ED SuperTracking quickens the pace of care delivery for lower-acuity patients This is another in a series of articles about projects that are transforming care delivery at Christiana Care. o patients, “emergency” means they expect to receive care fast. So spending more than an hour in a hospital emergency department can be frustrating. In August, Wilmington campus joined Christiana Hospital in implementing SuperTrack, a process to quicken the pace at which less-acute patients—those identified as emergency levels 4 and 5— move through treatment. Results are impressive. Average length of stay dropped from more than two hours to under an hour.
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Clinical News NIH grants support research
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Patient-Centered Medical Homes
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Diabetes services expand at Springside Plaza
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Centering Care program empowers pregnant women
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General News Focus on Excellence Awards exhibit
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Fall PTO cashout update
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Now testing SPEED Now, Christiana Hospital is testing a similar process for level 3 patients. Synchronous Provider Evaluation in the Emergency Department (SPEED) is scheduled to go live in December. “These programs are an example of the tremendous transformation that is taking place at Christiana Care,” says Janice Nevin, M.D., MPH, senior vice president/executive director Christiana CareWilmington and associate chief medical officer. “Two years ago,
SuperTrack quickens the pace of emergency care delivery for many Christiana Care Emergency Department patients. you would have said it couldn’t be done.” SuperTrack reduces length of stay In January 2008, a team of ED leaders and front-line staff began identifying bottlenecks and time wasters. The team implemented changes, then tested, modified, retested and continued this process until the change met patient needs and the staff could sustain it. In addition to changes such as modifying order entry and establishing different methods of communicating among staff
SUPERTRACK, CONTINUED
and departments, the team also redesigned the space. Wilmington created an entirely new space, which opened on Aug. 6. Because everyone from IT to ED health care providers contributed to
satisfaction,” says Angeline. “Patients are happy. Some are out in 30 minutes.” Will Paynter, PA-C, Wilmington ED, says one of the most successful parts of the overall redesign was stationing a team of a nurse, a physician’s assistant and a patient-care tech—Janice Nevin, M.D., MPH nician close to the patientarrival area. the design, the space is more effec- Now, rather than repeating infortive and efficient, according to mation at various stops, the lowSusan Angeline, RN, MSN, CEN, acuity patient goes through the Wilmington ED. intake and assessment process simultaneously, significantly “We’ve seen significant improveincreasing patient satisfaction as ment in flow and patient well as reducing length of stay.
Members of the SuperTrack Project Team are transforming care delivery in the Emergency Department, speeding wait times for patients with less-acute conditions. 2
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“The times are phenomenal,” says Michelle Reeder, LPN, Christiana Hospital ED. “Nearly 100 patients a day go through SuperTrack.” ‘SPEED’ shows great potential Level 3 patients—50 percent of patients seen at Christiana Care— have moderate to severe, but not life-threatening, conditions. On average, they wait 90 minutes before seeing a physician and stay an average of nearly 5.5 hours. Building on what has been learned through SuperTrack, a team of direct health care workers and physicians is developing a new process to standardize procedures, improve room use, decrease ancillary department delays and improve patient communication and flow through the ED for level 3 patients. Even in its testing phase, SPEED shows great potential. It helped trim the length of stay 1.8 hours to 3.6 hours – a 33 percent improvement. Linda Laskowski Jones, RN, MS, ACNS-BC, CCRN, CEN, vice president of Emergency, Trauma & Aeromedical Services at Christiana Care, attributes much of the early success to improved communication among team members and their commitment to redefining the department. “We work together so closely and support each other,” says Reeder. “You just build tighter relationships.”
Christiana Care offers heart transplant candidates essential tests, less stress and less expense
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hristiana Care’s Heart Transplant Evaluation Program is celebrating another successful case of partnering with a regional transplant center and community-based cardiologist to achieve an optimal outcome for a patient awaiting a heart transplant. Florence Gibson, 46, of Wilmington, needed extra help while waiting for a donor organ. Surgeons implanted a Jarvik 2000 ventricular assist device to help restore blood flow throughout her body. Mark Zweben, M.D., of Delaware Cardiovascular, referred her to Christiana Care’s Center for Heart & Vascular Health. The team coordinated Gibson’s care with Thomas Jefferson University Hospital in Philadelphia, where she received a donor Mark Zweben, M.D., of heart on Sept. 16. Delaware Cardiovascular, Gibson also will referred his patient Gibson receive follow-up to the Heart Transplant and long-term Evaluation Program. care at Christiana Care. Spares stress of traveling out of state According to Medical Director Mitchell Saltzberg, M.D., the program enabled Gibson to keep close to her family, sparing her the expense and stress of traveling while coping with serious illness.
