Below are the July Medical Staff Updates. As a reminder, all providers must complete the attestation at the bottom of this page by July 31.
Medical Leadership Message
Leading with CARE: A Culture of Safety
Beginning this month, all employees, providers and volunteers will again participate in a mandatory one-hour, instructor-led Leading with CARE session.
While last year’s Leading with CARE classes highlighted Kaleida Health’s mission, vision and values, this year’s classes will have a more specific focus on promoting a culture of safety using the concept “See, Say, Do” and applying it to various scenarios.
Participants will review Kaleida Health’s behavioral values with a focus on how they connect with safety:
C − Be patient centered by promoting safety for our patients, family members, and employees
A − Hold yourself and others accountable for all safety concerns |
R − Show respect and integrity by speaking up when you see a safety concern
E − Strive for excellence by paying attention to the environment around you
Each session will be led by a variety of specially-trained facilitators from across Kaleida Health, and will include ample opportunities for group discussions and interactions.
Like last year, classes will be multidisciplinary and offered at various sites and times throughout the day, evening and night.
Staff and physicians may begin enrolling for one of the sessions via Talent Management on Friday, July 1, 2016.
The first scheduled training sessions will begin on Tuesday, July 12, 2016, and classes will continue until all employees, volunteers and providers have participated in a session.
As Kaleida Health continues to improve the patient experience, it is essential to maintain the positive momentum of Leading with CARE. With more than 10,000 members of the Kaleida Health family equipped and empowered to lead with safety, we can and will make a difference for our patients, visitors, colleagues and the community.
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
Message from the President of the Medical/Dental Staff
In my comments last month, I noted that there is a critical interdependence among Kaleida Health’s Board of Directors, Medical/Dental Staff and management. These entities must be aligned around a shared vision that provides for the triad of good patient care, hospital success and provider success. Recognizing that interdependence, the American Medical Association and the American Hospital Association produced a joint whitepaper outlining principles for successful integrated leadership for hospitals and health systems (http://www.aha.org/content/15/ahaamaintegrleadership.pdf).
The whitepaper makes the case that physician leadership and health system leadership must partner in order to respond to the many changes in healthcare. It goes on to emphasize that the key element in successful integrated leadership is trust. The paper outlines six specific principles:
- Physician and hospital leaders must be aligned around values, goals and metrics
- An interdisciplinary structure must be in place that supports collaboration in decision-making between physicians and hospital executives, while maintaining physician clinical autonomy
- Integrated clinical physician and hospital leadership, including nursing and other clinicians, must be present at all levels of the integrated health system and participate in all key management decisions
- Clinicians and hospital leaders must be in a collaborative, participatory partnership built on trust
- There must be open and transparent sharing of clinical and business information
- A clinical information system infrastructure that allows capture and reporting of key clinical quality and efficiency performance data is essential
The Medical/Dental Staff has responsibilities in creating and fostering this partnership. These include maintaining our formal self-governance and management structure and providing leadership development for Medical/Dental Staff members. The whitepaper points out that we will need physician leaders with training or demonstrated competency in leadership and management skills and an environment that supports their success.
The Medical/Dental Staff officers and I look forward to working closely with the board and administrative leadership to continue to evolve our strong partnership.
Peter Winkelstein, MD, MS, MBA, FAAP
Medical/Dental Staff President
Kaleida Health
Patient Safety Stand-Down
Central venous catheterization (CVC) was once a commonly performed procedure that is technically challenging and associated with several risks and complications. Today, with new devices and efforts to reduce central line infections, CVC is not frequently performed by medical staff, including residents.
Kaleida Health, in conjunction with the University at Buffalo Jacobs School of Medicine, reviewed three recent serious safety events involving retained guidewires during central line insertions. All three cases involved residents, fellows and faculty either placing the CVC or supervising the placement. The concerns that have been generated from these three separate incidents elevated this to the level of a patient safety stand-down.
