurse Reception2:30–4:30amTrustees Room, Bulfinch 2

Nurse Recognition Week 2002Schedule of Events

Research posterson display in first-floor

corridor throughoutNurse Week

The EmployeeAssistance Program

presents

“Meditationfor Stress-Reduction”

Presented byBruce Shackelton, EdD

Incorporating meditation into ourdaily lives can help reduce the

level of stress we feel.

This seminar will outline thebasics of meditation and

provide an explanation of thecumulative and short-termbenefits associated with

meditation.

Participants will have theopportunity to experience a

meditation exercise withinstruction from the presenter.

At MGH on June 13, 2002At MGH on June 13, 2002At MGH on June 13, 2002At MGH on June 13, 2002At MGH on June 13, 200212:00–1:00pm12:00–1:00pm12:00–1:00pm12:00–1:00pm12:00–1:00pm

VBK 401VBK 401VBK 401VBK 401VBK 401

At BWH on June 26, 2002At BWH on June 26, 2002At BWH on June 26, 2002At BWH on June 26, 2002At BWH on June 26, 200212:00–1:00pm12:00–1:00pm12:00–1:00pm12:00–1:00pm12:00–1:00pm

ThorThorThorThorThorn Confern Confern Confern Confern Conference Roomence Roomence Roomence Roomence Room

For more information, call 726-6976.

Page 4

May 2, 2002May 2, 2002

n April 12,2002, in theNICU Con-ference Room,

Dorothy Iosua-Gonzales,RN, received the 2ndAnnual Orren CarrereFox Award. The Awardwas established by Eliza-beth DeLana and HenryFox to recognize care-givers in the NICU whosepractice is deemed bycolleagues to best repre-sent the principles offamily-centered care.The award is named forFox and DeLana’s sonwho was a patient in theNICU for the first fewweeks of his life. Foxrecalled the kind andcompassionate care pro-vided to their whole fam-ily in those difficult times.Happily, today Orren is ahappy, healthy, typicallyactive 5-year-old.

RecognitionRecognition

2nd Annual Orren Carrere Fox Award

Award recipient, Dorothy Iosua-Gonzales,RN (holding plaque), and NICUnurse manager, Peggy Settles, RN (left), with family members (r-l): Henry Fox,

Elizabeth DeLana, DeLana’s mom, and Orren (5) and Willy (7) Fox.

O

At reception are (l-r): Peter Slavin, MD, CEO of MGPO;LVC member, Dorothy Martin; MGH president, James Mongan, MD;

and Lourdes (Lulu) Sanchez, manager, Interpreter Services.

“Point to Talk”Program nationally

recognizedn April 8, 2002, in Washington,DC, at the annual meeting ofthe American Hospital Asso-ciation, the MGH Volunteer

Department was honored with the dis-tinguished Hospital Award for Vol-unteer Excellence (HAVE), which rec-ognizes outstanding contributions ofvolunteer programs across the country.

The award recognizes The Lang-uage Bridge Project, and specificallythe “Point to Talk” booklets created byJean Swaim and Dorothy Martin of theLadies’ Visiting Committee, and staffof MGH Interpreters Services. Thebooklets, available in 19 languages,were designed to help improve com-munication between clinical staff andnon-English-speaking patients.

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Page 5

May 2, 2002May 2, 2002

n Wednesday,April 17, 2002,The Center forClinical & Pro-

fessional Development(CCPD) presented itsfirst program in a new,ongoing series of educa-tional programs specific-ally designed for unitservice associates (USAs).

Deborah Washington,RN, director of Diversityfor Patient Care Services,kicked off the series withan interactive programon, “Teamwork.” Wash-ington opened with alively discussion inwhich participants offer-ed observations on theimportance of teamworkand respect. Small-groupexercises gave partici-pants a chance to thinkabout and prioritize theaspects of their work thatare most rewarding andfulfilling. Because ofoverwhelming enthusi-asm, a follow-up sessionhas been added for Wed-nesday, May 15, 2002, topick up where this ses-sion left off.

Trish Gibbons, RN,associate chief for TheCenter for Clinical &Professional Develop-ment, observed, “What awonderful beginning,and how powerful themessages we heard. Ourchallenge now is to con-tinuously improve ourability to create and sus-tain a culture of mutualrespect.”

