2021 Mercy Hospital Nursing Annual Report

Nurses:

the courage to care and the strength to help.

Our Nursing Journey: 2021 Annual Report

Messages From Our Leadership Dear Mercy Hospital Nursing Team,

Table of Contents

4 Structural Empowerment 17 Awards & Certifications 2 Leadership Messages

20 Transformational Leadership 21 Exemplary Professional Practice 24 New Knowledge, Innovations, & Improvements Annual Report Acknowledgements Committee Members: Allison Revelas- Chair Vicky Loretto Sarah Wiktor Doug Diver Suzie Coppola Joan Vetter Elaine Keegan Alex Foley Alex Gorrow Melanie Griffis- Editing/Layout

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Well, just when we thought it was over, it was back in 2021. The pandemic continued to impact our lives and the work we do each day.

Your annual report theme this year, “Nurses: the Courage to Care and the Strength to Help,” is a perfect way to describe our nursing team who faced challenge after challenge.

Eddie Bratko After nearly two years of stress, anxiety, Mercy Hospital President long hours, and another significant COVID surge, we were tired but didn’t stop. Coupled with social unrest throughout the country and a work stoppage in October, we persevered. Yes, you—our nurses—have shown courage, strength, and most of all, resilience. During these trying times, it’s more important than ever that we unite together as a hospital family as it will bring us even greater strength to carry on our Catholic Health mission and deliver quality, compassionate care to our community.

Through it all, your selfless dedication to our patients helped Mercy Hospital achieve national recognition for quality care despite everything we faced. In 2021, Mercy Hospital was rated among the best hospitals in the nation for heart bypass surgery, aortic valve surgery and care for stroke, heart failure, COPD, and diabetes by U.S. News and World Report. In addition, the American Heart/Stroke Association presented Mercy with the Stroke Gold Plus Quality Achievement Award for the ninth year in a row and the Gold Quality Achievement Award for Heart Attack Care. We also received the Healthgrades 2021 Labor and Delivery Excellence Award, placing Mercy Hospital in the top 10% of all hospitals evaluated in the nation for exceptional care of mothers during and after labor and delivery.

You are the backbone of the hospital and it is your commitment to making a difference in the lives of our patients and their families that is the basis for our transformational work—and it shows during these challenging times and every day. Thank you for all that you do.

Sincerely,

Eddie Bratko Mercy Hospital President

Stronger Through Teamwork Looking back to years past, we often reflect on those few defining moments which leave a significant imprint on our lives and create unforgettable memories. I would posit that you and I have never experienced a year such as the last two. A year that included a global pandemic, a slumping of economy, work stoppage, and the need for true social justice coming to the forefront—a time period that will forever change healthcare.

As nursing professionals, we are committed to being knowledgeable, inquisitive, caring and compassionate. We count on science and evidence-based practice to guide our decision making. As leaders, we use the ANA/ AACN scope of practice, standards of care and ethical practice to groom our nursing team members. For the last twenty years, nursing has been recognized as the most trusted profession. It’s a profession that has persevered over the last 100 years and a profession that is tired and questioning itself now. There are team members who have lost the passion and the stamina to do that one last thing. A large contributor to these challenges is the nursing shortage lending to short staffing, which is my number one priority. There are two options: 1– to feel so overwhelmed or unqualified or undervalued that we do nothing. 2– to start with one small act and qualify ourselves. We say, “please change, we need change.” But how do we show up to change our own lives? How do we show up to change the lives of the people in our workplace and our communities?

Shari McDonald, RN, MSN VP, Patient Care Services Chief Nursing Officer

James Baldwin, a famous writer and voice of the American Civil Rights Movement, once said, “Everything now, we must assume is in our own hands; we have no right to assume otherwise.” I want to re-ignite that passion, and for you think back to why you became a nurse. I challenge you to share your story and feel the light within. The way we find our strength is through our challenges. I want you to know that each of us is more resilient then we can ever imagine. As I reflect on my own feelings the last two years and trying again to find my inspiration, I reflected on the power of nursing and encourage you to do this also. Do this with compassion. Do this with forgiveness. Learn to forgive others. Start by truly learning to forgive yourself. We are all more than our mistakes. We are all more then who we were yesterday. We are all deserving of our dignity. See yourself in others.

The many accomplishments featured in this annual report are proud moments for Mercy Hospital Nursing. It truly highlights the extraordinary commitment and care provided by our nursing staff, despite the overwhelming adversities facing them and our healthcare system. I have witnessed innovation, dedication, commitment and creativity from our nursing staff as they identify and develop solutions for managing new challenges created by COVID 19. Despite uncertainty during the fall work stoppage, our nurses’ voices were heard and changes were made. As a unified voice, nursing can make a difference for themselves and for our patients. Our stories are our greatest strength. A wonderful success story was the virtual patient rounding whereby the peri-op team as a conduit reached out to each patient’s family to update and communicate how the patient was doing. The staff were able to relieve the families’ stress and let them know their loved one was well cared for and we cared. Our shared services also supported each ministry with boots on the ground and support for the nurses, environmental services, and dietary. There are so many remarkable stories throughout the organization.

As I reflect on this year that presented lifelong altering and unparalleled challenges, I am most grateful for our nursing staff’s commitment and dedication to making Mercy Hospital not only survive, but to thrive. As you read the pages of this Nursing Annual Report, please take a moment to reflect on your power as a nurse and a caregiver.

Respectfully,

Shari McDonald, RN, MSN Vice President, Patient Care Services

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Structural Empowerment

“Nurses Supporting Nurses” Mentor Program A message from Sharon Scime RN and Chris Anderson RN, PCCN: “In 2017, our dream to start a mentorship program for nurses came to fruition.

When starting up the RN Mentorship program, our goal was to provide professional and personal development through a supportive and guided mentorship program with experienced professional RNs working in healthcare at Mercy Hospital. In addition, our team wanted to create an environment that could provide leadership and coaching to our future nurses and sometimes novice nurses in their personal and professional career growth. Hospitals are facing nurse retention challenges coming out of the recent pandemic, and because of this, nurses are abandoning the bedside from job dissatisfaction related to staffing issues. Mentorship programs are developing to enhance nursing satisfaction, ultimately improving retention, patient outcomes, and the quality of care our patients deserve. Evidence-based research has proven mentorship programs to be successful in decreasing turnover and improving retention. Our program here at Mercy Hospital of Buffalo has shown to be successful as nurses transition into their new roles as they come off orientation. They have told us through surveys and personally that the program has supported them emotionally and professionally in preparing them for their new roles and developing clinical skills.

