FOCUS Information Technology develops new program to improve patient care
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magine an interactive computer program that gives you more accurate assessments of symptoms than a person-to-person interview, providing the best insight into how your patient is feeling. Insight, a new patient software program developed at Christiana Care, promises more accurate and detailed information from patients to health care providers. Research has shown that patients sometimes don’t reveal symptoms such as pain or depression to an interviewer. But when responding to 20 questions on a laptop computer or PC tablet, these same patients seem to overcome the anxiety that may cause them to give inaccurate, vague information during a live interview.
Inside Eliminating health care disparity
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General Surgery graduating residents share gender
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Trauma program is a national model of teamwork
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$1 million-gift for Wilmington campus expansion
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Swank Foundation gift will help build memory center 10 First Jefferson Award winner Caring for yourself Smoking relapse
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Mitchell Saltzberg, M.D., medical director of Christiana Care’s Heart Failure Program and Insight software clinical co-leader, shows a patient how to use the symptom self-assessment computer program .
What’s more, the information comes directly from the patient, not filtered through a doctor or a nurse, which can lead clinicians to downplay the importance of a symptom to a patient. Staff from Christiana Care Information Technology designed Insight for easy Gets better feedback on pain severity use in the waiting room. An immedi“Insight elicits symptoms from ate report printed to the physician’s patients not only in a yes-or-no way, work station makes it easy to review but also by letting them provide input all the indications and spend more on severity,” says Theresa Gillis, medtime with the patient on the more seriical director of Oncology ous symptoms. Rehabilitation Services and a specialist “The next visit, the patient repeats the in oncology pain and symptom management. “The patient might be asked symptom assessment and then the physician can compare the reports to about his or her pain intensity or shortness of breath, or fatigue intensi- get a sense of whether interventions ty, in the past week on a scale from 0- are helping or not,” says Dr. Gillis. 10. So you gather not only the presence of a symptom, but how severe that symptom is, and a sense of how important that is to the patient.
Mitchell Saltzberg, M.D., medical director of the Heart Failure Program, was co-leader along with Dr. Gillis of CONTINUED,
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we think this clinical tool will improve patient-to-provider reporting so we “The name ‘Insight’ really reflects what we’re trying to do,” Dr. Saltzberg can more accurately address their says. “Patients often do not report all problems. It creates a more meaningof their symptoms and concerns, and ful, more focused dialogue. The ability of the software to monitor trends in symptoms over time will provide another measure of clinical progress.” the clinical part of the project.
From left, John DiGiovanni, Catherine Burch and Mike Bledsoe led the IT efforts on the Insight software.
Few, if any, health care providers employ such software for clinical use, according to Drs. Gillis and Saltzberg. The Oncology and Heart Failure programs began using Insight in May, with the 20 questions tailored for the two types of patients.
ated the Insight program, say the sixmonth project included usability tests to ensure Theresa Gillis, M.D. patients felt comfortable with the computer. “We also had excellent support from other IT colleagues behind the scenes who helped configure the PC tablets,” Bledsoe says.
Mike Bledsoe, Catherine Burch and John DiGiovanni, the IT team who cre-
ACLS training center called ‘a national model’
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hristiana Care’s Adavanced Cardiac Life Support (ACLS) education program received a score of 100 percent in a recent reaccreditation evaluation by the American Heart Association Emergency Cardiovascular Care Program on May 18.
Virtual Education & Simulation Training Center officially opens Virtual Education & Simulation Training Center Medical Director Glen Tinkoff, M.D., (center, with scissors) and Chief Academic Officer Brian Little, M.D., Ph.D., (center, holding ribbon), officially opened Christiana Care’s new state-of-the-art facility. The training center offers a virtual environment where physicians,surgeons and other health care professionals learn basic to advanced skills practicing on high-tech mannequins that simulate the way humans react during a myriad of treatments.
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“The program is a model ACLS training center,” says ACLS national faculty reviewer, Claire Karis, RN, Ph.D. The ACLS training team, which includes Valerie SlobodaMague, coordinator, Chuck Fort, Nancy Blackburn, and Wilma Yu, has relocated to the recently opened Virtual Education & Simulation Training Center, on the ground floor of the John H. Ammond Medical Education Building.
