In This Issue:Carroll Hospital designated as a primary stroke center pg. 2

2015 Physician of the Year pg. 4

Potentially Preventable Complications pg. 5

Enhancing Patient Communication pg. 6

Reducing Hospital Readmissions pg. 7

SCOPEMAY 2015

A PUBLICATION FOR THE MEDICAL STAFF OF CARROLL HOSPITAL

Physicians of the Month

January 2015 Keith O’Reilly, M.D., urology

February 2015 Sumit Bhutani, M.D., infectious disease

March 2015 (Provider of the Month) Rob Giangrandi, P.A.-C. adult hospitalist

April 2015 Dona Hobart, M.D., general surgery

Carroll Hospital Officially Partners with LifeBridge Health

On April 1, Carroll Hospital became a subsidiary of LifeBridge Health following a vote by members of the Carroll County Health Services Corporation, the former parent company of Carroll Hospital Center, to approve the affiliation agreement. With the new partnership, the hospital’s name has changed to Carroll Hospital, a LifeBridge Health center.

With the agreement, LifeBridge Health has made a commitment to implement Carroll Hospital’s strategic plan to grow and advance in areas like cardiovascular, cancer, hospice/home care, surgery, women and infants services and outpatient services. LifeBridge Health will invest $250 million in capital at Carroll Hospital, including facility construction and renovation as well as the development and expansion of medical services. LifeBridge Health will build upon Carroll Hospital’s commitment to the people of Carroll County, ensuring that residents have access to a vibrant acute care hospital offering a wide range of medical specialties, services and community physicians.

In addition, LifeBridge Health will make a $50 million contribution to the endowment fund of the Carroll Hospital Foundation to help fund patient care, scholarships, community education and other community benefit related programs.

“Our hospital has been a cornerstone of the Carroll County community for more than 50 years,” says Leslie Simmons, president. “When developing our Vision 2020 plan, we firmly concluded a strategic partnership was the best path forward for the next 50 years. LifeBridge Health’s shared vision and willingness to collaborate with us is energizing. I am extremely excited about our agreement and future together.”

“At LifeBridge Health, our philosophy has been to build on the strengths and local expertise of our hos-pitals, while providing them with the resources and efficiencies of a larger medical system. Through the LifeBridge Health affiliation, the people of Carroll County will have access to expanded health services that build on Carroll Hospital’s already strong foundation with expanded access to high quality specialists and the convenience of a hospital and affiliates that are already integral parts of their community,” says Neil Meltzer, president and CEO of LifeBridge Health.

The hospital and its affiliates remain nonprofit under the affiliation with LifeBridge Health. Also, repre-sentatives of Carroll Hospital now comprise 25 percent of the LifeBridge Health board of directors, with representation also on each system committee.

From left to right, starting with the front row, are LifeBridge Health President and CEO Neil Meltzer; and Carroll Hospital President Leslie Simmons. Back row: LifeBridge Health Board of Directors Chair Jason Blavatt; and Carroll Hospital Board of Directors Chair Helen W. Whitehead.

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Carroll Hospital designated as a Primary Stroke Center Carroll Hospital has been designated as a Primary Stroke Center by the Maryland Insti-tute for Emergency Medical Services Systems (MIEMSS). The designation recognizes the hos-pital for its ability to provide timely, coordinated stroke care and for meeting and/or exceeding the state’s requirements for effectively diagnosing and treating stroke patients.As a Primary Stroke Center, Emergency Medical Services (EMS) personnel will transport patients

who have stroke symptoms to Carroll Hospital for treatment when the hospital is the closest Primary Stroke Center in the area.To receive the designation, Carroll Hospital’s stroke program underwent a rigorous examination in which MIEMSS surveyors evaluated the hos-pital’s processes, treatment plans and outcomes for stroke patients. The hospital was found to have met or exceeded the state’s guidelines.“Every minute during an ischemic stroke, millions of brain cells die. As a Primary Stroke Center, since patients with acute stroke symptoms will be brought to our hospital by EMS, we can now treat patients in our com-

