From the Offices of Elliot Joseph and Jeffry Nestler, MD
May 1, 2011 Edition

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"Quality is not an act, it is a habit." - Aristotle


Excellence

Dr. Kumar Joins HH as Chief of the Division of Hospital Medicine

Dr. Ajay Kumar has joined Hartford Hospital as the chief of the Division of Hospital Medicine and will chair the department’s Quality and Safety Committee. He will also be active in the integration of the hospital medicine physicians into student and resident education programs. Dr. Kumar, who is nationally known for his work in blood management and preoperative evaluation, joins us from the Cleveland Clinic where he was the medical director of the IMPACT Center (preoperative evaluation center), medical director of blood management, medical director of the Quality and Patient Safety Initiative and vice quality review officer for the Medicine Institute.

Dr. Wakefield Elected Vice-chair of CSNS Northeast

Dr. Andrew E. Wakefield has been elected vice-chairman of the Council of State Neurosurgical Societies (CSNS) Northeast Quadrant, representing New England, New York, New Jersey and Pennsylvania. He has served this society on multiple committees for six years. The CSNS functions as a joint committee of the AANS and CNS much as the AANS/CNS Washington Committee and the various subspecialty joint committees.

Dr. Kureshi Elected Treasurer of NENS

Dr. Inam Kureshi has been elected treasurer of the New England Neurosurgical Society, the largest organized group of neurosurgeons in New England. The NENS was founded in the 1950s by Dr. William B. Scoville, who founded the Department of Neurosurgery at Hartford Hospital in 1939, and was its director until 1968.

Care Coordination

Dr. Keating To Lecture on Avoiding Adverse Drug Effects in the Elderly

Dr. Herbert Keating from Geriatric Medicine will be presenting a program at Medical Grand Rounds on Thursday, June 2, entitled “Effective Prescribing for the Elderly- Practical Ways to Reduce Adverse Drug Effects (ADEs).” Dr. Keating has lectured on the topic several times. “This is a topic about which I feel strongly and which I think is a major area of iatrogenic injury,” he said. Grand Rounds will be held in Gilman Auditorium at 8 a.m., immediately following the annual medical staff meeting.

Innovative and Complex Care

Primary Care and Cancer Care Together:
Multidisciplinary Care of Genitourinary Cancers

The Helen & Harry Gray Cancer Center is presenting a dinner program on the multidisciplinary care of genitourinary cancers on Tuesday, May 24 from 6 to 8:30 p.m. at the cancer center in Avon. Moderator will be Dr. Anoop Meraney from the Connecticut Surgical Group, who will present along with Dr. Stuart Kesler from CSG. There will be a multidisciplinary panel of clinicians including specialists in radiology, pathology, urology, surgery, medical oncology and radiation oncology to discuss each case and respond to questions. To register, email cancerconnect@harthosp.org or call 860-545-6000.

Operational Update

SCM Downtown Scheduled Overnight on Saturday, May 14

There will eight hours of downtime in the Sunrise Clinical Manager (SCM) system as it is upgraded to version 5.5 starting at 9 p.m. on Saturday night, May 14. Downtime will last until 5 a.m. Sunday morning. All clinical areas will be using use downtime procedures for orders and documenting patient care. The SCM DOWNTIME ICON will be available to view historic documentation, orders and results during the hours SCM is unavailable. More information is available on the HH intranet in the SCM 5.5 Information Center. http://portal.harthosp.org/hhintranet/hh/dept/819

Safety Action Group:
New Building Entrance Access Restrictions/Active Shooter Policy

Safety is one of HHC’s core values. In response to concerns raised during town hall meetings last fall, a Safety Action Group was formed in October to prepare for potential threats, review access control, and develop an active incident response plan.

A new “Active Shooter/Armed Intruder” policy is now posted on the intranet. The policy establishes overhead announcement codes for violent and potentially violent situations. GREY ALERT (at a certain location) will be announced overhead when there is a potentially violent situation, and SILVER ALERT (at a certain location) will be announced when there is a violent situation with a weapon involved. If you hear one of these announcements, stay away from the given location. If an active shooter is in your work area and security or the police are not present, call 5-2147 or 911. If police officers are on the scene, listen to their directives, and expose your hands so they know that you are not the one with a weapon.

