Volume 11
Issue 4
April 2012
SYSTEMnews Weekly meetings help the staff in Dermatologic Surgery work better as a team to solve problems. (Left Photo) Nina Manogue responds to a question posed by Michelle Sparrow, practice administrator, who led the meeting. (Middle Photo) Christopher Miller, MD, shown with Terri Nunnciato, offers his point of view as both a physician and director of Dermatologic Surgery. (Right Photo) Also participating in the weekly meeting were (l. to r) Tara Svedas, Elizabeth May, Jennifer Lacey, Helen Sneller, Xiao Zhu, Jovan Green, Nunnciato, Miller, and Julia Tzu, MD. Photo Credit: Daniel Burke Photography
CEO’s corner RALPH W. MULLER
CEO, University of Pennsylvania Health System
This time every year the president and governor release their proposed budgets for the upcoming fiscal year. For the federal government the new budget year begins on October 1. At the state level the start date is July 1. Both budgets have enormous impact on our operations, so it’s important to understand what is being proposed and how we could be affected if the budgets are adopted. Proposing the budgets is only the first part of the story however. Hearings are then held by the legislative branch. At these sessions lawmakers review the proposals, hear from expert witnesses, and eventually make changes (amendments). At the national level this is done by Congress; in Harrisburg it’s the General Assembly. In both cases the Penn Medicine government relations team tracks events as they develop and keeps us informed. We also work with colleague institutions on registering our views and recommending changes. At the state level Governor Corbett’s overall proposed budget amount is essentially flat. This means there are no proposed reductions or increases in the total spending amount. There are, however, proposed changes within individual categories that could have serious consequences for both the Health System and the Perelman School of Medicine. But let’s begin with the positive news — in this case, for safety-net hospitals such as ours. Safety-net hospitals have an open door policy for all patients, regardless of their ability to pay. (continued on page 4)
INSIDE UPHS Hospitals Accredited for Top Cancer Care........................2 Making a Match.........................2 Strom Appointed an Executive Vice Dean ...........2 Penn Medicine@Work..............3
TAKING EMPLOYEE ENGAGEMENT > > > TO THE NEXT LEVEL PENN MEDICINE STAFF TRANSLATES SURVEY RESULTS INTO ACTIONS Valerie Layden, MSN, director, Patient Services & Operations, and her colleagues in Obstetrics & Gynecology, share a belief.
W hen we create a great environment in which to work, we create a great environment for patients to receive care. It’s a sentiment that is shared by the organization at large. At Penn Medicine, we recognize that our ability to deliver world-class care to patients and their families is a direct result of the talent and dedication of the people who work here. And so we invest in tools that can help us improve the overall staff experience and strengthen Penn Medicine’s position as a great place to work and a great place for patients to receive care. Most recently we partnered with the Advisory Board, a global consulting firm that helps health-care organizations serve their patients better. We were interested in finding out how engaged our staff feel. In other words, to what degree do they think of themselves as involved in and enthusiastic about their jobs and Penn Medicine in general? We used a web-based Employee Engagement Survey to find out. Key goals of the questionnaire, which was administered at the end of last year, were to assess and build on our strengths and identify areas that needed improving. The response rate for this voluntary employee engagement survey was outstanding. More than 13,000 employees — 85% of the targeted participants from UPHS and the Perelman School of Medicine — completed the survey. Every entity surpassed an 80% participation rate. Overall, our results were very encouraging. Fortyfour percent of Penn Medicine staff can be classified as “highly engaged,” compared to 35 percent in comparable organizations nationwide. At the point of care, we also scored above the national benchmark, with nurses and clinical directors registering well above average. Physician assistants and nurse practitioners scored a full 27 percent above the norm. For Layden and her team, the survey results provided unique insights into the department’s strengths and highlighted
opportunities for improvement. Through a collaborative process that included department leadership and staff at all levels, they identified one or two areas for improvement. “We asked ourselves four questions when deciding where to focus,” said Layden. “Is this focus within our span of control? Is it important to our entire group as a whole? Do we have the resources to make an impact in this area? And can we get results in three months or less?”
