McCabe’s Rounds

I have just finished the exit interview with the four reviewers from DNV, who arrived here unexpectedly on Wednesday for our annual hospital accreditation visit.  They have spent the last three days roaming through our institution, looking in every crack and crevasse, talking to our staff, reviewing our policies, and interrogating our medical records.  At the end of their three day visit, the reviewers sit with Senior Staff of the hospital and discuss their findings.

Overall, they were very complimentary of our institution, our staff, our patient care, and our facility.  They repeatedly told us that we are a very complicated and large institution and that they were impressed with the coordination, care, and attitude of our staff.  They were particularly complimentary of their review of our Stroke Program and our facilities maintenance.

We reviewed with them all of the findings from a year ago and all but two findings have been completely resolved since last year.  The two remaining findings were minor and certainly we are well on our way to correcting these issues as well.

Typically, the DNV issues its final findings in two different categories (non-conformance Category 1, and non-conformance Category 2).  The non-conformance Category 1 findings are the more serious that require immediate attention on our part.  Overall, there were very few non-conformance Category 1 findings.  We were complimented for our patient care plans and for how we now manage patient restraint issues and DNR forms.  We have areas for improvement in legibility in medical records (especially in discharge documents), in some areas of medication management, and control of our documents.

Overall, this is a very satisfying visit for us.  The DNV visit is an opportunity for someone else to look at our processes and to help us improve.  I want to personally thank everyone in the institution who has contributed to where we are today.  I especially want to thank Joyce Mackassy, who helps manage our accreditation process.  All of the hospital Senior Staff and the Nursing Directors were intimately involved in making this review a success.  Finally, thanks to all who interacted with the DNV accreditation review team over the last few days.

As always it is wonderful to have external validation of what I think I know every day, that Team Upstate is an outstanding team to work with and work for.  Many thanks to all!

Mike Jordan, RN in the OR was recognized by Katie Mooney and Dr. McCabe on July 13th for his professionalism and responsiveness on June 15, 2011 when his actions helped save the life of another.

Mike Jordan attended his son’s lacrosse game at Fayetteville-Manlius High School. A lacrosse ball hit one of the 16 year old boys in the left chest, which caused him to arrest. Mike along with the coach initiated CPR and quickly followed up with the AED.  The 16 year old did respond by the time the ambulance arrived.

Pictured below are the celebratory events honoring, 9F-Neuroscience ICU, PMR Concussion Management Program and the Breast Cancer Program. These teams had the most improved overall patient satisfaction scores for the first Quarter of 2011.

Inpatient Champion Trophy:
9F-Neuroscience ICU
The Neuroscience ICU had the greatest improved overall patient satisfaction score with an 18.6 point increase for the first Quarter of 2011

Back Row, Left to Right: Paul Seale, Sharon Klaiber, RN, Patrick Smith, RN, Amy King, RN, Gretchen Hoffman, RN, Rachel Phillips, RN, Chiquota Thomas, RN, Kim Spinelli, RN, Dr Elwaleed El Nour
Front Row, Left to Right: Cathy Stephens, RN, Deb Gazarra-Ralph, RN, Linda Aue, RN, Emily Nye, RN, Tara Tulowiecki,RN, Katie Mooney, RN, Patty King, RN

Outpatient Non-Press Ganey Champion Trophy:
PMR Concussion Management Program
The PMR Concussion Management Program had an improved overall patient satisfaction of 9.4 points Non-Press Ganey outpatient satisfaction surveys for the first Quarter of 2011.

Back Row, Left to Right: Dr. McCabe, Angelina Rodner, Mike Romandetti, PT, Amy DeBois, PT, Yvonne Freeman, OT, Susan Giegold, PT, Michelle Brand, Stephanie Cooper, Steve McClintic
Middle Row, Left to Right: Deborah Spinks, PhD, Tammy Bartoszek, PsyD, Jennifer Donnelly, OT, Debra Blanchard, RN, Diane Clark, Paul Trela, NP Kim Nemi, OT, Paul Seale
Front Row, Left to Right: Joan Pagano, Tanya Clos

Outpatient Champion Trophy: Breast Cancer Program
The Breast Cancer Program had an improved overall patient satisfaction score of 7.3 points on their Outpatient satisfaction surveys for the first Quarter of 2011

Back Row, Left to Right: Amy Scullion, NP, Tina Evans, Dr. McCabe, Pam Romer, Carolyn Flewelling, Donna DeStefano, Paul Seale
Front Row, Left to Right: Richard Williams, RN, Katie Mooney, RN

In addition, the following areas were recognized at Management Forum in April for improving their patient satisfaction scores by 3 points in the first Quarter of 2011:
Breast Cancer Center +6.7
Perinatal Center +6.5
Hyperbaric Medicine &
Wound Care Center +6.3
UPAC +6.2
8G-Medicine Cardio +5.3
Dental Service +4.1
Cardiac Rehabilitation +4.0
4B-Psychiatry +3.4
Medicine Subspecialties +3.3

New Patient Satisfaction Champions will be announced at July’s Management Forum. We will be recognizing the teams with the highest combined patient satisfaction scores for overall rating of care given and likelihood of recommending hospital or practice.

