Focus: September 29, 2010

FOCUS Christiana Care pursues national safe patient handling distinction

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he PEEPS Injury Prevention team and the Department of Nursing this fall will submit Christiana Care’s application for the American Nurses Association (ANA) Handle with Care recognition award.

equipment, but ongoing education in safe patient handling, the system launched a six-month educational pilot in 2000 to help address a high rate of LTIs caused by patient handling duties.

The prestigious award would draw attention to Christiana Care’s leadership in safe patient handling and employee injury prevention. Success will make Christiana Care hospitals among the first in the nation to be rigorously rated on safe patient handling initiatives.

Selected as beta testing sites Based on Christiana Care’s advanced progress in its safe patient handling program, representatives from the ANA decided to visit Christiana Care during the summer of 2008 to observe the PEEPS training and education program first-hand and to view our ceil-

Like Magnet, the ANA Handle with Care program involves both extensive documentation (separate applications for both Christiana and Wilmington hospitals) and site surveys anticipated in late fall or winter.

Inside CPOE launch in EDs

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Patient praise for CyberKnife 4 IHI adopts Christiana Care teaching module

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Jennifer LeComte, D.O., wins Schubiner Award

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Photos: 2010 Wilmington START! Heart Walk

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BIG Therapy helps Parkinson’s patients

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Christiana Care, YMCAs co-sponsor sports injury prevention lecture series

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Christiana Care’s commitment to addressing losttime injuries (LTIs) due to repositioning and transferring patients dates back to the 1990 purchase of the first portable patient transfer devices.

Recognizing that a successful injury prevention program required not just

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Ceiling-mounted lifts, first installed at Christiana Care in 2002, now number more than 725 systemwide. The equipment is now standard for new construction at all Christiana Care facilities.

Thanks to a 10-year partnership between Nursing and PEEPS, losttime injuries for employees related to patient handling has decreased by 85 percent.

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ing mounted lifts and other equipment in action. As a result, Christiana and Wilmington were selected as two of five beta testing sites nationwide for the ANA Handle with Care recognition program. ANA used feedback provided by the PEEPS team during the beta test to craft the final application process we’re now working on today.

Lost-time injuries fell 85 percent The now decade-long partnership between Nursing and PEEPS has helped decrease LTIs related to patient handling by as much as 85 percent.

PEEPS training and education is specifically crafted for each unit. Unit PEEPS teams serve as “champions” for safe patient handling on their units. All new patient-care staff complete PEEPS training during new employee orientation and PEEPS is an integral part of Nursing and unit orientation (including the student nurse program). Safe patient handling skills are incorporated in annual Web-based education and are included in required competency demonstration for nurses and patient care providers.

The first lifts at Christiana Care were installed on 5 E/W and WICU in 2002.

Today, there are 729 lifts throughout Christiana Care facilities, in patient rooms, Radiology and other diagnostic testing areas, the Breast Center, Emergency Departments, the outdoor ambulance bay at Christiana and the morgue. A new operating room equipped for moving heavy patients having C-sections opened at Christiana Hospital this year. The widespread availability of ceiling mounted lifts throughout both campuses—in numbers unimaginable at many hospitals nationwide—is a unique feature of Christiana Care’s safe patient handling program.

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Wilmington Hospital's Center for Rehabilitation team surprised PEEPS/Injury Prevention Director Carys Price, PT, MS, (above, cutting the cake) with a celebration this summer marking PEEPS: A Decade of Care. (Check Flickr at www.christianacare.org to see who else is in this photo.)

Ceiling-mounted lifts now standard Ceiling-mounted lifts are now standard for new construction at all Christiana Care facilities and will be fully incorporated into the Wilmington Hospital transformation.

“Our goal was to simplify life for our staff through technology,” says CNO Diane Talarek, MA, RN, NE-BC. “We wanted to offer every possible safeguard against injury and make it easier for our Nursing staff to do their jobs. We now have the necessary equipment readily available.”

More than just equipment Talarek emphasizes that ceiling mounted lifts alone do not make a safe patient handling program, and credits the leadership and education provided by the PEEPS/Injury Prevention Program with bringing the initiative to life and helping reduce patient-handling-related LTIs. For all the news and announcements on our PEEPS teams, check the PEEPS homepage on your portal under Education.

P - Patient E - Environment E - Equipment P - Posture S - Safety The PEEPS acronym serves as an assessment tool to determine appropriate patient handling based on the patient’s dependency level, rather than patient weight.

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Emergency Department team gets ready for CPOE launch

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ach day brings a new challenge to our Emergency Department team.

The doctors, nurses, clerks and technicians on duty never know whether the next event will be a car crash, heart attack, hunting accident or some other emergency.

But here’s a challenge they can well anticipate:

Jones, RN, MS, ACNS-BC, CEN, vice president, Emergency, Trauma and Aeromedical Services. “That is why we are working very hard to structure the eMAR/CPOE system to expedite patient care. We have to have medications and get them to the patients right away.”

for those very sick patients,” Laskowski-Jones says.

