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


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In This Issue...

March 16, 2014 Edition

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:

2003 - New England’s first PET/CT scanner was installed at Hartford Hospital.

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Chief's Corner

GreeneWelcome To "Chief's Corner"

We recognize the need for sharing information about activities throughout the hospital more widely with our Medical Staff.

Chief's Corner will bring you highlights of activities of interest, which will be authored by our Department Chiefs. Should you have any comments or suggestions along the way, please share them with us.

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


Thank You To the CareConnect Content Experts

I just want to say thank you.

The demands on our time continue to grow and we often face requests to share our expertise. It is clearly not always possible to participate. With that in mind, I want to say thank you to the members of our medical staff who have agreed to serve as content experts in our Care Connect Project.

The switch to Epic will truly be transformational and will help us reach our goal of excellent and coordinated care for our patients. It is an enormous undertaking requiring many resources. One of the many elements necessary to ensure success is input from our medical staff.

Many of you have agreed to serve as our content experts over the upcoming validation sessions. While this commitment is time consuming, it is critical to the success of the building of our Epic platform. Our physicians must be clinically engaged in the process.

So, thank you again for sharing your valuable time.

Top News

Town Hall Meetings for Medical Staff

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.


Seeking Nominations for Medical Staff Awards

The Annual Medical Staff Awards honor individuals on the Medical Staff who have made exceptional contributions to the medical community.

If you know of someone you would like to nominate, please send their name, category (see list below) and a brief narrative as to why you feel they should receive the award to Dr. Stacy Nerenstone or any of the Medical Staff officers.

Awards will be presented at the Board of Directors and Medical Staff Spring Event on May 22, 6 p.m., Heublein Hall.

    For recognition of leadership, excellence in clinical care and research, innovation, teaching, advocacy and activism on behalf of the art and science of medicine and the Hartford Hospital community.
    For extraordinary qualities of compassion, civility, vision and integrity that set an example for all future generations of caregivers at Hartford Hospital.
    For recognition of exceptional leadership in philanthropy through work, commitment, personal giving and unending care and concern for mankind on behalf of Hartford Hospital.
    For extraordinary and sustained contribution to the health and welfare of the citizens of our community by advancing the science of medicine in his/her field, and for the exemplary initiative, creativity and long term commitment to the vision of Hartford Hospital.
    For outstanding commitment to quality improvement, safety and learning directed toward enhancing the patient experience, improving clinical outcomes and making our workplace a safer environment.


VAD Program Earns Joint Commission's Gold Seal of Approval

Hartford Hospital has earned The Joint Commission’s Gold Seal of Approval™ for its ventricular assist device destination therapy program by demonstrating compliance with The Joint Commission’s national standards for health care quality and safety in disease-specific care. The certification award recognizes Hartford Hospital’s dedication to continuous compliance with The Joint Commission’s state-of-the-art standards.

Hartford Hospital underwent a rigorous on-site review in from October 21-22, 2013. An expert Joint Commission reviewer evaluated Hartford Hospital for compliance with the requirements for The JC’s Disease-Specific Care Certification program as well as ventricular assist device destination therapy-specific standards, clinical practice guidelines and performance measures.

"With our second consecutive Joint Commission advanced certification, we are demonstrating our continued multidisciplinary investment in quality on a day-to-day basis from the entire patient care team. The Joint Commission provides us a framework to take our program to the next level and reinforces our commitment to a culture of excellence,” says Dr. Jason Gluck, Medical Director of the VAD program.


Tourniquets and the White House?

Following the incident at Sandy Hook, Dr. Lenworth Jacobs, vice president of Academic Affairs and chief academic officer, founded The Hartford Consensus, a group of experts in emergency medicine and military and law enforcement from across the nation, to determine better ways to respond to mass casualties.

One of the early outcomes was the recognition that early and aggressive medical response and additional training of first responders can save lives. Expanding the use of tourniquets to control bleeding is a relatively simple technique that can be readily learned and the propagation of access to simple supplies can have a profound impact.

Hartford Hospital will be training staff in the use of tourniquets and will be placing tourniquet kits near all defibrillators in the hospital in order to enable our staff to respond quickly should the need arise.   

Dr. Jacobs has been invited by Dr. Richard Hunt, director for Medical Preparedness Policy for the National Security Council, to brief members of the Council March 17 at the White House about the Hartford Consensus recommendations for the medical response to active shooters.

