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FSCI: Setting a National Example for Quality Improvement
The Lee Memorial Health System has enrolled in the Florida Surgical Care Initiative (FSCI), a component of the American College of Surgeons National Surgical Quality Improvement Program (ACS-‐NSQIP). This is a nationally validated, risk-‐ adjusted, outcomes based program to measure and improve quality of surgical care.
The program employs a prospective, peer-‐controlled, validated database to quantify 30-‐day risk-‐adjusted surgical outcomes. This process allows valid comparison of our outcomes among hospitals participating in the program in conjunction with comparison of national averages.
Data collection will begin as of June 1, 2011 and will be entered into the secure acsnsqip.org website. Physicians and patients will be contacted for outcome data if/when the patient falls out thru the random selection process. The patient and surgeon identifiers will be scrambled to prevent identification outside LMHS.
For more specific information about this program, please contact: Surgeon Champions -‐ Darren Miter, D.O., James Orr, M.D., Michelle Mon, M.D., Thomas Carrasquillo, M.D., and Valerie Dyke, M.D. or Chairmen of Surgery -‐ Randall Buss, M.D., Jeffrey Henn, M.D., and John Sarzier, M.D.
TAKING THE LEAD TO IMPROVE SURGICAL PATIENT OUTCOMES
Inside this issue.
System News 2
Practice Updates 3
SafeLee and U 4
What’s the Buzz? 5
CMEs 6
New Physicians 7
ICU Update Back
May 2011
Florida Surgical Care Initiative
www.leememorial.org/physicianpub
System News.
2
Get Ready For EPIC! The Epic Electronic Health Record (EHR) will go-‐live at GCMC on June 1. At that time, providers will begin reviewing all clinical results and reports in the Epic EHR. Physician orders and progress notes will continue to be written and remain in the paper chart.
Providers who admit, attend, or consult on patients at GCMC need to complete training to obtain access to Epic. GREAT NEWS! CMEs are offered for this program! Training offerings include a 1-‐hour instructor led program or a 1-‐hour series of interactive e-‐learning modules that are available online 24/7. Either offering requires the completion of a competency assessment and class evaluation. Providers will then receive their secure Epic login and 1 CME!
E-‐Learnings and instructions can be found at: http://www.leememorial.org/physicianpub/cme.asp Classroom training sessions are offered in the GCMC Physicians Lounge through May 31st at the following times:
Days Class Time Class Time Class Time Class Time Mon -‐ Fri 0700-‐0800 1200-‐1300 1600-‐1700 1800-‐1900 Saturday 1200-‐1300
Contact Pam Pull at 343-‐8014 [email protected] if you need the secure physician website login or to register for a classroom session. Contact Bonnie Quaintance, RN Physician Liaison at 343-‐7967 [email protected] with any questions.
Pharmacy Update: National Drug Shortages Affecting LMHS
We are experiencing shortages on the following drugs
as a result of national shortages:
New Shortages Potassium Phosphate Injection*
Sodium Phosphate Injection* Acetylcysteine Inhalation
Ongoing Shortages
Bactrim Injection Cytarabine Injection
Doxorubicin Injection
*Note: Drug shortage implications/actions include conservation and preparation for lack of availability. In
some cases we have begun to run out of sodium phosphate, and the supply of potassium phosphate is
very limited at LMHS sites. For more information on these shortages, please
contact John Armitstead, MS, RPh, FASHP, System Director of Pharmacy Services at
[email protected] or 239-‐343-‐2166
Pharmacy Change
Note LMHS Pharmacy will be changing from IV Nexium to IV Protonix as our IV proton pump inhibitor of choice.
Please make note of this in your ordering.
New Psych Hospital Construction Underway
Construction is underway for a for-profit 76-bed adult psychiatric hospital in south Fort Myers. The 76 bed in-‐patient psychiatric hospital facility located on the HealthPark Medical Center campus will house four nursing units: a 19-‐bed Seniors Transitions Program, a 19-‐bed Seniors Intervention Program, a 19-‐bed Adult Psychiatric Intensive Care Unit, and a 19-‐bed Adult Treatment Program.
