DIRECTOR S CORNER THE ONLY THING CONSTANT IS CHANGE. Volume 4, Issue 2 April 2011

Transcription

1 Volume 4, Issue 2 April 2011 Inside this issue: PA Highlight: Lynn Pagliaccio 2 DIRECTOR S CORNER THE ONLY THING CONSTANT IS CHANGE This may sound like an oxymoron, but it is the truth. We can always count on change happening. And change is happening in the way PAs practice at Cleveland Clinic Health System. No longer do we go by names other than PA; no more clinical assistants, staff assistants, or even surgical assistants. No longer do we function like Medical assistants, limited in what we can do. No longer do we work a straight Monday to Friday, 8 am to 4:30 pm. We are now manning 12 hour days, 7 days on and 7 days off, three 12 hour shifts, weekend coverage, call, evenings, and holidays. And we are prescribing. We are Physician Assistants. And since 2006, have practice laws which allow us to be fully utilized in the model of care designed for physician assistants nationally. We have asked for recognition as providers and we have received this. And along with this recognition comes greater responsibility. That responsibility includes ownership to cover more hours of patient care. Come July, the residents hours will once again be limited. This will directly affect all of us. Staff is presently looking to ways to provide coverage of patient care for the non-resident services, (no longer called non teaching services). We have implemented new FTEs (full time employees) positions for hospital medicine. We are looking to create a boot camp for new grads who would want to do rigorous 6 month training in hospital medicine and in turn be hired into any area of our system. And we are working with the primary care physicians to move into the future of health care with the Medical Home model, incorporating PAs and APNs into this model of care. In order to do all June Pharm & Clinical Medicine CME 9 of this, and meet MyPractice eprescribing Changes 10 the needs of our institutes, we 2011 Events Calendar must become flexible, (even Make Extra Money! 13 more flexible than New Hires 14 what we have already been). Job Postings 15 The PA of the future will be open to innovative scheduling. And this PA will most likely come up with the scheduling plan, such as how to rotate through hospital, outpatient and home services. Opportunities abound for PAs within our system. And we only see more opportunities on the horizon. And we see more responsibilities for PAs within our system. You only have to look at any news article concerning CCHS to see that PAs are identified as being critical to the needs of patient care. How will we meet these needs? First and foremost, lets get innovative! Start thinking of ways PAs can assist with the decreased residents hours. We know this will include some new FTE s but how will they be utilized and what if we do not bring on new FTE s, what flexibility will be needed to cover all of our patients needs? What scheduling will have to occur for all patients in non-resident services be covered? I know you have some great ideas out there. Let s start the think tank! PAs have long been proactive and not reactive in trailblazing throughout Ohio. Lets do it here! Thanks for reading, Josanne Carpe Diem Medication Communication 3-4 New Process for Counts in OR 5 Onboarding a New PA 6 Quality & Performance Initiatives 7 Pat Ginley Retirement Party 8

