August 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 that 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.
August 2009
Summer is a time when, generally, life slows down. People steal away and take vacations, spend time with their families, travel, or enjoy Long Island. It is also a time when we at SBUMC reflect on how we have done over the past year and ask where we are going.
Since this past July, Stony Brook University Medical Center (SBUMC) has expanded or started several clinical programs. We’ve introduced our interventional stroke program (to remove blood clots or put stents in brain blood vessels), enhanced CT scanning to routinely visualize coronary arteries (in many cases avoiding the need for a heart catheterization and speeding the evaluation of chest pain), expanded the minimally invasive surgical program with the use of a surgical robot (for cardiac, urologic, and gynecologic surgery), and expanded the cardiac electrophysiology program (EP) (with the addition of new faculty and an EP robot) enabling precise treatment of heart arrhythmias. Fifty-seven new faculty were hired and 28 community physicians joined the medical staff during the past year.
The completion of Phase I of the Major Modernization Project allowed SBUMC to open ten state-of-the-art operating rooms, modernize the Emergency Department, dedicate single-bedded rooms for obstetrical patients, and dramatically enhance patient and visitor first impressions as a result of our new lobby and Starbucks Cafe. We launched a program called Partners in Care in an effort to formally commit to a patient centered environment. Partners in Care is a group of patients, family members, and staff pulled together to guide SBUMC decision making. They will participate in strategic planning, staff hiring, and more. We expect great things from our Partners program.
For our staff, we successfully vaccinated more than 3,500 staff (nearly 70 percent of the workforce) to help prevent influenza. The SBUMC campus went smoke free! Many of our staff used this moment to kick the habit, thereby extending their lives and improving their own health (and those around them—congratulations). Thanks to the leadership in Employee Health and Wellness, we have launched lunchtime lectures and several wellness programs.
On the safety front, the electronic medical record reached a critical milestone, turning on computerized provider order entry (CPOE). CPOE assures automatic safety checks, preventing potential medical errors when writing orders. Crew resource management (CRM) training began. CRM training is used to enhance communication among healthcare workers modeled after the airline industry. More than thirty failure mode and effect analysis (FMEAs) were completed by our department heads. FMEAs are done in anticipation of potential problems. The FMEA process requires putting practices and redundant systems in place to avoid errors. The Cardiac Intensive Care Unit was recognized as a high reliability unit reducing errors and mortality dramatically. This accomplishment led to statewide recognition with a Pinnacle Award from HANYS.
SBUMC has submitted a Baldrige application, and we hope for a Baldrige site visit some time next year. Winning a Baldrige Award would be like winning an Oscar, in the context of healthcare performance excellence. A site visit alone would be quite an achievement. Also underway is documentation in anticipation of submitting an application for a Magnet Award. As reported in the July CEO Update, SBUMC received many awards and recognitions this past year, including a gratifying Joint Commission Reaccreditation Survey.
We selected a new Chief Medical Officer, Dr. Todd Griffin, a stalwart in the Stony Brook community for over 20 years. SBUMC signed affiliation agreements with three east end hospitals (Peconic Bay Medical Center, Eastern Long Island, and Southampton Hospitals, also known as the Alliance). We conducted regular town hall meetings for our staff and created an electronic distribution network to broadcast these meetings throughout the Medical Center. Likewise, we held Town Hall Meetings for community-based physicians. Also, SBUMC launched an award-winning marketing and branding campaign, Home of the Best Ideas in Medicine, to educate the community about what an academic medical center is. Visit BestIdeasInMedicine.com.
Just slightly more than a year ago, we reviewed and updated SBUMC’s mission and vision statements. We have been working hard to share these with the community.
Our mission: Stony Brook University Medical Center improves the lives of our patients, families, and communities, educates skilled healthcare professionals, and conducts research that expands clinical knowledge.
