January 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, M.D.  Dr. Strongwater distributes a monthly update which 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 satisfaction, patient safety and community connections.

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January 2009

Something significant happened a few weeks ago at SBUMC. During a routine inspection, one of our staff identified a potential flaw in one of our instrument cleansing/disinfection processes. Why was this important? At one level, it was important because we want our instrument disinfection process to be flawless, which as we subsequently learned, it is. On an even more important level, it was reassuring that our staff member acted immediately to protect patient safety, and felt comfortable enough to speak up and tell us there might be something wrong.

In many organizations, problems remain hidden because people are afraid to pass on bad news. Perhaps you are familiar with the expression, "Don't kill the messenger!" Rarely does someone want to be that "messenger." Yet, patients and staff can be hurt when key information is left unspoken.

In this particular example, one person raised a concern. That person was not challenged, but rather was supported and praised for drawing attention to a potential problem. There was an immediate, broad-based response involving Infection Control, Surgical Services, Procurement, Nursing, Quality, Gastroenterology, Epidemiology, and many others. In less than 24 hours, essential data was assembled, information was communicated internally to staff, contacts were made with regional and national experts including the NYS Department of Health, and immediate steps were taken to protect the safety of our patients. At the end of the day, we verified that our existing process was safe. Had there been a problem, it would have been identified and rectified immediately, which is, of course, a critical part of being a safe and high reliability organization.

In retrospect, these events tell us that a culture of safety is growing at SBUMC. This is something that we can and should take pride in!

It has been said many times that "culture trumps strategy." Quite literally, this means that even when a great plan with the best of intentions is in place, if the people responsible for the successful execution of the plan don't embrace the principles of the plan-and actually change the way they act-it is likely to fall short. SBUMC is on a critical journey toward a culture of safety. James Reason, a safety expert, describes four subcultures to facilitate this journey. Roughly paraphrased:

1. "Reporting" Culture. The need to reinforce a safe environment for reporting if something or someone makes an error or experiences a near miss. We must thank and recognize, in the most positive way, people who come forward to identify or point out potential weaknesses in our systems. This is the reason we have put into place the Patient Safety Net, an online reporting tool for potential or actual adverse events. (Events can be reported anonymously should anyone be concerned about being the messenger.)

2. "Just" Culture. The need to avoid apportioning blame when something goes wrong. It is so easy to blame the messenger, especially if you don't like the message, and then ignore the problem. We can't do that if we are to achieve our goal of total commitment to patient safety! We must adopt a culture of heightened awareness to potential or real problems. It is too easy to continue familiar routines, even if they do not lead to the best outcomes-a potentially dangerous philosophy.

3. "Flexible" Culture. The need to assure that people can adapt to sudden and potentially radical changes and incremetal changes in pressure or stress, pace, and/or intensity. This requires transferring authority for decision making during times of stress to the most capable individual, regardless of his or her role in a management hierarchy, which is exactly what happened at SBUMC in the situation described earlier.

4. "Learning" Culture. The need to assure that people can apply lessons they have learned from one situation to effect change in processes, procedures, and operations, so that the lessons learned benefit the entire organization going forward. Said otherwise, we must keep an open mind and accept that we not only can change, we must change in response to a changing environment.

These four elements describe a highly supportive work environment: a place that values and supports individual talent, contributions, and leadership. In healthcare, more than in almost any type of work, every individual is critically important to the care, safety, and healing of a patient.

It is challenging to change a culture. Every organization has skeptics who say, "It has always been this way; nothing ever changes." They are wrong, and we are proving that here at SBUMC. We are making great strides in changing to a culture of safety. We see it every day.

Thank you all for your help on our journey to becoming a high reliability organization!

