October Message from Steven L. Strongwater, MD, CEO

The information below is an employee update of activities at Stony Brook University Medical Center prepared by Stony Brook University Hospital CEO, Steven L. Strongwater, MD. Dr. Strongwater distributes a monthly update that is sent to all hospital faculty and staff to communicate initiatives and activities undertaken at the Medical Center to reach goals in the areas of patient safety, patient satisfaction, and community connections.

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October 2010

Please enjoy this partial summary of Stony Brook University Medical Center (SBUMC) achievements over the past year. Congratulations SBUMC!

• On June 30, SBUMC launched the opening of Stony Brook Long Island Children’s Hospital.
• Stony Brook University Hospital (SBUH) celebrated its 30^th anniversary in February.
• Patient Safety Fridays (and Thursday nights) began on March 12.
• Gastroenterology was named to the U.S.News & World Report’s 2010-11 Best Hospitals (August 2010 issue). 
• On April 7 the new Pediatric Emergency Department held a formal ribbon cutting and Sergey Kunkov, MD, the new Chief of the Pediatric ED, was introduced.
• Hospitals and Health Networks (H&HN) awarded SBUH a Most Wired Award. 
• Becker’s Hospital Review named the SBUMC Cardiovascular Program to its list of the top 25 in the nation.
• Patient Safety Breakfasts began on February 8 to give staff a voice and to recognize that the richest information comes from our own employees.
• SBUMC was recognized as the best performing hospital on Long Island by the Niagara Health Quality Coalition in its eighth annual report card published May 31, 2010, scoring best in more areas than any other Island hospital, including heart attack and congestive heart failure rates.
• SBUMC was awarded a Partner for Change with Distinction Award from Practice Greenhealth, which recognizes healthcare facilities that have achieved improvement in their mercury elimination, waste reduction, and pollution prevention programs beyond the Partner for Change basic criteria.
• Luis Gruberg, MD, Interim Chief, Cardiovascular Medicine, performed the first myocardial stem cell infusion at SBUMC as part of a national clinical trial to revitalize infracted (dead) myocardial tissue.
• Cleverley + Associates recognized SBUH with a 2010 Community Value Leadership Award 100 and Five-Star Hospital in the State of the Hospital Industry 2010 Edition. The Community Value Index (CVI^®) provides a measure of the value a hospital provides the community, and is composed of 10 measures of a hospital’s performance in the areas of financial viability and plant investment, hospital cost structure, hospital charge structure, and quality performance.
• Groundbreaking took place on June 4 for the new Comprehensive Psychiatric Emergency Program (CPEP) Annex—a 10,000-square-foot state-of-the-art patient care facility. 
• The American Heart Association’s Get With The Guidelines^®-Heart Failure program granted SBUMC a Silver Award for heart failure outcomes in recognition of SBUMC achieving an 85 percent or higher rate on all heart failure indicators aggregated over a 12-month period.
• The American Heart Association awarded SBUMC a Get With The Guidelines (GWTG)-Stroke Silver Award for achieving more than 85 percent adherence to the GWTG-Stroke Performance Measures and Guidelines for more than 12 consecutive months.
• Aetna designated SBUMC a Center of Excellence for its Kidney Transplant Program.
• E-Health Network of Long Island, Stony Brook’s Regional Health Information Organization, was selected as a New York e-Health Collaborative (NYeC) Regional Extension Center (REC) Outreach and Implementation Agent.
• The HANYS Pinnacle Award for Quality and Patient Safety ranked SBUMC in the top ten percent of all applications submitted for its role in reducing deep venous thrombosis (DVT).
• SBUMC became a Mentor Hospital for the Institute for Healthcare Improvement (IHI) after successfully deploying quality initiatives related to Rapid Response Teams, Surgical Safety Checklists, and treatment of patients with acute myocardial infarction.
• SBUH’s efforts to standardize the central line insertion credentialing process, “Moving Beyond the Central Line Bundle,” was recognized by the Nassau-Suffolk Hospital Council, Inc. with an honorable mention for 2009 Excellence in Patient Safety awards. The “First Do No Harm” initiative also received an honorable mention.
• SBUMC was one of three state trauma centers recognized by the NYS Department of Health as having significantly lowered patient mortality rates.
• The first and second successful implantations of permanent left ventricular assist devices (LVAD) on Long Island were completed at SBUMC.
• Kevin Watkins, MD, Chief, Upper Gastrointestinal and General Oncologic Surgery Group, performed novel surgery for pancreatic cancer using “irreversible electroporation (IRE),” a minimally invasive surgical technique (also referred to as the “Nanoknife^®”) that selectively kills tumor cells by using electrical fields to poke holes or generate pores in tumor cells.
• Marie A. Badalamente, PhD, and Lawrence C. Hurst, MD, Chair, Department of Orthopedics, discovered and developed Xiaflex^® (collagenase) to treat Dupuytren’s contracture, a debilitating hand disorder that affects millions worldwide.
• Jason C. Ganz, MD, and his team were recognized in the press for two pioneering surgeries performed at SBUMC: hand reattachment of a 29-year-old man, and a “toe-to-thumb” transplant (also known as thumb reconstruction using microvascular toe transfer) for a 25-year-old woman.
• Eric Rashba, MD, and the electrophysiology (EP) team were recognized by Hansen Medical for completing their 30^th arrhythmia treatment procedure using the Sensei^® Robotics Platform, becoming a top user in the tri-state area.
• Assemblyman Robert K. Sweeney presented a 2010 NYS Proclamation in recognition of continuous prostate cancer screening efforts in Suffolk County. This is the second proclamation presented to the Prostate Care Program, now in its fifteenth year of partnership with the Assemblyman and the North Lindenhurst Fire Department.
• The Department of Health approved SBUMC’s application for an autologous bone bank (harvesting, storage, and re-implantation).
• SBUH was featured on the American Hospital Association’s Web page on Urgent Matters Learning Network II for its work in the Emergency Department Patient Flow Collaborative.
• SBUMC achieved the lowest number of patients who leave the Emergency Department without being seen (0.71 percent) compared to 18 other Level 1 Trauma Centers in the U.S.
• Richard Daines, MD, Commissioner of the Department of Health, recognized and thanked SBUMC’s Pharmacy Director, Jeannene Strianse, for sharing SBUMC’s medication safety systems with a group of consultants from Deloitte Inc.
• SBUMC received its best Joint Commission S3 report ever, in the first quarter of 2010.  The lower the S3 score the better your performance.
• SBUMC will receive a U.S. Department of Health and Human Services Organ Donor Bronze Medal of Honor in November in recognition of the Medical Center’s achievement of an 83 percent conversion rate for the period of October 2008 through March 2010—the third time in four years that SBUMC has received this prestigious award.
• The Department of Radiation Oncology installed the Rapid Arc™ Radiation Delivery System, a form of radiation knife to precisely treat cancers. With the Rapid Arc, treatment time is reduced by 20 minutes—from 25 minutes. The very first patient treated at SBUMC with Rapid Arc was treated in just five minutes.
• The Stony Brook University Hospital Auxiliary was honored with a Distinguished Service Award from the Healthcare Association of New York State (HANYS) for its years of dedicated and ongoing service to the community.
• Pediatric Hematology/Oncology had a 36.5 percent decrease in central-line infection rates (April 2009 to April 2010), the result of numerous efforts overseen by a subcommittee formed last May.
• SBUMC achieved 100 percent compliance for both acute myocardial infarction core measure aspirin indicators (aspirin within 24 hours of arrival and aspirin at discharge) in 2009 the third quarter of 2009. SBUH achieved 97.2 percent for the acute myocardial infarction composite score, the highest score achieved thus far for this metric. 
• SBUMC had a 20 percent increase in orders for Foley catheters and a decrease in the number of attributed urinary tract infections as a result of work done by the Preventing Catheter-Associated Urinary Tract Infection team.
• The following units were recognized for reducing hospital-acquired infections.
  No reported central line infections were reported in:
  
