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From left, PFC Lori Washburn, RN, 5C Nurse Manager John McMillan, RN, BSN, PFC Heather Powell, RN, and PFC JeanMarie Okoniewski, RN-C, BSN, are members of the first Patient Care Coordination Program at Christiana Hospital.

Transformation Reducing readmissions

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Clinical News Convergent procedure combines surgery, EP skills EEG lab now accredited

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General News Spirit of Women Awards Nominees sought for Jefferson Awards A chemistry lesson for tobacco users

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n March, a patient in her early 40s was admitted to 5C with multiple diagnoses. Nervous and overwhelmed, wondering what was going to happen, she and her husband tried to piece together everything they had heard since she had arrived at Christiana Hospital. Within a few minutes her patient care facilitator (PCF) arrived and spent an hour walking the couple through all the details of her plan of care, patiently answering their questions. When the PCF finished, the woman, crying in relief, said, “Thank you. Thank you.

This is just what we were looking for—information.” And the patient and her husband hugged the PCF. Since Feb. 1, when the Department of Medicine and the Inpatient Medicine Service Line officially launched the care coordination program, scenes like this have become increasingly common on 5C. In early 2009, as part of Christiana Care’s drive to transform patient safety and satisfaction, a multidisciplinary team started studying care coordination and communication among staff, patients and families. As Robert C O N T I N U E D, N E X T PAG E


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Dressler, M.D., vice chair, Department of Medicine, says, “Even though we are providing excellent care, we continually look for ways to close the communication gaps in care we deliver and make care more patient- and family-centered.” Focusing on care coordination Discovering that patient care was often inconsistent because it was shared among many providers, the team looked at best practices in other health care systems. The team ultimately developed the Christiana Care model, which assigns PCFs responsibility for coordinating and communicating care plans. Using 5C, a large general medicine floor, as its project unit, the team recruited and trained the three PCFs and educated the 5C staff.

Many benefits Everyone is beginning to realize the program’s benefits. Physicians have a consistent contact person. Staff nurses have more time at the patient bedside and do not have to worry about possible gaps in care. One nurse said, “All patients have stories that need to be heard. I just never had time to listen before the PCFs took charge.” And the patients and their families are much more at ease, knowing that the PCF is overseeing every part of the plan of care. According to John McMillen, RN, 5C nurse manager, “The whole process gives patients and

families a sense of comfort. They feel more relaxed because they are participating in their plan of care.” At the end of the six-month test period, if the pilot is successful, plans are to move the model onto other units. Virginia U. Collier, M.D., Hugh R. Sharp, Jr. Chair of Medicine, says, “This is an example of our ongoing efforts to transform inpatient care at Christiana Care. We will continue to refine how we care for patients until we reach the point that coordinated care is optimized for the patient and the process is better and easier for our providers.“

Highly trained and skilled nurses, the three PCFs are responsible 24/7 for 13 to 15 patients each—from the time the patients come onto the unit until after they are discharged. The PCFs collaborate with the physician and staff nurseson each patient’s plan of care, lead daily interdisciplinary rounds and oversee the transition to post-acute care to ensure appropriate and timely discharge. PCFs are the primary contacts for patients and their families and for care team members. The result is seamless coordination of care. Although it is too soon to have hard metrics, all signs point to success. In addition to increased patient and staff satisfaction, more patients are being cared for on the unit. The PCFs are further defining their role, developing online forms, for example.

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JeanMarie Okoniewski, RN-C, BSN, PCF, spends time explaining the plan of care to a patient on 5C.

It’s Magnetic! “Forces of Magnetism” 5. Professional Models of Care 6: Quality of Care 7: Quality Improvement


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Hospitalists use discharge clinic to head off readmissions

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oncerned about the high rate of readmissions, Christiana Care hospitalists are focusing harder on the follow-up care of discharged patients.

for safe transitions for patients,” Dr. Dressler notes. “It’s not meant to compete with the primary care providers in the community.”

Patients who do not have a follow-up appointment at time of discharge are now released through a patient discharge center, part of an initiative to help make the transition from the hospital to primary care physicians safer and easier.

Transformation opportunity While still relatively rare, the concept has far-reaching and transformative possibilities, such as helping the Philadelphia-based Society of Hospital Medicine establish national best practices on care for patients after discharge.

Readmissions rate too high Currently, about one in five Medicare patients treated for heart attack, heart failure or pneumonia is readmitted within 30 days, Dr. Robinson says. The government is using legislation that would withhold Medicare payments for avoidable readmissions to press health care systems to do better. “If patients can’t receive prompt follow-up care, they are at increased risk to be readmitted, possibly through the Emergency Department,” says Robert Dressler, M.D., vice chair, Department of Medicine. The discharge clinic sees on patients who cannot schedule a follow-up appointment with their PCP within seven days. Completes cycle of hospital care “The discharge center allows us to complete the cycle of hospital care for patients who don’t have a follow-up appointment with a primary care provider,” says Edmondo Robinson, M.D., MBA, medical director of Christiana Care Hospitalist Partners. Discharge clinics ensure that patients are taking their medications as prescribed. When a follow-up visit takes place within a week of discharge problems can be detected sooner, when they are easier to treat. “Our goal is to assist our primary care physicians when needed by providing

“This is a tremendous opportunity to share what we have learned to improve transitional care on a much broader scale,” Dr. Robinson says. Dr. Robinson, who has an MBA with an emphasis on health care management from the Wharton School at the University of Pennsylvania, first experienced a discharge clinic in California, where he completed his residency at the Harbor-UCLA Medical Center. Christiana Care’s new discharge clinic, which opened in October 2009, operates weekdays and typically serves three or four patients a day. Added nurse practitioner Recently, the practice expanded to include a nurse practitioner. Dr. Robinson believes non-physician providers will become more important in the future. “Our work at the clinic can play a part in looking at the best ways to accomplish that,” he says. Hospitalists and PCPs also hope discharge centers will enhance patient satisfaction—and so far, patients like what they see. “Anecdotally, we have gotten very positive feedback from patients,” Dr. Robinson says. “We are eager to see what the quantitative results of our work will be.”

