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A Satellite Campus of Tulane University School of Medicine

VIS1ON – page #

A Publication for BRG Medical Staff Fall 2013

Hit the Ground Running Mark F. Slyter, President and CEO with Evelyn K. Hayes, MD

What’s Inside EMR Upgrade

3

Strategic Direction

4

Heart & Vascular Updates

6

Mid City Moving Forward

8

Driving Quality

12

A Satellite Campus of Tulane University School of Medicine


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A Satellite Campus of Tulane University School of Medicine

A Message From Mark F. Slyter, FACHE President and CEO

Baton Rouge General has a longstanding legacy of leadership in quality, innovation and compassionate caregiving in this community. In an ever-changing healthcare environment, we are poised for continued success and I am extremely proud to have the opportunity to lead our organization into the future. Uniquely positioned to respond to the evolving needs of the communities we serve, both campuses are experiencing tremendous momentum. While we face challenges as healthcare resources in our communities shift, Baton Rouge General stands together with all providers, in finding responsible solutions to ensure patients have access to quality care. We are achieving gains in patient satisfaction and driving accountability at every level and in every aspect of patient care through our evidence-based leadership development initiative. Our quality improvement platform

is cultivating a strong culture of transparency across our organization and I am excited to continue to build upon our solid foundation of quality, safety, teamwork and excellence. Through these efforts and with data-driven action plans based on our medical staff survey results, we are focused on strengthening collaboration among physicians, staff and leadership, enhancing operational efficiencies, and engaging physicians in process and quality improvements to make our hospital a better place for physicians to practice. I look forward to working closely with our valued medical staff members as we continue to raise Baton Rouge General to the next level. Thank you for your commitment to our patients and community. (Left to right) Mark Slyter with Dr. Eugene Berry during a recent meet-and-greet with medical staff members.

Sincerely,

Mark F. Slyter, FACHE President & CEO

A Message From Evelyn Hayes, MD With the strength of our dedicated medical staff members, compassionate team of nurses, clinicians and employees, Baton Rouge General is a thriving organization. During the past year, we have experienced unprecedented growth and development and paved the way for continued achievements in quality, patient satisfaction, technology and expansion of services in 2014. Baton Rouge General is on the leading-edge when it comes to implementing the most highly reliable best practices and standards to provide the safest, quality care for patients, and with the leadership of our physicians we continue to excel when it comes to clinical excellence and quality performance. Our team has achieved remarkable clinical

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successes – most recently, earning top ratings by CareChex, referred to as the most comprehensive site for rating hospital care: • #1 in the Region and Top 100 Hospital in the Nation for Overall Medical Care •#1 in the State for Heart Failure • #1 in the Region for Heart Attack We have the very best team, our future is bright, and we will continue on a path of exciting momentum. It has been my honor to lead this organization over the last seven months. I look forward to continuing my service as part of the Board of Trustees leadership and working with Mark. Sincerely,

Evelyn K. Hayes, MD


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A Satellite Campus of Tulane University School of Medicine

Driving Physician Satisfaction Feedback to Follow Through

Physician-Guided EMR Upgrade

Each and every physician response from our annual medical staff survey received critical evaluation, and with your feedback we have actionable information that is helping us enhance our hospital efficiencies, services and facilities to meet your needs and provide exceptional care for your patients. Under the guidance of a physicianled steering committee, multi-disciplinary work groups are putting plans into action around three important focus areas:

Results from our medical staff survey demonstrated the importance of a system with CPOE capabilities that effectively enhance patient care. With this in mind, physicians and key clinical stakeholders in collaboration with IT have led Baton Rouge General’s development of a patient-centered, clinically sound EMR system. As the February launch of the upgraded McKesson Paragon IT system approaches, steps are in place to help prepare physicians and other clinical staff for the transition.

• Subspecialty access • Communication • EMR system/Computerized Physician Order Entry (CPOE) efficacy Improving comfort, amenities and convenience is an important part of physicians’ experience in our hospital. Recent enhancements have been made to improve nutrition options and redesign the space at the Mid City physicians lounge. Additionally, renovations are in progress for the second floor OR physicians lounge at the Bluebonnet campus to enhance accommodations that will include private dictation areas and new furniture. Over the coming months, we will work closely with medical staff to continue to gain input and implement enhancements with the goal of making Baton Rouge General the hospital of choice for physicians to practice.

Baton Rouge General’s Medical Informatics team will facilitate both faceto-face and online training opportunities beginning in November that will continue up to the February go live date. In addition, technical support team members from Paragon will be present on the units throughout the hospital to provide prompt, real-time support for physicians and clinical staff and will work in collaboration with Baton Rouge General’s IT staff to provide support during the February rollout of the new system. “As a physician member of the clinical advisory team, we’ve brought together a multi-disciplinary team of physicians, nurses, clinicians and IT experts to create a seamless, accessible medical record system that fits into physicians’ workflow to increase efficiency and enhance quality and patient safety,” said Dr. Tonya Jagneaux, critical care and pulmonary care specialist.

