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The New Normal:

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Giving Hospital-Physician Alignment Priority p8

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August, 2013

Hospital Newspaper - NY

SPECIALIZING IN CARDIOLOGY, INTERNAL MEDICINE AND GASTROENTEROLOGY

HONORED ON

‘Best Doctors’ LISTS YEAR AFTER YEAR

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Success story Michael Babboni returns to Burke Rehabilitation Hospital While Babboni regained strength to stand and walk short distances with the help of braces and crutches, he was not able to recover motion below his shoulders. “There’s sensation everywhere but I have limited independent motion and truly only with my left little finger. But that’s not what you should focus on,” he added. “And this is what I want to tell all the other spinal cord injury patients. You have to appreciate what you have and focus on that. Focus on what you can do, not on what you can’t. Being at Burke has helped me see that.” With his undeterred will, Babboni went on to finish his computer science bachelor’s degree at Iona College and his master’s degree at Rensselaer Polytechnic Institute,

using a mouth stick instead of his fingers to type. He currently resides in Delray Beach, Fla., with his wife and son, and drove the nearly 1,300-mile distance from there to White Plains by himself with his new van, equipped with a joystick driving system. Burke Rehabilitation Hospital is a private, not-for-profit, acute rehabilitation hospital. Founded in 1915, it is the only hospital in Westchester County dedicated solely to rehabilitation medicine. Burke offers both inpatient and outpatient programs for those who have experienced a disabling illness, traumatic injury or joint replacement surgery. Burke is both an acute rehabilitation hospital and medical research center. Burke’s world renowned doctors and

provided

therapists provide state-of-the-art treatment, while its research scientists at the Burke Medical Research Institute explore the frontiers of neurological and rehabilitation medicine.

All share the Burke mission to ensure that every patient makes the fullest possible recovery from illness or injury regardless of their ability to pay.

E X C E L L E N C E I N R E H A B I L I TAT I O N F O R N E A R LY 1 0 0 Y E A R S

Where You Go For Rehab Matters Founded in 1915, Burke Rehabilitation Hospital is the only hospital in Westchester County dedicated to rehabilitation medicine. Burke

PROGRAMS: • Amputee • Joint Replacement • Brain Injury • Cardiopulmonary • Neurological • Orthopedic • Spinal Cord Injury • Stroke Recovery

offers inpatient and outpatient programs for those who have experienced a disabling illness, traumatic injury or surgery. Burke

is both a rehabilitation hospital and medical research institute.

Burke's doctors and therapists provide the highest quality

treatment, while its research scientists explore the frontiers of

rehabilitation medicine. All share the Burke mission to ensure that

every patient makes the fullest possible recovery.

BURKE R

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BURKE

Rehab + Research = Results

It’s been nearly three decades since Michael Babboni wheeled through the halls of Burke Rehabilitation Hospital in White Plains, but he recently returned to where the his second life began. Babboni toured the nursing unit and the clinic where he spent nine months rehabilitating after his spinal cord injury, along with his wife Roseann and 17-year-old son Matthew. “I want [Matthew] to see Burke and see what helped shape who I am today,” Babboni said. “I think it’s important for him to understand what happened.” Babboni shared his story with current spinal cord injury patients, including Elliot Vasquez, 20, who, like Babboni, injured his spinal cord at a young age. Prior to his injury, Babboni was an active 19-year-old from New Rochelle, attending Siena College for computer science. In the spring of 1984, while playing mud volleyball with his friends at school, he dove for a ball not seeing a hard mass beneath the surface of murky, muddy water. His chest collided with the earth, whipping his head back and snapping his C3 and C4 vertebrae. Babboni was rushed to Albany Medical’s trauma center where they re-set his spine and admitted him to the intensive care unit. He spent five weeks in the ICU before he was able to have spinal fusion surgery. During that time, he began to get some movement back—wiggle his toes and eventually bend his knees. On July 3, 1984, Babboni was admitted to Burke where he would spend the next nine month in intensive inpatient rehabilitation therapy and another nine months as an outpatient. “Dr. Peter Stern [Babboni’s then doctor] was great,” he said. “He advocated to keep me here until our house was accessible and something I can work with, but more importantly, kept me until I was ready.” Babboni received intense physical and occupational therapy to strengthen his legs and arms and increase his range of motion. As a computer science student, it was his goal to be able to type on a keyboard and go back to school to finish his degree. “When you start, it’s great. You have little but constant progress throughout and you start to think you’re stabilizing and are going to get back to where you were,” Babboni explained. “Things keep coming back but then you get to a point where you realize, that’s it. This is as far as I can go.”

785 Mamaroneck Ave. White Plains, NY 10605 888.99.BURKE www. Burke.org

PAGE 4

August, 2013

Hospital Newspaper - NY

Fund-Ex aims to shorten and simplify the financing process By Patrick Harrigan | Syracuse, NY

Todayâ&#x20AC;&#x2122;s medical professionals face a myriad of challenges in their efforts to provide high-quality care. Change has become an industry constant and requires SK\VLFLDQV WR OHDUQ DQG DGDSW RQ WKH Ă&#x20AC;\ Much of the conversation revolves around increased healthcare regulation and compliance requirements. While its long-term effects remain to be seen, the 13,000-page Affordable Care Act promises to bring about considerable change and uncertainty. From a technology standpoint, the push is on to implement EHR systems and demonstrate meaningful use. New HIPAA rules will soon require practices to have policies and procedures in place to ensure that patient health information is secure. Change is also a major theme when it comes to patient interaction. As technology improves and information becomes more accessible, the methods by which patients gather information and interact with care providers will continue to evolve. While increased engagement can ultimately prove valuable as patients take a more active role in their health care, it will also require more time and attention from providers, not to mention DQ LQFUHDVHG ÂżQDQFLDO LQYHVWPHQW In addition, many practitioners still face the day-to-day business challenges of running a practice. Physicians PXVW PDQDJH ÂżQDQFHV FRPPXQLFDWH effectively and delegate responsibility ZKLOH PDLQWDLQLQJ D VWHDG\ Ă&#x20AC;RZ RI SDWLHQWV 6WDII PXVW IHHO IXOÂżOOHG DQG patients must feel comfortable to ensure a positive experience. The frantic pace and ever-expanding task list can often mean that things get overlooked, impacting the long-term health of the practice. Debt can accumuODWH ZKLOH RIÂżFH XSJUDGHV DQG PDQGDWRU\ technology updates can get pushed down the priority list. A medical professionalâ&#x20AC;&#x2122;s WLPH LV DOUHDG\ OLPLWHG DQG ÂżQGLQJ WKH UHVRXUFHV WR VHHN QHFHVVDU\ ÂżQDQFLQJ can seem overwhelming.

Fund-Ex, LLC was founded with the simple goal of providing medical SURIHVVLRQDOV ZLWK DIIRUGDEOH ÂżQDQFLQJ solutions while minimizing the disruption of their day-to-day routine. â&#x20AC;&#x153;Healthcare professionals have made WUHPHQGRXV VDFULÂżFHV WR JHW ZKHUH WKH\ are today. They continue to work hard every day, and that means something to us,â&#x20AC;? said Albert Crawford, Owner and CEO of Fund-Ex. â&#x20AC;&#x153;Thatâ&#x20AC;&#x2122;s why we have built our business around them. We VWULYH WR SURYLGH D KDVVOH IUHH ÂżQDQFLQJ experience that helps achieve business goals and allows more time to focus on the mission of medicineâ&#x20AC;&#x201D;the patient.â&#x20AC;? An unwavering focus on providing capital to healthcare professionals has helped Fund-Ex develop a thorough understanding of their needs, challenges and business cycles. This knowledge allows Fund-Ex to provide smart ÂżQDQFLQJ VROXWLRQV ZLWK XQSDUDOOHOHG VHUYLFH DQG HIÂżFLHQF\ DOORZLQJ SK\VLcians to get back to practicing medicine. Fund-Ex can provide a custom, no-cost, no-obligation loan proposal in just

24 hours and healthcare professionals can get the capital they need in as few DV ÂżYH EXVLQHVV GD\V 7KH FRPELQDWLRQ of speed and single-digit rates makes Fund-Ex an attractive and affordable option for healthcare professionals looking to put their practice in a better position looking forward. Fund-Ex provides capital for a wide variety of commercial purposes, including business debt consolidation, working capital, expansion and improvement, practice acquisition/start-up/buy-in as well as real estate.

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Hospital Newspaper - NY August, 2013

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PAGE 6

August, 2013

Hospital Newspaper - NY

OUR VIEW

ADVERTISER INDEX Company

Page 23

AkrimAx / Nitromist

Hospitals preparing for major implementation of the Affordable Care Act

Bankers Healthcare Group, inc.

Burke rehabilitation Hospital

The Federal Patient Protection and Afford-

Those that have gone without insurance

of healthcare services to our economy as

ColumbiaDoctors

able Care act is scheduled to be implemented

are expected to use the services provided by

well as the human cost of the uncared for

in January 2014.

their new insurance.

members of the community.

EmA

7, 18

This includes the growth of Medicaid,

Primary care physicians and family doctors

Hospital News will keep you informed as

employer changes and essential health

are expected to receive up to 20% more

changes develop across the industry. As always

benefits for individuals and families.

newly insured patients. There is also an

we welcome your news and thoughts!

GNYHA Services

interfacemD

Jewish Home Lifecare

Hospital preparations include more staff,

increase of some specialty physicians that

Long island University

expanded square footage and continued

will gain referral from the additional patients.

Staten island University Hospital

communication as hospital leaders prepare

Some private physicians are actually be-

NorthWest Seminars

for an impact that is yet to be measured.

coming employees of local health system.

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resource Directory

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Sun Home Loans

Please share your stories with us: news@hospitalnewspaper.com

The key point is that hundreds of thousands

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Jim Stankiewicz can be reached at

of people in each state will now be eligible

add physical space and build a network of

845-534-7500 ext. 219 and via email at

for some type of insurance.

clinics. Healthcare leaders realize the cost

jim@hospitalnewspaper.com.

