ACGME-Gold DeWitt (Bud) C. Baldwin, Jr. Award
What are some of the best ways to enhance the compassionate practice of medicine? How do you make sure the culture of an institution values caring? This is the second in a series of interviews with the three winners of the 2017 DeWitt C. Baldwin, Jr. Award. We previously highlighted Montana Family Medicine’s accomplishments in humanistic care. The third interview focused on honoree Virginia Commonwealth University. By highlighting practices for teaching and implementing compassionate, collaborative, and scientifically excellent practice, we hope to share and facilitate widespread adoption of replicable humanistic education and practice.
A Joint Venture
The Baldwin Award is jointly sponsored by the Arnold P. Gold Foundation and the Accreditation Council for Graduate Medical Education (ACGME), and named for Dr. Bud Baldwin, a pioneer in inter-professional education and collaborative practice. The award recognizes accredited residency and fellowship sponsors that foster supportive and humanistic environments for medical education and patient care, contributing to the personal and professional development of learners.
Of the 60 institutions invited to apply for this award, six were selected as finalists and participated in an on-site visit. During the site-visit, each institution exhibited their humanistic culture through interviews with leadership, residents, nurses, administrative, technical, and other staff. The awardees demonstrated a shared commitment to exceed the accepted standards of care. The winners had created impressive institutional cultures that promoted wellness without stigmatization. One important question kept coming to mind: how did they manage to do this so well?
Vanderbilt University Medical Center: Nashville, Tennessee
Vanderbilt was selected as one of the winners of the Baldwin award. Dr. Donald W. Brady, who serves as the Senior Vice President for Educational Affairs and the ACGME Designated Institutional Official at Vanderbilt University Medical Center (VUMC), sat down for an interview with the Gold Foundation to discuss his institution’s best practices in humanistic education and patient care. He has served in his current role for over a decade, and says that the culture of compassion at Vanderbilt has been a priority at this hospital for a long time.
Dr. Brady noted that it was critically important for the institution to first make an inward statement about what they believe in, and then to make those values explicit and visible to all levels of the organization. At Vanderbilt, the leadership has developed a Credo, which includes the statement “I am committed to my colleagues.” This Credo, along with the “Patient and Family Promise,” an outward promise to patients about quality care, are two value statements that are displayed around the hospital. “These visual reminders are the bedrock of coalescing our sense of community around humanism,” Dr. Brady said.
He notes that it is important to recognize staff, residents and faculty members who do an excellent job of living the mission of VUMC. Vanderbilt not only gives out awards for individuals who go the extra mile for patient care, but they also give out a “team award” to celebrate groups of people who work together to accomplish something that an individual could not achieve alone. Presented at large quarterly leadership assemblies, all of these awards recognize and celebrate the embodiment of the Patient and Family Promise and the Credo.
Vanderbilt has also instituted a Center for Patient and Professional Advocacy, where complaints are addressed by having reflective “cup-of-coffee” conversations with the affected parties. This leads to a nonjudgmental environment for improving behaviors, and the success of these interventions has been high. “We have to accept that people make mistakes, and when they do, we should address them with compassion,” Dr. Brady said. “It’s important for us, as an organization, to listen and learn where we can make things better.”
A Commitment to Education
VUMC is committed to its residents. Wellness programs for residents have been a long-standing tradition, but the organization has now branched into more innovative ways to promote well-being. For example, MHAMA, the Minority Housestaff for Academic and Medical Achievement, is committed to creating opportunities for the advancement of underrepresented house staff by providing opportunities for mentorship, networking and professional development. VUMC also recognizes the importance of residents’ social support systems as evidenced by the Vanderbilt Housestaff Alliance, an organization for the spouses and significant others of current residents funded in part by the GME office. This group focuses on engaging in a wide variety of social support-building activities and community engagement.
The focus on wellness for medical trainees does not stop at residents. The medical center is closely aligned with the medical school, and the culture at VUMC affects how students experience their medical education. “We also ask medical students to reflect with us and help us maintain a culture of caring,” Dr. Brady said. “We’re always looking to evolve and do things better. The new generation entering the workforce brings new energy and creativity and, if we listen well, can help us evolve our systems while remaining true to our commitment to patients and their families. It’s also crucial to honor, celebrate, and promote diversity.”
Dr. Brady spoke about how the Baldwin award has helped Vanderbilt take stock of the full range of humanistic practices that the institution offers. “Having everyone from senior administration to educational leadership to our trainees reflect on the impact of our work in humanism was helpful and served to reinvigorate our commitment to it. It benefited the whole enterprise,” Dr. Brady said. The review process for the Baldwin award also afforded the administration the opportunity to ask staff, particularly residents, about their experiences working at Vanderbilt. “Reading and learning about personal experiences of our residents was incredibly insightful, and reminds us why this work is necessary.” These institutional practices at Vanderbilt serve as excellent examples of how to do that work well.