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Hospital Newspaper - NY
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Help Program continues to be a success Among other things, physicians Anil Narula and David Feldman, are successful, caring and very busy. With long days, they didn’t need to be burdened with a long process when looking for a mortgage. Of course, the pair also wanted a good rate. Enter the Sun National Bank Hospital Employee Loan Program (H.E.L.P). 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. Count Narula and Feldman as two of the many satisfied clients since the H.E.L.P. program was launched about a year ago. “At the end of the day, the rates are the most competitive, and the process is simple,” ,” said Feldman, an emergency room physician at Morristown (N.J.) Medical Center. “I don’t have a ton of time to fax papers back and forth. The H.E.L.P. staff helps you with all of that and the process is not intrusive as it is with other mortgage companies.” Why has the H.E.L.P. program been such a success? Simple. Great customer service combined with some of the best rates in the industry. Sun National Bank is honored to work with the heroes of the hospital community and their families. It’s a natural fit. Sun National Bank believes that doing business in the community means being a part of it: We believe all of our clients deserve the best service and products. The H.E.L.P. program provides discounted mortgage rates designed for hospital employees and pre-qualifications to shop for your next home. Refinancing can save you hundreds, even thousands, of dollars per year. Not only that, 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. “My interaction with the H.E.L.P staff was outstanding,” said Narula, a general surgeon who practices in the Bronx. His wife, Dr. Anita Narula, is a physician at Bronx Lebanon Hospital. “Whenever I had any questions, they never hesitated to get back to me. They were very honest and fair. I have the highest praise for the program. I wouldn’t expect anyone to get back to me 24/7, but some always was available.” In addition, Sun National Bank provides a fullrange 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: Our clients deserve the best service and products. Whether purchasing a new home or refinancing an existing one, the H.E.L.P. Program is offered exclusively, providing personal service, benefits and rates not normally available to the general public. 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 1st Responder 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,
PROGRAM INFORMATION
is proud to serve the heroes in our community
We understand that the current economic environment has created
who dedicate their lives to serving the rest of us: doctors, nurses and other hospital employees.
challenges to home ownership. Working with our own resources and
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
the path to home ownership.
hospital employees in their new homes by their contract dates.
Federal government programs we will create a solution that opens
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
PAGE 4
July, 2013
Hospital Newspaper - NY
Fund-Ex Provides Customized Financing Solutions to Healthcare Professionals By Patrick Harrigan | Syracuse, NY
In a time of extraordinary change within the industry, healthcare professionals face a list of challenges that seems to grow longer by the day. Providers are required to juggle priorities and effectively delegate responsibility in an effort to deliver high quality care. External pressures such as declining reimbursements, increasing compliance requirements and uncertainty surrounding the Affordable Care Act only add to the burden. Additionally, healthcare providers must adapt to the changing dynamics of the doctor-patient relationship as patients take a more proactive approach in how they gather information and interact with care providers. Despite these challenges, providers must make sure that operations continue to run smoothly while maintaining a steady Ă€RZ RI SDWLHQWV (TXLSPHQW QHHGV WR EH upgraded, additional staff may be needed to distribute the workload, and payroll or WD[ SD\PHQWV PD\ EH GXH 7KH ÂżQDQFLDO burden can often be overwhelming, leaving bills unpaid and projects stalled. In 2010, Fund-Ex, LLC was founded to provide healthcare professionals with the FRPPHUFLDO ÂżQDQFLQJ QHFHVVDU\ WR UXQ DQG grow a practice. As a lender that works exclusively with healthcare professionals, )XQG ([ RIIHUV D VXLWH RI ÂżQDQFLQJ VROXWLRQV GHVLJQHG DURXQG WKHLU VSHFLÂżF QHHGV and challenges. The funds can be used for a wide range of business purposes including working capital, debt consolidation, HTXLSPHQW ÂżQDQFLQJ UHDO HVWDWH RU WR VWDUW a practice. Fund-Ex’s goal is to simplify and shorten the lending experience for healthcare providers, ensuring that time away from patients is minimized. Âł:H XQGHUVWDQG WKDW D GRFWRUÂśV RIÂżFH doesn’t run like your typical business. Every second that a doctor spends away from patients means lost revenue,â€? said Albert Crawford, Owner and CEO of Fund-Ex. “We launched Fund-Ex to give healthcare professionals access
WR LQWHOOLJHQW ÂżQDQFLQJ RSWLRQV ZKLOH keeping the disruption of their day-to-day routine to an absolute minimum.â€? $OWKRXJK )XQG ([ RIÂżFLDOO\ RSHQHG LWV doors in 2010, principal owners Albert Crawford, Eric Castro and Robert Castro KDYH EHHQ SURYLGLQJ ÂżQDQFLQJ WR KHDOWKcare providers for more than two decades. That extensive experience has helped them gain a deep understanding of healthcare business cycles. It also led them to the realization that healthcare professionals QHHGHG PRUH ÂżQDQFLQJ RSWLRQV “Our years of experience have helped XV ÂżQH WXQH WKH IXQGLQJ SURFHVV DOORZLQJ us to provide capital to our healthcare clientele with unparalleled speed, service DQG HIÂżFLHQF\ ´ VWDWHG (ULF &DVWUR Owner and COO of Fund-Ex. “Combine that low-stress, no-pressure experience ZLWK D EURDGHU RIIHULQJ RI ÂżQDQFLQJ solutions and you have winning combination for healthcare professionals.â€? In addition to being time consuming and tedious, healthcare professionals IUHTXHQWO\ ÂżQG WKH VHDUFK IRU FDSLWDO fruitless. Traditional lenders are often
unfamiliar with healthcare professionals and unwilling to look outside their credit matrix to understand the complete picture surrounding the borrower. “Day after day we hear how challenging LW FDQ EH WR REWDLQ ÂżQDQFLQJ HYHQ IRU healthcare professionals with healthy incomes and solid credit histories,â€? said April Brissette, Chief Lending 2IÂżFHU IRU )XQG ([ Âł2XU FUHGLW PRGHO is rooted in a thorough understanding of their business process, and we take the time to understand the entire situation. This understanding allows Fund-Ex to say yes when other lenders are saying no.â€?