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News in Emergency Medicine About Emergency Medical Associates Emergency Medical Associates (EMA), headquartered in Parsippany, N.J., is a physician-led, physician-owned medical practice that specializes in emergency, hospitalist and urgent care medicine. Dedicated to providing exceptional solutions for the measurable success of our hospital partners, EMA is recognized for clinical excellence, quality service and sustained improved patient satisfaction. For more information, visit www.ema.net, www.facebook.com/EMANews or www.twitter.com/EMANews. Shih presents research to U.S. and International audiences

Stuhlmiller presents poster at Critical Care Transport Medicine Conference David F.E. Stuhlmiller, MD, FACEP, CMTE, presented a poster entitled, "HEMS STEMI Bedside Time: Impact of Medication Changeover Prior to Transport” at the Critical Care Transport Medicine Conference held April 8, 2013, in Austin, Texas. The results of the research concluded a median of 4 minutes (average of 3.5) per infused medication can be saved by HEMS medical crew by not changing over each medication infusion at the bedside of ST elevation myocardial infarction (STEMI) patients. Dr. Stuhlmiller is a partner of Emergency Medical Associates and chairman of the department of emergency medicine at Newton (N.J.) Medical Center.

Amato and Weiner host Workshop at Goryeb Children’s Hospital Continuing Medical Education Conference Drs. Christopher Amato, MD, FACEP, FAAP, and Ethan Wiener, MD, FAAP, presented at Goryeb Children’s Hospital’s 15th Annual Continuing Medical Education Conference held May 31-June 2 at Skytop Lodge, Skytop, Pa. The workshop focused on wound care, basic life support and pediatric advanced life support cases. Dr. Amato also lectured on office preparedness. Dr. Amato is the director of the Pediatric Emergency Medicine Fellowship and an attending pediatric emergency physician at Goryeb Children’s Hospital, Morristown, N.J. He also is the medical director of pediatric advanced life support for Atlantic Health. Dr. Wiener is the associate director of pediatric emergency medicine at the Goryeb Children’s Hospital, Morristown, N.J. Both are partners of Emergency Medical Associates.

Dr. Richard Shih, MD, FACEP, FAAEM, is an active in medical research and education and has traveled extensively to share his findings. Dr. Shih co-authored a case report entitled, “Glycine Induced Hyperammoniemia After Bladder Rupture During Transuretheral Resection of a Bladder Tumor.” The report was published in the Journal of Medical Cases. In addition to co-authoring a case report, Dr. Shih has given various presentations, lectures and was a discussant at various conferences. Presentations: • Oral research presentation entitled, “5 Year Prospective Study: OSCE Evaluations Do Not Correlate with EM Faculty Evaluations” at the 2013 Council of Residency Directors Scientific Assembly in Denver • Poster research presentation entitled, “QTc Prolongation and Torsades in Bupropion Overdose Presenting to U.S. Emergency Departments” at the 2013 American College of Medical Toxicology Scientific Assembly in San Juan, Puerto Rico • Poster research presentation entitled, “Ensuring Equity: Complaints by Race, The Beginning Investigations of MD Complaint Profilers” at the 2013 Society of Academic Emergency Medicine Northeast Regional Meeting held April 3 in Providence, R.I. Dr. Shih gave two lectures at The University of Texas Southwestern Medical Center May 1-2 in Dallas. • Emergency Medicine Journal Club, Discussant • Emergency Medicine Grand Rounds, Cases in Medical Toxicology Dr. Shih gave three presentations at the 2013 New Jersey American College of Emergency Physicians Scientific Assembly Review Course held May 7 in Princeton, N.J. • Ensuring Equity: Complaints by Race, The Beginning Investigations of MD Complaint Profiles • ED Patients Who Complain Are Less Likely To Be Repeat Customers • Dr. Shih and Michael Silverman, MD, presented “2013 Lifelong Learning and Self-Assessment Review Course” Dr. Shih gave three lectures at the Florida Emergency Physicians 13th Annual Symposium on Emergency Medicine Resuscitation of the Critically Ill 2013 held April 14 in Orlando. The lectures were entitled: • Get Up to Speed on New Drugs of Abuse • The Crashing OD: Give ‘Em Fat! • One Pill Can Kill – Practical Approach to Pediatric Poisoning Dr. Shih is residency director for the department of emergency medicine at Morristown (N.J.) Medical Center, and a partner of Emergency Medical Associates.

The Sign of Excellence ence in Emergency Medicine edicine® ree Decades for More Than Three

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PAGE 8

August, 2013

Hospital Newspaper - NY

Ask An Expert Christopher J. O’Connor Executive Vice President, GNYHA Ventures, Inc., President, GNYHA Services, Inc. and President, Nexera, Inc.

The New Normal: Giving Hospital-Physician Alignment Priority Both the present and the future of healthcare are about care coordination. Given the current environment—its regulatory and financial mandates, patient needs, and technological advancements—hospitals, health systems, and physicians are collaborating more than ever before to help increase care value while improving delivery systems. But whether through physician-hospital organizations (PHOs), accountable care organizations (ACOs), or other arrangements, hospital-physician alignment is a multifaceted cooperative relationship that requires continuous nurturing with clear, strategic practices and goals. Nearly 70 percent of physicians in a 2013 survey expect increased hospital-physician integration in the next one to three years. And they should. There is a substantial incentive to focus on the hospital-physician relationship. In a healthcare delivery system that rewards data sharing as well as cost and quality improvements, physician buy-in is key. Because of their central role in treatment decisions, and their power to decide when to admit and discharge patients, trying to significantly improve quality and outcomes while lowering hospital costs without physician participation may be impossible. Accordingly, hospitals must strengthen physician partnerships. This can entail the challenge of overcoming long-standing competing interests in order to develop an alignment strategy that best fits the organizational culture. The characteristics of a healthy hospital-physician relationship include 1. support for and commitment to change, from senior management down; 2. physician stakeholders actively engaged in hospital governance; 3. adequate staffing, technology, and practices that facilitate alignment; 4. pay models, including incentive compensation programs, developed by the hospital and physicians; 5. established procedures and policies to deal with conflict. While grounded in mutual leadership, resources, and patient-centered goals, hospital-physician alignment should also be mutually beneficial. It should deliver tangible opportunities to lower costs while improving efficiencies. One example is the GNYHA Services Alternate Care Purchasing Platform, which allows physicians affiliated with hospitals and health systems (like those owned, leased, or managed by hospitals or in PHO relationships) to purchase medical and non-medical products at prices typically available only to acute care health systems. Interdependency and teamwork are markers of today’s healthcare environment. Undeniable forces, such as ACOs, bundled payments, health IT requirements, lower reimbursement rates, and quality-based payments, are engendering close hospital-physician collaboration. However, these partnerships are not one-size-fits-all nor can they be forced. Providers must proactively determine their own strategy, based on their needs, their resources, alignment gaps, and the organizational climate. A comprehensive collaborative assessment, start-up plan, and implementation can result in alignment programs that are effective as well as tailored—ones that balance differences, goals, and operational/management capabilities, and provide incentives for continued success. Christopher J. O’Connor is Executive Vice President of GNYHA Ventures, Inc., the for-profit arm of the Greater New York Hospital Association, and President of two GNYHA Ventures companies: GNYHA Services, Inc., an acute care group purchasing organization, and Nexera, Inc., a healthcare consulting firm. Mr. O’Connor is Chair-Elect of the Association for Healthcare Resource & Materials Management (AHRMM).

Hospital Newspaper - NY August, 2013

CONQUER COSTS WHILE COORDINATING CARE More than ever before, healthcare providers are working together to lower costs and overcome complex industry challenges. GNYHA Services is an excellent partner for providers aspiring to create a collaborative supply chain. Our expertise and best-in-class purchasing portfolio can be leveraged to unify procurement across the continuum of care. Unleash new savings opportunities! Call us today at (212) 246-7100 to connect your health network with savings you never thought possible.

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Page 9

PAGE 10

August, 2013

Hospital Newspaper - NY

interfaceMD a trendsetter in Electronic Medical Record systems Joel Kanick’s vision for interfaceMD dates back to 2001 when he created the enterprising electronic medical record (EMR) system. Kanick devoted four years to the development and evolution of interfaceMD before its launch in 2005. Today, interfaceMD, a division of Kanick And Company with headquarters in Buffalo, N.Y., is a business model of sharing, efficiency and security – a wave of the future. “The buzz words we use are customized, comprehensive and connected,” said Kanick, president and CEO of Kanick And Company and an expert in the EMR field. “I have the kind of technology that will make you a better doctor. It will make your practice run much smoother. Doctors are not supposed to be IT experts and interfaceMD will help them. We built a great application for them.” Kanick was one of the first HIPAA certified consultants in the eastern U.S. As the architect of interfaceMD, he has ensured that the program’s solution was built to match the present and future framework of the Federal and State legislation, and has chosen technology components that will allow his solution to evolve as new regulations are adopted and new technologies are developed. An Electronic Medical Record (EMR) is collection of health information pertaining to a patient's care, treatment plans, lab results, prescriptions, etc., in electronic form. Healthcare providers utilize EMRs to replace traditional paper charts. An EHR is a summary of a person's current state of health. There is no definitive standard for people to carry an electronic copy of their EHR on their person.

