November 2001

Medical Staff Bulletin

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

Terrorism, and potential for large numbers of civilian casualties, has been cause of much public concern in the last two months. Public and private institutions, physicians and hospitals have acknowledged responsibility to recognize evidence of all forms of terrorism, develop systems for communication and response and implement appropriate measures of preparedness.

YNHH tested its capacity to mobilize resources for mass casualties on September 11. The outcome was reassuring. Clinical and administrative leadership coalesced; roles, authority and responsibility were defined consistent with the hospital’s Emergency Preparedness Management Plan; and the hospital was ready to accept up to 200 casualties. Innumerable individuals, ranging from medical students to community attending physicians, volunteered to participate in any way possible. In fact, the major issue identified was inadequate lines of communication with external agencies.

Since September 11, there has been considerable objective assessment of measures necessary to respond to the full spectrum of terrorist attacks, with a goal of optimally serving the community while ensuring the integrity of YNHH’s capacity to respond. Norman Roth, senior VP for administration, has been charged with coordinating the overall response. Bernadette Forget, administrative director for emergency services, with assistance from outside consultants, is completely revising the YNHH Emergency Management Program. This will be based on an All Hazards Incident Command System. Dr. Scott Weir, together with Drs. David Cone and Sandy Bogucki from Emergency Medicine, are facilitating coordination with external agencies and analyzing disaster preparedness in all relevant departments. Drs. Louise Dembry and Jeffrey Topal, Epidemiology and Infection Control, have developed materials and plans specific to bioterrorism. Dr. Reuven Rabinovici, chief of trauma and critical care, is organizing trauma-related physician resources. Drs. Asghar Rastegar and Michael Bennick are educating physicians, other health care providers and the public about bioterrorism.

It was said early, and often, that our world will never be the same after the destruction of the World Trade Center towers. Much of what may yet occur is outside our control. We can, nonetheless, rapidly prepare our response to community needs, within the limits of our capacity, and such preparation is underway.

Streamlined direct admissions process

To facilitate direct admissions from physicians’ offices and to bypass the Emergency Service, the hospital has developed a streamlined process requiring only one phone call from your office. Once a physician identifies a patient requiring admission, your office phones the YNHH Admitting Office at 688-4281. Appropriate information, such as diagnosis, insurance, etc., will be requested. Admitting will then locate a bed, contact the appropriate admitting resident, and call your office to confirm the admission. Patients proceed directly from your office to the Admissions Office, located on the first floor of the East Pavilion. The resident will call you to discuss the care of the patient. Patients requiring an extensive preadmission evaluation, or, possibly ICU level of care, should be sent through the Emergency Department. This process will be effective January 1, 2002. For questions, problems or more information, call Dr. Victor Morris at 203-688-4663 or beeper 860-260-7972.

Bioterrorism listserv forms

A Security Task Force for Yale University, chaired by Secretary and Vice President Linda Lorimer, has been established. Dr. John Schriver, co-director of the YNHH Emergency Department and Dr. Paul Genecin, director, Yale University Health Services, are establishing a closed subscriber listserv for efficient exchange of clinical information about bioterrorism. Most bioterrorism is not overt and primary care physicians are best positioned to recognize unusual or worrisome diseases and to report them in a timely fashion. By maintaining a “closed” subscriber list, it will be possible to limit access to incomplete, though worrisome, information while facilitating communication. The New York Commissioner of Health has developed the following criteria for unusual illness or disease clusters:

1. Any unusual increase or clustering in patients with clinical symptoms that suggest an infectious disease outbreak (e.g., two or more patients presenting with an unexplained febrile illness associated with sepsis, pneumonia, ARDS, mediastinitis or rash; or a botulism-like syndrome with flaccid muscle paralysis, especially in an otherwise healthy person)
2. Any suspected or confirmed communicable disease that is not endemic in our region (e.g. plague, anthrax or viral hemorrhagic fever)
3. Unusual age distributions or clustering for rare or common diseases (adult chicken pox or measles)
4. Sudden increase in the following nonspecific syndromes, especially if illness is occurring in previously well individuals and if there is an obvious common site or source of exposure: respiratory illness with fever, GI illness, encephalitis or meningitis, neuromuscular illness (e.g., botulism), fever with rash, bleeding disorders.
5. Simultaneous disease outbreaks in human and animal populations
6. Any unusual temporal and/or geographical clustering of illness (people who attended the same public event)

