BULLETINTHE

Even in year of monumental change, employees earn 2.23 percent PIP payout

The Newsletter of Yale-New Haven Hospital

Throughout fiscal year 2012, employees provided exceptional patient care to a record number of patients, confronted new regulatory requirements and navigated the highly complicated process of integrating two hospi-tals. In spite of these monumental challenges, Yale-New Haven Hospital employees earned a 2.23 percent Perfor-

mance Incentive Plan (PIP) payout – out of a possible maximum 3 percent.

To be eligible for the PIP award, employees must have worked at least 1,000 hours between September 25, 2011 and September 22, 2012 and be active as of December 13, when PIP payout checks are scheduled to be distributed.

Category Measure Threshold Target Max Actual

Financial (30%) Net operating margin 3.0% 3.2% 3.4% 6.1%

Patient Safety & Quality (30%) Blood stream infections 24 20 16 23.08

Value-based purchasing 93% 95% 97% 96% measures

Readmissions 18% 17% 16% 19.7%

Environment-of-care 96% 97% 98% 95% mock survey

Patient Satisfaction (30%) Overall rating (HCAHPS) 65% 66% 74% 74%

Staff responsiveness (HCAHPS) 55% 62% 70% 65%

Environment (HCAHPS) 57% 63% 70% 60%

Press Ganey scores 88.9 89.3 89.8 89.2

Throughput (10%) 11 a.m. discharges 21% 22% 23% 23.9%

Length of stay 5.18 5.14 5.10 4.99

December 6, 2012 • Volume 35 • No. 22

Year-end PIP 2012 Goals and Results

During a recent morning safety report meeting, team members on the York Street Campus collaborated with colleagues on the Saint Raphael Campus via teleconference. Participants included (l-r): Tori Dahl Vickers, RN, director, Accreditation, Safety and Regulatory Affairs; Jessica Nuzzo, quality improvement specialist, Performance Management; Dr. Thomas Balcezak; and Sue Fitzsimons, RN, PhD, senior vice president, Patient Services.

Safety first…first thing every morningPatient safety is Yale-New Haven Hospital’s top priority. So important, in fact, that on

day one of the integration of Yale-New Haven Hospital and the Hospital of Saint Raphael, hospital leaders instituted the morning safety report.

Each morning at 8 a.m., seven days a week, Yale-New Haven Hospital senior leaders, selected managers and medical directors come together for a brief safety meeting to discuss

KEY – red – below threshold; yellow – met threshold; green – met target; blue – met maximum

Continued on page 4

Financial resultsWith revenue growth of 18.3 percent

year-to-year and disciplined expense management, the financial measure of net operating margin came in at 6.1 per-cent for the end of the year. This result not only exceeded the maximum goal, but is also the strongest operating margin in the hospital’s history.

Patient safety and qualityThe patient safety and quality category

included four measures. Blood stream infections (BSIs) – the number of infec-tions caused by patient line insertions and line maintenance – were 23.08 BSIs per 10,000 patient discharges, and met the threshold goal.

Value-based purchasing is based on a

combination of HCAHPS results and core measures. The year-end score of 96 percent exceeded the target goal. HCAHPS, or Hospital Consumer Assessment of Health Providers and Systems, is a publicly reported gov-ernment survey that measures patient satisfaction at hospitals.

Readmissions – the number of heart attack, heart failure and pneumonia pa-tients re-admitted to the hospital within 30 days of their discharge – were at 19.7 percent, missing the threshold goal of no more than 18 percent.

The environment-of-care mock survey measure, which involved practice sur-veys on patient care units to identify op-portunities for improvement, scored 95

percent, also missing its threshold goal.

Patient satisfaction The patient satisfaction category also

included four measures. Overall rat-ings for patient satisfaction, based on the percentage of patients who gave the highest possible response on the HCAHPS survey, reached maximum goal of 74 percent for year’s end.

With a rating of 65 percent, staff responsiveness exceeded its target goal. Results for the hospital environment came in at 60 percent exceeding its threshold goal. At a score of 89.2, re-sults from Press Ganey patient satisfac-tion surveys also exceeded the threshold goal, narrowly missing the target of 89.3 out of a possible 100.

ThroughputThe throughput category included

11 a.m. discharge and length of stay. Discharging clinically ready patients by 11 a.m. exceeded the maximum goal with a result of 23.9 percent. Length of stay also exceeded its maximum goal coming in at 4.99 days for the average length of a patient stay.

