Year in Review
2011
A Leader in Health Care
Touching lives in 2 million ways As one of the largest health care providers in the nation, Christiana Care Health System touches lives in many ways. In fact, we provided medical care to our neighbors more than 2 million times last year, in encounters with patients that range from routine screenings to complex surgeries to cutting-edge clinical trials. In Delaware and the surrounding area, patients trust Christiana Care to deliver their babies, provide emergency services, promote wellness and give the highest quality care regardless of people’s ability to pay.
ACCORDING TO THE AMERICAN HOSPITAL ASSOCIATION’S LATEST SURVEY OF 6,269 U.S. HOSPITALS, CHRISTIANA CARE RANKS AMONG THE LEADERS BY VOLUME IN SEVERAL CATEGORIES.
IN THE U.S.: ADMISSIONS 17 TH BIRTHS 26 TH
ON THE EAST COAST: 10 TH ADMISSIONS 12 TH BIRTHS
EMERGENCY VISITS 20 TH
10 TH EMERGENCY VISITS
TOTAL SURGERIES 23 RD
11 TH TOTAL SURGERIES
Our commitment to patient-centered care is the foundation of our national reputation for excellence.
Dear Neighbors,
As you read our 2011 Year in Review, you will learn that we at Christiana Care have increasingly used the concept of “value” to focus our work. Our concept of value is grounded in the needs of our patients, as they perceive them. It is likewise grounded in a careful scrutiny of the benefits and costs of what we can do to meet our patients’ needs. The newly created Christiana Care Value Institute will formalize our thinking, our work and our learning as an organization committed to value. The Institute builds on the strong foundations established by the Christiana Care Center for Outcomes Research, the Department of Quality and Safety and our work in Operational Excellence. A new Center for Health System Design Research also will be developed.
from heart care to cancer research to prevention, from advances in technology to honors bestowed upon the talented and dedicated people who work here. This edition of the Year in Review depicts ways in which we are adding value for our patients. We are steadfast in our commitment to provide the very best care to our neighbors in need. Thank you for your confidence in Christiana Care.
The vision for the Christiana Care Value Institute is to improve the health of Delawareans in ways that can be shared with the nation. The Institute will enable Christiana Care to develop, implement, and study the benefits of health care delivered to the individuals we care for. The results—better health outcomes and lower costs—will benefit us all. Our commitment to patient-centered care is the foundation of our national reputation for excellence. In this report, you will read about many of Christiana Care’s community partnerships and accomplishments,
Robert J. Laskowski, M.D., MBA PRESIDENT AND CHIEF EXECUTIVE OFFICER
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Heart & Vascular Care at Christiana Care THE CENTER FOR HEART & VASCULAR HEALTH features a full range of cardiovascular services.
“This is a nationally ranked heart program that significantly improves outcomes to patients in the region.” — TIMOTHY J. GARDNER, M.D., MEDICAL DIRECTOR, CENTER FOR HEART & VASCULAR HEALTH
FACTS
OPEN-HEART CASES CHRISTIANA HOSPITAL
638 BEEBE MEDICAL CENTER 168 4,536 1,722
CARDIAC CATHETERIZATION CASES ELECTROPHYSIOLOGY CASES
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VASCULAR SURGERY CASES
1,515
VASCULAR INTERVENTIONAL CASES
4,293
18,491 VASCULAR ULTRASOUND STUDIES 33,170 CARDIAC REHABILITATION MONITORED VISITS 17,395 CARDIOVASCULAR NON-INVASIVE STUDIES
Leaders in heart and vascular care Christiana Care’s Center for Heart & Vascular Health is the only center in the region to integrate services under one roof, including cardiac surgery, vascular surgery, vascular interventional radiology, cardiology and interventional nephrology. Our prestigious heart program has earned a national reputation, with a 3-star rating for openheart surgery from the Society of Thoracic Surgeons. Christiana Care ranks in the top 2 percent in the United States for advanced heart arrhythmia capabilities and is No. 2 in the nation for stroke volume. From prevention to planned care and emergency care, through rehabilitation and ongoing support, we partner with our patients to achieve optimal heart and vascular health.
HIGHLIGHTS
Heart Failure Program receives Joint Commission certification Christiana Care Health System’s Center for Heart & Vascular Health is the only hospital in Delaware, and one of just 33 in the United States, to earn The Joint Commission’s Gold Seal of Approval™ for its heart failure program. The award recognizes Christiana Care’s dedication to continuous adherence to The Joint Commission’s state-of-the-art standards. Christiana Care voluntarily underwent a rigorous on-site survey as part of the process. A team of Joint Commission expert surveyors evaluated the program for compliance with standards of care specific to the needs of patients and families with heart failure. Christiana Care earned recognition for its progressive care models, levels of staff engagement and collaboration among providers.
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H I G H L I G H T S from THE CENTER FOR HEART & VASCULAR HEALTH
Highest quality ranking from Thoracic Surgeons Christiana Care’s heart surgery program at the Center for Heart & Vascular Health has received the highest ranking—3 stars—from the Society of Thoracic Surgeons, an honor awarded to only 13.5 percent of hospitals in the Society’s cardiac database. The heart surgery program includes an affiliation with Beebe Medical Center in Lewes. Combined, the programs perform more than 850 open-heart surgeries a year. “The Society’s rating is widely regarded by clinicians as the gold standard by which to evaluate cardiac surgery programs,” says Michael Banbury, M.D., the W. Samuel Carpenter III Distinguished Chair of Cardiovascular Surgery. “We received this award because of real coordination among all our team members at both program locations that allows our patients to move seamlessly through the care process.”
“The Society’s rating is widely regarded by clinicians as the gold standard by which to evaluate cardiac surgery programs.” — MICHAEL BANBURY, M.D., THE W. SAMUEL CARPENTER III DISTINGUISHED CHAIR OF CARDIOVASCULAR SURGERY
ACC honors Dr. Weintraub William S. Weintraub, M.D., FACC, the John H. Ammon Chair of Cardiology and director of the Christiana Care Center for Outcomes Research, received the American College of Cardiology’s 2011 Distinguished Service Award. Dr. Weintraub, an internationally distinguished cardiologist and expert in outcomes research, earned recognition for numerous contributions to medicine and the delivery of health care.
A policy statement for the American Heart Association William Weintraub, M.D., is the lead author of a policy statement published in Circulation: Journal of the American Heart Association that says preventing heart disease is a good long-term investment in the nation’s health. The statement summarizes years of research on the value of investing in prevention through community-based changes to make it easier to lead a healthy lifestyle: • Every dollar spent on building walking or biking trails saves $3 in medical costs. • Companies that invest in workers’ health with comprehensive worksite wellness programs and healthy work environments have less absenteeism, greater productivity and lower health care costs. • Initiating a plan to drastically cut the amount of salt in the food supply to an average intake of 1,500 mg per day may reduce high blood pressure in the country by 25 percent, saving $26 billion in health care costs annually.
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Get With The Guidelines® lauds heart failure and stroke care The Center for Heart & Vascular Health has received the Get With The Guidelines–Heart Failure Gold Quality Achievement Award from the American Heart Association. The recognition signifies that Christiana Care has reached an aggressive goal of treating heart failure patients with at least 85 percent compliance for at least 24 months to core standard levels of care as outlined by the AHA/American College of Cardiology secondary prevention guidelines for heart failure patients. In addition, Christiana Care received the AHA’s Get With The Guidelines–Stroke Silver Plus Quality Achievement Award. To receive the award, Christiana Care achieved at least 12 consecutive months of 85 percent or higher adherence to all stroke quality achievement indicators and at least 75 percent or higher compliance with six of 10 stroke quality measures during that same period of time.
