Staff from Christiana Care InformationTechnology designed Insight for easyuse in the waiting room. An immedi-ate report printed to the physician’swork station makes it easy to reviewall the indications and spend moretime with the patient on the more seri-ous symptoms.

“The next visit, the patient repeats thesymptom assessment and then thephysician can compare the reports toget a sense of whether interventionsare helping or not,” says Dr. Gillis.

Mitchell Saltzberg, M.D., medicaldirector of the Heart Failure Program,was co-leader along with Dr. Gillis of

Inside

Eliminating health caredisparity 3

General Surgery graduatingresidents share gender 4

Trauma program is a national model of teamwork 6

$1 million-gift for Wilmingtoncampus expansion 9

Swank Foundation gift will help build memory center 10

First Jefferson Award winner 16

Caring for yourselfSmoking relapse 17

F O C U SInformation Technology develops new program to improve patient care

Imagine an interactive computerprogram that gives you more accu-

rate assessments of symptoms than aperson-to-person interview, providingthe best insight into how your patientis feeling.

Insight, a new patient software pro-gram developed at Christiana Care,promises more accurate and detailedinformation from patients to healthcare providers.

Research has shown that patientssometimes don’t reveal symptomssuch as pain or depression to an inter-viewer. But when responding to 20questions on a laptop computer or PCtablet, these same patients seem toovercome the anxiety that may causethem to give inaccurate, vague infor-mation during a live interview.

What’s more, the information comesdirectly from the patient, not filteredthrough a doctor or a nurse, whichcan lead clinicians to downplay theimportance of a symptom to a patient.

Gets better feedback on pain severity“Insight elicits symptoms frompatients not only in a yes-or-no way,but also by letting them provide inputon severity,” says Theresa Gillis, med-ical director of OncologyRehabilitation Services and a specialistin oncology pain and symptom man-agement. “The patient might be askedabout his or her pain intensity orshortness of breath, or fatigue intensi-ty, in the past week on a scale from 0-10. So you gather not only the pres-ence of a symptom, but how severethat symptom is, and a sense of howimportant that is to the patient.

C O N T I N U E D , N E X T P A G E

Mitchell Saltzberg, M.D., medical directorof Christiana Care’s Heart Failure Programand Insight software clinical co-leader,shows a patient how to use the symptomself-assessment computer program .

the clinical part of the project.

“The name ‘Insight’ really reflectswhat we’re trying to do,” Dr. Saltzbergsays. “Patients often do not report allof their symptoms and concerns, and

ated theInsight pro-gram, saythe six-month proj-ect includedusabilitytests toensurepatients felt comfortable with thecomputer.

“We also had excellent support fromother IT colleagues behind the sceneswho helped configure the PC tablets,”Bledsoe says.

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we think this clinical tool will improvepatient-to-provider reporting so wecan more accurately address theirproblems. It creates a more meaning-ful, more focused dialogue. The abilityof the software to monitor trends insymptoms over time will provideanother measure of clinical progress.”

Few, if any, health care providersemploy such software for clinical use,according to Drs. Gillis and Saltzberg.The Oncology and Heart Failure pro-grams began using Insight in May,with the 20 questions tailored for thetwo types of patients.

Mike Bledsoe, Catherine Burch andJohn DiGiovanni, the IT team who cre-

From left, John DiGiovanni, CatherineBurch and Mike Bledsoe led the IT effortson the Insight software.

Theresa Gillis, M.D.

Virtual Education & Simulation Training Center officially opensVirtual Education & Simulation Training Center Medical Director Glen Tinkoff, M.D.,(center, with scissors) and Chief Academic Officer Brian Little, M.D., Ph.D., (center,holding ribbon), officially opened Christiana Care’s new state-of-the-art facility. Thetraining center offers a virtual environment where physicians,surgeons and otherhealth care professionals learn basic to advanced skills practicing on high-techmannequins that simulate the way humans react during a myriad of treatments.

ACLS training center called

‘a national model’

Christiana Care’s AdavancedCardiac Life Support (ACLS)

education program received a scoreof 100 percent in a recent reaccredita-tion evaluation by the AmericanHeart Association EmergencyCardiovascular Care Program onMay 18.

“The program is a model ACLStraining center,” says ACLS nationalfaculty reviewer, Claire Karis, RN,Ph.D. The ACLS training team,which includes Valerie Sloboda-Mague, coordinator, Chuck Fort,Nancy Blackburn, and Wilma Yu, hasrelocated to the recently openedVirtual Education & SimulationTraining Center, on the ground floorof the John H. Ammond MedicalEducation Building.

I N S I G H T, C O N T I N U E D

Social and Environmental Factors

n How do you get your medications? n Are they difficult to afford? n Do you have time to pick them up? n How quickly do you get them? n Do you have help getting them if

you need it?

Fears and Concerns

n Does this medication soundokay to you?

n Are you concerned with the dosage? n Have you heard anything about this

medication?n Are you worried about side effects?

Therapeutic Contracting (Treatment)

n Do you understand how totake the mediation?

n Can you tell me how you'll take it?

The ESFT model developed at theDisparities Solutions Center at

Massachusetts General Hospital can be aneffective tool for helping health careproviders understand and overcome barri-ers to quality health care.The model sug-gests questions health care providers canask culturally diverse patients to help theproviders learn what barriers prevent thepatient from understanding a diagnosis andadhering to a plan of care.

