From the Offices of Stuart Markowitz, MD and Jeffry Nestler, MD

In This Issue...

November 3, 2013 Edition

HAND HYGIENE
Wash In - Wash Out

Wash

 

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HH Facts and Firsts:

2001 - Hartford Hospital was the first hospital in the state to enter into a collaborative arrangement with Dana Farber/Partners CancerCare of Boston to enhance services for cancer patients in Connecticut.


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Top News

Leadership Update From President Markowitz

Late September Elliot Joseph announced a broad reorganization of the Hartford HealthCare leadership structure. The purpose was to create an organizational structure that could be more responsive to the changing needs of our patients, payers and communities. At Hartford Hospital this meant that Jeff Flaks assumed the position of chief operating officer of Hartford HealthCare and I assumed the position of president of the Hartford region and Hartford Hospital.

Jeff has assumed the task of overseeing operations across the established three regions (Hartford, Central and East) and will be responsible for systemwide service lines such as cancer. This structure will move to consolidate resources and decision-making to allow for speed and flexibility in this rapidly changing environment.

Immediately following this announcement, we instituted a 45-day plan, which will end November 15, to assess our entire management structure across the system. We will look for areas in which we can create greater efficiency and remove redundancy.

The Central and East regions are able to streamline operations as a result of acute care hospital alignment and consolidation. At Hartford we are looking internally at our operations and structure for other opportunities with the goal to both remove cost from the system as well as create streamlined reporting structures. This is difficult work but an absolute necessity for us to remain competitive in the marketplace.

We continue to advance our quality initiatives and have performed extraordinarily well in many areas. As our journey continues from volume to value, quality remains a paramount goal. But at the same time we need to become far more cost-competitive to succeed.

Your understanding and support for the work we are doing is critical to its success. I thank you in advance for your dedication and the work you have all done to keep us focused on our vision and committed to our mission.

Stuart K. Markowitz, MD
President

 

Annual HHC Board Retreat Focuses on the Future

About 100 participants, including members of both the HHC board of directors and local HHC boards, as well as physician leaders from across the system, gathered on Oct. 28-29 for the Annual Hartford HealthCare Board Retreat at Hartford Hospital.

This year’s theme was “Roadmap to Our Vision,” and it featured a major address from Elliot Joseph, president and CEO of HHC, called “Mastering the Future.” His “Five Keys to Mastery” are: reducing variation, eliminating silos, moving to value, controlling the cost structure and physician alignment.

In addition, those in attendance also heard from Joseph Swedish, CEO of Wellpoint, Inc. on “Changing Landscape for Payers and Providers.

Dr. James Cardon, EVP and Chief Clinical Integration Officer for HHC, gave a presentation on “Journey from Volume to Value.”

A segment on new systemwide service lines featured an overview by Jeffrey Flaks, EVP and COO of HCC and insight from our new cancer partner offered by Dr. Richard Barakat, deputy physician-in-chief for regional network and affiliations at Memorial Sloan-Kettering Cancer Center.

 

Flu Vaccine Update; Deadline is Friday

Employed staff and all bedside staff (employed or non-employed) who have not received exemptions, must receive a flu shot by Nov. 8 as planned. Nothing has changed for these individuals. We will provide flu shots to this group.

For now, we will not provide flu shots to non-employed individuals, including students, volunteers and licensed independent practitioners – except those who provide bedside care. As a result, these individuals will not have to meet the Nov. 8 deadline.

Those without exemptions who are not vaccinated will have to use a mask in accordance with our policy, which calls for masking during flu season in areas that may be in use by patients, which includes lobbies, etc. (Frequently Asked Questions related to Universal Influenza Policy may be found here: https://portal.harthosp.org/hhintranet/hh/content/5628/doc85824.pdf

We strongly encourage everyone in the above group to receive flu shots in the community (family physician, pharmacy, etc.) and to supply Occupational Health with proof of vaccination. After Nov. 8, we will assess our supply and may offer flu shots to non-employed individuals.

Flu shot clinics will be held for employed staff and all bedside staff in Occupational Health Services in the basement of the Brownstone Building on the Hartford Hospital campus next week. Make sure to bring your ID badge with you.

  • Monday, Nov. 4: 7-8 a.m., 11 a.m.-12 p.m., 2:30-3:30 p.m.
  • Tuesday, Nov. 5: 7-8 a.m., 11 a.m.-12 p.m., 2:30-4 p.m.
  • Wednesday, Nov. 6: 7-8 a.m., 11 a.m.-12 p.m., 3-5 p.m.
  • Thursday, Nov. 7: 7-8 a.m., 11 a.m.-12 p.m., 3-4 p.m.
  • Friday, Nov. 8: 7-8 a.m., 11 a.m.-12 p.m., 2:30-3:30 p.m.

 

JohnsonMandatory Benefits Enrollment for Employed Physicians Nov. 4-15

Employed physicians who want to receive HHC employee benefits in 2014 must enroll during open enrollment Nov. 4-15.

If you do not enroll at this time, you will not receive benefits in 2014.

Visit HHCandMe.com to learn more.

 

 

 

 

Remind a Colleague: Wash In, Wash Out

All health care workers and patients should feel comfortable reminding any other health care worker to sanitize regardless of their role. This should always be done in a courteous and constructive manner. All health care workers should respond courteously and gratefully when reminded.

If you remind another health care worker to sanitize, and he or she responds with irritation or hostility, please notify their department chief, Dr. Jamie Roche or Dr. Jack Ross, who will communicate with them to prevent recurrences.

 

Finances for September: Favorable

Inpatient volumes based on discharges for the month of September were 2.4% above budget. The comparison to the prior year shows September of 2013 discharges, approximately 4.8% above the prior year. Outpatient revenues exceeded budget by approximately 2.5% for the month. The favorable outpatient revenue variance was driven by Emergency services, Perioperative Services, Women’s Health Services and the Eye Surgery Center.

Through end of fiscal year 2013, inpatient discharges were 0.5% greater than budget and 1.4% greater than the prior fiscal year. Outpatient revenues were 1.6% above budget for the fiscal year ending 2013. The favorable outpatient revenue variances for the year were in Emergency Services, Perioperative Services, Radiation /Oncology and Rehabilitation Services.

 

Tiger Text (secure HIPAA compliant text app) To Be Provided Free For All Providers

Many of you routinely use your smartphone to communicate with your colleagues, perhaps by text messaging. Unfortunately, the texting applications on most smartphones are neither secure nor HIPAA compliant.

To provide you with convenient yet secure texting functionality, we are providing free of charge to all HHC providers an encrypted HIPAA compliant text messaging app called TigerText, which:

  • Allows secure text messaging from your mobile device
  • Improves efficiency of provider communication
  • Does not require you to know other providers' cell phone numbers
  • Does not use cell phone minutes
  • Tracks the status of the message so you know if it has been read

Our ultimate goal is zero data breaches.

Clinicians exchanging patient-related text messages over a Wi-Fi or cellular connection create significant security risks and compliance problems. In August 2013, we adopted a secure texting policy that says all sensitive information transmitted via text message by members of Hartford HealthCare must be encrypted. Tiger Text is the application we have chosen to assure compliance.

TigerText, a closed network health care professional communication application, will enable you to use your smartphone, tablet or laptop to securely send and receive HIPAA compliant text messages and easily collaborate to make rapid, accurate decisions about diagnoses and treatments.

A TigerText pilot has already been completed at MidState Medical Center, with positive results.

TigerText takes less than five minutes to install and learn, and we’ve arranged to deliver it directly to your mobile device. You will get an email inviting you to download ‘Air Watch,’ and we will push Tiger Text to your mobile device via this application.

Representatives from the hospital IT Department and TigerText will be on campus during deployment to show you how it works, and will provide support after launch. In addition, there are instructional videos and documents posted on the Medical Staff pages on the intranet.

We are certain that TigerText will help you by increasing the speed and ease of communication with your colleagues via text messaging, while maintaining security with patient information.

Thank you for your cooperation during this important initiative.

