From the Offices of Jeffrey A. Flaks and Jeffry Nestler, MD
In This Issue...
July 14, 2013 Edition
Wash In - Wash Out
Keep Our Patients Safe - who is NOT going to wash their hands today?
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Dr. Casey Kuwada Performs First TransOral Robotic Surgery Procedure at Hartford Hospital
Dr. Clinton “Casey” Kuwada, co-director of the Head and Neck Cancer Program at the Helen & Harry Gray Cancer Center, and his skilled OR team performed the first TransOral Robotic Surgery (“TORS”) procedure at Hartford Hospital on June 28.
TORS has truly revolutionized head and neck cancer care for many patients. daVinci Surgery maintains the oncologic principles of open head and neck surgery while also providing the benefits of a minimally invasive approach in procedures such as radical tonsillectomy, base of tongue resection and supraglottic laryngectomy.
When compared to standard surgical approaches and chemoradiation, potential advantages include:
• Reduced need for tracheostomy and gastrostomy tubes
• Reduced need for or avoidance of adjuvant radiation/chemoradiation in many of the patients treated
• Avoidance of mandibulotomy for access to the oropharynx
• Decreased length of hospital stay
• Potentially faster recovery
The addition of this new technology allows Hartford Hospital to offer the most cutting-edge and patient centered treatments available, with the goal of building the one of the most comprehensive head and neck cancer program in the region.
The addition of the Otolaryngology/Head & Neck Surgery program represents the 10th specialty in the daVinci service line and further solidifies Hartford Hospital’s position as a leader in multidisciplinary collaborative Robotic Surgery including: Urology, Gynecology, GYN Oncology, Urogynecology, Bariatric, Thoracic, Cardiac, Colorectal, Pediatric Urology, and now Otolaryngology/Head and Neck Surgery.
Dr. Kuwada joined the Department of Otolaryngology/Head & Neck Surgery in July 2012. He completed his fellowship training at Vanderbilt Medical Center in 2012 in Head & Neck Surgical Oncology and Microvascular Reconstruction.
Congratulations to Dr. Kuwada and his team on this achievement.
Dr. Joseph Radojevic Named Director of Heart Failure and Transplant
Dr. Joseph Radojevic has accepted the position of director of Heart Failure and Transplant at Hartford Hospital. Dr. Radojevic replaces Dr. Detlef Wencker, who is leaving to become the director of Heart Failure and Cardiac Transplant at the University of Kansas.
Dr. Radojevic earned his MD degree at SUNY-Downstate; completed a residency in internal medicine and a fellowship in cardiovascular disease at Saint VIncent Hospital in Manhattan, and a fellowship in advanced heart failure/ heart transplantation at Columbia University Medical Center.
Dr. Jason Gluck
has accepted the position of medical director of the ventricular assist device program. Dr. Gluck graduated from New York College of Osteopathic Medicine and completed his residency in internal medicine at New York Hospital Medical Center, Queens. He did his fellowship training in cardiology at New York Hospital Medical Center, Queens, and a fellowship in advanced heart failure/heart transplantation at Columbia University Medical Center.
We are in the process of searching for an additional transplant cardiologist for the program.
PSAG Evolving To Daily Huddle
The Patient Safety Action Group (PSAG) was created at Hartford Hospital in 2008 to resolve regulatory issues. It has evolved into a morning safety huddle, and we have witnessed significant improvement in safety and quality. Now PSAG is evolving even further.
Beginning this month, PSAG will gather an invited group every day at 7:30 a.m. for 15 minutes to identify safety and quality concerns and assist with and support resolutions. Designated attendees will stand in a huddle led by the hospital administrator on call, and senior management always will be present to learn firsthand about issues. Major clinical services will have physician representation.
Every meeting will include discussion about serious safety events, great catches that prevented events, obstacles to delivering safe care, and any non-routing procedures that are scheduled so we can be better prepared to deal with them.
Were You A "First" At Hartford Hospital?
Are you a first of some kind, or do you have a story of one? (i.e. the first heart transplant, the first robotic surgery.)
The Academic Department is compiling a list of "Firsts At Hartford Hospital."
Please contact Jeanne Kiernan at firstname.lastname@example.org with your story before Aug. 8.
June Financial Report: Below Budget
Inpatient volumes based on discharges for the month of June were 1.8% below budget. The comparison to the prior year shows June of 2013 discharges, approximately 1.2% below the prior year.
Outpatient revenues were below budget by approximately 5.2% for the month. The unfavorable outpatient revenue variance was driven by Cardiology Services, Radiology Services, Radiation/Oncology and Dialysis services.
Through nine months of fiscal year 2013, inpatient discharges are 0.3% less than budgeted and 0.9% greater than the first nine months of the prior fiscal year. Outpatient revenues are 0.6% above the budget for the nine months ending June 2013.
SCM Orders Reconciliation Module to Go Live July 23; Training Required
On Tuesday, July 23, Hartford Hospital will go live with SCM Orders Reconciliation Module and Prescription Printing. The new ORM Orders Reconciliation Module will allow providers to complete an ELECTRONIC Medication Reconciliation upon admit and discharge. Medication reconciliation is the responsibility of the provider.
