August/September 2008

Medical Staff Bulletin

Contents

Message from the Chief of Staff
A slightly belated, but most sincere, welcome to the new residents and fellows who joined the Medical Staff of Yale-New Haven Hospital in July. Every spring, you literally renew the face of YNHH. We share your optimism and enthusiasm, your commitment to advancing as professionals, and we are most grateful for what you will contribute to the care of our patients. Your growth in knowledge and skills will grow rapidly over the next few years.

As we begin this academic year, I wanted to share the following "commitment" with you. It was developed a year ago by the Medical Staff Leadership:

YNHH Medical Staff Professional Commitment:

1. Recognizing the complex needs of patients presenting for hospital care, I commit to timely, efficient and compassionate management of all patients referred to me.
2. The hospital is an environment where most work under time pressures, physical demands and emotional stress. I commit to respectful and courteous interactions with all who work with me to better create a healing environment for patients.
3. I commit to strictly maintain the confidentiality of all patients.
4. Because communication among caregivers is an essential component of successful patient outcomes and satisfaction, I commit to consistently and fully communicate, in writing and orally, with all members of the patient care team.
5. I will assist in maintaining a care environment that is clean and safe, where compliance with infection control standards is universal, and where safeguards against medical injury to patients and staff are strictly maintained throughout the hospital.
6. Medical staff membership is a privilege that requires I take ownership of all aspects of YNHH within my control. I shall personally take direct and immediate action when I can right a potential wrong to patient care or the environment of care.
7. I acknowledge the compact between resident physicians and their teachers as well as my status as a role model, and I pledge full commitment to the professional and personal development of YNHH trainees.

In the next month we shall mail, to attendings and residents, the compact between resident physicians and their teachers and hope all will return a signed copy.

New Medical Staff officers announced
Effective September 1, the following members of the Medical Staff will assume positions as elected officers: Dr. Brett Gerstenhaber (Internal Medicine) will complete his two-year term as president and will become past president. As past president, Dr. Gerstenhaber will serve as chair of the Medical Board Finance Committee. Dr. Leo Cooney (Internal Medicine) will assume the role of president. Dr. Thomas Sweeney (Surgery) was recently chosen by the Medical Staff as president elect and Dr. Lynda Rosenfeld (Internal Medicine) as secretary/credentials committee chair. Their appointments are effective through Aug. 31, 2010.

Thanks to Dr. Robert Weiss (Surgery) who finishes as past president, thus completing his six-year commitment as an officer. The Medical Staff would also like to recognize Dr. Gordon Reid who served as secretary/credentials committee chair until his death in April.

Demand management initiative kicks off to improve YNHH patient flow
Last year, YNHH broke volume records in inpatient discharges, adult emergency department visits, outpatient visits and surgical procedures — and will break more records in 2008. This volume increase has resulted in significant capacity constraints, even though the hospital has added 44 beds in the past two years and plans to add another 22 over the next few months. Until Smilow Cancer Hospital opens in late 2009, YNHH needs to find ways to manage the tremendous demand for beds and services.

As a result, YNHH has become one of the first U.S. hospitals to apply demand management techniques to patient flow. YNHH has engaged a consulting firm, Carpedia International, to help with patient demand management and minimize its bed shortage. Under the direction of Thomas Balcezak, MD, vice president of Performance Management, and Sandra Bacon, RN, MSN, director, Operations Improvement, the hospital has created a patient flow management team to study systems and processes and gather data on impediments to smooth patient flow. The data will be used to redesign and streamline problematic systems, clearly define staff accountabilities, and make investments in or redirect existing resources toward improving patient flow.

This initiative is expected to last about 40 weeks. The first third will involve assessing opportunities, the next third implementing solutions and the final third surveying results. Members of the Patient Flow Management Team include: Susannah Bernheim, MD, MHS, deputy director of Performance Management; Lorraine Lee, associate director of medication safety and regulatory compliance, Pharmacy Services; and Joan Rimar, RN, DNSc, finance clinical coordinator of Decision Support.

