From the Offices of Elliot Joseph and Jeffry Nestler, MD
September 19, 2010 Edition

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"Perfection is not attainable, but if we chase perfection we can catch excellence." - Vince Lombardi

Transition of Care and Patient Readmission: Hartford Hospital Heart Failure Initiative

The 30-day readmission rate national average for heart failure is 24.5 percent; the rate for Hartford Hospital is 23.4 percent. Readmissions are often costly, adverse events for patients. The Medicare Payment Advisory Commission has identified heart failure readmissions as common, expensive and often preventable. Readmission measures complement the process of care and mortality data also reported on Hospital Compare, and these measures increase the transparency of hospital care and provide consumers with helpful information. Measuring and reporting hospital readmission data encourages hospitals and hospital systems to evaluate the entire spectrum of care that they and their affiliated providers furnish to patients and more carefully transition patients to outpatient settings or other levels of care.

Over the past year a Hartford Hospital team has been looking carefully at heart failure patients and examining all factors that may lead to a preventable readmission. An important Balanced Scorecard initiative for 2011 is to “Coordinate Care across the Continuum” and an Action Group is forming to address the goal of reducing the percent of heart failure readmissions within 30 days. The overarching goals of this initiative are:

  • To enhance and facilitate the safe, comprehensive delivery of care to our patients across the entire continuum of care through an integrated and coordinated approach within and across our health system
  • To work toward becoming a top-decile performer in this measure
  • To understand how the processes and protocols developed may be applied to other high risk patient populations
  • To enhance customer satisfaction
  • To facilitate a collaborative partnership with all key stakeholders

Medical Staff-Funded Research Targets Safety & Quality

The Medical Staff has continuously funded a wide array of research projects through several Research Committee administered programs, with the emphasis placed on new investigators and pilot/preliminary projects to support external grant applications. The funding focus this year was on efforts to improve patient safety and to enhance the quality of care. A total of $86,000 was awarded to a diverse group of departments. Recipients are: Lincoln Abbott, MD; Ellen Blair, RN; John D’Avella, MD; Joao Delgado, MD; Pavlos Papasavas MD and Darrin Tischler MD; Gualberto Ruano, MD; and Cunegundo Vergara, MD.

Negotiations with Anthem

Hartford Hospital and Windham Hospital continue to negotiate with Anthem Blue Cross of Connecticut to obtain more fair and reasonable contracts with rates similar to the rates paid to other hospitals in the Northeast and in Connecticut. Unless an agreement is reached before Oct. 31, 2010, Hartford and Windham hospitals’ current contracts with Anthem will expire. This means that Hartford and Windham hospitals will no longer be participating providers in the Anthem network, and patients with Anthem insurance will have to pay more money out of pocket to continue their care with us as of Nov. 1, 2010. A letter to physicians went out last week and letters explaining the current situation also are being sent to patients. There will be regular updates for physicians.

Town Meetings

Jeff Flaks, Hartford Hospital COO and EVP, is conducting town hall meetings with staff members through early October. The one-hour meetings give employees a chance to raise issues of interest and concern and give Jeff a chance to talk informally about the hospital’s vision and the challenges ahead. The schedule of meetings is available here, and on the Hartford Hospital Intranet.

Important Changes to Hartford Hospital’s DNR Policy and Form

The Hartford Hospital DNR Policy and DNR Form have been revised by the Ethics Committee and approved by the Medical Executive Committee. The major changes include a new definition of a DNR order and significant changes in patient options on the form. The DNR Policy now includes new sections on pre-existing DNR orders, patients with DNR bracelets from the community and changes in DNR orders. A letter describing the changes also is available here. The revised policy is available on the Hartford Hospital Intranet (Novell log-in required). On the Intranet homepage, select “Hospital-Wide Policies (Alfresco®/Mosby®)” under the "Reference" sub-heading. On the search page produced by this link, search “DNR” and click on the appropriate search result. The policy is available here. The form is available here.

Hartford Hospital in the News: The Hartford Courant on Treating the Yom Kippur Headache

Dr. Michael Drescher, reporting in Headache: The Journal of Head and Face Pain, describes a possible treatment for the headache that can accompany Yom Kippur’s 25-hour fast. The intervention group had fewer and milder headaches and “a more spiritual experience.”

HH2020: Building Our Future

There are a number of upcoming closures required to complete projects that support clinical care and that create public spaces that set the tone for a high-quality patient encounter: The Bliss elevator lobby outside the cafeteria was closed for renovation this weekend and slated to reopen today (Sunday). The main dining area will be completed in a few weeks. Lobby construction will be completed this month, as will the Emergency Department waiting area. Future closures include:

  • ERC 2: Hallway closures through mid-November - Select portions of ERC 2 are closed for construction. Maps posted within the ERC show detour routes.
    • Of Note: Next weekend, 9/25-9/26, the ERC elevator will not stop on ERC 2. For elevator access to ERC 2 during that time period, use the ERD elevators.
  • Bridge to Conklin Building: Closed through early October - The bridge connecting the Conklin Building and the South Building is closed. Patients are transported through the underground tunnel. Staff should use the tunnel or outdoor routes to travel between the buildings.
  • Main Lobby: Evening shutdowns during September - The main lobby to the hospital will be closed during the evenings (from 9 pm – 5 am) to accommodate construction work this month. All patients and staff will be routed through Admitting.

Top Docs for Cancer Research

The Cancer Clinical Research Office has recognized Drs Amy Brown and Stacy Nerenstone for their high accruals to clinical trials during the second quarter of 2010. Dr. Brown enrolled four patients and made six referrals and Dr. Nerenstone enrolled four patients and made 10 referrals. Congratulations to our top performing physicians who are making a difference in patient care and who are assisting in determining the best treatments for cancer.

13th Annual Nite of Lite Laughter, October 22

Lite 100.5 and Hartford Hospital are proud to present Lily Tomlin for the 13th Annual Nite of Lite Laughter fundraising event on Friday, October 22, at the Bushnell Theatre in Hartford. Proceeds will support Breast Cancer Programs at the Helen & Harry Gray Cancer Center. Tickets are on sale at the Bushnell Box Office. Tickets are available by phone at (860) 987-5900 or online at

Research Update: Scientific Progress for Patients

The 2010 Research Symposium, "Genomics and Personalized Medicine: The Future is Now" will take place from 4 to 6:30 pm on Thursday, Oct. 14, in Heublein Hall at the Educational Resource Center on the Hartford Hospital campus. The keynote speaker will be Lawrence J. Lesko, PhD, FCP, director, Office of Clinical Pharmacology, Center for Drug Evaluation and Research, Food and Drug Administration. A wine and cheese reception and poster session will follow the presentations. Attendance is free. Please contact Chris Harvey (860) 545-5620 to register. Investigators interested in presenting posters are invited to contact Anita Fowler (860) 545-2093 for more information.


The Seymour Street Journal (SSJ) has been developed to communicate key messages pertinent to our hospital’s physicians. It will keep you informed and up-to-date on hospital, network, and health care news in a concise, convenient format. The SSJ will be sent to your preferred e-mail address every other Sunday. Back issues can be viewed here. For any questions or suggestions, please contact Dr. Jeffry Nestler, Medical Staff President, at (860) 836-7313.