Some people carry this information in their wallets, others wear medical alert bracelets in the meantime. Practice Management refers to the daily operation of practice flow. Patient demographics, appointment scheduling and billing are traditional components. The goal is to select an application that will manage your practice, store and share medical information in EMRs and generate EHRs for your patient base. Unlike most companies whose customer service is unresponsive, whose help is half-hearted, and who assume you’re a technology expert, interfaceMD includes the client support desired. Specialists are available to walk you through the process, helping you make the best business decisions possible. This company is not only concerned with your current needs, but they’re also helping you plan for your future. Many EMR providers claim to be customized systems but they really only allow you to change a handful of fields or they have pre-made exam forms for particular specialties. From exam forms, to documents, to tabs, fields, or educational resources, this intuitive system works the way you do. All aspects of interfaceMD can be customized for each practice. When you purchase an EMR/PM system, most vendors will send you a CD in the mail or an internet login ID, but the rest of your network is for you to figure out. Kanick And Company realizes that you’re a healthcare professional and not an IT specialist, you shouldn’t be expected to know the ins and outs of running a network. “That’s why our customers look to us as their technology partner.” Kanick responded.

The single most important factor in choosing a practice management application and solution provider is that your data must always be available. Therefore you have no alternative but to select an application that has no single point of failure. With interfaceMD all your office application needs are included in this one system. There is no need to purchase additional email or instant messaging software. All of your word processing, charting and presentation capabilities are included. interfaceMD provides one complete comprehensive solution that meets all of your EMR and practice management needs. “We asked doctors how software impacts their lives and we built an application for all of those things. We’re thrilled with our product and it works better than any other system on the market. All the parts work together. We want to make sure doctors have the best technology, the best information, when they are treating you and your family. This is the future. It makes everything easier for everyone in the office and streamlines the process. Really, it’s a no brainer,” Kanick shared. Kanick and his staff will be holding info sessions to further inform the medical community about EMR Best Practices. The info sessions are being held on July 18th and 23rd at the Millennium Hotel on Walden Ave. in Buffalo. For more information about interfaceMD or the info sessions, visit www.customEMRsolutions.com or email us at interfaceMD@kanick.com. Hospital Newspaper will feature interfaceMD in two upcoming issues this summer.

interfaceMD Services ■

Business Assessment Review your business processes and policies to determine how you are using technology to meet the needs of your business. Many companies invest in technology but are unable to determine its impact on the business, cost of maintenance, return on investment or plan for future needs.

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Disaster Recovery & Business Continuance Do you know the cost and impact on your business if operation stops? It is critical to develop a disaster recovery plan to rebound from the unexpected tragedy. In addition, you must also develop a business continuance plan so that your business does not stop operating for any prolonged period of time. The most important aspect is for your patient to not feel the "pain" of your service interruption.

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HIPAA Checkup & Compliance Planning HIPAA regulations affect every health care provider and have a dramatic impact on all of the internal and external operations of your practice. Any resulting changes must address both operational procedures and technical resources to ensure overall compliance.

■

Network & Security Assessment Detailed analysis of your existing computer hardware and software. We are experts in technology and can help you. As an independent third party, we do not sell these types of products so our opinions and recommendations are always unbiased.

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Technology Workshop We will sit down with you and review all your options. Our staff can assess your needs, help you choose the best solutions and empower you to understand the issues. Our goal is to help you run a better business.

Hospital Newspaper - NY August, 2013

Customized Custo Cus omized o ed | Comprehensive Compreh Co p ehensive e s e | Connected Connec Co ecccted ed

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expensive software to buy up-front or contracts long-term contracts DICTATION, DICT TA ATIO TION, ON, you are done with the y leave the exam m room patient when you

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August, 2013

Hospital Newspaper - NY

H HOSPITAL of the Month

STATEN ISLAND UNIVERSITY HOSPITAL The healthcare leader on Staten Island, Staten Island University Hospital (SIUH) has a 152-year tradition of challenging the future. “Our founding mission of providing the community with the highest quality health care is a motivator,” explained Anthony C. Ferreri, the hospital’s CEO and executive director of the North Shore-LIJ Health System’s Western Region. “We’ve kept up the pace of progress since 1861, the year the hospital started as a one-room infirmary to treat the poor who could not afford a doctor.” Today, SIUH is a two-campus 714-bed tertiary care teaching hospital. A network of community-based care centers serve New York City’s fastest-growing borough, while specialized programs attract patients from the global community. SIUH has earned a number of prestigious awards, including a top spot tie in all six years of the CMS quality incentive project. SIUH is Staten Island’s largest employer with a staff of nearly 7,000: 1200 nurses, 900 physicians, nearly 300 faculty physicians and 900 volunteers. Staten Island University Hospital South Site

Centers of care at SIUH include: The Heart Institute, renowned for MICS CABG (pronounced mix cabbage): minimally-invasive coronary artery bypass graft surgery. MICS pioneer, Dr. Joseph McGinn, teaches surgeons the world over the technique of operating on a beating heart while restoring blood flow around plaque- clogged coronary arteries. Heart specialists also perform valve surgery, treat afib with cryo- and radial ablation, do angiography, calcium score testing, and heart failure therapy. SIUH’s Regional Burn Center is a national leader in pediatric burn care. Long-term support is offered for healing. Firefighter families have close ties to the center and are a source of support. Staff at The Elizabeth A. Connelly Emergency and Trauma Center utilize computerized navigational and electronic health record systems. The facility is designed to convert to mass casualty mode in minutes. North and South Site EDs annually record about 125,000 combined visits. The new Regina M. McGinn, MD, Education Center is a hub for medical and community education featuring satellite capability for video-conferencing.

North Site centers of care include: The hospital’s cancer and pediatric cancer services program. Staten Island University Hospital North Site

Women’s health center and high-risk pregnancy program. Newer Pediatric Unit with its Firehouse Playroom and “hero- themed” kids’ rooms made possible with help from the Joseph Maffeo Foundation. This spring, a gynecologic surgeon successfully performed a total radical hysterectomy using the robotic da Vinci surgical system.

South Site special services offer Islanders: A geriatric program for seniors the fastest growing segment of Staten Island’s population. The Sleep Medicine Institute is fully equipped for stay-over studies that diagnose and treat sleep apneas. photos provided

What lies ahead? At this spring’s 131st Charity Ball, the SIUH Service Auxliliary celebrating its 150th year, pledged $350,000 towards further development of a Comprehensive Breast Center and children’s cancer program. “Living with change is a constant in healthcare. At Staten Island University Hospital, we embrace the challenges change imposes. When you think about it, it makes for better medicine,” said Ferreri.

Hospital Newspaper - NY August, 2013

Each year, more than 16,000 New Yorkers trust us for cancer diagnosis and treatment. Because they know when we fight cancer, we donâ&#x20AC;&#x2122;t fight fair.

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August, 2013

Hospital Newspaper - NY

Boomers & Beyond Schaffer Extended Care showcases fashion favorites Sound Shore Medical Center of Westchester’s Schaffer Extended Care Center showcases fashion favorites during their 18th annual event. Recently the residents, family, friends and staff of Schaffer Extended Care Center (SECC), located on the campus of Sound Shore Medical Center in New Rochelle, enjoyed their 18th annual fashion show.

The staff of the Department of Recreation Therapy worked their magic and transformed the day room into a visual delight. Live music and a dynamic emcee added to the festive atmosphere for the event attended by more than 50 individuals – most of whom were tapping to the music as they applauded the volunteer models and their glamorous outfits. SECC residents and volunteer models chose a personal favorite outfit to showcase, which always provides an array of styles – from casual to formal and everything in between, including exquisite ethnic ensembles. Broad smiles and loud applause greeted each participant as they made their way down the runway. The annual Fashion Show is greatly anticipated and was another successful event on the busy calendar at Schaffer Extended Care Center. It was often difficult to tell who was having the best time – the onlookers or the models. Schaffer Extended Care Center offers the convenience of compassionate, respectful, community-based care for long term residents as well as short-term rehabilitation patients. Families will discover the caring that makes Schaffer a perfect choice when remaining at home is no longer possible. For more information on Schaffer Extended Care Center, please call the Vice President for Long Term Care/Administrator of SECC, Susan Sales at 914.365.3702. For physician referrals in all specialties, call MDs-LINE (914.637.5463); and for additional information on Sound Shore Medical Center’s Care. For Life. services, visit www.soundshore.org today!

Hospital of the Month Hospital Newspaper highlights one hospital per month as the centerfold feature. Great way to get information about your facility to interested readers.

For more details contact: GENERAL MANAGER

Jim Stankiewicz (Jim@hospitalnewspaper.com) 845-534-7500 ext 219 Scan this barcode with your smart mobile device to see Hospital of the Month examples on www.hospitalnewspaper.com

photos provided

Hospital Newspaper - NY August, 2013

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Boomers & Beyond Preserving dignity through the very end Jewish Home Lifecare social worker fulfills last wish for a special client Making sure that nursing home residents have their individual needs met, even when it comes to their final days, is something that Jewish Home Lifecare’s caring social workers attend to with heart and compassion. While most people know of Jewish Home’s exceptional nursing and homecare in life, the way its staff members take it upon themselves to prepare for the eventual death of a resident is beautiful. Social worker Meredith Levine, who works at Jewish Home’s Bronx campus, recently fulfilled a special, last wish for a client. James Whelan, 86, a beloved resident and U.S. Military veteran who served in WWII and the Korean War, wanted to be buried in A r l i n g ton National Cemetery. He, like all Jewish Home Lifecare residents, had several preliminary conversations with his social worker about his wishes.

While Meredith typically counsels family members about their elder’s eventual passing and final plans, James did not have a single relative with whom to consult. In fact, despite his larger-thanlife charismatic presence and generous spirit, which touched the hearts of his fellow residents and staff, he only had one long-time friend from the outside community. Sister Alice, who James befriended some 35 years ago after making a book donation to the local Catholic school, was his sole outside advocate. With little personal income, final arrangements for James presented challenges. Meredith, who upholds a personal responsibility to see that every one of her clients is buried in a way that meets his or her cultural or religious expectation, couldn’t fathom a nameless burial for James. She explains, “I really would have paid for his cremation myself if I had to.

