April Message from Steven L. Strongwater, MD, CEO
The information below is an employee update of activities at Stony Brook University Medical Center prepared by Stony Brook University Hospital CEO, Steven L. Strongwater, MD. Dr. Strongwater distributes a monthly update which is sent to all hospital faculty and staff to communicate initiatives and activities undertaken at the Medical Center to reach goals in the areas of patient satisfaction, patient safety, and community connections.
April 2009
It may be hard to believe, but one of the most risk-prone processes in healthcare is how we pass on information—yes, how we communicate with one another. In February, after more than five years of preparation, we went live with a fully integrated electronic medical record with computerized physician order entry (CPOE).
Stony Brook University Medical Center (SBUMC) is the first hospital on Long Island to have an integrated electronic medical record with such a high degree of technological sophistication. Using CPOE, orders are now communicated electronically, immediately, in legible formats, which are screened automatically for potential patient problems (i.e., allergies, medication safety, kidney function); standardized order sets help ensure consistent levels of care (i.e., checklists); medication administration is standardized with dose verification at the point of administration, along with many other safety checks for nursing and other staff. President Obama has made this part of a set of funded national priorities. It is what the rest of the nation is struggling to achieve. Indeed, it is a tremendous step forward for our patient safety program and toward enhanced effective and efficient communication, but it is not enough. Because, as good as our electronic records are, they are only one part of the safety process. What else must we do? We must focus on communication systems.
During an average medical or surgical admission, 60 hospital workers—doctors, physicians in training, nurses, staff—interact with a patient. With each interaction, there is a compounding risk of miscommunication. There are ways to minimize these risks, but they have not been broadly embraced or adopted in healthcare. SBUMC is about to try to change that using the latest developments in patient safety. You see, just as there have been medical discoveries (e.g., new drugs to treat cancer), there have been comparable discoveries in ways to improve patient safety.
In February, Rhea Seddon, MD, from Vanderbilt University, and the coauthor of Crew Resource Management: The Flightplan for Lasting Change in Patient Safety, visited SBUMC to kick off our communications program. She is one of the first women trained at NASA to become an astronaut. Dr. Seddon trained as a surgeon and continues to practice as an emergency medicine physician. Her clinical background and experience as a surgeon enabled her to take what she learned about communications and safety while serving three missions and more than 700 hours in space, and translate it to the hospital operating room.
The aviation industry has long used crew resource management (CRM) techniques to train teams. Anyone watching a NASA space shuttle launch can mimic the process. Fuel pressure normal? Roger. Ignition ready? Roger. Thrusters ready? Roger, thrusters ready. NASA learned the importance of clear ongoing communications in very public settings. In healthcare we can do a much better job using aeronautical aviation as a model for CRM. Each one of our patients is every bit as important to us as a space launch is to NASA. The strategy requires the use of safety tools, such as checklists and highly structured language (i.e., read-back verification, routine process checking) to minimize errors and trap them before they cause a serious or fatal mistake.
While at SBUMC, Dr. Seddon shared her expertise with the Intensive Care Unit Clinical Service Group, Clinical Chairs, and representatives from the Emergency Department, Surgical Services, Intensive Care Units, and OB/GYN. She also provided an Administrative Grand Rounds for Department Heads and Nurse Managers. We plan to launch broad-based CRM training to enhance communication in selected units and to eventually implement CRM techniques for high-risk processes everywhere.
The combination of the electronic medical record and CRM techniques will enable us to continue building a solid foundation for SBUMC on its way to becoming a high reliability organization. Please join us on our journey toward high reliability and toward improving patient outcomes.
STONY BROOK PRIDE
SBUMC’s Cancer Services Program receives prestigious award. The Cancer Services Program received the 2008 American College of Surgeons Commission on Cancer (CoC) Outstanding Achievement Award (OAA). This award is designed to recognize cancer programs that strive for excellence in providing quality care to patients with cancer. A commendation level of compliance was obtained in the seven standards that represent the full scope of the cancer program—cancer committee leadership, cancer data management, clinical services, research, community outreach, education, and quality improvement. Ninety-three programs received the award in 2008, and Stony Brook’s Cancer Services is proud to be within the 19 percent of surveyed hospitals that have received this distinguished award.
Stroke Program recognized for its achievements. The American Heart Association/American Stroke Association recognized SBUMC and the Department of Neurology with its “Get With The Guidelines–Stroke” (GWTG-Stroke) Bronze Achievement Award. The Award acknowledges our ability to achieve 85 percent adherence to the GWTG-Stroke Performance Measures and Guidelines for 90 consecutive days and demonstrates continued commitment to quality—a commitment that benefits the patients and caregivers who come to SBUMC seeking stroke treatment. We are on our way to a gold award! Congratulations to all involved on the team!