New Paragon system enhancements include:

• P atient information viewable across the continuum of care to provide a complete picture of the patient’s medical story • S treamlined dashboard that features a guided process for order entry and medication reconciliation that fits into physician work flow

Contact Baton Rouge General’s Medical Informatics Physician Liaison at (225) 819-1070 for questions and support.


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A Satellite Campus of Tulane University School of Medicine

Poised for the Future

To thrive in a constantly evolving healthcare landscape, providers must be agile and innovative – staying one step ahead while remaining true to a foundation that is patient-centered and qualitydriven. With two unique campuses and more than a century long legacy of excellence and compassionate caregiving, Baton Rouge General is well-positioned for an ever-changing healthcare future. The General’s vision for the road ahead remains focused on a strategy

that embraces change as opportunities to innovate in response to the progressive needs of the community around it. As Baton Rouge General’s strategic plans move forward, alignment with integrated and independent medical staff and expansion of quality primary care, investing in specialty care enhancements and leading accountable care concepts remain key to the hospital’s vision.

BLUEBONNET

MID CITY

Specialty Service Focus

Community Focus

Regional leader in high quality, innovative specialty services: • Cardiovascular • Cancer • Specialty areas, including Neurosurgery and Obstetrics

Expansion of medical education and training: • Tulane University School of Medicine Satellite campus • Family and Internal Medicine Residency Programs • Sports Medicine Fellowship Program • PharmD Program in partnership with the University of Louisiana-Monroe • School of Nursing • School of Radiologic Technology • Other training programs, including CRNA, PA and NA

Facility expansion and enhancement: • New medical technologies • Hybrid surgical suite • Heart and Vascular Tower • State-of-the-art medical office building • Patient tower expansion

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Expansion of specialized clinical programs and services to serve the community’s needs: • Burn • Primary care • Complex wound care • Imaging • Women’s health services • Senior care and wellness • Emergency care • Behavioral health • Rehab • Skilled care


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A Satellite Campus of Tulane University School of Medicine

GI Service Expansion With the recent expansion of its gastroenterology specialists and the opening of the new Gastroenterology Center, Baton Rouge General and private physicians network Baton Rouge General Physicians is enhancing its comprehensive gastroenterology and digestive health program. Led by Baton Rouge General Physicians’ gastroenterology specialists Drs. Shaban Faruqui, Paul McNeely, Oleana Lamendola, Alan Sonsky and pediatric gastroenterologist Dr. Elizabeth Alonso-

Most recently, gastroenterologist Dr. Oleana Lamendola joined the Baton Rouge General Physicians Gastroenterology group at the Center.

Rubiano, the Gastroenterology Center brings together seasoned GI and digestive health expertise, leading edge technology and comprehensive GI services all under one roof. The Center provides a convenient outpatient location near the Bluebonnet campus to serve patients’ GI and digestive health needs within the hospital’s comprehensive care community.

Ahead of the Curve Innovative Care for Patients

Across the country, providers and payors are looking toward enhancing the quality and value of healthcare for patients. Baton Rouge General and its physician network are paving the way for adaptability and innovation with patient-centered care concepts that are making important strides toward improving the overall quality of healthcare in our state and also reducing costs. Recognizing that improving the health of our state starts with primary care and prevention, Baton Rouge General Physicians’ network embarked on a patientcentered medical home pilot with BlueCross BlueShield (BCBS) that has given way to Quality Blue Primary Care (QBPC), a new population health and quality improvement program. QBPC is designed to get better outcomes for patients with chronic diseases, support doctors and transform healthcare delivery, and is being rolled out in primary care physicians’ offices and clinics statewide over two to three years. Baton Rouge General Physicians is among the first providers in Louisiana to participate. “The Quality Blue Primary Care program is an important step toward enhancing patient care, improving the overall quality of healthcare in our state and also reducing costs,” said Brad Gaspard, MD, family medicine physician with Baton Rouge General Physicians.” Brad Gaspard, MD, Family Medicine, Baton Rouge General Physicians


