Strategic Directions A bi-monthly update from Advocate BroMenn Medical Center Advocate Eureka Hospital • Advocate Medical Group October/November 2013
3D mammography provides more accurate detection Conventional 2-dimensional (2D) mammography scans the entire breast in one exposure, resulting in a “flat” 2D picture that can be challenging to read because of overlapping tissue. In September, Advocate BroMenn Medical Center introduced 3-dimensional (3D) mammography, which provides images from multiple angles and arranges the high resolution “slices” into a 3D image. The 3D image can then be manipulated in order to look through and around the breast structure in a powerful new way. “3D mammography, also known as digital breast tomosynthesis, gives us a three-dimensional view of breast tissue, so it improves breast cancer screening and detection,” says Xiantian Austin, MD, radiologist with Bloomington Radiology. “It also helps us distinguish harmless abnormalities from real tumors, leading to fewer callbacks for further testing and less anxiety for women.” 3D mammography offers: • More accurate detection: By minimizing the impact of overlapping breast tissue, 3D mammography can make a tumor easier to see. Reviewing a 3D image has helped doctors find more cancers than with 2D images alone, according to clinical experience cited by the FDA. • Earlier diagnosis: Overlapping tissue can hide small cancers in a 2-dimensional scan. But with 3D mammography, the image “slices” can be taken apart and looked at, one-by-one.
• Better detection in dense breast tissue: Dense breast tissue, often found in younger women, can cause shadows—due to overlapping tissue—that hide tumors from traditional 2D mammography. 3D mammography takes images of the breast from multiple angles and arranges these individual views into a 3-dimensional image that offers a look through and around breast tissue. • Less anxiety: 3D mammography can help reduce false alarms. The improved accuracy in diagnosing abnormal structures offered by a 3D view of the breast decreases the number of unnecessary callbacks to women for additional scans and biopsies. • Safety and Effectiveness: During a 3D mammogram, women experience a minimal amount of additional radiation compared with a standard mammogram. However, this dose is under the FDA-regulated limit for mammography, and no risk from an amount of radiation this small has been proven.
Advocate BroMenn Medical Center Strategic Framework
Our Vision A faith based system providing the best health outcomes and building lifelong relationships with those we serve.
Our Role To be the leading regional medical center in central Illinois.
Advocate Experience Creating the safest and best place for patients to heal, physicians to practice and associates to work.
Growth
Regional Destination
Operational Excellence
Physician Recruitment Marketing/Brand Identity Community Partnerships Philanthropic Relationships
Critical Access Hospitals Service Line Development Ambulatory Network
KRA Performance Patient Centered Care Efficiency/Cost Management Infrastructure Development
Physician Engagement Pioneering into the future
Welcome new providers!
We hope you enjoyed the Advocate BroMenn Medical Center history video shown at the associate picnic in late August. If you would like to see it again, please visit the Intranet and click on “BroMenn History Video.�
Julie D Kenny, Au.D., audiologist Advocate Medical Group Elizabeth Wilson, PA, physician assistant Advocate Medical Group Jyoti Randhawa, MD, psychiatrist Advocate Medical Group Christian Badillo, MD, emergency medicine specialist Advocate Medical Group Grace George, MD, hospitalist Cogent Healthcare of Illinois, LLC Richard Castillo, MD, emergency medicine specialist The Vein Specialists, LLC Adrienne Schupbach, MD, dermatologist Dermatology and Mohs Surgery Institute, Ltd
Advocate Experience Creating the safest and best place for patients to heal, physicians to practice and associates to work.
James L Nevin Jr., MD, Vice President of Medical Management Advocate BroMenn Medical Center has appointed James L. Nevin Jr., MD, as vice president of Medical Management. “I am delighted that Dr. Nevin has joined our health care ministry,” said Colleen Kannaday, president of Advocate BroMenn Medical Center and Advocate Eureka Hospital. “He brings a wealth of experience and innovation in quality and safety, as well as physician engagement and patient satisfaction.” “Please join me in warmly welcoming Dr. Nevin and his wife Cathleen to the Bloomington-Normal area and to the Advocate Health Care system.”
Modahl Gift On June 25, a very good friend of Advocate BroMenn Medical Center—Gertrude Modahl—passed away following a sudden illness. Only two months shy of her 98th birthday, Gertrude was a steadfast supporter of BroMenn Medical Center through regular giving to the Advocate Charitable Foundation. Gertrude had a keen interest in supporting health programs that were new and interesting, and enjoyed learning about the impact her annual gifts were having in the community. Her most recent gifts helped fund the new patient tower and the Advocate for Young Hearts program. In early July, the Foundation was notified that Gertrude had included BroMenn Medical Center in her estate plan. Her final gift of more than $550,000 helped secure Gertrude’s place as one of BroMenn Medical Center’s most generous friends. Per her will, Gertrude directed that BroMenn Medical Center use this final gift to support the new patient tower.