For more information about this facility, please go to www.parkroyalhospital.com.
Our Docs are Shining Bright!
Kudos to Luis Faverio, M.D., Pediatric Pulmonologist, Robin Churchill, M.D., Pediatric Infectious Diseases physician, and Craig MacArthur, M.D. Pediatric Hematologist/ Oncologist, for collaborating with Blanca Gonzalez, M.D. on a work accepted for publication in the Clinical Vaccine Immunology Journal’s May 2011 issue entitled “Elevated serum beta-‐D-‐glucan levels in immunocompromised children with clinical suspicion for Pneumocystis jiroveci pneumonia”. Great job everyone! Major Charles Boggs, M.D., General Surgeon, has recently been deployed back into the U.S. Armed Forces. This is his second deployment. He is supported by our Military Support Team at Lee Memorial Health System. We graciously honor you for your service, Dr. Boggs! Governor Scott appointed Jimmy Orr, M.D., Gynecologic Oncologist, to the Florida Board of Medicine. Dr. Orr is founding physician of Florida Gynecologic Oncology, Medical Director for Lee Cancer Care and a leading advocate for women’s health issues. He is past president of the National Society of Gynecologic Oncologists as well as the Florida Society of Gynecologic Oncologists. The Florida Board of Medicine oversees physician licensure and quality assurance activities. This is an impressive recognition of Dr. Orr’s leadership, integrity and passion.
www.leememorial.org/physicianpub
Latest Updates & Recognitions.
Medical Staff Updates & Changes
3
Michael Raab, M.D. Family Practice
Lee Memory Care Phone: 239-‐343-‐2608
Fax: 239-‐343-‐2012
Vikti Gosalia, M.D. Internal Medicine
Florida Medical Affiliates 16304 Crown Arbor Way #102
Fort Myers, FL 33908 Phone: 239-‐930-‐5483
Fax: 239-‐791-‐1261
Christina Flint-‐Lowe, ARNP Inpatient Consultants of Florida 4513 Executive Drive, 2nd Floor
Naples, FL 34119 Phone: 239-‐597-‐5638
Fax: 239-‐597-‐5628
Avery Wright, D.O. Family Practice
Lee Convenient Care – Pine Island Road
Phone: 239-‐424-‐1655 Fax: 239-‐424-‐1649
Please communicate your practice updates to the Medical Staff Services Office at 239-‐343-‐2747
Diagnostic Test Scheduling PHONE NUMBER CHANGE
Please note: To schedule diagnostic tests at Gulf Coast Medical
Center, please call our Central Scheduling Department at
239-‐434-‐1499
Patient First, Every Time.
4
The Transfer Center: One Year Later
Did you know…the transfer center now handles an average of 750 direct admits per quarter?
The transfer center places patients with the appropriate level of care in the appropriate unit, eliminating the need to transfer the patient unnecessarily after admission. Your patient’s safety is our biggest concern. We would be happy to visit your office, or attend your staff meeting, and provide an inservice on the process. For more information, please contact Andrea Snyder, Director, at 239.533.7810 or [email protected].
4
I make those I serve my highest priority: • promote the health and well being of all patients who seek care at LMHS
• support trainees in all of their academic endeavors • respect colleagues and those we serve who differ by gender, race, religion, culture, national origin, mental and physical abilities, sexual orientation and treat them with dignity, respect and compassion
• recognize that every member of the LMHS team makes important contributions
• ensure that all team members understand overall team goals and their roles
• answer questions posed by patients, trainees or staff to ensure understanding and facilitate learning
I respect privacy and confidentiality: • only engage in conversations regarding patients according to LMHS policies and regulatory requirements
• discuss confidential matters in a private area • keep written/electronic information out of the view of others • knock prior to entering a patient’s room, identify myself and ask permission to enter
• utilize doors, curtains, blankets as appropriate to ensure privacy and explain to the patient why I am doing this
I communicate effectively: • introduce myself to patient/families, visitors, colleagues • wear my ID badge where it can be easily seen • smile, make eye contact, greet others, speak in ways that are easily understood and show concern and interest; actively listen
• recognize that body language and tone of voice are important parts of communication
• listen and respond to dissatisfied patients, families, visitors and/or colleagues
• remain calm when confronted with or responding to pressure situations
Lee Memorial Health System Credo Passed by all FMECs
We provide excellence in healthcare and education. We treat others as we wish to be treated.
