March 2006

Medical Staff Bulletin

Message from the Chief of Staff

The Department of Medicine’s Hospitalist Service at Yale-New Haven Hospital, under the direction of Dr. Victor Morris, achieved new activity milestones in the last year. Patients are admitted to the service through several routes. A number of primary care internists and family practitioners have formal participation agreements with the service and all patients of these practitioners are selectively admitted to the Hospitalist Service. When Medicine firm teams reach maximal total or daily admission numbers, patients are directed to the Hospitalist Service. Moreover, between 1 a.m. and 7 a.m., all admitted general medical patients not triaged to ICUs are referred to the Hospitalist Service.

The admission rate to the Hospitalist Service has increased geometrically in the last five years. In calendar year 2000, patients were admitted at a rate of approximately 100 per month. In 2005, numbers reached 500 to 600 per month. Two factors accounted for the rise in activity. First, admissions to the department of Medicine increased from 12,000 to more than 16,000 in this period. Second, ACGME restrictions on resident work schedules and hours necessitated dramatic changes in our teaching program.

Currently, there are nine physicians and 19 physician associates caring for Hospitalist patients during the day and roughly 15 physicians managing the service during evenings, nights and weekends. Certain subspecialty services, including cardiology and nephrology, are integrated with the Hospitalist Service, and some MICU care is provided as well. Hospitalist attendings also regularly participate on the resident teaching firms and the medicine inpatient consult service. Moreover, the Hospitalist team is a major site for physician associate training.

The physicians and physician associates of the Hospitalist Service bring great value to Yale-New Haven Hospital. Community physician, patient and nursing satisfaction with care is high, and team member satisfaction with the work experience is similarly high. The service began as a concept several years ago and has evolved into a central component of Yale-New Haven Hospital patient care and graduate medical education.

National Doctors' Day is Thursday, March 30

This year Yale-New Haven Hospital is recognizing its Medical Staff by holding a lunch buffet from noon to 1:30 p.m. in the special events area of the East Pavilion Cafeteria. Invitations have been mailed; Medical Staff members who wish to attend can RSVP to the Department of Physician Services at 203 688-2615.

East Pavilion elevator policy reinforced

The East Pavilion service elevators are the only bank of elevators that shares services for patient transport and the daily delivery of supplies, linen and food. Patient transport takes precedence over all other transports in the service elevators. To address the congestion and traffic flow, staff are reminded they should not use these elevators unless they are transporting a patient or supplies. Staff not engaged in these activities, including physicians, should use the public elevators near the pre-admission office.

Performance management update

Below are Yale-New Haven Hospital’s November performance numbers for the set of measures reported monthly to Medicare and JCAHO. The initial 10 measures were first reported in November 2004; others were added in April 2005. In September 2005, three additional measures (appropriate antibiotic selection for pneumonia, antibiotic given 1 hour before surgery, and discontinuation of surgical antibiotics in 24 hours) were added and we will report them with January 2006 discharges.

The big news this month is that Medicare is planning to publicly report, within the next 9 months, the results of a 27-item patient satisfaction survey it will begin sending to a random selection of our Medicare patients. This measure, called the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) was developed by Medicare with help from the Agency for Healthcare Research and Quality (AHRQ). Its intent is to provide an "apples to apples" comparison across all the acute care hospitals in the U.S. which, together with the data already reported on quality, will help patients choose among their healthcare options.

Thanks to all employees and staff for all the work aimed at improving these measures and improving the care and experience of our patients. If you have any questions, please call Dr. Tom Balcezak at 203 688-1343.

November Performance

*Measures added in April 2005

Valet Parking extended to Dana Clinic and EDs

In February, Yale-New Haven Hospital began valet parking for Dana Clinic patients, visitors and vendors. Between 7 a.m. and 5 p.m., a Propark valet captain assists each patient or family member with parking needs. Valeted cars are taken to Lot 1 by the valet runner until the patient or visitor requests it. In addition, valet parking is now available for patients and visitors at the adult and pediatric emergency departments (EDs). Parking is complimentary for the vehicle which is transporting the patient to the ED. Unless otherwise indicated, visitors are encouraged to park in the Air Rights Garage.

New director of Primary Care Center named

Inginia Genao, MD, is the new medical director of the Adult Primary Care Center. Dr. Genao, assistant professor of medicine in General Internal Medicine, graduated from Marymount College and received her MD from the University of Rochester School of Medicine where she served her residency. She was an assistant professor of medicine at Emory University Medical School and the director of Multicultural Affairs at Grady Hospital in Atlanta where she established and directed the International Primary Care Clinic.

New interim chief of Hematology appointed

Nancy Berliner, MD, has been appointed interim chief of Hematology. A graduate of Yale College and Yale School of Medicine, Dr. Berliner received residency and fellowship training at Brigham and Women’s Hospital, where she also served as chief medical resident. She joined the Yale faculty in 1986. Dr. Berliner is a professor of Internal Medicine and Genetics; her research is focused on the dissection of the molecular pathways involved in differentiation of granulocytes and the molecular pathways of early myeloid gene expression in normal and leukemic cells.

Refer items for the next issue of Medical Staff Bulletin via phone, fax, e-mail or mail to:
Peter N. Herbert, MD
1063 Clinic Building
P: (203) 688-2604, F: (203) 688-7152
herbertpn@ynhh.org
or
Katie Murphy
Marketing & Communications
GB 443
P: (203) 688-2492, F: (203) 688-2491
Katie.Murphy@ynhh.org

Back issues of the Medical Staff Bulletin:

• January 2006
• December 2005
• November 2005
• September 2005
• August 2005
• June 2005
• March 2005
• January 2005
• December 2004
• November 2004
• October 2004
• September 2004
• July 2004
• June 2004
• May 2004
• April 2004
• March 2004
• February 2004
• January 2004
• January/February 2003
• October/November 2002
• August/September 2002
• April/May 2002
• February/March 2002
• January 2002
• November 2001
• July/August 2001

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Last revised: March 9, 2006 (mv)

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