CEO Update May 2008
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.
May 2008
Yesterday, my day ended with a pleasant surprise. The person who emptied my trash told me how proud he was to work at SBUMC, and how he and his colleagues are working to help SBUMC become a high reliability organization (HRO). He said it with such pride and enthusiasm. There is no more powerful statement defining how essential each staff member is to the care and support of our patients, no matter what area you work or what you do. It's only when all members of our staff understand that we're working as a team to become an HRO that we will truly be on our way. I ask each of you to think about how you can help us in our journey.
We have all heard how "it takes a village" to raise a child. Indeed, it takes an entire team to care for one patient, their family and each other. This month we will celebrate National Nurses Week from May 12 to 16. As individuals and as a group, nurses epitomize what we do in healthcare: caring, delivering human touch, using years of training and intelligence, demonstrating commitment, excellence and compassion. Nurses are the people at the bedside twenty four hours a day. They are who patients see most and who we rely upon to make sure "care" is delivered. And they do it with such good cheer and equanimity.
Please join us all in recognizing the role nurses play at SBUMC and their importance in the lives of our patients, the faculty and other staff at SBUMC. Nurses, we salute and celebrate you! Congratulations and thank you for choosing this critical career.
STONY BROOK PRIDE
SBUMC Cardiology Recognized for Second Lowest Risk Adjusted Mortality in the University HealthSystem Consortium (UHC). Some exciting data from UHC. For 2007 Stony Brook University Medical Center had the second lowest risk-adjusted cardiac mortality (the death rate, when taking into account a patients medical problems) of any hospital in the Consortium. This is a tribute to attending physicians, fellows, nurses, staff and administrators who work so hard to make the SBUMC Heart Center such an outstanding place to receive cardiac care. Well done!
HealthGrades Awards SBUMC its Coronary Intervention Excellence Award. In rankings released on April 7 SBUMC was recognized with the "Coronary Intervention Excellence Award," the one of the highest honors from HealthGrades, an independent national ranking firm. This award recognizes the caliber of cardiac care provided compared to all other hospitals in the nation. It is an unsolicited award recognizing excellence.
Dr. John Ricotta to be Inducted in Johns Hopkins Society of Scholars. Chairman, Department of Surgery, Dr. John J. Ricotta, will be inducted into the Johns Hopkins Society of Scholars this month. Created by the board of trustees in May 1967 on the recommendation of then President Milton S. Eisenhower, the Society of Scholars honors the significant accomplishments of men and women who spent part of their careers at Johns Hopkins. The society - the first of its kind in the nation--inducts former postdoctoral fellows and former junior or visiting faculty at Johns Hopkins who have gained marked distinction in their fields of physical, biological, medical, social or engineering sciences or in the humanities and for whom at least five years have elapsed since their last Johns Hopkins affiliation. Congratulations Dr. Ricotta.
Cardiac Mortality Continues to Improve at SBUMC. The most recent UHC Product Line Mortality Report for the Cardiology Service identifies Stony Brook's relative performance as, "substantially better than target range" and includes us in the "Recent Year UHC Top-10 Mortality O/E in Cardiology" list (observed to expected references the actual, observed mortality rate as compared to the expected mortality rate based on the application of a severity of illness system). Congratulations to all of you who contributed to the care of these patients and helped us save lives!
Happy Birthday to our ORs! In 1980, 28 years ago, Dr. Mark Funt, an OB/GYN, performed the first operations at SBUMC. 28 years later, we are now performing more than 18,000 surgical cases annually.
Renal Transplantation Celebrations. On March 14, 2008 the Kidney Transplant Program reached a milestone in transplantation by performing the 1000th transplant. In this milestone case, a daughter donated a kidney to her father (both are doing very well). Dr. Frank Darras performed the donor nephrectomy and Dr. Wayne Waltzer performed the transplant. The Kidney Transplant Program began in 1981 with a kidney donation from a brother to his sister. Last year, Dr. Waltzer performed a living donor transplant on the daughter of the very first recipient, whose donor also was her brother. Over the last five years the program has grown from about 45 transplants per year to 73 transplants in 2007. It is the goal of both Drs. Waltzer and Darras to reach 100 transplants per year in the near future. Congratulations to the entire transplant team.
