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 15, 2012 Edition

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HH Facts
1965 - Under the direction of Dr. Donald Morrison, Hartford Hospital created one of the first defined respiratory departments in the state and began focusing on providing comprehensive respiratory services to hospitalized patients.


Top News

 

Medical Staff Award Winners Announced

Congratulations to the five physicians who will receive awards at the Medical Staff spring event on May 23:

Helen & Harry Gray Cancer Center to Join the Cancer Genome Atlas Network

The Research Program is pleased to announce that the Helen & Harry Gray Cancer Center has been selected to join The Cancer Genome Atlas (TCGA), a comprehensive effort to accelerate our understanding of the molecular basis of cancer through the application of genome analysis technologies, including large-scale genome sequencing. Funded through the National Cancer Institute (NCI) and the National Human Genome Research Institute (NHGRI) under the American Recovery and Reinvestment Act of 2009, TCGA is comprised of an international network of research institutions, including clinical sites, a specimen processing facility, genomic characterization centers, and a data management center working together with the overarching goal of improving our ability to diagnose, treat, and prevent cancer. TCGA explores the entire spectrum of genomic changes involved in human cancer. Methods include characterizing DNA copy number changes, large (chromosome segments) and small (1,000-100,000 kb) scale rearrangements, transcription profiling, epigenetic modifications, and sequence variation. The Helen & Harry Gray Cancer Center, one of the original pilot sites for the National Community Cancer Center Program and a biospecimen site for the Moffitt Total Cancer Care project, was chosen to participate as a tissue site due to its expertise in processing biospecimens and its ability to contribute high-quality, clinically annotated primary, untreated tumor specimens from select cancer types. The cancer center’s selection was announced in March. The successful application reflects the cancer center’s excellent research track record and was facilitated through the strong ongoing collaboration between the cancer center and the grant writing and grants administration staff of the Hartford Hospital Research Program. For more information please visit the projects website at http://cancergenome.nih.gov.

HealthGrades Named Hartford One of America's 100 Best Hospitals

HealthGrades, a provider of consumer healthcare information, named America’s 100 best hospitals for 2012 in a report issued April 2. The list included two Connecticut hospitals: Hartford Hospital and Middlesex Hospital in Middletown. (http://hmsabc.wordpress.com/2012/04/02/hartford-middlesex-hospitals-among-nations-best/)

In addition, Hartford Hospital received HealthGrades Quality Awards in Neurosciences Excellence (2012), Stroke Care Excellence (2010, 2011, 2012), and Neurosurgery Excellence (2012),. This is the first year we got both the Neurosciences and Neurosurgery Excellence Awards. HH has the most HealthGrades awards in the state, and is the only recipient in Connecticut of the Neurosurgery and Neurosciences Excellence Award.

New Director of Cardiac Surgery Joins the Medical Staff

Dr. Robert C. Hagberg, who was named chief of cardiac surgery at Hartford Hospital in January, began his work here on April 2. He is a nationally renowned surgeon, researcher and educator who will further elevate Hartford Hospital’s cardiac surgery program, contribute to cardiac surgery research, expand cardiac surgical procedures and help train the next generation of advanced heart surgeons. Dr. Hagberg comes to us from Beth Israel Deaconess Medical Center/Harvard Medical School in Boston where he taught the clinical practice of cardiac surgery to Harvard medical students, residents and fellows. He was previously in private practice in Norfolk, Va., where he also acted as investigator for a number of device trials in cardiac and vascular surgery, including several valve and stent graft trials, which eventually led to FDA approval. Dr. Hagberg’s clinical interests include minimally invasive cardiac surgery, mitral valve repair, treatment for atrial fibrillation, stent grafting of the thoracic aorta and percutaneous valve techniques.

Say Thanks to Your Residents and Fellows This Week

April 15-21 is Housestaff Appreciation Week. Please join us in thanking our Hartford Hospital and University of Connecticut residents and fellows for all their efforts, knowledge, expertise and compassion that they bring to the care of our patients at Hartford Hospital. Their participation in our clinical activities is essential to the quality of our outcomes.