Mitchell Saltzberg, M.D., medical director of Christiana Care’s Heart Transplant Evaluation Program, with patient Florence Gibson. “For Ms. Gibson, the coordinated approach provided by the Heart Failure Program, Dr. Zweben and the transplant physicians at Jefferson serves everyone’s needs,” says Dr. Saltzberg. “The patient stays connected to her long-term care providers while simultaneously undergoing testing that previously could only be performed at the regional transplant centers. Everybody wins.” For information and referrals, call the Center for Heart & Vascular Health at 302-733-1663.
National Institutes of Health stimulus grants boost heart and cancer research
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hristiana Care has received two grants for heart and cancer research from the National Institutes of Health, part of the $5 billion government stimulus package aimed at cutting-edge medical research. Claudine Jurkovitz, M.D., MPH, director of operations at the Christiana Care Center for Outcomes Research, is principal Dr. Jurkovitz investigator of a $211,925 grant to study elevated levels of the protein troponin often found in patients with chronic kidney disease. High troponin levels also indicate a patient has suffered a heart attack. Dr. Jurkovitz’s research will take a retrospective look at patients who have been admitted to the emergency department with suspected acute coronary syndrome. “As a result, we’re going to be able to better understand heart disease in kidney patients and offer treatment that is better tailored to their condition,” says William Weintraub, M.D, John H. Ammon chair of Cardiology and director of CCOR. Dr. Weintraub says the NIH grants represent a trend toward supporting population-based research, which focuses on how particular disorders affect groups of people, rather than individuals. Christiana
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Care is ideally positioned for this type of clinical research because Delaware represents a microcosm of the nation, yet is small enough to readily manage. A $239,776 grant goes to the Community Cancer Oncology Program (CCOP) to develop software to more accurately track and manage patients in clinical trials of new treatments. The data will be shared with program affiliates, Beebe Medical Center in Lewes, Cooper Hospital in Camden, N.J., and Union Hospital in Elkton. CCOP Dr. Grubbs Research Director Kandie Dempsey, RN, MS, OCN, CCRP, researched the software and put together the grant proposal. The money also will fund Webbased technology that will help patients to identify which clinical trials might be a match for them. “If a new trial becomes available, we can contact the patients and let them know about it,” says Stephen Grubbs, M.D., principal investigator of the program. “It has the potential to be very meaningful to our patients and their families.” The funding from NIH is part of the American Recovery and Reinvestment Act of 2009.
Chart Completion project launches 3rd and final phase The third and final phase of the Chart Completion project rolls out Oct. 12—bringing us a step closer to the ultimate goal of a paperless medical record. Phase 3 provides the paper portion of the medical record within 48 hours of the patients discharge for viewing within accessANYware. Benefits of having the record available in accessANYware shortly after discharge include: n Immediate access to the record when needed for patient care. n Physicians can dictate discharge summaries without coming to HIMS. n Multiple people can access the record at the same time. Phase 1, rolled out in January 2006, provided the ability to view the patient’s historical medical record through accessANYware. Phase 2, implemented in June 2007, provided physicians the ability to sign and edit their dictation in PowerChart and gave the physician a view through their portal page of what documents needed to be completed.
