Clinical News

CREST study results 3

Wilmington campus update 4

Transformation

Lab & Pathology automationimproves processes 5

General News

Great Place to Work:A look back at 2009-2010 6

CPOE launch success bodeswell for Christiana HospitalMarch 23 start-up 8

Practical advice on quickhealthy meals at home 17

Virginia U. Collier, M.D., Hugh R.Sharp Jr. Chair of the Department ofMedicine.

Leadership in advocacy, outreachThe program is honoring ChristianaCare for its leadership in patient educa-tion and support services and in com-munity outreach. Christiana Care “cap-tures the true spirit of Zakheim’sefforts against chronic kidney disease(CKD) by championing key issues inthe transplant and nephrology commu-nities with passion and quality leader-ship.” Dr. Zakheim, a New Jerseynephrologist, was a leader in bringingexcellent CKD care to the region.

“Our leadership involves our neigh-bors, not just our patients. Advocacyand outreach are part of being atChristiana Care,” says John Swanson,M.D., FACS, chief, Christiana CareKidney Transplant Program.

Three-and-a-half years ago, therewas no kidney transplant program

serving adults in Delaware. Today, 51patients have received transplants atChristiana Care and the NationalKidney Foundation has recognizedour remarkable success.

For its outstanding work in fightingchronic kidney disease, ChristianaCare’s Kidney Transplant Program hasearned the National KidneyFoundation’s Bruce Zakheim, M.D.,Memorial Legislative and AdvocacyAward. The National Kidney Found-ation serving the Delaware Valley(NKFDV) presented the award onMarch 6 at the 26th annual Kidney Ball.

“Christiana Care is grateful to theNKFDV for recognizing the outstand-ing care that our kidney transplantprogram brings to Delaware patientswith chronic kidney disease,” says

Kidney Transplant Program wins honors

C O N T I N U E D , P. 2

F O C U SFocus is published only oncethis month. The next issue willcome out on April 8, 2010.

John Swanson, M.D.,FACS, chief,Christiana CareKidney TransplantProgram, andStephanie Gilibert,M.D., KidneyTransplant Programmedical director,accept the BruceZakheim, M.D.,Memorial Legislativeand Advocacy Award.

meet monthly and are open to areapatients transplanted in other hospi-tals.

n See listed patients regularly, ensur-ing that they are well and able toreceive the transplant.

On average, patients wait 52 monthsfrom being listed for transplant toreceiving a transplant from a deceaseddonor. A living kidney donor allowsthe transplant to proceed without thiswaiting time.

‘Everyone contributes’Stephanie Gilibert, M.D., KidneyTransplant Program medical director,says, “The entire practice is a multidis-ciplinary undertaking. Everyone in thecenter contributes to what we do.”

To ensure that all Delawareans haveconvenient access to excellent end-stage renal disease care, the programrecently established a satellite clinic inLewes.

In different parts of the state twice ayear, the program holds a patient edu-cation symposium for CKD patientsand their families, typically reaching150 to 200 people each time. The pro-gram participates in health fairs andCKD screenings throughout Delaware.

In 2008, to raise community awarenessof the disease and the need for organdonation, the Kidney TransplantProgram spearheaded Delaware’s firstKidney Walk. The walk was held againin 2009, and plans are underway for2010’s walk.

Administrative Director of Renal andTransplant Services Geri LiBetti, RN,CCTC, sees Christiana Care’s support asa vital part of the program’s accomplish-ments. “Christiana Care has provided uswith the opportunity to assemble a teamof transplant professionals who sharethe common goal of providing excellenteducation and transplant care to allDelaware residents,” LiBetti says.

Patients, dialysis units and physicianscan call the Christiana Care KidneyTransplant Office for information andreferrals at 302-623-3866.

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It’s Magnetic!The efforts that helped earnthe prestigious award fromNKFDV reflect these“Forces of Magnetism”

#10. Community and the healthcare organization

“Our team works closely with the NKFand other community organizations toprovide education and screenings.”

#13. Interdisciplinary relationships

“The multidisciplinary transplant teamcomprises surgeons, physicians, coordi-nators, social work, pharmacy, nutri-tion, medical assistants and clericalstaff. Each member represents their dis-cipline and accepts responsibility fortheir area of expertise.”

Geri LiBetti, RN, CCTCAdministrative directorRenal and Transplant Services

“This award is a remarkable achieve-ment for a young program.”

In 2005, recognizing that adultDelaware end-stage renal diseasepatients had neither the same access tocare nor the follow-up care and sup-port systems that patients in otherareas of the country had, ChristianaCare and privately practicing nephrol-ogists from Nephrology Associatesbegan developing a transplant pro-gram.

By October 2006, with a multidiscipli-nary team in place, the ChristianaCare Kidney Transplant Programopened officially—the first adult trans-plant program in the state.

Now, in addition to the 51 completedtransplants, 308 patients are listed aswaiting for kidney transplant and 800have been evaluated for transplant.

But the program does much more thantransplants. Team members:

n Serve as a resource for area nephrol-ogy practices.

n Provide multidisciplinary care fortransplant recipients and living kidneydonors before, during and after surgery.

n Offer patient support groups that

C O V E R S T O R Y, C O N T I N U E D

From left, Emily Pruitt,RN, Laura Bishop, RD,Stephanie Gilibert, M.D.,Gail Eastman, RN, AlineStant, RN, MSN, S. JohnSwanson, M.D., NadiaHellenga, Pharm.D.,Helen Chang-Deguzman,M.D., Velma Scantlebury,M.D., Tom Gay, GeriLiBetti, RN, and SeniorSocial Worker II EileenEdge.

Christiana Care physicians andsurgeons now have more options

in tailoring treatments for patients atrisk for stroke.

The CREST study, a landmark clinical

trial that included patients atChristiana Care, showed that twomedical procedures designed to pre-vent strokes are safe and effective forpeople at risk for stroke.

One of the largest randomized strokeprevention trials ever, the CarotidRevascularization Endarterectomy vs.Stenting Trial (CREST) took place overa nine-year period at 117 centers inCanada and the United States, includ-ing Christiana Care’s Center for Heart& Vascular Health.

