Focus: November 19, 2009

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FOCUS Focus on Excellence speaker stresses team work and responsibility

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ake responsibility. Help your teammates. And always land on target.

That was the message of Master Sgt. Dana Bowman, keynote speaker at the Annual Focus on Excellence Awards and Exhibit ceremony. More than 300 people attended the event held Thursday, Nov. 13 in the John H. Ammon Medical Education Center. Bowman is a double amputee and former member of the elite Golden Knights parachute team. Robert Laskowski, M.D., Christiana Care president and CEO, said the transformational spirit of the teams infuses their work with excellence day in and day out. “Every year is better than the year past,” he said. Formal recognition for PDCA efforts

Clinical News Tricia Strusowski completes teaching tour

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Outpatient physiatry now available at hosptials

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General News Junior Board celebrates 25 years of service

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Council plans diversity and inclusion strategy

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Caring for Yourself Smoking’s financial impact

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The awards give formal recognition to teams of employees who enter projects that demonstrate improvement in process or outcomes using the PDCA Plan-Do-Check-Act) model. Teams have submitted 512 projects since 2003. This year, 18 winners were selected from 89 projects. “There was some really excellent work from across the health care system,” said Donna Mahoney, BS, CPHQ, director of Data Acquisition and Measurement. On 4C, a med-surg floor, the team launched a successful strategy to improve shift-to-shift communication

Master Sgt. Dana Bowman, keynote speaker at the annual Focus on Excellence Awards and Exhibit among nurses using the DATAS (Demographics Assessment Tests Alert Status) form. That initiative reduced length of stay and overtime costs while increasing patient satisfaction. “It helped us to work more efficiently,” said Maria Alvarado, LPN. Carol Moore, RN, MS, a Quality and Safety Education specialist, worked on projects to improve perioperative teamwork and communication, as well as plan-of-care briefings. “I am thrilled by the efforts of the teams I’ve been working with,” she said. CONTINUED

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Annual FOE Awards recognize excellence in Plan-Do-Check-Act improvements

Accepting for the Presidents Award winner, “Improving Diabetes Care in the Adult Medicine Office,” from left, Shanda Hall, RN, Ed Ewen, M.D., Kevin Copeland, M.D., and Crystal Pollock, RN.

Former Army Ranger lost legs in air accident Many were moved to tears when Bowman, who lost both legs in a midair skydiving collision, showed a video of soldiers who are recent amputees and are learning to use artificial limbs at Walter Reed Army Hospital in Bethesda, Md.

Accepting the People’s Choice Award for “Automating the Emergency Department Call Log,” from left, front row, John DiGiovani, Kim Turner, Michael Bledsoe; top row, Heather Stiebel, Toni Howard, Ray Seigfried and Catherine Burch.

of five has a commercial pilot’s license and frequently parachutes into outdoor speaking engagements. His motto: “It’s not the disability … it’s the ability!”

He said the keys to his success were the discipline and training he received in the military. Bowman urged the honorees to “be a participant, not a “Think about the beginning steps of spectator,” and put their training to some of the patients who come to your the highest use in helping their neighhospital,” he said. “There’s a lot of bors. responsibility in this room today.” “You’re helping yourselves and your Bowman served in the Ranger, teammates through your education Airborne and Special Forces divisions and training,” he said. and made more than 1,000 parachute Dr. Laskowski said Bowman’s story of jumps after his accident. determination and triumph teaches an Now retired from the Army, the father

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important lesson. “It has particular poignancy for us because it’s one of transformation,” he said.


Helen F. Graham Cancer Center teaches patient care management

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hanks to Tricia Strusowski, MS, RN, director of Cancer Care Management at the Helen F. Graham Cancer Center, cancer care nurses in five states better understand patient care navigation The Association of Community Cancer Centers’ (ACCC) 26th annual economic conference in September confirmed a national movement toward patient care navigation, says Strusowski. “Even small cancer centers realize the key to better care is decreased duplication of efforts and increased communication.”

ACCC member hospitals how to model Christiana Care’s successful program. “Most significant to our program was Tricia’s advice on ‘right sizing’ and managing the navigator’s case loads,” says Virginia Brooks, RTT, director of Cancer Services at St. Francis Hospital in Indiana.

Two hospitals Strusowski visited also presented their progress.

Sharing our success with others

“We have better defined what our navigator will do because of Tricia’s training, and we are confident we will be successful,” shares Matt Sherer, MBA, MHA, administrative director of the John B. Amos Cancer Center in Georgia.

At the conference, Strusowski shared patient navigation basics and advanced training on sustainability, performance improvement and coordinating resources for hospitals with existing navigator programs.

