VitalSigns. New Cancer Center Opening to Patients Puget Sound Cancer Centers Joins Swedish Cancer Institute

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1 54 March 2013 Medical Staff Swedish/Edmonds VitalSigns this issue P.1 New Cancer Center Opening, PSCC Joins SCI P.2 ED Team Supports Nick of Time Event Grand Opening Celebration Swedish Cancer Institute, Medical Oncology, at Edmonds Medical Staff Invited Wednesday, April p.m Highway 99 in Edmonds Patient Satisfaction Survey Comments P.3 ARNP Joins Team at Sound Women s Care CDIP Report P.4 CME Report: Choosing Wisely Swedish CME Events P.5 Laboratory Storage Times Changing Save the Date, Medical Staff Meeting Create Your Swedish Web Profile P.6 Commission Supports New Heart Attack Alert System Grateful Patients Honor Caregivers Pavilion Pharmacy New Hours P.7 Doctors Day Celebration March 29 New Cancer Center Opening to Patients Puget Sound Cancer Centers Joins Swedish Cancer Institute The opening of Swedish Cancer Institute, Medical Oncology, at Edmonds a new twostory, 16,000-square-foot, outpatient facility at Swedish/Edmonds is just two weeks away. Along with the grand opening on April 2, are changes for Puget Sound Cancer Centers (PSCC). The medical oncology practice in Edmonds is making plans to relocate to the new cancer center as well as change its name to Swedish Cancer Institute/Edmonds. The number of people turning to Swedish/ Edmonds for their cancer treatment has grown over the last decade, says Richard McGee, M.D., medical oncologist with the Swedish Cancer Institute. This new facility will allow us to offer an enhanced level of care to a growing population For nearly 25 years, PSCC physicians have collaborated with the Swedish Cancer Institute in the coordination and delivery of oncology services for patients in the north King and south Snohomish county areas. This relationship has evolved beyond an affiliation, and on April 1, PSCC physicians and care teams will formally become a part of the Swedish Cancer Institute (SCI). As Swedish Cancer Institute/Edmonds, the practice will continue to offer chemotherapy, immunotherapy, biologic therapy, radioimmunotherapy and supportive care all supervised by board-certified physicians and administered by oncology-care certified nurses. When you visit us at our new site you will see all the old familiar faces, but they will be surrounded by all new equipment in an environment that will allow more efficient and comfortable patient care, says Dr. McGee. We will also be outfitted with all new computer software for scheduling, billing and medical records. Our staff has been using an electronic medical record for seven years, but we will be switching to the EPIC system which is also utilized for inpatients at Swedish/Edmonds and by many other surrounding clinics. With physician services provided by Swedish Please See Cancer Center on Page 7 P.8

2 Emergency Department Team Supports Nick of Time Event Free Heart Screenings Provided for Student Athletes The Swedish/Edmonds Emergency Department team assisted with screening 469 students at Edmonds Woodway High School for possible heart conditions to help prevent sudden cardiac arrest, the leading cause of death in young athletes on the playing field. The nonprofit Nick of Time Foundation organized the February 6 event with 108 volunteers from local hospitals, fire departments and other community groups. the athlete and parents were relieved and appreciated the peace of mind we were able to provide. As a result of the screenings, followups with a physician were recommended for 15 students with elevated blood pressure, 10 students with a family medical history or secondary symptoms and two students for immediate follow-up. signals of the heart. All children received limited physical exams and in some cases they had an echocardiogram. The results were reviewed on site by cardiologists and sports physicians experienced in heart screenings. This is the kind of event I strongly support because the screenings can identify a previously undetected heart condition and help a student avoid sudden cardiac arrest, says event volunteer, Gregg Miller, M.D., medical director at Swedish/ Edmonds Emergency Department. Most of the students I examined did not have risky heart conditions so Heart screenings consisted of a Heart Health Survey asking about possible signs and symptoms or family history of a heart condition. Electrocardiograms (ECGs) were performed that analyze the electrical Gregg Miller, M.D., medical director