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.

January 22, 2012 Edition

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HH Facts
1948: Hartford Hospital was the first to install an automatic vertical conveyor system for the transport of sterilized goods and supplies from one floor to another.


Top News

 

Dr. Robert Hagberg Named Chief of Cardiac Surgery

Dr. Robert C. Hagberg has been named the new chief of cardiac surgery at Hartford Hospital. He will begin work here in early April. Dr. Hagberg, who comes to us from Beth Israel Deaconess Medical Center/Harvard Medical School in Boston, is a nationally renowned surgeon, researcher and educator who will further elevate our well-respected cardiac surgery program, contribute to cardiac surgery research here, expand the portfolio of cardiac surgical procedures and help us train the next generation of advanced heart surgeons. Dr. Hagberg an assistant professor of surgery at Beth Israel Deaconess Medical Center/Harvard Medical School and director of Graduate Medical Education, Cardiac Surgery for the BIDMC Cardiothoracic Surgical Residency Program. He has co-authored dozens of articles in peer-reviewed journals. His current research interests include minimally invasive cardiac surgery, including techniques for cardiac resynchronization therapy, mitral valve repair, treatment for atrial fibrillation, stent grafting of the thoracic aorta and percutaneous valve techniques. 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. As an educator, he has been deeply involved in teaching the clinical practice of cardiac surgery to Harvard medical students and general surgical residents, as well as cardiothoracic surgical residents and fellows.

Dr. Stuart Markowitz Assumed New Role As Hospital’s Chief Medical Officer

On Jan. 1, Dr. Stuart Markowitz, chair and medical director of Hartford Hospital’s Department of Radiology, assumed the role of chief medical officer. Markowitz has been a leader here for decades, serving as VP of the medical staff for two years and chair and medical director of radiology since 1995. He spent nearly 30 years in private practice. “The work ahead is complex and varied and the initiatives will be most successful with the support and participation from the entire medical staff,” Dr. Markowitz said. “We have begun to look at restructuring our various meetings to bring our medical leadership into an integrated working group with our executive team and CEO. This will entail assessing the frequency and content/agendas of our various forums to increase efficiency, reduce redundancy, and enhance communication. Many of my efforts will focus on quality and safety initiatives including hand hygiene, global immunization, decreasing readmission rates, and medical staff engagement in support of advancing our HCAPS scores and improving the patient experience. I know our medical staff firmly believes in the mission and vision of Hartford Hospital and Hartford HealthCare. We will work together to establish mechanisms to improve our alignment, further our collaboration, refine our communication, and focus our efforts to improve the welfare of our patients and the success of our hospital.” 

Patient Satisfaction Reaches All-time High

During the first quarter of FY 2012, Hartford Hospital achieved our highest patient satisfaction scores ever: 68.5%. Our balanced scorecard goal for FY 2012 is 70.5%. Usually, the first quarter has the lowest patient satisfaction score of the year, so we expect to at least achieve our goal. The 68.5% score is a 5% improvement over the first quarter of FY 2011, and puts us in the 50th percentile of hospitals nationwide. Four years ago, we were in the 18th percentile with a patient satisfaction score of 54%. We expect our new uniform policy to be a big boost in improving satisfaction scores.

Hartford Hospital One of Three in State With Top Level Performance on BSIs

Over the past two years Hartford Hospital has witnessed dramatic improvements in the prevention of bloodstream infections (BSI), and recent BSI rates are at the top decile level nationally. Since February 2011, the Connecticut Department of Public Health (DPH) has posted reports of Central Line Associated Bloodstream Infections (CLABSI) on their website by hospital name. In the newest website public posting, Hartford Hospital is one of only three organizations out of more than 30 statewide in the highest category, called “better than expected performance” rates, meaning the CLA-BSI rate is significantly lower than the national average. The outcomes of the BSI Action Group in addressing the HH Balanced Scorecard Bloodstream Infection Prevention initiative were significant enough to result in this team being awarded the Team of the Year Award at the State of the Hospital event in October 2011.