In the trial of 2,502 participants,carotid endarterectomy (CEA), a surgi-cal procedure to clear blocked bloodflow and considered the gold-standardprevention treatment, was comparedto carotid artery stenting (CAS), anewer and less invasive procedurethat involves threading a stent andexpanding a small protective device inthe artery to widen the blocked areaand capture any dislodged plaque.

“Vascular surgeons along with inter-ventional cardiologists and radiolo-gists at the Center for Heart &Vascular Health participated and

enrolled patients in the CREST Trial,”says Tim Gardner, M.D., medicaldirector of the Center for Heart &Vascular Health.

The overall safety and efficacy of thetwo procedures waslargely the samewith equal benefitsfor both men and forwomen, and forpatients who hadpreviously had astroke and for thosewho had not.

However, when theinvestigators looked

at the numbers of heart attacks andstrokes, they found differences. Theinvestigators found that there weremore heart attacks in the CEA group,2.3 percent compared to 1.1 percent inthe stenting group; and more strokes

in the stenting group, 4.1 percent ver-sus 2.3 percent, for the surgical groupin the weeks following the procedure.

“Having this multi-disciplinary capa-bility here will serve future patientswell. The principal finding of CREST isthat the choice of treatment must beindividualized for each patient withcarotid disease. Our cardiovascularspecialists will be able to performeither traditional surgical carotidendarterectomy or carotid stentingusing whichever treatment is mostappropriate for the particular patient.”

The trial was funded by the NationalInstitute of Neurological Disorders andStroke (NINDS), part of the NationalInstitutes of Health, and led by investi-gators at Mayo Clinic, Jacksonville,Fla., and the University of Medicineand Dentistry of New Jersey inNewark.

“ The principal f inding of CREST is thatthe choice o f treatment must be individu-al ized for each pat ient with carot id dis-ease .”

Tim Gardner, M.D., medical directorCenter for Heart & Vascular Health

Research resolves question of best treatment for blocked carotids in high-risk stroke patients

The 21st Annual Updatein Cardiology confer-ence on Feb. 27 in theJohn H. Ammon MedicalEducation Center attract-ed more than 220 healthprofessionals. The con-ference featured presen-tations from ChristianaCare Center for Heart &Vascular Health physi-cians and visiting guestspeakers and coveredclinical news, latestemerging technologyand research for themanagement and treat-ment of cardiovasculardisease.

From left, Timothy J. Gardner, M.D., medical director,Center for Heart & Vascular Health, Andrew Doorey,M.D., program director, and William Weintraub, M.D.,John H. Ammon Chair of Cardiology.

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Join Christiana Care Health Systemand Hanover Presbyterian Church

to learn how the $205 million expan-sion of Wilmington Hospital willtransform the delivery of health carein our community.

Janice Nevin, M.D., MPH, senior vicepresident/executive directorChristiana Care - Wilmington Campusand associate chief medical officer, will

share the vision of the future ofWilmington Hospital, including ananimation of the progression of theproject.

Following the formal presentation,light refreshments will be provided byHanover Church. Members of thecommunity will have a chance to talkabout areas of mutual concern.

Janice Nevin, M.D., is responsiblefor all clinical activity and opera-tions on the Wilmington campusand is helping to lead the transfor-mative building project. She is theformer chair of the Christiana CareDepartment of Family andCommunity Medicine, a featuredcolumnist for the News Journals’Tuesday health section, and shesees patients in the FamilyMedicine Center on theWilmington campus.

Janice Nevin, M.D.

Wilmington campus at a glance

Bids are now coming in on fit-out work scheduled to start in April/May.

22

Resulting delays:The opening of Washington Streetentrance—a prerequisite for excavationto begin Washington Street side of the project.*

*Washington Street entrance reopened March 8.

T R A N S F O R M A T I O N

Automation and improved efficiency efforts havemade the hospital environment safer for both

patients and Pathology & Laboratory Medicine staff atChristiana Care hospital.

Patients are safer thanks to reduced risk for misidentifi-cation. Staff is safer thanks to reduced biohazard riskdue to minimal sample handling. Plus, added speedand efficiency has enabled the department to handleincreasing demand and cut turnaround time.

Compared with pre-initiative measurements:

n There are 138 fewer repeat tests performed each day,with a cost savings of $9,800 a year in test-related sub-stances.

n The average in-lab turnaround time for morningrounds decreased from 89 minutes in 2006 to 40 min-utes in 2009.

Here’s how they did it:n Redesigned the central receiving area, placing workareas next to the pneumatic tube delivery system andcloser to the automation line.

n Introduced several new automated systems, includ-ing a robotic specimen transport system and labautomation system with two high-volume routine ana-lyzers online.

n Rewrote software to eliminate the need for redun-dant testing and unnecessary technologist intervention,such as issuing paper reports for normal results.

veryone in America is watching health care today. Increased oversight from the privatesector, government and consumers is challenging us to transform how we deliver care.

Christiana Care has accepted the challenge to make dramatic change. We are focusing onimproving quality and safety, decreasing costs and building our financial strength to rein-vest in our mission of care and service.

Transformation does not occur in small, incremental steps. It comes about throughbreakthrough initiatives, radical thinking and big changes. It leads to dramatic improve-ments in patient safety and satisfaction, quality of care, clinical outcomes, employeeengagement and value—all aspects of our Focus on Excellence diamond.

A robotic transport system now helps Labstaff make sure the right specimens get tothe right place, right on time.

Pathology & Laboratory Medicine automation

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From good to great: People make the differenceA look back at FY ‘09

Christiana Care Health System is aGreat Place to Work largely

because of its employees and successin recruiting and retaining high-per-forming, committed and engagedteam players at all levels. Our contin-ued success depends on your effortsand we value your vital input to helpensure progress.

Throughout the health system, workgroups, service line councils and com-mittees are energetically seeking waysto improve our work environment andmaintain our focus on excellence inproviding the best available care toour neighbors.

Employee Engagement Soon, all Christiana Care employeeswill be able to participate in the 2010Employee Satisfaction andEngagement Survey conducted by theGallup organization April 12-25.

More than 7,000 employees—a systemrecord 77 percent force—took part inthe 2008 (most recent) survey.Previous survey results provide aframe of reference for our 2010 goals.For example, in 2008:

n Employees ranking Christiana Careat a best-possible 5 of 5 increased to 33percent from 31 percent in 2006, plac-ing Christiana Care at the 61st per-centile of Gallup’s overall database.

n Christiana Care’s combined rating(4s and 5s) for employee satisfactionwas a positive 78 percent.

