From the Offices of Jeffrey A. Flaks and Jeffry Nestler, MD

Nov. 25, 2012 Edition


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HH Facts:

1985—Life Star became the first air ambulance system (and remains the only) in the state of Connecticut.

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.

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.

 
In This Issue...
Top News

Thanksgving Message From Elliot Joseph

Happy ThanksgivingThe holidays are a very special time of year – a time for all of us to take time to enjoy our friends and family, celebrate the magic of the season, reflect on our achievements, and look forward to a New Year.

When I look back at 2012, the first thing that comes to my mind is the commitment Hartford HealthCare staff members demonstrate every day as you care for our patients, their families and our community members. During particularly difficult times, such as during Hurricane Sandy in October, so many of you always are willing to step forward to work extra shifts and spend the night away from your own families in order to ensure our patients and communities receive the care they need and that your coworkers receive your support.

I’m truly in awe of your dedication and profoundly proud of your commitment to living our values of integrity, excellence, caring and safety … always doing the right, best, kindest and safest thing in everything you do. The way we work together through H3W to implement best practices and constantly improve quality, care coordination and the patient experience makes us special and is critical to building a culture of excellence. I have no doubt that we have the ingenuity, innovation, expertise and compassion to achieve our vision “to be nationally recognized for excellence in patient care and most trusted for personalized coordinated care.” Thanks to you, we’re on our way.

For those of you working during the holidays and giving up time at home, I offer you my sincerest thanks and admiration. I hope you will have the opportunity over the next few weeks to spend some relaxing time with the people you love.

Thanks to every member of the Hartford HealthCare family for everything you do every day. I look forward to next year and all the things I know we will accomplish as a unified team of dedicated, caring people.

I wish you and your loved ones a happy, safe and healthy Thanksgiving and holiday season.

Best Wishes,
Elliot Joseph
President & CEO, Hartford HealthCare

Town Hall Meetings with President Flaks

President/CEO Jeff Flaks will be holding Town Hall Meetings over the next month open to all staff members. This is a time to ask questions or discuss any ideas or concerns you have about Hartford Hospital. Please join President Flaks at one of these meetings:

  • Tuesday, Nov. 27 – 1-2 p.m., Gilman Auditorium
  • Friday, Nov. 30 – 3-4 p.m., Blue Back Square, 4th Floor Education Room
  • Thursday, Dec. 6 – 3-4 p.m., IOL, Commons Building, Hartford Room
  • Friday, Dec. 7 – 10-11a.m., ERN Glastonbury, 330 Western Blvd., Education Room
  • Monday, Dec. 17 – 5-6 p.m., Newington Eye Center, Waiting Room Lobby

Advancing Medicine: Holiday Miracles

Thursday, Dec. 6

7:30 p.m., WFSB

Hartford Hospital’s continuing TV series Advancing Medicine airs on Hartford’s CBS affiliate, WFSB Channel 3 on Thursday, Dec. 6 at 7:30 p.m. This will be a special holiday miracles episode. After the show, Hartford Hospital physicians will be live in the WFSB studios to take calls.

Hartford Hospital Opens New Epilepsy Center

On Nov. 16, Hartford Hospital officials cut the ribbon on the hospital’s new multi-bed inpatient Epilepsy Center on Center 11. Epilepsy is now the fourth leading neurological disorder in the US, after migraine, stroke and Alzheimer’s disease. There are more than 60,000 people in Connecticut diagnosed with epilepsy - and thousands more who may remain undiagnosed or not effectively treated. For years, patients in the greater Hartford area would have to travel long distances for inpatient EEG monitoring and for surgical treatments. Because an epilepsy diagnosis often means someone cannot drive, many have gone without the right care. Hartford Hospital is developing the only Level IV Epilepsy Center in central, northern and eastern Connecticut with one goal: making patients seizure and symptom free. The center provides: The latest diagnostic, surgical and treatment technology in the state, 24-hour EEG inpatient monitoring in a newly renovated center, up to 72 hour home EEG monitoring, minimally invasive craniotomy surgery, and individualized care by a dedicated team of epilepsy experts.