Otherwise, I wouldn’t have been able to sleep at night.” After many phone calls, Meredith found a Brooklyn funeral director who agreed to handle the cremation when the time came, free of charge, as long as James agreed to appoint Jewish Home Lifecare with responsibility for his remains. When James passed last November, Meredith commenced to fulfill his final wish. Immediate outreach to Arlington National Cemetery required a series of checklist items, which included the submission of his Army discharge papers. Fortunately, Sister Alice had them. After seemingly endless faxes and phone calls, Arlington National Cemetery agreed to accept his ashes. Since the burial was contingent on date availability, James was finally able to rest in peace on June 20th. His funeral procession was distinguished with 50 servicemen, a horse drawn caisson, and a military band.

Meredith transported James’ remains from New York to Arlington and attended his funeral with Sister Alice, who made the trip from Rockland County. As his sole friend, Sister Alice was presented with the American flag that represented a dignified goodbye. According to Meredith “It’s my job to advocate for our residents dignity until the very end. I feel comforted that in the end, James received the respect he hoped for and deserved.” Rita Morgan, Bronx Administrator, proudly remarks, “Jewish Home’s social worker’s do an outstanding job of meeting the needs of our resident’s and their families. Meredith, who has been with us for three years, really puts her heart into her work in the most exemplary way. Her commitment to dignifying James’ memory moved me and our staff. We are grateful for all her efforts,”

Jewish Home Lifecare has been meeting the needs of New York’s elders for over 165 years. It provides a network of care that includes long term skilled nursing, post acute care, Alzheimer’s/Dementia special care communities, respite care, senior housing and community programs, such as home care and adult day care along with other specialized services. Jewish Home Lifecare has campuses in the Bronx, Manhattan and the Sarah Neuman Center in Westchester. It also serves clients where they live using innovative technology such as the awardwinning HealthMonitor® program. Best practice programs are provided in fall management, wound care, pain management, mental health and wellness, diabetes and congestive heart failure. For more information, visit www.JewishHome.org.

Sarah Neuman Center presents:

Health Tips for Staying Well : rs fe of er nt Ce an um Ne h ra Sa t i F Fi g ng ing yi y ay ta SSt healthy lifting and kickboxing may not be For most seniors, jogging, weight remember s to boost your fitness, but please options. Try these simple, fun task . re starting a new exercise regimen to first check with your doctor befo Be Active your usual stop and walk the Step off the bus two blocks before rest of the way. on the joints, improves your Take a Tai Chi or Yoga class. It’s easy balance and makes you stronger. uming, mopping, dusting and Doing everyday chores, like vacu shopping, count too.

* * * * * *

Walk a dog; play with a cat.

Be Social ” invite a friend over to “cut the rug. Join a local dance class or simply r rs blood pressure and decreases you Laugh more. It reduces stress, lowe risk of heart disease. Be Mindful couch ure, whether you’re sitting on the Always try to maintain good post ry. inju to ble ng and less suscepti or on a chair, to keep your back stro k adequate fluids throughout the Eat breakfast and remember to drin ty. day — even if you don’t feel thirs

* *

apy bilitation with individualized ther Comprehensive short-stay reha plans and care teams a beautiful residential campus Skilled Nursing care services on social models—for health and Adult Day Programs—medical and ion wellness support and social interact those caring for an elder at home Respite Care providing a break for

Need Ne eed ee ed mo more mor ree iinf infofo ? Health Tips are for you from your neighbors at Sarah Neuman Center. Helping you stay well and safe is our first priority.

To learn more about us, call (914) 864-5621. www.jewishhome.org

845 Palmer Avenue, Mamaroneck NY 10543

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August, 2013

or nfo f i t s e Lat s and

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Hospital Newspaper - NY

Nurseâ&#x20AC;&#x2122;s Viewpoint

By Alison Lazzaro

Hospital Newspaper Correspondent

Mind, Body, Spirit Set an intention If you have ever tried yoga, you will notice that the class begins by setting an intention, or a reason for coming to your mat. This technique allows the yogi to center his or her thoughts and consciously set aside one's own concerns in order direct positive energy to a person or thing. This practice of yoga mirrors holistic nursing. Evidence based practice dating back to Florence Nightengale exemplifies holistic nursing via setting an intention, commitment to self-care, and transcendent presence. Nurses are encouraged to pause for a moment before entering a patient's room, close their eyes, take a deep breath, and direct awareness to someone or something that brings to mind love and compassion. Being fully present in the moment allows nurses to promote a caring and healing interaction. Go through your flow Vinyasa yoga goes through a series of poses while focusing on inhaling and exhaling through flowing movements. Nurses can easily become caught up in the tasks they need to accomplish in the 12-hour work day, but calling to mind that intention and remembering to breath throughout the day can bring back the realization that nursing is about caring for human beings first and foremost. It is also important to care for yourself before you can competently take care of others. Self care is an integral part of holistic nursing. This includes analyzing one's own habits with self-awareness by journaling, meditation, or creating time for reflection. Holistic nursing includes practicing aromatherapy, healing touch, guided imagery, and reflexology to name a few. These methods are backed by the professional American Holistic Nurses Association and American Holistic Nurses Credentialing Corporation. These techniques enrich the scope of nursing practice by treating people's physiological, psychological, and spiritual needs in conjunction with conventional medical therapies. Aromatherapy uses essential oils from plants and herbs to treat physical imbalances. Yogis frequently use lavender and citrus oils to relax deeper. Pre-op and post-op nurses integrate this practice into nursing for relaxation techniques with patients. Healing touch is an energy-based approach to influence healing by restoring harmony and balance. Seal your practice At the end of each yoga class, the student's hard work is acknowledged and sealed with an audible "om." Before sealing your day at work, try to incorporate a holistic technique into your practice. Be mindful of self-care each day because it will expand your capacity to be present and compassionate in nursing. Self-care will rejuvenate your mind, body and spirit and enhance your love of nursing.

Hospital Newspaper - NY August, 2013

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H.E.L.P. Program helps the hospital community that means so much to us They are the kind and caring faces that treat you for routine check-ups, unexpected trips to the emergency room and, even worse, catastrophic events. They do it under pressure, but always have a smile and soothing words. They are the doctors and nurses that take care of us, often saving lives, at hospitals and healthcare facilities. No matter what, they are always there to help. That’s why Sun National Bank Hospital created the Employee Loan Program (H.E.L.P) and it‘s been a huge success. Sun Home Loans and Hospital Newspaper came together to bring the emergency services community a special mortgage opportunity. Whether purchasing a new home or refinancing an existing one, the Sun Home Loans H.E.L.P. program is offered to members of the hospital community and their families. “We are always looking for programs that benefit our clients and the communities we serve,” said Steven Testa, a Vice President with Sun Home Loans. “This seemed like a natural fit. The men and women who work at hospitals work selflessly every day to take care of our loved ones. They are, indeed, special people. For us, we are just excited to be able to work with them.” Among other things, caring doctors, nurses and their support staffs, protect and promote patients. They prevent illness and injury, advocating for them, their families and communities. Indeed, these men and women are a special breed, tireless and determined. As for the H.E.L.P. program? The enterprising initiative has set itself apart through wonderful customer service with some of the best mortgage rates in the country. Sun National Bank makes that pledge to all of its satisfied clients. The H.E.L.P. program provides discounted mortgage rates designed for hospital employees and pre-qualifications to shop for your next home or refinance. A H.E.L.P. program representative will assist you in making sure the process is cost-effective and works for you and your family. H.E.L.P. Program clients enjoy unmatched customer service and attentiveness throughout the process - from their initial inquiry - through closing. In addition, Sun National Bank provides a full-range of banking products and services, delivered by experienced bankers. Sun National Bank believes that doing business in the community means being a part of it. To receive more information about the program and its benefits, contact Steven Testa at stesta@sunnb.com or call 973-615-9745. Sun National Bank Home Loans and Hospital Newspaper are not affiliated. All loans subject to approval. Certain conditions and fees may apply. Mortgage financing provided by Sun National Bank Loans, Equal Housing Lender.

Win an iPad! If you are a member of the hospital community, now is your chance to enter Sun Home Loans and Hospital Newspaper's contest to win a free iPad. Just to go our website at www.hospitalnewspaper.com and fill in the entry form. Once you complete it, you will receive an email that requires you to confirm your email address. Once you do that you are entered. Hospital Newspaper will also be accepting applications at all conventions that it attends. A total of Five iPads will be given away so your chances to win are excellent. Sign up today to win today!

Hospital Employee Loan Program

Sun Home Loans, a division of Sun National Bank, is proud to serve the heroes in our community who dedicate their lives to serving the rest of us: doctors, nurses and other hospital employees. That is why we teamed up with Hospital News to create the Hospital Employee Loan Program (HELP). With a competitive mortgage rate and discounted fees, this program helps our community heroes purchase new homes or refinance existing homes. Plus, the program comes with our pledge to get hospital employees in their new homes by their contract dates.

PROGRAM INFORMATION We understand that the current economic environment has created challenges to home ownership. Working with our own resources and Federal government programs we will create a solution that opens the path to home ownership. The Hospital Employee Loan Program delivers these advantages: » A competitive mortgage rate, available specifically for hospital employees » Discounted fees » Personal service from program specialists » Our pledge to have you in your home by the contract date

COMMUNITY FOCUS Sun National Bank, a full-service provider of banking products and services, is dedicated to playing an active part in the communities we serve. We support a variety of organizations, events and programs whose goals are to make our neighborhoods a better place to live and work and improve the lives of those living around us. Hospital News is the leading provider of local news and information for doctors, nurses and other hospital staff.

Learn More To find out more about our Hospital Employee Loan Program, email stesta@sunnb.com or call 973-615-9745 to talk with our program specialist, Steve Testa (NMLS #460176), who will discuss your need and explain how the program could benefit you.

www.sunnb.com Sun Home Loans, Sun National Bank, and Hospital News are not affiliated. All loans subject to approval. Certain conditions and fees may apply. Mortgage financing provided by Sun Home Loans, a division of Sun National Bank, member FDIC. Equal Housing Lender.