Cross-cultural learning helps eliminate health care disparities
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n an ideal world, adhering to good principles of patient-centered care would lead to universally excellent health care. But the many differences in culture, language and beliefs among patients, health care providers and systems really create health care disparity. Alexander R. Green, M.D., MPH, associate director of the Disparities Solutions Center at Massachusetts General Hospital and assistant professor at Harvard Medical School, visited Christiana Care June 3 to conduct a physician workshop and general presentation on cross-cultural competency and ways of eliminating health care disparities. Not a black-and-white concept Dr. Green says cultural competency is not a black-and-white concept, but it is dynamic, evolving over the years. Initially, cultural competency meant treating every patient with respect and dignity, regardless of race, ethnicity, language spoken and other attributes that might lead to discrimination. “But, even with your heart in the right place, you couldn’t eliminate all disparities,” he says. Later, the definition became having a working knowledge of important customs, values and beliefs about health care. For example, when treating Muslim patients for diabetes, it helped to know the Islamic religious rules related to fasting during Ramadan. “But it is tough to know everything,” Dr. Green observes. Now, cross cultural competency is best understood as having the necessary skills to communicate well enough with any patient to understand customs, beliefs and other barriers to quality health care. Understanding is key Understanding why health care disparities exist is key to overcoming
those barriers that lead to the disparities, Dr. Green says. The reasons can be sorted into three groups, including patients, providers and systems, with some reasons listed in more than one group. Patient factors include: Language and financial barriers, low health care literacy, lack of trust in the medical system, and different beliefs or preferences about treatment. Provider factors include: Lack of awareness, ineffective means of communication, difficulty building trust, bias (both conscious and unconscious), and time limitations. System factors include: Poor data collection that makes systems unaware of disparities; quality improvement initiatives that fail to focus on the needs of disparity populations; systems that often lack services to amend barriers, such as
Rosa M. Colon-Kolacko, Ph.D., vice president System Learning, introduces Alexander R. Green, M.D., MPH.
skilled interpreters capable of translating nuances; and the fact that minorities receive care from lowest performers.
The ESFT Model
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he ESFT model developed at the Social and Environmental Factors Disparities Solutions Center at n How do you get your medications? Massachusetts General Hospital can be an n Are they difficult to afford? effective tool for helping health care n Do you have time to pick them up? providers understand and overcome barri- n How quickly do you get them? ers to quality health care.The model sug- n Do you have help getting them if gests questions health care providers can you need it? ask culturally diverse patients to help the Fears and Concerns providers learn what barriers prevent the patient from understanding a diagnosis and n Does this medication sound okay to you? adhering to a plan of care. n Are you concerned with the dosage? Explanatory Model - Health and Illness n Have you heard anything about this n What do you think caused medication? your problem? n Are you worried about side effects? n Why do you think it started? Therapeutic Contracting (Treatment) n How does it affect you? n Do you understand how to n What worries you most? take the mediation? n What kind of treatment do n Can you tell me how you'll take it? you think you should receive?
General Surgery Residency Program graduates all-female class
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his year’s graduating surgery residents are all exceptional doctors, and, for the first time at Christiana Care, all are women. “We were early in the curve in integrating women into the residency program,” says Frederick Giberson, M.D., FACS, program director of the General Surgery Residency Program. “I believe we were unique in having that all-female match in a large program.” Diana Dickson-Witmer, M.D., was the first female surgical resident, serving as chief resident in 1982 at what was then the Medical Center of Delaware. Today, she is associate medical director of the Christiana Care Breast Center at the Helen F. Graham Cancer Center.
“It was a real struggle for women when I was chief resident, so I am especially delighted to see an allfemale group of surgeons,” says Dr. Dickson-Witmer, who will host a graduation party for the residents on June 18. “These are wonderful, talented and dedicated, women.” The ranks of the residents include a physical therapist, a soccer player and a member of a team that developed a web-based system to improve resident sign-out. Two are mothers. They are: n Deanna Blanchard, M.D., who plans a career in general surgery. Dr. Blanchard is as focused on the soccer field as she is in the operating room. “She is an extremely grounded indi-
vidual with great clinical skills, who relates very well to patients,” Dr. Giberson says. n Nicole Fox, M.D., who will work in trauma/critical care. “She is a leader, a born organizer who is keenly aware of safety issues,” Dr. Giberson says. Dr. Fox, who also worked on the webbased sign-out system and other safety initiatives, holds a master’s degree in public health. n Kristie Halm, M.D., who will focus on general surgery. Before attending medical school, Dr. Halm worked as a physical therapist. “Because of her life experience, she brings a calmness and maturity to her work,” Dr. Giberson says. n Sherry Sixta, M.D., who will specialize in trauma/critical care. “In a word, enthusiasm,” Dr. Giberson says. “She wants to experience it all and take care of patients every waking minute.” n Kristine Widders, M.D., who will pursue a fellowship in breast surgery. “She and Nicole Fox are both mothers who have proven that you can pursue a very difficult program and still be a parent,” Dr. Giberson notes.
Currently, 50 percent of medical school graduates are women, according to the Association of American Medical Colleges. At Christiana Care, 48 percent of surgery residents are female, Dr. Giberson says.
The 2010 graduating class of General Surgery residents, from left, include Kristine Widders, M.D., Deanna Blanchard, M.D., Kristie Halm, M.D., Nicole Fox, M.D., and Sherry Sixta, M.D.
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“The faculty and this institution are supportive of women,” he says. “I am also proud of this group. They have worked hard and proved themselves.”
