Volume 14
Issue 2
November 2014
SYSTEMnews CEO’s corner Ralph W. Muller
CEO, University of Pennsylvania Health System
Kindness is a powerful healer. These simple yet far-reaching words capture the philosophy at the foundation of our commitment to an outstanding patient experience. Patients expect -- and deserve -- safe and effective care. While this is of course extremely important, it’s not enough. By also doing everything we can to ensure a first-rate patient experience, we can help lessen the anxiety and apprehension that inevitably come with a hospital stay, doctor’s visit, or outpatient procedure. This is not only vital for the patient's frame of mind but also central to good health outcomes. At UPHS the patient experience is as crucial a part of the quality framework as clinical effectiveness and patient safety.
Connexus: Real-time Patient Information in a Mobile-Friendly View With the advent of electronic medical records, patient information became as close as the nearest computer. But securely logging in to a desktop and waiting for the EMR to load can be a lengthy process, a struggle for clinicians on the go providing patient care. Now, Connexus takes this access to clinical data to a new level. The recently launched website, created by Information Services in partnership with the Office of the Chief Medical Information Officer, provides real-time patient information in a mobilefriendly view. “The site frees the provider from the need to log onto a computer or depend on out-of-date information from printouts produced hours earlier,” said William Hanson, MD, vice president and CMIO of the Health System.
A positive patient experience best occurs within a service-minded culture: one continually stressing the importance of putting patients first. It simply can’t be achieved through unconnected initiatives. That’s why at a strategic level, our Blueprint for Quality and Patient Safety frames the patient experience as an integral and equal part of our mission. By our actions, we want patients to know they are at the heart of everything we do.
The application also presents the data in a format that “we as clinicians need to make medical decisions,” said Subha Airan-Javia, MD, of Internal Medicine, who worked with Glenn Fala, senior director for Software Development, and the Information Services team to create the site.
CPUP’s recent Patient Experience Week is a case in point. Bringing together a range of patient-supporting activities under the evocative tagline Be Someone’s Umbrella, the week proved an excellent opportunity to highlight the many ways CPUP staff members put patients first. Events took place at every CPUP location, comprising over 2,000 people.
Connexus began as a challenge Hanson made to Airan-Javia to make handoff documents mobile. A handoff document contains essential patient information passed from one provider to another, enabling better care of their shared patients but, as Airan-Javia noted, “it is a tool that I check throughout the day, a think space.” Currently, even though information is keyed into Sunrise (the electronic records system for inpatients), handoff documents have to be printed and shared.
Activities offered to thank and re-energize staff members, included bagel breakfasts, massage appointments, stress reduction techniques, and book club discussions. A terrific array of in-house speakers offered suggestions for enhancing patient communications and managing wait-time more effectively. A live panel of patients spoke movingly about how something as simple as a warm smile can help put patients and family members at ease. A new video promoting the patient experience was premiered, a fresh emphasis on a pro-patient perspective was added to our new-hire orientation, and an award ceremony recognized staff members who go the extra mile. Posters challenged and inspired everyone to be at the top of their game. Patients of course took notice and recognized how much we value their trust in us. Our aim is to expand this excellent model throughout the health system in the coming year. (continued on page 5)
Inside Theresa Larivee Named PAH Executive Director.............2 Ebola Preparedness at Penn Medicine...........................2 Penn Medicine Valley Forge a LEED Facility...........................2 PennSeek: A Major Change in Data Access................................2 Penn Medicine@Work..............3 Newsmakers..............................4 Anatomy of a Move..................5 Leadership Transitions.............6
Where It Began
onnexus frees the provider from the need C to log onto a computer or depend on out-ofdate information from printouts produced hours earlier. The first step was to figure out how to display so much data on a smartphone. “At first, it seemed insurmountable,” Fala said. But the team kept working at it — finding ways to collapse and expand information — and finally came up with a clean design that worked. Fala's team had also developed MedView Mobile, an iPhone app that allows users to look up any patient's care-provider team as well as recent labs and radiology studies. Connexus takes these functions several steps further, Airan-Javia said. “It gives providers the ability to create patient lists that automatically populate based on selected criteria and provides a more comprehensive set of patient data.” Additionally, while MedView Mobile offers access to recent patient data, it only goes back two years, leaving many gaps for patients with chronic conditions that have been treated at Penn over time. “Connexus can search all of a patient's EMR record, removing that limitation,” she said.