at Swedish/Edmonds Emergency Department, examines Connor O Brien at a recent heart-screening event at Edmonds Woodway High School. Congratulations These physicians were mentioned by name in the December Press Ganey Patient Satisfaction Surveys and complimented for their great work. 2 Adam Balkany, D.O. Swedish Edmonds Specialty Clinic Aric Christal, M.D. Edmonds Orthopedic Center Catherine Zeh, M.D. Elena Geamanu, M.D. Swedish Edmonds Specialty Clinic Gregg Miller, M.D. Emergency Services J. Bruce Williams, M.D. Edmonds Internal Medicine Jeremy Hammel, M.D. Emergency Services Judith Babcock, M.D. Katrina Erickson, M.D. Keith Luther, M.D. Swedish Internal Medicine at Edmonds Kimberly Dickey, D.O. Sound Women s Care Linda Strong, M.D. Swedish Internal Medicine at Edmonds Marci Nelson, M.D. Martha Moe, M.D. Sound Women s Care Maurene Cronyn, M.D. Michelle Sinnett, M.D. Surgical Associates of Edmonds Ryan David, M.D. Emergency Services Thomas Jurich, M.D. Surgical Associates of Edmonds Timothy Little, M.D. Puget Sound Gastroenterology Timothy Roddy, M.D. Urology Northwest PS

3 ARNP Joins Team at Sound Women s Care A new provider has joined the team at Sound Women s Care. In March, Susan Forester Goodall, CNM, ARNP began caring for women in their teens to menopause years at the clinic. Susan has Master of Nursing and Bachelor of Science degrees from the University of Washington and is a certified nursemidwife. I love midwifery s emphasis on educating women and reassuring them about normal changes related to pregnancy while also carefully screening them in case a problem occurs, says Susan. I really like to get know each patient as an individual and I feel that I m good at talking with patients, putting them at ease so they can tell me about their concerns and helping them to make informed decisions about their care. Clinic services Susan offers include: Prenatal and postpartum care Annual gynecologic exams Birth control and fertility counseling Hormone therapy Additionally, Susan is available to perform procedures including colposcopies, endometrial and vulvar biopsies, and Nexplanon and IUD insertion and removal. She also has an interest in alternative medicine and believes in an integrative approach to caring for patients. It s not one size fits all with medicine, Susan says. Patients have different beliefs in how they want to treat their bodies. Some want a medicine to fix a health issue and some want to avoid taking medicines at all costs. I think it s good to be able to offer different options for care. Susan is detail oriented and supports open lines of communication with fellow providers. In addition to speaking English, Susan is proficient in French and In March, Sound Women s Care at Swedish/ Edmonds welcomed a new provider Susan Forester Goodall, CNM, ARNP. Spanish. Outside of medicine, she enjoys singing, playing the piano, traveling, gardening and exploring Seattle s beaches and parks with her three children. Clinical Documentation Integrity Program (CDIP) Report: January Total Reviews: 441 Total Clarifications: 96 Response Rate: 98% Januarys Top Queries: 1. Sepsis 2. Acute respiratory failure 3. Encephalopathy 4. Acute blood loss Physician Agree Rate: 65% Thank you to the medical and surgical staff for taking the time to respond to these queries. Please contact Melanie Westerinen, Documentation Integrity Liaison, at with any questions. 3

4 CME Corner John Arveson CME Program Coordinator 4 Choosing Wisely Choosing Wisely: Improving Outcomes and Reducing Costs was the topic of the February 13 Grand Round CME talk presented by Carrie Horwitch, M.D., MPH, FACP, and the current governor of the Washington Chapter of the American College of Physicians. Choosing Wisely is a long-term initiative of the American Board of Internal Medicine (ABIM) Foundation to encourage physicians and patients to be better stewards of limited health-care resources. Spurred by Institute of Medicine data that $210 billion per year are spent on unnecessary services in the U.S. and an additional $130 billion are spent on inefficiently delivered services, the ABIM launched the Choosing Wisely campaign in It initially garnered the support of nine national specialty societies including the American College of Physicians, the American Academy of Family Practice, the American College of Cardiology, as well as consumer organizations such as the AARP and Consumer Reports. Now there are 35 specialty organizations that support the effort. Initially, each of the original nine specialty