CEO Update September 2007
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.
September 1, 2007
The robot is coming! The robot is coming! The robot is coming!
To remain at the forefront of technology, Stony Brook University Medical Center is installing a state of the art surgical robotic system this month. The da Vinci® S HD™ Surgical Systemwill be on display in the Galleria on September 5 from 7 am to 11 am and September 6 in the Main Lobby 10 am to 3 pm. It is described in more detail below.
As relayed in my August update, the Cerebrovascular Surgical program began with the arrival of Dr. Henry Woo in August. He has already performed several minimally invasive procedures, and in January, additional new imaging equipment will be installed in the Department of Radiology to enhance the program.
We are proud and excited by the caliber of Stony Brook faculty and the exciting advances they bring to SBUMC and Suffolk County. This is happening at a time when patient satisfaction scores continue to rise.
–As mentioned in my last update, we continue the strategic planning process. Through this year’s strategic planning which began in March, we have identified five critical issues facing the institution for which we are preparing enterprise-wide strategies. These issues cut across the institution, impacting many departments within the medical center, and thus require an institution-wide approach. They include: enhancing patient satisfaction, enhancing community physician relations, preparing a regional outpatient strategy, insulating SBUMC from major payers’ reimbursement reductions, and enhancing physician recruitment and retention. Small, interdisciplinary teams of clinicians and administrators are working together to prepare these strategies. This work will also be presented to the Strategic Planning Steering Committee in September.
In addition, to ensure that the Medical Center’s resources are allocated in a way that supports the institution’s mission and vision, we initiated a competitive service line planning process. Service lines are defined as broad categories of care such as cardiac services or cancer services. Physician, nursing, and administrative leadership of the hospital’s service lines have been preparing an analysis of their service line’s strengths, weaknesses, opportunities, and threats, defining their service line’s 5-year vision, and compiling the preliminary information needed to complete business plans for all new projects or programs needed to achieve their
5-year vision. This work will be presented in September to the SBUMC’s Strategic Planning Steering Committee for review and approval.
Stony Brook Pride
Robotic Surgery Arrives At SBUMC. The da Vinci® S HD™ Surgical Systemprovides surgeons with an alternative to both traditional open surgery and conventional laparoscopy, putting a surgeon’s hands at the controls of a state-of-the-art robotic platform. The system is the first da Vinci S HD in clinical service on Long Island and NYC. It integrates 3 dimensional HD endoscopy and state-of-the-art robotic technology to virtually extend the surgeon’s eyes and hands into the surgical field, providing surgeons greater than twice the viewing resolution and 20% more viewing area. Patients experience significantly less pain, blood loss, and scarring, while recovering faster returning to normal daily activities, and in many cases, there is a better clinical outcome. Initial plans call for using the robot for minimally invasive prostate surgery. Dr. Rahuldev (Rahul) Bhalla, who completed his residency training at Stony Brook, has returned to SBUMC as Director of Minimally Invasive Urology. He is a robotic expert and trainer and plans cases for this month. There are many other indications for the use of the robot including cardiac, gynecologic, urologic, general, and pediatric surgery. Advanced robotic equipment will also enable our training programs.
Cardiothoracic Surgery Expands SBUMC Minimally Invasive Cardiac Surgical Capabilities. Dr. Frank Siefert has introduced a new surgical technique which allows anastomoses (connections) of blood vessels as small as one millimeter in internal diameter. The hope is this will allow less invasive bypass surgery while maintaining high quality results similar to those achieved with open cardiac bypass procedures. The device is the “C-Port Flex A Anastomoses”. This allows secure connection even in the most difficult to reach areas of the heart.
SBUMC leads all Long Island hospitals by offering a broadening array of minimally invasive cardiac surgical techniques including mini-thoracotomy aortic valve replacement, Off Pump Cardiac Bypass Graphs (CABG), Minimally Invasive CABG, mini-mitral valve surgery and the thoracic stent program.