Connexus is a mobile web application, not an app, which means there is nothing to download. It is essentially a mobile friendly web page that can be accessed from any mobile device that is connected to the UPHS network. This ensures the patient information displayed is secured behind the UPHS firewall. “Only providers with the security rights to access patient information can access the site” Airan-Javia said.
What It Offers Providers can view a variety of clinical information on the Connexus website including up-to-date vital signs, allergies, inpatient and home medication lists, labs, radiology studies, and medical history reports. But it goes well beyond just accessing data from Sunrise. According to Airan-Javia, one of its best features is the ability to quickly find the names of each member of a patient’s care provider team and ensure that everyone is in the loop, sharing information and up-to-date on evolving care situations. “It’s often very hard to find out who is taking care of a patient. Connexus has the name of the patient’s attending, primary intern, covering intern and nurse, and any other services that are consulting on the patient,” she said. Even better: the clinician can click on any name on the list to immediately call or email. “This helps increase communication between care providers,” she said. “If I have a question or problem, I can easily call one of the providers right away instead of wasting time tracking down the right person and the right contact information.” “If a clinician is in a patient’s room, he doesn’t want to be searching for information on a computer,” added Fala. “Now he can tell the patient ‘Let me call your doctor’ and simply click on the name. Tap and you’re connected.”
How It’s Formatted With Connexus, all of a patient’s data is presented in a clinically oriented way. For example, vital signs are graphed and trended, and inpatient and outpatient labs and radiology studies are integrated. “This allows clinicians to compare old data with new data,” Airan-Javia said. “I can easily see trends, such as a sudden spike in a value. “An EMR does not always present information in a way that coincides with provider needs. It’s much more spread out,” she continued, adding that “I have to teach residents how to access data on the EMR multiple times for them to understand. (continued on page 2)
Awards & Accolades.................6
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Theresa Larivee Named PAH Executive Director Theresa Larivee has been named the new executive director of Pennsylvania Hospital. Larivee succeeds Michael Buckley, MD, who retired after four very successful years leading and 37 years in total at the hospital. Prior to this promotion, Larivee was the Health System’s VP for Financial Operations. During her six years with UPHS, Larivee implemented a system-wide strategic analytical team, setting the foundation for key matters of strategy and business assessment. She has provided professional mentorship for staff across the system and serves as a Penn Medicine Leadership Academy faculty member in the “Leaders as Teachers” program with a focus on the Strategy & Finance curriculum. For the past year, Larivee has worked closely with faculty and staff within the Department of Medicine to facilitate an operational and fiscal turnaround and structural reorganization. Larivee joined UPHS in 2008 with 22 years of academic medical center experience. Before coming to Penn, Larivee was SVP and chief financial officer at Fox Chase Cancer Center. “Theresa’s collaborative leadership style has allowed her to work across all UPHS entities and instill a culture of cooperation and communication,” said CEO Ralph W. Muller. “With her highly effective client-focused and action-oriented leadership style – along with her deep commitment to staff and faculty development — we’re confident the tradition of excellence at the nation’s first hospital will be in good hands.”
Ebola Preparedness at Penn Medicine Penn Medicine is able to provide expert clinical care under a broad range of circumstances, keeping the safety and protection of our patients and staff as our top priority at all times. As our preparations for the potential of receiving an Ebola patient continue, plans have been made to provide care at HUP for any suspected or confirmed Ebola patients who may present at a Penn Medicine hospital or outpatient practice. HUP will provide inpatient care to these patients in a special isolated area of the hospital. Information is added daily to the UPHS Intranet site for Ebola preparedness. Clinical staff are encouraged to check this site regularly to stay abreast of updates: http://pennpoint.uphs.upenn.edu/sites/ebola/ default.aspx. Additionally, two phone lines have been established to assist clinicians and staff around the clock:
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Clinicians with patient-related questions should call 215.614.0524. A physician will answer and handle calls about screening, isolation and, if necessary, lead arrangements for patient transport to HUP from another entity.
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General questions not pertaining to direct patient care can be directed to 215.615.2929.
