July 1, 2009
We are pleased to announce that United Radiation Oncology is now Saint Joseph Radiation Oncology. Effective today, United Radiation Oncology is part of Saint Joseph Health System. United Radiation Oncology opened their first office in 2001 and has remained a trusted resource for radiation treatment to cancer patients in Kentucky. That same philosophy will continue as Saint Joseph Radiation Oncology.
The same physicians and staff will also continue providing state-of-the-art treatments at the two locations in Lexington, 701 Bob O Link Dr. (Saint Joseph Office Park) and 3470 Blazer Parkway (behind Saint Joseph East).
Drs. Oscar Mendiondo, Jacqueline Matar and Richard Matter, who have 70 years of combined experience, will remain as the radiation oncology physician team. If you have any questions regarding the transition, you can call the staff at Saint Joseph Radiation Oncology at 859.277.3737.
Please join us in welcoming the United Radiation Oncology team to the Saint Joseph family.
June 17, 2009
PACS Upgrade Coming June 29! The Saint Joseph Health System PACS will be undergoing an upgrade. The upgrade will begin 11:59 p.m. on Friday, June 26 and end approximately noon Sunday, June 28.
A few of the highlights of the new version are:
- Greater functionality and customizability for all PACS users - more tools, more flexibility
- The web product DX View will be replaced by HRS-D and more closely resemble the dedicated PACS system
- HRS-D is functional with Windows Vista and Internet explorer 7
- Database is on a more stable platform - increasing stability, decreasing downtime
The upgrade timeline is as follows:
- HARD downtime: 11:59 p.m. Friday, June 26 to 2:00 a.m. Saturday, June 27 - No PACS images available (hard copy images only); Radiologists will read stats via Centricity.
- 2:01 a.m. Saturday, June 27 through noon Sunday, June 28 - Limited availability of PACS (ED and RADS only)
- PACS upgrade complete at approximately noon on Sunday, June 28
Below are the links to reach the new PACS AFTER JUNE 28, 2009:
Need training, have questions or concerns? Call Tracey Eades, PACS Administrator, at 859.321.3339 or Lisa Davis, Radiology Support Services Coordinator, at 859.313.4465.
eMed is a communication tool created by the Communications/Marketing/Public Relations department of Saint Joseph Health System to keep physicians informed on news about Saint Joseph Hospital, Saint Joseph East and Saint Joseph - Jessamine. Please respond to this e-mail if you have any questions or contact Cynthia Salamanca at 859.313.1096.
June 3, 2009
News bulletin for the medical staffs of Saint Joseph Hospital, Saint Joseph East and Saint Joseph - Jessamine Ambulatory Care Center
eMed Returns with Stronger Focus
eMed is returning to physicians' inboxes with a stronger purpose: to deliver short, timely, physician-specific news and updates to the medical staffs of Saint Joseph Hospital, Saint Joseph East and Saint Joseph - Jessamine. eMed will act as an e-mail "bulletin" or "alert" to deliver information that is only valuable for physicians as they care for their patients. Messages will be very brief, often with links to redirect readers for more details if desired. The frequency may vary depending on the amount of news, but it will always be sent out the first week of each month.
Examples of eMed topics:
- Drug Shortages
- Capacity Alert Status
- Lab Values Changes
- PowerChart Updates
- Continuing Medical Education
- Health Information Management Reminders
Additionally, information that appears in eMed will be filtered onto the electronic boards in the physician lounges at Saint Joseph Hospital and Saint Joseph East, and posted at http://www.saintjosephphysicians.org/. If you have any questions or suggestions regarding this communication, contact Cynthia Salamanca at 859.313.1096.
View STAR Order Status in PowerChart
Beginning Monday, June 8, physicians of Saint Joseph Hospital, Saint Joseph East and Saint Joseph - Jessamine will be able to view the status of their lab and radiology orders in the Cerner System. An Order Status Interface will allow the information to be transported from STAR into Cerner PowerChart and Firstnet. Simply select the "PowerOrders Tab" to "View Order Status." If you have any questions, contact Paula Keally in clinical informatics at 859.313.4776 or Will Short, physician liaison, at 859.361.2851. Click here to review more details regarding this new functionality.
Capacity Alert Update
The capacity alert guidelines for bed capacity at Saint Joseph Hospital and Saint Joseph East expedite patient flow when bed capacity is limited. In summary, the criteria used for determining Capacity Zone are:
GREEN Zone
Beds readily available
YELLOW Zone
No bed in 1 or more service
with ED and/or PACU boarders
Patients waiting > 4hrs for beds
RED Zone
No beds in > 2 services
with multiple boarders in ED and/or PACU
Patients waiting > 4hrs
The capacity alert status is paged overhead when Saint Joseph Hospital/Saint Joseph East is within the guidelines of either Yellow or Red status. In addition, Capacity Alert Poster boards will be displayed in all patient care areas to alert hospital staff and physicians of the status. E-mails related to the capacity status will be sent to office managers of surgeons and hospitalists to alert them of the need to join the hospital's efforts in expediting discharges and rapid transfers when applicable. For more information, contact Melanie Sanguigni, House Administrator at Saint Joseph Hospital (beeper 712.668, or call 313.1000 and ask for the House Administrator).
