Hupdate

Volume 24

HUPdate

Number 13

June 28, 2013

Hospital of the University of Pennsylvania

THE FUTURE

HAS ARRIVED

HUP’s three new Silverstein ORs, which officially opened earlier this month, are truly the future of medicine.

In each of the 900-square-foot rooms, equipment is up on a boom which can be easily moved when and where it’s needed… or out of the way when not. Multiple, large, HD surgical monitors allow all members of the peri-op team to observe the surgical procedure.

Using advanced software technology called “Live data,” all crucial patient information,

INSIDE IP Gets a ‘Facelift’ ...................... 2 Speaking with HUP’s Leaders .. 3 Walking in the Footsteps of Florence Nightingale ............ 3 The New Wellfocused Healthy Rewards Program ....... 4

such as vital signs, can be displayed on monitors for the surgical team to easily and quickly see. In addition, digital video technology — as well as cameras in multiple locations — allows easy recording and broadcasting of procedures, for example to the Flyers/76ers Surgery Theater or by satellite to people around the world.

Three clean-supply rooms provide the ORs with their own area to store sterile supplies and equipment. Also, each OR has pointof-care blood testing, resulting in quicker response times to hemodynamic changes in patients. Previously, a resident would wait for a phone call to hear results of a blood gas test at least five or six times during a typical operation.

At the ribbon cutting, James Mullen, MD, director of PeriOperative Services,

thanked the many people who were part of “the smoothest run construction project I’ve ever been involved in. It was truly a team effort.”

Michael Acker, MD, chief of Cardiovascular Surgery, noted that, in the last decade, the annual number of cardiovascular surgical procedures performed at HUP has doubled, from approximately 800 to 900 cases to nearly 1,700. “That’s amazing growth in 10 years, in this marketplace,” he said.

“I want to thank everyone, the whole cardiac team — our nurses, nurse practitioners, perfusionists, doctors and everyone in administration — that have really allowed us to grow.”

The new ORs, he continued, will provide yet “another inflection point of growth.” (continued on page 2)

¢ Cutting the ribbon to officially open the new Silverstein ORs were (l. to r.) CEO Ralph Muller; Stuart Weiss, MD; Katharine Geiger, South Zone nurse manager; HUP executive director Garry Scheib; and Michael Acker, MD, chief of Cardiovascular Surgery.

THE FUTURE HAS ARRIVED (continued from page 1)

The Silverstein ORs weren’t the only part of HUP surgery to receive a major upgrade. Instrument Processing got a ‘facelift’ as well, earlier this year. It took six weeks, which is short in terms of what was done, but long for staff who had to work in cramped, makeshift locations. But, pulling together as a team, they did it and the new Instrument Processing has made a significant impact on the flow of cases (see article at right).

5K for the IOA and Memory Mile Walk Mark your calendars for Penn’s Second Annual 5K for the IOA and Memory Mile Walk on Sunday, September 22. The event will be held on Penn’s campus, starting at Shoemaker Green, between the Palestra and Franklin Field, and running through Penn Park. The 5K Run will begin at 8:00 am; the Memory Mile Walk at 8:10 am. Medals will be awarded to the top male and female runners in several age groups. Free parking at the Perelman Center for Advanced Medicine and post-race refreshments will be provided.

Proceeds will help further research by Penn’s Institute on Aging for the treatment and care of patients with Alzheimer’s, neurodegenerative and other age-related diseases.

Last year’s race proceeds supported two pilot projects for young investigators “in novel areas which might not otherwise be funded, to potentially identify new opportunities for understanding the diseases and identifying new therapies,” said PJ Brennan, MD, senior VP and chief medical officer of the Health System.

Last year’s race raised $40,000; this year’s goal is $50,000. Ask your friends and family to support your run! To register, go to http://www.pretzelcitysports.com and click on ‘Online Registration’ in left column.

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 Tony Griffin gives IPs new state-of-the-art equipment — and the now open space — a thumbs-up for increasing efficiency and eliminating breakdowns!

IP GETS

A ‘ FA C E L I F T ’ “It was almost on life support.”

That’s how Tony Griffin, manager of Instrument Processing (IP), jokingly described the former system used to clean HUP’s surgical instrument sets. The washers would go down a lot, he said, and, when you’re responsible for processing as many as 450 instrument sets a day, even minor glitches can cause a lot of problems.

