Below are the August Medical Staff Updates. As a reminder, all providers must complete the attestation at the bottom of this page by August 31.
I received a great deal of feedback, both positive and negative, on the original version of this column. After reflection, I felt that some modification was appropriate so as to emphasize my central theme of inclusiveness. As always, I welcome your comments and thoughts.
In February, I called your attention to our new lesbian, gay, bisexual, transgender and questioning (LGBTQ) policy. In light of the recent ban on transgender people serving in the military purportedly due to their medical costs, I would like to re-emphasize that our policy affirms Kaleida Health’s commitment to minimizing barriers to healthcare for members of our LGBTQ community. This policy represents a tangible part of our effort to be an inclusive organization, not just for the LGBTQ community, but for people of all backgrounds.
Inclusiveness extends to everyone in our institution: patients, families, colleagues and co-workers. It is only by treating each other with respect and dignity that we can provide the consistent high-quality care for which we strive. Unfortunately, bigotry is still present in America. We must not let this interfere with our mission of providing the best healthcare to all and we must be prepared to speak out for those who face discrimination, as the American Medical Association has done (https://www.ama-assn.org/ama-statement-transgender-americans-military). Our single goal is to provide everyone in our community, without exception, with the finest healthcare.
Peter Winkelstein, MD, MS, MBA, FAAP
Medical/Dental Staff President
Kaleida Health
In 2012, the Centers for Medicare and Medicaid Services (CMS) put a healthcare acquired conditions (HAC) penalty program together that impacted one percent of CMS reimbursement to hospitals beginning in 2015.
Kaleida Health has paid approximately $1.5 million in penalty for every year of the program based on the organization's infection rates for a total of about $4.5 million.Thanks to the efforts of caretakers across the system implementing the Quality Improvement and Patient Safety (QIPS) Plan, Kaleida Health will not be paying a penalty in 2018 for the first time in the history of the program. Congratulations and thank you, providers, for your hard work and commitment!
Online registration for the Gates Vascular Institute Symposium: Updates in Cardiac, Vascular & Neuroendovascular Medicine is now open. Register before September 1, 2017 to SAVE!
This year's event will take place on Friday, October 13, 2017 and Saturday, October 14, 2017. Please note the new location:
The Grapevine Banquets
333 Dick Road
Depew, NY 14043
Visit the Gates Vascular Institute Symposium website for additional details.
Kaleida Health always strives to provide the highest quality care and look for ways to improve safety and outcomes for patients. To help identify these areas for improvement, Buffalo General Medical Center (BGMC) recently joined the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) for its adult surgical programs.
ACS NSQIP is based on collecting clinical, risk-adjusted, 30-day outcomes data in a nationally benchmarked database. By using clinical data gathered from patients’ medical charts rather than administrative data, the hospital will be able to catch more complications, helping BGMC to improve patient outcomes and cut healthcare costs. The results can then be compared to other hospitals similar in size and type across the country to help determine where to make quality improvements.
On average, ACS NSQIP participating hospitals have been able to prevent 250 to 500 complications and save 12 to 36 lives each year, saving millions of dollars annually. Tracking 30-day outcomes helps identify complications such as surgical site infections, urinary tract infections and pneumonia.
BGMC is already accredited as a Comprehensive Center under the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP®). To earn the MBSAQIP designation, BGMC met essential criteria to ensure that bariatric surgical patients receive a multidisciplinary program, not just a surgical procedure, which improves patient outcomes and long-term success.
In 2015, Women & Children’s Hospital of Buffalo joined the ACS NSQIP Pediatric program, which compares outcomes in each of six specialties – urology, neurosurgery, general/thoracic, plastics, orthopedics and otolaryngology – to those of over 90 other children’s hospitals. Each of the specialties can access their individual results to develop targeted quality improvement projects.
Each participating site has a surgeon champion who oversees implementation of the quality improvement program, educates others about the program, and works closely with a surgical clinical reviewer (SRC) who collects and enters data. The SRCs work closely with surgeons and internal hospital committees to ensure accurate data collection and best results.
