Focus: December 17, 2009 by ChristianaCare

FOCUS Christiana Care is first Delaware hospital to receive the U.S. EPA Trailblazer Award

hristiana Care became the first Delaware hospital to receive a Trailblazer Award for environmental leadership from the U.S. Environmental Protection Agency. The award recognizes hospitals in Delaware and Pennsylvania that are models for other hospitals and show leadership in a particular area of sustainability. Ten hospitals received the award. Fourth environmental award It is Christiana Care’s fourth environmental award in the past two years, following Making Medicine Mercury Free awards for Christiana and Wilmington hospitals in 2007 and 2009, and Practice Greenhealth’s Partner for Change Award this year. For the past three years, Christiana Care invested time and resources to

Clinical News Orthopedics becomes a department

New spinal anesthesia program

Navigational bronchoscopy

GetWellNetwork upgrades

reduce its environmental footprint. Recent successes include: n Negotiating a nine-year agreement to purchase 40 million kilowatt hours of electricity annually from the Iberdrola Renewables Locust Ridge II Wind Farm in Schuylkill and Columbia, Pa., counties. Beginning Jan. 1, 2010, the wind farm will provide clean, renewable power that will satisfy 30 to40 percent of Christiana Care’s electricity needs. n Cutting air emissions by 49 percent from fiscal year 2008 to fiscal 2009. n Recycling 1.4 million pounds of paper, cardboard, plastic, cans and bottles in 2009. n Reusing sharps containers, reducing plastics waste. n Reducing medical waste by 34 percent from fiscal year 2008.

General News Employee Engagement Q1

Tobacco cessation four-week counseling sessions start in January 17 Caught exercising!

Robert Mulrooney, vice president (right of center, holding the award), joined by 24 Christiana Care colleagues, accepted the EPA’s Trailblazer Award on behalf of our health system.

Christiana Care to found Orthopedics Department

hristiana Care’s Orthopedics Section will become a full-fledged Department of Orthopedics early next year. According to Brian Galinat, M.D., Orthopedics section chief in the Department of Surgery, becoming a department provides the necessary structure to advance bone and joint care for Delaware and our region. “Orthopedics is a highly active and successful section within the Department of Surgery,” he says. “The timing is right for this strategic step forward.” Success stories abound from all areas of orthopedics, including the Center for Advanced Joint Replacement, Orthopedic Trauma Service and Spine

Surgery Center of Excellence. “The quality of our programs and our talented, highly skilled orthopedic surgeons position us for potentially even greater achievement,” adds Dr. Galinat. “With support from Christiana Care and a new departmental organizational framework, the sky’s the limit.” The status change for Orthopedics means doing more, even better: Continuing to work across departments and specialties to shorten length of stay and improve outcomes. n

n Building on a successful joint replacement program to create programs in foot and ankle, upper extremity and sports medicine. n Strengthening relationships with private practitioners. n Promoting education as well as clinical and outcomes research.

Department status adds leverage

Many of the 51 orthopedic surgeons on Christiana Care’s Medical-Dental Staff roster are active educators. Shown above with Sen. Tom Carper (front row, red tie) are 15 of the surgeons who spoke at the annual Delaware Orthopedic Symposium in October.

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Department status for Orthopedics also adds leverage to partnerships such as the Delaware Health Science Alliance. As an Alliance member, Christiana Care collaborates with Thomas Jefferson University, the University of Delaware and the Alfred I. duPont Hospital for Children to advance education and research to improve health outcomes. With duPont Hospital, the Section is developing transitional pathways to adult care for patients with muscu-

loskeletal issues, and, with the University of Delaware, is seeking to broaden research activities in sports medicine and gait analysis. Potential exists for expanding opportunities in orthopedic clinical training at Christiana Care for Thomas Jefferson and other area institutions, and for more educational programming such as the highly successful Orthopedics symposiums. In the future, Dr. Galinat expects to see a clinical research program helping to evaluate the latest “orthobiologics”—injectables that help people with arthritis, cartilage damage and other conditions. “We won’t be doing the bench research, but we are a great clinical site for evaluating the comparative effectiveness of new techniques that come out of the lab.” The transition from section to department comes after 2-1/2 years of planning and leadership support from Department of Surgery Chair Michael Rhodes, M.D., Christiana Care orthopedic surgeons and members of the Medical Executive Committee. “Our mission as a department is to provide the highest-quality bone and joint care to the people in Delaware and neighboring states so they can lead active, healthy lifestyles,” says Dr. Galinat. “People in our region already know about our excellent clinical outcomes. They are going to hear a lot more from us.”

New spinal anesthesia program reduces wait time for patients

s baby boomers line up in increasing numbers at Christiana Care’s Center for Advanced Joint Replacement for new knees and hips, a change in anesthesia protocols is significantly decreasing their wait times. The new protocols add hours each day to surgeons’ available time in the OR and is boosting physician satisfaction. When the program began in 2007, doctors administered spinal anesthesia after patients arrived in the OR. Procedures could not begin until patients were fully anesthetized. Now, patients receive anesthesia before they go to the OR, so procedures can begin immediately. In 2007, for patients of orthopedic surgeons Alex Bodenstab, M.D., Steven Dellose, M.D., and Leo Raisis, M.D., time from arrival in the OR to the beginning of surgery was almost 11 minutes. Now that time has dropped to less than 30 seconds. More time for more procedures Since each surgeon does five to 10 cases a day, saving more than 10 minutes per case adds one to two hours a day to the time each surgeon can spend in the OR. For joint center surgeons as a whole, time savings are equally impressive— dropping 10 minutes per patient in 2007 to a wait time of just under 1.5 minutes. The impetus for the change came from the surgeons’ concern that as case loads increased, the center was running out of time and space. Dr. Bodenstab advocated for administering spinal anesthesia before the

