January 2011 :: State in Focus


Published Sunday Jan 2, 2011

Stroke Team Honored With Annual Lifespan Quality Award


(L-R) Barnet Fain; Jessica Brier, RN, MS, CV CNS-BC, cardiovascular clinical nurse specialist, The Miriam Hospital; Todd Seigel, MD, emergency physician and Stroke Center co-medical director, The Miriam Hospital; Celia Gomes McGillivray, RN, BSN, MPH, CHES, quality improvement and stroke coordinator, The Miriam Hospital; Diana Wantoch, RN, BSN, MBA, CPHQ, director of quality management, The Miriam Hospital; Fred Griffith, MD, neurologist and Stroke Center co-medical director, The Miriam Hospital; and Gerardo Carino, MD, director of the intensive care unit, The Miriam Hospital.

PROVIDENCE, RI – The Miriam Hospital’s Stroke Center recently received the 2010 Lifespan Barnet Fain Quality Award. Established in 2002, this award recognizes outstanding efforts by teams or individuals to improve the quality of care provided by Lifespan’s partner hospitals.
The hospital’s stroke committee was selected for developing and implementing several quality initiatives to enhance stroke care and continually improve performance measures, including coordination of care, ongoing education and documentation.
“We are proud of the progress and growth of the Stroke Center and I congratulate the entire team on this well-deserved honor,” said Arthur Sampson, executive director of The Miriam Hospital. “During this time, our mission has remained the same: to provide the highest quality stroke care to reduce the burden of stroke on our patients and their families. Thanks to the hard work and dedication of everyone involved with the Stroke Center, we’ve been successful, as evidenced by our third Primary Stroke Center certification.”
Following a thorough analysis and data review, the hospital’s stroke committee identified several measures as improvement indicators in order to ensure consistency in stroke diagnosis and care, reduce variation in practice patterns and better educate staff about stroke treatment guidelines.
As a first step, a concurrent review process was outlined and implemented in June 2008 to provide immediate feedback to physicians, nurses and other health care workers who care for stroke patients. This collaborative program was designed to help identify system of care issues while also helping clinicians adhere to national stroke guidelines and standards of care.
According to The Miriam’s stroke committee, the concurrent review process is particularly effective because the patient care team receives immediate performance feedback and reminders, allowing them to make any necessary changes while the patient is still hospitalized. For example, care providers are prompted to assess the patient for rehabilitative services, such as physical or occupational therapy. As part of concurrent review, stroke patients’ records are examined daily and information is transferred to a data collection tool to form a patient profile, which is used to communicate the information daily with the responsible clinicians and nurses.
To improve information systems, a stroke order set was built for the emergency department’s (ED) tracking and patient order system, since the majority of stroke patients come through the ED. The set includes standard orders for stroke management that reflects the hospital’s standards of care, and a similar order set was duplicated on the hospital’s side and included as part of the physician order management system. Having the recommended tests and screenings included in the order set served as a prompt for physician and nurses to order the necessary tests and medications.
To provide continued stroke education to staff, the team designed a multi-faceted approach that includes grand rounds, case study reviews, on-the-spot training, nurse education and certification, annual competency trainings, community stroke lectures, an ED fair and a stroke clinical forum that is available online for staff.
As a result of these multidisciplinary efforts, all of the individual stroke measures improved dramatically between May 2008 and May 2010. In particular, the concurrent review process has proven extremely effective. A data review comparing The Miriam’s stroke outcomes to national benchmarks for stroke measures provides evidence that the hospital has met or exceeded in overall stroke performance over time. And since the implementation of concurrent review, The Miriam Hospital received its third Joint Commission certification as a Primary Stroke Center. However, the distinguishing difference with this certification is that the hospital – for the first time – received no recommendations for improvement.
Also, since 2008, The Miriam Hospital has twice received the American Heart/American Stroke Association (AHA/ASA) Get With The Guidelines Gold Plus Achievement Award in recognition of the hospital’s commitment and success in providing the highest standard of stroke care for patients, according to evidence-based guidelines. Approximately 250 hospitals around the country have received this top honor.
The Miriam’s 2010 Stroke Committee is comprised of nearly 30 physicians, nurses, allied health professionals and local emergency medical services representatives. Stroke committee leadership includes Jessica Brier, RN, MS, CV CNS-BC, cardiovascular clinical nurse specialist; William Corwin, MD, senior vice president of medical affairs and chief medical officer; Celia Gomes McGillivray, RN, BSN, MPH, CHES, quality improvement and stroke coordinator; Fred Griffith, MD, neurologist and Stroke Center co-medical director; Bryan Jay, MD, vascular intervention radiologist; Carol Lamoureaux, director of the Center for Professional Practice;  Todd Seigel, MD, emergency physician and Stroke Center co-medical director; and Diana Wantoch, RN, BSN, MBA, CPHQ, director of quality management.

