Focus: February 26, 2009

s se cu ea o Pl le F c cy re

A publication for Christiana Care Health System physicians and employees

February 26, 2009 VO L U M E 2 0 , N U M B E R 4

Published every two weeks by Christiana Care Health System External Affairs P.O. Box 1668 Wilmington, DE 19899-1668 www.christianacare.org

Christiana Care achieves national best recruiting for RTOG trials

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ore patients enrolled in Radiation Therapy Oncology Group (RTOG) trials in 2008 at Christiana Care than at any other Community Clinical Oncology Program (CCOP) in the country.

In fact, last year Christiana Care out-recruited all but nine of the nation’s top-accruing sites for RTOG trials, surpassing five of 11 full-member sites and nine of 11 affiliate member sites, according to the February 2009 RTOG Newsletter.

Consistently high accruals

in

this

issue

Clinical News Bone Marrow Transplant Program earns reaccreditation 2 Navy doctor chooses Christiana Care for fellowship training 4 Up Close: Paul Kupcha, M.D., lengthens limbs the Russian way 6 New Code Blue stations can save lives General News Newsletter adopts color format Unfolding the new federal stimulus fund

Ple a s e r e c ycle F o cu s

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“My congratulations to Principal Investigator Adam Raben, M.D., Research Director Kandie Dempsey, MS, RN, OCN, CCRP, Research Coordinator Karen Sites, RN, BSN, OCN, and the entire Christiana Care RTOG team,” says Nicholas J. Petrelli, M.D., Bank of America endowed medical director of the Helen F. Graham Cancer Center.

“This achievement tops our consistently high patient accruals in National Cancer Institute CCOP trials, particularly those designed to optimize radiation therapy against cancer.”

The Christiana Care RTOG team enrolled 38 patients, more than Roswell Park, Emory University, Mt. Sinai and two dozen other cancer centers listed We were also the second-highest CCOP enrollers in 2006 and 2007.

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Adam Raben, M.D., Karen Sites, RN, BSN, OCN, and (not shown) Kandie Dempsey, MS, RN, OCN, CCRP, are key members of the Christiana Care RTOG team.

Treating a range of cancers RTOG trials lead to important new cancer therapies by linking basic research with clinical care.

Currently, 15 RTOG trials that integrate radiation therapy with a variety of new drugs, systemic therapies and surgery are open to Christiana Care patients to treat brain, head and neck, lung, gastrointestinal, genitourinary, cervix and breast cancers.

For more information, call the Cancer Research Office at 302-7336227. ar y

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Clinical News Bone Marrow Transplant program earns reaccreditation Only program in Delaware performed 31 transplants last year Christiana Care’s Bone Marrow/ Stem Cell Transplant program has again been reaccredited by the prestigious organization that evaluates programs in the United States and Canada.

The three-year reaccreditation by the Foundation for the Accreditation of Cellular Therapy (FACT) demonstrates that Christiana Care’s program meets FACT’s rigorous standards for the collection, processing and transplantation of bone marrow and stem cells.

Started in 1991, the Christiana Care program remains the only FACTaccredited program in Delaware, and one of only 169 in the U.S. and Canada.

Bone Marrow Transplant Program team members, are (top row, from left), Patricia Strusowski, RN, MS, Kathy Hinckle, RN, Tina Scherer, RN, MSN, OCN, Yong Zhao, M.D., Betty Stone, RN, Courtney Crannell, RN. (Front row, from left) Dawn Henry, MT, Frank Beardell, M.D., Shirley Amato, RN, Liz West, RN, and Danielle Brown, MSW. Missing from photo is Stem Cell Transplant Coordinator Mary Sheridan, RN.

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“The accreditation reinforces the great care that patients receive from the transplant team and is another reason why patients don’t have to leave Delaware for their cancer care,” says Nicholas Petrelli, M.D., the Bank of America-endowed medical director of Christiana Care’s Helen F. Graham Cancer Center.

The evaluation process included submitting mountains of documentation and required months of preparation before a site visit in December.

Doctors at Christiana Care have performed more than 500 transplants in the program’s 18-year history, including 31 transplants in 2008. The number has grown each year since 2006.

Photo by Helen Blau, 11/7/05 21

“We’re hoping to do at least that many, if not more,” in 2009, says Frank Beardell, M.D., the program’s medical director. Dr. Beardell calls the reaccreditation “a major accomplishment that defines quality in a program today.”