SBUMC Care in the Last Two Years of Life. In an effort to understand unnecessary variations in care, investigators at Dartmouth University have cataloged the costs of care in the last two years and last six months of life. SBUMC costs were lower than any of our major competitors on Long Island and far better than the major centers in Manhattan. Thank you for using our collective resources compassionately and wisely.
Additional Inpatient Beds Open. On April 8, 14 beds were opened on 12 South and 4 beds opened on 19S. These beds will allow us to meet the growing demand for medical/surgical beds and for cancer care. SBUMC is now operating at our full DOH-approved licensed capacity of 536 beds.
Nursing Recognition Week. As we enter May, take a moment to congratulate Stony Brook Nurses for "MAKING A DIFFERENCE EVERY DAY!" Without their expertise and compassion, we would not be able to provide high quality care to our patients and families. Many activities are planned to celebrate, including everyone's favorite "Family Feud" on Monday May 12 starting at 4 pm; a special luncheon on Thursday and a Jubilee! celebration on Friday from 11 am - 2 pm, followed by a Formal Ceremony at 3 pm in the Galleria. Please stop a nursing colleague and wish them a Happy Nurse's Week.
Baldelli and Paciella Publish SBUH Pressure Ulcer Outcomes. Congratulations to Perrilynn Baldelli and Mary Paciella whose paper entitled, "Creation and Implementation of a Pressure Ulcer Prevention Bundle Improves Patient Outcomes," was published in the American Journal of Medical Quality (23)136, 2008.
Christine Edwards President Elect for LIHIMA. On April 14, Chris Edwards was sworn in as President Elect for the term running July 1, 2008 through June 30, 2009 for the Long Island Health Information Management Association (LIHIMA). LIHIMA is the largest association within the New York State for Health Information Management. Doreen Wisnewski, Assistant Director of HIM (Tech Park), was sworn in as the Correspondence Secretary as well. Congratulations.
Radiation Oncologist Wins LI Technology Hall of Fame Award. F. Avraham Dilmanian, Ph.D., Associate Professor of Research, Department of Radiation Oncology at Stony Brook University Medical Center, along with colleagues from Brookhaven National Laboratory (BNL), won the 2008 Long Island Technology Hall of Fame award for Innovation for the Individual. The award is for a patent of a method implementing an experimental radiation therapy to treat cancer, called microbeam radiation therapy (MRT). Dr. Dilmanian and colleagues were selected for the award from among more than 1,600 patents that were granted to Long Island residents in 2007. The patent describes a way to interlace the arrays of thicker beams to produce an unsegmented radiation field at a target tumor to increase the killing potential there, while sparing healthy tissue. Results from experiments using these thicker beams showed cancerous tumors in small regions of rodent brains were destroyed without damaging surrounding tissues.
Opening of Operating Rooms. ORs 24 & 25 were opened in April! They are functioning to assist with the increase in surgical activity and prevent surgical delays secondary to construction. Thanks to Mary Catalano, Ken Rosenfeld, Kathy Scheriff, Carole Capps and the entire Perioperative Service Team to bring this dream to a reality, under the project management direction of John Neverka.
"Who's in Your OR?" Nursing Poster Presented. OR Nursing leadership recently presented a poster entitled, "A study of what keeps the RN Circulators in (or out) of the OR," at the April Association Operating Room Nurses (AORN). Congratulations Kathy Scheriff RN, MSN, CNOR, Anthony Intelisano RN, Joaquin Quiason MS, SSBB, Dr. Peter Glass ChB, FFA, Donna Keehner-Nowak RN, MSN, MPS, PNP, Kenneth Rosenfeld MD, & Lee A. Xippolitos PhD.