Our vision: To be a world-class healthcare institution, recognized for excellence in patient care, research, and healthcare education. The first choice of patients for their care and the care of their families. An academic medical center that attracts educators and students with the desire and ability to provide and receive the highest quality, innovative education. One of the top ranked institutions for scientific research and training.
In the coming months we will begin the second phase of the Major Modernization Project. This will complete construction of the Emergency Department (including a dedicated Pediatric Emergency Department and an expanded Comprehensive Psychiatric Evaluation Program or CPEP), the Neonatal Intensive Care Unit, the Labor and Delivery Operating Rooms, and modernize the remaining sections of the Main Operating Rooms and SBUMC’s Lobby.
We plan to open a dedicated Neuro-Intensive Care Unit (to care for neurosurgical and stroke patients), open a Palliative Care Unit (to help patients cope with life-threatening illnesses), and a Geriatric Unit or ACE Unit (Age Center of Excellence). Several new faculty will or have already joined us. They bring new competencies to the Medical Center—in cardiac surgery, cardiology, gastroenterology, oncology, pulmonary, vascular surgery, orthopedics, neurology, pediatric emergency medicine, hospitalists, and many more—to assist us on our journey to bring world-class care to the community. We have been granted emergency approval to increase our bed size, which will allow us to meet patient needs, while improving workflow by clustering together similar patients and house staff.
This is an exciting time for SBUMC. It is true that the external environment is changing, with healthcare reform and budget constraints, so there is understandably uncertainty about the future. Change happens and always will. SBUMC will adjust and thrive as we have for the past thirty years, a tribute to the many faculty and staff who work so hard at SBUMC. Thank you all.
STONY BROOK PRIDE
Urology is ranked as one of the nation’s best. For the second time, the Department of Urology is ranked among the top 50 urology programs in the “America’s Best Hospitals” August 2009 issue of U.S. News & World Report. SBUMC was one of only four hospitals from New York State highlighted and the only Long Island hospital so ranked in Urology. The program had the second highest survival rate out of the top 50 programs included on the ranking list in that category. This year, the Department’s ranking rose to number 32 from being ranked 48 in 2007. The 2009-2010 listing of America’s Best Hospitals is online at www.usnews.com/besthospitals and on newsstands.
SBUMC wins “Most Wired” Award. The award, sponsored by Hospitals and Health Networks, was given in the “Most Improved” category. Linda Shanley, Chief Information Officer, and Jane Wu, Associate Director for Information Technology attended the 17th Annual Health Forum/AHA 2009 Leadership Summit in San Francisco in July to receive the award on behalf of SBUMC. They also participated in informative educational sessions led by top technology leaders. This accomplishment is a direct result of the progress made to implement the electronic patient record.
SBUMC scientists receive nearly $4 million in new state funding for stem cell research. Wadie F. Bahou, MD; Ira S. Cohen, MD, PhD; Soosan Ghazizadeh, PhD; Ute Moll, MD; and Hsien-yu Wang, PhD, researchers from SBUMC, have been awarded a total of nearly $4 million in New York State funding for stem cell research projects that will potentially enhance the understanding of stem cell biology and lead to cell-based therapies to treat life-threatening diseases. Last year, Stony Brook received a NYS development grant for stem cell research, which has been used to lay the foundation of stem cell research in many areas of medical science throughout the institution.
Stony Brook cancer investigators receive LILAC Grant. Cancer researchers in the Department of Pharmacological Sciences received a $9,995 grant from the Long Island League to Abolish Cancer (LILAC) to purchase a DNA imager, an ultraviolet (UV) light and camera source that enables researchers to analyze DNA gels of tissue to advance molecular studies of cancer. Pharmacological Sciences investigators Howard Crawford, PhD, Associate Professor; Stella Tsirka, PhD, Professor; Emily Chen, PhD, Associate Professor; and Sabine Brouxhon, MD, Visiting Associate Professor, Emergency Medicine, will use the new DNA imager to conduct laboratory studies on pancreatic, brain, breast, and skin cancer.
