November 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.

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November 2008

Patient care at Stony Brook University Medical Center is safer today than at any time in our nearly 30-year history. Over the past year we have achieved many successes in advancing patient care. Unsolicited recognition has come from many places, none more important than the patients we treat. Our Medical Center has received recognition for quality, safety and patient satisfaction initiatives from a National Firm, the University Health System Consortium, Nassau Suffolk Hospital Council, HANYS and Practice Greenhealth (Environmental Excellence) to name a few. SBUMC has made meaningful, irrefutable, progress in improving patient care.

And yet, there is more to be done.  We are reminded of this when something does not go as we would hope.  We must accept this as a challenge to perform at an even higher level, with greater resolve. 

Healthcare is highly complex, yet a loosely coupled system. As such, patients are at risk for errors. Errors can occur as a result of many factors: poor handoffs, lack of timely information, staffing, bias, poor judgment, patient compliance, misunderstandings, system deficiencies, etc. For outcomes to be perfect, we must have strategies to avoid as many errors as possible. To date, we have embraced the importance of medical knowledge in treating patients. We have recognized the importance of patient spiritual needs for healing. We have constructed more modern, efficient space and purchased sophisticated equipment to improve care. It is time to fully embrace the science of safety with the same zeal, move SBUMC to be as close to error free as humanly possible to become a High Reliability Organization (HRO).

Cardiac services outcomes have dramatically improved over the past several years. A look at the remarkable achievements in the Heart Center (which includes Cardiology and Cardiothoracic Surgery) speaks loudly about this journey. The Heart Center has been:

• Recognized as being #1 in New York State by an independent rating agency for mortality and morbidity and in the top 5% nationally
• Ranked by University HealthSystem Consortium as
  • 3rd out of 96 academic medical centers in the USA for the lowest overall cardiac mortality
  • 5th best out of 95 hospitals for lowest mortality following angioplasty
  • 10th best out of 96 hospitals for lowest mortality following acute myocardial infarction (heart attack) and,
  • 5th best out of 96 hospitals in the mortality of patients with congestive heart failure

And in January, the Coronary Intensive Care Unit became the first patient service to be designated as a High Reliability Organization unit at SBUMC and, along with the adoption of Institute for Healthcare Improvement principles and bundles of care, has achieved remarkable reductions/elimination of central line infections and mislabeled specimens while adopting daily goal sheets, interdisciplinary rounding and early adoption of elements of Patient and Family-Centered Care.

These accomplishments did not happen on their own; getting there required a great deal of work and dedication, commitment of the leadership and staff toward prioritizing communication, effective and collaborative working relationships, and understanding patient needs and our systems.

We have the skills, people, focus and drive to spread this initiative throughout the Medical Center. Yet, it requires a change in mindset, because physicians are trained to function independently as experts, and the demands of care in today's hospitals require a shift toward integrated team work - incorporating and respecting the roles of different providers, coordinating care in a seamless manner. Cross walking and connecting expert system thinkers (physicians) and hospital based providers (nurses, pharmacists, technologists, therapists, etc.) is inherently challenging.  I am certain we can do it institution-wide, just as we have done in the Heart Center.

When the performance improvement staff asks you to participate in activities to improve team based approaches to care, please join in. And if you notice an unsafe situation, speak up! You can make a difference.

STONY BROOK PRIDE

Distinguished Hospital Award for Clinical Excellence 2009.  A well-known independent rating company of hospitals and physicians, has designated SBUMC a "Distinguished Hospital Award for Clinical Excellence" in its 2009 ratings. This ranking is achieved by only 270 (i.e., about 5%) of the 4,971 hospitals that are reviewed. We particularly excelled in the provision of care for cardiac and pulmonary conditions, being ranked #1 in New York State for Cardiac services. Congratulations to all those who have worked so hard to improve the quality of care to our patients.

