Below are the February Medical Staff Updates. As a reminder, all providers must complete the attestation at the bottom of this page by February 29.
For 2016, Kaleida Health has identified its top three quality priorities:
1. Reduce hospital-acquired conditions
2. Improve adult and pediatric sepsis bundle compliance to greater than 50 percent
3. Improve the patient and their family’s experience
Achieving a reduction in hospital-acquired conditions will require a renewed focus on hand hygiene, appropriate use of personal protective equipment (PPE), and universal bundle compliance. Through the joint leadership of the chief medical officers, chief nursing officers and site presidents, the goal is to build on the successes in 2015, spreading the lessons learned and processes across the organization.
The adult and pediatric sepsis teams are creating additional multidisciplinary educational opportunities and drills, clarifying the sepsis protocols and order sets, and leveraging the tools within the Electronic Medical Record (EMR) early sepsis alert to standardize practices and identify opportunities for improvement.
The patient experience managers and their teams of associates are rounding daily and providing real-time feedback and service recovery. Positive comments and constructive feedback are reaching every level of the organization as all strive to provide patients with the absolute best and highest quality experience.
Through your partnership and leadership, we will continue to lead with CARE and create one of the best healthcare organizations in the nation.
David Hughes, MD, MPH
Chief Medical Officer
Kenneth Snyder, MD, PhD
Vice President, Physician Quality
Colin McMahon, MD
Chief Medical Officer
Buffalo General Medical Center
David Pierce, MD, FACEP
Chief Medical Officer
Millard Fillmore Suburban Hospital and DeGraff Memorial Hospital
Stephen Turkovich, MD
Chief Medical Officer
Women & Children’s Hospital of Buffalo
Kamil Alpsan, MD
Site Medical Director
DeGraff Memorial Hospital
This year, the Kaleida Health Medical/Dental Staff Medical Executive Committee is pleased to provide members the opportunity to access the 2016 Election Ballot online.
Please use the link below to vote electronically for the individuals who will advocate on behalf of the medical staff.
Thank you in advance for your participation.
Kaleida Health received several awards in 2015 recognizing the quality of care. Here are just a few accomplishments:
On February 1, 2016, Kaleida Health will begin to implement use of New York State eMOLST. eMOLST is an electronic form completion and documentation system for the New York State Department of Health MOLST form. The eMOLST system guides clinicians through end-of-life conversations and the MOLST process. eMOLST makes sure the MOLST form and process are completed correctly and are accessible at all times. eMOLST includes programming to prevent errors and will not allow for incompatible medical orders.
The use of eMOLST will first be implemented on 9 North, 9 South and in the MICU at Buffalo General Medical Center, with rollout to other units and sites shortly thereafter. At the same time, providers at other sites should be aware that patients may present having completed the eMOLST process at another facility.
eMOLST also serves as the registry of New York eMOLST forms, which allows easy access to eMOLST forms completed by providers in other care settings. eMOLST forms are printed for any necessary workflow in the paper world, including patient discharge. eMOLST allows physicians to sign MOLST orders electronically. eMOLST ensures quality and patient safety, reduces patient harm and helps achieves the triple aim.
Please contact Elaine David, LMSW, manager, corporate social work services at 716-859-2536 or Father Richard Augustyn, manager, pastoral care at 716-859-8264 for additional information.
Doximity is quickly becoming the largest professional network for U.S. physicians, with more than 60 percent of doctors as members (surpassing the American Medical Association (AMA) in 2014). Doximity allows physicians to instantly connect with other healthcare professionals, whether it is to securely collaborate on patient treatment, grow their practices, find referrals, or discover new career options. U.S. News & World Report also surveys physicians through Doximity, for its “Best Hospitals Rankings.”
As Kaleida Health continues to make great improvements, Kaleida Health wants to be recognized as one of the best healthcare systems, not just locally, but also nationally and internationally. One way to achieve that recognition is to be included in U.S. News & World Report’s “Best Hospitals Rankings.” To calculate hospital rankings, U.S. News & World Report surveys physicians across the country about what they perceive to be the “Best Hospitals” based on a number of metrics. One of these metrics is a hospital’s “Reputation with Specialists,” which accounts for 27.5 percent of the hospital’s overall score.
In an effort to help improve Kaleida Health’s recognition across the country, all partner physicians are encouraged to sign up for Doximity and list Kaleida Health as a top hospital for a particular specialty in an upcoming survey. Physicians are typically surveyed sometime between January and March, and their responses are used in the rankings released in July.
To sign up, users must create a profile and provide personal information, such as date of birth and medical school, to verify they are a physician. There are premium services available, but benefits listed above are available as part of Doximity’s free services.
Learn more or sign up at www.Doximity.com.
