July/August 2001

Medical Staff Bulletin

Message from Dr. Peter N. Herbert,
YNHH Chief of Staff

A few weeks ago, about 200 directors and managers from YNHH participated in a one-day offsite meeting, focusing on two critical components of our business plan: patient safety and patient satisfaction. After introductory presentations on these two issues, breakout sessions developed detailed plans for next year. This work complemented that of task forces engaged in these areas for the last several months. The outcomes of this meeting will be reported over the next several months.

This summer, YNHH will initiate a sustained effort to reduce nosocomial infections. Everyone having direct patient contact will be expected to follow guidelines concerning hand hygiene and contact precautions. It is recognized that just saying so will not make this happen. The medical literature documents that hand hygiene guidelines—disinfecting hands before and after each patient contact—is observed only about 40 percent of the time in many prestigious institutions. Intensive care units do somewhat better than general nursing units. Nurses are more compliant than other caregivers. Attending physicians do less well than residents.

A paucity of convenient sinks has been cited as a reason for suboptimal hand hygiene. Dispensers have recently been installed throughout YNHH containing a solution that disinfects better than soap and water, is gentler to skin and has very little odor. The product was selected after three such disinfectants were piloted by hospital Epidemiology and Infection Control and should make good hand hygiene very convenient. We are asking all caregivers to repeatedly remind each other until the habit is ingrained. If others take the trouble to remind you, please thank them.

Contact precautions are very well posted outside patient rooms but, as in the case of hand hygiene, compliance has not been good. Gowning and gloving take more time than hand disinfection. Failure to gown and glove, however, greatly increases probability that identified, antibiotic resistant pathogens will be silently carried to colonize other patients or to infect susceptible hosts. Here, too, the culture must change and tolerance for ignoring contact precautions must abate.

YNHH and GE working together to improve quality

With the help of General Electric, Yale-New Haven is exploring an innovative performance improvement method called Six Sigma—a statistically based technique used with much success by Fortune 500 companies. Six Sigma was originally developed by Motorola in the late 1980s in response to an increase in their production of defective merchandise. By determining "critical to quality" characteristics and defining a numerical range in which those characteristics must fall, Motorola was able to significantly reduce defects in their products. They also found that when quality rises, costs go down. While not new to health care, the implementation of Six Sigma at YNHH will be the biggest undertaking of its kind in a medical center. For more information, contact Dr. Richard Stahl, Six Sigma program coordinator, at 688-2187.

U.S. News & World Report lists YNHH among America's best hospitals

The July 23 issue of U.S. News & World Report has listed YNHH among America's Best Hospitals in 12 of 17 specialties, including cancer, gastroenterology, geriatrics, gynecology, hormonal disorders, kidney disease, orthopedics, otolaryngology, psychiatry, respiratory diseases, rheumatology and urology. Call 688-2488 or E-mail if you would like a copy.

HIPAA privacy plans in development at YNHH

As you probably are aware, the Health Insurance Portability and Accountability Act (HIPAA) requires that all physicians and other health care providers re-think and reorganize the way they handle patient information. Particular concerns include guaranteeing patient privacy and confidentiality and the security of patient information, both paper and electronic.

pYale New Haven Health System is undertaking a large, long-term project to bring its patient information handling into HIPAA compliance. This initiative includes all Yale New Haven Health System member hospitals. YNHHS has engaged a consultant group, Healthlink, to help analyze the status of patient information security and privacy and inform us as to where we need to change in order to come into HIPAA compliance. Healthlink is organizing educational sessions and focus groups to help with their gap analysis.

pIt is vitally important that the physician perspective be included in any solutions Yale New Haven Health System develops. We welcome and appreciate your active participation in this initiative. If you have questions about HIPAA and how it affects physicians, please contact Gayle Capozzalo, tel: (203) 688-2605, fax: (203) 688-3472, Jean Ahn, tel: (203) 688-8605 or Dr. Martha Radford, tel: (203) 688-8692, fax: (203) 688-5571. Dr. Radford is co-chair of the HIPAA Privacy Working Group for YNHHS.

Medical staff dues due

Invoices for medical staff dues were sent to members of the YNHH attending, associate and courtesy medical staff last month. If you have not submitted your payment, please do so immediately to avoid suspension of your privileges. All dues should have been paid by July 1. Medical staff dues are used to support the missions of the medical staff, support house staff functions and medical staff social events and for other purposes at the discretion of the Medical Board. YNHH does not have direct use of these funds.

Colleagues honor John Fenn with portrait

A portrait of former YNHH Chief of Staff and Senior Vice President of Medical Affairs, Dr. John Fenn, commissioned in honor of his retirement, was dedicated on June 28. YNHH President Joseph A. Zaccagnino remarked on Dr. Fenn's accomplishments during his 11-year term, including his ability to draw together the entire medical staff under a fair and equitable system of medical governance. Dr. John Seashore, former YNHH medical staff president; Dr. Gerard Burrow, former dean of YSM; and Dr. Andrew Graham, former medical staff president and hospital trustee, who were members of the portrait committee, also spoke. The portrait, by artist Joseph Funaro of Hamden, was funded by contributions from Dr. Fenn's colleagues and admirers, and will hang in the Medical Staff Lounge.

Medical Staff Office re-location

The Department of Physician Services (Medical Staff Office and IPA Office) re-located from the Clinic Building to the first floor of the Grace Building in early August. This move will make Physician Services more convenient to attending physicians.

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 Krauss
Marketing & Communications
GB 443
P: (203) 688-2492, F: (203) 688-2491
krauss@ynhh.org

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Last revised: April 13, 2004 (cfs)

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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.