 This is a tremendous opportunity for Hartford Hospital to play a major role in enhancing national policies to increase survival from active-shooter and intentional mass-casualty events. Dr. Hunt has been very impressed with the preparedness activities that Hartford Hospital has implemented, including placing tourniquets throughout the hospital and educating our leadership.  


Dr. Hank Schwartz Participates in Panel at CT Forum

Dr. Hank Schwartz, psychiatrist-in-chief and vice president of Behavioral Health at Hartford Hospital/Institute of Living, was a panelist at the Connecticut Forum at The Bushnell on March 7. The topic was “An Honest Look at Mental Illness,” and the Forum was hosted by Hartford HealthCare.

The two other panelists were authors Kay Redfield Jamison, authority on bipolar disorder, and author of An Unquiet Mind, and Andrew Solomon, psychologist and mental health advocate and author of Far From the Tree: Parents, Children, and the Search for Identity. The Forum was moderated by John Dankosky, host of WNPR’s "Where We Live".

A sold-out Forum audience of 2,800 attended, and also had the opportunity to learn more about mental health organizations in a special "Mental Health Showcase" in The Bushnell lobby, sponsored by Mental Health Association of CT.


Stop the Stigma of Mental Illness

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

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

The goal is to obtain 10,000 individual pledges, spreading the message that changing attitudes can begin to change minds. So far, nearly 7,000 have taken the pledge.

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



Obituary: Dr. Edward Fredericks

Dr. Edward J. Fredericks, 76, of Bradenton, Fla., died on January 3. His solo neurology practice was connected to Hartford Hospital, where he worked part-time in electromyography and served as director of neurologic education and medical director of the rehabilitation unit.

Dr. Fredericks was an intern and medical resident at Hartford Hospital, a neurology resident at the University of Wisconsin, and a fellow in physiology (electromyography) at the Mayo Clinic in Rochester, Minn. He was a consultant for the Newington Children’s Hospital Muscle Disease Clinic for 18 years, clinical professor of neurology at the University of Connecticut, and fellow of the American Board of Psychiatry and Neurology and the American Board of Electrodiagnostic Medicine. He served on the Connecticut Medical Examining Board for six years.

He received five "Teacher of the Year" awards, one in the Department of Medicine and four in the Department of Neurology.

Dr. Fredericks is survived by his wife of 50 years, the former Judith Penney; his daughters, Kimberly Bantham, Kirsten Albrecht, and Bethany Cass; his son, Scott; his brother, John; and 11 grandchildren.

Read the obituary here.


Dr. Helaine Bertsch Named to American Lung Association's CT Leadership Board

Dr. Helaine F. Bertsch has been appointed as a board member of The American Lung Association of the Northeast Connecticut Leadership Board. Dr. Bertsch is a radiation oncologist for the Helen & Harry Gray Cancer Centers at both Hartford Hospital and in Avon, where she has been since 1998. She also serves as head of Pediatric Radiation Oncology at the Connecticut Children's Medical Center.


Dr. Michael Conway To Be Honored by American Lung Association CT Pulmonary Section

Dr. Michael Conway will be honored with the American Lung Association Connecticut Pulmonary Section Award on April 4 at An Evening of Life & Breath at 7 p.m. at The Aria in Prospect, Conn. Connecticut Multispecialty Group and Hartford Hospital have sponsored the event.


Advancing Medicine Focuses on Transplants

Advancing Medicine: "Transplanting Hope" aired March 6. Seven doctors were featured: Patricia Sheiner, Carolyn Rochon, Anne Lally, Colin Swales, Matt Brown, Daniel Fusco, and Jonathan Hammond. Most of them turned out for the live viewing at Ch. 3 to answer viewer questions. A few callers were inspired by the stories and inquired about becoming organ donors. Watch it here.


Dr. Steven Zweibel First in Connecticut to Implant New Cardiac Monitor

Hartford Hospital was the first in Connecticut to implant a new implantable cardiac monitor (Medtronic Reveal LINQ). This device is 87% smaller than the previous monitor, lasts three years, and is implanted by injecting it under the skin in the chest. The entire procedure takes only a few minutes and only requires a small amount of local anesthetic. These devices are used to detect arrhythmias, like atrial fibrillation, which can cause palpitations, passing out, and strokes.