Christiana Care continues to be proudof the outstanding quality care ouremployees provide and the externalrecognition they receive. Recent high-lights include:

n Recognition as a Nursing Magnet

hospital by the American NursesCredentialing Center for a four-yearterm starting Feb. 18, 2010.

n Recipient of the 2009 Beacon Awardfor Critical Care Excellence, one ofonly 35 hospitals nationwide and thefirst in Delaware to earn the honor.

n Named a News Journal “Best in theBusiness” employer for the fifthconsecutive year.

n Rated in Nursing ProfessionalsTop 100 Hospitals to Work With.

n Continued recognition by USNews and World Report as one ofAmerica’s “Best Hospitals.”

n Awarded the Department of Healthand Human Resource’s 2009 Medal ofHonor recognizing excellence inempathetic family care coupled withoutstanding organ donation levels.

Over the next five weeks, you’ll finddetailed descriptions of importantefforts on the portals:

n Recruitment & Retention March 9.

n Total Rewards - Week of March 15.

n Health and Wellness - Week ofMarch 22.

n Better and Easier - Week of March29.

n Growth and Development - Week ofApril 5.

Workforce SupplyThe recruitment and retention of ahigh-performing and engaged healthcare team at all levels is again a majoraccomplishment.

RecruitmentChristiana Care successfully hired1,062 new employees this past fiscalyear. Of these new hires, 166 were

bedside nurses.

This fiscal year, through December2009, an additional 454 new employeesjoined our health care team. The sys-tem-wide vacancy rate for all positionsremains at or below 2 percent, consis-tently below the national average.As a sought-after employer, ChristianaCare received more than 32,000 appli-

cations in calendar year 2009. Targetedtactics and enhancements used torecruit our new team members include:

n Internet sourcing with social mediatools including Facebook, Twitter,LinkedIn and a new web 2.0 searchengine optimization strategy

n College recruitment.

n Scholarships.

n Specialty training programs for newgraduates.

n Employment of students in nursingand allied health professions.

n Special events, such as Career Night,Student Nurse Expo, and regionalrecruiting job fairs.

RetentionIdentifying the right fit for individualswithin Christiana Care is a key goal ofour retention strategy. Our success atretaining high-performing employeesis evident by our low turnover rates,which exceed the health care industrybenchmarks. Christiana Care’s full-time current turnover is less than 6percent and less than 4 percent for rolemodel employees.

A G R E A T P L A C E T O W O R K

As a sought-after employer,Christ iana Care received morethan 32,000 appl icat ions in 2009.

As we continue our journey of making Christiana Carea Great Place to Work, consider how you would

respond to the following employee engagement state-ments from our survey:

“At work, my opinions seem to count.”

Take advantage of opportunities to share opinions, pro-vide feedback and express ideas that improve the healthof our patients. Departments provide better patient careservices when individuals actively and openly share sug-gestions for improvement. Sharing your opinions andideas with your co-workers and your manager is a greatway to provide valuable input.

What can you do?

n Learn about opportunities within your department andacross the system to share your feedback and ideas.

n Volunteer for committees and projects and actively par-ticipate as part of the team.

n Volunteer for performance improvement initiatives orother opportunities outside normal job duties.

n Express your opinions and ideas to individuals whohave the ability to initiate positive change (your supervi-sor, your co-workers, etc). Take a solutions-orientedapproach when sharing your ideas.

n Be willing to identify opportunities for improvementand solicit ideas and opinions from colleagues within andoutside of your department to maximize the impact ofyour idea.

n Keep channels of communication open. Be willing toshare feedback, and to receive it, as well.

n Encourage others to share their opinions with you.

n Remember that your opinions matter.

“The mission or purpose of my company makes me feelmy job is important.”

As human beings, we like to feel as if we belong.Individual achievement is great; however, being part ofsomething bigger gives us that sense of belonging. Eachof us has different values; identifying how our own val-ues relate to those of Christiana Care enables us to find aconnection between the mission of the organization andour position, creating that unique sense of belonging.

E M P L O Y E E E N G A G E M E N T

What can you do?

n Seek to understand how your individual role fits intothe success of Christiana Care’s mission.

n Find the common link between your own values andthose of Christiana Care.

n Identify opportunities to improve personal perform-ance to support the mission through successful imple-mentation of business goals. Your personal performanceaffects those we serve internally and externally, includingand most importantly, our patients!

“My associates or fellow employees are committed todoing quality work.”

The best work teams value and leverage each individual’stalents toward providing quality service and care to ourpatients. In order to place the needs of our patients first,cooperation among all departments is essential. Tobecome a highly functioning work team, discuss withyour colleagues and managers opportunities to improvethe quality of the services your work team provides.Develop action plans to remove barriers that hinder yourteam’s ability to focus on excellence.

What can you do?

n Recognize co-workers within your department andsupporting departments with paper or electronic dia-monds when they are doing quality work.

n Ask your manager to discuss job performance expecta-tions at your next staff meeting.

n Keep channels of communication open. Be willing toshare constructive feedback, as well as receive feedbackregarding performance opportunities.

n Refer incidents of poor performance, including corevalue behaviors, to management for follow-up. Sharewith your manager the impact the performance is havingon your ability to provide quality services, and follow-upwith management if improvement is not seen.

Providing your feedback and suggestions allows you to con-tribute to achieving the organization’s mission. Valuing ourcolleagues and working together as a team contribute to makingChristiana Care a Great Place to Work.

It has been relatively smooth sailing forComputerized Provided Order Entry,

(CPOE) launched at Wilmington Hospitalon Jan. 28 in a sea of green coats.

“On the very first day, a few people actu-ally said it was faster than paper,” saysTerri Steinberg, M.D., MBA, chief medicalinformation officer. “By Wednesday, thecorner was turned and CPOE went froma novelty to a way of doing business.”

One green jacket for every 3 doctorsThere was one tech support person—cladin an immediately identifiable green jack-et—on board for every three doctors.

Still, there were bumps in the road. Some

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providers were frustrated by the numberof alerts that fired as they entered theirorders.

“We had our alert threshold set way toolow,” Dr. Steinberg recalls. “So we jumpedin and changed it.”

