Facts & Figures Report 2008

FACTS & FIGURES REPORT

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2008

OUR MISSION

“transforming health care across the region”

Christiana Care Health System is one of the region’s leading health care providers, serving Delaware and neighboring areas in Maryland, Pennsylvania and New Jersey. With more than 10,000 employees, Christiana Care is the largest private employer in Delaware and the 10th largest employer in the Philadelphia region.

HERE IS A SNAPSHOT OF CHRISTIANA CARE: ON A SUBURBAN CAMPUS SOUTH OF THE CITY OF WILMINGTON:

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Christiana Hospital (907 beds) Center for Heart & Vascular Health in the Bank of America Pavilion Helen F. Graham Cancer Center Breast Center Christiana Surgicenter

ON THE DOWNTOWN WILMINGTON CAMPUS:

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Wilmington Hospital (241 beds) Wilmington Hospital Health Center Center for Advanced Joint Replacement Center for Rehabilitation Roxana Cannon Arsht Surgicenter

THROUGHOUT THE STATE OF DELAWARE:

• 16 School-Based Health Centers • Home Health & Community Services—Visiting Nurse Association • 2 Alzheimer’s Day Programs THROUGHOUT NEW CASTLE COUNTY (NORTHERN DELAWARE):

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Eugene du Pont Preventive Medicine & Rehabilitation Institute 17 Primary Care Centers (2 in New Jersey) 9 Christiana Care Physical Therapy PLUS sites (2 in Kent County) 10 Christiana Care Imaging Services locations (2 in Kent County)

A MESSAGE FROM THE PRESIDENT & CEO

Dear Neighbors, On behalf of the entire Christiana Care Health System family, I am pleased to share with you our 2008 Facts & Figures Report.

Christiana Care exists to take care of our neighbors in our community. Our ability to deliver this promise is embodied in the extraordinary talent and dedication of our physicians, surgeons, nurses, health care professionals, community outreach coordinators and administrative staff members.

Our growing national reputation enables us to attract some of the best health care specialists in the country. Beyond this, the generous support of our partners in business, government and the community helps us expand and enhance the care we provide to all community members, regardless of their ability to pay.

Last year, in fact, we provided $37.7 million in free care and medicine to those who could not afford to pay. Each year, our Wilmington Health Center alone provides primary and specialty medical care for more than 70,000 patient visits.

Every day, professionals throughout Christiana Care demonstrate their exceptional commitment to improving the health and well-being of everyone in our community through innovative programs, initiatives and partnerships.

Because of all of these efforts, we continue to transform the very landscape of health care excellence for all of our neighbors. In the pages that follow, you will read about just a few of our efforts to improve the quality of life for those we are so privileged to serve. Thank you for your trust in Christiana Care.

Sincerely,

Robert J. Laskowski, M.D., MBA PRESIDENT AND CHIEF EXECUTIVE OFFICER

Facts & Figures

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Leading heart & vascular care

Timothy Gardner, M.D., leads American Heart Association

Timothy Gardner, M.D., medical director of Christiana Care's Center for Heart & Vascular Health, is national president of the American Heart Association.

Active with the AHA for more than 25 years, Dr. Gardner serves as chief volunteer science and medical officer for the association’s national board of directors and is responsible for medical, scientific and public health matters.

death and disability from heart disease and stroke as well as to improve the cardiovascular health of all are due to the work and dedication of, literally, millions of volunteers, both medical professionals and others,” he says. “With so many of us joined together on behalf of the American Heart Association, including many here at Christiana Care and throughout Delaware, I am very honored to be able to lead the association's efforts.”

“The organization’s strength and effectiveness in achieving its mission to reduce

The Center for Heart & Vascular Health features a full range of cardiovascular services.

33,987 VASCULAR ULTRASOUNDS

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Christiana Care Health System

764 4,727 1,766 1,463 3,264 18,148 33,987 17,500

OPEN-HEART CASES CARDIAC CATHETERIZATION CASES ELECTROPHYSIOLOGY CASES VASCULAR SURGERY CASES VASCULAR INTERVENTIONAL CASES CARDIOVASCULAR NON-INVASIVE STUDIES VASCULAR ULTRASOUND STUDIES CARDIAC REHABILITATION MONITORED VISITS

State-of-the-heart transplant evaluation

For the first time, heart-failure patients who are candidates for transplant can get high-quality care close to home.

Christiana Care’s Heart Transplant Evaluation program, under the direction of transplant-trained physician Mitchell Saltzberg, M.D., makes it possible for patients in Delaware and adjoining areas to obtain extensive risk evaluation testing and other care locally.

That saves patients and their families the time, stress and expense of making multiple trips to regional transplant centers elsewhere.

The team offers seamless care, working with the cardiology community to produce optimum outcomes for patients, most of whom do not need a transplant and can be treated near their homes and loved ones. For patients who do need a heart transplant, Christiana Care coordinates efforts with regional centers.

A triple win in ‘Get with the Guidelines’ awards Christiana Care earned three “Get with the Guidelines” Awards from the American Heart Association for excellence in treating coronary artery disease and heart failure and for our stroke quality and safety initiatives.

Here’s what we won: • Silver Performance Achievement Award for Coronary Artery Disease, earned by hospitals that have demonstrated that for at least one year 85 percent of coronary patients were discharged in compliance with the AHA’s recommended treatment guidelines and secondary prevention program.

• Heart Failure Bronze Achievement Awards for treating patients for a minimum of three months with 85 percent compliance to core standards of care outlined by AHA/American College of Cardiology secondary prevention guidelines.

