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Physician Focus - Summer 2009 


In This Issue
Welcome! It's a New Way to Link Medical Staff
Emergency Services Revamped, Revved Up
St. Mary's Expands to Sun Prairie
ED Gains Clinical Pharmacy Service
"Wisconsin DRL e-credentialing" Service Launches
Care Coordination to Enhance Outcomes, Efficiency, Satisfaction
Are you a Guardian Angel?
Meet a New Doc in Town
Hail to the Chef
Honors and Recognitions


Welcome! It's a New Way to Link Medical Staff!
This inaugural issue of the quarterly Physician Focus represents a new direction for our medical staff newsletter. We’re going digital to provide easy access to news, information and kudos regarding your role and our St. Mary’s community. As you scan the topics highlighted, you have the option of reading more details if you’re interested. Also, be sure to notice the links on the left-hand side because they house much of the nuts-and-bolts information that used to populate the former Medical Staff Newsletter.

Another initiative under way is our own medical staff website, a one-stop shop for many of your information quests (general updates, policy manuals, committee meeting minutes, etc.). I’ll let you know when we’re ready to launch.

Let me know your thoughts on this first edition by taking this survey. As these official communications evolve, I’ll be gauging interest in frequency and content, and working to keep our dialogue going.


We All Need to Row the Same Direction
It has been 7 months since I took this job as VPMA and it continues to be a learning experience. Last year, about this time, I was beginning the mental gymnastics of whether to follow this path. I concluded then that the next several years were going to be very tumultuous for physicians and the entire health care system but that we had all of the essential elements that we needed to not only weather this change but to help lead the way. The challenge we all face is putting these pieces together; we all need to be rowing the same direction if we are to achieve our true potential.

Our medical staff redesign effort is moving forward to support this journey of collaboration. The Medical Executive Committee has been apprised of the progress to date and a steering committee of 14 medical staff leaders has committed to designing a structure that supports the goals of “streamlining decision-making, empowering physician leadership and partnering with executive leadership to take full advantage of collaborative opportunities based on a shared vision of the future.” Like most of these efforts, the devil is in the details so the steering team will be bringing its conclusions, controversies and recommendations to the broader medical staff in late summer, early fall for discussion and debate.

Another tool I'm relying on is the 2009 physician satisfaction survey, conducted by HealthStream Research. Even though it garnered a lower-than-hoped-for 40 percent response rate from the 380 physicians who were asked for input, it provides a starting point to understanding your needs. St. Mary's Administrative Council is reviewing the results and will create a plan to respond to concerns. Watch this newsletter for further communications about the survey results and our plans for an improved partner s hip with physicians.

The Medical Staff Services is now partnered with the CME department under the leadership of Gale Garvey. Many of you know Gale from the great work that she has been doing with our CME program and I am confident that Gale will bring her enthusiasm, expertise and service orientation to the Medical Staff Office. If you have any questions or comments regarding the office or CME please give Gale a call at 258-6290.

Finally, if you have suggestions for this newsletter, content that you would like to contribute or any general comments please send them my way. I always appreciate your comments, criticisms and suggestions. Have a great summer!

John Butler, MD
VP/Medical Affairs
Comments? Contact Dr. Butler.



Emergency Services Revamped, Revved Up
A major renovation and conversion to the electronic health record in 2008 were just the beginning for St. Mary’s Emergency Services Department. Following work to improve “door to doc” time to less than 30 minutes on average, 2009 adopted even more improvements: a model of team-oriented patient care and a new process for monitoring patients with chest pain.

Among the changes resulting from the renovation is the expansion to 29 exam rooms (from 16) and completion of a central charting station that configures the main emergency treatment area to be more like that of a race track. All changes, including steps like bedside registration, have been made with efficiencies in mind to improve patient care.

As of January, a team-based model of patient care also contributes to swift and effective medicine for nearly 40,000 emergency patients each year. Exam rooms are assigned to a team with a physician, team nursing leader, two team nurses and a technician. This helps to streamline communication within the team, and limit the geographic area for which the team is responsible. The team leader continues on some of the functions of the charge nurse, but also has a greater knowledge of the patient’s condition, and is more available for direct patient care. A designated area for consulting physicians has been set aside for the care and/or admission of patients into the hospital.

