March Message from Steven L. Strongwater MD, CEO

Wouldn't you agree there has been a lot of discussion about healthcare reform? It is not a new topic. For nearly 15 years, I have been lecturing to graduate and medical students about this very topic. It has been one of the top three issues in American politics for the last five presidential elections (sometimes being nudged out as the top priority by the economy or war).

The healthcare reform debate began in the tumultuous 1960s when two important social commitments became embedded in our political psyche: Medicare and Medicaid. Medicare is the federal program that provides healthcare to the elderly, and for some specialized programs such as kidney dialysis. Medicaid is a state designed healthcare program for the poor that is dually funded by state and federal taxes. The amount of the federal match varies by state. Why is this important? How does it affect you and me? The short answer is, we are the largest payer for healthcare! Through our taxes, we fund nearly half of all healthcare provided in this country. The other half comes from the private sector-employer purchased commercial healthcare insurance.

There are common misperceptions about Medicaid. For instance, Medicaid is not only for the poor. Children are eligible for Medicaid, and so are employed people who earn below a proportion of the federal poverty level. Medicaid also pays for the indigent elderly who are forced to live in nursing homes.

As an academic medical center (AMC), Stony Brook University Medical Center must follow this debate carefully, because a significant portion of our funding also comes from the government through the vehicles of Medicare and Medicaid. AMCs are different than community hospitals. AMCs fuse together the provision of highly complex care with education (training the next generation of providers: physicians, nurses, therapists, social workers, dentists) and research (developing cures for disease, working in the laboratory and then transferring discoveries to the bedside and the community). One focus of AMCs is on developing and deploying highly complex technologies to improve care, especially technologies not available elsewhere, like bone marrow transplantation for patients with cancer, robot-assisted heart surgery, the use of stem cells to replace skin in burn victims, or the provision of high-risk obstetrics and advanced neonatal intensive care. AMCs also provide "capacity" within a community, by serving as safety net providers for the poor and uninsured and by caring for transfer patients deemed too sick to be treated in a community hospital. AMCs like Stony Brook University Medical Center have higher staffing needs (more intensive care unit beds, more staff per bed, and more around-the-clock services) and hence higher costs (and often more expensive intensive technology).

 This part of the delivery system is needed for every community in the nation. Medical discoveries made in AMCs, such as antibiotics to treat infections that previously required hospitalization and imaging modalities for treatment that previously required surgery, drive down healthcare costs and extend the duration and the quality of life. Many more discoveries, such as personalized medicine through genetic profiling to tailor the use of medications like chemotherapy for cancer, are on their way.

 As a nation, we must face the economic reality that we cannot continue to spend as we have over the past several years. We must make choices. War or healthcare? Research or prisons? Housing or police? Teachers or TSA agents? These may not be the specific options for today's debate, but policymakers will have to make decisions on how to allocate funds. Key portions of AMC budgets are funded by Medicare, Medicaid, and governmental support. AMCs provide a societal good and assure the quality of life in many communities. We hope our legislators and policymakers understand these issues as they struggle in allocating scarce resources. And we ask for your support when these debates come up. Thank you for helping preserve the quality of life in Suffolk County.

STONY BROOK PRIDE
Urgent Matters invites SBUMC to discuss HealthGrades recognition. Dr. William Greene was invited by Urgent Matters to share information about SBUMC's best practices that led to the recognition by HealthGrades as a 2009 Distinguished Hospital for Clinical Excellence. Urgent Matters is a national initiative funded by the Robert Wood Johnson Foundation and is dedicated to finding, developing, and delivering strategies to improve patient flow and reduce Emergency Department (ED) overcrowding. Urgent Matters highlights patient flow best practices through its educational communications and activities including e-newsletters, web seminars, and regional conferences. SBUMC is participating in the organization's ten-hospital collaborative Learning Network.