Explanatory Model - Health and Illness n What do you think caused

your problem?

n Why do you think it started? n How does it affect you? n What worries you most? n What kind of treatment do

you think you should receive?

The ESFT Model

skilled interpreters capable of trans-lating nuances; and the fact thatminorities receive care from lowestperformers.

In an ideal world, adhering to goodprinciples of patient-centered care

would lead to universally excellenthealth care. But the many differencesin culture, language and beliefs amongpatients, health care providers and sys-tems really create health care disparity.

Alexander R. Green, M.D., MPH, asso-ciate director of the DisparitiesSolutions Center at MassachusettsGeneral Hospital and assistant profes-sor at Harvard Medical School, visitedChristiana Care June 3 to conduct aphysician workshop and general pres-entation on cross-cultural competencyand ways of eliminating health caredisparities.

Not a black-and-white conceptDr. Green says cultural competency isnot a black-and-white concept, but it isdynamic, evolving over the years.Initially, cultural competency meanttreating every patient with respect anddignity, regardless of race, ethnicity,language spoken and other attributesthat might lead to discrimination.“But, even with your heart in the rightplace, you couldn’t eliminate all dis-parities,” he says.

Later, the definition became having aworking knowledge of important cus-toms, values and beliefs about healthcare. For example, when treatingMuslim patients for diabetes, it helpedto know the Islamic religious rulesrelated to fasting during Ramadan.“But it is tough to know everything,”Dr. Green observes.

Now, cross cultural competency is bestunderstood as having the necessaryskills to communicate well enoughwith any patient to understand cus-toms, beliefs and other barriers toquality health care.

Understanding is keyUnderstanding why health care dis-parities exist is key to overcoming

those barriers that lead to the dis-parities, Dr. Green says. The reasonscan be sorted into three groups,including patients, providers andsystems, with some reasons listed inmore than one group.

Patient factors include:Language and financial barriers, lowhealth care literacy, lack of trust inthe medical system, and differentbeliefs or preferences about treat-ment.

Provider factors include:Lack of awareness, ineffective meansof communication, difficulty build-ing trust, bias (both conscious andunconscious), and time limitations.

System factors include:Poor data collection that makes sys-tems unaware of disparities; qualityimprovement initiatives that fail tofocus on the needs of disparity pop-ulations; systems that often lack services to amend barriers, such as

Rosa M. Colon-Kolacko, Ph.D., vice presidentSystem Learning, introduces Alexander R.Green, M.D., MPH.

Cross-cultural learning helps eliminate health care disparities

“It was a real struggle for womenwhen I was chief resident, so I amespecially delighted to see an all-female group of surgeons,” says Dr.Dickson-Witmer, who will host a grad-uation party for the residents on June18. “These are wonderful, talented anddedicated, women.” The ranks of the residents include aphysical therapist, a soccer player anda member of a team that developed aweb-based system to improve residentsign-out. Two are mothers.

They are:

n Deanna Blanchard, M.D., who plansa career in general surgery. Dr.Blanchard is as focused on the soccerfield as she is in the operating room.“She is an extremely grounded indi-

This year’s graduating surgery resi-dents are all exceptional doctors,

and, for the first time at ChristianaCare, all are women.

“We were early in the curve in inte-grating women into the residency pro-gram,” says Frederick Giberson, M.D.,FACS, program director of the GeneralSurgery Residency Program. “Ibelieve we were unique in having thatall-female match in a large program.”

Diana Dickson-Witmer, M.D., was thefirst female surgical resident, servingas chief resident in 1982 at what wasthen the Medical Center of Delaware.Today, she is associate medical direc-tor of the Christiana Care BreastCenter at the Helen F. Graham CancerCenter.

vidual with great clinical skills, whorelates very well to patients,” Dr.Giberson says.

n Nicole Fox, M.D., who will work intrauma/critical care. “She is a leader, aborn organizer who is keenly aware ofsafety issues,” Dr. Giberson says. Dr.Fox, who also worked on the web-based sign-out system and other safe-ty initiatives, holds a master’s degreein public health.

n Kristie Halm, M.D., who will focuson general surgery. Before attendingmedical school, Dr. Halm worked as aphysical therapist. “Because of her lifeexperience, she brings a calmness andmaturity to her work,” Dr. Giberson says.

n Sherry Sixta, M.D., who will spe-cialize in trauma/critical care. “In aword, enthusiasm,” Dr. Giberson says.“She wants to experience it all and

take care of patients everywaking minute.”

n Kristine Widders, M.D.,who will pursue a fellowshipin breast surgery. “She andNicole Fox are both motherswho have proven that youcan pursue a very difficultprogram and still be a par-ent,” Dr. Giberson notes.

Currently, 50 percent of med-ical school graduates arewomen, according to theAssociation of AmericanMedical Colleges. AtChristiana Care, 48 percent ofsurgery residents are female,Dr. Giberson says.

“The faculty and this institu-tion are supportive ofwomen,” he says. “I am also

proud of this group. They haveworked hard and proved themselves.”

The 2010 graduating class of General Surgery residents, from left, include KristineWidders, M.D., Deanna Blanchard, M.D., Kristie Halm, M.D., Nicole Fox, M.D., andSherry Sixta, M.D.

General Surgery Residency Program graduates all-female class

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Dr. Dickson-Witmer chaired the CoCAccreditation Committee for threeyears before becoming co-chair of theStandards Revision Task Force.