Patients have leukemia, lymphoma and multiple myeloma Bone marrow transplants are most commonly performed on patients with hematological malignancies, including leukemia, lymphoma and multiple myeloma, to allow significant chemotherapy dose escalation. Additional benefit comes from transplantation using a donor’s stem cells, where the donor’s immune system helps fight the cancer, as well.

The bone marrow, which contains the stem cells is the factory of the blood that produces white and red blood cells and platelets.

Stem cells counter bad effects of high-dose chemotherapy Providing a fresh source of stem cells to patients who have received high doses of chemotherapy can save the patient from the effects of high-dose chemotherapy.

Stem cells can be harvested from either the peripheral blood or directly from the bone marrow.

Depending on the condition being treated, hematologists can consider using either the patient’s own stem

Flourescent tracking shows transplanted bone marrow cells in neural cells of leukemia patients. Dendrites indicate new growth.

cells (called an autologous transplant) or stem cells from a donor (called an allogeneic transplant).

In the latter, the stem cells come from either a matched sibling or a non-relative, depending on what is best for the patient. The Christiana Care program performs both autologous and allogeneic transplants.

Supporting National Marrow Donor Program Of the 31 transplants performed last year, 19 were autologous transplants and 12 were allogeneic transplants. Christiana Care doctors performed 41 harvests in 2008, many of which were for the National Marrow Donor Program, which works to secure stem cells from unrelated donors around the world.

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Christiana Care Emergency Ultrasound Fellowship attracts applicants from around the globe Joel Schofer, M.D., spent five months during the spring and summer of 2003 as a general medical officer assigned to a U.S. Marine Corps battalion in Iraq.

The U.S. Navy lieutenant commander‘s experience of caring for 1,500 U.S. Marines and crisscrossing much of Iraq with a mobile emergency room helped prepare him for an Emergency Ultrasound (EUS) Fellowship at Christiana Care, where he is on a team of doctors who diagnose and treat patients at Christiana and Wilmington hospitals.

Emergency Ultrasound fellow Joel Schofer, M.D., with Paul Sierzenski, M.D., fellowship director and director of Emergency, Trauma, & Critical Care Ultrasound.

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One of three physicians currently serving one-year EUS fellowships, Dr. Schofer is mastering ultrasound—a tool that uses sound waves to produce an image of the body’s organs—to diagnose life-threatening conditions such as penetrating and blunt trauma, ruptured abdominal aortic aneurysms or pulmonary embolism—the condition that claimed the life of NBC News reporter David Bloom in Iraq in 2003.

Program is one of first in the nation The fellowship, which was among the first in the country when it accepted its first fellow in 2002, is also one of the busiest. Because of the four-state area from which Christiana Care draws more than 150,000 ED patients, physicians at Christiana and Wilmington hospitals perform more than 10,000 emergency bedside ultrasounds a year, exposing the fellows to one of the busiest and most varied case loads in the country.

The highly sought-after program — still one of only about 30 in the nation—receives about 15 applications a year from physicians as far away as Japan, China and the United Arab Emirates. During the year-long fellowship, each fellow performs between 800 and 1,200 emergency ultrasounds and reviews another 3,000 scans, says Paul R. Sierzenski, M.D., RDMS, the

fellowship director and director of Emergency, Trauma & Critical Care Ultrasound at Christiana Care.

EUS Fellows perform more than 14 ultrasound applications including trauma, cardiac and aorta, as well as some pioneered at Christiana such as ocular, thoracic ultrasound and transcranial doppler for acute stroke care. On average, the fellows see two ruptured abdominal aortic aneurysms and 10 pericardial effusions a month – more than their peers at many other hospitals are likely to see. In a two-week period in December alone, the fellows diagnosed three cases of pulmonary embolism with evidence of severe cardiac compromise on ultrasound, prompting immediate thrombolytic therapy, Dr. Sierzenski says.

Fellows learn to lead EUS programs at other hospitals The variety of different conditions fellows get to treat—what Dr. Sierzenski calls “some really unbelievable pathology”—has prepared physicians to go on to head emergency ultrasound programs at other hospitals around the country.

Fellows develop skills in clinical ultrasound performance, quality assurance, program integration and ultrasound education and research.

“From a training standpoint, and as a result of our collaborative relationships with other departments, it is superior to most universitybased teaching hospitals,” Dr. Sierzenski says.

When Dr. Schofer completes his fellowship in September, he will be assigned to the medical staff at the Naval Medical Center in Portsmouth, Va., as director of its emergency ultrasound program.

Chance to see patients with wide range of serious conditions The opportunity to work with patients with such a wide variety of serious medical conditions is one reason Dr. Schofer chose to apply for a fellowship at Christiana Care over competing programs. “You don’t see patients in other hospitals with the kind of severe diseases that come rolling through the door here,” says Dr. Schofer.