Nursing will continue to enter Home Medications in Outpatient Medication Review, but will not be trained on this reconciliation function.
This NEW module will allow providers to view Home Medications & SCM Active Orders on one screen for reconciliation. The Discharge Reconciliation will replace the current process for the Discharge Medication List created in the SCM Discharge Instructions Notes.
Training is required to use this module.
Classroom Training is being offered until July 26 (30 min. classes-0.5 CME). Please plan now to attend one of these scheduled sessions. No advanced registration is required. Multiple sessions at varying times are available; all meet in ERC 108.
Monday, July 15: 6:30-7 a.m., 12-12:30 p.m.; 3-3:30 p.m.
Tuesday, July 16: 6:30-7 a.m., 11:30 a.m.-12 p.m.; 5-5:30 p.m.
Wednesday, July 17: 6:30-7 a.m., 12-12:30 p.m.; 6-6:30 p.m.
Thursday, July 18: 6:30-7 a.m., 11:30 a.m.-12 p.m.; 7:30-8 p.m.
Friday, July 19: 6:30-7 a.m., 12-12:30 p.m.; 3-3:30 p.m.
Wednesday, July 24: 6:30-7 a.m.
Friday, July 26: 6:30-7 a.m.
In addition, computer-based training will be available and details for this will be forthcoming.
Go-live support will be on-site for two weeks from July 23 until August 4.
You may contact Cynthia Thompson at 860-250-7361 (email@example.com) to schedule training or additional classes. Contact Marc Palter (firstname.lastname@example.org) with any additional questions.
Editor's note: Read about the importance of medication orders reconciliation by Dr. Marc Palter and
Dr. Stuart Markowitz.
Chapel Named for Rabbi Philip Lazowski and the Late Father Jack Kiely
The multi-faith chapel at Hartford Hospital has been named the Lazowski/Kiely Multifaith Chapel, for Rabbi Philip Lazowski and the late Father Jack Kiely.
The naming was celebrated June 27, in a program that drew roughly 100 friends, family and colleagues of the two renowned religious leaders.
Those participating in the program included Jeffrey Flaks, Dr. Harold I. Schwartz, The Most Reverend Christie A. Macaluso, Auxiliary Bishop of the Archdiocese of Hartford; Rabbi Jim Rosen of Beth El Temple; and Attorney General George Jepsen.
E. Clayton Gengras, Jr., a long time benefactor and Board leader of the Institute of Living offered remembrances of Father Kiely; Alan Lazowski offered reflections on his father, Rabbi Lazowski; and Rabbi Lazowski also spoke of Father Kiely and formally dedicated the chapel. The Reverend Jay Cooke, director of Pastoral Services, led the program.
In his remarks, Alan Lazowski announced that he has made a generous lead gift for a special initiative in support of the Institute of Living and will be seeking support from others to honor Rabbi Lazowski and Father Kiely, while supporting the Depression Initiative, which is helping people with depression, bipolar disorder and anxiety disorders achieve not just improvement, but full, functional recovery. Funds raised will support access to mental health care and research to improve the care that is
Rabbi Lazowski and Father Kiely worked together at the Institute of Living and Hartford Hospital for decades prior to Father Kiely's passing in 1996. During those years of service together, they became the best of friends and worked collaboratively to love, heal and pray for our community of patients.
Several Efforts Result in 40% Drop in CAUTIs in Our ICUs
One of our HHC balanced scorecard initiatives is the decrease of catheter-associated urinary tract infections (CAUTIs).
Our multi-pronged efforts have shown great results.
We developed protocols for removing Foley catheters, added key documentation and increased efforts with proper hand hygiene.
In May, we noted a 40% drop in our surveillance rates for CAUTIs in the ICUs.
Save the Date: Dr. Eric Coleman to Talk About Safe Patient Handoffs
Dr. Eric A. Coleman, the nationally recognized director of the Care Transitions Program of the University of Colorado, will provide a special Department of Medicine Grand Rounds on Wednesday, July 24 at 8 a.m. in Heublein Hall. His talk is called "Infusing Person-Centered Care Into Improving transitional care.”
This session should be attended by physicians, nurses, care coordinators, social workers, and all involved in safety and quality of care and patient care transitions.
Dr. Coleman is professor of Medicine and head of the Division of Health Care
Policy and Research at the University of Colorado at Denver. He is also the executive director of the Practice Change Fellows Program, designed to
build leadership capacity among health care professionals who are responsible for geriatric
programs and service lines.
Please hold the date and make every effort to attend. Breakfast will be provided. Further information regarding the specifics of the talk and break out sessions will be provided in the near future.
Innovative and Complex Care
Length of Stay - The Role of Consultants
One of the great strengths of Hartford Hospital is the breadth and depth expertise expertise of our Medical Staff. It is in part this incredible diversity of training and the specialization and sub-specialization of our colleagues that makes Hartford Hospital a destination center. But it is also the large number of clinical consultants and consultations brought to bear that can present challenges related to timely, efficient and coordinated care.
know from the literature and from our own experience that the more consultants involved with a particular patient, the greater the communication challenges and more cryptic the “captain” of the care team becomes to the patient. While consultants bring expertise to the clinical situation and improve overall outcome, with each added consultant we see a rise in the Length of Stay. Our own experience shows that more consultants are engaged in patients with a higher CMI or medical complexity.