Few hospitals using CPOE yet Christiana Care joined an elite group of health care systems with the introduction of CPOE earlier this year, first at Wilmington Hospital and then at Christiana Hospital.

In the EDs, the CPOE system has “ . . . We a r e u s e d t o d e a l i n g On Oct. 27, the EDs at both Christiana been modified to with something new ever y day Hospital and Wilmington Hospital permit most medwill launch computerized order entry in the Emergency Department. ications to be disand medication administration systems pensed without the C u l t u r a l l y, t h a t w i l l w o r k i n designed to reduce errors and enhance time-consuming o u r f a v o r.” patient safety. review and verificaPractice makes perfect tion process applied Charles L. Reese IV, M.D., Chair To prepare for the transformation, a in the rest of the Department of Emergency Medicine dedicated multi-disciplinary team is hospital. helping the ED staff build experience Nurses enter patient allergies on a Dr. Reese says those successful launchbefore the system goes live, using a computerized assessment sheet before es have helped to ease the way for the closed-loop, power chart environment medications are ordered. Through a latest initiative. “Plus, we are used to that simulates a random variety of hand-held barcode reading device, dealing with something new every day patient scenarios. eMAR enables a nurse to scan both the in the Emergency Department,” he Although there are always a few patient and the drug to make certain says. “Culturally, that will work in our bumps in the road, abundant prepara- the right patient is receiving the correct favor.” tion and cooperation in the ED will medication. help to smooth the transition, says Reduces risk of medication errors Terri Steinberg, M.D., MBA, chief “Implementation of CPOE and eMAR medical information officer. will transform the way we provide care The initiative has been a monumental to our patients in the ED by significantundertaking at two busy Emergency ly reducing the risk of medication and Department facilities. Wilmington order entry errors,” says Heather Hospital’s ED served 52,800 patients Farley, MD, FACEP, assistant chair, last year. More than 112,500 patients Department of Emergency Medicine. received emergency care at Christiana “Our multi-disciplinary implementaHospital—one of the highest-volume tion team has worked hard to ensure EDs in the United States. that electronic processes will not inhib“The Emergency Department at it time-critical actions for emergency Christiana Hospital is as big as many patients.”

Forces of Magnetism small hospitals,” says Charles L. Reese The ED will not become completely No. 3: Management Style IV, M.D., chair, Department of paperless. Orders for patients presentThe organization and nursing Emergency Medicine. Christiana ing with time-critical emergencies will leaders create an environment Hospital’s 65-bed ED typically treats continue to be processed by hand. supporting participation and 320-370 patients each day.

“We can’t get them medications fast direct-care nurse feedback.

“There is no limit to how many enough through CPOE, so we will conpatients we might have to treat at any tinue with the system that is in place given time,” says Linda Laskowski-

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Patient praises radiation oncology care, Cyberknife In August 2009, Myrle Bowe, a patient at Helen F. Graham Cancer Center, elected to have CyberKnife Robotic Radiosurgery to treat a brain tumor.

The following is her account and

be cancerous. It was positioned at the left side front of my head on the covering of the brain; it was neither invading the brain nor pressing on

“Do what you think is best, and we will support that.” The risk of waiting was the continued slow growth of the tumor which could effect vital functions and a remote possibility of

appreciation of her experience.

“ I c o u l d h ave h a d r a d i a t i o n i n P h i l a d e l p h i a o r B a l t i m o r e a t a ny o n e o f s e ve r a l t r e a t m e n t centers, but the more I learned about the Helen F. G r a h a m Ce n t e r a n d C y b e r k n i f e , t h e m o r e I w a s r e a s s u r e d t h a t t h i s w a s t h e r i g h t c h o i c e .”

– Editor

Myrle Bowe

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y robust life as a senior citizen included volunteering, visiting grandchildren, pursuing a second career and having fun . . . until a tumor appeared. For years, I had and ignored regular headaches. Then in late 2008, I mentioned a new, sharper headache to my primary care physician. He immediately referred me to neurosurgeon Kennedy Yalamanchili, M.D., of the Delaware Neurosurgical Group.

anything which would interfere with vital functions like vision, hearing or the pituitary gland. It was unclear whether the tumor was causing the occasional sharp head pain I felt.

seizures. Since my work involved a considerable amount of driving in Delaware and adjacent states, seizures were a major concern. The first option was not feasible. I had to do something.

I am rarely without a headache; they just varied in intensity. The new headaches added to my usual sinus, allergy, tension and migraine problems. I only used over-the-counter pain medications to get relief.

Since my previous experiences with anesthesia (delivering two babies) were not pleasant, surgery on my skull did not appeal to me.

From discussions with Dr. Yalamanchili and Internet research, I learned there are three treatment options, unless there's a drastic change: n Wait and see—put up with sharp headaches plus my usual migraines and do an MRI in a year.

CyberKnife I dithered for three months but eventually concluded that Cyberknife was my best treatment option. I could have had radiation in Philadelphia or Baltimore at any one of several treatment centers, but the more I learned about the Helen F. Graham Center and Cyberknife, the more I was reassured that this was the right choice.

