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HOSPITALS HOSPITAL

Cohesive Cost Management Solutions for Maximized Savings A Case Study Presented by PHX

of

2013

See page 4

Don’t Miss! 2013 NJLN Nurse Recognition Awards Gala November 1 See page 26

67th Annual PostGraduate Assembly in Anesthesiology December 13-17 Marriott Marquis New York See page 3

PROFILES See pages 12-24

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November, 2013

Hospital Newspaper - NJ

WHAT WHA AT MAKES MAKES A LEADER LEADER IN HEAL HEALTHCARE THCARE C TH COST OS ST MANAGEMENT? MANAGE A EMENT?

TS C U D O R P CE N A M R PERFO HIP S R E N T R PA

At PHX, we of offer fer a comprehensive solution that’ that’s hat’s tailored to fit your advantage innovative business – take adva antage of our suite of inno ovative Products and Performance long-term Partnership. outstanding Per formance m e while building a lo ong-term Par tnership. >> 888.311.3505 888.311.3505 | PHX-online.com

©2013 Premier Healthcare re Exchange, Inc. All Rights Reserved. Reser ved.


Hospital Newspaper - NJ November, 2013

Page 3

67th Annual PostGraduate Assembly in

Anesthesiology Friday - Tuesday December 13 - 17, 2013 Marriott Marquis New York

Program and Registration Materials: m m m m m m m m m

Internationally Renowned Speakers Scientific Panels & Focus Sessions Hands-on & Interactive Workshops Mini Workshops Medically Challenging Case Reports Problem-Based Learning Discussions Scientific Exhibits Poster Presentations Technical Exhibits

ONL I NE R E GI ST R AT I ON :

m m m m m m m m m

Resident Research Contest Pre-PGA Hospital Visits 3,500 Anesthesiologists in Attendance More than 6,000 Registrants New York City Tours Holiday Shopping Jazz Clubs Broadway Shows Opera

www.nyssa-pga.org Featuring programs in conjunction with:

Sponsored by: The New York State Society of Anesthesiologists, Inc.

The New York State Society of Anesthesiologists, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Up to 46.5 AMA PRA Category 1 CreditsTM


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November, 2013

Hospital Newspaper - NJ

A Day in the Life of a Claim at PHX $1.2

MILLION

IN SAVINGS

PATIENT

CLAIM HISTORY CLA

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Cohesive Cost Management Solutions for Maximized Savings A Case Study Presented by PHX Summary Like many businesses in today’s challenging healthcare administration environment, this Payor which is our focus in this case study, manages 20,000 employee lives and was faced with a myriad of customer objectives, competitive challenges and business building imperatives. This included customer pressure to manage escalating healthcare cost and a competitor’s discount based business model. To remain competitive, they needed to increase operational efficiency, reduce cost and validate that their methodology to produce the “real” cost of a claim fulfilled their customers’ healthcare cost management goals. Key Challenges In addition to the external pressures faced by our spotlighted Payor, their system capabilities were strained by the process of editing claims internally. This had a ripple effect on the accuracy of claims’ payments and drained substantial amounts of time and resources from other administrative tasks. To solve these issues and successfully fulfill their cost savings objectives, our Payor needed the expertise of certified coders and nurses to accurately assess the real value of their claims. However, with resource limitations, it would not be efficient for them to employ a large staff of professionals internally in addition to maintaining the software that’s necessary for the systematic analysis of their claims. As a result, they engaged PHX to provide a claims management solution that could improve their operational efficiency, ensure the integrity of their claims, and provide maximum savings by generating the “real” cost of their claims. The solution included the utilization of The Power of 3″ – Product, Performance and Partnership, focusing on the Claims Integrity services, where substantial savings are produced from claim analysis.

This Payor used all three of PHX’s services, thus the claims followed this path to maximized savings: • Claims were first routed through a proprietary claims editing system and then transferred to a team of certified coders that reviewed the patient claim history for each claim to determine appropriateness of billing. This process found over $440,000 in savings.

From claims’ editing, claims then traveled to the Bill Review and Audit department where a team of nurses performed line by line audits to determine the accuracy of each claim’s charges. This stage captured an additional savings of over $457,000.

Finally, the claims were then routed to the PHX out-of-network department where expert negotiators conducted claim by claim negotiations to achieve an additional $1,245,108 in savings.

Results By eliminating the need to use multiple outside vendors and utilizing all the PHX services, our spotlighted Payor was able to solidify their profit margin, satisfy the needs of their client base and thus meet the challenges of a highly competitive marketplace. Moreover, this Payor minimized the level of claims processing complexity and enhanced their operational efficiencies - including the amount of time staff formerly required to process claims and consequently they reduced expenses and maximized their savings. This led to savings for the Payor in the amount of $2.1 million, which is realized as pure profit and affords the opportunity for the client to redistribute those savings to other areas. For more information about PHX services, visit us at www.phx-online.com.

Once the customer centric implementation process was completed, the client began forwarding post adjudication-prepayment claims to PHX totaling over $10.5 million during the subsequent 12 months.


Hospital Newspaper - NJ November, 2013

A uunique nique business... bus siness... requires i a unique nnetwork. etwork. PHX – network solutions management solution ns to help lower your

Š2013 Premier Healthcare Exchange, Inc Inc. c. All Rights Reser Reserved. ved.

healthcare costs

>> 888.311.3505 888.311.3505 | PHX-online.com

Page 5


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November, 2013

Hospital Newspaper - NJ

OUR VIEW

ADVERTISER INDEX Company

Page

AkrimAx / Nitromist

36

Bankers Healthcare Group, inc.

11

Bergen regional medical Center

15

EmA

7

GNYHA Services

9

Holy Name medical Center

21

Hunterdon medical Center

19

Less Stress instructional Services

29

matheny School and Hospital

23, 31

meadowlands Hospital medical Center

17

New Jersey League for Nursing

26

NorthWest Seminars

35

PGA67

Hudson Valley Honor Flight reaches World War II Memorial in Washington My sister, Patricia Dalton, volunteered to take part in a honor flight from Stewart Airport in New York that took 88 Veterans from the Hudson Valley to the World War II Memorial in Washington, D.C. Thanks to the volunteer-run organization and local corporate sponsors, the Honor Flight took off on September 21 and landed at Reagan National Airport. The Honor program gives veterans a free trip to the memorials commemorating the wars in which they served. Also, along for the trip to the memorials was filmmaker Joe Allen. Allen filmed the trip for a full-length documentary titled, "Hudson Valley Honor Flight: Generation Bridges”. There are so many heroes that are forgotten and it is an organizations like Honor Flight that tell everyone how important those who serve are! It would great to see a lot of flags flying on Nov. 11. The veterans deserve it! Please e-mail your thoughts to news@hospitalnewspaper.com or write to Hospital Newspaper, 1 Ardmore Street, New Windsor, NY 12553. Jim Stankiewicz can be reached at 845-534-7500 ext. 219 and via email at jim@hospitalnewspaper.com.

3

Premier Healthcare Exchange, inc. (PHx) 2, 5 Plymouth rock management Co of NJ resource Directory

25

32, 34

rWJ rahway

24

Sun Home Loans

33

St. Joseph's Healthcare System

22

St. Peter’s University

27

Trinitas regional medical Center

13

H

HOSPITAL NEWSPAPER

845-534-7500 • (fax) 845-534-0055 Info@HospitalNewspaper.com

My sister Patty with her daughter Kathleen and WW II Navy veteran Rodger.

Picture of veterans the day of the event.

PUBLISHER

Joseph P. Belsito (Joe@hospitalnewspaper.com)

HOSPITAL

H

••• GENERAL MANAGER

James Stankiewicz (Jim@hospitalnewspaper.com)

••• MANAGING EDITOR

Cathryn Burak

NEWSPAPER

Go to www.hospitalnewspaper.com click on Online Newspaper Subscription Form

(Cathy@hospitalnewspaper.com)

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Michelle Belsito (845-534-7500 x220)

••• BUSINESS DEVELOPMENT, PUBLISHER'S REPRESENTATIVE

Jeff Horton

Field office; Mahopac, NY cell- 845-729-2525 jeff.hospitalnewspaper@gmail.com

CORPORATE INFORMATION Hospital Newspaper - New Jersey edition - Vol. 11 No. 11is published monthly, 12 times a year for $36 per year by Belsito No. Communications, 1 Ardmore Street, New 1 - is publishedInc., monthly, 12 times a year for Windsor, NY 12553. Postage Paid at New Windsor, NY $ and additional mailing offices. Postmaster: Send address changes to Hospital Newspaper, 1 Ardmore Street, New Windsor, NY 12553. No financial responsibility is assumed by this newspaper to publish a display, classified, or legal ad or for typographical errors except of reprinting that part of the ad which was omitted or in error. Omissions or errors must be brought to the attention of the newspaper during the same month of publication.

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Hospital Newspaper - NJ November, 2013

Emergency Medical Associates Experiences Record Growth

Page 7

If you’d like to reach the health and hospital communities of New Jersey each month, there is no more cost-effective way than the Hospital Newspaper. Call Jim Stankiewicz to place your advertisement: 845-534-7500 *219

The Sign of Excellence ence in Emergency Medicine edicine® for More Than Three ree Decades

Emergency Medical Associates (EMA) has experienced record growth during the last 18 months, signing 9 new contracts and increasing its number of annual emergency department patient visits by nearly 35 percent. Since April 2012, Emergency Medical Associates has grown its client base from 19 emergency departments to 28 emergency departments in New Jersey, New York, North Carolina and Rhode Island – 47 percent increase. This growth has increased the company’s annual number o f ED patient visits to nearly 1.4 million. “It’s an exciting time in our history,” explains Raymond Iannaccone, MD, FACEP, president and chief executive officer. “While we’ve expanded our footprint exponentially over the last year and half, we’ve continued to invest in our physicians, mid-levels, support staff and technology to continue to deliver the high-quality emergency medicine that has been our gold standard.” It’s this commitment to its clinical staff that has led Emergency Medical Associates to be recognized by Modern Healthcare as one of the “Best Places to Work in Healthcare” three times. The company’s personalized iPad recruiting application enables recruiters to quickly match a physician’s geographic, lifestyle and facility preferences to the right career position. Recruiters and physician partners will be onsite during ACEP’s Scientific Assembly to meet with physicians and residents to discuss career opportunities, including emergency medicine, urgent care and observation medicine positions. For more information about clinical positions at Emergency Medical Associates, including urgent care and hospitalist opportunities, visit http://www.ema.net/careers.