• AHA recognition for participating in the American Stroke Association's Get with the Guidelines program to improve overall care for stroke patients and prevent future strokes and cardiovascular events. Christiana Care initiated a system for rapid diagnosis and treatment of stroke for patients admitted through the Emergency Department.

Minimally invasive aneurysm procedure a first A Christiana Care vascular interventional radiology team made Delaware health care history, successfully completing the first endovascular coil embolization of a ruptured brain aneurysm.

Leading the surgical team was Barbara Albani, M.D., an interventional radiologist. Now, patients no longer need to

leave the state for treatment of this potentially fatal condition.

Cerebral aneurysms are bulges or balloons on weakened parts of the walls of blood vessels.

The lifesaving treatment involves soft, springy woven platinum wires tightly packed into the aneurysm to cut off its blood flow. Eventually, the vessel scars around the coil pack.

Facts & Figures

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Leading Heart & Vascular Care

Christiana Care research gets international audience Researchers from Christiana Care presented several papers at the American College of Cardiology 57th Scientific Session in Chicago.

The abstracts included: • Follow-ups to the seminal Clinical Outcomes Utilizing Revascularization and Aggressive DruG Evaluation (COURAGE) trial, the internationally recognized study that found optimal medical therapy alone can prevent heart attacks and death as well as therapy, plus angioplasty and stent placement. New research supports the original findings.

• “Frequency of Provider Contact Directly Impacts Quality of Life for Heart Failure Patients Enrolled in a Telemonitoring Program” that suggests more regular contact with nurses makes significant improvements in the health and wellbeing of heart-failure patients.

• A study from the Center for Heart & Vascular Health that found nurses and technicians performed as well as surgeons in using a collagen-based device to close puncture wounds in the groin after cardiac catheterizations.

HeartAware identifies heart and stroke risk

Dr. Weintraub presents at the conference.

William S. Weintraub, M.D., director of the Christiana Care Center for Outcomes Research and chief of cardiology, co-authored 19 of the abstracts.

People at high risk for heart attack or stroke can learn how to stay healthy longer through HeartAware, a comprehensive cardiovascular screening and prevention program offered by the Center for Heart & Vascular Health.

HeartAware takes a proactive approach, directing patients to a seven-minute, Web-based risk assessment test focusing on such factors as smoking, family history, blood pressure, stress and other indicators. Patients receive personalized reports to discuss with their doctors. People who are at risk can schedule on-site cardiovascular screening.

In addition to referrals for patients who don’t have a primary care physician, the program also offers counseling for people who want to quit smoking, lose weight, exercise, eat healthy, manage stress and connect with social services or women’s heart programs.

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Study tests vaccine to fight infections after heart surgery

Christiana Care is one of seven sites worldwide participating in a clinical trial to test a vaccine to prevent antibiotic-resistant staph infections following heart surgery.

Infectious disease specialists and cardiac surgeons are collaborating to fight these “superbugs,” including methicillin resistant Staphylococcus aureus. MSRA is a common cause of post-operative infections that develop around surgical incisions and can produce grave consequences.

The vaccine boosts the body’s immune system to produce antibodies that identify and attack the bacteria’s outer capsule, destroying the bacteria and blocking the signals that would cause it to shift into virulent mode.

Cardiology fellowship programs enhance academic status Expanded fellowships in cardiovascular disease further strengthen Christiana Care’s status as an academic medical center.

In July, Swarna Bheemreddy, M.D., began a one-year cardiovascular disease research fellowship. She completed a postdoctoral research fellowship at Brigham and Women’s Hospital, Harvard Medical School, and was chief fellow in cardiovascular imaging at Yale University School of Medicine. She joins Divya Tiwari, M.D., who began her fellowship in 2007 with interests in stroke and heart failure in older patients.

When diuretics fail, ultrafiltration can help

Four doctors started three-year cardiovascular disease fellowships, including Matthew Grove, D.O., and Zeshan Rana, M.D., who recently completed internal medicine residencies at Christiana Care. Leonid Mandel, M.D., completed a fellowship in advanced heart failure management at St. Francis Hospital and Medical Center in Hartford, Conn. Andra Popescu, M.D., recently completed a residency in internal medicine at Thomas Jefferson University in Philadelphia.

Next year, Christiana Care will introduce an interventional cardiology fellowship program. Nowwar Mustafa, M.D., currently a third-year cardiovascular disease fellow, will be the first to hold the position.

A new ultrafiltration system at Christiana Care helps heart failure patients remove excess fluid safely and effectively.

Traditionally, heart failure patients receive diuretics to reduce the fluid volume. But many patients stop responding to the medication, resulting in fluid overload.

Cardiology practice expands in Chester County

New, improved ultrafiltration therapy uses a small catheter rather than a large-gauge device and requires only one-tenth the blood-flow rate of conventional dialysis to remove up to one-half liter of fluid per hour.

Patients in southern Chester County, Pa., can now receive the care they know and trust closer to where they live and work. Located in West Grove, Christiana Care Cardiology of Southern Chester County offers inpatient care at Christiana Care and Jennersville Regional Hospital, as well as full-service cardiology, including EKGs, stress and 2D echocardiograms, pacemaker interrogations and nuclear medicine studies.

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Innovative cancer care

Architectural rendering of the new expansion

Growing toward the future

HELEN F. GRAHAM CANCER CENTER

EXPANSION

A major expansion of the Helen F. Graham Cancer Center is underway.

The project—slated to open in spring 2009—more than triples the space for cancer care, enabling Christiana Care to provide high quality cancer treatment and research for more patients in the region.

