physician f lash february 2007 Find Everything You Need with the Saint Joseph Physician Portal http://easyaccess.trinity-health.org http://raportal.trinity-health.org/tibco/PUPSBApps Physician Flash is designed to keep you informed about the latest happenings in the Saint Joseph health system. This publication features new technology, services and programs important to you, your office staff and your patients. To access the information you need, do you have to remember multiple locations and Web sites to find different applications and resources? Now, everything you are looking for can be at your fingertips in a matter of seconds with the Saint Joseph Physician Portal. One location or log in using Trinity Health Easy Access, http://easyaccess.trinity-health.org, which will take you directly to Saint Joseph Physician Portal page. There you will find: • Clinical Applications • Resources • Calculators • Databases •E vidence-based Information • Calendars • CME Events •D ate, Agendas and Minutes for Committee Meetings •A Physician & Department Phone Directory Now up and running, the Saint Joseph Physician Portal offers one location where Physicians can find the clinical applica rces and other items they need. Access the portal on campus through a link located in our network’s Clinical Folder. For remote access off-campus, go to: http://raportal.trinity-health.org/tibco/PUPSBApps continued on page 2… To submit information or story ideas for future issues of Physician Flash, or to receive a copy of Physician Flash via e-mail, please send an e-mail to the Marketing Department care of Lindahl Wiegand, Editorial Specialist, at wiegandl@sjrmc.com. continued from page 1… “The main benefit of the portal is to locate all online clinical applications, database resources, and evidence-based content for our medical staff into one convenient, easily accessible site,” said Dr. Alan Snell, SJRMC Chief Medical Information Officer. We heard you! At Saint Joseph, we want to provide you with the tools you need to practice to the best of your ability. Your responses from the Physician Satisfaction Survey alerted us to how difficult it can be for you to access information. “Our Physicians have to access so many different Web sites, applications and programs for so many different resources,” Dr. Snell said. “At times it can be inconvenient and time costly.” While some of these intricacies will be alleviated once the hospital goes wireless, the portal will greatly streamline the process. “As long as they download Citrix ICA Client, Physicians can have a secure remote access to the portal from anywhere,” Dr. Snell said. To apply for Easy Access from Trinity, contact Jennifer Helmen, SJRMC Medical Librarian, at 237-7228 or helmenj@sjrmc.com. After you receive a username and password from Trinity, Jennifer can also assist with setting up your first login, if needed. Additional Features While the portal is constructed by Trinity, it maintains the Saint Joseph look, and all of the information is specific to our hospital system. Access Applications available on first page include: • Heart Lab •M ichiana Health Information Network • PowerChart/PowerChart Office • GroupWise •T eaching demos for Cerner as Genesis approaches The Physician Portal is available at all of our Saint Joseph campuses, in South Bend, Mishawaka and Plymouth. You will also have the capability for access from your home or office, with one initial download of Citrix ICA Client, which is needed to run the portal. “We will use the physician portal to assist the medical staff in our major transition to electronic inpatient records and computerized order entry for SJRMC’s Genesis project in early 2008,” said Dr. Snell. “It will also be essential as we move into our new acute care facility at It’s been an unbelievable start to 2007 for Saint Joseph Regional Medical Center. We have so much exciting news to share! On page1, find out how accessing the information you need may get easier thanks to our new Saint Joseph Physician Portal. page 2 On pages 4-5 read about Saint Joseph’s 913 CODE STEMI– our activation system for heart attack emergencies. The collaboration of the EMS units, ER, CathLab, and Cardiologists using this system has led to outstanding door-toballoon times for our patients. I hope you enjoy two new features of Physician Flash. Page 3 includes the Fan Mail we have received and recognizes Physicians who have been “PEG’d” by Saint Joseph Associates. Through your actions you have shown distinction with our PEGS - People, Excellence, Growth and Stewardship – and it hasn’t gone without notice. Another new addition includes the Physician Spotlight on page 7, which will feature one Saint Joseph doctor each month. Edison Lakes in 2009.” Two Web sites on the portal have been built locally, and are dedicated to the Medical Staff and Medical Library. The Medical Staff Web site will include: • Incidence Reporting • Licensing – NPI • Medstaff policies •C alendar of CME and committee meetings Medical Library Web site will include: • Online journals • Online textbooks • Database resources •R equired articles or literature searches Other Resources on the Physician Portal: • PDF of Physician Flash • Clinical calculators • Evidence-based order sets • Sign up to receive e-mail updates! Questions? For more information or a tutorial on using the Physician Portal and/ or getting a username and password to Easy Access, please contact Jennifer Helmen, SJRMC Medical Center Librarian, at 237-7228 or helmenj@sjrmc.com. Also, check out the long list of Physicians who have reached landmark years of medical practice (page 6), read about a new procedure being performed in our community (page 7), and see how local physicians are giving back (page 8). Thank you for the significant role you play that allows us to accomplish so much. Remember to help us get the word out your personal achievements! Please share your news with us at SJRMC. Contact Marketing Associate Lindahl Wiegand at wiegandl@sjrmc. com or 472-6903. Thomas F. Lavelle Jr., M.D. F.A.C.P., F.C.C.P. Fan Mail Edison Lakes Internal Medicine Just a quick note to say thank you to the office staff and the doctors there for all the services rendered to me during the past five years as a patient. I was first Dr. Kiran Singh’s patient and then Dr. Dahan Al-Fadhl. The office staff has been very courteous in all that they did for me. Dr. Dahan Al-Fadhl Thank you so much. You are the best doctor I have ever had. Sorry we had to move