munity faster and thereby potentially reduce disability in those stroke patients eligible for treatment,” said Sandra Ruby, M.D., neurologist and medical director of the stroke program.For the past four years, the hospital has implemented numerous policies, procedures and programs to enhance its stroke program and to become a Primary Stroke Center. This includes a stroke alert protocol to ensure stroke patients are diagnosed and treated within 60 minutes of the alert being activated; extensive staff education on administering tissue plasminogen activator (tPA); and a support group for stroke survivors, their caregivers and family members. In addition, in 2014, the hospital received the American Heart Associ-ation/American Stroke Association’s Get With the Guidelines®-Stroke Silver Plus Quality Achievement Award.“We are extremely proud of this designation. Every minute counts when someone is having a stroke, so to be able to provide urgent treatment to stroke patients closer to home is a huge benefit not only to patients, but also their family members,” said Robert White, vice president of operations.

Carroll Hospital has expanded its cardiovascular care with the addition of General Electric Compa-ny’s (GE) Discovery 740 Interventional Imaging System™, a state-of-the-art imaging system that allows vascular surgeons to treat patients more quickly, efficiently and, soon, with more sophisticated procedures. The hospital is the first in Maryland and in the mid-Atlantic region to have this innovative technolo-gy. Funds donated to Carroll Hospital’s Campaign to Cure & Comfort Always and gifts to the Carroll Hos-pital Auxiliary helped purchase the equipment and finance construction of the new vascular room.

The Discovery 740 is an advanced imaging system that enhances the quality of service and vascular procedures the hospital provides. “The new system will dramatically enhance patient care because it’s a completely versatile system that is designed for a multitude of cases from interventional radiology to vascular surgery, and procedures can be performed more efficiently,” said Kristian Hochberg, M.D., medical director of vascular surgery, who was instrumental in researching and selecting the technology for the hospital, and in the design of the new lab.Rather than being tethered to the ceiling, the Discovery 740 rides on the floor and has a free-flowing C-arm that enables technologists and surgeons to take images of any portion of a patient’s body from various angles. The system produces remarkably clear three- dimensional (3-D) images that can be taken in one rotation, thus reducing the amount of radiation exposure to the patient. It also allows staff to superimpose an image from another modality, such as a CT scan, over a live image taken by the system to assist in procedures such as stent placements. However, one of its greatest features is how the Discovery 740 Interventional Imaging System will impact the sophistication of procedures available at the hospital in the future. “This innovative technology will take our hospital to a new level by enhancing the portfolio of procedures vascular surgeons can perform,” said Robert White, vice president of operations. “Patients will be able to stay right here in the community to receive any complex procedures they may need, rather than traveling to a different facility.”

Carroll Hospital opens newly enHanCed VasCular lab

New imagiNg system expaNds the raNge of sophisticated procedures available to patieNts

Upcoming EventsNational Cancer Survivors DaySunday, June 7Noon – 3 p.m.Carroll County Farm MuseumRegistration is required.Call 410-871-7000 or visit CarrollHospitalCenter.org/NCSD to register now.

Carroll Golf ClassicFriday, September 187:30 a.m. and 1 p.m. flightsPiney Branch Golf & Country Club. To register or for more information, please call 410-871-6200.

56th Annual Auxiliary GalaBenefiting the expansion of cardiovascular servicesSaturday, November 76:30 p.m.Martin’s WestminsterTickets will be on sale in September. For more information, please call 410-871-7280.

Sandra Ruby, M.D., neurology

Kristian Hochberg, M.D., vascular surgery

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For Information

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Pharmacy UpdateDantrolene (Ryanodex) Added for Malignant Hyperthermia Malignant hyperthermia (MH) is a potentially fatal, inherited disorder usually associated with the administration of certain types of general anesthetics and succinylcholine. In MH, skeletal muscle is broken down and as a result can cause muscle rigidity, rapid heart rate, high body temperature, muscle breakdown and increased acid. Immediate treatment with the drug dantrolene usually reverses these signs. Mortality is extremely high without prompt treatment. Ryanodex® is a new formulation of 250 mg dantrolene and only requires 5 ml for reconstitution. Prior to this, dantrolene was only available in 20 mg/20 ml vials (Revonto®). This new formulation means a 100 kg person would only need one vial of Ryanodex versus 13 vials of Revonto®. It has been added to the MH cart in the operating room. After the initial dose, maintenance doses will be prepared by the pharmacy department.

