F e b r u a r y 2 6 , 2 0 0 9 F O C U S • 1

A publication for Christiana Care Health System physicians and employees

February 26, 2009VOLUME 20, NUMBER 4

Published every two weeks byChristiana Care Health System

External AffairsP.O. Box 1668

Wilmington, DE 19899-1668www.christianacare.org

i n t h i s i s s u e

Clinical News Bone Marrow Transplant Program earns reaccreditation 2

Navy doctor chooses Christiana Care for fellowship training 4

Up Close: Paul Kupcha, M.D., lengthens limbs the Russian way 6

New Code Blue stations can save lives 9

General News Newsletter adopts color format 13

Unfolding the new federal stimulus fund 15

Please reCyCle FoCus

More patients enrolled in Radiation Therapy Oncology

Group (RTOG) trials in 2008 at Christiana Care than at any other Community Clinical Oncology Program (CCOP) in the country.

In fact, last year Christiana Care out-recruited all but nine of the nation’s top-accruing sites for RTOG trials, surpassing five of 11 full-member sites and nine of 11 affiliate member sites, according to the February 2009 RTOG Newsletter.

Consistently high accruals

“My congratulations to Principal Investigator Adam Raben, M.D., Research Director Kandie Dempsey, MS, RN, OCN, CCRP, Research Coordinator Karen Sites, RN, BSN, OCN, and the entire Christiana Care RTOG team,” says Nicholas J. Petrelli, M.D., Bank of America endowed medical director of the Helen F. Graham Cancer Center.

“This achievement tops our con-sistently high patient accruals in National Cancer Institute CCOP trials, particularly those designed to optimize radiation therapy against cancer.”

The Christiana Care RTOG team enrolled 38 patients, more than Roswell Park, Emory University, Mt. Sinai and two dozen other cancer centers listed We were also the second-highest CCOP enrollers in 2006 and 2007.

Treating a range of cancers

RTOG trials lead to important new cancer therapies by linking basic research with clinical care. Currently, 15 RTOG trials that integrate radiation therapy with a variety of new drugs, systemic therapies and surgery are open to Christiana Care patients to treat brain, head and neck, lung, gas-trointestinal, genitourinary, cervix and breast cancers.

For more information, call the Cancer Research Office at 302-733-6227.

Christiana Care achieves national best recruiting for RTOG trials

Please

recycle Focus

adam raben, M.D., Karen sites, rN, BsN,

oCN, and (not shown) Kandie Dempsey,

Ms, rN, oCN, CCrP, are key members of

the Christiana Care rToG team.

2 • F o C u s F e b r u a r y 2 6 , 2 0 0 9

Christiana Care’s Bone Marrow/Stem Cell Transplant program has again been reaccredited by the prestigious organization that evalu-ates programs in the United States and Canada.

The three-year reaccreditation by the Foundation for the Accredita-tion of Cellular Therapy (FACT) demonstrates that Christiana Care’s program meets FACT’s rigorous standards for the collection, pro-cessing and transplantation of bone marrow and stem cells.

Started in 1991, the Christiana Care program remains the only FACT- accredited program in Delaware, and one of only 169 in the U.S. and Canada.

“The accreditation reinforces the great care that patients receive from the transplant team and is another reason why patients don’t have to leave Delaware for their cancer care,” says Nicholas Petrelli, M.D., the Bank of America-endowed medical director of Christiana Care’s Helen F. Graham Cancer Center.

The evaluation process included submitting mountains of docu-mentation and required months of preparation before a site visit in December.

Doctors at Christiana Care have performed more than 500 trans-plants in the program’s 18-year history, including 31 transplants in 2008. The number has grown each year since 2006.

Bone Marrow Transplant program earns reaccreditationOnly prOgram in Delaware perfOrmeD 31 transplants last year

Bone Marrow Transplant

Program team members,

are (top row, from left),

Patricia strusowski, rN,

Ms, Kathy Hinckle, rN,

Tina scherer, rN, MsN,

oCN, yong Zhao, M.D.,

Betty stone, rN, Courtney

Crannell, rN. (Front row,

from left) Dawn Henry,

MT, Frank Beardell, M.D.,

shirley amato, rN, liz

West, rN, and Danielle

Brown, MsW. Missing

from photo is stem Cell

Transplant Coordinator

Mary sheridan, rN.

C l i n i c a l N e w s

F e b r u a r y 2 6 , 2 0 0 9 F O C U S • 3

“We’re hoping to do at least that many, if not more,” in 2009, says Frank Beardell, M.D., the program’s medical director. Dr. Beardell calls the reaccreditation “a major accom-plishment that defines quality in a program today.”

Patients have leukemia, lymphoma and multiple myeloma

Bone marrow transplants are most commonly performed on patients with hematological malignancies, including leukemia, lymphoma and multiple myeloma, to allow significant chemotherapy dose escalation. Additional benefit comes from transplantation using a donor’s stem cells, where the donor’s immune system helps fight the cancer, as well.

