July 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, M.D. 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.
July 2008
A quote from a recent patient satisfaction survey... "I would drive a million miles ...just to come here. The nurses were so good in every department...they were definitely the best of any hospital I had surgery in."
If you have ever been an admitted patient, recovered from anesthesia or been treated in an Emergency Room, you know that nurses are the ones who are at your bedside. Nurses spend time and talk with you, interpreting the language and customs of medicine; nurses touch patients both physically and in a metaphorical sense; they are an essential link in patient healing. Stony Brook University Medical Center is fortunate to have such highly skilled and compassionate nurses. We could not live without them! Congratulations to you all.
As I reflect on how special our nursing staff is, I cannot help but think of the large network of people and systems that support Nursing, all of which must work in synchrony. When Nursing is valued, there is an implicit vote of confidence in the entire team assembled at Stony Brook, including many physicians, pharmacists, technicians, transporters, imaging staff, therapists and many others, who directly or indirectly enable care. So, as patient satisfaction scores rise, take pride in all of your efforts. Well done Stony Brook!
STONY BROOK PRIDE
NSHC Recognizes SBUMC with Inaugural Excellence in Patient Safety Award. The Nassau-Suffolk Hospital Council selected Stony Brook University Medical Center to receive its inaugural "Excellence in Patient Safety Award," recognizing Stony Brook's distinguished achievements in patient safety and quality improvement in decreasing sepsis mortality. The award was presented to SBUMC at the NSHC annual meeting for its program: "Increasing Detection and Standardizing Care for the Treatment of Severe Sepsis."
SBUMC engaged in the "Surviving Sepsis Campaign," via the Institute for Healthcare Improvement's (IHI) Critical Care and High-Risk Patients Learning Collaborative. The Medical Center adopted and exceeded the campaign's goal of a 25 percent reduction in mortality, experiencing a 33.7 percent reduction in the severe sepsis mortality rate when comparing patients admitted with this condition through the Emergency Department in 2007 versus 2006. At the same time, there was a 16.6 percent increase in compliance with the sepsis resuscitation bundle (a group of immediate diagnostic and treatment measures endorsed by the Society for Critical Care Medicine) and an 18.9 percent decrease in the average length of stay for such patients admitted through the Emergency Department. Length of stay reductions resulted in an estimated $3,500-$8,500 cost per patient savings.
Honorable Mention
In addition, SBUMC received an honorable mention for the same award for its initiative entitled, "Reducing Complications in the Neonatal Intensive Care Unit by Optimizing Nutrition and Growth" which showed substantial improvement in head and body growth and improved time to oral feeding among our smallest infants weighing less than 1500 grams at birth.
These accomplishments demonstrate the powerful impact of Teamwork among the medical staff, nursing, respiratory therapy, other clinicians and quality management staff.
SBUMC in the Top 10 Percentile for HANYS 2008 Pinnacle Award. Plaques were awarded to Dr. Strongwater at the Annual Meeting of the Hospital Association of New York State (HANYS) in June for achievement in the areas of "Reducing Complications in the Neonatal Intensive Care Unit by Optimizing Nutrition and Growth," and for "Increasing Detection and Standardizing Care for the Treatment of Severe Sepsis,." HANYS received 133 qualified nominations this year and SBUMC submissions demonstrate excellence in the execution and management of quality and safety performance. Our achievements will be highlighted in the 2008 HANYS' Profiles in Quality Improvement and Patient Safety, which will be distributed and posted on HANYS' web site in the fall.
SBUMC Wins Recognition for Blood Donations by the Red Cross. The 24 not-for-profit and public hospitals on Long Island were honored as "Partners in Preparedness" by the Red Cross of Nassau County at its Annual Gala on May 28. The hospitals were recognized. SBUMC, in particular, was recognized for staff blood donations over the past year.
UHC Selects SBUMC Poster for Presentation at National Fall Forum. Stony Brook University Medical Center received a coveted poster slot at the University HealthSystem Consortium's (UHC) Annual Quality and Safety Fall Forum. The poster presentation entitled, "Using a Wide Range of Reports Based on the UHC Core Measure Database to Drive Accountability at Stony Brook University Medical Center,"was selected as one of only 30 posters for presentation at the conference.
