HUPdate

Volume 23

Number 12

June 15, 2012

Hospital of the University of Pennsylvania

`` Thanks to a collaboration between OncoLink and Nursing Development Education, 20 nurses from the Ocean Road Cancer Institute in Tanzania successfully completed the oncology nursing review course offered at HUP.

OUTREACH TO TANZANIAN NURSES MAKING A DIFFERENCE FOR CANCER PATIENTS

The entire team at ORCI clearly made improving patient care a top priority in the last year, and we couldn’t be more impressed.

In Tanzania, only 10 percent of patients who have cancer make it to the Ocean Road Cancer Institute (ORCI) — the sole cancer center serving the country’s 38 million people. And most are in the last stages of the disease. What has made these circumstances worse was that the country had no formal training program for oncology nurses.

“Most of the nurses come from community health and AIDS clinics,” said Maggie Hampshire, RN, BSN, OCN, managing editor of OncoLink, who traveled to Tanzania in 2010 with James Metz, MD, of Radiation Oncology and Oncolink’s editor-in-chief, to observe the situation. “They had no knowledge of how to treat side effects of cancer treatment and symptom management.”

But, starting in February 2011, that all changed. Thanks to a collaboration between OncoLink and HUP’s Nursing Development and Education, the oncology nursing review course offered at HUP — including videotaped lectures and slide presentations — was made available to ORCI nurses on CDs, along with three computers. The program, tailored to meet their needs, included presentations on treatment modalities, pain management, oncologic emergencies, supportive care, and end-of-life care. Quizzes taken after each of the 20 modules were sent back to Penn for analysis.

Nearly two years after their first visit to Tanzania, and more than a year after the program roll-out, the OncoLink team returned to formally present each of the 20 OCRI nurses with a certificate of completion.

INSIDE Speaking with HUP’s Leaders............................2 An LVAD Primer: What We Need to Know...........2

“In less than a year, ORCI had completed construction on a new building, implemented new nursing care standards, installed a chemotherapy prep hood, and began the establishment of treatment guidelines,” said Hampshire. “The entire team at ORCI clearly made improving patient care a top priority in the last year, and we couldn’t be more impressed.”

“The doctors and nurses who greeted us at ORCI were incredibly grateful for the training they received through the program,” Metz said. “We look forward to continuing our relationship with ORCI, and expanding the program so it will be broadly helpful to other African institutions.”

Art Transforms Neuro ICU........3 2012 Nursing Excellence Award Winners..........................4

1

SPEAKING WITH HUP’S LEADERS “HUP has had a good year,” said Diane Corrigan, HUP’s chief financial officer, at last month’s Meal with an Administrator.

Lower patient activity and reduced reimbursements have had an impact on hospitals throughout the region, but HUP “is experiencing some growth in both our inpatient and outpatient sides, especially in our cancer services,” she said. “We have good net operating margins as well, which means we have money available to reinvest in the hospital, our education programs, and our people.”

She noted that HUP’s bad debt is higher than expected.

This occurrence stemmed from an anticipated problem with the EPIC APM billing installation and a new universal claim form introduced this year, which created a delay in getting patient bills mailed out to insurance companies.

However, “as planned, we’re catching up and will reduce this factor before the fiscal year ends on June 30.”

The recently started construction of the South Pavilion expansion clears the way for more outpatient capacity.

Depending on many factors — including the health-care environment and Penn Medicine’s financial state — “we plan another project to replace and add new beds to the inpatient services.” But, she stressed, “we won’t overextend ourselves financially. We’re doing all of this with a no-regret strategy, only a piece at a time so we can fund the projects without risking our financial stability.”

‘Big Ideas’ Being Examined Last month, two ideas were selected as winners in Penn Medicine’s Innovation Tournament, aka Your Big Idea. “The presentations were awesome, all focusing on improving the patient experience,” said Judy James, HUP’s associate chief HR officer.

One of the winning ideas proposed the use of kiosks for patient check-ins at clinical practices. “I’m hoping we can expand their functionality — potentially make copayments or schedule a new appointment,” Corrigan said. The second winning idea would allow patients to schedule appointments with Penn doctors online, instead of having to make a phone call.

The end of the tournament does not mean that none of the other submitted ideas will be put into practice, James said. Garry Scheib, HUP’s executive director, has asked his leadership team to examine all the ideas submitted from HUP for possible implementation.

Corrigan said that the father of one of the winners who attended the Tournament finale commented on how unique this type of competition is.

“He said that not many places ask employees for ideas and then commit resources to do the right thing.”

In other HR news, James said that a new learning management system — which is “very user friendly” — will be brought onboard some time in late summer to replace Knowledge Link.

She also encouraged employees to visit the Wellfocused site to learn more about losing weight, quitting smoking, becoming active and other healthy lifestyle information. “Penn Medicine is moving towards a healthier workforce,” she said. In fact, the Philadelphia Business Journal recently selected UPHS as one of the ‘Healthiest Employers’ in the Philadelphia area with 5000+ employees. It cites our free annual biometric screenings, gym discounts, as well as many work-life balance resources through the “Wellfocused” initiative.

AN LVAD PRIMER: WHAT WE NEED TO KNOW The implantable left ventricular assist device (LVAD) that former VP Dick Cheney received last year saved his life … but took away his pulse. Why? Normally, the left ventricle fills with blood and the heart muscles squeeze it all out with one push — the blood being pushed into the arteries is what a person feels as a pulse. The LVAD, however, is a mechanical heart pump — blood moves from the ventricle into the aorta continuously.

Unlike an implanted defibrillator or pacemaker, the LVAD requires a power source outside the body. A cable connected to the device comes out of the body and connects to a mini computer that plugs into batteries. These batteries are placed in a pocketed vest or specially designed case that LVAD patients keep with them at all times. They must also carry a bag that contains their emergency equipment.

