SYSTEMNEWS MARCH 2017
Lancaster General’s
STATE-OF-THE-ART ENERGY CENTER Emergency electricity, hot water and steam
In the event the gas turbine goes down and the hospital loses its connection to the power grid, two emergency generators will power the hospital and boilers that will provide hot water and steam
CEO, University of Pennsylvania Health System
Electricity
Steam-driven Turbine Chiller Remaining Steam
Steam
Gas Line
3.5 megawatt gas turbine
Heat Recovery Boiler
Used for cooking, humidification, food-prep services, HVAC, sterilization, and laundry services
Chilled Water for Cooling
Ensuring Reliability and Efficiency When Hurricane Sandy struck in 2012, two major hospitals within the path of the storm lost electricity, resulting in the emergency evacuation of more than 200 patients. But it doesn’t take a Category 5 storm to disrupt a hospital’s power. A blown transformer led to a 15-hour power interruption at the Bon Secours Medical Center in Virginia in 2015, and similar disruptions have occurred at other facilities in recent years. While a loss of electricity can be an inconvenience for some, in a hospital environment, it can easily be the difference between life and death. That’s why Penn Medicine’s Lancaster General Health has invested in a $28 million “Energy Center of the Future” – a state-
of-the-art trigeneration energy center to improve system reliability and increase energy efficiencies. Launching this spring, it will be located in a two-story addition built on top of LGH’s previous power plant.
How Does It Work?
At the heart of the energy center is a nearly $8 million combined heat and power plant (CHP), comprised of a 3.5-megawatt combustion turbine and heat recovery boiler. By itself, the CHP is often referred to as a “cogeneration plant” (providing electricity and heating). But the addition of a steam-driven turbine chiller gives the energy center cooling capabilities, meaning that LGH will have a trigeneration system.
“While electricity reliability is at an alltime high, LGH’s tolerance for failure is literally zero. During surgery or at other critical moments in patient care, even a flicker of power has the potential to impact outcomes. In our homes and offices, we’ve all experienced periodic electricity failures. In contrast, few of us have ever dealt with the inconvenience of a gas leak. LGH values the proven reliability of natural gas.”
John Hartman, senior director of Facilities Management at LGH, explained that the new energy center will be powered by natural gas, reducing the hospital’s reliance on the power grid.
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UPHS NAMES THREE in this issue An “Angel” to Feed the Homeless.............................2 PSOM Ranked in Top 5.............2 Penn Medicine@Work .............3 CCH Unveils New Website.......3 Million Dollar Bike Ride............3 Penn Medicine Magazine is Now Online! ..........................3 Leadership News.......................4 Awards and Accolades.............4 PPMC Launches New Program to Diagnose Dyspnea................4 Charting the Path for PennChart .................................4
CORNER RALPH W. MULLER
75-85% of hospital electricity
Hot Water
CEO’s
to Top Leadership Posts Garry Scheib will step down from his roles as COO of the Health System and chief executive officer of HUP at the end of this month, following more than 17 years at Penn Medicine. Three Penn Medicine executives have been appointed to new roles to coincide with Scheib’s transition. Phil Okala has been named COO for the Philadelphia Region of UPHS; Regina Cunningham, PhD, RN, will become HUP’s chief executive officer; and Lori Gustave has been appointed SVP for Business Development for the Health System. As COO for the Philadelphia region, Okala will be responsible for program integration across our three Philadelphia hospitals. He will join Tom Beeman, COO for Regional Operations, in uniting our Health System at all programmatic levels. Okala provided executive leadership for some of the Health System’s key strategic initiatives, including integration of Chester County Hospital and Lancaster General Health and creation of Penn
When hospitals go “green,” the resulting healthy environment not only benefits patients and staff, but also the communities they serve — and our world at large. That’s why Penn Medicine has made signficant strides in becoming more energy efficient and sustainable. This commitment to good environmental sterwardship is clear in recent major investments: the energyefficient power plant at Lancaster General; the expansions planned for Chester County Hospital; the South Tower at the Perelman Center for Advanced Medicine; and an electrical substation for HUP. These projects take years to design and create, and a major consideration is meeting the high-performance energy standards that result in LEED — Leadership in Energy & Environmental Design — Certification. Such a designation not only requires attention to the all-important lighting and cooling systems, to ensure maximum efficiency, but also looks