But did you know we re also transforming cancer facilities and services on the campus?

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1 37 October 2011 Medical Staff Swedish/Edmonds VitalSigns this issue P.1 Expansion of Cancer Services The new two-story, 16,000-square-foot Swedish Cancer Institute Building is scheduled to open in Spring Rendering courtesy of Perkins+Will. P.2 Seattle Met Top Docs Patient Satisfaction Survey Comments P.3 New Internist CPDI Report P.4 Telemedicine Program Flu Shot Reminder P.5 Diabetes Services Expanded P.6 CME Corner P.7 Safety Culture Survey Swedish/Edmonds Gala P.8 Robotic Assisted Surgery P.9 Swedish-Providence Affiliation P.10 Welcome New Physicians New Cancer Facility Opens in 2012 Swedish/Edmonds is beginning its Master Site Development Plan for the campus. The plan includes a new Emergency Department, operating rooms, expanded Childbirth Center services and an expansion of ICU/ PCU beds. But did you know we re also transforming cancer facilities and services on the campus? More than 2,600 cancer patients were cared for by Swedish Cancer Institute, Puget Sound Cancer Centers (PSCC) and other local cancer care providers affiliated with Swedish/Edmonds last year. Now there are plans to improve facilities and coordination of cancer services on and around the campus to serve even more patients and provide greater convenience and access to advanced, comprehensive cancer care. As part of these efforts in program development, there will be a three-phased improvement in facilities. In spring 2012, cancer services at Swedish/ Edmonds will expand with the opening of a new, two-story, 16,000-square-foot building. Anticipated to open in spring 2012, the new cancer building will feature: A medical oncology suite with physician services provided by PSCC Chemotherapy and infusion services Patient care areas with enhanced patient privacy and comfort Later phases under planning include exciting new changes to the existing cancer facility. The first floor of the facility will accommodate a new linear accelerator (LINAC) technology commonly used for cancer radiation treatments. A LINAC works by delivering a uniform, high-energy, X-ray dose to cancer tumors. The precision and accuracy of the X-ray dose allows for cancer cells to be destroyed, while sparing surrounding normal tissue. The second floor of the existing cancer Please See SCI Construction on Page 9

2 Seattle Met Survey Names Top Docs Fifteen physicians on the medical staff at Swedish/Edmonds are top doctors according to Seattle Metropolitan magazine. The monthly magazine partnered with Avvo for its annual survey to identify top doctors. Avvo is a research company that rates and profiles physicians. Congratulations to the following physicians at Swedish/Edmonds who were named top doctors by Seattle Met: Preetam Bandla, M.D., pediatric pulmonary medicine Carol Cornejo, M.D., general surgery David Corwin, M.D., hematology pathology, anatomic pathology Todd Czartoski, M.D., neurohospitalist medicine, inpatient neurology, cerebrovascular neurology Margaret Hall, M.D., internal medicine, cardiac CT Julie Heyn, M.D., internal medicine, echocardiography Mary Kelly, M.D., diagnostic radiology Daniel Landis, M.D., Ph.D., radiation oncology Brian Lee, M.D., Ph.D., radiation oncology Daniel Markowitz, M.D., medical oncology, internal medicine Richard McGee, M.D., medical oncology, internal medicine Jon Olson, M.D., anesthesiology, pain management Steven Rostad, M.D., neuropathology Jehuda Sepkuty, M.D., neurology Marko Yakovlevitch, M.D., internal medicine, nuclear cardiology Congratulations These individuals were mentioned by name in the July Press Ganey Patient Satisfaction Surveys and complimented for their great work. 2 Alexander Chung, M.D. Hospitalist Program Anita Chopra, M.D. Swedish Internal Medicine at Edmonds Catherine Rogers, M.D. Catherine Zeh, M.D. D.J. Wardle, DPM Stevens Foot and Ankle Clinic Daniel Timmons, M.D. David Spiro, M.D. Debora Sciscoe, M.D. Gretchen Lockard, M.D. Jeffrey Bray, M.D. Jill Jelacic, M.D. Pacific Anesthesia Judith Babcock, M.D. Katrina Erickson, M.D. Keith Luther, M.D. Swedish Internal Medicine at Edmonds Khanh Nguyen, M.D. Swedish Internal Medicine at Edmonds Kimberly Dickey, D.O. Linda Strong, M.D. Swedish Internal Medicine at Edmonds Maurene Cronyn, M.D. Michael Olsen, M.D. Hospitalist Program Randolph Bourne, M.D. Timothy Little, M.D. Puget Sound Gastroenterology

