October 2016

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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, October 2016 topics include:


Welcome

Every day when I walk into work I am amazed by the heroics that occur on a daily basis. In just the past month, we had a complicated Abdominal Aortic Aneurysm save, an emergent airway expertly handled, and a family consoled by a compassionate hospitalist during their loved one's final days. The pressures to provide high quality care, maintain work-life balance and the ever-changing landscape of health care has led to multiple reports of increased burnout among our physicians, APCs, and nursing staff. It is not easy to recognize burnout or what to do if you are experiencing it. The first part is recognition and there are self-assessment surveys out there like this one

This issue of eFocus will have a variety of things to improve the provider’s well-being. Feed the soul by giving to others. The benefit of reading to our newborns is something many of us take for granted. The benefits of reading for a newborn’s brain development are well known and researched. The Medical Staff Office will be starting a Books for Babies program to support the Newborn Nursery and Dr. Marie Kanagie-McAleese's efforts. Read on about the details of the program and how you can help by donating children’s books. We are also including an invitation from the Maryland Hospital Association for a conference that is dedicated to clinician burnout. There is no easy fix, magic bullet or pill that will address burnout. Becoming self-aware, addressing the things we can control and reaching out for help is the start. Chocolate and other candy may also help during this time of year. Happy Halloween everyone; see you in November. 

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


Books for Babies at UM Upper Chesapeake Medical Center

Mission statement: The Books for Babies program is designed to provide developmentally appropriate books to families of at-risk infants in Harford County, MD. Our goal is to offer more opportunities for families to read together, and promote literacy and school readiness.

Research has shown that reading frequently to children within the first five years of life helps to promote brain growth and development,1 and exposure to a greater vocabulary in early childhood improves school readiness.2 However, many families do not include reading in their daily routines, and at least 1/3 of families below the poverty line do not read regularly to their children.3 The Reach Out and Read program, started in 1991, has proven that pediatricians and primary care providers can promote reading and literacy, which in turn improves school performance.4,5,6

Cognitive development of a child is influenced by genetic, perinatal, and environmental factors. Of particular importance in today’s society is the rising rate of drug-exposed newborns. Narcotic use during pregnancy increased in the US from 1.2 per 1000 live births in 2000 to 5.6 per 1000 in 2009, and the rates continue to rise.7 The rate of narcotic abuse within Harford County has been rising faster than that for the entire state of Maryland,8 and the numbers of drug-exposed newborns born at UM UCMC have also risen over the past several years. Data suggests that children who experience narcotic withdrawal after birth, or neonatal abstinence syndrome (NAS), have higher incidences of ADHD, cognitive delay, and poor school performance.9 It is crucial to encourage a supportive home environment for families affected by NAS; providing families with the information and tools needed to accomplish this is critical to promote global development.

The aim of the Books for Babies program is to provide developmentally appropriate books for infants with NAS and other at-risk infants during the hospitalization in the Special Care Nursery at UM UCMC. This program is one arm of the global infant development initiatives being established at UM UCMC, which also includes occupational therapy involvement to teach infant massage to parents. The books provided will include alphabet books and picture books, so that all parents, including those with lower literacy levels, can read to and interact with their babies. Families will also be provided with education and information on the importance of reading to infants, and how to establish reading into their daily routines. We will encourage parents to read to their infants both while hospitalized, and after discharge. Ideally, the bond between parent and child will be deepened, a love of reading will be established, and more children will enter school ready to learn and prepared for success.

See attached list of suggested books and program description. The first person to email fbarrueto@uchs.org with the titles of three suggested books for the program will win a $20 Starbucks gift card.

Book drop-off locations include the following:

UM UCMC

  • Physician lounge
  • Pediatrics unit
  • Peds ED
  • Outside of the Family Birthplace
  • Children's Center waiting room
  • Outside of the cafeteria

UM HMH

  • Physician lounge
  • Outside of the cafeteria


Dr. Phil's Corner

  • After his young wife died unexpectedly, Peter DeMarco wrote a letter to the caregivers who helped him cope.  Read the full article to see how we as caregivers impact people’s lives.
  • Corporate culture is more important to your happiness than salary, title or position. But how can you find out what the corporate culture is?  Read this article to think about the great stories people would tell about UM UCH.

Clinical Highlights

Dr. Meghan Milburn’s practice recently received the SAVI Center of Excellence Designation. This award honors practices that have reached the highest levels of care in radiation oncology. SAVI is an advanced form of radiation therapy used in early stage breast cancer that allows physicians to precisely target treatment where it is needed most. 


Safety Update

UM UCH conducted the Hospital Survey on Patient Safety Culture in August 2015. The lowest scoring composite of the survey was Non-punitive Response to Error. Non-punitive Response to Error “relates to the extent to which team members and providers feel that their mistakes and event reports are not held against them and that mistakes are not kept in their file.” A multidisciplinary team is working to integrate “Just Culture” principles into the response to events process at UM UCH. We are developing an algorithm to ensure there is a standardized approach regardless of role.


MEC and P&T Summaries

New Forms:

  • Discharge Checklist

New Protocol:

  • ED Protocol for Management of New-Onset Atrial Fibrillation/Flutter

P&T Committee:

  • Entereg removed from formulary
  • Automatic substitution: ceftazidime to cefepime

Order Set Updates:

  • PICC/CVC/Mid-Line Placement, Adult
  • PED PICC/Mid-Line Placement
  • ICU ADM
  • IMC ADM
  • PCA IV & Adjunct
  • Warfarin, Initial
  • CRRT Heparin
  • CRRT Citrate
  • Negative Pressure Wound Therapy (VAC)
  • Pneumococcal Vaccine
  • Preop, Day of Surgery
  • GEN Appendectomy, Postop
  • GEN Cholecystectomy, Postop
  • GEN Hernia Repair, Postop
  • GEN Intestinal Surgery, Postop
  • GEN Thyroid/Parathyroidectomy, Postop
  • No Anticoagulant/No Antiplatelet List
  • ICU IV Insulin

Top Docs

Twenty-six doctors (three of whom were named in multiple categories) who practice at UM UCH were recognized as "Top Doctors" in the November 2016 issue of Baltimore magazine. The results are based on a survey of nearly 12,000 physicians in the Baltimore area, including Baltimore City and the surrounding seven counties, asking where they would send a member of their family in dozens of specialties. 

Check out our list of "Top Docs" and their specialties at umuch.org/topdocs. Congrats to all!


Upcoming Meetings and Events

Mark your calendars for important standing meetings and special events.

Special Events

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., Second 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