Focus: July 16, 2009

Christiana and Wilmington hospitals receive Environmental Excellence Awards

Recognition for hard work and determination C O N T I N U E D N E X T PAG E

E N V I R O N M E N TA L , C O N T I N U E D

Reducing medical waste and training staff

Reaching higher

Pioneering environmental responsibility

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Senior social worker Danielle Brown earns prestigious Patient Service Award

Christiana Care collaborates in study of new use for glucose challenge diabetes screening

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esearchers from Christiana Center for Outcomes Research (CCOR) collaborated with colleagues at Emory and Johns Hopkins Universities in a study that found that the glucose challenge test (GCT), commonly used to screen for diabetes in pregnant women, may be an accurate, convenient and inexpensive way to screen the general population for undiagnosed diabetes and prediabetes.

Therapeutic Notes National Patient Safety Goal 3E (NPSG 3E)

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Implemented MD5605, an order set for initiating warfarin therapy, which was the topic of a Focus April 23 article. With this order set, a prescriber can order a baseline INR, document the goal INR, initiate a follow-up INR monitoring schedule, and select a method of dosing warfarin. The order set also provides information about the most commonly encountered drug interactions with warfarin in the acute care setting.

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Implemented revised UFH protocols (MD5613), the topic of a Focus May 23 article, to guide physicians and nurses on dosing and monitoring heparin. It includes both standard and lowered dose protocols for use with patients who are not being treated for a stroke.

Folded the Christiana Care anticoagulation reversal guidelines into one comprehensive document that addresses UFH, LMWHs and warfarin.

such as body weight and renal function.

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Monitor daily INR levels and alert prescribing physicians to any potential interactions between warfarin and other medications patients are receiving.

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Provide counseling sessions to inpatients receiving warfarin, including, but not limited to information about how to take warfarin, what to do in the event of a missed dose, the importance of monitoring their INR, and potential drugdrug interactions.

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Offer patients an informational video on warfarin and provide them with educational materials and handouts.

Anticoagulation Monitoring Program

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Monitor a patient access list (PAL) each day to determine patients who are ordered anticoagulation. For these patients, the pharmacists monitor each order for appropriateness looking at dosages, drug interactions, lab values and patient characteristics

Under the direction of the Pharmacy and Therapeutics committee, order a baseline INR before dispensing warfarin, if one is unavailable.

And Christiana Care nurses start bleeding precautions and other appropriate interventions as part of the patient’s plan of care.

Live surgery Webcasts put a global spotlight on Christiana Care surgeons

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C O N T I N U E D N E X T PAG E

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Holly Wright to represent Delaware Nurses Association on Adult Correction Healthcare Review Committee

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n June, the State Senate confirmed Holly Wright, MSN, FNP, Department of Family Medicine, as the inaugural representative of the Delaware Nursing Association on the new Adult Correction Healthcare Review Committee.

Wright has a long history of caring for underserved populations—11 years in alcohol and drug rehabilitation at the New Orleans VA Hospital, six years at the Henrietta Johnson Medical Center in Wilmington.

Created by the Delaware General Assembly, the seven-member committee will advise the Commissioner of the Department of Corrections on inmate healt care.

Now, as part of her work with the Department of Family Medicine’s geriatric practice in the Wilmington Senior Center, Wright spends one day a week at Howard High School’s Wellness Center and one day at the Ferris School for Boys Wellness Center.

Although the committee will meet quarterly, Wright expects ongoing communication among committee members as they review healthcare services, inmate deaths and autopsies, healthcare contracts, and all inmate health care statistics.

APPOINTMENTS

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“I enjoy working in challenging situations where I’m teaching and empowering people—helping them take better care of themselves and their families,” says Wright. “My life is

so blessed. I feel I’ve been called to work with families in our community who have less. I am richly rewarded by my associations with them.”

2010 Cardiovascular Disease Fellowship Program announces 2010 match results

CLINICAL NEWS

First ‘MiniMed School’ draws more than 100 participants

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six-week, free public lecture series jointly sponsored by Christiana Care and the Delaware Academy of Medicine finished on May 27 with excellent ratings from participants.