Anand Panwalker, M.D., president of theChristiana Care Medical-Dental Staff, sayshe welcomes CPOE as a necessary step for-ward in patient care. The electronic systemeliminates errors and delays created indeciphering handwriting, making patientcare faster, more efficient and safer.

Still, asking doctors to give up paper andembrace technology is a radical shift.

“There was great anxiety,” Dr. Panwalkersays, “and then a great sigh of relief.”

A few days after the launch, he had hisfirst real-time experience with CPOE whenhe entered several orders.

“I needed a bit of help, but it was there,thanks to all those people with greencoats,” he says. “There were a few brokenviolin strings in this orchestra—but theywere quickly fixed.”

Dr. Steinberg says frequent updates onCPOE’s status helped to mentally preparedoctors, nurses and pharmacists for thelaunch.

“It was a low rumbling that got louder andlouder,” she says. “People knew it wascoming.”

Doctors continue to provide feedback as toways the system can be improved.

“The speed with which physicians haveadapted has been impressive and amazing,a true reflection of their commitment,” Dr.Steinberg says. “Every day gets better andbetter.”

CPOE: The new way of doing business

“The speed with which physic ians haveadapted has been impressive and amazing, atrue re f lect ion of their commitment.”

Terry Steinberg, M.D., MBAChief Medical Information Officer

ing implementation when nurses sat side by sidewith physicians at the computer working to getorders entered. The success of CPOE implementa-tion brought out the best in the physician-nurserelationship.”

Dr. Steinberg also expressed appreciation for thesupport and dedication of Dr. Nevin.

“She was in the hospital 24/7, bridging the techni-cal and medical,” she says.

Department heads played a crucial role in prepar-ing for the launch, organizing training sessions.Hundreds of doctors helped to write order sets.

“So many people gave so generously to make thistransformational event a success,” Dr. Steinbergsays.

CPOE rollout at Christiana Hospitalbegins March 23.

Rolling out the Computerized Provider OrderEntry system was a team effort with many

helping hands.

“Wilmington Hospital is a special place,” saysTerri Steinberg, M.D., MBA, chief medical infor-mation officer. “There is a sense of family there.”

Residents, who worked hard to troubleshoot thesystem, played a key role in the project’s success.

“They adapted to CPOE like a fish to water—andtheir help has been invaluable,” Dr Steinberg says.

Hospitalists also showed a willingness to embracechange, providing insights and feedback on thesystem.

“The nurse managers also played a major role inour success,” says Janice Nevin, M.D., MPH, sen-ior vice president/executive director ChristianaCare - Wilmington Campus and associate chiefmedical officer. “There were many moments dur-

Nurse managers, hospitalists, residentsplay major role in successful launch

From left: Terri Steinberg,M.D., and CarolynZinner, project leader;Chuck Molloy, projectleader and David Bercaw,M.D.; and StaffDevelopment SpecialistKim Berl.

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Are you or someone you knowthinking about a career in health

care? Are you working in health careand looking to advance your educa-tion or expand your career options?

If so, come to Exploring Careers inHealth Care on April 6, from 5-7:30p.m., in the John H. Ammon MedicalEducation Center main auditorium onthe Christiana Hospital campus. Whilethis is not a recruitment event, youwill have an opportunity to meet rep-resentatives from a host of health carefields.

You’ll also get the chance to exploreeducational options from the local col-leges and universities.

Here are a few participating schools:

n Arcadia College.

n Delaware Technical & Community College.

n Delaware State University.

n Drexel University.

n Eastern University.

n Immaculata University.

n Neumann University.

n Wilmington University.

n University of Delaware.

If you have questions, call DominicKayatta at 302-327-5706.

Exploring careers inhealth care eventApril 6

Welcome New Medical-Dental Staff

Four fourth-year medical studentsserving internal medicine electives

at Christiana Care had their abstractsaccepted out of 250 submissions forthe National American College ofPhysician’s (ACP) Annual ScientificMeeting in Toronto in April.

An abstract by Kelly McGlaughlin,Jefferson Medical College (JMC) MS3,is a Top 10 Winner in the NationalACP Student Clinical VignetteAbstract Competition and will be oneof only 10 selected oral podium pre-sentations. McGlaughlin’s abstract,“Propionibacterium Acnes: When WillYou Grow Up?” was co-authored bymentor Anand Panwalker, M.D.

An abstract by Richard Medford, JMCMS3, “Venous Thrombosis, PulmonaryEmbolism and Factor VII Deficiency,”under the mentorship of Med-PedsResident Mark Troiano, D.O., andattending Charles V. Roche, M.D., alsowill be presented as a poster finalist at

the national meeting.

An abstract by Peter A. Burke Jr., ofthe Philadelphia College ofOsteopathic Medicine and soon to be aChristiana Care Internal Medicine resi-dent, “Diagnosis and Management ofTTP/HUS in an HIV positive patient,”under the mentorship of medicine res-ident PGY3, David Aljadir, M.D., andintensivist, Tuhina Raman, M.D., willbe on display as a poster finalist at themeeting.

An abstract by Stefanie Golebiewski,JMC MS4, and mentor MichaelBenninghoff, M.D., titled “β-agonistuse and Lactic Acidosis” also earneddistinction as a poster finalist and willbe on view at the meeting.

The top 10 were selected for podiumpresentations and given all-expensepaid trips to the meeting. The next top25 in each category are invited to pres-ent posters of their abstracts for judg-ing and monetary prizes.

Internal Medicine med students earn national distinction

The Delaware Health SciencesAlliance (DHSA) will host its sec-

ond Annual Research Conference atthe John H. Ammon MedicalEducation Center on May 4.

The conference will bring togetheracademic and clinical researchers fromChristiana Care Health System andAlliance partner institutions TheUniversity of Delaware, ThomasJefferson University and Nemours /Alfred I. duPont Hospital forChildren.

The conference goal is to showcaseDHSA joint programs and to explorenew opportunities to enhance transla-tional research collaborations.Dedicated breakout sessions will focuson cancer, cardiovascular health, neu-rosciences, rehabilitation sciences,bioinformatics, outcomes and commu-nity research.

Keynote speaker John J. Nance, JD,author, broadcaster, consultant andlawyer, will present “Why HospitalsShould Fly: The Ultimate Flight Planto Patient Safety and Quality Care.”