Allen Jeremias Patient Testimonial Featured in J&J's Annual Report. Congratulations to Dr. Allen Jeremias, Director of Vascular Medicine and Peripheral Intervention in the Heart Center, who brought significant attention to SBUMC when he was featured in Johnson & Johnson's 2007 Annual Shareholder Report. The feature highlighted in the form of a testimonial Dr. Jeremias' use of two new state-of-the art Cordis devices to successfully remove what had previously proven to be intractable chronic total occlusions (CTO) from a young patient's legs. Using the "Frontrunner" which facilitates placement of a guidewire to cross a CTO and the "Outback" catheter which is used to restore blood flow, Dr. Jeremias was able to successfully remove the CTOs and restore blood flow in both legs. The testimonial can be found on pages 22 and 23 of the online version of the annual report - go to: http://files.shareholder.com/downloads/JNJ/284599764x0x171267/057640F8-B2C0-4B0F-9F54-7A24A553C3CE/2007AR.pdf. The case was also presented on video at J&J's annual shareholder meeting in March.
Smadar Kort Receives Multiple Appointments with Prestigious Society
Dr. Smadar Kort, Director of Non-Invasive Cardiology, Cardiovascular Imaging and Echocardiography, was recently nominated to the Board of the American Society of Echocardiography (ASE) for which she will serve as leader for its activities and initiatives relating to public education. As such, Dr. Kort is one of only a handful of board members designated by the ASE President to lead one of the society's six strategic goals. ASE is the largest subspecialty society in cardiology with over 14,000 members in the U.S. and internationally.
Edmund Hayes, PharmD, Assistant Director of Pharmacy Elected to the Board of Directors of the American Heart Association Long Island Region. Edmund Hayes, PharmD, has been elected to the Board of Directors of the American Heart Association Long Island Region as the first Pharmacist ever to have this privilege nationally! This is a tribute to Ed's skills and a credit to SBUMC. Congratulations.
Going Green: People, Profit and our Planet. "Going Green/Respecting Our Environment" has been formally added to SBUMC's strategic plan. So, SBUMC is Going Green. It is the right thing to do for the people who work here, for fiscal expediency (going green can save money) and for planet Earth. What can you do to support this effort? Lots of things. You can request reduced product packaging when ordering supplies; you can use products from recycled materials or products that can be recycled; you can avoid unnecessary printing and make double-sided copies when possible. You should also recycle cans and bottles, reduce energy consumption by shutting down or hibernating your computer when not using it, turn off lights when you leave your office or work area, use silverware when dining in the Market Place Cafe grab to reduce use of plastic, have your morning coffee in a refillable mug and, in by doing so, reduce our solid waste stream. The key to going green is to reduce, reuse and recycle whenever possible. Together, we can reduce our environmental impact by making environmentally protective choices.
PATIENT SATISFACTION
Patient and Family Centered Care Launched (PFCC). A visit by three experts from the Medical College of Georgia on June 12 signaled the official launch of the Patient and Family Centered Care model at Stony Brook University Medical Center. Patricia Sodomka, Roslyn Marshall, and Dr. Curt Steinhart spent the day sharing information about the whys and hows of including patients and families in all aspects of patient care and decision making. Several hundred members of the Medical Center's staff attended the two grand rounds sessions, and small groups of staff met with our guests in focused break-out sessions throughout the day. The patient and family centered care model is based on four core concepts: Dignity and Respect, Information Sharing, Participation, and Collaboration. The implementation at Stony Brook is being led by Dr. Lee Xippolitos and Dr. Thomas Biancaniello, assisted by Michael McClain.
Real Time Patient Satisfaction Survey Results. A new process is now in place for securing patient satisfaction comments in real time for services provided in the Emergency Department, the Center for Outpatient Services, Oncology and Ambulatory Surgery. The new process makes it easier for us to improve because it provides weekly distribution of comments to managers sorted by unit/department so they can be responded to in a timely manner
Patient Orientation Videos. Production is underway on a series of patient orientation videos that will air on the hospital's internal patient education channel. These short videos will explain what to expect while in the hospital and communicate important information including how to order meals, telephone and television service options, and visiting hours, among other helpful highlights.
Patient Rounding a Best Practice. Three inpatient units are piloting hourly patient rounding, a best practice highlighted in a recent Press Ganey webinar. The units, 15 North, 15 South and MR North began the pilot at the beginning of the month; the chief expectation for this program is that it will increase patient satisfaction, improve patient safety and reduce the incidence of call bells.
