HUPdate

Volume 24

Number 5

March 8, 2013

Hospital of the University of Pennsylvania

m a a r l e Gosphts Up Our Hearts L ig

`` Performers at this year’s Gospelrama included (clockwise from lower left): Tamika Patton of Administration; James Burton of Security and his granddaughter, Ianna Perry McCall; Harolene Mack of Rhoads 4, Keanna Parks of Materials Management and her brother, Darryl Brown; Shakti Knox, nephew of Madeline Dawson; and Jeanette Davis of Radiation Oncology.

The 18th annual Gospelrama rocked Medical Alumni Hall, with no shortage of talent among the employees, friends and families who performed. “This event helps to recognize and celebrate our diversity,” said HUP executive director Garry Scheib, adding that Gospelrama is “one of my favorite events.”

Inside Making it to the Top..................2 Good Catch!...............................2 Speaking with HUP’s Leaders....3 Penn Kids Judge!......................3 A Tobacco-Free Future..............4 HUPdate Readership Survey...4

“We appreciate the diligence needed to keep this program going, year after year,” said Al Black, HUP’s chief operating officer. “You keep history alive by singing the songs, saying the poetry, and doing the dances.”

After a rousing musical welcome by Lorraine Harris, chaplain resident, the show took off, with special guest host Brother Marcus of Philly Praise 103.9 FM, keeping up the pace.

Many thanks to members of Pastoral Care and Tamika Patton-Watkins of Administration, who pulled the program together. Also thanks to those who contributed to the delicious after-show meal, including Lorna Taylor of Silverstein 9 and Royale Jewel Creations.

And thank you to all the performers who brought the audience to its feet, clapping and singing along!

To see more photos, go to http://news.pennmedicine.org/inside/.

1

Making it to

the TOP

Kham Xapakdy, Business Intelligence and Data architect in IS, has been where few of us have ventured: the top of Mount Kilimanjaro.

Located in Tanzania, East Africa, it is not only the highest peak on the African continent, but also the tallest free-standing mountain in the world. At its peak, it rises more than 19,000 feet above sea level (19,336 to be exact).

Xapakdy did the climb with an expedition group which included his wife, Jessica Lamey, who works at Penn Presbyterian. “I’ve always tried to do things that expand my experiences and boundaries,” Xapakdy said.

According to the Tanzania National Park website, Kilimanjaro is one of the world’s most accessible high summits. Still, the climb isn’t easy. The high altitude makes it both a challenge and a danger. “We trained for the climb, but it was hard to be physically prepared for the altitude. You can run a marathon but, up there, every step is a challenge,” he said.

And the altitude’s impact on him mentally was a surprise. “The higher you climb, the harder it becomes to think straight, to concentrate,” Xapakdy said.

It took six days to reach the top. Kilimanjaro is so large, it creates its own weather system.

“The bottom is a rainforest and, as you go up, you pass through many climate zones,” he explained. “The top is an arctic desert, with 30 mph winds.”

The last day was the final push to the top. “It took 8 hours to reach the peak that day. It was really hard to push yourself to do that last 4,000 feet.”

The reward, he said, was conquering the physical and mental aspects. “The climb itself was more enriching than reaching the summit. You have to want to do it.”

Good Catch!

Congratulations to Jeremy Bonzo, MD, of Urology, who received the Good Catch Award. The honor is presented on behalf of the Housestaff Quality and Safety Leadership Council to a Penn resident or intern who authors an important Penn Safety Net report. Penn Medicine Safety Net, the event reporting and tracking system that replaced PORTS, aims to improve patient safety by promoting awareness and identifying key issues and concerns. Bonzo’s report documented an important medication issue that occurred on the Urology service.

“Residents are at the front lines,” said Jennifer Myers, MD, Patient Safety officer. “They see gaps and opportunities for patient safety and we want to recognize, reward, and act upon what they see and report.” `` (L to r): Dan Caroff, MD; Jennifer Myers, MD; Jeremy Bonzo, MD; Patricia Sullivan, VP, Quality and Patient Safety; and Meera Gupta, MD.

