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Joanne's Journal - Thursday, December 21, 2017

Joanne's Journal - Thursday, December 21, 2017

Dear Colleagues:

During the winter holidays, we celebrate from many religious perspectives. The essence of these celebrations is grounded in kindness, respect and generosity. Here are a few of my reflections on how important these are any time of year, but especially during the holiday season:


There is a myriad of things the world could benefit from having more of. Kindness is one of them. When you are a kind person, you're not only helping others; you are helping yourself too. There is substantial scientific evidence that being kind makes you (and others around you) happy. In a study conducted at University of California, Riverside, students were assigned to do five random acts of kindness per week for a period of six weeks. At the end of the study, the students' levels of happiness had increased by 41.66 percent. Being kind had a profoundly positive effect on their happiness.

"Kindness is the language, which the deaf can hear and the blind can see." Mark Twain


Respect is an essential part of human life. Respecting others is a silent way to express our feelings for them. It is an unspoken way of communication, which builds strong relationships. When we respect someone, we recognize their value. When we disrespect someone, we are really saying, “You are not valuable.” Some people believe that showing respect is a sign of weakness. In fact, it demonstrates immense strength.

Civility and respect matter. It enhances your influence and performance as a leader or as a team member. Being respectful doesn’t just benefit you….it benefits everyone around you. No other leadership behavior has a bigger effect on employees than being treated with respect. It is more important than recognition and appreciation, communicating an inspiring vision, or even opportunities for learning, growth and development.

“Give to every other human being every right that you claim for yourself.” Thomas Paine


Giving makes you thankful. Until you learn to give, you keep score by money. When you give, you get to see how your gift fills a need in someone else’s life, and it makes you appreciate all the things you have in yours. Giving creates an awareness of abundance.

We have all experienced this. For instance, when someone offers his or her seat to an elderly person on a bus or subway or in a crowded lecture hall. The generous person feels noble, the elderly person beams with gratitude, and even those who are watching, feel like cheering inside just from having witnessed a simple act of kindness. Maybe it is tough economic times or natural disasters that bring out our neighborly generosity. In the aftermath of Hurricanes Hugo and Floyd in South Carolina in the '90s, kindness, and generosity were more important than ever and fueled the resilience of the communities affected. 

“In the end though, maybe we must all give up trying to pay back the people in this world who sustain our lives. In the end, maybe it's wiser to surrender before the miraculous scope of human generosity and to just keep saying 'thank you,' 'forever' and 'sincerely,' for as long as we have voices.” Elizabeth Gilbert

There are some simple ways to be kind, show respect and be generous through the holidays and at any time of the year. 

  1. Leave a bouquet of flowers at the hospital — the nurses will know who needs it the most.
  2. If you have a big basket of groceries, invite the person behind you to go first.
  3. Arrange to pay anonymously for a soldier’s breakfast when you see him or her dining alone.
  4. Make sure you have a little gift for the mail delivery person for the holidays.

And my personal favorites…

  1. Smile.
  2. Make eye contact. Connection happens. We need more connection!
  3. Acknowledge one another’s presence. As you fly by those people in your life, it’s a really kind thing to acknowledge their presence. I wave and smile at everyone like I was not wired correctly. It takes little effort, and yet it goes a long way to acknowledge those people you pass by on a regular basis.
  4. Compliment someone. See people’s faces light up after you deliver an impulsive compliment to a stranger… sometimes lands with a thud, but more often it surprises them with delight.
  5. Listen….there is no better way to show respect.
  6. Say thank you…sincerely. Make sure people know you appreciate them and their actions. Simply saying it in front of someone else can have a big impact.

I want to thank all of you for everything you do for Dartmouth-Hitchcock and for the patients and families we serve…and a big thank you to those working extra shifts to take care of patients during the holiday week.

We will not have a Journal message next week so please enjoy the holidays.

Be safe, enjoy your families and friends. Get ready for a great 2018!