"This new implantable loop recorder will revolutionize the way we monitor and treat atrial fibrillation," said Dr. Steven Zweibel, the director of Electrophysiology.

The device connects to a wireless cellular transmitter that is provided to the patient and can send information on the patient's heart rhythm back to their physicians almost immediately. The patient who received the injectable monitor has had two mini-strokes (TIAs) which may have been caused by atrial fibrillation. The hope is that the LINQ device and monitor will reveal the cause of these events and allow his doctors to more appropriately target therapy so he does not go on to have a stroke.


Dr. Ajay Kumar To Speak at National Hospitalist Conference

Dr. Ajay Kumar will be speaking at the Society of Hospital Medicine Annual Conference in Las Vegas on March 25. His presentation is entitled: "You Gotta Know When to Hold ’em: Evidence-Based Stewardship of Blood Products." The conference is attended by nearly 3,000 hospital medicine professionals.


Drs. Frallicciardi and Nowicki Present at International Simulation Conference

Several HH staff members participated in the 2014 International Meeting on Simulation in Healthcare held last month in San Francisco, Calif. 

Dr. Alise Frallicciardi presented a poster titled, “Program Innovation: Milestone 1: A Simulation Based Residency Preparation Curriculum for Fourth Year Medical Students.” In addition, Dr. Frallicciardi served as an expert panel member for the presentation, “The Role of Immersive Learning in the ACGME NAS.” 

Drs. Frallicciardi and Thomas Nowicki, along with Steve Donahue, Leah Connors, Chris Madison, and Rebecca Gleason from CESI, gave a presentation entitled “Effective Simulation Curriculum Development.”




Our Physicians Are Great Sources For Local Media

Dr. Heather Einstein was interviewed by WFSB on March 6 about the BRCA1 gene and recommendations that women with the gene should have their ovaries removed by age 35.

Dr. Darren Tishler was interviewed on WTIC AM on March 5 about a rare gene mutation that protects against Diabetes II even in obese people. He was also interviewed on WTIC AM on March 5 about a study at the Genetic Research Center about how patients respond to weight loss surgery. Listen here.

Dr. Andrew Salner was interviewed by Channel 3 on March 5 about a study that found diets high in protein can lead to premature death. Watch it here. He was also intervewed by WNPRnews on March 12 about e-cigarettes. Read it here.

Dr. Francoise Roux was interviewed by WFSB on March 5 discussing the importance of sleep and highlighting national sleep awareness week. Watch it here. She was also interviewed by NBC CT on March 10 about daylight savings time.

Dr. Hank Schwartz was interviewed by News 8 on March 6 about suicide. Watch it here. Dr. Schwartz was also interviewed on WNPR on March 12 about Peter Lanza's interview. Listen here.

Dr. Jack Ross was interviewed by WFSB and NBC CT on March 10 about recent cases of measles in Fairfield County. Watch it here.

Dr. Inam Kureshi was interviewed on Fox CT on March 8 on the topic of concussions. Watch it here. He was also interviewed on News 8 on March 10 about brain injuries sustained in victims of the "knockout game." Watch it here.

Dr. Laura Saunders was interviewed on Channel 3 on March 12 about the interview with Adam Lanza's father. Watch it here.

Drs. Gretchen Diefenback and Mihal Assaf were interviewed on News 8 on March 11 about the IOL's anxiety study.

Dr. Kelly Johnson-Arbor was interviewed by the Hartford Courant on March 10 about heroin-related deaths. Read it here. She was also interviewed by WTNH on March 11 about treating a pregnant woman who was exposed to carbon monoxide. Watch it here.

High Reliability Training

High Reliability Training Sessions for Physicians

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

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

  • Tuesday, May 6 – 6:45-8:15 a.m.
  • Wednesday, May 7 – 5:30-7 p.m.
  • Tuesday, June 3 – 6:45-8:15 a.m.
  • Wednesday, June 4 – 5:30-7 p.m.
  • Tuesday, July 8 – 6:45-8:15 a.m.
  • Wednesday, July 9 – 5:30-7 p.m.
  • Wednesday, August 13 – 6:45-8:15 a.m.
  • Thursday, August 14 – 5:30-7 p.m.
Enhancing The Patient Experience

Voices of Our Patients: Kudos To Dr. Rachana Kanauija

We’ve had discussions at MERC meetings regarding the need for medical providers that are present for a 2-1111 call to treat the individual if life-threatening and cannot wait for transport to the ED. I have a positive story to convey.

