Did you know GRMC offers childbirth classes?

Guest post by Ashley Grundler, graphic designer, GRMC

My husband, Chris, and I have been attending weekly childbirth classes through GRMC. The two-hour classes run for four weeks on Tuesday evenings. These classes seem to be a bit of a hidden gem and I'm here to tell you, they are a must for any first-time parents.

So far we've attended two classes that have touched on everything from discomforts of pregnancy to what to expect during labor and delivery. And can I just say, I have learned so much!

Kim Jones, RN, is an experienced OB nurse and she has carefully walked us through breathing techniques, showed us equipment we shouldn't be startled to see during delivery, and truly prepared us for what to expect once we arrive at the hospital.

I urge all expecting moms and dads to attend this wonderful and informative four-week class. I already feel less anxious about childbirth and my husband feels more comfortable in his role as my labor support person.

It won't be long now before our daughter is born. These classes answer questions we didn't know we had and have eased a lot of our fears. Our doctors and the staff at GRMC have been with us every step of this journey. We are enjoying these last weeks of pregnancy and are looking forward to welcoming our daughter soon!

Please, don't hurt the ones you love...

The current national debate over the federal budget and debt limits/debt reduction could have a severe impact to hospitals and healthcare centers across the country. Some in Congress are considering a $100 billion cut in Medicare and Medicaid reimbursements to hospitals. These funding programs exist to care for persons with disabilities, seniors, children, and the most poor in our nation.

Most people know the financial challenges that Grinnell Regional Medical Center has faced because of already low reimbursement from Medicare and Medicaid. More than half of our patients rely on these programs for their primary health insurance. Cuts in these programs affect all of us, whether we use them ourselves or not.

All over the country, hospitals just like GRMC are open 24/7 and stand ready as the only source of medical care for millions of Americans. Please, join me in telling Congress to protect hospital care.

To learn more, go to http://www.protecthealthcare.org/

Another measure of quality healthcare

The following is a guest blog, written by Janet Lacey, director of patient experience at GRMC.

"Our way to create and enhance a service excellence journey to build patient loyalty, foster teamwork, and celebrate the joy of caring."

The phrase above sums up our Compassion in Action service initiative program. We recognize employees and volunteers as they are "Caught In The Act" of providing exceptional service, of going above and beyond what's expected. We have been following this and other paths for years to provide patients with quality healthcare, and an outstanding experience, all at a good value.


For the next several weeks, GRMC employees will participate in short, effective 30-minute meetings called "huddles." These sessions are just like football huddles: short, to the point, and unite us as a team.

Quality huddles contain information for GRMC employees that explains a new program from the Centers for Medicare and Medicaid Services called Value Based Purchasing. VBP as it is known, is an initiative required by the Patient Protection and Affordable Care Act. Through the VBP, CMS will withhold one percent of hospitals' Medicare inpatient payments as an incentive for meeting quality measures. Hospitals can earn back part of that withheld payment by how well we meet certain standards of quality.

This program starts on July 1, 2011, just a couple of weeks away. But, at GRMC, the focus has always been on quality healthcare. The incentive payments are definitely important, but we focus on quality for one major reason. We want to keep our patients as safe and well cared for as we possibly can. After all, we are caring for each other's friends, family, and neighbors.

Over the next few weeks, all employees will participate in a huddle to learn more about the program and how important every single staff member is to this process. The huddles will explain how the safety and satisfaction of our patients, HCAHPS survey scores, Core Measures, and Value Based Purchasing all interact, what they mean, and how we can use them to improve the quality of care delivered at GRMC.

Walking In the Shoes of the Revenue Cycle Team

Recently, I had the pleasure of walking in the shoes of another great GRMC department, the revenue cycle team. This department includes admitting, coding, and patient accounting. A "walk in the shoes" is like a job shadowing experience and I learn new things about the various functions that employees do everyday to make this hospital run smoothly.

What a very busy and complex world the revenue cycle team lives in each day!

Let's walk through it from a patient's perspective:
It all begins with a physician order for the patient to get care from the hospital. When the patient arrives, they are greeted by our resource nurse and/or our volunteer. If they need their car parked or have a question with the order, the resource nurse is there to help. The volunteer helps organize the patient's trip through the process and often escorts them exactly where they need to go.

The admitting clerk goes through a very detailed process of making sure we have all the necessary information so the patient receives the care or service they came to the hospital for and so the hospital can appropriately bill for those services.

The patient receives an identification wristband and then they move on for testing, a procedure, treatment, or whatever brings them to GRMC that day.