Dr. Schofer’s enthusiasm and what Dr. Sierzenski calls his “rubbermeets-the-road kind of performance” were two of the main reasons he was selected for the program, Dr. Sierzenski says, adding, “These are qualities he shares with his 20082009 EUS fellowship colleagues Jason Nomura, M.D., and Mick Bauman, M.D.” Dr. Schofer, 33, is a 2001 graduate of MCP Hahnemann School of Medicine. He completed his emergency medicine residency at the Naval Medical Center San Diego.

He is married to a pediatrician and has two children.

For more information on Christiana Care’s EUS program and fellowship, visit www.christianacare.org/residentbody.

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Surgeon Paul Kupcha, M.D., performs limb-lengthening procedures in Delaware OrthopedIC SURGEON took Ilizarov training in Siberia

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iving with legs that are two different lengths is challenging and painful.

“It can affect every area of life, from employment to relationships,” says Paul Kupcha, M.D., an orthopedic surgeon trained in limb lengthening and reconstruction.

For years, adults who required surgery to lengthen or shorten limbs had to travel to Baltimore for care. Since 2002, Dr. Kupcha has been treating patients at Christiana Care, the only health system in Delaware that offers these life-changing procedures to adults.

Dr. Kupcha also works with doctors at A.I. du Pont children’s hospital to treat children who suffer from congenital deformities or injuries.

Patients come from all walks of life At Christiana Care, Dr. Kupcha’s patients have ranged from an 80-year-old woman who had suffered a badly broken ankle to an immigrant who had sustained a

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Dr. Kupcha and his wife, Grace Kelly, pose before a statue of the Russian surgeon Gavril Ilisarov, who developed the apparatus for lengthening limb bones.

childhood injury that had not been properly treated because he didn’t have access to medical care.

In adults, skiing accidents and motorcycle crashes can result in limbs of different length. Infections in the bone or old fractures that didn’t heal properly also are factors. In children, birth defects such as clubfoot can cause legs to grow at different lengths.

“Someone who is in constant pain, is on crutches, can’t put weight on his leg can experience a tremen-

dous improvement in quality of life,” Dr. Kupcha says. “In some cases, patients weren’t able to work and now they can get jobs.”

Procedures started in Russia Surgical procedures to lengthen limbs were developed in the late 1950s by Dr. Gavril Ilizarov, a renowned Russian surgeon, but weren’t recognized in the United States until the 1990s. Dr. Kupcha traveled to Siberia twice, in 2003 and 2004, to study with Ilizarovtrained surgeons.

“Fortunately, it was in the summer, so it was pretty mild,” he recalls.

To lengthen a leg, the limb is encased in a scaffold-like frame called a fixator that is connected to the bone with wires, pins or both.

A small crack is made in the bone and each day the crack is widened about one millimeter as the bone fills in. The average growth rate is about one inch per month.

The fixator is worn until the bone is strong enough to support the patient safely. This usually takes about three months for each inch.

In Dr. Ilizarov’s day, the frames were fabricated in a machine shop.

The president of the Delaware Society of Orthopaedic Surgeons, Dr. Kupcha practices at the Delaware Orthopaedic Center and is the only fellowship-trained foot and ankle surgeon in the state.

Paul Kupcha, M.D., takes part in an Ilizarov procedure in Russia in 2004.

He is a graduate of the University of Pennsylvania, where he played football and baseball, as well as Georgetown University Medical School. He completed his surgical and orthopedic residencies at Thomas Jefferson University Hospital in Philadelphia.

“Now, it’s high tech,” Dr. Kupcha says. “We use computers.”

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Focus on Excellence – Best Practice Review Consistent with our strategies for engagement of staff in continuous improvement and best practice, we regularly review important topics in Focus to help reinforce safe practice behaviors. These tips will reinforce information and enable staff to better articulate our safety practices during an unannounced survey.

n The patient may be released from

the procedure area with a postsedation score greater than or equal to nine or no less than the pre-sedation score. n In the outpatient setting, the patient

may be discharged if: n The patient has not had any

Patient Safety and Joint Commission Hotline The Patient Safety and Joint Commission Hotline is a quick and easy way to report safety concerns that are not routinely reported through Safety First Learning Reports. All staff and physicians may use the hotline to: n

Communicate a near miss or a ‘’good catch.’’

n

Report a potential safety issue that may not be associated with an individual patient but is of concern to you.

n

Seek clarification on a regulatory question.

sedation for 30 minutes.

