May 2014

Sedation Training now available on Mercy’s NEW Provider Website – p.mercycare.org You can begin your sedation training by going to p.mercycare.org – Check it out under the RESOURCE CENTER tab. All you need to access the training page is your Mercy username and password. If you access the page in-house, your credentials will automatically be remembered with Mercy’s single sign-on feature! (See below and enclosed flyer for more details.)

To complete your Sedation Training, please follow the steps below. 1. Watch the video.

2. Complete the appropriate test(s) and send your completed test(s) to the Medical Staff Office for scoring (lbrandt@mercycare.org).

3. Schedule a simulation lab session with Chris Walsh, MD at Mercy (iowasleepdoc@yahoo.com), or John Herring, MD for St. Luke's simulation at Kirkwood (contact St. Luke's Medical Staff Office at 319-369-7391.)

4. Results will be communicated to you via the Medical Staff Office and automatically shared with Mercy and St. Luke’s. You've completed your training!

Sedation Tests Available Online: • Adult Moderate Sedation Exam

• Adult Deep Sedation Exam

• Pediatric Sedation Exam

Additional Information Available Online: • Practice Guidelines for Sedation and Analgesia by

Non-Anesthesiologists

2014 Annual Provider AwardsNominations Accepted NOW through May 19, 2014The Annual Provider Awards were developed in 2003 as a way for Mercy staff and providers to recognize outstanding provider role models and colleagues. Anyone can nominate physicians, nurse practitioners or physician assistants for these exclusive awards for the following categories: Mentor/Educator; Patient Advocate; Colleague; Planetree Physician Champion; and Outstanding NP/PA. Winners will then be selected by the Staff Nurse Committee and recognized at the annual Community Celebration of Excellence event in the fall.

Visit p.mercycare.org/annual-provider-awards/ to complete an online nomination or stop by the HR office at Mercy for a print nomination form.

Questions? Contact Andrea Ault at (319) 558-6405 or aault@mercycare.org

Recent AwardsMercy re-certification by The Joint Commission demonstrates highest level of care for stroke patientsThe Joint Commission, in conjunction with The American Heart Association/American Stroke Association, has once again recognized Mercy Medical Center as an Advanced Primary Stroke Center. Achievement of Primary Stroke Center Certification demonstrates Mercy’s dedication to achieve long-term success in improving outcomes for stroke patients, as well as to provide education on stroke prevention and early symptom recognition to the community.

This voluntary two-year, re-certification required a rigorous on-site review in February 2014. A Joint Commission expert reviewed Mercy’s compliance with the requirements for The Joint Commission’s Disease-Specific Care Certification program for stroke care and prevention.

This Certification program is available only to stroke programs in Joint Commission-accredited acute care hospitals that volunteer to be reviewed. The Joint Commission is an independent, not-for-profit organization.

For more information on The Joint Commission and American Heart Association’s Advanced Certification for Primary Stroke Center visit http://www.jointcommission.org/ or www.heart.org/myhospital. And for more information on Mercy’s award-winning stroke program and services, visit www.mercycare.org.

Hall-Perrine Cancer Center earns highest award from Commission on Cancer of the American College of Surgeons

The Commission on Cancer (CoC) of the American College of Surgeons (ACoS) has once again granted its highest award - Three-Year Accreditation with Commendation - to the cancer

program at Mercy Medical Center’s Hall-Perrine Cancer Center. The surveyors awarded seven extra commendations for exceeding industry standards, giving Hall-Perrine Cancer Center a “gold level” designation.

To earn voluntary CoC accreditation, a cancer program must meet or exceed 34 CoC quality care standards, be evaluated every three years through a survey process, and maintain levels of excellence in the delivery of comprehensive patient-centered care.

As a CoC-accredited cancer center, Hall-Perrine Cancer Center takes a multidisciplinary approach to treating cancer as a complex group of diseases that requires consultation among surgeons, medical and radiation oncologists, diagnostic radiologists, pathologists, and other cancer specialists. This multidisciplinary partnership results in improved patient care.