Guest speaker Richard Baron, M.D., lectures on ‘Patient-Centered Medical Homes’
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uest speaker Richard J. Baron, M.D.’s message about patient-centered and family-centered health care drew more than 150 physicians, surgeons and staff to the Departments of Surgery and Medicine combined Grand Rounds at the John H. Ammon Medical Education Center. Dr. Baron’s Sept. 30 lecture, “The Patient-Centered Medical Home : What Is It, and Why Should an Integrated Delivery System Care?” reflected input from the American College of Physicians, American Academy of Family Physicians, American Academy of Pediatrics and American Osteopathic Association and others, in a revision of NCQA’S Physician Practice Connections® a tool for assessing whether physician practices are functioning as medical homes. Hard-hitting facts He began with a series of hard-hitting facts about general internal medicine career trends, comparisons of U.S. and other nations’ health care systems, and challenges and obstacles to change and performance and quality improvement. For example, according to Dr. Baron, as the U.S. population ages, our nation can expect a severe shortage of primary care physicians. Reasons: only two percent of medical school graduates plan careers in general internal medicine (GIM). Ten years after starting out, 20 percent of GIM physi-
cians leave their practice. Ironically, he said, a trend among medical residents toward more specialists and fewer primary care physicians leads to higher health care spending and a situation where costs are inversely related to quality. “The more you spend, the less you get,” he said. Nation’s quality of care has fallen Moreover, the quality of U.S. health care compared with other industrialized nations having advanced health care systems has fallen dramatically. On a point scale where 100 equals the best health care, our nation’s total score is only 66. And efficiency— with a dismal category score of
Virginia U. Collier, M.D., Hugh R. Sharp, Jr. Chair of Medicine, briefs Richard J. Baron, M.D., before the combined Surgery-Medicine Grand Rounds Sept. 30 at the John H. Ammon Medical Education Center. 51—is a major reason for low performance. Dr. Baron, a past chair of the American Board of Internal Medicine, has served on the National Committee for Quality Assurance (NCQA) Standards Committee since 2005. He is president of Greenhouse Internists, PC, a national leader in the use of electronic health records.
Diabetes & Metabolic Diseases Center celebrates 20 years of service and progress Twenty years ago, the Diabetes & Metabolic Diseases Center began seeing patients in the old ICU at Wilmington Hospital. “They would pull the curtains and that would be the offices,” says Jim Lenhard, M.D., medical director, who joined the center in 1993. In 1989, the only physician was G. Stephen DeCherney, M.D., a native Delawarean who had come from the National Institutes of Health to open the center with Bernardine Henderson, RN, CDE, an LPN and a secretary. Today, there is a staff of more than
Christiana Care’s Diabetes and Metabolic Diseases Center celebrates its 20th anniversary this year.
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35 to care for Delaware’s growing population of people with diabetes and metabolic diseases, including five doctors, four nurse practitioners, seven patient educators and several support staff. U.S. News & World Report has named Christiana Care one of the top 50 centers in endocrinology multiple times. Although the rate of diabetes in Delaware has risen dramatically— from an average of 3 percent in 1989 to 8.2 percent today—deaths in New Castle County have declined, from a five year average of 34 for every 100,000 residents to 24.5 per 100,000. That’s largely due to improvements in drugs, devices and testing, Dr. Lenhard says. “There have been more diabetes medications developed in the past 20 years than in all the previous years in history combined,” he notes. “Twenty years ago, an insulin pump was the size of a clock radio. Now, it’s the size of a deck of cards.” Still, diabetes is on the upswing because more people are overweight, sedentary and growing older.
Diabetes and Metabolic Diseases services expanding at Springside Later this fall, patients with diabetes and metabolic disorders will have greater access to care when a 4,400-square-foot suite opens at Springside Plaza on Route 40 in Glasgow. The facility will offer expanded services from physicians, nurse practitioners and educators. The move is in response to feedback from patients in western New Castle County and Maryland who asked for care that is more geographically accessible, says Dale Lowe, director, Eugene du Pont Preventive Medicine & Rehabilitation Institute. “You have to make health care convenient in order to make it helpful,” Lowe says.
At the center, patients are treated in a collaborative, multi-disciplinary approach that combines diet, medication and education on healthy living. “We have made tremendous strides in the past 20 years,” Dr. Lenhard says. “We’re working hard to do even more to care for people with these disorders.”
