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

 

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In This Issue...

March 30, 2014 Edition

HAND HYGIENE
Wash In - Wash Out

Wash

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

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

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

Click Headlines Above to Read Full Story

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HH Facts and Firsts:

2003 - The state’s first 3-Tesla MRI scanner was installed at the Institute of Living’s Olin Neuropsychiatry Research Center to aid in schizophrenia (and related illnesses) research.


Follow Hartford Hospital on facebook, youtube and twitter

 

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

 

kirtonACS NSQIP now at Hartford Hospital

By Dr. Orlando Kirton, ACS NSQIP Surgeon Champion, and Jay A. Encarnacion, RN, BSN, ACS NSQIP Surgical Clinical Reviewer

Hartford Hospital is continuing its commitment to put our patients first and improve surgical quality. Through the Hartford HealthCare system and along with our sister organizations, The Hospital of Central Connecticut, MidState Medical Center, Windham Hospital, and soon Backus Hospital, we are now proudly participating in the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP). It is the leading program to produce nationally validated and risk-adjusted outcomes.

Today, there is a strong demand to do more with less. It has been proven that each year a hospital uses NSQIP, there is opportunity to:

• Prevent 250-500 complications

• Save 12-36 lives

• Reduce costs by millions of dollars

Since inception of NSQIP in September 2013, the program has already assisted Hartford Hospital in identifying opportunities for improvement including the adoption of the AORN wound classification system, ASA classifications, standardizing OR time out and debriefing, and identifying trends in our patients returning to the ED within 30 days.

NSQIP has further strengthened our Surgical Clinical Council in our efforts to standardize processes across the HHC system and allow us to be a leader in the healthcare industry.

Currently, the patient case reviews focus on General and Vascular surgery; but we will be expanding to include Orthopedic spine and hip surgery. Hartford Hospital as a member of the Connecticut state-wide Surgical Quality Collaborative joins 530 NSQIP participating hospitals across the country and Canada, with the sole imperative to improve the surgical quality in the patients and communities we serve.

 

emmelEye Surgery Center Features First Femto-second Laser in New England

By Dr. David Emmel, Medical Director, Hartford Hospital Eye Surgery Center

The Hartford Hospital Eye Surgery Center is very excited to be the first institution in New England and one of the first in the entire Northeast to have access to femto-second laser technology for enhancing the precision and quality of cataract surgery.

The femto-second laser has already pretty much replaced scalpel technology in LASIK surgery and is now poised to create a similar revolution in how cataract surgery is performed. The LenSX device, now in use for over a year, allows ophthalmic surgeons to take advantage of the ability of computerized laser technology to preplan and then precisely deliver laser energy to perform incisions that can alter and correct astigmatism, improve the centration and stabilization of intraocular lens implants, and soften hard lenses, facilitating their removal by ultrasound.

Femto-second laser technology creates a precisely patterned array of focal photo-disruption within the transparent tissues of the eye including the cornea, lens and its capsule, essentially creating microscopic perforations in two and three dimensions that simulate the effect of scalpel incisions, but in ways that a scalpel could never achieve. The programmable cutting is in essence the reverse of 3-D printing where material is layered to achieve a complex structure. With the femto-second laser the array of photo disruption can be layered moving from back to front through the transparent tissues of the eye to create complex cuts that are completed by the surgeon with gentle manipulation using blunt instruments.

Virtually all of the 40 or more ophthalmologic surgeons working at the Hartford Hospital Eye Surgery Center have received training in the use of the device and have been performing these procedures very successfully for the past year. Our surgeons cover a broad area of central Connecticut, including Hartford, New Britain, Middletown and Meriden and can be accessed by calling the Hartford Hospital Eye Surgery (860-665-0174).

For more detail please see the recent article in Rounds Magazine, or look at the attached flyer we have developed to promote what we feel is the most significant development in cataract surgery since the invention of phacoemulsification and small incision surgery.

Top News

thanksToday is Doctors' Day

Dear Hartford HealthCare Physician:

National Doctors’ Day, March 30, was established to recognize the tremendous contributions physicians make to the lives of patients and their families and to the overall health and well-being of communities.

This day recognizes that medicine is much more than science and technology. It is a special calling that carries with it great responsibility and personal sacrifice.

On behalf of all of Hartford HealthCare, we want to express our appreciation and gratitude for all that you do, every day. Our communities depend on and put their trust in us, thanks to the outstanding care you and other Hartford HealthCare staff members provide. Your dedication, skill, compassion and wisdom improve and save lives every day.

