February 2017

‚Äč




Welcome to eFocus.  Our goal is to provide you with timely, informative and useful short summaries and links about UM UCH related news, issues, or events.  Feel free to contact us if you have news to share, story ideas or any other feedback. As always, your comments are welcome.

eFocus, February 2017 topics include:


Welcome

Though the weather is saying spring, the hospital census says, “It is still winter!” UM Upper Chesapeake Medical Center and UM Harford Memorial Hospital have both instituted their influenza plan. We are still seeing a peak in our positive flu test rate and, if you would like to see how we compare to previous years, look at the graph below (Graph 1). It shows that we are experiencing the most intense flu season when compared to the last four years. To all team members and medical staff, your continued dedication and compassionate care in the face of this high volume is admirable.

If a rough flu season is not enough, we had the flood in our Operating Rooms at UM UCMC, which has knocked out half of our ORs. Incredible work by everyone to minimize damage and disruption to the OR schedule. Special thanks to the orthopedic surgeons that have transplanted their cases to UM HMH and assisted with our constrained OR capacity.

We have some innovative solutions headed our way as we have completed implementation of BioFire for blood borne pathogens (positive blood cultures). This has decreased the identification of a blood borne pathogen after a positive blood culture to just several hours. We will have CSF and Respiratory online in the April-May timeframe. We have two new CT scanners coming to Upper Chesapeake in the next few months as well, which will herald our Coronary CTA program. Lastly, you are probably opening up this email right before our planned prolonged downtime for our upgrade to Meditech v6.15. Look onto the intranet page, upper right hand corner, “Provider Education for Meditech 6.15" for the effects that providers will see. 

We have had a challenging start to our 2017 year with the flu, flood, CAP survey, CMS survey and our challenges with CAUTI. However, it is these challenges that test our metal and it has been impressive to see our team rally. We passed both surveys with flying colors, minimal disruption of OR services to our community and a decreasing length of stay of our hospital patients despite high volume and flu. “There is no success without hardship.” – Sophocles. I know we are poised for some great success as we enter the spring months.

Enjoy this issue of eFocus and be on the lookout for a hidden question. Be the first person to answer it correctly and you'll win a little something to kick off next month's St. Patrick's Day celebrations.

Fermin Barrueto, Jr., M.D., M.B.A.
Senior Vice President/CMO
Medical Staff Affairs

Graph 1



We Can't Have a CAUTI if we Don't Have a Foley!



Cyber Security Update

It’s an unfortunate, well known reality that cyber-crime/terrorism/mischief is on the rise and health care is not immune. Organizations struggle to find a balance between data security and access. For the end user, that access is typically tied to a User Name and Password. It’s a method we have used as long as there have been computers to manage user identity. But as the value and risk associated to loss or damage to critical data and systems has risen, the security community has agreed this “single factor” of authentication isn’t enough.

Enter “Multi-Factor Authentication” or MFA. MFA adds a physical component—something you have—to the standard log on scenario so the compromise of the user name and password—something you know—isn’t enough to gain access to the account. Many of you likely use this for sensitive accounts such as bank or credit card access over the web.

At UM UCH, we are implementing MFA for users who access our systems remotely (from outside hospital grounds). This will be a progressive process during 2017 with the goal being to have all users who must access UM UCH systems when offsite use MFA to enter our systems.  

This process will involve an app that gets installed on a user’s smartphone (the something you have). The app gets tied to the user’s account at UM UCH. Then, when a user signs on, he/she generates a code on the app that is used rather than the password. Only the owner of the phone with access to the app can generate the specific code to validate the user’s identity.  

Almost 200 users at Upper Chesapeake are already using MFA for remote access, some using fingerprint identification on supporting devices to authenticate access. We look forward to working with our users to enable secure access to our systems. Keep an eye out for more information soon.

Rick Casteel
Vice President, Information Technology
University of Maryland Upper Chesapeake Health 


Evidence Based Self-Management

Given the increasing incidence of chronic diseases across the world, the search for more effective strategies to prevent and manage them is essential. The use of evidenced based self-management programs is assisting individuals with chronic conditions, and their caregivers, to increase control over and improve their health. These programs focus on overall health, quality of life and well-being. The programs are for both ill and well and strive to empower individuals to achieve greater sense of control over the many complex factors that affect their health. They are an adjunct to the care individuals receive from their PCP and/or specialists.

The programs introduce tools needed in day-to-day life with chronic conditions. Participants of the programs practice using self-management skills, focus on goal setting and share experiences emphasizing mutual support. The programs are highly interactive.