The Funding Expert for Healthcare Professionals www.fund-ex.com
|
877.851.9405
Hospital Newspaper - NY July, 2013
Page 5
Your healthy financial future is here.
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At Fund-Ex, our specialty is you. As a lender that works exclusively with healthcare professionals, we take the time to
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PAGE 6
July, 2013
Hospital Newspaper - NY
OUR VIEW
ADVERTISER INDEX Company
Page
Summer is Here…and so are the Cicadas
24
AkrimAx / Nitromist
5
Have you heard that unending noise from the cicadas? Just like
Always remember to protect yourself to prevent sunburn. For
Bergen regional medical Center
14
everyone looking for summer the cicadas have decided to drop in
babies under 6 months the two main recommendations from the
Burke rehabilitation Hospital
17
after seventeen years! It’s one of life’s mysteries. Sleep for seven-
AAP are to avoid sun exposure and parents can apply a minimal
teen years, mate and then you are done.
amount of sunscreen with at least 15 SPF to small areas, such as
ColumbiaDoctors
2
Bankers Healthcare Group, inc.
EmA
7, 18
Meanwhile it is finally getting warmer. Time to remember some
the infants face and the back of the hands. If an infant gets sunburn, apply a cold compress to the affected area.
important tips to keep your family cool and safe.
For older children and the rest of us, use a sunscreen with an SPF
The Center for Diseases says spending time in an air conditioned
GNYHA Services
9
interfacemD
11
Jewish Home Lifecare
15
North Shore-LiJ Huntington Hospital
13
prevention measures should include reducing or eliminating strenu-
Hospital News wishes you a safe and fun summer!
NorthWest Seminars
19
ous activities or rescheduling them for cooler parts of the day; drink-
Please share your stories with us: news@hospitalnewspaper.com
Planetree
21
ing water or nonalcoholic fluids frequently; wearing lightweight, light
Jim can be reached at 845-534-7500 ext. 219 and via email at
of 15 or greater that protects against UVB and UVA rays!
area is the strongest factor in preventing heat-related deaths.
Please look out for the elderly during heat waves and look for
The use of fans does not appear to be protective during periods
resource Directory
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Sun Home Loans
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of high heat and humidity. If exposure to heat cannot be avoided,
colored, loose fitting clothing; and avoiding direct sunshine.
signs of heat exhaustion or heat stroke.
jim@hospitalnewspaper.com.
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News in Emergency Medicine Amato Gives Lecture at the Second Biennial Pediatric Emergency Medicine Symposium 2013: Current Clinical Concepts Chris Amato, MD, FACEP, FAAP, lectured at the Second Biennial Pediatric Emergency Medicine Symposium 2013: Current Clinical Concepts held Tuesday, April 9 at The Valley Hospital Conference Center in Ridgewood, N.J. Dr. Amato gave a Pediatric Asthma Update 2013 – An evidence based review. 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 is also the medical director of pediatric advanced life support for Atlantic Health. 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 Co-Authors Articles, gives lectures
The Sign of Excellence ence in Emergency Medicine edicine® ree Decades for More Than Three
Richard Shih, MD, FACEP, recently co-authored four articles and gave four lectures. The articles were entitled: • “Tissue Plasminogen Activator and Stroke: Review of the Literature for the Clinician” American Journal of Emergency Medicine • “Mushroom Toxicity” Encyclopedia of Intensive Care Medicine • “Salicylate Overdose” Encyclopedia of Intensive Care Medicine • “Acute Colonoscopy-Induced Splenic Rupture Presenting to the Emergency Department” Case Reported Emergency Medicine The lectures included: • 2012 Lifelong Learning and Self-Assessment Review Course at the Florida Chapter of the American Academy of Emergency Medicine Scientific Assembly held Jan. 6 in Orlando • Grand rounds on Cases in Medical Toxicology at the Medical Center of Delaware held Jan. 24 in Christiana, Del. • 2012 Lifelong Learning and Self-Assessment Review Course at the 2013 American Academy of Emergency Medicine’s Scientific Assembly held Feb. 12 in Las Vegas
t
35 yyears ears of expertise exper x tise
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Serving Ser ving patients patie ents in New York, York, New w Jersey and Pennsylvania, Pennsyllvania, as w ell as North No or th Carolina Carolina and Rhode Rho ode Island well
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Dedicated board-certified Dedicated bo oard-cer tified emergency emerge ency physicians physicians integrate integ gra te iinto nto yyour our hos spital’ss cultur e hospital’s culture
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Recognized for Recognized for clinical excellence, excellence, quality quality service ser vice and high patient satisfaction pa tient sa tisffaction
• A poster presentation entitled, “Hydrogen peroxide overdose associated with pneumonia” at the American Academy of Emergency Medicine’s Scientific Assembly held Feb. 12 in Las Vegas Dr. Shih is the residency director for the department of emergency medicine at Morristown (N.J.) Medical Center and is a partner of Emergency Medical Associates.
Top 2012 T op 10 Emergency Department artment Contractors 2012 Best Places to Work Work orrk in Healthcare
(877) 692-4665 5
info@EMA.net
www.EMA.net www .EMA A.net
PAGE 8
July, 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.