GI Pediatric Fellowship in Gastroenterology Reaccredited. The Pediatric Gastroenterology Fellowship was awarded the longest possible accreditation of three years by the American College of Graduate Medical Education (ACGME) Accrediting Body. Congratulations to Dr. Chawla and Dr. McGovern.
Maffetone Community Service Awards. Michael Maffetone, DA served as Director and Chief Executive Office of Stony Brook University Hospital from 1994 through 2000. To honor his memory and legacy, the Michael A. Maffetone Community Service Awards were established. The Suffolk County Chapter of CHADD (people affected by Attention Deficit/Hyperactivity Disorder) received the Community Service Grant, Judith Specht, RN is the Community Service Award recipient, Barbara Ludwig-Cull, RPSGT received the Distinguished Speaker of the Year Award and Regina M. Haszinger, RN was awarded the Distinguished Outreach Provider of the Year.
National Medical Laboratory Professions Week - April 20 to 25. Laboratory professionals serve a critical role in our healthcare system - from diagnosis, to treatment, to disease monitoring. We honor and celebrate the contributions of Stony Brook University Hospital's Laboratory healthcare professionals who provide the vital information that saves lives, reduces morbidity and impacts the quality of patient care throughout the hospital.
PATIENT SATISFACTION
SHHH! Program Initiated. On April 2 the "Silent Hospitals Help Healing" (SHHH) program was initiated at SBUH. "Yacker TrackersR," a device which measures noise (in decibels) and displays visual alerts (traffic sign, red, yellow and green), as well as signage alerting staff and visitors, were installed throughout the hospital. All staff are asked to observe quiet hours and to adjust all beepers and phones to vibrate. We continue to identify and work to reduce noise from rolling carts and other unit-based equipment. Studies show that noise levels directly affect physical and mental healing, so we expect improved patient and staff outcomes of a result of this initiative. Thank you for keeping noise levels to a minimum!
Cardiac Interventional Program Reduces Wait Times and Improve Patient Satisfaction. The Cardiac Catheterization Lab and Catheterization Lab Holding Areas raised their Press Ganey patient satisfaction scores from the 3rd to 4th quarter of 2007 through the work of the Cardiology and Holding Area Management Project (CHAMP). Initiatives were put into place to decrease wait time for the patient pre-procedure, as well as decrease length of stay. In the Press Ganey patient survey category of "Likelihood of recommending," positive response increased from 94.4 to 97.4 (above the all facilities ranking of 95.9). Great job.
16 South Achieves Significant Gains in Press Ganey Patient Satisfaction. In the Press Ganey category "Readiness for Discharge," patient satisfaction scores for the 4th quarter 2007 improved from 79.6 to 81.9 (above hospital mean). This was achieved through the implementation of ongoing patient/family/interdisciplinary meetings and responsive changes by the staff.
Non-Invasive Cardiology Introduces Initiatives to Improve Patient Satisfaction. We are now tracking the time patients arrive to this unit until their tests are completed Everyone is greeted personally by a staff member after registration. A Patient Survey is given out after each study for feedback. Scripting is used for scheduling, answering the telephone, and greeting the patient. This process has significantly improved patient perception, especially in the Heart Center offices located in Islandia.
Radiology Implements Patient Survey Cards and Real Time Service Recovery. Patient survey cards are now distributed at the time of a visit to the Radiology Department. This has enabled identification of issues or concerns and implementation of a quick recovery program. Overall Press Ganey scores in the department of Imaging Services have increased from 85.3 to 88.7. Part of this program includes service recovery vouchers worth $5, which is redeemable in the parking garage, cafeteria, the gift shop, and if an inpatient, for TV or phone service. have been instrumental in providing a patient or family member a token of apology. Although it is small, it is usually very well received and appreciated by the patient and family.
Radiology Implements Radiology Hotline for Patients Concerns. Radiology has established a hotline for patients to call to report issues or concerns. The number to call with any issues is 631-444-1518.
Radiology Prepares for Child Studies. Coloring Books and small toys are now provided for the children or siblings awaiting or going through studies, to help make the child and parent feel more at ease.
