FORT SAM HOUSTON, Texas –
Electrician Indalecio Morales was in a “bucket” working on
power lines when 14,000 volts of electricity shot into his chest, knocking him
unconscious. He doesn’t recall much about the accident, but vividly recalls his
flight here and the “angel” doctor who never left his side.
Morales later learned that his doctor not only is considered
one of the best burn surgeons in Texas, but is the commander of the busiest
hospital in the Department of Defense.
“I had the main guy for my doctor and the main guy for the
hospital,” said Morales, now an outpatient at the U.S Army Institute of
Surgical Research Burn Center at Fort Sam Houston. “What more could I ask for?”
Army Col. (Dr.) Evan Renz, commander of Brooke Army Medical
Center and a trauma surgeon, is among the top hospital leaders who carve out
time each week to engage in patient care. BAMC encompasses San Antonio Military
Medical Center – the largest U.S. military hospital and only Level 1 Trauma
Center in the DOD – six outpatient clinics across the region, as well as the
Center for the Intrepid, an extremity injury rehabilitation center.
While his schedule is packed with meetings, briefings and
visits with staff across the facilities he oversees, Renz has made it a
priority to serve on call as an attending surgeon at least one day a week since
he took command.
“I feel a deep sense of responsibility for knowing how
medicine is practiced within our walls, for knowing if and how we are meeting
the needs of our patients,” he said. “The single best way for me as a physician
leader to do that is to remain clinically active and see patients each week.”
Active, engaged leadership at all levels is vital to
continued success for BAMC, the colonel noted.
“Our delivery of safe, quality care is greatly enhanced when
leaders responsible for it remain intimately knowledgeable of the practices and
processes used each and every day within our system of health,” the commander
Army Col. (Dr.) Douglas Soderdahl, deputy commander for
acute care and a urologist, devotes one day a week to patient engagement. Time
in the “trenches” has multiple benefits, he said. He’s able to maintain
continuity of care for his patients, better understand staff challenges and
fast-track needed improvements for both patients and staff.
As an added bonus, Soderdahl is able to continue mentoring
and training urology residents. “Teaching is a passion of mine,” he said. “I
hope the next generation of urologists can benefit from my experience.”
Air Force Col. (Dr.) Kimberly Pietszak, interim chief,
Department of Quality Services, and assistant chief of the Department of
Medicine, works clinical care into her daily schedule. Like Soderdahl, she
appreciates the opportunity to mentor junior providers, particularly when it
comes to her areas of expertise: quality and safety.
“I believe it is of the utmost importance to remain
clinically active,” said Pietszak, an internal medicine physician. “In my
administrative job I make decisions which impact clinical care, and my clinical
responsibilities give me perspective on how those decisions will affect our
To encourage leader-patient engagement even further, Army
Col. Richard Evans, deputy commander for nursing, implemented the “Suits to
Scrubs” program in March. One day a month, senior nurse leaders step away from
their desks and work a shift in an inpatient ward to get a “pulse check in the
organization” and experience day-to-day operations firsthand.
“It’s an opportunity for leaders to role model effective
patient communication,” he said. “We encourage staff to establish a personal
connection with patients; see them as more than just a room number or a
diagnosis, but as incredible generations of service and family members.”
This communication can lead to improvements for both
patients and staff, noted Maj. Gen. Jimmie O. Keenan, U.S. Army Medical Command’s deputy commanding general
Keenan described a recent “Suits to Scrubs” shift at SAMMC
in which she assisted a patient with a walk through the ward, asking about her
care along the way. Her patient pointed out the heavy weight of the telemetry
monitor, a portable box that monitors heart rate and rhythm, the general
recalled, while also noting marked improvements in bedside manner.
“Leaders can benefit greatly from talking with patients and
staff and learning their challenges,” said Keenan, who also serves as chief of
the Army Nurse Corps. “We can use this feedback to make changes not only at
BAMC, but across Army Medicine.”
Engaged leadership and robust process improvement are vital
in the journey to become a High Reliability Organization, which is an ongoing
commitment to provide the safest, highest quality care possible to patients,
the general said.
“At the end of the day, our patients are at the center of
everything we do,” she said.
Army Col. (Dr.) Pedro Lucero, the new assistant deputy
commander for clinical services and former chief of the Pulmonary Disease
Service, said he’s been able to strike a balance between his leadership role
and patient care. He noted his gratitude for the “100 percent” command support
of his clinical time.
“It’s a privilege to be a part of this outstanding
leadership team and still continue to make a difference for our patients and
advocate for staff in my new role,” he said.