“We will be able to place all cancer resources under one roof, making it easier and better for patients,” says Nicholas J. Petrelli, M.D., Bank of America endowed medical director.

The Cancer Program features a full range of cancer services.

3,010

PATIENTS NEWLY DIAGNOSED AND/OR NEWLY TREATED*

2,244

RADIATION ONCOLOGY CONSULTS

32,880 755

New equipment will include a CT scanner, a PET/CT scanner and a dedicated MRI. A glass-enclosed walkway will connect the addition to the existing facility.

PATIENT VISITS TO THE HELEN F. GRAHAM CANCER CENTER

EXTERNAL BEAM TREATMENTS PATIENTS ENROLLED IN CLINICAL TRIALS* * MOST RECENT DATA AVAILABLE.

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Plans call for an additional 124,000 square feet, which will provide more room for the Christiana Care Breast Center, the Center for Translational Cancer Research, a chemotherapy infusion suite, gynecologic oncology and other services.

60,113 75,639 97,135 108,395 109,506

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Delaware cancer rate drops twice national average

Comprehensive strategies to prevent and treat cancer are saving lives in the First State.

Once among the top five states in cancer rates and mortality, Delaware is now one of only 16 states where cancer deaths are declining, according to the American Cancer Society.

In fact, Delaware experienced the most rapid decline in cancer mortality in the United States from 1990-2005, at a time when cancer deaths were increasing nationwide.

NCI-selected Community Cancer Center One of only 14 cancer centers in the United States selected for the National Cancer Institute Community Cancer Centers Program, the Helen F. Graham Cancer Center is making tremendous strides to speed up research and raise the quality of care for minority and underserved patients.

That special emphasis on helping minority patients, as well as people who are elderly, poor or live in rural areas, resulted in expanded clinical trials in those communities. Patients are receiving access to cutting-edge treatment, with at least 700 patients enrolled in as many as 130 different studies at any given time.

Christiana Care completed the first year of the three-year pilot program. The goal of the initiative is to define what it will take to establish a national network of community cancer centers fully engaged with the research community, which can provide the latest, evidence-based treatment for patients of all ethnic and economic origins.

Participating in Cancer Genome Atlas

Christiana Care’s Helen F. Graham Cancer Center is now part of The Cancer Genome Atlas (TCGA) project, a federally funded effort to accelerate the understanding of the molecular basis of cancer to help establish personalized medicine to base patients’ diagnoses and treatments on their own genetic profiles.

With a $4.6 million, four-year research subcontract and funded by the National Cancer Institute (NCI)—part of the National Institutes of Health—the Helen F. Graham Cancer Center plays a vital role in TCGA’s

comprehensive, coordinated program by collecting, storing and sharing tissue and blood samples for cancer research. Other U.S. cancer centers involved in TCGA project include Mayo Clinic, MD Anderson Cancer Center, Memorial Sloan-Kettering, Duke University, Emory School of Medicine, University of Pittsburgh, Henry Ford Hospital System, Gynecologic Oncology Group Tissue BankChildren’s Hospital of Ohio State University and University of California at San Francisco Medical Center.

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Innovative Cancer Care

Accelerating research in GI cancers

The Helen F. Graham Cancer Center is among a select group of institutions chosen to join a consortium and receive a $125,000 grant to accelerate research of gastro-intestinal cancers.

The eight-member Aptium Oncology GI Consortium will select promising new drugs designed to target specific types of cancers. Unlike larger trials sponsored by the government or industry, the project allows more input from local investigators and opens avenues for more translational studies.

Practice receives honor for clinical trials research Medical Oncology Hematology Consultants, PA is one of only 10 community oncology practices in the nation to receive honors from the American Society of Clinical Oncology (ASCO) and the ASCO Cancer Foundation for improving cancer care through participation in clinical trials.

Stephen S. Grubbs, M.D., principal investigator for the Community Clinical Oncology Program (CCOP), attributed the prestigious award to the practice’s patients and the infra-

Helen F. Graham Cancer Center honored as Beacon of Hope

structure provided by the Helen F. Graham Cancer Center at Christiana Care. The National Cancer Institute funds the CCOP, which has ongoing trials in all major forms of cancer.

Among the criteria considered by the ASCO was patient accrual to clinical trials over a three-year period. More than 300 patients cared for by the physicians of Medical Oncology Hematology Consultants participated in clinical trials in 2007, five times the national average.

Susan G. Komen for the Cure honored the Helen F. Graham Cancer Center with its Beacon of Hope Award, presented to the organization that proves to be the exceptional leader and health care provider in the fight against breast cancer in the Delaware Valley.

Presenters at the Pink Tie Ball in Philadelphia cited Christiana Care’s excellent, compassionate care and the bonds of trust the Helen F. Graham Cancer Center has formed throughout the community.

Multiple grants from Susan G. Komen for the Cure have supported outreach and education at Christiana Care, including initiatives to help seniors, African-Americans and Hispanics. Funding made it possible to expand the role of the area’s first bilingual breast-screening navigator to promote access to care, follow-up and other services. In addition, more women without insurance now receive mammograms, ultrasounds, MRI scans and biopsies.

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Christiana Care Health System

CyberKnife® delivers cutting-edge treatment Patients with cancerous tumors once considered too risky for surgery are now getting treatment with the state’s only CyberKnife®. The robotic radiosurgery device provides noninvasive radiation therapy anywhere in the body.

The painless procedure provides extreme accuracy without anesthesia, minimizing damage to surrounding healthy tissue. And, if patients happen to shift position, the CyberKnife® moves right along with them. Patients frequently can resume normal activities the same day.