patient came to the OR so surgeons could begin procedures as soon as patients arrived. Eugene Tolpin, M.D., Ph.D., clinical director of Anesthesia at Wilmington Hospital, took on the challenge. As a resident, he had seen that safely moving a patient under spinal anesthesia short distances was possible. And now, advances in electronic monitoring allow patients under spinal anesthesia to be safely transported longer distances. With the support of the nursing staff, the orthopedic surgeons, the Anesthesia Department and the administration, Dr. Tolpin set up a spinal induction room for two patients—with all the staff and equipment to meet the same safety and monitoring requirements as in the OR. “This project is another example of the great teamwork being done by the Center for Advanced Joint Replacement," says Janice E. Nevin, Eugene Tolpin, M.D., clinical director of Anesthesia at Wilmington Hospital (right), championed the new spinal induction room, where patients can receive anesthesia before they reach the OR, saving time and increasing physician satisfaction. Assisting Dr. Tolpin are Chris Azevedo, CRNA, center, and Joan Pratcher, PPCT 1.

M.D., MPH, senior vice president/executive director, Christiana Care - Wilmington Campus and Christiana Care’s associate chief medical officer. Anesthetized on stretchers in the induction room, patients are then transported under full monitoring to the OR. With excellent team coordination and communication, the patient enters the OR just as preparation for the surgery is complete, and patient positioning starts immediately. “We are doing more cases now in a given amount of time with the same number of staff and with no increase in costs,” says Dr. Tolpin. “And we maintain all safety standards for the patients. “ He credits the entire team with the success of the project. “You can’t do something like this unless everyone’s on board, unless you have a great teamworking relationship.”

CLINICAL NEWS

Pressure mapping clinic at Riverside improves wound healing results

hristiana Care’s Wound Care & Hyperbaric Medicine Center now offers pressure mapping services at its Riverside location. Previously available only at Christiana and Wilmington hospitals, the added service gives wound care patients the

tools they need to improve healing. According to Adrienne Abner, MBA, MSN, RN, NE, BC, CWS, LNC, director of the center, limited mobility and transportation issues often prevented wound care patients from accessing this important service. Consequently,

New Orthopedics Department offers more trauma training opportunities

roviding the only Level I trauma center between Baltimore and Philadelphia is one of Christiana Care’s best-known attributes. As such, we offer not only the highest level of trauma care, but the best place for our emergency, trauma and family medicine residents to learn from hands-on training. As the primary clinical education affiliate in Delaware for Jefferson Medical College, Philadelphia, we also provide a single rotation for a resident from Thomas Jefferson University Hospital of Orthopaedic Surgery, The Rothman Institute, in Philadelphia. It offers essential trauma experience in his or her fourth post-graduate year. Eric Johnson, M.D., head of Christiana Care’s Ortho-Trauma Service, says, “The volume and diversity of our cases and the quality of our orthopedic attendings rival just about any other national center. As many as 50 percent of the trauma patients we see have some orthopedic component to their injuries.” As Christiana Care moves toward establishing a full-fledged Orthopedics Department early in

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2010, more orthopedics residents will gain from the advantages of learning here. Seven more fourthyear orthopedic residents are enrolled in a new program rotating through Christiana Care during the academic year that ends June 30, 2010. “One thing that defines a department is a mission toward education and research,” says Brian Galinat, M.D., Christiana Care Orthopedics section chief. One of the first to participate in the new ortho-trauma clinical rotation at Christiana Care is Arjun Saxena, M.D., a fourth-year rotating orthopedics resident from Jefferson. “What’s different here from my previous training is the sheer volume of high energy, high-speed trauma cases,” he says. “Christiana Care is a busy hospital with a phenomenal system in place for treating these types of injuries— from the ER to the OR to the floors. “Everyone works to coordinate rapid and appropriate care in an environment that is very conducive to learning.”

patients often returned with new or reopened wounds several months to a year after being discharged. Bringing the clinic to an already familiar environment transforms care and improves outcomes. “Adding the pressure mapping clinic on-site completes the clinical pathway pressure ulcer patients need to successfully heal wounds and prevent recurrences,” says Abner. Patient compliance with referrals has jumped from 20 percent to 73 percent since the move. In addition, none of the patients who received pressure-reducing or pressure relieving surfaces as a result of the clinic’s assessment have reported new wounds. Pressure mapping identifies areas of the body at risk for wounds. Clinicians use the information to educate patients on proper pressure relief techniques, exercises and equipment to maintain skin stability. “Pressure ulcers can occur with as little as 15 minutes of unrelieved pressure, making proper seating and positioning vital to the healing process for patients who are unable to reposition or turn themselves,” says physical therapist Lissa Weigert, DPT, ATP. Twenty-five percent of the center’s patients receive treatment for pressure ulcers. The pressure mapping clinic is available the fourth Tuesday of each month at Riverside. For more information or to make a referral, call 302-765-4132.

Gerald O’Brien, M.D., pioneers image-guided navigational bronchoscopy technique

ulmonologist Gerald M. O’Brien, M.D., is helping to pioneer technology at Christiana Care that can spare many patients from having painful, invasive lung biopsies, help diagnose and determine the extent of diseases such as lung cancer to set the stage for future care and treatment. In traditional bronchoscopy, a thin, rigid tube is guided down the windpipe, but it can give access only to the central part of the lungs and not the perimeter, where two-thirds of tumors are located, Dr. O’Brien explains. But the new navigational bronchoscopy technology uses advanced imaging techniques and electromagnetic guidance to steer a thread-like probe through the complex of bronchial tubes directly to tumors, providing a virtual road map of the lungs that guides doctors to a tumor or other target.