Edmondo Robinson, M.D., MBA, medical director of Christiana Care Hospitalist Partners, reviews the chart of a patient ready for hospital discharge.

GET HELP WITH TOBACCO CESSATION


Employee’s care reaches all the way to native Haiti

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fter Jean-Gerard Delinois ensures our employees receive healthy meals in the cafeteria at Christiana Hospital, he turns to the challenging job of nurturing 21 children with food, shelter and education at the orphanage he founded in his native Haiti. But Delinois, a Christiana Care administrative manager in Nutrition Services, is worried. Since the devastating earthquake rocked the island nation on Jan. 12, the children and their caregivers have been sleeping in tents beside the ruins of the building. “Haiti is desperately poor, and there are many children in need of care,” he says. “Even before the earthquake, there were children who had no parents—or who had parents who could not take care of them.” Delinois and his wife, Nadege, established the orphanage in Petit-Goave, the town 35 miles south of Port-auPrince where Nadege grew up. Began mission in 1997 Delinois has been working to help poor people in Haiti since 1997, when he established the Justified Help Mission. Jean Gerard Delinois (seated in the right corner) holds a counseling session with a group of boys at the Justified Help Mission in Petit-Goave, Haiti. Currently, 21 children are living at the orphanage supported by Delinois and his wife, Nadege, and friends. They hope to return this summer to Haiti for the first time since the earthquake struck in January.

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At the time, Delinois was managing the dining room of Harry’s Savoy Grill in North Wilmington, where he received support and encouragement from restaurateur Xavier Teixido and, later, his brother, Michael Teixido, M.D., an ear, nose and throat specialist on Christiana Care’s Medical-Dental Staff. “We went with shoes, clothes and food,” he recalls. “We could see that the need was far greater than what we were providing—and we would have to come back.” Established a school For years, Delinois and his wife have been making regular trips to Haiti, establishing nutrition programs for hungry people and a school where children receive food, uniforms, education and religious training. The couple funds the programs by donating 10 percent of their earnings,

contributing their tithe through Holy Ground Church of Jesus Christ in Wilmington. The Teixidos also have supported fundraisers along with Neil S. Kaye, M.D., a psychiatrist. Christiana Care has supported relief efforts in Haiti since the quake, providing medicine and money to the effort as well as paid time off for employees who volunteer. Delinois says children in Haiti are especially vulnerable. One day six years ago, a young mother came to the school he founded with her 4-year-old daughter. “She put the girl on the step—and walked away,” he recalls. “I got a call here in Delaware asking ‘what do we do?’” Founded an orphanage The couple established an orphanage, which currently cares for children age 5-13. Nadege’s mother, Elizabeth CONTINUED

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Procedure treats atrial fibrillation without major surgery

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hristiana Care is one of only a few mid-Atlantic heart centers offering the convergent procedure, a minimally invasive approach to treating chronic or persistent atrial fibrillation (AF) without a painful chest incision or the need to stop the heart. AF affects some 5 million Americans, making it the most common heart rhythm disorder. For many, associated pain, weakness and shortness of breath can dramatically impact quality of life. AF also causes blood clots that can lead to stroke. Caused by abnormal electrical impulses that make the heart’s upper chambers beat erratically, AF is most often treated with medication or catheter-based ablation to restore normal heart rhythms. But up to 40 percent of AF patients have a type that is resistant to this treatment. Combines surgery and EP techniques “The convergent procedure allows us to combine techniques used in the OR with those used in the electrophysiology lab,” says heart surgeon Ray Blackwell, M.D., who performs the surgical portion of the procedure at Christiana Care. “We combine a minimally invasive surgical procedure with catheter ablation for a patient- friendlier

way to treat AF in those who are not responding well to catheter ablation or medication alone.” With the convergent procedure the surgeon gains access to the heart through small incisions in the abdomen. Using tiny cameras and laproscopic instruments along with standard catheter ablation technology, first the surgeon, then the electrophysiologist ablates abnormal tissue both outside and inside the left and right atria while the heart is still beating and the patient is unconscious. Upon completion, doctors confirm correction of the irregular heartbeat. So far, six patients with AF have had the convergent procedure at Christiana Care. “If this procedure is as successful as we hope it to be, it will open the doors to treatment for a large number of patients,” says Brian Sarter, M.D. Drs. Sarter and Blackwell, with Joseph Pennington, M.D., Roger Kerzner, M.D., and Piamsook Ankeow, M.D., are members of the co-disciplinary team offering the convergent procedure at the Center for Heart & Vascular Health.

Ray Blackwell, M.D.

For information and referrals, please call 302-623-CARE (2273) or toll-free 800693-CARE. Brian Sarter, M.D.