2 P AGE 2 IN THE SPOTLIGHT LYNN PAGLIACCIO PA-C In this spring issue the spotlight is on Lynn Pagliaccio, PA C APN/PA Coordinator in the Emergency Department on main campus. Lynn was raised in the Buffalo, NY area and knew that she wanted a career in the medical field. Immediately out of high school she pursued a career as a surgical technician before becoming a surgical assistant and a registered nurse. She graduated from Lake Erie College in Ohio in 1986 as a Physician Assistant and went on to earn her Master s Degree in She is an active member of the PA Council and PA Privileging Committee. Lynn has been with the Cleveland Clinic as a practicing PA for almost 25 years. She has practiced in Pulmonary Medicine, Cardiovascular Surgery, and has now been in the Emergency Department for the past 17 years. She currently works as the APN/PA Coordinator. Lynn thoroughly enjoys her work. I absolutely enjoy the challenges of working in the ED. To be successful you must have a solid general knowledge base, be able to multitask and prioritize well. She believes the most overlooked challenge of working in the ED is the need to develop trusting relationships with 20+ different physicians with vast differences in personality and practice styles. Her role model and a key figure in her career is Patricia Curtis McCarthy, with whom she worked in Pulmonary Medicine when first coming to the Cleveland Clinic. Educating the future Physician Assistant s is very important to Lynn and she strongly believes that all departments should share in the important responsibility of helping to guide and train them. We should all aspire to become the best practitioners that we can be, share our knowledge and serve as role models for newer generations of PAs. Today s CC PA student could be tomorrows new CC PA. The ED currently takes on 2 PA students at a time, where both MD s and PAs are preceptors and the students have the opportunity to delve into all areas of the department. Lynn has been involved in the development of the low acuity clinic in the ED. This clinic has helped improve low acuity patient length of stays, has encouraged team work, improved time to provider times, and has had a positive financial impact. For more information on this project: ESIImproveDoor2DocandLengthofStay/tabid/5951/Default.aspx She is also excited to be a part of the Split Flow Model of care project which all CCHS Emergency Departments will eventually follow. This future model will dramatically change the way patients are processed in the ED and will definitely affect the care they receive. When Lynn does find time to be away from the hospital, her love is being near the water, boating with her husband, and experiencing their shared passion, scuba diving! She is a certified rescue diver. Their most recent excursion was in February to Honduras and a trip is planned in May to dive in Cozumel and the cenotes.

3 P AGE 3

4 P AGE 4 Medication Communication (continued)

5 P AGE 5 NEW ANNOUNCEMENT!!! New Process for Counts in the Operating Room - Procedural Pause Beginning Monday, April 4, 2011 there will be a new process for counts in the operating rooms throughout Main Campus. At the time of closure of a cavity or a compartment and prior to final skin closure, there will be a complete procedural pause with complete cessation of all surgical activity other than the counting of laparotomy pads, sponges, needles and instruments. This new process is viewed as an enhancement to our current positive culture surrounding patient safety. The leadership team in surgical operations is committed to supporting our front line staff and employees as they lead this initiative to further promote a culture of safety and the elimination of potential adverse events in our operating rooms. The Chairmen of all Surgical Departments and the Surgical QIO's have had an opportunity to review, comment and finalize this change in process. This change in process is due to the large number of unintentionally retained foreign bodies over the past year in operating rooms. In nearly all cases, an environment of haste led to errors in counting or failure to count. Ongoing surgical activity during the count process is a distraction to the nurses and makes localization of the different potential foreign bodies challenging when they are entering and leaving the field during the count. While this introduces a brief delay in each case, it will avoid the extreme delays and harm to patients created when a count is incorrect, a cavity or compartment needs to be reopened, or an x-ray needs to be obtained. There may be some cases where there are few foreign bodies to count and the incisions are so small that it is nearly unimaginable for a foreign body to be retained. In these cases, the count process will be nearly instantaneous and of no consequential delay. Several surgical departments have already developed zero tolerance policies and procedural pauses similar to the one we are now instituting hospital wide. All of the operating room nurses were educated on this new count process on Wednesday morning, March 9, 2011, at their weekly meeting. Should any nurse, staff physician or surgeon, resident, fellow or physician assistant have any concerns or resistance in complying with this process, they should contact Dr. Winans, Dr. Bergfeld, or Dr. Ebrahim for discussion. This document contains confidential, privileged information protected by the Quality Assurance and Peer Review privileges as outlined in Ohio Revised Code Sections 2317 (A), , , and 2305.