Sharing Responsibilities Leads to Success Susan Niskey Popp, MBA/MS, Dermatology’s chief operating officer, similarly emphasized a team approach to solve problems. Their survey results highlighted a need to improve communications between staff and managers, and in particular improve how ‘bad news’ was delivered. Since receiving its survey results, the staff have implemented a meeting that has been held each week, without exception. “At first, there were some staff members who felt it was strictly leadership’s responsibility to fix problems illuminated in the survey,” said Niskey-Popp. “But it’s all of our responsibilities. It’s our action plan. We own this environment. We own this team. Since the start of this process, we’ve seen a healthy shift, where each person is now recognizing our shared responsibilities in helping our team become stronger.” These experiences are similar to the ones that each department is currently going through as part of their Action-Planning processes. According to Kristi Pintar, corporate director of Organizational Development and Leadership Practice, the action planning process begins with employees reviewing the survey results and analyzing those results to better understand what the data mean. “The survey results give us our baseline quantitative data. Subsequent conversations with work teams give us that extra understanding of strengths and opportunities for improvement,” she said. Managers follow a process of leading these conversations, gathering additional information, prioritizing the issues, identifying root causes of the issues and then brainstorming possible actions for improvement. “The action planning process is the key to continuous improvement. It’s designed to be repeated as improvements are made and new opportunities are identified.” (continued on page 2)
Newsmakers..............................3 Awards and Accolades.............4
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MAKING A MATCH
UPHS HOSPITALS ACCREDITED FOR HIGHEST LEVEL OF CANCER CARE All three UPHS hospitals have received three-year accreditation from the American College of Surgeons Commission on Cancer (CoC) in recognition of their commitment to the highest level of quality care. HUP and Pennsylvania Hospital received the commission’s top honor, the Outstanding Achievement Award (OAA), and Penn Presbyterian Medical Center received an accreditation with Commendation. Penn’s Abramson Cancer Center is the only National Cancer Institute-designated comprehensive cancer center in the nation to receive the OAA for 2011. The Outstanding Achievement Award confers an extra level of distinction to cancer programs based on performance during an on-site assessment by a physician surveyor. “I am proud of our incredible team, which every day is making great strides to advance cancer research and care from the laboratory to the clinic,” said Chi Van Dang, MD, PhD, director of the Abramson Cancer Center, which integrates the cancer care and research efforts at HUP, Penn Presbyterian, and the Joan Karnell Cancer Center at Pennsylvania Hospital. “The Commission on Cancer’s accolades validate our tremendous efforts and prove that patients can be assured that they will receive the most cutting edge, promising treatment for every type of cancer. In particular, Dang notes that the Penn Medicine hospitals’ cancer registries — a cornerstone for CoC accreditation — provide ongoing opportunities to learn more about the trajectory of cancer diagnosis, treatment, and recurrence. “We can go back and look at this information to learn and ultimately develop better treatment recommendations to ensure patients have the best possible chance of living their lives without cancer,” he said.
Last month — during the annual Match Day ceremony — 140 students from the Perelman School of Medicine gathered in Dunlop Auditorium to open their residency placement envelopes and learn where they will spend the next few years receiving their advanced medical training. Among them were Kathryn and Michael Hall (shown at left with 10-month-old son Logan). Happily, they both matched to Penn residencies. Kathryn will soon start a three-year pediatric residency at CHOP; Michael will spend the next four years training in anesthesiology. Early in her medical school training, Kathryn founded Power Up Gambia, a non-profit organization, to fund construction of a lifesaving solar-energy system for a hospital in Gambia. Since that time, the group has installed a second system in another Gambian hospital and are also partnering with the country’s only vocational school to create a solar energy curriculum as part of the electrician’s training. “This will really make a difference. These people can start their own solar business or work for solar companies in the country to maintain and repair these systems.” Starting in June, Kathryn will shift her focus to her residency and step down from her role on the Power Up Gambia board…at least for the next three years.
