ImagesAUGUST 2015

for Physicians

Mark your calendars

WELCOME AND RECOGNITION

WelcomeFamily Medicine Belle Plaine welcomes Angela Fults, DO & Chassidy Ruby, ARNPDr. Fults provides “comprehensive and patient-centered care. She works as a team to maintain and improve her patients’ health so they can enjoy their lives.” She completed her medical degree at Des Moines University and residency with Cedar Rapids Medical Education Foundation.Chassidy Ruby is “thorough and compassionate about the care she provides her patients. She listens and addresses all of her patients concerns, while treating them like she would want to be treated.” She completed her education at Allen College of Nursing and the University of Iowa and is board certified by the AANP.

Allen Wu, MDWelcome to Dr. Wu who joins the St. Luke's Neonatology team. Specializing in neonatology and perinatology, he completed his medical degree at the University of Iowa, an internship and residency at Dell Children’s Hospital in Austin, TX and a fellowship at Vanderbilt University Medical Center in Nashville, TN. He describes his best qualities as his ability “to be meticulous which is useful in taking care of infants especially premature ones.”

Sandhya Litterer, MDWelcome to Dr. Litterer who joins the St. Luke's Hospitalist team. She completed her residency at the University of Iowa and her medical degree at the University of Missouri Columbia. She describes herself as “motivated by the opportunity to improve someone's life through health care and education” and “as an attentive patient advocate.”

Angela Fults, DO

Chassidy Ruby, ARNP

Allen Wu, MDSt. Luke's Neonatologist

U.S. News & World Report Names St. Luke’s Among the BestSt. Luke’s Hospital is among the nation’s Best Regional Hospitals, according to U.S. News and World Report. St. Luke’s is ranked fourth in Iowa in the U.S. News & World Report 2015-16 edition. The annual U.S. News Best Hospitals rankings, now in its 26th year, recognize hospitals that excel in treating the most complex patients. In May, St. Luke’s was ranked as a high performing hospital in the treatment of chronic obstructive pulmonary disease (COPD) and heart failure in the U.S. News & World Report Best Hospitals for Common Care ratings, which was a new initiative for the publication. The ratings evaluate more than 4,500 hospitals nationwide on common inpatient procedures and conditions.Rankings have been published online at usnews.com and will appear in print in the U.S. News Best Hospitals 2016 guidebook. Sandya Litterer, MD

St. Luke's Hospitalist

Diabetes Education Will Move to New LocationOn Tuesday, Sept. 8, Diabetes Education providers will see patients and offer classes at the UnityPoint Clinic Diabetes and Kidney Center located at: 1002 4th Ave. SE, Cedar Rapids.The Diabetes Education phone number will change to: (319) 363-3565. Follow the operator prompts to reach an educator.Diabetes Education providers are:

Diana Cira, RN, BSN, MA, CDEDeAnn Jurgensen, RN, BSN, CDEMichelle McGovern, RD, LDMegan Munoz, RN, BSN, MSNKris Noring, RN, BSN, CDEJoyce Sankey, RD, LD, MBAKelly Westphal, RN, BAN, CDELadonna Woerdeman, RD, LD, MS, CDEPatti Zessin, RD, LD, CDE

Diabetes Education joins UnityPoint Clinic kidney, diabetes and endocrinology specialists who use the latest information, treatments and technology available. The center provides one convenient location for patients to access the full continuum of care for diabetes and kidney care.

Discover the Future of Cancer CareThe new St. Luke's Albert G. and Helen Nassif Radiation Center is scheduled to open in October. Bobby N. Koneru, MD, Medical Director of St. Luke's Radiation Center and the Finley Wendt Cancer Center in Dubuque will oversee the center's advanced cancer-fighting therapies.The center will begin scheduling appointments on Sept. 14. To schedule a consult or an appointment, call (319) 861-6944.

Guardian Angels Stan Mathew, MD, Physical Medicine and Rehabilitation

Elizabeth Gates was a recent patient on the 6 West Rehab Unit. She wanted to do something special to recognize and thank the caregivers that provided her exceptional care, so she made a Guardian Angel donation.

Ms. Gates wrote, “Dr. Mathew - I needed your special care to heal my pain. You were always asking what you could do to help me. Thank you for making me feel so comfortable, you are a very good doctor! This is a wonderful hospital with wonderful staff. You all did wonders for me!”