Our formal program starts after orientation and carries through a six-month commitment between mentee/ mentor. Our team has aspirations of a continuing relationship after the six months. Mentors must have at least one year of experience and be on a volunteer basis. The mentor/mentee pairing is completed by establishing a “good fit” after carefully comparing both profiles submitted by each individual. We are always recruiting committed mentors with a positive outlook, who are great listeners, and have a passion for developing our future nurses.” MENTOR—Learning from someone who wants you to grow!

Nursing Professional Practice Council

The Nursing Professional Practice Council is excited to embrace the new format of Shared Governance this year. Last year, the members were very excited to share the results of their hard work. These endeavors included: assisting with a streamlined and efficient linen delivery service, recruiting many new members to the team, working with transport issues and resolving inconsistencies, updating the EMR and MAR to show which Pyxis station the medications are stocked in, resolving IV fluid / Pitocin issues from Labor and Delivery, getting disaster documentation into Epic, and installing the new ceiling tiles in the inpatient units that advertise to the patient to call for assistance before getting out of bed. We look forward to an exciting 2022 and can’t wait to update you all on the projects we are working on already!

Charge Nurse Council

The Charge Nurse Council meets monthly. The council is led by Desiree Korbs, Nursing Supervisor, and Sharon Panzica Nursing Supervisor. It is comprised of the charge nurses from all of our medical surgical units. The charge nurses in this building have a very important role. They are the leaders of their units, mentors, and problem solvers. They motivate their team to reach higher and expand their critical thinking. Our charge nurses are effective communicators with patients, families, physicians and staff.

The council felt that the night shift wanted a stronger voice, so the meetings were expanded to include a monthly night meeting. This has increased the cohesiveness between shifts. It also brought many new ideas. The supervisor group introduced the staffing grids, and the daily staffing sheets to the group. The group participated in a round table discussion to understand how daily staffing decisions are made for the medical surgical units. Everyone participated in staffing their own units. It was a very thought provoking and brainstorming session. Many great thoughts and ideas for improvement came from this session. We are looking forward to reigniting this group for 2022.

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“You are the Heart of Mercy” Nurses/Hospital Week 2021 “You Are the Heart of Mercy” was this year’s theme for National Hospital and Nurses Week in May. The week was jammed with festivities including a Blessing of the Hands, Ice Cream Sundaes, Taco Tuesday, Plinko and Popcorn, Coffee and Donuts, and even a Scavenger Hunt and a Canvas Painting Contest.

Associates honored at the Annual Nursing Awards Ceremony were: Nurse of Distinction Alexandria Foley ‘21 and Mary Ann Murphy ‘20; Outstanding Staff Nurse Jennifer Worthington ‘21 and Alexandra Rabarsky ‘20; Catherine McAuley Award Sharon Panzica; Jon C. Carlson Award Wendy Cushing; Father Nelson Baker Award Sarah Raab and Miok Priester; Outstanding Nurse Aide Clarissa Jones; Outstanding Surgical Tech Daniele Berdysiak; Outstanding Unit Secretary Ann Marie Desiderio; and DAISY Nurse Leader of the Year Joan Vetter.

Mercy Hospital also unveiled its new Associate Wellness Room located on the 7th floor during National Hospital Week. Critical care nurse Meghan Quinn came up with the idea in response to the stress and fatigue she and her co-workers felt during the pandemic. She collaborated with Michelle Wild, Director of Nursing and Operations, to create the relaxing space that is now available free to all associates. The room was made possible through donations from the Conor J. Long Foundation, named after Meghan’s late brother who passed away in 2018 from a hiking accident, and contributions from nursing leadership.

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Structural Empowerment

Community Outreach EMS Liaison Outreach The EMS Liaison team has continued its EMS outreach program throughout the pandemic. Programs include continuing medical education programs such as “Dialysis Emergencies”, “Stroke – The Large Vessel Occlusion”, “Cardiology Simulation”, ‘General Medical Emergencies”, “Mental Health for the First Responder”, and “Mobile Simulation Training”, as well as education drop offs to the crews at their posts.

The Mobile Simulation and Training Unit below was unveiled in November of 2020 and has become our most requested training opportunity. This unit is a fully stocked ALS ambulance which includes an ACLS simulation mannequin, a difficult airway mannequin, an IO gun trainer, and a number of video laryngoscopes for the area EMS providers to train on. A number of the ED’s throughout the CHS system have also requested to utilize our simulation equipment for some enhanced training.

The Mobile Simulation and Training Unit is the first of its kind of WNY, one of only two in NYS, and one of only a handful in the country.

We are blessed to have this asset at our disposal. This unit would not have been possible if it weren’t for the relationships that the EMS Liaison team has grown over the last 5 years. The ambulance was purchased from the Lewiston # 1 FD, the simulation equipment is on loan from Erie County Emergency Services, and the equipment to stock the rig has been donated by a large number of EMS agencies throughout WNY.

The EMS Liaison department is extremely proud of our outreach program and the relationships that we continue to build with our EMS partners.

Mercy Hospital Foundation Autumn Ball—”Thankful Hearts” Mercy Hospital Foundation’s “Thankful Hearts” Autumn Ball was held virtually in early December, raising more than $77,000 to support the hospital. Honorees included Dr. Stephen Downing—Dr. Thomas A. Raab Physician Champion Award; Scott R. Bieler Foundation—Community Partner Award; Alexandria Foley, RN, MSN—2021 Nurse of Distinction; Jennifer Worthington, RN, BSN—2021 Outstanding Staff Nurse; Mary Ann Murphy, RN, MS, IBCLC—2020 Nurse of Distinction; and Alexandra Rabarsky, RN, BSN, CCRN, CSC—2020 Outstanding Staff Nurse. Sincere thanks to our Autumn Ball sponsors who also treated all associates to a pastry heart to help end 2021 on a ‘sweet’ note!

Alexandria Foley

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Mary Ann Murphy

Jennifer Worthington

Alexandra Rabarsky

4 North Unit While 2021 presented our team with many challenges, the 4 North crew has remained committed to providing quality care to our patients, supporting our co-workers and being team players. Late in the year, the decision was made to formally close our unit and even while being displaced and working on other floors within the hospital, the team managed to stay intact and strong. Not once did we lose vision of our drive for excellence in patient care and quality in the service that we provide. We were glad that we could lend a hand for our patients and wish good luck to all the friends we’ve made through our contributions to other units throughout 2021.