STROM APPOINTED EXECUTIVE VICE DEAN FOR INSTITUTIONAL AFFAIRS Brian Strom, MD, MPH, has been appointed executive vice dean for Institutional Affairs, at Penn Medicine. In his new role, Strom will assume the responsibilities of coordinating Penn Medicine’s efforts in comparative effectiveness research, as well as the Neuroscience of Behavior Initiative, which seeks to strengthen Penn’s programs in basic, translational, clinical, and population research in the areas of addiction, depressive disorders, and neurodegenerative disease. In consultation with J. Larry Jameson, MD, PhD, executive vice president of the University of Pennsylvania for the Health System and dean of the Perelman School of Medicine, Strom will also provide administrative leadership for the recruitment of department chairs, center and institute directors, and other senior faculty members. Along with other members of Penn Medicine leadership, he will also assist with implementing recommendations that emerge from the School’s current strategic planning process. Since 2007 Strom has served as vice dean for Institutional Affairs, with primary responsibilities as Penn Medicine’s liaison to the Philadelphia Veteran’s Administration Medical Center and Penn’s global health programs in Guatemala and Peru. He will continue to serve the Perelman School of Medicine in these areas.
TAKING EMPLOYEE ENGAGEMENT TO THE NEXT LEVEL > > > PENN MEDICINE STAFF TRANSLATES SURVEY RESULTS INTO ACTIONS (continued from cover)
How Can You Engage? Penn Medicine offers several ways employees can help improve patient — and staff — experiences. For example, you can help shape the future of Penn Medicine by visiting www.med.upenn.edu/strategy. Learn about Penn Medicine’s planning efforts and contribute to the Penn Medicine strategy blog. Or visit “The Square,” the vehicle for employees to connect with their colleagues from all across Penn Medicine and discuss the things they care about. Participation is voluntary, and membership on the site has more than tripled since the launch late last year. To join, visit www.pennmedicine.org/TheSquare. Some employees have contributed by participating in the Penn Medicine Academy’s “Performance Improvement in Action” program. PIIA teams consist of interdisciplinary front-line providers working on projects that have been identified as critical to, and in alignment with, the Blueprint for Quality and Patient Safety. PIIA teams learn performance improvement methodologies such as GE LEAN®, Six Sigma® and PDCA to implement, evaluate, and measure processes and safety outcomes. (To learn more about Performance Improvement in Action, e-mail christopher.klock@uphs.upenn.edu.) Others submitted ideas to Penn Medicine’s first annual Innovation Tournament, “Your Big Idea. ” Faculty and staff from throughout the Health System submitted over 1700 ideas for improving the patient experience at Penn Medicine! This overwhelming response is a tribute to our dedicated staff. To see which ideas were chosen to move onto the next round, go to www.pennmedicine.org/YourBigIdea and click on View Ideas. The Tournament finale is on May 9. By measuring employee engagement and providing tools and resources for all employees to contribute their unique talents, we nurture an environment where employees can thrive. “The level of care and support we provide to our employees translates directly to the quality of care we provide to our patients and their families,” said Judy Schueler, VP, Organizational Development and Chief Human Resources Officer. “That’s why the employee engagement survey process is so important to us — ensuring that we are positioning our employees for success.”
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> > > COMING: FOCUS ON 4
“Focus on 4” is a new tool that will help teams track their action-planning progress in each of the four key result areas for advancing Penn Medicine:
• Quality • Employee Engagement • Patient/Customer Experience • Financial Performance In each area, teams define their own action items, goals, baseline metrics, target dates, and a description for the question, ‘What will success look like?’ Focus on 4 tools and templates will be made available to all departments over the next several months. More information will follow in an upcoming issue of System News.
penn medicine
work
Open Enrollment: Get Premium Discounts! During open enrollment this year — which takes place Monday, April 16, through Sunday, April 29 — you have the opportunity to receive an earned premium discount on your medical contributions. To earn the discount, you must certify that you are not a tobacco user or that you are enrolled in a tobacco cessation program or will be enrolled by June 30, 2012 and on the road to becoming tobacco free! If you’re eligible, your current contribution rate for medical benefits will not increase for the 2012-2013 benefit year — it will stay exactly the same!
REWARDING EMPLOYEES FOR
Healthy Lifestyles!