YNHH offers "telestroke" service
The Yale-New Haven Stroke Center recently began the first telemedicine stroke program — or telestroke program — in Connecticut. Under the leadership of Joseph Schindler, MD, neurologists at YNHH use a video and image-sharing telecommunications system to provide acute stroke care consultative services when patients present with acute stroke symptoms at an affiliated hospital and are deemed eligible for intravenous tPA or interventional procedures. Telestroke programs throughout the country have demonstrated that telemedicine conferencing between outlying emergency departments and trained stroke neurologists can enhance the use of tPA at hospitals that do not have on-site neurologists 24/7.

YNHH is partnering with Lawrence and Memorial Hospital in New London in the pilot telestroke program. Members of the YNHH stroke team actively communicate with the clinical staff at L&M during the acute stroke phase. Both YNHH and L&M are DPH-designated Primary Stroke Centers.

Sundown of paper medical record
Yale-New Haven Hospital's transition to a fully electronic medical record will take another step in mid-September. Within about 48 hours after the record is received in the Health Information Management Department post-discharge, all handwritten elements of the current paper medical record will be scanned into the patient's 3M (formerly known as SoftMed) ChartView record. The paper records will then be available in the West Pavilion Record Office for two weeks after which time the paper records will be discarded. Clinicians who prefer dictating discharge summaries from the paper rather than electronic chart should be alert to this timeline.

YNHH to go tobacco-free in January 2009
Beginning Jan. 1, 2009, Yale-New Haven Hospital and the area surrounding the main campus will officially be designated "tobacco free." YNHH will join hundreds of other American hospitals in eliminating tobacco from its campus.

To prepare employees, patients, visitors and those who do business with YNHH, the hospital organized a focus group of 25 employees — some of them smokers — to help organize the change. Drs. Mike Bennick and Ed Funai represented the Medical Staff in two of the work-out sessions. Hospital buildings have been tobacco-free since 1984, but the new program means that smokers will no longer be able to smoke in the "hut" attached to the front of the building or on the sidewalks surrounding its buildings.

Kevin Myatt, senior vice president, Human Resources, and Denise Fiore, executive director, Radiology and Laboratory Services, are co-chairing the effort. The hospital will share the specifics of the tobacco-free policy this fall, and is encouraging employees to consider smoking cessation resources in advance of January 1 to help them refrain from smoking during the work day. Some of these resources include: confidential counseling and assistance at YNHH Occupational Health Service, the American Cancer Society Quitline, Anthem Blue Cross & Blue Shield smoking cessation programs and CVS Caremark prescription tobacco cessation drug coverage.

SCM is now house-wide
The implementation of Sunrise Clinical Manager, which began on the Psychiatry service in late February, was completed on June 7 and 8, with the activation of SCM order entry/clinical documentation on all remaining inpatient units. Over that weekend, 40 physicians and PAs re-entered the CCSS orders of about 600 patients into SCM. Every order that was entered into the system was reviewed by clinicians on the various units for accuracy. All medication orders were verified by 12 YNHH pharmacists, who verified approximately 7,800 orders. An outside activation team supported the units and the SCM analyst group staffed a command center around-the-clock for 10 days to make necessary changes and quick fixes. Since February, more than 4,000 physicians and staff members have been trained on SCM, which provides a more state-of-the art CPOE application.

YNHH adult emergency department to expand
In response to the high demand for emergency services and consistent with our commitment to meeting the needs of our patients, YNHH is planning to enlarge its emergency care area. The plan calls for expanding the current building out to the curb on Howard Avenue and York Street, although the ED portion of the construction would be only the first floor. The hospital is in the process of preparing a Certificate of Need application to submit to the Connecticut Office of Health Care Access. If approved by the State and the City, the project could begin in early 2009. Emergency services throughout the country are experiencing high volume and long wait times. Last year, the YNHH ED had nearly 123,000 visits.

YNHH again named to U.S. News & World Report's Honor Roll
For the second consecutive year, U.S. News & World Report has named Yale-New Haven Hospital (YNHH) to its national honor roll as one of the top hospitals in the United States. YNHH is ranked 19th in the U.S. according to the publication's annual "America's Best Hospital's ranking in the July 14 issue. Yale-New Haven Hospital was one of only three New England hospitals to be selected, joining Massachusetts General Hospital and Brigham and Women's Hospital, both of Boston, on the 2008 honor roll.