to Texas! ICU & Oncology Staffs I would like to recognize your staff for the care they provided to my husband, Denis Goulet. Denis spent the week of Dec. 17 – Dec. 26 at St. Joseph’s, spending six days in ICU and three in Oncology; he was in the final, aggressive stage of leukemia and had also sustained a subdural hematoma after a serious fall. During this difficult hospital stay, my daughters and I were more than impressed with the exceptional care that the nurses and medical staff provided. The ICU and Oncology ward nurses and medical staff showed professionalism and great medical skill. Everyone’s compassion, however, is what stays with me. I so appreciated their continuous gentleness towards my husband and empathy towards me. My daughters remarked that they appreciated how kindly nurses always spoke to Denis; even when he was unresponsive, nurses always addressed him, explaining any procedure they would perform, using a kind tone of voice. Denis himself recognized the nurses’ care, although speaking was very laborious for him, he did say, “The nurses are superb…they are superior.” Denis passed away on Dec. 26. Our family is in the midst of deep mourning. However, many experience sustain us during this time. One is a sincere appreciation for the wonderful care he received during his hospital stay. Thank you. You’ve Been PEG’d The following Physicians have been PEG’d by Saint Joseph Associates for exemplifying the Saint Joseph PEGS of People, Excellence, Growth and Stewardship. Dr. James Dyer “Thank you so much for your support and leadership during the rabies crisis. The teamwork was awesome.” Dr. Josephine Randazzo Dr. J. Timothy Aldridge “Thank you for helping out when no one else is around.” Dr. Dan Triezenberg Thank you for preparing the comments and scores for Rank Night. Your assistance came at a perfect time. We appreciate your help.” Dr. Robert Kolbe “For your kindness to patients. It makes them feel special when you let them know you care.” Dr. Genevieve Maloney “For seeing extra patients for us.” “Dr. Randazzo is an awesome team player and was sincerely dedicated to a patient and his family in need.” Dr. Kathleen Long Compliments for your care from a patient’s spouse were called into administration.” Thanks for your help! Marketing and Public Relations would like to thank the following Physicians for offering their time and information to appear in various medical stories or stories about Saint Joseph Regional Medical Center in local print media and television and radio stations. Your cooperation in enhancing Saint Joseph’s message and mission through the media is very much appreciated. Dr. Elizabeth Rutherford Dr. Juan Garcia Dr. Steve Gerber Dr. Bruce Harley Dr. Farid Jalinous Dr. Ashfaq Turk Dr. Jon Shenk Dr. Bruce Speicher Dr. Josephine Randazzo Dr. Jennifer Ludwig Dr. Michael Eifrid Dr. Joseph Prahlow Dr. Stephen Simons page 3 In Matters of the Heart, “ time —The Need For Speed It’s called Acute Myocardial Infarction (AMI). Most know it as a heart attack. Understanding it isn’t quite as complex as one may think. Blockage of a coronary artery deprives the heart muscle of blood and oxygen, causing injury to the heart muscle, which causes chest pain and pressure. If blood flow is not restored within 20 to 40 minutes, irreversible death of the heart muscle will begin to occur. “That’s why speed is so crucial when treating heart attacks,” said Saint Joseph Regional Medical Center’s Dr. Farid Jalinous. “The heart muscle continues to die, permanently replaced by scar tissue. It cannot be repaired because dead is dead.” How It Works In order for 913 CODE STEMI to work, coordination between all departments involved is critical. “What is truly a thing of beauty is the amount of pride everyone takes in their role,” said Dr. Jalinous. “It’s not rocket science – it’s an incredible human effort.” The ER physician activates a 913 STEMI call based on the EMS call in and EKG result. If the patient is a walk-in, the ED physician activates the 913 page as soon as the EKG is completed showing the ST elevation, which indicates a heart attack. The ER physician pushes one button on the telephone that alerts the cardiac CathLab team. They have 30 minutes to arrive. SJRMC Introduces 913 CODE STEMI According to the American Heart Association, nearly one million Americans suffer a heart attack each year. Four hundred thousand of them die as a result of their heart attack. This roughly means that every 65 seconds, an American dies of a heart attack. These sobering statistics prompted Saint Joseph’s AMI Taskforce to spearhead a collaborative system with Saint Joseph’s Emergency Department and Catheterization Laboratory (CathLab), and the local EMS communities, giving heart attack patients the best possible chance for survival. SJRMC’s initiative was met due to the commitment of the hospital’s Dr. Jalinous, Dr. Ashfaq Turk, and Dr. Josephine Randazzo, representing Cardiology for each of SJRMC’s campuses (South Bend, Mishawaka, and Plymouth), and Dr. Jon Shenk, serving as the ED liaison, and Dr. Bruce Speicher, serving as the EMS liaison. “Our system is an entirely coordinated effort between the EMS units, ER, CathLab, and Cardiologists,” Dr. Turk explained. “And it’s the result of meeting after meeting after meeting, this tremendous coordination, and the wonderful support of the Saint Joseph Administration.” The AMI Taskforce began meeting monthly at the end of 2004 and their perseverance and teamwork led to the 913 CODE STEMI (ST-Segment Elevation Myocardial Infarction) – Saint Joseph’s activation system for heart attack emergencies. SJRMC implemented the system on January 1, 2006. page 4 is muscle” Since Saint Joseph implemented its 913 CODE STEMI system, it has seen over 80 heart attack patients. The average times in each of the phases involved from door-toPCI put Saint Joseph well above the 35% of US hospitals meeting the gold standard. Some of the ER portion of 913 CODE STEMI Here’s why: Average Times Since January 1, 2006 ER Arrival to EKG Time– 5 minutes ER P hysician Exam from EKG Completion– 3 minutes ER Arrival to CathLab Arrival – 45 minutes ER Arrival to PCI – 80 minutes Eighty-two percent of heart attack patients SJRMC treated in 2006 had a door-to-PCI time less than 90 minutes. Dr. Farid Jalinous and Thad Cook of SJRMC’s CathLab get ready to perform a PCI procedure on a patient. SJRMC Compared To National Times In November, 2006, a national study found that only one-third of hospitals provide