From the Offices of Jeffrey A. Flaks and Jeffry Nestler, MD
The Seymour Street Journal is published every two weeks to communicate key messages pertinent to our hospital’s physicians, and to promote alignment between the medical staff and administration. It will keep you informed on hospital news in a concise, convenient format. SSJ will be sent to your preferred email address every other Sunday at 6 p.m.
October 17, 2011 Edition
We’d like to hear from you. For any questions or suggestions, please contact Dr. Jeffry Nestler, medical staff president, at 860-836-7313, or firstname.lastname@example.org.
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1902 - Wildwood Tubercular Sanatorium opened as the first of its kind in Connecticut. It was operated by Hartford Hospital and was part of a state program for the care and treatment of tubercular patients.
- The medical staff welcomes Dr. Patricia Sheiner as director of transplantation tomorrow.
- Dr. David Hull was honored for his service and leadership on Oct. 12.
- The physician survey results are in: We did well, and will do better.
- Only two risk management sessions remain to qualify for 6% malpractice premium discount in 2012.
- The first physician focus group on Patient Centered Institutes generated a great deal of input.
- Ground was broken Oct. 4 for a new staff garage and fitness facility on Hudson Street.
- Our new Avon Family Health Center opened yesterday.
- Nominations are being sought for the Medical Executive Committee.
- Flu shots will be available here starting Oct. 25.
- The $16 million ED expansion/renovation project is on schedule.
- You can follow Hartford Hospital on facebook and twitter.
Dr. Patricia Sheiner Assumes New Role As Director of Transplantation
Dr. Patricia Ann Sheiner begins work today (Oct. 17) as director of transplantation for Hartford Hospital. Sheiner joins HH from Westchester Medical Center in Westchester, N.Y. where she was director of liver transplant and hepatobiliary surgery, and vice chair of the Department of Surgery. She has also worked at Mount Sinai Medical Center in New York and Toronto General Hospital. She has served as a professor of surgery at New York Medical College and an assistant professor of Surgery at the Mount Sinai School of Medicine. She has directed a number of clinical trials and research studies, and has trained several physicians who moved on to head transplant programs.
Dr. David Hull Honored For 24 Years of Service and Leadership
Dr. David Hull, retiring director of the transplant program, was honored for his 24 years of service and leadership and was welcomed to his new position as the program’s emeritus director on Wednesday, Oct. 12 at the Education Resource Center.
"This coming together is such an extraordinary reflection on the contributions made by Dr. David Hull, and what he’s meant to our community, what he’s meant to countless patients, and what he’s meant to every aspect of this institution," said Jeffrey Flaks, president and CEO. "Here at Hartford Hospital, we strive to live our values every day, and I can’t think of anybody who has done that more than Dr. Hull. I’ve never encountered a physician who is more dedicated to his work, who is more committed to his patients and their families, and to doing the right thing."
Cathy Yavinsky, nurse director of transplant and dialysis, shared several messages from colleagues about Dr. Hull: "He is absolutely relentless in his pursuit of what we thinks is best for patients and the program;" "Patients describe him as the man who saved their lives;" and "He elevates the day-to-day work we do by reminding us of the spirituality of the gift of life."
Dozens of transplant recipients attended the celebration, and Hull asked if anyone would be willing to stand and tell what organ they had received. Patient after patient stepped forward, 35 in all, most tearfully expressing gratitude that they were alive and thanking Hull for his work.
"I received a liver in February of 1999, and Dr. Hull, you were one of the doctors who did that transplant," one man said. "Words fail to express the depth and breadth of my gratitude to you."
"You are a hero," another said. "Because of you, I am here today. I received my liver in 1999, and I’m doing very well. I don’t know how I could ever repay you.
Yavinsky presented Hull with a plaque on behalf of the transplant staff:
"The gift of life for our patients;
The gift of inspiration for our team."
Physician Survey Results: “We did well, and we will do better”
Results are back from the physician survey conducted June 8 to July 12. The Press Ganey survey was designed to assess physician satisfaction and engagement.
- 44% of the 840 physicians surveyed responded.
