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Medical Staff Reference Medical Staff Reference ............................................................................................................................. 1 Welcome to the Mercy Hospital Anderson Medical Staff .......................................................................... 4 Medical Staff Office (624-4058) 8:00-4:30 weekdays ........................................................................... 4 Director of Physician Services ........................................................................................................................... 4 History of Mercy Hospital Anderson .......................................................................................................... 5 Physician Parking Available -‐-‐Requires Decal ................................................................................................... 5 Medical Staff Members Photo Identification Badge ......................................................................................... 6 The Stair Steps of the Mercy Mark ................................................................................................................... 6 Catholic Health Partners (CHP) ......................................................................................................................... 6 CHP Divisional Structure ................................................................................................................................... 6 Mercy Hospital Anderson Nursing Units ................................................................................................... 7 A Tower ................................................................................................................................................ 15 A1 Medical Telemetry Unit – Transforming Care at the Bedside ................................................................... 15 A3 an Extension of A1 ..................................................................................................................................... 15 A2 Cardiology and Step-‐Down ........................................................................................................................ 15 Family Birthing Center (FBC) 3rd floor A Tower ............................................................................................... 16 B Tower ................................................................................................................................................ 16 Admits and Discharges ......................................................................................................................... 16 Executive Health Resources® (E.H.R.) -‐ Physician Advisory Group ................................................................. 16 Outpatient Observation Services .................................................................................................................... 17 Discharge Planning ......................................................................................................................................... 17 Mercy Hospital Anderson Clinical Laboratory......................................................................................... 19 Lead Technologists ......................................................................................................................................... 19 Turn-‐around Times ......................................................................................................................................... 19 Referral Tests .................................................................................................................................................. 19 Add-‐on Tests ................................................................................................................................................... 19 Blood Bank Available Products: ...................................................................................................................... 19 Ordering Blood Products ................................................................................................................................ 20 About Mercy Anderson............................................................................................................................. 21 Medical Staff Reference Updated June 20, 2011 1 Service Areas of Mercy Anderson ........................................................................................................ 21 Primary service areas ........................................................................................................................... 22 Categories of Medical Staff Membership ............................................................................................. 22 2011 Mercy Hospital Anderson Medical Staff Governance ......................Error! 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Serious Adverse Event Management ........................................................................................................ 23 Immediate Response Following a Serious Adverse Event ................................................................... 23 Incident Reporting For Physicians Available Through SafeCARE ...................................................... 24 Modified Early Warning System (MEWS) -- Early Detection of Patient Deterioration ...................... 24 Code Blue.............................................................................................................................................. 24 FAST Team – Rapid Response Team ............................................................................................................... 25 The Clinical Administrator (CA) ....................................................................................................................... 25 Administrator on Call ............................................................................Error! 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Epic Electronic Medical Records and Physician Order Entry .................................................................. 25 Dictation Instructions ............................................................................................................................ 25 Epic Tips and Tricks ............................................................................................................................. 26 Orders Management – Inpatient Preference List ........................................................................................... 26 Discharge Navigator – Prescription Preference List ....................................................................................... 26 Surgical Navigator – Phases of Care ............................................................................................................... 26 In Basket – How Things Get There .................................................................................................................. 26 SmartPhrases Speed Up Documentation ........................................................................................................ 27 Guard Your Epic Password Closely and Do Not Give to Anyone Else ............................................................. 27 Epic Access From Home or Office ................................................................................................................... 27 Three Methods for Order Authentication ...................................................................................................... 27 Epic Challenge Questions ................................................................................................................................ 27 Hospital Operation .................................................................................................................................... 28 Emergency Department Security .................................................................................................................... 28 Translators Available, call the Operator ......................................................................................................... 28 Over the phone Interpreters, dial “O” for the operator ................................................................................. 28 Sign Language Interpreters ............................................................................................................................. 28 How to View the Hospitalist Schedule – amion.com ...................................................................................... 28 Patient Complaints and Grievance Management .................................................................................. 28 Volunteers Alive and Well at Mercy Anderson .................................................................................... 29 Medical Education .................................................................................................................................... 29 Medical Student and Resident Policy ............................................................................................................. 29 Medical Students May Have View Only Epic Access ....................................................................................... 29 Medical Student Rotation Schedules .............................................................................................................. 30 Medical Staff Reference Updated June 20, 2011 2 Department of Pharmacy .......................................................................................................................... 30 Additional Opportunities for Physicians at Mercy Anderson ................................................................... 31 Mercy Care Clinic ................................................................................................................................. 31 Physicians Charitable Foundation (PCF) .............................................................................................. 31 Medical Explorer Scouting – Terri Martin ........................................................................................... 31 2011 Medical Staff Social Events ............................................................................................................. 31 Mercy Hospitals Anderson/Clermont Medical Staff Members Golf Outing – September 21 ......................... 31 Dr. John Cardosi Physician of the Year Award – September 22 ...................................................................... 31 Taste of Mercy Wine Tasting – September 30 ................................................................................................ 32 24th Annual Charles M. Barrett Memorial Golf Tournament – October 4 ...................................................... 