“At UPHS, we take pride in providing the best care for our patients, but we can’t do that without our hard working and dedicated employees,” said Michele Fletcher, AVP of Human Resources. But, with so much focus on doing your job well and taking care of patients, “it’s important to remember to take good care of yourself and we want to help our employees do just that.” We all have the ability — and the responsibility — to make good choices, ones that improve our health and make us feel better, both mentally and physically. UPHS wants you to be healthy, and our focus and attention is on implementing healthier workforce initiatives to help you. That’s why UPHS is rewarding you for taking steps toward a healthy lifestyle! Wellfocused, our healthy workforce initiatives, provides you with programs, tools and resources that can help you be more aware of your current health status, and improve your health or maintain it. For example, you can:
• obtain discounts for gym memberships. • receive reimbursements for weight management programs, regularly attending a gym, and purchasing fitness equipment (if enrolled in an IBC medical plan)
•
quit smoking with the UPHS free tobacco cessation program.
To find about all the above — and more — simply go to www.uphshrandyou.com and click on the Wellfocused tab.
And there’s more! During the month of May, complete a Personal Health Assessment and participate in two healthy behaviors, and you’ll be eligible to receive healthy credits. What are examples of healthy behaviors? Getting an annual physical to learn your important health numbers (cholesterol, blood pressure and blood sugar levels). Engaging in physical activity on a regular basis. Eating healthy and managing your weight. You can choose from nine options on the Carewise Health page. Simply go to www.uphshrandyou.com, click on the Wellfocused tab, and then choose ‘Carewise Health,’ located in the apps on the right side of the page to learn more. You can receive up to a $5.00 per pay credit ($130 annually) that will be reflected on your paycheck starting July 1. Remember: You can complete the PHA and select your healthy behaviors on the Carewise Health website beginning May 1. You will have the entire month of May to complete the PHA and select your healthy behaviors to get your $130 credit. All employees should have received an Open Enrollment newsletter in the mail providing an overview of benefits and discounts for your healthy habits. Beginning April 16, you can easily access the 2012-2013 Online Enrollment Guide online (www.uphshrandyou.com). If you have not received the newsletter, or have any questions about Open Enrollment or the Wellfocused program, contact your HR benefits specialist at 215.615.2675. UPHS strives to become a Culture of Health, and that starts with you. Stay tuned for future Wellfocused programs and incentives coming your way!
YOU COULD WIN FREE MEDICAL COVERAGE FOR A YEAR! If you enroll for your benefits between Monday, April 16 and Sunday, April 22, you’ll be entered into the Early Bird raffle. Ten lucky winners will receive medical coverage for the 2012—2013 year without having to pay the bi-weekly payroll contributions. Act Fast!
Penn Medicine
NEWSmakers / / / Autism in the News A new study by Perelman School of Medicine researchers highlights the unique financial burden faced by families of children with autism, MSNBC. com reports. The burden is particularly significant for mothers, the study finds. “We don’t think that autism creates more of a strain on the family per se than other chronic conditions of childhood,” said senior author David Mandell, ScD, associate director of the Center for Mental Health Policy and Services Research and associate professor of Psychiatry and Pediatrics. “I think the reason these mothers are leaving the workforce is because the service system for children with autism is so fragmented.” Coverage of the new research is also featured on ABCNews.com, CNN.com, Reuters, The Huffington Post, CBSNews.com, WebMD.com, WashingtonPost.com, and MedPageToday.com. Autism costs the US $126 billion each year, according to a new study released by the advocacy organization Autism Speaks. Health care, education, intervention services all contribute to this multi-billion-dollar figure, as do lost wages for parents who quit jobs to take care of their children with autism, said David Mandell, ScD, associate director of the Center for Mental Health Policy & Services at Penn and study co-author, in an
interview with WHYY radio. “The residential needs of adults with autism are part of this,” said Mandell, “and even more importantly that we have not been successful in developing programs that help adults with autism become productive members of the workforce.” Coverage also appeared in The Los Angeles Times.
/ / / Adults in Their 80s Report Sleeping Better, Penn Study Says While it’s a common belief that getting older means less sleep and more fatigue, a new study from Penn Medicine suggests that older adults may actually enjoy better sleep than their younger counterparts, ABC News reports. Researchers conducted phone surveys of more than 150,000 Americans and found that people in their 80s had the fewest complaints about sleep disturbances and daytime fatigue compared to other age groups. The study appeared in the journal Sleep. “These results suggest that the often-reported increase in sleep problems is a non-linear phenomenon, mediated by factors other than physiologic aging,” wrote the authors, led by Michael Grandner, PhD, research associate, Center for Sleep and Circadian Neurobiology. Coverage of the new study was also featured on BBCNews.com, MSNBC.com, WebMD. com, The Huffington Post, and U.S. News & World Report.