Kaleida Health has over five hundred clinical research studies being conducted on its campus at any given time. Most of this research takes place at Buffalo General Medical Center/Gates Vascular Institute and Women & Children’s Hospital of Buffalo. These research studies often offer cutting edge treatment options to patients in our community that are not available at other Western New York facilities. Kaleida Health and the University of Buffalo Clinical Research Center will highlight one of these amazing clinical research studies in each edition of the Medical Staff Updates.
Congestive heart failure is a leading cause of death and illness in the United States. A new drug called Entresto™ (sacubitril/valsartan) is designed to treat heart failure using a novel inhibitor of the enzyme that breaks down a natural diuretic protein called brain-derived natriuretic protein. In patients with systolic congestive heart failure, the PARADIGM-HF clinical trial showed Entresto significantly reduced cardiovascular deaths and heart failure hospitalizations versus enalapril. Entresto™ is now FDA approved for treatment of systolic congestive heart failure.
While the results of the PARADIGM-HF trial are encouraging to patients with systolic congestive heart failure, up to half of patients with congestive heart failure have diastolic congestive heart failure. Thomas Cimato, MD, PhD, assistant professor, is the local Principal Investigator for the PARAGON-HF study sponsored by Novartis Pharmaceuticals. The goal of the PARAGON-HF study is to determine if treatment with Entresto™ (sacubitril/valsartan) results in reduction in cardiovascular death and heart failure hospitalizations in subjects with diastolic congestive heart failure. Dr. Cimato is seeking patients who are male or female, 50 years of age or greater, who have an LVEF greater than or equal to 45 percent, are on daily diuretic, and have evidence of structural heart disease on echo (left atrial enlargement or increased septal thickness). Additional inclusion and exclusion criteria apply. If you have a patient who has symptoms of shortness of breath with exertion and may meet study entry criteria, or would like further guidance regarding heart failure management, please contact Eileen M. Daetsch, RN, NP, at 716-888-4848 or at firstname.lastname@example.org or Thomas Cimato, MD, PhD, at email@example.com.
Pediatric Surgery – Presented by David Rothstein, MD, MS
The National Surgical Quality Improvement Program, Pediatric (NSQIP-P), collects data from 82 children’s hospital nationwide to provide risk adjusted, highly accurate 30-day surgical outcome measures in six pediatric surgical specialties: general, cardiothoracic, plastic, orthopedic and neuro surgery as well as urology. Each site contributes up to 1,400 cases per annum, randomly selected from a group of defined procedures among these six specialties. A surgical clinical reviewer reviews each case and makes determinations of 30-day complications from a strictly defined data dictionary, based on chart review and phone calls to families. Each facility also has a surgical champion who oversees the program and helps adjudicate any data disparities or questions.
The NSQIP-P data collection and analysis has been validated against single institution chart reviews and allows individual sites to compare outcomes against national standards. Hospitals participating in the adult version, in place for several years longer than NSQIP-P and at many more hospitals, have shown steady declines in mortality and surgical complications. Although a causal relationship cannot be demonstrated, the evidence that high fidelity surgical quality improvement programs improve care and decrease complications and associated costs is strong. Belief is that the same will prove true with NSQIP-P, both at the national level and at Women & Children’s Hospital of Buffalo.
Rehabilitation Medicine Department – Presented by Aaron Jerzewski, MD
The rehabilitation medicine department currently consists of three physicians: Phillip Kuruvilla, MD, Aaron Jerzewski, MD, and Jill Schleifer-Schneggenburger, MD.
Providing primary service for the 28-bed Medical Rehabilitation Unit (MRU) at Buffalo General Medical Center and the 18-bed MRU at DeGraff Memorial Hospital, the team consults at these two hospitals, Millard Fillmore Suburban Hospital and reviews cases from non-Kaleida Health hospitals to determine admission to the MRU. They also see outpatients for electrodiagnostics and botox injections for spasticity.
Criteria for admission to the MRU are established by the Centers for Medicare & Medicaid Services (CMS) guidelines and include:
The main diagnoses admitted to the MRU include: stroke, brain injury, spinal cord injury, cardiac or general deconditioning, multiple scrolosis, amputations, and other conditions resulting in functional deficits. The MRU is Commission on Accreditation of Rehabilitation Facilities (CARF) accredited for stroke rehabilitation.
The team looks forward to exploring the opportunities to expand the department and for multidisciplinary collaboration in the fields of electrodiagnostics, amputee treatment, prosthetic management, and in the field of occupational medicine.
Below are the new and revised policies that affect providers at Kaleida Health. Please take a moment to review this month's updates. The policy links below are accessible from a Kaleida Health computer only. For additional assistance, please contact Amy Palombo at firstname.lastname@example.org or 716-859-8447.
MED.36 – Medical Staff Morbidity and Mortality (M&M) Review
MED.35 – Medical Staff Peer Review Committee (PRC) – Revised to add case review and conflict of interest information
By submitting this attestation, I confirm that as a member of the medical staff I have read and understand the information included in this email from Kaleida Health in accordance with Kaleida Health policy MED.41 as approved by the Medical Executive Committee.
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