5 East Unit

It was a busy year for 5 East! Some of our highlights from 2021 included: •

• • • • • • • • • •

Attained Age-Friendly level II Designation- with Committed to Care Excellence badge to be used for marketing 5E as an Age Friendly Health System Committed to Care Excellence and began reviewing Age Friendly criteria in SIDR rounds Submitted Age-Friendly stipend request and obtained $10,000 grant stipend for Mercy Hospital to be used on our Age-Friendly program this year Implemented 5-East Facebook Group to enhance our communication on 5-East 5-East nursing staff were part of a Mobility Survey and Assisted with Implementation of unit Mobility program We implemented a Fall Prevention program which continued to include the use of 3-Zone beds In 2021, we closed our unit for several weeks, and reopened with an additional 10 beds, making 5-East a 40-bed unit All 5-East staff maintain stroke competencies 8 hours yearly Implemented Pressure Ulcer prevention plan with T&P clocks at patient bedside Angel of Mercy Award given to 3 RN’s through the Mercy Hospital Foundation who received a donation for care provided by 5-East RN’s...Madeline Jacobs, Jenna Cochran and Dana Schiavone. Dana was new to our unit at this time and was still on orientation. Great job!

5-East RN Tom Lasker was honored at a Bison’s game for Frontline Healthcare Workers appreciation and was elected to throw the first pitch of the game 5-East Unit Clerk Ann Marie Desiderio won Unit Clerk of the Year award-Congratulations Ann Marie!

5 West (former 7E/8E) Unit

In 2021, the 7 East/8 East Units combined to one medical surgical unit and was relocated to 5 West. The team manages to maintain quality care for the patients while being a red zone. Goals for the upcoming year are to continue to collaborate and work as a team on the new unit and to decrease the fall rate.

Staff will continue to reinforce their commitment to quality care and providing a great patient experience. 5 West looks forward to 2022!

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Structural Empowerment

5 North Unit 2021 was a whirlwind of a year for 5 North. From being a COVID only unit, navigating supply chain issues, to splitting off from 5 North Center to create our own separate unit, the 5 North team has taken such changes and challenges in stride. 5 North has celebrated many wins this year including piloting a new mobility program at MHB that focuses on early mobility to increase mobility/function, with the goal of decreasing length of stay, pressure ulcers and falls. We have enjoyed our work with our partners for OT/PT and are excited to see the results of this pilot. The 5 North team looks forward to 2022.

5 Center Unit

The 5 Center staff continues to focus on improving patient experience.

• Working as a team throughout several challenges.

• Establishing the unit as a separate unit.

• Working on improving the appearance of the unit—painting the nurses station and replacing hand rails.

• The 5 Center Team looks forward to 2022!

6 East Unit

The 6 East Surgical Telemetry Unit update includes: » New Masimo monitors for every bed. The monitors download vitals into Epic in real time to increase patient safety and decrease time documenting. » Education given to staff on documenting in flow sheets in Epic to create accurate reports generated by Epic. » Utilizing Kronos for switches and picking up shifts to create an accurate schedule and decrease transcription errors.

6 West Unit

These past couple of years have been very transformative for 6 West.

Since the beginning of the pandemic, our normal has not been normal. We were made into a Covid team from a surgical team overnight, as we were one of the first red zones. We adapt well as a team and continue to make our patients’ safety and wellness our priority. Since the strike we have become a 20 bed unit from a 33 bed unit and care for medical, end of life, and Covid patients mainly. This is much different than our normal, surgical patients. We have become very strong because of this and have proven we can work well together through even the hardest times. We have gained many new nurses and aides and we look forward to what the future holds!

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7 East (former 5 W) Stroke/Neuro Unit The staff are very proud of all accomplishments in 2021. We continue to focus on patient experience including quality of care. We promote a welcoming environment to our patients, families and staff as well. All nurses maintain their BLS, ACLS and NIHSS certifications.

Goals are to continue to improve a positive patient experience, maintain staff retention and continue to provide quality patient care with a focus on reduction of falls.

Highlights from 2021 include: • Improvement in patient satisfaction • Initiative and focus on measures to reduce patient falls • Falls reduced after implementation of “stop sign” poster over the bed • Increase in retention • Bedside reporting to improve patient experience • SIDR rounds to enhance progressive patient care at discharge • Every staff member received a minimum of three CHEER awards for the year.

7 West Unit The 7 West Unit continues to focus on providing a welcoming environment to all patients, family members and staff. Quality is a top priority.

All 7 West RNS have 8 hours of stroke education and have certification with NIHSS stroke scale.

Education is top priority on 7 West. We routinely educate on CHF and CAD.

Documenting in patient zones—all staff document in close proximity to their assigned patient rooms, which helps with quicker response times.

Staff on 7 West provide enhanced communication to COVID family members.

I personally want to THANK all the staff on 7 West for their DEDICATION to the calling of health care and the staff who work together to deliver high quality care this past year.

Our Goal for 2022: Committed to make the patient experience the best it can be!

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Structural Empowerment

ICU, Rapid Response & 8 East Vent Stepdown Unit Resolve and resilience was the dominant theme for 2021.

Coming off the heels of the first wave of the Covid-19 global pandemic in 2020, the Critical Care Team learned many letters of the Greek alphabet in 2021, each time they were introduced to a new variant of the Covid virus. They saw red zones come up and down as cases waxed and waned, and tackled each associate challenge in stride. Through it all, the Critical Care Team never failed to exude kindness and compassion, providing much comfort, reassurance and exceptional care to members of the community.

Staff of the ICU, Critical Care Float Pool, and Rapid Response Team welcomed a new addition to the Critical Care Team when the 8 East Vent Step-Down Unit opened its doors in mid-November. A small group of exceptional staff left the comfort of their old home on the 5 West Stroke Unit, and did an amazing job tackling the challenges associated with embarking on this new adventure. The 8 East Vent Step-Down Unit houses long-term vent-dependent patients who are unable to be discharged to rehabilitation facilities, as well as patients who are not quite ill enough to be admitted to ICU, but need more monitoring than what can be provided on a medical-surgical floor.

ICU • • • • • • •

Successfully achieved a Silver-level Beacon Award for Excellence, an esteemed accolade recognizing ICU staff commitment and success in employing evidence-based practices to improve patient and family outcomes.

Joined forces with CVICU staff for 12 weeks to manage patient care for Medical, Neurocritical, and Cardio Thoracic service lines. The experience broadened the knowledge base of and strengthened relationships between the two units.

Introduced Tablo, a revolutionary dialysis machine that can deliver multiple modalities to treat both acute and chronic conditions, allowing nursing staff to fully manage and customize patient care in a flexible, streamlined way.

Launched the use of FloTrac, a device that uses arterial pressure waveform analysis to calculate stroke volume and cardiac output, consequently providing a method to determine hemodynamic status, changes in the clinical course, and responses to therapeutic intervention.