Dr. Dickson-Witmer leads Commission on Cancer task force
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iana Dickson-Witmer, M.D., associate medical director of the Christiana Care Breast Center at the Helen F. Graham Cancer Center, is vice chair of a task force charged with helping to establish the Commission on Cancer’s (CoC) new standards for cancer centers around the country. Commission member organizations include the American College of Surgeons, the American Cancer Society and the American Society of clinical Oncology. Improving survival rates and quality The task force is responsible for revising all 36 standards set by the CoC, a consortium of 50 organizations dedi-
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cated to improving survival rates and quality of care for people with cancer. Existing CoC standards cover organization of a cancer center, cancer conferences and quality review of cancer care, with an emphasis on multidisciplinary treatment and use of evidencebased guidelines. New standards will address the continuum of care—from prevention programs to palliative care and survivorship—at 1,500 participating cancer centers in the U.S. “There are some 13 million cancer survivors in America today. We need to address the needs of that group, as well as the needs of those newly diagnosed,” Dr. Dickson-Witmer says. “There is always a flurry of activity during active treatment, but when the treatment is finished, many patients feel a little lost, alone and frightened.” A plan in plain language Under the new standards, each patient will receive a Survivor Treatment Summary and Care Plan, which shows them, in language they understand, what cancer they have or had and at what stage, as well as details on the specific treatment they have undergone. The information also will include a plan of follow-up that is coordinated among multidisciplinary members of the treatment team. The work of revising the standards involves medical oncologists, radiologists, radiation oncologists, surgeons and a full multidisciplinary team, including genetic counselors, psychologists, social workers and researchers. “The plan should spell out exactly who they should expect to see, how often and for how many years,” Dr. Dickson-Witmer says. “It should outline any long-term effects of treatment for which they are at risk.”
Diana Dickson-Witmer, M.D.
Dr. Dickson-Witmer chaired the CoC Accreditation Committee for three years before becoming co-chair of the Standards Revision Task Force. “Diana has been instrumental in revising the criteria by which the Commission on Cancer accredited programs are evaluated,” says Stephen Edge, M.D., CoC chair. Two years in the making, the new standards are more relevant with an emphasis on simplicity and quality measurement. “As a physician, it has been a very rewarding effort because these standards will reach many more patients than I could ever see in my office in my lifetime,” Dr. Dickson-Witmer says. A final review of the standards takes place this summer. The standards will be introduced in 2011 and go into effect on Jan. 1, 2012.
Trauma Program is a national model for teamwork
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id you know that Christiana Care is a national model for collaboration between the Trauma Program and the Emergency Department in the initial care and resuscitation of the trauma patient? When trauma patients arrive at Christiana Hospital, the trauma team begins working with providers in the Emergency Department the moment the patient comes through the door. “From the nurses to the physicians to the administration, everything we do here is a team effort,” says Mark Cipolle, M.D., Ph.D., FACS, FCCM, medical director of the Trauma Program since 2008. Even after a trauma patient is stabilized and admitted beyond the ED, the Trauma Service remains engaged, caring for patients until they go home or begin rehabilitation.
Leading cause of death up to age 44 Trauma is the leading cause of death for people age 1-44, greater than cancer, heart disease and other illnesses.
three years. Christiana Hospital most recently qualified in December 2009. Soon afterward, Delaware redesignated Christiana Hospital as Level I.
As the only Level I trauma center between Philadelphia and Baltimore, Christiana Care saves lives every day by providing the highest quality of care for adult and pediatric patients.
Rising volume, aging population The Trauma Program experienced two major changes since the last ACS visit in November 2006:
Trauma surgeons and teams provide 24-hour, in-house coverage. Sub-specialists such as orthopedic surgeons and neurosurgeons are on call 24/7. Complementing the around-the-clock care providers are experts in addictions counseling, physical, occupational and speech therapy, pastoral care, care management and social work, plus an orthopedic trauma physician assistant. Becoming and remaining a Level I trauma center is part of a rigorous process involving the American College of Surgeons’ (ACS) Committee on Trauma and the State of Delaware. The ACS committee reverifies that Christiana Care provides all the necessary services of a Level I center every
Each year, Christiana Care hosts an awards event to show appreciation to those who contribute to team spirit of the Trauma Program. From left, Brian Pellini, M.D., Kim Schulenberg, Speech Therapy, Ethan Ross, M.D., Kathy Gallagher, RN, Neil Jansani, M.D., Jane Sutton, RN, Steve Johnson, M.D., Tammy Miller, RN, Mark Cipolle, M.D.,Josie Robinson, RN, and Darrin Ensinger, RN. Not shown: OR Surgical Tech Patty Robbins.
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n The volume of trauma cases has expanded dramatically, from 2,700 in 2006 to more than 3,600 last year. The nature of the injuries has shifted, as well, with falls now exceeding motor vehicle crashes as the leading cause of injury treated per year. “Our patient population is aging rapidly and that plays a major role in why falls now exceed motor vehicle accidents as the major reason for admission,” says Trauma Program Manager Joan Pirrung, RN, APRN-BC, MSN. n The team of Advanced Practice Nurses (APNs) on the Trauma team grew from six to eight. “The APNs are the frontline care providers for our trauma floor and intermediate care unit patients and also assist in coordinating discharge planning to home or rehab,” says Pirrung.