Regulatory Surveys Completed

There was a collective sigh of relief around the Dartmouth-Hitchcock (D-H) Lebanon campus when The Joint Commission (TJC) surveyors left on Monday, December 18, from their revisit. But D-H leaders are gearing up for more hard work to continue to address the issues identified. TJC surveyors first came to D-H on November 7 for the triennial accreditation survey, with a follow-up revisit that took place on December 18. Centers for Medicare & Medicaid Services (CMS) surveyors arrived on December 11 for a validation survey, which lasted through December 14.

“Coming out of the Joint Commission and CMS surveys, I am very optimistic,” said George Blike, MD, chief quality and value officer. “While we did relatively well throughout all three surveys, the real work now begins. To continue to improve as an organization, we need to invest in our staff and leaders, set clear expectations and focus on the areas identified by the surveyors that need to be addressed. Once these areas are addressed, we need to make sure we have in place what is needed to sustain good performance consistently over time.”

At a special meeting of the Board of Governors and Senior Leadership Group, Blike and D-H CEO and President Dr. Joanne Conroy talked about the next steps in improving our quality and safety efforts after these regulatory surveys. One of the items to be addressed is reaffirming the responsibilities of the Board of Governors. Members of the Board of Governors also serve in the role of Medical Executive Committee, which is a TJC requirement to have a governing body provide oversight for quality and safety efforts, regulatory and standards performance, and approve and review performance against annual goals and targets.

Blike also addressed some of the areas of vulnerability that D-H was cited on during the original TJC survey in November and what has been done to address those findings. One area was high-level disinfection, in locations such as the operating rooms and other procedural areas. Blike explained that the reason for the citation was the variability of education and adherence to protocols among staff in those areas. To address this, D-H leaders retrained more than 600 staff on high-risk infection prevention procedures to prepare for the TJC revisit. “I’m enormously proud of the work we did in this instance to demonstrate we had a plan in place to address the issue,” said Blike. “But more focused work in this area will need to be done.”

Blike also noted a number of positive comments from both survey teams, including:

  • Open and engaged staff
  • Best practices, such as ICN [Intensive Care Nursery] rounding, safety champions, simulation training and ongoing standard readiness
  • High reliability in a number of inpatient areas
  •  Improvement in ability for Quality Assurance teams to perform robust audits and tracers

The senior leadership team has identified some areas that need improvement for the long-term sustainability of meeting these ongoing quality and safety standards. These areas include:

  • Leadership training and accountability
  • Staff recruitment and retention
  • Staff core competencies (documentation of sustained performance)
  • Strengthening team performance/relationships

“All of us ‘own’ quality and safety,” said Conroy. “It isn’t just the responsibility of George’s team. All staff and leaders throughout the organization have this important responsibility. Not just because we get visited by regulatory surveyors, but more importantly, because it is the right thing to do for our patients. While the end of this survey period is a cause for celebration, it is also time for us to focus on continuous improvement so that we can be even better for the patients and families we serve.”

Sharing Holiday Traditions from D-H Staff

In previous editions of Joanne’s Journal, we asked staff to share their “interesting” holiday traditions. From handmade ornaments to special family outings, these holiday memories are sure to bring smiles, nods of recognition and the sense of fulfillment and joy in helping those less fortunate. Thanks to all of you who shared these special memories.

Read the full story online here.

D-H Lebanon Employees Support Local Community Programs for the Holidays

Dartmouth-Hitchcock (D-H) Lebanon employees not only help our community members stay healthy, but they also help through gift donations, baking and fundraising to make the holidays a little brighter for countless people throughout New Hampshire and Vermont. Here are two of the departments lending a hand:

Volunteer Services

The gift pile

Gifts donated by numerous D-H departments for LISTEN.