Uses satellite technology The navigational system was developed by an Israeli entrepreneur who focused on inventions using satellite technology, such as global positioning systems. He soon realized that these highly specialized guidance systems could be used to help doctors navigate the complex passages in the lungs. When Dr. O’Brien introduced navigational bronchoscopy at Christiana Care a year and a half ago, he was the only physician performing the procedure in Delaware. “When I first saw it, I thought, ‘Why didn’t someone think of this before?’” Dr. O’Brien says. “We can use this procedure on patients who couldn’t withstand lung resections.

get to places in the lung and use a number of different techniques to help patients,” he says. Dr. O’Brien, director of Respiratory Care and Bronchoscopy and Interventional Pulmonary Medicine, performs about six navigational procedures a month at Christiana Care. He also collaborates with Thomas Bauer, M.D., chief of Thoracic Surgery, who also performs the procedure. Dr. O’Brien came to Christiana Care in 1999 from the Temple Lung Center, where he was medical director of the transplant program. He has been a leader in interventional procedures of the lungs for more than 20 years.

“We’ve just seen the tip of the iceberg in how we can use this procedure to

“We have been able to change a patient’s course of treatment in a number of cases,” Dr. O’Brien says. “For example, if lung cancer has spread to the lymph nodes, surgery may be avoided or postponed in favor of chemotherapy.” Some of the benefits of the navigational bronchoscopy include: Eliminating unnecessary surgeries. Patients learn quickly whether they have a malignancy or not and avoid the anxiety of watchful waiting. n

n Allowing physicians to biopsy lymph nodes that cannot be accessed by traditional bronchoscopy. n Enabling doctors to place markers that will guide CyberKnife, an intelligent robotic radiosurgery system that directs radiation beams to previously unreachable areas in the body with pinpoint accuracy, at the Helen F. Graham Cancer Center.

Gerald M. O’Brien, M.D., performs an image-guided navigational bronchoscopy procedure at Christiana Hospital.

CLINICAL NEWS

Tom Mueller, M.D., succeeds Lanny Edelsohn, M.D., as Neurology section chief Neurology Teaching Coordinator supervising hundreds of medical students as well as residents in medicine, family medicine and neurology, including his successor, Dr. Mueller. He remains in that post, while pursing current research projects in Parkinson’s and Alzheimer’s diseases. He continues to practice outpatient neurology as part of Christiana Care Neurology Specialists.

Lanny Edelsohn, M.D.

Thomas Mueller, M.D.

members of his section. Dr. Edelsohn has worked closely with Dr. Mueller in recent months to ensure a seamless transition in leadership and joins me in welcoming Dr. Mueller as the new section chief.”

fter 23 years of service to Christiana Care, Lanny Edelsohn, M.D., stepped down as chief of the Section of Neurology in December.

Thomas Mueller, M.D., currently medical director of the Sleep Lab and chief of Inpatient Neurology, is now section chief and a member of the Department of Medicine Executive Committee. “Please join me in thanking Dr. Edelsohn for the outstanding leadership he has provided his section,” says Virginia U. Collier, M.D., Hugh R. Sharp Chair of the Department of Medicine. “During more than 25 years as section chief, Dr. Edelsohn fostered the highest standards of clinical excellence in Neurology at Christiana Care. He developed popular clinical rotations for medical students and residents, and maintained close ties with the Jefferson Medical College Neurology Residency Program. He also supported life-long learning by developing a stimulating continuing medical education conference for 6

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During Dr. Edelsohn’s tenure as chief, Neurology experienced sustained growth in specialists and sub specialists as well as in the treatment of increasingly complex neurologic cases. As chairman of the Stroke Task Force in 2000, he guided the initial development of Christiana Care’s stroke program. His departure, he says, presents new opportunities for those younger in his specialty to take more responsibility for the future of neurologic care in the community. “It is time for new ideas and new blood to take a leadership role,” he says. A clinical professor of Neurology at Jefferson Medical College, Dr. Edelsohn honed the character of neurology education at Christiana Care as well. Since 1973, he has served as

Dr. Edelsohn was a member of the Christiana Care Board of Directors for 14 years, the Nominating Committee of the Board, the Board of Trustees and the Department of Medicine Executive Committee. He is a pastpresident of the Medical-Dental Staff (1994-1996), and served on Staff Council for 12 years, the Pharmacy & Therapeutics and Medical Ethics committees, the board of the Christiana Care Physician’s Organization, and numerous strategic planning and quality improvement committees. His community work includes membership on the boards of the Institute for the Study of Aging in New York, The Arc of Delaware, the Kutz Nursing Home, the Grand Opera House, and the Homes For Life Foundation, which he and his wife, Micki, established in 1999 to raise funds to build safe and comfortable homes for adults with intellectual/cognitive disabilities. To date, they have built and furnished 25 homes. Dr. Edelsohn plans to continue his volunteeer work—since keeping several balls in the area poses no problem. His hobby is juggling. You might even see him at a jugglers convention.