The bone marrow, which contains the stem cells is the factory of the blood that produces white and red blood cells and platelets.

stem cells counter bad effects of high-dose chemotherapy

Providing a fresh source of stem cells to patients who have received high doses of chemotherapy can save the patient from the effects of high-dose chemotherapy.

Stem cells can be harvested from either the peripheral blood or directly from the bone marrow. Depending on the condition being treated, hematologists can consider using either the patient’s own stem

Flourescent tracking shows transplanted

bone marrow cells in neural cells of

leukemia patients. Dendrites indicate

new growth.

cells (called an autologous trans-plant) or stem cells from a donor (called an allogeneic transplant).

In the latter, the stem cells come from either a matched sibling or a non-relative, depending on what is best for the patient. The Christiana Care program performs both autol-ogous and allogeneic transplants.

supporting National Marrow Donor Program

Of the 31 transplants performed last year, 19 were autologous transplants and 12 were alloge-neic transplants. Christiana Care doctors performed 41 harvests in 2008, many of which were for the National Marrow Donor Program, which works to secure stem cells from unrelated donors around the world.

Phot

o by

Hel

en B

lau,

11/

7/05

21

4 • F o C u s F e b r u a r y 2 6 , 2 0 0 9

C L i N i C A L N E W S

Joel Schofer, M.D., spent five months during the spring and summer of 2003 as a general medical officer assigned to a U.S. Marine Corps battalion in Iraq.

The U.S. Navy lieutenant com-mander‘s experience of caring for 1,500 U.S. Marines and crisscrossing much of Iraq with a mobile emergency room helped prepare him for an Emergency Ultrasound (EUS) Fellowship at Christiana Care, where he is on a team of doctors who diagnose and treat patients at Christiana and Wilmington hospitals.

One of three physicians currently serving one-year EUS fellow-ships, Dr. Schofer is mastering ultrasound—a tool that uses sound waves to produce an image of the body’s organs—to diagnose life-threatening conditions such as penetrating and blunt trauma, rup-tured abdominal aortic aneurysms or pulmonary embolism—the condition that claimed the life of NBC News reporter David Bloom in Iraq in 2003.

Program is one of first in the nation

The fellowship, which was among the first in the country when it accepted its first fellow in 2002, is also one of the busiest. Because of the four-state area from which Christiana Care draws more than 150,000 ED patients, physicians at Christiana and Wilmington hospitals perform more than 10,000 emergency bedside ultrasounds a year, exposing the fellows to one of the busiest and most varied case loads in the country.

The highly sought-after program — still one of only about 30 in the nation—receives about 15 applica-tions a year from physicians as far away as Japan, China and the United Arab Emirates. During the year-long fellowship, each fellow performs between 800 and 1,200 emergency ultrasounds and reviews another 3,000 scans, says Paul R. Sierzenski, M.D., RDMS, the

Christiana Care emergency ultrasound Fellowship attracts applicants from around the globe

emergency ultrasound fellow Joel schofer,

M.D., with Paul sierzenski, M.D., fellow-

ship director and director of emergency,

Trauma, & Critical Care ultrasound.

F e b r u a r y 2 6 , 2 0 0 9 F O C U S • 5

fellowship director and director of Emergency, Trauma & Critical Care Ultrasound at Christiana Care.

EUS Fellows perform more than 14 ultrasound applications including trauma, cardiac and aorta, as well as some pioneered at Christiana such as ocular, thoracic ultrasound and transcranial doppler for acute stroke care. On average, the fellows see two ruptured abdominal aortic aneurysms and 10 pericardial effu-sions a month – more than their peers at many other hospitals are likely to see. In a two-week period in December alone, the fellows diagnosed three cases of pulmo-nary embolism with evidence of severe cardiac compromise on ultrasound, prompting imme-diate thrombolytic therapy, Dr. Sierzenski says.

Fellows learn to lead eus programs at other hospitals

The variety of different condi-tions fellows get to treat—what Dr. Sierzenski calls “some really unbelievable pathology”—has pre-pared physicians to go on to head emergency ultrasound programs at other hospitals around the country. Fellows develop skills in clinical ultrasound performance, quality assurance, program integration and ultrasound education and research. “From a training standpoint, and as a result of our collaborative rela-tionships with other departments, it is superior to most university-based teaching hospitals,” Dr. Sierzenski says.

When Dr. Schofer completes his fellowship in September, he will be assigned to the medical staff at the Naval Medical Center in Portsmouth, Va., as director of its emergency ultrasound program.

Chance to see patients with wide range of serious conditions

The opportunity to work with patients with such a wide variety of serious medical conditions is one reason Dr. Schofer chose to apply for a fellowship at Christiana Care over competing programs. “You don’t see patients in other hospitals with the kind of severe diseases that come rolling through the door here,” says Dr. Schofer.

