HUPdate Hospital of the University of Pennsylvania

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New portable AEDs now accessible throughout public areas

Making HUP more Heart Safe

Volume 23 Number 2 January 27, 2012

Sudden cardiac arrest is the most time-sensitive of all diseases; for every minute without treatment, a person’s chance of survival decreases by 10 percent. It kills over 300,000 Americans each year.

According to Benjamin Abella, MD, MPhil, clinical research director at Penn’s Center for Resuscitation Science, immediate use of an AED (automatic external de�brillator) can triple the chance of survival, but �nding one close by – even in a hospital – is not always easy. �e sudden cardiac arrest last summer of George Hettenbach, HUP’s Safety manager, as he was walking to his o�ce on 1 Maloney, brought this fact to light.

“�e Rapid Response team was able to save him because someone knew where to �nd a de�brillator,” Abella said, “but it made us realize that we had an Achilles heel. We have de�brillators in the emergency room and other clinical areas but they weren’t readily available in public or employee areas of the hospital.”

Abella worked with members of HUP’s Clinical Emergencies Committee, which he co-chairs with Heather Ross, RN, BSN, Nursing Clinical Coordinator of Rapid Response, to identify key areas within HUP for portable AEDs. “We based it on foot-tra�c patterns and distance from clinical areas, choosing such locations as the lobby and cafeteria,” he said. New AEDs are now installed throughout the hospital (See sidebar for locations).

Your Big Idea .............................3

Come to the Magnet Fair .........3

The Positive Impact of Exercise .................................4

The Final Contribution .............4

INSIDE

(Continued on page 2)

We know automatic external de�brillators (AEDs) can save lives; the challenge is �nding one when you need it. In cardiac arrest, a person will die within minutes without CPR and de�brillation.

Now, thanks to MyHeartMap Challenge, a project by Penn Medicine researchers, locating an AED in Philadelphia will eventually be as simple as checking a smartphone application.

Join Penn’sMyHeartMap

C H A L L E N G ESnapping photos can save lives!

(Continued on page 2)

` George Hettenbach (c) knows firsthand that AEDs save lives. With him are Heather Ross and Ben Abella, who together led the initiative to bring portable AEDs to key locations throughout the hospital.

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Taking the Luck Out of Survival�e AED, which delivers an electrical charge to restart the heart, can help people but does no harm. “It is a ‘smart” machine. It will only send a shock if it detects a cardiac arrest rhythm. If applied to a person with a pulse, it will not discharge,” Abella said. “It has a very simple design and is very safe. �ey are designed for anyone to use.”

Now that the AEDs are in place, Abella is partnering with Joe Forte, head of HUP Security. HUP guards will be responsible for bringing the nearest AED to where the person has collapsed. “�at was one of our challenges – getting the AED to the scene.”

�e wall cabinets holding the AED are not locked but an alarm will go o� when the AED is removed from the case “to alert people to an emergency.”

“�is program is really in honor of George. We want the next person to be equally lucky but we don’t want survival to be a matter of luck,” Abella said. “We want to take the ‘luck’ out of it.”

Putting AEDs Where They’re Needed MostHUP has de�brillators in the emergency room and other clinical areas but, until recently, they were not available in the more public areas, such as the lobby and cafeteria. Now, thanks to the Clinical Emergencies Committee and senior leadership, HUP is more heart safe, with an AED in the following locations:

• HUP lobby, near main security desk

• Inpatient pharmacy in Silverstein basement

• Penn Tower Bridge, near security desk

• Ground Gates, near Spruce Street entrance

• 1 Maloney, near hair salon

• 7 Gates, near clinical lab areas

• 7 Founders, near clinical lab areas

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Making HUP more Heart Safe: New portable AEDs now accessible throughout public areas

(Continued from cover story)

Where are the AEDs?The Penn Medicine contest, which kicks off at the end of January, challenges people to locate and document as many AEDs as possible in Philadelphia County. Using a free application on their mobile phones, contest participants will snap pictures of the lifesaving devices wherever they see them in the city and use the app to tag the photos with location information and details about the device, such as its color and manufacturer. Then they’ll send that information to the research team via the app itself or to www.med.upenn.edu/myheartmap, the project’s website. The MyHeartMap team will post clues on the website to help participants locate AEDs. “The clues will be in many different forms, such as Sudoku, poems, riddles, math problems and pictures,” said Raina Merchant, MD, MS, of Emergency Medicine, who leads this city-wide initiative.