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Roger, a former UNICEF administrator, a scratch on the leg of a girl who was volunteers to supervise the orphanage. struck by a piece of falling metal. Delinois plans to establish a vocational Quake struck during recess training program where the orphans “All the children were playing in the can learn such skills as data entry and courtyard and no one was inside the sewing as they become young adults. building,” Delinois says. When the quake struck, half the build- He has not visited the orphanage since ing collapsed. Roger’s home was the quake. But Delinois and his mothdestroyed. Luckily, the only injury was er-in-law are working with the mayor

of Petit-Goave, asking that the town donate the land adjacent to the site so a new facility can be built. “We are hopeful that we can get the land and then raise enough money to build an orphanage that we can own instead of rent,” he says. “That is our prayer.” Delinois’ e-mail address is jdelinois@christianacare.org


Christiana Care now has only accredited EEG lab in Delaware

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hristiana Care’s Electroencephalography (EEG) Laboratory received accreditation from ABRET, the national credentialing board for EEG Technologists. ABRET’s lab accreditation process evaluates technical standards, the quality of the laboratory’s output and lab management issues.

EEG Lab staff, from left, Eva Roberts, EEG technician, Lisa Leschek-Gelman, M.D, medical director, Wendy Meixell, EEG technician, Mary Ann Mihaliak, EEG technician, Michael Walley, clerk, and Mary Rose Hancock, REEG/EPT, RPSGT, manager.

Successful accreditation means the EEG Laboratory has met strict standards and is to be recognized as a place where patients and physicians can have confidence they are receiving quality diagnostics. Christiana Care’s EEG lab is the only ABRET-accredited lab in Delaware.

National Nurses Week is May 6-12

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t Christiana Care and all around the world, people celebrate National Nurses Week and National Visiting Nurse Week May 6-12. It’s a time to recognize nurses and the nursing profession for all they do to support our health and wellness. Scheduled events at Christiana Care include:

Wednesday, May 5 n Gifts for nurses will be distributed throughout the week on the units. n Healthy Work Environment Webinar, 11:30 a.m. - 12:30 p.m.

Thursday, May 6 n Liz Jazwiec, author of “Eat That Cookie,” 2-3 p.m., John H. Ammon Medical Education Center main auditorium. Teleconferenced to the Wilmington Hospital Trustees Room.

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n Nursing Excellence Award Ceremony (by invitation only for award winners and their guests) in the Ammon Education Center Auditorium, 4:30-8 p.m. Keynote speaker: Liz Jazwiec.

raffles! If you feel good about your health care today, be sure to thank a nurse!

n Christiana Care’s Annual Nursing Story Contest winners announced.

Friday, May 7 n Gift basket raffle winners will be announced by e-mail. Sponsored by the System Shared Decision Making Councils. Saturday, May 8 n Unit-based celebrations.

Nursefest! 11:30 a.m. - 2:30 p.m. Visit tables showcasing your neighboring units. Free food, giveaways and

It’s Magnetic! “Forces of Magnetism” Force 12: Image of Nursing


$2.8 million NCI grant will expand cancer research

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he Helen F. Graham Cancer Center at Christiana Care is the recipient of $2.8 million from the National Cancer Institute (NCI), part of the National Institutes of Health, to expand cancer research. The funding is part of $80 million from the American Recovery and Reinvestment Act (ARRA) awarded the 16 members of the NCI Community Cancer Centers Program (NCCCP) and supports an additional 14 new network sites. The Helen F. Graham Cancer Center will use the funding to expand its community outreach programs, improve health care disparities, leverage information technology to benefit patient safety, and enhance survivorship and palliative care. The award will also promote smoking cessation among cancer survivors, and boost genetic counseling and breast cancer research. The NCCCP is a network of community-hospital cancer centers working to provide research-based cancer care spanning the full cancer continuum – from prevention, screening, diagnosis, treatment and survivorship through end-of-life care. The community-based program supports basic, clinical and

population-based research initiatives. Grant demonstrates success “The continued funding of the NCCCP demonstrates the success that this network has brought to patients in their community cancer centers,” says Nicholas J. Petrelli, M.D., Bank of America endowed medical director of the Helen F. Graham Cancer Center at Christiana Care. “We are proud to be part of this elite group of cancer centers across the country as we continue to make progress in all aspects of cancer care.” NCCCP began in 2007 with 16 hospital-based community cancer centers in 14 states. The expansion uses approximately $40 million of ARRA funds to support additional research opportu-

nities within the original network of sites and another $40 million to expand the network with 14 new community cancer centers in eight new states. The NCCCP, designed to create new research opportunities across the cancer continuum, emphasizes minority and underserved populations. Expanding the NCCCP network will include access to more patients in community cancer centers to support basic, translational, clinical and population-based research to find effective new prevention strategies and treatments. For more information about the NCCCP network, go to ncccp.cancer.gov.


Three receive Spirit of Women awards for inspiring work helped run three farmers markets located within the city and gained experience in community organizing and health education. She was instrumental in helping to build and maintain Wilmington’s first urban

2010 Spirit of Women Award winners, from left, Stephanie Phillips, Kera Carter and Kim Petrella, RN, each received an award from Christiana Care.