at the use of recycled products — such as drywall — in construction, and whether the waste generated can be recycled instead of sent to landfills. This detail-oriented process even suggests the installation of things like bike racks, as a demonstration of Penn Medicine’s commitment to promoting alternative means of transportation for our staff. But new construction is not the only greening happening at Penn Medicine. As we renovate older facilities, we replace air-cooling units that use refrigerants with more efficient chill water systems; add more efficient air-handling units with motor speeds that vary based on demand and space; and install monitors that allow us to track usage over time and tweak systems to become even more efficient. We are switching our roofing materials from heat-absorbing black, which requires more energy to cool our buildings, to white. Single-pane windows are giving way to double-paned. The conversion of lighting from fluorescent to the now-affordable LED technology proceeds apace, one fixture at a time in some areas, or whole rooms or floors in one fell swoop. Our new South Tower is completely lit by LED lighting. These improvements are happening systemwide, from our hospitals to our physicians’ offices. For example, over the past year, the Main Parking Garage at Pennsylvania Hospital was converted fully to LED, resulting in a 25 percent savings on the electric bill. Continued on page 4
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UPHS NAMES THREE
to Top Leadership Posts Medicine’s strategic alliance with Virtua Health System, as well as ongoing efforts for our merger with Princeton Health Care System. Cunningham, who will be transitioning from her role as chief nursing executive for Penn Medicine and HUP, has developed an ability to lead across many clinical and administrative areas as a result of her deep understanding of hospital operations. Her thoughtful leadership approach, collaborative style and expertise in administrative matters will serve the
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Health System well as it embarks on greater integration of our service lines across the hospitals and physician practices. Gustave is presently the chief administrative officer for Penn Medicine’s Musculoskeletal & Rheumatology Service Line and COO for Orthopaedic Surgery. In this role, she oversaw design and implementation of the fully integrated Penn Musculoskeletal Center at Penn Medicine University City and implemented a new disease team care model for the MSKR service line.
Penn's Perelman School of Medicine Again Ranked Among Top 5 Penn’s Perelman School of Medicine has been ranked among the top five medical schools in the United States for the 20th year in a row. According to the annual medical school survey in U.S. News & World Report's “Best Graduate Schools” report, Penn Medicine is ranked #5 in the country.
Joan Wielgoszinki (seated, right) with Justine Fairlie and other Connect by Night volunteers
An “Angel” to Feed the Homeless Joan Wielgoszinski, a patient service associate at Penn Medicine, Valley Forge, met caterer Justine Fairlie several years ago, at her granddaughter’s christening at the Marple Presbyterian Church. In talking with her, Wielgoszinski learned that Fairlie also ran Justine’s Food Angels, a charity that provides dinners for the homeless as part of a project called Connect by Night. The more she heard about the program, in which Marple is one of six churches that all provide both dinners and overnight shelter two months out of the year, the more she wanted to be a part of it. Today, helping to feed the homeless is a regular part of Wielgoszinski’s week. Indeed, every Wednesday evening for the past five years, she and other volunteers are chopping up salad ingredients, setting out plates and serving dishes, and then serving food to the 50-70 homeless men and women who are part of the Connect By Night program. (The participants are bussed to the church for dinner and then brought back to the shelter in the morning.)
During Wednesdays in May and October, the outreach is at the Marple church. The other 10 months, Fairlie and the volunteers pack up the food and head for the Connect by Night Day Shelter in Upper Darby every Wednesday. Wielgoszinski said going makes her realize how good her life is. “The first time I came home after volunteering, I looked in the bathroom mirror and told myself how lucky I was,” she said. “I come home to a house, with a bed to sleep in.” In addition to helping to prepare and serve the meals, Wielgoszinski and others collect clothes and bring them to the center. Over the holidays, they collected toiletries and other new items, allowing the participants to take what they need. It costs about $8,000 a year to provide these weekly meals. To raise the needed money, they hold fundraisers but she has also received two Penn Medicine CAREs grants to purchase supplies, such as paper products. “It’s one of the most amazing things that I’ve ever been involved in,” Wielgoszinski said. “I can’t imagine not doing it.”