New Director of the Health Sciences Library is named. Andrew White, PhD, comes to Stony Brook from serving as Associate Dean for Technical and Automated Services at Adelphi University Libraries. Before his tenure at Adelphi, for 18 years, Dr. White held positions in both technical and public services at the Stony Brook University Music Library, and worked with and supervised library information technology operations in both the Melville and the Health Sciences Libraries. He was the Associate Director of the Health Sciences Library until January 2008.
Visit our Web site to view videos. Want to learn about the Sensei® Robotic Catheter System to treat atrial fibrillation, or get an idea about what Cancer Survivors Day at the Stony Brook Cancer Center is all about? Simply visit our Web site. For the Sensei demonstration, click on the image that appears on the homepage; for Cancer Survivors Day, go to “Centers & Institutes,” select “Cancer Center” and then click “view video.” Look for additional videos in the coming months to keep you in the loop about some of the great things happening at SBUMC.
PATIENT SAFETY
Influenza Immunization Bill is based on research by SBUMC physician. In early June, the New York State Senate and Assembly passed the Influenza Immunization Bill (Bill A. 876-A), which requires hospitals with a neonatal intensive care unit (NICU) to offer flu vaccine shots to parents and family members of newborns being treated in a NICU. The bill, based on the research of Dr. Shetal Shah, neonatologist at SBUMC, is expected to help protect thousands of newborns each year. The bill is before Governor David Paterson for his signature to make it law.
Patient joins Patient Safety Committee. The Patient Safety Committee has welcomed Peggy Confoy, the first patient member named to the committee. Ms. Confoy is also a member of the Partners in Care Advisory Council. Roseanna Ryan, the Patient and Family Centered Care Coordinator, is also a recent addition to the committee. The committee is interested in supporting the concept of Patient and Family Centered Care, and in turn, the concept of Patient and Family Centered Care will fully support the mission of the Patient Safety Committee—to create a safe environment and minimize the risk to patients of any potential harm.
Coumadin® Multiphase PowerPlans moving into Cerner production environment in August. The standardization and use of this approved protocol is directly linked to The Joint Commission's National Patient Safety Goal (NPSG.03.05.01) which requires healthcare organizations to “reduce the likelihood of patient harm associated with the use of anticoagulation therapy.” Anticoagulation therapy poses risks to our patients due to the complexity of dosing, monitoring, and compliance. The newly developed PowerPlans will direct the individualized treatment of our patients during initiation and maintenance, and considers the condition being treated. This initiative will assist SBUH’s efforts in becoming a High Reliability Organization. Resident training is currently available through New Innovations on the Hospital Intranet.
Venous Thromboembolism (VTE) Lighthouse application is currently under development. Nationally, there are reportedly 300,000 VTE cases annually, with associated costs of nearly $1.5 billion. The Lighthouse application, a Cerner Solution, was introduced to the VTE Task Force as a method to improve overall compliance with assessing and treating our adult, in-patient, at risk population. It offers the provider a means by which all susceptible patients can be identified and have appropriate prevention orders in place within 24 hours of admission, reducing mortality and readmission rates. This solution also enables outcomes measurement and dashboard reporting. It is expected to go live in November. For more information, contact either Dr. Antonios Gasparis or Doreen Elitharp from the DVT Service at 444-4DVT.
SBUMC continues to focus on reducing the incidence of ventilator-associated pneumonia (VAP). The Neonatal ICU has worked diligently to reduce the incidence of ventilator-associated pneumonia (VAP) and their efforts have paid off! NICU has been VAP-free for the last twelve months. The Unit’s running 12-month rate has officially dropped to 0.0! In addition, the Medical ICU has observed zero incidence of ventilator-associated pneumonia for the last consecutive 3 months. The Pediatric ICU has observed zero incidence of central line infections for the past three months as well. Reducing ventilator-associated pneumonia is a performance improvement priority for SBUH.