Heart Failure Outpatient Center stresses follow-up For patients living with heart failure who have been hospitalized, scheduling that first follow-up appointment after discharge is essential. A new Heart Failure Outpatient Center offers patients a convenient location and time to schedule that key appointment. A nurse practitioner experienced in heart failure care sees patients every Tuesday at Wilmington Hospital Health Center. “With timely follow up, working closely with their cardiologists and primary care providers, we can
ensure that patients get the best care possible to maintain their independence and quality of life and avoid hospital re-admission,” says Heart Failure Program Clinical Leader Carolyn Moffa, MSN, FNP-C. The nurse practitioner can conduct a physical exam and review prescribed medications to help ensure patients are getting the maximum benefit and not experiencing any side effects. The clinic also can provide counseling and education about diet, lifestyle and fluid management, as well as advice on how to recognize signs and symptoms of worsening heart failure so patients can report problems as soon as they arise, when they are most easily treated.
“With timely follow up ... we can ensure that patients get the best care possible to maintain their independence and quality of life and avoid hospital readmission.” — CAROLYN MOFFA, MSN, FNP-C, HEART FAILURE PROGRAM CLINICAL LEADER
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H I G H L I G H T S from THE CENTER FOR HEART & VASCULAR HEALTH
Outcomes, iPads and cardiovascular research
Christiana Care presents at national conference
Cardiology fellows at Christiana Care were lead authors on abstracts presented at the Society for General Internal Medicine (SGIM) National Meeting, Society for Cardiovascular Angiography and Interventions (SCAI) Conference, National Lipid Association (NLA) Annual Meeting, and the American Heart Association’s Quality of Care and Outcomes Research (QCOR) in Cardiovascular Disease and Stroke Conference.
At the American College of Cardiology Annual Scientific Session in New Orleans, authors from Christiana Care were in the spotlight.
Anitha Rajamanickam, M.D., presented at QCOR on her study showing that elevated blood levels of creatine kinase (CK-MB) in the absence of elevated troponin did not change treatment decisions at Christiana Care. Eliminating CK-MB testing potentially could save billions of health care dollars nationwide each year. Cardiovascular Research Fellow Doralisa Morrone, M.D., reported at QCOR that pregnancy-related hypertension is an indicator of hypertension later in life. Interventional cardiologists-on-call who were once tied to their fax machines can now roam thanks to a 3G network hookup that transmits electrocardiograms (ECGs) to their iPads. “Now, time-sensitive decisions are just a phone call away from just about any location,” says third-year fellow Matthew Grove, D.O., who designed the feasibility study presented at SCAI with Andrew Doorey, M.D. “We showed that ECGs converted to portable digital files (PDFs) transmit clearly to our iPads, allowing us to zoom in for a closer look at suspicious leads.” 6
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Among them was Kevin Copeland, D.O., who presented on the prevalence of valve damage that requires open-heart surgery as a result of radiation therapy for cancer. Three studies reported outcomes from ongoing efforts to shorten the time to treatment for acute heart attacks. Ehsanur Rahman, M.D., associate chief of cardiology, reported that “door-to-balloon” times at Christiana Hospital average about 70 minutes, a significant improvement and well below the 90-minute national benchmark. William Weintraub, M.D., was a co-author on four in-house studies as well as three others presented by investigators from other institutions. Two of the studies report on data from the COURAGE Trial, for which he served as national co-principal investigator. A third study presents results from the National Cardiovascular Data Registry, which Dr. Weintraub helped create and now serves as a board member. O N i PA D S A N D E C G s
“Now, time-sensitive decisions are just a phone call away from just about any location.” — MATTHEW GROVE, D.O., THIRD-YEAR FELLOW
Treating atrial fibrillation— without major surgery
Making care readily accessible to heart patients
Atrial fibrillation is the most common heart rhythm disorder, impacting 5 million Americans who suffer from pain, weakness and shortness of breath. 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 AF that eliminates the need for a painful chest incision and stopping the heart.
The Center for Heart & Vascular Health is making access to first-rate cardiology care easier and more convenient for patients in Delaware.
Instead, the procedure combines minimally invasive techniques with catheter ablation, accessing the heart through small incisions in the abdomen. Patients recover more quickly and can resume their normal lives with less disruption.
Stereotaxis remote navigation offers speed, precision The Gerret and Tatiana Copeland Arrhythmia Center at Christiana Care’s Center for Heart & Vascular Health is one of only about 130 centers in the United States to offer stereotaxis remote navigation, a $1.5 million system that performs cardiac catheter procedures with greater speed and accuracy. This advanced technology uses two giant external magnets to steer a thin, magnet-tipped catheter through a patient’s veins to the heart to treat atrial fibrillation, an irregular rhythm that can cause clots to form in the heart. The standard procedure of manually snaking a catheter to the heart takes about six hours, with a success rate of 60-70 percent. Stereotaxis has a success rate as high as 90 percent.
At the Christiana Care Cardiology Consultants Same Day Clinic at Christiana Hospital, patients who have cardiovascular issues that need urgent attention can get appointments within 24 hours of their call—and most are scheduled on the same day. Same-day cardiac diagnostic testing also is available. Christiana Care Cardiology Consultants also provide care at the Smyrna Health & Wellness Center. As part of Christiana Care Health System, cardiologists work with primary care physicians to coordinate primary and cardiac care and provide a direct link to advanced heart support through the Center for Heart & Vascular Health. They also specialize in pacemaker and defibrillator management. Cardiovascular diagnostic testing, including EKGs, cardiac ultrasound, nuclear stress tests and peripheral vascular ultrasound also are available in the Smyrna center.
VNA telemonitoring benefits heart failure patients Patients with heart failure enrolled in Christiana Care’s telemonitoring program are much less likely to be rehospitalized than the national average, according to statistics by Strategic Healthcare Programs. In the program, nurses from the Visiting Nurse Association work closely with patients to monitor such vital signs as weight, blood pressure and the oxygen level in the blood so patients can make adjustments as soon as their numbers indicate a problem. Nurses also help patients to set goals and maintain heart-healthy diets. In New Castle County, 22.8 percent of heart failure patients were readmitted to the hospital within 30 days of discharge. That is significantly less than the 32.7 percent of patients readmitted nationwide.
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Cancer Care at Christiana Care THE HELEN F. GRAHAM CANCER CENTER features a full range of cancer services.
“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.” — AMERICAN COLLEGE OF SURGEONS COMMISSION ON CANCER PERFORMANCE REPORT
FACTS
3,132 PATIENTS NEWLY DIAGNOSED AND/OR NEWLY TREATED RADIOLOGY ONCOLOGY CONSULTS EXTERNAL BEAM TREATMENTS
2,026
31,135
771 PATIENTS ENROLLED IN CLINICAL TRIALS
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National model for cancer care As one of the first National Cancer Institute Community Cancer Centers Program sites awarded in the United States, the Helen F. Graham Cancer Center is a national model for other hospitals to follow. In fact, at 24 percent, the Graham Cancer Center has one of the highest patient accrual rates into clinical trials in the United States, far above the national average of 4 percent. One of the original National Cancer Institute’s Community Cancer Centers established in 2007, the Graham Cancer Center is also one of the most technologically advanced and largest cancer programs on the East Coast, recording more than 170,000 patient visits last year. The center features some of the world’s most advanced medical technology, an on-site laboratory that allows researchers and oncologists to collaborate in developing new treatments for individual patients, and a comprehensive array of services to make cancer diagnosis and treatment as convenient and comfortable as possible. Our patient-navigation system and unique model of care give every cancer patient quick access to a team of world-class cancer specialists.
HIGHLIGHTS
Helen F. Graham Cancer Center leads the way in reducing cancer in Delaware Through research, evidence-based physician 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.