Last week a CB5 staff member seized and fell to the floor while in a patient room with a patient and nurse. There was some initial confusion over what number to call as staff rushed to the aid of their peer that brought ED staff but no equipment initially.

Dr. Rachana Kanauija, CMG medical hospitalist, was on the unit and immediately responded, going directly to the room. She directed and worked with the staff to secure the patient to prevent further injury. An IV was started, meds given to control the seizures, airway and oxygenation assessed, and VS taken. Dr. Kanauija stayed with the patient until she was collared, boarded and transported to the ED.

When we thanked her, her only reply was “I’m doing my job. What kind of doctor would I be if I didn’t?”

I commend Dr. Kanauija, CB5 staff and Andrew, an RN from the ED, for their care of this young woman.

Ginger Goddu RN, MSN
Nurse Educator, Division of Medical Nursing
Hartford Hospital

Operational Update

Farewell Party for Dr. Robert Siegel on March 25

Dr. Robert Siegel, medical director of cancer clinical research and chair of the Institutional Review Board, has provided distinguished cancer care and leadership at Hartford Hospital for 23 years. He has accepted a position as director of the cancer program in Greenville, South Carolina.

Please join us in celebrating him and wishing him well in his new position on Tuesday, March 25 from 5:30-7:30 p.m. in the Atrium of the Helen & Harry Gray Cancer Center in Hartford.


Listen to Our A-Fib Commercial

Listen to the new radio spot referring to the Hartford Hospital Afib Center.


Marketing Support Available To Physicians

The Marketing Department has issued a summary of the marketing and communication tools they make available to support physicians, including print ads, internal communication, multimedia, community education support and training and development.

See it here.


CareConnect Team Begins Validation Process

On March 3, hundreds of experts from across our system began a two-month process called “validation,” in which they will work together and with specialists from Epic to map out key workflows that encompass the ways we provide care.

As a team, and with assistance from our Epic partners, they will work to ensure that we have common, best-practice workflows that optimize the power of the Epic software. This process will tap into the incredible talent at Hartford HealthCare, bring us closer together as a system and go a long way toward achieving our “Five Ones” pledge of a single standard of excellence.

In February, we conducted a CareConnect kickoff event. At that meeting, President and CEO Elliot Joseph outlined how important CareConnect is to the fulfillment of our vision. We have created a short video of Elliot delivering his thoughts on this topic, and it is available 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 Date:


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

Countdown To The Upgrade: 198 Days To The ICD-10 Conversion

ICD-10 Training Needs Assessment - Physicians Survey Results

Thanks to the 300 providers who complete the initial survey related to ICD-10. Below are the survey results.

The important messages after reviewing the data are:

  1. Providers are aware of the transition to ICD-10, but few have significant knowledge of details.
  2. A sizable minority (41%) is not aware that HHC has begun a major initiative to make sure that both providers and the hospital are ready for the conversion on October 1, 2014.
  3. Most recognize that ICD-10 will be important to both their practices and Hartford HealthCare.
  4. Many of the comments in the survey text area said they would like training to start soon.

Our general ICD-10 awareness campaign is currently underway. We will soon start training individual providers, and provide further details relevant to individual specialties or sub-specialties.

Our goal is not to make providers good coders, but rather, good documenters.

Thank you for your cooperation.

Dr. Fred Rubin, ICD-10 Physician Consultant

Check out the ICD-10 resources for physicians we have placed on our SharePoint site:
E-mail questions to


