August 2012

Dear Colleagues:

Medical liability costs place intense financial pressure on physicians and health care institutions and drive up costs throughout the health care system. New York’s hospitals spend more than $1 billion annually on medical liability expenses. Hospitals have had to look at different ways to navigate the rising demands of medical malpractice claims and coverage. Today, an increasing number of hospitals are self-insured to manage the escalating cost of insurance premiums. Many physicians cannot afford malpractice premiums, and many have altered their practice or left practice altogether.

NYHQ is self insured; and we also purchase commercial insurance including excess liability. We budget prudently to ensure that estimated professional liabilities are sufficiently funded. A recent news article on this issue suggests that hospitals that are self-insured are at risk of bankruptcy. That might be a risk indicator for some hospitals, but that is not the case for us.

The loss of medical malpractice reform momentum in New York State is disturbing . The state has a high stake in passing the reforms. Medical malpractice reform has been cited as a priority of Governor Cuomo’s Medicaid Redesign Team (MRT) as a way to lower state Medicaid costs. But, so far, the state’s legislative action has had more valleys than peaks. To date, the industry has been active in Albany countering attempts to increase the malpractice burden.

• In 2011, the legislature stalled a proposal to cap malpractice damages for non-economic costs, such as pain and suffering, at $250,000 per provider.

• A win for the Cuomo administration, a proposal that passed in the NYS 2011-2012 budget, created a neurologically impaired infant medical indemnity fund administered by the state. The state agreed with health care providers that in most cases of neurologically impaired infants, the impairment usually was not the result of provider negligence. The medical indemnity fund would pay for the future medical costs of neurologically impaired infants, which actuaries estimated could reduce hospital costs by as much as 20 percent.

• So far in 2012, medical malpractice has not received much attention in state legislation. This may be due in part to the inertia of the MRT Medical Malpractice work group. The group was tasked to assess malpractice coverage costs in New York State, including significant cost drivers, review insurance data and develop recommendations on reducing costs by year’s end 2011. The work group cited differences of opinion and did not come up with any recommendations for 2012.

It is very clear that our hospital and our voluntary and attending medical staff have a large stake in medical malpractice reform. We encourage dialogue with our elected officials. For guidance on how to address this topic with our community leaders or elected officials, call Camela Morrissey, vice president and chief marketing officer, at (718) 670-2985. Or, for more details about our insurance coverage, call William Wissemann, senior vice president and general counsel, at (718) 670-1044.

 
Sincerely,

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

PEOPLE

We are pleased to announce the following appointment of our medical and professional staff:

We announce the anticipated September 1 arrival of Paul Di Cesare, M.D., appointed director, Total Joint Arthroplasty. Di Cesare is returning to New York from the University of California - Davis, where he served as chairman and professor of Orthopaedic Surgery. Formerly a director at NYU Hospital for Joint Diseases, he is well known in the New York medical community for his expertise and volume of successful hip and knee reconstruction. He has performed more than 2,000 hip and knee replacements and more than 300 total joint replacements.

Welcome to four attending anesthesiologists who have been appointed to our medical staff:

	Justin Kim, M.D., achieved his medical degree from Florida State University College of Medicine, Tallahassee, Fla., and his bachelor’s degree in biochemistry and microbiology from the University of Florida, Gainesville, Fla.  He completed his residency in anesthesiology at NewYork-Presbyterian Hospital. To reach Dr. Kim, call (718) 670-1080.
	Vitaly Kotlyar, M.D., achieved his medical degree and bachelor’s degree in biochemistry from the State University of New York/Stony Brook.  He completed his residency in anesthesiology at SUNY Downstate Medical Center in Brooklyn, N.Y., where he served as chief resident. To reach Dr. Kotlyar, call (718) 670-1080.
	Deepali Mude, M.D., achieved her medical degree from the Jefferson Medical College at Thomas Jefferson University, Philadelphia, Pa., and a bachelor’s degree in psychology from New York University.  She comes to us from Mount Sinai Medical Center where she completed her residency in Anesthesiology.  To reach Dr. Mude, call (718) 670-1080.
	Sheronda Smith, M.D., achieved her medical degree from the University of Medicine and Dentistry of New Jersey, Newark, N.J., and a Bachelor of Arts from Rutgers University in New Brunswick, N.J.  She completed her residency in anesthesiology at NewYork-Presbyterian Hospital. To reach Dr. Smith, call (718) 670-1080.

