From the Offices of Jeffrey A. Flaks and Jeffry Nestler, MD
In This Issue...
July 28, 2013 Edition
Wash In - Wash Out
Keep Our Patients Safe - who is NOT going to wash their hands today?
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HH Recognized by U.S. News & World Report As Number One in Metro Hartford
Hartford Hospital has been recognized by U.S. News & World Report again as being the number one hospital in the metro Hartford region, and among the highest-performing hospitals in the nation in nine specialties – the most in our history.
The specialties are cardiology and heart surgery; diabetes and endocrinology; gastroenterology and GI surgery; geriatrics; gynecology; nephrology; orthopedics; pulmonology; and urology.
Our reputation for excellence continues to grow, thanks to the amazing dedication of every single Hartford Hospital staff member to delivering the best possible care in the right, best, safest and most compassionate way.
HH Named One of "Most Wired" Hospitals
Hospitals & Health Networks, (H&HN), the flagship publication of the American Hospital Association, has named Hartford Hospital to its15th annual list of "Most Wired" hospitals.
Hospitals must meet criteria in each of four main areas to achieve this status: infrastructure, business and administrative management, clinical quality and safety, and clinical integration.
CESI Expansion To Begin This Fall; Phase One To Be Completed in December
This fall, thanks to a state grant of $15 million and recent approval by the City of Hartford Planning and Zoning Commission, we will begin expanding our Center for Education, Simulation and Innovation (CESI), further differentiating our hospital as a leader in medical technology, innovation and training.
Our immediate CESI expansion will be the renovation of 6,000 square feet, essentially the second floor, of the Education Resource Center (ERC) with a projected completion date of December 2013. The second expansion phase will be a new 25,000-square-foot, two-story building next to the ERC with a projected opening of January 2015. We also have a third phase planned for some point in the future.
In Fiscal Year 2012, CESI’s staff conducted more than 5,600 hours of training for more than 7,200 care givers. We expect to train more than 11,000 medical personnel this fiscal year – many of them Hartford Hospital and other Hartford HealthCare staff members.
Medical providers have traveled from around the world, including from Europe, Asia and South America, to train at CESI as have members of the Army National Guard and U.S. Navy. CESI also offers virtual training locally, regionally, nationally and globally through advanced information technology systems that our expansion will improve.
Goodbye GroupWise! Hello Outlook!
E-mail Blackout Aug. 2-5; Please Make Alternate Arrangements for Communication
Hartford HealthCare is moving from GroupWise to Microsoft Outlook for e-mail next weekend ( Aug. 3-4) . This transition is part of HHC Unity and is a vital step in Hartford HealthCare’s growth as an integrated health care delivery system. It will enable us to communicate, collaborate and schedule across our member organizations so we can provide the coordinated care that our patients and communities depend on.
NOTE: NO e-mail will be available from 5 p.m. Friday, Aug. 2 to 5 a.m. Monday Aug. 5. Arrange for alternative means of communication during the transition weekend such as sharing phone numbers or creating phone trees.
At the time of the switch, every Hartford Hospital e-mail address will change. Hartford Hospital addresses (such as jdoe @harthosp.org) will be replaced with this format: firstname.lastname@example.org. The new addresses will be effective Monday, Aug. 5.
It is a good idea to begin preparing for this change by notifying associates outside of HHC of your new email address. E-mails sent to your current address will continue to be delivered for six months.
Here is some important information to help you get ready:
- Print your GroupWise calendar before 5 p.m. on Aug. 2 to keep track of your schedule over the weekend
- Everything in your GroupWise mailbox will be moved to Microsoft Outlook.
- Organize your GroupWise mailbox now by deleting unnecessary messages and filing important ones in folders that will be easy to find in Outlook
- Move contacts you wish to keep into your GroupWise personal address book. Frequent contacts will not move from GroupWise to Outlook
- Delete duplicate contacts
- To be safe, stop scheduling recurring appointments and end any recurrences by the end of July. Recurring appointments will be moved to your new Microsoft Outlook calendar. However, changes made to an appointment series in GroupWise now may not transfer to Outlook
- Rules (such as vacation and auto-forward) will not move to Outlook so be prepared to create new rules in the Outlook system.
- Mobile devices will have to be re-configured and will be required to have PIN/password to connect to e-mail. Do-it-yourself instructions are available online for I-phones. For Blackberry users, technicians will be available at kiosks from 8 a.m. to 6 p.m. on Monday, Aug. 5 and Tuesday, Aug. 6. Please be prepared to leave your Blackberry for at least two hours and bring all cords and your Novell Password when you drop off your device.
