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


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In This Issue...

January 26, 2014 Edition

Please double-click on links to go to stories.

Wash In - Wash Out


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:

2002 - Hartford Hospital performed the state’s first successful operation on a fetus with an oral obstruction prior to full delivery.

Follow Hartford Hospital on facebook, youtube and twitter


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

ICD-10 Conversion:
Bottom Line: if you don’t code properly, you won’t get paidOrlando

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

Change is now the norm for physicians. With hospital mergers and affiliations, electronic health records, and evolving payment systems and regulations, it can be difficult to keep up.

There is yet another huge change on the horizon that will demand our time and attention. In a few months, the United States will adopt ICD-10, a new medical coding system.

While it may seem a long way away and not very significant on a doctor’s busy radar screen, it will change everything for us. The bottom line: if you don’t code properly, you won’t get paid.

ICD-10 is the latest version of the International Classification of Diseases, used throughout the world. Here in the U.S., we have been using version 9 since 1979, and have been federally mandated to make the complex transition to ICD-10 by October 1, 2014.

The change to ICD-10 may be the most challenging transition since the inception of medical coding, and will require changes throughout the health care industry. Since ICD-10 is the first new diagnosis coding system adopted since the widespread use of computers, the change will involve updated software installation, as well as staff training, changes to business operations, data conversion, testing, reprinting of manuals and other materials, and more.

For physicians, whether employed or in private practice, documentation must be adapted to conform to ICD-10 coding requirements.

It will be time consuming, labor intensive, and costly for all involved. It is essential to the financial wellbeing of both our hospitals and each of you to prepare for the change to ICD-10.

Hartford HealthCare is committed to helping all our physicians adapt to this changing environment with minimal disruption. We are planning a series of communications and training – written, web-based and in person - to assist you with this transition.

Please take some time to familiarize yourself with what ICD-10 is all about. We have set up a SharePoint page ( with links to a variety of information. Take a few minutes to look over the Resources for Physicians we have posted there.

Also, watch for regular postings called “Countdown to the Upgrade,” here in Seymour Street Journal. We will share information, links and tips that will help you get ready for what promises to be a massive change.

If you have questions, please send them to

Together, we will meet the challenges posed by the transition to ICD-10. We have 258 days to get ready, and the clock is ticking.

Top News

2014 Black & Red  Is on Track to Bring in $1 million

Support of the 23rd annual Black & Red on Jan.25 was outstanding.  A sold-out house was treated to an exciting evening of music by the pop band Barenaked Ladies, dinner, dancing, and dessert at the Bushnell.  More than 1,200 guests attended the annual fundraising event, which this year benefited the Institute of Living (IOL). The gala is on track to net more than $1 million.

In addition to BNL, entertainment was also provided by the high-energy dance band Flipside in the Bushnell’s Belding Theater and by Twilight in the Bushnell’s Great Hall.

The evening also marked the IOL’s “Stop the Stigma” campaign, which is aimed at eliminating the fear of stigma and discrimination that makes it hard for people with mental illness to get the help they need. The IOL is asking everyone to make a difference and help change the way people view mental illness by taking a pledge to "Stop the Stigma" at  

The gala was such a tremendous success, in part, because of the support of the 2014 Black & Red Medical Staff Advisory Committee, which is chaired by Hank Schwartz, MD, and includes members:

Rehan Aziz, MD
Sanjay Banerjee, MD
Sudeshna Basu, MD
Adrienne L. Bentman, MD
Karen Blank, MD
Greg Bonaiuto, MD
Lee D. Brauer, MD
James F. Brodey, MD
Deepti Chopra, MD
Eric D. Cohen, MD
Jeffrey L. Cohen, MD
Michael Dewberry, MD
Jeffrey A. Finkelstein, MD
Joanna H Fogg-Waberski, MD
Evan Fox, MD
Ethan B. Foxman, MD
John W. Goethe, MD
John F. Greene  Jr., MD
Robert C. Hagberg, MD
Victor Herson, MD
Alfred Herzog, MD
Orlando Kirton, MD
Ajay Kumar, MD
Inam U. Kureshi, MD
Vernon Kwok, DMD
Courtland G. Lewis, MD
Mirela Loftus, MD
Steven H. Madonick, MD
Salma Malik, MD
Radhika Mehendru, MD
Raveen Mehendru, MD
Theodore F. Mucha, MD
Lisa B. Namerow, MD
Stacy R. Nerenstone, MD
Jeffry Nestler, MD
Jerry Neuwirth, MD
Sara H. Niego, MD
William T. Pastuszak, MD
Godfrey D. Pearlson, MD
David A. Pepper, MD
Ann L. Price, MD
Osman Qureshi, MD
Francisco A. Ripepi, MD
Tilla F. Ruser, MD
Dahlia A. Saad Pendergrass, MD
Robert A. Sahl, MD
Matthew L. Saidel, MD
Andrew L. Salner, MD
Patricia A. Sheiner, MD
Steven J. Shichman, MD
Samuel M. Silverman, MD
Joel Sorosky, MD
Caren B. Teitelbaum, MD
Witold Waberski, MD
Karina R. Weiss, MD
Andrew Winokur, MD
Leslie I. Wolfson, MD
Peter M. Zeman, MD