You are doing important work at a difficult time. Because of our changing and very challenging health care environment, Hartford HealthCare is working to transform the way we deliver care. We are building a truly coordinated system to provide seamless, high-quality care when and where patients need it, throughout their lives. Your expertise and leadership will help us achieve our system vision to “be nationally known for excellence in patient care and most trusted for personalized coordinated care.” Together, we are reaching this goal.

Your feedback and suggestions always are welcome. On National Doctors’ Day and every day, we honor your profession and each and every one of you. 

Elliot Joseph, President and CEO, Hartford HealthCare

Dr. Rocco Orlando, Senior Vice President and CMO, Hartford HealthCare

 

Medical Staff Interim Meetings Touch on Many Topics

The Medical Staff held its inaugural semi-annual interim meeting on March 26. Close to 80 physicians attended the two open forum Town Hall style meetings with hospital and medical staff leaders.

On the panel were Dr. Stu Markowitz, president; Dr. Jack Greene, chief medical officer for HH; Dr. Rocco Orlando, chief medical officer for HHC; Dr. Jim Cardon, executive vice president and chief clinical integration officer for HHC; Dr. Stacy Nerenstone, president of the medical staff, and Peter Fraser, vice president of Human Resources.

Topics discussed included ICD-10, quality and safety programs, ICP rollout, CareConnect and Epic, consolidation of the hospital system, legislative issues, and issues concerning Hartford Hospital administrative staff transitioning to Hartford HealthCare roles and filling resulting vacancies.

"It was a great opportunity for physicians to engage in a dialogue with leadership and get answers to their questions," Dr. Nerenstone said. "We hope this will be happen every six months to promote this dialogue."

 

Top Docs Listed in Connecticut Magazine

The April issue of Connecticut Magazine features the "Top Docs 2014" listings. It recognizes 834 doctors in 31 specialties from throughout the state. Of those listed, more than 100 are affiliated with Hartford Hospital.

When you review the Top Docs list, it’s easy to find doctors from Hartford Hospital in every category. Our doctors earned this distinction because they are the ones that fellow physicians from throughout the state said they would refer their own family members to if the need arose.

This heartfelt endorsement from their peers confirms what we have known all along — Hartford Hospital has some of the best physicians in practice, anywhere. Congratulations to all of our doctors who have earned a spot on this list. Their outstanding skills, compassion and commitment to excellence have resulted in this well-deserved honor.

Read the list here.

 

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.

In past years, some or all of the following awards have been presented:

  • YOUNG PRACTITIONER AWARD
    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.
  • JOHN K. SPRINGER HUMANITARIAN AWARD
    For extraordinary qualities of compassion, civility, vision and integrity that set an example for all future generations of caregivers at Hartford Hospital.
  • PHYSICIAN IN PHILANTHROPY AWARD
    For recognition of exceptional leadership in philanthropy through work, commitment, personal giving and unending care and concern for mankind on behalf of Hartford Hospital.
  • DISTINGUISHED SERVICE AWARD
    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.
  • QUALITY & SAFETY AWARD
    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.

 

Dr. Len Jacobs Holds Press Conference on "Bleeding Control Bags"

Hartford Hospital trauma surgeon Dr. Lenworth Jacobs explained the contents of the "Bleeding Control Bag" during a news conference March 20 in Hartford.

He says the bags will be available every half-mile of this year's Boston Marathon course. The main purpose of the medical bag is to provide tourniquets in public places.

Hartford Hospital is helping to transform how the nation responds to mass-casualty events like the Boston bombings or public shootings. In all of those instances, a simple tourniquet could have helped save lives. Much like automatic external defibrillators that hang in public spaces, experts believe bleeding control bags could save lives.

Hartford Hospital has installed the nation's first bleeding control bags in public areas throughout the hospital campus.

Here are links to the coverage from that news conference.

http://media.harthosp.org:80/ermweb/player?id=C3x84We2&fullwindow=true

http://media.harthosp.org:80/ermweb/player?id=1bTWwRL5&fullwindow=true

http://media.harthosp.org:80/ermweb/player?id=xnl9Ngls&fullwindow=true

Reports also aired on CT Radio Network and WTIC AM radio, and in the Hartford Courant.