Service excellence is a team sport

linical services most rapidly come to mind when we think about the care our patients receive. However, the likelihood that patients will recommend Christiana Care services to others is influenced by every encounter that patients and their visitors experience—from the moment they call or arrive at our facilities until they leave. Contributions—no matter how small—from every employee help ensure the most positive experiences for our patients. The Nov. 5 issue of Focus listed everyday tips for caregivers that can create an atmosphere of warmth and welcome, including smiling and saying hello, offering to assist lost visitors and picking up trash to keep our environment clean and safe. Although not everyone has direct contact with patients, we all have an impact on the work of our colleagues and how our patients and their families perCeive us. Some indirect services that can affect our patient care include:

n Incomplete or inaccurate instrument sets sent to the OR.

Meals that are delivered with wrong or missing items (e.g., no drink or eating utensils). n

n Rude telephone conversations between departments, particularly when transferring patients from unit to unit (keep negative emotions in check; try not to upset other staff members).

“If you’re not taking care of the patient directly, you’re taking care of somebody who is taking care of a patient,” says Katherine PereiraOgan, RN, BSN, BC, 7E staff in photo above are, front row, from left, Jessica Parag, RN, MSSL, Tina Vattilano, RN, Nicole Farrell, RN, Pam Causi, PCT, Audra director of Posey, RN; back row, from left, Sheila Penn, RN, Diwanya Deputy, Service PCT, Tina Fisher, RN, Christine Rumberger, RN II, Jessica Jadlocki, Excellence. RN, Drew Wedel, RN, Nurse Manager Jennifer Johnson, RN, and The key is Charmaine Scott, PCT. putting the patient first and workdoing well, what we can do better. ing together as a team. “As long as we follow through with “The Spine and Bariatric Center at them, I think that means a lot to our Christiana receives consistently good patients.” patient satisfaction scores,” says Patient satisfaction scores are now Pereira-Ogan. “They provide patient posted on the “Think of Yourself as a care using a team concept.” Patient” Web page on our I-Net. At Wilmington Hospital, patient- and Let’s continue to work together to take family-centered care is a priority. “We care of our neighbors and deliver the bring our patients in early for educabest care. tion, which helps decrease their anxiety,” says Terry Foraker, RN, MSN, ONC, nurse manager, Center for Advanced Joint Replacement, Wilmington Hospital. “We have a dedicated unit—our staff members are experts in the care of this population. We ask our patients what we’re

Publishing, Presentations, Appointments, Awards Publishing n

Dr. Garcia shares advances in chronic DVT treatment

ark J. Garcia, M.D., Christiana Care Vascular & Interventional Radiology Fellowship program director and Vascular & Interventional Radiology section chief, discussed pioneering work at Christiana Care on deep vein thrombosis (DVT) at the 36th annual VEITHsymposium™ for Vascular & Endovascular Issues, Techniques and Horizons at The Hilton Hotel in New York City, Nov. 18-22, 2009.

Dr. Garcia presented a series of 50 patients with chronic, hard and occlusive DVT successfully treated with endovascular techniques to restore flow and reduce their symptoms to achieve a major breakthrough, restoring quality of life to the patient. 8

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“The ultrasound-assisted thrombolysis, in addition to standard angioplasty and stenting techniques, led to successful venous recanalization and patency with improved venous outflow,” he concluded. For more details about Dr. Garcia’s presentation and an overview of the symposium, visit www.veithpress.org.

Publishing

(continued)

GetWellNetwork launches Medication Integration Project

GetWellNetwork upgraded with a new Medication Integration feature that enables inpatients to view their medications online and enhances patient education effectiveness for staff nurses.

Appointments, Awards

he GetWellNetwork (GWN) Medication Integration Project successfully launched on Dec. 16 after a two-week pilot study on 5B, 5E and 4C.

recognition for the success of this project. We could not have done it without them.”

Phase II of the project in 2010 will provide PowerChart auto-documentation The project interfaces with PowerChart, of patients viewing their medications. which enables patients to view a perFuture upgrades still in the planning sonal list of medications prescribed for stages include: them during their hospital stay. Patients are alerted to view their “My n Automated white boards, allowing patients to monitor who is on staff and Medication” list whenever new medwhat their care plan is for the day. ications are prescribed or any are discontinued. n Cameras for viewing patients in the NICU and ICU. In addition, a staff function that enables the nurse to pull up and n Discharge planning. review the medication list at the n New designs for the computer patient’s bedside, as well as a Safety, screen so geriatric patients can easily Education and Service Request feature use the system. for staff. This GWN initiative is in response to “Kristen Lindsey Raber is our project our Annual Operating Plan Goal to manager for GWN,” says Katherine increase our HCAHPS patient satisfacPereira-Ogan, RN, BSN, BC, MSSL, tion score in communication about director of Service Excellence. “She medications and their side effects. and her IT team deserve plenty of

Wellness coaching benefits cancer survivors

ight years after losing her thyroid to cancer, Sharon Ruth felt alone and misunderstood. Instead of the usual weight and hair loss from chemotherapy, Ruth faced fatigue, weight gain, body aches, brain fog, dry skin and brittle nails. Daily medication helped boost her metabolism, but didn’t fix everything. That was before Ruth discovered wellness coaching, a holistic approach to connecting with your dreams and goals through purposeful planning and counseling. In 2008, she began working with Cindy Waddington, RN, MSN, AOCN, a nurse and certified wellness coach, to improve her energy and lose weight. “When you have cancer, you lose focus of yourself,” says Ruth. “Coaching helped me reflect on where I was and look beyond my fears to where I wanted to go.”