Two more programsare scheduled. The first

one, to be held Wednes-day, July 17, 2002, willengage participants in adiscussion on: “Whyyour job is so important.”This session will be anew approach to thetopic of infection con-trol.

The following ses-sion will be held Wednes-day, October 16, 2002,and focus on communi-cation.

Members of the USAEducational Series com-mittee are:

Ruth Dempsey, RN,(co-chair) Nancy DeCoste,CCPD, (co-chair)Deborah Washington,RN, director of PCSDiversity

ONew educational series

for unit service associates—by Nancy DeCoste, training & development specialist, and Ruth Dempsey, RN, professional development coordinator

Education/SupportEducation/Support

Cristina Charles, USA,Ellison 10Aura Colon, USA,White 9Eileen Degraan Fla-herty, RN, nursemanager, Bigelow 11and White 11Keith Perleberg, RN,nurse manager, Phil-lips House 20Beverly Cunningham,operations coordinator,Phillips House 20 and22Katrina Toland, opera-tions coordinator,Blake 8 and Ellison 8For more information

about the USA Educa-tional Series, please callThe Center for Clinical& Professional Develop-ment at 6-3111.

Warming up the crowd!Warming up the crowd!

(At left): Washington facilitates discussion on teamwork;(at right): participants engage in a friendly game of catch

to help break the ice and get acquainted.

Do you know all you needto know about advance

directives?The Ethics in Clinical Practice Committee

and the Patient and Family Learning Centerare co-sponsoring an information table

to help educate the MGH community aboutadvance directives. Come learn more about

your options and the importance ofhaving an advance directive.

ThursdayThursdayThursdayThursdayThursday, May 16, 2002, May 16, 2002, May 16, 2002, May 16, 2002, May 16, 20027:00a7:00a7:00a7:00a7:00am –m –m –m –m –4:00pm4:00pm4:00pm4:00pm4:00pm

Main CorridorMain CorridorMain CorridorMain CorridorMain Corridor

For more information, contactEllen Robinson at pager #3-0513

The next issue of Caring Headlines

will be distributed on May 23, 2002,

one week later than scheduled,

to allow for full coverage of Nurse

Recognition Week events.

Page 6

May 2, 2002May 2, 2002ExemplarExemplar‘Never say never’ approach

results in positive breastfeedingexperience for mother

and baby

Germaine Lambergs, RN,lactation consultant

y name isGermaineLambergs,and I am a

lactation consultant forthe Labor & Deliveryand Newborn Familyunits. Years ago, whenwomen wanted to breast-feed their babies theywere pretty much ontheir own. When I wasbecoming a nurse, breast-feeding techniques werenot taught in nursing ormedical schools, and thespin from advertisingand ‘pop culture’ was(and in many cases con-tinues to be) that bottleformula is just as goodas breast milk. There waswidespread belief thatonly poor people andwomen in third-worldcountries breastfed theirbabies. Women whowere unable to breast-feed felt that it was their‘fault;’ their breasts weretoo small or they didn’thave maternal instincts.

I have always believ-ed that knowledge ispower and empowering.When I first met andworked with a lactationconsultant, I knew I hadfound my mission andmy passion. As a lacta-tion consultant myself, Ihave been able to helpwomen as they learn tobreastfeed and at thesame time, I’ve been ableto ‘mother them’ as theylearn to mother theirchildren. I say mother

them because in our fast-paced society, womenare often forced to returnto an active life longbefore they are physical-ly and psychologicallyready. Taking the time totalk to, and teach, moth-ers about their bodiesand how to care for them-selves as they care fortheir newborns is criti-cal. I spend time withbabies’ fathers showingthem how to place pil-lows and supports tohelp their partners breast-feed successfully.

I was recently con-sulted on a case that Ithink illustrates my com-mitment to my patientsand their well-being. Aclinical nurse specialistapproached me with arequest from one of theobstetricians regarding anewly pregnant mother.Mrs. C’s dreams andhopes for a ‘perfect”child had been shatteredwith news that her childwas going to be bornwith a severe bi-lateralcleft lip and palate (acongenital fissure in theroof of the mouth). Mrs.C had looked forward tonursing her baby andwas devastated that thiswould not be able tohappen. The clinicalnurse specialist asked if Iwould call Mrs. C.