For online tutorials and complete transition instructions, please visit our website A New Outlook and use your desktop user name and password to log in. If you have specific questions please email them to email@example.com and you will receive a reply within 72 work-week hours. Questions and answers will be posted to the website.
Dr. Carolyn Hoban Named Vice President of Research
Carolyn J. Hoban, Doctor of Science (D. Sc.), has been named vice president of research at Hartford Hospital, and will join us Sept. 16.
Dr. Hoban has more than 20 years experience developing research strategies and translating research into patient treatments. She will report to Dr. Lenworth Jacobs, vice president of Academic Affairs and chief academic officer.
Dr. Hoban currently serves as director of translational research at the Multiple Myeloma Research Foundation in Norwalk, Conn. She previously served at the University of Michigan Medical School at Ann Arbor as research assistant professor in Internal Medicine, Oncology and as executive officer of the National Cancer Institute Cooperative Oncology Group.
She has a bachelor of science degree in biology and classics and a certificate in community health from Tufts University, and earned her Doctor of Science at the Harvard School of Public Health. She also completed a National Institutes of Health Genetics Fellowship in cancer biology at the Massachusetts Institute of Technology’s Center for Cancer Research and completed the eMBA program at the Universityof Michigan Ross School of Business.
Dr. Hoban’s business knowledge and extensive experience in fundraising, competitive grant applications and building collaborative relationships will be important in CESI’s expansion and further development as a world-renown training and research center.
Her experience building collaborations with pharma and biotech companies and government agencies will prove extremely valuable in developing more partnerships.
State Okays Affiliation of HHC With Backus
The state Office of Health Care access has approved the certificate of need for the affiliation of Hartford HealthCare (HHC) and Backus Corporation. This means that Backus will become a member of the HHC system of care.
With this affiliation, HHC will create an Eastern Region consisting of HHC members in New London and Windham counties, including Windham Hospital. Windham and Backus will work together to provide greater access to care for Eastern Connecticut communities.
Backus President and CEO David Whitehead also will serve as CEO of the region. Stephen Larcen, currently CEO of Windham and Natchaug hospitals, will continue in his Natchaug role and also serve as senior vice president of the HHC Behavioral Health Network, overseeing the system’s behavioral health and substance-abuse programs at The Institute of Living, Natchaug and Rushford and coordinating the behavioral health programs at HHC’s acute-care hospitals.
Backus Health System, with approximately 2,000 employees, includes The William W. Backus Hospital, a 213-bed acute care hospital that is the only state-licensed trauma center east of the Connecticut River; a home health care agency; an outpatient care center in Norwich with an array of services; health centers in Colchester, Ledyard, Montville, North Stonington and Norwich; a satellite 24-hour emergency department in Plainfield; Backus Physician Services, which is a multi-specialty surgical group; and
Community Medical Partners, a medical foundation. Backus also is one of two sole members of the Center for Hospice Care and has an ownership interest in dialysis centers in the region.
We look forward to a strong partnership serving Connecticut’s communities and working together toward achievement of the HHC vision.
Medical Board Welcomes New Chair: Kathryn Emmett, Esq.
The Medical Board of the State of Connecticut, the arm of the Department of Public Health responsible for oversight of physician and physician assistant licensure and activities, has welcomed a new chairperson. Governor Dannel Malloy has appointed Kathryn Emmett, Esq., a prominent lawyer from the Stamford area, as chairperson. The web site for her firm is: http://www.emmettandglander.com/attorneys.htm
The Medical Board has recently been restructured to include more lay people. The Board is responsible for oversight of physicians and physician assistants in the State of Connecticut and in imposing disciplinary action when necessary.
Here is a link to the Medical Board of the State of Connecticut.This web page also provides information on mandatory CME, recent changes in statutes and regulations impacting physicians, board members and rules of practice.
Drs. Andy Salner, Henry Jacobs and Michael Lindberg from HH currently sit on the board.
Chef to Farm Dinner Enjoyed By 100 Members of Medical Staff
More than 100 guests attended the Second Annual Medical Staff Chef to Farm Dinner that was held on July 12 at Rosedale Farms & Vineyards in Simsbury. Guests had the opportunity to enjoy an array of local fresh foods prepared by Chef Scott Miller of Max's Oyster Bar.
The evening successfully fulfilled Dr. Stacy Nerenstone's vision of providing a venue for members of the Medical Staff to socialize and enjoy each other’s company.
The evening began with a wine tasting reception, tours of the farms and concluded in a tented area where tables dressed in white linen and candlelight offer a view of the al fresco kitchen. Each dinner was cooked from scratch and showcased that day's best produce.