Improving Family Communications Using "CaringBridge." CaringBridge is a not-for-profit web service that connects family and friends during a critical illness, treatment or recovery. A CaringBridge website is personal, private and available 24/7. It helps ease the burden of keeping family and friends informed. Patients and caregivers draw strength from loved ones' messages of support. At SBUMC, we insert Caring Bridge brochures into Patient Amenity Kits, and Concierge Services make laptop computers available to inpatients to facilitate using CaringBridge. For more information go to http://www.caringbridge.org/.
PATIENT SAFETY
Inpatient Safety Hotline in Place. To solicit feedback from our patients and staff regarding patient safety issues, SBUMC has put in place a "Patient Safety Hotline." This is a phone mailbox that records patient safety suggestions which will be brought to the Patient Safety Committee for follow up. Anyone with a safety concern should call 44I-CARE (444-2273).
Patient Safety Walk Rounds Underway. Survey Work Action Teams (SWAT) led by Dr. Joseph DeCristofaro and Carolyn Santora have begun "walk rounds" to solicit patient and staff input regarding patient safety. Many great ideas have come from the staff already, such as programming the Patient Education Channel as the default station that comes on when a patient television is turned on. In addition, a TV brochure has been produced and will be distributed in Patient Amenity Kits. Thanks to Ken Piorun, Sabra Bouhgton, Kathy Holzmacher and crew, Bob Kirincic, and Kevin Lorio and crew, Joanne Moreau, Steve Weisman and Kathy Werther.
Medication Reconciliation Transfer Pilot to be Implemented in July. As a bridge to
Computerized Order Entry, a new medication reconciliation process is being tailored for
patients transferred from one unit to another. A new transfer medication reconciliation form will function as an order sheet and is intended to streamline and provide "forced function" so that medication reconciliation is addressed by both nursing and medical staff to ensure safety on transfer.
SICU Celebrates Institute for Healthcare Improvement (IHI) Gains. May 2008 marks the second consecutive month without ventilator associated pneumonia (VAP) in the Surgical Intensive Care Unit (SICU) and the third month since January. In addition, there were no central line-related bloodstream infections (CLBSI) in May 2008. This is the second month in a row with a rate of zero, with only two central line-related bloodstream infections identified during the prior seven months, bringing us to a total of five CLBSI FREE months, since November '07.Systematic deployment of VAP and central line bundles really can make a difference for our patients.
New FMEA Prepares for ED Systems and ED Relocation. Whenever new processes are implemented, it is useful to conduct a failure mode and effect analysis (FMEA) before change occurs to understand potential risks and plan ahead to mitigate failure modes. Since the Emergency Department will be undertaking an electronic triage process and also moving to a new space, it was determined that a FMEA will be conducted to flowchart the new process within the context of the new space and identify potential failure modes so that risk reduction strategies can be implemented.
On the Road to Becoming an HRO. As part of the journey to become a HRO, the CCU has not had a mislabeled specimen reported since instituting several process changes related to specimen collection. The process includes bringing all materials into the room and labeling the specimen in the presence of the patient (National Patient Safety Goal #1). Good job!
Baldrige Journey Continues. Earlier this month, senior leaders from SSM Healthcare, a Baldrige award winner in 2002, provided a well-attended administrative grand rounds to share their Baldrige journey. They met with the Clinical Chairs to share how physicians can become engaged in the processes relevant to leadership, strategic planning, workforce engagement, measurement and process management.
A Baldrige Retreat was recently held with the Senior Executive Group and Baldrige Workgroup Team Leaders to discuss progress with the organization's self-assessment against the Baldrige criteria. After the gap analysis is completed by the end of the month, the next step is to begin writing a draft application and coordinate the effort to capture outcomes and results that tell the SBUMC story. We will also begin to draft action plans to address the gaps found during the self-assessment process. Remember, it's not about winning the award, but about continual improvement to become a world class organization.
COMMUNITY CONNECTIONS
Coming Soon: 3rd Annual Kids Health & Safety Expo: On Wednesday, July 9 from 10am to 3pm, SBUH will host its 3rd annual Kids Health & Safety Expo at Flowerfield in St. James. The free event provides a fun and educational opportunity for parents and children to learn tips on how to stay safe during the summer months and year round. In addition to interactive exhibits, there will be face painting, performances by the Silly Magician (our own Michael Maione), and other entertainment.