Beyond Plug and Play—Strategizing for Optimal IT Spurred by consumer expectations, federal requirements, and the connectivity demanded by patient-centered care models, hospitals are adopting information technology (IT) at a faster rate than ever before. In fact, many hospitals expect IT to be the largest capital investment in the coming year. Over 75% of healthcare CIOs and IT executives polled in a recent survey planned to upgrade their network infrastructure in the next two years. And according to the Department of Health & Human Services, more than 80% of eligible hospitals have adopted electronic health records (EHRs), up from 9% in 2008. But these upgrades are not an exercise in technology for technology's sake. The most successful IT integration is a well mapped out organization-wide effort to meet transparent goals, not just an IT department project. The Health Information Technology for Economic and Clinical Health (HITECH) Act and meaningful use incentives have a lot to do with the uptick in IT interest. But that’s only part of it. From apps to clouds, IT can be a powerful tool, significantly impacting care delivery and day-to-day operations. It can help improve workflow and connectivity, patient experience, and outcomes; integrate clinical and financial systems; and promote evidence-based care. These are all vital to quality care and hospital viability in an increasingly value-based healthcare environment. According to one report, physicians and nurses waste more than 45 minutes a day on average using older technologies, such as pagers, instead of more up-to-date options, such as smartphones. Excess time spent discharging patients using outdated or deficient technology can cost a hospital more than $550,000 in lost revenue annually. That translates into an industry-wide loss of $8.3 billion a year. To make the right investment, the proposed technology should not be considered novel gadgetry but assessed by its ability to afford clinicians, executives, and patients quick access to critical analytical data. Truly successful technology systems work in a straightforward manner, make tasks easier to perform, and deliver essential information. They also align with hospital goals and show clinical/financial value. Strategies that help ensure IT success while avoiding implementation roadblocks include: 1. 2. 3. 4.
engaging stakeholders to evaluate current procedures and technology and business needs; considering integration, connectivity, and actionable data opportunities and challenges when selecting systems; creating an effective workflow and other procedures that support the technology; and devising and maintaining performance reports and evaluation processes.
While enormously valuable, IT comes with a number of challenges. Among them are cost and the sometimes disparate technology needs of hospital departments and organizations in a setting where information is expected to flow smoothly between systems. In addition, because technology evolves so rapidly, it is difficult to determine if an upcoming development will best this year's newest advancement. What’s more, there are important security and privacy considerations. As you attempt to address these issues and regulatory mandates, you can rely on your group purchasing organization to keep pace with your shifting needs. GNYHA Services continues to expand the role of the traditional group purchasing organization, prioritizing our IT contract portfolio—including software, hardware, and service categories—to provide members with opportunities to communicate their technology requirements directly in order to shape vendor agreements that deliver the most value. As part of a strategic IT initiative, it can achieve what winning IT programs do—facilitating, not replacing, organization-wide plans and objectives. 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 July, 2013
Achieve Optimal IT—SYNC to SAVE
From iPads to EHRs, hospitals are placing renewed focus on IT capital investments. GNYHA Services helps providers keep pace with this dynamically changing industry. Our contract portfolio is built using member feedback to ensure that members achieve savings in every healthcare IT category.
Turn to GNYHA Services to sync systems with savings. Call us today at (212) 246-7100.
555 West 57th St. I New York, NY 10019
Page 9
PAGE 10
July, 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.
■
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.
■
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.
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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 July, 2013
Customized Custo Cus omized o ed | Comprehensive Compreh Co p ehensive e s e | Connected Connec Co ecccted ed
Q F Fully ully
customizable custtomizable for yourr medical specialty, practice and eac specialty, eachh provider
Q N Noo
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Page 11
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July, 2013
Hospital Newspaper - NY
HOSPITAL
H of the Month
Cutting-edge surgery sets Huntington Hospital apart It’s not uncommon for Dr. Michael Grosso, Senior Vice President of Medical Affairs at North Shore-LIJ Huntington Hospital, to run into a patient at the supermarket or somewhere else around town. Whether it’s a hello on the go or a quick chat, Grosso and the rest of the staff at Huntington Hospital enjoy these interactions. After all, they are a part of the community they treat. “You absolutely have a sense of community work at this hospital,” Grosso said. “That involves the relationships you build with patients. It’s a very pleasant environment in which to work.” Of course, Huntington Hospital always provides patients with cutting-edge and advanced procedures. One of the latest is the recent addition of the state-of-the-art da Vinci® Robotic Surgical System. This method places the surgeon’s hands at the control of a cutting-edge surgical platform, enabling the performance of even the most complex procedures through a minimally invasive approach. At Huntington, this system is used for robotic thoracic surgery, oncology surgery, general surgery, bariatric surgery, urology surgery, colorectal surgery and gynecologic surgery. In fact, Huntington was recently designated as a Center of Excellence for Minimally Invasive Women’s Surgery, and received the same designation for bariatric surgery late last year. “These procedures reduce tissue trauma during surgeries and accelerate recovery,” Grosso explained. “Our surgical quality committee also emphasizes safety and quality.
North Shore-LIJ Huntington Hospital
Together, using these pathways, we provide a clear advantage for our patients. We have a state-of-the-art surgical suite, built six years ago, and we have a great anesthesiology department. We have all the moving parts we need to continue to be successful.” Robotic surgery allows patients to experience less invasive surgical procedures— procedures that were once only possible with more traditional open surgery. The goal of Huntington Hospital’s team of robotic surgeons and their supporting network of health care professionals is to continuously strive to reduce our patients’ stay in the hospital, as well as to minimize the pain and scarring associated with surgery and facilitate faster recovery, a quicker return to normal activities and improved functional outcomes. Established in 1916, Huntington Hospital is a full-service, 408-bed, nonprofit community hospital serving Huntington Township and surrounding communities. Huntington Hospital has been a member of the North Shore-LIJ Health System since 1994, and shares the System’s vision of being a preeminent healthcare delivery system in the tradition of excellence and the embodiment of community values and human dignity. Dr. Grosso, among so many other professionals at Huntington Hospital, are certainly fine examples of that. “This, indeed, is a very exciting time for us,” Grosso said. “We can even be more efficient for our patients. The feedback we are getting compared to our local peers has been excellent.” For more information, visit hunthosp.org.
photos provided
Control Room for Interventional Radiology Suite at Huntington
Huntington’s technologically-advanced Interventional Radiology Laboratory
Hospital Newspaper - NY July, 2013
Each year, more than 16,000 New Yorkers trust us for cancer diagnosis and treatment. Because they know when we fight cancer, we don’t fight fair.
