From the Offices of Elliot Joseph and Jeffry Nestler, MD
June 12, 2011 Edition

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"It is not necessary to change. Survival is not mandatory." - W. Edwards Deming


Living Our Values

Hospital Establishes Fund To Help Staff Dealing With Tornadoes

The devastating tornadoes that struck Springfield and nearby communities June 1 left many struggling to find shelter and to meet other basic needs. The affected area of Massachusetts is home to a number of Hartford Hospital staff members, several of whom had their homes destroyed or seriously damaged. We are establishing a fund that will provide immediate help to staff dealing with catastrophic circumstances from the tornadoes. Those who wish to donate money can contact Beverly Sherbondy, director of HR, at 860-545-3135.

Excellence

Response Times Improve In ED As Staffing Ramps Up

The percentage of patients seen by a provider in 30 minutes or less in the Emergency Department has improved by almost 47% in the past four months, according to Dr. A. Jon Smally, medical director of Emergency Medicine. In June, 41.1% of patients were seen within 30 minutes; in May, the figure had risen to 60.4%. In some weeks, the figure was as high as 70%, Smally said. The increase was due to hard work by our ED staff and leadership; to increased staffing; to the work of our newly added ED nurse director, Ann Dion; and to the time and effort devoted by Maryanne Pappas, PA and nurse practitioner manager, and Dr. Kenneth Robinson, LIFE STAR program director, in his role of associate chief of Emergency Medicine. Smally said they have also hired new attending physicians, physician assistants and nurse practitioners to work in the ED. “That should allow us to narrow the gap even further, and continue to see more people in a more timely fashion,” he said. The overcrowding of the ED continues to be an issue as well. Often patients are admitted from the ED, but must wait there until an inpatient bed is available. In any given hour, 11-15 of the 35 treatment rooms may be occupied by patients waiting to be admitted, Smally said. The situation should be eased considerably by the expansion of the ED, expected to start within three weeks. The project will provide 25 new treatment spaces, and is expected to be complete by early 2012.

Medical Staff Semi-Annual Meeting Last Thursday

There was good attendance at the medical staff semi-annual meeting on Thursday, June 2. President Elliot Joseph, COO Jeffrey Flaks, and Dr. Rocco Orlando, senior VP and CMO, conducted a town hall meeting entitled “How the changing Connecticut health care landscape will affect Hartford Hospital and its medical staff: Ask the Leadership.” "The discussion at the town hall meeting was well received by the physicians in attendance, and addressed many issues including clinical integration in a pluralistic medical staff environment," said Dr. Jeffry Nestler, president of the medical staff.

Generous Support for the Depression Initiative Reflects High Regard for Dr. Schwartz and the IOL

With deep respect and admiration for Dr. Harold Schwartz and his leadership of The Institute of Living, Steven and Blanche Goldenberg recently made a generous gift to support the Depression Initiative at the IOL. They directed their gift from an advised fund at the Hartford Foundation for Public Giving. The Goldenbergs have been long-time supporters of the IOL and, more directly, the important work being done there under the guidance of Dr. Schwartz. In December 2009, the philanthropic couple hosted an informational gathering at their West Hartford home for some 30 guests. The highlight was a presentation by Dr. Schwartz, who explained the critical importance of the initiative that supports treatment, education and research for depression, bi-polar and anxiety disorders. To date, the hospital has raised nearly two-thirds of its goal of $3 million to support the Depression Initiative. Dr. Schwartz has played a primary role in our solicitations for the initiative.

Innovative & Complex Care

Genomas Wins $1.3 Million Research Grant from NIH

Genomas has won a $1.3 million grant from the National Institutes of Health to develop technology that will help predict—based on a patient’s DNA— if that patient is likely to experience debilitating side effects while using statins. Dr. Gualberto Ruaño, president of Genomas and HH’s director of genetics research, and Dr. Paul D. Thompson, chief of cardiology at the Henry Low Heart Center, are co-investigators. More than 40 million Americans use statins, and up to 20 percent stop using them because their muscle pain is debilitating. Genomas has created the SINM PhyzioType® System which consists of four tests that use a patient’s DNA to predict statins’ LDL lowering efficacy, HDL raising efficacy, the likelihood of developing myalgia or myopathy. “Through Phase II Renewal funding, Genomas will be able to confirm that PhyzioType® is reliable, reproducible and cost-effective,” said Dr. Ruaño. “We can help physicians optimize treatment strategies in lipid disorders and ultimately help more patients.” According to Dr. Thompson, "Growing evidence indicates that genetics have so much to do with how a body responds to treatment. The renewal grant will allow us validate studies of the multi-gene biomarker system. This goes a long way and will help personalize cardiovascular therapy.” To date, Genomas has received $6.1 million of NIH SBIR funding for PhyzioType® product development.