 

February Finances - Inpatient and Outpatient Revenues Below Budget

Inpatient volumes based on discharges for the month of February were (1.0%) below budget.  The comparison to the prior year shows February, 2014 discharges approximately 1.7% above the prior year.  Outpatient revenues were below budget by approximately (1.2%) for the month.  The unfavorable outpatient revenue variance was driven by Radiation Oncology and Psychiatric outpatient services.                

Through the first five months of fiscal year 2014, inpatient discharges exceeded budget by 0.2% and were 0.7% greater than the prior fiscal year.  Outpatient revenues were 6.0% above budget for the five months ending February 2014.   Year to date, the favorable outpatient revenue variances were in Perioperative services, Radiology, Cardiology, Emergency services and Laboratory services. 

 

Final Tally for the 2014 Black & Red: $1 Million+

The 2014 Black & Red, with 1,250 guests attending, netted a total of $1,079,348 to benefit the Institute of Living. The proceeds this year will be used to improve access to mental health services and treatments, especially for adolescents and young adults.

It is the second consecutive year that the fund-raiser netted more than $1 million for its beneficiary.

The Stop the Stigma campaign, which was launched at the Black & Red in January and is aimed at changing the way people view mental illness, has received more than 8,000 responses to calls for pledges. The campaign’s goal is 10,000 pledges.

 

Stop the Stigma of Mental Illness

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

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

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

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

Excellence

Dr. Charles McKay Participates in Press Conference on Heroin Abuse

Dr. Charles McKay participated in a roundtable press conference with Senator Murphy on heroin abuse, and what we are seeing in the ED. The press conference was held on March 17 at the ADRC clinic in Hartford.

 

Dr. Francoise Roux Chairs Session at World Congress of Chest Physicians in Spain

Dr. Francoise J. Roux, served as a general session chair at the inaugural CHEST World Congress on March 21-24 in Madrid, Spain. It was hosted by The American College of Chest Physicians (ACCP) and the Spanish Society of Pneumology and Thoracic Surgery (SEPAR).

She was the chair of a plenary presentation on preoperative management of obstructive sleep apnea.

This groundbreaking event is the first global gathering of leading respirologists, critical care physicians, sleep specialists, cardiothoracic surgeons, and allied healthcare professionals from all regions of the world to share best clinical practice.

 

Our Physicians Are Great Sources For Local Media

Dr. Maria Johnson was interviewed on Fox CT on March 26 about national colorectal cancer awareness month.

Dr. Kelly Johnson-Arbor was interviewed by FOX CT on March 13 about the rise in heroin-related deaths. Watch it here.
She was also interviewed by News 8 on March 20 about the dangers of children using hookah pens. Watch it here.

Dr. Stu Markowitz was interviewed by News 8 on March 20 about the need for bleeding control bags.

Dr. Charles McKay was interviewed by Channel 3 on March 13 about the rise in heroin-related deaths. Watch it here.

Dr. Raveen Mehendru was interviewed on WNPR on March 25 on hearing voices. Listen to it here.

Dr. Hank Schwartz was interviewed by Fox CT about the on March 13 about physician-assisted suicide and end of life care.

Academics and Research

Stroke Center Presents Symposium on Spontaneous Intracerebral Hemorrhage

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

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

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

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

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

Enhancing The Patient Experience

Voices of Our Patients: Kudos To Hospitalist Dr. Jacqueline Rheiner

Hi Dr. Rheiner,

I want you to know how appreciative I am for the exceptional care of my mom, Catherine Doran. As you know she moved around between N12, N10 and CB2 over the last couple of weeks and you were a constant in her care.

As a nurse manager in the Cancer Center, I understand some of the multitude of challenges in both caring for hospitalized patients and also communicating with family members when patients don’t often understand the complexity of their medical condition.

Your exceptional communication to me helped me be at work when needed and take care of mom as she needed. None of us could be with her every minute, but we always how she was doing from your daily phone call update.

I am copying Dr. Kumar on this email so that you can be recognized for going the extra mile. You are most kind.

Kathy Burns, RN, MSN, OCN
Nurse Manager, Radiation Oncology
Hartford Hospital

Operational Update

High Reliability Training Sessions for Physicians

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

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.

 

First CareConnect Validation Session Maps Epic Electronic Records Workflows

Hundreds of experts from across Hartford HealthCare gathered at the Farmington Marriott March 4 -6 for the first of three CareConnect validation sessions. Assisted by our partners from Epic Systems, the teams mapped out key workflows aligned to the ways we deliver care.

