Physician Communication Packet March 2014
PHYSICIAN COMMUNICATION FOLDER
What’s Inside: 3
Stroke & Cerebrovascular Center at Baptist Medical Center Jacksonville
Physician Introduction - Ricardo A. Hanel, MD, PhD and Eric Sauvageau, MD
4 Baptist Health Transfer Center 6
Updated Bylaws and Rules & Regulations for All Facilitates
Emergency and Urgent Consultations
Large Volume Shortage Mitigation Plans
Baptist Endocrinology - Leslie “Brandi” Salomone, MD has moved
Pastoral Care Conference Save the Date
Premier Open MRI Oasis
Link - March 2014
Baptist Briefs Link - February 2014
Meet Doctors Hanel and Sauvageau Stroke & Cerebrovascular Center at Baptist Medical Center Jacksonville
Ricardo A. Hanel, MD, PhD and Eric Sauvageau, MD, have joined Baptist Health and Lyerly Neurosurgery to lead the new Stroke & Cerebrovascular Center at Baptist Medical Center Jacksonville. Highly trained cerebrovascular neurosurgeons, Dr. Hanel comes from Mayo Clinic Jacksonville and Dr. Sauvageau from Ohio State University Neurosurgery. They treat all neurovascular conditions, including strokes, cerebral aneurysms, brain tumors and brain arteriovenous malformations (AVMs). Doctors Hanel and Sauvageau have unique endovascular fellowship training from State University of New York at Buffalo and Neurovascular and Skull Base training at Barrow Neurological Institute. They specialize in ground-breaking minimally invasive procedures to treat aneurysms, including flow diverter technology, stenting and coiling, as well as more traditional methods, such as clipping and bypasses. Their philosophy of care focuses on the team approach to ensure easy access to care and optimal patient outcomes. Ricardo A. Hanel, MD, PhD n
Eric Sauvageau, MD
Medical degree from Universidade Federal
Do Parana in Brazil n
Sherbrooke in Quebec
PhD from combined program of
Universidade Federal Do Parana and State
n Endovascular n Skull
Clinical Fellowship from SUNY at Buffalo
Base and Cerebrovascular Clinical Fellowship from
the Barrow Neurological Institute
Office location: Lyerly Neurosurgery 800 Prudential Drive Weaver Tower, 11th Floor Jacksonville, FL 32207 Appointments: 904.448.3416 Emergencies: 904.202.brain (2724)
Endovascular Clinical Fellowship from State University of New York at Buffalo
in Neurosurgery from Hospital Nossa Senhora
das Gracas in Brazil
Residency in Neurosurgery from the University of Montreal
University of New York (SUNY) at Buffalo n Residency
Medical degree from the University of
Base and Cerebrovascular Clinical Fellowship from the
Barrow Neurological Institute in Phoenix, AZ
Baptist Health Transfer Center Stroke & Cerebrovascular Transfers Effective March 17, Baptist Health’s new, system-wide Stroke & Cerebrovascular Transfer Center will serve as the single point of contact, providing a streamlined process for connecting physicians and coordinating the transfer of stroke and cerebrovascular patients to, from and between any of Baptist’s hospitals and Wolfson Children’s Hospital. It is available: n
24 hours a day
7 days a week
365 days a year.
This new Transfer Center is designed to enhance our timeliness and quality of care. Currently, the Transfer Center is set up for stroke and cerebrovascular transfers only. In the near future, this service will expand to include all service lines, with the exception of behavioral health. This will be rolled out in phases and communication will be sent in advance to all referring hospitals and physicians in the region. What will the Stroke & Cerebrovascular Transfer Center do for stroke patients? Now, emergent patients requiring stroke and cerebrovascular treatments can be transferred into Baptist Medical Center Jacksonville with just one phone call. Physicians call 904.202.BRAIN (2724) for 24/7 contact with an experienced transfer coordinator who will handle the complete transfer process including: n
consultation with the accepting physician specialists
arranging for a patient bed
communicating with nursing
arranging for patient transport (ground or air)
and all other transfer needs.
The goal is to ensure timeliness, quality and continuity of care for the patient. If for some reason there is a delay, the center keeps all parties informed every step of the way.
Stroke & Cerebrovascular Transfer Center FAQs Q.
When should 904.202.BRAIN (2724) be called?
Generally, if the patient has an NIH score greater than 8, the Stroke & Cerebrovascular Transfer Center should be called. Otherwise, consult Neurology who will evaluate the patient prior to calling the Transfer Center.
