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Joanne's Journal - Thursday, January 4, 2018

Joanne's Journal - Thursday, January 4, 2018

My New Year’s Resolution

At the beginning of every calendar year, about 50 percent of Americans make a resolution for the next year. Resolutions can be hard to keep if they are created based on what someone else (or society) is telling you to change, if they are too vague and/or do not have a realistic path to success. The most successful ones are reaffirming because of your commitment, and they give you pride in what you have accomplished.

My resolution this year is to make a measurable improvement in employee engagement across Dartmouth-Hitchcock. We have been discussing how important this is for the past five months, and I appreciate all the work our teams have put toward action planning. Strong employee engagement is critical to implementing our strategy, improving our retention and recruitment and building our future. It is also connected to the quality of care we deliver and our patients’ experience.  Engagement is both a local and a system-wide effort. Every site will have a different way of approaching engagement. All initiatives will be in service of the same tenants: 

  • Caring for and valuing our colleagues
  • Building and reinforcing two-way communication
  • Creating and sustaining access to leadership
  • Promoting transparency

These are some of the steps we are taking at D-H to support employee engagement:

  • We will be convening a Colleague Experience Council in February. We are asking people to nominate others to be a part of the council, and we commit to having broad representation across D-H. This group will help us develop programs that meet employee needs and serve as a long-lasting employee focus/feedback group. We will establish rotating terms of service to allow for broad participation and to encourage employee development. More information will be forthcoming on how you can volunteer or nominate a colleague.
  • We will be hosting employee focus groups to hear what is working and what is not working as related to the D-H directional goals from the employee engagement survey organizational results in the upcoming months.
  • We are holding quarterly Town Hall meetings that will be available in person, online as well as recorded for later viewing. We will hold two this year in Lebanon and two in the Community Group Practice sites. The first Lebanon date is on January 22 at 12 noon in Auditorium H. More details are forthcoming.
  • I have met many of you during my lunch-time visits in the cafeteria, but in order to connect with more of our staff, I am starting a series of breakfast sessions. We are limiting the group to 15, so we can have more interactive participation. We will host these at varying times and different days of the week to accommodate as many employees as we can. I actually love breakfast so this will be an easy lift. (I have been spotted at a couple local Lebanon/Hanover favorites—4 Aces, the Fort and Lou’s on weekends!). Stay tuned for more information about where these will be hosted and how to attend.
  • We will measure our success. Based on the results from the May 2017 engagement survey, the Human Resources team, led by Aimee Giglio, interim chief human resources officer, will send a mini-engagement survey questionnaire to “check the pulse” of the organization. This will give us a sense if we are going in the right direction. These short online surveys will come out in April and in November.
  • We will continue our quarterly Facebook Live conversations. The first one we did in October had 3,319 views and the December session had 2,918 views (some watched it live and some watched the recording). I am going to also start interviewing employees on Facebook live about the great things you are doing! The next one will be an interview with Carol Majewski, director of the Office of Patient Experience at D-H, who has a great experience story that should not be missed. Mark your calendars for Monday, January 29, at 12 noon for this conversation with Carol.
  • In January, we will begin Senior Leadership Rounding to give employees a chance to interact with our senior leadership team on a regular basis. See article below for more details.
  • And finally, our senior leadership teams are hosting ice cream socials pre- and post-holidays. Leaders from the Community Group Practice sites scooped up ice cream for employees before the holidays, and we’ll be hosting similar events on the Lebanon campus on January 15 (see article below for details). Now I could point out that hot chocolate seems more appropriate than ice cream when it is 24 below zero outside…but there is something about New Englanders and ice cream!

As you can see, we have a lot planned to support and enhance our employee engagement efforts. But the essence of engagement for all of us as individuals and as leaders is to live and lead with our organizational values:

Honor and respect each other; live with integrity; commit to each other; promote transparency; anchor our relationships in trust; value teamwork; steward our resources; and commit to our communities.

My resolution in 2018 is to apply each of these to caring for our employees every day. As always, I welcome your feedback. If you have any comments or suggestions about employee engagement and what we have planned in the coming year, please reply to this email or send a note to me at

125 Years of Caring for the Community

Mary Hitchcock Memorial Hospital, 1893

Mary Hitchcock Memorial Hospital, 1893

As 2018 begins, the coming year offers an opportunity to celebrate 125 years of caring for the Upper Valley community with the historic anniversary of the day Mary Hitchcock Memorial Hospital (MHMH) opened. While the official anniversary date is May 3, the D-H community will be celebrating this important milestone throughout the year.