SBUMC reduces door-to-balloon time to an all-time record low. In the third quarter of 2008, SBUMC demonstrated its lowest median time to percutaneous coronary intervention (PCI) at 69 minutes (the standard is to allow no more than 90 minutes elapse from the time of a heart attack to the insertion of stent). The Emergency Department Door-to-Balloon CQI Team is continuously striving to shave minutes off the time it takes to bring our heart attack victims to the Cardiac Cath Lab. Through the collaborative efforts of all staff along the continuum of care required for these complex patients, including Emergency Medical Services, the Emergency Department, Cardiac ICU, and the Cath Lab, we have been able to render this lifesaving treatment sooner and preserve cardiac muscle. Great teamwork while placing patients first using world-class processes!

SBUMC to participate in the Urgent Matters Learning Network II. Urgent Matters is a Robert Wood Johnson Foundation program in collaboration with the U.S. Agency for Healthcare Research and Quality. SBUMC’s selection recognizes our commitment to increasing access to high quality healthcare by improving hospital and Emergency Department patient flow. Over the next 18 months, the Urgent Matters Team will work closely with Eileen Dowdy, RN, Eric Niegelberg, Administrative Director for Emergency Services, and other Medical Center staff on this important project, the success of which will result in numerous benefits, among them better patient outcomes, and increased patient, physician, and staff satisfaction.

 There are common misperceptions about Medicaid. For instance, Medicaid is not only for the poor. Children are eligible for Medicaid, and so are employed people who earn below a proportion of the federal poverty level. Medicaid also pays for the indigent elderly who are forced to live in nursing homes.

 As an academic medical center (AMC), Stony Brook University Medical Center must follow this debate carefully, because a significant portion of our funding also comes from the government through the vehicles of Medicare and Medicaid. AMCs are different than community hospitals. AMCs fuse together the provision of highly complex care with education (training the next generation of providers: physicians, nurses, therapists, social workers, dentists) and research (developing cures for disease, working in the laboratory and then transferring discoveries to the bedside and the community). One focus of AMCs is on developing and deploying highly complex technologies to improve care, especially technologies not available elsewhere, like bone marrow transplantation for patients with cancer, robot-assisted heart surgery, the use of stem cells to replace skin in burn victims, or the provision of high-risk obstetrics and advanced neonatal intensive care. AMCs also provide "capacity" within a community, by serving as safety net providers for the poor and uninsured and by caring for transfer patients deemed too sick to be treated in a community hospital. AMCs like Stony Brook University Medical Center have higher staffing needs (more intensive care unit beds, more staff per bed, and more around-the-clock services) and hence higher costs (and often more expensive intensive technology).

 This part of the delivery system is needed for every community in the nation. Medical discoveries made in AMCs, such as antibiotics to treat infections that previously required hospitalization and imaging modalities for treatment that previously required surgery, drive down healthcare costs and extend the duration and the quality of life. Many more discoveries, such as personalized medicine through genetic profiling to tailor the use of medications like chemotherapy for cancer, are on their way.

 As a nation, we must face the economic reality that we cannot continue to spend as we have over the past several years. We must make choices. War or healthcare? Research or prisons? Housing or police? Teachers or TSA agents? These may not be the specific options for today's debate, but policymakers will have to make decisions on how to allocate funds. Key portions of AMC budgets are funded by Medicare, Medicaid, and governmental support. AMCs provide a societal good and assure the quality of life in many communities. We hope our legislators and policymakers understand these issues as they struggle in allocating scarce resources. And we ask for your support when these debates come up. Thank you for helping preserve the quality of life in Suffolk County.

SBUMC invited by the Institute for Healthcare Improvement (IHI) to share success on Web. The IHI contacted SBUMC to share its successes on its ihi.org Web site. Particularly, we were asked to share our improvements with decreasing sepsis mortality and hospital-acquired infections. IHI also asked SBUMC to share its efforts and outcomes with the sepsis management bundle on IHI Open School, which is a web-based educational program designed for healthcare professionals.

American Hospital Association invites SBUMC to share improved sepsis outcomes. SBUMC was asked to contribute to the American Hospital Association's guide "Hospitals in Pursuit of Excellence." The American Hospital Association (AHA) collected 29 case studies in four different areas: hospital-acquired infections, medication management, patient throughput, and patient safety. Chris McMullan, CQI, was asked to write a case study detailing our success in decreasing severe sepsis mortality. The guide will be posted on AH's Web site this coming spring.