“Our patient accrual rate into clinical trials is almost seven times the national average— 24 percent.” — NICHOLAS J. PETRELLI, M.D. BANK OF AMERICA-ENDOWED MEDICAL DIRECTOR OF THE HELEN F. GRAHAM CANCER CENTER
Formerly first in the nation for rates of cancer incidence and mortality, Delaware now ranks 4th in cancer incidence and 12th in mortality. Rates for cancer mortality in Delaware are dropping faster than anywhere else in the country, at twice the national rate. The slight uptick in cancer incidence owes to effective screening programs diagnosing more cancers at an earlier stage, leading to fewer deaths. “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 America-endowed medical director of the Helen F. Graham Cancer Center. “Our patient accrual rate into clinical trials is almost seven times the national average—24 percent, compared to the national rate of 4 percent.” Dr. Petrelli also credits the 16 Multidisciplinary Disease Centers at the Graham Cancer Center for helping to reduce cancer in community. In addition, Delaware is first in enacting cancer laws and policies that save lives and money, according to the American Cancer Society’s Cancer Action Network. ACS CAN ranks Delaware highest in five priority areas: breast and cervical cancer early detection program funding, colorectal screening coverage, smoke-free laws, tobacco prevention programs and tobacco taxes.
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H I G H L I G H T S from THE HELEN F. GRAHAM CANCER CENTER
N U M B E R O F PAT I E N T V I S I T S
IN 2010, THE HELEN F. GRAHAM CANCER CENTER HAD 174,034 PATIENT VISITS – WHICH IS ALMOST THREE TIMES THE 60,000 PATIENT VISITS RECORDED IN 2003.
Christiana Care and Wistar Institute forge historic bond
Cancer commission praises clinical trials, reduced disparities
Christiana Care Health System’s Helen F. Graham Cancer Center and The Wistar Institute of Philadelphia, an international leader in biomedical research, have entered into an historic partnership to collaborate on translational cancer research with the aim of bringing the latest discoveries in research to cancer patients in the community.
The Helen F. Graham Cancer Center has received another three-year accreditation from the Commission on Cancer of the American College of Surgeons. The commission has accredited the cancer program at Christiana Care since 1985.
The partnership combines Wistar’s strengths in basic biomedical research with the Graham Cancer Center’s exceptional cancer treatment and patient care. The goal of the translational cancer research collaboration is to “translate” or advance research discoveries made in Wistar’s labs into early phase clinical trials with patients at the Graham Cancer Center.
Says the commission: “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 setting.” Further, the commission praises the Graham Cancer Center for “terrific clinical outreach program geared toward reducing disparities in the community” and for a “phenomenal clinical trial accrual each year.”
“Forming this partnership with one of the foremost cancer research institutions in the nation will be greatly beneficial to finding cures and treatment options for many cancers,” says Robert J. Laskowski, M.D., Christiana Care president and CEO. “This collaboration is exciting news for Christiana Care and our cancer program, but most importantly, for our patients and neighbors in the community.” Areas of initial research in the Wistar-Christiana Care partnership will focus on colon cancer stem cells, targeted treatments for melanoma and novel approaches for molecular profiling, and treatment of advanced and metastatic disease.
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O N T H E W I S TA R PA R T N E R S H I P
“Forming this partnership with one of the foremost cancer research institutions in the nation will be greatly beneficial to finding cures and treatment options for many cancers.” — ROBERT J. LASKOWSKI, M.D., CHRISTIANA CARE PRESIDENT AND CEO
NCI funding advances research The Helen F. Graham Cancer Center at Christiana Care is the recipient of $2.8 million from the National Cancer Institute, part of the National Institutes of Health, to expand cancer research. The Graham Cancer Center will use the funding to expand its community outreach programs, improve health care disparities, leverage information technology to benefit patient safety and enhance survivorship and palliative care. The award also promotes smoking cessation among cancer survivors and boosts genetic counseling and breast cancer research.
Helen F. Graham Cancer Center performs first gene therapy to stop cancer in Delaware Christiana Care doctors used genetically engineered cells from a patient’s own blood to trigger the destruction of cancer cells in his leg and foot. The patient was the first in the region to undergo collection of his white blood cells to make his personalized vaccine.
Research Coordinator Michele Johnson, RN, AS, Principal Investigator Michael Guarino, M.D., and Research Nurse Supervisor Kathy Combs, RN, OCN, CCRP, attend to Howard Anderson, the first patient in the region to receive a new melanoma vaccine.
The historic clinical trial for advanced melanoma marks the first foray for the Helen F. Graham Cancer Center into cancer gene therapy. Christiana Care is the only East Coast center participating in this early-phase study and one of only 11 sites nationwide.
Christiana Care leads colorectal cancer trial The Helen F. Graham Cancer Center is leading a national clinical trial to determine if Crestor® (rosuvastatin), a cholesterol-lowering drug, can prevent new colon tumors from forming after colon-cancer surgery. The study seeks to determine if Crestor can stop the growth of tumor cells by blocking some of the enzymes that affect cell growth. The trial will also determine if Crestor can keep new colon tumors from forming after surgery to remove a patient’s initial colon cancer. The study, titled “P-5: Statin Polyp Prevention Trial in Patients with Resected Colon Cancer,” is conducted under the auspices of the National Cancer Institute by a network of cancer-research professionals, the National Surgical Adjuvant Breast and Bowel Project.
Center for Translational Cancer Research is a team effort The Center for Translational Cancer Research at the Helen F. Graham Cancer Center is a dynamic, 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 center is a collaborative effort with the University of Delaware, A.I. du Pont Hospital for Children/Nemours, and the Delaware Biotechnology Institute, who share a common vision to improve cancer research and treatment delivery. 2 0 11 Ye a r i n Re v i e w
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H I G H L I G H T S from THE HELEN F. GRAHAM CANCER CENTER
Christiana Care contributes to landmark breast cancer study Christiana Care was in the top 20 sites for number of patients participating in a groundbreaking study published in The Journal of the American Medical Association that found many women with early breast cancer do not appear to benefit from complete removal of the lymph nodes under their arm, even when cancer is found in one or two representative (sentinel) nodes. The American College of Surgeons Oncology Group study involving nearly 900 women treated at 115 sites found those who did have more lymph nodes removed were no more likely to survive five years after the surgery than those who had only the sentinel lymph nodes removed, even when tumor was found in the sentinel nodes. The group who had only the sentinel lymph nodes removed had a lower incidence of swelling of the arm and other complications, but had the same low risk of recurrence under the arm as did the group who had more lymph nodes removed.
“This trial is truly a landmark study for early breast cancer patients,” says Diana Dickson Witmer, M.D., principal investigator for the study at Christiana Care and associate director of the Christiana Care Breast Center. “The results of this study will most likely change the way we practice.”
“This trial is truly a landmark study for early breast cancer patients.” — DIANA DICKSON WITMER, M.D. ASSOCIATE DIRECTOR OF THE CHRISTIANA CARE BREAST CENTER
Breast Center first to earn accreditation The Christiana Care Breast Center at the Helen F. Graham Cancer Center has been awarded a three-year term of accreditation in breast magnetic resonance imaging (MRI) by the American College of Radiology. The breast center is the only facility in Delaware to earn this accreditation. MRI of the breast offers valuable information about many breast conditions that other methods of imaging, such as mammography or ultrasound, might not obtain.
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Graham Center is Community Cancer Center pioneer The Helen F. Graham Cancer Center is a leader in speeding research and raising the quality of care for underserved patients in the groundbreaking National Cancer Institute Community Cancer Centers Program. One of the original 16 of the 30 cancer centers in the United States selected for the program, the Graham Center contributes to enhanced quality of care for patients, as well as advances in cancer research. As a result, more patients have access to cutting-edge treatment in clinical trials. The ultimate vision is a national network of community cancer centers engaged in research that will provide the latest, evidence-based treatment for patients of all ethnic and economic backgrounds.