Waddington guided Ruth in developing her initial wellness vision and goals around her diagnosis and treatment into account. Ruth started walking, but soon added jogging at Waddington’s suggestion. Ruth’s confidence grew as the weight came off. She joined a gym, began weight training and signed up to run a 5k. “Cindy’s constant validation enabled me to dream bigger. Every time I said ‘I can’t,’ she helped me believe I could,” she says. Wellness coaching is part of the Mind, Body, Spirit wellness program at Christiana Care’s Helen F. Graham Cancer Center. The program is open to cancer patients, survivors, and caregivers at any point during treatment. Topics include weight management, nutrition, exercise, personal growth, spirituality and quality of life. Multidisciplinary care also is available for those interested in investigating

Wellness Coach Cindy Waddington RN, MSN, AOCN complementary therapies such as yoga, tai chi, acupuncture, herbs and guided imagery. Forty pounds lighter and physically fit, Ruth has completed 25 races since April 2009 and is training for a half marathon. “Sharon’s story is a great example of how small changes over time can help a person create and live the life they truly desire,” says Waddington. For information, call 302-623-4707.

Leave of Absence Policy changed to align with FMLA

hristiana Care has revised its leave of absence policy to be in agreement with recent changes to the Department of Labor’s Family and Medical Leave Act (FMLA). The revisions take effect Jan. 1, 2010. To be eligible for FMLA employees will need to have 12 months of Christiana Care service and have worked 1,250 hours in the 12 months immediately preceding the start of leave. Christiana Care will also track FMLA leave using a “counting forward” methodology to increase employee understanding of key job protection

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FOCUS Dec. 17, 2009

dates. This method establishes the employee’s plan year on the first day of leave he or she takes leave under FMLA and calculates over the next 12 months. Previously, Christiana Care calculated leave by counting back over the previous 12 months. Employees may occasionally need to request a leave of absence for family and/or medical reasons. Employees with six months of service may qualify for up to 24 weeks of unprotected leave under Christiana Care leave policy for a serious health condition. These policy revisions conform to the new legal requirements and ensure

that our leave program continues to meet the needs of our employees. They also enable us to continue to provide our community with exceptional care. The FMLA is a 1993 federal law that provides certain employees with up to 12 work weeks of unpaid, job-protected leave a year and requires group health benefits to be maintained during the leave. For more information about the new leave of absence policy, see the Employee Handbook or contact the HR Service Center at 327-5555.

Employee Engagement: I know what is expected of me at work

o you know how to respond to the first of our 12 employee engagement questions, “Do I know what is expected of me at work?” Your response should entail more than a mere description of your job. It should reveal your understanding of how what you are supposed to do fits in with what everyone else is supposed to do. The answer should help you perceive how your role helps Christiana Care achieve its mission of improving the health of the communities we serve. So “knowing what’s expected” is about the big picture and the little picture. It includes the myriad details that make up what you do each day. When circumstances on the job change, expectations often do, too. It’s the manager’s responsibility to establish expectations, and the employee’s responsibility to follow up with questions. Ideally, managers and employees set goals together. What can you do? Ask to participate in setting expectations and in determining your goals for the upcoming year. n

n Recommend three kinds of goals to your manager: current role, future growth and personal goals.

Clarify the tasks you should do exactly as instructed and when you are free to develop your own way of doing things.

tions to clarify and ensure you agree.

performance standard?

Think about your performance this past year. Were there opportunities to clarify expectations? Did you take personal ownership to ensure you understood the expected outcome or

Thank you for your personal contributions in fulfilling our mission and for your efforts in making Christiana Care a Great Place to Work!

what is expected of At work, my opinions Q.1meI know at work. Q.7 seem to count.

Q.2

I have the materials and equipment I need to do my work right.

The mission/purpose of Q.8 my company makes me feel my job is important.

At work, I have the My coworkers are Q.3 opportunity to do what I Q.9 committed to doing do best every day. quality work.

In the last seven days, I I have a best friend at Q.4 have received Q.10 work. recognition or praise for doing good work.

Q.5

My supervisor, or someone at work, seems to care about me as a person.

In the last six months, Q.11 someone at work has talked to me about my progress.

Suggest to your manager that you meet regularly to review progress. n

n Ask questions when you’re not sure what is expected. Repeat the instruc-

Q.6

There is someone at work who encourages my development.

This last year, I have Q.12 had opportunities at work to learn and grow.

Verizon supports VNA’s COPD program Christiana Care Visiting Nurse Association received a generous grant of $25,000 for its Chronic Obstructive Pulmonary Disease (COPD) management program from the Verizon Foundation. Bill Allan (at right), president of Verizon Delaware and a trustee of Christiana Care Health System, presented the check to Bob Laskowski, M.D., MBA, president and CEO at the Annual Trustees Meeting on Nov.18.

Volleyball benefit serves a third year The third Annual Serve for a Cure volleyball tournament between Archmere Academy and St. Elizabeth’s High School raised $12,000 for the Helen F. Graham Cancer Center. Accepting the gift is Nicholas Petrelli, M.D., Bank of America-endowed medical director with senior volleyball players and coaches Dana Delle Donne, St. Elizabeth’s High School, and MaryPat Kwoka, Archmere Academy (far right).

Motorcycle run benefits Special Needs Fund The Cancer Center Special Needs Fund received a $3,800 check from the Franny Glynn Motorcycle Run held in Glynn’s memory and organized by family members. Nicholas Petrelli, M.D., Bank of America-endowed medical director (left) and Tricia Struskowski, RN, director, cancer care management (right), accepted the check from (from left) Elaine Morton and Kellie Glynn. 12

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CPOE launches Jan. 28 at Wilmington campus

CPOE leadership Send feedback on CPOE via e-mail or call 302-327-3952. Terri Steinberg, M.D. Chief Medical Information Officer tsteinberg@christianacare.org

After several years of preparations, Christiana Care launches Computerized Provider Order Entry next month—an initiative few hospitals nationwide have yet to dare.