SBUMC’s Cystic Fibrosis Center receives commendation. The American Board of Pediatrics recognized SBUMC’s Cystic Fibrosis Center’s success in improving care for patients. Under the leadership of Dr. Catherine Kier, the Center is part of the Cystic Fibrosis Foundation’s QI Collaborative, which works toward instilling best practices and care capabilities. The collaborations have demonstrated dramatic gains in life expectancy for people with cystic fibrosis. Between 1999 and 2006, the life expectancy has risen by eight years, from age 29 to 37.
Creating the Stony Brook Long Island Children’s Hospital. On March 23, administrators, faculty, and staff in Pediatrics, and members from multiple subspecialties met to officially begin plans for the creation of the Children’s Hospital. This meeting marked the progression from the concept stage to planning. It is expected that the project will remain in the planning stage for approximately six months. The Children’s Hospital will be dedicated to providing the safest, most advanced pediatric healthcare available. Programs will support the physical, emotional, and mental development of infants, children, and teenagers, and be provided in a state-of-the-art facility that promotes healing and comfort to families in times of crisis.
High Reliability efforts highlighted at University HealthSystem Consortium (UHC) Meeting. Chief Quality Officer William Greene, MD, was invited to speak at the UHC’s 2009 Risk Management & Quality Management Council Meeting in February to describe SBUMC’s efforts to become a High Reliability Organization (HRO), with particular emphasis on the HRO pilot in the Cardiac Intensive Care Unit (CICU). The presentation, titled “Risk & Quality: Do You Know the Road to HRO?,” submitted by Lisa Sokoloff, was well received and was made possible based upon the promising outcomes relating to process changes. Congratulations to all the staff, administrators, and physicians involved!
SBUMC nurses shine on Research Day. SBUH nurses demonstrated their inquisitiveness, keen intellect, and clinical passion on March 16 at Research Day. Sponsored by the School of Nursing, the Division of Nursing, and Kappa Gamma Chapter of Sigma Theta Tau International, this year’s theme was “Culturally Competent Curriculum, Culturally Competent Care.” Congratulations to the following individuals for their keynote presentations:
- Danielle Bellucci, RN, BSN; Maureen McHeffey, RN, BSN; and Sabra Boughton, PhD, RN, ANP: “Cultural Competency at the Bedside—Creating an Environment of Transcultural Care”
- Elke Wagner, RN, MS; Eileen Dowdy, RN, BS; Julie Mount, RN, BS; Afrodite Boukas, PA; and Marijean Buhse, PhD, RN, ANP: “Evaluation of Anxiety and Stress in Triage Nurses in the Emergency Department”
The following poster presentations were selected for verbal presentations by the Research Committee:
- “Nursing Research Quality Improvement Initiative: CICU 2008 High Reliability in CICU: Perfection is a Direction Not a State of Being,” authored by Jude Webber, RN, BSN, CCRN; initiative by staff RNs, SBU CICU
- “Deep Vein Thrombosis,” authored by Doreen Elitharp, NP, and Barry Florence, MD; initiative by the DVT Team
- “Improving Knowledge and Perception of the Institute for Health Care Improvement Processes in the NICU,” authored by Adriann Combs, RN; initiative by Physicians and Nursing Staff in NICU
- “Implementing Patient and Family Centered Care in the CICU: First Steps,” authored by Sara Spronz, RN, BSN. Special recognition was given to Ms. Spronz, a graduate of our Residency Program, with first prize in the poster presentations at the University HealthSystem Consortium Conference in Florida. Kathy Gorman, Director of Clinical Staff Development; Julianne Gentile, Director of the Residency Program; and Jude Webber, RN, BSN, assisted in guiding Ms. Spronz’s work.
Congratulations to all. We look forward to seeing these presentations in publications soon!
New Cytopathology Service enhances patient care. The Cytopathology Division in the Department of Pathology opened a new Fine Needle Aspiration (FNA) Cytopathology Service. The FNA laboratory is located on the first floor of the Cancer Center. Now, many patients can get their preliminary diagnosis on the same day of their visit. SBUMC’s Cancer Center is the first cancer center in Suffolk County with this capability. The service is staffed by four highly experienced cytopathologists, including Kenneth R. Shroyer, MD, PhD, Chair, Department of Pathology; Alan Heimann, MD, Chief of Cytopathology; Meenakshi Singh, MD, PhD, Vice Chair for Anatomic Pathology; and Sonya Hwang, MD, Staff Cytopathologist. FNAs can be done on virtually any palpable mass. In most cases, the procedure can be completed, including microscopic examination for a preliminary diagnosis within about 30 minutes. Clinicians can then discuss treatment plans at the same visit based on the preliminary FNA diagnosis.