Dr. Schofer’s enthusiasm and what Dr. Sierzenski calls his “rubber-meets-the-road kind of performance” were two of the main reasons he was selected for the program, Dr. Sierzenski says, adding, “These are qualities he shares with his 2008-2009 EUS fellowship colleagues Jason Nomura, M.D., and Mick Bauman, M.D.”

Dr. Schofer, 33, is a 2001 graduate of MCP Hahnemann School of Medicine. He completed his emer-gency medicine residency at the Naval Medical Center San Diego. He is married to a pediatrician and has two children.

For more information on Christiana Care’s EUS program and fellowship, visit www.christi-anacare.org/residentbody.

6 • F o C u s F e b r u a r y 2 6 , 2 0 0 9

Living with legs that are two dif-

ferent lengths is chal-lenging and painful.

“It can affect every area of life, from employment to relationships,” says Paul Kupcha, M.D., an orthopedic sur-geon trained in limb lengthening and reconstruction.

For years, adults who required surgery to lengthen or shorten limbs had to travel to Baltimore for care. Since 2002, Dr. Kupcha has been treating patients at Christiana Care, the only health system in Delaware that offers these life-changing procedures to adults.

Dr. Kupcha also works with doc-tors at A.I. du Pont children’s hos-pital to treat children who suffer from congenital deformities or injuries.

Patients come from all walks of life

At Christiana Care, Dr. Kupcha’s patients have ranged from an 80-year-old woman who had suf-fered a badly broken ankle to an immigrant who had sustained a

childhood injury that had not been properly treated because he didn’t have access to medical care.

In adults, skiing accidents and motorcycle crashes can result in limbs of different length. Infections in the bone or old fractures that didn’t heal properly also are fac-tors. In children, birth defects such as clubfoot can cause legs to grow at different lengths.

“Someone who is in constant pain, is on crutches, can’t put weight on his leg can experience a tremen-

Surgeon Paul Kupcha, M.D., performs limb-lengthening procedures in DelawareOrthOpeDiC sUrgeOn tOOk ilizarOv training in siberia

C L i N i C A L N E W S

Dr. Kupcha and his wife, Grace Kelly, pose

before a statue of the russian surgeon

Gavril Ilisarov, who developed the appa-

ratus for lengthening limb bones.

F e b r u a r y 2 6 , 2 0 0 9 F O C U S • 7

Paul Kupcha, M.D., takes

part in an Ilizarov proce-

dure in russia in 2004.

dous improvement in quality of life,” Dr. Kupcha says. “In some cases, patients weren’t able to work and now they can get jobs.”

Procedures started in russia

Surgical procedures to lengthen limbs were developed in the late 1950s by Dr. Gavril Ilizarov, a renowned Russian surgeon, but weren’t recognized in the United States until the 1990s. Dr. Kupcha traveled to Siberia twice, in 2003 and 2004, to study with Ilizarov-trained surgeons.

“Fortunately, it was in the summer, so it was pretty mild,” he recalls.

To lengthen a leg, the limb is encased in a scaffold-like frame called a fixator that is connected to the bone with wires, pins or both. A small crack is made in the bone and each day the crack is widened about one millimeter as the bone fills in. The average growth rate is about one inch per month.

The fixator is worn until the bone is strong enough to support the patient safely. This usually takes about three months for each inch.

In Dr. Ilizarov’s day, the frames were fabricated in a machine shop.

“Now, it’s high tech,” Dr. Kupcha says. “We use computers.”

The president of the Delaware Society of Orthopaedic Surgeons, Dr. Kupcha practices at the Delaware Orthopaedic Center and is the only fellowship-trained foot and ankle surgeon in the state.

He is a graduate of the University of Pennsylvania, where he played football and baseball, as well as Georgetown University Medical School. He completed his surgical and orthopedic residencies at Thomas Jefferson University Hospital in Philadelphia.

8 • F o C u s F e b r u a r y 2 6 , 2 0 0 9

C L i N i C A L N E W S

Focus on excellence – Best Practice review

n The patient may be released from the procedure area with a post- sedation score greater than or equal to nine or no less than the pre-sedation score.

n in the outpatient setting, the patient may be discharged if:

n The patient has not had any sedation for 30 minutes.

n A reversal agent has not been administered for at least two hours.

n The sedation-recovery score is greater than or equal to nine or no less than the pre sedation score.

n Appropriate discharge planning/instructions have been provided and documented.

n The patient has assistance with transportation home (patients will not be permitted to drive home).

To ask questions, contact the content expert: Barb Eaton, 733-5815. To reach the Safety Hotline, call SAFE (7233) from within Christiana or Wilmington hospitals. From outside the hospitals, call 302-623-SAFE. Further information is available in the Archives of Best Practices. From your portal, choose Focus on Excellence, Joint Commission Readiness, Ongoing Strategies, Educational Strategies, Monthly Q&A.