After discussions with the various departments involved, the university GME faculty, Kaleida Health Medical/Dental Staff leadership and administration, it was decided that effective June 20,2016, all residents and fellows at all Kaleida Health facilities will have their competency (UB credentials) in CVC placement temporarily suspended. In order to have the suspension lifted, residents and faculty must complete a training module. This suspension did not impact patient care as Kaleida Health had many privileged medical staff and a policy that allows for trained physicians to perform procedures in emergency situations.
All cases will have root-cause analyses completed to identify opportunities for system/process improvements. At this time, the CVC insertion checklist has been amended to include guidewire count documentation. This allows the physician the opportunity to observe for the pulled guidewire.
The safety stand-down served as a collaborative opportunity for Kaleida Health and the University at Buffalo to promote patient safety as our highest priority.
New Chiefs of Service Named
George E. Matthews, MD, was named chief of service for internal medicine for Kaleida Health.
In his new role, Dr. Matthews will oversee the largest cohort of physicians and providers within Kaleida Health and will continue to advance performance expectations for internal medicine and its subspecialties. He will participate in structured review of new technologies, use evidence-based medicine to further achieve best practices, and oversee internal medicine physicians, nurse practitioners and physician assistants to assure efficiency, safety and favorable healthcare outcomes.
Dr. Matthews most recently served as president of the Kaleida Health Medical/Dental Staff. He is in private practice with UB|MD Internal Medicine. In addition, Dr. Matthews is an attending physician at Buffalo General Medical Center/Gates Vascular Institute.
Dr. Matthews received his bachelor’s degree in biology from Brown University in Providence, Rhode Island, and received his medical degree from Cornell University Medical College. He completed his internship, residency, and fellowship at The Medical College of Pennsylvania, Philadelphia, Pennsylvania. Dr. Matthews is board certified in cardiovascular diseases and internal medicine. Dr. Matthews is a fellow of the American College of Cardiology, American College of Physicians and American Society of Echocardiography.
Thank you to Stanley Schwartz, MD, for his service as the immediate past chief of service for medicine.
Stacey A. Watt, MD, was named chief of service for anesthesiology for Kaleida Health.
In her new role, Dr. Watt will be responsible for defining and clarifying performance expectations for anesthesiology services at all sites. She will also review new technologies in collaboration with hospital administration and use evidence-based literature to achieve best practices. She will oversee anesthesiology physicians, nurse practitioners and physician assistants to ensure efficient, effective and safe patient care.
Dr. Watt currently serves as program director of the University at Buffalo Pediatric Anesthesiology Fellowship Program as well as the program director of the University at Buffalo Obstetric Anesthesiology Fellowship Program. She is also the anesthesiology site director at DeGraff Memorial Hospital and a designated institutional official at Women & Children’s Hospital of Buffalo. Dr. Watt is board certified in anesthesiology with specialty certification in pediatric anesthesiology.
Dr. Watt received her bachelor’s degree at the University of Florida and her medical degree from the State University of New York Upstate Medical Center in Syracuse.
Dr. Watt serves as an editorial board member for the BAOJ Pediatric Journal. In addition, she is a member of the American Medical Women’s Association (AMWA) Board of Directors, Linda Brodsky Memorial Fund Advisory Board, American Medical Association, American Society of Anesthesiologists and American Medical Women’s Association among others.
Thank you to Jon Grande, MD, for his service as the immediate past chief of service for anesthesiology.
Southtowns Surgery Center Open House
Join Kaleida Health for the new Southtowns Surgery Center Open House on Thursday, July 14, 2016, from 6-8 p.m. at 5959 Big Tree Road, Orchard Park, New York 14127.
The event offers guests the opportunity to tour the neighbors of BrookBridge Medical Park, including Chestnut Ridge Family Medical Care, Great Lakes Cardiovascular, Great Lakes Medical Imaging, Kaleida Health Laboratories, UB Neurosurgery and UBMD Orthopaedics & Sports Medicine. Light refreshments will be served.
RSVP to 716-859-8751 by Friday, July 8, 2016.