NMLS #429900

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August, 2013

Hospital Newspaper - NY

2013 Advanced Emergency and Acute Care Medicine Conference

11th Annual

September 17, 2013 — September 20, 2013 Sheraton Atlantic City Convention Center Hotel—Atlantic City, NJ

“Best CME Value in the Northeast” Presenting Evidence-Based Medicine Best Practices on Key Disease States and Medical Technologies for ED, Acute Care, IM/FP and Hospitalist Providers Delivering Evidence-Based Medicine Best Practices Designed to Improve Clinical Outcomes, ED Operations, Reduce Risk and Enhance Patient Satisfaction Featuring Educational Tracks for Physicians, Mid-Level Providers, Nurses and ACHE Healthcare Executives Exceptional Variety of Courses Complimentary Exhibit Hall on 9/18/13 and 9/19/13 Registration Includes Breakfast and Lunch on Tuesday — Thursday

Program Highlights • Nationally Recognized Lecturers • Learn the Latest Treatment Options on Key Disease States • Separate Hospitalist Track • Full day ACHE Healthcare Executive Track on 9/18/13 • Registration Includes Daily Breakfast and Lunch (except Friday) • 3-hour Advanced Difficult Airway Hands-On Lab Course • 2-hour ED Ultrasound/Vascular Access Hands-On Lab Course • 1-hour Dental Block Lab Hands-On Course • 2013 LLSA Review Course General Information Courses: Tuesday, September 17, 2013 – Friday, September 20, 2013 On-Site Registration: Tuesday, starting at 8:30 am; Wednesday and Thursday, starting at 6:30 am; Friday, starting at 7:30 am. Location: Sheraton Atlantic City Convention Center Hotel Two Convention Boulevard • Atlantic City, NJ 08401 (609) 344-3535 • www.sheraton.com/atlanticcity

Target Audience This conference is designed for: Emergency, Acute Care, Hospitalist, Internal Medicine and Family Practice Physicians. Additional audiences include Mid-Level Providers (PAs and NPs), Nurses, Nurse Managers, Healthcare Executives, Healthcare Marketing, Community Outreach and EMS Professionals.

Course Objectives The practice of Emergency and Acute Care Medicine is a challenging and ever-changing specialty. This exciting conference covers the most up-to-date evidence-based medicine information on key disease states, clinical and operational best practices and ground breaking technology, which can make a significant impact on the practice of emergency and acute care medicine, both now and in the future. All attendees will be able to discuss and apply the clinical and operational best practices presented by some of the country’s top emergency and acute care medicine lecturers at this conference. Attendees will be able to explain and apply the latest evidence-based medicine information on: Stroke, Geriatric Emergencies, Pediatric Emergencies, Infectious Disease, Observation Medicine, Advanced Difficult Airway, Ultrasound Guided Vascular Access, ACS, Stroke, Medical Legal Risks, Atrial Fibrillation, Emergency Medicine in an Era of Healthcare Reform, Pain Management, Dental Emergencies, EM Literature Update, Dental Blocks, The Role of Scribes in Hospital Medicine, Challenges in Healthcare Reform to providing the right care to the right patient at the right time; Hospitalist Leverage in an Era of Healthcare Reform; Hospitalist Medicine in an Era of Healthcare Reform; ED Hospitalist Integration – A Best Practices Approach; Acute Decompensated Heart Failure: Transitions of Care from Door to Discharge and Beyond to improve clinical quality as the result of identified provider practice gaps.

Scott Serbin, Director of Provider Marketing Emergency Medical Associates 3 Century Drive, Parsippany, NJ 07054 Phone: (973) 740-0607 Fax: (973) 740-9895 Email: Serbins@alpha-apr.com Special Hotel Rates: A special room rate of $139 has been secured for attendees of the 2013 Conference. Rooms at this special rate may be limited and should be booked no later than August 27, 2013. You may book your room on-line via www.bestemconference.com, or by calling (888) 627-7212.

All information, including Conference Registration and Hotel Room Registration, can be conveniently accessed on-line at: www.bestemconference.com.

Hospital Newspaper - NY August, 2013

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North Shore University Hospital unveils new 640-Slice CT Scanner; offers most advanced cardiac imaging Only one of its kind in Northeast, CT provides faster scans, superior images, low dose radiation North Shore University Hospital (NSUH) recently announced it has installed the most advanced cardiac computed tomography (CT) scanner to help diagnose heart disease and a patient’s risk for heart attack. Developed by Toshiba Medical Systems, the Aquilion™ ONE ViSION 640-slice CT scanner captures an image of the heart in less than one heartbeat – resulting in ultrafast scan times, superior three-dimensional images of the heart and significantly lower exposure to radiation compared with conventional scanners. The new CT scanner, which costs between $2.5 and 2.8 million, is one of only three in the US – and the only one in the Northeast. “The 640-slice CT’s high speed gives us the ability to capture a complete high-resolution image of the heart muscle in less than one-third of a second,” said Jesse Chusid, MD, a cardiothoracic radiologist and chief of imaging informatics at NSUH. “In the past, cardiac scans required 10 phases of imaging to obtain an entire picture of a beating heart, compensating for movement. This new scanner allows us to evaluate the coronary arteries while delivering a lower dose of radiation to enhance patient safety.”

A cardiac CT combines X-rays and advanced computer technology to produce 3-D images of the beating heart. Using the 640-slice CT physicians are able to look at the heart’s structure, vessels and circulation to detect any coronary artery disease or defects in the heart. According to the US Centers for Disease Control and Prevention, heart disease is the leading cause of death in United States and soon projected to be the leading cause of death worldwide. It causes about 600,000 deaths in United States annually. Two thirds of those deaths are due to coronary artery disease. “Cardiac CT is an excellent and useful diagnostic modality to rule out heart disease with 99 percent accuracy and avoid more invasive testing,” said Biana Trost, MD, director of cardiac CT of the department of cardiology at NSUH. “If the images show a low degree of calcium in the heart arteries, patients can be started on preventive therapy. On the other hand, if the CT scans show a high risk of disease, which may lead to heart attack, patients can be referred for an angiogram and possible stenting or even surgery.”

James Naidich, MD, a practicing radiologist at the hospital for 42 years, recently underwent a 640-slice CT scan and beat the odds of having a major heart attack, thanks to the new technology. Although Dr. Naidich had some risk factors for heart disease, the scan revealed that he had severe blockages in all three arteries of his heart, much to the surprise of his colleagues. “The good news is that the proper diagnosis was made – almost by happenstance – and it provided the opportunity for me to get treated,” Dr. Naidich said. This spring, Dr. Naidich underwent an angioplasty procedure to unblock arteries in the heart, using stents to restore blood flow. The procedure was performed by Dr. Naidich’s cardiologist, Stanley Katz, MD, senior vice president of cardiovascular services at the North Shore-LIJ Health System. “With the detailed 3-D images of the heart, we are able to look deep inside coronary arteries to detect evidence of disease and to identify any build up of calcium,” said Dr. Katz. “The CT images help cardiologists make a more accurate diagnosis and select the best course of treatment.”

provided

Dr. James Naidich, right, with his doctors and colleagues who helped diagnose and treat his heart disease, with the aid of a newly installed 640-slice CT scanner at North Shore University Hospital, which produces the most advance cardiac imaging . Pictured from right: Dr. Biana Troust, Dr. Stanley Katz and Dr. Jesse Chusid.

A major advantage of the noninvasive 640-slice CT is that it can be used in the emergency room to rule out heart attacks and other problems in low- to moderate-risk patients with chest pain, often avoiding the need for patients to be admitted to

the hospital. The Aquilion™ ONE ViSION CT scanner can also be used for neurological studies. For more information about the 640-slice CT, call 855-HEART-11 or 855-432-7811