How will the Transfer Center process work?
Once a physician places a call to 904.202.BRAIN (2724), an experienced transfer coordinator will immediately work to conference in the on-call endovascular neurosurgeon at BMCJ. The transfer coordinator will remain on the line while the physicians speak.
Once an agreement has been reached about accepting the patient, the Transfer Center will begin coordinating transportation, activate a “code stroke” at BMCJ, notify the OR desk to call in the appropriate team, connect the referring physician to an Emergency physician, and place a bed request with the house supervisor. Once a bed has been assigned, the Transfer Center will then connect the nurse at the referring facility to the nurse at BMCJ to give report. Finally, once the patient has arrived, the Transfer Center will notify the referring physician that the patient has arrived.
Q. Why does Baptist Health need a Transfer Center for stroke? A. Patients experiencing a stroke are time-critical. No time should be lost trying to contact a physician through an answering service. Having an easy-to-remember phone number and streamlined, single process helps to ensure the patient can be provided the necessary care as soon as possible.
A physician can call 904.202.BRAIN (2724) anytime and from anywhere, even from non-Baptist Health facilities, so having a centralized number helps to get patients to the care they need sooner.
When will non-stroke transfers be handled through the new Transfer Center?
There is not yet a specified go-live date for expansion of the Transfer Center service beyond stroke; protocols must be established and those will take time to develop and test. When the overall Baptist Health Transfer Center is rolled out, it will have a single, easy-to-remember toll-free number that will be used for all adult transfers. Wolfson Children’s Hospital will keep their current transfer number, but just have it routed to our new centralized Transfer Center.
March 5, 2014
All Medical Staff
Keith L. Stein, MD, FCCM, FCCP Chief Medical Officer
Updated Bylaws and Rules & Regulations for All Facilities
For your reference, the updated Professional Staff Bylaws and Rules & Regulations for the above campuses have been placed on the Physician Portal found at www.e-baptisthealth.com and on the home page of the Baptist Health intranet. The following sections of the Bylaws and Rules & Regulations below have been updated. Should you have any questions, please contact my office at (904) 202-2938.
BMCJ/BMCS/WCH Section Reference 07.2 Orders R&R Responsible physician must authenticate admission Orders;Drugs;Treatment
orders (whether to inpatient or observation status) within 24 hours of admission Clinical Students Physician supervising students must follow the hospital policy for student guidelines. Pediatric Behavioral Health Patient management in the pediatric behavioral health unit. Requirements Patient management in the adult behavioral health unit. Medical Staff Governance Removal of officers by the Active Staff Department Chairman Resignation and removal of Chair Department Vice Chairman Resignation and removal of Vice Chair Section Chief Resignation and removal of Chief Independent Service Chief Resignation and removal of Chief
Department of Psychiatry Bylaws
R&R General Conduct of Care
NASSAU R&R General Conduct of Care
Orders Responsible physician must authenticate admission orders (whether to inpatient or observation status) within 24 hours of admission Section Reference
Orders Responsible physician must authenticate admission orders (whether to inpatient or observation status) within 24 hours of admission
Physician Members of the Medical Staffs
From: Keith L. Stein MD, FCCM, FCCP
Chief Medical Officer, Baptist Health
Emergency and Urgent Consultations
Please be reminded that, in the interest of patient safety (which is often driven by effective communication) and consistent with our Rules and Regulations, emergency (stat) and urgent consult requests require the ordering physician to directly contact the receiving physician. Note that, to facilitate this direct communication, physician cell phone numbers are available on the password protected side of the Baptist Health physician portal. The language from the Rules and Regulations is: “CONSULTATION” Routine The attending physician may request a consultation with a qualified staff physician by placing an appropriate order in the patient’s chart and indicating the purpose for the consultation. It is preferable, but not required, that the attending physician personally contacts the consultant. If the attending does not specify a consultant by name, the physician on-‐call for that specialty for the Emergency Room shall be called and is expected to respond. Routine consultations shall be performed within twenty-‐four (24) hours. Emergency Should the attending physician determine that a consultation must be obtained without delay, it shall be his responsibility to speak with the consultant personally and shall place an appropriate order in the patient’s medical record. Urgent Should the attending physician determine that a consultation must be obtained urgently; it shall be his responsibility to speak with the consultant personally and place an appropriate order in the patient’s medical record. Urgent consultations shall be performed within six (6) hours unless the physicians mutually agree that the consult can be performed as a routine one.” Please do not hesitate to contact the Medical Staff Office at 202-‐1117 with any questions.