Long Island Business News Achievements in Healthcare Award.  Congratulations to Stony Brook University Medical Center's "Code H Lifesaving Initiative Team," which was recognized on October 24 at Long Island Business News' annual "Healthcare Heroes" awards ceremony, as the winner in the "Achievements in Healthcare" category. The Code H Team was selected over two other finalists for its interdisciplinary and methodical initiative to reduce door-to-balloon catheterization time to 71 minutes -- well below the American College of Cardiology and American Heart Association guidelines of 90 minutes. Healthcare Heroes is an annual award program to recognize excellence, promote innovation, contribute to the enhancement of the value and quality of health care and, ultimately, recognize the men, women and organizations whose tireless work, contributions and dedication to healing and caring ensure the well-being of everyone on Long Island. Congratulations to Dr. Bill Lawson, Lisa Wilbert, Eileen Dowdy, Eric Niegelberg, and Carol Gomes who represented the larger Code H team at the ceremony and to all who collaborate on the Code H protocol. Congratulations also to Dr. Michael Lydic, Reproductive Endocrinologist and School of Medicine Clerkship Director for OB/GYN, who was selected as a finalist in the Physician Hero category.

RRT Task Force Receives 2008 President's Award.  The Rapid Response Team Task Force was recognized by President Shirley Strum Kenny at the University Convocation and received the 2008 President's Award at a special celebration immediately following the Convocation.  The team was selected due to its ability to demonstrate positive and proactive results from a customer perspective, demonstrate outstanding collective commitment of the team to the mission of the university, and provide outstanding contributions to the university as a whole. Congratulations to members of the Rapid Response Team Task force and RRT responders for a job well done!

Dr. Lee Anne Xippolitos, Associate Dean School of Nursing. Dr. Xippolitos, Chief Nursing Officer, Stony Brook University Hospital, has agreed to add to her responsibilities by assuming the role of Associate Dean for Education and Nursing Practice in the School of Nursing. This is a pivotal role in solidifying the relationship between the School of Nursing and the hospital. Congratulations Lee!

New Lobby Delivery: Kudos to Robyn McKeefrey, RN (Risk Management), Nicole Rouhana, CNM (Midwifery/School of Nursing) and hospital concierge, James Williams. All three employees were in the right place at the right time to help a fully dilated pregnant patient as she unexpectedly gave birth to a healthy new son near the information desk in the new lobby. The blessed event occurred Friday morning October 17 about 8:30 am as this patient and her spouse arrived at the hospital already in labor. James Williams supported the patient throughout the delivery while Robyn, who is a labor and delivery nurse by training, and Nicole tended to the new arrival. An L&D team responded promptly and transported a healthy mother and baby to the unit, where they recovered nicely. Congratulations and thanks to the threesome.

Family Medicine Earns Four Year Accreditation! Congratulations Dr. Jeffrey Trilling and the Department of Family Medicine on a successful Residency Review Committee Accreditation site visit. Props to Dr. Donna Meltzer, Family Medicine Residency Director for her work preparing for the review. The entire faculty united, resident participation was strong and everyone on staff pulled together. A wonderful accomplishment!

New Division, New Chief of Colon and Rectal Surgery. Roberto Bergamaschi, M.D., Ph.D., recognized worldwide for his expertise in the field of laparoscopic surgery for colorectal diseases, has been named Professor of Surgery and Chief of the newly established Division of Colon and Rectal Surgery at Stony Brook University Medical Center. Appointed by Todd K. Rosengart, M.D., Interim Chair of the Department of Surgery, Dr. Bergamaschi will oversee the Division, advance surgical procedures, and spearhead resident training in colon and rectal surgery. Dr. Bergamaschi will focus his practice on laparoscopic and conventional surgery for colon and rectal cancer, Crohn's disease, ulcerative colitis, diverticulitis, and many other diseases where patients may benefit from leading-edge surgical procedures.

Recognition from the American Diabetes Association. The Diabetes Self-Management Education Program at the Stony Brook Outpatient Diabetes Center has been awarded continued recognition from the American Diabetes Association. This program offers high-quality education services to the patients it serves. The ADA Education Recognition effort is a voluntary process which assures that approved education programs have met the national standards for Diabetes Self-Management Education Programs. Programs that achieve Recognition status have a staff of knowledgeable health professionals who can provide state-of-the-art information about diabetes management for participants.

