st. vincent times march 2012
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St. Vincent Medical Center newsletter, Los AngelesTRANSCRIPT
How’s my profile?
St. V incent TimesMARCH 2012 publication of St. Vincent Medical Center
RespectCompassionateServiceSimplicityAdvocacyforthePoorInventivenesstoInfinityVINCENTIANVALUES:
• House C linic and SVM C Enter Into Co- Management Agreement
• Charting the Way to Excellent Profiles
• Hourly Rounding
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1sthospitalinLosAngeles
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COVER STORYPhysicians who are working with CDI specialists are raising their “physician profiles” and benefiting in many other ways. Paperless office pioneers also are raising their profiles and earning incentives too. Page 4
HOUSE CLINIC-SVMC WORK TOGETHERHouse Clinic and SVMC have entered into a co-management agreement to expand neurotology and neurosurgery services, maintaining the highest quality and efficiency of care. Page 3
HOURLY ROUNDING EVERY DAYPatient satisfaction depends upon good communication and frequent interaction with nurses and other caregivers. Hourly rounding is a proactive approach, steeped in the tradition of caring. Page 8
St. Vincent Times is a publication for St. Vincent Medical Staff and Associates. Please submit articles as soon as possible prior to or after an event for the earliest inclusion in the newsletter by e-mailing information to [email protected] or by calling (213) 484-5593. Medical Staff submissions may also be sent to [email protected]. Or call (213) 484-5525.
Ronald S. Fishbach, MD – chief of medical staff
Cathy Fickes – president/chief executive officer Sr. Mary Hale, DC – chairman of the board
MARCH 2012
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sthefirsthospitalinLosAngelesandtheonlyCatholichospitalin
thegreaterLosAngelesmetroarea,wehavehistoryandtraditiontoguideus.AtSt.Vincent’s,wetakecareofthesickwhoneedourservices.Someofourpatientscomefromfaraway.Recently,theArchbishopofNewark,N.J.askedforhelponbehalfofalittlegirlinhisparish.ThechildwasflowntoSt.Vincent’sforararesurgicalprocedure,performedbyophthalmicplasticsurgeonRobertLevine,MD.ThankstoDr.Levineforansweringthecallforhelpalongwithus.
NursingleadershipandallofourassociatescontinuetopracticeStuderGroupprinciples:engaginginhourlypatientrounding,embracingculturaldifferences,andcollaboratingmosteffectivelyontheunits.Wemonitorourpatientsatisfactionresultscloselyandevaluatepatientresponsestoprovidefeedbackonimprovingcare.Whathelpsthemostishavingourcultureofcaringwithafocusonthebestpatientexperience.Thisfollowsabasiclifetenet,“Treatothersasyouwouldwanttobetreated.”
Weworkeverydaytogiveourpatientsthekindofexperiencethattheywould“always”recommendtotheirfriends.Ourgoalis100percentsatisfactionforeachpatientandhis/herfamily.Wemustcontinuehourlyroundingandcommunicatingwithourpatientsaboutwhatwe’redoingandwhywe’redoingittoprovideabetterunderstandingoftheircare.
SVMCalsoisactivelyworkingonbusinessdevelopmentprojects,expandinglinesofservicelikeneurotology,neurosurgery,orthopaedics,cardiaccare,andsurgicaloncology.InFebruary,SVMCandtheHouseClinicenteredintoaco-managementagreementthatwillhelpexpandtheservicesbeyondperceivedgeographicalbarriersandhelpmorepeople.
PrimarycareisanotherstrategicfocusforSVMC,oneofthemostcomplexandall-encompassingservices.Everydepartmentandancillaryserviceinthehospitalworkstoprovidethepatientcareandfollow-throughthatourprimarycarephysiciansexpectwhentheyadmitapatienttoSVMC.
Asweenterabeautifulspringseason,letusallkeepworkingandcaring,andleadingtheway.SVT
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g o t c o n c e r n s ?Physicians may report safety or quality of care concerns:
physician Quality hotline: (213) 207-5783.