“Diana has been instrumental in revis-ing the criteria by which theCommission on Cancer accreditedprograms are evaluated,” says StephenEdge, M.D., CoC chair. Two years inthe making, the new standards aremore relevant with an emphasis onsimplicity and quality measurement.

“As a physician, it has been a veryrewarding effort because these stan-dards will reach many more patientsthan I could ever see in my office inmy lifetime,” Dr. Dickson-Witmersays.

A final review of the standards takesplace this summer. The standards willbe introduced in 2011 and go intoeffect on Jan. 1, 2012.

Diana Dickson-Witmer, M.D.,associate medical director of the

Christiana Care Breast Center at theHelen F. Graham Cancer Center, isvice chair of a task force charged withhelping to establish the Commissionon Cancer’s (CoC) new standards forcancer centers around the country.Commission member organizationsinclude the American College ofSurgeons, the American CancerSociety and the American Society ofclinical Oncology.

Improving survival rates and qualityThe task force is responsible for revis-ing all 36 standards set by the CoC, aconsortium of 50 organizations dedi-

cated to improving survival rates andquality of care for people with cancer.

Existing CoC standards cover organi-zation of a cancer center, cancer con-ferences and quality review of cancercare, with an emphasis on multidisci-plinary treatment and use of evidence-based guidelines. New standards willaddress the continuum of care—fromprevention programs to palliative careand survivorship—at 1,500 participat-ing cancer centers in the U.S.

“There are some 13 million cancer sur-vivors in America today. We need toaddress the needs of that group, aswell as the needs of those newly diag-nosed,” Dr. Dickson-Witmer says.“There is always a flurry of activityduring active treatment, but when thetreatment is finished, many patientsfeel a little lost, alone and frightened.”

A plan in plain languageUnder the new standards, each patientwill receive a Survivor TreatmentSummary and Care Plan, which showsthem, in language they understand,what cancer they have or had and atwhat stage, as well as details on thespecific treatment they have under-gone. The information also willinclude a plan of follow-up that iscoordinated among multidisciplinarymembers of the treatment team.

The work of revising the standardsinvolves medical oncologists, radiolo-gists, radiation oncologists, surgeonsand a full multidisciplinary team,including genetic counselors, psychol-ogists, social workers and researchers.

“The plan should spell out exactlywho they should expect to see, howoften and for how many years,” Dr.Dickson-Witmer says. “It should out-line any long-term effects of treatmentfor which they are at risk.”

Dr. Dickson-Witmer leads Commission on Cancer task force

Diana Dickson-Witmer, M.D.GET HELP WITH TOBACCO

CESSATION

three years. Christiana Hospital mostrecently qualified in December 2009.Soon afterward, Delaware redesignat-ed Christiana Hospital as Level I.

Rising volume, aging populationThe Trauma Program experienced twomajor changes since the last ACS visitin November 2006:

n The volume of trauma cases hasexpanded dramatically, from 2,700 in2006 to more than 3,600 last year. Thenature of the injuries has shifted, aswell, with falls now exceeding motorvehicle crashes as the leading cause ofinjury treated per year. “Our patientpopulation is aging rapidly and thatplays a major role in why falls nowexceed motor vehicle accidents as themajor reason for admission,” saysTrauma Program Manager JoanPirrung, RN, APRN-BC, MSN.

n The team of Advanced PracticeNurses (APNs) on the Trauma teamgrew from six to eight. “The APNs arethe frontline care providers for ourtrauma floor and intermediate careunit patients and also assist in coordi-nating discharge planning to home orrehab,” says Pirrung.

Other key members include the trau-ma educator, the registry staff, a per-formance improvement coordinatorand an injury prevention coordinator.

Christiana Care has a large catchmentarea, receiving patients from lowerlevel trauma centers in Delaware aswell as patients from Maryland, SouthJersey and Chester County, Pa.

These many services provide a deepwell of resources for trauma patients,who at any time might require addi-tional consultations.

Did you know that Christiana Careis a national model for collabora-

tion between the Trauma Program andthe Emergency Department in the ini-tial care and resuscitation of the trau-ma patient?

When trauma patients arrive atChristiana Hospital, the trauma teambegins working with providers in theEmergency Department the momentthe patient comes through the door.

“From the nurses to the physicians tothe administration, everything we dohere is a team effort,” says MarkCipolle, M.D., Ph.D., FACS, FCCM,medical director of the TraumaProgram since 2008.

Even after a trauma patient is stabilizedand admitted beyond the ED, theTrauma Service remains engaged, car-ing for patients until they go home orbegin rehabilitation.

Trauma Program is a national model for teamwork

Leading cause of death up to age 44Trauma is the leading cause of deathfor people age 1-44, greater than can-cer, heart disease and other illnesses.

As the only Level I trauma centerbetween Philadelphia and Baltimore,Christiana Care saves lives every dayby providing the highest quality ofcare for adult and pediatric patients.

Trauma surgeons and teams provide24-hour, in-house coverage. Sub-spe-cialists such as orthopedic surgeonsand neurosurgeons are on call 24/7.Complementing the around-the-clockcare providers are experts in addic-tions counseling, physical, occupation-al and speech therapy, pastoral care,care management and social work,plus an orthopedic trauma physicianassistant.

