Diane Bohner, M.D., FACP

Diane Bohner, M.D., FACP, has always been good with patients.  In private practice, her patient satisfaction scores consistently hovered at the top. But while attending a recent intensive training seminar sponsored by the Institute for Patient and Family Centered Care, she learned about new and exciting possibilities for patient and family centered health care—and about and what she and Christiana Care had not been doing.

“I wasn’t surprised that I didn’t know everything,” she said.  “But now that I understand the possibilities for patient and family centered health care, I can’t imagine continuing the other way.”

The “other way” was patient-focused.  Christiana Care has long been patient-focused, Bohner says. We do the best things “for” our patients.  We provide the best treatment “to” our patients.  And we deliver excellent results, but we have an opportunity to do even better.

A patient and family centered approach means that we stop doing things “to” and “for” our patients and instead make choices “with” our patients.

In November 2011, Dr. Bohner was appointed medical director of Patient and Family Centered Care and Resource Management.  Since then, she has been on a mission to educate herself and her colleagues about what it means to be patient and family centered.

“We work very hard to help patients, but often we don’t actually ask the patients in what way we can help them best,” she said.  “It reminds me of the first Christmas with my husband when I didn’t ask him what he wanted; I just bought stuff.  Yes, I got some things right and some things not so right.  As medical professionals, when we realize that we can ask and involve the other person in decisions, we can be so much more successful.

“In medicine, we create frontline processes, but we don’t always ask the frontline person what would work best for him or her.  We create processes for the patient without asking them about what they want or need and then wonder why we’re not as successful as we should or could be.”

Dr. Bohner believes that the time is right for a major transformation in how we provide care.

“We have pressures that are forcing this change,” she said.  “We have changing payment sources for the hospital that now focus on outcomes, on patient satisfaction and on readmission.  These changes can be stressful, but with all of the regulation changes, we can no longer simply do what we’ve always done.

“Everything we’ve done for the past two years has worked to make us very good but has not necessarily made us great.  I think that patient and family centered care is a platform for us to be great.”

Patient and family centered care was first introduced at Wilmington Hospital in 2008, under the leadership of Janice Nevin, M.D., now chief medical officer.  The concepts and core practices have already taken hold in many parts of Christiana Care.  Hospital units on both campuses have implemented bedside shift reporting, patient-communication whiteboards, AIDET, multidisciplinary rounds and nurse manager rounding.  Patient and family advisory councils currently exist for the Wilmington campus, the Helen F. Graham Cancer Center, Women’s and Children’s Services, and the NICU.  Patients and visitors have noticed a change in culture at Wilmington, in particular as staff routinely smile and greet patients and each other in the hallways, elevators and public spaces on campus.

Over the next year, Dr. Bohner hopes to see these core practices become uniform across Christiana Care.  Working with a new council structure that includes a Think of Yourself as a Patient focus, she plans to foster an environment in which staff on both campuses and in every unit share a common vision for what the patient and family centered experience should be at Christiana Care.

Bohner also has been tapped to develop a new program based on a concept called “medical home without walls,” along with Patty Resnik, corporate director, Quality & Utilization Management. The program will include a team of an RN or LPN and a social worker who will work with high-risk patients while in the hospital, and then continue to see those patients after discharge at a place convenient for each patient—at home, on the street, at a shelter, etc.

“The great thing about patient and family centered care is that it ultimately helps us to be better at taking care of our patients,” she said. “It puts us in the frame of mind to take care of patients as whole people—to think about the quality of their care from inpatient to outpatient, and their quality of life while they are in the hospital and also after they go back out into the community.”

Dr. Timothy Hennessy demonstrates the efficiency of the new electronic message center built into Christiana Care's computerized order entry system for physicians. The tool provides a secure, convenient messaging system to help doctors coordinate patient care.

Timothy Hennessy, M.D., has an early morning question about a patient’s heart medication but hesitates to call the patient’s cardiologist. So, he logs into Christiana Care’s Computerized Provider Order Entry/PowerChart 2012 tools for physicians, goes to the message center, selects “communicate” and sends a message to the cardiologist, who responds several hours later.

Dr. Hennessy is a general internist who also works as a hospitalist. Several times each week, he uses the system to reach out to another internist or a specialist. He makes inquiries such as,  ”Would the patient benefit from another day in the hospital?” Or “How can we help a patient who is having trouble sleeping?”

Technology makes it easier to communicate, he says. But e-mail, text messaging and mobile phones also have fragmented the way people, including doctors, communicate.

“When doctors use different kinds of technology to communicate, it can actually make it difficult to know how to get in touch with a colleague,” Dr. Hennessy says.

The message center is part of Christiana Care’s transformation to an integrated electronic health record, says Janice Nevin, M.D., MPH, chief medical officer. Working with one, streamlined system that is solely for physicians benefits doctors because there is a central location for messages and a mechanism for quick response.

Dr. Hennessy acknowledges that not all doctors are enthusiastic about yet another mechanism for communication. But he has used the system frequently and finds it extremely useful.

The message center offers an additional advantage in that messages are secure, ensuring patients’ privacy. All messages are purged from the system after 60 days and are not part of the permanent record.

“Since the message is compliant with HIPAA, it allows for a freer exchange of information,” Dr. Hennessy says.

The system can be accessed remotely, and exchanges typically take only a few seconds. The patient’s name automatically pops up in the message header.

Dr. Hennessy says the message center nurtures collaboration and can help to build relationships between primary care physicians and specialists.

“The more doctors talk to each other about their patients, the better the patient care will be,” he says.

In 2011, 45 donors and their families gave 141 patients the lifesaving gift of a heart, lung, liver, pancreas or kidney. Another 94 donated bone, skin, cornea and heart-valve tissue, potentially saving the lives of or assisting more than 6,000 patients. This represents record participation from the communities Christiana Care serves.

The success of the program stems from Christiana Care’s strong support of the donation and transplant process, and the supportive collaboration of Christiana Care’s critical care teams and Gift of Life staff, according to Joanne Matukaitis, RN, director of Patient Care Services, Critical Care, and Christopher Schimpf, RN, Gift of Life Donor Program Hospital Services coordinator.

When a patient is approaching death, with no chance of survival, Christiana Care staff begins working with Gift of Life. Together they coordinate all aspects of the donation process: supporting the family, obtaining consent, ordering appropriate tests, recovering the gifts, and following up with the family.

“One of the aspects of organ and tissue donation that can be overlooked is the solace it can bring to donor families in the midst of their loss,” says Schimpf. One mother of a 16-year-old girl, who donated her daughter’s organs after a car accident, said that when the phone stopped ringing with people offering support, the only thing keeping her going was that her child saved eight lives. That knowledge was the only comfort she had in her grief. She called it her lifeline.

In our region, 6,482 candidates are on the waiting list for organs. More than 113,000 candidates are waiting nationally.

To learn more, please visit DonateLife.org in Delaware, Pennsylvania or New Jersey.

Gregory Cooper, BSN, RN

Bullying, once dismissed as a normal part of growing up, is now recognized as far more dangerous and consequential than once believed. High-profile incidents, including school shootings and suicides, have sparked a national conversation about bullying, placing it front and center in the minds of parents, educators and health care professionals.

For Christiana Care’s Gregory D. Cooper, BSN, RN, a crisis interventionalist at Wilmington Hospital, preventing adolescent suicide is his life’s work. He is the lead author of “Examining Childhood Bullying and Adolescent Suicide: Implications for School Nurses,” published in the March issue of the Journal of School Nursing, with colleagues from Drexel University. Their earlier paper, “A Review and Application of Suicide Prevention Programs in High School Settings,” appeared in October 2011, in Issues in Mental Health Nursing.

Q & A with Gregory D. Cooper, BSN, RN

Q: How common is bullying, and what is its link to suicide?

Cooper: The Centers for Disease Control and Prevention estimates that 20 percent of high school kids are being bullied, but that number is probably quite low, because bullying primarily happens in middle school. Suicide is the third-leading cause of death in 10- to-24-year-olds, and several studies show a correlation between bullying and adolescent suicide.

Q: What should health professionals watch for?

Cooper: Simply ask: “has anyone in the past week or two said mean things to you, taken things, punched you, sent a mean text message—or have you done that to anyone else?’’ You’ll be surprised how readily kids will answer the questions. Listen and validate their experience. You may be the first to hear this, so validation may be thanking them for sharing, asking, “how has it affected you? Do you not want to go to school? Do you feel sick a lot? Have you ever thought about harming yourself because of this?’’ Then advocate for them. That means you bring in parents, educators and professionals.

Q: How has Christiana Care addressed these issues?

Cooper: Our crisis intervention team is unique. You would be hard-pressed to go to any (other) ED in the country and get a full psychiatric crisis evaluation and get placed into an appropriate level of care, inpatient or outpatient, 24/7.

Q: What more should be done?

Cooper: What’s difficult is to create policy change. That takes greater awareness and education, identifying the symptoms so people don’t slip through the cracks. When there is an adolescent in the hospital, we must consider this.

Q: Why do kids bully others?

Cooper: For many kids, there’s a biochemical aspect. And there is a learned social aspect for kids who see violence at home. Boys with conduct disorders or who are impulsive are more likely to bully.

Q: Is there a typical victim?

Cooper: In general, what puts you more at risk for bullying is being an outlier. That is, being someone who is quiet or passive, someone of a different sexual orientation, somebody who has friendship difficulties or low self-esteem.

Q: What are the red flags to watch for?

Cooper: Behavior changes. This applies to children involved in bullying on any side — bullies, victims, bystanders. Other signs are increased anger or fear, decreased appetite, decrease in grades or self- esteem, withdrawal — not wanting to go to school, saying they’re sick, withdrawal from activities they previously liked to do, visiting the school nurse a lot. Kids who are bullied go to the nurse on average five times or more in a school year. Also look for unexplained injuries and unexplained broken or lost property.

Q: What strategies do you suggest for parents?

Cooper: Three strategies: communication, communication and communication. Talk to kids about bullying, identify it, talk about how to handle bullies, such as using humor, avoiding situations or removing yourself from a situation where you know it’s going to happen. I would advise a child to defend himself only when he has exhausted all other means, because it never is a good thing when two people get into a physical altercation. If it has to go physical, it is dangerous for everyone. Parents should monitor all their children’s electronic communication. A child should never have a Facebook account that restricts parents from viewing it, or restricted texting capability.

Q: How effective are school anti-bullying programs?

Cooper: They vary, but many of them are not research-based. Seventy-seven percent of high schools have suicide prevention programs and most have not proven successful. Fewer schools have anti-bullying programs. You’ve got to start in kindergarten.

Learn more

• StopBullying.gov
• CDC: Measuring Bullying, Victimization, Perpetration, and Bystander Experiences: A Compendium of Assessment Tools
• Christiana Care Adolescent Health

By creating the Pediatric Emergency Care Facility Recognition Program, Delaware became only the fifth state create a standard of care that includes equipment, protocols, staffing and continuing education.

Each year, more than 15,000 patients ages 15 and under seek treatment at Christiana Care’s Emergency Department facilities at Christiana and Wilmington hospitals. Now, through a new network, the hospital emergency departments will be able to save the lives of even more children.

Overall death rates through the Delaware Trauma System—a network of the Delaware Division of Public Health—have been cut by 40 percent, thanks to the efforts of emergency department health care staff at those hospitals.

Delaware recently launched a Pediatric Emergency Care Facility Recognition Program and became only the fifth state to create a standard of care that includes equipment, protocols, staffing and continuing education.

The system has three levels:

• Christiana Hospital is designated as a Level 2 pediatric center, meaning it can provide inpatient pediatric care as well as critical care.
• Wilmington Hospital is designated a Level 3 center because it has the personnel and resources to treat pediatric patients for a range emergency care services, including the ability to stabilize and transfer pediatric patients for more intensive services.
• Only children’s hospitals, such as Nemours/Alfred I. duPont Hospital for Children, qualify for Level 1 status.