Save the Date: Sept. 25, Hospital Auxiliary Gala. The planning for an exciting evening together that includes a "moveable feast" and a spectacular silent auction is underway by the Hospital Auxiliary and Gala committee for September 25, 2008. Please join me in supporting this year's Gala as we honor the Heart Center and give special recognition to Dr. Richard N. Fine, Dean of the School of Medicine. The Auxiliary works tirelessly to support SBUMC and to date has donated $6 million dollars to programs, special initiatives and equipment. Whether through your attendance or sponsorship, we should all support the Auxiliary by participating in the festivities. For ticket or information on sponsorship opportunities contact Jennifer Desposito at 444-3956.
Mission Vision and Values Statement Rollout. The formal roll out of the new mission vision and values statements is going to occur in July, beginning at the July 3 Department Head meeting. A mission, vision, and values learning kit has been prepared by our Corporate Education and Training Department for use in all hospital departments and will be distributed at this meeting. There will also be many reminders posted throughout the hospital of the new statements. It is a Joint Commission requirement that our staff be familiar with the institution's mission, vision and values. Please make sure that you participate in this important educational effort and understand how you contribute to Stony Brook's mission and achieving our vision of being a world-class medical center.
Sixth Annual Sunrise Fund Walk Held to Benefit Pediatric Oncology Program.
Students at the Mount Elementary School, along with students and faculty from SBUMC walked 1.5 miles on June 1 to benefit the Pediatric Oncology Fund. The event raised more than $14,000 and was part of a "Children Helping Children" Campaign for the Sunrise Fund (http://www.sunrisefund.org/), which supports the Division of Pediatric Hematology/Oncology at SBUMC. Thank you to all the walkers!
Employee Wellness Program. Employee Health Services is scheduled to move to its new location in late July. Employee Health is currently planning a hospital-wide Wellness Program which will include an American Heart Association "Start Walking" campaign, personalized health and nutrition education, exciting wellness incentive rewards programs, lectures and much more. In keeping with evidence based research, we are also developing a Tranquility Waiting Room for our new location. Studies have shown that just 3 to 5 minutes in a naturalistic setting will decrease stress, reduce anger and increase a feeling of well being. Our goal is to promote, encourage and maintain the mental and physical health of our employees.
Cancer Survivors Day Celebration. On June 1, SBUMC hosted a celebration of life, for cancer survivors, the fourth annual celebration of National Cancer Survivors Day. Former patients were excited to see their doctors and nurses for a different kind of "treatment," one of celebration! It was also great to see the Outpatient Cancer Center used for such a wonderful occasion. This year's event featured live music from "Practicing Without a License," a band of players who have a day job - they are all practicing physicians at SBUMC. Also new for children was a disc jockey-led scavenger hunt. The Setauket Fire Department supplied a pumper for children to play with a fire hose. My thanks to all - especially Cynthia Lombardo and Linda Bily for their leadership.
29th Annual Medical Staff Meeting a Success. On June 2, approximately 150 medical staff attended the 29th Annual SBUMC Medical Staff Meeting. A review of the past year's activities, ranging from the Major Modernization Project to advances in patient safety was presented as were plans for the future. Dr. Ken Rosenfeld was elected President of the Medical Board; Todd Griffin was elected Vice President, Robert Mormando was elected Treasurer/Secretary. Chairs elected to the Medical Executive Committee include Mark Henry, Margaret McGovern, John Ricotta and Kenneth Shroyer. Members at large elected include John Dervan ,William Wertheim, Latha Chandran. Drs. Dervan and Wertheim were also elected to serve on the MEC.
CTICU Renovations Completed. The Cardiothoracic Service faculty and staff are extremely proud and excited about the renovations of the Cardiothoracic Intensive Care Unit (CTICU). New lighting, colors and design make this unit a more peaceful area to recuperate/heal and for the faculty and staff to work. The feedback from family members has been positive. All the rooms were updated with the latest bedside equipment and flat panel monitors. The rooms were also reconfigured to take advantage of natural lighting. Many thanks to Dr. Rosengart, Judy Stefano, RN, Peg Duffy, RN and the CTICU staff for their input and support. Many thanks to the physical plant for creative design and quality work.
Starlight Starbright Children's Foundation to Fund Fish Tank. In response to a grant submitted by the Child Life Program, the Starlight Starbright Children's Foundation has made a donation of $37,000 to purchase a salt water fish tank to be enjoyed by patient visitors in the pediatric waiting area.