For more information on MH, visit the Malignant Hyperthermia Association of the United States website at mhaus.org.

Palliative Care Services: Providing chronically ill patients with an extra layer of support at any stage of their illnessWhen patients are diagnosed with a chronic or serious illness, Carroll Hospital offers a palliative care program to provide them with the specialized care and support needed to manage their condition and improve their quality of life.

The program includes a multidisciplinary team of physicians, nurses, clergy, social workers, case managers, respiratory care practitioners and pharmacists who work together to provide patients with resources or treatment to relieve the pain, symptoms and stress from their illness. It’s care that is provided alongside curative treatment and is appropriate at any age and at any stage of a serious illness.

Palliative care services for patients include emotional and spiritual sup-port; pain and symptom management; education to better understand their disease; assistance in coordinating care between multiple providers and consultants; assistance with advance directives; and more. While

palliative care is available to patients during their hospital stay, it also is available to patients after discharge through the hospital’s home care program. A physician’s referral is required for both programs.

“Our goal is to improve the quality of life of patients with a chronic illness and their family members by connecting them to the support they need. This has a huge impact on patients while they are here and after they are discharged,” said Stephanie Reid, vice president of quality and chief nursing officer.

To ensure all appropriate patients are able to receive this valuable service, the hospital is screening patients once admitted to assess whether they may benefit from a palliative care consult. If appropriate, the admitting physician will be contacted to make a referral.

For more information or to order a palliative care consult, please call 410-871-7890.

Departmental Update

Hemalatha Naganna, M.D., M.P.H., medical director of cardiovascular services

The hospital is pleased to announce the appointment of Hemalatha Naganna, M.D., chief of cardiology, as medical director of cardiovascular services. Dr. Naganna, along with Jim Ridge, executive director of cardiovascular and diagnostic imaging services, will provide vision, leadership and direction over the hospital’s cardiovascular service line.

Urgent Care vs. Emergency CareWhere to send your patients for the appropriate level of careLast year, Carroll Hospital expanded its services with the addition of urgent care centers in Eldersburg and Reisterstown. Carroll Hospital My Care Now has given patients an alternate place to receive urgent care in the community and provides primary care providers with a more conve-nient setting to refer patients for care during non-office hours, instead of the Emergency Department (ED), when appropriate.

If you are unsure of when to refer a patient to urgent care versus the hospital’s ED, below are some reminders.

Refer patients to the ED if they experience any of the following symptoms:

• Stopping or having trouble breathing• Passing out or fainting• Severe chest pain or pressure• Severe head, neck or spine injury• Sudden inability to speak, see, walk or move• Sudden weakness or droopiness on one side of the patient’s body• Heavy bleeding• Broken bones • Severe allergic reaction• Suicidal or homicidal feelings• Drug or alcohol overdose• Sudden loss of vision

During non-office hours, refer patients to our urgent care facilities, if they have:

• Cold, flu and other viral illnesses• Ear and sinus infections• Bronchitis, pneumonia and mild to moderate asthma exacerbations• Rashes and allergic reactions• Nausea, vomiting, diarrhea and dehydration• Bladder infections• Minor pediatric illnesses• Skin infections• Lacerations (cuts), abrasions (scrapes) and minor burns• Insect stings and bites• Simple fracture care• Abscess care including drainageTo learn more about Carroll Hospital My Care Now and its range of services, please visit CarrollHospitalCenter.org/MyCareNow

Click HERE

For Information

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Congratulations to Christopher Grove, M.D., chief of pathology, who was chosen as the 2015 Physician of the Year at the annual Doctor’s Day celebration held on March 24.

Affiliated with the hospital for three years, Dr. Grove was honored for his extraordinary care.

“Dr. Grove is a phenomenal pathologist whose exceptional leadership of the hos-pital’s lab team has been an integral part of the success of our hospital opera-tions,” said Leslie Simmons, president. “His outstanding work in the lab touches essentially every hospital service and every patient who walks through our doors.”