STONY BROOK PRIDE

Continuous Quality Improvement (CQI) poster wins first place. The poster, depicting the formation and workings
of the Pediatric Intensive Care Unit (PICU) Family Advocacy Group, was presented at the Institute for Healthcare
Improvement (IHI) annual meeting. The poster demonstrates our early efforts at Patient and Family Centered Care are being well received. The meeting was attended by one of the family members of the PICU Family Advocacy Group. The poster also was accepted for presentation at the 8th Annual Forum for Improving Children's Healthcare in March 2009 where nearly 1,000 healthcare leaders will gather to discuss the latest thinking and methods to improve children's healthcare. Congratulations to all!

Orthopedics research team wins prestigious award. Lawrence Hurst, MD, Marie Badalamente, PhD, and Edward Wang, MD, are the recipients of the 2009 Orthopaedic Research Foundation/Kappa Delta Society/American Academy of Orthopaedic Surgeons Clinical Research Award. This award recognizes the work they have done in the past ten years on the use of collagenase in the treatment of Dupuytren's contracture (a disease where the fingers bend towards the palm and cannot be fully extended/straightened) and the use of collagenase for the treatment of frozen shoulder. They will present their work and receive the award at the Orthopaedic Research Society meeting in February. It is not very often a research team takes an idea from inception to applied clinical use. Well done!

SBUMC forms new Upper Gastrointestinal and General Oncologic Surgery group. Dr. Kevin Watkins has been appointed the new Chief of Upper Gastrointestinal (GI) and General Oncologic Surgery. As part of the development of a comprehensive surgical program for treating upper GI malignancies and other disorders, Dr. Watkins plans to continue to expand his efforts in laparoscopic pancreatic surgery, and expand the role of minimally invasive surgery for complex GI tumors, including robotic surgery. Dr. Watkins will be joined by Dr. Colette Pameijer whose area of expertise include therapies for melanoma and other skin and soft tissue tumors, as well as regional therapies for advanced cancers. Dr. Pameijer has also led efforts for the treatment of intra-abdominal malignancies including warm chemotherapy or "IPHC," a complex procedure available at only a few centers on the east coast. Congratulations Drs. Watkins and Pameijer!

New Emergency Department (ED) is open! On December 18, SBUMC opened the doors to new space that will enhance the care delivered to thousands of patients each year. The ED now sees approximately 70,000 patients a year. The new space includes:

• 33 private rooms
• 10 private critical care rooms (included in the 33), including a new trauma resuscitation area
• A dedicated Radiology Suite with a rapid speed 64-slice CT scanner and two digital x-ray rooms,which enable online viewing of images (on or off site)
• New drive-up patient entrance/drop-off zone located at the front of the Hospital (south side)
• A new ambulance entrance located on the north side of the Hospital
• Electronic tracking system that tracks patient stay, lab results, x-rays, and discharge information
• Vocera® portable communication systems for staff to minimize overhead noise

We are two thirds of the way to the final ED construction! We look forward to the final Pediatric and new Psychiatric sections to be constructed shortly.

Drs. Fine and Strongwater provide testimony to the Obama Transition Team. On December 22, the Suffolk County Health Department held a forum on East Campus to collect recommendations to be collated and forwarded to the Obama Transition Team. Dr. Fine's testimony stressed the need to increase the number of medical students and trainees to meet the nation's pending physician shortage as well as recommendations to eliminate drug company and hospital advertising. Dr. Strongwater requested that caps on graduate medical education slots be eliminated with additional Medicare funding for trainees, increased support for disaster preparedness, establishment of a National Patient Safety Organization (and funding for the National Patient Safety Act of 2005), and support for the infrastructure and oversight of telemedicine as a means to meet the increasing demand for healthcare. There were over 30 people offering testimony, ranging from the head of the Nassau Suffolk Health Council to a reverend from the Shinnecock Indian Nation.

We are "Smoke Free." Since health and well being is at the core of all we do, becoming smoke free not only makes sense, it is our responsibility. SBUMC, the Health Sciences Center, and the Long Island State Veterans Home are ringing in the New Year with a new smoke-free policy. The new policy is posted at: http://www.stonybrookmedicalcenter.org/smokefree.