Call the values line at (800) 371-2176 or go online at www.dchsvaluesline.org to report concerns
confidentially and anonymously.
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TwoofLosAngeles’soldestandmostvenerablehealthcareinstitutionshaveformallyjoinedforcesinauniquebusinessandclinicaloperationalpartnershiptoextendaccesstohighlyspecializedcareforthosewithhearingandskullbasemedicalproblems.
Theprincipalpurposeoftheco-managementagreementistoimprovequalityandefficiencyofcareprovidedtopatientsatSVMCsothatthehospitalmayrenderthehighestqualityofcareconsistentwiththebestinterestsofthepatientandinfurtheranceofthehospital’scharitablemission.
TheHouseClinic’soutstandingdeliveryofcareandexcellentoutcomeshaveearnednationalattentionandcontributedtothe2011-2012nationalqualityrankingearnedbySt.VincentMedicalCenterforEar,Nose&Throatservices,accordingtoU.S. News & World Report,basedonasurveybytheCentersforMedicare&MedicaidServices(CMS).
“Thispartnershipagreementisatremendousmilestoneinourmissiontoprovidethecommunitywiththehighestqualityofmedicalcareavailabletoday,”saidSVMCPresident/CEOCathyFickes.“ThephysiciansoftheHouseClinicandthehospitalhaveworkedside-by-sidefordecades,buttodaywebeginaneweraofcollaborationtoexpandandimprovetheclinicalcareforthosewithhearingandrelatedissues,”shesaid.
MillionsofpeopleworldwidehavebeentouchedbytheadvancesmadebytheHouseClinicphysicians.Innovationslikethecochlearimplantdeviceandthedevelopmentofmicrosurgicaltechniqueshavemadearealimpactontheartoftreatingpeoplewithhearing,balanceandothersensoryconditions.
SomepatientstravelveryfartoseekdiagnosisandtreatmentattheHouseClinic.Also,HouseClinicphysicianstraveltheworld,teachingandproviding
trainingtootherphysiciansinunderdevelopednations.
TheHouseClinichasastaffofabout100,including10surgeonswhoarefellowship-trainedinotologyorneurosurgery,andmorethan15audiologistsandotherhearingdiagnosticanddispensaryspecialists.BesidesthedowntownLosAngelesfacility,theHouseClinicalsohasasatelliteofficeinOrangeCountyandhearingdispensariesintheSanFernandoValley,SantaMonicaandBakersfield.
TheHouseClinicservesasaclinicaltrainingaffiliateoftheKeckSchoolofMedicine,providinginstructioninotologyforotolaryngologyresidentsatLAC+USCMedicalCenter.Morethan22,000physicianshavereceivedtrainingintheHouseClinicandHRIfacilities.
Aspartoftheagreement,St.VincentMedicalCenterwillserveasabusinessandclinicalpartnerwiththephysiciansofHouseClinic.Thehospitalwilllocategrowthopportunitiesfortheneurotology-neurosurgeryservicelineandworkwithHouseClinictoimplementclinicaloperationalefficienciestosupportthemutualgoalsofthepartnership.
“WehavecalledSt.VincentMedicalCenterhomeformorethanhalfacentury,”saidJohnW.House,MDoftheHouseClinic.“Thisuniquepartnershipwillallowourgrouptofocusontheexceptionalclinicalcareweprovideourpatientsandcontinueourcommitmenttoresearch,”hesaid.“Byworkingintandem,wecantogetherachievebetterpatientcarethroughputandmaintainourtopclinicaloutcomes.”SVT
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expansion: neurotology-neurosurgery
Women&Spirit:CatholicSistersinAmericaexhibitopenedinJanuaryatTheCaliforniaMuseum,1020OStreetinSacramento.SponsoredbytheLeadershipConferenceofWomenReligious,thiscomprehensiveexhibitfeaturesmorethan70artifactsfrom400Sistercommunities.