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 last night 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 5,000 individual pledges, spreading the message that changing attitudes can begin to change minds. Ask everyone — fellow employees, volunteers, patients, the community — to “take a pledge.” It is online now at


HHC Launches ImageConnect, a Cloud-based imaging system

Hartford HealthCare is launching an initiative called ImageConnect, which will help deepen the integration of caregiving across our system.

ImageConnect is aimed at creating a robust, flexible and scalable cloud-based imaging system that will further reshape the way we diagnose and treat patients. It will allow patients' imaging histories to follow them across our system.

We will move from the complexity and inconvenience of multiple imaging systems to a single platform – available to clinicians via the Epic dashboard.

Unlike CareConnect, which will make use of the Epic EHR tool, the ImageConnect system will be largely homegrown, with the help of several vendors and, most important, the contributions of a broad-based, systemwide group of leaders.

Dr. Rocco Orlando is the project’s executive sponsor. Interventional radiologist Dr. Barry Stein, HHC chief imaging informatics officer, and Hank Tessier, ImageConnect program director, will lead it. Steering and operations committee members represent system talent from clinical services, ITS and other areas.

Work begins immediately to build and test the ImageConnect system together with the first two customers: Radiology and Cardiology. Dr. Stein will be the clinical sponsor for Radiology and Dr. Justin Lundbye will be the clinical sponsor for Cardiology. We expect to begin to bring these system-wide service lines onto ImageConnect before the end of 2014. Other service lines will quickly follow.


Update on Cancer Institute's Alliance With Memorial Sloan Kettering

Memorial Sloan Kettering (MSK), the world’s oldest and largest private cancer center, has selected the Hartford HealthCare (HHC) Cancer Institute, which includes all HHC cancer-care facilities, as the first member of the MSK Cancer Alliance.

As a system, HHC treats more than 6,000 new cancer cases annually. This unique partnership with MSK will give HHC cancer patients unprecedented access to MSK standards of care and clinical trials by HHC physicians in HHC facilities.

To learn more, please visit our new HHC Cancer Institute Web site at:

FAQs and other information about the alliance are available there for both physicians and patients.


NBC Nightly News Uses Video From Our ED

We pitched a story to NBC Nightly News last week over the record number of patients in the ED, many with viral illnesses. A producer contacted us and a flu patient was interviewed. Dr. Richard Quintiliani Jr. from Medicine/Infectious Diseases is in the video.

The story appeared on NBC Nightly News with Lester Holt on Jan. 19. Courtesy: NBC Nightly News


Atrial Fibrillation Center To Open in February

The Division of Cardiology is pleased to announce the opening of the Hartford Hospital Atrial Fibrillation Center.

The center, which will officially open in February, is a joint venture between the departments of Electrophysiology, Cardiology, and CT surgery.

It is the first center in the region to offer comprehensive evaluation, management, and treatment services for patients with atrial fibrillation (AF) in a collaborative and multi-disciplinary fashion.

"The center will assist patients and their doctors in navigating the wide array of therapeutic options (drug therapy, pacemakers, catheter ablation, and surgery) that are now available to treat AF," said Dr. Eric Crespo, director of the Interventional Electrophysiology Lab.

Patients can be referred for evaluation through the department of Electrophysiology at 860-972-1506.



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.


Dr. Michael Lindberg Selected As Contributing Question Author to Geriatric Review Syllabus

Dr. Michael Lindberg, physician-in-chief for the Geriatric and Palliative Medicine Institute of Hartford HealthCare, has been selected by the editorial board of the upcoming 9th edition of the Geriatric Review Syllabus to be a contributing question author.

Dr. Lindberg has authored questions and critiques for the previous four editions of the Geriatric Review Syllabus. The 9th edition will be published in 2015.


Dr. David Tolin To Receive Lifetime Achievement Award

David F. Tolin, Ph.D., director of the Anxiety Disorders Center at the Institute of Living, will be given a lifetime achievement award at the annual meeting of the Connecticut Psychological Association in October.