Excellence

Drs. Gluck, Thompson and Wencker Publish in Journal of Heart and Lung Transplantation

Drs. Jason Gluck, Sara Thompson and Detlef Wencker from the Heart Failure and Transplant section of Cardiology were published recently in the Journal of Heart and Lung Transplantation. Their article described the training program they established for health care professionals in dealing with patients with Left Ventricular Assist Devices or LVADs. LVAD patients can present with confusing clinical signs since their rotary heart pump device generates forward blood flow but does not produce a blood pressure due to the lack of pulsatile flow. The authors used CESI to establish training protocols in managing these devices.

Dr. Paul Thompson Presents Statin Study Results at Conference in Spain

Dr. Paul D. Thompson, chief of Cardiology gave a presentation at the seventh International Coenzyme Q10 Conference in Seville, Spain Nov. 9. His presentation focused on the results of an NIH-funded study examining how statin cholesterol drugs affect skeletal muscles.

State of the Hospital 2012 / Teams of the Year

This year's Teams of the Year were selected from among 49 nominated teams in two categories: clinical and clinical support. They were announced at the Nov. 13 State of the Hospital event. You may view the event, featuring Hartford Hospital President and CEO Jeffrey A. Flaks, at http://bit.ly/Ug1YZ0 via our media website. The winning clinical team is the Medicine, Oncology and IV Therapy Nursing Team, a leadership team from several clinical areas that implemented five H3W retreats to bring together 450 staff members so they could realize how bringing our values to patients could lead to excellence. The winning clinical support team was the Planning and Marketing Department. Through this department's efforts, the expertise of Hartford Hospital's staff and the innovative technology and compassionate care we offer has become much better known.

H3W Goes National

Hartford Hospital's cultural transformation story (H3W) is being shared regionally and nationally. On Nov. 14, President and CEO Jeff Flaks and Dr. Jamie Roche, VP Patient Safety & Quality, presented a keynote address for the Executive Track at the 2012 Press Ganey National Client Conference in Washington, D.C. The presentation was titled "Hartford Hospital's Journey Towards Excellence: H3W (How Hartford Hospital Works)." In this presentation, Flaks and Roche shared the origins of H3W, the key elements of this operating model, and recent outcomes with an audience of several hundred senior executives from around the nation.

Innovative and Complex Care

Call For Abstracts on Improving Patient Experience

Deadline: Jan. 11, 2013

Event: April 12, 2013

How did you or your area improve the patient experience?

You are invited to submit an abstract about it for a tabletop poster display on "The Patient Experience - Connecting With Purpose" for the First Annual HHC Patient Experience Event on April 12, 2013. The event, to be held at Heublein Hall, is designed to showcase best practices and innovation across HHC.

Staff can submit an abstract in one of three categories: Improved Transitions of Care, Innovation, or Enhanced Patient and Family Centered Care. A winner and runner-up will be chosen in each category. The winner will be asked to present a brief presentation.

The deadline for submission is January 11, 2013. We encourage you to take advantage of this exciting opportunity and share with other health care practitioners how you or your area improved the patient experience. Download the rules and application form here.

Research and Academics

S.T.A.B.L.E. Program - A LIFE STAR Educational Opportunity

Jan. 12, 2013

JB-118

LIFE STAR will hold a S.T.A.B.L.E. program session Jan. 12, 2013 from 8 a.m.-4:30 p.m. in JB-118. S.T.A.B.L.E. is an educational tool developed for maternal/child health care providers to organize care during the post-resuscitation/pre-transport stabilization period. It is the most widely distributed and implemented neonatal education program to focus exclusively on this care for sick infants. S.T.A.B.L.E. stands for the six assessment and care modules in the program: Sugar, Temperature, Airway, Blood pressure, Lab work and Emotional support. Instructors will be Jason Doonan, RN, and Michael Frakes, APRN. Registration is $25 and includes a continental breakfast, lunch and an afternoon snack. For more information, contact Patrick Dowd at 860-545-4369 or at pdowd@harthosp.org.