The collected data will be used to create an updated app linking locations of all public AEDs in the city. “We’ll make the information available to the city’s 911 call system as well as to the public via a smartphone application,” which will provide GPS coordinates to help locate the nearest AED during an emergency.

Merchant hopes the contest is just a first step in what will be a nationwide, crowd-sourced AED registry project that will put the lifesaving devices in the hands of anyone ... anywhere ... anytime.

A Win-Win CompetitionThe benefits of participating are significant: saving lives, raising awareness, and educating the public. But there’s a monetary stake as well: The person or team who finds the most AEDs will receive a $10,000 prize. And participants who find the various ‘golden ticket’ AEDs will win $50. “They look no different than the other AEDs—just take as

many photos of AEDs as you can and send them in,” she said.

Challenge participants can register as individuals or teams, developing creative ways to maximize their chances of winning, for example, by using social networks via Twitter and Facebook to engage people to take photos of AEDs. Participants can also organize AED scavenger hunts or mini-contests to locate all the AEDs in a workplace building, or compete against friends to see who can find the most devices.

The Challenge, which combines the expertise of investigators from throughout the University and the Children’s Hospital of Philadelphia, runs six weeks, through mid-March.

To learn more about the MyHeartMap Challenge or to register, please visit www.med.upenn.edu/myheartmap.

MyHeartMap C H A L L E N G E (Continued from cover story)

` An alarm sounds when the AED is removed from the case.

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COME TO THE MAGNET FAIR!

Help us improve the patient experienceDo you have an idea that could help our patients and their families have a better experience at Penn Medicine? Submit it in Penn Medicine’s upcoming Innovation Tournament and you might see it put into action!

Innovation tournaments help identify the best ideas. Think of it in terms of American Idol which begins with numerous performers and ends with the best. “Your Big Idea: Penn Medicine’s Innovation Tournament” will start with a large pool of submissions from our employees and, through a series of rounds, be narrowed down to a final few that will receive funding and the resources to be put into action.

All employees are welcome – and encouraged – to submit their ideas. The best solutions often come from those closest to the problems. The idea doesn’t have to be clinically based or even complex. “No idea is too small,” stressed Neil Ravitz, COO of the Office of the Chief Medical Officer, who’s leading the initiative. “We’re looking for a diverse range of suggestions.”

The first round of the tournament – submitting ideas – starts Tuesday, February 7. Faculty and staff can submit ideas in one of three ways: online, via email or in drop boxes located at each entity. All are invited to view and provide feedback on all submitted ideas. The deadline for round one is Friday, March 23.

The most promising ideas will move on to the next round, a facilitated workshop in which the employees who submitted the winning ideas will work together to narrow the choices down to the top 10 and then form teams to create proposed budgets and cost/benefit analyses. In the last round, the ideas will be pitched to Penn Medicine leadership, who will choose the best.

As the kick-off date approaches, look for more information about Penn Medicine’s Innovation Tournament at PennMedicine.org/yourbigidea.

The 2012 Penn Medicine strategic planning process is underway! To learn how you can help Shape our Future, please visit www.med.upenn.edu/strategy

THE 2012 PENN MEDICINE

STRATEGY

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HUP received Magnet designation from the American Nurses Credentialing Center in 2007, which put it among the top hospitals in this country. Now we’re on a journey to redesignation and we’re celebrating!

Come to the Magnet fair and learn what the upcoming ANCC site visit – on February 6-8 – means to all of us. “We are celebrating the role each of us plays in delivering excellent patient care,” said Danielle Calabrese, HUP’s Magnet director. “The site visit is a chance for the entire organization to shine.”

The Magnet fair will be held on the Dr. Bernett L. Johnson, Jr. Mezzanine on Tuesday and Wednesday, January 31 and February 1, from 6 am to 2 pm. There will be games, giveaways and free food!

