August Message from Steven L. Strongwater, MD, CEO

The information below is an employee update of activities at Stony Brook University Medical Center prepared by Stony Brook University Hospital CEO, Steven L. Strongwater, MD. Dr. Strongwater distributes a monthly update that is sent to all Hospital faculty and staff to communicate initiatives and activities undertaken at the Medical Center to reach goals in the areas of patient safety, patient satisfaction and community connections.

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August 2011

Stony Brook Long Island Children’s Hospital is where nearly 4,000 new lives begin each year. Now we are beginning a new chapter in our own development with the opening of our new Neonatal Intensive Care Unit (NICU) and Labor & Delivery Suite. On Tuesday, August 2, at 2 pm we will celebrate the opening of the first all-private-room NICU in New York State, equipped with 46 beds, as well as 10 beautiful new Labor & Delivery suites. This completes another key part of Stony Brook University Medical Center’s (SBUMC) Major Modernization Project (MMP) and follows on the heels of completing construction of our spectacular main lobby. Please join us on August 2 from 2 pm to 4 pm in the main lobby as we celebrate another landmark achievement while we work to meet the patient care needs for Suffolk County residents.

In addition to sharing the latest milestones of the second phase of the MMP, I also want to highlight several new faculty who have joined us this summer. Please welcome Dr. Sajive Aleyas from the Department of Medicine, Division of Pulmonary Medicine, who will be overseeing our Lung Cancer Evaluation Center. This long-standing SBUMC program is being strengthened with the addition of new leadership and technologies. We have acquired an advanced localization system that allows very precise endoscopic lung biopsies to be performed without the need for open surgery. Dr. Aleyas will serve as co-director of the Lung Cancer Evaluation Center and will work closely with other specialists, including fellow co-director Dr. Thomas Bilfinger in Thoracic Surgery, to carefully plan treatments and cures for patients with lung cancer. After completing his medical degree and residency, Dr. Aleyas completed his Pulmonary and Critical Care Fellowship at Thomas Jefferson University Hospital, followed by advanced fellowship in Interventional Pulmonary at Henry Ford Hospital.

In June, Dr. Fazel Khan joined the Department of Orthopedics. He specializes in the treatment of cancer, which involves bone. Bone involvement in cancer is particular problematic because it impacts a patient’s quality of life by affecting the patient’s ability to bear weight, walk or sometimes just to sit. Dr. Khan trained in orthopedic surgery at the Mayo Clinic in Rochester, MN, and in Musculoskeletal Oncology at Memorial Sloan-Kettering in New York City. We are fortunate to have recruited Dr. Khan, as there are very few musculoskeletal oncologists in the nation. Dr. Khan is the only musculoskeletal oncologist on Long Island that is a full-time faculty member at an academic institution.

Melissa Henretta, MD, MPH, will join the Division of Gynecologic Oncology in September, after completing her fellowship in Gynecologic Oncology at the University of Virginia in Charlottesville. The Division members have three overlapping goals: to provide comprehensive, multidisciplinary care for women with known or suspected gynecologic cancers, as well as for those with complicated gynecologic surgical and selected preinvasive conditions; to conduct research into the development and treatment of these cancers; and to educate healthcare professionals and the public about gynecologic cancers and precancerous conditions. Dr. Henretta’s training in robotic surgery will add a new element to the surgical management of patients with gynecologic cancer at Stony Brook University Hospital. While a fellow, she earned a Master’s in Public Health. Her research centers on public health issues, including comparative effectiveness research in genomic and personalized medicine as a part of the Comparative Effectiveness Research Team. Dr. Henretta has lectured extensively and received numerous awards during her training. We are thrilled that she will be joining us.

STONY BROOK PRIDE

Eighty-five Stony Brook University Medical Center (SBUMC) physicians—68 full-time and 17 affiliated—were named to this year’s America’s Top Doctors® list. This prestigious list is compiled by Castle Connolly Medical Ltd., a healthcare research and information company. Castle Connolly has established a survey and research process that identifies the top doctors in America and provides consumers with detailed information about their education, training and special expertise in its paperback guides, national and regional magazine “Top Doctors” features and online directories. Congratulations to the physicians who have been included as “among the very best.”