Moderate sEdation Q. What is moderate sedation?

A. Moderate sedation is a druginduced depression of consciousness during which patients: n Respond purposefully to verbal

commands, either alone or accompanied by light tactile stimulation. n Do not require to maintain a

patent airway. n Have adequate spontaneous

ventilation. n Maintain cardiovascular function.

Q. What are the post-procedure/ discharge requirements?

A. Requirements include the following: n Blood pressure, pulse, pulse ox

and level of consciousness will be monitored at least twice, every 15 minutes, for one-half hour, and then continuing until the patient meets recovery criteria according to the post-sedation score.

n A reversal agent has not been

administered for at least two hours. n The sedation-recovery score is

greater than or equal to nine or no less than the pre sedation score. n Appropriate discharge planning/

instructions have been provided and documented. n The patient has assistance with

transportation home (patients will not be permitted to drive home).

To ask questions, contact the content expert: Barb Eaton, 733-5815. To reach the Safety Hotline, call SAFE (7233) from within Christiana or Wilmington hospitals. From outside the hospitals, call 302-623-SAFE. Further information is available in the Archives of Best Practices. From your portal, choose Focus on Excellence, Joint Commission Readiness, Ongoing Strategies, Educational Strategies, Monthly Q&A.

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Calls can be placed at any time (24/7). Callers may leave their names or choose to remain anonymous. The call should describe the safety concern and department or area affected. If you are calling from outside of the hospitals, please call 302-623-SAFE (7233).

To report a safety concern from within Wilmington or Christiana hospitals, call SAFE (7233).

All calls are logged into an established database and referred to the appropriate department or individual who can address and/or resolve the issue(s).

Thank you for improving patient safety.

New first-floor code blue stations installed at Christiana Hospital Five new code blue stations on the first floor of Christiana Hospital go live on Feb. 24 and provide greater access to resuscitation equipment for life-threatening emergencies. A blue light identifies the location of each station.

Locations of new code blue stations n

E tower by visitor elevators

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Outpatient way

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Station 4

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Station 9

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Middle way (The hallway behind and parallel to outpatient way)

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D tower outside of CT scan

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A tower in radiology department

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Proceed with basic life support until code team arrives.

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Stay with patient to answer code team questions and until disposition is determined.

For more information, go to the Code Blue Education Web Site: http://inet/codeblue/codebluehp. htm.

How to use the stations If you are transporting a patient on the first floor who becomes unresponsive or stops breathing, transport the patient immediately to the nearest code blue station. n

Access the station via employee badge.

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Pick up phone and say exactly what is on the script card on the bulletin board.

Brittany Rhoads, RN, shows one of the Code Blue stations just installed on the first floor at Christiana Hospital.

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Kidney Transplant Program launches downstate clinic Christiana Care’s Kidney Transplant Program launched a kidney clinic Jan. 29 for 35 patients who live south of Dover and are awaiting transplants at Christiana Care. The patients represent about 15 percent of the waiting list, currently at 236.

The bimonthly clinic at the Christiana Care Center for Heart and Vascular Health satellite office on the Beebe Medical Center campus in Lewes means a shorter commute and less cost for downstate patients.

“It is 82 miles and 88 minutes of drive time from Seaford to Newark, not to mention gas and tolls,” says Transplant Coordinator Gail Eastman, RN, MSN. At most, “Lewes is only 31 miles away – saving patients 57 minutes and about $10 each way in transportation costs,” says Eastman.

awaiting a kidney,” says S. John Swanson III, M.D., chief, Transplant Surgery. “The six month follow-up is an important visit and our effort to remedy the problem. Reaching patients where it makes sense for them is important because it puts them at ease, improves compliance with regular visits and allows us to track their progress closely.”

Christiana Care’s Kidney Transplant Program has performed 35 transplants and evaluated more than 800 individuals for transplant since January 2007. For upcoming clinic dates in Lewes, call the Kidney Transplant Program at 302-6233866.

Improves continuity Physicians see patients on the list every six months to ensure they remain viable transplant candidates and to review new allocation rules for transplant listing.

“It’s been a long-standing failing of the transplant community to follow patients while they are listed and From left, Christiana Care Kidney Transplant Coordinator Gail Eastman with office assistant Vicky Jenkins and Medical Assistant Moira Quint at the kidney transplant clinic in Lewes.

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p u b l i s hing , p r e s e nt a ti o n s , A P P O I N TM E N T S , awa r d s The following Christiana Care nurses, physicians and staff have earned recognition for professional achievement.

