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.

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 jnestler@connecticutgi.org.

April 1, 2012 Edition

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Friday, March 30 was National Doctors' Day.

We salute the hardworking
doctors/researchers/teachers/scientists/humanitarians
of the Hartford Hospital Medical Staff.


HH Facts
1960 - The first acute hemodialysis treatment in the state was performed at Hartford Hospital.


Top News

 

Delegation from Israeli Visits HH to Explore Developing Relationships

On March 28, an Israeli delegation including Nili Shalev, the economic minister from Israel to North America, visited with Hartford Hospital leadership to explore opportunities to develop relationships with existing and evolving companies in Israel focusing on health care technology, research and development. Accompanying Ms Shalev were Oded Grinstein, deputy minister; Sandra Johnson, vice president for business development for the Hartford Metro Alliance; and Laura Zimmerman, associate vice president of the Jewish Federation. The group took an extensive tour of CESI and were very impressed with the facilities, staff and programs currently in place and most excited about the prospects of working with Israeli companies to share and grow both our educational programs, as well as our technology and development opportunities. We look forward to further discussions with Ms. Shalev and will pursue specific relationships that will enhance our research and educational missions.

 

Top Docs in CT Magazine

Hundreds of Hartford Hospital-affiliated doctors were named in the Top Docs 2012 list released in the April issue of Connecticut Magazine. It is the largest group of Top Docs ever—840 doctors in 30 categories: dermatology, gastroenterology, general surgery, neurology, ophthalmology, psychiatry, urology and infectious diseases. See the complete list: http://www.connecticutmag.com/Connecticut-Magazine/April-2012/Top-Docs-2012.

Hartford Hospital Steps In To Help Charter Oak Health Center

Hartford Hospital will provide an interim team of medical and administrative professionals to run and evaluate Charter Oak Health System, a community health center that has provided primary care in Hartford since 1978. In February, state health officials demanded a plan of correction by March 9 from Charter Oak for problems with its infection control program. The plan of correction was deemed unacceptable, and "lacked elements required by CMS for participation in the Medicare/Medicaid certification program." As a result, the health center's CEO was placed on administrative leave. The interim CEO will be Peter Velez, MPH, a respected administrator from with substantial experience managing community health centers. Rita Parisi, CEO of ERN, Dr. Peru Venkatesh, assistant director of the Department of Medicine, and Pam Clark, nurse manager of Women's Ambulatory Health Services, will be providing services at Charter Oak to determine the personnel needs and management structure for the center and help implement corrective actions determined by the Department of Public Health.

At 101, "Mrs. Chase" Is a Medical Marvel
Hartford Courant, March 27

Long before there was "Annie," the iconic doll used for CPR-training classes, there was "Mrs. Chase." Created in 1911, the lifesize Mrs. Chase doll is the first known doll to have been designed specifically for training health care workers. The original was built in Rhode Island for Hartford Hospital, which — to the surprise of just about everyone at the hospital — still has it. A few weeks ago Steven Donahue, director of the hospital's Center for Education, Simulation and Innovation, was putting together a brochure about the hospital's training mannequins. A Google search he did revealed that simulation mannequins began with the Mrs. Chase doll and that Hartford Hospital had the very first. It was the first that Donahue ever had heard of Mrs. Chase, and he doubted the doll was still in the hospital after 101 years. But he mentioned it to Steven Lytle, the hospital's archivist. Lytle confirmed that there was a Mrs. Chase in storage and retrieved it, which was wearing an original, hand-stitched Hartford Hospital gown.

HH received Six of the Top 10 NIH Grants in CT in 2011

Hartford Hospital had the first four largest grants, and a total of six out of the top 10 grants from the National Institutes of Health to Connecticut hospitals in 2011. The six grants total $2.3 million. The other four went to St. Francis and CCMC, which received two each, according to the Hartford Business Journal.

ERN Receives 100% of Pay for Performance Incentives with ConnectiCare

Eastern Rehabilitation Network,a department of Hartford Hospital, has attained 100% of the payout in their pay for performance contract with ConnectiCare, Inc., for the second year in a row. The incentive payments were worth over $150,000. The performance metrics focus on patient satisfaction, outcomes and utilization. ERN exceeded the thresholds in each area.