Dr. Courtland Lewis Addresses Young Leaders Board
Dr. Courtland Lewis, physician-in chief of the Musculoskeletal Institute and chief of orthopedics, was the featured speaker at Hartford Hospital’s Young Leaders Advisory Council Executive Committee (YLAC) meeting on July 17.
Dr. Lewis spoke on how the institute will transform musculoskeletal care. This presentation helped equip the group with knowledge as they disseminate information throughout their networks, as well as select beneficiaries of upcoming YLAC events around the Hartford area.
Innovative and Complex Care
Dr. Jeffrey Sawyer Offers Outpatient Balloon Sinuplasty
Dr. Jeffrey Sawyer, an ear, nose and throat specialist on the Hartford Hospital staff, has opened an office in Windsor specializing in sinus disorders.
Dr. Sawyer offers a treatment called "balloon sinuplasty," which is an endoscopic office procedure for patients diagnosed with recurring sinusitis. The procedure used to require general anesthesia and admission to a hospital. Now, it’s performed in the outpatient office setting and with topical anesthesia. The patient goes home after the procedure, which minimizes risks and reduces recovery time.
Research and Academics
HH CME: Best Practices in the Evaluation and Treatment of Agitation
Dr. David Pepper, director of Emergency Psychiatric Services, will present a continuing medical education program called "Best Practices in the Evaluation and Treatment of Agitation" on Wednesday, September 4 at 12 noon in Gilman Auditorium.
Max 1 AMA PRA Category 1 credit . The program will satisfy the new DPH behavioral health physician licensure requirement. It is sponsored by Academic Affairs. It will be recorded for Jubilant.
Everyday Health, July 17
Endurance exercise and frequent exercise are dangerous for people with an inherited heart rhythm condition known as ARVD/C, found a study published today in the Journal of the American College of Cardiology. When people with this type of arrhythmia compete in sports, they have a five-fold increased risk of sudden death, according to researchers.
According to cardiologist Paul D. Thompson, MD, Chief of Cardiology at Hartford Hospital,
screening for the arrhythmia gene mutation in clinical practice is not usually done. “I don’t think anyone gets the screening routinely,” Dr. Thompson said. “If a person had a lot of arrhythmias and we had a suspicion, we might screen, but screening is not that common.”
“The problem with genetic screening is you often find variants of uncertain significance, and you don’t know what those things mean," Thompson added.
How much exercise is too much for those in the general population or for athletes who don't have documented arrhythmia risks is something that “we don’t know the answer to,” said Thompson.
“There have been reports of increased atrial fibrillation in athletes,” he added. Not everyone who trains for endurance sports develops heart arrhythmia. “Atrial fibrillation varies with inheritance, how much exercise they are doing, and how many years they have been doing it," he said, adding that, “In endurance sports and in older athletes, the risk of atrial fibrillation increases.”
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
Hand Hygiene Update
Note: Hand hygiene observations by role - to mid-month July: APRNs, medical students, rad techs, social workers and student nurses were at 100% compliance. Physicians were at 65%.
We know that each year in hospitals across the United States, nearly two million patients acquire infections, many of which can be life threatening. Hand hygiene is one of the most important ways to prevent the spread
of infection and one of the simplest steps for all of us to take.
Because of its importance, we set an aggressive goal of 90% compliance across Hartford HealthCare system and have put reliable measures in place. While our overall compliance at Hartford has improved, we have a very long way to go.
The report for June showed overall compliance at 65% with washing going into rooms at 54% and coming out at 74%. In June, our medical students and APRNs were our highest performers at 100%, while our physicians performed at 66%. It appears we may be able to learn a lot from our medical students and advanced practitioners to achieve a performance we can be proud of.
Creating a safe environment for our patients requires we all take ownership for success in hand washing and continue to set the standard for the entire institution. We have the opportunity every day to role model for all those around us, and to demonstrate our values of safety and caring.
Please make this behavior part of what you do each and every day at every opportunity. Teach and mentor those you interact with, and be receptive to feedback from every member of our health care team. We all want to do what is best for our patients, and hand washing is a simple way to improve the health and welfare of those that entrust us to care for them at their most vulnerable times.
Thank you for making this important in your daily activities.
Enhancing The Patient Experience
ER and Hospitalists Get Compliments From Patients
Franca Biancamano, patient concierge in the Hospitalist Division, passed along these compliments from patients discharged July 10-16:
- I liked Dr. Kiran Dintyala. Give my regards to him. The nurses and PCAs were wonderful.
- Fabulous! Very nice aides. Nurses were great! They were good conversationalists and very nice people. I was very impressed with their care. Food has also improved! My regards to Dr. Zhenghao Zhang.
- Dr. Rachana Kanaujia was a sweetheart. She was just great.