That might be expected. But the LOS may increase out of proportion with each additional consultant brought onto the care team.
this because we bring more consultants on board than may be truly necessary to manage our patients? Does this increased LOS result from the ordering of studies that may not be necessary during the acute care period but could be performed later as an outpatient? Or does this correlation exist because we fail to communicate effectively when so many are involved in rendering clinical opinions, decisions, scheduling and performing exams and procedures, and we lose the central source of knowledge of the
patient’s true care plan?
Until we know the true additive value brought by each consultant to the care of a patient, we can work on enhancing responsiveness by consultants, communication between primary clinicians and consultants, and aligning all too often disparate care plans between providers.
have an obligation to communicate directly with each other when we request a consultation and again when we complete that encounter so that all are aware of the decisions made and the actions proposed resulting in a single voice that can communicate back to the patient and their families as well as to the remainder of the care team, especially the nursing staff who have more contact with the patient than any single physician. Therefore it is absolutely essential that we directly communicate with each
other at every opportunity. We should look to standardize this wherever appropriate and use as few intermediaries as possible so as to assure complete understanding across the care team.
The responsiveness of our consultants is generally quite good and we are tracking this through our Clinical Progression Rounds looking for opportunities for improvement. Timely responses can only improve the quality of the care we render.
As we continue to look for ways to appropriately decrease our Length of Stay, we recognize that how we use consultants and how consultants communicate with the primary care team and with the patient presents significant opportunities for enhanced care, greater coordination and an improved patient experience.
So, let me suggest that while we may have opportunity to decrease the number of consultants called into action and decrease the procedures and processes triggered by that consultation, we certainly have opportunity to improve our communication and thereby enhance the efficiency and effectiveness of the care we provide. I am certain with some attention to this we will also see an appropriate adjustment in the patient’s length of stay.
Research and Academics
Dr. Bruce Browner Organized Second Trauma Internet Conference With Tanzania
Dr. Bruce Browner, Chair Emeritus of the Department of Orthopaedic Surgery, organized the second international multidisciplinary trauma Internet conference held on June 20 from Gilman Auditorium.
The topic was “Spine Injury Management: USA & Tanzania,” and speakers were from Hartford Hospital and the Muhimbili Orthopedic Institute (MOI) in Dar es Salaam, the largest city in Tanzania.
Dr. Anthony Benedict Assey, a spine surgeon from MOI in Dar es Salaam, spoke via videoconference. Speakers from HH were Drs. Inam Kureshi, chair of the Department of Neurosurgery, and Jay Krompinger, co-director of the Hartford Hospital Spine Center.
Following 20-minute presentations by the speakers, there was live question and answer interaction between the participants in the Gilman auditorium and the World Bank Conference Center in Dar es Salaam.
Dr. Browner has been working as a consultant with a group in Dar es Salaam to help them establish a trauma system for that city and the coastal region. The plan is to extend the system to the rest of Tanzania and then to have it serve as a model to similar system development in other East African countries.
The College of Surgeons of East Central and South Africa (COSECSA) that includes representation from 10 countries is engaged in the process. These conferences are seen by COSECSA leadership as being an important part of their effort to deal with the immense challenge of caring for victims of road traffic injuries, war, agricultural and industrial accidents.
The first Internet conference was held on March 14, and the topic was Open Fractures Management.
Dr. Edmond Cronin Studies Safety of Recalled ICD Lead Extraction
The recent Riata ICD lead recall has led to uncertainty over how to manage patients with these leads. One concern is that they might be more difficult to extract than other leads.
Dr. Edmond Cronin, who recently joined the Department of Cardiac Electrophysiology, and co-authors from Cleveland Clinic, examined this issue in over 1,000 transvenous lead extraction procedures performed there. They found no difference in clinical success or complications between extractions of recalled (Riata and Sprint Fidelis) and other, non-recalled ICD leads.
Clinical success was achieved in 99.1%, and the rate of major complications was 1.5%. This study demonstrated that, in a high-volume, experienced center, recalled ICD leads can be extracted with comparable safety and efficacy to non-recalled ICD leads.
Welcome To "Chief's Corner"
We recognize the need for sharing information about activities throughout the hospital more widely with our Medical Staff.
Chief's Corner will bring you highlights of activities of interest, which will be authored by our Department Chiefs under my direction. Should you have any comments or suggestions along the way, please share them with us.
- Dr. Stuart Markowitz, Vice President, Chief Medical Officer
Improving the Patient Experience in the Emergency Department
Dr. Jeff Finkelstein, Chief of Emergency Medicine
The Hartford Hospital Emergency Department is stepping up its approach to customer service and trying to enhance the patient experience. There is a renewed focus on streamlining operations and improving flow.
People come to the Emergency Department to be seen by a provider, treated and not wait. We are committed to providing the very best in care and customer service. We are striving to meet our goals of an average length of stay in our Fast Track (Gold Pod) of less than 90 minutes, a “left without being seen rate” of less than 2% and being in the top decile in patient satisfaction.
In addition to improving operations, we are also focusing on professionalism and enhancing communication. The Emergency Department physicians, advanced practitioners, and emergency medicine residents are now required to wear white coats while on duty and hand out personalized business cards so that the patients and families know who is taking care of them.
