From the Offices of Jeffrey A. Flaks and Jeffry Nestler, MD

The Seymour Street Journal is published every two weeks to communicate key messages pertinent to our hospital's physicians, and to promote alignment between the medical staff and administration. It will keep you informed on hospital news in a concise, convenient format. SSJ will be sent to your preferred email address every other Sunday at 6 p.m.

We'd like to hear from you. For any questions or suggestions, please contact Dr. Jeffry Nestler, medical staff president, at 860-836-7313, or

November 27, 2011 Edition

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HH Facts
1947: Dr. Starr Lampson performed the nation's first ligation of the thoracic duct.

Top News



Please vote in the elections for medical staff officers and executive committee members. Ballots were emailed to all medical staff members last week. There is one contested position in the medical staff officer elections. Voters must choose one of two candidates for vice president to replace Dr. Stuart Markowitz: Dr. James Dougherty, Consulting Cardiologists, or Dr. Stacy Nerenstone, Oncology Associates. The three other medical staff officer positions are uncontested: President - Dr. Jeffry Nestler, Connecticut GI; Treasurer - Dr. Jeffrey Cohen, Hartford Clinical Associates; and Secretary - Dr. Matthew Saidel, Womens' Comprehensive Health Care.

We are also seeking four at-large members of the medical executive committee to replace members whose terms are expiring. Candidates are:

  • Dr. Erika Cappelluti, CT Multispecialty Group
  • Dr. April L. Goller, CT Multispecialty Group
  • Dr. Jeffrey Kluger, Hartford Hospital
  • Dr. Saverio Ligato, Hartford Pathology Associates
  • Dr. Justin B. Lundbye, Hartford Hospital
  • Dr. Leah D. Meisterling, Hartford Anes. Assoc., Inc.
  • Dr. Robert J. Piorkowski, (incumbent), Surgery Hartford Hospital
  • Dr. Jarrod B. Post, (incumbent), CT Multispecialty Group
  • Dr. Kenneth J. Robinson, Emergency Medicine, Hartford Hospital
  • Dr. Andrew E. Wakefield, CT Neurosurgery & Spine Associates

All ballots must be received by 5 p.m. this Wednesday, Nov. 30. You can hand deliver them to the Medical Staff Office JB-114 during the workday; fax them to 860-545-3755; or email them to Make sure your ballot has a name/signature, or it WILL BE VOID. If you did not receive a ballot, you can pick one up in the Medical Staff Office at JB-114. Results will be announced on Dec. 1 at the annual meeting of the medical staff.

Annual Medical Staff Meeting This Thursday: Election Results, Free Flu Shots

The Annual Meeting of the Medical Staff will be held this Thursday, Dec. 1 at 7 a.m. in Gilman Auditorium. Results of the medical staff elections will be announced, and free flu shots will be available at the meeting.

End of Fiscal Year 2011:
Inpatient Volume Off; Offset By Strong Outpatient Activity; Gain From Operations Exceeds Budget

Inpatient volume was 3% below budget for the fiscal year ending on September 30, 2011. The inpatient volume shortfall, however, was offset by strong outpatient activity. Outpatient revenues exceeded budget for the fiscal year by approximately 8%. The largest contributing factor to the favorable outpatient activity was the acquisition of the Eye Surgery Center in February 2011. Additional ancillary areas which contributed to the favorable variance were Surgical Services, Radiology, Emergency Department, Laboratory and Radiation/Oncology.
We are in the process of completing the audit for the 2011 fiscal year. Based on the estimates pending the final outcome of the fiscal year audit, the hospital is anticipated to achieve a gain from operations for the year of approximately $20.8 million, exceeding the budgeted $19.6 million gain from operations by approximately 6.1%.
October, the first month of fiscal year 2012, showed inpatient discharges 1.6% below budget. But they did exceed the discharges of the prior year by approximately 1.2%, showing some growth in inpatient activity. Outpatient revenues for the month of October where even with our budget for the month. 