Rocco Orlando III, MD, FACS
Senior Vice President and Chief Medical Officer, Hartford HealthCare

 

Good News for Participants in the HHC Physician Insurance Program

The HHC Physician Insurance Program continues to be strong and vibrant as it begins its 25th year. You will notice the above name change from the CHS Insurance Program to the HHC Physician Insurance Program. This new name more appropriately reflects the fact that HHC is the program’s sponsor and only physicians affiliated with an HHC organization are eligible for coverage. The ongoing objective will continue to be to pass positive underwriting results back to the program physicians through either rate reductions or program experience credits.

Based on historical program loss performance, the Board was able to declare a 15% premium credit for all current policyholders in the 2013 program year. This credit will reduce your CHS insurance program costs by 15% for 2013. This is the second year in a row that we have been able to apply a credit because of good performance.

The board also announced that the base rates for the 2014 program year will be unchanged from 2013, and all program discounts including a potential maximum 6% Risk Management discount will continue to be available.

If you have any questions, please contact Mary Ann Nelligan, the HHC Insurance Program director, at 860-696-6265, or Sharon Daust, program coordinator at 313- 393-6528.

 

New 12-Bed PACU Opens Tomorrow on HB4

Perioperative Services is opening its new post-anesthesia care unit (PACU) on Monday, November 4. This area, located on HB 4, provides 12 additional state-of-the-art beds for patients as they recover from the procedures performed throughout the Operating Room. It will be staffed by the same complement of PACU nurses who provide care in the current inpatient PACU.

The HB PACU telephone number is (860)-972-8030.

The Anesthesia and PACU staff will continue their current process of triaging and placing patients appropriately once their procedures are complete. This process will fully utilize both the new HB PACU and the existing PACU.

SISCOM has been updated to include the new bed locations, and will be used by staff to provide assistance as we transition our patients to the recovery phase of their care.

 

Olin Center Celebrates Opening of Annex

A ribbon cutting for the opening of the Olin Center Annex at the Institute of Living took place October 30.

The Olin Neuropsychiatry Research Center is at the forefront of neuroscience research in brain disorders. In 2010, the center was awarded a $3.2 million building grant from the federal government’s Economic Stimulus Act and received $2.2 million in matching funds from Hartford Hospital to expand the center and add state-of-the-art equipment.

The expansion project has fostered much collaboration among Hartford HealthCare’s neurosurgery, cardiology and bariatric surgery service lines and a number of federally funded studies.

 

Dr. Michael Karasik Performs First Endoscopic Submusosal Dissection in Connecticut

Dr. Michael Karasik, gastroenterology, did the first endoscopic submucosal dissection (ESD) in Connecticut Oct. 28 in the GI unit.

An 81-year-old patient had a cancerous lesion in his esophagus removed endoscopically rather than having an Ivor- lewis esophagectomy. The procedure was three hours long and the patient was awake and in no discomfort 30 minutes post procedure. Assisting Dr. Karasik were team members Izabela Burzynski, Marylou Tuchols, and Andres Rivera.

 

Comprehensive Epilepsy Center Anniversary and Open House

The Comprehensive Epilepsy Center team will be in the Hartford Hospital lobby on Wednesday, Nov. 6 from 10 a.m.-12 p.m. celebrating the beginning of Epilepsy Awareness Month.

The Epilepsy Center is also conducting an open house to celebrate its one year anniversary on Wednesday, Nov. 13 from 9 a.m.-12 p.m. in the epilepsy conference room on Center 11.  Come and learn more about epilepsy and our 6 bed Epilepsy Monitoring Unit. Beverages and snacks will be served.

 

HHCMG Specialty Physicians Host "Speed Meeting" Event With Primary Care Providers

In an effort to build relationships between and among our primary care and specialty providers, and to build a group culture focused on the HHC vision of personalized, coordinated care, Hartford HealthCare Medical Group (HHC MG) held its first "Speed Meeting" event.

Groups of HHC MG specialty physicians and advanced practitioners rotated every 7 minutes between groups of primary care providers, working out bidirectional referral pathways, best practice handoffs, and developing a greater understanding of the services provided by each office and / or specialty service.

As the evening was seen as a great success, HHC MG hopes to broaden the invitees to include other HHC specialists in the next iteration of the event.

Excellence

Top Dentists Listed in Hartford Magazine

The October issue of Hartford Magazine published a list of top dentists in the area. The following 21 top dentists who are teaching staff in the Department of Dentistry at Hartford Hospital, were included on the list:

Prosthodontists: Drs. Peter Pasciucco and Vernon Kwok

Endodontists: Drs. Robert Balla and Martin Ungar

General Dentists: Drs. Thomas Dolan, Hal Dym, Paul Korus, Marc Scoles, Matthew Scoles, Bruce Tandy, and Shawn Zahner

Oral and Maxillofacial Surgeons: Drs. Judd Fink, Dennis Gianoli, Stuart Lieblich, David Shafer, Siobhan Stephen, and Brett Weyman

Orthodontists: Drs. Robert Gange and James Lovell

Periodontists: Drs. Barry Gelber and Ernest Spira

 

Dr. Robert Siegel on Planning Committee for National Oncology Symposium

For the second year, Dr. Robert Siegel, medical director of the Hartford Hospital Cancer Clinical Research Office and IRB chair, is on the planning committee for the American Society of Clinical Oncology Quality Care Symposium, which will be held November 1-2 in San Diego.

He has been invited to speak on "Quality care in Oncology. How do we move forward?"

 

Dr. Len Jacobs Keynote Speaker at Rensselaer Alumni Association Leadership Speaker Series

Dr. Len Jacobs, director of the Trauma Institute, was the keynote speaker at the Rensselaer Alumni Association Leadership Speaker Series Meeting on Oct. 24. The meeting was held at Hartford Hospital. His presentation was called "Leading Through innovation - Changing Medical Education Through Simulation." The event benefited the Injury Prevention Center at Hartford Hospital Trauma Institute.

 

Dr. D'Andrea Joseph Selected to Committees

Dr. D’Andrea Joseph was selected as a committee member of the Acute Care Surgery Committee of The American Association for the Surgery of Trauma; and as a member of the EAST injury prevention committee.

 

Dr. Orlando Kirton Elected to Board of Managers, Chair of Critical Care Committee

Dr. Orlando Kirton, director of surgery, was elected to the Board of Managers and as chair of the Critical Care Committee of The American Association for the Surgery of Trauma. He was also elected as the Connecticut Representative of the Program Committee for the New England Surgical Society.

 

Dr. Bruce Browner Conducts Another International Trauma Conference With Tanzania

Continuing Hartford Hospital’s expansion beyond our borders, Dr. Bruce Browner set up another International Multidisciplinary Trauma Conference with Muhimbili University in Tanzania. Speakers from Hartford Hospital and Tanzania discussed complex pelvic and acetabular fractures in a video conference Oct. 31.

Presenting were Dr. Browner, site director of the Orthopedic Residency Program at Hartford Hospital and professor and chair emeritus of the UConn Health Center Department of Orthopedic Surgery; Dr. Michael Miranda, chief of the Orthopedic Trauma Service at Hartford Hospital and clinical assistant professor with the UConn Health Center Department of Orthopedic Surgery; and Dr. Violet Lupondo, staff orthopedic surgeon at the Muhimbili Orthopedic Institute in Dar Es Salaam, United Republic of Tanzania.

The goal is for participants to understand the challenges of treating these types of fractures in Africa and how these fractures are handled in the United States.

