Medical Staff Swedish/Edmonds Vital Wound Healing Clinic Opening P.1 P.2 P.3 P.4 P.5 P.6 Please see Lantern Award on page 7 inside P. 7 P.

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1 69 July 2014 Medical Staff Swedish/ VitalSigns this issue P.1 Wound Healing Clinic Opening Two EDs Recognized With Nurse Lantern Award P.2 Improved Performance Measures Worthy of Comment Swedish CME Events P.3 Obstructive Sleep Apnea Program Returns New Hospital Parking Garage Opens CDIP Report P.4 Physicians Recognized as Top Docs New Foundation Staff Member P.5 New Swedish Insulin - SC Basal Bolus Correctional - Adult Create Your Swedish Web Profile P.6 Patient Satisfaction Survey Comments What are Patients Saying? P. 7 New Parking Garage, Lantern Award cont. P. 8 Welcome New Physicians Two Swedish Emergency Departments Recognized With Nurse Lantern Award The Emergency Department (ED) nursing teams at Swedish/ and Swedish/ Ballard are among only 17 ED teams nationwide to be honored with the Emergency Nurse Association (ENA) 2014 Lantern Award. The Lantern Award recognizes an ED s commitment to quality, safety, a healthy work environment and innovation in nursing practice and emergency care. Achievement of the Lantern Award indicates that an ED exemplifies outstanding and exemplary performance in the core areas of leadership, practice, education, advocacy and research. The Lantern Award is a result of tremendous hard work and dedication by the ED caregivers to serve the medical needs of our community, says David Jaffe, chief executive at Swedish/. I m so very proud of the ED nursing staff, who in collaboration with all physicians, technicians, laboratory and imaging staff, for their ongoing ability to make great strides in the delivery of the highest quality care. The ED nursing team has focused recent initiatives on reducing the time patients spend in the ED as well as Wound Healing Clinic Opening Celeste Sather, Sarah Zabel, David Jaffe, Beth Mueller, Darren Mazza, Tony Armada and Peter Ro, M.D., celebrate the opening of the new Swedish/ Center for Wound Healing & Hyperbarics at Kruger Clinic. The clinic moved to Kruger Clinic, Highway 99, suite 150, in May. The new location offers more space and enhanced accessibility for patients. contacting ED patients after discharge to follow up on their care. Also credited with working closely to collaborate on improving ED care are physicians, technicians, laboratory and imaging staff. This award reflects the diligence of our nurses, physicians, physician assistants, technicians, social workers and ancillary staff to improve the care our patients receive, says Heather Gutierrez, clinical nurse manager of the Swedish/ ED. We have transformed this ED on many levels over the past several years and our hard work is now nationally recognized. In addition to Swedish/, the Ballard ED nursing team is also a recipient of the Lantern Award. "Our campus and the community surrounding Swedish/Ballard are truly thrilled Please see Lantern Award on page 7 inside

2 Improved Performance Measures Worthy of Comment By: Bruce Williams M.D., chair, Quality Council All staff at Swedish/ work diligently to continuously improve the quality of the care we deliver to our patients. Everyone in the institution, from housekeeping to specialty physicians, from bedside nurses to the executive administrative team, focuses daily on steps we can take to bring the best medical science and compassionate care to each and every patient that comes through our doors. And while medicine is very much a human endeavor and perfection is the ultimate goal, improving in performance measures along the road is a gratifying affirmation of our achievements to date. The Medicare program, under the umbrella of the Centers for Medicare and Medicaid Services and the legal framework of the Affordable Care Act, now compiles and reports publicly many measures of the health care delivered in hospitals around the country. Recent results regarding Swedish/ are worthy of comment. First, according to Medicare s Hospital Specific Report, May Medicare Spending Per Beneficiary, which compares what our facility actually costs to deliver services for specific diagnoses and patients to other hospitals in Washington and around the country, our bottom line number is 0.95 for This means we spent significantly less per dollar average cost compared to American hospitals as a whole. This number in fact places us in the top third of hospitals nationally for efficiency. Second, our readmission rate is 15.6 percent for 2013, down from 17.3 percent in 2010 and significantly below the state (15.9 percent) and national (18.16 percent) averages according to the Hospital Performance Report: Medicare Fee for Service 30-day Readmissions Report. We are arguably doing superior work in integrating patients with community resources at the time of discharge; improving patient well-being by providing durable results. Third, a recent comparison of hospitals in the Seattle metropolitan area by "hospital acquired conditions," meaning harms experienced by patients during their stay, ranks Swedish/ in the top quartile of 22 citywide facilities. The measure includes catheter related infections, falls, bedsores and other potentially preventable injuries and is a reflection of the care we take and the emphasis we place on patient safety by all hospital staff. Swedish CME Events Bruce Williams, M.D. Our goal at Swedish/ is to be the best community hospital in Washington state. We are well on the road to providing an exceptional level of medical service and care to the residents of south Snohomish County with superior, measurable improvements in efficiency, safety and the successful integration of care after discharge. Below are upcoming Swedish CME activities. Please visit for locations, times and the most up-to-date information about upcoming CME activities. 4th Annual Intensive Update in Neurology Thursday and Friday, Sept TeleHealth: Improving Access to Health Care Friday, Sept th Annual Pain Management Symposium: Be an Einstein Use the Brain to Treat Pain Friday, Sept. 26 Medical Ethics Conference Series for Health-Care Providers 4th Wednesdays, broadcast to the 4th Floor Conference Room at Swedish/ 2