32 Physician Holiday Celebration – December 2, 2011 ....................................................................................... 32 Employee Health ....................................................................................................................................... 32 Bloodborne Pathogen Exposure (pager 343-‐5076) ........................................................................................ 32 TB Skin Testing ............................................................................................................................................... 32 Respirator Fit Testing ...................................................................................................................................... 32 Core Measures .......................................................................................................................................... 33 Acute MI ......................................................................................................................................................... 33 Heart Failure ................................................................................................................................................... 33 Pneumonia ...................................................................................................................................................... 33 SCIP ................................................................................................................................................................ 33 Stroke .............................................................................................................................................................. 33 Spiritual Care Services .............................................................................................................................. 34 Advance Directive Information and the Chaplaincy Role .................................................................... 34 Management Directory ............................................................................................................................. 35 Medical Staff Reference Updated June 20, 2011 3 Welcome to the Mercy Hospital Anderson Medical Staff You are joining a medical staff of 700 with a hospital of 1200 employees. Mercy Anderson is an eight time Reuters Top 100 hospital. Your colleagues and nursing staff welcome you. The hospital provides a fully electronic environment for physicians that includes the Epic electronic medical records, physicianorder entry, digital radiology and remote access. You will need some basic training and orientation before receiving your Epic log-in. If you cannot find a specific number, call the main hospital number at 513-624-4500. Medical Staff Officers Chief of Staff Chief of Staff Elect Past Chief of Staff Dept of Medicine Chair Dept of Surgery Chair Dept of OB/Gyn Chair Dr. Don Buckley (cardiac surgery) Dr. Lee Megois (anesthesia) Dr. Scott Behrens (cardiology) Dr. Marvin Lopez (internal medicine / gastroenterology) Dr. David Ward (general surgery) Dr. Michael Fesenmeier (OB/Gyn) Hospital Executive Leadership (624-4502) Gyasi Chisley – Site Administrator and Chief Operating Officer Cell: 404-423-7314 Office: 624-4882 Email: [email protected] Julie Holt, RN – Chief Nursing Officer, Vice President Patient Care Services Cell: 608-2945 Office: 624-4505 Email: [email protected] Dr. Steve Feagins (Internal Medicine) – Vice President Medical Affairs Cell: 203-4336 Office: 624-3281 Email: [email protected] Medical Staff Office (624-4058) 8:00-4:30 weekdays You must report in person with a government issued photo ID (driver license) to the Medical Staff Office for a hospital photo identification badge before your application can be approved. Medical students and residents must report on their first day at the hospital and fill out a brief information form. An updated event and meeting calendar is located on the door. Shel Carnahan is your coordinator for medical staff services. Nissa Walker is the manager; her direct number is 624-4391. Direct any questions you may have for committee chairs or medical staff governance to the office at 624-4058 and we will see that the message is immediately transferred. Director of Physician Services (624-4784) Joanie Manzo Our physician liaison, Joanie Manzo, assists physicians and their staff to efficiently utilize hospital services through information, problem resolution, orientation and timely communication. Physicians and/or staff may reach Joanie Manzo at 624-4784, pager: 350-5680 or email: [email protected]. Medical Staff Reference Updated June 20, 2011 4 History of Mercy Hospital Anderson The hospital is licensed for 193 beds; we admit an average of 30 patients per day or 920 per month. Awards and recognitions: • 2011 Thomson Reuters 100 Top Hospitals Award (for the 8th time) • 2010 Best Workplace for Men in Nursing by the American Assembly for Men in Nursing • Winner of the John M. Eisenberg Patient Safety and Quality Award 2009 for the Modified Early Warning System (MEWS) • #1 in Ohio for overall Orthopaedics • Top 5% in the Nation for Patient Safety (2008) • Designated as Baby Friendly • 2007 Respiratory Care Recognition Award • 2007 Outstanding Achievement Award for Cancer Care by American College of Surgeons' Commission on Cancer Mercy Hospital Anderson Acute Admissions Deliveries Inpatient Surgeries Outpatient Surgeries ER Visits 2009 10,538 1,846 2,853 8,466 47,517 2010 10,941 1,831 2,584 7,674 46,326 2011 12,250 1,822 2,457 7,417 47,656 Physician Parking Available --Requires Decal Convenient covered “physician-only” parking is available in the MOB II garage on level 1 and 2 behind administration and the medical staff office. Get your vehicle decal from the Medical Staff Office. You will need this to avoid ticketing from Security. Medical Staff Reference Updated June 20, 2011 5 Medical Staff Members Photo Identification Badge Obtain a photo identification badge from the Medical Staff Office during business hours. This must be worn at all times in the hospital. An extra tab identifies you as a physician. The badge contains a magnetic strip that allows entrance to the physician lounge across from the Medical Staff Office, the library, and the external door after hours. The Stair Steps of the Mercy Mark The Mercy system “mark” is formed as religious and medical crosses come together. The “stair steps” created by the three-dimensional intertwining of the two crosses denote upward movement, inspiring the ideas of energy, excellence, change, and growth. The outward thrust of the sun’s rays within the elements reflects our devotion to a shining, evolving future. Multiple squares and rectangles created by the elements fit together – blending religious service and dedication with the precision of science and design. The selection of warm, organic colors reflects the spirit of our ministry. Catholic Health Partners (CHP) Catholic Health Partners is the largest health system in Ohio and fourth largest employer in Ohio with $5.1 billion in assets, CHP employs nearly 32,480 associates in more than 100 organizations, including 24 hospitals in Ohio and Kentucky. In 2010 CHP provided $365.1 million in targeted community benefit. CHP earned national ranking as a top 10 health system for quality and efficiency in 2009, 2010 and 2011 by Thomson Reuters, which studied more than 250 health systems across the country. Catholic Health Partners, the 7th largest nonprofit health system in the US, uses Explorys’ Enterprise Performance Management solutions across their 24 hospitals, 15 long-term care facilities, and seven regional health systems to analyze populations, providers, treatments and outcomes in real-time, as well as measure processes and financial results. The corporate home office is located in downtown Cincinnati at 615 Elsinore Place. For more information about CHP, visit www.health-partners.org. CHP Divisional Structure Mercy Hospital Anderson is in the Southwest Ohio Region which is in the Central / SHHS Division. There are two divisions, a North and Central Division. The Central Division also includes Senior Health and Housing (SHHS) or long term care in addition to the Community Mercy Health Partners region which includes Springfield and Urbana. Our division reports to Divisional CEO James May. • • The North Division is overseen by Division CEO John Starcher. This Division includes Humility of Mary Health Partners, Mercy Health Partners – Kentucky, Mercy Lorain Region, Mercy Northern Region and St. Rita’s Health Partners. Five regional CEOs report to John Starcher. The Central/SHHS Division is overseen by Division CEO James May. This Division includes Community Mercy Health Partners, Mercy Health Partners – Southwest Ohio and Senior Health & Housing Services (SHHS). Springfield regional CEO Mark Wiener and SHHS CEO Jason Niehaus, report to James May. Southwest Ohio Market Share Mercy Health Partners TriHealth UC Health Christ Premier Kettering All Other ED 32.0% 14.0% 11.6% n/a 6.9% 5.8% 31.0% Inpatient 28.0% 24.0% 14.5% 10.5% 7.1% 6.6% 9.2% Medical Staff Reference Updated June 20, 2011 Mercy Health Partners of Southwest Ohio MHP is the original CHP region, founded in 1993 and currently employees 6,284 with 2,435 credentialed physicians. Hospitals include Mercy Anderson, Mercy Fairfield, Mercy Clermont, The Jewish Hospital, Mercy Mt. Airy, and Mercy Western Hills. Free standing emergency departments are located at Mt. Orab and Harrison. 