Inside

CPOE launch in EDs 3

Patient praise for CyberKnife 4

IHI adopts Christiana Careteaching module 7

Jennifer LeComte, D.O.,wins Schubiner Award 11

Photos: 2010 WilmingtonSTART! Heart Walk 12

BIG Therapy helpsParkinson’s patients 13

Christiana Care, YMCAsco-sponsor sports injuryprevention lecture series 14

F O C U S

equipment, but ongoing education insafe patient handling, the systemlaunched a six-month educationalpilot in 2000 to help address a highrate of LTIs caused by patient han-dling duties.

Selected as beta testing sitesBased on Christiana Care’s advancedprogress in its safe patient handlingprogram, representatives from theANA decided to visit Christiana Careduring the summer of 2008 to observethe PEEPS training and education pro-gram first-hand and to view our ceil-

The PEEPS Injury Prevention teamand the Department of Nursing

this fall will submit Christiana Care’sapplication for the American NursesAssociation (ANA) Handle with Carerecognition award.

The prestigious award would drawattention to Christiana Care’s leader-ship in safe patient handling andemployee injury prevention. Successwill make Christiana Care hospitalsamong the first in the nation to be rig-orously rated on safe patient handlinginitiatives.

Like Magnet, the ANA Handle withCare program involves both extensivedocumentation (separate applicationsfor both Christiana and Wilmingtonhospitals) and site surveys anticipatedin late fall or winter.

Christiana Care’s commitment toaddressing lost-time injuries(LTIs) due torepositioningand transferringpatients datesback to the 1990purchase of thefirst portablepatient transferdevices.Recognizing thata successfulinjury preven-tion programrequired not just

Christiana Care pursues nationalsafe patient handling distinction

Ceiling-mounted lifts, first installed atChristiana Care in 2002, now numbermore than 725 systemwide. The equip-ment is now standard for new construc-tion at all Christiana Care facilities.

C O N T I N U E D , N E X T P A G E

Thanks to a 10-year partnershipbetween Nursing and PEEPS, lost-time injuries for employees relatedto patient handling has decreased

by 85 percent.

P - PatientE - EnvironmentE - EquipmentP - PostureS - Safety

The PEEPS acronym serves as anassessment tool to determine

appropriate patient handling basedon the patient’s

dependency level, rather thanpatient weight.

Ceiling-mounted lifts now standard

Ceiling-mounted lifts are now stan-dard for new construction at allChristiana Care facilities and will befully incorporated into the WilmingtonHospital transformation.

“Our goal was to simplify life for ourstaff through technology,” says CNODiane Talarek, MA, RN, NE-BC. “Wewanted to offer every possible safe-guard against injury and make it easi-er for our Nursing staff to do theirjobs. We now have the necessaryequipment readily available.”

More than just equipmentTalarek emphasizes that ceilingmounted lifts alone do not make a safepatient handling program, and creditsthe leadership and education providedby the PEEPS/Injury PreventionProgram with bringing the initiative tolife and helping reduce patient-han-dling-related LTIs.

2 ● F O C U S S e p t . 2 9 , 2 0 1 0

ing mounted lifts and other equip-ment in action. As a result, Christianaand Wilmington were selected as twoof five beta testing sites nationwide forthe ANA Handle with Care recogni-tion program. ANA used feedbackprovided by the PEEPS team duringthe beta test to craft the final applica-tion process we’re now working ontoday.

Lost-time injuries fell 85 percentThe now decade-long partnershipbetween Nursing and PEEPS hashelped decrease LTIs related to patienthandling by as much as 85 percent.

PEEPS training and education isspecifically crafted for each unit. UnitPEEPS teams serve as “champions”for safe patient handling on theirunits. All new patient-care staff com-plete PEEPS training during newemployee orientation and PEEPS is anintegral part of Nursing and unit ori-entation (including the student nurseprogram). Safe patient handling skillsare incorporated in annual Web-basededucation and are included inrequired competency demonstrationfor nurses and patient care providers.

The first lifts at Christiana Care wereinstalled on 5 E/W and WICU in 2002.Today, there are 729 lifts throughoutChristiana Care facilities, in patientrooms, Radiology and other diagnostictesting areas, the Breast Center,Emergency Departments, the outdoorambulance bay at Christiana and themorgue. A new operating roomequipped for moving heavy patientshaving C-sections opened atChristiana Hospital this year. Thewidespread availability of ceilingmounted lifts throughout both cam-puses—in numbers unimaginable atmany hospitals nationwide—is aunique feature of Christiana Care’ssafe patient handling program.

Wilmington Hospital's Center for Rehabilitation team surprised PEEPS/InjuryPrevention Director Carys Price, PT, MS, (above, cutting the cake) with a cel-ebration this summer marking PEEPS: A Decade of Care. (Check Flickr atwww.christianacare.org to see who else is in this photo.)

C O V E R S T O R Y, C O N T I N U E D

For all the news and announce-ments on our PEEPS teams, check thePEEPS homepage on your portal underEducation.

for those very sick patients,”Laskowski-Jones says.

Few hospitals using CPOE yet Christiana Care joined an elite group ofhealth care systems with the introduc-tion of CPOE earlier this year, first atWilmington Hospital and then atChristiana Hospital.

Dr. Reese says those successful launch-es have helped to ease the way for thelatest initiative. “Plus, we are used todealing with something new every dayin the Emergency Department,” hesays. “Culturally, that will work in ourfavor.”