  • Medical Intensive Care Unit (MICU) for 7 months (February 2010-August 2010)
  • Pediatric Intensive Care Unit (PICU) for 17 months (April 2009-August 2010).
  No reported ventilator-associated pneumonia (VAP) infections were reported in:
  
  • MICU for 8 months (January 2010-August 2010)
  • NICU for 10 months (November 2009-August 2010)
  • PICU for 15 months (June 2009-August 2010).

• A 17-member team of College of American Pathologists inspectors provided an overwhelmingly favorable review of SBUMC’s Pathology Department.

Congratulations to all! 

STONY BROOK PRIDE 

Tell us about your experiences as employees at SBUMC. All Hospital employees will soon have an opportunity to provide valuable feedback about their work experiences at SBUMC. A letter from Press Ganey Associates, Inc. and a survey titled, “Employee Partnership Survey” will be mailed to each employee’s home. The purpose of the survey is to respond constructively to employee concerns and suggestions, with the ultimate goal of creating an environment that promotes employee satisfaction—which is critical to both improving patient satisfaction and fulfilling our important role in the community. Press Ganey will prepare reports based on the survey results and group the results so that individuals cannot be identified. Confidentially will be strictly imposed. No one at SBUMC will ever see your completed survey and no individual responses will ever be posted. Please take the time to read the letter for more details, and complete the survey. Your participation is strongly encouraged and greatly appreciated.

