January 2004

Medical Staff Bulletin

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

Happy 2004 to all members of the Yale-New Haven Hospital Medical Staff! And thanks so much for all you did to make 2003 a great year for our Hospital. We met the majority of our patient safety and clinical process goals. Hand hygiene after patient contact reached 84 percent, observation of contact precautions 80 percent, and surgical laterality identification 98 percent, all exceeding prospective targets. The target rate for ICU central line infections was less than 4.0 per 1,000 patient line days and the Yale-New Haven Hospital rate was 3.2. Among other measures, only use of angiotensin converting enzyme inhibitors, in the setting of low cardiac ejection fraction, was significantly below target and candidate charts will henceforth contain reminders.

In 2003, we lost two major clinical leaders to whom we will always be indebted. Dr. Lawrence K. Pickett started the Yale-New Haven Hospital Pediatric Surgery Program in 1964 and later served as Associate Dean for Clinical Affairs and Chief of Staff. Joseph B. Warshaw, M.D. chaired the Department of Pediatrics for a decade and for several years was Deputy Dean for Clinical Affairs. We are a much richer medical center because of their contributions to our development.

We have unfortunately entered into another year of the union driven "corporate campaign" against YNHH by the Service Employees International Union (SEIU). Using the Connecticut Center for a New Economy, an organization financed and supported by the union, the SEIU has generated negative media attention. Billboards, newspaper ads and public demonstrations continue in an effort to harm the reputation of the hospital and its leadership. The intent of this activity is to exert external pressure on the hospital to accept a process that would not guarantee National Labor Relations Board granted rights to a secret ballot election for employees. I encourage you to review the enclosed Forum article by Mr. Zaccagnino and the testimony of Professor Jarol Manheim to the U.S. House of Representatives. The materials more fully describe the elements of a corporate campaign and provide important context on the issues impacting YNHH.

11 a.m. Discharge Time

Bulletin boards in most patient rooms, as well as information pamphlets, notify patients of the expectation that they will leave by 11 a.m. on the day of discharge. Currently, the majority of patients leave their rooms between 2:30 and 4:30 p.m. As a consequence, both the Emergency Service and the Operating Rooms experience gridlock at mid-day and most patients are not placed until late afternoon/early evening. If even 30 percent of patients left by 11 a.m. (currently less than 10 percent) the worst congestion in the ED and PACU could be avoided. Please reinforce the 11 a.m. discharge time with your patients and their families. Try to complete all discharge paperwork (scripts, W-10s, priority discharge summaries, follow-up plans, education) the evening before discharge. Achieving the discharge time goal will be a major initiative at YNHH this year and we are committed to removing the system barriers to achieving this goal.

2004 Quality Conference

The annual YNHHS Quality Conference will be held on Friday, March 26, from 8:30 a.m.-2:30 p.m. in Harkness Auditorium. This year's theme is "Patient-Centered Care at YNHHS." The 2004 conference will provide insights from national and local leaders and opportunities for individuals throughout YNHHS to meet and discuss projects and plans related patient centered care. The keynote speaker will be James B. Conway, senior vice president and COO at the Dana-Farber Cancer Institute.

The Yale New Haven Health System invites you to present your project at the 2004 Quality Conference. Please see poster abstract and submission guidelines for details.

• January 16: Deadline for project abstract submission
• February 4: Deadline for electronic project submission

For information, call Diane Collins at 688-8692.

MD Link Update

MD Link provides web-based access to all clinical results available on the clinical workstations at YNHH. Currently, 477 YNHH Medical Staff members have access outside our walls and the system has been progressively improved since implementation in 2000. Patients are readily and rapidly accessed by name and the organization of data is superb. The "Results Viewer" presents all Laboratory and Radiology reports in reverse chronological order, with no necessity to do a secondary search. Results can be individually retrieved or accessed in tabular and spreadsheet form. Transcribed operative reports and discharge summaries, as well as ESA, are directly available in the system and separate access to Chart View is not required. The Stentor system, permitting review of both radiographs and Radiology reports, is available under "clinical application" but a separate user name and password must be established. For information on access to MD Link, send an email to mdlink@ynhh.org or call 688-4357 (the Help Desk).

SARS Update

As part of the national effort to take precautions for the possible re-emergence of SARS, YNHH has instituted new protective measures, recommended by both the CT Department of Public Health and the national Centers for Disease Control and Prevention, to reduce the risk of transmitting the viruses that cause colds, flu and other respiratory illnesses.

Patients and visitors to the ED and to outpatient clinics are being asked to wash their hands when arriving at the hospital and wear paper surgical masks if they have respiratory symptoms. Posters in English and Spanish have been placed at the ED and outpatient entrances to publicize the new measures.

Severe acute respiratory syndrome (SARS) is an emerging infectious disease that appears to be caused by a novel coronavirus. Symptoms include high fevers followed by the development of respiratory symptoms several days later. There have been two confirmed cases of SARS in China this winter (one in a laboratory researcher). It is of the utmost importance that you notify Hospital Epidemiology (688-4634 or page operator off-hours,) if you suspect a patient meets the suspect SARS case definition. The CT Department of Public Health website, CDC website, or the WHO website have the most up-to-date information regarding travel advisories, case definition, diagnosis, treatment and reporting.

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

Back issues of the Medical Staff Bulletin:

• January/February 2003
• October/November 2002
• August/September 2002
• April/May 2002
• February/March 2002
• January 2002
• November 2001
• July/August 2001

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Last revised: April 13, 2004 (cfs)

Home page URL: http://www.ynhh.org

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.