2

To report an incident, please follow the ‘UPHS Quality and Patient Safety’ link on the UPHS Intranet homepage.

Speaking with HUP's Leaders Lawmakers at state and federal levels are grappling with budgets for the next fiscal year. Some of their proposals to bring down huge deficits could have a significant impact on health care. At a recent Meal with an Administrator, HUP executive director Garry Scheib discussed the potential consequences on HUP and the Health System.

To get an appreciation of just how big the federal deficit is, Scheib compared the government’s numbers (minus 8 zeroes) to that of a single family: Family income $29,000 Spending $38,000 Credit card debt $164,000 On the federal level, that translates to annual spending of $3,800,000,000,000 on tax revenue of $2,900,000,000,000, with a national debt of $16,400,000,000,000.

“Everyone agrees that our nation cannot continue spending more money than it brings in,” he said. “But elected officials can’t agree on how to fix it.”

This inability to come to a resolution may lead to sequestration — the fiscal cliff that calls for an across-the-board cut in the budget, including a 2 percent cut in healthcare expenses. If implemented, UPHS would lose nearly $6 to 7 million in Medicare reimbursements between March and June this year, with a full impact of approximately $23 million the following year.

Another proposal on the table would eliminate the annual federal cost-of-living increase on Medicare reimbursement.

“Historically, the rate has increased annually between 1 to 3 percent. If there’s no increase, the Health System will lose between $8.5 and 9.5 million.” Yet another targets payments for indirect medical education. With one of the largest teaching programs in the country, UPHS receives approximately $125 million in total medical education payments to train residents and fellows. The proposed cut would reduce the payment by around $8.6 million.

On the state level, the governor’s proposed budget does not significantly cut health care.

However, the federal government may reduce its contribution to the Medicaid program, which may affect reimbursements.

Decreasing Admissions Hospital admissions have been decreasing throughout the country. “Since the economic downturn in 2008, many people have been putting off elective surgery. Plus, many surgeries once done inpatient are now performed on an outpatient basis.”

Regionally, admissions have declined 7 percent in the past few years but UPHS admissions have declined less than 4 percent. Scheib said that, up to this year, these decreases have been offset by increases in our outpatient activity.

“Some of our outpatient services, such as chemotherapy, MR, proton and CT, have grown at nearly a double-digit pace.”

What is UPHS doing in anticipation of the potential cuts in reimbursement, asked one participant. “We’re focusing on reducing expenses in non-payroll areas now,” Scheib said, adding that, since 2008, just about every hospital or health system in the area has had

a fairly large layoff, “but we’ve avoided that — and will continue to try to avoid layoffs — by being pro-active in reducing our costs.” But, he cautioned, “we can not predict what future actions might be necessary.”

One way to reduce costs is to decrease variations in care, which may contribute to higher per-item costs. “Buying expensive devices such as implants or VADs through fewer vendors will get us better prices,” he said. “We’re also looking into travel expenses and utility costs… it all adds up!” The goal this year is to cut $50 million from the Health System’s operating expenses.

In addition to cutting expenses, the Health System is also trying to grow revenue. “We’re putting money into buildings because Penn needs more research and clinical space to stay ahead,” he said. The Health System’s strong financial position -- double-A rated with a stable outlook from both Moody’s and Standard & Poor’s – has allowed us to move ahead with capital investments that will increase our patient base.

Scheib also spoke about the recently announced signing of a non-binding Letter of Intent with Chester County Hospital and Health System. He sees bringing Chester County into the Health System as another “big growth opportunity,” increasing patient activity from that area beyond our current rate of approximately 5 to 7 percent of our patients. “It’s a good hospital with good patient outcomes.”

Penn Kids Judge!