6 Eastside Market Structure Mercy Health operates a HealthPlex at the Anderson, Fairfield, and Western Hills sites. Mercy Hospital Anderson Nursing Units Unit A1 A2 A3 B1 ICU B3 FBC SCN ER Beds 30 30 14 20 19 30 24 10 31 Rooms 101-120 201-220 301-314 151-170 248-267 351-370 331-350 1-31 Phone 624-4640 624-4650 624-4960 233-6830 624-4020 624-4010 624-4300 624-4320 624-4083 Manager Sharon Ellerbrock Mary Yorio Sharon Ellerbrock Carrie Herron Beth Butz Kristin Shelley Jasmine Rausch Jasmine Rausch Brian Pope Medical Staff Reference Updated June 20, 2011 Pager 343-0598 343-0157 343-0598 230-0060 660-3137 343-1075 343-0134 343-0134 230-3504 Description Remote telemetry Telemetry, step-down Medical non-telemetry Orthopedics ICU/CCU/CVICU Surgery / oncology Family Birthing Center Level II nursery Emergency Services 7 2012 Mercy Hospital Anderson Medical Staff Governance Members of Regional Physician Council Chief of Staff – Donald Buckley, MD (chairs MEC and Practitioner Effectiveness committee) Chief of Staff Elect – Lee Megois, MD (chairs Quality committee) Past Chief of Staff – Scott Behrens, MD Vice President Medical Affairs – Steve Feagins, MD Physician Council Chair – Tony Asher, MD Medical Executive Committee Members Tony Asher, MD Robert Bradley, MD Andrea Murphy, MD Robert Rechtin, MD Chair, Department of Surgery – David Ward, MD Chair, Department of Medicine – Marvin Lopez, MD Chair, Department of Ob/Gyn - Michael Fesenmeier, MD Section Chief, Orthopedics - Suresh Nayak, MD Section Chief, Pediatrics - John Furby, MD MEC Representatives Anesthesia Representative - Lee Megois, MD Pathology Representative - Cynthia Westermann, MD Radiology Representative - Tony Asher, MD Hospitalist Service Representative – Asad Ali, MD Emergency Representative/Chief, Section of Emergency Medicine – Michael Argus, MD Section of Cardiology, Section Chief / Representative – Rakesh Gupta, MD Committee Chairs Credentials Committee - Robert Krone, MD Advisory (peer review) Committee - Michael Kramer, MD Pharmacy and Therapeutics / Infection Control Committee - Bruce Hamilton, MD Ethics Committee - Michael Fiedler, MD GME Committee for Orthopedic Fellowship – Denver Stanfield, MD GME Committee for Transitional Year Residency – Steve Feagins, MD Oncology Committee - Jeffrey Grass, MD MEC Administrative Ex-Officio Non-voting Members Mercy Health Regional CEO – Jim May Mercy Health Regional COO – Lee Ann Liska Site Administrator and Chief Operating Officer – Gyasi Chisley Chief Nursing Officer and VP Patient Services – Julie Holt, RN, MSN Divisional Chief Medical Officer – Leonard Randolph, MD Manager, Medical Staff Services – Nissa Walker, CPCS Medical Staff Reference Updated June 20, 2011 8 ADVISORY (PEER REVIEW) COMMITTEE (monthly) Michael Kramer, MD – Chair* Michael Argus, MD – Emergency Medicine Matthew Roberts, MD – Emergency Medicine Andrea Murphy, MD – Internal Medicine / Hospitalist John Eckman, MD – Internal Medicine / Hospitalist David Wilson, MD – Internal Medicine Robert Rhoad, MD – Orthopaedics Norb Berberich, MD – Anesthesia Robert Barnhorn, MD – Ob/Gyn J.D. Corl, MD – Cardiology Diane Dolensky – Internal Medicine Christopher Fleming, MD – Ob/Gyn Charles Perme, MD – Radiology David Reed, MD – Medicine/Cardiology Mike Smith, MD -- Cardiology David Ward, MD – Surgery Charles Hattemer, MD -- Cardiology Galen Warren, MD – Urology Ex Officio: Steve Feagins, MD – Vice President Medical Affairs Julie Holt, Chief Nursing Officer Janice Maupin, Quality Director Kristen Boggs, Risk Management Michelle Williamson, Quality Coordinator* CREDENTIALS COMMITTEE (monthly) Robert Krone, Jr., MD, Chair Kristen Kent, MD – Emergency Medicine Asad Ali, MD – Hospital Medicine William Forten, MD, -- Hospital Medicine Will Strub, MD – Radiology Cynthia Westermann, MD – Pathology Anna Zabrecky – Ob/Gyn Doug Knight, PA – Allied Health / Orthopaedic Ex Officio: Nissa Walker, Manager, Medical Staff Services* Steve Feagins, MD, VPMA Julie Holt, Chief Nursing Officer Gyasi Chisley, Site Administrator Ed Ruffenach, Surgery Nursing Rep QUALITY COUNCIL (bimonthly) Lee Megois, MD – Chair; Chief of Staff Elect Medical Staff Reference Updated June 20, 2011 9 Janice Maupin, RN – Coordinator; Quality Director* Norbert Berberich, MD – Anesthesia Paul Favorito, MD – Orthopaedics David Wilson, MD – Internal Medicine Michael Halvonik, MD – Pulmonary Michelle Williamson – Quality Coordinator Jasmine Rausch – Birthing Center Director Kristin Boggs, Risk Management Bill Carroll, Pharmacy Director Colleen DeHaan, Imaging Director Steve Feagins, MD, VPMA Julie Holt, Chief Nursing Officer Gyasi Chisley, Site Administrator Kathi Edrington, Clinical Services Director Terri Martin, Nursing Director Kathy Puthoff, Infection Control Ed Ruffennach, OR Director Community Member ETHICS COMMITTEE (quarterly) Michael Fiedler, MD – Chair Sue Motz – Chaplain, Ethics committee coordinator* John Cardosi, MD – Emeritus physician Andrew Klafter, MD – Psychiatry Andrea Murphy, MD – Internal Medicine / Hospitalist Peter Ruehlman, MD – Oncology Todd Tegtmeier, MD – Family Practice Bethany Kapp, MD – Emergency Medicine Michael Fesenmeier, MD – OB/Gyn Department Chair Sr. Mary Lou Averbeck, rsm – Mission Integration Kristen Boggs, Risk Management Elizabeth Butz, ICU Nurse Manager (or ICU designate) Tiffany Brown, RN – Birthing Center Sandy Cooney, RN – ICU Mardee White, RN – Palliative Care Steve Feagins, MD, VPMA Jack Gallagher, PhD – CHP representative/Consultant Julie Holt, Chief Nursing Officer Don Rohling, Regional VP Missions Rich Schuster, Regional Corporate Responsibility SPORTS MEDICINE GRADUATE MEDICAL EDUCATION COMMITTEE (quarterly) Denver Stanfield, MD – Program Director Steve Feagins, MD – Designated Institutional Official Medical Staff Reference Updated June 20, 2011 10 Richelle Gwin – Program Coordinator* Paul Favorito, MD Brian Crellin, DO Robert Heidt, Jr., MD Mark Ziegler, MD – Anesthesia Rep 2010 – 2012 Fellows – Nyagon Duany, MD; Stephen Jacobsen, MD; Douglas Matey, DO Gyasi Chisley, Site Administrator Julie Holt, Chief Nursing Office Nissa Walker, Manager Medical Staff Office ONCOLOGY COMMITTEE (quarterly, 75% annual attendance required) Jeffrey Grass, MD – Chair Karen Smith – Cancer Program Administrator, Cancer Registry Quality Coordinator* Peter Ruehlman, MD – Oncology, Cancer Conference Coordinator Cynthia Westermann, MD – Pathology, Cancer Liaison, Quality Improvement Coordinator David Ward, MD – General Surgery Kevin Weber, MD – Radiology Sandra Miller, MD – Breast Surgery Steve Feagins, MD – Internal Medicine, Vice President Medical Affairs Bill Carroll, PharmD – Pharmacy Director Colleen DeHaan, Imaging Director Gyasi Chisley, Site Administrator Adam Momper, Ambulatory Services Manager Kay O’Rourke, Spiritual Care Services Manager Kristen Shelley, Oncology Unit Nurse Manager Lisa Thomas, Quality/Case Management (cancer survivor) Mardee White, Palliative Care Nurse Rita Garrision, Outreach Coordinator Andrea Anderson, American Cancer Society Beth Shannon, Cancer Survivor Open – Clinical Research Coordinator Open – Psychosocial Services Coordinator P&T / INFECTION CONTROL COMMITTEE (quarterly) Bruce Hamilton, MD – Chair Leah Whitener, PharmD – Pharmacy Coordinator* Kathy Puthoff, RN – ID Coordinator* Arthur Lee, MD – Orthopaedics Joel Forman, MD – Cardiology Rakesh Gupta, MD – Cardiology Mark Ziegler, MD – Anesthesia Medical Staff Reference Updated June 20, 2011 11 Ex Officio: Steve Feagins, MD, VPMA Julie Holt, Chief Nursing Officer Gyasi Chisley, Site Administrator Bill Carroll, PharmD – Pharmarcy Director Terri Martin, Nursing Director Janice Maupin, Quality Director Ed Ruffennach, Peri-op Director Chad Balwanz, Lab Manager Ruth Grant, Regional Lab Representative PERIOPERATIVE SERVICES COMMITTEE (bimonthly) David Ward, MD – Chair Edward Ruffenach – Coordinator* Karl Braun, MD – Surgery Urology Don Buckley, MD Cardiothroacic Brad Busacco, MD – Ob/Gyn David Kirkpatrick, MD – Surgery Michael Kramer, MD – Neurosurgery Joel Sorger, MD - Ortho Cindy Westermann, MD – Pathology Bill Carroll, Pharmacy Steve Feagins, MD, VPMA Carrie Herron, Orthopedic Unit Manager Julie Holt, Chief Nursing Officer Doug Knight, PA Janice Maupin, Quality Director Lori Mondary Kathy Puthoff PRACTITIONER EFFECTIVENESS COMMITTEE (quarterly) Don Buckley, MD – Chair, Chief of Staff Scott Behrens, MD – Past Chief Lee Megois, MD – Chief of Staff Elect Michael Fesenmeier, MD – OB/Gyn Department Chair David Ward, MD – Surgery Department Chair Marvin Lopez, MD – Medicine Department Chair Tony Asher, MD (past Chief) Rob Hiltz, MD (past Chief) Medical Staff Reference Updated June 20, 2011 12 Ex Officio: Steve Feagins, MD (VPMA) Janice Maupin, Quality Director Nissa Walker, Manager Medical Staff Office* Gyasi Chisley, Site Aministrator Julie Holt, RN; Chief Nursing Officer CRITICAL CARE COMMITTEE (bimonthly) Andrea Murphy, MD – Chair Elizabeth Butz, RN – Coordinator, ICU Manager* Michael Halvonik, MD – Pulmonary Medical Director Asad Ali, MD – Hospitalist Medical Director Steve Feagins, MD – Vice President Medical Affairs Kathi Edrington, Nursing Director Cassie Herald, Respiratory Therapy Manager ER Medical Director… Dr. Mike Argus or designate Anesthesia Medical Director … Dr. Lee Megois or designate Radiology Medical Director … Dr. Tony Asher or designate Pharmacy Clinical Director … Leah Whitener or designate PICC Line Representative – Lorraine Bloemmer Infection Control Specialist / data coordinator … Kathy Puthoff TRANSITIONAL YEAR GME COMMITTEE (quarterly) Stephen Goldberg; MD; Program Director and DIO Stephen Feagins, MD; Site Education Coordinator* Shel Carnihan; Program Coordinator* Andrew Klafter, MD Charles Perme, MD Denver Standfield, MD Doug Knight, MD Joan Kolodzik, Md Lee Megois, MD Ram Atluria, MD Nissa Walker, Manger Medical Staff Office Gyasi Chisley, Site Administrator Julie Holt, RN; Chief Nursing Officer Medical Staff Reference Updated June 20, 2011 13 SCHEDULE OF COMMITTEE MEETINGS – 2012 MEETING DAY & TIME ADVISORY COMMITTEE MOB Conf. Rm C CREDENTIALS COMMITTEE MOB Conf. Rm A CRITICAL CARE COMMITTEE MOB Conf. Rm D DEPARTMENT OF MEDICINE/ MEDICAL GRAND ROUNDS MOB Conf. Rm C DEPARTMENT OF OB/GYN Meeting Rooms 1,4,5 EXECUTIVE COMMITTEE MOB Conf. Rm C GENERAL MEDICAL STAFF MOB Conf. Rm B&C GME MOB Conf. Rm. C QUALITY/PATIENT SAFETY MOB Conf. Rm C ONCOLOGY COMMITTEE MOB Conf. Rm C P&T/INFECTION CONTROL MOB Conf. Rm C PERIOPERATIVE SVS. CTE/SCIP MOB Conf. Rm C PRACTITIONER EFFECTIVENESS COMMITTEE MOB Conf. Rm A SECTION OF EMERG. MED MOB Conf. Rm B SECTION OF CARDIOLOGY MOB Conf. Rm D SECTION OF PEDIATRICS MOB Conf. Rm. C ETHICS MOB Conf. Rm C JAN FEB MAR APR MAY JUN 7:00 a.m. 1st Thurs 5 2 1 5 3 7 7:30 a.m. 2nd Tues 10 14 13 10 8 12 7:00 a.m. 1st Wed 12:15 pm 3rd Wed. 1 18 7:30 a.m. 3rd Thurs 6:30 p.m. 3rd Mon 6:30 p.m. varies 7:30 a.m. 2nd Mon. 4 16 20 16 SEP OCT NOV DEC 2 6 4 1 6 11 9 13 11 1 3 18 19 19 AUG 10 6 18 16 JUL 21 21 18 17 16 16 18 17 27 7:00 a.m. 4th Wed 25 7:00 a.m. 2nd Wed 11 8 7:00 a.m. 2nd Thurs 9 7:00 a.m. 4th Thurs. 23 7:00 am 1st Tues 7 7:30 a.m. 2nd Thurs 12 C 7:30 a.m. 3rd Thurs. 