Care Coordination

Procedure Change: TPN Must Be Ordered By Noon

Starting June 14 there will be a new procedure for ordering TPN, as the pharmacy will outsource its preparation. TPN must be ordered through SCM by 12 noon each day. If you order it after noon, you will be informed that it cannot be ordered for that day, and you may order Dextrose 10% replacement fluid or plain Clinimix 5/25 without electrolytes to supplement the patient until the TPN can be ordered the following day. The pharmacy staff will deliver the TPNs daily between 6:30-7:30 p.m. and nurses should hang the bags every evening at 8 p.m. If you have any questions please contact the clinical pharmacy manager, Nick Tessier, at ntessie@harthosp.org, or call 860-542-2221.

HH/CT-GI Team Raised $13,000 In Walk To Fight Crohn’s and Colitis

More than 50 people from Hartford Hospital, Connecticut Gastroenterology, Connecticut GI Endounit Bloomfield and Glastonbury Endoscopy Center participated in the “Crohn’s and Colitis Taking Steps Walk” on May 14, and raised more than $13,000 to fight the digestive diseases. Our team was called the "GI Joes", and it was the biggest group out of the 500 people who participated. Dr. Joseph Cappa and Dr. Michelle Smedley from CT GI coordinated the team. The three-mile walk at Central Connecticut State University in New Britain was sponsored by Hartford Hospital and CT GI. The event raised a total of $112,000.

Research & Academics

IOL Investigators Shine at APA Annual Meeting

Investigators from The Institute of Living gave 10 presentations (seven scientific and clinical report sessions, and three poster presentations) at the American Psychiatric Association Annual Meeting in Honolulu, Hawaii, May 14-17. Participants in the research were Keera Bhandari, Dr. Karen Blank, Dr. John Bonetti, Jaclyn Cmero, Dr. Megan Ehret, Dr. John Goethe, Dr. Adam Jaffe, Atul Padole, Dr. Gualberto Ruaño, Dr. Michael Stevens, Bonnie Szarek, David Villagra, Dr. Stephen Woolley and Charles Wilber.

2011 Summer Student Research Fellows

Hartford Hospital will have 16 student research fellows here from June 6 to August 12 working in conjunction with senior investigators on a variety of projects.

  • Dr. Yu Fang will be working with Emily Davis on a prenatal testing project: subject pending.
  • Dr. David Hull will be working with Andrew Polio on a transplant project: Combined Liver Kidney Transplants: Indications, Outcome Analysis and the HHLTP Experience.
  • Dr. Amy Johnson will be working with Alissa Correll on a women’s health project: Identifying Potential Barriers to Exclusive Breast Feeding.
  • Dr. Kelly Johnson-Arbor will be working with Daniel Leibman on an ED/Wound Center project: Characteristics of utilization of carbon monoxide detectors in residential settings.
  • Dr. Kristrina Johnson will be working with Kevin Abraham on a colorectal surgery project: Entereg Laparoscopic Colon Resection Study.
  • Dr. Stuart Kesler will be working with Tyler Cottrell on a urology project: Bilateral pelvic lymph node dissection during Robotic Assisted Radical Prostatectomy: Impact on biochemical recurrence and complication rates.
  • Dr. Inman Kureshi will be working with Jeffrey Weinreb on a neurosurgery project: Aspirin-related complications of External Ventricular Drain Placement.
  • Dr. Charles McKay will be working with Melanie Dubois on a toxicology project: Survey of changing utilization of high-fidelity simulation by emergency medicine residencies and medical toxicology fellowships.
  • Dr. Martin Ollenschleger will be working with Claire Melley on a neuro/interventional radiology project: Analysis of Imaging Findings and Outcomes Following Acute Stroke Intervention.
  • Dr. Pavlos Papasavas will be working with Jamie-Marie DeFelice on a bariatric surgery project: Cardiac work-up in patients undergoing bariatric surgery.
  • Dr. Andrew Salner will be working with Daniel Kowalsky on an oncology project: Racial and ethnic determinants of cause specific recurrence and survival in breast cancer.
  • Dr. Steven Shichman will be working with Adam Abel on a urology project: Comparison of complications between robotic partial nephrectomies and open partial nephrectomies.
  • Dr. Paul Tulikangas will be working with Hilary Whelan on a urogynecology project: Use of a vaginal pessary in the treatment of overactive bladder and pelvic organ prolapse.
  • Dr. Cunegundo Vergara will be working with Jaime Bernstein on a primary care project: Analysis of Primary Care Preventive Care Services Provided by a Hospital-based Primary Care Center.
  • Dr. Joseph Wagner will be working with Adam Korus on a urology project: Robotic Radical Prostatectomy: Biochemical Recurrence rates and Quality of Life with 10 Year Follow-up.
  • Dr. Wetlef Wencker will be working with Brendan Gontarz on a cardiology heart failure project: Exploring the Functional Role of Caspase 1 in Heart Failure Patients.
(Click here to view photos of the Summer Research Student Fellows)