Three from SBUMC Selected Finalists for Health Care Heroes Awards. Carol Gomes, Todd Rosengart and Suzette Smookler have been selected as finalists in the “Health Care Heroes” Award competition sponsored by Long Island Business News. Carol was selected in the Achievements in Health Care category, Dr. Rosengart in the Physician Hero category, and Suzette Smookler in the Health Care Professional Hero category. Finalists were selected by a committee of business and health care leaders based on the biographical information sent to LIBN reflecting career and professional accomplishments. All finalists will be honored at a special breakfast that will be held on Thursday, Oct.18 at The Crest Hollow Country Club in Woodbury. Congratulations and good luck.
SBUMC Neonatologist Named Top Young Innovator Worldwide by Technology Review Magazine. Shetal Shah, M.D. was named by Technology Review magazine as one of the top innovators in the world under the age of 35 for the creation of a device to measure forces imparted on patients during transport or trauma. Dr. Shah was selected from more than 300 nominees. This is the most recent recognition for Dr. Shah. He was also selected recipient of the 2007 Most Distinguished Young Physician Award from the American Association of Physicians of Indian Origin (AAPI). The AAPI is the largest ethnic physician organization in the United States with a membership of 57,000 physicians, residents and medical students. He was also appointed by the Council for the International Exchange of Scholars and the J. William Fulbright Foundation to the Senior Specialist Roster of the Fulbright Senior Specialist Program. The program matches specialists with overseas academic institutions. In April, he practiced in the Neonatal Intensive Care Unit at Kashiben’s Children’s Hospital in India. There he treated patients, taught residents, and helped clinicians adapt existing technology to current treatment modes.
New Portable Operating Rooms Arrive at SBUMC. Two portable operating rooms have arrived at SBUMC and will be installed this month. The addition of these Operating Rooms in October will improve surgical access and make way for the construction of ten new operating rooms as part of the Major Modernization Project.
SBUMC to Present at National Quality Meeting. Dr. Bill Greene and Carol Gomes were selected to present at a breakout session at the University Health System Consortium (UHC) 2007 Quality and Safety Fall Forum titled "Using Dashboards and Scorecards: Setting Expectations for Board Members and Front-line Staff". The presentation will focus on SBUMC efforts to utilize dashboards and scorecards to encourage active engagement by integrating goals and targets into daily practices.
Full Joint Commission Accreditation. During the past month, the hospital successfully completed its final audits for all Joint Commission surveys and sentinel event measures of success. The audits demonstrated sustained compliance with all Joint Commission standards. The Joint Commission's acceptance of the audits ensured the continuance of the hospital's full accreditation. At the same time, the hospital completed its annual self evaluation - the Periodic Performance Review. This assessment also showed that the hospital remains in substantial compliance with Joint Commission standards.
Patient Satisfaction
Patient Daily Activity Cards. Patient Activity Cards are nearing the end of a three month pilot. A formal evaluation has been part of this program. It appears many patients and their families find the activity cards helpful. Staff are also evaluating the effectiveness of the activity card. All comments will be discussed and analyzed before a house wide rollout. Thank you for your support of this important program. .
Emergency Room Patient Representative Program. The introduction of a dedicated Patient Representative for the Emergency Department is part of an overall strategy to focus on excellence in service, the quality of the human experience and to improve patient satisfaction. The Patient Representative provides an array of services to meet the needs of patients and families in the ED. They serve as vital liaisons to patients and caregivers. Among other roles, Patient Representatives continuously round on patient treatment areas and waiting rooms, provide a visible welcoming presence to patients and families, keep open lines of communication (particularly with regard to concerns about care, waits, or delays), respond to questions (i.e. about policies, amenities), and provide for comfort needs such as blankets, telephone connections, reading material, and boxed meals. They also offer emotional support to those in need and track the “voice of the patient”.
