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medical staff

U p dat e Issue 2, 2013

St. Joseph Health Center

HMHP Establishes $1 Million Medical Student Scholarships

HMHP is creating a scholarship that will fund two years of medical school for up to five eligible medical students, $50,000 per student for each of the last two years of medical school. Students would then enter residency according to the medical education "match" system, after which they would return and establish medical practices in the Mahoning Valley, joining the staff of an HMHP facility. After 5 years of medical staff membership, the amount of the scholarship would be forgiven. "This initiative will help ensure a supply of talented medical professionals in the Valley for the future,” says Robert Shroder, CEO of Humility of Mary Health Partners. "The Mahoning Valley has experienced shortages of physicians for decades; many current area physicians are originally from the area. By funding these scholarships, HMHP is contributing to the medical education of students and bringing them back to the area to care for the community."

How it works HMHP's hospitals, St. Elizabeth Health Center and St. Joseph Health Center, have medical residency programs and are affiliated with NEOMED, LECOM, and OUHCOM for the training of medical students. The scholarship is

New Patient Care Coordination Model at HMHP Hospitals

open to medical students who graduated from a high school in Mahoning, Trumbull, and Columbiana Counties in Ohio and Lawrence and Mercer Counties in Western Pennsylvania. Students must be in the last two years of medical school at NEOMED, LECOM, or OUHCOM. Scholarship recipients will be selected based on objective criteria. Interested medical students should submit a letter of interest that highlights: • Why the applicant would like to practice in the Mahoning Valley • Their commitment to provide care consistent with the mission of HMHP • A description of academic accomplishments Applicants should also submit an undergraduate and graduate transcript, three letters of recommendation, curriculum vitae or resume, a dean’s letter, and evidence of graduation from a high school in the region. All materials should be sent to: David Gemmel, PhD Department of Medical Education St. Elizabeth Health Center 1044 Belmont Avenue Youngstown, OH 44501

A new patient care coordination model was implemented at St. Elizabeth Health Center on May 6 and will be phased in at the other two hospitals over the next several months. Through new functions and standard operating procedures, the new model allows for: • Clinical screening of patients prior to admission to make sure the appropriate patient status order (inpatient or observation) is obtained and the patient is placed in the unit that best meets their medical needs • Managing the clinical progression of the patient while in the hospital • Proactive discharge planning

The new care coordination model is: Patient-Centered – the model will ensure that information and throughput processes empower an excellent patient experience, with active patient and family engagement in managing their care and health. It will maximize evidence-based holistic outcomes and deliver optimal care in the most efficient and effective location. High Quality – the model will ensure that care across the continuum meets or exceeds top decile quality, outcome, safety, and mortality goals. Continued on page 2

New Treatment for Severe Asthma Introduced at St. Elizabeth St. Elizabeth Health Center is among the first in the United States to offer a new procedure for severe asthma patients, known as bronchial thermoplasty. The Alair® Bronchial Thermoplasty System was recently approved by the U.S. Food and Drug Administration (FDA). Patients who are 18 years and older and suffer from severe persistent asthma that is not well controlled with inhaled corticosteroids and long acting beta agonists, the current standard-of-care treatments, will be eligible for the procedure.

Timothy J. Barreiro DO, FCCP, FACOI, FACP St. Elizabeth Pulmonary Health and Research Center

“Bronchial Thermoplasty is an exciting, new advancement in the treatment of severe asthma,” says Timothy Barreiro, DO, director of the St. Elizabeth Pulmonary Health and Research Center. “It has the potential to greatly improve the quality of life for many patients suffering from constant asthma symptoms and we’re proud to offer it here at St. Elizabeth.” Millions of patients with asthma struggle to keep their disease under control. Asthma accounts for 2 million emergency room visits in the US each year. Each day, roughly 40,000 unscheduled physician office visits, 5,000 emergency room visits, and 1,000 hospitalizations occur due to asthma. The Alair® Bronchial Thermoplasty System helps patients with severe asthma gain substantially better control over their disease. Bronchial thermoplasty is performed through the working channel of a bronchoscope that is introduced through a patient’s nose or mouth, and into their lungs. The tip of the small diameter Alair® catheter is expanded to contact the walls of targeted airways. This device then delivers controlled thermal energy to the airway walls to reduce the presence of excess smooth muscle that narrows the airways in patients with asthma. The minimally invasive procedure, like many other endoscopy procedures, is done under moderate sedation, allowing the patient to return home the same day. For more information, visit or contact the St. Elizabeth Pulmonary Health and Research center at 330-480-3258. Brief Statement of Relevant Indications for Use, Contraindications, Warnings, and Adverse Events: The Alair® Bronchial Thermoplasty System is indicated for the treatment of severe persistent asthma in patients 18 years and older whose asthma is not well controlled with inhaled corticosteroids and long acting beta agonists. The Alair® System is not for use in patients with an active implantable electronic device or known sensitivity to medications used in bronchoscopy. Previously treated airways of the lung should not be retreated with the Alair® System. Patients should be stable and suitable to undergo bronchoscopy. The most common side effect of BT is an expected transient increase in the frequency and worsening of respiratory-related symptoms.