societies identified five tests or procedures commonly used in their field whose necessity should be questioned and discussed. The goal is that these questions will spark a discussion about the need or lack thereof for many frequently ordered tests and procedures. Many of these are issues that are not new and are considered low-hanging opportunities to conserve valuable health-care resources such as: Don t order a CT scan or indiscriminately prescribe antibiotics for uncomplicated acute rhinosiusitis. Don t diagnose or manage asthma without spirometry. Don t do imaging for low back pain within the first six weeks unless red flags are present. Don t do imaging for uncomplicated headache. Avoid admission or preoperative chest X-rays for ambulatory patients with unremarkable Swedish CME Events history and physical exam. For a complete list of all of the current questions go to Many attendees at our Grand Round CME talk stated that patients have expectations that something be done even though there is not clinical justification for a test or a prescription of a treatment. This is a real challenge faced by physicians especially when patient satisfaction scorecards are becoming more prevalent and have payment ramifications. However, it is important for physicians to have Below are additional Swedish CME activities for May-June Please visit Swedish.org/CME for locations, times and the most up-to-date information about upcoming CME activities. Third Annual Pacific Northwest Head, Neck and Thyroid Cancer Symposium: Update on Skin Cancers of the Head and Neck Friday, April 19 Annual Oncology Symposium Women s Cancer: Why Sex Matters Friday, May 3 Seventh Annual Cerebrovascular Symposium Thursday and Friday, May 9-10 Sixth Annual Iris and Ted Wagner Endowed Lectureship Wednesday, May 22 Fifth Annual Acute Care Neurology and Neurosurgery Friday, May 31 Adolescent Health and Pediatric Obesity (R3 Talks) Friday, June 7 Pacific Northwest Epilepsy Symposium, 2013 Friday, June 14 Please See Choosing Wisely on Page 7

5 Swedish/Edmonds Laboratory Storage Times Changing by Alan C. Boudousquie, M.D., Medical Director, Swedish/Edmonds Laboratory Services As medical director for Swedish/ Edmonds Laboratory Services, I recently presented to a few hospital committees the possibility of reducing the number of days for storage of blood samples in our hospital laboratory. We keep samples stored in refrigeration for up to two weeks to allow clinicians the opportunity to add on test requests after the initial tests have been performed. These add-on tests are performed on those assays where test results are still considered valid on refrigerated samples (based on known analyte stabilities) at the time of the add-on request. A six-month review was performed through our IS department to determine how many add-on tests are requested after a certain time frame. The vast majority (up to 99 percent) of add-on requests are made within seven days. In the review of over 800+ add-ons requests, only one was requested after 10 days past the collection date. There was agreement at the committee meetings to limit add-on requests, and thus storage times, for chemistry samples (in red top or marble top tubes) to 10 days. Hematology samples (purple top tubes) will be limited to seven-day storage, with CBC's only good for up to 48 hours. Hematology samples, however, can be used for Hemoglobin A1c assays, results of which are good up to seven days later. Coagulation samples will only be stored for one day since those results are no longer valid after several hours - some clotting factors are quite labile despite refrigeration. The changes in storage times will be effective on Monday, April 15. Please note that even if a sample is available for use, add-on requests can only be done on assays where results can still be considered valid based on the elapsed time between collection and testing (based on studies performed by reagent manufacturers). Also, do consider recollection of blood sample(s) from the patient after a few days since any test results obtained on older samples may no longer accurately reflect the current values in the patient. Save the Date Medical Staff Quarterly Meeting Tuesday, April 16 Dinner starts at 5:30pm Meeting starts at 6:00pm Swedish/Edmonds, 4th Floor, Auditoriums A, B, C Create Your Swedish Web Profile All active Swedish/Edmonds physicians are eligible to create a physician web profile at Follow the steps below to create your profile today and attract new patients. Go to or and enter your user name and temporary password: User name: Firstname.Lastname Password: Lastname (case sensitive) It s recommended that physicians provide their login information to clinic managers to maintain office information on profiles such as office hours, address/phone changes, etc. If You Need Help Please contact Suzanne Iversen-Holstine, Director of Business Alliances & Service Optimization at Swedish/Edmonds, at or suzanne.iverson-holstine@swedish.org. 5