All ED team members are also being taught AIDET, a framework for emergency staff to interact with patients and their families. It is a simple acronym that represents a very powerful way to communicate with people who are often nervous, anxious and feeling vulnerable.
A: Acknowledge – “Good morning, Ms. Jones. I am sorry about the wait”.
I: Introduce - Introduce yourself politely. Tell them who you are and how you are going to help them. Hand them your business card.
D: Duration - Estimate how long the ED visit is going to take, (under promise and over deliver).
E: Explanation – Describe what you are doing and why. “Is there anything else I can do for you? I have the time.”
T: Thank You – “Thank you for using Hartford HealthCare”.
We hope that by taking a multi-faceted approach to patient satisfaction including improving operations, focusing on flow, enhancing professionalism and standardizing how we communicate, that the ED will reach its goal of being in the top decile in patient satisfaction.
How Much Does Health Care Really Cost? Let's Look At The Price Tags
The health care environment is rapidly evolving and one of the central components is value, the intersection of cost and quality. This is how we will be paid and how we will be assessed and judged relative to our peers and our competitors.
The higher the quality at the lowest cost produces the most value. Much of our energy has and will continue to be focused on quality, but we now need to bring transparency to cost.
Hartford Hospital would like to focus attention on supply costs, so we are beginning a pilot project in the operating room by placing price tags on certain items.
We hope this will create an awareness of the cost of the supplies we use each day and give us pause to assure their use is firmly indicated and that it adds value to the care of that patient in that situation at that point in time.
We will also be publishing prices of some standard items that we use on a daily basis as well as procedures we order or perform in future issues of Seymour Street Journal to create even grater understanding of the cost component of the value equation.
By increasing the value of our services, we position ourselves well for this ever-changing environment.
New Medication Reconciliation Module To Be Implemented in Sunrise Clinical Manager
Dr. Marc Palter, Chief Medical Information Officer, and
Dr. Stuart Markowitz, Vice President, Chief Medical Officer
Patients admitted to a hospital commonly receive new medications or have changes made to their existing medications. Hospital-based clinicians also may not be able to easily access patients’ complete medication lists, or may be unaware of recent medication changes.
As a result, the new medication regimen prescribed at the time of discharge may inadvertently omit needed medications, unnecessarily duplicate existing therapies, or contain incorrect dosages.
Such unintended inconsistencies in medication regimens may occur at any point of transition in care (e.g., transfer from an intensive care unit to a general ward), as well as at hospital admission or discharge. Studies have shown that unintended medication discrepancies occur in nearly one-third of patients at admission, a similar proportion at the time of transfer from one site of care within a hospital, and in 14% of patients at hospital discharge.
reconciliation refers to the process of avoiding such inadvertent inconsistencies across transitions in care by reviewing the patient's complete medication regimen at the time of admission, transfer, and discharge and comparing it with the regimen being considered for the new setting of care. Though most often discussed in the hospital context, medication reconciliation can be equally important in ambulatory care, as many patients receive prescriptions from more than one outpatient provider.
<Source: Cornish PL, Knowles SR, Marchesano R, et al. Unintended medication discrepancies at the time of hospital admission. Arch Intern Med. 2005;165:424-429.
As of July 2011, medication reconciliation has been incorporated into National Patient Safety Goal #3, "Improving the safety of using medications." This National Patient Safety Goal requires that organizations "maintain and communicate accurate medication information" and "compare the medication information the patient brought to the hospital with the medications ordered for the patient by the hospital in order to identify and resolve discrepancies."
Most hospital-based medication reconciliation efforts have relied on pharmacists or information technology–based interventions. A 2012 systematic review of 26 inpatient medication reconciliation studies did find some evidence supporting pharmacist-led medication reconciliation processes, but overall, no conclusions could be reached regarding the most effective or generalizable strategies.
One study utilizing a pharmacist-led medication reconciliation process at discharge did improve clinical outcomes, and other studies have shown reductions in actual and potential medication errors. Information technology solutions do appear to significantly reduce medication discrepancies.
The medication reconciliation process comprises five steps:
- Develop a list of current medications
- Develop a list of medications to be prescribed
- Compare the medications on the two lists
- Make clinical decisions based on the comparison
- Communicate the new list to appropriate caregivers and to the patient.
On July 23, Hartford Hospital will be going live with the orders reconciliation module of Sunrise Clinical Manager in order to support the process of medication reconciliation.
Home medications will be entered into the nursing admission database within 12 hours of admission. Medication Reconciliation is required within 24 hours of admission and again at the time of discharge.
It is also suggested that it be performed during transitions of care such as in and out of the ICU. Special printers are also being installed in the nursing units that will allow the printing of prescriptions when medication reconciliation is done at the time of discharge.
Training has begun and will be available through implementation. If you have any questions please contact Dr. Marc Palter: email@example.com or at 860-970-7205.
Enhancing The Patient Experience
The CXO Report: Public Reporting for Providers is on it's Way...
By "Chief Experience Officer" David Fichandler, Director of Patient Experience
Health care reform legislation passed by Congress required the creation of a Physician Compare web site that was developed in January 2011. Physician Compare includes clinical measures already collected through the Physician Quality Reporting Initiative (PQRI).