Jones, RN, MS, ACNS-BC, CEN, vicepresident, Emergency, Trauma andAeromedical Services. “That is why weare working very hard to structure theeMAR/CPOE system to expeditepatient care. We have to have medica-tions and get them to the patients rightaway.”

In the EDs, theCPOE system hasbeen modified topermit most med-ications to be dis-pensed without thetime-consumingreview and verifica-tion process appliedin the rest of thehospital.

Nurses enter patient allergies on acomputerized assessment sheet beforemedications are ordered. Through ahand-held barcode reading device,eMAR enables a nurse to scan both thepatient and the drug to make certainthe right patient is receiving the correctmedication.

Reduces risk of medication errors“Implementation of CPOE and eMARwill transform the way we provide careto our patients in the ED by significant-ly reducing the risk of medication andorder entry errors,” says HeatherFarley, MD, FACEP, assistant chair,Department of Emergency Medicine.“Our multi-disciplinary implementa-tion team has worked hard to ensurethat electronic processes will not inhib-it time-critical actions for emergencypatients.”

The ED will not become completelypaperless. Orders for patients present-ing with time-critical emergencies willcontinue to be processed by hand.

“We can’t get them medications fastenough through CPOE, so we will con-tinue with the system that is in place

Emergency Department team gets ready for CPOE launch

Each day brings a new challenge toour Emergency Department team.

The doctors, nurses, clerks and techni-cians on duty never know whether thenext event will be a car crash, heartattack, hunting accident or some otheremergency.

But here’s a challenge they can wellanticipate:

On Oct. 27, the EDs at both ChristianaHospital and Wilmington Hospitalwill launch computerized order entryand medication administration systemsdesigned to reduce errors and enhancepatient safety.

Practice makes perfectTo prepare for the transformation, adedicated multi-disciplinary team ishelping the ED staff build experiencebefore the system goes live, using aclosed-loop, power chart environmentthat simulates a random variety ofpatient scenarios.

Although there are always a fewbumps in the road, abundant prepara-tion and cooperation in the ED willhelp to smooth the transition, saysTerri Steinberg, M.D., MBA, chiefmedical information officer.

The initiative has been a monumentalundertaking at two busy EmergencyDepartment facilities. WilmingtonHospital’s ED served 52,800 patientslast year. More than 112,500 patientsreceived emergency care at ChristianaHospital—one of the highest-volumeEDs in the United States.

“The Emergency Department atChristiana Hospital is as big as manysmall hospitals,” says Charles L. ReeseIV, M.D., chair, Department ofEmergency Medicine. ChristianaHospital’s 65-bed ED typically treats320-370 patients each day.

“There is no limit to how manypatients we might have to treat at anygiven time,” says Linda Laskowski-

“ . . . We a r e u s e d t o d e a l i n gw i t h s o m e t h i n g n e w e v e r y d ayi n t h e E m e r g e n c y D e p a r t m e n t .C u l t u r a l l y, t h a t w i l l w o r k i no u r f a v o r.”

Charles L. Reese IV, M.D., ChairDepartment of Emergency Medicine

Forces of Magnetism

No. 3: Management Style

The organization and nursingleaders create an environmentsupporting participation anddirect-care nurse feedback.

E M E R G E N C Y M E D I C I N E

My robust life as a senior citizenincluded volunteering, visiting

grandchildren, pursuing a secondcareer and having fun . . . until atumor appeared. For years, I had andignored regular headaches. Then inlate 2008, I mentioned a new, sharperheadache to my primary care physi-cian. He immediately referred me toneurosurgeon Kennedy Yalamanchili,M.D., of the Delaware NeurosurgicalGroup.

CT and MRI scans revealed a lump—ameningioma tumor the size of mygrandson’s Matchbox car. The goodnews was that this type of tumorgrows slowly and was very unlikely to

Patient praises radiation oncology care, Cyberknife

be cancerous. It was positioned at theleft side front of my head on the cov-ering of the brain; it was neitherinvading the brain nor pressing on

anything which would interfere withvital functions like vision, hearing orthe pituitary gland. It was unclearwhether the tumor was causing theoccasional sharp head pain I felt.

I am rarely without a headache; theyjust varied in intensity. The newheadaches added to my usual sinus,allergy, tension and migraine prob-lems. I only used over-the-counterpain medications to get relief.

From discussions with Dr.Yalamanchili and Internet research, Ilearned there are three treatmentoptions, unless there's a drasticchange:

n Wait and see—put up with sharpheadaches plus my usual migrainesand do an MRI in a year.

n Have CyberKnife radiation now orlater to destroy the tissue—but notknow whether the tumor is cancerous.

n Have conventional surgery and testfor cancer, maybe followed by anti-seizure drugs, chemo, and aftereffects.

What to do?

My initial decision was wait and seeand ignore it as long as possible (stickmy head in the sand). I had not saidmuch about it, even to family. I knewtheir concern would come down to

“Do what you think is best, and wewill support that.” The risk of waitingwas the continued slow growth of thetumor which could effect vital func-tions and a remote possibility of

seizures. Since my work involved aconsiderable amount of driving inDelaware and adjacent states, seizureswere a major concern. The first optionwas not feasible. I had to do something.

Since my previous experiences withanesthesia (delivering two babies) werenot pleasant, surgery on my skull didnot appeal to me.

CyberKnife

I dithered for three months but eventu-ally concluded that Cyberknife was mybest treatment option. I could have hadradiation in Philadelphia or Baltimoreat any one of several treatment centers,but the more I learned about the HelenF. Graham Center and Cyberknife, themore I was reassured that this was theright choice.