Collaborated with provider teams to improve structure of multidisciplinary rounds.

Participated in “Wipeout Wednesday,” and implemented suggested improvements for reduction of falls, meeting the target for 2021.

Graduated three nurse interns to full-time night shift staff nurses.

Rapid Response • • •

Educated and encouraged staff nurses to call rapid responses sooner than previously recommended, to reduce the number of rapid to code conversions.

Were enlisted as members of the Pulmonary Embolism Response Team, coordinating with critical care providers to rapidly assess and provide treatment for patients with acute pulmonary embolisms.

Implemented new strategies to respond to codes and other emergent situations that take place in non-patient care areas, including the introduction of the MegaMover transfer sheet which allows for easy maneuvering and transport of the ill or injured.

8 East Vent Stepdown Unit •

Provided comprehensive education to staff to expand their knowledge base and skill set to care for and manage: Diabetic ketoacidosis; Hyperosmolar hyperglycemic state;Thrombolytic therapy via tPA catheter; Small intracranial hemorrhages; Uncomplicated IV thrombolytics for acute ischemic stroke; Post-operative uncomplicated craniotomies; Ventilators.

• Bridged the gap between the ICU and medical-surgical floors, providing a smaller nurse-to-patient ratio for patients whose required level of care falls between the two.

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Cardiovascular Intensive Care Unit- CVICU The CVICU is located on the 2nd floor of Mercy Hospital next to the cath labs and down the hall from the Operating Room. The RN and ITA staff are very well engaged in the shared governance model and AACNs Healthy Work Environment Initiative. We have a very active UPC that has redesigned our whiteboards in our patients’ rooms, focused on patient satisfaction including noise at night, created a Buffalo cough buddy to replace our current bears for splinting after open heart surgery, created an activity bulletin board to encourage participation with “guess who we are” with our baby pictures, and what zodiac signs do our staff fall under (most staff were born under the sign of Taurus, followed by Virgo, and Cancer, Aquarius and Sagittarius are a tie for 3rd most frequent), in addition with staff activities outside of work to build relationships and friendships. We had a summer picnic and a winter party well attended.

The CVICU team leads the building with patient call light response for the past year, always exceeding the target of 80% of the calls within 2 minutes by >92% and under 1 minute. We are in the top 10 depts. at Mercy for our JCAHO compliance rounds, top 6.4% of all hospitals for cardiac surgery by US News & World report, and America’s Top 50 Best Hospitals by Healthgrades for cardiac surgery.

All of our accomplishments are the direct result of a CVICU team that leads by example, has a questioning attitude and delivers relationship based care to all our patients. We had 12 new RNs join and orient in the CVICU in 2021 and 40% of our RNs earned or maintained their CCRN certification.

Non-Invasive Cardiology Non-Invasive Cardiology had continued growth and focus on quality initiatives in 2021. The Stress Lab operates 7 days a week with services 7am to 3pm on Weekends and Holidays. The Echo Lab operates 7 days a week including holidays and 24/7 for emergencies.

EKG department operates seven days a week including weekends and Holidays from 6:30am to 11pm.

• • • • • • • • • • •

Noninvasive works closely with invasive labs since many heart procedures require TEE/echo as part of the procedure.

Mercy Sonographers are highly specialized and trained for invasive and noninvasive procedures.

Credentialed Cardiac Sonographers with RT Licenses obtained their injection licenses and can now administer echo contrast and do bubble studies.

Increase in invasive procedures—performed 1101 Transesophageal echoes and 532 Cardioversions which is 4.9% above budget.

Continued expansion of the Structural Heart Program.

Relocation of echo services to the care unit to provide a better patient experience for inpatients and increase efficiencies with a larger space allowing for better flow and increased capacity.

Successful Reaccreditation in Adult echo from the IAC. Partnered with Parkside Anesthesia group to increase patient safety, and improve physician satisfaction.

Instituted new Biotel holters allowing for an increase in monitoring from 48 hours to 120 hours.

Partnered with Trinity Cardiology for research study Goldilox.

Multidisciplinary team to decrease the door to EKG time for walk in chest pain patients.

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Structural Empowerment

Cardiac Cath Lab (CCL) & Mercy Interventional Unit (MIU) The Cardiac Catheterization Lab and Mercy Interventional Unit continue to focus on quality and the patient care experience.

Shockwave Intravascular Lithotripsy has been initiated: As coronary artery disease progresses, plaque in the arterial wall often evolves into calcium deposits, which narrow the artery and restrict blood flow. These bone-like structures make the artery rigid and more difficult to reopen with conventional treatments including balloons, which attempt to crack the calcium when inflated to high pressure, and atherectomy which drills through the calcium to open the artery. While atherectomy has been available for several decades, its use remains low, despite the high prevalence of calcium, due to its complexity of use and potential to result in adverse patient outcomes.

Intravascular Lithotripsy uses sonic pressure waves, also known as shockwaves that pass through soft arterial tissue and preferentially disrupt calcified plaque by creating a series of micro-fractures. After the calcium has been cracked, the artery can be expanded at low pressure and a stent safely implanted to improve blood flow, with minimal trauma to normal arterial tissue. The coronary technology has been widely adopted internationally.

The first case of Deep Venous Arterialization for limb salvage was performed here at Mercy Hospital with Dr. Henry Meltser (interventional cardiologist) and Dr. William Bevilacqua (vascular surgeon). The patient’s desire for a minimally invasive approach and the presence of significant comorbidities continue to drive physicians toward a predominantly endovascular-first approach. Deep venous arterialization (DVA) involves shunting arterial blood to the deep veins.

Care Management The Care Management Department at Mercy Hospital comprises of two distinct RN Case Manager Roles: Utilization Review & Transitions of Care, BSW & MSW Social Workers (SW) and Administrative Assistant, who work as a team. While Discharge Planning is the most visible role of the department, Utilization Review is our second functional role. In this role the RN CM utilize their clinical knowledge and skills to ensure and validate the correct level of care. This work begins the revenue cycle for reimbursement with our government and 3rd party payers and is accomplished through collaboration with the Clinical Documentation Integrity Team, HIM, Clinical Appeals and Denials Team and our Physician Advisors. SW supports the interdisciplinary care team in addressing patients’ social determinants of health and coordinating community resources including sub-acute placement.

Through Standard Operating Procedure development, implementation and auditing, Care Management has become an increasingly reliable partner; impacting LOS, patient safety, network referrals, reimbursement, community engagement and more.