At the second annual Spirit of Women Awards reception, Christiana Care recognized 35 local women for making their communities healthier, safer and more inspirational places for women. Three women received Spirit of Women Awards on April 27 at the awards event, held at the John H. Ammon Medical Education Center on the Christiana Hospital campus. Christiana Care employees submitted 35 nominees in three categories, with winners chosen by the Spirit of Women committee. This year’s awards recipients are: Kera Carter, Young Person Role Model Award: Kera Carter, a senior at Howard High School, was a summer of 2009 member of Camp FRESH, the health-focused youth leadership program promoting positive health choices for the urban communities in Wilmington. Carter 8

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Eagles and Professional Football Ultimate Fan Association, she continues to raise awareness and funds for cancer research. Phillips recently agreed to become a mentor for newly diagnosed patients with the Delaware Breast Cancer Coalition. Breast cancer is a devastating disease but Phillips has embraced its effect on her life and turned it into a positive. Kim Petrella, RN, Health Care Hero Award:

Kim Petrella is a labor and delivery registered nurse at Christiana Care. She serves as a member of the Bereavement Team and offers labor and delivery support to deployed farm. Delaware Air National Guard She currently volunteers eight hours a Members and their families, even week in Christiana Care’s Center for offering breastfeeding house calls for Community Health with Moving moms in need. Petrell works in the Mom’s Forward, a community procommunity as a spokesperson and gram offering nutritional education nurse educator for umbilical cord and exercise for expectant mothers. blood donation, working with the She returns community phone calls, Brady Kohn Foundation to raise organizes mailings, registers members awareness for non-embryonic stem for classes and creates fun nutritional cell health related issues. games for children. In her spare time, Petrella recently colStephanie Phillips, Community Hero lected medical supplies from the Avon Award: Grove Middle School for TEAM Stephanie Phillips is a breast cancer DELAWARE to take to Haiti. She has survivor and passionate advocate for been involved in Girl Scouts of breast cancer awareness, raising funds America as a leader, the Special and awareness through her “Score for Olympics, and the Hockessin and U-D the Cure” Relay for Life team. This fire companies. year, she raised funds by selling 300 Our winners enter into consideration pink tulip bulbs that were planted in a for the Spirit of Women national memory garden at Bellevue State Park awards, announced at the Spirit of to remember those who fought and Women National Executive Meeting, lost their battle and to honor those July 8-10 in Boca Raton, Florida. who survived. Spirit of Women, a national coalition Through pretzel sales, an annual of hospitals and health care facilities spaghetti dinner fund raiser and a advancing the cause and business of partnership with the Philadelphia women’s health, organizes the Spirit of Women Awards.


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New Medicaid eligibility creates challenges and opportunities for states

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he health reform law taking effect in 2014 will bring a significant increase in Medicaid-eligible patients, as States must accept patients with incomes below 133 percent of the federal poverty level. Medicaid presently represents 13 percent of Christiana Care Health System’s business. Of the 32 million people expected to gain coverage under the newly enacted Patient Protection and Affordable Care Act (Pub. L. No. 111-148), about half will be enrolled in the Medicaid program. This expansion sets out a significant challenge for states tasked with managing the program. During the reform debate, much of the discussion surrounding the Medicaid expansion centered on how much budget-strapped states could afford to spend to cover the newly eligible. Most states have already closed significant budget gaps as the recession decreased revenues and increased the demand for services. States urged federal lawmakers to assume as much of the cost as possible for newly eligible Medicaid beneficiaries. The federal government will fully fund the costs of the expansion for 2014-2016. After that time, the federal government will gradually reduce the states' enhanced matching funds, to 95 percent of the costs in 2017, 94 percent in 2018, 93 percent in 2019 and 90 percent for 2020 and beyond. The law gradually phases in the enhanced federal medical assistance percentage rate for states like Delaware that have already expanded coverage to adults at or above 100 percent of the federal poverty level. Beginning in 2019, those states will receive the same level of funding as the other states. While states are being asked to assume the burden of new costs in health reform, including the administrative burdens that come with implementing the new law, there are provisions in the bill that could reduce costs. One such provision is the potential savings to be found as states draw federal funds for other populations and services they have had to support on their own.

Other reforms designed to shift from a fee-for-servicebased system to one that rewards quality and value also have the potential to slow cost growth, in part by improving overall population health. Those reforms include patient-centered care, accountable care organizations, community-based long-term care, and plans to better integrate care. A Families USA fact sheet explaining early Medicaid expansion options is available at www.familiesusa.org.

Gift stores offer convenient shopping

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eed a gift but don’t have time to go shopping?

The Glass Box gift shop at Christiana Hospital and the Window Box gift shop at Wilmington Hospital may have just what you are looking for, whether it’s flowers, balloons, refreshments, reading materials, or a special gift for a loved one, co-worker or baby. The gifts shops are run by the Junior Board of Christiana Care and feature a great selection of reasonably-priced merchandise. The gift shops also have convenient hours for Christiana Care employees on the go. Profits from both gifts shops benefit Christiana Care programs. Window Box Wilmington Hospital 302-428-2246 Monday – Friday 9 a.m. to 4 p.m. Saturday and Sunday 11 a.m. to 2 p.m. Glass Box Christiana Hospital 302-733-1100 Monday – Friday 9 a.m. to 7 p.m. Saturday and Sunday 11 a.m. to 4 p.m.