Consistent with our strategies for engagement of staff in continuous improvement and best practice, we regularly review important topics in Focus to help reinforce safe practice behaviors. These tips will reinforce information and enable staff to better articulate our safety practices during an unannounced survey.

MoDeraTe seDaTIoN

Q. What is moderate sedation?

A. Moderate sedation is a drug-induced depression of consciousness during which patients:

n Respond purposefully to verbal commands, either alone or accom-panied by light tactile stimulation.

n Do not require to maintain a patent airway.

n Have adequate spontaneous ventilation.

n Maintain cardiovascular function.

Q. What are the post-procedure/discharge requirements?

A. Requirements include the following:

n Blood pressure, pulse, pulse ox and level of consciousness will be monitored at least twice, every 15 minutes, for one-half hour, and then continuing until the patient meets recovery criteria according to the post-sedation score.

Patient safety and Joint Commission Hotline The Patient Safety and Joint Commission Hotline is a quick and easy way to report safety concerns that are not routinely reported through Safety First Learning Reports. All staff and physicians may use the hotline to:

n Communicate a near miss or a ‘’good catch.’’

n Report a potential safety issue that may not be associated with an individual patient but is of concern to you.

n Seek clarification on a regulatory question.

Calls can be placed at any time (24/7). Callers may leave their names or choose to remain anony-mous. The call should describe the safety concern and department or area affected. If you are calling from outside of the hospitals, please call 302-623-SAFE (7233).

To report a safety concern from within Wilmington or Christiana hospitals, call SAFE (7233).

All calls are logged into an estab-lished database and referred to the appropriate department or individual who can address and/or resolve the issue(s).

Thank you for improving patient safety.

F e b r u a r y 2 6 , 2 0 0 9 F O C U S • 9

Five new code blue stations on the first floor of Christiana Hospital go live on Feb. 24 and provide greater access to resuscitation equipment for life-threatening emergencies. A blue light identifies the location of each station.

locations of new code blue stations

n E tower by visitor elevators

n Outpatient way

n Station 4

n Station 9

n Middle way (The hallway behind and parallel to outpa-tient way)

n D tower outside of CT scan

n A tower in radiology depart-ment

How to use the stations

If you are transporting a patient on the first floor who becomes unresponsive or stops breathing, transport the patient immediately to the nearest code blue station.

n Access the station via employee badge.

n Pick up phone and say exactly what is on the script card on the bulletin board.

n Proceed with basic life support until code team arrives.

n Stay with patient to answer code team questions and until disposition is determined.

For more information, go to the Code Blue Education Web Site: http://inet/codeblue/codebluehp.htm.

New first-floor code blue stations installed at Christiana Hospital

Brittany rhoads, rN, shows one of the

Code Blue stations just installed on the

first floor at Christiana Hospital.

F e b r u a r y 2 6 , 2 0 0 9 F O C U S • 10

Christiana Care’s Kidney Transplant Program launched a kidney clinic Jan. 29 for 35 patients who live south of Dover and are awaiting transplants at Christiana Care. The patients represent about 15 percent of the waiting list, currently at 236.

The bimonthly clinic at the Christiana Care Center for Heart and Vascular Health satellite office on the Beebe Medical Center campus in Lewes means a shorter commute and less cost for down-state patients.

“It is 82 miles and 88 minutes of drive time from Seaford to Newark, not to mention gas and tolls,” says Transplant Coordinator Gail Eastman, RN, MSN. At most, “Lewes is only 31 miles away – saving patients 57 minutes and about $10 each way in transporta-tion costs,” says Eastman.

Improves continuity

Physicians see patients on the list every six months to ensure they remain viable transplant candi-dates and to review new allocation rules for transplant listing.

“It’s been a long-standing failing of the transplant community to follow patients while they are listed and

awaiting a kidney,” says S. John Swanson III, M.D., chief, Transplant Surgery. “The six month follow-up is an important visit and our effort to remedy the problem. Reaching patients where it makes sense for them is important because it puts them at ease, improves compliance with regular visits and allows us to track their progress closely.”

Christiana Care’s Kidney Transplant Program has performed 35 trans-plants and evaluated more than 800 individuals for transplant since January 2007. For upcoming clinic dates in Lewes, call the Kidney Transplant Program at 302-623-3866.

Kidney Transplant Program launches downstate clinic

From left, Christiana Care Kidney

Transplant Coordinator Gail eastman with

office assistant Vicky Jenkins and Medical

assistant Moira Quint at the kidney

transplant clinic in lewes.

11 • F o C u s F e b r u a r y 2 6 , 2 0 0 9

C L i N i C A L N E W S

expo attracts 266 students from area nursing schoolsThe 2009 Student Nurse Expo on Jan. 30 attracted 266 nursing stu-dents—30 percent above last year’s attendance—from more than 20 area nursing schools to the John H. Ammon Medical Education Center.

Christiana Care nursing leaders and staff acted as health system ambassadors while representa-tives of various nursing specialties provided history, knowledge and interactive learning programs.

