From the Offices of Elliot Joseph and Jeffry Nestler, MD
April 3, 2011 Edition

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“Management is doing things right; leadership is doing the right things.” - Peter F. Drucker


In The News

Hartford Hospital Tops Regional Rankings

Hartford Hospital was selected as the number one hospital in the Hartford metro area by U.S. News & World Report. The magazine selected Hartford Hospital from among 19 area hospitals based on its performance “nearly at the level of nationally ranked U.S. News Best Hospitals in eight adult specialties.” These are: Diabetes and Endocrinology, Geriatrics, Gynecology, Kidney Disorders, Orthopedics, Psychiatry, Pulmonology and Urology. In the number three position is the Hospital of Central Connecticut, also a Hartford HealthCare member, which is listed by the publication as high-performing in Urology. See the rankings.

Hartford HealthCare Takes Exclusive Area License On 1-800-DOCTORS®

Hartford HealthCare has licensed the right to use the phone number 1-800-DOCTORS on an exclusive territory basis to help link patients with physicians on our medical staff. When patients call the toll free 1-800-DOCTORS number, a call center counselor guides them through a process designed to help them find a doctor who best meets their needs. Since Hartford HealthCare has licensed exclusive rights to use the number in this area, only our affiliated physicians will be referred by the service, which is widely regarded as the most recalled telephone number in health care. Based on results data from 1-800-DOCTORS, the network should provide a significant flow of new patients to our physicians. “Hartford HealthCare partners with more than 2,000 of our region’s finest physicians. Making it easy for our community to connect with the doctors who best meet their needs is good for everyone,” says Elliot Joseph, CEO and President of Hartford HealthCare.

Changing Partnerships and Affiliations at St. Mary’s and Yale/Saint Raphael

Last week, it was announced that LHP Hospital Group of Plano, Texas, will acquire a majority interest in St. Mary’s Hospital in Waterbury. This will result in the conversion of St. Mary’s to a for-profit institution, only the second such hospital in the state. On Friday came news that Yale-New Haven Hospital and the Hospital of Saint Raphael, both in New Haven, have signed a letter of intent to explore a merger. Read stories from The Hartford Courant about changes at St. Mary’s Hospital here and about The Hospital of Saint Raphael here, and from the CT Mirror on the Yale-Saint Raphael merger talks at http://ctmirror.com/story/11990/busy-week-hospital-transactions-more-come-experts-say

Innovative and Complex Care

Dr. Zweibel Implants One of the First Newly Approved Protecta Defibrillators

On Thursday, March 31, Dr. Steven L. Zweibel, director of electrophysiology, was one of the first surgeons in the country to implant a new Medronic Protecta cardiac defibrillator, approved three days earlier by the FDA. The Protecta defibrillator can distinguish between benign and fatal arrhythmias, largely removing the threat of unneeded shocks. Hartford Hospital was one of just two hospitals in the Northeast to receive the first shipment of the device. The surgery was featured in a March 31 Hartford Courant article, “Hartford Hospital Puts New Heart Device in Patient.” http://www.courant.com/health/connecticut/hc-buck-new-heart-device-0401-20110331,0,6518891.story Medtronic estimates, based on a study, that 92 percent of patients using its new technology will be free of inappropriate shocks five years after implantation.

Staff Provides Personal Look at CESI for MetroHartford Alliance Group

Thanks to the efforts of Drs. Jeff Cohen, Tom Nowicki, Steve Shichman, Neil Yeston, clinical educator Ann Russell and CESI director Steve Donahue, members of the MetroHartford Alliance’s Economic Development Council are spreading the word about Hartford Hospital’s Center for Education, Simulation and Innovation (CESI). The Alliance held its Economic Development Council meeting in Heublein Hall on March 8, and nearly every attendee toured CESI following the program. Simulation areas highlighted in the tours included the OR, the ED, OB-GYN, the ICU, robotics training, the skills lab and fundamentals of laparoscopic surgery. In addition to reinforcing the area’s reputation for medical innovation, a presentation by Elliot Joseph, president and CEO of Hartford HealthCare and Hartford Hospital, described the current healthcare environment and talked about HHC and the hospital as economic drivers in our region.

