From the Offices of Stuart Markowitz, MD and Stacy Nerenstone, MD

 

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In This Issue...

April 27, 2014 Edition

HAND HYGIENE
Wash In - Wash Out

Wash

Hartford Hospital has held relatively steady with hand-hygiene compliance, achieving an 82 percent compliance rate last month. This is almost at the level of best practice.

This is strong progress, but it is not, and should not, be good enough for Hartford Hospital.

We have plateaued and are increasing our efforts to improve. Although our goal for this year is 90 percent, we will not be satisfied until we reach 100 percent compliance, so we still have work to do.

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HH Facts and Firsts:

2003: New England’s first hospital-based 10-person hyperbaric chamber was installed in Hartford Hospital’s new Wound Center.

 


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Chief's Corner

GreeneWelcome 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

High Reliability Training Sessions for Physicians

As you know, we are on a journey to become a high reliability organization, with an overall goal to have no episodes of preventable harm to our patients. The staff is in the midst of their training sessions and we are ready to roll out the physician training.

This journey cannot be successful without the participation of the medical staff. The goal of zero harm to our patients is so important that the MEC voted to make participation a requirement for reappointment for all active staff (except those in the refer and follow category.) The next set of reappointments will occur in December.  

The goal is that all physicians who actively care for patients in a Hartford HealthCare facility will participate.

There is evidence that this program works. Hospitals that have embraced this program have seen their Serious Safety events decline by up to 80%. Last year, a number of participating hospitals had ZERO cases of preventable harm. This is our goal and our patients deserve this attention to safety.

The training session is 90 minutes long and facilitated by your physician colleagues. Initial training sessions have been scheduled. We will also provide other sessions at times which are most convenient.

The initial sessions for physician training in high reliability are scheduled. We will be adding additional classes as requested.

All providers who go into the hospital should plan on taking the 90-minute course. Send email to Marybeth.Scanlon@hhchealth.org to register .

Sessions will be held in Jefferson Building 118. The initial schedule is as follows:

• Tuesday, May 6: 6:45-8:15 a.m.

• Wednesday, May 7: 5:30-7 p.m.

• Tuesday, June 3: 6:45-8:15 a.m.

• Wednesday, June 4: 5:30-7 p.m.

• Tuesday, July 8: 6:45-8:15 a.m.

• Wednesday, July 9: 5:30-7 p.m.

• Wednesday, August 13: 6:45-8:15 a.m.

• Thursday, August 14: 5:30-7 p.m.

 

 

Department of Medicine's Adult Cystic Fibrosis Center at Hartford Hospital

GreeneGreene GreeneLeft to right: Dr. John McArdle, Dr. Sam Pope, and Dr. Rick Knauft, Adult Cystic Fibrosis Center

The Department of Medicine’s Adult Cystic Fibrosis Center at Hartford Hospital works in collaboration with Connecticut Children’s Medical Center to comprise the Central Connecticut Cystic Fibrosis Center (CCCFC).

Historically, all cystic fibrosis patients were admitted to a pediatric setting. But due to the increase in the number of patients, life expectancy, the need for adult-specific services and a mandate by the Cystic Fibrosis Foundation, a partnership between HH and CCMC ensued.

Cystic fibrosis is an inherited chronic disease affecting over 30,000 individuals in the United States. It has classically been a progressive, fatal condition characterized by respiratory failure, malnutrition, liver disease, diabetes, and a host of other organ specific abnormalities causing altered longevity and quality of life. More than 1,000 new cases of CF are diagnosed yearly in the United States. Through the work of the CFF and the CF centers nationwide, the prognosis for individuals with the disease has changed from a death sentence by elementary school in 1950 to a life expectancy of more than 37 years today.

The Adult Cystic Fibrosis Center at Hartford Hospital has been committed to a seamless transition from pediatric to adult care, continuous quality improvement, and adherence to established standards of medical therapy. The Central Connecticut Cystic Fibrosis Center at Hartford Hospital is comprised of a multidisciplinary team dedicated to providing exemplary CF care through integration of education and research. The center today has grown to serve 100 patients.

The essential elements and building blocks of excellence in patient care and nursing are evidenced by the attainment of accreditation from the nationally recognized Cystic Fibrosis Foundation in 1996. The outpatient clinic was accredited by the CFF in 2006 and received re accreditation in 2013. The center is one of 117 centers nationally accredited by this prestigious foundation.

Persons with CF require an extensive regimen of medication and care to survive. Treatments range from a litany of inhaled therapies including antibiotics and mucous thinning agents to pancreatic enzyme replacement with meals; vitamin and hormone supplements to treat deficiencies, insulin for CF related diabetes and many nonspecific airway clearance therapies and dietary restrictions.

Frequent hospitalization and ultimately lung transplantation are often necessary as the disease progresses. Caring for a CF patient is a complicated and often very difficult matter. It requires attention to all aspects of the person’s life and can only be accomplished with a robust multi-disciplinary model.

