Welcome to eFocus.  Our goal is to provide you with timely, informative and useful short summaries and links about UM UCH related news, issues, or events.  Feel free to contact us if you have news to share, story ideas or any other feedback. As always, your comments are welcome.

eFocus, April 2018 topics include:  


Welcome

Happy Mother’s Day to all of the moms of UM UCH! As the sun begins to shine and lifts the fog of seasonal affective disorder, we start to see the pent-up demand for outdoor activities and steamed crabs. We have much to celebrate this month with UM UCH winning the top award at the Maryland Patient Safety Center Conference – the Minogue Award for Patient Safety Innovation. S.T.A.R.T. with the patient: A safe transition and risk assessment tool, was submitted by Leslie Clark, RN and Lori Wilson, RN. We also had two Circle of Honor awardees. What an incredible testament to the team we have here at UM UCH.

With these accomplishments, we must also remain diligent as it relates to our own well-being. Burnout and engagement are the two opposing forces that exist within our teams. Physician and APP well-being can be nebulous, but we often suspect when a fellow provider is suffering from burnout. Signs include an increase in disruptive behavior and changes in performance. If you have identified someone who may need assistance, please reach out to the chair of your department or myself. We are here to help.

We have a full eFocus this month and we continue to see great strength in our pay for performance metrics. We are tracking an average readmission rate between both hospitals of 10.15 with UM UCMC having one of the best/lowest readmission rates in the UMMS system. Take a look at our Hospital Acquired Infection composite score; what an incredible performance so far tracking at 22! It is not over until we get through the fiscal year so keep up with all of those best practices. There will be a day that the composite score is ZERO! Enjoy this month’s eFocus and the sun!

Fermin Barrueto, Jr., M.D., M.B.A.
Senior Vice President/CMO
Medical Staff Affairs 


Announcements

Undifferentiated Coagulopathy After Synthetic Cannabinoid Use

For our situational awareness, the Harford County Health Department is sharing this public health alert from the Maryland Department of Health/Maryland Poison Center about a recent Maryland case in which a user of a likely adulterated synthetic cannabinoid experienced significant bleeding and was hospitalized on 4/3/18. Although probably not opioid related, the issue of bleeding dangers associated with synthetic cannabinoids, also known as spice, K2, or fake weed, represents a serious public health threat. Persons suspected of this condition should immediately seek medical care at a hospital and the Maryland Poison Center contacted at 1-800-222-1222.

2018 Maryland Legislative Session Wrap-up Materials

From the MHA Member Alert: The hospital field’s advocacy work yielded significant accomplishments during the 2018 General Assembly session. For the first time, the legislature increased the governor’s proposed reduction to the sick tax, opting for a $30 million reduction for fiscal year 2019 instead of the proposed $25 million, and committing to $40 million for the following fiscal year. We avoided a new hospital assessment that had been proposed to help fund a reinsurance effort, and we made significant progress on behavioral health, as a state crisis grant program was established and the legislature committed to fully fund Institutions for Mental Diseases and increase pay for behavioral health workers by $38 million. We defeated bills that would have worsened Maryland’s liability climate and compromised our strong self-referral laws, and we blocked several bills that would have raised health care costs and jeopardized our success under the All-Payer Model.

Hospital Week and Parking Changes

National Hospital Week is fast approaching and celebrations will take place primarily throughout the week of Monday, May 7 to Friday, May 11.  Please join us for special Good Vibrations beach-themed events and activities including: a beach BBQ with a live Beach Boys cover band at lunchtime, free ice cream, Lyle’s open meetings, chair massages, raffle entries and drawings, and much more. The schedules for the celebrations can be found in an upcoming special edition of Connections as well as on the Intranet. During the week, you can also expect some changes in parking:

  • UM UCMC Physician Parking (lot E) will be impacted. Approx. one half of the lot will be closed for the event being held on Thursday, May 10.  Physicians who do not find parking in Lot E may park in the Pavilion II garage or in the designated reserved spaces in Lot G and Lot L (see attached map). UM HMH physician parking will not be affected (see map).
  • Team member parking will not be changed for either hospital; however please anticipate the parking lots to be at capacity.  Please allow patience and some extra time for parking from 11:00am - 2:00 pm.  Call Security at X2444 (UCMC) and X5324 (HMH) for parking questions and further directions the day of the events.
  • Towne Park Inc. will assist at UM UCMC with monitoring the reserved spaces for physician parking from 8:00am - 4:00 pm on Thursday, May 10.