“As a result, many of the student nurses expressed interest in working as student-nurse externs, PCTs or in other capacities” says Manager of Recruiting Services Wendy Gable.

About 70 of the student nurses who attended the Expo will graduate Nursing school in May.

P u B l I s H I N G , P r e s e N TaT I o N s , a P P o I N T M e N T s , aWa r D s

Publishing

susan Mascioli, RN, CPHQ, BSN, MS, linda laskowski-Jones, RN, ACNS-BC, CCRN,

CEN, BSN, MS, sharon urban, RN-BC, MSN, and shirley Moran, RN, CNA, MS,

published an article titled “improving Handoff Communication” in the February issue of

Nursing 2009, Vol. 39 No. 2

Hisham M.F. sherif, M.D., FAHA, ehsanur rahman, M.D., Nowwar Mustafa, M.D.,

Vinay r. Hosmane, M.D., Vivek reddy, M.D., angela Disabatino, RN, MS and William

Weintraub, M.D., published and article titled “Recovery After Resuscitation from Cardiac

Arrest in ST Elevation Myocardial infarction: A Computer-based Decision Support Tool,

in Studies in Healthcare and Informatics, vol. 142 (2009) 310-312. There also was a poster

presentation on the same subject at the 17th annual Medicine Meets Virtual Reality

conference, Long Beach, Calif., Jan. 19-22.

Hisham M.F. sherif, M.D., FAHA, published an article titled “Calcification of Left-sided

Valvular Structures: Evidence of a Pro-inflammatory Milieu,” in the Journal of Heart Valve

Disease, 2009 (January);18.

Marsha Babb, RN, BSN, MS, CNOR, published an article titled “Clinical Risk Assessment:

identifying Patients at High Risk for Heart Failure,” in the AORN Journal, February 2009,

Vol 89, No. 2.

Darcy Burbage, RN, MSN, AOCN, emily Penman, M.D., renee Mullaney, MS,

Jacqueline Napoletano, M.D., Zora ali-Khan Catts, MS, CGC, and lois Torgerson

published an article titled “High-risk breast and ovarian cancer: The experience of one

community-based teaching hospital and cancer center” in Oncology Issues, January/

February 2009.

appointments

Christiana Care vice president of Operations and Business Development Joseph richichi

was appointed to the Town of Smyrna’s Business Development Committee.

The following Christiana Care nurses, physicians and staff have earned recognition for professional achievement.

Submissions to Publishing, Presentations, Appointments and Awards are welcome. Nurses should e-mail submissions to Carol Boettler at cboettler@christianacare.org.

Resident physicians and attending physicians should e-mail their submissions to Jo Ann Umbel at jumbel@christianacare.org and staff to Corp Comm-Focus Editor.

F e b r u a r y 2 6 , 2 0 0 9 F O C U S • 12

G e n e r a l N e w s

In the Jan. 29 issue, Focus announced Focus’s “Go Green” strategies that are intended to help our award-winning employee newsletter become an environmen-tally friendlier publication.

To achieve our goal, we’ve figured out how to fit two weeks worth of news and information into a 16-page format, without affecting the quality of the publica-tion. It weighs half as much as before and we are saving 14 tons of ink and paper with our new Focus format.

We’ve been busy encour-aging many employees, physicians, retirees and other Focus readers to access Focus online at www.christianacare.org. So far, we’ve managed to reduce the amount of paper needed to dis-tribute Focus in print by 35 percent.

In this issue, we’re delighted to introduce a new full color format. From now on, photos that show our health system’s people, places and things will be published in vivid colors on high-quality recycled paper.

And, we’re able to do it without increasing the cost of printing above what we were paying to print Focus in only two colors.

Here’s why:

Since our vendor’s printing presses almost always run full-color printing jobs, shifting to our two-color job required a thorough press cleaning to drop down to only two colors.

By skipping that step, the printer saves significant time and labor and passes enough of these cost

savings to us to make Focus a color publication without increasing our costs.

So, we’re happy to say we’re not only saving paper, but also helping prevent a lot of ink from being wasted during the cleaning process.

The next step in making Focus environmentally friendlier belongs to you, the readers. It is printed on recycled paper and should be returned to the recycling process when no longer wanted. We hope you will take care of that detail while routinely placing it and any other recyclable paper and materials in the appropriate bins throughout Christiana Care.

Focus thanks contributors for their useful feedback and encourages readers to continue to share helpful insights and suggestions and story ideas by e-mailing Corp Comm – Focus editor on Outlook.

The new format enables

Focus to present striking

full-color graphics, illustra-

tions and photos, such

as this image from the

combined PeT/CT scanner

at Heart & Vascular Health.

(For the full story, see

the Feb. 28, 2008 issue in

the Focus archives on the

portal.)