The latest in radiation technology The Helen F. Graham Cancer Center is the second site in the United States to install the ARTISTE,™ the newest innovation in dose-guided radiation therapy.

Because the size of a patient’s tumor can change over the course of treatment, it’s a challenge for radiation teams to deliver the highest possible doses without damaging surrounding healthy tissue.

This latest generation linear accelerator offers enhancements that take images of the patient just before treatment, verify the patient’s position is correct and adapt to any anatomical changes immediately before, or even during, treatment.

Helping cancer survivors lead quality lives

Adult post-treatment cancer patients are learning the skills they need to move forward in life through the Cancer Survivorship Program at the Helen F. Graham Cancer Center.

A multidisciplinary team that includes the director of cancer psychology, a clinical nurse specialist and a senior social worker developed the program. The goal is to empower people treated for cancer to adapt to the challenges of life, armed with knowledge about the disease.

Patients and their loved ones attend free seminars on such topics as stress management, personal growth and physical activity. A 116-page Survivorship Journal offers self-help advice and other learning tools.

Facts & Figures

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Dedicated to the community

Wilmington campus undergoing $205 million transformation A major, five-year, $205 million expansion and renovation of Christiana Care’s Wilmington campus is underway. The upgraded hospital campus, with new, renovated and expanded facilities, will allow the hospital to continue its tradition of service in the heart of Wilmington for many years to come.

“For over a century, the nurses and physicians at Christiana Care’s Wilmington campus and its Emergency Department have been serving the Wilmington community, meeting the community’s diverse medical needs and providing the safety net for the underserved,” says Bob Laskowski, M.D., Christiana Care’s President and CEO. “Expanding and renovating Christiana Care’s Wilmington campus continues our commitment to serve, to benefit our community and to ensure that our neighbors can access and receive the highest level of care and comfort.”

The expansion will add 337,000 square feet to the campus, bringing the total medical square footage to more than one million square feet. All medical

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services will continue to be provided during construction.

More than 62,000 square feet of existing hospital space will be renovated as part of this project.

The plan also includes: • A nine-story, 286,000-square-foot tower with 13 new operating room suites, replacing 10 existing operating rooms; • 60 new patient beds, all in single rooms, including 30 Intensive Care/Stepdown beds; • Capacity for up to 60 additional patient care beds; • A new 51,000-square-foot, state-of-the-art medical office building will allow more physicians to practice on site; • Doubling the physical size of the Emergency Department and related services.

Participating hospitals in Maryland eCare

eCare expands to six Maryland Hospitals Christiana Care is helping hospitals in rural Maryland by monitoring patients remotely around the clock. ®

The VISICU eICU Program, in place at more than 200 hospitals nationwide, improves the quality of care in Intensive Care Units. In 2005, Christiana Care was the first health system in America to adapt the program to monitor critically ill patients in the Emergency Department and post-anesthesia care units.

The six hospitals, known collectively as Maryland eCare, joined forces two years ago to solve the shortage of critical care physicians. Studies show that patients do

Special care for seniors

Washington County Health System, Hagerstown

The hospitals collectively admit more than 66,000 patients every year.

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Civista Medical Center, LaPlata

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Peninsula Regional Medical Center, Salisbury St. Mary’s Hospital, Leonardtown Atlantic General Hospital, Berlin

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better and require shorter stays in the hospital when doctors trained in critical care manage their care.

Under the agreement, Christiana Care critical care physicians and nurses monitor patients at the Maryland hospitals

An 11-bed unit for Acute Care of the Elderly, also known as ACE, opened on the Wilmington campus. Based on an existing program at Christiana Hospital, the unit addresses specific concerns of patients age 70 and older, who may be more susceptible to falls and pressure wounds or may be cognitively impaired.

ACE nurses receive special training in providing care to older patients.

The concept serves an increasing population of especially frail patients coming to the hospital from nursing homes.

Connecting uninsured patients with health coverage programs

Calvert Memorial Hospital,

• •Prince Frederick

Christiana Care reaches out to our neighbors who don’t have insurance by providing assistance with financial services through the Medical Assistance Eligibility Program.

Through PATHS LLC, self-pay patients who qualify are enrolled in Medicaid.

Christiana Care refers about 7,500 unin-

through audio and visual technology, combined with intelligent monitoring and alarm systems. In addition to enabling health care professionals to act quickly and prevent complications, the system also reduces stress and improves nurse retention in the ICUs.

That also was the inspiration for a housecall program for the elderly. The project augments the work of existing senior centers in New Castle and Wilmington by ensuring elderly people who are housebound have access to health care.

“By providing a medical arm to social services already provided by the centers, we can improve care in place to frail, elderly people in the community,” says Ina Li, M.D., associate director of Geriatrics.

sured patients to PATHS each year; last year 5,500 enrolled in Medicaid.

The 2,000 patients who did not qualify aren’t left to financially fend for themselves. They’re referred back to Christiana Care, where they can learn if they are eligible to participate in the Financial Assistance Program.

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Dedicated to the Community

Baby makes three in family-centered care There’s a new arrival at Christiana Hospital. All three maternity units now offer “rooming in,” a family-centered postpartum concept that allows babies to stay with their moms and dads 24 hours a day instead of in a nursery.

Rooming in promotes child-parent bonding and helps maternity nurses to spend more time with the new parents, providing coaching and advice on topics such as bathing, circumcision care and breast-feeding.

The unit still offers traditional nursery-based care for mothers or babies with special needs.