The multidisciplinary team staffing the center includes:

Dr. Sam Pope and Dr. John McArdle: co-directors

Dr. Rick Knauft: associate director

Dee Rendock, APRN: clinical coordinator

Allison Morreau, RRT: clinic coordinator

Erin Paice, RD: Dietician

Jenifer Ash, APRN: Department of Medicine

Evelyn Williams: Medical administrative assistant

*Amy Mueller, MSW: Social Worker

*Amy Mueller, the social worker from the Adult Cystic Fibrosis Program, recently traveled to Italy as she has been accepted onto the committee for the development of guidelines for depression and anxiety screening and treatment in patients with CF. This is a joint North American and European committee.

Top News

New Policy: Discharge Summary MUST Be Completed in Two Days

In order to provide coordinated care across the continuum for our patients, timeliness of discharge summaries about the hospital episode of care is paramount.

Our goal is to have these discharge summaries completed within 24 hours of patient discharge.

The MEC has approved a new policy that discharge summaries MUST be completed within two business days. Noncompliance with the policy will lead to suspension, starting this Thursday, May 1.

 

Medical Staff Leaders Serving on Campaign Steering Committee

The Hartford Hospital Board of Directors has established a steering committee for a campaign to raise funds for building and program enhancements that will position the hospital for a vital future in a rapidly changing health care environment.

The enhancements will reach into many areas of the hospital, greatly reinforcing existing centers of excellence and creating new centers of clinical prominence.

Anchoring this transformational, multiyear initiative is the $130 million Hartford HealthCare Bone & Joint Institute.

Philanthropist and corporate leader Geo Estes is serving as chair of the steering committee and the campaign.

Serving with him on the committee of 17 individuals are the following members of the Medical Staff: Dr. Stuart Markowitz, Dr. Stacy Nerenstone, Dr. Jeffry Nestler, and Dr. Hank Schwartz.

The committee will work over the next 12 to 18 months to secure gifts through the campaign’s “lead phase.”

 

Watch For A Physician Engagement Survey

Be on the lookout for a 30-second RED Cap survey about physician engagement that will be sent out soon. (RED Cap is a secure web app that is designed exclusively to support data capture for research studies.)

Please take half a minute to complete the survey to help us better respond to your needs.

 

March Finances: The Good and the Bad

Inpatient volumes based on discharges for the month of March were (1.8%) below budget. The comparison to the prior year shows March, 2014 discharges approximately 3.2% above the prior year.

Outpatient revenues were on budget for the month. Unfavorable outpatient revenue variances in Radiation Oncology and Psychiatric outpatient services were offset by the favorable variances in Cardiology, Radiology and Emergency services.

Through the first six months of fiscal year 2014, inpatient discharges were below budget by (0.2%) and were 1.1% greater than the prior fiscal year. Outpatient revenues were 4.9% above budget for the six months ending March 2014.

Year to date, the favorable outpatient revenue variances continue to be in Perioperative services, Radiology, Cardiology, Emergency services and Laboratory services.

 

Stop the Stigma of Mental Illness

We are asking all HHC medical staff to take a pledge and sign their name to the following:

  • I pledge: To teach by sharing my own experiences with mental illness and encouraging others to share their stories with me; I will learn in order to change.
  • I pledge: To show compassion by reaching out to those in need of help; I will not let anyone suffer in silence.
  • I pledge: To have the courage to speak up and challenge stereotypes and attitudes; I will not tolerate or perpetuate stigma.
  • I pledge: To demand a change in how we view and address mental illness; I will help lead the way.

The goal is to obtain 10,000 individual pledges, spreading the message that changing attitudes can begin to change minds. So far, more than 8,000 have taken the pledge.

Ask everyone — fellow employees, volunteers, patients, the community — to “take a pledge.” It is online now at www.StopTheStigmaCT.org.

Excellence

Drs. Fernandez and Thompson Publish Editorial in Circulation

Drs. Antonio Fernandez and Paul Thompson have published an editorial in the American Heart Association's journal Circulation. It is called "Detection of Cardiac Abnormalities in Elite Black and White Athletes Still Not Black and White." Read it here.

 

Dr. Jim Cardon To Speak at Power Breakfast

Dr. Jim Cardon, HHC's chief clinical integration officer, will be a featured speaker at a Hartford Business Journal Power Breakfast on May 14 from 7:30-10 a.m. at the Society Room, 31 Pratt Street in Hartford. The session is called Health Care Innovation: Where is the state's healthcare industry headed and how will it impact employers?

Also speaking are Mark Schaefer, director of healthcare innovation for the State of Connecticut, and Paul Grady, partner, Mercer.

Tickets are $45. Register here.

 

 

Our Physicians Are Great Sources For Local Media

Dr. Hillary Hernandez-Trujillo was interviewed by NBC-CT and WNPR on April 16 about the allergy season.

Dr. Kelly Johnson-Arbor was interviewed on News 8 and NBC CT on April 21 about a teenager transferred here from four hours away to be treated in the hyperbaric chamber. Watch it here.

Dr. Johnson-Arbor was also interviewed on Channel 3 on April 21 about the dangers of children mistakenly eating laundry balls as candy.

Academics and Research

Surgical Resident Research Day

The 4th Annual UConn School of Medicine Department of Surgery Resident Research Day will be held on Friday, May 23 from 8 a.m. to 12 noon in Gilman Auditorium.