3 New Internist Follows Father s Example Excited to Build Patient Relationships at Swedish/Edmonds Like father, like daughter. As a child, Anny Soon, M.D., spent many hours watching her father, a physician, enjoy caring for patients. Now, inspired by her father and the desire to always learn more about the field of medicine, Dr. Soon is a new internist at Swedish Internal Medicine at Edmonds. I became an internist because I enjoy building relationships with patients in a relaxed, clinic setting, says Dr. Soon. Growing up in the Seattle area, I ve always known Swedish as a center of excellence and I m excited to be starting this new chapter in my career, providing patients with quality care. Patients can expect a comforting smile from Dr. Soon followed by three things she believes are essential for quality, compassionate care; honesty, open communication and good listening skills. Listening skills are a must in this field in order to empathize and understand where a patient is coming from, says Dr. Soon. Honesty and an open line of communication are the cornerstones of building a relationship with a patient. Dr. Soon offers comprehensive care with an emphasis on preventive care and treating chronic illnesses such as hypertension and diabetes. She encourages patients to have an active voice in their care so that they re well informed and fully understand their diagnosis and treatment options. The key to treating disease successfully is a patient who is involved in their care and who feels Anny Soon, M.D. confident sharing information with me, says Dr. Soon. Dr. Soon received her medical degree from George Washington University School of Medicine in Washington, D.C. and completed her residency in internal medicine at the University of California, San Diego Medical Center. Outside of medicine, she enjoys playing the piano, Shotokan karate and needle work. In addition to English, she also speaks Mandarin Chinese. To schedule an appointment with Dr. Soon at Swedish Internal Medicine at Edmonds, please call CPDI Report: August Concurrent / Retrospective Total Reviews: 414 / 580 Total Queries: 68 / 5 Response Rate: 97% / 60% August s Top 5 Queries: 1. Documentation Clarification 2. Sepsis 3. Congestive Heart Failure 4. Morbid Obesity 5. Respiratory Failure Most Effective Query: Documentation Clarification Impact of most effective query: Revenue: $32,300 Case mix: Physician Agree Rate: 62% / 100% 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, CPDI Program Supervisor, at with any questions. 3

4 Telemedicine, TeleEEG Program Now at Swedish/Edmonds Swedish/Edmonds is now one of five Swedish sites with a TeleEEG program, adding to the depth of the hospital s neurohospitalist program, helping patients receive a faster diagnosis and facilitating real-time decision making by providers. Electroencephalography (EEG) is a technique which records brain activity and reflects normal/abnormal brain function to help clinicians make decisions in scenarios such as seizure disorder, nonconvulsive status epilepticus, coma etc. Technical aspects of applying electrodes on a patient s scalp and operating an EEG machine are performed by a certified EEG technologist. Interpretation of the record and the clinical correlation is done by an expert neurologist who is trained and qualified to interpret EEGs. In the last decade, due to developments in technology and the digital revolution, EEG machines now record data digitally and display it on a computer as opposed to the paper and ink machines of the past. This, plus huge advances transmitting over the network large amounts of encrypted data safely and by HIPPA standards, allows EEG to be read anywhere if properly set up. Taking advantage of this technology, Swedish Neuroscience Institute developed a telemedicine program under the leadership of Marcel Loh, senior vice president and chief administrative officer, Swedish/Cherry Hill and Tammy Cress, director, Swedish TeleHealth. Swedish s nationally and internationally known level-4 epilepsy center and clinical neurophysiology programs are among the different divisions of the growing telemedicine program. TeleEEG allows Swedish s expert clinical neurophysiologists (neurologists with 2 years additional training in epilepsy and EEG, and additional board certification in clinical neurophysiology) to remotely interpret EEG signals recorded at community or peripheral hospitals including at Swedish/Edmonds. These facilities have the technical ability to record EEG, but may lack the medical expertise to achieve the highest level of interpretation. The Swedish Epilepsy Center, headed by Jehuda Sepkuty M.D. and the center s pediatric epilepsy program headed by Marcio Sotero, M.D., cover adult and pediatric EEGs of all ages. The team of interpreting physicians includes Lisa Caylor, M.D., Michael Doherty, M.D., Ednea Simon, M.D., Jehuda Sepkuty, M.D. and Marcio Sotero, M.D. For further information and questions, please call Colleen Douville, program manager, at Flu Shot Reminder Don t forget to get your shot! Free influenza vaccinations for Swedish/ Edmonds medical staff are available on the 4th floor of the hospital. Drop in clinic times are Mondays and Wednesdays, 7:30 a.m.-9:30 a.m. and 1:30 p.m.-3:30 p.m. while supplies last. Vaccination or signed declination is required. If a declination is signed, a mask will be required to be worn in patient care areas. Flu shots are also available to members of the public who are not employed by Swedish/Edmonds, family members of employees, volunteers or medical staff and non- Swedish/Edmonds medical office staff for $18. Medicare can be billed directly. If you have questions, please call Swedish/Edmonds Employee Health Services at Dr. Daman Chugh, hospitalist, receives his flu shot from Ruth Sharrett, LPN, during a Swedish/Edmonds vaccination clinic last year. 4