Dorothy Lane, MD, PhD, Appointed to ACGME Board of Directors. The Accreditation Council for Graduate Medical Education (ACGME) is the national organization responsible for accrediting all residency (post-MD) medical training in the United States. The mission of the ACGME is to improve the quality of health in the United States by ensuring and improving the quality of graduate medical education experience for the physicians in training. Dr. Dorothy Lane, Distinguished Service Professor, Vice Chair and Director of the General Preventive Medicine & Public Health Residency Program in the Department of Preventive Medicine, and Associate Dean of Continuing Medical Education (CME). She was previously recognized by ACGME in 2007 when she received their "Parker J. Palmer Courage to Teach Award."

Benveniste Research Featured in AUA Newsletter.  In the fall issue of the Association of University Anesthesiologists (AUA) newsletter, Dr. Helene Benveniste and her collaborators from the Department of Anesthesiology and Brookhaven National Lab (BNL) are featured describing their pivotal work using a 9.4 T MRI magnet in stem cell, biomarker and pain research. This is a terrific story of the research efforts of SBUMC's Anesthesiology Department and collaboration with Brookhaven National Lab and Cold Spring Harbor Lab. It is tremendous national recognition for Anesthesiology. Please follow the link for the article. Congratulations. http://www.auahq.org/Fall2008.pdf

Dr. Marie Gelato, Distinguished Service Professor. On Oct. 14, Stony Brook Unviersity President, Shirley Strum Kenny recognized a few select faculty for their many years of contributions and achievement. Dr. Gelato, Professor of Medicine specializing in Endocrinology, and the Director of the GCRC, and was lauded as an exemplary physician role model with local and international prowess in the field of endocrinology. Congratulations!

Recertification Survey for Child Psychiatry Expected. Surveyors from the Office of Mental Health (OMH) recently conducted a reaccreditation review of the Child Psychiatry service.  Based upon preliminary feedback we anticipate reaccreditation. All aspects of the site visit went well including the open and closed records review, described as "excellent," and reviews of the comprehensive and individualized treatment plans. OMH was impressed with the documentation of communication with school systems. There were no environmental concerns identified. Well done!

Mary Jo Longobucco Awarded President's Award for Excellence in Classified Service. More than a twenty year employee at SBUMC, Mary Jo Longobucco, an RN for more than 10 years, and long time employee in the dialysis center, President Kenny recognized Mary Jo for her dedication and contributions to SBUMC at the annual award dinner on Oct. 14. Congratulations!

IHI Accepts SBUMC Poster for Presentation. Jean Mueller has been invited to display SBUMC performance improvement work at the Institute for Healthcare Improvement's 20th Annual National Forum, December 8-11 in Nashville. The presentation is entitled "One Academic Medical Center's Efforts to Maintain Normothermia in the Orthopaedic Patient." Congratulations!

Advance's second Annual Reader's Choice Awards.  In the October 13, 2008 edition of Advance for nurses, Stony Brook University Medical Center walked away with four out of five "top picks" for nurses. This is Advance's second annual Reader's Choice awards that asked nurses to rank hospitals based on elements that would make a difference to them: quality of care, organizational culture, communication, professional development and retention efforts. SBUMC excelled as one of the region's best hospitals for nursing practice in the areas of quality, professional development, organizational culture and retention. Congratulations Lee Xippolitos and to all of SBUMC's dedicated nursing staff! We are proud of you all.

EMS Leadership Award from REMSCO! Congratulations to Kevin O'Hara. With 35 years of exceptional service, Kevin was an obvious choice for recognition from the EMS Community.  We're very fortunate to have him as a member of our Regional Resource Center team and appreciate all of his efforts on behalf of Stony Brook, the RRC and our partners.

PATIENT SAFETY

AJMQ to Feature Work with Dashboard Metrics.  Representatives from Decision Support Services received an invitation to publish an abstract in the March 2009 edition of the American Journal of Medical Quality which earned third place in the poster contest at the UHC Quality Forum.  Entitled, "Using a Wide Range of Reports Based on the UHC Core Measure Database to Drive Accountability at Stony Brook University Medical Center" the abstract will be posted to the UHC web site. Congratulations!