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Page 13
PAGE 14
July, 2013
Hospital Newspaper - NY
Boomers & Beyond Jewish Home Lifecare partners with eCaring to demonstrate effectiveness of home care management system for elderly home care patients eCaring, the nation’s most extensive inhome real time health care data company, recently announced that it has been selected as a strategic partner by JewishHome Lifecare to enhance the organization’s managed care, telehealth and home health care services. The program is collaboration between Jewish Home Lifecare’s licensed home care service agency, Home Assistance Personnel Inc. (HAPI) and Senior Health Partners, a managed long term care plan (MLTC). Jewish Home Lifecare serves over two thousand patients in the city’s five boroughs and is actively expanding to Long Island and Westchester. Senior Health Partners provides services to over five thousand members in the New York metropolitan area. “Jewish Home Lifecare has long been an innovator in using technology to improve patient care,” said Bridget Gallagher, Senior Vice President of Community Services at Jewish Home Lifecare. “We arevery enthusiastic about the potential of eCaring to us improve care quality, as well as help us make the in-home aide a major player in the care team.”
By capturing real-time information about a patient’s care, activities and clinical data from the home, eCaring will improve carecoordination efforts between Jewish Home Lifecare and Senior Health Partners in order to avoid costly, serious events such as emergency room visits and hospitalizations. eCaring will also help the organization increase in-home caregiver engagement, resulting in greater employee satisfaction and retention. To begin, the program will run with 30 elderly patients receiving home health aide service—a population that eCaring has demonstrated remarkable effectiveness with in prior trials. During a 90-daytrial with Morningside Long Term Home Health Care in the Bronx, NY, eCaring prevented ER visits, hospitalizations, doctor visits and unplanned nurse visits, saving an average of $2,500 per patient, per month. “For managed care organizations, such as Managed Long Term Care Plans, Accountable Care Organizations and Medical Homes, getting actionable real time health care data from the home is essential to containcosts
while enhancing care quality for better outcomes,” said Robert M. Herzog, CEO of eCaring. “We're proud to be working with farsighted organizations such as Jewish Home Lifecare and Senior Health Partners that understand and are addressing the changing demands of our health care environment.” In addition to partnering with Jewish Home Lifecare, eCaring has ongoing trials with Morningside Long Term Home Health Care, Maimonides Hospital, and Beth Israel Medical Center to reduce preventable readmissions through timely access to clinical, behavioral and medication adherence data from a patient’s home. About Jewish Home Lifecare 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, short term rehabilitation, Alzheimer’s/Dementia special care communities, respite care, senior housing and community programs, such as home care and adult day care along with many other specialized
services. Jewish Home Lifecare has campuses in the Bronx, Manhattan and Sarah NeumanCenter in Westchester. It also serves clients where they live using innovative technology such as the award winning HealthMonitor® monitoring program. Best practice programs areoffered in fall management, wound care, pain management, mental health and wellness. http://www.jewishhome.org/ About eCaring eCaring is a privately held, New Yorkbased technology company that uniquely integrates behavioral and clinical data to provide a real-time, round-the-clock home health care management and monitoring system for seniors and people with chronic conditions. The unique web-based platform allows hospitals, family caregivers and care providers to spot changes in a patient’s normal patterns, receive alerts when intervention is required to keep small problems in the home from becoming big ones in the hospital, and improve information sharing among all health careproviders. www.ecaring.com
1Áå ÌÎ Ì A kÌ/Ø kÀÌ, A Ķ Ì If you have an elderly or ill loved one at home, who will take care of them?
kÀ k Ì.k A Ì A Ì k « All caregivers need breaks. Respite Care Program at Bergen Regional Medical Center provides a place for your loved one to stay while you take care of personal business, go on vacation, or just relax and rejuvenate. Have peace of mind knowing our guests are cared for by skilled nursing and medical staff. Because Bergen Regional is a full service medical center, you are assured a safe and secure environment that provides quality care to your loved one 24 hours a day, seven days a week.
For more information or to schedule a tour, please call 201.967.4073 230 East Ridgewood Avenue, Paramus, New Jersey 07652 • www.bergenregional.com
Hospital Newspaper - NY July, 2013
PAge 15
Boomers & Beyond Sarah Neuman Center’s Rehabilitation Team pulls out all stops to return a patient to his own home… A Rehab success story, thanks to Telehealth technology Kira Capowski, Nurse Manager at Sarah Neuman Center is actually beaming when she talks about her recently discharged patient, 87year-old NYC resident Leonard Miniowitz. “To see the smile on his face when he left to go home was worth millions.” Mr Minowitz’s care team at Sarah Neuman was determined to work out the laborious details to make sure all measures were in place for him to live safely and comfortably upon returning to his own apartment after eight arduous months of numerous hospitalizations and rehabilitation stays. Mr Minowitz has multiple myeloma with a secondary diagnosis of congestive heart failure (CHF). He’s been out of his home since last October, bouncing from one hospital to another, including an admission to hospice care at Calvary Hospital in the Bronx. The end-of-life care specialists realized
Mr. Minowitz was actually well enough to go to rehabilitation! Upon his arrival at Sarah Neuman Center, the staff observed that Mr. Minowitz didn’t smile much, if ever. Despite his depressed state, he was making good progress physically, walking with more strength and meeting his rehabilitation goals. Because of his CHF condition, Sarah Neuman’s Telehealth Kiosk program became an important part of his health care monitoring. Using the electronic monitoring device, Mr. Minowitz answered questions about his health, three times a week by pressing the appropriate button on the unit’s digital display. The easy-touse device allowed him to feel in control of his chronic issue, while alerting the nursing staff when any of the responses detected changes in his condition. The Sarah Neuman team of case managers, social workers, and med-
ical staff knew its patient’s unwavering desire to return to his own home. They team wanted to give him a fighting chance to achieve that goal and after many meetings with him and his family, Mr. Minowitz was told he’d be able to celebrate his May birthday in his own apartment. Upon getting the good news, Mr. Minowitz’s demeanor brightened and his engagement with life was nothing short of remarkable. “You would have never guessed it was the same man from the time he came in here,” reports his nurse. Minowitz is managing well in his own environment. He was sent home with all the supportive services in place including a visiting nurse, a compact teleheath in-home unit, which enables him to chat electronically with nurses on a daily basis to share his diagnostic information, along with other private help.
