Thursday, September 30, 2010

One of my favorite things

No, this is not a Julie Andrews musical about to begin (although I do love watching the Sound of Music every year) but rather a couple more “walkrounds” where I get to spend a few hours with GRMC team members as they show me what it takes to do their job. Recently, I got the chance to shadow employees in the pharmacy department.

The most impressive thing about watching our pharmacy team perform their jobs is the obvious commitment to safety. Checks and double-checks keep the pharmacists and pharmacy techs busy as they go about their daily duties.

On the day I visited our pharmacy, I got an overview of our chemotherapy program. Obviously, these are some of the most powerful and dangerous drugs we administer and keeping tabs on how our patients are responding to the oncologists’ orders is a top priority. The drugs need to kill the cancer with minimal damage to the rest of the patient. I also got an overview of our competency program as one of our pharmacists demonstrated the procedure to clean and test our chemo drug preparation hood. This is a specially-designed containment area for our pharmacists to prepare the chemo drugs for each individual patient. Keeping our pharmacy and nursing staff safe with their exposure to these chemicals is very important.

I also went along with a pharmacist to visit a patient in the process of being discharged. This patient had an extensive list of medications. The pharmacist spent time reviewing in detail each new medication and their possible side effects. The doctor had also made changes to the patient’s previous medications. The pharmacist explained those changes and answered many questions with a caring attitude. Careful notes and explanations were clearly appreciated by the patient.

Finally, I ended my visit to our pharmacy with an opportunity to be a currier! A Des Moines hospital called while I was visiting the department and asked if we had extra of a very expensive chemo drug. Because of the high cost, hospitals do not keep many of this on hand. As it turned out we did have a few doses left in our inventory. I transported the medication to Des Moines that afternoon since I was headed that way for a meeting. It was great to see the sharing that goes on when a patient needs a medication, even those we only keep in short supply.

There are so many excellent staff members dedicated to the best outcome for the patient. These walkrounds always make me feel proud to be a part of healthcare and GRMC.

Friday, September 24, 2010

An Open Letter to HHS Sect. Kathleen Sibelius

Dear Secretary Sibelius,

I enjoy serving on your National Advisory Committee for Rural Health and Human Services. I was particularly pleased to welcome your committee to Iowa for the first time since Governor Bob Ray was the inaugural chair of the committee when it was established in 1987. It was really special to have Gov. Ray welcome the committee to Iowa at its recent three-day meeting in the Amana Colonies.

This year we are focusing our work around three important topics: childhood obesity, early childhood development, and the implications of healthcare reform on rural America. The Honorable Ronnie Cosgrove is our new chair, the former Governor of Mississippi. He enjoyed a real Iowa treat as he took over the reins of our committee.

We assembled a wonderful group of health and human services experts from around the state to give testimony to the committee on these three topics. We also had some good ol’ fashioned Midwestern fun as we introduced the committee to the seven colonies that make up the Amanas.
Good food, neighborly folk, great entertainment, and some serious topics made for a memorable few days here in Iowa. At this time of year, rural Iowans are preparing for the harvest that will feed and fuel the country and world. We witnessed all that work as we toured the countryside.

As you know, your committee meetings are open to the public and for those interested in the agendas for our meetings, you can find them at the committee website:

It was an eventful week and I look forward to helping to prepare our report to you as the committee seeks to keep those who choose to live and work in rural America well- supported with high-quality health and human services.



Monday, September 13, 2010

The Door is Open

I’m in the midst of another round of quarterly open forum meetings with staff. I figure that I have done about 800 of these meetings in the past 16 years. We schedule around eight meetings over the course of four weeks at a variety of times throughout the day and one at 11 p.m. for those who work overnight.

Topics include financials, physicians, medical staff issues, and what’s on the rumor mill. These forums are always well attended and worth the time. I begin with an overview of the topics and that’s usually plenty of information to begin the discussion. I find the dialogue is helpful for me and for those in the room. A small group setting like that can really foster good conversation.

There are some employees I always know will ask a great question and the others in the room will benefit from their willingness to ask something of me that others may be too intimidated to ask. I’m really upfront that I want people to ask the tough questions. If one person is wondering about a question, it’s likely someone else is wondering about it, too. I want employees to know they can talk to me openly without fear of any reprisal from me or their supervisor.

Over the past two years, this organization has cut expenses by 20 percent. Many cost-cutting ideas and suggestions came out of these open forums with employees. A hospital cannot operate without caring and competent staff. I am happy to say our expense reduction was achieved without a lay off. Through creative problem-solving and finding new ways to provide the same high quality healthcare GRMC is known for, our employees stepped up to the challenge.

I extend this open door invitation to the public as well. If people have issues with us that they want to discuss with me, I welcome that call. You’ve no doubt heard the saying, “It takes a village to raise a child…” I would apply that to GRMC. It takes a community to make a great hospital like Grinnell Regional Medical Center.

I’d love to hear from you!

Tuesday, September 7, 2010

Guest Blog: Beat Cancer–Mammograms Are Valuable

The debate over mammography’s value still continues even months after the United States Preventive Services Task Force’s new recommendations. I know that this recommendation and therefore value of mammography has outraged many people in the radiology field.

Most of us see it as taking 10 steps backward. In the early years of mammography, screening was just not done, but so much progress has been made in the early detection of breast cancer! We believe that a decrease of 30 percent mortality rate is largely due to screening mammography.

As the medical world works to eliminate breast cancer, we still need to face the reality. If an abnormality is identified, you want it to be as early as possible. With GRMC radiology technologists as your health partners, you can detect breast cancer early and beat the disease before it’s too late. Our breast imaging partners at Iowa Radiology post their opinions regarding the USPSTF’s recommendations on mammography.

GRMC has an excellent breast health team. Dr. Nicholas Kuiper recently joined Surgical Associates, bringing extensive expertise in breast surgeries – both benign and malignant. He joins the excellent radiologists and breast imaging specialists from Iowa Radiology and oncology specialists already caring for patients at GRMC. We have a breast health team who truly are focused on you.

Seated in Front: Terri Nath, Kathy McNulty
Second Row: Mindi Koehler, Kris Watts, Jean Walston,
Monica Kellogg, William Heggen, MD, Nicholas Kuiper, DO
Third Row: Brooke Uhlmann, Gina Pitman

If our radiologists see a questionable spot on a mammogram, we follow up on the concern. We do this in a quest to make sure it is not a cancer. That’s the point: to make sure it is not cancer. The American Cancer Society continues to support annual mammography screening beginning at age 40. This is a simple noninvasive screening test that helps save lives. Of all the models, the greatest mortality reduction was the annual mammograms starting at age 40.

Someday we may eliminate breast cancer but for now early detection is the best way to beat the disease.

Gina Fuller, RT, (R), (M)