Connexus: Real-time Patient Information in a Mobile-Friendly View (continued from cover)
Connexus requires zero training. It’s much more intuitive.” The Connexus project team is now working on integrating the handoff document into the Connexus site, to eliminate the need to print it from Sunrise. Not surprisingly, that project is one of many Fala and his team of developers, designers, project managers and infrastructure specialists are tackling. Over the past 15 years they have created more than 75 apps. “Some apps, like MedView, have been around for the entire time. Others come and go,” he said. “There’s a constant cycle of retiring old apps and rolling out new ones.” The role of technology in health care clearly goes beyond apps and smart phones. The Penn Data Store and implementation systems such as EPIC help capture and aggregate patient data and now “we’re driving value from that data,” said CIO Michael Restuccia, for example, monitoring systems that look for trends, clinical decision support, and alerts and dashboard reports. “Working with those who work with patients, the IS team is helping Penn Medicine provide better care and improved outcomes for our patients.”
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Penn Medicine Valley Forge A LEED Facility Penn Medicine Valley Forge has received a LEED (Leadership in Energy and Environmental Design) Silver designation. The LEED rating system is the internationally accepted benchmark for the design, construction and operation of high performance green buildings. Energy saving and environmental strategies in the design, construction, and operation of Valley Forge include:
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On-site bicycle storage, preferred parking for low-emission vehicles and for carpool parking, and access to public transportation.
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Vegetated green roof and double-deck garage to reduce heat island effect.
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The use of paints and other solvent-based products with a low-VOC (volatile organic compounds) content and negatively pressurized janitor closets with exhaust directly to the outside.
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Office heating, ventilating, and air conditioning equipment monitored and controlled by a direct digital control (DDC) building automation system.
Penn Medicine Valley Forge joins one other Penn Medicine facility that has received a LEED Silver designation: the Perelman Center for Advanced Medicine. `` Pictured with the glass Silver LEED plaque are (from left) Steve Bisha, John Patten (Stantec design firm), Ron Barg, Betty Sheller, Jerry Bronstein and Jim Kerr (IMC Construction), and Larry Bell.
PennSeek: A Major Change in Data Access Traditionally, researchers have struggled with accessing data across multiple clinical systems, especially when that data is unstructured, as in the case of progress notes and reports. Researchers had few choices except to manually search through data or to request a report from the Penn Data Store, Penn Medicine’s data warehouse for clinical research data. PennSeek takes the search to the next level. This web-based application, created by IS, allows IRB-approved users to access not only discrete data — for example, patient demographics and diagnosis codes — but also progress notes and reports from clinical systems such as Epic, Cerner, and ProSolv. The self-service shopping-like aspect of this application is the key that makes PennSeek an indispensable research tool, said Jesse Zlatsin, senior clinical data analyst of Information Services. “If a patient tells a doctor ‘I wake up in a cold sweat’, and a researcher later wants to know if that phrase is an early indicator of another condition, that information may only be captured in a progress note,” he said. “A regular search using database tools wouldn’t show this information.” PennSeek also highlights the exact location where searched words appear in context. “Previous search methods could sometimes find the report or progress note, but the researcher would have to read through the entire text to find key words,” Zlatsin said. At present, PennSeek is available for clinicians involved in research studies, but “we hope the future will have us using tools like PennSeek to support patient care.”
penn medicine
work
`` David E. Lentz with his Best of Show entry
One of those ‘Best of Show’ honorees, David E. Lentz, RN, BSN, CMSRN, an intensive care nurse at Pennsylvania Hospital, is a talented artist specializing in mixed media on canvas painting – including watercolor, acrylic, and frisket. Like Dr. Johnson, David is self-taught. “I just picked up watercolors and tried it about 16 years ago,” said David. “I slowly taught myself over the years. I gave away most of my first pieces. I never realized I had gotten good enough that people would want to purchase them. One day a friend came over to practice her photography and finished taking pictures of the paintings on my walls. I opened my art closet to show her more and dozens spilled out onto the floor. She was astounded and from that day on I started to catalog and sell them.”
A CELEBRATION OF ART & LIFE His patients knew HUP’s beloved former chief medical officer, Bernett L. Johnson, Jr., MD, for his compassion and skill as a physician. His students knew him for his patience and guidance as a teacher. His colleagues remember him for his insight, counsel, and friendship. Everyone recognizes him as the inspiration behind the annual art exhibition A Celebration of Art and Life. Dr. Johnson, who passed away in 2009, was a self-taught artist. The story, as shared by his widow Mary Martha Johnson, is that he purchased an oil painting kit for a family member. When it became evident that the recipient wasn’t going to use it, Johnson picked it up…and the rest is history. It turns out that artistic talent is more prolific in the Penn Medicine community than one might first imagine. Last year’s exhibition brought ‘Best of Show’ honors to staff from Neurology to Facilities Management to Surgery.