“We know from experience when a state or region organizes a system of care, benefits follow” says state Trauma System Coordinator Mary Sue Jones, RN, MS. “A standard system results in smoother communication between hospitals for ease of transfer and consistency of care.”

Emergency Medicine Department physician Christopher Moen, M.D., represents Christiana Care Health System on the state subcommittee and helped develop the new standards for the pediatric system. Delaware will be part of a study on how effective the new system will be. That study could help other states model similar initiatives.

Nursing leaders from Christiana Care’s Emergency Department also played a key role in assuring facility readiness.

Roger Kerzner, M.D., director of Electrophysiology Research at Christiana Care, was among the instructors at the 2012 Mini Medical School, an annual event that offers people of all ages a chance to gain a deeper understanding of medicine.

Sevriano Seda and Nelson Mweberi both plan to become doctors someday.

But the 17-year-olds are still in high school, in the nursing tech program at Hodgson Vocational Technical High School in Newark, Del.

The teens are getting a head start on their aspirations at Mini Medical School, a free, six-week lecture series offered to young people and adults of all ages. The faculty is made up of Christiana Care doctors, who offer in-depth lectures on important health issues and advances in medicine and research.

“My teacher suggested I come because this might look good on my college applications,” says Seda, of Bear. “I want to become a cardiologist, so I’m especially interested in this lecture.”

The topic of the evening at Christiana Care’s John H. Ammon Medical Education Center was “The Beat Goes On: Heart Rhythm Solutions,” presented by Roger Kerzner, M.D., director of Electrophysiology Research at Christiana Care Cardiology Consultants. Other topics have included “The Aging Brain: Fact and Fiction about Brain Health,” and “Pancreatic Cancer: Approach and Treatment Options.”

“I want to be a surgeon, so I was very interested in the kidney transplant lecture,” says Mweberi, of Newark.

Mini Medical School is sponsored by Christiana Care Health System, the Delaware Academy of Medicine and the Delaware Academy of Family Physicians. There are no tests or grades. No previous medical training is required.

The participants who attend all six sessions don’t get an M.D., but they do earn a certificate of achievement. A similar five-lecture series also is offered in Lewes, Del.

This year, the sponsors reached out to students throughout New Castle County, distributing posters and flyers to public, parochial and independent schools.

“There are many kids in high school who are thinking deeply about what they will do in life, and we think this series could be very meaningful to them,” says Timothy Gibbs, executive director of the Delaware Academy of Medicine.

Victoria Sanchez of North East, Md., 16, is a junior at St. Mark’s High School in Wilmington who has clearly defined career aspirations.

“My mom is a doctor, and I want to go into that field, as well,” she says.

Sara Buni of Elkton, Maryland, a 16-year-old sophomore at St. Mark’s, says she has always had an awareness of the importance of health care. Both her parents are nurses.

She is impressed that Mini Med School provides information on health that is accessible to learners who don’t have a background in medicine.

“It’s really understandable, even from a high school point of view,” she says. “I learned that stroke is so much more complicated than it seems.”

Participants have an opportunity to ask questions after each presentation. Between 100 and 160 people registered for each lecture in the series, says Tracy Miller, program coordinator.

Young Seda committed to attending them all. He took lots of notes so that he could follow up with independent studies. He also made arrangements to shadow a primary care doctor for an afternoon at his office.

“Mini Med School is a wonderful learning experience,” he says. “I have learned more about health care, and I feel more confident that I am on the right career track.”

To receive an e-mail invitation to the next annual Mini Med School, subscribe to our e-mail list.

Photo gallery: Mini Medical School

From left, Ted Van Name, president and CEO of Goodwill, Tom Corrigan, Christiana Care's chief financial officer, and Chris Quintanilla, chairman of the Board of Directors for Goodwill.

Christiana Care has received the 2011 Community Partner of the Year Award from Goodwill of Delaware and Delaware County.

The award recognizes Christiana Care’s leadership in partnership with Goodwill, the Red Clay Consolidated School District and the Delaware Departments of Labor and Education to be the inaugural employer in the state to host Project SEARCH. This innovative, nine-month school-to-work program enables students with intellectual disabilities to obtain real-life work experiences, combined with training in employability and independent living skills to help program participants make successful transitions from school to productive adult life.

The successful launch of Project SEARCH took more than three years to develop. Gov. Jack Markell visited the classroom at Christiana Hospital in March where he praised the unique collaboration between government, business, education and the community.

2012 Christiana Care Volunteers Hall of Fame honorees include (back row, from left): Joanne Patchak, Elayne Tomb, Nancy Bowman, Barbara Campbell, Thomas Campbell; (front row, from left, flanked by Robert J. Laskowski, M.D. Christiana Care president and CEO at left and Delaware Lt. Gov. Matt Denn at right): Norwood Sloan, Margaret DeCoursey, Roger Ayers, Ralph Boardley, and Regina Brothers. 2012 Hall of Fame honoreers unable to attend the event and not in the photo include: Irma Dill, Phyllis Kortvelesy, Claire Nanis, Willie Richardson, Regina VanVeen and Shirley Wittman.

Christiana Care leaders recognized the extraordinary dedication of hospital volunteers at the annual Thank You event April 20 at the John H. Ammon Medical Education Center. The event gave special to honor those who have reached the 10-year service milestone.

Christiana Care President and CEO Robert J. Laskowski, M.D., praised everyone who contributed to the total of 60,377 volunteer hours worked in the past year.

“Your volunteerism inspires me,” he said. “The difference you make is a fundamentally human difference.”

“People don’t live in isolation,” Dr. Laskowski says. “They live as members of families and neighborhoods. If you want to understand people and be helpful to their health, you’ve got to be involved in the things that affect their health, which means the community in general.”

“Volunteers affect the quality of our patients’ experience with Christiana Care Health System across the full continuum of care,” said Margarita Rodriguez-Duffy, MSW, director of Volunteers and Visitors Services. “We are very grateful for all they do.”

Delaware Lt. Gov. Matt Denn also attended the Volunteers Thank You event. Denn’s observation: Outcomes are not only the result of the quality of medical care; they “also have much to do with the caring and nurturing of others.” Denn thanked volunteers for the work they do to lighten the workload of Christiana Care employees and help fill gaps in health care resources.

The week event also honored three 2012 Jefferson Award winners. The quarterly award recognizes Christiana Care employees who exemplify actions and attitudes of service, caring and leadership beyond the work they do each day for Christiana Care. This year’s Jefferson Awards Winners were Rose Mili, for her work the MS Society, Lynda Sydnor for advocating for the elderly and John Di Giovanni for his work with a group that would later provide backup communications to Christiana Care and other non-profits. One of the three, John Di Giovanni was selected to represent Christiana Care in Washington, D.C., at a National Volunteer Week event, Celebrating People in Action.

Photo gallery: Volunteer Thank You Event

Lynn Pierce, BSN, challenged nurses to embrace compassion and customer service, and to be drivers of positive change in health care.

Lynn Pierce’s husband suffered a heart attack at age 40.

In the emergency department of an unfamiliar hospital, nurses barred her from the treatment room. She was only a few feet away, in the waiting room, when he died.

“How could they let my boyfriend since age 13 die alone?” she asked, as she addressed an audience of about 150 nurses at the Evidence Based Nursing Practice Council and Quality and Safety Combined Retreat on April 27 at the John H. Ammon Medical Education Center.

Pierce is a consultant at Healthcare Performance Improvement, a Virginia-based firm that specializes in improving human performance using evidence-based methods derived from high-risk industries. She has more than 30 years’ experience as a registered nurse.

During her keynote presentation titled “Patient-Centered, High Quality, Safe Care: Doing the Right Thing,” Pierce said that in this era of sweeping reforms in health care, nurses play a leading role in implementing positive change, offering professionalism, responsiveness and, above all, compassion.

Pierce encouraged nurses to embrace compassion and customer service in delivering care to patients and their families, who are likely to be confused and frightened by their illness or injury.

“We have to back up and say ‘what makes a great nurse?’ What if that person has all the skills you might ever need, but the attitude is bad?

“How long is too long to wait when you’re in pain?” she asked. “We have patients out there who are saying ‘comfort me. Don’t make me wait.’

She emphasized the importance of initiatives like hourly rounding, as well as safety tools and procedures such as phonetic and numeric clarification.

“It’s got to be 15, then ‘one-five,’ because 15 and 50 sound so much alike,” she said. “When things don’t feel just right, it’s our job to question that.”

At the inaugural Value Institute Symposium: Michael Lauer, M.D., William Weintraub, M.D., Robert J. Laskowski, M.D., MBA, Arkadi Kuhlmann, HBA, MBA, LLD, U.S. Sen. Christopher Coons, David B. Nash, M.D., MBA, Peter L. Slavin, M.D., and Virginia L. Hood, MBBS, MPH.

The medical profession must refocus attention on the patient to deliver quality care at greater value, according to speakers at the Christiana Care Value Institute’s inaugural symposium “Value: Medicine’s New Frontier” held Monday, April 30.

More than 200 health care experts from top institutions in the nation discussed how returning to the basics of medicine – listening to the patient, better use of resources and a greater emphasis on quality and safety – can transform patient care and deliver far greater value.

Christiana Care established the Value Institute this year to study and design solutions to the questions of value in the real world settings of health care delivery, said Timothy J. Gardner, M.D., Medical Director of Christiana Care’s Center for Heart & Vascular Health and interim Director of the Christiana Care Value Institute. He said the institute aims to implement strategies to achieve better health outcomes at lower costs.

The speaker lineup included widely respected thought leaders in the health care industry: Robert Laskowski, M.D., MBA, president and CEO of Christiana Care; Virginia L. Hood, M.D., immediate past president, American College of Physicians; David B. Nash, M.D., MBA, dean of the Jefferson School of Population Health; Michael Lauer, M.D., director of the Division of Cardiovascular Sciences at the National Heart, Lung and Blood Institute, National Institutes of Health; and Peter L. Slavin, M.D., president of Massachusetts General Hospital. U.S. Senator Chris Coons and Arkadi Kuhlmann, MBA, founder of ING DIRECT USA, also participated.

“Value is more than the benefits and costs of serving our patients’ needs,” said Dr. Laskowski in his address “Value: the Patient’s Perspective.” “The concept of value is grounded in the needs of our neighbors as they perceive them,” he said. Dr. Laskowski outlined his views in an op-ed published prior to the symposium.

He said those who deliver and finance health care must continually remind themselves that it is “first and foremost” the patient who is served.

“On the issue of patient care, what the individual “feels” appears to matter at least as much as the facts,” he said. “We who lead health care must understand these feelings as well as the facts if we are to improve quality and safety and reduce costs.”

What is at issue, said Dr. Hood, is “conserving resources at the physician-patient level.” She said the drivers of cost in health care are technology, chronic disease and aging, excessive pricing, fewer primary care services and liability.

She cited a recent American College of Physicians survey that found 42 percent of primary care physicians believe patients are receiving too much testing.

She said the national debate should be about “Rational care, not rationing care. We need to encourage people to follow treatment guidelines if they are relevant to the patient.” To achieve high-value, cost conscious care, she supports more patient-centered medical homes.

Dr. Nash, who is also the Dr. Raymond C. and Doris N. Grandon Professor of Health Policy of Thomas Jefferson University in Philadelphia, PA, spoke about quality and safety in health care.

“In order to make health care reform work, we need medical education reform,” said Dr. Nash. This is a cultural challenge. Doctors are well prepared in science-based medicine and in obtaining the skills necessary to care for patients. But very few are qualified to measure and improve what they do every day.”

On average, the typical medical student gets one day in four years of true didactic training from an expert in quality and safety, he said. There is a great need for a new cadre of leaders with content experience in the quality and safety field.