emergency care to heart attack patients quickly enough to meet scientific guidelines for saving lives, standardized by the American College of Cardiology (ACC). Studies show that reopening clogged arteries with Percutaneous Coronary Intervention (PCI), inflating a tiny balloon at the site of the blockage, can increase a patient’s chance of surviving a heart attack by 60%, but only if it is done within 90 minutes of the patient’s arrival at the hospital. This is the door-to-PCI time gold standard. The study, sponsored by the National Heart, Lung, and Blood Institute, reported that only 35% of hospitals in the United States meet the 90-minute, or less, gold standard door-toPCI time. Nearly half of US hospitals have a time between 91 to 120 minutes, 13% came in at 121 to 150 minutes, and 4% topped 150. “This protocol is great representation of the true team efforts to deliver higher quality care and better clinical outcomes across disciplines, both within Saint Joseph’s Emergency Room and CathLab, and the community through solid support of our local EMS,” said Chris Karam, SJRMC’s Vice President of Clinical Services. Time, commitment, a total team effort, and even a little luck, all factor into Saint Joseph’s successes in treating heart attacks. But luck is a luxury and never a given. “Oh, sure, we’re more fortunate during the day because there are just more people here and things are readily in place,” Dr. Jalinous explained. “But what is really impressive is the numbers we are turning out in the middle of the night when it can be tough to get a hold of people.” During the nighttime hours, Saint Joseph’s average door-to-PCI time is just over 70 minutes. “This is incredible and just shows the pride and dedication from everyone involved,” said Dr. Jalinous. The last ten patients Saint Joseph treated in 2006 experienced an average time of 60 minutes. Then there’s the case of Mr. John Snyder of Niles, Michigan. “I Want To Go To Saint Joe . . .” December 14, 2006, was just like any other Thursday for John Snyder who in just two weeks would be celebrating his first full “I told my wife to call an ambulance,” he said. “Something is drastically wrong.” While in the ambulance, the EMS crew asked him where he wanted to be taken for treatment. Though “very groggy” by admission, he was able to give a rather emphatic reply: “I want to go to Saint Joe Regional Medical Center,” he said. What followed, literally, minutes later, was nothing short of incredible. At 2:13 PM, the EMS called SJRMC/ South Bend as the 12-lead EKG was started. Immediately, Saint Joseph’s Emergency Dr. Bruce Harley called Dr. Turk in the CathLab. At 2:22, Snyder arrived at Dr. Ashfaq Turk helped spearhead SJRMC’s 913 CODE STEMI and administered PCI to Mr. John Snyder. Left - Dr. Farid Jalinous just before heading into the CathLab for a PCI procedure. Dr. Jalinous helped spearhead SJRMC’s 913 CODE STEMI. year of retirement. The unseasonably mild pre-Christmas weather allowed Snyder to get some exercise in his favorite way – a four-mile bike ride through the rolling hills of Southwest Michigan. Right - A closer look on the monitor at Dr. Farid Jalinous administering PCI to a patient. “On my Dad’s side of the family, four of my Uncle’s had heart problems,” Snyder said. “So I try to do what’s right in getting exercise by taking nice bike rides.” When Snyder returned from his ride, he sat down at his computer experiencing some unusual tightness in his chest. Thinking it was cold air he had taken in, he tried to ignore it – until the tightness persisted, turning to what he called “terrific pain” after just five minutes. CathLab X-ray Technician Pam Brawley monitors data as Dr. Farid Jalinous (seen on the monitor at the upper right) completes a PCI procedure. Paston, SJRMC’s Quality Care Coordinator. “It’s the culmination of hard work in progress from a great team that began in 2004. We are always looking for ways to improve patient outcomes.” Every month, each case is evaluated so the team can determine where those improvements can be made insuring the most efficient and safe treatment. “By attacking each facet of treatment separately, yet in precise coordination, we’ve been able to establish a realistic goal here of one hour across the board – one hour, or less, for every case,” said Dr. Jalinous. “That’s how it has to be because when you are dealing with heart attacks, time is muscle. Time is muscle.” Left to right, Elizabeth Berger, RN, and Heather Pepper, RN, are part of the 913 CODE STEMI team who helped initially treat Mr. John Snyder in the South Bend ER. the South Bend ER and was cared for by Dr. Harley and Saint Joseph’s Elizabeth Berger, and Heather Pepper. By 2:27, the EKG was complete. At 2:33, Snyder was in the CathLab, only eleven minutes from the time he arrived in the ER. By 2:50, Snyder was receiving PCI and the blockage in his artery had been cleared – an astonishing 28 minutes from his time of arrival. Saint Joseph’s team had shattered the gold standard time by 62 minutes! “They said it was a record,” Snyder said. “All I know is that everything was precision, precision, precision – and professionalism. And the treatment I received afterward was fantastic. This is why I tell everyone I know, ‘if you’re having a health problem, go to Saint Joseph Regional Medical Center.’” Mr. John Snyder is examined by Dr. Ashfaq Turk during a follow-up visit after he received treatment from SJRMC while having a heart attack. Mr. Snyder received PCI at SJRMC’s CathLab in just 28 minutes after entering the Emergency Room. A very special thank you to Saint Joseph’s core AMI Taskforce that began this journey to excellence in 2004: Jeanne Dodds, Sue Fritz, Dorothy Potts, Rich West, Bridgette Dudash, Deb Berger, Ronnie Pinter, Keely Paston “One Hour — Across The Board” Even if it’s just a handshake or a pat on the back, Mr. Snyder’s case is cause for some type of celebration, and the EMS, Saint Joseph’s ER, and CathLab deserve all the accolades. But Saint Joseph’s 913 STEMI CODE team will not rest on its laurels. “This is by far the fastest ER arrival to PCI time I have ever heard of,” said Keely page 5 Medical Staff Recognizes Dr. McCrea for Years of Leadership Dr. Michael McCrea was recognized for his guidance and service on the Medical Staff during the last Saint Joseph Quarterly Medical Staff Meeting held in January. Dr. McCrea was President of the Medical Staff in 2005 and 2006. He also served as Vice President for two years, SecretaryTreasurer