Dr. Grove’s exceptional performance was brought to the forefront when he was selected as May’s Physician of the Month in 2014 for his dedication to consistently

providing timely lab results to physicians to ensure patients received swift diagnosis and care. He also played a critical role in the hospital’s stellar performance during the College of American Pathologists (CAP) inspection of the lab in November. The CAP inspectors were extremely impressed with the lab’s level of quality and service such that they planned to implement several of the lab’s processes as best practices in their own lab.

Raised in Carroll County, Dr. Grove began working at the hospital as a pathology assistant for two years before seeking a medical degree. After earning his degree at The George Washington University School of Medicine, he served in the military for nine years at Walter Reed Army Medical Center in Washington, D.C., where he completed his residency. Dr. Grove then returned to Carroll County, where he assumed the role of chief of the pathology department at Carroll Hospital.

“I am so deeply honored to receive this award, especially given the fact that the other nominees are incredible physicians whom I respect and admire,” said Dr. Grove. “Although it’s an individual award, I prefer to view it as an award on behalf of the entire laboratory and the great work that everyone in our lab does every day.”

Leslie Simmons, president; and Christopher Grove, M.D., chief of pathology.

2015 Physician of the Year

Doctor’s Day 2015Close to 100 physicians were honored for their dedication to patient care during the annual Doctor’s Day celebration, held on March 24 in the Shauck Auditorium.

The evening included a cocktail-style dinner, catered by Linwoods, and a chance for medical staff to mingle in the East Pavilion atrium.

Before the dinner, guests enjoyed remarks from members of the executive management team, including Leslie Simmons, president, Ellen Finnerty Myers, chief development officer and vice president of corporate development, and Mark Olszyk, M.D., vice president of medical affairs and chief medical officer.

Among the highlights of the evening were a special video presentation featuring each Physician of the Month honoree in classic movie scenes, a special ceremony honoring medical staff members celebrating milestone anniversaries, ranging from five to 45 years, as well as the presentation of the 2015 Physician of the Year Award to Christopher Grove, M.D., chief of pathology.

1) From left to right are Sohaila Ali, M.D., vascular and thoracic surgery, and president of the medical staff; and Swarna Tammana, D.O., family medicine.

2) From left to right are Vajira Gunawardane, M.D., pain management; Adam Riso, P.A.-C., orthopaedic surgery; and Myles Brager, M.D., orthopaedic surgery.

3) From left to right are Jessica Komlos, M.D., pediatric hospitalist; and Cynthia Roldan, M.D., pediatric hospitalist and chief of pediatrics.

New Lung Cancer

Screening Guidelines

In February, the Centers for Medicare & Medicaid Services (CMS) issued changes in cov-erage for people undergoing a lung cancer screening. Medi-care will now cover lung cancer screenings with low dose com-puted tomography (LDCT) once per year for patients who meet all of the following criteria:

• they are between the age of 55 and 77, and are either current smokers or have quit smoking within the last 15 years;

• they have a history of smok-ing tobacco an average of one pack a day for 30 years; and

• they receive a written order from a physician or qualified non-physician practitioner who meets certain requirements.

This Medicare coverage includes a visit for counseling and shared decision-making on the benefits and risks of a lung cancer screening. CMS also requires data collection, including eligibility criteria for radiologists and radiology imaging centers consistent with the National Lung Screen-ing Trial (sponsored by the National Cancer Institute), U.S. Preventive Services Task Force recommendations, and other evidence-based guidelines. For more information, please visit www.cms.gov

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Potentially Preventable Complications

Lymphedema Treatment Program

A comprehensive program offering treatment, education and support for people living with lymphedema and other types of

swelling/circulation issues

Potentially preventable complications (PPC)—also called Hospital Acquired Conditions—are one of several quality measures tracked on the hospital’s quality dashboard. This measure is tied to the hospi-tal’s performance and our payment as set by the Health Services Cost Review Commission (HSCRC), but most importantly it’s tied to our hospital’s patient safety efforts.