Dr. Orlando Kirton Named Master of Critical Care Medicine

Dr. Orlando Kirton, director of the Department of Surgery and chief of the Division of General Surgery, was selected as Master of Critical Care Medicine by the Council of the Society of Critical Care Medicine.

The selection as an MCCM reflects his status as a long-standing Fellow of the American College of Critical Care Medicine and is based on achievements as a prominent and distinguished leader of national and international stature, personal character, leadership, eminence in clinical practice, outstanding contributions to research and education in critical care and exemplary contributions to SCCM, ACCM and the field of critical care.


Cardiology Expands LDL Apheresis Program

Hartford Hospital has one of only 50 LDL apheresis programs in the country.

"We recently treated a woman with primary biliary cirrhosis whose total cholesterol was over 3,000 mg/dl and who was having cerebral symptoms because her levels were so high," said Dr. Paul Thompson, chief of Cardiology.

In the past year, Dr. Thompson said, the program has expanded and it is now one of the largest in the country.


Our Physicians Are Great Sources For Local Media

Dr. Jack Ross was interviewed on NBC CT on Jan. 12 about the flu.

Drs. Gretchen Diefenbach and Mical Assaf were interviewed on WNPR on Jan. 14 about a new study currently taking place at the IOL involving neuronavigation in the treatment of anxiety disorders. Hear the segment here.

Scott Healer, a PA from HHC MG, was interviewed by NBC CT on Jan. 15 about how the harsh winter weather can exacerbate pre-existing skin conditions.

Dr. Hank Schwartz was a panelist on "Out of the Shadows: A Community Conversation on Mental Health," broadcast live on CTN on Jan. 14. He also recorded a segment for "The Real Story" on Fox CT about the need for the"Stop the Stigma" campaign, which will air on Jan. 19. He was interviewed by News 8 on Jan. 17 about Peter Lanza's cooperation with the Sandy Hook commission; by the Yale Daily News on Jan. 21 about the relationship of mental illness to violence; and by Fox CT on Jan. 23 about the "Stop the Stigma" campaign.

Dr. Jeff Finkelstein was interviewed on WTNH and the Hartford Courant on Jan. 15 about the high census in the ED due to viral illnesses.

Dr. Ken Robinson was interviewed on Channel 3 and Fox CT on Jan. 15 about the high census in the ED due to viral illnesses.

Dr. Mike Drescher was interviewed on WTIC on Jan. 17 about the ED status of patients.

Dr. Andrew Salner appeared on WFSB Medical Rounds on Jan. 22 talking about the alliance with Memorial Sloan Kettering. Watch the segment here.

Dr. Kelly Johnson-Arbor was interviewed by Fox CT on Jan. 21 and WTNH on Jan. 22 about hypothermia and frostbite. Watch the segment here.

Dr. Cliff Rios was interviewed by WFSB on Jan. 23 about the dangers of cross-fit training.

Dr. Stuart Markowitz was interviewed on Fox CT on Jan. 24 about the Black & Red.

Dr. Laura Saunders was interviewed on Foxt CT on Jan. 24 to discuss the psychological impact behind Justin Bieber's arrest.

Dr. Vasanth Kainkaryam was interviewed on WFSB on Jan. 25 about an event he is facilitating at the CT Science Center about pediatric obesity.

Research and Academics

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: or



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.


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


Ophthalmology Fellowship Certified

The ophthalmology office of Dr. Paul Gaudio, located at 85 Seymour Street, recently received formal credentialing for an ophthalmology fellowship specializing in ocular infection and inflammation (uveitis) from the Association of University Professors in Ophthalmology (AUPO).

Dr. Gaudio's office has had two uveitis fellows in the recent past.


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

TigerText Update

Tiger Text is the encrypted HIPAA compliant text messaging application that HHC has endorsed for our providers.

This application provides:

  • Secure text messaging
  • Efficiency in provider communications
  • Tracking of messages sent to colleagues

Tiger Text is the application chosen to assure compliance across the system and to facilitate superior coordinated care for our patients.

Our goal is to enroll as many providers as possible to enhance our ability to communicate about patient issues, leading to more efficient coordinated care. It allows real time communication about patient issues which enhances our ability to communicate in an effective and timely manner. Once installed, it is a simple application to use. We encourage everyone to enroll.

The application is available to credentialed physicians and mid-level providers. We have already enrolled a large number of providers and hope to expand it to the entire medical staff.

If you wish to enroll, send an email to the TigerText project manager, Christine Greene, at with the heading “tiger text enrollment.”