Medicine/Oncology Inpatient Units. Congratulations to Medical Oncology Units for rising inpatient patient satisfaction scores. Strategies for continued improvement include rounding for success, activity cards, white board communication, safety huddles, and the welcome/admission packets. 17N leads the division in Press Ganey scores, while 19N showed increase in 2.1 points from last quarter.
PATIENT SAFETY
Hand Hygiene at Record High! SBUH has achieved a 91% overall compliance with hand hygiene. Sometimes the simplest things are the hardest to achieve. Due to the efforts of many faculty and staff, we are getting closer to "high reliability" when it comes to hand washing. My thanks for reminding each other of the importance of hand hygiene.
Resident Simulations and Testing Begins. In March, a three-hour seminar and simulations were performed, educating 50 Emergency Department and Surgery residents as well as medical students on tube thorocotomies; and the surgical residents on ED thorocotomies. The post test results showed marked improvement over the pre-test and the critique of each performer was priceless. House staff were grateful for the hands-on training.
Higher Standards Required for Central Line Insertion. A standardized central line certification policy and procedure was approved by the Medical Executive Board requiring house staff to demonstrate competency in central line insertion on a simulator before they are allowed to insert lines in a patient. The policy also requires completion of an educational module and an 80% achievement on a post test. This policy goes into effective July 1, 2008 but will begin to be trialed in April 2008. Central line maintenance guidelines were also approved by the Nursing Clinical Practice Committee.
Chest Tube Placement Certification Under Development. Just as the central line insertion competency activities are finalized, a standardized policy and procedure for the certification of residents and fellows to insert chest tubes is underway.
National Patient Safety Posters Accepted. Two posters were accepted to be presented at the 2008 National Patient Safety Foundation Annual Patient Safety Congress: Connect, Communicate, Commit! which is scheduled to be held on May 14-16, 2008 in Nashville, Tennessee. The posters focus on SBUMC's efforts relating to the Modified Early Warning System and the Pediatric Early Warning System, as well as "Achieving Survival at Stony Brook University Medical Center". Congratulations to all who have participated in this effort! On a related note, MEWS and PEWS have spread to all medical/surgical units within the hospital.
Patient Safety Committee Survey Underway. To assess patient safety culture at SBUMC we are asking all physicians and staff to complete an anonymous Patient Safety Cultural Survey Questionnaire. The three minute survey can be accessed on the intranet at the following URL address: Please take a moment to visit the website athttp://inside.hospital.stonybrook.edu/app/culturalsurvey/default.asp. The ID is "sbuh" and the password is "survey". The Patient Safety Committee plans to use the survey results to determine the effectiveness of its efforts as well as to identify opportunities for improvement.
Kidney Transplant Waiting Times Improve. After initiation of several PDCA cycles in the Kidney Transplant Service, the median time it takes to get a patient from the point of their initial referral by a nephrologist or dialysis center, to activation on the transplant waiting list has been reduced from a median time of 267 days in December 2007, to 72 days in February 2008. The goal is for a mean time of 90 days or less. In comparison, the median time for all the Transplant Centers in the nationwide Health Resources and Services Transplant Growth and Management Collaborative was 159 days in December 2007 178 days in February 2008. Congratulations to the Transplant Team!
Deep Venous Thrombosis (DVT) Reduction Plans Underway. To focus on high-risk patient safety opportunities, an interdisciplinary Deep Vein Thrombosis Team is drafting DVT screening tools, a contraindication list, risk scores and evidence suggested therapies. A DVT happens when a blood clot forms in a deep-lying vein, usually in the leg. Clots may break loose, travel in your bloodstream and block arteries in your lungs or other parts of the body, causing permanent damage. SBUMC's campaign currently includes mandatory attention to DVT parameters being established electronically on admission, with acuity/unit transfer and re-review every 3 days. DVT prophylaxis is one of the key strategies to improve patient safety in hospitals.