Development Council Hosts Cultivation Reception. The SBUMC Development Council, along with Drs. Fine and Strongwater, hosted its first cultivation reception on June 3 at the Center for Outpatient Services. The evening, entitled "Journey to World-Class Healthcare," featured presentations by Dr. Bhalla, Dr. Savatic and Dr. Woo. Guests were impressed with the innovative techniques, interventions and groundbreaking research that help to make Stony Brook the hospital of choice for Long Island's most challenging cases. Several guests expressed interest in becoming more involved with our needs and working directly with us to promote the SBUMC message further throughout our community.
SBUMC Introduced at Elements Magazine Party. Dr. Strongwater and Development Council members recently attended the Elements Magazine 5th Anniversary Party. Scott Neher, Development Council member and publisher of Elements Magazine, recognized SBUMC during his remarks. In addition, Dr. Strongwater was asked to address the hundreds in attendance, many of whom expressed personal interest in learning more about opportunities for supporting needs within SBUMC
Community Physician Forum on Getting Connected to SBUMC Systems. Community physicians have been invited to a special Town Hall Meeting on Monday, June 30 at 6 pm in the Hospital's Market Place Café Dining Room for a presentation by CIO, Linda Shanley, to learn about the Medical Center's electronic patient records - the latest information technology available to community physicians and what is on the horizon. All are welcome to extend this invitation to office staff who will use these applications. For more information or to register call Debbie Lang at 631.335.2239 or e-mail debra.lang@sunysb.edu.
LAST TOUCH
Change. Change can mean a lot of things. Not the kind of change you get when you buy something, but the kind of change that alters your world. Some changes are small and seemingly inconsequential, like having to drive out of your way to avoid traffic. Other changes are much more significant. What trips the threshold to count as a big change?
I have struggled with the question of big change for years. Almost no two days are alike, so change is constant. Is it the scale of change; the number of changes? I am not so sure. Sometimes a single change of sufficient magnitude tips the balance. Perhaps, change within a certain "zone" is fine, but once you leave that comfort zone, change is frightening, destabilizing and stressful.
I like the expression "all change is good, unless it affects me." Said differently: "Let the world change around me, but leave me alone...I have enough stress in my life; leave me in my comfort zone."
Change can be motivating or immobilizing. Too much change is simply overwhelming. Paralyzing. We have all reached this point, where you just have to stop and gather yourself up before moving on. On the other hand, many changes are good and invigorating: the birth of a child, a promotion, a vacation, you can think of many positive changes. Is there a way to embrace change in such a way that it moves from overwhelming to exciting; to face change as a challenge, much as an explorer discovering new lands? The answer is, there has to be or as a civilization, we could not have progressed to where we are today.
How do you do it?
The first step is to "read" your body's signals. Your body knows when it is stressed. Your pulse races, you may perspire. Sometimes you get headaches. Sometimes you need more sleep. It is critical you recognize you are in the midst of major change and moving out of your comfort zone. The next step is to peel back the onion or tease apart the layers causing change(s). You then have to pose the question of whether this change, under any scenario, can be good. Said otherwise, can change create a platform of opportunity for something far better?
When you move to a zone of envisioning a positive future as a result of this change, your stress will greatly diminish. The hardest step is entertaining the "art of the possible." Talking it out with someone, as a sounding board may help. Remember...
"Chance favors the prepared mind."
- Louis Pasteur
Why think about change in the context of work? Healthcare, in many ways, is constantly changing; new medications, new diagnostic modalities, new technology, etc. Perhaps the single biggest change we face in the near term will be the computerization of everything we do (the electronic medical record[EMR] and provider order entry). Just as the ATM has revolutionized banking, the EMR will revolutionize what we do. Will this be a change? Absolutely! Will it be stressful? Perhaps, but it doesn't't have to be. You can peel back the onion, and imagine the art of the possible. The EMR will make care safer, enhance communication, make data more readily available, allow us to put bigger pieces of a puzzle together, and much more.
A common reaction to change is to resist it. To hold on to what is comfortable. On the other hand, some changes are inevitable. Be an explorer. Engage in the excitement of change. Enjoy the journey....
Steven L. Strongwater, MD
Chief Executive Officer
Stony Brook University Hospital
Patients first-World class processes-Teamwork-Growth-Use resources wisely