Open to adults and high school students, the program is designed to educate the public about advances in clinical medicine and scientific research being conducted nationally.

Positive feedback “Feedback from the community has been extremely gratifying,” said Academy President Barry Kayne, D.D.S. The Wednesday evening classes at Arsht Hall on the Wilmington Campus of the University of 8

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Delaware offered topics and interactive discussion in pulmonary medicine, renal medicine, infectious disease, diabetes and metabolism, and cardiology, as well as a look at the future of medical education.

cardiologist Mitchell Saltzberg, M.D., as well as faculty from the Universities of Pennsylvania and Delaware and Pulmonary Associates, PA.

The series returns to New Castle County in Spring 2010. And in the Nearly 100 people attended each fall of 2009, Christiana Care and weekly session, with more than 40 the Delaware Academy of people attending all six sessions.

Medicine hope to offer another Christiana Care pulmonologist and mini medical school simultaneously Academy programs chair Albert in Lewes and Dover, as organizers Rizzo, M.D., led the sessions. continue to seek financial underwriting.

Also participating were a pharmaceutical research and development If you are interested in supporting consultant, faculty members from this program, or know a potential the Academy and Christiana Care underwriting source, please email Medical staff—nephrologist Arun Tracy Miller at Malhotra, M.D., endocrinologist tmiller@delamed.org, or Tim Gibbs James Lenhard, M.D., and at tgibbs@delamed.org.

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GENERAL NEWS

Did you know?

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Medicare analyzes outcomes for hospitals nationwide and publishes the results on its Hospital Compare Web site. One metric Medicare uses to gauge hospital quality and safety is the 30-day mortality rate after a patient leaves a hospital.

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The latest Medicare data on mortality rates for patients with heart failure and pneumonia places Christiana Care among the top five percent in the nation.

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Christiana Care joins 213 out of 4,700 U.S. hospitals with heart-failure mortality rates better than the national rate and 253 hospitals with pneumonia rates better than the national average.

Check these and more results at http://www.hospitalcompare.hhs.gov.

Annual Resident Research Grand Rounds

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Christiana Care Residents join free at the Delaware Academy of Medicine your username and password.

Robb Mackes is the person responsible for this program and he can be reached at 733-3989 or at his e-mail, rmackes@delamed.org.

S Join the Wilmington Blue Rocks for Family Health Care Night on Saturday, July 18, at 6:05 p.m.

ince 1930, the Delaware Academy of Medicine has served the professional and lay communities through educational programs, library services, database and e-resource access, maintenance of the history of medicine and dentistry in Delaware, student financial aid, and many other programs.

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We are located on the lower level of the John H. Ammon Medical Education Center and have a conference room that seats up to 12 people comfortably. There is wireless and wired Internet access in the room, as well as availability of an LCD projector. You have access to this space on a first-come, first-served basis. Just call Liz Lenz at 733-3952 to reserve space, or e-mail Liz at elenz@delamed.org.

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The Academy is committed to understanding and acting upon the needs of the professional community. One of the ways we accomplish this task is through the periodic formation of special interest groups (SIGs) that may meet only once, or have an ongoing existence. If you have a topic or need to be addressed, contact Tim Gibbs at 733-3919 or tgibbs@delamed.org and we’ll do what we can to convene a group.

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Throughout the year the Academy directly provides and underwrites educational conferences and symposia. Attendance at these events is discounted (in most cases) for members of the Academy.

The Blue Rocks play the Frederick (Md.) Keys.

Christiana Care employees receive a special discount rate of $7 per ticket.

July 18 is also SNL Characters Night and Delaware Lottery Cap Giveaway Night at the Blue Rocks game.

The first 1,000 adults receive a cap courtesy of the Delaware Lottery. In addition, Frawley Stadium offers tribute to SNL's most popular characters like the Coneheads, church lady, Wayne Campbell and many others.

Order your tickets by faxing back the Family Healthcare Night order form found on the portals under externalaffairsnews/FamilyHealthcare Night.pdf.

As we enter into our 80th year of operation, we acknowledge that budgets already stretched to the limit will not support most of you joining the Delaware Academy of Medicine.