“I’m an optimist,” he said. “Given the leadership we have in a room like this, we can get the job done.”

There’s a lot the medical profession can learn from other professions, including banking, said Arkadi Kuhlmann. “To tap into the value proposition, health care must address the emotional side of the equation.” Banks do this well, he said.

“Consumers are driven by an emotional assessment. This requires innovation and flexibility,” he said. “You need to adjust business model so the customer understands the value proposition because happy customers end up talking about what they’re happy about.”

Dr. Lauer believes health care must return to its scientific roots. “Every clinical encounter between doctor and patient is an opportunity to leverage the power of the scientific method – the most powerful tool at our disposal for assuring that medicine will continue to evolve as one of human society’s greatest accomplishments,” he said.

“We need to rediscover the value of real world clinical trials,” he said. Unfortunately, the majority of doctors have nothing to do with clinical trials.”

“I believe one of the biggest health care problems is the cost of health care itself,” said Dr. Slavin. “We have to see if we can bend the cost curve and make health care more affordable. We have no other choice. We don’t want to finance unnecessary care; we want to finance care that adds value to our patients because that in the end is most sustainable.”

He advocates shifting to population management as a way to ensure high-quality health care while controlling costs.

“We need to re-learn what we have forgotten,” said Sen. Coons. “It’s about learning what we used to know, the things we knew before we became so well educated.”

He cited a recent grant Christiana Care received to care for elderly patients in the home. “It’s a perfect example of returning to the basics of care.”

Photo gallery: Value Symposium

At the event unveiling the Domestic Violence Resource Manual for Healthcare Professionals: Gordon Reed, M.D., medical director of the Forensic Nurse Examiners program at Christiana Care; Kathy Keating, RN, Nanticoke Memorial Hospital forensic coordinator; Delaware Attorney General Beau Biden; Anita Symonds, RN, Christiana Care Forensic Nurse Examiners program coordinator; Dawn Culp, RN, Bayhealth Medical Center forensic coordinator; and Matthew Hoffman, M.D.

A new resource manual designed to assist health care professionals was officially released at an event hosted Wednesday, April 11, in the Women’s Health Services department of Christiana Hospital.

The Domestic Violence Resource Manual for Healthcare Professionals was designed by the Domestic Violence Coordinating Council—a state agency whose mission is to improve Delaware’s response to domestic violence—in partnership with the Medical Society of Delaware and Christiana Care.

Christiana Care speakers included Matthew Hoffman, M.D., director of OB/GYN Education and Research at Christiana Care, and Anita Symonds, R.N., the forensic nurse examiner program coordinator.

Delaware Attorney General Beau Biden also spoke at the event. State Rep. Michael A. Barbieri and State Sen. Liane M. Sorenson, both whom are members of the council, were in attendance.

The resource manual provides accessible information to health care professionals to assist them with the screening and treatment of patients involved in domestic violence.

“Health care professionals often meet victims of domestic violence at moments of crisis, but these terrible situations can also present the opportunity to intervene and break the cycle,” Biden said. “By educating professionals on the signs of domestic violence, the unique medical and mental health needs of victims, and the resources available to their patients, this manual can help Delaware’s health care professionals change lives.”

Added Dr. Hoffman: “Domestic violence has been recognized as the cause of substantial medical costs by the Centers for Disease Control and Prevention—totalling over $5.8 billion dollars in 2003. With this manual we now recognize that we have a resource to meaningfully address domestic violence as a medical issue.”

The Hill, published in Washington, DC, is written for and about the U.S. Congress with a special focus on business and lobbying, political campaigns and other events on Capitol Hill.

Sen. Patricia Blevins

State Sen. Patricia Blevins (D—Elsmere), the Senate majority leader, toured the neonatal intensive care unit (NICU) at Christiana Hospital on Monday, April 16. David Paul, M.D., a neonatologist at Christiana Hospital and chair of the Delaware Healthy Mother and Infant Consortium, hosted the tour. Blevins was impressed with the size and services of the NICU – the region’s only delivering hospital with a Level 3 neonatal intensive-care unit. Sen. Blevins also learned about the NICU Family Support Program, which was launched to inform and comfort families during the NICU hospitalization of their newborn and the transition to home life, and to help in the event of a newborn death.

“Christiana Care’s NICU is so impressive, not only for the extraordinary medical care that the infants are receiving, but also for the tremendous support that the entire family is receiving, both from Christiana Care and from their partnership with March of Dimes,” Sen. Blevins said. “These families are so lucky to have top-notch medical care along with such caring and compassionate care of the entire family, providing lifelong benefits for these at-risk babies.”

Also accompanying Sen. Blevins on her tour were: Sherry Monson, RN, MBA, MSN, vice president of Women’s and Children’s Services at Christiana Care; Aleks Casper, the state director of the March of Dimes, Delaware Chapter; Jennifer Uro, senior community director of the March of Dimes, Delaware Chapter; and Megan McGlinchey, chair of the board of directors for the March of Dimes, Delaware Chapter.

Shirley Brogley, ACHPN, APN-BC

Congratulations to Shirley Brogley, ACHPN, APN-BC, winner of the Delaware End-of-Life Coalition (DEOLC) Annual Excellence Award for Pain and Palliative Care in the nursing category. Brogley participates in the Pain/Palliative Care Nurse Liaison Course at Christiana Care and was integral in creating the No One Dies Alone program.

“Shirley’s initiative and drive to improve the care for our patients at Christiana Care helped form the No One Dies Alone Program,” said Director of Visitor and Volunteer Services Margarita Rodriguez-Duffy. “She helped create the policies and procedures, and continues to support the program by training the vigil volunteers. Her knowledge that she so freely shares with others is very valuable. We appreciate and benefit from her expertise.”

Brogley is active within Christiana Care and the community, constantly networking to promote the causes of excellent pain management and palliative care. She is board-certified in hospice and palliative nursing care. She is a founding member of the Delaware Medical Orders for Life Sustaining Treatment Initiative and a board member and treasurer of the Delaware Pain Initiative and the national/local chapter of Hospice and Palliative Nurses Association. She has 25 years of hospice nursing experience and has worked in the pain management and palliative care specialty since 2005. She completed the Harvard “Palliative Care in Education and Practice” course.

In presenting the award, DEOLC President Terry A. Towne, MS, RN-BC, NE-BC, said Brogley “clearly represents an extraordinary nurse … hard-working, and an unbelievable networker … who knows how to get the right people engaged and get things done. Her organizational and networking skills make her the glue of the clinical team.”

Timothy Gardner, M.D.

On April 30, Christiana Care Health System’s Value Institute hosts its inaugural symposium titled “Value: Medicine’s New Frontier,” focusing on the evolving systems in the health care world and the ways in which to improve the value of patient care. The event features Dr. Robert J. Laskowski, president and CEO of Christiana Care Health System, and Dr. Timothy Gardner, interim director of the Christiana Care Value Institute and past national president of the American Heart Association, along with other leading figures from among the nation’s most respected institutions. Speakers will address enhancing health care access, reducing costs and adding value to the patient’s experience.

Christiana Care’s Value Institute demonstrates its commitment to patient care by designing and studying systems of care that are more effective, more evidence-based and more efficient, in order to deliver better outcomes at lower costs. The Value Institute is using the symposium to highlight initiatives being used to inform and educate the health care community on the challenges—and possible solutions—associated with delivering greater value to patients.

Among the featured speakers and special guests will be:

• U.S. Sen. Chris Coons, D – Delaware.
• Dr. Robert J. Laskowski, President and CEO of Christiana Care Health System.
• Dr. Timothy Gardner, Interim Director of the Christiana Care Value Institute and past national president of the American Heart Association.
• Dr. David Nash, Dean of the Jefferson School of Population Health at Thomas Jefferson University.
• Dr. Peter J. Slavin, President of Massachusetts General Hospital.
• Arkadi Kuhlmann, Founder of ING Direct USA.
• Dr.Virginia L. Hood, President of the American College of Physicians.
• Dr. Michael Lauer, Director of the Division of Cardiovascular Sciences at the National Heart, Lung and Blood Institute, National Institutes of Health.

The Learning Institute invites men to a kick-off breakfast on Tuesday, May 15, at 7:30 a.m. in the John H. Ammon Medical Education Center Main Auditorium on the Christiana Hospital Campus. After choosing a set of books, they will join other men to go to elementary schools in the community to read aloud to students.

The school visits don’t just promote literacy. They also encourage men to get involved as positive role models for children in the community, according to Rosa Colon-Kolacko, Ph.D., MBA, Christiana Care’s senior vice president of System Learning and Chief Diversity Officer. Studies indicate many children lack a male role model in their lives, she says.

Christiana Care’s First State School for chronically ill children, a collaboration with the Delaware Department of Education through the Red Clay Consolidated School District, welcomed a reader last year.

“I truly enjoyed partnering with our Christiana Care Learning Institute and the United Way to make this day happen,” said Coleen O’Connor, First State School program director.

Last year, Christiana Care employees also read to students at Thomas Edison Charter School and Kuumba Academy Charter School.

“It was great to have an opportunity to volunteer to encourage kids to read,” said Terrence Townsend, operations manager in Environmental Services at Christiana Hospital.

The 100 Men Reading Day is a program of the American Literacy Corporation (ALC), a non-profit organization that promotes reading to elementary school students. Since 2001, the ALC has promoted reading to more than 110,000 children in all 50 states.

If you would like to participate, call 302-420-1819 or e-mail bvfriendsofthechildren@yahoo.com.

Marci Drees, M.D., MS

Marci Drees, M.D., MS, hospital epidemiologist and medical director of infection prevention at Christiana Care Health System, is the first recipient of a new research award from the Society for Healthcare Epidemiology of America (SHEA).

The $20,000 inaugural grant, called the SHEA Epi Project Award, seeks to advance research in health care epidemiology through the SHEA Research Network. The network is a consortium of nearly 200 hospitals collaborating on multi-center research projects that identify gaps in the health care epidemiology science base and address them by contributing data and expertise. Christiana Care participates in the network.

“It is a great honor to be the first recipient of the SHEA Epi Project award,” said Dr. Drees. “With increasing public concern over health care-associated infections, antibiotic-resistant bacteria and the global spread of these organisms, it is vital that health care workers and the public know about effective infection control practices.”

Dr. Drees’ research focuses on defining variability of infection control practices for multi-drug resistant Gram-negative organisms. These organisms, which include Pseudomonas, Klebsiella and Acinetobacter species, are increasingly reported worldwide and can result in untreatable infections with currently available antibiotics.

These germs are not under national surveillance and resistance is more difficult to detect using standard laboratory procedures. As a result, individual facilities may have limited capability to detect antibiotic resistance and may employ a wide variety of measures to prevent or control them. Dr. Drees’ study will assess these factors among hospitals nationally and internationally to determine current practices and capabilities as well as prevalence of these pathogens.

“Dr. Drees’ proposal serves as an excellent example of the direction for future research to help further our understanding and approach to multi-drug resistant organisms,” said Jan Patterson, M.D., MS, SHEA president.

SHEA is a professional society representing more than 2,000 physicians and other health care professionals around the world with expertise in health care epidemiology and infection prevention and control. SHEA’s mission is to prevent and control health care-associated infections and advance the field of health care epidemiology.

In a project championed by Christiana Care's Environmental Stewardship Committee, perioperative and patient-care staff at Christiana Care are making dramatic reductions in the waste generated by the operating rooms. Operating rooms typically generate about 20 to 30 percent of a hospital's total waste.

The operating rooms at all hospitals produce a lot of waste. Case studies have estimated that 20-30 percent of the total waste generated by a hospital comes from the OR.