 

Excellence

 

Dr. Rocco Orlando Publishes Two Chapters Regarding Quality and Patient Safety

Dr. Rocco Orlando III, senior vice president and chief medical officer for Hartford HealthCare, recently had two book chapters published in the SAGES Manual of Quality, Outcomes and Patient Safety (2012). The chapters are entitled: "Disclosure of Complications and Error" and "Second Opinion and Transfer of Care."

Dr. Tarantino Directs Urology Conference in Washington DC

Dr. Arthur Tarantino, a urologist from Hartford Specialists, was co-program director for the 9th Annual Urology Joint Advocacy Conference in Washington, D.C. March 3-6. The three-day program covered federal legislative advocacy, educating urologists on the urology legislative agenda and including a visit to legislators.

 

Research and Academics

 

Five Physicians Author Article in March Issue of International Journal of Gyn Pathology

Drs. Stephanie Ricci, Aaron Shafer, Stacy Nerenstone, Srini Mandavilli, and Joel Sorosky authored an article entitled A Surveillance Conundrum: A Case of 4 Distinct Primary Malignancies in a BRCA-1 Mutation Carrier, which was published in the March 2012 issue of the International Journal of Gynecological Pathology. Dr. Ricci is a fourth year resident in obstetrics and gynecology who will be starting a fellowship in gynecologic oncology at Johns Hopkins in July. Drs. Shafer and Sorosky are from the Division of Gynecologic Oncology. Dr. Mandavilli is from the Department of Pathology, and Dr. Nerenstone is from the Division of Medical Oncology.

Research Proposals Sought for Medical Staff Grant Competition

The Medical Staff Executive Committee is once again committing a total of $75,000 to the Medical Staff Patient Safety and Quality Research Grant Competition, a program designed to encourage investigators to develop research projects aimed at improving patient safety and enhancing the quality of health care service delivery at Hartford Hospital. This RFP will be administered by the HHC Research Institute and will be evaluated by the HHC Research Committee. We are interested in funding multiple projects with the potential to impact patient care. Project budgets should be approximately $15,000. Interested investigators must complete a two-page Letter of Intent, which is due April 16. Please contact Dr. Ilene Staff Istaff@harthosp.org with any questions.

Dr. Goethe Conducting New Trial on sTMS for Depression; Presents on Antipsychotics

Dr. John Goethe, director of clinical research at the Burlingame Center for Psychiatric Research at the IOL, is conducting a new trial using a new, non-invasive medical device for the treatment of depression known as low emission NeoSync EEG synchronized transcranial magnetic stimulation (sTMS). Inclusion criteria for the trial include a diagnosis of Major Depressive Disorder, failure to respond to exactly one medication in the current Major Depressive Episode and age between 22 and 65 years old. The trial consists of five 30-minute treatments per week for six weeks. There is no recovery period after a treatment. For further details about the trial, please visit www.neosync.com/. To speak with the trial coordinator, Jennifer Higgins, Ph.D., please call 860-545-7502, or email at jhiggins@harthosp.org.

In addition, Dr. Goethe recently made a presentation at a psychopharmacology conference sponsored by the Nevada Psychiatric Association regarding antipsychotic prescribing practices for patients under age 18. The study, thought to be the largest of its kind, was undertaken at the Institute of Living. “This is an important issue because these antipsychotic medications are commonly prescribed," said Dr. Goethe. The amount of published data about antipsychotic use in children and adolescents who are inpatients is scant, he said, and antipsychotics are commonly used for indications that have not been approved by the FDA. The clinical rationale for this type of use is not well understood. Key findings from a single-center study were that nearly 45% of children and adolescents admitted as inpatients to a psychiatric hospital were prescribed antipsychotics over a 10-year period. The top five variables significantly associated with use of antipsychotics were a diagnosis of psychosis (odds ratio, 7.2), taking anticonvulsants (OR, 2.7), taking lithium (OR, 2.5), having posttraumatic stress disorder (PTSD; OR, 2.3), and taking benzodiazepines (OR, 2.0). The presentation was reported in the March 13 Family Practice News.