Becoming and remaining a Level Itrauma center is part of a rigorous

process involv-ing theAmericanCollege ofSurgeons’(ACS)Committee onTrauma and theState ofDelaware. TheACS committeereverifies thatChristiana Careprovides all thenecessary serv-ices of a Level Icenter every

Each year, Christiana Care hosts an awards event to show appreciation to thosewho contribute to team spirit of the Trauma Program. From left, Brian Pellini,M.D., Kim Schulenberg, Speech Therapy, Ethan Ross, M.D., Kathy Gallagher,RN, Neil Jansani, M.D., Jane Sutton, RN, Steve Johnson, M.D., Tammy Miller,RN, Mark Cipolle, M.D.,Josie Robinson, RN, and Darrin Ensinger, RN. Notshown: OR Surgical Tech Patty Robbins.

6 ● F O C U S J u n e 1 8 , 2 0 1 0

Christiana Care also partners with theOffice of Highway Safety to talk toparents and teens about staying safeon the roads, and with the U.S.Attorney’s Office to reach at-riskyouths in programs designed toreduce violent behavior.

Fall injuries prevention programTo prevent falls, a water exercise pro-gram helps elderly women buildstrength and increase flexibility.Christiana Care also holds educationalseminars for about 100 seniors eachyear on minimizing the risk of falls bymaintaining clear, well-lighted hall-ways, wearing sturdy, properly fittingshoes and other fall prevention ideas.

Trauma Program Medical DirectorMark Cipolle, M.D., Ph.D., FACS,FCCM, says deaths from traumaticinjuries typically occur at three differ-ent times:

n Immediately after the injury.

n Within hours after the injury.

n As a result of major organ failurewhile in the intensive care unit.

“There is only one way to address thefirst group—and that is prevention,”Dr. Cipolle says.

Injury-prevention outreach is a key Level I component

The most effective remedy to trau-matic injuries is to prevent them

from ever happening, says VirginiaCorrigan, RN, MSN, injury preventioncoordinator.

It’s a message Christiana Care takes toschools, community centers and seniorcenters statewide. “It takes a commu-nity’s effort and involvement for pre-vention efforts to be effective,”Corrigan says.

As a Level I trauma center,Christiana Care is required tooffer outreach and preventiveprograms designed to educatepeople to avoid actions thatlead to the traumatic injuriesseen most frequently atChristiana Care hospitals.

Reaches thousands of childrenThe Think First InjuryPrevention Program reachesmore than 10,000 children andyoung people with the messagethat injury is preventable if youthink first protect your body beforeengaging in risky behaviors, such asdiving into shallow water, driving

To raise money and enhance awareness of injury prevention, the Trauma Servicesponsors a Think First 5-K race each spring, In addition to supportive runners andChristiana Care employees, the race draws former trauma patients who compete bywheelchair and on foot.

without a seatbelt or riding withsomeone who has been drinking.

“One second, one bad decision, canchange a life forever,” says Corrigan,the director of Think First Delaware, achapter of the National InjuryPrevention Foundation.

More than 200 presentationsThis year there have been more than200 Think First presentations at whichVoices for Injury Prevention Speakers,or VIPS, talk about the devastatinginjuries that changed their lives.

To gauge the effectiveness of the pro-gram, students are tested for attitudesand beliefs about the lasting conse-quences of spinal cord injuries beforethe presentations and again a monthlater.

“We’ve found that 55 percent of stu-dents change their beliefs regardingthe permanency of brain and spinalcord injury and the importance ofsafety behaviors, such as helmet andseat belt use,” Corrigan says. “Theprogram also helps our VIPS withtheir recovery, allowing them to dis-cuss factors surrounding their injuriesand how it affects their lives.”

Virginia Corrigan, RN, MSN

Nationally noted maxillofacial surgeon Eric J.Dierks, M.D., D.M.D., FACS, delivered the

annual George A. Zurkow Lecture May 19 at theAmmon Medical Education Building.

Dr. Dierks completed residency training in oral-maxillofacial surgery at Christiana Care in 1977and is known for founding the first Fellowshipin Head & Neck Oncologic Surgery in the U.S.that was available to graduates of oral and max-illofacial surgery residency. His Grand Roundswas titled “The Evolution of Maxillo-MandibularReconstruction: From Creative Beard Trimmingto Computer-Guided Free Flaps.”

After 50 years, Lillian Barnett still enjoys going the extra mile

In November 1959, Richard Nixonand John F. Kennedy were vying for

the U.S. presidency. Bobby Darin’s“Mack the Knife” topped Billboard’sHot 100 list. And 18-year-old LillianBarnett began work as a nurse’s aideat Wilmington General Hospital.

Today, Barnett is still hard at work atChristiana Care Health System, as an

administrative services coordina-tor at Christiana Hospital, whereshe supervises forms clerks forthe Nursing Department.

Loves the teamwork“I greatly enjoy interacting withthe vendors, the physicians andthe nursing staff,” she says.“Every day, I feel as if I’vehelped someone.”

Barnett is known for her upbeatpersonality, dedication to doinggreat work and willingness to gothe extra mile.

“She is an amazing individualwho consistently displays a posi-tive attitude towards her job and

the people with whom she works,”says Ruth Morse, RN, MSN, CEN,NE-BC, director, Nursing Resources.“She is committed to the success notonly of her department but the entireorganization.”

In March, Barnett was honored at acelebration in her department. Inkeeping with her wishes, it was aquiet but joyous event.

Lillian Barnett

Starts daily at 5 a.m.Then it was back to work as usual.Barnett is at her desk each day at 5a.m. sharp, ready to take on what-ever responsibilities the daybrings.