From my first meeting with KarenKarchner, the CyberKnife care coordi-nator at the Helen F. Graham CancerCenter, through the succession ofappointments with radiologist SunjayShah, M.D. and appointments withradiation therapists and other staff, theattitude of every person I met at thecancer center communicated that inaddition to providing state-of-the-science treatment, my comfort andwell-being were important. Wait-timewas always short, explanations about

Myrle Bowe

In August 2009, Myrle Bowe, a patientat Helen F. Graham Cancer Center,elected to have CyberKnife RoboticRadiosurgery to treat a brain tumor.The following is her account and

appreciation of her experience.

– Editor

H E L E N F . G R A H A M C A N C E R C E N T E R

“I could have had radia t ion in Phi lade lphia orBa l t imore a t any one of severa l t reatmentcenters , but the more I learned about the HelenF. Graham Center and Cyberkni fe , the more Iwas reassured that th i s was the r ight choice.”

4 ● F O C U S S e p t . 2 9 , 2 0 1 0

procedures clear, and my questionstreated with respect and a desire tohave me understand the process.

Following a consultation with Dr.Shah, the next appointment was forshaping a mesh mask—called anAquaplast—to the contours of my face(think fencing mask, except largermesh). The fabric felt like a warmwashcloth and stayed on till it driedand set. During treatment the maskwould be clipped to the head frame onthe treatment table to hold my headstill.

After the necessary lab tests andanother MRI, the CyberKnife proce-dure was scheduled for half-hourtreatments on three consecutive morn-ings in mid-August 2009. Meanwhile,the neurosurgeon and Dr. Shah pre-cisely mapped, or contoured, thetumor so that therapists could directradiation to it alone.

For the treatment I was lying on apadded table with a light blanket overme and a safety belt fastened. The facemask neither interfered with watchingbeautiful scenes on a ceiling TV norlistening to the accompanied relaxingmusic.

From the next room the radiation ther-apists guided a space-age equipmentarm to different positions around myhead. If I had difficulty or discomfortwith anything, I was assured that Ionly had to ask and they would stopto take care of it. There was no problem,no stress. Relaxation techniques I hadlearned put me into a dreamlike state.

My daughter had taken me to the can-cer center the day of the first treatment, incase I did not feel like driving home.As it turned out, I had no ill effects atall. After tjat I drove myself to andfrom the cancer center.Four months later, in December 2009, Ihad a follow-up MRI and an appoint-ment with Dr. Shah. The good newswas that the tumor had stopped grow-ing. It is expected to shrink over time,

Leslie C. Verucci, MSN, RN, CNS,CRNP, APRN-BC, has joined the

Radiation Oncology Department atthe Helen F. Graham Cancer Center.

She previously worked as a nursingeducator of oncology nurses andnutrition support nurse within theChristiana Care Health System.

Verucci is a 2001 graduate of theUniversity of Delaware Masters inNursing Program. She is certified asan adult health nurse practitioner andas a cardiopulmonary clinical nursespecialist. She also has a post-masterscertificate in Family Medicine fromthe University of Delaware. Sheearned her undergraduate degree atWilmington University.

She is a member of the DelawareNurses Association (DNA) and servesas the DNA’s chairperson for the

H E L E N F . G R A H A M C A N C E R C E N T E R

Leslie Verucci, APRN joinsRadiation Oncology Department

Leslie C. Verucci

Advanced Practice Council, a memberof the Legislative Committee and amember of the ProfessionalDevelopment Committee.

but the smaller version will remainand will show on an MRI.Barring unforeseen events, I am tohave an MRI in December 2010 andprobably each year thereafter. Nolong-term effects are expected fromthe radiation. I am extremely grateful to everyone atthe Graham Center who helped me. Iknow there are many patients withmore serious conditions than I had,and all I have talked to feel that thereis no better source of treatment. Weare fortunate to have it in Delaware.

For more information on CyberKnifeRobotic Radiosurgery treatments at theHelen F. Grahan Cancer Center, visitwww.christianacare.org/cyberknife or call302-623-4836

CyberKnife Robotic Radiosurgery is availableat the Helen F. Graham Cancer Center.

Center for Heart & Vascular Health welcomes new doctors

Awealth of new physician talent,including two cardiac surgeons, a

cardiologist, and an interventionalradiologist, joined Christiana Care’sCenter for Heart & Vascular Health inthe summer of 2010.

n Cardiac surgeons Lenord RayKuretu, M.D., and Harsh Jain, M.D.,started June 1 and July 1, respectively,as the newest members of ChristianaCare Cardiac Surgery. Dr. Kuretu ispracticing at Beebe Medical Center,Lewes, along with Fernando Garzia,M.D. Dr. Jain is working at ChristianaHospital along with Michael K.Banbury, M.D., FACS, W. SamuelCarpenter III Distinguished Chair ofCardiovascular Surgery, Ray A.Blackwell, M.D., and Hiep Nguyen,M.D.

n Heather Horton, M.D., arrived July1 to practice Cardiology at ChristianaCare Cardiology of Southern ChesterCounty, in West Grove, Pa. Dr. Hortonjoins Michael Duzy, D.O.

n Interventional Radiologist MarkHorvath, D.O., became part ofChristiana Care’s RadiologyDepartment and Heart and VascularInterventional Services team in July,joining Chief of InterventionalRadiology Mark J. Garcia, M.D., andcolleagues Daniel A. Leung, M.D.,George Kimbiris, M.D., Michael A.Dignazio, M.D., Randall Ryan, M.D.and Stephen Zvonimir Grahovac,M.D.

