Town Meetin Q & A- BWH Bulletin - For and about the People of Brigham and Women's Hospital
Town Meetin Q & A- BWH Bulletin - For and about the People of Brigham and Women's Hospital
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November 22, 2000
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Town Meetin Q & A
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At the November 15 Town Meeting, the audience of BWH employees, staff and volunteers engaged President Jeffrey Otten, Chief Medical Officer Anthony Whittemore, MD, and Chief Operating Officer Matthew Van Vranken in a dialogue on current topics at the hospital. The following are excerpts from that discussion.
Q: How do you balance equipment-related budget constraints when it comes to providing patient safety, especially in dynamic environments like operating rooms and surgical units?
A (MVV): That’s a great question. BWH consists of over 2 million square feet of space. Physical plant operations require us to set aside $8-10 million dollars a year just for infrastructure, such as roof repairs, structures, HVAC, and more. That’s approximately one-third of our total budget. We need to generate an operating margin, despite the fact that we’re non-profit. The main use of those incremental dollars is to put back into our physical plant and new technology and invest in areas to ensure we continue to maintain a safe environment. I’ve asked a group of people who are closer to the action to help us to prioritize about one-half million dollars of small equipment requests that can really make a big difference in some of the clinical areas. I hope this experiment of allocating dollars will work, and that we can expand on it next year. A (AW): We try to be aware of as many problems as possible here, but please feel free to e-mail me or any one of us with your concerns or ideas. A (MVV): We carry a contingency budget and when we’re constrained, it’s really that much more important for people to say that this particular piece of equipment malfunctioned. We have a very good clinical engineering department that helps us track those incidents, but we welcome your feedback on urgent needs. A (Karen Nelson, Quality Management): I just want to point out two examples of decisions we had to make regarding equipment and safety. The first was the purchase of beds that have alarms for patients who are at risk to fall. It’s been incremental—only so many are bought every year. The other example is the needle safety, which addresses patient safety and—equally important—staff safety.
Q: My question is regarding how Beth Israel is rumored to be closing psychiatric beds and dermatology. What kind of an impact will these closings have on BWH, and on people being trained in those departments?
A (AW): It is not in our best interests, or the best interests of our patients, to have the BI fail in anything. To the extent they do, it does increase the load placed on our already constrained facilities. What they are going to cap off or retain is not cut in stone. What is cut in stone is their commitment to honor their financial resources and commitments to see that the residents enrolled there now will continue their training, be it here or at other hospitals. They will ensure that that is the case.
Q: Where are we regarding the Picker study?
A (JO): BWH made a commitment to gauge our patient satisfaction improvement process by using objective data that we would get over time from the Picker study. We participated in a series of cycles and we did not receive any results back. Eventually it came to light that Picker had subcontracted data processing out to a new company that it had formed—a for-profit subsidiary—and that corporation failed. We just received the data that we were supposed to receive in the spring about two weeks ago and are just looking at it. However, the results are so problematic that the validity of the data is in question. We have decided to go with another company, Press-Ganey, that does a similar survey through the University Hospital Consortium; so it will consist of 70-80 of the best hospitals in the country; and we’ll gauge our improvement process based on the results we get from that. A (MVV): One of the advantages of this situation is that many other institutions are also going through this issue with Picker. Press-Ganey will be a good way to cross-reference the results we received from Picker, and we can then interpret what it means if Press-Ganey says one thing across a dimension that had a Picker store in the past. That will be very helpful for us. We’re committed to quarterly sampling also, just as we were with Picker.