Annual Meeting: History and Future of Imaging Technology at Hartford Hospital

Dr. Barry Stein, an internally-recognized innovator in the development of non-invasive diagnostic imaging techniques, wowed those in attendance at Hartford Hospital's Annual Meeting with an presentation titled "Beyond Advanced: Clinical Innovation at Hartford Hospital." Dr. Stein cataloged - and illustrated - Hartford Hospital's many imaging "firsts" for the nearly 170 board members and corporators at the Nov. 15 meeting. The annual meeting allows our corporators to get to know "the best and brightest" from the medical staff. Dr. Stein's presentation underscored the pioneering role Hartford Hospital has played in the development and evaluation of leading-edge diagnostic imaging. The event also included reports of the board governance committee, the board of directors and the president.

Operational Update

Physicians Must Have Flu Shots By Dec. 1

Hartford Hospital requires all staff members - including licensed independent practitioners with any kind of staff privilege - to receive the influenza vaccine by Dec. 1. Flu shots can be obtained through Occupational Health in the Brownstone Basement Monday through Friday from 7a.m. to 5 p.m. If you prefer an appointment, call (860) 545-2175. Individuals who get flu shots off campus must bring proof of vaccination to the Medical Staff Office in order to receive a blue tag that indicates the individual has been vaccinated. (The tag attaches to the I.D. badge.) Thank you for helping to protect patients and other staff members from influenza.

A Friendly Reminder from Infection Control

Please remember when visiting our patient care areas at Hartford Hospital:

  • Perform hand hygiene before and after every patient encounter
  • Follow isolation signage posted by wearing appropriate personal protective gear for Contact, Droplet or Airborne precautions
  • No food or drink in patient care areas

Thank you for keeping our patients and yourself healthy during cold and flu season.

Medicine and Cardiology Units to Go Live With Electronic W10s This Week; Classes Available

All medicine and cardiology units will go live with electronic W10s starting this Tuesday, Nov. 27.

  • Cardiology units (B10E, B10i, B10S, C10) will go live Tuesday (Nov. 27)
  • Medicine Units (B11E, B11i, B11S, C12, N12, N11 0 will go live Thursday (Nov. 29)

Providers: You will need to know how to create an electronic W10 - the following training classes held this week:

  • Monday, Nov. 26, 7-7:30 a.m. and 3-3:30 p.m. in CB5B
  • Wednesday, Nov. 28, 12-12:30 p.m. in CB5A.
  • Friday, Nov. 30, 7-7:30 a.m. and 12-12:30 p.m. in CB5A

For more information, or for other training options (including completing the Medication Section), please contact Cynthia Thompson at 860-250-7361.

"Help Wanted Ads" in Seymour Street Journal

Looking for a clinician? Why not check with your colleagues at Hartford Hospital? Upcoming issues of Seymour Street Journal will feature free "ads" for physicians and other clinicians that could make your talent search easier. Send the job description to Dr. Jeffry Nestler, editor of the Seymour Street Journal at jnestler@connecticutgi.org.

HH In the News

Hartford Hospital Offers 24-Hour Monitoring for Epileptic Patients

Hartford Courant, Nov. 9

To get a better handle on the severity and condition of epileptic patients, Hartford Hospital will begin 24-hour monitoring Monday, in which patients will stay at the hospital for up to five days under constant observation.

About two years in the planning, the Comprehensive Epilepsy Center has six hotel-like rooms. Epilepsy patients who volunteer for the program stay in the rooms for about five days, or until they have a seizure. Being monitored by video 24 hours a day, it allows doctors to see their seizures and observe the symptoms first-hand. Patients are also monitored by electroencephalography (EEG), which records the electrical activity of the brain.