From my first meeting with Karen n Have CyberKnife radiation now or Karchner, the CyberKnife care coordilater to destroy the tissue—but not know whether the tumor is cancerous. nator at the Helen F. Graham Cancer Center, through the succession of n Have conventional surgery and test appointments with radiologist Sunjay for cancer, maybe followed by antiseizure drugs, chemo, and aftereffects. Shah, M.D. and appointments with radiation therapists and other staff, the CT and MRI scans revealed a lump—a What to do? attitude of every person I met at the meningioma tumor the size of my My initial decision was wait and see cancer center communicated that in grandson’s Matchbox car. The good and ignore it as long as possible (stick addition to providing state-of-thenews was that this type of tumor my head in the sand). I had not said science treatment, my comfort and grows slowly and was very unlikely to much about it, even to family. I knew well-being were important. Wait-time their concern would come down to was always short, explanations about 4

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Leslie Verucci, APRN joins Radiation Oncology Department

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eslie C. Verucci, MSN, RN, CNS, CRNP, APRN-BC, has joined the Radiation Oncology Department at the Helen F. Graham Cancer Center.

She previously worked as a nursing educator of oncology nurses and nutrition support nurse within the Christiana Care Health System.

CyberKnife Robotic Radiosurgery is available at the Helen F. Graham Cancer Center.

procedures clear, and my questions treated with respect and a desire to have me understand the process.

Following a consultation with Dr. Shah, the next appointment was for shaping a mesh mask—called an Aquaplast—to the contours of my face (think fencing mask, except larger mesh). The fabric felt like a warm washcloth and stayed on till it dried and set. During treatment the mask would be clipped to the head frame on the treatment table to hold my head still.

After the necessary lab tests and another MRI, the CyberKnife procedure was scheduled for half-hour treatments on three consecutive mornings in mid-August 2009. Meanwhile, the neurosurgeon and Dr. Shah precisely mapped, or contoured, the tumor so that therapists could direct radiation to it alone.

For the treatment I was lying on a padded table with a light blanket over me and a safety belt fastened. The face mask neither interfered with watching beautiful scenes on a ceiling TV nor listening to the accompanied relaxing music.

Verucci is a 2001 graduate of the University of Delaware Masters in Nursing Program. She is certified as an adult health nurse practitioner and as a cardiopulmonary clinical nurse specialist. She also has a post-masters certificate in Family Medicine from the University of Delaware. She Leslie C. Verucci earned her undergraduate degree at Advanced Practice Council, a member Wilmington University. of the Legislative Committee and a She is a member of the Delaware member of the Professional Nurses Association (DNA) and serves Development Committee. as the DNA’s chairperson for the

From the next room the radiation therapists guided a space-age equipment arm to different positions around my head. If I had difficulty or discomfort with anything, I was assured that I only had to ask and they would stop to take care of it. There was no problem, no stress. Relaxation techniques I had learned put me into a dreamlike state.

but the smaller version will remain and will show on an MRI. Barring unforeseen events, I am to have an MRI in December 2010 and probably each year thereafter. No long-term effects are expected from the radiation.

I am extremely grateful to everyone at the Graham Center who helped me. I My daughter had taken me to the can- know there are many patients with cer center the day of the first treatment, in more serious conditions than I had, case I did not feel like driving home. and all I have talked to feel that there As it turned out, I had no ill effects at is no better source of treatment. We all. After tjat I drove myself to and are fortunate to have it in Delaware. from the cancer center.

For more information on CyberKnife Four months later, in December 2009, I Robotic Radiosurgery treatments at the had a follow-up MRI and an appointHelen F. Grahan Cancer Center, visit ment with Dr. Shah. The good news www.christianacare.org/cyberknife or call was that the tumor had stopped grow302-623-4836 ing. It is expected to shrink over time,

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Center for Heart & Vascular Health welcomes new doctors

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wealth of new physician talent, including two cardiac surgeons, a cardiologist, and an interventional radiologist, joined Christiana Care’s Center for Heart & Vascular Health in the summer of 2010.

n Cardiac surgeons Lenord Ray Kuretu, M.D., and Harsh Jain, M.D., started June 1 and July 1, respectively, as the newest members of Christiana Care Cardiac Surgery. Dr. Kuretu is practicing at Beebe Medical Center, Lewes, along with Fernando Garzia, M.D. Dr. Jain is working at Christiana Hospital along with Michael K. Banbury, M.D., FACS, W. Samuel Carpenter III Distinguished Chair of Cardiovascular Surgery, Ray A. Blackwell, M.D., and Hiep Nguyen, M.D.

Heather Horton, M.D., arrived July 1 to practice Cardiology at Christiana Care Cardiology of Southern Chester County, in West Grove, Pa. Dr. Horton joins Michael Duzy, D.O. n

Lenord Ray Kuretu, M.D., Cardiac Surgery, Beebe Medical Ctr.

Harsh Jain, M.D., Cardiac Surgery, Christiana Hospital

Heather Horton, M.D., Cardiology, Southern Chester County, Pa.