/ / / CT Scan Can Weed Out Heart Attack Threat Quicker Using a CT scan of the heart in the emergency room to rule out heart attacks and other problems in low-risk patients with chest pain can save hospitals billions of dollars, according to a Penn Medicine study published in The New England Journal of Medicine. Chest pain is the most common reason people visit the emergency room. Yet, 85 percent of the time, it is not related to a heart problem. The new Penn study compared the use of coronary CT angiography with traditional testing methods such as stress testing and found that the CT scan test is a safe way to quickly rule out heart attacks among certain patients. “Patients who arrive at the emergency room with chest pains are given a variety of tests, some that cost more than a CT scan,” lead author Harold Litt, MD, PhD, chief of Cardiovascular Imaging in Radiology, told Bloomberg Business Week. “In terms of direct costs, a CT scan is fairly competitive. If you can get out of the emergency department faster, if you don’t have to be admitted to the hospital — those things will decrease costs.” The study was picked up by several other outlets, including The Chicago Tribune and The Baltimore Sun (via Reuters), Forbes, The Philadelphia Inquirer, and U.S. News and World Report.
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AWARDS AND ACCOLADES PERELMAN SOM RANKED #2 The Perelman School of Medicine was ranked number 2 by U.S. News & World Report in its annual survey of researchoriented medical schools. This year marked the School of Medicine’s 15th consecutive year ranking in the nation’s top five medical schools. It also ranked #11 in the rankings of Primary Care schools. In addition, the School ranked among the top medical schools in the country in five areas of specialty training, including pediatrics (#2), women’s health (#4), internal medicine (#5) drug/alcohol abuse (#5) and AIDS (#9). The School of Medicine tied with the Johns Hopkins University for the #2 spot.
AMF FOUNDER RECEIVES WELCOME BACK AWARD David Fajgenbaum, a third-year student at the Perelman School of Medicine, recently received a Welcome Back Award for his achievements in the fight against mental illness. In 2003, just before he started college at Georgetown University, his mother, Anne Marie, was diagnosed with a terminal brain tumor. “During her illness, I told no one at college what I was going through,” he said. “I felt alone, helpless and guilty. I believed no one could possibly understand…not even my closest friends.” Fulfilling a promise he made to his mother before she died fifteen months after diagnosis, Fajgenbaum took that grief D avid Fajgenbaum (l) received the Welcome Back Award from Christopher and, with the help of Georgetown staff and students, created Bojrab, MD, for creating the National Students of AMF, an organization dedicated to supporting college students who are coping with the death an outlet for college students who, like himself, were coping of a loved one. with a loved one’s illness or death and suffering in silence. He called the group Students of AMF, a dual acronym for his mother (Anne Marie Fajgenbaum) and Ailing Mothers and Fathers. “I found out that many students had gone or were going through this — even friends of mine.” The program was so successful that, in 2006, the National Students of AMF was created. Since then, “over 2000 students have participated in support groups on campus throughout the country and thousands have received virtual support.” Fajgenbaum received the award from the National Council for Community Behavioral Healthcare who partnered with Eli Lilly and Company. To learn more about National Students of AMF, go to www.studentsofamf.org. Jill Baren, MD, chair of Emergency Medicine, has been elected to the board of directors of the American Board of Emergency Medicine, a medical specialty board that certifies emergency physicians who meet its educational, professional standing, and examination standards. Steven Brem, MD, of Neurosurgery, has received the Joel A. Gingras, Jr. Award from the American Brain Tumor Association for making a noteworthy impact on furthering the ABTA’s mission to advance the understanding and treatment of brain tumors. Brem leads the Penn Brain Tumor Center. Clifford S. Deutschman, MD, MS, of Anesthesiology and Critical Care, has been named president of the Society for Critical Care Medicine, the largest multiprofessional organization dedicated to ensuring excellence and consistency in the practice of critical care. Eydie Miller-Ellis, MD, director of Glaucoma at Scheie Eye Institute, was presented with the Women in Ophthalmology’s Suzanne Veronneau Troutman Award. This recognizes a woman who has done the most over the past year to further women in ophthalmology. Michael Restuccia, vice president and chief information officer, Corporate Information Services, received a Smart CXO award from Philadelphia Smart CEO magazine. Restuccia was recognized for leadership in maintaining and building on Penn Medicine’s implementation of technology and innovation to advance patient care, and for starting WeCARE, “Community Activity Rewards Everyone,” a program engaging information services staff in networking and community service opportunities.