19 9 21 28 23 19 11 9 17 25 13 11 10 26 17 12 28 15 10 10 26 8 12 28 10 9 25 7 14 17 12 19 9 14 12 8 23 1 8 15 20 23 12 14 5 27 6 13 20 11 8 13 15 8:30 a.m. 1st Wed 7 6 5 5 7:30 a.m. 2nd Thurs 8 14 13 13 Medical Staff Reference Updated June 20, 2011 14 Continuing Medical Education Activities – 2012 MEETING DAY & TIME CME ACTIVITIES CANCER CARE CONFERENCE MOB Conf. Rm C 1st Wed–11:30 am 2nd Fri–7:00 am 3rd Thurs–7:00 am 4th Wed–11:30 am OMEN Weekly Conference MOB Conf. Rm. C PED. MORT/MORB CONFERENCE MOB Conf. Rm. C CARDIOLOGY GRAND ROUNDS ECHO/CARDIOLO GY/CATH 1st Wed 2nd Fri 3rd Thur 4th Wed 12:30 – 1:30 pm Wednesday JAN 4 13 19 25 4 11 18 25 FEB 1 10 16 22 MAR 7 9 15 28 1 8 15 22 29 7:30 a.m. 1st Weds 7 14 21 28 APR 4 13 19 25 4 11 18 25 MAY JUN JUL AUG SEP OCT NOV DEC 2 11 17 23 6 8 21 27 4 13 19 25 1 10 16 22 5 14 20 26 3 12 18 24 7 9 15 28 5 14 20 26 2 9 16 23 30 6 13 20 27 4 11 18 3 10 17 24 31 7 14 21 28 5 12 19 26 7 7:30 a.m. 4th Thursday 26 23 7:00 a.m. every Monday 9 16 23 30 6 13 20 27 12-1 pm Thursday 5 12 19 26 2 9 16 23 6 22 26 31 5 12 19 26 2 9 16 23 30 7 14 21 1 8 15 22 29 5 12 19 26 3 10 17 24 31 28 5 26 23 5 27 25 22 27 10 17 24 1 8 15 22 29 5 12 19 26 3 10 17 6 13 20 27 4 11 18 25 1 8 15 29 6 13 MOB Conf. Rooms B or D WOSM X-Ray MOB Conf. Rm. C Noon Conference MOB Conf Rm D 7 14 21 28 5 12 19 26 2 9 16 23 30 A Tower A1 Medical Telemetry Unit – Transforming Care at the Bedside In an effort to transform the care delivered in our nation’s hospitals, the Robert Wood Johnson Foundation and the Institute for Healthcare Improvement (IHI) created Transforming Care at the Bedside (TCAB), a program that harnesses the power of teamwork to improve patient safety and nursing staff retention. The A1 unit has been a member of the TCAB program since 2009. Several A1 nurses have presented at national seminars. A1 works with the hospitalists for quality and efficiency improvements through a biweekly task force. Studies to date include bedside discharge with nursing, reduction in post discharge length of stay, improved medication reconciliation, and patient experience. A3 an Extension of A1 On the third floor of the A tower is A3, a non-telemetry 20 bed unit with 10 rooms. It is considered an extension of A1 and in the same staffing grid. A2 Cardiology and Step-Down Unit A2 on the second floor of the A tower is our main cardiology / telemetry unit with 30 beds (20 semi-private and 10 private). Telemetry monitoring for A1 and A2 occurs at this nurse station. A2 is a Medical Staff Reference Updated June 20, 2011 15 Progressive Care Unit, specializing in caring for patients with heart failure, acute MI, arrhythmias, and complicated pulmonary and renal conditions. A2 nurses pull arterial lines on patients who have undergone percutaneous coronary interventions. All A2 nurses are ACLS certified. Family Birthing Center (FBC) 3rd floor A Tower The Family Birth Center on the third floor A tower consists of 24 private LDR suites and focuses on family-centered care. Services include a special care nursery for underweight or sick newborns, childbirth education, home care and lactation support. Breast pump rental services and childbirth and family education are available. A house officer covers 24/7 for all unattached patients. B Tower B1 Mercy Anderson Center for Orthopaedic Excellence The first floor of the B tower is devoted to recovery from orthopaedic surgery and orthopaedic injuries. This unit collaborates with the Wellington Orthopaedic and Sports Medicine. B2 Cardiovascular Intensive Care Unit (CVICU) The ICU has 19 beds with cardiovascular care. Post open heart patients stay in the ICU until discharge. B3 Oncology/Surgery B3 is a recovery unit for surgery and cancer treatment floor. Patients receiving chemotherapy treatments are often placed on this floor. It is a 20 room unit with 30 beds. Admits and Discharges Active and Courtesy members of the medical staff have admitting privileges. The admission navigator in Epic must be used in order to actually admit a patient – either through the emergency department or as a direct admit. In addition to location (telemetry, ICU, surgical) you must specify a status (inpatient or observation) based on your assessment at the time. Status can be changed at any time but there must a status specified upon admission. An inpatient is a person who has been admitted to a hospital for bed occupancy with the purpose of receiving inpatient hospital services. A patient is considered an inpatient if formally admitted as inpatient with the expectation that he or she will remain at least overnight and occupy a bed if though it later develops that the patient can be discharged or transferred to another hospital and not actually use a hospital bed overnight. Factors to be considered when making the decision to admit include such things as: • • • • The severity of the signs and symptoms exhibited by the patient; The medical predictability of something adverse happening to the patient; The need for diagnostic studies that appropriately are outpatient services (i.e., their performance does not ordinarily require the patient to remain at the hospital for 24 hours or more) to assist in assessing whether the patient should be admitted; and The availability of diagnostic procedures at the time when and at the location where the patient presents. Executive Health Resources® (E.H.R.) - Physician Advisory Group RN Utilization managers review each medical record for medical necessity. When a case does not meet medical necessity criteria according to specific national criteria, the Utilization Reviewer will call the E.H.R. physician for medical necessity determination. When needed, the E.H.R. physician may contact you, the attending physician, to discuss the case to assist in determination. Medical Staff Reference Updated June 20, 2011 16 Length of Stay The Geometric Mean Length of Stay (GMLOS) is the national mean length of stay for each Diagnosis Related Group (DRG = Principal Diagnosis) as determined and published by CMS (Centers for Medicare and Medicaid Services). A continued stay review is performed to determine the appropriateness of continued stay at a level of care. When the criteria for continued stay are not met determination for the next appropriate level of care within the facility (transfer to another unit) or discharge from the facility will need to be made. The Discharge Planners are here to assist you in this process. Outpatient Observation Services A well-defined set of specific, clinically appropriate services which include short term treatment, assessment, and reassessment before a decision can be made regarding whether the patient will require further treatment as hospital inpatient or if they are able to be discharged from the hospital Person who presents to the Emergency Department and who then requires a significant period of treatment or monitoring in order to make a decision concerning their admission or discharge Person who is directly admitted to the hospital for outpatient observation services – community physician refers patient to hospital for observation, bypassing the emergency department Person placed in Observation by order of a physician or another authorized individual to admit patients to the hospital or to order outpatient tests Decision whether to discharge from the hospital or admit as inpatient timeframe: Usually decision can be made in less than 24 hours 48 hour limit before an automatic medical necessity review by Medicare Greater than 48 hours is considered “rate and exceptional cases” All hospital observation services, regardless of duration, that are “Medically reasonable and necessary” are covered by Medicare Discharge Planning The discharge planning staff is a team of RNs and social workers. Criteria for automatic discharge planning consult include any patient over age 70 or a physician order for social services or referral for from nursing staff. Factors contributing to a referral to discharge planning: • Patient comes from a nursing facility or has a new order for a nursing facility (skilled/long term care) • Long term acute care (LTAC) • Acute rehab • Home care • Hospice care • Oxygen • Hand held nebulizers • Equipment for home • Home IV antibiotics • Indigent patient care at discharge • High cost medications Medical Staff Reference Updated June 20, 2011 17 Forms required by discharge planners when patient is going home or to a facility: • Continuity of Care (COC) form for home care and facility placement • 7000 form or passer form for facility placement • Face to face form for new home care • Prescriptions for any schedule II-V medications when a patient is going to a facility • Indigent medication program forms Forms that need signed when going home or to a facility Discharge planners communicate the need for a physician to complete a form by placing a sticky note in the physician communication box. Any documentation is in the progress notes of the chart. Any paper forms to be signed are placed in the paper chart with “sign here” stickers idon pages requiring a signature. List of Medical Directors for 2012 Medical Directors oversee service lines in conjunction with the service line manager and are distinct from our medical governance physicians, who are elected or appointed by the medical staff. Medical Directors work with the hospital by contract, and are physician contacts for information or questions about the service line. For reference we have listed our current Medical Directors at Mercy Hospital Anderson. Dr. Michael Fesenmeier – Obstetrical Services Dr. Asad Ali – Hospital Medicine Dr. Michael Argus – Emergency Medicine Dr. Michael Halvonik – Pulmonary Rehabilitation and Respiratory Care Dr. Donald Buckley – Cardiac Surgery Program Dr. Mary Alfidi – Women’s Center Dr. Cynthia Westermann – Lab and Pathology Services Drs. Tony Asher and Corky Weber – Radiology Services Dr. Laura Ward – Neonatology Dr. Lee Megois – Anesthesia Services Dr. David Lewis – Maternal Fetal Medicine Dr. Marc Mosbacher – Radiation-Oncology Dr Arthur Lee- Anderson Physicians Surgical Management Dr. Mohammed Sheatt – Sleep Center Dr. Steve Feagins – Coumadin Clinic, Mercy Care Clinic, Outpatient Infusion Unit Medical Staff Reference Updated June 20, 2011 18 Mercy Hospital Anderson Clinical Laboratory Laboratory Main Phone: 624-4591 available 24/7 for questions. Hematology and Coagulation: 624-4589 Chemistry: 624-3214 Blood Bank: 624-4527 Microbiology: Mercy Core Lab at 853-5817 Pathology / Histology: 624-3211 or 624-4383 (Pathologist on site 8 am – 6 pm, Mon-Fri). After hours, call the main number at 624-4591 to contact the on-call pathologist. Medical Director: Dr. Cynthia Westermann (office: 624-4337) Pager: 230-1605 Email: [email protected] Manager: Chad Balwanz (624-4890) [email protected] Lead Technologists Blood Bank: Ken Dansberry [email protected] Chemistry: Lisa Dockus [email protected] Hematology/Coagulation: Rick Triplett [email protected] Turn-around Times Stats: 45 minutes Routine samples which have been ordered for first morning draw are collected starting at 5:00 a.m. and should be completed by 7:30 a.m.. All other routines will be completed within regular business hours. Arterial Blood Gases: 15 minutes Type & Screen: 1 hour (15 minutes for O-neg emergency need, 4 units always available) Histology samples: 24-48 hours Referral Tests Many less commonly ordered tests are sent to one of the referral laboratories utilized by MHP. Most are sent to ARUP, located in Utah. Specimens are sent daily and most results are back within 48 hours. If you need information on a particular test please visit the ARUP website at www.aruplab.com or call the main lab number (84591) for assistance. Infrequently ordered tests which need a "stat" turn-around time will be sent to a local laboratory which performs those tests: (i.e. stat coag factors go to University Hospital Laboratory). Add-on Tests Please call the lab before adding on a test to a sample previously sent to the lab to insure the amount of sample and age are within limits for the new test being added. Then in EPIC go to: 1. Order Entry for the patient. 