Initiatives include: Lead SIDR rounds, URC Committee, Physician Advisor committee; participate in capacity management and many other strategic planning efforts to positively impact key initiatives and Key Performance Indicators. In the Emergency Department the role of the ED RN Case Manager and MSW has been redefined to assist the physicians in placing the patient in the right level of care, diverting patients who do not require admission, community referrals and placement.

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Lastly, staff has been involved in the Age Friendly Health Care System Pilot project and the Mobility project.

Emergency Department (ED) 2021 was a very busy year for the Emergency Department. We were very fortunate to welcome new members to our Emergency Department leadership team as well as many new nurses and ITAs. We completed a major renovation project in our Emergency Department lobby and held a blessing and dedication ceremony. A portion of our lobby was turned into more care space for our patients. We now have a private triage area, two private ambulance bays and a large internal waiting area where less critical patients can wait while their testing is being completed. This new addition has helped to improve the flow and efficiency of our department.

In 2021, we also worked on our triage skills. Twenty-nine staff members had the privilege to take The Sullivan Group Web-Based Triage Training Course. The staff that took this class found it to be a great learning opportunity. This class has helped to improve our triages on our patients and helped to identify and prioritize which patient needs to be seen next. This has led to improved patient care and outcomes.

The Emergency Department also worked very hard on our quality metrics. In 2021, we have seen improvements in ambulance off load times, handwashing, and door to imaging within 25 minutes for our stroke patients and have also improved our door to ECG metric within 10 minutes. We also participated in the successful Joint Commission Survey and were able to award a Great Catch winner in April of 2021.

We look forward to even more accomplishments in 2022!!

Mercy Ambulatory Care Center (MACC) The MACC is a 12-room emergency center with two dedicated inpatient hospital beds; we have 24/7/365 board certified physician coverage with midday physician assistant coverage along with registered nurses and immediate treatment assistants.

Highlights included: • Total Emergency Volume 21,000 patients with additional outpatient services available throughout the building • Left without being seen continue their downward trend and are now 1% of our patient population, a decrease from 2020 of 1.4% • Arrival to room decreased 3 minutes from the previous year along with an 8 minute improvement in our door to doctor metrics • Multiple donations to the Mercy foundation brought 2 new cardiac room monitors and 8 new wheelchairs to the MACC, which have expanded our patient safety initiatives for monitoring as well as patient movement • A generator upgrade was completed. An addition to the building was constructed and a new diesel 300kW generator was installed that is equipped to run the entire building.

• New CT machine installed in 2021 also, giving us access to cutting edge technology for better patient care

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Structural Empowerment

Float Pool The Float Pool can best be described as a team at Mercy Hospital that represents independence, resilience, broad knowledge and excellent skill level time and time again.

They are a specialty team that has dedicated their careers to learning the ins and outs of many areas at Mercy Hospital. Arriving each day, they face the unknown of when and where the need will be—but always arriving with a caring attitude to provide excellent care for all.

The Float Team includes Registered Nurses, Nursing Assistants and Immediate Treatment Assistants. Each and every team member contributes to hospital wide safe staffing ratios and supports the Catholic Health mission to provide excellent patient care. This team has pride in what they do and it shows. They support one another, they have each other’s backs, and they have a bond that has carried them through challenging times.

They are here, present and ready to work for a better tomorrow.

This team has many years of experience—an invaluable resource. They have stepped up to welcome and train new associates with a positive attitude. As we recover and rebuild in healthcare, the float team will be there, wherever and whatever the need.

Members of the float team support Nursing Professional Practice; Peer Review; Mentoring; AVA Monitoring; and 1:1 coverage.

Hemodialysis

The hemodialysis (HD) unit is committed to providing excellent care for patients with acute and chronic kidney disease. The nursing staff focuses on high quality patient care.

• • • • • •

HD department collaborates with other ancillary department to ensure the best plan of care for our patients.

Introduced the TABLO a new hemodialysis machine.

Staff learned new machine and new policies and procedure were created.

The unit welcomed five new hemodialysis nurses.

Working on getting a PD cycler to assist without increasing peritoneal dialysis patients.

HD department collaborates with other ancillary department to ensure the best plan of care for our patients.

Nursing Supervision 2021 brought about some great challenges for this group. All of us worked very hard with a smile and warm gestures in our hearts. We were delighted and so proud that one of our own was selected for the Catherine McAuley Award FOR 2021 Sharon Panzica has all the qualities of this award. She lives the Catholic Health values and exemplifies the highest standards of practice and behavior.

Mother Catherine McAuley Foundress, Sisters of Mercy

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Mother Baby Unit 2021 was an eventful year in the Maternal Child Units. L&D experienced a major renovation of all birthing rooms, nurses’ station and both ORs. The renovation of the birthing rooms includes updated décor, technology and increasing the square footage of all rooms to be incompliance with the latest architectural code. The surgical suites are modernized, enlarged and have enough space to allow for the care of the newborn inside the room. This is exciting as we now do not need to separate the family at time of a surgical birth.

Maternal Child/L&D is proud of our quality measures. Our OB Safety Committee is nurse-led and consists of a dynamic group of team members from the entire division. Issues are discussed and the team devises a plan to mitigate risk and improve processes. L&D continues to have 100% of experienced nurses attained and maintained their NCC Electronic Fetal Monitoring Certification. L&D was awarded the Healthgrades 5-star award for quality excellence as we have for the previous six years.

Maternal Child has experienced their highest patient satisfaction scores in 2021, despite the visitation limitations set forth by New York State due to the COVID pandemic. Patients expressed that they appreciated a more relaxed hospital stay and the ability to bond with their baby, uninterrupted.

Perioperative Services Mercy Ambulatory Procedure Unit (MAPU) In 2021, the Mercy Ambulatory Procedure Unit welcomed two new GI providers. Dr. Ghazala joins us from Tulane, and Dr. Masood joins us from Upstate. They are both employed by CHS, and will help us maintain continuity and high quality care for our GI patients. MAPU also began to offer a new service to our patients, which is an Endo Bronchial Ultrasound (EBUS). This procedure allows us to stage lung cancer for some of our sickest patients. In addition, a new Advanced Practice Provider was hired to stimulate our Dialysis Access Services, and we are working diligently to build that service line.

Ambulatory Surgery Unit (ASU)/ PST

ASU had an interesting year of fluctuations in surgical volume, Covid testing, and visitation limitations. Resilience was the key. There was a lot of teamwork. Like everyone, there were adjustments to our everyday routines on a regular basis to keep up with an ever changing situation. I am proud to say that we were able to be 100% compliant with Covid testing of our surgical volume. The nurses took it upon themselves to call family members, both pre and post op, to update them while visitation wasn’t allowed. With the lower surgical volume, we were able to utilize some nurses to call and speak to loved ones of patients on the inpatient departments, especially those on Covid units. Even with all of the challenges and restrictions, ASU has maintained and even improved their patient satisfaction scores. They also took the lower volume as a time to reinvigorate our UPC and have been working diligently on some projects including ways to better secure patient belongings.