We continuously evaluate and improve our performance.
I conduct myself professionally: • recognize the increasing diversity of our community and broaden my knowledge of the cultures of the individuals we serve
• refrain from loud talk and excessive noises – a quiet environment is important to heal, learn and work
• continue to learn and seek new knowledge to enhance my skills and ability to serve
• strive to maintain personal well-‐being and balance of work and personal life
I have a sense of ownership: • take any concern (real, perceived, big or small) seriously and seek resolution or understanding – ask for help if the concern is beyond ability or scope of authority
• approach those who appear to need help or be lost and assist/direct them appropriately
• clean up litter, debris and spills promptly or notify the best resource to keep the environment clean and safe
• remain conscious of the enormous cost of health care, teaching and research and optimize resources while delivering exemplary service
I am committed to my colleagues: • treat colleagues with dignity, respect and compassion; value and respect differences in background, experience, culture, religion, and ethnicity
• contribute to my work group in positive ways and continuously support the efforts of others
• view all colleagues as equally important members of the LMHS team regardless of job, role or title
• promote interdepartmental cooperation • recognize and encourage positive behaviors • provide private constructive feedback for inappropriate behaviors
It’s Who We Are.
www.leememorial.org/physicianpub
Welcome New Physicians.
5
What’s the Buzz?
What is ISO 9001?
Think Quality
Lee Memorial Health System has replaced The Joint Commission with DNV as its formal accrediting agency. DNV, which is fully approved by CMS, DNV’s adherence
to ISO continuous quality improvement standards provides guidance to a superior approach to quality. Lee Memorial Health System is seeking ISO 9001 certification
from DNV, and while it does not replace current accreditation requirements, it is a proven quality
management system.
ISO 9001 is used throughout the world in all types of industries as a systematic approach to improving quality
by providing consistent service, improving patient satisfaction, and continually improving the organization. Many of the principles of ISO 9001 have already been in place at LMHS. ISO 9001 helps hospitals go to the next level, and to apply a more formal framework for quality
that ensures even the smallest act of innovation is captured, shared and consistently applied to the benefit
of patients.
By implementing a formal quality management system, we can increase efficiencies, patient satisfaction, internal
communication, and increase overall internal satisfaction.
Look for more information about ISO 9001 in upcoming issues of Medical Staff Matters.
Did you know…
Clostridium difficile PCR Does Not Need Retesting
A recent survey completed by LMHS Epidemiology revealed some interesting findings with respect to Clostridium difficile (C diff) tests within our System. Since 2009 we have been using Cepheid’s Xpert® PCR C diff molecular test as a replacement for the traditional C. diff A/B toxin screening test. The advantage of PCR testing versus toxin screen relate directly to the sensitivity and specificity of the molecular testing. The PCR sensitivity is > 93%, meaning that 93 out of 100 individuals with C diff are detected by the test (6-‐7 false negatives per 100). Alternatively, the specificity of the molecular test is 94%, meaning that 94 out of 100 individuals without C diff are classified as disease-‐free by the test (6 false positives). The traditional toxin screen was considerably less sensitive and less specific – hence the practice of ordering up to three tests to detect C diff positive patients.
The Epidemiology Department reviewed 30 patients whose initial PCR C diff test was positive. Of these 30 patients, 18 had only one sample submitted, 8 had two samples submitted 2 had three samples submitted, 1 had six samples submitted and 1 had nine samples submitted. A total of 55 samples were submitted for these 30 patients, and all of them were positive. All 55! On the other hand, 30 patients whose initial C diff PCR was negative were also reviewed. Of these, 15 had one test submitted, 11 had two tests submitted, 3 had three tests submitted, and one had five tests. A total of 51 samples were submitted for these 30 patients, and all of them were negative.