for two years and Chair of the Radiology Department for three years. The duties included in his various positions over the years included the Medical Executive Committee, the Physician WellBeing Committee and the Credentials Committee. During his tenure as President, Dr. McCrea was very instrumental with the Bylaws Committee during a major revision of the bylaws project. A member of a local band, Dr. McCrea received an electronic drum set along with a plaque as a parting gift. Dr. Michael McCrea accepts a plaque from Lori Price for his years of service on the Medical Staff. The new Medical Staff Appointments for 2007 – 2008 include: Samuel Milligan, MD President David Tribble, MD Vice-President F. Moncrief Dobson, MD Secretary/Treasurer SJRMC Chief Operating Officer Lori Price, Dr. Michael McCrea, CEO and President Nancy R. Hellyer and Chief Medical Dr. Thomas Lavelle pose after recognizing Dr. McCrea at the Quarterly MedStaff Meeting. At the Quarterly Medical Staff Meeting in January, the following Physicians were recognized for their years of practice. 45 Years 35 Years John J. Byler, M.D., Family Medicine Richard C. Buck, M.D., Family Medicine George B. Friend, M.D., Surgery/General & Vascular Earl J. Heller, M.D., Orthopedics 30 Years Thomas F. Lavelle, Jr., M.D., Medicine/Pulmonary Medicine Robert N. Hunt, M.D., Medicine/Infectious Diseases Juan C. Garcia, M.D., Medicine/Hematology/Oncology Michael R. Johns, D.D.S., Dental/Pediatric Dentistry Daniel W. Kletzing, M.D., Surgery/Otolaryngology 25 Years Stephen T. McTigue, M.D., Surgery/Otolaryngology Stephen Mitros, M.D., Orthopedics John N. Porter, M.D., Anesthesiology Lawrence R. Curry, D.O., Family Medicine Debra R. McClain, M.D., Family Medicine James M. Debereaux, M.D., Emergency Medicine Etta K. Nevel, M.D., Obstetrics & Gynecology 20 Years Hendrica E. Sisk, M.D., Pediatrics John J. Cavanaugh, M.D., Medicine/Endocrinology Rebecca Moskwinski, M.D., Family Medicine Richard J. Wein, M.D., Medicine/Internal Medicine James P. Kelly, M.D., Surgery/Cardiac & Thoracic Surgery Stephen M. Simons, M.D., Family Medicine Patricia A. Jordan, M.D., Family Medicine James F. Blechl, M.D., Family Medicine Holly L. Harris, M.D., Medicine Dermatology James B. Harris, M.D., Pediatric/Pediatric Allergy/Immunology Bernard J. Asdell, D.D.S., Dental/Oral Surgery Ana S. Cardenas, M.D., Family Medicine John Bernero, D.O., Medicine/Cardiology Theodore R. Neumann, M.D., Family Medicine Robert J. Rust, M.D., Radiology page 6 20 Years continued — Nancy K. Madden, M.D., Obstetrics & Gynecology Jan E. Sanders, M.D., Pediatrics Kurt H. Stiver, M.D., Obstetrics & Gynecology John H. Mahon, M.D., Orthopedics Walter H. Halloran, M.D., Surgery/Cardiac & Thoracic Surgery Carlton L. Lyons, M.D., Obstetrics & Gynecology Michelle A. Migliore, D.O., Family Medicine Mark Stanish, M.D., Medicine/Internal Medicine David B. Tribble, M.D., Family Medicine Arthur F. Wang, M.D., Family Medicine Alan J. Birnbaum, M.D., Medicine/Rheumatology Ruta Gandhi, M.D., Pediatric/Pediatric Allergy/Immunology Guy Kedziora, M.D., Radiology/Radiation Oncology Cynthia Mayfield, M.D., Medicine/Dermatology Kosaraju R. Rao, M.D., Pediatric/Pediatric Allergy/Immunology Thomas A. Soisson, M.D., Pediatrics Richard A. Stoldt, M.D., Family Medicine 10 Years Michelle I. Cervin, D.O., Family Medicine Susan H. Ballinger, M.D., Pediatric/Pediatric Rheumatologist Edward J. Durbin, M.D., Obstetrics & Gynecology Charlie Higgs-Coulthard, M.D., Family Medicine Jeffrey P. Lindquist, M.D., Anesthesiology Timothy S. Smith, M.D., Radiology Jeanne E. Ballard, Obstetrics & Gynecology Rachelina P. Bartlett, Medicine/Internal Medicine Raman L. Mitra, M.D., Medicine/Cardiology Janet A. Galanes, M.D., Family Medicine Lisa M. Moore, D.D.S., Dental/Pediatric Dentistry William H. Stonehill, M.D., Surgery/Urology Nicholas R. Straniero, M.D., Medicine/Rheumatology Douglas M. David, M.D., Family Medicine Josephine Randazzo, D.O., Medicine/Cardiology Nita R. Gerig, M.D., Pathology 5 Years Jennifer L. Ludwig, M.D., Family Medicine Associate Director Saint Joseph Family Medicine Residency Physician trained in New Esophageal Procedure at Mishawaka After completing training, Dr. Norbert Schwer recently performed a procedure at Saint Joseph Regional the Residency, Dr. Ludwig colposcopic, dermatologic, Medical Mishawaka that is experiencing the other and other similar proce- may be considered one of side of the program – as dures. the better alternatives to a teacher. At the end of the day, Dr. Nissen fundoplication for When she’s not teach- Ludwig and her husband patients suffering from ing residents and medical Dave manage to stay busy GERD. students or holding work- at home - which isn’t dif- In this less invasive proceshops, Dr. Ludwig keeps ficult with their four chil- dure, generally performed busy with patients in her dren, ages 2, 4, 6 and 8. in an outpatient endoscopy private practice at Associ- “I wanted to balance my suite, an endoscopic devise ates in Family Medicine. career with family life,” (Plycator) is used to correct Certified by the American she said. “I thought family the underlying mechanical Board of Family Medicine medicine would be con- defect that causes GERD. and a Fellow in the Ameri- ducive to that, and it has The Plycator is guided can Academy of Family been.” down the esophagus to Physicians, she handles evAt the Saint Joseph Fam- the gastro esophageal juncerything from pre-natal ily Medicine Center, Dr. tion where a fold is created care to delivering babies to Ludwig is grateful for the and a suture is delivered to adult health. opportunity to provide hold the fold in place. “I picked this specialty be- care to the uninsured and The fold results in fullcause of the diversity,” she underserved population of thickness placation, which said. “I enjoyed obstetrics, our community. tightens tissue at the gastro but I also wanted to care “Saint Joseph cares so much esophageal junction and for the babies after delivfor the poor and indigent,” restores the anti-reflux ery, as well as the rest of she said. “Originally, that’s barrier. The Plycator and the family.” why I was drawn to this or- endoscope are removed, Dr. Ludwig also wanted ganization, because of our and most patients are disto perform medical proce- outreach and our faith- charged home within a dures in her practice. Now based origins. I’m proud couple of hours. she regularly performs to work here.” In every issue of Physician Flash, we will spotlight