SBUMC receives recognition for kidney transplant services. The Donation and Transplantation Community of Practice is recognizing its high performing transplant programs in a new way this year. The new award process, developed by the Donation and Transplantation Community of Practice’s Transplant Center Task Force with assistance from Organ Procurement Transplant Network (OPTN) and Scientific Registry of Transplant Recipients (SRTR) data experts, measures performance that takes into account post-transplant survival rates, transplant rates, and mortality rates after being placed on the waitlist. SBUMC’s program was recognized with a bronze award.

Division of Otolaryngology–Head and Neck Surgery (ENT) announces new team members. With two key new team members joining the Division this summer, the five-member ENT faculty, under the direction of David A. Schessel, PhD, MD, now provides a full range of specialized care for both adults and children with disorders of the ear, nose, and throat. New faculty members are Wasyl Szeremeta, MD, pediatric otolaryngologist, and Mark F. Marzouk, MD, head and neck surgeon, who specializes in minimally invasive endoscopic techniques. Other team members are Dr. Elliot Regenbogen, otolaryngologist/laryngologist, and Dr. Ghassan J. Samara, head and neck surgeon/rhinologist.

E-Health Network of Long Island connects with the East End. The e-Health Network of Long Island, the Regional Health Information Organization (RHIO) affiliated with SBUMC, is now connected with Eastern Long Island Hospital (ELIH) in Greenport for electronic patient health information exchange. Connectivity allows physicians to view their patients’ medical records from other facilities in the network, where their patients have been treated and when they have been given consent to do so. The health information exchange by providers at different treatment facilities translates into a better quality of care for the patients they serve. ELIH is the second East End hospital to go live on network, with Southampton Hospital connecting late last year. The Long Island State Veterans Home and Winthrop-University Hospital in Mineola are also live, and there are plans to connect Peconic Bay Medical Center along with several nursing home facilities in the near future.  

Patient flies cross-country for help from SBUMC surgeon. Kevin Watkins, MD, the first surgeon in the world to use NanoKnife^® technology to treat cancer of the pancreas, performed the procedure this past July on a patient who traveled from San Jose, California. After receiving a diagnosis of stage IV pancreatic cancer, the patient and his family sought out SBUMC and Dr. Watkins. After months of preliminary chemotherapy and correspondence with Dr. Watkins and his team, the patient learned he was a candidate for IRE (irreversible electroportation), where the NanoKnife is used to disrupt the cell membrane and kills cancer cells by using controlled electrical pulses to open microscopic pores in the cells of the targeted area. IRE is also used to treat liver, colon, renal, urologic, and lung cancers. Although considered breakthrough technology, the procedure is not a viable option if the cancer has metastasized, or spread elsewhere in the body.

SBUMC imaging specialist advocates 3D MRI as a tool for displaying fetal anatomy. Jeffrey C. Hellinger, MD, pediatric imaging specialist at SBUMC, recently detailed the uses and advantages of 3D MRI to improve the understanding and ability to display fetal anatomy, thus enhancing exam interpretation and communication, in “Fetal MRI in the Third Dimension,” a review published online and in the July-August issue of Applied Radiology. The editor-in-chief of the journal, Stuart E. Mirvis, MD, called the review, which served as the cover story, “Quite likely the first article of its kind. It is an excellent review of 3D Fetal MRI techniques.”

SBUMC Blood Bank honors platelet donor. A milestone was met this past August when donor Rey Nimons, 63, made his 301^st platelet donation—the most in the Blood Bank’s 30 years of operation. Mr. Nimons, who donates blood platelets about every two weeks, every year, and has done so for the past 15 years, was recognized with a commemorative plaque. According to the Blood Bank Medical Director, Dennis Galanakis, MD, just one donation of platelets can help treat one adult or several infants who are bleeding badly from trauma or do not produce enough platelets because of cancer or other diseases. SBUMC and the Health Sciences Center, along with the New York Blood Center, are running a fall Blood Drive on October 6. For more information, call (631) 444-3662.

SBUMC welcomes new Information Officer for Ambulatory Clinics. Gerald Kelly, MD, Clinical Associate Professor of Family Medicine, has been appointed as the Assistant Chief Medical Information Officer for the Ambulatory Clinics. In his new role Dr. Kelly will provide leadership and oversight to the rollout of the Ambulatory Electronic Medical Record (EMR). His knowledge and experience in the outpatient EMR will be a valuable asset in this initiative. He will work closely with Clinical Informatics, IT, and practitioners to ensure a smooth transition from paper to electronic record. 

Congratulations to October Employee of the Month. Octavio Juarez, Medical Records Assistant in the Department of Health Information Management, was chosen as the Employee of the month for October. In his role, Mr. Juarez demonstrates a high sense of responsibility, loyalty, and true commitment. He offers assistance with a warm and cheerful disposition and often comes up with innovative suggestions for improvement, ultimately using resources and staff time in a more efficient manner. When necessary, he assists in Spanish interpretation and always shows respect and compassion for our patients and their family members. Mr. Juarez is admired by his peers, as well as employees from other departments for his integrity, sincerity, and professionalism.