provided
Sarah Neuman Center’s sub-cute Certified Nurse Assistant (CNA) demonstrates how to use the telehealth kiosk to their rehabilitation patient. Monitoring chronic health issues using this on-site unit, helps familiarize patients with the technology so they can return home more quickly with the easy-to-use home version. The benefit of this monitoring technology affords a patient prompt intervention when necessary, keeping small problems in the home instead of becoming bigger ones in a hospital
Kiera recognizes that a heightened quality of life has been restored to this gentle man. She remarks, “Working with Mr Minowtiz is one of those cases that really moves you. You can’t imagine the difference it has made for him to go home.” She adds, “I think he’s going to do just fine.” Sarah Neuman Center is the Westchester campus of Jewish Home Lifecare. It is a 300-bed, long-term skilled nursing care facility in Mamaroneck, NY, that offers nursing home care, a full range of post-surgical, disease recovery and
short-stay rehabilitation, an adult day program and respite care. In addition to a highly trained staff, Sarah Neuman features private rooms, dining options, beautiful gardens and lounges, Internet-equipped computers, concerts and art programs and even award-winning pet therapy to enhance any stay. Sarah Neuman is a key provider in the Westchester area and a partner of UJA Federation, serving over 1,000 individuals annually with 400 staff and over 360 volunteers from the community. For more information, please visit www.JewishHome.org.
Sarah Neuman Center presents:
Health Tips for Staying Well Sarah Neuman Center offers: ngg FFiit SSttaayyyiing healthy lifting and kickboxing may not be For most seniors, jogging, weight ember rem 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 rs blood pressure and decreases your 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 ng and less susceptible to injury. 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 Nee Ne eed ed mo more orree 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
PAGE 16
July, 2013
Hospital Newspaper - NY
Boomers & Beyond
photo by Anthony Mairo
Celebrated artist Frances Manacher approaches her 100th birthday at Drum Hill
Frances Manacher, a resident at Drum Hill Senior Living Peekskill, will turn 100-years-old on April 19th next year. Talk about a milestone. Talk about longevity. Talk about a treasure. Manacher’s secret to enduring nearly a century? Well, there are no secrets, just simple words of wisdom. Pick the right grandparents, Manacher said with a laugh. She had loving ones. Don’t ever make mountains out of mole hills, added Manacher. Translation: Don’t sweat the small stuff.
As for Manacher’s last pearl of wisdom: Concentrate on your similarities with people, focus on what you have in common, what you can agree on. Not your difference. Manacher is the closest thing to a celebrity at Drum Hill, which combines the privacy of spacious individual apartments with security and dependable services at an outstanding value. In this caring environment, each resident has the opportunity to explore new activities, discover new friendships, and continue to lead an active lifestyle with the advantage of less household responsibility. Manacher was an accomplished artist. She is the first female artist to display her work in India. Manacher’s work has also been exhibited at the Museum of Modern Art, the Passedoit Gallery in New York and the Tirca Karlis Gallery in Mass. There is also a permanent exhibition at the Jewish Museum of New York that features her work. Manacher has received sparkling reviews from, among other publications, the New York Times. Some of her paintings and press clippings hang on that walls of her Drum Hill apartment wall. Manacher has even given some of her paintings, which have been displayed around the world, to Drum Hill.
“I’m not a great painter, I’m not a bad painter,” Manacher said. “It’s given me a good life and I enjoy what I did. A lot of wonderful things have happened be through art.” Manacher discovered her natural talent as an artist in her late teens, when she started sketching for designers. Then one summer soon after, Manacher was painting in the garden of her Croton vacation home when a neighbor took notice and set her up with an art dealer he knew in New York City. The rest, as they say, is history. Indeed, Manacher had some career. She’s had some life and Drum Hill can’t wait to celebrate Frances’ 100th birthday with her next year. Located in historic Peekskill, New York, Drum Hill Senior Living Community offers gracious and affordable independent living overlooking the spectacular Hudson River Valley. Combining the privacy of individual apartments with the comforts and services of a senior community, Drum Hill provides an innovative housing alternative for those 62 years of age and over. Drum Hill features 120 apartments filled with fascinating and accomplished residents. The compassionate and caring staff helps to provide a secure environment. Supportive services and amenities allow time for new interests and friendships to form. All in all, Drum Hill boasts an atmosphere which encourages independent seniors to thrive.
Drum Hill Senior Living Community © Overlooking the Spectacular Hudson River © Spacious Studio, 1-2 Bedroom Apartments Equipped with Full Kitchens © Weekly Housekeeping Including Linen Service © Restaurant Style Dining Serving Lunch & Dinner © Transportation to Doctors, Shopping & Outings © Entertainment, Educational Courses & a Full Array of Activities © 24-Hour Security/Emergency Response System
Call To Arrange Complimentary Lunch or Tour
914.788.8860 or Visit
DrumHillSeniorLiving.com
90 Ringgold Street | Peekskill | NY 10566
Hospital Newspaper - NY July, 2013
Page 17
Dr. George D. Yancopoulos, Founding Scientist, Regeneron Laboratories, honored by Burke Rehabilitation Center Dr. Yancopoulos received his M.D. and Ph.D. from Columbia University, where he is also an adjunct professor. He was recently awarded Columbia University’s Stevens Triennial Prize for Research and its University Medal of Excellence for Distinguished Achievement. Dr. Yancopoulos lives in Yorktown Heights, NY. In addition to Dr. Yancopoulos, two other individuals will be
honored with the 2013 Burke Award: Harry Carson and Marc Tesler. Carson played as a linebacker for the New York Giants for 13 years and was inducted into the National Football League’s Hall of Fame in 2006. Carson is now a spokesperson on concussions in sports, an advisor to brain injury groups and an advocate for athletes and veterans who live with the aftermath of traumatic brain injuries.