Evidence of Chronic Disease Self-Management Program (CDSMP) Effectiveness


A key feature of CDSMP is the strength of evidence about its impact. Based on a review of major published studies, CDSMP results in significant, measurable improvements in health and quality of life for people with chronic conditions. These include considerable upgrades in health status, self-efficacy, and psychological well-being; increased physical activity; fewer social role limitations and reduced fatigue; and enhanced partnerships with physicians. Research on cost savings has also shown impressive results: 

  • One U.S. study published in Medical Care found a 2.5 visit reduction in ER and outpatient visits per participant over 2 years, and a 0.49 day reduction in hospitalizations in the first 6 months of the study. 
  • Another U.S. study published in Effective Clinical Practice of CDSMP participants recruited from Kaiser Permanente hospitals and clinics and the Group Health Cooperative of Puget Sound found that, over a 1-year period, participants had a mean 0.97 day reduction in hospitalization and averaged 0.2 fewer ER visits. This suggests an estimated savings of about $1,000 per participant in the first year. 
  • In a 2010 United Kingdom study, 50% of CDSMP participants reported fewer unscheduled visits to their primary care physician, and 35% reported reducing the amount of medication they used after attending CDSMP. Total cost savings were approximately $2,934 per CDSMP participant per year. 
  • According to a 2008 Lewin Group analysis, improving access to CDSMP could save Medicare approximately $280 million per year, or almost $1.5 billion over 10 years.

Programs that are currently being offered and facilitated by Community Outreach and the Kaufman Cancer Center:

  • Chronic Disease Self-Management Program (CDSMP - Living Well)
    6 weeks, 2.5 hours per week
  • Hypertension Self-Management
    1 week, 2.5 hours
  • Diabetes Self-Management Program (DSMP)
    6 weeks, 2.5 hours per week
  • Thriving and Surviving (for cancer survivors)
    6 weeks, 2.5 hours per week
  • Stepping-On (a falls prevention program)
    7 week program  
  • Diabetes Prevention Program
    16 weeks, 1 hour per week
    Follow-up with participants for 1 year

If you would like more information regarding any of these programs, to refer a patient, or have someone present to your department, office or group, please contact Vickie Bands at 443-643-4255 or HealthLink at 1-800-515-0044.



Online Reputation Management

In December's issue of eFocus, we talked about the importance of maintaining your online professional presence, particularly on the UM UCH website and physician rating and listing sites. But what about social media? Or even Google?  

National Databases

Make sure the national databases for Centers for Medicare & Medicaid Services (CMS), National Provider Identifier (NPI) and Maryland Board of Physicians have your current information. These sites are often used to populate the doctor rating and review sites.

Google

Google your name on a regular basis. This exercise will give you some sense of how many ways consumers can get information about you, and what they are seeing.

  • Google different variations of your name, both with your medical degree and without – e.g.: John Smith MD; Dr. Jonathan Smith; John K. Smith – and then add the word “rating.” For each site that comes up, review your listing and note any errors.
  • If your first search result is a Google business listing with your name and address, click “Feedback,” which appears in the bottom right-hand corner of the listing box.
  • Edit each of the fields separately with the desired address, phone number, website, title, etc.  This will send the update to Google for review.
  • Google Alert: Set up an alert using your name, and receive an email notification when Google finds your name in new search results. Learn how to create an alert.

Professional Social Media Sites

  • LinkedIn: Created a professional profile on LinkedIn at linkedin.com, a networking site for professionals. You control all of the information that appears in your LinkedIn profile.
  • Doximity: Find and update your profile: doximity.com/sign_up_search/new. Note: Doximity also powers the search for the physician listings on US News and World Report: health.usnews.com/doctors

Ovid eResources

UM UCH's NEW online electronic resources, Ovid, is off to a great start. Since its rollout in October, staff usage of journals, databases and ebooks has been fantastic. 

Our clinicians have:

  • Read over 1000 articles in full text
  • Searched ebooks over 750 times
  • Utilized the Cochrane Database over 500 times

Top Journals utilized were: JAMA, AJN, Critical Care Medicine, Annals of Emergency Medicine, NEJM

Top eBooks utilized were:  Lippincott Manual of Nursing Practice, A to Z Drug Facts, Operative Techniques in Orthopaedic Surgery

All UM UCH staff have access to these resources and, starting in March, the breadth of content will expand to even more interprofessional rehab, clinical and nursing journals. You will also be able to receive emails with journal table of contents automatically sent to you when new issues are published. We hope you make use of this service!

Journal Auto Subscribe:

You can auto subscribe so each new journal is automatically delivered to your email inbox:

  1. go to the link below and enter your email address (hopefully@woaltd.com)
    1. http://pt.wkhealth.com/pt/re/ovidspealerts
  2. select HTML and find the journal.  Add subscriptions to the active eToc box and this updates your account. 


Meditch 6.15 Downtime

On March 1st, Meditech will be down; please note the following:

  • Meditech will be down from 12 midnight until approximately 10 am, March 1st
  • CPOE needs to stop in general hospital at 10:30 pm, Feb. 28
  • CPOE stops in ER at 11:30 pm, Feb. 28
  • CRISP is the best resource for historical data and will be accessible via the internet from all devices.

Additional provider education can be found by visiting the Intranet.


TIGR: Coming Soon

TIGR is the nation’s leading interactive patient education solution – streamlining patient education and helping hospitals experience new levels of patient satisfaction, improved processes of care, and optimal outcomes. The on-demand system engages patients in their recovery by providing custom health education plans and hospital information to the patient’s bedside television. Since this technology requires hardware upgrades, changes in work flow and has many additional value added services that will benefit everyone, we will be rolling out the implementation in phases over the next year. Both hospitals at UM UCH will launch the first phase of our plans in June 2017. Stay tuned!