- 29 specific questions asked about quality of patient care, ease of practice, communication and collaboration.
- Our overall mean score was 76.7, which put us in the 49th percentile compared with 408 comparable facilities nationwide.
“We are very interested in knowing the satisfiers and concerns of the medical staff, and this survey helps identify what those are,” said Jeffrey Flaks, president and CEO. “Results show us that the satisfaction level of our physicians is comparable to other institutions; but we want to do better. We have heard your concerns, and we will work with the medical staff to respond to those concerns and move the institution towards top decile performance in all areas.”
Strengths were identified as:
- visibility/accessibility of administration
- communication between physicians and administration
- degree to which physicians are involved in decision making
- turnaround time for radiology results and lab results
- staff’s concern for your patients
- quality of nursing staff
- ease of admitting patients
Opportunities for improvement were identified as:
- responsiveness of administration to ideas and needs of medical staff
- degree to which physicians are treated as valued members of the medical staff
- degree to which administration seeks mutually beneficial solutions to physician issues
- timeliness of follow-though on orders
- ease of scheduling outpatient surgery, tests/therapy, and inpatient tests/therapy
- access to patient information
“We are looking at the areas that were identified as needing improvement, and we are taking action to make them better,” said Dr. Joseph Klimek, vice president of physician relations.
Committees have been formed to develop action plans to improve:
- communication and collaboration
- quality of patient care
- ease of practice.
These action plans will be presented to the medical staff at the semi-annual meeting on December 1.
Only Two More Chances for CHS/CNA Insured Physicians To Attend Risk Management Program, Receive 6% Credit on Malpractice Premium
All physicians insured by Connecticut Health Systems, Ltd (CHS)/CNA Insurance are eligible to receive a 6% credit off next year’s premium for full completion of the 2011 Risk Management Educational Program. It must be completed by the Dec. 31 deadline in order to receive the premium credit. Requirements are:
1. Attend one Risk Management Rounds session. The two remaining events are:
- EHR Symposium: Thursday, Oct. 20 from 6-8 p.m. in Heublein Hall. Dinner will be served. This special lecture is available to all specialties. To RSVP, go to www.harthosp.org/ehr-panel.
- General: Thursday, Nov. 10 from 6-7:30 p.m. in Gilman Auditorium.
2. Watch two web-based modules, accessible at www.mrmportal.com.
- “Patient Relations–Strategies to Mitigate Risk,” and
- “Standard of Care in the Hospital Setting” OR “Standard of Care in the Physician Group Setting.”
Medical Risk Management, LLC (MRM) is managing the education and monitoring compliance with these requirements. If you cannot attend one of these dates, need to confirm your current compliance with the requirements or have any questions about the Risk Management Program curriculum, please contact MRM at 860-920-5475. If you have questions about the premium credit or your insurance policy, please contact the CHS Insurance Department at 860-696-6227.
Physician Input On Patient-Centered Institutes Sought in Focus Groups
Hartford Hospital is reinventing the way physicians work through a multidisciplinary, patient-centered and disease-focused model called the Hartford Hospital Patient-Centered Institutes. We need the input of our medical staff and adjunct medical staff (PAs and APRNs) as we work toward this momentous change.
Please attend a focus group session that will feature a presentation on the broad outlines of the institute model, discussion of the work to date and, of course, an opportunity to provide direction and wisdom. Space is limited; RSVP this week to Sandi Beggs at email@example.com or 860-545-2390. The sessions are:
- Tuesday, Oct. 25: 6-7:30 p.m., Boardroom
- Tuesday, Nov. 1: 6:30-8 a.m. in the Boardroom
- Tuesday, Nov. 1: 5-6:30 p.m. in the Special Dining Room
- Wednesday, Nov. 9: 6:30-8 a.m., Taylor Conference Room
Ground Broken for Hudson Street Parking Garage
Ground was broken Oct. 4 for a new staff garage and fitness facility on Hudson Street. It’s the second phase of the 10-year master plan to transform the hospital campus. Construction is expected to last 14 months, cost $40 million, and bring 150 jobs to the area. The new 9-floor garage will add 1,250 parking spaces on campus - a 20% increase to the current 5,000 spots. It will be dedicated to staff parking, and the current staff garage next to the CCMC will become public parking. Visitors and patients will find more convenient and closer parking, and staff will have access to a new facility that will include a state of the art wellness center on the ground floor. The new garage will be one of the greenest buildings in Hartford, made of largely recycled content, and will restore green space to the area and have electric car charging stations. Rain gardens will surround the building to manage the storm water, which mitigates the demand on municipal systems and restores natural aquifers. It will also be one of the safest garages in the country, and will feature electronic security, cameras and access controls throughout. There will be an air walk across Jefferson Street connecting the garage to the hospital so employees will not have to cross the street when going to and from the garage.