5 Diabetes Services Expanded Insulin Pump Training Now Offered Swedish/Edmonds has two diabetes educators that are now certified to teach patients how to use diabetic insulin pumps technology that can help patients and physicians customize insulin management. We show patients how to operate a pump and calculate insulin doses within the parameters set by the physician, says Karen Harris, R.N., MSN, CDE and diabetes nurse educator. Additionally, we provide them with a nutritional counseling to manage and adjust their food intake in various situations. In addition to Harris, Swedish/ Edmonds registered nurse and certified diabetes educator, Julie Cantwell, also trains patients 18 years or older on how to use an insulin pump. An insulin pump is a small mechanical device, about the size of a pager, that s worn by a diabetes patient to deliver precise doses of insulin continuously throughout the day using a tiny catheter. A pump replaces the need for insulin injections and allows a patient more Missed the Medical Staff Meeting? There s an easy way for physicians to find out what happened at Swedish/Edmonds medical staff meetings. Just visit edmondsmedicalstaffnews where a recap of the last meeting is posted as well as other news/information relevant to medical staff. flexibility to adjust doses to better meet lifestyle needs. Our expansion of diabetes services offers physicians a new methodology to help patients manage their diabetes, closer to home, says Harris. Currently, Harris and Cantwell are certified to show patients how to use Medtronic insulin pumps. They will soon be certified to use devices from other manufacturers and next year, they ll undergo training for continuous glucose monitoring certification. Glucose monitoring is a check of blood sugar levels that involves a finger prick to draw blood. A continuous glucose monitor is a small electronic device that a patient can use to automatically measure and transmit blood sugar levels in five minutes. Results can be uploaded to a computer where a physician or nurse can spot trends and immediately identify ways to improve a patient s insulin management. If you have patients with diabetes and would like learn more about diabetic insulin pump training at Swedish/Edmonds, please call to speak directly with a registered nurse. Karen Harris, R.N., MSN, CDE and diabetes nurse educator, educates patients on how to use insulin pumps to better manage diabetes. 5