Heart failure improvement efforts recognized. A poster titled, “Nursing Education is Essential for Improving Quality of Care and Outcomes for Patients with Acutely Decompensated Heart Failure (ADHF)” was accepted for presentation at the Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Conference 2009. Congratulations to the Heart Failure Service, the Heart Failure CQI Team, and the Heart Center Staff that coordinated and supported this work.
American College of Cardiology invites SBUMC to present posters. Elisa Horbatuk and other staff from Decision Support Services submitted three abstracts for the upcoming American College of Cardiology National Cardiovascular Data Registry (ACC-NCDR) annual meeting. All three were accepted for poster presentations. The NCDR annual meeting provides training and updates to enhance accuracy, consistency, and reliability of data collection efforts for the four NCDR registries, as well as offering presentations on clinical topics relevant to cardiac care. SBUMC currently participates in three of the four NCDR registries, reporting data for the following procedures: implantable cardioverter defibrillators, carotid artery stent placement, and percutaneous coronary interventions. The three posters accepted for presentation at the meeting, held March 26-27, cover both data capture efforts and quality improvement activities: “Improvements in Quality of Care at SBUMC Driven by Participation in the NCDR CARE Registry,” Data Completeness in NCDR Registries at SBUMC,” and “Maximizing Use of Electronic Data Sources at SBUMC for NCDR ACTION Registry—GWTG Elements.”
Institute for Healthcare Improvement (IHI) invites SBUMC to share glucose control experiences. IHI invited SBUMC to submit a summation on its efforts to achieve tight glucose control for publication on its “Success Story” Web site. SBUMC was recognized as a leader in glucose control among the 30 participating Critical Care Learning Collaborative Hospitals.
Care Management recognized for efforts. Catherine Morris, Executive Director, Care Management, was invited to speak at the University HealthSystem Consortium Performance Excellence Forum in March. As part of a breakout session on “Managing the Continuum of Patient Care,” she presented a lecture titled, “Improving Discharge Hand-off Communication,” which served as a review of SBUMC’s efforts to improve the discharge process. In addition, an article titled, “Coordinating and Negotiating with the Patient, the Family and the System” was accepted on the HCPRO blog and can be found at the following link:
http://blogs.hcpro.com/casemanagement/2009/02/coordinating-and-negotiating-%E2%80%93-with-the-patient-the-family-and-the-system/#comments
National Institute for Standards and Technology (NIST) invites SBUMC staff to serve as trainer. Carol Gomes, Associate Director, Quality Management and Director, Continuous Quality Improvement, was invited to serve as a trainer/facilitator in May at the National Institute for Standards and Technology for the Malcolm Baldrige Examiners Board. She will be conducting a four-day training session for Baldrige Examiners, which includes a focus on feedback report writing, consensus procedures, application scoring, examiner roles and responsibilities, and site-visit protocol.
Second of five Pediatric Emergency Medicine Physicians hired. Carl P. Kaplan, MD, board certified in Pediatric Emergency Medicine and Pediatrics, was appointed as Clinical Assistant Professor of Emergency Medicine. Dr. Kaplan will work in the Pediatrics area of the Emergency Department. After earning a medical degree from the Sackler School of Medicine in Tel Aviv, Israel, Dr. Kaplan completed his internship and residency in Pediatrics at North Shore University Hospital in Manhasset, NY. He finished his fellowship in Pediatric Emergency Medicine at New York Presbyterian Hospital/Weill Cornell Medical College in 2006. Prior to joining Stony Brook, Dr. Kaplan was an attending physician in pediatric emergency medicine at Jacobi Medical Center and Assistant Professor of Pediatrics at Albert Einstein College of Medicine.
Ophthalmology welcomes Dr. Federici. Thomas J. Federici, MD, has joined the Department of Ophthalmology as Assistant Professor of Clinical Ophthalmology, effective January 2009. Dr. Federici is board certified in ophthalmology. After earning a medical degree from Albany Medical College in Albany, NY, he completed residency training in ophthalmology at Geisinger Medical Center in Danville, PA, where he served as Chief Resident and was awarded the Louise Justin Sabol Resident Teaching Award by the Department of Ophthalmology in 2006. He completed a fellowship in vitreoretinal surgery at the Foundation for Retinal Research in New Orleans, LA. Dr. Federici is the author of numerous peer-reviewed publications and book/chapters and has been an invited lecturer and reviewer for numerous ophthalmologic journals, including Ophthalmology and Retinal Cases & Brief Reports (2007-2008).
Employee Health & Wellness expands services. Employee Health & Wellness (EH&W) moved to a new location on Level 3, Room 557 (across from Lab Administration). EH&W is committed to providing a stress-free and safe environment for all employees, and realizes that good health is multidimensional. In addition to physical health, its mission is also to address the overall well being of employees by providing wellness programs that promote this philosophy, with an ongoing interactive series of lectures. EH&W continues to offer its free six-week Smoking Cessation classes. Future programs include “Walk-in and Weigh-in,” “Employee Health and Fitness Day,” “Laughter at Lunch,” and “10,000 Steps a Day.”