SBUMC receives Most Wired Award. For the third consecutive year, SBUMC has received the award as one of the Top 100 Most Wired Hospitals in the U.S. The award is sponsored by Hospitals and Health Networks (H&HN). We are very honored to receive this award for the third year,” said Linda Shanley, MBA, Chief Information Officer for Stony Brook University Medical Center. “This award represents a total team approach, with technical, clinical and support staff working together to foster better processes and eliminate steps to promote high quality patient care for our patients and their families through technology.” Katherine Holzmacher, Director of Clinical Informatics, and Bel Milosevich, Director of IT Project Management Office, accepted this year’s award on the Hospital’s behalf at the American Hospital Association’s Leadership Summit. To view the list of Most Wired Hospitals, visit www.hhnmostwired.com.

Stony Brook University Hospital (SBUH) is named third “Most Beautiful Hospital in America.” The Hospital ranked third in a list of 50 healthcare facilities around the country and was the only New York hospital in the 2011 Top 20 list compiled by Soliant Health, a leading specialty healthcare provider. A panel of experts reviewed each healthcare institution and picked 50 top entries based on measures such as architectural style, photogenic properties, landscaping and distinctiveness. More than 70,000 visitors to Soliant.com cast votes for the most beautiful hospital among those 50 entries. “We were inspired to create this list by recent data that found that ‘happy hospitals make happy patients,’” said David Alexander, President of Soliant Health. To read more about the winners of the contest, see Soliant Health’s 20 Most Beautiful Hospitals 2011 listing.

New NICU and Labor & Delivery Suite will celebrate its grand opening and offer tours. Employees are invited to an open house and tour of the new facilities on Tuesday, August 2, from 7 to 9 am. All are also invited to attend the grand opening and ribbon-cutting ceremony scheduled later in the day, from 2 to 4 pm in the Hospital lobby. An open house and tours for physicians is scheduled for Wednesday, August 3, from 7 to 8 am and again from 5 to 7 pm.

“9/11: An American Requiem” makes world premiere. The film, which premiered on July 24 at the Stony Brook Film Festival, features first responders to the 9/11 terrorist attacks telling their own gripping stories. The film is part of “Remembering 9/11,” an oral history project conceived by its Executive Producer, Benjamin J. Luft, MD, Edmund D. Pellegrino Professor of Medicine at Stony Brook University School of Medicine, and Medical Director, World Trade Center Medical Monitoring and Treatment Program (WTCMMTP) at Stony Brook.

The Stony Brook WTCMMTP has cared for 6,000 men and women, all 9/11 first responders, including police officers, firefighters, paramedics and construction workers. Dr. Luft’s belief that the responders’ experiences are part of our nation’s history to be preserved led to the recording of personal stories as an oral history and he is consulting with the Library of Congress on the “Remembering 9/11” oral history project. To be released as a companion piece to the movie is the book written by Dr. Luft titled, We’re Not Leaving: 9/11 Responders Tell Their Stories of Courage, Sacrifice, and Renewal. The movie and book are also part of a larger Stony Brook project that includes developing educational materials, particularly the creation of a curriculum within Stony Brook University School of Medicine designed to help inspire and train aspiring physicians on medical and psychological issues that surface during a disaster and aftermath, and how to care for victims in that process.

Stony Brook University Medical Center World Trade Center Medical Monitoring and Treatment Program (WTCMMTP) expands its services. The WTCMMTP will expand its clinical center of excellence to care for thousands more who were exposed to toxic chemicals and who continue to suffer from upper and lower respiratory tract distress, mental health symptoms and other conditions related to the environment at Ground Zero. This program has grown an average of 17 percent annually, and provides comprehensive and integrated healthcare to all eligible WTC responders who are based in Nassau and Suffolk Counties. With new funding from the National Institute for Occupational Safety and Health, it will now serve Kings County. The new contracts will fund the existing clinical center of excellence in Islandia, and establish two satellite locations, one at Winthrop-University Hospital, and a second based at SUNY Downstate Medical Center for the underserved population in Brooklyn. For more information about the consortium and program, see www.wtcexams.org.