In summary, 60 patients had 106 tests, and in every case, the results of the subsequent tests did not deviate from the initial tests. This test has proven itself to be highly accurate and initial results, whether positive or negative, can reliably be used to guide clinical decision-‐making without the need for repeated testing.
Questions? Please contact Stephen A. Streed, MS, CIC System Director, Epidemiology/Infection Prevention 239.343.5645
www.leememorial.org/physicianpub
Current CME Opportunities
6
AdvancesinTreatmentof
VoidingDysfunction
JamesD.Borden,M.D.
SouthwestFloridaUrologicAssociates
Wednesday,June1,2011
6:30‐7:30PM
HealthParkMedicalCenter
RoomHP1B
RSVPforCMEandDinnerbyMay27th
424‐2680
Hirschsprung'sDisease:Diagnosis
andSurgicalManagementPediatricGrandRounds
RodrigoA.Mon,M.D.
PediatricGeneralSurgery
Wednesday,June8,2011
6:30‐7:30PM
HealthParkMedicalCenter
RoomHP1B
RSVPforCME&DinnerbyJune6th
424‐2680
MinimallyInvasiveSpineSurgery
PaulD.Fuchs,D.O.
OrthopedicSpecialistsofSouthwestFlorida
Monday,June20,2011
6:00‐7:00PM
GulfCoastMedicalCenter
CommunityRoom
RSVPforCME&DinnerbyJune17th
424‐2680
DidyoucompleteyourPatient
SafetyEducationyet?1.5CMECredits
Gotowww.leememorial.org.
ClickonMedicalStafflinkontheleft.
ClickonPatientSafetyTrainingarticlein
thecenterofthepage.
EnterloginandpasswordforonlineCMEs.
AmyotrophicLateralSclerosis:
TheMythandContemporary
ManagementThe1stQuarterlyNeurologyGrandRound
CME
NimaMowzoon,M.D.
FloridaNeurologyGroup
Wednesday,June22,2011
6:30‐7:30PM
HealthParkMedicalCenter
RoomHP1B
RSVPforCME&DinnerbyJune20th
424‐2680
TheChildren'sHospitalof
SouthwestFlorida9thAnnual
PediatricConferenceJune4and5,2011
SanibelHarbourMarriottResort&Spa
11CMECredits
Needbrochure?Call239.424.2397oremail
AnnualGIConferenceJuly9&10,2011
SanibelHarbourMarriottResort&Spa
8CMECredits
Needbrochure?Call239.424.2397oremail
Faculty:FirasAl‐Kawas,M.D.,
ChristopherForsmark,M.D.,Baharak
Moshiree,M.D.,BarryRosser,M.D.,
JamesScheiman,M.D.,Philip
Schoenfeld,M.D.,ArunSwaminath,
M.D.andMichaelWallace,M.D.
Topicsincluderadiofrequencyablation,
pancreatitis,gastroparesis,hepatitis,
periendoscopicmanagementofNSAIDs&
anticoagulants,coloncancerscreening,IBD
andGIimaging.
www.leememorial.org/physicianpub
New Physicians.
7
Please welcome the following physicians to Lee Memorial Health System:
Congratulations to April 2011
Physician of the Month
Ovidiu Ranta, M.D. Internal Medicine
Andrea Esch, D.O. Anesthesiology Anesthesia and Pain Consultants James Frizzell, M.D. Gastroenterology Digestive Health Physicians Lawrence Isaacs, M.D. Emergency Medicine Southwest Florida Emergency Physicians Jon Kimball, M.D. Orthopedic Surgery Joint Implant Surgeons of Florida
Archana Mandala, M.D. Family Practice Solo practitioner Bruce Storrs, M.D. Pediatric Neurosurgery All Children’s Neuroscience Institute Parisima Taeb, M.D. Internal Medicine Cogent Jacqueline Twitchell, Psy.D. Psychology Solo practitioner
Viraine Weerasooriya, M.D. Pediatric Gastroenterology Pediatric Gastroenterology, Hepatology & Nutrition of Florida
Patient First � Every Time Medical Staff Matters is a publication of the
Lee Memorial Health System. Please direct all inquiries to Yvonne Luckett at
Teamwork = HHS’ Outstanding Leadership Award!