35 yyears ears of expertise exper x tise

Serving Ser ving patients patie ents in New Jersey, Jersey, New New York York and Pennsylvania, Pennsylvania, well as North No or th Carolina Carolina and Rhode Rho ode Island as well

Dedicated board-certified Dedicated bo oard-cer tified emergency emerge ency physicians physicians integrate integ gra te into your your hos spital’s cultur e into hospital’s culture

Recognized for Recognized for clinical excellence, excellence, quality quality service ser vice and high patient satisfaction patient sa tisffaction

About Emergency Medical Associates Emergency Medical Associates (EMA), headquartered in Parsippany, N.J., is a physician-led, physician-owned medical practice that specializes in emergency, hospitalist and urgent care medicine. Dedicated to providing exceptional solutions for the measurable success of our hospital clients, EMA is recognized for clinical excellence, quality service and sustained, improved patient satisfaction. The company is the recipient of Modern Healthcare’s 2013 “Best Places to Work in Healthcare” award. For more information visit www.ema.net, www.facebook.com/EMANews or www.twitter.com/EMANews.

(877) 692-4665 5

info@EMA.net

www.EMA.net www .EMA A.net


PAGE 8

November, 2013

Hospital Newspaper - NJ

Ask An Expert Christopher J. O’Connor Executive Vice President, GNYHA Ventures, Inc., President, GNYHA Services, Inc. and President, Nexera, Inc.

Beyond Supply Chain – Connecting Cost, Quality, and Outcomes to Be the Best To be the best is a lofty goal for any organization. But because of the complex nature of healthcare delivery—including clinical, legislative, regulatory, and fiscal issues—striving to be the best can be enormously challenging. It entails the oversight, sometimes even the overhaul, of several multi-faceted parts. Most importantly, it requires significant organization-wide shifts to provide a solid foundation for change. Focusing on the relationship between cost, quality, and outcomes is a key framework for success using the new healthcare model. In order to manage the necessary changes in hospital people, processes, and technology while coordinating them with elements beyond hospital walls requires hospital leadership that is committed to fostering a collaborative environment. In a 2011 study on acute myocardial infarction mortality rates, organizational culture proved the most significant differentiator between high-performing and low-performing hospitals. The staff at the high-performing hospitals reported the presence of physicians leaders, empowered nurses, and involved pharmacists, as well as an engaged senior management. They also noted strong communication and coordination. The holistic approach, linking cost with patient care quality and outcomes using the emerging value-based models, exemplifies the underlying thread of the new healthcare landscape—collaboration. By viewing products from a clinical, operational, and fiscal perspective (instead of cost alone), hospitals can identify unnecessary expenditures while simultaneously improving patient outcomes and satisfaction. As I have stated on many occasions, it is supply chain management’s cross-disciplinary position in hospitals that makes it especially well-suited to take on a leadership role in managing the intersection of cost, quality, and outcomes in order to align procurement decisions with hospital objectives. The best decisions are the most informed ones. Increased collaboration optimally leverages skill sets for better, more efficient care, processes, and decision-making. When physicians, nurses, and other stakeholders are integrated into the purchasing process and educated about the financial impact and the value (or lack of value) of devices and other items, when supply chain is knowledgeable about the links between medical supplies and patient outcomes, that is when decisions that most positively impact care and the hospital bottom line are made. Connectivity across healthcare systems, services, and professional silos while accessing vital data and balancing different perspectives are key to success. The best hospitals have made the correlation between cost, quality, and outcomes. They have created clear roadmaps for improving care, quality, and efficiency while reducing costs. The quality of leadership coupled with the quality of organizational and cultural support determine the ultimate success of institutional objectives—and how close hospitals get to becoming the best that they can be. Christopher J. O’Connor is Executive Vice President of GNYHA Ventures, Inc., the for-profit arm of the Greater New York Hospital Association, and President of two GNYHA Ventures companies: GNYHA Services, Inc., an acute care group purchasing organization, and Nexera, Inc., a healthcare consulting firm. Mr. O’Connor is Chair-Elect of the Association for Healthcare Resource & Materials Management (AHRMM).


Hospital Newspaper - NJ November, 2013

BEST IN CLA BEST-IN-CLASS BEST-IN-CLA ASS HOSPITALS KNOW THAT COLLABORATION COLLABORA ATION YIELDS SUCCESS. S At Nexera, our consulting sulting and management ment services pr programs ogram ms are are designed to foster ssupportive, interdisciplinary interdiscip plinary cultures cultures focused d on lowering costs, imp roving quality, and achieving ac chieving optimal outcomes. comes. improving W e bring hospital stakeholders sttakeholders together to make better-informed better-infor med m We GHFLVLRQVWKDWKDYH   HFOLQLFDORSHUDWLRQDO   DQGĂ€VFDOLPSOLFDWLR    Q  QV GHFLVLRQVWKDWKDYHFOLQLFDORSHUDWLRQDODQGĂ€VFDOLPSOLFDWLRQV ther eby positively affecting a affecting patient car e and bottom lines. thereby care Call (877) NEXERA-0 0 to discover how Nex xera can help your Nexera or ganization operate operate at its best. organization

Follow us on

555 WEST 57TH STREET l NEW N YORK, NY 10019 l ww www.nexerainc.com ww.nexerainc.com

Page 9


PAGE 10

November, 2013

Hospital Newspaper - NJ

Consolidate Debt and Raise Working Capital By Patrick Harrigan | Syracuse, NY

Today’s doctors face a myriad of challenges in their efforts to deliver high-quality care. Increased regulation, declining reimbursements and industry uncertainty add pressure to an already high-stress environment. On top of that, many physicians are faced with the added responsibility of owning and running a practice.

Saving

healthcare professionals an average of

$6,000 per month

Juggling numerous due dates and balances can be time consuming, not to mention costly. Fund-Ex can help you consolidate your debt into a single, affordable monthly payment, allowing you to free up time and cash.

The Funding Expert for Healthcare Professionals

One of the most challenging aspects of running a successful business is managing WKH¿QDQFHV)LQDQFHFDQEHGLI¿FXOWIRU someone with training doing it full-time, even more so for doctors focused on providing care, managing a staff and PDLQWDLQLQJDVWHDG\ÀRZRISDWLHQWV As a practice grows, commercial debt is a frequent by-product of that progress. Business credit cards offer convenience and attractive rewards, while commercial ¿QDQFLQJLVRIWHQQHFHVVDU\ZKHQSXUchasing expensive medical equipment and keeping the practice up to date. Managing numerous payment dates and balances can be time consuming, not to mention costly. Amidst the scramble of changing priorities and daily tasks, payments can get overlooked leading to fees, higher rates and ultimately more debt. Consolidating debt can help doctors save time and money, leaving a single, more affordable monthly payment. Lower interest rates can yield substantial cost VDYLQJVHDVLQJWKH¿QDQFLDOVWUDLQWKDW many practices experience. Managing just a single payment can also save time, allowing physicians to focus on more important matters. Whether it’s more time with patients, the practice, family or just some free time, consolidating debt can help conserve the most limited resource; time. 7KHLQFUHDVHGRSHUDWLRQDOFDVKÀRZ can help jump-start stalled practice improvements. Increased marketing can attract new patients. Additional staff

can be hired to help manage the workload. Even building a healthy cash reserve can help ease the stress during leaner times. While a debt consolidation loan may seem like a no-brainer, not all solutions are created equal. Be sure to do your homework. In addition to your monthly payment, make sure that you are comfortable with the loan rate and terms.

Lower interest rates can yield substantial cost savings, easing WKHžQDQFLDOVWUDLQ that many practices experience. Be cautious of debt consolidation services that don’t actually consolidate your debt. Instead of paying off the entire balance, these organizations simply take your payment and pay each of your creditors every month, charging a fee for the service. It is also important to carefully select a lender. While a local bank is always a logical starting point, these institutions ODFNVSHFL¿FXQGHUVWDQGLQJRIWKHKHDOWKcare industry and the challenges you face. Working with a traditional bank can also be time consuming. Look into niche lenders that work exclusively with healthcare professionals. Their indusWU\VSHFL¿FNQRZOHGJHKHOSVWKHPWDLORU WKHLUVROXWLRQVDQG¿QDQFLQJSURFHVV around your needs as a doctor. The Better Business Bureau is a great way to learn more about a lender and ensure that they are trustworthy. The BBB’s Trustlink site provides real, unedited customer testimonials that can give you some insight on what to expect.


Hospital Newspaper - NJ November, 2013

Your healthy financial future is here.

At Fund-Ex, our specialty is you. As a lender that works exclusively with healthcare professionals, we take the time to understand your needs and determine the best solution for you and your business. Fund-Ex can help you improve operational cash flow, expand or relocate, upgrade equipment or just simplify and save by consolidating high-interest debt.

Call 877. 851.9405 or visit www.fund-ex.com/HNNJ to connect with one of our funding experts.

The Funding Expert for Healthcare Professionals

Loan proposal in 24 hours, funding in 5 business days • No hard collateral required • Won’t appear on personal credit • Loan amounts from $25,000 to $5,000,000

Page 11


PAGE 12

November, 2013

Hospital Newspaper - NJ

Trinitas Regional Medical Center Best Hospitals of 2013

Trinitas Regional Medical Center in the Vanguard of Life-Saving Cardiac Treatments )& ,*'& 3"6*.( 0/4&.4*", /' "% 6".$&% $"2%*"$ $"2& *3 2&",*:&% &6&29 4*-& " )&"24 "44"$+ 0"4*&.4 *3 &. 2/54& 4/ 2*.*4"3 &(*/.", &%*$", &.4&2 *. ,*:"#&4) /7 4)".+3 4/ 4)& &,*4& 34"'' 7)/ "33&33 0"4*&.43 &. 2/54& )&"24 0"4*&.43 7)/ 02&3&.4 30&$*'*$ 39-04/-3 "2& '"-*,*"2 4/ 4)& -&2(&.$9 &0"24-&.4 %/$4/23 ".% .523&3 &6&. #&'/2& 4)&9 $/-& 4)2/5() 4)& %//23 !)&. 4)& 2&$/-&.%&% 4*-&'2"-& 4/ #&(*. ". &-&2(&.$9 ".(*/0,"349 02/$&%52& *3 /.,9 -*.54&3 &6&29 -*.54& *3 $25$*", !)&. 4/ -*.54&3 $". #& 3)"6&% '2/- <%//2 4/ #",,//.= 4*-& 4)& 0/4&.4*", 4/ 3"6& ,*6&3 3/"23 *-*,"2,9 7)&. 4)/3& 35''&2 *.( " )&"24 "44"$+ "2& "4 2*3+ /' ,/3*.( #2"*. '5.$4*/. 4)& 2&30/.3& $"0"#*, *4*&3 /' 0&23/..&, ".% /4)&2 )&",4)$"2& 02/'&33*/.",3 "4 2*.*4"3 $". )&,0 "6/*% &6&. 4)& -/34 *.'*.* 4&3*-", ,/33 /' #2"*. '5.$4*/. 2*.*4"3 *3 /.& /' /.,9 " '&7 -&% *$", $&.4&23 *. &7 &23&9 4/ /''&2 4)& <%//2 4/ #",,//.= %*2&$4 ,*.& 4/ $"2%*"$ $"2& *&,% "33&33-&.43 /' &-&2(&.$9 2&30/.%&23 42*((&2 ". &"2,9 $",, 4/ 4)& "2%*"$ "4)&4&2* :"4*/. "# )& "4) "# 4&"- *. 452. $",,3 4)& -&2(&.$9 &0"24 -&.4 7)&2& %/$4/23 $". "33&33 4)& 0"4*&.4 ".% $/.'*2- 4)& %*"(./3*3 *--&%*"4&,9 50/. 4)& 0"4*&.4>3 "2 2*6", 2&35,4*.( *. 2&%5$&% 4*-& 30&.4 *. 4)& -&2(&.$9 //-

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Hospital Newspaper - NJ November, 2013

The best-dressed wounds in New Jersey. That’s the beauty of Trinitas.