A leader in recruiting for clinical trials Christiana Care’s Community Clinical Oncology Program (CCOP) ranked near the top for recruiting patients for clinical trials for the period from May 1, 2010 to April 30, 2011, according to the Cancer and Leukemia Group B, known as CALGB. Christiana Care was fifth overall out of 45 participating organizations, and first among non-university cancer centers. Christiana Care’s accrual rate is 24 percent of all patients, 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 provide patients with information about clinical trials. Clinical trials play an essential role in cancer research.
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Community Care at Christiana Care EDUCATION, OUTREACH AND CHARITY CARE bring health care to our neighbors.
“We remain steadfast in our commitment to provide the very best care to any and all neighbors in need.” — ROBERT J. LASKOWSKI, M.D., MBA, PRESIDENT AND CEO
VISITING NURSE ASSOCIATION
A tradition of caring Christiana Care has a long tradition of caring for our neighbors, regardless of their ability to pay. Last year we provided $28 million in charity care and more than $15 million in unreimbursed Medicaid services. Our community outreach workers bring education and screenings directly to people who otherwise might not have access to health care. The Helen F. Graham Cancer Center’s Community Outreach and Education Program alone reached 15,000 people in the past year through cancer control, public awareness and educational activities. The new Christiana Care Value Institute represents the next level in patient-focused care, balancing safety, quality and cost to benefit both patients and the community. Our landmark transformation of Wilmington Hospital and its campus will significantly enhance care for our neighbors in the city and surrounding communities. 14
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HIGHLIGHTS
Patient needs drive Value Institute The founding of the Christiana Care Value Institute signals Christiana Care’s commitment to taking value in health care services to a higher level, says Robert J. Laskowski, M.D., MBA, president and CEO. A service is valuable if it makes a difference in the life of patients in a way that they perceive and that patients and society can afford. Value includes safety, quality and cost. James Newman, M.D., senior vice president and executive director of the new Christiana Care Value Institute and chief academic officer
“Through the Value Institute, Christiana Care will be able to develop, implement and study the benefits of the health care we deliver with the expectation of achieving better outcomes at lower costs to patients, the community and the health system,” Dr. Laskowski says.
Transforming the Wilmington campus Christiana Care is investing in building a healthier community in the City of Wilmington with its sweeping, $210 million expansion and renovation of Wilmington Hospital. The Wilmington campus will grow by 337,000 square feet, creating a 1 million-square-foot, state-of-the-art medical center. The hospital is open and fully functional throughout the construction process. The project will be complete in 2014 and adds 600 jobs to the community. WILMINGTON HOSPITAL EXPANSION
Christiana Care leads in protecting the environment As part of its ongoing commitment to green initiatives, Christiana Care is the first Delaware health care system to receive a Trailblazer Award for environmental leadership from the U.S. Environmental Protection Agency, an honor recognizing hospitals that have established a model for other institutions to emulate. Christiana Care also buys electricity from a wind farm, and has rolled out programs to reduce regulated medical waste, decrease emissions into the air from power plants and increase recycling.
Memory care center launches Christiana Care has launched the Swank Memory Care Center, providing multidisciplinary care for patients suffering from memory disorders such as Alzheimer’s disease, as well as for their caregivers. Located at 205 W. 14th St. in Wilmington, the center is a collaborative effort of the Departments of Medicine, Family and Community Medicine and Psychiatry. The center provides specific expertise and coordinated approaches for patient and family support with the goal of increasing access to services.
VNA reduces hospitalizations and falls Christiana Care Visiting Nurse Association is reducing the number of hospitalizations and falls of home health care patients. Last year the VNA achieved a 18.8 percent hospitalization rate for Medicare patients, compared to a national rate of 25 percent. Also, patients requiring emergency care because of falls dropped to .8 percent, a 10 percent improvement from 2010 and better than the national rate of 1.4 percent. That translates into saving approximately 50 VNA patients from serious injury due to falls.
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H I G H L I G H T S of COMMUNITY CARE
Christiana Care moves toward electronic health record
Rx for safer medicine cabinets, from Christiana Care
Christiana Care has launched a pilot program in which more than 100 community physicians will employ electronic health records in their practices. Christiana Care also is hardwiring electronic content into resident training programs and is offering continuing education to about 1,500 community physicians on the benefits of electronic record systems.
A joint partnership of Christiana Care Health System, the Drug Enforcement Administration and the Delaware State Police, Medication Cabinet Clean-Out Day provides an opportunity for consumers to bring in unnecessary and outdated prescription drugs, over-thecounter medicines, inhalers and vitamins so they can be safely disposed.
By the end of 2011, 80 percent of providers in the state are expected to use the Delaware Health Information Network, a conduit for hospitals and labs to send results to doctors. The system also provides a reliable way for doctors to access information about registered patients.
The Christiana Care event enables consumers to dispose drugs easily without having to fill out forms or provide personal information.
Latest phase of CPOE puts Christiana Care in elite group Christiana Care’s journey to fully implement an electronic health record took another significant step forward when the Emergency Departments at both Christiana and Wilmington hospitals joined patient care units and ancillary areas already using Computerized Provider Order Entry (CPOE) and Electronic Medication Administration Record (eMAR). Bringing the EDs online builds on the 2010 inauguration of CPOE, further advancing the goal of having the entire health care system ordering, delivering and verifying medications and tests electronically.
This year, drugs were collected at Wilmington Hospital for the first time, in addition to Christiana Hospital. Public announcements, flyers and posters promoted the event. Christiana Care also encouraged staffers to help spread the word through Facebook, LinkedIn and Twitter.
Patient and Family Advisory Council forms With the launch of a Patient and Family Advisory Council, Christiana Care has taken an important step forward in our journey toward Patient and Family Centered Care. Advisers are patient and family volunteers who collaborate with Christiana Care to shape policies, programs, facility design and day-to-day service interactions to continuously improve the care experience. Patient and family advisers must have been patients or family members who received services within the past three years, train to become an official Christiana Care volunteers and commit to meeting monthly for at least two years.
O N T H E PAT I E N T A N D FA M I LY A DV I S O R Y C O U N C I L
“We learn a lot from the stories our patient advisors tell us. They watch our behavior closely. They will help us be far better care providers.” — JANICE E. NEVIN M.D., CHIEF MEDICAL OFFICER
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Treating teen psychiatric issues Often, kids who get into trouble with drugs also have underlying psychiatric problems. Young people with a co-occurring diagnosis of a psychiatric condition and substance abuse are now receiving comprehensive treatment through a dynamic new program at the Herman Rosenblum, M.D., Child and Adolescent Center in Wilmington.
White House, Deputy Director of the Office of National Drug Control Policy David K. Mineta, MSW, talks with Christiana Care Chief Medical Officer Janice Nevin, M.D., and Hugh R. Sharp Jr. Chair of Medicine Virginia Collier, M.D., during a visit to Christiana Care to learn about an innovative substance-abuse intervention program.
At the Rosenblum Center, patients age 12-18 receive intensive, personalized treatment for emotional, developmental and behavioral issues, as well as classroom instruction that enables them to keep up with their schoolwork. Young people attend the program Monday-Friday, 8:30 a.m.-2:15 p.m. and spend weekends at home.
