January 2016

Below are the January Medical Staff Updates. As a reminder, all providers must complete the attestation at the bottom of this page by January 31.

Medical Leadership Message

Medical LeadersLooking Forward

Each January provides an opportunity to reflect on the previous year while looking forward to the possibilities ahead.

At Kaleida Health, 2015 was a year of numerous gains and achievements. Beyond improvements in patient satisfaction and safety scores, the opening of the neonatal intensive care unit at Millard Fillmore Suburban Hospital, the addition of a gastroenterology procedures suite at Buffalo General Medical Center and the ongoing construction of the new John R. Oishei Children's Hospital represent positive progress.

From the medical staff point of view, physician and provider engagement is at an all-time high as well. Physicians are involved in decision making and setting the course for Kaleida Health.

In 2016, the goal is to continue this momentum. From quality and safety to achieving national recognitions to financial stability and investment in infrastructure, Kaleida Health will continue to move forward. Through ongoing planning with provider input, the strategic plan will allow us to continue as the healthcare leader in Western New York.

Thank you not only for the care that you provide each and every day to your patients, but also for your vision and commitment to the momentum.

We are looking forward to 2016.

David Hughes, MD, MPH
Chief Medical Officer
Kaleida Health

Kenneth Snyder, MD, PhD
Vice President, Physician Quality
Kaleida Health

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

A Message from the President of the Medical/Dental Staff

George E. Matthews, MDOn behalf of the Kaleida Health Medical/Dental Staff Medical Executive Committee and the Nominating Committee, chaired by Kevin Gibbons, MD, it gives me great pleasure to provide a list of candidates for election to the Medical Executive Committee.

K. Kent Chevli, MD
John Pastore, MD

Omar Al-Ibrahim, MD
Fred Archer III, MD
James Armstrong, MD
Christopher Bartolone, MD
Michael Beckwith, MD
Vincent Callanan, MD
David Carlson, Jr., MD
Christopher Deline, MD
Greg DiFrancesco, MD
Richard Gilbert, MD*
Frederick Hong, MD
Armen Kirakosyan, MD
Jody Leonardo, MD*
Joanne Massucci, MD*
Lucy Mastrandrea, MD
Michael Mineo, MD
Molly Moore, MD
Alan Posner, MD
Michelle Penque, MD
Ann Marie Reynolds, MD
Andrew Symons, MD*
*Currently serving on the MEC

These nominees are all individuals who distinguish themselves not only by their clinical or surgical skills, but also as colleagues instrumental in strengthening our medical staff and assisting to make Kaleida Health a preeminent institution.

Ballots will be emailed to providers' kaleidahealth.org email in early February. Please make sure to vote! This is your opportunity to identify who among these individuals will provide the strongest advocacy on behalf of the medical staff.

Electronic Prescribing Mandate

Electronic PrescribingThe New York State mandate to electronically prescribe all medications, including controlled substances, is scheduled to go into effect on March 27, 2016. An electronic prescription is one created, recorded or stored by electronic means; issued and validated with an electronic signature; and transmitted by electronic means directly from the prescriber to a pharmacy. Prescriptions generated on an electronic system and printed to the Official New York State Prescription Form or faxed are NOT electronic prescriptions.

To prescribe controlled substances after March 27, 2016, providers will need to use two-factor authentication. In addition to a password, providers will also need to enter a unique, one-time use passcode for each prescription.

To obtain two-factor authentication providers can go to www.kaleidahealth.org/DIGIPASSapp to download the DIGIPASS for Mobile Enterprise Security Edition application for an Android, iOS or Windows smartphone or tablet. Providers who do not have an Android, iOS or Windows smartphone or tablet can obtain a VASCO© fob by calling the Technology Assistance Center (TAC) at 859-7777.

Providers who practice at the DeGraff Memorial Hospital Skilled Nursing Facility, HighPointe on Michigan, Women & Children's Hospital of Buffalo Dental Clinic, Women & Children's Hospital of Buffalo Psychiatry Clinic, or any Kaleida Health clinics not yet on the Electronic Medical Record (EMR) will not use the DIGIPASS application. If you provide service at any of these locations, you will receive a separate communication from Kaleida Heath Information Technology (IT).

Additional information is available through the following resources:

PCA Syringe Shortage

Hospira is experiencing a supply chain interruption of the sterile patient controlled analgesia (PCA) vials, which are required for operation of the PCA pain management pump currently used across Kaleida Health. The vials are used by commercial vendors and hospital pharmacies to prepare morphine and hydromorphone PCA syringes.

This shortage could last until spring as inventory was placed on a quality hold and Hospira does not have an estimated time when manufacturing will resume.

In response, Kaleida Health Pharmacies implemented the critical shortage policy, which includes a complete inventory and usage analysis. The current supply of PCA products will be exhausted in early January.

As Kaleida Health continues to identify other alternatives, Hospira received approval by the FDA to extend the GemStar pump retirement until March 31, 2016. Kaleida Health has an adequate supply of these pumps, which can be used for PCA administration. Kaleida Health is in the process of obtaining the pendants needed to operate the GemStar pump. Nursing Education, Pharmacy and Clinical Engineering are working to rollout of these pumps and train staff on their use.

While we have a sufficient supply of all injectable pain medications, i.e. morphine, hydromorphone, it is likely providers will need to use bolus scheduled or prn pain strategies until the pump solution is instituted fully.