Tesler is a retired technology investor and venture capitalist. Tesler is currently chairman of the Advisory Committee for the Restorative Neurology Clinic at Burke, a new and innovative program that offers robotic assisted therapy for patients with neurological impairments such as paralysis. This year’s honorees will join an esteemed group of individuals who have contributed greatly
to the field of medical rehabilitation, including Congresswoman Nita M. Lowey, late actor and medical research activist Christopher Reeve, Paralympic gold medalist Sarah Will, 9/11 survivor Lauren Manning, among other extraordinary individuals. The Burke Rehabilitation Center is very grateful to all of its award recipients for their dedication and effort to this cause.
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
PROGRAMS: • Amputee • Joint Replacement • Brain Injury • Cardiopulmonary • Neurological • Orthopedic • Spinal Cord Injury • Stroke Recovery
Where You Go For Rehab Matters
Founded in 1915, Burke Rehabilitation Hospital is the
only hospital in Westchester County dedicated to rehabilitation medicine. Burke 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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He is an M.D., a Ph.D. and, of course, a pioneer. Burke Rehabilitation Hospital and Burke Medical Research Institute honors George D. Yancopoulos, M.D., Ph.D., with the 2013 Burke Award. “Burke is pleased to honor Dr. Yancopoulos for his work, investigating new therapeutic approaches for treating neurological disorders. He and his company, Regeneron Pharmaceuticals, have made significant scientific contributions to those with debilitating conditions like macular degeneration,” said Mary Beth Walsh, M.D., CEO and executive medical director, Burke Rehabilitation Hospital. Dr. Yancopoulos is the founding scientist and president of Regeneron Laboratories, and and chief scientific officer of Regeneron Pharmaceuticals, Inc., both headquartered in Tarrytown, N.Y. He joined the company in 1989 and was the 11th most highly cited scientist in the world in the 1990s. In 2004, Dr. Yancopoulos was elected to the National Academy of Sciences whose members serve as advisors to the nation on science, engineering and medicine. Dr. Yancopoulos is a principle inventor and developer of Regeneron’s FDA-approved drugs, which are primarily used by people who have visual and metabolic disorders, as well as cancer. Dr. Yancopoulos also works with Glen Prusky, Ph.D., director of the Center for Vision Rehabilitation laboratory at Burke Medical Research Institute, to investigate new therapeutic approaches to treat disorders affecting the vision system. Dr. Yancopoulos and Dr. Prusky worked closely to develop Regeneron’s newest drug, EYLEA®, which is indicated for the treatment of patients with neovascular (Wet) Age-related Macular Degeneration (AMD).
785 Mamaroneck Ave White Plans, NY 10605 888.99.BURKE www. Burke.org
PAGE 18
July, 2013
Hospital Newspaper - NY
Feinstein Institute, Hofstra North Shore-LIJ School of Medicine have strong presence at 36th Annual Conference on Shock Twelve investigators from The Feinstein Institute for Medical Research and four researchers from the Hofstra North Shore-LIJ School of Medicine attended and participated in the 36th Annual Conference on Shock on June 1-4 in San Diego, CA.; Kevin J. Tracey, MD, president of the Feinstein Institute, provided the keynote address, and Ping Wang, MD, served as the meeting’s program chair. “I am thrilled that so many from the Feinstein Institute and the Hofstra North Shore-LIJ School of Medicine had a strong presence at this year’s Shock Society,” said Kevin J. Tracey, MD. “This demonstrates the strength in our research and dedication in the area of inflammation.” The Shock Society selects five out of approximately 60 applicants to receive the new investigator award, in which the finalists are recognized with a plaque, a cash award (first place $600, four other finalists $350) and a travel grant of $1,000. Sergio Valdes-Ferrer, MD, an investigator at the Feinstein Institute, was a finalist, and Matthew Giangola, MD, a post-doctoral research fellow at the Hofstra North Shore-LIJ School of Medicine, won the second prize. “Resident researchers from the Department of Surgery at the North ShoreLIJ Health System were finalists in the Shock Society’s New Investigator Competition for the last three consecutive years. They took first prize in 2011 and 2012, and this year, Dr. Giangola won second prize,” noted Jeffrey Michael Nicastro, MD, vice chair of surgery for the North Shore-LIJ Health System. “This acknowledgment of the Department of Surgery’s prowess in scientific contributions is greatly appreciated and well deserved.” In addition, 40 travel grants of up to $1,000 for travel and lodging expenses are provided by the Shock Society to investigators based on scientific merit and financial need. Two Feinstein Institute investigators – Cletus Cheyuo, MD, PhD, and Sergio Valdes-Ferrer, MD – and two Hofstra North Shore-LIJ School of Medicine investigators – Matthew Giangola, MD, and Michael Kunce-
witch, MD – were awarded travel grants. Details on what the twelve Feinstein Institute investigators presented at the annual meeting are below (in order of when they presented at the meeting) Ping Wang, MD, program chair of the meeting, provided the welcome and introductions Sangeeta Chavan, PhD, presented abstract 1, “Transcutaneous Auricular Vagus Nerve Stimulation Attenuates Pro-Inflammatory Cytokine Response in Healthy Volunteers” Cletus Cheyuo, MD, PhD, presented abstract 7, “MFG-E8 Regulates Neural Stem Cell Proliferation and Migration via Integrin AVB3/PPARGamma/Cyclin D2/Netrin-1 Pathway” Kevin J. Tracey, MD, president of the Feinstein Institute, presented the keynote address entitled “Reflex Integration of Inflammasome Responses” Sergio Valdes-Ferrer, MD, presented abstract 9, “HMGB1 Mediates Persistent Splenomegaly, Leukocytosis, and Splenocyte Priming in Sepsis Survivors” Haichao Wang, PhD, presented a mini-symposium, entitled “Sepsis: Mechanism and Therapeutics” Ben Lu, MD, presented abstract 19, “Cholinergic Neuronal Signals Attenuate Inflammasome Activation Through Inhibiting Mitochondrial Stress” Barbara Sherry, PhD, presented a symposium, entitled “Parallel Symposium II: Cytokine and Chemokine Regulation” and “Dysregulated Cell Trafficking in Sepsis: Mechanisms and Clinical Consequences” Wei Li, MD, PhD, presented abstract 35, “Carbenoxlone Blocks LPS-Induced HMGB1 Release by Impairing PKR Activation” Christine Metz, PhD, presented a mini-symposium, entitled “Inflammation Signaling” Huan Yang, PhD, presented abstract 37, “HMGB1 Binds to MD-2 in the TLR4/MD2 Complex to Elicit Inflammatory Responses” Edmund J. Miller, PhD, presented a mini-symposium, entitled “Ischemia and Reperfusion Injury”