The CoC Accreditation Program provides the framework for Hall-Perrine Cancer Center to consistently improve its quality of patient care through various cancer-related programs that focus on the full spectrum of cancer

TrueBeam™ brings advanced radiotherapy treatments to Hall-Perrine Cancer Center

care including prevention, early diagnosis, optimal treatment, rehabilitation, life-long follow-up for recurrent disease, and end-of-life care.

“We are pleased to once again receive this highest award from the CoC,” said Dr. Vincent Reid, medical director at Hall-Perrine Cancer Center. “When patients receive care at a CoC facility such as ours they can be assured of the very best cancer care, with access to information on clinical trials and new treatments, genetic counseling, nurse navigators, support groups, and a comprehensive care plan that seeks to improve quality of life.”

The Hall-Perrine Cancer Center is also being considered for an Outstanding Achievement award, which is given to hospitals that meet every area of commendation from CoC. The award will likely be granted in early 2015.

The American Cancer Society estimates that more than 1.6 million cases of cancer were diagnosed in 2013. There are currently about 1500 CoC-accredited cancer programs in the U.S. and Puerto Rico, representing about 30 percent of all hospitals.

Recent Awards (continued)24 hours a day, 7 days a weekCoordination of admissions and transfers for Mercy Medical Center

Direct Admit Instructions for all patients, except Cardiac or Stroke Alert1. Call (319) 398-6220 or Toll Free (866) 583-9691.

2. Know the patient’s name, date of birth and diagnosis.

3. Please specify if you would like to utilize the hospitalist program.

Transfers for Cardiac or Stroke Alert - Call (866) 583-0896

Reminder: Direct Admit or Transfer Process

Please complete the one-time registration when you launch UpToDate via Mercy’s Epic system and take advantage of all the benefits our free subscription has to offer. The username and password created during registration will provide you the UpToDate Anywhere access. *If you already have an existing

account, you will need to log in with your existing username and password and your new/existing accounts will automatically merge.

Benefits of Registering:• Free UpToDate® Mobile App for your iPhone, iPad, Android and

Windows 8 devices.

• Fast and easy access to UpToDate by logging in from any computer with an Internet connection. After registration, you'll get the evidence-based clinical information you need from home, the office or wherever you are!

• CME credits when you research a clinical question using UpToDate onsite or remotely - including on your mobile device.

All Epic users, who have registered for UpToDate through Mercy’s Epic system, now have access to the UpToDate Mobile App and UpToDate off-site. Please follow the directions below to obtain the UpToDate Anywhere access.

Download the UpToDate® Mobile App 1. Go to your respective App store, and download the free UpToDate

Mobile App.

2. Use your UpToDate Username and Password created during the registration process via Epic to log in to the app.

3. You may download and log in to the UpToDate mobile app on up to two different devices.

UpToDate Customer Service: Phone: 1-800-998-6374 Email: customerservice@uptodate.com

Using UpToDate Off-site: In addition to the mobile device, with the credentials that you created during the registration process, you can now access UpToDate from any computer with internet access by going to www.uptodate.com and clicking the “Log In” button located in the top right corner of the website.

Reminder: Re-verify your account after 30 days of inactivity – here’s why and how: You need to verify affiliation with Mercy to maintain mobile and remote access. Complete verification once every 30 days by:

Access UpToDate® Anywhere!

Patients at Mercy’s Hall-Perrine Cancer Center are now able to receive powerful and precise radiotherapy cancer treatments within just a few minutes per day through a new TrueBeam advanced medical linear accelerator system.

The TrueBeam Radiotherapy System from Varian Medical Systems is the latest advancement in radiation technology available in the United States. It has the unique ability to capture 3-D images during treatment,

which allows for high dose, narrowly targeted radiation delivery while monitoring the patient’s breathing and compensating for movement of the tumor while the dose is being delivered.

“The new TrueBeam system opens the door to new possibilities for the treatment of lung, breast, prostate, head and neck, as well as other cancers,” said Dr. Janet Merfeld, radiation oncologist at Hall-Perrine Cancer Center. “It gives us an additional tool to treat even more complex cancer cases.”

This new technology replaces Mercy’s oldest linear accelerator, purchased in 2001. A $1.5 million dollar grant award from the Hall-Perrine Foundation helped with the purchase of the new technology.