 

Our Physicians Are Great Sources For Local Media

Dr. Peter Boelger was interviewed by WNPR about C sections on the rise

Dr. Patricia DeFusco was interviewed by NBC CT on our partnership with Memorial Sloan Kettering, and the drug Perjeta; WTNH about cardiac and breast cancer treatments

Dr. Sheila Gatelywas interviewed by WFSB on vitamin D deficiency in women; vitamin supplements; and low dose estrogen for women

Dr. Khuram Ghumman was interviewed by WFSB about flu season

Dr. Jason Gluck was interviewed by WFSB about ECMO device

Dr. Len Jacobs was interviewed by the Wall Street Journal, WTIC AM, and Hartford Courant about the Hartford Consensus II

Dr. Kelly Johnson-Arborwas interviewed by the Hartford Courant on tainted heroin that has surfaced in CT; and by NBC-CT, WTNH and Fox CT on carbon monoxide safety

Dr. Brendan Killory was interviewed by WNPR on left-handedness study

Dr. Inam Kureshi was interviewed by WFSB on the upcoming Hartford Med program

Dr. Stacy Nerenstone was interviewed by Fox CT and WFSB on breast cancer

Dr. Joe Portereiko was interviewed by WTNH about fall cleanup safety

Dr. Jack Ross was interviewed by News 8 on this year's flu season.

Ellen Rothberg was interviewed by NBC CT on the government shutdown's impact on flu monitoring

Dr. Andy Salner was interviewed by WTIC AM on the government wanting to change the word "cancer"

Dr. Gayatri Sarkar was interviewed by Fox CT Type 2 diabetes

Dr. Laura Saunders was interviewed by WTIC AM on addictions to cell[phones and tablets; WTIC AM on suicide symptoms; and WTIC AM on the murder of a teacher in Danvers

Dr. Hank Schwartzwas interviewed by News 8 and WFSB, Ch. 3 about our ribbon cutting celebration of The Olin Neuropsychiatry Research Center Annex; by WFSB, NBC CT, Fox CT and WFSB on postpartum depression; by WNPR about guilt

Dr. Steven Zweibel was interviewed by WTIC AM and Fox CT on Sudden Cardiac Arrest month

 

These physicians are scheduled to appear on Medical Rounds:

Oct. 30 - Dr. Heather King, breast cancer

Nov. 6 - Dr. Erica Schuyler, epilepsy

Nov. 13 - Dr. David Tolin, Canary trial for panic disorders

Nov. 20 - Dr. Colin Swales, fibroscan

Nov. 27 - Dr. Ryan Dorin, Movember

Dec. 4 - Dr. Len Jacobs, Hartford Consensus II

Dec. 11 - Dr. Stacey Nerenstone, NSKCC Update

Dec. 18 - Dr. Ken Robinson, winter weather safety

 

Research and Academics

Tallwood Urologists Present at New England American Urologic Association Meeting

The following presentations were made by urologists from the Tallwood Institute at the annual meeting of the New England section of the American Urological Association held September 26-28 in Hartford.

The following urologists served as moderators and panelists at the NEAUA annual meeting.

In addition, Hartford Hospital sponsored two additional programs:

Young Urologist Forum: Lap/Robotic Olympics at CESI – Hartford Hospital
The competition consisted of 32 residents representing New England residency programs participating in a series of tests including laparoscopic suturing and peg transfer using FLS (Fundamentals of Laparoscopic) testing units and advanced robotic skills testing using the Mimic dV-Trainer® and the intuitive da Vinci Skills Simulator (robotic simulators). The three winners of the competition were all from the UCONN Urology residency program that train at HH and CESI.

Fundamentals of Robotic Surgery Course, Hosted by Hartford Hospital Tallwood Urology & Kidney Institute and CESI at Hartford Hospital in conjunction with New England AUA
A hands-on skills training course designed to give the urologist a basic understanding of the specific skills necessary to perform key urologic robotic surgery. Participants utilized the Intuitive Surgical daVinci Si Robotic System, da Vinci Skills Simulator and the dV-Trainer from Mimic Technologies, Inc. Attendees also participated in thorough tutorial discussions and video reviews with the expert robotic faculty.

 

Seeking Patients For MIRACLE ER Study

Dr. Joseph Radojevic and the research staff will begin recruiting patients in November for the MIRACLE EF study sponsored by Medtronic. This study seeks to evaluate the effectiveness of CRT-P therapy in delaying the progression of heart failure in patients with an LVEF of 36-50% and LBBB. CRT already has a Class Ia indication in a HF population with LBBB and LVEF <35%. Eligible subjects will be implanted with a CRT-P system and randomized in a 2:1 fashion to either treatment (CRT-P ON) or control (CRT-P OFF) groups. Please contact Ellen Volponi at 860-972-1250 if you have any potential subjects.

 

Stahl Lecture Addresses PTSD

The fifth Stahl Lecture at the Institute of Living (IOL) on Oct. 31 featured professor, researcher, and clinician Barbara O. Rothbaum, PhD, who spoke on “Treatment of PTSD: From Pharmacotherapy to Virtual Reality.” Rothbaum is associate vice chair of clinical research and director of the Trauma and Anxiety Recovery Program at Emory University School of Medicine, Department of Psychiatry.

The lecture was part of the IOL’s Grand Rounds Lecture series. The Stahl Lecture is supported by the Kristina Stahl Fund for Anxiety. It was established in 2010 by Bill and Karin Stahl in memory of their daughter. It is coordinated by David Tolin, PhD, director of the Anxiety Disorders Center at the Institute of Living.

 

Cohen Symposium on Brain Tumors Featured Neurologist From Memorial Sloan-Kettering Cancer Center

Hartford Hospital’s special Grand Rounds 7th Annual Cohen Symposium on Nov. 1 was “Brain Tumors-Standard Therapy and Why We Need a Bigger Boat: Tumor Morphology or Molecular Array” with guest speaker Dr. Craig Patrick Nolan, neurologist at Memorial Sloan-Kettering Cancer Center.

Attending were neurologists, neuro-oncologists, neurosurgeons, APRNs, oncology nurses, geriatric specialty nurses, clinical nurse specialists, physician assistants, pathologists, pharmacists, oncology surgeons, medical oncologists, radiation oncologists, hospitalists, speech therapists, occupational therapists, physical therapists, nutritionists and dietitians, psychologists, psychiatrists, psycho-oncologists, and other interested oncology clinicians and specialists.

Hartford HealthCare recently formed a special alliance with Memorial Sloan-Kettering to share research and bring leading-edge cancer care and clinical trials to Connecticut communities.

Chief's Corner

MarkowitzWelcome 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. Should you have any comments or suggestions along the way, please share them with us.

- Dr. Jack Greene, Hartford HealthCare regional vice president of Medical Affairs for the Hartford Region and Hartford Hospital

 

 

HHC Starts Low Dose CT Scan Lung Cancer Screening for High-Risk Patients

salnerDr. Andrew Salner, Chief, Department of Radiation Oncology; Director, The Helen & Harry Gray Cancer Center

Lung cancer is the leading cause of cancer deaths in the U.S. and worldwide for both men and women. Primary prevention (smoking cessation) has been successful in decreasing the overall number of deaths in the United States. Most people who die from lung cancer are now former smokers.

To improve overall survival for lung cancer for smokers who have already incurred the damage from smoking, secondary prevention in the form of screening is required. Results of the National Lung Screening Trial demonstrated a 20% reduction in mortality with annual LDCT scan screening for the high risk population of smokers and former smokers, so we now have a way to make a major change in lung cancer survivability.

We are starting a new study that will provide us with the opportunity to revolutionize lung cancer survival with broad implementation of lung cancer screening for the high-risk population.

The Hartford HealthCare Low Dose CT scan lung cancer screening study is designed to answer the question: “Can we implement lung cancer screening for high-risk subjects that will find lung cancer at an earlier, more treatable stage?”

This study is the first of its kind being conducted at all three HHC regions – Hartford, Central and Eastern regions, including Hartford Hospital, THOCC, MidState Medical Center and Windham. All sites have a co-investigator and coordinator conducting the study under PI Dr. Andrew L. Salner.

The eligible population is patients who meet NCCN guidelines for high-risk groups:

Group 1: 55-74 years old, currently a smoker or have quit with in the past 15 years, and have smoked at least a pack a day for 30+ years

Group 2: 50-74 years old, have smoked at least a pack a day for 20+ years, and have one additional lung cancer risk factor not to include secondhand smoke exposure

The additional risk factors include:

• a personal history of a smoking related cancer,

• family history of lung cancer in a first degree relative,

• chronic lung disease such as emphysema or pulmonary fibrosis,

• carcinogen exposure, i.e.: arsenic, asbestos, cadmium, chromium, diesel fumes, nickel, radon and silica.