A Satellite Campus of Tulane University School of Medicine

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Heart & Vascular Updates

Regional Destination for Vascular Training Cardiovascular specialists and vascular surgeons from the mid west and across Louisiana and the southeast have visited Baton Rouge General in recent months to attend an advanced training course in Chronic Total Occlusions (CTO) and techniques for crossing completely blocked peripheral arteries. Led by vascular surgeon Dr. Glen Schwartzberg, the specialized training course is held in the General’s state-of-the-art hybrid operating suite in the heart and vascular tower. Drawing physicians from across the country, the newly designed CTO course provides surgeons and specialists the opportunity to receive clinical and technical training in minimally-invasive procedures through a preceptorship in the clinical environment. Baton Rouge General is currently one of 12 sites in the U.S. to offer the course which is facilitated through a clinical education collaborative with Covidien’s advanced training program. “As an experienced physician in treating PAD, I’m always interested in gaining additional insight and this CTO course was a great opportunity to be able to enhance my own expertise,” said Dr. Dwight Dishmon, an interventional cardiologist in Memphis, Tennessee. “The spacious environment and versatility

of imaging modalities in the hybrid operating room here at Baton Rouge General is the most impressive I’ve seen – it provides the optimal operating experience for physicians.” Dr. Maher Nahlawi, an interventional cardiologist whose practice is based outside of Chicago, Illinois, also attended the course and added, “This CTO course provides a valuable opportunity to observe a colleague’s approach to complex below the knee interventional cases and the hospital’s top notch hybrid room enhanced the training experience.” Through the two-day course, physicians observe between four and five cases involving endovascular interventional procedures during which the vascular surgeon employs a variety of atherectomy techniques and technologies for crossing complete blockages in patients with Peripheral Artery Disease (PAD). Additional CTO training opportunities at Baton Rouge General will be available for physicians. If you are interested in participating, contact Naomi Nelson, Director, Cardiovascular Service, at (225) 763-4255 or Naomi.Nelson@BRGeneral.org.

Five-Star

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Baton Rouge General recipient of rating for treatment of Heart Failure and Stroke by Healthgrades -2014


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A Satellite Campus of Tulane University School of Medicine

Clinical Trial Examines Stroke Prevention Device A new clinical trial studying the safety and effectiveness of the RX Acculink Carotid Stent System is underway at Baton Rouge General. The CANOPY (Carotid Artery Stenting Outcomes in the Standard Risk Population for Carotid Endarterectomy) trial will assess the continued use of the RX Acculink system in patients at standard risk for adverse events from Carotid Endarterectomy (CEA), a surgical procedure to prevent stroke in which the surgeon corrects a narrowing in the carotid artery with a stent instead of a more invasive surgery. Men and women age 18 and older with at least 50 percent stenosis of the common or internal carotid artery are eligible to participate. Vascular surgeons Andrew Olinde, MD and Victor Tran, MD will serve as Sub-Principal Investigators to the trial’s Principal Investigator, Albert Sam, MD.

For more information about clinical trials at Baton Rouge General, visit BRGeneral. org/clinicaltrials or contact the Clinical Trials Office manager Kristi Rau at krau@ guidestarclinical.com or (504) 799-4400 ext. 4424.

Victor Tran, MD, Vascular Surgeon, with Andrew Olinde, MD, Chief of Staff, Baton Rouge General

Cardiology Presence Expands Interventional cardiologist Lance LaMotte, MD, FACC, and invasive cardiologist Nakia Newsome, MD, recently joined Baton Rouge Cardiology Center’s (BRCC) physician practice location in Baton Rouge General’s Heart and Vascular Tower on the Bluebonnet campus. Joining BRCC physicians Drs. Darrin Breaux, Evens Rodney, Venkat Surakanti and Brian Swirsky at the practice location, Baton Rouge General welcomes Drs. LaMotte and Newsome to its campus community. With the recent multi-million dollar expansion of its heart and vascular services and its growing community of heart, vascular and

cardiothoracic physician tenants, Baton Rouge General brings together comprehensive heart and vascular services all under one roof. The General’s heart and vascular enhancements include an expanded surgical space equipped with an innovative hybrid OR build-out. Compared to traditional surgery space, the General’s hybrid room uniquely allows for the simultaneous IT integration of sophisticated diagnostic technologies, precise imaging capabilities and multiple surgical therapies – with the goal of maximizing treatment options for cardiac and vascular procedures.

Located in Baton Rouge General’s Heart and Vascular Tower on its Bluebonnet campus, physician tenants with Baton Rouge Cardiology Center are pictured left to right: Drs. Darrin Breaux, Evens Rodney, Nakia Newsome, Baton Rouge General Cardiology Service Chief Venkat Surakanti, Lance LaMotte and Brian Swirsky.