one Saint Joseph doctor working in our community. We want to recognize and thank all of our physicians for your hard work and commitment to improving the health of all we serve. If you wish to nominate someone for the Physician Spotlight, please contact Lindahl Wiegand in Marketing at 472-6903 or wiegandl@sjrmc.com. Service Recognition Devon W. Frash, M.D., Family Medicine Physician Spotlight on… Morris S. Bollegraf, D.O., Family Medicine Walter D. Kolmodin, D.P.M., Orthopedic/Podiatry 5 Years continued — Michael Rodriguez, M.D., Obstetrics & Gynecology Ziya D. Toper, M.D., Pediatrics Stephen D. Kennedy, D.O., Family Medicine Abul W. Basher, M.D., Medicine/Cardiology Brian N. Carter, M.D., Family Medicine Mark H. Hoyer, M.D., Pediatric/Pediatric Cardiology Daniel C. Maloney, M.D., Family Medicine Sachin R. Patel, M.D., Medicine/Cardiology Christopher D. Powers, M.D., Medicine/Cardiology Alfredo V. Casetti, M.D., Surgery/General & Vascular Uthman Cavallo, M.D., Obstetrics & Gynecology Edward P. Delle Donne, M.D. Surgery/Colon & Rectal Surgery Laura A. Hester, M.D., Family Medicine Henry Kim, M.D., Orthopedics Emily C. Walvoord, M.D., Pediatric/Pediatric Endocrinology Michael A. Yergler, M.D., Orthopedics Ilana T. Kirsch, M.D., Obstetrics & Gynecology Fred M. Busse, M.D., Pathology John P. Grand, M.D., Pediatric/Neonatology John W. Landgraf, M.D., Pathology Rolan A. Pascual, M.D., Medicine/Hematology/Oncology Rajendra V. Shah, M.D., Obstetrics & Gynecology Matthew S. Brennan, D.D.S., Dentistry David W. Douglas, D.D.S., Dentistry Nancy B. Johnson, M.D., Pediatric/Pediatric Endocrinology William B. Coulter, D.D.S., Dentistry Terrance P. Mahoney, D.D.S., Dentistry George A. Mighion, D.D.S., Dentistry Sloan S. Shah, M.D., Obstetrics & Gynecology Michael Jagger, M.D., Pediatrics Marybeth F. McClure, D.O., Pediatrics Mary E. Graber, M.D., Pediatrics MaryJo S. Meier, M.D., Pediatrics Robert C. Burke, M.D., Radiology Kathryn L. Park, M.D. Medicine/Physical Medicine & Rehabilitation Jennifer A. Nordby, M.D., Pediatrics Dr. Jennifer L. Ludwig’s interest in healthcare started long before her days of studying and taking tests in medical school. Instead, it blossomed from hearing her mother’s personal experiences with patients as an ER and ICU Nurse. “I remember as a little girl hearing all her stories,” she said. “It just seemed so exciting.” A Michiana native, Dr. Ludwig attended the University of Notre Dame and the Indiana University School of Medicine, before returning back to South Bend. She began her residency at Saint Joseph Regional Medical Center as her mother was wrapping up 20 years as the Executive Director of Women’s & Children’s Services at the hospital. Now, eight years later as an Associate Director of page 7 Sister Maura Brannick Health Center Helps “Give Kids a Smile” Kids like to smile and SJRMC’s Sister Maura Brannick Health Center made sure the brighter, the better. The Near Westside clinic in South Bend provided free dental services to area children, on Feb. 2, in an effort to make parents more aware of oral healthcare. The Sister Maura Brannick Health Center’s participation was part of “Give Kids A Smile Day,” a national initiative by the American Dental Association (ADA) to focus attention on the epidemic of untreated oral disease among children. Nearly 51,000 dental professionals and volunteers provided free educational, preventive, and restorative dental services to children at 2,137 locations across the United States. “An event like this really helps to make the community aware that oral health is important to kids of all ages,” said Carla Bice, Director of the Sister Maura Brannick Health Center. “This was our first year involved with this and, as always, we’re glad to do anything that we can to help.” The Sister Maura Brannick Health Center provided free fillings, X-rays, cleanings, and information on further treatment plans, where necessary, to 14 children during a four-hour stretch. The clinic also used the day as a way of familiarizing very young patients with a dental office. “Some kids can be seen by a dentist as early as age two,” said Darlene Barnes, Dental Assistant at the Health Center. “Even if it’s just making them aware of the environment. As with every patient, we want those who are very young to have a pleasant dental visit in a friendly atmosphere in the hopes of eliminating those natural fears we have about going to the dentist.” Also eliminated were a lot of stained teeth, as the Colgate-Palmolive Company supplied over 275,000 toothbrushes and sample sized tubes of toothpaste for children at “Give Kids A Smile Day” events nationwide. Dr. George Mighion takes a look at Daniel Koehler’s teeth as part of Give Kids A Smile Day at the Sister Maura Brannick Health Center. The clinic was one of 2,137 locations across the United States participating in the initiative to create awareness about oral health for children. “Look, Ma! No cavities,” said Chris Koehler, showing off his smile after receiving free dental services as part of Give Kids a Smile Day at the Sister Maura Brannick Health Center. SJRMC RECEIVES MEDAL FOR ORGAN DONATION Honoring our mission to heal, SJRMC Associates have worked for several years with the Indiana Organ Procurement Organization (IOPO) to improve the process of organ donation. Because of that work, Saint Joseph recently received national recognition and was awarded the Department of Health and Human Services Medal of Honor for Organ Donation. From a pool of 787 hospitals with the eligibility criteria, there were 371 winning hospitals in the United States. Saint Joseph was one of seven hospitals in Indiana to receive the Medal of Honor. All winning hospitals had to achieve and sustain a donation rate of 75 percent or more from among eligible donors for at least a year. “We acknowledge the need for lifesaving organs for those who are sick and we have seen the comfort that grieving families can experience by donating the gift of life,” said Nancy R. Hellyer, SJRMC page 8 CEO and President. “We remain respectful to the needs of the donating patient and the patient’s family members at all times.” To raise awareness about the vital importance of organ and tissue donation to the nation’s health and to increase donation rates, the Department of Health and Human Services began the Gift of Life Donation Initiative in 2001. The SJRMC Donor Task Force joined the national collaborative effort to generate significant, measurable increases in organ donation