Patients with complaints of chest pain and a non-diagnostic EKG will benefit from the new Chest Pain Center for low-risk patients. They will be placed into a four-bed unit of the Emergency Services Department, under management of the Dean hospitalist group, for observation to rule out myocardial infarction as the source of their pain. Standardized protocols call for timely, noninvasive cardiac stress testing and serial Troponin assays, allowing the hospitalist to discharge in most situations in 6 to 12 hours without compromise of patient safety.



St. Mary's Expands to Sun Prairie
The new St. Mary’s Sun Prairie Emergency Center, set to open July 1, will shave half an hour or more from the drive to a downtown Madison emergency room.

Located at Highway 151 and Reiner Road, Wisconsin’s only satellite emergency center will operate as a department of St. Mary’s Hospital and will be staffed by the same emergency physicians and nurses who serve the hospital.

“Our emergency physicians will rotate between the two facilities and among Columbus Community Hospital and Upland Hills Health in Dodgeville to ensure the same level of care throughout the region,” says St. Mary’s President Fra nk Byrne, MD.

St. Mary’s Sun Prairie Emergency Center will feature 10 treatment rooms (including a firetruck-themed room for pediatric patients), a full-service laboratory, radiology (including a CT scanner), a helipad and a two-ambulance garage.



ED Gains Clinical Pharmacy Service
A clinical pharmacist is now present in the Emergency Services department Monday through Friday from 2 to 10:30 p.m. in addition to covering 3 SW.

The Emergency Services pharmacist’s primary role is to update patient medication histories before the admitting physician or prescriber orders medications, facilitating the medication reconciliation process. This saves a step for emergency nurses as well as nurses on the admitting unit who will no longer have to repeat the medication interview on admission. The pharmacist also is available to emergency staff to answer drug information questions.

A 2008 survey of hospitals throughout the country found that 6.8% of hospitals have a pharmacist regularly assigned to the emergency department and that pharmacist-acquired medication histories were more complete than those acquired by other health professionals. St. Mary's Emergency Services pharmacists are Randy Binning, Bobbi Aulie, Krista McCaulley, Cathy Ackeret, and Joel Jones. They are available via cell phone at 209-6772.



"Wisconsin DRL e-credentialing" Service Launches
Starting this summer, your renewed credential will be delivered fast to your inbox, not your mailbox. The Better E-Credentialing capability of the Wisconsin Department of Regulation and Licensing (DRL) will reduce complexity and redundancy for users by offering access to multiple credentials from a single source so that users enter information once rather than multiple times. It’s available at http://drl.wi.gov/index.htm

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Care Coordination to Enhance Outcomes, Efficiency, Satisfaction
Transformational change is beginning in the Department of Patient and Family Services (PFS) to help achieve better clinical outcomes, improved patient satisfaction and improved efficiency of care as measured by length of stay and cost per case. Physicians are critical to the success of this effort.

PFS has worked compassionately with patients and closely with others on the clinical care team to assure safe and effective plans for discharge from St. Mary’s. The expertise of this department will now serve as the focal point for improving the coordination of care for patients throughout their hospital stay. An interdisciplinary team of physicians, nurses, PFS staff, joined by an expert in process improvement, has been meeting weekly over the past few months and has identified multiple interventions to improve care coordination, including a well-defined plan for the day and/or plan for the hospital stay that is articulated on hospital day 1, daily interdisciplinary rounds and a PFS nurse working as the coordinator of the process. Physicians and advanced practitioners will be:
  • invited to participate in the daily rounding whenever possible,
  • contacted by the care coordinator nurse who will assist you in making your patient’s stay as effective as possible,
  • asked to assist the rest of the care team in clearly understanding the care plan and
  • able to count on the care team to assist in communicating your plans to patients and their families.
Regular reports will be provided regarding patient satisfaction, length of stay, readmission rate and unit-specific quality measures. Please contact Larry Peterson (director of PFS) 258-6560 or John Butler (VP/Medical Affairs) 258-5658 with any suggestions or feedback on this process.



Are You a Guardian Angel?
St. Mary's Guardian Angel program provides a grateful patient or family member with an opportunity to recognize a caregiver or other staff or volunteer who has made a difference during a patient's stay. Anyone at St. Mary's may be recognized as a Guardian Angel.