6 P AGE 6 SPECIAL INFORMATION ON BOARDING A NEW PA When a new PA is hired into your department, there are a number of items that must be completed before that PA may have a start date. Since 2006, the OSMB has changed the paperwork for supervision plans. In fact, a supervision plan for a physician is ONLY used when that physician is in a PRIVATE PRACTICE. Any hospital based physicians or physician s practices are all to utilize the new Supervision Agreement forms. All of CCHS is now Hospital based. This means that even if you are working in a strictly Out patient office, you are still considered HOSPITAL OUT PATIENT SERVICE (HOPS). All of our physicians apply with for a SUPERVISION AGREEMENT. The process for bringing a new PA in involves the following duties: 1. Identify what physicians the PA will be working with 2. Check the OSMB website look up to see if the physicians all have existing supervision agreements: 3. If they do not have a supervision agreement, they must EACH fill out the supervision agreement forms: 4. This form must be filled out correctly; PA Services has a sample form for you to follow. 5. This form then must be sent overnight to the OSMB with a check for $25 (for each application). 6. The OSMB only meets on the second Wednesday and Thursday of the month and this application MUST be in their hands before the last week of the previous month in order to make the agenda. 7. Once this application is approved, it will show up on the OSMB website. 8. If the physicians ALREADY have supervision agreement in place, and it is ACTIVE, then you only need to fill out an addendum form, have the physician and the PA sign the form and send it to the OSMB. No money is needed. PAaddendummutliplenames.pdf, MDaddendummutliplenames.pdf 9. The whole process for a physician to apply for a new supervision agreement may take as long as 2 to 3 months. During this time, the new PA must also be privileged through the BOG. This process takes place in the PA Services and Credentialing office. I hope this gives a clear idea of what needs to be done to bring a PA on board. And all of this information can be found on the PA Website:

7 P AGE 7 Quality Initiatives Today s consumers can review a number of metrics on quality, safety, patient experience and outcomes to help them make informed decisions, This provides a transparent comparison across hospitals and serves as a stimulus for hospitals to improve their performance and outcomes What can we do to improve? Our 2011 quality initiative goals are to improve performance on: Domain Measure Aspirational Goals Safety Patient Safety Indicators VTE ( Pressure ulcers, Falls 90th Percentile Hospital Acquired Conditions Wrong site, retained FB Hospital Acquired Infections CLABSI ( SSI Zero 50% from 2010 Quality Core Measures ( 90th percentile Patient Experience Readmissions ( Mortality O:E ( HCAHPS ( FINAL.pdf) 90th percentile HF, AMI, PN, Surg 90th percentile 90th percentile

8 P AGE 8

9 P AGE 9 Offering 10 hrs of Category I CME in Pharmacology and Clinical Medicine CCHS PA Services presents: Pharmacology & C linical Medicine CME Date: June 23 & 24, 2011 Bunts Auditorium T his program has been reviewed and is approved for a maximum of 10 hours of AAPA Category 1 CM E credit by the Physician Assistant Review Panel. Physician Assistants should claim only tho se ho urs actually spent participating in CM E activity. T he program was planned in accordance with AAPA s CM E Standards for Live Programs and for Commercial Support of Live Programs. Topics Muscular/Skeletal imaging T rends in Knee Cartilage Restoration Hospital Psych consult: identifying the issues Managing CHF Metabolic Syndrome: recognizing the symptoms Overview o f sugar substitutes; reactions, interactions (P harm ) Joint Injectables (P harm ) New options for lipid control; when diet and exercise are not enough (P harm ) VRE and MRSA treatments and containment (P harm ) Proper Utilization of scheduled agents for pain control (P harm ) Registration: $150 (B oth day s) Thurs only: $85 Friday only: $85 De adline for re gistration: June 3, 2011 Late registration fee: $ (After June 3, 2011) For info: Josanne Pagel, Dir. PA Services Phone: Fax: pagelj@ ccf.org Offe ring 10 hrs of C ate gory I CME in Pharmacology and Clinical Medicine Registration total: Thurs only: Friday only: Return form and payment to: PA services CCF EB 1 16 d Fax: O nly those with com ple te payment will be registe re d NAME: Address: City/State/Zip: Phone: PAYMENT: CCHS cost center: Check: VISA/MC: SIGNATURE: NO REGISTRATION WILL BE TAKEN WITHOUT PAYMENT

10 P AGE 10 IMPORTANT ANNOUNCEMENT **MyPractice Update: eprescribing Changes** The Family Health Centers will be set up with additional eprescribing/rxhub functionality effective March 1, The mail order functionality is set up for two areas on main campus, Internal Medicine and Peds Gastro. The plan is to turn on mail order and other functionality to the rest of main campus in a few months. Please review the file above for discreet signatures and other updates.

