Christiana Care 2010 Year in Review
National Leader in Delivery of Care
Christiana Care Health System is one of the country’s largest health care providers, serving more than 600,000 patients yearly, placing it as the 16th leading hospital in the nation and 10th on the East Coast in terms of admissions.
According to the American Hospital Association’s latest survey of 6,342 U.S. hospitals, Christiana Care ranks among the leaders by volume in several categories.
admissiOns
16th
With more than 10,000 employees, Christiana Care is the largest private employer in Delaware and the 10th largest employer in the Philadelphia region. Christiana Care is a $ 2.03 billion health care system and provided the community with $ 55.7 million of free care and medicine in 2010.
H
in the u.s.:
Births
28th emergency Visits
22nd tOtal surgeries
19th
On the east cOast: admissiOns
10th Births
12th emergency Visits
13th tOtal surgeries
10th
Dear Neighbors, On behalf of all my colleagues at Christiana Care Health System, I am pleased to share our 2010 Year in Review. As you read 2010 Year in Review, you will learn about many of Christiana Care’s community partnerships and accomplishments, from heart care to cancer research to prevention, from strides in technology to honors bestowed upon the talented, caring and dedicated people who work here. We live in historic and exciting times as we transform access to medical care – making health care more accessible to people throughout the nation. These are also historic times for Christiana Care, as our landmark transformation of the Wilmington Campus continues. Once completed, we significantly enhance care for our neighbors in the city and surrounding communities. Our commitment to patient-centered care continues to bolster Christiana Care’s national reputation for excellence. That commitment has also enabled us to attract some of the top specialists in America to enhance our extraordinary team of physicians, surgeons, nurses, health care professionals, community outreach workers and administrative staff. We remain steadfast in our commitment to provide the very best care to any and all neighbors in need, regardless of their ability to pay. If you have benefitted from our services in the past, I hope you see your experience reflected in the following pages. If you have not needed care, I hope what you read gives you confidence that if the time comes, you can rely on us for the expertise, dedication and compassion you expect. Thank you for your confidence in Christiana Care. Best regards,
Robert J. Laskowski, M.D., MBA PRESIDENT AND CHIEF ExECUTIVE OFFICER
page 1 Christiana Care Health System
Leaders
in Heart & Vascular Care Christiana Care receives Gold Seal for stroke treatment Christiana Care is the recipient of the prestigious Gold Seal of Approval from the Joint Commission of Primary Stroke Centers. This honor is the result of meticulous documentation and a rigorous on-site visit that demonstrated the health system’s program follows national guidelines and standards that can significantly improve outcomes for stroke patients.
Center for Heart & Vascular Health awarded highest-possible rating Christiana Care’s Center for Heart & Vascular Health was awarded three stars, the highest possible national ranking, from The Society of Thoracic Surgeons (STS) for 2009. The STS comprehensive rating system compares the quality of cardiac surgery at hospitals across the country. Only 11.7 percent of hospitals nationwide received this year’s STS three-star rating.
THE CENTER FOR HEART & VASCULAR HEALTH features a full range of cardiovascular services.
OPEN-HEART CASES Christiana Hospital 695 Beebe Medical Center 150 CARDIAC CATHETERIZATION CASES ELECTROPHYSIOLOGY CASES VASCULAR SURGERY CASES
4,792
1,733 1,446
VASCULAR INTERVENTIONAL CASES
4,123
CARDIOVASCULAR NON-INVASIVE STUDIES VASCULAR ULTRASOUND STUDIES
18,491
32,945
CARDIAC REHABILITATION MONITORED VISITS
page 2 Christiana Care Health System
16,988
Christiana Care lauded for treatment of heart attack, heart failure and stroke The Center for Heart & Vascular Health is exceeding national standards in the treatment of heart attack, heart failure and stroke. Christiana Care is the winner of the American Heart Association’s Gold Performance Achievement Awards for both heart attack and heart failure treatment. The awards recognize that Christiana Care attained the noteworthy goal of treating patients with at least 85-percent compliance for at least 24 months to core standards of care as outlined by the AHA/American College of Cardiology. Christiana Care also is the recipient of the Stroke Association’s Bronze Performance Achievement Award, which recognizes success in implementing a higher standard of stroke care for at least 90 days.
Cardiac education program gets an A+ Christiana Care’s Advanced Cardiac Life Support education program has received a score of 100 percent and is described as a model training center in a reaccreditation evaluation by the American Heart Association Emergency Cardiovascular Care Program.
Treating atrial fibrillation without major surgery Christiana Care is one of a few select health care systems in the Mid-Atlantic region offering the convergent procedure, which is a minimally invasive approach to treating chronic or persistent atrial fibrillation (AF) that eliminates a painful chest incision and the need to stop the heart. AF is the most common heart rhythm disorder, affecting 5 million Americans, who suffer from pain, weakness and shortness of breath. The procedure combines minimally invasive surgical procedures with catheter ablation, accessing the heart through small incisions in the abdomen.
Stereotaxis remote navigation system goes live Available at only approximately 100 hospitals in the United States, stereotaxis remote navigation performs cardiac catheter procedures with greater speed and accuracy. The $1.5 million system includes two giant external magnets that drive a thin, magnet-tipped catheter through a patient's veins to the heart. The advanced technology treats atrial fibrillation, which occurs when the heart rhythm is irregular. This irregular beating can cause blood clots to form in the heart. Stereotaxis is much more precise than the standard procedure of manually snaking a catheter to the heart, which typically takes approximately six hours and has a success rate of approximately 60 to 70 percent. Stereotaxis has a success rate as high as 90 percent. This technology was provided by a generous gift from Gerret and Tatiana Copeland.
2010 Year in Review page 3
Leaders in Heart & Vascular Care
Cardiovascular screenings expand to Wilmington Hospital
Heart failure nurse navigators guide patients
The highly successful Cardiovascular Screening and Prevention Program of the Center for Heart & Vascular Health is available at the Roxana Cannon Arsht Surgicenter at Wilmington Hospital, which makes the service more accessible to Christiana Care’s neighbors in the city. At Christiana Hospital, the program has helped more than 5,000 at-risk patients learn how to reduce their odds of heart attack, stroke and peripheral vascular disease.
Specially trained nurses are guiding patients through Christiana Care’s Heart Failure Program. Heart failure is a complex illness that requires specialized care, testing, procedures and consultations with a variety of health professionals. Nurse navigators are advocates who act as liaisons between patients, their families, doctors, therapists, social workers and other members of the health care team. They also teach patients to manage their illnesses through medications, nutrition, activity and monitoring of weight and fluid intake.
