From the Offices of Elliot Joseph and Jeffry Nestler, MD
July 24, 2011 Edition

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"The future belongs to those who see possibilities before they become obvious." - John Sculley, former CEO of Pepsi and Apple Computer

Happening at Hartford Hospital

Governor Dannel P. Malloy Visits Hartford Hospital

Gov. Dannel P. Malloy visited Hartford Hospital on July 19, meeting with leaders from Hartford HealthCare and Hartford Hospital and visiting our clinics in the Brownstone Building as well as the Center for Education, Simulation and Innovation at the ERC. Among the governor’s priorities for the state are enhancing research, addressing health disparities, economic development and further enriching medical education at the University of Connecticut. Hartford HealthCare institutions already are involved in these activities. “Gov. Malloy was very engaged with everyone during his tour, asked a lot of questions and, overall, seemed very impressed with both the great work being done in our Brownstone clinics and with the extraordinary technology on display at CESI,” said Yvette Melendez, vice president of government and community alliances.

Governor Names Yvette Melendez to State Board for Higher Education

Connecticut Governor Dannel Malloy has named Yvette Melendez, vice president of government and community alliances, to the state’s new Board of Regents for Higher Education. The new board is central to Malloy’s reorganization of higher education, which involves consolidation of the leadership of the state’s four smaller universities, the 12 community colleges, and the state’s online college. As of Jan. 1 the boards of trustees for those colleges will be dissolved and replaced completely by the new board of regents. The new board will have 19 members: nine appointed by Malloy, two student representatives, four legislative appointments and four ex-officio members who are commissioners of state agencies. Before joining HH, Melendez served in the roles of chief of staff and chief administrative officer for the Connecticut state university system.

Help Put Our Physicians and Services in the Media Spotlight

You can help open our own multi-media studio at Hartford Hospital with a gift to the Medical Staff Annual Campaign. The studio will have a Ready Cam, which will allow the Hospital to let everyone in the nation know about our extraordinary clinical expertise. Many physicians have already given to the project, which will enhance Hartford Hospital’s national recognition as a top-flight institution and benefit all of us. While the technology will provide the means to showcase the expertise of the Hospital's physicians and staff, it will also allow educational opportunities for our community physicians that might otherwise not be available to them. We’re off to a good start. Please join your colleagues in making a gift to support this project through the campaign. As a convenience, click here to make your donation online.


Hartford Named One of 100 Most Wired Hospitals in US

For the fifth consecutive year, Hartford Hospital has been named one of the nation's 100 Most Wired hospitals. The honor comes from Hospitals & Health Networks, the journal of the American Hospital Association. Most Wired hospitals show better outcomes in patient satisfaction, risk-adjusted mortality rates and other key quality measures. This year's survey included 1,388 hospitals. Only four other hospitals in Connecticut were named: MidState Medical Center (a Hartford HealthCare partner), Bridgeport, St. Francis, and Yale-New Haven. The biggest differentiator between the "Most Wired" organizations and others is the ability to present patient documentation as structured data, a major criteria for meaningful use under the ARRA. The July cover story detailing results is at

Dr. David Crombie, Former Chief of Surgery, Honored by Connecticut Medicine

Dr. David Crombie, former chief of surgery at Hartford Hospital, was honored July 15 at a gala celebrating the 75th anniversary of Connecticut Medicine, the scientific journal of the Connecticut State Medical Society. Dr. Crombie is stepping down as the editor of Connecticut Medicine, a position he has held since 1999. The staff and leadership of CSMS wrote: “We at CSMS are thankful and fortunate to have had the privilege of sharing Dr. Crombie’s expertise, work ethic and commitment. Under his leadership, Connecticut Medicine has flourished and today is one of a handful of peer-reviewed medical journals remaining in the country. Dr. Crombie leaves a remarkable legacy behind that will remain for years to come. Connecticut Medicine would not be the success it is today without his leadership and vision.”

Dr. David Glahn Receives Prestigious Theodore Reich Prize

Dr. David C. Glahn, an investigator at the IOL’s Olin Neuropsychiatric Research Center, is this year’s recipient of the Theodore Reich Prize from the International Society for Psychiatric Genetics. Dr. Reich (1938-2003) was an outstanding researcher and mentor, and the award named in his honor is given to promising young investigators for exceptional published work in psychiatric genetics. Dr. Glahn, who has published more than 100 peer-reviewed scientific articles, received the award for his work developing and applying neurocognitive and neuroimaging endophenotypes for psychotic and affective disorders.