In addition to the honor roll distinction as one of the best U.S. hospitals, Yale-New Haven was ranked among the very best in the nation in 11 of the 16 medical specialties considered: cancer; ear, nose and throat; endocrinology; gastrointestinal disorders; geriatric care; gynecology; heart and heart surgery; kidney disease; neurology and neurosurgery; psychiatry and respiratory disorders.

YNHH selected as a 2008 Most Wired hospital
For the ninth year, Yale-New Haven Hospital (YNHH) has been selected as one of the top 100 Most Wired Hospitals in the nation by Hospitals and Health Networks, a magazine published by the American Hospital Association. YNHH was one of only 12 New England hospitals to be selected as Most Wired. YNHH was also selected for the fifth year as a Most Wireless award winner.

For the fifth consecutive year, all three Yale New Haven Health System (YNHHS) hospitals — Yale-New Haven, Bridgeport and Greenwich — were named to the 100 Most Wired list. This recognition is based on technologic advancements made by the organizations to enhance patient safety, clinical quality and customer service.

According to Hospitals and Health Networks magazine, the nation's 100 Most Wired hospitals have demonstrated better outcomes in four key areas — mortality rates, patient safety, length of stay and the federal government's "Hospital Compare" core measures.

Some recent information technology improvements at YNHH include: implementation of Sunrise Clinical Manager clinical information software; upgrade of Lawson multidisciplinary business processes software; implementation of a telemedicine link between Lawrence and Memorial Hospital in New London and YNHH; and upgrade of data network that will result in lower costs, higher speed and higher reliability for network connectivity.

Transplant Awareness Fair on September 6
On Saturday, Sept. 6, from 11 a.m.-2 p.m., Sukru Emre, MD, and the Yale-New Haven Transplantation Center, will host a Transplant Awareness Fair on the New Haven Green. The free event will offer food and entertainment, and will heighten awareness about YNHH organ transplant services, feature stories from living donors and transplant survivors and register new organ donors.