Centering Care program provides pregnant women skills in health assessment, education and mutual support
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n the Centering Room at the Wilmington Hospital Annex, what looks like a game is in progress. A group of pregnant women are talking and laughing, dropping pompoms on top of cards on the floor. But it’s not a game. It’s a group exercise, part of Christiana Care’s Centering Care program for pregnant women. They are ranking common discomforts at their stage of pregnancy for discussion—the discomfort on the card with most pompoms is first. Integrating key elements of effective health care At first every four weeks, then every two, from the end of the first trimester through delivery, groups of eight to 10 women meet for two hours in prenatal care sessions that integrate health assessment, education and support, three key elements of effective health care. Each of the 10 sessions begins with women taking their own vital signs (with assistance from the program staff) and recording them in their “Mom’s Notebooks. The notebooks also contain topics for discussion and self-assessment worksheets. As they chart their vitals and complete their work sheets, the women take turns going to an area set aside for their exam where a midwife or nurse practitioner may also talk about any
concerns or schedule more time after class. Same physical care plus ‘so much more’ “The women receive exactly the same physical care that they would in a regular prenatal visit,” says midwife Elizabeth Sushereba, MSN, CNM, “but they receive so much more. The classes are educational and help the women develop a support network.” Class topics range from nutrition to birth control to domestic violence issues to what is happening to both mother and fetus during this phase of their pregnancy. Examining fetal models at 16 and 30 weeks helps them conceptualize fetal development and why they may feel pressure or why kicks are so hard—“It’s so big!” “Look at the size of that foot!” “I love to teach, so I love this
Centering Care program instructor Caroline Conard, NP, and Stefanie Hahn use a lifelike model to discuss pointers on infant care and development.
model of care,” says Caroline Conard, NP. “We talk about issues that we never have time for in a regular checkup and are able to focus on issues important to the group.” Informal support most important Both Conard and Sushereba say that one of the most important parts of the program is the informal support that the women provide each other. “They really learn from each other,” says Conard. Since its beginning in 2008, the Centering Care program continues to expand. Wilmington Hospital is holding its 14th class. Christiana Hospital’s first class began in September and the Smyrna Women’s Health Group’s first class will begin October.
At fifth anniversary, CAPES looks back at its impact on emergency mental health care in Delaware
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or five years, the Crisis Assessment and Psychiatric Emergency Services (CAPES) unit at Wilmington Hospital has provided a safe, secure area that meets the special needs of psychiatric patients while removing them from a busy emergency department.
In recognition of its achievements, CAPES received a community service award from the State Health and Social Services Division of Substance Abuse and Mental Health. The CAPES team evaluates patients in a locked unit, adjacent to Wilmington Hospital’s
“We provide compassionate care rather than pushing patients into restrictive care.” —Sandeep Gupta, M.D. CAPES medical director
Partnership revolutionized care A successful partnership between Christiana Care and the State of Delaware, CAPES has revolutionized the way patients with serious mental health problems are treated, reducing the number of patients who are committed while decreasing the cost of care. “In the past, there were times when patients were handcuffed and taken away by police like a criminal rather than a patient,” says Sandeep Gupta, M.D., medical director, Intensive Outpatient and Partial Hospital Program and CAPES. “We provide compassionate care rather than pushing patients into restrictive care.”
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Emergency Department. The staff is highly trained to work with patients experiencing acute psychiatric emergencies. This may include de-escalating an agitated patient while ensuring safety for all. After a comprehensive psychiatric assessment, patients are discharged to the most appropriate level of treatment, in either an inpatient or outpatient setting. Proud of ‘cutting-edge’ approach “They can see a psychiatrist in the ED. We can get them medication,” Dr. Gupta says. “We take a lot of pride in being on the cutting-edge of psychiatry, keeping patients focused and coordinating their care.”
After several mental health institutions in Delaware closed, the CAPES unit was created to help address an influx of patients with psychiatric emergencies at the Emergency Department. CAPES is staffed around the clock by state-employed mobile crisis workers, registered nurses who specialize in mental health nursing and mental health associates. In addition to Dr. Gupta, a psychiatric resident from Delaware Psychiatric Center rotates to CAPES. Increasing volume, but fewer committals After only a year of operation, involuntary commitments were down 43 percent as more patients were successfully referred to and treated in intensive outpatient programs. Although the volume of patients being served in CAPES continues to increase, committal rates remain low. In addition to psychiatric evaluations, CAPES staff provides support to family members of patients in crisis. “It is a wonderful example of the way the state and a private organization can cooperate to provide better care,” Dr. Gupta says.