Avon Family Health Center Grand Opening Held Yesterday
A grand opening celebration was held yesterday (Oct. 15) for the Avon Family Health Center, which houses offices for Hartford Medical Group and Hartford Specialists. They will provide urgent and primary care there as well as surgical specialty services with the intent of growing Hartford Hospital’s recognition as the place for comprehensive care. The center, located at 339 West Main Street in Avon, expands HHC presence in the Farmington Valley. For more information, please contact Eveline Schaffer at 860-545-7704, or by email at firstname.lastname@example.org.
Nominations Sought for Medical Executive Committee
Four two-year terms are available on the 16-member Medical Executive Committee. Contact Linda Calli at 860-545-6167 or email@example.com with nominations by Oct. 31.
Flu Shots Available Starting Oct. 25
All Hartford Hospital staff must be immunized against influenza this fall, or sign a declination form. Free flu vaccinations will be available for all staff and volunteers (with ID badge) starting Oct. 25 at the following times and places:
Occupational Health Services, Brownstone Basement:
Tuesday, Oct. 25, 7 a.m.-5 p.m.
Wednesday, Oct. 26, 7 a.m.-5 p.m.
Thursday, Oct. 27, 7 a.m.-5 p.m.
Cafeteria, Dining Room A:
Monday, Oct. 31, 7 a.m.-2 p.m.
Tuesday, Nov. 1, 7 a.m.-2 p.m.
IOL - Thursday, Nov. 10, 7 a.m.-5 p.m.:
7-9 a.m., Donnelly lobby conference room 2
9:30-11 a.m., Research Building first floor conference room
11:30 a.m.-2 p.m., Commons Building cafeteria
2:30-5 p.m., Donnelly lobby conference room 2
Newington Campus - Jefferson House
Thursday, Nov. 10, 7-9 a.m. and 2:30-4 p.m.
(also available for Cedar Mountain Commons staff):
Newington Campus – Curtis Building
Wednesday, Nov. 16, 2:30-4 p.m.
Next year we will have universal flu vaccination.
ED Expansion/Renovation Project On Schedule For January Completion
Work continues on the $16 million Emergency Department expansion/renovation project. It will add 20,000 square feet and 25 new treatment spaces to the ED’s existing 60 beds. Work will be complete in January, and patients will be seen in the new space Feb. 1.
Cancer Center Granted Accreditation with Commendation
The Commission on Cancer of the American College of Surgeons has granted three-year accreditation with commendation to the cancer program at the Helen & Harry Gray Cancer Center, recognizing its commitment to the community and patients, demonstrated through cancer services, the scope of high quality care provided, and a program of studies that improve access to patient care and patient outcomes. Receiving care at a CoC-accredited cancer program means that patients will have access to comprehensive and multidisciplinary care, clinical trials, cancer education and support, a cancer registry, and high quality care close to home. The Commission on Cancer is a consortium of professional organizations dedicated to improving survival rates and quality of life for cancer patients. Accreditation is given only to cancer programs that have voluntarily committed to providing the highest level of quality care, and have undergone a rigorous evaluation process and performance review.