PPCs consist of 65 complications which the HSCRC has deemed should never occur at a hospital. They are conditions that are not present when a patient is first admitted and appear to have occurred while an inpatient, thus considered an illness associated with his or her care. Examples include urinary tract infections without a catheter, a blood infection, collapsed lungs, bed sores or pneumonia.

Additionally, while PPC prevention is important for all patients, the HSCRC’s reporting methodology excludes patients who have accepted either palliative or hospice care moving forward.

During 2014, the number of PPCs recorded at the hospital increased. Some of this increase was due to incomplete medical documentation or an oversight in that documentation, rather than the quality of our care.

As a result, the hospital is employing various strategies to ensure proper documentation by all medical staff in order to enhance patient care.

Some of the strategies include: • identifying and documenting ALL existing conditions that are present or are suspected to be present in a patient upon admission• providing additional physician education to assist in standardizing, understanding and documenting various medical terminology• encouraging, when appropriate, consultations for palliative or hospice care and physician documentation of the results of those consultations• devising ways to improve quality to prevent patients from developing complications.

To access the list of PPCs set by the HSCRC and read related background information, please visit www.hscrc.state.md.us and select “Maryland Hospital Acquired Conditions” beside the “HSCRC Initiatives and Hospital Performance” tab. To view the hospital’s PPC rates along with the hospi-tal’s performance scores on various other quality measures, stop by the Pillars of Excellence Wall located in the Ground Floor lobby across from the cafeteria.

Do you have a patient with lymphedema who needs assistance in managing his or her condition?

Carroll Hospital, in collaboration with Central Maryland Rehabilitation Services, Inc., is offering a comprehensive treatment program for people with lymphedema and pre-lymphedema conditions.

Directed by a certified lymphedema therapist, the program offers inten-sive treatment and education to help patients successfully treat and manage their condition. Participants will be evaluated and a comprehen-sive treatment plan will be developed and modified to address their indi-vidual needs as they progress through the program.

Services available include lymphatic massage, compression, exercise, skin care and referrals to community resources.

An appointment and physician referral are required. For more information or to make an appointment, please call 410-848-4248.

According to the American Cancer Society, excluding skin cancers, colon cancer is the third most common cancer diagnosed in both men and women in the United States. But the good news is it is one of the most preventable cancers. That is why having patients screened for the disease early is extremely important.A study published in U.S. National Library of Medicine found that 44.9 percent of adults 50 years old and older, who did not have a history of colorectal cancer or polyps, but were exposed to educational information regarding the importance of receiving a screening, participated in one. In other words, screening participants and knowledge continually increased with the exposure to the screening information and guidelines.Screening guidelines recommend a routine colonoscopy beginning at age 50 and at age 45 for African Americans. For those with possible symptoms or a family history of the disease, screening at an earlier age may be recommended. The hospital encourages our medical staff to discuss the importance of colorectal cancer screenings with their patients and to recommend that they have one when appropriate. To learn more about colorectal cancer and screening guidelines, please visit cancer.org 5

Raising Colon Cancer Awareness: The importance of colon cancer screenings

Offering Comfort and Support to Patients with Colon Cancer

The Gina’s Warriors Comfort FundFor men and women diagnosed with colon cancer, Carroll Hospital is offering additional relief and support, thanks to the Gina’s Warriors Comfort Fund.

Established in memory of Gina Maria Barnes, who passed away following a valiant battle with colon cancer, the fund will provide indi-viduals undergoing colon cancer treatment with a range of resources to improve their quality of life—physically, financially and emotionally—in all aspects of their cancer journey.

Patients who are being treated for colon cancer and reside or are employed in Carroll County are eligible.

Services the Gina’s Warriors Comfort Fund support may include: • massage therapy and acupuncture treatments at the Tevis Center for Wellness • gift cards for food, gas, transportation and comfort items for patients • the cost of wigs and other cancer-related supplies • copay and deductible assistance (some restrictions apply)

For more information, please contact Mary Peloquin, manager of community health and wellness, at 410-871-7119.

*Limited funds available. Requests are fulfilled according to the order in which they are received.

