September 2004

Medical Staff Bulletin

Message from the Chief of Staff

The Patient Safety Committee (PSC) has been meeting in my office on alternate Monday mornings for the last four years. Sally Roumanis, RN, from the Center for Outcomes Research and Evaluation (CORE), has been the inspiration for this group. The PSC includes individuals from Quality Improvement Support Services, hospital epidemiology and infection control, pharmacy, risk management and nursing. Attendees have been added as the scope of interest of the PSC has been expanded to include compliance issues in addition to a rapidly expanding institutional and national patient safety agenda. Patient safety, through these four years, has remained the first priority in the Yale-New Haven Hospital Business Plan.

Areas of highest concern identified four years ago were medication safety, patient identification, nosocomial infections and safety education. Not surprisingly, each of these remains a work in progress but it is appropriate to bring two areas of focus closer to closure. The hand hygiene and contact precautions initiatives, pursued to reduce nosocomial infections, have brought us to an enviable position among American hospitals, but not to 100 percent compliance. In the remaining months of 2004, we will be working with nursing and with our Graduate Medical Education programs to complete these initiatives and enter a maintenance phase in 2005. Simultaneously, we will be working hard to document effects on nosocomial infections, particularly the incidence of VRE and MRSA infections. I have committed to personally champion this effort with my colleagues from hospital epidemiology and infection control.

The current major project concerning medication safety relates to electronic documentation of administered drugs, is led by Sandy Bacon, RN, and is going very well. The next major initiative in this area awaits the implementation of the new clinical information system with its accompanying decision support. Patient identification has been expanded to include the now Joint Commission of the Accreditation of Healthcare Organizations (JCAHO)-mandated use of two patient identifiers before diagnostic or therapeutic interventions and the “time-out” protocol in the operating room. Patient safety education - which has often focused on improving communication to avoid adverse events - continues on many fronts. Newer initiatives in this area will be shared in future issues of the Medical Staff Bulletin.

New online adverse event reporting system implemented

Yale-New Haven Hospital's new online event reporting system replaces the old paper system and allows clinicians to easily and rapidly enter information formerly collected on hard copy. The program is web-based and can be found on all clinical work stations under “Administrative” (Event Reporting)." Anyone on the health care team can enter an event anonymously. The ultimate goal of collecting data on adverse events is to learn from everyday error and re-design our work environment to make it less error prone. One problem many organizations face is the lack of reliable data concerning the frequency and severity of events. The data entered in the new online system is available in real time to managers. Managers now have the ability to run reports on frequency and severity of events in their areas, enabling them to make timely improvements in their environment. For more information on access and use of the system, call Dr. William Crede in Quality Improvement Support Services at (203) 688-2252.

New clinical information system passwords

The new clinical information system, Sunrise Clinical Manager (SCM), is being piloted for the final time on the obstetrics service between September 8 and 15. The entire hospital will go “live” on SCM on September 20, 2004. Medical staff members should go to the CCSS area behind the East Pavilion cafeteria to obtain passwords and instructions for system use. You can obtain web-based training at ynhhslearning.com.

CCSS will remain available for order entry for the next year, but you will find SCM much more desirable for results retrieval. All transcriptions of operative reports, pathology reports, ECG reports, and discharge summaries will be available on SCM, as well as laboratory data and radiology reports.

Performance Management Update

Detailed below are our publicly reported quality metrics for May 2004. Due to the time necessary to collect and validate the data from completed discharges, there is usually a three-month lag time before results are available.

May Performance

Apkon named VP of Performance Management

Michael Apkon, M.D., has been named VP of Performance Management for Yale New Haven Health. In his new role, Dr. Apkon will facilitate performance management initiatives throughout the System, supervise the performance management resource group and lead the development, evaluation and communication of balanced scorecard performance systems. Dr. Apkon, recently vice chairman of pediatrics, medical director of the Pediatric Intensive Care Unit and medical director of the Yale-New Haven Health System New Clinical Program Development Fund, is an associate professor at both the Yale School of Medicine and the Yale School of Management. He received an M.B.A. from the Yale School of Management and M.D. and Ph.D. in Neural Sciences from Washington University.

Yale-New Haven Hospital achieves U.S. News & World Report rankings

For the 13th consecutive year, U.S. News & World Report has ranked Yale-New Haven Hospital as one of the nation's top hospitals, according to its annual “America's Best Hospitals” issue. Yale-New Haven Hospital was named in 12 of the 17 medical specialties evaluated, including cancer, cardiology, gastroenterology, geriatrics, gynecology, hormonal disorders, kidney disease, otolaryngology, pediatrics, psychiatry, respiratory disease and urology. Of these, geriatrics and psychiatry ranked among the nation's top 10, while cancer, cardiology, gastroenterology, gynecology, hormonal disorders, pediatrics and respiratory disease specialties all ranked among the top 25. Yale-New Haven Hospital is the only Connecticut hospital listed in this year's survey, and placed second among all New England hospitals, ranking behind Massachusetts General, which was named in 14 specialties.

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

Back issues of the Medical Staff Bulletin:

• July 2004
• June 2004
• May 2004
• April 2004
• March 2004
• February 2004
• January 2004
• 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: October 14, 2004 (mv)

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