On December 19, SBUMC held a press conference to announce the smoke-free policy to the larger community. Attending were Assemblyman Steve Engelbright; Dr. Hank Chaudhry, Commissioner, Suffolk County Department of Health; Sylvia Diaz, American Cancer Society; Dr. Fine, Dr. Strongwater, Craig Lehmann, PhD, Interim Executive Dean, Health Sciences, Theodore Gabig, MD, Chair, Department of Hematology/Oncology; Yvonne Spreckels, Director of Community Relations; Fred Sganga, Executive Director, Long Island State Veterans Home; Dr. Frank Cervo, Medical Director, Long Island State Veterans Home. For smokers we plan to lend support while you make the transition to this new environment. From now through January 31, we are providing nicotine replacement gum and lozenges to employees as follows:

• Between the hours of 7:30 am and 4:00 pm, and 6:30 pm and 8:30 pm at Employee Health &Wellness (EH&W), located on level 5 of the Hospital
• Employees at the Ambulatory Surgery Center, the Cancer Center, and the Imaging Center shouldcontact the nurse manager on duty.

To register for our next six-week smoking cessation session, call EH&W at 4-7767. Sessions begin on January 19 at the Outpatient Cancer Center Conference Room and January 20 at the Hospital. To learn about other resources to help with smoking cessation, contact EH&W at 4-7767 or HealthConnect® at 4-4000.

New Directors for Burns and Surgical ICU. James Vosswinkel, MD, has been appointed by Dr. Rosengart, Interim Chair of Surgery, as Medical Director of the Surgical Intensive Care Unit (SICU). Dr. Rosengart also appointed Steven Sandoval, MD, Medical Director of the Burn Unit. Each brings extensive knowledge, experience, and a history of extended service to SBUMC. Dr. Vosswinkel has been an active member of the trauma and critical care division of the Department of Surgery since 2002. Since 2004, he has served as the medical director of the 18N Intermediate Care Unit. Dr. Sandoval completed fellowship training in surgical critical care at Stony Brook, and received specialized training in burn care at the Weill Cornell Medical Center. He has passionately led efforts for the burn unit here for many years, and complements this clinical work with research efforts with the United States Army in its regenerative medicine research initiative. In close collaboration with the Suffolk County firefighters, he serves as an executive member of the Suffolk County Burn Center Fund. Congratulations Drs. Vosswinkel and Sandoval!

Stroke Program recertified by The Joint Commission-longest possible accreditation awarded. SBUMC received notification from the Commission on December 11 that a renewal of Advanced Certification has been granted to our Stroke Program. The program is surveyed under the Disease Specific Care certification program. The Joint Commission surveyor commended the program for the excellence of its clinical care and the compassion of the staff. No recommendations for improvement and only one supplemental finding were made. Congratulations to Dr. Candice Perkins, Ann Marie Byers, and the entire staff of the Stroke Service!

Finance team engages in performance improvement! Admitting and Care Management have collaborated since July to reduce payment denials due to delays in insurance company notification of a patient's admission. A new process has been implemented where key information is faxed to the payer at the time of registration and then verified the next business day. This type of denial decreased by over 70% since July. Well done!

Sleep Disorders Center celebrates its 30th anniversary in 2009. The Center was established in 1979 when it studied its first patients in the Health Science Center. Eventually, a specially constructed lead-lined, four-bed unit was built into the quiet Medical Records floor. Currently, the Sleep Disorders Center houses an eight-bed outpatient unit for adult and pediatric patient testing in a new state-of-the-art diagnostic facility at 240 Middle Country Road in Smithtown. Happy anniversary, Sleep Center! Congratulations also to Rashid Ahmed, supervisor of the Sleep Disorders Center, who recently passed the examination to be a registered polysomnography technician.