The legislation also calls for the collection of patient experience ratings starting in 2012. Beginning in 2014, Physician Compare will also include quality of care ratings for Group Practices. Ratings for individuals will be added in the future. The bill includes a Quality Reporting provision that will tie non-participation to loss of reimbursement.
For more information, please click on the Physician Compare website at: http://www.medicare.gov/physiciancompare/search.html?AspxAutoDetectCookieSupport=1
To see the types of questions asked in the survey, expected responses and national bench marking information, please click here: https://www.cahps.ahrq.gov/clinician_group/cgdata/avtopboxscores.htm
If you have any additional questions or feedback, please contact Dave Fichandler, director, Patient Experience at: firstname.lastname@example.org.
Voices of Our Patients: Kudos To Staff of Bliss 5
I just wanted to express my feelings of gratitude to the nurses, doctors, and staff on Bliss 5.
You all without exception are wonderful caring people who do everything you can to make a patient’s stay as comfortable and successful as possible. This attitude extends to the support staff as well as medical personnel. Everyone takes pride in their work and is fully committed to it.
I would recommend Hartford Hospital to anyone who wants top-flight care. Please be sure the people on Bliss 5 sees this because I can’t thank them individually, so I want to thank them as a group.
Hartford HealthCare has developed a mobile device policy designed to address the information needs of our staff while meeting the challenges of corporate asset management and security.
The policy applies to operation of corporate owned or individual’s personal mobile devices: laptops, notebooks, PDA’s, smart phones, pagers, portable media storage hardware and any other mobile device that is capable of storing or transmitting sensitive information.
• Only HHC authorized mobile devices may be connected to HHC systems and internal networks.
• HHC reserves the right to investigate activity, threat or potential violation of policy on any of its mobile device equipment connected to HHC networks.
• Users should have no expectation of privacy. HHC reserves the right to inspect and monitor all information on mobile device related equipment.
• Incidental personal use of HHC mobile device is permitted providing it does not interfere with worker productivity, preempt any business activity, or violate HHC policy. Prolonged personal use of mobile device including internet streaming and other high-bandwidth activities is not appropriate.
• Mobile devices shall never be used to create, display, store or transmit illegal, inappropriate, derogatory, harassing, or offensive material.
• Users shall lock, logout of, or activate password-protected screen savers to secure unattended mobile devices that have access to HHC applications.
• Only approved text messaging applications should be used by hospital staff for clinical conversations.
New Media Relations Manager Invites Medical Staff To Submit Story Ideas
Tina Varona has joined the Planning and Marketing team as the
media relations manager for
Hartford Hospital. She started here on July 1, after spending 7 years at Saint Francis Hospital and Medical Center in the Marketing Department as media manager.
Her main goal is to generate news coverage with robust, innovative, human-interest and leading-edge technological stories that will keep Hartford Hospital in the spotlight, and further promote our presence as an established market leader.
She offers these tips as to what makes a great health news story:
- Timeliness - Stories with "news value". This includes breaking news on medical innovations, research results or events of the day that capture the public's interest.
- Personality - Stories that feature compelling patients and clinic employees with unique or inspiring stories to share.
- Uniqueness - Stories that may be a bit less timely, but explain a treatment unique to Hartford Hospital.
- Universal Interest - Stories that feature conditions or diseases which affect large numbers of individuals and families all across the country. Always ask, 'why would a person in Fargo, North Dakota care?
- The "Wow" Factor - Stories that are compelling and will make the audience want to repeat the story to family and friends.
- Visual Appeal - Stories with interesting, easy-to-interpret graphics or visuals to explain a complicated process.
- Celebrity - Stories that feature care provided to VIPs.
Varona invites physicians to email her at email@example.com or call her at 860-972-4475 with story ideas that might be publicized.
Make Your Pledge to The Medical Staff Annual Fund
Join your colleagues and make your Annual Campaign gift or pledge by September 30 and continue keeping Hartford Hospital the very best in the region. One hundred percent of your donation goes to programs and services that make a difference for our patients and the community we serve.
Dr. Sharon Diamen is the chair of the Medical Staff Annual Campaign. To date, 155 physicians have contributed nearly $100,000 to the Annual Campaign.
Your gift can be directed to an established department fund or to the Medical Staff Annual Fund, which this year has provided support so far to the Institute of Living (through Behavioral Health Case Management), the Health Assistance Intervention Education Network (HAVEN), the CT Medical Society Medical Malpractice Campaign, Hartford Hospital's Outpatient Transplant Center, and to medical education through a summer pre-med research program.
For more information, please contact Mary Parola in Fund Development at 860-545-2322 or firstname.lastname@example.org. You can also make your gift online at https://giving.harthosp.org/medstaffdonation
New Issue of Clinical Integration Newsletter, Connected Care, Available Here First
In the new July 15 issue of Connected Care, the Clinical Integration newsletter for Hartford HealthCare, Dr. James Cardon,
CEO of Integrated Care Partners and HHC chief integration officer, writes about the new management team that has been put in place to handle ICP's operations.
