Volume 23
Number 20
October 5, 2012
Hospital of the University of Pennsylvania
`` Founders 14 has passed 600 days without a catheter-associated urinary tract infection.
More Success in Fighting HAIs HUP’s fight against HAIs (health-care acquired infections) continues, with many successes along the way. For example, Ravdin 9, Silverstein 7 and Silverstein 10 all passed the 1,500-day mark without any central-lineassociated bloodstream infections. To put this into perspective, Senator Barack Obama was on the campaign trail the last time any of these units had a BSI … for his first presidential campaign!
catheter-associated urinary tract infection UTI (urinary tract infection) and the CCU has reached 1,000 days without a ventilatorassociated pneumonia (VAP).
Just as exciting: For the first time since starting the HAI recognition program, two of HUP’s patient care units have reached new highs in fighting infections. Founders 14 has passed the 600-day mark without a
Remaining UTI-free No Easy Task
Even with all of these preventative actions, though, reaching 500 days without a UTI is not easy, said Staci Oppleman, MSW, the unit’s Quality and Safety Project Manager. “So many variables across the care team could have an unfavorable impact.”
“I’m extremely proud,” said Betty Ann Boczar, BSN, nurse manager of Founders 12 and 14, a 40-bed medical patient care unit which combines multiple services. “Reaching this level is a hallmark of the care we give, especially considering the acuity of our patients.”
Also, while central lines are maintained using sterile technique, this is not possible with an IUC. “External elements in that location can contribute to an infection,” said Joanne Fante, MHA, BSN, RN, CCU Quality and Safety project manager.
Unit Based Clinical Leadership, UTI champions, and clinical staff engagement and accountability are key components of Founders 14’s success, Boczar said. Reporting on patients with indwelling urinary catheters (IUCs) is part of the interdisciplinary rounds checklist as well as the shift-to-shift report and daily audit.
Which makes this accomplishment all the more impressive.
INSIDE Support Light The Night Walk....2 Speaking With HUP’s Leaders.......................................3 Flu Campaign Starts Next Week..................................3 Penn’s Way 2013: We Are Passionate!...................4 OncoLink Brown Bag Chat.......4
“These achievements truly illustrate that sustained improvement in the processes of care leads to marked reductions in the risk of these infections,” said Richard Shannon, MD, chair of Medicine.
In addition, “we educate all our staff in following evidence-based practice policies and procedures, and partner with physicians for catheter placement and surveillance,” Bozcar said.
High Standards Prevent VAPs Just as urinary catheters present specific challenges in the fight against infections, so do ventilators. Fante explained that nurses (Continued on page 2)
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degree angle. Special kits are used for mouth care, done every 30 minutes. “It becomes a standard,” said Cynthia Sabourin, BSN, of the CCU. “The expectation is that it’s done. “We also do a spontaneous breath trial each day. This lets us know what the patient is capable of doing. The results are part of our interdisciplinary rounding.”
(Continued from page 1)
More Success in Fighting HAIs `` The CCU reached 1,000 days without a ventilator-associated pneumonia.
usually insert urinary catheters and are responsible for maintaining and managing them, but this is not the case with ventilators. An anesthesiologist intubates a patient, a respiratory therapist manages the ventilator, while nurses and physicians manage the continued care of the patient on the ventilator. “It’s a huge effort with multiple people,” she said. To reach this level of VAP-free days, “you have to rely on the rest of the health-care providers to meet the same standards you have. It’s everyone’s job.” Intubated patients require special care to help keep them free of infection. For example, the head of their bed must be kept at a 30
This new awareness about preventing infections is part of an overall culture change, Fante said. “Regardless of staff turnover — including nursing and house staff — our culture of safety remains the same. It’s taught from provider to provider.”
Since the Health System began its fight against HAIs, the rates of catheter line associated bloodstream infections, UTIs, and VAPs have plummeted. “We’ve sustained performance at historically low levels,” said PJ Brennan, MD, the Health System’s chief medical officer and senior vice president. Penn Medicine’s goal is to be free of HAIs by July 2014. Shannon said that reaching that status requires “a constant pursuit for improvement. Habitual excellence is what we seek. Continuous improvement requires continuous learning about how to do things better and better. This is the next step in Penn Medicine’s journey.”