 SBUMC Cancer Program accredited with commendation! SBUMC's Cancer Program received a full three-year reaccreditation with commendation in all categories for which commendation is available from the American College of Surgeons Commission on Cancer (ACOS COC). This followed a site visit survey in December. SBUMC is now eligible for the ACOS COC Outstanding Achievement Award. Awardees will be notified between March and June 2009. Congratulations to the Cancer Committee, especially Dr. Theodore Gabig (Chair), Rose Cardin (Administrator), and Vencine Kelly, who led the preparation for the site visit.

Radiation Oncology residency program receives full accreditation. SBUMC's Radiation Oncology Medical Physics Residency Program is now one of only a handful of programs in the United States to receive full accreditation from the internationally recognized American Radiology Commission on Accreditation of Medical Physics Educational Programs (CAMPEP). The Commission is incorporated with joint sponsorship from the American Association of Physicists in Medicine, the American College of Radiology, the College of Medical Physics, and the Canadian College of Physicists in Medicine. Accreditation has been granted through the end of 2013.

University HealthSystem Consortium (UHC) accepts SBUMC presentation. The Cardiac Intensive Care Unit embarked on a journey to utilize high reliability principles, which will serve as an institution-wide pilot to become error-free over time. Due to the commitment and dedication of the CICU staff, several improvements were realized. To share our success with this initiative, Lisa Sokoloff and Dr. William Greene made a presentation titled, "Risk and Quality: Do You Know the Road to HRO?," at the UHC's Quality and Risk Management Council meeting held in San Antonio in February. Dr. Greene also spoke on this topic and shared a summary of our experience with UHC's 24/7 Benchmarking initiative.

 Patient- and Family-Centered Care (PFCC) poster selected for national and international presentations. Dr. Lee Xippolitos, Chief Nursing Officer, will present "Leading Change: An Institutional Commitment to Patient- and Family-Centered Care" at the 24th Quadrennial Congress of the International Nurses Council Congress in June. This presentation will be one of 70 symposia, 490 concurrent session presentations, and 800 posters providing a global view on present health systems. Dr. Xippolitos is proud to be one of 140 American nurses who will present their work. Additionally, a poster titled, "An Academic Medical Center's Commitment to Organizational Redesign: Patient- and Family-Centered Care," submitted by Dr. Xippolitos and Roseanna Ryan, Coordinator of PFCC, will be presented at the 4th International Conference on Patient and Family-Centered Care: Partnerships for Enhancing Quality and Safety in August. The poster was selected from among nearly 400 abstract submissions.

CACU poster accepted for UHC 2009 Performance Excellence Forum. The poster by Cardiac Acute Care Unit nursing leadership titled, "A Fall Prevention Program-How a Cardiac Step-Down Unit Refused to Fall for It Anymore," will be presented at the Forum to be held on March 8. A falls reduction program was initiated in 2008 resulting in a 66 percent decrease in the fall rate from 2007. Some elements of the program include use of bed and chair exit alarms, patient involvement, staff involvement through the implementation of "Days/Nights Without a Fall" program, and daily auditing by leadership.

SBUMC Nursing Department to present at Education Conference. Four posters will be presented at the National Association for Healthcare Quality (NAHQ) 34th Annual Education Conference in September by the Department of Quality and Outcomes Management. The posters and their primary authors are as follows: "The Impact of Maintaining Normothermia in the Orthopaedic Patient" (part two of the 2008 poster presentation, which won third place at last year's conference) by Jean Mueller, RN; "Correlation Between the Frequency of Vital Signs and Missed Opportunities for Early Intervention and RRTs" by Nancy Avino, RN; "Nursing Fellowship in Quality and Patient Safety: Enhancing the Role Bedside Nurses Play in Quality Improvement" and "One Academic Medical Center's Approach to Effective Medication Reconciliation at the Point of Transfer" by Karin Ganetis, RN.

Baldrige retreat brings SBUMC closer to application submission in May. The Baldrige Journey continues! Hospital leadership met in February to prioritize action plans that were developed by Category Workgroups. These action plans were created to address opportunities for improvement relating to the Baldrige Health Care Criteria, and were categorized by each of the Hospital's four main strategic objectives: 1) demonstrate superior quality by becoming a high reliability organization; 2) stabilize and expand patient referral base; 3) be a great place to work in the eyes of the employees; and 4) stay vital for the long haul. The workgroups are in the process of completing a third draft of the application, which will be finalized in April.