There will be changes in access to the hospital, effective June 1. The Admitting Office double doors and the sidewalk gate to the loading dock will be closed to all. In addition, four other doors will be closed to the public, but accessible by employees via badge swipes: the Cafeteria level single door and double doors near Bliss Building elevators; the High Building single door facing the Brownstone Building; the tunnel double doors from CCMC; and the Conklin Building side door. Please be sure that unauthorized persons do not follow you through the entrances that are closed to the public.

We will begin offering workplace violence training sessions quarterly starting this month. The one-hour program includes identification of warning signs for potential violence, appropriate responses, and a presentation by the Hartford Police Department. There will be a session in Newington in the Curtis building on May 5 at 1 p.m.; and at Hartford Hospital in Gilman Auditorium on May 18 at 4 p.m. Please sign up via HealthStream: under the catalog tab, learning and organizational development.

Also by June 1, we will be enrolling an emergency response team in EVERBRIDGE, a paging system that alerts beepers and phones in the event of an emergency. Funded by the State of Connecticut, the Everbridge system will be rolled out to additional staff in the fall.

Sending Secure Email on GroupWise

Email sent across the Internet is in “clear text,” without any kind of encryption, meaning that it can be read by anyone. Because of this lack of information security with Internet email, it is against Hartford HealthCare policies, as well as many laws (such as HIPAA) to transmit sensitive or private information (e.g., patient-related, financial, contractual, etc) via Internet email. Three years ago we implemented a ZIX Corporation (www.zixcorp.com) email encryption system which reviews all Internet-bound email, checking for content that we believe violates our policies and/or the law. If such content is found, it quarantines the email on a web server, sending to the recipient only a notification of pending email. Recipients must select that link, create an account on the server if necessary, and read the email using an encrypted web browser session. In addition, any Internet-bound email will be sent securely in GroupWise if you type the word "secure" (without quotes, case insensitive) as the first word in the subject line. This system is here to protect you, our patients, and HHC when communicating patient information via email. Read FAQs about the email encryption system here: http://apps.harthosp.org/EmailFAQs.htm.

Labor and Delivery Transitions Paper IntraOperative Records to SCM

The Labor and Delivery Department has taken a step towards implementing the electronic medical record in their ORs. As of April 26, the IntraOperative Record for OB patients can be viewed in Sunrise Clinical Manager (SCM) under the documents tab. This documentation in the EMR is replacing the Nursing Intraop record and the OR Registry that was formerly documented on paper. Please contact Carrie Ferrindino at Cferrindino@harthosp.org if you have any questions.

New Physicians

Aruna Adaikkalam, MD, Internal Medicine - Connecticut Multispecialty Group, Hospitalist Division
Olusegun A. Apoeso, MD, Internal Medicine - Hebrew Healthcare
Matthew E. Boyer, DO, Internal Medicine - Valley Sports Physicians & Orthopedic Medicine
Amber S. Cheema, MD, Internal Medicine - Hartford Medical Group
Maureen Dana, MD, Geriatrics - Hebrew Healthcare
Elizabeth A. Deckers, MD, Obstetrics and Gynecology - Hartford Hospital
Richard P. Dibala, MD, Geriatrics - Hartford Medical Group
Alina I. Dobrita, MD, Internal Medicine - Hartford Medical Group
Meir Friedman, MD, Electrophysiology - Hartford Hospital
Robert K. Gildersleeve, MD, Obstetrics and Gynecology - Women's Health Group
Kristin S. Gildersleeve, MD, Internal Medicine - Hartford Medical Group
Elisa Gil-Pires, MD, Geriatrics - Hebrew Healthcare
Bennett S. Goss, MD, Emergency Medicine - Hartford Hospital
Naveed Hussain, MD, Neonatology - CCMC
Reinhard K. Kage, MD, PhD, Allergy - Rheumatology & Allergy Institute of Connecticut
Barbara A. Kage, MD, Rheumatology - Rheumatology & Allergy Institute of Connecticut
Seth A. Lotterman, MD, Emergency Medicine - Hartford Hospital
Roger D. Luskind, MD, Ophthalmology - Middlesex Eye Physicians
Alexander Mbewe, MD, Geriatrics - Hebrew Healthcare
Bernadette S. McKell, DO, Internal Medicine - Hartford Medical Group
Richard L. O’Sullivan, MD, Psychiatry - Hartford Hospital/Institute of Living
Onyechela Ogbonna, MD, Internal Medicine - Hebrew Healthcare
Ava M. Pannullo, MD, Geriatrics - Hebrew Healthcare