Show your SBUMC pride by wearing red on Fridays. At the onset of the new academic year, University President Samuel L. Stanley Jr., MD, reminded all Stony Brook faculty, staff, and students to “Get Your Red On!” every Friday to celebrate the spirit of Stony Brook and the pride we share in being part of this wonderful campus community. Let’s all join in on “Red Fridays” as a gesture that serves to bring us all together in a show of pride. You can “Get Your Red On” with officially licensed Stony Brook University gear available at any one of four on-campus locations including the Seawolves MarketPlace, Barnes & Noble bookstore, Matthew’s bookstore, and the Wang Center Gift Shop. The clothing line is also available online at shopsbu.com and goseawolves.org.

PATIENT SAFETY

Patient Safety Fridays continues to evolve. A full six months of Patient Safety Fridays have now been completed, and was marked with a celebratory cake at the September 24 Patient Safety Friday. The process has evolved: the areas visited are expanded; focused surveys, such as the “Professional Communication Audit” designed to solicit feedback on interdisciplinary relations, were added; and off-shift visits are conducted with “Fridays on Thursdays.” These efforts have resulted in improvements in patient safety. Specifically, the Pain Management process has improved, measured by both patient outcomes and process surveys. Knowledge of the Rapid Response process has improved for both staff and patients. Handwashing has improved from a low of 68 percent to the most current 82 percent. The Press Ganey Culture of Safety Survey, which many of you completed, shows a significant improvement in our overall score. You will soon be hearing more details regarding the outcomes of the survey. These successes make us even more determined to continue our weekly efforts to improve safety for all our patients and provide our staff with necessary information and a safe environment in which to work. Thank you for participating in Patient Safety Friday surveys, and for contributing to the success!

Hand hygiene is non-negotiable. Individually, everyone needs to take accountability for his or her own practice. In addition, no one should hesitate to remind other staff members that they must wash their hands. If you observe someone who has not performed hand hygiene appropriately, you must correct him or her, and report the observation for more formal follow-up. Reports can be made to Robert.Kirincic@stonybrook.edu. The reporter’s name will be kept confidential and the individual and his/her supervisor will receive a letter noting the infraction. Hand hygiene is non-negotiable and failure to properly apply hand hygiene places our patients at risk for hospital-acquired infections.

Rapid Response Team (RRT) calls continue to increase. SBUMC reached an all-time record number of RRT calls for the period of August 2009 through July 2010—a positive indication of the program’s effectiveness. The team received 938 calls, the highest number of calls for a 12-month period since the team began in December 2005. Currently, the Hospital is focusing on educating patients, family members, and visitors about their right to call a rapid response team if they feel they need immediate assistance. Signs have been posted in all patient rooms to provide information on how to call a Rapid Response by dialing 321.

Rapid Response Team (RRT) calls increase during the night shift. Since the Rapid Response Team (RRT) was expanded to 24-hours a day, seven days a week in September 2006, the number of calls made during the night shift has continued to steadily increase. For the period of August 2009 through July 2010, calls made during the night shift accounted for 29 percent of all of the calls made. The number of calls made throughout the day, evening, and night shifts continue to approach an equal distribution, which demonstrates how important the team is to the care of patients at SBUMC.

Institute for Healthcare Improvement (IHI) Sepsis Collaborative concludes. The IHI Sepsis Learning Collaborative ended with a webinar on September 2, which was attended by representatives from the Continuous Quality Improvement Department and several of our medical staff. SBUH’s 12-month running severe sepsis mortality rate was 13.23 through July 2010, below our reduced target of 14.00, and under the baseline average of 26.70. Congratulations to all!

Rankin Scale Scores documentation. Clinical Informatics and Stroke Service staff have worked together to enhance CMS-required reporting for patients presenting with stroke in whom carotid artery stents are placed. Donna Moller, in consultation with Ann Marie Byers and Andrea Kabacinski, developed PowerForms to assist in capturing Modified Rankin Scale Scores in the legal medical record for patients presenting with stroke. Antonieta Rosenberg and Joanne Clyde have trained nursing staff on 13N and the new assessment form was moved into production for use.

Lean Poster is accepted for presentation. A poster submitted by the Department of Quality Management in collaboration with the Department of Emergency Medicine was selected for presentation at the 2011 Society for Health System’s conference. The poster represents a collaborative effort of applying lean concepts to facilitate change to patient flow in the Emergency Department. Titled, “Educating Healthcare Professionals to Use Lean–Just What the Doctor Ordered,” the poster focuses on a large academic medical center’s approach to adopting and applying lean principles and tools in healthcare.