 

25th Annual Mary Mulready Sullivan Oncology Symposium: Advances in Breast Cancer May 14

The 25th Annual Mary Mulready Sullivan Oncology Symposium, Advances in Breast Cancer: Treatment and Survivorship, will be held Wednesday, May 14 from 7:15 a.m. to 1:45 p.m. in the ERC.

Faculty members from Hartford Hospital are Dr. Jennifer Logan; Dr. Andrew Ricci, and Sara Carroll, MS.

Faculty members from other locations are Larry Norton, Memorial Sloan-Kettering Cancer Center; Dr. Maura Dickler, Memorial Hospital for Cancer & Allied Diseases; Dr. Lisa Sclafani, Memorial Sloan-Kettering Cancer Center; Dr. Beryl McCormick, Memorial Hospital; Mary Schwarz McCabe, RN, Memorial Sloan-Kettering Cancer Center.

Fee is $50 for physicians and $20 for non-physicians, which includes lunch. Registration deadline is May 5. For more information, contact Sandi Beggs at 860-545-2390 or email sandi.beggs@hhchealth.org.

 

7th Annual Neil J. Grey, M.D. Memorial Lecture in Diabetes May 22

The 7th Annual Neil J. Grey, M.D. Memorial Lecture in Diabetes will be held on Thursday, May 22 from 12-1 p.m. in Gilman Auditorium.

A joint grand rounds with Neurology and Medicine, the lecture will be delivered by internationally renowned researcher in diabetes, Aaron I. Vinik, MD, PhD. The topic will be “Current State of Diabetic Neuropathies.”

One of the leading diabetes researchers in the world, Dr. Vinik is key in the Strelitz Diabetes Center’s quest to cure diabetes. His focus of attention is the prevention and reversal of diabetic neuropathy.

 

Stroke Center Presents Symposium on Spontaneous Intracerebral Hemorrhage May 30

Hartford Hospital's Stroke Center presents a one-day symposium called Spontaneous Intracerebral Hemorrhage: Are We Making An Impact on Outcome? on Friday, May 30 from 7 a.m. to 4:30 p.m. in Heublein Hall.

It is designed to update generalists and specialists alike on state-of-the-art treatments that are now a part of mainstream care.

The visiting professor lecture on New Clinical Trials for ICH will be delivered by Dr. Daniel Hanley from Johns Hopkins University.

Speakers will be Drs. Lauren Sansing, Sanjay Mittal, Catherine Hosley, Isaac Silverman, Robert Brown and Martin Ollenschleger.

For more information or registration, please visit www.harthosp.org/event/607

Enhancing The Patient Experience

Voices of Our Patients: Kudos To Dr. Anne Lally

Dr. Sheiner,
Having had three major operations in the past 10 years, I recognize staff exceptionalism when I see it.

During my small bowel obstruction surgery in March, I was in the skilled hands of Dr. Anne Lally, who I found to be upbeat and direct, yet listened patiently answering all the family’s questions --- attributes that I personally appreciated.

Others on your Transplant team also stood out, most notably the nurses. They simply couldn’t do enough. Their passion and caring made up for the inexperience of youth. Also, Shannon, a PA, was especially helpful in describing procedures.

How fortunate you are to have (transplant clinical coordinator) John McNab, the consummate professional. I found his calming manner, knowledge, advice and sincerity an immeasurable comfort. Maybe it was my gray hair or enthusiasm for golf that helped build our rapport. Whatever it was, I felt that during this difficult period, I might have even made a new friend. And what better service can Hartford Hospital offer than friendship?

Lastly, a suggestion for other post surgery patients. Since walking is an important part of a faster recovery, I find it so much easier on the body to walk at a children’s play ground where the flooring is rubberized (it gives) as opposed to (no give) amosite or concrete.

Cordially,
J.P.

Operational Update

High Reliability Training Sessions for Physicians

Sessions for physician training in high reliability training are being scheduled. All doctors who go into the hospital should plan on taking the 90-minute course.

Pick a time today! Email Marybeth Scanlon (Marybeth.Scanlon@hhchealth.org) to register.

Sessions will be held in Jefferson Building 118. The initial schedule is as follows:

  • Tuesday, May 6 – 6:45-8:15 a.m.
  • Wednesday, May 7 – 5:30-7 p.m.

  • Tuesday, June 3 – 6:45-8:15 a.m.
  • Wednesday, June 4 – 5:30-7 p.m.

  • Tuesday, July 8 – 6:45-8:15 a.m.
  • Wednesday, July 9 – 5:30-7 p.m.

  • Wednesday, August 13 – 6:45-8:15 a.m.
  • Thursday, August 14 – 5:30-7 p.m.

 

Please Take This Brief Survey: Center For Global Health

Please take this brief survey to help us identify the global health activities of our physicians, clinicians, and staff, as well as your interest in participating in future opportunities.

We are developing a Center for Global Health at Hartford Hospital in order to identify our footprint, create value, establish lasting partnerships, and strengthen our opportunity to provide world-wide impact.

Integration and coordination of current HH activities will promote collaboration; improving cost-effectiveness and sustainability, both domestically and abroad.

Survey results will be used in the development of Hartford Hospital's first global health database.