Twenty-seven hospitals have toured the Cancer Center since 2002 to learn about Christiana Care’s nationally renowned multidisciplinary cancer care, patient navigation, and research programs.

A leader since 2000 The Graham Cancer Center has been a leader in patient navigation since 2000 when it first introduced nurse navigators to cancer care. These specially trained nurses oversee and help orchestrate all aspects of a cancer patient’s treatment with other essential team members. This summer, Strusowski trained six

Outpatient physiatry care now available at Christiana and Wilmington hospitals

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hristiana Care’s Rehabilitation Services Department now offers outpatient physiatry appointments at Christiana and Wilmington hospitals. A physiatrist is a medical doctor who specializes in physical medicine and rehabilitation, helping patients manage musculoskeletal conditions, spasticity, bowel and bladder issues, and other conditions that can occur following a stroke, brain or spinal cord injury, fracture or other trauma.

Tricia Strusowski, MS, RN

In addition, physiatrists serve as a resource for primary care physicians managing care for patients in the community with disabilities. “Our role is to help patients manage their ongoing rehabilitative, therapy and equipment needs once they return to the community,” says Kelly Eschbach, M.D., medical director of Rehabilitation Services.

Kelly M. Heath, M.D., offers outpatient hours at Medical Arts Pavillion II, suite 1205, on the Christiana Hospital campus. Heath’s specialties include stroke, traumatic brain Kelly M. Heath, M.D. injury, spasticity management, and post-amputation care and prosthetics. Vaishali Vora, D.O., provides both inpatient and outpatient services at Wilmington Hospital. Her interests include stroke, spinal cord injury, brain injury, and other post-trauma or neurologic diagnoses. She speaks fluent English, Spanish, Gujarati and Hindi. For referrals and appointments, call 302-428-2717 at Wilmington Hospital or 302-623-4051 at Christiana Hospital.


Junior Board of Christiana Care celebrates 25 years of devoted service

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hristiana Care Health System thanks and honors the Junior Board of Christiana Care Inc. as the board celebrates a quarter century of service in 2009.

The Junior Board marked another milestone this year, passing the $1 million mark in funding scholarships for nursing students and allied health professionals.

In 1984, the boards of the Memorial, Delaware and Wilmington General hospital divisions pooled their skills, talents and membership into a unified group, dedicated to service and

Thoughtful, creative and focused Christiana Care President and CEO Bob Laskowski, M.D., praised the Junior Board for its spirit of caring and the unique role it plays in helping care for our neighbors. “They are a part of Christiana Care, yet they have their own identity, which is organized, thoughtful, creative, and speaks to the focus of the many projects they put together to help Christiana Care and the people we serve,” says Dr. Laskowski.

Surgical Waiting Lounge fundraising for what would become Christiana Care Health System. Since then, members, wearing their signature salmon-colored jackets, have been an integral part of our health care system, providing 17,000 hours of service each year. Since 1984, the Junior Board has raised more than $11 million. About $7 million of that has been raised in the last 10 years.

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At Christiana Hospital, members work at the Information Desk, at the Helen F. Graham Cancer Center, in Maternity and in the Surgical Waiting Lounge. At Wilmington Hospital, board members serve at the Ambulatory Surgical Suite and the Roxana Cannon Arsht Surgicenter. At both hospitals, the Junior Board works in the gift shops. “With the expansion at Wilmington Hospital, we just started working as

Junior Board greeters help guide the way at Wilmington Hospital greeters to help people find their way around,” says Junior Board President Barbara Burd. “We are always looking for new ways to help.” Roots go back to 1888 The roots of the Junior Board go back to 1888, when a group of determined women banded together to raise $10,000—the equivalent of $228,023 today—to establish the first hospital in Wilmington at the intersection of Van Buren Street and Shallcross Avenue. Over the years, as more hospitals were established, members organized boards to benefit those organizations. members at the Delaware Division donned pink pinafores. In 1940, Memorial members adopted uniforms in French blue. The three original hospitals were remembered at the board’s 25th cele-


Christiana Care salutes the Junior Board CONTINUED

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Traditionally, the Medicine Ball has been the Junior Board’s largest fundraiser. But in the spring of 2009, with the economy in distress, the board decided to put a different spin on the ball. The Medicing Ball instead became a “non-event.” The Junior Board sent out invitations asking for support, announcing that, while the ball would be taking a break, “nurses never do.” The campaign raised $100,400.

The Medicine Ball Committee bration on Nov. 17 at Wilmington Country Club. Each of three cakes will be decorated with a screened image of a hospital. Silver candelabras, polished by volunteers for decades, were gleaming.