Read about these surgeons andphysicians and more about ChristianaCare’s Center for Heart & VascularHealth at www.christianacare.org/heart.

C E N T E R F O R H E A R T & V A S C U L A R H E A L T H

Lenord Ray Kuretu, M.D.,Cardiac Surgery, Beebe Medical Ctr.

Harsh Jain, M.D., Cardiac Surgery, Christiana Hospital

Heather Horton, M.D., Cardiology,Southern Chester County, Pa.

Mark Horvath, D.O.Interventional RadiologyChristiana Hospital

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Consistent with our strategies for engaging staff in continuous improvement and best practices, we regularly reviewimportant topics in Focus to help reinforce safe-practice behaviors. These tips reinforce information and enable staffto better articulate our safety practices during an unannounced survey.

Organ DonationQ. What is the process of identification and referral of a potential organ donor?

A. The process of identification and referral is as follows:

Every patient will be asked upon admission if he has a donor card or designation on his Driver’s license. This is docu-mented on the Anatomical Gift Status/Advance Directive Form. Absence of license, or other designation, does not createany presumption regarding the patient’s wishes regarding his anatomical gift status. For EVERY patient, at or near thetime of imminent death, the nurse will contact The Gift of Life Donor Program (1-800-543-6391) to determine a patient’ssuitability for eye, tissue, and/or organ donation. Imminent death is defined in Christiana Care Health System Policy:Organ, Tissue and Body Donation, Cadaveric. The nurse will contact the Gift of Life and notify the attending physician,HIMS and the Nursing coordinator.Q. Where does the Nurse/OPO Representative document if the patient is determined not to be suitable for The Gift ofLife Donor Program?A. Even if the patient is determined not to be suitable for The Gift of Life Donor Program, the Nurse/OPORepresentative will document this on the “Referral/Request for Anatomical Donation Form.”

Well-informed Caregivers and patients are the vital link in the safety chain to prevent errors

“They can be accessed from theChristiana Care portals. Go to the MedicalLibrary home page and select Survival

Acollaborative effort involvingChristiana Care’s Academic

Affairs and Quality and PatientSafety teams, along with ThomasJefferson University Clinical SkillsCenter and the Institute forHealthcare Improvement (IHI) hasproduced two outstanding qualityimprovement learning tools.

The tools, a fishbone video andPowerPoint presentation, demon-strate how team analysis can deter-mine potential causes of an identi-fied problem.

“Our modules are featured in theIHI Patient Safety 104: Root Causeand Systems Analysis module,”says Lee Ann Riesenberg, Ph.D, RN,

director Medical Education Research& Outcomes, Academic Affairs.

IHI adopts Christiana Care team analysis teaching modules Kits, then select Faculty Resources,then select “ACT FishboneIntroduction & Template.”

“Initially, members of ChristianaCare’s Achieving Competency Today(ACT) facilitator team started devel-oping the fishbone as a teaching toolfor the ACT course participants,”says Brian Little, M.D., Ph.D.,Christiana Care’s Chief AcademicOfficer. “It wasn’t long before the IHIOpen School learned of our plansand saw it as a great instructionalresource for their module thataddresses Root Cause Analysis.”

“I love the video and PowerPointslides! I’m impressed by their high-quality production,” says IHI’sDeepa Ranganathan. “Fishbone dia-grams are an important aspect ofRCA.”

Focus on Excellence - Best Practice Review

The Institute for Healthcare Improvement (IHI)has adopted this diagram as a teaching tool onits website, www.IHI.org.

Steven P. Greer, M.D.131 Continental Drive, Suite 200 Newark, DE 19713 Phone: 302-366-1868

Sarah L. McTighe, D.O.Dept. of Medicine Residency Room 6A39, Christiana HospitalPhone: 302-733-6342

Trong T. Trinh, M.D.200 Hygeia Drive, Suite 2100 Newark, DE 19713 Phone: 302-623-0188

Erin E. Watson, M.D.Dept. of Medicine, Room 5A43 Christiana HospitalPhone: 302-733-6344

Medicine/Medicine/Pediatrics Nancy Fleurancois, M.D.200 Hygeia Drive, Suite 2100 Newark, DE 19713 Phone: 302-623-0188

Elizabeth H. Muth, M.D.Christiana Care Hospitalist Partners 200 Hygeia Drive, Suite 2100 Newark, DE 19713 Phone: 302-623-0188

Adam M. Rudnick, M.D.Rockwood Family Medicine 2002 Foulk Road, Suites C&D Wilmington, DE 19810 Phone: 302-529-1975

Medicine/Neurology Jason M. Silversteen, D.O.Christiana Care Neurology Specialists 774 Christiana Road, Suite 201 Newark, DE 19713 Phone: 302-731-3017

Medicine/Pulmonary & CriticalCare Medicine Marjan Bahador, M.D.eCare Telemedicine 200 Hygeia Drive, Suite 2470 Newark, DE 19713 Phone: 302-623-0600

Emergency MedicineDavid T. Cook, M.D.Department of Emergency Medicine Christiana Hospital, Room 1071Phone: 302-733-1840

Daniel B. Cummings, M.D.Department of Emergency Medicine Christiana HospitalPhone: 302-733-1840Jenna M. Fredette, M.D.Department of Emergency Medicine Christiana HospitalPhone: 302-733-1840