Red Pump Ball Raises $50k for HVI

In its tenth year, the Red Pump Ball recently raised over $50,000 in support of the Heart and Vascular Institute at UM UCH. To date, the event has raised over $290,000 to fund such things as a LIFENET System upgrade, medical equipment for the CVPR suite and, this year, an ultrasound machine with 3D and strain capabilities.

Held each year in February to celebrate American Heart Month, Mark Gonze, MD, served as honorary chairman for the event. For more information and to view event photos visit uchfoundation.org. Mark your calendar for next year!

*The first person to email fbarrueto@uchs.org with the correct names of those pictured below (in both photos) will win a $50 gift card to Looney's...St. Patrick's Day IS coming soon!


MEC and P&T Summaries

The following items are from the MEC meeting held on February 8. 

  • Continued CAUTI trend / use of Foley catheters
  • Proposed Bylaws amendments will be discussed at March 15th general staff meeting
  • Cardiac cath lab appropriateness criteria
  • Order sets approved:
    • COPD
    • Observation:  COPD
    • Hysterectomy, postop
    • ACS
  • P&T Committee items approved by MEC:
    • FEIBA (factor VIII inhibitor bypassing activity) checklist was approved
    • Formulary additions:  Cellcept and Gammagard
    • Formulary deletion:  flebogamma
    • Revised intrathecal infusion pump policy
    • ASP guideline revision
    • Isoproterenol – concentration change
  • Credentialing items approved by MEC:
    • CRNP delineation of privileges changed to include “Chest Tube Placement (pigtail catheter)”
  • General Staff Meeting:March 15th at 5:30 pm at the Maryland Golf and Country Club
  • Doctors’ Day Celebrations will be held as follows:

UCMC:  Wednesday, March 29th
                                Breakfast from 7:30 to 9 am in the Doctors’ Lounge
                                Lunch from 11:30 am to 2 pm in the Chesapeake Conference Center

         HMH:    Thursday, March 30th
                                Breakfast from 7:30 to 9 am in the Doctors’ Lounge
                                Lunch from 11:30 am to 2 pm in the Susquehanna Room


Upcoming Meetings and Events

Mark your calendars for important standing meetings and special events.

Special Events

  • Necessary Conversations: Informed Consent and Disclosure of Adverse Events …what to say, when, and how… legally, morally and ethically. 
    Save the date for a discussion on topics that will include Adverse Events and Medical Error, Unanticipated Outcomes vs Known Complications—the power of a solid informed consent conversation.  Also, Disclosures through Transparent Communications, “Apology” according to Maryland’s Apology Law, and UM UCH Policy and Your Legal Responsibilities.
    Thursday, April 6
    UCMC: 1-2 pm and 5-6 pm, Chesapeake Conference Center
    HMH: 1-2 pm (Admin Conference Room) and 5-6 pm (Medical Staff Conference Room)
    Credits: 1hr AMA Category 1 credit 
    Sponsored by UM UCH Risk Management and Medical Mutual of NC (formerly HPIX)  

  • Foundations of Spinal Cord Injury Management: Creating a Solid Foundation for Rehabilitation
    Designed to provide rehabilitation practitioners with the fundamental tools to manage spinal cord injured patients. This course will give practitioners with limited or no spinal cord injury experience the basic tools to create a solid foundation for rehabilitation.
    Saturday, Mar. 18, 7:30 a.m. – 3:30 p.m.
    The Conference Center at Sheppard Pratt, 6501 N. Charles Street, Baltimore
    Six contact hours of continuing education are available for PT, OT and SLP.
    For more information and to register, visit umms.org/rehabconf 
    *UMMS staff and students can attend for the discounted rate of $75 (regularly $100)!

Standing Meetings

  • Pediatric Grand Rounds: Held the first Wednesday of every quarter (Jan., Apr., July, Oct.) from 7 - 8 p.m. Guest lecturers present different topics in pediatric medicine, including common dermatologic conditions, effects and management of obesity in children, pediatric head injuries, and more.  
  • Multidisciplinary Thoracic and General Conferences: 12 Noon, Alternates Every Thursday (e.g., Thoracic is 11/3, General is 11/10)
    UM UCMC, KCC Streett Conference Room
  • Multidisciplinary Breast Conference: 8 a.m., Every Tuesday
    Radiology/Oncology Conference Room
  • Pharmacy &Therapeutics (P & T) Committee: 7:30 a.m., Third Wednesday of each month
    UM UCMC Maryland Room 
  • Credentials Committee 7:30 - 9 a.m., Third Friday of each month
    UM UCMC, MSCR 
  • Medical Staff Leadership  8 - 9 a.m., Fourth Thursday of each month
    UM UCMC, Fallston Room/UM HMH, MSCR
  • Metabolic Bariatric Surgery Committee: 5 p.m., Quarterly, Wednesdays
    HMH MSCR and UCMC Fallston Rm

    Upcoming dates: March 15, June 21, Sept 20, Dec 20