Wearing a Santa Claus t-shirt that reads, “Believe in Magic,” Marcy Sanborn, watched happily two weeks ago as the Dartmouth-Hitchcock Medical Center (DHMC) Volunteer Services office quickly filled with donations for LISTEN’s Holiday Basket Program. Sanborn, D-H Volunteer Services coordinator, oversees the holiday magic every year, organizing the donations that numerous D-H departments make to support LISTEN Community Services in Lebanon, NH, and other Upper Valley community members in need.

This year, D-H Lebanon departments sponsored 53 families, 128 children, and two seniors. LISTEN, a local community service organization, interviews families to find out how many people are in the household, the ages of the children and what their needs are, and then D-H departments “adopt” families or individuals. The various department’s employees purchase clothing and gift cards to help the recipients pay for holiday meals. Families also receive vouchers for children’s toys from the Toys for Tots program, which is managed by the United States Marines and local volunteers to collect new, unwrapped toys for less fortunate children.

“We are the biggest sponsor of this program for LISTEN,” says Sanborn, who has been involved with the LISTEN Gift Basket project since she started working at D-H in 1999. “This program can help as many families as it does thanks to the incredible support of D-H departments and staff.” According to LISTEN’s Facebook page, they will be providing 196 holiday baskets to local families in need this year.

Linda Jordan, an administrative assistant with the Repairs & Maintenance Department, says her department is always eager to help and are “happy that LISTEN and DHMC do this every year. As I said in my thank-you email to our department, ‘Life can be scary sometimes. Through no fault of one’s own, especially the kids, unexpected turns can happen. Thankfully, for our adopted family, you are here to help fill their hearts.’”

Visit LISTEN’s website to learn more about the programs and community services they offer.

Pathology and Laboratory Medicine

Last year the Pathology and Laboratory Medicine Department decided to “adopt” local families to help in a crucial time of need during the holidays. According to Denee Fioravanti, an administrative assistant in the department, this year, they worked with the New Hampshire Department of Health and Human Services’ Division of Children, Youth and Families to adopt four families and are also donating baking ingredients to the Community Helpers team (a local group led by Fioravanti that donates baked goods to various organizations throughout the Upper Valley) and the Upper Valley Humane Society.

The adopted families will be receiving items such as money toward medical treatment for a child in foster care, toys, clothing and food items. For the Humane Society, the group is donating money, dog and cat food, toys, trash bags, paper towels and blankets.

“We will be continuing this widespread, heartfelt tradition as the years go on,” Fioravanti says.

Fifty Years of Sending Holiday Wishes to D-H

50 year Christmas Card

Above is this year's Christmas card sent by Carolyn Gilman.

After diagnosing her with cancer 50 years ago, Carolyn Gilman’s doctor in Dover, NH, recommended that she drive to the then-Mary Hitchcock Memorial Hospital (MHMH) in Hanover, NH, for her treatment (now Dartmouth-Hitchcock Medical Center in Lebanon). He had interned at MHMH and thought the radiation treatment they offered would be beneficial.

He was right, and she completed her two-week treatment in April 1967. As she prepared to return to her home on the New Hampshire Seacoast, her D-H doctor told her he had just one request. “‘All I want from you is a Christmas card every year.’ So, I have sent a Christmas card every year since 1967,” says Gilman, who is now 92.

Dartmouth-Hitchcock (D-H) CEO and President Joanne Conroy was surprised and delighted to receive Gilman’s card recently. Gilman was equally delighted to receive a card back from Dr. Conroy last week. “I was so surprised to get a little note back,” Gilman says. “Dr. Conroy said, ‘You certainly are an inspiration.’ Isn’t that wonderful? I thought that was pretty special for her to do that.”

Gilman, who now lives in Maine with her husband of 50 years, Ronald, hasn’t needed to return to D-H for care. But she fondly remembers the “wonderful care I had. Every morning about 12 doctors would come around together, and I would be sitting in my bed, bathed, dressed and with my lipstick on. And they told me that’s the best thing you can do. You’ve got to get up and go; you can’t just sit there and think about it.”