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Innovation doesn’t have to be revolutionary or life altering. Sometimes, all innovation requires is a simple shift in perspective or attitude, and a willingness to step outside the lines. That’s what Gerard Galarneau, MD, has done at Catskill Regional Medical Center. And it’s working.
On any given day, Dr. Galarneau can be found in a variety of places. Meeting with associates to discuss quality measures. Sharing a smile or laugh with patients or staff in the halls of the hospital. Consulting with a patient in his office. Or even cleaning the floors with the environmental services team.
Dr. Galarneau wears many hats at Catskill Regional Medical Center. He’s a practicing urologist. Chief Medical Officer. Chief Executive Officer. But titles—or roles—don’t completely encompass his many qualities that have helped him guide Catskill Regional to where it is today. As a leader, Dr. Galarneau goes a step beyond an open-door policy. His demeanor and attitude invite anybody to make suggestions about ways to improve patient care and enable them to do their jobs better.
Dr. G, as some call him around the hospital, is known for being approachable. His personality allows staff to open up to him and tell him what’s happening at the point of care. He says most of the time, staff are asking for ways to do their jobs better.
“When we open up that conversation, our staff asks for more training. They want to change things that would allow them to do their job better,” Dr. Galarneau says. “It’s my job to listen and help make those ideas a reality.”
Innovation in Action
In 2014, under the guidance of Dr. Galarneau, the hospital embarked on a Sterling-funded journey to perform $5 million in renovations. The move has already dramatically shifted the look and feel of the hospital in Harris, New York.
Before the renovations began, about half of the hospital’s licensed 150 acute care beds were triple-bed rooms. The renovations will convert 82% of the hospital to single-bed rooms and 18% to two-bed rooms. Several areas have already been renovated and are receiving rave reviews from patients and staff.
Overall, the renovations support an environment more conducive to healing, and they dovetail with the hospital’s mission to provide the highest quality care.
“Our goal is to renovate the entire facility,” Dr. Galarneau says. “These renovations help us ensure the best quality. While small community hospitals may not have the depth of services compared to a 1,000-bed facility, our goal is to be the very best at what we do. We also work with staff on enhancing quality measures, and it’s made a huge difference in the last two years.”
Catskill Regional has reduced the number of “never events”— which include patient falls that result in injuries, bedsores, and hospital acquired infection—to one per year. Part of this reduction can be attributed to open forums that allow administration, staff , and physicians to discuss problems affecting different departments and what can be done or changed to enhance patient care.
Positive reinforcement is part of the culture of openness at the hospital, too. Administration rewards employees who make a “good catch” or work to prevent a potential problem instead of ignoring it.
A Patient-First Approach
Dr. Galarneau’s background and experience as a urologist directly impacts his role as a CEO. He continues to practice as a urologist, just upstairs from his administrative office, and performs surgeries three days a week. In his words, he’s a doctor 365 days a year and a CEO 365 days a year.
The parallels between clinical and administrative work help Dr. Galarneau stay focused on improving the patient experience. Too oft en, in both business and in healthcare, there is too much emphasis on effort and not enough on outcomes.
“When we as a hospital or as a team see that we’re really trying but something isn’t working, we need to make changes,” Dr. Galarneau says. “I don’t have all the answers. The staff have all the answers, and chances are nobody bothered to ask them.”
Lessons From the Front Line
Dr. Galarneau emphasizes the importance of asking questions, and he is willing to jump in wherever needed. So much that in the last year he worked a whole day with the environmental services team when they said they needed more staff . He buff ed floors and cleaned toilets.
“There’s a huge hierarchy in hospitals— doctors talk down to nurses, nurses to nursing assistants, all the way down,” Dr. Galarneau says. “That starts to shift when the CEO is working with the environmental services team telling them how important their job is. A hospital can do a wonderful job clinically, but if the floor is dirty and the room is a mess, how good could the clinical care be? It’s crucial that as an organization, we understand that everything has to do with clinical care, from the cleanliness of our rooms to the food we serve patients when they’re here. Some people separate clinical from non-clinical—I say everything is clinical and can impact our patients choosing Catskill Regional.”
Key Applied Lessons:
>Create a space for and encourage associates to share perspectives.
>Build prototypes and test ideas before implementing a process system wide.
>Be approachable and open as a leader. Be responsive, and listen.
>Put yourself in their shoes. Part of Dr. Galarneau’s success is that he doesn’t just hear about a situation that happens in the operating room, he experiences it
firsthand as a surgeon. Find new ways to engage with
Other Quality Initiatives at Catskill Regional:
1. The transition to the Epic system for electronic medical records (EMR), which has drastically improved safety. The system reduces errors in writing prescriptions that may interfere with a patient’s allergies or existing medications. It interfaces with the hospital’s other systems, as well.
2. Implementing a centralized telemetry station for monitoring patients’ vitals from one location
3. Implementing Vocera—a hands-free, wireless communication system that enables instant connection between hospital staff.