Dr. Thomas Biancaniello assumes new role in Pediatrics. Dr. Biancaniello has accepted the role as Vice Chair for Clinical Affairs in the Department of Pediatrics. As such, he will provide leadership for clinical program development and evaluation, recruitment of clinical faculty, and allocation of clinical resources. He also joins the leadership team to plan for the Children's Hospital.

Dr. John D. Shanley appointed Associate Dean of International Health and Professor of Preventive Medicine. Dr. Shanley joins SBUMC after many years at the University of Connecticut Health Center and Veterans Administration Medical Center in Newington, Connecticut where he served as Professor and Chair of the Division of Infectious Disease. Dr. Fine appointed Dr. Shanley, Associate Dean of International Health at Stony Brook University School of Medicine in the Department of Preventive Medicine. Dr. Shanley's practice will focus on travel medicine.

Dr. Shanthy Sridhar appointed Chief of Neonatology. Dr. McGovern announced the appointment of Dr. Sridhar as Chief of Neonatology. Dr. Sridhar has served as the Interim Chief of neonatology for the past several months. Under her guidance patient satisfaction scores have risen and two additional neonatologists have been recruited. Dr. Esther Speer will be joining SBUMC in January, and Dr. Aruna Parekh will be joining us in March.

Dr. Michael Frohman appointed Chair of Pharmacology. Dr. Frohman has been a faculty member in the Department of Pharmacology for over 15 years and is currently a tenured Professor. He is a highly productive researcher and has been recognized internationally for his research studies. Dr. Frohman is also an active educator, having served as a lecturer and course director, as well as the Director of the MD/PhD program for the past several years.

Candiano Rienzie named Distinguished Alumna. Candi, Associate Director of Outpatient Physical Therapy and the Interim Director of the Sleep Center, received this honor from the School of Health Technology and Management. Congratulations!

Robyn McKeefrey selected as Employee of the Month. Robyn, Risk Management Coordinator in the Department of Risk Management, was selected as the Employee of the Month for December. Robyn has worked at SBUMC in several roles including Maternity and more recently in Risk Management. She was one of the employees who helped a woman deliver her baby in the new hospital lobby, going above and beyond the call of duty! Congratulations!

Marilyn Lawler Haig, Katherine Holzmacher, and Paul Murphy have successfully completed the HANYS/Cornell certificate program. Marilyn, Kathy, and Paul tackled the Academy for Healthcare Leadership Advancement program this past November. The rigorous eight-week program required significant commitment by the participants in addition to their ongoing professional and personal demands. Thank you for pursuing your personal growth!

Judith Maler named Business Operations Risk Officer. Judy will work with Hospital administration to assess business operations risk and develop policies and procedures to mitigate these risks. We thank Judy for her many years of service overseeing Internal Audit and more recently, Compliance. Stephanie Musso will serve as Interim Compliance Officer, and Jean Boeje, Senior Policy Analyst in Finance, will oversee Audit until a search is completed to appoint a permanent Internal Audit Director.

PATIENT SAFETY

Hospital-wide retreat held on safety of medication management processes. On December 18, a full-day retreat was held at the Charles B. Wang Center attended by hospital executive staff, physicians, and staff from pharmacy, nursing, clinical informatics, information technology, and quality management, among others. The purpose of the retreat was to review the safety of medication management processes particularly in light of the impending change to CPOE (computerized provider order entry) and the E-MAR (electronic medication administration record), which will go into effect on January 28. After a discussion on the nature of the present and planned future medication processes, four breakout groups considered the relevance of this information to: medication prescribing, dispensing and administration, as well as the patient's and family's role in medication safety. Unique to the latter group, was the inclusion of the mother of two children who were cared for at SBUMC. Each group formulated a series of high priority "risk points" in the process of doing mini-FMEAs (failure mode effects analyses) on the assigned process. These risk points were also accompanied by suggested risk-reduction approaches which were then presented to the entire group of approximately 40 persons. The resulting list was placed into a spreadsheet, with assigned responsibility for each strategy. This comprehensive overview and analysis will help to minimize medication safety risks during the EPR transition and thereafter. Particular thanks are due to Pamela Boremski and others from Quality Management, Kathy Jayne, Jeannene Strianse and her staff, and Kathy Holzmacher and her staff in both the planning and execution of the retreat.