Failure Mode and Effect Analysis (FMEA) training available for managers and staff. The Continuous Quality Improvement Department has scheduled FMEA training sessions for department heads, managers and staff for August 14 and November 13 from 8:30 am to 12:30 pm. You can register through SBUH’s Intranet on the “Human Resources” link to the Corporate Training & Education Web site by clicking on the “Knowledge Network.” The name of the course is “HTNW28 Root Cause Analysis and Failure Mode and Effect Analysis.” All nurse managers and department heads were asked to attend training and begin working on an FMEA which allows for the analysis of a high-risk process, ultimately leading to the development and implementation of risk reduction strategies. By implementing risk reduction strategies, it is anticipated that the studied process will become safer. After FMEAs are completed, departments are asked to continuously identify high-risk processes and proactively utilize the FMEA process to improve performance. The results of FMEAs are shared regularly with Dr. Strongwater, Chief Executive Officer. If anyone requires assistance about ideas for FMEAs, call Carol Gomes at 444-0575.
PATIENT SATISFACTION
Award-winning Pediatric ICU Family Advocacy Board expands scope. The Pediatric ICU Family Advocacy Board agreed to broaden its scope to include pediatric oncology and hematology as well as general pediatric patients. As a result, the board changed its name to the Pediatric Family Advocacy Board.
Abdominal pain protocol is piloted in SBUMC’s Emergency Department. As a result of the Emergency Department identifying abdominal pain as a high volume chief complaint among patients seen in the ED, an abdominal protocol was developed by the Urgent Matters Emergency Department Patient Flow Team and piloted by Dr. Asa Viccellio, Associate Chair of Emergency Medicine. The protocol initiates blood tests, medication for nausea, and administration of fluids while the patient is waiting to be examined, and is designed to decrease the wait time for patients, assist in providing physicians with valuable information for diagnosis, and increase patient comfort and satisfaction. Use of the protocol by other ED physicians is expected in August.
Focusing on denial reduction. A FMEA was initiated to decrease the number of hard denials for radiological tests and procedures. The goal of decreasing radiological hard claim denials due to a lack of authorization or referral by 25 percent for fiscal year 2009-2010 was identified. Members from Patient Accounts, Radiology, Pre-Registration, and Continuous Quality Improvement were identified as participants of this FMEA.
Hospital patients are more willing to recommend SBUMC. HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) patient satisfaction data was recently updated and shows improvement in the willingness of Stony Brook patients to recommend SBUMC. The Center for Medicare and Medicaid Services survey of patients discharged between October 2007 and September 2008 is updated quarterly and the results are publicly reported. On the “willingness to recommend” scale, Stony Brook compares favorably with other hospitals on Long Island and in New York State. The two out of ten survey items reported where Stony Brook scored below the LI average are “Communication with Doctors” and “Quietness at Night.”
“Sunrise on Wheels” brings joy to Stony Brook patients. Sunrise Day Camp, a day camp dedicated to children with cancer, is initiating “Sunrise on Wheels.” With the new program, hospital volunteers bring a piece of the day camp experience to children in the Pediatric Hematology/Oncology outpatient clinic while they are waiting for treatment. Volunteers visit young patients while towing a “magical” tie-dye trunk on wheels filled with fun camp-type items for children 18 months to 18 years old.
Camp Adventure brings “fun in the sun” for pediatric patients and their siblings. Twenty-one pediatric patients with cancer treated at SBUMC, along with 24 of their siblings and SBUMC physicians and staff of the Division of Pediatric Hematology/Oncology, will gather August 15 through 21 for summer fun and activities on the grounds of Camp Quinipet on Shelter Island. Sponsored by the American Cancer Society (ACS), “Camp Adventure” for 20 years has provided a needed respite for kids with cancer, who can simply be kids and enjoy everything from swimming to nature walks, scavenger hunts, and arts and crafts.While numerous hospitals in the region support and send their patients to Camp Adventure, a significant portion of the campers each year are represented by SBUMC staff, patients, and their siblings.