Because seizures vary so widely, Dr. Erica Schuyler said, it's important for a doctor to observe the seizure directly. With older people, she said, "sometimes it's not clear if it's dementia or if it's a seizure." "The sooner I make an accurate diagnosis, the better it is for everybody," said Schuyler, a neurologist at Hartford Hospital. In most cases, the patients taking part have been referred to the program by the hospital's epilepsy specialist, added Schuyler. The earlier patients get an accurate diagnosis, she said, the sooner doctors can decide on a means of treatment.

This usually means determining which drugs will be used. For those patients who don't respond to medication, surgery becomes an option. Dr. Brendan Killory, a neurosurgeon at the hospital, said surgery will cure or relieve the condition in most cases.

Changes Made In Detecting Child Abuse

News 8, wtnh.com, Nov. 13

Changes are coming to the way child abuse is detected and dealt with in Connecticut. "Over a hundred kids a month are injured or abused. One every month is admitted to hospital and, or dies," Dr. Lenworth Jacobs of the Hartford Hospital said. Those are alarming numbers, and that's why Connecticut is changing what doctors do to stop child abuse. "This tragedy led to a great deal of searching for answers, and one of the results of that search is the resolve to work together to improve child safety," Dr. Jacobs said.

That search for answers led to doctors from all over the state coming together to look at how they identify and prevent child abuse. They formed a committee and came up with two simple and basic changes, give every kid a thorough exam, and if there's any suspicion, look at the child's medical history.

"Check children who present with traumatic injury under the age of 6 and do a thorough examination, that means disrobing them, putting them in gowns, and examining them. They will also examine their own medical records," Dr. Jacobs said. And if need be, the state can look at all medical records. It means re-training doctors to do that in all cases, but it also means educating parents that this is the new procedure, and they're not singling anyone out for suspicion of abusing their kids.

Hospitals To Get More Aggressive in Child Abuse Detection

Hartford Courant, Nov. 12

Hospitals have adopted more aggressive child-abuse protocols in the wake of the death last year of 3-year-old Athena Angeles of Willimantic. Athena, who was treated for a serious head injury at Windham Hospital, was released to her mother's care and died several hours later after being beaten by the mother's boyfriend.

The guidelines, proposed by the Department of Children and Families, require that doctors conduct a physical examination and check medical records for any history of abuse or neglect if they become suspicious of any injury to a child under six.

That will take some getting used to, said Dr. Lenworth Jacobs, but so did changes in attitudes about drunken driving, smoking, wearing seat belts, and domestic violence. Annual refresher training on the guidelines will be required as part of a doctor's license renewal every two years. "We want this to be a lasting, cultural change,'' said Jacobs, director of trauma and emergency medicine at Hartford Hospital, "not just a response to a very difficult situation. Connecticut is saying that we're going to step up and be much more vigilant. We will be successful when parents come to expect that we will ask questions on behalf of children under six who come into the hospital with a suspicious or traumatic injury.''

In the HHC System

Hospitals Using Debt for Growth

Hartford Business, Nov. 12

While Connecticut hospitals have been struggling to maintain healthy margins in recent years, it hasn't sapped their appetite for taking on new debt. In fact, some of the state's 30 acute care hospitals have been aggressively borrowing funds to invest in new infrastructure and technology, make acquisitions or refinance existing debt.

About a year ago, for example, Hartford HealthCare issued $375.8 million in bonds. The move represented the first time the traditionally conservative hospital system tapped the debt markets. Prior to that, the hospital used cash from operations to fund capital projects. Thomas Marchozzi, Hartford HealthCare's chief financial officer, said the offering was part of a larger strategy to consolidate and then refinance the debt of all the individual hospitals, including Hartford Hospital, the Hospital of Central Connecticut, Windham Hospital and MidState Medical Center.

About 90 percent of the group's collective debt at the time had variable interest rates, so the strategy was to refinance into less risky fixed rate debt when interest rates were at historical lows, Marchozzi said. Now, about 75 percent of Hartford HealthCare debt has fixed interest rates, and 25 percent has variable interest rates.