“This was a year of extraordinary challenge and historic change in our hospital and industry,” said Richard D’Aquila, YNHH president and COO. “Even in the face of unprecedented challenge, employees remained en-gaged and motivated and rose to the oc-casion time after time to meet our goals – a very impressive accomplishment.”

‘Tis the season for giving. PLEASE give blood:

Thursday, December 13, 7 a.m. - 12:45 p.m., SRC cafeteria

Thursday, December 27, 7 a.m. - 6 p.m., 55 Park St.

NewsbriefsYNHH cash account pension continues to earn 3.8% percent

Each November 30, an employee’s Cash Account Pension Plan account balance is updated by an annual pay credit, plus an interest credit, which is entirely funded by Yale-New Haven Hospital.

The annual interest rate credited as of November 30, 2012, was 3.8 percent. As of December 1, 2012, the interest rate contin-ues to be 3.8 percent for the coming plan year. The annual pay credit is a percentage of covered pay for the plan year ending on November 30 and is based on an employee’s completed years of benefit service. As years of benefit service increase, so does the employee’s pay credit percentage for future credits, as follows:

Years of benefit service Pay credit percentage

0-4 3%

5-9 4%

10-14 5%

15-19 6%

20-24 7%

Over 24 8%

Employees are fully vested after three years of service. For more information about the Cash Account Pension Plan, employees should call the Benefits Office, 688-2401, or visit the HR website on the YNHH Intranet.

Dec. 14 deadline to elect 2013 PTO cash-in

The Benefits Office reminds employ-ees that they have until 5 p.m. on Friday, December 14, to elect either “on demand” or “ongoing” paid time off (PTO) cash-in for 2013. Employees must make their election choice online at Employee Self Service from a computer at work or at home or a kiosk at the York Street campus or at Selina Lewis 3 on the Saint Raphael Campus. They should print a confirmation statement to complete the process.

Make your New Year’s resolu-tion a quiet one on Dec. 12

Employees who visit the YNHH Quiet Helps Healing Fair on Wednesday, Decem-ber 12, 6 a.m.-midnight, may make their New Year’s resolution to be quieter in 2013. Those who fill out the questionnaire

on how they will create a quieter hospital environment in 2013 will be entered in a drawing for Bose headphones. The fair will also offer giveaways and provide information with tips on how to contribute to a more healing environment. The fair will be held in the YNHH Atrium and the Saint Raphael Campus cafeteria.

YNHH holds holiday blood drives: Dec. 13, Dec. 27

Employees have the opportunity to help others this holiday season by giving the gift of life – blood. YNHH will sponsor two blood drives in December.

The first blood drive will be on the Saint Raphael Campus on Thursday, December 13, 7 a.m.-12:45 p.m. in the SRC cafeteria. Employees may call Bryan Runyon, manager, Blood Bank, 789-3805, or bryan.runyon@ynhh.org, to make an appointment.

The second drive will be on Thursday, December 27, 7 a.m.-6 p.m., on the 2nd floor of the 55 Park Street building. The last 15 minutes of each hour will be kept open for walk-in donors.

To make an appointment, employees

should contact Lonnie Avery, tissue and transfusion safety officer, Blood Bank Laboratory, at lonnie.avery@ynhh.org or 688-8425.

YNHH is a major trauma and surgical center and the largest user of blood in Con-necticut. The Red Cross continues to need donations of all types of blood – especially during the holiday season when donations are down.

YNHH livingwell Fitness Center celebrates first year on Dec. 14

YNHH invites employees to celebrate the first anniversary of its fitness center on Friday, December 14, 5 a.m.-9 p.m. Guests at the open house may enter their names in a drawing to win fitness center prizes. The grand prize is a full-year membership to the center.

Employees who are not fitness center members and who wear comfortable clothes and rubber-soled shoes may par-ticipate in sample classes throughout the day. The classes include a stretch and stress break, 11:30-11:45 a.m., and zumba, 1-1:15 p.m. YNHH outpatient dietitians will be on

The “Go Ahead and Ask” online e-forum has added a telephone component to make it easier for employees to ask questions and share their thoughts with senior leaders.

YNHH first began its online “Employ-eforum” in 2002 so that employ-ees would have easy, direct, electronic access to the hospital president and could raise issues or ask questions on the Intranet. In 2006, when Richard D’Aquila joined YNHH, he assumed responsibility for the site which was renamed “Go Ahead and Ask.”

The e-forum is an active employee communication vehicle for employees who want to email D’Aquila with questions, comments and suggestions about how to make Yale-New Haven a better place to work. Employees are encouraged to iden-tify themselves so they may receive a personalized response, or they may remain anonymous. Go Ahead and Ask is also a good tool for employees who have ques-tions and comments about the integration of the two hospitals.