Exclusion criteria include:

• Patients with current symptoms of a lung condition, such as a new cough, hemoptysis, or shortness of breath

• Treatment for lung cancer or other malignancy within the last 5 years

• Chest CT in the past 18 months

• Unable to lie on back with arms over head

HHC will provide annual LDCT scans for eligible high-risk patients. LDCT scans will be offered at Hartford Hospital, MidState Medical Center, The Hospital of Central Connecticut, and Windham Hospital, at no charge to the patient if they qualify and consent to the trial.

All Hartford HealthCare physicians are encouraged to participate in the program and identify and discuss lung cancer screening with their high-risk patients. Physicians, especially those involved in primary care of the target population, will be critical in implementing the study. Most patients are not aware of recommendations for lung cancer screening and many, especially former smokers, are not aware of their lung cancer risk.

Following your discussion with the patient, if lung cancer screening is recommended, the patient will call the study coordinator at 860-545-LUNG to verify eligibility. The patient will need a physician order for a LDCT scan for lung cancer screening and will need to sign an Informed Consent before the LDCT scan is scheduled.

Follow up notification of results will be via the LUNG RADS system (similar to system used for mammography). You, the physician, and your patient will each receive a letter with the results and the recommended follow-up. The primary care physician will work with a multi-disciplinary medical team to develop a plan of action for those with suspect findings. These plans will follow NCCN guidelines.

There is a Medical Grand Rounds briefing scheduled at HH on Thursday, Nov. 21 at 8 a.m. Please contact us at 860-545-LUNG if you would like more information or would like an immediate briefing for your office.

Enhancing The Patient Experience

Voices of Our Patients: Kudos From Dr. John Banta

Dear Jeff,

Over the last 20 years I have undergone elective surgical procedures but was never admitted via the E.R.

The staff both in the E.R. and then on Bliss 8 was absolutely superb. The coordination between the two departments was expertly handled.

The care throughout was very professional and compassionate.

Best of all, a very serious condition was rapidly reversed and made comfortable.

I am returning to my orthopedic clinic supervisory role in the morning.

Thank you and your administration for providing such a well-run hospital.

Sincerely,
John V. Banta, MD

Operational Update

Medical Staff Elections Nov. 21

There are eight open positions in medical staff leadership – four officers: president, vice president, treasurer and secretary - and four at-large members of the Medical Executive Committee (replacing these current members whose terms are expiring: Drs. Saverio Ligato; Leah Meisterling; Jarrod Post; and Andrew Wakefield).

Current officers whose terms are expiring are Dr. Jeffry Nestler, president; Dr. Stacy Nerenstone, vice president; Dr. Jeffrey Cohen, treasurer; and Dr. Matthew Saidel, secretary.

Candidates are:

President: Dr. Stacy Nerenstone

Vice president: Dr. Matt Saidel

Treasurer: Dr. William Sardella or Dr. Ken Robinson

Secretary: Dr. Herbert Keating or Dr. John D'Avella

Medical executive committee (four open positions):

Drs. Alex Cech, Jeff Finkelstein, April Goller, Fran Gurtman, Syed Hadi, John Hammond, Leah Meisterling (incumbent), Sam Pope, Jarrod Post (incumbent), Bob Spilane, Cune Vergara, Andy Wakefield (incumbent).

Watch your e-mail for ballots around Nov. 14. Voting will take place between then and November 20, and results will be announced Nov. 21 at the Semi-annual meeting of the Medical Staff.

 

Medical Staff Funding FTE To Help With HealthConnect Data

The medical staff is funding an FTE who will help with the following tasks on the HealthConnect database:

  • Working closely with physician liaisons (Luisa Machado et al) to input new physician data, and update existing physicians, into the the database and also into the HH website.
  • Performing maintenance on the database to match and remove duplicate provider and practices records.
  • Updating the database with information received from other MSOs.
  • Entering patient contact information that will be used for patient communications.

The HealthConnect database is also being used to provide data for the secured texting application that is currently being rolled out, 1-800-Doctors, and EPSI, an automated connection with the HHC Call Center.

 

Leadership Team Named for CareConnect

We have established an outstanding team to lead the HHC Unity: CareConnect implementation. This group – working together with departments throughout our system - will implement the Epic electronic health record (EHR) system as a tool to help us fundamentally transform the way we care for our communities.

We look to this team to guide one of the most important projects in Hartford HealthCare’s transformation to the health care system of the future. The CareConnect leadership team is:

  • Dr. Jon Velez, program sponsor
  • Lynn Amarante, application director
  • Michelle Codianna, application director
  • Brian Jaworowski, application director
  • Jennifer Lewis, application director
  • Kathy Martin, application director
  • Elise Sinha, application director
  • Craig Stearns, program director
  • Stacey Angelo, project manager
  • Lisa Canonge, project manager
  • Beatriz Heredia, project manager
  • Amber Patterson, project manager
  • Sharon Casey, training director
  • Joe Hurley, reporting manager
  • Ellie McAuliffe, testing manager
  • Bob Schwarm, technical director

Our next critical step is to continue to staff the CareConnect core team, which will include about 160 employees. We are still seeking applications, particularly from those with experience in home care, report writing, revenue cycle and ancillary applications. For applications and more information about the available positions, you can access the CareConnect employment page directly at http://www.hartfordhealthcare.org/careconnect.

 

New Physicians Welcomed

We proudly welcomed new physicians to our staff with a networking event Oct. 23 at The Hartford Club in downtown Hartford.

In FY 2013, 156 new active medical staff joined Hartford Hospital, including 71 with refer-and-follow privileges. The hospital has an active medical staff of 1,338 physicians, including 269 with refer-and-follow privileges.

 

Balanced Scorecard for FY 2013

These initiatives are expected to hit target by date:

  • Utilize HHC Thrive
  • Establish the HHC Cancer Network
  • Develop vision and strategic plan for Academics (Education and Research)
  • Reduction in length of stay
  • Develop an orthopedic strategy
  • Develop an integrated summary of Patient Treatment Plan through Electronic Medical Record (EMR)
  • Develop and implement institute infrastructure

These initiatives are at risk for missing target by date:

  • Improve quality effort to eliminate harm
  • Grow volume and number of attributed lives

These are the 2014 operational initiatives (first three are strategic priorities):

  • Length of stay reduction
  • Orthopedics
  • Adopting and hardwiring best practices
  • Eliminate patient harm
  • Improve employee health
  • Increase employee engagement
  • Grow the system
  • Improve the patient experience
  • Reduce our cost structure
  • Strategic expansion of the HHC network
  • Integrate the cancer service line
  • Cross continuum care coordination

 

Emergency Management Exercise a Success

On the anniversary of Hurricane Sandy, Hartford Hospital conducted and emergency management drill and exercise. This disaster preparedness and response event took place on October 29, and was eerily similar to an actual emergency encountered by the hospital during Sandy in 2012.

“It brought memories back from exactly a year ago,” said Bimal Patel, HHC regional VP of Operations, who led the exercise as Incident Commander. “One of our real life vulnerabilities during natural disaster is flooding.” The simulated emergency was conducted under the direction of the hospital’s Center for Emergency Medical Preparedness in conjunction with several other departments including Fire Safety and Engineering.

The two-hour response was most effective and a formal review of the day’s activities noted that a multi-disciplinary team of engineers, fire safety specialists public safety officers, IT and communications staff, Infection Control and Occupational Safety personnel worked cohesively and performed like a well-oiled machine.“

An 1800-gallon water tank was brought to the hospital’s campus and filled with water in order to test the system capacity of several portable generators and over a dozen pumps. Clean-up tools used by Environmental Services were also assessed. More than 40 staff members participated in the on-site drill and functional exercise. A formal debriefing was held immediately following the “all clear” notification.