The new team includes:
- Debra Hayes, vice president and chief operating officer
- Steve Godfrey, vice president of Payer Relations and Contracting
- Tracy King, director of Clinical Integration
- Trudi McKenna, director of Finance and Administration
- Sharon Goulet, executive assistant to Dr. James Cardon
State mandated CME for physician license renewal is available free on the Hartford Hospital Jubilant Learning Platform. You will need your Novell sign on information to access the portal. If you have forgotten your sign on, please call the HELP desk 55699
To access Jubilant from the web, go to the Hartford Hospital page and click on the gold tab “Medical Professionals.” Click on “Learning Portal” from the drop down menu, and then click on the green tab “Learning Portal Login.”
From the home page of the intranet (inside HH), click on the Learning Portal for Medical Education and Training link. Once you’ve clicked on the link, use your Novell sign in, and the CME is under Physician License renewal CME.
Once you have passed the post-test, you will be awarded a printable CME certificate. Your CME will also be maintained and easily self-service accessed on the Learning Portal site, should you need a copy in the future.
Please note that your Risk Management required activities through MRM will provide your Risk Management CME.
Questions? Contact Maryanne Pappas at email@example.com
HH In the News
NBC News, July 9
Country singer Randy Travis remains in critical condition in a Texas hospital after being admitted for complications from a recently acquired viral heart infection. The 54-year-old Travis was hospitalized Sunday in Dallas suffering from viral cardiomyopathy.
Viral cardiomyopathy is an infection of the heart muscle most often caused by the Coxsackie B virus, said Dr. Paul Thompson, chief of cardiology at Hartford Hospital in Hartford, Conn.
Symptoms typically include fever, headache, sore throat and stomach problems, as well as chest and muscle pain. The infection can damage heart cells or cause the heart to go into abnormal rhythms, Thompson said.
Viral cardiomyopathy is often seen in young people, including military recruits who live in close quarters, where they can easily transmit the virus. It is a frequent cause of sudden death during exercise, Thompson said.
Fox CT, July 6
Raffaella Coler, director of emergency medical service education at Hartford Hospital, shows some CPR basics that everyone should know, especially in summer, when the risk of drowning increases as more people hit the beach.
Psychiatric News, July 10
The horrific mass shooting that took the lives of 20 young students and six educators at Sandy Hook Elementary School in Newtown, Conn., December 14, 2012, has produced an extended response from the state’s mental health community.
One unexpected consequence arose well beyond Newtown after the tragedy, said Harold Schwartz, M.D., psychiatrist-in-chief at the Institute of Living and vice president of behavioral health at Hartford Hospital.
“After the shooting, we had a crush of children and adolescents brought into the emergency department by families who feared they could become seriously dangerous,” he told Psychiatric News.
On the legislative front, new mental health legislation enacted so far in Connecticut is a mixed bag, said Schwartz, who is also legislative chair of the CPS. On the positive side, steps were taken to increase access to early treatment for young people, expand training in mental health first aid, and develop school-based mental health programs.
“But I’m disappointed in proposals requiring that all voluntarily hospitalized psychiatric patients be reported to the state and are thus prevented from obtaining gun permits,” said Schwartz. Under existing law, patients involuntarily committed by the courts are added to the registry and the federal gun-purchase database, but those hospitalized under a physician’s emergency certificate are not.
In the HHC System
My Record Journal, July 1
Mental illness and ways to reduce the stigma that surrounds it were discussed at a public forum Monday evening at Rushford Center.
Inside the Paddock Avenue facility, members of the public gathered to listen to four panelists, including U.S. Rep. Elizabeth Esty, D-5th District, and to ask questions of all four. The forum was held in response to the mass shooting at Sandy Hook Elementary School in Newtown last December.
“We have a national challenge,” said Stephen W. Larcen, senior vice president of Hartford HealthCare’s Behavioral Health Network and president of Natchaug Hospital. “We have to engage the community in an active discussion on mental health.”
The Hartford Courant, July 8
Bradley Memorial Hospital is not closing, despite some false reports otherwise, hospital officials told the town council Monday.
Steven D. Hanks, chief medical officer of The Hospital of Central Connecticut, said the Bradley campus is undergoing some changes to clinics and services to address needs of a changing patient demographic, specifically the increase of younger adults in town.
"We'll morph into something new to meet the primary needs of our community of patients," Hanks told the council. "We may close some clinics, make other changes, but we are trying to do this without layoffs. And we have no plans to close."
Bradley merged with New Britain General Hospital in 2006, forming The Hospital of Central Connecticut. Hanks said the unfounded rumors have been so pervasive that a few ambulances were diverted to other hospitals because of worries about service.
Hanks said some of the changes contemplated or already made at Bradley are in response to a national trend where more people are getting medical care from specialty clinics, including chain pharmacies that offer flu shots and other vaccines.
PR Newswire, July 2
EHE International, a nationally recognized leader in preventive medicine and annual physical exams, today announced that the Hartford HealthCare Medical Group - Avon has been named an EHE-certified preventive care center.
Through Hartford HealthCare Medical Group - Avon, EHE members in the Avon region now have greater access to its preventive care program to help them proactively maintain their health.