Now, a new anonymous telephone voicemail box has been added for employees who would like to communicate, but prefer to use the telephone instead of email. The voicemail box number is 688-6888.

Got a question? Go Ahead and Ask; now employees can call or email

Patient transporters on the York Street Campus have developed a tradition of recognition and celebration each year in November and last month, they introduced that tradition to the Saint Raphael Campus.

“We wanted to celebrate the transition and the collaboration we are de-veloping with the 27 transporters on the Saint Raphael Campus,” said Tina Washington, manager, Patient Transport. “We recognize Patient Transport Week in November so this year’s celebration was perfect timing for our new colleagues.”

On York Street, Patient Transport celebrated the productive year that the department had. Its 115 transporters now frequently transport more than 1,300 patients in a day. They also celebrated how – with the help of improved software and the use of Spectralink phones – they are able to reduce the time between transports.

“Over time, we will standardize practice on the Saint Raphael Campus and introduce the tools that we use on the main campus,” explained Washington. “These tools – which are tied to our goals – allow us to safely transport more patients in less time, and that adds positively to the experience patients have at Yale-New Haven Hospital.”

Patient transporters celebrate their week on both campusesWashington notes that one of the first programs that will be introduced on the

SRC is the successful “Ticket to Ride” program. Each patient is given a ticket that tells patient transporters and nurses information that might include where the pa-tient is coming from and going to, if the patient speaks English or if the patient is at risk of falls. This information helps to ensure the patient’s safety and provides a smooth transition as the patient goes from an intensive care unit to procedure areas like radiology and then back to his or her room.

“We are excited about sharing best practices with our colleagues on the Saint Raphael Campus,” said Washington. “As capacity on the campus increases, we will be able to help them move more patients safely, and in less time. We’re al-ready looking forward to our celebration on both campuses next year.”

SRC patient transporters showed off the bags they received for their first annual celebra-tion of Patient Transport Week. Patient transporters Tammy Laudicina and Andrew Morro hold their bags and flank supervisors (l-r) Walter Reynolds and Scott Aldridge.

A former medicine/telemetry unit on the third floor of the Sister Louise Anthony wing is the first patient care unit to be renovated and returned to service on the Saint Raphael Campus.

When Yale-New Haven Hos-pital and the Hospital of Saint Raphael started discussions, one of the overriding chal-lenges facing YNHH was the need for additional capacity, as its census soared over the past few years and shows no signs of abating. Among many other good things, HSR offered that capacity – a benefit not only for the two hospitals, but for the state and federal regulatory agencies that had to approve the acquisition.

The unit on SLA 3 had been closed for more than a year and the original plan was to simply give the unit a deep-clean. At the renovated unit’s November 19

into the super clean, I was quickly persuaded to make this project a renovation so we could create a better, more functional, more patient-centered unit – and that is exactly what you see in this space today.”

Tall ceilings, ample natural and diffused light, a soothing green on the walls and a welcoming front desk invite visitors into the new 14-room, 24-bed Medicine/Telemetry Unit. Function is as important as form on this renovated unit: a former patient room is now the unit’s charting room – home to eight desks and comput-ers, and workstations on wheels – better known as WOWs – accompany nurses in and out of patients’ rooms.

Peter Herbert, MD, chief medical officer, who had served as chair of HSR’s De-partment of Medicine for 10 years before joining YNHH in 1999, told the guests, “I started working on this unit 23 years ago and I don’t recognize it at all!

“The configuration of this unit warms my heart,” Dr. Herbert continued. “There’s a room for document-ing and with Epic coming in June, staff will appreci-ate this room and what it means for patient care. It is spectacular what emerged from the old SLA 3 – this unit is a wonderful beginning to our new hospital.”

Stephen Carbery, vice president, Facilities, called the SLA 3 renovation, “a terrific first opportunity for our facilities, design and construction teams to work together and the results speak for themselves.”

According to Carbery, the group is now working on Verdi 4 North which, by early May, should open as a 28-bed medical/surgical unit with telemetry capabil-ity.

“SLA 3 is our first major project since the inte-gration and so many helped with it,” said Michelle Miranda, RN, patient service manager of the newly opened unit. “Our future is bright and I can’t wait to see what comes next – our patients.”