11 P AGE EVENTS CALENDAR CODING REIMBURSEMENT & DOCUMENTATION PRESENTATION Thursday, April 7, 2011, 1:00pm 4:00pm Gail Pfeiffer, Director of Coding Compliance Healthspace Building, Basement, Room 124 KNOWLEDGE SHARING MEETING Topic: Reinforcing Self Care and Adherence Wednesday, April 13, 2011, 6:30am 9:00am Building E, 3rd floor, E3 53 MIS Conference Room Supported by: GlaxoSmithKlein (GSK) CODING REIMBURSEMENT & DOCUMENTATION PRESENTATION Thursday, May 5, 2011, 1:00pm 4:00pm Gail Pfeiffer, Director of Coding Compliance Healthspace Building, Basement, Room 124 PA FOCUS GROUP ROUNDTABLE (topic to be announced) Wednesday, May 11, 2011, 4:30pm 5:30pm Building E, 3rd floor, E3 53 MIS Conference Room, Supported by: Pfizer A Private Reception given by PA s for PA s To Celebrate the Retirement of Pat Ginley Thursday, May 19, 2011, 5:00pm 7:00pm Table 45, Private Dining Area Appetizers & Cash Bar IMPACT 2011 AAPA s 39th Annual PA Conference! Las Vegas Convention Center (CME Courses, AAPA Events) Hilton Las Vegas (Product Theaters, Adjunct Symposia, House of Delegates, and CO Events) May 30 June 4, events/annual conference/details MIDLEVEL MANAGER MEETING Tuesday, June 7, 2011, 12:00pm 1:30pm Building E, 3rd floor, E3 53 MIS Conference Room KNOWLEDGE SHARING MEETING Topic: Review of 12 Lead EKG, Speaker: Anbazhagan Prabhakaran Wednesday, June 8, 2011, 6:30am 9:00am Building E, 3rd floor, E3 53 MIS Conference Room CME PROGRAM Thursday Friday, June 23 24, 2011 Bunts Auditorium, 10 hours CME (5 hrs Pharmacology, 5 hrs Problematic) PA FOCUS GROUP ROUNDTABLE (topic to be announced) Wednesday, July 13, 2011, 7:30am 8:30am Building E, 3rd floor, E3 53 MIS Conference Room, Supported by: Pfizer

12 P AGE EVENTS CALENDAR KNOWLEDGE SHARING MEETING (topic to be announced) Topic: Trends in Knee Cactalize Restoration, Supported by: Genzyme Wednesday, August 10, 2011, 6:30am 9:00am Building E, 3rd floor, E3 53 MIS Conference Room PA FOCUS GROUP ROUNDTABLE (topic to be announced) Wednesday, September 14, 2011, 4:30pm 5:30pm Building E, 3rd floor, E3 53 MIS Conference Room, Supported by: Pfizer CME PROGRAM Friday, September 23, 2011 Lerner Building, Room NA5 08/Amphitheater, 8 hours Pharmacology MIDLEVEL MANAGER MEETING Tuesday, October 4, 2011, 12:00pm 1:30pm Building E, 3rd floor, E3 53 MIS Conference Room PA WEEK EVENTS! ANNUAL AWARDS CEREMONY Awards presented for: Distinguished PA s, Outstanding PA s, Outstanding Physician/PA Team & Outstanding Department Foundation House October 6 12, 2011 KNOWLEDGE SHARING MEETING (topic to be announced) Wednesday, October 12, 2011, 6:30am 9:00am Building E, 3rd floor, E3 53 MIS Conference Room AAPA CLINICAL LEADERSHIP CONFERENCE Thursday Friday, October 27 28, 2011 Intercontinental Hotel By Invitation Only PA FOCUS GROUP ROUNDTABLE (topic to be announced) Wednesday, November 9, 2011, 7:30am 8:30am Building E, 3rd floor, E3 53 MIS Conference Room, Supported by: Pfizer KNOWLEDGE SHARING MEETING (topic to be announced) Wednesday, December 14, 2011, 6:30am 9:00am Building E, 3rd floor, E3 53 MIS Conference Room