Generous Gift Honors Dr. Kluger and ICD Staff
A generous gift inspired by Dr. Jeffrey Kluger, Danette Guertin, APRN, and the ICD staff will benefit the patients and families of our Heart Rhythm Management Program for many years to come. For the donor, Sharon Poupart, the gift represents a memorial to her husband, Ron, a long-term ICD patient here who died last year, and a grateful tribute to the compassionate care he received from the staff. The gift will be used to refurbish a vacated file room, which will be turned into an educational center to teach patients about their ICDs and how to use the remote transmitters to allow their devices to be followed from home. A portion of the gift also will support our annual dinner for the ICD patients support group, which Mrs. Poupart has attended in the past.
Innovative and Complex Care
Dashboards in Action
Dr. Michael Lindberg, chairman of the Department of Medicine, is quoted in an Oct. 1 story in Health Data Management Magazine about using dashboards to aggregate information from disparate sources, spot performance trends and curb small problems before they become big ones. One year ago, Hartford Hospital put in dashboard technology from CareFx, fed by the hospital’s EHR from Allscripts, and its financial system from Siemens. Lindberg uses the dashboard to track patient data, bed availability, and the readmission rate, and can identify trends and run comparisons over a several month period. "We had a shortage of real-time data in useable form," he said. "Now we can take the high performers, see what looks to be effective for them, and model their behavior for others."
HHC To Implement Computer-Assisted Coding for ICD-10 Readiness
Hartford HealthCare is one of the 30 leading U.S. hospitals that will implement OptumInsight’s (formerly Ingenix) Actus computer-assisted coding (CAC) solution, according to the Sept. 26 issue of Wall Street Journal Marketwatch. The software will enable HHC to quickly and accurately code medical charts for more consistent and complete reimbursement of medical claims and to prepare for the eight-fold increase in codes required for ICD-10 documentation.
Research and Academics
Pathology Residency Programs Reaccredited
The results of recent RRC visits to Hartford Hospital to review the educational programs in the Department of Pathology and Laboratory Medicine have been received. The Anatomic and Clinical Pathology residency program received continued accreditation until Sept. 1, 2014, the Hematology fellowship received continued accreditation until Sept. 1, 2015, and the Selective Pathology fellowship program received continued accreditation until Sept. 1, 2016.
Cancer and the Heart: HH Researchers Explore the Link
MedPage Today, Sept. 24:
Researchers at Hartford Hospital are investigating the impact of cancer therapies on the endothelium that appears to contribute to coronary artery disease, said Dr. Paul Thompson, director of cardiology, in an email to ABC News. Damage to the endothelium also can cause arteries to become stiff. When they move with every beat of the heart, it’s like "bending a hose that's been out in the sun too long," Thompson said, and the vessel lining can crack, leading to thrombus. Vigorous exercise, in particular, can be dangerous for cancer survivors whose arteries have become brittle due to damaged endothelium.
Cardiology Study Suggests Runners Should Avoid Prescription Drugs
Gulfnews.com Oct. 6:
Many marathon runners take prescription drugs, unaware of potential side effects that affect runners. A study conducted by Dr. Beth Parker of the Henry Low Heart Center is the first to measure CK levels in athletes taking statins after physical activity in a real-life environment rather than in a laboratory.
Breast Cancer In Connecticut: Some Surprising Findings
Hartford Courant, Oct. 3
PResearchers have long documented higher rates of late-stage breast cancer in low-income communities. But a new study in Connecticut shows that several high-income suburban towns also have high rates. Dr. Andrew Salner, director of The Helen & Harry Gray Cancer Center, said a three-pronged approach — mammography, breast self-examination and an annual breast exam by a physician — has decreased mortality rates by 30 percent over the past 15 years. But Salner said he was dismayed to learn that minority women in Hartford had higher mortality rates than the general population. To reach them, he said, Hartford Hospital launched a mobile mammography unit and an outreach effort.
Quantros Event Reporting System Replaces Peminic
Hartford Hospital recognizes that to ensure a safe environment, we must create an environment in which it is safe to report and learn from incidents and near-misses. Our goal is to increase reporting of all events and near-misses in order to identify and track events to continuously improve systems and processes. To help in that effort, a new event reporting system has replaced the Peminic Event Reporting web-based system. The new system, Quantros, includes reporting Patient Safety Events, Employee Safety Events and Visitor Safety Events. The Event Reporter Icon will remain on all workstation desktops to access Quantros. Please contact Marybeth Scanlon at firstname.lastname@example.org or 860-545-2625 for any questions.
