March 2017

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

Medical Leadership Message

Medical LeadersKaleida Health remains focused on continuing to reduce the number of hospital acquired infections. This year’s quality goals will further drive down hospital acquired infections, improve patient care and reduce readmissions. Because of their vital role in driving these initiatives, providers should be aware of the following:

CLABSI Changes

Previously, providers were able to document “suspected manipulation or access” to exclude laboratory confirmed blood stream infections from NHSN surveillance criteria as central line-associated blood stream infection (CLABSI). Based on new surveillance guidelines, providers must document “suspected or witnessed injection” in order to continue to have this exclusion take place.

Clostridium difficile Infections

Kaleida Health continues to collaborate across the system on efforts to reduce Clostridium difficile infections (CDI). We are proud of reaching our 2016 goal and have an aggressive goal set for 2017. Below are the top 10 key points for CDI consideration:

  1. Test only patients likely to have disease
  2. Order a single C. difficile test. Current methods do not require multiple samples
  3. If the patient is being admitted, ensure that the test is sent within the first 72 hours so that it is not counted as a hospital onset infection
  4. There  is no indication to test asymptomatic patients or patients with formed stool 
  5. Target patients with loose, watery or unformed stool that takes the shape of the container
  6. Malodor and/or “green” color is a poor positive predictive value for CDI 
  7. There is NO indication for “test of cure” repeat assays
  8. A repeat (+) after 8 weeks generates a new reportable event
  9. Place patient in appropriate – hospital specific – precautions while waiting for results
  10. Please utilize the CDI Order Set for treatment orders

Thank you for your commitment to providing the highest quality, safest care for our patients each and every day!

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/Gates Vascular Institute

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

Message from the President of the Medical/Dental Staff

Peter Winkelstein, MD, MS, MBA, FAAPIt was very heartening to see Buffalo featured in a New York Times article recently (“A Surprising Salve for New York’s Beleaguered Cities: Refugees” on February 20, 2017). The article highlighted what many of us know: Buffalo’s resurgence is due in part to the positive impact of our refugee community. “Perhaps nowhere has that impact been more profound than in Buffalo, the self-described ‘City of Good Neighbors,’ where about 10,000 refugees have been placed over the last decade,” says the New York Times article, which goes on to quote Mayor Byron Brown saying, “One of the reasons that Buffalo is growing, that Buffalo is getting stronger, that Buffalo is getting better, is because of the presence of our immigrant and our refugee community.”
Many of Buffalo’s immigrants and refugees come to Kaleida Health’s facilities for their care. We provide a welcoming, safe environment for our patients, regardless of what borders they may have crossed. Our aim is to provide the best in class care for everyone. Caring for all is one of the oldest and most important commitments of medical professionals. We must be vocal about and actively affirm this commitment.

Next time you are near City Hall, look for the yellow Refugees Welcome flag and celebrate that we really are the City of Good Neighbors and an example to all.

Peter Winkelstein, MD, MS, MBA, FAAP
Medical/Dental Staff President
Kaleida Health

Hand Hygiene Emergency Call-to-Action

hand hygieneKaleida Health has an “emergency call-to-action” for hand hygiene. Key points are:

It is vital to follow proper technique for hand hygiene, including the 5 moment of hand hygiene to reduce the spread of infections.

Doctors’ Day Celebrations

In honor of National Doctors’ Day, Kaleida Health is hosting special breakfasts at each of our hospitals on Thursday, March 30, 2017 from 7-9 a.m. to recognize physicians’ tireless efforts. Physicians will receive a formal invitation to the breakfasts in the mail with a token of our appreciation. Thank you for always leading with CARE!

Thank you doctors

Medical Staff Semiannual Meeting

Medical/Dental Staff Semiannual Meeting on April 27

All Kaleida Health and ECMC physicians and advanced practice providers are invited to the Medical/Dental Staff Semiannual Meeting on Thursday, April 27, 2017, at Templeton Landing in Buffalo.

Cocktails and hors d'oeuvres begin at 5:45 p.m.; the business meeting and dinner will begin at 6:30 p.m.

Guest speaker David Rich, executive vice president, government affairs, communications, and public policy, Greater New York Hospital Association, will discuss the impact of the election on health care. CME credit will be available.

Due to limited space, this event is first-come, first-served, and RSVP is required by Friday, April 14, 2017. If you are attending, please be sure to add the meeting to your own calendar as there will not be an invitation sent via Microsoft Outlook.

Visit the Survey Monkey link to RSVP and select your meal choice. For questions, call the Kaleida Health Medical Staff Office at 859-5501.

Free Buprenorphine Waiver Training: Prenatal Care – Pregnancy & Addiction Focus

The Erie County Department of Health is hosting a free Buprenorphine Waiver Training for physicians, physician assistants and nurse practitioners and any OB providers managing prenatal care and special issues associated with pregnant women who have opiate use disorder.

The course will be offered on Saturday, June 10, 2017 from 8 a.m.-1 p.m. at Catholic Health, 144 Genesee Street, Buffalo, NY 14203.

Learning Objectives:

Participants are required to complete a 4-hour online component within two weeks of the in-person training. Participants will meet the requirement of DATA 2000 to be qualified to prescribe buprenorphine for opioid-dependent patients.
Online registration is available at For additional information, please email or call 716-858-4941.

This program has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for CME (ACCME) through joint providership with the University at Buffalo School of Medicine and Biomedical Sciences and the American Academy of Addiction Psychiatry (AAAP).
The University at Buffalo is accredited by the ACCME to sponsor CME for physicians.

The UB School of Medicine & Biomedical Sciences designates this live activity for a maximum of 8.0 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Clinical Research: Fatty Liver: A Serious Entity on the Rise

Non-alcoholic fatty liver disease (NAFLD), or more commonly known as “fatty liver,” is rapidly becoming the most common cause of chronic liver disease within the United States and the leading reason for liver transplantation. Fatty liver is characterized by excess liver fat deposition and includes a spectrum of disease ranging from simple fatty liver to an entity known as “nonalcoholic steatohepatitis” or NASH, which is fatty liver accompanied by inflammation. NASH can progress to fibrosis (scarring) and cirrhosis, while simple fatty liver generally does not progress. NASH commonly develops due to diet, genetics and/or obesity. Sometimes diabetes can be a factor, but science is trying to understand the relationship of diabetes and the other factors in NASH and how they relate.

Given the increase in obesity in the US, there is a rising incidence of fatty liver and NASH. Presently, there is urgent need for early diagnosis and accurate disease staging to distinguish between these two entities, especially since they are underdiagnosed in the general population.

In the past two years, the Buffalo General Medical Center and ECMC Liver Clinics have become a regional referral source for patients with all types of liver disease, including those with fatty liver. The clinic’s physicians have access to the latest diagnostic and treatment modalities for fatty liver, including several clinical trials of promising treatments not yet available to all physicians. If you have potential cirrhotic and non-cirrhotic NASH or NAFLD subjects interested in participating or have questions, please call Rick Rejman, Clinical Research Study Coordinator, at 878-3320 for more information on the current NASH studies that we are actively enrolling patients for.

Policy Updates for Providers

Below are 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 or 716-859-8447.

New Policy:
IAC.29 – Communication with Deaf/Hearing Impaired

Medical Staff Attestation - March 2017

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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