Link to Information on American College of Cardiology Conference in Chicago

Doctors attending the American College of Cardiology 61st conference 2012 in Chicago can link to an eBook with information from ACC 2011 in MD Conference Express via the Hartford Hospital Health Science Libraries. The link is: http://www.nxtbook.com/nxtbooks/md_conference_express/acc2011/#/0. MD Conference Express is a data base service. It can be found on the Library Intranet page under the category “Additional Literature Search Tools.” This service gives you access to all the major medical conferences around the globe. If you have any questions about this service or you would like instruction on using this service call/email Sheila Hayes 860-545-2416 or shayes01@harthosp.org.

Stroke Symposium May 18: "Fantastic Voyages"

The Stroke Center is presenting a symposium on Friday, May 18 called "Fantastic Voyages." It will explore current endovascular management of stroke, aneurysms and brain AVMs. Keynote speaker is Dr. Alejandro Berenstein, chief of Interventional Radiology at Beth Israel Medical Center & St. Luke’s-Roosevelt Hospital Center in New York. The symposium will be held in the Education Resource Center (ERC). Fee is $150 for physicians; $50 for non-physicians; $25 for HH staff members who have an employee number. There is no charge for trainees (medical students/residents/ fellows/tech students, and nursing students). For more info, and to register online, go to www.harthosp.org/event/607.

 

Operational Update

 

 

HH In the News

 

Dr. Smally Quoted on NECN About Ticks and Lyme Disease
NECN, March 21

Tick season may be off to an early start with the early spring. Dr. AJ Smally at Hartford Hospital says to check your dog and yourself for ticks after you've been outside. "If you got bit is not a problem," Dr. Smally explained. "A tick has to stay on you at least 24 hours, probably more like 24 to 36 hours, before that tick can give you Lyme Disease." If you do get Lyme Disease, don't worry, advises Dr. Smally. "If the disease is recognized early, our treatment is 100 percent effective in eliminating the Lyme disease," said Dr. Smally.

Hospitals, Patients Concerned By Drug Shortage
NewsTimes, March 25

When Susan Block was diagnosed with ovarian cancer 2008, she was shocked and terrified. But when staff at Hartford Hospital, where she received her chemotherapy treatments, called her and told her they were canceling her upcoming round of treatments because the drug they were using was unavailable, she didn't know how to feel. Though Block was eventually able to get access to her medication, her alarming dilemma sheds light on what many are calling a national crisis. 

Statin Linked to Increased Myalgia
Cardiology Today, March 26

Individuals taking atorvastatin were twice as likely to report symptoms of myalgia as compared with individuals taking placebo, according to study findings presented at the American College of Cardiology’s 61st Scientific Sessions. Researchers for the blinded, controlled Effect of Statins On Skeletal Muscle Function and Performance (STOMP) study administered daily atorvastatin 80 mg (n=203) or placebo (n=217) to statin-naïve adults for 6 months or until they met the study criteria for myalgia. Half of the participants were women, and most were middle-aged and relatively healthy, Beth A. Parker, PhD, of the department of preventive cardiology at Hartford Hospital, said during an oral session.

Medical First! Bloodless Heart Transplant
wftv.com, March 27

With someone needing blood every two seconds in the U.S., surgeries and medical procedures performed without the use of blood are a preferable choice by many. Some religions, such as Jehovah Witnesses, believe that the blood carries the soul and that would make a blood transfusion sacrilegious. Also, thousands of people are dying each year due to contaminated blood. Bloodless surgery is an approach to health care that began in the 1960s as simple avoidance of the use of transfused blood. It has grown over the last four decades to include changed attitudes toward blood conservation as well as new technologies that minimize the need for transfusions during surgery. The Center for Bloodless Medicine and Surgery at Hartford Hospital defines bloodless surgery as "...surgical and medical treatment without the administration of blood or blood-related products.” Nationwide Children’s hospital recently performed its first successful bloodless heart transplant on a 6-year-old boy.