If you have any issues with the application, you may contact the Customer Service Center at 860-545-5699. The Mobility team for your region will process a resolution for you as soon as possible.


GreeneHand Hygiene Champions Debut on Nursing Units

Dr. Jack Ross, Chief, Infectious Diseases, HIV Programs, Epidemiology

Starting in February, you will see physicians, nurses, patient care assistants and others wearing this button on all our nursing units. They are our new unit based hand hygiene champions!

At the suggestion of the ICU nurses and their managers, each unit, each role, each shift throughout the hospital will have individuals who will prompt all caregivers to perform hand hygiene.

The hand hygiene champions will speak to you if you forget to wash in, wash out. There will be zero tolerance for disrespectful behavior, and leadership will speak to anyone who pushes back when spoken to by the unit champions. If the behavior continues, a Quantros report for unprofessional conduct will be submitted. The unit champions are in addition to hand hygiene observers and accountability agents on the units currently.

The buttons and champions also serve a second purpose of messaging to our patients, their families, and our colleagues that we value hand hygiene and patient safety at Hartford Hospital.

Hartford Hospital Medical Staff members are currently fourth in HHC for compliance with hand hygiene at 80%. For comparison, THOCC and MidState physicians are at 100% and 94% respectively.  We need to improve hand hygiene both entering and leaving our patients' rooms.

Enhancing The Patient Experience

Voices of Our Patients: Kudos To Drs. Smedley and Al-Bagdhadi

Dear Sir or Madame,

On Jan. 8, I was an inpatient for a colonoscopy procedure.

Every step of the way (including phone conversations with Maria beforehand), the hospital and its staff maintained the very high standard of care and expertise that we (as a family) have experienced in our nearly four years of living in Hartford.

The receptionist was gracious and efficient.

The staff involved from start to finish in my procedure under the care of Dr. Michelle Smedley were as follows: Pauline, Precious, Julia, Dr. Yasser Al-Bagdhadi in admittance, and Jen and Andre in recovery.

Our proximity to the hospital and our experiences there during our time in Hartford have been a big part of our strong attachment to the city.

With gratitude,

Dectora Coe Jeffers

Operational Update

Announcing a SECOND Psychotherapy Group at the IOL for Medically Complex Young Adults

The Institute of Living will be starting a second ongoing therapeutic support group for young adults (approximately 17-26 years old) who are struggling with co-occurring medical and psychiatric conditions. This new group will run on Fridays at 2 p.m. in the conference room of the Center Building on the Institute of Living campus.

A collaboration of the divisions of Health Psychology, Neuropsychology, and Young Adult Services, this psychotherapy group provides patients an opportunity to grieve the losses and limitations brought on by their medical conditions, while maintaining a future oriented focus. By modifying hopes, expectations, and plans in an empathic environment patients support one another in their pursuits of fulfilling and meaningful lives.

This group is open to any and all young adults -- they do not have to be current patients of IOL/HH.  Patients will be registered by the Young Adult Services billing department.

While the number of referrals we receive in the coming weeks will determine the start date of the new group, presently we believe we will be up and running no later than mid-February.  Patients, families, and referring providers seeking additional information may contact Dr. David Bendor directly at 860-545-7008 or at 


Please Take This Brief Survey: Center For Global Health

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.

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.

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

To participate in this 5-10 minute survey please click here. (

(You may have already taken the Hartford Hospital Humanitarian Mission Survey last February. This is not the same survey. This survey is designed to more accurately capture data that can be collected in the Center for Global Health's database.)



Please Take This Brief Survey: ICD-10 Awareness

Hartford HealthCare is well underway preparing for the transition to ICD-10 on October 1, 2014. This will affect physicians in both the inpatient and outpatient arena, as physician payments will require the use of ICD-10 coding.

We would like to have physicians involved and integrated with this project as it evolves.

Here is a link to a very short questionnaire consisting of only eight questions. ( Our purpose is to establish a baseline understanding of physician knowledge and preparation for the ICD-10 transition.

Please take a minute to answer these questions by Feb. 4. We will analyze the data and then communicate the results back to you.



“Safety Starts with Me” Training Session

Patient safety is our priority. Our goal is to train all physicians who care for patients in our hospital to fully participate in this effort.

The medical staffs at THOCC and Backus have already undergone this training. Dr. Peter Shea, the vice president for Medical Affairs in the Eastern Region, will conduct a training session for physicians on Monday, February 3 In Gilman Auditorium. This session will take place from 11:30 a.m.-1 p.m. during the time set aside for our combined clinical chiefs/MEC meeting. Members of these groups will be expected to attend. We are also inviting all members of our medical staff.