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Diversity and Inclusion Day highlights power of perspective

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hristiana Care held its inaugural Diversity and Inclusion Day on Monday, April 19. The aim of the day was to raise our awareness of the strengths inherent in our differences. Fostering a culture of inclusion helps us leverage our diversity to enhance innovation and teamwork and improve our quality of care. Among the day’s highlights was a kick-off event with Bob Laskowski, M.D., president and CEO of Christiana Care, and keynote speaker Fred Hobby, MA, chief executive officer of the Institute for Diversity in Health Management, an affiliate of the American Hospital Association. Participants attended workshops on Spirituality and Cultural Sensitivity at the Bedside; Managing Generations, Language Services and Interpretation, Diversity and Inclusion, and a Physician Workshop on Disparities and Cultural Care. More than 300, including representatives from our community and other health care systems, attended events. For more information about Christiana Care’s efforts in diversity and inclusion, visit the Cultural Competency page on the System Learning website. To see more photos of the Diversity and Inclusion Day, visit Christiana Care’s Flickr site.

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In-school Wellness Center catches teen’s high blood pressure Kay McLean, nurse practitioner and coordinator of the Concord High During a sports physical for football at School-based the Wellness Center, Ralph learned he Wellness Center, was needed to tackle some health issues. first to discover stuHis blood pressure was high and his dent 15-year-old body mass index (BMI) measurement Ralph Eaton had was above the 95th percentile. Upon high blood pressure. follow up with his primary care physi- In addition to physician, his cholesterol count was elevat- cal exams, centers at ed as well. high schools “I feel very fortunate that we caught it throughout the state while I’m young,” says Ralph, 15. “If I provide immunizadidn’t do something about my weight tions, counseling, nutrition and weight and my diet, I could wind up with management, and diabetes.” treatment for minor Health system, school district partner illnesses and injuries.

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alph Eaton is a gifted athlete who enjoys playing sports at Concord High School.

The Wellness Center is operated by a partnership that includes Christiana Care and the Concord school district, as well as the Delaware Division of Public Health. In addition to physical exams, centers at high schools throughout the state provide immunizations, counseling, nutrition and weight management, and treatment for minor illnesses and injuries.

Because the center is located in the school, students don’t have to worry about transportation or scheduling an appointment. Care is free and confidential. “We can take care of acute medical problems right here, without parents taking time off from work,” says Kay McLean, nurse practitioner and center coordinator. The Wellness Center helped Ralph’s family to obtain insurance coverage through Medicaid. His primary care provider prescribed medication to

control his blood pressure and worked with McLean to coordinate his care. Ralph also joined the Wellness Center’s Biggest Winner program, in which kids are encouraged to eat right and exercise. Focuses on having healthy habits “Our focus is not on losing weight,” McLean says. “It’s about developing healthy habits.” Ralph has learned to make wise choices in his diet, substituting wholewheat bread for white bread. He now reaches for the pepper shaker and leaves the salt shaker on the table. Instead of breaded, fried chicken, he opts for skinless, grilled poultry that is lower in fat. “I’ve gone from whole milk to 2 percent milk,” he says. “My goal is to go to skim milk.”

His most difficult adjustment has been giving up cola. That task is a bit easier since Concord High stopped serving soda in the cafeteria. Ralph made the switch from soda to low-sugar lemonade. Since June, Ralph has sprung up two inches, to 5 feet, 10 inches tall. His weight has dropped 20 pounds, from 245 to 225 pounds. His BMI is lower, too, decreasing from 39 to 34.5. “Ralph has done an amazing job,” McLean says. He is now playing baseball. And his blood pressure has improved so much that his doctor expects him to be able to stop taking medication soon. “Everyone here has made it so much easier to stay motivated,” Ralph says. “It’s great to have this center in our school.”


Pediatrics backs Delaware’s first oncology camp for kids From left, Laura Lawler, M.D., (pediatric hospitalist), Louis E. Bartoshesky, M.D.,MPH, chairman of Pediatrics, Bill and Laurie Warren (Kaylyn Warren’s parents), Amanda J. Kay, M.D., (pediatric hospitalist, medical director of Kay’s Kamp), Susan Pederson (administrative assistant, Pediatrics), Debbie L. Brown (administrative assistant, Pediatrics), Theresa Scarfo, RN (4A Pediatrics/Adolescent Maternity).

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aylyn Warren knew what it’s like to be a child with cancer. She was diagnosed with leukemia at 17. It became her dream and her legacy to open a summer camp for children with cancer. Kay’s Kamp, the first oncology camp in Delaware, opened in August 2009. Partially sponsored by Christiana Care, Kay’s Kamp provides children who have survived cancer or are liv-

ing with cancer a chance to experience the pleasures of summer camp, including all the crafts, sports, fishing and campfires, in a medically supervised environment. Recapturing childhood Amanda Kay, M.D., a pediatric hospitalist at Christiana Care, is the Kamp medical director. “Children with cancer spend much of their time fighting their disease. With our help, Kay’s

Kamp allows them to recapture their childhood and live carefree for a week during the summer,” she says. On April 8, Christiana Care’s Pediatric Department donated $1,000 so campers could attend free. Many of last year’s volunteers, physicians, nurses and staff from the Helen F. Graham Center and the departments of Hematology/ Oncology, Pediatrics, Pharmacy and Maintenance have signed on for this year’s adventure: Kay’s Kamp Goes to the Movies, Aug. 7-14. “Like Kaylyn, these children have been through so much in their short lives. Supporting Kay’s Kamp exemplifies our commitment to long-term cancer care beyond diagnosis and treatment,” says Dr. Kay.