T

he Center for Wound Healing & Hyperbaric Medicine at Trinitas Regional Medical Center is New Jersey’s leading comprehensive wound care center. We utilize advanced wound care technologies such as Hyperbaric Oxygen (HBO) Therapy and Vacuum-Assisted Closure (VAC®) negative pressure wound therapy. And we were the first in the state to use Apligraf ® - a living, bi-layered skin substitute. We enjoy healing rates that are consistently above 90%. That’s why so many area hospitals send their most difficult wounds to us. And why Diversified Clinical Services named us a Center of Excellence. This is wound care that goes way beyond bandages. And it’s available right here, right now. Beautiful.

CENTER FOR WOUND HEALING & HYPERBARIC MEDICINE 240 Williamson St., Suite 104, Elizabeth, NJ 07202 908-994-5480 • www.WoundHealingCenter.org TRINITAS CENTERS OF EXCELLENCE

Behavioral Health • Cancer Care • Cardiology • Diabetes Management Maternal & Child Health • Renal Services • School of Nursing • Senior Services Sleep Disorders • Women’s Services • Wound Healing & Hyperbaric Medicine

Trinitas Regional Medical Center is a Catholic teaching institution sponsored by the Sisters of Charity of Saint Elizabeth in partnership with Elizabethtown Healthcare Foundation.

Page 13


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November, 2013

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Hospital Newspaper - NJ

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Bergen Regional Medical Center Best Hospitals of 2013

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Hospital Newspaper - NJ November, 2013

Page 15

Three Divisions of Careâ&#x20AC;Ś One Commitment to Excellence In uncertain times, its good to know that Bergen Countyâ&#x20AC;&#x2122;s safety net hospital is here for you. If you are underinsured or uninsured, or if you have a need for long term care or behavioral health care, Bergen Regional Medical Center (BRMC) is your medical facility. Services available at BRMC include: %(+$9,25$/+($/7+&$5( ` Inpatient and Outpatient Mental Health Services ` Collaborative Medical and Behavioral Health Continuum of Care ` Addiction Services ` Adult, Geriatric, Child and Adolescent Services

/21*7(50&$5( ` Home Like Atmosphere with Quality Medical Care an Elevator Ride Away ` Wound Care Treatment ` Alzheimerâ&#x20AC;&#x2122;s/Dementia Care ` 24 Hour Skilled Nursing Care ` Respite Care ` Winner NJ Biz Healthcare Heros Nursing Home of the Year

$&87(&$5( ` More than 20 medical specialties ranging from allergy to podiatry all within the BRMC Clinic ` Full Service Pharmacy Department for Clinic Patients ` 24/7 Emergency Department ` Operating Suites and Surgical Services ` Physical Rehabilitation Department ` Imaging Services ` One of 2 Certified NICHE (Nurses Improving Care for Healthsystem Elders) facilities in Bergen County

 %HKDYLRUDO+HDOWK6HUYLFHV$FFHVV&HQWHU  /RQJ7HUP&DUH$GPLVVLRQV  Dr. Ramin Zaghi, podiatrist

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PAGE 16

November, 2013

Hospital Newspaper - NJ

Meadowlands Hospital Medical Center Best Hospitals of 2013

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Hospital Newspaper - NJ November, 2013

Page 17


PAGE 18

November, 2013

Hospital Newspaper - NJ

Hunterdon Medical Center Best Hospitals of 2013


Hospital Newspaper - NJ November, 2013

A Report Card to Be Proud Of Hunterdon Healthcare consistently achieves top honors for our dedication to patient safety, leading-edge technology and overall excellence in health care.

2013 Report Card NAME

H u nterdon H ealthca r e Subject

Grade

National Ratings

Patient Safety

A

Excels in patient safety. Earned ‘A’ rating by The Leapfrog Group three times consecutively and ranked among Top 5 Hospitals in New Jersey for patient safety by Consumer Reports

Nursing Excellence

A

Exhibits superior quality of patient care and excellence in nursing. Magnet®-recognized by American Nurses Credentialing Center

Medical Excellence

A

Meets highest standards in quality, safety of care, treatment and services. Accredited by the Joint Commission

Medical Technology

A

Improves patient experience through smart use of health care IT. Among Hospitals & Health Networks 100 Most Wired Hospitals

Elder Care

A

Demonstrates outstanding patient-centered care of older adults. NICHE-designated hospital

Please visit our new Hunterdon Medical Center Foundation website at Foundation.HunterdonHealthcare.org To make a donation to the HMC Foundation, visit HunterdonHealthcare.ThankYou4Caring.org

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November, 2013

Hospital Newspaper - NJ

Holy Name Medical Center Best Hospitals of 2013

Holy Name Medical Center &".&$+ /"% !

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Hospital Newspaper - NJ November, 2013

Major achievements in minimally invasive therapies

John Rundback, MD Director, The Interventional Institute

As the Director of the Holy Name Medical Center Interventional Institute, Dr. John Rundback and his team of renowned physicians are developing new ways to identify, target and treat diseases. Thanks to advanced techniques such as integrated CT scans and 3-D roadmapping, patients with peripheral arterial disease (PAD), diabetic foot wounds, uterine fibroids, liver and lung tumors, and even varicose veins now have minimally invasive alternatives to major surgery. So they get back to a better quality of life faster and easier than ever before. Visit holyname.org/interventional for more information, or call 1-877-HOLY-NAME (1-877-465-9626).

Healing begins here â&#x20AC;˘ 718 Teaneck Road â&#x20AC;˘ Teaneck, NJ 07666

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November, 2013

Hospital Newspaper - NJ

St. Joseph's Healthcare System Best Hospitals of 2013

St. Joseph’s: Revolutionizing health care. Revitalizing our community. St. Joseph's Healthcare System is proud of its longstanding tradition of patient care service excellence and community advocacy. Since its founding in 1867 by the Sisters of Charity of Saint Elizabeth, St. Joseph’s has continued to redefine the way responsive, compassionate, high quality care is delivered in the region. A recognized leader in the New York Metropolitan Area healthcare industry, St. Joseph’s is the second largest provider of Charity Care in New Jersey, the second largest provider of Medicaid services in New Jersey, and the Passaic Region’s urban safety net hospital. True to the organization’s mission of caring, St. Joseph’s Healthcare System is the anchor of an extensive urban development and beautification project that is transforming its environments for healing and positively impacting the surrounding community and its cityscape. Facilities expansions and renovation projects – components of the largest master facilities investment plan in the history of St. Joseph’s Healthcare System – are focused primarily at St. Joseph’s Regional Medical Center, the hub of the Healthcare System. An academic tertiary care comprehensive medical center in South Paterson, St. Joseph’s Regional Medical Center includes state designated St. Joseph’s Children’s Hospital. Old and underutilized buildings have been razed and replaced with award-winning architecturally significant structures equipped with sophisticated equipment for use by St. Joseph’s highly skilled team of clinical experts. The cornerstone and most extensive project of St. Joseph’s master facilities investment plan is the 183,000 square foot state-of-the-art Critical Care Building opened in October 2011. The impressive structure features separate Pediatric, Adult, and Geriatric Emergency Departments with a total of 88 treatment areas; 12 systemsintegrated operating theaters with pre-operative and post-operative areas; and 56 private rooms in specialized critical care units.

St. Joseph’s high-tech rooftop helipad, fully accessible to even the largest medical and military-style helicopters, tops off the Critical Care Building, expanding expedited ambulance and mobile intensive services, orchestrated through St. Joseph’s centralized 24/7 transfer center. Additional new facilities on the St. Joseph’s Regional Medical Center South Paterson campus include a pediatric and adult ambulatory care center, an outpatient rehabilitation center, an ambulatory radiology and laboratory entrance and reception area, a dedicated women’s and children’s services tower, a main lobby with dedicated waiting areas and high-tech conference center, as well as the ongoing modernization of all patient care areas. Convenient driveways, parking areas, and an adjacent multi-level parking garage enable easy access to St. Joseph’s Regional Medical Center and St. Joseph’s Children’s Hospital services. St. Joseph’s extensive facilities projects have not only revitalized the Regional Medical Center’s campus, they have spurred the actions of community-based investors who are developing medical offices, residential buildings, retail/restaurant space, and a hotel. The New Jersey Business & Industry Association honored St. Joseph’s Regional Medical Center with a 2013 New Good Neighbor Award which recognizes the best and most exciting commercial and industrial development projects in New Jersey based on economic benefit, job creation, architectural merit, and community involvement. St. Joseph’s Healthcare System is proud to set new standards for leading edge healthcare services and community advocacy by providing powerful medicine, revolutionizing healthcare and revitalizing our community. St. Joseph’s Regional Medical Center and St. Joseph’s Children’s Hospital, members of St. Joseph’s Healthcare System, are conveniently located near the Garden State Parkway, Routes 4, 20, 46, and at Exit 58A/Route 80 in South Paterson, NJ. To learn more about the comprehensive programs and services of St. Joseph’s Healthcare System, please visit www.StJosephsHealth.org or call 877.757.SJHS (7547).