IP’s new equipment included three basin sinks for the manual pre-cleaning process, four state-of-the-art washer decontaminators, and a large automated walk-in cart washer.

And what a difference they’ve made!

While the new equipment has larger capacity, it is more compact, freeing a lot of space in the cleaning area. This change alone produced a much better workflow model, eliminating the need to move baskets of heavy instruments from one side of the room to the other — and then back again. In addition, the washer’s programmable cycles better clean today’s instrumentation, which often requires special handling.

And no more equipment breakdowns! At more than 10 years old, the previous washers would break down fairly frequently and, if just one of the three washers wasn’t working, that alone reduced throughput 33 percent.

“And it could be down for hours or even till the next day,” he said. To keep up the pace,

Griffin would need to pull employees from one area to help out in another, which, inevitably, slowed the entire process.

About 80 percent of instrument sets arrive in rigid metal containers. An inner basket containing the instruments is removed and put through the washing process. The new cart washer cleans and dries the containers in a mere 22 minutes. Previously, the carts were run through the washer decontaminator, a further drain on productivity.

The employees who assemble the cleaned instruments into sets also received an upgrade: new workstations that have a bigger table top, better lighting, and are height adjustable.

“It has been truly a team effort both operationally and clinically,” Griffin said. “We all contributed to the success of this project.”

Another benefit of the new equipment: Keeping up with the continually increasing number of surgical cases at HUP. “The number of sets we processed increased 10 percent from FY10 to FY11 and 7 percent from FY11 to FY12,” he said. “It was hard to keep up with the old equipment but, with the new system, we’re able to process the current volume and are positioned to handle volume increases in the future.”

Speaking with HUP’S LEADERS Patient activity has picked up over the past six months, and we’re very close to meeting our operating budget target said Al Black, HUP’s chief Al Black, COO operating officer, at this month’s Meal with An Administrator. “We made a small positive variance in April and expect the same in May as well,” he said. However, “overall, we’re in a very tough economic climate.

I feel that, moving forward, we need to manage our business as if we were on a fixed income.”

He said that two parts of the Affordable Care Act will provide insurance coverage for the uninsured: the new health insurance exchanges, which start in October, and the expansion of Medicaid. PA governor Tom Corbett has opted out of the Medicaid expansion for the time being. “As a result, many people in the state, who will still need medical care, will still have no ability to pay for it.” (To learn more, go to http://www. careforpa.org/action/).

UPHS is also in a very competitive environment, for many of our services. “We need to do all we can to keep expanding our business.”

This includes our continued investment

in ambulatory-care facilities, such as the expansion to the Perelman Center and PPMC’s Penn Center for Specialty Care, scheduled to open in 2014. In addition, Penn Trauma will move to PPMC when the new Advanced Care Hospital Pavilion opens in 2015. “This will help strengthen the clinical infrastructure at PPMC.”

New EMR Applications Terese Kornet, MSN, RN, director of Clinical Nursing Systems, spoke about new EMR (electronic medical records) applications being launched throughout the Health System to increase efficiency and improve patient safety.

EPIC OpTime/Anesthesia will replace the present electronic systems used by nursing and anesthesia and streamline the OR documentation throughout UPHS. According to Kornet, this is moving us one step closer to using EPIC for inpatients. “We want to go paperless so records are always accessible. It will help improve the continuity of care because we’re not depending on paper being in the patient’s chart and all caregivers have easier access no matter where the patient is located.”

Another new program — which will be piloted on Founders 12 and 14 — is bar code medication administration (BCMA). “It is

the final step in our closed-loop medication process.” Essentially, there will be a system of checks and balances for the entire process, from ordering to dispensing to administration.

On the pilot units all medications administered to patients will first be electronically scanned at the bedside. If the medication is not ordered for that patient or the dose is incorrect, an alert will appear and not allow the caregiver to administer the medication. The pilot is a collaborative effort involving pharmacy, nursing, respiratory and information services.