Stroke Center Honored by American Stroke Association

Hartford Hospital received the American Stroke Association's Get With The Guidelines Stroke Gold Plus Achievement Award. The award recognizes the hospital for providing high-quality, safe care for stroke patients. HH was also recognized by the ASA for its timely care of patients. Hartford Hospital's Stroke Center celebrated its 10th anniversary in 2011.

ERRACE Raises $56,000 for Cancer Research and Support

More than 600 cyclists, runners and walkers participated in the 4th annual ERRACE (Everyone Ride/Run Against Cancer Everyday) on July 17. The race, which began and ended at the Helen & Harry Gray Cancer Center in Avon, raised more than $56,000 for the Cancer Center and for The Lance Armstrong Foundation. It included 25-, 50- or 100-mile bike rides, and a 5-10K walk or run. The event is run by Hartford Hospital surgeon Dr. Andy Caputo and his wife, Alyson, an ovarian cancer survivor. For more information, visit

Innovative & Complex Care

CESI: Boot Camp for Residents

The Center for Education, Simulation and Innovation (CESI) at Hartford Hospital is an ideal setting to begin to establish a culture of patient safety and open communication among the interdisciplinary team. Its mission is to promote excellence in clinical care, advance patient safety and improve multidisciplinary team performance through high-fidelity medical simulation. Participants train in a setting similar to their actual work environments to create an atmosphere of realism. Working in this environment lends support to the simulator’s extended capabilities to mimic multiple types of acute crises and patient care scenarios. The 14,000 square foot center, located in the ERC, provides “Boot Camps” for first year residents. Click here for an update on CESI facilities.

Research & Academics

CAIRD Awarded Grant To Improve Drug Regimens For Children With Cystic Fibrosis

The Center for Anti-Infective Research and Development (CAIRD) has been awarded a new two-year $316,117 grant through the Thrasher Research Fund for a project entitled “Population Pharmacokinetics of Meropenem in Children with Cystic Fibrosis: Justifying High-dose, Prolonged Infusion Regimens.” Under the leadership of Dr. Joseph Kuti, associate director of CAIRD, the project will seek to improve upon currently available antibiotic regimens for children with cystic fibrosis, a population that is particularly vulnerable to infection from anti-biotic resistant bacteria.

Care Coordination

New Policy on Patient Advocates From Medical Executive Committee

There is a new policy on patient advocates approved by the medical executive committee. According to the new policy, a patient advocate is a licensed clinical professional (licensed nurse, licensed social worker or other licensed health care professional) who has been engaged by a patient admitted to Hartford Hospital. Patient advocates must be approved prior to providing services to patients in the hospital and the patient advocate’s information must be entered into the vendor relations database (“Reptrax”). Patient advocates may obtain protected health information for the purpose of communicating to the patient and assisting the patient and/or patient’s family in decision making. Click here to see the policy in its entirety. All of the policies are posted on the Alfresco site.

Sunrise Update: Look at the Banner

Admitting attending physicians’ names are no longer on a sticker in the medical record. You can find it in SCM, on the banner. You can also find information on the patient’s primary care doctor and other consultants by clicking on the Patient Info icon. Providers can electronically change a patient’s attending provider in both SMS and SCM by submitting an order: CHANGE ATTENDING PHYSICIAN entered in SCM will automatically be transmitted to SMS, which will then update clinical applications. A required field on the order form allows easy look-up of provider names and will auto-populate the information.

Central Scheduling Implements “CarePricer”

Hartford Hospital recently launched CarePricer under the Central Scheduling initiative. CarePricer is a technology that produces accurate and fast liability estimates so patients understand their out-of-pocket responsibility at the time of scheduling. Estimates are calculated based on procedure type, the patient’s underlying managed care plan and eligibility and benefit information. This replaces an often-frustrating process that was inconsistent and cumbersome. Calls go to Central Scheduling (860-696-3000) or Patient Financial Services customer service (860-696-6119), and timely accurate estimates are given over the phone. Email and mailed letters are available with the information, which will be good for 30 days. The initiative is expected to improve the overall patient experience while lifting a burden off staff members who formerly were responsible for tracking down this information.