We will soon be changing the way we care for patients with a new Electronic Medical Record (EMR) called Epic. With this new Epic system we will be the only health care system in this area to have such a sophisticated product for building bridges with our patients, our providers, our practices and our referring physicians focused on improved communications for and management of quality patient care. We will be implementing our ambulatory systems beginning in January 2012, and will follow shortly after this with an inpatient system. I would like to provide my vision and support for this major initiative.

Our search for an EMR began in 2005. After all of our analyses, Epic, from Madison, WI, became our vendor of choice. In 2009 we began searching for a Project Director, and in February 2010 Christine Personius was hired.

We have a number of committees working to implement the Epic system. We have included representatives from all areas who will be impacted by the use of Epic.

You may be wondering, why are we doing this, and, why the change? Here are some of the reasons I believe this is important:
• Provide quality patient care safely , effectively, and efficiently
• Comply with coming regulatory requirements and meaningful use – insurers will be mandating
• Set an example as more environmentally friendly – a lot less paper
• Qualify for available financial incentives to help offset some funding needs
• Reduce redundancy – now, many providers collect and store the same data
• Improve patient satisfaction and empowerment
• Improve employee satisfaction in accessing information and improving workflows

Now understanding the whys of Epic, we can think about who will be affected:
• We all will! Patients, families, physicians, nurses, business staff, administrators, billers, coders, other medical professionals. All of us who strive to provide the best patient care and experience.

What will change with Epic? The short answer is almost everything about the way we deliver patient care:
• We will work in a totally electronic system. This includes ordering, scheduling, billing, and other patient related functions
• Sharing of patient care information will be almost immediate.
• We can better track outcomes and be proactive in managing and collecting information on patient health conditions
• Our thought process will change radically

An Epic survey was completed in June. As a result, there were some themes I would like to note along with my responses:
• Will we have enough training for the major change required? – We will be implementing what we refer to as “mini bangs” a different service will go-live each month. We have tried to manage this change very proactively. This includes an extensive training schedule leading up to the change, mandatory schedule reductions during implementation and super users to help us manage the change.
• What will this mean for me and what I do? – Your hard work and support will be needed going forward although it may be in different ways.
• Will the new system have the functionality needed to care for patients? – The new system will have all that we need to provide for patients. However, there will be a learning curve to learn all of the options available to us.

There will be much more information in the coming months on the Epic implementation. Currently, you can review training and get other information on the iPage, and then click on Epic. Additionally, there will be posters, email, information in the Update and other communication to keep all of us informed.

Please join me in this challenge to help us achieve our vision for the future, our vision of Epic proportions. It is important for all of our patients.

If all goes according to plan, at 12:01 AM tomorrow, Thursday, July 7th, University Hospital will take over the operation and management of what we all know currently as Community General Hospital. We will begin to operate one hospital, one medical staff, and one workforce for the betterment of the patients in Central New York. This is a success that everyone in the Upstate and Community General families should embrace and celebrate.

Just about a year ago, Upstate leadership joined with the leadership at Community General Hospital in a journey to see if we could conclude a successful acquisition of Community General Hospital assets. The goal is to create one hospital system that would ensure acute care services for the population of the west and southwest side of Syracuse, expand the capacity of University Hospital to meet regional needs, recognize the quality Community General workforce, appropriately use the assets of the building/fixtures, and preserve the history of Community General Hospital. We sought to do this through a and hospital consolidation that has been talked about in the Syracuse area for over 20 years. At the outset, many thought that such a task was impossible.

Through the efforts of many individuals at both Community General Hospital and Upstate, the goal of this acquisition is within our grasp. On Thursday morning I will stand with the leadership at Community General Hospital when it is announced that the acquisition is complete, to unveil the new name of the Community General Hospital Campus, and to thank many of the people who have worked tirelessly to achieve this important milestone.

The efforts of Tom Quinn, Community General Hospital’s CEO, to bring this deal to closure have been nothing short of spectacular. His hard work, tireless dedication to Community General Hospital, and his vision to seek a new future for his beloved hospital have been important driving forces for the acquisition. Tom’s senior management team, as well as the senior management team at University Hospital have been instrumental in beginning to merge two very different cultures. The work of the Upstate Human Resources Staff to bring on nearly 900 new employees has been monumental. We have had superb cooperation from the State Department of Budget, Attorney General’s Office, Office of the State Comptroller, and the Department of Health. With the assistance of PricewaterhouseCoopers we have carefully prepared and honed a financial plan that we hope will ensure long-term success of this united entity. Finally, Regina McGraw and the SUNY legal staff, along with our legal partners at Hogan Lovells have taken on the daunting task of document review, legal analysis, document preparation, regulatory approvals and thousands of other tasks to get us to a successful closing.

I look forward to working with Meredith Price as she begins her new role as Chief Administrative Officer at Community General. She brings great experience and expertise to the role, and will be instrumental in our future success.

I sincerely hope that all 4000+ members of the University Hospital family will welcome Community General and its excellent work force into our hospital system. Over time, I am sure we will see the opportunity for many areas of integration, collaboration, and practice improvement. There will be many opportunities for personal growth. Over time, I think we can certainly say that we have single handedly improved, expanded, and preserved quality medical care in Syracuse and throughout the region. We have changed the landscape of healthcare in our region forever. I look forward to everyone’s participation in this exciting venture. I, again, thank all of those who had a hand in the absolutely phenomenal work of the last year and look forward to the challenge transition over the next few years.

Congratulations to a great team and a job well done and to the new employees of the Upstate University Hospital at Community General!