Other key members include the trauma educator, the registry staff, a performance improvement coordinator and an injury prevention coordinator. Christiana Care has a large catchment area, receiving patients from lower level trauma centers in Delaware as well as patients from Maryland, South Jersey and Chester County, Pa. These many services provide a deep well of resources for trauma patients, who at any time might require additional consultations.
Injury-prevention outreach is a key Level I component without a seatbelt or riding with someone who has been drinking. “One second, one bad decision, can change a life forever,” says Corrigan, the director of Think First Delaware, a chapter of the National Injury Prevention Foundation. More than 200 presentations This year there have been more than 200 Think First presentations at which Voices for Injury Prevention Speakers, or VIPS, talk about the devastating injuries that changed their lives. To gauge the effectiveness of the program, students are tested for attitudes and beliefs about the lasting consequences of spinal cord injuries before the presentations and again a month later. Virginia Corrigan, RN, MSN
“We’ve found that 55 percent of stuhe most effective remedy to trau- dents change their beliefs regarding the permanency of brain and spinal matic injuries is to prevent them cord injury and the importance of from ever happening, says Virginia Corrigan, RN, MSN, injury prevention safety behaviors, such as helmet and seat belt use,” Corrigan says. “The coordinator. program also helps our VIPS with It’s a message Christiana Care takes to their recovery, allowing them to disschools, community centers and senior cuss factors surrounding their injuries centers statewide. “It takes a commuand how it affects their lives.” nity’s effort and involvement for prevention efforts to be effective,” Corrigan says.
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Christiana Care also partners with the Office of Highway Safety to talk to parents and teens about staying safe on the roads, and with the U.S. Attorney’s Office to reach at-risk youths in programs designed to reduce violent behavior. Fall injuries prevention program To prevent falls, a water exercise program helps elderly women build strength and increase flexibility. Christiana Care also holds educational seminars for about 100 seniors each year on minimizing the risk of falls by maintaining clear, well-lighted hallways, wearing sturdy, properly fitting shoes and other fall prevention ideas. Trauma Program Medical Director Mark Cipolle, M.D., Ph.D., FACS, FCCM, says deaths from traumatic injuries typically occur at three different times: n
Immediately after the injury.
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Within hours after the injury.
n As a result of major organ failure while in the intensive care unit.
“There is only one way to address the first group—and that is prevention,” Dr. Cipolle says.
As a Level I trauma center, Christiana Care is required to offer outreach and preventive programs designed to educate people to avoid actions that lead to the traumatic injuries seen most frequently at Christiana Care hospitals. Reaches thousands of children The Think First Injury Prevention Program reaches more than 10,000 children and young people with the message that injury is preventable if you think first protect your body before engaging in risky behaviors, such as diving into shallow water, driving
To raise money and enhance awareness of injury prevention, the Trauma Service sponsors a Think First 5-K race each spring, In addition to supportive runners and Christiana Care employees, the race draws former trauma patients who compete by wheelchair and on foot.
After 50 years, Lillian Barnett still enjoys going the extra mile administrative services coordinator at Christiana Hospital, where she supervises forms clerks for the Nursing Department. Loves the teamwork “I greatly enjoy interacting with the vendors, the physicians and the nursing staff,” she says. “Every day, I feel as if I’ve helped someone.” Barnett is known for her upbeat personality, dedication to doing great work and willingness to go the extra mile.
Lillian Barnett
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n November 1959, Richard Nixon and John F. Kennedy were vying for the U.S. presidency. Bobby Darin’s “Mack the Knife” topped Billboard’s Hot 100 list. And 18-year-old Lillian Barnett began work as a nurse’s aide at Wilmington General Hospital. Today, Barnett is still hard at work at Christiana Care Health System, as an
“She is an amazing individual who consistently displays a positive attitude towards her job and the people with whom she works,” says Ruth Morse, RN, MSN, CEN, NE-BC, director, Nursing Resources. “She is committed to the success not only of her department but the entire organization.” In March, Barnett was honored at a celebration in her department. In keeping with her wishes, it was a quiet but joyous event.
Starts daily at 5 a.m. Then it was back to work as usual. Barnett is at her desk each day at 5 a.m. sharp, ready to take on whatever responsibilities the day brings. “She is truly a go-to person,” Morse says. “If there is anything that needs to be accomplished, from hanging a picture to ordering supplies, Lil knows how to get the job done.” Both Barnett and her husband Douglas have a long history of dedication to the health care system. Last year, Douglas Barnett, a service assistant in the operating room, retired after 49 years. Next year, the Barnetts will mark a combined century of service to Christiana Care. “I have no plans to retire, as long as my health is fine and my husband is well,” Barnett says. “After 50 years, I can say Christiana Care is a great place to work.”