2008 Cerner Health Conference accepts SBUMC Poster Submission. A poster focusing on the Electronic Implementation of the Early Warning Score Assessments was accepted by Cerner for presentation at its upcoming conference. The MEWS/PEWS teams collaborated with Clinical Informatics to develop electronic solutions for documentation. Congratulations to all departments involved in these initiatives.

The United Hospital Fund accepts SBUMC Poster Submission focusing on Sepsis.  Chris McMullan's poster submission titled "Increasing Detection and Standardizing Care for the Treatment of Severe Sepsis" was accepted for inclusion in the poster session at the 19th Annual Symposium on Health Care Services in New York, which is sponsored by the Greater New York Hospital Association Foundation and United Hospital Fund.  Congratulations to all of the CQI teams focusing on efforts to improve sepsis outcomes  and the staff and physicians directly involved in implementing interventions to enhance patient safety.

SBUMC Patient Safety Council Scheduled for November 18. The Patient Safety & Quality Advisory Council, a group of nationally recognized experts on patient safety and quality, will meet at SBUMC on November 18. We plan to focus on FMEAs and improving communications and to learn what actions other leading organizations are embracing nationally.

PATIENT SATISFACTION

Patient and Family Centered Care Initiative Gets Support. Roseanna Ryan has been appointed Coordinator for the Patient and Family Centered Care Initiative. Roseanna brings with her 15 years of Stony Brook experience. Her first major task will be to work closely with the CNO to create the Medical Center's Patient and Family Advisory Council. The primary goal of this advisory group will be to guide and assist SBUMC in improving patient satisfaction and to support the development of a safe environment for our patients. The integration of patient and family centered care into our hospital is an exciting initiative that you will continue to hear about as we move forward.

Stony Brook Nutritional Assistance Card (SNAC) Underway. As part of our commitment to patient and family centered care, the Hospital has created a program to help meet the nutritional needs of a patient's family. The program, funded by the Hospital Auxiliary, provides cards to eligible caregivers that can be used for food purchases in the cafeteria. SNAC is provided to caregivers who, during the course of caring for their loved ones in the hospital, may not have enough money to buy food while they are here. Each recipient benefits from a full professional Social Service assessment in order to qualify them for the program and to address other psycho-social needs they may have. Since its inception in July 2008, the SNAC program has dispensed 25 cards which have assisted 13  families. The program was recently enhanced to expand card availability on weekends.

Patient Satisfaction Survey Ratings Continue to Improve. The Press Ganey inpatient satisfaction survey report for the 3rd quarter has arrived. The report shows slight continued improvement in the overall satisfaction score. It also shows improved ratings of service for both 15 North and 15 South. Both units have been working hard to bring scores closer to the hospital average by implementing hourly rounding, walking rounds and streamlining the discharge process. Two units scored significantly better than the hospital average in the 3rd quarter. They are 11South and 17 North. One outpatient unit scored above the overall hospital outpatient satisfaction rating. The unit was Pre-Admission Testing. Congratulations!

Volunteers Honored: On October 29, our junior volunteers and their parents were honored at a recognition dinner and award ceremony in the Galleria. Three Junior Volunteers were chosen to receive Excellence In Service awards. The award winners, Amanda Brennan, Michael Nunez, and Veda Talanki each received a $100 dollar check donated by the SBUMC Auxiliary.

New Gift Shop Opened. On October 14, the Hospital Auxiliary opened the new Gift Shop. The  shop is located across from the new Information Desk in the lobby. The larger store is warm and inviting and offers a broad selection of cards, gifts, boutique items, flowers, magazines and newspapers. Several new items such as New York State Lottery, holiday gifts, Stony Brook University apparel, and a line of mineral cosmetics will be introduced in the coming weeks.