Ceren Ozek, third-year student in Penn’s neuroscience PhD program, demonstrates parts of various animal brains to third-grade students asked to “judge” the work of Penn neuroscience students at the annual Penn Kids Judge! Neuroscience Fair.

To learn more about the fair, visit http://bit.ly/12zWa0X.

3

Moving Toward a Healthy Work Environment The health and well-being of our patients, visitors, and employees is very important. In order to promote and maintain a healthy work environment, UPHS will no longer hire tobacco users effective July 1, 2013. A tobacco user is an individual who uses cigarettes, chewing tobacco, snuff, cigars, etc.

The new policy will not have an impact on current UPHS employees who are tobacco users.

However, those who use tobacco can expect to pay a higher premium on their healthcare benefit if they are not actively enrolled in a smoking cessation program or nicotine replacement therapy. The Health System provides a free smoking cessation program to all employees and dependents covered under a medical plan.

HUPdate

Readership

Survey

This policy will not apply to UPHS employees working exclusively in New Jersey due to state laws, nor will it apply to faculty and staff employed by the University.

To learn more about the UPHS Tobacco Free Hiring Policy, go to http://www.pennmedicine.org/careers/working-at-penn-medicine/tobacco-free.html.

New Oxygen Storage Policy Recent observations in accreditation and mock surveys indicated an abundance of E-Cylinders marked as “empty” but containing significant volumes of unused oxygen gas.

This situation results in two problems: • A rack of cylinders marked empty and still containing significant volumes of gas are counted toward the fire department’s total allowable gas volume. When added to the unused cylinder volumes, it can place the area in violation of fire code.

• Refill charges on O2 tanks are based upon cylinder number and not the volume of used gas.

Therefore, a ¾ full cylinder costs the same to refill as a mostly empty cylinder.

Following HUP’s new Oxygen/Compressed Gas Cylinder Storage policy (http://uphsxnet.uphs. upenn.edu/safety/) will keep us in compliance with Life Safety Code and also help the hospital avoid unnecessary cost by sending back fewer cylinders for refilling.

Please contact the HUP Safety Management Office (662-3630) for additional information or for any questions related to this site-specific safety policy.

Abramson Cancer Center at Valley Forge Earlier this year, Penn Medicine Valley Forge opened an Abramson Cancer Center. The new on-site service offers a state-of-the-art linear accelerator, access and evaluation for Proton Therapy, and a multidisciplinary team of medical and radiation oncologists. For expedited direct referrals to schedule patients, call 610-576-7500.

Heartfelt Thanks A letter sent to Robin Obelmejias of the Perelman Endoscopy Suite

4

I feel I need to personally thank you for your professionalism and courtesy. I was very impressed by your personal attention; you taking time to explain the procedure and taking away some of my personal fear. … I have been a police officer for over 34 years and I have found that just listening to someone helps ease some of their issues… Your calm demeanor and professionalism really helped me through this ordeal. I have always felt that you can tell a person’s sincerity by how they respond to your questions and treat you like a human being not a case load…. You can now add me to the list of your growing fan club.

Tell Us What You Want!

Help us improve our employee publications by taking a quick readership survey, starting Friday, March 8.

We want to know what you think we’re doing right and, more important, how we can be better.

It only takes a few minutes to complete the survey, either online at http://pennmedicine.pubsurvey. sgizmo.com/s3/ or the printed insert. The deadline for submitting the survey is Friday, March 29.

Thank you for your help!

HUPdate Editorial Staff Sally Sapega Editor and Photographer Julia Fiorello Designer

Administration

Susan E. Phillips Senior Vice President, Public Affairs Contact HUPdate at: 3535 Market Street, Mezzanine Philadelphia, PA 19104 phone: 215.662.4488 fax: 215.349.8312 email: sally.sapega@uphs.upenn.edu

HUPdate is published biweekly for HUP employees. Access HUPdate online at http://news.pennmedicine.org/inside/hupdate.