Generous Grants Enhance Our Excellence in Training, Cancer Screening

Two recent charitable gifts to Hartford Hospital will significantly enhance our excellence in training tomorrow's surgeons and breast cancer screening. The Connecticut Health and Educational Facilities Authority (CHEFA) has made a $75,000 grant that will allow us to purchase the Simbionix LAP Mentor II System for our Center for Education, Simulation and Innovation. This life-like system will be used by students of all disciplines, but primarily gynecology, urology, and general surgery. The equipment simulates laparoscopic surgery, allowing students a realistic model to practice maneuvers that require immense precision and to train while visualizing the actual surgery. The second gift, a grant of $375,000 from the Hartford Foundation for Public Giving, supports the upgrade of our mobile mammography program from analog to digital technology, enabling the program to double its daily volume of screenings. This gift, coupled recently with a $500,000 contribution from an anonymous donor and a $100,000 donation from the Hartford Hospital Auxiliary, completes the $1.3 million goal we established to make the upgrade possible.

"Advancing Medicine: Digestive Disorders" To Air Dec. 1

Episode six of Hartford Hospital's TV series, "Advancing Medicine: Stories of Hope and Healing" will air next Thursday, Dec. 1 from 7:30-8 p.m. on WFSB Channel 3. Entitled "Digestive Disorders: Keeping Your GI Tract on Track," the program will feature Drs. Jeffry Nestler, Joseph Cappa, David Chaletsky, Paul Shapiro and Kiran Sachdev, and follows courageous patients whose stomach issues were more than a mere inconvenience. Some turned to us with debilitating pain, seeking state-of-the-art care to diagnose and treat their conditions. Others went in for routine screenings, where they learned of their life changing cancer diagnoses. Every patient was helped by an extraordinary team of our doctors. After the show, viewers can chat online or by phone with our physicians.

Free Flu Shots Available At Your Convenience

The first rule of medicine is to do no harm. One of the best things we can do to safeguard the health of our patients and their families is to get a flu shot. Free flu shots are available in Occupational Health in the basement of the Brownstone Building, Monday through Friday, 7 a.m.-5 p.m. Appointments are encouraged but not required, and can be made by calling 860-545-2175. If you have questions, call Kathy Hersey at 860-545-3475 or email

Last Chance To Qualify 6% Credit on Malpractice Premium

All physicians insured by Connecticut Health Systems, Ltd (CHS)/CNA Insurance are eligible to receive a 6% credit off next year's premium for full completion of the 2011 Risk Management Educational Program by the Dec. 31 deadline. Requirements are:

1. Attend one Risk Management Rounds session.
The last sessions of this year are
 Wednesday, Dec. 14, 7:30-9 a.m. in JB-118(leadership) and Thursday, Dec. 15, 11 a.m.-12:15 p.m. in the IOL Commons Room 2nd Floor (Psychiatry)
2. Watch two web-based modules, accessible at  
       "Patient Relations-“Strategies to Mitigate Risk," and
       "Standard of Care in the Hospital Setting" OR "Standard of Care in the Physician Group Setting."  

 Medical Risk Management, LLC (MRM) is managing the education and monitoring compliance with these requirements. If you have any questions, please contact MRM at 860-920-5475, or the CHS Insurance Department at 860-696-6227.




Surgery Department Semi-annual Recognition Awards Announced

Clinicians and programs were honored at The Department of Surgery and the Surgical Collaborative Management Team Semi-Annual Recognition Awards Ceremony on Nov. 17. Winners are:

  • Director's Award: John McNab, PA-C, MHS, Team Leader
  • Clinical Quality/Safety Award: Wound Care Team: Dr. Thomas Banever, Lisa Q. Corbett, Barbara Falkowski, Becky Morton, Nancy Ough
  • Service Awards: Anne Cronin, Jennifer Freund, Maria Rinaldi, Frieda Winnick
  • Educator Award: Dr. Lori Fritts.
  • Department of Surgery Supporter Award: Palliative Medicine Team: Dr. Sharon Diamen, Reverend Derly Foerste, Dr. Evan Fox, Patricia Fraisier, Richard Gannon, Diedre Giobbe, Dr. Alison Lane-Reticker, Colleen Mulkerin, Maryann Steed

Dr. Lenworth Jacobs Receives Honorary Doctorate

Dr. Lenworth M. Jacobs, Jr., director of the Trauma and Emergency Medicine, received an honorary doctor of science degree from the University of the West Indies, his alma mater, on Nov. 5.