TravelthroughtimeandexperiencetheCivilWar,1906Earthquake,CivilRightsMovementandotherdefiningnationaleventsasseenthroughtheeyesoftheAmericanwomenwhohelpedshapeourcountry’ssocialandculturallandscape.Formoreinformation,visitwww.womenandspirit.organdwww.CaliforniaMuseum.org.SVT
mission integrat ion
DaughtersofCharity,ProvinceoftheWestwillberepresentedinthissix-monthexhibit.
TheHouseInstitutebuiding,whichincludestheworld-renownedHouseResearchInstituteandtheHouseClinic,isat2100W.3rdStreet,acrossfromSt.VincentMedicalCenter.
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C D I E f f o r t H e l p s P h y s i c i a n s M a s t e r N e w Vo c a b u l a r yIt’smorethanamatterofsemantics.WordsarepowertoolsintheClinicalDocumentationImprovement(CDI)effort.CDIisafieldthatbringstogetherelementsofmedicalrecords-keeping,practicemanagement,andevenmarketing.Properdocumentationreflectsthehardworkandexcellentclinicalachievementsofphysiciansonadailybasis.
Itisaprocessofone-on-oneinterventionsanddiscussionsbetweenCDIspecialistsandphysiciansaboutcharting.Thegoalisaccuracyandtheeffortisallinthedetails.Indocumentation,itisimportanttocreatearealisticpictureoftheartofmedicine:thecomplexityofdiseasesandtheacutemanifestationsofchronicillnesses.Throughproperdocumentation,SVMCphysicianshaveanopportunitytomaintainawell-deservedpositivephysicianprofileinthenewageofonlinerankings.OngoingdocumentationeffortshaveplacedSVMCinthenationalrankingsforqualityofcare.
Inthefuture,rankingsorprofilesofhospitalsandphysicianswillbepubliclyaccessibleonwebsites.Calculatedbyhealthcareregulatory
agenciesandpostedbyhealthplansforpublicviewing,physicianprofilesandhospitalprofileswillreflect,inpart,theacuityofeachpatientrelativetothepatient’slengthofstay.Improvingclinicaldocumentationwithmoreaccuratedescriptionsofhighacuityinpatientailmentswillhelpbuildaccurateprofilesofhospitalsandphysicians.
AnexampleofwhattheCDIteamdoesduringchartreviewistoscanfortermsthatarecommonlyusedinterchangeably,like“incisional”and“excisional.”ThecorrectICD.9-CMTMcodingdescriptionforremovingnecrotictissuefromawoundshouldbe“excisionaldebridement”ratherthan“incisionaldebridement.”
“Doctorsareconservativeandthetermstheyusearetheonesthey’veknownforalongtime.Sotheyarenowfamiliarizingandupdatingtheirterminology,”saidCDIspecialistKathyAnnArde,RN.Sherelatedhowshehadhelpedaphysiciantocodeproperly:“Hewasn’tsurewhethertowritedownMIbecausehehadn’tyetdeterminedthat.SoIsuggestedheconsiderwriting‘possible/probable/suspected’,asitcanstill
becodeduntilruledout.”
CDIspecialistAaronDay,RNnotedthatphysiciansaretrulyinterestedinimprovingtheirdocumentation.“Eversinceweintroducedthemtothedocumentationtipsspecifictotheirspecialty,manydoctorshavedroppedtheirolddocumentationhabits.”Onephysicianwasparticularlyinterestedinhelpingthehospitalincreaseitsprofileandimprovinghisdocumentation.“Heinvitedustocometohisofficetoexplainwhatweweredoingandhowwecanhelphimdocumentbetter,”herecalled.