To participate in this 5-minute survey please click here. (https://redcap.harthosp.org/surveys/?s=Dbb8n9HJv3)

 

CareConnect Validation Sessions Focus on Workflows

Experts from across Hartford HealthCare returned to the Farmington Marriott late last month for the second of three CareConnect validation sessions scheduled through early May. The event - held March 31-April 2 - is actually a series of short sessions scheduled over the course of the three days, each focused on specific activities, or workflows, ranging from wound care to lab patient registration and provider billing.

Working with partners from Epic, our subject matter experts, or SMEs, provided feedback on a series of statements aligned to the ways we deliver care.  After each statement, or validation point, SMEs held up a green card to agree with, or validate, the statement or a red card, if they did not agree.

The CareConnect team uses the feedback to make adjustments that will insure the system is built appropriately and able to support our organizational goals. Tom Lahman, a program advisor with CareConnect, compared the process to the interaction between an architect and builder as they prepare to start building a house.

The homeowner tells the architect what feature they want and the builder pushes back and says “you can’t do that without doing this,” Lahman explained.  

“The architect would be Epic and the builder is all the SMEs,” he said. “CareConnect  [team analysts]  then take those suggestions and start building out the system. “

HHC is transforming care by using the Epic electronic health record tool to improve how we collect, share and track health information. The common, best-practice workflows coming out of the validation sessions with Epic will promote consistently better care and a great patient experience. It will also allow HHC to lead in the new health care environment.

Many of the SMEs at this session also took part in the first one in early March. SMEs are invited to participate because they are knowledgeable in their areas and the workflows associated with them.

Reaction coming out of the sessions was positive.

“I like the way they are getting input from every one so that the system works right,” said Amanda Bill, a critical care nurse at Windham Hospital.

“It’s nice to know they are taking our opinion into account,” added Jamie Sharron, another critical care nurse from Windham and Bill’s colleague.

Jamaica Mack, a revenue cycle consultant at Hartford Hospital, called the sessions, very helpful.

“There are a lot of questions still to be answered but the content being provided allows for that discussion,” said Mack.

The third and final validation session is scheduled May 5-7 at the Farmington Marriott.

 

Learn More About Retirement Saving With Prudential

General information meetings with representatives from Prudential are being offered throughout HHC through May, to cover how to manage your account on the web or by phone. Tools to help plan your retirement savings and investment strategy also will be introduced.

These one-hour meetings will provide a broad overview of Prudential’s products and services. In the future, there will be opportunities to get more personalized information specific to your plan and your situation.

You are invited to attend any session at any convenient location, regardless of where you work. Or, for your convenience, log into one of the webinars right from our desk.

Visit the HHC & Me Employee Service Center website for the most up-to-date schedule and information.

Read our Employee Guide FAQs about Retirement Savings with Prudential here.

 

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.

 

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.

 

ICD-10 Implementation Delayed At Least a Year

As you may have heard, the scheduled conversion to ICD-10 has been delayed from October 1, 2014 to at least October 1, 2015.

We are proceeding with our planned preparation schedule. The additional year will give us more time for training and testing.

We will update you as more information becomes available.

Check out the ICD-10 resources for physicians we have placed on our SharePoint site: https://myhhc.hhchealth.org/hhcProjects/icd10/info
E-mail questions to
ICD10.info@hhchealth.org

 

 

Save These Dates:

 

Medical Staff Spring Event - May 22

The Board of Directors and Medical Staff Spring Event will be held Thursday, May 22, starting at 6 p.m. with a cocktail hour in Heublein Hall at the ERC.

The awards ceremony will begin at 7 p.m. We will be presenting awards to .

 

Valedictory Grand Rounds With Dr. AJ Smally - June 19

Dr. AJ Smally, medical director of the Emergency Department, will be giving his Valedictory Grand Rounds on Thursday, June 19 at 12 noon in Gilman Auditorium. The occasion is his Imminent retirement after 27 years of service at Hartford Hospital. The topic will be: “A Quarter Century plus of Emergency Medicine at Hartford Hospital.”

 

3rd Annual Medical Staff Chef to Farm Dinner - June 20

You and your guest are invited to join the Officers and other members of the Hartford Hospital Medical Staff for this special evening – celebrating the beauty and abundant bounty of our local farms – as a unique opportunity for members of the Medical Staff to socialize and enjoy each other’s company.

Friday, June 20; Rosedale Farms, 25 East Weatogue Street, Simsbury. $100 per person.

Did You Know?

Supply Cost Stats

Hartford Hospital is the first acute care center in the country to have created a risk sharing agreement with Siemens for scanning equipment, saving an average of $20,000 per machine per year in service costs.

Medical Staff Quality Corner

Quality Management Collaborates with HIM For Concurrent Review of Complications

The Quality Management Department and the Clinical Documentation Management Program (CDMP) are collaborating to identify opportunities to assure appropriate reflection of patient outcomes and validate complete and compliant clinical documentation in the medical record.

This will enable accurate reporting of patient outcomes (including Patient Safety Indicators and any hospital acquired conditions), ensure proper and compliant coding of clinically supported diagnoses, and confirm the appropriate severity of illness of our patient population.

The Patient Safety Indicators (PSIs), set forth by the Agency for Healthcare Research and Quality, are a set of indicators providing information on potential in-hospital complications and adverse events following surgeries, procedures, and childbirth.