NICU is now using the Alaris®smart pump syringe module. The use of specialty intravenous pumps improves the safety of medication administration. Thanks to the efforts of John Bruno of the Pharmacy, Bill Tappin, Cheryl Pouletsos from nursing, and Bill Giangarra of biomedical engineering, NICU has standardized its pump technology to help ensure the safe administration of intravenous medications to our most fragile and vulnerable patients.

Medication standardization is introduced for oxytocin. Due to the efforts of the medication standardization task force, oxytocin is now available in only two strengths commonly prescribed to patients in Labor and Delivery. This will help to avoid errors due to mixing or preparing medications.

Successful flu vaccination campaign continues. Once again, Employee Health & Wellness has increased the number of flu vaccines dispensed as a result of its annual influenza vaccine initiative. To date, more than 3,200 vaccines have been given to employees throughout the Hospital, Tech Park, the Cancer and Imaging Centers, and Ambulatory Surgery Center. We are proud to say, that 60% of our workforce has been vaccinated! There is still time to get a flu vaccine. Visit Employee Health & Wellness during office hours (Monday through Friday, 7:30 am to 4:00 pm) to get yours. It takes five minute but will last the entire flu season. It is our responsibility as healthcare providers to stay healthy not only for our own benefit, but for the benefit of our families and our patients.

Ronnie McKinnon, RN, JD, Office of University Counsel, completes Patient Safety Certificate Program. Ronnie has successfully completed all requirements and has earned a Certificate for the Patient Safety Certificate Program, sponsored by the Quality Colloquium and co-sponsored by AHRQ, American Society for Quality, The Joint Commission, National Quality Forum, and NCQA. The program entailed four full days of lectures by international quality and patient safety experts at Harvard University, followed by take-home and online readings related to quality, reducing medical errors, and patient safety. Certification is contingent on the requirement to satisfactorily pass a timed test. Thank you Ronnie for your commitment to safe, quality care.

PATIENT SATISFACTION

Outpatient Pediatric Hematology/Oncology "splashed" with hope. On December 11, the doctors, nurses, and staff of Stony Brook University Cancer Center, along with pediatric patients with cancer and their families celebrated the unveiling of colorful sea-themed murals that decorate the walls and ceilings of the Pediatric Hematology/ Oncology Outpatient Unit. Provided by the organization "Splashes of Hope," the murals adorn clinical exam rooms, chemotherapy infusion areas, and the waiting area. Artists from Splashes of Hope, a non-profit organization based in Huntington, donated their time and talent to create the paintings for the Cancer Center. A grant from the Laurence W. Levine Foundation, which selected SBUMC for the project, helped bring it to fruition. Senator John Flanagan (R-East Northport) also secured an additional grant to bring the project to completion.

Concierge Services help enhance patient stay. Better Health, Better Living, the publication produced by the Medical Center for the community, is now being delivered to admitted patients by Concierge Services. The publication contains health-related information and happenings, and keeps readers informed about the services and accomplishments of the Medical Center. No one comes to a hospital thinking they will lose personal belongings, such as dentures or hearing aids. But, it happens. As part of a pilot project to help identify patient belongings, Concierge Services will be distributing bright green denture cups, hearing aid cups, and eyeglass cases to patients on 16S, 15N and 15S, and 18N to help prevent loss of these critical aids.

