eFocus - July 2016
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, July 2016 topics include:
- Welcome Message
- Quality Update
- Safety Update
- MEC and P&T Updates
- Patient Experience
- Infection Prevention
- Upcoming Meetings and Events
As I move on to my new role as Chief Medical Officer for UM UCH, I am looking forward to interacting with all service lines and promoting physician and APC engagement while striving to implement strategies that promote healing and improve the health of the communities we serve. I want to acknowledge what an honor and privilege it was to serve the Department of Emergency Medicine as Chairman over the last eight years. Thank you to Dr. Kevin Lynch, my predecessor, for his tremendous support through this transition. I would also like to express my excitement to join Lyle Sheldon and the UM UCH leadership team.
eFocus will work towards shortened, defined, summary content published on a monthly basis. The goal of the publication is to provide you with a snapshot of activity that is happening in and around the hospital. If you have any suggestions or comments on how to improve this newsletter, please send them my way, excluding Pokémon maps.
*I'd also like to show my appreciation for your readership of this newsletter. The first five individuals who reply to me via email at email@example.com with the word 'coffee' will receive a $20 Starbucks gift card.*
Fermin Barrueto, Jr., M.D., M.B.A.
Senior Vice President/CMO
Medical Staff Affairs
Introduction to Heather Beauchamp
It is my pleasure to join the Medical Staff leadership team under the direction of Dr. Barrueto. Over the last 10 years with UM UCH I have had the opportunity to work in multiple nursing departments and manage 2 West, Oncology. Most recently, I worked for the UMMS Corporate Quality department. I am looking forward to utilizing my clinical and project management knowledge to facilitate improvements in provider workflow and patient experience.
Heather Beauchamp, MSN, RN
Director, Medical Staff Strategic Support
- Will MACRA make physicians even more accountable for cost and quality? Several provisions in the recently released proposed rule appear to push physicians into a new world of financial accountability for quality and cost for the patients they care for.
- Sentinel Events - In 2015, the Joint Commission reviewed 936 sentinel events that occurred in hospitals, ambulatory care settings and other care locations, up dramatically from the 764 events it reviewed in 2014: http://www.beckershospitalreview.com/quality/top-10-sentinel-events-in-2015.html
A just and safe culture includes improving processes identified by team members on the frontline. You can identify any patient safety concerns or opportunities for improvement through our Event Tracking System (ETS) in Meditech or hotline (x1133). Most events reported are “Near Miss” or “Good Catch” events. Good Catches are patient safety events that did not reach the patient. UM UCH awards the Josie King Foundation Hero Award pin to team members who report good catches. These serve as a mechanism to proactively improve processes to prevent harm to patients. Here are a few of our most recent good catches recognized at the quarterly Culture of Excellence Award ceremony:
- Jeff Gorschboth, Pharmacist, UM UCMC- Prevented a patient from receiving 4 times the dose of Morphine when ML was transposed to MG on the Pharmacy prescription at discharge.
- Shelby (Michelle) Baratko, Pharmacy Technician, UM UCMC- Prevented a patient from receiving 2 times the dose of Synthroid by requesting a secondary review of home medications by the Pharmacist because she remembered the patient being on a lower dose of the medication.
- Karen Tennesen, RN, UM HMH 4T- Prevented a newly admitted patient from receiving a wrong insulin dose and medications they were no longer taking due to a medication list that was not completed properly.
FDA Warning: Quinolones
Due to risk of disabling and other potentially permanent adverse events, the FDA is initiating stronger warning labels for quinolones informing risk generally outweighs benefit in specified conditions that could be treated by other means. As a result, the UM UCH order sets have been revised to reflect these changes: Observation Cellulitis, COPD, and Observation COPD.
FDA Drug Safety Communication: Metformin
The FDA has revised warnings regarding the use of metformin in certain patients with reduced kidney function.
- Use of eGFR instead of serum creatinine as measure of kidney function as it takes into account patient’s age, gender, race, and weight.
- Do not start patient on metformin if eGFR is 30-45 L/min/1.73m2.
- In patients taking metformin, assess risk/benefit if eGFR falls below 45. Discontinue if eGFR falls below 30.
- Pharmacy and Radiology are updating UM UCH Renal Dosing Guidelines to correspond.
- Erythromycin Injection: limited supply. Very low usage; will address with prescriber (case-by-case). ID physicians informed.
- Colace Liquid: Due to contamination, Colace Liquid has been removed from Diebold and shelves until further notice. Suggested alternatives are senna liquid, miralax, or dulcolax.
The top three performing units for Quarter 3 2016 are:
- 3 E TELE
Help Prevent Healthcare-Associated Infections
Upcoming Meetings and Events
Mark your calendars for important standing meetings and special events.
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 Conference:
12 Noon, Every Monday
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., Second Wednesday of each month
UM UCMC Maryland Room
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