Panel Discussion on Malpractice Liability and Electronic Health Records Thursday
A panel discussion on "Electronic Health Records: Malpractice Liability Concerns and Consequences" will be held this Thursday, Oct. 20, 5:30–8 p.m., in the ERC, Heublein Hall. A moderated panel of experts will discuss the "Pitfalls and Perils of the Electronic Health Record" and how to effectively overcome them. Speakers are healthcare attorney Jennifer Cox; medical malpractice defense attorney Neil Danaher; Dr. Spencer G. Erman, a medical director with Hartford Medical Group and chair of the Clinical Advisory Board for Practice Central HER; Dr. Marc Palter, chief of informatics at Hartford Hospital; and Jenn Searls, vice president of information services with ProHealth Physicians. This is a free event that includes a light dinner. Pre-registration is required. To register online, please visit: www.harthosp.org/ehr-panel.
HH In the News
Dr. Thompson Discusses Marathon Deaths
Dr. Paul D. Thompson, director of cardiology and director of the Athlete’s Heart Program at Hartford Hospital, was quoted following the heart attack death of a 32-year-old at the Montreal Marathon. Thomson said deaths at marathons are usually split into two categories: men under 30, most often found to have a heart defect from birth, and men over 40, who normally die of heart attacks brought on by coronary disease. Thompson said that athletes should not view exercise as a cure-all; People with high cholesterol or high blood pressure need to take care of those risk factors, and not assume running will fix it, he said. All studies show exercise decreases rates of heart disease, but research he conducted in the 1980s also showed that a person’s risk of dying was higher when they were exerting themselves. He has studied the effects of training on heart disease, the effects of statins on muscle function and genetics. Thompson, 64, is a former U.S. Olympic marathon trials qualifier and 16th-place finisher at the 1976 Boston Marathon, and has completed that race 28 times.
Dr. Smally Writes About Expedited ED Care for VIPs
Becker’s Hospital Review, Sept. 30; msnbc.com, Sept. 30; Fierce Health Finance, Oct. 4
Dr. A.J. Smally, medical director in emergency medicine, wrote in the Annals of Emergency Medicine that more than half of Connecticut ED directors offer quicker medical attention to "influential people." Smally noted the quicker care has no bearing on the quality of care: Emergency triage protocols mandate treating the sickest patients first, no matter their social status. But high-ranking patients may be made more comfortable, more quickly. Not all staffers endorse such treatment. Smally’s survey was, in part, a response to an attending who objected to providing expedited care to a visiting VIP.
Cancer Center Physicians Discuss Customized Care and New Treatment Options
Drs. Elizabeth Brady, Patricia DeFusco and Andrew Salner were part of an Oct. 1 story in the Hartford Courant about breast cancer treatment at Hartford Hospital.
Following Death of Steve Jobs, Dr. Jimenez Speaks About Pancreatic Cancer
News 8, wtnh.com, Oct. 6:
Dr. Ramon Jimenez, Hartford Hospital cancer surgeon, was quoted in a local news story about pancreatic cancer, saying that with little funding for research available, progress in screening and treatment is slow. "Unless I can find a very early pancreatic cancer, the results are not going to be optimum," says Jimenez. "A lot of the therapies today are still on a palliative type of nature."
Windham Hospital Medical Office Building Groundbreaking Held Oct. 11
NorwichBulletin.com, Oct. 11
HHC president/CEO Elliot Joseph joined hospital administrators and city and state officials at Windham Hospital in Willimantic, an HHC partner, for a groundbreaking for an $8.354 million Medical Office Building on Oct. 11.
Dr. Smally Discusses Hartford Hospital’s Preparation for the Hartford Marathon
CTnow.com, Oct. 12
Interview with Dr. A.J. Smally, director of the Emergency Department, about how the hospital is preparing for exhausted and injured runners in the Oct. 15 ING Hartford Marathon.