Neuro ICU opens A new, six-bed unit at Christiana Hospital provides specialized care for patients with critical neurological conditions. The plan is for a full-time neurointerventionist as well as critical care surgeons with board certification in neuro critical care to staff the unit. The unit also is staffed by highly trained, advanced practice nurses. The Neuro Intensive Care Unit is focused on patients who present with intracranial hemorrhages.
page 4 Christiana Care Health System
GetWell Network improves outcomes
New one-piece stent facilitates complex aortic aneurysm repairs Patients who have an abdominal aneurysm but are not candidates for open surgery or commercially available endografts now have the option of a customized UNITE stent graft designed especially for them. Christiana Care is one of only 21 research sites in the United States in Phase II trials of the UNITE stent, which is a single, flexible tube that runs from the aorta into only one of the iliac arteries. Widely used in Europe, the stent typically reduces length of stay in the hospital from a week to a day.
Christiana Care is one of three sites in the nation to implement GetWell Network’s Heart Failure Interactive Care Plan, following a successful one-year pilot study at a Virginia hospital. Results from the study show remarkable improvement in outcomes from 2007 to 2008, including a 13-percent reduction in length of stay, 74-percent reduction in the rate of readmission 30 days after discharge, and 43-percent improvement in patient satisfaction scores. Heart failure is one of the most common and fastestgrowing reasons for hospitalizations and requires the involvement of patients in managing their chronic conditions. GetWell Network’s plan engages patients and their families early in the process, with outstanding results.
AHA Scientific Sessions feature Christiana Care authors Christiana Care investigators focused on outcomes and quality of care in four studies and two poster presentations at the prestigious American Heart Association’s Scientific Meetings. Topics included treatment in the blockage of arteries, repair of artery perforation during angioplasty, anticoagulation therapy as a reduction in stroke therapy and the ways in which physical limitations can predict outcomes for cardiovascular events in patients with stable coronary artery disease. “Christiana Care investigators are publishing in some of the top journals and increasingly bringing in grant money to support our growing research programs,” says William S. Weintraub, M.D., director of the Christiana Center for Outcomes Research.
2010 Year in Review page 5
Innovative Delivering
Cancer Care
Helen F. Graham Cancer Center leads the way in reducing cancer in Delaware Through research, evidence-based practice and community outreach, Christiana Care’s Helen F. Graham Cancer Center plays a leading role in Delaware’s rapidly declining cancer incidence and mortality rates. Formerly first in the nation for its cancer mortality rates, Delaware now ranks 13th.
In 2009, the Helen F. Graham Cancer Center had 134,296 patient visits – which is more than double the 60,000 patient visits recorded in 2003.
60,112
75,639
97,135
03
04
05
Rates for cancer mortality in Delaware are dropping faster than anywhere else in the country, at twice the national rate. “Ninety percent of the progress in cancer care and research results from clinical trials sponsored by the National Cancer Institute,” says Nicholas J. Petrelli, M.D., Bank of Americaendowed medical director of the Helen F. Graham Cancer Center. “Our patient accrual rate into clinical trials is almost seven times the national average—26 percent, compared to the national rate of 4 percent.” Dr. Petrelli also credits the 16 Multidisciplinary Disease Centers with increasing patient visits to the Graham Center from approximately 60,000 in 2003 to more than 134,000 in 2010.
108,395 109,506 110,630 134,296
06
07
08
09
PATIENTS NEWLY DIAGNOSED AND/OR NEWLY TREATED
THE HELEN F. GRAHAM CANCER CENTER features a full range of cancer services.
RADIOLOGY ONCOLOGY CONSULTS EXTERNAL BEAM TREATMENTS
2,270
30,988
PATIENTS ENROLLED IN CLINICAL TRIALS
page 6 Christiana Care Health System
925
3,112
Commission on Cancer praises clinical trials and reduced disparities The Helen F. Graham Cancer Center received another three-year accreditation with commendation from the Commission on Cancer of the American College of Surgeons. The commission has accredited the cancer program at Christiana Care since 1985. “This is an excellent cancer program that should serve as an example of how multidisciplinary care and clinical trials can be delivered in a private practice setting,” says the Commission on Cancer performance report, which cites the Graham Center for a “terrific clinical outreach program geared toward reducing disparities in the community” and for a “phenomenal clinical trial accrual each year.”
Medical Genetics program opens door to the future of medicine Christiana Care’s new Medical Genetics program is transforming the diagnosis, treatment and prevention of many diseases, offering full clinical genetics services in Delaware for the first time. The program encompasses cancer, cardiology, maternal-fetal medicine and pediatrics. The goal is to build an infrastructure to diagnose inherited disorders while tailoring treatment based on the patient’s unique genetic profile. The combined database of Christiana Care’s Center for Heart & Vascular Health and the Helen F. Graham Cancer Center will enable researchers to learn even more about the relationship between genetics and health.
Center for Translational Cancer Research is a joint effort
“This is an excellent cancer program that should serve as an example of how multidisciplinary care and clinical trials can be delivered in a private practice setting.”
The opening of the new Center for Translational Cancer Research (CTCR) on the Helen F. Graham Cancer Center campus enhances the center as a comprehensive cancer program that highlights prevention, treatment and laboratory research. Under the leadership of Bruce Boman, M.D., Ph.D., medical director of Cancer Genetics and Stem Cell Biology, the CTCR is a collaborative effort with the University of Delaware and the Delaware Biotechnology Institute.
Commission on Cancer Performance Report
2010 Year in Review page 7
Delivering
Innovative
Cancer Care
Graham Center selected for Community Cancer Centers program The Helen F. Graham Cancer Center is making tremendous strides to speed research and raise the quality of care for minority and underserved patients in a groundbreaking program. One of only 30 cancer centers in the United States selected for the National Cancer Institute Community Cancers Centers Program, the Graham Center places special emphasis on minority patients, as well as people who are elderly, poor or live in rural areas. The result is expanded clinical trials in those communities, with patients receiving access to cutting-edge treatment in as many as 130 studies. The goal is to determine what it will take to establish a national network of community cancer centers fully engaged in research that can provide the latest evidence-based treatment for patients of all ethnic and economic backgrounds.
NCI funding advances research The Helen F. Graham Cancer Center is the recipient of $2.8 million from the National Cancer Institute, part of the National Institutes of Health, to expand cancer research. The funding is part of $80 million from the American Recovery and Reinvestment Act awarded to the 16 members of the NCI Community Cancer Centers Program and supports an additional 14 new network sites.
Dr. Petrelli shares cancer success story at national conference Christiana Care took the national stage at the American College of Surgeons Conference in Chicago, with Nicholas Petrelli, M.D., Bank of America endowed medical director of the Helen F. Graham Cancer Center, giving the Commission on Cancer Keynote Address. Among Christiana Care’s successes that Dr. Petrelli highlighted were: • Delaware’s colorectal screening rate is first in the country, with screening for blacks 25 percent higher than the national average. Increased access to screening is saving lives in minority communities, with cancer rates for blacks declining three times faster than for whites. • Both cancer mortality rates and the adult smoking rate are falling twice as fast in the state as the national average.