Grant supports leading-edge research. The National Cancer Institute has awarded a $310,454 grant for colon cancer cause and prevention research led by Dr. Basil Rigas, Professor and Director of Stony Brook's Center for Cancer Prevention Using Wireless Technology. Congressman Tim Bishop announced the award, which supports innovative research. The research involves a tiny state-of-the-art device, made possible by federally funded research through the Department of Defense, consisting of a nanosensor that evaluates cancer markers and is comprised of a compartment loaded with anticancer drugs and a wireless transmission component. When implanted in the body of patients at high risk for cancer, it will periodically assess tumor markers and, if needed, it will release the anticancer drug to eliminate the developing tumor.

Regional Perinatal Center receives DOH award. The New York State Department of Health has awarded more than $193,000 to help support services provided by SBUMC's Regional Perinatal Center. The award is for one year beginning April 1, 2009.

School of Dental Medicine welcomes new Dean. Internationally known researcher and educator in dental medicine, Ray C. Williams, DMD, has been named Dean of the Stony Brook University School of Dental Medicine. Appointed by Stony Brook University President, Shirley Strum Kenny, Dr. Williams will oversee the educational, clinical, and research components of the School. The School of Dental Medicine is of key importance to Stony Brook's academic and research programs as well as our mission of excellent healthcare for Long Island. The appointment of Dr. Williams helps assure a great future for the School.

 New appointment in the Department of Pathology. Meenakshi Singh, MD, was appointed Vice Chair of Anatomic Pathology and Visiting Professor of Pathology. Dr. Singh is a board certified pathologist with over 20 years of experience in surgical pathology and cytopathology. Dr. Singh is the recipient of numerous honors and awards, many of them for teaching, and the author of 70 peer-reviewed publications, book chapters, and online atlases in her field. She has been invited as a lecturer nationally and abroad. Her research interests include gynecologic oncology, breast oncology, and biomarkers of cancer.

 Pediatrics welcomes Dr. Aschettino-Manevitz. The Department of Pediatrics announced the appointment of Diana L. Aschettino-Manevitz, MD, MA, as Assistant Professor of Clinical Pediatrics in the Division of Adolescent Medicine. She is board certified in pediatrics and joined Stony Brook Children's Service in August 2008. Dr. Aschettino-Manevitz' expertise includes adolescent primary care, adolescent gynecology, eating disorders, weight management issues, and adolescent mental health issues. Her areas of interests and future research include endocrine issues related to eating disorders, adolescent self-esteem issues, adolescent weight management issues, medical school curriculum and program development for community prevention, and parent education programs.

PATIENT SAFETY
Cardiac Intensive Care Unit celebrates one year of high reliability. As part of ongoing efforts to become a High Reliability Organization (HRO), the Cardiac Intensive Care Unit just passed the one-year mark without any falls occurring in the Unit. In addition, in the past year, the Unit has experienced no catheter-associated bloodstream infections and no medication errors. Also, patient mortality rate has been reduced by greater than 20 percent over the last year since establishing the HRO Continuous Quality Improvement (CQI) Team. Congratulations to the members of the Cardiac Intensive Care Unit-your efforts are making a difference and saving lives!

FMEA (Failure Mode and Effect Analysis) focuses on utilizing National Provider Identifier (NPI) numbers.  A new process for assigning identification numbers to referring community doctors to order Hospital labs and other tests at SBUMC is up and running. After a team FMEA study to assess the risks associated with the use of multiple physician identifiers in a Computerized Physician Order Entry (CPOE) environment, it was established that there is a need to control and limit the entry of these numbers in order for results to be routed to the correct physician. Specially trained registrar personnel are now responsible for generating these new identification numbers using established National Provider Identifiers (NPI). This past spring, the new NPI number was required nationally as a unique identifier for healthcare providers in standardized transactions such as medical claims and electronic transactions. The SBUMC team worked diligently to ensure that all of our current providers in the system are assigned the required NPI, and paved the way for a successful CPOE launch. Special thanks to team members from Information Technology, Medical Staff Office, Registrar staff, and CQI.