New Treatment Option for Blood Clots More than 600,000 pulmonary embolism (PE) cases occur in the U.S. each year, 40 percent of which are sub-classified as intermediate Paul Perkowski, MD, Vascular Surgery Chief, risk or submassive Baton Rouge General PE. Patients with submassive PE have a major clot in one or both pulmonary arteries, which interferes with the heart’s ability to pump blood into the lungs for oxygenation, causing enlargement of the right side of the heart. Not removing the clot may result in permanent pulmonary hypertension, right heart failure or even death. A new endovascular catheter system called EkoSonic (EKOS), in conjunction with anticoagulation therapy, can now help safely dissolve clots in addition to preventing the formation of further clots. The EKOS catheter was recently cleared by the FDA for placement into the pulmonary arteries for infusion of physician specified fluids (including clot dissolving drugs). The EKOS catheter uses ultrasound technology to penetrate deep into the clot, making it porus and allowing for targeted delivery of the clot dissolving drug – resulting in a quicker, less systemic effect. Traditional treatment of PE involves intravenous and oral anticoagulation and hospitalization. A significant number of massive and submassive PE patients go on to require major cardiopulmonary surgery. Results from a clinical trial showed a 23 percent average 24-hour improvement in right heart dysfunction among the patients treated with the endovascular catheter system, as measured using the RV/LV ratio heart parameter, compared to a 3 percent average improvement in patients treated with anticoagulation therapy alone.* “It is exciting to now have expanded treatment options available for treating submassive PE with fewer side effects,” said vascular surgeon and Chief of Vascular Surgery with Baton Rouge General Dr. Paul Perkowski, who has been using the technology and seen firsthand its benefits for treatment of PE. “With this innovative endovascular treatment, we can help improve outcomes for many patients who have suffered a submassive PE.” *ULTIMA trial results, level 1 data


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A Satellite Campus of Tulane University School of Medicine

Mid City

Moving Forward Making an Impact Medical education in Baton Rouge is growing and Baton Rouge General’s academic footprint does more than boost medical manpower. It also strengthens our communities and supports the local and state economy. Without a doubt, the skilled physicians graduating from Baton Rouge General’s medical education programs are ensuring access to high quality healthcare, but they are also supporting viable communities across our state through ancillary jobs and allied industry, and creating an economic halo that helps sustain local businesses. As the satellite campus of Tulane University School of Medicine, Baton Rouge General trains students during their fourth and fifth years of medical school through the Baton Rouge LEAD (Leadership, Education, Advocacy and Discovery) Academy. The program provides exceptional clinical training and, what’s more, instills leadership skills and quality improvement principles to develop future physician champions that advance the practice of medicine. To date, the LEAD Academy has graduated 19 Tulane students, 8 of which are continuing their residency training here in Louisiana. An accredited teaching hospital since 1991, the General’s School of Nursing, School of Radiologic Technology, Sports Medicine Fellowship Program and ULM School of Pharmacy are also based on the Mid City campus. Through training and education, Baton Rouge General trains approximately 500 medical students, residents, fellows, nurses, pharmacists, physician assistants, nurse practitioners, certified registered nurse anesthetists, and radiation technologists.

Baton Rouge General trains more than 300 residents and medical students, including Tulane LEAD students, each year. The economic impact of Baton Rouge General’s physician residents upon graduation is over $63 million and 252 full-time jobs annually.* *Source: The Economic Impact of Baton Rouge General’s Mid City Campus, Tripp Umbach, 2012

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Family Medicine Residents Class of 2016

Seated (L to R): Michelle Duhe, MD; Jennifer Winchester, MD; Smita Prasad, MD; Sunitha Korapati, MD. Standing (L to R): Daniel McMahon, MD; Shawn Skarpnes, MD; Bryan Picou, Jr., MD; Zachary Pray, MD

Internal Medicine Residents Class of 2016

Seated (L to R): Shravani Surakanti, MD; Ania Kosztowski, MD; Sarah Robichaux, MD; Charmi Patel, MD. Standing (L to R): John Thornton, MD; Ryan Leonards, MD; Christopher Hodnette, MD; Ramsy Abdelghani, MD; Hiren Patel, MD

Tulane University School of Medicine Baton Rouge LEAD Academy Class of 2015

Pictured (L to R): Alma Sanchez; Maggie Black; Esther Joo; Kevin Kirschman; Leigh Anna Robinson; Cameron McGuire; Layla Abushamat; Ashraf Elhofy; Elisabeth Cole; Kaitlyn Hardin; Fahad Faruqi; Trevor Rosenlof; Kevin Kammel Affiliated with Tulane University School of Medicine

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A Satellite Campus of Tulane University School of Medicine

Development and Growth While not as visible as cranes and construction equipment, Baton Rouge General’s Mid City campus has experienced tremendous growth and development of services as well as facility renovations across the campus.