SUPPORT LIGHT THE NIGHT WALK The Light The Night Walk is The Leukemia & Lymphoma Society’s annual fundraiser to pay tribute and bring hope to people battling cancer. Hundreds of thousands of participants raise funds for lifesaving research and patient services. One of those groups is Team Penn Medicine. Each year, staff from Rhoads 3, 6, and 7 (HUP’s inpatient oncology units) hold fundraisers throughout the late summer and fall to raise money to fight blood cancers. According to Carrie Marvill of Rhoads 7, “We’ve done candy and bake sales, themed raffle baskets, and a happy hour with raffles.” This year’s happy hour alone raised over $2,200! “People get so excited.…it really elicits comradery,” she continued. “We’re all passionate about being an oncology nurse. It’s so much more than just a job.” This year, her unit also did a balloon wall, in which people donated money for a paper balloon on the wall in memory or support of a loved one. Marvill said they got the motto ‘Keep Calm and Fight On’ from a patient. “He had the original sign in his room which said ‘Keep Calm and Carry On,’ which he showed to everyone.” The sign
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`` Rhoads 7 raised money for The Leukemia & Lymphoma Society with its balloon board.
is a copy of a poster produced in England during World War II to help raise the morale of the public. Their enthusiasm has paid off. The team — which has been a participant at least since the 1990s — has been a top corporate fundraiser for the last few years. Last year, team members raised over $10,000 and their goal is to exceed that amount this year as well. The Light The Night Walk will take place on Saturday, October 27. To join the team – or make a donation – go to lightthenight.org and click on ‘Find Participant/Team.’ Search for Team Penn Medicine.
SPEAKING WITH HUP'S LEADERS Value-based purchasing — an initiative created by the Centers for Medicare & Medicaid — started this month at hospitals throughout the country. This program measures both clinical and nonclinical areas and bases its payment for services on a total performance score. At last month’s Meal with an Administrator, Al Black, HUP’s chief operating officer, discussed how it will affect HUP and other hospitals. As part of the program, “Medicare has started withholding one percent of our normal payment for service which goes into a national incentive pool. If we reach a score of 50 percent or higher, we earn some of our money back,” he said. “But if we are lower, the money is divided among hospitals with higher scores.” He noted that the amount held back will increase to 2 percent over the next four years. According to Black, 70 percent of the score represents clinical areas while the remaining 30 percent will be based on results from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey which measures how patients view their hospital experiences. While our clinical scores remain high, the HCAHPS results have provided some opportunities for improvement. HUP has already started working on these challenges, with promising results. One area involves communication about medication. Working with unit-based pharmacists and unit nurses, a structured approach — with scripting — was created to use when
discussing a patient’s medications, which includes an explanation of the drug as well as potential side effects. “Our HCAHPS scores have improved but there’s still work to be done in this area,” said John Kirby, associate executive director of HUP Operations. “We’ll continue to focus on all areas where scores are a challenge.” Value-based purchasing is just one of the areas affecting our bottom line, Black said. “The health-care trend, in general, is shifting to outpatient care, which pays less than inpatient services.” Observation patients – which in the past may have been admitted – are now “too sick to go home but, according to current coding, not sick enough to justify being admitted. We receive a much lower payment for these types of patients. “We’re also dealing with increased competition,” he continued. “Our mindset needs to be on providing quality care while showing patients kindness and empathy.” Improving a patient’s experience is not limited to those providing direct patient care, said Judy James, HUP’s associate chief HR officer. “You can help by doing your part to keep the hospital clean and talking with patients who may need assistance.” Black encouraged employees to continue to watch operating expenses and “let us know if you have any ideas to save money.”
Kirby brought up one area that can save HUP money while helping our patients: donating blood at the Penn Medicine Blood Donation Center.* “Every pint of blood costs us $200. Platelets cost $600. Spread the word. This really helps the organization.” In other news, as of November 30, paystubs will no longer be distributed on paydays to those who use direct deposit for their paychecks. Employees can easily access the paystub information online. Just go to What’s Hot on the Intranet home page and click on ‘Employee Records and Checks.’ The online paychecks are printable. “You can also change your address there, see performance evaluation scores, and update your personal profile,” James said. Occupational Health has started its flu shot initiative (see below). Employees can receive the vaccines on the Ravdin Mezzanine and in the Perelman Center for Advanced Medicine through October. After that, employees will need to go to Occupational Health on 4 Penn Tower. * To schedule an appointment to donate blood at the Penn Medicine Blood Donation Center, go to www.pennmedicine.org/give-blood.