Survey Results

1. Are you aware of the nationwide transition to ICD-10 beginning October 1, 2014?


94.3 %      


  5.7 %

2. Are you aware of the ICD-10 project throughout Hartford HealthCare?


59.2 %      


40.8 %

3. How would you rate your knowledge of ICD-10?


16.1 %      


64.2 %


18.4 %

Very knowledgeable

  1.3 %

4. How would you rate the importance of ICD-10 for your practice?


  4.0 %      


  7.0 %


18.4 %

Very important

70.6 %

5. How would rate the importance of ICD-10 to Hartford HealthCare?


  3.0 %      


  2.0 %


  8.0 %

Very important

87.0 %

6. What is the primary location of your clinical work?

Hospital based

34.1 %      

Office based

37.1 %


28.8 %

7. With regard to employment, do you work in:

Independent practice

35.5 %      


24.8 %

For a hospital

32.4 %


  7.4 %

8. If your practice is solely office based, who currently is responsible for your coding?


43.8 %      

Front desk

  3.7 %

Coding experts in your office or group

31.1 %

Outside vendor

  4.4 %


13.4 %

Not office based

13.4 %

9. How would you prefer to be trained in ICD-10?

Computer based

42.9 %      

Classroom or group

  6.5 %


50.7 %

10. If you see patients in the hospital, does your group use a standardized note?


20.7 %      


61.2 %

Don’t see patients in the hospital

18.1 %

HH In the News

OP-ED by Dr. Hank Schwartz: Money at Root of Mental Health Care Woes

Hartford Courant, Feb. 28

If our national dialogue is telling us anything about mental health, it is that we have to improve access to care.

Here are three suggestions for reform:

1. Increase funding for mental health services and maintain that increased funding so that the pathway to full recovery is open to everyone.

2. Require that insurers pay for the rehabilitation programs that are critical to full recovery for the mentally ill. Rehab is available for cardiac patients, why not for the mentally ill?

3. Shift the burden to prove "medical necessity" from the clinician and patient, and make the insurer disprove it. Require that all precertification and recertification denials by insurers are reviewed by an independent panel of clinicians, housed in the Office of the Health Care Advocate, and reimburse care during the review and any appeals.

Read more here.


OP ED by Dr. Richard Shulman: Mental Illness - Another Point of View

CT Mirror, March 4

Written by Dr. Richard Shulman, is a licensed psychologist and director of West Hartford-based Volunteers In Psychotherapy, which provides private therapy to people in exchange for community volunteer work.

The Connecticut Forum will soon host a panel of celebrities and professionals to take “An Honest Look at Mental Illness.” The selected panelists’ consensus is that science has demonstrated that ‘mental illnesses’ are illnesses – biological diseases of bodily tissue… (and that pharmaceuticals are indispensable). The problem: Prominent psychiatrists – the same people who promulgated this view – now admit that this isn’t demonstrated fact. Never has been.

A prominent psychiatrist admitted in the "Psychiatric Times" that the truism repeated to the public, about people’s problems being rooted in “chemical imbalances,” is an “urban legend” – “never a theory seriously propounded by well informed psychiatrists.” There’s little evidence that this viewpoint, or the centrality of psychotropic medications, will be questioned by Forum panelists.

For 20 years I served on the Institutional Review Board (IRB) of Hartford Hospital–Institute of Living, an ethics-in-research committee.

Researchers are required to submit to IRBs their research designs, including comprehensive summaries of previous research. Buried in pages of background, these scientists repeatedly admit that the conditions we mislabel “psychiatric illnesses” are simply not documented to be diseases of the body – despite decades of attempts to verify biomarkers, specific lesions or physical/chemical malfunctions that might cause these “conditions.”

Read more here.


Not Enough Sleep Can Be Harmful To Your Health

WFSB 3, March 6

Doctors marked Sleep Awareness Week with a warning: not enough sleep could be harmful to your health. Dr. Francoise Roux, a sleep specialist at Hartford Hospital, said a lack of sleep could not only lead to being tired, but can and will affect the person's mental and physical health.

"Sleep is an important regulator needed for hormonal regulation, metabolic regulation," said Roux. "It's also important for memory consolidation."

Roux said studies found that children sleeping less can lead to obesity problems. The same problem in teenagers can lead to depression. Later in life, Roux said lack of sleep can cause dementia for seniors.

"Sleep is also important for regulation of sugar," she explained. "So people who don't get enough sleep secrete hormones differently. Basically, increased appetite mainly for sugar. They may want to eat more cookies, things like that."

Medical centers, including Hartford Hospital, said they have sleep disorder centers where patients can check in for an entire night. Sleep technicians there can closely monitor sleeping patterns.

Read more here.

In the HHC System

Teamwork Helps HOCC Respond To Heart Attacks With Lifesaving Speed

New Britain Herald, March 1

After two days of relentless chest pain, Sean Curry, cigarette in hand, drove himself to The Hospital of Central Connecticut Family Health Center in Bristol. At 38, he’d quickly learn he was having a heart attack, setting the wheels in motion for a rapid, coordinated response for his lifesaving angioplasty within 42 minutes of arrival at HOCC.