“She is truly a go-to person,”Morse says. “If there is anythingthat needs to be accomplished,from hanging a picture to orderingsupplies, Lil knows how to get thejob done.”

Both Barnett and her husbandDouglas have a long history ofdedication to the health care sys-tem. Last year, Douglas Barnett, aservice assistant in the operatingroom, retired after 49 years. Nextyear, the Barnetts will mark acombined century of service toChristiana Care.

“I have no plans to retire, as longas my health is fine and my hus-band is well,” Barnett says. “After50 years, I can say Christiana Careis a great place to work.”

Noted oral-maxillofacial surgeon returns to clinical roots

From left, Joel Reynolds, D.M.D., Samuel Nwogu, D.M.D., Greg Burns, D.M.D.,Edwin L. Granite, D.M.D. (Department chair), Dr. Dierks (seated), LawrenceGiordano (Associate Program Director), and William Klein, D.M.D.

sion will upgrade and double the sizeof the Emergency Department, add anew surgical suite, including 13 oper-ating rooms and four procedurerooms, and add capacity for 120 pri-vate patient rooms. The transforma-tion will also include:

n A new intensive-care unit.n An upgraded, 30-bed unit for theCenter for Advanced Joint Replacement.n A nine-story tower.n A 51,000-square-foot, state-of-the-artmedical office building.n A new main lobby entry reposi-tioned on Jefferson Street.n An enclosed walkway to parking.n A tranquil atrium.n The Junior Board of Christiana Carehealing garden.

AstraZeneca presented a $1 millioncornerstone gift for the transfor-

mation of Wilmington Hospital May21.

AstraZeneca President Rich Fante,speaking to about 100 people gatheredatop the employee parking garageoverlooking the construction, said“AstraZeneca is strongly committed toworking with partners whose missionand interests align with our commit-ment to strengthening and improvingthe health of patients. WilmingtonHospital is an outstanding facility andcritical health resource in our commu-nity. AstraZeneca takes pride in help-ing it grow.”

Christiana Care Health SystemPresident and CEO Bob Laskowski,M.D., joined by U.S. Sen. Tom Carper,Gov. Jack Markell, U.S. Rep. MikeCastle and others at the announce-ment ceremony, accepted the gift.

“For more than a century, ChristianaCare and our Wilmington facility havebuilt a tradition of caring for ourneighbors when they are ill and help-ing them maintain their health whenthey are well,” Dr. Laskowski said.“With this gift Wilmington is set tobecome a modern, leading-edge hospi-tal offering a full range of best-in-carepreventive and wellness services.

“Together we can ensure Delawareansreceive the highest level of care andcomfort across the broad spectrum ofdiverse medical needs for decades tocome.”

The new, three-story atrium in the cen-ter of the campus will be named inhonor of AstraZeneca.

Gov. Markell said “This gift and the

$1 million gift boosts Wilmington campus expansion

expansion of the hospital will bringjobs to the city while building on thehard work that's already being done atthe hospital for its patients. It repre-sents an investment in the city and inthe health and welfare of its citizens."

The $210 million investment in therenovation of Wilmington campuscontinues our mission of building ahealthy community for Wilmingtonand the surrounding region. The sec-ond-largest project in Christiana CareHealth System’s history, it createsmore than 2,000 construction jobs andwill transform the hospital campus’capacity, adding 337,000 square feetand creating a one million-square-foot,state-of-the-art medical center.

When completed in 2012, the expan-

AstraZeneca President Rich Fante presented a check for $1 million to Christiana Careto help fund the transformation of Wilmington Campus. Robert J. Laskowski, M.D.,Christiana Care President and CEO (right), accepted the gift on behalf of the healthsystem. At left is Delaware Gov. Jack Markell.

T R A N S F O R M A T I O N

a nurse and a social worker withextensive knowledge of communityand regional resources.

gram coordinators.

“As President of ARCS I will workdiligently at being an effective leader,”DelCoglin says. “My peers on thecommittee are wonderful people andalso share in the commitment of edu-cating our members. Over the next 12months we will work hard at planninga successful and educational springmeeting in Boston, which will incorpo-rate discussions of the most importantissues facing surgical residency educa-tion and coordinators.

I would like to thank Department ofSurgery Chair Michael Rhodes, M.D.,Surgical Residency Program DirectorFrederick Giberson, M.D., andChristiana Care Health System, foraffording me the opportunity and pro-viding the support necessary to carryout my commitment as president.

Acornerstone gift from the HowardW. Swank, Alma K. Swank and

Richard Kemper Swank Foundationhas created the Swank Memory CareCenter at Christiana Care, a collabora-tive effort of the Departments ofMedicine, Family Medicine andPsychiatry. The center will providepatients and caregivers with a "onestop" location for care with priorityservice when referrals are necessary.

Every 71 seconds, someone in Americadevelops Alzheimer's disease. Anyonewho has witnessed the effects ofAlzheimer's and other forms ofdementia knows how overwhelmingthe condition can be.

Presently in Delaware, the integrationof health care services, caregiver sup-port, and education to treat memoryloss is not available in one location.Delaware residents often face accessbarriers to receiving dedicated, multi-disciplinary memory care.