Mark Horvath, D.O. Interventional Radiology Christiana Hospital

n Interventional Radiologist Mark Horvath, D.O., became part of Christiana Care’s Radiology Department and Heart and Vascular Interventional Services team in July, joining Chief of Interventional Radiology Mark J. Garcia, M.D., and colleagues Daniel A. Leung, M.D., George Kimbiris, M.D., Michael A. Dignazio, M.D., Randall Ryan, M.D. and Stephen Zvonimir Grahovac, M.D.

Read about these surgeons and physicians and more about Christiana Care’s Center for Heart & Vascular Health at www.christianacare.org/heart.

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IHI adopts Christiana Care team analysis teaching modules Kits, then select Faculty Resources, then select “ACT Fishbone Introduction & Template.”

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collaborative effort involving Christiana Care’s Academic Affairs and Quality and Patient Safety teams, along with Thomas Jefferson University Clinical Skills Center and the Institute for Healthcare Improvement (IHI) has produced two outstanding quality improvement learning tools.

The tools, a fishbone video and PowerPoint presentation, demonstrate how team analysis can determine potential causes of an identified problem.

The Institute for Healthcare Improvement (IHI) has adopted this diagram as a teaching tool on its website, www.IHI.org.

“Our modules are featured in the IHI Patient Safety 104: Root Cause and Systems Analysis module,” says Lee Ann Riesenberg, Ph.D, RN, “They can be accessed from the director Medical Education Research Christiana Care portals. Go to the Medical Library home page and select Survival & Outcomes, Academic Affairs.

“Initially, members of Christiana Care’s Achieving Competency Today (ACT) facilitator team started developing the fishbone as a teaching tool for the ACT course participants,” says Brian Little, M.D., Ph.D., Christiana Care’s Chief Academic Officer. “It wasn’t long before the IHI Open School learned of our plans and saw it as a great instructional resource for their module that addresses Root Cause Analysis.”

“I love the video and PowerPoint slides! I’m impressed by their highquality production,” says IHI’s Deepa Ranganathan. “Fishbone diagrams are an important aspect of RCA.”

Focus on Excellence - 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.

Organ Donation Q. What is the process of identification and referral of a potential organ donor?

A. The process of identification and referral is as follows: Every patient will be asked upon admission if he has a donor card or designation on his Driver’s license. This is documented on the Anatomical Gift Status/Advance Directive Form. Absence of license, or other designation, does not create any presumption regarding the patient’s wishes regarding his anatomical gift status. For EVERY patient, at or near the time of imminent death, the nurse will contact The Gift of Life Donor Program (1-800-543-6391) to determine a patient’s suitability for eye, tissue, and/or organ donation. Imminent death is defined in Christiana Care Health System Policy: Organ, Tissue and Body Donation, Cadaveric. The nurse will contact the Gift of Life and notify the attending physician, HIMS and the Nursing coordinator.

Q. Where does the Nurse/OPO Representative document if the patient is determined not to be suitable for The Gift of Life Donor Program?

A. Even if the patient is determined not to be suitable for The Gift of Life Donor Program, the Nurse/OPO Representative will document this on the “Referral/Request for Anatomical Donation Form.”

Well-informed Caregivers and patients are the vital link in the safety chain to prevent errors

Welcome New Medical-Dental Staff Emergency Medicine David T. Cook, M.D. Department of Emergency Medicine Christiana Hospital, Room 1071 Phone: 302-733-1840 Daniel B. Cummings, M.D. Department of Emergency Medicine Christiana Hospital Phone: 302-733-1840 Jenna M. Fredette, M.D. Department of Emergency Medicine Christiana Hospital Phone: 302-733-1840

Family & Community Medicine Erin M. Kavanaugh, M.D. Family Medicine Center 1401 Foulk Road, Suite 100B Wilmington, DE 19803 Phone: 302-477-3300 Michael P. Rosenthal, M.D. Family Medicine Center 1400 N. Washington St., Suite 420 Wilmington, DE 19803 Phone: 302-428-6809 Hillel Wirsztel, M.D. 111 Continental Drive, Suite 406 Newark, DE 19713 Phone: 302-984-2577

Medicine/Cardiology Heather L. Horton, M.D., Ph.D CC Cardiology of Southern Chester Co. 1011 W. Baltimore Pike, Suite 304 West Grove, PA 19390 Phone: 610-869-1278

Medicine/Dermatology Matthew R. Hanson, M.D. 537 Stanton-Christiana Road, S-207 Newark, DE 19713 Phone: 302-633-7550

Medicine/Internal Medicine Andrew J. Abraham, M.D. 200 Hygeia Drive, Suite 2100 Newark, DE 19713 Phone: 302-623-0188

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Steven P. Greer, M.D. 131 Continental Drive, Suite 200 Newark, DE 19713 Phone: 302-366-1868

Sammy Bostaji, M.D. 4745 Ogletown-Stanton Rd, S-220 Newark, DE 19713 Phone: 302-368-5515

Sarah L. McTighe, D.O. Dept. of Medicine Residency Room 6A39, Christiana Hospital Phone: 302-733-6342