“It’s known to us that unexpected events will occur at some point—it’s not a matter of ‘if’; it’s a matter of ‘when,’” Bimal Patel commented. “ The more experience as a team we have during emergency preparations and drills, the better prepared we are to deal with the challenges together. It is all about our patients and community as we are, and must be, the healthcare backbone of the area. Especially during time of crisis, hospitals become the dependable destination centers.”

The Center for Emergency Medical Preparedness (CEMP) is the hospital’s team for ensuring the safety of our patients, staff, and visitors and the integrity of the campus’ physical infrastructure. They do this by attending to the 4 phases of emergency management—preparation, mitigation, response, and recovery.

“The effective and safe management of operations during an emergency or disaster is every employee’s responsibility,” states Edward Kramer, newly appointed program manager of CEMP. “Knowing what to do and when to do it is the foundation of Emergency Management.”

 

October Scrubs Tour

The third Scrubs Tour of the year, held in October, was a great success, with 19 attendees.

The presenters included:

  • Dr. Hank Schwartz, psychiatrist-in-chief, Institute of Living
  • Dr. Kenneth Robinson, program manager, LIFE STAR
  • Karen Weingrod, program manager, Helen & Harry Gray Cancer Center
  • Dr. Ted Steger, radiation oncology physicist, Cancer Center
  • Kathy Burns, RN, medical oncology nurse manager, Cancer Center
  • Dr. Charles Primiano, director, cardiac CT, director, Exercise Testing Laboratory, Cardiac Catheterization Lab
  • Jeanne Bodett, RN, manager, Cardiac Catheterization Lab
  • Dr. Steven Schichman, chair, Department of Urology
  • Dr. Courtland Lewis, physician-in-chief, Hartford HealthCare Bone & Joint Institute, chief, Department of Orthopedics
  • Stephen Donahue, BS, RRT, program director, Center for Education, Simulation and Innovation (CESI)
  • Dawn Filippa, RN, surgical simulation coordinator, CESI
  • Liza Nowicki, RN, nurse educator, CESI
  • Dr. Barry Stein, radiology, section director, cardiovascular MRI and CT

Thank you to all the presenters who welcomed the donors and members of the Hartford Hospital Auxiliary who took part in the tour. The next Scrubs Tour is scheduled for December 6.

 

Nominate a Connecticut Hero

The Red Cross is looking for people who have performed extraordinary acts of courage to save someone's life or who commits countless hours to a special cause to honor as Connecticut Heroes. Each year, the Red Cross accepts nominations for recognition of people who go above and beyond in service to others, exemplifying the spirit of the Red Cross mission. These heroes are honored in recognition of their good works at the Community Heroes Breakfast Celebrations, on March 7, 2014, in Hartford.

Nominate your Community Hero for deeds that occurred in the last 15 months. Nominations must be received by December 31, 2013 to be considered for this year’s event. The nominee must live or work in, or the event must occur in, Connecticut. Nominations may be made for both living and posthumous Heroes. Details about the Heroes Celebration and an online nomination form are available at the Red Cross website, www.redcross.org/ct/heroes.

For more information about the Red Cross Community Heroes Celebration and sponsorship opportunities, contact Devin Cleary at (860) 678-4310 or email him at devin.cleary@redcross.org.

 

Watch Hartford Med: Living Miracles

If you missed watching "Hartford Med: Living Miracles" which aired on Oct. 10 you can watch it at this link. You can view any of the past episodes of Advancing Medicine at: http://www.harthosp.org/AdvancingMedicine

 

New Medical Staff Vendor Relations Policy

Hartford Hospital has a new Medical Staff Vendor Relations Policy which applies to all medical and adjunct staff members.

The policy states that any medical staff member who has any type of personal or business relationship with a vendor that does business with HHC or any affiliate must fully disclose the relationship with the vendor to the Office of Compliance, Audit and Privacy (OCAP) and provide information, as requested by OCA.

The medical staff member may participate in discussions about the vendor and its/their good or services but may not participate in any decision on whether to engage the vendor or purchase goods or services from such vendor.

 

State Mandated CME Renewal Available Free To HH Doctors on Jubilant Learning Portal

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 (outside: 860-545-5699).

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 maryanne.pappas@hhchealth.org.

Supply Cost Stats

Did you know?

Hartford Hospital spends $1.2 million on disposable exam gloves each year.

HH In the News

Farmington Valley Towns Work To Address Mental Health Issues, Prevent Suicide

Farmington Valley Times, Oct. 23

A collection of Farmington Valley residents and officials came out to take part in a mental health awareness and suicide prevention forum at the Community Center. Following the Sandy Hook shooting last December, the Boston bombings in April and the Washington Navy Yard shooting just last month, mental health and suicide have become a part of the national agenda. In Connecticut, Gov. Dannel P. Malloy’s adoption of stricter gun legislation has also brought the mental health component into focus.

David Vaughn of the Institute of Living in Hartford was the final speaker of the evening. He discussed the Young Adult Services the Institute provides to youth, “who have significant mental health problems to live a full and independent life.”

The Institute was started in 2004 by Vaughn and two other mental health professionals to help people with psychosis. It was expanded to all mental illnesses in 2009. The emphasis in all cases is on early intervention, because as he put it the sooner you get involved with a person with mental illness, the better outcome for the lifespan of the illness.

 

Protecting Yourself Against The Flu

WTNH, Oct. 30

Flu season is just about here and experts predict we could be hit hard this year. The best way to fight the flu is to get a flu shot.

Connecticut is gearing up so that there are plenty of vaccines to go around.

It only hurts for a second but can head off days of pain later this winter. Doctors say now is the time to get the flu shot because it takes about 15 days for the vaccine to take hold and last year the first cases were reported around Thanksgiving and ramped up the first week of December.

"Get those around you that you love vaccinated. You create a cocoon effect. If you get vaccinated or if I do, perhaps we protect our mom or dad or grandparents or even our young children," said Dr. Jack Ross, Hartford Hospital.

At Hartford Hospital they have about 19,000 flu vaccines and they keep them in highly regulated refrigerators. But according to the CDC, almost all of the flu vaccine has been distributed and this year they are adding a new type of vaccine to about 20 percent of the shots.

 

 

Injuries Increase With Fall Cleanup

WTNH, Oct. 18

A warning as you head outside to do some fall clean-up. Hartford Hospital has seen a number of injuries over the past couple weeks and with this warm weather, they want to make sure you stay safe. The ER at Hartford Hospital has seen a spike in trauma surgeries.

"It happens two to three times a week, and as trauma surgeons we only see the really bad cases. We don't see the little cuts to the hand, the small things like that," said Dr. Joseph Portereiko, Hartford Hospital.

Dr. Portereiko is a trauma surgeon at Hartford Hospital. As leaves clog the gutters, he says one of the most common injuries is ladder falls.

 

Avoiding Carbon Monoxide Poisoning

WTNH, Oct. 25

With this colder weather moving in, a lot of people are firing up their furnaces for the first time. And because of that there have been a number of carbon monoxide emergencies in our state.

"This is the problem every winter when it starts to get cold and they turn the furnace on," said Dr. Kelly Johnson-Arbor, Hartford Hospital.

The cold is here and Hartford Hospital has seen a spike in carbon monoxide poison from plugged chimneys and cracked furnaces.

"As it gets more severe you can have chest pain, have problems breathing, pass out, have trouble walking, trouble talking and that is when you get really sick and you may be too sick to call for help," said Johnson-Arbor.

There is a hyperbolic chamber at Hartford Hospital and it is how they cure carbon monoxide poisoning. The idea is to get the carbon monoxide out as quickly as possible so they put a mask over the patient and then pump it full of pure oxygen. That way they get the carbon monoxide out and sometimes it can take three treatments to get the patient healed.

 

FEMA Adopts Active-Shooter Guidelines Calling For 'Warm Zones,' Tourniquets

Hartford Courant, Oct. 21

The Federal Emergency Management Agency has developed guidelines for responding to active-shooter events based on a plan devised by a group of physicians and emergency response officials started by a Hartford Hospital trauma physician.