This training will be mandatory over the next year and multiple other sessions will be scheduled. Please take advantage and attend this kick-off session if at all possible. Feedback from those who have attended other sessions has been outstanding.

The safety behaviors that are included in the hospitalwide training include clear communications, effective hand-offs, attention to detail, mentoring and coaching others and practicing with a questioning attitude. These safety behaviors have been successfully deployed in more than 300 other hospitals nationwide, resulting in reduction of preventable harm rates of 85-90 percent on average.

HH’s goal with the HRO journey is to substantially reduce incidents of preventable harm, to the eventual goal of to at least one year without an incident. It’s part of our commitment to do the safe thing for every patient, every time.



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.

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: 247 Days To The ICD-10 Conversion

You May Need Several Months Emergency Cash Reserves for ICD-10

Healthcare IT News

Healthcare providers may face disruptions in their payments even if they are on target to operate using ICD-10 codes on Oct. 1, 2014. 

Since providers will, and indeed need, to be able to pay rent and staff salaries if the transition does not flow as smoothly as testing has indicated, experts advise having up to several months' cash reserves or access to cash through a loan or line of credit to avoid potential headaches.

"Just figure that with the transition to ICD-10 there will be delays in reimbursement," said April Arzate, vice president of client services at MediGain, a Dallas-based revenue cycle and healthcare analytics company.

Paul Weygandt, MD, vice president of physician services at J.A. Thomas & Associates, said that the amount of cash reserves will vary depending on the healthcare organization.

"The better way to look at this," Weygandt explained, "is that the amount of money that you need to set aside is inversely proportional to the preparation work you do for ICD-10." 

Read more here.

HH In the News

New Hospital Rooms Designed For Mental Health Disorders

WTNH, Jan. 14

There are some new emergency rooms at Hartford Hospital designed to safely treat those with mental health disorders. If you are looking at a bed in the emergency room at Hartford Hospital, it's in the purple pod where there is tempered glass in the windows and covering the TV. There are no electrical outlets in the room, a camera monitors the patient 24/7 and all the security measures blend into the room.

"If a patient is all on edge, already it's hard to make sure you get a thorough evaluation. They may be sayings things just to get out of the room, out of the bad experience," said Dr. David Pepper, Hartford Hospital.

Doctors say by relaxing the patient, they can be more confident in their diagnosis. The lighting has been studied and altered in the purple pod. It can be dimmed and colors changed from yellow to blue to green.

"Different colors can help a patient feel more calm and relaxed and we really tailor toward the patient. If they prefer the blue or green light, we can adjust the light to their preference," said Pepper.

One of the biggest problems is dignity. When you take four, five or six patients and put them in the same room, they have no privacy. At the Hartford Hospital rooms, all you have to do is flip a switch and it tints the glass and it is instant privacy inside the room.

"So you can see that we have windows that can close it down, and be able to do some therapy and give them privacy," said Danette Alexander, Hartford Hospital.

Right now, Hartford has ten of the new rooms in the purple pod up and running, and there are 13 more that will be done next month.

These state of the art, one of a kind rooms in Connecticut are leading the way to changing the way behavioral health patients are treated.

"It allows us to have access to the patient and allows the patient security and a calm, quiet environment," said Pepper.

Watch the 2 minute video clip which aired on News 8 here.


Flu Cases in CT Now Top 1,000; Hartford Hospital ER Sees Record Day

Hartford Courant, Jan. 15

State health officials reported on Jan. 15 that more than 1,000 people in Connecticut have now come down with the flu this season, a fact not lost on emergency room staff at Hartford Hospital.

They saw 376 patients Jan. 13, erasing a daily record there that goes back at least 15 years.

Emergency room doctors are seeing more and more cases not only of the flu, but of a gastrointestinal illness that has been hitting the region.

"I think we're right in the middle of an outbreak of both, and I don't think it's peaked yet," said Dr. Jeff Finkelstein, chief of emergency medicine for Hartford Hospital and the Hospital of Central Connecticut.

Read more here.


Reviving a Life Saver, the Tourniquet

The New York Times, Jan. 19

As far back as Alexander the Great’s campaigns, tourniquets were wartime staples, used to stanch the bleeding of wounded soldiers. But they became a last resort for both military and civilian emergency personnel after World War II, when medical experts blamed the prolonged cutoff of blood for frequent amputations.