CESI Named International Training Center for Sensei Robotics

The Center for Education, Simulation and Innovation (CESI) has been selected to be a Center of Excellence for the Sensei(R) X Robotic Catheter System, where electrophysiologists from around the globe will come to be trained on flexible robotics with our skilled and experienced physicians in a high-­‐volume electrophysiology lab setting. It will serve as the training center for the Northern United States, and is expected to commence operation in February. The hospital recently purchased its second Sensei X Robotic Catheter System, powered by a highly accurate, robotically controlled arm that allows for catheter navigation, stability and positioning within the patient's heart. "The Sensei X Robotic Catheter System has changed the way we perform complex cardiac procedures. It has also increased the number of procedures we are able to perform in our lab, so we are offering our patients a greater range of minimally invasive cardiac procedures than we could before we acquired our first robotic system," said Dr. Steven Zweibel, director of Cardiac Electrophysiology. "It is our intention to create an institutional focus on cardiovascular robotics and to become one of the leading cardiovascular robotics programs in the world,” said Dr. Steven Shichman, medical director of CESI and chairman of Peri-­‐operative Services. “Becoming a pioneer in flexible robotics will provide our institution with clinical recognition and technological differentiation in many spheres, and will enable us to serve all three of our missions: research, education and clinical activity." Hansen Medical, Inc, makers of the Sensei Robotic system, selected Hartford Hospital based on the institution's strong reputation for providing complex and innovative care and its renowned excellence in patient care, teaching and research. "Since there is data showing the benefits derived when operator experience with the Sensei X System increases, it is important to replicate these successes in other centers through improved training and the sharing of best practices,” said Hansen’s president and CEO, Bruce Barclay.

Newly Expanded ED Opening Jan. 31; Open House Planned

There will be an open house and ribbon cutting ceremony for the newly expanded Emergency Department on Tuesday, Jan. 31 at 2 p.m. Patients will be seen in the new area the following day, Feb. 1. There will be 26 new treatment spaces, bringing the total to 86. Construction began in July on the $16 million project. 

New Medical Risk Management Rounds Schedule for 2012; 6% Malpractice Discount Available

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 2012 Risk Management Educational Program. All physicians insured by CHS/CNA Insurance must attend one session of Risk Management Rounds, which is 1-2 hours long, and the schedule is below. You may now RSVP for all live events on the portal.  

  1. Cardiology: Feb. 14, 11 a.m.-1 p.m., JB-118
  2. Surgery: April 20, 7-8 a.m., JB-118
  3. Leadership: April 26, 4:30-5:30 p.m., JB-118
  4. ED: May 2, 12-1:30 p.m., Gilman Auditorium
  5. Women’s Health: May 3, 7:30-8:30 a.m., Special Dining Room
  6. ED: May 17, 8:15-10 a.m., Dining Room B & C
  7. Medicine: May 23, 4:30-6 p.m., Gilman Auditorium
  8. Leadership: June 8, 7:30-8:30 a.m., JB-118
  9. Surgery: June 25, 5-6 p.m., Gilman Auditorium
  10. Medicine: July 18, 4:30-6 p.m., JB-118
  11. Psychiatry: TBA

Medical Risk Management, LLC (MRM) is managing the education and monitoring compliance with these requirements. If you have any questions, please contact MRM at 860-920-5475, or the CHS Insurance Department at 860-696-6227.

"HealthCare Matters” Radio Show Debuts

HealthCare Matters, a monthly radio series produced by Hartford HealthCare, debuted on WTIC-AM (1080) Jan. 15. The show, which aims to further the conversation about health care in America, is hosted by Elliot Joseph, HHC president and CEO, and Rebecca Stewart, Hartford Hospital’s director of media relations. “We want to engage our community and broaden the discussion on health care,” Joseph said. “We intend to shine a light on the real issues our country faces, including access to care, quality of care and the cost of care. Starting the dialogue is key if we are to shape the health care policy of the future." The inaugural show featured guest Dr. David Blumenthal, who served as the national coordinator for Health Information Technology under President Barack Obama. The next program is live on Feb. 15 at 11 a.m. We want to hear from you: Call in at 1-860-522-WTIC.
Listen to the inaugural show here: http://connecticut.cbslocal.com/healthcare-matters-with-hartford-healthcare/ A Health Care Matters page, with links to archived broadcasts, as well as to the live broadcast, is under construction for the HHC Web site (www.hartfordhealthcare.org ) and will be in place by the end of the month.