Regina Janney, RN, recognized for exemplary psychiatric mental health nursing
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n October at the annual American Psychiatric Nurses Association (APNA) conference, Regina Janney, RN II, BC, MS, will receive the APNA Award for Excellence in Practice—RN-Psychiatric Mental Health Registered Nurse. This award recognizes exemplary psychiatric mental health nursing practice through collaboration, patient and public advocacy, mentoring/supervision and continuing education. Janney insists that she is receiving the award for many nurses at Christiana Care. “Every day lots of nurses do the same things I do,” she says. Credits colleagues, health system Janney credits Christiana Care with supporting their work. “Christiana Care is all about excellence. It encourages staff to grow and advance. And it supports staff in delivering care to the community.” Within Christiana Care, she worked with a multidisciplinary team to develop a support program for families of critically ill and trauma patients in the Emergency Department. She mentors student nurses and nurse interns, teaching them to provide the care they would want their own families to receive. In the community, she teaches constables and county police intervention techniques. She works with New Directions Delaware, which offers support groups to people with depression and bipolar disorder and to their families. She talks with church youth groups about suicide and organizes
Regina Janney, RN II, BC, MS supplies and equipment for local domestic violence centers. Helped develop crisis center Because Delaware had no crisis center for psychiatric patients, Janney helped develop a Crisis Assessment Psychiatric Emergency Services (CAPES) unit at Wilmington Hospital and later one at Christiana Hospital. When praised for her commitment to Christiana Care and the community, Janney refuses to take credit. “I just reflect the goals of Christiana Care. It is a great place to work,” she says. And she adds, “If you don’t have a relationship with your community, there’s no sense in being here.”
Therapeutic Notes
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romethazine (PhenerganŽ) has been on the market since 1956. It has been used by oral, intramuscular and intravenous routes as a sedative, hypnotic, antiemetic, antiallergic and anti-motion sickness agent. Concern The FDA recently requires the manufacturer of promethazine to add a “black box� warning at the top of the package insert explaining that when the drug is administered incorrectly, it can damage skin severely including causing gangrene. Severe tissue injury can occur from perivascular extravasation, unintentional intra-arterial injection, and intraneuronal or perineuronal infiltration. Mechanism of harm Promethazine contains phenol and has an alkalinic pH of approximately 4.0-5.5, making it damaging to veins and tissues. Accidental intra-arterial injection or perivascular extravasation during administration of promethazine can lead to vascular and tissue damage. Another possible mechanism of harm involves crystallization and precipitation, due to the high alkalinity of promethazine, causing arterial blockage that could result in severe spasm and eventual tissue necrosis. Signs/symptoms Adverse events associated with tissue injury include: pain, burning, erythema, swelling, arteriospasm, thrombophlebitis, venous thrombosis, phlebitis, paralysis, abscess, nerve damage, tissue necrosis and gangrene. Recommendations Avoid the use of intravenous promethazine. The preferred method is to use an agent from the Christiana Care Formulary alternatives to intravenous promethazine. If patient failed therapy using an agent(s) from the Christiana Care Formulary alternatives to intravenous promethazine and if intravenous promethazine must be used, please consider the following recommendations: n Deep intramuscular injection is the preferred injection route of administration of promethazine n Intra-arterial and subcutaneous administration of promethazine are contraindicated. n The Pharmacy and Therapeutics (P&T) Committee recommends a maximum single dose of 6.25 mg IV promethazine. n The maximum recommended rate of administration is 25 mg per minute. n For IV administration, dilute to 10 mL with NaCl 0.9% and give via Y port through which IV fluid is running. n Be alert for signs and symptoms of potential tissue injury including burning or pain at the site of injection, phlebitis, swelling and blistering. n Injections should be stopped immediately if a patient complains of pain during injection. n Inform patients that side effects may occur immediately while receiving the injection or may develop hours to days after an injection. n Promethazine should not be used in patients less than 2 years of age due to the risk of fatal respiratory depression.