- I completely enjoyed Dr. Patel. He was so invested and interested in my care. He came to see me so many times. I really so much appreciated him. I could not believe the amount of care that I was offered. People just couldn’t do enough. I felt unworthy.
- Dr. Venkata Kotais so sweet. She is very soft spoken, soothing, and lovely to talk to. She impressed me.
- Dr. Joao Delgado in ER was outstanding. There were a couple of outstanding nurses (Brittany, Emily Mario) and PCAs (Maria, Blanca).
- The ER was awesome. Fast, prompt. Everyone was kind, cheerful and compassionate.
Voices of Our Patients: Kudos To Drs. Castiglione, Bloom, and Miller
I don't even know if I can describe in words or thank the numerous staff of Hartford Hospital enough for the wonderful care that I received when I had my surgery on December 5th.
First I would like to say that I live in New Haven County and would have preferred not to have had my surgery far away from home. I am so glad that I did, because I was taken care of by the best of the best and HH values were always demonstrated. I am an employee at Hartford Hospital and see this on a daily basis, now I was able to see it in the perspective of a patient.
I would like to thank my wonderful doctors, Dr. Charles Castiglione and Dr. Peter Bloom; the great O.R. staff, Michael Gilgenbach, Zaley Lumpkin, Patricia Clark; Anesthesia, Charlene Ferris and
Dr. Keith Miller as well as Cheryl Ficara, Carla Sullivan, Gwen Richardson, Andrea Hagstrom, Pre-Op Nurse Nancy and PACU Nurse Mary.
I know that you may be thinking that I received such great care because I work here, but that is not the case at all. I stayed overnight on North 8 where the staff had no idea who I was and I received the same demonstration of great care.
The PCAs that took care of me and checked on me all the time were Stephanie Malpica, Kristen Steiner, Chassiday Moody and Linda Kingsbury. The wonderful and caring nurses that attended to my every need were Kara Scanlon, Karen Flynn, and Linda Kaelin. Many thanks to North 8.
I would also like to thank my caring staff (CSS) for all of the flowers, thoughts and prayers. I am so honored and proud to work for such a great institution, where the core values of Caring, Safety, Excellence and Integrity are demonstrated on a daily basis.
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
Newly Updated DPH Physician Licensure Requirements; Added Behavioral Health Requirement
Licensed physician/surgeons are required to participate in continuing medical education (CME) activities pursuant to Connecticut General Statutes. Please note the following:
Number of Hours
A licensed physician shall earn a minimum of fifty contact hours of qualifying continuing medical education every two years commencing on the first date of license renewal on and after October 1, 2007. One contact hour means a minimum of fifty minutes of continuing education activity.
Continuing medical education shall be in an area of the physician’s practice, reflect the professional needs of the licensee in order to meet the health care needs of the public and during the first renewal period in which continuing medical education is required and not less than once every six years thereafter, include at least one contact hour of training or education in each of the following topics:
(A) Infectious diseases, including, but not limited to, acquired immune deficiency syndrome and human immunodeficiency virus
(B) risk management
(C) sexual assault
(D) domestic violence
(E) cultural competency
(F) behavioral health (NEW)
continuing medical education activities include, but are not limited to, courses offered or approved by the American Medical Association (AMA), American Osteopathic Association (AOA),Connecticut Hospital Association (CHA), Connecticut State Medical Society (CSMS), county medical societies (CMSs) or equivalent organizations in other jurisdictions, educational offerings sponsored by a hospital or other health care institution or courses offered by a regionally accredited academic institution or a state or
local health department.
Clinical Councils Developed in 11 Areas
Clinical Councils promote excellence in clinical care, foster professional development to identify best practices in that specialty and to achieve the highest level of excellence.
At Hartford Hospital, councils have been developed in:
- Hospital Medicine
- Emergency Medicine
- Pharmacy and Therapeutics
- Patient Experience
- Infection Prevention
The councils will identify potential gaps, variations in practice, and integrate common practices and standardization for optimal outcomes. Councils are expected to be long term groups which drive process improvement and standardization within clinical disciplines – they are not management structures but serve to coordinate activities across HHC.
Each council will develop a charter to identify measures of success, membership from HHC, customers and their expectations, initiatives for first year, and short and long term targets.
New Issue of Clinical Integration Newsletter, Connected Care, Available Here First
In the new July 29 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 payment for value and improving the quality of care
"As committed providers, we want to deliver excellent clinical care and a unique and rewarding experience to our patients," wrote Dr. Cardon. "To do this, physicians and hospitals must be financially secure. owning and managing a private practice carries with it responsibilities and obligations that create increasing financial pressure. The way we're paid must align our clinical and financial goals for everyone's benefit."