Lynne McCone Director, Clinical Application Services lmccone@christianacare.org

Wilmington Hospital, except the Emergency Department, goes live on Thursday, Jan. 28. Christiana Hospital, except the Emergency Department and Women’s and Children’s Services, goes live on Tuesday, March 23. Training key to success To prepare for this initiative, all providers who practice in a CPOE unit will be offered, and expected to complete, both an independent-study Webbased training module, and a one-hour classroom session. Realizing demands on providers’ time, the CPOE training team made part of the mandatory provider training Webbased. CPOE Provider Web-Based Training courses can be found in the Christiana Care Education Center. The courses are offered beginning Jan. 4, 2010. On Jan. 11, 2010, a required one-hour classroom session will be available for all providers who practice at Wilmington Hospital. Classroom sessions for Christiana Hospital providers begin Feb. 15. An important part of this effort is training some providers as CPOE Physician Ambassadors. Ambassadors

Bid Schreppler Manager, Information Technology eschreppler@christianacare.org will receive early instruction and will also be able to demonstrate the CPOE system prior to the go-live dates. High levels of support The CPOE project team has also planned an extensive level of support during the immediate weeks after golive at each hospital. Both super users and support staff will be available 24 hours a day for at least two weeks after go-live to assist providers with the transition to CPOE. Providers get multiple training opportunities to build confidence and skill in CPOE. As go-live dates approach, look for frequent updates through e-mail, staff meetings, Portal announcements and grand rounds. Or, contact any of the CPOE Leadership team.

Jan Gibson-Gerrity Director, Clinical Informatics jgibson-gerrity@christianacare.org Kelly Marsh Consultant, Information Technology kmarsh@christianacare.org Carolyn Zinner Project Leader czinner@christianacare.org Carolyn Zsoldos RN, Clinical Support Specialist czsoldos@christianacare.org Chuck Molloy Physician Liaison cmolloy@christianacare.org

Magnet project leaders reflect on nurses’ support of site survey

hristiana Care has taken another giant step forward in the journey toward Magnet designation. Four appraisers from the American Nurses Credentialing Center (ANCC) conducted an intensive four-day site visit in November, evaluating such factors as quality of nursing care, performance in quality and safety initiatives and outcomes, collaborative relationships with physicians and peers, and the nurses’ voice in shared decision-making. Appraisers came to validate “The appraisers wanted to validate that what they read in our application is how we truly practice. It was very thorough—and very intense,” says Carol Boettler, MS, RN, BC, Magnet project manager The appraisers spoke with nurses in all patient care areas and settings, including nurses who work on the evening and night shifts at both Christiana and Wilmington hospitals. Nurses were selected at random each day to join the appraisers for breakfast and lunch.

Formulary Update

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“It’s important for Magnet appraisers to talk with as many direct care nurses as they can during the site visit to validate performance,” Boettler notes.

proud to tell the appraisers about their accomplishments and they were very successful in doing so.”

The appraisers also met with the executive team, physicians, board members, human resource representatives, nursing councils, community stakeholders and leaders from affiliated schools of nursing.

Magnet is a hallmark of excellence in health care. In compiling its list of America’s Best Hospitals, U.S. News & World Report includes Magnet status in its scoring. In the 2009 list, 15 of the 21 medical centers named to the magazine’s Honor Roll are Magnet-recognized organizations.

“Throughout this two-year process, our nurses have shown overwhelming support and determination for attaining Magnet,” notes Diane Talarek, RN, MA, NE-BC, senior vice president, Patient Care, and CNO. “I know we will be successful and I look forward to celebrating. Our staff truly deserves this national recognition.” “I am so proud of our nurses, who have shown incredible dedication throughout the Magnet journey,” says Janet Cunningham, RN, MHA, NEABC, CENP, vice president, Professional Excellence/associate CNO and Magnet program director. “You could feel the enthusiasm grow and peak during the site visit. They were clearly

Hallmark of excellence

Christiana Care completed the first half of the Magnet journey in August, sending five voluminous binders of documents to the ANCC’s headquarters in Silver Spring, Md., for review. Well-wishers cheered as the binders were sent off with a security escort. The site visit is the second and final part of the review process. The appraisers will complete their evaluation at ANCC headquarters. A decision is expected early in 2010.

iving with chronic lung disease, Heather Wilson spends a lot of time as a patient at Christiana Hospital, where she has come to know the nurses on 3D pretty well.

“I had asked her then if she’d ever met Mr. Cena, and she said no,” Gabrielli says. “We decided to make it happen to help lift her spirits.

They know and care a lot about her, too. A few months ago, one of the nurses, Eileen Gabrielli, RN, came up with a thoughtful surprise to make Wilson happy.

“With friends’ help, we arranged a backstage meeting at intermission during the show,” Gabrielli says. “Heather was so nervous, but so excited. John Cena posed for several pictures and signed a few items for Heather. He was so down-to-earth and very friendly.

“We all know Heather so well and that her idol is [professional wrestler] John Cena,” Gabrielli says. “She usually decorates her hospital room with his wrestling pictures. We were talking about Heather going to the World Wrestling Entertainment show at the Bob Carpenter Center at UD. Heather said she had great ringside seats and was excited to see him wrestle.

“It was an awesome experience and I was thankful to be a part of it. Heather had to collect herself after the meeting because she was so completely shocked that it actually happened. I think it took a few days to sink in, but she has some great photos to remind her.”