Improving Smoking Cessation! Quarter 3 2007 Core Measure data revealed a significant achievement for SBUMC related to smoking cessation advice and counseling. 100% of our Congestive Heart Failure, Acute Myocardial Infarction and Community Acquired Pneumonia patients included in the sample received smoking cessation and advice and counseling. By systematically deploying processes, we were able to achieve perfect scores for this key metric.
Continuing on the Baldrige Journey.... Team leaders were identified for workgroups that will be focusing on conducting a gap analysis relating to the Baldrige criteria. Workgroups are in the process of being formed for Leadership, Strategic Planning, Patient Focus, Information Management, Human Resource Focus and Process Management. The gap analyses will be completed by the end of June 2008 in anticipation of beginning to write the application for the award, which will be submitted in May 2009. We are off to a great start! Save the date for Baldrige Grand Rounds on June 11, 2008.
Impressive Pharmacy Improvements. Medication delivery to nursing units improved dramatically, as reflected by a 90% reduction in Patient Safety Net Reports of delayed medication delivery (over the past two years) and an 82% decrease in "missing med" reports over the past year. Overrides of medications retrieved from unit based dispensing instruments (Pyxis) decreased by 84%. This is a direct reflection of improved timeliness of Pharmacist order entry. Total turnaround time measurements showed a 56% improvement (from 138 minutes to 61 minutes for routine meds) from 2006 to 2007.
Emergency Management. Regional Resource Center Coordinator Connie Kraft delivered a very well received poster presentation entitled "Regional Approach to Hospital Emergency Planning and Bed Surge Capacity Identification" at the Joint Commission and Joint Commission Resource's Annual Emergency Preparedness Conference in Alexandria, Virginia last week. Le DeBobes presented on Healthcare Emergency Preparedness for the New York City Case Management Society of America's (NYC-CMSA) Association Conference.
On May 7th, Connie Kraft and Leo DeBobes will be conducting Tabletop Emergency Response Exercises for the American Society of Safety Engineers' (ASSE) Long Island Chapter Professional Development Conference, and Dr. Susan Donelan, who is the RRC's Medical Director, will present on "MRSA in the Workplace and Home."
COMMUNITY CONNECTIONS
Save the date: Town Hall Meeting. Community Physician Town Hall Meeting, "Get Connected" will be held June 30, 2008, 6 to 8 pm in the Health Sciences Center, Galleria.
Save the date: "Survivor Stony Brook" - 4th Annual Cancer Survivors Day Celebration. On Sunday, June 1, from 11:00 am to 2:00 pm, Stony Brook University Medical Center will host its fourth annual National Cancer Survivors Day® at the Stony Brook University Cancer Center and Center for Outpatient Services. Called "Survivor Stony Brook," the event uses the popular "Survivor" television show theme to bring hundreds of cancer survivors together to celebrate with their physicians, SBUMC staff, and their families. The event will be held on the grounds of the Cancer Center and Center for Outpatient Services. This year's event also features live music from "Practicing Without a License," a live band made of players who have a day job - they are all practicing physicians at SBUMC. Also new for children is a disc jockey-led scavenger hunt. For more information or to register, call 4-4000; online registration is being accepted at http://www.stonybrookhospital.com/index.cfm?id=2296.
Save the Date: May 21, SBUMC at Smith Haven Mall for Hospital Week. On Wednesday, May 21, from 10 am - 3 pm, Smith Haven Mall, Center Court, Stony Brook University Medical Center celebrates National Hospital Week and its theme, "Where Healing Happens Every Day." Healthcare professionals from the Medical Center offer free screenings, valuable information, and information on the innovative services available at Stony Brook. In addition, blood donation appointments are being set up for the week of June 2 through June 6, at the Stony Brook University Hospital Blood Bank. Call 4-4000 for more information, or to make an appointment with the Blood Bank.
Drs. Fine and Strongwater Address Faculty Senate. In an effort to improve faculty communications, Drs. Strongwater and Fine met with the Faculty Senate on April 29. The format was an open question and answer session. Thanks to all who attended and contributed. Faculty Senate President, Dr. Roy Steigbigel hopes to operate similarly Town Hall-type sessions into the Faculty Senate meeting agenda.