Next year, members and other supporters will once again break out their dancing shoes. The Medicine Ball is slated for April 23 at Wilmington Country Club. Coffee, gift shops and more All year round, the Junior Board raises money through a coffee kiosk and hospitality cart at Christiana Hospital, as well as gift shops at both hospitals. A Century of Serving, their cookbook, is sold at the shops. “I understand the recipe for apple cake is wonderful,” Burd says.

First State School all are women, although men are welcome to join. There are an additional 102 emeritus members, age 80 and older, and 94 associate members, classified as members who have spent more than 10 years on the board. Emeritus and associate members aren’t expected to put in service hours, although many do. Each spring and fall, the board offers provisional classes for prospective members. Burd says interest is on the rise, with about 20 recruits in each session. “We’re seeing an active increase in members, especially young retirees,” she says. “People are looking for ways they can be of service—and this is a great way to help others.”

The group has about 150 active members, who commit to working a minimum of 50 hours each year in the hospitals. Burd notes that many members put in much more time, with more than a third working more than 100 hours. “There are members who give more than 400 hours,” she says. Easy Street, Center for Rehabilitation at Wilmington Hospital

Most are age 40-60 and

The Visiting Nurse Association


Creating a culture of inclusion

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magine seeking medical care from a hospital where no one speaks your native language or understands the importance of your culture and religion in making medical decisions. In Delaware, this may be closer to reality than you think.

By 2030, 28 percent of the men, women and children who live in this state will be people of color. This reflects an increase from 23 percent in 2000 and an increase of 107 percent of the Hispanic population. In 2005, 11.5 percent of Delaware’s population spoke a language other than English at home, up from 9.5 percent in 2000. At Christiana Care, the Diversity and Inclusion Council is already hard at work implementing a new strategy to help meet shifting demographics. Respect, understanding and leveraging our diversity The Council’s main purpose is to create an inclusive culture that respects, understands and leverages the diversity of our colleagues so that we can deliver the best care to our diverse range of patients for increased safety, productivity and enhanced reputation as a leader in culturally competent patient-centered health care. Chaired by Rosa M. Colon-Kolacko, Ph.D., vice president, System Learning, and co-chaired by Ray Blackwell, M.D., cardiothoracic surgeon, the council comprises 17 colleagues representing areas ranging from pastoral services to food and nutrition. The council works in partnership with the Health Equity Committee, led by Dr. Blackwell and Alan Greenglass, M.D., senior vice president of the Medical Group of Christiana Care Health System.

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Through this partnership, both patients and staff benefit. From the patient perspective, disparity in care continues to be an opportunity for the entire health care industry. By identifying disparities, providers can tackle specific issues, such as higher infant mortality in premature babies born to teenage African-American mothers and increased rates of high blood pressure and HIV/AIDS among African-Americans and Hispanics. From a staff-inclusion viewpoint, the Council’s goal is to help create a work environment in which all individuals are treated fairly and respectfully, have equal access to opportunities and resources, and can contribute fully to our organization’s success in providing the best possible patient care. Advances through the work of the council already include enhancing our language services with focus on the Spanish population, to make screening more convenient for minorities who currently are more likely to develop cancer and cardiovascular disease. Other projects include addressing the diversity and inclusion needs for patients and staff, and implementing a more robust cultural competency education and implementing a plan to meet new standards developed by the Joint Commission for culturally competent patient-centered care that go into effect in 2011. “When people collaborate across cultures and experiences, everybody wins,” says Dominic Kayatta, Program Manager, System Learning. “At the end of the day, this could help to save a life.” To learn more, visit the Cultural Resources page and the System Learning Web site on the portals.

Welcome New M-D Staff Family & Community Medicine Kathy C. Cornelius, M.D. Westside Family Healthcare 1802 W. 4th Street Wilmington, DE 19805 Phone: 302-655-5822 Nicole E. Hancq, M.D. 908-B East 16th Street Wilmington, DE 19802 Phone: 302-575-1414 Lauren Noto Bell, D.O. Family Medicine Center 1401 Foulk Road, Suite 100 B Wilmington, DE 19803 Phone: 302-477-3300 Medicine/Cardiology Lawrence Narun, M.D. 3521 Silverside Road, Ste 1C Wilmington, DE 19810 Phone: 302-477-6510 Vincent Y. See, M.D. 252 Chapman Road, Suite 150 Newark, DE 19702 Phone: 302-366-1929 Medicine/Internal Medicine Vijaya Surekha Bhamidipati, M.D. 200 Hygeia Drive, Suite 2100 Newark, DE 19713 Phone: 302-623-0188 Jude Ediae, M.D. 200 Hygeia Drive, Suite 2100 Newark, DE 19713 Phone: 302-623-0188 Obstetrics-Gynecology Gretchen Makai, M.D. MAP 2, Suite 2103 4735 Ogletown-Stanton Road Newark, DE 19713 Phone: 302-623-4410


