tpmgawards.com Sidney R. Garfield, MD Exceptional Contribution award

Transcription

1 tpmgawards.com 2011 Sidney R. Garfield, MD Exceptional Contribution award

2 Sidney R. Garfield, MD, was the physician founder of Kaiser Permanente and one of the great innovators of 20th century American health care delivery. Sidney R. Garfield Exceptional Contribution Award Dr. Garfield was a surgeon and visionary. He first applied the novel principles of prepayment, prevention, and group medical practice in the 1930s, while he was providing medical and hospital services for construction workers building the Colorado River Aqueduct in the Mojave Desert. Then, during World War II, he developed a medical care program for hundreds of thousands of workers and family members at Kaiser shipyards in the San Francisco Bay Area, the Vancouver/Portland area, and at the Kaiser Steel Mill in Southern California. His health care system focused as much on the prevention of illness as on caring for the sick. Dr. Garfield looked for innovations in health care throughout his career. In the 1950s, his revolutionary hospital designs drew international praise. In 1960, he was in the vanguard of physicians who embraced the computer as a tool that could radically improve the delivery of medical care. Historians writing about events of the 1900s see the work of Dr. Garfield in co-founding Kaiser Permanente as one of the major social contributions of the century. The Exceptional Contribution Award was established by the TPMG Board of Directors in 2000 to recognize physicians who are instrumental in the development and dissemination of ideas and programs that have a significant impact on patients, colleagues and the broader community.

3 Stephen Parodi, MD Infectious Diseases Napa/Solano Throughout my career I have had two passions one for direct patient care and the other for ways we can affect the health and welfare of the greater patient population. Antimicrobial Stewardship Program and H1N1 Pandemic Response What started as a local initiative to address an overuse of meropenem, evolved under Dr. Parodi s leadership into a successful regionwide Antimicrobial Stewardship Program. The impetus was the discovery that 20% of the time meropenem was prescribed at Vallejo, the medication was not indicated. In response, Dr. Parodi developed a program in which the pharmacist would present cases of patients receiving meropenem to the infectious disease (ID) physician on call. If the physician determined that the antibiotic regimen was not appropriate, he or she would call the treating physician and suggest discontinuing the therapy or substituting an alternative medication. Within three months, use of meropenem fell by about 40%. As the program expanded to include all inpatient antimicrobial agents, resistance rates for certain gram negative organisms declined, as did Clostridium difficile infection rates. Antimicrobial Stewardship Programs were launched at every KPNC hospital in January During the first year, antimicrobial usage declined an average of 10%. While planning for the rollout of the Antimicrobial Stewardship Program, Dr. Parodi got a call about a new strain of influenza. Within days he was serving as primary clinical leader for KPNC s response to the H1N1 pandemic. The next year was busy, as he provided advice on vaccine distribution and infection control; interacted with state and national government agencies; and briefed the media. Now that the pandemic has abated, the legacy of his leadership leaves us much better prepared to respond to infectious disease outbreak.

4 Elizabeth Kass, MD Dermatology Central Valley Area Teledermatology Confronted with high referral rates and significant access challenges, Drs. Kass and Crowley teamed up in 2006 to identify ways to improve efficiency and enhance care delivery. One medical center, San Francisco, had one-third fewer referrals than the rest of the region - thanks to their Roving Dermatology Program, in which a dermatologist is on call every weekday to see patients in the primary care physician s exam room. This model is practical when all of the primary care physicians (PCPs) are located in the same building and there is an adequate supply of dermatologists. There are some things we do in our professional careers that ultimately become our legacies. After I retire, I hope that this program will be ongoing, making the practices of our physicians better and helping our patients get great care. Undaunted by the fact that most facilities couldn t replicate this model, Drs. Crowley and Kass envisioned a way to use technology to create a virtual roving dermatology program, now known as Teledermatology. Instead of the dermatologist going to the exam room, a medical assistant uses a digital camera (sometimes fitted with a dermatoscope) to create an image of the patient s skin condition, which is uploaded to KP HealthConnect for remote viewing and response by the teledermatologist usually within 30 minutes.

5 Teledermatology (cont d.) Based on the success of pilot projects at five different facilities, regionwide rollout of the Teledermatology Program began in While some facilities chose to keep onsite roving dermatologists, the majority of facilities are now using teledermatology exclusively. Teledermatology helps primary care doctors take care of certain conditions, so patients who need a dermatologist s expertise can get it quickly, notes Dr. Crowley. Currently about 70% of members get their skin care issues addressed during their visit with their PCP; other patients leave with a Dermatology appointment scheduled within a week, and many times on the same day. Improvement was so dramatic that Dermatology quickly went from having some of the worst access in the region to having some of the best same-day access of any specialty. By providing very rapid access to dermatologist expertise, we have been able to make diagnoses, like disseminated herpes zoster and melanoma, fast enough to have a tremendous impact on the patient s life, notes Dr. Kass. We probably have even saved some lives. Eileen Crowley, MD Dermatology Napa/Solano I was working in a system I found frustratingly inefficient and given the right opportunity I knew I could make it better.