EMERGENCY MEDICINE UPDATE CME 2013 Conferences 9/23-26 Las Vegas, Nevada

11/4-8 Maui, Hawaii

2014 Conferences 1/20-23 Duck Key, Florida

2/2-7 Turks and Caicos

2/10-14 Telluride, Colorado

3/17-20 Las Vegas, Nevada

4/12-19 7-Day Caribbean Cruise

5/19-22 New Orleans, Louisiana

7/5-12 7-Day Alaskan Cruise

7/21-25 Yosemite, California

8/25-29 Whitefish, Montana

9/15-18 Las Vegas, Nevada

11/13-16 Key West, Florida

12/9-12 Paradise Island, Bahamas

2014 Ultrasound in Emergency Medicine 3/20-21 Las Vegas, Nevada

9/18-19 Las Vegas, Nevada

2015 Tentative Conferences 3/16-19 Las Vegas, Nevada

4/19-24 Turks and Caicos

9/14-17 Las Vegas, Nevada

2016 Tentative Conferences 3/14-18 Las Vegas, Nevada

north west S E M I N A R S

9/12-16 Las Vegas, Nevada

(800) 222-6927 www.northwestseminars.com

PAgE 20

August, 2013

Hospital Newspaper - NY

RESOURCE DIRECTORY ARCHITECTURE

Bernstein & Associates, Architects Founded in 1990, Bernstein & Associates, Architects, specializes in the design and construction of hospital and healthcare facilities. Our focus: high-quality design, excellent service, and client satisfaction. We have worked for over 100 hospitals and another 200 private healthcare facilities, across the United States. Our project types have included all hospital and healthcare service groups, including: Adult Day Care, Alcoholism Treatment Facilities, Ambulatory Surgery Centers, Assisted Living, Cancer Centers, Cardiac Cath, Cardiology, CCU/ICU, Clinics, Coronary Care, Dental, Dermatology, Dialysis Clinics, Doctors Offices, Drug Treatment Facilities, Elder Care, Employee and Student Health Support Services, Emergency Departments, Emergency Preparedness, Endoscopy, ENT, Expert Witness, Group Practices, Hospices, Hospitals, Infectious Disease, Information Systems, Intensive Care, JCAHO Survey, Joint Commission Survey, Laboratories, Master Plans, Medical Offices, Medical Equipment, Medical Libraries, Medical Records, Neurology, Nursing Homes, Ophthalmology/Eye Center, OB/Gyn, Orthopedic, Pain Care Facilities, Pathology, Patient Safety Consulting Services, Pediatric, Pharmacy, Physical Fitness and Sports, PT/OT, Primary Care Programs, Psychiatric, Radiology, Rehabilitation, Senior Citizen Facilities, Sleep Centers, Social Services, Statement of Conditions, Surgical Suites and Ambulatory Surgery Centers, Urgent Care Centers, and USP 797 Consulting Services. The firm's projects have won design awards from Progressive Architecture, Architectural Record, and the Architectural Woodworking Institute, and have been published in Advance, Health Facilities Management, Medical Technology Today, Bio/Technology, Progressive Architecture, Architectural Record, Design Solutions, Hospitality Design, Sound and Communication, Contract Design and Hospital Newspaper. Architectural Services include: programming, planning, design, construction documents, bidding and negotiation, and construction administration. The firm also offers sustainable or “green” healthcare design. The firm has a number of LEED-accredited professionals, has successfully completed numerous green healthcare projects, and has published articles on “Greening the Healthcare Environment”. Project Management (or Owner’s Representative Services) is offered as a stand-alone service through our affiliated project management company, Empire Projects, Inc. (www.empireprojects.com). Bernstein & Associates, Architects - PLLC 51201 Broadway - #803, New York, NY 10001 Contact: William N. Bernstein, AIA Managing Principal Tel: 212.463.8200 • Fax: 212.463.9898 wb@bernarch.com NEW YORK - HARTFORD - PRINCETON

FAST & COMFORTABLE PELVIC EXAMS TSK PRODUCTS The Wedgie Pelvic Exam Wedge provides fast, comfortable pelvic exams in the ER, Radiology, SANE and Women’s Health. It is a much more comfortable than using a hard bedpan. The 6" height of the Wedgie lifts the patient's pelvis significantly higher then a bedpan, thus allowing physicians to perform a better exam. The Wedgie’s unique cutout design allows the physicians to maneuver their speculum in all directions without interference. The Wedgie support patients weighing up to 350 lb. It is made of a medical grade foam and an anti-microbial, anti-bacterial, and stain resistant medical grade vinyl cover. It can be cleaned with standard disinfectant products. Optional: disposable one-time use protective covers and room wall holders are available.

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CAREER MAnAgEMEnT

Connect with Leading Healthcare Recruiters Join BlueSteps, the executive career management service of the Association of Executive Search Consultants Healthcare executives are in demand. Are you being considered for the top leadership jobs? Join BlueSteps today to put your resume and confidential careerprofile at the finger tips of over 8,000 of the world’s top executive recruiters, including hundreds who specialize in healthcare and life sciences recruiting. In addition to a unique connection to the executive search community, BlueSteps also provides a suite of proactive career management tools including: • a free resume review and career consultation • access to the International Executive Search Firm Directory • exclusive information on hundreds of active executive searches • online brand management tools • career management content and events specifically for senior-level executives As a service of the Association of Executive Search Consultants, you can rest assured that your career details will be confidentially and securely managed within BlueSteps. Unlike other mass job boards, only the highest caliber executive search consultants (all members of the AESC) will have access to your BlueSteps profile. Each year, AESC members recruit for over 70,000 of the highest level executive positions globally, many of which are never advertised publically. Join BlueSteps today and receive 15% OFF your membership! Visit www.BlueSteps.com and enter Healthcare15% at checkout to get this exclusive discount. Contact info@bluesteps.com to learnmore or for assistance getting started!

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EDUCATIOn

Prepare for a Career in Healthcare Sector Management at Long Island University. Earn an advanced certificate or an M.B.A. degree in the growing field of healthcare management at Long Island University’s Hudson Graduate Center at Westchester. Demand for healthcare managers with business skills has never been greater. Responding to this need, Long Island University has launched a new Healthcare Sector Management program, offering two graduate study options in the field of healthcare administration. After completing your advanced certificate or your M.B.A. at the University’s Hudson Graduate Center at Westchester, you will be prepared to advance in middle and upper management positions in the healthcare industry. Option A: The Advanced Certificate in Healthcare Sector Management Enhance your credentials by enrolling in the advanced certificate program. Certificate candidates will complete four healthcare sector management courses for a total of 12 graduate credits on a part-time basis in just two semesters. Option B:The M.B.A. Degree with a Healthcare Sector Management Concentration Students in the M.B.A. program follow the standard 48-credit curriculum, normally completed by part-time students over a 24-month period, with a focus on leadership in healthcare organizations. The Healthcare Sector Management Program will be offered at Long Island University’s Hudson Graduate Center at Westchester, located on the grounds of Purchase College, 735 Anderson Hill Rd., Purchase, N.Y. Courses are offered on weekday evenings and on Saturdays. “The healthcare management field is one of the few sectors of our economy we know will continue to grow significantly over the next five years,” according to Dr. Lynn Gunnar Johnson, director of the M.B.A. Healthcare Sector Management program. For information, contact Dr. Johnson at 914-931-2711 or lynn.johnson@liu.edu. Long Island University Hudson Graduate Center at Westchester 735 Anderson Hill Rd. Purchase, NY 10577

EMERgEnCY MEDICInE SERVICES COnSULTATIOn SERVICES Customer Satisfaction TeamBuilding/Staff Development Conflict Mediation ED Systems Analysis PRACTICE MAnAgEMEnT SERVICES Hospital and Physician Billing/Coding/Auditing/Consultation nEW YORK BASED OFFICE MED★EXCEL USA

Contact Jim Stankiewicz to find out how your organization can be featured in our Resource Directory.

845-534-7500 ext.219 Fax: 845-534-0055 Please contact Marie Buchanan at 800.563.6384 Ext. 249 mbuchanan@medexcelusa.com all inquiries are confidential

Online Directory available at www.hospitalnewspaper.com

Hospital Newspaper - NY August, 2013

Orange Regional Medical Center Physician Leader selected for FDA Study Participation

PAGE 21

If you’d like to reach the health and hospital communities of New Jersey each month, there is no more cost-effective way than the Hospital Newspaper. Call Jim Stankiewicz to place your advertisement: 845-534-7500 *219

provided

Dr. Ofer Jacobowitz to study device for Obstructive Sleep Apnea

October 6-9, 2013 Ofer Jacobowitz, MD, PhD, an Otolaryngologist and Sleep Medicine specialist, was one of three doctors selected in the United States to participate in a FDA study for ImThera Medical’s aura6000™, a neurostimulation device for treating Obstructive Sleep Apnea (OSA). Dr. Jacobowitz, the Associate Medical Director of Orange Regional’s Center for Sleep Medicine, has implanted the device in five patients at Orange Regional. The aura6000™ device was designed to increase the upper airway opening during sleep by preventing the tongue from blocking the airway. The small battery powered device is implanted under the skin and is programmed by a physician and customized for each patient. “To be selected for this FDA study is a tremendous honor,” says Dr. Jacobowitz. “This device offers hope to those patients that are unable to use CPAP, an air pressure device, to get a good night’s sleep.” Dr. Jacobowitz is a highly experienced clinician with more than 12 years practice in Otolaryngology and maintains board certifications in Head and Neck Surgery, Otolaryngology and Sleep Medicine. He is an active member of national sleep committees and task forces and served as Orange Regional’s Department Chairman of Otolaryngology from 2007 – 2010. Dr. Jacobowitz is a national and international speaker, author and editor of sleep publications on obstructive sleep apnea and is a partner with Hudson Valley Ear, Nose and Throat P.C. Dr. Jacobowitz completed his Medical School training at the Mount Sinai School of Medicine, in New York and completed his residency at Mount Sinai Medical Center. For more information about on sleep services at Orange Regional Medical Center, visit www.ormc.org/sleepcenter. Orange Regional Medical Center is a member of the Greater Hudson Valley Health System. About Orange Regional’s Center for Sleep Medicine Sleep study services performed at Orange Regional’s Center for Sleep Medicine aid in the diagnosis of potential sleep disorders that may also contribute to other health related conditions. A sleep study is a painless, non-invasive test that allows specially-trained technicians to monitor a patient’s breathing, heart rate, blood oxygen levels, eye movement, muscle tone and other factors. Sleep studies take place in our state-of-the-art facility located in the Orange Regional Medical Pavilion at 75 Crystal Run Road, Middletown, New York and offers the latest diagnostic technology in a quiet, comfortable and peaceful environment.

You are Invited to the Longest Running, International Conference on Patient-Centered Care! Join the longest running, most successful educational event for healthcare professionals who strive to create culture change and deliver health care that puts the needs of the patients first.

Participate in a variety of breakout sessions that appeal to different learning styles Enter the no power point zone and immerse in “Planetree Live” Engage with the best minds in health care and be inspired and re-invigorated by our world renowned keynotes Experience patient-centered care real time by touring premier Planetree facilities Connect with more than 1,200 attendees from across the continuum of care from large urban systems to small critical access hospitals and long-term care communities Collaborate with conference participants from around the globe. Our global presence, with countries ranging from Canada, Denmark, France, Belgium Italy, The Netherlands and Brazil, as well as some of the largest and innovative health care systems in the U.S., come together as a true collaborative community Gain vital information, innovative tools, and the support needed to transform your health care organization Location Montreal, a cosmopolitan city enriched by the diverse cultures of its people embodies the personality of this a one-of-a-kind educational event for health care professionals who strive to create culture change and deliver health care that puts the needs of the patients and residents first.