 

Cynthia Pan, M.D., director of Palliative Care Medicine since 2010, has been additionally appointed as director, Division of Geriatrics, and director,Geriatrics Fellowship Program. Dr. Pan achieved her undergraduate degree in biology from Harvard University and her medical degree at the School of Medicine at Stony Brook University. She completed her fellowship in geriatric medicine at Harvard Medical School and her internship and residency in primary care internal medicine at the University of Rochester Medical Center. Dr. Pan also completed a program in Clinical Effectiveness at the Harvard School of Public Health and a program in End-of-Life Care at Stanford University.

NYHQ Graduates 110, Welcomes New Residents & Fellows
We prepare physicians of the future through robust residency and fellowship training in medicine, dental and oral medicine, emergency medicine, internal medicine, podiatric medicine and surgery, radiation oncology, cardiovascular, gastroenterology, geriatrics, infectious disease, nephrology and pulmonary/critical care medicine. Currently, there are 232 residents and fellows in the hospital’s programs. In June, we awarded 110 diplomas across our programs. On July 1, we welcomed 109 new residents and fellows.

 

It is an honor for us when our hospital team members attain professional achievements and when they are recognized by other organizations:

	Burton Wasserman, D.D.S., has been selected as the guest of honor at the Seventh Annual Theresa Lang Dinner to be hosted by NYHQ on November 12, 2012. The Theresa Lang Award recognizes outstanding contributions to clinical research, education or patient care by an NYHQ physician, dentist or podiatrist. This is the highest award offered to a member of the NYHQ medical staff.
2012 Excellence in Teaching Awards were presented to Edward Chai, M.D., (pictured left) director, Neurology, and Wesner Thenor-Louis, M.D., (pictured right) director, OB/GYN Medical Student Education, by the medical students of Weill Medical College of Cornell University.

Our hospital encourages the continuing education of all employees through medical symposia, NYHQ College courses and our Management Studies program. Fifteen NYHQ employees were awarded certificates by NYHQ College and Queens College for completing a intensive 48-hour course on effective management: Sonia Alleyne, R.N., Patient Care Services; Irene Angmor, Pharmacy; MaryAnn D’Orazi, R.N., Patient Care Services; Joseph Faggiano, Radiology; Carol Juliano, R.N., Patient Care Services; Maureen Lee, Blood Bank; Andrew Leeb, Radiology; Leon Lipkovich, Radiology; Patricia Montoya, Quality Management Administration; Thomas Moroney, Materials Management; Yogesh Pancholi, Pathology and Clinical Laboratories; Dina Pantelias, Human Resources; Joseph Verrengia, Radiology; Richard Verrette, Respiratory Medicine; and Kathleen Winkler, Finance. 

 

Our physicians and clinical staff frequently present their work and share their expertise at medical conferences, in peer-reviewed publications and at community meetings:

At the New York American College of Emergency Physicians Resident Research Conference hosted by the Mount Sinai School of Medicine, Anita Datta, M.D., R.D.M.S., director, Ultrasound, Emergency Medicine, and David Barlas, M.D., associate chairman, Emergency Medicine, were invited to present “How to Write a Research Abstract” for first-year residents.

 

PROGRAMS & PROGRESS

Program News

NYHQ Opens Center for Wound Healing at Silvercrest

Currently, close to five million people in the U.S. suffer from chronic wounds and that number is on the rise. The Center for Wound Healing at Silvercrest can help those most at risk of chronic wounds, such as the elderly and those with diabetes and obesity, by providing easier access to more aggressive wound treatment. The center has two hyperbaric oxygen chambers for the treatment of hard-to-treat chronic wounds such as pressure ulcers, diabetic ulcers and radionecrosis (the destruction of tissue). Treatment using an increase in oxygen in the blood encourages the creation of blood vessels and increases production of collagen, both necessary for wound healing. The NYHQ site for wound healing is one of only two Centers in Queens that offers this treatment.