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Structural Empowerment

Post-Anesthesia Care Unit (PACU) In 2021 PACU continued to provide high quality care to our post-operative patient population. This year, we saw some changes to our lineup and welcomed some amazing, talented nurses to the unit. With these additions, our team increasingly adds to our ability to secure our goal of safe, calm, responsive and comfortable patients.

Operating Room

2021 proved to be a challenging year for the Operating Room staff. We managed to survive a stoppage of elective cases during COVID peaks by using our skills to help out at the donning/doffing stations placed throughout the hospital. Staff kept their morale up by utilizing a PEER to PEER group to discuss matters that were of importance in the unit, as well as socialized outside of work in a bowling league and various other activities. We look forward to opening up more of our Operating Rooms in 2022 and growing all of our service lines.

Sterile Processing Department (SPD)

2021 couldn’t have started out any better for the SPD team, as the future of the department’s new design and workflow planning got underway! The team had the opportunity to partner with Opus Solutions and extensively review the new department’s architectural drawings and suggested workflows. By working together, the team was able to ensure the proposed infrastructure met regulatory, safety, and equipment needs, optimizes the current and anticipated workflow, and is of value and enables future innovation and adaptation. The best part was that the team was able to map to size and scale the proposed new decontam area in our current sterile stores area to get an idea of what the new space would look and feel like. The team is so excited for construction to get underway!

In addition, throughout 2021, the team played a major role in the hospital’s PPE conservation efforts by reprocessing the reusable half mask respirators utilized across the hospital. Sterile processing technicians are highly trained in cleaning a wide variety of contaminated instruments and equipment, and they will always step up to help and support our patients and healthcare team when called upon. Thank you for all YOU do!!!

Fun Fact: 80% of the Mercy Hospital Sterile Processing Team holds a Nationally Recognized Certification in Sterile Processing and Distribution. In addition, all team members are required to complete yearly continuing education related to all areas of their field! Awesome Job Team!!!

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Awards & Certifications

Best Wishes to Our 2021 Retirees To our retirees: Your enthusiasm and dedication for Mercy Hospital and our patients remain a great example for all of us.

Thank you for all the contributions you have made. We wish you a wonderful future filled with harmony and joy!

2021 Christine Budek Sue Coppola (ASU) Sharon Coughlin Mary Diaz Mary Beth Gallagher Lois Ganschow Sharon Herko Lynn Ilig Denise Juliano Gretchen Koester Cathleen Krautsack

Suzanne Majewski Sandra Mellerski Mary Kay Milks Debra Peterson Judy Petkovsky Gloria Sawyer Denise Schmitt Mary Schuta Patrice Sedar Ellen Sibenik Gail Walton

Congratulations to our 2021 DAISY Award Winners The DAISY (Diseases Attacking the Immune System) Award is an international recognition program that honors and celebrates the skillful, compassionate care nurses provide every day. The DAISY Foundation was established by the family of J. Patrick Barnes after he died from complications of the auto-immune disease ITP in 1999. During his hospitalization, they deeply appreciated the care and compassion shown to Patrick and his entire family. Patrick’s family felt compelled to say “thank you” for the compassion and skill nurses bring to patients and families every day. The DAISY Award for Extraordinary Nurses celebrates nurses in more than 2,400 healthcare facilities around the world.

Mary Pat Gajewski, RN

Beth Colarusso, NP

Pam McFarland, RN, BSN

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Awards & Certifications RN Certification List

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RN Certification List, continued Certifications give a nurse professional recognition. It proves that the nurse has met stringent professional requirements and demonstrates professional competency in a specialty.

Certified nurses help to create an environment of professionalism, contributing to staff retention and patient safety. Nurses with certification have a positive impact on patient outcomes. They routinely report a sense of pride, fulfillment and empowerment.

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Transformational Leadership

Nursing Strategic Plan The Mercy Hospital of Buffalo Nursing Strategic Plan gives everyone a shared vision for our direction of Nursing. The Strategic Plan gives the ability to set priorities and provides us direction and a focus as a department. The plan describes what we want to achieve, sets our goals and develops a plan to accomplish those goals. The strategic plan aligns us to our Nursing Mission and Vison and to the Catholic Health System’s Strategic Plan.

Our strategic plan is led by our journey with the Clinical Pathways to Excellence.

We are committed to continually improving and evolving as necessary to meet the ever-changing demands of our industry and patients. Our journey has evolved and enhanced the development of the Nurse Executive Council (NEC), representing the overarching structure of shared governance. The shared governance has expanded to include nurses represented from each committee to sit at the table and share committee activities that occur every month. These committees include: Recruitment & Retention, Research, Professional Practice and Peer Review.

Our first task is to update our Professional Practice Model (PPM). We are excited for the participation and engagement from the UPC’s and committees to elevate our practice.

Nursing Peer Review Committee The Nursing Peer Review Committee reviews incidents referred to them to identify nursing actions for their appropriateness in standards of practice. This committee consists of Registered Nurses from all areas of the hospital to ensure that nursing processes, scope of practice and standards of nursing practice are adhered to in-patient care. This committee allows nurses to identify areas of improvement to further extend resources, education and safe practices for nurses and patients. The nurses that participate in this committee have dedicated time and attention to supporting their fellow nurses in adhering to best practices utilizing evidence based practice for process reviews and nursing development.

In 2021, the committee voted in a new Chair and Co-Chair. Chris Anderson of 7 West was named Chair, and Jen Driscoll of 5 East was named Co-Chair. These newly appointed Chairs assisted in the restructure of the peer review committee as a whole. All cases are reviewed and presented by the chair and co-chair in order to facilitate open and honest discussion. Additionally, in that time, the committee members truly embraced the full understanding of the peer review process, and the discussions based on standards of practice for themselves as well as their colleagues. This allowed for lively discussions and finding the root cause of certain issues that sent a cascade effect of change, not just at Mercy Hospital, but throughout the Catholic Health System.

Having just undergone another year of the pandemic, this restructure has re-energized and empowered our nurses to effect change in their profession.

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Exemplary Professional Practice Patient Experience...the Journey Continues!

2021 continued to be a challenge for our entire team as COVID continued to rage throughout our community, however, we were able to maintain our patient satisfaction scores at a consistent level. Our “Overall Rate Hospital” category for 2021 was 62.4%.