Operational Update

Financial Update for June

Inpatient discharges in the month of June were 1.9% below budget, but exceeded the discharges of the prior June by 1.3%. Year to date through June, inpatient discharges are 3.3% below budget.
Outpatient revenues continued to be strong, as the case has been for much of this fiscal year, exceeding the budgeted revenues by approximately 15%. (The areas of outpatient revenue that contributed to the favorable variance were the Eye Center, Radiation Oncology and Ambulatory Surgery.) Year to date through June, outpatient revenues are approximately 6.5% greater than budgeted.

Physician Survey Complete; Prize Winners Announced

The physician survey, which ran from June 8 to July 12, was completed with 44% response. Results will be analyzed and distributed to the medical staff in August. Winners of the gift certificates for Max Restaurants are: Jordan Blinder, Anesthesiology; Sara Blomstrom, ED; Gary Heller, Cardiology and Christina Kozar, Pediatrics. Janice Fernandez, Anesthesiology won an iPad.

Hartford Hospital Welcomes Dr. Timothy Machon

Dr. Timothy J. Machon has joined Hartford Hospital as a gynecologist, specializing in robotic surgery. He was head of the Northeastern Benign GYN Epicenter for robotic surgery at Saint Francis Hospital and Medical Center in Hartford for the past three years. Dr. Machon attended medical school at Temple University in Philadelphia and completed his OB-GYN residency at Lankenau Hospital in Wynnewood, Penn. He has been in practice at Women’s Health Group for the past 16 years, with offices in Enfield, Hartford, and Rocky Hill.

Throughout the HHC Network

Becker Assumes Dual CFO Role at MidState and HOCC

Ralph Becker, vice president of finance and CFO at MidState Medical Center, will also become the CFO at The Hospital of Central Connecticut as of Oct. 1. He succeeds Brian Rogoz, the current VP for finance and treasurer at HOCC, who is retiring in October. “Having a single CFO for two institutions represents the kind of integrated leadership that will be needed as we bring the system together and create a truly cohesive health care delivery network,” said Elliot Joseph. Becker has been at MidState since 1985, and before that was a senior consultant with the health care practice of Ernst & Young and worked in Medicare reimbursement at Blue Cross/Blue Shield of Connecticut.

Windham CEO Brvenik Leaving Hartford HealthCare

Dick Brvenik, senior vice president at Hartford HealthCare and president and CEO of Windham Hospital since 1999, is leaving HHC to take a position as president and CEO at Carteret General Hospital in Morehead City, N.C. His last day with Windham will be Aug. 31.

Living Our Values

Advice From A Passionate Patient Advocate

The following essay was written by St. Ella Massiah, an employee from the Health Sciences Library, who has worked at Hartford Hospital for several years. Originally from Barbados, Massiah was struck by the interactions she observed between physicians and patients when she began working as a PCA on CB2. A passionate patient advocate, she wrote the following note to Dr. Rocco Orlando, who shared it with colleagues at a medical chiefs meeting. The piece inspired much discussion, and medical leadership thought it would be valuable to share with the medical staff. “Studies show that communication with patients goes a long way in improving quality and safety, and the role that physicians play in that is critical,” said Dr. Jamie Roche, vice president for patient safety and quality.

Doctors are to be seen more regularly by their patients; if not in the morning, then try to get it done before the day ends. Do not allow a day to pass without a visit to your patient. I know that this is very hard sometimes because of work schedules and other things, but this is one of the main things patients complain about. This I know of because during my time as a PCA, patients would always ask: 'when am I going to see my doctor?' Let us try to make sure that patients do not have to ask these kinds of questions.

If you have a patient that is admitted during the night and you cannot get in to see that patient right away, call the patient's room as soon as he or she is admitted and settled. Most likely a family member will be with that patient whom you can talk to giving them reassurance. It also shows that Hartford Hospital's doctors care and our patients come first, and it will make the family member know also that you care. I can imagine being admitted to the hospital at 12:00 a.m. at night and receive a call from my doctor stating that I would see him or her the first thing the next morning. As sick as I might be, this one call would make me feel more comfortable because I would then know that my doctor has not forgotten me.

To doctors, nurses and PCAs: when speaking to or with a patient or family member, always make sure they can see your front (face) and not your back. This shows respect.