Documentary About Hartford Hospital Fire of 1961 To Premier on CPTV Jan. 26

On Dec. 8, we remembered one of Hartford Hospital’s darkest days: the 50th anniversary of the tragic fire of 1961 that killed 16 people and forced a national debate on fire safety. A new documentary, "The Hartford Hospital Fire: Inferno on the 9th Floor," will premier on CPTV at 8:30 p.m. Thursday, January 26, with an encore on Sunday, January 29 at 6 p.m. The documentary was produced by the Hartford Hospital News Service and uses survivor interviews, archival footage and photographs. This 30-minute program documents one of the worst hospital fires in U.S. history and some of the most courageous acts of selflessness by hospital personnel and firefighters.

Pet Therapy Pilot Expands Canine Presence to Hospital Lobby

The executive management team has approved a six-month pilot program to expand the Pet Therapy program to have dogs visit in the main hospital lobby two to three times a week to greet patients and visitors. Certified teams of canine greeters will be in the lobby from 1-2 p.m. on Tuesdays or Wednesdays, and 6-7 p.m. on Tuesdays. Our 16-year-old pet therapy program, run by Volunteer Services, is the biggest in the Northeast with 33 dogs participating. The pilot, which will begin in February, is modeled on programs at Baylor Health Care System and Cleveland Clinic. If the pilot is successful, Volunteer Services hopes to expand the program to more lobbies, days and hours.

 

Excellence

 

Dr. Andrew Wakefield Elected President of State Neurosurgical Society

Dr. Andrew Wakefield, associate director of the Department of Neurosurgery and co-chair of the Spine Center at Hartford Hospital, was recently elected president of the Connecticut State Neurosurgical Society and the Northeast vice-chair for the Counsel of State Neurosurgical Societies, a national organization that provides legislative recommendations to the AMA Washington Committee and Med-PAC. Dr. Wakefield has made tremendous strides at local political and national events to represent physicians’ interests, which has led him to become a leader among New England neurosurgeons.

Cancer Center Accredited with Commendation

The Commission on Cancer (CoC) of the American College of Surgeons has granted three-year accreditation with commendation to the Helen & Harry Gray Cancer Center. Accreditation is given only to those facilities that provide the highest level of quality cancer care, and that undergo a rigorous evaluation process and review of their performance. "We are so pleased to be recognized for our comprehensive efforts in cancer outreach, diagnosis, treatment, support and research," said Dr. Robert Piorkowski, chief of Surgical Oncology, and chair of the Cancer Committee. "Through our partnership with the NCI as an NCI Community Cancer Center, our program has grown tremendously in the last few years in terms of scope and innovation. All of this means we are taking even better care of our patients."

MRI Department Performs First Scan On Patient With Pacemaker

Friday, Jan. 6 was a milestone for the Hartford Hospital MRI Department: they scanned their first patient that had a pacemaker. Five million people worldwide have pacemakers, and at least 200,000 a year forgo having an MRI because they have the older models implanted. The new Revo pacemaker was designed with MRI and safety in mind. It goes into a "safe" mode before the patient is placed in the MRI scanner, so the unit ignores outside interference. The ferrous elements are gone and the reed switch was replaced by a hall sensor, which is more reliable. The lead wire itself is made of a material that is not attracted to the magnet. This was a true team effort to pull this off: present were a cardiologist, a cardiac nurse, a representative from Medtronic, three MRI technologists and Dr. Michael O'Loughlin, MRI section chief. The patient was referred by Dr. Steven Zweibel, director of cardiac electrophysiology.

