Lakeland HealthCare

July 2009

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Lakeland Cardiac Surgery:a Model for Qualityand E� ciency

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Lakeland Recognized for Cardiac Excellence

www.lakelandhealth.org

Physician’s AdvantageThe latest in clinical and patient care advances at Lakeland HealthCare

A6Business Briefs

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CARDIOTHORACIC

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Surgery Department Expands

Continuing Medical Education Summer Symposium

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Paw Paw Lake Medical Center Opens

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Lakeland HealthCareA2 Physician’s Advantagewww.lakelandhealth.org

Lakeland Cardiac Surgery: a Model for Quality and E� ciency

The Michigan chapter of the Society of Thoracic Surgeons (STS) will visit Lakeland HealthCare this summer. According to Dr. Kourosh Baghelai

of Lakeshore Cardiothoracic and Vascular Surgery, STS will highlight the quality improvement initiatives implemented by the cardiac surgery team over the past fi ve years.

“Since 2003, Lakeland has achieved the national benchmarks in quality and patient safety,” said Dr. Baghelai.

The Lakeland cardiac surgery program’s case volume increased 30% over the fi ve-year period, while adding new open-heart surgery options. Lakeland provides a full spectrum of cardiac surgical procedures, such as high-risk coronary artery bypass graft (CABG), aortic and mitral valve repair/replacement, maze for atrial fi brillation, and ascending aortic and arch repair. Between 2005 and 2008, these more complex procedures accounted for nearly 30% of the cardiac surgery case mix at Lakeland. In order to improve clinical outcomes, the cardiac surgery program tailored best practices that were developed by leading institutions to fi t the specifi c characteristics of the community served by Lakeland, with all quality measures tracked for improvement. The team implemented evidence-based protocols for pre-operative

preparation, intra-operative management, intensive care unit management, and rigorous monitoring of patients after the ICU and early post-discharge. A multidisciplinary approach required collaboration among the various areas of patient care, including critical care, cardiac anesthesia, physical therapy, and home health nursing services.

Clinical outcomes at Lakeland have improved every year and compare favorably to national statistics. For instance, for all major cardiac surgical procedures performed at

Lakeland, the 30-day mortality rate was 1.4% in 2008, compared to the national average of 2.6% reported by Society of Thoracic Surgeons’ participating hospitals in 2008 (see chart on next page). Post-operative complications at Lakeland also had a lower incidence than the national average. The average patient length of stay at Lakeland was 8.1 days, versus the 9.2 day national average. Readmission rates within 30 days of a procedure were signi� cantly lower at Lakeland than the national averages, 6.3% versus 9.7%.

“The success of the cardiac surgery program is due to the Lakeland’s multidisciplinary approach to achieving excellent clinical outcomes,” said Laurie Fleming, Vice President, Outpatient and Diagnostic Services, Lakeland HealthCare. “The program requiresDr. Kourosh Baghelai

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Lakeland HealthCare Physician’s Advantage A3www.lakelandhealth.org

significant coordination throughout the system to make sure all elements work, from the referring physicians all the way to physical therapists after surgery. Everyone on our team shares the same high expectations.”

The quality initiatives implemented by the cardiac surgery team have improved overall efficiency for Lakeland HealthCare. In comparing costs associated with the program from 2008 with 2006, the organization saved more than $1.6 million by reducing the average length of stay for cardiac patients in the intensive care and step-down units, reducing ventilation

Metric Lakeland National30-day mortality 1.4% 2.7%

Total length of stay 8.1 days 9.2 daysPostoperative length of stay 5.8 days 7 days

Initial ventilation hours 10.4 hours 26.2 hoursExtubated less than 6 hours 41.3% 29.8%

Reintubation 3.1% 3.8%Readmission to ICU 1.6% 3%

Readmission within 30 days 6.3% 9.7%

Comparison of 2008 Outcomes, Lakeland HealthCare versus

Society of Thoracic Surgeons’ Reporting Hospitals

time, and decreasing the number of readmissions.