Embracing a continuous goal of zero tolerance for central-‐line bloodstream infections, HealthPark Medical Center’s intensive care units have been recognized with a first-‐ever “Outstanding Leadership Award for Achievements in Eliminating Central Line Associated Bloodstream Infections” by the U.S. Department of Health and Human Services and the Critical Care Societies Collaborative.
HealthPark Medical Center is one of only eight organizations to receive the new national award recognizing health care organizations that have had sustained success over at least 25 months in the prevention or elimination of central-‐line infections and that share their information and knowledge in eliminating infections with other medical organizations.
To help drive down the rate of hospital infections and to recognize organizations that raise the bar in preventing and eliminating infections, the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Health, Office of Healthcare Quality and the Critical Care Societies Collaborative – composed of the American Association of Critical-‐Care Nurses, American College of Chest Physicians, American Thoracic Society and Society of Critical Care Medicine -‐ have joined together in establishing the National Awards to Recognize Achievements in Eliminating Healthcare-‐Associated Infections.
“Receiving this award speaks volumes in terms of the dedication and commitment on the part of our team of health care professionals to improve the quality of care for our patients,” says Sandra Simmons, MSN, RN, MHA. “We are now able to mark the time since we’ve experienced central-‐line infections in years versus months.”
GULF COAST HOSPITAL AND SOUTHWEST FLORIDA REGIONAL MEDICAL CENTER
MEDICAL STAFF PRESIDENTGary Correnti, MD
PRESIDENT ELECTCharles Bisbee, MD
PAST PRESIDENTSJames Borden, MD, SWFRMCRichard Bloy, MD, GCHSECRETARYWilliam Hearn, DO
CHAIRPERSON, MEDICINEDebra Roggow, MD, GCHSunil Lalla, MD, SWFRMC
CHAIRMAN, SURGERYLarry Black, MD, GCHRichard Lane, MD, SWFRMC
CHAIRMAN, OB/GYNSteven Sager, DO, GCH
CHAIRMAN, PEDIATRICSEmilio DelValle, MD, GCHCHAIRMAN, ANESTHESIACharles Homolka, MD
CHAIRMAN, EMERGENCY MEDICINELarry Hobbs, MD
CHAIRMAN, PATHOLOGYLarry Seidenstein, MD
CHAIRMAN, RADIOLOGYRandy Knific, MD
CAPE CORAL HOSPITAL
MEDICAL STAFF PRESIDENTTimothy Dougherty, MD
PRESIDENT ELECTDavid Reardon, MD
PAST PRESIDENTThomas Carrasquillo, MD
SECRETARYDonn Fuller, MD
CHAIRMAN, MEDICINETimothy Keys, MD
CHAIRMAN, SURGERYAlexander Lozano, MD
CHAIRMAN, OB/GYNWilliam O'Brien, MD
CHAIRPERSON, CLINICAL DEPT OF THE CHILDREN'S HOSPITALAnantha Krishnan, MD
HEALTHPARK MEDICAL CENTER AND LEE MEMORIAL HOSPITAL
PRESIDENTF. Brett Shannon, DO
CHAIRPERSON, MEDICINEMary Magno, MD
CHAIRMAN SURGERYRalph Gregg, MD
CHAIRMAN, OB/GYNWilliam O'Brien, MD
CHAIRPERSON, THE CHILDREN'S HOSPITAL (PEDIATRICS)Anantha Krishnan, MD
CHAIRMAN, PATHOLOGYGeorge Kalemeris, MD
CHAIRMAN, RADIOLOGYDonald Gerson, MD
CHAIRMAN, EMERGENCY MEDICINEJason Wilson, MD
FT. MYERS, FLPERMIT NO. 131