PATIENT SAFETY
SBUMC celebrates National Patient Safety Awareness Week. National Patient Safety Awareness week, themed “Prescription for Patient Safety: One Partnership, One Team,” was celebrated March 9 through 12. At SBUMC, a week of patient safety-related events culminated with the Patient Safety Fair and poster contest. In the spirit of the theme, staff and patients, families, and community visitors were invited, and more than 300 people attended the Fair. Highlights of the event included:
- An “Ask the Pharmacist” booth
- Health screenings, including blood pressure and deep vein thrombosis (DVT) risk assessment and education
- Education on each of the National Patient Safety Goals
- Safety-related lectures sponsored by the Long Island Geriatric Education Center (LIGEC)
- Hand hygiene lecture
- Kidney disease education
- Failure Mode and Effect Analysis (FMEA) education
- Roving patient safety cart
A poster contest was held with 22 safety posters submitted from different areas of the Hospital. Prizes were given to three top scorers:
First Place: “Code Blue Positions: Anticipating the Worst Every Shift, Elimination of Chaos” (16S CTICR/Cardiac Telemetry)
Second Place: “Patient Safety in the NICU” (NICU)
Third Place: “Q4H Vital Signs” (15 South)
Congratulations to all those who submitted posters and for their efforts to advance patient safety at SBUMC, and thank you to all who participated in the Patient Safety Fair!
Stony Brook to be represented at National Patient Safety Foundation Annual Meeting. Several SBUMC posters were accepted to be presented at the National Patient Safety Foundation’s 2009 Annual Patient Safety Congress. Adam Buckley, MD, submitted a poster titled, “The Obstetrical Bariatric Task Force: A Multidisciplinary Approach to Improving Outcomes in a Complex Patient Population.” Additional poster applications were submitted by Chris McMullan and Carol Gomes from the CQI Department, and those accepted for presentation include, “Moving Beyond the Central Line Bundle,” “A Guide to Developing a Unit-Based Family Advocacy Board,” and “First Do No Harm: SBUH’s Journey to Become a High Reliability Organization and Proactively Prevent Harm.”
Joint Commission Resources (JCR) conducts mock survey. On February 24, a team of five consultants from JCR performed a mock survey over the course of four days to assess our preparedness with The Joint Commission Standards. They visited a wide cross section of our operations including inpatient units, outpatient clinics, procedural areas, Operating Room, the Emergency Department, and support areas such as the Pharmacy. In addition, they held Leadership, Human Resource, and Medication Management sessions. They noted our strengths including: a leadership team that is committed to a culture of quality and safety; strategic planning that addresses quality; good interdisciplinary care processes in many areas; knowledgeable staff committed to patient satisfaction; and good infection control support for the ambulatory services. They also provided us with a list of priorities to address including the National Patient Safety Goals and Universal Protocol. In the area of Medication Management, they reviewed our CPOE process and recommended the organization continue to work, as we have been doing, to ensure a safe, effective Electronic Patient Record (EPR) process.
Medication retreat planned in April. As a follow-up to a Medication Retreat held earlier this year, a multidisciplinary group will be meeting on April 15 to discuss the impact of the Computerized Physician Order Entry (CPOE) system on medication management processes. The group will focus on lessons learned and opportunities for improvement. There will also be a focus on the use of alerts, medication order options, dose range checking, eMAR functionality, and priority settings.
Raising awareness to prevent catheter-associated urinary tract infections (CA-UTIs). UTIs account for 40 percent of hospital-acquired infections (HAIs). Of these, 80 percent are attributable to indwelling catheters. Additional statistical data reported from the Institute for Healthcare Improvement (IHI) reveal that 25 percent of all admitted patients will receive a catheter during their hospitalization, and 50 percent of these patients do not have a valid reason for insertion of the Foley catheter. A UTI may increase a patient’s length of stay by one-half to one day. Four components of patient care recommended by the IHI to prevent or reduce the risk of CA-UTIs are: avoid unnecessary urinary catheters, insert catheters under aseptic technique, maintain urinary catheters based on recommended guidelines, and review urinary catheter necessity daily and remove promptly.
With the support and direction of Andrea Kabacinski, Nurse Manager of 13 North, the clinicians and educators gathered evidence-based literature, implemented best practices, and developed an education awareness initiative for the staff. From June through December 2008, 13 North saw a significant reduction of CA-UTIs. Starting in January 2009, Ms. Kabacinski began working collaboratively with Christine Schuhmacher from CQI, Francina Singh from Infection Control, and Kathy Gorman from Clinical Education to develop a formalized process improvement initiative. This group developed Foley Catheter Insertion and Maintenance bundles (checklists), an Insertion and Maintenance Protocol, and a Best Practice guideline. This was presented to all Nurse Managers and Nurse Educators in March. The rollout of this initiative is expected to begin on May 1 to the units considered “high users” of Foley catheters (ED, SICU, MICU, 18N, 16N, 16S, 15N, 15S, and MRN). Thank you to all for your collaborative efforts!