Hospital Newspaper - NJ November, 2013

Page 23

Matheny Medical and Educational Center Best Hospitals of 2013

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PAGE 24

November, 2013

Hospital Newspaper - NJ

Best Hospitals of 2013

Robert Wood Johnson Health System

Whole-heartedly better.

Introducing HeartHealth, comprehensive cardiology services integrating the acclaimed services of RWJ Rahway with the worldclass expertise and state-of-the-art resources of the Robert Wood Johnson Health System. From emergency services to advanced treatment, rehabilitation, diagnostics and preventative care, HeartHealth is a wholeheartedly better approach to care, dedicated to helping our community

GET BETTER. STAY BETTER.

865 S Stone tone S St. t. Q R Rahway, a ay, NJ Q RWJHear ahw RWJHeartHealth.com tHea alth.com

The Cardiovascular Center of Excellence at RWJ University Hospital Renowned academic medicine and advanced heart care:

Electrophysiology Q TAVR for aortic stenosis Q Atrial fibrillation ablation Minimally invasive robotic surgery Q Ventricular assist device Q Heart transplantation


Hospital Newspaper - NJ November, 2013

PAGE 25

Hunterdon Medical Center breaks ground on Cardiovascular Center No other health concern affects more people in Hunterdon County than cardiovascular disease. It is the County’s leading cause of death and its incidence is on the rise due, in part, to the growing number of area residents between the age of 45 and 64 – a time in life in which the onset of cardiovascular disease is most likely to occur. Hunterdon Medical Center has begun construction on its new Cardiovascular Center. The expansion will centralize all acute care cardiovascular services. “We are taking cardiac care to a new level. The new cardiovascular center completes the full circle of care by combining advances in 21st century cardiovascular medicine with an extraordinary team of cardiac specialists, all in one location,” explained Robert P. Wise, President and CEO, Hunterdon Healthcare. The new center will be constructed above the hospital’s existing 3 west wing, which will be directly accessible by elevator from the Emergency Department in order to better accommodate cardiac emergencies. Construction will include: • Two new cardiac catheterization labs providing emergency coronary intervention, carotid and peripheral angioplasty; • Cardiac critical care unit; • Twenty private patient rooms; • Expanded space for cardiac imaging and intervention and the creation of specialty clinics in congestive heart failure and stroke; and, • State-of-the-art cardiopulmonary rehabilitation services.

Hunterdon Healthcare provides a broad range of cardiovascular services under the expert guidance of ten board-certified cardiologists. With timing so critical in heart attack and stroke events, Hunterdon Medical Center’s active and reputable angioplasty program is a great benefit to area residents. National guidelines recommend that heart attack patients receive emergency angioplasty within 90 minutes of arrival to a medical facility. Hunterdon Medical Center significantly exceeds this national standard, leading the way in advancing cardiac care in the community by providing heart attack patients with an average 55-minute “door-toballoon-time.” This means patients experiencing a heart attack will receive emergency angioplasty within 55 minutes of entering the emergency room. In 2005, Hunterdon Medical Center became the first community hospital in New Jersey to perform carotid artery stenting for stroke prevention. The interventional cardiologists at Hunterdon Medical Center are specially trained and have the technological expertise to diagnose and treat peripheral artery disease as well, which affects 50% of Hunterdon Medical Center’s cardiac patients. In addition, the interventional cardiologists perform radial artery catheterizations where blocked arteries are opened and stents are inserted through the patient’s wrist rather than through their groin. At Hunterdon Medical Center, 80% of acute heart attack patients are

treated through this approach, placing Hunterdon Medical Center among the top hospitals in the state and nationally as well. According to Christopher Sickels, Executive Vice President of the Hunterdon Medical Center Foun-

dation and Senior Vice President of Community Affairs, “Although the original set fundraising goal of $15 million has been met and has enabled construction of the cardiovascular center to start, the Hunterdon Medical Center Foundation will

continue to raise additional funds over the next two years which will include naming opportunities.” Donations to the cardiovascular project can be made online at www.donatetohunterdonhealthcare.org or by calling 908-788-6141.

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Pictured left to right: Maria Feo, RNC, CTTS, Heart and Vascular Care Coordinator, Robert Cody, M.D., Chairperson, Hunterdon Medical Center Board of Trustees, Glen Tonnessen, M.D., Cardiologist, George Muller, Chairperson, Hunterdon Medical Center Foundation, William Schafranek, M.D., Interventional Cardiologist, Robert Wise, President and CEO, Hunterdon Healthcare, Christopher Sickels, Executive Vice President of the Hunterdon Medical Center Foundation and Senior Vice President of Community Affairs and Debra Porcelli, Vice President of Marketing, Hunterdon Healthcare.

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PAGE 26

November, 2013

Hospital Newspaper - NJ

NLN

NEW JERSEY LEAGUE FOR NURSING An Affiliate of the National League for Nursing 2013 NJLN PRESIDENT’S AWARD

Congratulations to All of the 2013 Nurse Recognition Award Winners

Eileen Williamson, RN, MSN Senior Vice President & Chief Nurse Executive, NURSE.com

2013 NJLN CORPORATE AWARD University Correctional Health Care The dedicated Nurses working in the New Jersey Correctional System

2013 NJLN SPECIAL AWARD “HOME CARE NURSES: HURRICANE HEROES” The dedicated Nurses of the Home Care Association of New Jersey

2013 NURSE RECOGNITION AWARDS Saundra Austin-Benn, MSN, APN Private Practice, Psychiatric Advance Practice Nurse Edna Cadmus, RN, PhD, NEA-BC, FAAN Clinical Professor, Specialty Director, Rutgers University Brian Dolan, RN, BSN, CEN, ACM, CCEMT-P Director E. D. & Disaster Preparedness Service, University Hospital Mary Fortier, EdD, RN, CNL Assistant Professor, Seton Hall University Daphne Foster, RN Staff Nurse, St. Barnabas Medical Center, Hospice & Palliative Care Griselda Frane, MA, RN, CCRN, CS, APN, CNE Instructor, CarePoint Health School of Nursing Janine Graf-Kirk, MA, RN-B, CNE Faculty, Trinitas School of Nursing Diane Hassa, RN, MSN Education Specialist, Saint Clare’s Hospital Mary E. Koch, RN, MSN, CNOR Perioperative Nurse Educator, Newark Beth Israel Medical Center Nancy Munoz, RN, MSN, CNS New Jersey State Assemblywoman Kathleen Neville, PhD, RN Professor & Program Coordinator, Kean University School of Nursing G. Elaine Patterson, EdD, EdM, MA, RNC, CNE Professor of Nursing, Ramapo College of New Jersey Susan W. Salmond, EdD, RN, ANEF, FAAN Dean & Professor, Rutgers University

T P NURSES of

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Rita Smith, DNP, RN Sr. Vice President & Chief Nursing Officer, Jersey City Medical Center Chris Wade, RN, BSN, CRRN Nurse Manager, Rehabilitation, JFK Johnson Rehabilitation Institute Deborah K. Zastocki, DNP, RN President & Chief Executive Officer, Chilton Hospital

All award winners will be honored at the 2013 NJLN Nurse Recognition Awards Gala on November 1st – For additional information, please visit our web site at: www.NJLN.org Tickets are available at $90 each. Please make reservations at: 908-789-3398 (or) email: NJLNurse@aol.com Advertisements and Sponsor Support is available. Contributions to NJLN are tax deductible as allowed by law.


Hospital Newspaper - NJ November, 2013

Page 27

education & careers

provided

Bergen Regional Medical Center’s Katie Richardson honored with NJBIZ Forty Under 40 Award Katie Richardson, Vice President and Administrator of Bergen Regional Medical Center’s (BRMC) Long Term Care Division, has been named a winner in the 2013 NJBIZ Forty Under 40 awards program. The award program, produced by NJBIZ, New Jersey’s premier business news publication, is presented by Rothstein Kass and sponsored by Comcast Business, Stark & Stark, First Bank and Miles Technologies. The Forty Under 40 awards program honors men and women under the age of 40 who have been making headlines in their field and who share a commitment to business growth, to professional excellence and to the community. To qualify, a nominee had to meet selection criteria that included working in New Jersey and possessing significant authority for decision making within a company or organization. As the Vice President and Administrator of BRMC’s Long Term Care Division, Katie Richardson has direct oversight, coordination and control of New Jersey’s largest licensed nursing home, with 574 beds. Under her guidance, the facility received the prestigious Joint Commission Accreditation and became one of only six percent of nursing homes nationwide to achieve that status. Richardson also continually works to enhance the quality of life for residents, providing an array of programs that keep residents engaged physically, mentally and emotionally. “I’m honored to receive this prestigious award from NJBIZ,” said Richardson. “I’m fortunate to work at a facility that is dedicated to creating a supportive environment where all patients, residents and staff are treated with dignity, caring and respect.” Richardson is a Licensed Nursing Home Administrator, a member of the American College of Health Care Administrators; Second Vice President for the New Jersey Chapter, American College of Health Care Administrators; Certified Dementia Practitioner; Activity Director Certified; National Certification Council for Activity Professionals and a member of the Society of Licensed Nursing Home Administrators. She holds a Bachelor of Science in Health Sciences, Physical Education Studies from the University of Delaware and a Master of Public Administration, Health Services Administration from Kean University. The Forty Under 40 winners were chosen by an independent panel of judges including: Aldonna R. Ambler, CMC, CSP, The Growth Strategist; John Farrell, Rider University; Brenda Hopper, Small Business Development Centers; James Morris, Rutgers University; James F. Shannon, Choose: New Jersey. NJBIZ and the program sponsors will honor this year’s winners during an awards ceremony on Monday, October 28, 2013 at The Palace at Somerset Park in Somerset, NJ. The honorees will also be highlighted in a special supplement to NJBIZ on November 11, 2013.

For more information about the 2013 Forty Under 40 awards program, please visit www.njbiz.com/events or contact Melissa Sullenberger at melissas@njbiz.com or (732) 246-5737.

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PAGE 28

November, 2013

Hospital Newspaper - NJ

education & careers Janssen Pharmaceuticals funds Scholarships to support next generation of Nurses By the time students, staff and supporters congregated to celebrate the opening of Thomas Edison State College’s new Nursing Simulation Laboratory last month, some attendees had already formed an indelible bond. Five students in the W. Cary Edwards School of Nursing’s Accelerated 2nd Degree Bachelor of Science in Nursing (BSN) Program are closer to their academic goals due to scholarships made possible with support from Janssen Pharmaceuticals, Inc., of Titusville, N.J. The scholarship is a huge help to me,” said student Stephen R. Fox, of Maple Shade, N.J. “I’m a divorced father of two small boys and pay most of my tuition and program costs out of pocket. With the scholarship, I can certainly focus more on my education and care for my boys.” It is likely that Fox and fellow scholarship recipients Lauren Apgar of Pennington, Dennis Malamut of Trenton, Aidel Ozur of Lakewood and Monica Shah of Lawrence, N.J., need all the support they can get.