S U M M E R F I T N E S S E S S AY

WINNER

‘Roadrunner’ says it’s a miracle she found the courage to start

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ne of my favorite quotes is by John “The Penguin” Bingham, a career runner and motivational speaker, who said: “The miracle isn’t that I finished. The miracle is that I had the courage to start.” I never thought I could do it. Running was for tall, thin, gazelle-like people. I’m short and decidedly ungazelle-like. But this year, I was also very tired of being still and doing nothing. I wanted to move my body. So I started walking, and when that wasn’t enough I added some running. Gradually, I increased the running and added distance. About four months later, I was a roadrunner. Started entering fundraiser races Up and down Route 13, Schoolbell Road, through New Castle’s Battery Park, and even around the Christiana Hospital campus. After some initial fears, I decided to just do it and make myself an official runner: I entered four fundraiser races. Each race was completely different, offering its own unique experience and challenges. My first one was nerve wracking. About 1,500 people raced, and it was everyone for himself. Watch out or get run over! The second race was five miles. It felt like 50. The third race was across hilly park terrain in Pennsylvania. I quickly learned that flat Delaware was spoiling me. The fourth race was PMRI’s Second Annual Sugar Free

Leslie Harvell, a medical technologist in Molecular Diagnostics, says she started walking for exercise and gradually shifted to running this year. Miles event. I placed third in my age group, my best finish yet! For me, running has been a great way to relax, and a terrific way to relieve tension. Feeling your heart pound in your chest, listening to your feet hitting the pavement, feeling cold air in your lungs or rain on your face … concentrating on these things, even for a short time, can give you renewed strength to face whatever lies ahead. Running gives me a chance to think, to review the day and decide how I

can improve myself tomorrow. It’s exhilarating to run at night and watch the full harvest moon rise. Or in the evening, while the sun goes down, to see the gorgeous pinks, purples and oranges in the sky. Running enriches life Becoming a runner by myself, for myself, has added another layer to who I am. Running is exciting, challenging and rewarding, both physically and psychologically. And the road ahead is open to many other possibilities.


Publishing, Presentations, Appointments, Awards Publishing Javed Gilani, M.D., and Omar Khan, M.D., et al., will publish an article, “No more Doritos and lobster tails: a case of life-threatening sublingual hematoma,” in the Delaware Medical Journal. Leo Marcoff, M.D., et al., published an article, “Cost Effectiveness of Enoxaparin in Acute ST-Segment Elevation Myocardial Infarction (ExTRACT-TIMI 25),” in the Journal of the American College of Cardiology 2009; 54:1271-9. Presentations At the American Academy of Pediatrics National Conference in Washington, D.C.: David A. Paul, M.D., Amy Mackley, RNC, Lou Bartoshesky, M.D., Aaron Chidekel, M.D., presented “Immunoreactive Trypsinogen is Elevated in Very Low Birth Weight Infants who Die.”

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Amy Mackley, RNC, and Wendy Sturtz, M.D., presented “A Randomized Controlled Trial of Fiberoptic Blanket Blue LED vs. Overhead Spot vs. Combination Phototherapy Devices.”

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At the American Academy of Otolaryngology-Head and Neck Surgery in San Diego in October, Robert L. Witt, M.D.: Presented “Lumen Formation in 3D Cultures of Salivary Acinar Cells.”

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Served on the panel “Controversies in Recurrent and Persistent Papillary Thyroid Cancer.”

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Instructed the course “Advances in the Management of Papillary Thyroid Cancer.”

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At the AHRQ 2009 Annual Conference

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held in Bethesda, Md., “Michele Campbell, MSM, RN, CPHQ, FABC, Corporate Director, Patient Safety & Accreditation, co-presented “So You’re Doing Quality Safety & Improvement: How Can you Tell Whether It’s Working?” featuring Christiana Care’s Safety Mentor program. Mark Cipolle, M.D., Ph.D., medical director of the Trauma Program, published “Preinjury Warfarin Worsens Outcome in Elderly Patients Who Fall From Standing” in the June 2009 Journal of Trauma and "Hepatic Angioembolization in Trauma Patients: Indications and Complications” in the September 2009 Journal of Trauma. At the 68th annual American Association for the Surgery of Trauma in Pittsburgh: n Glen Tinkoff, M.D., Ross Megargel, D.O., and James Reed, Ph.D., presented “Delaware's Inclusion Trauma System: Impact on Mortality."