Obstetrics-Gynecology

Trong T. Trinh, M.D. 200 Hygeia Drive, Suite 2100 Newark, DE 19713 Phone: 302-623-0188 Erin E. Watson, M.D. Dept. of Medicine, Room 5A43 Christiana Hospital Phone: 302-733-6344

Medicine/Medicine/Pediatrics Nancy Fleurancois, M.D. 200 Hygeia Drive, Suite 2100 Newark, DE 19713 Phone: 302-623-0188 Elizabeth H. Muth, M.D. Christiana Care Hospitalist Partners 200 Hygeia Drive, Suite 2100 Newark, DE 19713 Phone: 302-623-0188 Adam M. Rudnick, M.D. Rockwood Family Medicine 2002 Foulk Road, Suites C&D Wilmington, DE 19810 Phone: 302-529-1975

Medicine/Neurology Jason M. Silversteen, D.O. Christiana Care Neurology Specialists 774 Christiana Road, Suite 201 Newark, DE 19713 Phone: 302-731-3017

Medicine/Pulmonary & Critical Care Medicine Marjan Bahador, M.D. eCare Telemedicine 200 Hygeia Drive, Suite 2470 Newark, DE 19713 Phone: 302-623-0600

Vanita D. Jain, M.D. 774 Christiana Rd, Suite 109 Newark, DE 19713 Phone: 302-731-0260 Julia L. Powell, M.D. 3706 Kennett Pike Wilmington, DE 19807 Phone: 302-623-6320 Emily K. Saks, M.D. Center for Uro-Gynecology & Pelvic Surgery MAP 2, Suite 1208 4735 Ogletown-Stanton Road Newark, DE 19713 Phone: 302-623-4055

Oral & Maxillofacial Surgery & Hospital Dentistry/Oral & Maxillofacial Surgery Daniel J. Meara, M.D., D.M.D. Dept. of Oral & Maxillofacial Surgery Wilmington Hospital Phone: 302-428-6555

Pediatrics/General Pediatrics Justin M. D’Antuono, M.D. Nemours Pediatrics 1400 Peoples Plaza, Suite 300 Newark, DE 19702 Phone: 302-836-7820 Francisco R. Vranic, M.D. duPont Peds at St. Francis 7th and Clayton streets, Suite 400 Wilmington, DE 19805 Phone: 302-421-9700

Pediatrics/Neonatology Ursula Guillen, M.D. MAP 1, Suite 217 4745 Ogletown-Stanton Road Newark, DE 19713 Phone: 302-733-2410

Pediatrics/Pediatric Cardiology Deepika Thacker, M.D. Nemours Cardiac Center 1600 Rockland Road Wilmington, DE 19803 Phone: 302-651-6600

Radiology Christopher A. DeMauro, M.D. 5936 Limestone Road, Suite 301 Hockessin, DE 19707 Phone: 302-234-5800 Mark D. Horvath, D.O. Department of Radiology HVIS, S-1E10 Christiana Hospital, Phone: 302-733-5625

Surgery/Cardiac Surgery Harsh Jain, M.D. Dept. of Surgery, Suite 1E50 4755 Ogletown-Stanton Road Newark, DE 19718 Phone: 302-733-1980

Surgery/Podiatric Surgical Service Travis J. Dwyer, D.P.M. 1010 North Bancroft Parkway Wilmington, DE 19805 Phone: 302-658-1129 Heather M. Rafal, D.P.M. Brandywine Podiatry 1010 N. Bancroft Parkway, S-12 Wilmington, DE 19805 Phone: 302-658-1129

Welcome urogynecologist Emily Saks, M.D.

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rogynecologist Emily Saks, M.D., has joined the Christiana Care Center for Urogynecology and Pelvic Surgery (teaming with Babak Vakili, M.D., and Howard B. Goldstein, M.D.).

Dr. Saks was raised in Central New Jersey and attended Rutgers College and UMDNJ-Robert Wood Johnson Medical School in New Brunswick.

In 2007, she completed a residency in Obstetrics and Gynecology at Pennsylvania Hospital in Philadelphia where she was recognized for excellence in minimally invasive surgery by the Society of Laparoendoscopic Surgeons.

Dr. Saks then joined the Hospital of the University of Pennsylvania to pursue a fellowship in Female Pelvic Medicine and Reconstructive Surgery.

During this time, she received funding from the National Institute of Health for the investigation of reproductive epidemiology and completed a Master of Science in Clinical Epidemiology at the University of Pennsylvania School of Medicine.

Emily Saks, M.D.

Dr. Saks has presented her original research at multiple national scientific meetings, published numerous articles in peer-reviewed journals, and has coauthored a book chapter.

To contact Dr. Saks, call the Center for Urogynecology and Pelvic Surgery at 302-623-4055

GET HELP WITH TOBACCO CESSATION

Christiana Care colleagues Bob Laskowski, M.D., president and CEO, (left) and Emily Irish, RN, pose for a post-race photo after the Sept. 19 Philly Half-Marathon. Emily’s sister Gerri Irish, a Christiana Care nurse anesthetist, took the photo and also ran in the race.