Cleft lip and palatecan be a devastating diag-nosis for parents. Their

dreams of the perfectchild are dashed by thefear of disfigurement. Iknew Mrs. C would needa great deal of support inaccepting the diagnosisand coming to grips withthe loss of her dream, butI also knew that herdream of breastfeedingmight not be over. Itwasn’t clear from theultrasound that the babywas totally missing thelip (and therefore theability to suck) or if thelip was present, whichwould allow Mrs. C,with special care andpositioning, to be able tobreastfeed.

I called Mrs. C thatday and introduced my-self. She voiced her sad-ness over the diagnosisand her deep desire tobreastfeed. She told meshe feared that the nurs-ing staff wouldn’t beable to help her feed herbaby given the deform-ity. I promised her thatwould not be the case.She immediately relaxedand we began to talkabout the baby’s diagno-sis. I asked her to tell mewhat she knew. Fromthere, I explained what acleft lip and palate areand how we would dealwith the unknowns—thepresence or absence of alip.

If the baby didn’thave enough of a lip tobe able to suck, Mrs. Cwould have to pump and

then bottle-feed her baby.The idea of using a pumpfor many women is theantithesis of what thebreastfeeding experienceshould be. They feel thatthe intimacy betweenmother and child is re-placed by a piece ofequipment. I spoke toMrs. C about how shecould have a positiveexperience even with theuse of technology.

When I work with amother who will be usinga pump, I spend a greatdeal of time talkingabout the physiology oflactation and also thepsychology involved.Mothers need to relaxand focus on their child.I’ll often have a mothertake a baby blanket orarticle of her baby’s clo-thing and keep it close toher. I’ll ask her to closeher eyes and breathe inthat wonderful smell ofnewborn baby. This re-laxes her, but also themental and sensory im-ages trigger hormonesthat allow the milk toflow. It might be hard torelate to a cold, sterile

breast pump, but thesweet smell of yourbaby—that’s easy. Whena mother feeds her babywith a bottle, I have themhold the child close tothem, skin-to-skin. Thesense of smell is verystrong for a child, andthey quickly come toknow mom by her scent.

Mrs. C and I talkedon the phone for a longtime. I offered to sendher a sample of the bot-tles we use to feed babieswith this diagnosis andadditional informationon the topic. She was sograteful as we said good-bye and promised to callif she had any questionsor concerns. I told her Ilooked forward to meet-ing her when her babywas born, and again Ipromised that our nurs-ing staff would be readyfor her. I immediatelywent to work to keep thatpromise.

One of the greatestthings about MGH is thetalented people who workhere. I contacted the dir-ector of the Feeding

continued on next page

M

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May 2, 2002May 2, 2002

Team and apprised her ofthe situation. We devel-oped a plan to conductinservice training fornurses on feeding a childwith a cleft lip and pal-ate. I videotaped the ses-sion so that staff whoworked off-shift andweekends could haveaccess to this valuableinformation and be com-fortable caring for Mrs.C and her baby. I metwith the nursing staff toreview ways of feedingan infant with a cleft lip.I looked forward to fi-nally meeting Mrs. Cand her family when shedelivered.

As it happened, I wasaway when Mrs. C gavebirth, but when I return-ed she was the first per-son staff told me about.Mrs. C’s obstetrician, thenursing staff, and feed-ing team all told me howsmoothly everythingwent. Happily, the babywas born with enough ofa lip to breastfeed. Mrs.C was ecstatic. Staffrelayed Mrs. C’s disap-pointment at not beingable to meet me andthank me personally.

I subsequently learn-ed that the baby wasscheduled to have cor-rective surgery.

I love my work.

Comments byJeanette IvesErickson, RN, MS,senior vice presidentfor Patient Care andchief nurse

For most women thedecision to breastfeed is

made long before theirbaby is born, and thatwas the case for Mrs. C.When it was discoveredthat Mrs. C’s baby wouldbe born with a cleft lipand palate, she turned toGermaine for guidanceand support. What shegot was the full benefitof Germaine’s years ofexperience, expertise,and compassion. In asingle phone call, Ger-maine was able to calm,reassure, and empowerMrs. C as she preparedfor the birth of her baby.But Germaine didn’t

The Employee Assistance Programpresents

“Effective Communication”Many issues related to interpersonal

relationships and teamwork can be attributedto a lack of communication skills and/ordifferent styles of communicating. This

seminar will highlight some components ofeffective communication and offer

suggestions for dealing with individualswhose communication style may be

different from our own.