Having no pulse is normal for these patients but if a patient with a LVAD becomes ill, it is vital to call the VAD team at 267.253.2196 immediately. This emergency contact number is placed on both the patient’s bag as well as on the mini computer. `` The implantable left ventricular assist device continuously moves blood into the aorta. This eliminates the patient’s pulse, which is normally heard as the heart squeezes blood into the arteries.

2

ART TRANSFORMS NEURO ICU PROVIDES A CALMING AND HEALING EFFECT

People say the effect is only on the mind. It is no such thing. The effect is on the body too.

— Florence Nightingale, Notes on Nursing

Even Florence Nightingale knew the impact of art on patients.

Indeed, its calming and healing effect on both mind and body makes it a vital presence in a hospital environment. This is especially true in an intensive care unit which can be a frightening experience for both patients and visitors, with all its unfamiliar equipment and sounds.

When the Neuro ICU was being planned, the cost of the advanced technology necessary to provide life-saving care to its patients — many of whom have suffered severe brain injury — depleted the funding normally reserved for decorative art. The staff tried to be creative, framing neuro education posters and putting them around the unit, but that did not do the trick, said nurse manager Mary Ledwith, RN, BSN. So they sent a proposal to the Board of Women Visitors for a grant to use art to bring “comfort, solace and a welcoming atmosphere to our patients, families, and staff.”

The BWV supports Penn Medicine in many ways but improving patient care and comfort remains its priority. Each year on average, the BWV approves $300,000 to help fund projects on the ‘wish lists’ of departments throughout the Health System. The members generously provided a $20,000 grant to help transform the ICU.

Staff members met with art specialist Joan Swenson and chose pieces of art for the unit’s public areas, including around the nurses station, the waiting area, and, especially, the consultation room, which seemed cold and uninviting. “That’s where we’re telling families critical information about their loved one, where they sometimes have to make life or death decisions,” Ledwith said.

After much debate, the unit’s Healing Arts Committee chose 25 pieces, in a variety of subject matter and mixed media . Some are traditional paintings of nature, while others are more modern, such as the colorful glass discs that now grace the walls of the consultation room.

Not surprisingly, feedback from both patients and staff has been positive. “Art contributes to the environment of healing,” said M. Sean Grady, MD, chair of Neurosurgery. “It helps our patients and families through the recovery process.”

“This art work alters your focus and takes you someplace else,” added Eileen Maloney, MSN, ACNP, director, Clinical Research in Neurosurgery. “It’s nice to be surrounded by beautiful things.”

`` The 25 pieces of artwork in the Neuro ICU, which range from traditional paintings of nature to more modern pieces, contribute to the environment of healing.

3

2012

NURSING EXCELLENCE

AWARD WINNERS

`` CPUP ( l to r): Kara Pravdo, Rachel Woods, Kimberly Olson, and Linda Phillips

Each year, Penn Medicine’s Nursing Clinical Excellence Awards recognize nurses for their contributions to high-quality patient care, their clinical knowledge and professional achievements.

Congratulations to this year’s winners from HUP and CPUP!

• Lillian Brunner Clinical Judgment and Decision-Making Award: Heather Trout, BSN, RN, and Linda Phillips, BSN, RN.

• Rosalyn J. Watts Nurse-Patient/Family Relationship Award: Dawn Namiotka, RN, and Kara Pravdo, BSN, RN.

• Dorothy Botdorf Award for Clinical Leadership:

Vonda Davidson, BSN, RN, CPAN, and Rachel Woods, BSN, RN.

• Helen McClelland Award for Clinical Scholarship:

Laura Carpenter, BSN, RN, IBCLC, and Kimberly Olson, MSN, RN, CDE.

`` HUP (l to r): Heather Trout, Dawn Namiotka, Laura Carpenter, and Vonda Davidson

ANNUAL COLLEGE SEARCH SEMINAR The University’s Office of Admissions will hold the third annual College Search Seminar on Wednesday, June 27. These sessions are designed to help staff and faculty with children entering their senior year of high school with the college admissions process, no matter where they apply.

The seminar will be held from 4:30 to 6:30 pm in Room F85 in Huntsman Hall on 3730 Walnut Street. To register, go to www.admissions.upenn.edu/seminars. If you can’t attend, admissions advising sessions are available by appointment. E-mail Patrick Bredehoft, regional director of Admissions, at patrb@admissions.upenn.edu.

A GREAT ADVENTURE AT SIX FLAGS! On Saturday, June 23, employees can enjoy food, fun, and all three theme parks at Great Adventure for a reduced price! Tickets include admission to the theme park, wild safari, and Hurricane Harbor as well as an all-you-can-eat BBQ-style lunch. The cost is $41.34 per person.

Tickets are sold online. Go to www.sixflags.com/greatadventure and enter penn2012 in the small promo box in the right corner. A Great Adventure representative will be outside of the cafeteria on Friday, June 15, to answer questions. Or contact Casey Smith at kasmith@sftp.com or 732.766.0632.

SUMMER CONCERT SERIES BEGINS The third annual P.M.@Penn Museum Summer Nights concert series begins Wednesday, June 20.

Showcasing international music ranging from Middle Eastern folk/rock to Brazilian bossa nova and lively Creole zydeco, the concerts will be held every Wednesday, from 5 to 8 pm, through August 29 in the Penn Museum’s Stoner Courtyard. Museum galleries, including the special exhibition Maya 2012: Lords of Time, are open until 8 pm. For more information, call the Museum at 215.898.4000.

4

HUPdate EDITORIAL STAFF Sally Sapega Editor and Photographer Trissy Harding 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.