Regional Healthcare News
Connecticut Children's Medical Center to Invest $20M in Health IT Upgrade
Becker’s Hospital Review, Oct. 3
The Connecticut Children’s Medical Center is planning a $20 million health IT upgrade to integrate its providers under one health IT system, according to a Hartford Business report. The project will include rewiring the hospital’s main campus, providing electronic health records to its specialty medical practices and extending data-sharing capabilities to community physicians it does not employ, which will help the hospital create a health information exchange infrastructure.
St. Francis ER Launches Online Check-In Service: New web program aimed at cutting down on long waits for non-emergency care
Hartford Courant, Oct. 4, and HartfordBusiness.com, Oct. 5
St. Francis Hospital and Medical Center’s emergency room launched a free online check-in service Oct. 4 to minimize the amount of time people have to wait for non-emergency care at the ER. The new web-based InQuickER service enables people to wait at home or work. Nearly 100 hospitals use the proprietary software; no others in the Northeast. InQuickER allows patients with non-emergency conditions to request a visit up to two hours in advance. It is not an appointment setting service; it is a check-in service that estimates treatment times based on patient traffic conditions and allows its users to wait from home instead of in the waiting room. Nationwide, nine out of 10 InQuickER users are seen by a health care professional within 15 minutes of their projected treatment times.
http://www.courant.com/health/connecticut/hc-st-francis-emergency-appointments-1005-20111004,0,890639.story; and http://www.hartfordbusiness.com/news20781.html
Quinnipiac, St. Vincent’s Announce Partnership
CTpost.com, Oct. 10:
The Quinnipiac University School of Medicine in Hamden has selected St. Vincent’s Medical Center of Bridgeport as its clinical partner. A five-year agreement calls for St. Vincent’s medical staff to work with the School of Medicine to design clinical curriculum and academic policies, recruit doctors to teach and ensure the quality of the education. Quinnipiac announced plans in January 2010 to seek approval to open a School of Medicine with an emphasis on primary care. The school is scheduled to begin classes in the fall of 2013.
October 20 (Thursday):
Traumatology and Emergency Medicine Grand Rounds: Gang Violence
Dr. Michael Soltis, Pediatric Emergency Medicine, Connecticut Children’s Medical Center; Hartford Regional Child Abuse Services. 12 noon, Gilman Auditorium.
November 11 (Friday):
Surgery Grand Rounds: Ethical Controversies in Organ Transplantation
Dr. Robert D. Truog, professor of medical ethics, anesthesiology and pediatrics, Harvard Medical School. 6:45 a.m., Gilman Auditorium.
Hot Topics in Healthcare
Patient Experience: Hospitals' Holy Grail?
HealthLeaders Media, Sept. 30
The topic of value-based purchasing regulations, including the emphasis on HCAHPS scores, has been a hot topic in health care, and many providers and professional associations have expressed concern. However, when we are attempting to align disparate incentives from the old healthcare framework, we need to ask ourselves: How much attention would we give the patient experience if HCAHPS scores were not so heavily weighted? http://www.healthleadersmedia.com/content/COM-271544/Patient-Experience-Hospitals-Holy-Grail
Editor’s note: For the past two quarters, Hartford Hospital has achieved our all-time high HCAHPS scores for overall patient experience. Our most recent score was 67.4%, and we are actively working toward our 2011 Balanced Scorecard goal of 69%.
Reforming Provider Payment – The Price Side of the Equation
NEJM, Oct. 6
For some time, public health care payers, such as Medicare and Medicaid, have focused much of their cost-containment effort on constraining the prices they pay for health care services, which they set. The Affordable Care Act includes additional constraints on Medicare prices. But public payers recognize the limits of this strategy and hope to develop better methods of paying providers — such as bundled payment for episodes of care and payments to accountable care organizations (ACOs) and patient-centered medical homes — that will create incentives for treating patients using services more efficiently. http://www.nejm.org/doi/full/10.1056/NEJMp1107019?query=health-policy-and-reform
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.