6% Malpractice Discount Available Again in 2012 for Completing Risk Management Education

CHS Insurance LTD is continuing participation in the Annual Risk Management Educational Program (RMEP) available to all CHS voluntary attending physicians. By successfully completing the program, eligible participants (CHS Insurance policyholders effective January 1 of this policy year) qualify for a credit of 6% on their malpractice insurance premium. Please feel free to call 860-920-5475 with any questions. There are two sessions scheduled this month:

  • Surgery: Friday, April 20, 7‐8 a.m., JB‐118
  • Leadership: Thursday, April 26, 4:30‐5:30 p.m., JB‐118

 

Excellence

 

Dr. Joel Sorosky Invited to Speak on Women's Cancer

Dr. Joel Sorosky was an invited speaker at the 2012 Annual Meeting on Women's Cancer for the Society of Gynecologic Oncologists in on March 27 in Austin, Texas. Dr. Sorosky, along with physicians from Dartmouth, UCLA, the University of Minnesota, and Carolinas Medical Center in Charlotte, North Carolina, participated in a plenary session called “Tumor Board.”

Institute of Living Receives $4.2 Million Legacy Gift

The Institute of Living’s long and proud tradition of expert clinical care has been recognized with a $4.2 million gift from the estate of an anonymous grateful patient. The gift has been received in the form of a trust distribution, reflecting careful and thoughtful planning by the donor in appreciation for compassionate care. Born in the 1920s, the donor suffered a severe breakdown when she was in her 20s. She was treated at the Institute of Living with insulin shock treatments, and her family recalls her saying that the IOL "gave her back her life." Similar legacy gifts have played an important role in the development of the Institute of Living through the years, including the establishment of the Olin Neuropsychiatry Research Center.

 

Research and Academics

 

Dr. David Nicolau Discusses Antibiotic Resistant Infections at Yale Summit

Dr. David Nicolau, from Hartford Hospital’s Center for Anti-Infective Research, presented a talk entitled “The challenges facing medical care professionals and hospitals in treating antibiotic resistant infections” at a summit April 5 at Yale University on antibiotic research, development and resistance. Also speaking were US Senator Richard Blumenthal and Nobel Laureate Thomas Steitz. Blumenthal discussed the GAIN (Generating Antibiotic Incentives Now) act that he sponsored, which is an important piece of legislation for our pharmaceutical industry here in Connecticut. In reference to the worldwide spread of antibiotic resistant infections, Dr. Nicolau was quoted in an article in the April 5 New Haven Register: “It has changed the paradigm of how we handle patients,” he said. Strains of bacteria once easily handled are “wimps no more,” he said. “Clearly, the infections are devastating to our patients.” As many as one-third of hospital patients are on antibiotics on any given day, Nicolau said. Resistant strains are causing more deaths, longer hospital stays and higher medical costs. The GAIN act will add five years of patent life to new antibiotics and promote further research.

Dr. Carl Moeller Authors Article on Ketorolac Use

Dr. Carl Moeller, otorhinolaryngology, was the primary author of a recently published article on the use of ketorolac (toradol) following endoscopic sinus surgery in the Journal of Allergy and Rhinology. It was entitled “The safety and efficacy of intravenous ketorolac in patients undergoing primary endoscopic sinus surgery: a randomized, double-blinded clinical trial.