Delaware babies in national spotlight Christiana Care is one of only two dozen health care providers and universities in the nation chosen for the National Children’s Study, the largest long-term study of children’s health ever in the United States.

Researchers hope to develop a snapshot of American children by following 100,000 youngsters from before birth to age 21.

The government-funded study could help researchers understand how genetics and the environment interact to affect

health. It could also provide clues to conditions such as autism, asthma, obesity, mental illness and other disorders.

In Delaware, the emphasis will be on perinatal care, focusing on 1,000 babies in New Castle County. Christiana Care will work with the University of Delaware and Alfred I duPont Hospital for Children to provide input to investigators at Children’s Hospital of Philadelphia and Drexel University College of Medicine.

Excellence in Women’s Health Christiana Care is the region’s only National Community Center of Excellence in Women’s Health. That recognition is based on the following: • Improving the health and well-being of women through community-based organizations.

• Providing integrated, coordinated care with strong links to existing programs in the community.

• Offering access to comprehensive care in a way that reduces fragmentation and recognizes the complexity of women’s lives.

In addition, Christiana Care offers excellent clinical care and preventive services, training for health care professionals and public outreach and education.

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Plastic Surgery Center of Excellence Christiana Care now offers comprehensive plastic and reconstructive surgery at the Plastic Surgery Center of Excellence on the Wilmington campus.

A new, eight-bed outpatient recovery area provides full, 24-hour coverage for patients who need to stay overnight after procedures that range from cosmetics and aesthetics to acute and chronic wound care.

Ground-breaking therapy for ischemic stroke The Christiana Care Emergency Medicine Research team launched a treatment that could restore blood flow to the brain of acute ischemic stroke victims more quickly, a key factor in recovery.

Called the TUCSON (Transcranial Ultrasound in Clinical SonoLysis), the study evaluates how various doses of SonoLysis + tPA therapy, which combines ImaRx Therapeutics’ proprietary microbubbles, ultrasound and the thrombolytic drug tPA to dissipate blood clots underlying a stroke.

The first patient, rushed to the hospital after suffering a stroke, was successfully treated and has few lasting effects.

Growing a crop of doctors to serve rural Delaware

Christiana Care is planting seeds in a program designed to grow a healthy crop of family physicians in rural areas.

The Department of Family & Community Medicine is expanding an existing program at Jefferson Medical College in Philadelphia to include the First State. Founded in 1974, the Physician Shortage Area Program recruits and educates medical students from rural areas who intend to practice in those settings.

According to the U.S. Department of Agriculture, Delaware’s population is 21 percent rural. Graduates of the program are more than eight times as likely as their peers to practice in rural areas and small towns.

Facts & Figures

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Dedicated to the Community

Taking care of Delawareans at home since 1922

For 86 years, visiting nurses have been providing in-home care throughout the state. Today, the Christiana Care Visiting Nurse Association is Delaware’s largest, most-experienced home health agency.

Our dedicated professionals touch the lives of thousands of patients and their loved ones every day, whether it’s checking on newborn babies and their moms, administering chemotherapy to cancer patients, giving physical therapy to people recovering from surgery, providing the tools to manage heart disease or helping old people to stay safely in their homes.

Health disparities – providing quality care to all When it comes to health, all Americans aren’t created equal. That powerful message launched a lecture series that Christiana Care President and CEO Bob Laskowski, M.D., says will inspire “analysis and action that will make our community a better place to live.”

The speaker was Risa Lavizzo-Mourey, M.D., president and CEO of the Robert Wood Johnson Foundation. The series is a collaborative effort between Christiana Care and the Delaware Academy of Medicine.

Dr. Lavizzo-Mourey said the poor, less educated typically live six years less than wealthier, better-educated people. Children in the lowest-income families are seven times more likely to be in poor health, compared to children in the highest-income households.

Risa Lavizzo-Mourey, M.D.

VNA Telehealth Program monitors patients at home To patients who suffer from chronic illnesses, the Visiting Nurse Association’s Telehealth Program might seem like a medical miracle.

Through home-based telemonitoring devices, patients transmit vital signs to a centralized station where a VNA nurse reviews them. Daily monitoring enables nurses to detect small changes in patients’ conditions so they can receive care before they get worse.

According to data gathered through the program, patients experience less shortness of breath, are more likely to take their medications and are less likely to need readmission to the hospital.

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Leading the Way | Honors, Awards & Appointments

Recognized for excellence

Joint Commission seal of approval

Best Hospital ranking from U.S. News & World Report

Christiana Care Health Services has received the Joint Commission’s Gold Seal of Approval, based on an unannounced on-site survey. The seal is proof of our organization-wide dedication to providing quality care for our neighbors.

The news is out. Christiana Care is one of “America’s Best Hospitals,” according to an elite list of 173 institutions named by U.S. News & World Report, which evaluated more than 5,400 hospitals.

The only hospital in Delaware to make the list, Christiana is among the tops in three specialties: Ear, Nose & Throat, Endocrinology and Gastrointestinal Disorders.

Leadership in patient safety

The Alliance of Independent Academic Medical Centers selected Christiana Care to be part of a national initiative to improve patient safety through graduate

medical education. Qualifications were based on demonstrated leadership and regard for education and research in providing patient-centered care.

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Leading the Way | Honors, Awards & Appointments

Thomson Reuters 100 Top Hospital Performance Improvement leader For the second consecutive year, Christiana Care is a Thomson Reuters 100 Top Hospital Performance Improvement Leader. Formerly Solucient, Thomson Reuters is a nationally known provider of health care information.