Michael Lauer, M.D., director of theDivision of Cardiovascular Sciences atthe National Heart, Lung and BloodInstitute and the Ancel Keyes lecturerin preventative cardiology, will dis-cuss The American Recovery andReinvestment Act of 2009 andComparative Effectiveness Research,which will improve health outcomesby developing and disseminating evi-dence-based information to patients,clinicians and other decision-makers.

The full agenda and registration linkfor the DHSA Research Conference areavailable at www.delawarehsa.org/conferences.php.

National Experts to speak at Delaware Health Sciences Alliance conference

John J. Nance, JD Michael Lauer, M.D.

Publishing, presentations, appointments, awards

Publishing

Lionel Malebranche, M.D., publisheda personal account of what he wit-nessed in his native country ofHaiti inthe aftermath of the Jan. 12 earth-quake. Dr. Malebranche saw the dev-astation of Port-au-Prince and greathuman suffering. Read his account inthe Feb. 18 issue of the Annals ofInternal Medicine, the publication ofthe American College of Physicians, oronline at www.annals.org.

Robert Witt, M.D., published an arti-cle titled “Surgery After CocaineIngestion,” in Ear Nose and ThroatJournal, 2010;89(2):E14

David A. Paul, M.D., Amy Mackley,RNC, et al., published “Thyroid func-tion in term and late preterm infantswith respiratory distress in relation toseverity of illness,” in Thyroid,February, 2010.

Robert Abel Jr., M.D., has published anovel, Lethal Hindsight, a medicalthriller about an ophthalmologist whostumbles on an international plot. It’savailable online at www.xlibris.com.

Robert Abel Jr., M.D., has published aa pictorial children's book, Lumi's Bookof Eyes, available at www.wasteland-press.net

Presenting

James Gill, M.D., presented:

n “Using Centricity Encounter Formsto Improve Quality of Care for ChronicDiseases in Primary Care” at the 2009AAFP Conference on PracticeImprovement: Constructing theMedical Home, in Kansas City, Mo., inNovember 2009.

n “Impact of an EMR-basedIntervention on Diagnosis & Follow-upof Depression” at the 2009 NAPCRGMeeting in Montreal, in November2009.

Bikash Bose, M.D., FACS, FICS,FAHA, et al., presented an oral digitalposter titled "tceMEP MonitoringImproves Detection of Iatrogenic NerveRoot Injury During Cervical andLumbar Spine Surgery" at the 26thAnnual Meeting of the Spine Section ofthe AANS/CNS in Orlando, Feb. 18-20.

Appointments, Awards

Lee Ann Riesenberg, Ph.D., RN, wasnamed to the editorial board of theAmerican Journal of Medical Quality inOctober 2009.

VNA CEO and President Lynn C.Jones has been appointed a memberof the American Hospital Association(AHA) Governing Council for LongTerm Care, Rehabilitation and HomeHealth Care, beginning a three-yearterm in March.

Michael Kalina, D.O., FACOS,earned the Leadership DevelopmentWorkshop scholarship from theEastern Association for the Surgery ofTrauma. Dr. Kalina completed thefirst of three workshops, Part 1 at theJanuary 2010 conference in Arizona.

Sherry Mars, BSN, RN-BC, patientcare coordinator and staff develop-ment specialist on the ACE Unit atWilmington Hospital received a bach-elor of science degree in Nursingfrom Immaculata.

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CALL FOR ENTRIES COMMENDATION FOR EXCELLENCE AWARD 2010

Nominations are being sought forthe 10th Commendation for

Excellence Award. This award, estab-lished by the Medical-Dental Staff,honors physicians who have madeexceptional contributions to the com-munity through their clinical, scholar-ly, educational or humanitarian activi-ties.

Current and former members of theMedical-Dental Staff are eligible to benominated. Medical-Dental Staff mem-

bers may nominate an eligible personfor the award.

Requirementsn A letter outlining the reasons for thenomination.

n The Qualifications of the nominee.

n The nominee’s CV, if available.

Please help recognize the outstandingcontributions that physicians make toour community. Reply with your nom-ination by May 28, 2010 via e-mail to

Dawn Gies atdgies@christianacare.org.

The physician or dentist selected bythe Awards Committee is endorsed bythe Medical Executive Committee.This year’s Commendation forExcellence Award recipient will beannounced at the Medical-Dental StaffAnnual Event.

For more information about theCommendation for Excellence Award,please call 302-733-1049.

Christiana Care’s Community Outreach at theHelen F. Graham Cancer Center received a

$50,000 one-year grant from the Avon FoundationBreast Care Fund for its breast cancer awarenessprograms that increase awareness of the lifesavingbenefits of early detection of breast cancer.

The program has received funding from the AvonFoundation for Women for the Ninth consecutiveyear in recognition of its excellence.

Christiana Care’s Community Outreach breasthealth programs educate Delaware women andrefer them to low-cost or free mammograms andclinical breast exams in their own communities.

This vital outreach program works with otheragencies such as federally qualified health centers,senior centers, sisters on a mission and the localavon sales representatives.

Since January 2002, the Helping Hands for BreastHealth at Christiana Care has assisted with screen-ing more than 7,000 women. Each year, the pro-gram focuses its efforts on reaching more womenwho need assistance while sending reminders tothose screened the previous year. Last year, morethan 20,000 women were informed about theimportance of early detection of breast cancerthrough health fairs, blocked screenings for sen-iors, education programs and distribution of breasthealth education materials. In addition, screeningreminders were mailed to 855 individuals, 300women were enrolled in the program, 951 werereferred for mammograms and clinical breastexams, and 12 breast cancers were found.

For more information on Helping Hands for BreastHealth at Christiana Care, call Nora Katurakes at302-623-4628.

Avon Foundation supportsbreast cancer awareness

Joyce Bunkley, RN, primary care nurse at the HIVProgram Lancaster Avenue site, will receive the

Guardian Angel Award, recognizing an individual forefforts to help improve the daily lives of people living withHIV/AIDS.

Lisa Phillips, M.D., will receive the Ryan White Award, rec-ognizing an individual in the medical profession who isdedicated to the health and well being of people livingwith HIV disease.