Jaime Giraldo, M.D., Nicole Fox, M.D., Steve Johnson, M.D., James Reed, Ph.D., Mark Cipolle, M.D., Ph.D., and Gerard Fulda, M.D., presented a poster, “Utility of Blood Volume Measurements in Resuscitation: An Evaluation of Two Noninvasive Methods.” n

n Glen Tinkoff, M.D., Brian Little, M.D., Ph.D., James Reed, PhD, and Mark Cipolle, MD, PhD presented a poster, “Impact of Helmet Use on Victims of All Terrain Vehicle Crashes: The NTDB Experience.”

Nicole Fox, M.D., gave an oral presentation, “Team training: A tool to improve resident teamwork and communication,” at the 95th Annual Clinical Conference in Chicago.

At the TRENDS in Critical Care Nursing Fall Conference in King of Prussia, Pa., Michelle L. Collins MSN, RN, BC, manager, Patient Care Services Education, presented “Mentorship: Benefits at the Bedside and Beyond,” and “Teaching Strategies that Foster Critical Thinking.” Omar Khan, M.D., led a workshop on “Mentorship for National Public Health Institutes” in Johannesburg, South Africa, a part of a World Health Organization-affiliated group of directors of their countries’ national institutes of health. Omar Khan, M.D., along with Dr. Lee Dresser (chair), helped coordinate the Annual Meeting of the Delaware Stroke Initiative, held at the Ammon Medical Education Center. Omar Khan, M.D., served as a moderator in the panel "Megacities and Drinking Water,” for a United Press International conference on clean drinking water, in Washington D.C., September 2009. Omar Khan, M.D., chaired a panel on “Megacities and Global Health” at the annual meeting of the American Public Health Association in Philadelphia, Nov. 9. In a video presentation, Nicholas J. Petrelli, M.D., medical director of Christiana Care’s Helen F. Graham Cancer Center, introduces the American Society of Clinical Oncology’s Clinical Cancer Advances 2009 report. Dr. Petrelli is chair of ASCO’s communications committee. The report is in the Journal of Clinical Oncology online ahead of print at www.jco.org on Nov. 9, 2009. C O N T I N U E D N E X T PAG E


More than 30 Christiana Care colleagues present at annual 21st Century Visions of Nursing conference

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atient Care Services Education and the Department of Nursing hosted the 6th Annual 21st Century Visions of Nursing conference, titled “Excellence through Knowledge.” The conference planning committee works diligently each year to provide an educational opportunity that meets not only the clinical needs but also the professional developmental needs of our nurses. Next year’s conference will be Sept. 15-16, 2010. Thank you to all Christiana Care employees who participated as speakers or poster presenters, including: Barbara Albani, M.D. Ann-Marie Baker, BSN, RN, CPAN Michelle Bailiff, LCSW

Elisabeth Bradley, ACNS-BC, CCNS, CCRN Fern Butler, MS, RNC Elizabeth M. Carson, RNII, BC Michelle L. Collins, MSN, RN, BC Laura Dechant, MSN, RN, CCRN, CCNS Thea Eckman, BSN, RN, CCRN Megan Farraj, PharmD Patricia Fenimore, RN, CCRN, CNRN Charles Fort, MSN, RN Edward Goldenburg, M.D., PACC, FACP, FNLA Dawn E. Johnson, BSN, RNC-OB Karen Karchner, RN, OCN Gerald Lemole, M.D. James Lenhard, M.D., FACE, FACP

Brian Levine, M.D. John H. McMillen, RN, NM Gerald O’Brien, M.D. Guy Scotolati, MS Velma Scantelbury, M.D. Maureen Seckel, APN, APRN, BC, CCNS, CCRN Sunjay Shah, M.D. Tamekia L. Thomas, MSN, RN, PCCN Sonya Tuerff, M.D. Karen Tyczkowski RNC Amy Tyler RN BSN CEN Dina Viscount, BSN, RNC-OB Cynthia Waddington, MSN, RN, AOCN Sister Julian Wilson Pam Woods, MSN, RN, CEN

Publishing, Presentations, Appointments, Awards Wendy Wintersgill, MSN, RN, CRRN, ACNS-BC, attended the 35th Anniversary Association of Rehabilitation Nurses Annual Education Conference in Albuquerque N.M., to present, “Critiquing a Research Article: Tell It In A Poster.” At the Mid-Atlantic Laryngectomy Conference: n Jen Thomas, MS, CCC-SLP, Speech Pathology clinical supervisor, presented “Basics in Laryngectomee Communication, Equipment and Supplies” and served on the conference planning committee. n Janet Sechrist, MA, CCC-SLP, presented “Hands-free speaking valve fittings,” moderated the laryngectomee panel and was a conference planning committee member. n Theresa Gillis, M.D., director of Oncology Pain and Symptom

Management at the Graham Cancer Center, presented “Physical Therapy and Lymphedema” and served on a doctor’s panel. Christy Arnold, PT, and Christine Wilson, PT provided head/neck/ shoulder dysfunction screenings. n

n Dale Gregore, MS, CCC-SLP, clinical rehabilitation specialist, presented on esophageal speech.