2. In the "New Order" box type the test to be added-on and hit ENTER. 3. Click on the desired test to highlight and then click "ACCEPT". 4. The test will display in a blue box - click on the "priority (ie routine) listed in the blue box. 5. At "Priority" box click on the magnifying glass, choose add-on, and ACCEPT. 6. Choose "ACCEPT" again to place the order. Blood Bank Available Products: Packed Red Blood Cells Fresh Frozen Plasma Apheresis Platelets (considered a therapeutic dose that is equivalent to 6-8 random donor platelets) Cryoprecipitate Medical Staff Reference Updated June 20, 2011 19 Mercy blood banks use an additional patient blood bank wristband. This wristband is linked with the type-and-screen specimen which can be used for crossmatching blood products during a three day interval from the date of collection. Ordering Blood Products: EPIC ordering for blood products is a multi step process. • Order a "Type and Screen" if one has not been ordered within the last 3 days. Type and Screen tests on in-patients expire after 3 days and need to be re-ordered as necessary. • Order "PREPARE.” This is what was traditionally known and ordered as a cross-match. This section gives options for number of units, special instructions (i.e. irradiated). • Order "TRANSFUSE". This section gives options for duration, special needs (i.e. blood warmer), and pre-medication notes. The PREPARE and TRANSFUSE are set up together as a single order screen, but these components can be ordered separately by unselecting one part or the other. Order blood products in EPIC under "GEN BLOOD". Medical Staff Reference Updated June 20, 2011 20 About Mercy Anderson Anderson Township area growth rate is expected to be 2.6% over the next 10 years. This compares to an Ohio growth rate of 0.6%. In addition, the average age of the local population is expected to increased by 4.7 years – suggesting a need for more procedures and hospital admissions. Overall, our admissions over the next year are expected to remain steady, while the market growth rate is -2.7%. Hospitals are challenged to grow in a manner that is not only profitable, but also clinically appropriate and supported by community needs. We frequently assess the environment in which Mercy Health Partners operates. Service Areas of Mercy Anderson Medical Staff Reference Updated June 20, 2011 21 Primary service areas (PSA) are defined as a zip code in which 75% of those patients are discharged from our hospital. Secondary service areas (SSA) include any areas in which more than 25% of population . As you can see from the chart and table below, Mercy Anderson serves a large segment of the eastside population in the Cincinnati region. We do not have any zip codes in northern Kentucky with more than 25% of population despite being closer than much of our primary service area. Categories of Medical Staff Membership Active Members regularly provide evaluation and management services or procedures to inpatients or outpatients at the Hospital. Active Members may admit patients without limitation within the scope of granted Clinical Privileges; attend and vote at all Department, Section, committee, and general Medical Staff meetings; hold office; and chair committees. Active members are required to take emergency calls, unless excused for good cause by the Department Chair. Courtesy Members do not regularly admit patients and do not regularly care for Hospital patients. Courtesy Members may attend Medical Staff meetings but may not vote except in assigned committees. They may request or be required to take emergency call in accordance with the provisions of the Rules and Regulations. Affiliate Medical Staff consist of Practitioners affiliated with the Hospital who do not hold Clinical Privileges. Affiliate Members may visit their patients who are in the Hospital and review their patients’ Hospital medical records, but may not make entries; order outpatient diagnostic tests but NOT therapeutic procedures, and attend Medical Staff meetings as non-voting members. Affiliate Members may have “view only” Epic access to medical records. Honorary Members are nominated by the MEC and approved by the Board for distinguished service. They must have served as an Active Member. Medical Staff Membership and Clinical Privileges Medical Staff Membership by itself confers no Clinical Privileges. Each Practitioner must request Clinical Privileges and may only practice within the scope of the Privileges. Expectations of Medical Staff Membership 1. Compliance with Medical Staff bylaws, rules, and regulations • Maintain current evidence of licensure, DEA, and liability coverage. • Complete medical records documentation. • Participate in the Emergency Department call schedule. • Payment of medical staff dues. 2. Participate in medical staff committees 3. Adherence to National Patient Safety Goals, including Core Measures. 4. Compliance with approved patient care protocols. Credentialed Medical Staff Required to Follow Ethical and Religious Directives (ERD) Catholic health care is premised on the human dignity of all persons and the sacredness of human life. Our bylaws require that all medical staff abide by the Ethical and Religious Directives (ERDs) for Catholic Health Care Services. Compliance with these ERDs is a condition for medical staff privileges. Medical Staff Reference Updated June 20, 2011 22 When you accept hospital privileges, you are agreeing to practice in a manner consistent with the ERD when rounding and performing procedures at any Mercy facility. “Consistent” neither implies nor suggests that the physician personally espouses the Directives or adheres to the Catholic faith. “Consistent” does imply that the physician will participate in the healing mission of the hospital and will not provide a limited set of prohibited services – direct abortion, direct sterilization, active euthanasia or some means of contraception. A full copy of the ERDs is available at http://www.usccb.org/bishops/directives.shtml. Serious Adverse Event Management A Sentinel Event, is defined by the Joint Commission as an unexpected occurrence involving death or serious physical/psychological injury, or the risk thereof. The phrase “or the risk thereof” includes any process variation for which a recurrence would carry a significant chance of a serious adverse outcome. Such events are called “sentinel” because they signal the need for immediate investigation and response. Immediate Response Following a Serious Adverse Event Ensure patient safety: Stabilize the patient, provide necessary and appropriate medical care. Attending physician is called, may give additional orders if necessary. Remove any unsafe devices, equipment, or medications. Determine whether the Adverse Event puts other patients at immediate risk and address accordingly. Appropriate administrative leadership and risk management are notified. Preserve Evidence: Risk management may secure any physical evidence involved in the adverse event, take pictures, and preserve electronic data. Do NOT tamper with, clean, or modify any physical evidence. Relief and Support of Caregivers: Nursing leadership evaluates the impact of the Adverse Event and provides support. They immediately address patient ratios and redistribute patient loads to allow the involved staff to cope with the situation. The VPMA evaluates the impact of involved physicians and supports accordingly. Hospital management assures a “just culture” by consistent and transparent application of the accountability algorithm. Documentation: In addition to appropriate documentation regarding the event in the medical record, any communication with the patient and family (if available) is documented. A SafeCARE report should be completed within 24 hours. Convene Event Management Team: Collaborate among care providers to ensure that the ongoing needs of the patient are met and which members of the Event Management Team are critical to the initial stages of theprocess. Determine the scope of the investigation and scheduling of participants for the Root Cause Analysis (RCA) process. Initial RCA meetings should be convened within 24 hours after the event is discovered. The RCA must be completed within 45 days of the identification of an Adverse Event. Patient and Family Communication: As soon as possible and within 24 hours of the discovery of any Adverse Event, initial communications with the patient and/or family or representative will occur. Initial communications may be limited to general information and concern, a promise that it is being addressed, and identification of who will be communicating with the family and who is their contact within the hospital. The attending physician should be informed and included in all decisions and communications. Action Plan: Corrective actions developed as a result of the root cause analysis are a Medical Staff Reference Updated June 20, 2011 23 high priority and must be tracked to ensure that the changes occur. Both the effectiveness and possible undesirable effects of the changes are monitored. The root causes must be detailed with clear identification of and distinction between issues. Then action items are developed with clear responsibility for implementation. Incident Reporting For Physicians Available Through SafeCARE SafeCARE is an electronic reporting system available on all hospital computers. But if you need an alternative, the Medical Staff Office has established a voicemail SafeCARE Reporting Line at 624-4390. Report the facts in a brief narrative and risk management will enter the issue and follow up with you. Remember to specify the patient name and medical record number, location or department, and your contact information. For questions regarding serious adverse events, please contact Kristin Boggs, Director of Risk Management Office: 624-4059 Pager: 230-7066 Email: [email protected] Modified Early Warning System (MEWS) -- Early Detection of Patient Deterioration A nurse may call and mention the MEWS score, which is a scoring system that identifies high risk patients. The score is calculated based on heart rate, blood pressure, respiratory rate, temperature, and neurological status. The score is calculated in Epic to enable nurses to identify patients who are deteriorating and need urgent intervention such as a call for a Rapid Response Team. Code Blue The operator overhead pages "Code Blue" and location three times. Clinical Administrator and ICU nurse assumes leadership role and follow ACLS protocol until physician present. Any physician in the area is expected to respond until relieved by responding hospitalist. The Critical Care Committee will review Code Blues quarterly. Code Code Blue Code Pink (neonatal or pediatric patients) Medical Staff Reference Updated June 20, 2011 Respondents Hospitalist (First responder) Emergency physician (back-up) Clinical Administrator Respiratory therapy Nurses (ICU, ED, A2) Laboratory