At Penn Medicine, David has found a way to combine his two passions. You will find his work on display throughout the Health System at PAH, PCAM, Penn Tower and in the nurses break room in the Oncology unit at PAH where he recently worked before transitioning to a critical care unit this past year. “The paintings have such a positive impact on patients. It helps them to reflect on themselves as they’re studying my pieces. There is a lot more to my pieces than a first glance can give you.” David continued. “They also cheer up coworkers and family members. The paintings help distract patients from their conditions, if just for a moment. The process of painting allows me to reflect and let go of sometimes stressful days working as a critical care nurse.” You can also view David’s work on his website: DevidLentzArt.com.
A Call for Artists Faculty, staff, students and patients are invited to participate in the 2015 Celebration of Art and Life exhibition, a juried competition showcasing individual creative expression. Painters, photographers, printmakers and craftspeople are welcome to submit all techniques and subjects within a wide range of ideas and styles. The exhibition will open in January 2015. To apply, visit https://cfeva.slideroom.com. The application deadline is December 1, 2014. For inquiries, please contact Genevieve Coutroubis at Genevieve@cfeva.org.
THE GREAT AMERICAN SMOKEOUT IS COMING... Make it your quit day! The Health System is proud to join the American Cancer Society in promoting the Great American Smokeout on Thursday, November 20, 2014! Did you know that tobacco use is the single-most preventable cause of disease and premature death in the United States? In fact, tobacco use is responsible for nearly one in five deaths in this country. You can earn Healthy Reward points by joining the Great American Smokeout challenge in the Healthy Rewards site and quitting for the day or by supporting a loved one or co-worker quit for the day. To join the challenge, go to the HR and You website (www.uphshrandyou.com) on November 20, click on Healthy Rewards, and use your network credentials to log in and sign up. Why Quit? Research shows that if you pick a quit date in the next 30 days and stick to it, you’ll be more likely to quit for good. So pick a quit date, and, as you mark it on your calendar, consider these benefits of quitting:
20 Minutes after quitting: Your heart rate and blood pressure drop.
12 Hours after quitting: The carbon monoxide level in your blood drops to normal.
2 Weeks to 3 Mo. after quitting: Your circulation improves, and your lung function increases.
1-9 Months after quitting: Coughing and shortness of breath decrease; cilia (tiny hair-like structures in the lungs) regain normal function, increasing the ability to handle mucus, clean the lungs, and reduce the risk of infection.
1 Year after quitting: The excess risk of coronary heart disease is half that of a smoker’s.
5 Years after quitting: Risks of cancer of the mouth, throat, esophagus, and bladder are cut in half. Cervical cancer risk falls to that of a nonsmoker. Stroke risk can fall to that of a nonsmoker after 2 to 5 years.
10 Years after quitting: The lung cancer death rate is about half that of a smoker. The risks of cancer of the larynx and pancreas decrease.
15 Years after quitting: The risk of coronary heart disease is that of a nonsmoker’s. To learn more about the free UPHS Tobacco Cessation Program (for employees and dependents covered under a medical plan) through Health Advocate, call 1-866-695-8622. Additional resources can be found on the UPHS HR and You Wellfocused website under the “Tobacco Cessation — Quit Smoking” section.
Honoring
& Remembering
Our Veterans For over 200 years Penn Medicine has proudly stood shoulder to shoulder with the brave men and women of our armed forces. During the American Revolution, Pennsylvania Hospital tended to both Continental and British soldiers while throughout the Civil War it treated wounded Northern troops. Our medical school graduates served as physicians and surgeons in both the Union forces and Confederate Army. All UPHS hospitals played vital roles during World War I and II. And, today, hundreds of Penn’s faculty, staff and students have served — or are currently serving — in the US Armed Forces across the globe. During the month of November, we celebrate Veterans Day and are reminded of the sacrifices the brave men and women of our armed forces make each and every day – including our Penn Medicine colleagues who have served, and who continue to serve, in the Armed Forces Reserves today. For those friends and colleagues who have fallen in the line of duty – and the many more who continue to serve as members of the Penn Medicine family — thank you.
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Penn Medicine
NEWSmakers / / / Is Your Brain Male or Female? A BBC documentary turned to research by Ragini Verma, PhD, research assistant professor in Radiology, and Ruben Gur, PhD, professor of Psychology, that delved into differences between the male and female brain. The team scanned the brains of more than 900 males and females to create a detailed map of the two hemispheres of the brain. "We can conclude that the ability to use verbal, analytic, and emotional information is enhanced in women," said Gur. Gur also noted the research found a stronger connection between the front and back of the brain in males, suggesting that males have a stronger way to connect what they see and what they do.