The team from Epic – our electronic records tool – demonstrated workflow and reviewed decisions with system users, a process that ensures the system is built appropriately and able to support organizational needs. The sessions also ensure that workflows are shared across the organization and reflect best-practices that will optimize the power of the Epic software.

The validation process taps into the wealth of talent at HHC, unifies us as a system and brings us closer to fulfilling our promise of the “Five Ones” single standard of excellence, said vice president and chief medical information officer Jonathan Velez, MD.

Two more sessions are scheduled at the Farmington Marriott, on March 31-April 2 and May 5-7. These two sessions will build on the first event by continuing to review decisions about system configuration and content, said CareConnect program director Craig Stearns. But they are by no means the only opportunity for the organization to participate in designing and reviewing the new system, he said.

“Over the next year, additional opportunities will be offered by the program team, including more demonstrations and collaboration with focus groups,” Stearns said.

 

Learn More About Retirement Saving With Prudential

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

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

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

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

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

 

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

State mandated CME for physician license renewal is available free on the Hartford Hospital Jubilant Learning Platform. You will need your Novell sign on information to access the portal. If you have forgotten your sign on, please call the HELP desk 55699 (outside: 860-545-5699).

To access Jubilant from the web, go to the Hartford Hospital page and click on the gold tab “Medical Professionals.” Click on “Learning Portal” from the drop down menu, and then click on the green tab “Learning Portal Login.”

From the home page of the intranet (inside HH), click on the Learning Portal for Medical Education and Training link. Once you’ve clicked on the link, use your Novell sign in, and the CME is under Physician License renewal CME.

Once you have passed the post-test, you will be awarded a printable CME certificate. Your CME will also be maintained and easily self-service accessed on the Learning Portal site, should you need a copy in the future.

Please note that your Risk Management required activities through MRM will provide your Risk Management CME.

 

Remind a Colleague: Wash In, Wash Out

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

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

 

Save These Dates:

 

Medical Staff Spring Event - May 22

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

The awards ceremony will begin at 7 p.m. We will present awards such as 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.

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

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

Friday, June 20; Rosedale Farms, 25 East Weatogue Street, Simsbury.

More details to come.

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: 184 Days To The ICD-10 Conversion

ICD-9 to ICD-10 Crosswalk

The American Academy of Professional Coders (AAPC) is offering quick reference cards with the top 50 most frequently used codes by medical specialty, crosswalked from ICD-9 to ICD-10.

The double-sided, laminated cards are available for purchase for $19.95 on their website.

Click here for more information.

 

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

HH In the News

The ABCs of Monoclonal Antibody Drugs

Hartford Business Journal, Jan. 13

Dr. Madhavi Gorusu, an oncologist and assistant clinical professor at the University of Connecticut School of Medicine, explains the basics of monoclonal antibody drugs.

Read more here.

 

Tax Reform Talks Offer Hope, Anxiety for Businesses

Hartford Business Journal, March 24

House Speaker Brendan Sharkey's plan to subject nonprofit hospitals and colleges to property taxes would have far reaching implications for Hartford. Hartford's significant stockpile of tax-exempt property is a key reason the city's mill rate is highest in the state. That has put a heavy tax burden on businesses, making executives and developers skittish about investing capital here.

Nearly 51 percent of Hartford's property, for example, is tax-exempt because it's owned by state, educational, nonprofit, or religious groups. In 2012, the city valued tax-exempt property at about $3.6 billion. Yes, that's billion with a "B."

Sharkey's plan would require nonprofit hospitals and colleges to pay property taxes and then seek state grants to offset a portion of the cost. In Hartford, a reverse PILOT would likely target three institutions: Hartford Hospital, St. Francis Hospital and Medical Center, and Trinity College. They each have a major economic impact employing thousands of people and drawing customers to local businesses, but they also own lots of tax-exempt real estate that drains millions of dollars from the city's coffers.

Read more here.

 

Parents Share Tales of Navigating State's Mental Health System for Children

Hartford Courant, March 26

Mary Jo Andrews, Carol Poehnert and several other West Hartford mothers of children with mental-health problems had quietly met for eight years, usually over dinner, to share their experiences and frustrations, and to trade tips and shortcuts learned while navigating the treatment system. Then the Sandy Hook School tragedy happened in December 2012.