We encourage our medical and patient care services staff to utilize and recommend this service to patients in need of aggressive wound care. For more information or to refer a patient, please call 1-855-480-HEAL (4325). The Center is located on the 1st floor of the Silvercrest Center for Nursing & Rehabilitation at 144-45 87th Avenue, Briarwood, N.Y.

Care, Innovation and Transformation of Patient Care
In the fast-changing health care environment, it is our responsibility to perfect our processes in order to provide consistent, high quality care to our patients. Nursing staff from the medical-surgical units on 5 West and 8 North are participating in the “Care, Innovation and Transformation” (CIT) initiative supported by the American Organization of Nurse Executives. The goal of the CIT initiative is to provide strategic tools and identify processes that transform care at the bedside, and implement these findings throughout the organization. Pilot programs on the 5 West and 8 North patient care units focus on collaboration and communication between nursing and medical staff.


NYHQ Opens New Central Sterile Supply Area

The Central Sterile Supply Department has moved to a new, larger space in the lower level of the West Building. In 2011 alone, NYHQ performed more than 30,000 surgeries and 4,000 obstetrical deliveries. These statistics are significant because the Central Sterile Supply Department is responsible for preparing and distributing all surgical supplies including, dressings to sterilization of obstetrical and surgical packs and all special equipment, including the preparation of sterile trays for certain treatments. The new space is double the size of the former location in the lower level of the North Building. The new location is conveniently situated one floor below the Ambulatory Surgery Center for expedient access to surgical supplies.


Cancer Services Program at NYHQ
Each week in Queens, 64 individuals die from cancer and 192 individuals are diagnosed with cancer, according to the American Cancer Society. The number of people diagnosed with cancer each week could fill every seat of our Lang Auditorium. To battle cancer, our hospital provides education, free screenings and affordable treatment for the community through our Cancer Services Program as well as HealthOutreach. Since the program started last year, 700 people have been screened and 22 cancers were found.

Led by Jacqueline Xouris R.N., M.S., director, HealthOutreach-NYHQ, and director, New York State Department of Health Cancer Services Program (CSP) of Eastern Queens, the program emphasizes the importance of early detection. The CSP provides breast, cervical and colorectal cancer screenings at no cost to uninsured residents of New York State who cannot afford to pay for these exams. If screening tests show abnormal findings, diagnostic testing services are available through the CSP, at no cost, for eligible men and women. If breast, cervical or colorectal cancer is found, eligible men and women may be able to enroll in the NYS Medicaid Cancer Treatment Program to receive full Medicaid coverage during the entire time of the cancer treatment. All screening, diagnostic, and treatment services are available right here at NYHQ.  Those in need of a screening, can call (718) 670-1211 to schedule an appointment.

Grants Program Update—Award for Mobile Pediatric Asthma Clinic
NYHQ was selected to receive a $326,000 grant from the TransCanada/NYC Economic Development Corporation to launch a part-time mobile pediatric asthma clinic in Northwest Queens. Pending certificate of need approval by the New York State Department of Health, the project is expected to begin in fall 2012. By bringing treatment directly to patients via a mobile clinic, the program will help patients and their families overcome barriers to care (e.g. cost, finding a regular source of care, securing appointments), which often prevent them from successfully preventing and managing asthma.  Asthma is the most common chronic condition among children.  Approximately 7 million children in the U.S. and about 491,000 children in New York State have asthma. We anticipate that children who receive medical care and health education through this innovative program will experience fewer emergency room visits, hospitalizations and missed school days.