Kent Hospital’s 60th Annual Meeting Highlights

Warwick, RI – At its 60th Annual Meeting,  Kent Hospital announced the creation of a new hospital-based physician group designed to improve quality of medicine and services provided to the community. In addition, it was announced that for Fiscal Year 2010 Kent Hospital is reporting operating income of $2.2 million, an increase of $1.2 million from the previous year.

Sandra L. Coletta, Kent’s President and CEO, announced the creation of Affinity Physicians to a gathering of more than 200 of the hospital’s board, incorporators, staff and invited guests.

“The creation of Affinity Physicians is an exciting and new approach to providing quality healthcare to our community while preparing for health reform and improving patient care by working with the same vision between the hospital and the physician. This alignment allows us to be financially prepared to respond to future changes in reimbursement, along with providing for better retention and recruitment of physicians to our region,” said Coletta.

Currently, nearly 40 physicians have joined Affinity Physicians. As a multispecialty group of physicians employed by the hospital, benefits that will be realized include improved patient care, ability to respond to healthcare reform as in the formation of Accountable Care Organizations, professional practice administration, improved physician recruitment and retention, along with the ability for improved financial stability for healthcare in the community.

The model allows for physicians to take advantage of hospital employment while still being able to keep their private practice intact. Physicians are able to focus on patient care and improving the quality of care through a seamless hospital relationship resulting from their direct employment.

FY 2010 Highlights

Coletta also announced operating income of $2.2 million for the past fiscal year and presented a series of significant accomplishments that have taken place at Kent.

“This past year has not been without its challenges,” said Coletta. “But I am very proud to be able to announce financial growth and numerous programs and services that all lead to better patient care and enhanced clinical care that is saving more lives.”

Among these highlights are: therapeutic hypothermia treatment, Family Activated Safety Teams, ongoing redesign of the Emergency Department through the work of the Michael J. Woods Institute, preparations for a new Ambulatory Surgery Center to break ground in a matter of weeks, introduction of the new Breast Health Center at Kent, new surgical weight loss program and more.

Physician of the Year Award

The 2010 Kent Hospital Physician of the Year Award was presented to Candace L. Dyer, MD, of Warwick, breast cancer surgeon and physician director of the Breast Health Center at Kent. The Breast Health Center at Kent is a unique collaboration between Kent Hospital and Women & Infants Hospital. Dr. Dyer has practiced at Kent since 1984. 2010 saw the official opening of the new Breast Health Center at Kent, a realization of much hard work and leadership on the part of Dr. Dyer.

“Dr. Dyer is truly dedicated and devoted to her patients. She is a true advocate for her patients and for breast cancer awareness. She takes an active role in the community providing leadership not only in the clinical setting but with support groups, community outreach events such as Making Strides Against Breast Cancer and much more,” said Coletta.

Board Updates

Jonathan Farnum, of Coventry, assumes the role of treasurer. Raymond Bolster, of Wakefield, assumes the role of assistant treasurer. Laura Hilderley, of East Greenwich, assumes the role of secretary. Stephen Rooks, of Providence, assumes the role of assistant secretary. Vincent J. Yakavonis, of Cranston, assumes the role of new board member.

New Incorporators

Barrington: Richard J. DeRienzo, CPA; Richard I. Gouse; Coventry: Charles L. Cronin, III, DO; Cranston: Lawrence J. DiBoni; Mayor Allan W. Fung; East Greenwich: Ronald A. Bomberger; Hope: Joseph A. Nagle; Jamestown: Robin L. Main, Esq.; Narragansett: Kerry I. Rafanelli, Esq.; North Kingstown: Robert G. Driscoll; Richard A. Padula, CIC; North Providence: John J. Palumbo; Providence: Mark U. Gasbarro; Rev. Brian J. Shanley, O.P.; Warwick: John D. Gaskell; West Kingston: Brian J. Pickett, MD

 Trustee Service Awards

5 Years of Service

Herbert J. Brennan, DO; Michael A. Grande

10 Years of Service

Andrew M. Erickson

The Hon. Francis X. Flaherty

Physician Service Awards

25 Years of Service

Alexander Calenda, MD; Alfonso C. Cardenas, Jr., MD; Leslie E. Cashel, MD; John F. Horan, DO; Guy Lancellotti, MD; Christine M. Pfeiffer, CNM; Richard P. San Antonio, MD

30 Years of Service

Rosanne M. Lowe, Ph.D.

35 Years of Service

Antoine F. Hadamard, MD; Vincent R. Iacono, MD; Thomas R. Leddy, MD; Thomas F. Morgan, MD; Daniel B. Reardon, MD

40 Years of Service

Robert E. Baute, MD; Owen, B. Gilman, MD