AUGUST 2011

Dear Colleagues:

As of July 2011, a patient’s satisfaction with their hospital experience formally became the next “pay for performance” measure in the Centers for Medicare and Medicaid (CMS) value-based purchasing payment model for hospitals across the country. Providers that accept federal government payments, increasingly, are held accountable for using evidenced-based practices and delivering positive outcomes. 

Now CMS has pulled the trigger on the much anticipated HCAHPS (health consumer assessment of health provider services) program. HCAHPs data on hospital performance—attainment of a required baseline measurement and then improvement beyond that—will be used to calculate reimbursement payments for the coming year, including a hospital’s ability to earn back payments that CMS has withheld. For our hospital, approximately $770,000  has been withheld by CMS for clinical measures and $330,000 for patient satisfaction measures—totaling $1.1 million. This dollar “take back” will increase over time.

NYHQ has a robust and successful program to improve and maintain clinical core measures, and we have spent the past 18 months focused on improving patient satisfaction levels by improving the patient’s experience.   

Improving that experience is both simple and complex.  In our staff education process, we ask our people to put themselves in the patients shoes, rather than focus on scores and data.  If we understand how the patient feels about how we treat them, we should be able to improve that experience tenfold, and then make it the best in the nation.  

In summary, here’s how a patient’s perception of their experience now impacts an institution’s ability to obtain reimbursement:

1. Health care team provides medical care for a patient
2. Each patient forms perception of their care based upon totality of experience with all providers and the institution
3. After returning home, each patient is surveyed (by CMS HCAHPS survey administrators, such as Press Ganey); patient evaluates experience and rates it, including if they would recommend the care to others
4. Data from the patient’s evaluation and rating of the hospital are analyzed by CMS and aggregated with reponses from across the country
5. As of July 1, results count toward level of reimbursement dollars an institution will earn back from funds witheld by CMS

Our Office of the Patient Experience guides employees and medical staff about the factors that shape a patient’s experience, including courtesy, communication and control of pain. For example, a new initiative called HUSH (Help Us Support Healing), focuses attention on the patient’s opinion of noise levels and sets guidelines on how to minimize it for a quieter healing environment.

The patient’s perception of their experience has always mattered.  Now, the patient’s voice about that experience will have an impact on the bottom line.  We embrace this and have committed our organization to providing an experience that patients know has contributed to their clinical outcome and that they can recommend to others with pride and enthusiasm.

Sincerely,

Stephen S. Mills, F.A.C.H.E.

PEOPLE & PROGRAMS

People News

Jaime Edelstein, M.D., (pictured left) joins our medical staff as an attending physician, Department of Emergency Medicine. She completed residency training and achieved her M.D. degree from SUNY Downstate Medical Center and Kings County Hospital.

Welcome to Margaret Chiu, M.D., attending physician, Department of Anesthesiology. Dr. Chiu achieved her medical degree from Mount Sinai School of Medicine/New York University. Dr. Chiu comes to us from Mount Sinai Medical Center, where she completed her residency.

The Division of Emergency Ultrasound in the Department of Emergency Medicine welcomes two new fellows: Cara Brown, M.D., who completed Emergency Medicine training at Baystate Medical Center in Springfield, Mass., and earned her M.D. degree from Virginia Commonwealth University School of Medicine in Richmond, Va.; and Omar Corujo, M.D., who comes to us from the University of Puerto Rico, where he achieved his M.D. degree and served as chief resident. 

Our physicians and clinical staff frequently present their work at medical conferences and in peer-reviewed publications:

Osvaldas Pranevicius, M.D., attending physician, Anesthesiology, co-authored, “Partial Aortic Occlusion and Cerebral Venous Steal: Venous Effects of Arterial Manipulation in Acute Stroke,” which was published in the medical journal, Stroke.

Alexander Golant, M.D., attending physician, Orthopaedics and Rehabilitation, co-authored “Return to Sports after Shoulder Arthroplasty: A Survey of Surgeons' Preferences,” which appeared in the Journal of Shoulder and Elbow Surgery.

Peter Wasserman, R.D., M.A., metabolic support, Infectious Disease Division, Department of Medicine, and David S. Rubin, M.D., medical director, HIV/AIDS Specialty Care Center, presented the preliminary findings of an investigator initiated study conducted on “Adverse Drug Reactions and Co-morbidities in HIV,” at a conference in Rome, Italy. Their abstract, “Prevalence of Sarcopenia Defined by Skeletal Muscle Mass and Function in an Urban Cohort of Older HIV-infected Patients under Care,” is scheduled for publication in the journal, Antiviral Therapy.

A team of attending neurologists, Nitin Sethi, M.D., Padmaja Kandula, M.D., Douglas Labar, M.D., Neil Schaul, M.D., and Dmitriy Kolesnik, M.D., co-authored “The value of intraoperative electrocorticography in surgical decision making for temporal lobe epilepsy with normal MRI,” which was published in the medical journal, Epilepsia.

The Department of Emergency Medicine gave several research and didactic presentations at the Society for Academic Emergency Medicine (SAEM) Annual Meeting in Boston, Mass.:

• Nidhi Garg, M.D., medical resident, and Sanjey Gupta, M.D., attending physician, presented, “Barriers to Pap Smear Testing as a Preventive Health Measure among Adult Patients Presenting to the Emergency Department.”
• Dr. Gupta and Joseph Walline, M.D., former chief resident, presented, “The Management of Specialty Patients by Emergency Physicians in Beijing, China.”
• Dr. Garg, Alison Suarez, M.D., assistant residency director, and Michael S. Radeos, M.D., M.P.H., research director, presented the results of their work on the “Derangements of Mean Arterial Blood Pressure, Pulse Oximetry and Hematocrit as Predictors of 28 Day Mortality in Adult Emergency Department Patients with Suspected Infection.”
• Drs. Garg and Suarez co-authored “An Evaluation of Shock Index as a Predictor of Hyperlactatemia and 28-day Mortality in Adult Emergency Department Patients Screened for Severe Sepsis” in collaboration with researchers from two institutions.
• Dr. Gupta presented a lecture on “The Definition and Academic Emergency Medicine Practice of Wilderness Medicine,” and Dr. Radeos, discussed “Navigating Large Datasets for EM Research Questions: A How-To Primer.”