Three Golden Apple Awards

This prestigious award places Christiana Care among the top 100 U.S. hospitals—and among the top 15 major teaching hospitals— for the fastest, most consistent performance improvement over five consecutive years.

Christiana Care received a trio of Golden Apple Awards from Quality Insights of Delaware, the state’s only Medicare Quality Improvement Organization: • Quality Leader Award for the Appropriate Care Measure program, which experienced a 15 percent improvement in treating patients hospitalized for heart attack, pneumonia and stroke.

• Quality Leader Award for the Surgical Care Improvement Project for a 13 percent improvement in preventing infections.

• Quality Partner Award to the Department of Family & Community Medicine for its outreach programs and cultural competency training.

Nursing research team honored Seven nurses from Christiana Care and the University of Delaware received the Research Dissemination Award from the Sigma Theta Tau International Honor Society of Nursing for their important work in establishing guidelines for taking blood pressure.

The nurses compared two blood pressure measurement sites, the forearm and the upper arm, in emergency and medical-surgical patients. Their studies concluded that upper-arm measurements are more accurate and that forearm measurements should only be taken when the upper arm is not accessible or the maximum-size cuff does not fit.

The American Journal of Critical Care published their report “Better Blood Pressure for Better Patient Care.”

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Nursing research team

News Journal ‘Best in the Business’

For the fifth consecutive year, the News Journal named Christiana Care a Best in the Business employer, an honor based on employee surveys from 107 companies.

Christiana Care is one of only 15 large employers honored.

Here’s what some of the employees had to say in the survey: • The company is going in the right direction.

• Company has strong values and ethics.

• I have opportunities to learn and grow.

• My manager praises my good work.

• I have the flexibility I need to balance work and personal life.

Consumer Choice Award

Based on a National Research Corporation survey of 200,000 area households, Christiana Care has been the top choice of health care providers for 13 straight years.

A champion for families in need

Christiana Care received the 2008 Business Champion Award from the Delaware Covering Kids & Families program for providing medical care to people who don’t have insurance. The award is based on commitment to charity care, financial assistance and community mission.

Bariatric Surgery Center rates dual accreditation

Christiana Care’s Bariatric Surgery program has received two stamps of approval, the only hospital in the greater Delaware Valley to be accredited by two professional programs.

The American College of Surgeons’ Bariatric Surgery Center Network awarded Christiana Care the highest level of accreditation, meaning the hospital is “able to manage the most challenging and complex patients.”

The American Society for Metabolic and Bariatric Surgery and Surgical Review Corporation named Christiana Care a Bariatric Surgery Center of Excellence.

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Leading the Way | Honors, Awards & Appointments

Robert Laskowski, M.D., chairs United Way of Delaware, appointed to COTH Christiana Care Health System President and CEO Robert J. Laskowski is in the second year of his two-year term chairing the Board of Directors of the United Way of Delaware. The organization includes 110 member agencies and partners with social service agencies, businesses, government, non-profit groups and citizens to improve the quality of life throughout the state. Dr. Laskowski was also appointed a member of the Council of Teaching Hospitals (COTH) and Health Systems Administrative Board and is a COTH representative to the Association of American Medical Colleges Assembly.

Linda Laskowski Jones honored for nursing excellence The Marie Hippensteel Lingeman Award for Excellence in Nursing Practice was presented to Linda Laskowski Jones, RN, MS, APRN, BC, CCRN, CEN, Christiana Care vice president of Emergency, Trauma & Aeromedical Services.

The award, given by Sigma Theta Tau International Honor Society of Nursing, recognizes professionals who demonstrate breadth of knowledge, develop creative approaches to nursing, possess clinical expertise, advance the scope of nursing and serve as mentors.

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Timothy Gardner, M.D., receives AHA award Timothy J. Gardner, M.D., medical director of Christiana Care’s Center for Heart & Vascular Health, received a Distinguished Achievement Award from the American Heart Association’s Regional Affiliate Board.

Dr. Gardner, national president of AHA, received the honor for his longtime commitment to reducing death and disability from cardiovascular diseases.

Nicholas Petrelli, M.D., named ASCO Statesman Nicholas J. Petrelli, M.D., Bank of America endowed medical director of the Helen F. Graham Cancer Center, is the recipient of a Statesman Award from the American Society of Clinical Oncology.

The award recognizes Dr. Petrelli’s many years of volunteer service to ASCO.

Linda Bucher joins nursing board Linda Bucher, RN, DNSc, a Christiana Care nursing research facilitator, was elected to the board of directors of the American Association of CriticalCare Nurses. The largest specialty nursing organization in the world, the AACN represents more than 500,000 nurses who care for critically and acutely ill patients.

Distinguished Alumnus Award goes to Robert Witt, M.D. Robert Witt, M.D., section chief of Head and Neck Oncology at the Helen F. Graham Cancer Center, is the 2008 Distinguished Alumnus for the Department of Biological Sciences at the University of Delaware.

Dr. Witt, who earned his BS at UD in 1977, collaborates with his alma mater in a research program on vocal fold implants. He also is studying efforts to create artificial salivary glands for people with glands damaged by chemotherapy.

Jennifer Genuardi, M.D., wins Med-Peds award A fourth-year resident in Christiana Care’s MedicinePediatrics Program received the prestigious Howard Schubiner Award from the National MedPeds Residency Association.

Heather Bittner Fagan, M.D., gets cancer research grant The American Cancer Society awarded its prestigious Cancer Development Award for Primary Care Physicians to Heather Bittner Fagan, M.D., of the Department of Family & Community Medicine.