SBUMC Volunteer Corps continues to grow. The average number of active hospital volunteers for the last fiscal year reached an all time high of 645. Over 65 departments hospital-wide use the services provided by hospital volunteers. SBUMC has one of the largest volunteer programs in the area. High school students, college students, and adults find volunteering at SBUMC a rewarding and enjoyable experience that enhances our patients’ experience. The volunteer program also helps introduce the healthcare profession to over 500 Stony Brook University students annually who become volunteers to serve their community while exploring their own career options.
Hospital Auxiliary Gift Shop introduces new items. The gift shop continues to expand its offerings to better serve the needs of hospital visitors, patients, and staff. In addition to floral arrangements, cut flowers and plants are for sale, and mylar balloons can be purchased as gifts for patients. The gift shop accepts orders by phone and arranges for purchases to be delivered to patients. Congratulations to Jennifer Desposito who has taken on the role of Gift Shop manager.
COMMUNITY CONNECTIONS
Music Idol for Kids on August 8. Music Idol for Kids is a singing competition organized by Idol Entertainment and SSLI Recording Studio to benefit the Sunrise Fund and the Child Life Program at SBUMC. Thirty vocal adult contestants, many from the Stony Brook campus community, will perform on Saturday, August 8 starting at 7:00 pm in the Student Activity Center on Main Campus. The winner of the competition will record an original song at SSLI Studios written and produced by Beautiful Vision Productions in association with SSLI Recording Productions. Sponsors of the show include WBLI and Cactus Salon. Tickets are $45 per person in advance; $55 at the door and refreshments are available. For tickets, call (631) 864-2450 or order on line at www.sslistudios.com/idolforkidstix.pdf.
New ALS research laboratory opens. Stony Brook opened a new cryopreservation laboratory dedicated to advancing research of ALS (amyotrophic lateral sclerosis) and other neuromuscular diseases. The dedication of the lab was a hallmark moment in educational philanthropy and a first at Stony Brook University, as the Medical Center and University recognized a group of Northport High School students who contributed $125,000 to the opening of the lab. The gift comes from a Northport High School annual fundraiser, “A Midwinter Night’s Dream,” an annual charity fundraiser, which has raised more than $1 million to benefit ALS research.
SBUMC participates in Kids Health and Safety Expo. Stony Brook, the Elsie Owens North Brookhaven Family Health Center, SafeKids Suffolk, and other local organizations co-hosted this free event featuring health screenings and information, nutrition tips, and demonstrations on how to preserve safety and prevent injuries to children during traditional summertime and year-round activities. In addition to healthcare professionals from SBUMC, students and faculty from the Stony Brook University School of Dental Medicine provided evaluations and screenings, and instruction about maintaining oral health. SBUMC’s Community Relations team organized the expo, held on July 8 at Flowerfield in St. James.
Carol M. Baldwin Breast Cancer Research Annual Celebrity Golf Outing raises $170,000. Over 120 golfers joined celebrity guests including actors Alec and Billy Baldwin; former New York Giant players, Otis Anderson and Curtis McGriff; and former Howard Stern cast members and comedians Jackie Martling and John Melendez for an enjoyable day of golf and fundraising to support breast cancer research at SBUMC. A special thank you to all who contributed to the success of this event!
SBUMC hosts the 2009 Suffolk County Heart Walk. SBUMC has partnered with the American Heart Association as a corporate sponsor of its Suffolk County Heart Walk, scheduled for October 25 at Stony Brook University. Hospital CEO Dr. Steven Strongwater is Chair of the event along with co-vice chairs Dr. Todd Rosengart and Dr. David Brown. The walk includes a 5K walk around the campus, live music, give-a-ways and an informational health fair. All are invited to support this worthy cause by becoming a Team Captain, registering as a walker, or making a contribution. SBUMC has set up its own fundraising web page at www.longislandheartwalk.org. For more information, please contact Kimberly Baumgartner, American Heart Association Representative, (516) 450-9106, e-mail, Kimberly.Baumgartner@heart.org; Peg Duffy, SBUMC Cardiac Services 444-2946, e-mail, Margaret.duffy@stonybrook.edu; or Melissa Donnelly, SBUMC Burn Unit, CICU/CACU, CVICU, 444-1371, e-mail Melissa.connelly@stonybrook.edu.