FMEA efforts to be showcased at Department Head meetings. Last fall, the CQI Department provided training for all Department Heads and Nurse Managers on conducting Failure Mode and Effect Analyses (FMEA) using standardized tools. Departments were asked to identify a high-risk process and utilize the FMEA problem-solving framework to implement process changes to ultimately reduce risk and enhance patient safety. At February's Department Head meeting, Dr. William Moore presented a FMEA focused on Magnetic Resonance Imaging (MRI) safety. Led by Susan Aiello and facilitated by Pam Boremski, the team's efforts resulted in the implementation of multiple risk-reduction strategies, making it a safer process for all involved. It is anticipated that a FMEA will be presented at the monthly Department Head meetings to highlight the Hospital's efforts on the journey toward becoming a High Reliability Organization.

 Patient Safety Awareness Week (PSAW) at SBUMC. As a member of the National Patient Safety Foundation, SBUMC participates in a national education and awareness campaign for improving patient safety. During National Patient Safety Awareness Week, March 8 to 14, SBUMC will sponsor activities that promote processes to improve patient safety. A "Patient Safety Fair" will be held on Thursday, March 12, from 10:00 am to 3:00 pm, in the Hospital Lobby. All Hospital staff and members of the community are invited to learn about how to partner with their healthcare providers to enhance safety. Working with the PSAW national theme, "A Prescription for Patient Safety," the SBUMC event will feature free health screenings and educational materials and resources. We urge you to join our team and partner for your health.

SBUMC observes DVT Awareness Month in March. The Deep Vein Thrombosis (DVT) team is making significant strides throughout SBUMC in creating awareness about the risks and prevention of DVT. In observance of DVT Awareness Month, the team secured nationally known expert Dr. Anthony Comerota, Director of the Jobst Vascular Center, to conduct three separate Grand Rounds on March 25 and 26. On March 25, he will address the Department of Medicine and the Division of Nursing with lectures on "Deep Vein Thrombosis-Prevention and Treatment" and "Preventing Hospital-Acquired Venous Thromboembolism," respectively. On March 26, he will present at the Department of Surgery Grand Rounds on "Contemporary Approach in the Management of DVT."

Heart Center holds demonstration on robotic ablation for cardiac arrhythmias. The Heart Center recently hosted a demonstration of the Sensei® Robotic Catheter System for staff. Also known as the "Hansen Robot," this state-of-the-art technology is currently being used at SBUMC-the only hospital on Long Island and one of a handful of centers in the U.S. with this technology-to support our advanced ablation program for complex cardiac arrhythmias. Dr. Eric J. Rashba, Director of Electrophysiology Laboratories, who performed the first robotic ablation procedure, reports that the System has performed brilliantly and that we can anticipate improved clinical outcomes and faster procedure and recovery times.

Anaphylaxis kits will soon be available from the Pharmacy. The Medication Standardization Process Team is finalizing the details of providing a standardized anaphylaxis kit before rolling it out to identify procedural areas and outpatient clinics. SBUMC adopted the use of an evidence-based anaphylactic protocol, endorsed by the Society for Cardiovascular Angiography and Interventions (SCAI), which will be included in the kit, as well as medications and supplies necessary to begin the treatment of such a life-threatening emergency. Providing standardized anaphylaxis kits will help ensure that the healthcare team has access to a standardized set of tools for patients requiring immediate care.

 NASA astronaut/surgeon shares Crew Resource Management (CRM) techniques with SBUMC. Dr. Margaret Rhea Seddon, one of the first women trained at NASA to become an astronaut, met with several SBUMC groups to discuss the use of CRM in healthcare. Her experience as a surgeon allowed her to easily transition the use of CRM skills from the cockpit to the operating room. The aviation industry has long used CRM techniques to train teams to use specific teamwork and communication behaviors and to implement the use of safety tools, such as procedures, protocols, and checklists that complement those behaviors, to detect and trap small errors before they become serious or even fatal mistakes. Dr. Seddon's experience as a surgeon allowed her to easily transition the use of CRM skills. She shared her expertise with the Intensive Care Unit Clinical Service Group, Clinical Chairs, and representatives from the Emergency Department, Operating Room, Intensive Care Units, and OB/GYN. She also provided Administrative Grand Rounds for Department Heads and Nurse Managers. The next step is to provide additional training for selected pilot units to eventually implement CRM techniques for high-risk processes, especially those involving hand-offs and communication.