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
Hartford Courant, July 12
Ken Trump, the most important changes that Connecticut schools should make after the Sandy Hook school shootings aren't bulletproof backpacks and chalkboards or teachers carrying weapons. Instead, the Cleveland-based security consultant told the governor's Sandy Hook Advisory Commission on Friday that schools should focus on changes that cost less and are easier to implement — like more security cameras — while also adding staff who can help troubled students, such as school resource
officers and mental health professionals.
Commission member Harold Schwartz, the psychiatrist-in-chief at Hartford Hospital's Institute of Living, for example, said that schools have to have enough resources to actually treat students who are identified as a possible safety risk by staff such as the resource officers, instead of simply labeling them.
"Those descriptors become prophesies," said Schwartz. "It's all well and good to diagnose, but there has to be follow-through."
Hartford Courant, July 14
According to a study published this year in the New England Journal of Medicine,
total health care costs for Alzheimer's disease in the U.S. were as high as $215 billion in 2010 — higher than the costs associated with either cancer or heart disease. The researchers, from the RAND Corp., predict that the costs associated with Alzheimer's will more than double in 30 years. Most of the costs cited by RAND don't go toward medical services; 75 percent to 84 percent of the money is spent on long-term care, whether in the patient's home or in an institution. Before long, better tests
and more sophisticated technology are expected to make earlier detection more common.
“That [diagnosis] will start shifting earlier and earlier with all the excellent information coming and with baby boomers who will want to know earlier,” said Dr. Karen Blank, who practices geriatric psychiatry at Hartford Hospital. Memory
lapses that were once brushed off as “senior moments,” Blank said, now lead many middle-aged people to see their doctor.
Hartford Courant, July 15
When Ed Richardson speaks of "Connecticut champions," he doesn't mean the UConn Huskies. He's talking about Fagus sylvatica – the colossal European beech in Pomfret that is 27 feet in circumference and towers 100 feet in the air.
Richardson's favorite tree is the majestic bur oak on the grounds of the Institute of Living in Hartford. It was planted by the great landscape designer, Hartford-born Frederick Law Olmsted, in 1862, one year into the Civil War. At the Institute is also seen one of the state's largest ginkgo trees, a primitive species native to eastern China and known for is pretty fan-shaped leaves.
WTNH, July 16
If you're not careful in this oppressive heat, you could end up at the hospital. Emergency departments are filling up with patients dealing with heat-related health problems.
"A lot of people will get exposed to heat. They may not even have heat exhaustion but if they have diabetes, it will make their diabetes worse. If they have chronic lung disease, the air will be bad, they will get worse," said Dr. A.J. Smally, Hartford Hospital.
Dr. Smally is the Medical Director of the Emergency Department. With the weather conditions expected to linger throughout the week, he expects to see an increase in the number of people coming in with heat related conditions.
West Hartford Patch, July 17
Yale-New Haven Hospital is Connecticut’s best-performing hospital according to the annual list released this week by U.S. News & World Report, which analyzed hospitals across the nation.
Hartford Hospital and Saint Francis Hospital and Medical Center took second and third place, respectively in Connecticut, with St. Vincent’s Medical Center in Bridgeport ranked #4 in the state, followed by Middlesex Hospital at #5, Norwalk Hospital ranked sixth, Danbury Hospital and Waterbury Hospital, tied at #7, Bridgeport Hospital and Lawrence and Memorial Hospital tied at #9, and Stamford Hospital ranked eleventh.
Hartford Hospital, ranked #1 in Greater Hartford, “performed nearly at the level of nationally ranked U.S. News Best Hospitals” in 9 adult specialties, U.S. News reported. The hospital had 36,841 admissions in the latest year for which data are available. It performed 11,828 annual inpatient and 20,955 outpatient surgeries and had 95,567 emergency room visits.
At #3 statewide, Saint Francis “performed nearly at the level of nationally ranked U.S. News Best Hospitals” in 8 adult specialties. The hospital had 29,113 admissions, performed 9,178 annual inpatient and 10,482 outpatient surgeries and its emergency room had 71,446 visits.
Hartford Courant, July 18
A Yale study published Thursday states that a backlash against estrogen therapy has led to thousands of unnecessary deaths of women, specifically women who had hysterectomies. The study, published in the American Journal of Public Health, suggests that concerns about estrogen have scared away many women who would benefit from the hormone.
Dr. Peter Beller, in the obstetrics and gynecology department at Hartford Hospital, said the benefits of estrogen aren't news to him and his colleagues, but it's been an uphill battle convincing his patients.
"I work at Hartford Hospital, and I think every gynecologist who works here knows that this is true," Beller said. "But to try to get patients to take it is pretty hard to do because they hear the word 'estrogen' and they're scared of it."