May 9, 2002May 9, 2002May 9, 2002May 9, 2002May 9, 200212:00–1:00pm12:00–1:00pm12:00–1:00pm12:00–1:00pm12:00–1:00pm

WWWWWellman Conferellman Conferellman Conferellman Conferellman Conference Roomence Roomence Roomence Roomence Room

For more information, call 726-6976.

stop there. She took theinitiative to educate allmembers of the nursingteam to ensure continuityof knowledge and skill.Her preparation was sothorough that despiteGermaine’s absencewhen Mrs. C delivered,she was able to success-fully breastfeed her baby.

So much of the prac-tice of nursing takesplace behind the scenes;sometimes we don’t evenget to witness the happyoutcomes we help toachieve.

Thank-you, Germaine.

The Employee Assistance Programpresents

“Working and Breastfeeding”Presented by

Germaine Lambergs, RN, lactation consultant

This seminar will provide expectant andnursing parents with the basics on how

to use breast pumps and how to maintain amilk supply while working. Assistance andguidance will be provided around potential

problem situations.

Time will be allotted for a tour of the Mother’sCorner Lactation Room.

May 21, 2002May 21, 2002May 21, 2002May 21, 2002May 21, 200212:00–1:00pm12:00–1:00pm12:00–1:00pm12:00–1:00pm12:00–1:00pm

VBK 401VBK 401VBK 401VBK 401VBK 401

For more information, call 726-6976.

ExemplarExemplarExemplarExemplarExemplarcontinued from page 6

Call for Research Proposals!Yvonne L. Munn Nursing Research

ProgramThe Yvonne L. Munn Nursing Research

Program supports research initiated by MGHnurses for the purpose of improving the care

of patients and families.

Research proposals are now being acceptedby The Center for Clinical & Professional

Development, Founders House 636.

Applicants must be MGH clinical nurses.

Deadline for submissionsDeadline for submissionsDeadline for submissionsDeadline for submissionsDeadline for submissionsis August 24, 2002is August 24, 2002is August 24, 2002is August 24, 2002is August 24, 2002

PrPrPrPrProposals should be submittedoposals should be submittedoposals should be submittedoposals should be submittedoposals should be submittedto Brian Frto Brian Frto Brian Frto Brian Frto Brian French, Founders 636ench, Founders 636ench, Founders 636ench, Founders 636ench, Founders 636

For more information, call 724-7843

Infectious Disease Update:Nursing Implications and

PerspectivesTopics to include:

Current issues in the managementof HIV/AIDSHepatitis B and CSexually transmitted diseasesTB and parasitic infectionsBioterrorism

WWWWWednesdayednesdayednesdayednesdayednesday, May 22, 2002, May 22, 2002, May 22, 2002, May 22, 2002, May 22, 20028:00am–4:30pm8:00am–4:30pm8:00am–4:30pm8:00am–4:30pm8:00am–4:30pm

Starr ConferStarr ConferStarr ConferStarr ConferStarr Conference Centerence Centerence Centerence Centerence CenterCharles River PlazaCharles River PlazaCharles River PlazaCharles River PlazaCharles River Plaza

Registration fee: $35For more information, call 617-726-0984

Come take a DIPat the Treadwell Library!

Treadwell Library, the Cancer ResourceRoom, and The Friends of the MGH Cancer

Center are introducing a new digital collectionof information for cancer patients (DIP).

Dip provides access to more than 400 full-textarticles, chapters, pamphlets and fact sheets.

MondayMondayMondayMondayMonday, May 6, 2002, May 6, 2002, May 6, 2002, May 6, 2002, May 6, 200212:00–4:00pm12:00–4:00pm12:00–4:00pm12:00–4:00pm12:00–4:00pm

TTTTTrrrrreadwell Librareadwell Librareadwell Librareadwell Librareadwell Libraryyyyy

TTTTTuesdayuesdayuesdayuesdayuesday, May 7, 2002, May 7, 2002, May 7, 2002, May 7, 2002, May 7, 2002Bulfinch patioBulfinch patioBulfinch patioBulfinch patioBulfinch patio

Ice crIce crIce crIce crIce cream will be served.eam will be served.eam will be served.eam will be served.eam will be served.