Curry’s doctor at the Family Health Center saw him right away that Friday morning, Jan. 10. “‘I don’t know how to tell you this,’” he recalls her saying after she took vitals and an EKG, “‘but I called an ambulance. You’re having a heart attack.’” Then she gave him two aspirin.

Within minutes, a highly synchronized care plan would have Bristol Hospital EMS providers bring Curry to The Hospital of Central Connecticut for a successful angioplasty procedure by interventional cardiologist Manny Katsetos, M.D., that cleared the blood clot in an artery around the heart that triggered his ST-elevation myocardial infarction (STEMI). Katsetos also placed a stent — a mesh-like pipe — into the artery to keep it open. Curry had 99 percent right coronary blockage.

That 42-minute door-to-balloon (D2B) time — from hospital arrival to angioplasty — is well below the 90 minutes or less recommended by the American Heart Association and American College of Cardiology.

HOCC’s designation as a STEMI receiving hospital by the state means patients have a 90 minutes or less D2B time. HOCC’s mean D2B time is 61 minutes, one of the lowest in Central Connecticut and Greater Hartford, according to Justin Lundbye, M.D., FACC, chief of cardiology at HOCC.

Read more here.


Area Hospitals Support Legislation Mandating Interpreter Services

New Britain Herald, March 1

Local hospitals indicated unanimous support for a bill raised last week in the General Assembly that would require state hospitals to provide language interpreter services for non-English-speaking patients. The legislation was introduced by the Public Health Committee and was referred to the Joint Committee on Public Health.

Matt Burgard, spokesman for the Hospital of Central Connecticut, said the hospital is committed to serving a diverse population.

“The Hospital of Central Connecticut makes every effort to provide translation services for patients, through both automated technology and personal translators,” he said. “In particular, the hospital uses CyraCom technology, an over-the-phone system that allows caregivers and patients to communicate in numerous different languages. The technology is available at both HOCC campuses in New Britain and Southington. In addition, personal translators for Spanish and other languages are available throughout the hospital.”

Read more here.


Colon Cancer - Preventable, Treatable and Beatable

Healthy Living blog from Backus, March 3

I’ll be dressed in blue on Friday, March 7. Why? Backus and Windham Hospitals will be promoting colon cancer awareness throughout the community.

Read more here.


Backus, Windham Take Patient Safety To New Level

Backus Achievements, March 4

While clinicians work tirelessly to provide competent and compassionate care, to err is human. The National Patient Safety Foundation (NPSF) estimates that one in every 10 diagnoses is wrong, delayed, or missed completely. All together, these diagnostic errors may account for 40,000-80,000 deaths per year in the United States.

As healthcare organizations celebrate patient safety initiatives this week, Hartford HealthCare’s East Region is celebrating in its own way. Backus and Windham hospitals are taking time to reflect on the past year’s quality accomplishments and are organizing activities to further encourage positive patient safety habits.

Throughout the last year, Backus has developed, launched and engaged a cultural shift to become a high reliability organization (HRO). In response to a call from the CHA in 2012, all Level 3 hospitals in the state, such as Backus, have worked with Healthcare Performance Improvement (HPI), a patient safety consulting firm, to decrease the occurrence of incidents that reach the patient and result in harm, also known as Serious Safety Events or SSEs.

In August, Windham Hospital officially partnered with Backus under the Hartford HealthCare affiliation. As the two hospitals work toward creating one culture, Safety Starts with Me training was introduced to Windham staff in late January. Safety Starts with Me is a major step in Windham’s journey to becoming a high reliability organization. Staff will learn how errors occur, the science behind them, how to prevent them, and eliminate harm.

Read more here.


Fitch Rates HHC Series D/E Reevs 'A'; Outlook Stable

Fort Mill Times, March 7

Fitch Ratings assigns an 'A' rating to the following bonds expected to be issued on behalf of Hartford HealthCare (HHC):

--$162,611,000 Hartford HealthCare Corporation taxable bonds series D;

--$92,635,000 Connecticut Health and Educational Facilities Authority revenue bonds, series E .

Additionally, Fitch affirms the 'A' rating for the following bonds issued on behalf of HHC:

--$254,730,000, Connecticut Health and Educational Facilities Authority revenue bonds, series 2011A;

--$71,085,000, Connecticut Health and Educational Facilities Authority variable rate revenue bonds, series 2011B *;

--$50,000,000, Taxable variable rate revenue demand bonds, series 2011C**.