Noted oral-maxillofacial surgeon returns to clinical roots
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ationally noted maxillofacial surgeon Eric J. Dierks, M.D., D.M.D., FACS, delivered the annual George A. Zurkow Lecture May 19 at the Ammon Medical Education Building. Dr. Dierks completed residency training in oralmaxillofacial surgery at Christiana Care in 1977 and is known for founding the first Fellowship in Head & Neck Oncologic Surgery in the U.S. that was available to graduates of oral and maxillofacial surgery residency. His Grand Rounds was titled “The Evolution of Maxillo-Mandibular Reconstruction: From Creative Beard Trimming to Computer-Guided Free Flaps.”
From left, Joel Reynolds, D.M.D., Samuel Nwogu, D.M.D., Greg Burns, D.M.D., Edwin L. Granite, D.M.D. (Department chair), Dr. Dierks (seated), Lawrence Giordano (Associate Program Director), and William Klein, D.M.D.
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$1 million gift boosts Wilmington campus expansion
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straZeneca presented a $1 million cornerstone gift for the transformation of Wilmington Hospital May 21. AstraZeneca President Rich Fante, speaking to about 100 people gathered atop the employee parking garage overlooking the construction, said “AstraZeneca is strongly committed to working with partners whose mission and interests align with our commitment to strengthening and improving the health of patients. Wilmington Hospital is an outstanding facility and critical health resource in our community. AstraZeneca takes pride in helping it grow.” Christiana Care Health System President and CEO Bob Laskowski, M.D., joined by U.S. Sen. Tom Carper, Gov. Jack Markell, U.S. Rep. Mike Castle and others at the announcement ceremony, accepted the gift. “For more than a century, Christiana Care and our Wilmington facility have built a tradition of caring for our neighbors when they are ill and helping them maintain their health when they are well,” Dr. Laskowski said. “With this gift Wilmington is set to become a modern, leading-edge hospital offering a full range of best-in-care preventive and wellness services. “Together we can ensure Delawareans receive the highest level of care and comfort across the broad spectrum of diverse medical needs for decades to come.” The new, three-story atrium in the center of the campus will be named in honor of AstraZeneca. Gov. Markell said “This gift and the
AstraZeneca President Rich Fante presented a check for $1 million to Christiana Care to help fund the transformation of Wilmington Campus. Robert J. Laskowski, M.D., Christiana Care President and CEO (right), accepted the gift on behalf of the health system. At left is Delaware Gov. Jack Markell.
expansion of the hospital will bring jobs to the city while building on the hard work that's already being done at the hospital for its patients. It represents an investment in the city and in the health and welfare of its citizens." The $210 million investment in the renovation of Wilmington campus continues our mission of building a healthy community for Wilmington and the surrounding region. The second-largest project in Christiana Care Health System’s history, it creates more than 2,000 construction jobs and will transform the hospital campus’ capacity, adding 337,000 square feet and creating a one million-square-foot, state-of-the-art medical center. When completed in 2012, the expan-
sion will upgrade and double the size of the Emergency Department, add a new surgical suite, including 13 operating rooms and four procedure rooms, and add capacity for 120 private patient rooms. The transformation will also include: A new intensive-care unit. An upgraded, 30-bed unit for the Center for Advanced Joint Replacement. n A nine-story tower. n A 51,000-square-foot, state-of-the-art medical office building. n A new main lobby entry repositioned on Jefferson Street. n An enclosed walkway to parking. n A tranquil atrium. n The Junior Board of Christiana Care healing garden. n n
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Gift will transform Alzheimer’s patient care
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cornerstone gift from the Howard W. Swank, Alma K. Swank and Richard Kemper Swank Foundation has created the Swank Memory Care Center at Christiana Care, a collaborative effort of the Departments of Medicine, Family Medicine and Psychiatry. The center will provide patients and caregivers with a "one stop" location for care with priority service when referrals are necessary.
sionals will include neurologists, psychiatrists, geriatricians, internists and family medicine physicians, as well as
To be located in an outpatient clinical care setting, the Swank Memory Care Center will have a single focus on patients with all types of memory loss. The interdisciplinary team of profes10
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a nurse and a social worker with extensive knowledge of community and regional resources.
gram coordinators.
Every 71 seconds, someone in America develops Alzheimer's disease. Anyone who has witnessed the effects of Alzheimer's and other forms of dementia knows how overwhelming the condition can be. Presently in Delaware, the integration of health care services, caregiver support, and education to treat memory loss is not available in one location. Delaware residents often face access barriers to receiving dedicated, multidisciplinary memory care.
The Swank Memory Care Center at Christiana Care has become a reality thanks to a recent cornerstone gift from the Howard W. Swank, Alma K. Swank and Richard Kemper Swank Foundation. Announcing the gift are, from left, Donald J. Franceschini, Trustee, Swank Foundation; Nancy N. Gale, Trustee, Swank Foundation; Robert J. Laskowski, M.D., President and CEO, Christiana Care; Denise D. Schwartz, Trustee, Swank Foundation; Edward M. Goldenberg, M.D., President, Swank Foundation; Patricia M. Curtin, M.D., Chief of Geriatric Medicine, Christiana Care; and Stephen T. Bruni, Trustee, Swank Foundation.