FLU CAMPAIGN STARTS NEXT WEEK The annual kick-off for flu vaccines will begin Wednesday, October 10, with the following schedule: Perelman Center, second floor atrium
Starting Monday, October 29, employees can receive the vaccine in Occupational Medicine on 4 Penn Tower.
Ravdin Mezzanine
New this year: Employees can print their own bar-code consent forms through Employees Records and Paychecks under ‘What’s Hot’ on the Intranet home page. You can also access the form — and get more information — by clicking on “2012-2013 Flu Campaign.”
• Wednesday October 10, from noon to 5 pm • Thursday and Friday, October 11 and 12, from 8 am to 5:30 pm
• Monday, October 15, through Friday, October 19, from noon to midnight. • Monday, October 22, through Friday, October 26, from 7:30 am to 8 pm.
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ONCOLINK’S NEXT BROWN BAG CHAT: DATE: Friday, October 12 TIME: 1 to 2 pm TOPIC: Focus on Lung Cancer Join the OncoLink team for a webchat to learn about lung cancer. Go to www.oncolink.org/webchat to submit questions to our experts in advance, view and participate in the webchat, and read a transcript after the live event. You can also use your (public) Twitter account to participate during the live event (hashtag #oncochat).
A New and Improved Knowledge Link The new Knowledge Link — which will go live this month — will enable Penn Medicine to deliver more effective learning solutions that can improve employee performance. It’s easy to use, tailored to meet every employee’s unique needs, and offers flexible learning programs through a variety of modalities. Even better, you can access the site using the same link and Penn Key user name and password you’ve used in the past. More information to come!
PENN’S WAY 2013: WE ARE PASSIONATE! Each year our staff displays its passion and generosity by participating in the Penn’s Way campaign. This year the Health System and the University have been challenged to raise $1.4 million to support charities in our community. The Penn’s Way 2013 campaign, which kicked off on Monday, will run through Friday, November 16. Please visit www.upenn.edu/pennsway or contact your Penn’s Way 2013 entity Coordinator or Captain to find out more about Penn’s Way. We appreciate your support!
Support Services Annual Report Meeting All employees are invited to attend the FY12 Support Services Annual Report meeting on Wednesday, October 10, from 9 to 10 am. The presentation — which will highlight their accomplishments of the past year and goals for the current FY — will be held on the first floor of the Translational Research Center, in the Rubenstein Auditorium. Light refreshments to follow.
Helping People ALL THE TIME
Congratulations to April’s winner of the Helping People All the Time raffle: Gregory Caison. . . . . . . . Radiology Kristen Coia . . . . . . . . . . . Rhoads 2 Erin Colden . . . . . . . . . . . Rhoads 2 Kimberly Daniels. . . . . . . Rhoads 2 Jeremy Davis. . . . . . . . . . Founders 9 Maureen Dickerson . . . . Radiology Mel Duka. . . . . . . . . . . . . . Radiology Michelle Falance. . . . . . Radiology Joseph Formelio . . . . . . . Security Debra Green. . . . . . . . . . . Radiology Pamela Jackson . . . . . . . Admission Center Shiney Joseph. . . . . . . . . Silverstein 7
Antoine Joyner. . . . . . . . . Materials Management Kevin Joynt. . . . . . . . . . . . Rhoads 2 Lisa Lewis. . . . . . . . . . . . . Radiology Sreekala Pillai. . . . . . . . . Silverstein 7 Trina Sawicki. . . . . . . . . . Radiology Alicia Scully. . . . . . . . . . . Radiology Rachael Sherrerd. . . . . . Rhoads 2 Patricia Stern. . . . . . . . . . Rhoads 1 Camille Stevens. . . . . . . . Radiology Anita Tate . . . . . . . . . . . . . Radiology Lizy Thomas . . . . . . . . . . . Silverstein 7 Jill Vermeeren. . . . . . . . . Radiology
Coming soon! Look for Helping People All The Time Service Recognition Program on the Intranet page. Beginning this month, a faster way to celebrate your colleagues’ accomplishments!
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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.