PATIENT SATISFACTION
“Hot Topics” Town Hall Meetings. Two Hot Topics Town Hall Meetings were held on March 19 to keep employees apprised of ongoing activities within SBUMC. Among the topics discussed were the patient safety journey to high reliability; The Joint Commission recent mock review and opportunities for improvement (e.g., need to date/time all entries in medical records); the creation of the Stony Brook Long Island Children’s Hospital; the proposed New York State budget and the fact that it includes a substantial reduction in support; new faculty hires that are bringing national attention to SBUMC; the progress in the search for a new University President (the hope is to have someone in place before July 1, 2009); plans to distribute the Employee Satisfaction Survey results in April; multiple programs offered through Employee Health to help reduce stress; the need for additional parking spaces; and our status as a smoke-free campus. Chief Nursing Officer Lee Xippolitos gave a presentation on our Magnet journey and the changes to the Magnet framework.
Charting the journey to Magnet designation. In 2007, the Commission on Magnet Recognition developed a new model for Magnet. The new model for Magnet focuses on evidence-based exemplary professional practice; the creation of new knowledge, innovations, and evolving technologies; patient partnerships; and supporting excellence in nursing with transformational leadership and structural empowerment. Stony Brook University Medical Center, in partnership with Stony Brook University School of Nursing, is charting the journey to Magnet designation with a cadre of Ambassadors who are the unit level representatives of everyday Magnet work and the Magnet Writing Team who record the message of Magnet. With great anticipation, the nursing staff is looking forward to a first draft document of this journey by mid-October. Every day and in every way, the nurses of Stony Brook are making a difference.
Units recognized as Patient Satisfaction standouts. Our thanks and congratulations, along with trays of cookies, were sent to the following inpatient units and ancillary outpatient service areas: 8N, 05CH, 05CC, 11S1, 17N, CT Imaging, Ultrasound, and the Patient Service Center (outpatient blood drawing) in March. The recognition was provided in appreciation of the high scores these units received from patients in 2008 on the Press Ganey patient satisfaction surveys. Quarterly units that score significantly above the Hospital average are recognized for achieving this noteworthy accomplishment.
Patient and Family Centered Care efforts continue in the Pediatric Intensive Care Unit (PICU). As a pilot program, PICU is planning to include patients’ family members during the nursing change of shift reports. In preparation, a teleconference was held with staff members of Virginia Mason Medical Center, located in Seattle, WA, who has included family members in their change of shift reports for the past several years. PICU Family Advocates volunteered to role-play with nursing staff to assist in the transition and to better prepare staff for questions or issues that may arise during the report.
Helping to ensure quiet for patients. Controlling noise, especially at night, is a challenge in every inpatient unit. The staff of units 15N, 15S, 16N, 12S, 17N, and 17S came up with a novel idea that is already having a positive effect—each unit now has its own “Noise Police.” The police are clinical assistants and nursing station clerks who, in addition to their regular roles on evening and night shifts, remind the staff to be quiet, and make sure that after 10:00 pm, as long as it is safe, lights go out and patient room doors get closed. Based on the Press Ganey patient satisfaction data for March, these efforts seem to be contributing to the improved patient satisfaction scores.
Ambulatory Surgery Center lowers cancellation rate. Looking to improve an already high patient satisfaction rate, while also improving cost efficiencies, staff at the Ambulatory Surgery Center (ASC) embraced the opportunity to bring the ASC’s cancellation rate of 6.8 percent more in line with the national rate of 5 percent. Staff analyzed the reasons why procedures are cancelled and discovered that about one third of cancelled surgeries were being cancelled because pre-op instructions to patients were not being properly followed, especially those concerning fasting and transportation. To address this communication issue, the ASC borrowed ideas from the Press Ganey Solutions Starters and developed a comprehensive pre-operative packet that includes all the relevant patient information, as well as a checklist, an educational DVD, and the address of the ASC Web site at www.sbdaysurgery.com. The ASC also focused on making sure that patients speak directly to an RN the night before surgery to review their pre-op instructions. In addition, two days prior to the patient’s scheduled surgery, the patient receives an automated phone call to remind them of the date of surgery, and the need to fast and arrange transportation. They are also given an alternate number to call if additional information is needed.
The effort has reduced the percent of cancellations, due to pre-op instructions not being followed, from 31 percent to 3 percent and has brought the overall cancellation rate down to 3.6 percent. The initiative has resulted in an increase of seven cases per month, and significant revenue improvements. Congratulations to the dedicated and creative staff at the ASC!