/ / / What Doctors Can't Do A New York Times article showcased the IMPaCT program at the Penn Center for Community Health Workers, detailing the increasing role that these lay members of the community play in caring for patients who live in high-poverty neighborhoods, are hospitalized or dealing with multiple chronic diseases, and either have Medicaid or no insurance at all. Shreya Kangovi, MD, MS, an assistant professor of Medicine who directs the program, is quoted, along with UPHS COO Garry Scheib and Mary White, one of the community health workers. Early data shows the program works: Kangovi's team tracked the impact of having a CHW visit patients at hospital discharge and for two weeks after. Patients who got the visits saw a doctor sooner, had better mental health and were less likely to later have multiple readmissions than patients in a control group.
/ / / Does Enhanced HPV Knowledge Among Teens and Parents Increase Vaccination Rates? Penn Study Says No Despite efforts to get the word out, the percentage of kids who get the HPV vaccine is much lower than for other shots recommended for pre-teens. A new Penn study questioned whether improving knowledge among parents and kids actually works to improve vaccination rates. Jessica Fishman, PhD, a behavioral scientist, and her team surveyed low-income girls and their parents in Philadelphia to find out what those families knew about the virus and the vaccine to see if having better HPV information meant you were more likely to get the shots. The researchers found, surprisingly, that, "it didn't really make a difference if you had the knowledge or not," Fishman told WHYY radio.
/ / / Study of Jewish Women Shows Link to Cancer Without Family History An article from The New York Times reported on new research showing that some women who tested positive for cancer-causing genetic mutations during random screenings have high rates of breast and ovarian cancer even when they have no family history of the disease. Based on the finding, some are calling for universal screening for BRCA mutations regardless of family history. Others, however, advise against routine genetic counseling for women whose family history does not indicate a risk of harmful mutations. Susan Domchek, MD, executive director of the Basser Research Center for BRCA at Penn’s Abramson Cancer Center, commented on the difficult choices faced by patients who test positive for BRCA mutations, as well as the social and psychological consequences, and possible alternatives to closely monitor for cancer development in patients without a family history of the disease.
/ / / Flu Shot Time is Now, Officials Say Thomas Frieden, director of the Centers for Disease Control and Prevention, encouraged Americans to get their flu shot, as some local hospitals reported delays in shipments, reported The Philadelphia Inquirer. Patients this year will have the choice of a nasal spray vaccine or shots that protect against three strains of virus or four (quadrivalent). David Pegues, MD, medical director of Health Care Epidemiology, Infection Prevention and Control at HUP, was quoted in the piece.
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/ / / Your Body Clock May Influence How Many Drugs Work John Hogenesch, PhD, a professor of Systems Pharmacology and Translational Therapeutics, led a new effort mapping 24-hr patterns of expression for thousands of genes in 12 different mouse organs. This study, published in the Proceedings of the National Academy of Sciences, provides important clues about how the role of timing may influence the way drugs work in the body. "I'm hopeful that we can use this information to design better therapies with existing drugs, and that's huge because it's not going to cost any more money,” said Hogenesch in a BBC News report. The study also appeared in many international outlets, including WHYY, Forbes, and The Scientist.
/ / / Vitamin D Shows Promise for Local Patients Battling Pancreatic Cancer
/ / / Penn Medicine Prepares for Potential Ebola Cases The Hospital of the University of Pennsylvania agreed to be among hospitals to care for U.S. medical workers who contract the Ebola virus while working in Africa, if needed, reported The Philadelphia Inquirer, 6ABC, NBC10 and CBS3. Several outlets, including 6ABC, CBS3, the Daily Pennsylvanian and the Daily Local, also reported on preparations being made by Penn Medicine hospitals to treat any possible patient suspected of having Ebola or those who test positive. Trish Henwood, MD, assistant professor of Emergency Medicine, was also featured in front page articles in The Philadelphia Inquirer and The New York Times on her work in an Ebola treatment unit in Liberia for five weeks.
/ / / Study Shows 25 Percent Fewer Opioid-Related Deaths in States Allowing Medical Marijuana States that legalized medical marijuana appear to have nearly 25 percent fewer deaths from overdoses involving prescription painkillers, according to a new JAMA Internal Medicine multiinstitutional study led by Perelman School of Medicine researchers. Lead author, Marcus A. Bachhuber, MD, Robert Wood Johnson Foundation Clinical Scholar at Penn and the Philadelphia VA Medical Center, expected to find differences in painkiller-associated deaths among states with different medical marijuana laws, but did not anticipate such dramatic differences. Many outlets nationwide covered the research, including The Washington Post, CNN.com, and the Boston Globe.