SVMC’sCDIspecialistsKathyAnnandAaronhaveateamofphysicianchampionsbehindthem.Theteamdeliversadailydoseofdocumentationreviewsandqueries.“Thephysicianleadership,providedbyDr.FayeMontegrande,Dr.AlanJasper,andDr.BrianKahn,isessentialtotheprogramandhelpsgarnerengagementthroughoutthehouse,”saidLoriSeargeant,DirectorofHealthInformationManagementandCDI.“Itisallaboutbuildingtrustandgoodrelationshipswiththephysicians,”saidLori.“AaronandKathyAnnhavebuiltagoodrapportwithourphysicians,whoseethemasavaluableresource.”SVT
KathyAnnArde,RNAaronDay,RN
Fromleft,AaronDay,RN,AlanJasper,MD,BrianKahn,MD,FayeMontegrande,MD,andKathyAnnArde,RNdiscussthedocumentationofapatient’scondition.
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Poweredbyfederalincentivesandregulatorypressures,thewindsofchangeareblowingawaythepapercharts.Implementationofanelectronicmedicalrecordssystemisoccurringatasteadypaceatcommunity-basedphysicianofficesandSVMChospital-basedclinics.
RonaldShigematsu,MDandSumiKawaratani,MD,whoshareafamilypracticeinLittleTokyo,havepavedapathtoapaperlessoffice,achieved“meaningfuluse”oftheircertifiedEMRsystem,andeachreceived$18,000infederalstimuluspayoutsthispastJanuary.
Thefinancialincentivesarenottheonlybenefit.Theyshouldbeabletosecuregoodphysicianprofilesbecausehealthplansaregoingtoratephysiciansbasedinpartonmeaningfuluse.
Drs.KawarataniandShigematsuarethefirsttoreceivethestimuluspayments“forusingEMReffectivelyandefficiently,”accordingtoDaughtersofCharityHealthSystem(DCHS)PhysicianEMRProjectConsultantLoriMoore.Shesaidthatotherphysiciansareoncoursetoqualifyfortheirstimulusfundssoon.
Bothphysicianstransitionedtothe“tablet”portablecomputerinJune2011forchartingandprescriptionwiththeAllscriptsMyWaysystem.TheyandanotherdozenearlyadoptershavereceivedhospitalsupportforthemeaningfuluseoftheEMRsystem.
“Ithasitsadvantagesanddisadvantages,”saidDr.Kawaratani.“There’sdefinitelyalearningcurveandfinancialinvestment,buttherearealotofpotentialbenefits.”
DuringthetransitiontoEMR,thereisopportunitycostintermsoftimethatmightotherwisebespentwithmorepatients,accordingtoDr.Kawaratani.However,she’senthusiasticaboutthefuturefunctionalityofthesystemthatcanbeexpectedtospeedupthechartingprocess.
DCHSPhysicianEMRConsultantRebeccaGraysonaddedthattheachievementofmeaningfuluseissomethingworthcelebrating.It’sespeciallyimportantinpracticeswherephysicianstreatchronicallyillpatients.
“MeaningfuluseofEMRfocusesontreatmentofpopulations,howyouprovidestandardofcareforpatientswithdiabetes,cardiacproblems,highbloodpressure,osteoarthritis,”saidRebecca.“Thetrackingthattheyhavedone,inordertoearnthestimuluspayments,showsthattheyhaveachievedmeaningfuluseandprovidedthatcaretotheirpatients.”
WiththecomingofanintegratedEMRphysicianorderentrysystemhospitalwide–anticipatedtotakeplacewithinthiscalendaryear–therewillbeworkstationsonwheelsontheunitsthatwillhelpbringtogetherphysicianordersandelectronicchartingbyrespiratorytherapists,chaplains,dietitiansandothercareproviders.
MelindaCanny,directorofITforSVMC,whohasimplementedEMRsystemsfortwohospital-basedclinicssofar,willbeworkingwithateamtorolloutanintegratedsystemthroughoutthehospital.
“We’relookingathowpeopledotheirjobs,howEMRwillchangetheworkflow,andthemostefficientwaytousecomputersystemsthatwealreadyhave,”saidMelinda.