Pediatric Oncology School Re-Entry Program Receives Funding. Thanks to a generous $100,000 grant from the Seraph Foundation, our School Re-Entry Team, comprised of physicians, nurse practitioners, nurses, child life specialists and educational liaisons, will continue their collaborative effort to sensitively facilitate a child's return to the classroom after an absence due to medical treatment.
Funding Provided to Cover Costs of TVs on Pediatric Units. Thanks to two generous donors, Kathleen & Duffy Mich and The Smiles for Scott Foundation, families of children in our pediatric units will not be charged a daily fee for television service this year.
Culture of Philanthropy Boards on Display throughout Medical Center. In an effort to continue to build a culture of philanthropy, grateful patients, grateful families and donors have agreed to appear on poster boards explaining their gratitude for our services and/or reasons for supporting our ongoing efforts. For those patients and visitors with an interest in donating to specific programs, our "Say Thank You" brochures are located throughout the facility. Please be in touch with Advancement at 444-2899 with any questions.
Doctors' Day offered Opportunity to Honor Special Doctors. Thanks to all those who made donations in honor of their favorite physician during March because of Doctors' Day Each respective doctor received a certificate to notify them of this special recognition.
SBUMC Supports Stroke Awareness. On May 6, Dr. Perkins and staff from Neurology, will be supporting the Long Island Stroke Alert Program. The program seeks to educate patients and families about the warning signs of a stroke and to seek rapid medical attention. Today's treatments make stroke outcomes better than ever if treated rapidly.
Smithtown Chamber Visited by Dr. Strongwater April 17, 2008 . More than 50 community leaders attended an update outlining the Major Modernization, new technologies available at SBUMC (i.e. robotic surgery, stroke, minimally invasive cardiac surgery).
LAST TOUCH
Do you face your fears? My guess is most of us seek a safe place, a comfort zone, and try hard to avoid what scares us most. From day to day and over the long term, fears can be overwhelming. Fear is the kind of thing that wakes you at night. Perhaps it involves your children, your siblings, money, work, security? We all have them. What should we do about our fears? Is avoidance the right path? Is confrontation the right approach? Should you face your fears alone or with your friends or family or anyone else?
Doesn't the answer to these questions really "depend" - depend upon what you do, how old you are, whether you live alone or with a large family, etc.? Is there anything in common to deal with facing your fears?
It is crucial to understand what is causing your fears as clearly and crisply as possible. Surprisingly, many fears are irrational and if you talk those fears out with someone you trust, you get an entirely different perspective. It is well worth doing battle with your fears because they can be draining and even worse, they affect your mood and how you interact with others, even when you are not aware of it.
Fear of failure. This type of fear is insidious. It prevents people from realizing their potential. Why didn't you try this or that? Is a voice inside your subconscious holding you back? Should you stretch beyond what you think you are capable of? What would you tell your friends, children, etc.? My guess is you tell the people you care most to "go for it!" when they are worried about trying something new. That is the right approach! How else can you determine how far you can go...how much you are capable of? Part of facing your fears requires a willingness to stretch beyond what you think is possible. "We have nothing to fear but fear itself." (Franklin D. Roosevelt)
People in health care are special. What sets us apart is our willingness to face some of the most frightening and challenging situations imaginable. The complexity and emotional demands of each new challenge are extraordinary and draining. I know this is not easy. I know you look fear in the eye every day. I am proud of you and proud to work with you at SBUMC. Take pride in your skills, your continued growth, your new degrees, and your willingness to help each other.
"Obstacles are those frightful things you see when you take your eyes off your goals."
-- Unknown
"I can't understand why people are frightened of new ideas. I'm frightened of the old ones."
-- John Cage
"Things do not change. We change."
-- Henry David Thoreau
Steven L. Strongwater, MD
Chief Executive Officer
Stony Brook University Hospital
Patients first—World class processes—Teamwork—Growth—Use resources wisely