Christiana Care is producing less waste, thanks to the efforts of perioperative staff members and patient-care coordinators, championed by Debbie Dibert, RN, a member of the Christiana Care’s Environmental Stewardship Committee. Guided by the Greening the OR initiative of Practice Greenhealth, a national organization promoting efficiency through environmental sustainability, the staff are looking to reduce, reuse and recycle waste from Christiana Care’s operating rooms.

“Greening the OR provides direction on how to reduce and prevent waste, buy environmentally friendly products, and change our working space and systems to use less and recycle more,” Dibert says. Right now, Christiana Care operating rooms recycle cardboard, plastics, irrigation bottles, paper and blue wrap. This recyclable waste fills 10 40-gallon bins twice per shift, five days a week—diverting it from landfills.

Christiana Care is one of only 116 hospitals in the world that have signed on to the Greening the OR initiative.

Creating an environmentally conscious work team is key to reducing waste. Operating-room teams encourage each other to suggest ways to reduce waste, improve processes to use less and be proactive in their recycling efforts.

“Staff education is critical to success,” Dibert says.

Kathy Boyer, RN, CCRN, injury prevention coordinator, Trauma, and Brian Vincenzo, a trauma survivor, speak about the Think First program, Brian’s life-threatening injuries following a car accident and the Think First 5K Run/Walk held April 19.

Hospital staff and construction crew put their signatures on the last structural steel beam before it was lifted into place, marking an important milestone in the transformation of Christiana Care Health System's Wilmington Hospital campus.

Several news organizations were atop the Wilmington Hospital parking garage Thursday, April 12, to cover the topping out ceremony commemorating Christiana Care’s $210 million expansion. Hundreds of Christiana Care and SKANSKA employees signed the last steel structural beam before it was lifted by a crane from the parking garage to the peak of the nine-story patient tower.

The project has required about 2,000 construction workers and will create approximately 600 new hospital jobs of varying nature when completed. Wilmington Hospital has remained fully operational during the construction project, which is slated to be finished in 2014.

During the topping out ceremony, U.S. Air Force Maj. Jeff Matthew—also a Senior Project Engineer with SKANSKA—presented a flag to Robert J. Laskowski, M.D., MBA, Christiana Care’s president and CEO. On a recent tour of duty, Matthew had the flag flown on his KC-10A tanker aircraft over Afghanistan in honor of the Wilmington Hospital expansion project team. The flag was carried by the crew, who also signed a certificate of authenticity.

News coverage of Wilmington Hospital topping out ceremony

• Delaware News Journal
• Philadelphia Business Journal
• Medical Construction and Design
• CityBizRealEstate.com
• WHYY Newsworks
• BisNow

Photo gallery: Wilmington Hospital topping out

Louis Bartoshesky, M.D., MPH

Babies born at Christiana Care Health System now are being tested for potentially fatal heart defects within their first two days of life, allowing them to receive immediate care if necessary, thanks to a new pulse oximetry initiative. The simple, 15-minute screening can identify a number of critical congenital heart defects in babies who may otherwise appear healthy. These defects, while rare—affecting three to four children in every 1,000 live births—can be fatal if not diagnosed and treated immediately after birth.

“When babies are 24 to 28 hours of age, a nurse attaches a tiny electrode to one hand and one foot to measure oxygen saturation in their blood,” said Louis Bartoshesky, M.D., chairman of Christiana Care’s Department of Pediatrics. “The test can take place either at the mother’s bedside or in a treatment room and is not invasive. There are no needles, just electrodes measuring skin color at those sites. It identifies children whose blood oxygen level is lower than it should be.”

A test that shows a newborn’s oxygen to be higher in the hand than the foot, for example, can indicate a narrowing of the aorta, one of the several potential critical congenital defects. If the screening produces any type of abnormal result, the newborn’s primary care physician and an on-site pediatric hospitalist are alerted immediately, Dr. Bartoshesky said.

Research nurses at the Helen F. Graham Cancer Center are participating in an increasing number of Phase I pharmacolgy trials testing new cancer fighting drug combinations. From left, Renitia Pulliam, RN, patient Aurea Harden, Katie Alexander, RN, and Michele Johnson, RN.

Two breast cancer trials currently under way at the Helen F. Graham Cancer Center are already showing promise, says Christiana Care’s principal investigator, Michael Guarino, M.D.

”The hope is that by targeting to growth pathways, we get better results,” Guarino says. In one trial, trastuzumab, a drug known to be effective in treating certain types of cancers, is linked with another antibody called pertuzumab and the combination creates a dual blockade to delay spreading of the disease. Another trial links trastuzumab and a toxin, Maytansine, to form a compound that targets and poisons cancerous cells while sparing normal cells and reducing chemotherapy side effects.

Says Dr. Guarino: ”The concept is simple. If we can find a target in the cancer cell, we can hit that target and knock out the bad guys without hitting the good guys.”

His group is also using new drug compounds to attack non-small-cell lung cancer, which comprises some 85 percent of all lung cancer patients. Patients with widespread lung cancer who no longer respond to first-line therapy can benefit from a drug called erlotinib, which, combined with a chemical called ARQ–197, provides another way to target two different tumor cell-growth pathways.

Still another clinical trial, in partnership with the Hoosier Oncology Group, compares standard chemotherapy with or without ZD6474, a drug that inhibits cancer cell growth by preventing the growth of new blood vessels that would help the cancer to grow, as well as by targeting a growth receptor on cancer cells. Pancreatic, lymphoma and lung cancer phase I trials are also under way, according to Dr. Guarino.

Trials exploring vaccines for shingles, an extremely painful inflammation of the sensory nerves caused by the same virus as chicken pox, are in progress. Healthy people recover from shingles, sometimes with chronic pain. But in patients who are elderly and have suppressed immune systems, shingles can cover the body and become life-threatening. Chronic pain also can be much worse in these patients. The currently available live virus vaccine is not recommended for these patients for fear of giving them an active infection. Researchers are trying to determine if a vaccine using the killed shingles virus works as well.

“We believe the killed vaccine is safer, but is it effective?” Dr. Guarino asks. “Learning the answers to these important questions is revolutionizing the way we care for people with cancer.”

Sandra Weiss, M.D.

The radial approach to cardiac catheterization—entering through an artery in the patient’s wrist, rather than the femoral artery in the groin area—offers many advantages, according to Sandra A. Weiss, M.D., an interventional cardiologist at the Christiana Care Center for Heart & Vascular Health.

“A radial approach is safer, with less bleeding or risk of vascular complications,” Dr. Weiss says. Immediately after the procedure, patients can walk and move around, resulting in less need for nursing care. “The patient needs only to wear a little inflatable bracelet to cover the cath insertion site for one to three hours. People are a often pleasantly surprised that we are using this approach.”

Dr. Weiss performs catheterizations through the radial artery in 80–85 percent of her cases, while intervential procedures around the country are just the reverse, entering through the wrist in about 15 percent of the time, she says. There are reasons why the radial approach to catheterization is not an option and the femoral artery is preferred, Dr. Weiss says. Such exceptions include:

• A procedure calling for larger gauge catheter must still use groin.
• Patients who have had bypass surgery, or a heart attack.
• Many elderly patients.

More than 350 people attended Christiana Care’s 2nd annual Dance Your Heart Out event at Wilmington’s Chase Center on the Waterfront on March 8.

Dance Your Heart Out provided participants with opportunities to do just that – with Wii Dance, Zumba® fitness, belly and line dancing. The evening’s theme, “Health is Motion” highlighted the important role physical activity plays in total health.

New offerings this year included demonstrations for yoga, meditation and stress-reduction, along with a performance by Tapestry Tribal, a local belly-dancing troupe. The event offered health screenings for blood pressure, bone density and body-fat analysis.

Christiana Care Health Coach Team members were on-hand to assist individuals in finding a doctor. Additionally, participants were able to visit information tables on stroke prevention, heart health, arthritis, joint replacement, nutrition and exercise.

Photo gallery: Dance Your Health Out

Christiana Care is a sponsoring partner of Delaware Health Tracker, a free website that features 100 dashboard indicators assessing the health and well-being of Delaware.

Christiana Care is a sponsoring partner of Delaware Health Tracker, a new Web-based source of population data and information about community health and healthy communities.

The free website, www.dehealthtracker.com, is a key resource for community health professionals, policy makers, researchers and advocates to address identified health problems. Dozens of sources meeting rigorous criteria for data collection and analysis provide content to the site.

Delaware Health Tracker features 100 dashboard indicators assessing the health and well-being of Delaware by color code. Green represents “good” indicators; yellow represents “cautionary” indicators; and red represents “serious” indicators, pointing toward areas where more work needs to be done.

Additional features include: evidenced-based promising practices to promote best practice sharing; the ability to set, track and evaluate local goals and priorities; readily available comparison reports; and local, regional and national news. There is no sharing of patient data.

“This is a valuable tool, not only for hospitals and all health care providers, but for community leaders as well,” said Wayne A. Smith, president and CEO of the Delaware Healthcare Association. “Delaware Health Tracker supports decisions about where to allocate precious resources in order to maximize opportunities for improving the health and quality of life for all Delawareans. The website also encourages collaboration in order to avoid duplication of services.”

“The website is another important resource in the ongoing efforts to both inform and empower Delawareans,” said Paul Silverman, Ph.D., associate deputy Director for Health Information and Science at the Delaware Division of Public Health.

Healthy Communities Institute (HCI), a California-based health care information company and creator of the nationwide Healthy Communities Network, designed the information system for Delaware Health Tracker. Delaware is the fourth state to implement the HCI system statewide.

Other sponsors of the project are Bayhealth Medical Center, Beebe Medical Center and the United Way of Delaware. The Delaware Healthcare Association manages the website.

Gov. Markell praises the Project SEARCH program at Christiana Care, the inaugural employer in Delaware to host the nationally recognized program dedicated to training individuals with disabilities to obtain job skills necessary to secure competitive employment and possess the self-confidence to enter the workforce after graduation.

Gov. Jack Markell visited the first Project SEARCH classroom in Delaware at Christiana Care Health System on Friday, March 30.

Christiana Care is the inaugural employer in Delaware to host Project SEARCH, a nationally recognized program dedicated to training individuals with disabilities to obtain job skills necessary to secure competitive employment and possess the self-confidence to enter the workforce after graduation.

“I am overjoyed to be here. This event is the highlight of my day,” said Gov. Markell. Addressing the student interns, he said, “You are learning skills here that will benefit you for the rest of your life.”

The cornerstone of the project is total immersion in the employment environment coupled with continued classroom training and mentoring.

Nine students from the Red Clay Consolidated School district currently attend classes each day at Christiana Hospital to learn valuable workplace skills while also working as interns in several departments at the hospital.

“Our participation in the program is an example of how Christiana Care embraces innovative programs to benefit our community, transform the care we provide and add greater value by fostering learning and inclusion,” said Robert Laskowski, M.D., Christiana Care president and CEO.

“Programs like this demonstrate how we can change our culture,” said Mervin Daugherty, Ph.D., superintendent of Red Clay Consolidated School District. “Everyone here is committed to our children. When we commit to our children, we bring about change in society.”

Project SEARCH is seeking additional business sponsors in Delaware.

Current partners in Project SEARCH are Christiana Care, the Red Clay Consolidated School District, Goodwill of Delaware and Delaware County, Inc., and the State of Delaware’s Department of Education and Department of Labor, Division of Vocational Rehabilitation.

More on Gov. Markell’s visit to Project SEARCH:

• News Journal
• WDEL News Radio

Photo gallery: Gov. Markell visits Project SEARCH

William S. Weintraub, M.D., FACC, FAHA

William Weintraub, M.D., director of Christiana Care’s Center for Outcomes Research and the health system’s John H. Ammon Chair of Cardiology, was featured in several national and local publications on the results of the ASCERT study.

National media coverage:

• Wall Street Journal
• NPR Shots
• Bloomberg
• Philly.com
• Bloomberg Businessweek

Local media coverage:

• Delaware News Journal
• WDEL

Mark J. Garcia, M.D.

