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FALL 2012 A GBMC Publication for Physicians Good Catches Result in System Changes from the deskof . . . Dear Colleagues, Integrated, high quality care among physicians, as well as between physicians and the hospital, is the goal of the best healthcare delivery systems. Several articles in this issue of M.D. Today detail GBMC’s efforts to achieve that type of care for our patients. As outlined in this issue, Greater Baltimore Health Alliance (GBHA) including GBMC hospital, was designated as an Accountable Care Organization (ACO) and will participate in Medicare’s Shared Savings Program. Becoming an ACO has been an important part of the forward-looking strategy of GBMC’s leadership, regardless of what actually happens politically to President Obama’s plans. Becoming an ACO requires a large and well integrated primary care base that provides cost efficient but comprehensive care to meet pre-established high quality goals. GBMC has formed an alliance among employed and allied primary care providers and the hospital that is committed to this concept and has committed significant resources to advances in medical information technologies, integrating these various practices with the hospital and its specialists. By participating in the Shared Savings Program, which poses no financial risk to the hospital, being an ACO seems to be a win-win proposition for GBMC, the physicians and, importantly, the patients. Developing a strong, integrated primary care base is vital to the future of GBMC, but developing strong and integrated specialty care is also critical to our reputation. Since its inception, GBMC has been known for its ENT and Head and Neck Cancer surgeons. These physicians, working together with the area’s largest group of endocrinologists and our highly regarded pathologists, have developed a Thyroid Center to better diagnose and manage both benign and malignant disorders of the thyroid gland. This newly formed center can greatly aid physicians in the management of patients with these common, but often perplexing, conditions. A variety of specialists will coordinate their approaches to provide the best and most up-to-date care for patients with thyroid problems. Finally, communicating to the medical staff lessons learned about quality and patient safety issues is always a sensitive and difficult, but essential, task. In this issue of M.D. Today, we introduce a new feature, highlighting a lesson learned from our Quality and Patient Safety program. A culture that emphasizes patient safety is actively promoted at GBMC by promoting the reporting of “good catches” by the staff and publicly reporting those findings for all to learn from, so patient safety is seen as everyone’s responsibility. Please read the article on “look alike-sound alike” drugs to see what a “good catch” can mean for a safer GBMC. Harold J. Tucker, MD Chief of Staff [email protected] 2 M.D.Today ■ Fall 2012 what’s new New Technology Modernizes Hand Hygiene Compliance It’s a well-known fact that improper hand hygiene is one of the biggest contributors to hospital-acquired infections and the spread of disease throughout the hospital. Although GBMC has always placed great emphasis on hand hygiene, there’s room for improvement. Recently, a new technology was introduced in the Medical Intensive Care Unit (MICU) to further boost hand hygiene compliance in one of the hospital’s most sensitive areas. GBMC received a free one-year trial of a new hand hygiene compliance technology from the Sparks, Maryland-based company, AiRISTA. With this new technology, physicians and care providers are given a special badge that hangs behind their hospital IDs (pictured above). This badge wirelessly communicates with several sensors to monitor their entry and exit from a patient’s room, as well as when and if they activate either the alcohol-based hand sanitizer or soap dispenser. “With this new equipment, each sanitizer and soap dispenser is synched up with the clinician’s badge,” says Stephanie Mayoryk, RN, BSN, CIC, Infection Control Practitioner. “If a healthcare worker did not activate a soap dispenser or alcohol hand sanitizer dispenser within 30 seconds of entering or exiting a room, a reminder feature will activate. After this signal is activated, the clinician has the chance to perform hand hygiene without it being counted against them.” While some staff members are concerned this new technology will act more like a “Big Brother” tracking device, rather than just something for monitoring hand hygiene, supporters of the pilot program stress that’s not the case. Chelsea Woodell, RN, BSN, practices effective hand hygiene before working with a patient. “The real purpose of this tool is that it will act as a reminder to our staff to perform hand hygiene,” says John R. Saunders, Jr., MD, FACS, Chief Medical Officer. “The device is specifically designed to only monitor hand hygiene and cannot act as a location tracker.” The AiRISTA devices were installed in the MICU in August and were up and running in September. Although the