From the editor Focus’s new color format

13 • F o C u s F e b r u a r y 2 6 , 2 0 0 9

u P C o M I N G e V e N T sThinking about changing your lifestyle and eating a healthier diet? Come to the “Nutrition Fair” on Monday, March 23 from 9 a.m.-1 p.m. and Wednesday, March 25 from 1-3 p.m. in the Wilmington Hospital Health Center main hallway on the 2nd floor. There will be a variety health and nutrition of information provided as well as opportunities to question staff physicians, nurses and nutritionists.

social Work Department-sponsored vendor fairs featuring representatives from transportation companies and medical equipment companies, hospices, home health care and private duty caregiver agencies, and nursing and assisted living facilities to provide information and answer questions.

Schedule: Christiana Hospital, Room 1100, noon-2 p.m. n Feb. 27 – Transportation and medical equipment companies. n March 5 – Hospices, home health care and private duty agencies. n March 10 – Nursing and assisted living facilities.

Wilmington Hospital Conference Center, noon-2 p.m. n March 20 – Hospices, home health care and private duty caregiver agencies and medical equipment companies. n March 25 – nursing and assisted living facilities and transportation companies.

All staff, patients and their family members are invited to attend. Contact Jaynnette Tirado at 733-5727 for Christiana Hospital or Debbie Kling at 428-2149 for Wilmington Hospital.

The ICD support Group for patients with implantable cardioverter defibrillator (iCD) devices meets for a discussion series on either the first or second Tuesday of each month, from 6-7:30 p.m. Next up: Tuesday, March 10, 2009, “The differ-ence in signs and symptoms of heart disease in men and women,” with Kathleen McNicholas, M.D., medical director of Performance improvement. Meetings are free, but registration is requested for each session. To register, call 800-693-CARE (2273) or 302-623-CARE (2273).

A free comprehensive weight-loss surgery seminar takes place monthly at the John H. Ammon Medical Education Center. Participants can meet a bariatric surgeon and members of Christiana Care’s Weight Management Center staff to have questions answered and learn more the Weight Management. Next seminars are: n Tuesday, March 17, 6:30-8 p.m. n Tuesday, April 21, 6:30-8 p.m. Contact the Weight Management Center at 302-661-3475.

The Ninth annual Think First 5K-run/Walk to support Christiana Care Trauma Program injury prevention efforts will be April 16 at 6:30 p.m. The race starts and finishes near the Emergency Department on Christiana Hospital campus. Register online in advance at www.races2run.com or race day starting at 5:40 p.m.

The 13th annual Diabetes update, at the John H. Ammon Medical Education Center, is Saturday May 2, 7:30 a.m.-4 p.m. This is a full day of educational activity for health care professionals providing an update on the management of diabetes. The advance registration fee is $70 ($35 for students; residents registered in advance attend free). Tickets at the door are $90, $50 for students. Please make checks payable to Christiana Care and mail to Cheryl Klecko, Physician Relations, Christiana Hospital, Suite 2177, 4755 Ogletown-Stanton Road, Newark, DE 19718. For informa-tion, call 302-733-1961 or e-mail cklecko@christianacare.org.

an evening in Monte Carlo, a fundraiser for the Helen F. Graham Cancer Center, will be Friday, May 15, 7 p.m. to midnight at Longwood Gardens. The event supports acquisition of an FACS cell sorter in the Center for Translational Research opening in the new building this spring. The sorter helps isolate malignant cells from colon, breast, lung, prostate and other cancers.

Call for entries: 2009 Commendation for excellenceThe Christiana Care Medical-Dental Staff Awards Committee seeks nominations for the 10th annual Commendation for Excellence to be presented at the Medical-Dental Staff Annual Event this fall.

The Commendation was established to honor current and former mem-bers of the Medical-Dental Staff who have made exceptional contri-butions to the community through their clinical, scholarly, educational or humanitarian activities.

Any member of the Medical-Dental Staff may nominate an eligible person for the award by the May 4 deadline by submitting:

n A letter outlining the reasons for the nomination.

n Qualifications of the nominee.

n The nominee’s curriculum vitae, if available.

The physician or dentist selected by the Awards Committee is endorsed by the Medical Executive Committee.

Send nominations to Dawn Gies, Christiana Hospital, 4755 Ogletown-Stanton Road, Suite 1270, Newark, Del., 19718; e-mail to dgies@christianacare.org; or fax to Dawn Gies at 302-733-1366.

For more information Contact Gies at 302-733-1049.

G E N E R A L N E W S

F e b r u a r y 2 6 , 2 0 0 9 F O C U S • 14

As state offi cials in Dover are busy

reviewing the details of the stim-

ulus funds headed to Delaware,

Christiana Care has charged an ad

hoc committee chaired by Senior

VP of External Affairs Michele

Schiavoni to review and recom-

mend ways in which Christiana

Care might benefi t. The recom-

mendations of that committee will

be reviewed and reported at leader-

ship meetings, on our portals and

in Focus.

Here is a brief rundown of how Dela-

ware’s stimulus funds will be applied.