Mark J. Garcia, M.D., FSIR, chief of Vascular & Interventional Radiology at Christiana Care, was featured in national publications for his research findings for his work on chronic deep vein thrombosis.

National media coverage:

•  MedPage Today

Timothy Gardner, M.D., medical director of the Center for Heart & Vascular Health at Christiana Care, was featured on ABC News for his insights into Left Ventricular Assist Device implants on the heels of former Vice President Dick Cheney’s recent heart transplant operation.

• ABC News

Timothy Gardner, M.D.

The Center for Heart and Vascular Health was prominently featured Tuesday in the Health Section of the Delaware News Journal for an article on clinical studies. Christiana Care’s Helen F. Graham Cancer Center, the Department of Emergency Medicine and the Department of Obstetrics and Gynecology also were featured in the article.

• Delaware News Journal

Flanked by U.S. Sen. Tom Carper and Division of Public Health Director Dr. Karyl Rattay (seated), Dr. Michael Rosenthal unveils the "Collaborate for Healthy Weight” initiative at Westside Family Healthcare in Dover. (Photo used by permission: Katie Wilson, office of Sen. Tom Carper.)

Michael Rosenthal, M.D., chair of the Department of Family & Community Medicine at Christiana Care Health System, helped unveil the “Collaborate for Healthy Weight” initiative Friday at Westside Family Healthcare in Dover.

Rosenthal was joined by a number of key leaders in Delaware, including U.S. Sen. Tom Carper (D-Del.), Delaware Health and Social Services Secretary Rita Landgraf, Division of Public Health Director Dr. Karyl Rattay, and U.S. Dept. of Health and Human Services Regional Director Joanne Grossi.

The initiative, which was funded through the Affordable Care Act, is a national effort to reverse the obesity epidemic through innovative local partnerships between primary care doctors and nurses, public health professionals, and leaders of community-based organizations. Delaware’s partnership is one of 50 teams nationwide that will be working together to reverse the obesity epidemic in communities. In Delaware, teams will be formed to work with obesity prevention leaders from across the United States who will provide technical assistance for developing creative methods of education, quality improvement, and supportive care.

“The Delaware Healthy Weight Collaborative provides a unique opportunity to integrate primary care practice, public health, and community-based approaches to address the increasing problem of weight gain and obesity in Delaware,” Rosenthal said. “It will allow us to develop innovative plans to enable children and their families achieve and maintain a healthy weight.

Her role in organizing and managing fundraising events for the Delaware Chapter of the MS Society, and her own efforts at fundraising, earned Rose Mili (pictured with Christiana Care Chief Operating Officer and Executive Vice President Gary Ferguson) a quarterly Christiana Care Jefferson Award.

Rose Mili, senior communications manager in the External Affairs Department, is the latest recipient of the quarterly Christiana Care Jefferson Award.

The quarterly award recognizes Christiana Care employees who exemplify actions and attitudes of service, caring and leadership beyond the work they do each day for Christiana Care.

For the past 20 years Mili has produced all of the marketing and promotional materials—brochures, T-shirts, prizes, ads and posters—needed to make the Society’s annual Thanksgiving MS Walk/Run a success.

The 2011 event was the largest ever for the Delaware chapter, netting more than $115,000 and drawing nearly 3,000 participants.

Mili received the MS Communicator of the Year Award in 2007 and helped the Race/Walk’s planning committee win the Helen Serbu Volunteer of the Year Award in 2009.

“Around 1998, a good friend was diagnosed with MS,” Mili says. With a personal connection, she says, the cause began to resonate more. “You know how someone is affected, how having an unpredictable disease affects your life,” she says.

“That year, in addition to being on the planning committee I began to participate in the 5K walk and raise additional funds through my walk pledges. I have probably raised on average about $500 per year.” In addition to walking, she helps manage a plethora of tasks on the day of the event, from assisting with registration, to directing participants and working with volunteers.

That kind of fundraising success earned Mili a “Golden Sneaker” moniker from the race officials, meaning she is one of the chapter’s top fundraisers. Now, to benefit the MS Society she has added even more effort, joining the planning committee for the Women Against MS events and serving on the executive committee of the charity’s new “MSquerade” in November.

While Mili says she has no idea how many people she has affected, she says she does feel a wonderful sense of community and she gets energized by seeing several thousand people show up on race day, ready to help a good cause.

Christiana Care partners with the Jefferson Awards to encourage and honor employees who provide community service.

If you know of someone deserving of consideration, simply complete the Jefferson Award nomination form on the portal. Nominations are welcomed on a rolling basis and winners are announced quarterly.

WDEL

WHYY Newsworks

Delaware News Journal

Newark Post

Mark J. Garcia, M.D., FSIR

Findings from research led by Christiana Care Health System’s Mark J. Garcia, M.D., FSIR demonstrate that people treated for chronic deep vein thrombosis can experience a reduction in disabling symptoms and an improved quality of life. Dr. Garcia, who is the chief of vascular interventional radiology and medical director of the heart and vascular peripheral labs at Christiana Care, presented the findings today during the Society of Interventional Radiology’s 37th Annual Scientific Meeting in San Francisco.

Dr. Garcia’s abstract was one of only nine abstracts– out of 455 submitted worldwide – chosen by the Society for Interventional Radiology to highlight during its annual meeting. Dr. Garcia also co-moderated the meeting’s opening session on Saturday, which focused on the treatment of deep venous diseases. That session was attended by more than 500 interventional radiologists from around the world.

Dr. Garcia’s abstract was chosen because his findings are novel. They show that minimally-invasive interventional radiology techniques can successfully treat patients who are suffering from post-thrombotic syndrome, a constellation of chronic symptoms from pain and swelling to ulcers and gangrene that are due to deep vein thrombosis.

Dr. Garcia’s findings found that a treatment strategy that focuses on the removal of the patient’s chronic clots is superior to the traditional treatment methods. Those methods include blood thinners and elastic compression stockings to medically manage the clots.

“People suffering from post-thrombotic syndrome have been told that no treatment options are available to remove the clots and help relieve the symptoms, but that no longer is true,” said Dr. Garcia, who also serves as chair of SIR’s Venous Service Line. “Interventional radiologists now have an opportunity to help individuals afflicted with the post-thrombotic disorder who are desperately seeking an improved quality of life. We are showing there is hope for these patients”

The U.S. Centers for Disease Control and Prevention estimates that between 300,000 and 600,000 Americans develop deep vein thrombosis each year, which is the formation of a blood clot in a vein, commonly in the legs. The clot can block blood flow and cause symptoms, most commonly pain and swelling. Once someone develops deep vein thrombosis, several things can occur. Clot can potentially break off and travel through the bloodstream and get stuck in the lungs, a phenomenon called pulmonary embolism, which can cause severe damage and even death. Combined, deep vein thrombosis and pulmonary embolism kill between 100,000 and 180,000 people each year.

It has been shown that approximately half the people who experience deep vein thrombosis and receive appropriate blood thinner medication and compression stockings see their condition deteriorate to the point where they develop post-thrombotic syndrome, despite appropriate medical management. The syndrome is characterized by a constellation of symptoms including leg pain, swelling, fatigue and permanent skin changes including open sores or ulcers.

However, the findings reported by Dr. Garcia show that the post-thrombotic syndrome symptoms can significantly improve with the minimally invasive treatments, which led to an improved quality of life. His study included more than 100 patients who were suffering from post-thrombotic syndrome. Over a three-year period, his team performed the minimally invasive treatments in an attempt to relieve the blockage and restore blood flow. The findings showed that his team was able to restore flow in 97 percent of patients with 93 percent of the patients reporting significant symptomatic improvement. Only 7 percent experienced symptoms that went unchanged. None reported worsening of their symptoms.

“There is increasing evidence that early and complete removal of the blood clot is likely to give people their best chance to avoid disabling symptoms, such as pain, swelling, skin changes and ulcer formation,” Dr. Garcia said.

Very few studies to date have evaluated endovascular treatments for chronic deep vein thrombosis. Dr. Garcia said more research into this area should be performed, given the promising findings.

“This study has the potential to drastically improve the quality of life for patients who thought there was no hope for their chronic clots,” Dr. Garcia said. “As interventional radiologists, we must embrace minimally-invasive techniques that can help restore both the blood flow in people’s veins and the quality of their lives. We are trying to give them hope”

Certified Nurses Day is a national day to recognize the important achievement of nursing specialty and subspecialty certification, a milestone of personal excellence along a nurse’s professional journey.

More than 100 different specialty certifications are represented by certified nurses at Christiana Care.

Board certification of nurses plays an increasingly valuable role in assuring high standards of care for patients. Board certification also folds into one of the 14 “Forces of Magnetism,” which, according to the American Nurses Credentialing Center, calls for health care organizations to value and support the personal and professional growth and development of staff through programs that include formal education, professional certification and career development.

The professional development characteristic that nurses can achieve by becoming certified also falls under the “Structural Empowerment” component of the ANCC’s Magnet Recognition Program.

Julie Silverstein, M.D., Daniel Elliott, M.D., Neeta Milasincic, M.D., and Sean R. Tunis, M.D., founder and director of the Center for Medical Technology Policy, at the 2012 SGIM regional meeting at Christiana Care.

Choosing treatment options for early stage prostate cancer is not like selecting the best electric screwdriver on the market, said Sean R. Tunis, M.D., keynote speaker at the 2012 Mid-Atlantic SGIM (Society of General Internal Medicine) regional meeting held March 16 at the John H. Ammon Medical Education Center on the Christiana Hospital campus.

More than 200 physicians attended the event titled “Generalism on the Front Lines: Defining and Delivering High-Value Care.” SGIM’s mid-Atlantic region comprises Delaware, Maryland, New Jersey, New York, Pennsylvania, Puerto Rico and Washington, DC.

Co-chairs of the conference were Christiana Care’s Daniel J. Elliott, M.D., MSCE, co-director of Ambulatory Medicine and Clinical Outcomes Research and Neeta P. Milasincic, M.D., director of the 4th Year Clerkship in the Department of Medicine.

Dr. Tunis, founder and director of the Center for Medical Technology Policy and past chief medical officer and director of the Office of Clinical Standards and Quality for the Centers for Medicare and Medicaid Services (CMS), spoke about “Defining High-Value Health Care through Comparative Effectiveness Research.”

While there is ample comparative information to help consumers choose a screwdriver, there are serious limitations in the body of evidence to help patients decide on a course of treatment for many different diseases, he said.

Dr. Tunis said CMS recruited him to create an evidenced-based policy making system for Medicare and Medicaid programs. He collected, reviewed and analyzed scientific literature related to paying for treatments such as a PET scan for Alzheimer’s disease or a defibrillator for cardiac care. “Every systematic review of the literature handed to us had serious defects that left significant uncertainties in what we could recommend,” he said.

Dr. Tunis advocates for comparative effectiveness research, which, he said, reduces the gaps in evidence if projects engage the decision makers themselves – patients, practicing clinicians and payers – to determine the most important unanswered questions.

Comparative effectiveness research must:

• Inform clinical or health policy decision.
• Compare at least two alternatives, each with potential to be best practice.
• Achieve results at population and subgroup level.
• Measure outcomes important to patients.
• Use methods and data sources appropriate for the decision of interest.
• Be conducted in real world settings, not just under optimal conditions.

“If a research study does not actively incorporate the decision makers and other key stakeholders in defining what the questions are, it probably isn’t comparative effectiveness research,” he said.

Robert Laskowski, M.D., Christiana Care president and CEO, welcomed attendees to the conference. “This is the most exciting time of my professional career,” he said. “I’ve spent a large part of my career figuring out ways to improve the way we care for people. For the first time, I see the big picture changing. We need to think bold thoughts and work like crazy to bring those thoughts to reality,” he said.