So we have created a new class of membership in the Academy at no cost to you—Resident Membership Membership in the Academy is as valuable as you decide it will be.

Consider these advantages: ■

In conjunction with the access you receive from Christiana Care, you have additional access to electronic resources via our DelMIRA program. You have a brochure on this program in your materials and will be receiving an e-mail with

Please consider, as a part of your residency, developing involvement in the professional organizations that have served those who came before you and support you as you begin your career.

Family centered activities support togetherness and fitness elbow pads and wrist guards to prevent injuries in a fall.

Dance the blahs away Try square dancing or folk dancing, both mild forms of exercise. And they help to develop coordination as well as social skills.

Build a snowman

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oth parents and kids need regular exercise to get fit—so why not build a healthy family by getting in shape together?

Grownups require at least 20 minutes of aerobic exercise a day to stay healthy and reduce stress. And you can turn exercise time into a mini family outing by including your kids.

So why not get the kids away from their video games and into family fitness?

Take a walk Walking is a great way to start. All you need to get started is a hat with visor, sunglasses and sunscreen.

Your jaunt can be as simple as a stroll around the neighborhood with the

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baby strapped in a stroller.

You can hike in the city, carrying snacks and juice boxes in a backpack so you can enjoy a picnic in a park. Or put on bug repellent, lace up sturdy shoes and head for the woods with a pair of binoculars and a nature guide so you can spot birds along the trail.

Walking together can add fun to routine tasks, such as walking the dog. Or you can exercise for a good cause by signing up for a walk-athon.

Ride a bike Learning to ride a bike is a rite of passage. If your kids are already riding and you haven’t pedaled for a while, don’t worry. It will come back to you—like riding a bike.

Wear helmets and stay off busy roads.

If you’re cycling more than a few blocks from home, carry a repair kit so you can fix flat tires and chains that jump off track.

Roll away Roller blading is another exercise that benefits parents and kids. You will likely have fewer spills if you skate in areas designated for roller blading— but bike and walking paths work too.

You do need a helmet, knee pads,

Don’t give up your exercise routines in the winter. Unless it’s icy, you can still take walks together as long as you bundle up and wear a hat. And you can add cross country skiing, snow shoeing and ice skating to your list of activities.

Find creative ways to make fitness part of your family routine. The important part is to get started. Soon, exercise will become a healthy habit the entire family can enjoy.

Plenty of time left for summer fun, rest and relaxation

Check out day camps Get kids involved

Diagnosis is key to early asthma intervention

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Consider low-cost get-aways

Learn commuting options to save the environment, time and cash when RideShare and DART First State visit

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ar pooling and riding the bus save money and reduce pollu-

tion.

To ease the parking crunch on our campuses and to lessen the impact on the environment—as well as to save you money—Christiana Care encourages employees to car pool and use public transportation.

Christiana Care provides preferred

car pool parking spaces to employees who register with Public Safety and Rideshare Delaware, which guarantees a ride home to registered employees who are unable to ride home with their carpool.

And employees can purchase DART bus passes with pre-tax dollars.

In supporting our use of alterna-

tive transportation, Christiana Care has scheduled the staff of Rideshare Delaware and DART First State to visit us and provide information about transportation options and answer questions.

Please attend one of the following sessions to learn more about how you can save money while helping save the planet: ■ July 20 from 10 a.m. to 2 p.m. in the Christiana Hospital cafeteria.

■ July 22 from 10 a.m. to 2 p.m. in the Wilmington Hospital cafeteria.

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Literature & Medicine: Humanities at the Heart of Health Care program still open

Acute Care for the Elderly unit celebrates fifth anniversary

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he special Acute Care for the Elderly (ACE) unit at Christiana Hospital celebrates its fifth anniversary July 26.

The ACE unit’s mission is to reduce medical complications and readmittance to the hospital and improve clinical outcomes in elderly patients using an interdisciplinary approach to patient care.

ACE unit patients benefit from a health care team consisting of a medical director, a geriatric nurse specialist, geriatric pharmacist, dietitian, physical therapist, social worker and case manager.