Operational Update

Act Now to Earn Incentives in Medicare’s ePrescribing Program

You have until the end of this month to report the eRx G-code at least 10 times on Medicare claim forms to earn an incentive and avoid a penalty in 2012 through Medicare’s five-year program to promote ePrescribing (eRx). To read more, click here.

New Order in SCM: “CHANGE ATTENDING PHYSICIAN”

Starting Thursday (June 16), providers can electronically change a patient’s attending provider in both SMS and Sunrise Clinical Manager (SCM) by submitting an order. The order, CHANGE ATTENDING PHYSICIAN (or ATTENDING MD) 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. Once submitted, the order will appear on the SCM orders tab and update the Care Provider list on the Patient Info tab. Applications that interface with SMS will also be updated with the change in Attending Physician.

Hartford Hospital Welcomes New Doctors

Dr. Gada M. Abdelhafiz, Internal Medicine - CT Multispecialty Group, PC
Dr. Gaurav Chawla, Psychiatry - Institute of Living
Dr. Daniel B. Freess, Emergency Medicine - Hartford Hospital
Dr. Samya H. Hawley, Psychiatry - Institute of Living
Dr. Caroline C. Jadlowiec, General Surgery - Hartford Hospital
Dr. April E. Mott, Internal Medicine - Hartford Medical Group
Dr. Eugenia I. Popescu, Psychiatry - Institute of Living
Dr. Clifford G. Rios, Orthopedic Surgery - Orthopedic Associates of Hartford, PC
Dr. Timothy P. Spurrell, Obstetrics and Gynecology - Planned Parenthood

Change in Database Access on the Library Intranet/Internet Pages

There is a change in the access to the Database OvidSP. Access will now be through three portals:

  • Cochrane Reviews
  • Ovid Medline 1947 – Present
  • PsycINFO 1967 – Present 

Obituary

Dr. Chester Wiese

Dr. Chester Wiese, former assistant chief of surgery at Hartford Hospital for many years until retiring in 1988, passed away on May 31 in Fort Myers, Florida at the age of 94. A 'Celebration of Chet's Life' will be held in Connecticut in August. The date and location will be announced at DoctorWiese.com. Read the obituary in Thursday’s Hartford Courant:
www.legacy.com/obituaries/hartfordcourant/obituary.aspx?n=chester-a-wiese&pid=151704605

In The News

Bioscience Zone Sought to Help Planned Medical Development: Plainville Wants State To Designate Area Abutting Parcel in New Britain

Hartford Courant, June 5:
Plainville officials want the state to designate 19 acres abutting New Britain as a bioscience zone, hoping that will help with plans to build a cancer treatment center on the parcel. Town planner Mark Devoe said the cancer center and an office building at the site would be occupied by the Hospital of Central Connecticut in New Britain.
www.courant.com/health/connecticut/hc-plainville-medical-0606-20110605,0,7275504.story

Malloy's UConn Health Center gets final approval on the fast track

CT Mirror, June 8:
Gov. Dannel P. Malloy's plan to revamp the UConn Health Center is the fourth attempt in five years to revitalize the financially troubled Farmington medical campus. And after receiving final legislative approval early Wednesday, it might actually happen.
www.ctmirror.org/print/12865