Dr. Paul Thompson Delivers Five Major Lectures This Month

Dr. Paul Thompson, medical director of Cardiology and The Athletes' Heart Program, delivered five major lectures in the past month:

  • Oct. 28: keynote lecture entitled Is This Marathon Killing Me? at the American Medical Athletic Association Sports Medicine Symposium at the Marine Corps Marathon in Arlington, Va.
  • Oct. 29: Exercise and Statin Myopathy also at the AMAA symposium
  • Nov. 1: the third James Quinn, MD Memorial Orator Lecture at Hallmark Health in Medford, Mass., entitled Exercise, Sports and Cardiology
  • Nov. 14: Screening Athletes for Cardiac Problems-Role of the ECG at the American Heart Association scientific sessions in Orlando, Fla.
  • Nov. 17: Statin-Associated Myopathy at the Kowa Cardiovascular International Summit in Orlando, Fla.

Gifts From Grateful Patients Recognize Superb Medical Staff Members

Philanthropic gifts to Hartford Hospital support our superb medical care through advanced technology, research, cutting edge clinical practices, and compassionate patient care. Gifts also recognize our superb staff. When employees go above and beyond for a patient and their family, it is unquestionably noticed and appreciated. Often Fund Development receives donations with a note that the gift is being made in honor of someone who works here. The following physicians were recognized in donations made from July 1-“September 30.


Innovative and Complex Care


Telemedicine Program Improves Diagnosis of Diabetic Retinopathy for At-risk Patients in Primary Care Settings

A study conducted by Connecticut's Community Health Center, Inc. in conjunction with the Yale Eye Center/Department of Ophthalmology, supported telemedicine, using digital imaging technology in the primary care office, as a strategy that can be used to screen underserved and at-risk patients for DR, increase compliance with screening, and streamline specialist referrals. The study included the expertise of Dr. Diana Sobieraj, research associate at Hartford Hospital and the University of Connecticut School of Pharmacy.

A Successful Hamilton Retreat: Developing The Institute Model

The Hamilton Retreat, a vital element of Hartford Hospital's culture since 1971 when Dr. Stewart Hamilton convened the first meeting for hospital leadership to confer and plan about important issues, took place Nov. 17 and 18 at the Saybrook Point Inn. At the retreat, board members, physician leaders and hospital administrators had meaningful discussion on creating patient centered institutes that are designed around and organ and disease systems. A decision was made to move forward with a pilot in the Cancer Institute.


Care Coordination


Focus on Health Luncheon Features Presentation by Dr. Amy Johnson

Thanks to a featured presentation by Dr. Amy Johnson, more than 50 donors and friends of Hartford Hospital learned about complex and innovative treatment for women on October 27. Johnson, a member of the hospital's OB-GYN staff, provided the group with an overview of our Women's Health Services, including comprehensive and complex treatment for every stage of a woman's life. The presentation focused on the latest advancements in high-risk obstetrics, infertility, menopause and others. Also attending were Dr. Joel Sorosky, director of OB-GYN, and Dr. Jack Greene, co-director of Women's Health Services. Women's Health Services will be the beneficiary of the 2012 Black & Red to be held February 4 at the Bushnell in Hartford. In addition to Johnson's presentation, President/CEO Jeff Flaks provided guests with a year-in-review of the hospital. Focus on Health luncheons, sponsored by the Fund Development Department, provide an opportunity to showcase members of our medical staff and the innovative medical advances taking place in many areas at Hartford Hospital.