First renovated patient care unit on Saint Raphael Campus re-opens

At the entrance to Yale-New Haven’s newest unit, quick scissors made short work of the ribbon placed at the entrance to the bright and airy new Medicine/Telemetry Unit on SLA 3. Shown (l-r) are: Thomas Donohue, MD, chief, Medical Service, SRC; Michelle Miranda, RN; Ena Williams, RN, associate chief nursing officer, SRC; Richard D’Aquila; Dr. Peter Herbert; Stephen Carbery; and Marna Borgstrom, CEO, YNHH.

hand to answer questions on nutrition, 3-5 p.m.

IRS increases maximum em-ployees can contribute to 403(b)

For 2013, the Internal Revenue Service has increased the amount that employees can contribute to their 403(b) plan, also known as a tax-sheltered annuity.

In pre-tax contributions, employees under the age of 50 may contribute up to $17,500 per year; employees 50 and older may con-tribute $23,000. The hospital matches up to 3 percent of the employee’s first 5 percent contribution.

Holiday stressed? Consider Em-ployee and Family Resources

The holidays can be particularly stressful and employees now have a new way to seek help. YNHH provides assistance to em-ployees and their family members through the Employee and Family Resources (EFR) program. This confidential resource helps employees manage the demands of work and personal life and is available 24 hours a

day, 365 days a year. The toll-free number is 1-877-275-6226.

EFR will put the employees in touch with the appropriate professional who can provide counseling for stress, anxiety or depression, marital or relationship problems, or alcohol or substance abuse. EFR can also help employees with work/life issues from childcare and eldercare referrals to legal and financial assistance services.

There is no charge to the employee for these consultations.

Religious Ministries and Pastoral Care become Spiritual Care

On January 1, Religious Ministries on the YNHH Campus and Pastoral Care on the Saint Raphael Campus will change their names to become the Department of Spiritual Care at YNHH. The new name will be consistent with the departments that serve the spiritual needs of patients at both Bridgeport and Greenwich hospitals.

The Department of Spiritual Care pro-vides for the spiritual and religious needs of patients, their families and friends, and the hospital staff. Its multi-faith chaplains cover

all inpatient units and many clinics. Chaplains respond to deaths, trauma or other critical situations where they provide compassion-ate listening and presence along with prayer, anointing of the sick, baptism and com-munion. Worship services are held regu-larly, including Mass on Sundays in the York Street chapel and daily on the Saint Raphael Campus, and on holy days and other days of remembrance.

2013 Wish Book focuses on pe-diatric patients

Yale-New Haven’s third annual Wish Book is a gift list focusing exclusively on the needs of the hospital’s youngest patients – those being treated at Yale-New Haven Children’s Hospital. The list is a collection of items suggested by YNHCH staff that will comfort children and their families at a time when they are most challenged and vulnerable.

Many of the gifts in the Wish Book are items that some families are unable to pur-chase themselves and other items include equipment that may be in short supply.

Over the past two years, supporters – in-cluding many employees – contributed more

than $62,000 for Wish Book gifts.

The items in the 2013 Wish Book are designed for gift-giving throughout the year – donations are not limited to holiday giving. Employees may request a copy of the new Wish Book by calling 200-GIFT (4438) or make donations online at www.ynhhwish-book.org.

Compliance reminds employees about gift guidelines

With the holidays quickly approach-ing, Corporate Compliance is reminding employees about the hospital’s guidelines for accepting gifts from vendors and contractors that range from tokens of appreciation to gift baskets. Compliance counsels employees that they may accept perishable gifts which can be shared with the entire department, with manager approval. Gifts of cash or gift cards are not permitted. Employees can access the policy and more information on the Corporate Compliance/ Privacy page on the Intranet.

Last year, YNHH started to celebrate Veterans Day by honoring its employee-veterans. This year, celebrations took place on both campuses. The day started with a breakfast on 55 Park Street where veterans displayed photos of themselves when they were in the service. At noon, a contingent of veteran-employees from the York Street Campus – led by Carlos Lourenco, director, Materials Management – went to the Saint Raphael Campus where they hosted a luncheon for their SRC counterparts. Before sitting down to lunch, employee-veter-ans from both campuses stopped for a Veterans Day photo.

YNHH celebrates Veterans Day, and its veteransribbon-cutting, Richard D’Aquila, president and COO, noted that, “Three days

NewsmakersRogerio C. Lilenbaum, MD, chief medical officer, Smilow Cancer Hospital at Yale-New Haven

Rogerio C. Lilenbaum, MD, has been appointed chief medical officer of Smilow Cancer Hospital at Yale-New Haven. Dr. Lilenbaum is a practicing medical oncologist and will also care for patients through the Thoracic Oncology

Program.