Hartford Courant, July 2
VNA HealthCare, an affiliate of Hartford HealthCare, was honored June 25 by the MetroHartford Alliance for Careers in Healthcare, a collaboration made up of Capital Workforce Partners and the Connecticut Women's Education and Legal Fund, as an innovator in employee training and support in the advancement of professional careers.
In 2012, VNA HealthCare designed a comprehensive on-the-job year-long development program for recently graduated RNs to become Home Care Professional Caregivers. In addition through MACH funding, ten VNA HealthCare employees graduated from Capital Community College with a Certificate in Gerontology earning each graduate in excess of 27 credit hours of accredited studies.
Health Care News In the Region
News 8, WTNH, July 2
How do you make sure your child doesn't end up in the hospital? The experts say you have to use that parental superpower - SUPERvision.
Connecticut Children's Medical Center is teaming up with the state police, the Red Cross and other organizations to get the word out about staying safe.
"I think we all need to use our supervision and the power that we have with our supervision to keep kids safe," said Faith Vos Winkel of the Office of the Child Advocate. Supervise the kids any time they're around water; pools, rivers, lakes, anything. And if the family goes boating, wear a life jacket.
The Washington Post, July 4
HARTFORD, Conn. — Facing tight deadlines and daunting workloads, states across the country are scaling back ambitions for implementing the Affordable Care Act.
At a monthly board meeting of Connecticut’s health insurance exchange, members of the standing-room-only crowd got a reminder that they, too, were behind schedule. The insurance marketplace they were working on nights and weekends won’t be completely ready on time.
“It is highly complex, it’s unprecedented and it’s not going to be smooth,” Kevin Counihan, chief executive of the state’s exchange, Access Health CT, told the group.
That’s why Connecticut — like other states across the country — has lowered the bar, doing what it can in the time it has left before the health-care law’s major programs are launched Oct. 1.
New London Patch, July 10
L+M Hospital hosted a community cookout Wednesday for the folks in Westerly, to celebrate its takeover of The Westerly Hospital.
William Stanley, vice president of development and community relations, said the hospital out on the barbecue party "for the greater Westerly community to come in and say hello. We had an employee celebration a couple of weeks ago and we decided it was a good idea to have something for the residents to say hello and how do you do."
L+M purchased Westerly for $69 million after Westerly went into receivership, in a deal that was finalized on June 1. Westerly Hospital was an independent hospital for 91 years.
Hot Topics in Health Care
Kaiser Health News, July 8
Long wait times, jammed schedules, confusing insurance plans – there’s no shortage of obstacles between a patient and her doctor. That is, if she has a doctor.
But a Health Affairs study published Monday says the barriers for poor people looking to get care are even higher, and it’s leading them away from preventive doctor visits and toward emergency rooms and costly, hospital-based care.
The study found that common themes driving the group to hospitals included how they perceived their ability to pay for care, location of facilities and availability of treatment based on their schedules.
Kaiser Health News, July 5
Two years ago, Linda Smith was a very different kind of doctor.
She worked in the emergency room at the busy Anchorage hospital, where the goal was to quickly stabilize a patient and move on. But two decades into her career, she started to question how she was caring for patients at the very end of their lives. She remembers putting patients on breathing tubes and hearing family members say things like, "I know Dad didn't want this, but we're just not ready to let him go."
"I started to have a lot of regret about doing things to people that were painful and uncomfortable and were prolonging their suffering," Smith says. She thought, "if I only had the time to sit down with the family, I probably wouldn't be doing these things."
In 2011, Smith enrolled in a one-year palliative care fellowship at Providence. She had a lot to learn. She found out she was a bad listener. And she was abrupt. As an ER doctor, sometimes she was so busy she didn't even sit down to deliver devastating news.
Smith is now a palliative care doctor, a specialty that is growing rapidly in the U.S. The idea is to help patients cope with a terminal or life-altering illness. And unlike hospice care, it is not offered only in the final months of life. Smith works on pain management, coordinating care and even does some counseling.
Kaiser Health News, July 5
These days, interns, as first-year residents fresh out of medical school are known, no longer face the punishing shifts Casoy endured just four years ago. In July 2011, after more than two decades of impassioned debate, the Accreditation Council for Graduate Medical Education (ACGME) reduced the maximum allowable shift for the least experienced doctors from 30 straight hours to 16.
That's the point at which studies have found performance begins to deteriorate, and roughly double the consecutive
hours of flying time allowed pilots. The council, which oversees residencies for 111,000 young doctors, also reaffirmed a controversial 2003 directive limiting the average workweek for all residents to 80 hours -- the equivalent of two full-time jobs.
mandating shorter shifts for interns, a move opposed by more than 70 percent of residency program directors, the ACGME cited studies linking fatigue to serious medical errors and injuries to residents from needle sticks and auto accidents. After their internship year, residents are permitted to work up to 28 hours per shift, on the theory -- disputed by sleep researchers -- that they learn to effectively manage fatigue. Depending on the specialty, residency training lasts an additional two to seven
But as a new class of interns, who arrived July 1, begins treating patients in teaching hospitals around the country, a recent spate of studies questions whether the rules have made the situation worse.
July 15-16 (Monday-Tuesday)
Fundamentals of Laparoscopic Surgery
The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) is offering its FLS (Fundamentals of Laparoscopic Surgery) New Proctor Workshop on July 15-16 at the Center for Education and Simulation in Innovation (CESI) at Hartford Hospital.