Community Clinical Oncology Program is accrual champion The Cancer and Leukemia Group B, known as CALGB, places Christiana Care’s Community Clinical Oncology Program (CCOP) at the top for recruiting patients for clinical trials for the period May 1, 2009, to April 30, 2010. Christiana Care was fifth overall out of 45 participating organizations. Christiana Care’s accrual rate is 26 percent, far above the national average of 4 percent. That is due, in part, to recruiting community physicians to CCOP and making nurses available to oncology practices at the Helen F. Graham Cancer Center to enroll patients. Clinical trials play an essential role in cancer research. page 8 Christiana Care Health System
Colorectal Cancer Program brings latest treatments home Christiana Care’s Helen F. Graham Cancer Center is a leader in care for colorectal cancer, providing the latest treatments and cutting-edge research. It is the only such program in Delaware and one of only a few in the region. In Delaware, colorectal cancer is the third most often diagnosed cancer and the third most common cause of cancer death. “The Colorectal Cancer Program catalyzes the Center for Translational Cancer Research’s (CTCR) ability to conduct colon cancer stem cell research aimed at finding curative treatments while potentially doubling the number of active research protocols through new collaborations and increased trials,” says Bruce Boman, M.D., Ph.D., director of Cancer Genetics and Stem Cell Biology at the CTCR.
Helen F. Graham Cancer Center expansion wins design award The expansion of the Helen F. Graham Cancer Center is Mid-Atlantic Construction magazine's 2009 project of the year in the health care category. The trade publication honored only 40 projects in 16 categories representing the finest in design and construction in Delaware, Maryland, Pennsylvania, Virginia and the District of Columbia. The project, designed to provide a continuum of cancer care under the same roof, more than tripled the size of the center.
NCI website puts Helen F. Graham Cancer Center in spotlight Visit the National Cancer Institute’s Cancer Biomedical Informatics Grid (caBIG®) website for a video about Christiana Care’s Helen F. Graham Cancer Center. A member of NCI’s Community Cancer Center Program, Christiana Care harnesses caBIG’s vast information network, designed to share knowledge and data among the entire cancer community with the goal of accelerating discovery and saving lives.
2010 Year in Review page 9
Serving our Community
Christiana Care is a leader in protecting the environment Christiana Care is the first Delaware hospital to receive a Trailblazer Award for environmental leadership from the U.S. Environmental Protection Agency. The award recognizes hospitals in Delaware and Pennsylvania that are models for other hospitals. Christiana and Wilmington hospitals both received the Partners for Change with Distinction Award from Practice Greenhealth in recognition of Christiana Care’s comprehensive environmental stewardship program and leadership in both the community and health care sectors. What’s more, Christiana Care now buys 40 percent of its electricity from a wind farm in Pennsylvania. In addition, Christiana Care hosted two medicine cabinet clean-out events for the community in the past year, in cooperation with the Delaware Nurses Association.
CHRISTIANA CARE IS A LEADER IN ENVIRONMENTAL STEWARDSHIP resulting in:
page 1 0 Christiana Care Health System
REDUCING REGULATED MEDICAL WASTE BY
50%
REDUCING AIR EMISSIONS FROM POWER PLANTS BY INCREASING RECYCLING BY
15%
80%
Christiana Care moves toward Electronic Medical Record Christiana Care has joined an elite group of hospitals— only 3.8 percent nationwide—that have implemented a closed loop medication process and are in the top 10 percent of hospitals who have gone live with Computer Provider Order Entry (CPOE) at both Wilmington and Christiana hospitals. CPOE, a generic name for software that providers use to write orders for patients, is a major step toward completing our state-of-the-science paperless medical record. Because CPOE introduces supportive technology for orders, it can dramatically improve safety. CPOE streamlines practice standards, incorporates clinical decision support into daily practice, improves interdepartmental communication, facilitates patient transfers and captures data for management, research and quality monitoring.
Delaware Medical Relief Team brings care to Haiti Sometimes our “community” extends beyond our regional borders. Several relief teams from Delaware brought desperately needed medical care and supplies to Jacmel, Haiti, in the wake of the devastating earthquake there. The teams included Christiana Care physicians, surgeons, nurses, physician’s assistants and emergency medical technicians. Christiana Care supported the volunteers by providing medications and supplies as well as paid time off for employees.
Christiana Care has gone even further in its quest for improving health care delivery. In support of the federal government’s implementation of “meaningful use” standards for health information technology, Christian Care is partnering with Quality Insights of Delaware in a pilot project for community-based, primary care physicians for rapid adoption of electronic health information technology. The initiative leverages the Delaware Health Information Network, the nation’s first statewide health information network.
When the first team arrived, they found the hospital in Jacmel, 60 miles from the Haitian capital of Port au Prince, in ruins. So the team set up tents, managed to get an abandoned generator working and started treating patients. The volunteers also shared supplies with other medical workers. That first week the group treated approximately 5,000 patients and performed more than 20 surgeries, including four amputations. “Without the amputations they performed, those people, including a little girl, would be dead,” Lanny Edelsohn, M.D., of Christiana Care Neurology Specialists, told a News Journal reporter who accompanied the group.
2010 Year in Review page 1 1
Serving our Community
Wilmington campus transformation underway
Emergency Departments reduce waiting times
Christiana Care is expanding and renovating Wilmington Hospital – a $210 million investment that helps to continue building a healthy community in the city of Wilmington. The hospital is open and fully operational during construction. The Wilmington campus will grow by 337,000 square feet, creating a 1 million-square-foot, state-of-the-art medical center. The project will be complete in 2014.
How does one of the nation’s busiest emergency departments treat patients with non-life-threatening injuries or illness faster? Christiana Care’s two Emergency Departments—which handle more than 160,000 patient visits per year—quickened the pace by stationing a patient care team composed of a nurse, a physician’s assistant and a patient-care technician close to the patient-arrival area. Now, rather than repeating information at various stops, this patient goes through the intake and assessment process simultaneously, significantly reducing length of stay. The results are impressive. More than 100 patients a day with non-life-threatening injuries or illnesses go this route. Many receive treatment within 30 minutes, reducing the overall average Emergency Department time of stay by about 50 percent. A similar process is underway for patients with moderate-to-severe but not life-threatening illnesses. In its testing phase, the Synchronous Provider Evaluation and Efficient Disposition (SPEED) process shows great potential, trimming the treatment length of stay by nearly 30 percent.
page 1 2 Christiana Care Health System
Christiana Care honored for Gift of Life program The Philadelphia chapter of the Gift of Life program recognizes Christiana Care for its leading role in the transplant program. More than 40 families donated 100 organs for transplant, making Christiana Care the top health care system in providing lifesaving donations in the Philadelphia chapter.
eCare team connects hospitals across Maryland
Improved procedures increase patient safety, reduce MRI wait times
St. Mary's Hospital in Leonardtown, Md., is the latest of seven rural hospitals in the Maryland eCare network to connect in real time to critical care physicians and nurses at Christiana Care’s eCare Central. By 2012, Christiana Care will connect to almost 80 beds in intensive care units in the network. eCare virtually connects physicians, nurses and patients via voice, camera and data, enabling remote hospitals to provide the highest level of critical care around the clock. The hospitals work most closely with eCare on nights, weekends and holidays, when fewer local specialists are available.