Appointments, Awards The Delaware Emergency Nurses Association Education Committee received the Team Award from the Emergency Nurses Association (ENA) at its annual conference in Baltimore. Seven of the 10 members are Christiana Care nurses: Meriam L. Dennie (chairperson), Ruth E. Morse, Susan R. Palmer, Karen Rollo, Kara W. Streets, Terry Thorley and Beverly VonGoerres.

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Brother and sisterJineen Redden-Huff, RN II, Post Anesthesia and Robert Redden Huff, sterilization service technician, Clinical Engineering, will represent Christiana Care at a breakfast reception Nov. 20 hosted by Gov. Jack Markell, 2009 chairman of the Black Achievers Steering Committee. Their mother, Thelma Redden-Huff, senior systems analyst, IT Administration, is a former honoree of the Black Achiever Program. The HIV Program congratulates Dorothy Minor, RN and Julie Moorehead, RN, for passing the Association of Nurses in AIDS Care certification exam.


Financially, smokers pay more for practically everything

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igarettes are expensive, about $5.50 a pack in Delaware. A pack-a-day habit translates to $2,007.50 going up in smoke each year, assuming the price will stay the same. But it won’t. And that isn’t the only cost of smoking. On average, smokers spend $1,300 more in health care costs each year than non-smokers. The good news is Christiana Care employees who want to kick the habit don’t have to pay for nicotine patches or other medications that can help make quitting easier. They also will receive free, one-on-one counseling. Quitting smoking is the right choice for your health. But if you need an added incentive, start adding up the money you’ll save giving up tobacco.

What could you do with an extra $2,007? Well, you could go to the movies 217 times, based on the average $9.25 theater ticket price. You could enjoy dinner out for two every other weekend for a year, assuming you spend $75 on the tab. Costlier home maintenance Smokers’ homes also are more expensive to maintain because they require new paint and wallpaper more often. Figure at least $2,000 to prime and paint an average-size living room, dining room and two bedrooms, according to Contractors.com. The Carpet Buying Handbook says to expect a bill of $280 to clean 1,000 square feet of carpeting. Insurance companies typically

Dennis Harris, RN, 5D, was slated to be an ambassador and escort during the four-day Magnet Recognition Program site visit starting Nov. 3, but wife Meaghan, went into sudden labor at home. “It happened so fast, we couldn’t even call 9-1-1,” Harris says. Their son, Matthew Charles Harris, and mother are doing fine.

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charge smokers 10 percent more on homeowner premiums than non-smokers. So, if you’re paying $1,100 a year to insure your home, $100 covers smoking. And when you want to sell your house, expect to pay for professional cleaning to remove the scent of smoke from your home. According to a Tobacco Free Florida poll, 76 percent of prospective buyers won’t consider a house that smells of smoke. That also goes for your car. The resale price for cars owned by smokers is 9 percent less than for vehicles owned by non-smokers, according to a study by the University of San Diego. Unexpected expenses Smoking also racks up unexpected expenses, such as burn marks on tables or singed clothes that have to be tossed. Illnesses caused by smoking and secondhand smoke also cost employers and government agencies in health care and lost productivity. On average, each smoker costs society an average of $3,391 a year, according to a study by the Centers for Disease Control and Prevention. Money spent on cigarettes literally turns to ashes. It can’t be invested, meaning smokers will have less cash down the road. Consider the hypothetical case of two 40-year-old smokers. One quits and puts the money she spent on cigarettes into a 401(k) retirement account. She can expect to accumulate about $250,000 by the time she hits 70, while the guy who keeps puffing away hasn’t made a dime in interest. If you think it’s time to stop smoking and start saving, contact Employee Health at 302-733-1878. Delaware also offers the Quitline, a toll-free line smokers can call to get help in kicking the habit. The number is 866-409-1858.