“Three decades from now,” Dr. Laskowski continued, “we will look at this time with general internal medicine being at the forefront of how American medicine reinvented itself, and, in the process, reinvented medicine for the entire world.”

Julie Silvestein, M.D., chief of General Internal Medicine at Christiana Care, moderated a panel discussion on “The Future of General Internal Medicine.” Panelists agreed that general internists will turn to new technologies, including telemedicine, to reach patients.

“One of the beauties of general internal medicine is the ability to innovate,” said panelist Katrina Armstrong, M.D., division chief of General Internal Medicine at the University of Pennsylvania. Her message to young general internists: “Have a dream and carry it forward. Pick a problem and pursue it.” General internists will lead the change that is coming in medicine, she said.

Tabassum Salam, M.D., associate program director of the Internal Medicine Residency Program, presented her work “Using a Standardized Adaptive Clinical Encounter for Interprofessional Team Training” in a session about innovations in medical education. Deborah Ehrenthal, M.D., director of Health Services Research for Women and Children at Christiana Care, was awarded the Best Oral Presentation for her work “The Influence of Maternal Factors on Early Childhood Obesity.”

Christiana Care’s Value Institute sponsored the poster tour.

Photo gallery: 2012 SGIM regional meeting

Georgia Harb, here flanked by clinical practice coordinator Deb Dougherty, RN, and W. Samuel Carpenter III Distinguished Chair of Cardiovascular Surgery Michael Banbury, M.D., is among the first U.S. recipients of the Sapien Transcatheter Heart Valve, a new treatment option for patients with severe aortic stenosis.

Christiana Care is among a select group of hospitals in the U.S. implanting the first FDA-approved heart valve replacement that doesn’t require open heart surgery.

A cardiac team at the Center for Heart & Vascular Health treated the first four patients in February with the Sapien Transcatheter Heart Valve, a new option for patients with severe aortic stenosis for whom surgery is too risky.

“We were one of the first sites to get approval to do it,’’ said Erik Marshall, M.D., medical director of Christiana Care’s echocardiology lab, one of a group of specialists trained to perform the procedures. Others, who make up two teams, include cardiac surgeons Michael Banbury, M.D., and Hiep Nguyen, M.D., and cardiac interventionalists James Hopkins, M.D., Wasif Qureshi, M.D., and Ajith Kumar, M.D.

Only 150-250 U.S. hospitals are being approved by valve developer Edwards Lifesciences to use the device. As a top U.S. hospital for cardiac care, Christiana Care has the patient volume, medical expertise, equipment and facilities Edwards required, said Billie Speakman, executive director, Heart & Vascular Interventional Services. “We had 256 aortic valve replacements in 2010, and we’re targeting a portion of that population,’’ she said. “We’re anticipating starting out with 20 (Sapien valves) in the first year, taking up to 57 by year five.’’

The procedure offers a less traumatic, potentially life-saving alternative for patients with age-related aortic stenosis, a narrowing of the valve that allows blood to flow from the major artery of the heart. The Sapien valve has been used since 2007 in Europe and was approved in November by the Food and Drug Administration for patients who are not candidates for open heart surgery because of other health problems.

The valve is made of cow tissue and polyester on a steel-mesh frame that is compressed into a pencil-width catheter and threaded from a small incision in the leg through the femoral artery to the site of the diseased aortic valve. There, the new valve is deployed and becomes immediately functional.

While it’s not appropriate for use in all patients who can’t undergo open heart surgery, it is likely to offer a lifeline to increasing numbers of patients as the population ages and the number of people with comorbidities that preclude surgery increases, said Dr. Banbury. The procedure puts less stress on the body than open heart surgery, he said, and “people recover more quickly.’’

One who appears to be doing just that is Georgia Harb, 80, who was sitting up in bed two days after undergoing the trans-aortic valve replacement. Before coming to Christiana Care, she said, she was experiencing weakness and breathlessness, which she thought were caused by chronic lung problems. After collapsing while out on a walk near her Newark home, she was brought to Christiana and learned she needed a new aortic valve.

“But I have COPD and couldn’t have surgery,’’ she said. “It turned out I was a candidate (for the new procedure), and I’m very grateful.’’

“We’re optimistic about the potential for patients who once had few options to regain health and enjoy active years ahead,” says Dr. Banbury. “As with all innovative technologies, this one will continue to mature and develop.’’

Christiana physicians have been aware of the Sapien valve as it proceeded through clinical trials, Speakman said. “Our physician community has been paying attention, because it is a less-invasive approach than replacing the aortic valve, and we wanted to be in forefront of implementing it as soon as it was approved,’’ she said.

The procedure won’t replace open heart valve replacement surgery, but will “be used in tandem with it,’’ Dr. Banbury said. “Programs will offer both.’’

Kaitlin Johnson, RN, and Tamara Schoell, RN, model the new blue uniforms that signify Christiana Care Nursing.

Christiana Care nurses are showing off their new navy blue uniforms this month. But it’s not simply a fashion statement.

Our nurses adopted standardized uniforms this month for good reason. Research shows that clearly distinguishable uniforms give patients a better sense of security and safety. They also enhance the quality of care because patients know immediately whom to go to for help.

Scrubs drop-off

Now, even more good can come from the conversion to new uniforms. Anyone wishing to donate scrubs may drop them off the week of March 19. Christiana Care will donate the uniforms to Medical Missionaries, a nonprofit organization.

• At Christiana Hospital: 7 a.m. to 3:30 p.m. Monday, March 19 and Tuesday, March 20, at 2D (former Coronary Intensive Care Unit, or CICU).
• At Wilmington Hospital: 7 a.m. to 3:30 p.m. Wednesday, March 21 and Thursday, March 22, at Environmental Services, located at the Park Entrance (“PE” on the elevator button).

Scrubs must be in good condition and must not be embroidered with personal identifiers or logos.

Call Karen Maykut at 302-733-2633 to volunteer for the scrub collection project.

Social workers at Wilmington Hospital. The National Association of Social Workers Delaware Chapter recognized Christiana Care’s Department of Social Work as its Agency of the Year. Our Social Work staff of 43 served more than 23,000 clients in 2011.

The Delaware chapter of the National Association of Social Workers has awarded Christiana Care’s Social Work Department its highest honor: Social Work Agency of the Year for 2012.

The award recognizes a human services organization that exhibits the values, ethics and principles of the National Association of Social Work and the social work profession.

Social workers at Christiana Hospital.

“We are honored to receive this recognition,” says Linda Brittingham, corporate director of Social Work. “It rightfully belongs to our strong team of professional, service-driven, innovative social workers who support each other, their clients, Christiana Care and the community. They work hard to strengthen the overall community safety net, the network of social workers in the state and to advance the profession itself.”

Social workers at Christiana Care provide inpatient and outpatient services to a variety of clients, ranging from newborns to the elderly. The team provides services to people with needs beyond their medical condition, from those who lack insurance or are under-insured to those who have no resources, to those who have psychosocial issues or are homeless.

During 2011, the Social Work team at Christiana Care provided services to more than 23,000 patients.

The department will receive the award at the Annual Social Work Celebration and Awards Ceremony March 27 at the Duncan Center in Dover.

Mitchell Saltzberg, M.D., medical director of the Heart Failure program at Christiana Care, with a patient using Insight.

For creating a unique software program that enables patients to use a self-assessment tool to evaluate their symptoms, Christiana Care won a 2012 Laureate award from International Data Group’s Computerworld Honors Program.

Computerworld annually honors companies demonstrating visionary applications of information technology promoting positive social, economic and educational change. Christiana Care won its award in the health category, one of ten classifications that in total received more than 500 nominations.

“This award is a wonderful honor for Christiana Care and is evidence of innovative thinking and collaboration of our clinical and Information Technology staff  to improve the care we provide our patients,” says Karen Gifford, Christiana Care’s director of Information Technology.

“What the Computerworld Honors Laureates so clearly demonstrate is technology’s role in moving society forward,” says John Amato, vice president and publisher of Computerworld. “Computerworld acknowledges and applauds the outstanding work being done by individuals and organizations to successfully use technology to improve the quality of our lives and that of future generations.”

Christiana Care’s winning software program, called Insight, enables patients to use a tablet-based, clinician-friendly wireless format to report the severity of their symptoms and how they affect their quality of life. Patient feedback helped develop the program.

Cancer patients first used the tool in a pilot program in May 2010 followed by heart failure patients. Christiana Care’s Information Technology team is launching a new release this year for a wider patient audience for use with an Apple iPad.

Seventy-six percent of patients report they like using Insight, with 67 percent claiming the tool better prepares them to speak with their doctor. Doctors use the data to spark meaningful conversations with their patients.

“Insight makes it easier for the patient and the doctor to have a conversation about more sensitive issues or symptoms they might not otherwise volunteer,” says Theresa Gillis, M.D., medical director of Oncology Pain and Symptom Management and Rehabilitation Services at Christiana Care. “The patient’s ratings give ‘insight’ into their distress, their function and independence and their well-being. Patients seem more comfortable discussing feelings of anxiety and depression after using this tool.”

The 2012 Laureates receive public recognition at the Laureate Medal Ceremony and Gala Evening on June 4 in Washington D.C. At the event, Christiana Care’s winning entry is eligible for an additional honor. The judges single out one finalist in each category for special recognition.

Founded in 1988, The Computerworld Honors Program is the longest running global program that honors individuals and organizations for their use of information technology in innovative ways. Computerworld, with an online audience of more than 3.5 million unique, monthly visitors, is a leading source of technology news and information for IT influencers worldwide.

Qiu qi Li and Mei zhen Dong, owners of the Golden Palace restaurant in Newark, Del., got needed health screenings after encouragement from Xiangfen Gu (right), who on behalf of the Helen F. Graham Cancer Center is taking cancer prevention and health screening information into Delaware's Chinese community.

Qiu qi Li and his wife Mei zhen Dong knew it was important for them to take care of their health. But the couple knew little about how to access services in their local community that could save their lives.

For example, the Lis were unaware that free cancer screenings were available to them at Christiana Care’s Helen F. Graham Cancer Center. The center is one of the first National Cancer Institute Community Cancer Centers Program-awarded sites in the United States. It also is only three scant miles from Golden Palace in Newark, the Li-owned restaurant.

Like other Chinese Delawareans, language and cultural barriers hindered the Lis’ ability to access cancer services available in their community. In fact, it was not uncommon for Chinese Delawareans to travel as far as Chinatown in New York City to access the same live-saving screenings that are available only a few miles from home.

Fortunately, Xiangfen “Fen” Gu is helping the Lis and other Delawareans of Chinese descent overcome these challenges. After moving to Delaware from Nanjing, China, two years ago, Fen has been scouring New Castle County—from the streets of Wilmington to the strip malls of Middletown—for Chinese eateries. She’s visiting those restaurants not to eat, but to educate.

“Most Chinese people don’t go to the doctor until they feel bad,” Fen says. “And when they work at restaurants, they’re very busy and often have no insurance.”

So Fen goes to them. Her position was made possible by a grant from the National Cancer Institute with funding from the American Recovery and Reinvestment Act of 2009 (ARRA)—also referred to as the “stimulus” bill.

After she visited the Lis, the couple took preventive steps to undergo screenings through the Screening for Life program, a cooperative effort of the Delaware Division of Public Health, the U.S. Centers for Disease Control and Prevention and health institutions such as Christiana Care.

Mr. Li underwent a colonoscopy, which turned out to be a lifesaver, as the test caught several polyps that he subsequently had removed. On the insistence of Fen, Mrs. Li underwent a colonoscopy, a Pap smear and a mammogram. Fen even accompanied Mrs. Li during her breast cancer screening and explained the procedure to her in Chinese.

“You are doing such an important job for people that don’t speak English,” Mr. Li said through a translator. “We are very lucky to have Fen.”