Regional Burn Center Outpatient Renovation The second phase of a three-phased total renovation of Baton Rouge General’s Regional Burn Center, the outpatient area enhancements include specialized treatment rooms with enhanced lighting, tiled walls and specialized equipment for wound care, a rehabilitation gym, and family consultation room. The Burn Center provides comprehensive adult and pediatric burn treatment services to our community and the entire Gulf Coast petrochemical corridor. In addition, the Burn Center renovations also include a familyfriendly waiting area equipped with overnight accommodations including a shower as well as a designated overnight room to ensure patients and their families who travel from across the state and region receive leading-edge burn care in a comfortable environment. Through generous support from the community through Baton Rouge General’s Foundation, Phase 2 of the Burn Center renovations is now complete. As the Burn Center looks ahead to the third phase of the project, which includes enhancing the inpatient treatment facility to create a state-ofthe-art inpatient unit, the General’s Foundation will look to the community to play a critical role in supporting the completion of the vision for the Burn Center.

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Lesson learned

Seniors ER Expansion As the region’s only emergency room dedicated to the unique medical needs of seniors, the recently expanded Seniors ER features senior-friendly accommodations and importantly, senior patients also receive follow-up phone calls from nurses trained in geriatric care to ensure they transition home safely after hospitalization. In addition, all of the General’s senior programs are led by a multi-disciplinary team of physicians and nurses specially trained in geriatric care in collaboration with clinicians from related care areas, including physical therapists, pharmacists and social workers who have specialized geriatric sensitivity training. As a NICHE designated facility for excellence in senior care, Baton Rouge General remains focused on evidence-based nursing approaches to interdisciplinary geriatric care that promote positive experiences for senior patients. Baton Rouge General’s Volunteer Auxiliary provided significant funding for the expansion of this service for seniors in our community.

Skilled Care, Behavioral Wellness Enhancements Further enhancements on the Mid City campus include a phased refresh of inpatient rooms and expanded skilled care nursing services. Skilled care is an important step in the recovery process after a hospitalization for many patients, seniors in particular. The General’s skilled care services involve a multi-disciplinary team approach that includes physicians with specialized training in internal medicine and geriatric care, nurses, therapists, dieticians, pharmacists and social workers. In addition, expanding behavioral wellness services has also been an important component of program and service expansions to meet the needs of the community. Enhancements in psychiatric services have included expansion of the outpatient behavioral wellness center at Mid City, as well as enhancements in emergency services, including a specialized ER area to ensure psychiatric patients receive appropriate, safe care.

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or n corrid ducatio e r o h c an to help campus Midcity

inesses

Noting the campuses’ tremendous economic impact and anchor as a medical education corridor, Mid City was recently featured in The Advocate.

Investing in the Community While enhancing health services and programs at the Mid City campus directly impacts the health of the local community, it is also an indirect investment in the long-term economic viability of the Mid City region. Through creating jobs and growing medical education, Baton Rouge General’s Mid City campus is also a critical part of the many local businesses, schools, churches and other community organizations that form the vital economic foundation of Mid City.

Baton Rouge General’s Mid City campus has an economic impact of $290 million annually on the state and, accounts for nearly one out of every six jobs, either directly or indirectly, in the Mid City region.*

Mid City

Moving Forward


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A Satellite Campus of Tulane University School of Medicine

Growing Physician Offices at Mid City Baton Rouge General’s Mid City campus recently welcomed the following new physicians representing various specialties. Cardiology Lance LaMotte, MD Nakia Newsome, MD Evens Rodney, MD

Surgery

ENT Christopher L. Surek, DO

Burn and Cosmetic Tracee Short, MD

Family Medicine Tarisha Mixon, MD

OB/GYN Jo Anne Barrios, MD Taylar Childress, MD Angelique Goedeke, MD Kimberly Guillory, MD Evelyn K. Hayes, MD Jane B. Peek, MD

General and Burn Jeffrey Littleton, MD Ernest Mencer, MD

Internal Medicine Kalyan Gonugunta, MD Wound Care and Hyperbarics Roy F. Brabham, Jr., MD

Dr. Roy Brabham, Jr. (above right) joins Medical Director Dr. Shaun Carpenter in leading Baton Rouge General’s wound care program – housed at Mid City’s Wound Care Center with wound care services offered at the Bluebonnet campus.