Welcome new Medical Staff

July
Kathleen Marie Akgun, MD; Attending, Internal Medicine
Delly Karin Alcantara, MD; Attending, Internal Medicine
Aymen A. Alian, MD; Associate, Anesthesiology
Sarah Katherine Apgar, MD; Associate, Internal Medicine
Marc Gal Bodman, MD; Associate, Ophthalmology
John Scott Bomann, DO; Attending, Surgery
Anoli Jivraj Borad, MD; Attending, Internal Medicine
Marcus W. Bosenberg, MD, PhD; Attending, Dermatology
Tobias John Eric Carling, MD, PhD; Associate, Surgery
Bryan William Chang, MD; Associate, Therapeutic Radiology
Jason Sangjin Chang, MD; Associate, Neurology
Keith Adam Choate, MD, PhD; Associate, Dermatology
Mark X. Cicero, MD; Attending, Pediatrics
Lara Ann Colabelli, DO; Associate, Internal Medicine
Oscar Rene Colegio, MD; Associate, Dermatology
Elise J. Connell-Boudoya, MD; Associate, Diagnostic Radiology
Anthony J. Coppola, MD; Attending, Surgery
Kristin Elena D’Aco, MD; Associate, Pediatrics
Eugene Christopher DePasquale, MD; Associate, Internal Medicine
Kelly Lynne Dodge, MD; Associate, Surgery
Eva Jennifer Edelman, MD; Associate, Internal Medicine
Tore Eid, MD, PhD; Associate, Laboratory Medicine
Karim ElSahwi, MD; Associate, Obstetrics & Gynecology
Edward Vincent Faustino, MD; Associate, Pediatrics
Jaime Lynn Geisel, MD; Associate, Diagnostic Radiology
John Sebastian Giuliano, MD; Attending, Pediatrics
Heather Elizabeth Goff, MD; Attending, Psychiatry
Christina S. Han, MD; Associate, Obstetrics & Gynecology
Faisal Hasan, MD; Attending, Internal Medicine
Cynthia Paige Horak, MD; Associate, Internal Medicine
Balazs Horvath, MD; Associate, Anesthesiology
Derek Lawrence Isenberg, MD; Associate, Surgery
Hitender Jain, MD; Attending, Internal Medicine
Paul Jubinsky, MD; Attending, Pediatrics
Kamal J. Khiani, MD; Associate, Diagnostic Radiology
Amy Briana Kirby, MD; Attending, Diagnostic Radiology
Veronica Kon Jara, SA; Affiliated, Ophthalmology
Simon Kotlyar, MD; Associate, Surgery
Iakovos K. Koutras, MD; Associate, Diagnostic Radiology
Lana Lee, MD; Associate, Internal Medicine
Lisa A. Loeffler, MD; Associate, Diagnostic Radiology
Stephen John Maddox, MD; Courtesy, Pediatrics
Brian Joseph Malm, MD; Attending, Internal Medicine
Ernest Israel Mandel, MD; Associate, Internal Medicine
Kavita Mariwalla, MD; Associate, Dermatology
Tannaz Moin, MD; Associate, Internal Medicine
Michael Anthony Monaco, MD; Associate, Pediatrics
Bianca C. Monteiro, MD; Attending, Internal Medicine
Neha Dinesh Nanda, MD; Attending, Internal Medicine
Sarah Nikiforow, MD, PhD; Associate, Internal Medicine
Elizabeth Adoma Ofori-Mante, MB, ChB; Associate, Internal Medicine
Sarah Kyung Oh, MD; Associate, Diagnostic Radiology
Manmeet Singh Padda, MD; Attending, Internal Medicine
Jesse Patrick Parks, DPM; Associate, Orthopedics
Abhijit Ajit Patel, MD, PhD; Associate, Therapeutic Radiology
Virginia Margaret Pierce, MD; Associate, Pediatrics
Madhavi Raghu, MD; Associate, Diagnostic Radiology
Dmitry Rakita, MD; Associate, Diagnostic Radiology
Michael Jude Rest, MD; Associate, Surgery
Sarah Elizabeth Rowan, MD; Associate, Internal Medicine
Tamer Sallam, MD; Associate, Internal Medicine
Leah Sara Samson, MD; Associate, Internal Medicine
Richard Scartozzi, MD; Attending, Ophthalmology
Rajeev K. Seth, MD; Associate, Ophthalmology
Anish Amarish Sheth, MD; Attending, Internal Medicine
James Philip Stewart, MD; Associate, Internal Medicine
Stephanie Nicole Sudikoff, MD; Attending, Pediatrics
Enrique J. Tello Silva, MD; Attending, Psychiatry
Edward Thomas Tham, MD; Associate, Surgery
Christopher Anthony Tormey, MD; Associate, Laboratory Medicine
Josef Lee Toussaint, MD; Associate, Internal Medicine
Sunil Kumar Upender, MD; Associate, Diagnostic Radiology
David M. Walker, MD; Attending, Pediatrics
Erika F. Werner, MD; Associate, Obstetrics & Gynecology
Kirstin T. Wilkes, SA; Affiliated, Ophthalmology
Francis Scott Winstanley, PhD; Affiliated, Neurosurgery
Navid Aliyari Zenooz, MD; Associate, Diagnostic Radiology

Refer items for the next issue of Medical Staff Bulletin via phone, fax, e-mail or mail to:
Peter N. Herbert, MD
1063 Clinic Building
P: (203) 688-2604, F: (203) 688-7152
herbertpn@ynhh.org
or
Katie Murphy
Marketing & Communications
GB 443
P: (203) 688-2492, F: (203) 688-2491
Katie.Murphy@ynhh.org

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Last revised: Sept. 5, 2008 (dh)

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All information is intended for your general knowledge and is not a substitute for medical advice or treatment for specific medical conditions. You should seek prompt medical care for any specific health issues and consult your physician before starting a new fitness regimen.