PATIENT SATISFACTION
Year-end Press Ganey survey reveals milestone achievement, helps direct improvement. Congratulations to the Imaging Center and outpatient services-the 2008 year-end Press Ganey survey reveals that outpatient services satisfaction scores improved to 90.4, the highest ever achieved for that area. This score may be attributed to the opening of the new Outpatient Center, and qualifies outpatient services as the area of greatest improvement over the past eight years. According to these Press Ganey patient satisfaction surveys, SBUMC ED scores improved slightly in the fourth quarter. Inpatient ratings were essentially unchanged in 2008, increasing a tenth of a point to 83.9. Since more than half of our inpatients are admitted from the ED, patient satisfaction scores have been helpful in directing us to focus on ways to improve ED patient satisfaction.

 SBUMC develops patient orientation videos. Production began in February on a series of patient education videos to help orient newly admitted patients to the Hospital. The vignettes, which will be about the length of television commercials, will explain how to order meals, give instruction on activating the telephone, describe the visiting policy and parking, and provide essential information to patients and their families. The vignettes are scheduled to air on SBUMC's Patient Education Channel beginning in May.

 Hospitality and Physical Plant round to improve patient satisfaction. The departments of Hospitality and Physical Plant have combined forces in an effort to improve patient satisfaction with room and meal accommodations. Focusing on issues that are often the source of patient dissatisfaction such as room temperature, housekeeping issues, and TVs and call bells in need of repair, representatives from the departments conduct rounds on patients and staff to find and fix potential problems. In addition to soliciting feedback from patients and staff, the team has been placing cards in patient rooms that provide contact information to make it easier for patients, visitors, and staff to report problems.

COMMUNITY CONNECTIONS
Advertising campaign expands to radio. On the heels of our successful print and television advertising, we have expanded our advertising campaign to include radio. Now through April 12, WALK 97.5 FM is airing 30-second radio commercials about SBUMC services. The five ads can be heard Monday through Friday, 6:00 am to 3:00 pm, and feature the areas of cardiac and stroke (seen also in print and TV ads) and introduce pediatric oncology, lung cancer, and emergency medicine.

Dr. Rosengart interviewed on WALK. For those who might have missed the airing, Dr. Todd Rosengart was a featured guest on the weekly WALK 97.5 FM talk show Island Assignment to discuss American Heart Month and describe to listeners some of the ways to prevent and treat heart disease. To listen to a podcast of the interview, visit www.walkradio.com, click on the "WALK Cares" pull-down menu, and select "Island Assignment," or click on this link: http://walkradio.com/cc-common/podcast/single_podcast.html?podcast=IslandAssignment4_2_06.xml.

Little Angel Fund Celebrates 25th Anniversary of Service. On Friday, March 6, the Little Angel Fund will celebrate its many milestones at The Watermill Caterers in Smithtown. The dinner celebration begins at 8:00 pm; tickets are $100 per person, and guests will be entertained with music, a silent auction, door prizes, Silver Anniversary Gifts and a 50/50 raffle opportunity. A long-time partner and grass roots support system for the Stony Brook's Neonatal Intensive Care Unit (NICU), the Little Angel Fund consists of a group of parents helping parents of premature infants through a difficult time in their lives. For more information, call (631) 736-2512 or visit www.littleangelfund.org.

SBUMC staff provides community health education and screenings during the month of February. SBUMC kicked off American Heart Month by participating in "National Wear Red Day" on February 6. Throughout the month, the Heart Center provided dozens of free lectures open to the public with topics ranging from "Cardiac Disease in Pregnancy" to "Valve Disease in Women." A big thank you to Carol Ruane for coordinating these educational events, and to the presenters. In addition, we were privileged to celebrate with our heart surgery patients and their families at a special Valentine's Day party and reunion on February 12. Many thanks to Danielle Gruebel for organizing this special evening. Also, many thanks to our SBUMC nurses who provided free blood pressure and cholesterol screenings throughout the region, including the court offices in Central Islip and Riverhead.