The new Radial Suite at Stony Brook University Heart Center allows for alternate approach for patients requiring cardiac catheterization. Stony Brook’s interventional cardiologists are performing “transradial access,” where instead of accessing the arteries in the heart through the groin (transfemoral), surgeons can now gain access through the wrist (transradial). With wrist access, patients are able to get up almost immediately after the procedure, while with groin access patients usually must lie flat for four to six hours after the procedure so that a nurse or technician can apply pressure to the groin to ensure the puncture site reaches hemostasis. This transradial procedure is making a real difference in patient outcomes, patient recovery and patient satisfaction, and in some patients, including those who are obese, women, older adults and patients with peripheral vascular disease, transradial access reduces the risk of bleeding complications by 58 percent compared to transfemoral access. 

SBUMC’s Heart Team—first on Long Island to perform LVAD implant on a female patient. This past April, members of the Stony Brook University Medical Center Heart Team performed lifesaving surgery by implanting a left ventricular assist device (LVAD) on a female patient, the first woman to receive an LVAD on Long Island. In 2010, the Stony Brook University Heart Center was the first on Long Island to implant a LVAD in a patient. Specialists through the Ventricular Assist Device Program, under the leadership of Allison J. McLarty, MD, and Hal Skopicki, MD, PhD, have successfully implanted five patients with the device.

SBUMC to serve as a HeartMate® teaching center. In recognition of Stony Brook’s exemplary rollout of its Ventricular Assist Device (VAD) program, Stony Brook was selected for this distinction and will join only two other of the 32 U.S. non-transplant VAD centers. Only 20 percent of new VAD programs have come close to Stony Brook’s level of success in launching a new program. Developed by Thoratec® Corporation, HeartMate is a ventricular assist device used to improve and extend the lives of patients with heart failure.

Stony Brook researchers discover mechanism of action behind novel cancer agents targeting tumor cell metabolism. The discovery of the mechanism of action behind a novel class of anticancer drugs designed to disrupt cancer cell mitochondrial metabolism may be a major step toward furthering clinical trials of the agents. An analysis of CPI-613, the lead compound in this first-in-class group of anticancer drugs developed by Paul M. Bingham, PhD, Associate Professor, and Zuzana Zachar, PhD, Research Assistant Professor, both in the Department of Biochemistry and Cell Biology, Stony Brook University School of Medicine, is published in the Journal of Molecular Medicine.

Alzheimer’s Disease Assistance Center was awarded New York State Department of Health (NYS DOH) grant. The Department of Psychiatry and Behavioral Science at Stony Brook University was awarded a $450,000 grant to continue its Alzheimer’s Disease Assistance Center (ADAC) for the next five years. The Department has sponsored the ADAC of Long Island since 1988. Department Chairman Mark Sedler, MD, MPH, who serves as the Center’s Medical Director, said the grant will enable the department to continue providing advanced diagnostic services for the region. The ADAC provides personalized information to caregivers of people with Alzheimer’s disease, hosts weekly support groups for patients and caregivers, conducts educational programs for professional providers and hosts an annual conference in the fall. This year’s conference is scheduled for November 4 at the Stony Brook Health Sciences Center. The grant is one of eight awarded throughout New York State after a competitive bidding process. Information about the ADAC can be found on the Department’s website.

Dietetic Internship Program received accreditation. The Commission on Accreditation for Dietetics Education has once again granted full accreditation to Stony Brook University School of Medicine’s Dietetic Internship. The next review of the program will be in 2015, the five-year midpoint of the ten-year accreditation period. Congratulations to Josephine Connolly Schoonen, PhD, RD, Program Director, and the entire Division of Nutrition.

Apostolos K. Tassiopoulos, MD, named Chief of the Division of Vascular Surgery. Dr. Tassiopoulos, Associate Professor of Surgery, has served with distinction as Interim Chief and as Program Director of the Vascular Surgery Residency and Fellowship Programs, leading the Vascular Division to a number of exceptional accomplishments. An active scholar and dedicated, double-boarded clinician treating the spectrum of vascular diseases, Dr. Tassiopoulos is the author of numerous peer-reviewed articles and book chapters, and has participated extensively in the national and international scientific arena.