6 Verdant Health Commission Supports New Heart Attack Alert System Every second counts when responding to a heart attack and communication between medics in the field and emergency department (ED) staff must be efficient. With a grant from the Verdant Health Commission, the Swedish/Edmonds ED team and emergency responders are now using the LIFENET System from Physio-Control, Inc., a new electrocardiogram (ECG) transmission and heart attack alert system. LIFENET transmits diagnostic-quality ECGs from the ambulance to hospital staff via a secure, web-based alert system. If the heart attack is determined to be a STEMI (STelevation myocardial infarction), the most damaging to heart muscle, an alert goes out to everyone involved in the patient s care, from emergency department physicians and nurses, to the cardiac catheterization (cath) lab team at Swedish/Edmonds. The standard of care is to get the patient from the ED doors to the cath lab in 90 minutes or less. Our goal is to get heart patients from our ED door to our cath lab in 60 With the LIFENET system, an ECG can be transmitted from a tablet computer used by paramedics in the field to the ED team at Swedish/Edmonds. Photo courtesy Physio- Control, Inc. minutes or less. says Heather Gutierrez, nurse manager for the Swedish/Edmonds ED. We believe that with our close relationship with EMS and LIFENET, and with the support that we ve received from the Verdant Health Commission, that we can accomplish our goal and immediately treat heart attack patients in our cath lab, instead of spending additional assessment time in the ED. About Verdant Health Commission For nearly 50 years, Public Hospital District No. 2, Snohomish County s commissioners governed and managed what was Stevens Hospital. Since reaching an agreement with Swedish Health Services in 2010 to operate the hospital, the Board of Commissioners shifted its focus to prevention and wellness, creating the Verdant Health Commission. The commission works to educate and empower the community to make healthy lifestyle choices, using income generated through an agreement with Swedish, while protecting the ownership of the hospital for future generations. In addition to the LIFENET heart attack alert system, community programs supported by the Verdant Health Commission include the Nurse-Family Partnership. This is an in-home health education program that addresses the physical, mental and socio-emotional health of children and their mothers to improve health, school readiness and increase maternal employment. The commission also supports Move 60! an initiative to get children to move at least 60 minutes a day and the Edmonds Mobile Medical Clinic which involves volunteer physicians, nurses, interpreters and greeters donating their time to provide uninsured and low-income adults with access to health-care services free of charge. Last May, Swedish/Edmonds joined with the Verdant Health Commission to support 6 Weeks to a Healthier You a six-week program focused on practical education, awareness and empowering individuals to make positive behavior changes to manage health, stress, eating healthy, exercise and family support. Swedish/Edmonds conducted preand post-program health screenings including blood draws. The blood draws provided program participants with biometric data on key health indicators such as body mass index, blood pressure, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides and glucose. Six months after the 6 Weeks to a Healthier You program, the Verdant Health Commission reported that participants had lost an average of nine pounds. Learn more about the commission at New Pharmacy Hours Pavilion Pharmacy and Pavilion Homecare Pharmacy have new customer hours: Monday to Friday 8 a.m. - 6 p.m. Saturday 10 a.m. - 3 p.m. Closed Sundays and holidays The pharmacies are located on the first floor of Edmonds Medical Pavilion, suites 100 and 100B. For more information, please go to 6