HOPE students learn from SBUMC healthcare professionals. SBUMC offers a program called HOPE (Health Occupations Partnership for Excellence), which promotes the development of promising high-school-age students from underserved communities who wish to pursue careers in healthcare. Recently, our HOPE students enjoyed a tour of the Sleep Disorders Center and presentations on careers in Care Management and Child Life. Many thanks to Barbara Ludwig-Cull of the Sleep Disorders Center, Catherine Morris of the Care Management Department, and Paulette Walter of Child Life for volunteering their time to support this program.

Annual Give Kids a Smile Day proves to be a success. Stony Brook University School of Dental Medicine provided free exams, cleanings, and sealants to 225 children during National Give Kids a Smile Day on February 6. Margaret Bakos from the Dental Care Center works tirelessly every year to ensure that children without dental insurance can maintain good oral health.

Local high school students commit $125,000 to ALS research. The Northport High School student group, "A Midwinter Night's Dream," has pledged $125,000 for the creation of a 650-square foot cryopreservation laboratory for Amyotrophic Lateral Sclerosis (ALS) research in the Department of Neurosciences. Inspired by former Northport school teachers, Christopher Pendergast and David Deutsch, who were diagnosed with ALS, A Midwinter Night's Dream is a nonprofit organization dedicated to raising funds to benefit ALS research. The cryopreservation laboratory will provide a vehicle for the long-term access of promising mouse models for ALS, in addition to scores of other human diseases. The laboratory is scheduled to open this summer.

MY LAST TOUCH
Do you live in the "moment"? The first time I heard this expression, I was very confused. Of course I am living in the moment. I am here, aren't I? But as this concept was explained to me, I was not so sure. Most of us carry with us events of the past as well as hopes, dreams, and perhaps fears for the future. These influence how we behave right now-in "the moment." For instance, we may be distracted by events that happened just before we come to work (e.g., a sick relative, sleeping late, bad dreams, a flat tire, a runaway dog). If the degree of distraction is high enough, such as experiencing the death of someone close to you, it may be virtually impossible to be in "the moment." But, what if we need you, and you are not in the moment?

This is actually not a hypothetical situation. Most of us bring these distractions to work-and to life-every day. Sometimes they are the happiest of distractions, like planning a wedding or awaiting the birth of a child or grandchild. For some reason, we are equipped as humans to put aside happy distractions and focus on "the moment." But not so for more tragic distractions like death and dying, which tend to take control of our attention. It is then the people around us who must help. How we react during these circumstances defines who we are and what our micro community (SBUMC) is like. Can we listen? Can we tell when someone is not in the moment?

It is tempting and easy to criticize those not in "the moment." Surely, they are not functioning at their full capacity. What should you do? Confront them? Tell their supervisor? I suspect this depends upon how often it happens. But, my hope is your first act will be to ask if they need help. Take a moment to connect. Sometimes just listening and providing moral support can make an enormous difference. And you may surprise yourself by offering sage advice.

At Stony Brook University Medical Center, we commit every day to providing supportive care. This is not enough. We need also to create a caring, supportive environment for our staff. This requires understanding the lesson of "the moment." I know it is much to ask. Not only must we care for our patients, but must we care for each other? The short answer is yes. We need to help and care for each other. Who knows, perhaps someday you will be the one who is distracted and needs help.

There is a famous line from the film and novel Zorba the Greek. I have borrowed it, not from Zorba the Greek, but from a book written by Jon Kabat-Zinn, PhD, about mindfulness. In effect, Zorba, who has several daughters and is just struggling to make ends meet, is approached and asked how it is going. He says, "I am living the full catastrophe," meaning he is inhaling life, with all of its inherent pleasures, successes, and failures. Aren't we all? Take it in. Be in the moment. Enjoy the moment!

 It is not irritating to be where one is.
It is only irritating to think one would like to be somewhere else.
-John Cage

 
He that is discontented in one place will seldom be happy in another.
-Aesop

Thank you for your help on our journey.

