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David T. Feinberg, MD, MBA
CEO, UCLA Hospital System
Associate Vice Chancellor
As our academic year closes, I want to thank you for your dedication, skill and compassion in helping all of us at UCLA Health System to achieve our mission of alleviating suffering, promoting health and delivering daily acts of kindness. In all candor, I am not a great writer and it is difficult for me to find the right words to express the depth of my gratitude to you. Perhaps it is the patients whom we serve who, through their experiences, can say it best, and, with their permission, I would like to share the words of two who wrote to us in the past week.
As it literally goes without saying that UCLA has the best and most accomplished doctors practically anywhere in the United States, I will actually refrain from doctor-related accolades here. What I DO want to comment on is my ‘Entrance-to-Exit-UCLA-Medical-Experience’, as it confirmed, in real-time with real people, the extent to which yours is the most outstanding, professional and integrated system of service I have perhaps ever encountered.
Before I even walked through your doors, every single phone encounter I had with a member of your various staffs was professional, cordial and informative. As this was my second surgical procedure (the first being in August 2009), I was often on the phone with staff members who remembered speaking with me before – and who expressed both concern that I needed to be back (even though the subsequent visit was a positive thing) and hope that all would turn out well. This even occurred with a member of the Nutrition/Dining Staff I spoke to the morning I ordered breakfast, in addition to my phone conversation with the Anesthesia Clinic prior to my arrival. Knock me over with a feather!
From the lovely people in Admissions at 5:00 a.m. to the crack medical-support staff in Pre-Op on Two, to the Post-Op Nurses in the Surgical Recovery Center to William, who wheeled my gurney up to 6 West, and of course to all the RNs and LVNs and Training Nurses, and to the support staff who visited my room and inquired if I had any concerns or questions.
OK, here’s what I am really getting at: I have come away with the decided opinion that every single person who works at UCLA Medical LOVES what they do, strongly and passionately, and they are also charged that they get to work with other such motivated and dedicated people, and that there is no cog too small at your institution that is not fully committed to the big picture of good health, good energy and superlative results.
Every single person did exactly what they said they were going to do – every single one. Their word was their covenant. And it was all done with pride of purpose.
And, yes, there is one person I would like to highlight and bring to your attention: my surgeon’s manager, Marine Keshishkeryan. When I felt that maybe, just maybe, my file had been misplaced and I would never hear back about how we were going to move forward, I expressed my neuroses to Marine and she immediately calmed me down, promised/pledged to get me an answer, and had me on the books within 48 hours – tout suite! And ALL of it via email, as I know your staff is exceedingly busy, and I felt email was less invasive.
I am a UCLA patient on Medi/Medi and SS disability, and I wish I could give back to you beyond my utterly heartfelt thanks and admiration in recognition of the incredible work you do. Perhaps some day I will be able because if I am, I most assuredly will.
Thank you so much for what you do, and for taking the time to read my note.
Grateful Patient No. 1
I am delighted to have been asked to say a few words about John McFall. I was hospitalized last November, having suffered a major cardiac event that was accompanied by multiple organ failure. During a traumatic and chaotic time, complete with emergence delirium, CICU Psychosis, ECMO and a BiVAD, there was one constant, soothing presence. At 5:00 a.m., rain or shine, I would hear the whirr of the portable X-ray machine, the sliding of my ICU door and the soft salutation of John McFall, or “Big John”, as I called him.
With incredible grace and gentleness, his large hand and arm would lift me while the other placed the film behind my back. He would assure me that I did not need to assist him, and I was comforted by his touch. Our unspoken joke came when he would tell me to take a deep breath. With so little lung capacity, and having wasted very quickly, I would take the smallest of breaths. He would never cajole nor criticize my efforts, but simply say thank you. Then he would once again lift me, remove the film and gently place me back down.
“Big John” became my orienting beacon. If I heard his voice, I knew immediately that I was safe, I had made it another day and it must be close to 5:00 a.m. We repeated this ritual over the next three months.