 

In the HHC System

 

Growing Home Care Sector a Boon For Some, Trouble for Others
Hartford Business Journal, March 19

In 2010 alone, Right at Home, part of an international franchise, brought in $10 million providing mostly live-in services to about 200 private-pay clients in Hartford County. The Right at Home franchise is now looking to expand in Connecticut in Fairfield, New Haven, New London, and Middlesex counties. But the success isn’t being shared by all providers in the state home-care sector. Within the last 10 months, three nonprofit home-care agencies have either have gone under or been forced to merge. Agencies like Right at Home focused solely on patients who pay out of pocket are finding a strong business market. But other agencies, particularly nonprofit Visiting Nurse Associations, which take on a large share of Medicaid patients, are struggling for survival as government reimbursements fail to cover costs. That is leading to closures, mergers, and layoffs. VNAs, which rely on government payers for up to 90 percent of their revenue, also must diversify their business models to attract more private-pay customers. Just last week, VNA HealthCare announced a new care transition program with Jefferson House, a unit of Hartford Hospital, to help patients and families successfully navigate from a skilled nursing facility to home.

 

Health Care News In the Region

 

Quinnipiac's New Medical School in North Haven Sees 700+ Applicants for 20 Faculty Jobs
Post Chronicle, March 22

More than 700 people from across the country have applied for 20 faculty positions with Quinnipiac University’s new medical school. Quinnipiac expects to spend nearly $100 million on the school before the first class of 60 students arrives in August 2013. The medical school will be Connecticut’s third and is one of 18 new medical schools being developed across the country in response to a major expected shortage of primary care physicians. Unlike Yale and UConn, Quinnipiac will focus on training primary care physicians rather than specialists. It will also push a philosophy that sees physicians as part of a “team of health care professionals” focused on the patient, vs. the traditional autocratic model where nurses, aides and lab technicians may be afraid to question a doctor’s authority.

Quinnipiac Medical School Adds UConn Professor
Hartford Business Journal, March 20

A veteran physician who specializes in hematology has joined the faculty of Quinnipiac University's new medical school. Dr. Robert Bona will coordinate the school's core curriculum in hematology and related issues. He plans to emphasize mentorship and newer approaches to medical education. The Windsor resident comes to Quinnipiac from the UConn School of Medicine, where he was a professor of medicine. He was active in the teaching programs at the medical school, directed the hematology/oncology fellowship program and also served as an attending physician at the UConn Health Center. Bona was previously affiliated with Saint Francis Hospital and Medical Center in Hartford.

Change to Medical Malpractice Law in Dispute
NewsTimes.com, March 24

State lawmakers are moving ahead with legislation they say will fix a problem with Connecticut's medical malpractice law that has kept some legitimate lawsuits out of the courts, despite heavy opposition from the medical industry. The current law, enacted in 2005, forces people who want to sue health care providers to get an opinion from a similar provider supporting their malpractice allegations before they can file their lawsuits. If plaintiffs don't submit such an opinion with their lawsuits, or the opinion doesn't meet the requirements, judges can dismiss the cases before the merits are even heard. Legislators passed the law under pressure from doctors in an effort to prevent frivolous lawsuits and drive down skyrocketing malpractice insurance rates. But lawmakers say they never intended for the 2005 law to spark hosts of court fights over the credentials of the pre-lawsuit opinion writers and have proposed a bill that would increase the types of health care providers who can write the opinions. A host of doctors, hospital officials and industry groups, including the American Medical Association, submitted testimony against the legislation, saying it would undo the 2005 reform that curbed the skyrocketing malpractice insurance rates. They also said getting rid of the requirement for similar providers would open the legal system to faulty opinions and more legal challenges to those opinions, as well as deter doctors from practicing in Connecticut.