The theme for this year-long celebration is “Honoring Our Past; Embracing our Future” with the goal of recognizing the creation of MHMH as foundational work for the Dartmouth-Hitchcock health system today, and how this supports our vision for the future.

One of the ways to honor our rich history is to feature a moment in our history each month in Joanne’s Journal. Below is a brief description of events that led to the opening of Mary Hitchcock Memorial Hospital on May 3, 1893.

Humble Beginnings: Mary Hitchcock Memorial Hospital

Originally called the Dartmouth Medical College, Dartmouth’s medical school was founded by Dr. Nathan Smith in 1797. It was the fourth medical school in the United States (preceded by schools at the University of Pennsylvania in 1765, Columbia in 1767 and Harvard in 1783). Noting the lack of medical professionals in the rural Connecticut River Upper Valley area, Smith petitioned the Board of Trustees of Dartmouth College in August 1796 to fund the establishment of a medical school to train more physicians for the region. The board approved the request, and Smith began lecturing on November 22, 1797.

Nearly a century later, Dr. Carlton P. Frost, dean of Dartmouth Medical College, headed the newly formed Dartmouth Hospital Association, which purchased a small piece of land at the northern end of Hanover. He contacted his friend, the prosperous hotelier, Hiram Hitchcock, who embraced the prospect of building a small hospital in the area, a facility that would not only serve the sick, but would also provide a place for the training of doctors and nurses.

The death of Mr. Hitchcock’s wife, Mary Maynard Hitchcock, in 1887 prompted Hiram and Dr. Frost to move forward with their plan to build a small hospital. The new hospital was built in Hanover with funds donated by Mr. Hitchcock and dedicated as a memorial to Mary. The official opening of the hospital was on May 3, 1893. For more information about the history of Mary Hitchcock Memorial Hospital and its transformation into the Dartmouth-Hitchcock health system, click here.

Senior Leadership Rounding Program to Begin

In health care, we know that rounding is an important part of the patient care process. Through rounding, our care teams learn how to best serve the patient and are able to make decisions based on patient and caregiver feedback. Our Office of Patient Experience team would say that the best way to improve the patient experience is to ask the patients themselves.

The same is true for our employees. The best way to support our employees is to ask what is working well and where we need to focus. Therefore, much like patient rounding, we are implementing a formalized senior leadership rounding program. We believe that opening lines of communication through rounding is just one way we can create opportunities to learn and grow—and, ultimately improve the employee and patient experience.

Beginning January 15, members of our senior leadership team will be scheduled for at least one hour per week to purposefully walk around and talk with employees in our inpatient, ambulatory and administrative areas of D-H. They will be reaching out to local managers and directors to schedule these times.

Our 2017 Employee Engagement Survey suggests that employees may not know or have the opportunity to interact with our senior leaders. In response to these survey results, this rounding program aims to:

  1. Encourage communication across all levels of our organization
  2. Build relationships and trust
  3. Learn what is going well
  4. Identify opportunities for improvement
  5. Create opportunities to provide information to our senior leaders to support   decisions and actions

During these interactions, we will learn from each other. Employees are encouraged to interact and communicate with leaders as they visit work units. Results and learnings from the senior leadership rounding—including themes and follow-up actions—will be shared across Dartmouth-Hitchcock through Joanne’s Journal and other communications.

For more information or questions, contact Amanda Cook at or Aimee Giglio at .

D-H Bedford

D-H Manchester

D-H Nashua

We All Scream for Ice Cream

While the New England winter weather has been particularly cold lately, D-H staff have been and continue to enjoy a non-traditional winter treat—ice cream!

The holiday tradition started on the Lebanon campus many years ago when senior leaders would serve ice cream to staff in the Main Dining Room at DHMC. The tradition was brought back in 2016 on the Lebanon campus and introduced in the Community Group Practice locations in December 2017 (see photos at right).