CAREs Announces New Grant Recipients The Penn Medicine CAREs Grant program was founded to provide institutional support for our employees and medical students who volunteer their time to our neighborhoods, our city, and our world. Congratulations to the most recent recipients:
Penn’s School of Medicine also ranked among the nation's top medical schools in four areas of specialty training, including a first place ranking in Pediatrics, and honors in Women's Health (#3), Internal Medicine (#4), and Drug/Alcohol Abuse (#6). The Perelman School of Medicine is also #8 in the rankings for training in Primary Care.
Zoe Soslow
Gary Ginsberg
PPMC UGO
Sheila Cummings
CPUP Riverview Avenue Community Center
Roseann Day
PSOM Penn Interprofessional Student Collaborative
“As the nation’s first medical school, established more than 250 years ago, we continuously renew our commitment to top-quality education, innovative research, and excellent patient care,” said J. Larry Jameson, MD, PhD, dean of the Perelman School of Medicine. “This recognition from U.S. News & World Report is a testament to our talented faculty and staff and their dedication to giving our future clinicians and scientists their very best, day in and day out. We are proud to be included on this prestigious list again this year.”
Mark Mumbauer
CORP Crossroads 4-H Afterschool Program
Leah Rethy
PSOM HHBC/UCC Diabetes Initiative
Joanne Miles
HUP Health Testing at Grace Cafe
Helena Pittman
Melinda Lamb
PAH St. Wilfrid's Clinic
According to survey results, the medical schools earning a top-5 ranking are, in order: Harvard, Stanford, Johns Hopkins University and the University of California—San Francisco, and Penn. There is a very narrow scoring margin separating schools in the top five from one another. The complete survey results as well as the methodology used can be found at USnews.com.
Scott Bowman
PSOM Project Home Clinic
Heidi Lewis
HUP Get Fresh at Manna
Tigist Hailu
PSOM Dance for Health: Active Body, Active Mind
Krystal Hill
PSOM Cut Hypertension
Lancaster General’s
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PAH Project Safe Sleep
PPMC PPMC Nurses 59th Street Baptist Church
Learn more about how to apply for a Penn Medicine CAREs grant for your community service at http://bit.ly/2nxJMSD.
STATE-OF-THE-ART ENERGY CENTER The combustion turbine, which looks similar to a passenger-jet engine, will provide the hospital with about 75 percent of its power in the summer months and 85 percent in the winter months. In addition, it will power a large boiler that will provide the hospital with hot water and steam. Any steam not used in areas like food prep and sterilization will power a second turbine, which will create chilled water to be used by the hospital’s HVAC system.
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What Backs Up the Trigeneration System?
a restoration of electricity or gas, or a refueling of the fuel tanks.
million in grants and rebates, anticipates a full payback in less than eight years.
By switching to natural gas, a loss of electricity – even a catastrophic one – will have little impact on the system’s operation.
Self-sufficiency is one reason LG Health invested in the energy center. Producing power on site also enables Lancaster’s largest hospital to be more energy efficient, and, in turn, save money. For example, a trigeneration system like the one at LGH has the ability to convert “waste heat” from electrical generation into energy that can be used for heating and cooling.
Hospitals must perform critical, lifesaving functions, even when a widespread disaster interrupts the supply of natural gas and electricity from the utility grid. LGH has always maintained backup procedures and systems for all critical functions. However, the new Energy Center of the Future will enable the hospital to operate at full capacity during a loss of electricity and natural gas.
But what happens in the event of an electrical failure and a disruption to the gas service? If LGH loses electrical power and gas service, responsibility for powering the hospital would go to a new pair of two-megawatt backup generators. The generators, which are fueled by massive 50,000 gallon fuel tanks, will work in conjunction with two existing generators to power LGH for up to four full days. After four days, LGH would require either
Initial estimates indicate that the new energy center will help the health system save about $1.3 million per year, as well as offering protection against the rising cost of electricity. Some energy systems can provide a simple payback within 10 years. LG Health, which also received $1.8
“When a natural disaster disrupts power and our community is in need, people turn to hospitals to be the light on the hill,” Hartman said. “This upgrade ensures that we are able to meet the community’s needs today and in the future.”