EKG Chaplain Anesthesia Attending physician (if available) Neonatology (first responder if in house) Emergency physician (back-up) Clinical Administrator Anesthesia NICU/ED nurse Chaplain 24 FAST Team – Rapid Response Team The Operator overhead pages “FAST Team” and location three times. Respondents include the Hospitalist, Clinical Administrator, respiratory therapist, and nursing. Others like radiology or EKG tech may be called. This is intended for “pre-codes” or significant change in status requiring an immediate evaluation. The Clinical Administrator (CA) Shifts: 6a-6p and 6p-6a. They cover the hospital 24/7 Location: their office is located next to Nursing Administration on the second floor across from the lab in the staffing office. Contact Information: Office 233-6561 or pager 540-0253 Clinical Administrator primary responsibilities: • Throughput • Coordinate patient bed placement using EPIC and Awarix • Quick register direct admits in EPIC • Staffing and staffing readjustment every 4 hours to meet needs • Primary nursing responder for FAST Team and Code Blues • Critical care trained, able to manage patients • Update GCHC when hospital is at or over capacity • Fill out CA report twice daily for administration • Follow up on MEWS and lactic acid scores • Initiate chain of command • Start IVs • Nights: do in-house restraint log and locate equipment • Weekends: assist in diagnostic center with port/PICC line draws • Call in OR and cath lab teams for acute issues At all times, an administrator takes calls to deal with issues beyond that of the Clinical Administrator. You can page directly following the schedule above. Epic Electronic Medical Records and Physician Order Entry All physicians are required to attend EPIC physician training prior to caring for patients. You will receive your log-in at that time. Epic classes are scheduled on Thursdays 5-10 pm. Other times may be available. Schedule your training with the Medical Staff Office at 624-4058 or with Dana Fender at pager 230-2610. Epic may be used for all documentation and is fast and easy with customization. However, dictation is still permitted. Dictation Instructions Dial 76370 (or 981-6370 outside the hospital). Enter 5-digit Medical License number, followed by # sign. To create a dictation, press 1. Worktype, then #-key. 01 H&P 05 Discharge Summary 02 H&P Pre-op 07 Emergency Department admission (or 01 for H&P) 03 Consult 08 Emergency Department note 04 Operative Note 14 Letter or memo • Enter patient location: 1 Anderson • Enter 10-digit account number, then # key. Medical Staff Reference Updated June 20, 2011 25 • • Job number will be given at this point, write it down and enter into an Epic note. Ready to dictate. Press 2 to begin recording. Press 8 to end the report and start another OR hang up to disconnect. Begin dictation with: Patient name Patient account number Date (admission, discharge, surgery, etc.) Any problems with dictation or transcription, call regional transcription at 981-6495. After hours you can call the IT Service Desk at 800-498-1408. Pick up a dictation card from transcription services located next to the physician lounge. For patient safety and to prevent transcription errors, we encourage physicians to enter their own orders into the computer whenever possible. When a computer is not readily accessible, a telephone order may be given. Verbal orders when the physician is present are only accepted in an emergency or in a gloved procedure. In all cases, any verbal or telephone order MUST be authenticated (co-signed) by the physician within 48 hours of giving the order. Epic Tips and Tricks Orders Management – Inpatient Preference List Customized order sets are key for admissions or transfers. For an individual order, use the minimum number of letters to “find” the order. Expand the search by clicking on the Facility List (F6). When you’ve got what you want, add it to your preference list by clicking on the STAR to the right of the order. Organize your preference list into sections. Discharge Navigator – Prescription Preference List Follow through with the discharge navigator and Med Reconciliation to (1) Reconcile the Meds for Discharge (2) Complete the discharge order and write prescriptions, and (3) Review and Sign. There is no other way to get to the discharge order except through Med Reconciliation. This preference list is for discharge prescriptions or post-discharge orders (like labs or X-ray). You can write a range like “take 12 tablets every four hours” for a prescription, but not an inpatient medication. Surgical Navigator – Phases of Care Be sure to place your orders in the correct phase of care. Pre-op orders are placed in Pre-Op Consult and Post-op orders are placed in either Inpt Post Op (staying in the hospital) or Post-op Discharge (going home from the PACU). Both Post-op phases of care require you to go through Med Reconciliation to get to the transfer order. Otherwise, they’re not going where you intend. Before your surgical patient is admitted, if the patient is in Epic, you can go directly to Direct Admit Orders under the Epic button and the orders can be released by the nurse under the correct account number. In Basket – How Things Get There Click on “sign” for orders. You can highlight multiple orders by using the SHIFT and the mouse. Anything with the letters “hpf” can be completed in DocView. CC’d Results are just that – copies for you as a courtesy. Just click Done to remove them. Refresh takes away the Signed and Done tasks. Medical Staff Reference Updated June 20, 2011 26 SmartPhrases Speed Up Documentation Colleagues can share their documentation templates with you as a starter document. Email [email protected] for basic templates. The @phrases@ are SmartLinks to data somewhere in Epic. Guard Your Epic Password Closely and Do Not Give to Anyone Else Be careful with your password. Anyone who logs in under your ID and password becomes you for all practical purposes. Access can be monitored throughout Epic. Avoid opening and viewing charts for which you do not have a clinical or administrative reason. Do not give your log-in information to anyone else. Mid-level providers and ED scribes have their own log-in that is appropriate for their level of access. Passwords must be reset every six months. Epic Access From Home or Office The website for OUTSIDE the hospital is https://chpEconnect.health-partners.org Best to use Windows Explorer or Firefox. Only works with Firefox on the Mac (not Safari). Does NOT work on an iPad. You will need to download Citrix the first time you use this site. Click Accept. This may take some time. Enter you Epic Username and password to enter the Citrix site. It is very important to scroll down to MSWO in the third box. Citrix will load. This takes a minute. Be patient. You will need to download Citrix the first time you do, call 981-5050 for guidance and help. Click on the Epic Hyperspace PRD South Central icon. At the Epic Hyperspace log-in screen put in your username and password, just like in the hospital. How to Get Out of Epic Freeze Sometimes Epic “freezes” and you cannot move further. This usually occurs when signing orders. The chart cannot be accessed from another computer, it is “locked up”. When this occurs, RIGHT click on the blue circle Citrix icon on the bottom right of the screen and LEFT click on Log Off Sessions. Restart Epic and reenter the orders. Three Methods for Order Authentication The Ohio Board of Pharmacy requires a secondary authentication for any medication orders. That’s why we must use the RF-‐ID “tap” to sign orders, the challenge questions or RSA token outside the hospital. Away from the hospital, the RSA token is used as secondary authentication when ordering any medication. This must be activated and a PIN number specified before use. Call 981-‐5050 to set up an RSA token. Otherwise, challenge questions work in all three cases. Epic Challenge Questions To meet Board of Pharmacy requirements, set a total of 15 “challenge questions” under the EPIC tab. Remember that no two answers can be the same, answers must be at least three characters, and case sensitive. The Ohio Board of Pharmacy requires a pool of 15 questions. You answer two questions with each order. Compliant Documentation The attending physician is responsible for documenting consistently throughout the medical record the most appropriate, comprehensive, and specific diagnosis. This includes diagnoses that may be presumptive or "possible/probable,” which describe patient diseases to support medical necessity, severity of illness, quality reporting, and correct ICD-9-CM coding. ICD-10CM guidelines and rules will be implemented effective October 1, 2013 and will impact the specificity of documentation by increasing the coding options from 14,025 codes to 68,069 Medical Staff Reference Updated June 20, 2011 27 codes. Additional documentation pocket guides are available on request. Questions or concerns should be directed to the Mikki Doerger, head of the Clinical Documentation Specialist (CDS) team, Monday -Friday 8:00 - 4:30, 233-6605, or by leaving a CDS sticky note in EPIC. Hospital Operation Emergency Department Security A uniformed sheriff’s deputy is now stationed in the emergency department from 7 p.m. to 3 a.m. seven days a week. This is an increase from weekend only coverage in the past. This provides another layer of security and protection to patients and staff. Translators Available, call the Operator In accordance with CLAS Standards and Title VI, patients who are identified as Limited English Proficient (LEP) will be provided access to qualified interpreters to aid in facilitating communication related to patient needs at all times. LEP patients are those do not speak English as their primary language and who have a limited ability to read, write, speak or understand English. To obtain a dual headset phone call the operator at “O”. This stays with the patient until discharge. Bilingual employees cannot be used as staff interpreters unless they have undergone the process to become a qualified interpreter. Services of a qualified foreign language interpreter must be offered, at no additional cost, to all patients and/or relatives identified as Limited English Proficient. To preserve patient confidentiality, family and friends should not be asked to interpret for a patient unless there is an emergency situation (until an interpreter can be arranged and arrives), or the patient expressly requests to use that person. Document this in the medical record. Over the phone Interpreters, dial “O” for the operator Pacific Interpreters is the preferred vendor. Language Line and Vocalink are used as a backup service for rare languages. Sign Language Interpreters Sign language interpreters are among the most difficult to find. Translation of health care terms to sign language can be challenging. MHA contracts with Affordable Language Services – who specialize in medical translation. They are used by Cincinnati Children's Medical Center. They are certified and trained on medical terminology with required continuing education. How to View the Hospitalist Schedule – amion.com To know who is on for the hospitalists, you can view from any internet capable computer at www.amion.com. The password is “skh”. Ask for a list of hospitalist pager numbers at the Medical Staff Office or Hospitalist Office across from the cafeteria entrance. Patient Complaints and Grievance Management Hospitals are required to formally address any complaint by a patient or family member. CMS Definitions • Complaint: any expression of dissatisfaction with staff or service, which can be resolved quickly by staff present o Receive immediate response to avoid escalation to formal grievance o Acronym “HEART” helps manage complaints Hear Empathize Apologize Medical Staff Reference Updated June 20, 2011 28 Respond Thank • Grievance: a formal or informal written or verbal complaint that cannot be resolved at the time of the complaint by staff present o Includes any allegations of patient abuse or neglect, violation of patient rights, patient harm, or compliance with CMS requirements o Grievances require a written response within 7 days o Require formal investigation and address each concern specifically The patient advocate and appropriate administrator follow up with the patient and family the next day to assure resolution. If asked for your input, please respond in a timely manner. Our Patient Representative is here to listen to patients, families and others regarding concerns and complaints relating to their care and treatment. She will investigate and direct inquiries to appropriate staff to help resolve their issues. Most of the time this issues can be resolved, but at times the physician’s assistance may be needed. Most complaints are communication issues. Some common physician-related complaints are: a) Lack of adequate information to patient/families, b) Not allowing enough time for patient/ family input, c) Patient confusion regarding care/treatment/diagnosis from various physicians on the case, d) Who is coordinating care? Many patients have numerous physicians on their case. This is very often a source of frustration with patients and their families. They aren’t sure who is coordinating their care or which physician can answer their questions. Please do not hesitate to call the patient representative if your patients/families have any complaints or if you are sensing frustration or dissatisfaction from the patient. Sometimes, just having a person take the time to listen to them and look into their concerns can make all the difference between a Good or Bad hospital stay. Mercy Hospital Anderson Patient Representative: Trisha Heekin, RN 624-3270 Office 660-3361 Pager 233-6050 Fax Volunteers Alive and Well at Mercy Anderson Over 500 volunteers worked 58,722 total hours worked in 2010. Volunteers work in radiology, admitting, records, Medical Staff Office, Emergency Department, Same Day Surgery, Mercy Care Clinic, Information Desk, Spiritual Care, Dietary, Linen Room, Human Resources, Pharmacy, and the Women's Center. Volunteers also assist the nursing staff with daily rounding and discuss with patients their needs and any patient experience comments. These are accumulated and reviewed by the Patient Experience team. Medical Education Medical Student and Resident Policy We encourage all our credentialed physicians to participate in medical education. Rotating medical students with our attending physicians enhance our intellectual environment – something we want. Medical Students and Residents must register with the Medical Staff Office prior to being in the building. They must be a student in good standing at an accredited school. Medical Students May Have View Only Epic Access All medical students must register with the medical staff office and wear their school photo ID at all times. Students may have “view only” access to Epic charts – but this requires at least a 48 hour notice Medical Staff Reference Updated June 20, 2011 29 for IT to build. Advise your rotation. Decentralized Clinical Pharmacists are on each floor of the hospital. A clinical pharmacist is always available to assist you. If you need help from a pharmacist on any issue, please callmedical the pharmacy or office use Epicat to least enter student to call the staff an inpatient consult to pharmacy. a week before their scheduled Medical Student Rotation Schedules AT Still University 3rd year medical students rotate through Mercy Anderson in conjunction with HealthSource. This is their 3rd year inpatient Internal Medicine month. Our credentialed medical staff serves as attending faculty, including the hospitalists. The students are based on the A1 annex at A3. The students pre-round on their 3-4 patients, round with nurses on A1/A3, spend time with pathology, lab, and pharmacy. They are expected to present Grand Rounds patients at noon conference on Fridays. All medical staff is welcome to participate with the clinical discussions. Department of Pharmacy Mercy Hospital Anderson Clinical Pharmacist Team Pharmacy Main Phone: 624-4668 (84668) Pharmacy Fax: 624-4820 Pharmacy Director – Bill Carroll, RPh Office: 624-3268 Mobile: 332-8962 Pager: 343-0181 Email: [email protected] Clinical Pharmacy Coordinator – Leah Whitener, PharmD, CACP Office: 233-6788 Mobile: 233-6889 Pager: 209-0493 Email: [email protected] Lead Pharmacist – Jason Glasgow, PharmD Office: 624-4689 Email: [email protected] Coumadin Clinic Pharmacists – Jed Tuten, Martha Glenn, Leah Whitener, Rachel Osborne Office: 233-6038 Fax: 233-6644 Pager: 359-1008 ICU Pharmacist – 86529 or 233-6529 A1/B1 Pharmacist – 86610 or 233-6610 Surgery Pharmacist – 81095 or 233-1095 8am Pharmacist – 86784 or 233-6784 Pharmacists Sue Brohaugh Ileana Sosa Jenny Hertelendy Jason Glasgow Debra Bokulic Elliot Shreve Martha Glenn Shital Patel Joe Victor Greg Alverson Adam Holbrook Jed Tuten Rachel Osborne Leah Whitener Medical Staff Reference Updated June 20, 2011 Overnight Pharmacists Miranda Muma Lindsey Meucci Shay Burnett 30 Additional Opportunities for Physicians at Mercy Anderson Mercy Care Clinic Opened in July 2009, in partnership with the Muslim Clinics of Ohio, the clinic operates one evening a week in the Medical Arts Building (MOB I). Patients are typically referred by the emergency department or hospitalists and must meet financial requirements. One of the goals of the Mercy Care Clinic is to expand to a second weekly session in 2011. All members of the medical staff are encouraged to volunteer a few hours – roughly 6-8 clinic sessions per year. Clinic sessions operate from 5:30 – 8:30 pm and typically see up to 4 patients per hour. Dr. Tariq Sultan is the medical director and can be reached by pager at 209-0130. The Mercy Care Clinic at MHA was named a finalist in The Business Courier’s 2011 Health Care Heroes Awards – in the category of Community Outreach. Physicians Charitable Foundation (PCF) The Physicians’ Charitable Foundation is charitable arm of the medical staff of Mercy Hospital Anderson. 2011 marks the 17th year of scholarships awarded. The Mission of PCF is to promote, sponsor, and provide physician leadership in community health issues and provide support for education programs in the community. PCF is a 501(C)3 (tax deductible) legal entity that serves as the charitable arm of the medical staff. The purpose of the scholarship program is to financially assist and reward deserving students. Students must be pursuing a career in medicine, nursing or allied health. A number of scholarships ranging from $500 to $2000 will be awarded at the close of the school year to students graduating from high schools in the extended Anderson Township area. Children of MHA hospital employees, nursing staff, and other associates are encouraged to apply -- even if they live outside the Anderson area. Children of current Medical Staff members are not eligible for the scholarship to avoid conflict of interest. Guidance counselors are involved in recommending financially and academically deserving individuals. Medical Explorer Scouting – Dr. Steve Feagins You may be approached for brief assistance with our Medical Explorers. This is a part of the Boy Scouts, although males and females are welcome. Weekly sessions involve several areas of the hospital with 30 minutes of discussion from specialist physicians this fall. This is a great opportunity for these explorers to have a few minutes with a physician. We will work with your schedule. 2011 Medical Staff Social Events Mercy Hospitals Anderson/Clermont Medical Staff Members Golf Outing in September Come join your colleagues on September 21, 2011 at Legendary Run Golf Course for a relaxing afternoon of lunch, golf, and dinner at this beautiful course and lodge. Can’t get away from the office? Come join us for dinner and socialize with other medical staff members. Contact the Medical Staff Office (624-4058) or Physician Liaison (624-4784) for further details. Dr. John Cardosi Physician of the Year Award in September In its fifth year, the Dr. John F. Cardosi Physician of the Year award is presented during Heritage Week in September. Nominations are due by September 1 each year. The award will be presented during Heritage Week on September 22nd at 2:00 pm in the atrium. Dr. John Cardosi was a dedicated physician and lifelong Anderson resident who practiced family medicine for 38 years. Now retired, Dr. Cardosi continues to serve as a member of the hospital’s Ethics Medical Staff Reference Updated June 20, 2011 31 Committee and as a volunteer at the Catherine McAuley Health Center. The recipient of this award exemplifies the same compassion, respect for human dignity and willingness to serve as Dr. Cardosi. 2007 Dr. John Cardosi, Family Practice 2008 Dr. Bruce Hamilton, Infectious Disease 2009 Dr. Peter Ruehlman, Hematology / Oncology 2010 Dr. Mark Fiedler, Anesthesiology Taste of Mercy Wine Tasting – September 30 Save the date for Friday, September 30, 2011 at the Anderson Center from 7 – 9 pm. This event supports the Physicians’ Charitable Foundation of Mercy Hospital Anderson. You are welcome to invite friends and family. For additional information, contact the Medical Staff Office at 624-4058. 