Embarking on our Magnet journey The American Nurses Credentialing Center’s (ANCC) prestigious Magnet designation is the gold standard by which nursing and patient care are measured, and is the highest honor awarded for excellence in nursing services. It indicates Advocate BroMenn Medical Center is an exceptional provider of health care, and exemplifies our commitment to creating and sustaining an environment in which nurses are able to do what they do best: plan and provide high quality care to patients and their families. “I firmly believe that we are ready to begin our Magnet Journey,” says Laurie Round, vice president of Patient Care Services and chief nursing executive. “We have a strong foundation and proven success. We have also completed strategic mapping for the future of nursing at BroMenn Medical Center. Although a lot of work remains, it is an exciting time for all of us!”
To achieve Magnet Designation, we will undergo a rigorous evaluation that includes preparing documentation of how we meet standards as well as an onsite visit with Magnet reviewers interviewing the nursing staff and speaking with administrators and physicians. “Magnet designation makes a difference,” says Laurie. “Nurses, physicians and the public look for this designation as an indicator of the highest level of care and of the best place to work and practice. While this is a nursing designation, reaching it takes the entire team; nurses, physicians, staff and administrators must work together and support efforts to achieve and maintain the designation.” Watch for further updates and information about our Magnet journey!
Strategic Initiative 1 – Growth
Outpatient Center Growth! Since its opening in August 2012, the Advocate BroMenn Outpatient Center at 3024 East Empire in Bloomington has seen wonderful growth in the services we provide to area residents. Below is a list of all services currently available. Advocate BroMenn Medical Center services Women’s Imaging Hours are: Monday, Tuesday, Thursday and Friday from 7:30 am to 4 pm. For more information or to schedule an appointment, please call 309.268.2662. Outpatient Lab Services Hours are: Monday – Friday, 7:30 am to 4:30 pm. To make an appointment or for more information, please call 309.556.7250. Therapy Services Hours are: Monday – Friday, 8 am to 5:30 pm. For more information or to schedule an appointment, please call 309.556.7900. Advocate Medical Group services Cardiology and Pulmonology Robert Braastad, MD Samir Shah, MD John Burr, MD David Koh, MD Hours are: Cardiology – Tuesday from 1 to 4 pm Pulmonary – Friday from 8:15 am to 11:15 am For more information or to make an appointment, please call 309.556.8300. General and Colorectal Surgery Brian Gebhart, DO Hours are: Monday and Thursday, 9 am to 12 pm. For more information or to schedule an appointment, please call 309.452.1193. Immediate Care and Occupational Health Hours are: Monday – Friday, 7 am to 8 pm; Saturday – Sunday, 8 am to 5 pm. For more information or to schedule an appointment, please call: Occupational Health: 309.454.4411 Immediate Care: 309.556.7556
Pediatrics Adam Ebreo, DO Andrea Kane, MD Aaron Traeger, MD Hours are: Monday, Tuesday, Wednesday and Friday, 7 am to 5 pm, and Thursday 8 am to 5 pm. For more information or to schedule an appointment, please call 309.556.7337 (PEDS). Family Medicine Sasikala Royyuru, MD Qamer Syeda, MD Raju Shanmugam, MD Hours are: Monday and Friday, 8 am to 5 pm; Tuesday, Wednesday and Thursday, 8 am to 8 pm. For more information or to schedule an appointment, please call 309.556.7700. Other services Dermatology & Mohs Surgery Institute Doug Leone, MD Adrienne Schupbach, MD Jenny Hinegardner, CNP Luke Walters, PA-C For more information or to make an appointment, please call 309.451.DERM (3376). Maternal Fetal Medicine, SIU Healthcare Robert Abrams, MD 800.342.5748 Springfield Clinic, LLP – Allergy & Immunology Ellen Pratt, MD 217.735.5900 Digestive Disease Consultants Vijay Misra, MD 309.454.5900 Mid Illinois Hematology & Oncology Associates Bhanu Vakkalanka, MD, MRCP, FRCR 309.452.9701
Strategic Initiative 2 – Regional Destination Emergency Department Improvements As part of our strategic plan, Advocate BroMenn Medical Center is working to become the regional destination for health care services. A critical piece of that goal includes several process improvements in our emergency department. “One really great improvement has been our Direct Bedding initiative,” says Joseph Maslar, MD, interim medical director for the Emergency Department. “By bypassing a traditional triage station, we get patients into a room faster, which helps them to be seen by the nurse and physician a little faster.” “Another area we are working on is standing orders based on the symptoms the patient is experiencing on arrival,” says Aaron Barclay RN, BSN, nurse manager for the Emergency Department. “That way, if a patient presents with a common set of symptoms, the nurse can initiate lab, radiology and other diagnostics in order to provide some initial results to the physician in a more timely manner. This speeds up the time it takes to get the patient diagnosed and treated.” Initial results of all of the Emergency Department’s process improvement initiatives are remarkable: • “Door to Doc” time—in September, 2012, patients averaged 55 minutes from the time they walked in the door to the time they first saw a physician. During the first six weeks of implementing these process improvements, Door to Doc time was reduced to just 22 minutes. In fact, 65 percent of patients were seen by a physician in less than 20 minutes (the national average is 33 minutes).