Research and Academics


Hands-on Workshop: Surgical Hemostasis and Blood Management

A comprehensive review of surgical blood management and live hemostasis lab will be held on Friday, Dec. 2 in the ERC from 7:30 a.m. to 12 noon. This free educational activity is designed for surgeons, anesthesiologists, perfusionists, hospitalists, transfusion medicine specialists, medical and surgical residents, surgical midlevels, quality managers, nurses, and blood management directors and coordinators. Faculty will discuss methods to optimize blood transfusions in hospitalized patients through appropriate use of guidelines and algorithms; explain the most recent evidence-based use of blood component therapy in hospitalized perioperative patients; describe the adverse consequences of allogeneic transfusions and their effect on patient outcomes; and demonstrate surgical haemostatic techniques with unique hands-on approach on animal models. Guest presenter will be Dr. Mark H. Ereth, medical director of blood management at the Mayo Clinic College of Medicine in Rochester, Minn., who will be speaking about TEG and cardiac surgery. Hartford Hospital faculty will be Dr. Lenworth Jacobs, chairman of the Department of Traumatology and Emergency Medicine and director of the Trauma Program, speaking on strategies for surgical hemostasis; Dr. Witold Waberski, chief of the Division of Anesthesia, speaking on perioperative fluid management and fluid optimization; Dr. Jonathan Hammond, chief of Cardiothoracic Surgery, speaking on STS Guidelines; Dr. D'Andrea Joseph, trauma attending in the Department of Surgery; and Dr. Ajay Kumar, chief of the Division of Hospital Medicine, speaking on "Blood Management: Introduction and Challenges." Breakfast and lunch will be provided. After lunch, Dr. Jacobs will host an animal lab. To register, email Whitney Giel at This program is supported by generous grant from Baxter Biosurgery.

IOL/Genetics Research Publish Article on Cardiovascular Risk in Psychiatric Patients

Drs. Gualberto Ruaño, director of genetics research, Harold Schwartz, vice president of behavioral health and director of the Department of Psychiatry, and John Goethe, director of the Burlingame Center for Research and Education at The Institute of Living, have published an article entitled "Validation of Candidate Genes Associated with Cardiovascular Risk Factors in Psychiatric Patients" in Progress in Neuro-Psychopharmacology & Biological Psychiatry. This is the third major publication for IOL and the Genetics Research this year.

CESI Hosts Team From Laerdal To Give Feedback On New Simulation Products

The Center for Education, Simulation and Innovation at Hartford Hospital (CESI) hosted a visit last week from Jon Laerdal, product manager at Laerdal Medical AS in Norway, and his team. Laerdal is the company that pioneered resuscitation-training manikins in 1960, and is now a leader in interactive medical simulation training products. Because of our long history with the company, Laerdal had reached out to Hartford Hospital for input on development and testing of two new medical simulation products.

Operational Update


ED Expansion/Renovation Project On Schedule For January Completion

Work continues on the $16 million Emergency Department expansion/renovation project. It will add 20,000 square feet and 25 new treatment spaces to the ED's existing 60 beds. Work will be complete in January, and patients will be seen in the new space Feb. 1.

Schwartz Center Rounds Canceled for Nov. 30

This month's Schwartz Center Rounds on November 30 has been canceled. The Schwartz Center Rounds will resume on January 25, 2012.

Hartford Hospital Holiday Schedule for 2012

Holiday Observed by Hartford Hospital On
New Year's Day (Sunday) Monday, January 2, 2012
President's Day Monday, Feb. 20, 2012
Memorial Day Monday, May 28, 2012
Independence Day Wednesday, July 4, 2012
Labor Day Monday, Sept. 3, 2012
Thanksgiving Thursday, Nov. 22, 2012
Christmas Tuesday, Dec. 25, 2012


HH In the News


OCD Leaves Hoarding Out
Daily Rx, Nov. 13

Real-life sufferers of hoarding bring questions to the minds of health professionals. While hoarding was once considered to be a symptom of obsessive-compulsive disorder (OCD), after recent review it is now classified as its own disorder with specific diagnosis criteria. According to Hartford Hospital in Connecticut, this disease is thought to result from problems in one or more areas of an individual's mental health, including information processing, beliefs about possessions, and emotional distress about discarding.