Beller said the risks are increased for those who have not had hysterectomies, but forgoing hormone therapy altogether also carries risks, he said, adding that's it's a "double-edged sword." Depending on the patient's overall health and other factors, he still might recommend estrogen plus progestin for them. But not for longer than five years — that's when the increased risks tend to kick in, he said.
Hartford Courant, July 23
than a year after the state's medical marijuana laws took effect, doctors have certified more than 700 people to use marijuana. Of the certifications, 212 were issued to people with post-traumatic stress disorder, the most of any of the medical conditions that qualify for marijuana certifications under state law. The medical condition with the second-highest number of certifications is spinal cord damage, with 192. Other conditions include multiple sclerosis, cancer, HIV/AIDS and Parkinson's disease.
The report also states that 91 physicians have registered with the state Department of Consumer Protection to issue certifications for medical marijuana use. One of them is Dr. Andrew Salner, chief of the department of radiation oncology at Hartford Hospital.
Salner said he has issued certificates to two of his patients, both of whom have pain and other complications from cancer. He said he is in talks with five other patients about marijuana.
"I've been pretty stringent, at the outset of the program, about wanting to really make sure [patients] fit the criteria of the program," he said. Both patients have used marijuana on their own, he said, and have found that it can replace some of their regular medicines.
"They have a sense of relief that once the program is up and running that they can get it legally and from a safe source without additives or pesticides."
As for other doctors, he said, "I think they're in a wait-and-see mode to see how well the program will work, and to make sure they're not susceptible to federal action," he said.
All Things Considered, NPR, July 24
Homer Bell was 54 years old when he killed himself in April in a very public way — he laid down his head in front of a stopped bus in his hometown of Hartford, Conn. It was the last act in a life filled with struggle, as Bell and his family endured his schizophrenia.
At a time when there are calls to strengthen the mental health system, Bell's story shows how hard coping with mental illness can be.
Harold Schwartz, the psychiatrist in chief for Hartford Hospital's Institute of Living, describes some of the difficulties for a family: It's hard to get help, provide a home, and give the right kind of support. Bell's struggle to deal with the frightening voices in his head led to outbursts of anger, and even some run-ins with the police.
Psychiatrist Schwartz has been a part of the conversation about Connecticut's mental health system that has gained new urgency since the school shootings in Newtown. He says a lot of attention is now being paid to identifying young people with emotional struggles who need help, but when it comes to helping people like Bell — the homeless, chronically mentally ill adult living in the community — he sees less movement.
And in some cases wisdom, patience and compassion aren't enough. He says sometimes suicidal intent is a terminal disease.
OUR STAFF ON THE AIR:
NBC Connecticut, July 22
Dr. Amy Johnson, Ob-Gyn, discusses the impending birth of the royal baby on NBC Connecticut.
NBC Connecticut, July 24
Dr. Laura Saunders discusses the psychology surrounding the Anthony Weiner case on NBC Connecticut.
NBC Connecticut, July 17
Lisa Enslow, nurse educator, interviewed by NBC Connecticut on DVT and pregnancy and the use of compression boots for all patients at Hartford Hospital who may be at risk of developing DVT.
WNPR, July 22
Dr. Inam Kureshi, chair of the Department of Neurosurgery, appears on WNPR's "Where We Live" discussing the case of H.M., who lost his ability to form, store and access new memories after a disastrous brain surgery at Hartford Hospital in 1953.
WNPR, July 23
Drs. Michael Drescher, associate chief of the Division of Emergency Medicine, and Reza Mansoor, cardiologist, on WNPR's "The Colin McEnroe Show" discussing fasting and the physical impacts on the body.
In the HHC System
WTNH, July 15
Dr. Peter Leff, a surgeon with MidState Medical Center, was in the studio to discuss a very common affliction, hernias. Be sure to watch the video for all the details.
The Hartford Courant, July 17
An all-day emergency preparedness drill will be held at the Hospital of Central Connecticut Thursday. New Britain emergency responders will conduct an emergency preparedness exercise at the hospital's New Britain General campus involving a mock active shooter.
The drill is a coordinated effort among the hospital and New Britain Police, Fire, EMS and Public Safety Communications departments. The exercise will occur on a former patient care unit.
The exercise will involve hospital staff, including the hospital's Emergency Operations Center; police recruits; and current officers in the city's Police, Fire, EMS departments. New Britain Police Chief Jim Wardwell said the exercise presents "a perfect opportunity to put what we learn in theory to test," adding the department regularly trains for potential crises.
The Hospital of Central Connecticut HOCC regularly conducts exercises as part of its emergency preparedness efforts. Thursday's hospital exercise efforts is funded with a grant from the state department of public health. The exercise will not affect patient care services or visits with patients.