Pro wrestler John Cena (center), patient Healther Wilson (2nd from right, an avid Cena fan ), and her father, Norwood Wilson (left), met at the Bob Carpenter arena, thanks to the caring and effort of Eileen Gabrielli, RN (right), and her colleagues on 3D.

Congratulations Fall Shining Stars

ongratulations to all Shining Star Recognition Award winners and nominees announced since our last Focus listing. The most recent winners are: September 2009 6E Heather Arbaugh October 2009 3A/4B Noel Mucha

Fifth-year resident Christian Coletti, M.D., and first-year resident J. Daniel Hess, M.D., with Charles L. Reese IV, M.D. , chairman of Emergency Medicine and EM/IM program director.

December 2009

4D DAM 3B 4C 5D 2C 3A 5B 4A 3B/3C 4D 5A 2C 5B 5D 6E 4C 4D 4C 2C 3A/4B 4A 5E 5D 6A 5B

wo Emergency Medicine residents earned national recognition at the 2009 American College of Emergency Physicians Scientific Assembly. Fifth-year Emergency Medicine/Internal Medicine Program resident Christian Coletti, M.D., won the Emergency Medicine Residents Association Leadership Excellence Award for outstanding leadership abilities. First-year resident J. Daniel Hess, M.D., won the National Outstanding Medical Student Award, which recognizes students who excel in compassionate care of patients, professional behavior and service to the community and/or specialty. Dr. Hess was nominated by a faculty members at his alma mater, the University of Maryland School of Medicine.

Dr. Petrelli nominated for ASCO president-elect

icholas Petrelli, M.D., Medical Director, Helen F. Graham Cancer Center, has been nominated as 2011 president-elect of the American Society of Clinical Oncology.

Dr. Petrelli has a distinguished record of service to the organization and chairs ASCO’s Communications Committee.

ASCO’s mission is to improve cancer care and prevention by advancing the education of doctors. The group also Alexandria, Va.-based ASCO is fosters communication among medical the world’s leading professional subspecialties and is an advocate for group representing doctors who patients, supporting access for all to care for people with cancer. high-quality care. ASCO is a champiFounded in 1964, the non-profit on for cancer research, especially clinigroup has more than 27,000 mem- cal research oriented toward patients. bers around the globe.

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FOCUS Dec. 17, 2009

3B Nancy McLaughin Nominees included: Alexandra Gouveia Jen Anderson Marcella Shields (Dietary) Thurman Scott Autumn Snyder Dorothy Rose Karen Howard Ben McQuiston Maria Thomas Antonia Roberts Danyell Bishop Kerry Fulton Jane Sutton Shiny Chandy Dominique Perkins Brittany Ennis Marisa Garfinkel Danyell Bishop John Savage Jessica Seador Robin Brayerton Maria Thomas Josh France Kristen Crowder Melissa Reineck Jamie Bartsch

Cessation counseling increases chance of success

s part of our commitment to strive for healthier living, starting in January Christiana Care is offering four-week tobacco cessation counseling programs with free nicotine replacement therapy for employees and their eligible spouses. Research shows people who attempt to stop the use of tobacco products with the help of a tobacco cessation program have a much higher success rate than those who attempt to quit “cold turkey.” Dramatic benefits

Tuesday, Jan. 5, 12, 19, 26

Castle, Room 23.

7:30-8:30 a.m., Christiana Hospital Room 1303 (inside West End Café).

3:30-4:30 p.m., Christiana Hospital Room 1303.

7:30-8:30 a.m., Wilmington Hospital Trustees Room.

Enrolling in a Workshop n From any Portal, click on Education, select “Education Center,” select “Register for a Class.“

Noon-1 p.m., Christiana Hospital Room 1303. 1-2 p.m., Wilmington Hospital - Room 8119 (main hospital, 8th Floor). Wednesday, Jan. 6, 13, 20, 27 3:30-4:30 p.m., Wilmington Hospital Room 8119.

n Scroll down to System Learning Classes and type in “Tobacco Cessation Program.” Click “Go” button. n Select the session you wish to attend. To register your spouse for one of the sessions, please contact Diane Chaffin at 302-327-5520.

Stopping smoking has immediate effects, such as decreasing blood pressure and heart rate. Within 24 hours, the chance of heart attack decreases. Avoidance of smoking results in decreased risk for:

6-7 p.m., Christiana Hospital - Room 1303.

Lung cancer. n Other cancers. n Heart disease. n Stroke. n Chronic lung disease. Moreover, individuals who quit smoking experience fewer colds, less shortness of breath, improved circulation and a renewed sense of smell and taste.

Smile! You’ve been caught exercising!

Don’t forget smoking’s financial costs Smoking has many financial costs that stretch farther than the cost of buying cigarettes. Smokers spend more for insurance, dry cleaning and dental care, and lose money on the resale value of cars and homes. The costs add up: A 40-year-old who quits and puts the savings into a 403(b) could save approximately $250,000 by age 70. If you have a tobacco habit and you want to stop, now is the time to take action. Start by enrolling in a fourweek counseling program today.

Thursday, Jan. 7, 14, 21, 28 12:30-1:30 p.m., 11 Read’s Way New

f you’re taking the stairs instead of the elevator, don’t be surprised if you are rewarded for this quiet act of fitness. So far, more than 50 employees have been tapped in the “Caught You Exercising!” program, which encourages fitness in the workplace. “We find them at all sites, walking the perimeter of their buildings, on the indoor and outdoor walking trails, taking the steps instead of the elevator and encouraging their coworkers to try an exercise class,” says Alisa Carrozza, specialist at the fitness center at Christiana Hospital. Employees receive water bottles, stress-relief balls, glow-in-the-dark bracelets and back massagers as rewards for their efforts.