“Lakeland has developed a cardiac surgery program that has earned the confidence of referring physicians,” said Bart Berndt, Executive Director of Cardiovascular Services, Lakeland HealthCare. “We have demonstrated that we are capable of performing a wide range of procedures, while continuing to report clinical outcomes that exceed national averages.”

Visit the Society of Thoracic Surgeons website at www.sts.org to view the risk calculator used for patient assessment.

To schedule a consultation with Dr. Kourosh Baghelai, call Lakeshore Cardiothoracic and Vascular Surgery at (269) 408-1660.

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Lakeland HealthCare A4 Physician’s Advantage www.lakelandhealth.org

Blue Cross Blue Shield of Michigan recently designated Lakeland HealthCare as a Blue Distinction Center for Cardiac Care.® This honor is given to facilities that demonstrate their commitment to quality care, which has resulted in better overall outcomes for cardiac patients. Since the Blue Distinction Centers for Cardiac Care program was established in 2006, only 400 hospitals across the country have earned this designation.

“Lakeland is proud to be a Blue Distinction Center for Cardiac Care, as it shows we meet stringent clinical criteria,” said Laurie Fleming, Vice President, Outpatient and Diagnostic Services. “This honor is another reason that physicians and patients can be confident that they have access to high-quality cardiac services at Lakeland.”

LakelandRecognized for Cardiac Excellence

Initially developed as a space for outpatient services, the Lakeland Health Park continues to grow to support

Lakeland’s patients and partner physicians.

This recognition indicates that Lakeland has a dedicated team in place to provide a full range of cardiac care services, including inpatient cardiac care, cardiac rehabilitation, cardiac catherization, and cardiac surgery. Evidence-based selection criteria were developed in collaboration with physician panels and surgeons, including the American College of Cardiology and the Society of Thoracic Surgeons, in order to provide a comprehensive evaluation of facilities’ volume, structure, processes, and outcome measures. The criteria include a minimum volume of cardiac procedures performed annually, adequate experience and credentialing of team members, documented patient care and follow-up procedures, and acceptably low complication and mortality rates.

“As a Blue Distinction Center for Cardiac Care, Lakeland HealthCare has demonstrated its commitment to quality care, resulting in better overall outcomes for cardiac patients. This facility has met clinical criteria, developed in collaboration with expert physicians’ and medical organizations’ recommendations,” said Dr. Marc Keshishian, Chief Medical Officer, Blue Care Network.

For more information about Blue Distinction Centers for Cardiac Care, visit www.bcbs.com/innovations/bluedistinction/centers.

Center for Cardiac Care

Designated as a

of Michigan

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Lakeland HealthCare Physician’s Advantage A5www.lakelandhealth.org

Lakeland HealthCare has completed an expansion of the Surgery Department at Lakeland Regional Medical Center, St. Joseph.

The Surgery Department is the most recently completed element of Lakeland’s master facilities plan, which envisioned a healing environment that incorporates elements of nature with a home-like atmosphere. The goal of the plan was to enhance every aspect of the healing process to improve patient outcomes.

The conclusion of the new Surgery Department expansion project follows the opening of the new four-story patient addition at Lakeland Regional Medical Center, St. Joseph, in March. Work continues on the final phases of the expansion of the St. Joseph Emergency Department, set for completion in November.

The Surgery Department project added more than 3,000 square feet of space and created a new Post-Anesthesia Care Unit (PACU), family waiting area, and 16 private rooms for patients’ surgical preparation and recovery. Similar to the new addition at the St. Joseph campus, the Surgery Department’s space incorporates evidence-based design principles for efficiency, patient comfort, safety, and for a health and healing atmosphere. A new nurses’ station is centrally located in the department so that nurses can quickly access patient rooms and spend more time caring for patients, increasing efficiency. The design allows for generous use of windows and skylights for natural light in the PACU and the patient rooms.