Transportation was so poor in those days that it took the wounded hours, if not days, to receive adequate medical attention — far too long for a tourniquet to remain in place. “The treatment was initially worse than the disease,” said Dr. Lenworth M. Jacobs, the head of the Hartford Consensus, a group of experts in emergency medicine who have studied how to respond more effectively to mass casualties.

Although the expanded use of tourniquets has encouraged some medical experts, they believe more needs to be done. Dr. Jacobs said that “when they began putting $15,000 defibrillators in public places 15 to 20 years ago, there was no concept” that terrorist attacks or mass shootings might one day be more common.

“There’s no reason a $15 tourniquet can’t be right beside the defibrillator,” he said.

Read more here.


New Anxiety Research Targets Brain Using Magnets

WNPR, Jan. 22

Patients diagnosed with generalized anxiety disorder usually have two treatment options: medication or counseling. But new research underway at Hartford Hospital is looking to add a third choice -- magnets.

Gretchen Diefenbach is the doctor in charge of the society. She said both medications and counseling treatments like cognitive behavioral therapy only help about half of the people who do those treatments. So she's looking at a new idea, Transcranial Magnetic Stimulation, which targets so-called "worry circuits" in the brain.

"It's a therapy where we put a magnetic pulse on the scalp," Diefenbach said. "That pulse is used in order to change the electrical activity underneath, in the brain site."

Read more here.


Feds Probe Use of Surgical Robots

Journal Inquirer, Jan. 23

Million-dollar robotic surgical systems touted by hospitals in Connecticut as state-of-the-art medical technology have had a spike in reported problems and a series of manufacturer recalls. Now these systems are under review by federal regulators.

But officials at three regional health care systems that together use eight of the robots for patient care — Eastern Connecticut Health Network, Hartford Healthcare, and St. FrancisCare — say none of them was affected by the recalls.

They also say they haven’t had to report any injuries to patients in connection with the use of the “da Vinci” surgical systems manufactured by a California company, Intuitive Solutions.

In the HHC System

MidState Medical Center Opens Unique Hybrid Operating Room

WTNH,Jan. 17

MidState Medical Center in Meriden is among the first in the country to offer a high-tech operating room where patients can be diagnosed and treated in one sitting.

The hybrid operating room is robotically controlled with the latest software in 3-D imaging.

"It's sort of like having R2D2 bring you an X-ray machine," said vascular surgeon Dr. Jonathan Hasson. "It lets you do surgical procedures and minimally invasive vascular procedures in the same setting."

The sophisticated room at MidState Medical Center enables surgeons to be more precise in repairing a patient's problem with little or no incision.

"We can do diagnostic angiography and find problems and in the same setting, and repair the problems as we find it, rather than two separate imaging settings," Hasson said.

Read more here.


Gastric Bypass Surgery Available At Backus

The Day, Jan. 21

The William W. Backus Hospital has begun offering gastric bypass surgery for obese patients seeking to lose weight, the hospital announced Monday.

Hospital spokesman Shawn Mawhiney said Dr. Mark Tousignant has already done a few of the procedures, and more are scheduled. The procedure is the second type of bariatric surgery offered by Backus, adding to the adjustable gastric banding done there since 2010.

Read more here.


New HHC Defined Contribution Funds mentioned in industry journals for high performance options with less market risks

4 Traders, Jan. 15

Lazard Asset Management announced that the Lazard Emerging Markets Multi-Strategy Portfolio has been selected by Hartford HealthCare as the first emerging markets investment option for its defined contribution retirement plan.

"Our intention is to give our employees access to some of the best thinking behind our top performing endowment funds, namely to capture the market growth potential of emerging economies without subjecting employees' savings to the full risks of emerging stock markets," said David Holmgren, Chief Investment Officer of Hartford HealthCare.

Read more here.

Health Care News In the Region

Startup's Cancer Therapy Preps For 2014 Clinical Trials

Hartford Business Journal, Jan. 13

A Connecticut startup developing a new cancer treatment is drawing the eyes and interest of investors and big pharma, as it prepares to begin clinical trials this year on its drug discovery.

Kolltan Pharmaceuticals Inc. is developing a drug therapy that targets and aims to block chemical signals in cancer cells that help form tumors.

The New Haven privately-held firm got its start based on lab discoveries from Yale professor Dr. Joseph Schlessinger, and hopes to eventually tap into a $24 billion cancer drug market for targeted antibody therapies.

Kolltan has raised $75 million from a host of life science investors and signed a key licensing agreement in July with MedImmune, the R&D arm of bio pharmaceutical giant AstraZenca.

"Our goal is to build an industry-leading company that can generate and develop novel [drugs] for use in oncology and other severe diseases," said Gerald McMahon, a former MedImmune executive who took over as Kolltan's CEO in 2012.