Pediatric rehabilitation partners with Exceptional Care for Childrentm

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xceptional Care for Children (ECC), a residential pediatric health care facility in Newark relies exclusively on Christiana Care for rehabilitation services for many reasons, says Annette V. Moore, NHA, ECC administrator. The ECC and Christiana Care teams share an aggressive, compassionate and thorough approach to helping technology-dependent children. Children at the center receive skilled pediatric nursing, transitional and palliative care. Ranging from newborns to teenagers, most were born prematurely and have developmental delays, along with some combination of feeding tube, tracheotomy or ventilator dependency, Moore says. Physical, occupational and speech

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therapists from Christiana Care collaborate with ECC staff to determine what therapy, equipment or adaptive devices will help each child maintain independence or achieve an improved quality of life.

provides a safe, consistent environment for therapy,” she says.

“We look to uncover each child’s untapped potential, taking into account the child’s challenges, diagnosis and developmental stage, as well as typical behaviors associated with their particular age group,” says Christiana Care Pediatric Rehabilitation Clinical Supervisor Pamela A. Green, BSED OTR/L.

Christiana Care’s Pediatric Rehabilitation Services Department provides inpatient and outpatient therapy services across a variety of age groups and settings, including Christiana Hospital’s neonatal intensive care unit, First State School at Wilmington Hospital, Delaware’s statewide Child Development Watch Program, early intervention in the “natural environment” aquatic therapy, and traditional outpatient therapy services.

Kelly Neal, RN, of ECC says collaboration with multiple therapists from each discipline who share one caseload is reassuring to young patients. “Having a core group of therapists

For more information about Christiana Care Pediatric Rehabilitation Services, contact Pamela A. Green, at 302-733-1037 or e-mail pgreen@christiancare.org.


Nominees sought for Jefferson Awards

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any Christiana Care employees volunteer in the community, committing their spare time to mentoring, tutoring, working in food pantries or on building projects, and many other ways of improving the lives of our neighbors. At Christiana Care, Service is a Core Value, and it shows. Join Christiana Care in celebrating the talent and dedication of our employees and volunteers who devote themselves to contributing countless hours and endless energy in their communities. Nominate them for a Jefferson Award.

The Jefferson Awards are a prestigious national recognition system honoring community and public service in America. The awards started in 1972 to create a significant prize recognizing public service. A call to action Today, their primary purpose is to serve as a "Call to Action for Volunteers� in local communities. Each month Christiana Care spotlights an outstanding employee or volunteer with a Jefferson Award bronze medallion. Winners become eligible for national consideration by the Jefferson Awards for Public Service organization. Eligibility requirements:

Groups of employees or volunteers are not eligible

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Volunteer activities/services should not be part of every day work duties

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Any employee, manager or co-worker can make a nomination. A Christiana Care Jefferson Award committee reviews and researches all nominations before deciding on winners. Complete the Nomination Form by May 10 and fax it to Margarita Rodriguez-Duffy, manager of Volunteer Services, at 733-3417. You can also drop it off at Volunteer Services at Christiana Hospital. For more information, call 733-1284.

n All Christiana Care employees, volunteers and Junior Board members

Christiana Care leads the world in certificates completed

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he Christiana Care chapter of the Institute for Healthcare Improvement (IHI) has earned more Open School basic certificates of completion than any other chapter in the world. An online curriculum in quality improvement, the IHI Open School is a worldwide community of medical students, nursing students, physicians, nurses and other health care professionals afforded access to free curriculum about health care quality and safety.The IHI offers a certificate in performance improvement to those who complete all of their courses. There are more than 10,000 participants worldwide. Christiana Care congratulates Matt Judd, D.O, our IHI Open School chapter leader and faculty advisors Patty Resnik, RRT, MBA, CPUR, Loretta Consiglio-Ward, RN, MSN, Charles L. Reese, M.D., and Lee Ann Riesenberg, Ph.D., RN, along with all colleagues who have earned certificates to date. If you are interested in joining the chapter, contact Dr. Judd directly at 302-388-7941 or mjudd@christianacare.org. Go to http://www.ihi.org/ for more information on the Open School.


Publishing, Presentations, Appointments, Awards

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Chris Zebley, APN-BC, MSN, AAHIVS

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Therapist appreciates care from a patient’s point of view Pete Sullivan, a Speech Pathologist at the Center for Rehabilitation at Wilmington Hospital, writes about his recent experience as a patient at Christiana Care.

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ear Dr. Laskowski,

I've been meaning to write you for months and did not want to put it off any longer. On Sept. 3, 2009, I experienced some neurological symptoms at work that led to me being admitted to the Emergency Department at Wilmington Hospital, where a CT was done revealing two large brain masses. I was subsequently transferred to Christiana Hospital with a differential of brain metastasis. After a week of workups and a biopsy/aspiration, it was determined that the masses were abscesses. I made a speedy recovery and was able to return to work quite quickly. The reason I’m e-mailing you is because I wanted to let you know how grateful I am for the care I received from the beginning to end of my stay and I wanted to recognize all of those who participated in my care. The nurses in 6B and 6C were incredible. They were diligent and encouraging through some uncertain and scary times. They were warm, outgoing and respectful to both me and my family. I truly felt as if they were pulling for me throughout this ordeal. I will never forget the smiles and cheers that arose from the unit when I came up from my biopsy and was able to tell them that it was positive for strep bacteria and not cancer. The care I received from the M.D.s in Internal Medicine, Infectious Disease, Oncology/Hematology and Neurosurgery was outstanding as well. I was very impressed with the collaboration between the physicians that led to my eventual diagnosis. Without their collective efforts, things would most certainly not have turned out as well as they did. Having recently moved here for this position, it was of great comfort to me and my family knowing that I was in such great hands. On top of the impeccable care I received, the support that everyone showed me was absolutely overwhelming. My coworkers in the department strongly urged me to go to the ED when I otherwise might not have done so. They paid me frequent visits and were able to lift my spirits when the situation looked bleak. The entire Rehab floor made me feel as if I was part of a family. I will never forget their support. My experience has completely validated my decision to move here and work for Christiana. I am proud to say that I work for an outstanding department as well as with thousands of dedicated professionals. In a short time, I feel very much at home here. I am fortunate to work for such a remarkable institution. Sincerely, Peter J. Sullivan, MA, CCC, SLP