Surgeon Shang Loh, MD, joins the Division of Vascular Surgery. Dr. Loh, recently arrived from NYU Langone Medical Center, has joined the Division of Vascular Surgery as Assistant Professor of Surgery, bringing to Stony Brook the very latest in aortic stent technology and expertise in endovascular surgery, and contributing significantly to the building of our Aortic Disease Center. Dr. Loh’s research interests include endothelial cell dysfunction, recruitment of bone marrow-derived endothelial progenitor cells, and emerging endovascular technologies for the treatment of thoracoabdominal aneurysms and aortic dissections.

Tara L. Huston, MD, has joined the Division of Plastic and Reconstructive Surgery as Assistant Professor of Surgery. Dr. Huston comes to Stony Brook from Weill Cornell/New York-Presbyterian Hospital, where she recently completed a three-year fellowship training program in plastic and reconstructive surgery, following the completion of her general surgery residency there. She also received additional training in reconstructive surgery at both Memorial Sloan-Kettering Cancer Center and the Hospital for Special Surgery. Dr. Huston received her MD with “distinction in research” from Stony Brook in 2001, where she was elected to the prestigious Alpha Omega Alpha National Honor Medical Society. She has published more than 20 peer-reviewed articles, as well as eight book chapters. At Stony Brook, Dr. Huston’s practice will encompass the broad range of aesthetic and reconstructive surgery, with special attention to the face, breast and body.

Distinguished University Professor receives prestigious international award. Eckard Wimmer, PhD, Distinguished University Professor, Department of Molecular Genetics & Microbiology, Stony Brook University School of Medicine, and internationally recognized for his poliovirus genome research, has received the M.W. Beijerinck Virology Prize by the Royal Netherlands Academy of Arts and Sciences. The prestigious international award is given every three years to recognize outstanding achievement by a virologist. The award is in recognition of Dr. Wimmer’s contributions to the RNA virology field and his lifelong work on poliovirus. Dr. Wimmer has been a faculty member at Stony Brook since 1974 and served as Chair of the Department of Molecular Genetics & Microbiology between 1984 and 1999.

Stony Brook professor is lead author of study reported online in Pediatrics. Lauren Hale, PhD, Associate Professor of Preventive Medicine, Stony Brook University School of Medicine, and her colleagues, concluded that there do not appear to be any negative associations between bed-sharing in toddlerhood and children’s behavior and cognition at age 5. The study examined the predictors and consequences of mother-child bed-sharing at 1, 2 and 3 years of age in a racially/ethnically and geographically diverse sample of low-income families across the United States. Research for the study was supported by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Employee of the Month for July is Christopher Biasi. Christopher is Assistant Director for Health Information Management who is recognized for his expertise in the field of health information management and record imaging. In addition, he continuously seeks improved and efficient processes and, as a consummate team player, shares knowledge openly and “goes the extra mile,” especially when training others—all with a friendly and positive attitude. Congratulations, Chris!

PATIENT SAFETY

SBUH upgrades its incident reporting system. The updated version of the online incident reporting system “Patient Safety Net” (PSN) was initiated in June. PSN is a real time, web-based event reporting system, which serves as a data collection tool for performance improvement. The University HealthSystem Consortium (UHC) manages PSN. The upgraded system has added functions, many more categories for sorting and tracking, and upgraded reports functions. The transition was seamless due to the hard work of the new PSN Task Force who planned, educated, refined processes, hand migrated data and ensured that the institution did not miss a beat. All involved dedicated a great deal of time during the transition, in particular Kathy Ferrara and Kathy Jayne, Risk Management, who led this effort; Karen Wallin, IT, who coordinated the technical components; the Nurse Quality and Safety Managers who oversaw the migration; Karin Ganetis, MSN, RN, PNP, CPHQ, Nancy Avino, BSN, RN, Jean Mueller, MPS, RN, CPHQ, Nursing Quality Management, and especially Rose Bukovsky, MS, RN, ANP-C, CNN, from Nursing Quality Management who single handedly migrated over 800 individual PSN reports from old to new taxonomy; David Harris, Continuous Quality Improvement, who helped with data management; Judith Stefano, RN, Patient Safety and Regulatory Affairs, who oversaw the coordination efforts and outreach to staff; and Kathy Gorman, RN, and Cheryl Pouletsos, RN, Clinical Education, who provided the educational component.  