COMMUNITY CONNECTIONS

School Re entry Conference. On Tuesday, November 4, the Division of Pediatric Hematology/Oncology at Stony Brook University Medical Center is offering a free, one-day conference for school teachers, nurses, counselors, social workers, psychologists, other educators, and parents to educate the educators about childhood cancer, the effects of treatment and  preparation for school re-entry following treatment. Speaking at the conference are Dr. Robert Parker, Director, Division of Pediatric Hematology/ Oncology, Professor, Vice Chairman of Pediatrics for Academic Affairs and Associate Director of the Stony Brook University Cancer Center and Dr. Devina Prakash, Associate Professor of Clinical Pediatrics, Division of Pediatric Hematology/ Oncology . Dr. Parker will be discussing common pediatric hematological disorders, and Dr. Prakash will give an overview of common pediatric cancers.  In addition to presentations about the side effects of pediatric cancer treatment, and its impact on a child's learning, Dr. Norman Fried, PhD of Winthrop-University Hospital will be discussing The Creative Expressions of Loss, Recovery and Survivorship in Critically Ill Children.  Participants will also have an opportunity to hear from a panel of pediatric cancer and hematology patients, their parents, and their educators about their experiences with returning to school following their diagnosis and treatment. For more information on this free conference and for a complete program, please call 444-7521.

Little Miracles Fashion Show. On Thursday, November 19, children and young adults who are recovering from cancer will be the stars of a fashion show to benefit the Sunrise Fund. The Sunrise Fund benefits pediatric oncology services and research at Stony Brook University Medical Center. The fashion show, "Little Miracles: For Childhood Cancer Survivors" will feature children as young as one year old modeling the latest fashions in young clothing. The event in its fourth year, takes place on Thursday, November 19 at Villa Lombardi's in Holbrook from 6:30-10:30 pm. Dinner tickets to Little Miracles Fashion Show are $60 each; individuals may sponsor a child for $50 and a child and family for $250. Corporate sponsorship packages range from $250 to $2,500. The evening includes beautiful raffle baskets, live auction and entertainment! To purchase tickets or for more information, please call 444-7720.

Suffolk County Minority Health Action Coalition Summit. SBUMC was a major sponsor of the Suffolk County Minority Health Action Coalition Summit on October 20.  Several members of the hospital staff, including Yvonne Spreckels, Ruth Alvalle, Anna Rosenthal , Averina Swann and Michael McClain participated in the day-long event aimed at eradicating health disparities in Suffolk County. The summit, which was cosponsored by the Suffolk County Department of Health Services and Stony Brook's Center for Public Health and Health Policy Research, attracted more than a hundred community leaders who are working together to eliminate health disparities associated with race, ethnicity and socioeconomic status.

Golden Gathering Health Fair:  On October 20th, hundreds of senior citizens attended the Golden Gathering Health Fair St. Joseph's College. Volunteer Services offered opportunities to serve our patients and distributed HealthConnect brochures as well as the current edition of Better Health and Better Living.

The 15th Annual Walk for Beauty, Walk for Life held in Stony Brook on October 5th was a huge success. Over 1,000 SBUH staff and community members braved the rain and helped to raise $75,000 for targeted breast and prostate cancer research right here at Stony Brook. Net proceeds of the Walk will be presented to the School of Medicine at a ceremony in January. Many thanks to Michael McClain, Yvonne Spreckels and the Community Relations Department for coordinating the event with the Ward Melville Heritage Organization and the planning committee. Thanks also to the cancer services team and all of the hospital staff who served on the committee, volunteered, walked, and raised crucial funds for this year's Walk.

Farewell to Dr. Ricotta. On October 10, several hundred people gathered to bid farewell to Dr. John Ricotta, Chairman Department of Surgery at SBUMC for the past 10 years. He will assume the Chairmanship at Washington Medical Center, Washington, DC. Dr. Todd Rosengart has agreed to assume the role of interim chair at SBUMC, and Dr. Apostolos Tassiopoulos as Interim Chief of the Division of Vascular Surgery. We wish Dr. Ricotta good fortune and thank him for his leadership and many contributions over the past 10 years. Best of luck.

Happy Retirement to Arnold Katz. Dr. Katz was celebrated on October 28 in the Galleria to wish him well on his retirement after serving as Professor and Chief of the Division of Otolaryngology - Head & Neck Surgery since 1989. Thank you Dr. Katz for your valued and trusted service. Best wishes for a wonderful retirement.