Physicians interested in participating in the proposed bioterororism listserv should Email: paul.genecin@yale.edu

YNHH receives national and local awards

On October 18, the U.S. Department of Labor honored Yale-New Haven Hospital in Washington, D.C., with the 2001 Exemplary Voluntary Efforts (EVE) Award for its outstanding efforts to increase employment and advancement opportunities for minorities, women and individuals with disabilities. The Honorable Elaine L. Chao, U.S. Secretary of Labor, presented the award. YNHH President and CEO Joseph A. Zaccagnino accepted the award on behalf of YNHH board members, hospital staff, local elected officials, members of the clergy and community leaders who were in attendance. YNHH was the only health care organization in the United States to receive the EVE Award, the only Connecticut corporation to be recognized this year, and one of only two health care organizations in the country to receive the award since it was established 17 years ago. At the local level, the Greater New Haven Chamber of Commerce just honored YNHH with its Community Programs Award.

Medical staff dining room

The Max Taffel Room (Sides C & D) is reserved as a medical staff dining area daily from 11:30 a.m.–1 p.m. During the coming year, there are several dates when the area will not be available because the Department of Medicine needs it for residency interviews and educational presentations. These dates are posted in the Physician Lounge. We apologize for this inconvenience and hope you will take advantage of seating available in the atrium or East Pavilion Cafeteria. If you have questions, contact Theresa Zinck Lederer, director, Physician Services, at 203-688-2073.

Anniversary Gala successful event

It was a fitting tribute to 175 years of service of a very special institution. More than 1,260 people enjoyed socializing, dinner and dancing with friends, colleagues and other hospital supporters at a beautifully decorated Oakdale Theatre. More importantly, the event raised over $200,000 for the new 175th Anniversary Clinical Innovation Fund which will enable Yale-New Haven to continue its contributions to patient care and the advancement of clinical practice. Thanks for tremendous support from members of the medical staff.

Quality Conference draws 260

On November 1, Yale New Haven Health System held a systemwide quality conference, “Patient Safety for YNHHS: 2001 and Beyond” in Harkness Auditorium. Bridgeport, Greenwich and Yale-New Haven hospitals submitted 36 posters outlining successful performance improvement initiatives that had taken place during the year. Brent James from Intermountain Health Systems was the morning keynote speaker and a panel discussion on patient safety was moderated by Dr. Peter Herbert in the afternoon. Dr. Jeffrey Topal accepted YNHH’s award, one of three YNHHS awards, for a Six Sigma Patient Safety Project entitled, “Reduction in Bloodstream Infections in the SICU.”

New Members of the YNHH Medical Staff
October

Mehran Afshari, M.D. - Opthalmology, Attending
Gabriela Balf-Soran, M.D. - Internal Medicine, Associate
Wellman Cheung, M.D. - Surgery, Associate
Jeffrey DeLott, D.P.M. - Orthopaedics/Podiatry, Affiliated
Wihelma Echevarria-Cortes, M.D. - Pediatrics, Associate
Diane Kowalski, M.D. - Pathology, Associate
Lori Kwan, M.D. - Internal Medicine, Associate
Silva Markovic-Plese, M.D. - Neurology, Attending
Michael Medvecky, M.D. - Orthopaedics, Associate
Michael Niles, M.D. - Diagnostic Imaging, Attending
David Roth, M.D. - OB/GYN, Attending
Kenneth Vives, M.D. - Neurosurgery, Associate
Richard White, M.D. - Internal Medicine, Associate

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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