Enhanced Magnetic Resonance Imaging procedures and a new MRI unit reduced inpatient wait times at Christiana Hospital from 13 hours to eight—a 40-percent improvement that also reduces length of stay. The procedures are so successful that Wilmington Hospital is now implementing them, as well.
Christiana Care honored for excellence in women’s health Christiana Care is the region’s only National Community Center of Excellence in Women’s Health. That prestigious designation is based on:
A team from nursing units, the Radiology Department and Operational Excellence modified procedures and protocols in three key areas: patient interviews, communication between the units and Radiology, and orders for pre-MRI x-rays. Instead of handwritten, faxed orders and safety checklists that could be misinterpreted, mislaid or missed at shift change, the process is now electronic and completed within two hours 80 percent of the time. The result is fewer backlogs and improved patient satisfaction and safety.
• Improving the health and well-being of women through community-based organizations. • Providing integrated, coordinated care with strong links to existing programs in the community. • Offering comprehensive care in a way that reduces fragmentation and recognizes the complexity of women’s lives. In addition, Christiana Care also provides excellent clinical care and preventive services, training for health care professionals, and public outreach and education. 2010 Year in Review page 1 3
Serving our Community Home telemonitoring assists heart failure patients The Visiting Nurses Association is helping to reduce costly hospital readmissions and improve outcomes for heart failure patients through home telemonitoring technology. Analysis shows 40 percent of heart failure patients incur 60 percent of the costs associated with multiple inpatient stays and Emergency Department visits. The VNA pilot study tracked complications among discharged heart failure patients. Through daily blood pressure, pulse and weight readings transmitted by phone to a nurse, VNA provided the interventions needed to prevent hospital readmissions. Fewer readmissions and fewer ED visits for monitored patients resulted in cost reductions of 85 percent and 73 percent, respectively. Patients also report less anxiety and depression at discharge and a high sense of satisfaction with the program. Plans call for enrolling more patients in home telemonitoring and establishing a support group.
Christiana Care hosts Medicare enrollment event Seniors confused by Medicare eligibility options and drug plans now have answers, thanks to an information and enrollment event hosted by Christiana Care. Counselors from the Centers for Medicare and Medicaid Services (CMS) and ELDERinfo met with 47 seniors at the event, a nearly 20-percent increase over last year’s session.
Triplets? Christiana Hospital prepared for multiple births and more Christiana Hospital’s new state-of-the art operating room in Labor and Delivery is bigger and better, outfitted to accommodate the extra staff that is present at multiple births. Christiana Care has been home to more than 500 multiple births in the past five years. The OR is equipped with a lift to place mothers with special needs, such as paraplegic women, safely on an extra-wide table that can support up to 1,000 pounds. Lights and fetal monitors are mounted on booms.
page 1 4 Christiana Care Health System
Emergency response team acts quickly in obstetrical crises
On-site addictions counseling helps to transform lives
At Christiana Care, expectant mothers in peril receive care within minutes, thanks to the Obstetrical Emergency Response Team (OBERT). Instead of going through traditional escalation steps, OBERT brings immediate support to obstetricians and nurses responding to such conditions as shoulder dystocia, hemorrhage and fetal distress. “Things can deteriorate quickly in obstetrics and many problems can’t be predicted,” says Matt Hoffman, M.D., MPH, director of the Division of Education and Research. “With OBERT, we often are able to intervene before something becomes a full-blown emergency.”
More patients with substance abuse issues are receiving potentially lifesaving treatment for their addictions, thanks to an innovative peer-to-peer counseling program at Wilmington Hospital in which an on-site counselor engages patients with drug and alcohol problems. The program has produced dramatic results: 35 percent of the 313 individuals who received peer-to-peer counseling as of June 2010 have participated in a licensed inpatient or outpatient treatment program. “Before, the only option available to engage patients in communitybased drug treatment was to hand them a phone number, and few, if any, would follow through,” says Terry Horton, M.D., an internist on the faculty of the Department of Medicine.
Clothes closet helps patients in need
Hospitalists use discharge clinic to head off readmissions Concerned about the high rate of readmissions, Christiana Care hospitalists are offering followup care to patients leaving the hospital with a discharge center. “The discharge center allows us to complete the cycle of hospital care for patients who don’t have a follow-up appointment with a primary care provider,” says Edmondo Robinson, M.D., MBA, medical director of Christiana Care Hospitalist Partners. Discharge clinics also ensure that patients are taking their medications as prescribed. When a follow-up visit takes place within a week of discharge, problems can be detected sooner when they are easier to treat.
In order to treat emergency and trauma patients quickly, their clothes are typically cut and removed. Sometimes that means patients need clothes to wear home, either because their garments were damaged or because they have no one to bring them clothes. For more than 20 years, social workers at Christiana and Wilmington hospitals have maintained clothes cupboards that enable patients who are poor, homeless or without friends or family to leave the hospital with a sense of dignity. “We are here to help people who are often in horrible situations,” says Susan Grieg, a social worker in the Trauma Department.
2010 Year in Review page 1 5
Research & Education Advancing medical care through research and education
Christiana Care is one of the largest community-based teaching hospitals conducting research in the United States. Robust partnerships in clinical, translational and outcomes research boost Christiana Care’s national reputation and speed new ideas, technologies and treatments to communities challenged by today's most pressing health concerns. Christiana Care’s commitment to exploring the science of medicine keeps clinicians at the top of their specialty and attracts the best and the brightest to serve as faculty and mentors in our fully accredited graduate medical education programs and undergraduate student rotations – where tomorrow’s health providers learn state-of-the science medical care. CHRISTIANA CARE CONDUCTED 631 CLINICAL RESEARCH AND PHARMACEUTICAL STUDIES including:
10
BONE MARROW TRANSPLANT 1
CARDIAC SURGERY
OB/GYN
CARDIOVASCULAR RESEARCH 63
1
54
PHARMACEUTICAL ONCOLOGY
2
PLASTIC SURGERY 24
RADIATION ONCOLOGY RADIOLOGY
2
INFECTIOUS DISEASE
10
RADIOLOGY-CARDIOLOGY
INTERNAL MEDICINE
12
SURGERY
NEONATOLOGY
9
43
RADIOLOGY/INTERVENTIONAL
1
MATERNAL/FETAL MEDICINE
29
NEUROLOGY/NEUROSURGERY
1
5
SURGICAL CRITICAL CARE/TRAUMA
19
WOMEN’S HEALTH
NEPHROLOGY/RENAL TRANSPLANT
page 1 6 Christiana Care Health System
2
PULMONARY/RESPIRATORY CARE
9
HEMATOLOGY HEMOPHILIA
3
26
2
PHARMACY
1
GENETICS ONCOLOGY
1
2
PEDIATRICS
GYN ONCOLOGY
7
18
PEDIATRIC ONCOLOGY
2
EMERGENCY MEDICINE GENETICS
OUTCOMES 15
DIABETES & METABOLIC
FAMILY MEDICINE
4
OTHER RESEARCH (NON-CATEGORIZED)
COMMUNITY SERVICE EDUCATION
192
ORTHOPEDICS
9
CRITICAL CARE
17
ONCOLOGY
4
COMMUNITY OUTCOMES
18
NURSING
3
2 GrAnd ToTAl
631
1
7
Christiana Care honored for innovative approach to education, research Christiana Care is the recipient of the 2010 Alliance Innovation Award from the Alliance of Independent Academic Medical Centers, a national organization made up of 69 major academic medical centers and health systems. The award recognizes Christiana Care for innovative approaches to medical education and research that result in better patient outcomes.