Publishing Susan Mascioli, RN, CPHQ, BSN, MS, Linda Laskowski-Jones, RN, ACNS-BC, CCRN, CEN, BSN, MS, Sharon Urban, RN-BC, MSN, and Shirley Moran, RN, CNA, MS, published an article titled “Improving Handoff Communication” in the February issue of Nursing 2009, Vol. 39 No. 2 Hisham M.F. Sherif, M.D., FAHA, Ehsanur Rahman, M.D., Nowwar Mustafa, M.D., Vinay R. Hosmane, M.D., Vivek Reddy, M.D., Angela DiSabatino, RN, MS and William Weintraub, M.D., published and article titled “Recovery After Resuscitation from Cardiac Arrest in ST Elevation Myocardial Infarction: A Computer-based Decision Support Tool, in Studies in Healthcare and Informatics, vol. 142 (2009) 310-312. There also was a poster presentation on the same subject at the 17th annual Medicine Meets Virtual Reality conference, Long Beach, Calif., Jan. 19-22.

Hisham M.F. Sherif, M.D., FAHA, published an article titled “Calcification of Left-sided Valvular Structures: Evidence of a Pro-inflammatory Milieu,” in the Journal of Heart Valve Disease, 2009 (January);18.

Marsha Babb, RN, BSN, MS, CNOR, published an article titled “Clinical Risk Assessment: Identifying Patients at High Risk for Heart Failure,” in the AORN Journal, February 2009, Vol 89, No. 2.

Darcy Burbage, RN, MSN, AOCN, Emily Penman, M.D., Renee Mullaney, MS, Jacqueline Napoletano, M.D., Zora Ali-Khan Catts, MS, CGC, and Lois Torgerson published an article titled “High-risk breast and ovarian cancer: The experience of one community-based teaching hospital and cancer center” in Oncology Issues, January/ February 2009.

Appointments Christiana Care vice president of Operations and Business Development Joseph Richichi was appointed to the Town of Smyrna’s Business Development Committee.

Submissions to Publishing, Presentations, Appointments and Awards are welcome.

Nurses should e-mail submissions to Carol Boettler at cboettler@christianacare.org.

Resident physicians and attending physicians should e-mail their submissions to Jo Ann Umbel at jumbel@christianacare.org and staff to Corp Comm-Focus Editor.

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Expo attracts 266 students from area nursing schools The 2009 Student Nurse Expo on Jan. 30 attracted 266 nursing students—30 percent above last year’s attendance—from more than 20 area nursing schools to the John H. Ammon Medical Education Center.

Christiana Care nursing leaders and staff acted as health system ambassadors while representatives of various nursing specialties provided history, knowledge and interactive learning programs.

“As a result, many of the student nurses expressed interest in working as student-nurse externs, PCTs or in other capacities” says Manager of Recruiting Services Wendy Gable.

About 70 of the student nurses who attended the Expo will graduate Nursing school in May.

General News From the editor

Focus’s new color format In the Jan. 29 issue, Focus announced Focus’s “Go Green” strategies that are intended to help our award-winning employee newsletter become an environmentally friendlier publication.

The new format enables Focus to present striking full-color graphics, illustrations and photos, such as this image from the combined PET/CT scanner at Heart & Vascular Health.

(For the full story, see the Feb. 28, 2008 issue in the Focus archives on the portal.)

To achieve our goal, we’ve figured out how to fit two weeks worth of news and information into a 16-page format, without affecting the quality of the publication. It weighs half as much as before and we are saving 14 tons of ink and paper with our new Focus format.

We’ve been busy encouraging many employees, physicians, retirees and other Focus readers to access Focus online at www.christianacare.org.

So far, we’ve managed to reduce the amount of paper needed to distribute Focus in print by 35 percent.

In this issue, we’re delighted to introduce a new full color format.

From now on, photos that show our health system’s people, places and things will be published in vivid colors on high-quality recycled paper.

And, we’re able to do it without increasing the cost of printing above what we were paying to print Focus in only two colors.

Here’s why: Since our vendor’s printing presses almost always run full-color printing jobs, shifting to our two-color job required a thorough press cleaning to drop down to only two colors.

By skipping that step, the printer saves significant time and labor and passes enough of these cost savings to us to make Focus a color publication without increasing our costs.

So, we’re happy to say we’re not only saving paper, but also helping prevent a lot of ink from being wasted during the cleaning process.

The next step in making Focus environmentally friendlier belongs to you, the readers. It is printed on recycled paper and should be returned to the recycling process when no longer wanted. We hope you will take care of that detail while routinely placing it and any other recyclable paper and materials in the appropriate bins throughout Christiana Care.

