The News You Need

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

 

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In This Issue...

February 16, 2014 Edition

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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 - Hartford Hospital opened two “bi-plane labs,” the only surgical suites of their kind in the state, for both heart- and brain-related problems employing revolutionary 3-D imaging techniques.


Follow Hartford Hospital on facebook, youtube and twitter

 

Top News

Please Watch The Video About Contact Precautions

During a recent DPH inspection, a medical staff member did not properly wash his stethoscope upon exiting a contact isolation room.

It is essential that all equipment including your stethoscope be sanitized when leaving a contact isolation room.

Please watch the video linked here, which will illustrate the proper sequence to follow for gowning and gloving when entering and exiting a Contact Isolation room.

It will also show you how to properly disinfect any equipment including your stethoscope after you leave the room. This step is required to prevent the transmission of infection on our units, and to protect the safety of the next patient that you see. The use of a glove over the bell of the stethoscope by some practitioners is not adequate by itsself.

Video link: http://media.harthosp.org:80/ermweb/player?id=i560TWO9

 

Milestone Reached: 100th TAVR at Hartford Hospital

Surgeons in Cardiology performed their 100th transcatheter aortic valve replacement (TAVR) procedure on Jan. 30.

TAVR is a procedure for select patients with severe symptomatic aortic stenosis (narrowing of the aortic valve opening) who are not candidates for traditional open chest surgery or are high-risk operable candidates.

 

VAD Program Receives Certificate of Distinction from Joint Commission

Hartford Hospital has received a Certificate of Distinction from the Joint Commission for our Ventricular Assist Device Program. The certificate is awarded a maximum of two years, which is what we received.

This is the second consecutive award of distinction earned by our VAD program and comes as a result of the hard work of a large multidisciplinary, patient-centered inpatient and outpatient VAD team. It’s based on a review of compliance with national standards, clinical guidelines and patient outcomes.

Stop the Stigma of Mental Illness - The Theme for HH's Fundraising Gala

Hartford Courant, Dec. 20

Hartford Hospital kicked off a campaign to end the stigma of mental illness at the annual Black & Red gala at The Bushnell.

Harold (Hank) Schwartz, M.D., Hartford HealthCare Regional vice president, Psychiatrist-in-Chief Institute of Living at Hartford Hospital, says for some people, a mental illness may be a lifelong condition, like diabetes. "However, as with diabetes, proper treatment enables many people with a mental illness to lead fulfilling and productive lives. By helping combat the stigma associated with mental illness, we can help increase the number of people that seek treatment."

"We will be looking to our employees of Hartford Hospital and across the Hartford HealthCare system to take a pledge to stop the stigma," said Stuart Markowitz, M.D., president Hartford Hospital and Hartford Region, senior vice president Hartford HealthCare. "As a health care leader in the community and the state, it is our duty to set the example and stop the stigma associated with mental illness. Together, we can do it."

We are asking all HHC 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, nearly 7,000 have taken the pledge Ask everyone — fellow employees, volunteers, patients, the community — to “take a pledge.” It is online now at www.StopTheStigmaCT.org.

 

Hartford HealthCare, Hebrew Health Care ink clinical partnership

Hartford HealthCare has forged a strategic partnership with West Hartford's Hebrew Health Care that both providers say will enhance elderly care.

The consulting and clinical affiliation will help Hebrew make some of its services more cost effective, while giving Hartford Healthcare access to Hebrew's array of care offerings largely aimed at elderly patients, including rehabilitation, acute care, hospice and other services, the organizations said.

"Hartford Healthcare's organizational management expertise, together with Hebrew Health Care's recognized geriatric experience and skill, will allow us to deepen our shared commitment to the seniors we serve across the region," Elliot Joseph, president and CEO of Hartford Healthcare, said.

Hebrew is made up of nine affiliates, including The Hospital at Hebrew Health Care, the Hebrew Health Visiting Nurses and Hospice and Hebrew Health Assisted Living Services, among others. Hebrew will remain an independent organization with its own board of trustees and management.

Hartford Healthcare operates five hospitals: Backus Hospital, Hartford Hospital, MidState Medical Center, The Hospital of Central Connecticut and Windham Hospital.

 

HHC and Memorial Sloan Kettering Alliance Ads Aired During Superbowl

Hartford HealthCare aired TV ads during the Superbowl about how we and our partners of the Memorial Sloan Kettering Cancer Alliance are working together to stay ahead of cancer.

Our commercials (broad Connecticut market only) appeared during extremely high viewership times: Overall game received a 47.1 household rating, which is huge. Ratings for each of our ads: 47.7, 47.7, 48.7 and 44.7.

Take a look at the commercials, as well as other information about the alliance, at our http://TogetherAhead.org website .

 

What’s New with The HHC Cancer Institute/Memorial Sloan Kettering Cancer Alliance?

Available now online: the first edition of Plus, the HHC Cancer Institute/Memorial Sloan Kettering Cancer Alliance newsletter.

Find out what’s happening with this unique partnership: http://www.togetherahead.org/alliance

The web site includes our Super Bowl commercials, FAQs to answer patient questions and other information.

 

January Finances: Favorable Variances in OP Driven by Emergency, Perioperative and Lab Services

Inpatient volumes based on discharges for the month of January were 1.7% above budget.  The comparison to the prior year shows January of 2014 discharges, approximately 0.7% below the prior year.  Outpatient revenues were above budget by approximately 5.5% for the month.  The favorable outpatient revenue variance was driven by Emergency, Perioperative and Laboratory services.               