Student interns in Nursing Quality Management. The Department of Nursing Quality Management had the privilege of precepting and mentoring Beatrice Sartor, a senior at St. Joseph’s College. After completing an internship and senior practicum this past summer, she is earning a Bachelor of Science in Health Administration. During her internship, Beatrice participated in Patient Safety Fridays, Clinical Peer Review meetings, Patient Safety Net drill-downs, the Patient Safety Net Oversight Committee, quality improvement initiatives, mortality reviews, the Nursing Quality Council meetings, the United Nursing Council, and Department Head meetings. In her evaluation for her Internship/Senior Practicum, Beatrice indicated, “during the internship, my educational knowledge and understanding of the quality improvement process came together like an orchestra. All the pieces to the puzzle fit, making a larger picture which, without this opportunity, would not have been possible.” Many thanks to all who helped make this a positive educational experience for her. This was a wonderful opportunity for the Department as well.

PATIENT SATISFACTION

16N focuses on improving patient satisfaction. The focus is in three areas that are highly correlated to overall patient satisfaction on the unit and for inpatients in general. The issues are “staff included in decisions regarding treatment,” “response to concerns and complaints,” and “how well your pain was controlled.” Several proven strategies are being implemented. These include: nurse shift report at the bedside, which involves passing on information about the patient’s condition and treatment to the next caregiver in the presence of the patient; allowing patients to ask questions, express concerns, and provide input about their care; and hourly rounding, which focuses on patient positioning, pain, bathroom needs, and making sure things like the phone, television remote, etc. are within the patient’s reach, and providing more opportunities for patients to ask questions and provide feedback.

Ultrasound responds to patient surveys. The areas of “convenience of parking, ease of finding way, waiting time in registration, and comfort of the waiting area” are being addressed in response to patient feedback. Staff is working harder to communicate the availability of valet parking, which is reasonably priced and convenient. Better signage on Level 4 is being developed, as well as maps to specific test areas for distribution at the Information Desk to make it easier for patients to locate the ultrasound area. To make registration easier, Radiology will test moving a registrar to the Hospital Information Desk. And new furniture with cushioned chairs will replace the hard wooden chairs currently in use in the waiting area to help make patients more comfortable.

Spotlight on Quality. The SICU-SICR and the Burn Unit hosted a Spotlight on Quality titled, “Monitoring Effectiveness: Our Journey Toward HRU (High Reliability Unit),” with approximately 120 people stopping by to network with the “Pod Squad.” To provide some cultural diversity training, nurse educator Sabra Boughton, RN, PhD, demonstrated the dual set hand phone used as part of SBUMC’s for interpreting services.

COMMUNITY CONNECTIONS

Suffolk County schools support Stony Brook Long Island Children’s Hospital. Working with the Suffolk County Superintendent’s Association, the Stony Brook Children’s Hospital Task Force launched its “Change for Children” campaign. The campaign invites every school district in Suffolk County to show their support for Stony Brook Children’s by distributing “Change for Children” spare change collection boxes (to elementary students) or by organizing collection drives (for middle and high school students). The Task Force’s goal is 100 percent participation of all Suffolk school districts and collected funds totaling at least $1 million. In addition, the Task Force has sent letters to prospective and current donors to encourage them to match the efforts of their local school districts. 

SBUMC Development Council extends welcome. The Development Council gathered at the home of the Council’s Chair, Dr. Charles Ryan. Dr. Ryan and Dr. Maria Ryan held a welcome reception in honor of Kenneth Kaushansky, MD, newly appointed Senior Vice President of the Health Sciences and Dean of the School of Medicine. The Development Council has grown to 16 members who work to support the mission of Stony Brook University Medical Center through philanthropy and by increasing community involvement.

Bone marrow transplant patients celebrate together on a cruise. More than 100 of Dr. Michael Schuster’s patients from the Bone Marrow and Blood Stem Cell Transplantation Program, along with family and staff, set sail around Port Jefferson Harbor in a “Celebration of Life.” The cruise was sponsored by the Times Beacon Record Newspapers, Lombardi’s Market, and the Port Jefferson Ferry. 

Stony Brook marks the 9th anniversary of September 11. A Commemoration Ceremony was held on September 13, for students, faculty, and staff, who gathered at the Alumni Memorial Arch to reflect on the loss of the 21 alumni and other family members and friends who died on that day. The noon ceremony was followed by a silent procession up the Academic Mall to the Memorial Grove (SAC Circle).

The School of Medicine held its annual White Coat ceremony on September 19. The Class of 2014 consists of 124 students, and matches the largest incoming class in the School’s history. Each student received a white coat, a symbol of professionalism, responsibility, and compassion in the practice of medicine, and recited the Hippocratic Oath. The ceremony also provided students the opportunity to meet the new Dean of the School of Medicine, Dr. Kenneth Kaushansky.