The Patient Safety Indicators include (but are not limited to): death in low mortality DRGs, pressure ulcers, death in surgical patients with treatable complications, Iatrogenic pneumothorax, central line associated bloodstream infections, post-op hemorrhage or hematoma, post-op respiratory failure, post-op PE or DVT, post-op sepsis, accidental puncture or laceration.

The PSIs were developed after a comprehensive literature review, analysis of ICD-9-CM codes, review by a clinician panel, implementation of risk adjustment, and empirical analyses.

The PSIs, which are publicly reported, can be used to help hospitals identify potential adverse events that might need further study; provide the opportunity to assess the incidence of adverse events and in hospital complications using administrative data found in the typical discharge record; include indicators for complications occurring in hospital that may represent patient safety events; and have area level analogs designed to detect patient safety events on a regional level.

In the coming weeks, we will be using Seymour Street Journal as a means to disseminate educational information regarding the PSIs. Members of the quality team may reach out to you to discuss particular patient case reviews. Should you have any questions in the meantime, feel free to contact Laura Kushner, director of quality, at 860-545-3322.

HH In the News

New Duncaster Center for Adult Primary Care Pioneers a New Wellness Approach

Hartford Courant, April 16

Duncaster Retirement Community is pioneering a unique approach to wellness and preventive health care, taking its collaboration with Hartford Hospital to a new level.

The new Duncaster Center for Adult Primary Care is the first of its kind in a continuing care, retirement community in the region. Together, Duncaster Retirement Community and Hartford Hospital will be offering primary medical care to members of the local community ages 50 and older, whether or not they live at Duncaster. In national studies, this kind of integrated relationship has proven to lead to a marked reduction in hospitalizations and more satisfied patients.

The Duncaster Center for Adult Primary Care will provide all patients of the Center services from board-certified geriatricians and advanced practice registered nurses (APRN) with geriatric care certification.

Read more here.

 

Almost Half of Regions' Hospitals Post Red Ink in FY'13

Hartford Business Journal, April 21

The state's chief hospital lobby announced last month that the industry shed 1,400 jobs and saw their collective operating income fall by $175 million in 2013 thanks to Medicare and state funding cuts as well as a new provider tax.

Now, new data posted by the state Office of Health Care Access, sheds light on which hospitals were the biggest losers.

In Greater Hartford, nearly half of the region's hospitals posted operating deficits in fiscal 2013, led by a $10.5 million operating loss by Connecticut Children's Medical Center. In fiscal 2012, Connecticut Children's operating loss was far lower: $688,420.

Windham Hospital, which operates under the Hartford HealthCare banner, had the second largest operating deficit in the region at $8.8 million, followed by Hartford, UConn's John Dempsey, and Johnson Memorial hospitals, which saw operating losses of $4.9 million, $4 million, and $3.2 million, respectively.

Hartford Hospital's $4.9 million loss represented the largest performance swing; a year earlier it had an operating surplus of $52 million.

Across the state, Connecticut's 29 acute care hospitals had a combined 3.28 percent operating margin, down from 4.81 percent a year earlier.

Read more here.

 

Consumer Engagement Needed to Keep Changing Hospital Landscape in Focus

Health Square, April 22

The landscape of Connecticut’s hospitals is shifting rapidly. This change is happening on a number of fronts, but we are seeing three main trends:

1. Mergers, through which multiple hospitals consolidate (one example is Hartford Hospital bringing four hospitals – Windham, Midstate Medical Center, The Hospital of Central CT and Backus; and, three mental health facilities – Institute of Living, Natchaug Hospital and Rushford under the Hartford Healthcare banner).

2. Hospital acquisition of medical practices, which is happening throughout the state and raising questions of physician autonomy, billing practices and patient choice.

3. Proposed for-profit, national hospital network takeovers of nonprofit, community hospitals, such as Tenet Healthcare’s bid to acquire Waterbury, Bristol, Manchester and Rockville hospitals.

The state legislature is considering a few bills that address part, but not all, of the challenges our state faces regarding hospitals. What legislators do before the session ends on May 7 will likely leave the door open for continued uncertainty.

One thing we can be sure of is that all the stakeholders should be engaged in a discussion regarding the future of hospitals in Connecticut. And, that discussion should not just be about the bottom line or saving hospitals – but also about how we want our health care system to evolve to focus on the best patient care, improving health and slowing costs.

Read more here.

In the HHC System

Rushford Doctors Receive Prevention Award

Middletown Press, April 14

Rushford’s addiction medicine fellow Brian Murray, MD, and fellowship director Samuel Silverman, MD, FAPA, FASAM, have been selected by the American Board of Addiction Medicine (ABAM) Foundation to receive the Next Generation Award for Adolescent Substance Use Prevention.

“This award speaks volumes not only about Dr. Silverman’s leadership, but also about the potential of the Rushford fellowship program to influence the next generation of addiction providers like Dr. Murray,” said Stephen W. Larcen, Rushford President and Senior Vice President of the Hartford HealthCare (HHC) Behavioral Health Network (BHN), in a written statement announcing the awards. “We are very thankful to the ABAM Foundation for its support.”