Safety Updates

Healthcare Acquired Infections: The Latest

UTI vs. Cystitis or Asymptomatic Bacteriuria

New documentation changes for UTI will align with the diagnostic criteria set forth by Infection Prevention in the diagnosis of cystitis vs. an undetermined urinary tract site.  The diagnosis criteria for cystitis vs. UTI impacts our reportable Hospital Acquired Conditions (HAC) for those cases that are not present on admission. 

Twenty-six cases of UTI and Cystitis were investigated from Jan –September 2017. All of these cases were diagnosed and documented as either UTI or Cystitis NOT present on admission. 

Of those 26:

  • 13 were ruled OUT because they did not have a urine culture > 100K and WBC > 100 according to Infection Prevention criteria (IP)
  • 13 had qualifying culture and WBC results, but only 3 had the other required elements to meet the UTI definition, per IP.
  • So, only 3 out of 26 should have been diagnosed as true UTI’s/cystitis. That means that 23 (88.4%) were incorrectly reported as urinary tract infections that occurred under our care.  Please review the diagnosis criteria for urinary tract infection cystitis along with provider progress note examples.

Urinary Tract Infection/Cystitis Tip Card

*WBC 10-100 use clinical judgment for diagnosis and treatment decision*

Provider Progress Note Example for UTI

Provider Progress Note Example for Cystitis

UM UCMC Receives Top Honors from Maryland Patient Safety Center

UM UCMC received the 2018 Minogue Award for Patient Safety Innovation at the 14th Annual Maryland Patient Safety Conference on April 13 in Baltimore. In addition, UM UCMC also received two Circle of Honor for Patient Safety Innovation Awards on April 12.

Presented each year by the Maryland Patient Safety Center as one of its two top honors, the 2018 Minogue Award recognizes the UM UCMC program, “S.T.A.R.T. with the Patient: A Safe Transition Assessment and Risk Tool.”

UM UCMC was also presented with two Circle of Honor Awards. They are for the programs "An orthopedics approach to population health management--development of a geriatric hip fracture program" and "Stop snoring with a bang! Reducing postoperative complications by screening patients for obstructive sleep apnea (OSA) risk factors."

"Patient safety is priority one for us at University of Maryland Upper Chesapeake Health," said Lyle E. Sheldon, FACHE, president and CEO. "Recognition of the work we do by the Maryland Patient Safety Center is a great honor. I am very proud of our team members for their outstanding work in developing the S.T.A.R.T. program in addition to their innovations in the areas of orthopedics and sleep apnea."

The S.T.A.R.T. status board assesses patients for readmission risks from the time of admission through discharge. The program alerts the clinical teams to obtain appropriate resources and interventions to improve outcomes and experiences of care transitions for their patients.

Through S.T.A.R.T., team members focus on communication, education and collaboration to reduce hospital readmissions to improve effectiveness and safety in the patient experience. For example, team members follow up with patients who have been discharged to discuss their medications--from getting them filled to taking them to discussing any side effects that may occur. They also discuss follow-up appointments and refer patients to case management colleagues when necessary.

Since the start of the program in 2016, the UM UCMC readmission rate has decreased nearly 2 percent. Statewide statistics during the same time show a little more than a 1 percent decline in readmissions.

"The creation of the START status board was a collaborative effort across clinical disciplines and in partnership with our Information Technology and Business Intelligence teams," said Lori J. Wilson, assistant vice president, patient services, University of Maryland Upper Chesapeake Health. "Everyone on the team was inspired and committed to creating this innovative tool that will benefit the safety of our patients throughout their transitions of care. We are extremely honored to receive the 2018 Minogue Award for  S.T.A.R.T. with the Patient."

 

The Minogue Award winner was selected by a panel of independent judges who are leaders in the Maryland health care community. Read summaries of all three awards and recognitions HERE.


Empathy Update

Supporting Second Victims

When a patient suffers an adverse event, many people are affected - the patient, his or her family, and the health care providers. The provider most directly involved in the event becomes the "second victim." While the patient's and family's needs become the priority for the health care organization, the provider may be emotionally traumatized by the event, and have lasting effects that persist for months or years afterward. If not treated, a second victim experience can harm the emotional and physical health of the individual and subsequently compromise patient safety. READ MORE.