Dr. Lilenbaum is currently chairman of the Cancer Institute at the Cleveland Clinic in Florida and will begin his tenure at Smilow on January 1. Prior to joining the Cleveland Clinic, Dr. Lilenbaum was the director of cancer research and director of the Thoracic Oncology Program at Mount Sinai Medical Center in Miami Beach, Florida. He also served as the principal investigator of the Mount Sinai Community Clinical Oncology Program.

Dr. Lilenbaum received his medical degree from the Federal University of Rio de Janeiro School of Medicine in Brazil and earned a master’s degree in clinical epidemiology and clinical investigation from the Harvard School of Public Health. He completed his hematology/oncology fellowship at Washington University School of Medicine and a clinical and research fellowship at the University of California San Diego.

Jasper L. Tolarba, RN, MSN, named PSM, Behavioral Intervention Team

Jasper L. Tolarba, RN, MSN, an off-shift nurse leader since November 2010, has been appointed to the role of patient service manager of the Behavioral Intervention Team (BIT). The BIT is a specialized psychiatric program which provides consultative services for patients with potential co-morbid

psychiatric illnesses on the eight medical units on the York Street Campus.

Prior to YNHH, Tolarba worked at St. Mary’s Hospital in Waterbury as a clini-cal nursing supervisor and at Sacred Heart University as a member of the adjunct faculty.

He earned a BSN and master’s in education at Bicol University in Legaspi City, Philippines, an MSN in nursing administration at Xavier University in Cincinnati, and is currently earning a doctor of nursing practice at Yale School of Nursing.

December 6, 2012 • Volume 35 • No. 22

Editor: Leah Colihan

Graphic designer: Tracy Cole

Contributors: Myra Stanley

Photography: Kathleen Testa

Next issues: January 10, January 24

Copy deadlines: December 7, January 11

Submit story ideas to Leah Colihan, 688-9440, or to leah.colihan@ynhh.org.

Yale-New Haven Hospital is an EEO/ AAP employer.

Photos, meeting notes, department records, publications, correspondence – these are just a few of the items that Susan Dee (left), hospital archivist, collects. Working with intern Caitlin Costa, Dee actively solicits materials that describe the unique contributions made by hospital staff and physicians to medicine, nursing and allied fields. She works in the basement of the Clinic Building where she carefully catalogues materials that may someday serve as the basis for a display like the one she did last year that illustrated the hospital dur-ing the Civil War or the current one that highlights the histories of YNHH and the Hospital of Saint Raphael, which is now part of YNHH. Dee also answers questions from research-ers about hospital firsts and historical developments. Employees who have something that may be of interest to a future audience should contact Dee at susan.dee@ynhh.org.

Hospital archivist works to record all that is the hospital

patient safety and quality concerns. On the Saint Raphael Campus, partici-pants gather in the Selina Lewis Building and connect via videoconference to participants on York Street. On weekends, the administrator on call runs the meeting via conference call.

The 15-minute briefings are based on the Healthcare Performance Im-provement (HPI) model. HPI is a leading comprehensive safety improve-ment organization that serves more than 200 hospitals throughout the country.

YNHH’s morning safety report is led by the hospital’s Performance Management Department and includes a four-point agenda: looking back at significant safety or quality issues from the last 24 hours; looking ahead to anticipated safety or quality issues in the next 24 hours; discussing safety catches, or near misses where an employee catches a mistake or error before it causes harm to a patient; and implementing follow-up, including status reports on previously identified issues. All issues are documented until they are resolved.

“The morning safety report is a practice new to both campuses,” said Thomas Balcezak, MD, associate chief of staff and chief quality officer. “Because our organization is so large, it is extremely helpful to have rep-resentatives from throughout the hospital come together to share concerns, identify potential safety issues and collaborate on solutions. These daily meetings have been very productive.”

Key milestones to successful Epic implementation on both campuses

Each campus has its own deadlines for completion of responsibilities in order to successfully implement Epic. To help employees know where they are at a glance in terms of important milestones leading up to implementa-tion on their campus, the Bulletin will run this chart as it is updated until the entire hospital has implemented successfully.

Additional information on each of the steps can be found at http://project-epic.ynhh.org

Safety • Continued from page 1

York Street Campus Saint Raphael Campus

PTO black-out dates January 27-February 16, 2013 May 27-June 15, 2013

Technical/equipment audit DONE Current

Review department workflows DONE December

Identify super users DONE Current

Manager meetings DONE December-January

Register for training DONE January-March

Training December-January March-May

Dress rehearsal January May

Go-live prep for super users mid-January mid-May

Go live! February 1! June 1!