Each patient room provides a significantly larger space for patients and surgery team members, with unique features to enhance healing. Glass doors with curtains reduce noise and increase privacy for patients. The recovery rooms are similar to the new patient rooms, featuring amenities such as flat screen televisions.

Surgery Department Expands A caregiver zone, in the room, allows surgery staff members to access the technology needed for patient charting, without leaving the patient’s room.

The Surgery Department’s improvements enhance the hospital experience not only for patients, but also for their family members. For outpatient procedures, surgery team members provide patients with a private room prior to and following the surgery, which helps family members more easily locate loved ones and their caregivers. To enhance communication, the Surgery team has introduced a new system that allows family members to walk anywhere on the St. Joseph campus and be notified via a portable pager when a patient is out of the operating room or if the surgeon needs to speak with a family member.

“The patient’s first and last impressions of the Surgery Department, as well as each family member’s experience, make a significant impact on patient satisfaction,” said Angela Kacynski, Director of Perioperative Services, Lakeland HealthCare. “As we have opened new sections of the department, we have received very positive feedback from patients, and our patient satisfaction scores continue to rise.” For more information about the Surgery Department at Lakeland Regional Medical Center, St. Joseph, call (269) 983-4432, or visit www.lakelandhealth.org.

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Lakeland HealthCare A6 Physician’s Advantage www.lakelandhealth.org

. . . B R I E F L YThe American Board of Urology recently certi� ed Dr. Benjamin Stockton of Lakeside Urology and Continence Center.

The Michigan Health & Hospital Association selected Lakeland HealthCare’s Senior Center RN Prescription Assistance Program to receive the 2009 Ludwig Community Benefi t Award.

The Berrien County Health Department named Sandy Hayes, RN, clinical nurse specialist at Lakeland HealthCare, as the 2009 Friend of Public Health, an

award that honors outstanding contributions to a healthy community.

The Lakeland Stroke Center announced that all registered nurses in Lakeland’s Orthopedics/Neurology, Cardiac Telemetry, and Post Surgical units have attained certi� cation for the NIH Stroke Scale (NIHSS), a clinical assessment tool used to evaluate the acuity of stroke patients, determine appropriate treatment, and predict patient outcomes.

Physicians can now admit patients to Lakeland hospitals and discuss patients with hospitalists by calling the 24-hour admissions line at (269) 556-7178.

Lakeland HealthCare has a new central fax repository system, which will electronically archive physicians’ orders into Quadramed Enterprise Scheduling (QES) software.

Physicians and their sta� s should use the central scheduling fax numbers, (269) 556-2850 or(866) 994-2850, when submitting orders for outpatient services. For more information about the central fax repository system, contact Holly Busick at (269) 556-2867.

The Lakeland Laboratory’s new website, www.lakelandhealth.org/lab, provides physicians and their staff s with information such as laboratory services and pricing. Although walk-in lab tests are available, patients are encouraged to register ahead of time by calling (269) 556-2810 or (800) 791-2810.

Lakeland Regional Medical Center, St. Joseph, now provides $3 valet parking for the convenience of patients, visitors, and staff members. The service is available at the hospital entrance, which can be accessed from the Napier Avenue entrance. The Lakeland Women’s Physician Network meets monthly. If you would like to participate, contact Dr. Katherine Kwon at (269) 428-0819.

The Lakeland Physician Spouse Network meets quarterly. For details, contact Kimberly Simpson of Lakeland Physician Services at (269) 985-4485.

THE FOLLOWING PHYSICIANS RECENTLY JOINED LAKELAND’S MEDICAL STAFF: Mustafa Huseini, MD, HospitalistDr. Huseini earned his medical degree at Al-Ameen Medical College in India and completed a residency at St. Joseph Mercy Hospital in Oakland, Michigan. He will be seeing patients at the St. Joseph and Niles hospitals.