“Partnering to Heal” video promotes patient safety. Patient Safety First (PSF) is an important initiative at SBUMC. At a recent PSF session, the Hospital team previewed the “Partnering to Heal” video. This video is a computer-based, video-simulation training program on infection control practices for clinicians, health professional students and patient advocates, and highlights best practices in the healthcare field. View the brief video at the website www.hhs.gov/ash/initiatives/hai/training/partneringtoheal.html. Developed by the U.S. Department of Health and Human Services in consultation with experts and patient advocates, the video is intended to increase awareness of the risks of healthcare-associated infections and the opportunities for preventing such infections. For information on Stony Brook’s PSF initiatives, visit http://uhmc-iweb1.uhmc.sunysb.edu/PSF.

A reminder to complete the Safety Culture Survey. Please take time to share feedback and input regarding patient safety in the Culture of Safety survey, which was emailed to all employees. The survey, administered by Press Ganey Associates, Inc., will be kept confidential. No individual responses will be reported. For questions that do not apply, or may be uncomfortable to answer, feel free to leave them blank. No one at SBUMC will ever see completed survey. The last survey question allows for comments about patient safety, error or event reporting. Comments are encouraged and will be included, without being linked to individual employees.

PATIENT SATISFACTION

ED is holding the gain. In the first quarter of 2011 the Emergency Department achieved the best score it ever attained on the Press Ganey (PG) patient satisfaction survey, placing it above the 50th percentile in the PG “all hospitals” database, as well as in the University HealthSystem Consortium (UHC) and 40K or more peer group databases. The PG report for the second quarter shows that once again the ED ranks above the 50th percentile in all three databases, indicating that the gains made over the past two years are being sustained. The ED has implemented several strategies to improve patient and family communication and patient satisfaction, including hourly rounding, discharge phone calls for all pediatric patient families and white boards in the Pediatric ED that identify staff caring for each patient and the plan of care.

The ED has also begun performing “Lightening Rounds,” brief meetings with the patient, the physician and the nurse to discuss the plan of care. The addition of a second attending physician on the night shift has also helped shorten waiting times and the opening of the CDU has made more space available for ED patients.

14S achieves highest satisfaction rating. During the second quarter of 2011, 16S, 05&6EP (post partum), 9N and 14S received patient satisfaction ratings above the Hospital average. 14S improved satisfaction ratings by nearly 5 points in the second quarter of 2011. The 89.3 rating is the highest rating any inpatient unit received in the second quarter and it is the highest rating 14S has ever received. Nurse Manager, Donna Hoffman, RN, attributes the improvement to a series of efforts, including the unit staff working to consistently perform hourly rounds and bedside rounding, something that has helped the unit improve at pain management.

The unit has also been working to conduct post-discharge calls. Three-quarters of those surveyed reported receiving a post-discharge call compared to just over 60 percent of those who completed surveys received in the first quarter. In addition, the unit clinician makes regular rounds and, in May, special team rounds started on the unit that brings the patient’s entire care team together at the bedside to answer questions and address concerns.

“Heating gowns” help Ambulatory Surgery Center (ASC) improve quality and satisfaction. Second quarter Press Ganey survey reports show that the ASC has once again received scores placing it at the top of the University HealthSystem Consortium peer database. The ASC continually works to improve quality and patient satisfaction. Recently the ASC began using new pre-op heating gowns that patients wear before they enter the operating room. The heating gown has controls that allow patients to regulate the temperature to make themselves more comfortable. In addition, the gown meets Surgical Care Improvement Project (SCIP) criteria for pre-warming core body temperature, which decreases the chances of intra-op and post-op hypothermia and post-op infections hypothermia may cause. The new heating gowns, which are resistant to fluids, are worn by patients pre-op, intra-op and post-op, and reduce linen costs. 