A Candlelight Celebration was held to recognize National Gynecologic Cancer Month. The Celebration was held at the Stony Brook University Cancer Center on September 20, to honor women whose lives are affected by gynecologic cancers. Speakers included physicians, nurses, and survivors sharing their stories. As each name was read aloud, a flame was passed to light another candle, symbolizing unity in the fight against gynecologic cancers. Participants included survivors of ovarian, uterine, cervical, and other forms of gynecologic cancers, and their families, in addition to families of those who lost a loved one. Michael Pearl, MD, Director, Division of Gynecologic Oncology at SBUMC, his staff, staff at the Cancer Center, and members of Long Island OCEANS (Ovarian Cancer Education Awareness Network and Support) helped to organize the event.

The Center for Biotechnology at Stony Brook University hosted a Life Sciences Summit. The summit, held September 22 and 23 in Hauppauge, brought together some of the world’s top bioscience companies with entrepreneurs and academic innovators to explore the next generation of biomedical solutions that will bring groundbreaking medicines to patients worldwide. Approximately 125 speakers presented, including sessions led by pharmaceutical company CEOs, venture capitalists, and leading physicians and researchers specializing in areas such as regenerative medicine, the neurosciences, and genetics. The program, developed by the Center for Biotechnology in partnership with Demy-Colton Life Science Advisors, includes expert presentations and interactive symposia centered on how to develop and market the next generation of medicines.

Be sure to “Walk for Beauty, Walk for Life” on Sunday October 3. Since 1994, breast and prostate cancer survivors along with their families, physicians, and staff of SBUMC have joined forces with the community to raise much needed funds for cancer research and resources needed by patients. This year SBUMC’s own Nora Geiser, NP, of the antepartum unit, will be singing the National Anthem to kickoff the event. If you haven’t registered already, you may bring your $20 registration fee along with any additional pledges you have collected to the Walk. Registration begins in front of the Stony Brook Post Office at 8:30 am, and the Walk starts at 9:30 am. We will also be recognizing breast cancer survivors and longtime friends of Stony Brook University Hospital Judy Granville, Jean Larsen, Lorraine Pace, and Maryann Varvao. For more information, call (631) 444-4000. 

Innovative Geriatric Care Ministry Program, hosted by the School of Social Welfare, is scheduled for October 4. Stony Brook’s School of Social Welfare is sponsoring the program, designed to help clergy of all faiths and other spiritual leaders improve the quality of life for older people in their congregations and communities. The free program will take place at the Long Island State Veterans Home from 8:00 am to 3:00 pm. A Certificate of Achievement in Geriatric Care Ministry from the Center for Aging Policy Research, Stony Brook University School of Social Welfare, will be awarded, in addition to continuing professional education units when authorized by discipline-specific governing boards. For more information, contact Mamie Gladden at (631) 444-3142, or Mamie.Gladden@stonybrook.edu.

8^th Annual Long Island Educators & Healthcare Professionals Cup Golf Tournament will support ALS research. The event takes place on Columbus Day, October 11, at the Spring Lake Golf Course in Middle Island. Teachers and healthcare professionals will compete in the tournament, sponsored by the Ride for Life, an organization that raises awareness of ALS (amyotrophic lateral sclerosis) and funds to help find a cure for the disease. Proceeds benefit the ALS Comprehensive Care Center at Stony Brook University Medical Center, the only ALS Association Certified Center on Long Island. Proceeds will also help fund the Ride for Life ALS Scholarship Program, which assists Long Island students whose families have been impacted by ALS. For more information or to register, contact Ride for Life, (631) 444-1292 or Rfloffice21@aol.com.

Human Resource Services presents its first Campus Community and Services Fair. Learn what Stony Brook can offer you. The fair is open to all faculty and staff and provides an opportunity to meet with service providers such as Liberty Mutual, NYSHIP healthcare providers (Empire Blue Cross, Medco, HIP/Vytra/HIP Prime, United Healthcare), retirement providers (TIAA-CREF, ING, MetLife, etc.), Stony Brook Athletics, Stony Brook’s Wellness Center, and many more. The fair is scheduled for Wednesday, October 13, from 11:30 am to 2:30 pm in the main lobby of the Charles B. Wang Center.

The 10^th Annual Fall Fashion Festival features SBUMC “models.” The Fall Fashion Festival, where our celebrity models are our medical staff, is scheduled for October 14 at Villa Lombardi’s in Holbrook. Funds raised from the Fashion Festival benefit patients being treated for cancer at SBUMC. The evening includes a basket auction, DJ, cocktail hour, dinner, and a “Parade of Survivors.” For more information or for tickets, call (631) 444-4000.