Dr. O’Loughlin Hosts National Webinar on Dose Reduction in Diagnostic Imaging

Dr. Michael O’Loughlin of Jefferson Radiology hosted a national webinar on March 23 about Practical Dose Reduction Techniques in Diagnostic Imaging. Jefferson Radiology and Hartford Hospital have introduced many innovative techniques, especially in CT imaging, to address this issue, and Dr. O'Loughlin is becoming recognized as a national expert in dose reduction techniques. The webinar was presented in conjunction with GE Healthcare.

Excellence

Dr. Thompson to Deliver Inaugural Baughman Lecture at Brigham & Women’s

Dr. Paul D. Thompson, director of cardiology, has been selected to deliver the first-ever Kenneth L. Baughman, MD Memorial Lecture for the Brigham & Women’s Hospital’s Cardiovascular Symposium on May 4. Dr. Thompson, who will speak on “The Role of Exercise in Modern Cardiology,” was chosen in recognition of his achievements as a leading sports cardiologist and his advocacy for the public health benefits of regular physical activity. Dr. Thompson’s lecture is in memory of Dr. Baughman, a beloved cardiologist and director of the Brigham’s Advanced Heart Failure Management Program until his tragic death in 2009. An accomplished triathlete, Dr. Baughman was struck by a car and killed while jogging during an American Heart Association conference. He was 63.

40th Anniversary of First Kidney Transplant

March 25 was the 40th anniversary of the first kidney transplant performed at Hartford Hospital. Dr. Stanley Bartus, one of the surgeons who performed the procedure on March 25, 1971, was quoted in an article in the March 25 Hartford Courant. “We started doing animal transplants and we did that until we were confident we could do this,” he said. “When you embark on something that hasn't been done before and all eyes in the hospital all looking at you to see what will happen, you don't enter it with a swagger of confidence. There's an ongoing anxiety that goes with it. But once you start operating, it all goes away.” http://www.courant.com/health/connecticut/hc-weir-kidney-transplants-40-years-020110325,0,2700513.story

Academics & Research

Dr. Ruaño Appointed Adjunct Professor at GWU Division of Genomic Medicine

Dr. Gualberto Ruaño was recently appointed adjunct professor of medicine in the newly created Division of Genomic Medicine at George Washington University School of Medicine in Washington DC. GWU is among the first medical centers to bring genomics into the clinical realm of an academic Department of Medicine. The new appointment will facilitate collaboration between GWU and Hartford Hospital in alignment with the goals of the new Institute of Translational Medicine to continue to expand the scope of HH’s research programs beyond Connecticut.

Hartford Hospital Welcomes Administrator From China for Year-Long Internship

Xuehong Lian, deputy director of the administrative office of Qilu Hospital, our sister hospital in Shandong, China, has begun a one-year resident internship here at Hartford Hospital. His goal is to further his understanding of hospital administration in the United States, in order to bring this knowledge back to his hospital in China. Mr. Lian, who is a Ph.D. candidate in the School of History and Culture at Shandong University, had spent three months here last year. He is keenly interested in how we are gearing up for healthcare reform, which is also a reality in China. Hartford Hospital has a 20-year relationship with Qilu Hospital. President Elliot Joseph delivered a keynote address there at the 120th anniversary celebration of Qilu Hospital on Dec. 18, 2010.