Although our score decreased by 4.1 percentage points from the previous year, the 62.4% score for Mercy was a positive accomplishment. We were able to achieve this by working together as an entire team and working diligently to ensure that we were communicating with our patients during their admission and their families via telephone or Ipad. Through our continued discharge phone call process this year, 6,067 patients were reached. During most of the year, although challenged with constraints on visitation, we were still able to work together to find ways to communicate. Purposeful patient rounding efforts still occurred with 2,983 being completed. In 2022, we look forward to to renewing and re-igniting our passion to deliver excellent care to our patients!

6 West Unit receives Most Improved in Patient Satisfaction Award

The Wound and Ostomy Nurses

The Wound and Ostomy Advisors focused on pressure injury prevention education through empowerment of the bedside RN and nurse’s aide by actively participating in the following activities: • Wound care education classes were redesigned to give system-wide education, develop competencies and empowerment regarding staff RNs’ ability to identify and treat pressure injuries, more importantly, prevent them from occurring.

• A system-wide assessment of patients’ risk factors were completed with an outcome of identifying equipment and surfaces that are required and purchased. This aids CH nurses and helps in the battle against pressure injuries.

• System-wide education and roll out of a simplified incontinence associated dermatitis and skin tear protocol to not only empower nurses but provide state-of-the-art care for their patients.

• Real-time staff education at the bedside utilizing innovative and state-of-the-art equipment to assist in pressure injury reduction and patient comfort such as; seated positioners, heel offloading boots and surfaces.

• Re-design the methodology of prevalence and incidence of pressure injuries ensuring data collection and benchmarking against national and international standards as well as reducing unnecessary nurse labor.

• Plan, support and continue the journey to becoming recognized as a system in excellence in both wound and skin prevention and care.

Mercy Hospital Clinical Education

The Clinical Education team at MHB had a very busy year and underwent a complete change of staff. Education/Rounding topics that were provided in 2021 for the RN’s/ NA’s/ITA’s included: • TPA rounding points • Carpuject education • TPN-Lipid filter updates and rounding • Stroke case scenario education at huddles • Commonly misused abbreviations in documentation- rounding topic • Secondary IV tubing education • Heparin aPTT protocol changes and complete Heparin Education • Telemetry lead placement and tips- rounding topic • Charge nurse education on Epic Dashboards • Charge nurse education on code cart checks • Curos Cap rounding topic • Massimo education • Cleaning of glucometers • Covid equipment cleaning protocol education • Restraints

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Exemplary Professional Practice Quality and Patient Safety Efforts in place to improve Patient Safety by continuously educating our staff about safe care practices, encouraging staff to have a questioning attitude, use of “Safety Alerts”, and recognizing and learning from our staff when they prevent a harm event. Each month we recognize any associate or clinician at Mercy Hospital who have “spoken up” through our “Great Catch Program”. Below are the Mercy Hospital winners of a “Great Catch” for 2021. Each winner receives a “Great Catch” certificate and pin. The Midas Occurrence Reporting system is used to identify a “Great Catch”.

Shannon Balus (6E), Erica Chevalier-Slisz (ITA), Alicia Courtney (Pharmacy), Tina Swan (ED), Laurie Belge (GI/MAPU), Jerome Tallington (NA), Rachel Weber (Pharmacy), Tammy Smith (Environmental Services), Jillian Owens (Pharmacy), Tara Graham (Infection Control) and Renee Puleo (Pharmacy) Joint Commission Hospital Accreditation- A very successful Joint Commission hospital survey was completed 9/21- 9/24/2021. At the end of the survey, there were 26 citations received, all standard level citations with no condition level citations. Joint Commission accreditation provides valuable reassurance that we are providing safe, high quality care to our patients. This was a Mercy Hospital (including all off sites) team accomplishment that everyone was well prepared for! It was recognized that all of our nurses, staff and physicians demonstrate their commitment every day to medical excellence and patient-centered care. The Joint Commission’s team of surveyors recognized and praised everyone with words like, “engaged”, “knowledgeable”, “professional” and “dedicated”.

Falls Data: MHB improved fall rate 2021 (2.03) compared to 2020 (2.25) and target met for 2021 (2.28). MHB was the only Catholic Health site to meet their 2021 target. Many initiatives are in place to prevent and reduce patient falls, including: chair and bed alarms; AVA sitter; purposeful rounding; chairs in patient rooms mounted to wall to prevent clutter and tripping hazard; “Stop Signs” in ceiling tiles on several units to create a visual reminder to call for help; 3-Zone bed project on 6E; and weekly “Wipe-Out Wednesday” huddle for managers to review all falls from the week and opportunities for improvement/lessons learned to prevent falls across the units.

Infection Prevention & Control Team In 2021, Infection Prevention & Control focused on “getting back to basics”. The Covid pandemic flipped all of our worlds upside down and we realized that many of our basic infection control practices were forgotten or had changed since early 2020. The IC Team started concentrating on education with all staff; nurses, nurses’ aides, providers and ancillary staff all needed to be brought up-to-date on what our practices should be in the hospital (all while learning to live in a world with Covid-19). Our main focuses were isolation precautions, cleaning reusable equipment, CLABSI and C diff prevention. Epic allowed us to communicate with the care team directly so we were able to educate on the spot which was different than how we used to practice; it was a great change. The staff seems very engaged and work with us so well to address everyday Infection Prevention & Control issues.

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Tara Graham, IC Coordinator “Great Catch Winner”

Cardiovascular Services Highlights from 2021 include: • 3-star top rating with Society of Thoracic Surgeons (STS) for CABG only from July 2018 through June 2021 • Mission Lifeline Get With The Guidelines (GWTG) – (Coronary Artery Disease) 2021 Gold Award for NSTEMI (Heart Attack Care) • Application in process to reapply for Blue Center of Distinction 2022 • Secured RFP for Cardiac Cath Lab upgrade with Phillips equipment • Syngo upgrade was completed with enhanced remote reading capability for physicians • Epiphany upgrade completed. (Physicians can now view ECG wave forms in Epic and ECG’s are available in HEALTHeLINK and Epic Care Link.

Neuroscience/ Stroke Services Mercy Hospital is a Joint Commission accredited Comprehensive Stroke Center (CSC)—this is the highest level of stroke care that can be provided to patients and their community. We will be having our recertification survey this year. In the two years since our last survey, we have implemented stroke neurology and neurocritical care telemedicine consults to our system of care. Our neurologists and neurocritical care intensivists can now assist in consults, assessments and treatment recommendations to manage care for patients at all acute Catholic Health sites throughout the system.