Medical Society Harps State $10 Million Bill That Would Subsidize Docs in Targeted Areas
Hartford Courant, March 14

State legislators are proposing that the state borrow $10 million in order to spend $2 million a year for the next five years to subsidize salaries, pay off student loans or pay for capital projects in small doctors' practices in the state. The money would go to practices in 10 towns in the state where there is a shortage of specialists and other physicians. Some people have to travel 20, 30 minutes to get the care they need. The student loan forgiveness and recruiting bonuses would be available for any kind of doctor. Some of the subsidies would be loans, but the loans could be converted into grants if the doctors stay long enough.

Urgent Care Clinic Fills Gap Between ER and Primary Care
Hartford Courant, March 19

Dr. Michael Gutman, who has worked in the ER at St. Francis Hospital in Hartford for more than 20 years, opened New England Urgent Care in West Hartford about a year ago, intending to fill the gap between primary care and emergency medicine. "The vast majority of people can be treated as an outpatient much faster in a more friendly way," he says. How does this differ from a standard walk-in clinic? Gutman says his nationally certified facility offers a higher standard of care and features life-saving equipment. There are only four other clinics like his in the state. The extended hours, 365 days a year, really appeal to parents. Demand has been so great that Gutman and his wife, a nurse, have plans to open clinics in Enfield and Simsbury in the next few months.

Johnson Memorial Hospital Introduces New Infusion Services in Enfield
Enfield Patch, March 19

Johnson Memorial Hospital has announced the expansion of services on its Enfield campus with the opening of a new infusion center. Saint Francis Care will relocate its local infusion services from Elm Street in Enfield, to the Johnson Memorial Cancer Center, creating the only hospital-based infusion center in Enfield. Medical directorship of the Johnson Memorial Cancer Program is provided by Saint Francis Careand the new infusion center is staffed by physicians from Saint Francis Medical Group’s hematology-oncology practice.

 

Coming Events

 

April 4 (Wednesday):

Hartford Medical Society Meeting

The next Hartford Medical Society event will be held on Wednesday, April 4. Mary Cappello, PhD, Fulbright Scholar, will present an illustrated reading featuring her book "Swallow: Foreign Bodies, Their Ingestion, Inspiration, and the Curious Doctor Who Extracted Them." The event is 5:30-8:30 p.m. at The Town & County Club, 22 Woodland Street in Hartford. There will be cocktails and a buffet dinner before the reading. Cost for event is $35 per person. The registration form may be found here: http://library.uchc.edu/hms/pdfs/SwallowInvitation.pdf.


9th Annual Heart Rhythm Symposium: Bridging Electrophysiology and Heart Failure II

A series of lectures, case presentations and work shops will focus on an understanding of rhythm abnormalities in heart failure patients and how advanced treatments with drugs, resynchronization therapy (CRT), ventricular assist devices and cardiac transplant can be applied. Open to cardiologists, practitioners of internal medicine and family practice, cardiology fellows, midlevel practitioners and nurses. April 4, 7 a.m. to 4:15 p.m., at the Farmington Marriott. For more information or to register online, go to www.harthosp.org/class/578.

April 6 (Friday):
Department of Surgery Grand Rounds:
Therapeutic Hypothermia: Management of Post-Cardiac Arrest Patients

Dr. Justin Lundbye, director of Inpatient Cardiology Service, medical director of Cardiac ICU, and director of the Cardiology Hospitalist Program. 6:45-7:45 a.m., Gilman Auditorium.

April 12 (Thursday):
Department of Medicine Grand Rounds:

AML: Chapter and Verse from the Book of Leuk (Acute Myelogenous Leukemia )
Dr. Stephen I. Firshein. 8–9 a.m., Gilman Auditorium.

April 26 (Thursday):
Take Your Child To Work Day

Children from 4th-12th grade are eligible to participate. Applications must be submitted by Friday, April 6. If your child is interested in participating please contact Amanda Blaszyk at 860-545-4732.