Daniel J. Meara, M.D., D.M.D., joins OMS faculty Director of Training,” says Edwin L. Granite, D.M.D., chair, program director and section chief of Christiana Care Health System’s Department of Oral and Maxillofacial Surgery. “He is a valuable addition to our Christiana Care academic faculty and greatly enhances our nationally fully accredited OMS educational programs,” Dr. Granite adds. “He is well-known in the field of OMS research and he is a principle investigator in numerous ongoing studies. He has authored many articles in peer-reviewed journals as well as textbook chapters, presentations and posters at national conferences.”

Daniel J. Meara, MS, M.D., D.M.D.

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ral & Maxillofacial Surgeon Daniel J. Meara, MS, M.D., D.M.D., has joined the faculty of Christiana Care Health System’s Oral and Maxillofacial Surgery Residency Program.

“Dr. Meara has assumed the full-time position of Residency Program

degree, in Economics, at the University of Notre Dame, his master’s degree, in Toxicology, from Michigan State University, and his medical degree from Wayne State University in Detroit. He spent research time at the National Institute of Health and has studied abroad in London (England), Melbourne (Australia), and Tokyo and Osaka (Japan).

Currently, Dr. Meara is a member of the American Cleft Palate-Craniofacial Association Education Committee.

Also, he was a member of the Mil Sonrisas and Smile Train medical missions to Juarez, Mexico, where he Dr. Meara joined Christiana Care after helped complete numerous cleft lip/palate repair procedures for chilcompleting a Craniomaxillofacial dren. Dr. Meara has both a medical Surgery Fellowship at West Virginia license and a dental license in the State University/Charleston Area Medical Center. Prior to that he completed Oral of Delaware and is accepting new patients. He has a broad scope of pracand Maxillofacial Surgery Residency tice with particular interest in facial at the University of Alabama, Birmingham, where he also completed trauma and reconstruction, cleft-craniofacial surgery and obstructive sleep a separate general surgery internship. apnea surgery.

Further, he previously completed an internal medicine internship at the University of Pittsburgh.

To contact Dr. Meara, call 302-4286458, or e-mail dmeara@christianacare.org.

Dr. Meara earned his bachelor’s

Medication – Generic/Brand Name

Strength/Size

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Lidocaine with Epinephrine injection

Lidocaine 2% with Epinephrine 1:100,000, 1.8 mL cartridge

Local anesthetic for dental procedures

who “super-duper tracked” him through to admission, and to the WACE unit who led him on the road to recovery. The entire multidisciplinary team was wonderful, especially y family and I would like to extend heartfelt appreciation to Medicine, Nursing, Respiratory Care, PT, Case Management, Social Work, everyone who cared for my father, John Connolly during his recent hospi- Food and Nutrition, and Environmental Services. Everyone's expertise, focus talization. Special thanks to W-ED

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on excellence, and caring was evident.

Seeing Christiana Care teamwork and patient/family-centered care in action was impressive, made me very proud of my colleagues, and most importantly, helped my father feel safe and confident in the care he received.

Andrea Rogers, MSN, CIC Infection Control Nurse

Jennifer LeComte, D.O., receives prestigious Med-Peds honor

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ennifer LeComte, D.O., received the Howard Schubiner Award, a prestigious honor offered by the National Med-Peds Residency Association.

patients and with colleagues in medicine and hospital coworkers, involvement in community activities, and contributions to the field of Medicine-Pediatrics.”

Dr. LeComte, a recent graduate of Christiana Care’s Medicine-Pediatrics Residency Program and current chief resident of pediatrics at duPont Hospital for Children, accepted the award Oct. 3 in San Francisco. The award is presented to a resident physician who makes extraordinary, lasting contributions to the organization’s success and/or Med-Peds at the local or state level.

“She has already been asked to speak to local and national organizations about her involvement in the transition of YASHCN from pediatric providers to adult providers. The transition from the pediatric medical world to the adult medical world is a stressful time for patients and their families.

Delaware would benefit from more providers like Dr. LeComte,” Dr. Friedland says.

“It is such an honor to receive this award," says Dr. LeComte. “I chose to train in internal medicine and pediatrics in order to be able to care for complex patients throughout a life span, recognizing that there would be many transitions. I am so excited that the leadership at A.I. DuPont Hospital for Children and Christiana Care Health System value the process of transition and have devoted resources to improve the process.”

Allen Friedland, M.D., FACP, FAAP, director of Christiana Care’s MedicinePediatrics Residency Program, who nominated Dr. LeComte, says, “She has helped to develop and create a pilot program medical home for some of the most vulnerable people in our community. Young adults with special health care needs (YASHCN) deserve intelligent and compassionate primary care physicians. They definitely get that with Jen.” According to the award’s namesake, Howard Schubiner, M.D., the honor goes to a resident who “exemplifies the highest standards for excellence in

Jennifer LeComte, D.O.

Med- Peds, including exemplary clinical care of patients, compassion and humanism in relationships with

Dr. LeComte is graduate of the Philadelphia College of Osteopathic Medicine.

hristiana Care Health System teams Snapshots: C continued their proud tradition of supporting the annual Wilmington Start!