3 Obstructive Sleep Apnea Program Returns We are pleased to announce the return of the Obstructive Sleep Apnea (OSA) management program at Swedish/. As a first step in reintroducing the OSA program, nursing has already begun screening any patient placed in a bed, inpatients as well as outpatients, for known sleep apnea or at higher risk of sleep apnea using the hospital s former STOP- BAG criteria. Providers may have already noticed the yellow OSA banners that appear in Epic on some patients. This means the patient was identified as having known sleep apnea or screened positive for being at higher risk for OSA. When the program is live July 21 and the yellow banner designation appears on a patient s Epic record, physicians/providers will be responsible for initiating the OSA protocol by placing a stand-alone order which activates the protocol for staff to begin OSA monitoring and care. As part of the protocol, patients will also receive OSA educational materials at discharge and instructions to follow up with their primary care physician to discuss whether a referral for a sleep study is appropriate for them. We look forward to once again improving the care delivered to this population of at risk patients. New Hospital Parking Garage Opens The first phase of the Swedish/ expansion project, construction of a new parking garage, is complete. In celebration, a ribbon-cutting ceremony for the new garage was held on June 27. Following the ribbon cutting, the mayor of, Dave Earling, was the first driver to officially park a vehicle in the new structure. The parking garage is now open for use by Swedish/ caregivers and the community. The garage provides free parking for more than 360 vehicles and includes added security features such as security cameras and assistance buttons. Providers and staff may also request an escort from Swedish/ security to and from the garage. Looking ahead to the next phase of the hospital expansion project, a ground-breaking ceremony will be held in September for the new ambulatory center which will include an emergency department (ED), urgent care center, outpatient diagnostic imaging center, spacious public lobby and more. But not everything being planned for the project is new. In fact, a feature has been identified that s been around millions of years. Please see New Parking Garage on page 7 inside Clinical Documentation Integrity Program (CDIP) Report: May Total Reviews: 343 Total Clarifications: 39 Response Rate: 77% Physician Agree Rate: 59% May s Top 5 Clarifications: 1. Acute kidney failure 2. Hyponatremia 3. Malnutrition 4. Acute blood loss anemia 5. Sepsis Total Case Mix Index for Medicare and Managed Medicare: 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 Swedish and Swedish/ Physicians Recognized as Top Docs in Seattle Magazine The results of Seattle magazine s 14th annual Top Doctors survey are published in the July issue, now available on newsstands. As in years past, several Swedishaffiliated (or credentialed) physicians are recognized in the popular issue because they were nominated by their peers. Congratulations to the following physicians: Amir Bastawrous Andrew Ting Angeli Mayadev Arpan Waghray Brenna Born Brian Louie Claire Buchanan Clark Coler Dan S. Veljovich David Ege David Luthy Drew Schembre James Willems Jay Parikh Jim Walsh Joel Wassermann John Wynn John Joseph Brandabur Joseph Teply Kathleen Moen Kristine Rinn Laurie Fouser Lily Jung Henson Lina Fine Michelle Sinnett Neil Siecke Pamela Paley Per Danielsson Philip Gold Ralph Aye Tanmeet Sethi Tracy Johannsen Vivek Mehta * Bolded names are those of Swedish/ physicians. New Foundation Staff Member for Swedish/ Maggie Keelan joined the Swedish Foundation team on May 19 as the major gifts officer for Swedish/. In this role, Maggie will work closely with Swedish/ chief executive David Jaffe to secure gifts for the hospital s expansion project and to build community support for the hospital. Maggie was most recently the director of annual giving at Seattle University where she raised $2.4 million annually from alumni and friends of the university. Maggie is also a professional harpist. For information on giving, contact Maggie at maggie.keelan@swedish.org or call Ednea Simon Rebecca Duke Elizabeth Meade Richard Lindquist Eric Vallieres Robert Weinsheimer Erin Ellis Ross McMahon Fran Broyles Sameer Gopalani Gad Kletter Gregory Rudolf Sarah Bork Sean Lawler Maggie Keelan 4 Hank Kaplan James Harding Steven Han