Keynote Presenters Lyn Heward, Montreal's Cirque du Soleil Director of Creation David Nash, MD, Founder of the Jefferson School of Population Health Regina Holliday, Trailblazing patient rights arts advocate Polly LaBarre, Best-selling author, original team member of Fast Company magazine Rosalind W. Picard, ScD, Founder and Director of the Affective Computing research group at MIT Media Lab Richard Kogan, MD, Distinguished concert pianist and psychiatrist To learn more and sign up now while space is available: www.patient-centeredcareconference.com

PAGE 22

August, 2013

Hospital Newspaper - NY

RESOURCE DIRECTORY HOSPITALS Calvary Hospital Founded in 1899, Calvary Hospital is the nation’s only accredited acute care hospital devoted to palliative care for adult advanced cancer patients. Its mission is to address the physical, psychological, and spiritual needs of patients and their families. Press Ganey has consistently ranked Calvary among the top one percent in patient satisfaction among 7,000 hospitals in the country Each year, Calvary cares for more than 6,000 patients and their families. The continuum of care includes inpatient, outpatient, home hospice, nursing home hospice, home care, and the care of complex wounds. Calvary cares for inpatients at its 200-bed hospital in the Bronx and at its 25-bed Brooklyn satellite at Lutheran Medical Center. Calvary@Home offers home care, hospice, and nursing home hospice for patients suffering from advanced cancer and other chronic and acute terminal illnesses. • Home care is available in the Bronx, Brooklyn, Queens, Manhattan, Staten Island, and lower Westchester. • Hospice services are offered in the Bronx, Brooklyn, Queens, Manhattan, as well as Nassau, Westchester, and Rockland counties. • also offers hospice services in more than 35 nursing homes in Brooklyn, Manhattan, Queens, the Bronx, and Westchester, Rockland and Nassau counties. In 2004, Calvary opened the Center for Curative and Palliative Wound Care at its Bronx facility. Since then, a team of experienced physicians, surgeons, and certified wound care nurses has helped more than 800 patients to date with complex chronic wounds caused by complications of diabetes, cancer, venous and arterial disease, and other illnesses.

NURSING HOME Jewish Home Lifecare is one of the premier non-profit geriatric and rehabilitation institutions in the country. The Home serves more than 9,000 older adults daily through traditional long term care, subacute care, rehabilitation services, community services and senior housing programs. These services are offered on the Home's three campuses in Manhattan, the Bronx, and Westchester at the Sarah Neuman Center for Healthcare and Rehabilitation, as well as through our Lifecare Services Division, which provides programs throughout the metropolitan area. Many levels of care are provided by the Home's health system so that as needs change, individuals can transfer from one level of care to another. Skilled nursing and medical care are provided 24 hours a day by on-site clinical staff as well as a complement of physicians representing a full range of medical specialties. The Home also educates and trains physicians and medical professionals in geriatrics. In an unprecedented teaching program with Mt. Sinai School of Medicine, over 2400 fourth year Mt. Sinai Medical School students have participated in a mandatory rotation program at the Home. A strong component of the Home's activities include conducting research to improve the quality of life of older adults. Jewish Home Lifecare is the home of the Lester Eisner, Jr. Center for Geriatric Education, the Saul Alzheimer's Disease Special Care Unit (Bronx), the Greenberg Center on Ethics in Geriatrics and Long Term Care and the Center on Pharmacology for the Elderly (COPE). The Home has added a new service titled, CONNECTIONS, an information and referral service for the professional and lay communities, connecting people to programs.

For more information, visit www.calvaryhospital.org or call the following numbers: Calvary Hospital (718) 518-2300, Calvary@Home (718) 518-2465, and Wound Care (718) 518-2577.

Jewish Home Lifecare Manhattan - Bronx - Sarah Neuman Center 120 West 106th Street, New York, New York, 10025 Call Connections Information and Referral at 212- 870-5919 or 800-544-0304

NEW PRODUCT TECHNOLOGY

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WORKERS’ COMPENSATION HOSPITAL WORKERS HAVE YOU BEEN INJURED ON THE JOB? Learn What You Must Do To Protect Your Workers' Compensation And Disability Rights! Do Not Make These Mistakes That Can Cost You Benefits 1. You must report the accident or injury as soon as possible, even if you might not lose time from work or need immediate medical care. 2. Report all injuries to all body parts, no matter how minor they may seem. If you do not report it and the injury gets worse over time, the job may deny benefits. 3. Remember, you are entitled to treatment and benefits even if you have previously injured the same body part in a prior accident. Do not let the job tell you different. 4. Your doctor controls the treatment, not risk management. If you need an MRI and the job will not approve it, the experienced attorneys at BAGOLIE FRIEDMAN can fight to get it approved at no cost to you. 5. When you are released from treatment, you may be entitled to money for your injury and disability. You may also collect for repetitive stress, cumulative trauma, cancer, hearing loss & hepatitis. 6. Contact Attorneys Ricky Bagolie or Alan Friedman now for a confidential and free consultation and to discuss your workers' compensation and disability rights. There is no fee if there is no recovery.

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PLACE YOUR AD HERE!

Getting better…. just got better. We are proud to announce that our stunning new nursing center has opened and has private and semi-private rooms with magnificent views of Long Island Sound. United Hebrew is a not-for-profit, non-sectarian, multi-service senior living campus serving the Westchester metropolitan area since 1919. Our dedicated short-term rehabilitation suite is staffed by Burke Rehabilitation professionals. The exemplary clinical team of professionals will design a personalized treatment plan for care in our nurturing environment. Features include country kitchens, recreation rooms on each floor, a courtyard garden for recreational use, private dining and family rooms and wireless internet access. United Hebrew Family of Services: • Nursing Home Care • Burke Rehabilitation at United Hebrew • Willow Towers Assisted Living Residence • Soundview Apartments for Independent Seniors • Long Term Home Health Care Program • Azor Home Health Agency For more information or to schedule a tour please call Admissions at 914-632-2804 x1148 or email Karen Nodiff at knodiff@uhgc.org. United Hebrew 391 Pelham Road, New Rochelle, NY 10805 914.632.2804 www.uhgc.org

associations NYSNA www.nysna.org healthcare consultants Medco Consultants, Inc. www.medcoconsultants.com hospitals HealthAlliance of the Hudson Valley® www.HAHV.org North Shore LIJ www.northshorelij.com medical equipment & Products TSK Products www.tskproducts.com rehabilitation www.stcharles.org

To list your business website contact: Jim Stankiewicz Tel: 845-534-7500 ext. 219 jim@hospitalnewspaper.com

Hospital Newspaper - NY August, 2013

Page 23

Calling All Emergency Responders

When every second counts... Count on NitroMist

NitroMist provides fast, effective symptom relief. NitroMist provides a consistent dose with each metered spray.* NitroMist offers secure storage, ensuring potency for up to 36 months from date of manufacture.† Available in 90 & 230 spray bottles. For product samples, patient educational material, and the NitroMist ER Box (Shown), Go to: www.NitroMistPro.com Now covered on UnitedHealthcare. Check with your GPO for low contract pricing. For additional information, please contact us at info@akrimax.com BRIEF SUMMARY NitroMist® (nitroglycerin) lingual aerosol Rx Only INDICATIONS AND USAGE– NitroMist is indicated for acute relief of an attack or acute prophylaxis of angina pectoris due to coronary artery disease. CONTRAINDICATIONS– PDE5 Inhibitor Use: Administration of NitroMist is contraindicated in patients who are using a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5), as PDE5 inhibitors such as sildenafil, vardenafil, and tadalafil have been shown to potentiate the hypotensive effects of organic nitrates. Severe Anemia: NitroMist is contraindicated in patients with severe anemia. Increased Intracranial Pressure: NitroMist is contraindicated in patients with increased intracranial pressure. Hypersensitivity: NitroMist is contraindicated in patients who have shown hypersensitivity to it or to other nitrates or nitrites. Skin reactions consistent with hypersensitivity have been observed with organic nitrates. WARNINGS AND PRECAUTIONS– Tolerance: Excessive use may lead to the development of tolerance. Only the smallest number of doses required for effective relief of the acute anginal attack should be used. As tolerance to other forms of nitroglycerin develops, the effect of sublingual nitroglycerin on exercise tolerance, although still observable, is reduced. Hypotension: Severe hypotension, particularly with upright posture, may occur even with small doses of nitroglycerin. The drug should therefore be used with caution in patients who may be volume-depleted or who, for whatever reason, are already hypotensive. Hypotension induced by nitroglycerin may be accompanied by paradoxical bradycardia and increased angina pectoris. The benefits of NitroMist in patients with acute myocardial infarction or congestive heart failure have not been established. If one elects to use NitroMist in these conditions, careful clinical or hemodynamic monitoring must be used because of the possibility of hypotension and tachycardia. Hypertrophic Cardiomyopathy: Nitrate therapy may aggravate the angina caused by hypertrophic cardiomyopathy. Headache: Nitroglycerin produces dose-related headaches, which may be severe. Tolerance to headaches occurs. ADVERSE REACTIONS– Headache, which may be severe and persistent, may occur immediately after nitroglycerin use. Flushing, drug rash and exfoliative dermatitis have been reported in patients receiving nitrate therapy. Postural hypotension, as manifest by vertigo, weakness, palpitation, and other symptoms, may develop occasionally, particularly in erect, immobile patients. Marked sensitivity to the hypotensive effects of nitrates (manifested by nausea, vomiting, weakness, diaphoresis, pallor, and collapse) may occur at therapeutic doses. Syncope due to nitrate vasodilatation has been reported. DRUG INTERACTIONS – PDE5 Inhibitors: Administration of NitroMist is contraindicated in patients who are using a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5). PDE5 inhibitors such as sildenafil, vardenafil, and tadalafil have been shown to potentiate the hypotensive effects of organic nitrates. The time course and dose dependence of this interaction have not been studied, and use within a few days of one another cannot be recommended. Appropriate supportive care for the severe hypotension has not been studied, but it seems reasonable to treat this as a nitrate overdose, with elevation of the extremities and with central volume expansion. The use of any form of nitroglycerin during the early days of acute myocardial infarction requires particular attention to hemodynamic monitoring and clinical status. Antihypertensives: Patients receiving antihypertensive drugs, beta-adrenergic blockers, and nitrates should be observed for possible additive hypotensive effects. Marked orthostatic hypotension has been reported when calcium channel blockers and organic nitrates were used concomitantly. Labetolol blunts the reflex tachycardia produced by nitroglycerin without preventing its hypotensive effects. If labetolol is used with nitroglycerin in patients with angina pectoris, additional hypotensive effects may occur. Aspirin: Coadministration of aspirin and nitroglycerin has been reported to result in increased nitroglycerin maximum concentrations by as much as 67% and AUC by 73% when administered as a single dose. The vasodilatory and hemodynamic effects of nitroglycerin may be enhanced by concomitant administration of aspirin. Tissuetype Plasminogen Activator (t-PA): Intravenous administration of nitroglycerin decreases the thrombolytic effect of tissue-type plasminogen activator (t-PA). Plasma levels of t-PA are reduced when coadministered with nitroglycerin. Therefore, caution should be observed in patients receiving nitroglycerin during t-PA therapy. Heparin: Intravenous nitroglycerin reduces the anticoagulant effect of heparin. Activated partial thromboplastin times (APTT) should be monitored in patients receiving heparin and intravenous nitroglycerin. It is not known if this effect occurs following single nitroglycerin doses. Ergotamine: Oral administration of nitroglycerin markedly decreases the first-pass metabolism of dihydroergotamine and subsequently increases its oral bioavailability. Ergotamine is known to precipitate angina pectoris. Therefore, patients receiving sublingual nitroglycerin should avoid ergotamine and related drugs or be monitored for symptoms of ergotism if this is not possible. USE IN SPECIFIC POPULATIONS– Pregnancy: Pregnancy category C: Animal reproduction and teratogenicity studies have not been conducted with NitroMist or nitroglycerin sublingual tablets. It is also not known whether NitroMist can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. A teratogenicity study was conducted in the third mating of F0 generation female rats administered dietary nitroglycerin for gestation day 6 to day 15 at dose levels used in the 3-generation reproduction study. In offspring of the high-dose nitroglycerin group, increased incidence of diaphragmatic hernias and decreased hyoid bone ossification were seen. The latter finding probably reflects delayed development rather than a potential teratogenic effect, thus indicating no clear evidence of teratogenicity of nitroglycerin. There are no adequate and well controlled studies in pregnant women. NitroMist should be given to a pregnant woman only if clearly needed. Nursing Mothers: It is not known whether nitroglycerin is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when NitroMist is administered to a nursing woman. Pediatric Use: The safety and effectiveness of nitroglycerin in pediatric patients have not been established. Geriatric Use: Clinical studies of NitroMist did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other rep-