MICU is currently the only unit planning to pilot this new technology, Ms. Mayoryk and Dr. Saunders are optimistic that it will reveal additional insights into hand hygiene behaviors. “We’re very excited about the potential impact this system has on patient safety and hope it helps to take hand hygiene compliance at GBMC to the next level,” says Ms. Mayoryk. ■ in the news GBMC Collaborates with Johns Hopkins Home Care Group GBMC has selected Johns Hopkins Home Care Group as its preferred provider for home care services through the entire system. For several years, Johns Hopkins has been the contracted provider for patients being discharged from GBMC, in addition to providing home infusion and home medical equipment for Gilchrist Hospice Care and its Gilchrist Kids program. After screening multiple home care providers, a GBMC committee with representatives from the Hospitalist Group, Wound Care, ED, Care Management, Nursing, Pharmacy, GBHA and GBMA unanimously selected Johns Hopkins to continue to offer the home care support services that patients often need. These include skilled nursing; occupational, physical and speech therapies; infusion; respiratory/medical equipment and supplies (HME); and home health for both pediatric and adult patients. Three on-site Johns Hopkins Home Care and HME liaisons assist GBMC’s Care Managers in arranging the services for patients in the home. Additionally, they have on-site equipment such as oxygen, ambulatory aides, pumps and other items needed to safely transition patients to the community. While certain criteria need to be met in order for Medicare patients to qualify for skilled home health coverage, Johns Hopkins also owns a private duty home support agency that patients and families can choose to fund personal care provided by certified nursing assistants to help with activities of daily living and other services on an hourly, shift or live-in basis. For information on Johns Hopkins Home Care Group services or to refer a patient, call one of the following numbers. ■ Home Health, Infusion, Private Duty: 443-257-0214 Respiratory/Medical Equipment: 410-288-8150 “GBMC and Johns Hopkins are committed to providing the highest quality and most cost-effective home-based services for patients,” says Cathy Hamel, Vice President of Post Acute Services at GBMC and Executive Director of Gilchrist Hospice Care. “We’re thrilled to be collaborating with Johns Hopkins to extend these much-needed services to those we care for in the Greater Baltimore community. The collaboration between hospitals and post-acute providers is crucial to reducing readmissions and improving patients’ health.” Johns Hopkins has agreements with most payers and also agreed to provide “gratis” services for especially needy patients/families eligible for charity care. Johns Hopkins Home Care and HME liaisons (L to R): Judy Ledford, RN; Vickie Spencer, RN; and Joel Fernandez, DME Coordinator 4 M.D.Today ■ Fall 2012 GBMC Recognized for “Green” Hospital Efforts In recognition of the organization’s significant earth-friendly accomplishments, GBMC HealthCare has been named a winner of a Practice Greenhealth Environmental Excellence Partner for Change Award! GBMC’s Green Team includes representatives from 20 different departments, led by Mike Forthman, Vice President of Facilities and Support Services. The group has helped to make significant strides in the hospital’s commitment to sustainability, including: Achieving a 13 percent annual reduction in total waste output via a campus-wide recycling program. Saving nearly $1 million in gas and electric bills via various initiatives such as lowering energy usage during peak load consumption days in the summer, when demand on the energy grid is at its highest. Diverting more than 10,000 pounds of food scraps every month from landfills via a composting program. Changing office supply vendors to a company that has less of a carbon footprint, such as a more efficient delivery system and using environmentally friendly reusable plastic totes instead of cardboard boxes. Reducing printer inventory by identifying very low-use printers and older units that were not energy efficient. Switching to multi-use condiment pumps from wasteful single-serve packets. Introducing paperless meal tickets for employees to cut out unnecessary paper. Organizing an annual Earth Day event to promote environmentally responsible behavior, both at work and at home. Joseph Califano Announced as Medical Director of Dance Center Joseph A. Califano, III, MD, FACS, has been named Medical Director of GBMC’s Milton J. Dance, Jr. Head and Neck Center. Dr. Califano earned his medical degree from Harvard University, completed his residency at Johns Hopkins Hospital and completed his fellowship at Memorial Sloan-Kettering Cancer Center. He also serves as a surgeon with Johns Hopkins Head and Neck Surgery at GBMC and as Professor, Otolaryngology-Head and Neck Surgery, and Head & Neck Research Division at The Johns Hopkins University. Board-certified in Otolaryngology, Dr. Califano’s clinical interests include salivary gland