Family & Community Medicine Erin M. Kavanaugh, M.D.Family Medicine Center 1401 Foulk Road, Suite 100B Wilmington, DE 19803 Phone: 302-477-3300

Michael P. Rosenthal, M.D.Family Medicine Center 1400 N. Washington St., Suite 420 Wilmington, DE 19803 Phone: 302-428-6809

Hillel Wirsztel, M.D.111 Continental Drive, Suite 406 Newark, DE 19713 Phone: 302-984-2577

Medicine/Cardiology Heather L. Horton, M.D., Ph.DCC Cardiology of Southern Chester Co. 1011 W. Baltimore Pike, Suite 304 West Grove, PA 19390 Phone: 610-869-1278

Medicine/Dermatology Matthew R. Hanson, M.D.537 Stanton-Christiana Road, S-207 Newark, DE 19713 Phone: 302-633-7550

Medicine/Internal Medicine Andrew J. Abraham, M.D.200 Hygeia Drive, Suite 2100 Newark, DE 19713 Phone: 302-623-0188

Sammy Bostaji, M.D.4745 Ogletown-Stanton Rd, S-220 Newark, DE 19713 Phone: 302-368-5515

Obstetrics-Gynecology Vanita D. Jain, M.D.774 Christiana Rd, Suite 109 Newark, DE 19713 Phone: 302-731-0260

Julia L. Powell, M.D.3706 Kennett Pike Wilmington, DE 19807 Phone: 302-623-6320

Emily K. Saks, M.D.Center for Uro-Gynecology & PelvicSurgery MAP 2, Suite 1208 4735 Ogletown-Stanton Road Newark, DE 19713 Phone: 302-623-4055

Oral & Maxillofacial Surgery &Hospital Dentistry/Oral &Maxillofacial Surgery Daniel J. Meara, M.D., D.M.D.Dept. of Oral & MaxillofacialSurgery Wilmington HospitalPhone: 302-428-6555

Pediatrics/General Pediatrics Justin M. D’Antuono, M.D.Nemours Pediatrics 1400 Peoples Plaza, Suite 300 Newark, DE 19702 Phone: 302-836-7820

Francisco R. Vranic, M.D.duPont Peds at St. Francis 7th and Clayton streets, Suite 400 Wilmington, DE 19805 Phone: 302-421-9700

Pediatrics/Neonatology Ursula Guillen, M.D.MAP 1, Suite 217 4745 Ogletown-Stanton Road Newark, DE 19713 Phone: 302-733-2410

Welcome New Medical-Dental Staff

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Dr. Saks has presented her originalresearch at multiple national scientificmeetings, published numerous articlesin peer-reviewed journals, and has co-authored a book chapter.

To contact Dr. Saks, call the Center forUrogynecology and Pelvic Surgery at

302-623-4055

Pediatrics/Pediatric Cardiology Deepika Thacker, M.D.Nemours Cardiac Center 1600 Rockland Road Wilmington, DE 19803 Phone: 302-651-6600

Radiology Christopher A. DeMauro, M.D.5936 Limestone Road, Suite 301 Hockessin, DE 19707 Phone: 302-234-5800

Mark D. Horvath, D.O.Department of Radiology HVIS, S-1E10 Christiana Hospital, Phone: 302-733-5625

Surgery/Cardiac Surgery Harsh Jain, M.D.Dept. of Surgery, Suite 1E50 4755 Ogletown-Stanton Road Newark, DE 19718 Phone: 302-733-1980

Surgery/Podiatric Surgical Service Travis J. Dwyer, D.P.M.1010 North Bancroft Parkway Wilmington, DE 19805 Phone: 302-658-1129

Heather M. Rafal, D.P.M.Brandywine Podiatry 1010 N. Bancroft Parkway, S-12 Wilmington, DE 19805 Phone: 302-658-1129

Urogynecologist Emily Saks, M.D.,has joined the Christiana Care

Center for Urogynecology and PelvicSurgery (teaming with Babak Vakili,M.D., and Howard B. Goldstein,M.D.).

Dr. Saks was raised in Central NewJersey and attended Rutgers Collegeand UMDNJ-Robert Wood JohnsonMedical School in New Brunswick.

In 2007, she completed a residency inObstetrics and Gynecology atPennsylvania Hospital in Philadelphiawhere she was recognized for excel-lence in minimally invasive surgery bythe Society of LaparoendoscopicSurgeons.

Dr. Saks then joined the Hospital ofthe University of Pennsylvania to pur-sue a fellowship in Female PelvicMedicine and Reconstructive Surgery.During this time, she received fundingfrom the National Institute of Healthfor the investigation of reproductiveepidemiology and completed a Masterof Science in Clinical Epidemiology atthe University of Pennsylvania Schoolof Medicine.

Emily Saks, M.D.

Christiana Care colleagues Bob Laskowski, M.D., president andCEO, (left) and Emily Irish, RN, pose for a post-race photo after theSept. 19 Philly Half-Marathon. Emily’s sister Gerri Irish, a ChristianaCare nurse anesthetist, took the photo and also ran in the race.

Welcome urogynecologist Emily Saks, M.D.

GET HELP WITH TOBACCO CESSATION

degree, in Economics, at theUniversity of Notre Dame, his mas-ter’s degree, in Toxicology, fromMichigan State University, and hismedical degree from Wayne StateUniversity in Detroit. He spentresearch time at the National Instituteof Health and has studied abroad inLondon (England), Melbourne(Australia), and Tokyo and Osaka(Japan).