Act Now to Avoid Medicare’s ePrescribing Program’s Penalties to Begin Next Year

Medicare’s five-year program of incentives and penalties to promote ePrescribing (eRx) is in its first year, and you are reminded that physicians who are eligible for the incentive payments but fail to adopt eRx will face a 1% penalty beginning in 2012. To avoid penalties in 2012, eligible physicians must report the eRx G-code at least 10 times on Medicare claim forms by June 30, 2011. To avoid a 1.5% penalty in 2013, an additional 15 e-prescriptions must be reported by the end of this calendar year. www.harthosp.org/Portals/1/Images/56/MedicareElectronicPrescribing.pdf

Tracy Church Appointed Senior Vice President of Human Resources for HHC

Tracy Church has been appointed as senior vice president of human resources for Hartford HealthCare effective May 31. She will report to Elliot Joseph. She brings more than 25 years of health care industry experience, especially in employee and labor relations, compensation and benefits, workforce planning, rewards and recognition, strategic planning, and learning and organizational development. She most recently served as vice president for human resources operations and compliance at San Francisco-based Catholic Healthcare West (CHW), a system of 42 hospitals and medical centers. Read the announcement.

Risk Management Programs for Private Staff; 6% Premium Credit Available

Members of the private medical staff who are CHS insurance policyholders can take advantage of a risk management educational program CHS is offering, and be eligible for a credit of 6% on your malpractice premium. You must complete two one-hour web-based modules a year with post tests, and attend one live session of risk management rounds. If you have questions, contact Medical Risk Management at 860-493-5790; for questions about your premium, call the CHS office at 860-696-6265. For dates and times of upcoming sessions, see below.

Specialty Date Time Location
ENT/Ophthalmology May 4 6-7:30 p.m. HH, Gilman Auditorium
Surgery May 6 7:30-9 a.m. MidState Medical Center, Conf Rm 2/3
Surgery May 10 6-7:30 p.m. HH, Gilman Auditorium
Radiology May 12 6-7:30 p.m. 399 Farmington Ave., Farmington
Medicine May 19 6-7:30 p.m. HH, Gilman Auditorium

In The News

Hartford Courant, April 21:
Hospitals Say Malloy's Proposed Tax Will Harm Their Financial Health

This spring, lawmakers will consider Gov. Malloy’s plans to erase a $3.5 billion budget deficit with an array of new taxes, including a new hospital tax. Malloy's plan would eliminate the state’s uncompensated care fund, and instead the state would collect a 6 percent "provider fee" based on a hospital's revenues. The new tax would raise about $350 million from the state's 29 hospitals and then redistribute it back to hospitals, under a complicated federal Medicaid formula that rewards states that assess provider fees to help defray the costs of caring for the uninsured and poor. The Malloy administration insists that the tax will maximize federal reimbursement funds for Connecticut. But hospital administrators say it will burden them collectively with $33 million in new costs. Twenty hospitals will end up losing money, according to the Connecticut Hospital Association, but Hartford Hospital would gain about $2.4 million. www.courant.com/health/connecticut/hc-buck-hospital-tax-0421-20110421,0,1275005.story

Hartford Courant, April 22:
Breast Cancer Rate Among State's Middle-Aged Women Is Stabilizing

Updated figures on the incidence of breast cancer rates in middle-aged women show that Connecticut still has the highest incidence of the disease in the country, but those rates appear to be stabilizing after 60 years of increases. "We don't have final answers yet, but all the studies show that highly industrialized, thickly settled states with high per-capita income tend to have higher breast cancer rates than more rural states," said Dr. Andrew Salner, the director of the Helen & Harry Gray Cancer Center. "But this may just reflect that with wealth and higher educational levels we have higher mammogram rates, and we are detecting more breast cancer in this age group." Salner said that concentrations of certain ethnic groups with a higher genetic disposition toward breast cancer, such as Ashkenazi Jews, also might explain Connecticut's higher rate. But the decreased use of hormone therapy for post-menopausal women, which may play a role in breast cancer, might be driving down the rate of the disease. www.courant.com/health/connecticut/hc-buck-breast-cancer-study-0423-20110422,0,7492739.column

Obituaries

Pamela Vecchiarino, Nurse Director of Medicine, Oncology, and IV Therapy

Pamela Vecchiarino, 46, nurse director of medicine, oncology and IV therapy at Hartford Hospital, died here April 16 after a brief illness. She began her nursing career at Hartford Hospital in 1986 as an intern, becoming a staff nurse and moving through the ranks. She was a champion of patient safety, a strong proponent of multidisciplinary collaboration and a skillful teacher. www.legacy.com/obituaries/hartfordcourant/obituary.aspx?n=pamela-leigh-vecchiarino&pid=150378368&fhid=4120

Coming Events

May 5:
Collaborative Research Day

“A better understanding of ADHD, autism and other neurodevelopmental disorders via neuroscience, genomics and stem cells.” 1:30-5 p.m., Cell and Genome Sciences Building, University of Connecticut Health Center, 400 Farmington Avenue, Farmington. Light refreshments will be served. Free parking. Co-sponsored by Connecticut Children’s Medical Center, Hartford Hospital, and the University of Connecticut Health Center.