The NYHQ Pediatric Asthma Center is the longest-running, community-based program in Queens dedicated to the care of children with asthma.  The Center’s goals are to minimize the impact of asthma related symptoms and illness on both the patient and family, and to reduce acute episodes that require hospitalization.  Services are offered at NYHQ and the Jackson Heights Family Center.  Additionally, the Center facilitates access to prevention education and asthma screenings by offering these services in its wheelchair-accessible, mobile clinic.

 
New Linear Accelerator Coming Soon
The Ned Arnold Center for Radiation Oncology, part of the NYHQ Cancer Center, is planning for the installation of a new, state-of-the-art linear accelerator for the radiation treatment of cancer. Construction to accommodate the new equipment is expected to begin this month. A linear accelerator precisely delivers high-energy radiation beams to the patient’s tumor. The new linear accelerator is image-guided to provide a targeted radiation therapy for our patients. This new technology’s precision preserves healthy tissue and organs. It is also quieter, which improves the patient experience. 

 

Progress

Medication Safety at NYHQ
In May, the Institute of Safe Medication Practices (ISMP), the premier medication safety advocacy group in the United States, came to NYHQ to review medication safety. The ISMP was impressed with our hospital’s ongoing efforts to make the electronic health record (EHR) a dynamic tool to increase medication safety. The ISMP identified several “best practices” that we use with our EHR to maintain medication safety standards.

24th Annual Frank Randazzo Jr. Golf and Tennis Classic
NYHQ will host its 24th Annual Frank Randazzo Jr. Golf and Tennis Classic on Monday, September 10, 2012, at Old Westbury Golf & Country Club.  Guests will enjoy a full day of golf or tennis and a deluxe cocktail reception and dinner banquet. As always, event participants will be eligible for prizes in a number of categories of play. Over the years, funds raised from this event have strengthened our cancer research and cancer patient programs. This year, proceeds will be used to upgrade the Radiation Oncology recovery room for patients receiving treatment at The Cancer Center at New York Hospital Queens. For tickets, underwriting opportunities and sponsorship information, please contact Julie Varghese, director, Special Events, at juv9007@nyp.org or (718) 670-1564.

New York Hospital Queens HANYS-PAC Campaign 2012
New York Hospital Queens has kicked off the 2012 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 2012 HANYS-PAC, or for more information, please contact Debra Pagano Cohen, director, Community and Government Affairs, (718) 670-1586 or dec9067@nyp.org.


Excellence in Neonatal Care —A Patient Shares Her Story
Two-year-old twins Josiah and Jazlynn attended a “Preemie Party” at NYHQ, a celebration of the health of premature babies born at the hospital. Running and laughing like toddlers should, no one could guess that these twins had the fight of their lives two years earlier.

 

Chaniece Santiago, 20, had just enrolled in college when she received the news that she was having fraternal twins and a high-risk pregnancy. When she reached 22 weeks of pregnancy, the sac of one of her twins ruptured. Ms. Santiago was immediately admitted to NYHQ where she and the fetuses were monitored constantly. Five weeks later, at 27 weeks, she went into labor and had an emergency cesarean section, performed by Cliff Blumstein, M.D., attending physician, Obstetrics & Gynecology.

The twins barely weighed two lbs., each. Under the care of Pinchi Srinivasan, M.D., director, Neonatology, and Elise Lavery, M.D., attending neonatalogist, the twins were intubated, received blood transfusions and were placed on feeding tubes. Josiah had air leak syndrome (air in places in the body where it is not normally present) and required chest tubes. Jazlynn had sleep apnea. Sleep apnea is interrupted breathing during sleep and is a potentially serious disorder.

After a month and a half of care in the hospital, the twins grew stronger and healthier and Ms. Santiago was able to hold them for the first time. And after a two-month stay, the twins went home with Ms. Santiago. “The physicians and nursing staff were amazing. They physically helped my children, and provided me with positive emotional support through the ups and downs of my twins’ health,” said Ms. Santiago. “My twins are my biggest blessing and I am so grateful for the care my children and I received at NYHQ. For that, I am extremely thankful.”

The patient granted written permission, in accordance with HIPAA regulations, to use her name and information for the purposes of this testimonial.