Save the Date – Gates Vascular Institute Symposium
Kaleida Health is excited to present the third annual Gates Vascular Institute Symposium: Updates in Cardiac, Vascular & Neuroendovascular Medicine.
This educational symposium will be held Friday, October 14, 2016 (full day) and Saturday, October 15, 2016 (half day) at Templeton Landing in Buffalo.
This year’s symposium will offer a wide range of speakers, topics and continuing education credits.
Registration opens August 1, 2016. For more information, visit www.kaleidahealth.org/gvi-symposium.
Medical Executive Committee - Department Presentations
Chief Of Medicine – Presented by George E. Matthews, MD
It has been my pleasure to serve as chief of medicine for the past three weeks. During that time, I have appreciated the chief of service position is largely administrative. However, although the position may begin there, the role of chief of service will evolve into providing a vision and direction for the department. Let me share with you my vision.
Two aspects of the department that I will devote my initial efforts towards are improving upon include the hospitalist service and ensuring that we have a significant role in teaching medical students and residents. I have had the opportunity to speak with several members of the department who acknowledge that our hospitalist service serves as the face of the department of medicine. New providers will be joining our health system shortly to bolster the care afforded our patients. It is imperative that each individual in the hospital assist the hospitalist to provide the necessary care.
We are a department that accepts and welcomes the role of teaching the next generation of physicians. That being said, with the assistance of several of the individuals within the department, we will be attempting to increase the educational experience provided to our students and residents. Several individuals have suggested that we rework morning report, and with the assistance of the chief resident, we will attempt to make this a more stimulating experience.
Finally, I have been reaching out to several members of the department and will continue to reach out to individuals to learn what works and how we can improve upon the foundation that is presently in place. I would welcome any and all suggestions as we strive to elevate the stature of the department and realize the vision of excellence in all that we do.
Division of Neonatology, Department of Pediatrics – Presented by Satyanarayana Lakshminrusimha, MD
The Division of Neonatology at Women & Children’s Hospital of Buffalo (WCHOB) is the regional perinatal center for Western New York. We have a 64-bed unit level 4 neonatal intensive care unit (NICU) at WCHOB and have expanded our services with the opening of the first single-room NICU in Western New York with 10 beds at Millard Fillmore Suburban Hospital. We perform whole-body cooling for hypoxic-ischemic encephalopathy. We are one of the first centers in the country to implement CCHD screening in the NICU and to use oral dextrose gel to treat hypoglycemia and avoid the need for IV fluids. Stephen Turkovich, MD, chief medical officer, WCHOB, championed this project in newborn nursery which led to reduced length of stay, cost savings and promotion of exclusive breastfeeding. Our dedicated PICC line team, under the leadership of Anne Marie Reynolds, MD, achieved 365-days of CLABSI-free period.
For the past five years, our division has been a part of two multicenter NIH funded clinical networks. The Prematurity Respiratory Outcomes Project evaluates long-term respiratory outcomes of extremely premature infants. The Neonatal Research Network comprises 15 academic units throughout the United States conducting multicenter clinical trials. WCHOB will be the lead site for a multicenter trial evaluating milrinone therapy in congenital diaphragmatic hernia in 2017.
Neonatologists and trainees in our division present the innovation and research occurring at WCHOB and the University at Buffalo at all major national and international meetings in the field and have won seven grants from the American Academy of Pediatrics. These exciting advances in clinical, academic and research fields have put the division on the national map in recent years.
Policy Updates for Providers
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 apalombo@kaleidahealth.org or 716-859-8447.
New Policies:
IC.15 – Prevention and Control of Clostridium difficile Infections
MR.6 – Suspension Process for Missing Discharge/ Expiration Summary
PED.26 – Pediatric Sepsis Protocol
Revised Policies:
LE.9 – Informed Consent – Updated to reflect new form
MED.2 – Continuing Medical Education Requirements for Medical and Dental Staff Members – Revisions to statement A.1 regarding CME hours
Medical Staff Attestation - July 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.
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