Rolled into every cigarette are 60 good reasons for quitting

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f you look at a cigarette, you likely see a slim paper tube filled with tobacco with a filter on the end. In reality, a cigarette is a highly effective delivery system for channeling harmful chemicals into our bodies, substances that wreck our health. Smokers can feel some of the effects, such as a heightened pulse rate. But they might not be able to discern other reactions, such as higher blood pressure.

Carbon monoxide Nicotine

Formaldehyde

So here is a chemistry lesson, part of a healthy education on the hazards of smoking. Cigarettes have at least 60 carcinogens At least 60 of the chemicals included in cigarettes are known to cause cancer. That includes tobacco-specific Nnitrosamines or TSNAs, potent carcinogens found in tobacco smoke, snuff and smokeless tobacco. Another cancer-causing chemical in cigarettes is benzene, which is used to make pesticides and gasoline. In fact, smoking accounts for nearly half of all human exposure to this carcinogen, including second-hand smoke. Nicotine, the component that gets smokers hooked on tobacco, is used in pesticides, too. Manufacturers enhance nicotine’s effect by giving it a boost with ammonia, which is used to make fertilizer and cleaning products. You have probably heard of formaldehyde, a chemical used to preserve dead bodies. It also is an ingredient in cigarettes. Formaldehyde is the substance that irritates smokers’ eyes, noses and throats.

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FOCUS May 6, 2010

Hydrogen-cyanide

A cigarette is a highly effective delivery system for channeling harmful chemicals into our bodies.

The list of dangerous ingredients associated with smoking is a long one. It also includes arsenic, commonly used in rat poison, and cadmium, a toxic heavy metal used to make batteries. Cigarette smoke contains lead-210 and polonium-210, toxic heavy metals that are radioactive.

Within the first 20 minutes of quitting, your blood pressure and heart rate will return to normal, immediately lowering your risk of heart attack. So why not say goodbye to harmful chemicals and hello to a healthier lifestyle?

Carbon monoxide, hydrogen cyanide Carbon monoxide, a poisonous gas in automobile exhaust, is present in cigarette smoke, too, as are small amounts of the lethal gas hydrogen cyanide.

As part of Christiana Care’s commitment to creating a tobacco-free workforce, employees who want to quit smoking can receive free medications, face-to-face counseling and other support.

While it might be scary to think of the harm these chemicals can cause to smokers and the people around them, there is another important lesson to be learned: It is never too late to quit.

To learn more, contact Employee Health at 302-428-2285 at Wilmington Hospital or 302-733-1512 at Christiana Hospital. Delaware also offers the toll-free Quitline. The number is 866-409-1858.


Upcoming events

Funyak named director of Environmental Services

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ason Funyak is the Director of nvironmental Services. Funyak joined Crothall Healthcare five years ago and has been assigned to Christiana Hospital since 2006 as the Environmental Services Manager. Christiana Care began a partnership with Crothall in 2003 to provide and management of housekeeping services. As Christiana Care returns to in-house management of Environmental Services, Funyak becomes a Christiana and course marshal help. For information contact Joel Schiller at jschiller@artisansbank.com.

Christiana Care’s 3rd annual Great Place to Work celebration takes place May 915, coinciding with National Hospital Week. Check your portal for a calendar.

21st Annual Kennett Run on Saturday, May 15 in downtown Kennett Square, Pa., features 10K and 5K runs, a 5K Walk, Kids 1-Mile Race and a Mile Fun-Walk, prizes and a post-race festival in the park. Racer participants and volunteers visit ww.kennettrun.com.

The Many Faces of Breast Cancer, an event focusing on the unique needs and issues of survivors and providing Volunteers needed for Delaware Marathon weekend May 14-16. Packet the lates information on breast cancer, stuffers, equipment setup, water station will be Wednesday, June 9, from 5:30-

Formulary update

Care employee and will be working over the next several months to build his in-house management team. Jason received a BS in Jason Funyak business logistics from Pennsylvania State University and has nine years’ experience in environmental services management. 7:30 p.m. at the Helen F. Graham Cancer Center. Featues leading medical experts, including Christiana Care Breast Center Medical Director Emily J. Penman, M.D., Associate Medical Director Diana Dickson-Witmer, M.D., Chief of Oncology David Biggs, M.D., and Health Psychologist and Director of the Survivorship Multidisciplinary Center Scott Siegel, Ph.D. Moderated by Nicholas Petrelli, M.D., Bank of America endowed Medical Director of Graham Cancer Center and Delaware’s First Lady, Carla Markell. RSVP to 877267-2316.