To be located in an outpatient clinicalcare setting, the Swank Memory CareCenter will have a single focus onpatients with all types of memory loss.The interdisciplinary team of profes-

1 0 ● F O C U S J u n e 1 8 , 2 0 1 0

General Surgery ResidencyProgram Coordinator Sandy

DelCoglin has been selected presidentof the National Association ofResidency Coordinators for Surgery.DelCoglin holds special certificationfor graduate medical education pro-

Sandy DelCoglin

sionals will include neurologists, psy-chiatrists, geriatricians, internists andfamily medicine physicians, as well as

The Swank Memory Care Centerat Christiana Care has become areality thanks to a recent corner-stone gift from the Howard W.Swank, Alma K. Swank andRichard Kemper SwankFoundation. Announcing the giftare, from left, Donald J.Franceschini, Trustee, SwankFoundation; Nancy N. Gale,Trustee, Swank Foundation;Robert J. Laskowski, M.D.,President and CEO, ChristianaCare; Denise D. Schwartz,Trustee, Swank Foundation;Edward M. Goldenberg, M.D.,President, Swank Foundation;Patricia M. Curtin, M.D., Chief ofGeriatric Medicine, ChristianaCare; and Stephen T. Bruni,Trustee, Swank Foundation. Gift will transform Alzheimer’s patient care

T R A N S F O R M A T I O N

Timothy J. Gardner, medical direc-tor of Christiana Care's Center for

Heart & Vascular Health, was appoint-ed to the AstraZeneca Foundation'sBoard of Trustees.

Dr. Gardner, a graduate ofGeorgetown University MedicalSchool, received his postgraduatetraining in surgery at Johns Hopkins.

Department’s first annual retirementsalute, held at Grand Rounds, June 3,2010, honored Philip Blatt, M.D., (28years of service), Paul Pennock, M.D.,(40 years of service) and Siamak Samii,M.D., (35 years of service).

Physicians devoted 103 years to keeping neighbors heathy

Celebrating more than a century ofcombined service to Christiana

Care and the people of our communi-ty, the Department of Medicine gavespecial recognition to three physicianswho retired during the past year. The

From left, Virginia U. Collier, M.D., HughR. Sharp Jr. Chair of Medicine, PhilipBlatt, M.D., Paul Pennock, M.D., SiamakSamii, M.D., and Vice Chair of MedicineRobert Dressler, M.D.

Timothy Gardner, M.D.

Timothy Gardner, M.D., appointed to Astrazeneca Foundation Board of Trustees

He is a member of the American HeartAssociation's Science Advisory andCoordinating Committee and NationalBoard of Directors. He is the immedi-ate past president of the AmericanHeart Association and has also servedas the association's chief volunteer sci-ence and medical officer.

Christiana Care Health System’sMother-Baby Class celebrated 10

years in May.

The Class began as a program helpinghealth-care professionals assess forpostpartum depression, encouragebreastfeeding and ease the transitionto parenting, says Maternal ChildEducator Mindy Neff.

Today, it has evolved from one courseto three, fostering friendships amongmoms that have deepened andendured year after year.

Relationships can last years“The was a godsend for me,” saysMonica Glick, who attended thereunion celebration with her threechildren, ages 4, 2-½ and 3 months. “Iwas a first-time mom when I enrolledin the class. My son cried a lot and itwas hard to get any sleep. It was sohelpful to see that others were goingthrough the same thing.” Four yearslater several of the moms in Glick’sclass still get together every Monday.

Program helps navigate changesMother-Baby 1, for moms of new-borns, works primarily as a supportgroup for the mothers. “It helps us toreinforce that the postpartum period isa time of adjustment when the parentsare changing from a couple to a familyand the mom might be undergoingcareer changes,” says Sheila Hobson,Parent Education manager.

Mother-Baby 2, for moms of 3- to 6-month-olds, and Mother-Baby 3, formoms of 6- to 9-month-olds, focusmore on child development.

The reunion brought together moms,

kids and educators fromseveral different classes. It alsoserved to introduce the program to aprenatal group from Bayard House, aCatholic Charities program forhomeless pregnant teens. “Theseyoung women can see thatChristiana Care is a home-like placethat offers them support,” saysKaren Bastianelli, maternal childeducator.

New moms find support, encouragement in Mother-Baby program

Maternal child educators Mindy Neff(top right in salmon sweater) andKaren Bastianelli (left,in floral shirt),hosted a reunion, inviting moms andchildren who have participated inChristiana Care Mother-Baby classes.

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Focus on Excellence – Advance Directive - Best Practice Review

Consistent with our strategies for engaging staff in continuous improvement and best practices, we regularly review impor-tant topics in Focus to help reinforce safe-practice behaviors. These tips reinforce information and enable staff to betterarticulate our safety practices during an unannounced survey.

Advance DirectiveQ. What is an Advance Directive?

A. An Advance Directive is a legal document allowing an adult person 18 years of age and older to give direction aboutfuture care and to designate another person(s) to make medical decisions if the individual loses decision making capacity.

Q. What are the nurse’s responsibilities related to advance directives for inpatients?

A. The Nurse is responsible to:

n Complete the anatomical gift status advance directive form for each patient 18 years of age or older.

n Provide a copy of the “What is an advance directive?” flyer, even if the patient has an advance directive.

n Ask the patient to bring the most recent copy of their advance directive to the hospital if applicable.

n Provide additional information and resources upon request.

Q. What additional resources are available Regarding Advance Directives?

A. Patients seeking more information can be offered the following:

n “Planning Your Health Care Choices – Advance Directives” brochure

n “Advance Directives - Partners in Care” video located on Wilmington Hospital patient TV channel, and on theGetWell Network at Christiana Hospital.

n Assistance from the Patient Relations Department, Pastoral Services, Department of Social Service, EthicsCommittee, The Delaware Division of Social Services for Aging and Adults with Physical Disabilities, the Pain and PalliativeCare Consult Service and / or the patient’s physician.