When I returned to UCLA to receive my wonderful new heart, I had to have a chest X-ray downstairs upon admission. I was overjoyed to find John emerging from behind the door, and knew at once that I would be fine. It seemed so very fitting that he would be there for such a celebration. This would be our last X-ray. What surprised me most was to realize that “Big John” was actually my size (but with much bigger hands). In my time of fear and vulnerability, his presence loomed larger than in reality. But what remains “big” about John McFall are his caring, compassion, professionalism, and his own big heart.
Grateful Patient No. 2
Our beloved Coach John Wooden would be proud of William, Marine and John because Coach believed “you can’t live a perfect day without doing something for someone who will never be able to repay you.”
I am lucky. I get to see letters like these everyday, and I get to meet with patients and their families who tell me about our great caring environment. They tell me about the thousands of Williams, Marines and Johns who fill our hospitals and clinics. To all of you who touch their lives, my most heartfelt thanks.
In addition to taking this opportunity to thank you, I want to update you on how our hospitals and clinics are performing, and on the challenges that are ahead.
Despite the unstable fiscal climate of our country, our state and our university over the last year, UCLA Health System has performed incredibly well. Our profit this year will be an all-time high, and our cash-on-hand will reach record levels. While this is clearly fortunate, we need to temper our celebration and consider some of the issues we face.
- Many of our salaries for both union-represented and non-represented staff are starting to fall below market. Furloughs will end on August 31, and over the next year we will address compensation to make sure we are able to retain and attract the very best people.
- The University of California pension system is underfunded. To correct this situation, employees will continue to redirect retirement savings into their pensions and UCLA Health System also will need to direct hundreds of millions of dollars into the pension fund over the next few years.
- We are embarking on a new electronic medical record (EMR) for all of our hospitals and clinics. This undertaking is very exciting, and long overdue. The new EMR will improve our ability to care for our patients. However, we are looking at a cost of close to $200 million for software, hardware and implementation.
- The building of our Santa Monica-UCLA Medical Center and Orthopaedic Hospital is almost finished, and with its completion, all of our inpatient facilities will meet seismic standards. Even with the Ronald Reagan and Santa Monica construction projects behind us, our building is not over. For example, we need to renovate and expand our laboratory space in the Center for Health Sciences, as well as retrofit all of the “old hospital” space in CHS.
CHALLENGES OF HEALTHCARE REFORM
Healthcare reform is now law, and millions of Americans who are uninsured will become covered over the next few years. Our challenge as a healthcare system will be to transform from an organization reimbursed for episodic and unit-based treatments to one reimbursed for value, outcomes and population management. I believe that our strong primary-care base coupled with our world-class tertiary treatment expertise positions us to not only meet this new market dynamic, but to become a model for the rest of the state and nation to follow.
Certainly, our patient-centered culture will serve us well as the healthcare marketplace settles into the new reform dynamics. When patients are asked if they would refer us to a friend or to rate us on a scale of 1-to-10, we now rank as the No. 1 academic medical center in the country and the highest of all hospitals (teaching and non-teaching) in Southern California. Our steadfast commitment to our patients and their families will most assuredly reflect positively on UCLA in this new environment.
Finally, we welcomed a new and special friend to our UCLA family: Dr. A. Eugene Washington, vice chancellor for UCLA Health Sciences and dean of the David Geffen School of Medicine at UCLA. Under the unparalleled leadership of Dr. Gerald Levey over the past decade-and-a-half, our health system and medical school have flourished like few others in the country. I am certain that with Dr. Washington’s leadership, vision, energy, passion and commitment, our future will be even brighter than our storied past.
On a final, personal note, I wish every one of you and your families a happy, healthy, safe and sun-screened summer.
A good life is one lived in service to a cause that is greater than we are. I am so humbled by the opportunity to work with you all in this great institution. As long as we remember to place our patients’ needs first, we will always be on the right path. Thank you for accompanying me on this journey.