COMMUNITY CONNECTIONS

Local elementary students make a thoughtful donation to pediatric patients. Students in Mrs. Donna Haakonson’s fourth-grade class at William Floyd Elementary School recently donated books for sick or hospitalized children at SBUH. After winning $100 worth of books at a teacher preview raffle, Mrs. Haakonson let her students decide what to do with them. The students chose to keep $25 worth of books for the classroom library and used the remaining $75 to purchase books to donate to the Child Life Program at Stony Brook University Medical Center. The students worked in groups at a school book fair to pick out a variety of books that they believed would appeal to boys and girls of varying ages. Before the books were delivered to the Hospital, the students wrote special messages on the inside cover of each book, such as, “We picked this book out just for you,” “Happy exploring” and “May this book take your imagination on a wild adventure.” The Child Life Program is designed to bring comfort to children that are in unfamiliar surroundings and faced with illness or upcoming medical procedures.

“Special Delivery” for pediatric patients. A delivery of 100 teddy bears to pediatric patients treated at Stony Brook Long Island Children’s Hospital from a group of Nassau County State Farm Insurance agents—who refer to themselves as SWAAT (State Farm Women Agents Are There)—created a summer surprise and smiles for the hospitalized children. SWAAT contributes to charitable causes for women and children’s issues.

Concerned Women of the Grove to hold event for breast cancer research. The event, the 16th annual fundraiser for breast cancer research and prevention, is scheduled for Saturday, August 6, and will take place at Heaven ’n’ Earth, 2 Bayview Walk, Cherry Grove, Fire Island from 3 to 7 pm. Enjoy a memorable day of fun, food, music and good company and support a worthy cause.

Walk for Beauty Kick-off. Join us as we honor Brian O’Hea, MD, Director of the Carol M. Baldwin Breast Care Center, at the Walk for Beauty Kick-off on Monday, August 15, from 6 to 8 pm. Walk for Beauty raises crucial funds for breast cancer research at Stony Brook. Funds raised also provide wigs and prostheses for women who are uninsured/underinsured. Refreshments will be served. For more information or to RSVP for this free event, call 444-4000 or visit www.stonybrookmedicalcenter.org/walkforbeauty.

School of Medicine to honor its 2011 Distinguished Alumni. On August 21, Lee A. Fleisher, MD ’86, will receive the School of Medicine Distinguished Alumni Award and Breena R. Taira, MD ’05, MPH ’09, will receive the Outstanding Recent Graduate Award during the White Coat Ceremony and Distinguished Alumni Award Presentation. Dr. Fleisher is a Professor and Chair of Anesthesiology and Critical Care and a Professor of Medicine at the University of Pennsylvania School of Medicine. Dr. Taira is an Emergency Room resident at Stony Brook University Medical Center, as well as an Affiliate Faculty Member of the Stony Brook University Graduate Program in Public Health. This year’s recipients personify the School of Medicine’s tradition of excellence and have demonstrated through professional development, research and/or community involvement a desire to make a contribution to and a difference in society. The award winners will receive their awards during the White Coat Ceremony as the incoming medical class of 2015 is welcomed.

My Last Touch

I will never forget walking through the North End of Boston alongside open-air markets, bars and restaurants. On one occasion televisions and radios were broadcasting an international soccer match. Almost like a volcanic eruption, the announcer billowed out at super decibel levels the word “SCORE!” His voice trailed on, holding that “S-C-O-R-E” longer than seemed possible. We all know what happened: a rare goal during a critical soccer match. Both the act of scoring and announcing the goal were remarkable. What was so important about scoring that goal? With sports as a metaphor for life, the question is how important are goals? 

Professor Edwin A. Locke from the University of Maryland studied the importance of goal setting from the 1960s through approximately 1990s. He relied upon Aristotle’s initial observations referred to as the form of final causality. Final cause, or telos, is defined as “the purpose, end, aim or goal of something.” Aristotle believed that a telos could be present without any form of deliberation, consciousness or intelligence. According to Aristotle, “once a final cause is in place, the material, efficient and formal causes follow by necessity.” He speculated that purpose causes action. In turn, this led Dr. Locke to study the impact of having purposeful individual goals.

Goals, in general, have intrinsic value, which can help you navigate your life. Per Wikipedia, “A goal or objective is a desired result a person or a system envisions, plans and commits to achieve—a personal or organizational desired end-point in some sort of assumed development. Many people endeavor to reach goals within a finite time by setting deadlines.” Goal setting helps by:

• Facilitating decisions about what you want to achieve in your life.
• Separating out what’s important from what’s irrelevant, distracting.
• Providing motivation.
• Building self-confidence, based on successful achievement of your goals.