For more information, call 6-8600

Page 8

May 2, 2002May 2, 2002

he AmbulatoryHealth Profes-sions Billing(AHPB) Project

reached another mile-stone on Monday, April12, 2002, when SocialServices went ‘live’ onthe Ambulatory HealthProfessions WorkloadManagement System.What this means is thecomplete elimination ofmanually completed,paper encounter forms asSocial Services convertsto the new computerizedsystem. This installationmarks the most recentelectronic conversion forthis project, which in-cludes Physical Therapy,Occupational Therapy,and Speech-LanguagePathology, on the maincampus and at healthcenter locations includ-ing Charlestown, Revere,

Chelsea, and MGH Westin Waltham.

The AmbulatoryHealth Professions Bill-ing Project began inMarch of 1999, and hasreceived two Partners inExcellence Awards forthe core product and aMedicare managementmodule that was addedlater. The computerizedprogram automates thepatient’s entire encounterprocess from the point offirst contact to comple-tion of care.

In the past, keepingtrack of referral and visit-authorization informa-tion had been a difficultand sometimes over-whelming task. The elec-tronic system enablesclinicians to spend moretime delivering patientcare by eliminating re-dundant business pro-

cesses, providing conti-nuity of information,managing insurance com-pliance, and enhancingrevenue-collection capa-bilities.

David Romagnoli,MS, RRT, NHA, seniorproject specialist forPatient Care Services,reports, “The benefits ofthis product continue toimpress us and often gofar beyond our originalexpectations. We havebeen able to make sys-tem enhancements tobuffer providers from thedemands of complex andfrequently changing in-surance and regulatoryrequirements. Clinicianscan remain focussed onpatient care while weadjust the system to meetchanging rules.”

Paper encounter-formprocessing for the more

than 50,000 visits peryear in the health profes-sions is officially non-existent. Support staffmanage referral informa-tion while providers man-age clinical information.Charge reports contain100% of the informationrequired before movingforward to Revenue Con-trol. The longest delay inprocessing is seven days.Occasionally re-work isnecessary to managedifficult insurance auth-orizations, but this israre. The electronic vali-dation system reducesthe amount of rejectedcharges sent to RevenueControl to almost non-existent.

Each site manages itsencounter and authoriza-tion process separately.In the event assistance isneeded from staff on themain campus, central-ized support is available.Bill Fair, LICSW, clinicalsystems coordinator,says, “Conversion to theAmbulatory Health Pro-fessions Billing System

Social Services enjoysambulatory patient processing

with no encounter forms

T

has been extremely help-ful for the ambulatorypractice of the SocialService Department. Wenow have a system ofchecks and balances notpreviously available. Wecan verify that everypatient seen for psycho-therapy is billed appro-priately. We are betterable to confirm patients’insurance coverage priorto their visits, and havedata readily accessible ifproblems do arise. TheAmbulatory Health Pro-fessions Billing Projecthas improved the effi-ciency of the entire bill-ing process, resulting infewer problems and im-proved patient care.”

Continued advance-ments will enable us tolook at historical trendsusing data we’ve beencollecting for more thantwo years. Preparation isunder way for changesthe Patient Administra-tive Cycle EnhancementProject will bring, whichwill be rolled out overthe next two years.

patient-education aroundpost-operative care andthe discharge process.

Ellison 19 nurse man-ager, Colleen Snydeman,RN, suggested creatingan educational video as ameans to inform patientsand families about thedischarge process and asa tool to teach patientshow to care for them-selves at home after sur-

gery. With funding fromThe Making a DifferenceGrant Program, staff fromthe three surgical areascollaborated to produce avideo entitled, Post-Op-erative Discharge Plan-ning.

Patients and familieswill be able to view Post-Operative DischargePlanning on the hospi-tal’s closed circuit tele-vision station free of

charge. Clinicians canthen tailor their teachingto the unique concerns ofeach patient. Procedure-specific information willalso be available on-lineat the MGH website.

Dr. William Abbott,physician leader for thesurgical CPM group,says, “The making ofthis video has been atruly collaborative effort.Nurses, surgeons, casemanagers, administrativedirectors, and projectspecialists from the De-cision Support Unit allcontributed.”