Currently, Dr. Meara is a member ofthe American Cleft Palate-CraniofacialAssociation Education Committee.Also, he was a member of the MilSonrisas and Smile Train medical mis-sions to Juarez, Mexico, where hehelped complete numerous cleftlip/palate repair procedures for chil-dren. Dr. Meara has both a medicallicense and a dental license in the Stateof Delaware and is accepting newpatients. He has a broad scope of prac-tice with particular interest in facialtrauma and reconstruction, cleft-cran-iofacial surgery and obstructive sleepapnea surgery.

To contact Dr. Meara, call 302-428-6458, or e-mail dmeara@christianacare.org.

Oral & Maxillofacial SurgeonDaniel J. Meara, MS, M.D.,

D.M.D., has joined the faculty ofChristiana Care Health System’s Oraland Maxillofacial Surgery ResidencyProgram.

“Dr. Meara has assumed the full-timeposition of Residency Program

Director of Training,” says Edwin L.Granite, D.M.D., chair, program direc-tor and section chief of ChristianaCare Health System’s Department ofOral and Maxillofacial Surgery. “He isa valuable addition to our ChristianaCare academic faculty and greatlyenhances our nationally fully accredit-ed OMS educational programs,” Dr.Granite adds. “He is well-known inthe field of OMS research and he is aprinciple investigator in numerousongoing studies. He has authoredmany articles in peer-reviewed jour-nals as well as textbook chapters, pre-sentations and posters at national con-ferences.”

Dr. Meara joined Christiana Care aftercompleting a CraniomaxillofacialSurgery Fellowship at West VirginiaUniversity/Charleston Area MedicalCenter. Prior to that he completed Oraland Maxillofacial Surgery Residencyat the University of Alabama,Birmingham, where he also completeda separate general surgery internship.Further, he previously completed aninternal medicine internship at theUniversity of Pittsburgh.

Dr. Meara earned his bachelor’s

Daniel J. Meara, M.D., D.M.D., joins OMS faculty

Daniel J. Meara, MS, M.D., D.M.D.

Local anestheticfor dental procedures

Medication – Generic/Brand Name Strength/Size Use/Indication Comments

Lidocaine with Epinephrine injection Lidocaine 2% with Epinephrine1:100,000, 1.8 mL cartridge

who “super-duper tracked” himthrough to admission, and to theWACE unit who led him on the roadto recovery. The entire multidiscipli-nary team was wonderful, especiallyMedicine, Nursing, Respiratory Care,PT, Case Management, Social Work,Food and Nutrition, and EnvironmentalServices. Everyone's expertise, focus

My family and I would like toextend heartfelt appreciation to

everyone who cared for my father,John Connolly during his recent hospi-talization. Special thanks to W-ED

on excellence, and caring was evident.Seeing Christiana Care teamwork andpatient/family-centered care in actionwas impressive, made me very proudof my colleagues, and most impor-tantly, helped my father feel safe andconfident in the care he received.

Andrea Rogers, MSN, CICInfection Control Nurse

1 0 ● F O C U S S e p t . 2 9 , 2 0 1 0

Jennifer LeComte, D.O., receives prestigious Med-Peds honor

Jennifer LeComte, D.O., received theHoward Schubiner Award, a

prestigious honor offered by theNational Med-Peds ResidencyAssociation.

Dr. LeComte, a recent graduate ofChristiana Care’s Medicine-PediatricsResidency Program and current chiefresident of pediatrics at duPontHospital for Children, accepted theaward Oct. 3 in San Francisco. Theaward is presented to a resident physi-cian who makes extraordinary, lastingcontributions to the organization’ssuccess and/or Med-Peds at the localor state level.

“It is such an honor to receive thisaward," says Dr. LeComte. “I chose totrain in internal medicine and pedi-atrics in order to be able to care forcomplex patients throughout a lifespan, recognizing that there would bemany transitions. I am so excited thatthe leadership at A.I. DuPont Hospitalfor Children and Christiana CareHealth System value the process oftransition and have devoted resourcesto improve the process.”

Allen Friedland, M.D., FACP, FAAP,director of Christiana Care’s Medicine-Pediatrics Residency Program, whonominated Dr. LeComte, says, “Shehas helped to develop and create apilot program medical home for someof the most vulnerable people in ourcommunity. Young adults with specialhealth care needs (YASHCN) deserveintelligent and compassionate primarycare physicians. They definitely getthat with Jen.”

According to the award’s namesake,Howard Schubiner, M.D., the honorgoes to a resident who “exemplifiesthe highest standards for excellence in

Med- Peds, including exemplary clini-cal care of patients, compassion andhumanism in relationships with

patients and with colleagues inmedicine and hospital coworkers,involvement in community activi-ties, and contributions to the field ofMedicine-Pediatrics.”

“She has already been asked tospeak to local and national organi-zations about her involvement inthe transition of YASHCN frompediatric providers to adultproviders. The transition from thepediatric medical world to the adultmedical world is a stressful time forpatients and their families.Delaware would benefit from moreproviders like Dr. LeComte,” Dr.Friedland says.

Dr. LeComte is graduate of thePhiladelphia College of OsteopathicMedicine.

Jennifer LeComte, D.O.

Snapshots: 2010 WilmingtonSTART! Heart Walk

Christiana Care Health System teamscontinued their proud tradition of

supporting the annual Wilmington Start!Heart Walk, at the WilmingtonRiverfront on rainy Sept. 12, 2010.