The award, made possible by funding from the Conrad N. Hilton Foundation, recognizes addiction medicine fellows whose achievements and career plans distinguish them as emerging leaders in the field of addiction medicine.

Read more here.

 

Bradley Hospital Continues To Serve Southington Despite Internal Changes

My Record Journal, April 16

Despite plans to close the in-patient unit, Hospital of Central Connecticut officials say emergency care services at Bradley Memorial will remain and be available at all hours.

Plans to close the unit, predicated on approval from the state, were announced to employees last week. The Bradley campus in-patient unit, containing a maximum of 40 beds, will be reduced to 15 beds for the next year to match decreased volume.

Nancy Kroeber, Hospital of Central Connecticut operations president, said hospital officials will spend the year determining what will be done with the space occupied by the in-patient unit.

Read more here.

 

Experts Discuss Protecting Kids From Dangers in Digital Age

The Day, April 18

Before giving their children their own cell phones, access to the Internet and video games, parents should develop a media plan, set time limits for use and establish rules their children will be expected to follow or risk losing the privilege.

That was one of the recommendations made by Dr. Paul Weigle, Natchaug Hospital psychiatrist and expert on video game and Internet addiction, during a forum Thursday titled "iSafety: Protecting Kids in the Digital Age."

Read more here.

Health Care News In the Region

For-Profit Hospitals Bill Moves Forward

Hartford Courant, April 15

A bill that would restrict conversions of hospitals from non-profit to for profit is moving forward in the legislature.

The Office of Legislative Research completed an analysis of the bill last week, clearing it to go to the Senate for a vote, although it may not come up before the end of the legislative session May 7.

The bill, voted out of the public health committee last month, would also put an outright ban on any hospitals converting to for-profit status after Oct. 1 of this year.

The bill most immediately affects the proposal for a merger between Waterbury Hospital and Tenet Healthcare Corp., a Dallas-based for-profit organization. Bristol Hospital and Eastern Connecticut Health Network are also in merger talks with Tenet. Yale-New Haven Health System has signed a partnership with Tenet, but no regulatory approvals were needed because both will remain separate entities.

Read more here.

 

Attorney General Issues Report In Push For Transparency in Hospital Bills

Hartford Courant, April 16

With the release of a report on the impact of hospital facility fees, Attorney General George Jepsen urged state lawmakers to pass two bills designed to clarify hospital billing practices.

Since last year, Jepsen has been calling for greater transparency in how hospitals charge patients, particularly in regard to facility fees — charges that he says often take patients by surprise. He has drafted two bills addressing the matter. House Bill 5337 is designed to increase transparency in how hospitals bill patients. The other, Senate Bill 35, would require that hospitals and private physicians notify the attorney general's office when the two merge.

Independent physicians are "are more likely than ever" to sell their practices to hospitals because of the many changes in the health care field, according to Jepsen's report. Selling their practices to hospitals means that physicians don't have to bear the brunt of higher malpractice premiums or the costs of health insurance for their staffs.

Read more here.

 

Farmington startup draws attention for its breast cancer research

The CT Day, April 17

A stone's throw away from the newly designated biotech incubator on Pfizer Inc.'s campus, about 50 scientists gathered Wednesday to hear the story of a startup company from Farmington that is making waves in breast cancer research.

Marcia Fournier, who relocated Bioarray Therapeutics from Massachusetts to incubator space at the University of Connecticut Health Center, said she now has clinical evidence showing the effectiveness of a diagnostic test her company developed. The test, she said during a presentation at Pfizer's main research building, can determine whether a specific person will likely see positive results from traditional breast cancer therapy.

More than three-quarters of patients traditionally fail to respond to the usual first-line treatment, wasting precious time and money, she said. By using her company's diagnostic test, Fournier said, the percentage of breast cancer patients who were unresponsive to treatment was cut by more than half.

Read more here.

 

Lawmakers, Officials Meet in Waterbury to Discuss Combatting CT's Heroin Problem

New Haven Register, April 17

Gathered in a circle at City Hall Thursday morning, 11 mental health, medical and law enforcement professionals from around the state shared ideas about how to combat Connecticut’s growing heroin problem as U.S. Rep. Elizabeth Esty, D-5, moderated.

In 2013, 257 state residents died from heroin overdoses—47 percent more than in 2012.

At least eight of those confirmed deaths occurred in Torrington, with two deaths confirmed so far in 2014. According to the latest available figures from the state’s medical examiner, 33 people died of heroin-involved intoxication in January, a sharp increase from the 19 who died the same month in 2013.

Read more here.

 

Tenet Discloses Compensation for Executives

Journal Inquirer, April 17

The top five executives at Tenet Healthcare Corp., the for-profit hospital chain poised to buy Eastern Connecticut Health Network, collected a total of $31 million in compensation in 2013, the Texas company has told its stockholders.

Tenet says that last year it also paid a total of $2.9 million in cash and stock awards to the nine members of its board of directors, including nearly $300,000 to John Ellis “Jeb” Bush, the former governor of Florida and potential Republican presidential candidate in 2016.

The company made the disclosures in a 142-page proxy statement inviting shareholders to its annual meeting next month in Dallas.

Tenet's CEO and president, Trevor Fetter, was its most richly rewarded official in 2013, collecting $22.7 million in cash, stock awards, “option awards,” and incentive compensation.