Julie Saddler, MD, St. Luke's Pain Clinic

Aimee Traugh recognized and thanked the caregivers in the Pain Clinic who helped her achieve her goal of running a half marathon. “Dr. Saddler, thank you for explaining all the options and taking the time to help me choose the right one for my situation. And for your skill; six injections and I barely felt a thing.” Aimee also had an individual message for everyone. To the whole clinic she wrote, “Many thanks to all of you; each of you played a vital part in making me pain free. I am so grateful!”For information about the Guardian Angel Program, call St. Luke’s Foundation at (319) 369-7716 .

Join us: St. Luke’s Albert G. & Helen Nassif Radiation Center Grand OpeningPCI Medical Mall 202 10th St. SE, Suite 195Mon., Sept. 2111 a.m. – 1:30 p.m. Associate Open House & Tours4:30 – 6 p.m. - Public Open House, Program, Ribbon Cutting, Tours

The new TrueBeam Linear Accelerator arrives at the center on Sat., July 25. This machine has the most advanced radiation technology to treat cancers anywhere in the body.

L-R: Dustin Arnold, DO, CMO/CMIO, Stan Mathew, MD, Ashley Wicker and Chris Rutledge.

Front row L-R: Ted Townsend, President & CEO, Dee Ryan Naber, Kim Rizzio, Dr. Saddler, Lori Henry, Aimee Traugh, Amanda Rios, Cathy Mineck, Melanie Clendenen. Back row L-R: Annie Lloyd, Mary Noland-Houtz, Becky Johnson

EPIC UPDATE

Epic Update

Dustin Arnold, DOCMO/CMIO

Long-Term Medications Issue – All Clinicians Epic recently found an issue where signing a new long-term medication will cause expired medications of the same name to sometimes appear on the patient’s medication list, MyChart, and the AVS. Clinicians are encouraged to discontinue expired medications from the medication list to prevent patients from viewing duplicates.

Vestibular PT Order Change The process to order vestibular physical therapy has changed; it is now found by ordering physical therapy and specifying "vestibular."

Duplicate Lab BPA To assist with patient care coordination, a series of new Best Practice Advisories (BPAs) will be added to Epic. These BPAs will be added for the following lab orders: Hemoglobin A1C, Lipid Panel, Free T4, and TSH. The BPA will fire upon ordering one of these labs if the patient has had one with results in the past 90 days where the result interfaces to the UnityPoint database. (The last lab results do not include results from non UnityPoint locations or manually entered results.) The BPA will show the most recent result to help clinicians determine if they need to proceed. To cancel the order, click Accept. To continue to place the order, un-check the “remove unsigned order” box and click Accept. (Please note: BPAs will not impact Epic Ambulatory at this time.)Sample BPA: Hemoglobin A1C

Epic SupportFor Epic assistance or 1:1 training sessions, contact:Dustin Arnold, DO, CMO/CMIO, dustin.arnold@unitypoint.org; Rose Hedges, provider informatics specialist, rosetta.hedges@unitypoint.org ; Mary Henry, physician liaison, mary.henry@unitypoint.org or Scott Whitson, physician IT liaison, scott.whitson@unitypoint.org.Epic help line – (319) 369-5191 or Call Center for IT issues – (319) 369-8181

MAR Placeholders MAR placeholders are approved for use through the Willow (pharmacy) user group. St. Luke’s pharmacists will enter place holders in the following situations:• All warfarin patients at the

initial order placement• Vancomycin patients who

currently receive vancomycin therapy, but do not have an active order on the MAR for the medication (ex. “dose-by-levels” patients).

The MAR placeholder on the medication list/MAR provides benefits:• Communication between the prescriber, pharmacist and nurse

that this is an active warfarin patient, regardless if there is an active medication order. Scenarios where this is useful are patients that a daily “ONCE” order is being entered that the order falls off, and patients who have a high INR but are waiting for the INR to come down before an order is placed.

• It provides a prompt for the nursing/pharmacy staff if a daily order hasn't been entered to contact the prescriber for an order.

• It is a prompt on discharge for the prescriber to enter an order on the AVS if the daily order has not yet been entered.

• It allows the provider to indicate therapy is to be discontinued on a patient without an active order by discontinuing the placeholder.

CT, Nuc Med & MRI Orders Reason for Exam Reminder to those placing orders for CT, NUC MED, and MRI: ACR Select has added items to the “reason for exam.” Staff placing orders (transcribed, verbal, and telephone) should attempt to use the indications from the list before entering a free text reason for exam. If there is a frequently used reason not on the list, submit the reason and exam to the informatics department.