tumors, cancers of the mouth, throat, larynx, sinuses, thyroid and skull base. In his new role, Dr. Califano oversees all aspects of the specialized, interdisciplinary patient care delivered at the Dance Center. “It is truly an honor and a privilege to have the opportunity to serve as Medical Director of the Milton J. Dance, Jr. Head and Neck Center,” says Dr. Califano. “I look forward to working with a superb staff to provide innovative, personalized care to our patients.” Dr. Califano succeeds John R. Saunders, Jr., MD, FACS, who acted as the Dance Center’s Medical Director for 19 years, expanding it from a staff of five to a team of more than 35. During his tenure, the practice of Johns Hopkins Head and Neck Surgery at GBMC was integrated with the Dance Center, the Johns Hopkins Voice Center at GBMC was developed, the Head and Neck Tumor Board was formed and collaborative research efforts were standardized. “Under Dr. Califano’s leadership, I look forward to both further expansion of the Center’s programs and recognition of its unique role in the treatment and management of head and neck diseases,” says Dr. Saunders, who currently serves on GBMC’s Executive Team as Chief Medical Officer. ■ For more information about GBMC’s Green Team, please visit the “Green Pages” of the InfoWeb! ■ 5 M.D.Today ■ Fall 2012 feature ^ Good Catches Result in System Changes Since the launch of Quantros, there has been a significant rise in reported incidents and increased reporting is now an organizational goal. While it may seem counterintuitive to encourage reporting, these good catches and near misses actually allow patient safety experts to study the processes of care to prevent similar events in the future. In an effort to keep staff informed of such incidents and make them more real, Carolyn Candiello, Vice President of Quality and Patient Safety, and John R. Saunders, Jr., MD, FACS, Chief Medical Officer, are sharing the good catch stories and actual events by presenting them at meetings of GBMC Leadership, the Board Quality Committee, Medical Board and Board of Directors. “The stories are often shared from the patient’s perspective and include corrective actions and learning. Incidents viewed as statistics don’t seem real. Hearing about how an error or a near miss has impacted an individual patient or their family makes it real,” says Ms. Candiello. To further spread the word about these stories, they will also be featured regularly in M.D. Today and in GBMC’s employee publication, Greater Connections. “Our hope is that all physicians and staff will learn from these stories and continue reporting incidents through Quantros so that we can address systems that are working and those that need to be changed,” says Dr. Saunders. 6 M.D.Today ■ Fall 2012 GBMC has made it a strategic and organizational priority to focus on quality and patient safety. Providing patients with the safest, highest quality care that we would want for our own loved ones remains at the core of the organization’s mission. Although significant strides have been made, until we reach perfection, there will always be room for improvement. That is why GBMC invested in and implemented a sophisticated patient safety reporting system called Quantros within the past year. This tool allows employees to easily report both actual and near-miss events (also known as “good catches”) quickly and even anonymously. Look Alike-Sound Alike Medication Error Prevented This first story involves one of the most common mistakes, a “look alike-sound alike” medication error. Earlier this year, a 48-year-old female patient was scheduled for a hip arthrogram. The patient was prescribed epinephrine, an injectable drug typically used in this situation to help the contrast dye from spreading to other tissues. It’s supplied in a tiny vial with virtually unreadable text. The radiology technician noticed that something didn’t seem right before administering the injection, and pointed it out to the physician. Upon further examination, it was discovered that the vial provided to the technician was labeled ephedrine, not epinephrine. This incident was considered a good catch or near miss, since it did not reach the patient. In this instance, the radiology technician’s questioning attitude helped avoid a medication error. “We want to ask for physicians’ help as we work to change the culture of safety here at GBMC,” says Dr. Saunders. “When physicians and other leaders encourage a questioning attitude, we foster a culture where safety and quality can flourish. In fact, it was the physician who reported this incident.” Using what was learned from this incident resulted in a few simple system changes that can help prevent it from occurring a second time. These included: ■ Epinephrine and Ephedrine are no longer stored next to each other in any medication storage areas. ■ Tallman lettering is now used on the labels, allowing the provider to clearly see the differences: EPINEPHrine and ePHEDrine. ■ The pharmacy has also field-tested and will implement a bar code system later this year that allows the medication