Report Gives CT Emergency Rooms a 'C'

Hartford Business Journal, Jan. 16

A report grading the conditions of the nation's emergency departments said Connecticut's are 15th best in the country, with a 'C' grade.

That was down from a 14th-place ranking in 2009, when Connecticut earned a 'C+' grade.

The American College of Emergency Physicians, which created the report card, commended Connecticut for having a low rate of fatal injuries and residents with "general good health."

But the state's emergency departments lost points for having an average wait time of nearly six hours, the sixth longest in the country.

Points were also docked on the report's access-to-care category. Emergency rooms in the state have a high occupancy rate, despite the high number of trauma centers in the state.

The report also said that Connecticut has not kept pace with other states in preparing for a large-scale disaster.


Multiple Kidney Transplants Becoming More Common

Hartford Courant, Jan. 17

Ryan Dasilva, 23, of Danbury needed his third kidney transplant, but his blood was incompatible with more than 99 percent of potential donors.

His options were running out when he received a call that he was eligible to be part of a six-person kidney transplant, performed simultaneously in December at Yale-New Haven Hospital, the University of Toledo Medical Center in Ohio and the Maine Medical Center.

Multiple live-donor kidney transplants — considered the best way to lower the number of people on the waiting list for organ donations — are becoming increasingly common. In 2012, the most recent available data, there were 529 multiple kidney swaps, the most in any year.

Read more here.


Jackson Labs Wins $7.5 Million Research Grant

Hartford Courant, Jan. 17

The Jackson Laboratory, the state's partner in a massive bioscience expansion, has won a $7.5 million grant from the South Korean government for a large-scale cancer genomics project. The grant will pay for research using Jackson Laboratory mice that can host human tumors.

"This is a wonderful example of the international collaborations that JAX is building to rapidly advance its research mission, in this case: individualized cancer diagnosis and treatment," said director of The Jackson Laboratory for Genomic Medicine and leader of the JAX component of the project,

Lee, who also is a distinguished visiting professor at Seoul National University, will work with principal investigator Jong-Il Kim, M.D., Ph.D., of the Seoul National University College of Medicine and other academic collaborators in Seoul.

During the first phase of the grant, from 2013 to 2015, Kim and colleagues will collect and store tumors from patients with gastric, breast, colon, lung and rare cancers and determine the genomic signatures of those cancers.

Lee will lead the development of hundreds of new mouse model systems for gastric, breast and other cancers that will be made available to the worldwide scientific community. The models will allow for more detailed study of the cellular and genomic characteristics of specific cancers. The research team will also build a publicly accessible library of anticancer drugs.

Read more here.


Hospital Exec Explains Decision To Lease Hardware

CIO, Jan. 15

Last fall, after mulling the buy-vs.-lease question, St. Francis Hospital and Medical Center, based in Hartford, Conn., determined that leasing computers would save it 10% based on a three-year timetable.

The decision to switch to leasing was taken up as part of the preparation for a major upgrade of clinical applications systems now underway, says Glenn Mason, director of infrastructure and enterprise services. "We had the opportunity to replace 5,000 end-user client devices -- 3,700 PCs and 1,200 thin clients," says Mason. Other equipment, such as servers and workstations on wheels were also going to be upgraded as part of what was anticipated to be more than a $3 million technology refreshment focused around the Epic electronic healthcare application and the implementation of new workflow systems.

Mason said the hospital's management took a look at the upfront costs for buying hardware versus leasing it, based on a deal offered by HP Financial Services, and determined it would save at least $150,000 in 2014 alone under a three-year lease plan. "At the end, it will save 10% in the total cost of ownership over three years," says Mason.

Read more here.


UnitedHealthcare's Plan to Drop Doctors From Medicare Advantage Scrutinized At Federal Hearing

Hartford Courant, Jan. 22

UnitedHealthcare's recent decision to drop thousands of doctors from its Medicare Advantage plan came under harsh criticism at a U.S. Senate hearing Wednesday.

U.S. Sen. Richard Blumenthal chaired the field hearing of the Senate Special Committee on Aging at the Legislative Office Building. He was joined by another committee member, U.S. Sen. Sheldon Whitehouse of Rhode Island.

In early October, UnitedHealthcare sent letters to an unknown number of doctors in Connecticut and elsewhere, informing them that they would be dropped from its Medicare Advantage network as of Feb. 1. UnitedHealthcare officials say the number of doctors to be dropped is proprietary, but the Connecticut State Medical Society estimates that the number in Connecticut is at least 2,200.