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Transformation Rewards Program rewards collective success
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hristiana Care continues to transform the way we deliver care. The new Transformation Rewards program (TRP), introduced in August, was created to reward our collective success. Initial feedback about the program has been overwhelmingly positive. Departments have begun to meet, brainstorm and implement changes to improve the way we deliver care and achieve our Focus on Excellence goals. To date, our progress in meeting our goals—operating gain that exceeds budget and the HCAPHS score for the question, “Likelihood to recommend the hospital” are
Continuing through Oct.30, Christiana Care’s United Way of Delaware campaign is off to a strong start. This year, the goal at Christiana Care is to increase employee United Way participation to 40 percent. Here are some FAQS for anyone who needs to know more before participating. Q. Where can I find the link to respond? A. On the green bar on all portals, click “United Way.” Q. Where do I get my USER ID and password? A. An e-mail was distributed to all employees. If you deleted the information click the United Way tab then click on
mixed, but encouraging. Remember, it’s the cumulative result at the end of the fiscal year that will trigger a payout to all employees. As of the end of August, our operating gain exceeded budget by $4.6 million. This amount is enough to trigger a payout if we can maintain it throughout the remainder of the fiscal year ending June 30, 2010. However, for the month of July, the score for the question, “Likelihood to recommend the hospital” has a 75 percent positive response rate which is below the minimum threshold of 76 percent.
“forgot password,” enter your badge ID number and e-mail address. The information will be resent to your inbox. Q. Where do I get the paper pledge forms? A. Both administration offices at Christiana and Wilmington hospitals have a supply of them. All paper pledge forms should be sent to the Christiana Care Development Office, 13 Reads
This means we still have work to do! Our challenge is to remain focused and reach performance goals. We can accomplish this by: n Maintaining open lines of communication. n Being fully productive in our roles. n Saving time, resources and/or money without compromising quality. n Delivering the very best patient experience. Remember, it takes all of us working as a team to transform care and meet our goals!
Way, Suite 203, New Castle, DE 19720. Q. I want to make my gift to a specific agency. How can I find the agency code before going into the E-Pledge System? A. Go to the United Way of Delaware Web site at www.uwde.org. Click on the Community Impact link and select “Search agency database”. Once you identify the agency, click to display and identify the agency code. Q. I am still having problems with the E-Pledge System. What can I do? A. Call the United Way of Delaware help-line at 302573-3791.
Using Christiana Care services assures quality, saves money, and supports our mission
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s an employee of Christiana Care, we encourage you to seek medical treatment at one of Christiana Care facilities when possible. By using a Christiana Care facility, you: n Receive high quality medical care. n Save money. n Help reduce the rate of rise of Christiana Care benefit costs and your contribution for your medical insurance coverage. n Support Christiana Care’s mission to take care of our neighbors in our community. Remember, if you are a participant in the health benefit plan and live in New Castle County, you are subject to a $500 copayment if you do not seek medical treatment within Christiana Care. Medical treatments include, but are not limited to, inpatient hospitalization, outpatient surgery, imaging and machine testing
services, such as colonoscopy or sigmoidoscopy, and maternity care, such as having a baby. If your medical treatment requires a visit to a non-Christiana Care facility, contact the HR Service Center at 302-327-5555 prior to the scheduled procedure and/or treatment. There are some exceptional circumstances where Christiana Care will not apply the copayment. Frequently Asked Questions Q. If my doctor has a scheduling conflict within Christiana Care, what should I do? A. If Christiana Care cannot make reasonable accommodations in scheduling the procedure, contact the HR Service Center at 302-3275555 prior to the scheduled procedure. Q. If my doctor does not have privileges to perform the services at Christiana Care, what should I do?
A. You have a choice. If you choose to stay within a Christiana Care facility, the copayment will be waived. If you use a non-Christiana Care facility, you will be charged the $500 copayment (Examples: cataract surgery performed at the Cataract & Laser Center or maternity/newborn care performed at St. Francis Hospital). Q. If my doctor recommends a procedure that Christiana Care cannot perform, what should I do? A. If Christiana Care cannot perform the service, contact the HR Service Center at 302-3275555 prior to the scheduled procedure.