Hartford HealthCare also used about $110 million from the offering for new projects including the construction of a parking garage and expansion of the emergency department at Hartford Hospital. About $40 million was set aside for capital expenditures at other hospitals within the system.

Meriden Hospital Operates in Black for 13th Straight Year

My Record Journal, Nov. 15

MidState Medical Center has posted a $24.3 million operating surplus, accounting for 10.2 percent of its net revenue in the fiscal year. It is the 13th straight operating surplus for the hospital. An operating margin of 5 percent is generally recommended nationally as an indication of fiscal fitness. MidState’s inpatient volume increased 0.9 percent over the previous year, while the state overall dropped about 2 percent. Emergency Department visits went up 4.2 percent. Ralph Becker, MidState’s chief financial officer, said MidState’s ownership and investment into a captive insurance company accounted for $17.1 million in revenue. He said ownership of that company will be transferred to Hartford HealthCare next year.

 

Health Care News In the Region

St. Francis, UConn Med School Open Connecticut Institute for Primary Care Innovation

Officials from St. Francis Hospital and Medical Center and the University of Connecticut School of Medicine celebrated the opening of the Connecticut Institute for Primary Care Innovation (CIPCI), located on the main St. Francis campus in Hartford, on Nov. 8. The institute is based in a newly dedicated and completely redesigned facility, "The Innovation + Learning Center at St. Francis," which also includes state-of-the-art conference and training rooms, research space and the Health Sciences Library. The CIPCI space includes:

  • A collaborative theater to support teaching and training for clinicians and their teams;
  • A simulation studio with a flexible floor plan for patient flow and office redesign analyses, as well as simulations to improve procedural skills, communication and teamwork;
  • Multiple locations for interactive learning, debriefing and high-definition videoconferencing.

Read this story from the Hartford Business Journal
Read this story from the Catholic Transcript

Down Economy Injures Local Hospitals

NPR, Nov. 14

The health care industry is one of the most reliable sources of new jobs in the country. And in cities that suffer from high unemployment, the local hospital is often the biggest employer still standing. But the downturn in the economy has left some hospitals in perilous financial shape. In Waterbury, CT, the biggest hospitals are going through a painful process of outsourcing and layoffs.

Connecticut Children's Medical Center Featured in Launch of First-Ever Crowdfunded Hospital Gift Catalog

Woodbury-Middlebury Patch, Nov. 15

Connecticut Children's Medical Center is taking part in the launch of the first-ever crowdfunded hospital gift catalog – www.GiveMiracles.org – as part of a national campaign led by the world’s largest crowdfunding-for-good platform, Fundly, and Children’s Miracle Network Hospitals. Through www.GiveMiracles.org, individuals wanting to give back with their holiday gifts can purchase critically-needed medical equipment and medical care for children at Connecticut Children's Medical Center. Once donors choose their gift from the www.GiveMiracles.org catalog, ranging from comfort toys ($30), to a pediatric wheelchair ($970), to an entire hospital wing devoted to neonatal intensive care ($12 million), they will receive updates on exactly how their gift is being utilized to benefit local children with critical medical needs.

Coming Events

November 28 (Wednesday)

Schwartz Center Rounds

11:30 a.m.-12:45 p.m., Gilman

The November Schwartz Center Rounds will be held Wednesday, Nov. 28 from 11:30 a.m.–12:45 p.m. in Gilman Auditorium. Presenters will be Ellen Blair, nursing director for the IOL, and Danette Alexander, nursing director for Emergency Department Services. At this session, entitled "Come Together... Right Now... or Else!" We will be discussing the gorilla in the room as represented by the "us vs. them" dynamic. Learning how to build consensus amongst two different departments with a single initiative can be challenging. Hear how the ED accomplished their goals by meeting the needs of the psychiatric patient in the Purple Pod. Schwartz Center Rounds is a forum where staff get together to discuss a common theme in health care. It has always been a safe place to share the joys and challenges in patient care. All staff/volunteers/physicians are encouraged to share their experience.