“This new technology made possible through the generosity of the Hall-Perrine Foundation will allow us to meet the community’s need for the very best cancer care close to home,” said Tim Charles, president and CEO of Mercy Medical Center. “This technology provides patients with the best treatment options available in a comfortable, familiar atmosphere.”

TrueBeam gives Mercy the capability to offer a Stereotactic Body Radiation Therapy (SBRT) program. This technology delivers a high dose of radiation to a very small area, thus allowing the tumor to be treated with just a few treatments. SBRT can fight cancers throughout the body, such as lung, pancreas, and liver, as well as tumors that have invaded the liver and spinal cord from distant organs. SBRT is a well-established approach for treatment of certain cancers and is supported by numerous research trials.

Previously, he worked as the CFO and in various accounting and finance positions at the Jefferson Hospital Association in Pine Bluff, Ark. Nathan also held various roles with the healthcare group of a public accounting and consulting services firm in Springfield, Mo.

Nathan’s strong background in healthcare operational and financial management, as well as his business development experience, will complement our existing leadership team well. These skills will help him continue the strong financial leadership integral for Mercy’ s success, which was built and maintained by our previous CFO, Phil Peterson.

Nathan, his wife, Catrina, and his daughter, Madison, look forward to settling into the Cedar Rapids area. Please join us in welcoming them to the community and Mercy!

Access UpToDate® Anywhere! (continued)1. Simply use UpToDate via Epic at least once every 30 days. This

will automatically re-verify your affiliation and you will not receive any re-verification messaging. This method requires no UpToDate log in.

2. Or log into UpToDate by going to www.uptodate.com from a computer or device connected to your organization’s Wi-Fi or VPN network. This method does require you to log in to UpToDate.

Please Note: In-application & email messaging will inform you of the need to verify affiliation if you have not done so by day 25. You will receive a second alert at day 30. If you fail to re-verify by day 30, you will lose mobile and remote access. To regain access, please complete the re-verification process outlined in steps 1 or 2 above.

2014 Michael J. Daly Humanitarian AwardA note from Dónal Gordon, MD – CRMEF

Well-known and well-loved within the Cedar Rapids community, Dr. Michael J. Daly (1941-2010) practiced here as a general surgeon from 1988 until his retirement in 2007. Mike’s retirement was the life of adventure, as anyone might imagine, but which he lived.

Born in Scotland, Mike was raised in Kenya, completed medical school in Ireland and residency in England. He later practiced in Kenya, England, Dubai and Saudi Arabia.

That life’s adventure became even more adventurous in the mid-1970s, when, as a British Red Cross surgeon in Cambodia, Mike was captured by the Khmer Rouge, his experiences during this time tellingly depicted in the Oscar-winning film, The Killing Fields, with Mike himself depicted in the movie as Dr. MacEntire.

Mike’s practice in Cedar Rapids was marked by a devotion to teaching, with many a local Family Medicine resident, this writer among them, having had the privilege of working — and learning — at his side.

To honor Mike, to honor all that he accomplished in his lifetime, to honor all the good that he himself exemplified in the practice of medicine, the Cedar Rapids Family Medicine Residency welcomes nominations for the 2014 Michael J. Daly Humanitarian Award.

Any Cedar Rapids community physician who exhibits the kind of courage, compassion and love for life that Dr. Michael Daly himself exemplified is eligible. The Award will be presented at the residency graduation ceremony in late June.

Nomination forms are available on the residency web site: www.crmef.org. Alternatively, you may call the residency office at (319) 297-2300 to request a nomination form. The deadline for nominations is Monday, May 26, 2014.

Introducing our new CFOPlease welcome Nathan Van Genderen, CPA, to the Mercy executive team as our new Executive Vice President and Chief Financial Officer (CFO) effective immediately.

Nathan is a Certified Public Accountant (CPA) who comes to us from Sentara Northern

Virginia Medical Center in Woodbridge, Va., where he has served as the CFO since January 2011.

Introducing our new CFO (continued)

You might have heard retroactive penalties are pushed back, but Mercy is still working with providers to avoid real-time denials. In addition to the temporary SGR fix for another year, the bill included delayed implementation of ICD-10 and the implementation of penalties for the 2-Midnight Rule. We will continue to keep you updated through the physician newsletter, monthly bundle, p.mercycare.org and additional face-to-face and direct mail pieces.