Ranked second on the compensation chart was Tenet’s president of hospital operations, Britt T. Reynolds, at $3.4 million, followed by Daniel J. Cancelmi, its chief financial officer, at $3.1 million.

The company’s vice chairman, Keith B. Pitts, collected $2.6 million and its senior vice president and general counsel, Audrey F. Andrews, $1.4 million.

A second Tenet director also is associated two other companies in Connecticut, where Tenet is seeking to purchase not only ECHN’s Manchester Memorial and Rockville General hospitals but also Waterbury and Bristol hospitals. She is Karen M. Garrison, 65, the former president of a Stamford Pitney Bowes Inc. division who now serves as a director at the Kaman Corp. in Bloomfield.

Fetter in a letter to stockholders included in the proxy said Tenet has made “substantial progress in virtually all sectors of our business, despite a challenging environment that affected inpatient volumes across the entire hospital industry.”

He trumpeted Tenet’s acquisition of Vanguard Health Systems, the smaller Tennessee hospital chain that made the initial bid for ECHN, as well as gains made by Tenet’s Conifer Health Solutions unit, which had become an industry leader in “hospital revenue cycle management, value-based care, and patient communications.”

The CEO said the outpatient business at Tenet — which includes 189 outpatient centers — “exceeded our performance goals.” But he also said that in Tenet’s hospital operations inpatient volumes “remained soft overall,” although “our emergency departments showed strong performance.”

 

Sen. Cassano Backs Hospital Buyout Plans

Journal Inquirer, April 19

Manchester’s state senator says the legislature shouldn’t pass any laws that would impede a for-profit company’s plan to buy Manchester Memorial and Rockville General hospitals.

Sen. Stephen T. Cassano, a Democrat, says that without the support of a for-profit company, he fears the hospitals will close.

“They cannot continue to afford to go at the rate they are going today. And this region cannot afford to lose them,” Cassano said in an interview this week.

Lawmakers are considering proposals aimed at protecting workers at four hospitals, including Manchester Memorial and Rockville General in Vernon, which are owned by Eastern Connecticut Health Network. The ECHN facilities, along with Bristol and Waterbury hospitals, are in the process of being bought by for-profit Tenet Healthcare Corp. of Texas.

ECHN officials maintain the Tenet buyout would enable the hospitals to access money for equipment and keep up with the latest trends in medicine.

Read more here.

 

Courtagen Collaborates with CCMC to Identify Alterations in Genes Associated With ASD

News Medical, April 23

Courtagen Life Sciences, Inc., an innovative molecular information company, announced today a collaboration with Connecticut Children's Medical Center to utilize Courtagen's sophisticated Next Generation Sequencing assays to help identify and characterize alterations found in genes associated with ASD.

"Our study will look at the association between specific genetic changes and phenotypes in children diagnosed with autism in our Autism Spectrum Assessment Program (ASAP) and Autism Neurogenetics Clinic," said Louisa Kalsner, MD, Pediatric Neurologist at CCMC.

Read more here.

Hot Topics in Health Care

15-Minute Visits Take a Toll On The Doctor-Patient Relationship

Kaiser Health News, April 21

Patients – and physicians – say they feel the time crunch as never before as doctors rush through appointments as if on roller skates to see more patients and perform more procedures to make up for flat or declining reimbursements.

It’s not unusual for primary care doctors’ appointments to be scheduled at 15-minute intervals. Some physicians who work for hospitals say they’ve been asked to see patients every 11 minutes.

And the problem may worsen as millions of consumers who gained health coverage through the Affordable Care Act begin to seek care — some of whom may have seen doctors rarely, if at all, and have a slew of untreated problems.

Read more here.

 

Docs Should Go With the Flow

Hospitals and Health Networks Daily, April 23

It seems inevitable that nurse practitioners and physician assistants, and similar providers, are going to expand their scope, so why are doctors fighting that?

The role of the physician in health care is undergoing a major change, and fighting that change too hard likely is a waste of time.

Physicians are going to lose some of their autonomy and may take a hit in compensation, mainly as a result of the juggernaut known as health care reform.

But those health care forces are virtually impossible to stop for now, so physicians can fight over every last scrap of the shrinking health care pie or, instead, can help figure out how to bake a better pie.

I'm thinking in particular of the current situation in which some physicians are opposing greater autonomy for advanced practice nurses and other similar providers, while at the same time others are lamenting that physicians are miserable, leaving the field in droves and deserving of empathy.

But that doesn't change the fact that if physicians are overworked, it would at the very least be an option for consideration to make greater use of nurse practitioners and their kind to fill in the gaps.

Read more here.

Coming Events

May 1 (Thursday)

Medicine Grand Rounds

Gilman Auditorium, 8 a.m.

Topic: Thrombosis in Cancer: What have we learned in 150 years since Trousseau?

Speaker: Dr. Gerald Soff, chief of Hematology at Sloan-Kettering Cancer Center

 

May 6 (Tuesday)

High Reliability Training Session for Physicians

JB-118, 6:45-8:15 a.m.

 

May 7 (Wednesday)

High Reliability Training Session for Physicians

JB-118, 5:30-7 p.m.