Dr. Paul Grundy To Speak at HPHO Clinical Integration Education Forum

Dr. Paul Grundy, IBM's director of Health Care, Technology and Strategic Initiatives for IBM Global Wellbeing Services and Health Benefits, will be the keynote speaker at the Clinical Integration Education Forum presented by the Hartford Physician Hospital Organization (HPHO) on Wednesday, May 16. Dr. Grundy’s topic is: Major Employer Groups: What do they want from Healthcare Systems and Practitioners? The meeting will be held at the Hartford Club at 46 Prospect Street from 4-6:30 p.m. The forum is by invitation only and free of charge for HPHO members and invitees, with free parking (enter to the right of the club entrance). The Hartford Physician Hospital Organization is a partnership between the Hartford Physicians Association and Hartford Hospital which advances the competitive position of the two organizations by integrating and improving the delivery of comprehensive clinical services in order to proactively meet market demands for demonstrable value. It was founded in 1987 as a collaborative vehicle for managed care strategy development, contracting, and medical management

 

Operational Update

 

Ready Cam Studio Available for Live Conference Presentations

If you are invited to speak at a conference anywhere in the world but cannot attend for any reason, you can go live from our in-hospital Ready Cam television studio, located on Jefferson 5, and give your presentation. For more information, contact Rebecca Stewart, director of Media Relations, at rstewart@harthosp.org or 860-545-4285.

New Hematology Analyzers/Additional CBC Parameters

Hartford Hospital Clinical Laboratory has implemented new hematology analyzers (Sysmex XE Series) for automated CBCs. Please note that some minor changes occurred in reference ranges. More significant is the reporting of two new parameters. The automated differential count will now include IG (Immature Granulocytes) and NRBC (Nucleated Red Blood Cell Count) in addition to the traditional WBC differential (neutrophils, monocytes, lymphocytes, basophils and eosinophils). Immature granulocytes (promyelocytes, myelocytes and metamyelocytes) are neutrophil precursors which indicate a granulocytic left shift when appearing in peripheral blood. IG presence is a more objective indicator of a clinically significant granulocytic left shift than the poorly reproducible “band” count. Reference ranges are 0-1% (% IG) and 0-0.1 Thou/uL (Absolute IG). IG counts >0.1 Thou/uL indicate acute inflammation. IG counts >0.3 Thou/uL correlate with serious inflammatory processes and/or systemic infections. BANDS are not included in the IG count, but are included in the automated NEUTROPHIL count. The laboratory has various criteria for smear review and manual differential counting. If a manual differential count is performed, the lab will continue to report segmented neutrophils, bands, metamyelocytes and promyelocytes. The new hematology instrument also accurately enumerates Nucleated RBC Counts at very low numbers. The presence of even one NRBC in peripheral blood may be significant. This feature along with the ability to automatically correct the WBC is a significant advance in reporting these results. Please address questions to Dr. William Pastuszak at 860-545-2223, Dr. Bradford Sherburne at 860-545-2848, or Dr. Gregory Makowski at 860-546-8024.

New Reportable Tests in SCM for Hematology Labs

This week, there were changes made to the names and format for some of the tests reported in a CBC with Differential. Most notable is the addition of Immature Granulocyte Percent and Absolute which will show in SCM as:

Immature Granulocyte
Immature Granulucyte, Absolute

Additionally, please make note of the following name changes to existing test parameters in SCM:
Current: New:
WBC White Blood Count
RBC Red Blood Count
PLT Platelet Count
HGB Hemoglobin
HCT Hematocrit
NU RBC nRBC
NUC RBC# nRBC, Absolute
LYMPH% Lymphocyte
(same format for Mono, Eo, Baso, Myelo, Meta, Promyelo and Blast)
LYMPH# Lymphocyte, Absolute
(same format for Absolute Mono, Eo, Baso, Myelo, Meta, Promyelo and Blast)
CELLS COUNTED Cell Count
TEAR DROP Tear Drop Cells

 

HH In the News

 

When Shopping is Part of Cancer Therapy
Harford Courant, April 8

During treatment and recovery, female cancer patients need merchandise you just can't find at the mall. Cancer patients can find products and advice at the Boutique at Hartford Hospital's Gray Cancer Center. The Boutique stocks and sells items for cancer patients like breast prostheses, head wraps, special cosmetics and body products and wigs.