"And we decided we needed to get out and do some advocating,'' Andrews told 70 parents and health care professionals at a forum at the Institute of Living Wednesday evening.

It is the first of a handful of planned sessions — part of an effort driven by the state Department of Children and Families to gather input that might fuel reform of Connecticut's overwhelmed mental-health network for children.

Read more here.

 

Why Runners Can't Eat Whatever They Want

The Wall Street Journal, March 26

As a 10-mile-a-day runner, Dave McGillivray thought he could eat whatever he wanted without worrying about his heart. "I figured if the furnace was hot enough, it would burn everything," said McGillivray, who is 59. But a diagnosis six months ago of coronary artery disease shocked McGillivray, a finisher of 130 marathons and several Ironman-distance triathlons.

"'I will run it off'—that attitude clearly prevails among the marathoners themselves, almost sometimes to an arrogance," said Paul Thompson, a veteran marathoner who is chief of cardiology at Hartford Hospital.

Thompson … believes that in many cases endurance athletes diagnosed with heart disease can safely continue doing marathons and triathlons, if their conditions are treated. Thompson argues that risk must be weighed against quality of life.

Read more here.

In the HHC System

Pharm Techs Praised for Spot-on Med Reconciliation

Pharmacy Practice News, March issue

Emergency department (ED) pharmacy technicians from several hospitals received praise at the American Society of Health-System Pharmacists 2013 Midyear Clinical Meeting for conducting medication reconciliations with up to 96% accuracy. The studies found that pharmacy technicians were able to detect a substantial number of errors included in ED nurse-obtained medication histories, heading off costly and harmful adverse events.

“Our program has been so successful that our technicians are often called to floors to obtain home medication lists for direct admissions,” said Colleen Teevan, PharmD, an ED clinical pharmacist at The Hospital of Central Connecticut (THOCC), in New Britain.

Dr. Teevan said the 22,000 patients admitted annually through THOCC’s ED more than justified hiring seven pharmacy technicians to provide around-the-clock medication reconciliation services and an ED pharmacist to verify the accuracy of their work. Between late 2012, when the program was launched, and late 2013, the pharmacy technicians conducted more than 25,000 ED medication reconciliations, averaging roughly 250 per week. Documentation from the ED pharmacist who approved each list demonstrated that techniques were accurate 96% of the time.

That number stands in contrast to the 66% accuracy rate for medication lists gathered by other ED health care providers at THOCC, noted Dr. Teevan.

Read more here.

 

3 Area Hospitals Record Negative Profit Measures

Journal Inquirer, March 4

Three hospitals in north-central Connecticut are among only four acute-care facilities in the state that recorded negative total margins in the 2013 fiscal year, regulators say. “Total margin” might also be called profit. A positive 6 percent margin, for example, means that a hospital keeps as “profit” 6 cents for each dollar of revenue.

Topping that list was Windham Hospital, which recorded a negative 8.58 percent total margin in the 2013 fiscal year. The negative margin at Windham Hospital, now partnered with Hartford Healthcare Corp., is significantly bigger than the negative 0.75 margin it recorded in the previous fiscal year.

By contrast, ECHN’s second hospital — Rockville General in Vernon — ended the year with a $3.3 million gain from operations and had $2.6 million more in revenue than expenses. Rockville General Hospital is one of the 25 hospitals that had positive total margins, which across the state average about 5.76 percent, data show.

The list was led by William W. Backus Hospital in Norwich at 12.45 percent, St. Vincent’s Medical Center in Bridgeport at 12.02 percent, and the Hospital of Central Connecticut in New Britain at 8.9 percent.

Of the two big acute-care facilities in Hartford, St. Francis Hospital and Medical Center recorded a total margin of 4.13 percent, an improvement from its negative 0.34 percent the prior year. Hartford Hospital had a total margin of 2.22 percent, down significantly from its previous 9.42 percent total margin.

Read more here.

 

Few Residential Treatment Programs For Connecticut Adolescents

WNPR, March 20

One out of every 22 Connecticut high schoolers has taken medication such as painkillers that weren’t prescribed for them, according to the National Survey of Drug Use and Health. In the second of a three-part series, WNPR looks at treatment options available for local teens with substance abuse issues.

In 2011, Rushford, an affiliate of Hartford HealthCare’s behavioral health network, opened a treatment center in Durham. Rushford at Stonegate is a 28-day program. Dr. Christy Jackson, clinical director of child and adolescent services at Rushford, said, "We have a second residential on campus, Rushford Academy, that is DCF-funded. It's a six month program."