A new approach to addiction outreach Christiana Care partners with Brandywine Counseling and Community Services in Project Engage to provide intervention for Wilmington Hospital patients who are addicted to drugs or alcohol. Thanks to a generous $1.1 million grant, the program is expanding to Christiana Hospital. Instead of referring the patient for community counseling—which few patients subsequently schedule—a counselor initiates contact with patients when they are still in the hospital, a time when studies indicate intervention efforts are more successful. The program has yielded dramatic results that could ultimately reduce serious illnesses associated with addiction, such as pancreatitis, heart disease, kidney failure, cirrhosis and pneumonia. In just over two years, 423 patients agreed to speak with a Project Engage interventionist. Of those, 42 percent were admitted to a substance use and disorder treatment program.
eCare connects rural hospitals Rural hospitals in the Maryland eCare network rely on critical care physicians and nurses at Christiana Care’s eCare Central. By 2012, Christiana Care will connect to nearly 80 beds in the network, enabling remote hospitals to provide the highest level of care around the clock. The hospitals work most closely with eCare on nights, weekends and holidays, when fewer local specialists are available.
Dental program offers affordable care Since the 1950s, the Department of Oral & Maxillofacial Surgery and Hospital Dentistry has offered quality dental services at greatly reduced costs to patients with little or no insurance. Services range from routine care to complex reconstructive maxillofacial surgery. In the past 20 years, the department has provided more than 1,500 dental implants, most at cost. In fiscal year 2010-2011, more than 30 patients received 111 implants. Dentists supervise residents and work with patients to restore their smiles. Oral surgeons perform such procedures as bone grafts to build up bone before an implant is placed. Under the direction of Edwin L. Granite, D.M.D., the department also provides care for uninsured and underinsured patients at clinics in the community, including Westside Family Healthcare and Henrietta Johnson Medical Center, both in Wilmington.
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H I G H L I G H T S of COMMUNITY CARE
Christiana Care employees feed the hungry Hungry people who do not have the means to buy food can get a free, nutritious meal every Sunday, rain or shine, from Premier Charities, a not-for-profit group founded by a group of doctors on Christiana Care’s Medical-Dental Staff and others who are dedicated to serving people who are poor, homeless or otherwise disadvantaged. “People are in need of food, no matter what the weather,” says Reynold Agard, M.D., who also went on medical missions to Haiti with other volunteers from Christiana Care. The group served its first meal in December 2009 and feeds about 150 people each week in a lot near the Sunday Breakfast Mission in Wilmington.
Promoting breast health to Latinas At Christiana Care, Latinas are learning about breast health and cancer screenings, essential information they can share with others as Promotoras—promoters of health education—to Delaware’s rapidly growing Hispanic community. “If you teach someone, then ask her to go talk to her family, her community, you raise awareness that cancer is not a death sentence,” says Nora Katurakes, RN, MSN, OCN, Christiana Care’s manager of Community Health Outreach and Education. At a workshop at the Helen F. Graham Cancer Center, Promotoras-in-training learned facts about breast health and the effectiveness of early detection and treatment in saving lives. Throughout the year, Christiana Care’s outreach staff works with Hispanics and people in other underserved communities to make health care more accessible. Among Hispanic women, breast cancer is the leading cause of cancer death, according to the American Cancer Society.
Raising awareness in communities Skin cancer is the most common of all cancers, with more than 2 million cases each year in the United States, according to the American Cancer Society. For 21 years, Christiana Care has been shedding light on the disease, offering free screenings in order to diagnose skin cancer early, when it is curable, and educating people so they can take steps to prevent the disease. The screenings, held at the Helen F. Graham Cancer Center, involve the entire body, including between the fingers and toes, soles of the feet, behind the ears and at the scalp. Christiana Care partners with the Delaware chapter of the American Academy of Dermatology for the event. Dermatologists volunteer their services. At the Black Expo at the Doubletree Hotel in Wilmington, Community Health Outreach and Education workers reached hundreds of people in a single day, providing blood pressure screenings and information on such vital topics as smoking cessation, diabetes wound care, self breast exams and HIV prevention.
“If you teach someone, then ask her to go talk to her family, her community, you raise awareness that cancer is not a death sentence.” — NORA KATURAKES, RN, MSN, OCN, MANAGER OF COMMUNITY HEALTH OUTREACH AND EDUCATION
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Excellence in women’s health
Building bridges to better care
Christiana Care is the only health care system in the region to earn the prestigious designation as a Community Center of Excellence in Women’s Health. The honor is based on:
Christiana Care’s Diversity & Inclusion Council is addressing the needs of an increasingly diverse population of patients and staff with workshops for doctors and other health care providers.
• Improving the health and wellbeing of women through community-based organizations.
At Christiana Care’s new Center for Diversity, Cultural Competency and Communications, interpreters and dual handset phones allow patients and health care providers to access interpreters at any hour in more than 150 languages. Most documents are available in Spanish, with translations planned for a number of other languages. And, Christiana Care has launched a Spanish language version of its website at http://es.christianacare.org/.
• Providing integrated, coordinated care with strong links to existing community programs. • Offering comprehensive care in a way that reduces fragmentation and recognizes the complexity of women’s lives. In addition, Christiana Care provides excellent clinical and preventative services, training for health care professionals, and public outreach and education.
‘Community Connections’ highlights screenings Christiana Care’s health screenings at local farmers markets were featured in the American Hospital Association’s “Community Connections,” a published collection of hospital programs benefitting communities across the nation.
COMMUNITY HEALTH SCREENINGS
Pioneering patient radiation exposure scores Christiana Care has implemented a software scanning system that tracks radiation doses, providing an accurate estimate of the lifetime exposure that a patient has received in the Christiana Care system. That includes radiation exposure from CT scans, imaging performed in the Cath Lab, Nuclear Medicine, X-ray, ontra-operative fluoroscopy and other diagnostic exams. The program assigns a color-coded rating to let doctors know the relative exposure level that a patient has received in the past at Christiana Care. The patient’s radiation exposure score offers important information in weighing the risks and benefits of performing a radiological study.
The health screenings, from Christiana Care’s department of Community Health Outreach and Education, are one of just 24 highlighted initiatives under the category “Access and Coverage.” These programs “demonstrate the strong commitment hospitals have to ensuring that everyone gets the care they need regardless of their ability to pay,” says the publication.
Innovative flow helps SPEED up care Christiana Care is moving patients through the Emergency Department process with greater SPEED, thanks to the Synchronized Provider Evaluation and Efficient Disposal Project. SPEED teams a resident or physician assistant with three nurses: one for assessment, the next for treatment and the third for disposition, to synchronize the care process. As a result, patients wait less time to see a doctor, and receive diagnostic tests and test results more quickly. That facilitates a timely diagnosis, medication orders and treatment before patients are either released from the ED or admitted to the hospital. During inaugural testing, SPEED reduced the length of stay in the ED by 40 percent. 2 0 11 Ye a r i n Re v i e w
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Research and Education at Christiana Care CLINICAL, TRANSLATIONAL AND OUTCOMES RESEARCH with a national reputation.
CLINICAL & PHARMACEUTICAL RESEARCH STUDIES
“Research defines a means of transferring basic discoveries in the laboratory into new clinical interventions for the diagnosis, treatment, prognosis, or prevention of disease with a direct benefit to the patient. This idea forms the basis of our ‘Discovery to Recovery’ motto.” — CENTER FOR TRANSLATIONAL CANCER RESEARCH
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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 specialties and attracts the brightest and the best 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.
HIGHLIGHTS
Christiana Care approved as participating hospital in Delaware Branch Campus of Jefferson Medical College Christiana Care has been approved as a participating hospital in Jefferson Medical College’s Delaware Branch Campus. The approval comes from The Liaison Committee on Medical Education, the accrediting authority for medical education programs leading to the M.D. degree in U.S. and Canadian medical schools. Other participants are the duPont Hospital for Children and the Wilmington Veterans Administration Hospital. This achievement underscores the transformative role Christiana Care plays in medical education. It specifically spotlights our core competency in providing clinical education to third- and fourth-year medical students. Christiana Care has a long-standing relationship in providing first-rate medical education to students from Jefferson Medical College, one of the top-rated medical schools in the country.