24th Annual Charles M. Barrett Memorial Golf Tournament – October 2 For 25 years the Charles Barrett Memorial Golf Tournament has been supporting Mercy Hospital Anderson in a multitude of ways including our President’s Scholarship Fund. Dr. Barrett (1913-1989) was one of the founding physicians of Our Lady of Mercy Hospital in Mariemont, the forerunner of Mercy Hospital Anderson. Dr. Barrett served as Medical Director of the hospital’s department of radiology. He was also President of the Medical Staff, served As Chairman of the hospital Board of Trustees, and a trustee of the Foundation. The outing is held the first Tuesday of October, held this year Tuesday, October 2, 2012 at Coldstream Country Club. We have planned a wonderful day of golf, entertainment, contest, and prizes at one of Cincinnati’s premier courses. For more information, contact Peggy A’Hearn, Director of Development for the Mercy Health Partners Foundation at 624-4916 or email her at [email protected]. Many thanks to Mrs. Helen Williams who began this tournament. Physician Holiday Celebration – December 2, 2011 The Administration & Medical Staffs of Mercy Hospitals Anderson and Clermont cordially invite you and a guest to attend a holiday dinner/dance on Friday, December 2, 2011. Hosted in the historic Hall of Mirrors, Cincinnati Hilton Netherland Plaza Hotel in downtown Cincinnati, it is an event not to be missed. Invitations will be sent. For additional information, contact Nissa Walker at 624-4391 or Joanie Manzo at 624-4784. Employee Health 7am – 3pm Tuesday, Thursday and Friday. Bloodborne Pathogen Exposure (pager 343-5076) If you are exposed at any time, page 343-5076. The hotline nurse will order labs on the source patient and the physician involved free of charge. Labs include Rapid HIV, Hep C and Hep B antigen on source and HIV, Hep C and Hep B antibody on physician involved. This hotline is also used for any other communicable disease exposure that can be treated with prophylaxis, i.e. meningitis. TB Skin Testing is available on site in Employee Health Office. Annual TB Testing is done every March. Specialties requiring annual TB testing include: any Mercy employed physician, Cardiology, Anesthesia, Radiology, Pediatrics, and OB/GYN. Respirator Fit Testing -- Annual fit testing takes place in Employee Health every June, July and August and is available to any physician. Medical Staff Reference Updated June 20, 2011 32 Core Measures Acute MI • Aspirin administration within 24 hours before or after arrival and ordered on discharge, or documented contraindication • Beta Blocker ordered on discharge or documented contraindication • Smoking Assessment and Cessation Instruction-Document! (History of smoking in last 12 months) • ACE or ARB ordered on discharge or documented contraindication • Statin ordered on discharge or documented contraindication • If indicated, PCI performed within 90 minutes (60 minutes ideal goal) Heart Failure This may include Dialysis patients with fluid overload • Left Ventricular Function Assessment must be documented, either from current admission or past assessment of EF • ACE or ARB ordered on discharge or documented contraindication • Smoking Assessment and Cessation Instruction-Document (History of smoking in last 12 months qualifies for instruction) • Need follow-up appointment within 5 days of discharge Pneumonia • Administer Antibiotics within 6 hours of arrival • Blood Cultures must be drawn PRIOR TO Antibiotics (only indicated for suspected sepsis) • Blood Cultures always for admit or transfer to ICU within 24 hours of arrival • Assure that appropriate antibiotic is ordered for med/surg or ICU level care – see orderset • Smoking Assessment and Cessation Instruction-Document! (History of smoking in last 12 months) • Vaccines are given per nurse-driven criteria SCIP (Surgical Care Improvement Project) (CV surgery, Colons, Hysterectomy, Primary Total Joint Replacement, and Vascular Surgery except Carotids) • Physician must have current weight in kg to order appropriate antibiotic dose • Prophylactic Antibiotics must be discontinued 24 hours post OR stop time. (48 hours for CV surgery) • All surgical patients require DVT prophylaxis • Patients currently prescribed Beta Blockers should continue unless contraindicated per physician order • VTE prophylaxis ordered and given within 24 hrs of Anesthesia end time • Foley DC by POD 2 or documented reason by physician to continue • Post op CV surgery patients require documentation of blood glucose POD1 and POD 2 at 6 AM Stroke Absence of any of the following requires documentation of contraindication or pt/family refusal • Assess for rehab needs (PT/OT or speech)– all ischemic and hemorrhagic stroke patients • VTE Prophylaxis administered (mechanical or pharmacologic) day of or after hospital admission for all stroke patients • IV Thrombolytic therapy for those ischemic stroke patients who arrive within 2 hours of last known well • Antithrombotic therapy for ischemic stroke patients by end of hospital day 2 Discharge medication requirements • Ischemic stroke patients should have antithrombotic therapy prescribed on DC • Ischemic stroke patients with Afib/Flutter should have anticoagulation therapy prescribed on DC Medical Staff Reference Updated June 20, 2011 33 • Ischemic stroke patients who were on statin prior to arrival or who have documented LDL ≥ 100, either on this admit or within 30 days of arrival, should have statin prescribed on DC Spiritual Care Services Chaplains • Are available 24/7 for all patients needing spiritual/emotional support and may be contacted by calling the operator • Are board certified through professional chaplaincy associations • Represent multi-faith backgrounds and approaches • Are members of the inter-disciplinary team • Assess spiritual needs without disrespecting individual beliefs, values, or faith • Support a holistic approach to patient care • Assist with advance directives and end-of-life discussions for patients and families Advance Directive Information and the Chaplaincy Role Chaplains receive referrals for advance directive information. Health Care power of Attorney (HCPOA) and Living Will (LW) information is offered to all patients admitted to our facility. The HCPOA lets the patient name who they would want to make their health care decisions if they are unable to do so. The LW directs the physician on a patient’s wishes for end-of-life care. The HCPOA goes into effect if the patient is temporarily or permanently unable to speak for him/herself. The LW is activated only after two physicians determine and document the patient has a terminal condition (defined in the document) or is permanently unconscious with little hope of regaining consciousness. The LW is not a DNR order. A DNR order must be written by a physician. While chaplains are available to discuss issues related to a patients’ journey with illness, meaning and hope, they do not discuss DNR orders. Code status discussions are outside of the scope of practice of chaplains as they require the patient to understand how their medical condition affects their goals. Mercy belongs to the US Living Will Registry and offers registration free to all patients and their families. This is a national database that stores the ADs electronically so that caregivers have access to them wherever the patient is. Chaplains help patients complete this process. Ethical concerns are handled with a multidisciplinary approach. Patients (or their decision makers) are given all the information and support they need to make decisions. The patient’s physician should be advised of patient concerns. The Ethics Committee is a consultative resource for patients, families, physicians and staff. This committee can be reached by calling the operator. Chaplains are available to support patients and their medical team in difficult discussions. Spiritual Care is represented on the hospital ethics committee. Medical Staff Reference Updated June 20, 2011 34 Management Directory Title Sr. Development Officer Director Department Foundation Phone 624-4916 Pager/Cell 378-0883 Mission Services 624-1001 670-0472P Manager Lab 624-4890 Berlage-Ingram, Teresa Berus, Lisa Operations Manager Manager Food & Nutrition Services 624-4583 230-2660P 315-9345C 660-3163P 233-6301 Butz, Beth Manager Ambulatory Surgery Center MAASC ICU Boggs, Kristin Director Risk Management Boles, Wanda Bruns, Chad Team Lead Manager Materials/Linen Facility Management 624-4059MHA 735-1531 MHC 624-4551 624-4698 Carroll, Bill Director Pharmacy 624-3268 732-8670 233-6632 382-1827 660-3137P 607-4291C 230-7066P 746-7986 C 209-1171P 209-1969P 706-2508 C 332-8962 C 343-0181P Chisley, Gyasi VP Operations Administration 624-4882 404.423.7314 DeHaan, Colleen Manager Radiology 233-6758 Dunn, David Lead Tech Biomed Edrington, Kathi Ellerbrock, Sharon Evans, Denise Director Manager Clinical Services A1/A3 624-4533 732-8390 624-4963 624-4086 670-0379P 382-2798C 660-3057P 720-2306C 343-0498P 343-0598P Manager Peri-Operative Services 624-3296 Feagins MD, Stephen Vice President Medical Affairs Administration Medical Staff 624-3281 343-0014P 292-0812C 203-4336C Fedders, Neil Fender, Dana Manager Clinical IT Specialist Rehab, Physical Therapy Nursing Admin 624-1836 624-4543 209-0954C 230-2610P Glasgow, Misty Manager Medical Records 230-1745P Harten, Susan Director Human Resources Herald, Cassie Herron, Carrie Manager Manager RTD/Transport/EEG B1/Ortho 624-4072 735-1739 233-6922MHA 870-7083 MHF 233-6438 233-6843 Holt, Julie Kirk, Bridget CNO Manager Nursing Administration Cath Lab 624-4505 624-4528 Name A’Hearn, Peggy Averbeck, Sr. Mary Lou Balwanz, Chad Medical Staff Reference Updated June 20, 2011 624-1047 209-1085P 343-0501P 230-0060P 313-7569C 608-2945C 343-1114P 35 Kovacs, Deb Knight, Doug Malblanc, Ron Manzo, Joanie Manager Ortho PA Team Leader Director Sleep Lab Orthopedics Protective Services Physician Services 624-1212 675-2262 624-4582 624-4784 Martin, Terri Director Critical Care Services 624-4359 Maupin, Janice Director Quality/Care Management 624-4536 Mixon, Robin Mondary, Lori Manager Director Admitting MAASC 624-4628 624-1957 Momper, Adam Nastold, Sr. Ruth Manager Assistant to the President Manager Manager Ambulatory Services Administration 624-3223 624-4848 Spiritual Care Services Emergency Department 735-7521 624-4032 Nutrition & Food Services 624-4035 Puthoff, Kathy Rausch, Jasmine Regional General Mgr Director Clinical Director 660-0637P 230-3504P 368-4630C 650-0665P 624-4608 624-4317 350-2840P 343-0134 Ruffennach, Ed Director Infection Control FBC, SCN, Maternal/Fetal Medicine, OB Clinic Director Periop Services 624-4855 343-0207P 330-962-9652 C Savicki, Stephanie Schroer, Patti Shelley, Kristin Sr. Director Marketing 981-6348 President/CEO Manager Administration B3 624-4501 624-4959 Stone, Diane Thomas, Dennis Director Manager Volunteer Services Environmental Services 624-4676 624-1066 Tritch, Pam Vacant Case Management HR 624-4903 624-1990 Vacant Manager Sr. HR Consultant Director 624-1279 Vacant Walker, Nissa Will Woodward Manager Manger Director Women’s and Children’s Services PACU/SDS Medical Staff Office Finance Yorio, Mary Manager A2 O’Rourke, Kay Pope, Brian Pramuk, John Medical Staff Reference Updated June 20, 2011 624-4526 624-4391 624-3282 735-7548 624-4040 n/a 343-2817P 350-5680P 546-9597C 408-1908P 604-3302C 660-3024P 708-6245C 350-0191 408-2845P 305-4088C 476-1977 660-3162P 324-6958C 343-1075P 218-9383C 382-0695C 237-7049C 209-1360P 660-3667P 660-3026 515-2048C 343-0157P 36