Delaware Health Sciences Alliance powers research Christiana Care and three other leading hospitals and educational institutions have formed the Delaware Health Sciences Alliance, a dynamic partnership dedicated to cuttingedge research, quality education for health care providers and better health care for the people of Delaware. The alliance joins Christiana Care with Thomas Jefferson University, the University of Delaware and Nemours/Alfred I. du Pont Hospital for Children. The historic foursome will share resources on such vital topics as cancer treatment and prevention, cardiovascular disease and rehabilitative medicine. A key component of the initiative is establishing a Jefferson presence near the University of
Delaware. The campus will house classrooms, study halls and residences for up to 150 medical, pharmacy, nursing, occupational and physical therapy students.
2010 Year in Review page 1 7
V I R T U A L E D U C A T I O N & S I M U L A T I O N T R A I N I N G
C E N T E R
Education Center safely simulates real life Imagine a seven-room hospital where doctors gain a firm foundation in surgical techniques, hand-to-eye coordination and repetitive skills exercises—before they pick up a scalpel to operate on a real patient. The bodies are simulated, but the Virtual Education and Simulation Training Center functions like a hospital, complete with a trauma bay, intensive care unit, operating room and standardized patient rooms.
page 1 8 Christiana Care Health System
The patients are adult and pediatric high-fidelity human patient simulators that breathe, speak, blink their eyes and respond to stimuli, enabling doctors, nurses, emergency medical technicians and first responders such as police and firefighters to obtain highly realistic, hands-on training at the John H. Ammon Medical Education Center on the Christiana Hospital Campus. Audio and visual recordings enable learners to review and analyze their work.
R E S E A R C H
|
Heart & Vascular Medicine
Pioneering clot-busting technique enters national clinical trial A revolutionary way to treat large-volume acute clots in patients with deep vein thrombosis is going national in a new clinical trial. The procedure was developed by Mark J. Garcia, M.D., FSIR, and his Interventional Radiology colleagues. Christiana Care is one of 28 U.S. hospitals selected to participate in ATTRACT (Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-Directed Thrombosis) to evaluate outcomes using the pharmacomechanical thrombolysis technique instead of standard therapy with blood thinners. Dr. Garcia and his colleagues previously have shown that their “Rapid Lysis” technique safely and effectively breaks up and removes acute blood clots in the veins faster and more efficiently without surgery, reducing the odds of pulmonary embolism and long-term disability.
Christiana Care cardiologist publishes commentary on cardiac rehab study William Weintraub, M.D., John H. Ammon Chair of Cardiology at Christiana Care, published an editorial in the Jan. 4 issue of Circulation, an American Heart Association journal, commenting on a finding that people who have had a heart attack or bypass operation should stick with rehab to prevent another one. “Although the statistical methods were quite sophisticated, the interpretation of the data is uncertain,” he writes. Dr. Weintraub argues that because the study cannot account for why people went to fewer or more sessions, it cannot prove that rehab alone accounted for better survival rates. Even so, he believes rehabilitation has been shown to be beneficial in clinical trials and, pending more data, patients should be counseled to finish their full set of sessions.
2010 Year in Review page 1 9
R E S E A R C H
|
Heart & Vascular Medicine
CREST trial a landmark in stroke research A landmark clinical trial shows two medical procedures designed to prevent future strokes are safe and effective for people at risk for stroke. As a result, physicians now have more options in tailoring treatments for at-risk patients. One of the largest randomized stroke prevention trials ever, the Carotid Revascularization Endarterectomy vs. Stenting Trial (CREST) took place over a nine-year period at 117 centers in Canada and the United States, including Christiana Care. Carotid endarterectomy is a surgical procedure to clear blocked blood flow and is considered the gold-standard prevention treatment. In a trial of 2,502 participants, it was compared to carotid artery stenting, a newer and less invasive procedure that involves threading a stent and expanding a small protective device in the artery to widen the blocked area and capture any dislodged plaque. The overall safety of the two procedures is largely the same. However, when the investigators looked at the numbers of heart attacks and strokes in the weeks following the procedure, they found that there were more heart attacks in the surgical group—2.3 percent compared to 1.1 percent in the stenting group—and more strokes in the stenting group—4.1 percent versus 2.3 percent for the surgical group. “The principal finding of CREST is that the choice of treatment must be individualized for each patient with carotid disease,” says Timothy Gardner, M.D., medical director of Christiana Care’s Center for Heart & Vascular Health.
page 2 0 Christiana Care Health System
Study compares effectiveness of cardiac procedures The Christiana Care Center for Outcomes Research (CCOR) is sharing in a $4.026 million grant in a groundbreaking study to compare the effectiveness of catheter-based and surgery-based cardiac procedures. The National Heart, Lung, and Blood Institute of the National Institutes of Health awarded the grant to the American College of Cardiology in partnership with The Society of Thoracic Surgeons (STS). The principal investigator is William Weintraub, M.D., CCOR director and chair of the ACC’s National Cardiovascular Data Registry CathPCI Registry Steering Committee. The research uses combined databases of more than 10 million patients from ACC and the STS as well as the Centers for Medicare and Medicaid Services’ MEDPAR data. The data will help doctors make better decisions and improve care for patients with coronary artery disease. Christiana Care will analyze economic outcomes of the study.
R E S E A R C H
|
Cancer Care
Trial studies cholesterol drug’s effect on colon cancer The Helen F. Graham Cancer Center is leading a national clinical trial to determine if Crestor, a cholesterol-lowering statin, can prevent new tumors from forming after patients have had surgery to remove Stage I or II colon cancer.
New lung cancer screening trial could advance early detection Researchers at the Helen F. Graham Cancer Center taking part in a Phase II and Phase III clinical trial could help to launch a key diagnostic test for early-stage lung cancer. Christiana Care is recruiting lung cancer patients who have been diagnosed but have not yet received any other therapy to participate in the test, which uses a molecular marker that binds to cancer cells and
fluoresces red under ultraviolet light. Biomoda Inc., maker of the diagnostic test called CyPath®, says the data from Christiana Care should complete the pilot phase of the study. “This trial has the potential of developing a useful alternative to invasive needle biopsy or bronchoscopy, which are currently used to establish the diagnosis of lung cancer,” says Thomas Bauer, M.D., principal investigator. “If accurate, this method could be used to diagnosis other cancers.”