Rapid Response Team
To help assist with early recognition of deteriorating patient conditions and "failure to recognize" the Rapid Response Teams at Saint Joseph Hospital and Saint Joseph East have fully implemented a new trigger alert process for notification of critical lab values. The Rapid Response Team as well as unit designees receive alerts via text pager when a patient is experiencing any of the following:
- GLUCOSE < 40 and GLUCOSE > 450
- MAGNESIUM < 1.2
- LABS: POTASSIUM > 5.5 and POTASSIUM < 3.0
- LABS: HEMATOCRIT < 24.0
- LABS: HEMOGLOBIN < 8.0
- LABS: PLATELET < 75
- IONIZED CALCIUM < 1.0
- PHOSPHORUS < 1.8
In addition to the trigger alert initiative, as required by The Joint Commission, family members also may activate the Rapid Response Team by dialing 1-1-1-1 using a process we call "Condition H" if they notice signs of patient deterioration. The team can provide immediate evaluation and assistance with the patient at the bedside for families, staff as well as physicians. For more details, contact Satessa Grimes at 859.313.4480.
Surgical Antibiotic Prophylaxis
Exclusion Criteria for SCIP Infection measures:
The Physician/ARNP/PA must document the following for your patient to be excluded from the SCIP data:
- If you choose an antibiotic not on the pre or post op prophylactic order set
- Please document reason for use: adverse effect, untoward effect, and intolerance
- If adding antibiotics post op or continuing the prophylactic antibiotic greater then 24 hours
- Please document the reason, see below
- Abscess, cellulitis, gangrene
- Bloodstream infection
- Bone infection, osteomyelitis
- Gross/extensive fecal contamination
- H. pylori
- Leaks
- Necrotic, ischemic, infracted bowel
- Penetrating abdominal trauma
- Pneumonia, lung infection
- Possible/suspected infection
- Pus or purulence
- Sepsis
- Surgical site infection, wound infection
- UTI
Please contact Dana Stephens at 859.313.4715 with any questions or concerns.
Experts Urge Caution in Response to the Nice-Sugar Study
The NICE-SUGAR study, published in the New England Journal of Medicine (March 26, 2009), looked at intensive versus conventional blood glucose control in critically ill patients. In this international study:
- 6,104 patients were randomized to intensive control (81-108mg/dl) versus conventional control (<180mg with an average of 144mg/dl)
- Primary end point was death from any cause within 90 days after randomization
- Study indicates that critically ill patients treated in the intensive group had an increase in mortality as compared to the conventionally treated group
In their joint statement, the American Diabetes Association (ADA) and the American Association of Clinical Endocrinologists (AACE) stated they "caution against letting this study swing the pendulum of glucose control too far in the other direction where providers in hospitals are complacent about uncontrolled hyperglycemia." The ADA and AACE have established a Consensus Panel to review the current literature. Dr. Inzucchi in his editorial "Glucose Control in the ICU - How Tight is Too Tight?" (NEJM, March 26, 2009), stated "it would be a disservice to our critically ill patients to infer from the NICE-SUGAR data that neglectful glycemic control involving haphazard therapeutic approaches (e.g., use of insulin "sliding scales") - all too common a decade ago - is again acceptable practice in our ICUs."
The inpatient blood glucose control goal for Saint Joseph Hospital and Saint Joseph East is in the moderate range of 80-140mg/dl for the critical care units and 70-180mg/dl for the medical/surgical/telemetry units. With this focus, our severe hypoglycemia rate has always been below the national average. The Saint Joseph Diabetes and Nutrition Center (DNC) is monitoring further developments and findings related to the NICE-SUGAR study. The DNC works with the medical staff and patient care services to ensure safe, evidenced-based glycemic control.
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Please mark your calendars for a lively CME discussion on this timely topic:
"MANAGEMENT OF INPATIENT HYPERGLYCEMIA"
Wednesday, June 24 at 5:30 p.m. at Sal's Chophouse
(repeated on)
Thursday, June 25 at 7:00 a.m. in Blakely Auditorium
Presented by:
Guillermo E. Umpierrez, MD
Professor of Medicine
Associate Director, Clinical Research Center
Emory University School of Medicine
Director, Diabetes & Endocrinology, Grady Health System
(Dr. Umpierrez has authored several studies on inpatient management of blood glucose)
Reporting Compliance Issues
Workplace integrity is a commitment to both legal and ethical principles and behavior. We are responsible for being good stewards of public and private resources. We are entrusted with government and commercial funds to provide the necessary care and services to beneficiaries. We have a duty to prevent waste or abuse and to prevent or stop fraud of any kind.
It requires the commitment of each of us to ask questions when we are unsure of what the right action might be and to promptly speak up whenever we see or discover something that does not seem right or is a potential violation of law, regulation, policy, procedure or the "Our Values and Ethics at Work" Reference Guide (distributed to each new medical staff member).
To ask questions or report potential issues please:
- Contact the SJHS Corporate Responsibility and Privacy Officer, Carla Aldridge Walter, at 859.313.2707 or 866.910.6888
- If you want to report a concern anonymously, you have two options:
eMed is a communication tool created by the Communications/Marketing/Public Relations department of Saint Joseph Health System to keep physicians informed on news about Saint Joseph Hospital, Saint Joseph East and Saint Joseph - Jessamine. Please respond to this e-mail if you have any questions or contact Cynthia Salamanca at 859.313.1096.
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