House Approves UConn Health Center Expansion

Hartford Courant, June 8:
The House of Representatives gave final legislative approval early Wednesday morning for an $864 million proposal that would enlarge both the medical and dental schools at the University of Connecticut Health Center while constructing a new hospital on the Farmington campus. Hartford Hospital and the cancer center at the Hospital of Central Connecticut in New Britain would also receive assistance.
http://blogs.courant.com/capitol_watch/2011/06/house-debates-uconn-health-cen.html

Surgery Centers Hoping Larson Bill Increases Medicare Revenue

CT Mirror, June 8:
The number of ambulatory surgical centers has swelled in the last decade, but ASC leaders say their financial well-being is under threat, with hospitals eager to gobble them up. So this increasingly powerful health care sector is pushing legislation that could tilt the balance between surgical centers and hospitals, as the competition for lucrative procedures balloons along with America's aging population. But officials in the industry say hospital purchases of ASCs are driven by quality considerations, not financial incentives. "When we acquire a center, it becomes an integrated center with our hospital and our health system," said Jeff Flaks, chief operating officer for Hartford Hospital. "It's to create a center of excellence within broader context and to integrate inpatient and outpatient services."
www.ctmirror.org/story/12856/larsonsurgerycenters 

Leading Healthcare Organizations Protect Data in the Cloud and On-the-Go with Gazzang

Business Wire, June 9:
Gazzang, Inc., the company securing data in the cloud, announced ongoing momentum in the healthcare market with customer wins including Children’s Hospital of Boston, Hartford Hospital, Johnson & Johnson, Quest Diagnostics, UC Irvine Healthcare, and the University of Pittsburgh Medical Center among others. These organizations are using Gazzang’s ezNcryptTM data security solution to encrypt the proliferation of electronic health records, including patient medical histories, doctors’ notes, laboratory results and other sensitive information increasingly stored in the cloud and on healthcare professionals’ mobile devices.
www.businesswire.com/news/home/20110609005133/en/Leading-Healthcare-Organizations-Protect-Data-Cloud-On-the-Go

Coming Events

THIS WEEK:

June 14 (Tuesday):
The Lowell P. Weicker Jr. Clinical Research Center Seminar Series on Methods in Clinical Research: “Hormonal Effects on ACL Laxity”

12 noon to 1 p.m. Dr. Thomas Trojian, director of injury prevention/sport outreach at the New England Musculoskeletal Institute; sports medicine fellowship director at UConn Health Center. Low Learning Center, UConn Health Center, Farmington. Light lunch and beverage provided.

June 15-17 (Wednesday, Thursday, Friday):
June Jubilee

The Hartford Hospital June Jubilee is an outdoor festival of food, games and fun meant to show appreciation to our staff for the terrific work you do every day.
June 15: Newington Campus, Noon-2 p.m.
June 16: IOL Campus, 2-4 p.m.
June 17: Hartford Hospital Campus, 11:30 a.m.-4 p.m. and 10:30 p.m.-Midnight

June 16 (Thursday):
Department of Medicine Monthly Meeting

8 AM, Gilman Auditorium.

NEXT WEEK:

June 22 (Wednesday):
Stroke Center 10th Anniversary Celebration

The Stroke Center’s 10-year anniversary reception will be held at Heublein Hall in the ERC on Wednesday, June 22, from 3:30-6:30 p.m. Click here for more information.

Click here for more events

Hot Topics in Healthcare

A Model Health Care Delivery System for Medicaid

New England Journal of Medicine, June 1
When the Patient Protection and Affordable Care Act (ACA) is fully implemented, Medicaid will cover an additional 16 million people who are currently uninsured. Many of the newly insured will seek care from community health centers (CHCs). At a time when we need CHCs more than ever, many states are contemplating deep Medicaid cuts that could threaten their survival. To sustain CHCs and preserve access to care for Medicaid beneficiaries while controlling costs, we propose a novel care delivery model: Community Health Center and Academic Medical Partnerships, or CHAMPs.
http://healthpolicyandreform.nejm.org/?p=14617&query=TOC

ACO Debacle Exposes Obamacare’s Fatal Conceit
(Guest Opinion: Michael Cannon, director of Health Policy Studies at the Cato Institute)

Kaiser Health News, June 3
Obamacare’s number one idea for improving health care quality and reducing costs is to promote ACOs in Medicare. That effort is sinking like a stone, because it – like the rest of this sweeping law – is premised on the fatal conceit that government experts can direct the market better than millions of consumers making their own decisions.
www.kaiserhealthnews.org/Columns/2011/June/060311cannon.aspx


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.