Meeghan Lautner, MD, MSc, was selected to serve as BGMC’s surgeon champion to oversee the implementation of ACS NSQIP, educate others on the program and work closely with the surgical clinical reviewer (SCR) to accurately capture BGMC’s data.
Lynn Andzel, RN, will serve as BGMC’s SCR and will undergo special training through the American College of Surgeons. The SCR role is dedicated to collecting and entering data and works closely with the surgeon champion, surgeons, and internal hospital committees to ensure accurate data collection and best results. Because the SCR is responsible for tracking 30-day patient outcomes, Andzel will be contacting surgeons’ offices and hospital committees.
For more information on ACS NSQIP, visit http://site.acsnsqip.org/, or contact Dr. Lautner at mlautner@kaleidahealth.org with questions specific to BGMC’s surgical quality improvement efforts.The trauma center at Women & Children’s Hospital of Buffalo has been successfully verified as a Level I Pediatric Trauma Center – one of only five in New York State – by the Verification Review Committee, an ad hoc committee of the Committee on Trauma (COT) of the American College of Surgeons (ACS).
This achievement recognizes the trauma center's dedication to providing optimal care for injured patients. Congratulations to Kathryn Bass, MD, and the entire trauma committee on a job well done!
The COT's Consultation/Verification Program for Hospitals promotes the development of trauma centers in which participants provide not only the hospital resources necessary for trauma care, but also the entire spectrum of care to address the needs of all injured patients. This spectrum encompasses the prehospital phase through the rehabilitation process.
Achievement of the high standards of the ACS required many process changes throughout the facility with support from Kaleida Health and the Medical Executive Committee. It took a lot of team work to implement the changes and dedication by all involved to make the changes fruitful and long lasting.
Great Lakes Cardiovascular, a partner of General Physician, P.C. and affiliate of Kaleida Health, opened the first Atrial Fibrillation Center in Western New York, located in Buffalo General Medical Center (BGMC). An estimated 2.7 million Americans have atrial fibrillation (AFib or AF), a common heart rhythm disorder. Many are unaware they have AF, and when left untreated, there is an increased risk of stroke, heart failure and heart-related death. AFib can causes palpitations, shortness of breath, light headedness and significant fatigue when left undiagnosed.
The Atrial Fibrillation Center, opened July 1, 2017, will offer patients new hope. The Center’s multidisciplinary team consists of: electrophysiologists (a cardiologist who specializes in heart rhythm conditions), cardiovascular and thoracic surgeons, nurse practitioners and physician assistants. The specialty treatment team, with Ashish Bhatia, MD, as medical director of the Center, is dedicated to the diagnosis and treatment of AF– whether it is chronic (persistent) or paroxysmal (intermittent) using the most advanced techniques and treatments.
The Center, centrally located at BGMC and connected to the Gates Vascular Institute, will offer multiple options, including minimally invasive procedures, to treat and monitor atrial fibrillation.
“The new Center will be a game-changer for those who suffer with AFib. It offers a full continuum of care for these patients,” explained Dr. Bhatia. “We have a dedicated team of skilled physicians who work collaboratively to ensure the best possible outcomes for our patients.”
The Center will offer individualized, compassionate care by developing a customized treatment plan to provide patients with a full range of options targeted at rhythm control, rate control and stroke prevention strategies. The AFib Center offers a full complement of advanced cardiac care, state-of-the-art technology and innovative treatment options.
The Women & Children’s Hospital of Buffalo Diabetes Center provides medical care to over 900 children and young adults with Type 1 diabetes in the greater Western New York area. The team consists of nine board-certified pediatric endocrinologists who work with nurse-CDEs, registered dieticians, a social worker, and a psychologist to care for children with diabetes. The Center is in a select group of pediatric diabetes centers to be accredited by the American Diabetes Association for the Education Recognition Program.
