The Valley Health System
Physician Update - July 2013
Three Valley Health System Hospitals Offer
Both Single-Site™ and Multi-incision
da Vinci® Robotic Surgery
Latest da Vinci SI robotic systems now available
Centennial Hills, Spring Valley and Summerlin hospitals
Currently, the surgeries listed below are performed
robotically at one or more of our hospitals:
 General Surgery: Single-Site™ da Vinci Surgery
for Gallbladder Disease (Cholecystectomy)
 Multi-port Cholecystecomy
 Gynecological Surgeries: endometriosis
removal, hysterectomy, myomectomy, ovarian
cystectomy, sacrocolpopexy, unilateral/bilateral
salpingo oophorectomy
 Urological Surgeries: nephrectomy, partial
nephrectomy, prostatectomy, pyeloplasty
 Nissen Fundoplication
 Bowel resections
Y-90 Procedure for Metastatic Liver Cancer
Patients Available at Centennial Hills
SIR-Spheres microspheres for patients with metastatic
liver cancer is now available at Centennial Hills
Hospital. SIR-Spheres microspheres are the only fully
FDA-approved microspheres for colorectal cancer that
has metastasized to the liver. Interventional radiologist
Trey Pham, MD, performed the first two cases on
July 24.
The microscopic radioactive spheres are delivered by the
millions directly to the tumor site. The microspheres
contain the radioactive isotope yttrium-90 (Y-90), which
delivers beta radiation to the tumor. The microspheres
selectively target liver tumors with a dose of internal
radiation up to 40 times higher than conventional
radiotherapy while sparing healthy tissue.
EP Lab Will Be First of Its Kind in Nevada
Coming in 2014…Desert Springs will be the first in
Nevada to have an EP lab with Stereotaxis robotic
navigation, which delivers advanced technology for the
treatment of cardiac arrhythmia. They will also have a
new 256-slice CT scanner in late 2013; it will be the
only hospital in Southern Nevada with this technology.
MAKOplasty ® for Knee & Hips
Valley Hospital is the only facility in Southern Nevada
with MAKOplasty robotic capabilities for knee and hip
surgery. If your patients could benefit from the newest
technology, please encourage them to attend our
upcoming seminar on July 29 at 5:30 p.m. in the
Graduate Medical Education Auditorium. Call (702)
388-4888 to RSVP; walk-ins welcome. Valley also has a
new MRI which was installed a few months ago.
People News
Edwin “Flip” Homansky, MD, is Regional Chief Quality
Officer for VHS.
Daniel McBride, MD, is Regional Chief Medical Officer
for VHS.
Lynda Smirz, MD, MBA, is Chief Medical Officer and
Vice President of Quality for our parent company,
Universal Health Services; she is based in Pennsylvania.
Clinical Integration Update
Over 300 practices and almost 1900 physicians have
now joined The Valley Health System Quality Care
Alliance. To participate, please contact
Allyson.Hoover@uhsinc.com or call 702-460-1568.
Coming This Fall: Cerner 2+
This includes:
 PowerChart Maternity/FetaLink Replacement
for OBTraceVue and QMI
 Bridge Blood Product Barcoding (nursing)
 Anesthesia documentation, including pre- and
post-documentation
 CPOE for IP physicians with all content
available, primarily adding OR and OB order
sets.
Go-Live Dates:
 Centennial Hills – October 8
 Spring Valley – October 17
 Summerlin – October 29
 Desert Springs – November 12
 Valley – December 3
Look for more information to come from Information
Services.
Continued on page 2
Site Marking Reminders
OB Sterilization Consent, cont.
Please ensure these documents are received in order that
they are placed in the patient’s medical record.
Questions? Contact any Women’s Services director.
Site markings are mandatory for every procedure
except the three noted below:
Peripheral IV insertion
Urinary catheter insertion
Central line insert
What Patients Are Saying: Delays in
Discharge Leads to Decreased Satisfaction
Page 2 – VHS Physician Update, July 2013
Important Patient Transfer Announcement
The “Authorization and Consent For Transfer Form”
(Cobra form) has been revised and is to be used on all
patient transfers to other licensed facilities (including
SNFs, Group Homes, Inpatient Rehab. assisted living,
behavioral health, etc.).
Several of our VHS hospitals have received State
Regulatory Citations for failure to complete required
patient transfer documentation and this revised form and
transfer process is a part of the Hospital’s Plan of
Correction (POC).
The “Authorization and Consent For Transfer Form”
(PMM#41832) is available on Forms On Demand (FOD)
and can be copied and/or ordered as “tri-fold” from
IKON. Do not print or make copies of existing forms as
the version that has been previously copied may not be
the up to date version.
Note: The transfer form is to be entirely complete with
no "blanks.” If areas on the form are not applicable to
patient, N/A must be documented.
OB Sterilization Informed Consent
Federal regulations and Nevada Medicaid policies
require that the informed consents for sterilization
procedures must be obtained at least thirty (30) days in
advance of the surgical procedure and in the appropriate
format as defined in the requirement of 42 C.F.R.
§441.257 and 441.258. The “Physician’s Statement”
form must be signed by the physician shortly before the
sterilization is performed. The VHS facilities must have
a copy of both forms on the chart to substantiate the
billing. This requirement applies to any federally
funded insurance program (Medicaid / Medicaid
HMO / Medicare / TriCare).
Most providers are filling out this form 30 days in
advance in their offices. The form must be present in the
patient’s hospital chart at the time of her tubal
sterilization. The physician must fill out the remaining
portion of this form at the time of the procedure. There
are specific provisions in the C.F.R. § 441.258 for
premature delivery or emergency abdominal surgery.
Every patient who is discharged home receives a posthospital discharge follow-up call. Based upon feedback
from the calls, a delay in their discharge has resulted in
lower patient satisfaction. Example: patients are told
they will be discharged the next morning but don’t
actually leave the hospital until late afternoon or
evening.
To improve the patients’ experience and throughput
from admission through discharge, please round on
patients in the Med/Surg units first to evaluate likelihood
of discharge. This allows us to transition patients from
higher to lower levels of care more quickly.
Earlier discharges also result in safer discharges since
patients can get their medications filled through our
Walgreens Bedside Delivery Program weekdays from 11
a.m. to 8 p.m. or the pharmacy of their choice; schedule
follow-up appointments right away; and just be in the
comfort of their own home.
Readily available Med/Surg beds allow us to relocate
critical care patients from the ER to the ICU, increasing
patient safety and satisfaction for everyone.
Hand Hygiene Reminders – No Exceptions
For alcohol hand gel to be effective, it requires a
minimal contact time of about 15 seconds – not waving
the hands in the air to accelerate drying.
All members of the medical staff should continue to be
vigilant in their hand hygiene with each patient contact,
particularly after removing gloves. As agreed by the
medical executive committees, members of the medical
staff who are observed not performing hand hygiene
maybe referred to the peer review committee.
Soap and water are effective and simple and is required
for patient with CDIF disease, or if gross soiling is
apparent. A 15-second process using both soap and
warm water will effectively remove transient organisms.
For encounters where there is not obvious soiling of the
hands, and after removal of examination gloves, the
alcohol hand gel, with a dry time of about 15 seconds
will successfully eliminate the transient organisms from
the hands. Questions? Contact your hospital’s Infection
Prevention specialist.