A case report by Kris Zaporteza, M.D., emergency medicine resident, was published in the medical journal, Vascular, on “Recurrent Collapse of a Gore TAG Endograft in Treating an Aortoesophageal Fistula.”

Suzanne C. Pugh, R.N., clinical director, Emergency Medicine, delivered a presentation at the New York State Emergency Nurses Association (ENA) Annual Conference on "Setting the Bar: Performance, Consistency and Employee Relations."

David Barlas, M.D., associate residency director, Emergency Medicine, delivered a Grand Rounds presentation at NewYork-Presbyterian Hospital/ Cornell Campus on “Job Satisfaction in Emergency Medicine.”

Joseph Habboushe, M.D., attending physician, Emergency Medicine, contributed a case report, “Woman with painful swelling in fingers,” for the medical journal, Annals of
Emergency Medicine.

Program News

Palliative Care Update

Cynthia X. Pan, M.D., (pictured left) attending physician, Geriatrics, and director, Palliative Care, and Jane Morris, R.N., (pictured right) clinical care coordinator, Palliative Care, successfully redeveloped our Palliative Care Program in 2010. In that time, they have provided consultations on more than 500 patients.

In February, New York State (NYS) enacted the Palliative Care Information Act to ensure that terminally ill patients are fully informed of the options available to them. Physicians and nurse practitioners are required to offer terminally ill patients information and counseling concerning palliative care and end-of-life options.

Palliative care is defined as a comprehensive plan of care for strengthening the quality of life for individuals with any serious illness. Palliative care also helps
patients and families with decision making in the
setting of serious illness and navigating a complex health care system.

For consultations or for advice on how to approach a situation that may require palliative care services, please contact Dr. Cynthia Pan at (718) 679-2434.

NYHQ Community Advisory Council and Auxiliary Fundraising Project
Frank Macchio, chairman, NYHQ Community Advisory Council, announced the start of a collaborative fund-raising project with the Women’s Auxiliary, called the “Save-A-Life Community Campaign.” The campaign goal is to collect the funds necessary to purchase new cardiac monitors for the hospital’s ambulances. To make a donation, checks can be made out to New York Hospital Queens – Women Auxiliary or make a donation online at www.nyhq.org by clicking on the “Ways to Give” section. Please note that the donation is to be directed to the “Save-A-Life Campaign.” For further information, contact Debbie Pagano Cohen at 718-670-1586.

New York Hospital Queens HANYS-PAC Campaign 2011
New York Hospital Queens has kicked off the 2011 Annual HANYS-PAC campaign. HANYS (Healthcare Association of New York State) is an industry advocacy organization that represents hospitals on issues related to health care policy at the state and federal government levels. As a participant in the HANYS political action committee (PAC), New York hospitals have a unified voice for our budgetary and legislative needs. Elected officials need to understand the challenges we face so they can advocate for the health care needs of New Yorkers. To make a voluntary donation to the New York Hospital Queens campaign for the 2011 HANYS-PAC, or for more information, please contact Debra Pagano Cohen at (718) 670-1586.

PROGRESS 

OUR VISIBILITY IN THE COMMUNITY

NYHQ Promotes Colon Cancer Awareness in the Community


New York Hospital Queens is helping spread the word about the importance of colon cancer screening. The hospital has joined a citywide effort sponsored by the New York City Department of Health and Mental Hygiene to heighten colon cancer awareness. Patient navigators from the NYHQ Center for Digestive Diseases have been reaching out this summer to the downtown Flushing community by visiting branches of Cathay Bank and the Charles B. Wang Ambulatory Center. The team is fluent in English, Mandarin, Cantonese, and Spanish, and provides information on how obtain colon cancer screenings. For more information about the screening program, call (718) 670-2216 or email, xix9002@nyp.org.

Collaboration with Assembly Member Meng To Promote Healthy Lifestyles for Children
New York Hospital Queens joined Assembly Member Grace Meng for “Healthy Active Kids Day” at Kissena Corridor Park on July 16. A therapist and dietician from NYHQ provided education to children and their parents.

New York Hospital Queens Participates in “Night Out Against Crime”


The 28th Annual National Night Out Against Crime was observed throughout the country. We were well represented in Queens and participated in events hosted by the 110th Precinct (serving Elmhurst/Corona) at Flushing Meadows Corona Park, 109th Precinct (serving Flushing) at P.S. 20 in downtown Flushing, and the 107th Precinct (serving Fresh Meadows) at Local Union #3 IBEW.

New York Hospital Queens To Compete in the Hong Kong Dragon Boat Festival
We are a proud sponsor of the 21st Annual Hong Kong Dragon Boat Festival featuring the New York Dragon Boat Championship and the U.S. Dragon Boat Open Championship Races, on Meadows Lake, Flushing Meadows Corona Park, August 13-14, 2011. This year we are entering two teams in the race; the DragonHearts led by Jackson Yeh, systems coordinator, Cardiology, and The Baby Catchers with Team Captain David Chiang, M.D., attending physician, Obstetrics & Gynecology. Our teams join 170 others, which includes more than 2,000 crew members from across America and Canada. More than 60,000 spectators are expected to attend.