LifeStar Staff Hosts Tour for Loyal Annual Campaign Donors

When the Fund Development Department wanted to reward loyal Annual Campaign donors with a personal tour of LifeStar last month, Dr. Kenneth Robinson, medical director and program director of LifeStar, was more than happy to help coordinate the event. Dr. Lauri Bolton, assistant medical director of LifeStar, respiratory nurse Patricia Lohan and pilot Dennis McAfee graciously conducted the tour for 11 donors. The group had a chance to see the helicopter up close, walk around the helipad and learn more about the incredible work our air ambulance does for the Hartford community and the New England region. Their hosts explained what their typical day looks like, what the helicopter and staff can and cannot do, and how they work with other hospitals in New England. So far the tour has resulted in one gift to support LifeStar. Such tours are conducted quarterly for selected Annual Campaign donors, and similar tours are available for hospital staff who support the Employee Giving Campaign.

 

Care Coordination

 

Diet Orders Can Now Be Canceled in SCM

Starting February 1, you will be able to discontinue diet orders in SCM (Sunrise Clinical Manager). This will cancel orders in the system used by the Food & Nutrition Diet Office. Changes are also being made to Diet Order forms to make ordering diet restrictions easier and diet orders easier to understand on the SCM Orders Tab. By discontinuing inappropriate diet orders, patients will have only one active diet order in SCM.

All Departments Will Receive Zoll Defibrillators Before March

Hartford Hospital will be rolling out new Zoll defibrillators in January, February, and March in 2-week increments. The hospital has purchased the Zoll R series+, which will standardize the type of defibrillator encountered in every department, minimizing confusion and improving safety. This defibrillator has additional features such as continuous Sp02 monitoring, continuous ETC02 monitoring, and NIBP monitoring.

HMG Avon Sees Increase in Volume

Hartford Medical Group (HMG) at the Avon Family Health Center saw 287 more patients in December than November, increasing the number of patients seen from 41 to 50 per day. HMG has been working with the Avon Volunteer Fire Department and Police Department concerning providing physicals and exams for workers’ compensation issues.

 

Academics and Research

 

Presentation on Emergency Psychiatric Treatment Wins Top Award

A recent Hartford Hospital study, “Can emergency medicine nurse practitioners and physician assistants predict disposition of psychiatric patients?” was awarded Best Oral Presentation at the Connecticut College of Emergency Physicians Annual Meeting. The study was authored by Dr. Michael Drescher, associate chief of the Division of Emergency Medicine; Dr. David Pepper, acting director of emergency psychiatry services; Dr. F. Russell; and M. Pappas, MS, NP, and was supported through a generous grant from the Hartford Hospital Medical Staff.

New Funding Received For Screening Tool To Predict Pacemaker Needs

Dr. Steven Zweibel, director of the Department of Cardiac Electrophysiology, and co-investigators Dr. Michael O’Loughlin (MRI section chief) and Dr. David O’Sullivan (Research Program) have been awarded new funding through Medtronic to evaluate a new questionnaire as a screening tool to predict the future need of an MRI-conditional pacemaker in patients scheduled to receive a single- or dual-chamber pacemaker. The new study represents approximately $81,000 in new research funding.

 

Operational Update

 

Financials: December Was Strong in Both Inpatient and Outpatient

Inpatient discharges in December were on budget and exceeded December of the prior year by about 2%. Outpatient revenues in the month were strong, exceeding budget by approximately 8%. The areas of outpatient revenue that contributed to the favorable variance were Ambulatory Surgery, Cardiology, Gastroenterology, Laboratory and Radiology. Year to date through December, inpatient discharges are 1% below budget, but are greater than the first quarter of FY 2010 by 1%. Outpatient revenues are about 3% greater than budgeted.

“HHC Thrive” To Launch; Aims To Bolster Competitiveness and Flexibility

This month, Hartford HealthCare will roll out HHC Thrive, a system-wide initiative to bolster HHC’s competitiveness and flexibility in a difficult and unpredictable market. Meetings will be held for leadership and physician groups at HHC member organizations, and the initiative will be shared with staff throughout HHC. The objective is to review our costs, processes and outcomes from top to bottom to ensure that HHC doesn’t just survive in the years ahead, but thrives. Chicago-based Huron Healthcare, with a global perspective on health care system organization and performance, will assist us in the early phase of HHC Thrive, as will H3W efforts across the network. Regular updates will be given to all system staff members as HHC Thrive takes root and grows.