Steven L. Strongwater, MD
Chief Executive Officer
Stony Brook University Hospital

Patients first | World-class processes | Teamwork | Growth | Use resources wisely

As an academic medical center (AMC), Stony Brook University Medical Center must follow this debate carefully, because a significant portion of our funding also comes from the government through the vehicles of Medicare and Medicaid. AMCs are different than community hospitals. AMCs fuse together the provision of highly complex care with education (training the next generation of providers: physicians, nurses, therapists, social workers, dentists) and research (developing cures for disease, working in the laboratory and then transferring discoveries to the bedside and the community). One focus of AMCs is on developing and deploying highly complex technologies to improve care, especially technologies not available elsewhere, like bone marrow transplantation for patients with cancer, robot-assisted heart surgery, the use of stem cells to replace skin in burn victims, or the provision of high-risk obstetrics and advanced neonatal intensive care. AMCs also provide "capacity" within a community, by serving as safety net providers for the poor and uninsured and by caring for transfer patients deemed too sick to be treated in a community hospital. AMCs like Stony Brook University Medical Center have higher staffing needs (more intensive care unit beds, more staff per bed, and more around-the-clock services) and hence higher costs (and often more expensive intensive technology).

 This part of the delivery system is needed for every community in the nation. Medical discoveries made in AMCs, such as antibiotics to treat infections that previously required hospitalization and imaging modalities for treatment that previously required surgery, drive down healthcare costs and extend the duration and the quality of life. Many more discoveries, such as personalized medicine through genetic profiling to tailor the use of medications like chemotherapy for cancer, are on their way.

 As a nation, we must face the economic reality that we cannot continue to spend as we have over the past several years. We must make choices. War or healthcare? Research or prisons? Housing or police? Teachers or TSA agents? These may not be the specific options for today's debate, but policymakers will have to make decisions on how to allocate funds. Key portions of AMC budgets are funded by Medicare, Medicaid, and governmental support. AMCs provide a societal good and assure the quality of life in many communities. We hope our legislators and policymakers understand these issues as they struggle in allocating scarce resources. And we ask for your support when these debates come up. Thank you for helping preserve the quality of life in Suffolk County.

As an academic medical center (AMC), Stony Brook University Medical Center must follow this debate carefully, because a significant portion of our funding also comes from the government through the vehicles of Medicare and Medicaid. AMCs are different than community hospitals. AMCs fuse together the provision of highly complex care with education (training the next generation of providers: physicians, nurses, therapists, social workers, dentists) and research (developing cures for disease, working in the laboratory and then transferring discoveries to the bedside and the community). One focus of AMCs is on developing and deploying highly complex technologies to improve care, especially technologies not available elsewhere, like bone marrow transplantation for patients with cancer, robot-assisted heart surgery, the use of stem cells to replace skin in burn victims, or the provision of high-risk obstetrics and advanced neonatal intensive care. AMCs also provide "capacity" within a community, by serving as safety net providers for the poor and uninsured and by caring for transfer patients deemed too sick to be treated in a community hospital. AMCs like Stony Brook University Medical Center have higher staffing needs (more intensive care unit beds, more staff per bed, and more around-the-clock services) and hence higher costs (and often more expensive intensive technology).

This part of the delivery system is needed for every community in the nation. Medical discoveries made in AMCs, such as antibiotics to treat infections that previously required hospitalization and imaging modalities for treatment that previously required surgery, drive down healthcare costs and extend the duration and the quality of life. Many more discoveries, such as personalized medicine through genetic profiling to tailor the use of medications like chemotherapy for cancer, are on their way.

As a nation, we must face the economic reality that we cannot continue to spend as we have over the past several years. We must make choices. War or healthcare? Research or prisons? Housing or police? Teachers or TSA agents? These may not be the specific options for today's debate, but policymakers will have to make decisions on how to allocate funds. Key portions of AMC budgets are funded by Medicare, Medicaid, and governmental support. AMCs provide a societal good and assure the quality of life in many communities. We hope our legislators and policymakers understand these issues as they struggle in allocating scarce resources. And we ask for your support when these debates come up. Thank you for helping preserve the quality of life in Suffolk County.