7 Doctors Day Celebration March 29 National Doctors Day was officially designated as a national day of recognition in 1990 to honor physicians. In recognition of the talented medical staff at Swedish/ Edmonds, and for all physicians do to provide patients with compassionate, safe care using the highest standards in the delivery of medical care, we invite physicians to attend this year s Doctors Day celebration at Swedish/Edmonds. On Friday, March 29, a special buffet lunch will be served in the hospital s physicians lounge located on the third floor from 11 a.m. to 1:30 p.m. In addition to lunch, stars with messages of appreciation from hospital staff to physicians will decorate the lounge. Previous Doctors Day celebrations have resulted in many stars and notes of appreciation thanking physicians for their professionalism and exceptional patient-first care. Swedish/Edmonds physicians consistently apply their skills and talents in a way that makes lifechanging and often life-sustaining differences in the health of patients and their families. Thank you for your uncompromising commitment and dedication to the health and well-being of patients and to the community served by Swedish/ Edmonds. Cancer Center (continued from page 1) Cancer Institute/Edmonds, the new cancer center will provide highquality, comprehensive medical oncology services to patients through an infusion unit, laboratory, pharmacy and cancer resource center. The facility is anticipated to care for as many as 175 patients each day and provide improved access to cancercare services for people living north of Seattle. Medical and hospital staffs are invited to take a tour of the new cancer facility. A grand opening celebration will be held on Wednesday, April 17 from 4 7 p.m. The facility is located on the Swedish/Edmonds hospital campus at Highway 99 in Edmonds. Choosing Wisely (continued from page 4) information and a strategy to quickly explain their rationale for taking a more conservative approach. Admittedly, there is not a lot in the way of patient material for your office. There is one page of information available at It s expected that there will be resources available in the near future from AARP and Consumer Reports. If you think this is just another obscure national trend, I would point out that Consumer Reports featured an article on the campaign last April and AARP has published five articles about the campaign since last May. Also, the Puget Sound Health Alliance and the Washington State Medical Association have endorsed the initiative. It will be worth following as more lists are released. Physicians and patients need to be better partners in being good stewards of limited health-care resources. Coming Up On April 10 there will be a presentation on the U.S. Preventive Task Force (USPSTF) recommendations on screening for breast and prostate cancers. These recommendations vary from specialty society guidelines and those recommended by the American Cancer Society. The USPSTF recommendations have triggered significant debate within the medical profession and have generated a lot of confusion in the press and with patients. Physicians across the country have expressed frustration and confusion about how to discuss and counsel patients about screening for these cancers. The April 10 Grand Rounds speaker will be David Grossman, M.D., who has been a member of the USPSTF since 2008 and is a professor of health services and pediatrics at the UW schools of Public Health and Medicine. It should be a lively discussion. Please plan to attend. 7

8 Newsletter Access Vital Signs is available on our website. Visit the Medical Staff section swedish.org\edmondsmedicalstaff and select Physicians Links & Resources from the menu on the left. Contributions Any medical staff member with an article or item for the newsletter should contact Amy Morrow, marketing copywriter, at by the 1st of the month. WELCOME New Swedish/Edmonds Medical Staff February Name Group Specialty James D. Bowen, M.D. Swedish Neuroscience Specialists Neurology Devorah A Chock, M.D. Northwest Weight Loss Surgery Bariatric Surgery Robert L. Michaelson, M.D. Northwest Weight Loss Surgery Bariatric Surgery Kevin Montgomery, M.D. Northwest Weight Loss Surgery Bariatric Surgery Peiqing Oian, M.D. Swedish Neuroscience Specialists Neurology Payle Repovic, M.D. Ph.D. Swedish Neuroscience Specialists Neurology Scott C. Sattler, M.D. R.A. Baxter Plastic Surgery Clinic Plastic Surgery To Admit a Patient to Swedish/Edmonds, Call For Medical Staff information on the web, visit: Vital Signs Issue 54 March th Avenue West, Edmonds, WA 98026