Developing a better test for cancer genes A study at the Center for Translational Cancer Research could lead to the development of a faster, cheaper blood test to identify individuals who are at high risk for colon cancer and other cancers. Researchers are focusing on two genes, MSH2 and MLH1, known as mismatch repair genes. Four of five people who inherit these genes will develop cancer. In the study, researchers are examining blood samples from patients in the Familial Risk Assessment Program at the Helen F. Graham Cancer Center.
2010 Year in Review page 2 1
R E S E A R C H
|
Cancer Care
Cancer Genome Atlas charts genetics The Helen F. Graham Cancer Center is part of the Cancer Genome Atlas, a massive, federally funded effort to speed up scientific insight into the molecular basis of cancer so doctors can ultimately diagnose and treat patients based on their genetic profiles. Christiana Care participates in a four-year, $4.6 million subcontract from the National Cancer Institute, which is part of the National Institutes of Health. The Graham Center plays a vital role in the initiative, collecting, storing and sharing tissues and blood samples for research.
Research program examines salivary gland bioengineering Robert Witt, M.D., section chief of Head and Neck Oncology at the Helen F. Graham Cancer Center, collaborates with scientists at the University of Delaware in a research program on creating a tissueengineered artificial salivary gland for people with dry glands damaged by radiation treatments. He has published in leading peer-reviewed scientific journals and has spoken on the topic in North
America, Europe and Asia. He published his first book, Salivary Gland Diseases, in 2006. He recently completed his second book, Advances in the Management of Thyroid Cancer, Surgical Oncology Clinics of North America.
Cardiovascular and cancer research expands A five-year, $17.4 million federal grant broadens research into the diagnostics and treatment of cancer and cardiovascular disease. The funding supports 15 projects, including research on cancer stem cells and biomarkers, as well as how kidney function impacts the link between obesity and heart disease. The National Institutes of Health awarded the grant to the Delaware IDeA Network of Biomedical Research, which includes Christiana Care, the Delaware Biotechnology Institute at the University of Delaware, Nemours/Alfred I. du Pont Hospital for Children, Delaware State University, Delaware Technical and Community College and Wesley College. page 2 2 Christiana Care Health System
R E S E A R C H
|
Health Care Delivery
Christiana Care authors analyze handoffs during shift changes
Center for Outcomes Research evaluates cost and care to find best treatment
Lee Ann Riesenberg, Ph.D., director of Medical Education Research and Outcomes at Christiana Care, is lead author of an article in the American Journal of Nursing titled “Nursing Handoffs: A Systematic Review of the Literature.” Co-authors are Janet M. Cunningham, RN, MHA, vice president of Nursing, and Jessica Leisch, BS. “Nursing handoffs occur when shifts change two, three or more times daily, seven days a week, yet … there are few evidencebased standardized procedures to ensure that communication is managed effectively,” Dr. Riesenberg concludes. “Errors in communication give rise to substantial clinical morbidity and mortality and, therefore, must be addressed.” Dr. Riesenberg is also lead author of “Systematic Review of Resident and Attending Physician Handoffs,” published last December in Academic Medicine, and “Handoff Mnemonics” in the American Journal of Medical Quality.
Christiana Care is leading the way in comparative effectiveness research, identifying the best ways to treat patients at the most efficient cost. The Christiana Care Center for Outcomes Research (CCOR) is one of a handful of national groups in the science of evaluating the consequences of health care delivery. “We compare one form of therapy or treatment with another,” says William Weintraub, M.D., John H. Ammon Chair of Cardiology and CCOR director. “We look at different approaches to management, how we take care of people, not just comparing one pharmaceutical to another.” Delaware’s dense, diverse population makes Christiana Care ideally suited to these types of studies. The health care system’s patient base includes 1.2 million people in Delaware and its surrounding areas.
2010 Year in Review page 2 3
R E S E A R C H
|
Women’s & Children’s Health
Study links inductions and C-sections
JAMA
®
The Journal of the American Medical Association
Deborah Ehrenthal, M.D., of the Departments of Obstetrics and Gynecology and Internal Medicine at Christiana Care, is lead researcher in a study published in the July issue of Obstetrics & Gynecology. Researchers found that women who had their labor induced were twice as likely to need Cesarean section. “The current findings suggest that putting more limits on elective inductions would help lower the number of C-sections performed nationally,” Dr. Ehrenthal says. “The bottom line for pregnant women is that they should understand the reasons for and potential risks of all types of delivery methods and have a frank discussion with their doctor about all of their options.”
page 2 4 Christiana Care Health System
Study delivers new findings on late pre-term births
Christiana Care played an important role in delivering a study showing that the likelihood of a baby developing respiratory problems shortly after birth increases substantially for late preterm infants—babies born between 34 and 36 weeks—compared to full-term births of 38 to 40 weeks. Matt Hoffman, M.D., director of OB/GYN Education & Research, was a co-author, and data from 15,000 births at Christiana Care contributed to the findings published in the July 28 issue of Journal of the American Medical Association.
Christiana Care undertakes pioneering research into fetal growth Christiana Care is undertaking groundbreaking research to establish a national standard for normal fetal growth, gathering data that will help doctors to more accurately determine if babies are developing normally. One of only six institutions in the United States selected for a $1.136 million grant from the National Institutes of Health, Christiana Care is the first to enroll expectant mothers in the three-year program. The study focuses on low-risk women, age 18-40 and of all ethnicities, living above the poverty line. Christiana Care’s large, diverse population—more than 6,500 babies were born here last year—and proven track record in OB/GYN research make it an ideal institution for the project.
Basic training reduces rate of stillbirths Stillbirths are a leading cause of infant mortality, especially in the developing world. Most of the stillbirths occur during labor and thus represent infants whose lives can be saved. Research from National Institutes of Health’s sponsored Global Research Network for Women and Children’s Health indicated that with early intervention, 30 percent of stillbirths can be born alive. Richard J. Derman, M.D., MPH, Christiana Care’s chair of Obstetrics and Gynecology, is a principal investigator in the collaborative study published in the Feb. 21 edition of the New England Journal of Medicine and included sites in Argentina, the Democratic Republic of Congo, Guatemala, India, Pakistan and Zambia. Christiana Care’s collaboration, along with its partner in south India, JNMC Medical School, supports research on the leading causes of death in women and infants. This work has relevance to our own patient population in Delaware, as the same conditions that affect women globally occur in the United States at lesser rates and lessons learned are often transferrable.
Delaware babies in national spotlight Christiana Care is one of the 105 sites of the National Children’s Study, the largest long-term study ever of children’s health in the United States. Researchers, including Deborah Ehrenthal, M.D., of the Departments of Obstetrics and Gynecology and Internal Medicine at Christiana Care, hope to develop a snapshot of American children by following 100,000 youngsters from before birth to age 21. The government-funded study could help researchers understand how genetics and the environment interact to impact health. It also could provide clues to conditions such as autism, asthma, mental illness, obesity and other orders. In Delaware 1,000 babies in New Castle County will be included in the study. Christiana Care is working with the University of Delaware and Alfred I. du Pont Hospital for Children in partnership with investigators at the Children’s Hospital of Philadelphia.