Cancer Patient Satisfactions Scores Rise. Outpatient cancer patient satisfaction scores as measured by Press Ganey surveys for the month of August, the first month that includes patients seen at SBUMC’s new facility, are the highest we have received since the survey was initiated in 2004.
Patient Safety
Patient Safety Exemplar Unit Selected. One step toward becoming a high reliability organization (HRO) is to identify and implement best practices and high standards that differentiate SBUMC. In order to become a high reliability organization, the CCU (Cardiac Care Unit) and CACU (Cardiac Acute Care Unit) were identified as pilot units to work toward becoming “Exemplar Units”. A team is in the process of identifying key characteristics of Exemplar Units and will develop an implementation plan to move toward becoming an HRO.
MEWS/PEWS Update. 13N continues to plan for MEWS (Modified Early Warning Scores) implementation. The interdisciplinary team is in the process of testing the assessment tool while awaiting the purchase of a whiteboard which will be used to display acuity scores. In addition, the nursing staff and physicians, including hospitalists, are in the process of being educated on how to utilize the algorithm and accurately assess patients for the MEWS.
The PEWS (Pediatric Early Warning Scores) Team modified the blood pressure criteria to address age appropriateness. 11N/Pediatrics is in the process of testing the revised assessment scale. The Kardex was updated to include the PEWS score.
Patient Safety Council Annual Meeting Scheduled. The next Patient Safety and Quality Council Meeting is scheduled on November 13, 2007. In order to improve the care provided at SBUMC, we are in the process of implementing recommendations provided from the last meeting, such as forming Patient Advisory Councils to obtain feedback from patients. Council members include Dr. James Bagian, U.S. Department of Veterans Affairs; Dr. Albert Bothe, Geisinger Health System; Ms. Carolyn Brady, Planetree; Dr. David Burnett, University Healthsystem Consortium; Ms. Ilene Corina, Patient Advocate; Dr. Peter Deckers, University of Connecticut; Ms. Wendy Everett, New England Healthcare Institute; Dr. Andrew Gaffney, Vanderbilt University School of Medicine; Dr. Martin Hauptman; Ms. Laura Pizzi, Thomas Jefferson University; Dr. Gail Powell-Cope, VISN 8 Patient Safety Center; Mr. Satya Sharma, Stony Brook University; Father Robert Smith, St. James Roman Catholic Church; Dr. Susan Pingleton, University of Kansas.
Quality Assessment Review Board (QARB) To Meet in September. The newly empanelled QARB will begin meeting this month. QARB was appointed by the Board of Trustees. Matt Cody has agreed to serve as the chair. Other QARB members include: Rev. Dr. Beresford Adams, Dr. Arthur Aufses, Mr. Harold Davitian, Dr. Richard Fine, Ms. Esther Fortunoff Greene, Mr. John Gallagher, Dr. William Greene, Dr. Martin Karpeh, Mr. Joseph Purcell, Ms. Ronni Schultz, Mr. Cary Staller, and Dr. Steven Strongwater.
SBUH Baldrige Journey Officially Begins. The Senior Executive Group and Executive Staff recently completed a leadership survey to identify strengths and opportunities for improvement relating to Leadership, Strategic Planning, Customer and Market Focus, Measurement/Analysis and Knowledge Management, Human Resource Focus, Process Management and Business Results (Baldrige Categories). This will enable the development of action plans as we become a world-class high reliability organization.
ICU Committee Forms Failure Mode and Effects Analysis Team. This FMEA will focus on patients admitted to ICUs after being admitted to the floor via the Emergency Department within 24 hours prior to transfer.
Central Line Policy Standardized. A subgroup of the ICU Committee developed a standardized central line insertion policy.. Next steps include plans to develop educational and credentialing standards for central line insertion throughout the hospital.