Learning Institute embraces education The Learning Institute of Christiana Care, officially launched July 1, aims to engage and inspire creative education, advancing across the tapestry of a diverse health system with an overarching goal to learn better ways to deliver health care. It is a virtual institute that embraces collaboration and innovative learning, nurturing new ways of thinking and intelligent growth at all levels of the organization. The Learning Institute focuses on the capabilities and passions we all possess to derive the greatest benefit from our combined strengths. Distinct parts of the Learning Institute act as think tanks for research, development and best-practice educational products and services.
Christiana Care a model for translational research The chief scientific officer of the Association of American Medical Colleges says Christiana Care is a leader in linking research and education into the health system’s clinical care mission. Ann Bonham, a leading advocate for research training, has challenged America’s teaching hospitals to do a better job of translating research into clinical practice. She spoke on “The Role of Independent Academic Medical Centers in Translational and Clinical Research” at the John H. Ammon Medical Education Center. Eleven students who started their third year of medical education at Christiana Care in July comprise the inaugural class of the Delaware Branch Campus of Jefferson Medical College.
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H I G H L I G H T S of RESEARCH AND EDUCATION
Center for Outcomes Research evaluates Dr. Riesenberg authors care and cost to find best treatment most popular article The Christiana Care Center for Outcomes Research (CCOR) is a leader in comparative effectiveness research, identifying the best ways to treat patients at the most efficient cost. CCOR is one of only a handful of groups involved in the science of evaluating the consequences of health care delivery by comparing results of one form of therapy or treatment to another. “We look at different approaches to management, how we take care of people, not just comparing one pharmaceutical to another,” says William Weintraub, M.D., CCOR director and John H. Ammon Chair of Cardiology, noting that Christiana Care’s diverse population base of 1.2 million people in Delaware and the surrounding areas makes the health system ideally suited to these types of studies.
A groundbreaking review of communications during shift changes by a Christiana Care author was the mostdownloaded article in the American Journal of Medical Quality in 2009 and 2010, according to SAGE Publications, an independent international publisher of journals, books, and electronic media. Lee Ann Riesenberg, Ph.D., director of Medical Education/DIO and director Medical Education Research and Outcomes, was lead author of “Systematic Review of Handoff Mnemonics Literature.” Mnemonics are commonly used to enhance memory. In the case of handoffs, mnemonics may increase memory of important steps and provide a structured process to follow. Dr. Riesenberg also is the lead author of reviews focusing on effective communication during handoffs for nurses, residents and attending physicians.
VIRTUAL EDUCATION AND SIMULATION TRAINING CENTER
Simulated patients, real education At the Virtual Education and Simulation Training Center, doctors can gain a firm foundation in hand-to-eye coordination and repetitive skills exercises before they ever pick up a scalpel to operate on a real patient. Located at the John H. Ammon Medical Education Center, the VEST center includes a trauma bay, intensive care unit, operating room and standardized patient rooms. The patients are high-fidelity simulators that breathe, speak, blink their eyes and respond to stimuli like real adults and children. Doctors, nurses, emergency medical technicians and first responders such as police officers and firefighters obtain highly realistic hands-on training that will better equip them to deal with real-life emergencies. 22
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Ear pain responds to migraine treatment Many patients suffering from unexplained ear pain can be helped with migraine therapy, says Michael Teixido, M.D., an otolaryngologist and medical director of the Balance and Mobility Center at Christiana Care. Using rigorous scientific standards in analyzing the results, Dr. Teixido concluded that he had identified a new clinical entity called migraine-associated otalgia. His seven-year study, “Otalgia Associated With Migraine,” was published in the February issue of the journal Otology and Neurology.
CA N C E R & CA R D I OVA S C U L A R R E S E A R C H
Cancer and cardiovascular research broaden Research into the diagnostics and treatment of cardiovascular disease is expanding through a five-year, $17.4 million federal grant. The grant supports 15 projects, including cancer biomarkers and stem cell research, 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.
Study compares effectiveness of cardiac procedures The Christiana Care Center for Outcomes Research is sharing in a $4.026 million grant in a pioneering study that compares the effectiveness of catheter-based and surgery-based cardiac procedures. The American College of Cardiology, partnering with the Society of Thoracic Surgeons, received the grant from the National Heart, Lung and Blood Institute of the National Institutes of Health. The research, which compares data from more than 10 million patients, will help doctors to improve care for patients with coronary artery disease. The principal investigator is William Weintraub, M.D., CCOR director.
Advancing toward a better test for cancer genes People who are at higher genetic risk for colon cancer and other cancers could gain essential information as a result of a study at the Center for Translational Cancer Research at the Helen F. Graham Cancer Center. The study focuses on MSH2 and MLH1 genes, commonly known as mismatch repair genes. Four of five people with this gene develop cancer. The goal is to develop a cheaper, faster blood test to identify individuals who are at risk. Researchers are examining blood samples from patients in the Graham Cancer Center’s Familial Risk Assessment Program.
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 Cancer Center plays a vital role in the initiative, collecting, storing and sharing tissues and blood samples for research.
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H I G H L I G H T S of RESEARCH AND EDUCATION
W O M E N & C H I L D R E N ’ S H E A LT H
Pioneering research in fetal growth Christiana Care is expanding its groundbreaking research in fetal growth, adding expectant mothers of twins to its study of women age 18-40 of all ethnicities living above the poverty line. The data researchers gather will help to establish a national standard for fetal growth that will help doctors to better determine if babies are developing normally. Christiana Care was the first health system in the nation to enroll expectant mothers in the program and one of only six institutions in the United States selected for a $1.136 million grant from the National Institutes of Health. Christiana Care’s large, diverse population and proven track record in OB/GYN research make it an ideal choice for the project.
CHRISTIANA CARE WAS THE FIRST HEALTH SYSTEM IN THE NATION TO ENROLL EXPECTANT MOTHERS IN THE FETAL GROWTH PROGRAM
Delaware babies in national spotlight Christiana Care is one of 105 sites in the National Children’s Study, a dynamic initiative that is the largest long-term study ever of children’s health in the United States. Researchers hope to develop a clear snapshot of American children by following 100,000 youngsters from before birth through age 21. The government-funded study will help researchers to understand how genetics and the environment impact health and also could provide insights into such conditions as asthma, autism, mental illness and obesity. In New Castle County, researchers will study 1,000 babies. Christiana Care is working with Alfred I. du Pont Hospital for Children and the University of Delaware, in partnership with investigators at the Children’s Hospital of Philadelphia.
Christiana Care plays key role in reducing infant mortality Thanks, in part, to Christiana Care initiatives, the infant mortality rate in Delaware declined for the third consecutive reporting period, dropping to 8.4 deaths for every 1,000 live births, according to the Delaware Division of Public Health. Since 2007, Christiana Care has provided the hormone progesterone to obstetric care providers, which is highly effective in preventing premature labor. Through the Healthy Beginnings program, Christiana Care offers preconception and prenatal care to women who are at risk for multiple reasons, including high stress levels, chronic health conditions and living in high crime areas.
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Groundbreaking research on new moms Christiana Care plays an important role in a groundbreaking study of first-time mothers that will ultimately result in identifying problems sooner, and developing new strategies and interventions to help mothers and babies. Sponsored by the National Institute of Child Health and Human Development, the nuMoM2b Study focuses on understanding predictors and causes of adverse outcomes in women with their first pregnancies. The study will enroll 10,000 women across the United States, including 750 expectant moms at Christiana Care, one of the highest-volume hospitals for deliveries in the Mid-Atlantic region. About 40 percent of women who give birth are first-time mothers.