WTNH, July 18
This hot weather has been keeping paramedics busy dealing with people who are overwhelmed by the heat.
With the scorching heat, doctors are seeing a spike in heat related ER visits.
"Any time we have humidity like we've seen over the past week, we know we are going to see an increase in people coming in complaining about shortness of breath," said Dr. Alan Weiner, Assistant Director Emergency Department, Midstate Medical Center.
"I think people who have chronic disease they know well enough to stay inside and air-conditioning. It's younger people have to work and have to be outside, they are the ones who are dealing with a heat exhaustion and are brought to the emergency room," said Weiner.
WFSB, July 18
Patients with the potential of having Parkinson's Disease, can now have a test at Midstate Medical Center in Meriden, which is designed to confirm or dismiss a Parkinson's diagnosis.
"Patients with Parkinson's Disease have reduced supplies of dopamine within the brain, and that leads to the symptoms of poor mobility, tremors," said Dr. Holley Dey at Midstate Medical Center.
A new test called the DATscan has a patient injected with a tiny bit of radiation. Then their brain is scanned, where it takes images of the brain's function.
The Hartford Courant, July 21
Hartford HealthCare's next Walk with a Doc will be held at 9 a.m. Saturday, July 27 at YMCA Camp Sloper Outdoor Center, Southington.
It will include a 30-minute walk and health tips from Inku Lee, M.D., cardiologist, who will address the topic "You Have Heart Disease: Now What?"
Hartford Business Journal, July 22
When the half-million or so 911 calls are placed each year by Connecticut residents, just who shows up to provide life-saving support depends on location. Some cities, like Hartford, outsource ambulance transport services to private companies. In Wallingford, emergency medical transport services are provided in-house by paramedics employed by the town.
In Hartford, ambulance services are outsourced to two private companies: American Medical Response (AMR), which is the largest commercial player in the state, and Aetna Ambulance Service Inc.
Wayne Wright, who is the president and CEO of Hartford's Aetna Ambulance Service Inc. and Ambulance Service of Manchester, said all ambulance providers are facing financial challenges as a result of declining Medicare reimbursement rates, which are down about 8.6 percent from a few years ago. Still, that hasn't stopped his two ambulance companies, which are jointly owned by Hartford HealthCare and Eastern Connecticut Health Network, from
experiencing 3 to 6 percent growth in recent years.
Combined, the two companies have a fleet of 48 ambulances and 228 employees, who respond to about 70,000 calls a year. They provide transport services to many Greater Hartford cities and towns including Hartford.
The Hartford Courant, July 21
A traditional topping off ceremony at the construction site of The Hospital of Central Connecticut's new $40 million cancer center was held July 10, marking placement of the last piece of steel into the center's top.
The construction milestone was highlighted with remembrance of HOCC employee Pat Hamel, who died in May. As the steel beam was turned for placement in front of attendees, who included Hamel's family, politicians and hospital staff members, they saw a posted inscription saying, "In memory of our friend and colleague, Pat Hamel, July10, 2013."
Hamel was an HOCC construction coordinator and instrumental in finalizing the cancer center's design. He had previously been director of Plant Operations and Maintenance at HOCC for more than 30 years.
The nearly 70,000-square-foot state-of-the-art cancer center is being built on over nine acres on the New Britain/Plainville line. TBI Construction, LLC is building the cancer center. The Hospital of Central Connecticut's new $40 million state-of-the-art cancer center will consolidate outpatient services in one convenient location and allow for future expansion of cancer care.
The CT Mirror, July 24
State regulators have approved plans for Backus Hospital to affiliate with Hartford HealthCare, bringing the small Norwich hospital into a growing chain of health care facilities that cover a wide swath of the state.
The move makes Backus the fifth hospital in Hartford’s network. Hartford HealthCare is also the parent company of Hartford and Windham Hospitals, The Hospital of Central Connecticut, and MidState Medical Center in Meriden. It also includes physician practices in the Hartford Medical Group and several behavioral health facilities.
Hartford HealthCare also announced plans to establish an “East Region” that covers members of its system in New London and Windham counties, including Backus and Windham hospitals. The region will have its own CEO, Dave Whitehead, who is currently the president and CEO of Backus.
Windham Hospital’s CEO Stephen W. Larcen will become senior vice president of Hartford HealthCare’s behavioral health network. He currently servces as president and CEO of Natchaug Hospital, and will maintain that role, in addition to overseeing the rest of the system’s behavioral health and substance abuse programs, including The Institute of Living and Rushford.
