November 2017

Below are the November Medical Staff Updates. As a reminder, all providers must complete the attestation at the bottom of this page by November 30.

Message from the President of the Medical/Dental Staff

Peter Winkelstein, MD, MS, MBA, FAAP

The Jacobs Institute just released a report called “The Future of Medicine.” This fascinating document tries to describe what health care might look like over the next 20 years. I recommend that you look through it:

One section addresses the provider workforce, including changes in how we might educate providers and how technology will change the way we provide care. Notably, the report gives significant space to the specific issue of physician morale. It says that physician burnout has increased during the period 2011 to 2014 from 45.5 percent to 54.4 percent (compared to 28.6 percent in 2014 for the general population) and that satisfaction with work-life balance has decreased from 44.9 percent to 36 percent (compared to 61.3 percent). It says there are an estimated 400 physician suicides each year, one of the highest rates among all professions. The report reminds us that the AMA has declared burnout as a matter of “absolute urgency.” It also points out the consequences of burnout: “Burned out doctors make more mistakes and appear to deliver lower quality of care.” There is enormous financial cost to burnout as well, both in lower productivity and increased turnover (the report estimates it costs $250,000 to $1 million to replace a physician).

The report does provide suggestions on how to reverse this trend. Improved technology that reduces the effort of data capture is on the near-term horizon. The report also recommends the following ways to improve morale:

Provider morale has been an on-going topic of conversation between Dr. Katie Grimm, president of the ECMC Medical Staff, and me. We both hope to be able to put programs in place to help address this issue. There is no question that we must address this so that we can continue to provide the best health care for our community.

On behalf of all of the Medical/Dental Staff, I would like to wish the Children’s Hospital team the best of luck on the move from Women & Children’s Hospital of Buffalo to Oishei Children’s Hospital. I know that the extremely meticulous planning, training and practicing will result in a flawless move day!

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

Quality Update: 2017 Nonconformances

Kaleida Health received the report from the DNV GL/ISO 9001:2015 survey that was conducted in September. Below is the list of identified nonconformances. Kaleida Health treats all nonconformances equally with the same rigor to ensure sustainable corrective action plans are put into place.

  • Patient Rights – Provision of Rights/Physical Environment – Safety Management System: No objective evidence in the medical record that suicide patient had appropriate safety equipment checks done in room or sitter ordered
  • Physical Environment – Life Safety: Lapse in fire pump testing documentation; Missing protective covers on fire sprinkler cabinets
  • Nursing Services – Assessment and Plan of Care/Medical Records Service: Record Content: Titration of high-risk medications and ensuring monitoring of sedation levels are documented; Pain intervention with central nervous system pharmacologic meds to ensure monitoring of sedation level is done
  • Medication Management – Medication Practices: Nurses follow orders or clarify orders so they are written as expected (i.e. physician order for Levophed continuous IV rate vs. titrate for MAP > 65 mm Hg)
  • Medication Management – Medication Orders: Physician communication in orders for nurses to follow instructions/parameters (multiple orders for pain meds prn – need to clarify “x” given for moderate pain, “y” given for severe pain)
  • Patient Rights: Delivery of Important Message for Medicare patients (IMM) at discharge missing; IMM at admission missing; Spanish speaking patient missing Spanish version of IMM

Teams formed to determine true root causes and develop action plans. Kaleida Health’s corrective action plan report was submitted, and Kaleida Health will report to DNV GL on the effectiveness of its corrective action plans following the Plan-Do-Check- Act (PDCA) model for continuous improvement.

To ensure Kaleida Health meets its goal of zero repeat nonconformances and continue its journey to mature the Quality Management System, it is everyone’s role to implement corrective action plans that their teams have put in place. Remember, accreditation and quality is everyone’s responsibility.

Oishei Children’s Hospital Move Day on November 10

On November 10, 2017, Kaleida Health will complete the move from Women & Children’s Hospital of Buffalo to the new John R. Oishei Children’s Hospital on the Buffalo Niagara Medical Campus.

Thank you to all those who have been involved in the planning of this historic event, and thank you to those who will be there on November 10 to ensure a safe move for each and every patient.

Video Available from Medical/Dental Staff Semiannual Meeting

On October 19, 2017, Kaleida Health hosted the Medical/Dental Staff Semiannual Meeting. Guest speakers Michael E. Cain, MD, vice president for Health Sciences and dean, Jacobs School of Medicine and Biomedical Sciences and Stephen Turkovich, MD, chief medical officer of Women & Children’s Hospital of Buffalo, discussed the exciting growth and changes happening on the Buffalo Niagara Medical Campus, which will be the new home of the Jacobs School of Medicine and Biomedical Sciences and John R. Oishei Children's Hospital. Click HERE to watch the presentations from the meeting.