5 New Swedish Insulin - SC Basal Bolus Correctional - Adult This updated best practice order set has been in use at First Hill (excluding obstetrics) since January and was formally introduced system wide on June 17. The order set replaces existing subcutaneous insulin order sets in Epic, both basal bolus and sliding scale, with few exceptions. Three IV insulin order sets, including two transitional order sets, were also created by the Glycemic Control Project team and have been piloted and fine-tuned at First Hill since January. These order sets will be rolled out to other campuses later in the year. The new order sets are not meant to be further customized. Save time, save to your favorites Open Order Sets from any Navigator or from Manage Orders and do the following: 1. Type Swedish Insulin in search box, then select Swedish Insulin SC Basal Bolus Correctional Adult. 2. Right-click on the order set title. 3. Select Add to Favorites. To remove any prior saved sets from your favorites: 1. Right click on the set title 2. Select Remove from Favorites What s new in the Swedish basal bolus correctional order set? The updated basal bolus insulin order set, when completed as written, provides a more individualized approach to glycemic management for each patient. The term correctional replaces the term sliding scale. Insulin used to correct BG in the moment vs. being given proactively before a meal (nutritional) R.N.s will be able to give nutritional insulin up to an hour after a patient has eaten R.N.s will be able to choose between giving half of prescribed nutritional dose or full amount, depending on a patient s appetite or intake (how much they ve eaten or are anticipated to eat) HS glucose checks (approximately 9 p.m.) for all patients. Those given correctional insulin at bedtime will need a 3 a.m. check. Inform the patient ahead of time of the need for a 3 a.m. check to make sure their blood sugar stays in a safe range during the night. Please contact Fran Broyles, M.D., Endocrinology, at Frances.Broyles@swedish.org; Beth Ann Reimel, Surgery, at BethAnn.Reimel@swedish.org; or Clark Coler, Hospital Medicine, at Clark.Coler@swedish.org for questions or concerns. Create Your Swedish Web Profile All active Swedish/ 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 and enter your user name and temporary password: User name: Same as your username on the Swedish network, e.g., Tom G. Smith would be SmitTg1 Password: Lastname (case sensitive) Physicians are asked to maintain their own office information on profiles such as office hours, address/phone changes, etc. It s recommended that you change your default password (last name) to your strong password used on the Swedish network, so your Swedish logins are consistent and easier to remember. If You Need Help Please visit 5

6 Congratulations These physicians were mentioned by name in the April Press Ganey Patient Satisfaction Surveys and complimented for their great work. Adam Balkany, D.O. Swedish Specialty Clinic Irina Zigelboym, D.O. Hospitalist Parul Sharma, D.O. Premier Orthopedic Group Anand Patani, M.D. Anny Soon, M.D. Aric Christal, M.D. Orthopedic Center Bich-Khanh Nguyen, M.D. Catherine Rogers, M.D. Sound Women s Care Jeremy Hammel, M.D. Emergency Services John Maldazys, M.D. Sound Urological Associates Keith Luther, M.D. Kurt Harmon, M.D. Surgical Associates of Linda Strong, M.D. Peter Ro, M.D. Center for Wound Healing & Hyperbarics Richard McCLelland, M.D. Emergency Services Swastik Sinha, M.D. Western Washington Medical Group Thomas Jurich, M.D. Surgical Associates of Zerin Rahman, M.D. Hospitalist What are Patients Saying? Below are a few positive comments from recent Press Ganey Satisfaction Surveys and discharge calls at Swedish/. Congratulations to physicians and hospital staff mentioned. Intensive Care Dr. Youssef saved my life. It can't get better than that! Childbirth Center We loved Dr. Moe! Progressive Care inflammatory immune responses to antidepressants. They talked with me at night to encourage me to try a third with success. I will never forget all the staff and doctors on 9-West. They are kind, compassionate and caring. They saved my life. Emergency Department patient appreciated how he explained everything before he did it. Day Surgery I had the best team. My surgeon is awesome. I love Dr. Pham. So honest and up front with all my surgeries. 6 I had all the trust in my physicians and they really listened to me. Great team. 9-West The nurses and doctors on 9 -West cared for me and supported me through two serious hyper Dr. Chow called us from his home the day after we came in for treatment to follow up! Patient says the entire staff from the front of the ER to the back was fantastic. Patient offered a special thank you to Dr. Chow because the Outpatient Dr. Althouse sent me to Swedish/ for an electrocardiogram. Dr. Althouse is the greatest doctor. I really like him. 5-West Dr. Min is an excellent doctor.