The following physicians make up the physician offices located at Mid City’s campus: Cardiology Jay Hollman, MD Steven Kelley, MD Lance LaMotte, MD Nakia Newsome, MD Cordell Parris, MD Evens Rodney, MD Marius Sharon, MD Critical Care and Pulmonary Disease Stephen Brierre, MD Roy Culotta, MD John Godke, MD Tonya Jagneaux, MD Hollis O’Neal, Jr., MD Kevin Reed, MD

Family Medicine Derek Anderson, MD Raynando Banks, MD Donnie Batie, MD Robert Chasuk, MD C. Edward Geno, MD Wayne D. Gravois, MD Ruby Ibekwe, MD Stacy Jones, MD Tammy Mayo, MD Tarisha Mixon, MD Brian Schulte, MD Vasanthi Vinayagam, MD Gastroenterology Elizabeth Alonso, MD (Pediatric)

Endocrinology Justin G. Matrisciano, MD

Mid City

Moving Forward BRGOneVision.org

Hospital Medicine Rachel Aaron, MD Oana Apavaloaie, MD Rabih Atallah, MD Amir Ausef, MD Samer Bakhos, MD Venkat R. Banda, MD Vamshi Bende, MD Uyen Caro, MD Mark Garbutt, MD Subhakar Gummadi, MD John Brian Green, MD Heather Hill, MD Keith Kellum, MD Charles Mason, MD Melanie McKnight, MD Catalina Negulescu, MD Bijay Risal, MD Karthik Reddy, MD Manzoor Shah, MD Vasudev Tati, MD S. Raju Vatsavai, MD Vijaya Vellanki, MD Kaycee Weaver, MD Violeta Yakimova, MD

Infectious Disease Patrick Njoku, MD

Pulmonology Reza Sheybani, MD

Internal Medicine Nicholas Campo, MD Lalithia Chalasani, MD Henry Dixon, MD Kalyan Gonugunta, MD Katherine May, MD Darakhshan Wahid, MD

Sports and Family Medicine Brian Harrell, MD Vincent Shaw, Jr., MD

Neurology Amer Awad, MD Obstetrics & Gynecology Jo Anne Barrios, MD Taylar Childress, MD Angelique Goedeke, MD Kimberly Guillory, MD Evelyn K. Hayes, MD Jane B. Peek, MD Psychiatry Herbert LeBourgeois, MD Navin P. Patel, MD Venugopal Vatsavayi, MD

Surgery General and Burn Surgery Dhaval Adhvaryu, MD Jeffrey Littleton, MD Ernest Mencer, MD Burn and Cosmetic Tracee Short, MD Surgical Oncology Joseph Benton Dupont, Jr., MD Urology Spyrie D. Mays, MD Wound Care and Hyperbaric Medicine Roy Brabham, Jr., MD Shaun Carpenter, MD Scott Legasse, MD


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A Satellite Campus of Tulane University School of Medicine

More Choices

For Women

Women’s Health Services Expansion Pictured L to R: Erin Michel, RN, BSN, IBCLC, WHNP; Jo Anne Barrios, MD; Angelique Goedeke, MD; Kimberly Guillory, MD; Evelyn K. Hayes, MD; Taylar Childress, MD; Jane B. Peek, MD

Baton Rouge General and private physicians network Baton Rouge General Physicians recently expanded its comprehensive women’s health program –– welcoming new women’s health specialists and opening a new practice location on the Mid City campus to serve the need for more women’s health options in the Mid City region. Drs. Taylar Childress and Angelique Goedeke join Drs. Evelyn K. Hayes, Jane B. Peek, Jo Anne Barrios, Kimberly Guillory and Nurse Practitioner Erin Michel at Baton Rouge General Physicians Obstetrics and Gynecology. The group’s new Mid City campus office offers more choices and convenience for outpatient women’s health services, including well woman exams and prenatal care, infertility, imaging and mammography services.

Mid City

Moving Forward


A Satellite Campus of Tulane University School of Medicine

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Driving Quality Improving OR Efficiency, Enhancing Patient and Physician Satisfaction

As a healthcare community, providers share the journey toward perfection in patient care, and at Baton Rouge General, we recognize the journey to high reliability is ongoing. Across our organization, at every level, in every aspect of patient care, we continuously strive day-in and day-out to raise our bar to an even higher level. Through our innovative, physician-guided performance improvement platform Work Excellence, which utilizes rigorous Lean and Six Sigma methods, and supported by a culture that embraces transparency, Baton Rouge General is focused on driving quality and patient safety to improve outcomes. The success of the General’s quality platform centers on a multi-disciplinary approach that engages physicians and gains input from frontline staff.

pre-admission processes, Same Day Surgery, the OR and Post-Anesthesia Recovery Unit (PACU). Most recently, the multidisciplinary perioperative team launched an initiative to improve the number of scheduled 7 a.m. operating room cases that start on time. A critical first step in the improvement process is gaining voice of customer feedback. The project team collected feedback from 128 members of the perioperative team, including surgeons, anesthesiologists, nurses and schedulers, on the definition of “7 a.m. start time.” Seventy-five percent of respondents indicated that wheels should be in the OR at 7 a.m., and an additional 21% responded that anesthesia should be induced or incision started at 7 a.m.