Sandy DelCoglin
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eneral Surgery Residency Program Coordinator Sandy DelCoglin has been selected president of the National Association of Residency Coordinators for Surgery. DelCoglin holds special certification for graduate medical education pro-
“As President of ARCS I will work diligently at being an effective leader,” DelCoglin says. “My peers on the committee are wonderful people and also share in the commitment of educating our members. Over the next 12 months we will work hard at planning a successful and educational spring meeting in Boston, which will incorporate discussions of the most important issues facing surgical residency education and coordinators. I would like to thank Department of Surgery Chair Michael Rhodes, M.D., Surgical Residency Program Director Frederick Giberson, M.D., and Christiana Care Health System, for affording me the opportunity and providing the support necessary to carry out my commitment as president.
Timothy Gardner, M.D., appointed to Astrazeneca Foundation Board of Trustees
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imothy J. Gardner, medical director of Christiana Care's Center for Heart & Vascular Health, was appointed to the AstraZeneca Foundation's Board of Trustees. Dr. Gardner, a graduate of Georgetown University Medical School, received his postgraduate training in surgery at Johns Hopkins.
He is a member of the American Heart Association's Science Advisory and Coordinating Committee and National Board of Directors. He is the immediate past president of the American Heart Association and has also served as the association's chief volunteer science and medical officer.
Timothy Gardner, M.D.
Physicians devoted 103 years to keeping neighbors heathy
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elebrating more than a century of combined service to Christiana Care and the people of our community, the Department of Medicine gave special recognition to three physicians who retired during the past year. The
Department’s first annual retirement salute, held at Grand Rounds, June 3, 2010, honored Philip Blatt, M.D., (28 years of service), Paul Pennock, M.D., (40 years of service) and Siamak Samii, M.D., (35 years of service).
From left, Virginia U. Collier, M.D., Hugh R. Sharp Jr. Chair of Medicine, Philip Blatt, M.D., Paul Pennock, M.D., Siamak Samii, M.D., and Vice Chair of Medicine Robert Dressler, M.D.
New moms find support, encouragement in Mother-Baby program
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hristiana Care Health System’s Mother-Baby Class celebrated 10 years in May. The Class began as a program helping health-care professionals assess for postpartum depression, encourage breastfeeding and ease the transition to parenting, says Maternal Child Educator Mindy Neff. Today, it has evolved from one course to three, fostering friendships among moms that have deepened and endured year after year. Relationships can last years “The was a godsend for me,” says Monica Glick, who attended the reunion celebration with her three children, ages 4, 2-½ and 3 months. “I was a first-time mom when I enrolled in the class. My son cried a lot and it was hard to get any sleep. It was so helpful to see that others were going through the same thing.” Four years later several of the moms in Glick’s class still get together every Monday. Program helps navigate changes Mother-Baby 1, for moms of newborns, works primarily as a support group for the mothers. “It helps us to reinforce that the postpartum period is a time of adjustment when the parents are changing from a couple to a family and the mom might be undergoing career changes,” says Sheila Hobson, Parent Education manager. Mother-Baby 2, for moms of 3- to 6month-olds, and Mother-Baby 3, for moms of 6- to 9-month-olds, focus more on child development. The reunion brought together moms,
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kids and educators from several different classes. It also served to introduce the program to a prenatal group from Bayard House, a Catholic Charities program for homeless pregnant teens. “These young women can see that Christiana Care is a home-like place that offers them support,” says Karen Bastianelli, maternal child educator.
Maternal child educators Mindy Neff (top right in salmon sweater) and Karen Bastianelli (left,in floral shirt), hosted a reunion, inviting moms and children who have participated in Christiana Care Mother-Baby classes.
Focus on Excellence – Advance Directive - Best Practice Review Consistent with our strategies for engaging staff in continuous improvement and best practices, we regularly review important topics in Focus to help reinforce safe-practice behaviors. These tips reinforce information and enable staff to better articulate our safety practices during an unannounced survey.
Advance Directive Q. What is an Advance Directive? A. An Advance Directive is a legal document allowing an adult person 18 years of age and older to give direction about future care and to designate another person(s) to make medical decisions if the individual loses decision making capacity. Q. What are the nurse’s responsibilities related to advance directives for inpatients? A. The Nurse is responsible to: n
Complete the anatomical gift status advance directive form for each patient 18 years of age or older.
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Provide a copy of the “What is an advance directive?” flyer, even if the patient has an advance directive.
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Ask the patient to bring the most recent copy of their advance directive to the hospital if applicable.
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Provide additional information and resources upon request.
Q. What additional resources are available Regarding Advance Directives? A. Patients seeking more information can be offered the following: n
“Planning Your Health Care Choices – Advance Directives” brochure
“Advance Directives - Partners in Care” video located on Wilmington Hospital patient TV channel, and on the GetWell Network at Christiana Hospital. n
Assistance from the Patient Relations Department, Pastoral Services, Department of Social Service, Ethics Committee, The Delaware Division of Social Services for Aging and Adults with Physical Disabilities, the Pain and Palliative Care Consult Service and / or the patient’s physician. n
To ask questions, contact the content experts: Barbara Bramble 733-1131 or Donna Casey 428-2707. To reach the Safety Hotline, call SAFE (7233) from within Christiana or Wilmington hospitals. From outside the hospitals, call 302-623-SAFE. Further information is available on the portals in the Archives of Best Practices. From your portal, choose Focus on Excellence, Joint Commission Readiness, Ongoing Strategies, Educational Strategies, Monthly Q&A.