Through four months of fiscal year 2014 inpatient discharges are 0.4% greater than budgeted and 0.5% greater than the first four months of the prior fiscal year.  Outpatient revenues are 7.7% above the budget for the four months ending January 2014.    

 

Hand Hygiene Champions Join the Campaign To Remind All To Wash In and Wash Out

To continue to improve hand-hygiene compliance, a group of physicians, nurses, patient-care assistants and other caregivers on the nursing units are wearing a button stating, “Please ask me if I washed my hands.”

These Hartford Hospital hand-hygiene champions will remind their coworkers to “wash in and wash out.” At the suggestion of ICU nurses and their managers, each unit, each role and each shift throughout the hospital now has individuals who will prompt all caregivers to perform hand hygiene.

The buttons and champions also serve a second purpose of sending the message to our patients, their families and our colleagues that we value hand hygiene and patient safety.

 

Update From the VTE Action Group

The VTE Action Group has undertaken the task of decreasing HH’s incidence of Venous Thromboembolism (DVT, PE). The team’s initial focus has been on perioperative VTE, as performance on this indicator has routinely been poorer than benchmark which poses patient risk and negatively impacts public reporting.

The team has identified several areas of focus and has set goals of development and implementation of evidence-based clinical practice guidelines for:

1. Chemical prophylaxis of VTE in orthopedics, neurosurgery and trauma.

2. Mechanical VTE prophylaxis including strategies related to storage and deployment of sequential compression devices (SCDs) and pumps.

3. Referral criteria regarding screening and diagnosis of suspected VTE

Current target is for chemical and mechanical prophylaxis guidelines to be completed, reviewed by Pharmacy and Therapeutics Committee, Medical Staff Quality Council and Medical Executive Committee by the end of April. Rollout, educational, and continuous improvement plans will be included with each guideline.

The team has also completed outreach to members of the HH community who identified themselves as currently engaged in VTE–related projects and collaboration is underway with several parties.

Any suggestions or input related to guidelines, education or rollout would be welcome, and may be addressed to Dr. Bob Spillane, project chair.

Excellence

Dr. Jack Greene to Present at Risk Management Conference

Dr. Jack Greene has been selected to present with Attorney Joyce Lagnese at the 24”th Annual New England Regional Healthcare Risk Management Conference on Getting Physicians “onboard” with Risk Management and Patient Safety. The conference will be held at the Mystic Marriott Hotel on May 4-6, 2014.

 

Dr. Kelly Johnson-Arbor Authors Article in NEJM

Dr. Kelly Johnson-Arbor authored an article, “Digital Frostbite” which was published in the January 9, 2014 issue of the New England Journal of Medicine.

 

Drs. Johnson-Arbor, Nugent, McKay and Schwartz Teach College Class on Hyperbaric Medicine

Dr. Kelly Johnson-Arbor was the course director of an undergraduate college class, “Hyperbaric Medicine”, during the fall 2013 semester at the University of Hartford. Drs. Jim Nugent, Chuck McKay, and Dan Schwartz, along with several of our wound/hyperbaric nurses and technicians, participated in the teaching also.

 

Dr. Kenneth Robinson Chairs Faculty Development Committee of SAEM

Dr. Kenneth Robinson has been selected to chair the Faculty Development Committee of the Society for Academic Emergency Medicine.

 

Dr. Drescher, Pepper and Russell Author Article in European Journal of Emergency Medicine

Drs. Michael Drescher, David Pepper, and Francis Russell and Maryanne Pappas APRN authored an article, "Can Emergency Medicine Practitioners Predict Disposition of Psychiatric Patients Based on a Brief Medical Evaluation?" in the European Journal of Emergency Medicine.

 

Dr. Hank Schwartz Participates in CT Forum Panel on Mental Illness

Dr. Hank Schwartz, psychiatrist in chief at the IOL, will be on the panel at an event called "An Honest Look at Mental Illness," part of the Connecticut Forum series at the Bushnell, on Friday, March 7. This event is hosted by Hartford HealthCare's Behavioral Health Network.

Other panelists will be Royce White, NBA draft pick; and authors Andrew Solomon and Dr. Kay Redfield Jamison. The panel will be moderated by John Dankosky, host of WNPR's "Where we live."

The forum is described as "a conversation about perceptions, realities and what it's like to work and live with the stigma of mental illness."

The Connecticut Forum is a non-profit organization that hosts live panel discussions with experts and celebrities and conducts community outreach programs.

 

Dr. Aidan Flynn Wins Best Manuscript From Cardiology Journal

Dr. Aidan Flynn of the Division of Cardiology is an author of a manuscript that has been selected as the winner of the newly established Best Manuscript Award in the Category of Basic Science from the distinguished cardiology journal Circulation: Cardiovascular Imaging. All original articles published in the journal in 2012 were eligible for the award.

Dr. Flynn's paper demonstrates and validates the use of contrast ultrasound to characterize the blood flow to brown adipose tissue in mice. Brown adipose tissue is abundant in human infants but was thought to be absent in adults.

It has recently been shown to be present in small quantities in most adults and is now being studied as a target for weight loss interventions given its unique metabolic properties. It is highly metabolically active due to its numerous mitochondria, which also account for its brown color. The mitochondria play a major role in converting energy to heat, and brown adipose tissue can burn more calories than any other tissue, leading to the interest in it as a target for weight loss interventions.