Over the past several years, Baton Rouge General has focused improvements in perioperative services, achieving significant results in

According to baseline data from fiscal year 2012, only 29% of scheduled 7 a.m. surgery cases entered the operating room by 7 a.m. resulting

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A Satellite Campus of Tulane University School of Medicine

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in 456 hours of wasted OR room utilization. According to statistical data analysis, the key contributing factors to delays in 7 a.m. starts were labs drawn the day of surgery and delays on OR team readiness, anesthesia readiness and surgeon arrival time. Specifically, analysis indicated that the OR team and anesthesia team must be ready by 6:40 a.m. and the surgeon must arrive by 6:45 a.m. to achieve and on-time start for a 7 a.m. case. Conducted in July 2013, this pilot project focused on streamlining workflows and enhancing communication among OR staff, anesthesia teams and lab staff the morning of surgery, and ensuring that pilot physicians arrived at the patient bedside by 6:45 a.m.

As a result, an impressive 72% improvement in 7 a.m. “wheels in” time to the OR was achieved among the pilot group of participating physicians’ cases. Following the presentation of the results from the July 2013 OR pilot project at the Surgical Services Department meeting in August, surgery leadership has agreed to require patients scheduled for a 7 a.m. case to have their pre-admission evaluation complete to reduce the need for labs and additional paperwork on the day of surgery, and to require surgeons to arrive at the patient bedside by 6:45 a.m. “With the redesigned flow in the operating room, the practice environment is more efficient for physicians and patients – enhancing the quality and value of our patients’ experiences in the hospital,” said Dr. Jeffrey Littleton, Chairman of Surgical Services for Baton Rouge General. Building on the outcomes of the OR pilot project, Baton Rouge General has launched a quality initiative to enhance the admission process to improve patients and physicians experiences. Through implementation of streamlined pre-admission and pre-registration processes and enhanced communication between the pre-admission team members and physician offices, patients are experiencing smoother and quicker admissions. Technology enhancements, including mobile instant messaging tools and patient tracking boards, in the admission process are improving patients’ interactions as they transition through the hospital and improving communication among staff members with the goal of enhancing care quality and patient satisfaction.

As a result of the admissions process improvement pilot, the amount of time patients spent in admissions was reduced by 45%, and importantly, 100% of the physician offices participating in the new pre-admission process report they are satisfied or very satisfied with the new process and it has reduced multiple followup calls for missing or incomplete information from the hospital admissions office to clinic staff.

Leading-Edge Efficiency and Patient Safety Providing safe patient care begins with accurately identifying patients when they enter the hospital. With the wave of a hand, patients will be identified using a new palm vein scanning technology that will ensure secure, accurate patient identification. Leading the region with this technology, called Patient Secure Identity (PSI), Baton Rouge General continues to find innovative ways to enhance efficiency and patient safety. Launched this month, the new system scans the unique vein patterns on a person’s hand and converts this digital image to a number that corresponds with the patient’s medical record. Beyond the efficiencies and securities created by reducing the need for additional ID, such as a driver’s license or social security number, the new system will integrate with the Paragon EMR when that system is implemented in February. Importantly, this will reduce the incidence of duplicate medical records which could lead to missed patient information and potentially medical errors. Multiple medical records for a patient increase the potential for critical information to be missed because it is located in the duplicate record. The existence of a duplicate record can also lead to unnecessary replication of lab orders and tests that can cause patient dissatisfaction. Additionally, emergency care situations are another area where palm scan identification can be potentially important for caregivers. In the event a patient comes into the ER unresponsive, with a quick palm scan providers will have critical information about the patient’s medical history, and the medications they are prescribed, if they are in the hospital system. Along with web cameras, the scanners will be installed at all existing patient registration points on both campuses including Admissions, ER, and in affiliated outpatient clinics and facilities.


A Satellite Campus of Tulane University School of Medicine

MD Spotlight

At the top of his game A conversation with

James Crowell, MD

BRGOneVision.org

VIS1ON – page 14


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A Satellite Campus of Tulane University School of Medicine

Finishing sixth in his age bracket in Ironman Florida – one of the toughest endurance competitions in the world – James Crowell, MD, epitomizes healthy aging.

Seniors ER and the newly launched senior wellness offerings at the Mid City campus, the General is leading our region and evolving services for seniors to provide not only quality emergency care but also to help aging adults in our community stay well and improve their health.”

Dr. Crowell devoted the past year to preparing for the 140-mile triathlon, which was held earlier this month and consisted of a 2.4-mile ocean swim, 112-mile bike ride and 26.2-mile marathon. Under the guidance of his coach, Dr. Crowell, who is also the reigning state sprint triathlon champion, committed himself to a rigorous training schedule. Devoting six days per week to a regimen of long-distance swimming, biking, running and weight-training, he focused on one or two activities each day before work or on his days off. He also carefully monitored his diet – sticking to a strict nutrition plan to optimize his athletic performance.