by helping the national community of organ procurement organizations and hospitals to quickly identify, learn, adapt, replicate, and celebrate “breakthrough” practices that are associated with higher donation rates. The medal was presented Monday, Jan. 15 by Ruth Hutt, IOPOProfessional Services Coordinator, to Linda DeHahn, Donor Task Force Chairperson and to Keely Paston, Dee Harman, and Joan Hunt, collaborative team leaders, on behalf of the Donor Task Force and all leaders, requestors, and Associates at SJRMC who facilitate donation. From left, Ruth Hutt, IOPO Coordinator; Linda DeHahn, Center for Spiritual Care; Lori Price, Chief Operating Officer; Keely Paston, Quality Care Coordinator; Dee Harman, ICU; Paige Edison, ICU; Anne Short, ICU and Dr. Lavelle, Chief Medical Officer pose with the organ donation medals earned by Saint Joseph. Ed and Stroke Unit Partner Up A new system change has been put into place and inter-departmental collaboration between the Emergency Department and the Stroke Unit staff is improving the level of care SJRMC patients receive. A recent meeting between the ED and Stroke Unit staff implemented the system enhancement. It consists of having the NIH stroke scale scoring performed by stroke unit staff in the Emergency Department within 10 minutes on all possible thrombolytic CVA patients. “The change should improve our uniform assessment and ability to recognize changes that can affect treatment, since these staff members do this on a daily basis,” said Dr. Steven Susler, SRJMC Emergency Department Medical Director. The process also frees up the Emergency Department staff to attend to other critical duties. “Since scoring it is a complicated and in-depth task, it’s not easy to get good if you’re only doing it once a month,” he said. “It takes the stroke nurses a third of the time it takes us, because they do it regularly.” Finding Balance: Indiana nurse combines two jobs and time with grandchildren to live the American dream. _By Sandy Keefe, MSN, RN SJRMC’s own Diane Kirkpatrick, RN, was recently featured in ADVANCE for Nurses magazine, Vol. 5, Issue 1, page 10. The following story ran in the magazine’s “In the Spotlight” feature. Diane Kirkpatrick, RN, a weekend night nurse at Saint Joseph Regional Medical Center in South Bend, IN, has achieved a wonderful balance in her life by combining careers in nursing and real estate with family life. By working 12-hour shifts Saturday, Sunday and Monday nights at the hospital, Kirkpatrick creates a block of days for selling houses and playing with her grandchildren during the week. “I’ve been very fortunate and blessed in my four children and eight grandchildren,” she said. “I sold all of my kids houses within 5 miles of me, so we’re able to stay close.” Always Wanted to Be a Nurse When she became a single parent responsible for raising her children, Kirkpatrick turned to her childhood dream. “I went to the nursing program at Indiana University (IU) and graduated in 1991 — the same year my oldest son graduated,” she said. “I put myself and my kids through school with income from my real estate business, scholarships and a lot of student loans.” Pragmatic but determined, Kirkpatrick took stock of her resources and set an ambitious goal. “When I was raising my children, we didn’t have a lot of resources. I realized, ‘I have this much money to support my kids while I finish my degree,’” she recalled. “I had credits from my first college experience, but I had to redo all my sciences. I took 23 credit hours a semester to get through the nursing program quickly. “I was so motivated to do well I was named valedictorian of my class and received IU’s coveted academic and clinical excellence award, which was a tremendous honor.” Selling Houses A realtor since 1978 and the owner of a realty company for the past 10 years, Kirkpatrick finds her reputation brings her a comfortable client base. “I don’t do cold calls or go out and look for new listings, but now I have a reputation and receive referrals through word-of-mouth from satisfied clients and medical professionals in the community,” she said. Mature and wise in the ways of life, Kirkpatrick already has started planning for her retirement. “I just turned 62 in January and, although I will probably retire from full-time nursing in the next 2 or 3 years, I doubt if I’ll retire from real estate,” she said. “Right now, that third night shift is a killer, but splitting up the nights would require sacrificing time dedicated to the grandchildren. I really enjoy that block of free time during the week.” An Enduring Legacy Kirkpatrick is proud of her success in both professional arenas, but her greatest pride and most enduring legacy is her family. “When I became a single parent, my oldest was 16 years old,” she said. “Our resources were minimal and in some of those early months, my kids helped pay the bills with their paper route income. It was often their determination that inspired me.” Kirkpatrick took pains to ensure each of her four children were well-grounded. “They were all competitive swimmers, which instilled tremendous self-discipline, and I made sure they got really crummy summer jobs, so they could understand what life would be like without a good education,” she said. Today, two of Kirkpatrick’s children are teachers, her oldest son is a project engineer, and her youngest, whom she adopted at the age of 9 months, is a construction worker and an estimator for Home Depot. And in her spare time? “I’m an avid reader, but basically my hobby right now seems to be grandkids,” Kirkpatrick said. “I go to their Little League games and their swim meets, supporting them just like I supported their parents during all of those growing years.” A Perfect Day Immediately after graduation, Kirkpatrick worked for awhile as a staff nurse, and then explored other nursing positions. “I did interim management to fill in, but found I didn’t like a supervisory role,” she said. “I don’t like being the boss; I like being at the bedside. “A very wise person once said, ‘You cannot live a perfect day without doing something for someone who can never repay you,’” Kirkpatrick concluded. “Bedside nursing has afforded me many perfect days.” page 9 News Please send any news, honors, awards or certifications you would like to see included in Physician Flash to Lindahl Wiegand, wiegandl@sjrmc.com or contact her at 472-6903. Congratulations Dr. McGuire! New requirements for Physicians age 68 & Over Documentation of