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pennmedicine
WORK
It’s That Time Again—Open Enrollment and Annual UPHS Health Fairs! Spring is here and that means Open Enrollment and the Annual UPHS Health Fairs are upon us. This is the time to learn more about the valuable benefits you receive as a UPHS employee. You’re “living your life’s work” and taking action for you and your family’s optimal well-being.
Open Enrollment: Be In The Know Look for the Annual Open Enrollment newsletter being mailed home to all UPHS employees in early April. It outlines benefit information for the 2017-2018 plan year. More information can be found on the HR & You website (www.uphshrandyou.com). All employees are encouraged to read through the newsletter and contact the Benefits Team with any questions by calling 215.615.2675, option #4 or emailing BenefitsQuestions@uphs.upenn.edu.
Get Empowered with the Annual UPHS Health Fairs The annual Health Fairs will be held during the first three weeks of April at nine UPHS locations (see below). You can visit with many of our vendors, enter raffles for cool prizes, grab free giveaways and learn about your medical plan and other benefits as a UPHS employee.
2017 UPHS
» Health Fair Schedule
April 4...............HUP Mezzanine » 10am-2pm
A Brand New Wellfocused Program is Coming! The Wellfocused website is going on hiatus for the summer beginning April 3, 2017. But not to worry – come this fall, we will introduce a brand new mobile health and benefits platform for all UPHS employees. Enhancements to the platform include: »» Brand new mobile app »» Electronic device tracking capabilities (Fitbit, Garmin, etc.) »» New and improved wellness challenges
April 5 ..............PPMC Cafe » 10am-2pm April 7 ..............HCHS Conference Rooms A and B » 8am-11am April 10 ............3001 Market Street, Training Rooms » 10am-1pm April 11 ............PAH Café » 10am-2pm April 17 ............Cherry Hill, 2nd Floor Common Area » 11am-2pm April 19 ............1500 Market Street, 9th Floor, West Tower » 10am-2pm April 20 ............CCH Conference Rooms A and B » 9am-1pm April 21 ............Radnor Conference Room » 10am-2pm
»» Ability to call your benefit resources or access your benefit information
straight from the app
»» And much, much more!
This change allows us to continue offering an action-oriented, innovative and engaging wellness program that recognizes you for taking steps to improve or maintain your good health. Even though the current Wellfocused site will be shutting down on April 3, UPHS will continue to offer many wellness programs throughout the summer to keep you Wellfocused on your health. You can find the details for upcoming programs and resources by going to www.uphshrandyou.com and clicking on Wellfocused.
Help Raise Awareness and Funds for Orphan Disease
The Penn Medicine Orphan Disease Center will hold its 4th annual Million Dollar Bike Ride on Saturday, May 20, starting at 7:30 am. The routes for the Ride will start and finish at the University of Pennsylvania campus in downtown Philadelphia. Whether you're an avid or beginner cyclist, we hope you'll join us to raise awareness and much-needed funds for rare disease research! For more information, go to milliondollarbikeride.org.
Is Running Really Good for the Heart? From the Broad Street Run here in Philadelphia to the Cherry Blossom 10-mile run in Washington, DC, and others across the country and overseas, running season is just around the corner! And for many people, from avid runners to weekend warriors, that means it’s almost time to lace up your shoes and dust off those training plans. But, news stories about runners suffering sudden cardiac arrest (SCA) and other heart-related complications mid-race might leave some wondering if there may actually be a risk to running. “Running, or any kind high-intensity exercise, puts a strain on the heart muscle, as it does on lung tissue, and leg and arm muscles,” said Neel Chokshi, MD, an assistant professor of Clinical Cardiovascular Medicine, and medical director of the Penn Sports Cardiology and Fitness Program. While evidence suggests an increased risk of cardiac events during high intensity exercise, the overall likelihood of such events is ultimately very, very low. There is more far research to support running and exercise as a benefit to heart health, rather than a detriment. “It’s important to understand that the likelihood of cardiac events is greatest in those individuals who have a low baseline level of physical activity and suddenly jump into moderate to high intensity exercise,” Chokshi said. “So, as long as you train in a progressive manner, gradually increasing mileage, pace of a run, or amount and type of exercise, and you listen to your body, your heart and lungs will adapt at the same rate. This will allow you to continue your training while minimizing risk of injury to both your heart and other muscles.” To learn more, go to http://bit.ly/2n4GfbS.