The title of Dr. Flynn's article is “In Vivo Noninvasive Characterization of Brown Adipose Tissue Blood Flow by Contrast Ultrasound in Mice” and the reference is Circ Cardiovasc Imaging 2012;5:652-659. Details of the award were published in the January 2014 issue of Circulation: Cardiovascular Imaging.

 

 

Our Physicians Are Great Sources For Local Media

Dr. Vasanth Kainkaryam was interviewed on WFSB on Jan. 28 about exercising when you are sick.

Dr. Laura Saunders was interviewed on WFSB on Jan. 28 about anxiety teenagers face over excessive cell phone use; on WFSB Jan. 29 about Facebook addictions; on NBC CT on Jan. 30 about kids and stress; on WFSB on Feb. 11 about people obsessed with Facebook; on WFSB on Feb. 11 about teenagers and anxiety over social media.

Dr. Kelly Johnson-Arbor was interviewed on WFSB on Jan. 29 about the new trend of children snorting candy to appear as cocaine; and on NBC-CT on Feb. 5 about a potentially dangerous chemical used in bread at Subway; and by the Hartford Courant on Feb. 5 about the resurgence of heroin use following the death of Philip Seymour Hoffman.

Dr. Hank Schwartz was interviewed on WFSB on Jan. 29 recapping the Black & Red; on News 8 on Feb. 3 about seasonal affective disorder; and on News 8 about the study at the IOL on depression treatment.

Dr. Gualberto Ruano was interviewed on News 8 about the study at the IOL on depression treatment. View it here.

Dr. Subramani Seetharama was interviewed on Fox CT on Jan. 30 about concussions.

Dr. Cliff Rios was interview on WFSB Jan. 30 about the dangers of extreme workouts.

Dr. Jack Ross was interviewed on NBC CT on Jan. 31 about flu.

Dr. Andrew Salner was interviewed on Fox CT on Feb. 4 about World Cancer Day.

Dr. Ken Robinson was interviewed on WFSB on Feb. 5 about activity in the ED due to the storm, and shoveling safety; and on WFSB on Feb. 6 about a rise in snowblower-related injuries.

Dr. Ed Salerno was interviewed on Fox CT on Feb. 5 about CVS ceasing to sell tobacco products.

Dr. Tom Nowicki was interviewed on WFSB on Feb. 6 about shoveling safety.

Dr. Gregory Shangold was interviewed on News 8 on Feb. 6 about a patient who suffered a hand injury from a snowblower.

Dr. Louise McCullough was interviewed on WFSB, NBC CT and WTIC on Feb. 7 about women and stroke. More here.

Dr. Eric Crespo was interviewed on NBC CT on Feb. 10 about A-Fib.

Dr. Lauren Burke was interviewed on Channel 3 on Feb. 13 about proper shoveling techniques to avoid injury. Watch it here.

Research and Academics

Dr. Godfrey Pearlson published in American Journal of Psychiatry

Dr. Godfrey Pearlson, psychiatrist at the IOL, was quoted in an article about research he is involved in about similarities in brain abnormalities in patients with schizophrenia and bipolar disorder. The findings have been published in the American Journal of Psychiatry.

Researchers at the Institute of Living in Hartford and Yale —as well as four other sites in Massachusetts, Illinois, Texas and Maryland— are studying 20 potential biological disease indicators in 3,000 individuals. The subjects include those with schizophrenia and psychotic bipolar disorder, as well as their close relatives and unrelated healthy controls. The study is known as BSNIP (Bipolar-Schizophrenia Network on Intermediate Phenotypes).

Read more here.

 

Hyperbaric Training Course Offered for Healthcare Providers

Hartford Hospital in collaboration with the OxyHeal University, is offering a 40-hour course in Hyperbaric Training for Healthcare Providers on Feb. 24-28 at the Backus Wound and Hyperbaric Center in Norwich. It will meet daily from 8 a.m.-5 p.m.

The Hyperbaric Training for Healthcare Providers Course is designed to meet the requirements of a Designated Introductory Course in Hyperbaric Medicine and will introduce to physicians, registered nurses, technicians and other allied health care providers the clinical indications, documentation and operational requirements of a Clinical Hyperbaric Medicine Facility. NBDHMT 40 Category A Credits.

This course is required for physicians who wish to supervise and bill for hyperbarics, and for nurses and technicians who would like to sit for the National Certification Exam. Free of charge to any Hartford HealthCare employee. 

Call Michael Powers at 860-798-8155 with questions. Register today: mpowers@oxyheal.com or michael.powers@hhchealth.org.

 

Dr. Ajay Kumar Serves As Course Director of Transformative-Fusion of Innovative Patient Blood Management

Hartford Hospital and the Mayo Clinic are offering TransFuse 2014, a 3-day multidisciplinary conference devoted to exploring the current state-of-the art techniques and program development to implement a blood management program in hospitals. It will be held March 26-28 at the JW Marriott Desert Ridge Resort and Spa in Phoenix, Arizona.

Dr. Ajay Kumar, chief of the Department of Medicine, is one of the course directors.

Also on the faculty from Hartford Hospital are Dr. Elizabeth Deckers, Ob-Gyn; Dr. Steve Shichman, chair of the Department of Urology; and Chris Donovan, executive director of fiscal services.