New Patient Care Coordination Model at HMHP Hospitals Continued from page 1

Agile – the model will allow quick response to changing demands and community needs for health care services to provide health benefits that meet community needs and ensure effective stewardship of limited ministry resources. Proactive – the model will allow HMHP to accurately predict and project patient demand and staffing needs to provide the right staff at the right time and place to ensure high quality care via highly reliable systems of integrated care across the continuum. The model will exhibit a workforce with cross-continuum competency that can transition between sites. Integrated – the model allows HMHP to provide high quality clinical care and documentation through standardized operational processes that ensure clinicians across the care continuum provide optimal care in the appropriate setting. It also will ensure that HMHP can generate accurate, appropriate, and compliant claims for reimbursement in a timely manner.

Pharmacy Update: 2013 Patient Safety Initiative Orders and Titration, Taper, Wean Intravenous Infusion Orders – Provide Specific Instructions for Safe Administration

Duplicate Medication Orders - please be alert to the provision of specific ADMIN INSTRUCTIONS for DUPLICATE PRN Medication therapy (such as pain therapy or nausea/vomiting therapy). i.e. Ibuprofen 600mg every 4 hour prn pain, “HEADACHE OR MILD PAIN” in ADMIN INSTRUC Oxycodone/Acetaminophen 5/325 tablet 1 tabs every 3 hrs prn pain, “MODERATE PAIN” in ADMIN INSTRUC Oxycodone/Acetaminophen 5/325 tablet 2 tabs every 3 hours prn pain, “SEVERE PAIN” in ADMIN INSTRUC Titration, Taper, Weaning or Intravenous Infusions - please provide specific ADMIN INSTRUCTIONS with parameters to guide nurses in rate adjustments. i.e. norepinephrine (Levophed) titration order – norepinephrine 16mg/250ml start at 12mcg/min, titrate every 10 minutes, “KEEP MAP > 65” in ADMIN INSTRUC.

HMHP Care Network: Enhancing Quality, Reducing Cost

State of the Art Cosmetic Laser Technology at HMHP

The newest member of the HMHP family is HMHP Care Network, a clinically integrated organization. The purpose of the entity is to enhance quality and reduce the cost of health care. HMHP Care Network is a physician led organization that enables physicians and the HMHP hospitals to collaborate and share accountability to create better health outcomes for the community. The network includes employed and independent physicians who collectively commit to holding one another accountable for best practices to achieve quality and efficiency goals. HMHP Care Network is a physician-driven and physician-led network. The board of managers includes eight physicians: Dr. John Baker, chair Dr. Bryan Veynovich, vice chair Dr. Hiba Abdel-Aziz, secretary Dr. Albert J. Cook II Dr. Jared Bunevich Dr. Chander Kohli Dr. Howard Dickey-White Dr. Ned Underwood.

Dr. Adam D. Cash is proud to announce cutting-edge Sciton® Laser technology in the division of Plastic and Reconstructive Surgery at HMHP. This state of the art instrument introduces exciting new capabilities in facial and body rejuvenation. Facial aging occurs with the passage of time and effects of gravity. It is exhibited on the face through loss of fullness specifically in the cheek area, loss of skin glow with increase in red and brown pigment to the skin, as well as both deep and fine wrinkles. Our combination of Laser procedures can help diminish these signs, and are significantly more affordable than surgery with little or no downtime.

Bob Shroder, Dr. Nick Kreatsoulas and Paul Olivier are board members representing HMHP. Physicians who apply to join HMHP Care Network agree to adhere to physician-developed standards to improve quality and efficiency. This will allow HMHP Care Network to contract collectively. It will be able to negotiate with commercial payers and local, self-insured employers for improvement in reimbursement based on the ability to achieve quality benchmarks.

Daniel Fitzpatrick, DO Returns to the Wound Care Center Dr. Daniel Fitzpatrick is returning to St. Joseph Wound Care Center. Upon his return, he will assume the role of Medical Director for St. Joseph Wound Care Center and Hyperbaric Medicine. Dr. Fitzpatrick will be seeing patients in the center on Thursdays.