A total of 668 people—well ahead oftheir registration goal of 500 fromChristiana Care—registered for theannual event to support cardiovascularresearch and education.

The total goal for the event was $240,000.Final fundraising figures are still beingtallied.

Check you next Focus for a START!Heart Walk update.

(Above) Timothy Gardner, M.D., immediatepast president, American Heart Association,medical director for the Center for Heartand Vascular Health at Christiana Care.

(Above, right) Ray A. Blackwell, M.D.,honorary chair of the 2010 START!Heart Walk.1 2 ● F O C U S S e p t . 2 9 , 2 0 1 0

“But the more my patients ‘ThinkBIG,’ the more confidently they moveand the greater ability they have totransition and move safely in theirenvironment.” BIG is also effectivewith other conditions including stroke,multiple sclerosis, cerebral palsy, andDown syndrome.

Start therapy early

LSVT BIG protocols recommend incor-porating therapy into treatment at thetime of diagnosis, which “is a hugeparadigm shift for physicians andtherapists with patients who don’texhibit traditional therapy needs,”says Kogon. “Previously, therapyfocused on compensating for existingdeficits and helping patients maintaincurrent status.”

For more information, call 302-429-6962 at Wilmington Hospital or 302-838-4709 at Springside Plaza.

Anew physical therapy program,dubbed BIG, at Christiana Care is

helping patients with Parkinson’s dis-ease improve function and slow motordeterioration by retraining sensory,motor and cognitive functions throughintensive exercise and patient empow-erment.

“Even patients with slight deficitsshow measurable improvements with-in the first 50 minutes of BIG therapy,”says Jay Kogon, DPT, ATC, one of twoChristiana Care therapists certified inthe program.

The BIG program is an adaptation formuscular disorders of the clinicallyproven Lee Silverman Voice Training(LSVT) LOUD method developed in1987 to improve voice and speech inindividuals with Parkinson’s disease.

Those principlesthat made LSVTLOUD an effec-tive treatment forthe speech motorsystem have nowbeen successfullyapplied to thelimb motor sys-tem.

Symptoms andtreatmentParkinson's dis-ease is character-ized by musclerigidity, tremor, aslowing of physi-cal movement(bradykinesia)and increasingly smaller movement

(hypokinesia). Symptoms are theresult of decreased stimulation ofthe motor cortex by the basal gan-glia, normally caused by dopamineproduced in the brain. LSVT BIGtherapy includes repetitive, exag-gerated movements to increasedopamine production in the brainand recalibrate muscle function.

‘Do what I do’Therapists model the structuredmovements while giving simplecommands such as “do what I do”or “move bigger.” This creates anautomatic response in the patient’sbrain that results in larger, morenormalized movements by thepatient.

“Patients with Parkinson’s diseasemay shuffle, appear stooped over,or struggle with transitions ofmovement,” says Laurie Scott,OTR/L, site manager at SpringsidePlaza Rehabilitation Services,

where BIG therapy is becoming a bighit.

Jay Kogon, DPT, ATC, helps a patientaffected by Parkinson’s disease train to over-come functional losses using BIG therapy.

Thinking BIG improves function for some Parkinson’s patients

Laurie Scott, OTR/L, teaches therapeuticBIG motions to a patient at Springside Plaza.

R E H A B I L I T A T I O N S E R V I C E S

problems before they happen.

Here’s a list of schedued events for thisvaluable STOP Sports Injuries series:

n Tuesday, Oct. 5, 7 p.m., MichaelAxe, M.D., Western YMCA, KirkwoodHighway.

n Wednesday, Oct. 20, 7 p.m., DamianAndrisani, M.D., Brandywine YMCA,Concord Pike.

n Wednesday, Oct. 20, 7 p.m., MarkBoytim, M.D., Sussex YMCA.

n Wednesday, Oct. 27, 7 p.m., ElliottLeitman, M.D., Central YMCA,Wilmington.

n Saturday, Nov. 6, noon, RandeepKahlon, M.D., Bear-Glasgow YMCA

Register online at healthcare.chris-tianacare.org/stopsportsinjuries or call800-693-CARE (2273).

The Heart Failure Summit2010 will be Friday, Oct. 29,at Clayton Hall on theUniversity of DelawareNewark campus. Sign up onthe education portal to receivecredit. Cost is $50 forChristiana Care employees,who may be sponsored bytheir nursing unit. ContactChris Friday to arrange a jour-nal transfer at cfriday@chris-tianacare.org. For more infor-mation, call Chris Friday at733-1507.Friday, October 29, 2010

7 a.m. to 3:30 p.m.

John M. Clayton Hall University of Delaware Campus

Center for Heart & Vascular HealthHeart Failure Program

Invites You to the

HEARTFAILURESUMMIT2010

Surgeons to present injury preventionideas at state YMCAsChristiana Care’s Department ofOrthopedic Surgery, the DelawareSociety of Orthopaedic Surgeons andthe YMCA of Delaware will co-host aseries of talks with orthopedic surgeonsat Delaware YMCA branches through-out October.

The discussions will focus on prevent-ing sports injuries in children andadults. Held on evenings and week-ends, these talks, facilitated by anorthopedic surgeon from a local prac-tice—will identify the source of overuseand crash injuries, explain treatmentmodalities and list prevention strategies.Amateur and serious athletes of any ageare encouraged to join the conversationand explore how they can prevent

Orthopedics partners with YMCAs to prevent sports injuries

Michael Axe, M.D., kicks off theStop Sports Injuries lectureseries Oct. 5 at the WesternYMCA on Kirkwood Highway,Newark.