Update on SGR Fix, ICD-10 and 2-Midnight Rule

Mercy Transcription has partnered with Precyse in order to meet a higher service standard for providers. This includes 24/7 transcription coverage and improved turnaround times with greater quality.

Two new work types will be available: • Pre-Op H&P (Dial 11)

• Transfer Summary – patient being sent to another facility (Dial 5)

To access the telephone dictation system following this interruption, please use the following steps (Your office will soon be receiving updated dictation cards including these new instructions):

• Enter your USER ID followed by the # key

• Enter the WORKTYPE NUMBER followed by the # key

• Enter the PATIENT FULL 8-DIGIT CSN NUMBER followed by the # key

• Begin dictating after the “Thank You” prompt

PRESS 5 TO END REPORT/BEGIN ANOTHER RECEIVE CONFIRMATION JOB# PRESS 9 TO END REPORT/DISCONNECT RECEIVE CONFIRMATION JOB#

Questions or concerns: Contact Mercy Health Information Management Transcription Support Staff at (319) 369-4773 or email HIMTranscriptionSupport@mercycare.org.

Transcription Changes

Mercy Medical Center | 701 10th Street SE, Cedar Rapids, IA 52403

www.mercycare.org

Mercy’s System Strategic Plan for FY15-17A Note from Tim Charles and Tim Quinn, MD As you know, the delivery of healthcare throughout the country continues to evolve, and Mercy is diligently working to transform the organization for the future. Despite the challenges that arise as a result of the changing healthcare landscape, we have made great progress and celebrated many successes this past year. Our work continues to position Mercy to sustain its strong financial performance and to ensure the delivery of our mission for years to come.

This past winter we engaged our management team, physicians and the executive team in our annual planning process. These groups reviewed our current performance, evaluated the healthcare environment and recalibrated our system strategic plan for the next three years. We would like to express our appreciation of the Physician Leadership Council’s continual involvement in the development and execution of our system strategic plan.

We are pleased to share with you the MercyCare Service Corporation FY15-17 System Strategic Plan Executive Summary. (Please refer to the enclosed letter and attachment in this month’s bundle, or visit p.mercycare.org to view the strategic plan executive summary.) The Board Planning Committee endorsed the system strategic plan in January and the full Board of Trustees approved it March 20, 2014. Work still remains to ensure our organization’s success in the future. Your involvement is critical to our ability to deliver high-quality, patient-centered care to our community.

If you are interested in learning more about specific strategic initiatives, we would be happy to share the good work underway.

Strategic Pillar Breakdown: Care DeliveryFor the next several months, we will highlight one of the five strategic pillars. This month we turn our focus to Delivery.

• Continued reduction in Mercy employee healthcare spending through the Employee Health Clinic, health coaches and Wellness Initiatives.

• Continued work in matching patients with appropriate care providers.

• Multiple teams are in place focusing on topics like medication variances, discharge education, fall reductions and antibiotic administration. Their work is moving forward.

Next month, we will report out the second of five pillars – Continuous Improvement.

Therapeutic Interchanges:• Amphotericin B (ABELCET) to Amphotericin B (AmBisome)

• Lanthanum (Fosrenol) to Sevelamer (Renagel)

• Oxazepam (Serax) to Lorazepam (Ativan)

Formulary Deletions:• Methyclothiazide 5 mg ta

• Lupron Depot 3.375 mg kit

• Pancuronium

Formulary Addition:• Brintellix (Vortioxetine) will not be added to formulary at this time

Drug Shortages:• Nitro Infusion

• Heparin

Protocols and Policies:• Pediatric Vancomycin Protocol

• Adult Vancomycin Protocol

The Medical Executive Committee reviewed the proposed revisions to the Influenza and Pneumococcal Policy. It was recommended to add wording under influenza recommendations of, “All pregnant patients are strongly encouraged to receive influenza vaccination” and to change “Personas” to “Persons”.

Effective April 9th, the new reference range for a PTT will be 24.7-31.0 seconds.

Sepsis Alert PathwaysDr. Baustian reviewed the proposed revisions to the Critical Results of Test Policy included in the agenda packet. It was moved, seconded and approved to accept the revisions as presented.