Staff on the Lebanon campus will get their post-holiday treat on Monday, January 15. Details are below:

  • 2:30 to 4:00 pm in the Main Dining Room at DHMC
  • Senior leaders will deliver ice cream to late-shift staff

Treats will be delivered to other Lebanon campus locations:

  • Lyme Clinic
  • Heater Road
  • Colburn Hill
  • Novell
  • Evergreen 1 and 2
  • Wells Fargo building
  • Labombard Road

Our Patients. Their Stories. Madison Berry

For as long as she can remember, Madison Berry, 13, of Bedford, New Hampshire, has been an athlete, whether performing on the ice as a figure skater or crouching behind the plate as catcher for her softball team.

And for many of Madison’s early years, little could stop her from running the bases at full speed or performing on ice—not even a heart murmur.

Madison Berry, Our Patients. Their Stories.

Madison Berry, Bedford, NH

When Madison was three, her pediatrician in northern Vermont—where she and her family lived at the time—first noticed the murmur; a murmur is the sound blood makes as it moves through the heart. Most childhood heart murmurs are normal and do not require any medical treatment. Madison’s mother Courtney Berry recalls, “We decided at that time it was not very significant. We were going to watch it. And every year she had her well-child check, it was still there, still noticeable and getting louder.”

At the age of seven, Madison’s pediatrician referred the Children’s Hospital at Dartmouth-Hitchcock (CHaD). Under the care of Michael Flanagan, MD, in Pediatric Cardiology at CHaD in Lebanon, Madison underwent the first of many specialized cardiac tests.

Flanagan diagnosed Madison with subvalvular aortic stenosis, a rare heart defect in which a narrowing of the left ventricle obstructs the flow of blood as it exits the heart. The narrowing was mild at first, but the family was cautioned that it might worsen over time. “At that point, it was not restrictive to Madison. She could still play sports. So we decided to just continue yearly checks to see how things went,” Courtney says.

When Madison and her family moved to New Hampshire in 2015, she continued her care with Flanagan at CHaD in Manchester.

At a routine checkup in February 2016, Flanagan noticed a change in Madison’s condition. The degree of narrowing below her aortic valve had worsened. The blockage was increasing to a point that it would not be safe for her to continue being as active without repairing the defect.

“That’s when we decided to go ahead with surgery,” Courtney says.

Read the full story here.

Inside Scoop: Joshua P. Aronson, MD

Joshua P. Aronson, MD

Joshua P. Aronson, MD

In our staff profile series highlighting the roles of individuals and their departments across the organization, D-H Today visits with neurosurgeon Joshua P. Aronson, MD, who came to Dartmouth-Hitchcock (D-H) in June 2016 and is also an assistant professor of surgery (neurosurgery) at the Geisel School of Medicine at Dartmouth. He received his bachelor’s degree from Massachusetts Institute of Technology (MIT), and attended Harvard Medical School in the Health Sciences and Technology program, a joint MD program with MIT. He then completed neurosurgery residency at Massachusetts General Hospital in Boston, followed by a fellowship in stereotactic and functional neurosurgery and epilepsy surgery.

Why did you choose to come to D-H?

I chose to join D-H for multiple reasons. I was looking for an academic position that would allow me to focus my clinical interests in functional and epilepsy neurosurgery, but also run a translational neuroscience laboratory. My research focus is studying brain circuitry involved in learning and memory, particularly after traumatic brain injury. Over the years, I held multiple conversations with D-H’s now emeritus neurosurgery chief, Dr. David Roberts. He is a national leader in stereotactic and functional neurosurgery and when he decided to retire, he was instrumental in recruiting me here. In addition, my wife, Leila Agha, is a health economist and was also recruited to join Dartmouth College’s Department of Economics faculty. We have two young children and the Upper Valley provides wonderful schools and recreational opportunities.

What made you want to specialize in this area of medicine and what are your areas of expertise?

During my undergraduate time at MIT, I worked in a lab investigating tissue engineering, growing replacements for the body’s tissues to restore function. This idea stayed with me and in the second year at Harvard Medical School, an MGH resident taught neuroanatomy. What fascinated me was the microscopic connectivity that underlie the brain’s function. The idea of operating on such a delicate and elegant structure drew me to neurosurgery. In residency at MGH [Massachusetts General Hospital], I returned to the principle of restoring function, which led me to my subspecialty interests within neurosurgery. Both clinically and in the lab, I focus on deep brain stimulation as a treatment for Parkinson’s disease, essential tremor and obsessive compulsive disorder, as well as epilepsy surgery to reduce or eliminate seizures. My other surgical interests are facial pain (trigeminal neuralgia) and brain tumors.

Read the full story here.