Support the 2010 Suffolk County Start! Heart Walk. This year’s heart walk will be held on the Stony Brook University campus on Saturday, October 16. “Start!” is the American Heart Association’s movement to get America walking and promote physical activity and heart-healthy living in a fun environment, and raises funds for the American Heart Association. This year’s Walk is chaired by Lee Anne Xippolitos, RN, PhD, SBUMC Chief Nursing Officer and Dean of the Stony Brook University School of Nursing. SBUMC nurses and other staff will provide educational information on nutrition, fitness, and heart-healthy living, as well as provide blood pressure screenings. A health fair will include vendors and health organizations promoting health and wellness, and a Kid Zone will offer fun activities just for children. Pets on leashes are welcome to the “Paws for a Cause” Dog Walk. Donation turn in is at 8:30 am, and the Walk begins at 10:00 am. For more information or to register, call (631) 444-4000 or visit suffolkcountyheartwalk.org.

22nd Annual Run for Children supports SBUMC’s Child Life Program. The Run, which raises funds to support the Child Life program, takes place at Gelinas Jr. High School in Setauket on Sunday, October 17. The Child Life program helps make children feel comfortable and cared for during their hospital stay by providing therapeutic, educational, and recreational activities to meet the unique emotional and developmental needs of children. Registration begins at 7:30 am, and the race starts at 9:30 am.  For more information or to register, call (631) 444-4000.

Cody Center friends host reception. Jeannette and Ralph Fresolone hosted a Cody Comedy sponsor reception at their home, allowing supporters to explore and discuss new ways to provide essential resources needed by the Cody Center. This year’s Cody Comedy Festival, featuring comedian Larry Miller, will be held Wednesday, October 20. For tickets to the cocktail reception or show, visit stonybrook.edu/codycomedy. 

Stony Brook Children’s presents expert on children and the media. Dimitri Christakis, MD, MPH, an international expert on media and children and author of the book, The Elephant in the Living Room: How to Make Television Work for your Family, will discuss the effects of screen violence and real world aggression, the role that media play in promoting “tween” and teen risk taking, and Internet use, misuse, and addiction. The event is free and will be held on October 20 at the Nesaquake Middle School in St. James, at 7:00 pm. For more information or to register, call (631) 444-4000.

SBUMC experts provide breast cancer update. Healthcare experts from the Carol M. Baldwin Beast Care Center at SBUMC will provide information on the latest in breast cancer diagnosis and treatment on Wednesday, October 27, at the Ward Melville Heritage Organization Educational & Cultural Center in Stony Brook. A light supper will be provided. For more information or to register, call (631) 444-4000. 

E-Health Network promotes enhancing the quality of patient care through use of the Electronic Medical Record. Denise Reilly, Director of the e-Health Network of Long Island, discussed Meaningful Use of an Electronic Medical Record (EMR) at a recent New York eHealth Collaborative EMR Summit. The purpose of the summit was to bring EMR companies together with physicians in the community to educate and provide demonstrations of various EMR products. E-Health Network will be hosting its own series of EMR Vendor Fairs on October 27, at two locations: Winthrop-University Hospital, 9:00 am to noon; and SBUMC, 4:00 pm to 8:30 pm. A vendor fair is also scheduled for October 28, at Southampton Hospital, from 10:00 am to 2:00 pm. CME credits will be offered at the Stony Brook event, where CIO, Linda Shanley, will be presenting a lecture on meaningful use. For more information call (631) 444-4000. 

Free individual health and nutrition session are being offered. Employee Health and Wellness is offering free nutritional education to help manage weight loss, diabetes, and other health issues. The 30-minute, individual sessions began in September. To learn more or to schedule your session, call (631) 444-7767.

Get your flu shot at one of SBUMC’s Flu Fairs. Employee Health and Wellness has begun administering flu shots. Get yours by stopping at the ACP Conference Room on October 1, between 8:30 am and 1:30 pm, or at 31 Research Way, Conference Room A, on October 4 or 6, between 8:00 am to 4:00 pm. To receive the vaccine, your ID badge must state “Hospital Access.” Vaccines will also be available after those dates during regular Employee Health and Wellness office hours, and mobile carts will be visiting units during nights and weekends. For information, call (631) 444-7767.  

Stony Brook is serious about safety. As Robert J. Lenahan, Stony Brook University Chief of Police, recently reminded us, a significant amount of vehicular accidents and pedestrian injuries can be directly attributable to driver or pedestrian distraction. Whether you are walking or driving your car, the use of cell phones, iPods, or other electrical devices puts you and others at risk. To reduce that risk, everyone is encouraged to refrain from using these devices when traveling to his or her destination, and to simply “Put it Down.” For more information please go to stonybrook.edu/police/safety/reactions-not-distractions. While visiting this site, please commit to making Stony Brook University a safer place by taking the pledge.

My Last Touch

Why do people apologize? Why do some people find it so hard to apologize? Why do some apologies fail? Why do some apologies make matters even worse? Is it ever too late to apologize?