Focus thanks contributors for their useful feedback and encourages readers to continue to share helpful insights and suggestions and story ideas by e-mailing Corp Comm – Focus editor on Outlook.

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general news

UPCOMING EVENTS Thinking about changing your lifestyle and eating a healthier diet? Come to the “Nutrition Fair” on Monday, March 23 from 9 a.m.-1 p.m. and Wednesday, March 25 from 1-3 p.m. in the Wilmington Hospital Health Center main hallway on the 2nd floor. There will be a variety health and nutrition of information provided as well as opportunities to question staff physicians, nurses and nutritionists.

Social Work Department-sponsored vendor fairs featuring representatives from transportation companies and medical equipment companies, hospices, home health care and private duty caregiver agencies, and nursing and assisted living facilities to provide information and answer questions.

Schedule: Christiana Hospital, Room 1100, noon-2 p.m. n Feb. 27 – Transportation and medical equipment companies. n March 5 – Hospices, home health care and private duty agencies. n March 10 – Nursing and assisted living facilities.

Wilmington Hospital Conference Center, noon-2 p.m. n March 20 – Hospices, home health care and private duty caregiver

agencies and medical equipment companies. n March 25 – nursing and assisted living facilities and transportation companies.

All staff, patients and their family members are invited to attend. Contact Jaynnette Tirado at 733-5727 for Christiana Hospital or Debbie Kling at 428-2149 for Wilmington Hospital.

The ICD Support Group for patients with implantable cardioverter defibrillator (ICD) devices meets for a discussion series on either the first or second Tuesday of each month, from 6-7:30 p.m. Next up: Tuesday, March 10, 2009, “The difference in signs and symptoms of heart disease in men and women,” with Kathleen McNicholas, M.D., medical director of Performance Improvement. Meetings are free, but registration is requested for each session. To register, call 800-693-CARE (2273) or 302-623-CARE (2273).

A free comprehensive weight-loss surgery seminar takes place monthly at the John H. Ammon Medical Education Center. Participants can meet a bariatric surgeon and members of Christiana Care’s Weight Management Center staff to have questions answered and learn more the Weight Management. Next seminars are: n Tuesday, March 17, 6:30-8 p.m. n Tuesday, April 21, 6:30-8 p.m.

Contact the Weight Management Center at 302-661-3475.

Call for Entries: 2009 Commendation for Excellence The Christiana Care Medical-Dental Staff Awards Committee seeks nominations for the 10th annual Commendation for Excellence to be presented at the Medical-Dental Staff Annual Event this fall.

The Commendation was established to honor current and former members of the Medical-Dental Staff who have made exceptional contributions to the community through their clinical, scholarly, educational or humanitarian activities.

Any member of the Medical-Dental Staff may nominate an eligible person for the award by the May 4 deadline by submitting: n

A letter outlining the reasons for the nomination.

n

Qualifications of the nominee.

n

The nominee’s curriculum vitae, if available.

The Ninth Annual Think First 5K-Run/Walk to support Christiana Care Trauma Program injury prevention efforts will be April 16 at 6:30 p.m. The race starts and finishes near the Emergency Department on Christiana Hospital campus. Register online in advance at www.races2run.com or race day starting at 5:40 p.m.

The physician or dentist selected by the Awards Committee is endorsed by the Medical Executive Committee.

The 13th Annual Diabetes Update, at the John H. Ammon Medical Education Center, is Saturday May 2, 7:30 a.m.-4 p.m. This is a full day of educational activity for health care professionals providing an update on the management of diabetes.

The advance registration fee is $70 ($35 for students; residents registered in advance attend free). Tickets at the door are $90, $50 for students. Please make checks payable to Christiana Care and mail to Cheryl Klecko, Physician Relations, Christiana Hospital, Suite 2177, 4755 Ogletown-Stanton Road, Newark, DE 19718. For information, call 302-733-1961 or e-mail cklecko@christianacare.org.

Send nominations to Dawn Gies, Christiana Hospital, 4755 Ogletown-Stanton Road, Suite 1270, Newark, Del., 19718; e-mail to dgies@christianacare.org; or fax to Dawn Gies at 302-733-1366.

An Evening in Monte Carlo, a fundraiser for the Helen F. Graham Cancer Center, will be Friday, May 15, 7 p.m. to midnight at Longwood Gardens. The event supports acquisition of an FACS cell sorter in the Center for Translational Research opening in the new building this spring. The sorter helps isolate malignant cells from colon, breast, lung, prostate and other cancers.