6 Douglas Holsclaw, MD Ophthalmology Redwood City This is truly the first time that a group of corneal surgeons and hospitals have stood together to demand better service from an antiquated national eye banking system. Corneal Transplant Quality of Care With vision and persistence, Dr. Holsclaw and other TPMG cornea specialists transformed the process of obtaining tissue to restore the sight of their patients. The new program improved the quality of corneal tissue for our members, and it is a model program for humanitarian cornea donation. In 2008, acquiring an adequate supply of local high-quality corneas was difficult; staff members had to contact eye banks in other states, where donation rates are higher than in California. Because eye banks give preference to their local hospitals, TPMG surgeons were faced with a tenuous supply of corneas, which led to delays in surgery and an average cancellation rate of nearly 7%. That changed with the unique partnership Dr. Holsclaw forged with SightLife, a not-for-profit eye bank based in Seattle, which provides high-quality tissue to hospitals internationally. As a result of the partnership, our patients receive the highest quality corneas, and surgical case delays and cancellations have been virtually eliminated. The impact on the donation side has been equally remarkable. Working with KPNC nurses, staff and patient families, SightLife has dramatically increased the number of corneas harvested at our hospitals. Of the approximately 750 corneas obtained annually, more than 400 are donated to our patients for sightrestoring surgery. The remaining corneas are made available to other hospitals. Through this program, KP donors have helped restore sight in 27 countries, including Mongolia, Ethiopia, Germany, and Japan.

7 Sidney R. Garfield, MD Exceptional Contribution Award Recipients 2000 Wendy Huber, MD Dermatology, South Sacramento Latex Allergy Prevention Program Tom Kidwell, MD Opthalmology, North Valley Re-engineering Vision Services Keith Matsuoka, MD Head and Neck Surgery Greater Southern Alameda Area Hearing Aid Centers Barry J. Miller, MD Orthopedics, San Jose Medical Spine Unit Michael Wilkes, MD Internal Medicine South San Francisco Congestive Heart Failure Program 2001 Ernie Bodai, MD Surgery, North Valley Breast Cancer Stamp Richard Boise, MD and Maria Borquez, MD Pediatrics, Diablo Service Area Pregnancy Teen Counseling Program Susan Kutner, MD Surgery, San Jose Breast Cancer Care Delivery Brigid McCaw, MD Internal Medicine, East Bay Area Family Violence Prevention Program 2002 Louis Fehrenbacher, MD Oncology, Napa/Solano Oncology Clinical Trials Program Doug Grey, MD Surgery, San Francisco Operation Access Walter Kinney, MD Ob/Gyn, North Valley Cervical Cancer Screening Ron Melles, MD Ophthalmology, Redwood City TrackER and Notewriter Michael Wong, MD Allergy, Central Valley Area Neighbors in Health 2003 Charles Wibbelsman, MD Adolescent Medicine, San Francisco Adolescent Health Services Steve Bornstein, MD Ob/Gyn, South San Francisco Clinical Information Presentation System Ronald Bachman, MD and Edgar Schoen, MD Genetics, East Bay Area Regional Genetics Service Eleanor Levin, MD Cardiology, Santa Clara Cholesterol Management, Cardiac Rehabilitation & Heart Failure Programs Hernando Garzon, MD Emergency, North Valley Urban Search and Rescue Team 2004 John Chuck, MD Medicine and Family Practice North Valley New Physician Orientation and Mentoring Programs Scott Gee, MD Pediatrics, Diablo Service Area CIPS Preventive Health Prompt Pat Hybarger, MD HNS/Mohs, San Rafael Mohs Surgery Reconstruction Program Tim Tsang, MD Urology, San Jose E-Consult System 2005 Towie Fong, MD Internal Medicine, San Francisco Chinese Bilingual Bicultural Module Preston Maring, MD Ob/Gyn, East Bay Area Friday Fresh Farmers Markets Mary Pat Pauly, MD Gastroenterology, North Valley Care of Patients With Hepatitis C Charito Sico, MD Pediatrics, Fresno Community Health Fair David Sobel, MD Internal Medicine, San Jose Health Education and Health Promotion

8 Sidney R. Garfield, MD Exceptional Contribution Award Recipients David Baer, MD Oncology, East Bay Area Case Management for Medical Oncology Sobha Kollipara, MD Endocrinology, North Valley Programs for Children and Adolescents with Diabetes John Rego, MD Radiology, San Francisco Virtual Radiology and Digital Imaging KM Tan, MD Radiology, San Rafael Allied School of Health Sciences Rob Burger, MD Occupational Medicine, North Valley Prevention and Emergency Management of Youth Sports Injuries Richard Fleming, MD Internal Medicine, Napa/Solano Volunteers in Public Service Joseph Phaneuf, MD Dermatology Greater Southern Alameda Area Ashland Free Medical Clinic Alan Whippy, MD Emergency Medicine, East Bay Area Population Disease Management Tom Barber, MD Orthopedic Surgery East Bay Area CyberKaiser Evan Bloom, MD Pediatrics, South Sacramento Physician Wellness Paul Preston, MD Anesthesiology, San Francisco Patient Safety Gail Wagner, MD Hematology/Oncology Greater Southern Alameda Area Matibabu Foundation Alan Wong, MD Pediatric Hematology/Oncology Santa Clara JW House Richard Dlott, MD Endocrinology, Diablo Service Area Cardiovascular Risk Reduction Program Marc Jaffe, MD Endocrinology, South San Francisco Cardiovascular Risk Reduction Program Warren Taylor, MD Hospital Medicine, Napa/Solano Cardiovascular Risk Reduction Program Joe Young, MD Internal Medicine, East Bay Area Cardiovascular Risk Reduction Program Gary Heit, MD, PhD Neurosurgery, Redwood City Americare Neurosurgery International Susan Lindheim, MD Pediatrics, East Bay Area Allen Fischer Local Employees Assistance Fund Nilima Sabharwal, MD Pathology, San Jose Home of Hope Brian Hoberman, MD Hospital Medicine, San Francisco KP HealthConnect Inpatient Implementation Edward Lee, MD Internal Medicine, South Sacramento KP HealthConnect Toolbar Jerry Schlegel, MD Neurology, San Rafael Excellence in Stroke Care Cliff Sweet, MD Radiology, Santa Rosa Radiology Information Integrator