13 P AGE 13 $$$ Send a PA our Way and Make Extra Money $$$ Midlevel Providers Employee Referral Program EMPLOYEES & APPLICANTS WHO IS ELIGIBLE TO PARTICIPATE IN THIS PROGRAM? All Cleveland Clinic Health System exempt and non exempt employees, EXCEPT Staffing and Recruitment and other recruitment based positions. Must remain employed at Cleveland Clinic during the cash award pay out period. THE APPLICANT YOU REFER: MUST include your name as the referring employee on their Application for Employment (NO exceptions will be given consideration). Cannot be currently employed in any capacity within Cleveland Clinic Health System. MAY be a former employee who left Cleveland Clinic Health System (Florida, Main Campus, RMP or System Hospital) more than 6 months ago. MUST be hired into a full time or part time Midlevel Provider position defined as: Physician Assistant at Cleveland Clinic.. WHAT IS THE AMOUNT OF THE CASH AWARD I WILL RECEIVE? $1,500 cash award (after taxes) for the referral of a full time Midlevel Provider and $800 for a part time Midlevel Provider referral. The cash award will be paid out as follows: FOR FULL TIME: $500 after the completion of the 90 day probationary period; $500 after six month's employment at Cleveland Clinic, and the remaining $500 after the completion of one year employment at Cleveland Clinic. FOR PART TIME: $400 after the completion of the 90 day probationary period and $400 after the completion of one year employment at Cleveland Clinic.

14 P AGE 14 NEW HIRES Please join us in welcoming the following PA s to Cleveland Clinic: Laura Blesse PA C Colorectal Surgery Sharon Scully PA C Beachwood Express Clinic Theresa Griffin Martin PA C Strongsville Express Clinic

15 P AGE 15 Josanne Pagel, MPAS, PA-C, RMT PA Services Director, Cleveland Clinic 9500 Euclid Avenue, EB116h Cleveland, OH Phone: Fax: Tammela Jeffries, PA Coordinator Cleveland Clinic 9500 Euclid Avenue, EB116d Cleveland, OH Phone: Fax: Our VISION is to offer the most professional and educational opportunities to Physician Assistants. throughout the world! MISSION To work with physicians to provide quality and accessible health care to our patients. To continue our professional and personal development as Physician Assistants. To increase awareness of the Physician Assistant profession at Cleveland Clinic. PURPOSE By disseminating information, increasing communication, and promoting educational activities for continual medical and professional opportunities, the Physician Assistants of Cleveland Clinic are committed to providing affordable and accessible quality health care to all patients. physicianassistants/ Job postings For info contact Selena Rodebaugh, PA Recruiter, ; or MAIN CAMPUS: Breast Center (1) Bone Marrow Transplant (2) Cardiothoracic Surgery (1) Epilepsy (1) Gastroenterology (2) General Surgery-Hepato-Pancreato (1) General Surgery (Acute Care) (1) Hematology/Oncology (1) Hospital Medicine IMPACT Program (2) Neuro ICU (1) Oncology/Pallative Medicine Inpatient (1) Pediatric Cardiothoracic Surgery (1) Plastic Surgery (1) Respiratory MICU (6) WORDS FOR THE DAY: Just as energy is the basis of life itself, and ideas the source of innovation, so is innovation the vital spark of all human change, improvement and progress. Ted Levitt FAMILY HEALTH CENTERS: Independence Express Clinic Part Time (1) Elyria Chestnut Commons Geriatrics (2) REGIONAL HOSPITALS: Hillcrest OR Evenings (2) Huron Road Surgical Services (1) Outpatient Clinic (1) Euclid Surgical Services PRN (1) Fairview Surgical Suite Moll Center (1) AMBULATORY SURGERY CENTERS: TWINSBURG ASC Emergency Medicine (1)