What happens behind the scene is vitally important for the patient, even though they may never meet these staff members. After the service is provided to the patient, a record is established and sent to the coding team. Their job is to convert the record of the care the patient received into one of what seems like a zillion codes to be submitted on a bill to Medicare, Medicaid, or a private insurance company. This is very detailed work.

The coded description of the care the patient received at the hospital is sent to our staff members who create and submit the bill to the insurance company, Medicare, or Medicaid for payment.

When the hospital receives payment from the insurance company or from Medicare or Medicaid, it is time to create and submit a bill to the patient if needed. At GRMC, we have outsourced this activity to a third-party billing company and information is submitted to them to create a bill for the patient.

We also have cashiers who interact with patients directly that might not have insurance. The cashiers receive payments or help patients set up a payment plan.

Bottom line: these employees have challenging jobs because the details frequently change and the work can be very complicated. I was impressed with the cross training that employees have and the team environment that has been created. They work hard to balance great customer service with the need to be sure we are safeguarding the financial health of the medical center.

Also located in this area is the hospital operator. That is another job that can be really hectic at times with the number and variety of calls that come to GRMC.

Everyone on this team is dedicated to great patient care and to the mission of GRMC. Thanks for all you do!

Creating Coherent Caring Environments

The focus of the first HeartMath Best Practices Conference is how to create the kind of healthcare environment that transforms lives of caregivers and patients alike.

Robert Browning is the director of project development for HeartMath. He led us through an exercise around caring with another person that can be used in any setting, but particularly in patient care.

This is another example of how this is a different kind of conference. We are not only hearing presentations and getting great ideas, we are also experiencing and participating. Conference attendees have the option of starting the day with "Morning Renewal: Running with Qi." The setting for this conference also lends itself to renewal and greater coherence. The beauty of the California coastline is remarkable. In some ways, this is as much a retreat as a conference.

Healthcare organizations of all sizes are using HeartMath. Yesterday, I wrote about the Mayo Clinic and HeartMath. Like Mayo, Kaiser Permanente is widely recognized around the country as one of the leaders in patient care quality and experience. Anne Foss-Durant is a director of caring services integration for Kaiser and shared her work while she was the Chief Nursing Officer for Kaiser in Antioch, CA. Many healthcare organizations are adopting Jean Watson's work on caring theory and integrating it with HeartMath. The results of this approach from Antioch were remarkable. In the last two JCAHO inspections, there were zero deficiencies listed. In fact, when the inspection team arrived, Kaiser staff invited the team to join them in a Heart Lock-In to start the survey process. Now that is coherence in action!

Another highlight of Anne's presentation was her statement that the level of trust between nursing and administration improved because caring sciences and HeartMath fostered the practice of staff truly caring for themselves which in turn nurtured caring for the patient. Anne remarked that it really put joy into patient care.

Eric Faller, Jeremy Hagar, and Toni Carreon represented Kaiser Permanente in Fresno, CA. Because of the success that Anne and her team had with HeartMath at Kaiser in Antioch, the administration decided to expand HeartMath and caring sciences to all of their regional hospitals. These representatives provided several stories of innovation and engagement by their teams. Ultimately, they said the benchmarking data for patient quality became a byproduct of genuine care for patients.

Chesapeake Regional Medical Center did a great job providing tips on how healthcare facilities can utilize several standard training programs in a consolidated approach. For example, they merged HeartMath with Jean Watson's Caritas program that best serves their organization. Again, creating a better environment for staff facilitates better care for patients from clinical staff.

There are so many models for excellent patient care that tie in beautifully with HeartMath. Another approach was presented by Memorial Hospital in South Bend, Indiana. Memorial began integrating HeartMath into their leadership development program in the mid-1990's. George Soper, Barbara Walsh, and Deborah Drendall explained how the fundamental HeartMath concept of coherence was really the foundation for effective performance. It was an impressive presentation of how they used Stephen Covey's Seven Habits of Highly Successful People as the framework for their leadership development along with HeartMath. It all fit together with assessments, teamwork, discipline, and accountability as a most effective process.

Two teaching hospitals, University of Oklahoma College of Nursing and Indiana University Health of Bloomington presented incredible information on how they have used HeartMath.

At the University of Oklahoma, HeartMath has helped to create high level performance and cultural empathy from the student to the expert. They outlined a way to create an environment that looks at traditional native healing, holistic healing, and energy work.

Indiana University Health of Bloomington presented on how to integrate the HeartMath program into relationship-based care as the core of self-care, patient care applications, and pain management. IUH outlined ways to create a culture that keeps HeartMath tools and techniques in front of every employee. They also reported on ways they use HeartMath with occupational health and employee wellness to help lower costs and reduce insurance claims.