John Mulligan, MD, Emergency MedicineDr. Mulligan joins EPMG as part of the Emergency Department team. A graduate of the Loyola University Chicago Stritch School of Medicine, Dr. Mulligan completed a residency at Johns Hopkins Hospital.

Richard Swanson, MD, RheumatologyDr. Swanson joins Lakeland Rheumatology, and will be seeing patients in St. Joseph, Benton Harbor, and at the new Paw Paw Lake Medical Center in Coloma. A graduate of the Creighton University School of Medicine in Omaha, Dr. Swanson completed a residency at the Naval Regional Medical Center.

John Taglia, MD, PsychiatryDr. Taglia is seeing patients in St. Joseph. He received his medical degree at the University of Illinois at Chicago College of Medicine. Dr. Taglia completed a residency at the University of Illinois Hospital in Chicago and a fellowship at the University of North Carolina School of Medicine.

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Lakeland HealthCare Physician’s Advantage A7www.lakelandhealth.org

Paw Paw Lake Medical Center Opens

Summer Symposium Lakeland HealthCare’s fi rst-ever summer symposium CME program will be held on Wednesday, August 12, from 5:30 to 8:30 p.m., in the Frederick S. Upton Center, Lakeland Regional Medical Center, St. Joseph. This program will focus on sports-related health issues, including the following presentations:

Neurological Injuries in Athletes Dr. Robert Ward, Berrien Regional Associates in Neurology

Orthopaedic Injuries in AthletesDr. Ken Edwards, Southwest Michigan Center for Orthopaedics & Sports Medicine

Skin Conditions in Athletes Dr. Frederick Johansen, Medical Director, Berrien County Health Department

The summer symposium is designated for 3.0 CME credit hours. Registration forms and more details will be sent to area physicians in early July. All area physicians are invited to attend.

For more information, contact Debra Killingbeck, CME coordinator, Lakeland Care Inc., at (269) 927-5153.

Summer The summer symposium is designated Summer Summer The summer symposium is designated The summer symposium is designated Summer Summer Summer Neurological Injuries in Athletes The summer symposium is designated Summer The summer symposium is designated Summer The summer symposium is designated The summer symposium is designated The summer symposium is designated

Lakeland HealthCare and its medical staff will soon begin providing care to patients at the Paw Paw Lake Medical Center, a new medical facility designed to serve residents of the Coloma and Watervliet area.

Located in the heart of the Coloma business corridor, the medical center will include primary care physicians, specialists, and ancillary services, such as a laboratory and diagnostic imaging, in one central facility. The 23,000 square-foot building was designed to complement the surrounding community and create an environment that promotes healing.

“It is important to us to provide Coloma and Watervliet residents with high-quality, high-value, accessible health care, close to home,” said Joseph Wasserman, President and CEO, Lakeland HealthCare. “Lakeland is proud to be a part of the Coloma and Watervliet community, and to meet the medical needs of local residents.”

Dr. Michael Mayle, primary care physician, will begin practicing July 13 through his practice, Family Care of Coloma-Watervliet. Dr. Alexander Runowski joins the practice and begins seeing patients August 1. Specialty physicians, including cardiology, rheumatology, gynecology and orthopedics are scheduled to begin seeing patients in mid-August.

“As a longtime primary care physician in Coloma, I am looking forward to being able to refer patients to excellent specialists

here in our own community,” said Dr. Mayle. “With family physicians and specialists working together in one medical facility, patients can be confi dent that they will receive the best and most convenient medical care possible.”

Grand Opening A grand opening event for Paw Paw Lake Medical Center will be held on Saturday, August 1, from 11 a.m. to 3 p.m. Area residents are encouraged to attend. For more information, visit www.lakelandhealth.org/pawpaw.

Serving the Coloma and Watervliet AreaTo view a list of specialists holding clinic hours at Paw Paw Lake Medical Center or to refer a patient, visit www.lakelandhealth.org/pawpaw.

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