REGISTER ONLINE NOW! http://www.mayo.edu/cme/anesthesiology-2014r455

HHC members gets a discount with registration at the Blood Summit.

 

Updates in Urology for the PCP

Hartford Hospital’s Tallwood Urology & Kidney Cancer Institute will be providing a series of three free educational seminars for primary care providers. You can attend one, two or all three. 

Each session is independent and will provide 2 CMEs and dinner. They will be held form 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.

Thursday, April 10:  Prostate Health. Speakers: Drs. Stuart Kesler, Arthur Tarantino and Joseph Wagner. The session will focus on criteria for PSA testing, managing BPH and new developments in Active Surveillance for patients diagnosed with prostate cancer.

Tuesday, May 13:  Kidney Stones. 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.

Tuesday, June 4:  Pelvic Health. 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.

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

ICD-10 Training Update

On October 1st, 2014 the United States will join the rest of the world by switching from ICD-9 to ICD-10 Coding. The basic changes are that there are many more codes that are far more specific. In fact, we will be increasing our number of codes from 13,000 to more than 68,000. This will help in payment structures that are currently evolving, research, utilization, physician profiling, and quality assessment, amongst others.

This will affect all providers, whether employed by HHC or not, and will include all providers both inpatient and outpatient. ICD 10 codes will be needed on all billing, authorizations, lab requests and many more items. Challenges will include choosing the proper codes but, more importantly, documenting properly to justify your code. Please note that CPT codes will remain the same.

Many of our providers have asked when ICD 10 training will begin and how it will work. We also found in our ICD 10 Survey that many providers would like to begin training as quickly as possible.

Here are the plans for education leading up to the mandatory go-live date of October 1, 2014. Dr. Fred Rubin is leading the effort for Hartford HealthCare.

  • We are currently in the midst of our General Awareness Campaign, which includes posters, digital signage, our website, newsletters and presentations to medical executive boards and staff meetings throughout all of HHC.
  • Computer-based training will begin in March, with both general and specialty specific training modules. We will then offer classroom training.
  • There will be presentations to divisions for further training.
  • Throughout this period our Clinical Documentation Experts will help provide one on one education on the floors using individual charts as examples.
  • Plans for training will evolve over time.
  • Please use our website for further education: https://myhhc.hhchealth.org/hhcProjects/icd10/info/SitePages/Physician%20Resources.aspx

And for any questions, our email address is ICD10.info@hhchealth.org.

A Message From Dr. Rocco Orlando, HHC Chief Medical Officer

Transforming Care With CareConnectOrlando

Dr. Rocco Orlando, HHC Senior Vice President and Chief Medical Officer

Employees on the frontline of HHC Unity: CareConnect as well as leadership and staff member from across the system, gathered in Hartford earlier this month for the much-anticipated kickoff of the systemwide initiative to transform the way Hartford HealthCare delivers care.

The event, held at the Theater of the Performing Arts on Washington Street, was both a celebration of the start of project – the largest in HHC history - and a rallying point for HHC leaders, who thanked those in attendance.

“We are putting all these efforts in on the front end to get it right,” said Hartford HealthCare President and CEO Elliot Joseph.

The program featured presentations on the importance of care transformation from Joseph, Jeffrey Flaks, executive vice president and chief operating officer of Hartford HealthCare and myself. Project leaders also addressed the group, outlining the scope and schedule for the project, and representatives from Wisconsin-based Epic were on hand with a live demonstration of the Epic electronic health record tool.

Leaders stressed, however, that HHC Unity: CareConnect is not an IT project.

“This is about redesigning care,” Joseph said. “It’s about breaking down silos and incorporating standardization. We need to get out of our own institution mentality, our silos, to look at what Janet needs and, to above all, focus on the “Five Ones” of one registration, one health record, one standard of care, one bill and one relationship.”

“The next three years will have tremendous successes,” said Dr. Jonathan Velez, vice president and chief medical officer of HHC Unity: CareConnect. “At other times, it will be rough and we will bump shins with each other.”

Attendees included Core Team employees and managers, managers overseeing implementation and subject matter experts, but it was the employees not in the room that Joseph asked them to keep in mind.

“The 18,000 people working at HHC will be impacted in very real ways, especially in terms of workflow,” said Joseph. “We need to appreciate this and that HHC Unity: CareConnect is fundamental to our organization as we go forward.”

“Change is personal for everybody and we need to get everybody there,” added Craig Stearns, HHC Unity: CareConnect program director. “We are not just changing the wheels on the bus, we’re changing the transmission, painting and detailing, all at the same time.”

Enhancing The Patient Experience

Voices of Our Patients: Kudos To Drs. Kesler, Murphy, Waggoner, Doak, Laut, Brown, Ely and Duggan

Dear Ms. Ficara,

A belated, but very sincere, thanks of gratitude and appreciation for the amazing care received by my husband, Frank D'Annolfo, when he was hospitalized from Nov. 26-29, 2013 for renal nephrectomy surgery. I hope that this letter will be shared with all those who need to hear about the incredibly caring and competent team of health care professionals we were fortunate to be involved with during this time, from the receptionists, to the nurses, to the surgeon, and everyone in between.

Special thanks to the care, guidance and surgical procedures performed by Dr. Stuart Kesler. From the beginning consult meetings, to the preparation, surgery and follow-up, he has been a constant sources of strength, clarity in information, and kindness.

In addition, the residents in urology, Dr. Gregory Murphy, Dr. Waggoner, and Dr. Hoyt Doak showed evidence during this time of the great training they are receiving.

