Medical Staff

Swedish/Edmonds 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

69 July 2014

Two Swedish Emergency Departments Recognized With Nurse Lantern Award The Emergency Department (ED) nursing

teams at Swedish/Edmonds 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/Edmonds. “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 Edmonds ED nursing team has focused

recent initiatives on reducing the time

patients spend in the ED as well as

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/Edmonds

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/Edmonds, the Ballard

ED nursing team is also a recipient of the

Lantern Award.

"Our campus and the community

surrounding Swedish/Ballard are truly thrilled

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/Edmonds Center for Wound Healing &

Hyperbarics at Kruger Clinic. The clinic moved to

Kruger Clinic, 21600 Highway 99, suite 150, in May.

The new location offers more space and enhanced

accessibility for patients.

Please see Lantern Award on page 7 inside

2

All staff at Swedish/Edmonds 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/Edmonds are

worthy of comment.

First, according to Medicare’s

Hospital Specific Report, May 2014 -

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 2013. 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/Edmonds 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.

Our goal at Swedish/Edmonds 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.

Bruce Williams, M.D.

Improved Performance Measures Worthy of Comment By: Bruce Williams M.D., chair, Quality Council

Swedish CME Events

Below are upcoming Swedish CME activities. Please visit www.swedish.org/cme

for locations, times and the most up-to-date information about upcoming CME

activities.

4th Annual Intensive Update in Neurology

Thursday and Friday, Sept. 11-12

TeleHealth: Improving Access to Health Care

Friday, Sept. 19

18th 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/

Edmonds

4

3

We are pleased to announce the

return of the Obstructive Sleep

Apnea (OSA) management program

at Swedish/Edmonds. 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.

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 425-640-4378 with any questions.

Obstructive Sleep Apnea Program Returns

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: 1.6507

Clinical Documentation Integrity Program (CDIP) Report: May

New Hospital Parking Garage Opens The first phase of the Swedish/

Edmonds 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 Edmonds, 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/Edmonds 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/

Edmonds 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

4

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 Swedish-

affiliated (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

Ednea Simon

Elizabeth Meade

Eric Vallieres

Erin Ellis

Fran Broyles

Gad Kletter

Gregory Rudolf

Hank Kaplan

James Harding

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

Rebecca Duke

Richard Lindquist

Robert Weinsheimer

Ross McMahon

Sameer Gopalani

Sarah Bork

Sean Lawler

Steven Han

Tanmeet Sethi

Tracy Johannsen

Vivek Mehta

* Bolded names are those of Swedish/Edmonds physicians.

New Foundation

Staff Member for

Swedish/Edmonds Maggie Keelan joined the Swedish

Foundation team on May 19 as the

major gifts officer for Swedish/

Edmonds. In this role, Maggie will work

closely with Swedish/Edmonds 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

206- 386-2751.

Swedish and Swedish/Edmonds Physicians Recognized

as Top Docs in Seattle Magazine

Maggie Keelan

4

5

Create Your Swedish Web Profile

All active Swedish/Edmonds physicians are eligible to create a physician web profile at www.swedish.org. Follow the steps below to create your profile today and attract new patients.

Go to www.swedish.org/CMSDesk 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 www.swedish.org/physician.

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.

New Swedish Insulin - SC Basal Bolus Correctional - Adult

6

Adam Balkany, D.O.

Swedish Edmonds Specialty Clinic

Anand Patani, M.D.

Swedish Internal Medicine at

Edmonds

Anny Soon, M.D.

Swedish Internal Medicine at

Edmonds

Aric Christal, M.D.

Edmonds Orthopedic Center

Bich-Khanh Nguyen, M.D.

Swedish Internal Medicine at

Edmonds

Catherine Rogers, M.D.

Sound Women’s Care

Irina Zigelboym, D.O.

Hospitalist

Jeremy Hammel, M.D.

Emergency Services

John Maldazys, M.D.

Sound Urological Associates

Keith Luther, M.D.

Swedish Internal Medicine at

Edmonds

Kurt Harmon, M.D.

Surgical Associates of Edmonds

Linda Strong, M.D.

Swedish Internal Medicine at

Edmonds

Parul Sharma, D.O.

Premier Orthopedic Group

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 Edmonds

Zerin Rahman, M.D.

Hospitalist

Congratulations… These physicians were mentioned by name in the April Press Ganey Patient

Satisfaction Surveys and complimented for their great work.

Intensive Care

“Dr. Youssef saved my life. It can't

get better than that!”

Childbirth Center

“We loved Dr. Moe!”

Progressive Care

“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

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

“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

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.”

Outpatient

“Dr. Althouse sent me to Swedish/Edmonds for an electrocardiogram. Dr. Althouse is the greatest doctor. I really like him.” 5-West

“Dr. Min is an excellent doctor.”

What are Patients Saying? Below are a few positive comments from recent Press Ganey Satisfaction Surveys

and discharge calls at Swedish/Edmonds. Congratulations to physicians and

hospital staff mentioned.

7

New Medical Staff (continued from page 8) Name Group Specialty

Jennie M. Allen, M.D. Pediatrix Cardiology of Washington Pediatric Cardiology

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

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

New Parking Garage (continued from page 3) Just along the Swedish/Edmonds

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.

A ribbon-cutting ceremony opens the new Swedish/Edmonds three-story parking garage on June 27. Cutting the ribbon are David Jaffe, chief executive at Swedish/Edmonds, 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.

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 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.

21601 - 76th Avenue West, Edmonds, WA 98026

Vital Signs Issue 69 July 2014

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

Amy.Morrow@swedish.org by

the 1st of the month.

To Admit a Patient to Swedish/Edmonds, Call 425-640-4444 For Medical Staff information on the web, visit:

www.swedish.org/EdmondsMedicalStaff

WELCOME New Swedish/Edmonds 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

Dinesh Thekke-Karumathil, M.D. Swedish Pediatric Hospitalists Pediatrics

Elizabeth H. Meade, M.D. Swedish Pediatric Hospitalists Pediatrics

Farah L. Cassis-Ghavami, M.D. Swedish Pediatric Specialty/First Hill Pediatric Infectious Diseases

Izabel R. Belem, M.D. Swedish Pediatric Specialist Anesthesiology

Pediatric Critical Care Medicine

Anne Nguyen-Vermillion, M.D. Pediatrix Medical Group Pediatrics

Barbara Z. Harper, M.D. Swedish Residential Care Team Internal Medicine

Please see New Medical Staff on page 7 inside