Care Coordination

Multidisciplinary Cancer Care Series for Primary Care Physicians

The first in a new series of multidisciplinary cancer care programs was held at the Helen & Harry Gray Cancer Center in Avon on March 29. Organized for primary care physicians, the program was structured as a Tumor Case Conference moderated by Dr. Joseph Cappa. It featured case presentations on rectal and pancreatic cancers by Drs. Jeffrey Cohen and Ramon Jimenez. Pathology was reviewed by Dr. Saviero Ligato, and radiology findings by Dr. Michael O’Loughlin. A multidisciplinary panel reviewed treatment approaches in each case: medical oncologists Drs. Jeffrey Baker and Robert Siegel; radiation oncologists Drs. Andrew Salner, Helaine Bertsch, and Kenneth Leopold; and gastroenterologists Drs. Michael Golioto, Michael Karasik and Michael Selden. Q&A followed the cases with discussion of clinical trials and new approaches to the diagnosis and treatment of gastrointestinal cancers. CME credit was offered. The next program, in May, will focus on genitourinary cancers, followed by sessions later in the year on thoracic tumors and melanoma.

DNR Status: Requires Both Order in SCM and Purple Form

Completing a DNR doctor’s order requires that it be entered into Sunrise Clinical Manager (SCM) AND that a DNR purple form be filled out and placed in the patient’s chart to fully establish the DNR status. To enter a DNR order in SCM, click on “Orders” and then click on the icon of the prescription pad in the upper left hand corner. The Code Status page will appear. Click on the appropriate code status box: choices are Full Code, DNR, DNI, and RN May Pronounce.

Calcium Gluconate on Backorder

Calcium gluconate is once again on a national backorder status. Our sources are unable to process any orders until further notice, and there is no definitive date for renewed availability. Please make every effort to convert patients receiving parenteral calcium gluconate to either oral chewable dosage forms or calcium liquid preparations.

HIPAA Compliance: Requests for Faxing Copies of Surgical Pathology Reports

Surgical Pathology has been receiving specimen requisitions with requests for faxing additional copies with only a fax number identifying the recipient. HIPAA regulations do not allow us to comply with such requests; we must have the specific name and address of the recipient identified on the requisition.
Community Activities

Volunteer Physicians Sought for July Medical Mission to Dominican Republic

Arm2Arm is running a medical mission to the Dominican Republic in July and is in desperate need of volunteer physicians. For six years more than a dozen people from Connecticut and nearby states have been traveling there to give medical help to hundreds of severely disadvantaged Haitians migrants who lives in the bateyes, Dominican Republic and work in the sugarcane fields. Please contact Maryse Adonis, executive volunteer director of Arm2Arm, Inc. at 860-478-9209 or email Maryse@arm2arm.net.

Operational Update

 Changes in IT Leadership

In order to realize its vision of being “nationally respected for excellence in patient care and most trusted for personalized, coordinated care,” Hartford HealthCare has asked two national experts to help the system position itself for success in a world in which how we get paid – and what we get paid for – is changing. One is Bruce Campbell, Ph.D., M.D., of C.M. Smith, who is a national authority on reform and its impact on health systems. The other is our own Stephan O’Neill, who has moved from his position leading Information Services to work fulltime with Dr. Campbell, and will bring his considerable background in health care information technology to the project. In the interim, Luis Taveras, Ph.D., a longtime Information Systems administrator and currently the leader of Hartford HealthCare’s ICD-10 project, will direct HHC’s Information Services.

URGENT: Applications Due for Summer Approval of Medical Staff Membership

Physicians, chiefs of service and practice managers who are planning to bring new associates into their practices this summer are reminded that applications for medical staff membership should be filed as soon as possible. The process takes approximately 90 days from receipt of application to final approval (60 days for adjunct staff). The application can by found at www.harthosp.org/medstaff/Application. For more information, contact Linda Calli, manager of the medical staff office, at 860-545-6167.