Don’t miss the annual Focus on Excellence Awards exhibit. It’s an opportunity to learn with and from our colleagues about some of the most exciting things that have happened at Christiana Care over the past year. Here are the times and places to go: Wilmington Hospital Conference Center: Sunday, Oct. 11, 2 p.m. thru Wednesday, Oct. 14, noon. Christiana Hospital Room 1100: Sunday, Oct. 18, 2 p.m. thru Friday, Oct. 23, noon. 12
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Christiana Care Laboratory Outreach offers many convenient locations
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he minute your doctor orders lab tests, do you, like many otherwise intelligent and sensible adults, begin looking for creative reasons to delay having the tests done? “I work when the lab is open— transportation is too complicated—I don’t have time.” With 12 sites throughout the area, Christiana Care’s Laboratory Outreach program makes coming up with those excuses more difficult. Seven of the sites are open to any outpatient with orders for tests, and five are located in Christiana Care practices. Weekday hours range from 6 a.m. to 8 p.m.; Saturday hours, from 7 a.m. to noon. Even though the impetus for the program was outreach to the community, to make being tested easier and more convenient for outpatients, the program has also improved the quality and safety of patient care. Serving the community “The program is another example of Christiana Care’s willingness to serve the community,” says Cheryl Katz, MS, MT(ASCP), vice president, Department of Pathology and Laboratory Medicine. “But it also ensures continuity of care.” Because a courier picks up and delivers specimens throughout the day, allowing tests to be completed within 24 hours, specimen integrity is better preserved, and questions about physician orders can be resolved immediately. And
because results are posted in PowerChart, physicians anywhere in the system have access to the results, enhancing timeliness and consistency of care. Sue Saltar, practice manager, Christiana Medical Group, says, “The patients love being able to walk down the hall for a test. And the physicians are happy because patient compliance has greatly improved.” According to Joanne Downey, MBA, BHS, MT, outreach business manager, the number of patients using the services is growing rapidly, particularly at new sites, such as Foulkstone Plaza. Opened in 2009, the program served more than 50,000 patients this fiscal year. Continual quality improvement To accommodate the increased volumes in the Pathology lab, Kathleen Gorczyca, MT(ASCP) DLM, manager of laboratory operations, says that rather than just hire more staff, the team continually evaluates ways to make the lab more efficient. In 2007, the team added an automated line that not only increased lab capacity but also improved testing consistency. “The Outreach program is excellent for both Christiana Care and our patients. It provides the opportunity to have all care done within the system, ensuring high quality and seamless patient care,” says Department of Pathology and Laboratory Medicine Chair Gary Witkin, M.D.
Upcoming events The Magnet Video, produced at Christiana Care and featuring Christiana Care employees, premieres at Wilmington Hospital Conference Center on Monday, Oct. 12. Screenings of the threeminute program are slated from 7-8 a.m., and from1-3 p.m. Another screening is scheduled at Wilmington Hospital Conference Center on Saturday, Oct.24, from 11 a.m.-1 p.m. Christiana Hospital screenings are scheduled on Monday, Oct. 19 and Saturday, Oct. 24. Oct. 19 showings are in the main auditorium at the John H. Ammon Medical Education Building from 6-7:30 a.m.,11 a.m.1 p.m., 2:30-4 p.m. There also will be a 6-7 p.m. screening in Room 14. All screenings at Christiana Hospital on Saturday, Oct. 24 are scheduled in Room 1100: 7-8:30
a.m., 11 a.m.-1 p.m., 2:30-4 p.m. and 6-7:30 p.m. Come enjoy the video celebrating our quest for Magnet Nursing status and have some popcorn! Christiana Care Breast Center and The Helen F. Graham Cancer are sponsors of the American Cancer Society 2009 Making Strides against Breast Cancer Walk/Run on Sunday, Oct. 18. Registration begins at 7 a.m., the run begins at 8:30 a.m. and the walk at 9 a.m. The location is Rodney Square in downtown Wilmington. Sign up at www.strideswilmington.org. To be a team captain, walker, runner or a volunteer please contact Kim Strickler at 623- 4206. Medical Grand Rounds on Thursday, Oct. 29, from 8-9 a.m. features Peter Green, M.D., noted
CORRECTION The photo at left in a Sept. 24 story about a pharmaceutical/oncology clinical trial at Helen F. Graham Cancer Center should have identifed the nurse pictured at left as Katie Alexander, RN.