2010 Year in Review page 2 5
Excellence Every Day
Joint Commission awards seal of approval Christiana Care Health Services is the recipient of the Joint Commission’s Gold Seal of Approval, based on an unannounced on-site survey. The seal is proof of Christiana Care’s organization-wide dedication to providing quality care for its neighbors.
Christiana Care receives Magnet® recognition for nursing care Christiana Care Health System has achieved Magnet recognition for excellence in nursing by the American Nurses Credentialing Center. Only 6 percent of the nation’s hospitals have earned this honor, the highest level of national recognition for health care organizations that demonstrate sustained excellence in nursing care. Christiana Care is the only hospital in Delaware to achieve Magnet status.
Christiana Care named a US News & World Report Best Hospital For the fourth consecutive year, Christiana Care ranks as one of the nation’s best hospitals. US News & World Report places Christiana Care’s Department of Medicine and Department of Surgery among the top hospitals in two specialties – Gastroenterology and Urology. More than 4,800 U.S. hospitals are evaluated, and only a select 152—or 3 percent—are included. Christiana Care is the only hospital in Delaware to make the list.
Christiana Hospital recognized for excellence in community value Christiana Hospital has been recognized as one of the top 100 hospitals for community value in the nation by Cleverley + Associates as part of its Community Value Leadership Awards. Cleverley, a health care data and consulting services firm, ranks the top 100 hospitals each year based on financial viability and plant reinvestment, hospital cost and charge structure and quality performance. Christiana Hospital also earned recognition as a Community Value Five-Star Hospital for 2010 for placing in the top 20 percent of all hospitals nationwide.
page 2 6 Christiana Care Health System
Consumer Choice Award earned again For the 15th consecutive year, Christiana Care has been named the top health care provider of choice in Delaware based on a National Research Corporation survey of 200,000 area households. Winning hospitals possess the best doctors, nurses and reputation and provide the best overall quality of care.
Christiana Care tops in improvement education The Christiana Care chapter of the Institute for Healthcare Improvement Open School received recognition from IHI for earning more basic certificates of completion than any other chapter in the world.
Kidney Transplant Program is a leader in treating kidney disease Christiana Care’s Kidney Transplant Program has earned the National Kidney Foundation’s Bruce Zakheim, M.D., Memorial Legislative and Advocacy Award for outstanding work in fighting chronic kidney disease.
Christiana Care named a top workplace employer For the seventh consecutive year, the News Journal names Christiana Care a Top Workplace employer, an honor based on employee surveys from 90 companies in the Delaware region. Only 50 companies made the best-place-to-work list. Here is what some of Christiana Care’s employees say: • I believe this organization is going in the right direction. • I have many opportunities to learn and grow at this organization. • I have the flexibility I need to balance my work and personal life.
Christiana Care noted for providing quality respiratory care Christiana Care has been named a Quality Respiratory Care Institution for 2010 by The American Association for Respiratory Care. The honor recognizes hospitals that promote patient safety by providing access to qualified respiratory therapists. Only approximately 700 of the more than 5,000 U.S. hospitals received the recognition.
2010 Year in Review page 2 7
Excellence Every Day
Dr. Laskowski serves on COTH board
Dr. Gardner named to research foundation
Dr. Petrelli provides leadership in cancer care
Christiana Care Health System President and CEO Robert J. Laskowski, M.D., MBA, is a member of the Council of Teaching Hospitals (COTH) and Health Systems Administrative Board and is a COTH representative to the Association of American Medical Colleges Assembly. He serves on the Health Management Academy Chief Executive Officers Forum and the American Medical Association Section on Medical Schools. He also serves on the board of directors of the United Way of Delaware and the Wilmington HOPE Commission and chairs the Delaware Public Policy Institute. He was appointed to the Economic Advisory Council of the Federal Reserve Bank of Philadelphia.
Timothy Gardner, M.D., medical director of the Center for Heart & Vascular Health and past president of the American Heart Association, was elected Trustee of the University of Delaware’s Research Foundation and appointed to the AstraZeneca Foundation’s Board of Trustees. Dr. Gardner is also chair of the Steering Committee, Cardiothoracic Surgery Clinical Research Network of the National Heart Lung and Blood Institute of the National Institutes of Health.
Nicholas J. Petrelli, M.D., Bank of America endowed medical director of the Helen F. Graham Cancer Center, delivered the Commission on Cancer keynote address at the American College of Surgeons annual clinical conference. Dr. Petrelli is also a president-elect nominee of the American Society of Clinical Oncology.
Dr. Dickson-Witmer appointed vice chair of CoC task force Diana Dickson-Witmer, M.D., associate medical director of the Christiana Care Breast Center at the Helen F. Graham Cancer Center, was appointed vice chair of a Commission on Cancer task force charged with helping to establish the CoC’s new standards for cancer centers around the country. She is also a member of the American Society of Breast Disease’s Education Program Committee and of the Education Committee of the American Society of Breast Surgeons.
Dr. Little honored with medical education award Brian Little, M.D., Ph.D., chief academic officer, received the Association for Hospital Medical Education’s President’s Award, a distinction that honors national thought leaders in graduate medical education.
page 2 8 Christiana Care Health System
Dr. Galinat elected to AOA Brian Galinat, M.D., chair of the Department of Orthopedic Surgery, has been elected to membership in the American Orthopaedic Association. He is also in his last year of a six-year term as the Board of Councilors representative to the American Academy of Orthopaedic Surgeons and serves on the American Academy of Orthopaedic Surgeons Coding, Coverage and Reimbursement Committee.
Dr. Masters honored as statesman in cancer care
Dr. Granite reappointed to exam committee
Dr. Rizzo chair-elect of Lung Association board
Gregory A. Masters, M.D., FACP, medical oncologist at the Helen F. Graham Cancer Center at Christiana Care, is a recipient of a 2010 Statesman Award from the American Society of Clinical Oncology.
Edwin L. Granite, D.M.D., chair of the Department of Oral and Maxillofacial Surgery and Hospital Dentistry, was reappointed for the third year to the Examination Committee of the American Board of Oral and Maxillofacial Surgery.
Albert A. Rizzo, M.D., chief of the Section of Pulmonary and Critical Care Medicine at Christiana Care, was elected Chair-Elect of the National Board of Directors for the American Lung Association.
Lynn C. Jones receives AHA appointment
Darcy Burbage receives national oncology award
Tricia Strusowski joins cancer panel
Lynn C. Jones, president and CEO of the Christiana Care Visiting Nurse Association, was named to the American Hospital Association Governing Council for Long Term Care, Rehabilitation and Home Health Care.
Darcy Burbage, RN, MSN, clinical nurse specialist at the Christiana Care Breast Center at the Helen F. Graham Cancer Center, is the 2010 recipient of the Pearl Moore Making a Difference Award from the Oncology Nursing Society.