Formulary update FORMULARY ADDITION Medication – Generic/Brand Name Strength/Size Use/Indication C1 esterase inhibitor, human / Berinert 500 units per vial Treatment of acute attacks of hereditary angioedema REVISED CCHS MEDICATION POLICY Policy on ordering acetate content of and Prescribers must specify the actual amount of acetate (in milliequivalents) to be added to volume of TPN admixtures a total parenteral nutrition (TPN) admixture and the total volume of the admixture (in milliliters) when ordering TPN. It is unacceptable to order ‘maximum concentration’, ‘minimum volume,’ or ‘max’ within any order detail field. There is a link to the CPOE TPN care set instructions on the physician CCHS intranet portal. The instructions include a description of how the amount of acetate and the total volume are calculated. FORMULARY DELETIONS Dextrose 10% injection, 5-mL ampuls Removed from formulary because it is no longer manufactured Codeine phosphate injection Removed from formulary because it is no longer manufactured Ethiodized oil 37% injection Removed from formulary because it is no longer manufactured Tretinoin 0.05% solution Removed from formulary because it is no longer manufactured. The cream and gel are still available.
Christiana Care honored for environmental stewardship
Townsley appointed vice president
Judy Townsley, MSN, RN, CPAN
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udy Townsley, MSN, RN, CPAN, has been appointed vice president of Clinical Operations and Perioperative Services.
Standing, from left, Jason Funyak, Bob Mulrooney, Jill Karpinski and Sandra Reddy. Kneeling, from left, Marcus Suhr and Jeff Krebs
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hristiana and Wilmington hospitals both received the Partners for Change with Distinction award in recognition of Christiana Care’s comprehensive environmental stewardship program and leadership role in both the community and health care sector. Since the inception of program, Christiana Care has achieved:
n A 50 percent reduction in regulated medical waste.
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n An 80 percent reduction in air emissions from the power plants. n
A 15 percent hike in recycling.
What’s more, Christiana Care now buys 40 percent of its electricity from a wind farm in Pennsylvania. In addition, the Environmental Stewardship Committee, in cooperation with the Delawares Nurses Association, hosted two medicine cabinet clean-out events for the community within the past year.
Promoted from director of Clinical Operations for Perioperative Services, Townsley began her career at Christiana Care in 1977. She previously served as a nurse manager in PACU at Christiana Hospital. She currently serves on the Advisory Board for OR Managers. She received her BSN and MSN degrees, with a focus on health promotion and wellness, from Wesley College. Townsley has presented at a number of national forums and is a leadership sponsor for the implementation of team training in Perioperative Services. Under her leadership, Perioperative Services has improved teamwork coordination, quality and effectiveness. Her new title recognizes her great leadership and the vital importance of her role in Perioperative Services.
Publishing, Presenting, Appointments, Awards
Sue Sokira is first to win Jefferson Award at Christiana Care
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o underscore our support of community service, Christiana Care has launched the Jefferson Awards program. Each month the program spotlights an outstanding employee or volunteer for providing exemplary community services during off-duty time.
family and raises funds for supplies for our men and women in the military. She also persuaded the Cranston Heights Fire Company to donate a used vehicle to a local family in need. Sokira says she “was humbled” by receiving the award. “I feel as if I don’t do anything more than anyone else does for his or her community.”
Fundraiser, firefighter, EMT Sue Sokira, a Transfer Center Representative in the Emergent Transport Access Center at Christiana Care, is the first to win the Jefferson Award bronze medallion. Sokira, a volunteer firefighter and EMT, additionally raises money each year for the March of Dimes and for several 5Ks, including the “Tunnel to Towers,” a run in memory of a New York City firefighter. During the holidays, she adopts a
Eligible to win national award The Jefferson Awards is a national program started in 1972 by Jacqueline Kennedy Onassis, U.S. Sen. Robert Taft Jr. and Sam Beard as a call-toaction for volunteers in local communities. Monthly winners are eligible for national consideration by the Jefferson Awards for Public Service. Sue Sokira
Estelle Whitney, M.D., joins Christiana Care Health System
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stelle Whitney, M.D., long an advocate for women’s health education, has joined Christiana Care, a Center for Excellence in Women’s Health.
in the family benefit, too, physically, emotionally and spiritually.” The mother of two daughters, Dr. Whitney is a well-known public speaker and an advocate for empowering girls and women.