They will receive the awards on April 17 at the annualDelaware HIV Consortium WOW evening gala—Delaware’s largest HIV/AIDS fundraiser—at the ClarionHotel’s Belle and Augusta Grille Restaurant, 1612 N.DuPont Highway, New Castle.

For information, call John Hinkson, coordinator of commu-nications and special events at the Delaware HIVConsortium, 302-654-5471 or visit www.delawarehiv.org.

Two from Christiana Care earnHIV Consortium awards

Lisa Phillips, M.D.Joyce Bunkley, RN

Upcoming eventsThe 13th Annual Medicine Ball, spon-sored by the Junior Board of ChristianaCare, on Friday, April 23, 7-11 p.m., atthe Wilmington Country Club. Proceedssupport scholarships and continuing edu-cation for nursing and allied health pro-fessions at Christiana Care. E-mail jgold-ston@christianacare.org for more infor-mation or to be added to the invitationlist.

Center for Comprehensive BehavioralHealth Open House, Wednesday, March24, 4-6 p.m., 201 W. 14th St.,Wilmington. For information, call 428-2962.

The "Lucky 7" Evening in Monte Carlo,hosted by the Friends of the Helen F.Graham Cancer Center, Friday, May 14 inthe Gold Ballroom at the Hotel du Pont,11th and Market streets, Wilmington.Proceeds support the Center forTranslational Cancer Research and theCancer Special Needs Fund at the HelenF. Graham Cancer Center. E-mail jgold-ston@christianacare.org for more infor-mation or to be added to the invitationlist.

The 2010 Christiana Care DelawareMarathon Running Festival Sunday,May 16, Tubman Garrett RiverfrontPark, Wilmington, includes Delaware’soldest and largest certified road-runningmarathon, a certified half-marathon anda four-person team relay marathon. Seewww.delawaremarathon.org. A portionof the proceeds benefits the Center forHeart & Vascular Health.

The 14th Annual Diabetes Update,Saturday, March 20, 7:30 a.m.-4 p.m.,at the John H. Ammon MedicalEducation Center for physicians, RNs,NPs, dieticians, physician assistants,ophthalmologists and others. Fee: $70,$35 for students and emeritus. Registeronline and download a program underEvents & Classes on physician, nursingand physician office staff portals.

Trauma Program hosts the 10thThinkFirst 5K and 1KChildren’s FunRun on April 15 to support communityinjury prevention efforts. Register atwww.races2run.com.

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Unless otherwise noted, all events are inthe John H. Ammon Medical EducationBuilding.

Tuesday, April 6

9-10:30 a.m., Loretta Consiglio-Ward,RN, MSN, and Lee Ann Reisenberg,Ph.D., present “Adult Learning Principles /Learning Preferences, rooms 4-6.11 a.m.-noon, Glenn Tinkoff, M.D.,Simulation presentation, rooms 4-6.Noon-1 p.m., Guest speaker RebeccaPhillips, M.D., vice president, Education& Training, Cincinnati Children's HospitalMedical Center, presents “Educator'sStrategy” rooms 4-6.1-2 p.m., Simulation Presentation, GlennTinkoff, M.D., Wilmington HospitalConference Center.2-3 p.m., Simulation: Nursing Education,Katie Muther, RN, Wilmington HospitalConference Center.3-4 p.m., Simulation: Code Blue, Ann-Marie Baker, RN, Wilmington HospitalConference Center.

Wednesday, April 7

7-8 a.m., Surgical Grand Rounds, Julie G.Nyquist, M.D., Professor of ClinicalPediatrics, University of SouthernCalifornia, Main Auditorium.8:30-10 a.m. Physicians AssistantConference, back auditorium.9-11 a.m., Federal regulations affectingChristiana Care research, rooms 11-12.9-10:30 a.m., Loretta Consiglio-Ward,RN, MSN, and Lee Ann Reisenberg, RN,Ph.D., present “Adult LearningPrinciples/Learning Preferences,”Wilmington Hospital Conference Center.11 a.m.-noon, Jerry Brannen and RosaColon-Kolacko, Ph.D., present “LearningMeasurement Strategy and EvaluationMethodology,” rooms 11-12.10:30-noon, Chris Lepine/ Trevor Clarkpresent “Instructional Design,”Wilmington Hospital Conference Center.

Noon-1 p.m., Lee A. Learman, M.D.,Ph.D., present OB/GYN Grand Rounds,“Learning and Teaching Strategies, ORProfessionalism,” Women’s & Children’sServices Building, rooms 1926/1927.Noon-1 p.m., Michelle Biros, M.D., pres-ents Emergency Medicine Grand Rounds,room 1100, main hospital. 1-2 p.m., Katie Muther presentsSimulation: Nursing Education.rooms 11-12.2:30-4 p.m. Chris Lepine and Trevor Clarkpresent “Instructional Design,” rooms 11-12.

Thursday, April 8

8-9 a.m., Medical Grand Rounds, GuestLecturer Thomas J. Nasca M.D., MACP,

Dean of Jefferson Medical College, mainauditorium.9:30-12:30 p.m., Guest Speaker BrentSchlenker, presents “Education Strategiesand Trends,” main auditorium.1-2:30 p.m. Guest Speaker: Karen Barley,Corporate University, presents “Becominga Learning Institute,” Karen Barley,Corporate University, rooms 11-12.2:30-4 p.m., Ann-Marie Baker presents, Simulation: Code Blue, Ann-Marie Baker,RN, rooms 11-12

5-8 p.m., Reception, Main Auditiorium.

Friday, April 9

9-10:30 a.m., Wendy Wintersgill presents“Preparing Your Poster Presentation,” rooms11-12.