Our Viz AI app, which processes all the stroke imaging for our stroke patients and sends immediate imaging results directly to the providers’ phones, partnered with our telemedicine access, further enhances quality care. This technology allows for increased communication for our teams, immediate access to imaging, earlier discussions between team members as well as earlier interventions, transfers and overall improved outcomes for our patients.

For the ninth consecutive year, our CSC has achieved the American Heart, American Stroke Association Get With the Guidelines Stroke Gold Plus with Honor Roll Elite and Target: Type 2 Diabetes Honor Roll award. This is the highest achievement level in quality awards in this category. This a testament to the quality care our nurses, providers and healthcare teams provide to our stroke patients every day. This is a tremendous achievement and it should be noted that this award has been achieved by our nurses, providers, imagining team, and direct care staff throughout the pandemic.

PNA Research Summary

Since our last annual review, our stroke department had submitted several nursing led research abstracts to the International Stroke Conference as well as the Western New York chapter of the Professional Nurses Association. With our transition to Epic as our electronic medical record, there were areas of opportunity identified for nursing documentation of posterior stroke symptoms. Our stroke coordinator and neuroscience nurse care coordinator worked with the Epic team to build and educate nurses on this specific neuro check flow sheet in order for the nurses to document and take credit for their neuro assessments in their entirety. This allowed the providers and nurses caring for the patient to identify changes in posterior stroke symptoms and follow the patients’ progress more closely.

There was also a submission by the neuroscience research coordinator and a neurology Nurse Practitioner that was focused on a barber shop project that provided blood pressure checks in underserved areas to assist in the education and identification of high blood pressure for high risk populations and provided referrals to primary care providers for blood pressure management. This allowed for education on signs and symptoms associated with high blood pressure, stroke risk factors and coordinating care for management of these risk factors by health care professionals.

The neurocritical care nurse practitioner team provided an abstract in which they created an acuity assessment tool that tracked patient acuity and outcomes with the number of providers to optimize neurocritical care provider care based on the piloted model. The research identified multiple areas in which nursing care, education and interventions directly impact the patients they care for.

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New Knowledge, Innovations & Improvements Zebra Mobile Device/Rover Rover is EpicCare Inpatient for users on the go. Nurses, respiratory therapists, and other inpatient clinical staff can complete key clinical workflows at the bedside using Rover on mobile devices.

Rover for clinical documentation is designed to supplement desktop and wheelie workflows, allowing clinicians to perform barcoded medication administration, document in flowsheets, chat with colleagues, validate device data, and more directly on a handheld device as they move around the floor. This mobility frees up workstations for other users and allows clinicians to more directly interact with patients.

Clinicians can document vitals and other information at the point of care so that documentation is filed to the chart more quickly. CH nurses have adopted Rover and are ranked in top 25% of ALL Epic users, including Patient Care Techs who have embraced the technology. On-Time flowsheet documentation is closer to near real time observation with use of a Rover device.

Secure Chat Secure Chat allows users to send secure text messages to colleagues in real time from a mobile device or desktop computer, enhancing the quality and speed of communication and reducing phone call interruptions. Secure Chat facilitates quick communication and collaboration between all users, not just physicians and nurses, like case managers, bed planners, and unit secretaries.

Disposable Telemetry Leads

In the Fall of 2021, the Emergency Department and 6 East began using disposable telemetry leads. Previously, both units were using reusable ECG lead wires. Reusable ECG wires come in close proximity to incisions and catheters on the chest and abdomen. They are a potential source of cross contamination that could pose and increased risk of HAIs in our patients. Using disposable telemetry leads has helped to reduce the risk of cross contamination between patients and helped to enhance patient care in the Emergency Department and 6 East.

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Maternity Education In 2021, the main focus of our L&D/Maternal Child education concentrated on postpartum hemorrhage and severe maternal hypertension management. We also included the Emergency Department (ED) staff at Mercy Hospital and the MACC with this education. It was well received by the staff. “Fire in the OR” drills were held with our safety team. Two ATOM infant warmers were a nice addition to the ED and the L&D OR. It is a free-standing warmer with transport and resuscitation capability. Our EPIC documentation process is ongoing and continues to evolve.

Nursing Research Committee The Nursing Research Committee (NRC) had to take a hiatus due to the pandemic and held two meetings in April and May 2021 where they reviewed the Research Charter, and decided on some changes to the verbiage. They also began looking at ways to disseminate research and chose to utilize the PICOT method. It was decided that all members must take the CITI course which is a free course that covers research and IRB processes and certification lasts 3 years. The plan was to meet in June 2021 to discuss the research models, evidence-based practice models, and acquire retention rates from past NDNQI satisfaction surveys done and review scores. Unfortunately, between the pandemic and the strike, the committee was unable to meet for most of the year and many of the members left. Once staff returned in November 2021, the NRC has undergone a rebuilding phase. We have had continued efforts to obtain new committee members and two new committee Administrative Liaisons were appointed. Talks began for the new Shared Governance and how and where the research committee would fall and we look forward to a re-launch of this much needed committee with all new members in 2022.

Electrophysiology and Stroke Team Collaboration

The Electrophysiology program and the Stroke program continue to work collaboratively to monitor cryptogenic stroke patients. Cryptogenic stroke has been defined as a cerebrovascular event of unknown origin, despite thorough work-up and represents 20- 30% of all ischemic strokes. Ischemic stroke is an important cause of morbidity and mortality when untreated.

Identifying atrial fibrillation is important because atrial fibrillation ischemic related strokes are associated with an increased risk of disability and death compared with strokes of other etiologies and tend to recur without anticoagulation. However, atrial fibrillation detection can be difficult when it is asymptomatic and paroxistic and may be the underlying cause of some cryptogenic strokes or strokes of unknown origin. Loop recorder monitoring (invasive monitoring device) is one method of monitoring for atrial fibrillation that can increase the risk of stroke.

Extracranial-intracranial (EC-IC) Arterial Bypass Surgery Utilizing the biplane in the cath lab, Neurosurgeon Dr. Jason Davies and the neuro OR team have offered a new procedure to Mercy Hospital—Extracranialintracranial (EC-IC) arterial bypass surgery. A cerebral bypass is the brain’s equivalent of a coronary bypass in the heart. The surgery connects a blood vessel from outside the brain to a vessel inside the brain to reroute blood flow around a damaged or blocked artery. The goal of bypass surgery is to restore blood supply to the brain and prevent strokes.

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Nurses : the courage to care

...and the strength to help.

565 Abbott Road | Buffalo, NY 14220 chsbuffalo.org