Community Connections
Community Faculty Town Hall Meeting Planned for September 11, 2007 at the Watermill in Smithtown from 6 to 8 PM. In an effort to reinforce our commitment to engage the community, a Town Hall meeting has been scheduled for September 11, 2007. We will discuss a variety of topics including our new Patient Transfer Center; new services and innovative techniques such as LVAD (left ventricular assist device); same-day faxing of discharge notes; and free valet parking for community physicians. Updates on the Major Modernization Project, the Berger Commission, and HealthConnect® will be provided. Faculty representatives from each department have been requested to attend.
Dr. Strongwater Invited to Meet with Brookhaven Hospital Medical Leadership. On August 8, 2007 I met with the medical leadership of Brookhaven Memorial Hospital. The agenda included an overview and update on the Major Modernization Project as well as an overview of our numerous community physician outreach initiatives, including the appointment of a Physician Outreach Manager; activation of the Transfer Center number (631- 444-1911) for one stop shopping for all transfers; the enhanced role of SBUH HealthConnect (faxing discharge summaries less than 24 hours after admission, single point of contact for outpatient referrals); and, an overview of the beginning phases in the development of the Suffolk County Regional Health Information Organization (RHIO). Feedback from the meeting was shared with the Clinical Chairs.
The Employee Breast Milk Pumping Room will open for staff effective September 4. Please contact Employee Health Services Monday – Friday 8:00 am to 3:30 pm. @ 444-7767 or 444-8023. Employee health staff will provide you with direction for accessing the pumping room located in the hospital.
The Fourteenth Annual Walk for Beauty, Walk for Life is scheduled for Sunday, September 30 in the Stony Brook Village Center. The Stony Brook Medical Center teams up with the Ward Melville Heritage Organization to sponsor the walk, which raises money for breast and prostate cancer research and increases community awareness of the fight against cancer. Since its inception in 1994, the walk has raised more than $800,000. Registration begins at 8:30 and the Walk itself begins at 9:30. I invite you to join us there. Individual and team registrations are available. Call 444-4000 for information.
The First Responder Program in the Manorville/East Moriches, and the Riverhead/Mattituck areas began operation mid July. This is a program which provides patients access to advanced life support by Stony Brook paramedics in mobile vans supporting existing emergency response community based programs.
The Regional Resource Center, in collaboration with the Burn Unit, hosted the 1st Advanced Burn Life Support Course. This is part of the strategic plan in preparation for Disaster Preparedness in Suffolk County. This course was attended by two staff members from approximately ten community hospitals in Suffolk County. There are plans to host a second course in the fall.
Last Touch
“I must admit that I personally measure success in terms of the contributions an individual makes to his or her fellow human beings.”
-- Margaret Mead“Some succeed because they are destined to; most succeed because they are determined to.”
-- Anatole France“Fall seven times, stand up eight.”
-- Japanese saying“Success is never a destination—it’s a journey.”
-- Satenig St.Marie
SBUMC has accomplished so much. In our short 27 years, we have become the tertiary care center for trauma, emergency services, heart care, neurology, AIDs, cancer, neonatal care, urology, high risk obstetrics and many, many more. As we continue to grow and evolve, we face many challenges. It is almost pointless to talk about competition, financial pressures due to declining reimbursement, the comings and goings of important staff and faculty, etc. Like it or not, these are realities for SBUMC and every academic health center in the nation. And yet, SBUMC and all academic health centers are relied upon to ensure care for the sickest patients twenty four hours a day, to discover and be most current about medical knowledge (did you know that the average medical discovery takes 17 years to become commonly used!), to be at the cutting edge of technology and to make all these services available under one roof in a supportive, compassionate, patient centered way. What a wonderful set of responsibilities! What a tremendous set of challenges. We do occasionally fall short of our own expectations. This should harden our resolve because we serve a greater good. Forget what you have heard many times over…“we tried this already and it did not work”. Stay on task. You make a difference and provide an important societal good every day.
I am proud to say I work with you. Thank you for choosing SBUMC.
On the journey to becoming world class…
Steven Strongwater, M.D.
Chief Executive Officer
Stony Brook University Medical Center