New patient-education videopromotes discharge planning

—by Rosalia Chow, project specialistDecision Support & Quality Management Unit

The surgicalClinical Perfor-mance Manage-ment (CPM)

team is a group compris-ed of leaders from Gen-eral, Vascular and Thor-acic Surgery, that focus-es on clinical improve-ments that will impactpatient care throughoutthe surgical service. TheCPM team has been ex-ploring ways to improve

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Technology/ResourcesTechnology/Resources

Snydeman encourag-es all clinicians caringfor surgical patients toview the video and urgetheir patients to watch it,too, so they can be active-ly involved in the dis-charge process. SaysSnydeman, “The infor-mation presented in thevideo is applicable tomost surgical patients. Itprovides basic guidelinesto patients on how bestto care for themselves athome.”

For information aboutthe video, contact RosaliaChow at 6-5214.

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May 2, 2002May 2, 2002

Published by:Caring Headlines is published twice eachmonth by the department of Patient Care

Services at Massachusetts General Hospital.

PublisherJeanette Ives Erickson RN, MS,

senior vice president for Patient Careand chief nurse

Managing Editor/WriterSusan Sabia

Editorial Advisory BoardChaplaincy

Mary Martha Thiel

Development & Public Affairs LiaisonGeorgia Peirce

Editorial SupportMarianne Ditomassi, RN, MSN, MBAMary Ellin Smith, RN, MS

Materials ManagementEdward Raeke

Nutrition & Food ServicesPatrick BaldassaroMartha Lynch, MS, RD, CNSD

Office of Patient AdvocacySally Millar, RN, MBA

Orthotics & ProstheticsEileen Mullen

Patient Care Services, DiversityDeborah Washington, RN, MSN

Physical TherapyOccupational Therapy

Michael G. Sullivan, PT, MBA

Police & SecurityJoe Crowley

Reading Language DisordersCarolyn Horn, MEd

Respiratory CareEd Burns, RRT

Social ServicesEllen Forman, LICSW

Speech-Language PathologyCarmen Vega-Barachowitz, MS, SLP

Volunteer, Medical Interpreter, Ambassadorand LVC Retail Services

Pat Rowell

DistributionPlease contact Ursula Hoehl at 726-9057 for

all issues related to distribution

Submission of ArticlesWritten contributions should be

submitted directly to Susan Sabiaas far in advance as possible.

Caring Headlines cannot guarantee theinclusion of any article.

Articles/ideas may be submittedby telephone: 617.724.1746

by fax: 617.726.8594or by e-mail: ssabia@partners.org

Please recycle

Next Publication Date:May 23, 2002

2000. The program offers aninterdisciplinary care-manage-ment approach with a register-ed nurse and clinical socialworker enhancing the care pro-vided by the patient’s desig-nated caregiver.

Joan Monahan, RN, andAlice Rotfort, LICSW, of theFamily Care Program, mademany visits to Billy and Steph-en’s home during the course ofBilly’s illness. These visitsallowed Monahan and Rotfortto assess Billy’s personal careneeds and explore the mosteffective and nurturing ways toaddress those needs. Says Rot-fort, “Quite often, home visitswere filled with stories, family

lore, and conversations aboutthe realization of living with aprogressive chronic illness.Those special moments infusethe program with its uniquecharacter and create opportu-nities to discover creative solu-tions to problems.”

At the reception on April 2,Billy’s parents, Mr. and Mrs.Edward Kirrane, and other fam-ily members shared stories andfond memories of the visits,support, and kindness given toBilly and Stephen in the lastfew years of Billy’s life.

For more information aboutthe MGH Family Care Programplease contact Eileen White at617-724-0759.

MGH Family Care Programrecipient of memorial donation

—by Alice Maron Rotfort, MSW, LICSW

Social ServicesSocial Services

n April 2, 2002, at asmall, informal recep-tion in the WalcottConference Rooms,

family, friends, and caregivers ofBilly Kirrane gathered to acknow-ledge a generous donation madeby the Kirrane family to the MGHFamily Care Program, a serviceoffered by the department ofSocial Services since 1978. Thedonation, in memory of WilliamJ. Kirrane, directly benefits fami-lies in the program by helping toprovide services that enable pa-tients to maintain an independentlife style.

Billy Kirrane and his partner,Stephen Drenga, participated inthe program for almost five yearsup until Billy’s death on June 7,

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Caregivers, Alice Rotfort, LICSW (wearing ID badge), and Joan Monahan, RN (in light suit directly to the right of Alice),surrounded by members of Billy Kirrane’s family. Mrs. Kirrane and Stephen hold framed mementos

of the occasion presented to them at the reception.