Medical Records Completion Policy Amended

The Medical Executive Committee approved changes to the completion of medical records policy which added progressive suspension penalties for non-dictation or no written documentation of procedure or op notes and discharge summaries. Under the existing policy, any member of the medical or adjunct staff suspended, regardless of the length of the suspension, cannot admit a patient to the hospital, write any orders or perform any procedure in any inpatient or outpatient area of Hartford Hospital. Any violation (or work around) of these limitations will result in further disciplinary action, up to and including termination from the adjunct or medical staff. The revisions created two categories of deficiencies: Category 1 is a deficiency based non-dictation (or no written documentation) of operative or procedure notes or discharge summaries; and Category 2 is a deficiency based on non-completion of all other medical record requirements, including but not limited to e-signatures of orders, dictations, discharge summaries or any other documentation as well as queries. Additional penalties were added for Category 1 Deficiencies. Repeated suspensions will result in progressive suspensions as follows:

  • 5 suspensions for Category 1 Deficiencies during any part of 24 consecutive months, the provider will be suspended for at least 10 days AND until all outstanding medical records have been completed.
  • 6 to 10 suspensions for Category 1 Deficiencies during any part of 24 consecutive months, the provider will be suspended for at least 20 calendar days AND until all outstanding medical records have been completed.
  • More than 10 suspensions for Category 1 Deficiencies during any part of 24 consecutive months, the provider will be suspended for at least 30 calendar days AND until all outstanding medical records have been completed. This will lead to mandatory reporting to the National Practitioner Data Base (NPDB).

Category 1 Deficiencies will be re-set to 0 if all Category 1 Deficiencies are cleared by March 1, 2012. Please DO NOT be on the suspension list.

Invitation for Requests for Auxiliary Special Projects Funding

The Hartford Hospital Auxiliary Board of Directors will be selecting special projects for the Auxiliary's spring 2012 round of Special Projects funding. Requests are due Feb. 10. Successful requests will likely be $2,000 to $25,000. For more information, please contact Carol Garlick in Fund Development at cgarlic@harthosp.org. You may find it useful to see the following list of some previous beneficiaries of Special Projects funds:

  • Ambulatory Surgery - furniture for bariatric patients
  • B9I/B10I/B10SD - Nemscoff Serenity II Treatment Chairs
  • Brownstone Ambulatory Services - Equipment for adult primary care floor
  • Brownstone Dental Clinic - Ultrasonic scanner
  • Cancer Program/Department of Medicine, GI Division - Colon Cancer Awareness initiative
  • Social Work - Domestic violence prevention education
  • Institute of Living, Child and Adolescent Services - exercise equipment

 

HH In the News

 

Dr. Detlef Wencker Comments on Wait for Organ Donors In Connecticut
wtnh.com, News 8, Jan. 13

Dr. Detlef Wencker was quoted in a story on News 8 about a patient currently hospitalized here waiting for a heart transplant. "We hope we don't have to wait too much longer but we noticed that overall, transplantations nationwide, have dropped significantly," Dr. Wencker said. "If he fails to remain stable on medical therapy, and his heart condition continues to deteriorate, we might not find a donor heart in time for him." Donor availability is down; the average wait here at Hartford Hospital is three months.

Dr. Paul Thompson Quoted in Today Show Story About Cardiac Arrest Risk in Marathoners
Health on Today, Jan. 11

Just this fall, a 35-year-old man died while running a Chicago marathon; a 37-year-old man died at a Los Angeles half-marathon; and two men -- one 21, the other 40 -- died at the Philadelphia Marathon. According to a new study, the risk of cardiac arrest in long distance races is actually quite rare. “This is a pretty careful study, and it starts to give some more insight into who those people are," says Dr. Paul Thompson, a cardiologist at Hartford Hospital, who assisted the authors with the report and has studied the link between running and heart problems. Dr. Thompson explains that one of the big debates among cardiologists is whether everyone who wants to run a marathon should be given an exercise stress test to screen for underlying heart conditions. "This study suggests that it may be useful in people who are going to run marathons," Dr. Thompson says. 