She will receive a three-year, $300,000 research and training grant, awarded to a primary care physician pursuing an academic career with an emphasis on cancer control.

Dental Society honors Edwin Granite, D.M.D Edward L. Granite, D.M.D., received an Award for Excellence from the Delaware State Dental Society, recognizing his dedication to the Christiana Care Oral & Maxillofacial Surgery and General Dental Practice residency programs. The program has one of the largest volunteer faculties at Christiana Care.

An active food bank and Habitat for Humanity volunteer, Jennifer Genuardi, M.D., was recognized for compassion in the community, as well as exemplary clinical care of patients.

Albert Rizzo, M.D., is speaker of lung association Albert A. Rizzo, M.D., section chief of Pulmonary/Critical Care, is the new speaker of the American Lung Association. He is a well-known, nationally recognized advocate for clean air, tobacco regulations and government benefits for pulmonary rehabilitation services.

In his new role, Dr. Rizzo leads 15 regional associations in promoting healthy lungs and preventing disease through advocacy, education and research.

Facts & Figures

19

Leading the Way | Honors, Awards & Appointments

Jefferson Medal goes to volunteering couple

Alumni award goes to Omar Khan, M.D.

Frank and Veronica “Ronnie” Romanelli were among five medalists honored by the Jefferson Award for Public Service.

The Romanellis are patient escorts at Christiana Hospital.

Consummate team players, the couple also conducts tours for new employees and staff information booths during career day events.

Omar A. Khan, M.D., MHS, of Christiana’s Care MedicalDental Staff, is the recipient of the Recent Alumni Award presented by the University of Vermont College of Medicine.

Nursing Spectrum magazine honors two Patricia Strusowski, RN, MS, director of Cancer Care Management at the Helen F. Graham Cancer Center, received the regional Award for Excellence in Nursing Management from Nursing Spectrum magazine. Strusowski was cited for her dedication, leadership, expertise and support of cancer care coordinators across the state.

The magazine also recognized Dannette A. Mitchell, RN, BSN, CCRN, RN, II/Staff Educator. A critical care nurse in the ICU at Wilmington, Mitchell was a finalist in the mentoring category.

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Christiana Care Health System

Dr. Khan, who graduated from UVM in 2003, was recognized for co-authoring two books, Behind the Mask: How the World Survived SARS, and The End of Polio? Behind the Scenes of the Campaign to Vaccinate Every Child on the Planet. He also is co-founder of Writers Without Borders, a nonprofit organization dedicated to helping health professionals in the developing world communicate crises in their communities to a global readership.

William Weintraub, M.D., co-authors research

William S. Weintraub, M.D., John H. Ammon Chair of Cardiology and Cardiology Section chief, was lead author of an article published in the Aug. 14 edition of the New England Journal of Medicine about two approaches to managing patients with chronic, stable angina. Four other Christiana Care researchers were among the co-authors. They are: Paul Kolm, Ph.D., Claudine Jurkovitz, M.D., MPH, Wei Zhang, MS, and Jim Bowen, BS.

Teaching doctors win awards Two faculty physicians from Christiana Care received academic honors at the Jefferson Medical College Class Day program in Philadelphia.

Steven A. Johnson, M.D., a faculty member from the Department of Surgery, received the Leon A. Peris Memorial Award for excellence in clinical teaching and superior patient care.

Matthew J. Burday, D.O., clinical assistant professor of medicine and associate program director at Christiana Care, received the Blockley-Osler/Dean’s Teaching Award for excellence as an educator.

Nurse and cancer survivor receives Komen honor

Infectious disease specialist is Pharmacist of the Year

LaVaida Owens-White, RN, MSN, was honored for her dedication to health ministries by Susan G. Komen for the Cure. A breast cancer survivor, Owens-White is Health Ministries coordinator at Christiana Care.

Kimberly Couch, Pharm.D., IDSA, was named 2008 Pharmacist of the Year by the Delaware Society of Health System Pharmacists. An infectious disease specialist, she coordinates daily care and follow up and collaborates with infectious disease physicians at Christiana Care to ensure patients receive the best care possible.

Tops at ELCAP Barbara Marconi, RN, BSN, OCN, coordinator of the ongoing International Early Lung Cancer Action Project (I-ELCAP), has been named the Most Influential Coordinator among 48 I-ELCAP sites worldwide.

She also developed Christiana Care’s annual Antimicrobial Formulary publication into a sought-after reference.

Marconi has been coordinator of the program at the Helen F. Graham Cancer Center since its inception in 2003. Since then, the program has grown to one of the largest programs in the country, with more than 1,400 participants from Delaware, Maryland, New Jersey and Pennsylvania, with a waiting list for more.

At the Summer Olympics in Beijing, trainer Michele Gould helped bring home the gold for the U.S. women’s soccer team. “It’s the pinnacle of my career,” says Gould, a therapist at Christiana Care Physical Therapy PLUS in Brandywine Hundred.

She has been the team’s trainer since 2006, traveling to competitions throughout Europe and Asia.

Olympic trainer good as gold

Facts & Figures

21

Service Statistics | A Full Network of Health Care Services

The following statistics and service information help to further illustrate Christiana Care’s impact on the health and well-being of Delaware and the region.

CHRISTIANA CARE’S RANKING BY VOLUME COMPARED TO OTHER U.S. HOSPITALS

COST OF AVERAGE PATIENT STAY

$ 7,242

Christiana Care Health System

UNITED STATES RANK

14th in Admissions 28th in Births 24th in Emergency Visits 17th in Total Surgeries

Cooper University Hospital

$ 8,858

Crozer-Chester Medical Center

$ 8,948

Thomas Jefferson University Hospitals

$ 8,966

Georgetown University Medical Center

$ 9,165

EAST COAST RANK

9th in Admissions 12th in Births

Source: American Association of Medical Colleges’ Autumn 2007 Databook.