The surgical scheduling team contact, Jill Gray, was phenomenal!

Follow up in Dr. Kessler's office with Dawn Massey, APRN, was outstanding.

The referral to Dr. Jeffrey Laut from the Connecticut Multispecialty Group has also been very positive. And of course, Dr. Jeffrey R. Brown, Frank's PCP, has been accessible, helpful and always professional and kind.

And finally, Dr. Matthew Ely, Frank's primary urologist, was the guiding force in getting everything moving in an efficient and professional manner; he was so accessible and responsive to our questions and needs. The man is a superstar!!!

We were so impressed with all the nurses at their varying levels of responsibilities. Arlene Donato in pre-admission was so informative and calming. The day of surgery on the fourth floor, Kim in preparation for surgery and Jen the nurse in the OR tended to all our questions and took such good care of Frank.

Dr. William Duggan, the anesthesiologist, was very reassuring.

A deep thanks to all of them.

Of course, the after-care on Bliss 8 was superb with the leadership of Susanne Yeakel, nurse manager of B8. Frank was cared for primarily by Alison O'Donnell, RN, and Brittany Moore, RN. They both were so attentive, respectful, caring and kind. Their professionalism and knowledge were evident every second of every minute to both Frank, as the patient, and to me and my many questions.

All of the other people with responsibilities to follow up, take vitals, clean the room, and provide meals were excellent and are a credit to the great team of professionals and kind human beings at Hartford Hospital.

Words cannot express our gratitude to everyone. We sing the praises of all the professionals at Hartford Hospital to our friends. We are deeply grateful and appreciative of your collective health care and kindness.

Sincerely,

Suzi and Frank D'Annolfo

Operational Update

Take a Look At the New Integrated Care Partners Website

Here is a link to the ICP website: http://hartfordhealthcare.org/integrated-care-partners

Integrated Care Partners is a physician-led clinical integration organization that will play a critical role in improving how patient care is delivered. ICP is not an employed practice model, a program run by hospitals, physician employment or a practice-management service.

It includes private-practice physicians as well as physicians employed by or associated with Hartford HealthCare. There is no enrollment fee.

 

Big Y Donates $26,000 to Hartford Hospital Breast Care Program

Hartford Hospital’s comprehensive breast care program has received a $26,000 donation from Big Y Foods. The donation, made possible through the supermarket chain’s Partners in Hope Campaign, will support Hartford Hospital’s efforts to provide convenient, state-of-the-art mobile mammography services to women throughout Greater Hartford.

Dr. Patricia DeFusco, medical director for the hospital’s Breast Program, joined Karen Weingrod, manager of the Breast Program, in accepting the gift at the West Hartford Big Y in January.

The digital mobile mammography program, Take the Time, is operated by the Breast Program and the hospital’s Imaging Center/Radiology. Since 2005 it has provided screening, mobile mammograms, and breast health education. Thousands of women have benefited from life-saving mammography screenings in convenient community locations, including work sites, clinics, churches, senior centers, and other locations where the women will feel comfortable.

 

ICP News! Read about the ICP Care-Management Team

In the new Feb. 3 issue of the ICP News, the Integrated Care Partners newsletter for Hartford HealthCare, Dr. James Cardon, CEO of Integrated Care Partners and HHC chief integration officer, writes about ICP advances in managing patients' care

"Integrated Care Partners has taken a significant step in improving care for patients with chronic health issues who are at high risk for hospitalization and for complications from their illnesses," wrote Dr. Cardon. "We’ve hired seven care managers to work with high-risk patients who are covered by ICP shared-savings plans with Medicare and commercial insurers. Our care managers will connect the dots for patients and physicians. They will be part of primary care practices – both employed by Hartford HealthCare and private – that are affiliated with ICP and will work with patients who need the most help in managing their illnesses."

Read it 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.

 

 

 

Save These Dates:

 

Medical Staff Interim Meeting - March 26; 6:45-8 a.m. and 5:30-7 p.m.

We will be having two Town Hall Style meetings with the hospital and medical staff leadership on Wednesday, March 26 in Gilman Auditorium, 6:45-8 a.m. and 5:30-7 p.m. Planned participants include Drs. Stu Markowitz, president; Jack Greene, chief medical officer for HH; Rocco Orlando, chief medical officer for HHC; Jim Cardon, executive vice president and chief clinical integration officer for HHC; and Stacy Nerenstone, president of the medical staff. Come and ask your difficult questions, and find out what is going on at Hartford Hospital and at Hartford HealthCare.

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 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.

Did You Know?

Supply Cost Stats

Hartford HealthCare spends $8.8 million per year providing food to patients, visitors and staff.

Countdown To The Upgrade: 226 Days To The ICD-10 Conversion

CASE STUDY: APPLYING ICD-10 TO CROHN’S DISEASE

Consider the following scenario: A patient with ongoing Crohn’s disease presented to the office with cramping, diarrhea, melena, and increased abdominal pain. The physician performed a colonoscopy six months prior and diagnosed Crohn’s disease. Due to the severity of the flare up, the physician orders a second colonoscopy. The colonoscopy reveals an abscess in the large intestine with bleeding.

ICD-9 code descriptions are too generic.

In ICD-9, the physician uses regional enteritis of the small and large intestine. This is the same code that was used six months earlier for the original colonoscopy. This claim faces edits and possible denial due to frequency restrictions on diagnostic colonoscopies.