Cancer Center posts forms online for patients to access. In an effort to alleviate some of the stress that first-time visitors to the Cancer Center experience, the Center has placed all the forms that a patient must complete on the Hospital Web site. Patients or their family members can now complete the paperwork at home when they have time to think about questions asked and pull together the information needed to answer questions.
Check-in process for outpatients visiting Cancer and Imaging Centers streamlined. Cancer Center and Imaging Center patients who are pre-registered and do not have a co-payment can now pass the registrar’s window when going to their appointment, thanks to a process change implemented by the Admitting Department. The Admitting Department and the Cancer Center staff now prepare and deliver the necessary documents to the clinical areas in advance of the patient’s appointment. Upon arrival, the patient needs only to sign the forms at the check-in area prior to the visit or procedure. This change simplifies the process for about half our radiology outpatients and about one quarter of Cancer and Breast Care Center patients.
Seawolves partner with Pediatric Oncology. Members of the Stony Brook University football team score points and deliver good times to patients and their families in the Pediatric Oncology Clinic as part of a new initiative to make receiving treatments a more positive experience. Over 25 Seawolves visited the clinic in February. They played games with kids, spoke with the patients’ families, kept patients undergoing treatment company, and handed out Stony Brook T-shirts. This is an ongoing initiative that will take place weekly in the Cancer Center.
COMMUNITY CONNECTIONS
Cowles Charitable Trust contributes $15,000 to SBUMC’s new Cerebrovascular Research Center. The Cerebrovascular Research Center (CRC) will soon take up residence on the 12th floor of the Health Sciences Center within a 2,000 square-foot space in the Department of Neurosurgery. Also part of the CRC is a separately located single-plane angiography room. Thanks to the generosity of the Cowles family, the CRC will soon purchase a new piece of laboratory equipment.
Joseph M. Colombo joins SBUMC Development Council. The Development Council is pleased to welcome Joseph M. Colombo as its newest member. Mr. Colombo, who lives with his family in East Setauket, is the Managing Director of Garden City Financial Group in Garden City. Established in February 2008, the Development Council was created with a mission to further Medical Center’s vision of becoming a world-class institution through philanthropy and community support.
Starbucks Cafe now open for the community. The Starbucks Cafe is now open from 6:30 am to 8:30 pm, seven days a week, in the Main Lobby of the Medical Center. Manager Doug Bresnahan, formerly of the Market Place Café, oversees this fully licensed Starbucks for the benefit of SBUMC. The Cafe offers specialty coffees, teas, pastries, baked goods, and grab-and-go sandwiches.
Stony Brook promotes colorectal cancer awareness. In observance of March as Colorectal Cancer Awareness Month, SBUMC’s colon and rectal surgery experts Roberto Bergamaschi, MD, Marvin Corman, MD, and William Smithy, MD, provided a free community lecture on the prevention and treatment of colorectal cancer on March 25. Attendees were able to sign up for free colorectal cancer screenings.
Celebrating Social Work Month. Themed “Purpose and Possibility,” SBUMC staff celebrated National Social Work Month in March. A recognition luncheon and educational presentation for our social workers titled, “Human and Social Services—Using Outcome Measures to Plan and Evaluate Practice” was provided by Amy Hammock. Roy Burnham, Social Worker in the Care Management Department, educated staff about family violence and designed a placard, which was posted on all nursing units, that describes the clinical indicators of child, elder, and domestic violence, and the mandated reporting process.
SBUMC Social Worker answers the call. Roy W. Burnham, L-CSW, ACSW, in the Department of Social Work Services, and American Red Cross Disaster Mental Health (DMH) volunteer was called upon in early March to assist families that were displaced from the Coventry Apartments fire in Central Islip. DMH counselors provide emotional support, counseling, and referrals to community resources to victims of disasters. Last year, Mr. Burnham worked with Suffolk County DSS to provide counseling and secure temporary housing for 45 residents displaced in a fire/explosion in Bay Shore, many of whom now suffer from emotional and/or physical disabilities. He also accepted national deployment to Houston, TX, this past fall, where he worked as Department of Mental Health Supervisor at an 890-bed shelter that housed individuals and families, many of whom had active psychiatric and/or mental retardation disabilities and provide DMH oversight to smaller surrounding community shelters. Congratulations Roy!