The Fairfield County Medical Association and Hartford County Medical Association are suing UnitedHealthcare, seeking to prevent the company from dropping doctors who belong to the two associations on Feb. 1.

Read more here.

Hot Topics in Health Care

New Year Brings Change, Opportunity for Hospitals

Hospitals and Health Networks, Jan. 14

Hospital leaders will have some real opportunities to improve care in their communities in 2014.

On top of every hospital administrator's mind is the need to shoulder a new round of changes this year, from electronic health records and ICD-10 implementation to new penalty programs and payment models, to a host of new regulations, some with ambitious timelines.

Hospitals are also concerned with meeting the needs of the growing number of baby boomers reaching an age when they can be expected to put greater demands on the health care system and with responding rapidly to other demographic shifts in their communities.

Fortunately, with these changes come new opportunities. Even in states that are not expanding Medicaid, hospitals can expect considerable gains in coverage — with millions of newly insured Americans. This constitutes a significant and welcome step forward on the road to building healthier communities. But hospitals will have plans to achieve their own improvements this year.

Hospitals will be working hard to make further gains in quality and patient safety. Nothing succeeds like success, and we now have examples of highly effective, evidence-based improvement efforts across the board — from eliminating health care-acquired infections to reducing patient readmissions. Hospitals will evaluate carefully the many opportunities for improvement and make a strategic plan to implement those that will have the greatest impact.

Read more here.


Doctors' Dress Code Aims To Halt Nasty Germs

NBC News, Jan. 20

A new dress code for doctors, nurses and other health care workers calls for outfits that may be short on style, but long on what it takes to keep dangerous germs from spreading among patients.

Short sleeves, bare hands and forearms and white coats that are laundered at least once a week — if not more often — are the keys to keeping nasty bugs such as Staphylococcus aureus from hitching a ride on a doctor’s wrist.

Neckties are questionable. Watches and rings have to go. It’s not clear what to do about name tags, lanyards, necklaces and cell phones, but when in doubt, it’s best to clean the offending items — or get rid of them.

Read more here.


Hospital of the Future Will Be A Health Delivery Network

U.S. News and World Report, Jan. 14

To envision and build tomorrow’s hospital, one thing is clear: We’ll only get so far by re-engineering the hospital of the present. The hospital of the future will not be a hospital at all. Instead, it will be an inventive health delivery network that will require all of us -- industry, clinicians, caregivers, families, and patients -- to coordinate efforts in new ways, so we work together more efficiently to serve more people, with better outcomes at lower costs and higher quality standards.

We must break with traditional models and norms and challenge ourselves about how and where care is offered. We need to cooperate through arrangements like private-public-government partnerships that make powerful and meaningful associations among all people, technology, services, situations and costs involved in health delivery.

Read more here.


ICD-10: New Medical Codes Parse Ailments To The Finest Detail

Hartford Courant, Jan. 20

What's the difference if you get hurt at a Bruce Springsteen concert or a performance of "Die Fledermaus"? To your wrenched back, not much. But to the folks who process your medical records, it's a distinction worth noting.

The difference between an injury at a music hall and one at an opera house is one of many thousands of details that will be parsed by a new health care classification system that begins in the U.S. on Oct. 1 — a deadline that presses on every health care provider and insurer in the nation.

This is the first new version of the International Classification of Diseases, maintained by the World Health Organization, since the 1970s. Commonly known as ICD-10, the new system will increase the number of codes to describe various ailments and their treatments from 17,000 to 155,000.

It's a change that some say will improve health care and billing. Others maintain that it will merely drain resources.

Read more here.

Coming Events

February 3 (Monday)

"Safety Starts With Me" - High Reliability Training

Gilman Auditorium, 11:30 a.m.-1 p.m.

Dr. Peter Shea, the vice president for Medical Affairs in the Eastern Region, will conduct a training session for physicians We are inviting all members of our medical staff. This training will mandatory over the next year and multiple other sessions will be scheduled. Please take advantage and attend this kick-off session if at all possible. Feedback from those who have attended other sessions has been outstanding.


February 7 (Friday)

Surgery Grand Rounds: Trauma Resuscitation 2014 - What's New?

Gilman Auditorium, 6:45 a.m.

Dr. Kimberly A. Davis, Vice Chairman of Clinical Affairs and Chief of the Section of Trauma, Surgical Critical Care & Surgical Emergencies at Yale University School of Medicine; and Trauma Medical Director and Surgical Director, Quality & Performance Improvement at Yale New Haven Hospital


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 ONL INE NOW! HHC members gets a discount with registration at the Blood Summit.


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.



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 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.