Required Risk Management Grand Rounds for HH-Employed Providers

There are several Risk Management Grand Rounds sessions scheduled for Hartford Hospital-employed providers (MDs, DOs, APRNs and PAs), who must attend one session to fulfill the Risk Management requirement. It is recommended that you attend a session related to your specialty, but you will still receive credit by attending any session. These sessions are for Hartford Hospital-employed providers only.
  • ED: April 6 from 12–1:30 p.m. (Location TBD)
  • ED: April 21 from 8:30–9:30 a.m. (Location TBD)

Risk Management Programs for Private Staff; 6% Premium Credit Available

Members of the private medical staff who are CHS insurance Ltd. policyholders can take advantage of a risk management educational program CHS is offering through May. By completing all aspects of the program, you will be eligible for a credit of 6% on your malpractice premium. To be eligible for the credit, you must complete two one-hour web-based modules a year and complete post tests, and attend one live session of risk management rounds. These sessions coincide with the risk management sessions offered to providers employed by Hartford HealthCare. If you have questions, contact Medical Risk Management at 860-493-5790; questions about your premium should be directed to Mary Ann Nelligan at the CHS office, 860-696-6265.

Specialty Date Time Location
Radiology April 4 6-7:30 p.m. 399 Farmington Ave., Farmington
Anesthesiology April 14 6-7:30 p.m. HH, Dining Room A/B/C
Medicine April 20 6-7:30 p.m. HH, Gilman Auditorium
Anesthesiology April 27 6-7:30 p.m. HH, Dining Room A/B/C
Surgery April 27 6-7:30 p.m. HH, Gilman Auditorium
ENT/Ophthalmology May 4 6-7:30 p.m. HH, Gilman Auditorium
Surgery May 6 7:30-9 a.m. MidState Medical Center, Conf Rm 2/3
Surgery May 10 6-7:30 p.m. HH, Gilman Auditorium
Radiology May 12 6-7:30 p.m. 399 Farmington Ave., Farmington
Medicine May 19 6-7:30 p.m. HH, Gilman Auditorium
Coming Events

April 6:
8th Annual Heart Rhythm Symposium – Bridging Electrophysiology & Heart Failure

Lectures, case presentations and workshops will focus on an understanding of rhythm abnormalities in heart failure patients and how advanced treatments with drugs, resynchronization therapy (CRT), ventricular assist devices and cardiac transplant can be applied. Wednesday, April 6, 7 AM - 4:15 PM, Farmington Marriott. Please register by March 31 - you can register online at www.harthosp.org/heartfailuresymposium. For more information, download the flier or contact Janet Linden, 5-3602.

April 29:
Northeast Regional Symposium on Gynecologic Robotic Surgery

The course is designed for gynecologists and gynecologic subspecialists interested in acquiring or expanding their skills in robotic gynecologic surgery, and for surgical assistants and OR staff, seeking to improve their assisting technique and OR efficiency. Designated for a maximum of 8 hours AMA PRA Category 1 credit(s)™. 6:45 a.m.-5 p.m. For more information and to register online visit www.harthosp.org/GRSSymposium.

May 25: *NOTE DATE CHANGE*
Board of Directors and Medical Staff Spring Event

6-9 p.m., Heublein Hall, Education Resource Center

Click here for more events

Hot Topics in Healthcare

The ACO Model – A Three-Year Financial Loss?
New England Journal of Medicine - March 23, 2011

The accountable care organization (ACO) model is controversial among health care experts: Its proponents tout the potential savings and coordinated care that could be achieved through this model, while others point out the risks for anticompetitive effects. Many health care executives and physician practices are deciding whether to move forward with becoming ACOs, but they may be unaware that the limited data suggest that most organizations will lose money in the first 3 years under the ACO model. http://healthpolicyandreform.nejm.org/?p=13937&query=home


The Seymour Street Journal (SSJ) has been developed to communicate key messages pertinent to our hospital’s physicians. It will keep you informed and up-to-date on hospital, network, and health care news in a concise, convenient format. The SSJ will be sent to your preferred e-mail address every other Sunday. Back issues can be viewed here. For any questions or suggestions, please contact Dr. Jeffry Nestler, Medical Staff President, at (860) 836-7313.