Thereismuchthatearlyadoptersinthecommunitycanteach.Exceptforwritingprescriptionsforcontrolledsubstances,whichmustbedoneonpaper,Dr.
Shigematsuusesthetabletforallcharting.Hetakeshiscomputertablethomewithhim,haslearnedhowtouseitsmainfunctionalities,andalsolearnedhowtointroducethenoveltyofthetabletintohispatientinteractions.
“PatientsmadefunofmeatfirstwhenIwalkedinwithatablet,butnowthey’reusedtoit.It’snotslowingmedown,”saidDr.Shigematsu.SVT
Fromleft,RonaldShigematsu,MDandSumiKawaratani,MDshowofftheirtabletPCsthattheyuseinchartingalltheirpatientrecords.Theirofficeistruly“paperless.”Thepaperchartsinthebackgroundareusefulforreference.
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C D I E f f o r t H e l p s P h y s i c i a n s M a s t e r N e w Vo c a b u l a r y
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Mercedes “Mercy” StineyHIM
Vincentian Spirit Award WinnerOctober 2011
MercyStineyworksintheHIMDepartmentandtakesexcellentcareofphysicians,patients,andcolleagueswhoneedinformation.Shegoesoutofherwaytoanswereveryone’squeries.Shepatientlytrainsotherco-workersintheresponsiblemethodsforworkingwithmedicalrecords.SVT
ShawnMuleadyhasworkedfortheDaughtersofCharityHealthSystemfor10yearsandmovedfromSetonMedicalCentertoSVMCmorethanayearago.HeisclinicalcoordinatorforTelemetry,AcuteRehabandTCU,workingonscheduling,Kronostime-keeping,andequipment.Hefindsthetimetoassistvisitorstotheirdestinationsandmaintainapositiveattitudewitheveryonehemeets.SVT
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Shawn MuleadyTelemetry, ARU and TCU
Vincentian Spirit Award WinnerNovember 2011
VincentianSpiritAwardawards
Adaia “Lupe” SanchezMulti-Organ Transplant Center
December 2011
Adaia“Lupe”SanchezworksastheregistrationreceptionistattheMulti-OrganTransplantCenter.Sheistheonewhogreetspatientskindlyandrespectfullyoverthetelephone.Shetreatseachpatientwithrespect,honesty,andcompassionandgiveseachoneindividualattention.Lupealsohelpswiththesupportgroups.SVT
Maureen Leyran, RNDoheny ICU
January 2012
MaureenLeyranexemplifiestheVincentianSpiritinherworkwithherpatients,theirfamiliesandassociates.BeforeshewouldattendherVincentianSpiritAwardreception,shemadesurethepatientshadcoverage.Whatafineexampleofbeingpatient-focused.CongratulationsMaureen!SVT
Mario PalaciosO.R. – Patient Attendant
February 2012
Marioalwaysarrivestoworkontime;greetseverypersonhemeetswithasmileandpositiveattitude.Hetakesprideintheservicesheprovides,showscompassionandrespecttopatientsandtheirfamilies,anticipatestheirneedsandtheneedsoffellowassociates.MarioembodiestheVincentianValues.SVT
MaryLouYapp(frontmiddle)earnsthePrideoftheCCUAwardlastSeptember.
PrideoftheCCUAwards
ElsieBermudez(thirdfromleft)receivesthePrideoftheCCUAwardonJan.26.
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PatientsGiveGiftsinRecognitionofGuardianAngels
Sr.CeciliaNguyen,DCreceivesGuardianAngelrecognitiononNov.28,2011.
HarlanC.Amstutz,MD,foundingdirectoroftheJointReplace-mentInstitute,receivesGuardianAngelrecognitiononJan.30.