 

In the HHC System

 

Rushford Center to Offer Nurturing Program
The Middletown Eye, March 30

Rushford will offer a free 8-week Nurturing Program for parents of children ages 4-11. The goal is to improve a family’s quality of life by promoting a philosophy of caring for self, others and the environment. The sessions will include separate parent and children’s groups. Rushford is dedicated to meeting the substance abuse and mental health needs of children, adults and families. Working cooperatively with our Hartford HealthCare network partners, Rushford strives to provide affordable, accessible services of proven effectiveness and high quality that embrace the most current research in prevention, treatment and recovery. For more information, visit www.rushford.org.

Surgery: The Robotic Option at MidState
The Middletown Eye, April 5

A descendent of military technology, robotic-assisted surgery has become a sought-after option. Taking on the high-tech system two years ago, MidState Medical Center first used it only for prostate and gynecological surgeries. Now, MidState is expanding its uses. Patients needing gastric bypass, colon and heartburn surgery are now given the option of robotics. “The only limit as to why we don’t use it for everything else is the cost. It’s still very expensive,” said Dr. Aziz Benbrahim, a surgeon and director of surgical services at MidState. “We’re very lucky though at MidState to have a leadership that supports our vision despite the expenses.”

 

Health Care News In the Region

 

St. Francis Seeks Site At City Hall
Record Journal, April 9

St. Francis Hospital and Medical Center is in negotiations with the city of Hartford to open a new 1,000-square foot urgent care center in City Hall on Main Street. Under the terms of the proposed deal, which needs approval from the city council, St. Francis would invest $230,000 to convert ground floor space at City Hall into an urgent care center that will provide primary care services to city and state employees and their families. Although it would only be a small space with a limited patient base, the new facility would give St. Francis the opportunity to finally plant a flag downtown. The medical center has worked for years to try to become the first hospital to provide health care services in the city’s central business district. In 2009, St. Francis signed a letter of intent to open a location in the proposed AI Technology Center envisioned for Constitution Plaza. But that 12-story, $40 million office tower never materialized. The City Hall location may not offer the same visibility of being in a shiny new downtown office tower, but it is an initial beachhead and much less costly alternative. In exchange for the $230,000 build-out, the city will not charge St. Francis rent, according to the proposal for a five-year lease.

Building a Smart Hospital That Stays Smart Well Into the Future
UConn Today, April 3

The designers of the new hospital tower are being asked to not only build a state-of-the-art health care facility that satisfies the needs of patients, clinicians and staff – but to also predict the future. The latest technological advancement today will likely be quite different in 2016, when the building is estimated to be finished. Think iPad. Did you have one four years ago? “We need to design an IT infrastructure that is extremely flexible so that regardless of what comes along in the next 10, 15, 20 years the infrastructure is already there and we can adopt the new technology,” explains Sandra Armstrong, chief information officer at the UConn Health Center. To better prepare for the future, the IT department has held numerous “technology visioning” meetings involving dozens of nurses, physicians and other clinicians.

Western Connecticut Health Network, Norwalk Hospital Explore Partnership
Becker's Hospital Review, April 6

Western Connecticut Health Network and Norwalk Hospital have agreed to explore a partnership to enhance healthcare services in western Connecticut, according to a Hartford Business report. According to the report, a partnership could mean Western Connecticut Health acquiring Norwalk Hospital. Western Connecticut currently includes Danbury (Conn.) Hospital and New Milford (Conn.) Hospital. Hospital officials expect the exploration to take several months.

New Healthcare Offices To Open in Manchester
Hartford Courant, March 30

ProHealth Physicians plans to move doctors and their staff into a new building on West Middle Turnpike that also will include a walk-in medical center. The physicians' offices are slated to move into the 28,296-square-foot building on April 20 and begin treating patients on April 23. The walk-in center, ProHealth Express Care, is to open on May 1. St. Francis Hospital and Medical Center and Hartford Orthopedic Surgeons also are to open facilities in the building near the intersection of West Middle Turnpike and Adams Street. The ProHealth facilities include four existing primary care practices with six physicians and one physician's assistant and an ear, nose and throat specialist. The practices will employ a total of 16 people.