Adam D. Cash, MD Plastic and Reconstructive Surgery

MicroLaserPeel TM

With the introduction of our Erbium YAG Ablative Laser as well as BroadBand Light wavelengths, women and men of all ages can improve appearance and turn back the hands of time. The Sciton Joule Laser platform can effectively improve any of the following conditions: • Tighten fine lines and wrinkles of the face • Improve facial fullness • Vertical lines around the mouth • Facial scars caused by injury or accident • Scars caused by acne • Areas of uneven pigmentation, such as age spots • Lines on the cheeks caused by sun damage • Vascular lesions/Rosacea • Acne Patients are treated in the office with minimal pain and without the need for a trip to the operating room. Recovery generally occurs over a long weekend. To learn more visit Dr. Cash can help choose a treatment plan best for each individual in a private consultation at either his Howland or Boardman location. Howland 1950 Niles-Cortland Rd., NE Suite 9 Warren, OH 44484 Phone: 330-856-2545

Boardman Medical Pavilion 8423 Market Str. Suite 205 Boardman, OH 44512 Phone: 330-729-3128


Applause! Statewide Recognition Congratulations to Theresa Sheridan, DO, 3rd year Family Medicine Resident at St. Joseph Health Center. Dr. Sheridan's paper on the Autism Spectrum placed third in the Ohio State Society of the American College of Osteopathic Family Physicians (Ohio ACOFP)/CORE FP-RPAC paper competition. This is the third year in a row that a St. Joseph Resident has placed in the top three.

Resident of the Year Kim Jackson, DO, second year Family Medicine Resident from St. Joseph Health Center, was named 2013 Ohio ACOFP Family Medicine Resident of the year. This award recognizes a FM resident in an AOA-approved Ohio program who exhibits exemplary characteristics of an osteopathic family physician. These include compassion, leadership, and demonstrated commitment to osteopathic philosophy, patient care, community involvement and education.

Research on the National Stage Congratulations to the following residents and their physician advisors who will be presenting research at national conferences this year: National American College of Physicians, San Franciso, CA • Farhad Fakhrejahani, Radiation Exposure from Diagnostic Procedures in Allogeneic Stem Cell Transplantation – How Much is Acceptable? • Christian Ghattas, Cherry Valino, Tim Barreiro, Iatrogenic Tracheal Stenosis Presenting as Peristent Asthma (selected for presentation but not presented due to notification of acceptance in peer-reviewed journal before meeting) American Thoracic Society, San Diego, CA • Christian Ghattas, Amit Arbune, Basem Yacoub, Digvijay Singh, Inadequate Evaluation of Lung Volume Reduction Surgery Candidates • Christian Ghattas, A Dai, David Gemmel, Misdiagnosis and Mistreatment of Chronic Obstructive Pulmonary Disease in an Underserved Population • Christian Ghattas, Unique Radiologic Findings in Erionite Comparing to Asbestos Related Malignant Pleural Mesothelioma American Federation for Medical Research, San Francisco, CA • Rodjawan Supakul, Trends in Alcoholic Hepatitis Related Hospitalizations, Cost, and Mortality in the United States: 2002-2007

Core Measures of Quality: March 2013 Heart Failure















AMI St. Elizabeth St. Elizabeth Boardman St. Joseph

Medical Staff Update and Board Approvals available online at x

Speech Pathologists Certified in Swallow Evaluations One of the most critical roles of a Speech/Language Pathologist (SLP) is making decisions from a swallowing assessment about the ability to continue to eat and drink. The optimal swallowing assessment requires recognizing subtle variations in the physiologic components and events that comprise an intact, healthy swallow mechanism. The MBSImp is an evidence-based, standardization of the Modified Barium Swallow Study (MBSS) in adults. It assesses 17 critical components of swallowing and provides an objective profile of the physiologic impairment affecting adult swallowing function. Technicians base their recommendations for eating on the MBS results. Kimberly Marchetto, MS, CCC/SLP (SEHC, Acute Rehab) and Lisa Yanak, MS, CCC SLP (SJHC) recently received their MBSImp Registered Clinician Certification. Kimberly and Lisa share this distinction with 15 SLPs in the state of Ohio and just 540 SLPs worldwide.

Surgery Update St. Joseph Surgical Services welcomes Dr. Parisa Khavari. The Ohio State University College of Medicine graduate is Obstetrics and Gynecology board certified and is currently performing robotic-assisted procedure at St. Joseph. She has special expertise in disorders of the female lower genital tract and female lower genital tract diseases. St. Joseph Robotic Surgical Services celebrated its one- year anniversary in April. Over 250 robotic procedures have been performed since the program’s start. Today, gynecological as well as general and bariatric procedures are being performed robotically. Highlights of the first year include upgrading to the SI Model of the daVinci robot as well as Dr. Woodruff performing the first single site robotic procedure in the area. Surgeons currently performing robotic procedures are Drs. Amine Abdul-Aal, Emad Baky, Anthony DeSalvo, Parisa Khavari, Paresh Mehta, Mohammad Rashid, Tara Shipman and Robert Woodruff.

Med Staff Update - St. Joseph Health Center  
Med Staff Update - St. Joseph Health Center