*The series 2011B bonds are supported by a direct pay letter of credit issued by Bank of America N.A. **The series 2011C bonds are supported by a direct pay letter of credit issued by JPMorgan Chase Bank, N.A.

The Rating Outlook is Stable.

Read more here.

Health Care News In the Region

Hospital Officials Oppose More Buyout Regulations

Journal Inquirer, Feb. 28

Executives with Manchester Memorial and Rockville General hospitals and the for-profit company that wants to buy them are opposing a bill that would expand government oversight of hospital buyouts.

“We disagree with proposals that would create separate rules or requirements for nonprofit and for-profit hospitals,” Peter Karl, president and CEO of Eastern Connecticut Health Network, told lawmakers Thursday. “Any changes to regulations should apply evenly to both not-for-profit hospitals and investor-owned hospitals.”

The nonprofit ECHN owns the Manchester and Vernon hospitals that Tenet Healthcare Corp. is seeking to buy.

Read more here.


Yale New Haven, Tenet Sign Partnership Deal

Hartford Courant, March 6

Yale-New Haven Health Systems and Tenet Healthcare Corp. announced Thursday that they have officially formed a partnership.

Last year, Tenet, a for-profit corporation based in Dallas, and Yale-New Haven signed a letter of intent to form a partnership. Late last week, they signed the agreement.

They have been working together for several months to acquire four other hospitals in the state. Because both Yale-New Haven and Tenet would remain independent, the partnership doesn't need to go through any regulatory approvals and Yale-New Haven will remain a non-profit entity.

The two corporations have letters of intent to acquire Waterbury Hospital, Bristol Hospital and the Eastern Connecticut Health Network, the parent company of Manchester Memorial Hospital and Rockville Hospital.

Read more here.


UnitedHealthcare Provides $1 Million Grant To CCMC To Improve Access to Pediatric Care

Market Watch, March 11

UnitedHealthcare has provided a $1 million grant for the Connecticut Children’s Medical Center’s Office for Community Child Health (OCCH) to help enhance care delivery and address critical public health issues for children. These issues include child development, wellness, and chronic conditions such as asthma and obesity.

Connecticut Children’s OCCH is a first-of-its-kind model for providing community-based, coordinated care for children with an emphasis on healthy child development, wellness, and disease and injury prevention. OCCH is developing and testing health service delivery models that address community, state and health system needs. Many new programs will be piloted in Hartford with the goal of seeing them replicated on state and national levels.

Read more here.


CT Hospitals Cut 1,400 Jobs Last Year As Income Fell

Hartford Business Journal, March 12

Connecticut hospitals eliminated 1,400 jobs in 2013 as their collective operating income fell by $175 million, according to the Connecticut Hospital Association. That was down 34 percent from 2012 operating income of $513.6 million, according to state records.

The association blamed the income decline on a 2 percent cut to Medicare funding enacted as a part of federal sequestration; a $103-million state budget rescission passed in Dec. 2012; and a state hospital tax that amounted to $101 million last year and will increase to $235 million starting in July. The association is lobbying state legislators to eliminate the hospital tax over a five-year period.

The result for hospitals in 2013 was an average operating of margin of 3.3 percent —less than the 4 percent margin hospitals say they need to stay financially viable.

Hot Topics in Health Care

Next Step For Smart Phones: Keeping Tabs on Patients

Kaiser Health News, March 10

Dr. Eric Topol, a cardiologist at the Scripps Clinic in San Diego, knows when his patients’ hearts are racing or their blood pressure is on the rise, even if they’re sitting at home.

With high-risk patients hooked up to “personal data trackers” — a portable electrocardiogram built into a smart phone case, for instance — he and his researchers can track the ups and downs of patients’ conditions as they go about their lives. “It’s the real deal of what’s going on in their world from a medical standpoint,” says Topol, whose work is part of a clinical trial. “The integration of that with the classical medical record is vital.”

Similar efforts are underway around the country, as physicians and other providers seek to monitor patients remotely through new technologies, aiming to identify problems early and cut costs and inefficiencies in the healthcare system. The approach is a key focus of the nation’s Affordable Care Act, and the influx of data from internet-connected devices could be a valuable tool for health systems, helping them to maximize resources and target interventions toward patients who will benefit most. It’s also a huge potential boon for companies that manufacture these technologies and have the know-how to store and wring value from the data they generate.