1 4 ● F O C U S S e p t . 2 9 , 2 0 1 0

To promote our culture of safety andwellness, Employee Health is offeringfree seasonal influenza vaccinations toall employees, M-D Staff and volun-teers starting on Monday, Oct. 11.

This year’s vaccine includes the 2009H1N1 strain so staff needs to receiveonly one vaccination.

The flu vaccine is highly recommend-ed for all health care providers.During the 2009/2010 season,Christiana Care achieved an 83 per-cent vaccination rate for seasonal vac-cine (our highest ever) and a 57 per-cent rate for H1N1 vaccine. Our goalthis year is to achieve at least 85 per-cent.

Vaccinations will be available inEmployee Health at Wilmington andChristiana hospitals. For convenience,staff from Employee Health will alsobe stationed at several hospital loca-tions to administer the vaccine. As inpast campaigns, there will be arrange-ments for staff located off the hospitalcampuses to get the vaccination.

Employee Health is developing a fluvaccination administration schedulethat includes weekends and off shifts.It will be shared with managers andposted on all portals soon.

To better track vaccination rates andunderstand reasons for lack of vacci-nation, Christiana Care will berequesting that all employees com-plete a brief online vaccination/decli-nation process later during the flu sea-son. Look for more information on theportals as the flu season advances.

n 3rd Annual Del Tech Run/Walk isWednesday, Oct. 6 at 6 p.m. on theWilmington Riverfront. All proceedsbenefit Delaware Tech students in need.Amenities include T-shirts and refresh-ments. The cost to enter is $18 untilOct. 4. After that the fee is $20. Formore information or to register, visit thehttp://www.dtcc.edu/sw/alumni/5K.html.

n

n

n Join Christiana Care and the womenin your community as we laugh, playand learn at our first ever free GirlsNight Out event, Wednesday, Oct. 13,5-8 p.m., at the Christiana Care BreastCenter at the Helen F. Graham CancerCente. Enjoy complimentary food,music, gifts and raffles. The event fea-turs mini-lectures on cancer preventionand the role genetics plays in yourfuture health. Bring a friend or lovedone and get screened for breast cancer,heart and bone disease. Call 800-693-2273 to register today.

Can’t make it to Girls Night Out?Be at the Breast Center Fall Festival,Tuesday, Oct. 19, 11 a.m.-1 p.m. at the

Helen F. Graham Cancer Center, Ste.1400 (West Entrance).

n Christiana Care celebrates Patient-and Family-Centered Care Week Oct.21-27, leading off with a nationalspeaker, Juliette Schlucter, 11:30am-12:30 p.m. and 2-3 p.m. Oct. 21 atWilmington Hospital ConferenceCenter, simulcast to Christiana Hospital.Watch for a full schedule of events inthe coming weeks.

n The annual Books are Fun Book Fairis Thursday and Friday, Oct. 21-22 inthe Trustees Room at WilmingtonHospital. Thursday hours are 9 a.m.-5p.m. Friday open 7 a.m.-4 p.m. Thebook helps support Christiana CareVolunteer rograms

n A series of live webcasts from TheCollege of Physicians of Philadelphia,in Room 1100 at Christiana Hospital,brought sponsored jointly by ChristianaCare and the Delaware Academy ofMedicine, covers historical and contem-porary health and medical topics and isopen to all:

- Oct. 18, 6:30 p.m. “Dissection,Photographs of a Rite of Passage inAmerican Medicine 1880-1930.”

- Oct. 19, 6 p.m., The Thomas W.Langfitt Lecture Series—Health CarePolicy—Accountable CareOrganizations.

n Did you know that October is BreastCancer Awareness Month?

- Friday, Oct. 8 is National DenimDay. Employees who donate $5 get towear jeans that day.

- Sunday, Oct. 10, is time for theAmerican Cancer Society 2010 MakingStrides Walk. Registration begins at 7a.m., the walk at 10, in Wilmington’sRodney Square.

- Friday, Oct. 15 is NationalMammography Day. Visit the ChristianaCare Breast Center to celebrate withmorning mini-cupcakes and afternoonsoft pretzels.

Upcoming events Flu vaccinationcampaign launches Oct. 11

The automated ScriptCenterTM,now operating in the main lobby

at Christiana Hospital, offers pharma-cy services around the clock.

Setting up an account at the newkiosk, or online at scriptcenter.com,makes getting prescription refills easy.

“The addition of the ScriptCenterenables the pharmacy to provide serv-ices beyond normal operating hours,”says Outpatient Pharmacy ManagerSebastian Hamilton. “Having a way todeliver prescriptions to our patients attheir convenience will increase med-ication compliance and customersatisfaction.”

Getting a new prescription ordered oran existing one renewed still requiresa provider’s written order.

Automated kiosk provides pharmacy service round-the-clockBut, once a refill or renewal isordered, pickup is simple and quick,accessed with a user ID and PIN oroptional fingerprint identification.You can even collect prescriptionsfor family members. They need onlyorder ahead of your pickup, andeverything will be consolidatedwith your order. Any refills, exceptcontrolled substances or items thatare oversized or must be refrigerat-ed, can be picked up throughScriptCenter 24/7, for up to sevendays. Prescriptions will be availablefor pickup within hours after anorder is placed.