Not Actual Size

orted clinical experience has not identified differences in responses between elderly (greater than or equal to 65 years) and younger (less than 65 years) patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. OVERDOSAGE– Signs and symptoms of hemodynamic effects: The effects of nitroglycerin overdose are generally the results of nitroglycerin’s capacity to induce vasodilatation, venous pooling, reduced cardiac output, and hypotension. These hemodynamic changes may have protean manifestations, including increased intracranial pressure with any or all of persistent throbbing headache, confusion, and moderate fever; vertigo; palpitations; tachycardia; visual disturbances; nausea and vomiting (possibly with colic and even bloody diarrhea); syncope (especially in the upright posture); dyspnea, later followed by reduced ventilatory effort, diaphoresis, with the skin either flushed or cold and clammy; heart block and bradycardia; paralysis; coma; seizures; and death. No specific antagonist to the vasodilator effects of nitroglycerin is known, and no intervention has been subject to controlled study as a therapy of nitroglycerin overdose. Because the hypotension associated with nitroglycerin overdose is the result of venodilatation and arterial hypovolemia, prudent therapy in this situation should be directed toward increase in central fluid volume. Passive elevation of the patient’s legs may be sufficient, but intravenous infusion of normal saline or similar fluid may also be necessary. The use of epinephrine or other arterial vasoconstrictors in this setting is not recommended. In patients with renal disease or congestive heart failure, therapy resulting in central volume expansion is not without hazard. Treatment of nitroglycerin overdose in these patients may be subtle and difficult, and invasive monitoring may be required. Methemoglobinemia: Methemoglobinemia has been rarely reported with organic nitrates. The diagnosis should be suspected in patients who exhibit signs of impaired oxygen delivery despite adequate arterial PO2. Classically, methemoglobinemic blood is described as chocolate brown, without color change on exposure to air. If methemoglobinemia is present, intravenous administration of methylene blue, 1 mg/kg to 2 mg/kg of body weight, may be required. NONCLINICAL TOXICOLOGY– Carcinogenesis, Mutagenesis, Impairment of Fertility: Animal carcinogenicity studies with sublingually administered or lingual spray nitroglycerin have not been performed. Rats receiving up to 434 mg/kg/day of dietary nitroglycerin for 2 years developed dose-related fibrotic and neoplastic changes in liver, including carcinomas, and interstitial cell tumors in testes. At the highest dose, the incidences of hepatocellular carcinomas was 52% compared to 0% in untreated controls. Incidences of testicular tumors were 52% vs 8% in controls. Lifetime dietary administration of up to 1058 mg/kg/day of nitroglycerin was not tumorigenic in mice. Nitroglycerin was found to have reverse mutation activity in the Salmonella typhimurium strain TA1535 (Ames assay). A similar mutation in S. typhimurium strain was also reported for other NO donors. Nevertheless, there was no evidence of mutagenicity in an in vivo dominant lethal assay with male rats treated with oral doses of up to about 363 mg/kg/day or in ex vitro cytogenic tests in rat and dog tissues. In vitro cytogenetic assay using Chinese hamster ovary cells showed no chromosomal aberrations. In a 3-generation reproduction study, rats received dietary nitroglycerin at doses up to about 408 mg/kg/day (males) to 452 mg/kg/day (females) for 5 months (females) or 6 months (males) prior to mating of the F0 generation with treatment continuing through successive F1 and F2 generations. The highest dose was associated with decreased feed intake and body weight gain in both sexes at all matings. No specific effect on the fertility of the F0 generation was seen. Infertility noted in subsequent generations, however, was attributed to increased interstitial cell tissue and aspermatogenesis in the high-dose males. PATIENT COUNSELING INFORMATION– Interaction with PDE5 Inhibitors - NitroMist should not be used in patients who are using medications for erectile dysfunction such as sildenafil, vardenafil, and tadalafil. These products have been shown to increase the hypotensive effects of nitrate drugs such as NitroMist. Administration - Patients should be instructed that prior to initial use of NitroMist Lingual aerosol, the pump must be primed by pressing the actuator button 10 times to ensure proper dose priming. If the product is not used for more than 6 weeks, the bottle can be adequately re-primed with 2 sprays. NitroMist is meant to be sprayed on or under the tongue at the beginning of angina or to prevent an angina attack. Treatment with nitroglycerin products such as NitroMist may be associated with lightheadedness on standing, especially just after rising from a laying or seated position. This effect may be more frequent in patients who have consumed alcohol, since alcohol use contributes to hypotension. If possible, patients should be seated when taking NitroMist. This reduces the likelihood of falling due to lightheadedness or dizziness. Headache - Headaches can sometimes accompany treatment with nitroglycerin. In patients who get these headaches, the headaches may indicate activity of the drug. Tolerance to headaches develops. Flushing - Flushing, drug rash and exfoliative dermatitis have been reported in patients receiving nitrate therapy. Container information - The NitroMist bottle should not be forcefully opened. Because NitroMist contains a highly flammable propellant (butane), do not have the container burned after use and do not spray directly towards flames. While the container is in the upright position, if the liquid reaches the top to middle of the hole on the side of the container, a new supply should be obtained. When the liquid reaches the bottom of the hole, the remaining doses will have less than label content. Manufactured for Akrimax Pharmaceuticals, LLC E Cranford, NJ 07016 by Dynamit Nobel GmbH, Leverkusen, Germany E Marketed and Distributed by: Akrimax Pharmaceuticals, LLC, Cranford, NJ 07016 USA NitroMist is a registered trademark of NovaDel Pharma Inc., used by permission. 141B002 10/2012

*Priming NitroMist: After receiving a new prescription or refill, patients should remove the plastic cap, place forefinger on actuator button, and press 10 times. NitroMist is now primed for 6 weeks and ready to use. If not used for more than 6 weeks, the NitroMist bottle can be adequately reprimed with 2 sprays. † Store at room temperature (25°C, 77°F); excursions permitted to 15-30°C (59-85°F). NitroMist is a registered trademark of NovaDel Pharmaceuticals, LLC., used by permission.

PAGE 24

August, 2013

Hospital Newspaper - NY

Let L Let LIU IU Hudson Hudson help help you you to to llaunch aunch or or advance your career care. a dvance y our c areer iin n health health c are. L L L L

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Express E xpress Admission Admission Days Days August A ugust 20-22 20-22 L 112:00-7:00 2:00-7:00 p.m. p.m. Westchester - 7735 Westchester 35 A Anderson nderson H Hill ill R Road, oad, PPurchase, urchase, N NYY R Rockland ockland - 7700 R Route oute 3340, 40, O Orangeburg, rangeburg, N NYY Bring your Bring your transcripts transcripts for for an an o on-the-spot n-the-spot admissions a dmissions evaluation evaluation w with ith ffaculty. aculty. RSVP: R SVP: w westchester@liu.edu estchester@liu.edu or or r rockland@liu.edu ockland@liu.edu **For For gainful gainful employment employment iinformation nformation vvisit isit www.liu.edu/ge. www.liu.edu/ge.

lliu.edu/hudson/express iu.edu/hudson/express