Responding more quickly to patient concerns. Allegiance Voice of the Customer System (VOC) training for managers began in December. The system will improve the way SBUMC responds to patient concerns, compliments, suggestions, and questions by quickly alerting departments about patient issues, and streamlining interdepartmental communications and record keeping. As training continues into 2009, features of the powerful system will be expanded ultimately allowing a patient to interact directly with the system whereby an automatic alert will be transmitted to the hospital manager.

Print advertisements displayed in elevators. As an extension of our advertising campaign, SBUMC print advertisements are now prominently displayed in the Hospital main elevators. This is another vehicle where patients and visitors can learn about the services and expertise offered at SBUMC.

Sharing Positive Patient Comments from Radiology.

Breast Center. "There is a certain degree of angst connected to having a mammography. The tech made me feel relaxed. She was very professional and caring. You are fortunate to have such a high caliber professional in your employ. She couldn't have been nicer."

Nuclear Medicine. "The Tech and his assistant were so good and kind to me. They put me at ease. The person at registration and the desk clerk were also very helpful. It was a pleasure to work with your staff."

Imaging Center MRI. "Everyone was very pleasant and understanding. There was true compassion and everyone made me feel like royalty. The tech is a total asset to your organization. She was so cheerful and warm; she made a difficult test so much easier."

COMMUNITY CONNECTIONS

Cody Center receives $30,000 from Long Island Charities. SBUMC Development Council member John Tsunis has paved the way for a $30,000 donation to the Cody Center's Recreation/Respite Program from Long Island Charities, where he serves on the Board. The Program offers recreational opportunities during school vacations for children with autism spectrum disorder. Mr. Tsunis is the Chair and CEO of Long Island Hotels, LLC, which owns Holiday Inn Express, Stony Brook.

Auxiliary donates funds to purchase state-of-the-art critical care ambulance. The new 2008 transport ambulance will be used by SBUMC's Department of Emergency Medical Service. This is the third ambulance the Auxiliary has so generously donated over the past 28 years! This was recognized at a formal ceremony on December 2 attended by nine members of the Auxiliary. Thank you Auxilians!

NY Islanders and LI Ducks lift spirits in Pediatrics. Pediatric patients and staff at SBUMC had a special holiday visit on December 17 from three New York Islanders-Mitch Fritz (#49), Yann Danis (#34), and Tim Jackman (#28). The three dropped off donated gifts and visited with more than 40 patients and their families. Several days later, Buddy Harrelson, "Quacker Jack," and Dave LaPoint from the Long Island Ducks delivered some holiday cheer of their own, visiting patients and handing out gifts.

Firefighters donate vintage fire bells to Cancer Center. Members of several Suffolk County Fire Departments gathered with the staff of Stony Brook University Cancer Center, patients, and their families for a ceremony to acknowledge the donation of two vintage fire bells-a small bell for pediatric patients and a large bell for adult patients. These bells will be rung to signify the completion of chemotherapy for pediatric and adult cancer patients. The bells, donated by the Bohemia and East Brentwood Fire Departments, were displayed in the lobby of the Cancer Center and rung by patients during the ceremony, a tradition that will now continue at the Center. Many thanks to our firefighter friends. We hope to hear the bells ring often.

Employees raise money for Social Work Indigent Fund. Care Management held a special holiday raffle at its holiday party and collected more than $400 for the Medical Center Social Work Indigent Fund. This fund helps meet the needs of patients who are unable to pay for services or the equipment they need to leave the Hospital. Transportation, clothing, food, and medical supplies are some of the items provided through this fund. The department also donated and wrote 70 holiday cards that were sent to veterans' hospitals for recovering soldiers.

SBUMC celebrates the holiday season. Visitors to the Hospital lobby enjoyed holiday music from a variety of organizations, including the Gelinas Junior High School Band, as well as carolers from Centereach High School, Newfield High School, and local Girl Scout troops. On December 6, the Hospital held a Children's Celebration for staff and their families. More than 200 enjoyed breakfast, dancing with Disney characters, doing the hula-hoop, and taking pictures with Santa Claus. An annual Holiday Breakfast was held for night and day shift employees (on and off site) which included spectacular decorations created by our Market Place Café catering staff. Food was served by our executive staff, the COO, and CEO! Thank you to all who helped make the holidays special at SBUMC.