ICD-10 has better descriptions for diagnostic code choices.

In ICD-10, the Severity of Illness warranting this additional colonoscopy would be met with a specific code. Using the single ICD-10 code for Crohn’s disease of both small and large intestine with abscess (K50.814), reflects a progression in the disease and justifies the repeat colonoscopy.

HH In the News

Doctors Say Bully-free Zones Make Schools Safer

WTNH and Hartford Courant, Jan. 14

During a recent meeting of the Sandy Hook Advisory Commission, a group formed to investigate the factors that drove Adam Lanza to kill 20 children and six adults and to study the state’s mental health system, doctors spoke of the need for schools to adopt concrete principles of inclusion and recognition, in order to become even safer places.

Eighth grader, Kyra Bukowski, agrees: “After awhile, it’s in your mindset. So, you start to do more acts like that without even knowing it.”

Bukowski and her mom recently took Hartford Hospital’s pledge to “Stop the Stigma” (www.stopthestigmact.org), a movement to educate the public about mental illness and eliminate the use of offensive words, such as “psycho” and “demented”, in casual conversation. According to the website, mental disorders are the leading cause of disability in the U.S. So far, the hospital has received 5,500 pledges, working towards a year-long goal of 10,000 promises for change.

Read more here.

 

Middletown, Shoreline Restaurants Participate: Fundraiser For American Liver Foundation

The New York Times, Jan. 19

Local chef to take part in annual fundraiser. Backstage Eat Drink Live will be generously donating their time and talents in an annual Flavors of Connecticut gala, presented by Hartford Hospital and Yale New Haven Hospital, in April.

The event is an annual fundraiser for the American Liver Foundation, a nonprofit organization focused on promoting liver health and disease prevention. It will take place April 1 from 5:30 to 10 p.m. at the Aqua Turf Club in Plantsville. This year's gala will feature 35 of Connecticut's top chef's and restaurants.

Read more here.

 

Hartford Hospital's Simulation Center Earns National Accreditation

Hartford Courant, Feb. 1

The Center for Education, Simulation, and Innovation (CESI) at Hartford Hospital has been accredited as a comprehensive - Accredited Education Institute (AEI) by the American College of Surgeons (ACS). An ACS-AEI addresses the educational needs of a broad spectrum of learners and advances the science of simulation-based surgical education.

In 2013, nearly 11,000 people were trained at CESI in over 1,600 classes totaling more than 55,000 hours of classroom training.

Read more here.

 

DNA Study for Dealing With Depression

WTNH, Feb. 6

There is individualized therapy for patients with dealing with depression. It’s a focus of a DNA study here in Connecticut. Researchers at Hartford Healthcare are refining what they already know about DNA testing and applying it to patients with major depressive disorders. It’s estimated one in 10 people in the United States struggle with depression.

Symptoms are varied and so is treatment. But a specific enzyme could be key to unlocking what is most effective for the patient.

“Different people have different versions of the enzyme,” said Dr. Gualberto Ruano.

In a clinical trial, researchers at the Genetics Research Center and Institute of Living at Hartford Hospital are measuring its function then applying it to patient care. In short, targeted therapy for mental health patients.

“It’s very similar in that it uses the individual’s genetics to tailor the right treatment,” said Dr. Hank Schwartz, Institute of Living Hartford Hospital.

Dr. Schwartz says he expects the outcome will impact mental health and the overall health care system in a number of ways, including better outcomes for patients, shorter hospital stays and lower re-admissions.

Read more here.

In the HHC System

Tilcon Makes 50K Pledge to HOCC's New Cancer Center

Central CT Post, Jan. 28

The Hospital of Central Connecticut (HOCC) recently received a $50,000 pledge toward its new cancer center from Tilcon Connecticut on behalf of its employees. Tilcon’s gift supports the hospital’s $10 million fundraising campaign for the cancer center, currently under construction. The center’s main entrance patio garden will be named in recognition of Tilcon Connecticut employees.

The $40 million state-of-the-art cancer center, expected to open by early 2015, will consolidate outpatient services in one convenient location and allow for future expansion of cancer care. The nearly 70,000-square-foot cancer center is being built by TBI Construction, LLC, on over nine acres on the New Britain/Plainville line.

 

Rushford Center Getting $25,000 Donation

Middletown Press, Jan. 30

Rushford Hospital’s Silver Street location is receiving a $25,000 gift aimed at providing local physicians the necessary training in the field of addiction medicine.

The partner in the Hartford HealthCare Network is receiving the donation from the Hartford Dispensary Endowment Corporation that will go toward its addiction medicine fellowship.

Program director Dr. Samuel Silverman said the fellowship, accredited by the American Board of Addiction Medicine, offers physicians a year of training in the field which allows them to evaluate and treat patients coping with substance use disorders.

Given that Rushford and the Yale School of Medicine are the only two state organizations among the 18 ABAM-accredited fellowships in the country and in Canada, Silverman believes the donation speaks volumes to Rushford’s commitment in educating and training future physicians.

Read more here.

 

Endowment Branches Out From Bradley

Record Journal, Feb. 2

Grants awarded to the YMCA and Central Connecticut Senior Health Services earlier this month marked the first time the Bradley Barnes endowment went to groups other than the town’s hospital. The trust was established in 1973.