Hartford Hospital Participates in Fall Prevention Program for Elders

Harford Hospital's Jefferson House in Newington, which provides long term care and rehabilitation to seniors, is funding a program called "A Matter of Balance," designed to help older adults deal with their concerns about falling and increase their physical activity. The program is looking for coaches to help participants. For more information, contact Hilary Norcia at 860-665-8571.

IOL Psychologist Quoted in Story About Using Sensory Tools With Children
News 8,, Nov.17

Dr. Laura Saunders, a clinical psychologist for Hartford Hospital's Institute of Living, says sensory tools like weighted vests can be effective for children who do not have full-blown sensory disorders.

LIFE STAR Wins National Award
Hartford Courant, Nov. 18

LIFE STAR, the critical-care helicopter service owned and operated by Hartford Hospital, has been named "Program of the Year for 2011" by the Association of Air Medical Services. The association cited some of LIFE STAR's initiatives, including a new GPS system that keeps comprehensive track of all aircraft in the region and its new information-sharing system. The program, with bases in Hartford and Norwich, has been around since 1985. It transports more than 1,200 patients a year.


In The System


Eastern Rehabilitation Network Offers Concussion Therapy
Hartford Courant, Nov. 17

The Eastern Rehabilitation Network, a department of Hartford Hospital, began a concussion therapy program for area high schools athletes earlier this year. Dr. Subramani Seetharama, a specialist in physical medicine and rehabilitation with ERN, is overseeing the process of having student athletes take a series of tests to provide a baseline for each student's mental performance. If a student gets a concussion, he or she takes another series of tests and Seetharama compares the results to the original test to see if there are any changes in mental function. Without a personal baseline, he compares his results to a database of cognitive tests taken by thousands of others. Seetharama said he has a list of 24 symptoms indicating concussion, and bars athletes from returning to sports temporarily if they exhibit even one of them after a head trauma.


Regional Healthcare News


Day Kimball Seeks Funds To Rebuilt Its ER Space
Hartford Business Journal, Nov. 14

Day Kimball Healthcare has launched a capital campaign seeking $3 million to rebuild the emergency department of the Putnam hospital.

Three of State's Largest Medical Groups Form Alliance
Hartford Courant, Nov. 14:

Officials from three of the state's largest medical groups announced Monday that they're forming an alliance, which they say will create a coordinated health care system that decreases costs. The three medical groups -” ProHealth Physicians, Connecticut Multispecialty Group Women's Health USA and Women's Health Connecticut -” comprise more than 450 physicians and 500,000 patients. The new organization would be structured as an independent practice association, or IPA.

Phytel's Schelhammer to Speak at St. Francis Healthcare Partners Conference
MarketWatch, Nov. 17:

The tenth annual conference of Saint Francis Healthcare Partners, a large physician-hospital organization, was held Nov. 17 at the Hartford Marriott Farmington. It was called "Accountable Care Organizations: Learn From The Leaders."

Backus nurses file complaint over bonuses; Union rejected offer during contract talks, hospital says
Norwich Bulletin, Nov. 22:

The nurses union at The William W. Backus Hospital in Norwich has filed an unfair labor practices complaint over the hospital's bonus policy, saying its members are being unjustly excluded. The hospital counters that the nurses were offered participation in the bonus program, known as Shared Rewards, during a recent collective bargaining negotiating session as part of a larger contract proposal but rejected the proposal.


Coming Events


December 1 (Thursday):
Annual Medical Staff Meeting

Annual Medical Staff meeting and elections. Free flu shots will be available at the meeting. 7 a.m., Gilman Auditorium.

December 2 (Friday):
Hands-on Workshop: Surgical Hemostasis and Blood Management

A comprehensive review of surgical blood management and live hemostasis lab. ERC, 7:30 a.m. to 12 noon.

December 2 (Friday):
Department of Surgery Grand Rounds: Advances in Surgical Critical Care

Dr. Lena Napolitano, division chief of acute care surgery and director of trauma and surgical critical care at the University of Michigan. 6:45-7:45 a.m. in Gilman Auditorium. For more information, contact Herma Johnson at 860-545-2840.