SAGES and the American College of Surgeons (ACS) recommend that all surgeons practicing laparoscopic surgery be certified through FLS, the only validated, objective measure of a surgeon’s fundamental knowledge and skills related to laparoscopic surgical procedures.
This workshop will focus on training each participant to properly proctor the FLS exam and become an official FLS Proctor. It is only for staff members from currently designated FLS Test Centers interested in learning to proctor the FLS exam.
More information is available at: http://www.flsprogram.org/testing-information/becoming-an-fls-test-center.
July 16 (Tuesday)
Cardiology Grand Rounds
JB 118, 11 a.m.
Catheter Ablation of Ventricular Tacycardia in 2013: Who, When and How?
Dr. Edmond Cronin, electrophysiologist
July 18 (Thursday)
Emergency Medicine Grand Rounds
Gilman Auditorium, 12 p.m.
Cost and Emergency Care: How to Bring Sanity To Your Use of CT for Pulmonary Embolism
Dr. Jeremiah Schuur, Brigham & Women's Hospital
July 21 (Sunday)
16th Annual Michael Rosano Golf Tournament In Memory of Dr. David Hull
Blue Fox Run, Avon, 11 a.m.
Fee is $150/golfer or $550/foursome, which includes: greens fee, cart, prizes, BBQ lunch, and buffet dinner. Proceeds will benefit LifeChoice Donor Services in memory of Dr. David Hull.
To register, go to http://www.golfdigestplanner.com/22268-Lifechoice/, or call 860-286-3120.
July 24 (Wednesday)
Department of Medicine Grand Rounds - Dr. Eric Coleman to Talk About Safe Patient Handoffs
Heublein Hall, 8 a.m.
Dr. Eric A. Coleman, the nationally recognized director of the Care Transitions Program of the University of Colorado, will provide a special Department of Medicine Grand Rounds on Wednesday, July 24 at 8 a.m. in Heublein Hall. He will discuss what it takes to ensure high quality transitional care, with a goal of improving quality and safety during times of care “handoffs.” Breakfast will be provided.
July 27 (Saturday)
Take Charge of Your Health Series Golf Tournament
Wintonbury Golf Course, Bloomfield, 2 p.m.
It is open to all playing levels with male, female and mixed teams of two golfers per team welcome. Players will play their own golf balls off the tee and into the hole and the lower of two scores will be recorded as the team score.
Fee is $150/golfer $75 for dinner and awards ceremony only. Proceeds will support the Take Charge of Your Health Series of the Omega Foundation and Hartford Hospital.
To register, go to http://www.omegafoundationofhartford.orgor email Greg Jones at firstname.lastname@example.org.
Department of Surgery Awards To Be Presented Sept. 18
The Department of Surgery and Surgical Collaborative Management Team will be hosting their annual awards ceremony on Wednesday, September 18, 2-4 p.m., in Hartford Hospital's Special Dining Room.
The event was rescheduled from May 30, following the death of Dr. Mark Sebastian, director of the Trauma Service, on May 28.
The event recognizes faculty and staff for outstanding professional achievements and activities that improve the quality and safety of patient care. For more information, contact Erika Perricone, ext. 5-4670.
SAVE THE DATE: Oct. 2 (Wednesday)
29th Annual Cardiovascular Symposium
Connecticut Convention Center, 7:30 a.m. - 3:30 p.m.
Jan Basile, MD, Professor of Medicine, Seinsheimer Cardiovascular Health Program,
Medical University of South Carolina
Larry B. Goldstein, MD, Professor of Medicine (Neurology); Director, Duke Stroke Center,
Duke University Medical Center
Martin S. Maron, MD, Assistant Professor of Medicine; Director, Hypertrophic
Cardiomyopathy Center; Tufts Medical Center
Patrick T. O’Gara, MD,
Professor, Harvard Medical School; Executive Medical Director,
Shapiro Cardiovascular Center; Director, Clinical Cardiology,
Brigham & Women’s
Gosta Pettersson, MD, Vice Chairman, Thoracic and Cardiovascular Surgery,
Surgical Director of Lung Transplantation; Cleveland Clinic
Daniel J. Rader, MD, Edward S. Cooper, MD/Norman Roosevelt and Elizabeth Meriwether McLure Professor; Chief, Division of Translational Medicine and
Human Genetics; Associate Director, Institute for Translational Medicine
and Therapeutics; Director, Preventive Cardiovascular Program,
Penn Heart and Vascular Center
William S. Weintraub, MD, Christiana Care; John H. Ammon Chair of Cardiology, Center for
Heart and Vascular Health; Director of the Christiana Care
Center for Outcomes
To register visit www.harthosp.org/CVsymposium
SAVE THE DATE: Oct. 3 (Thursday) and Nov. 5 (Tuesday)
Updates in Urology for the PCP
A two-session education event for primary care physicians on updates in the care of the patient with urologic conditions or kidney disease. Attend one or both sessions- dinner and CME provided. No charge to attend. Location to be determined. Speakers will be urologists and nephrologists from the Tallwood Urology and Kidney Institute.
For more coming events, click here.
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