2010 Wilmington Heart Walk, at the Wilmington on rainy Sept. 12, 2010.

START! Heart Walk Riverfront A total of 668 people—well ahead of their registration goal of 500 from Christiana Care—registered for the annual event to support cardiovascular research and education.

The total goal for the event was $240,000.

Final fundraising figures are still being tallied.

Check you next Focus for a START! Heart Walk update.

(Above) Timothy Gardner, M.D., immediate past president, American Heart Association, medical director for the Center for Heart and Vascular Health at Christiana Care.

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(Above, right) Ray A. Blackwell, M.D., honorary chair of the 2010 START! Heart Walk.

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Thinking BIG improves function for some Parkinson’s patients

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new physical therapy program, dubbed BIG, at Christiana Care is helping patients with Parkinson’s disease improve function and slow motor deterioration by retraining sensory, motor and cognitive functions through intensive exercise and patient empowerment.

“Even patients with slight deficits show measurable improvements within the first 50 minutes of BIG therapy,” says Jay Kogon, DPT, ATC, one of two Christiana Care therapists certified in the program.

Those principles that made LSVT LOUD an effective treatment for the speech motor system have now been successfully applied to the limb motor system.

Symptoms and treatment Parkinson's disease is characterized by muscle The BIG program is an adaptation for rigidity, tremor, a muscular disorders of the clinically slowing of physiproven Lee Silverman Voice Training cal movement (LSVT) LOUD method developed in (bradykinesia) 1987 to improve voice and speech in and increasingly smaller movement Jay Kogon, DPT, ATC, helps a patient individuals with Parkinson’s disease. (hypokinesia). Symptoms are the affected by Parkinson’s disease train to overresult of decreased stimulation of come functional losses using BIG therapy. the motor cortex by the basal ganglia, normally caused by dopamine “But the more my patients ‘Think produced in the brain. LSVT BIG BIG,’ the more confidently they move therapy includes repetitive, exagand the greater ability they have to gerated movements to increase transition and move safely in their dopamine production in the brain environment.” BIG is also effective and recalibrate muscle function. with other conditions including stroke, ‘Do what I do’ multiple sclerosis, cerebral palsy, and Therapists model the structured Down syndrome. movements while giving simple Start therapy early commands such as “do what I do” LSVT BIG protocols recommend incoror “move bigger.” This creates an automatic response in the patient’s porating therapy into treatment at the time of diagnosis, which “is a huge brain that results in larger, more paradigm shift for physicians and normalized movements by the therapists with patients who don’t patient. exhibit traditional therapy needs,” “Patients with Parkinson’s disease says Kogon. “Previously, therapy may shuffle, appear stooped over, focused on compensating for existing or struggle with transitions of deficits and helping patients maintain movement,” says Laurie Scott, current status.”

OTR/L, site manager at Springside For more information, call 302-429Plaza Rehabilitation Services, Laurie Scott, OTR/L, teaches therapeutic 6962 at Wilmington Hospital or 302-838BIG motions to a patient at Springside Plaza. where BIG therapy is becoming a big 4709 at Springside Plaza. hit.

Orthopedics partners with YMCAs to prevent sports injuries Surgeons to present injury prevention ideas at state YMCAs Christiana Care’s Department of Orthopedic Surgery, the Delaware Society of Orthopaedic Surgeons and the YMCA of Delaware will co-host a series of talks with orthopedic surgeons at Delaware YMCA branches throughout October.

The discussions will focus on preventing sports injuries in children and adults. Held on evenings and weekends, these talks, facilitated by an orthopedic surgeon from a local practice—will identify the source of overuse and crash injuries, explain treatment modalities and list prevention strategies.

Amateur and serious athletes of any age are encouraged to join the conversation and explore how they can prevent

problems before they happen.

Here’s a list of schedued events for this valuable STOP Sports Injuries series: n Tuesday, Oct. 5, 7 p.m., Michael Axe, M.D., Western YMCA, Kirkwood Highway. n Wednesday, Oct. 20, 7 p.m., Damian Andrisani, M.D., Brandywine YMCA, Concord Pike.

Wednesday, Oct. 20, 7 p.m., Mark Boytim, M.D., Sussex YMCA. n

Wednesday, Oct. 27, 7 p.m., Elliott Leitman, M.D., Central YMCA, Wilmington. n

Michael Axe, M.D., kicks off the Stop Sports Injuries lecture series Oct. 5 at the Western YMCA on Kirkwood Highway, Newark.

n Saturday, Nov. 6, noon, Randeep Kahlon, M.D., Bear-Glasgow YMCA

Register online at healthcare.christianacare.org/stopsportsinjuries or call 800-693-CARE (2273).

Center for Heart & Vascular Health Heart Failure Program Invites You to the

HEART FAILURE SUMMIT 2010

Friday, October 29, 2010 7 a.m. to 3:30 p.m.

John M. Clayton Hall University of Delaware Campus

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The Heart Failure Summit 2010 will be Friday, Oct. 29, at Clayton Hall on the University of Delaware Newark campus. Sign up on the education portal to receive credit. Cost is $50 for Christiana Care employees, who may be sponsored by their nursing unit. Contact Chris Friday to arrange a journal transfer at cfriday@christianacare.org. For more information, call Chris Friday at 733-1507.