6 CME Corner John Arveson CME Program Coordinator Chronic Pain Grand Rounds Meeting Draws Big Turnout 6 The September 21 Grand Rounds on the new chronic pain rules drew more than 70 attendees in what was a very informative session which generated good questions and discussion on a timely and somewhat controversial topic. Mimi Pattison, M.D., the current chair of the Medical Quality Assurance Commission (MQAC) presented an overview of the regulations which take effect for M.D.s on January 1. Regulations are already in effect for DOs and other prescribers. The rules apply to physicians who prescribe opioids for chronic, non-cancer pain. They do not apply when prescribing for palliative care which is defined as care for life-limiting illness, end-oflife care, or for acute pain related to an injury or a surgical procedure. Dr. Pattison reviewed the requirements of the regulations pertaining to patient evaluation, treatment plan, informed consent, written agreement for treatment, periodic review, consultation, and continuing medical education (CME). She also explained the definition of a pain management specialist, and exigent and special circumstances. There is a lot of confusion about CME requirements. The regulations state that physicians prescribing long-lasting opioids for chronic pain should complete four hours of CME pertaining to this topic. The four hours do not need to be in one course; the Swedish/Edmonds Grand Rounds counts for 1.5 hours toward that recommendation. Physicians who are not pain management specialists and who are prescribing more than 120 milligrams morphine equivalent per day without seeking a consultation must have obtained 12 hours of CME pertaining to chronic pain management within the last two years. There are a variety of CME resources that are becoming available. The Washington State Department of Labor and Industries offers four hours of online free CME that is available at nn4cq5. The University of Washington offers a 3-hour course for $45 at A new CME resource is becoming available from Swedish at CME/HB2876. There is also a very good Q&A summary of the regulations available from the Washington State Medical Swedish CME Conferences Association available at nrwdzf. Michael Schiesser, M.D., presented some practical practice tips to comply with the new regulations. He suggested that physicians have a good understanding of the rules, apply the chronic disease model when treating and prescribing for chronic pain, and develop and implement internal policies, procedures and checklists. He emphasized that it is critical to involve office staff so that practice policies and protocols are used consistently. He also said that compliance is easier when the entire practice is involved so that the entire burden doesn t fall on the physician. Dr. Schiesser also presented sample documents that could be used in practices. These include a sample patient agreement, an ample change 25th Annual Roland D. Pinkham, M.D. Basic Science Lectureship Diversity and Evolution of the Human Genome: from Origins to Evo-Devo This activity will be held on Friday, Nov. 18 at Swedish/First Hill and has been approved for AMA PRA Category 1 Credit. Please visit for more information and to register online. Other Swedish CME Activities: Friday, November 4: Third Annual Anticoagulation Symposium: Fundamentals for the Primary-Care Provider Friday, November 11: Diabetes Management Update 2011 Please See CME Corner on Page 8

7 Take 10 Minutes For a Chance to Win $20 Swedish/Edmonds Safety Culture Survey You could win a $20 gift card while helping to make Swedish/Edmonds even safer for patients, staff and physicians. It's time for the hospital s annual Safety Culture Survey and this year the Quality Management and Regulatory Compliance Department (QMRC) has made it even easier for physicians and staff to complete the survey online or on paper, plus be entered to win a $20 gift card from Target. The survey will be available from November Physicians may pick up a survey packet, including a pin number for completing the survey online, in the Swedish/ Edmonds medical staff office or in the QMRC office located on the hospital s fourth floor. Hospital employees working in patient care areas are also eligible to complete the survey and may pick up survey packets from their department manager. Physicians and employees who complete the Safety Culture Survey will be entered into a drawing to win a Target gift card. To be included in the drawing, simply return the confirmation page from the online survey or the sealed envelope with you paper survey, to the QMRC department. Hospital employees may also return completed surveys to their department manager. The gift card drawing will be held on December 9. Twenty lucky individuals will each receive a gift card. Your input is vital and valuable, so please take minutes to complete the Safety Culture Survey. Responses to last year's survey helped Swedish/Edmonds implement the electronic Incident Reporting system and revise the hand-off communication procedure. The QMRC Department looks forward to your survey responses this year. If you have questions, please contact: Pamela Hanlon, QMRC, at pamela.hanlon@swedish.org or Physicians Support Swedish/Edmonds Imagine Gala The Swedish/Edmonds Imagine Gala is quickly approaching and sponsorship is filling up fast. Many physician groups have already signed on as sponsors of the event, and the Swedish Foundation is grateful for their leadership and support. It sends a strong message to the community to see this internal support. To learn more about sponsorship or to purchase a ticket, please visit swedishfoundation.org/ edmonds-gala. 7