Cancer Center Celebrates 8th annual Fall Fashion Festival (FFF). The FFF was held on Thursday, October 16 at Villa Lombardi's, run entirely by volunteers. All funds raised benefit cancer patients through the GIFT Program (Giving Inspiration, Fighting Together). The "models" this year included:  Frank Albergo, Dr. Duc Bui, Scott Gresslin, PA, Dr. Sami Khan, Mike Kocherkevich, Dr. Brian O'Hea, Bruce Solomon, Rose Cardin, Dr. Eva Chalas, Dr. Janice Lu, Keri Ohliger, Dr. Colette Pameijer, Dr. Neetu Radhakrishnan, Cathy Tuppo and Maria Wolfe. Special thanks and congratulations to the committee members:  Jayne Clarke, Vicki Irwin, Cynthia Lombardo, Fran Navaretta, Pat Spadaro, and Linda Bily who made this event a great success.

Smoke Free by January 1! Planning is underway to go smoke free on the SBUMC campus by January 1. Employee Health and Wellness (EH&W) is committed to making this a smooth transition for everyone and anyone on staff who seeks help. EH&W will kick off the "Great American Smoke Out" during the month of November with a six-week smoking cessation program. Resources to help employees quit smoking are available in EH&W. Nicotine replacement gum and lozenges will be available to Hospital and HSC employees from December 1 to January 31.

Fundraiser For Burn Center a Huge Success. The Suffolk County Volunteer Firefighters Burn Center Fund held a standing room only celebration/fund raiser on October 4th at Martha Clara Vineyards in Jamesport. It was a spectacular event and raised $6,000 to benefit the Burn Center at Stony Brook University Medical Center.

Laboratories Customer Service Awards. The Department of Labs Customer Service Focus Group Announces Winners of the Laboratories Customer Service Award for May 2008. Congratulations to James Lombardo from Immunology, who has  a great sense or responsibility to the department and to SBUMC. He has demonstrated an awareness of the needs of others and serves as a role model for others. Congratulations James.

Ed Hayes Appointed Pharmacy Residency Program Director. We are pleased to share that Ed Hayes, R.Ph., MS, Pharm D., has been approved by the American Society of Health System Pharmacists as residency program director for the postgraduate year one pharmacy residency program at SBUMC. 

Sunrise Fund Benefits from Local Fundraising Events.  The Three Strohm Sisters Foundation hosted a "Halfway to St. Patrick's Day Celebration" on September 20th to generate awareness and funds for our pediatric cancer program.  Held in memory of Edward J. Strohm, Sr., the evening raised over $6,000.  The Sunrise Fund also benefited from part of the proceeds generated from the Smithtown Spirit soccer team's summer golf outing.  The soccer players presented Dr. Robert Parker with a check for $5,000 to be used for pediatric oncology.

Building Bridges for a Healthy Community Health Fair.  On October 18, SBUMC partnered with the Suffolk County Latino Health Initiative at the Building Bridges for a Healthy Community health fair in Brentwood. Over 200 community members attended the event with 100 of them receiving blood pressure, glucose, and cholesterol screening courtesy of SBUMC nurses. We also provided information tables with staff from the Burn Unit and Community Relations. One individual with elevated blood pressure who also complained of chest pains had to be transferred by EMS to the nearest hospital.  A member of the EMS team that arrived is one of our HOPE program students, and we were pleased to witness her in action!  Many thanks to the Community Relations Department for all of their efforts as well as the Auxiliary for providing partial funding for the event.

Employee Perspective Survey.  We invite you to  "Take A Break - Make a Difference."   The Employee Perspective Survey will take place November 12 through November 20.  The survey provides you with an opportunity to voice your opinion about your work environment.   Your reflections on leadership and co-workers and your overall sense of job fulfillment are important to us.  The survey is administered anonymously and all responses are confidential.  The information we learn from the survey will help guide our efforts to be a world-class hospital.  Please make sure your voice is heard.

LAST TOUCH

Pressure has many meanings. Quite literally pressure means the force applied to a given surface (force per square inch); or the social impact from people around you (peer pressure); or when we experience personal stress. Of late, many of us seem to be under a great deal of pressure that is the stressful kind. The uncertainty in the economy has us all off balance. What was once entirely predictable now seems uncertain.

Reality is the leading cause of stress amongst those in touch with it.
--  Jane Wagner (And Lily Tomlin)