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May 2, 2002May 2, 2002

ne of the manyreasons health-care profes-sionals enter

the field is because theyderive pleasure and satis-faction from caring forpatients, answering ques-tions, and educating peo-ple. It can be frustratingfor everyone involvedwhen communicationbecomes an issue bet-ween caretakers and pa-tients.

Medical interpreters,when used effectively,improve interactionswith non-English speak-ing patients. Rather thanthinking of interpretersas a ‘third party,’ medi-cal interpreters should beconsidered part of thehealthcare team, profes-sionals working in col-laboration with clini-cians to help overcomecommunication barriers.

Because most provid-ers don’t work with med-ical interpreters on aregular basis, it’s under-standable that there willbe questions about thebest way to work with aninterpreter to help thepatient and the providerget the most out of theinteraction.

If you are a clinicianpreparing to interact witha non-English-speakingpatient, before enteringthe patient’s room, spenda minute giving the med-ical interpreter somebackground about thepatient and his or herhistory. This will help

the interpreter betterunderstand the situationand your objectives forthe encounter.

When you enter theroom, introduce yourselfand the medical interpret-er to the patient. As youspeak to the patient, con-tinue to address him orher with direct statementssuch as, “Can you tellme where it hurts?” Donot ask the interpreter to,“Ask her where it hurts.”

Make eye contactwith your patient whileasking questions andlistening to responses.It’s important to matchyour body language withthe words you’re saying.Non-English-speakingpatients pick up on vis-ual cues as well as verbalcommunication.

Patients from othercultural backgroundsmay tend to integratetheir treatment regimenwith their own particularhealth model and tradi-tions. They are morelikely to comply if theyfeel you are trustworthyand care about their bestinterest. Focusing on thepatient instead of theinterpreter, and provid-ing thorough explana-tions of diagnoses, tests,and treatments can helpbuild a sense of trust.

Pause periodically toallow the medical inter-preter to interpret whatyou have said. Feel freeto ask the interpreter torepeat what you’ve saidif you are concernedabout accuracy. Be cer-tain the patient under-

stands you by repeatingprevious statements ifnecessary. Do not inter-rupt a patient’s response;gently steer them backon track if they start toprovide irrelevant orextraneous information.

The medical interpret-er will enter and leavethe patient’s room whenthe provider does. Thisprevents patients fromdiscussing issues withthe medical interpreter inthe absence of a clinician.The interpreter will inter-pret everything that issaid, so be careful not tothink out loud in front ofpatients.

After the encounter,spend a moment with themedical interpreter toconfirm that the patientunderstood the discus-sion. The interpreter cantranslate short writteninstructions if necessary.Conclude by document-ing the presence of themedical interpreter in thepatient’s record. Legally,

Working effectivelywith medical interpreters

—by Andrea Beloff, administrative fellow

it is your responsibilityto document a patient’srefusal to use a medicalinterpreter and/or when amedical interpreter isunavailable for an en-counter.

The Office of Inter-preter Services is openweekdays from 7:00am–midnight, and weekendsfrom 10:00am–10:00pm.Not all interpreters arepresent when the officeis open, so requesting aninterpreter in advance isstrongly recommended.

During office hours,call 726-6966 to requestan interpreter. Afterhours, call 724-5700 andenter:

3-0001 for a Spanishinterpreter3-0003 for a Portu-guese interpreter3-0005 for an Arabicinterpreter3-0009 for all otherlanguages and authori-zation to use thetelephone services.

Medical InterpretersMedical Interpreters

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Contrado bidsfarewell to MGH

athleen Contrado, team leaderambassador, who has been afixture at the White Informa-tion Desk, bids a fond fare-well to MGH after 26 years.Contrado worked the early-

morning shift, arriving at the hospital asearly as 5:15am each morning.

Says Contrado, “I’ll miss seeingeveryone as they come into the hospital.I’ve met so many wonderful people overthe years. It’s going to be hard to saygood-bye.”

April 30, 2002, was Contrado’s lastday. On May 1st, Contrado was off toAtlantic City for a well-deserved vaca-tion. Bon voyage, Kathy. Thanks for thememories!