Fromleft,MaryAnneHattemercongratulatesChiquiVillaromanandHildegardeParaiso,bothregisterednursesintheDICU.JanStein,VP,executivedirectoroftheSt.VincentFoundation,presentstheirGuardianAngelrecognitiononFeb.14,2012.
DinoLaurenBautistaoftheE.D.(middle)receivesthefourthDAISYAwardonJan.5.
NeurosurgeonFardadMobin,MD,FAANS,atthenewSt.VincentSpineInstitute,washonoredFeb.10byapatientwhosaidshehadbackpainfor10years,butwaitedtofindtherightsurgeonattherightinstitution.
GeneralsurgeonCarlosCosenza,MDreceivesGuardianAngelrecognitiononFeb.22,presentedbyDougKleam,COO(center)andJanStein,VP,executivedirectoroftheSt.VincentFoundation.
NeurotologistDeraldBrackmann,MD,co-principalinvestigatorfortheauditorybrainstemimplantatHouseClinic,receivesGuardianAngelrecognitiononMarch1.
SVMCisoneofonly20hospitalstoearnQualityRespiratoryCareRecognitionfor2012,oneofonlyfourhospitalsoutof70inLosAngelesCounty.TheRespiratoryCareProgramteamcelebrates.
RespiratoryCareAwardDAISYAward
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PuttingourpatientsfirstisnothingnewatSt.VincentMedicalCenter.Butnursesmakingroundseveryhour,proactivelyaddressingpatientneeds,isnew.Andit’sawinforbothpatientsandnurses.“Consistentprocessandcommunicationimprovesthepatientexperience,”saidRosanneMaehara,DirectorofTelemetry.“Patientsfeelmoreateasewiththeirhospitalstaywhencareisconsistent,resultinginfewercalllights.”“Oneofthegoalsofhourlyroundingisfornursingtobemoreproactiveratherthanreactiveinmeetingpatientneedsandto
deliverbetterclinicaloutcomes,”explainsKimDeese,CNO.“Everyhourduringtheday(andeverytwohoursatnight),amemberofournursingstaffroundsoneverypatient.”Duringrounding,nursesatSt.VincentMedicalCenterensurethatimportantelementsofcareareaddressedsuchaspaincontrol,bathroomneeds,bodypositioning,andthatnecessaryitemsarewithinreach.HourlyroundingisoneofthecornerstonesofourDCHSpatientexperienceprogramandoneofthesignificantfactorsinourreductionofpatientfalls,accordingtoKimDeese.AccordingtoStuderGroup,researchshowsthatastrategyofconsistentlycheckingonpatientneedseffectivelyreducesmonthlycall-lightuseby38percent,patientfallsby50percent,andskinbreakdownsby14percent,while
simultaneouslyincreasingsatisfactionscores.“I’vealwaysbeeninandoutofmypatients’rooms,butnowI’mmorestructuredandfocusedonengagingmypatient,”saysMoonJeong.“Hourlyroundingdecreasestheiranxietyanddecreasesourwork.Iamabletoseemyworkthroughmypatient’seyes.”AccordingtoPresident/CEOCathyFickes,“Hourlyroundingcreatesaculturethatemphasizesexceptionalcustomerservice,inadditiontopatientsafetyandqualitycare.Itisn’tjustatask,it’salifesavingpractice.”SVT
pat ient experience
2131W.3rdSt.LosAngeles,CA90057www.StVincentMedicalCenter.comwww.facebook.com/stvincentmedicalcenter
Pain ManagementInternal MedicinePhysical MedicineAnesthesiologyOrthopaedic Surgery Orthopaedic SurgeryOrthopaedic Surgery
Welcome New Physic ians Sheldon Cho, MD
Azmy F. Ghaly, MDMaqbool Iffat, MDMichael Kim, MD
Jan Duncan, MDLuigi Galloni, MD John J. Regan, MD
MoonJeong,RNroundsonherpatienteveryhour.
H o u r l y R o u n d i n g : A Pr o a c t i v e A p p r o a c h
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