Her practice at the Medical Arts Pavilion 2 on Ogletown-Stanton Road in Newark focuses on gynecology, including peri-menopause, menopause and hormone replacement therapy. She is board certified in obstetrics and gynecology and holistic medicine, and brings a holistic perspective to her practice. “We talk about herbal medicine, lifestyle practices, visualization and other ways we can help patients to lead healthier lives,” she says. “We know that when women are more aware of their health the other people 16
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In addition to her work in the community in Delaware, she has volunteered for missions abroad, caring for people in Africa and the Caribbean. She recently returned from Haiti, where she worked with survivors of a devastating earthquake, many of whom have lacked medical treatment since the quake struck in January.
Estelle Whitney, M.D.
Dr. Whitney is a graduate of Howard University School of Medicine in Washington, D.C., and completed her residency at the Medical Center of Delaware, now Christiana Care.
After a smoking relapse, try, try again
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ou were fired up to quit smoking, stoked by the entreaties of people who love you and the knowledge that cigarettes can cause cancer. And then you started again. Perhaps you found a few cigarettes tucked away in a pack you left in an old jacket pocket. Maybe you asked a friend for a smoke. Or you might have impulsively bought a pack, telling yourself that it’s only one pack, not a carton. Quitting is difficult You might feel bad about backsliding, but the truth is that it is extremely difficult to quit smoking. Most people relapse. The statistics vary from study to study, from six attempts to eight tries to as many as 10 relapses before giving up tobacco for good.
relapse rate is about 1 percent each year.
your new life as a non-smoker. Think NOPE: Not One Puff Ever.
So, don’t hesitate to try, try again. The benefits of quitting are worth it. After a year without tobacco, a former smoker will have half the risk of heart attack as a non-smoker. Former smokers will notice other positive effects in their daily lives.
But you don’t have to count on willpower alone. Through Christiana Care, employees can receive free medications that will combat the cravings associated with quitting and significantly increase their odds of success. Face-to-face counseling also is available without charge.
You can look forward to a spring in your step—and a jingle in your pocket, as in the money you will save by not buying cigarettes. Start by programming your brain for
To learn more, contact Employee Health at 302-428-2285. Delaware also offers a toll-free Quitline. The number is 866-409-1858.
Relapses frequently occur in the first few weeks after giving up the habit, before the new habit of not smoking becomes engrained. In fact, many people start smoking again within 24 hours of vowing to stop smoking. That doesn’t mean they are weak. That doesn’t mean they are bad people. It is simply a reflection on the deeply addictive characteristics of nicotine, as well as the profound psychological bond that forms between smokers and their habit. Most important, one relapse—or two or three relapses—doesn’t mean you won’t succeed eventually. It just means you haven’t gotten there yet. Here’s the good news. People who go two years without smoking have a better than 80 percent chance of remaining smoke free for the rest of their lives, according to a study published in Nicotine & Tobacco Research. After 10 years of abstaining, the
Statistics vary from study to study, but people who quit smoking can expect to try from six to eight times and have as many as 10 relapses before giving up tobacco for good.
Robert J. Laskowski, M.D., named citizen of the year
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he Boy Scouts of America, Delmarva Council, honored Christiana Care President and CEO Robert J. Laskowski, M.D., as Citizen of the Year at the scouts’ 6th Annual award dinner June 1 at the Hotel du Pont in Wilmington.
A member of Boy Scout Troop 50 fixes a clasp on a scout uniform neckerchief to be worn by Dr. Laskowski during the June 1 Citizen of the Year Award Dinner.
In recognizing Dr. Laskowski, the Council cited his service as chair of the Delaware Public Policy Institute Board of Trustees, membership on the board of directors and executive committee of Wilmington Renaissance Corp., membership in the First State Innovation board, the University of Delaware Lerner College of Business and Economics college advisory board, and many other roles he plays as a citizen of Delaware and community and business leader.
Sen. Carper addresses combined Cardiology and Perioperative and Grand Rounds
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.S. Sen. Tom Carper of Delaware visited Christiana Care June 2 to talk about the passage of the Patient Protection and Affordable Care Act of 2010. More than 200 attended the Combined Cardiology and Perioperative Grand Rounds at the John H. Ammon Medical Education Building to hear Sen. Carper’s views on the new law.
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Monte Carlo Lucky 7 Night nets $177,000 for Cancer Research and Special Needs Fund Co-chairs and honorary co-chairs joined Nicholas J. Petrelli, M.D., Bank of America endowed medical director of the Helen F. Graham Cancer Center, to celebrate just before the doors opened at the Hotel du Pont Gold Ballroom.
More than 300 friends of the Helen F. Graham Cancer Center raised $177,000 in support of the Center for Translational Cancer Research and the Cancer Special Needs Fund at the 7th annual Evening in Monte Carlo on Friday, May 14.
Audience fills Ammon Center auditorium for heart health event
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capacity audience attended a special eveningwith a panel of Christiana Care heart and vascular specialists May 25 at the John H. Ammon Medical Education Center. Timothy Gardner, M.D., medical director of the Center for Heart & Vascular Health, moderated the panel including
From left, Timothy Gardner, M.D., Mark Garcia, MD., Brian Sarter, M.D., and Edward Goldenberg, M.D.