12th in Emergency Visits 9th in Total Surgeries Source: American Hospital Association Annual Survey Database of 6,280 U.S. Hospitals, FY 2006.

Copyright Health Forum, LLC

OUTPATIENT VISITS

ADMISSIONS

22

52,148

53,045

54,556

55,512

55,049

04

05

06

07

08

Christiana Care Health System

461,218 454,961 450,238 457,348

04

05

06

07

479,045

08

CHARITY CARE in millions of dollars

WILMINGTON HOSPITAL HEALTH CENTER VISITS

$ 25.2

$ 28.4

$ 32.4

$ 35.7

$ 37.7

66,929

69,811

67,281

68,937

70,047*

04

05

06

07

08

04

05

06

07

08

* Includes patient visits at two off-site locations.

PERSONNEL

PRIMARY CARE PHYSICIAN OFFICES* number of visits

10,467 Christiana Care Employees 1,424 Medical-Dental Staff 239 Medical & Dental Residents & Fellows

174,679 168,698 179,289

3,678 Medical & Dental Residents Trained in our 100-Year History

3,819 RNs, LPNs and Patient Care Technicians 06

1,276 Volunteers

07

08

* Includes the Medical Group of Christiana Care, Inc., and the Department of Family & Community Medicine.

EMERGENCY DEPARTMENT VISITS

04

46,562

90,476

137,038 TOTAL

05

46,801

91,391

138,192 TOTAL

06

47,051

96,541

143,592 TOTAL

07

47,652

97,160

144,812 TOTAL

08

48,679

98,057

146,736 TOTAL

Wilmington Hospital

Christiana Hospital, a 907-bed tertiary care and regional referral center, is designated by the state of Delaware, and verified by the Committee on Trauma of the American College of Surgeons, as a Level-I (highest capability) regional trauma center for Delaware and neighboring counties in Pennsylvania, New Jersey and Maryland. Christiana Hospital is the only Level-I trauma center between Philadelphia and Baltimore.

Christiana Hospital Facts & Figures

23

Service Statistics | A Full Network of Health Care Services

AVERAGE IN-PATIENT STAY number of days

BIRTHS

5.44

5.33

5.21

5.30

5.43

7,241

7,122

7,219

7,100

7,249

04

05

06

07

08

04

05

06

07

08

At Christiana Hospital, Delaware’s only Level-3 (highest capability) neonatal intensive care unit provides the most advanced neonatal care for newborns delivered prematurely or with congenital medical conditions.

CHRISTIANA CARE HOME HEALTH AND COMMUNITY SERVICES Home Health Care Visits

High School Wellness Centers and Alzheimer’s Day Program Visits

265,361

24,487

CENTER FOR ADVANCED JOINT REPLACEMENT AND CENTER FOR REHABILITATION Total Knee and Hip Replacements

1,505

Rehabilitation Patients

878

RESEARCH Christiana Care is one of the largest community-based teaching hospitals involved with research in the United States.

Clinical research and pharmaceutical studies include: Bone Marrow Transplant Cardiac Surgery Cardiovascular Research Community Outcomes Community Provider Services Critical Care Diabetes & Metabolic Education Emergency Medicine Family Medicine Genetics Genetics-Oncology GYN Oncology Hematology Hemophilia HPRO 24

Christiana Care Health System

10 1 60 6 1 14 11 6 46 5 2 2 18 13 2 2

Hypertension 1 Infectious Disease 19 Internal Medicine 7 Maternal/Fetal Medicine 33 Neonatology 17 Neurology/Neurosurgery 1 Nursing 16 OB/GYN 4 Oncology 195 Ophthalmology 1 Orthopedics 4 Other Research (non-categorized) 63 Outcomes 25 Pathology/Laboratory 22 Pediatric Oncology 4 Pediatrics 4

Performance Improvement Pharmaceutical Oncology Pharmacy Plastic Surgery Preventive Medicine & Rehabilitation Institute Psychiatry/Psychology Pulmonary/Respiratory Care Radiation Oncology Radiology/Interventional Radiology Surgery Surgical Critical Care/Trauma Women’s Health Grand Total

1 39 7 5 1 2 15 43 2 15 6 1 752

RADIOLOGY PROCEDURES

SURGICAL PROCEDURES

247,653 251,108 253,957 258,814 335,776

04

05

06

07

08

46,362

46,428

45,091

42,834

42,362

04

05

06

07

08

PHYSICAL THERAPY PLUS number of visits WHERE CHRISTIANA CARE HEALTH SERVICES’ OPERATING DOLLAR GOES

70,968

84,633

84,718

88,325

Other Affiliates Administration Depreciation & Interest

94,421 Nursing Services

04

05

06

07

.02 .03

.06

.25

Support Services .07

08 .08 .08 .26

Therapeutic & Diagnostic Services

Facilities & Services Medical Education & Social Services

.15

Employee Benefits

TOTAL PATIENT REVENUE in millions of dollars

1,097,813

1,273,876

1,408,818

1,546,441

1,709,954

04

05

06

07

08 Facts & Figures

25

P.O. Box 1668 Wilmington, Delaware 19899-1668 800-693-CARE (2273)

www.christianacare.org

Christiana Care is a private, not-for-profit regional health care provider and relies in part on the generosity of individuals, foundations and corporations to fulfill its mission.

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