To ask questions, contact the content experts: Barbara Bramble 733-1131 or Donna Casey 428-2707. To reach the SafetyHotline, call SAFE (7233) from within Christiana or Wilmington hospitals. From outside the hospitals, call 302-623-SAFE.Further information is available on the portals in the Archives of Best Practices. From your portal, choose Focus onExcellence, Joint Commission Readiness, Ongoing Strategies, Educational Strategies, Monthly Q&A.

FORMULARY ADDITION Medication – Generic/Brand Name Strength/Size Use/Indication C1 esterase inhibitor, human / Berinert 500 units per vial Treatment of acute attacks of hereditary angioedema REVISED CCHS MEDICATION POLICY Policy on ordering acetate content of and volume of TPN admixtures

Prescribers must specify the actual amount of acetate (in milliequivalents) to be added to a total parenteral nutrition (TPN) admixture and the total volume of the admixture (in milliliters) when ordering TPN. It is unacceptable to order ‘maximum concentration’, ‘minimum volume,’ or ‘max’ within any order detail field. There is a link to the CPOE TPN care set instructions on the physician CCHS intranet portal. The instructions include a description of how the amount of acetate and the total volume are calculated.

FORMULARY DELETIONS Dextrose 10% injection, 5-mL ampuls Removed from formulary because it is no longer manufactured Codeine phosphate injection Removed from formulary because it is no longer manufactured Ethiodized oil 37% injection Removed from formulary because it is no longer manufactured Tretinoin 0.05% solution Removed from formulary because it is no longer manufactured. The cream and gel are

still available.

Formulary update

n An 80 percent reduction in airemissions from the power plants.

n A 15 percent hike in recycling.

What’s more, Christiana Care nowbuys 40 percent of its electricityfrom a wind farm in Pennsylvania.

In addition, the EnvironmentalStewardship Committee, in coopera-tion with the Delawares NursesAssociation, hosted two medicinecabinet clean-out events for thecommunity within the past year.

Christiana and Wilmington hospi-tals both received the Partners

for Change with Distinction award inrecognition of Christiana Care’s com-prehensive environmental steward-ship program and leadership role inboth the community and health caresector.

Since the inception of program,Christiana Care has achieved:

n A 50 percent reduction in regulat-ed medical waste.

Standing, from left, Jason Funyak, Bob Mulrooney, Jill Karpinski and Sandra Reddy.Kneeling, from left, Marcus Suhr and Jeff Krebs

Christiana Care honored for environmental stewardship

Judy Townsley, MSN, RN, CPAN,has been appointed vice president

of Clinical Operations andPerioperative Services.

Promoted from director of ClinicalOperations for Perioperative Services,Townsley began her career atChristiana Care in 1977. She previouslyserved as a nurse manager in PACUat Christiana Hospital. She currentlyserves on the Advisory Board for ORManagers.

She received her BSN and MSNdegrees, with a focus on health pro-motion and wellness, from WesleyCollege.

Townsley has presented at a numberof national forums and is a leadershipsponsor for the implementation ofteam training in PerioperativeServices. Under her leadership,Perioperative Services has improvedteamwork coordination, quality andeffectiveness. Her new title recognizesher great leadership and the vitalimportance of her role in PerioperativeServices.

Townsley appointedvice president

Judy Townsley, MSN, RN, CPAN

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Publishing, Presenting, Appointments, Awards

family and raises funds for suppliesfor our men and women in the mili-tary.She also persuaded the CranstonHeights Fire Company to donate aused vehicle to a local family in need.

Sokira says she “was humbled” byreceiving the award. “I feel as if Idon’t do anything more than anyoneelse does for his or her community.”

Eligible to win national awardThe Jefferson Awards is a national pro-gram started in 1972 by JacquelineKennedy Onassis, U.S. Sen. RobertTaft Jr. and Sam Beard as a call-to-action for volunteers in local commu-nities. Monthly winners are eligible fornational consideration by the JeffersonAwards for Public Service.

in the family benefit, too, physically,emotionally and spiritually.”

The mother of two daughters, Dr.Whitney is a well-known publicspeaker and an advocate for empow-ering girls and women.

In addition to her work in the commu-nity in Delaware, she has volunteeredfor missions abroad, caring for peoplein Africa and the Caribbean. Sherecently returned from Haiti, whereshe worked with survivors of a devas-tating earthquake, many of whomhave lacked medical treatment sincethe quake struck in January.

Dr. Whitney is a graduate of HowardUniversity School of Medicine inWashington, D.C., and completed herresidency at the Medical Center ofDelaware, now Christiana Care.

To underscore our support of com-munity service, Christiana Care

has launched the Jefferson Awardsprogram. Each month the programspotlights an outstanding employeeor volunteer for providing exemplarycommunity services during off-dutytime.

Fundraiser, firefighter, EMTSue Sokira, a Transfer CenterRepresentative in the EmergentTransport Access Center at ChristianaCare, is the first to win the JeffersonAward bronze medallion. Sokira, avolunteer firefighter and EMT, addi-tionally raises money each year forthe March of Dimes and for several5Ks, including the “Tunnel toTowers,” a run in memory of a NewYork City firefighter.