A clinical trial underway at Penn Medicine is investigating the use of vitamin D in combination with chemotherapy for pancreatic cancer patients. It’s believed the supplement can help break down the extra layer of cells that surround and fuel pancreatic cancer. “By making those support cells less active, the tumor cells become more sensitive to the chemotherapy,” Peter O’Dwyer, MD, professor of Medicine in Hematology/Oncology, told CBS3. This first inhuman trial stems from a preclinical study published in the journal Cell last week, co-authored by Jeffrey A. Drebin, MD, PhD, chair of Surgery, and O’Dwyer, which found that the combo increased the lifespan of animals by 50 percent compared to chemotherapy alone. The first patient enrolled in the trial at Penn was also featured in the piece. The Los Angeles Times also covered the Cell study.
/ / / March of Dimes Providing $10M for Prematurity Research Center at Penn The Philadelphia Business Journal and Fox29 reported on a newly announced collaboration between Penn and the March of Dimes Foundation to create a $10 million research center to focus on discovering the unknown causes of pre-term births — and developing new strategies to prevent them. The March of Dimes will invest $10 million over the next five years to launch a transdisciplinary center led by physicians and researchers at the Hospital of the University of Pennsylvania and Children's Hospital of Philadelphia. Deborah A. Driscoll, MD, chair of Obstetrics and Gynecology, will serve as principal investigator at the center.
Visit the Penn Medicine news website at www.PennMedicine.org/news
Anatomy of a Move The Complexities of Moving Penn Trauma to PPMC Trauma care is complex. Indeed, depending on the type of injury, a trauma patient could require treatment by a neurosurgeon, an orthopaedist, an ophthalmologist, an obstetrician….and many other subspecialties. And that doesn’t count all the nursing, allied health, social work, pastoral care, respiratory, and other disciplines that are all essential parts of the trauma team. Now, consider what it would take to move this multidisciplinary group — and all of the physical infrastructure related to providing that specialized care — to a new location. That was the challenge facing the Penn Trauma Program when Penn Medicine decided to move its Level 1 Trauma Center from HUP to Penn Presbyterian. With Alyson Cole, MPM, assistant executive director PPMC, taking the lead as Trauma transition director, members of the Trauma program, clinical practice leaders and hospital directors* across both campuses have worked together for the past three years, pulling together the many pieces leading to a successful transition. “This is the first time in the state – and possibly anywhere in the country — that an established trauma program has been moved to a different hospital site within a health system,” Cole said. A tall order, to say the least.
Why Move Trauma? The decision to move trauma was based on a number of factors, but two important goals were to increase Penn’s Medicine’s capacity to care for patients and spread the capacity across the entire Health System. The move would immediately benefit HUP, providing breathing room to allow the landlocked hospital to expand its inpatient services. It would also support growth – and major upgrades — on Presby’s campus. “PPMC was creating its own strategic plan to modernize its facilities,” Cole explained. “The Trauma Program transition helped shape and enhance that campus growth.” Trauma’s move also coincided with construction of Penn Medicine University City, an ambulatory center which opened in August. Based on the shift in the health-care environment from inpatient to outpatient care, Penn Medicine leaders decided to follow in the successful footsteps of the Perelman Center for Advanced Medicine, creating PMUC to house many of Presbyterian’s outpatient services. This new space for PPMC was a great help to what Cole called the “domino moves” to accommodate other programs and services on the main campus.
Staffing Needs Moving trauma will shift 2,000 additional admissions to the PPMC campus. What staffing resources would be needed to care for these extra patients? The Transition Team turned to the trauma registry, which tracks patients from the time they come in till discharge. As John Gallagher, MSN, CCNS, CCRN, Trauma Program manager, explained, “This data helped us, for example, map out how many x-rays a trauma patient will require and how many staff to do it, how many trips to the OR, how many lab tests, blood units …” and the list goes on and on. “Every division had to decide what they needed for the move — and for 24/7 coverage — in terms of additional attendings, additional nurse practitioners, additional residents,” he added.