Alliance a collaborative vision The Delaware Health Sciences Alliance is forming dynamic partnerships, including a collaborative effort to gain global insights into ways to improve care for women and children. Nearly 300 people gathered at the DHSA Women & Children’s Health Research Conference at the University of Delaware, sponsored by the Alliance’s four member institutions: Christiana Care Health System, Nemours/A.I. du Pont Hospital for Children, Thomas Jefferson University and UD. “We view this as a visionary conference, born out of an exciting, collaborative effort,” said Richard J. Derman, M.D., chair of Obstetrics and Gynecology at Christiana Care. The alliance enables partner organizations to collaborate and conduct cutting-edge biomedical research, to improve the health of Delawareans through access to services in the region, and to educate the next generation of health care professionals.
Study links inductions and C-sections Women who have their labor induced are twice as likely to need Cesarean section, according to a study published in Obstetrics & Gynecology. The findings suggest that putting more limits on elective inductions would decrease the rate of C-sections, says Deborah Ehrenthal, M.D., of Christiana Care’s Departments of OB/GYN and Internal Medicine and the lead researcher in the study.
Landmark study on shoulder dystocia “We look to data to help us make better decisions.” — MATT HOFFMAN, M.D., MPH, DIRECTOR OF OB/GYN EDUCATION & RESEARCH
The largest study of its kind has shed new light on how obstetricians should manage shoulder dystocia, a rare but serious complication of childbirth. Data gathered from 132,098 births of babies delivered vaginally at term, including more than 15,000 at Christiana Hospital, indicate that doctors should deliver the posterior shoulder after they have tried two other widely accepted maneuvers for shoulder dystocia.
The study, funded by the National Institute of Child Health and Human Development, was published as the lead article in the June edition of the journal Obstetrics & Gynecology. “We look to data to help us make better decisions,” says Matt Hoffman, M.D., MPH, director of OB/GYN Education & Research and principal author of the study. “Christiana Care is helping to define and improve standards of care through large studies with the NICHD.”
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Achieving Excellence at Christiana Care AWARDS, RECOGNITION AND APPOINTMENTS affirm our commitment to patient care.
“Hospitals like these are ones you or those close to you should consider when the stakes are high. These are hospitals we call ‘high performers.’“ — US NEWS & WORLD REPORT
Giving our personal best Christiana Care’s many recognitions and honors are the sum total of individual efforts of people in the health system giving their best, each and every day, to provide the best in patient care. Christiana Care excels on many levels, as a quality health care provider, a caring voice in the community and a great place to work.
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AWA R D S A N D R E C O G N I T I O N
Best in the region ranking from U.S. News Christiana Care Health System ranked among the top hospitals in the region with high performance in 11 adult medical specialties in U.S. News & World Report’s 2011-12 Best Hospitals rankings. Of the 93 hospitals in the Philadelphia metropolitan area, Christiana Care ranked in the top 10, the only hospital in Delaware providing adult medical care to make the list. Christiana Care has received Best Hospital rankings from the magazine the past four years. The publication evaluates nearly 5,000 hospitals nationwide and includes only 3 percent in its rankings.
Joint Commission awards seal of approval Christiana Care Health Services received The Joint Commission’s Gold Seal of Approval, based on an unannounced on-site survey. The seal is proof of Christiana Care’s organizationwide dedication to providing quality care for its neighbors.
Christiana Care achieves Magnet® status for nursing Christiana Care Health System received Magnet recognition for excellence in nursing from the American Nurses Credentialing Center, joining an elite group of hospitals to achieve the highest level of recognition for sustained excellence in nursing care. Christiana Care is the only hospital in Delaware to achieve Magnet status; only 6 percent of U.S. hospitals have earned the honor.
Top 50 hospitals rating from Becker’s Christiana Care has been named one of the 50 best hospitals in America by Becker’s Hospital Review, a publication that covers business news and analysis of health care systems. In awarding the honor, Becker’s noted the health care systems launch of Computerized Provider Order Entry, its excellent bond rating and clinical outcomes.
ED system, IT ranked by Information Week Gold Seal for Center for Advanced Joint Replacement Christiana Care Health System’s Center for Advanced Joint Replacement has earned The Joint Commission’s Gold Seal of Approval™ for its total hip and knee replacement programs. The certification award recognizes Christiana Care’s compliance with The Joint Commission’s national state-ofthe-art standards for health care quality and safety in disease-specific care. Christiana Care is one of only 300 hospitals out of 8,000 in the U.S. to achieve total hip and knee replacement certification. In 2010, Christiana Care performed more than 2,000 total knee and hip replacements.
Christiana Care Wins Top Workplace Employer For the eighth consecutive year, the News Journal has named Christiana Care a Top Workplace employer, ranking the health system sixth in the large Workplace category and best in Career Opportunities. Only 50 companies made the best-place-to-work list this year.
Christiana Care’s use of large touch-screen monitors to better manage its emergency department's trauma rooms is one of “20 IT innovative ideas to steal” according to InformationWeek 500 magazine. The magazine also ranked Christiana Care 232 in the top 500 of North American enterprise IT. The publication annually shines a spotlight on IT innovation by identifying and recognizing business technology teams that have made a notable difference in how their companies do business.
Practice Greenhealth honors sustainability Both Christiana and Wilmington hospitals earned Partner for Change with Distinction Awards from Practice Greenhealth, an organization for health care institutions that are committed to sustainable, eco-friendly practices. Christiana Care’s waste reduction program has reduced regulated medical waste by more than 800,000 pounds; approximately 20 percent of solid waste is recycled. Christiana Care also purchases 40 percent of its electricity from a wind farm.
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AWA R D S A N D R E C O G N I T I O N
Consumer Choice Award winner For the 16th year in a row, Christiana Care was named the top health care provider of choice in Delaware based on a National Research Corporation survey of more than 250,000 households. Winning hospitals possess the best doctors, nurses and reputation and provide the best overall quality of care.
Family Medicine Center state’s first certified ‘medical home’ Christiana Care’s Family Medicine Center, with sites at Foulk Road and Wilmington Hospital Annex, is the first practice in Delaware—and one of fewer than 2,200 nationwide—to achieve designation as a Physician Practice Connections Patient-Centered Medical Home. To earn the honor, the FMC met key standards, including patient access, enhanced communications and charting tools used to track patients and organize clinical information.
Center of Excellence in Bariatric Surgery The American Society for Metabolic & Bariatric Surgery has designated Christiana Care as a Center for Excellence, based on a record of favorable outcomes in weight-loss surgery. The center also received accreditation as a Level I facility by the Bariatric Surgery Center Network Accreditation Program of the American College of Surgeons.
AHA gold award for fit and friendly Christiana Care has earned the Gold Level award in the American Heart Association’s Start! Fit-Friendly Companies program. Companies earn honors for being leaders in promoting exercise, healthy eating and wellness among employees.
APPOINTMENTS
Dr. Laskowski serves on COTH board 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 is a member of 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 board. He is a member of the Economic Advisory Council of the Federal Reserve Bank of Philadelphia.
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Dr. Petrelli provides leadership in cancer care Nicholas J. Petrelli, M.D., Bank of America endowed medical director of the Helen F. Graham Cancer Center, is a member of the National Cancer Institute Gastrointestinal Steering Committee that oversees and approves clinical trials in the United States for gastrointestinal cancers. Dr. Petrelli is also chair-elect of the Publications Committee of the American Society of Clinical Oncology and was appointed to the newly created position of Associate Director for Translational Research at the Wistar Institute Cancer Center.
Dr. Fulda chairs council Gerard Fulda, M.D., director of Christiana Care Surgical Critical Care and Surgical Research, has been named chair of the Council for Medical Specialty Societies’ Clinical Practice Guideline Developers Group.