Flu Vaccination Status Required by November 30

Following the practice of other Western New York facilities and clinical best practice, the influenza vaccination status of all healthcare personnel must be documented no later than November 30, 2017. Once influenza is declared prevalent in the region, all unvaccinated personnel must wear a surgical mask at all times while in areas where patients or residents are typically present during the entire influenza season.

Masks will be available at all main entrances of Kaleida Health’s hospitals throughout influenza season.

To obtain your vaccine:

Providers must have their Kaleida Health ID badge to receive the vaccine from Employee Health. At the time of vaccination, a Kaleida Health Employee Health nurse will apply a flu sticker on the right lower corner of the Kaleida Health ID badge to provide visual verification of vaccination.

Providers vaccinated by a facility or provider other than Kaleida Health will need to bring official proof of vaccination to Kaleida Health’s Employee Health Department in order to receive their sticker of verification.

Those who decline the influenza vaccine must complete a “Declination of Influenza Vaccine” form. Anyone who declines the vaccine due to a medical condition will also need to complete the “DOH Medical Exemption Statement” form. Details for both forms are available on Employee Health’s website on KaleidaScope.

Employee Health or a site designee will apply a yellow sticker on the right lower corner of the Kaleida Health ID badge of those who decline vaccination.

Kaleida Health’s Medical Staff Office will be tracking providers’ vaccination status. All providers must submit a copy of their proof of vaccination or declination of vaccination to the Medical Staff Office. Please scan and email documentation to Rosie Light at or fax to 859-5592.

Clinical Research: Heart Failure

Cardiovascular diseases are a significant cause of morbidity and mortality in the United States. Heart failure remains the leading cause of hospitalization in this country in patients over 65 years of age. Heart failure is often a consequence of ischemic heart disease, with heart attacks resulting in cardiac muscle damage and subsequent reduced systolic function (HFrEF). Increasingly, patients with long standing diabetes, hypertension and/or atrial fibrillation are developing heart failure with preserved ejection fraction ( HFpEF). Additionally, valvular heart disease, specifically aortic stenosis, causes symptoms of heart failure especially in the elderly population.

UBMD faculty and practicing cardiologists are conducting several clinical trials at the Clinical and Translational Research Center and Buffalo General Medical Center aimed at decreasing mortality from and improving quality of life in patients suffering from heart failure. Dr. Thomas Cimato is Principal Investigator in the DAPA-HF trial looking at the role of SGLT2 inhibitors in patients with symptomatic CHF with reduced ejection fraction. Dr. Saurabh Malholtra is Principal Investigator for a multicenter study to demonstrate the efficacy of AdreView imaging for appropriately guiding the decision of ICD implant in patients with LVEF between 30-35 percent. Dr. Vijay Iyer is the Principal Investigator on multiple cardiovascular trials including those designed to use the transcatheter method for replacing aortic valves in patients with symptomatic severe aortic stenosis.

To learn more about these trials or to refer a patient, please contact Courtney Bishop , MS, MPH, CCRP or Eileen Daetsch, RN, MS, ANP, in the clinical research office at 716-888-4839 or 716-888-4848.

New Providers

Please welcome the following new appointments to Kaleida Health:


Clinical Service

Category or Coll/Super

Ahmed, Imad M., MD

Internal Medicine/Nephrology


Blackley, Emma, PA

Emergency Medicine

APP – Sucharita Paul, MD

Cozzo, Diane M., ANP

Familly Medicine

APP – Priyanka Patnaik, MD

Dockstader, Chantel, MD

Internal Medicine/Pediatrics


Guerinot, Matthew, DO



Julian, Ashley, DO



Kim, Jennifer, MD



Mazhari, Amir C., MD



Milleville, Chelsey, PA

Internal Medicine/Gastroenterology

APP – Mohammad Fayyaz, MD

Misir, Devinalini K., MD

Psychiatry & Behavioral Medicine


Morr, Simon, MD, MPH



Murtha, Jennifer, FNP

Emergency Medicine

APP – Sucharita Paul, MD

Pham, Alise K., DOD


House Physician

Ruffino, John T., MD

Internal Medicine


Sheriff, Adnaan, DO

Family Medicine


Shivang, Joshi, MD



Siejka, Jacqueline, PA

Orthopaedic Surgery

APP – Peter Gambacorta, MD

Sosa, J’Leise D., MD

Obstetrics & Gynecology


Terhune, Julia H., MD



Policy Updates for Providers

Below is a revised policy that affects providers at Kaleida Health. Please take a moment to review this month's updates. The policy link below ia accessible from a Kaleida Health computer only. For additional assistance, please contact Amy Palombo at or 716-859-8447.

Revised Policy:

LE.9Informed Consent Revisions regarding DNR and time frame for obtaining consent

Medical Staff Attestation - November 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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