One of the major priorities of NCCCP is to serve communities disproportionally affected by cancer due to historic barriers. For some minority populations, that can mean publicizing screenings in neighborhoods where people live. The effort is more of a challenge with the Chinese community, which tends to be loosely-knit in Delaware.

They tend to be spread out across the First State instead of clustered in a handful of neighborhoods, so Fen’s effort has focused on restaurants and churches, temples and other places where Chinese people gather to work or worship.

Christiana Care’s effort to bring the education and information directly to the people—no matter where they are living—reflects the health system’s commitment to reaching out to neighbors in underserved communities, says Nora C. Katurakes, manager, Community Health Outreach and Education.

For example, a Christiana Care event in November at the New Castle Chinese Evangelical Church provided to 48 women information about breast cancer screening. On one Friday each month, members of the outreach team visit the New Castle Farmer’s Market, on U.S. Rte. 13, where a considerable number of vendors are Asian. And on March 10, a health fair reached more than 65 people at the Chinese American Community Center in Hockessin, where 50 individuals were screened for cardiovascular disease and bone density.

“If you don’t have a place where people congregate,” Katurakes says, “they’re not going to get the information. And if you go to an event and are told you need to do something, you’re not going to just go run and do it. … It’s a prevention model. People need to take time to process—to say, OK, do I need to do this or not.”

Fen’s success in helping local Chinese residents has prompted Katurakes to describe her as a “godsend.”

Fen already has shared information with more than 300 people. She approaches her job, which will continue through June under ARRA funding, with a determination that has led her to pull into every strip mall she notices. (There almost always is a Chinese restaurant in strip malls, she notes.) She began preparing with online searches, using GPS to augment what she finds.

Addresses and phone numbers sometimes lead to dead ends, so the effort at times can seem like a scavenger hunt. She takes notes at each stop and jots on a takeout menu what the people there need— say—one mammogram, two pap smears and a colonoscopy. For those who are not receptive to her visits—some mistakenly think she’s trying to sell insurance—Fen follows up.

On a recent Friday afternoon, Fen’s mission brought her to the business of Su Ru Chen and her husband Chong Shu Su on Philadelphia Pike, Unique Chinese and Japanese Restaurant. It was the 88th Chinese restaurant Fen had visited.

Chen, 33, sat with her over a couple of bowls of rice and pork at one of three tables inside the small storefront. On the table were a small assortment of medical brochures and a model of a breast. Fen showed her how to perform a self-examination for breast cancer. It was Chen’s first exposure to the simple and potentially lifesaving measure.

If someone like Fen had been available for one of Chen’s grandmothers, the restaurateur said, her cancer might have been discovered during a screening, not in response to swollen legs. By then, Chen said, it was too late.

“If there were no such person as [Fen],” Chen said, through a translator, “we wouldn’t know [Christiana Care] was here.”

Today, Fen continues to trace the roads of a state with which she still is familiarizing herself. At each restaurant and church she enters, a smile accents her Mandarin greeting. By the time she leaves, the people she has met have learned what is available not three hours away in New York, but in their own adopted state.

Photo gallery: Health fair at Chinese American Community Center, Hockessin, Del.

Respiratory therapist Donna MacVicar, CRT (right) traveled to South Carolina for the annual Lt. Dan Weekend, a special event for injured veterans, where she presented a customized mountain bike to Sgt. Andrew Litz, here with his wife, Healther.

For Christiana Care respiratory therapist Donna MacVicar, it was a weekend she’ll never forget. For Sgt. Andrew Litz, it was a bridge to the life he had before suffering devastating injuries while serving in Afghanistan in 2005.

On a recent trip back to her hometown of Beaufort, S.C., MacVicar, a longtime avid cyclist, donated a high-end mountain bike to Litz during an event for severely injured veterans that was spearheaded by actor and musician Gary Sinise.

Beaufort, S.C., is the site of Lt. Dan Weekend, an annual four-day event for severely injured veterans that carries the name of Gary Sinise’s “Forest Gump” character, Lt. Dan Taylor. MacVicar had lived in Beaufort for many years and worked there as a firefighter.

“I wanted to go down for that event, and I wanted to go down for a bike ride. Instead of just going, I wanted to do something a little more from my heart,” MacVicar said.

When MacVicar approached the event organizers about donating a bike, they identified Litz, who had been a cyclist before his injury, as someone who would benefit from the donation. Working with Ryan Miller of Gretnabikes in Lancaster, Pa., who had helped MacVicar with her own bikes for many years, she assembled a Cannondale 29’ER mountain bike with tires that would work on either a normal road or a trail, and standard pedals instead of the typical cleat system. The bike shop gave MacVicar a generous 50 percent discount to purchase the bike for Litz.

As with many injured veterans, Litz, who was 25 when he was injured by an improvised explosive device, is trying to reclaim connections to the life he had before his injuries, which include traumatic brain injury and nerve damage in his neck. Cycling has become a therapeutic activity for him as he adjusts to the realities of his new life. The Lt. Dan Weekend organizers wanted to make the donation a public surprise, so they contacted Litz’s wife Heather, who helped ensure that he would be at the event.

The surprise was successful, and after the event MacVicar worked with a bike shop to disassemble, pack and ship Litz’s bike from South Carolina to his home in Texas.

“In Beaufort, this event is a really a big deal,” MacVicar said. “It’s a military town. Most of my friends there are retired military. It’s an event that’s full of fun and music, including performances by Sinise’s Lt. Dan Band.”

The event also evokes strong feelings among the gathering veterans. “I think I cried three-quarters of that day,” MacVicar said. “It was a very moving experience. I got to meet Gary Sinise, which was the icing on the cake. To see what he does for the veterans is just amazing.”

But most moving to her was getting to meet Andrew and Heather Litz. She now keeps a photo capturing that meeting on her mantel. “It was amazing, especially after I met him,” MacVicar said. “Everything he’s going through, and he’s going to be going through it for the rest of his life … . His wife said to me that’s the first time he’s smiled in years.”

At a press conference, Bank of America Endowed Medical Director of the Helen F. Graham Cancer Center Nicholas J. Petrelli, M.D., details some of the extraordinary accomplishments that Delaware has made in the fight against cancer.

The continued progress in the reduction of Delaware cancer rates was unveiled during a statewide news conference held Wednesday, March 7, at the Helen F. Graham Cancer Center on the Christiana Hospital campus.

The cancer death rate in Delaware dropped 18 percent from 1993-97 to 2003-07, according to the report “Cancer Incidence and Mortality in Delaware, 2003-2007.” Delaware’s progress outpaces the U.S. rate of a 12.1 percent drop during the same 10-year period.

The news conference included a number of high-profile speakers: State Sen. Bethany Hall-Long (D-Glasgow and a Christiana Care trustee); Department of Health and Social Services Secretary Rita Landgraf; Division of Public Health Director Karyl Rattay, M.D.; Nicholas J. Petrelli, M.D., the Bank of America-endowed medical director of the Cancer Center; and Stephen S. Grubbs, M.D., medical oncologist and managing partner of Medical Oncology Hematology Consultants at the Cancer Center and the principal investigator for Christiana Care’s Community Clinical Oncology Program.

The latest report also noted that the incidence and mortality rates for all site cancers in Delaware continued to decline. Between 1993-1997 and 2003-2007, Delaware’s all-site cancer mortality rate for males decreased 22.4 percent compared to the U.S. rate of 15.7 percent. During the same period, Delaware’s all-site cancer mortality rate for females decreased 15.2 percent, compared to the national rate of 10.9 percent.

The most impressive results have been in colorectal cancer. A group formed in 2001 to advise the governor and lawmakers on ways to reduce cancer rates, known as the Delaware Cancer Consortium, prioritized increased screening for colorectal cancer through colonoscopies and sigmoidoscopies, which has led to earlier detection to catch cancer before it spreads. This initiative subsequently has decreased both the incidence and death rate from colorectal cancer and has eliminated the racial disparity through the outreach and education efforts.

“In Delaware, we have eliminated a racial disparity in colorectal cancer,” said Dr. Grubbs, a member of the consortium. “I challenge any state to show they have eliminated a health disparity statewide.”

Dr. Petrelli also credited the work of the Cancer Center’s Community Health Outreach and Education Program navigators, a team that is dedicated to helping Delawareans learn more about what causes cancer and the risk factors involved. He also praised other local hospitals and their outreach teams.

The cancer rates can be reduced “when you have the resources and the talented people like we do who go tirelessly into the community to find people who are at risk,” said Dr. Petrelli, who also is a member of the consortium.

Grubbs said about $8.75 million annually has been saved because of the colorectal cancer screening initiative, due to fewer cancer cases, less complicated treatments because cancers are detected early and fewer relapses since they don’t progress as far before detection and treatment. Those savings do not factor in the loss of work productivity and complications related to cancer cases that were averted.

“It’s an extremely cost-effective program,” Petrelli said. “With skyrocketing costs in medical care, we have to be cognizant of that.”

Secretary Landgraf praised Christiana Care’s efforts in encouraging people to get cancer screenings through the state’s Screening for Life program, which provides the payment for cancer screening tests to qualified Delaware adults. There have been 3,924 people screened by Christiana Care through the Screening for Life program, according to the Delaware Division of Public Health.

“In this very personal fight to save lives, Delaware is making substantial progress,” Landgraf said. “Across the spectrum of care, there are many reasons for our improvements, but we surely wouldn’t have come as far as we have—as quickly as we have—without the leadership provided by so many people here today.”

The highlight of the news conference was a testimonial by breast cancer survivor Jane Burslem of North Wilmington. Burslem was diagnosed with cancer in her left breast after a routine screening. She was treated successfully at the Cancer Center.

“It was the annual mammogram that found the cancer in the first place,” Burslem said. “… But the cancer is now a small blip in my life thanks to the message of early detection.”

Photo gallery: Delaware cancer statistics unveiled

John N. Russo, D.D.S., at the induction ceremony with Edwin L. Granite, D.M.D., chairman of the Department of Oral and Maxillofacial Surgery and Hospital Dentistry.

John N. Russo, D.D.S., who has practiced dentistry in Wilmington for 48 years, was inducted into the International College of Dentists (ICD) in recognition of his services to organized dentistry.

The ICD is the oldest and largest international honorary dental organization, established in 1927 with more than 12,000 fellows. Fellowship in the college is by invitation only and is granted in recognition of an individual dentist’s “outstanding professional achievement, meritorious service and dedication to the continued progress of dentistry for the benefit of humankind.”

Dr. Russo has been involved in educating General Practice Dentistry Program residents since 1967. He currently leads Christiana Care’s General Dentistry Section. He also served as president of the American Academy of General Dentistry, an organization of general dentists dedicated to continuing education.

Dr. Russo received his dental degree from the University of Maryland and undergraduate degree from Mount St. Mary’s College, Maryland.

William S. Weintraub, M.D., FACC, FAHA

William S. Weintraub, M.D., FACC, FAHA, the John H. Ammon Chair of Cardiology at Christiana Care and president-elect of the American Heart Association Great Rivers Affiliate, was one of 70 people invited to The White House on Friday, Feb. 24, for a briefing on cardiovascular health as part of American Heart Month.

Dr. Weintraub, also the director of the Christiana Care Center for Outcomes Research, participated in a workshop on the “Million Hearts” campaign, a national initiative to prevent 1 million heart attacks and strokes over the next five years. The initiative brings together communities, health systems, nonprofits, federal agencies and private-sector partners from across the nation to fight heart disease and stroke.

Under Dr. Weintraub’s leadership, Christiana Care is developing a partnership with the Million Hearts campaign to improve cardiovascular care in Delaware.

In a year, Wilmington Hospital recycles as many as 10,000 bags of sterile blue wrap, a material used in operating rooms.

Operating rooms at Wilmington Hospital recycle enough blue wrap — a polypropylene material used to wrap surgical instruments for sterilization — to fill 24 patient rooms each year.