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expert from Columbia speaking on celiac disease, which he describes as a silent epidemic. The Heart Failure Program at Christiana Care’s Center for Heart & Vascular Health presents a Heart Failure Summit on Friday, Oct. 30, 7:30 a.m.-2:30 p.m., at the John H. Ammon Medical Education Center. A $20 registration fee is due by Oct. 19 by check payable to Christiana Care Health System, mailed to Chris Friday, Heart Failure Program, Christiana Hospital, Suite 2E99, 4255 OgletownStanton Road, Newark, DE 19718. For more information, contact Chris Friday at 733-1507. cfriday@christianacare.org. 2009 Wilmington Walk for Life & Breath is Saturday, Nov. 14 at 10 a.m. at the Chase Center on the Riverfront, Wilmington, with registration open at 8:30 a.m. For information, call 302-655-7258. The Respiratory Care COPD Lecture Series continues in Room 1100, Christiana Hospital, with lectures scheduled Nov. 17 10 a.m.-noon, Feb. 16, 10 a.m.noon, and April 20, 1:30-3:30 p.m. Call Debbie Wood, 7332562 to register.
Fall PTO cashout includes new 60-hour option
HIV/AIDS facility named for Wm. Holloway, M.D.
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hristiana Care’s paid-time-off (PTO) cashout program allows full-time employees in Christiana Care Health Services and Health Initiatives who have a minimum paid-leave balance of 200 hours and part-time employees with a minimum paid-leave balance of 150 hours to participate. New this year, employees have a choice of selecting 40 or 60 hours of paid leave to cashout at their base rate. The default cashout amount will remain at 40 hours. This option, offered twice a year, in the spring and fall, gives employees additional flexibility in balancing personal needs. Because the cashout program is considered supplemental pay, shift differentials do not apply. Cashout letters mail out Oct. 23 Cashout letters will be mailed Oct. 23 and are based on paid leave account balances as of the pay period ending Oct. 17, after the time used and accruals are applied. If you do wish to participate in the cashout and you want to receive the default amount of 40 hours, you do not need to reply. Your PTO cashout will be provided to you in a separate check or direct deposit on Nov. 20, 2009. If you choose to increase your cashout amount to 60 hours or to decline the PTO cashout option, please go to HR Online, available from any portal, select My Personal Information, then click on Myself, PTO Cash Out, or return your letter to Payroll by Nov. 6. Accrued paid leave account time that exceeds the maximum allowable balance in a pay period will automatically roll over to the employee’s disability leave account. Disability leave time may be accessed for medical leaves of absence, thus serving as a shortterm disability bank. Disability leave is not available for cashout.
riends, colleagues, proteges and admirers joined in a ceremonial ribbon-cutting and plaque unveiling at the HIV/AIDS Community Outreach facility in Wilmington Hospital Annex to dedicate the facility to the late William Holloway, M.D. Dr. Holloway, an infectious disease specialist, was principal investigator for Christiana Care’s HIV Community Program. He came to Delaware in 1950. He died in May 2006.
Virginia U. Collier, M.D., Hugh R. Sharp Chair of Medicine (left), and Susan Szabo, M.D., medical director of the HIV Community Program, unveil the memorial plaque.
Junior Board quilters help beautify Wilmington campus surgical waiting room
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unior Board members (center with certificates) Sandra Parkins and Anne McCarren received certificates of appreciation for making three quilts to enhance the Wilmington Hospital Surgical Waiting Room. The Junior Board gave the quilts and decorative plants to make the room a warm and inviting location for families. Diane Thomas (far right), Second Vice President, Surgical Services, received a certificate of appreciation on behalf of all the Junior Board members who volunteer in the Surgical Procedure Unit. Barbara Burd (far left) Junior Board President and volunteers attended the presentation and tea in their honor.