Information on the program will be sent to the patients' home 30 to 60 days after discharge. When a patient makes a gift to St. Mary's Foundation in honor of someone at the hospital, that person will receive a Guardian Angel pin and recognition. The Foundation will use the gifts to support programs at St. Mary's Hospital. Currently the program will reach out to inpatients. Eventually the program will reach outpatients and clients at other St. Mary's entities.

In the coming weeks you will notice information about the program in patient rooms and throughout the hospital. When a patient asks what they can do to express their appreciation for the compassionate care they receive, please suggest they consider a gift to St. Mary's Foundation as those gifts directly benefit patients, families, physicians and staff. If you have questions about this program, contact St. Mary's Foundation at 258-5600.



Meet a New Doc in Town

Dr. Quinn Holzheimer, a member of Madison Emergency Physicians, joined St. Mary’s ER in December 2008 after moving here from Washington, D.C. He completed his residency and was chief resident at the University of South Florida in Tampa, graduating in 2006. He then worked at Georgetown University Hospital, a busy 800-bed facility with 80,000 visitors to the emergency department. In an email note to administrators, he offered some observations about St. Mary’s:

“I just wanted to let you know what an amazing health care system we have here at St. Mary’s. … By far, this is the most perfect environment to practice Emergency Medicine. A large majority of that is the system that is in place (I consistently refer to my work environment as a smooth running machine). I credit this to the physician administration, the nursing administration, and the soul of the ED, which are the nurses.

“I love absolutely all of our nurses. I have not yet found one that I didn’t think was more than competent, nor have I been concerned for the care being delivered on my patients. I adore all of our nursing staff, ESTs, registration, everything. I absolutely love my job and want to let you know how amazing the staff is here at St. Mary’s!”

Dr. Holzheimer and his wife, Wendy (a physical therapist), have two young sons, Noah and Cale.

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Chef David ScheifelHail to the Chef!
He may not be seated at your table, but David Scheifel is definitely part of your dining experience in St. Mary’s cafeteria and at hospital events, including the monthly physicians’ breakfasts, Grand Rounds and other medical staff events.

His culinary talents come well-backed. For 12 years, David owned and operated David’s gourmet restaurant in Monona. He also had served as executive chef at Top of the Park on the Square and won first-place honors four years in a row in a cheese-carving competition held at the Wisconsin State Fair.

He has been with St. Mary’s since 2001 and now holds the title of culinary specialist in the Food and Nutrition Department, where he continues to bring new ideas for the preparation and presentation of food for patients, the cafeteria and catered events.


Honors and Recognitions
Congratulations are in order for our colleagues who go above and beyond the duty of their day (or night) jobs.

Dean Health Plan ranks highest in member satisfaction against health plans in the Minnesota-Wisconsin region, according to the J.D. Power and Associates 2009 National Health Insurance Plan Study.

Dean Health System physicians were the most proactive in screening Madison-area patients for major diseases last year, and they generally outperformed doctors in most of the state, according to data from the Wisconsin Collaborative for Healthcare Quality. The measures include cancer screening, pneumonia shots, cholesterol testing and control, and asking about tobacco use. Higher scores are thought to lead to better prevention, identification and reduction in the severity of many diseases. To read an article about it, log onto the Wisconsin State Journal .

Dr. James Levin received the 2009 Volunteer of the Year Award from the American Liver Foundation - Wisconsin chapter for his work to improve diagnoses and outcomes of liver disease while also raising awareness and financial support for the organization.







The February issue of the Wisconsin Medical Journal features an article about medical information and the use of emerging technologies, written by two physicians with ties to St. Mary's. They are Dr. Anne-Marie Lozeau (photo right, Assistant Residency Director) and Dr. Beth Potter (photo left, Medical Director at Wingra Family Medical Clinic, which was built by St. Mary's). Both are faculty members in the UW Department of Family Medicine, housed in St. Mary's Alumni Hall.





Denise Mitton, RN (Emergency Services) will be recognized this spring as a Champion in Women's Health by the Wisconsin Women's Health Foundation for her role in organizing Dean & St. Mary's life-saving Level One Heart Attack Program.






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Physician Focus is produced by St. Mary’s Department of Public Relations and Marketing in collaboration with the Medical Staff Services. Article submissions of interest to the medical staff are welcome at any time. We reserve the right to edit for length and format. Please email short, well-organized information to SMH_MedStaff@ssmhc.com.

   
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