State Lags in Key Home Health Care Measures
Hartford Courant, April 3

As the Malloy administration seeks to expand home health care options and reduce reliance on nursing homes, a new national report shows Connecticut ranking in the bottom quarter of states on several key indicators of home health quality, including the percentage of home care patients who show improvement in mobility and who avoid hospitalizations. Data compiled in the report by the Commonwealth Fund show that the state's three hospital referral regions — Hartford, New Haven and Bridgeport — ranked 255th out of 306 regions in 2010-11 in the percentage of home health care patients whose ability to walk or move around improved. The state also was in the lowest quarter nationally for the percentage of home health patients whose wounds healed or improved after an operation. And Connecticut ranked in the bottom 25 of the 306 regions on the rate of keeping home health patients out of hospitals. The statewide rate of home care patients with a hospital admission was 33.5 percent — meaning one in three Connecticut home health clients landed in the hospital in 2010-11. The national median was significantly lower: 26.6 percent.

Coming Events

 

May 16 (Wednesday):
25th Anniversary Clinical Integration Educational Forum:

Major Employer Groups, What do they want from health care systems and practitioners?
Keynote Speaker: Dr. Paul Grundy,IBM's director of Healthcare, Technology and Strategic Initiatives for IBM Global Wellbeing Services and Health Benefits. Hartford Club, 46 Prospect Street, Hartford, 4-6:30 p.m.

May 18 (Friday):
Stroke Conference:

“Fantastic Voyages: Current Endovascular Management of Stroke, Aneurysms and Brain AVMs”
“Fantastic Voyages: Current Endovascular Management of Stroke, Aneurysms and Brain AVMs,” will be held Friday, May 18 from 6:45 a.m.-4 p.m. in the ERC. Presented by the Stroke Center, this program will be of interest to neurologists, neurosurgeons, radiologists, emergentologists, APRNs, PAs, nurses and technologists involved and interested in the care and treatment of patients with complex cerebrovascular disease. Conference faculty includes Hartford Hospital physicians Gary Spiegel, Howard Oakes, Martin Ollenschleger, Isaac Silverman and Inam Kureshi. Other faculty members are keynote speaker Dr. Alejandro Berenstein from Beth Israel Medical Center and St. Luks’-Roosevelt Hospital Center; Dr. P. Kim Nelson from NYU Langone Medical Center; Drs. David Fiorella and Henry Woo from Stonybrook University Medical Center; and Dr. Robert Lesser from UConn School of Medicine. Registration is $150 for physicians, $50 for non-physicians and $25 for HH staff members. There is no charge for trainees including medical student, residents, fellows and nursing students. You can register online at www.harthosp.org/event/607 or by calling our Health Referral Service at 860.545.1888 or toll free at 1.800.545.7664.

May 23 (Wednesday):
Annual Medical Staff Spring Event

More events

 

Hot Topics in Healthcare

 

For the Elderly, Emergency Rooms of Their Own
The New York Times, April 9

Emergency rooms, specifically designed for the elderly, are part of a growing trend of hospitals’ trying to cater to the medical needs and sensibilities of aging baby boomers and their parents.Many are quieter and havenonskid floors, rails along the walls, reclining chairs for patients and thicker mattresses to reduce bedsores. Hospitals have strong financial incentives to focus on the elderly. Classic emergency room focus on speed could lead to mistakes with elderly patients, whose condition is often complicated by their being on many medications, having more than one sickness and being unable to express what is wrong with them clearly. People over 65 account for 15 percent to 20 percent of emergency room visits, and that number is expected to grow as the population ages.