It turns out apologies are profoundly important. Without knowing it, each of us has the power to forgive extraordinarily painful experiences. Apologies not only help others, but they help to relieve our own pain and suffering. Why should an apology to someone else help you feel better? Precisely because apologies are often reflective of deep-seated guilt about something you said or did. Shedding or unloading guilt is, at a minimum, cleansing. 

Conversely, lack of an appropriate apology can lead to longstanding grudges. Families have been split apart because of short-lived events never intended to cause harm or pain, such as someone missing an important event, forgetting to recognize an important gesture, embarrassing a family member at a function, etc. These events are frequently accompanied by shame and/or humiliation, two powerful human emotions. Many people carry these emotions to their graves. Children carry lifelong guilt for failing to reconcile with their parents about something before the parents die. Imagine if a healthcare worked did something wrong to a patient and failed to apologize? Apologies are tremendously powerful, something we often forget.

Some people apologize with sincerity. Others say they are sorry, but their apologies do not ring true. What makes one apology different from another? Aaron Lazare, MD, has carefully examined the anatomy of apologies (On Apology, Oxford University Press, 2004). Lazare observed “…[that] the phenomenon of apology can be a window into the human emotions and behaviors that maintain and restore human dignity.” He defines apology as, “an encounter between two parties in which one party, the offender, acknowledges responsibility for an offense or grievance and expresses regret or remorse to a second party, the aggrieved.” 

The Greeks used the term apologia to distinguish between a defense or justification of an idea and a true apology. Initially, President Richard Nixon used an apologia, as opposed to an apology, for Watergate—“It was a way to keep the country safe.” We since learned this was not true, and Nixon ultimately apologized and paid a steep price for his transgressions. Apology (aka apologia), in this context, “does not acknowledge a transgression and thus needs no request for a pardon or forgiveness.”

There is also the notion of a compassionate or empathetic apology, such as “I am sorry you are sick.” This too is not really an apology because there is no acceptance of responsibility for or expression of personal remorse. Apologizing for leaving dinner early for an appointment is not really an apology. It is more an explanation or an expression of concern or sympathy for the limits or inconvenience placed on others. “I am sorry” doesn’t always convey the same meaning, so there can be confusion by the different meanings of an apology.

What is a true apology?

If you accuse another of an offense and that person answers with those two words, ‘I apologize,’ you receive little satisfaction, expecting other expressions, such as I feel terrible. It was wrong of me to do this. How can I make it up to you? [A successful apology requires]…the restoration of respect and dignity, assurances that they and the offender have shared values, assurances that they were not at fault, assurances that they are safe from further harm by the offender, knowledge that the offender has suffered as a result of their offense, a promise of adequate reparations, and the opportunity to communicate their suffering and other feelings about the offense. (Lazare)

According to Lazare, a successful apology has four parts: (1) the acknowledgement of the offense, (2) the explanation, (3) various attitudes and behaviors including remorse, shame, humiliation, and sincerity, and (4) reparations.

Not everyone understands or knows when to apologize. Lazare created a list of common situations to sensitize us to the need to apologize: overlooked or taken for granted; rejected; denied basic social amenity; manipulated or treated like an object; treated unfairly; verbally abused; reduced in status or role; betrayed; falsely accused; psychologically or physically threatened; physically or sexually abused; publicly shamed; beliefs or affiliations denigrated; boundaries or privacy violated. If there is a scale for these transgressions, so too there must be a scale for the kind of apology offered. Apologies should be clear and specific, and transfer the power of accepting or rejecting the apology to the injured party. Just saying “I apologize for whatever I did” fails to meet even a minimum acceptable apology standard.

There are two reasons why people fail to apologize (apart from not being aware of an offense requiring an apology). First, they “fear the reaction of the people to whom they apologize, and secondly, they are embarrassed or ashamed of the image they would have of themselves” (Lazare). Quotes from interviews of high school students, medical students, and medical professionals: “They would change their regard for me.” “I might never be forgiven.” “She might make a scene, especially in public.” “It makes me feel weak to apologize.” “Apology is an admission … of incompetence…” “It is difficult to apologize because it is giving in to the other person and that makes you feel as if you lost.” “When you say you are sorry, you are likely to take a battering to your self esteem.”

How does this relate to us? Apologies are critically important for healthcare workers. We must be constantly vigilant to offenses we cause our patients or our peers, whether for social, cultural, or medical reasons, and then apologize (a true apology). We must face up to our human frailties. If or when a medical error occurs, we must inform our patients and colleagues, and offer a full and complete apology. SBUMC will provide a safe environment to encourage appropriate and timely apologies. We are convinced this will improve care and support a healing environment for our patients.

An apology is a good way to have the last word.
—Author Unknown

Never ruin an apology with an excuse. 
—Kimberly Johnson 

A stiff apology is a second insult... The injured party does not want to be compensated because he has been wronged; he wants to be healed because he has been hurt.
—Gilbert K. Chesterton 

Enjoy the journey to world class.

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