The Accelerated 2nd Degree BSN Program is an intensive, one-year program meant only for the most motivated RN-hopefuls. Those admitted to the school’s program, come from all walks of life, already possess a non-nursing bachelor’s degree and will be prepared for the National Council Licensure Exam (NCLEX-RN) once they graduate. “The 100 percent pass rate for members of the program’s previous cohort who took the licensure exam in 2012 speaks volumes for the structure of the program,” said Fox, who had worked as a staff supervisor for a daily newspaper, a financial advisor and a PGA club professional before focusing on a career in nursing. In Janssen Pharmaceuticals’ view, our communities reap the most rewards – while addressing a projected nursing shortage – by nurturing students like Fox. “We at Janssen Pharmaceuticals invest in programs that align well with our mission to advance the health of our local community. Thomas Edison State College’s Nurs-

provided

At a reception celebrating the opening of Thomas Edison State College’s new Nursing Simulation Laboratory are, (foreground from l to r) Patricia Watts Mitchell and Peg Forrestel of Janssen Pharmaceuticals, Inc. Second row, from l to r: W. Cary Edwards School of Nursing’s Accelerated 2nd Degree BSN students Lauren Apgar, Dennis Malamut, Monica Shah, Aidel Ozur and Stephen Fox.

ing Simulation Laboratory and accelerated 2nd degree BSN programs complement Johnson & Johnson’s Campaign for Nursing’s Future by addressing a projected nursing shortage in an innovative, collaborative way. Janssen is proud to play a role in supporting the College’s efforts to

Unique Recruitment Opportunity Hospital Newspaper believes that high school students should be informed about potential healthcare careers. Special career sections will be placed in your local high schools, medical schools, colleges and nursing schools. This is your opportunity to display opportunities for: Faculty/Physician Nursing Administrative Support Positions Clinical Care

Medical Assistants Counselors Medical Imaging Dieticians

Please contact Jim Stankiewicz for more information. jim@hospitalnewspaper.com tel: 845-534-7500 x219

prepare and develop competent and adaptive nurses for the workforce,” said Peg Forrestel, director of Contributions and Community Affairs at Janssen Pharmaceuticals. In addition to scholarship support, Janssen Pharmaceuticals, Inc. provided funding for one of the

three high-fidelity simulators that serve as the technological centerpieces of the program. The simulators train students in a controlled clinical environment and are programmed to replicate healthcare emergencies and medical conditions, including physiological and verbal responses to care administered by the students. Outside of the simulation lab, Capital Health’s facilities in Trenton provide the on-ground, clinical experience of the students’ education. “The single greatest attribute I will take away from my clinical experiences at Capital Health is confidence,” said Fox. “The time spent on an active hospital floor treating patients together with my online coursework, lectures and simulation lab experience gives me the assurance that I chose the right profession.” For more information on the Accelerated 2nd Degree BSN and other nursing programs, visit: www.tesc.edu/nursing or contact the college at nursing@tesc.edu.


Hospital Newspaper - NJ November, 2013

PAGE 29

education & careers ‘Team Approach’ lured veteran occupational therapist back to Matheny

provided

Donna Kelly, right, assisted by speech-language pathologist Brynna Cunningham, helps a student use a foot switch to activate a Taylor Swift video on a computer.

provided

St. Joseph’ s Healthcare System Nurse receives 2013 NJAHR Nursing Scholarship

Valerie was congratulated by (left to right) Maria Brennan, DNPc, RN, CPHQ, Chief Nursing Officer, SJHS, and Vice President, Patient Care Services, St. Joseph’s Regional Medical Center; Rose Nagle-Girgenti, RN-BC, MA, Director, Clinical Education, SJHS; and Nancy Hill, BA, PHR, Nurse Recruiter, SJHS (member of the NJAHR).

St. Joseph’ s Healthcare System (SJHS) is proud to announce that Valerie Longo, RN, Critical Care Unit Educator, St. Joseph’s Regional Medical Center, was selected as the recipient of a New Jersey Healthcare Recruiters Association (NJAHR) sponsored scholarship. This is the 2nd consecutive year that a SJHS nurse is selected for the $1,000 scholarship given to a Registered Nurse pursuing an Advanced Degree in Nursing. Valerie (second from right), an employee of SJHS since June 2011, is currently enrolled in the Masters of Nursing (MSN) program at Walden University. With a tradition of excellence that spans more than 145 years, nationallyrecognized St. Joseph’s Healthcare System is an integrated multidisciplinary comprehensive health care organization renowned for the expertise of its clinical and professional staff, leading edge technology and ‘patients first’ approach to service excellence. St. Joseph’s Healthcare System is sponsored by the Sisters of Charity of Saint Elizabeth. To learn more, visit www.StJosephsHealth.org or call 877.757.SJHS (7547).

They say the third time’s charm, and, for Donna Kelly, MA, OTR/L, returning to the Matheny Medical and Educational Center in February 2013 as director of occupational therapy, had a special attraction. “When I first came here in 1983,” she says, “I was struck by the team approach, how we all worked together. Coming back earlier this year was wonderful. It was just like going home. . I love working with all members of the interdisciplinary team – the physicians, the personal care assistants and all of the other directors. This is something you miss at other places.” Matheny is a special hospital and educational facility in Peapack, NJ, for children and adults with medically complex developmental disabilities. It was Kelly’s first job out of the University of New Hampshire. After three years, she left to join the staff of the Lakeview School in Edison as a senior occupational therapist and then as director. Five years later, she was back at Matheny as director of OT and director of the seating and mobility clinic. She left again in 1993, first working in early intervention with the Arc of Somerset County and then serving as OT director at Children’s Specialized Hospital.

In the interim, she received her MA, advanced master’s degree from New York University, specializing in assistive technology. She also became trained in NDT (Neuro-Developmental Treatment) and SIPT (Sensory Integration and Praxis Tests). Kelly studied at NYU under the late Dr. Beverly Bain, who began working as a consultant at Matheny in 1998, bringing with her a special expertise in assistive technology. “These children and adults,” Dr. Bain once said, “can use technology to make themselves more independent – from pushing a bell in the morning to calling a nurse to riding in a wheelchair to doing something with a computer.” Assistive technology, says Kelly, “is still the focus here. It’s integrated into the classroom and after school. The level of care that students and patients get here is optimal.” Now, Kelly is involved in a new project called The Listening Program (TLP), which uses a soundbased music program to decrease self-stimulator behaviors in individuals with multiple disabilities. Matheny, says Kelly, will be collaborating with NYU on TLP research.


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or nfo f i t s e Lat es and

nursdents stu

Hospital Newspaper - NJ

Nurseâ&#x20AC;&#x2122;s Viewpoint

By Alison Lazzaro, RN

Hospital Newspaper Correspondent

Is the Customer Always Right? It's that time in your life, out with the old and in with the new. It's time to ditch your old mattress and purchase one for more support and stability. They persuade you in the store by saying, it's an investment in your health and you do not want to skimp on price! After doing your research, you attempt to navigate the market by selecting what seems like a good fit for a mattress online, but it's difficult to tell without testing it out. You get five minutes in the store to feel the mattress before you feel uncomfortable with people staring at you. So, you decide on the mattress, pay more than you are willing to pay because it is for your body's wellbeing. Now, you are locked into this decision and hope it fits your needs, budget, and makes you feel better. The employees at the mattress store have been trained in customer service and aim to please you. Feeding the consumer rehearsed lines is a way to sell a product in order to make a profit. They understand how tricky it is to compare prices. Similar to buying a mattress is navigating the healthcare world that is now rooted in patient satisfaction scores and the consumerism. But, is the consumer always right? In many circumstances, the consumer does not have a medical degree just as most people do not have extensive knowledge regarding mattresses. Yet, the consumer is expected to pick out what meets their needs and budget and if those needs are not met they will not recommend the store. That's bad for business, so we will try to do everything possible to make that customer happy. In 2013, are we taking this customer satisfaction principle too far when it comes to healthcare? For instance, a patient is seeking pain medication. The doctors and nurses who have gone through extensive schooling to learn the appropriate pharmacological dosing for pain medication know to withhold further pain medications at this time for safety reasons. They have tried different regimens, PCA pumps, and routes of administration to ease pain. However, the customer is still not satisfied. The customer complains to management, and all of a sudden, the doctors who have been in school for years to know their product are suddenly overturned by a consumer without full comprehension of the risks. With patient satisfaction scores influencing reimbursement, the customer is suddenly right. The healthcare system in America certainly has its strengths and weaknesses. It is important that, as nurses, we encourage patients to consider themselves customers. With that being said, customers should be educated and knowledgeable about the services they wish to receive. Whether buying a mattress or looking for the top rated cancer care, customers can use online tools and reviews to pick what best meet their needs. When exploring healthcare through this lens, patients can expect to receive care aligned with their needs while keeping in mind that the employees do have an insider perspective into their product. Healthcare is ever changing so the more educated we can make our customers, the more satisfied they can be.


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Matheny School has ‘changed our lives’ Ryan O’Connor was born 10 years ago with a very rare chromosome deletion. His family was told that he would function at an extremely low level and would never walk or talk. Ryan’s mother, Debbie O’Connor, described the family’s initial reaction to this news. “As with most parents with special needs children,” she said, “to say we felt discouraged would be an understatement.” Speaking at The Matheny School’s Open House on October 9, the Annandale, NJ, resident recalled what happened when Ryan reached three years of age, time for him to go to school. The O’Connors visited Matheny, having learned about it through Ryan’s therapists and the Clinton Township School District. “I’ll never forget the first day I brought him here,” she said. “I was in denial and was so afraid to leave my special child in the care of strangers. But these strangers quickly became the people who would change his life and our lives. A child who could barely eat began to slowly learn how to swallow. A child with very limited gross motor skills began to learn how to move. A child with no fine motor skills began to learn to pick up his own food.” And then, on Christmas Day 2008, “Ryan gave us a true Christmas miracle. With a house filled with family and friends, Ryan stood up and began to walk, completely unassisted, through our home. He wandered for several minutes from room to room, taking in his surroundings while we all watched in complete amazement.” All of these milestones, O’Connor said, were reached because of Matheny. “There are no limitations here,” she added. “No one looks at our children and ever says the words, ‘They can’t do that’. Matheny is not just a school for our children. It’s a safe environment made up of amazing people who give everything they have to give our children a life that, as a parent of a special needs child, you may have thought would never be possible. Matheny is a place where miracles happen everyday.” The Matheny School is part of the Matheny Medical and Educational Center, a special hospital and educational facility in Peapack, NJ, for children and adults with medically complex developmental disabilities. Students with multiple disabilities, ages 3-21, are provided with an opportunity to reach their highest level of academic achievement, while also obtaining maximum independence. Ryan O’Connor

Ryan with Cindy LaBar, Matheny director of physical therapy.

photos provided

Debbie O’Connor, speaking at The Matheny School Open House.