CEO’s corner
T his is the first time in the state — and possibly anywhere in the country — that an established trauma program has been moved to a different hospital site within a health system. Also, they had to consider the move’s impact on Penn Medicine’s missions of research and teaching. “We’re taking the most complex injured patients out of HUP — these are cases residents want to see,” Gallagher said. “We have to make sure we provide residents and fellows with the educational experience they need.” Based on the trauma registry information, keeping the trauma program operating at the same level will require an estimated 320 additional staff members at PPMC. At special town hall meetings at HUP and PPMC, “we explained to staff what we were building and how we needed these teams to join us,” Cole said. “We needed to move current staff with trauma expertise and experience to keep this program at the same level of excellence.” “The program has to remain as intact as possible to maintain our accreditation as a Level 1 Trauma Center,” Gallagher said. “Because of Penn’s long history of good outcomes and good survey outcomes, the Trauma Foundation is transferring accreditation, we’re not starting from scratch.” If the Foundation had not allowed Penn to retain its accreditation, “we would have had to duplicate both trauma centers for a period of time … or close both for a time.”
Almost There … The group depended on feedback from the extended trauma team when designing the various areas of the new Pavilion for Advanced Care – from trauma bays and ORs to periop areas and ICUs. “We took the knowledge that we had from front-line staff to create improvements,” Cole said. “This is a totally different design than anything that exists in Penn Medicine.” Another essential task was getting the word out to the public. Trauma patients don’t just show up, she said. “Most are delivered from other hospitals, or by fire department, rescue units, EMTs. We need to get out several messages, including the exact location and the best routes to get there.” “And we need contingency plans for patients that show up at HUP,” Gallagher added. As the official Trauma transition (February 4, 2015) comes closer, transition leaders at both hospitals have to make sure everything — staff and equipment – is ready to go. Because, as Gallagher said, once trauma moves, “the patients start arriving.” *In addition to Cole, the Trauma Coordinating Committee included Michele Volpe (PPMC CEO and executive director), Garry Scheib (HUP executive director and COO of the Health System), Peter Quinn, MD (UPHS vice dean for Professional Services), Jill Baren, MD (chair of Emergency Medicine), Lee Fleisher, MD (chair of Anesthesiology and Critical Care), Patrick Reilly, MD, (chief of Traumatology, Surgical Critical Care, and Emergency Surgery); C. William Schwab, MD, (former Trauma chief), Patrick Kim, MD, (Trauma Program director), John Gallagher, MSN, CCNS, CCRN, (Trauma Program manager), George Iyoob, BSN, MHA, (director of PPMC Trauma & Orthopedics), Kristen Chreiman, BSN, CCRN, (Trauma Program & Network clinical coordinator), and Sue Auerbach, MHA (Trauma Network administrator).
(continued from cover)
Another example of our commitment to putting patients first is newly introduced safe, secure, and confidential 24-hour online scheduling in select service lines. Using the myPennMedicine portal, patients can schedule their own appointments with our orthopaedic specialists. Specially designed questionnaires help find the first available appointment with the right provider. The service is now available at the Penn Musculoskeletal Center, with expansion to more sites coming. Other specialties will follow as well. We also want you to enjoy a positive experience when meeting your own health care needs. Our employee concierge program, which began earlier this year, features a dedicated phone line that allows staff members and their families to quickly and conveniently obtain appointments with UPHS primary care physicians. Reception has been so positive that we’re expanding it to include specialty services. Already on board are many UPHS dermatologists and ophthalmologists; orthopaedics is now being added, with additional service lines to come. Service excellence is important for many reasons. Market research has found that on average, happy customers tell five people about their experience while dissatisfied ones tell twice as many. Accreditation organizations and insurance companies increasingly incorporate patient satisfaction scores in their evaluations and payments. But most importantly, when patients feel secure in their care, they respond better. We in turn experience more pride in our work when patients and families are satisfied. Our commitment to improving the patient experience is a permanent one, a mainstay of our culture. Your hard work has substantially improved our patient satisfaction scores and, with your ongoing support, the results will continue to pay dividends.
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LEADERSHIP TRANSITIONS New Chief of PAH Cardiovascular Surgery Satoshi Furukawa, MD, has been named chief of Cardiovascular Surgery at Pennsylvania Hospital. Previously chief of CT surgery at Reading Hospital and Medical Center, Furukawa specializes in open and minimally invasive surgery, cardiac and lung transplantation, mitral valve repair, and other procedures. His other clinical specialties include high-risk cardiac surgery and off-pump ventricular assist device implantation surgery. He also has an interest in stress management and alternative medicine post-surgery. Furukawa has performed more than 400 heart and 120 lung transplants.