Upcoming events n 3rd Annual Del Tech Run/Walk is Wednesday, Oct. 6 at 6 p.m. on the Wilmington Riverfront. All proceeds benefit Delaware Tech students in need.

Amenities include T-shirts and refreshments. The cost to enter is $18 until Oct. 4. After that the fee is $20. For more information or to register, visit the http://www.dtcc.edu/sw/alumni/5K.html. n

Helen F. Graham Cancer Center, Ste. 1400 (West Entrance). n Christiana Care celebrates Patientand Family-Centered Care Week Oct. 21-27, leading off with a national speaker, Juliette Schlucter, 11:30am12:30 p.m. and 2-3 p.m. Oct. 21 at Wilmington Hospital Conference Center, simulcast to Christiana Hospital.

Watch for a full schedule of events in the coming weeks. n The annual Books are Fun Book Fair is Thursday and Friday, Oct. 21-22 in the Trustees Room at Wilmington Hospital. Thursday hours are 9 a.m.-5 p.m. Friday open 7 a.m.-4 p.m. The book helps support Christiana Care Volunteer rograms

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n Join Christiana Care and the women in your community as we laugh, play and learn at our first ever free Girls Night Out event, Wednesday, Oct. 13, 5-8 p.m., at the Christiana Care Breast Center at the Helen F. Graham Cancer Cente. Enjoy complimentary food, music, gifts and raffles. The event featurs mini-lectures on cancer prevention and the role genetics plays in your future health. Bring a friend or loved one and get screened for breast cancer, heart and bone disease. Call 800-6932273 to register today.

Can’t make it to Girls Night Out? Be at the Breast Center Fall Festival, Tuesday, Oct. 19, 11 a.m.-1 p.m. at the

n A series of live webcasts from The College of Physicians of Philadelphia, in Room 1100 at Christiana Hospital, brought sponsored jointly by Christiana Care and the Delaware Academy of Medicine, covers historical and contemporary health and medical topics and is open to all: - Oct. 18, 6:30 p.m. “Dissection, Photographs of a Rite of Passage in American Medicine 1880-1930.”

- Oct. 19, 6 p.m., The Thomas W. Langfitt Lecture Series—Health Care Policy—Accountable Care Organizations.

Did you know that October is Breast Cancer Awareness Month?

- Friday, Oct. 8 is National Denim Day. Employees who donate $5 get to wear jeans that day. n

- Sunday, Oct. 10, is time for the American Cancer Society 2010 Making Strides Walk. Registration begins at 7 a.m., the walk at 10, in Wilmington’s Rodney Square.

- Friday, Oct. 15 is National Mammography Day. Visit the Christiana Care Breast Center to celebrate with morning mini-cupcakes and afternoon soft pretzels.

Flu vaccination campaign launches Oct. 11 To promote our culture of safety and wellness, Employee Health is offering free seasonal influenza vaccinations to all employees, M-D Staff and volunteers starting on Monday, Oct. 11.

This year’s vaccine includes the 2009 H1N1 strain so staff needs to receive only one vaccination.

The flu vaccine is highly recommended for all health care providers.

During the 2009/2010 season, Christiana Care achieved an 83 percent vaccination rate for seasonal vaccine (our highest ever) and a 57 percent rate for H1N1 vaccine. Our goal this year is to achieve at least 85 percent.

Vaccinations will be available in Employee Health at Wilmington and Christiana hospitals. For convenience, staff from Employee Health will also be stationed at several hospital locations to administer the vaccine. As in past campaigns, there will be arrangements for staff located off the hospital campuses to get the vaccination.

Employee Health is developing a flu vaccination administration schedule that includes weekends and off shifts.

It will be shared with managers and posted on all portals soon.

To better track vaccination rates and understand reasons for lack of vaccination, Christiana Care will be requesting that all employees complete a brief online vaccination/declination process later during the flu season. Look for more information on the portals as the flu season advances.

Automated kiosk provides pharmacy service round-the-clock

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he automated ScriptCenterTM, now operating in the main lobby at Christiana Hospital, offers pharmacy services around the clock.

Setting up an account at the new kiosk, or online at scriptcenter.com, makes getting prescription refills easy.

“The addition of the ScriptCenter enables the pharmacy to provide services beyond normal operating hours,” says Outpatient Pharmacy Manager Sebastian Hamilton. “Having a way to deliver prescriptions to our patients at their convenience will increase medication compliance and customer satisfaction.”

Getting a new prescription ordered or an existing one renewed still requires a provider’s written order.

But, once a refill or renewal is ordered, pickup is simple and quick, accessed with a user ID and PIN or optional fingerprint identification.

You can even collect prescriptions for family members. They need only order ahead of your pickup, and everything will be consolidated with your order. Any refills, except controlled substances or items that are oversized or must be refrigerated, can be picked up through ScriptCenter 24/7, for up to seven days. Prescriptions will be available for pickup within hours after an order is placed.