March 19, 2014
Baptist Health Physicians & Providers
Kristin Certain, PharmD, Pharmacy Operations Manager, BMCJ/WCH
Large Volume Shortage Mitigation Plan: NS, LR, D5W
There is an industry-wide shortage of large volume fluids. The fluids most affected are NS, LR and D5W. All large volume fluid manufacturers, Baxter, BBraun and Hospira, are affected. Recovery is ongoing but large volume fluid shortages are expected to continue for the next several months. These recommendations do NOT apply to compounded bags prepared by Pharmacy. Recommendation 1: Use oral hydration whenever possible. Recommendation 2: Use smaller bag sizes for low rate infusions in outpatient settings if possible. ! OR/Procedural areas/ Emergency Department: For shorter procedures or those with low infusion rates (42 mL/hr or less) hang 500 mL bags rather than 1000 mL bags. Recommendation 3: Consider using alternative fluids. ! At this time, ½ NS and D5 ½ NS and D5NS are available in the supply chain. ½ NS is the most readily available of these fluid options. Recommendation 4: Infuse bags until empty. ! There is no nationally accepted length of hang time for most IV fluids. The Center for Disease Control and Prevention (CDC) Guidelines for the Prevention of Intravascular Catheter-Related Infections, 2011 provides some information concerning replacement of IV administration sets, but has no recommendations on the hang time for the majority of IV fluids. ! Per Baptist policy 7.01.04 tubing should be changed every 96 hours (except for those drugs which require every 24 hour tubing changes—ex. lipids & TPN—see policy No. 7.01.04 Section: Patient Care Subject: CENTRAL VENOUS ACCESS DEVICES (CVAD) for exceptions list). ! To preserve current supply, NS, LR and D5W fluid bags (without additives) should be infused until empty. Tubing is to be changed every 96 hours as per Baptist policy. Recommendation 5: Discontinue IV fluids as soon as possible. SAFETY Compounding sodium chloride solutions from sterile water for injection and concentrated sodium chloride injection is a last resort. Per ISMP this practice could lead to medication errors and inadvertent administration of plain sterile water. In addition this could contribute to current shortages of concentrated sodium chloride (23.4% or 14.6%).
Dr. Salomone is moving to Baptist South Endocrinologist, Baptist Endocrinology Dr. Leslie “Brandi” Salomone is excited to join Dr. Alan Cleland, Dr. Rosalyn Crawford, Dr. Wasim Deeb and Dr. Brijmohan Sarabu at Baptist Endocrinology located on campus at Baptist Medical Center South. Dr. Salomone completed her fellowship in Endocrinology and Metabolism at the University of Virginia. She earned her medical degree at the University of Louisville and completed her residency in Internal Medicine at Wake Forest University. Dr. Salomone also co-writes “The Thyroid” chapter of the Sabiston Textbook of Surgery. Dr. Salomone has 7 years of experience in Endocrinology practice, with special interest in: • Type 1 and type 2 diabetes • Thyroid dysfunction and cancer • Menopause and hypogonadism • P olycystic ovarian disease, osteoporosis, adrenal and pituitary disorders Baptist Endocrinology (located on the campus of Baptist South)
14540 Old St. Augustine Rd. Suite 2471 Jacksonville, FL 32258
904.880.9696 For patients preferring to see a physician in the Mandarin area, Melissa Morgan, MD, and Stacey Kelly, ARNP-BC, will continue to provide endocrinology services at the Baptist Endocrinology Mandarin Office located at: 11945 San Jose Blvd, Suite 301, Jacksonville, FL 32223 904.260.9699
DAT E :
May 2, 2014 University of North Florida, Adam W. Herbert University Center
The Way to Wellness: Coping with Mental Illness and Trauma through Pastoral and Psychological Counseling Baptist Health invites you to hear from experts in the fields of pastoral care and behavioral health on topics from domestic violence to faith struggles. The conference will feature speakers who will challenge caregivers to fully hear and respond to the voices of human struggle and suffering on the journey toward health and healing. Keynote Speaker Pamela Cooper-White, PhD, Professor of Pastoral Theology, Care and Counseling at Columbia Theological Seminary Register here: waytowellness.eventbrite.com
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