` Kathleen Moyer, MSN, RNC-NIC CNIV (l) and Bernice Jones RN, MSN, CCRN, CNIV, both Women’s Health Magnet Champions, with the game developed to acquaint HUP staff with our senior leaders.

Remember: Improving the patient experience starts with you!

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EDITORIAL STAFF Sally Sapega Editor and Photographer

Danielle Taraschi Designer

ADMINISTRATION Marc Kaplan Director of Communications

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.

HUPdate

B E N E F I T S O F E A R L Y M O B I L I Z A T I O N I N T H E M I C U

Over the years, the bene�ts of exercise for patients has gained momentum. Forty years ago, studies showed that getting heart attack patients out of bed as soon as possible led to a faster recovery. �e same turnaround occurred with patients with back pain in the 1990s. More recently, evidence shows that these bene�ts could also be realized in critically ill medical patients. William Schweickert, MD, associate medical director of the MICU and medical director of the Procedure and Resuscitation Service, was the lead author of a landmark trial published in the journal Lancet that clearly demonstrated these �ndings.

Traditionally critically ill patients have been viewed as too sick to tolerate early physical activity in the ICU but “patients can also su�er adverse e�ects from immobility,” said Joe Adler, MSPT, CCS, Acute Care team leader of Occupational and Physical �erapy. While MICU patients are very sick, “a relatively large percentage can safely undergo exercise and mobilization even during mechanical ventilation and while on vasopressor infustions.”

“We have standardized many other complex ICU care processes, using the expertise of our faculty and the power of interdisciplinary team work,” said Barry Fuchs, MD, MICU medical director. “Our patients are now being managed with less sedation and can be more engaged. Early mobilization was a natural next step.”

V E R Y P R O M I S I N G R E S U L T S

Once approved to expand the pool of physical therapists in the MICU, the care team collaboratively developed the program of early mobilization. Physicans, nurses, and respiratory and physical therapists in the MICU established a new clinical protocol with speci�c eligibility and safety criteria to identify suitable patients for early and safe mobilization. To ensure implementation they added formalized reporting of physical functioning and reminders for PT consultation to the interdisciplinary rounds checklist and developed standardized tools for measuring patient progress. Dedicated physical therapists certi�ed to work with ICU patients worked with “careful collaboration with the patient’s bedside nurse and the entire care team,” Adler said.

�e results of the mobiliation program were more than encouraging. �e average ICU stay for all MICU patients was reduced by one day. Furthermore, patient physical function

was substantially improved at ICU discharge. Patients in the program exhibited a greater ability to sit upright, transfer out of bed, and walk independently and for longer distances when compared to patients during the prior level of care.

“Although the pilot was a success, we believe we can confer even more bene�t as we reach our planned sta�ng level,” Schweickert said. “We envision patients receiving aggressive physical and occupational therapy services six days per week to fully recreate the environment and success of prior clinical trials.”

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THE P O S I T I V E IMPACT OF EXERCISE

After more than 50 years of service to its members and UPHS patients, the Women’s Committee of the University of Pennsylvania Medical Faculty (WCUPMF), formerly the Doctors’ Wives Committee, was dissolved last summer. Formed in 1954, the group initially volunteered with pediatric patients and organized social activities to engage its members. Later, when pediatric patients moved to CHOP, the Women’s Committee directed its charitable outreach to patients of the Department of Physical Medicine and Rehabilitation.

Through WCUPMF fundraising efforts, the department was able to purchase therapeutic tools for use on the wards, provided holiday meal celebrations for Rehab patients, families and staff, and even purchased a specially equipped van for Rehab patient transportation. In 2010, a major gift partially funded the purchase of an ultrasound system used for diagnosis and guided therapeutic injections in Rehab patients.

Women’s Committee: A FINAL CONTRIBUTION

` WCUPMF Board members (l. to r) Randi Gaiser, Debra Grady, Rosa Aukburg, Becky Levy, Maryann Salcido and Jean Bryan present a check to Timothy Dillingham, MD, chair of Physical Medicine and Rehabilitation, for the remaining funds in the WCUPMF treasury.

` MICU patient Cole Warminsky is up and walking with help from (l. to r.) physical therapist Kelly Butler, respiratory therapist Florence Holland, and respiratory student Shelagh Humes.