In 2007, Gary P. Latham, author and Secretary of State Professor of Organizational Effectiveness, Rotman School of Management, University of Toronto, et al laid out four ways goal setting affects outcomes in Industrial and Organizational Psychology, 2007. (Latham, Gary P.; Budworth, Marie-Hélène)

1. Choice: Goals narrow attention and direct efforts to goal-relevant activities and away from perceived undesirable and goal-irrelevant actions.
2. Effort: Goals can lead to more effort; for example, if one typically produces four widgets an hour, and has the goal of producing six, one may work more intensely than one would otherwise in order to reach the goal.
3. Persistence: An individual becomes more prone to work through setbacks if pursuing a goal.
4. Cognition: Goals can lead an individual to develop cognitive strategies to change his or her behavior.

Approaching how to set your own lifelong goals, however, is not something you do every day. As it turns out, there is a formulaic way to go about it. More detailed information can be found by visiting www.mindtools.com/page6.html, but here is an abbreviated version:

1. Set your lifetime goals first. Next, set five-year smaller sets of achievable goals. Regularly review and update your goals and take time to enjoy the satisfaction of achieving even small successes. Finally, create one-year, six-month and one-month plans of progressively smaller achievable goals, which build toward your lifetime goals.
2. Commit yourself. You will perform better when you are really committed. Commitment is influenced by (a) what is referred to as self-efficacy or your core belief that you are capable of achieving your goals; and by (b) your commitment to others. Promises or engagements to other people greatly improve your likelihood of success.
3. Measure and get feedback. You must measure and track your performance. Without feedback it is impossible to adapt and/or readjust your goals.
4. Watch out for complexity. The more difficult the goal(s) the more skills and training you will need. Obtaining and mastering skills require investments (e.g., education, training and apprenticeships), which may put off achieving your ultimate goal(s).
5. Stay motivated. Setting goals provides long-term vision and short-term motivation.
6. Frame and state your goals carefully. Write down your goals so they are clear in your own mind. Phrase them in the most positive manner possible (e.g., I will become an expert writer and will be an accomplished author by age 40). Be as specific as possible with regard to goals, timelines, etc.
7. Be realistic. Set performance goals, not just outcome goals. Take care to set goals over which you have as much control as possible. It is frustrating to fail for reasons beyond your control. Not everyone can be a professional basketball player, especially if you are just five feet tall.

Following are some categories, a kind of “starter set” to consider in helping you to set your lifelong goals. Of course, you may want to add goals that are important and individualized for you.

• Career. What do you want to achieve and what can you do to make this happen?
• Financial. What are your financial priorities and how much of your earnings do you wish to save for a future date?
• Education. What information and skills will you need to achieve these or other goals?
• Family. Do you want to have a family of your own? How do you want to be seen by a partner or by members of your extended family?
• Attitude. Is there anything holding you back? Do you wish to portray positivity?
• Physical. Do you have any physical or athletic limitations that you wish to overcome? What resources might be available to you for assistance?
• Public Service. Do you want to make the world a better place?

Goal setting works at the workplace, too. The simple act of defining and writing down your plan for the next 90 to 120 days is very helpful. It will force you to understand what is important and whether there are potential obstacles to overcome. Share your long-term goals with your manager, who should help you achieve your goals and/or speed the process by connecting you with appropriate resources (mentors, educational programs, internships, volunteer opportunities, etc.). Your personal growth is part of our plan too (SBUMC’s fourth rule, from our Simple Rules of Work).

A man has to have goals–for a day, for a lifetime–and that was mine, to have people say, ‘There goes Ted Williams, the greatest hitter who ever lived.’
—Ted Williams 

The journey of a thousand miles begins with one step.
—Lao Tzu

The level of our success is limited only by our imagination and no act of kindness, however small, is ever wasted.
— Aesop 

He who attends to his greater self becomes a great man, and he who attends to his smaller self becomes a small man. 
—Mencius

Enjoy the journey.

Steven L. Strongwater, MD

Chief Executive Officer
Stony Brook University Hospital