That’s a new finding by the Environmental Stewardship Committee, a multi-departmental team of health system employees committed to reducing and recycling waste.

Started in late 2011, the blue wrap recycling program at Wilmington Hospital diverts about 40 of the 40-gallon clear trash bags on 250 operating days each year. That’s as many as 10,000 bags kept out of the landfill and fed to recycling plants annually.

“This project was a no-brainer,” says Environmental Services Director Jason Funyak. “Blue wrap is sanitary, never soiled. It makes sense to recycle this stream of waste.”

Anthony Chambers, cook II, discards some banana peels in a special blue recycling bin in the kitchen at Wilmington Hospital cafeteria, where recycling garbage for gardening compost is now routine.

Wilmington Hospital serves more than 600 meals each day, according to Mike Wariwanchik, the hospital’s Food & Nutrition supervisor. In the process, twice weekly, Food and Nutrition staff fill eight special receptacles, each holding 96 pounds of leftover food and food byproducts: peels, rinds, coffee grounds, egg shells and table scraps,” Wariwanchik says.

What makes the receptacles special is that the contents are composted (naturally recycled) to transform them into natural fertilizers for local gardens — including several gardens at Christiana Hospital.

A vendor picks up the food scraps, mixes it with matter from other sites, and adds worms and pests to catalyze decomposition. In just a few weeks it becomes natural fertilizer for farms and gardens.

That amounts to:

• 1,536 pounds of food scraps weekly.
• A year’s worth works out to about 40 tons.
• That much food scraps will produce more than 16 tons of excellent compost.

Thanks to committed Environmental Services plus Food and Nutrition staff and environmental stewardship at Christiana Care, much less waste is going to landfills and more gardens are nourished with natural fertilizers.

Edward D. Miller, M.D.

Edward D. Miller, M.D., chief executive officer of Johns Hopkins Medicine, visited Christiana Care Feb. 15 to discuss how JHM is preparing for health care reform.

Headquartered in Baltimore, Md., Johns Hopkins Medicine is a $6.5 billion integrated global health enterprise and one of the leading health care systems in the United States.

Johns Hopkins Medicine’s preparation for health care reform includes developing a model for achieving “population health” while observing government and gauging the pace at which reform is likely to occur.

Dr. Miller described population health as a model in which a health system supplies all medical care to a population of people for a premium, per member, per month. For Johns Hopkins Medicine, the model currently includes 205,000 prioritized members, 60,000 Medicare members, 33,000 retired military members, and 52,000 JHM Employee Health Plan members.

Dr. Miller asked “What is needed to achieve population health?” His five-point answer included:

• Data.
• A network of primary care physicians (PCPs).
• Access to hospitals and outpatient facilities.
• Access to specialists.
• Home care.

With respect to the first point, data, he said Johns Hopkins Medicine has invested $600,000 to install new computerization technology to ensure that the electronic medical record for any patient at any point of care within the organization is the same.

Asked by Department of Surgery Chairman Michael Rhodes, M.D., about the current and anticipated future shortage of primary care providers, Dr. Miller said help from the health system in simplifying the delivery of care should lead more medical school graduates to choose careers in primary care.

Regarding access to hospitals, outpatient facilities and specialists, Dr. Miller referred to Johns Hopkins Medicine’s massive rebuilding and renovation projects at the East Baltimore medical campus, including research buildings and clinical and patient care facilities. He also discussed Johns Hopkins Medicine’s acquisition of several area hospitals, such as the 267-bed Howard County General Hospital in the suburban market between Baltimore and Washington, D.C.; the 328-bed Sibley Memorial Hospital, inside the District of Columbia; the 233-bed Suburban Hospital; and the 259-bed All Children’s Hospital. As a point of reference, the Johns Hopkins Home Care Group annually treats more than 100,000 adults and children in Central Maryland.

Turning to the pace at which health care reform will occur, Dr. Miller suggested a number of influential factors are involved, from debt markets and U.S. elections outcomes, to Medicare incentives for integrated care, states’ solvency, a Supreme Court mandate decision expected in June 2012, critical mass and the success or failure of health exchanges, and the state of accountable care organizations, or how well providers learn to partner with insurance companies.

One of the most important factors that will influence the pace of health care reform will be value measurement, Dr. Miller said. “Currently, all [value measurement] is based on process, not outcomes,” he said. Johns Hopkins is working on delivering outcome measurements in the near future, he said.

Regarding the impact of possible outcomes of 2012 elections and beyond, Dr. Miller opined that there are some things that Republicans and Democrats do agree on, such as the idea that integrated care drives value, and provider risk drives down cost.

Celebrating Christiana Care's recognition as a Top 125 training organization by Training magazine at Training annual event: Tamekia Thomas, Critical Care education coordinator; Robert Dressler, M.D., vice chair of the Department of Medicine, Loretta Consiglio Ward, Safety & Quality education specialist; Carys Price, director of Employee Injury Prevention/PEEPS Program; Lonie Sculley, Information Technology; Rosa Colon, Ph.D., senior vice president, System Learning, and chief diversity officer, Jerry Brannen, senior education specialist, System Learning, Michelle Collins, manager, Nursing Professional Development; Karina O’Brien, Operational Excelence; and Christine Sowinski, medical student liaison, Academic Affairs.

As a training institution, Christiana Care Health System ranks No. 60 among the Top 125 organizations by Minneapolis-based Training professional development magazine.

The magazine for training, human resources and business management professionals ranks the top 125 training organizations in the country across all industries using quantitative/qualitative criteria apportioned at 70 percent/30 percent, respectively. Christiana Care landed on the list for the first time this month.

The recognition from Training reflects Christiana Care’s commitment to learning and development and our organization’s culture of learning, says Rosa Colon, Ph.D., senior vice president, System Learning, and chief diversity officer.

“We decided traditional training functions, with their emphasis on data collection, classroom work and didactic orientation, are unlikely to help us to develop ourselves as a true ‘learning organization,’” explains Dr. Colon. “By focusing instead on helping our colleagues learn about themselves, their strengths and capabilities, and developing better ways to deliver care, training helps fulfill our mission of assisting the people we serve.”

In 2011, the systemwide Learning and Education Council, chaired by Dr. Colon, designed the Christiana Care Health System Learning Institute and launched a three-year strategic plan to integrate all common learning processes and support services into one easily accessible system.

“This virtual institute helps coordinate thousands of hours of continuing education and community, wellness and patient education offered by Christiana Care that reaches thousands of people every year,” Dr. Colon says. “It focuses on educator development, innovation, continuous professional education, diversity and inclusion, transforming leadership, employee development and patient education. We have moved from traditional employee ‘training,’ which focuses on tactics, content and individual development, to ‘learner-centered’ education, fostering innovation and leveraging technology to enable a learning environment where employees take personal responsibility for learning.”

Continuous learning, quality improvement and career development, paired with a spirit of inquiry and learning, are goals that become embedded in the daily work of all employees,” Dr. Colon says, adding: “The Institute’s offerings address key Christiana Care needs; contribute to the well-being, satisfaction and motivation of staff; and cultivate robust educational partnerships and affiliations with other organizations.”

Quantitative and qualitative criteria

Here’s a look at Training’s evaluation process, using quantitative/qualitative criteria apportioned at 70 percent/30 percent, respectively.

On the quantitative side, an outside research company scores the application on five different sections, including:

• Training program/scope (25 percent).
• Evaluation/metrics (25 percent).
• Human resources (20 percent).
• Training infrastructure and delivery (20 percent).
• Tuition reimbursement (10  percent).

On the qualitative side, Training judges look for:

• Demonstrable results.
• Progress of programs.
• Innovation.
• Success factors.
• Training strategically linked to business goals.
• Corporate commitment to training.
• Potential applicability of best practices companywide and to other organizations and industries.
• Ingenuity of outstanding initiatives (usually a fairly new program that hasn’t had a chance to demonstrate long-term results) and their potential to become best practices.

The qualitative score also depends on how well an organization demonstrates training’s part in achieving corporate strategic goals.

A group of Christiana Care employees attended Training’s annual event in Atlanta Feb. 14 to network with other organizations and to receive the award and recognition.

“Attending the Top 125 event and talking to people from other organizations helped us recognize the great work in learning that we’re doing here,” says Tamekia Thomas, Critical Care education coordinator. “There are many things we are doing that other employers aren’t, which shows how much motivation we have to develop our employees.”

Arlene Bincsik, RN

Arlene Bincsik, RN, director of the HIV Program at Christiana Care, is the recipient of the Sister Dolores Macklin Red Ribbon Guardian Angel Award from the Delaware HIV Consortium for her efforts to improve the overall health of individuals with HIV/AIDs and empower them to live richer and healthier lives.

She receives the award at the 8th Annual WOW Awards Celebration on April 20. The awards honor individuals, corporations and organizations for their excellence in community leadership, service, volunteerism and philanthropy in the field of HIV/AIDS throughout Delaware.

“I am honored to receive this award,” says Bincsik. “Sister Dolores Macklin exemplified the Guardian Angel Award through her faith, her work, her compassion, her intelligence, her fearlessness and her sense of humor. I have had the opportunity over the years to work with the most amazing people: the HIV Program team, our community partners, our friends at the Division of Public Health, the HIV Consortium staff and board members, and of course, the patients we serve.”

Bincsik has been integral to the HIV Program at Christiana Care since 1990. Since its inception, the program has been the major care provider for people with HIV/AIDS throughout the state of Delaware. It is estimated that Christiana Care’s HIV Program provides care to 65 percent of the people in Delaware who are HIV-positive and accessing medical services. In 2011, more than 1,600 individuals received medical care and services through the program.

She is a member of the Delaware HIV Consortium policy committee and current president of the board of trustees. The Delaware HIV Consortium is a statewide, non-profit organization dedicated to eliminating the spread of HIV/AIDS and to creating a seamless continuum of care for all people infected and affected in Delaware. Delaware ranks among the top eight states for the highest rate of AIDS cases, per capita.

For the third consecutive year, the Center for Heart & Vascular Health at Christiana Care Health System has received the highest designation given to hospitals—a three-star rating for quality of heart surgery—from the Society of Thoracic Surgeons (STS).

STS has established a comprehensive rating system that compares the quality of heart surgery among hospitals across the county. Medical professionals widely regard the rating as the gold standard by which to evaluate heart surgery programs.

Analyzing data from July 2010 to June 2011, the Society awarded Christiana Care its highest rating, the coveted three stars. Fewer than 15 percent of the heart programs in the nation achieved this level in the survey. Christiana Care is one of 1,007 participants in the STS database.

Christiana Care has a high-volume heart surgery program. Data from STS shows that Christiana Care performs more than twice as many heart surgery procedures than the national average.

“We are honored to receive the three-star rating from STS,” says Timothy Gardner, M.D., medical director and past national president of the American Heart Association. “Our higher surgical volumes, combined with increasingly complex and challenging conditions in patients being operated on here, account for our leadership position among heart surgery programs nationally.”

“We attribute our top national rating to the excellent work of our entire medical team,” says Michael Banbury, M.D., the W. Samuel Carpenter III Distinguished Chair of Cardiovascular Surgery at Christiana Care. “Everyone here is on the same page—focused on clinical quality and outcomes.”

The methodology for the STS comprehensive ratings system involves gathering data on 11 separate quality standards for patient care during and following coronary artery bypass graft surgery. The standards are comprehensive and broad-based and cover medical care before surgery, operative care, care following surgery and patient outcome. Together, these data form a composite score used to determine a hospital’s overall cardiothoracic clinical performance.

Founded in 1964, the STS is a not-for-profit organization representing almost 6,400 surgeons, researchers and allied health care professionals worldwide who are dedicated to ensuring the best possible outcomes for surgeries of the heart, lung, and esophagus, as well as other surgical procedures within the chest.