The Hartford Consensus, a group that includes representatives from the Navy, the FBI, the Dallas SWAT team and elsewhere, met in Hartford during the spring and summer to develop a plan responding to mass shootings.

The Hartford Consensus was formed after Dr. Lenworth Jacobs,director of trauma and emergency medicine at Hartford Hospital, approached the American College of Surgeons about developing a response to recent mass shootings. Jacobs said he had the idea for the group after the shootings at Sandy Hook Elementary School in Newtown.

In spring this year, the group drafted a rough outline of their plan. A few months later, members developed a more detailed plan, which includes more use of tourniquets and bringing EMS into "warm zones" to more quickly treat the wounded. The plan discussed earlier this month by the American College of Surgeons in Washington D.C.

Jacobs said the Hartford Consensus guidelines are to intended help municipalities and regions develop integrated and coordinated responses to mass casualties among the law enforcement, fire and emergency medical teams.

"You have to build a system where the most inexperienced person can function for 10 minutes," he said. "We need to build a system where the first responding group has a clear plan of action and can execute it immediately within five to 10 minutes, because after that help will come."

 

Program Aims To Save Lives in Mass Shootings

Medscape, Oct. 21

In response to the string of mass shootings like the one at a Nevada middle school today that killed a staff member and the gun-toting student, the American College of Surgeons (ACS) is spearheading a national effort to develop coordinated plans focused on preventing victims from bleeding to death.

"One of the real problems is that in most of these events, it is over in 15 minutes and the response has to be immediate, fully organized, fully orchestrated, and ready to go day or night in any locale in the United States," Lenworth Jacobs, MD, said during a panel discussion here at the ACS 2013 Annual Clinical Congress.

Dr. Jacobs, director of the Trauma Institute at Hartford Hospital and professor of surgery at the University of Connecticut, was involved in the autopsies after the 2012 shooting at Sandy Hook Elementary School in Newtown last year, in which a single gunman killed 26 people — mostly children — and wounded 2 adults.

"We felt that some good had to come of this," he said. The ACS established a committee with a mission to increase survival from active shooter and intentional mass-casualty events."

Dr. Jacobs pointed out that public education is a major goal, considering that bystanders were the ones who saved many lives in the 2013 Boston Marathon shooting.

"We're all first responders — every last one of us," Dr. Jacobs said. Generally speaking, the public wants to be helpful. Our job is to teach them what to do. That will increase survival at these events."

 

Dr. Marc Eisen Addresses Patients On Effects of Dizziness and Vertigo

Hartford Courant, Oct. 24

Dr. Marc Eisenrecently spoke at the Hartford Hospital Family Health Center in Enfield and addressed a group of patients on the effects of dizziness and vertigo.

"Dizziness affects about 40 percent of those over 40 at some time," said Dr. Eisen. "Vertigo, a form of dizziness marked by a sense that the patient or the surroundings are spinning, can be caused by inner ear disorders. The good news is that there are treatments, from physical therapy to surgery that can provide relief from these debilitating disorders," he said.

Dr. Eisen, who is board-certified in neurotology and fellowship trained at The Johns Hopkins Hospital in neurotology, leads the Hearing & Balance Center at Hartford Hospital, working alongside a highly trained audiologist, speech-language pathologists, and vestibular therapists to provide care to patients suffering from hearing impairment and balance disorders. Additionally, the center has access to all of the resources of Hartford Hospital, Connecticut Ear, Nose, & Throat Associates, and Hartford Hospital Rehabilitation Network. The Hearing & Balance Center provides a coordinated team of specially-trained professionals and access to physical therapy, provided by Hartford Hospital Rehabilitation Network, which can help treat a number of related balance problems.

In the HHC System

Hartford HealthCare Flirts With For- Profit Partner

Hartford Business Journal, Oct. 28

As Eastern Connecticut Health Network searched for a merger partner earlier this year, it seriously considered three offers before signing a letter of intent to pursue a deal with Tennessee for-profit hospital operator Vanguard Health Systems. It later became public that St. Francis Hospital and Medical Center, in partnership with Missouri's Ascension Health Care Network (ACHN), also put in a bid to buy ECHN.

The third bidder, however, was never made public. But the Hartford Business Journal has learned that Hartford Healthcare and Texas for-profit hospital operator LHP Hospital Group also made a joint effort to purchase to ECHN. LHP Hospital Group is the same company that made a serious bid to purchase Waterbury and St. Mary's hospitals. That deal, however, fell apart last year.

It's not clear exactly what type of partnership Hartford Healthcare and LHP Hospital Group proposed in their bid to buy ECHN.

Hartford Healthcare spokeswoman Rebecca Stewart declined to comment on any specific proposals but she did say challenging times in the industry require the health network to "be innovative and creative as we create new alliances to better serve our communities. National, regional and local health care markets are rapidly and dramatically shifting," Stewart said. "Hartford HealthCare continues to explore new partnerships to ensure our ability to serve the needs of each local community that depends upon us for their care."

ECHN signed a letter of intent earlier this year to be purchased by Vanguard Health Systems, which has since been acquired by another for-profit hospital company Tenet Healthcare Corp. The ECHN deal also includes an affiliation with Yale-New Haven Health System.

 

Wallingford Paramedics Get Hands-on Training at CESI

My Record Journal, Oct. 26

Set to open early next year, a new simulation lab at MidState Medical Center will offer a better hands-on training program for paramedics, according to officials from the hospital.

In the past, paramedics fulfilled continuing education requirements through more lecture-based training, according to Steve Alsup, deputy fire chief and director of emergency medical services. Finding the previous training to be inadequate, Alsup said he contacted MidState and “challenged them” to find something better for the paramedics. Because MidState is a part of the Hartford HealthCare network, Alsup learned that the paramedics could receive training hours at the CESI lab in Hartford. Upon visiting the facility for the first time, Alsup admitted he was speechless and that the simulation lab was the next generation of continuing education.

It was clear what the paramedics and hospital officials thought of the CESI lab as everyone praised it and painted it in a positive light. Lynn Amarante, assistant vice president of emergency services at MidState, said the hospital is in the process of bringing the CESI lab to their own facilities. So far, MidState has two advanced cardiac life support mannequins, two high fidelity mannequins to practice child births and two torso mannequins. Fitch said MidState hopes to expand to allow more mannequins to be used in the future.

The MidState CESI lab is scheduled to open in March, Amarante said, and it’ll be open to various individuals to receive training. Cindy Russo, senior vice president of operations at MidState, hopes to form other partnerships with other facilities in the area, including Quinnipiac University’s new medical school, to allow students to use the CESI lab.

 

MidState Medical Center Biennial Gala Goes Bollywood

My Record Journal, Oct. 21

Attendees of the biennial MidState Medical Center gala were treated to a sample of Indian culture Saturday night as part of the “Bollywood” theme put on at the Aqua Turf in Southington. The nearly 350 people in attendance dined on Indian cuisine and danced to the culture’s traditional music.

“It is an honor to be able to share with everyone the beauty and wonder of the culture of India, my homeland,” said Raj Nadkarni, an oncologist at MidState who was co-chairwoman of the gala, along with Jan Vocola, president of the MidState Medical Center Auxiliary. “This is just another example of how MidState remains in the forefront of embracing new ideas, seeking new challenges and leading the way for others to follow,” Nadkarni said

MidState Medical Center is an affiliate of Hartford HealthCare, a diversified health care system throughout the state. Through the partnership, the hospital is becoming more integrated with networking and collaboration, said Lucille Janatka, Hartford HealthCare’s senior vice president and central region president.

“What is more important is that we have come to share a common vision,” she said. “To deliver and coordinate quality care that is close to home.” With the achievements of the Midstate Cancer Center in the past few years, quality care can now be given to cancer patients without making them travel “miles away to unfamiliar places and unfamiliar faces,” Janatka said.