Critical Results of Test PolicyDr. Baustian reviewed the proposed Sepsis Alert Pathways included in the agenda packet. It was moved, seconded and approved to accept the pathways as presented.

Reminder: Enroll in the NEW Electronic Death Registration System (EDRS)The Iowa Board of Medicine is reminding physicians they must enroll to use Iowa’s new Electronic Death Registration System (EDRS), which became operational April 21, 2014. The EDRS has been placed in the https://apps.mercycare.org Citrix site for your ease in completion. Please observe the icon when you access the MMC apps site.

Medication Management Committee Meeting

As of May 1, Mercy’s Birthplace is now a permanently locked unit. Through traffic and holding the door for strangers are absolutely prohibited. Thank you for helping us ensure the safety of our tiniest patients!

Notice: Mercy Birthplace Now Locked 24/7

Mercy will be switching to a new vendor, Covidien, for suture and endo mechanical devices late summer 2014. This is the same vendor used by St. Luke’s Hospital and the Surgery Center. A full implementation plan is in development. Please watch for more details in forthcoming communication. Questions? Contact Barb Armstrong at (319) 398-6717 or barmstrong@mercycare.org.

Changes in Suture and Endo Mechanical Devices – Coming Summer 2014

Suzanne Bartlett, MDOB/GYN, Mercy Integrative

Medicine Center

Suguna Chirla, MDThe Ghosh Center For

Oncology & Hematology

WELCOME NEW PROVIDERS! Join us in welcoming the following new medical staff members:

Samy M. Maklad, MDMercy Medical Center

General Surgery / Trauma

Prashant Khullar, MDMercy Medical Center

General Surgery / Trauma

Hugh P. MacMenamin, MDPCI Orthopaedics/Podiatry

Luis J. Garcia, MDMercy Medical Center

General Surgery / Trauma

Richard J. Mersch, MDMercy Pediatric Clinic

Wieslaw Machnowski, MDMercy Pediatric Clinic

Imran Hassan, MDMercy Medical Center General Surgery Clinic

Sajida Ahad, MDMercy Medical Center General Surgery Clinic

Education CornerCME: A New Dimension of Mammography: What the Clinician Needs to Know about Digital Breast TomosynthesisMay 22, 2014 | 5:30 to 6:30 p.m. Hallagan Education Center

Presented by: Laura Hemann, MD

*Snacks and drinks provided

The learner will:1) Learn the method of DBT (Digital Breast Tomosynthesis)

compared to standard FFDM (Full Field Digital Mammography). Differences in radiation dose and changes to ordering.

2) Discuss patient education, coding and insurance claims/lack of insurance.

3) Discuss increased ability to detect and diagnose small tumors that may be hidden in a traditional mammogram, especially in dense breast tissue.

CME: Multidisciplinary ClinicsJune 5, 2014 | 4:00 to 5:00 p.m. Hallagan Education Center

Presented by: Panel including Hall-Perrine Cancer Center Radiation, Medical and Surgical Oncology Physicians and Nurse Navigators

*Snacks and drinks provided

The learner will:1. Recognize the benefits of multidisciplinary cancer clinics in

improving care for their patients.

2. Learn that through collaboration of the multidisciplinary team approach of care, that both the physician and patient benefit

3. Understand that through evidence-based practice guidelines the multidisciplinary team provides the best treatment options in a timely manner.

Trauma Multidisciplinary Committee – OPEN TO ALL CLINICAL STAFFQuarterly | 7:00 to 8:00 a.m. Mercy Hallagan Education Center, unless otherwise noted

FREE to attend; No Registration Required

• Wednesday, June 25

• Wednesday, September 24 at Hall-Perrine Cancer Center Community Room

• Monday, November 24

Trauma M & M Conference – PROVIDERS ONLYMonthly | 7:00 to 8:00 a.m. Mercy Hallagan Education Center

• Wednesday, May 28

• Wednesday, July 30

• Wednesday, August 27

• Wednesday, October 29

If you would like to present or have an idea for a future continuing education topic, please contact Andrea Ault at (319) 558-6405 or aault@mercycare.org.

Mercy Medical Center | 701 10th Street SE, Cedar Rapids, IA 52403

www.mercycare.org