December 7 (Wednesday):
Holiday Party

You are cordially invited to the 2011 Hartford Hospital Holiday Party at the following locations/times:
North and South Campus:

  • Afternoon Session: 11 a.m. -“4 p.m., Heublein Hall
  • Evening Session: 10 p.m. -“12 a.m., Main Cafeteria

Newington Campus: 11 a.m.-“2 p.m., Dining Room

More events


Hot Topics in Healthcare


AMA Opposes ICD-10, Nov. 15

The American Medical Association's House of Delegates voted today "to work vigorously to stop implementation" of the ICD-10 revision of diagnostic and procedural codes, citing the health care industry's already full plate for changes and reforms, including the federal push for physicians to adopt electronic health-record systems. "The implementation of ICD-10 will create significant burdens on the practice of medicine with no direct benefit to individual patients' care," AMA President Dr. Peter W. Carmel said.

5010 Crisis May Loom Despite Grace Period
Modern, Nov. 18

CMS is easing off a bit on compliance enforcement of its rule mandating an upgrade to the ASC X12 Version 5010, but it may not be enough to solve a looming claims payment crisis. The compliance deadline for the Version 5010 conversion is Jan. 1, 2012. The CMS said it will allow a 90-day grace period before enforcing its rule that hospitals, office-based physicians and health insurance plans upgrade from Version 4010 in current use to the more robust 5010 standards.

Aetna to Cut Co-Pays for Heart Patients to Increase Drug Use
Bloomberg BusinessWeek, Nov. 15

Aetna Inc., the third-largest health insurer in the U.S., will cut some co-payments on drugs aimed at preventing heart attacks after a study showed patients took their medicines and were healthier when there were no out-of-pocket costs for their treatments. The research, reported today at the American Heart Association meeting, found dropping co-pays helped 40 to 55 percent of patients take drugs as prescribed, compared with 36 to 49 percent. The move lowered heart attack and stroke risk by 14 percent, according to the study. Failure to take treatment is a leading cause of 325,000 recurrent heart attacks suffered annually in the US, said Lonny Reisman, chief medical officer for the Hartford, Connecticut-based company. Aetna will end co-pays on generics used to keep heart-attack victims from having a relapse, and trim upfront costs for some branded heart drugs.

Hurdles Remain for e-Prescribing, Nov. 21

Historically, the last mile in electronic prescribing has been the connection between physicians and other prescribers and the next handoff in the chain-”either pharmacies or mail-order pharmacy benefits managers. A study by the Center for Studying Health System Change concludes that improvements are needed to the structure of the national e-prescribing design targeting mail-order pharmacy connectivity and technical standards. Additional training of physicians and pharmacists may also be needed to improve e-prescribing use.


Voices Of Our Patients


Grateful Cancer Patient Thanks Dr. Lori Fritts

Starting with this issue, we will include letters we receive from patients.

Dear Dr. Kirton,

I would like to recognize Dr. Lori Fritts, the phenomenal surgeon who recently performed the procedure that will allow me to fight and overcome breast cancer.  Although my name is not included in this letter, Dr. Fritts will know who I am as Dr. Fritts ensures that her patients are known first and foremost as individuals -“ people -“ and not mere numbers or statistics. 

Dr. Fritts possesses unparalleled skill and talent; no one ever would be able to guess that I had this particular surgical procedure done.  At first, I was hesitant to remove the bandages.  To my surprise, however, I really do not look significantly different than before the surgical procedure.  I cannot believe this!

A woman faces numerous losses with the diagnosis of breast cancer, as the procedures and treatments necessary to ensure a woman's health threaten to destroy all the traits that make her female. Thanks to the exquisite artistry and exacting skill of Dr. Fritts, I face this diagnosis with confidence that I will defeat breast cancer and that my sense of self will remain intact despite the diagnosis.

Anonymous -“ a patient of Dr. Fritts


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.