8 Robotic-Assisted Surgery at Swedish/Edmonds Surgeries performed with greater precision and less invasively are some of the benefits surgeons and patients will experience with the new da Vinci Surgical System at Swedish/Edmonds. The advanced robotic technology arrived at Swedish/Edmonds in early October and the first group of surgeons has undergone training to use da Vinci. The first roboticassisted surgery at Swedish/ Edmonds is anticipated to take place next month. The system will be used primarily for urologic and gynecologic procedures. The da Vinci system consists of a console equipped with a special 3D HD monitor and hand controls to manipulate four interactive robotic arms. A camera at the end of one arm allows a surgeon to see the surgical site up to 12 times more closely than human vision allows, while the other robotic arms seamlessly maneuver surgical instruments that virtually put the surgeon s hands inside the patient. Compared to traditional surgical approaches, the da Vinci system offers patients significant benefits. Surgical incisions are smaller so there s the potential for less pain, less blood loss, a shorter hospital stay, less risk of infection, faster recovery time and a quicker return to normal daily activities. Robotic-assisted surgery is a growing trend around the world. In 2005, Swedish became one of the first health systems in the region to perform robotic-assisted surgery. For more information, go to We plan to host a physician CME event and an employee open house that showcase the da Vinci Surgical System. Details will be announced soon. The da Vinci Surgical System arrives at Swedish/Edmonds. CME Corner (continued from page 6) management plan and a sample pain management policy. Adam Balkany, D.O., offered closing comments and provided information about referral resources, a sample opioid therapy checklist, guidance for tapering or discontinuing opioids, and other useful information. For those who could not attend, I can provide the PowerPoint presentations and the sample resource material. Just send me an john.arveson@swedish.org and let me know which PowerPoint presentation or sample resource document you would like. Coming up next, the Swedish/ Edmonds Ethics Committee will be hosting a program on Using Physicians Orders for Life-Sustaining Treatment (POLST) to Improve Communications and Care from 12:30 2 p.m. on Monday, Nov. 7. The program will address the importance of POLST in providing the continuity of care that is in line with the patient s wishes, and the variation of using and interpreting POLST within the Swedish/Edmonds community. The speaker for the session will be a recognized authority in end-of-life issues, Stu Farber, M.D., from the University of Washington. We will also have a panel of local physicians discussing case situations. Plan to attend. 8

9 Swedish, Providence Plan Patient-Centered Affiliation A Message from David Jaffe, Swedish/Edmonds Interim Chief administrative Officer You ve probably heard the exciting news by now Swedish has announced plans for an affiliation with the Providence Health System. An internal announcement went out to hospital employees on Oct. 5th, and a press release was issued to members of the news media. In the release it was announced that the two health-care organizations plan to form a new not-for-profit healthcare system that will include all of Swedish s operations in King, Snohomish and Kittitas Counties and all of Providence s operations in King, Snohomish, Thurston and Lewis Counties. Swedish and Providence have signed a memorandum of understanding and are now working on the details of the proposed affiliation. Regulatory review and approval of the new operating arrangement may take some time; until then, the two organizations will continue to operate independently. The benefits of this proposed partnership are many, but include: Sharing resources to make it easier to access health care across the entire range of services from primary care, specialized care, research, hospice and long-term care Reducing costs by better organizing how care is delivered Creating improved models for delivering care and approaches to chronic disease management, which in turn will make health care more affordable for government payers, commercial insurers, employers and patients Providence and Swedish share a commitment to providing safe, highquality, patient-centered care and by working together, we can reduce costs and increase quality and access for patients in Western Washington. I encourage you to discuss any questions or concerns you may have about the proposed affiliation with medical staff leadership or administration. You may also go to one of the following web links for more information: or There will be more updates to come, including upcoming Open Mic with Dave sessions. We are at a critical time for health care and I m proud that Swedish and Providence are working together to be leaders in providing solutions. Best Regards, SCI Construction (continued from page 1) facility will also undergo changes and is planned to house a new Cancer Resource Center. The space will provide patient and family-centered education, social services, meeting rooms for support groups, as well as space for specialists and alternative providers related to cancer care. Expanding and improving the coordination of cancer care services will allow Swedish/Edmond to provide a more seamless, personalized experience for cancer FBIC Medical Staff Meetings Swedish/Edmonds medical staff is invited to attend the First Hill, Ballard, Issaquah and Cherry Hill (FBIC) Quarterly Medical Staff Leadership Council meetings. The next meeting is Tuesday, Nov. 15 from 6 p.m.-8 p.m. at the Swedish/ Cherry Hill Education and Conference Center. Representation from all Swedish hospital campuses is especially appreciated. A buffet dinner is available at 5:45 p.m. 9

10 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 (425) or by the 1 st of the month. WELCOME New Swedish/Edmonds Medical Staff September Name Group Specialty John W. Henson, IV, M.D. Swedish Neurosciences Neurology Justin S. Jin, M.D. Poly Clinic Infectious Disease Sarvesh S. Thakur, M.D. Transplant Nephrology Northwest Nephrology Jon P. Younger, M.D. Poly Clinic Internal Medicine Angela Yue, M.D. Edmonds Family Medicine Family Practice Darius Zoroufy, M.D. Swedish Sleep Medicine Sleep Medicine To Admit a Patient to Swedish/Edmonds, Call For Medical Staff information on the web, visit: Vital Signs Issue 37 October th Avenue West, Edmonds, WA 98026