The Bradley Henry Barnes and Leila Upson Barnes Memorial Trust, now at $18 million, was established to fund capital improvements at the former Bradley Memorial Hospital, now a campus of the Hospital of Central Connecticut. HOCC is a Hartford HealthCare partner.

Hospital mergers complicated awarding the trust’s grant money, due to stipulations included by Bradley Barnes. His endowment should be used to fund hospital projects only if it remained “as an independent community hospital and health care center,” according to a state Attorney General’s report in 2005. If not, the trust should be used to fund other charitable purposes to benefit Southington.

Concerns over whether the merger stripped Bradley Memorial Hospital of its independence, and therefore the benefits of the endowment, caused officials at New Britain General Hospital to request a ruling by former state Attorney General Richard Blumenthal.

Read more here.

Quinnipiac University Medical Students Tour MidState Medical Center

Record Journal, Feb. 3

Nearly 40 medical students from Quinnipiac University’s Frank H. Netter MD School of Medicine visited MidState Medical Center on Jan. 16.

Dr. Aziz Benbrahim, MidState surgeon and interim clerkship liaison, and Dr. Thomas Murray, associate professor at the Netter School of Medicine, opened the program and delivered welcome remarks. Following the remarks, groups of students toured the hospital, visiting the inpatient units, Family Birthing Center, operating room area, Emergency Department, and Center for Clinical Simulation. Dr. Richard Smith, MidState Chief-of-Staff led the tour.

They later returned to the hospital’s Horwitz Conference Center to view live streaming video from the operation room, which showcased the daVinci robot and new hybrid operating room.

MidState will serve as a clinical rotation site for the new medical school. The first class of medical students began last fall.

Read more here.

Health Care News In the Region

Records of Saint Francis Hospital Patients Stolen in Privacy Breach

Hartford Courant, Jan. 24

Paper records containing medical information on 858 patients of Saint Francis Hospital and Medical Center were stolen almost a month ago, compromising the patients' privacy, the hospital said Friday.

The records were stolen on Dec. 27 from the vehicle of an independent contractor physician who works in the emergency department, the hospital said.

"Our goal has always been to help ensure adequate safeguards are in place to protect our patients' confidentiality," Dr. John Rodis, executive vice president and chief operating officer of Saint Francis, said in a statement. "Education of our staff has already been completed and we are evaluating other opportunities to strengthen our compliance program."

Read more here.

 

UConn: 18 Months of Construction, 1,700 Jobs, and Counting

UConn Today, Jan. 28

The UConn Health campus continues to be a hotbed of construction activity, as the projects to build the Bioscience Connecticut infrastructure progress on schedule and on budget.

Since the first groundbreaking 18 months ago, the projects have created nearly 1,700 construction jobs. Almost 80 percent of the contracts have been awarded to Connecticut companies.

Read more here.

 

Medical Marijuana To Be Sold in CT by Summer

Reuters, Jan. 28

Medical marijuana will go on sale in Connecticut by summer 2014, dispensed throughout the state by four vendors, Governor Dannel Malloy said.

Marijuana is illegal in the United States under federal law, but Connecticut is among 20 U.S. states and the District of Columbia that allow use of marijuana for medical purposes.

Read more here.

 

Bristol Hospital Campaigns For Tenet Sale

Hartford Courant, Jan. 31

As Bristol Hospital works to build favor at the state Capitol for a takeover by the for-profit Tenet Healthcare Corp., the city's state legislators are generally supportive despite some lingering reservations.

Rep. Whit Betts, R-Bristol, told hospital executives at a breakfast meeting Thursday that he favors the acquisition because he's convinced it's the best way to preserve small, local hospitals such as the one in Bristol.

But Rep. Christopher Wright, D-Bristol, said that even though he's partly sold on the idea, he believes Bristol Hospital still needs to win over skeptical residents who are accustomed to an independent, not-for-profit hospital.

Read more here.

 

Idaho Hospital Ruling Could Impact ECHN Plans

Journal Inquirer, Feb. 5

In a significant recent case, The Wall Street Journal reported that a federal judge has ruled that “an Idaho hospital system must unwind its acquisition of the state’s largest independent doctor group.”This decision could have significant implications as health-care providers nationwide increasingly seek to join forces.

The ruling in favor of the Federal Trade Commission has a bearing on our local scene. If the ruling is followed in local courts, it would effectively prevent the purchase by hospitals of a physician group.

Eastern Connecticut Health Network already has a program to utilize doctors directly employed by the hospital and treat patients that are hospitalized. Tenet and ECHN both have referred to the possibility of increasing the number of doctors that are employed directly by the hospital. This procedure would be in jeopardy if the Idaho ruling stands.

We wonder how this might affect the proposed merger between ECHN and Tenet. Details of the merger — which was supposed to have been consummated by Jan. 1 — have been kept from the public.

Read more here.

 

Stafford Hospital Announces Administrative Shakeup

Journal Inquirer, Feb. 10

A corporate shakeup at Johnson Memorial Medical Center has left two key administrators out of their jobs, including one of its highest-compensated officials.

The changes — which some employees say reflect the increased influence of St. Francis Care Inc., the corporate parent of St. Francis Hospital and Medical Center in Hartford that entered into a partnership agreement with Johnson Memorial in 2012 — were announced last week in a memo from the hospital’s president and CEO, Stuart E. Rosenberg.

Out are Michele Urban, who was appointed vice president for patient care services in 2008, and James Fidanza, vice president for post-acute care and top administrator at Johnson Memorial’s nursing facility, Evergreen Health Care Center.