 

May 13 (Tuesday)

Kidney Stones Seminar

Glastonbury Pond House Grill, 5:30 p.m.

Hartford Hospital’s Tallwood Urology & Kidney Cancer Institute is providing free educational seminars for primary care providers. Each session will provide 2 CMEs and dinner. They will be held from 5:30-8:30 p.m., at the Glastonbury Pond House Grill. Advance registration is required; contact the Health Referral Service at 860-545-1888. For more information, contact Jan Ruderman at 860-817-5300.

Speakers: Drs. Jeffrey Morgenstern and  Jarrod Post.The session will focus on the identification and management of stone disease as well as the role of the PCP, urologist and nephrologist in caring for patients with kidney stones.

 

May 22 (Thursday)

The Board of Directors and Medical Staff Spring Event

Heublein Hall at the ERC, 6 p.m.

A cocktail hour begins at 6 p.m. The awards ceremony will begin at 7 p.m.This year we will present five awards: the Physician in Philanthropy Award; the Distinguished Service Award; the David Hull, MD, Young Practitioner Award; the John K. Springer Humanitarian Award; and the Quality and Safety Award.

 

May 30 (Friday)

Stroke Center Presents Spontaneous Intracerebral Hemorrhage Symposium

Heublein Hall at the ERC, 7 a.m.-4:30 p.m.

Hartford Hospital's Stroke Center presents a one-day symposium called Spontaneous Intracerebral Hemorrhage: Are We Making An Impact on Outcome? on Friday, May 30 from 7 a.m. to 4:30 p.m. in Heublein Hall.

It is designed to update generalists and specialists alike on state-of-the-art treatments that are now a part of mainstream care.

The visiting professor lecture on New Clinical Trials for ICH will be delivered by Dr. Daniel Hanley from Johns Hopkins University.

Speakers will be Hartford Hospital Drs. Lauren Sansing, Catherine Hosley, Isaac Silverman, Robert Brown and Martin Ollenschleger, and Dr. Sanjay Mittal from UConn Health Center.

For more information or registration, please visit www.harthosp.org/event/607

 

June 3 (Tuesday)

High Reliability Training Session for Physicians

JB-118, 6:45-8:15 a.m.

 

June 4 (Wednesday)

High Reliability Training Session for Physicians

JB-118, 5:30-7 p.m.

 

June 4 (Wednesday)

Pelvic Health Seminar

Glastonbury Pond House Grill, 5:30 p.m.

Hartford Hospital’s Tallwood Urology & Kidney Cancer Institute is providing free educational seminars for primary care providers. Each session will provide 2 CMEs and dinner. They will be held from 5:30-8:30 p.m., at the Glastonbury Pond House Grill. Advance registration is required; contact the Health Referral Service at 860-545-1888. For more information, contact Jan Ruderman at 860-817-5300.

Speakers: Drs. Richard Kershen, Adam Steinberg, Jill Peters-Gee and physical therapist Stacey Head. The session will focus on the role of the Primary Care Provider in identifying and managing: overactive bladder, urinary tract infections, and hematuria. A physical therapist will also provide an overview of the role of physical therapy in patients with pelvic health dysfunction.

 

June 6 (Friday)

Farm to Table in the City

Hartford Public Library, 6:30 p.m.

Sumptuous, fresh local food prepared by The Kitchen at Billings Forge $65 per person

RSVP by May 23 to Ginger Gillespie at gcgillespie@comcast.net or 860.216.5426.

Sponsored by the Hartford Hospital Auxiliary. Proceeds to benefit community health outreach.

June 6 (Friday)

Surgery Grand Rounds

Gilman Auditorium, 6:45 a.m.

Topic: Inflammatory Bowel Disease (IBD) Surgery in the Era of Biologics

Speaker: Dr. Neil Hyman, University of Vermont College of Medecine

 

June 19 (Thursday)

Valedictory Grand Rounds With Dr. AJ Smally

Dr. AJ Smally, medical director of the Emergency Department, will be giving his Valedictory Grand Rounds on Thursday, June 19 at 12 noon in Gilman Auditorium. The occasion is his Imminent retirement after 27 years of service at Hartford Hospital. The topic will be: “A Quarter Century plus of Emergency Medicine at Hartford Hospital.”

 

June 20 (Friday)

3rd Annual Medical Staff Chef to Farm Dinner

Rosedale Farms, Simsbury

You and your guest are invited to join the Officers and other members of the Hartford Hospital Medical Staff for this special evening – celebrating the beauty and abundant bounty of our local farms – as a unique opportunity for members of the Medical Staff to socialize and enjoy each other’s company. Rosedale Farms, 25 East Weatogue Street, Simsbury. $100 per person.

 

July 8 (Tuesday)

High Reliability Training Session for Physicians

JB-118, 6:45-8:15 a.m.

 

July 9 (Wednesday)

High Reliability Training Session for Physicians

JB-118, 5:30-7 p.m.

 

August 13 (Wednesday)

High Reliability Training Session for Physicians

JB-118, 6:45-8:15 a.m.

 

August 14 (Thursday)

High Reliability Training Session for Physicians

JB-118, 5:30-7 p.m.

 

 

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. Stacy Nerenstone, Medical Staff president, at (860) 545-3043.