“Not only were there 12 investigators from the Feinstein Institute who made presentations at this meeting, there were also approximately 15 more investigators who demonstrated their research posters,” noted Ping Wang, MD, an investigator at the Feinstein Institute and vice chair for research in the North Shore-LIJ Department of Surgery. “I am proud of this sizeable attendance, but moreover, I am proud of these investigator’s achievements and the quality of their research presentations – these efforts placed the Feinstein Institute at the top in shock research.” Details on what the four Hofstra North Shore-LIJ School of Medicine investigators presented at the annual meeting are below (in order of when they presented at the meeting): Weng-Lang Yang, PhD, presented “Cold-Inducible RNA-Binding Protein (CIRP): A New Player in Inflammation” Michael Kuncewitch, MD, presented abstract 6, “Inhibition of Fatty Acid Synthase with C75 Reduces Organ Injury After Hemorrhagic Shock” Matthew Giangola, MD, presented abstract 11, “Growth Arrest-Specific Protein 6 (GAS6) Attenuates Neutrophil Migration and Acute Lung Injury in Sepsis” Shingo Matsuo, MD, presented abstract 13, “PYR-41, a Ubiquitin-Activating Enzyme E1 Inhibitor, Attenuates Organ Injury in Sepsis” About The Feinstein Institute for Medical Research Headquartered in Manhasset, NY, The Feinstein Institute for Medical Research is home to international scientific leaders in many areas including Parkinson's disease, Alzheimer’s disease, psychiatric disorders, rheumatoid arthritis, lupus, sepsis, human genetics, pulmonary hypertension, leukemia, neuroimmunology, and medicinal chemistry. The Feinstein Institute, part of the North Shore-LIJ Health System, ranks in the top 5th percentile of all National Institutes of Health grants awarded to research centers. For more information, visit www.FeinsteinInstitute.org.
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Emergency Medical Associates now provides Emergency Department Management Services at Columbia Memorial Hospital Columbia Memorial Hospital, Hudson, N.Y., recently contracted with Emergency Medical Associates (EMA) to provide emergency care services. As a private organization of physicians and administrators, Emergency Medical Associates focuses on clinical excellence and world-class emergency care. It is widely recognized for its ability to provide expert medical care and improve patient satisfaction. “I’m excited to have EMA’s vast experience and resources to help us move forward with the ever-changing climate of emergency medicine,” said Michael Weisberg, MD, associate director of the emergency department and medical director of Columbia Memorial Hospital’s Rapid Care Center. “Expanding our footprint in the Hudson Valley is a major
milestone for us,” said Raymond Iannaccone, MD, FACEP, president and chief executive officer of Emergency Medical Associates. “Columbia Memorial Hospital is a fixture in Columbia County and its surrounding communities, and we’re proud to begin serving its patients.” Located in the Kellner Wing of Columbia Memorial Hospital, the Emergency Department saw more than 34,000 visits last year, offering rapid, attentive and personalized care. It is staffed 24 hours a day, 7 days a week by emergency physicians, on-call physicians, physician assistants, registered nurses and experienced patient care assistants. The Emergency Department is located adjacent to the surgical suite, which can save critical time in a life-threatening situation.
Hospital Newspaper - NY July, 2013
PAgE 19
Orange Regional Medical Center receives Stroke Gold Plus Award
provided
Standing (L to R): Dr. Anuj Vohra, Ann McEnroe-O’Connor, Cathy Ryan, Dr. Olga Fishman, Jessica Weiss, Jerry Dunlavey. Sitting (L to R): Luanne Troiano, Rose Toscano, Angela Marchionni, Robin Brennan Seibel.
For the second consecutive year, Orange Regional Medical Center has received the American Heart Association/American Stroke Association’s Get With The Guidelines-Stroke Gold Plus Quality Achievement Award. The award recognizes Orange Regional’s commitment and success in implementing a higher standard of stroke care by ensuring stroke patients receive treatment according to nationally accepted standards and recommendations. Based on the American Heart Association and American Stroke Association standards to earn this status, Orange Regional was recognized for achieving 85% or higher adherence to all Get With The Guidelines Stroke Performance Achievement indicators for consecutive 12 month intervals. Additionally, Orange Regional received 75% or higher compliance with 5 of 8 Get With The Guidelines Stroke Quality Measures to improve the quality of patient care and outcomes. “With a stroke, every second counts. This award reflects Orange Regional’s dedication in providing top rated stroke care to our patients,” says Vice President of Clinical Program Development & Operations, Jerry Dunlavey.
Orange Regional Medical Center is a designated Stroke Center by the New York State Department of Health. As a designated Stroke Center, Orange Regional has an expert Stroke Team comprised of highly trained physicians, nurses and technicians that can treat stroke patients quickly and effectively minimizing brain damage. Quick access to expert stroke services within the first three hours of stroke symptoms appearing is essential to preventing long-term neurological damage. Signs and symptoms of a stroke include: • Numbness or weakness of the face, arm or leg (especially on one side of the body) • Confusion, trouble speaking or understanding • Trouble seeing in or of both eyes • Trouble walking, dizziness, loss of balance or coordination • Severe headache (with no known cause) To learn more about the stroke services provided at Orange Regional Medical Center, visit www.ormc.org/Stroke. Orange Regional Medical Center is a member of the Greater Hudson Valley Health System.