SBUMC staff share expertise on a variety of health topics onsite and throughout the community. On March 12, World Kidney Day, the mother of one of our pediatric patients teamed up with our nursing staff to provide information about kidney disease to SBUMC visitors and staff. Throughout the month staff volunteered time to give presentations on Acupuncture, Careers in Health Technology, Careers in Recreation, Diagnostic Detective, Diet and the Oncology Patient, and Taking Your Medication Safely. Tours were provided at the Sleep Disorders Center. Staff members provided support to School of Medicine students at the Stony Brook HOME (Health Outreach and Medical Education) Health Fair in Central Islip. Many thanks to Claire Cascio, RN, Hemodialysis; Bruce Folz, RN, Hemodialysis; Doreen Day, Medical Care Review; Denise Friedman, Medical Care Review; Carole Agin, MD; James Wolkiewicz, Application Infrastructure; Marie Turchiano, Property Control; Michele Gilleeny-Blabac, Laboratories; Jennifer Fitzgibbon, Breast Care Center; Edmund Hayes, PharmD, Pharmacy; and Barbara Ludwig-Cull, Sleep Disorders Center, for their community service. In March, Dr. Strongwater spoke at our monthly Mall Walkers event at the Smith Haven Mall, where he received an enthusiastic welcome as he presented an update on SBUMC.
Stony Brook University Hospital to offer SANE Program. The Sexual Assault Nurse Examiner or SANE Program provides a nurse who has advanced education and clinical preparation in forensic examination to victims of sexual assault in a supportive environment. In the 1990s, SANE programs sprang up in communities across the country to address the inadequacy of the traditional model for sexual assault evidentiary exams. SANE programs have made a profound difference in the quality of care provided to sexual assault victims. SANEs offer victims prompt, compassionate care and comprehensive forensic evidence collection. In addition to helping preserve the victim’s dignity and reduce psychological trauma, SANE programs are enhancing evidence collection for more effective investigations and better prosecutions. This has been particularly useful in non-stranger sexual assault cases, where thorough documentation of evidence to corroborate a victim’s account of an assault by establishing lack of consent has led to more successful prosecutions.
SBUMC joins collaborative effort to host free medication take-back event. Clean out your medicine cabinet, and bring any unused, unwanted, and expired medications to the Setauket Firehouse on Saturday, April 18, 10:00 am to 3:00 pm, for free and proper disposal. Expired and unwanted prescriptions, over-the-counter medications, and pet medications will be collected. This includes controlled and non-controlled substances. Please bring all medicines in their original containers, if possible. This event is a collaboration of Stony Brook University, Stony Brook University Medical Center, New York Sea Grant, Assemblyman Steve Englebright, Suffolk County Legislator Lynne Nowick, Long Island Pulse Magazine, Long Island Sound Study, Suffolk County Department of Health Services, Suffolk County Water Authority, Triumvirate Environmental Inc., and WALK FM. Let’s all do our part to keep our families healthy and Long Island waters clean. Call (631) 444-4000 or e-mail SBUH CommunityRelations@stonybrook.edufor details.
Care Management Department hosts a Community Resources Fair. On February 24, the Department of Care Management held a Community Resources Fair in the HSC Galleria with over 400 people in attendance. Thirty-seven local agencies participated, and provided education about post-hospitalization services available to staff, patients, and families. During the event, a raffle was held, where over $400 was donated to the Stony Brook Indigent Fund.
March of Dimes® March for Babies®. The March of Dimes annual walking event, March for Babies, takes place locally on Sunday, April 26 at the Long Island Sheraton Hotel in Hauppauge. SBUMC is encouraging walkers and walking teams; visit www.marchforbabies.org/teams/564337 to register for the walk and/or donate. To start your own SBUMC team, contact Ronni Schultz at 444-2960. The money raised supports programs that help moms have healthy, full-term pregnancies, and funds research to find answers to the serious problems that threaten babies.
Stony Brook is smoke-free. As a reminder, SBUMC has been smoke free since January 1, 2009. The new smoke-free policy prohibits smoking not only inside and near buildings but also on the grounds of the Medical Center, Health Sciences Center (HSC) and the Long Island State Veterans Home (LISVH). In addition to the HSC and LISVH, this includes the Hospital, Ambulatory Surgery Center, Cancer and Imaging Centers, the Hospital and HSC parking garages, and all open space around these areas. To learn about smoking cessation, call Employee Health & Wellness at 444-7767 or HealthConnect® at 444-4000.
Aphasia Group offers support and help. Stony Brook’s Danielle Riccobono, Speech Language Therapist, conducts a free Adult Aphasia group at the Trinity Lutheran Church in Islip every other Saturday from 10:00 am to noon for people who have suffered a brain injury. The group is designed to help maintain language skills and to teach strategies to overcome communication challenges. Family members are also welcome.
Heart Center offers Cardiac Education Program for patients, family, and friends. The Heart Center hosts a free cardiac education program for its patients and their families and friends. Offered every two months, topics include “Learn about Heart Disease, Treatment, and Prevention,” “Take Charge of Your Cardiac Health and Learn to Lessen Your Risk for Heart Disease,” “Learn to Start an Exercise Program,” “What you Need to Learn About Your Cardiac Medications,” and “Learn How to Read Nutrition Labels and Make Healthy Food Choices.” To learn more about the program or to sign up, call HealthConnect® at 444-4000.