APPOINTMENTS
Dr. Gardner receives Gilliam award Timothy J. Gardner, M.D., medical director of Christiana Care’s Center for Heart & Vascular Health, and past national president of the American Heart Association, is the recipient of the 2011 James H. Gilliam Jr. Memorial Award from the American Heart & Stroke Association. 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.
Dr. Nevin named CMO Janice E. Nevin, M.D., MPH, was named Chief Medical Officer for Christiana Care Health System. Dr. Nevin serves on the Westside Health Board and is chair of the Quality Subcommittee and a United Way Cabinet Member. She is on the Delaware Health Care Commission and was appointed to the Board of the Delaware Community Foundation. She delivered this year’s keynote address at the White Coat Ceremony at Jefferson Medical College in Philadelphia.
Dr. Granite reappointed to exam committee Edwin L. Granite, D.M.D., chair of the Department of Oral and Maxillofacial Surgery and Hospital Dentistry, was reappointed for a fourth year to the Examination Committee of the American Board of Oral and Maxillofacial Surgery. The Commission on Dental Accreditation of the American Dental Association also reappointed him as Commission Consultant.
Dr. Rizzo chairs lung association board
Dr. Galinat serves on AAOS committee
Dr. Dickson-Witmer vice chair of CoC task force
Brian Galinat, M.D., chair of the Department of Orthopedic Surgery, is a member of the American Orthopaedic Association. He also recently completed his six-year term as the Board of Councilors representative to the American Academy of Orthopaedic Surgeons. He continues to serve on the AAOS Coding, Coverage and Reimbursement Committee and is the AAOS alternate to the American Medical Association Resource-Based Relative Value Scale Update Committee.
Diana Dickson-Witmer, M.D., associate medical director of the Christiana Care Breast Center at the Helen F. Graham Cancer Center, serves as vice chair of the Standards Revision Task Force for the Commission on Cancer, charged with helping to establish the CoC’s new standards for cancer centers throughout 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.
Albert A. Rizzo, M.D., chief of the Section of Pulmonary and Critical Care Medicine at Christiana Care, was named the national volunteer chair of the American Lung Association board of directors.
Residents place in national competition Christiana Care’s Emergency/Internal Medicine residents took second place in the annual competition at the Society for Academic Emergency Medicine conference. This year’s event, “Sim Wars,” involved teams of residents competing on simulated patients to demonstrate communication and clinical management skills.
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APPOINTMENTS
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Wilderness fellowship for Linda Laskowski Jones
EM/IM chief resident receives national award
Linda Laskowski Jones, RN, MS, vice president of Emergency, Trauma and Aeromedical Services at Christiana Care, was awarded Fellowship status in the Academy of Wilderness Medicine (FAWM), a national recognition from the Wilderness Medical Society.
De B. Winter, M.D., 5th Year Emergency/Internal Medicine chief resident, is the winner of the national Emergency Medicine Residents Association Clinical Excellence Award for outstanding work in the clinical aspect of emergency medicine.
Maureen Seckel secretary of national board
Sue Sokira is a Jefferson honoree
Maureen Seckel, RN, a clinical nurse specialist in medical pulmonary critical care, has been appointed to serve a one-year term as secretary on the American Association of Critical-Care Nurses national board of directors. She is also serving a concurrent three-year term on the board of AACN until 2013.
Sue Sokira was honored at the national Jefferson Awards ceremony in Washington, D.C. The 2011 winner of the Christiana Care Jefferson Award for Outstanding Community Service, Sokira is a transfer center representative in the Emergent Transport Access Center and works as a firefighter and EMT.
Lynn C. Jones is VNAA chair Lynn C. Jones, FACHE, president of Christiana Care Visiting Nurse Association, began a two-year term as board chair of the Visiting Nurse Associations of America. He has been on the VNAA board for six years and has been chair of its Public Policy Council the past two years. He is a member of the American Hospital Association Post-Acute Governing Counsel and Regent for Delaware for the American College of Healthcare Executives.
Pharmacist Trent Beach named Baldrige Award examiner
Keith Lamb chairs AARC adult acute care section
Christiana Care Clinical Pharmacy Specialist Trent Beach, Pharm.D., MBA, MHA, has been named to the 2011 Board of Examiners for the Malcolm Baldrige National Quality Award, the highest level of national recognition for performance excellence that a U.S. organization can receive.
Keith D. Lamb, RRT, received a four-year appointment to chair the American Association for Respiratory Care Adult Acute Care Section, along with a seat on the AARC board of directors. Lamb also was appointed to a three-year term on the Multidisciplinary Adult Critical Care Knowledge Assessment Committee of the Society of Critical Care Medicine, responsible for editing and updating the study guide and exam that critical-care fellows take to evaluate their knowledge.
He also received the Healthcare Leadership Network of the Delaware Valley’s Administrative Achievement Award for his achievements in developing quality, performance improvement, accreditation and education around medication management and pharmacy practice.
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Service Statistics at Christiana Care VITAL TO THE LOCAL ECONOMY and the state of Delaware.
Our landmark transformation of Wilmington Hospital will enhance care and bring 600 jobs to the community.
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S E R V I C E S T A T I S T I C S at CHRISTIANA CARE
Christiana Care’s impact on Delaware Christiana Care employees paid more than $23.5 million in taxes to the State of Delaware. On average, a Christiana Care employee returns $100,640 to Delaware’s economy every year. ABOUT OUR VOLUNTEERS
1,206 Christiana Care volunteers gave a total of 90,800 hours of service this year. That translates into more than $1.9 million dollars.
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CHRISTIANA CARE HOME HEALTH AND COMMUNITY SERVICES
HOME HEALTH CARE VISITS 279,740 HIGH SCHOOL WELLNESS CENTERS AND ALZHEIMER’S DAY PROGRAM VISITS 39,471
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CENTER FOR ADVANCED JOINT REPLACEMENT AND CENTER FOR REHABILITATION
TOTAL KNEE AND HIP REPLACEMENTS 2,241 REHABILITATION PATIENTS 677
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TEMPLE UNIV. HOSPITAL
THOMAS JEFFERSON UNIV. HOSPITAL
COOPER UNIV. HOSPITAL
HOSPITAL OF THE UNIV. OF PENN.
CROZERCHESTER MEDICAL CENTER
CHRISTIANA CARE HEALTH SYSTEM
Source: American Association of Medical Colleges’Autumn 2010 Databook.
2011
WHERE CHRISTIANA CARE HEALTH SERVICES’ OPERATING DOLLAR GOES
1¢ for Other Affiliates
28¢ for Therapeutic & Diagnostic Services
3¢ for Administration
PERSONNEL STATISTICS
6¢ for Depreciation & Interest
CHRISTIANA CARE EMPLOYEES 10,477
1
$
MEDICAL-DENTAL STAFF 1,447 MEDICAL & DENTAL RESIDENTS & FELLOWS 255 RNS, LPNS AND PATIENT CARE TECHNICIANS 3,683
7¢ for Support Services
8¢ for Facilities & Services
24¢ for Nursing Services
15¢ for Employee Benefits
8¢ for Medical Education & Social Services
2 0 11 Ye a r i n Re v i e w
33
Christiana Care offers a wide range of health care services in Delaware and surrounding communities.
At a Glance ON THE C HRISTIA NA CA MPUS : • • • • •
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 WILM INGTON CA MPUS: • • • • •
Wilmington Hospital (241 beds) Wilmington Hospital Health Center Center for Advanced Joint Replacement Center for Rehabilitation Roxana Cannon Arsht Surgicenter
DE LAWA RE A ND THE C OM MUNITY: • • • • • • •
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 11 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.
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