eFocus - November 2017
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, November 2017 topics include:
- Welcome Message
- Safety Updates
- Quality Update
- Empathy Update
- Efficiency Update
- CPOE Corner
- MEC and P&T Summaries
- Upcoming Meetings and Events
The mad dash for the perfect holiday gifts has started and Black Friday and Cyber Monday have come and gone. Last weekend I wrestled with Christmas lights and learned that you cannot put nine strings of lights in a series - oops! I should have paid more attention during my physics class. The end of the calendar year also marks the closure to the first half of the fiscal year. I am proud to say that we have made remarkable strides specific to our four pillars of care. Safety: We are tracking an excellent Hospital Acquired Infection composite score of 13 so far. This time last year, we had 26. Quality: We are also #1 in UMMS for readmission rates, which stands at 9.87%. Efficiency: Our LOS at UM UCH is 2.82 days and statewide LOS is 5.40! Patient Experience: We have seen great progress with regard to the Physician Callback program and the domain “Communication with Nurses” which is meeting the goal at UCMC at 81.6 (Goal is 80.0 Top Box Score).
Incredible teamwork and success stories, but we have no time for complacency. We are facing a national IVF shortage. University of Maryland Medical Center has run out of the 50mL normal saline bags, which is affecting the way they mix their medications. Take a look at this map of Puerto Rico and you can see the number of pharmaceutical manufacturing plants that exist on the island. We also have more work to do concerning the patient experience, since many domains did not hit target. And don't forget influenza season and the challenges of an increasing acuity coming into the hospital. There is plenty to keep all of us sharp.
This month’s eFocus will show you the Patient Experience scorecard, delineate the latest drug shortage (Dilaudid becoming critical), and give an introduction to a new nursing initiative called the “Pathway to Excellence”. We're also looking for feedback on eFocus so we can make it as beneficial to our readers as possible. In the coming month you'll receive a survey and we urge you to participate. In the meantime, though, if you have any suggestions we'd like to hear them! The first 10 people to send a suggestion or idea to firstname.lastname@example.org will receive a Starbucks gift card.
Fermin Barrueto, Jr., M.D., M.B.A.
Senior Vice President/CMO
Medical Staff Affairs
Pain Management and Opioid Prescribing: Training
The treatment of chronic pain has been through several changes over the past half century. In the 1980s, an increased emphasis on recognizing and treating pain led to a vast increase in the use of opioids. We are now aware of the consequences of this and prolonged use can lead to loss of function, increase in effective disorders, increased health care utilization and decreased quality of life. Appropriate and prudent opioid prescribing is of utmost importance and there now exist several guidelines. In addition, weaning opioids and changing behavior in those patients with chronic, noncancer pain can result in improved quality of life and restored function.
Join Dr. Greg Hobelmann, staff psychiatrist at Ashley Addiction Treatment, as he discusses this very important topic. This is a free event and open to all providers. More details and registration information can be found on the event flyer.
Celebrating our Advanced Practice Providers
This week we recognize our advanced practice providers at UM UCH; thank you for all you do!
Healthcare Acquired Infections: The Latest
Fortunately we are not out of the 50mL or 100mL normal saline bags here at UM UCH. However, in approximately 1 to 2 weeks we will begin making many products in syringes instead of bags. We are in the process of preparing syringe pumps for use and providing education to nursing. The 50mL bags will become 50mL syringes and the products that cannot be placed in 50mL we will leave in the 100mL bags for now. Fortunately most of our bigger movers can go in 50mL (Rocephin, Zosyn, etc). We will use the 50mL normal saline vials that we procured in pharmacy to make the 50mL syringes for now in order to save the 50mL bags and larger volume bags.
In regard to opiates we continue to have challenges obtaining injectable morphine and hydromorphone. Everything is on allocation. The only hydromorphone we can get right now is 0.5mg/0.5mL. Morphine is hit or miss. We are buying whatever is available, 2mg/mL, 4mg/mL, 5mg/mL, 10mg/mL and trying to deploy in a strategic manner to prevent confusion as much as possible. At HMH we are sending a Doc Halo to the hospitalists each day for any patients who have been on IV morphine or hydromorphone over 48 hours and suggesting PO. The supply of Duramorph for anesthesia and OB is adequate at this point.
Burnout Among Health Care Professionals
The US health care system is rapidly changing in an effort to deliver better care, improve health, and lower costs all while providing care for an aging population with high rates of chronic diseases and co-morbidities. Unfortunately, as a result of these changes and resulting added pressures, many health care professionals are burned out, a syndrome characterized by a high degree of emotional exhaustion and high depersonalization and a low sense of personal accomplishment from work. Read more.
Pathway to Excellence
The registered nursing team at UM UCH has embarked on its journey toward the American Nurses Credentialing Center (ANCC) Pathway to Excellence designation. This designation recognizes an organization’s commitment to creating a positive practice environment for delivering quality nursing services. In Pathway organizations, nurses flourish because they experience job satisfaction, professional growth, respect, and appreciation. Pathway to Excellence standards provide a framework for quality nursing practice, collaboration, career development, and accountable leadership to empower nurses.
For the next eight months, nurses will go on a virtual road trip through Maryland while learning a little about each Pathway Standard along the way. See your department manager to obtain your Pathway Passport. The best part of this journey is that our nurses get to tell their stories—whether they be about practice standards, professional advancement, or work-life balance—they all demonstrate our culture of nursing excellence.
Length of Stay (LOS) at UM UCH is 2.82 days; statewide LOS is 5.40!
This month's topics in the Provider Documentation Refresher and Updates include:
- carbohydrate diet changes
- non-formulary home medications
- common AM lab order set
- pneumococcal vaccine order set
- secretary/RN ONLY order sets
- medication shortage and electronic prescription transmission
- urinary catheter order changes
The following items were approved during the MEC meeting held on November 8th.
Upcoming Meetings and Events
Mark your calendars for important standing meetings and special events.
- UM UCH Holiday Meals
Join us at either of our hospitals for the annual Holiday Meal—with all the trimmings! This free meal is available to all Team Members/Volunteers/Physicians working on campus that day (make sure you have your ID badge) and campus tenants with a valid ticket.
UM UCMC, Garden Café
Friday, Dec. 8
- Breakfast: 5 – 6 a.m.
- Lunch: 11 a.m. – 2 p.m.
- Dinner: 5 – 7 p.m.
UM HMH, Café 501
Thursday, Dec. 14
- Breakfast: 5 – 6 a.m.
- Lunch: 11 a.m. – 2 p.m.
- Dinner: 5 – 7 p.m.
- Pain Management and Opioid Prescribing
Tuesday, Jan. 9, 2018
UCMC, Chesapeake Conference Room
- 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