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
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PAGE 20
July, 2013
or nfo f i t s e Lat s and
nursdeents stu
Hospital Newspaper - NY
Nurse’s Viewpoint
By Alison Lazzaro
Hospital Newspaper Correspondent
The Ripple Effect Nothing teaches the importance of staying hydrated quite as intensely as...hot yoga. Encapsulated in a room heated to a smoldering 95 degrees Fahrenheit, yogis are expected to gracefully twist in and out of human knots for fun. Whether participating in something that makes sure sweat escapes every inch of your body, or simply taking a deep breath while sitting on the couch, staying adequately fueled with water is vital to life and essential for nurses to teach their patients and keep mindful of for themselves! A Fish Out Of Water Water in our bodies regulates temperature (just as a dog sticks its tongue out when it is hot to shake off the heat), blood pressure, and digestion. Water is responsible for making up the majority of our bodies and we are accountable for replacing water loss. Not getting enough water affects the brain's processing abilities. Staying hydrated is essential for improved concentration, decision making and enhanced mood. Just another reason to sip up before taking an exam! The Well Runs Dry Dehydration is preventable, but without treatment can have serious consequences. Some early signs that you are not getting enough fluids include increased thirst, dry mouth, dizziness, confusion, fainting, and decreased urine output. These symptoms can progress to an emergency situation if not reversed. Experts from the Mayo Clinic caution that waiting to drink water until thirst kicks in is actually too late. Urine should be a dilute pale yellow color if you are maintaining adequate hydration. Many of us recognize the importance of drinking extra water when participating in strenuous exercise, but remember to teach patients to drink more when they experience fever, vomiting, diarrhea, diabetes, and infections because water can be lost rapidly. Be careful fueling up on drinks high in caffeine (coffee, tea, colas) because they have a diuretic effect. Rather teach patients to eat foods high in water content like lettuce, watermelon, broccoli, and yogurt. Quench Your Thirst Adequate hydration affects every body system and the kidneys get especially ticked off if you forget to drink enough. Your kidneys filter 180 L per day and remove waste from the body. Water helps them work properly to flush toxins out of the body. A consequence of not getting enough H20 is renal calculi, or kidney stones (supposedly more painful than childbirth and with the ability to make grown men cry!) Drinking your 6-8 glasses of water a day can also reduce the risk of urinary tract infections. Here's the Skinny... Drinking more water can actually help you lose weight. Hunger frequently gets confused with a need for more water. Responding to hunger by drinking a glass of water first can actually suppress appetite and kick up your metabolism to break down fat. So next time you do your patient teaching throughout the day, increase awareness about how beneficial it is to stay adequately hydrated this summer and throughout the year.
Hospital Newspaper - NY July, 2013
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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
Hospital gets more hospitable: LIJ recognized for patient care
October 6-9, 2013
provided
Dr. James Merlino, chief experience officer of the Cleveland Clinic Health System, and Agnes Barden, senior administrative director of the patient and family-centered care department at LIJ Medical Center.
LIJ Medical Center was recently given national recognition for its patient care education initiative launched in the Fall of 2011. The hospital got the first Association for Patient Experience Practice of the Year award at the fourth annual Cleveland Clinic Patient Experience: Empathy and Innovation Summit held by the Association for Patient Experience. The hospital underwent a shift in patient care practices, changing its focus from service to hospitality. Agnes Barden, DNP, senior administrative director of the patient and family-centered care department, explained that hospitality focuses on how something is done so now employees think about doing something with and for a patient rather than to the patient. “Hospitality is about building connections with the patient and creating positive teamwork,” Ms. Barden said. “The cultural shift at LIJ has made an environment that hones in on quality patient care to make people feel more comfortable while they are getting medical treatment.” LIJ Medical Center set up classes for its employees that focused on hospitality. The classes ran two hours and all 5,000 hospital staff members participated in one of the more than 300 sessions. The classes
featured an open dialogue, role playing exercises about empathizing with patients and observing how hospital employees worked with their patients. Ms. Barden, who led the initiative that has been supported enthusiastically by LIJ Medical Center’s Executive Director Chantal Weinhold, said these classes and efforts helped employees keep in mind what it is like to be a patient. In addition to the classes, there is also an initiative in which hospital leaders talk about hospitality-related topics with their staff and other departments. There is also a hospitality observation team, which helps to evaluate the staff’s practices. Employees will have a yearly behavioral competency review as a result of these new policies. One example of a change in practices at the hospital is that staff members are encouraged to pull up a chair and sit next to a patient when they are speaking with them instead of standing over their beds. Since implementing these practices, the hospital has gotten higher Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores and Ms. Barden said she is seeing more letters from patients who are pleased with their whole hospital experience -- from the valet parker to the physician.
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
July, 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
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 Online Directory available at www.hospitalnewspaper.com
Hospital Newspaper - NY July, 2013
PAGE 23
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. Calvary’s continuum of care includes inpatient, outpatient, home hospice, nursing home hospice, home care, and the care of complex wounds. 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. It 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, Queens, Manhattan, and lower Westchester. • Hospice services are offered in the Bronx, Brooklyn, Queens, Manhattan, as well as Nassau, Westchester, and Rockland counties. • Calvary also offers hospice services in more than 30 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. For more information, visit www.calvaryhospital.org or call the following numbers: Calvary Hospital (718) 518-2300, Calvary@Home (718) 518-2465, Wound Care (718) 518-2577.
NEW PRODUCT TECHNOLOGY
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. 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
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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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
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 Online Directory available at www.hospitalnewspaper.com
PAGE 24
July, 2013
Hospital Newspaper - NY
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.
©2012 Akrimax Pharmaceuticals, LLC., Cranford, NJ 07016 October 2012 NTR-145T