*TRUE or FALSE? It is estimated that nearly half of health care providers could experience the impact as a second victim at least once in their career. Send your answer to fbarrueto@uchs.org and you'll be entered into a drawing to win a gift card to Bonefish Grill!


Efficiency Update

The UM UCH Laboratory is proud to announce its new online test directory (testmenu.com/umuch). Here, you will see an explanation of all tests that are performed in-house as well as those frequently ordered from our reference lab, ARUP. Within the directory, users are also provided with test-specific instructions regarding collection, handling and transport of specimens, turnaround times, and more.

Please be sure to save this new website as a ‘favorite’ on your computer, tablet or mobile device in order to access it anywhere. In addition to accessing the site directly, users can get to the site via a link on the Meditech globe reports, or the Laboratory Services site on SharePoint, or the Nursing and Physician portals.

We encourage you to visit our test directory for updates as we continue to develop and enhance the web page. If you have any questions or comments, please contact Katherine Danish at x1435.


Quality Update

Board of Physicians License Renewal Updates: New laws and regulations have gone into effect that have changed the requirements for all physicians applying to renew their license this year: 

  • Licensees must submit their fingerprints for a Criminal History Records Check (CHRC) before renewing their license.
  • The Board has discontinued accepting checks and money orders for payment of license renewal fees.  The renewal is payable online by Visa or MasterCard credit cards only.  American Express is no longer accepted.  Medical license renewal fee is $512.00
  • Effective January 2017, the CME regulations were amended to allow licensees until the license expiration date to earn CME credits instead of prior to the submission date of the renewal application. 

UM UCH will be hosting on-site fingerprinting for CHRC.  Dates and information will be coming. 


Clinical Informatics Update

This month's topics from your Provider Documentation team include:

Please contact the Clinical Informatics line at x2763 with questions.


MEC and P&T Summaries

The following items were approved during the MEC meeting held on April 11th. 

 


 

Upcoming Meetings and Events

Mark your calendars for important standing meetings and special events. 

Special Events

  • 5th Annual Amanda Hichkad CCA Celebration Walk
    Saturday, May 12, 7:30 a.m.
    The John Carroll School
    This walk brings our community together to honor, celebrate, and remember all loved ones, friends, and neighbors in the fight against cancer. Named after a beloved Bel Air resident, wife, and mother of three, Amanda Hichkad, this annual community fundraising event supports the services and programs of Cancer LifeNet at UM UCH's Kaufman Cancer Center. Register by calling The Foundation at x3460.
  • Provider Social Networking Event
    Wednesday, May 23, 5 - 7:30 p.m.
    Humagalas, Bel Air
    Come network with colleagues and meet new providers!
  • Someone You Love: The HPV Epidemic
    Join us for a special showing of the movie that tells the story of five women whose lives were impacted and forever changed by the Human Papillomavirus (HPV). This movie is FREE but registration is required by calling 800-515-0044.
    Wednesday, May 9, 7 p.m.
    Horizon Cinemas, Fallston

Standing Meetings

  • Pediatric Grand Rounds: Held the first Wednesday of every quarter (Jan., Apr., July, Oct.) from 7 - 8 p.m. Guest lecturers present different topics in pediatric medicine, including common dermatologic conditions, effects and management of obesity in children, pediatric head injuries, and more.  
  • Multidisciplinary Thoracic and General Conferences: 12 Noon, Alternates Every Thursday (e.g., Thoracic is 11/3, General is 11/10)
    UM UCMC, KCC Streett Conference Room
  • Multidisciplinary Breast Conference: 8 a.m., Every Tuesday
    Radiology/Oncology Conference Room
  • Pharmacy &Therapeutics (P & T) Committee: 7:30 a.m., Third Wednesday of each month
    UM UCMC Maryland Room 
  • Credentials Committee 7:30 - 9 a.m., Third Friday of each month
    UM UCMC, MSCR 
  • Medical Staff Leadership  8 - 9 a.m., Fourth Thursday of each month
    UM UCMC, Fallston Room/UM HMH, MSCR
  • Metabolic Bariatric Surgery Committee: 5 p.m., Quarterly, Wednesdays
    HMH MSCR and UCMC Fallston Rm
    Upcoming dates: March 15, June 21, Sept 20, Dec 20

  • Allied Health Practitioner Committee:8 – 9 a.m., Third Tuesday of each month
    UM UCMC, MSCR