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Hospital Newspaper - NJ

RESOURCE DIRECTORY ARCHITECTURE

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Bernstein & Associates, Architects Founded in 1990, Bernstein & Associates, Architects, specializes in the design and construction of hospital and healthcare facilities. Our focus: high-quality design, excellent service, and client satisfaction. We have worked for over 100 hospitals and another 200 private healthcare facilities, across the United States. Our project types have included all hospital and healthcare service groups, including: Adult Day Care, Alcoholism Treatment Facilities, Ambulatory Surgery Centers, Assisted Living, Cancer Centers, Cardiac Cath, Cardiology, CCU/ICU, Clinics, Coronary Care, Dental, Dermatology, Dialysis Clinics, Doctors Offices, Drug Treatment Facilities, Elder Care, Employee and Student Health Support Services, Emergency Departments, Emergency Preparedness, Endoscopy, ENT, Expert Witness, Group Practices, Hospices, Hospitals, Infectious Disease, Information Systems, Intensive Care, JCAHO Survey, Joint Commission Survey, Laboratories, Master Plans, Medical Offices, Medical Equipment, Medical Libraries, Medical Records, Neurology, Nursing Homes, Ophthalmology/Eye Center, OB/Gyn, Orthopedic, Pain Care Facilities, Pathology, Patient Safety Consulting Services, Pediatric, Pharmacy, Physical Fitness and Sports, PT/OT, Primary Care Programs, Psychiatric, Radiology, Rehabilitation, Senior Citizen Facilities, Sleep Centers, Social Services, Statement of Conditions, Surgical Suites and Ambulatory Surgery Centers, Urgent Care Centers, and USP 797 Consulting Services. The firm's projects have won design awards from Progressive Architecture, Architectural Record, and the Architectural Woodworking Institute, and have been published in Advance, Health Facilities Management, Medical Technology Today, Bio/Technology, Progressive Architecture, Architectural Record, Design Solutions, Hospitality Design, Sound and Communication, Contract Design and Hospital Newspaper. Architectural Services include: programming, planning, design, construction documents, bidding and negotiation, and construction administration. The firm also offers sustainable or “green” healthcare design. The firm has a number of LEED-accredited professionals, has successfully completed numerous green healthcare projects, and has published articles on “Greening the Healthcare Environment”. Project Management (or Owner’s Representative Services) is offered as a stand-alone service through our affiliated project management company, Empire Projects, Inc. (www.empireprojects.com). Bernstein & Associates, Architects - PLLC 1201 Broadway - #803, New York, NY 10001 Contact: William N. Bernstein, AIA Managing Principal Tel: 609-309-7005 Fax: 609-309-7006 wb@bernarch.com NEW YORK - HARTFORD - PRINCETON

The Wedgie Pelvic Exam Wedge provides fast, comfortable pelvic exams in the ER, Radiology, SANE and Women’s Health. It is a much more comfortable than using a hard bedpan. The 6" height of the Wedgie lifts the patient's pelvis significantly higher then a bedpan, thus allowing physicians to perform a better exam. The Wedgie’s unique cutout design allows the physicians to maneuver their speculum in all directions without interference. The Wedgie support patients weighing up to 350 lb. It is made of a medical grade foam and an anti-microbial, anti-bacterial, and stain resistant medical grade vinyl cover. It can be cleaned with standard disinfectant products. Optional: disposable one-time use protective covers and room wall holders are available.

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Contact Jim Stankiewicz to find out how your organization can be featured in our Resource Directory.

845-534-7500 ext.219 Fax: 845-534-0055

Online Directory available at www.hospitalnewspaper.com

HOME MORTGAGES Gateway Funding specializes in mortgage options to the healthcare industry. We understand the nuances involved with obtaining mortgages for physicians, nursing staff, residents, or general staffing. You’re busy, we know it. Your unique, we get it. You need financing for a home, we provide it. One call or email to our experienced, licensed and fully trained loan officers, will put your mind at ease. We can provide No Cost Pre-Approvals prior to looking for a home, and highly competitive rates and fee’s once you do find your dream home!

Frank Mancino, Branch Manager NMLS#133472 3564 Quakerbridge Rd Hamilton, NJ 08620 877-583-3562 fmancino@gatewayfunding.com www.TheMancinoTeam.com


Hospital Newspaper - NJ November, 2013

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HELP Program looks out for the people who care so much about us Caring nurses, attentive doctors and their thoughtful staff don’t just treat patients. They care for families and communities, serving as advocates to the population. They work tirelessly, selflessly and take pride in what they do. That’s why we appreciate them so much, that’s why Sun Home Loans and Hospital Newspaper teamed up to create the Hospital Employee Loan Program (H.E.L.P.) last year. This innovative mortgage provides discounted mortgage rates designed for hospital employees and pre-qualifications for their next home or refinance. It has been an overwhelming success. Why? There are so many reasons. Sun Home Loans provides some of the best mortgage rates in the industry. Meanwhile, the customer service clients receive from initial inquiry up until the big day – closing – is first-rate. We believe that the doctors, nurses and other employees who treat us every day deserve nothing but the best service and programs. That will never change as H.E.L.P. continues to expand and gain popularity. In part, the initiative was created to honor these men and women. “I think everyone has been touched in some way by a caring doctor or nurse,” said Steven Testa, a Vice President with Sun Home Loans. “These caring individuals go out of there way for everyone they come into contact with on a daily basis. You are talking about a big part of the fabric of this society. That’s why we created the H.E.L.P. program and I can’t tell you who proud we are that we did.” Whether purchasing a new home or refinancing an existing one, the Sun Home Loans H.E.L.P. program is offered to members of the hospital community and their families. A H.E.L.P. program representative will assist you in making sure the process is cost-effective and works for you and your family. In addition, Sun National Bank provides a full-range of banking products and services, delivered by experienced bankers. It’s the least we can do for people who care and do so much for all of us. To receive more information about the program and its benefits, contact Steven Testa at stesta@sunnb.com or call 973-615-9745. Sun National Bank Home Loans and Hospital Newspaper are not affiliated. All loans subject to approval. Certain conditions and fees may apply. Mortgage financing provided by Sun National Bank Loans, Equal Housing Lender.

Win an iPad! If you are a member of the hospital community, now is your chance to enter Sun Home Loans and Hospital Newspaper's contest to win a free iPad. Just to go our website at www.hospitalnewspaper.com and fill in the entry form. Once you complete it, you will receive an email that requires you to confirm your email address. Once you do that you are entered. Hospital Newspaper will also be accepting applications at all conventions that it attends. A total of Five iPads will be given away so your chances to win are excellent. Sign up today to win today!

Hospital Employee Loan Program

Sun Home Loans, a division of Sun National Bank, is proud to serve the heroes in our community who dedicate their lives to serving the rest of us: doctors, nurses and other hospital employees.

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That is why we teamed up with Hospital News to create the Hospital Employee Loan Program (HELP). With a competitive mortgage rate and discounted

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fees, this program helps our community heroes purchase new homes or refinance existing homes. Plus, the program comes with our pledge to get hospital employees in their new homes by their contract dates.

We understand that the current economic environment has created challenges to home ownership. Working with our own resources and Federal government programs we will create a solution that opens

The Hospital Employee Loan Program delivers these advantages: » A competitive mortgage rate, available specifically for hospital employees » Discounted fees » Personal service from program specialists » Our pledge to have you in your home by the contract date

COMMUNITY FOCUS Sun National Bank, a full-service provider of banking products and services, is dedicated to playing an active part in the communities we serve. We support a variety of organizations, events and programs whose goals are to make our neighborhoods a better place to live and work and improve the lives of those living around us. Hospital News is the leading provider of local news and information for doctors, nurses and other hospital staff.

Learn More To find out more about our Hospital Employee Loan Program, email stesta@sunnb.com or call 973-615-9745 to talk with our program specialist, Steve Testa (NMLS #460176), who will discuss your need and explain how the program could benefit you.

www.sunnb.com Sun Home Loans, Sun National Bank, and Hospital News are not affiliated. All loans subject to approval. Certain conditions and fees may apply. Mortgage financing provided by Sun Home Loans, a division of Sun National Bank, member FDIC. Equal Housing Lender.

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November, 2013

Hospital Newspaper - NJ

RESOURCE DIRECTORY extended caRe & aSSiSted living daUgHteRS oF iSRael Daughters of Israel is a multi-faceted, stateof-the-art skilled nursing facility offering the most modern and comprehensive services available including: • • • • • •

Sub-Acute Rehabilitation Long-Term, Skilled Nursing Care Alzheimer’s Care Hospice & Palliative Care Respite Stays The Charles Bierman Home Senior Housing with Assistance • The Sarah & Aaron Franzblau Institute for Continuing Education Our team of skilled and dedicated professional staff deliver the highest quality of care for our 300+ residents. Services provided include: round-the-clock professional nursing care; 24hour medical coverage by board-certified geriatricians; on-site synagogue with full-time rabbinical services; a full range of stimulating and innovative recreational activities; on-site beauty salon, barber shop, work activity center, gift shop and coffee shop; spacious dining rooms, auditoriums, lounges and outdoor patio areas. Our sub-acute rehabilitation facility, which functions as a separate unit within the Home, features a spacious gym with state-of-the-art equipment and comfortable recovery suites with luxury amenities. Semi-private and private rooms are available at Daughters of Israel. The facility is covered by Medicare, Medicaid, commercial insurances and private payment. Daughters of Israel is a beneficiary agency of United Jewish Communities of MetroWest, N.J. 1155 Pleasant Valley Way, West Orange, NJ 07052 www.doigc.org Contact: Adena Twersky, Director of Admissions Tel: 973-400-3307 Fax: 973-731-8364 atwersky@doigc.org