Christiana Cares: Clothes closet helps patients in need

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irtually every day patients who are homeless, underserved or have no friends or family to help them come to us with so little that they don’t have clothes to leave the hospital once we care for them. “We help people who are often in horrible situations,” says Susan Greig, a social worker in the Trauma Department. “When we review discharge plans, one of the questions we ask is ‘do you have clothes available?’”says Caroline Corzine, senior social worker in the Trauma Department. “It isn’t that unusual to have a patient who simply doesn’t have clothes.” A tradition for 20 years To help these patients in need, Christiana Care created the Christiana Care Clothes Closet. The 20-year long tradition is a critical service for patients who have limited resources. Thankfully, the Clothes Closet is now supported exclusively by generous gifts from our neighbors in the community who understand that sometimes a patient’s health care needs go beyond traditional medical care. Almost every day, social workers or nurses give patients clothes so they can leave the hospital with dignity. Recently, a teenage mother injured in a car wreck left the hospital in donated pants, shirt and shoes. A traveler injured in an accident on Interstate-95 received a sweat suit to wear on the trip back to Boston. In winter, the homeless get sweaters and coats to warm them from the cold. Paula Steele, a social worker assistant, has been maintaining the Clothes Closet at Christiana Hospital since 2002. "Our staff are so dedicated that they actually stocked the closets personally

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FOCUS May 6, 2010

Debbie McGrath, SW, BAAS, Social Work, checks on items in the Clothes Closet at Christiana Hospital.

to be sure that there was an ample supply of trousers, shirts, sweaters, shoes and socks." As community need expanded and we cared for more and more of our neighbors, our staff’s personal generosity could not keep pace with the need. Thanks to gifts from generous donors, the social workers buy sweatpants, T-shirts, soft and comfortable clothes that can be worn by both men and women. "We’re here to help," Steele says. "And if that means making sure people have clean, wearable clothes that is what we do." Medical care is sometimes only a part of what a person needs.


Th e 2 0 1 0 M e d i c i n e B a l l

The Jun than Chris ior Bo don ks a tian ard a o l ors and l of the Care f succ volunt sponso rs essfu eers l ev for a , guests ent! noth , er

Robert J. Laskowski, M.D. (left), president and CEO of Christiana Care Health System, celebrated with members of the Department of Nursing.

An Evening of Elegance Medicine Ball sponsors this year included:

Gold

Betty and Jim Coker, in Memory of Dr. I. Lewis Chipman, Sr. and Dr. I. Lewis Chipman, Jr. The Glenmede Trust Company *** Synthes Spine

Silver AstraZeneca *** Blue Cross Blue Shield of Delaware *** Endo Pharmaceuticals *** Friess Associates, LLC Mason Building Group, Inc. *** Regal Heights and Regency Healthcare and Rehabilitation Centers

Bronze Action Coffee, Inc. *** Christiana Care Helen F. Graham Cancer Center *** DuPont *** Five Star Quality Care, Inc. Lessard Builders *** Patterson-Schwartz Real Estate *** PNC Bank *** Sysco Eastern Maryland, LLC *** Wilmington Trust Co.

Pewter Ameriprise Financial Services, Inc. *** Assurance Media, LLC *** Bayada Nurses *** Blood Bank of Delmarva Christiana Care Center for Heart & Vascular Health *** Conner Strong Companies, Inc. *** Frederick Enterprises, Inc. Hatzel & Buehler, Inc. *** Marvin & Palmer Associates, Inc. *** MedAssets, Inc. *** Mid-Atlantic Realty Company, Inc. Nason Construction, Inc. *** Sentinel Self Storage *** Skanska USA Building, Inc. *** Sodexo *** Spinnaker Medical, LLC W. L. Gore & Associates, Inc. *** Young Conaway Stargatt & Taylor, LLP

Friends Associates Graphic Services *** Mehdi Balakhani, M.D. *** Bancroft Construction Company Bassett, Brosius & Dawson Brew Ha Ha! *** Chandler Funeral Home & Crematory *** City of Wilmington Connolly Flooring, Inc. *** Doctors for Emergency Service, P.A. *** Elkton Florist *** Furness Electric Co., Inc. Gunnip & Company, LLP *** Hardcastle’s Newark Gallery *** International Medical Devices Wexler Kerns Brothers Tree Service & Landscaping Lincoln Financial Group *** McCrery Funeral Homes, Inc. Newmark Knight Frank Smith Mack *** The Old Lamplighter *** Parkowski, Guerke & Swayze, P.A. Pratt Insurance, Inc. *** Randall Renneisen, Morgan Stanley Smith Barney *** Drs. Leo and Irene Raisis Robert Layton Reed *** Valero *** Walter’s Steakhouse *** Wohlsen Construction Company With special thanks to the Philadelphia Chapter of Ikebana International for donating the Medicine Ball floral centerpieces.


Annual Medicine Ball benefits scholarships

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ore than 170 people enjoyed the 13th Annual Medicine Ball on Friday, April 23 at Wilmington Country Club. In its illustrious history this annual Junior Board event has raised more than $1 million. This year, proceeds will provide scholarships and continuing education for nursing and allied health professionals at Christiana Care. The ball garnered support this year from more than 60 sponsors, including individuals, small businesses and corporations.

Several members of the 2010 Medicine Ball Committee (from left) Carole Miller, Treasurer, Arlene Daney, Invitations, Sheryl Rogers, Vice Chairperson, Anne McCarren, Third Vice President, External Affairs and Fundraising Committee, Nancy Klein, Fundraising Chairperson, Denise Schwartz, Food, Helen Ferris, Fundraising committee, Maret Headley, Flowers, Judith Kirlan, Fundraising committee, Barbara Burd, Junior Board President and Fundraising Committee.


Focus: May 6, 2010