Read more here.

 

Malloy: Let Nurse Practitioners in CT Work Independent of Doctors

CT Mirror, Feb. 11

Nurse practitioners would be allowed to treat patients and prescribe medications independently under a proposal by Gov. Dannel P. Malloy’s administration, a potentially significant -- and controversial -- change in the medical landscape aimed at expanding access to primary care.

The ability of nurse practitioners to work independently of doctors has long been an issue of contention between the two professions, and states vary widely in how they allow nurse practitioners to practice.

Read more here.

Hot Topics in Health Care

As ICD-10 Deadline Looms, Healthcare Providers Fret

HealthLeaders Media, Jan. 20

Healthcare providers, payers, the government, and other players in the ICD-10 changeover are not working in a cohesive and coordinated fashion and won't be ready for the transition in eight months, says an MGMA policy expert.

The looming Oct. 1 implementation for ICD-10 has healthcare providers antsy about a potentially rocky transition to the new diagnostic code set in the midst of other fundamental and profound changes to the healthcare sector.

A survey of more than 570 practices representing more than 21,000 physicians finds that less than 10% of them had made significant progress when ranking their overall readiness for Oct. 1, up from 4.7% in June 2013.

Read more here.

 

Goodbye To the Doctor's White Coat?

The New York Times, Jan. 27

New recommendations on what health care workers should wear may mean an end to the doctor’s white coat.

The Society for Healthcare Epidemiology of America, a professional group whose mission is to prevent and control infections in the medical workplace, has issued guidance on what health care workers should wear outside of the operating room.

The paper, in the February issue of Infection Control and Hospital Epidemiology, suggests that to minimize infection risk, hospitals might want to adopt a “bare below the elbows” policy that includes short sleeves and no wristwatch, jewelry or neckties during contact with patients.

Read more here.

 

Data Analytics Takes on Medication Management

HealthLeaders Media, Feb. 5

The expansion of e-prescribing and data analytics is leading to improved outcomes, reduced costs, and enhanced patient engagement. And technology is allowing providers to earn hard cash for meeting medication adherence targets.This article appears in the January/February 2014 issue of HealthLeaders magazine.

Billions of dollars are wasted and thousands of lives lost each year through inefficient or ineffective medication management. It has been estimated that the misuse of prescription drugs in our healthcare system is up to a $300 billion problem annually.From the doors of the emergency room to the drawers of patients' home nightstands, medications are mixed up, misremembered, overdosed, underdosed, and laboriously documented or misdocumented.

Read more here.

 

Connected Health and America's War on Error

Health Affairs Blog, Feb. 5

There is a war going on in our healthcare system, where according to a recent analysis, the annual losses are worse than any other war in our nation’s history, including the Civil War, World War II and our War on Terror. It is an undeclared “war on error” within our healthcare delivery system.

It is the most deadly war we have ever waged, with errors and resultant harm in hospitals contributing to the death of nearly 1,000 people each day in the U.S., potentially more than 400,000 a year.

Read more here.

Coming Events

February 24-28 (Monday-Friday)

Hyperbaric Training for Healthcare Providers

Backus Wound and Hyperbaric Center in Norwich

Hartford Hospital in collaboration with the OxyHeal University, is offering a 40-hour course in Hyperbaric Training for Healthcare Providers on Feb. 24-28 at the Backus Wound and Hyperbaric Center in Norwich. It will meet daily from 8 a.m.-5 p.m.

 

March 26 (Wednesday)

Medical Staff Interim Meeting

Gilman Auditorium, 6:45-8 a.m. and 5:30-7 p.m.

We will be having two Town Hall Style meetings with the hospital and medical staff leadership on Wednesday, March 26 in Gilman Auditorium, 6:45-8 a.m. and 5:30-7 p.m. Planned participants include Drs. Stu Markowitz, president; Jack Greene, chief medical officer for HH; Rocco Orlando, chief medical officer for HHC; Jim Cardon, executive vice president and chief clinical integration officer for HHC; and Stacy Nerenstone, president of the medical staff. Come and ask your difficult questions, and find out what is going on at Hartford Hospital and at Hartford HealthCare.

 

March 26-28 (Wednesday-Friday)

TransFuse 2014

JW Marriott Desert Ridge Resort and Spa in Phoenix, Arizona.

Hartford Hospital and the Mayo Clinic are offering TransFuse 2014, a 3-day multidisciplinary conference devoted to exploring the current state-of-the art techniques and program development to implement a blood management program in hospitals. It will be held March 26-28 at the JW Marriott Desert Ridge Resort and Spa in Phoenix, Arizona.

Dr. Ajay Kumar, chief of the Department of Medicine, is one of the course directors. Also on the faculty from Hartford Hospital are Dr. Elizabeth Deckers, Ob-Gyn; Dr. Steve Shichman, chair of the Department of Urology; and Chris Donovan, executive director of fiscal services.

REGISTER ONLINE NOW! http://www.mayo.edu/cme/anesthesiology-2014r455 HHC members gets a discount with registration at the Blood Summit.

 

April 10 (Thursday)

Prostate 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. Stuart Kesler, Arthur Tarantino and Joseph Wagner. The session will focus on criteria for PSA testing, managing BPH and new developments in Active Surveillance for patients diagnosed with prostate cancer.

 

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.

 

June 4 (Tuesday)

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 .

 

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.