For more information Contact Gies at 302-733-1049.

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Delaware stimulus funds: How can Christiana Care benefit?

As state officials in Dover are busy reviewing the details of the stimulus funds headed to Delaware, Christiana Care has charged an ad hoc committee chaired by Senior VP of External Affairs Michele Schiavoni to review and recommend ways in which Christiana Care might benefit. The recommendations of that committee will be reviewed and reported at leadership meetings, on our portals and in Focus.

rules on limiting costs for public hospitals, eliminating federal aid for graduate education, and covering rehabilitation services for people with disabilities.

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Health care assistance ■

Provides a 65-percent subsidy for COBRA health insurance premiums for nine months to workers who have been laid off.

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Extends Transitional Medical Assistance (TMA) for families who risk losing Medicaid benefits if their income increases.

Here is a brief rundown of how Delaware’s stimulus funds will be applied.

Medicaid and Medicare ■

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Increases Delaware’s Medicaid Disproportionate Share Hospital Payment Program (DSH) allotments by 2.5 percent in 2009 and by 2.5 percent of the 2009 total in 2010. The only DSH hospital in Delaware is the Delaware Psychiatric Center.

Delays implementing Centers for Medicare & Medicaid (CMS) regulations that adversely affect state provider tax laws, specialized medical transportation to school for children covered by Medicaid, case management services that allow people with disabilities to remain in the community, and outpatient services.

Proposes that the Secretary of Health and Human Services not finalize the proposed CMS

Prevents the 2009 scheduled 50-percent reduction in indirect medical education capital payments to teaching hospitals.

Training ■

Funds scholarships, loan repayment and grants to training programs, including the National Health Services Corps program.

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Provides funds for nurse and physician training.

Prevention and wellness ■

Creates a prevention and wellness fund.

c o ntinue d on nex t p a ge

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S t imulus f un d , c o nt inue d n

Supports strategies to reduce chronic disease and health careacquired infection rates.

Comparative effectiveness research n

Funds comparative effective research through the NIH and the Agency for Health Care Research and Quality.

n

Provides funds to accelerate developing and disseminating the research.

Technology n

Awards grants for expanding and improving broadband service infrastructure.

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Provides funds to strengthen the health information technology (HIT) infrastructure.

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Provides grants, loans and incentive payments for providers who adopt and use HIT, such as electronic health records.

Hospital bonds n

n

Creates incentives for banks to buy and carry tax-exempt hospital bonds.

Funds oversight of the stimulus provisions and strengthens and codifies HIT privacy and security provisions.

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Federal stimulus plan to benefit Medicaid in Delaware The federal economic stimulus package will provide financial assistance to Delaware in many ways. One provision of the stimulus package increases the Federal Medical Assistance Percentage (FMAP) for the Medicaid program.

The FMAP is the federal match for state expenditures for Medicaid payments. Delaware’s FMAP is currently 50/50, meaning that the State pays 50 percent of the Medicaid costs and the federal government “matches” or pays the other 50 percent.

Under the economic stimulus bill, the federal share of Delaware’s FMAP will increase 6.2 percent. In other words, the federal government will now pay 56.2 percent of Medicaid costs while the State will pay 43.8 percent. It is also likely that Delaware will receive a bonus unemployment related FMAP increase, which is based on a complex, tiered structure comparing Delaware’s current unemployment rate to its lowest unemployment rate since Jan. 1, 2006.

The Delaware Division of Medicaid & Medical Assistance projects that the FMAP increase will probably be around $300 million over 27 months (Oct. 1, 2008, through Dec. 31, 2010). This number could change as the Division delves further into its analysis of the stimulus package. Important to note is that

the FMAP increase is temporary, and this, undoubtedly, has some policy makers concerned that the increase will not last long enough to stabilize State Medicaid budgets.

Gov. Markell visits to share state’s financial outlook More than 300 of Christiana Care’s physicians and managers attended Gov. Jack Markell’s Reality Check talk at John H. Ammon Education Center on Feb. 11. The governor outlined the economic conditions that are creating a $606 million economic shortfall for the state. The

economic challenges of the nation’s second smallest state, Delaware, are on par with the financial challenges of both Michigan and Ohio.

“We have painful decisions to make but we will survive and thrive if we work together,” Gov. Markell said. “Christiana Care is an incredible resource in the state.

Your brain power will be critical to our success.”

When asked about taxing hospitals, the governor predicted that the provider tax will come up again this session in the legislature.

When that happens, he said, “We want Christiana Care at the table, to be part of the conversation from the start rather than responding at the end. We want you to be part of the solution.”