May 19:
Surgery Recognition Awards

The Department of Surgery and Surgical Collaborative Management Team will host their semi-annual recognition award ceremony from 2 to 4 p.m. in the special dining room.

May 19:
Neil J. Grey 4th Annual Memorial Grand Rounds:
Management of Diabetes in Pregnancy, Labor and Delivery: A Model for Specialty Medical Collaborative Care

Dr. Donald R. Coustan, MD, Chairman Emeritus of Obstetrics and Gynecology at Brown Medical School and the OB/GYN in chief at Women and Infants Hospital. Dr. Coustan’s research interests have been focused on the epidemiology of gestational diabetes and its treatment. He is the regional PI for North America of the Hyperglycemia and Adverse Pregnancy Outcomes study, a recently completed National Institutes of Health (NIH) funded multi-national multi-institutional blinded evaluation of glucose tolerance test associations with various pregnancy outcomes, enrolling more than 25,000 subjects. The Neil J. Grey, M.D. Fund for Diabetes supports Hartford Hospital's Diabetes LifeCare program. 7:30 a.m in Gilman Auditorium.

May 25:
Board of Directors and Medical Staff Spring Event

6-9 p.m., Heublein Hall, Education Resource Center

June 2:
Annual Medical Staff Meeting

7 a.m., Gilman Auditorium

July 17:
Everyone Ride/Run Against Cancer Everyday (ERRACE)

The annual ERRACE, a bike and walk to benefit the Helen & Harry Gray Cancer Center and the Lance Armstrong Foundation, will start and finish at the Helen & Harry Gray Cancer Center in Avon. Dr. Andrew Caputo, co-director of the Hand Surgery Service, is co-executive director of the event with his wife Allyson Caputo, a cancer survivor. www.errace.org

Click here for more events

Hot Topics in Healthcare

Launching Accountable Care Organizations – The Proposed Rule for the Medicare Shared Savings Program

NEJM, March 31
The Affordable Care Act (ACA) establishes the Medicare Shared Savings Program for accountable care organizations (ACOs). The creation of ACOs is meant to foster change in patient care to accelerate progress toward better care for individuals, better health for populations, and slower growth in costs through improvements in care. Under the law, an ACO will assume responsibility for the care of a clearly defined population of Medicare beneficiaries attributed to it on the basis of their patterns of use of primary care. If an ACO succeeds in both delivering high-quality care and reducing the cost of that care to a level below what would otherwise have been expected, it will share in the Medicare savings it achieves. On March 31, the Department of Health and Human Services took a major step toward establishing ACOs by issuing a notice of proposed rule-making that will define how physicians, hospitals, and other key constituents can adopt this new organizational form. The Centers for Medicare and Medicaid Services (CMS) will carefully review the comments we receive in response to the proposed rule before issuing a final rule later this year.
http://healthpolicyandreform.nejm.org/?p=14106&query=TOC

Berwick Looks to Rewrite the Rules of the Medicare Game

POLITICO Pro, April 25
The Kaiser Health News has published a roundup of stories from the national press called “Analysis of the Health Law’s Effects Continues.” (http://www.kaiserhealthnews.org/Daily-Reports/2011/April/25/health-care-law.aspx). The first piece quoted, from the April 25 issue of Politico Pro, is called “Berwick Wants To Change The Medicare Game.” The piece is based on a wide-ranging interview April 22 with CMS administrator Don Berwick, in which he talks about “changing the game” for Medicare and Medicaid. Berwick says that a key piece of health care reform will involve changing what the system rewards — shifting from more care to better care. "The industry hits the pitch we throw, and if we set up a payment system and an environment in which doing more is a base hit, that's what they'll do." To read the full story online, go to: https://www.politicopro.com/go/?id=2851. Please note: full access to Politico Pro requires a paid subscription.


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.