KK

2002

2002

May 2, 2002Educational OfferingsEducational Offerings

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May 2, 2002

DescriptionWhen/Where Contact Hours

For more information about any of the above-listed educational offerings, please call 726-3111.For information about Risk Management Foundation educational programs, please check the Internet at http://www.hrm.harvard.edu

Continuous Renal Replacement Therapy(an offering of the ICU Consortium), St. Elizabeth’s Medical Center

TBAMay 138:00am–3:30pm

CPR—American Heart Association BLS Re-Certificationfor Healthcare ProvidersVBK 401

- - -May 147:30–11:30am,12:00–4:00pm

Pediatric Advanced Life Support (PALS) Re-Certification ProgramVBK601

TBAMay 148:00–12:00am

Conflict Management for OAs and PCAsVBK601

---May 161:00–2:30pm

Nursing Grand RoundsO’Keeffe Auditorium

1.2May 161:30–2:30pm

Social Services Grand Rounds“Basic Human Needs in Mediation and Negotiation.” For more informa-tion, call 724-9115.

CEUsfor social workers only

May 1610:00–11:30am

Post-Operative Care: the Challenge of the First 24 HoursWellman Conference Room

8.7May 208:00am–4:30pm

Pediatric Cardiac Series–Part IIIVBK 601

---

BLS Instructor ProgramVBK601

13.2for completing both days

May 22 and 238:00am–4:30pm

New Graduate Nurse Development Seminar IITraining Department, Charles River Plaza

5.4 (contact hoursfor mentors only)

May 228:00am–2:30pm

Psychological Type & Personal Style: Maximizing Your EffectivenessTraining Department, Charles River Plaza

8.1May 228:00am–4:30pm

ICU Consortium Critical Care in the New Millennium:Core ProgramSEMC

45.1for completing all six days

May 28, 29 and June 3, 4, 10, 117:30am–4:00pm

May 207:30–11:30am

This program hasbeen cancelled

Wound and Skin Care:Common Problems, Common ProductsTraining Department, Charles River Plaza

---May 30TBA

Basic Cardiac PacingVBK601

---May 281:00–3:00pm

Advanced Arrhythmia Interpretation ProgramHaber Conference Room

7.8May 308:00am–4:30pm

Chemotherapy Consortium Core ProgramWolff Auditorium, NEMC

TBAJune 48:00am–4:30pm

CPR—American Heart Association BLS Re-Certificationfor Healthcare ProvidersVBK 401

- - -June 67:30–11:30am,12:00–4:00pm

Nursing Grand RoundsO’Keeffe Auditorium

1.2June 61:30–2:30pm

OA/PCA/USA Connections“Working Together with Chaplaincy to Assist our Patients.”Bigelow 4 Amphitheater

- - -June 121:30–2:30pm

Mentor/New Graduate RN Development Seminar ITraining Department, Charles River Plaza

June 128:00am–2:30pm

6.0(mentors only)

Page 12

May 2, 2002May 2, 2002

CaringGRB015

MGH55 Fruit Street

Boston, MA 02114-2696

CaringH E A D L I N E S

First ClassUS Postage PaidPermit #57416

Boston MA

Occupational TherapyOccupational TherapyOccupational Therapy

Month at MGH!he MGH commu-nity had an oppor-tunity to learn first-hand about the im-

portant work of occupation-al therapists on Wednesday,April 11, 2002, as MGHcelebrated National Occupa-tional Therapy Month. OTsrepresenting inpatient, out-patient, and psychiatric ser-vices staffed eduationaltables in the Main Lobbyproviding information aboutjoint-protection, ergonomics,proper backpack fit, splints,stress, low vision, and otherimportant factors for max-imizing function in activit-ies of daily living.

As part of the event, thedepartment raffled off abackpack.

T

Above (l-r): Yvette Kershaw,

occupational therapy assistant;

Amy Orroth, OTR/L, senior

occupational therapist; and

Kate Russo, OTR/L, staff

occupational therapist, talk

to MGH visitors and passers-by

about services provided by

the MGH Occupational

Therapy Department.

Above: Dyna Schmeltz, OTR/L, staff occupational therapist,

helps visitor perform exercise to test her hand-eye coordination.

At right: Schmeltz and staff occupational therapist, Lori Loughlin,

OTR/L (right), accept raffle entry from Trish Gibbons, RN,

(who, coincidentally, went on to win the backpack!)