HoSpitalS BeRgen Regional Medical centeR, l.p. Located in Paramus, Bergen Regional Medical Center is the largest hospital in New Jersey dedicated to serving the residents of Bergen County and surrounding communities. With 1000+ beds and 1,500 staff members, the hospital specializes in Behavioral Health Services, which include child and adolescent, adult and geriatric psychiatric treatment. Long Term Care Services provides a scope of services, which far exceeds that offered in a standard nursing home. As a full service accredited medical center, we provide wound care, surgical care, cardiac care, rehabilitation services, respiratory care unit which includes ventilator dependent residents, Korean care services and an acute care unit all under one roof for our residents. The hospital excels in the treatment of substance abuse. The hospital offers detoxification, 21-day rehabilitation program, outpatient services, and treatment for the mentally ill and chemically addicted. Our Acute and Ambulatory Services offers same day surgery, medical and specialty clinics and state-of -the-art operating suites. www.bergenregional.com Tel. 201-967-4000

Medical Billing Cape Medical Billing (CMB) is your single source billing provider for curing undetected “revenue leakage” that plagues today's healthcare practices. CMB has been in business for 22 years and is uniquely qualified to help your medical practice reverse “revenue leakage” with fast, efficient, innovative and customized billing programs. We offer personalized and cost effective service with 92.9% of charges paid upon the first submission! We accomplish this everyday by utilizing our “state of the art” billing software and paying close attention to critical detail used to match and process data. We also pride ourselves on significantly reducing days in accounts receivable by deploying aggressive and consistent follow-up procedures. Our technology, expertise and personal approach drive our billing practices and produce unparalleled results for our clients. Are you currently doing billing in house and considering outsourcing? No problem, we can integrate our technology with your current EMR software package and help you convert your medical services to consistent cash flow! Our billing specialties: Cardiology, Internal Medicine, Podiatry, Family Practice, General Surgery, Pathology, Infectious Disease, Gastroenterology, OB/GYN, Neurosurgery, Urology, Trauma Surgery, PT/OT, Mental Health and Ambulance. We're the experts...STOP risking your money and profit by collecting it yourself, or utilizing a billing company with less experience. We collect the HARD Stuff and we do it every day! Call for a FREE Billing Analysis to detect and solve your revenue leakage! Contact: Richard Papperman, CEO/President of Cape Medical Billing Office: 609-465-8900 rich@capebilling.com or Sherrii Brentari Director of Sales and Marketing Cape Medical Billing sherrii@capebilling.com 609-465-8900

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contact Jim Stankiewicz to find out how your organization can be featured in our Resource directory.

845-534-7500 ext.219 Fax: 845-534-0055

Online Directory available at www.hospitalnewspaper.com

Learn What You Must Do To Protect Your Workers' Compensation And Disability Rights! Do Not Make These Mistakes That Can Cost You Benefits

1. You must report the accident or injury as soon as possible, even if you might not lose time from work or need immediate medical care. 2. Report all injuries to all body parts, no matter how minor they may seem. If you do not report it and the injury gets worse over time, the job may deny benefits. 3. Remember, you are entitled to treatment and benefits even if you have previously injured the same body part in a prior accident. Do not let the job tell you different. 4. Your doctor controls the treatment, not risk management. If you need an MRI and the job will not approve it, the experienced attorneys at BAGOLIE FRIEDMAN can fight to get it approved at no cost to you. 5. When you are released from treatment, you may be entitled to money for your injury and disability. You may also collect for repetitive stress, cumulative trauma, cancer, hearing loss & hepatitis. 6. Contact Attorneys Ricky Bagolie or Alan Friedman now for a confidential and free consultation and to discuss your workers' compensation and disability rights. There is no fee if there is no recovery call toll FRee 1-866-333-3529 (After Hours / Emergency Number 201-618-0508) Bagolie FRiedMan, llc Workers' compensation & disability attorneys The Five Corners Building 660 Newark Avenue - Jersey City, NJ 07306 (201) 656-8500 790 Bloomfield Avenue - Clifton, NJ 07012 (973) 546-5414

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HQ Location: Cape Medical Billing 5 Locust Lane P.O. Box 670 Cape May Court House, NJ 08210 Office: 609-465-8900 Fax: 609-463-8106 www.capebilling.com

apparatus Campbell Supply company www.campbellsupplyco.com expositions Abilities Expo www.abilitiesexpo.com financial Institutions Healthcare Employees Federal Credit Union www.hefcu.com home care specialists Comprehensive Home Care www.homecarenj.com hospitals Children’s Specialized Hospital www.childrens-specialized.org Matheny Medical & Educational Center www.matheny.org

internet address directory Meridian Health www.meridianhealth.com medical equipment & products TSK Products, Inc. www.tskproducts.com


Hospital Newspaper - NJ November, 2013

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FBI receives training at Holy Name Medical Center's Institute for Simulation Learning Recently, 12 members of the NY and Newark based FBI Operational Medicine Program participated in a customized simulation training program offered by the Institute for Simulation Learning at Holy Name Medical Center. The training event included the use of Holy Name’s high fidelity human patient simulators and trained simulation staff to recreate medical scenarios the FBI participants may encounter in the line of duty. The scenarios, written and implemented by the Institute for Simulation Learning, were customized for the FBI usingthe most recent bureau-established protocols to treat victims of a shooting, a stabbing, an anaphylactic reaction and a spinal injury. Ray Dwyer, the EMS (Emergency Medical Services) Manager and Clinical Coordinator for Holy Name Medical Center’s EMS Services, provided training related to anaphylactic shock and EpiPen® administration. Additional skill training including airway management and cervical spine immobi-

lization was offered prior to the simulation exercise. The training was well received by the participants who validated its relevance to their duties. Cedar Wang, MSN, RN, GNPBC, CHSE, Director of Simulation Learning at Holy Name says,“We anticipate that the training developed for the FBI can be offered to other law enforcement agencies and municipalities in the area.” Premier Interdisciplinary Education at the Institute for Simulation Learning The Institute for Simulation Learning at Holy Name Medical Center represents the leading edge in clinical education by offering an authentic, immersive environment for healthcare professionals to develop safe, innovative and compassionate approaches to patient care. The Institute for Simulation Learning provides premier interdisciplinary education and functions as a system-wide think tank that allows the healthcare team to replicate challenging medical, as well as non-medical, situations with the

provided

Member of the FBI Operational Medicine Program identifying anaphylaxis and administering lifesaving treatment after a child [SimJunior®] with a nut allergy eats a nut-tainted cookie.

goal of optimizing real-world outcomes. Advanced technology and authentic scenarios are designed to refine skills and to foster team collaboration and communication. The professional simulation staff incorporates evidence-based principles and practices to improve the quality, safety and efficiency of healthcare delivery.

Authentic Scenarios Unfold in a Controlled Setting Simulation education with computer-controlled technology and standardized patients (actors), enables clinicians, administrators, students and corporate professionals to improve their performance by developing and practicing techniques, skills and protocols with-

out compromising the safety of real patients. High-fidelity patient simulators—an adult male, a pregnant female, a child, and an infant that blink, breathe and have a heartbeat—replicate almost every bodily function and produce accurate responses to the caregiver's interventions. These virtual patients, in addition to standardized patients (actors), advanced audiovisual systems and trained simulation staff, provide the ideal context for modern healthcare training and continuing education. Learners apply their skills in realistic clinical encounters that representa wide spectrum of diagnoses, and/or situations involvboth clinical and ing interpersonal skills such as obstetric emergency, cardiac arrest, delivering bad news, counseling and conflict resolution—the customized learning opportunities are unlimited. To learn more about the Institute for Simulation Learning, visit www.holyname.org/Simulation.