Read more here.


Physician Alignment Revisited

Hospitals and Health Networks, March 11

Physician alignment is not going away anytime soon as a top CEO concern. In fact, the deeper we dive into health care transformation and the ongoing push into outpatient care, the larger it looms. Physicians make 80 to 90 percent of the decisions that drive where dollars go. That holds true if you are living on the first or the second curve of the new delivery system or even swimming around somewhere in between.

Physicians may be a dissatisfied bunch coming to you with offers to buy their private practices, but they are still a very big, important bunch. And many physicians have changed in fundamental ways.

Opting Out: Why all the physician interest in hospital employment over the last several years? Many don't know how to navigate the complex changes under way and aren't interested in taking up the task. The most commonly cited reasons are wanting a sense of security, reimbursement uncertainty, and a desire for a better work-life balance. Running a private practice is filled with hassles, fueled by government regulations, rising prices, new technology demands and overwhelming paperwork. I'm sure you can sympathize.

The fact is that many physicians have just had it. Older physicians never heard the phrase work-life balance, but now it has gained importance. Soon it will be a "must have" as opposed to a "nice to have" in medical practice terms of employment. And as the millennial demographic comes to dominate the clinical workforce, it will become common practice.

Read more here.


With a Few Months Left to Go, Are You Ready for ICD-10?

Hospitals and Health Networks, March 11

With approximately seven months to go, and after nearly three years of preparation, is your organization ready for ICD-10? On Oct. 1, hospitals must begin to report claims using the new ICD-10 coding system for all payers. It's likely that a lot of progress already has been made, including software changes. With the time left this year, hospital leaders must prioritize and monitor progress on the conversion across the entire organization with the focus being on coder education, improving physician documentation and testing software changes.

This is the biggest change in the coding field in the last 30 years and hospitals can expect a slowdown in coder productivity that may result in cash-flow delays. The transition to ICD-10-PCS is much more dramatic because the systems bear little resemblance in structure, format and complexity. Only hospital inpatient reporting will transition to ICD-10-PCS. This is important as the diagnosis and procedure codes are the DNA of DRG payments.

While physicians will not be responsible for knowing the actual codes, they need to understand the conceptual changes to the subset of codes in their clinical areas. It's not about increasing the volume of physician documentation, but about targeted improvements in a few specific areas.

Read more here.


Coming Events

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


April 4 (Friday)

Department of Surgery Grand Rounds

Gilman Auditorium, 6:45 a.m.

Topic: Mesenteric Ischemia

Speaker: Dr. Parth Shah, director of vascular surgery, Hospital of Central Connecticut


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.


April 13-19

Housestaff Appreciation Week

Please join us in thanking our Hartford Hospital and University of Connecticut Residents and Fellows for all their efforts, knowledge, expertise and compassion that they bring to the care of our patients at Hartford Hospital. Their participation in our clinical activities is essential to the quality of our outcomes.


May 6 (Tuesday)

High Reliability Training Session for Physicians

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


May 7 (Wednesday)

High Reliability Training Session for Physicians

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


May 13 (Tuesday)

Kidney Stones Seminar

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

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

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


May 22 (Thursday)

The Board of Directors and Medical Staff Spring Event

Heublein Hall at the ERC, 6 p.m.

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


June 3 (Tuesday)

High Reliability Training Session for Physicians

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


June 4 (Wednesday)

High Reliability Training Session for Physicians

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


June 4 (Wednesday)

Pelvic Health Seminar

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

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

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


July 8 (Tuesday)

High Reliability Training Session for Physicians

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


July 9 (Wednesday)

High Reliability Training Session for Physicians

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


August 13 (Wednesday)

High Reliability Training Session for Physicians

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


August 14 (Thursday)

High Reliability Training Session for Physicians

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



For more coming events, click here.

The Seymour Street Journal (SSJ) has been developed to communicate key messages pertinent to our hospital's physicians. It will keep you informed and up-to-date on hospital, network, and health care news in a concise, convenient format. The SSJ will be sent to your preferred e-mail address every other Sunday. If you would like to be added to the Seymour Street Journal email list, or to receive it at a different email address, please opt-in at 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.