Read more here.

 

Hospital Mergers in Connecticut Raise Concerns Over Patient Costs

WNPR, March 24

Hospital administrators in Connecticut who have been involved in the unprecedented streak of mergers and consolidations often tout the financial benefits and efficiencies of such moves.

But as the number of independent hospitals in the state dwindles – with more than half of the 29 acute-care hospitals now operating in networks with other hospitals or out-of-state partners – experts and advocates worry that the consolidations will reduce competition in the market and give hospitals more leverage to raise prices. Adding to their concerns is a proposal by a private company to convert four non-profit hospitals to for-profit entities.

Connecticut hospitals already are largely divided into four health care systems: The Eastern Connecticut Health Network; Western Connecticut Health Network, including Danbury Hospital, New Milford Hospital and newly-acquired Norwalk Hospital; Yale New Haven Health System, which includes Yale-New Haven Hospital, Bridgeport and Greenwich hospitals; and Hartford HealthCare, comprised of Backus and Hartford hospitals, the Hospital of Central Connecticut, MidState Medical Center, Windham Hospital and Natchaug Hospital.

In some cases, patients have seen care expanded through the partnerships. Jeffrey Flaks, chief operating officer for Hartford HealthCare, said that since the affiliation with Backus, the two hospitals have focused on providing more services and making care more affordable. Backus has expanded its primary care physician and outpatient surgery network, added an emergency helicopter, strengthened its trauma programs and created a preventive medicine institute.

Read more here.

Health Care News In the Region

CT House Speaker Sharkey Wants Hospital Conversion Vote This Year

The Register Citizen, March 12

House Speaker Brendan Sharkey doesn’t favor approving only an interim solution to the issue of non-profit hospitals converting to for-profit networks in Connecticut.

“On the issue of hospital conversions, I am very concerned that we must act this year, this session, on guidelines for determining how these conversions take place because the world in this area is changing so dramatically that if we wait until next session, if we spend too much time thinking about it, task forcing it ... the world will be completely different a year from now,” Sharkey said.

The immediate issue is a takeover of Waterbury Hospital by the Tenet Healthcare Corp., the second largest healthcare network in the country, although Bristol Hospital and the Eastern Connecticut Health Network are not far behind in developing a relationship with Tenet.

Without an infusion of cash from Tenet, it is unknown how long Waterbury Hospital can survive on its own.

Yale New Haven Health System has proposed a solution to getting around a state law that does not allow for-profit hospitals to hire doctors directly. Non-profit hospitals can hire practitioners through a medical foundation and the Yale New Haven Health System has offered to do this for Tenet.

Read more here.

 

For-Profit Hospital Regulations Weighed

Hartford Courant, March 20

Depending whom you ask, two proposals would either protect hospital employees and their communities, or create a regulatory burden that would prohibit hospitals from taking the necessary steps to financially survive.

The General Assembly's public health committee heard arguments Wednesday for and against two bills that would put additional requirements on non-profit hospitals that seek to convert to for-profit.

The issue of hospitals making the conversion from non-profit to for-profit has gained attention in recent years, as more hospitals in the state have begun courting for-profit partners. Some say such moves are needed for hospitals to survive amid the many changes in health care, but others fear that for-profit hospitals will be more devoted to shareholders than to patients and communities.

Read more here.

 

Urgent Care Center Now Open in Downtown Storrs

UConn Daily Campus, March 25

Student, staff or citizen are all welcome to visit the Urgent Care Health Center which opened its doors on Monday to the sick and injured. The center is supported by the John Dempsey Hospital in Farmington, and is an extension of the UConn Health Center and Infirmary.

The Urgent Care Center deals with non life-threatening injuries, general illnesses, testing and vaccination. What makes the center especially unique is that they accept walk-ins, meaning anyone off the street with insurance will be cared for by professionals, and almost every form of insurance – Medicare, Medicaid and foreign based – is accepted.

The center is staffed by one full-time doctor, a medical director, three physicians assistants and a radiologist. However, these initial services and staff sizes are only the beginning.

“As we ramp up we probably will bring more specialists,” said Jessica Underwood, the center’s ancillary services manager.

Read more here.

 

Getting Sick at the Hospital

Hartford Courant, March 26

Patients at Connecticut hospitals in 2012 caught infections during treatment at rates “significantly” higher than the national average in several key areas, according to a report released Wednesday by the U.S. Centers for Disease Control in Atlanta.