Physical addiction, psychological dependency make smoking a difficult habit to break

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ost people know that smoking is addictive—and a difficult habit to break. They might not know that there are two powerful components to smoking: the physical effects of nicotine and the psychological tug of habits that trigger the urge to light up at specific times and places. But knowledge is even more powerful than nicotine. And understanding the facts about tobacco is extremely helpful for people who want to kick the habit. Addiction doesn’t take long Nicotine, a key chemical component in tobacco, is a substance that draws smokers into a partnership with cigarettes. The average cigarette contains about 8.4 milligrams of nicotine, and it doesn’t take long for even a novice

smoker to get hooked. That’s because nicotine, when inhaled, stimulates the central nervous system. In addition to nicotine, there are as many as 4,000 other compounds, gases and particles in cigarettes, including hydrogen cyanide, carbon dioxide, carbon monoxide, traces of the poison arsenic and a number of cancer-causing agents. When a smoker inhales, chemicals move through the bloodstream to the brain. Blood pressure rises. The heart rate increases. Blood vessels constrict, reducing sensitivity to pain and stress, leading many smokers believe that smoking relaxes them. In truth, tobacco is damaging their health. Over time, smokers often report impaired sense of smell. They can’t taste food as well as they once did.

They don’t walk as briskly—and they don’t feel up to walking as far. Smoking also is a major contributor to stroke, heart disease and lung cancer. It is the primary cause of emphysema and chronic bronchitis. Smoking causes premature wrinkles. And women who smoke are more likely to miscarry or have low birth-weight babies. Beware of ‘companion habits’ Nicotine is not the only thing that gets smokers hooked. “Companion habits,” such as reaching for a cigarette each time you pour a cup of coffee, engrain tobacco into a smoker’s routine. Once smokers are aware of these reflexes, they can make a conscious effort to break the chain of events. For example, don’t pick up a cigarette each time you pick up the phone. Or, designate your car as a smoke-free zone instead of a place where you light up after you put the key in the ignition. If you want to quit and need help, contact Employee Health at 7331878. Delaware also offers the Quitline, a toll-free line help line for smokers. The number is 866-409-1858.

Identifying companion habits may be the key to success for many smokers who want to quit. Once smokers recognize what triggers their “reflex” to light up, they can begin focusing on breaking the links that keeps their addiction going.


Therapeutic Notes Upcoming Events

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ecause the integrity and conditions under which patients’ medications are stored before admission cannot be guaranteed, CCHS’s policy limits using or prescribing patients’ own medications to only a few situations:

n When the medication is not stocked in the pharmacy, there is no medically acceptable formulary alternative and therapy would be unacceptably delayed while the pharmacy obtains a supply of the non-formulary medication. n When the medication is complementary or alternative and is on the CCHS-approved list—at http://inet/PharmacyHP/herbal.htm. n When the medication is continuously infusing into the patient at the time of admission and is on the approved list, including:

- Total parenteral nutrition (TPN) for up to 24 hours. NOTE: After 24 hours, the pharmacy must prepare the TPN. - Insulin when administered with the patient’s own insulin pump. - Medications infused via an implanted pump. A medical director and the vice-president for Pharmacy Services or their designees must approve any exception to this policy before the medication is used. If the patient’s medication is used: n

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manufacturer’s or licensed pharmacy’s labeled container.

There will be an open house with tours and refreshments at the n A pharmacist must inspect the medication before it is administered to Christiana Care Breast Center on Wednesday, Dec. 16, 4:30-6:30 p.m. the patient. The Breast Center is in Suite 1400 at Christiana Care limits using patients’ the Helen F. Graham Cancer Center. own medications for a number of reaThe Office of Quality and Patient sons: Safety invites Christiana Care leadern Christiana Care’s comprehensive ship, departmental chairs, staff and formulary defines an appropriate other colleagues and clinicians to join scope of medication that the the Institute for Healthcare Pharmacy and Therapeutics Improvement’s 21st Annual National Operational Group (P&T Committee) Forum on Quality Improvement in has determined offers the best theraHealth Care Satellite Conference, peutic options in terms of efficacy, from Orlando, via satellite at safety and cost. Christiana Hospital, Room 1100 and n The formulary offers up-to-date the Wilmington Conference Center. prescribing information for all formu- Free to all employees, this real-time lary medications. broadcast includes four keynote sessions, plus four mini keynote sessions. n Nurses scan formulary medications at bedside to ensure patients are For more information or registration, contact Jean Davis at (302) 733-2462 or receiving the right medication and jeadavis@christianacare.org. For more dose. information on the forum, visit Financial concerns should not be an http://www.ihi.org/IHI/. obstacle in determining whether or not to use medications available on formulary. Inpatient hospital stays for Medicare patients are reimbursed based on drug related groups (DRGs). And in many cases, patients continue on the same therapy when they go home, so patients may use their own medications after they leave the hospital. If you have questions about using patients’ own medications, please call the Pharmacy at 733-3190 (Christiana Hospital) or 428- 2366 (Wilmington Hospital).