Holocaust Memorial Museum traveling exhibition comes to Stony Brook University. “Deadly Medicine: Creating the Master Race,” the United States Holocaust Memorial Museum’s traveling exhibition, makes its debut at Stony Brook University on Monday, April 6, at the Charles B. Wang Center. The exhibition examines how the Nazi leadership, in collaboration with individuals in professions traditionally charged with healing and the public good, used science to help legitimize genocide. This traveling version of Deadly Medicine is based on the acclaimed exhibition of the same name that originally opened at the United States Holocaust Memorial Museum in Washington, D.C. in 2004. The first of 10 public lectures and events scheduled to add context to the Deadly Medicine exhibition at Stony Brook will be held on Monday, April 20, in honor of Holocaust Commemoration Day, Yom Hashoah. On Monday, April 27, the University will host an opening celebration from 5:00 pm to 7:00 pm, which is open to the campus community and community residents. Information about additional events and lectures can be found at www.stonybrook.edu/sb/deadlymedicine/schedule.shtml.
Last Touch
Can healthcare workers, on the very front line of care day after day, remain compassionate? Compassion itself is an active desire to alleviate another’s suffering. It is a profound human emotion and extremely energy dependent; so much so that it can be draining.
Compassion is such an important aspect of providing medical care, it has been established as an area of study and research in academic medicine. Our own School of Medicine has established the Center for Medical Humanities, Compassionate Care and Bioethics, led by Dr. Stephen Post. The Center looks at compassionate care as integral to the art of healing. Yet, many patients and their families do not experience care in this basic sense. On a broader scale, compassion includes the pursuit of justice and access to healthcare at a time when patients can be adversely impacted by the stresses of dealing with the healthcare delivery system.
We all expect healthcare workers to be compassionate, in part, because someday we may become patients ourselves. Indeed, compassion is one of the most valued and rewarded emotions in most major religions; it is one of the greatest of virtues. Is it possible that we can we run out of our capacity for compassion?
It turns out the answer is yes, we can run out of compassion. In healthcare workers, it is referred to as compassion fatigue. It is a form of Secondary Traumatic Stress Disorder (STSD), defined as a gradual lessening of compassion over time. First diagnosed in nurses in the 1950s, it is common among victims of trauma and individuals that work directly with victims of trauma. People suffering from STSD can exhibit a variety of symptoms including hopelessness, a decrease in experiences of pleasure, constant stress and anxiety, and a pervasive negative attitude. This can have detrimental effects on individuals, both professionally and personally, including a decrease in productivity, the inability to focus, and the development of new feelings of incompetence and self doubt. Some may just refer to this collective as “burn out.”
Caregivers for dependent people are particularly vulnerable to compassion fatigue. We have all heard unfortunate stories of elder abuse, even by otherwise caring healthcare professionals. Primary providers for patients with terminal illness are at a higher risk of developing these symptoms. It results from the taxing nature of showing compassion for someone whose suffering is continuous and irresolvable. Workers in long-term care settings are likewise vulnerable to compassion fatigue.
It can be argued that reporters and journalists contribute to compassion fatigue in our society at large. Newspapers, broadcast news programs, and the Internet are saturated with decontextualized images and stories of suffering. The public then becomes desensitized, and worse, apathetic when it comes to helping people who are suffering.
I agree with Dr. Post when he says that as the connection between healing and emotions becomes better understood scientifically, we need to renew a commitment to compassionate care that is grounded in leading-edge research, scholarship, and educational efforts. Because when addressed appropriately, compassion fatigue can be prevented. The first step is to recognize signs of the disorder. Healing begins with simple, healthy practices such as regular exercise, increasing social activities, engaging in productive outlets for your feelings (i.e., writing in a journal), and getting enough sleep (many healthcare providers are sleep deprived). Exchanging information and feelings with people who can validate your concerns is also very important. Being on the front line all the time is hard and sometimes you need a break, a vacation, or a change in your routine. Perhaps most important is support at every level from the people around you—the SBUMC community can help provide this support.
If you want others to be happy, practice compassion. If you want to be happy, practice compassion.
— Dalai Lama
Compassion is that which makes the heart of the good move at the pain of others. It crushes and destroys the pain of others.
– Buddha
Every man supposes himself not to be fully understood or appreciated.
– Ralph Waldo Emerson
Thank you for supporting each other and making SBUMC a special place to work.
Steven L. Strongwater, MD
Chief Executive Officer
Stony Brook University Hospital
Patients First—World-Class Processes—Teamwork—Growth—Use Resources Wisely