Chester County Hospital Unveils New Website
Over the past two years, Chester County Hospital has conceptualized and designed the next generation of its website, and proudly launched a fresh new design in early 2017. The site complements Penn Medicine's website, which relaunched in the spring of 2016, while tailoring the experience to Chester County’s suburban community. Key features are its Find A Doctor search, that is specific to just Chester County Hospital's Medical Staff, and a new online registration system for the 350+ Community Wellness programs it hosts each year. The website (www.chestercountyhospital.org) mirrors Penn’s, but is administered locally by the six members of CCH’s Marketing and Public Relations team under the direction of Colleen Leonard Leyden and through the daily maintenance by Mark Wisniewski, senior web coordinator.
Penn Medicine Magazine is Now Online! Penn Medicine is published three times a year for alumni and friends of Penn Medicine. In the winter issue: the life and legacy of cancer researcher Peter Nowell, Penn pioneers research on how social media connects to health, and a medical mystery in Guam. Read these articles and more online at PennMedicine.org/magazine. Sign up to receive the email edition of the magazine and other emails from the Department of Communications including System News at PennMedicine.org/news/subscribe.
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LEADERSHIP NEWS Halpern Named Director of PAIR Center
Penn Presbyterian Launches New Program to Diagnose Dyspnea
Halpern has been principal investigator of more than 20 extramural research grants and has received several awards, including the Greenwall Foundation Faculty Scholar Award in Bioethics. In 2012, the Robert Wood Johnson Foundation identified him as one of the nation’s top 10 people aged 40 or under who offer “great promise for leading the way to improved health and health care for all Americans.”
Stephen Chrzanowski, MD
Scott Halpern, MD, PhD, has been named director of the newly created Palliative and Advanced Illness Research (PAIR) Center. The Center represents a central part of Penn Medicine’s strategy for improving the care of America’s sickest patients. Its mission is to generate high-quality evidence to advance healthcare policies and practices that improve the lives of all people affected by serious illness. The Center will accomplish that goal through partnerships with a growing roster of the nation’s leading health systems and will work closely with our clinical program in Palliative and Hospice Medicine.
AWARDS AND ACCOLADES Doubeni Appointed to U.S. Preventive Services Task Force Chyke Doubeni, MD, MPH, chair of Family Medicine and Community Health, has been appointed to the U.S. Preventive Services Task Force. Established in 1984, this independent, volunteer group of experts in prevention and evidence-base medicine improves the nation’s health by providing recommendations on clinical preventive services, such as screenings, counseling services, and preventive medications.
Six CCA Practices Receive Quality Recognition Six Clinical Care Associates (CCA) Internal Medicine and Family Medicine practices received level III certification, the highest designation granted, for their efforts to provide coordinated, efficient care through the Patient Centered Medical Home program operated by the National Committee for Quality Assurance. The recognized practices are Penn Family and Internal Medicine Lincoln, Penn Family and Internal Medicine Longwood, Penn Family Medicine New Garden, Penn Family Medicine Southern Chester County, Penn Family Medicine Unionville and Penn Primary Care and Integrative Medicine Whiteland. The Health System now features 30 practices with this designation. They include 24 CCA locations and six Clinical Practices of the University of Pennsylvania. “These practices serve communities throughout the region by continuously utilizing information technology and other collaborative efforts to put patient care first,” said Charles Orellana, MD, chief medical officer of CCA.