The conference concluded with roundtable discussions, dinner, and a bonfire on the beach....a perfect close to a wonderful day of learning, sharing, caring, and interacting.

A different kind of conference

As noted in my previous post, I am blogging this week from the HeartMath Best Practices Conference and it is a wonderful experience.

Mayo Clinic Arizona staff, Susan Launder, Barbra Hudak, and Lynne Hulvey shared how they have transformed the culture in their nursing unit by infusing HeartMath into the daily activities of their team. Susan is the team leader and she says, "When the staff is happy...everyone's happy and HeartMath bring happiness!"

Lynne is a SWAT nurse. This means that she is a critical care nurse who is available to respond quickly when a patient's medical condition rapidly deteriorates or when the nursing workload is becoming overwhelming. Barbra is the house supervisor. Those of us who participated in their presentations could not help but be impressed by the passion these nurses have for their teams and in turn the care they provide to their patients. Their presentation focused on how other hospitals can work to expand HeartMath to transform the culture of their entire hospital. In their case, they reported to the Mayo Board of Governors their experiences with HeartMath on their unit and how they felt HeartMath would be beneficial to the entire Mayo Clinic Arizona system.

The data they provided was striking. Since initiating HeartMath, error rates on their unit improved. Better communication, clearer critical thinking, and improved working relationships all contributed to overall improvement. As a result, the Board of Governors agreed and HeartMath was expanded throughout the Mayo Clinic Arizona System.

Personally, I know HeartMath changes lives. I've seen this many times in my own experiences. I think it is very powerful to also see the data that HeartMath also saves lives through improved patient safety.

As we finished the day, we were encouraged to consider what we appreciated most from the day... Appreciation is a big part of HeartMath...I found several things to appreciate.

• Lots of great ideas from very inspired leaders.


• Genuine compassion, caring, and passion.


• Profound organizational commitment.


• Stories that spread positive, good news to others.


• The connection between Qigong and HeartMath - to move and breathe with life


• Evidenced-based science adds creditability and opportunity for improved patient care.


• HeartMath changes and saves lives.

This is a different kind of conference...the pace is deliberate, content-focused, and thoughtful. I can hardly wait to see what's next.

I am so excited to be blogging from the HeartMath Best Practices Conference: Creating Coherent Caring Environments.

I have to admit, I’m a little travel weary. I actually flew from New York City this morning on a 6 a.m. flight, but the beautiful location here at the Seascape Beach Resort in Santa Cruz, California is reviving me. And, I got in on the last two presentations for the morning.

The conference is off to a great start. HeartMath CEO Bruce Cryer welcomed us to this first-ever best practices conference. Presenters from Fairfield Medical Center of Lancaster, Ohio, and Scottsdale Healthcare in Scottsdale, Arizona followed Bruce and they were great.

I first met presenter Cynthia Pearsall, chief nursing office from Fairfield Medical Center, when my team and I went through our first training session several years ago. It was really fun to see her again today and hear about their journey at Fairfield with HeartMath. Their presentation was all about integrating HeartMath into a hospital culture and it was inspirational to hear about all the lives that are being touched by HeartMath.

The Fairfield team followed their presentation with a wonderful video featuring seven staffers sharing their personal stories with HeartMath. One woman shared how it helps her and her husband deal with the hectic life of parents of six children. Another employee shared how HeartMath changed her life after a horrible traffic accident that she lived through as a teenager. The accident created lifelong anxiety whenever driving and now through the use of HeartMath, she is no longer paralyzed with fear. Cynthia shared how she uses Heart Lock-ins to solve difficult problems during meetings. Yet another woman told the touching story of how HeartMath transformed a very stressful bath time routine with her son into a loving and special bonding time. HeartMath helped another staff member though a difficult time dealing with several family member's significant illnesses. The video ended with the CEO and executive assistant sharing about the transformed executive suite after HeartMath came into their lives. We will have to talk them into putting their video on YouTube. It was awesome!

Marielena Murphy and Linda Larkey from Scottsdale Healthcare gave a presentation about how research in nursing practice at their institution is helping to expand HeartMath usage among the care team. One of the projects they highlighted focused specifically in the surgical services department. Early indications of the project indicate there is likely a correlation between the practice of HeartMath and the reduction of adverse events. More research is necessary to find correlations with HeartMath and patient satisfaction, turnover, and employee satisfaction.

The second half of their presentation focused on how HeartMath coherence correlates with the meditative movement practice with breast cancer survivors. Watch for a journal article out soon indicating the very positive impact of both HeartMath and Qigong have on patients with persistent fatigue after treatment.

Lunch time and then an afternoon full of more stimulating presentations from the Mayo folks...There’s more to come from Santa Cruz!