Education WeekApril 6-9events schedule

In a time often ruled by technology,physicians should not forsake some of

the most powerful tools in medicine:their ears, eyes and hands.That was the message of best sellingauthor Abraham Verghese, M.D., pro-fessor for the theory and practice ofmedicine at the Stanford UniversitySchool of Medicine. Dr. Verghese spokeat Hotel du Pont on Sunday, March 7 aspart of Christiana Care’s Health andSociety Lecture series. The title of hisaddress was “The Art of Medicine in aTechnological Era.”Preserving humanity in medicine

“The healing part still requires the doc-tor’s presence,” said Dr. Verghese.Bob Laskowski, M.D., Christiana Carepresident and CEO, introduced Dr.Verghese and stressed the personaltouch is an integral element in provid-ing care. “It is critical that we preservethe humanity involved in medicine,”said Dr. Laskowski.Dr. Verghese discussed the iconic paint-ing “The Doctor,” painted in 1887 bySir Luke Fildes, a Scotish artist. Thecanvas depicts a sick child, sleeping ona makeshift bed of two chairs pushedtogether. In the background are the par-ents, a stoic father standing by themother, her head bowed in prayer.In the center is the doctor, hand onchin, intently observing the child.Technology creates an ‘iPatient’

But the painting isn’t about the physi-cian. “It’s about the patient,” said Dr.Verghese. Making the patient the centerof care is still the priority. But in an eraof dazzling technology, doctors shouldnot rely solely on images to determine

the course of treat-ment, in essencecreating what Dr.Verghese calls the“iPatient.”“The iPatient getsfabulous care,” hesaid. “But very oftenthe patient in thebed wonders who isin charge.”In a question-and-answer session, doc-tors in the audienceraised the topic of“mindful medita-tion” and dialoguewith colleagues,which a recent studyat the University ofRochester reportscan reduce physi-cian burnout.Dr. Verghese agreedthat doctors areunder considerable stress in a fee-for-service system that includes multipleresponsibilities and the distraction ofpaperwork.

Listen to the patient

Dr. Verghese said it is essential to edu-cate the next generation of physicianson thorough physical examinationsinstead of relying on informationobtained through technology. He saidsloppy history taking also is a majorcontributor to missed or inaccuratediagnoses.It all comes down to listening to thepatient. “I’m a big believer inanecdote-based medicine,” he said.Dr. Verghese is the author of several

Physician-Author offers prescription for preserving humanity

best sellers, including Cutting for Stone,a novel set in Ethiopia, where he grewup; My Own Country : A Doctor'sStory, a memoir of his work withpatients in rural Tennessee during theearly days of the HIV epidemic; andThe Tennis Partner: A Story ofFriendship and Loss, chronicling theaddiction of a medical resident whowas his friend and tennis partner.

Abraham Verghese, M.D., (left) spokeand later signed copies of his works atthe Hotel du Pont March 7 as part of theHealth and Society Lecture Serieschampioned by Robert J. Laskowski,M.D., MBA, Christiana Care HealthSystem President and CEO (right).

Sharon Kurfuerstappointed to Del Techadvisory committee

Sharon Kurfuerst, Ed.D, OTR/L,FAOTA, administrative director of

Rehabilitation Services, is serving on theadvisory committee for DelawareTechnical & Community College’sPhysical Therapy Assistant (PTA) program.

“I want to reach out to students whowill soon be looking for jobs and offerthem opportunities to learn aboutChristiana Care,” Kurfuerst says. Toimprove the connection between the DelTech PTA program and RehabilitationServices at Christiana Care, Kurfuersthas invited PTA students and faculty toparticipate in in-services on clinical doc-umentation at Christiana andWilmington hospitals, and plan morecollaboration between Del Tech andChristiana Care.

“We’re thrilled to have Sharon help usshape and enhance our curriculum toensure students are successful in theirdesired career path,” says Del Tech PTAProgram Director Doug Husienga,MPT.

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Sharon Kurfuerst, Ed.D, OTR/L

Randall Gaboriaultto lead IT team

Randy Gaboriault joined ChristianaCare Health System in February

as vice president and chief informa-tion officer (CIO) from Teleflex Inc., amulti-billion dollar, global medicaldevice leader in Limerick, Pa., whereRandy spent more than 12 years lead-ing global teams for IT, logistics, oper-ational excellence, and strategic sourcing.He volunteers for the non-profit Boardof Directors for NPower Pennsylvaniaand Delaware, and also serves as aboard director for the CommunityPerforming Arts Center at thePennsylvania Institute of Technology.“I am very excited to lead theInformation Technology transforma-tion at Christiana Care, through therenovation of health care,” Gaboriaultsays. “IT is the intersection point forpeople, process and technology, andthe CIO is the wide angle lens on theorganization. My time will be allocat-ed between, the future, (Where are wegoing?) today (“managing the railroad”)and talent development (building theteam to deliver excellence).”

Randall Gaboriault Jay Moorhead

Jay Moorhead joined Christiana Carein January as director of

Communications, reporting to the sen-ior vice president of External Affairs,Michele A. Schiavoni.

Moorhead is responsible for all inter-nal brand management, media rela-tions, government relations, employeeand physician communications,including FOCUS and the employeeportal.

“I have great respect for the activitiesand efforts that take place throughoutour organization every day,” saysMoorhead. “I look forward to helpingget out the many positive stories thatdistinguish Christiana Care.”

Moorhead has more than 25 years ofexperience in health care marketingand communications, most recently ashead of his own marketing/communi-cation business. He previously servedas vice president of marketing andcommunications for Coventry HealthCare, based in Bethesda, Md.

Jay Moorheadnamed directorof Communications

Tammy Johnson israrely ill.

So she wasn’t con-cerned about herphysical well-beingwhen she reportedfor her biometricsevaluation as part ofher Health RiskAssessment. Johnson,an applications ana-lyst, was thinkingabout the $15 dis-count on her benefitscontributions thatshe would save eachpay period.

She was stunned to learn that her blood pres-sure was dangerously high, reading 180/103,putting her at risk of stroke. Within the hour,Johnson was whisked from her job at ReadsWay in New Castle to the employee health cen-ter at Christiana Hospital, where she was put intouch with her primary care provider.

Johnson’s doctor prescribed a regimen of walk-ing, as well as a low-sodium, low-fat, caffeine-free diet. Within a month, her blood pressurereading was down to 125/77, within the normalrange.

“An HRA not only saves you money,” she says.“It can save your life.”

Johnson, 49, is the mother of seven children. Shesays she has always felt comfortable lookingafter others.

“I am now learning to care for myself,” shesays. “It’s something I have to do.”

John C. Smith, informa-tion technology projectleader, discovered earlywarning signs of dia-betes and hypertensionduring his HRA.

“I knew my family his-tory and that my choles-terol was high—but Ididn’t know how high,”he says. “When Ilearned that I also waspre-diabetic and pre-hypertensive, it was acomplete surprise.”

Smith, 52, keeps hischolesterol count in check through medication.He has reduced his risk for diabetes and hyper-tension by curbing his intake of sweets and fats.