vial’s bar code to be scanned when stocking the drawers. With each good catch that is reported, we learn about holes in our processes, which allows us to make positive changes to prevent a similar outcome in the future. Sharing this story has raised awareness that errors can happen. “I have had staff stop me in the hall to tell me how much they appreciated that story and how it has helped them in their daily practice,” says Ms. Candiello. To report an actual event or a near miss, go to the InfoWeb and click on the “Quality and Patient Safety” tab. To report a GBMC event, click on the “Report a GBMC Event” button and to report a GBMA event, click on the “Report a GBMA Event” button. These can be reported anonymously or by using an employee ID number. Physicians who have questions are encouraged to contact Ms. Candiello at [email protected]. ■ 7 M.D.Today ■ Fall 2012 primary care point of view Diet and Exercise Still Rank Among the Most Effective Prescriptions By Kimberly Kesler, MD While obstetrician-gynecologists are technically specialists, many women do not get regular checkups with a primary care doctor, so we are left to address a number of routine health issues. I take advantage of this trend to focus on what I believe is the most influential medical treatment we have available – proper fitness and nutrition. The majority of women’s health issues we deal with are affected by exercise: breast cancer, pregnancy, urinary incontinence, osteoporosis and heavy menstrual cycles. It’s rare to meet patients who understand how much exercise can reduce their risks of these illnesses. ■ The risk of breast cancer has been shown to be significantly lower in women of normal BMI and those who exercise regularly. ■ We see better outcomes for mothers and their babies when the women are healthier and of an ideal body weight prior to pregnancy. ■ Evidence has shown that obesity increases the risk of urinary incontinence. Regular toning and strength exercises prevent and/or delay the onset of incontinence and also treat it once present, avoiding unnecessary medications or surgery. Primary Care Point of View focuses on the firsthand experiences of primary care physicians and fosters discussion of topics of concern or interest to practices. Share your ideas for future articles by emailing Jessica Schoeffield at [email protected] or Harold Tucker, MD, Chief of Staff, at [email protected]. 8 M.D.Today ■ Fall 2012 ■ Exercise stimulates bone growth/strength and improves flexibility, key factors for preventing osteoporosis. ■ Losing body fat can decrease heavy menstrual flows and associated pain without the need for medication. A combination of cardio and weight training is ideal for most women. I encourage patients to hire a personal trainer for at least one session to learn proper form and technique. In terms of proper diet, the amount of information on the Web makes nutritional information easy to find, but it can be difficult to discern what is actually “healthy.” In general, plans aimed at eating real foods instead of processed, combining protein, complex carbs and low saturated fats are the way to go. The “Food is Fuel” adage is only too true! The excuse I often hear for lack of exercise and poor diet is “I don’t have time!” Yes, we’re all busy these days, but most people watch TV or read for a few hours a week. There’s that missing time! Twenty minutes of high intensity cardio three days a week and two to three weight sessions a week are more than enough to keep the immune system primed and many health issues at bay. The list of benefits our patients can derive from fitness and good nutrition extends beyond what can fit onto this page, but we sometimes overlook them in favor of medications and surgery. It’s important to step back every so often to remind ourselves that some of the simplest treatments available are also the most powerful. ■ spotlight Treating Thyroid Patients with a Team Approach GBMC, in conjunction with Bay West Endocrinology Associates, has developed a comprehensive resource for patients with thyroid disorders. The Thyroid Center at GBMC, which opened in September 2012, diagnoses and treats a full range of thyroid and parathyroid conditions from hyperthyroidism and hypothyroidism to benign nodules and thyroid cancer. Patients of the Thyroid Center have easy access to Bay West’s endocrinologists and, if necessary, ear, nose and throat/head and neck surgeons and oncologists from GBMC’s Sandra & Malcolm Berman Cancer Institute. Its multidisciplinary team works closely with GBMC’s Departments of Pathology and Radiology to ensure comprehensive, integrated and coordinated care. “Thyroid disorders are quite prevalent in the United States.Though millions are known to have these disorders, many go undiagnosed,” explains endocrinologist Francis Lee, MD, Medical Director of the Thyroid Center at GBMC. “The disorders are often the culprit of common medical symptoms such as unexplained weight loss, obesity, swelling in the neck, changes in heart rate, depression/mood changes, fatigue and more. Most common in women, disorders of the