SBUMC employees give generously! As a part of the celebrations, employees donated non-perishable food items to the Greater Port Jefferson Food Pantry and throughout the holiday season held food and clothing drives, collected toys for children and provided help to those in need.

Pharmacy to host community medication safety talk. Edmund Hayes, Associate Director of Pharmacy, will give a talk on medication safety and the proper use of prescription and non-prescription medications to the "Setauket Homemakers" at the Setauket Neighborhood House on January 7.

Department of Laboratories provides tours for college students. Associate technical directors and the Quality Systems Manager in SBUMC's Department of Laboratories routinely conduct tours and participate in community programs to introduce the profession of Medical Technology to high school and college students. A recent tour was conducted by our Microbiology Associate Technical Director for 30 students from the Natural Sciences Department of Suffolk Community College.

Sleep Disorders Center offers education and support. The Sleep Disorders Center is continuing to reach out to the community by hosting Suffolk County A.W.A.K.E. meetings, a sleep apnea support and information group meeting. The Center will also be participating in student education regarding career opportunities in Sleep Medicine. The next meeting will take place on February 21 at 10:00 am at the Center, located at 240 Middle Country Road, Smithtown.

MY LAST TOUCH

Have you struggled with big questions like, "What is the meaning of life?" "What am I doing here?" Most of us have at one time or another. The questions are so straightforward, yet almost impossible to answer. In times of stress these questions become even more important, particularly when there is a major life stress and you may even question your purpose in life. It seems there is abundant stress to go around these days, with people losing their jobs, the economy struggling, and who knows what else...

Purpose itself is an interesting word. It can be a noun or a verb, and has some idiomatic uses like, "How could you do such a thing on purpose!" One meaning of purpose is to resolve to do something as in, "He purposed to change his way of life." Purpose also means to set an aim, to resolve to do something, to achieve a desired result. Focus, resolve, direction are so important when thinking about your purpose. These are hard concepts, perhaps probing and gnawing. Yet, at the beginning of a new year, they are worth thinking about. New Year's resolutions should begin with purpose in mind.

For people in healthcare, purpose may be easy-to heal the sick. But there must be other components to purpose, even in healthcare. What do we want to accomplish? What are our desired results?

• To guide patients and their families through difficult times.
• To support each other sometimes on a emotional roller coaster, as we stand by our patients throughtreatment, recovery, and sometimes less than desired outcomes.
• To find moments of joy to share and remember.
• To assure that we have the knowledge and skill to help our patients heal.
• To be confident in what we see.
• To be sure we communicate well.
• To be sure we take time to laugh.

Your list might be slightly different, but healthcare is not only about the technology of treatment, but also about healing. Our shared purpose is healing, and our five simple rules of work serve as a foundation for this purpose.

Enjoy the New Year. Thank you for being a part of SBUMC.

Steven L. Strongwater, MD
Chief Executive Officer
Stony Brook University Hospital

PATIENTS FIRST | WORLD-CLASS PROCESSES | TEAMWORK | GROWTH | USE RESOURCES WISELY

It is neither wealth nor splendor, but tranquility and occupation, which give happiness.
-Thomas Jefferson

I am only one, but still I am one. I cannot do everything, but still I can do something. And because I cannot do everything I will not refuse to do the something that I can do.
-Helen Keller

If a man is called to be a street sweeper, he should sweep streets even as Michalangelo painted, or Beethoven composed music, or Shakespeare wrote poetry. He should sweep streets so well that all the hosts of heaven and earth will pause to say, here lived a great street sweeper who did his job.
-Martin Luther King Jr.