THREE HONORED FROM PATH AND LAB MED Three faculty from Pathology & Laboratory Medicine received awards of recognition. Virginia LiVolsi, MD, received this year’s Harvey Goldman Master Teacher Award of the US and Canadian Academy of Pathology. Given in memory of Goldman’s monumental contributions to the teaching of pathology, the award recognizes a master educator and mentor in the field. Prabodh Gupta, MBBS, MD, was awarded the 2012 Papanicolaou Society of Cytopathology L.C. Tao Educator of the Year award. This acknowledges meritorious service and contributions to the field of cytopathology education. Edward Lee, MD, PhD, is this year’s recipient of the 2012 Excellence in Science Award from the American Society for Investigative Pathology, for outstanding and sustained achievements at the earliest stages of a career in biomedical research.
CEO’s corner
(continued from cover)
First, the governor’s budget does not cut core payments for inpatient DSH and outpatient DSH, medical education, and tobacco-settlement-funded uncompensated care, all of which were reduced in the current budget. (DSH stands for funding to disproportionate share hospitals, which, like Penn Medicine, treat significant populations of indigent patients.) Second, unlike previous budgets, this proposal does not recommend eliminating direct supplemental payments for OB, NICU, trauma, and burn programs. Third, while our strong preference is for no hospitals to see funding reductions, this year the governor’s budget does call for certain payment cuts for all hospitals, not just safety-net hospitals, as has often been the case in the past. Spreading the burden more equitably within a few programs lessens the unequal impact that safety-net hospitals have typically been subjected to. On the negative side, the governor proposes to change the criteria for General Assistance eligibility. If this happens, some patients would lose their Medical Assistance coverage. But they would still likely turn to hospitals for care — and to safety-net hospitals such as ours in particular. Providing care without being reimbursed would of course be a very serious development. In addition, the Perelman School of Medicine faces a potential $10-12 million cut as a result of the proposed elimination of the Commonwealth Universal Research Enhancement (CURE) healthresearch grants program, which was created under the Tobacco Settlement Act of 2001. The governor proposes transferring CURE funding to support long-term care appropriations. It’s important to note that the governor also proposes a 20 percent cut in payments to state-related universities. This means that health-care institutions are likely to find ourselves competing with colleges and universities for scarce dollars. At the federal level the picture is more complicated. President Obama’s proposed FY 2013 budget calls for cuts in Medicare, Medicaid, and other health programs that, on paper, would mean a $10 million reduction for Penn Medicine. But this year the president’s budget is superseded by the Budget Control Act of 2011, which set spending levels through 2013. That legislation calls for still-to-be-determined cuts of $1.2 trillion — which could include the president’s proposed cuts as well as other spending reductions. And if Congress and the president can’t agree on where to achieve savings, automatic cuts begin next January. These could include reductions in Medicare payments as well as other major across-the-board health-related cuts. At both the state and federal levels, Penn Medicine has been heavily involved in advocacy efforts to prevent cuts to hospitals. We will continue to fight against reductions that would have an adverse impact on how we operate.
SYSTEMnews EDITORIAL STAFF: Sally Sapega, M.A. Editor Trissy Harding Graphic Design
ADMINISTRATION:
Susan E. Phillips Senior Vice President, Public Affairs
LET US HEAR FROM YOU: 3535 Market Street, Mezzanine Philadelphia, PA 19104 phone: 215.662.4488 fax: 215.349.8312 Please feel free to share your thoughts and ideas for improving System News! E-mail the editor at sally.sapega@uphs.upenn.edu.