The Diabetes Center’s active clinical research team enrolls patients in international and national research programs, and participates in TrialNet, a federally funded program aimed at screening and prevention of Type 1 diabetes in high risk individuals. The Center offers additional studies in new onset T1D patients to take advantage of therapies aimed at targeting cytokines (golimumab, Simponi®) and oxidative stress (difluoromethylornthine) in order to preserve insulin production. In addition, the Center plays a key role in the Type 1 Diabetes Exchange, the largest registry for Type 1 diabetes in the United States. Through the exchange, Diabetes Center patients participate in studies to study residual β-cell function, quality of life in Type 1 diabetes, adjuvant therapies to treat Type 1 diabetes (SGLT1/SGLT2 inhibitor), as well as novel glucagon formulations for treating hypoglycemia, a major complication associated with insulin use.
The Diabetes Center research team physicians include Drs. Kathleen Bethin, Indrajit Majumdar, Lucy Mastrandrea, and Teresa Quattrin. To learn more or participate in research related to Type 1 diabetes, please contact Amanda House, MPH, at 878-7268.
Name |
Clinical Service |
Category or Coll/Super |
Baqai, Saad, MD |
Pathology |
Associate |
Baxter, James T., PNP |
Pediatrics |
APP – Rula Balluz, MD |
Becker-Weidman, David J.S., MD |
Radiology |
Associate |
Cullen, Kyle J., PA-C |
Orthopaedic Surgery |
APP – Lindsay Clark, MD |
Downie, Andrea, RNFA |
Surgery |
APP |
Elnasser, Dilafruz, FNP |
Family Medicine |
APP – Stephen Evans, MD |
Fahey, Daniel J., MD |
Emergency Medicine |
Associate |
Fuhrer, Greg S., MD |
IM/Pulmonary Disease/Critical Care |
Associate |
George, Matthew J., FNP |
Internal Medicine |
APP – Haider Khadim, MD |
Giesler, Daniel L., MD |
Internal Medicine |
Associate |
Hamid, Mohammed H., MD |
Internal Medicine |
Associate |
Karmo, Stephanie R., MD |
Internal Medicine |
Associate |
Knuppel. Robert A., MD |
Obstetrics & Gynecology |
Associate |
Lizarraga, Alexis A., MD |
Neurology |
Associate |
LoFaso, John R., DO |
Anesthesia |
Associate |
Maloney, Kristen, PA |
Internal Medicine/Cardiology |
APP – Chee Hoon Kim, MD |
McKinnon, Gayle, M., CRNA |
Anesthesia |
APP – George Toufexis, MD |
Mittal, Amol, MD |
Internal Medicine/Nephrology |
Associate |
Niles, Philip I., MD |
Ophthalmology |
Associate |
Nowak, Jessica, DPM |
Orthopaedic Surgery/Podiatry |
Associate |
Parkot, Christina, FNP |
Family Medicine |
APP – David Kupkowski, MD |
Patel, Megha H., FNP |
Internal Medicine |
APP – Steven Buslovich, MD |
Pisano, Heather M., FNP |
Internal Medicine |
APP – Michael Banas, MD |
Plaskett, Allen A., CRNA |
Anesthesia |
APP – George Toufexis, MD |
Rasnick, Joseph M., ANP |
Internal Medicine |
APP – Attiya Siddiqi, MD |
Reif, Rachael, PA-C |
Internal Medicine |
APP – Awais Ahmed, MD |
Stohrer, Hans L., MD |
Internal Medicine/Geriatrics |
Associate |
Weldy, Gregory, PA |
Internal Medicine |
APP – Colin McMahon, MD |
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.
TX.IVs&MEDS.28 – Penicillin Allergy Testing
ED.1183 – Emergency Department Provider Documentation Guidelines – Clarified ED patients must have H&P and medical decision making documented before transfer to floor and reduces days chart can be outstanding from two weeks to seven days before considered delinquent
HR.21 – Standards of Appearance – Combined with Nursing Standards of Appearance so all workforce members held to same standards
LE.10 – Treatment of Unemancipated Minor – Revision to consent requirements
TX.IVs&MEDS.18 – Anticoagulation Management – Changes to Triple Antithrombotic Consideration on pages 9 and 10
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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