“Bar code medication administration will also enable us to detect medication errors that we might have not detected in the past since no significant side effects appeared after administration,” Kornet said. UPHS will receive additional meaningful use dollars for implementing BCMA. Another new program — MyPennPharmacy — fills prescriptions for inpatients so they’re available at the time of discharge. The unit pharmacist not only dispenses the meds but also educates the patient about their use, both of which have the potential to decrease readmissions.

Walking in the Footsteps of

Florence Nightingale Earlier this year, six HUP nurses traveled with undergraduate nursing students, graduate nursing students, and nursing faculty from Immaculata University to walk in the steps of Florence Nightingale. Beth Chiatti, MSN, PhD, coordinator in Clinical Resource Management, led the trip. Among the many sights they visited was the oldest operating theater in Britain in St. Thomas’s Hospital to see where surgery — primarily amputations — took place in the 1800s. Their Florence Nightingale ‘tour’ included the Crimean War monument with her statue and the Florence Nightingale museum which houses many artifacts belonging to her. It also showcases her early life and privileged upbringing, her role in the Crimean War, and her contribution to the field of nursing and nursing research. “We found the Florence Nightingale sights inspiring!”

 HUP nurses who joined Beth Chiatti (c) in the Florence Nightingale tour were (l. to r.): Rebecca Zagatta, OR; Christina Duncan, OR; Brittany Moshen, OR; Alissa Ferri of Silverstein 8; Maria DiSciullo of Silverstein 8; and Kelly Convery of the Intensive Care Nursery.

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The NEW Wellfocused Healthy Rewards Program

 Gregory Licciardi, an 11-year old receiving proton therapy treatment for his cancer, received special permission to play the piano in the Perelman Center for Advanced Medicine. Mona Matson, associate director of Patient and Guest Relations & Reception, presented him with a special gift basket for the impromptu mini-concert. “Gregory was thrilled to play,” said mom Kristen Licciardi. “I was so touched that all of you came to listen to him!”

All Employee Meetings Be sure to attend one of the next All Employee Meetings and learn more about HUP and the Health System from Administration leaders.

• • •

July 10, from 8:30 to 9:30 am August 7, from noon to 1:00 pm September 11, from 5:00 to 6:00 pm

All meetings are held in Medical Alumni Hall on 1 Maloney.

This past open enrollment, UPHS launched a new points-based Wellfocused Healthy Rewards Program, allowing employees to earn points yearround by participating in activities and challenges. Employees can also earn the $150 reward by completing a Well-Being Assessment and Knowing Your Numbers and taking healthy actions. The reward is available all year long!

The Healthy Rewards program allows you to create a personal profile, set health goals, and participate in fun and engaging challenges, all while improving your health and well-being. The challenges and activities in the program focus on all aspects of health and are designed for all employees, regardless of your health or fitness level. You can even create your own challenges to help you reach your own personal goals — and earn points while doing so.

For each activity, challenge, or action you complete, you earn points. As you

accumulate more points, you move to higher levels of the program and get the opportunity to be entered into raffles to win rewards.

Every quarter there will be new and exciting challenges for all employees to participate in. Look for more information in upcoming issues of Hupdate. To learn more, go to www.uphshrandyou. com and log in by clicking on ‘Healthy Rewards.’ If you have been using the Wellfocused Rewards site and have found success in improving your health and well-being, we would love to hear about it! Please submit your healthy success story to HRSuccessStory@ uphs.upenn.edu.

HUPdate EDITORIAL STAFF Sally Sapega Editor and Photographer Abby Ernst Designer

ADMINISTRATION

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Heartfelt Thanks

Susan E. Phillips Senior Vice President, Public Affairs

“I was brought in and prepped for a lung transplant. From the first contact I had with the RNs and NAs at Penn I was impressed by their level of nursing expertise and their compassionate care giving .... I was diagnosed with COPD over 22 years ago and have had the misfortune to be treated in a number of hospitals in the Philadelphia area. That combined with the care I oversaw in the treatment of my aging and now deceased parents made me familiar with the quality of nursing in the area. The nurses at Penn and, indeed, the entire staff, but especially the nurses, displayed a professionalism of the highest order.... [They] gave me care and attention, kindness, discipline and a respect for my individual dignity unmatched in my experience…I have many things to be thankful for and few of them are greater than the nurses at Penn. You should be grateful and honored to have them on your staff.”

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.