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Following are providers who have been honored as Guardian Angels from December 12, 2014 to April 9, 2015: John C. Abel; Cristian D. Alba; Sohaila Ali; Michael Barnett; J. Mark Blue; Alexander M. Bogdaschewskyi;

Binu T. Chacko; Gabriel Del Corral; Johanna M. DiMento; Khalil A. Freiji; Thomas K. Galvin; Sarva Girdhar; Norman Goldstein; Christopher T. Grove; Deepak Gupta; Jason Hammond; Dona Hobart; Syed S. Hosain; Howard T. Jacobs; Dineshkumar Kalaria; Flavio W. Kruter; Wilbur Kuo; Reynaldo Madrinan; Marilyn D. Miller; Chitrachedu Naganna; Keith O’Reilly; Bertan Ozgun; Ketan P. Parikh; Robert M. Ricketts; Jed S. Rosen; Bernard Rubin; Sandra Ruby; Anastasios P. Saliaris; Danilo V. Santos; Evan Selsky; Stuart Shindel; John A. Steers; Hafeez Syed; and Kiarash Zarbalian.

Notables

ICD-10 Still on Track for October 1, 2015 implementation

Attempts to delay ICD-10 were avoided in April legislative session

On February 11, a panel of stakeholders from the health care indus-try that included providers and health care vendors, such as 3M, attended a hearing with the Energy and Commerce Subcommit-tee on Health to debate the ICD-10 readiness of the nation. Most members of the panel were in support of keeping the October 1, 2015 deadline for implementing ICD-10 because ICD-10 has greater specificity which would support efforts to gain a deeper understanding of diseases, causes of death and ways to make significant improvements in health care quality.

Only one provider from a urology group in Georgia and a few physicians in Congress, most prominently, Rep. Larry Buschon, M.D. (R-Ind), argued against the transition to ICD-10. In addition, the Med-ical Group Management Association (MGMA) and American Medical Association (AMA) are pushing for a third delay, citing lower provider productivity due to the granularity of the new code set and the tran-sition cost.

On February 25, two weeks after the hearing, the Centers for Medi-care & Medicaid Services (CMS) released a Fact Sheet on “Transi-tioning to ICD-10.” CMS indicated that ICD-9 is outdated with obso-lete terms and is inconsistent with current medical practice. ICD-9’s expansion was also cited as being limited, where ICD-10 provided the structure and room to be updated and to increase its diagnosis coding options well into the future.

CMS also made a statement that ICD-9 codes will no longer be accepted on claims with dates of service on or after October 1, 2015.

The April legislative session did not contain an ICD-10 delay, making the transition more of a reality.

Anyone with questions regarding ICD-10 is asked to contact Monica Hendrix, manager of compliance and auditing and ICD-10 project manager, at 410-871-7609 or mhendrix@CarrollHospitalCenter.org

Enhancing Patient CommunicationDo you remember what AIDET is? It’s an important technique all health care providers should use to effectively and satisfactorily commu-nicate with patients. It helps to reduce their anxiety, build trust with us as their health care provider and enhance their overall patient experience. Each letter in AIDET stands for an important tool in this communication technique. The following is a reminder of those tools:

A: Acknowledge your patient.

I: Introduce yourself to him or her.

D: Duration: Tell your patient how long the wait might be or how long the test may take.

E: Explain what you are doing for your patient, what to expect after his or her surgery or procedure/treatment and address any questions he or she may have in regards to his or her care, tests, procedures, etc.

T: Thank your patient for the privilege of taking care of him or her.

Employing AIDET with every patient will not only enhance your rap-port with patients, but it also will help the hospital further improve its Hospital Consumer Assessment of Healthcare Providers and Sys-tems (HCAHPS) scores. HCAHPS is the national survey that measures our patients’ experience and asks them to rate everything from the hospital’s environment, the hospital overall, their care from nurses and their care from physicians. Have you been employing AIDET in your patient care?