December 1 (Saturday)

Deadline for Mandatory Flu Shots

December 5 (Wednesday)

Staff Holiday Party

You are cordially invited to the 2012 Hartford Hospital Staff Holiday Party on Wednesday, Dec. 5. The North and South Campus afternoon session will be from 11 a.m. to 4 p.m. in Heublein Hall, and the evening session will be from 10 p.m. until midnight in the cafeteria. At the Newington Campus, the party will be held from 11 a.m.-2 p.m. in the Dining Room. Please wear your ID.

January 5 (Saturday)

Black and Red Gala

Bushnell

Hartford Hospital's 22nd annual Black & Red Gala will take place on January 5, 2013 at the Bushnell. It has an impressive headliner this year: Earth, Wind, & Fire. More than 1,000 medical, business, and community leaders will come together to raise money for Hartford Hospital's Transplant Program. For more information, visit http://giving.harthosp.org/blackandred.

For more coming events, click here

Hot Topics in Healthcare

Where Growth is Coming in Telemedicine

American Medical News, Nov. 13

Two of the most promising telehealth markets are ones that could have a direct impact on the physician-patient relationship. Research from Frost & Sullivan, a global business research and consulting firm, identified the top 20 telemedicine markets in terms of size and most impact. Topping the list were home health care and disease management monitoring, and remote doctor and specialist services. Frost & Sullivan ranked the various telehealth markets using a scale of 1 to 10 that took into consideration short-term and long-term revenue opportunity, the stability of the business models and the market’s transformative potential. Home health care and remote services had overall scores of 8.5 and 7.6, respectively.

AMA Adopts Principles To Ensure Autonomy For Employed Physicians

American Medical News, Nov. 13

Furthering the American Medical Association’s previously stated goal to be “the lead association for employed physicians,” the AMA House of Delegates adopted policy outlining principles for physician employment that seek to protect doctors’ autonomy and put patient welfare ahead of employers’ interests. This and other policies were approved at the AMA Interim Meeting on Nov. 12. The adopted employment principles were contained in an AMA Board of Trustees report that spelled out guidelines on conflicts of interest, contracting, peer review and other matters affecting employed physicians. One example of a conflict is when a health care organization requires or pressures its employed doctors to send referrals within the hospital or health system. The new policy says such practices should be disclosed to patients.

Voices Of Our Patients

Kudos to Dr. Sharon Diamen

Dear Ms. Ficara,

I’m not sure whether my sister and I can adequately capture in words the immense gratitude we feel for the excellent care our father received from the Hartford Hospital Center 10 nursing and medical staff over his last two weeks of life.  Although our dad has previous stays on Center 10 that were outstanding, the last two weeks of September were remarkable indications of how truly wonderful the staff assigned to him were in terms of both his care and comfort. From the moment he was admitted to Center 10 during this two week period he was welcomed back with compassion and warmth by all of the staff who had him previously. In a short time all who were assigned to him were extending the same quality of care and compassion.

We want to particularly acknowledge his nurses, his patient care associates, nursing manager Ann Vale, nurse practitioner Eileen Cuscik, and case coordinator Phyllis Demaine. 

We also want to thank Deidre Geskin and Dr. Sharon Diamen and her staff from Palliative Medicine for their consultation and services over dad’s final days of life. The remarkable care he was consistently given by all of these outstanding professionals during this very complex and difficult time will always be fondly remembered by my sister and I and other family members who witnessed their extraordinary attention and skillful services. 

We were always kept up-to-date on his changing condition and whenever we had questions, staff very patiently provided very detailed and thorough explanations. 

Please know that, despite our sorrow of losing such a great dad, we will always feel so fortunate that the Center 10 nursing and medical staff were such an integral part of keeping dad so comfortable during his final days and for his peaceful passing. He was a very generous man throughout his lifetime and it was very fitting that those who cared for him in his final days were as kind and giving as your marvelous staff were.

Fondly Submitted,
Anthony Maida

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.