While the hospital collaborates with Hartford HealthCare, Bruce Eldridge, chairman of MidState Medical Center’s board of directors, said it’s important to note that money raised by MidState “stays at MidState.” The hospital has gone through many changes in recent years, he said. The move to Hartford HealthCare has been a “big, big transition,” Eldridge added.

MidState Medical Center is a“collaborative and good environment,” said Susan Alsamarai, an oncologist at the hospital’s cancer center.

 

William Petit Joins Company Developing Diabetes Device

Hartford Courant, Oct. 24

Dr. William Petit is a partner in a company that's developing a new device for testing diabetes. Petit is one of four principals in Quick LLC, a Farmington-based company that announced Thursday the start of a fundraising campaign to raise money for developing a prototype of the device and testing it. (A former medical director of the Joslin Diabetes Center at the Hospital of Central Connecticut, Petit hasn't practiced medicine since 2007, when his wife and two daughters were killed in a brutal attack in their home.)

David Mucci and Ron Clark, both doctors at the Hospital of Central Connecticut who developed the device, demonstrated it to Petit.

Instead of using a finger prick to test blood, the device measures glucose levels in saliva. It's easier and less painful, Petit said, especially for people who need to test themselves several times each day. The new device, called the iQuickIt Saliva Analyzer, has been in development for about 18 months, Fox said. The company hopes to raise $100,000 over the next two months on the crowdsourcing website Indiegogo.com, which allows people to raise money for specific goals with contributions from many people.

 

HOCC Names Director of Breast Health Center

New Britain Herald, Oct. 30

Kristen A. Zarfos, M.D., FACS, a surgeon who specializes in breast and thyroid surgery, has joined The Hospital of Central Connecticut’s medical staff as surgical director of HOCC cancer center’s Comprehensive Breast Health Center. She is also a medical staff member of Hartford HealthCare Medical Group.

Zarfos, who performs surgery exclusively at The Hospital of Central Connecticut, welcomes new patients to her Hartford HealthCare Medical Group office at 399 Farmington Ave., Suite LL2, Farmington. She has specific interest in breast health and early detection, breast cancer identification and prevention for high-risk women, breast cancer management in geriatric women, and thyroid surgery for goiters, nodules and cancer.

She earned her medical degree at University of Maryland School of Medicine, Baltimore and completed a general surgery internship at Yale-New Haven Hospital. Zarfos was a surgical resident at Yale-New Haven Hospital and Baystate Medical Center, Springfield, Mass., and completed her chief residency at Baystate Medical Center, where she was also a Tufts University teaching fellow. Most recently, Dr. Zarfos was director, Comprehensive Breast Health Center, Saint Francis Hospital and Medical Center and an attending physician with Saint Francis Medical Group, Inc. in Hartford. She is an assistant professor of surgery at University of Conn.

Health Care News In the Region

Hospitals Show Financial Gains, but Smaller Facilities Struggle

Hartford Courant, Oct. 31

Connecticut's acute-care hospitals ended the last fiscal year in slightly better financial health than in the prior year, with just five of 30 hospitals reporting losses, according to a new state report.

Data filed with the state Office of Health Care Access (OHCA) shows that six hospitals had operating losses in the 2012 fiscal year – the same number as in 2011, but fewer than in 2010. When non-operating gains and losses are included, five hospitals had negative total margins, or deficits – down from eight in 2011.

The annual OHCA report paints a positive picture of the overall financial health of hospitals, highlighting that Connecticut's hospitals had a total gain from operations of about $513 million in the last fiscal year – a substantial increase, of close to 70 percent, over the prior year. Total hospital net assets also increased.

The report credits "improvement in (hospitals') financial operational performance" and a rebound in investment income, tied to the economy, for the positive changes. But the new data also shows that several smaller hospitals are struggling. Milford, New Milford, Windham and Griffin hospitals all ended the year with deficits. The fifth hospital in that group was Saint Francis Hospital & Medical Center in Hartford.

OHCA said Milford Hospital was of "particular concern" because it had reported a deficit in each of the last five years.

Twelve hospitals had declines in patient volume of less than 5 percent, while the remaining nine reported increases in patient volume, including Yale-New Haven and Connecticut Children's Medical Center.

Hospitals ending the 2012 fiscal year with the largest margin of operating gains included St. Vincent's Medical Center in Bridgeport, which cleared $63.8 million; MidState Medical Center in Meriden, which cleared $24.9 million; and Stamford Hospital, with a $47 million operating surplus. Yale-New Haven Hospital ended the year with the highest dollar amount gain from operations: $106.6 million.

Generally, hospitals that were part of larger health care networks, created by mergers and takeovers, fared about the same financially as freestanding facilities. Of the 13 hospitals that were part of larger health care networks, two, or 15 percent, ended the year with deficits, when non-operating revenue was included. Of the 17 individual hospitals, three, or 18 percent, ended the year in the red.

Despite efforts to reduce reliance on emergency departments for care, statewide emergency room visits increased at a higher rate in 2012 than the previous year, climbing 3.2 percent. The hospitals with the highest emergency department volume were Yale, Hartford, the Hospital of Central Connecticut, Middlesex, MidState Medical Center and Lawrence & Memorial, all located in urban areas.

 

Conn. Hospital Faces Squeeze From Budget, Union

Lexington (KY) Herald Leader, Oct. 19

Lawrence + Memorial Hospital in New London, which is losing millions of dollars because of government spending cuts, has another adversary in a union aggressively negotiating contracts for about 800 nurses. Adding to the hospital's difficulties is pressure from Gov. Dannel P. Malloy, who wrote to CEO Bruce Cummings this week, urging him to "take every possible step" to negotiate a new contract before the current agreement expires in November.

L+M, a 280-bed hospital founded in 1912, bought the Westerly Hospital in Westerly, R.I., for $69 million last year and opened a $34.5 million cancer center in Waterford in September with Dana-Farber Community Cancer Care. Yet it faces tight finances because of federal and state health care spending reductions, spokesman Michael O'Farrell said.

Cuts in the most recent budget passed this year by the Connecticut legislature and signed by Malloy will amount to $18 million in two years for L+M, Cummings said. Other spending cuts are part of federal Medicare and Medicaid funding, the extension of Bush-era tax cuts and automatic federal cuts that took effect in March.

In addition, L+M says it and other hospitals are losing revenue with falling patient volume due to the weak economy, fewer employers offering health insurance and a shift to high deductible health plans, forcing beneficiaries to reconsider hospital visits.

The hospital laid off 60 workers in the past year, about 2 percent of its 2,800 employees. The National Labor Relations Board is siding with AFT Connecticut, which represents the registered and licensed practical nurses seeking a new contract, over accusations that the hospital established different medical organizations, or "alter egos," to displace the work of union members. The union accused L+M of using the new medical groups to hire lower paid workers, replacing laid-off employees.

 

Bristol Hospital Opens Women's Center

Hartford Business Journal, Oct. 28

Bristol Hospital has opened its new Beekley Center for Breast Health and Wellness, it said. The Beekley Family Foundation contributed $1 million toward the construction of the 6,100-square-foot facility, which Bristol said offers a spa-like setting. ACG North America Inc. was the design builder of the project.

 

Bridgeport Hospital Ordered to Pay $9.2 Million

ctpost, Oct. 26

A Fairfield woman who walked into Bridgeport Hospital with a urinary tract infection and was discharged 75 days later in a hospital bed was awarded $9.2 million by a jury Friday.

The Superior Court jury of four men and two women deliberated about an hour and a half before finding the hospital's malpractice resulted in 72-year-old Barbara Lathan contracting MRSA, a bacterial infection resistant to most antibiotics. She went into the hospital healthy and came out "wheelchair-bound for the rest of her life," her lawyer, Antonio Ponvert III, said later.

The verdict was one of the largest against a hospital in Connecticut for a malpractice claim. There were 20 incidents of patient death or serious disability resulting from medication errors at Connecticut hospitals between 2005 and 2011, according to the state Department of Public Health. In 2007, the year of Lathan's injury, there was only one such incident recorded with the state.