Grateful Patient Program The Carroll Hospital Foundation is making it easy for your patients to show their gratitude for the exceptional care you provide, thanks to the new Grateful Patient Program. The program allows patients to share their stories and say thank you to their providers in a meaningful way. Their gratitude can be expressed in a myriad of ways such as making a gift to or volunteering at the hospital or hospice. The Foundation would like to recognize the following physicians for helping to pilot this program including J. Mark Blue, M.D., orthopaedics; Binu Chacko, M.D., inter-nal medicine; Johanna DiMento, M.D., oncology/hematology; Khalil Freiji, M.D., internal medicine; Dona Hobart, M.D., general surgery; Flavio Kruter, M.D., oncology/hematology; and John Steers, M.D., general surgery.

To learn more or to be a physician champion of the program, please contact the Foundation at 410-871-6200 or foundation@CarrollHospitalCenter.org

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Reducing Hospital Readmissions A Patient Safety Issue Requiring a Collaborative Approach

Did you know that half of our patients who are readmitted to the hospital return within 10 days of discharge? The issue of readmissions is being looked at throughout hospitals nationwide and is a priority at Carroll Hospital. A readmission is classified as any patient who is readmitted to the hospital within 30 days of being discharged—for any reason.

Under the Health Services Cost Review Commission’s (HSCRC) Readmission Reduction Program, hospitals are incentivized to meet certain targets for reducing readmissions. However, at Carroll Hospital, reducing readmissions is also about enhancing patient safety and improving patient outcomes.

To learn more about the issue, the hospital conducted a four-month study of those readmitted to the hospital last year. Following are some of the findings:

• One in five elderly patients returned to the hospital with 30 days of leaving

• The majority of patients (82 percent) were readmitted based on a medical issue related to their previous visit

• Of those patients, 37 percent were readmitted due to an exacerbation of a current illness

• A total of 35 percent of those patients were readmitted due to a system problem at discharge (e.g., lack of palliative care consults ordered for appropriate patients, inappropriate discharge instructions given, a lack of referrals to home care services when appropriate)

• Half of the patients were on 10 or more medications

• For 50 percent of the patients, the discharge instructions did not match the information on the discharge summary

How can the medical staff help reduce readmissions? According to Sharon Sanders, vice president of clinical integration, collaboration, teamwork and a greater attentive-ness to the needs of patients at discharge are key. “There is not one single magic bullet that will fix the readmission problem; it’s a variety of tailored solutions,” she said.

Some opportunities physicians can work on to improve patient outcomes and reduce readmissions include connecting appropriate patients to the hospital’s palliative care services earlier during their admission; better identification of patients who are at a high risk of readmission; greater attention to discharge planning; increasing referrals to home care services when warranted; and better coordination with health navigators.

“Readmissions are everyone’s responsibility,” says Mark Olszyk, M.D., vice president of medical affairs and chief medical officer. “By being more thorough, thinking ahead and realizing that health care transcends the walls of the hospital, we can provide a better system of care for our patients.”

To assist physicians in their discharge planning for patients, the hospital encourages the medical staff to use the convenient recommendations tab.

Located on the Paragon WebStation for physicians under “Clinical Assess,” the recommendations tab provides physicians with easy access to all information regarding a patient’s anticipated needs as identified by other departments or disciplines who have assessed the patient.

For example, if a physical therapist evaluates a patient and determines that he or she requires continued physical therapy at home or needs a particular assis-tive device, the therapist will enter the information in the patient’s record in the recommendation’s tab. If a social worker evaluates a patient and identifies that palliative care would be most appropriate, the social worker would document that assessment in the patient’s record in the recommendations tab.

The recommendations tab is a valuable tool when used consistently in discharge planning. It helps ensure patients receive the most effective treatment plan and that they are referred to the most appropri-ate setting for additional care once they leave the hospital.

For more information on accessing the recom-mendations tab, please contact Steve Goyette, nursing informatics analyst, at 410-871-6537 or Jed Rosen, M.D., chief medical information officer, at 410-871-6015.

Recommendations Tab A useful tool to help physicians in monitoring patients’ discharge planning

Maryland Board of Physicians Mandated Reporting Requirements Hospitals are mandated by State laws (e.g., Health Occupations Article sections 14–413 and 14–414) to report any action(s) taken against a physician or allied health practitioner which denies, restricts, limits, changes, removes, terminates, suspends or places any conditions or restrictions on the privileges of the physician or allied health practitioner. A report must be filed with the Maryland Board of Physicians within 10 days of the action taken.