• Decreases in lengths of stay for both admitted patients and “treat and release” patients. • “Left without being treated” patients during the initial six-week period decreased to 0.9 percent. The benchmark for similar hospitals is 2 percent. • Patient satisfaction has increased from the 18th percentile in January 2013 to the 64th percentile in July. Satisfaction for patients seen since July 15 has been as high as the 91st percentile. “One of the reasons these initiatives have been successful is that they allow our associates to react to the patient volume and acuity mix at hand,” says Aaron. “The system is dynamic enough to give associates the ability to flex into and out of different care modalities, such as direct bedding versus triage mode. It has also put the individuals making those decisions in close physical proximity, allowing real-time communication to occur.” “Emergency department associates and physicians are the reason this process is working so smoothly,” says Aaron. “They are the ones recognizing changes in volume and acuity and making on-the-fly adjustments as needed.” Several other initiatives, including “Door to Nurse” time, streamlining registration and collection of co-payments at discharge are also being implemented or evaluated and will be reported on in the months to come.
Addiction Recovery Expansion The Illinois Institute for Addiction Recovery at Advocate BroMenn Medical Center has been providing care to adult patients suffering from addictive behaviors since 1998. The program offers treatment for chemical addictions, as well as gambling, food, sex, Internet, video game and shopping/spending addictions, including inpatient, addiction day treatment and intensive addiction day treatment, intensive outpatient, continuing care and individual and family treatment.
Recently, we were able to remodel the unit and increase bed capacity in order to serve even more patients. We are committed to bringing these critical services to the Bloomington/Normal area so our patients and their families don’t have to travel outside our community for care.
Strategic Initiative 3 – Operational Excellence Surgery – process improvements One of the major focuses of Advocate BroMenn Medical Center’s strategic plan is Operational Excellence. This includes continually reviewing processes and procedures to determine if there are better or more efficient ways of providing patient care. Recently, the Perioperative Services team has seen great improvement in “On-Time Starts.”
our processes and providing some staff education. We saw some short-term improvement, but delays returned as awareness waned.”
“For Perioperative Services, starting our first cases of the day on time is critical to our success for the rest of the day,” says Trayce Bartley, Director of Perioperative Services at BroMenn Medical Center. “If a first surgical case of the day starts late, it delays subsequent cases, causing bottlenecks and frustrating patients, surgeons and staff.”
“We then engaged staff to create standardized timelines and processes for first cases of the day,” says Trayce. “They were excited to be a part of the solution and provided great ideas and input into solving the problem. Since implementing some of these ideas at the beginning of 2013, we have seen an increase in ontime start rates for first cases of the day. The greatest improvement has been in a reduction in the number of delays that are hospital caused.
“On-Time Starts is a core quality metric for Perioperative Services,” says Logan Frederick, operations improvement specialist with BroMenn Medical Center. “In September 2012, we were averaging 21 hospital-caused delays to our first cases each month. At that time, we began evaluating
SBAR Originated in aviation, SBAR is a communication tool adopted by many health care organizations to make both written and verbal patient consultations safer and more concise. You can use SBAR when talking with a physician about a patient. The tool includes four steps—Situation, Background, Assessment and Recommendation—allowing staff to communicate clearly and effectively, while reducing the need for repetition. S – Situation: • Identify yourself and the site/unit you are calling from • Identify the patient by name and the reason for your report • Describe your concern B – Background: • Give the patient’s reason for admission • Explain significant medical history • Provide patient’s background, including admitting diagnosis, date of admission, prior procedures, current medications, allergies, pertinent laboratory results and other relevant diagnostic results
A – Assessment: • Vital signs • Clinical impressions, concerns R – Recommendation: • Explain what you need—be specific about request and time frame • Make suggestions • Clarify expectations
SBAR can be used in non-clinical communications as well. Look for more information about using SBAR and try it out in the weeks to come!
Advocate Eureka Updates
Our second century! Founded in 1901, Advocate Eureka Hospital has been caring for the residents of Woodford County for more than a century. As a 25-bed Critical Access Hospital, Eureka Hospital saw 5,276 patients in its emergency department in 2012, and averages nearly 1,800 patient days and 32,800 outpatient admissions each year. Eureka Hospital has a medical staff of more than 100 physicians, including on-site clinics in 14 specialties. It ranks in the top decile nationally for length of stay and heart attack transfer times. Eureka Hospital also boasts some of the best patient satisfaction, associate satisfaction and health outcomes scores in the Advocate Health Care system.
In order to continue providing this incredible level of service to the residents of Woodford County, we must modernize the Eureka Hospital campus. The plan for “Our Second Century” includes a new, $11.5 million, threestory building with 10 private patient rooms on the top floor, two new operating suites on the middle floor, and space for future growth on the ground level. Philanthropy will play a key role in funding this project, with construction expected to begin in late 2013. The two new operating suites will replace the hospital’s current ORs, which were built in 1965. This will better position the facility to offer the latest in technology and even expand our surgical services. Completion of the addition is expected in 2015.
1304 Franklin Avenue Normal, IL 61761
Advocate BroMenn Medical Center associates having fun at this year’s picnic!