Medication errors aren't among the most common adverse medical events at state hospitals. Adverse medical events are defined as incidents where a patient dies or is injured as the result of a medical intervention, rather than the underlying medical condition.

The most common adverse events in the state are falls, causing 689 deaths or serious injuries between 2005 and 2011.

 

Saint Francis to open nearly $10 million Women's Center next weekend

Hartford Business Journal, Oct. 23

St. Francis Hospital and Medical Center said its $9.1 million patient center focused on women's health will open Nov. 2.

The 24,500-square-foot Comprehensive Women's Health Center is located on the footprint of the former emergency department.

It will combine services of St. Francis' Comprehensive Breast Health Center, Women's Heart Program, the Department of Obstetrics and Gynecology and the Center for Integrative Medicine.

In some cases, patients will be able to schedule multiple appointments in a single day, St. Francis said.

The center will also offer genetic counseling and testing for women at high risk of hereditary cancers.

"Focused on disease prevention, risk assessments, and wellness, the Comprehensive Women's Health Center demonstrates our ongoing commitment to integrated, coordinated healthcare for women," Christopher M. Dadlez, the hospital's CEO, said in a statement.

 

ESPN Pledges $750K To Connecticut Children's

Hartford Business Journal, Oct. 29

ESPN said its parent Walt Disney Co. has pledged $750,000 to the Connecticut Children's Medical Center Foundation to purchase a pediatric and neonatal intensive ambulance.

The Bristol sports network said the money will also help support the Hartford not-for-profit children's hospital's newly constructed Ambulatory Surgery Center in Farmington.

The foundation also offers pediatric services at St. Mary's Hospital in Waterbury, with neonatal ICUs at Hartford Hospital and the University of Connecticut Health Center.

Hot Topics in Health Care

Should Medical School Last Just 3 Years?

The New York Times, Oct. 24

Sandwiched between three mind-numbing years of basic science courses and hospital rotations and the lockdown years of residency training, the fourth year of medical school has long been a welcome respite for future doctors. It is the only time in their medical education when students have few requirements and a plethora of elective course offerings – and the time to go on vacation and spend time with friends and family.

For several years, medical educators have been engaged in an increasingly heated, and occasionally cantankerous, debate about streamlining medical education and training. Many experts have suggested lopping years off the residency training process, but surprisingly few have argued for such similarly dramatic changes in the medical school curriculum.

Established over a century ago as part of a sweeping change to a chaotic collection of schools, apprenticeships and fly-by-night training programs, the four-year medical school curriculum is the sacred cow of medical education. Like soldiers in lockstep, nearly all medical students over the last 100 years have spent their first two years in lecture halls learning the theory and basic science of medicine and their third and fourth years on the wards learning the practical clinical applications. Apart from a few short-lived experiments during World War II and in the 1970s to shorten the curriculum to three years, not even the most radical of educational reformers have dared stray from the norm, carefully integrating their changes well within the venerated four-year framework.

But now it appears that the perfect storm of physician shortages, rising health care costs and student debt has begun to tip this hallowed heifer.

 

Hospital Errors are Third Leading Cause of Death in U.S.

The Leapfrog Group, Oct. 23

New research estimates up to 440,000 Americans are dying annually from preventable hospital errors. This puts medical errors as the third leading cause of death in the United States, underscoring the need for patients to protect themselves and their families from harm, and for hospitals to make patient safety a priority.

Released today, the Fall 2013 update to The Leapfrog Group (Leapfrog) Hospital Safety Score assigns A, B, C, D and F grades to more than 2,500 U.S. general hospitals. It shows many hospitals are making headway in addressing errors, accidents, injuries and infections that kill or hurt patients, but overall progress is slow. The Hospital Safety Score is calculated under the guidance of the Leapfrog Blue Ribbon Expert Panel, with a fully transparent methodology analyzed in the peer-reviewed Journal of Patient Safety.

Leapfrog, an independent, national nonprofit organization that administers the Score, is an advocate for patient safety nationwide.

“We are burying a population the size of Miami every year from medical errors that can be prevented. A number of hospitals have improved by one or even two grades, indicating hospitals are taking steps toward safer practices, but these efforts aren’t enough,” says Leah Binder, president and CEO of Leapfrog. “During this time of rapid health care transformation, it’s vital that we work together to arm patients with the information they need and tell doctors and hospitals that the time for change is now.”

Coming Events

Nov. 5 (Tuesday)

Update in Urology and Kidney Disease for the PCP

5-8 p.m.

An education event for primary care physicians on updates in the care of the patient with urologic conditions or kidney disease.

Dinner and CME provided. No charge to attend. Angelo's on Main-Rockledge in West Hartford.

Speakers will be urologists and nephrologists from the Tallwood Urology and Kidney Institute.

Registration link.

 

Nov. 7 (Thursday)

8th Annual Interdisciplinary Transplant Symposium

Sheraton Hartford South Hotel in Rocky Hill, 7:45 a.m.-4 p.m.

The Transplant Symposium provides an opportunity for experts in the fields of kidney, liver and heart transplantation to present cutting-edge information to individuals working with transplant recipients and living donors. It also provides an opportunity for individuals interested in transplantation to learn more about this dynamic field.

Registration fees: (Early bird discount through September 30):

  • Hartford HealthCare Employees: $50 ($75 after Oct. 1)
  • Non-Hartford HealthCare Employees: $75 ($100 after Oct. 1)
  • Students: $25 ($50 after Oct. 1)

Participants paying the $100 registration fee may register online at www.harthosp.org/TransplantSymposium. All others should call the Health Referral Service at 860-545-1888 or toll-free 800-545-7664.

For more information, contact Eliz Valentin, Transplant Program, at Eliz.valentin@hhchealth.org or 860-972-4339.

 

Nov. 8 (Friday)

Deadline to get flu shots

 

Nov. 11 (Monday)

Technical Writing for Better Documentation and Communication

5-8 p.m.

Technical Writing for Better Documentation and Communication class will be held Monday, Nov. 11 from 2 – 4p.m. in ERC 3rd floor in the Library Classroom. It is the last offering for 2013.

Hartford Hospital is accredited by the Connecticut State Medical Society to sponsor Continuing Medical Education for Physicians. Hartford Hospital designates this educational activity for a maximum of 2 AMA PRA Category 1 credit (s). Two CME credits are offered for this class. Physicians should claim only credit commensurate with the extent of their participation in the activity.

To register call/email Sheila Hayes at 860-972-2416 or sheila.hayes@hhchealth.org.

 

Nov. 13 (Wednesday)

Comprehensive Epilepsy Center Anniversary Open House

Center 11, Epilepsy Conference Room, 9 a.m.-12 p.m.

The Comprehensive Epilepsy Center is conducting an open house to celebrate its one year anniversary on Wednesday, Nov. 13 from 9 a.m.-12 p.m. in the epilepsy conference room on Center 11. Come and learn more about epilepsy and our 6 bed Epilepsy Monitoring Unit. Beverages and snacks will be served.

 

November 21 (Thursday)

Annual Meeting of the Hartford Hospital Corporators

Heublein Hall, 11:45 a.m.-2 p.m.

 

November 21 (Thursday)

Semi-Annual Meeting of Medical Staff

Gilman Auditorium, 6:45 a.m.

 

December 4 (Wednesday)

Hartford Hospital Staff Holiday Party

 

January 25, 2014 (Saturday)

Black & Red

Bushnell Center for the Performing Arts, 6 p.m.

Featuring the music of Barenaked Ladies.

 

 

 

For more coming events, click here.

The Seymour Street Journal (SSJ) has been developed to communicate key messages pertinent to our hospital's physicians. It will keep you informed and up-to-date on hospital, network, and health care news in a concise, convenient format. The SSJ will be sent to your preferred e-mail address every other Sunday. If you would like to be added to the Seymour Street Journal email list, or to receive it at a different email address, please opt-in at www.harthosp.org/SSJ. This ensures that you will receive the newsletter at your preferred email address. Back issues can be viewed here. For any questions or suggestions, please contact Dr. Jeffry Nestler, Medical Staff President, at (860) 836-7313.