During the holidays, she adopts a

Estelle Whitney, M.D., joins Christiana Care Health System

Sue Sokira

Sue Sokira is first to win Jefferson Award at Christiana Care

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Estelle Whitney, M.D., long anadvocate for women’s health edu-

cation, has joined Christiana Care, aCenter for Excellence in Women’sHealth.

Her practice at the Medical ArtsPavilion 2 on Ogletown-Stanton Roadin Newark focuses on gynecology,including peri-menopause,menopause and hormone replacementtherapy. She is board certified inobstetrics and gynecology and holisticmedicine, and brings a holistic per-spective to her practice.

“We talk about herbal medicine,lifestyle practices, visualization andother ways we can help patients tolead healthier lives,” she says. “Weknow that when women are moreaware of their health the other people

Estelle Whitney, M.D.

your new life as a non-smoker. ThinkNOPE: Not One Puff Ever.

But you don’t have to count onwillpower alone. Through ChristianaCare, employees can receive free med-ications that will combat the cravingsassociated with quitting and signifi-cantly increase their odds of success.Face-to-face counseling also is avail-able without charge.

To learn more, contact EmployeeHealth at 302-428-2285. Delaware alsooffers a toll-free Quitline. The numberis 866-409-1858.

You were fired up to quit smoking,stoked by the entreaties of people

who love you and the knowledge thatcigarettes can cause cancer.

And then you started again.

Perhaps you found a few cigarettestucked away in a pack you left in anold jacket pocket. Maybe you asked afriend for a smoke. Or you might haveimpulsively bought a pack, tellingyourself that it’s only one pack, not acarton.

Quitting is difficultYou might feel bad about backsliding,but the truth is that it is extremely dif-ficult to quit smoking. Most peoplerelapse. The statistics vary from studyto study, from six attempts to eighttries to as many as 10 relapses beforegiving up tobacco for good.

Relapses frequently occur in the firstfew weeks after giving up the habit,before the new habit of not smokingbecomes engrained. In fact, many peo-ple start smoking again within 24hours of vowing to stop smoking.

That doesn’t mean they are weak. Thatdoesn’t mean they are bad people.

It is simply a reflection on the deeplyaddictive characteristics of nicotine, aswell as the profound psychologicalbond that forms between smokers andtheir habit.

Most important, one relapse—or twoor three relapses—doesn’t mean youwon’t succeed eventually. It justmeans you haven’t gotten there yet.

Here’s the good news. People who gotwo years without smoking have abetter than 80 percent chance ofremaining smoke free for the rest oftheir lives, according to a study pub-lished in Nicotine & Tobacco Research.After 10 years of abstaining, the

relapse rate is about 1 percent eachyear.

So, don’t hesitate to try, try again. Thebenefits of quitting are worth it. Aftera year without tobacco, a formersmoker will have half the risk of heartattack as a non-smoker. Former smok-ers will notice other positive effects intheir daily lives.

You can look forward to a spring inyour step—and a jingle in your pock-et, as in the money you will save bynot buying cigarettes.

Start by programming your brain for

After a smoking relapse, try, try again

Statistics vary from study to study, but people who quit smoking can expect to tryfrom six to eight times and have as many as 10 relapses before giving up tobaccofor good.

U.S. Sen. Tom Carper of Delaware visitedChristiana Care June 2 to talk about the

passage of the Patient Protection andAffordable Care Act of 2010.

More than 200 attended the CombinedCardiology and Perioperative GrandRounds at the John H. Ammon MedicalEducation Building to hear Sen. Carper’sviews on the new law.

Sen. Carper addresses combined Cardiology and Perioperative and Grand Rounds

The Boy Scouts of America,Delmarva Council, honored

Christiana Care President and CEORobert J. Laskowski, M.D., as Citizenof the Year at the scouts’ 6th Annualaward dinner June 1 at the Hotel duPont in Wilmington.

In recognizing Dr. Laskowski, theCouncil cited his service as chair of theDelaware Public Policy Institute Boardof Trustees, membership on the boardof directors and executive committeeof Wilmington Renaissance Corp.,membership in the First StateInnovation board, the University ofDelaware Lerner College of Businessand Economics college advisoryboard, and many other roles he playsas a citizen of Delaware and commu-nity and business leader.

Robert J. Laskowski, M.D., named citizen of the year

A member of Boy Scout Troop 50fixes a clasp on a scout uniform neck-erchief to be worn by Dr. Laskowskiduring the June 1 Citizen of the YearAward Dinner.

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More than 300 friends ofthe Helen F. GrahamCancer Center raised

$177,000 in support of theCenter for Translational

Cancer Research and theCancer Special Needs Fund

at the 7th annual Eveningin Monte Carlo on Friday,

May 14.

Co-chairs and honorary co-chairsjoined Nicholas J. Petrelli, M.D.,Bank of America endowed medicaldirector of the Helen F. GrahamCancer Center, to celebrate justbefore the doors opened at theHotel du Pont Gold Ballroom.

Monte Carlo Lucky 7 Night nets $177,000for Cancer Research and Special Needs Fund

Acapacity audience attendeda special eveningwith a

panel of Christiana Care heartand vascular specialists May 25at the John H. Ammon MedicalEducation Center. Timothy Gardner, M.D., medicaldirector of the Center for Heart& Vascular Health, moderatedthe panel including

Audience fills Ammon Center auditorium for heart health event

From left, Timothy Gardner, M.D., Mark Garcia, MD., Brian Sarter, M.D., and EdwardGoldenberg, M.D.