Health Care News In the Region
The Hartford Courant, July 18
Even though a recent decision by Gov. Dannel P. Malloy has blocked Vanguard Health Systems' purchase plan, Bristol Hospital remains on sound footing and will continue as an independent operation, hospital President Kurt Barwis told several legislators Thursday morning.
But like many of its small- and mid-sized counterparts across the country, Bristol Hospital can't raise enough money on its own to finance the building improvements, equipment acquisitions and physician recruitment that are necessary these days, Barwis said.
Bristol leaders expected Tennessee-based Vanguard would have invested tens of millions of dollars in Bristol Hospital had the purchase gone through, but Malloy last week vetoed a bill that would have made it possible.
The state has strict restrictions on the complex system that hospitals use to recruit and pay physicians within their region, and those rules are especially difficult for for-profit businesses to follow, according to Barwis and lobbyists for the hospital. Malloy has said that before easing those restrictions, Connecticut should examine possible ramifications if a wave of private businesses began buying up its community hospitals.
Republican-American, July 22
As expected, the legislature has let stand a veto of legislation considered crucial to the proposed joint venture between Waterbury Hospital and Vanguard Health Systems Inc.
The Democratic-led House and Senate passed Monday morning on an opportunity to override Gov. Dannel P. Malloy's veto of the bill.
The vetoed bill proposed an exception to state law that would permit the proposed joint venture between Vanguard and Waterbury Hospital to hire physicians.
The bill passed each chamber with more than the required votes to override a veto.
The legislature's Democratic leaders did not call any override votes in the constitutionally-required veto session today. Malloy had vetoed seven other bills.
Hot Topics in Health Care
The New York Times, July 18
I’ve always thought about respect as common decency, something we should do because it’s simply the right thing to do. In the medical world, we certainly need to strive for respectful behavior, especially given our historically rigid pecking order, our ingrained traditions of hierarchical bullying and, of course, a primary constituency — patients — who are often on uniquely vulnerable footing.
But then I stumbled across two articles in Academic Medicine that talked about respect as an issue of patient safety. The authors, a group of doctors and researchers at Harvard Medical School, outlined the myriad acts of disrespect that we’ve come to accept as a way of life in medicine, and showed how these can lead to a final pathway of harm to our patients.
Los Angeles Times, July 20
For years, the check-in process in the urgent care center of this city's large, downtown hospital was reminiscent of a visit to the DMV. The ailing and sick walked in, pulled a number, took a seat and waited to be called. Many grew impatient and exasperated.
Now, patients at San Francisco General Hospital are greeted by a smiling face and a helping hand to guide them along the path to getting care. It's one of a series of customer-friendly touches being added at the 156-year-old institution by a newly named “chief patient experience officer.”
Under the national healthcare overhaul, patient experiences matter. Federal payments are being tied to surveys that gauge patient attitudes about such things as a hospital's noise and cleanliness, communication and pain management.
If patients are happy, hospitals get more money. If they aren't, hospitals get less. That's prodding hospital executives to make changes to improve the patient experience. Televisions are being upgraded, cafeteria fare improved and patient call signals answered more promptly, officials say.
Kaiser Health News/Washington Post, July 22
Medicare is accelerating plans to peg a portion of doctors’ pay to the quality of their care.
The changes would affect nearly 500,000 physicians working in groups. The federal health law requires large physician groups to start getting bonuses or penalties based on their performance by 2015, with all doctors who take Medicare patients phased into the program by 2017.
The program is a major component of Medicare's effort to shift medicine away from its current payment system, in which doctors are most often paid for each service regardless of their performance. The current system, researchers say, financially encourages doctors to do more procedures and is one of the reasons health costs have escalated. The health law required Medicare to gradually factor in quality into payments for hospitals, nursing homes, physicians and most medical providers.
July 30 (Tuesday)
Cardiology Grand Rounds
JB 118, 11 a.m.
Update on TAVR
Dr. Raymond McKay, director of Interventional Cardiology Research at Hartford Hospital
August 9 (Friday)
Summer Pre-Med and Research Student Poster Presentation
ERC Formal Lounge, 9 a.m.
Poster presentations of the research projects that were completed by the 17 summer research students.
September 4 (Friday)
"Best Practices in the Evaluation and Treatment of Agitation"
Gilman Auditorium, 12 p.m.
Dr. David Pepper, director of Emergency Psychiatric Services, will present a continuing medical education program called "Best Practices in the Evaluation and Treatment of Agitation" on Wednesday, September 4 at 12 noon in Gilman Auditorium.
Max 1 AMA PRA Category 1 credit . The program will satisfy the new DPH behavioral health physician licensure requirement. It is sponsored by Academic Affairs. It will be recorded for Jubilant.
September 18 (Wednesday)
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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