Tricia Strusowski, RN, MS, director of Cancer Care Management, was named to a special Technical Expert Panel appointed by the National Cancer Institute and the Agency for Healthcare Research and Quality to develop a survey of cancer patients gauging their cancer care experience.
2010 Year in Review page 2 9
Excellence Every Day Linda Laskowski Jones’s article wins silver award Linda Laskowski Jones, RN, MS, vice president of Emergency, Trauma & Aeromedical Services, coauthored an article in Nursing 2009 that won a silver award in the “how to” category from the American Society of Healthcare Publication Editors.
Patrick Grusenmeyer joins ASCO advisory group
Sandy DelCoglin leads Maureen Seckel named residency coordinator group to nursing board
Patrick Grusenmeyer, Ph.D., completed his term as president of the Association of Cancer Executives in February and now serves as immediate past president. He was appointed to the American Society of Clinical Oncology Workforce Advisory Group for a four-year term, and serves on the Society’s Education Committee and Practice Management and Information Technology subcommittee. He is also a member of the Medicare Ambulatory Payment Advisory Panel.
Sandy DelCoglin, general surgery residency program coordinator, has been selected president of the National Association of Residency Coordinators for Surgery.
Maureen Seckel, RN, APN, MSN, clinical nurse specialist, Medical Pulmonary, was named to a threeyear term on the Board of Directors of the American Association of Critical Care Nurses, the world’s largest specialty nursing organization.
Dr. Jasani receives national appointment Neil Jasani, M.D., MBA, residency director and assistant chair of the Department of Emergency Medicine, was appointed to the Board of Examiners for the Malcolm Baldrige National Quality Award, the nation’s highest award for quality presented to recipients by the President of the United States.
EM residents Drs. Coletti and Hess are winners Two Emergency Medicine residents earned national recognition at the 2009 American College of Emergency Physicians Scientific Assembly. Fifth-year Emergency Medicine/Internal Medicine program resident Christian Coletti, M.D., won the Emergency Medicine Residents Association Leadership Excellence Award for outstanding leadership. First-year resident J. Daniel Hess, M.D., received the National Outstanding Medical Student Award, which recognizes students who excel in compassionate care of patients, professional behavior and service to the community and/or specialty. page 3 0 Christiana Care Health System
Vital
to the local economy
Christiana Care’s economic impact on Delaware Christiana Care employees paid more than $21.7 million in taxes to the state of Delaware. On average, a Christiana Care employee returns $93,000 to Delaware’s economy every year.
p
ADMISSIONS
54,556
55,512
55,049
54,597
53,267
06
07
08
09
10
OUTPATIENT VISITS
450,238 457,348 528,897 533,618 530,466
06
07
08
09
10
EMERGENCY DEPARTMENT VISITS
1,362 CHRISTIANA CARE VOLUNTEERS GAVE A TOTAL OF 91,375 HOURS OF SERVICE THIS YEAR. That translates to more than $1.9 million.
06
47,051
99,477
07
48,518
100,996
08
49,881
103,670
09
51,559
108,932
10
52,382
112,659
0
50,000
Wilmington Hospital
100,000
146,528 total 149,514 total 153,551 total 160,491 total 165,041 total 150,000
Christiana Hospital 2010 Year in Review page 3 1
200,000
Vital to the local economy BIRTHS
SURGICAL PROCEDURES
7,219
7,100
7,249
7,199
6,520
45,091
42,834
42,362
41,879
40,773
06
07
08
09
10
06
07
08
09
10
PHYSICAL THERAPY PLUS number of visits
RADIOLOGY PROCEDURES
253,957 258,814 335,776 320,907 317,863
06
07
08
09
10
WILMINGTON HOSPITAL HEALTH CENTER VISITS
84,718
88,325
94,421
06
07
08
101,877 100,332
09
10
AVERAGE INPATIENT STAY number of days
67,281
68,937
70,047
71,562
73,912
5.21
5.30
5.43
5.41
5.20
06
07
08
09
10
06
07
08
09
10
page 3 2 Christiana Care Health System
PRIMARY CARE PHYSICIAN OFFICES number of visits CHRISTIANA CARE HOME HEALTH AND COMMUNITY SERVICES
Home Health Care Visits
174,679 168,698 179,289 191,587 193,677
272,774
High School Wellness Centers and Alzheimer’s Day Program Visits 20,394
CENTER FOR ADVANCED JOINT REPLACEMENT AND CENTER FOR REHABILITATION 06
07
08
09
10
Total Knee and Hip Replacements Rehabilitation Patients
1,767
778
CHARITY CARE in millions of dollars
COST OF AVERAGE PATIENT STAY
$ 32.4
$ 35.7
$ 37.7
$ 46.8
$ 55.7 Christiana Care Health System
06
07
08
09
$ 7,861
Cooper University Hospital
$ 9,124
Thomas Jefferson University Hospital
$ 9,455
Temple University Hospital
$ 9,566
10
Georgetown University Medical Center $ 10,336 Crozer-Chester Medical Center
TOTAL PATIENT REVENUE in billions of dollars
$ 10,341
Source: American Association of Medical Colleges’ Autumn 2009 Databook.
$ 1.40
$ 1.55
$ 1.70
$ 1.87
$ 2.03 WHERE CHRISTIANA CARE HEALTH SERVICES’ OPERATING DOLLAR GOES
06
07
08
09
10
.27 Therapeutic & Diagnostic Services
.01 Insurance & Other .01 Other Affiliates .03 Administration .06 Depreciation & Interest
PERSONNEL STATISTICS
Christiana Care Employees Medical-Dental Staff
10,234
1,452
Medical & Dental Residents & Fellows RNs, LPNs and Patient Care Technicians
.07 Support Services
.24 Nursing Services
.08 Facilities & Services
238 3,641
.15 Employee Benefits
.08 Medical Education & Social Services
2010 Year in Review page 3 3
Christiana Care offers a wide range of health care services in Delaware and surrounding communities. On the Christiana campus: • • • • •
Christiana Hospital (907 beds) Center for Heart & Vascular Health in the Bank of America Pavilion Helen F. Graham Cancer Center Christiana Care Breast Center Christiana Surgicenter
On the Wilmington campus: • • • • •
Wilmington Hospital (241 beds) Wilmington Hospital Health Center Center for Advanced Joint Replacement Center for Rehabilitation Roxana Cannon Arsht Surgicenter
Delaware and the community: • • • • • • •
16 School-Based Health Centers Home Health & Community Services-Visiting Nurse Association 2 Alzheimer’s Day Programs Eugene du Pont Preventive Medicine & Rehabilitation Institute 18 Primary Care Centers (2 in New Jersey) 9 Christiana Care Physical Therapy PLUS sites 10 Christiana Care Imaging Services locations
P.O. Box 1668 Wilmington, Delaware 19899-1668 800-693-CARE (2273)
www.christianacare.org
Christiana Care is a private, not-for-profit regional health care provider and relies in part on the generosity of individuals, foundations and corporations to fulfill its mission. 11GEN4