In accordance with this law, Carroll Hospital must report the following, but not limited to: restrictions, revocations, terminations, limitations,

resignations (voluntary or involuntary), changes in staff category, admin-istrative suspensions (for such reasons as incomplete medical records, failure to comply with the influenza policy, failure to comply with manda-tory educational requirements, etc.).

The reporting requirements are intended to assure that hospitals make the Board of Physicians aware of any health care provider concerns that may impact the practice of medicine and the health, safety and welfare of the public. For more information, call Terri Wilson, director of medical affairs, at 410-871-6899.

Medical and Carroll Health Group Staff – Additions

200 Memorial AvenueWestminster, MD 21157CarrollHospitalCenter.org

NONPROFIT ORGU.S. POSTAGE

PAIDWESTMINSTER, MD

PERMIT NO. 348

Medical Staff WOW Service Recipients:

Congratulations to our Medical Staff WOW Service Recipients:

January 2015: Michael Beardsley, M.D.; Sumit Bhutani, M.D.; Thomas Galvin, M.D.; Natasha Raziuddin, P.A.-C.; and Abdel Sawan, M.D.

February 2015: Robert Giangrandi, P.A.-C.; Sarva Girdhar, M.D.; John A. Steers, M.D.; Megan Stroh, P.A.-C.; and Jeffrey Tabak, M.D.

March 2015: David Blumberg, M.D.; Dona Hobart, M.D.; Kiyoung (Steve) Kim, D.O.; Tina Latimer, M.D.; Vanessa Redd, M.D.; John Ruth, M.D.; Abdel Sawan, M.D.; Michael Vietz, M.D.; and Kevin Walsh, P.A.-C.

SCOPE is published for the medical staff of Carroll Hospital by the M arketing and Public Relations Department. All items are subject to editing by the Marketing/PR Department. Items for SCOPE should be sent to Simone Lindsay via e-mail at SLindsay@CarrollHospitalCenter.org, or by fax to 410-871-6321

(attention Simone). For more information, please call Simone at 410-871-6836.

Department of Diagnostic ImagingAngela Yim, M.D.Teleradiology

Department of MedicineSuhas Badarinath, M.D. Pain ManagementPain Management and Physical Medicine and Rehabilitation2702 Back Acre CircleMt. Airy, MD 21771301-703-8767

David Epstein, M.D.NeurologyCarroll Health Group NeurologyFisher Medical Building193 Stoner Avenue, Suite 310Westminster, MD 21157410-871-2204

Jeanette A. Linder, M.D.Radiation OncologyCarolyn O’Connor, M.D.Adult Hospitalist

Anita Nahar, M.D.Rohan Rengen, D.O.NephrologyFrederick Kidney Care Associates405 W 7th Street, Suite AFrederick, MD 21701301-696-0012

Department of OB/GYNKwadwo Baryeh, M.D.OB Hospitalist

Maria Del Mar Colon, M.D.Tasmia Henry, M.D.Jonathan Hodor, D.O.Wayne Kramer, M.D.Perinatology/Maternal Fetal MedicineMaryland Perinatal AssociatesBillingslea Medical Building295 Stoner Avenue, Suite 308Westminster, MD 21157410-857-7908

Kristy Crawford, D.O.OB Hospitalist

Department of PediatricsTimothy Perl, M.D.PediatricsCarroll Pediatric Center1645 Liberty Road, Suite 205Eldersburg, MD 21784410-795-7300

Department of SurgeryDavid Blumberg, M.D.Colon and Rectal Surgery Carroll Health Group Colon and Rectal SurgeryBillingslea Medical Building295 Stoner Avenue, Suite 102Westminster, MD 21157410-848-1818

Adam Riso, P.A.-C.OrthopaedicsCarroll Health Group Orthopaedics 844 Professional Center844 Washington Road, Suite 102Westminster, MD 21157410-871-0088

Contact

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