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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.

This month's eFocus topics include:

A Message from the Chief Clinical Officer

Opening a New Chapter in Healthcare

On February 6, 2024, we completed the transition of UM Harford Memorial Hospital to Upper Chesapeake Medical Center Aberdeen and the addition of 72 beds above the Kaufman Cancer Center (Floors 4T and 5T) at UM UCMC in Belair. What an incredible, coordinated effort led by our Chief Operating Officer, Colin Ward, supported by hundreds – perhaps even thousands – of team members, community leaders and vendors. Patients were kept safe, and by all accounts we executed a very successful transition. Now we focus on operational excellence.

Next, I want to thank one of our long-time physician leaders, Dr. Vijay Abhyankar, Assistant Vice President of Medical Affairs. He moved into this role in January 2006 but has been with UM UCH since the “Fallston” days. With over 42 years of service, he will be retiring from his administrative work, though he will continue his clinical work in our Comprehensive Care Center (we can’t let him escape that easily). He is an incredible clinician, physician leader and friend who has served UM UCH physicians, staff and community with honor and dignity. Dr. Abhyankar, you are a statesman. Thank you for all that you have done for our patients and community!

This is the first edition of eFocus since the transition. It illustrates our preparedness for future successes in safety, quality, patient experience and efficiency. 
I appreciate all of you for what you do for our patients.

Fermin Barrueto Jr., MD, MBA, FACHE 
Senior Vice President/Chief Clinical Officer
443-643-1508 | fbarrueto@umm.edu

Safety, Quality, Patient Experience Dashboard.

AOP Spotlight Summary

Discovery

Peer Review “Pearls of Wisdom”

As we all work toward better outcomes for our patients and in the spirit of process improvement, the UM UCH Quality Management Department highlights the following findings from case reviews.

  • To avoid injuries, electrosurgical units (BOVIE) should always be kept in their holders when not in use.
  • A wound/ostomy nurse should be consulted as soon as possible to guarantee that new ostomy patients receive the appropriate education before discharge. Please note, the wound/ostomy consult is available on colorectal surgery admission post-procedure order set.
  • When inserting drains and catheters, ensure that appropriate routine care instructions, including flushing guidelines, are ordered.
  • For physical exam documentation, limit copying and pasting and record what you find.
  • Ensuring that the appropriate medications and follow-up appointments are noted on the After-Visit Summary (AVS) is important for discharge planning.

Dr. Leo's "In the Literature" 

The latest round up of various medical studies and articles. 

  1. DDX can be improved and become more accurate with aid from LLM (Large Language Modes).
  2. Higher all-cause mortality was observed in older adults who received daily aspirin and was attributed primarily to cancer-related death.
  3. In Chinese older adults with normal blood pressure, replacing usual salt with a salt substitute can decrease incidence of hypertension from 24 to 11 per 100-person years without increasing incidence of hypotension.
  4. In pts with sepsis, COPD increases 28-day mortality from 16 to 28%.
  5. Cefepime–taniborbactam was superior to meropenem for the treatment of complicated UTI in reaching microbiologic and clinical treatment success (70% vs 58%).
  6. Fluoroquinolones and Bactrim had similar effectiveness in treating E.coli and Klebsiella uncomplicated bacteremia from urinary source.
  7. When treating MSSA bacteremia, there were no differences in outcomes of readmission with the same infection and 90-day all-cause readmission in patients treated with ceftriaxone compared to oxacillin/nafcillin or cefazolin.

Compassion

How to Provide Effective Wayfinding

Wayfinding refers to all the ways in which people orient themselves in physical space and navigate from place to place. With our new facilities opening, assisting others with how to get to certain areas is especially important and part of showing others compassion.

Wayfinding Steps

  1. Provide a warm welcome. Introduce yourself and welcome patients and visitors to the health care setting.
  2. Ask, "Can I help you?" Offer to walk with them to their next destination.
  3. Point to resources to guide the way. Utilize signage/maps. Check with team members at the front desk, if you are not familiar with the destination.
  4. Thank them for coming and ask if they need further assistance.

Results of Wayfinding

  • Improves the patient experience for everyone including team members
  • Decreases anxiety associated with hospital visits and medical appointments
  • Builds confidence in the health care setting
  • Reflects our mission, vision, and values

Excellence

Grand Rounds

UM UCH is reinvigorating Grand Rounds as a meaningful opportunity to build connections across our provider teams, bring updated information from the leaders of clinical services areas and highlight the path toward best practices. The sessions will be conducted on the first Wednesday of each month with leader of various specialties presenting their “top 10” things to know. Lunch will be provided for those attending in-person. Our success depends on the participation of our clinicians and we hope you will prioritize joining in this endeavor.  Look for more detailed invites and schedule of discussion leaders coming soon.

Epic Portfolio Personalization 

Configure Portfolio Epic to work for you by exploring our virtual sessions or setting up individualized sessions with an UMMS Portfolio Epic trainer.

Harford Memorial Hospital Commemorations

Integrity

Winner of award

History of the Award

Mason Nance was an exceptional second grader who was named “Student of the Month” three years in a row for the qualities of building relationships, responsibility and compassion.  At age 7, Mason had urological surgery at UM Upper Chesapeake Health in December 2008. Post-operative course was complicated by a bladder injury/leak diagnosed on January 14, 2009. Over the following three weeks there were multiple missed opportunities which led to Mason returning to the ER with seizures, unconsciousness and CPR. Mason did not survive.  

In 2022, UM UCH launched the Mason Nance Safety award to recognize team members who go above and beyond in preventing harm to our patients. Mason’s memory reminds us to do better, and to be better.

2024 Mason Nance Safety Award Winner

Congratulations to Lori Lagan, PACU clinical nurse, on receiving the Mason Nance Award, given to team members who go the extra mile to prevent a life-threatening incident. Lori received a 90-year-old patient for gallbladder surgery and was informed the patient was on Tylenol for leg cramps. Once in pre-op, Lori knew something more serious than leg cramps was going on and found that the patient did not have a lower extremity pulse. Vascular surgery was immediately notified and within two hours the patient was in the angio lab having a thrombectomy, which saved that extremity.

Diversity

One important initiative being addressed through the UMMS EDI committee is to address equity in patient care relating to pediatric asthma.  An indicator for this effort to reduce the pediatric asthma ED visits for minorities, particularly Non-Hispanic Blacks. The work of the Pediatric Asthma Committee includes raising awareness about health equity, the social determinants of health and the importance of addressing barriers to care.

Pediatric Asthma Information