Puopolo Named PAH Section Chief Karen M. Puopolo, MD, PhD, has been named the new section chief of Neonatology & Newborn Pediatrics at Pennsylvania Hospital. Puopolo comes to Penn from Brigham and Women’s Hospital in Boston. Puopolo’s research is focused on the incidence, microbiology, risk factors, and prevention of infections that affect all infants at birth — as well as those that affect premature babies in the NICU. She is board certified in neonatal/perinatal medicine and pediatrics.
Wilson Interim Director of Orphan Disease Center James M. Wilson, MD, PhD, has been named interim director of the Center for Orphan Disease Research & Therapy, an interdisciplinary program focused on discovering novel treatments for orphan diseases through innovation and translation of therapeutic strategies, and partnerships among investigators, academic institutions, industry, and funding agencies. Orphan diseases represent a collection of disorders that afflict fewer than 200,000 individuals for any single disease type. Over 25 million people in the United States suffer substantial morbidity and mortality from orphan diseases.
AWARDS AND ACCOLADES CCH Receives HAP Achievement Awards Each year, The Hospital & Healthsystem Association of Pennsylvania (HAP) recognizes hospitals and health systems that enhance and refine health-care quality, delivery and cost effectiveness. Chester County Hospital received two of the 15 HAP awards, in the categories of Patient Safety and Operational Excellence. “Reducing Falls: From the Patient’s Perspective” focused on increasing falls education and reporting among its nurses and introduced a “falls interview” document. Results showed that, between 2012 and 2013, the hospital’s falls rate decreased by 16 percent and serious injury from a fall decreased by 50 percent.
`` Betty Brennan, director of Emergency Services and Mike Suchanick, HAP COO.
“Physician Direct Queuing: Re-Engineered ED Patient Care Delivery Model” addressed many ED issues. For example, a Rapid Treatment Area (RTA) model and new ED patient-care flow process were established. A split-flow process designated patients as “vertical”— not needing to occupy a bed, and “horizontal”— needing a bed due to clinical conditions or treatment plans. An internal waiting room was added and the patient registration practices was modified. The results: a 78 percent reduction in time for walk-in patients to be seen by a provider, a 50 percent reduction in length of stay for RTA patients, a 32 percent reduction in length of stay for all ED patients. Finally, the RTA flow reduced the number of left-without-being-seen patients by 82 percent.
Recognizing Clinical Care Excellence
Penn Named National Pulmonary Hypertension Care Center
The Penn Medicine Awards of Excellence, established in 1996, recognize faculty from the Perelman School of Medicine who exemplify the profession’s highest values of scholarship and teaching, innovation, commitment to service, leadership and dedication to patient care. This year, 18 new recipients join the over 150 faculty members who have received this award to date.
Penn Medicine has been named one of the first fully accredited Pulmonary Hypertension Care Centers (PHCCs) in the country, with its Pulmonary Hypertension/ Pulmonary Vascular Disease Program at Penn Presbyterian and HUP. The Pulmonary Hypertension Association (PHA) announced the first six programs as part of its efforts to improve overall quality of care and ultimately improve outcomes of patients with pulmonary hypertension.
“I am extremely proud of this year’s distinguished recipients of the Penn Medicine Awards of Excellence,” said 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. “The contributions of these clinicians and scientists exemplify the outstanding quality of patient care, mentoring, research, and teaching of our world-class faculty. They epitomize the preeminence and impact we all strive to achieve.” To see a complete list of this year’s awardees, go to: http://news.pennmedicine.org/inside/system-news/.
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PHCC accreditation signifies that the program is dedicated to making a proper diagnosis and has the capacity to appropriately and comprehensively manage pulmonary hypertension patients according to a set of criteria established by the PHA Scientific Leadership Council. For more information about the accreditation, visit www.phassociation.org.
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Holly Auer Director of Communications Susan E. Phillips Senior Vice President, Public Affairs
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Another Successful 5K for the IOA
3535 Market Street, Mezzanine Philadelphia, PA 19104
Nearly 300 runners and walkers — ranging in age from six months to 91 years — took part in this year’s 5K for the IOA and Memory Mile Walk. This year’s event raised $37,500 for the Penn Institute on Aging, bringing the three-year total to more than $112,000! The funds will be used for the IOA’s research to help the millions of people with Alzheimer’s disease and other neuro-degenerative disorders.
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.