Connecticut’s “standardized infection ratio” — the barometer for healthcare-associated infections — was worse than the national ratio for infections arising from improperly inserted or dirty central lines and tubes, and urinary catheters.

Also, Connecticut patients contracted infections during or after colon surgery at a rate 27 percent higher than the national average. For abdominal hysterectomies, Connecticut’s infection rate was 9 percent higher than the national average, the CDC said.

Read more here.

Hot Topics in Health Care

Two-Midnights Rule Spells Grim Financial Forecast For Hospitals

Health Leaders Media, March 17

Hospitals will take a financial hit this year as a result of the new federal rule that cuts the Medicare payment rate for most patient stays that span less than two midnights, Moody's predicts.

A gloomy Moody's Investors Service sector comment on the controversial two-midnights rule for inpatient admissions came as little surprise last week to hospital finance executives, but federal officials say the negative impact on healthcare providers is overstated.

The comment, released Wednesday, predicts the "reimbursement difference between inpatient and outpatient cases will decrease profits" at hospitals, with the average revenue reduction per affected case set at $3,000 to $4,000.

"Previously, inpatient status was largely determined by medical necessity," Moody's wrote. "We expect the rule change will weaken hospital operating profitability in calendar year 2014 because it will lower Medicare reimbursement for these cases."

Read more here.

 

Doctors and Tech: Who Serves Whom?

The Atlantic, March 20

If you want to discourage a worker, subject them to policies and procedures that don’t make sense. This principle was first described by Frederick Herzberg, an American psychologist who developed one of the most widely studied theories of workplace motivation.

Unfortunately, Herzberg’s principle is being widely applied today in medicine. Changes in healthcare payment systems, the use of information technology, and the doctor-patient relationship have left many doctors deeply discouraged.

Consider three specific examples. A physician who could provide care for a pediatric patient over the phone asks the mom to drive three hours each way to the office, because he can get paid for an office visit. A physician taking a patient’s history points and clicks a computer form to record information, but recognizes that many parts of the patient’s story will be lost because they don’t fit the template. A physician trying to learn more about a patient’s prior hospital admission can’t find the information she needs because the record is an example of “note bloat,” overflowing with big chunks of information that were cut and pasted from day to day, but containing little of real use.

Read more here.

 

House "Doc-fix" Bill Would Delay ICD-10 By At Least A Year

Modern Healthcare, March 26

The implementation date of the nationwide conversion to the ICD-10 family of diagnostic and procedural codes would be delayed by at least a year under a House Ways and Means Committee bill aimed at providing the annual fix to the physician sustainable-growth rate formula.

The ICD-10 switch is scheduled to occur Oct. 1, 2014. But a single sentence in the proposed legislation says, “The Secretary of Health and Human Service may not, prior to Oct. 1, 2015, adopt ICD-10 code sets as the standard for codes sets” and finishes by citing sections in the Social Security Act and the Code of Federal Regulations where the secretary's authority to mandate ICD-10 are located.

Read more here.

Coming Events

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.

 

May 30 (Friday)

Stroke Center Presents Spontaneous Intracerebral Hemorrhage Symposium

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

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

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

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

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

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

 

June 3 (Tuesday)

High Reliability Training Session for Physicians

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

 

June 4 (Wednesday)

High Reliability Training Session for Physicians

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

 

June 4 (Wednesday)

Pelvic Health Seminar

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

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

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

 

July 8 (Tuesday)

High Reliability Training Session for Physicians

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

 

July 9 (Wednesday)

High Reliability Training Session for Physicians

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

 

August 13 (Wednesday)

High Reliability Training Session for Physicians

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

 

August 14 (Thursday)

High Reliability Training Session for Physicians

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

 

 

For more coming events, click here.

The Seymour Street Journal (SSJ) has been developed to communicate key messages pertinent to our hospital's physicians. It will keep you informed and up-to-date on hospital, network, and health care news in a concise, convenient format. The SSJ will be sent to your preferred e-mail address every other Sunday. If you would like to be added to the Seymour Street Journal email list, or to receive it at a different email address, please opt-in at www.harthosp.org/SSJ. This ensures that you will receive the newsletter at your preferred email address. Back issues can be viewed here. For any questions or suggestions, please contact Dr. Stacy Nerenstone, Medical Staff president, at (860) 545-3043.