Ginny Juliano, RN, left, and Karen Jones, RN, receive prizes from Alisa Carrozza on the walking trail at Christiana Hospital. “We will continue with this program —and whenever we see someone taking that extra effort we will try and catch them in the act,” Carrozza says.

EMT W. Mike McMichael gives generously

to Christiana Care’s Annual Fund

mergency Medical Technician (EMT) W. Mike McMichael has experienced Christiana Care from every perspective—as a volunteer, as an employee, as a patient and as a grieving friend and family member. His experiences have been so uniformly positive that McMichael often contributes to The Fund for Christiana Care. ‘I want to give back.’ When asked why he gives so generously, McMichael says, “I donate because I want to give back. The staff at Christiana Care took care of my family and took care of my friends. They even took care of me a couple of times. And I can see where the money’s going, how it’s spent.” Brought to Christiana Hospital more than once with heat exhaustion after fighting fires, McMichael says, “The

nurses were always looking out for me.” When his close friend and partner on the ambulance was fatally injured in the line of duty late last year, McMichael credits Debbie Johnson, RN, nurse manager in Christiana Hospitals Emergency Department, with helping him and his colleagues through the long wait for news. “She put us all in a big room, gave us coffee and snacks, and kept us updated on our co-worker’s condition,” he says. “We weren’t just left out there wondering what was happening.” A nationally registered EMT since 1990, McMichael is Delaware’s delegate to the National Association of Emergency Medical Technicians. He also traveled to Russia in 2005 representing Delaware and sharing American EMS skills with Russian EMS providers. Currently vice-presiW. Mike McMichael, EMT and vice president of Delaware City Fire Company, says his praise for Christiana Care comes from many perspectives, including volunteer, employee, patient, and grieving friend and family member.

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FOCUS Dec. 17, 2009

dent of the Delaware City Volunteer Fire Company after serving as president for three years, he has received numerous awards from the fire company and from state and national fire associations. Praise for hospital staff McMichael also praises the staff at Christiana Hospital for the care they took of both his grandmother and his father when they were in the hospital, and for their understanding and kindness to him when they died. “The whole staff was supportive and caring, especially Terry Buchanan, RN. When I received the message that Dad had died, Terry made sure I could drive before I left the Emergency Department that afternoon. I just can’t say enough about the staff here,” McMichael says. McMichael donates time as well as money to Christiana Care. About four years ago, he noticed that backboards from patients coming in from southern Delaware were taking up needed room in a storage area of the Emergency Department. So he began cleaning and sorting them out, and three or four times a month, he takes them back to downstate hospitals and fire companies. For the past 10 years, he has worked in the Emergency Department on weekends, holidays and a few evenings. “I try to do whatever I can to make things easier for the nurses— and the patients,” he says. “It’s just my way of being a team player and saying thanks.”

Welcome New M-D Staff Pediatrics/General Pediatrics Rebecca A. Achterhof, M.D. 2600 Glasgow Avenue, Suite 213 Newark, DE 19702 Phone: 302-836-4440 Helen C. McCarthy, D.O. 1802 West 4th St. Wilmington, DE 19805 Phone: 302-655-5822 Bridget L. Olsen, M.D. 3920 South DuPont Parkway Townsend, DE 19734 Phone: 302-449-2570 Bradley J. Smith, M.D. 2600 Glasgow Avenue, Suite 213 Newark, DE 19702 Phone: 302-836-4400 Radiology Leon M. Novak, M.D. 5936 Limestone Road, Suite 301 Hockessin, DE 19707 Phone: 302-234-5800 Surgery/Podiatric Surgical Service Cody A. Bowers, D.P.M. Garcia Podiatry Group 1941 Limestone Road, Suite 208 Wilmington, DE 19808 Phone: 302-994-5956 Gregory Mote, D.P.M. 2600 Glasgow Avenue #107 Newark, DE 19702 Phone: 302-834-3575

The Trauma Program hosted its 3rd Annual Holiday Mocktail Festivities Dec. 8 during lunch breaks in the cafeteria at Christiana Hospital. Collaborating with the Delaware Office of Highway Safety, their goal is to raise awareness of the hazards of impaired driving and promote responsible holiday party hosting, including recipes for non-alcoholic beverages. From left, Ann-Marie C. Baker, RN, Chaz Molins, MSN, LCSW, and Joan Pirrung, APRN.

Wilmington Handbell Ensemble provided holiday music Dec. 1 with two concerts at the Helen F. Graham Cancer Center and in the Christiana Hospital main lobby. The players, from left, are Beth Zupan, Ruthie Toole, Lois Torgerson, Kerry Dietz (director) and Terry Smith.

PEEPS honors Dr. Johnson for promoting safe patient handling guidelines

ric Johnson, M.D., received the PEEPS Distinguished Service Award for his efforts in promoting safe patient handling at Christiana Care. Dr. Johnson was instrumental in establishing a protocol for transferring orthopedic patients using the ceiling mounted lift. PEEPS also recognized him for addressing the concerns of the nursing staff through lecture and demonstration at the PEEPS Team Recognition Workshop in October 2008.

From left, Rick Zock, PT, Employee Injury Prevention Program Director Carys Price, Hazem Ozman, PT, Eric Johnson, M.D., Linda Sanderson, RN, and Terri Burgess, PT.

“Dr. Johnson’s recommendations and workshop teaching have been invaluable in improving our staff’s understanding of how Ceiling Mounted Lifts can be used with orthopedic patients and has promoted both staff and patient safety.”