ICD-10 Our clinical documentation staff has been reviewing chart entries with ICD 10 in mind and will provide feedback to improve documentation. ICD 10 coding documentation needs to reflect specificity to clinically support the selected diagnosis. The documentation that reflects the most accurate picture of the patient’s illness should be a continuation of the excellent care you already provide. Key documentation tips:

Location – laterality and site, i.e., left/right, ankle/handLink conditions – due to, caused by, related to, i.e., CKD 3 related to DMStatus – i.e., acute/chronicSpecificity – type, i.e., hypoxic/hypercapnic resp failure

Call a Documentation Management team member with questions: Lynne Johnson 369-7073, Carrie Bantz 286-4307, Kelly Pottebaum 558-4959 and Rhonda Holtkamp 560-6928.

CRMEF Welcomes New ResidentsThe Cedar Rapids Medical Education Foundation welcomes the following first-year residents who began in June.

Safa Y. Abukhalil, MD Jordan University

of Science and Technology

Zachary M. Hood, MD Saba University School of

Medicine

Prachi Jindal, MD Bharati Vidyapeeth

Medical College

Rose I. Schabilion, MD University of Iowa Carver

College of Medicine

Chiranjeevi P. Siddagunta, MD Sri Venkateswara Medical College

Brian E. Thatcher, MD University of Oklahoma

College of Medicine

Bradley J. Willis, MD University of Sint Eustatius

School of Medicine

Cath Lab Recognized for Exceeding Door to Dilatation Goals

Congratulations to the St. Luke’s Cardiac Catheterization Lab (CCL) for their team efforts. This team started their journey to improve Door to Dilatation (opening of the culprit lesion in STEMI cases) back in 2004. They have investigated ways to decrease their times through room set up and discussing complex cases ahead of time and are engaged in going out to surrounding hospitals to discuss the direct to Cath Lab approach and talk about new procedures. The American Heart Association / American College of Cardiology Door to Dilatation goal is less than 90 minutes. St. Luke's CCL has set an internal goal of less than 60 minutes. For the average of all their Door to Dilatation times they have been under 60 minutes for 2013, 2014 and year to date 2015. For this accomplishment and their continued work and determination to improve the experience for patients and families, they received the St. Luke's Spirit Cup.

President & CEO Ted Townsend and the St. Luke's Cardiac Cath team.

Urgent Care Labor Day HoursUnityPoint Clinic Urgent Care Clinics are open on Labor Day: 8 a.m. – noon.

2015 Child Protection ConferenceOct. 8, 7:30 - 4:30 p.m. & Oct. 9, 7:30 a.m. - noonThe Hotel at Kirkwood Center, Cedar RapidsTopics include: Investigating Unexplained Child Deaths and Severe Injuries with Detective Christopher Kolcharno, Blakely Police Department and Pediatric Aquatic Abuse and Death Investigations with Andrea Zaferes - Team LGS; Dutchess County Medical Examiner's officeRegister online at unitypoint.org/cedarrapids and click on Classes and Events. Approved for Continuing Education Credits for physicians (up to 10 AMA PRA Category 1 Credits), nurses and substance abuse counselors.

Prediabetes Community ClassesDiabetes educators offer a class for individuals at risk of prediabetes. Learn about risk factors, prevention strategies, including losing weight, eating healthy and being active. This class is held once a month and registration is required. The cost is $10 per person. For more information call (319) 369-7440.

Heart Check Dates St. Luke’s Heart Check is a series of five tests including: Electrocardiogram, Echocardiogram, Abdominal aortic aneurysm test, Carotid artery ultrasound, and Ankle-Brachial Index test for Peripheral Disease. These tests are given at St. Luke’s Hospital. The cost for all five tests plus a consultation with a heart care expert is $195.Heart Check is open to anyone concerned about their health. All tests are performed during one appointment. Share the upcoming testing dates with patients as appropriate.

• August 25 • November 3• October 14 • December 1

To schedule an appointment call (319) 369-8129.

Stroke Survivor RetreatAugust 21-22, Best Western Plus Hotel, DubuqueThe retreat is a fun and uplifting getaway for stroke survivors and their supporters and provides a chance for survivors and supporters to meet others going through similar situations and will inspire renewed joy in daily life, sending you home with your glass half full!Contact Cathy Wiseman at cathy.wiseman@unitypoint.org or (319) 369-8877 to register.

Breast and Bone Health Center of ExcellenceSt. Luke’s Breast and Bone Health achieved recertification at the status of a Certified Quality Breast Center of Excellence™ which is the highest level of recognition in the program by the National Consortium of Breast Centers. They are the only facility in Iowa with this designation. To make a referral, call (319) 369-7216.