One simple and immediate change is banishingcheese from his diet, eliminating both fat andcalories. Instead of a glass of red wine in theevening, Smith now unwinds with a cup ofgreen tea.

He uses computer software to help keep him ontrack, entering the calories of foods he eatsthroughout the day.

“I focus on calorie intake versus how manycalories I burn,” he says. “If I have calories leftover, I can treat myself with a light beer, whichonly has 104 calories.”

Five days a week, Smith devotes 30 minutes toworking out on the elliptical machine, melting acool 400 calories. He also lifts free weights tokeep in shape.

“I feel fortunate that I learned I was at riskbefore I developed full-blown diabetes or highblood pressure,” he says. “That’s the beauty ofan HRA.”

Tammy JohnsonJohn C. Smith

A biometric screening and HRA could save your life

Hustling homeafter a busy day,

it can be hard towarm up to thethought of cookingdinner.

Instead of calling outfor pizza, why notcreate somethingquick, easy and tastyin your very ownkitchen?

But before you donyour apron, put onyour thinking cap.

Success starts with shopping listYour recipe for success starts with ashopping list. Stock your pantry withnonperishable staples such as rice,low-fat canned chicken broth, cannedtomatoes, pasta, beans and tunapacked in water. Keep veggie burgersand bags of mixed vegetables at theready in the freezer—and a few low-fat frozen dinners for those eveningswhen you have just enough time andenergy to program the microwave.

In the fridge, maintain a supply offresh fruits and vegetables, includinglettuce, carrots and bell peppers. Buypre-packaged egg whites, no-fat milkand reduced-fat cheeses. (Experimentwith leftovers—perhaps chicken andbroccoli or shrimp and peas—andwhip up a yummy omelet.)

With the ingredients at hand and afew simple recipes under your beltyou will find you are much less likelyto pile on calories—and empty yourwallet—with prepared and takeoutfood. Think nutritious—and delicious.

So hold the fast food burgers and fries.

Serve up vegetarian chili in the time ittakes to add peppers, onions andspices to a few cans of tomatoes andpinto beans. Or steam frozen veggieswith rice. Add leftover chicken, veg-etables and noodles or rice to cannedbroth for a hurry-up version of home-made soup. And you can make a maincourse out of a salad in a snap byadding canned tuna or salmon andsliced, hard-boiled eggs.

Experiment with light alternativesIt’s fine to turn to such pantry pals asspaghetti and a jar of marinara sauce.But instead of prepared macaroni andcheese, experiment with a light alter-native, blending cubes of reduced-fatcheese and no-fat milk with the noo-dles. For variety, add a handful offrozen peas to the boiling water.

Still have a yen for pizza? You canmake your own version at home with-out tossing dough for delivery. Makeindividual mini pizzas by spreadingtomato sauce on bagels, pita bread,tortillas, French bread or even Englishmuffins. Sprinkle grated cheese on topand heat under the broiler or in atoaster oven.

Keep healthy foods around for quick meals

The image of bland hospital cafeteriafood is just a stereotype today, espe-

cially as compared with ChristianaCare’s Wilmington and Christiana hospi-tals, where the food is not only tastiernow, but healthier than ever before.

Over the past few months, the chef hasimplemented menus designed to main-tain sound health. The caloric content ofentrées has been reduced by at least 100calories.

Fat, sodium and calories all lowered“The executive chef has lowered the fat,sodium and calories while keeping theitems flavorful. We’re also increasing the

use ofhigh-fiber sidedishesand pro-motingthereduc-tion ofred meatentrées,”saysMaureenSimpson-White,

corporate director, Food and NutritionServices. “Our two new Combi ovens[that combine steam and convectioncooking] will help us make healthierfood, too.”

Other healthful measures include post-ing the nutritional value of menu items,eliminating the use of milk producedwith bovine growth hormone and usingonly natural chicken. Most recently, thecafeteria became trans fat-free.

And food is easier to purchase than ever:The Christiana and Wilmington cafete-rias now accept credit cards.

Cafeteria menus offertasty foods, lower fat,salt and calories

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Focus on Excellence – Best Practice Review – March 2010

Consistent with our strategies for engaging staff in continuous improvement and best practices,we regularly review important topics in Focus to help reinforce safe-practice behaviors. Thesetips reinforce information and enable staff to better articulate our safety practices during anunannounced survey.

Dating and timing medical record entries

Q. Do all Medical Record entries have to be dated and timed?

A. YES, all medical record entries must be dated, timed and signed.

Q. Why is dating and timing medical record entries important?

A. Proper documentation for the date and time for medical record entries:

n Facilitates collaborative planning of patient care, treatment and services to achieve optimaloutcomes and continuity of care among health care providers.

n Establishes when an order was given, and when an activity, intervention, treatment or proce-dure occurred or is to take place.

n Establishes a baseline for future actions or assessments and establishes a timeline of events.

Q. How should chart documentation be dated and timed?

A. Documentation is to be recorded legibly, dated, timed and signed.

See example below of correctly dated and timed documentations:

To ask questions, contact the content expert: Kathy Kozak, RN, 733-1697. To reach the SafetyHotline, call SAFE (7233) from within Christiana or Wilmington hospitals. From outside the hospi-

tals, call 302-623-SAFE. Further information is available on the portals in the Archives of BestPractices. From your portal, choose Focus on Excellence, Joint Commission Readiness, Ongoing

Strategies, Educational Strategies, Monthly Q&A.

Labrador rescued from pond finds a permanent homeNew master named the pooch ‘Graham’

The young male labrador that nearly drowned inearly February in the frozen pond behind the

Helen F. Graham Cancer Center was adopted by oneof his rescuers, Christiana Care Life Safety SpecialistLisa Carr.

Carr, who along with Christiana Care ConstablesCpl. Rick White, Cpl. Murray, Patient Guide RichardStout and Nicholas J. Petrelli, M.D., Bank of Americaendowed medical director of the Helen F. GrahamCancer Center, says she was hooked on the poochfrom the time they were trying warm him aftergetting him out of the bond.

“His teeth were chattering and we just kind of bond-ed,” Carr says.

From left, Safety Specialist Lisa Carr, Cpl. Rick White and Cpl.Murray with a frisky Graham revisit the scene of the dog’s close call.