A Louisiana State University School of Medicine alum, Dr. Crowell spent the earlier part of his medical career practicing in Colorado where he also enjoyed an active outdoor lifestyle – skiing, kayaking and mountaineering. Admittedly, he has always been athletic – running marathons since 1978, including the Hawaii marathon in 1979 and 1980. For the last 13 years, he and his wife, Dr. Sterling Sightler, retired Gynecologic Oncologist, have dedicated much of their time to competitive and recreational ballroom dancing. They have competed together at the national level and they continue to promote the development of ballroom dancing through their support of Saturday Night Ballroom, a local dance club, and Louisiana DanceSport, the organizer of the annual Gumbo DanceSport Championships, a ballroom competition which is a qualifying event for the national championships, in Baton Rouge.

Dr. Crowell knows that living well takes hard work and dedication – and he leads by example. As Chief of Emergency Services for Baton Rouge General, Dr. Crowell sees a wide range of patients and ailments but he takes a special interest in his senior patients and is pleased to see the General’s focus on enhancing the quality of care for seniors. Louisiana’s senior citizens ranked among the least healthy in the country according to a recent United Health Foundation report*. With the 65 and older population in the Greater Baton Rouge area expected to reach approximately 13 percent of the total population by the end of 2016*, identifying ways to improve senior care and meet seniors’ unique medical needs is more timely than ever. “Senior health is becoming increasingly important as our aging population grows,” notes Dr. Crowell. “With the recently expanded

Dr. Crowell’s first Half Ironman was in 2009, and this past spring, he finished second in his age group against a field of top competitors in the Half Ironman 70.3 in New Orleans. While he doesn’t have plans to tackle another full Ironman in the near future, he intends to continue doing shorter triathlons. At 65, Dr. Crowell is at the top of his game…and he’s not slowing down. * General Health System 2012 Environmental Scan


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A Satellite Campus of Tulane University School of Medicine

Chief Operating Officer Moves to Chicago-area Hospital Baton Rouge General Executive Vice President and Chief Operating Officer Edgardo Tenreiro recently accepted a CEO position at Palos Community Hospital, just outside Chicago, IL, and his last day at the General was November 2. During his time at Baton Rouge General, Edgardo Tenreiro has inspired transformational initiatives in the areas of quality and patient safety – the hospital’s Work Excellence performance improvement platform is driving tremendous organizational gains in safety and quality care for patients; enhanced nursing depth of talent continues to foster excellence in patient care at the bedside; evidenced-based leadership efforts are generating positive momentum in patient and staff satisfaction; and expanded innovative surgical infrastructure with robotics and hybrid capabilities have poised the hospital for meeting the needs of its patient and physician communities. “Though Edgardo has concluded his time at Baton Rouge General, his influence and accomplishments will continue,” said Evelyn Hayes, MD. “We are extremely proud to have worked with Edgardo and thank him for his leadership to raise the bar of our organization, for the good of our patients, staff and community.”

Remarking on the timing of this career opportunity, “This was a tremendous opportunity that I simply could not pass up and I am excited to embark on the new journey ahead – although I would have thoroughly enjoyed working with Mark Slyter, unquestionably a talented CEO whose experience will take our hospital to the next level,” said Edgardo Tenreiro. Mark Slyter, Baton Rouge General’s President and CEO, who began on November 11, said “Edgardo is a true leader and change agent whose passion and wisdom positioned this organization’s team soundly for our future.”

Save the Date Join Baton Rouge General as we recognize medical staff and honor retired physicians at the Physician Appreciation Gala.

Thursday, April 10, 2014 7-9 p.m. Hilton Baton Rouge Capital Center Heidelberg Ballroom 201 Lafayette Street Baton Rouge, LA

BRGOneVision.org

Comments? Story ideas? Email us at BRGMD@brgeneral.org with questions or to let us know what’s happening in your practice.

VIS1ON Editorial Committee Dr. Andrew Olinde Chief of Staff Dr. Floyd “Flip” Roberts Chief Medical Officer Dean, Tulane University School of Medicine’s Satellite Campus Michelle Capone Director, Medical Staff Services Edward Jeffries, MD Chief Operating Officer/Chief Medical Officer Baton Rouge General Physicians George Bell Senior Vice President, Community Relations Nicole Kleinpeter Vice President, Marketing and Communications Maryann Rowland Specialist, Communications and Public Relations

MD Vision Newsletter Fall 2013  
MD Vision Newsletter Fall 2013  
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