Debt to Christiana Care affects eligibility for Transformation Recognition Program awards

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hristiana Care must two key metrics in order to trigger a payout under Christiana Care’s new Transformation Recognition Program (TRP). While we continue to do well on our financial goal—operating gain that exceeds budget—we still need to see improvement in the quality metric, the HCAHPS score for the question, “Likelihood to Recommend the Hospital.” An additional criteria for eligibility

for a TRP payout at an individual level includes being an employee in “good standing.” As highlighted in the TRP brochure, an employee in good standing is defined as being fiscally responsible and satisfying any outstanding debt to Christiana Care. Examples of outstanding debt include expenses such as copays or insurance deductibles. The 863 employees who have received a bill or a payment notice from Christiana Care’s Finance Department

should submit payment as instructed or contact a Patient Financial Services, customer service representative at 302-623-7000 or in person at the Hygeia Drive site, Monday through Friday, between 9 a.m. and 4 p.m., as soon as possible to review payment options. If an employee does not address outstanding Christiana Care debt, he or she will not receive a TRP award if we achieve our systemwide metrics.

Second Annual Heart Failure Summit at Christiana Care Fills John H. Ammon Medical Education Center auditorium Carolyn Moffa, FNP-C, MSN, (left, at podium) teaches the Oct. 30 heart failure summit audience about the cardiorenal syndrome of heart failure.

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he Second Annual Heart Failure Summit on Oct. 30 in the John H. Ammon Medical Education Center attracted more than 300 health professionals. The summit, led by Mitchell Saltzberg, M.D., and Carolyn Moffa, FNP-C, MSN, featured presentations from members of the Christiana Care Center for Heart & Vascular Health and the Heart Failure Program. Topics included mechanical circulatory assist devices and heart transplantation, options for end-stage heart failure, use of ultrafiltration, psychological issues facing heart failure patients, obstructive sleep apnea and heart failure in women.

Left to right, Mitchell Saltzberg, M.D., Elisabeth Bradley, APN, ACNS, BC, CCNS, CCRN and Carolyn Moffa FNP-C, MSN.


Dentists honored for care given to special needs patients

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hree community-based dentists were honored for their pro bono service to special needs patients at the Wilmington campus. The Department of Oral and Maxillofacial Surgery and Hospital Dentistry, led by Edwin L. Granite, D.M.D., presented framed certificates to Victor L. Gregory Jr., D.M.D., Thomas E. Jenkins, D.M.D., and Frank S. Luxl, D.D.S. “These dentists voluntarily serve Christiana Care to provide direct care of special needs patients, adults and children,” Dr. Granite says. “We depend heavily on them to see patients with various disabilities, including the mentally and physically challenged, patients with autism,and others who require special care, including those with complicating medical issues.” The certificates are inscribed, “With Deepest Gratitude for Treating Patients with Special Needs and In Educating Residents to Care for Them.”

Victor L. Gregory, D.M.D., with Edwin L. Granite, D.M.D., chairman of the Department of Oral and Maxillofacial Surgery and Hospital Dentistry 14

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Thomas E. Jenkins, D.M.D. (left), with Edwin L. Granite, D.M.D., chairman of the Department of Oral and Maxillofacial Surgery and Hospital Dentistry

Frank S. Luxl, D.D.S., with Edwin L. Granite, D.M.D., chairman of the Department of Oral and Maxillofacial Surgery and Hospital Dentistry


Snapshot: Alzheimer’s Adult Day Program


Young philanthropists recognized for fundraising on behalf of Helen F. Graham Cancer Center

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he Association of Fundraising Professionals gave Alicia and Brandon Lewandowski, a brother and sister from Newark, its 2009 Youth in Philanthropy Award for their work with Kids Kickin’ Cancer, an organization they founded in 2007 in honor of their father, who died of cancer at 37. Kids Kickin’ Cancer, nominated for the award by Christiana Care, supports the Helen F. Graham Cancer Center, cancer research and other cancer-related causes. In the three years since the Lewandowskis established their organization, they have helped raise more than $65,000 through an annual 5K run/walk, golf and soccer tournaments and other fundraising activities.

From left, Brandon and Alicia Lewandowski celebrate with Gov. Jack Markell at the 2009 Philanthropy Day Awards Nov. 12 at Deerfield Golf and Tennis Club.


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