Living Micro Robot Has Potential To Detect Diseases in Humans
Medical News Today, April 2

A tiny prototype robot that functions like a living creature is being developed which one day could be safely used to pinpoint diseases in the human body. Called 'Cyberplasm', it will combine advanced microelectronics with latest research in biomimicry (technology inspired by nature). The aim is for Cyberplasm to have an electronic nervous system, 'eye' and 'nose' sensors derived from mammalian cells, and artificial muscles that use glucose as an energy source to propel it. The intention is to engineer and integrate robot components that respond to light and chemicals in the same way as biological systems. This is a completely innovative way of pushing robotics forward. Cyberplasm is being developed over the next few years as part of an international collaboration funded by the Engineering and Physical Sciences Research Council in the UK and the National Science Foundation in the US. The project originated from a 'sandpit' (idea session) on synthetic biology funded by the two organizations.

Doctor Panels Recommend Fewer Tests for Patients
The New York Times, April 4

In a move likely to alter treatment standards in hospitals and doctors’ offices nationwide, a group of nine medical specialty boards plans to recommend that doctors perform 45 common tests and procedures less often, and to urge patients to question these services if they are offered. Eight other specialty boards are preparing to follow suit with additional lists of procedures their members should perform far less often. By some estimates, unnecessary treatment constitutes one-third of medical spending in the United States.

Internet Allows Patients Immediate Access To Radiology Test Results
Medical News Today, April 3

A pilot study at Wake Forest Baptist Medical Center designed to determine if patients wanted online access to radiology test results and, if so, how quickly, was published in the April 2 issue of the Journal of the American College of Radiology. It showed that about half the participants preferred immediate access and about a third preferred access within three days, even in the face of very serious findings written in complex medical language and the knowledge that their doctor might not be available to discuss the results with them right away. An emerging trend in health care is establishing secure online systems that allow patients to access electronic health records. Multiple studies suggest that patients increasingly want to obtain information directly and be involved in making medical decisions. And research shows that this type of increased patient engagement has been associated with improved health outcomes and patient well-being.

Data Breaches of Small Business, Including Doctor Offices, On the Rise
American Medical News, April 5

Small organizations, including physician practices, represented the largest number of data breaches in 2011, according to Verizon’s annual Data Breach Investigations Report. The report examined 855 breaches across the globe that accounted for 174 million compromised records in 2011. One of the reasons breaches at small health care organizations are on the rise is that automated attacks searching for remote Internet access services combined with weak passwords “were successful against smaller health care businesses, such as physicians’ offices and clinics,” said a senior risk analyst of RISK Intelligence for Verizon. The report said 97% of the crimes could have been avoided through simple or intermediate security controls. Health care organizations represented 7% of the breaches. Between 2005 and 2008, 39.5 million patient records were breached in the United States. Medical information is considered not only easier to access, given the lack of data security at many organizations, but also valuable. Clinton said a thief could make $50 for a medical identification number compared with $1 for a Social Security number.

As Smartphones Become Health Aids, Ads May Follow
The New York Times, April 1

With smartphones changing the culture in many ways, more young people are using their mobile devices to keep track of their health. Young adults are much more likely than older people to have a smartphone and to use it to look for health information. And their health concerns differ markedly from those of older people. Nearly 100 million Americans own a smartphone, but “younger people use them very differently,” said comScore, an online research firm. Three of the top five symptoms searched for on Yahoo Mobile in January were early pregnancy, herpes and H.I.V. None of these showed up among the top searches on desktop computers, which are more likely to be used by older people.

 

Voices Of Our Patients

 

Kudos to Dr. Jeffrey Hirst

My wife Gail and I would like to take this opportunity to thank the entire staff, (literally from the bottom of her heart) for the “above and beyond” treatment received recently for a heart attack she suffered while visiting in Hartford.

From the miracle performed by Dr. Jeffrey Hirst and his team in those initial critical moments that saved her life, to the folks who brought her to the front door upon discharge, we ask you to please convey to everyone that we believe no one could possibly ask to be in better hands in such a traumatic situation as we found ourselves.

The doctors, nurses, aides, volunteers, food service folks, social services folks, and everyone else we came in contact with are a credit to their profession, which we believe is a credit to a fine administration.

We are forever grateful for your services, and thank you again!!

Skip and Gail Ryan and Family

 


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.