Co-Morbid Diseases Dr. Kelly Wayne McGuire recently fulfilled the necessary requirements to become a certified Diplomate of The American Board of Obstetrics and Gynecology, Inc. (ABOG). The ABOG is an independent, non-profit organization that certifies obstetricians and gynecologists in the United States. It is one of 24 specialty Boards recognized by the American Board of Medical Specialties. The ABOG examines and certifies nearly 1,700 obstetriciangynecologists and sub specialists in maternal-fetal medicine, reproductive endocrinology/ infertility and gynecologic oncology each year. Additionally, approximately 5,000 physicians are examined annually for the purpose of maintenance of certification. Section 4.A.5 of the new Medical Staff Credentials Policy now addresses clinical privileges after age 68: (a) “Individuals who desire to exercise clinical privileges after the age of 68 must obtain appropriate health assessments as part of the reappointment process.” (b) “Specifically, as part of the reappointment process, these individuals will be required to have a physical and mental health assessment performed by a physician who is acceptable to both the Medical Executive Committee and the applicant. The cost of the health assessment shall be borne by the applicant. The examining physician shall provide a written report, addressing whether the individual has any physical or mental condition that may affect his/her ability to safely and competently exercise the clinical privileges requested, discharge the responsibilities of Medical Staff membership, or work cooperatively in a hospital setting. The examining physician shall provide this report directly to the Committee and Documentation of co-morbid diseases is crucial to proper coding in the hospital setting as well as in the office. Documentation of the most specific diagnosis possible can significantly change reimbursement. In particular, there are three diagnoses that routinely require additional time by the case management staff. One is diabetes – it is important to note whether a patient has type I, type II, or type II on insulin. A simple diagnosis of “diabetes” is not adequate. Second, “anemia” should never be coded if you know the cause of the anemia. List blood loss anemia, anemia of chronic disease, bone marrow failure, GI bleed, or any other specific cause if it is known. Finally, renal insufficiency has been reclassified into multiple categories of chronic kidney disease based on the patient’s GFR and dialysis status. Please remember to document to the highest level of specificity and expect that a case manager may be speaking with you about clarifying these diagnoses. Spreading the Word Dr. Alan Snell, SJRMC Chief Medical Information Officer, recently spoke at the Bloomington E-Health Collaborative. Physicians and office staff were invited to join this regional discussion to learn how Indiana doctors are using electronic applications to improve their work while enhancing patient safety and quality. Dr. Snell spoke as the CEO of the Michiana Health Information Network. page 10 shall be available to discuss any questions or concerns that the Committee may have.” Beginning with the reappointment applications sent out April 1, 2007 for physicians whose last name begins with E through J, a health assessment will be required. Be sure to read the article in January Physician Flash for the Credentials Policy on clinical privileges for physicians age 75 and over. If you have any questions, please contact the specific Medical Staff Office where you have privileges: South Bend – Karyn Delgado, 237-7212 Mishawaka – Jean Patterson, 258-1299 Plymouth – Deb Traversa, 935-2260 Our Lady of Peace Hospital – Jackie Nadolny, 251-8238 remind health care providers of the number of days left before the compliance date; bookmark this page as new information and resources will continue to be posted. Providers should allocate a minimum of 120 days to achieve full use of the NPI, according to a MLN Matters article CMS issued January 4. With the May 23 compliance date approximately three months away, that leaves little time for providers to apply for and implement the new identifier. The article also provides guidance on the NPI transition and outlines the following areas: Hospital Committee Meetings Schedule New Medical Staff Officers for 2007-2008 President Samuel Milligan, MD Vice-President David Tribble, MD Secretary/Treasurer F. Moncrief Dobson, MD New Appointments Berneking, Michael W., MD, Family Medicine/Family Medicine Hadian, Djavid, MD, Medicine/Cardiology Byrne, Tracy S., MD, Obstetrics/Gynecology/Obstetrics & Gynecology Denson, Marilynn J., MD, Obstetrics/Gynecology/Obstetrics & Gynecology Roland, Sandra C., MD, Radiology/Radiology Medical Staff Meetings – February & March •C linical Resource Management Committee Feb. 15 & March 15, 7 a.m., Radiology Conf. Rm. •C redentials Committee March 2 & March 30, 6:30 a.m., St. Mary Conf. Rm. •E xecutive Committee March 5, 6 p.m., Ed Center ABCD •M edical Staff Officer’s Meeting Feb. 27 & March 27, 7 a.m., MedStaff Conf. Rm. •A nesthesia Department Tuesday, Feb. 13, 6 p.m., Patient Care Conf. Rm. – 3rd Floor •E mergency Department Feb. 20 & March 20, 8 a.m., the EMS Conf. Rm. •O B/GYN Department March 19, 12:15 p.m., Radiology Conf. Rm. •O tolaryngology Subsection Wednesday, Feb. 28 & Wednesday, March 28 7 a.m., St. Monica Conf. Rm. •P athology Department Feb. 27 & March 27, 8 a.m., St. Monica Conf. Rm. (South Bend Campus unless otherwise noted) •C ardiac Cath Committee - Feb. 22, 7 a.m., Radiology Conf. Rm. •C linical Operations Improvement Feb. 13, 7 a.m., St. Joe Conf. Rm. #1, Mishawaka Campus March 13, 7 a.m., Radiology Conf. Rm. •C linical Risk & Patient Safety Feb. 12, 11:30 a.m., St. Mary Conf. Rm. March 12, 11:30 a.m., St. Mary Conf. Rm. •C ritical Care - March 15, Noon, Radiology Conf. Rm. •E nvironment of Care Feb. 15, 1 p.m., Radiology Conf. Rm. March 15, 1 p.m., St. Joe Conf. Rm. #2, Mishawaka Campus • Ethic Advisory Committee - March 8, 7:30 a.m., St. Mary Conf. Rm. • I nfection Control Committee March 20, 12:30 p.m., St. Mary Conf. Rm. • I nstitutional Review Board Committee Feb. 15, 7 a.m., St. Mary Conf. Rm. • Maternal Child Services - Feb. 21, Noon, St. Mary Conf. Rm. • Oncology Committee - Feb. 20, 7 a.m., Cancer Institute Lower Level •P atient & Family Education Committee March 8, 10 a.m., Clinical Educ. Library – 6th Floor •P harmacy & Therapeutics March 13, 11:30 a.m., Radiology Conf. Rm. •Q