Upcoming events. SBUMC offers events throughout the year to provide important healthcare education and screenings to the community; raise funds to support a variety of efforts, including patient care and research; and celebrate people, causes, and milestones. For details about the many activities and events taking place throughout each month, visit the SBUMC Web site at StonyBrookMedicalCenter.org, and at the top go to “In the Community,” then select “Calendar of Events.” Some events coming up in August are the Gehrig’s Glove Softball Tournament benefiting “Ride for Life,” July 30 through August 2; “Concerned Women of the Grove” to benefit the Carol M. Baldwin Breast Care Center, August 1; Music Idol to benefit the Sunrise Fund, August 8; and the Suffolk County Police Department 6th Precinct “Cops Who Care” 2nd Annual Golf Outing, also benefiting the Sunrise Fund, August 17.
Last Touch
Are you an optimist? Do you bring enthusiasm and energy to what you do, or do you tend to be a skeptic and perpetually negative? Are you someone who begins many sentences with “Let me explain why that won’t work…”?
We all know negative people. Even if you have discovered the cure for cancer, they will react by telling you why your cure won’t work. As individuals, they may not be aware of their own negative personalities. Indeed, they may not be aware of their impact on the people around them. They might defend their negativity by arguing that they are attacking ideas, and through dialog and debate, these ideas get better. Ridiculous. Chronically negative people can only defend themselves for so long. Eventually, their attacks become personal. Some have dubbed these people “negatrons.” What they do is destructive. What do people do with “negatrons”? They stay away from them. Negatrons douse enthusiasm, kill creativity, discourage teamwork, and sometimes stop any and all positive progress. Yes, there is certainly room for some negativity in all of us. But perpetual negativism is counterproductive, and not healthy.
What we need in healthcare are optimists! Optimists encourage patients to heal. They encourage dialog, entertain new ideas, find new approaches to improve care, and ways to constructively and positively provide feedback. For the sake of our patients and each other, we need to encourage teamwork. The most effective team members want feedback. They want to know how to get better, much like elite athletes with great coaches. This translates the need to be open-minded and embrace feedback. Ironically, most of us get defensive when someone tells us that something we are doing is not right and could be improved. Feedback is essential to ongoing improvement. Negativity and criticism, on the other hand, are not the same as feedback. Feedback provides a positive path to improvement. It is most definitely intended to help.
So what can you do if you are the perpetual pessimist and criticizer? The good news is negatrons can be rehabilitated. It requires a certain discipline and a willingness to change. When you are ready to pounce with something negative, stop and think.
Step 1. Commit to finding something positive. Make sure you understand what is being said. The first thing you say must be positive and supportive. People will engage in a discussion when they believe you are trying to be helpful. They are also far more likely to at least listen to what you have to say and not just “turn you off.”
Step 2. Reframe your negative critique as a question. Instead of saying, “This will never work,” reframe your comment as something like, “Do you think there are scenarios where this might not work?” Your feedback (aka comments intended to help improve a process) will be received as constructive.
Step 3. Thank your colleague for keeping an open mind to your concerns!
It is really simple. When you catch yourself being negative, reframe what you’re saying. You can train yourself to be positive in all you do in life, and when you do, your attitude about life will become positive too. Try it.
A successful man is one who can lay a firm foundation with the bricks others have thrown at him.
—David Brinkley
Creative minds have always been known to survive any kind of bad training.
—Anna Freud
The way positive reinforcement is carried out is more important than the amount.
—B.F. Skinner
Steven L. Strongwater, MD
CEO, Stony Brook University Hospital
Patients First—World-Class Processes—Teamwork—Growth—Use Resources Wisely