7 New Parking Garage (continued from page 3) Just along the Swedish/ walk path, about 200 feet south of the ED ambulance bay, sits a 10-ton rock that a geologist has determined was formed between 150 and 200 million years ago. The rock was transported from Fidalgo Island to its current location during the glacial ice flow period. The new hospital expansion architecture will have a glacial theme and there s a possibility the rock will be moved and displayed outside what will be the hospital s new entrance. Signage will explain to hospital visitors the history of the rock including where it came from and how it was relocated. The rock will be a great aesthetic and historic feature for the new hospital addition. Lantern Award (continued from page 1) that our emergency department has been honored with the 2014 Lantern Award, says Jennifer Graves, chief executive at Swedish/Ballard. Our visionary manager and nursing staff have consistently sought to raise the bar and achieve the highest levels of professional practice, and through a relentless focus on continuous improvement, they have demonstrated exceptional care, quality and safety. As a nurse, I feel blessed to work beside this group of colleagues, and am particularly grateful to our ED Shared Leadership team who dedicated a significant amount of time and energy to telling our story of success through the Lantern application process." A ribbon-cutting ceremony opens the new Swedish/ threestory parking garage on June 27. Cutting the ribbon are David Jaffe, chief executive at Swedish/, Michelle Sinnett, M.D. and Carl Zapora, superintendent at Verdant Health Commission. Inset: security cameras and assistance intercoms are available throughout the new garage as added security features. A formal awards gala to honor ENA award winners, including Lantern Award recipients, will be held at the ENA annual conference in Indianapolis on Saturday, Oct. 11. New Medical Staff (continued from page 8) Name Group Specialty Jennie M. Allen, M.D. Pediatrix Cardiology of Washington Pediatric Cardiology Jennifer S. Kicker, M.D. Swedish Pediatric Specialist Anesthesiology Pediatric Critical Care Medicine Jerry D. McLaughlin, M.D. Swedish Pediatric Intensivists Pediatric Critical Care Medicine Johnny W. Sun, M.D. Swedish Pediatric Hospitalists Pediatrics Jordan W. Greenberg, M.D. Swedish Pediatric Intensivists Pediatric Critical Care Medicine Karen M. Stone, M.D. Radia Inc. Radiology Matthew N. Ashbach, M.D. WWMG Otolaryngology and Audiology Otolaryngology/Otorhinolaryngology Michael C. Shannon, M.D. Swedish Pediatric Specialist Anesthesiology Pediatric Critical Care Medicine Richard D. Kim, M.D. Swedish Critical Care Critical Care Sandeep Sachdeva, M.D. Swedish Hospital Medicine Internal Medicine Warren L. Dinges, M.D. Polyclinic Madison Center Infectious Disease 7

8 Newsletter Access Vital Signs is available on our website. Visit the Medical Staff section swedish.org\medicalstaff 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/ Medical Staff Name Group Specialty Andre Fallot, M.D. Swedish Pediatric Intensivists Pediatric Critical Care Medicine Anna B. Berry, M.D. Cellnetix Pathology, Seattle Pathology Anne Nguyen-Vermillion, M.D. Pediatrix Medical Group Pediatrics Barbara Z. Harper, M.D. Swedish Residential Care Team Internal Medicine Dinesh Thekke-Karumathil, M.D. Swedish Pediatric Hospitalists Pediatrics Elizabeth H. Meade, M.D. Swedish Pediatric Hospitalists Pediatrics Farah L. Cassis-Ghavami, M.D. Izabel R. Belem, M.D. Swedish Pediatric Specialty/First Hill Pediatric Infectious Diseases Swedish Pediatric Specialist Pediatric Critical Anesthesiology Care Medicine Please see New Medical Staff on page 7 inside To Admit a Patient to Swedish/, Call For Medical Staff information on the web, visit: Vital Signs Issue 69 July th Avenue West,, WA 98026