uality of Care Feb. 28, Noon, Radiology Conf. Rm. March 28, Noon, Katherine Kasper Rm., Mishawaka Campus • Surgical Services - March 21, 6:15 a.m., St. Mary Conf. Rm. • Trauma Committee - March 2, 6:30 a.m., EMS Conf. Rm. Physician Concern Line “Hotline” calls — 280-5899 The Medical Staff is encouraged to call the hotline and leave a message regarding any concerns, complaints, or compliments. If a return call is desired, please leave your name and number and someone from the Medical Staff Office will get back with you. Mishawaka News Plymouth News Medical Mission to Nicaragua NPI compliance date approaching National Provider Identifiers (NPI) will be required on electronic claims sent on and after May 23, 2007. Every health care provider should obtain an NPI! The process is not time consuming and takes a short time to get once the request is submitted. Learn more about NPI and how to apply by visiting: http://www.cms.hhs.gov/apps/ npi/01_overview.asp on the CMS Web site. This page also contains a section for Medicare Fee-For-Service (FFS) providers with helpful information on the Medicare NPI implementation. A Countdown Clock is now available on this page to South Bend News On May 23, providers must use the new UB-04 paper claim form CMS requires providers to submit their NPI on the UB-04 Medicare providers who submit claims for their primary facility and its subparts must report a taxonomy code on all claims they submit to their fiscal intermediary in 2007 Providers must share their NPIs with other providers, health plans, clearinghouses, and any organization that needs the identifiers for use in standard transactions (e.g., to identify an ordering or referring physician) Dr. James Reidy and Dr. A. Brooks Crofoot, along with SJRMC nurses Betty Kella, RN, Sheri Nater, RN, and Vicki Thompson, RN, have recently returned from a medical and construction mission in Nicaragua. Latin American Ministries organized the trip through Harris Prairie Church. Dr. Reidy reported that the physical and emotional demands of the trip were tremendous. The work hours were very long and conditions were often hot, dry and dirty. Medical team members endured long rides in school buses and pick-up trucks to see patients in the Managua City Dump, Chinandega that is one of the poorest areas of the country. They also saw patients at a home for seniors and during an overnight stay in the rain forest region of Nueva Guinea. The nurses not only assisted in every aspect of patient care from triage and vital signs to direct patient care, they also pitched in to do some back- breaking concrete and construction work. Dr. Reidy expressed his personal appreciation for the Saint Joseph sponsored Spanish lessons at Holy Cross College. The classes and the two-week immersion in Guatemala enabled him to treat most patients without in interpreter, freeing one of the interpreters to help another medical team member. As a result, over 1,387 patients were seen this year as compared to 972 patients seen by the team last year. The medical staff of SJRMC-Mishawaka donated $1,000 to help purchase medical supplies for this mission. February Meetings • Medical Executive Committee/ Medical Credentials Committee Feb. 19, Board Room at Noon • Physician/Administrator Luncheon Feb. 23, Education Center at Noon page 11 SJRMC Kicks Off 2007 House Raffle with Media Tour of Home Journey to our Future — Chance to Win $340,000 Home Begins March 6 On Tuesday, Jan. 23, local media toured the $340,000 home that will be given away during the 2007 House Raffle. This marks the 16th year for the annual fundraiser for SJRMC’s Healthy Family Center and the Women’s Care Center. Built by Place Builders specifically for the House Raffle, this year’s house is located at 50620 Ryestone Dr., Granger, in the Northbrook Shores subdivision. The 2,743 square foot home has 4 ½ bedrooms, 3 full bathrooms, a second floor laundry, a 3-car garage, hardwood floors in the kitchen, nook and foyer, tray ceiling in the dining room, fireplace, whirlpool tub in the master bath, 801 E. LaSalle Avenue South Bend, IN 46617 physician flash Physician Flash is a monthly newsletter published for SJRMC Physicians. Nancy R. Hellyer President & CEO, SJRMC Thomas Lavelle, MD Chief Medical Officer, SJRMC Andrew J. Snyder Vice President, Marketing Lindahl Wiegand Editorial Specialist Christine Weist Graphic Design Specialist Jennifer Hopper Market Information Coordinator Mike Stack Public Relations Coordinator Janet Kenyon Administrative Assistant kitchen island, stone accents, and much more. The alternative cash prize is $200,000. “There’s a reason we have continued to do this for 16 years,” said Tim Sexton, VP of Community Development. “The House Raffle has made it possible for the Healthy Family Center and the Women’s Care Center to return more than $2.9 million in healthcare services or our community.” Second place winners can choose either a 2007 GMC Canyon or a 2007 Ford Mustang. Second prize cash alternative is $15,000. Third prize is $5,000 and fourth and fifth prizes are $3,000 each. Cash prizes from $175 to $1000 complete the 40-prize list. Offers will be available for purchase beginning at 8 a.m. on March 6 in the lower level conference area at the Mishawaka Campus Courtyard Entrance. Only the first 3,800 offers at $150 each will be accepted. Odds of winning are one in 95. All offers entered by noon on March 12, will automatically be eligible for an “Early Bird Drawing” of $2,007 to be held later that day. The raffle drawing will be held at 5 p.m. on May 4 at the Healthy Family Center, 201 Lincolnway West in Mishawaka. For more information, call 234-0078. As the new hospital progresses, we hope you enjoyed touring the mock-up rooms for the new facility. Another round of tours in late January brought in 36 Physicians and more than 230 Associates! The mock-up rooms were a crucial part of the design and development phase of the Edison Lake Campus. “Thank you for taking such an enthusiastic interest and helping us create rooms that will improve efficiency and patient safety,” said Nancy R. Hellyer, SJRMC CEO and President. Special thanks goes to SJRMC Strategic Project Manager Sarah Hoshaw for her hard work building, touring and now tearing down the mock-up rooms. What’s new? A Web cam of the construction site is now up and running on w w w. m y n e w h o s p i t a l . o r g Weather permitting, you will be able to watch the concrete for the footings of the building be poured this month!