Hartford Hospital Dawns Color-coded Scrubs
Hartford Business Journal, Jan. 18

Hartford Hospital is adopting a new color-coded uniform system that aims to allow patients to more easily identify doctors and other hospital personnel. Nurses will wear royal blue scrubs, while technicians will wear hunter green uniforms and phlebotomists will wear gray scrubs. Hospital officials say the system aims to improve the patient experience by making it easy for patients to identify and approach staff to obtain information. Studies show that while patients and families feel it's important to know who to approach when they have concerns, they can have difficulty differentiating nurses from other staff. As a result, they either feel embarrassed when they approach the wrong person with their questions -- or sometimes, just refrain from asking a question.

 

In The HHC System

 

HoCC Radiologist Testified About Ultrasound Detection of Breast Cancer
Hartford Courant, Jan. 13:

Dr. Jean Weigert, a radiologist at Hospital of Central Connecticut, told state officials considering a law that required all mammogram reports include the patients’ breast density information that more data was needed to know whether ultrasound tests actually did a better job detecting tumors in breasts with high density. The bill became law in early 2009, nonetheless. Although she called it a case of "putting the cart before the horse," Weigert said the law presented a "golden opportunity." "Since this is the first place in the country doing this, and we were all struggling with this, let's see what we can pull from it," she said. "Let's gather some scientific information to prove or disprove whether this is a valuable tool or not." Weigert collected data from more than 70,000 cases, about 8,600 of which involved ultrasound screenings, from October 2009 to October 2010. Her study found that the ultrasound screenings detected 3.25 cancers per 1,000 women that otherwise would have been overlooked. "When you think about it, we find four or five per thousand breast cancers in an overall screening population. So, then you add that extra three on, I think that's not insignificant." Her study has been accepted for publication in The Breast Journal, and Weigert presented her findings at the Radiological Society of North America conference in Chicago in November.

 

Coming Events

 

January 26 (Thursday):
"The Hartford Hospital Fire: Inferno on the 9th Floor"

This new 30-minute documentary will premier on CPTV at 8:30 p.m.

February 3 (Friday):
Surgery Grand Rounds:

“Emergency Department Triage and Crowding." Dr. A.J. Smally, medical director of the Emergency Department. 6:45 a.m., Gilman Auditorium.

February 4 (Saturday):
Black & Red

This year, the Black & Red gala will benefit women’s health services. For more information on the event please e-mail black&red@harthosp.org or call 860-545-2116.

More events

 

Hot Topics in Healthcare

 

The Fate of Health Care Reform – What to Expect in 2012
NEJM, Jan. 11

The Patient Protection and Affordable Care Act of 2010 (ACA) is arguably the most significant health legislation enacted in generations. What the reform will actually accomplish is largely yet to be determined. Whether it slows the growth of costs, increases access to care, or improves the quality of care will depend on how it is implemented, and depends on the outcome of four key events in 2012.

Preparing for Precision Medicine
NEJM, Jan. 18

Personalized medicine (coupling established clinical–pathological indexes with state-of-the-art molecular profiling to create diagnostic, prognostic, and therapeutic strategies precisely tailored to each patient's requirements) comes with the potential for greatly advancing patient care. However, progress brings new challenges, and the success of precision medicine will depend on establishing frameworks for regulating, compiling, and interpreting the influx of information that can keep pace with rapid scientific developments.

 

Voices Of Our Patients

 

Nurse Compliments Physicians and Staff

I support Hartford Hospital because, as an RN, I believe Hartford Hospital has the most outstanding physicians, with high medical knowledge from the physicians and the staff. The quality of care while I was a patient at the hospital was a 10 on a scale of 1-10 and 10 the highest. The nurses, MAs, certified aides and lab workers were extremely efficient, professional and very caring. Hats off to Hartford Hospital, #1 in the state.

Anonymous

 


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.