Medicaid and Medicare

■ Increases Delaware’s Medicaid

Disproportionate Share Hospital

Payment Program (DSH) allot-

ments by 2.5 percent in 2009 and

by 2.5 percent of the 2009 total

in 2010. The only DSH hospital

in Delaware is the Delaware

Psychiatric Center.

■ Delays implementing Centers

for Medicare & Medicaid (CMS)

regulations that adversely affect

state provider tax laws, special-

ized medical transportation to

school for children covered by

Medicaid, case management ser-

vices that allow people with

disabilities to remain in the comm-

unity, and outpatient services.

■ Proposes that the Secretary of

Health and Human Services

not finalize the proposed CMS

rules on limiting costs for public

hospitals, eliminating federal

aid for graduate education, and

covering rehabilitation services

for people with disabilities.

■ Prevents the 2009 scheduled

50-percent reduction in indirect

medical education capital pay-

ments to teaching hospitals.

Health care assistance

■ Provides a 65-percent subsidy

for COBRA health insurance

premiums for nine months to

workers who have been laid off.

■ Extends Transitional Medical

Assistance (TMA) for families

who risk losing Medicaid ben-

efits if their income increases.

Training

■ Funds scholarships, loan repay-

ment and grants to training

programs, including the

National Health Services Corps

program.

■ Provides funds for nurse and

physician training.

Prevention and wellness

■ Creates a prevention and

wellness fund.

Delaware stimulus funds: How can Christiana Care benefi t?

continued on nex t page

19777.indd 1519777.indd 15 2/25/09 1:00:50 PM2/25/09 1:00:50 PM

15 • F o C u s F e b r u a r y 2 6 , 2 0 0 9

n Supports strategies to reduce chronic disease and health care-acquired infection rates.

Comparative effectiveness research

n Funds comparative effective research through the NIH and the Agency for Health Care Research and Quality.

n Provides funds to accelerate developing and disseminating the research.

Technology

n Awards grants for expanding and improving broadband service infrastructure.

n Provides funds to strengthen the health information technology (HIT) infrastructure.

n Provides grants, loans and in-centive payments for providers who adopt and use HIT, such as electronic health records.

Hospital bonds

n Creates incentives for banks to buy and carry tax-exempt hospital bonds.

n Funds oversight of the stimulus provisions and strengthens and codifies HIT privacy and security provisions.

Federal stimulus plan to benefit Medicaid in DelawareThe federal economic stimulus package will provide financial assistance to Delaware in many ways. One provision of the stim-ulus package increases the Federal Medical Assistance Percentage (FMAP) for the Medicaid program. The FMAP is the federal match for state expenditures for Medicaid payments. Delaware’s FMAP is currently 50/50, meaning that the State pays 50 percent of the Medicaid costs and the federal government “matches” or pays the other 50 percent.

Under the economic stimulus bill, the federal share of Delaware’s FMAP will increase 6.2 percent. In other words, the federal govern-ment will now pay 56.2 percent of Medicaid costs while the State will pay 43.8 percent. It is also likely that Delaware will receive a bonus unemployment related FMAP increase, which is based on a com-plex, tiered structure comparing Delaware’s current unemployment rate to its lowest unemployment rate since Jan. 1, 2006.

The Delaware Division of Medicaid & Medical Assistance projects that the FMAP increase will prob-ably be around $300 million over 27 months (Oct. 1, 2008, through Dec. 31, 2010). This number could change as the Division delves fur-ther into its analysis of the stimulus package. Important to note is that

Stimulus fund, continued

G E N E R A L N E W S

F e b r u a r y 2 6 , 2 0 0 9 F O C U S • 16

the FMAP increase is temporary,

and this, undoubtedly, has some

policy makers concerned that the

increase will not last long enough

to stabilize State Medicaid

budgets.

Gov. Markell visits to share state’s fi nancial outlookMore than 300 of Christiana Care’s

physicians and managers attended

Gov. Jack Markell’s Reality Check

talk at John H. Ammon Education

Center on Feb. 11. The governor

outlined the economic conditions

that are creating a $606 million

economic shortfall for the state. The

economic challenges of the nation’s

second smallest state, Delaware,

are on par with the fi nancial chal-

lenges of both Michigan and Ohio.

“We have painful decisions to

make but we will survive and

thrive if we work together,” Gov.

Markell said. “Christiana Care is

an incredible resource in the state.

Your brain power will be critical to

our success.”

When asked about taxing hospitals,

the governor predicted that the

provider tax will come up again

this session in the legislature.

When that happens, he said, “We

want Christiana Care at the table,

to be part of the conversation from

the start rather than responding at

the end. We want you to be part of

the solution.”

Gov. Jack Markell deliv-

ered his “Reality Check”

presentation at Christiana

Hospital Feb. 11 before a

packed auditorium.