If you have any questions, please contact Andy DiLuca, R.Ph., director of Pharmacy Services at 859-1196.

Kaleida Health Access Center

Kaleida Health Access Center teamThe Kaleida Health Access Center is available to provide physicians, support staff and patients with superior customer service. The Access Center (AC) team is comprised of experienced coordinators who serve as the caller's one-stop resource for a variety of both adult and pediatric inquiries. From start to follow up AC coordinators:

The AC also provides private pay quotes for patients who "opt out" of insurance, their insurance is not accepted by Kaleida Health, or insurance does not cover their visit. Provider offices or patients may obtain a private pay quote by calling (716) 859-CARE or emailing accesscenter@kaleidahealth.org.

For patients coming from outside of the area needing guidance for hotel accommodations, dining and transportation in preparation for their visit, the AC has established relationships with area hotels, transportation companies and restaurants that provide discounted rates for patients and families.

The AC is open Monday through Friday from 8 a.m. - 4:30 p.m. For more information contact the AC team at (716) 859-CARE (2273) or accesscenter@kaleidahealth.org.

Reference Resources

In early December, Kaleida Health's DynaMed subscription was discontinued. Currently, Kaleida Health providers can contact the Kaleida Health Libraries for assistance in finding evidence-based information to inform clinical decision making.

For assistance from Kaleida Health Library staff, please call:

Buffalo General Medical Center Library859-2878
Millard Fillmore Suburban Health Sciences Library568-6540
Women & Children's Hospital of Buffalo Library878-7304

University at Buffalo attending physicians, residents and students can use Clinical Key to access First Consult, which is embedded within Clinical Key. First Consult provides similar decision support information to DynaMed.

Medical Executive Committee - Department Presentations

Millard Fillmore Suburban Hospital Emergency Medicine – Presented by Michael Mineo, MD

The Millard Fillmore Suburban Hospital Emergency Department set a goal to improve the processes to decrease throughput times in order to meet CMS's metrics. By breaking down the throughput process into five distinct steps and focusing on improving each step, the team decreased the length of stay while experiencing increased volume.

For admitted patients, throughput times decreased from 415 minutes to 307 minutes. For discharged patients, length of stay decreased from 250 minutes to 159 minutes, below the national benchmark of 180 minutes.

As a result of this increased efficiency, including a virtual fast track, the "left without being seen" rate decreased to less than one percent, making the department a best performer according to third party rating agencies.

The Emergency Department also created a focus group to learn about Press Ganey and learn how to enhance the patient's experience in the department. Using information gleaned from some of the best performing hospitals, the team created an eight week educational series. At the completion of the series, provider patient satisfaction increased from the 30th percentile to the 70th percentile. The next step is to hardwire the cultural changes required to ensure continued kind, compassionate and efficient patient care.

Buffalo General Medical Center Family Medicine – Presented by Priyanka Patkanik, MD

At Kaleida Health, Family Medicine provides an excellent level of patient care, while assisting in the training and development of the next generation of family physicians in Western New York.

Seven family physicians and 17 residents at Jefferson Family Medicine are affiliated with the Buffalo General Medical Center Family Medicine program. The family medicine residency program has had a long association with Buffalo General, beginning at the Deaconess Hospital in 1969. The department now includes three additional sites.

An inpatient team, comprised of five residents and medical students is led by a family physician. A pharmacist is also part of the team. The goal of the Family Medicine Department is to provide excellent quality of care to patients from the time of presentation in the Emergency Department to the time of discharge.

The team manages an average daily census of 10-15 patients on the 13th and 15th floors and ambulatory telemetry. The team also refers patients for ancillary services (imaging, labs, and outpatient procedures) and to specialists. Among the 602 discharges, the most common diagnoses were congestive heart failure (CHF), chronic obstructive pulmonary disease and renal failure. The 30 day readmissions for patients with two specific diagnoses (CHF and cellulitis), has seen the greatest improvement. Hospital-acquired conditions (HACs) are at expected levels. Length of stay (LOS) represents an opportunity for improvement, at 5.61 (the expected rate is 5.08).

Additional opportunities for improvement include obtaining specialty consults in a timely fashion, optimizing inpatient palliative care and collaborating with the various service lines.

Department of Urology – Presented by Valerie Burkhard, MD and Teresa Danforth, MD

The Kaleida Health Department of Urology provides services in all areas of adult and pediatric urology. In addition, the department points with pride to its provision of exceptional care to all segments of the Western New York population. The team is particularly proud of the commitment to addressing disparities in urologic care and to the underserved and economically disadvantaged populations in Western New York.

The team is a unique amalgamation between the volunteer faculty and University providers. The seamless interaction between the academic and volunteer faculty, particularly with reference to graduate and undergraduate medical education, is evident as 58 percent of the urology residents at any one time are on rotation at Kaleida Health. This reflects the robust contribution of Kaleida Health to graduate medical education in urology.

Moving forward, one goal is to grow the Robotic and Minimally Invasive Surgery Program and recruit fellows to further the spectrum of urological care.

Medical Staff Attestation - January 2016

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.

Fields marked with an asterisk (*) are required.

First Name *
Last Name*
Practitioner Number *
Five-digit number assigned by Kaleida Health, also known as your dictation number. To look up your practitioner number, select "Practitioner Search" under Kaleida Links on KaleidaScope.
Kaleida Health Email*

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