thyroid can also cause disruptions in the menstrual cycle and fertility problems.” Though most of the thyroid cases seen through the Center will not need to progress past the endocrinology office, approximately 10 percent will be referred for further treatment at GBMC by specialists such as thyroid surgeons or oncologists. “The type of care coordination we offer is beneficial for our patients,” says Brian Kaplan, MD, FACS, Surgical Director of the Center. “The endocrinologist acts as the point person in the patient’s care but facilitates easy transitions and referrals to other thyroid specialists as necessary. Patients can feel confident in treatment provided by the Thyroid Center at GBMC, as our expert team treats more thyroid cases than any other community hospital.” GBMC’s thyroid experts are equipped to diagnose and treat a full range of thyroid conditions – from the most common to the rare, including: Hypothyroidism (such as Hashimoto’s thyroiditis) Hyperthyroidism (such as Graves’ disease, toxic adenomas and multinodular Goiter) ■ Thyroid cancer ■ Noncancerous thyroid tumors ■ Nodular or multinodular thyroid disease ■ Subacute thyroiditis ■ Pituitary gland malfunctions ■ Hypoparathyroidism ■ Hyperparathyroidism ■ ■ Diagnostic and treatment services for thyroid disorders at GBMC include: ultrasound, ultrasound-guided fine needle aspiration, radiologic imaging, expert pathologic evaluation, evaluation and treatment of parathyroid disease, medical management of thyroid conditions, and surgical expert evaluation and treatment for thyroid cancer. Endocrinologists at Bay West Endocrinology Associates serve as the starting point for patients seeking treatment through the Thyroid Center. Patient referrals should be made by calling 443-THYROID (443-849-7643). Visit www.gbmc.org/thyroid for more information. ■ 9 M.D.Today ■ Fall 2012 update Shared Savings Program is an Exciting Opportunity for the Organization According to Colin Ward, Executive Director of Greater Baltimore Health Alliance (GBHA), there is an overarching assumption in healthcare: “No one can continue paying for healthcare in its current state.” This was a major factor in GBHA’s decision to participate in the Medicare Shared Savings Program, which rewards Accountable Care Organizations (ACOs) for reducing growth in healthcare costs while meeting performance standards in quality care and putting patients first. Officially announced in July 2012, GBHA’s participation in the program is a significant milestone, as it became the first ACO in Maryland to have ties to a hospital. As an ACO, GBHA’s goal is to provide patients the best access to the highest quality care with the least amount of duplication and waste. Its participation in the Shared Savings Program is evidence that the Centers for Medicare and Medicaid Services (CMS) has recognized that the organization is on the right track to accomplish these goals. “Because it will help serve better care at a lower cost to patients, we believe healthcare will eventually shift from a fee-for-service model to a fee-for-health model. In anticipation of this, we’re building tools to properly care for our population of patients,” says Mr. Ward. “We’ve already put a permanent infrastructure in place – one that utilizes Electronic Medical Records (EMR) and allows for better care coordination.” 10 M.D.Today ■ Fall 2012 Now that it’s part of the program, GBHA is looking ahead to next steps, which include: ■ Gathering clinical (physician/appointment) and claims (what payers are actually paying for) data to identify gaps and opportunities in care. Practices can use this data to contact at-risk patients and create condition-specific care plans ■ Negotiating with commercial payers that have similar systems in place and encouraging them to align with GBHA ■ Developing an EMR subsidy for specialty providers GBHA has created a mechanism for community-based physicians to participate in this program which allows them to maintain independence in how they run their practice. It is also developing a program to link specialty providers to the ACO using a common EMR. Though GBHA will be eligible for a 50 percent savings bonus if certain quality metrics set by CMS and a minimum savings rate are achieved, there is no risk of penalty. “GBHA applied for the single-sided risk model of the Shared Savings Program, meaning that if the goals are not achieved, repayment to CMS will not be required. Something physicians can be excited about is that if we do meet the necessary criteria to receive the bonus, much of it will go straight back to them,” he says. ■ people Who’s New Ashleigh M. Hicks, MD, joined GBMC’s Gilchrist Greater Living practice as a geriatrician in July 2012. A graduate of the University of Maryland School of Medicine, Dr. Hicks completed her residency in Internal Medicine at the Johns Hopkins University Bayview Medical Center. She went on to receive fellowship training in Geriatric Medicine at Johns Hopkins University. Prior to joining GBMC, Dr. Hicks was employed as a physician with Keswick Multi-Care Center in Baltimore. She is