19777.indd 1719777.indd 17 2/25/09 10:56:14 AM2/25/09 10:56:14 AM

17 • F O C U S F e b r u a r y 2 6 , 2 0 0 9

G E N E R A L N E W S

PEEPS recognizes Center for Advanced Joint ReplacementThe Center for Advanced Joint

Replacement received the 2008

PEEPS Injury Prevention Award for

achieving the highest ratings for

leadership in Safe Patient Handling

and Mobilization. Teams receiving

honorable mentions include 2E,

5EW, 2C, 7E, 5B, WICU and 6C.

Several departments were rec-

ognized for signifi cant improve-

ment in their Lost Time Injuries

(LTI) over the last several years.

Congratulations to Textile Services

and Patient Escort for decreasing

their LTIs by 69 percent and

60 percent, respectively.

Service Assistant I Arnita Ridgeway likes to make a good impression Arnita Ridgeway works to keep

patients’ surroundings clean and

germ-free.

“It’s a very important job and I

love it,” says Ridgeway, a service

assistant I at Wilmington Hospital.

“I feel great when families come to

visit patients on the seventh fl oor and

remark how bright and clean it is.”

Attended soft skills training program

Ridgeway’s career path at

Christiana Care began seven years

ago with a soft skills training

program, presented by Anton

Associates and funded by the

Delaware Economic Development

Offi ce. Students learned the impor-

tance of self-discipline, punctuality

and taking responsibility.

“We learned things to get us ready

for the work world,” she says.

“Once I set my goals, doors started

opening for me.”

Ridgeway landed a part-time job

in Patient Transport and eventu-

ally took a full-time position in

Environmental Services.

Members of the Center for Advanced Joint Replacement

team recognized for highest ratings for leadership in

Safe Patient Handling and Mobilization include, from left,

Mary Ellen Hines, PT, Mercy A. Badu-Nkansah, RN, Nancy

Lampert, RN, BSN, SDS, Terry Foraker, RN, NM and Injury

Prevention Coordinator Beth D’Aurizio, PT. Missing from

the photo are Kenny Smith, PCT and Shirley Harris, PCT.

19777.indd 1819777.indd 18 2/25/09 10:56:15 AM2/25/09 10:56:15 AM

F e b r u a r y 2 6 , 2 0 0 9 F O C U S • 18

Jean Whidbee, operations manager of Environmental Services, says Ridgeway is a people person who has a gift for getting along with others.

Knows her job

“She has a good concept of the job and is a very pleasant person to work with,” Whidbee says. “In our business, that makes a big difference.”

Carvella Jackson, a Christiana Care recruiter, says Ridgeway is a testa-ment to both training and personal perseverance.

“Arnita is a role model, a complete success story,” she says.

Building her house

In recent months, Ridgeway also has been working with neighbors and volunteers from Habitat for Humanity, building a three-bedroom, one-bath townhouse in Wilmington’s Webster Village for herself and her 11-year-old daughter, Nyeema.

The program required that she attend home repair and personal finance classes and work for 225 hours to help build her own home, as well as townhouses for nine other families in the neighbor-hood. As the paint was drying, Ridgeway’s home-to-be was the site of a dedication ceremony attended by Gov. Jack Markell, U.S. Rep. Mike Castle and Councilwoman Stephanie Bolden.

Ridgeway says the culture of excel-lence at Christiana Care prepared her to take on the hard work of becoming a homeowner.

“My life took a big change for the better when I came to Christiana Care,” she says. “It truly is a won-derful place to work.”

service assistant I arnita

ridgeway (center), poses

with two colleagues she

has impressed, with

Christiana Care recruiter

Carvella Jackson (left) and

environmental services

operations Manager Jean

Whidbee.

CHrIsTIaNa Care’s CoMPlIaNCe HoTlINe

Christiana Care’s Compliance Hotline can be used to report a violation of any regulation, law or legal requirement as it relates to billing or documentation. The hotline will be answered 24 hours a day, seven days a week. All reports go directly to Compliance Officer Ronald B. Sherman. Callers may remain anonymous. The toll-free number is 877-REPORT-0 (877-737-6780). To learn more about corporate compliance, review the Corporate Compliance Policy online or contact Sherman at 302-428-4503.

External Affairs P.O. Box 1668 Wilmington, DE 19899

www.christianacare.org

PRSRT STD U.S. POSTAGEPaIDWILMINGTON, DEPERMIT NO. 357

P R i N T E D O N R E C y C L E D P A P E R

Dr. Gardner offers advice for staying healthy throughout life

Timothy J. Gardner, M.D., medical director of the Center for Heart and Vascular Health at Christiana Care and president of the American Heart Association (AHA), presented his popular community lecture “Staying Young at Heart at Every Age” on Tuesday, Feb. 10, to a full house at the John H. Ammon Medical Education Center. Visit www.christianacare.org for a chronicled list of Dr. Gardner’s statements and views throughout his term as national AHA president.

Timothy Gardner, M.D., (left) greeted enthusiastic audience members

who still had questions after the community lecture Feb. 10.