SAVE THE DATE: May 23
Annual Medical Staff Spring Event

 

More events

 

Hot Topics in Healthcare

 

Cutting Costs with Better Care for Advanced Illness
Wall Street Journal, March 19

A better approach to advanced illness, including fewer hospitalizations, could improve quality of life and satisfaction for the sickest patients — and save $25 billion in annual health-care costs, according to Gundersen Health System. The system is part of the Coalition to Transform Advanced Care, which aims to get more health systems to adopt programs such as caring for terminally ill patients at home instead of in hospitals. Gundersen outlines such programs in a new book, Having Your Own Say, which advocates helping patients and families prepare for end-of-life decisions, and avoiding unwanted treatments while providing comfort and pain relief

Establishing National Standards for Cancer Survivorship
Medical News Today, March 20

People are living longer with and after a cancer diagnosis, making survivorship clinics and programs - as well as guidelines and practices governing the care of survivors - an important emerging component of modern cancer care. Many institutions are looking to gather these resources into an easily understandable plan for survivors.

Hospital Groups Checklist Keeps Heart Failure Patients Out of Hospital
The Tennessean, March 25

An old-fashioned checklist has the potential to keep patients with heart failure out of the hospital — and save Medicare billions of dollars, a small new study suggests. The checklist aims to help ensure that patients stay healthy after discharge, instead of quickly returning to the hospital because their symptoms return or get worse, according to a study of 96 patients presented at the American College of Cardiology’s annual meeting. The list prompts doctors to make sure that patients understand when and how to take their medications, for example, and how to monitor their blood pressure and modify their diet and exercise. All patients in the study had been admitted to the hospital for a heart problem. Researchers then randomly assigned half to go through the 27-point checklist before leaving the hospital. Only 2 percent of patients whose doctors used the checklist were readmitted within a month, compared to 20 percent of other patients.

Emotional Impact of Patient Safety Incidents on Family Physicians and Their Office Staff
JABFM, March-April 2012 issue

All members of the health care team report experiencing emotions related to patient safety incidents in their practice. Incidents with minor or no harm still invoked emotional responses from the providers. It is important to understand the impact that patient safety incidents have on the medical clinic as a whole.

More Doctors Work Part Time, Flexible Schedules
amednews.com, March 26

A survey released March 12 by Cejka Search, a physician search firm based in St. Louis, and the American Medical Group Assn. found that in 2011, 22% of male physicians and 44% of female physicians worked less than full time. The 2011 survey covered 14,366 physicians in 80 practices. Two of the fastest-growing physician demographics -- men near the end of their careers, and women at the beginning or middle, are the most likely to demand part-time or flexible work schedules, according to experts in physician recruitment. Twenty percent of male and 23% of female physicians in practices of 500 or more doctors worked part time. Meanwhile, only 6% of male and 4% of female physicians in practices of three to 50 physicians worked part time. In hospital-based practices, the total working part time was 5% of male and 7% of female physicians.

Everything in medicine is going mobile (HIMSS meeting)

Cardiologist Eric J. Topol, MD, was on a cross-country flight when an attendant made an announcement asking if there was a doctor on board. Dr. Topol, chief academic officer for Scripps Health, responded and was brought to a man who was in obvious trouble. Only a year or two ago, Dr. Topol would have had to make an educated guess and hope he could take care of the patient until the plane landed. This time, though, he pulled out his iPhone, and with an app that produces an electrocardiogram, he determined that the patient was having a heart attack. The plane made an emergency landing. With each passing day, mobile technology is giving physicians more opportunities to practice medicine from anywhere, at any time.
http://www.ama-assn.org/amednews/2012/03/26/bisa0326.htm.

 

Voices Of Our Patients

 

Patient Thanks Dr. Piorkowski with Annual Campaign Gift

Doris Maynard of Wethersfield gave to the 2012 Annual Campaign in appreciation for Dr. Robert Piorkowski and the staff at Hartford Hospital giving her 10 more years with her husband, Clifford. Her experience goes back to 1988 when Clifford was diagnosed with colon cancer. As his surgeon, Dr. Piorkowski helped to extend Clifford’s life, from February 1988 to August 1998. “Cliff was very pleased with the good care he received from the doctors and staff, and I cannot begin to express in words how much I appreciate all they did to help him recover from this operation at age 88,” said Doris. “I am very grateful to them all and that is why I want to help Hartford Hospital and show my support for such a great hospital, doctors and staff

 


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.