board-certified in Internal Medicine. Charles Eck, MD, has joined the GBMC at Hunt Valley practice as a boardcertified Internal Medicine (primary care) physician. Dr. Eck earned his medical degree at the University of Maryland School of Medicine and completed his Internal Medicine internship and residency at the University of Nevada. Before joining GBMC, he served as a staff physician at Kaiser Permanente in White Marsh, Maryland. Prior to his work with Kaiser, Dr. Eck was in private practice for 21 years. COMP Earns Level 1 Accreditation In August 2012, GBMC’s Comprehensive Obesity Management Program (COMP) earned Level 1 accreditation by the American College of Surgeons (ACS) Bariatric Surgery Center Network. COMP is a multidisciplinary service that addresses the entire spectrum of care and needs of bariatric patients from the pre-hospital phase through the treatment process and postoperative care. The Level 1 designation means that the program has effectively demonstrated its ability to provide complete bariatric surgical care for some of the most challenging and complex patients. GBMC was formerly a Bariatric Surgery Center of Excellence with the American Society for Metabolic and Bariatric Surgery (ASMBS) from 2008 through June 2012. ASMBS merged with ACS Bariatric Surgery Center Network and GBMC underwent a new accreditation process. “This accomplishment demonstrates GBMC’s commitment to quality care and good outcomes,” says Peter Liao, MD, PhD, FACS, Medical Director of COMP. “Prospective bariatric surgery patients should feel comfortable knowing we have reached this high standard of care.” Accomplishments Ophthalmologist Alan L. Robin, MD, was recently honored with the prestigious Dr. G. Venkataswamy Endowment Oration Award by the Aravind Eye Care System in Madurai, India. This award acknowledges Ophthalmology and Vision Sciences professionals who have contributed to global prevention of blindness through their groundbreaking vision research, patient care and outreach. Dr. Robin was specifically recognized for his pioneering research in glaucoma as well as his significant efforts over the past 25 years to train ophthalmologists in developing countries, thus enabling them to detect and treat patients’ glaucoma symptoms earlier. Radiation Oncology Department Achieves ACR-ASTRO Accreditation The Sandra & Malcolm Berman Cancer Institute’s Radiation Oncology Department was recently surveyed by the American College of Radiology/American Society for Radiation Oncology (ACR-ASTRO) and earned accreditation through November 2014. This important recognition serves to acknowledge the facility’s commitment to high quality and to demonstrate it to patients, physicians, regulatory agencies and payers. The survey is conducted on-site by third-party peer reviewers, who evaluate all aspects of the facility’s radiation oncology services, from equipment to treatment planning and record keeping. 11 M.D.Today ■ Fall 2012 6701 N. Charles Street ■ Baltimore, Maryland 21204 443.849.2000 ■ TTY: 1-800-735-2258 ■ www.gbmc.org NON-PROFIT ORG U.S. POSTAGE PAID PERMIT NO. 4406 BALTIMORE, MD M.D. Today is published quarterly by the Marketing and Communications Department of Greater Baltimore Medical Center, a private, non-profit healthcare provider. ■ ■ ■ ■ ■ ■ ■ Michael P. Hartnett, Director of Marketing & Research Jessica Schoeffield, Publications Coordinator Heather Abdel-Salam, Contributing Writer Gwen Graham, Contributing Writer Tracey Brown, Contributing Photographer ShockDesigns, Design & Layout Schmitz Press, Printing Save These Dates Medical Staff Meeting Tuesday, November 13 at 6:30 p.m. in the Civiletti Conference Center, Physicians Pavilion East Reception to follow in the Dining Room. Twenty-Second Annual Physician Recognition Party Other Events Perspectives in Medicine Lectures Monday, December 3, from 6:00 - 9:00 p.m. Baltimore Country Club Roland Park Clubhouse 4712 Club Road Wednesday, November 7, 2012, 5:45 p.m. Speaker: Dr. Reginald Davis Topic: Advancements in Spine Surgery Please RSVP to Laurie Wagerman at 443-849-3670 or [email protected]. Continuing Education Conferences Schwartz Center Rounds at GBMC Thursday, March 7, 2013, 5:45 p.m. Wednesday, April 10, 2013, 5:45 p.m. Speakers: TBD $20.00 per person/dinner and lecture Civiletti Conference Center, Physicians Pavilion East Call 443-849-2773 for information or register online at http://foundation.gbmc.org/attend. Wednesday, November 7 Helping a Colleague in Trouble Wednesday, December 5 Saving Brittany - The Miraculous Recovery of a Victim of Torture in Baltimore County Women in Medicine Networking Luncheon Time: 12:00 – 1:00 p.m. Lunch served beginning at 11:30 a.m. Civiletti Conference Center, Physicians Pavilion East No registration required. Contact the CME Office at 443-849-3690 for more information. Thursday, January 24, 2013 12:00 – 1:00 p.m. Civiletti Conference Center, Physicians Pavilion East To register or for more information, contact Mary Ely at 443-849-2435. Read M.D. Today Online! VISIT WWW.GBMC.ORG AND CLICK ON THE “COMMUNITY ” TAB TO BROWSE GBMC ’S PUBLICATIONS.