We all know that we do not discuss one's patient information in another patient's room. They will tend to think that you would do the same thing to them. When two or more health care workers are in a patient's room, make sure that you do not carry on discussions about your personal life, for example where you went shopping or where you went to dinner. The patient is not interested, and it can be very disturbing. Also, the reason they are here is to have peace and quiet and to get well. We must do our very best to ensure that this happens.

Never show that you are in a hurry to get away from your patient, especially if they need something done. They would not like it, and if you were in their position, you would not like it either. Yes, we all are busy, but sometimes we must be a bit more discreet in how we do things.

Show some compassion. Sometimes all a patient needs is to have someone listen to them for a few minutes. It might slow your work schedule a bit, but it might mean the world to that patient. I cannot see how we can work in an environment such as ours and not care for our patients. We must have love and sympathy for all of our patients when they enter our doors, and for each other. As long as you have a heart, you will feel compassionate for anyone that is ill. We all are family here. Believe it or not, our patients are our family also. Let’s show them how Hartford Hospital takes care of its family.

Coming Events

August 5 (Friday)
Department of Surgery Grand Rounds:
Melanoma: An Update on Standard and Experimental Therapies

Dr. David Eisenberg, Hartford Surgical Oncology Specialists. 6:45-7:45 a.m., Gilman Auditorium. For information, call Herma Johnson at 860-545-2840.

Sept. 29 (Thursday)
Psychiatric Grand Rounds:
Bipolar Disorder and Schizophrenia: Two Disorders with Two Distinct Biologies, or a Continuum with a Complicated Biology?

Godfrey D. Pearlson, MD, director of the Olin Neuropsychiatry Research Center, The Institute of Living/Hartford Hospital; professor of psychiatry, Yale University School of Medicine. 12 noon, Hartford Room, Commons Building, IOL

Click here for more events

HH In The News

The CT Mirror, July 13
Fledgling UConn Health Center union caught in concession turmoil

Bruce Mayer, the research biologist who is president of the new faculty union at the UConn Health Center, talks about his union’s pending first contract, which includes the concession deal framework.

Hartford, July 18
Projects a boost for construction industry

Major construction projects from Connecticut’s health care sector could act as a much-needed stimulus for the construction industry. Among the projects in the pipeline is a $61 million investment by Hartford Hospital to expand its emergency department, renovate several buildings near its campus on Jefferson Street, and construct a $40 million parking garage. The article also mentions upcoming construction projects at Danbury Hospital, John Dempsey Hospital, the University of Connecticut Health Center and Windham Hospital.

Hartford, July 18
Hartford Healthcare bond offering to refinance debt, overhaul campus

Hartford Hospital is preparing for a significant $61 million investment in facilities, and Hartford Healthcare will be doing a $350 million bond offering to finance it. The remaining funds will go toward refinancing existing debt held by hospitals affiliated with Hartford Healthcare, including MidState Medical Center, The Hospital of Central Connecticut, and Windham Hospital.

Hartford Courant, July 19
Hartford Healthcare Plans $61 Million Expansion

Hartford Hospital is planning to spend $61 million on its facility, including a new parking garage, an expanded emergency department and a new chapel.,0,110463.story

Hartford, July 20
CT’s Hughes Health, Hartford Hospital cardiac partners

Hughes Health and Rehabilitation Inc. and Hartford Hospital are collaborating in a program aimed at curbing unnecessary readmissions of patients with congestive heart failure.

Hot Topics in Healthcare

NEJM, July 13
The ACO Rules — Striking the Balance between Participation and Transformative Potential

The authors believe there are ways for CMS to improve participation in ACOs without sacrificing the workhorse provisions of the new policy that defines payment incentives to providers.

TIME Healthland, July 19
Your Doctor’s Bedside Manner Could Affect Your Health

Studies show that rudeness and incivility among doctors, in particular in the operating room, can actually lead to poorer health outcomes and even higher death rates among patients.

HealthLeaders Media, July 19
Gawande on Cowboys and Pit Crews

Atul Gawande, the surgeon and author of 2009 book, The Checklist Manifesto, has over a very short amount of time become a champion for the difficult work of cutting costs and improving quality in healthcare. He spoke to a packed house at the 2011 American Hospital Association Leadership Summit last week in San Diego. Gawande's message: We are in a battle for the soul of healthcare. Though he didn't say it in so many words, we're probably in a battle for the soul of the American Dream, and whether people realize it or not, that battle will likely be won or lost on whether we, as a nation, are successful in driving down costs and improving quality in healthcare.

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.