Jason Fritz, MD
PPMC recently launched its new Dyspnea Program. Co-directed by Jason Fritz, MD, and Stephen Chrzanowski, MD, both of Clinical Medicine, the program will use a multidisciplinary approach to diagnose patients with difficult-to-explain shortness of breath or exercise limitation. Patients referred to the program will undergo a coordinated evaluation by both Fritz and Chrzanowski, using advanced diagnostic techniques to best identify the cause behind a patient’s symptoms. “Dyspnea can be very frustrating for both the patient as well as the physicians caring for them,” Chrzanowski said. “Quite often, we see patients who have been sent from doctor to doctor without getting a clear cause for their shortness of breath.” Following diagnosis, the patients will typically be returned to their primary doctor for care.
Charting the Path for PennChart When PennChart went live at Pennsylvania Hospital last October, what seemed like a quick flip of a switch to the new inpatient electronic medical records systems was actually the result of many months of planning, meetings, and trainings to ensure everyone was prepared. PAH and Chester County Hospital were the first Penn Medicine entities to transition to PennChart so they willingly shared the many lessons learned from their experiences to help HUP and Penn Presbyterian prepare to make the switch earlier this month. According to Kwon Lee, entity information officer at PAH, the team had to manage three key challenges:
1 E xperience: As the first entity to activate PennChart, PAH operational teams
did not have a working model they could use when developing clinical workflow changes. To mitigate this shortcoming, the PAH operational leads worked directly with their technical counterparts on the larger project team in order to ensure teams were getting the right experience to be ready for the go-live day.
A large number of users had to learn the new system in a relatively 2 Education:
short amount of time. Trainings were offered months in advance, with many PAH employees becoming “superusers,” meaning they were equipped to help other staff members troubleshoot in real time.
3 Enterprise Build: Operational groups worked across the UPHS enterprise to define and address various workflow issues, both within and between departments.
CEO’s CORNER Lighting is the predominant use of electricity in a garage, so we look for opportunities where practical. Watch for upgrades to Deck 2 in the next year, as well as in the Perelman Center garage. At HUP, the energy index (use per square foot) dropped 6 percent from 2015 to 2016. That’s all thanks to upgrades that include a new chiller plant, which provides more reliable and efficient cooling; new sensors in the Rhoads Building that offer better control of air flow in patient areas; and the conversion to LED lighting. With the new substation, we will now be able to monitor usage and track areas for improvement.
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In addition to sharing tip sheets with staff at HUP and PPMC, PAH invited colleagues from other Penn Medicine entities to shadow clinicians and staff so they could learn how to use the system firsthand. PAH team members were also on site on March 4 to support go-live activities, sharing their knowledge in real time as other teams manage the changeover.
“ Sharing our experiences, good or bad, is pivotal in ensuring the other entities are aware of the challenges we faced as even the best-laid plans need tweaking,” Lee said. “We at PPMC can’t be grateful enough for the lessons shared by Pennsylvania Hospital and Chester County Hospital,” said Theresa Hiltunen, PPMC entity information officer. “Because of their advice, we have a muchimproved support system for PennChart users and were able to provide additional support to departments where errors were more likely to occur to ensure the move went seamlessly.”
SYSTEMNEWS EDITORIAL STAFF: Sally Sapega, M.A. Editor
Continued from page 1. At the Perelman Center, we’re “daylight harvesting,” with sensors in the atrium turning off lights when sufficient natural light is available. At Penn Presbyterian, the Pavilion for Advanced Care also qualified for LEED certification, and PPMC leads the way in the safe disposal and recycling of waste. Staff at all the facilities are currently reviewing waste management and recycling system-wide, with an eye toward implementing changes in the next year. This massive undertaking will encompass
Alexa Creter Graphic Designer
the handling of everything from confidential paper records to batteries to fluorescent lights to biohazardous disposables. Making all this possible in a 24/7 environment devoted to excellent patient care is no small task. There is no down time, so greening must be part of our daily work lives, complementing clinical efforts and providing efficiencies that allow us to devote more resources to providing quality medicine. You’ve shown that you are more than up to the task.
ADMINISTRATION: Susan E. Phillips Senior Vice President, Public Affairs Holly Auer Corporate Director of Communications
LET US HEAR FROM YOU: 3535 Market Street, Mezzanine Philadelphia, PA 19104 phone: 215.662.4488 fax: 215.349.8312 Please feel free to share your thoughts and ideas for improving System News! E-mail the editor at sally.sapega@uphs.upenn.edu.