Gov. Jack Markell delivered his “Reality Check” presentation at Christiana Hospital Feb. 11 before a packed auditorium.

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GENERAL NEWS

PEEPS recognizes Center for Advanced Joint Replacement

Service Assistant I Arnita Ridgeway likes to make a good impression

The Center for Advanced Joint Replacement received the 2008 PEEPS Injury Prevention Award for achieving the highest ratings for leadership in Safe Patient Handling and Mobilization. Teams receiving honorable mentions include 2E, 5EW, 2C, 7E, 5B, WICU and 6C.

Arnita Ridgeway works to keep patients’ surroundings clean and germ-free.

Several departments were recognized for significant improvement in their Lost Time Injuries (LTI) over the last several years.

Congratulations to Textile Services and Patient Escort for decreasing their LTIs by 69 percent and 60 percent, respectively.

“It’s a very important job and I love it,” says Ridgeway, a service assistant I at Wilmington Hospital.

“I feel great when families come to visit patients on the seventh floor and remark how bright and clean it is.”

Attended soft skills training program Ridgeway’s career path at Christiana Care began seven years ago with a soft skills training program, presented by Anton Associates and funded by the Delaware Economic Development Office. Students learned the importance of self-discipline, punctuality and taking responsibility.

“We learned things to get us ready for the work world,” she says.

“Once I set my goals, doors started opening for me.”

Ridgeway landed a part-time job in Patient Transport and eventually took a full-time position in Environmental Services.

Members of the Center for Advanced Joint Replacement team recognized for highest ratings for leadership in Safe Patient Handling and Mobilization include, from left, Mary Ellen Hines, PT, Mercy A. Badu-Nkansah, RN, Nancy Lampert, RN, BSN, SDS, Terry Foraker, RN, NM and Injury Prevention Coordinator Beth D’Aurizio, PT. Missing from the photo are Kenny Smith, PCT and Shirley Harris, PCT.

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Jean Whidbee, operations manager of Environmental Services, says Ridgeway is a people person who has a gift for getting along with others.

Knows her job “She has a good concept of the job and is a very pleasant person to work with,” Whidbee says. “In our business, that makes a big difference.”

Carvella Jackson, a Christiana Care recruiter, says Ridgeway is a testament to both training and personal perseverance.

“Arnita is a role model, a complete success story,” she says.

Building her house In recent months, Ridgeway also has been working with neighbors and volunteers from Habitat for Humanity, building a threebedroom, one-bath townhouse in Wilmington’s Webster Village for herself and her 11-year-old daughter, Nyeema.

The program required that she attend home repair and personal finance classes and work for 225 hours to help build her own home, as well as townhouses for nine other families in the neighborhood. As the paint was drying, Ridgeway’s home-to-be was the site of a dedication ceremony attended

by Gov. Jack Markell, U.S. Rep. Mike Castle and Councilwoman Stephanie Bolden.

Ridgeway says the culture of excellence at Christiana Care prepared her to take on the hard work of becoming a homeowner.

“My life took a big change for the better when I came to Christiana Care,” she says. “It truly is a wonderful place to work.”

Service Assistant I Arnita Ridgeway (center), poses with two colleagues she has impressed, with Christiana Care Recruiter Carvella Jackson (left) and Environmental Services Operations Manager Jean Whidbee.

Christiana Care’s Compliance Hotline Christiana Care’s Compliance Hotline can be used to report a violation of any regulation, law or legal requirement as it relates to billing or documentation.

The hotline will be answered 24 hours a day, seven days a week. All reports go directly to Compliance Officer Ronald B. Sherman. Callers may remain anonymous.

The toll-free number is 877-REPORT-0 (877-737-6780).

To learn more about corporate compliance, review the Corporate Compliance Policy online or contact Sherman at 302-428-4503.

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Dr. Gardner offers advice for staying healthy throughout life Timothy J. Gardner, M.D., medical director of the Center for Heart and Vascular Health at Christiana Care and president of the American Heart Association (AHA), presented his popular community lecture “Staying Young at Heart at Every Age” on Tuesday, Feb. 10, to a full house at the John H. Ammon Medical Education Center. Visit www.christianacare.org for a chronicled list of Dr. Gardner’s statements and views throughout his term as national AHA president.

External Affairs P.O. Box 1668 Wilmington, DE 19899 www.christianacare.org

Timothy Gardner, M.D., (left) greeted enthusiastic audience members who still had questions after the community lecture Feb. 10.

PRSRT STD U.S. POSTAGE PAID WILMINGTON, DE PERMIT NO. 357