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Physician, nurse leaders carve out time for patient care

BAMC News & Awards



Story by Elaine Sanchez, BAMC Public Affairs
Published August 31, 2015



Army Col. (Dr.) Evan Renz, Brooke Army Medical Center commander, explains the function of a vacuum-assisted closure device to Indalecio Morales in the U.S. Army Institute of Surgical Research Burn Center at San Antonio Military Medical Center, Aug. 11, 2015. U.S. Army photo by Lori Newman

Army Col. (Dr.) Douglas Soderdahl, BAMC’s deputy commander for acute care, checks in with his longtime patient, Frank Samas, while Janet Schadee, urology and oncology clinical nurse, looks on in the Urology Department at San Antonio Military Medical Center, Aug. 11, 2015. Samas has rave reviews for his doctor. “He’s the best doctor here,” he said, “and that’s no lie.” U.S. Army photo by Lori Newman

Army Col. (Dr.) Pedro Lucero, assistant deputy commander for clinical services and former chief of the Pulmonary Disease Service, examines Jeannette Haygood, his patient since 2002, at San Antonio Military Medical Center, Aug. 19, 2015. “He left for another assignment several years ago and when he came back, I was there on his doorstep,” Haygood recalled. “I truly believe if it wasn’t for Dr. Lucero … I wouldn’t be here right now.” U.S. Army photo by Corey Toye

Army Col. Richard Evans, deputy commander for nursing, checks on retired Col. Randy Maschek as Pvt. Karinna Ortiz, a practical nurse course student, looks on in the 2 West inpatient ward at San Antonio Military Medical Center, Aug. 20, 2015. U.S. Army photo by Robert T. Shields

Air Force Col. (Dr.) Kimberly Pietszak, interim chief, Department of Quality Services, and assistant chief, Department of Medicine, examines Air Force Col. Patrick at San Antonio Military Medical Center, Aug. 26, 2015. U.S. Army photo by Corey Toye

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 here. “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, and 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 said.

Time in the ‘trenches’

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, 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 clinical staff.”

‘Suits to Scrubs’

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, Army Medical Command’s deputy commanding general (operations).

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.