EMERGENCY MEDICINE UPDATE CME 2013 Conferences 9/23-26 Las Vegas, Nevada

11/4-8 Maui, Hawaii

2014 Conferences 1/20-23 Duck Key, Florida

2/2-7 Turks and Caicos

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3/17-20 Las Vegas, Nevada

4/12-19 7-Day Caribbean Cruise

5/19-22 New Orleans, Louisiana

7/5-12 7-Day Alaskan Cruise

7/21-25 Yosemite, California

8/25-29 Whitefish, Montana

9/15-18 Las Vegas, Nevada

11/13-16 Key West, Florida

12/9-12 Paradise Island, Bahamas

2014 Ultrasound in Emergency Medicine 3/20-21 Las Vegas, Nevada

9/18-19 Las Vegas, Nevada

2015 Tentative Conferences 3/16-19 Las Vegas, Nevada

4/19-24 Turks and Caicos

9/14-17 Las Vegas, Nevada

2016 Tentative Conferences 3/14-18 Las Vegas, Nevada

north west S E M I N A R S

9/12-16 Las Vegas, Nevada

(800) 222-6927 www.northwestseminars.com


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Hospital Newspaper - NJ

Calling All Emergency Responders

When every second counts... Count on NitroMist

®

NitroMist provides fast, effective symptom relief. NitroMist provides a consistent dose with each metered spray.* NitroMist offers secure storage, ensuring potency for up to 36 months from date of manufacture.† Available in 90 & 230 spray bottles. For product samples, patient educational material, and the NitroMist ER Box (Shown), Go to: www.NitroMistPro.com Now covered on UnitedHealthcare. Check with your GPO for low contract pricing. For additional information, please contact us at info@akrimax.com BRIEF SUMMARY NitroMist® (nitroglycerin) lingual aerosol Rx Only INDICATIONS AND USAGE– NitroMist is indicated for acute relief of an attack or acute prophylaxis of angina pectoris due to coronary artery disease. CONTRAINDICATIONS– PDE5 Inhibitor Use: Administration of NitroMist is contraindicated in patients who are using a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5), as PDE5 inhibitors such as sildenafil, vardenafil, and tadalafil have been shown to potentiate the hypotensive effects of organic nitrates. Severe Anemia: NitroMist is contraindicated in patients with severe anemia. Increased Intracranial Pressure: NitroMist is contraindicated in patients with increased intracranial pressure. Hypersensitivity: NitroMist is contraindicated in patients who have shown hypersensitivity to it or to other nitrates or nitrites. Skin reactions consistent with hypersensitivity have been observed with organic nitrates. WARNINGS AND PRECAUTIONS– Tolerance: Excessive use may lead to the development of tolerance. Only the smallest number of doses required for effective relief of the acute anginal attack should be used. As tolerance to other forms of nitroglycerin develops, the effect of sublingual nitroglycerin on exercise tolerance, although still observable, is reduced. Hypotension: Severe hypotension, particularly with upright posture, may occur even with small doses of nitroglycerin. The drug should therefore be used with caution in patients who may be volume-depleted or who, for whatever reason, are already hypotensive. Hypotension induced by nitroglycerin may be accompanied by paradoxical bradycardia and increased angina pectoris. The benefits of NitroMist in patients with acute myocardial infarction or congestive heart failure have not been established. If one elects to use NitroMist in these conditions, careful clinical or hemodynamic monitoring must be used because of the possibility of hypotension and tachycardia. Hypertrophic Cardiomyopathy: Nitrate therapy may aggravate the angina caused by hypertrophic cardiomyopathy. Headache: Nitroglycerin produces dose-related headaches, which may be severe. Tolerance to headaches occurs. ADVERSE REACTIONS– Headache, which may be severe and persistent, may occur immediately after nitroglycerin use. Flushing, drug rash and exfoliative dermatitis have been reported in patients receiving nitrate therapy. Postural hypotension, as manifest by vertigo, weakness, palpitation, and other symptoms, may develop occasionally, particularly in erect, immobile patients. Marked sensitivity to the hypotensive effects of nitrates (manifested by nausea, vomiting, weakness, diaphoresis, pallor, and collapse) may occur at therapeutic doses. Syncope due to nitrate vasodilatation has been reported. DRUG INTERACTIONS – PDE5 Inhibitors: Administration of NitroMist is contraindicated in patients who are using a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5). PDE5 inhibitors such as sildenafil, vardenafil, and tadalafil have been shown to potentiate the hypotensive effects of organic nitrates. The time course and dose dependence of this interaction have not been studied, and use within a few days of one another cannot be recommended. Appropriate supportive care for the severe hypotension has not been studied, but it seems reasonable to treat this as a nitrate overdose, with elevation of the extremities and with central volume expansion. The use of any form of nitroglycerin during the early days of acute myocardial infarction requires particular attention to hemodynamic monitoring and clinical status. Antihypertensives: Patients receiving antihypertensive drugs, beta-adrenergic blockers, and nitrates should be observed for possible additive hypotensive effects. Marked orthostatic hypotension has been reported when calcium channel blockers and organic nitrates were used concomitantly. Labetolol blunts the reflex tachycardia produced by nitroglycerin without preventing its hypotensive effects. If labetolol is used with nitroglycerin in patients with angina pectoris, additional hypotensive effects may occur. Aspirin: Coadministration of aspirin and nitroglycerin has been reported to result in increased nitroglycerin maximum concentrations by as much as 67% and AUC by 73% when administered as a single dose. The vasodilatory and hemodynamic effects of nitroglycerin may be enhanced by concomitant administration of aspirin. Tissuetype Plasminogen Activator (t-PA): Intravenous administration of nitroglycerin decreases the thrombolytic effect of tissue-type plasminogen activator (t-PA). Plasma levels of t-PA are reduced when coadministered with nitroglycerin. Therefore, caution should be observed in patients receiving nitroglycerin during t-PA therapy. Heparin: Intravenous nitroglycerin reduces the anticoagulant effect of heparin. Activated partial thromboplastin times (APTT) should be monitored in patients receiving heparin and intravenous nitroglycerin. It is not known if this effect occurs following single nitroglycerin doses. Ergotamine: Oral administration of nitroglycerin markedly decreases the first-pass metabolism of dihydroergotamine and subsequently increases its oral bioavailability. Ergotamine is known to precipitate angina pectoris. Therefore, patients receiving sublingual nitroglycerin should avoid ergotamine and related drugs or be monitored for symptoms of ergotism if this is not possible. USE IN SPECIFIC POPULATIONS– Pregnancy: Pregnancy category C: Animal reproduction and teratogenicity studies have not been conducted with NitroMist or nitroglycerin sublingual tablets. It is also not known whether NitroMist can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. A teratogenicity study was conducted in the third mating of F0 generation female rats administered dietary nitroglycerin for gestation day 6 to day 15 at dose levels used in the 3-generation reproduction study. In offspring of the high-dose nitroglycerin group, increased incidence of diaphragmatic hernias and decreased hyoid bone ossification were seen. The latter finding probably reflects delayed development rather than a potential teratogenic effect, thus indicating no clear evidence of teratogenicity of nitroglycerin. There are no adequate and well controlled studies in pregnant women. NitroMist should be given to a pregnant woman only if clearly needed. Nursing Mothers: It is not known whether nitroglycerin is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when NitroMist is administered to a nursing woman. Pediatric Use: The safety and effectiveness of nitroglycerin in pediatric patients have not been established. Geriatric Use: Clinical studies of NitroMist did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other rep-

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orted clinical experience has not identified differences in responses between elderly (greater than or equal to 65 years) and younger (less than 65 years) patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. OVERDOSAGE– Signs and symptoms of hemodynamic effects: The effects of nitroglycerin overdose are generally the results of nitroglycerin’s capacity to induce vasodilatation, venous pooling, reduced cardiac output, and hypotension. These hemodynamic changes may have protean manifestations, including increased intracranial pressure with any or all of persistent throbbing headache, confusion, and moderate fever; vertigo; palpitations; tachycardia; visual disturbances; nausea and vomiting (possibly with colic and even bloody diarrhea); syncope (especially in the upright posture); dyspnea, later followed by reduced ventilatory effort, diaphoresis, with the skin either flushed or cold and clammy; heart block and bradycardia; paralysis; coma; seizures; and death. No specific antagonist to the vasodilator effects of nitroglycerin is known, and no intervention has been subject to controlled study as a therapy of nitroglycerin overdose. Because the hypotension associated with nitroglycerin overdose is the result of venodilatation and arterial hypovolemia, prudent therapy in this situation should be directed toward increase in central fluid volume. Passive elevation of the patient’s legs may be sufficient, but intravenous infusion of normal saline or similar fluid may also be necessary. The use of epinephrine or other arterial vasoconstrictors in this setting is not recommended. In patients with renal disease or congestive heart failure, therapy resulting in central volume expansion is not without hazard. Treatment of nitroglycerin overdose in these patients may be subtle and difficult, and invasive monitoring may be required. Methemoglobinemia: Methemoglobinemia has been rarely reported with organic nitrates. The diagnosis should be suspected in patients who exhibit signs of impaired oxygen delivery despite adequate arterial PO2. Classically, methemoglobinemic blood is described as chocolate brown, without color change on exposure to air. If methemoglobinemia is present, intravenous administration of methylene blue, 1 mg/kg to 2 mg/kg of body weight, may be required. NONCLINICAL TOXICOLOGY– Carcinogenesis, Mutagenesis, Impairment of Fertility: Animal carcinogenicity studies with sublingually administered or lingual spray nitroglycerin have not been performed. Rats receiving up to 434 mg/kg/day of dietary nitroglycerin for 2 years developed dose-related fibrotic and neoplastic changes in liver, including carcinomas, and interstitial cell tumors in testes. At the highest dose, the incidences of hepatocellular carcinomas was 52% compared to 0% in untreated controls. Incidences of testicular tumors were 52% vs 8% in controls. Lifetime dietary administration of up to 1058 mg/kg/day of nitroglycerin was not tumorigenic in mice. Nitroglycerin was found to have reverse mutation activity in the Salmonella typhimurium strain TA1535 (Ames assay). A similar mutation in S. typhimurium strain was also reported for other NO donors. Nevertheless, there was no evidence of mutagenicity in an in vivo dominant lethal assay with male rats treated with oral doses of up to about 363 mg/kg/day or in ex vitro cytogenic tests in rat and dog tissues. In vitro cytogenetic assay using Chinese hamster ovary cells showed no chromosomal aberrations. In a 3-generation reproduction study, rats received dietary nitroglycerin at doses up to about 408 mg/kg/day (males) to 452 mg/kg/day (females) for 5 months (females) or 6 months (males) prior to mating of the F0 generation with treatment continuing through successive F1 and F2 generations. The highest dose was associated with decreased feed intake and body weight gain in both sexes at all matings. No specific effect on the fertility of the F0 generation was seen. Infertility noted in subsequent generations, however, was attributed to increased interstitial cell tissue and aspermatogenesis in the high-dose males. PATIENT COUNSELING INFORMATION– Interaction with PDE5 Inhibitors - NitroMist should not be used in patients who are using medications for erectile dysfunction such as sildenafil, vardenafil, and tadalafil. These products have been shown to increase the hypotensive effects of nitrate drugs such as NitroMist. Administration - Patients should be instructed that prior to initial use of NitroMist Lingual aerosol, the pump must be primed by pressing the actuator button 10 times to ensure proper dose priming. If the product is not used for more than 6 weeks, the bottle can be adequately re-primed with 2 sprays. NitroMist is meant to be sprayed on or under the tongue at the beginning of angina or to prevent an angina attack. Treatment with nitroglycerin products such as NitroMist may be associated with lightheadedness on standing, especially just after rising from a laying or seated position. This effect may be more frequent in patients who have consumed alcohol, since alcohol use contributes to hypotension. If possible, patients should be seated when taking NitroMist. This reduces the likelihood of falling due to lightheadedness or dizziness. Headache - Headaches can sometimes accompany treatment with nitroglycerin. In patients who get these headaches, the headaches may indicate activity of the drug. Tolerance to headaches develops. Flushing - Flushing, drug rash and exfoliative dermatitis have been reported in patients receiving nitrate therapy. Container information - The NitroMist bottle should not be forcefully opened. Because NitroMist contains a highly flammable propellant (butane), do not have the container burned after use and do not spray directly towards flames. While the container is in the upright position, if the liquid reaches the top to middle of the hole on the side of the container, a new supply should be obtained. When the liquid reaches the bottom of the hole, the remaining doses will have less than label content. Manufactured for Akrimax Pharmaceuticals, LLC E Cranford, NJ 07016 by Dynamit Nobel GmbH, Leverkusen, Germany E Marketed and Distributed by: Akrimax Pharmaceuticals, LLC, Cranford, NJ 07016 USA NitroMist is a registered trademark of NovaDel Pharma Inc., used by permission. 141B002 10/2012

*Priming NitroMist: After receiving a new prescription or refill, patients should remove the plastic cap, place forefinger on actuator button, and press 10 times. NitroMist is now primed for 6 weeks and ready to use. If not used for more than 6 weeks, the NitroMist bottle can be adequately reprimed with 2 sprays. † Store at room temperature (25°C, 77°F); excursions permitted to 15-30°C (59-85°F). NitroMist is a registered trademark of NovaDel Pharmaceuticals, LLC., used by permission.

©2012 Akrimax Pharmaceuticals, LLC., Cranford, NJ 07016 October 2012 NTR-145T


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